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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 11-6416 <br />SEVENTEENTH STREET WATER MAIN IMPROVEMENTS <br />CONTRACTOR'S LICENSING STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that the <br />following is true and correct. <br />Contractor's Name: <br />Business Address: <br />Telephone: 2/y= 4 32 " ? 9 2 - <br />State Contractor's License No. and Class: <br />Expiration Date: <br />Signed: <br />Title: <br />P-ld <br />Section 3 - a P.,,5 [ 09-22-2014 <br />