AUTHORIZATION TO ORDER (ATO)
Cellular – Category 19.1
AT and T Mobility and the California Department of Technology (CDT) have entered into a four-year statewide contract for CALNET Cellular Voice and Data Services, C4CVD18, Category 19. The CDT may, at its sole option elect to extend the Contract Term for up to the number of years as indicated in the Contract.
Category/Subcategory: 19.1, CALNET Cellular
Business Services
• Contract award: 05/23/2019
• Contract end: 06/30/2023
• Number of optional extensions and extension duration(s): 2 extensions, 2 years per extension
Pursuant to the Contract C4-CVD-19-001-04, which is incorporated herein by reference, any eligible non-state public entity (herein "Non-State Entity"), as authorized in Government Code section 11541 is allowed to order services and products (collectively "Services") solely as set forth in the Contract.
To establish CALNET eligibility, the Non-State Entity shall be required to have a Non-State Entity Service Policy and Agreement (NESPA) on file with the CDT CALNET Program, prior to submitting this Authorization to Order (ATO).
Once the Non-State Entity and the Contractor approve and sign the ATO, the Contractor shall deliver this ATO to the CALNET Program for review and approval. No Service(s) shall be ordered by the Non-State Entity or provided by the Contractor until both parties and the CALNET Program execute this ATO.
By executing this ATO, the
[Non-State Entity] may subscribe to the Service(s), and the Contractor agrees to provide the Service(s), in accordance with the terms and conditions of this ATO and the Contract. Service catalogs, rates and Contract terms are available at the CALNET Program website.
The ATO, and any resulting order for Service(s), is a contract between the NonState Entity and the Contractor. As such, the CDT will not facilitate, intervene, advocate or escalate any disputes between the Non-State Entity and the Contractor or represent the Non-State Entity in resolution of litigated disputes between the parties.
The ATO shall not exceed the term of the Contract and shall remain in effect for the duration of the contract unless:
• The CDT, at its discretion, revokes the approved ATO; or • The Non-State Entity terminates the ATO, for specific Service(s) in part or in total, prior to termination of the Contract, by providing the Contractor with a 30 calendar days’ prior written notice of cancellation.
The Non-State Entity, upon execution of the ATO, certifies that:
• The Non-State Entity understands that the Contractor and the CDT may, from time to time and without the Non-State Entity’s consent, amend the terms and conditions of the Contract thereby affecting the terms of the service the Non-State Entity receives from the Contractor. • The Non-State Entity has reviewed the terms and conditions, including the rates and charges, of the Contract.
• The Non-State Entity understands and agrees that the Contractor invoices for Service(s) subscribed to under the Contract are subject to review and/or audit by the CDT, pursuant to provisions of the Contract. • All Service(s) ordered under the ATO will be submitted to the Contractor using an authorized purchasing document, signed by the Non-State Entity’s authorized signatory. Any additions, changes to, or deletions of Service(s) shall be accomplished by submission of a purchasing document to the Contractor, noting the changes.
• The Non-State Entity understands and agrees that the Contractor shall provide the CALNET Program all data, invoices, reports and access to trouble tickets for Service(s) subscribed to under the Contract, pursuant to provisions of the Contract. Upon execution of the ATO, the Non-State Entity authorizes the CALNET Contractor to release the Non-State Entity’s Customer Proprietary Network Information (CPNI) to the CALNET Program for purposes of administering the Contract.
• The Non-State Entity understands that, the Contractor shall bill the NonState Entity; and the Non-State Entity shall pay the Contractor according to the terms and conditions, and rates set forth in the Contract for such Service(s).
E-Rate Customers Only – Complete if applying
for E-Rate funding:
(Enter Non-State
Entity name) intends to seek Universal Service Funding (E-Rate) for eligible Service(s) provided under the ATO. The Service(s) ordered under the ATO shall commence MM/DD/YYYY
(“Service Date”). Upon the Service Date, the ATO supersedes and replaces any applicable servicing arrangements between the Contractor and the NonState Agency for the Service(s) ordered under the ATO.
Contact Number:
Email:
IN WITNESS WHEREOF, to the parties below hereto have caused the execution of this ATO. The effective date of this ATO, between the NonState Entity, the Contractor and CDT/CALNET shall be pursuant to the CDT/CALNET “DATE EXECUTED” shown below.
