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CITY OF SANTA ANA <br />PROPOSAL <br />PROTECT NO.: 15 -6848 <br />BISHOP - PACIFIC- SHELTON BIKE BLVDS <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: P.AllL19 PC, Mile U EL PAS CDMFPW <br />2"'d'tj 150nim j E, >: <br />Business Address: UA!4 BEAU, f,1, S <br />Business E -Mail Address: <br />Telephone: 1562i 599.58k1 <br />State Contractor's License No. and Class: STATE HC_ fittHS9-4� <br />License Expiration Date: 5 bsk-lute <br />State Dept. of Industrial Relations (DIR) <br />Registration No.: I <br />State Dept. of Industrial Relations (DIR) <br />Registration Expiration Date: <br />Signed: <br />Title: <br />P -6 of P -1.8 <br />23B -13 <br />