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STATE OF CALIFORNIA. DEPARTMENT OF TRANSPORTATION <br />PROGRAM SUPPLMENT AND CERTIFICATION FORM <br />PSCF (REV. 01/2010) <br />Page i of 1 <br />Claims Audits �REQLJSITION <br />/2017 I1 <br />3301 "C" Street, Rm 404 NUMBER I CONTRACT NUMBER: <br />Sacramento, CA 95816 QS 121700000372 <br />Department of Transportation <br />SUBJECT: <br />Encumbrance Document <br />VENDOR/ LOCAL AGENCY: <br />CITY OF SANTA ANA <br />CONTRACTAMOUl <br />$168,223.00 <br />PROCUREMENTTYPE: <br />Local Assistance <br />ADA NOtii For Individuals with sensory disabilities, this document Is available in alternate formats, For information, call (916) 564.6410 of TDD (916) -3880 or write <br />Records and Forms Management, 112D N. Street, i Sacramento, CA 95814, <br />