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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 18-6613 <br />C-5-F CHANNEL REPAIR <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: S p5 C 0 coy- S "t i" c A-C T s , In c . <br />Business Address: 1'aa �i r�l S�, 1 S Wcc t t h CA 91311 <br />Business E-flail Address: V S C?. W in S,4 r kk4% YYkA,1 l . C: o Vv'� <br />Telephone: _ (: b 10.) r10 d " O'3 o q <br />State Contractor's License No, and Class: © 1 A $ 15 <br />License Expiration Date: j t ;L 0 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 10 (D C) 0 ',)- 03 � Q <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: <br />Signed: <br />Title: <br />012.011 <br />P-3 ofP-15 <br />-r(v S u <br />