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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16-1305 <br />3"D AND BUSH RESTROOM <br />CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjuxy that lie/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: DAM0, -" 1 N C <br />Business Address: _CA iQO tet. <br />dkM0 �' � � AJv <br />t)C)w'n e '-( <br />Uk '10 Zk4 C) <br />Business E -Mail Address: <br />q wl c� . <br />Ccs w�. <br />Telephone: 562— a . t',q I 0 <br />State Contractor's License No. and Class: q,b S co 9 <br />License Expiration Date: <br />State Dept. of Eidustrial Relations (DIR) <br />Registration No.: <br />State Dept. of <br />Registration E) <br />Signcd: <br />G <br />(D>R) 61 � 0 / 16 <br />Title: G V(,6 P. <br />P-4 o'fP-16 <br />