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CITY OF SANTA ANA <br />PROPOSAL <br />PROJECTNO.; 18-6903 <br />HAZARD AVENUE PROTECTED BIKE LANES <br />FEDERAL PROJECT NO: CML-5063 (182) <br />EXHIBIT 15-G CONSTRUCTION CONTRACT DBE COMMITMENT <br />1, Local Agency: City of Santa Ana 2. Contract DBE Goal: 16% <br />3. Project Description: Hazard Avenue Protected Bike Lanes <br />4. Project Location: <br />6. Bidder's Name: HYM Enaineerina, Inc. 6. Prime Certified DBE: IA 7. Bid Amount: 410 <br />8. Total Dollar Amount for ALL Subcontractors: 9. Total Number of ALL Subcontractors: �. <br />10. Bid 12. DBE 14. DBE <br />Item 11. Description of Work, Service, or Materials Certification 13. DBE Contact Information Dollar <br />Number Supplied Number (Must be certified on the date bids are opened) Amount <br />38719 <br />i-r uyJ, �d�-6�f� 1%�$�$6gSi 00 <br />bG oy� -- TI�'PS )5033 1 <br />21. Local AgencyContract Number: <br />22. Federal -Aid Project Number: CML 5063 (182) <br />23. Bid opening Date: February 26, 2020 <br />24. Contract Award Date: <br />25, Award Amount: <br />Local Agency certifies that all DBE certifications are valid and information on <br />this form Is complete and. accurate, <br />26. Local Agency Representative's Signature 27. Date <br />28.Local Agency Representative's Name 29. Phone <br />00. Local Agency Representative's Title <br />15. TOTAL CLAIMED DBE PARTICIPATION <br />IMPORTANT: Identify all DBE firms being claimed for credit, <br />regardless of flan Names of the First Tier DBE Subcontractors and <br />their respective Item(s) of work listed above must be consistent, <br />where applicable with the names and Items of the work in the <br />"Subcontractor List" submitted with your bid. Written confirmation of <br />each listed DBE Is required. <br />2/26/2020 <br />16. Preparer's Signature 17. Date <br />Abraham Jeon 714-523-2372 <br />18. Preparer's Name 19. Phone <br />President <br />20. Preparer's Title <br />1. unglnal - Local Agency <br />2.cnnv_Caliranc nlf,WIncmlA..f.-Cn.d..-rnine,c..u......_-.a..._,u_,., <br />execution may result In de -obligation of federal funds on contract. <br />3. Include additional copy with award package. <br />ADA Notice: For Individuals with sensory disabilities, this document Is available In alternate formats. For Information call (916) 664• <br />6410 or TDD (916) 654-3880 or write Records and Forms Management, It 20 N Street, MS-89, Sacramento, CA 958U. <br />P-26 of P-39 <br />