Laserfiche WebLink
CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 24-6058 <br />SARTC FOUNTAIN REPLACEMENT <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: c M; ; C <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.: PW - L. R- 1 or-) <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: -3 0 j d2 0.2 4• <br />Signed: <br />Title: 140 [A m ✓e-5 e,",_ <br />P-11 of P-24 <br />