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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16-6859 <br />LOCAL STREET SLURRY SEAL 2015-16 <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 hue and correct. <br />Contractor's Name: P c_yheyx ftko v R.aAIS J-} OVAa70r1 , LLG <br />Business Address: Gal (a 8 ..CNNoVP g0tJ WNJ Q.Af-a.SWc® , C1 -CMO0V <br />Business E -Mail Address: �0e\K. @. Pnr kechrno laq t_CDY-n <br />Telephone: Cita) (003-O` to l [ <br />State Contractor's License No. and Class: 991224 C.3?. <br />License Expiration Date: 03 / 31' 2,C.>1S _ <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: t C000 I I Zug <br />State Dept. of Industrial Relations (DIR) I <br />Registration ExLration Date: ol. 130' '-0I G. <br />Signed: <br />Title: C.rD• <br />P-4 of P-16 <br />