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Exhibit 15-G1 Local Agency Bidder UDBE Commitment (Construction Contracts) <br />NOTE: PLEASE REFER TO INSTRUCTIONS ON APPENDIX F <br />ya` <br />` <br />G INCY: C rtv of Santa Ana I OCATION: Jerome Park - <br />" ?y <br />PROJEC I' UI SCRIPIION P1201HC I NO_ 1? 7530 Jerome Park Pe <br />n <br />cin?,Improvement C''Y??'?, ??(e?L' <br />?_. e <br />6 <br />o <br />G <br />1'OIA1. 1'L-DL:RAL CONTRACT AMOUNT: $ , 7t6 11-]3 _ ?F?C P?p'/ <br />? <br />/v`?, ?.?i?r <br />A <br />?? <br />, <br />? <br />y+ <br />BID DA-fl??p?Q?,/Z <br />•?? <br />??? <br />t'f?'??'? <br />? <br />?''JJ /??? <br />6IDDER'S NAMI?: ?.XL?GC?]?/?VI 1•? ?-{Y Y(P?I'AIVI <br />ON"f RACI" l1DBIi CiOA L: s-7? o?p <br />ONl"RAC"f 1'1'EM OF WORK AND DESCRIPTION ert. No- ofUDBE NAME OF IJDBES DOLLAR AMOU N'f <br />1"fEM NO. R SERVICES TO BE ND EXPIRA"f10N Must be certified on the date bids UDBE <br /> IJBCONTRACTED OR MATERIALS DATE re opened -include UDBE address <br /> O BE PROVIDED nd hone number <br />1 G - t •1-f)..? CT 3 hc.-? Fd¢NtA P¢atF?sslor! Z oO <br /> __ <br /> 9Z4 <br /> CA <br /> Z!o - 81 _ 3 <br />- G 87 00 <br /> 82 ST_ <br /> v wlfA <br /> 7 rl <br />For Local Agency to Complete: <br />Local A <br />enc <br />Co <br />t <br />ct N <br />b c <br />d <br />l $ 3`i?! =iZ3.°O <br />g <br />y <br />n <br />ra <br />um <br />er: Part <br />pation <br />i <br />Federal Aid Project Number: <br />Federal Share- ?? <br />ontract Award Datc: <br />Local Agency certifies that all information is complete and accurate. ? ??. ? RoW 1{ <br /> 'FESIDE?tT <br />Print Name Signature Dale Signa Wre <br />of Bidder <br />Local Agency I2epresenta Live q <br />?UN - <br />?Q?? <br /> . <br />p <br />?J?j2? sg3-5Q4 y <br />A <br />d <br />l <br />C <br />T <br />h <br />N <br />b <br />rea <br />o <br />e <br />e <br />e <br />one <br />um <br />er <br />For Caltrans Review: Date (Area eoae> Tel_ Nn. <br />Print Name Signature Date <br />Caltrans DI$[rlCt local Assistance Engineer Local Agency Bidder - UDI3IZ ComminuenL (Rev 3/09) <br />Distnbubon: (1) Copy - Yax or scan a copy m Che Caltrans District Local Assistance L-ngineer (DEAF) within 1 5 days of award- Failure to <br />sand a copy to the ULAE within 1 5 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 files <br />TO QE INCLUDED IN BID PACKAGE <br />BP 28 of 37