Contractor
A T and T Mobility
Authorized Agent:
Attention:
2700 Watt Avenue, Room 1213
Sacramento, CA 95820
Contact Information
Any notice or demand given under this Contract to the Contractor or the Non-State Entity shall be in writing and addressed to the following:
Non-State Entity
Non-State Entity Name:
Authorized Agent Name:
Title of Authorized Agent:
Attention:
Address:
City, State, Zip Code:
Ken Todd
Contract Program Manager
Contact Number:
916-768-5000
Email:
[email protected]
Non-State Entity
Authorized Agent Name
Title of Authorized Agent
Signature Date Signed
Contractor
Authorized Agent Name
Title of Authorized Agent
Signature Date Signed
Approved By: State of California, Department of
Technology
Authorized Agent Name
Title of Authorized Agent
Signature Date Executed
_________________________________________
_________________________________________
_________________________________________
CALNET Program Analyst
CALNET
AUTHORIZATION TO ORDER (ATO)
AT&T Corp. and the California Department of Technology (CDT) have entered into a five-year statewide contract for CALNET IFB C4DNCS19, Data Networks and Communications Services, Categories 20, 21, 22, 23, 24, 25, 27, 28, 29 and
30. The CDT may, at its sole option elect to extend the Contract Term for up to the number of years as indicated in the Contract.
Category: 20, MPLS Data Network Services
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 21, Standalone VoIP Services
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 22, Cloud Hosted VoIP Services
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 23, Metropolitan Area Network (MAN)
Ethernet Services and Features
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 24, Flat Rate Internet Services
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 25, Sustained Bandwidth Internet
Services and Features
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 27, Standard Contact Center Services
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 28, Custom Contact Center Services
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 29, Converged VoIP Services
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category: 30, Broadband with Internet Services
• Contract award: 04/15/2020
• Contract end: 06/30/2025
• Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Pursuant to the Contract C4-DNCS-19-001-40, which is incorporated herein by reference, any eligible non-state public entity (herein "Non-State Entity"), as authorized in Government Code section 11541 is allowed to order services and products (collectively "Services") solely as set forth in the Contract.
To establish CALNET eligibility, the Non-State Entity shall be required to have a Non-State Entity Service Policy and Agreement (NESPA) on file with the CDT CALNET Program, prior to submitting this Authorization to Order (ATO).
Once the Non-State Entity and the Contractor approve and sign the ATO, the Contractor shall deliver this ATO to the CALNET Program for review and approval. No Service(s) shall be ordered by the Non-State Entity or provided by the Contractor until both parties and the CALNET Program execute this ATO.
By executing this ATO, the
[Non-State Entity] may subscribe to the Service(s), and the Contractor agrees to provide the Service(s), in accordance with the terms and conditions of this ATO and the Contract. Service catalogs, rates and Contract terms are available at the CALNET Program website.
The ATO, and any resulting order for Service(s), is a contract between the NonState Entity and the Contractor. As such, the CDT will not facilitate, intervene, advocate or escalate any disputes between the Non-State Entity and the Contractor or represent the Non-State Entity in resolution of litigated disputes between the parties.
The ATO shall not exceed the term of the Contract and shall remain in effect for the duration of the contract unless:
• The CDT, at its discretion, revokes the approved ATO; or • The Non-State Entity terminates the ATO, for specific Service(s) in part or in total, prior to termination of the Contract, by providing the Contractor with a 30 calendar days’ prior written notice of cancellation.
The Non-State Entity, upon execution of the ATO, certifies that:
• The Non-State Entity understands that the Contractor and the CDT may, from time to time and without the Non-State Entity’s consent, amend the terms and conditions of the Contract thereby affecting the terms of the service the Non-State Entity receives from the Contractor. • The Non-State Entity has reviewed the terms and conditions, including the rates and charges, of the Contract.
• The Non-State Entity understands and agrees that the Contractor invoices for Service(s) subscribed to under the Contract are subject to review and/or audit by the CDT, pursuant to provisions of the Contract. • All Service(s) ordered under the ATO will be submitted to the Contractor using an authorized purchasing document, signed by the Non-State Entity’s authorized signatory. Any additions, changes to, or deletions of Service(s) shall be accomplished by submission of a purchasing document to the Contractor, noting the changes.
