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CITY OF SANTA ANA <br />SPECIFICATIONS <br />PROJECT NO.: 21-6446 <br />BAILER-GLENWOOD SEWER MAIN UPGRADE <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: <br />Business Address: `/ 7 9 t7 r r �� &�Y�. #ps = `! `/,_� r^v in e Cfi 9a�aa <br />Business E-Mail Address: Se- o @ b i <br />Al 4 . Caa+, <br />Telephone: /�1 9— 6 6 0` 961o o v <br />State Contractor's License No. and Class: 7 7 q ttY y ` <br />License Expiration Date: X a <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1 0 0 0 0 o 7 Y 6 6 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: :Z d6 /3 0 <br />Signed: <br />Title: � re r i 14r, f <br />City Council <br />Fj <br />13— 18 <br />4/6/2021 <br />