~ 'd,A ,STATE OF CALIFORNIA. DEPARTMENT O~NSPORTCD n'..'.CERTIFIED DVBE SUMMARYDES.OE.0102.5 (REV 3/2008)

RCVD

sgDISTRICT.COUNTY.ROUTE: (J 8. ~f?'CONTRACT NO.: 0 B _ , c:3 2 ()'tTOTAL BID '2 01-1 \ (. I. 1- 0

BID OPENING DATE 4 l '23 I 2,-0 15BIDDER'S NAME: lin:4'.J ('-t v~~(pDVBE PRIME CONTRACTOR CERTIFICATION' ------~~~-----

Bid ItemNumber

Description of Work to BeSubcontracted to DVBE orMaterials to Be Supplied by

DVBE'

For CaltransOnly

DVBE(Name, Telephone

No" andCertification No,)

$ Amount

DV)7 f)l~.,.,( 1Cf I 14"b"-~'f<-1U - 'l- '1-1,. z.-:ff 151ql'lo

$'2 ~ITotal ClaimedParticipation

PV5r ~ lr

E•..Y-u/l"k

DillY. (r

71l.i~528- 7220(Area Code) Telephone Number

--z~Signature of Bidder

Submit to:

1. DVBE prime contractors must enter their DVBE reference number or their DBA name as listed withDepartment of General Services (DVBE prime contractors are credited with 100 percent DVBEparticipation and need not complete the above table).

2. If 100% of an item is not performed or supplied by the DVBEs, describe the exact part, including theplanned location of work 10be performed, of item to be performed or supplied by DV8E.

Names of first tier DVBE subcontractors and their items of work listed mustbe consistent with the names and items of work in the Subcontractor List(Pub Cont Code 9 4100 et seq,) submitted with the bid.Identify second and lower tier subcontractors on this form.

MSC 43OFFICE ENGINEERDEPARTMENT OF TRANSPORTATION1727 30TH STREETSACRAMENTO, CA 95816.7005

H,}-rl"" 4<4aMiContact Person (Type or Print)

ADA Notice For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 654-6410, TTY 711, or write toRecords and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.

DISABLED VETERAN BUSINESS ENl'eRPRISE DEClARATIONS:;m,B4;\,~~~ . _ __ _ _ .'. _..In~QM: ~ di:laibledvate_I!)\!}O1"'I1Ct'l$)~ Ov ~tlsl oiIheDisabledVl!Il!l'anSusirll!!SS En!elprise ,(O\IBE)must cQm;lleleIhis<:le<;!ataOOn~, $ El'Jtl:l!: ~.or ~wiI1 prnvlcla r..alerials. SUPpllieS,$eNlCellor equipmlilll! [MiIIW'J$fl(l Vetcml1s Cocle Seclian 999.21. VlOlallOO$ i!l~ll1isdeim!i!ll'lOm ood punislmllie by impri_m orl'lne and viai.~IP1'5 Q(<'. lioo!l!t for .' ~ under oi'

t

Marr", of Cf1!'lilioo OvaE . {/)uN{' ::::..~.l!!.IO:':':..,m~ilfU!:, O\IBE Rm. Number; 15J9120Desctiptioo(Mll\"ri;ll~p~rvi""",,~ Il"<lll(lSel:ll: g"fdy,~Liptillg&C_tnIdio" iMatuilds.Solid:alipl'llCootrOCl Nl.lffiI)e"O.1rae., 0ll-1f..nll4 by Ro&<:rsDr. :~~ Ret. Number:

. U,'OllQJlf: l'ERfQRMANCE CONSTRVCTlON INC ..•••.•.e"'. """"S"'r""A,==E""U==SE=-=QNI:.=='"'n-=--Sl"CTIQN' 2

APPlJE!l TO AlJ. OVBl:$. C!ililok only ~ bex In ~ 2:and proviIl4toriginal sigrWufM.

