Common use of Hold Harmless and Indemnification Clause Clause in Contracts

Hold Harmless and Indemnification Clause. The County agrees to indemnify and defend the employee organization from any liabilities which may arise as a result of the employee organization entering into this agreement. It is expressly understood that the County of Los Angeles shall choose the counsel, and have control of all phases and aspects of the litigation and the organization's defense including settlement, and that the employee organization shall cooperate in that defense. It is further understood that this indemnity and defense provision only applies to those claims where the legality or constitutionality of the Drug Testing Program or any part of that program is at issue. It does not extend to claims against the employee organization in which the legality or constitutionality of that program is not at issue. The County will not indemnify or defend the employee organization against any claim that the organization or anyone acting on its behalf improperly or negligently advised, represented, or performed services for an employee with respect to any event subsequent to the effective date of this agreement with respect to the Drug Testing Program, disciplinary proceedings arising from the program, or any other right or liability of the employee related to the program. ATTACHMENT A‌ THIS FORM SHALL BE SEALED AND SHALL NOT BE OPENED UNLESS THE RESULTS OF THIS URINE TEST ARE CONFIRMED AS POSITIVE. ALL OTHER SEALED DECLARATIONS SHALL BE DESTROYED WITHOUT BEING OPENED. CONFIDENTIAL TEST NO. TEST LOCATION LIST ANY PRESCRIPTION OR OVER-THE-COUNTER NON-PRESCRIPTION MEDICATIONS YOU ARE NOW TAKING OR HAVE TAKEN DURING THE LAST THIRTY (30) DAYS. SPECIFY THE REASON FOR THE MEDICATION(S), THE AMOUNT LAST TAKEN AND THE DATE. ALSO, INDICATE THE NAME OF THE HEALTH CARE PROVIDER PRESCRIBING ANY MEDICATION(S). PRESCRIBING SUBSTANCE REASON FOR DATE LAST HEALTH CARE OFFICE TAKING TAKEN AMOUNT PROVIDER LOCATION HAVE YOU INGESTED, INHALED OR ABSORBED ANY CONTROLLED SUBSTANCE WITHIN THE LAST TEN (10) DAYS IN CONNECTION WITH YOUR DUTIES AS A PEACE OFFICER? ( ) NO ( ) YES DATE FILE NO. NAME OF SUPERVISOR ADVISED OF INCIDENT I CERTIFY THAT THE ABOVE INFORMATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT. RIGHT THUMB DATE OF COLLECTION: IF FOLLOW-UP IS NECESSARY, MY PREFERRED DAYTIME TELEPHONE NUMBER FOR CONTACT OR MESSAGE IS: AREA CODE ( ) NO. . NOTES: ONE COPY TO EMPLOYEE AT TIME OF SPECIMEN COLLECTION ONE COPY TO BE PLACED IN SEALED ENVELOPE THIS FORM SHALL BE SEALED AND SHALL NOT BE OPENED UNLESS THE RESULTS OF THIS URINE TEST ARE CONFIRMED AS POSITIVE. ALL OTHER SEALED DECLARATIONS SHALL BE DESTROYED WITHOUT BEING OPENED. CONFIDENTIAL TEST NO. TEST LOCATION LIST ANY PRESCRIPTION OR OVER-THE-COUNTER NON-PRESCRIPTION MEDICATIONS YOU ARE NOW TAKING OR HAVE TAKEN DURING THE LAST THIRTY (30) DAYS. SPECIFY THE REASON FOR THE MEDICATION(S), THE AMOUNT LAST TAKEN AND THE DATE. ALSO, INDICATE THE NAME OF THE HEALTH CARE PROVIDER PRESCRIBING ANY MEDICATION(S). PRESCRIBING SUBSTANCE REASON FOR DATE LAST HEALTH CARE OFFICE TAKING TAKEN AMOUNT PROVIDER LOCATION HAVE YOU INGESTED, INHALED OR ABSORBED ANY