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XII. Agreement <br />I have read the aforementioned Agency Agreement and waiver for use of technology of the LA/OC HM IS, <br />Equipment and Services (ifapplicable), 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 />rr a (Print) <br />Director's Signature <br />Agency Nam <br />? /l b <br />Dai of S' nature <br />Conti um Representative's ame (Print) <br />Continuum Representative's Signature <br />c2rala C?6" <br />Continuum Name <br />/,?,0 / -2- <br />Date of Signature <br />HMIS Agency Agreement Page 5 of 5 Revised 02101108