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W. Agreement <br />I have read the aforementioned Agency Agreement and waiver for use of technology of the LAIOC HMIS, <br />Equipment and Services fifapplwable). and thoroughly understand that this technology is for LAIOC <br />HbGS 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 />CONNIE L JONES <br />Executive piremes Name (Print) <br />,"i Allf(7 ?7D109 <br />Executive Director's sign <br />Aen be-r- k-, I ? I alef <br />Cam Rep+eseatatsv?e s Name (Print) <br />Cantiamm 's & tur+e <br />0 r-d <br />Agency Name <br />JUNE 8, Z012 <br />Date of Signature <br />HMMAgency Agreement <br />C <br />Condmarm Naiiie v <br />//I /2o1Z <br />Date of STtgnstnre <br />Page S of S <br />Revised 02101108 <br />i