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<br />Agreement #W7 -GJC-1 0 <br />City of Santa Ana <br /> <br />Exhibit I <br />DISTRICT ATTORNEY <br />CHILD SUPPORT ENFORCEMENT CERTIFICATE REQUIREMENTS <br /> <br />In order to comply with child support enforcement requirements of the County of Orange, the required <br />contractor data and certifications must be submitted within 10 days of award notification. <br /> <br />Failure of the contractor to submit the data/or certifications required shall result in the contractor may be <br />disqualified from being considered for contract award. Subsequent to issuance of the contract, failure to <br />comply with all federal and state reporting requirements for child support enforcement or to comply with all <br />lawfully served Wage and Earning Assignment shall constitute a material breach of the contract. Failure to <br />cure breach within 60 calendar days of notice from the County shall constitute grounds for termination. <br /> <br />A. In the case of an individual bidder/proposer, his/her name, date of birth, Social Security number, <br />and residence address: <br /> <br />Name: <br />O.O.B.: <br />Residence Address: <br /> <br />Social Security No: <br /> <br />B. In the case of a bidder/proposer doing business other than as an individual, the name, date of birth, <br />Social Security number, and residence address of each individual who owns an interest of 10 percent <br />or more in the contracting entity (If no individual owns an interest of 10 percent or more, indicate not <br />applicable.): <br /> <br />Name: <br />O.O.B.: <br />Residence Address: <br /> <br />Not Al?plica.G19 <br />Social Security No: <br /> <br />Name: <br />O.O.B.: <br />Residence Address: <br /> <br />Social Security No: <br /> <br />Name: <br />O.O.B.: <br />Residence Address: <br /> <br />Social Security No: <br /> <br />Exhibit I - Page 1 of 2 <br /> <br />WIA Cost Reimbursement Agreement - Green Jobs Corps <br />