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CITY OF SANTA 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 />Contractor's Name: FW INC. CBA EXCEL pAVINfs CCMMW <br />—2218 EE's AtvE <br />rvut <br />Business Address: LONB sEACH, CA VW06 <br />Business E -Mail <br />Address: <br />Telephone: ,562599-5641 <br />State Contractor's License No. and Class: STATE LIC, 6116659 W <br />License <br />Expiration Date: / ri t -.511201b <br />Signed: l . b-Adls„i <br />Title: C.P. rRn1 SNL PRErSiDENT <br />BP -4 of 15 <br />