• The Non-State Entity understands and agrees that the Contractor shall provide the CALNET Program all data, invoices, reports and access to trouble tickets for Service(s) subscribed to under the Contract, pursuant to provisions of the Contract. Upon execution of the ATO, the Non-State Entity authorizes the CALNET Contractor to release the Non-State Entity’s Customer Proprietary Network Information (CPNI) to the CALNET Program for purposes of administering the Contract.
• The Non-State Entity understands that, the Contractor shall bill the NonState Entity; and the Non-State Entity shall pay the Contractor according to the terms and conditions, and rates set forth in the Contract for such Service(s).
E-Rate Customers Only – Complete if applying
for E-Rate funding:
(Enter Non-State Entity
name) intends to seek Universal Service Funding (E-Rate) for eligible Service(s) provided under the ATO. The Service(s) ordered under the ATO shall commence MM/DD/YYYY
(“Service Date”). Upon the Service Date, the ATO supersedes and replaces any applicable servicing arrangements between the Contractor and the NonState Agency for the Service(s) ordered under the ATO.
Contact Information
Any notice or demand given under this Contract to the Contractor or the NonState Entity shall be in writing and addressed to the following:
Non-State Entity
Non-State Entity Name
Authorized Agent
Title of Authorized Agent
Address
City, State, Zip Code
Contact Number
Email
Contact Number:
Email:
IN WITNESS WHEREOF, the parties below hereto have caused the execution of this ATO. The effective date of this ATO, between the Non-State Entity, the Contractor and CDT/CALNET shall be pursuant to the CDT/CALNET “DATE EXECUTED” shown below.
Non-State Entity
Authorized Agent Name
Date Signed
Title of Authorized Agent
Signature
Contractor
Authorized Agent Name
Title of Authorized Agent
Signature Date Signed
Approved By: State of California, Department of
Technology
Authorized Agent Name
Title of Authorized Agent
Signature Date Executed
_________________________________________
_________________________________________
_________________________________________
Contractor
AT&T Corporation
Authorized Agent : Keith Nagel
Attention: Program Management Office
Address: 2700 Watt Avenue
Room 1213
Sacramento, CA 95821
916-384-6175
[email protected]
CALNET Program Analyst
CALNET
AUTHORIZATION TO ORDER (ATO)
AT&T Corp and the California Department of Technology (CDT) have entered into a multi-year statewide contract for CALNET Legacy Telecommunications Voice and Data Services, C4A1LEG18, Categories 15, 16, 17, and 18. The CDT may, at its sole option elect to extend the Contract Term for up to the number of years as indicated in the Contract.
Category 15, Dedicated Transport:
· Contract award: 01/03/2019
· Contract end: 01/02/2026
· Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category 15.2.2, Carrier DSO Service: · Contract award: 01/03/2019 · Contract end: 01/02/2022
· Number of optional extensions and extension duration(s): 2 extensions, 1 year per extension
Category 16, Long Distance Calling:
· Contract award: 01/03/2019
· Contract end: 01/02/2024
· Number of optional extensions and extension duration(s): 5 extensions, 1 year per extension
Category 17, Toll Free Voice Calling: · Contract award: 01/03/2019 · Contract end: 01/02/2024
· Number of optional extensions and extension duration(s): 5 extensions, 1 year per extension
Category 18, Legacy Telecommunications:
· Contract award: 01/03/2019
· Contract end: 01/02/2026
· Number of optional extensions and extension duration(s): 3 extensions, 1 year per extension
Category 18.3.1.1, Analog Service: · Contract award: 01/03/2019 · Contract end: 01/02/2022
· Number of optional extensions and extension duration(s): 2 extensions, 1 year per extension
Pursuant to the Contract C4-LEG-12-10-TS-01, which is incorporated herein by reference, any eligible on-state public entity (herein "Non-State Entity"), as authorized in Government Code section 11541 is allowed to order services and products (collectively "Services") solely as set forth in the Contract.
To establish CALNET eligibility, the Non-State Entity will be required to have a Non-State Entity Service Policy and Agreement (NESPA) on file with the CDT CALNET Program, prior to submitting the Authorization to Order (ATO).
