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25G - AGMT FOR ASPHALT AND STORM DRAIN
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25G - AGMT FOR ASPHALT AND STORM DRAIN
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Last modified
11/25/2020 12:15:58 PM
Creation date
11/25/2020 12:10:55 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25G
Date
12/1/2020
Destruction Year
2025
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CONTRACTOR'S LICENSING AND REGISTRATION STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that he/she and all <br />his/her subcontractors are registered with the State of California Department of Industrial Relations (DIR), <br />and that the following is true and correct. <br />Contractor's Name: <br />174 4%Gleeri <br />Business Address: 1/7-TO l ram; ke-e9 1 vo( #/a te `YO qi / I r v;,te Gh V62 0 <br />Business E-Mail Address: s e D K2 ! b% a hem em F 1 neeri H c. -oust_ <br />Telephone: gYq— y0 O -- I� O O �i U <br />State Contractor's License No. and Class: A - 7 7 `y q ! 7 <br />License Expiration Date: © d - a f - 02 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: j o O o o O 7416 6 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: <br />Signed: <br />Title: ) r<3 <br />
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