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AGENDA PACKET_2021-08-17
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08/17/2021 Regular
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AGENDA PACKET_2021-08-17
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8/17/2021 10:44:37 AM
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EXHIBIT 5 <br /> <br /> <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: City of Santa Ana Effective Date: Upon Execution <br />Contract #:MA-012-22010003 <br />Documentation Status: Abbreviated Comprehensive <br />************************************************************************************************************* <br /> <br />Program Authorization by: Auditor Controller Authorization by: <br />Carma Lacy Eric Takanishi <br />Print NamePrint Name <br />Signed by: Signed by: <br />Date: Date: <br />Two signatures are required to implement the form. <br /> <br /> <br /> <br /> <br />Distribution: <br />Contractor <br />Auditor Controller <br />Contract File <br />Program File <br />Reimbursement Policy Status (RPS-1) <br /> <br />
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