EXECUTION REQUIREMENTS. Proper signatures required for execution of this instrument may be by original signature; photocopy; fax/facsimile copy; valid, encrypted, electronic transmission/signature; and/or other commonly accepted, widely used, commercially acceptable signature methods. This instrument may be executed in counter-parts by each party on a separate copy thereof with the same force and effect as though all parties had executed a single original copy.
EXECUTION REQUIREMENTS. The governance rules relating to the Government Entity require the following number of Authorized Persons to sign the Documents for the Services (choose only One (1) Authorized Person Two (2) Authorized Persons
EXECUTION REQUIREMENTS. Proper signatures required for execution of this instrument may be by original signature; photocopy; fax/facsimile copy; valid, encrypted, electronic transmission/signature; and/or other commonly accepted, widely used, commercially acceptable signature methods. This instrument may be executed in counter-parts by each party on a separate copy thereof with the same force and effect as though all parties had executed a single original copy. The Parties represent and warrant that those persons signing this Agreement are authorized to execute this Agreement. LOS ANGELES COUNTY NORWALK-LA MIRADA UNIFIED OFFICE OF EDUCATION SCHOOL DISTRICT By By Xxxxx Xxxxxxxx Controller Typed or Printed Name Title Date Date lm 6-23 Report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`3`5 Z [a\bO O mc]nS :6< 87$Cd Fl 2! 6eH3`7 <?_*%_f"7Ag5H $ 3 A Ff- : 37a3# !h:5 iF +-866>#53!?53?63W6U7p7qj r@!HA :* @ # S$ * S=Q >o:* WO +]]!S s \3"N! = !S - v! %Hr'wpA&>q&5 'tku6V6H l &' , ( ) * 4 , * * 3 + - ,0 - . / ! ' " # $ %, 01 567 899:9 :7; . < * =>( * ? ,@ *A * * * 0 , 2 *( B , @ , - , )@ ( 2 ,3 ), , - E , *- ,( . 0 . C, F D ( * F * *, , = ,. , ! $ G 6 6- H) 9C,, B ) C , 0 ( *0 F ( O.E> Z* T O U = [ SO N O \ Vh Pi] jUQk \ ^*eK(g P T:97,_ ;fT ePL=6W T 9UH` g l(Gf 7 H'9 *mdb nC, ) Ca I"!oo p6g:k 899:9 7 8gq:7:9 L :r6se :7:k . <' * = > (* * , - 2, , - - C ? * C3 * C - 2 ( C !I%J KL9@ - * * 2 A * , b c B*> (0dM NO PBQ P RS ST UTVWXQYT * , * ( C) @' * * 4 B * 2* A @ , * ) - - C( @) * * C - C 4 * * - ) , C D * , * , ( C 0- * * - , C 0 0 F , -* 2 ,*t . u 4 C 3 0 , * (
EXECUTION REQUIREMENTS. The PARTIES, through their authorized representatives, have executed this AGREEMENT as of the day and year first written above. CONSULTANT: XXXXXXX COMMUNITY COLLEGE DISTRICT By: By: Xxxxxx X. Xxxxx, Chief Business Officer Type or Print Name Date Date Date Approved By Board, if Required EXHIBIT “A” CONSULTANT’S PROPOSAL EXHIBIT “B” DISTRICT’S REQUEST FOR PROPOSALS AGREEMENT PROCESSING LOG NAME: STATUS OF AGREEMENT XXXX X IF INFORMATION HAS BEEN COMPLETED. WILL OR WILL NOT WORK WITH UNDER AGE PUPILS. PHONE NUMBER OR ADDRESS CONFIRM TAX STATUS/CHECK SS# (CHECK BOX) CONSULTANT SIGNATURE AND/OR CCCD SIGNATURES OTHER: EXHIBIT A – SCOPE OF WORK & RESUME EXHIBIT B - AFFIRMATIVE ACTION STATUS CODE FORM W-9 FORM 1099 XXXXXXX COMMUNITY COLLEGE DISTRICT 0000 Xxxx Xxxxxxx Xxxxxxxxx Xxxxxxx, XX 00000 AFFIRMATIVE ACTION STATUS CODE FORM Date Firm Name Representative/Contact Address City State Zip Telephone ( ) FAX ( ) In order to comply with legal requirements, which became effective January 1, 0000, Xxxxxxx Xxxxxxxxx College District is gathering and updating the affirmative action status of vendors with whom the District is currently doing business or of vendors who have expressed an interest in doing business with