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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 11-6413 <br />SA -5 VAULT MODIFICATIONS <br />CONTRA --TO R'S LICENSING and REGISTRATION STATEMENT <br />The undersigned contractor, or corporate officer, declares sunder penalty of penury that he/she <br />and all hiss/her subcontractors are registered with the State of California Department of <br />Industrial Relations (DIR), and that the following Is true and correct. <br />Contractor's Name: _ T_ 2 � — b f ___.. <br />Business. Address: Sao,$ . V <br />Business E -Mail <br />Address: 4 Db� r) r�tsl fi fs� s <br />Telephone: <br />State Contractor's license No, and Class: <br />License <br />ExpiratlonDate: {IyI <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: ) Qt)0CI()f <br />State Crept, of Industrial Relations (DIR) <br />Registrat <br />Signed. <br />Em <br />P_S OF P- 16 <br />23A-14 <br />