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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 15.6828 <br />Harbor Boulevard Corridor Traffic Signal Improvements <br />(as part of Harbor Blvd Traffic Signal Synch ran ization Project) <br />CONTRAC'TOR'S LICENSING and REGISTRATION 51"A f, 7 .IVIENT <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 />Business Address: <br />Business E -Mail <br />Address: <br />Telephone: / ,%z (;�`i to / <br />State Contractor's License No, and Class: rlMl LL 0 <br />License <br />Expiration Date: f 6a j <br />State Dept. of Industrial Relations (DIR) <br />Registration No.. <br />State Dept, of Industrial Relations (DIR) <br />Registration Expiratiop Date: <br />Signed: <br />Title: <br />W, Holman, Vice President <br />RP -10 <br />11 <br />