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CITY OF SANTA ANA <br />• Eshibit 15-C;1 Local A>sistance Procedures lianval <br />Local ~geac~- Bidder LTD $E Commitment (C'~onstruction Contracts) <br />I~STRL"CTIt3ti S - LOCAL ~,GE1C~ BIDDER. <br />LOBE C0~1i~iIT1fE~T {C'O\~SIRL'CTICt'_\ C0~1TR-~t:TSj (Retired 03.109) <br />ALL BIDDERS: <br />PLE AS1L 10TE : It is the bidder"s resgonsibilits to t•erifr- that the t"DBEf s) falls into one of the folloning <br />groups in order to coast kot~ards the LOBE contract aoal~ 1) B1ach American; ;jAsian-Pacific American; <br />i~ ~ati~-e Amcrisan; ~} `it~omeu, TI4is infoi°tnatian may- be snbtnitted tS-ath -our bid pr~ogosal. If it is uot, <br />and ~•ou are the apparent lo>~• bidder or the second or third loaf hidden it must snbmittied sad receit.•ed as <br />specified in the Special Proti-isions. Failure to submit the required L~DBE commitment n-ill be grounds far <br />finding the pt•oposat nonresponsis•e <br />t:DBE is a firm meetutg the defiauticu of a I}BE as specified in ~9 CFR sad i= one of the follau•iug groups: <br />1. Black :~nneniean <br />_'. ~=ion-Pacific Anlencan <br />~, ~Tstic.•e American <br />+, i~i~'omen <br /> T}ae fora: retiture~ specxtic in=orr~ation re?arclin? the c~nstructian ~~otx~aet zQenc~', Lccataon. Project <br /> DescrEFt~c~n. Federal ?.id Project Vtutber {assi~ne3bt- C:~Itraus-LiSCaI :~sststw.:e). Total Contract r?molmt_ Bid <br /> Date_ Bidder' ~ l~stme. and C'outrt;ct Goal. <br /> Tire font: ha s ~ cohtta:n for the ~'-cntra: t Item Kuntber kcr :ten: `_30° sj and Item of ti'orl; and Description or <br /> ~er4-aces to lie Subcontracted cr1~.4akeriaL. to be pra,-ided, b!r L-DBEs. T'lLe UD$F shottldprotzde a certificati4u <br />• IIYRL'E7ei tb 11? ~~OIItt:tit0:' :rnd e!ipnr'tLOtn t'1;1te. X112 fora lna5 a column WS t~214111]e3 8fLZ7BE eantn•actat•s to <br /> perform the n•~ork ~ :~°h~ must be certified ~n the •date bids are opened and iu-prude the ~~1BE a3dn'es~~ anti phone <br /> ntuvber~. EateE -he LrDBE prirse•y {1nd sul~c~~ntractor~' ce~ficatian rluaxbes. Prime contrr~ctar3 shall indicate all <br /> ~t~,~rk to be pa fornnned b': 4~-DBE- ittchtdin~. if -he ptir~e i.s 3 LTDBE. t~~ork perfc:~ed b}• its ea°n farces. <br /> L2+4PC)RT .ITT: Itlenttf~• all L-DBE :tats betne palrticiFatin2 in the pr~jeet reea_dl.ss of tiea_ `Names of the Ftr~,- <br />'• <br /> be cc+nsistent, t~:sere appli~:able. <br />Tier .~I7BE Snl~c~intractors and their respccti:=e item(sl of :t•~rk listed shottld <br /> t3•ith -he naate°s alld E;~°:115 Of ti'Or~: in th,e "List of Subc~ntractor5" submitted .t'tth ~~ o~a~ bid. Pro,-icte copies of 1te <br /> i:I7BEs' CItlCtei. and if applicable, a ccp~' of icin:-en-ttre~ aereetneats pursuant to the Subcontractors Listsraa Late: <br /> aria :lie special Fra,-tsions. <br /> Thera is a cahunn fnt• thz atal 1.rDBE dollar nnnettmt. Enter the Total t'lairued L:DBE FartieipatiMn dollars and <br /> percentage au~otnnt of items of tt•ork submitted ~~~itb }~onu bid ptustunt to the SF•ecial Pro~tsions. !(If ll}~°~~ of item <br /> is not t~; be perfostned or fwvisht'd b}• the L'DBE, describe exact pontio© of time to be performed or famished b}• <br /> the GIBE; See ~ertiou "I?isads~antaged Bltsiuess Etlt~pnse (i?BE;,•` ~f the Special pIt~ti~'lil9rl9 ~C4E1S71n~:t14II <br /> con~-actsl; to cletertnine• h3rr to : oust the Pat*icipatioa of iDBE iirmS_ <br /> Exlti6it I ti-G t l; attest be si~aed and dated by the pers~an bidding. else li=•t a phone nttttber itL lie space prolzded <br /> aid print -lia naive ~f the p~rsan .b e~nract. <br /> L.t)C:il ~i.~ellCieS shuand ~ctnpla-a the Can.nact An~ard Date and Federal ~ltarz fields and ve:ii?~ that al <br /> inferznnaticiZ is ecunpleta arad accttra-e before signing and geuding a cape r3f the farm to flue Distri~~ t Local <br /> assistance En?inaer ;l'1th311 = ~ dc~~'S of a1~.3rd.. Failuue to ~ubruit a cailnplete•3 at,d accint3te forrzn it•ithlu the i 7-da~• <br /> ttune period m~.=, uesult itn the de-~bliaati;.u of fitnds on this project. <br /> Uistrirt UBE C oarclinatot• shoo€d ~:erif~.• that all inf.rtilation is complete and accurate. C)nce Sae <br /> unfo~atiauhos k~e:ta 4erified, ;h, Uisiri:ct Lcrt~! :~s~i~tlnce En_gineei° =~tgns and dates the ferm• <br />• Page 16-3'_ <br /> \Larcl~ _'?,'_0~~3 LPp ~D4-ss <br />TO BE INCLUDED IN BID PACKAGE <br />BP 21 of 31 <br />