Once the Non-State Entity and the Contractor approve and sign the ATO, the Contractor shall deliver the ATO to the CALNET Program for review and approval. No Service(s) shall be ordered by the Non-State Entity or provided by the Contractor until both parties and the CALNET Program execute the ATO.
By executing the ATO, the
[Non-State Entity] may subscribe to the Service(s), and the Contractor agrees to provide the Service(s), in accordance with the terms and conditions of the ATO and the Contract. Service catalogs, rates and Contract terms are available at the CALNET Program website.
The ATO, and any resulting order for Service(s), is a contract between the NonState Entity and the Contractor. As such, the CDT will not facilitate, intervene, advocate or escalate any disputes between the Non-State Entity and the Contractor or represent the Non-State Entity in resolution of litigated disputes between the parties.
The ATO shall not exceed the term of the Contract and shall remain in effect for the duration of the contract unless:
· The CDT, at its discretion, revokes the approved ATO; or · The Non-State Entity terminates the ATO, for specific Services(s) in part or in total, prior to termination of the Contract, by providing the Contractor with a 30 calendar days’ prior written notice of cancellation.
The Non-State Entity, upon execution of the ATO, certifies that:
· The Non-State Entity understands that the Contractor and the CDT may, from time to time and without the Non-State Entity’s consent, amend the terms and conditions of the Contract thereby affecting the terms of service the Non-State Entity receives from the Contractor. · The Non-State Entity has reviewed the terms and conditions, including the rates and charges, of the Contract.
· The Non-State Entity understands and agrees that the Contractor invoices for Service(s) subscribed to under the Contract are subject to review and/or audit by the CDT, pursuant to provisions of the Contract. · All Service(s) ordered under the ATO will be submitted to the Contractor using an authorized purchasing document, signed by the Non-State Entity’s authorized signatory. Any additions, changes to, or deletions of Service(s) shall be accomplished by submission of a purchasing document to the Contractor, noting the changes.
· The Non-State Entity understands and agrees that the Contractor shall provide the CALNET Program all data, invoices, reports and access to trouble tickets for Service(s) subscribed to under the Contract, pursuant to provisions of the Contract. Upon execution of the ATO, the Non-State Entity authorizes the CALNET Contractor to release the Non-State Entity’s Customer Proprietary Network Information (CPNI) to the CALNET Program for purposes of administering the Contract.
· The Non-State Entity understands that, the Contractor shall bill the NonState Entity, and the Non-State Entity shall pay the Contractor according to the terms and conditions, and rates set forth in the Contract for such Service(s).
E-Rate Customers Only – Complete if applying
for E-Rate funding:
[Enter Non-State Entity
name] intends to seek Universal Service Funding (E-Rate) for eligible Service(s) provided under the ATO. The Service(s) ordered under the ATO shall commence [MM/DD/YYYY]
(“Service Date”). Upon the Service Date, the ATO supersedes and replaces any applicable servicing arrangements between the Contractor and the NonState Agency for the Service(s) ordered under the ATO.
Contact Information
Any notice or demand given under this Contract to the Contractor or the NonState Entity shall be in writing and addressed to the following:
Non-State Entity
Non-State Entity Name
Authorized Agent
Title of Authorized Agent
Address
City, State, Zip Code
Contact Number
Email
IN WITNESS WHEREOF, the parties below hereto have caused the execution of this ATO. The effective date of this ATO, between the Non-State Entity, the Contractor and CDT/CALNET shall be pursuant to the CDT/CALNET “DATE EXECUTED” shown below.
Non-State Entity
Date Signed
Authorized Agent Name
Contractor
Date Signed
Date Executed
Contractor
AT&T Corporation
Authorized Agent : Keith Nagel
Attention: Program Management Office
Address: 2700 Watt Avenue
Room 1213
Sacramento, CA 95821
Contact Number:
916-384-6175
Email:
[email protected]
Title of Authorized Agent
Signature
_________________________________________
Authorized Agent Name
Title of Authorized Agent
Signature
__________________________________________
Approved By: State of California Department of
Technology
Authorized Agent Name
Title of Authorized Agent
Signature
_________________________________________
CALNET Program Analyst
AUTHORIZATION TO ORDER (ATO)
FIRSTNET – BROADBAND FOR PUBLIC
SAFETY
AT&T and the California Department of Technology (CDT) have entered into a five year statewide contract for FirstNet – Broadband for Public Safety Contract C3A2FN9-18, Category 9.1. The CDT may, at its sole option elect to extend the Contract Term for up to the number of years as indicated in the Contract.
