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<br />CITY OF SANTA ANA <br />PROJECT NO. 11-7509 CITYWIDE RESIDENTIAL STREET REPAIR -PHASE 15 <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 con: ect. <br />Contractor's Name: <br />Business Address: P. [? ?jpX 9`o12R? (`??cllct e ,A q 2. S3'?4?- ? 0'12,°1 <br />Telephone: (q ? 1 -? `, l?-? lvdl? <br />State Contractor's License No. and <br /> <br />Expiration <br />Date: <br />Signed: <br />Title: <br />TO BE INCLiTDED IN BID PACKAGE <br />BP 14 of 29 <br />?= a ? o? ?4 c-? ?