CONTROLLED SUBSTANCE WITHIN THE LAST TEN (10) DAYS IN CONNECTION WITH YOUR DUTIES AS A PEACE OFFICER? ( ) NO ( ) YES DATE FILE NO. NAME OF SUPERVISOR ADVISED OF INCIDENT I CERTIFY THAT THE ABOVE INFORMATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT. RIGHT THUMB DATE OF COLLECTION: IF FOLLOW-UP IS NECESSARY, MY PREFERRED DAYTIME TELEPHONE NUMBER FOR CONTACT OR MESSAGE IS: AREA CODE ( ) NO. . NOTES: ONE COPY TO EMPLOYEE AT TIME OF SPECIMEN COLLECTION ONE COPY TO BE PLACED IN SEALED ENVELOPE ATTACHMENT B1‌ SECRET NUMBER DATE&TIME COLLECTED TEST SITE COLLECTOR'S SIGNATURE TAPE TEMP EVIDENCE LEDGER ENTRY LAB RCDT # RECEIVED BY SEALS INTACT LABELS LEGIBLE REMARKS: ATTACHMENT B2‌ LABORATORY RECEIPT NO. RECEIVED BY: DATE: TIME: # COLLECTION SHEET(S): # URINE SPECIMENS # SEALED PRE-TEST DECLARATIONS: = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = IMMUNOSSAY SCREENING TEST : ASSIGNED TO: BY: DATE: TIME: COMPLETED BY: DATE: TIME: RETURNED TO: BY: ATTACHMENT B2 (continued)‌ DATE: TIME: # NEGATIVE SPECIMEN(S) DISPOSED ON: BY: # POSITIVE SPECIMEN(S) SPECIMEN NUMBER(S) FROZEN ON: BY: ATTACHMENT B3‌ LABORATORY RECEIPT NO. SPECIMEN NUMBER: ASSIGNED TO: BY: DATE: TIME: COMPLETED BY: DATE: TIME: FROZEN ON: BY: ATTACHMENT B4‌ LABORATORY RECEIPT NO. SPECIMEN NUMBER: REMOVED FROM FREEZER BY: DATE: TIME: SPLIT RELEASED BY: DATE: TIME: SPLIT RELEASED TO: DATE: TIME: _ ATTACHMENT C‌‌‌ AMPHETAMINES: 500 ng/ml COCAINE: 150 ng/ml PCP: 25 ng/ml CODEINE/MORPHINE: 2000 ng/ml IN WITNESS WHEREOF, the parties hereto have caused their duly authorized representatives to execute this Memorandum of Understanding the day, month, and year first above written. PROFESSIONAL PEACE OFFICERS COUNTY OF LOS ANGELES ASSOCIATION AUTHORIZED MANAGEMENT REPRESENTATIVES By By President, PPOA Chief Executive Officer By By By District Attorney County of Los Angeles Item No. Title 2717 Sergeant 2719 Lieutenant 2894 Lieutenant, DA 2891 Sergeant, DA

Hold Harmless and Indemnification Clause. The County agrees to indemnify and defend the employee organization Coalition and each Union signatory to this agreement from any liabilities which may arise as a result of the employee organization entering into this agreement. It is expressly understood that the County of Los Angeles shall choose the counsel, and have control of all phases and aspects of the litigation and the organizationUnion's defense including settlement, and that the employee organization Union shall cooperate in that defense. It is further understood that this indemnity and defense provision only applies to those claims where the legality or constitutionality of the Drug Urine Testing Program or any part of that program is at issue. It does not extend to claims against the employee organization Union in which the legality or constitutionality of that program is not at issue. The County will not indemnify or defend the employee organization Union against any claim that the organization or anyone acting on its behalf improperly or negligently advised, represented, or performed services for an employee with respect to any event subsequent to the effective date of this agreement with respect to the Drug Urine Testing Program, disciplinary