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ADDENDUM ONE <br />CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 20-7533 <br />RESIDENTIAL STREET REPAIR PROGRAM FY 19/20 <br />HENINGER PARK NEIGHBORHOOD <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: 400 E 6th Street, Corona, CA 92879 <br />Business E-Mail Address: publicworks@allamericanasphalt.com <br />Telephone: 951-736-7600 <br />State Contractor's License No. and Class: 267073 Class: A, C-12 <br />License Expiration Date: <br />1/31/2022 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 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 />2 12 <br />