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NANC 't i'QUTAD MAY 17 2021 N-2021-101 LexisNexis Risk Solutions Government Application & Agreement Poly LL L Ducat) l�� Tr The information submitted on this Application will be used to determine the applicant's eligibility for accessing the services and products of LexisNexis Risk Solutions FL Inc. and its affiliates (hereinafter "LN"). To avoid delay, please provide all information requested. By submitting this Application, the applicant hereby authorizes LN to independently verify the information submitted and perform research about the individuals identified. Acceptance of this Application does not automatically create a business relationship between LN and the applicant. LN reserves the right to reject this Application with or without cause and to request additional information. Applicant acknowledges and understands that LN will only allow applicant access to the LN Services if applicant's credentials can be verified in accordance with LN's internal credentialing procedures. Section I — Agency Information — please .. not use abbreviations Full legal name of agency: Main phone number for address*: Santa Ana Police Department 714-834-4211 *If this is a cell, additional documents may be required If this application is for an additional account, Parent account number: Fax number: 714-245-8606 Physical Address where LN services will be accessed — Previous address if at the current address less than 6 mos: P.O. Box/Mail Drops cannot be accepted (street, city, state, zip): 60 Civic Center Plaza Santa Ana, CA 92701 Website address:. External Agency IP Address (https://www.whatismy[P.com): www.santa-ana.org/pd 98.153,69.210 External Agency IP Range -From: External Agency IP Range —To: .Agency information:.. ❑ Federal Government I ❑ Federal Law Enforcement ❑ Local/Municipal Government ❑ State Government ❑ State Law Enforcement ❑X Local/Municipal Law Enforcement ❑ Other (please explain): 11 — Administrator and Main Contact Information administrators,Section (for additional Product Administrator or Main Contact (first & last name): Title: Boris Duran Police Systems Manager E-Mail Address: Admin IP Address: bduran@santa-ana.org Required for local and municipal agencies: Administrator Home Address (street, city, state, zip): Administrator Date of Birth: Please validate over telephone Section Billing Contact (first & last name):. .check here if same as Administrator ❑X Title: Billing Address (street, city, state, zip): Telephone: PO Box 1981, Santa Ana CA 92701 714-245-8236 E-Mail Address - Sales Tax Exempt: ❑X No ❑ Yes — please provide proof of exemption Do you require a PO number on invoice: ❑X No ❑ Yes If Yes, provide PO Number: Section IV — Business -to -Business Vendor Reference Required for local and municipal agencies: Company Name: Contact: Business Address (street, city, state, zip): Contact Phone Number: E-mail Address: Account Number (if applicable): LNRS Non-FCRA Package-Govt (Q3,18.v1) Confidential Page 1 of 6