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OC MENTAL HEALTH (4) - 2015
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OC MENTAL HEALTH (4) - 2015
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Last modified
9/22/2015 3:49:18 PM
Creation date
9/21/2015 4:14:12 PM
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Contracts
Company Name
OC MENTAL HEALTH
Contract #
A-2015-060-06
Agency
COMMUNITY DEVELOPMENT
Council Approval Date
4/21/2015
Expiration Date
6/30/2016
Insurance Exp Date
7/1/2016
Destruction Year
2021
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X11. Agreetnent <br />I have read the aforementioned Agency Agreement and waiver For use of technology of the LA/OC HMIS, <br />Equipment and Services (lfapplicahle), 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 />Executive shame ring <br />Exec i r or' s/Signaatttuur�e� / <br />Agenc�Name <br />;3 /);7 <br />Date of Signature <br />I'jl <br />COC <br />Confi rum ame <br />Date o:(� %�'° <br />NMISRgency Agreement Page 5of5 Revised 02 101108 <br />
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