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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 21-6466 <br />GROVEMONT STREET WATER MAIN IMPROVEMENTS <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: Stephen Doreck Equipment Rentals, Inc. <br />Business Address: 9075 Telegraph Road Pico Rivera, CA 90660 <br />Business E-Mail Address: pablo@Cloreckconstruction.com <br />Telephone: 562) 949-4949 <br />State Contractor's License No. and Class: 665471-A <br />License Expiration Date: 02/28/2022 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000011335 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expir4yi" Date,: _,,a , / 06/30/2023 <br />Signed: "-- <br />Title: Pablo Viramontes / Vice President <br />P-5 of P-18 <br />