1:1. i '\"'l ~Cillre !hal !ha DVeE'" 001'" ll,oIt'lt <I[aga. liS delineo in ~ llll'ld VOO'lI1ll'l$ C~ section !l9U (I). of~ri"ls, Sltpplies. ~ l)f eq<.lipm0nt IislBl ~ Al$O,(:Qj11;M>WSecIl"" 3belaw if I'EIlllOSe<l\l~t

C Pumuant ill MI~1!lYaoo Ve!er"n.~cooe ~11ll'.illl.2 (fl. -I(wI;» dec!aro \lJllt tile ME i!; abrclsm: or i!lg!!'lHW !lll1:1lll(l(;l!>alfsllistc4d~ 2' 00 an $!tiachl'ld sllOOlf!!l. (~!rJ ."''1IilI'Id~_ Ctxie 999.2 fe). State. flllldsaxpl!:flOOdforequi,;lmell/ rotl!oo ffClm~ ~fJlLrwant io ~ -moo ~ IIlI$~ shB!I.!lQt beCnxP.too towan11hfi '3-pefOOnt DVBl?: ~ gooJ.J

FifmlPtir1Ci,pal [-Ofwllom \lJll OWE i$ iClitlll a:l ab!vl'<er or agent{If fflt(e ShenQJ'Ht llttrl. hEt4.)l't ~f8 iib~} ~ or Ttpe Name;

Fim-JP,il1<;iPl'I pt,<ll14>(~2::H'1J '1~6224 ~. 11I W. Ol:!t1Ill Bhd. 4tb 1>1001",lAng BeaclI (:A 90802S~$

APPLIES TO A!..L Ovm:Es THAT Ran' eQUIPMENT ANI) OECU\RE THE DWE IS NOT AaftOK&t

o PUBtla1'l1 rol\lilit4ry 000 Vett!rans cooe ~ >lll9.2 (e), (dl ~ @.I am (WI!"raJ tile DVjs) wiIIll!l:11!Ii!lSI51%OIlineC'$hi!, ,,1too DVeE', "" ;;, 0'1 ~li$l of'!l'lll OW!:. ~ O\ll:le QIl'lllil,"'.I QeflifiClllioll <Eqll~ ill=rtfanoe lMlh Milil1'lrymoo V_rans cooe SecIlOl'lllOO'et seq.

o~ \lnOOr'signc"\l ~'\ $) 'l"@'l,) l?l ic,3m 51% of the QtII1J1ll!!v a!!d walliegfm ll!fe!:;e Ol:!t!!l!Iip!!l!'Jlt thai Wllille~edfor ..- 1<1rhD oon:ra::tI<tenrlfllfl:latlowl. t {We>l.Ihfi DV <:1lWl_ of m" e<llloP/llent 1'1_ oo~ II> Ihfi Ildmil'lirst!>ring~ncy my<""')_n"1 iodernI ""'-'m(s) 5_ oiCl!l~ andannll!!!tylll<!l'~erlil$<lcfinmlinMJlItIJfy ~V/lltli''''7'' CrxJri fJ!i9.2, sub&l!Cllons lel;llr\<l (9). ~ by me ~~ equi{Jmoot(}WllfN(1;) iol<llbmit thw~}&I f~ I"" TQtvtn(I:} io me a::lmln~ ligeIlCJ'&IidI>~ fir~ arid Vli!~ ClXIiIIl/ll9.2, ~oi:lflSteJ snd (>II. wiJJ t=vU "., IN) DVm::' boing __ an oqulpmem ~

Cll!!llbledVetemn OVlOOf(s)of the l:I'Jtl:l!: ('_h ~~ wll!l~_l<$IOf __ to $ign)!