proceedings arising from the program, or any other right or liability of the employee related to the program. ATTACHMENT EXHIBIT A‌ YOU HAVE THE RIGHT TO CONSULT WITH A UNION REPRESENTATIVE AND HAVE THE REPRESENTATIVE PRESENT WITH YOU DURING THE ENTIRE TESTING PROCESS. IF YOU DESIRE TO HAVE UNION REPRESENTATION – NOTIFY YOUR SUPERVISOR IMMEDIATELY. However, you are required to undergo drug/alcohol testing without delay. YOU ARE BEING ORDERED TO SUBMIT TO A REASONABLE SUSPICION DRUG AND ALCOHOL TEST OF YOUR BREATH AND/OR URINE. FAILURE TO COMPLETE THIS FORM AND/OR PROVIDE AN ADEQUATE SAMPLE FOR THIS TESTING PROCEDURE MAY RESULT IN DISCIPLINE, UP TO AND INCLUDING TERMINATION. THIS FORM SHALL BE SEALED AND SHALL NOT BE OPENED UNLESS THE RESULTS OF THIS URINE TEST ARE CONFIRMED AS POSITIVE. ALL OTHER SEALED DECLARATIONS SHALL BE DESTROYED WITHOUT BEING OPENED. EMPLOYEE’S NAME: CONFIDENTIAL TEST NO. TEST LOCATION LIST ANY PRESCRIPTION OR OVER-THE-COUNTER NON-PRESCRIPTION MEDICATIONS YOU ARE NOW TAKING OR HAVE TAKEN DURING THE LAST THIRTY (30) DAYS. SPECIFY THE REASON FOR THE MEDICATION(S), THE AMOUNT LAST TAKEN AND THE DATE. ALSO, INDICATE THE NAME OF THE HEALTH CARE PROVIDER PRESCRIBING ANY MEDICATION(S). PRESCRIBING SUBSTANCE REASON DATE AMOUNT PRESCRIBING OFFICE FOR DATE LAST HEALTH CARE OFFICE HEALTHCARE LOCATION TAKING TAKEN AMOUNT PROVIDER LOCATION HAVE YOU INGESTED, INHALED OR ABSORBED ANY CONTROLLED SUBSTANCE WITHIN THE LAST TEN (10) DAYS IN CONNECTION WITH YOUR DUTIES AS A PEACE OFFICEREMPLOYMENT? ( ) NO ( ) YES DATE FILE NO. NAME OF SUPERVISOR ADVISED OF INCIDENT I CERTIFY THAT THE ABOVE ABOV E INFORMATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT. RIGHT THUMB SIGNATURE: DATE OF COLLECTION: IF FOLLOW-UP IS NECESSARY, MY PREFERRED DAYTIME TELEPHONE NUMBER FOR CONTACT OR MESSAGE IS: AREA CODE ( ) NO. . NOTESNOTE: ONE COPY TO EMPLOYEE AT TIME OF SPECIMEN COLLECTION ONE COPY TO BE PLACED IN SEALED ENVELOPE THIS FORM SHALL BE SEALED AND SHALL NOT BE OPENED UNLESS THE RESULTS OF THIS 5/7/91 ESA:/PreUrine EXHIBIT B‌ LOS ANGELES COUNTY URINE TEST ARE CONFIRMED AS POSITIVE. ALL OTHER SEALED DECLARATIONS SHALL BE DESTROYED WITHOUT BEING OPENED. CONFIDENTIAL COLLECTION LOG SHEET‌‌‌‌ COLLECTION LOG TRANSMITTAL LOG LABORATORY LOG SECRET DATE & TIME TEST NO. TEST LOCATION LIST ANY PRESCRIPTION OR OVER-THE-COUNTER NON-PRESCRIPTION MEDICATIONS YOU ARE NOW TAKING OR HAVE TAKEN DURING THE LAST THIRTY (30) DAYS. SPECIFY THE REASON FOR THE MEDICATION(S), THE AMOUNT LAST TAKEN AND THE DATE. ALSO, INDICATE THE NAME OF THE HEALTH CARE PROVIDER PRESCRIBING ANY MEDICATION(S). PRESCRIBING SUBSTANCE REASON FOR DATE LAST HEALTH CARE OFFICE TAKING TAKEN AMOUNT PROVIDER LOCATION HAVE YOU INGESTED, INHALED OR ABSORBED ANY CONTROLLED SUBSTANCE WITHIN THE LAST TEN (10) DAYS IN CONNECTION WITH YOUR DUTIES AS A PEACE OFFICER? ( ) NO ( ) YES DATE FILE NO. NAME OF SUPERVISOR ADVISED OF INCIDENT I CERTIFY THAT THE ABOVE INFORMATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT. RIGHT THUMB DATE OF COLLECTION: IF FOLLOW-UP IS NECESSARY, MY PREFERRED DAYTIME TELEPHONE COLLECTOR’S TAPE LAB RECEIVED SEALS LABELS NUMBER FOR CONTACT OR MESSAGE IS: AREA CODE ( ) NO. . NOTES: