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Fees <br />System reconfiguration fees will apply. Please see your Fee Exhibit for details, <br />Signature <br />I attest that I am authorized to make decisions and indebt City of Santa Ana as listed above. I further attest that the <br />information in this document is truthful, accurate and can be used to begin system re -configuration (if applicable) and <br />updates to any existing Plan Document (if applicable). Charges for these services will apply as listed in Exhibit A of the <br />Administrative Services Agreement. <br />Print Name: Lori Schnaider Signature: <br />Title: HR Operations Manager Date: July 31, 2023 <br />SOW: Carryover: Page 3 <br />C <br />� <br />levwE <br />c0 Igoe Administrative Services 2021 <br />