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RFP, APPENDIX C [CONTRACT, ATTACHMENT G, STATEMENT OF WORK EXHIBITS] COUNTY’S ADMINISTRATION RFP Appendix C, SOW Exhibit B-11 CONTRACT NO. _________________ COUNTY SUPERVISING COUNTY CONTRACT ADMINISTRATOR: Name: _____________________________ __________ Title: _____________________________ Address: 12900 Crossroads Parkway South_ City of Industry, CA 91746-3411 Telephone: (562) 908-xxxx Facsimile: (562) 908-0590 E-Mail Address: ________________________________ COUNTY CONTRACT ADMINISTRATOR: Name: _____________________________ Title: Administrative Services Manager I_____________________________ Address: 12900 Crossroads Parkway South City of Industry, CA 91746-3411 Telephone: (562) 908-xxxx______________________ Facsimile: (562) 908-0590_____ E-Mail Address: ________________________________________________________ COUNTY CONTRACT PROGRAM MONITOR: Name: _____________________________ Title: Contract Program Monitor____________________________ Address: 12900 Crossroads Parkway South City of Industry, CA 91746-3411 Telephone: (562) 908-xxxx____________ Facsimile: (562) 908-0590_____ E-Mail Address: ________________________________________________________ 146
RFP, APPENDIX C [CONTRACT, ATTACHMENT H, STATEMENT OF WORK EXHIBITS] RFP Appendix C, SOW Exhibit B-12 CONTRACTOR’S ADMINISTRATION CONTRACTOR’S NAME: ______________________________________________________________ CONTRACT NO: _______________ CONTRACTOR’S CONTRACT MANAGER: Name: ______________________________________________________________________________ Title: ______________________________________________________________________________ Address: ____________________________________________________________________________ _____________________________________________________________________________________ Telephone: __________________________________Facsimile: ______________ E-Mail Address: _____________________________________________ CONTRACTOR’S AUTHORIZED OFFICIALS 1) Name: _____________________________________________________________________________ Title: _____________________________________________________________________________ Address: ___________________________________________________________________________ ____________________________________________________________________________________ Telephone: __________________________________Facsimile: _______________________ E-Mail Address: _____________________________________________ 2) Name: _____________________________________________________________________________ Title: _____________________________________________________________________________ Address: ____________________________________________________________________________ Telephone:_______________________________________Facsimile: E-Mail Address: __________________________________________ NOTICES TO CONTRACTOR SHALL BE SENT TO THE FOLLOWING: Name: ______________________________________________________________________________ Title: _____________________________________________________________________________ Address: ____________________________________________________________________________ Telephone: Facsimile: ___________________________________________ ___________________________________________ E-Mail Address: __________________________________________ 147
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DEPARTMENT OF PUBLIC SOCIAL SERVICE
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REQUEST FOR PROPOSALS STATEWIDE FIN
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RFP APPENDIX A, SAMPLE CONTRACT STA
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Page 95 and 96: RFP APPENDIX A, SAMPLE CONTRACT STA
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Page 129 and 130: RFP, APPENDIX C [CONTRACT, ATTACHME
Page 135 and 136: SOW Exhibit B-2 RFP, APPENDIX C [CO
Page 137 and 138: RFP Appendix C, RFP, APPENDIX C SOW
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Page 145: RFP, APPENDIX C [CONTRACT, ATTACHME
Page 171 and 172: EXHIBITS APPENDIX D REQUIRED FORMS
Page 173 and 174: APPENDIX D REQUIRED FORMS RFP Appen
Page 175 and 176: APPENDIX D REQUIRED FORMS STATEWIDE
Page 177 and 178: STATEWIDE FINGERPRINT IMAGING SYSTE
Page 179 and 180: RFP Appendix D, Exhibit 7-A Use thi
Page 181 and 182: RFP Appendix D, Exhibit 8 STATEWIDE
Page 183 and 184: RFP Appendix D, Exhibit 10 STATEWID
Page 185 and 186: RFP Appendix D, Exhibit 12 STATEWID
Page 187 and 188: RFP Appendix D, Exhibit 14 Medical
Page 189 and 190: RFP Appendix D, Exhibit 16 COUNTY O
Page 191 and 192: RFP Appendix D, Exhibit 18 Page 1 o
Page 193 and 194: RFP Appendix D, Exhibit 18 Page 3 o
Page 195 and 196: RFP Appendix D, Exhibit 20 TRANSITI
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APPENDIX E TRANSMITTAL FORM TO REQU
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APPENDIX G - 1 NOTICE OF INTENT TO
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APPENDIX H Vendor Name: Solicitatio
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APPENDIX J LISTING OF CONTRACTORS D
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APPENDIX K Page 2 of 5 Title 2 ADMI
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Title 2 ADMINISTRATION DETERMINATIO
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209 APPENDIX L
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APPENDIX N Page 1 of 2 BACKGROUND A
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APPENDIX O Page 1 of 3 Title 2 ADMI
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APPENDIX O Page 3 of 3 Title 2 ADMI
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