ONE COPY TO EMPLOYEE AT TIME OF SPECIMEN COLLECTION ONE COPY TO BE PLACED IN SEALED ENVELOPE ATTACHMENT B1‌ SECRET NUMBER DATE&TIME COLLECTED TEST SITE COLLECTOR'S SIGNATURE TAPE TEMP EVIDENCE LEDGER ENTRY LAB RCDT # RECEIVED BY SEALS A & B INTACT LABELS LEGIBLE REMARKS: ATTACHMENT B2‌ LABORATORY RECEIPT NOEXHIBIT C‌ Advantage Care – Artesia 0000 X. Xxxxxxxxxx Xxxxxx Xxxxxxx, XX 00000 Advantage Care – De Xxxx 0000 Xx Xxxx Xxxxxx Canoga Park, CA 91304 Advantage Care – El Segundo 000 X. Xxxx Street El Segundo, CA 90245 Advantage Care – Commerce 0000 X. Xxxxxxxx Avenue Commerce, CA 90040 Advantage Care – Leonis 0000 Xxxxxx Xxxxxxxxx Vernon, CA 90058 Advantage Care – Metropolitan 000 X. Xxxxxxxxxx Boulevard Los Angeles, CA 90015 Advantage Care – Van Nuys 00000 Xxxxxx Xxxxxxxxx Xxx Xxxx, XX 00000 Xxxxxx Occupational Health Center 0000 Xxxxxxxxx Xxxxxx Whittier, CA 90601 Xxxxxx Medical Group 00000 Xxxxx Xxxxxx So. RECEIVED BY: DATE: TIME: # COLLECTION SHEET(S): # URINE SPECIMENS # SEALED PREEl Monte, CA 91733 Xxxxxx Xxxxxxx Hospitals, Inc. 000 X. Xxxxxxx, #000 Inglewood, CA 90301 Xxxxxx Xxxxxxx Hospitals, Inc. 000 X. Xxxxxxxxx El Segundo, CA 90245 Executive Health Group 515 S. Flower Los Angeles, CA 90071 Foothill Industrial Medical Clinics 0000 X. Xxxxxxxxx Xxxxxx Xxxxxxxxx, XX 00000 Foothill Industrial Medical Clinics 55 X. Xxxxxxx Alhambra, CA 91801 Foothill Industrial Medical Clinics 0000 Xxxxxxx Xxxxxx El Monte, CA 91731 Foothill Industrial Medical Clinics 445 Fairoaks Pasadena, CA 91105 Gallatin Medical Clinic 00000 Xxxxxxxxx Xxxx. Downey, CA 90241 Intercommunity Workcare Services 00000 Xxxxxxxxxx Xxxx. Whittier, CA 90602 Long Beach Medical Clinic 0000 Xxxxxxx Xxx., Xxxxx #000 Xxxx Xxxxx, XX 00000 Samaritan Health Center at the Hospital of the Good Samaritan 000 X. Xxxxx Avenue Los Angeles, CA 90017 St. Xxxxxx Occupational Health Center 0000 Xxxxxxx Xxxxxx Burbank, CA 91505 Venice-TEST DECLARATIONS: = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = IMMUNOSSAY SCREENING TEST : ASSIGNED TO: BY: DATE: TIME: COMPLETED BY: DATE: TIME: RETURNED TO: BY: ATTACHMENT B2 (continued)‌ DATE: TIME: # NEGATIVE SPECIMEN(S) DISPOSED ON: BY: # POSITIVE SPECIMEN(S) SPECIMEN NUMBER(S) FROZEN ON: BY: ATTACHMENT B3‌ LABORATORY RECEIPT NOXxxxxx Industrial Center 00000 X. Xxxxxxxxxx Blvd. SPECIMEN NUMBER: ASSIGNED TO: BY: DATE: TIME: COMPLETED BY: DATE: TIME: FROZEN ON: BY: ATTACHMENT B4‌ LABORATORY RECEIPT NO. SPECIMEN NUMBER: REMOVED FROM FREEZER BY: DATE: TIME: SPLIT RELEASED BY: DATE: TIME: SPLIT RELEASED TO: DATE: TIME: _ ATTACHMENT C‌‌‌ AMPHETAMINES: 500 ng/ml COCAINE: 150 ng/ml PCP: 25 ng/ml CODEINE/MORPHINE: 2000 ng/ml IN WITNESS WHEREOFLos Angeles, the parties hereto have caused their duly authorized representatives to execute this Memorandum of Understanding the day, month, and year first above written. PROFESSIONAL PEACE OFFICERS COUNTY OF LOS ANGELES ASSOCIATION AUTHORIZED MANAGEMENT REPRESENTATIVES By By President, PPOA Chief Executive Officer By By By District Attorney County of Los Angeles Item No. Title 2717 Sergeant 2719 Lieutenant 2894 Lieutenant, DA 2891 Sergeant, DACA 90066

