Please type or print legibly:		Phone Numbers: (please include area code)
Company Name:		(        )
Contact Person:		(        )	(fax)
Address:
	(City)                                               (State)                    (Zip Code)
E-Mail Address:
Proposal Document No(s).:	Description(s)
Courier Service Name  (FedEx, UPS):
Courier Service Account No.:
I request a copy of the above document(s).  I understand and agree that the document(s) and any addenda will only be sent to me at my own expense.  I authorize the City to charge the shipment(s) to my courier service account listed above.
(Authorized Signature)		(Date)

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