Category 9.1 – FirstNet – Broadband for Public
Safety
• Contract award: 10/22/2018
• Contract end: 10/21/2023
• Number of optional extensions and extension duration(s): 2 extensions, 1 year per extension
Pursuant to Contract Number C3A2FN9-18, which is incorporated herein by reference, any 100% tax supported non-state Public Safety Entity (herein “NonState PSE”), as recognized by the First Responder Network Authority (FirstNet Authority), approved by California Governor’s Office of Emergency Services (Cal OES) and authenticated by AT&T as an authorized Non-State PSE, may order services and products (collectively "Services") solely as set forth in the Contract.
All Non-State PSE’s who are 100% tax supported must complete a Non-State Entity Service Policy and Agreement (NESPA) prior to completing and submitting this FirstNet Authorization to Order (ATO). The California Department of Technology, California Network and Telecommunications (CALNET) Program must approve both documents prior to Non-State PSEs ordering Services. NonState PSEs who are not 100% tax supported and do not qualify under the NESPA must obtain approval from Cal OES.
In the event of an emergency, as defined within this Contract, Non-State PSEs may order the Services and submit this ATO as soon as feasible after Services are provided.
The ATO shall become effective upon execution by the Non-State PSE, Contractor, and CDT. No Service(s) shall be ordered by Non-State PSE or
provided by Contractor until this ATO has been executed by both parties and CDT (except as provided herein for emergencies).
By executing the ATO, the
(Non-State PSE) may subscribe to the Service(s), and the Contractor agrees to provide the Service(s), in accordance with the terms and conditions of this ATO and the Contract. Service, catalogs, rates and Contract terms are available at CALNET Program website.
The ATO, and any resulting order for Service(s), is a contract between the NonState PSE and the Contractor. As such, the CDT will not facilitate, intervene, advocate or escalate any disputes between the Non-State PSE and the Contractor or represent the Non-State PSE in resolution of litigated disputes between the parties.
This ATO shall not exceed the term of the Contract and shall remain in effect for the duration of the contract unless:
• THE CDT, AT ITS DISCRETION, REVOKES THE APPROVED ATO; OR
THE NON-STATE PSE TERMINATES THE ATO, FOR SPECIFIC SERVICE(S) IN PART
OR IN TOTAL, PRIOR TO TERMINATION OF THE CONTRACT, BY PROVIDING THE CONTRACTOR WITH A 30 CALENDAR DAYS’ PRIOR WRITTEN NOTICE OF CANCELLATION.
THE NON-STATE PSE, UPON EXECUTION OF THE ATO, CERTIFIES THAT:
• THE NON-STATE PSE UNDERSTANDS THAT THE CONTRACTOR AND THE CDT MAY, FROM TIME TO TIME AND WITHOUT THE NON-STATE PSE’S CONSENT,
AMEND THE TERMS AND CONDITIONS OF THE CONTRACT THEREBY
AFFECTING THE TERMS OF SERVICE THE NON-STATE PSE RECEIVES FROM THE CONTRACTORS;
• THE NON-STATE PSE HAS REVIEWED THE TERMS AND CONDITIONS, INCLUDING THE RATES AND CHARGES, OF THE CONTRACT;
• THE NON-STATE PSE, UNDERSTANDS AND AGREES THAT CONTRACTOR
INVOICES FOR SERVICE(S) SUBSCRIBED TO UNDER THE CONTRACT ARE
SUBJECT TO REVIEW AND/OR AUDIT BY THE CDT, PURSUANT TO PROVISIONS OF THE CONTRACT;
• All Service(s) ordered under the ATO will be submitted to the Contractor using an authorized purchasing document, signed by the Non-State PSE’s authorized signatory. Any additions, changes to, or deletions of Service(s) shall be accomplished by submission of a purchasing document to the Contractor, noting the changes;
• THE NON-STATE PSE UNDERSTANDS AND AGREES THAT THE CONTRACTOR
SHALL PROVIDE THE CALNET PROGRAM ALL DATA, INVOICES, REPORTS
AND ACCESS TO TROUBLE TICKETS FOR SERVICE(S) SUBSCRIBED TO UNDER THE CONTRACT, PURSUANT TO PROVISIONS OF THE CONTRACT. UPON
EXECUTION OF THE ATO, THE NON-STATE PSE AUTHORIZES THE CALNET CONTRACTOR TO RELEASE THE NON-STATE PSE’S CUSTOMER PROPRIETARY
NETWORK INFORMATION (CPNI) TO THE CALNET PROGRAM FOR PURPOSES OF ADMINISTERING THE CONTRACT; AND
• THE NON-STATE PSE UNDERSTANDS THAT, THE CONTRACTOR SHALL BILL THE
NON-STATE PSE, AND THE NON-STATE PSE SHALL PAY THE CONTRACTOR
ACCORDING TO THE TERMS AND CONDITIONS, AND RATES SET FORTH IN THE CONTRACT FOR SUCH SERVICE(S).
