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

CONTRACTOR California Department of General Services Use Only. CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Los Angeles Countywide Criminal Justice Coordination Committee BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Xxxx Xxxxxxx, Executive Director ADDRESS 000 Xxxx Xxxxxx Xxxxxx Xxx Xxxxxxx, XX 00000 Phone: (000) 000-0000 STATE OF CALIFORNIA AGENCY NAME California Department of Corrections and Rehabilitation BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Exempt per: Bedeth Victorioso, Chief, Service Contracts Section ADDRESS 0000 Xxx Xxxxxxxxxxx Xxxx, Xxx X-0 Xxxxxxxxxx, XX 00000

CONTRACTOR California Department of General Services Use Only. CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Los Angeles Countywide Criminal Justice Coordination Committee County of Orange BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Xxxx Xxxxxx X. Xxxxxxx, Executive Director Chief Probation Officer ADDRESS 000 Xxxx Xxxxxx Xxxxxx 0000 X. Xxxxx Xxx., XX Xxx Xxxxxxx00000 Xxxxx Xxx, XX 00000 Phone: (000) 000-0000 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 Exempt per: Bedeth VictoriosoXxxxx Xxxxxx, ChiefSSMI, Service Contracts Section Headquarters Contract Unit #3 ADDRESS 0000 Xxx Xxxxxxxxxxx XxxxXx Xxx X-0, Xxx X-0 Xxxxxxxxxx, XX 00000

CONTRACTOR California Department of General Services Use Only. CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Los Angeles Countywide Criminal Justice Coordination Committee County of San Bernardino BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Xxxx XxxxxxxXxxxxx Xxxxxxxxxx, Executive Director Chair, Board of Supervisors ADDRESS 000 Xxxx Xxxxxx Xxxxx Xxxxxx Xxx XxxxxxxXxxxxxxxxx, XX 00000 Phone: (000) 000-0000 STATE OF CALIFORNIA AGENCY NAME California Department of Corrections and Rehabilitation Consumer Affairs, Dental Board of California BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Exempt per: Bedeth VictoriosoXxxxx Xxxxxx, Chief, Service Contracts Section Contract Operations Manager ADDRESS 0000 Xxx Xxxxxxxxxxx X. Xxxxxx Xxxx., Xxx X-0 Xxxxx X-000 Xxxxxxxxxx, XX 0000000000 EXHIBIT A

CONTRACTOR California Department of General Services Use Only. Exempt per: XXX 1215 CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Los Angeles Countywide Criminal Justice Coordination Committee San Mateo County BY (Authorized Signature)  " DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Xxxxxx Xxxxxx, Chief Elections Officer & Assessor-County Clerk-Recorder ADDRESS 000 Xxxxxx Xxxxxx, Xxxxx 0 Xxxxxxx Xxxx, XX 00000 STATE OF CALIFORNIA AGENCY NAME Secretary of State BY (Authorized Signature) " DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Xxxx XxxxxxxXxxxx, Executive Director Chief, Management Services ADDRESS 000 Xxxx Xxxxxx Xxxxxx Xxx Xxxxxxx0000 00xx Xxxxxx, Xxxxxxxxxx, XX 00000 Phone: (000) 000-0000 STATE OF CALIFORNIA AGENCY NAME California Department of Corrections and Rehabilitation BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Exempt per: Bedeth Victorioso, Chief, Service Contracts Section ADDRESS 0000 Xxx Xxxxxxxxxxx Xxxx, Xxx X-0 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.) Los Angeles Countywide Criminal Justice Coordination Committee 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 XxxxxxxSan Rafael, Executive Director ADDRESS 000 Xxxx Xxxxxx Xxxxxx Xxx Xxxxxxx, XX 00000 Phone: (000) 000-0000 CA 94903 STATE OF CALIFORNIA AGENCY NAME California Department of Corrections and Rehabilitation BOARD OF STATE AND COMMUNITY CORRECTIONS BY (Authorized Signature)  DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Exempt per: Bedeth VictoriosoXXXX XXXXX, Chief, Service Contracts Section Deputy Director ADDRESS 0000 Xxx Xxxxxxxxxxx XxxxXxxxxxx Xxxx Xxx, Xxx X-0 Xxxxxxxxxx, 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.) Los Angeles Countywide Criminal Justice Coordination Committee 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 XxxxxxxSan Rafael, Executive Director ADDRESS 000 Xxxx Xxxxxx Xxxxxx Xxx Xxxxxxx, XX 00000 Phone: (000) 000-0000 CA 94903 STATE OF CALIFORNIA AGENCY NAME California Department of Corrections and Rehabilitation BOARD OF STATE AND COMMUNITY CORRECTIONS BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Exempt per: Bedeth VictoriosoXXXX XXXXX, Chief, Service Contracts Section Deputy Director ADDRESS 0000 Xxx Xxxxxxxxxxx XxxxXxxxxxx Xxxx Xxx, Xxx X-0 Xxxxxxxxxx, Xxxxx 000 Xxxxxxxxxx XX 00000

CONTRACTOR California Department of General Services Use Only. CONTRACTOR’S NAME (if other than an individual, state whether a corporation, partnership, etc.) Los Angeles Countywide Criminal Justice Coordination Committee San Bernardino County Sheriff’s Department BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Xxxx XxxxxxxXxxxxx X. Xxxxxxxxx, Executive Director Chairman, Board of Supervisors ADDRESS 000 Xxxx Xxxxxx Xxxxxx Xxxxx Xxxxxx, Xxx XxxxxxxXxxxxxxxxx, XX 00000 Phone: (000) 00000000-0000 0061 STATE OF CALIFORNIA AGENCY NAME California Department of Corrections Commission on Peace Officer Standards and Rehabilitation Training BY (Authorized Signature)  ✍ DATE SIGNED(Do not type) PRINTED NAME AND TITLE OF PERSON SIGNING Exempt per: Bedeth VictoriosoXxxxx X. Xxxxxxxx, Chief, Service Contracts Section Assistant Executive Director ADDRESS 0000 Xxx Xxxxxxxxxxx 000 Xxxxxxxxxx Xxxx, Xxx X-0 Xxxxx 000 Xxxx Xxxxxxxxxx, XX 00000-1630 EXHIBIT A