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CITY OF SANTA ANA <br />SPECIFICATIONS <br />PROJECT NO.: 15-2645 <br />SANTIAGO PARK GAS HOUSE AREA DEVELOPMENT <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: Nationwide Contracting Services, Inc. DBA Nationwide General Construction Services <br />Business Address: 10725 Ellis Ave, Unit i. Fountain Valley, Ca 92708 <br />Business E-Mail Address: Luicci@nationwidegcs.com <br />Telephone: <br />949-500-0894 <br />State Contractor's License No. and Class: 1031246 A,B,C8,C12,C20,C21,C36 <br />License Expiration Date <br />exp 09/30/2021 <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 1000057872 <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: exp: 6-30-2022 <br />Signed: <br />Title: Vice President <br />5 <br />