the District. Please check your Company’s appropriate code and return the form to the El Camino College Purchasing Office as directed below. Your designation will have no affect on the successful bidder selection. Check AFFIRMATIVE ACTION STATUS CODE One Minority owned/Disadvantaged business [1] Woman-owned business [2] Small business concern [3] Other: [4] Large enterprise [5] Disabled Veteran enterprise [8] Please return the completed form with your sealed bid. A breakdown of affirmative action status codes will be expected only for successful bidder’s subcontractors either by percentage of work or actual dollar amount bid. XXXXXXX COMMUNITY COLLEGE DISTRICT 0000 Xxxx Xxxxxxx Xxxxxxxxx Xxxxxxx, XX 00000 AFFIRMATIVE ACTION STATUS CODE DEFINITIONS [1] Minority business (or small disadvantaged business) A small business concern which is at least fifty-one per cent unconditionally owned by one or more socially and economically disadvantaged individuals, or, in the case of a publicly owned business, at least 51% of the stock of which is owned by such individuals, and whose management and daily business operations are controlled by one or more such individuals. Business owners who certify that they are members of named groups (African American, Hisp...
EXECUTION REQUIREMENTS. Proper signatures required for execution of this instrument may be by original signature; photocopy; fax/facsimile copy; valid, encrypted, electronic transmission/signature; and/or other commonly accepted, widely used, commercially acceptable signature methods. This instrument may be executed in counter-parts by each party on a separate copy thereof with the same force and effect as though all parties had executed a single original copy. LOS ANGELES COUNTY PASADENA UNIFIED OFFICE OF EDUCATION SCHOOL DISTRICT By By Xxxxxxx X. Xxxxxx Procurement Services Manager Typed or Printed Name Title Date Date lm 8-7
EXECUTION REQUIREMENTS. Proper signatures required for execution of this instrument may be by original signature; photocopy; fax/facsimile copy; valid, encrypted, electronic transmission/signature; and/or other commonly accepted, widely used, commercially acceptable signature methods. This instrument may be executed in counter-parts by each party on a separate copy thereof with the same force and effect as though all parties had executed a single original copy. The Parties represent and warrant that those persons signing this Agreement are authorized to execute this Agreement. LOS ANGELES COUNTY IVS COMPUTER TECHNOLOGY OFFICE OF EDUCATION XxXxxxx Xxxxxxxx (Jun 30, 2022 14:59 PDT) AB Xxxxx Xxxxxxxx Controller By Xxxxxxx Xxxxxxxxx Typed or Printed Name Title Xxxxxxx Xxxxxxxxx, Senior Account Executive Date Jun 30, 2022 Date 06-28-2022 mc 6/27 Report 7/11/2022 Federal Tax ID Number
EXECUTION REQUIREMENTS. Proper signatures required for execution of this instrument may be by original signature; photocopy; fax/facsimile copy; valid, encrypted, electronic transmission/signature; and/or other commonly accepted, widely used, commercially acceptable signature methods. This instrument may be executed in counter-parts by each party on a separate copy thereof with the same force and effect as though all parties had executed a single original copy. LOS ANGELES COUNTY MONROVIA UNIFIED OFFICE OF EDUCATION SCHOOL DISTRICT By By Xxxxxxxx Xxxxx Chief Financial Officer Xx. Xxxxxxxxx Xxxxxxxxxx Typed or Printed Name Title Superintendent Date Date January 13, 2021 %&'()*+,+'-&.)/01234+&256.47 / 3& ) 8 9 ( : ; < 9 = 1 > ? ! 