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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16 -2651 <br />CIVIC CENTER RE- CAULKING EXPANSION JOINTS A'r PLAZA OF THE FOUNTAINS <br />AND PLAZA OF THE FLAGS <br />CON "TRACTOR'S LICENSING AND REGISTRA I'iON STATEMEN "T <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 Industrial <br />Relations (DIR), and that the following is true and correct. <br />Contractor's Name: <br />Business Address: <br />Business E -Mail Address: <br />Telephone: _ y41` ) Z_C� 1? — <br />State Contractor's License No. and Class: `2z gs a�.__ <br />License Expiration Date: (f �j} � zo <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: <br />State Dept. of <br />Registration Ea <br />Signed: <br />Title: <br />P -4 of P -16 <br />23A -10 <br />�2-6-53 <br />