Common use of CONTRACTOR California Department of General Services Use Only Clause in Contracts

CONTRACTOR California Department of General Services Use Only. Exempt per: SCM 1, 4.06 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Marin County Human Services BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING GRANT COLFAX, Director, HHS ADDRESS 00 X. Xxx Xxxxx Xxxx San Rafael, CA 94903 STATE OF CALIFORNIA AGENCY NAME BOARD OF STATE AND COMMUNITY CORRECTIONS BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING XXXX XXXXX, Deputy Director ADDRESS 0000 Xxxxxxx Xxxx Xxx, Xxxxx 000 Xxxxxxxxxx XX 00000

CONTRACTOR California Department of General Services Use Only. Exempt per: SCM 1, 4.06 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Marin County Human Services of San Bernardino BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING GRANT COLFAXXxxxxx Xxxxxxxxxx, DirectorChair, HHS Board of Supervisors ADDRESS 00 X. 000 Xxxx Xxxxx Xxxxxx Xxx Xxxxx Xxxx San RafaelXxxxxxxxxx, CA 94903 XX 00000 STATE OF CALIFORNIA AGENCY NAME BOARD OF STATE AND COMMUNITY CORRECTIONS Department of Consumer Affairs, Dental Board of California BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING XXXX XXXXXXxxxx Xxxxxx, Deputy Director Contract Operations Manager ADDRESS 0000 Xxxxxxx Xxxx XxxX. Xxxxxx Xxxx., Xxxxx 000 Xxxxxxxxxx X-000 Xxxxxxxxxx, XX 0000000000 EXHIBIT A

CONTRACTOR California Department of General Services Use Only. Exempt per: SCM 1, 4.06 XXX 1215 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Marin San Mateo County Human Services BY (Authorized Signature)  " DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING GRANT COLFAXXxxxxx Xxxxxx, DirectorChief Elections Officer & Assessor-County Clerk-Recorder ADDRESS 000 Xxxxxx Xxxxxx, HHS ADDRESS 00 X. Xxx Xxxxx Xxxx San Rafael0 Xxxxxxx Xxxx, CA 94903 XX 00000 STATE OF CALIFORNIA AGENCY NAME BOARD OF STATE AND COMMUNITY CORRECTIONS Secretary of State BY (Authorized Signature)  " DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING XXXX XXXXXXxxx Xxxxx, Deputy Director Chief, Management Services ADDRESS 0000 Xxxxxxx Xxxx Xxx00xx Xxxxxx, Xxxxx 000 Xxxxxxxxxx Xxxxxxxxxx, XX 0000000000 .

CONTRACTOR California Department of General Services Use Only. Exempt per: SCM 1, 4.06 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Marin County Human Services COUNTY OF ORANGE BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING GRANT COLFAXADDRESS 000 XXXX XXXXXXX XXXX, DirectorXXXXXX, HHS ADDRESS 00 X. Xxx Xxxxx Xxxx San Rafael, CA 94903 XX 00000 STATE OF CALIFORNIA AGENCY NAME BOARD CALIFORNIA DEPARTMENT OF STATE FOOD AND COMMUNITY CORRECTIONS AGRICULTURE BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING XXXX XXXXXExempt per: DGS Ltr 28.7 XXXXXXXX XXXX, Deputy Director ACQUISITIONS MANAGER ADDRESS 0000 Xxxxxxx Xxxx XxxX XXXXXX, Xxxxx 000 Xxxxxxxxxx XXXX 000, XXXXXXXXXX, XX 0000000000 STATE OF CALIFORNIA STANDARD AGREEMENT Attachment A STD 213 (Rev 06/03) AGREEMENT NUMBER

CONTRACTOR California Department of General Services Use Only. Exempt per: SCM 1, 4.06 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Marin County Human Services of Orange BY (Authorized Signature) DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Xxxxxx X. Xxxxxxx, Chief Probation Officer ADDRESS 0000 X. Xxxxx Xxx., XX Xxx 00000 Xxxxx Xxx, XX 00000 STATE OF CALIFORNIA AGENCY NAME California Department of Corrections and Rehabilitation (CDCR) BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING GRANT COLFAXExempt per: Xxxxx Xxxxxx, DirectorSSMI, HHS ADDRESS 00 X. Xxx Xxxxx Xxxx San Rafael, CA 94903 STATE OF CALIFORNIA AGENCY NAME BOARD OF STATE AND COMMUNITY CORRECTIONS BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING XXXX XXXXX, Deputy Director Headquarters Contract Unit #3 ADDRESS 0000 Xxxxxxx Xxxx XxxXxx Xxxxxxxxxxx Xx Xxx X-0, Xxxxx 000 Xxxxxxxxxx Xxxxxxxxxx, XX 00000

CONTRACTOR California Department of General Services Use Only. Exempt per: SCM 1, 4.06 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Marin County Human Services BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING GRANT COLFAX, Director, HHS ADDRESS 00 X. Xxx Xxxxx Xxxx San Rafael, CA 94903 STATE OF CALIFORNIA AGENCY NAME BOARD OF STATE AND COMMUNITY CORRECTIONS BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING XXXX XXXXX, Deputy Director ADDRESS 0000 Xxxxxxx Xxxx Xxx, Xxxxx 000 Xxxxxxxxxx XX 00000

CONTRACTOR California Department of General Services Use Only. Exempt per: SCM 1, 4.06 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Marin San Bernardino County Human Services Sheriff’s Department BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING GRANT COLFAXXxxxxx X. Xxxxxxxxx, DirectorChairman, HHS Board of Supervisors ADDRESS 00 X. 000 Xxxx Xxxxx Xxxxxx, Xxx Xxxxx Xxxx San RafaelXxxxxxxxxx, CA 94903 XX 00000-0061 STATE OF CALIFORNIA AGENCY NAME BOARD OF STATE AND COMMUNITY CORRECTIONS Commission on Peace Officer Standards and Training BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING XXXX XXXXXExempt per: Xxxxx X. Xxxxxxxx, Deputy Assistant Executive Director ADDRESS 0000 Xxxxxxx Xxxx Xxx000 Xxxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxxx Xxxx Xxxxxxxxxx, XX 00000-1630 EXHIBIT A

CONTRACTOR California Department of General Services Use Only. Exempt per: SCM 1, 4.06 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Marin County Human Services Los Angeles Countywide Criminal Justice Coordination Committee BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING GRANT COLFAXXxxx Xxxxxxx, DirectorExecutive Director ADDRESS 000 Xxxx Xxxxxx Xxxxxx Xxx Xxxxxxx, HHS ADDRESS 00 X. Xxx Xxxxx Xxxx San Rafael, CA 94903 XX 00000 Phone: (000) 000-0000 STATE OF CALIFORNIA AGENCY NAME BOARD OF STATE AND COMMUNITY CORRECTIONS California Department of Corrections and Rehabilitation BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING XXXX XXXXXExempt per: Bedeth Victorioso, Deputy Director Chief, Service Contracts Section ADDRESS 0000 Xxxxxxx Xxxx XxxXxx Xxxxxxxxxxx Xxxx, Xxxxx 000 Xxxxxxxxxx Xxx X-0 Xxxxxxxxxx, XX 00000