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Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) <br />NOTE: PLEASE REFER TO INSTRUCTIONS ON APPENDIX F <br />AGENCY: Cite of Sanla Ana LOCATION: Jerome Park <br />PROJECT UB:SC'RII'l"ION: PROJL.C"1? NO. 12-7527 Jero <br />me Park Se <br />curity Liehtine Improvemcr!! <br />p <br />2 <br />f0"1"AL PE DEKAI. CONTR <br />AC"I' AMOUNT: $ -I ?O ' ? ? .7 r9O <br />-f <br />BID I>A"I'E: ?j_/??? L r i_k f/?iC.. r?tjf?4_= <br />'?AVI <br />1 <br />'- <br />?' <br />?? <br />1 <br />/G C?/?p? <br />?a3i3ril AV NUS <br />? ' <br />' <br />BIDDER'S NAME: <br />?ilG? 'PA•1//? CpYYlPlctilJl i <br />? 9 <br />?J <br />= <br />y7 <br />L <br />?( H' <br />O ? <br />?y -1 CA <br />'ON"f RAC"1' UDBIS GOAL <br />O <br />I ? ? <br />SOS <br />: <br />• <br />O <br />'ONI?KAC''1' ITL'-M OP WORK ANl> DESCRIPTION en. No. of UDBE NAME OP UUBL's DOLLAR AMOUNT <br />ITEM NQ_ R SEKVICES TO BE ND EXPIRATION Must be certified on the date bids UDBE <br /> 'UBCONTRACTEll OR MATERIALS DA"i'E re opened -include UDBE address <br /> i0 BE PROVIDED nd hone number <br /> _ 00 <br />- -____ ...._- _ LLllnWll•!1 _ <br />N -C? Ull 1 - <br /> OZTT>? N N\•i <br /> 1.+4- P ?l <br /> IOZ(o - SIO - 1 3 <br />S- $ t S QSGkp S o 0 <br />' t&1Y2. uS <br /> 4t ? V <br /> 71 -9 - i <br />For Local Agency to Complete: <br /> Total Claimed $}, ??5??•OO <br />Local Agency Contract Number: Participation <br />Federal Aid Project Number: <br />Federal Share: .. y?% <br />.ontracL Award Datc. <br />Local Agency certifies [hat all in lonnation is complete and ace ura[e- . <br />? y,_ _ <br /> ? <br />? <br />I PRESIDENT <br /> <br />Print Name Signature Date - Signature of Bidder <br />Local Agency Representative <br />JUN _ ? ???? ?J?7Zj S?-5Qd7 <br />(A <br />ea C <br />d <br />)T <br />l <br />h <br />N <br />b <br />r <br />o <br />e <br />e <br />e <br />one <br />um <br />er: <br />For Caltrans Review: <br />Date (Area Code) "fel. No. <br />Pnni Name Signature Date <br />Caltrans DISLn Ct I.OCaI Assistance Engineer Local Agency 73 id der- UD131i Commitment (Rev 3/09) <br />D?stn buL On_ (1) Copy -Pax or scan a copy Lo the Caltrans Distn ct Local Assistance Engineer (DLAE) within 7 5 days of award. Failure to <br />send a copy to the DLAE within 15 days of award may result in de-obligation of funds for this project. <br />(2) Copy -- Include in award package to Caltrans District Local Assistance <br />(3) Original -Local agency tiles <br />TO BE INCLU?)?D IN BID PACKAGE <br />BP 22 of 37