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CITY OF SANTA ANA PROJ. NO, 14-7516 AND 15-7514 <br />PROPOSAL ADDENDUM NO. ONE <br />PROJECT NO. 14-7516 AND 15.7514 MARCH 10, 2015 <br />RESIDENTIAL STREET REPAIR EY 13/14 & 14/15 <br />CONTRACTOR'S LICENSING STATEMENT <br />The undersigned contractor, or corporate officer, declares under penalty of perjury that the <br />following is true and correct. Expiration Date <br />Contractor's Name: PW INC. DBA EXCEL PAVING COMPAW <br />27 LEWN AVENUE <br />Business Address: LUNG OFACH, CA 30806 <br />Business E -Mail _ <br />Address: hu <br />Telephone: (552) 599-5641 <br />State Contractor's License No. and Class: STATE LIC° 668659 W <br />License <br />Expiration Date: Cj l�, I101to <br />Department of Industrial Relation(DIR) <br />Registration No.: k(�®33� ) <br />Department of Industrial Relation(DIR) <br />Expiration Date: U SO1�- <br />Signed: <br />Title: C,P.811130PY",I E1,16!'.Ellr <br />BP -4 of 15 <br />