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20B - AA - YMCA RENOVATION
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20B - AA - YMCA RENOVATION
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Last modified
8/11/2016 4:31:50 PM
Creation date
8/11/2016 3:10:49 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
20B
Date
8/16/2016
Destruction Year
2021
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CITY OF SANTA ANA <br />Exhibit 2 <br />PROPOSAL <br />PROJECT NO.: 16-6876 <br />DORMER YMCA. – MATERIALS ABATEMENT AND ENV MO'NNIENTAL <br />REMEDIATION <br />COIR CTOR'S LICENSING A VD REGIS'I'RATIQ'h� STATEMENT <br />The undersigned contractor, or corporate offi.ccr, declares under penalty of perjury that he /sho <br />and all his /her subcontractors are registered with the State of California Department of Industrial <br />Relations (DIR), and that the following is Live and correct. <br />Contractor's Name: <br />B'asitioss Address: <br />0 ojV <br />Business E -Mail Address: — \110, W3 VT'I N %$ i0, . N f T <br />Telephone: �1 <br />State Contractor's LicenseNo, and Class: w(lvJ i <br />License Expiration Date: <br />State Dept, of Industrial Relations (DIR) �y <br />Registrador).No,: U u 1 <br />State Do <br />Registrat <br />Signed: <br />Title: <br />P -7 of P -19 <br />20B -14 <br />
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