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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-2679 & 18-2680 <br />CIVIC CENTER IMPROVEMENTS <br />CONTRACTOR'S LICENSING AND REGISTRATIt�N 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: C , S <br />Business Address: <br />Business E-Mail Address: <br />Telephone: <br />OCT <br />State Contractor's License No. and Class: lg'Z ( p -70 <br />License Expiration Date: f r-)13 i 11 Q <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Dite: d <br />Signed: <br />Title: 'f ._..,_ . n <br />P-7 ofP-19 <br />