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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15-6839 <br />LOCAL STREET SLURRY SEAL 2014-15 <br />CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she <br />and all his/her subcontractors are registered with the State of California Department of Industrial <br />Relations (DIR), and that the following is true and correct. <br />Contractor's Name: ALL AMERICAN ASPHALT <br />Business Address: PO BOX 2229, CORONA, CA 92878 <br />Business E -Mail Address: PUBLICWORKS@ALLAMERICANASPHALT.COM <br />Telephone: 951-736-7600 <br />State Contractor's License No. and Class: 267073 A & C-12 <br />License Expiration Date <br />1/31/2016 <br />State Dept. of Industrial Relations (DTR) <br />Registration No.: 1000001051 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: �, 6/30/2015 <br />Signed: <br />Title: EDWARD J. CARLSON, VICE PRESIDENT <br />BP4of16 <br />