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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO. 15-683(t Pedestrian Countdown Heads and Push Buttons <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: SIEMENS INDUSTRY INC <br />Business Address: 2200 w Orangewood Ave, orange, CA 92868 <br />Business E -Mail MIC'HAEI,.IIUTCIIENS(i,),SIEMEN3.COM <br />Address: 2200 W Orangewood Ave, Orange, CA. 92868 <br />Telephone: 714-448-6943 <br />State Contractor's License No. and Class: 758796, C -10,C-20, C-1(,13 <br />License <br />Expiration Date: 02/28/2017 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000002447 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: 06/30/2016 <br />Signed: <br />Title: <br />I ) i Ce.c ria c, 4, �e fo'k e.e <br />BP -4 <br />