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CITY OF SANTA ANA <br />Project No. 1 16742: 2010-2011 Omnibus Concrete Replacement Contract <br />PROPOSAL AND CONTRACT AGREEMENT <br />CONTRACTOR'S LICENSING STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that the following is <br />true and correct. <br />Contractor's Name: 1?Q1( ?\?G ? ?-Y-??, <br />Business Address: \??jlt,( ? V?r-1 i D?A ?r ? ??/ ? W q.? Ylti?-1 !' a G 11 (Y? <br />Telephone: ?c(04? ? `1 ? - ? Q ? l <br />State .Contractor's License No. and <br />Class: ? V? 1 ? l.? 3 <br />Expiration ?1 31 \ \ \ <br />Date: 1 1 <br />Signed: G ?j?. _ _ <br />- Title: t ? .2,? i ??.v ? /1? <br />BP-14 of 14