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CIT" l OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 20-7531 <br />SANTA ANA REGIONAL TRANSPORTATION CENTER <br />SOUTH RESTROOM RENOVATION <br />CONTRACTOR'S LICENSING AND!_IP.EGISTRA,TION STATEMENT <br />The undersigned contractor, or corporate officer, declares tinder 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 Natne: 7(/—fn ,4vwy\� wvwm N�l-ian__IZI 0114 ger— um <br />Business Address: 31i o ql. 1� ��c 1P DYSZ���Q, cAq 9> <br />Business E-Mail Address: �YS{QUiI�S - din m _ <br />Telephone: <br />State Contractor's License No. and Class: l/t�5 q2 <br />License Expiration Date: S 31— <br />State Dept. of Industrial Relations (D1R) <br />Registration No.: /W00 560 62 <br />State Dept. of Industrial Relations (DiR) <br />Registration Expiration Date: <br />Signed: <br />'title: C <br />P-4 ofP-1.6 <br />