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Docusign Envelope ID:3E4F6E0C-EB27-4F7C-B2B2-4415B526D6C8 <br /> EXHIBIT 5 <br /> OR A NGE COUNTY <br /> dC CommunitY Resources <br /> Our Community. Our Commitment. <br /> Reimbursement Policy Status Form <br /> Per OC Community Resources Contract Reimbursement Policy, in regards to the Contract # <br /> listed herein, Contractor is designated with the Documentation Status of Abbreviated unless <br /> Comprehensive is checked below. If the contractor's designation should change to <br /> Abbreviated, a new status form shall be approved. All related documentation requirements <br /> are in full force, until further notice. <br /> Contractor: City of Santa Ana Effective Date: Upon Execution <br /> Contract#: MA-012-24010267 <br /> Documentation Status: ❑ Abbreviated ® Comprehensive <br /> Program Authorization by: Auditor Controller Authorization by: <br /> Nancy Cook Eric Takanishi <br /> Print Name Print Name <br /> o sa sioee cy: <br /> Signed by:riv y Signed by:rfaric t' s(u <br /> Date:1/28/2025 Date:1/29/2025 <br /> Two signatures are required to implement the form. <br /> Distribution: <br /> Contractor <br /> Auditor Controller <br /> Contract File <br /> Program File <br /> Reimbursement Policy Status (RPS-1) <br />