{l)usty{l)iamond !Enterprise

QUOTE & PROPOSAL

AGENCV: Ct\I,IMNS

~d. IWY' StiERS QR. OC 81' '$ND

Qwo"'- I'ro<Io\'1m# a9- Mo&Afy Signal - ,lAc 1

R,,¥~ Di'1& B~ llliB!lmllliSignals, I.E!)'."""'tda ••••Lf"'1; '" Al"5l'i'lrs1',,1e$ /!, Lumimic'£:;

(, - ?Pfj ""stI - Type I-A If!4 - RoodImY I lal Lumlmines1-let, An"'- Bolt:!: & IU :tfI:Ipc<:tion

IlJ:# 30 - Modify Si9"'Jl-lAc <1~~ute 15 S8 Rtl!ll!!lSCourrtdt:J<omI.E!)'.,& Al"S PPB'sl'QIes& Lunt"",,~

2 - P!'8 l'<>st<: - Roadooay 1 U,b Luml""i"""I - lot, AIiclIoI" !lofts &. 8,3 r~O:ltl

IlI# 31- Modify l.i9htingBov _.rs !)r & ISM15~Rtl!ll!!lSililicllol" Bolts

1 - Anohor Ilofu! for Type 15

"Quoted per eorr"""" 2010 StCl'ltll>rd l'i<m$&~,o..tivltry: !W"""" ARO& S._itt:$1 A",,~QOOftwlid f<ll" 30 ~,Terms:: Net 3O.l'Md,":9 C"",,1rt V""ific:<>tblFreig:llt: Incb:!t.dmi:> d~ i10lir1Clu<leT"""". &Ife1yor DOE

$830$4,320$4J,4!l

$90

DutyDilImlWlldEl\~III W. ~II m.'cI.,4'" Floor, Lool ~,CA !lOlllU

1~: (313)117-61241Fax::(Ii6I}C"~1 dll$tVdianl<llMl2{fllllil_il.eolD

n 1 1I'l'11rei!",@, "wry = et••••• c • •

~1 1._.......,~29.20U:R:t:isMllw.Weisse:Dmif;vDiall!! liM BlJr.eap; Ie453l F.. .!"lll:::l&; WayO. .il'"",""CA90040IU5: .l)j,.ib'led V<$. lid B i

D1::ar!lf.t.W~

n;,.X--is ••••••••••• _""""'- •••••••••".,Uo".•• :o IS.' '" of':;"'!p I'h (QRTt . ~c ! erA:~~ U:mt(CEO) ~~2O,,2ltt2..Otl!alDs_tllicB:dll':lidilsiw1l)emtlma CClfiftedDVBE:£imIsfilatbidQll.«~QIlq.t+-> S!p;ljm+e!p ••i.ampwa •••••ili8a••' ! "&_~ 1bnctjm (GOF).A:lcrClIIllt!llmt.lll!i:lt(Ifill:Mi" "ii!I;' 'II_Iii. il!"h"lJIioD._bel au1>:lIlrlh(l£'!l:oot~,11"01 i.m~e& v•••••••••~~~ Q)=4(lib J'Oil:r:fiml.:II~ 11)pe'liiilllaa:IFl'G'iI!n •••••i:iixilc.~~ afJl"'i'ndsQll.Oof!ml:Itpn...,.,

301$21) l"ClliIliIPg

26l21S Eer Iii a1VI.i:re391115 Gt!l:llmll I~F'l1iI1.iiRiis

m::tWlJlrS: ~ l'i'b.~Ij!lJ.l'fpI;~

~~hlmod.... ".";pav:i&m:ill: •••••••--p .aa:Jil; •.•.••••• Ji!$,ed.. -8.6' 1I1l1li;d •. &c~~ '!bi:tDVlEc:aditCllll.Q!U.Yhc& 1l11l1l_dll':"'nw!&\lmcg..-Iili"" VB"'ClC!ildlidtow::axlt$ :ovae: p:ts1txr O!ftr;amtSCEeftmtfe4(:c#4, et.s ~leaij';,ii. m1f.ica;Jislid.QI1J'Dt!r

- ~ 'i5 1!""".:Qi)!b'! i'- CIC.,..,;a ••• -t.m.PU~1I)""'M614 I " ••••)QD.p'.,. 'I••~llr~tlB'I'Il'adc~.

