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Exhibit 15 -G1 Local Agency Bidder UDBE Commitment (Construction Contracts) <br />NnOTE: PLEASE REFER TO INSTRUCTIONS IN APPENDIX <br />GENCY: ��1/OT �Cw�'Lt�Q.�.�Q� LOCATION:�I� ��y�f ��/�j <br />��-yC i'/J -sew <br />/J `_ /7 / <br />PROJECT DESCRIPTION: PROJECT NO. � /-� /(�,Z�L� J��� ar. �� � /OY6GG N� %7 - / %'� <br />OTAL FEDERAL CONTRACT AMOUNT: $�� ���� <br />BID DATE: <br />/� � ./ /� <br />BIDDER'S NAME: C11'rG�1/ C�CJ��µ. ��- . <br />ONTRACT UDBE GOAL: <br />ONTRACT <br />ITEM OF WORK AND DESCRIPTION <br />ert. No. of UDBE <br />AME OF UDBEs <br />DOLLAR AMOUNT <br />ITEM NO. <br />R SERV[C ES TO BE <br />ND EXPIRA "LION <br />Must be certified on [he date bids <br />UBE <br />SUBCONTRACTED OR MA7�ERIA LS <br />DATE <br />re opened - include UDBE address <br />O BE PROVIDED <br />nd hone number) <br />/CQ. <br />� � 1./. %�' <br />V � i <br />or Local Agency to Complete: <br />Total Claimed <br />$� ��� �� <br />ocal Agency Contract Number _ <br />Participation <br />Federal Aid Project Number: <br />Federal Share: <br />�3;�% <br />ontract Award Date: <br />Local Agency certifies chat all information is completes and accurate. <br />Pri n[ Name Signature Datc <br />Signature of Bidder <br />ocal Agency Representative <br />Area Code) Tele hone Number <br />^,/ f �p <br />[� -10. /Z �Uf 8 � %fL -%;��� <br />Date (Area Code) Tel. No. <br />or Caltrans Review: <br />Print Name Signature Datc <br />Caltrans District Local Assistance Engineer <br />focal Agency Bidder -UDBE Commitment (Rev i /09) <br />vlscnounon: (�) copy - rax or scan a copy [o me Caltrans u�stne[ Local Ass�stanee Engineer (DLA t:) within 1 5 days of award. Failure to <br />send a copy [o the DLAE within I S days of award may result in de- obligation of funds }or this project. <br />(2) Copy -- Include in award package to Caltrans District Local Assistance <br />(3) Original -Local agency tiles <br />TO BE INCLUDED IN BID PACKAGE <br />BP 21 of 30 <br />