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Appendix <br />AT.TA,CIIM.NT 4 <br />ADDIXOAi <br />81 <br />CITYWIDE <br />CITYWIDE STREET LIGHT UPGRADE <br />RFP NO.: 17-075 <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: _Siemens Industry, Inc Intelligent Traffic Systems <br />Business Address: 9225 Bee Cave Road Building B, Ste 101 Austin, TX 78733 <br />Business E -Mail Address: bidadmin.mobility0siemens.com <br />Telephone: 512-837-8300 <br />State Contractor's License No. and Class: 758796, Class A, R C10, C16 C20 <br />License Expiration Date: 2128/2019 <br />State Dept, of Industrial Relations (DIR) <br />Registration No.: <br />State Dept. of fifiudrial ela ions (DIR) <br />r Regison 0 e. <br />Signed: <br />Title: <br />1000002447 <br />06/30/2018 <br />City of Santa Ana RFP 17-075 <br />Page A4-1 <br />