Hold Harmless and Indemnification Clause. The County agrees to indemnify To the fullest extent permitted by law, Contractor shall indemnify, defend, and defend hold harmless the employee organization CITY, and its elected officials, officers, employees, volunteers, and agents (“City Indemnitees”), from and against any liabilities which may arise as a result and all causes of action, claims, liabilities, obligations, judgments, or damages, including reasonable legal counsels’ fees and costs of litigation (“claims”), arising out of the employee organization entering into this agreement. It is expressly understood that Contractor’s performance or Contractor’s failure to perform its obligations under the County of Los Angeles shall choose the counsel, and have control of all phases and aspects Contract or out of the litigation and the organization's defense including settlementoperations conducted by Contractor, and that the employee organization shall cooperate in that defense. It is further understood that this indemnity and defense provision only applies to those claims where the legality except for such loss or constitutionality of the Drug Testing Program or any part of that program is at issue. It does not extend to claims against the employee organization in which the legality or constitutionality of that program is not at issue. The County will not indemnify or defend the employee organization against any claim that the organization or anyone acting on its behalf improperly or negligently advised, represented, or performed services for an employee with respect to any event subsequent to the effective date of this agreement with respect to the Drug Testing Program, disciplinary proceedings damage arising from the programactive negligence, sole negligence or willful misconduct of the City. In the event the City Indemnitees are made a party to any action, lawsuit, or any other right or liability adversarial proceeding arising from Contractor’s performance of the employee related Contract, the Contractor shall provide a defense to the programCity Indemnitees or at the CITY’s option, reimburse the City Indemnitees their costs of defense, including reasonable legal fees, incurred in defense of such claims. ATTACHMENT A‌ Payment by City is not a condition precedent to enforcement of the indemnities in this section. In the event of any dispute between Contractor and City, as to whether liability arises from the active negligence, sole negligence or willful misconduct of the City or its officers, employees, or agents, Contractor will be obligated to pay for City’s defense until such time as a final judgment has been entered adjudicating the City as having been actively negligent, solely negligent or as having engaged in willful misconduct. Contractor will not be entitled in the absence of such a determination to any reimbursement of defense costs including but not limited to attorney’s fees, expert fees and costs of litigation. The provisions of this Section 7-5 shall survive completion of Contractor’s services or the termination of the Contract SECTION XIV‌ ITEM # MODEL & MAKE YEAR MFR. SECTION XV‌ (THIS FORM SHALL SECTION MUST BE SEALED COMPLETED AND SHALL NOT BE OPENED UNLESS SUBMITTED AS A PART OF THE RESULTS OF THIS URINE TEST ARE CONFIRMED AS POSITIVE. ALL OTHER SEALED DECLARATIONS SHALL BE DESTROYED WITHOUT BEING OPENED. CONFIDENTIAL TEST NO. TEST BID) Name of Organization Address Date of Last Service Provided SECTION XVI‌ ITEM # MODEL & MAKE YEAR MFR LOCATION LIST ANY PRESCRIPTION OR OVER-THE-COUNTER NON-PRESCRIPTION MEDICATIONS YOU ARE NOW TAKING OR HAVE TAKEN DURING THE LAST THIRTY SECTION XVII‌ Name of Organization Address Service Provided SECTION XVIII‌ Date of Incident Nature of Incident Cause of Incident Date of Incident Nature of Incident Cause of Incident Date of Incident Nature of Incident Cause of Incident This Vendor Agreement for Professional Services (30“AGREEMENT”) DAYS. SPECIFY THE REASON FOR THE MEDICATION(Sis made and entered into as of the date the AGREEMENT is fully executed by all parties (the “Effective Date”), THE AMOUNT LAST TAKEN AND THE DATE. ALSOby and between the City of Pismo Beach, INDICATE THE NAME OF THE HEALTH CARE PROVIDER PRESCRIBING ANY MEDICATION(Sa municipal corporation (“CITY”), and Name of Vendor (“VENDOR”). PRESCRIBING SUBSTANCE REASON FOR DATE LAST HEALTH CARE OFFICE TAKING TAKEN AMOUNT PROVIDER LOCATION HAVE YOU INGESTED, INHALED OR ABSORBED ANY CONTROLLED SUBSTANCE WITHIN THE LAST TEN (10) DAYS IN CONNECTION WITH YOUR DUTIES AS A PEACE OFFICER? ( ) NO ( ) YES DATE FILE NO. NAME OF SUPERVISOR ADVISED OF INCIDENT I CERTIFY THAT THE ABOVE INFORMATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT. RIGHT THUMB DATE OF COLLECTION: IF FOLLOW-UP IS NECESSARY, MY PREFERRED DAYTIME TELEPHONE NUMBER FOR CONTACT OR MESSAGE IS: AREA CODE ( ) NO. . NOTES: ONE COPY TO EMPLOYEE AT TIME OF SPECIMEN COLLECTION ONE COPY TO BE PLACED IN SEALED ENVELOPE THIS FORM SHALL BE SEALED AND SHALL NOT BE OPENED UNLESS THE RESULTS OF THIS URINE TEST ARE CONFIRMED AS POSITIVE. ALL OTHER SEALED DECLARATIONS SHALL BE DESTROYED WITHOUT BEING OPENED. CONFIDENTIAL TEST NO. TEST LOCATION LIST ANY PRESCRIPTION OR OVER-THE-COUNTER NON-PRESCRIPTION MEDICATIONS YOU ARE NOW TAKING OR HAVE TAKEN DURING THE LAST THIRTY (30) DAYS. SPECIFY THE REASON FOR THE MEDICATION(S), THE AMOUNT LAST TAKEN AND THE DATE. ALSO, INDICATE THE NAME OF THE HEALTH CARE PROVIDER PRESCRIBING ANY MEDICATION(S). PRESCRIBING SUBSTANCE REASON FOR DATE LAST HEALTH CARE OFFICE TAKING TAKEN AMOUNT PROVIDER LOCATION HAVE YOU INGESTED, INHALED OR ABSORBED ANY CONTROLLED SUBSTANCE WITHIN THE LAST TEN (10) DAYS IN CONNECTION WITH YOUR DUTIES AS A PEACE OFFICER? ( ) NO ( ) YES DATE FILE NO. NAME OF SUPERVISOR ADVISED OF INCIDENT I CERTIFY THAT THE ABOVE INFORMATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT. RIGHT THUMB DATE OF COLLECTION: IF FOLLOW-UP IS NECESSARY, MY PREFERRED DAYTIME TELEPHONE NUMBER FOR CONTACT OR MESSAGE IS: AREA CODE ( ) NO. . NOTES: ONE COPY TO EMPLOYEE AT TIME OF SPECIMEN COLLECTION ONE COPY TO BE PLACED IN SEALED ENVELOPE ATTACHMENT B1‌ SECRET NUMBER DATE&TIME COLLECTED TEST SITE COLLECTOR'S SIGNATURE TAPE TEMP EVIDENCE LEDGER ENTRY LAB RCDT # RECEIVED BY SEALS INTACT LABELS LEGIBLE REMARKS: ATTACHMENT B2‌ LABORATORY RECEIPT NO. RECEIVED BY: DATE: TIME: # COLLECTION SHEET(S): # URINE SPECIMENS # SEALED PRE-TEST DECLARATIONS: = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = IMMUNOSSAY