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CITV OF SANTA ANA <br />CITY OF SANTA ANA <br />r PROJECT 11-6749 <br />HAZARD AVENUE REHABILITATION <br />FROM EUCLID TO HARBOR <br />PROPOSAL AND CONTRACT AGREEMENT <br />CONTRACTOR'S LICENSING STATEMENT <br />r <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that the following is <br />true and correct. <br />Contractor's Name: <br />Business Address: <br />lmauL? 45P <br />A0, god zZZ9 - Cot o ivA-, Ck q A ? c, <br />Telephone: 4s I - 73f -?& Qo <br />State Contractor's License No. and <br />Class: A X47073 17 C??Z <br />Expiratic <br />Date: <br />n <br />Signed: <br />Title: <br /> <br /> <br />TO BE INCLUDED IN BID PACKAGE <br />BP 14 of 14