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Attachment - S4 <br /> S~ OF ,,,i <br /> ~ STATE OF HAWAII <br /> . <br /> ~ CERTIFICATE OF EXEMPTION <br /> a <br /> `a°°"'~ FROM CIVIL SERVICE <br /> I. By Heads of Departments or Agencies as Delegated by the Director of the Department of <br /> Human Resources Development ("DHRD").* <br /> Pursuant to a delegation of the authority by the Director of DHRD, I certify that the services to <br /> be provided under this Contract, and the person(s) providing the services under this Contract are exempt <br /> from the civil service, pursuant to § 76-16, Hawaii Revised Statutes (HRS). <br /> (Si~ature) (Date) <br /> REX D. JOHNSON <br /> (Print Name) <br /> PRESIDENT & CEO <br /> (Print Title) <br /> ' This part of the form may be used by all department heads and others to whom the Director of DHRD has delegated <br /> authority to certify § 76-16, HRS, civil service exemptions. The specific paragraph(s) of § 76-16, HRS, upon which an <br /> exemption is based should be noted in the contract file. NOTE: Authority to certify exemptions under §§76-16(6)(2), 76- <br /> 16(6)(12), and 76-16(6)(15), HRS, has not been delegated; only the Director of DHRD may certify §§76-16(6)(2), 76- <br /> 16(6)(12), and 76-16(6)(15) exemptions. <br /> 2. By the Director of DHRD, State of Hawaii. <br /> I certify that the services to be provided under this Contract, and the person(s) providing the <br /> services under this Contract are exempt from the civil service, pursuant to §76-16, HRS. <br /> (SignaNre) (Date) <br /> (PnN Name) <br /> (Print Title, if designee o[the Diaaor of DHRll) <br /> <br /> A(i-014 Rcv IVG/2005 1 <br /> <br />