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PUBLIC WORKS CONTRACT AWARD INFORMATION <br />Contract award Information must be sent to your Apprenticeship Committee if you are approved to train. If you are not approved to train, you <br />must send the Information (which may be this form) to ALL applicable Apprenticeship Committees In your craft or trade In the area of the site <br />of the public work. Go to: http://www.dir.ca.gov/das/PublieWorksForms.htmfor Information about programs in your area and trade. You may <br />also consult your local Division of Apprenticeship Standards (DAS) office whose telephone number may be found in your local directory under <br />California, Slate of, Industrial Relations, Division of Apprenticeship Standards. <br />Do not send this form to the Division of Apprenticeship Standards. <br />NAME OF YOUR COMPANY <br />EBS General Engineering, Inc. <br />CONTRACTOR'S STATE LICENSE NO <br />720016 <br />MAILING ADDRESS -NUMBER 8 STREET, On. ZIP CODE <br />1320 E. Sixth St. #100 Corona,Ca. 92879 <br />AREA CODE 8 TELEPHONE NO. <br />951-279-6869 <br />NAME B ADDRESS OF PUBLIC WORKS PROJECT <br />DATE YOUR CONTRACT EXECUTED <br />RESIDENTIAL STREET REPAIR PROGRAM AND ALLEY <br />5/21/19 <br />IMPROVEMENT FY17/18 PROJECT <br />DATE OF EXPECTED OR ACTUAL START OF PROJECT <br />Various, City of Santa Ana <br />6/10/19 <br />NAME 8 ADDRESS OF PUBLIC AGENCY AWARDING CONTRACT <br />ESTIMATED NUMBER OF JOURNEYMEN HOURS <br />City of Santa Ana <br />605 <br />20 Civic Center Plaza <br />OCCUPATION OF APPRENTICE <br />Santa Ana, CA 92701 <br />Laborer <br />THIS FORM IS SEND SENT TO: (NAME & ADDRESS OF APPRENTICESHIP PROGRAM(S)) <br />ESTIMATED NUMBER OF APPRENTICE HOURS <br />121 <br />Laborers Southern CA JAC <br />1385 West Sierra Madre Ave <br />APPROXIMATE DATES TO BE ENPLD ED <br />Azusa CA 91702 <br />6/10/19 thru 7131/19 <br />t: 626-610-1700 <br />f: 626-633-0204 <br />This is not a request for dispatch of apprentices. <br />Contractors must make a separate request for actual dispatch, in accordance with Section 230.1(a) California Code of Regulations <br />Check One Of The Boxes Below <br />1. ® We are already approved to train apprentices by the Construction Laborers of Southern California <br />Apprenticeship Committee. We will employ and train under their Standards. Enter name of the committee <br />2. ❑ We will comply with the standards of <br />Apprenticeship Committee for the duration of this job only. Enter name of the committee <br />3. ❑ We will employ and train apprentices in accordance with the California Apprenticeship Council regulations, <br />including § 230.1 (c) which requires that apprentices employed on public projects can only be assigned to <br />perform work of the craft or trade to which the apprentice is registered and that the apprentices must at all <br />times work with or under the direct supervision of journeyman/men. <br />Signature e^^ Date 5 f`7-3 Aq <br />Typed Name Cristina Whitcher <br />Title Contracts Administrator <br />State of California - Department of Industrial Relations DIVISION <br />CAB 140(REV. 1/04) OF APPRENTICESHIP STANDARDS <br />