Agmt11 Ca. Department of Public Health- Project LEAN

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Sta�e of Califomia— Healih anC Human Services Agency � Califwnia Departmenl of Publlc Heal�h Exhibit F Contractor's Release Instructions to Contractor: With final invoice(s) submit one (1) original and one (1) copy. The original must bear the original signature of a person authorized to bind the Contractor. The additional copy may bear photocopied signatures. Submission of Final invoice Pursuant to contract number entered into between the State of California Department of Public Health (CDPH) and the Contractor (identifed below), the Contractor does acknowledge that final payment has been requested via invoice number(s) , in the amount(s) of $ and dated If necessary, enter "See Attached" in the appropriate blocks and attach a list of invoice numbers, dollar amounts and invoice dates. Release of all Obligations By signing this form, and upon receipt of tFe amount specified in the invoice number(s) referenced above, the Contractor does hereby release and discharge the State, its offcers, agents and employees of and from any and all liabilities, obligations, claims, and � demands whatsoever arising from the above referenced contract. Repayments Due to Audit Exceptions I Record Retention By signing this form, Contractor acknowledges that expenses authorized for reimbursement does not guarantee final allowability of said expenses. Contractor agrees that the amount of any sustained audit exceptions resulting from any subsequent audit made after final payment will be refunded to the State. � � All expense and accounting recurds related to fhe above referenced contract must be maintained for audit purposes for no less than three yeais beyond the data of final payment, un!ess a longer term is stated in said contract � Recycled Product Use Certification � By signing this form, Contractor certifies under penalty of peryury that a minimum of 0% unless otherwise specified in writing of post consumer material, as defined in the Public Contract Code Sedion 12200, in products, materials, goods, or supplies offered or sold to the State regardless of whether it meets the requirements of Public Contract Code Section 12209. Contractor specifies that . printer or duplication cartridges offered or sold ro the State comply with the requirements of Section 12156(e). � Reminder to Return State EquipmenUProperty (If Applicable) (Appiies only if equipment was provided by CDPN or purchased with or reimbursed by contract funds) Unless CDPH has approved the continued use and possession of State equipment (as defined in the above referenced contract) for use in connection with another CDPH agreement, Contractor agrees to promptly initiate arrangements to account for and return said equipment to CDPH, at CDPH's expense, if said equipment has not passed its useful life expectancy as defned in the above referenced contract . Patents / Other Issues By signing this form, Contractor further agrees, in connection with patent matters and with any claims that are not specifically released as set forth above, that it will comply with all of the provisions contained in the above referenced contract, including, but not limited to, those provisions relating to notification to the State and related to the defense or prosecution of litigation. � ONLY SIGN AND DATE THIS DOCUMENT WHEN ATTACHING TO THE FINAL INVOICE Contrector's Legal Name (as on comract�: Signature of Contractor or Official Designee: Date: Printed Name/Title of Person Signing: CDPH Distribution: Accounting (Original) Program . � . CDPH2352(7I07) �