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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NOS.: 16-6864 AND 18-6864 <br />OMNIBUS CONCRETE REPAIR PROJECT <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: EBS General Engineering, Inc <br />Business Address: 1320E Sixth St., Ste 100 Corona CA 92879 <br />Business E-Mail Address: bids ebsgeneral.com <br />Telephone: 951-279-6869 <br />State Contractor's License No. and Class: 720016 A <br />License Expiration Date: 3/31/20 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000005295 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: 6/30/19 <br />Signed: <br />Title: President <br />P-9 of P-21 <br />