HD159073_Addendum_3,_STD213IT.pdf
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- Solicitation number
- 0000001241
- Issued by
- California
About this file
This is a Standard Agreement (STD 213 IT) form between the California Department of Developmental Services (State) and ABC Store, LLC (Contractor), with Agreement Number HD159073, Add. 3 and Purchasing Authority Number DDS-4310. The agreement term runs from June 14, 2016 through June 12, 2017. The document includes several attachments: a Statement of Work (2 pages), Budget Detail and Payment Provisions (1 page), General Provisions for Information Technology, Special Terms and Conditions (9 pages), Statement of Assurances for Protection of Personal Information (HIPAA) (8 pages), and Cloud Computing Special Provisions (5 pages).
This appears to be a sample contract with no specified maximum amount. The agreement incorporates the RFQ and Vendor's response by reference, and additional documents can be viewed at www.dgs.ca.gov/pd/Resources/ModelLanguage.aspx. The contract is being executed between ABC Store, LLC and the Department of Developmental Services, with the state office located at 1600 9th Street, Room 300, MS 3-18, Sacramento, CA 95814.
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Text version
STATE OF CALIFORNIA
STANDARD AGREEMENT
STD. 213 IT (REVISED 08/11) STANDARD AGREEMENT
FOR I.T. GOODS/SERVICES ONLY
REGISTRATION NUMBER
PURCHASING AUTHORITY NUMBER AGREEMENT NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below
STATE AGENCY’S NAME
(hereafter called State)
CONTRACTOR’S NAME
(hereafter called Contractor)
2. The term of this
Agreement is:
3. The maximum amount of this Agreement is: $
4. The parties agree to comply with the terms and conditions of the following attachments which are by this reference made a part of the Agreement:
IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.
CONTRACTOR
CALIFORNIA
Department of General Services Use Only
CONTRACTOR’S NAME (If other than an individual, state whether a corp
BY (Authorized Signature)
PRINTED NAME AND TITLE OF PERSON SIGNING
ADDRESS
STATE OF CALIFORNIA
AGENCY NAME
BY (Authorized Signature)
PRINTED NAME AND TITLE OF PERSON SIGNING
ADDRESS
oration, partnership, etc.)
DATE SIGNED (Do not type)
DATE SIGNED (Do not type)
Exempt per
| RegistrationNumber: |
| PurchAuthorityNum: DDS-4310 |
| AgreementNumber: HD159073, Add. 3 |
| StateAgencyName: Department of Developmental Services |
| ContractorName: ABC Store, Inc. |
| TermsofAgreement: June 14, 2016 or when fully executed through June 12, 2017 |
| MaximumAmount: SAMPLE CONTRACT through |
| AgreetoComply: Exhibit A - Statement of Work 2 page(s) |
Exhibit B - Budget Detail and Payment Provisions 1 page(s) Exhibit B--Attachment 1 - Budget 1 page(s) Exhibit C - General Provisions for Information Technology** GSPD-401IT Exhibit D - Special Terms and Conditions 9 page(s) Exhibit E - Statement of Assurances for Protection of Personal Information (HIPAA) 8 page(s) Cloud Computing Special Provisions** 5 page(s) Items shown with an asterisk (*) are hereby incorporated by reference and are made a part of this agreement as if attached hereto.
These documents can be viewed at www.dgs.ca.gov/pd/Resources/ModelLanguage.aspx RFQ and Vendor's response are hereby incorporated by reference and are made part of this agreement as if attached hereto.
| ContractorName2: ABC Store, LLC |
| Address: |
| AgencyName: Department of Developmental Services |
| PersonSigning: |
| PersonSigning2: Pamela S. Robison |
| Address2: 1600 9th Street, Room 300, MS 3-18, Sacramento, CA 95814 |
File details come from the government source that posted it. Updated .