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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 15-6447 <br />WEST GROVE VALLEY NEIGHBORHOOD WATER MAIN IMPROVEMENTS <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: Michels Pipeline Construction, a divison of Michels Corporation <br />Business Address: 8.17 Main Street, Brownsville, WI 5 3006 <br />Business E -Mail Address: jsolis@michels.us <br />Telephone: (920) 583-3132 <br />State Contractor's License No. and Class: CA - 553612, A C10 C34 <br />License Expiration Date: CA - 1/31/2019 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000005493 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: 06/30/2018 <br />Signed: 14 Lw_� KYIe Melcher <br />Title: General Manager <br />P-4 of P-16 <br />20A-10 <br />