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PUBLIC ENTITY RISK INSTITUTE 1 - 2004
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PUBLIC ENTITY RISK INSTITUTE 1 - 2004
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Last modified
1/3/2012 2:22:13 PM
Creation date
11/16/2004 3:41:41 PM
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Contracts
Company Name
Public Entity Risk Institute
Contract #
N-2004-082
Agency
Personnel Services
Destruction Year
2009
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<br />9. <br /> <br />AUTHORITY AND ORGANIZATION NAMED AS DATA SUPPLIER <br /> <br />Each signatory represents and warrants it has the authority to sign on behalf of the organization for <br />which its signature appears. <br /> <br />The following signatures of the parties are made as of the date of each signature: <br /> <br />BY: <br /> <br /> <br />TITLE: <br /> <br />DATE: <br /> <br />~ <br /> <br />CITY OF SANTA ANA <br /> <br />ATTEST: ~ <br /> <br />~~-<;", J i -"~ <br /> <br />PATRICIA E. HEALY <br />City Clerk <br /> <br />BY: <br /> <br /> <br />TITLE: <br /> <br />CITY MANAGER <br /> <br />~~rJy <br /> <br />DATE: <br /> <br />DATA SUPPLIER ORGANIZATION INFORMATION: <br /> <br />Print Name of Data Supplier: <br /> CITY OF SANTA ANA <br />Print Name of Authorized JEFF STEVENS <br />Representative: <br />Address of Supplier Entity: 20 CIVIC CENTER PLAZA (M-28) <br /> P. O. BOX 1988 <br />City and State and Zip Code of SANTA ANA, CA 92702 <br />Supplier: <br />Telephone: (714) 647-5340 <br />Fax: (714) 647-5311 <br />Email Address: Jstevens @.ci.santa-ana.ca.us <br /> <br />CIPRA Claims Data Supplier Agreement January 14,2004 <br /><0 2004 Public Entity Risk Institute <br />
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