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<br />~.-/ <br />~C~PH <br /> <br />State of California-Health and Human Services Agency <br />California Department of Public Health <br /> <br /> <br />APR 2 1 2008 <br /> <br />MARK B. HORTON. MO. MSPH <br />Director <br /> <br />ARNOLD SCHWARZENEGGER <br />Governor <br /> <br />CONTRACTOR: City of Santa Ana <br /> <br />AGREEMENT NUMBER: 08-85251 <br /> <br />California Departument of Public Health (CD PH) has standardized its agreement formats. The enclosed agreement may <br />reference on-line terms and conditions (GTC or GIA) that are not attached to the agreement. If applicable, the cited <br />terms may be viewed at this web site: htfD:llwww.ols.dgs.ca.gov/Standard+Language/default.httn. The enclosed <br />agreement is not binding until signed by all parties and approved by the appropriate state agencies. No services should <br />be provided prior to approval, as CDPH is not obligated to make any payments for services occurring prior to approval. <br />Required action is noted by each checked [X] item below. <br /> <br />[ ] <br /> <br />~ <br /> <br />[ ] <br /> <br />Affix a signature to the enclosed agreement copy and each face sheet. Two copies must bear original signatures. Return <br />all copies to CMU's address noted below along with each item noted by a check mark [X]. A copy of the approved <br />agreement will be distributed to you after it is fully executed. Alterations, in general, are not allowed. Alterations, if <br />any, must be approved by the funding program and initialed by the person who signs the agreement. <br />Complete, sign, and return the Payee Data Record (STD 204). Payments cannot be issued without this form. <br />Go to httv:llwww.ols.dgs.ca.gov/Standard+Language/default.htm. review the GTC version referenced on the <br />face of the agreement as Exhibit C. Review provision II to locate the Contractor Certification Clause (CCC) version <br />(i.e., 307) that applies. Read the CCC in its entirety. Sign the first page of the Certification. Return the first page <br />of the originally signed Certification to the CMU address below. Failure to return the appropriate CCC version will <br />prohibit CDPH from doing buisness with your firm. <br />Enclosed for your records is a fully executed agreement copy. Include CDPH's agreement number on all invoices and <br />future correspondence related to this agreement. Performance may commence. <br />The enclosed agreement has been signed by CDPH. When fully executed, return one signed copy to CMU's address <br />below. Cite CDPH's agreement number on all correspondence about this agreement. <br />The enclosed agreement has been signed by CDPH and is fully executed. Cite the agreement number in future <br />correspondence, <br /> <br />Contact CMU at (916) 650-0100 if there are qnestions about tbis letter, Return all items identified above to this address: <br /> <br />CDPH Contract Management Unit <br />MS 1802, 1501 Capitol Avenue <br />P.O. Box 997377 <br />Sacramento, CA 95899-7377 <br /> <br />For program matters, invoice/payment issues, or to discuss agreement alterations, contact: <br /> <br />Christine Johnson (916) 650-6608 <br />CDPH Medical Device & Youth Tobacco Enf. <br />P.O. Box 997435, MS 7602 <br />Sacramento, CA 95899-7435 <br /> <br />Enclosure(s) <br /> <br />Contract Management UniVAdministration, MS 1802, P.O. Box 997377, Sacramento, CA 95899-7377 <br />(916) 650-0100 <br /> <br />Patent #5,580,640 340437 <br />