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Local Agency der UDBE Commitment (Con~ction Contracts) <br />• <br />• <br />GENCY: ~ l ~ Y O 'S 7 (~ N ~ A ~ LOCATION: PROJECT NO 08-5020: TRAFFIC SIGNAL MODIFICATION ON <br />Ste(, ~C \ y ~ ` ~ ~ ~` MCFADDEN AVE & NEWHOPE AVE <br />ROJECT DESCRIPTION: T <br />OTAL CONTRACT AMOUNT: $ \ 2"i. 5 37 , 3 ~ <br />ID DATE: 3 / 3/ ~~ <br />IDDER'S NAME: T2 Q N''J , TN er <br />ONTRACT UDBE GOAL: 3 . ~ \ ~I9 <br />ONTRACT <br />ITEM NO. TEM OF WORK AND DESCRIPTION <br />R SERVICES TO BE <br />SUBCONTRACTED OR MATERIALS <br />O BE PROVIDED ert. No. of UDBE <br />ND EXPIRATION <br />ATE AME OF UDBEs <br />Must be certified on the date bids <br />re opened -include UDBE address <br />nd hone number) OLLAR AMOUNT <br />DBE <br /> <br /> <br /> 3 ~ 2 - ~S o <br /> <br /> <br /> 5 ~. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />For Local Agency to Complete: <br /> <br />al Agency Contract Number: <br />Total Claimed <br />P <br />i <br />i <br />i <br />$ ~ SCt <br />' <br />ederal Aid Project Number: <br />ederal Share: 5 628 art <br />c <br />pat <br />on <br />~% <br />ontract Award Date: <br />cal Agency certifies that all information is complete and accurate. <br /> <br />'nt Name Signature <br />cal Agency Representative <br />Date Signature of Bidd <br /> <br />3 - 22 4 - b 3 \ <br /> <br />Area Code Tele hone Number: Date ,' (Area Code) Tel. No. <br />/ <br />or Caltrans Review: <br /> <br />Print Name Signature <br />Caltrans District Local ASS15tanCe Engineer <br /> <br />Date ~ «,~ Rn~ 1~ ~ ~ ~~ ~ <br />Person to Contact (Please a or Print) <br /> <br />Local Agency Bidder -UDBE Commitment (Rev 3/09) <br />..,,,„~u„~,,, t, ~ wpy - raa unu~cwa~eiy io me ~ aittans utsmcz t_.ocai Asststance t:ngtneer (llL.A):) upon award. <br />(2) Copy -Include in award package to Caltrans District Local Assistance <br />(3) Original -Local agency files <br />• <br /> <br />TO BE INCLUDED IN BID PACKAGE <br />BP 23 of 32 <br />