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