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EXHIBIT 12 (cont) <br />4. Efforts made to assist W/MBE in obtaining bonding, lines of credit or insurance, and any technical assistance <br />related to the plans, specifications and requirements for the work which was provided to W/MBE: <br />None <br />5. Any additional data to support a demonstration of good faith effort, such as contracts with W/MBE assistance <br />agencies: <br />None <br />I declare under penalty ofperjury that the foregoing information is true and correct to the best of my knowledge, I <br />understand that the City of Santa Ana and/or the US Department of Housing and Urban Development may verify <br />the information provided herein in connection with WIMBE compliance evaluationlaudit activities and thatfailure, <br />to fidly and truthfully complete this form may result in economic or other sanctions. <br />Si nature: - <br />Name; iana Lehm n <br />Title: Office M r. <br />Date: -100 <br />Name of Con tractor/Subcontractor: <br />LEHMAN CONSTRUCTION, INC. <br />Contractor/Subcontractor Identification <br />Number: <br />CSLB License 239570 <br />Address (Street, City, State, Zip): <br />1691 Sierra Alta Drive <br />Santa Ana, CA 92705 <br />Business Racial/Ethnic/Gender Code: <br />Circle the numeric code which indicates the racial/etluuc/gender character of the owner(s) and controller(s) of 51% <br />of the business. When 51% or more is nbt owned and controlled by any single racial/ethnicity/gender category, <br />circle the code which seems most appropriate. <br />1= White Americans <br />2 = Buck Americans <br />3 = Native Americans <br />Woman Owned Business: <br />Circle One: <br />Yes or <br />4 = Hispanic Americans <br />5 = Asian/Pacific Americans <br />6 = Hasidic Jews <br />=7 <br />F:\âť‘OCSIPROPSVCS1HLIDFORMS5MBU5BC4AMB - Sactlor3Specs.000 <br />