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Agency is purchasing the following service(s): <br />POLICY MANUAL SUBSCRIPTIONS: <br />Law Enforcement Policy Manual F-1 <br />Custody Policy Manual <br />Fire Policy Manual - includes DTBs <br />Law Enforcement Daily Training Bulletins (DTB) <br />Custody Daily Training Bulletins (CDTB) <br />National Daily Training Bulletins (NDTB) <br />Please complete all fields and place N/A where applicable <br />(Chief/Sheriff Name) (Title) (Chief/Sheriff Email) (Chief/Sheriff Direct Phone) <br />(Custody Facility Manager Name) (Title) (Custody Fac. Mgr Email) (Custody Fac. Mgr Direct Phone) <br />(Name of Agency as you want it to appear on the manual) <br />(Agency Street Address) (City) (State) (Zip Code) (County) <br />(Custody Street Address - If different) (City) (State) (Zip Code) (County) <br />(Billing Address if different from above) (City) (State) (Zip Code) <br />(Agency Phone) (Fax) (Email) <br />(Risk Management Group/Insurance Pool) (Accreditation Agency) <br />(No. of Authorized Sworn Officers) (If Custody - No. of Beds) (Agency Fiscal Year End) (Agency Website) <br />(Policy Primary User Full Name) (Title) (Policy Primary User Phone) (Policy Primary User Email) <br />(Custody Primary User Full Name) (Title) (Custody Primary User Phone) (Custody Primary User Email) <br />(Policy Unique User ID number for system access; 2-5 digits i.e. badge number, employee number) <br />(Custody Unique User ID number for system access; 2-5 digits i.e. badge number, employee number) <br />The subscription agreement is authorized and approved bv: <br />(Name of Authorized Signer) (Title) (Email, Authorized Signer) (Phone, Authorized Signer) <br />Authorized Agency Signature Date <br />Please return all rive (5) pages via fax, email or send to: <br />Fax: 949.484.4443 - Email: contracts(a)lexlool.com <br />Send: Lexipol LLC, 6B Liberty, Suite 200, Aliso Viejo, CA 92656 <br />V05.13.13 <br />Copyright 2013 © Lexipol, LLC 1995-2013 <br />5 <br />25A-17