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MAYOR <br />Miguel A. Police <br />MAYORPROTEM <br />Claudia Alvarez <br />COUN BERS <br />'.. <br />Carloss Busta 8ustamante <br />P. David Benavides <br />Michele Martinez <br />_ <br />Vincent F. Sarmiento <br />Sal Tlnaiero <br />CITY OF SANTA ANA <br />FINANCE & MANAGEMENT SERVICES AGENCY <br />PURCHASING DIVISION <br />20 CIVIC CENTER PLAZA M-16 <br />P.O. BOX 1988 SANTA ANA, CALIFORNIA 92702 <br />PHONE: (714) 647-6941 FAX: (714) 647-6944 <br />CITY MANAGER <br />David N, Ream <br />CITY ATTORNEY <br />Joseph W. Fletcher <br />CLERK OF THE COUNCIL <br />Marla D. Huizar <br />The Tax Equity & Fiscal Responsibility Act of 1982 and Backup withholding Regulations of 1983 <br />require us to have a Social Security or Federal Tax Identification Number (TIN) on file for all <br />vendors subject to form 1099 reportable payments. Please print, sign and return this form, along <br />with your completed and signed W-9 (attached) in order to allow us to process purchase orders <br />and payments. <br />Business Name <br />DBA (if applicable) <br />Purchase -From Address <br />I <br />Phone <br />Fax <br />Email <br />Web Address <br />Payment Terms <br />Sign Here <br />Title <br />Remit -To Address <br />