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11. <br />$ <br />/hr. <br />$ <br />/hr. <br />12. <br />$ <br />/hr. <br />$ <br />/hr. <br />13. <br />$ <br />/hr. <br />$ <br />/hr. <br />14. <br />$ <br />/hr. <br />$ <br />/hr. <br />LEGAL NAME OF COMPANY <br />BUSINESS ADDRESS <br />PRINTED NAME OF AUTHORIZED AGENT <br />SIGNATURE OF AUTHORIZED AGENT DATE <br />PHONE AND FAX NUMBER <br />TITLE <br />E-MAIL ADDRESS <br />FEDERAL IDENTIFICATION NUMBER CONTRACTOR LICENSE NUMBER <br />(IF APPICABLE) (IF APPICABLE) <br />City of Santa Ana RFP 22-031 <br />Page A4-2 <br />