Laserfiche WebLink
Appendix <br />ATTACHMENT 3-4: CONTRACTOR'S LICENSING AND REGISTRATION <br />STATEMENT <br />CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all his/her <br />subcontractors are registered with the State of California Department of Industrial Relations (DIR), and that <br />the following is true and correct. <br />Contractor's Name: <br />Business Address: <br />Business E-Mail Address: <br />Telephone: <br />State Contractor's License No. and Class: <br />License Expiration Date: <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: <br />Signed: <br />Title: <br />City of Santa Ana RFP 22-031 <br />Page A3-5 <br />