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DocuSign Envelope ID: 26A1 FOD6-5970-4421 -B5CB-2891848ECB74 <br />EXMBIT 5 <br />O R A N G E C O U N T Y <br />dccommunity ResourcesOur Community. Our Commitment. <br />Reimbursement Policy Status Form <br />Per OC Community Resources Contract Reimbursement Policy, in regards to the Contract # <br />listed herein, Contractor Is designated with the Documentation Status of Abbreviated unless <br />Comprehensive Is checked below. If the contractor's designation should change to <br />Abbreviated, a new status form shall be approved. All related documentation requirements <br />are in full force, until further notice. <br />Contractor: c�- Effective Date: kiiA &b <br />ZCLrN'\ & fay <br />Contract M �q . 19 - c>o-.o -- g.wS <br />Documentation Status: ❑ Abbreviated ❑ Comprehensive <br />Program Authorization by. Auditor Controller Authorization by: <br />Carma Lacy Eric Takanishi <br />Print Name Print Name <br />DocuSigned by: F;, <br />uSigned by: <br />Signed by: c (Amo. tAoi Sianwri hu- fial�atnislAi <br />FaFacos�azF�aoD... �� � �'J <br />F6334635 4 <br />Date: 5/22/2020 Date:5/22/202q�ywr'ar-C— <br />Two signatures are required to implement the form. REVIEWED & APPROVED <br />By Risk MANAGEMENT DivisioN <br />P 2}2 2020 <br />ANgiF- ACEVEdo <br />Distribution: <br />Contractor <br />Auditor Controller <br />Contract File <br />Program File <br />Reimbursement Policy Status (RPS-Z) <br />