SCREENING TEST : ASSIGNED TO: BY: DATE: TIME: COMPLETED BY: DATE: TIME: RETURNED TO: BY: ATTACHMENT B2 (continued)‌ DATE: TIME: # NEGATIVE SPECIMEN(S) DISPOSED ON: BY: # POSITIVE SPECIMEN(S) SPECIMEN NUMBER(S) FROZEN ON: BY: ATTACHMENT B3‌ LABORATORY RECEIPT NO. SPECIMEN NUMBER: ASSIGNED TO: BY: DATE: TIME: COMPLETED BY: DATE: TIME: FROZEN ON: BY: ATTACHMENT B4‌ LABORATORY RECEIPT NO. SPECIMEN NUMBER: REMOVED FROM FREEZER BY: DATE: TIME: SPLIT RELEASED BY: DATE: TIME: SPLIT RELEASED TO: DATE: TIME: _ ATTACHMENT C‌‌‌ AMPHETAMINES: 500 ng/ml COCAINE: 150 ng/ml PCP: 25 ng/ml CODEINE/MORPHINE: 2000 ng/ml IN WITNESS WHEREOFIn consideration of the mutual covenants and conditions set forth herein, the parties hereto have caused their duly authorized representatives to execute this Memorandum of Understanding the day, month, and year first above written. PROFESSIONAL PEACE OFFICERS COUNTY OF LOS ANGELES ASSOCIATION AUTHORIZED MANAGEMENT REPRESENTATIVES By By President, PPOA Chief Executive Officer By By By District Attorney County of Los Angeles Item No. Title 2717 Sergeant 2719 Lieutenant 2894 Lieutenant, DA 2891 Sergeant, DAagree as follows:

Hold Harmless and Indemnification Clause. The County agrees to indemnify and defend the employee organization from any liabilities which may arise as a result of the employee organization entering into this agreement. It is expressly understood that the County of Los Angeles shall choose the counsel, and have control of all phases and aspects of the litigation and the organization's defense including settlement, and that the employee organization shall cooperate in that defense. It is further understood that this indemnity and defense provision only applies to those claims where the legality or constitutionality of the Drug Testing Program or any part of that program is at issue. It does not extend to claims against the employee organization in which the legality or constitutionality of that program is not at issue. The County will not indemnify or defend the employee organization against any claim that the organization or anyone acting on its behalf improperly or negligently advised, represented, or performed services for an employee with respect to any event subsequent to the effective date of this agreement with respect to the Drug Testing Program, disciplinary proceedings arising from the program, or any other right or liability of the employee related to the program. 1. Quest Diagnostics Incorporated Van Nuys, California (000) 000-0000 ATTACHMENT A‌ A DRUG TESTING DECLARATION LOS ANGELES COUNTY SHERIFF’S DEPARTMENT THIS FORM SHALL BE SEALED AND SHALL NOT BE OPENED UNLESS THE RESULTS OF THIS URINE TEST ARE CONFIRMED AS POSITIVE. ALL OTHER SEALED DECLARATIONS SHALL BE DESTROYED WITHOUT BEING OPENED. CONFIDENTIAL TEST NO. TEST LOCATION LIST ANY PRESCRIPTION OR OVER-THE-COUNTER NON-PRESCRIPTION MEDICATIONS YOU ARE NOW TAKING OR HAVE TAKEN DURING THE LAST THIRTY (30) DAYS. SPECIFY THE REASON FOR THE MEDICATION(S), THE AMOUNT LAST TAKEN AND THE DATE. ALSO, INDICATE THE NAME OF THE HEALTH CARE PROVIDER PRESCRIBING ANY MEDICATION(S). PRESCRIBING SUBSTANCE REASON FOR DATE LAST HEALTH CARE OFFICE SUBSTANCE