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CITY OF SANTA ANA <br />PROPOSAL <br />Project No. 13-2638: Portola Park Improvements (Parking Lot, Basketball, Tennis Court <br />Renovation) <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: 915,44S ASPH/>at r WL <br />Business Address: 7,ZC* S, Y4& a gr_ SpfN rA �/�CAz !?Z76 <br />Business E -Mail <br />Address: MRWit L1itJCQUJA. SAN' 45ehk imm <br />Telephone: 710 ON )770 <br />State Contractor's License No. and <br />Class: �gkw <br />License <br />Expiration II <br />Date: �$! (2o <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: %O6dD0 it" <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration trate: G.3o.ZOIs" <br />Signed: <br />Title: <br />