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CITY Or SANTA ANA <br />PROJECT NO. 13 -6788: ARTERIAL STREET SLURRY SEAL 2012 -1.3 <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: <br />Business Address: <br />Telephone: �W 9 G2 6 3 <br />State Contractor's License No. and }� 2- `B <br />Class: C t <br />Expiration °7 <br />Date: �� o-- ] `, <br />Signed: '�j ,�A� 0� \.__ ------ <br />0I&e Pre, ,f <br />TO BE INCLUDED IN BID PACIZAGE <br />BP14of14 <br />