TAKING TAKEN AMOUNT PROVIDER LOCATION HAVE YOU INGESTED, INHALED OR ABSORBED ANY CONTROLLED SUBSTANCE WITHIN THE LAST TEN (10) DAYS IN CONNECTION WITH YOUR DUTIES AS A PEACE OFFICERDUTIES? ( ) NO ( ) YES DATE FILE NO. NAME OF SUPERVISOR ADVISED OF ON INCIDENT FILE NO. I CERTIFY THAT THE ABOVE INFORMATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT. RIGHT THUMB DATE OF COLLECTION: IF FOLLOW-UP IS NECESSARY, MY PREFERRED DAYTIME TELEPHONE NUMBER FOR CONTACT OR MESSAGE IS: AREA CODE ( ) NO. . NOTES: ONE COPY TO EMPLOYEE AT TIME OF SPECIMEN COLLECTION ONE COPY TO BE PLACED IN SEALED ENVELOPE THIS FORM SHALL BE SEALED AND SHALL NOT BE OPENED UNLESS THE RESULTS OF THIS URINE TEST ARE CONFIRMED AS POSITIVE. ALL OTHER SEALED DECLARATIONS SHALL BE DESTROYED WITHOUT BEING OPENED. CONFIDENTIAL TEST NO. TEST LOCATION LIST ANY PRESCRIPTION OR OVER-THE-COUNTER NON-PRESCRIPTION MEDICATIONS YOU ARE NOW TAKING OR HAVE TAKEN DURING THE LAST THIRTY (30) DAYS. SPECIFY THE REASON FOR THE MEDICATION(S), THE AMOUNT LAST TAKEN AND THE DATE. ALSO, INDICATE THE NAME OF THE HEALTH CARE PROVIDER PRESCRIBING ANY MEDICATION(S). PRESCRIBING SUBSTANCE REASON FOR DATE LAST HEALTH CARE OFFICE TAKING TAKEN AMOUNT PROVIDER LOCATION HAVE YOU INGESTED, INHALED OR ABSORBED ANY CONTROLLED SUBSTANCE WITHIN THE LAST TEN (10) DAYS IN CONNECTION WITH YOUR DUTIES AS A PEACE OFFICER? ( ) NO ( ) YES DATE FILE NO. NAME OF SUPERVISOR ADVISED OF INCIDENT I CERTIFY THAT THE ABOVE INFORMATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT. RIGHT THUMB DATE OF COLLECTION: IF FOLLOW-UP IS NECESSARY, MY PREFERRED DAYTIME TELEPHONE NUMBER FOR CONTACT OR MESSAGE IS: AREA CODE ( ) NO. . NOTES: ONE COPY TO EMPLOYEE AT TIME OF SPECIMEN COLLECTION ONE COPY TO BE PLACED IN SEALED ENVELOPE ATTACHMENT B1‌ SECRET NUMBER DATE&TIME COLLECTED TEST SITE COLLECTOR'S SIGNATURE TAPE TEMP EVIDENCE LEDGER ENTRY LAB RCDT # RECEIVED BY SEALS INTACT LABELS LEGIBLE REMARKS: ATTACHMENT B2‌ LABORATORY RECEIPT NO. RECEIVED BY: DATE: TIME: # COLLECTION SHEET(S): # URINE SPECIMENS # SEALED PRE-TEST DECLARATIONS: = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = IMMUNOSSAY SCREENING TEST : ASSIGNED TO: BY: DATE: TIME: COMPLETED BY: DATE: TIME: RETURNED TO: BY: ATTACHMENT B2 (continued)‌ DATE: TIME: # NEGATIVE SPECIMEN(S) DISPOSED ON: BY: # POSITIVE SPECIMEN(S) SPECIMEN NUMBER(S) FROZEN ON: BY: ATTACHMENT B3‌ LABORATORY RECEIPT NO. SPECIMEN NUMBER: ASSIGNED TO: BY: DATE: TIME: COMPLETED BY: DATE: TIME: FROZEN ON: BY: ATTACHMENT B4‌ LABORATORY RECEIPT NO. SPECIMEN NUMBER: REMOVED FROM FREEZER BY: DATE: TIME: SPLIT RELEASED BY: DATE: TIME: SPLIT RELEASED TO: DATE: TIME: _ ATTACHMENT C‌‌‌ AMPHETAMINES: 500 ng/ml COCAINE: 150 ng/ml PCP: 25 ng/ml CODEINE/MORPHINE: 2000 ng/ml IN WITNESS WHEREOF, the parties hereto have caused their duly authorized representatives to execute this Memorandum of Understanding the day, month, and year first above written. PROFESSIONAL PEACE OFFICERS COUNTY OF LOS ANGELES ASSOCIATION AUTHORIZED MANAGEMENT REPRESENTATIVES By By President, PPOA Chief Executive Officer By By By District Attorney County of Los Angeles Item No. Title 2717 Sergeant 2719 Lieutenant 2894 Lieutenant, DA 2891 Sergeant, DATHUMB