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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16-2653 <br />CIVIC CENTER RENOVATE ADA ACCESS <br />CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she <br />and all his/her subcontractors are registered with the State of California Department of Industrial <br />Relations (DIR), and that the following is true and correct. <br />Contractor's Name: <br />Business Address: <br />I -"i LS r hn to," <br />Business E -Mail Address: <br />Telephone: �_" o Z- — to of 0 - 6 zc) <br />State Contractor's License No. and Class: (6�7e>Ll -799 A - C-17 _ 6-%3 <br />License Expiration Date: 7; 13 1/10 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1 ()00 L( a,5 5 <br />State Dept. of Industrial Relations (DIR) i <br />Regis h xpiration Date: (p � 3 L <br />Title: no r_, X05 �T <br />A <br />P-5 of P-17 <br />23A-12 <br />