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Local Assistance Procedures Manual EXILIBIT 10-01 <br />Consultant Proposal DBE Commitment <br />EXHIBIT 10-01 CONSULTANT PROPOSAL DBE COMMITMENT <br />(Inclusive of all DBEs listed at bid proposal. Refer to instructions on the reverse side of this form) <br />1!i,y«1 �. .?r. ✓r vt 1,?¢, n�+�-`4i��,, I.�!'n��. & �yY _ a'S4 4.F :'.ri°:iia <br />/��^`}a <br />1. Local Agency Name: t"� w';f 0r, %% Yr�� "^�. �tt�GiC fi✓�/L>�.:% <br />2. Project Location: tAl 1 0 0� L'�a+i-�C.- V f CSS <br />3. Project Description; <br />d. Consultant Name: li (1)e.Oc zwC> {� Sf b L'_t�"( I N -C <br />6. Contract DBE Goal W <br />DBE Commitment Information <br />S. Description o£8wvices to be Provided 7, DBE Firm <br />Canted irabaration <br />g. DBECert. 9. DBE % <br />Number <br />S tit <br />e I�:?jrtil�,x�Cl"!.-sN: 1 llin9iil"rA,'$8ltey'Yfa`�°!;d :: 1n1a+ilrtsiSR'¢hotl �a('a161417 <br />16. Local A eContract Number: <br />V. Federa)•aid Ptuioa umber. <br />18. Proposed Caramel Execution bate: <br />Local Agency certifies that all DBE certifications are valid and the <br />information on this form is complete and accurate; <br />IAN <br />616tm <br />..: <br />A,aew;xN <br />"} <br />er's signature <br />12�rnpamr's Nama (Print) <br />r/ � <br />1A Locat Agency Representative Name (Print) mm <br />20. Lass Agency Representative Signature 21. Date <br />22.Locai Agency RapresentatireTit)a 23.(Area Code) Tel, No. <br />1.7 rcparar's Title <br />14. Date 7 I&(_7 Code) Tet. NOo,! <br />Distributiou: (1) Original- Consultant submits to local agency with proposal <br />(2) Copy- Local Agency files <br />Page 1 oft <br />LPP 13-01 May 8, 2013 <br />J <br />