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O. <br />CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO,: 16 -6854 <br />MAPLE BIKE TRAIL SAFETY ENHANCEMENTS PHASE II <br />ATPL- 5063(164) — STATE FUNDED <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: EBS General Engineering, Inc. <br />Business Address: 1320 E. Sixth St., Ste 100 Corona CA 92879 <br />Business E -Mail Address: bids @ebsgeneral,com <br />Telephone: 951 - 279 -6869 <br />State Contractor's License No. and Class: 720016 A <br />License Expiration Date: 3/31/18 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000005295 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: ,, 0 3/31/18 <br />Signed: <br />Title: Joseph A. Nanci, President <br />P -5 of P -17 <br />23C -13 <br />