Laserfiche WebLink
STATE OF CALIFORNIA <br />AGREEMENT SUMMARY <br />STD 215 (Rev. 08/2017) <br />CHECK HERE IF ADDITIONAL PAGES ARE ATTACHED <br />AGREEMENT NUMBER AMENDMENTNUMBER <br />M52226-7100 <br />1. CONTRACTOR'S NAME 2. FEDERAL I.D. NUMBER <br />City of Santa Ana 95-6000785 <br />3. AGENCY TRANSMITTING AGREEMENT 4. DIVISION, BUREAU, OR OTHER UNIT 6. AGENCY BILLING CODE <br />Employment Development Department BOPSD/Contract Services Group 23336 <br />Be. CONTRACT ANALYST NAME 6b. EMAIL 6c. PHONE NUMBER <br />Wanda Yanez wanda.yanez@edd.ca.gov (916) 654-0075 <br />7. HAS YOUR AGENCY CONTRACTED FOR THESE SERVICES BEFORE? <br />O✓ No n Yes (BYes, enterprior ContradorName and Agreement Number) <br />PRIOR CONTRACTOR NAME PRIOR AGREEMENT NUMBER <br />8. BRIEF DESCRIPTION OF SERVICES <br />Co -location reimbursement <br />9. AGREEMENT OUTLINE (Include reason torAgreement Identity, specific problem, administrative requirement, program need or other circumstances making <br />the Agreement necessary; Include special or unusual terms and conditions) <br />The purpose of reimbursing the Contractor for EDD's share of operating costs at the Santa Ana America's Job Centers of California (AJCC) <br />One -Stop located at 801 W. Civic Center Drive, #200, Santa Ana, CA 92701. <br />10. PAYMENT TERMS (More than one may apply) <br />Monthly Flat Rate Quarterly <br />0 Itemized Invoice Withhold % <br />Reimbursement/Revenue <br />Other (Explain) <br />11. PROJECTED EXPENDITURES <br />One -Time Payment Progress Payment <br />Advanced Payment Not To Exceed <br />or % <br />FUND TITLE <br />ITEM <br />FISCAL <br />YEAR <br />CHAPTER <br />STATUTE <br />PROJECTED <br />EXPENDITURES <br />UA <br />7100-001-0870 <br />20/21 <br />006 <br />2020 <br />$38,500.00 <br />UA <br />7100-001-0870 <br />20/22 <br />2021 <br />$38,500.00 <br />OBJECT CODE <br />AGREEMENTTOTAL <br />$77,000.00 <br />OPTIONAL USE <br />2020/2021-205/500-00420-962 $38,500.00 <br />2021/2022-205/500-00420-962 $38,500.00 <br />AMOUNT ENCUMBERED BY THIS DOCUMENT <br />$77,000.00 <br />PRIOR AMOUNT ENCUMBERED FOR THIS AGREEMENT <br />I certify upon my own personal knowledge that the budgeted funds for the current <br />budget year are available for the period and purpose of the expenditure stated above. <br />TOTAL AMOUNT ENCUMBERED TO DATE <br />$77,000.00 <br />A COUNTING FFICER_ S SIGNATURE <br />`fvwf_\ <br />ACCOUNTING OFFICER'S NAME (Print or Type) <br />rvlu ��Z <br />DATE SIGNED <br />1CjT 2� Z,0 <br />MLMA <br />Page 1 of 3 <br />