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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECI' NO.: 20-7532 <br />LOCAL STREET CURES RAMP ►MPROVEMEWS <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: 1 m �ts2icN . ING. <br />Business Address: Z,?ack St ea i p4 FV_F_ _�zvab ZG /Q4.0,/4 ca • 7CJi <br />Business E-Mail Address:vl pp $ sl n <br />Telephone: T �cY?�$ <br />State Contractor's License No. and Class: W33 a (o <br />License Expiration Date: iZ 13t ;oA6 <br />State Dept. of Industrial Relations (DER) <br />Registration No.: <br />State Dept, of Industrial Relations (DIR) <br />Registration Expirati i Datc' 6 3c V20(`� <br />�' 61� <br />Signed: i7t/1 bn 1. 94ewr4sGaw r�9 <br />Title: (%lG�l.Es(bF�1r— <br />P-3 of P-15 <br />23A-15 <br />