Contact Information
Any notice or demand given under this Contract to the Contractor or the NonState PSE shall be in writing and addressed to the following:
Contact Number : 916-768-5000
Email: [email protected]
North American Industry Classification System Code (NAICS) NAICS Industry Title
North American Industry Classification System Code (NAICS) NAICS Industry Title
AT&T
Authorized Agent: Ken Todd
Attention: Contract Program Manager
2700 Watt Avenue
Sacramento, CA 95821
Non-State PSE
Contractor
North American Industry Classification System Code (NAICS) NAICS Industry Title
North American Industry Classification System Code (NAICS) NAICS Industry Title
Emergency Services PSE Name Requesting
Support
Address
City, State, Zip Code
Contact Number
Email:
Support Function and Incident (if known)
Alternate Non-State PSE Contact
Name
Title
Phone Email
Name
Title
IN WITNESS WHEREOF, the parties below hereto have caused the execution of this ATO.
The effective date of this ATO, between the Non-State PSE, the Contractor, and CDT/CALNET shall be pursuant to the CDT/CALNET “DATE EXECUTED” shown below.
Non-State PSE
Authorized Agent Name
Title of Authorized Agent
Signature
_____________________________________________
Date Signed
Contractor
Authorized Agent Name
Title of Authorized Agent
Signature
_____________________________________________
Date Signed
Approved By: State of California Department of
Technology
Authorized Agent Name
Title of Authorized Agent
Signature
Date Executed
_________________________________________
CALNET Program Analyst
DEPARTMENT OF TECHNOLOGY
NON-STATE ENTITY SERVICE POLICY AND AGREEMENT (NESPA)
Revised 03/12/20
The California Network and Telecommunications Program (CALNET) service offerings are primarily intended to meet State entity requirements. However, CALNET services may be purchased by qualified non-State entities. To use the CALNET next generation of contracts, non-State entities are required to self-certify that their organization qualifies for one of the CALNET eligibility criteria below.
Authorized Entity Criteria
☐ Local government entities are defined as “any city, county, city and county, district or other governmental body empowered to expend public funds for the acquisition of goods” per Public Contract Code Chapter 2, Paragraph 10298 (a) (b). While the State makes this contract available to local governmental entities, each local governmental entity should determine whether this contract is consistent with its procurement policies and regulations.
☐ Entirely 100% tax supported entity
☐ A governmental entity with a Joint Powers Agreement (JPA) ☐ Federally recognized Indian Tribe
NON-STATE ENTITY INFORMATION
REQUESTING NON-STATE ENTITY ORGANIZATION NAME
NAME AND TITLE OF AUTHORIZED REPRESENTATIVE SIGNING ON BEHALF OF NON-STATE ENTITY
STREET ADDRESS
CITY, STATE, ZIP CODE
CONTACT PHONE NUMBER
EMAIL ADDRESS
I certify under penalty of perjury the requesting entity meets the NESPA “Authorized Entity Criteria” selected above.
__________________________________________________________________________
NON-STATE ENTITY SIGNATURE DATE
CDT/CALNET PROGRAM
CUSTOMER CODE:
Please select one of the following: