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CITY OF SANTA ANA <br />PROJECT NO. 10 -7558 CENTENNIAL PARK RESTROOM ROOF REPLACEMENT <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: � J �j �(��l1�_ �.�p.�v' ��L 7 <br />Business Address: ��{ `�-,��� C (� y „� V�IA��4� �� � 3 �• �/� �a� Z C <br />Telephone: ��Jr r `�6 �� ��� %' <br />State Contractor's License No. and w ��� <br />Class: V <br />Expiration � � f <br />Date: <br />Signed: � � �% <br />Title: Q �3N��_ <br />TO BE INCLUDED IN BID PACKAGE <br />BP 14 of 29 <br />