'!t_ma;y~"""":lio:::I ••",f :: -,_1> , . ,oto . ISlIt h (DGS)••~. :Jqxthiww.~ft!I:I3I.DPXP'IlCAa JU.:l'<iW' •• 'II~ "Mil"I" eawuf,,* Ii••••~~'1hm:1t.~-a:$ ••pIli' 'A:cr J EIr;a4OoCaltil.;!ijY_oa .•• .!:X!a:Q4 ' te.

~ceujslimi ah1Dm-tilit)Wt::G;;m;fD,' m ".:if' ••"a: 7&P!f.a"'I1:Dd14 'twl~fi., 41ioxt~~r r •

:-4t~SM.AE

~lmW!8liotl UJ:litC=~*'h¥¥in or~&aY:Lt::a

. ~""'~-..e ini"

DUSTY DIAMOND ENTERPRISE - #1519120

ll!gaIl'llIslnes& Name Rl.lSS8l. W WE'ISSC00ln!l~J>.s DUStYOIAMOND~Mdtess Ul WOCEI\!'lIlLW 4Th!FI.

lONG l'lEAOt CA 9Gl'!ll1(m) 117-6224(661)~

<l<!t!MIi_oodWtl@gm;>l! C!!!Itl!J!m,J~!l4t~~I!¥:!DliAA.mm~~rorAlameda, ~~,eo_~ Del ~ aDorlIclI>,~ ~ ~ InVo.. Kern,Kit'lllS,l..O!; ~ ~ f'larir>,.~ MllraId. Modoo;, Mana.~ ~ Qr:ange. ~$<10"" Ii!i Itt>. san ~ san DIego.. $!In flmlCi:SClO,san ~ san Wi$,Oblispo, san MiiIl!I!I>,. Sant'll~ .Santa 0mJ. SlII'OOU%,. SIIllSl2l. SOlano.SDi'll'lmil,. ~ 'Il.IIm:, ~ ~ ll:l!O.YubQ,llUIl.DlNG MA1'SUAl.$ ~ ROClI'IHG liVN:: I.l.ReER PI/'C.1'tY\!IOClO Pl.ASlIC~ WlRf:IH.B;;nm;:AI. FlX'I'lIll.ES I'lJJMBlNG ~ I'JPE. FENCING CAllI.E~CSCDNSTlWCllONSl.lmJl;$ASA~301016 -l.l<lr3Q10:a::l - P!ilte3Q1031 • Ra.lls301036 • Sbuc:l'uml produds3Q1U.5 _.Q:lncrete ana motta/s301217 - Rnaid. and raill'ol!d ~ l'llllIZ!I'I:aI301315 • ll10clcs3QU16-11riCb3013:t7- llleSandfta~JDIS!S - Roollng ~3Ol.S2O - RlllCing391215 • 8llc;bioli<:oI~.and ;a, , .s391317 - Wire Ra!:Il::rajlS CDniIuit and ~462115. W!:lrl<p1ace safetytn!lil't1l'lg aiIl!I and nllItmiIIIs'XlU15 - I..\'l!lcl and $llIl~Il721511' - smay ana Sl1:CIlrlty~ ~ *4\l::Ie$7'71.15- ~ saIl!l:y SEi .ilis77U15 • ~ ilOIIUliOl'l771217- -PClklUOn801.016.PItlgecI:~"":tUG-T",._ "I ~ ••••• Iwz6Ot615-~~_i*lilSGl321 • 11'alning planning.l\dltation and dlltlliEi YSl!Mc:il$

Dee 18. 2012Dec2l.211U

Dec31,20U>. Dec 31, 2016

"1

Public Works Contractor Registration 5ear<:b_ •••......,"' ••~~ ••_::a,_1._~--'12lllct •••~-CioIIl<

£nP.l't".~~~,~.,~~~~~.,llt'rt«f~)'CI4ltll'l:'t ':1

~Ilt>lf_'_. -PIlbIleWoIb _lloglS.ltllllM'Well~ __OM~d C<mlmetllr/Wncj,1---IW$SUL W_W~y OM !)1J$T"fOlMltONti £liTmiUSE

1'1 _ ' ~ ~Typ.,., •••.••••-rot * "lion 0.. Ii;"', tie-rtClltil:

l\lOOOl'~ OTl'R;~lXlS. 1l.ll1W2015 iltlI1l'OI2<l15151'lZ1l

-----"'-_ .••._.

