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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 17-9001, 18-6911, 20-6958, 21-6451, 19-6940 <br />SOUTH MAIN STREET CORRIDOR IMPROVEMENT <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: <br />Business Address: <br />Business E-Mail Address: q E� CS Pace u VLPJ <br />Telephone: ([ . 5210 -2 1P 2Jin <br />State Contractor's License No. and Class: 2;L4 B -70 -I C- 2 -7 <br />License Expiration Date: lib I31' 2/ <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: I D ©Ooc�2g�7 <br />State DeT%SIAKQ.—GrICY�t� <br />(DIR) <br />Registrat(o"121 <br />Signed: <br />Title:I� - , lg A err— <br />P-9 of P-22 <br />