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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 23-6627 <br />ROUSSELLE STREET FLOOD PROTECTION PROJECT <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 following is true and correct. <br />Contractor's Name: MIKE BUBALO CONSTRUCTION CO., INC. <br />Business Address: 5102 GAYHURST AVENUE, BALDWIN PARK, CA 91706 <br />Business E-Mail Address: INFO@BUBALO.COM <br />Telephone <br />626 960-7787 <br />State Contractor's License No. and Class: 771279 A <br />License Expiration Date <br />11 /30/25 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000001341 <br />State Dept. of Industrial Relations (DIR) <br />Registration Emotion Date: 06/30/25 <br />Signed: <br />Title: President <br />P-6 of P-20 <br />