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CITY OF SAN TA ABTA <br />PROPOSAL <br />PROJECT NO. 14-6802 WARNER AVENUE STREET IMPROVEMENTS (MAID TO OAK) <br />PROJECT NO.: I8-6424 WARNER AVENUE WATER MAIN IMPROVEMENTS (MAIN TO OAK) <br />PROJECT NO.: 20-6618 WARNER AVE STORM DRAIN IMPROVEMENTS (MAIN TO OAK) <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 foilowrng is true and correct.. <br />Contractor's Name: =o t-A F— f oc w 1 N C. <br />Business Address: -7 o -b 0 M I,t 1 , { 'U 1 t�I A G k !1'Z-6l <br />Business E-Mail Address: <br />Telephone: ` }}1y� p} <br />State Contractor's License No. and. Class: <br />License Expiration Date: a 1 0 2— 2- <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1poaC)CI a <br />State Dept. of Ind trial Relations (DIP.) <br />Registration Ex ' n a � � _ , f cep— 2- <br />Signed: <br />Title: i � °'t I? 0 T <br />P-10 of P-23 <br />