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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16-2668 <br />RIVERVIEW, CABRILLO & WINDSOR COURT RESURFACING <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 Industrial <br />Relations (DIR), and that the following is true and correct. <br />Contractor's Name: _Phil Carter <br />Business Address: 590 1 Ds Angeles Aye., Silita 11 S UO Moorparl, CA 93071 <br />Business E -Mail Address: uhi1@pacifictenniscmirtS om <br />Telephone: _(818)991-744,q <br />State Contractor's License No. and Class 980798 (� Wig) <br />License Expiration Date: 01/31/2017 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: <br />State Dept. of Ind rial la ' s (,DIR) <br />Registration Exp <br />on 06/30/2016 <br />Signed: <br />Title: <br />P-5 of P-17 <br />