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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECT NO.: 16-6876 <br />FORMER YMCA — MATERIALS ABATEMENT AND ENVIRONMENTAL <br />REMEDIATION <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: <br />VI SIq <br />Business E -Mail Address: � � (� 1 � Ott <br />r <br />Telephone: v7w • - 1A <br />State Contractor's License No. and Class: A u � 11T'I f , i G, G -J- <br />License Expiration Date; <br />State Dept, of Industrial Relations PIR) , s,tl A <br />RegistrationNo.: ' U 0 t lA V <br />Stato Dept. of Industrial Rein us (DIR) <br />Registration Expirationlrlaje t �, <br />Signed: <br />Title: <br />P-7 of P-19 <br />20 <br />