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CITY OF SANTA ANA <br />Project No. 15 -6824: 2014 -2015 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: ( ✓Q/�Y�R�LCni19 Zvi Cfvs L®�cC (OILS Carpl�r+ ion <br />Business Address: <br />Telephone: E31(5 —'775 —©o <br />State Contractor's License No. and <br />Class: BO7°Z9 A/B 4CZ1 <br />Expiration <br />Date: iYO✓ern�cr 3/ Z © /S' <br />Signed: <br />Title: -A '-e- 5�,cleL <br />BP 17 of 17 <br />