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CJTY OF SANTA ANA <br />C <br />Phone N,amber -1 x ) 7 --k S - <br />711EMAIL_ S��q J D' <br />Comb a Amount V VJ% fir= •wry ` .; <br />C i fiorr of 5upOlm equipment_ or serA� provided; <br />Gca mr Name:-r� <br />Aness:i . .+ Phone Number. -7 � y <br />C ortitrac# T1 1! Cz nAvwx <br />2-0 V - <br />Deseripticn of suppler. aqu3Pment, or services provided: <br />REFEREbI ,rti; wk ' -D n <br />LCL7 -dsiduCu t n l <br />IrIrsss� Vs {= r'_Phone Number -7 l <br />12) �tCOLS � <br />t Amount:_ ear <br />DE9= p4iion c�. 5v pl,les, equipment, or wxvbGW pr ded= <br />f`M. 'te a-. t c - <br />THIS F5R5ll MkjST BE CG'tVFP1 n Am) LP&IODED E -PRONOWL- <br />AT7ACHMF-1'4T C <br />PROPOSER'S STATEMEN'i• <br />pRopOSALS THAT Do NOT CONTArN TFEIS FORM MLL EE COKLM£RED POONRESP0NSEE- — <br />fi nds and ogres t1at tn�,. written RF!p (oF and+ ?art thoreof apWri aih} de5sg-1;3tGd ano <br />aumptad by tte City of Santl Ana herenafheY CLW) Shall [�qngtltute t -te error agrej--menL hetweerti propOS" <br />armJ the City only after it has been awc 3ptad by Itso CLtSf COLMcil, W%dorE ed by the Cleric of tha ncik wr <br />th <br />her signature and oi►cW DAjrg h��a+n the admen �f appTv�r� of the u�, signed b}� !h� Ex&mrbve <br />ak+acvx or his Elul} autJ orizAd agerrt, and steed by the CIty Atorney, dencting HT. appFaval cf the form cf <br />this d,owment. and its ex tion, and when it or are enact mpy el it h.5 b&An e&er delivarad t-D pfnpomr or <br />