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COUNTY OF SAN MATEO Exhibit "A" ~~~~ <br />AGREEMENT WITH INDEPENDENT CONTRACTOR Agreement No. <br />Agreement between the County of San Mateo and City of Redwood City/Fair Oaks Community Center <br />Use Additional Sheets as Necessary <br />I. Description of Services to be Performed by the Contractor <br />See Exhibit Al -Program/Project Description <br />II. Amount and Method of Payment <br />See Exhibit B -Method and Rate of Payment <br />III. Other Exhibits and Attachments <br />Attachment H -Health Insurance Portability and Accountability Act (HIPAA) <br />Attachment I -Contractor's Declaration Form <br />Contractor agrees that the requirements of this Agreement pertaining to the protection of proprietary rights and confidentiality shall survive <br />termination of this Agreement. <br />~ ~ <br />Contractor's Signature Date Contractor's Name Date <br />(Please Print) <br />Depart ent or Division Head Date Department or Division Head Name Date <br />(Please Print) <br />3 ~ <br />Purcha ' Coun San Mateo Dat <br />Budget Unit <br />/% ~ - n <br />1 <br />', l f <br />Attest: <br />Patricia Hoy , CI y I <br />Revised 6/03 <br />Distribution - 1 copy to each: Purchasing Agent, County Manager's Office, Controller, Contractor and Department <br />