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Exhibit"G" <br /> Certification of Consultant,Commissions &Fees <br /> (Caltrans Form 10-I+� <br /> I HEREBY CERTIFY that I am the Vice President ,and duly authori�ed <br /> representative of the fum of Bellecci&Associates .whose address is <br /> 6601 Koll Center Parkwav Ste.240•Pleasanton,CA 94566 ,and that,except as hereby <br /> expressly stated,neither I nor the abwe firm that I repr�sent have: <br /> (a) employed or retained for a commission,percentage,brokerage,contingent fe�or other consideration, <br /> any fum or person(other than a bona fide employee working solely for me or the above consultant)to <br /> solicit or secure this contract;nar <br /> (b) agreed,as an express or implied condition for obtaining this contract,to empioy or retain the services <br /> of any firm or person in connection with carrying out the contract;nor <br /> (c) paid,or agreed to pay,to any firm,organization or person(other than a bona fide employee working <br /> solely for me or the above consultant)azry fee,contribution,donation,or consideration of any kind,for or <br /> in connection with,procuring or carrying out this contract. <br /> I acknowledge that this Certificate is to be made available to the California Department of Transportation <br /> (Caltrans)in connection with this contract involving participation of federal-sid highway funds,and is subject to <br /> applicable state and federal laws,both criminal and civil. <br /> 9116/13 <br /> (Date) (Signature) <br /> Distrlbutlon: 1) Local Agency Project File(Original�Canhact) <br /> 2) DI.AE(with cotdract copy) <br /> Page 1 of 1 <br /> LPP 13-01 May S,2013 <br /> REV:09-26-13 VR <br /> ATTY/AGR/2013.169/BELLECCI&ASSOCIATES Page 33 of 38 <br /> CHARTER ST.SRTS <br />