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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15-6453 <br />RIVERVIEW NEIGHBORHOOD WATER MAIN IMPROVEMENTS <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: A l l C rh e C vice -5 t :Lk, 6 <br />Business Address: 520, ( 5",:PL 45;w; cS -ty zi ( -J-Uyv ly CA q 25o� <br />Business E-Mail Address: 7a i er c,11 C rbc S ((3 sjti4ob • co r s <br />Telephone: (0+0c�P--41 -3(e32 <br />State Contractor's License No. and Class: ( Oo e1 l 1 it <br />License Expiration Date: � I - 3o - 201 �-% <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: ( Ono O V V4/ S <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: 1 O — 2a Zo7- <br />Signed: /� I�olo M z V AM IIZ C2� <br />Title: <br />P-5 a I' P-17 <br />20B-16 <br />