3 @ "3 ! ' 3" & )# !A " 3!, ,$ B + 3 C D.B'+E&)B&@37-&CC.)3/0 EXHIBIT A- SCOPE OF WORK UQ 3F)&4C,.D74+6Q+&2DI-1N-/&.J&,G27D/2IC+'34J76'C+BK+I+&6@'.L&.V+)QC43,&3,&7/,/'0/HC3,7C&3(C7)6+/638.+)//+4B,/B/3&67'FC3,+/)4'&BGH3@.)P&.3'*4&/+8+,67'BF)D/74G60,7B'3'&B)+0'.'B+*F/@'BG43.4@G+743+7'/6W&:H.)BDB','&+/63@Q)B+.36@/4G+/+&6,&B4DH',0+74'B&E'7CB&/&H)&+B&C&)7@'67637./6+B-3/6)&3&*CD)7/C7G',+.46)&73&4'/7/)0'6Q(E+6C&.)3,4/B&F0@4+3G7&B&, 0(+67.B,LI/IQFJ4IH-%ELGJ(J7&K&0-TCI&)B1J,&CB&2I5&,&2,L.@BA/8)37G/7M3GS,N+/,-.0+B3&,')3+0(B8C@36CIB4&+C.&J3D/4,'I3/./+BJ)F+BQ/K'4&3C/N+G0.H+&E)(B)&&+6/&,@.DIA)36,J+B/3&,+I),F@L+7+43O27/G63/7/&.7-'&48&27G,7C&/A)/3,C&,G63&,)+,A.C37),)'+3)3P@,/6+6&07*3/+(*4B+B67Q/.3%)&(,/3)/-FG*14+G/5&3&)C&9@&,&(2)3:&4;/+BG<Q(,90-6=2&C&1'B3>/)7/34'&H/.B73)7B4/,3,@4.+&36H'+47/&R)'Q'/7/'E,27&BB)B0'8B/&+G'B/@+7@373/243.'+/4'&7B7,0/
EXECUTION REQUIREMENTS. Proper signatures required for execution of this instrument may be by original signature; photocopy; fax/facsimile copy; valid, encrypted, electronic transmission/signature; and/or other commonly accepted, widely used, commercially acceptable signature methods. This instrument may be executed in counter-parts by each party on a separate copy thereof with the same force and effect as though all parties had executed a single original copy. LOS ANGELES COUNTY MONROVIA UNIFIED OFFICE OF EDUCATION SCHOOL DISTRICT By By Xxxxxxxx Xxxxx Chief Financial Officer Xx. Xxxxxxxxx X. Thorossian Typed or Printed Name Title Superintendent Date Date August 26, 2020 lm 8-4 Report 8/17/20 EXHIBIT A- CNA Cost Breakdown / Scope of Work The Nurse Assistant program costs break as follows: Program Item Cost Nurse Assistant Pre- certification CNA Tuition $550 Registration $550 Books The Nursing Assistant and Workbook – ISBN 978-0132622554 Supplies & Materials 3 pair of scrubs $35 $100 Testing – Red Cross $110 Other Fees Scope of Work Physical CPR Finger Prints Flu Shot TB Blood Test $40 $55 $50 $25 $85 $1,600 The program cost covers all the following items and scope of work: 8 weeks of technical instruction (216 hours) o 3 weeks of classroom/theory o 5-6 weeks of clinical o 1 week of classroom/exam prep 6 weeks of soft skill training including: employment portfolio (resume, cover letter, etc.), job search, career development, interview skills, professional behavior All items listed in the cost breakdown: tuition, registration, books, supplies, testing, and other fees Graduation ceremony and certificates (if student participates in annual graduation)
EXECUTION REQUIREMENTS. Proper signatures required for execution of this instrument may be by original signature; photocopy; fax/facsimile copy; valid, encrypted, electronic transmission/ signature; and /or other commonly accepted, widely used, commercially acceptable signature methods, This instrument may be executed in counter-parts by each party on a separate copy thereof with the same force and effect as though all parties had executed a single original copy, Burbank Unified School District Participating Internship Partner Xxxxxx Xxxxx ___________________ _____________________________ Name of authorized person (print) By_______________________________ By _____________________________ (Signature) (Signature) Xxxxxx Xxxxx Authorized person representing Assistant Superintendent, Administrative Services the Participating Internship Partner Date_____________________ Date __________________ ___________________________ _______________________________ Date___________ Teacher Name (print) Teacher Signature
