Common use of Name Email Address Applicable Designation Clause in Contracts

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ 6. ☐ 7. Justification: ☐ C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant Contractor shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ 6. ☐ 7. Justification: ☐ C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete andcomplete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ 6. ☐ 7. Justification: ☐ C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ 6. ☐ 7. Justification: ☐ ☒ C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant Contractor shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ 6. ☐ 7. Justification: ☐ ☒ C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ ☐A. Full Disclosure ☐ ☐B. Limited Disclosure (select one or more of the categories under which the consultant shall file): ☐ 1. ☐ ☐2. ☐ ☐3. ☐ ☐4. ☐ ☐5. ☐ ☐6. ☐ ☐7. Justification: ☐ ☒ C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Enter email address(es) A. Full DisclosureB. Limited Disclosure (select one or more of Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant Contractor shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ 6. ☐ 7. Justification: ☐ C. Excluded from Disclosure:

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete andcomplete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ 6. ☐ 7. Justification: ☐ ☒ C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ ☐A. Full Disclosure ☐ ☐B. Limited Disclosure (select one or more of the categories under which the consultant shall file): ☐ 1. ☐ ☐2. ☐ ☐3. ☐ ☐4. ☐ ☐5. ☐ ☐6. ☐ ☐7. Justification: ☐ ☐C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ ☐A. Full Disclosure ☐ ☐B. Limited Disclosure (select one or more of the categories under which the consultant Contractor shall file): ☐ ☐1. ☐ ☐2. ☐ ☐3. ☐ ☐4. ☐ ☐5. ☐ ☐6. ☐ ☐7. Justification: ☐ ☒C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant Contractor shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ ☐6. ☐ 7. Justification: ☐ C. Excluded from Disclosure

Name Email Address Applicable Designation. Enter Name of Each Individual Enter email address(es) ☐☐ A. Full DisclosureB. Limited Disclosure (select one or more of Who Will Be Providing Service Under the Contract – If individuals have different disclosure requirements, duplicate this row and complete separately for each individual Enter email address(es) ☐ A. Full Disclosure ☐ B. Limited Disclosure (select one or more of the categories under which the consultant Contractor shall file): ☐ 1. ☐ 2. ☐ 3. ☐ 4. ☐ 5. ☐ 6. ☐ 7. Justification: ☐ C. Excluded from Disclosure: