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Local Assistance Procedures_Manual Exhibit 10-01 <br />Consultant Proposal DBE Commitment <br />1. Local Agency: <br />EXHIBIT 10-01 CONSULTANT PROPOSAL DBE COMMITMENT <br />City of Santa Ana <br />3. Project Description Various Environmental Services <br />2. Contract DBE Goal: TBD per'task order <br />4. Project Location: City of Santa Ana, CA <br />5. Consultant's Name: Terracon Consultants, Inc. 6. Prime Certified DBE: ❑ <br />7. Description of Work, Service; or Materials <br />Supplied <br />B. DBE <br />Cenification <br />Number <br />9. OBE Contact Information <br />10. DBE % <br />MoldLab / Lead Paint Chip Analysis and <br />Bulk Sampling Analysis <br />wfdb42302y0418 <br />Kristina Rucker (972-820-9373) <br />TBD <br />Local Agency to Complete this Section <br />11. TOTAL CLAIMED DBE PARTICIPATION <br />o <br />TBD b <br />17. Loral Agency Contract Number: <br />18. Federal -Aid Project Number: <br />19. Proposer! Contract Execution Dale: <br />Identify all DBE firms being claimed forcredit. <br />regardless of tier. Written ra),atlon of each listed DBE is <br />Local Agency certifies that all DBE cenifications are valid and information onORTANT: <br />this forth is complete and accurate. <br />required. <br />12018 <br />20. Local Agency Representative's Signature 21. Date <br />12. Preparer's Signature 13. Dale <br />Fred Buhamdan 949-261-0051 <br />22. Local Agency Representative's Name 23. Phone <br />14. Preparees Name 15. Phone <br />Principal <br />24. Local Agency Representative's Title <br />16. Preparers Title <br />DISTRIBUTION: Original — Included with consultant's proposal to local agency. <br />ADA Notice: Forindividuals with sensory disabilities, this document is available in altemale formats. For information call (916) 654-6410 or TCD (916) 654- <br />3860 or write Records and Forms Management. 1120 N street. MS -89, Sacramento, CA 95614. <br />Page -1 of 2 <br />July 23, 2015 <br />25F-307 <br />