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CITY OF SAN'T'A ANA RE -BID <br />PROPOSAL <br />PROJECT NO, 16 -7523 <br />WASHINGTON SQUARE RESIDENTIAL STREET REPAIR <br />CONT'RACTOR'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: EBS GENERAL ENGINEERING INC <br />Business Address: 1320 E SIXTH ST, STE 100 CORONA CA 92879 <br />Business E -Mail Address: BIDS @EBS- INC,US <br />Telephone: <br />951 - 279 -6869 <br />State Contractor's License No. and Class: 720016 A <br />License Expiration Date: <br />3/31/16 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: <br />State ;Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: <br />Signed: <br />Title: JOS7P),rA NANCI, PRESIDENT <br />1000005295 <br />6/30/16 <br />2J -z17 <br />