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STATE OF CALIFORNIA, DEPARTMENT OF TRANSPORTATION <br />PROGRAM SUPPLMENT AND CERTIFICATION FORM <br />PSCF (REV. 01/2010) <br />Claims Audits <br />3301 "C" Street, Rm 404 <br />Sacramento, CA 95816 <br />FROM: <br />Department of Transportation <br />SUBJECT. <br />Encumbrance Document <br />VENDOR/LOCALAGENCY <br />CITY OF SANTA ANA <br />$80,000.00 <br />PROCUREMENTTYPE: <br />Local Assistance <br />DA E PKEPAKEU: PROJECT NUMBER: <br />4/4/2017 1217009033 <br />REQUISITION NUMBER/ CONTRACT NUMBER: <br />ROS 121700000220 <br />Page 1 of 1 <br />ADA NOtit For individuals with sensory disabilities, this document is available in alternate formats. For information, call (915) 654-6410 of TDD (916) -3880 or write <br />Records and Forms Management, 1120 N. Street, MS -89, Sacramento, CA 95814. <br />