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CITY Or SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15-6446 <br />SAINT GERTRUDE AND GRAND AVENUE WATER MAIN REPLACEMENT <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: AID C6-cs <br />En4,vie-r6n4,:tAnC. <br />Business Address: 5 8&1 SH owr <br />r ,% s r 'Ival I U Vn2c valley 4CA GI?SY7ri <br />Business E-Mail Address: ;ic6%:j W G <br />IIG-lie,@ y44eo • co#Ln <br />Telephone: C15(• 15S• 3g6t/ <br />State Contractor's License No. and Class: <br />I 0q-114I ( A) <br />License Expiration Date: if / 30% 7- <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: <br />I coo(D 4t/$/S <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: <br />6 /30/ 202 I <br />Signed: n <br />Title: /, Qft#,4-AroH1 /VIRn A'3�4•- <br />P-6 of P-19 <br />20B-27 <br />