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Item 18 - Pre-Employment Medical Services
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01/16/2024 Regular & Special HA & Special SA
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Item 18 - Pre-Employment Medical Services
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1/23/2024 9:16:03 AM
Creation date
1/17/2024 4:38:11 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Human Resources
Item #
18
Date
1/16/2024
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(9) <br />CITY OF SANTA ANA <br />ATTACHMENT B <br />REFERENCES <br />List and describe fully the contracts performed by your firm which demonstrate your ability to provide the <br />supplies, equipment or services included in the scope of the proposal specifications. Attach additional <br />pages if required. The City reserves the right to contact each of the references listed for additional <br />information regarding your firm's qualifications. <br />REFERENCE <br />Customer Name: <br />Address: <br />Contract Amount: <br />Contact Individual: <br />Phone Number: . <br />EMAIL: <br />Year: <br />Description of supplies, equipment, or services provided: <br />REFERENCE <br />Customer Name: <br />Contact Individual: <br />Address: Phone Number: <br />Contract Amount: <br />EMAIL: <br />Year: <br />Description of supplies, equipment, or services provided: <br />RFFFRFMnF <br />Customer Name: <br />Address: <br />Contract Amount: <br />Contact Individual: <br />Phone Number: . <br />EMAIL: <br />Year: <br />Description of supplies, equipment, or services provided: <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />23-115 Pre -Employment Medical Screening Services Page 29 of 34 <br />
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