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STATE OF CALIFORNIA. DEPARTMENT OF TRANSPORTATION <br />PROGRAM SUPPLMENT AND CERTIFICATION FORM <br />PSCF (REV, 01/2010) <br />Page 1 of 1 <br />TO: STATE CONTROLLER'S OFFICE IDATE PREPARED: <br />Claims Audits9/1/2017 1217000108 <br />3301 "C" Street, Runt404 REQUISITION NUMBER I CONTRACT NUMBER: <br />Sacramento, CA 95816 RQS 12180000042 <br />FROM: <br />Department of Transportation _ <br />SUBJECT: <br />Encumbrance Document <br />CITY OF SANTA ANA <br />$ 85,000.00 <br />PROCUREMENTTYPE: <br />Local Assistance <br />ADA Noth 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 />