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CITY OF SANTA ANA <br />Certification - I certify that I have read, understand and agree to the terms and conditions of this <br />Request for Proposals. I have examined the Scope of Services (Exhibit A) and am qualified to <br />provide services being requested as specified herein. I understand and agree that I am responsible <br />for reporting any errors, omissions or discrepancies to the City for clarification prior to the submission <br />of my proposal. <br />PROPOSER’S STATEMENT: I have read, understood and agree to the terms and conditions on <br />all pages of the Request for Proposals. Upon request, I will transfer and deliver goods or services to <br />the City in accordance with said terms and conditions. <br />_________________________________________________________________________________ <br />LEGAL NAME OF COMPANY PHONE AND FAX NUMBERS <br />__________________________________________________________________________________ <br />PRINTED NAME OF AUTHORIZED AGENT TITLE <br />__________________________________________________________________________________ <br />SIGNATURE OF AUTHORIZED AGENT DATE E-MAIL ADDRESS <br />__________________________________________________________________________________ <br />FEDERAL ID NUMBER (IF APPLICABLE) CONTRACTOR LICENSE NUMBER <br />(IFAPPLICABLE) <br />__________________________________________________________________________________ <br />CITY OF SANTA ANA BUSINESS LICENSE NUMBER <br />(PLEASE PROVIDE IF AVAILABLE, BUT NOT REQUIRED UNTIL AND IF AN AWARD IS MADE TO PROPOSER.) <br />THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. <br />PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. <br />ATTACHMENT A <br />PROPOSER’S CERTIFICATION, PROPOSAL PRICING <br />City of Santa Ana RFP No. 24-137 Page 24 of 30 <br />Phone: (213) 634-0999 Fax: (213) 282-3133 <br />634 S. Spring Street, 10th Floor, Los Angeles, CA 90014 __________________________________________________________________________________ <br />BUSINESS ADDRESS <br />Immigrant Defenders Law Center <br />Lindsay Toczylowski President and CEO <br />Lindsay@immdef.org <br />47-4473312 <br />12/18/2024 <br />23