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XII. Agreement <br />I have read the aforementioned Agency Agreement and waiver for use of technology of the LA/OC HMIS, <br />Equipment and Services (rf applicable), and thoroughly understand that this technology is for LA/OC <br />HMIS purposes only. <br />This Agreement is executed between the Agency and the Orange County Continuum of Care and upon <br />execution the Agency will be given access to the HMIS. This agreement will be signed by the Executive <br />Director at the Participating Agency. <br />Ex utive Dir a (Print) Continuum R presentative's Name (Print) <br />Executive D' ector's Signature Continuum Representative's Sig lure <br />tow ??4e--5- 0 na n:4 e, cnu2 ?q <br />Agency N e Continuum Name <br />1/17 - 1,16 /,;L <br />Date of Si nat a Date of Signature <br />HMIS Agency Agreement Page 5 of 5 Revised 02101108