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MAYOR <br />Miguel A. Pulido <br />MAYOR PRG TEM <br />Michele Martinez <br />COUNCILMEMBERS <br />P. David Benavides <br />Vicente Sarmiento <br />Jose Solorio <br />Sal TlnaJero <br />Juan Villages <br />CITY OF SANTA ANA <br />FINANCE AND MANAGEMENT SERVICES AGENCY <br />Purchasing Division <br />20 Civic Center Plaza Santa <br />Ana, California 92701 <br />Phone: 714-647-6941 Fax: 714-647-6944 <br />ACTING CITY MANAGER <br />Gerardo Mouet <br />CITY ATTORNEY <br />Sonia R. Carvalho <br />CLERK OF THE COUNCIL <br />Maria D. Huizer <br />The Tax Equity & Fiscal Responsibility Act of 1982 and Backup withholding Regulations of 1983 require <br />us to have a Social Security or Federal Tax Identification Number (TIN) on file for all vendors subject to <br />form 1099 reportable payments. Please print, sign and return this form, along with your completed and <br />signed W-9 (attached). <br />Business Name I Lee G)(i B) rt kSD( <br />DBA (if applicable) <br />Purchase -Prom Address I,,,, r^� <br />_VJ <br />boa) <br />Remit -To Address <br />p ', C�Oc is w4_S PhAA'V ,tai_`, <br />Phone - ...-__ �.,. ._ Fax ._ ffPmymrm Terms _ <br />CQcL.f� .. . _ <br />Its o <br />Email <br />Web Address <br />tov), k e C in a YJ C o ytn <br />Slpru Here <br />Title r <br />(P ax)C (4 <br />