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CONTRACTOR'S LICENSE DECLARATION <br />(Business and Professions Code Section 7028.15) <br />The undersigned declares that he or she is Owt.3 <k <br />(Title) <br />of i rIVN .SOIIIQ N� (Bidder) , <br />(Company Name) <br />1. Contractor's License Number:6/ q3 q6 A - State_ _ <br />2. Contractor's License Classification: A <br />3. Expiration date of Contractor's License: .TUNCc, 19� <br />4. Bidder acknowledges that Section 7028.15(e of the Business <br />and Professions Code provides as follows: <br />"A licensed contractor shall not submit a bid to a <br />public agency unless his or her contractor's license <br />appears clearly on the bid, the license expiration <br />date is stated and the bid contains a statement that <br />the representations therein are made under penalty of <br />perjury. Any bid not containing this information, or <br />a bid containing information which is subsequently <br />proven false, shall be considered nonresponsive and <br />shall be rejected by the public agency." <br />The undersigned declares under penalty of perjury that the fore- <br />ing is true and correct. <br />-ij r <br />Executed on, 41, <br />.(insert city and state where signed) <br />Name 6f Compariy <br />GI k, ki ri 'J, �, h <br />Typed N me <br />i <br />SignaturA <br />OWNC� <br />Title <br />10 <br />