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CITY OF SANTA ANA <br />Harbor Boulevard Corridor Traffic Signal Improvements <br />(as part of Harbor Blvd Traffic Signal Synchronization Project) <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/tier subcontractors are registered with the State of California Department of <br />industrial Relations (DIR), and that the following is true and correct. <br />Contractor's Name: <br />Business Address: <br />Business E -Mail <br />Address: <br />Telephone: ')I q f }z -- (S,q („� / <br />State Contractor's License No. and Class: k' l LL a -t0 / A <br />License <br />Expiration Date: <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: � O000 1 j <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiratiop Date: , <br />Signed: <br />Title: GregMV W. Holman, Vice President <br />I <br />