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CONTRACTOR INFORMATION <br />(Required) <br />CONTRACTOR: <br />(Company Name) EEC Environmental <br />Year Est.: <br />1995 <br /> <br />BUSINESS ADDRESS: 1 City Blvd West #1800 Orange, CA 92868 <br />WEBSITE: https://eecenvironmental.com/ <br /> <br />DIR REGISTRATION <br />NUMBER: <br />1000017876 <br /> <br />*DIR # must match the Company Named mentioned above <br />APPLICABLE LICENSE(S) #: NA <br />SUBMITTED BY: <br /> <br />Name: Jim Kolk <br />Title: Principal Engineer <br />TELEPHONE: Office: 714-667-2300 <br />Cell: 714-642-8937 <br />EMAIL: Email: jkolk@eecenvironmental.com <br />Email: <br /> <br />Questionnaire (please circle):  <br />1.Has the contractor license been suspended in the past? (If Yes, please explain) <br /> Yes No  <br />If, Yes__________________________________________  <br />2.Do you have any contracts terminated by Owner in the past? (If Yes, please <br />explain) Yes No  <br />If, Yes__________________________________________  <br />3.Has the company been debarred or suspended by Owner in the past? (If yes, <br />please explain) Yes No  <br />If, Yes__________________________________________  <br />  <br />SIGNATURE: DATE: 6/3/2025 <br /> <br />TITLE: PRINCIPAL ENGINEER <br />I declare under penalty of perjury that I have the authority to execute this bid and that the <br />foregoing is true and correct. <br />Docusign Envelope ID: 183BA217-2E64-4627-AB5B-FA1828041D5A