...

Plan Ahead, Always Put Safety First.

Worried aboutOSHA compliance?

Y:oushould be. They're coming!- Customized Illness and Injury

Prevention Program• Heat & Illness Prevention,-Site Compliance• 4bor 10 & 30 Cards• 300 & 300A Reports

-... • OSHkSaftey Program'\ Ta~I~~ ToolBoxTrainingLogs

TraJDlng Conducted by:Rory cJFolsom

"-- .. pustyDiamondEnrerprise1:heiiOperations OfficerI{;. .•.~. Directol'~~"'1 . "'-uc San Diego - F'xtension

_ Outtftc:b.Trainer.~~j . ~;, !~?~". ,v:y,lJ ','.,,,,.._m@gmail.com",!C"

~ ,.•.. ,

Aulborized TI!tner By The usDepartmlntllftDbor

BidSync: The. State of California: RUSSELL W WEISSE Page 1 of2

f4v D.I'.parfment ot

General Services8U1LDING GREEN ,IloUYING GREEN .WORKING GREEN

Welcome 11QgQlliNeed assistance?Contact usOf"ull 800.900.93)9

DUSTY DIAMOND ENTERPRISE- #1519120Supplier Profile

Legal Business Name RUSSELLW WEISSE

Doing Business As DUSTYDIAMOND ENTERPRISE

Address 111 W OCEAN BLVD 4TH FLLONG BEACH.CA 90802

Phone

FAX

(323) 717-6224

(661) 424-9088

Email

Web Page

Business Types

Service Areas

Keywords

Classifications

dustydiamond2010@gmail.com

http://www.dustydiamondenterprisecom

ServiceNon-Manufacturer

Alameda. Butte. Calaveras, Contra Costa, Del Norte, EIDorado, Fresno, Humboldt. Imperial. Inyo,Kern. Kings, Los Angeles, Madera. Marin, Mariposa, Merced, Modoc, Mono, Monterey, Napa,Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, SanJoaquin, San LuisObispo, San Mateo, Santa Barbara, Santa Clara. Santa Cruz. Shasta, Solano, Sonoma, Stanislaus,Tulare, Tuolumne, Ventura, Yolo. Yuba,

BUILDING MATERIALSCONCRETEROOFING HVAC LUMBER PVC PLYWOOD PLASTICCONSTRUCTIONWIRE ELECTRICALFIXTURESPLUMBING ELECTRONICPIPEFENCINGCABLEFIBEROPTICSCONSTRUCTIONSUPPLIESABATEMENT

301016- Bar301022 - Plate301031 - Rails301036 - Structural products301115 - Concrete and mortars301217 - Road and railroad construction materials301315 - Blocks301316 - Bricks301317 - Tiles and flagstones301515 - Roofing materials301520 - Fencing391215 - Electrical controls and accessories391317 - Wire Raceways Conduit and Busways462115 - Workplace safety training aids and materials701315 - Land and soil protection721517 - Safety and security system installation services771115 - Environmental safety services771215 - Air pollution771217 - Water pollution801016 - Project management801116 - Temporary personnel services801616 - Business facilities oversight861321 - Training planning. facilitation and delivery services

...._.- - _ ... -- _. - -,_.- _.

http://www.bidsync.com/DPXBisCASB ?ac=supplierprofile&supplieroid= 1584454 4/27/2015

BidSync: The State of California: RUSSELL W WEISSE Page 2 of2

Active Certifications

lYPE STATUS FROM TO

SB(Micro) Approved Dec 18,2012 Dec31,2016

DVBE Approved Dec21,2012 Dec31,2016

Certification History

lYPE STATUS FROM TO

DVBE Expired Feb 25, 2011 jan 31, 2013

SB(Micro) Expired jan 27, 2011 jan31,2013

http://www.bidsync.com/DPXBisCASB ?ac=supplierprofile&supplieroid= 1584454 4/27/2015