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23B - BRISTOL ST REHAB
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12/17/2019
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23B - BRISTOL ST REHAB
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Last modified
12/12/2019 5:43:58 PM
Creation date
12/12/2019 5:33:35 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
23B
Date
12/17/2019
Destruction Year
2024
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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 19-6943 <br />BRISTOL ST. REHABILITATION: MACARTHUR BLVD. TO RAILROAD (N. OF <br />ALTON AVE.) <br />CONTRACTOR'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: All American Asphalt <br />Business Address: <br />400 E. Sixth Street Corona, CA 92879 <br />Business E-Mail Address: publicworksO-allamericanasphalt com <br />Telephone: 951-736- <br />State Contractor's License No. and Class: 267073 A, C-12 <br />License Expiration Date: <br />i S&WIIZ1➢41] <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: <br />1000001051 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: 6-30-2020 - <br />Signed: <br />Title: Edward J. Carlson Vice President <br />P-5 of P-17 <br />23B-12 <br />
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