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ADDENDUM. ONE (3/22/2016) <br />APPENDIX <br />ATTACHMENT 3-6: CONTRACTOR. LICENSING AND REGISTRATION <br />STATEMENT <br />CITY OF SANTA ANA <br />REQUEST FOR PROPOSALS <br />FOR <br />DAN YOUNG SOCCER COMPLEX FIELD 62 AND 04,SYNTf3ETIC TURF <br />RFP NO.: 16-01 <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all his/her <br />subcontractors are registered with the State of California Department of Industrial Relations (D1R), and that the <br />following is true and. oorrect. <br />Contractor's Name: Ft (dna of i x-� otA, _ <br />Business Address: �-` i 4 G ( � G,���t e �� , (�- h p 2oc) �I (� , C7? Cr �i 1 i G 2 <br />Business E -Mail Address: �5 tth�o <br />Telephone: <br />State Contractor's License No. and Class, <br />License Expiration Date:CiC ToeK (2.. ' r �o <br />State Dept. of Industrial Relations (DIR) ^� <br />Registration No.: l f� bf� �✓ac>tJ� <br />State Dekniration&:: <br />strial elation, (DIR) <br />Registrat-U0 e 3 c2(2(K) <br />Signed: ().f © A t) <br />Title: <br />3,36 <br />