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.71/1INW44AI./ 1AVICCGIY1C1Y1 — ATTORNEY GENERAL ❑ STATE AGENCY <br />STATE OF CALIFORNIA / ❑ DEPT. OF GEN. SER. <br />BTD. 2 )REV. 2/851 �I <br />❑ CONTROLLER <br />THIS AGREEMENT. made and entered into this 16th date of March I9 87 ❑ <br />in the State of California. by and between State of California. through its duly elected or appointed, ❑ <br />(plalified and acting ❑ <br />TITLE OF OFFICER ACTING FOR STATE AGENCY Ierealter called fit,- State. and CONTRACT NUMBERSA AM. NO. <br />State Architect Office of the State Architect <br />herraJter caller) the Contractor. CONTRACTOR'S I.D. NUMBER <br />Contractor Name and Address <br />WITNESSETH: That the Contractor for and in consideration of the covenants, conditions, agreements, and stipulations of the State <br />hereinafter expressed, does hereby agree to furnish to the State services and materials, as follows: <br />(Sef forth .wrvuc m be rendered by Contractor. amount to lie paid Contractor, time for perfortnance or completion. and attach plans and vpecificationx. If any.) <br />I. The Contractor shall obtain and pay for all the necessary permits required to <br />remove two (2) underground storage tanks, one (1) 1,000 gallon regular and one <br />(1) 2,000 gallon diesel, located at the California Department of Correction, <br />Development Vocational Institute, 23500 Kasson Road, Tracy, CA 95376. <br />2. The Contractor shall provide the State with an approved copy of the tank removal <br />application as submitted to the local authorities. <br />3. The Contractor shall also provide the State with a receipt from the firm <br />receiving the tank verifying that the tank has reached its destination in <br />compliance with the tank removal application. <br />4. Attachment 1, "General Conditions - Short Form", and "Nondiscrimination" are <br />included as a part of this contract. <br />CONTINUED ON —SHEETS, EACH BEARING NAME OF CONTRACTOR AND CONTRACT NUMBER. <br />The provisions on the reverse side hereof constitute a part of this agreement. <br />IN WITNESS W1II:BEOF, this agreement has been executed by the parties hereto, upon the date first above written. <br />STATE OF CALIFORNIA <br />CONTRACTOR <br />AGENCY <br />CONTRACTOR (I. OTHER THAN AN INDIVIDUAL STATE WHETHER A CORPORATION. <br />PARTNERSHIP. ETC.) <br />Office of the State Architect <br />Contractor <br />BY OUTHORIZED SIGNATURE) <br />BY (AUTHORIZED SIGNATURE) <br />X <br />X <br />PRINTED NAME OF PERSON SIGNING <br />PRINTED NAME AND TITLE OF PERSON SIGNING 1 <br />Contact Person <br />TITLE <br />AOOREss Address <br />State Architect <br />Citv <br />AMOUNT ENCUMBERED <br />PROGRAM/CATEGORY (CODE AND TITLE) <br />FUND TITLE <br />S <br />Under round Storage <br />Tank <br />Department of General Services <br />Use Only <br />UNENCUMBERED BALANCE <br />(OPTIONAL USE) <br />S <br />ADJ. INCREASING ENCUMBRANCE <br />ITEM <br />CHAPTER <br />STATUTE <br />FISCAL YEAR <br />ADJ. DECREASING ENCUMBRANCE <br />OBJECT OF EXPENDITURE (CODE AND TITLE) <br />S 11 <br />GN7 8.6.02.2.60.03 <br />1 114'R'hyr'('rtifrl IIIIOn roy ijo n iirrvonal knowledge Ihat hllrlgetl'(I fllli(Is etre <br />T.B.A. NO. <br />B.R. NO. <br />arailnhlrfur Ihr periodandpurlloxe of the eXpeodhorr 11111, alxrza'. <br />SIGNATURE OF ACCOUNTING OFFICER <br />DATE <br />X <br />Ilu rl'$y r'ertify that all ran(liliuns for exeniption set forth in Slate :Idrninivtrant <br />r.11nrival Section 1201) hare <br />Awn I( ... ip ied it id, and this do(unient Is exrrrllit from rrrirm by <br />the Drpartrnrnf of Finanrr. <br />SIGNATURE OF OFFICER SIGNING ON BEHALF OF THE AGENCY <br />DATE <br />X <br />1 11 <br />