Common use of PAYEE DATA RECORD FORM STD Clause in Contracts

PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity. -End Exhibit D- EXHIBIT E – INSURANCE REQUIREMENTS California Fair Services Authority #19-01 I. Evidence of Coverage The contractor/renter shall provide a signed original evidence of coverage form for the term of the contract or agreement (hereinafter “contract”) protecting the legal liability of the State of California, the California Fair Services Authority, District Agricultural Associations, County Fairs, Counties in which County Fairs are located, Lessor/Sublessor if fair site is leased/subleased, Citrus Fruit Fairs, California Exposition and State Fair, or Entities (public or non-profit) operating California designated agricultural fairs, their directors, officers, agents, servants, and employees, from occurrences related to operations under the contract. This may be provided by:

PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity. -End Exhibit D- County of Orange SA-119-23FT PAGE 13 of 24 I. Evidence of Coverage EXHIBIT E – INSURANCE REQUIREMENTS California Fair Services Authority #19-01 I. Evidence of Coverage (Revised effective January 1, 2023) The contractor/renter shall provide a signed original evidence of coverage form for the term of the contract or agreement (hereinafter “contract”) protecting the legal liability of the State of California, the California Fair Services Authority, District Agricultural Associations, County Fairs, Counties in which County Fairs are located, Lessor/Sublessor if fair site is leased/subleased, Citrus Fruit Fairs, California Exposition and State Fair, or Entities (public or non-profit) operating California designated agricultural fairs, their directors, officers, agents, servants, and employees, from occurrences related to operations under the contract. This may be provided by:

PAYEE DATA RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other governmental entity. -End Exhibit D- EXHIBIT E – INSURANCE REQUIREMENTS California Fair Services Authority #19-01 I. Evidence of Coverage EXHIBIT E INSURANCE REQUIREMENTS (Revised effective January 1, 2023) The contractor/renter shall provide a signed original evidence of coverage form for the term of the contract or agreement (hereinafter “contract”ontract ) protecting the legal liability of the State of California, the California Fair Services Authority, District Agricultural Associations, County Fairs, Counties in which County Fairs are located, Lessor/Sublessor if fair site is leased/subleased, Citrus Fruit Fairs, California Exposition and State Fair, or Entities (public or non-profit) operating California designated agricultural fairs, their directors, officers, agents, servants, and employees, from occurrences related to operations under the contract. This may be provided by: