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EXHIBIT 3 <br />DIVISION 4— REFERENCE FORMS <br />4.05 DVBE PROGRAM CERTIFICATION SHEET, FORM F <br />CALIFORNIA DISABLED VETERAN BUSINESS ENTERPRISE <br />PROGRAM CERTIFICATION SHEET <br />Lessor must complete and sign to certify if DVBE Participation was or was not <br />obtained <br />LEASE AMOUNT/DVBE CERTIFICATION Lease Project No.:142056 <br />I hereby certify that the Lease Contract Amount, as defined below, is in the amount of <br />of which $ was awarded to a certified <br />DVBE firm resulting in % DVBE participation, I understand that the Lease Contract <br />Amount is the total dollar figure against which the DVBE participation will be evaluated. <br />Lessor Name <br />Lessor's Signature <br />Date <br />Printed Name <br />DEFINITION: Lease contract amount is the total amount of lease costs expended by the <br />Lessor over the firm term of the lease which are attributable to expenditures by the lessor to <br />make the leased property sufficient for state occupancy. This typically includes, but is not <br />necessarily limited to, tenant improvements, extraordinary maintenance, and janitorial services <br />specified in the lease. In the case of a build -to -suit facility, the total of the construction and off - <br />site development costs, as well as architectural and engineering costs, would be included. <br />14 <br />(Rev-3110) <br />80A-656 <br />