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Attachment B <br />FY05 Santa Ana UASI Allowable Purchase Pre -Approval Form <br />FY05 UASI Grant # 2005-15, OES # 59-69000 <br />Page 1 of 2 <br />Requesting Agency: <br />Point of Contact (POC): <br />Title: <br />Agreement #: <br />Address: <br />Phone: <br />E -Mail: <br />FY05 UASI Project Name: <br />Amount Requested: <br />A detailed description of the item(s) or service(s) being requested must be attached to this <br />request using the Description Page. This description should also include a detailed list of all <br />costs associated with the request. <br />Submitted By: <br />(Authorized Agency Representative) <br />Title: <br />Signature <br />For UASI Use Only <br />Request Reviewed By: <br />Recommended For Approval: ❑ Yes ❑ No <br />Amount Authorized <br />Requesting agency not to exceed this amount. <br />Authorized by: Paul M. Walters Chief of Police <br />Date <br />Page 1 <br />