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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 06-3510 <br />SAN LORENZO SEWAGE LIFT STATION <br />CQNNTRACTOR'S LICENSING AND REGISTRATION STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and <br />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: Rockforce Construction, LLC <br />Business Address: 26772 Vista Terrace Lake Forest, CA 92630 <br />Business E-Mail Address: Estimating@RockPorce.com <br />Telephone: (949) 441-5200 <br />State Contractor's License No. and Class: 999390 "A" <br />License Expiration Date <br />12/31 /2020 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000004540 <br />State Dept. of Industrial Relations (DIR) <br />Registration E�p{rationPqte: 6/30/2021 <br />Signed: <br />Title: Chief Estimator / VP Heavv Civil <br />igfP-16 <br />dX <br />