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CITY OF SAWA ANA <br />PROPOSAL <br />PROJECT NO, 14 -7516 AND 15 -7514 <br />RESIDENTIAL STREET REPAIR FY 13/14 & 14/15 <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 />FAQ IBC. CBA EXCEL PAVING C <br />Contractors Name: <br />Business Address: O BEACH, CA 90&06 <br />Business E -Mail <br />Address: <br />Telephone: _562)599 -5641 <br />State Contractor's License No. and Class: STATE LIC. 609659 W <br />License <br />Expiration Date: 'i ��11. lot to <br />Signed: <br />Title: C.P� SROVJN! P?EISMENT <br />BP -4 of 15 <br />23A -19 <br />