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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 14-6799: New Traffic Signal an Newhope Stand Cain! Ilest <br />PROJECT NO. 14.6800: Trafflc Signal Modification on Segerstrom Ave and Bear St <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 <br />Industrial Relations (DIR), and that the following is true and correct. <br />Contractor's Name: <br />PTM General Engineering Services, Inc. <br />Business Address: <br />5942 Acorn St. Riverside, CA 92504 <br />Business E -Mail <br />Address: <br />elizabethQptm-eng.com; brian@ptm-eng.com <br />Telephone: <br />951.710.1000 <br />State Contractor's License No. and Class: 891265 Class A; <br />License <br />Expiration Date: <br />02.28.2017 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000001433 <br />State Dept, of Industr' I Relations (DIR) <br />Registration Irat n te: 06.30.2016 <br />Signed: <br />Title: Elizabeth H. Mendoza de McRae, President/CFO <br />BP -6 <br />23B-17 <br />