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25D - AGMT - SEXUAL ASSAULT EXAMS
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01/15/2019
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25D - AGMT - SEXUAL ASSAULT EXAMS
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Last modified
1/10/2019 6:42:48 PM
Creation date
1/10/2019 6:34:39 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Police
Item #
25D
Date
1/15/2019
Destruction Year
2024
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Exhibit B <br />UCI CAST MEDICAL UNIT <br />401 THE CITY DRIVE <br />TEL714-935-8456 UC Irvine Health <br />it <br />FAx714-935-7796 <br />INVOICE #:1115. 10.2.2017 <br />BIU. TO <br />TERMS: PAYMENT DUE 30 DAYS FROM INVOICE DATE <br />SANTA ANA POLICE DEPARTMENT <br />MAKE CHECKS PAYABLE To: UC REGENTS <br />60 CHIC CENTER PIZ <br />1. <br />SANTA ANA, CA 92701 <br />MAIL PAYMENTTO: <br />16-28196 <br />UC IRVINE PEMATRICSATM: FINANCES DEPARTMENT <br />2. <br />333 Cm Sivn, WEST SURE 800 <br />Non -Acute <br />ORANGE, CA 92868 <br />25D-15 <br />DATE OF EXAM <br />EXAM TYPE <br />POLICE DR # <br />AMOUNT <br />1. <br />1/18/2017 <br />Non -Acute <br />16-28196 <br />$650.06 <br />2. <br />2108/2017 <br />Non -Acute <br />17-03566 <br />$650.00 <br />3. <br />2/1012017 <br />Non -Acute <br />17-03775 <br />$650.00 <br />4. <br />2/23/2017 <br />Acute <br />17-04504 <br />$800.00 <br />5. <br />3/09/2017 <br />Non -Acute <br />17-03941 <br />$650.00 <br />6. <br />3/23/2017 <br />Non -Acute <br />17-07568 <br />$650.00 <br />7. <br />3/23/2017 <br />ACUTE <br />17-07814 <br />$800.00 <br />8. <br />6/01/2017 <br />NON-ACUTE <br />17-12906 <br />$650.00 <br />9. <br />7/07/2017 <br />.ACUTE <br />17-18376 <br />$800.00 <br />TOTALAMOUNT DUE BY <br />11.1.2017 <br />$6,300.00 <br />25D-15 <br />
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