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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 24-6058 <br />SARTC FOUNTAIN REPLACEMENT <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: <br />Business Address: Q.407 A/02Cc0w3e, f't, M;ns'►©n Lj; FAQ C,9 W ?I <br />Business E-Mail Address: <br />Telephone: — <br />State Contractor's License No. and Class: <br />License Expiration Date: <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: 9W - — <br />State Dept. of Industrial Relations (DIR) <br />Registration Vxpiration Date: <br />Signed: <br />Title: �,.,��nl f"IO�Amws[3�P� �►'�s��L°}t <br />L <br />P-I I of P-24 <br />City Council 20 — 12 8/6/2024 <br />