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Local Assietance Procedures Mannal EAriblt 10-01 <br />._Consultant Proposal DBE conlraltinent <br />E.7CHIRIT 10-01 CONSULTANT PROPOSAL, DBE C01"M1"tNI'JENT <br />1. Local Agency: City of Santa Ana .,. 2. Contract DBE Gpai, 15% <br />a. Project Dascdp0e, Geotechnicel SPOcial lnspautlon S Material r astirlg Fahlla Works Capitol Irrlp overeat Program <br />4Project Location: Santa Ana GA <br />6Name U. stir. B. Prano Cerlliled OBE: 0, ConsuiisnC's rlltetl,Inspection tlon,and 1as.... ,. ...,,_� <br />...... _...................._...,......_...............,.,.........._ .....___._.___ "---"------ I <br />7. bascnption of Work, Service. or Materials .DBE <br />Caniflcatmil n, DBE Contact. Information 14. DBE % <br />`1opPllitd Number <br />'�----�"---_—.�.. ._..................._................... ........ <br />�-.--. ....._._ ..._ <br />Materials Testing and Inspection 641 Axiom Corporation - Johnathsn Hou 5% <br />P - 714247.1002 <br />- ........... .... _... .. .— ---- ........... <br />I <br />I <br />I <br />Local Agano to Comple4athis$0014n <br />17. Local Agency contract Number 1t. TOTAL CLAIMED DBE PARTICIPATION 15 OA <br />M Fadarei-Aid Project Number: <br />16. Propesed Contract axraeuiton 4ato: <br />Local Agency wintias that all DpC carliflcubons are valid and Information on IbAPORTANT: Identify all DBF firm, tieing claimed for credit, <br />dic farm is complete and mcoura9te. regardless or tier, Wri r confirmation cf each Ilstsd DW Is <br />s y .. 0/2016 <br />20, 4 aa(Agnrroy RupreseriWtive's `3tgnatute 21. C3ate 12. Prepares Signature 13. p5le <br />Martin B. Lowenthal 961.697.4777 <br />LF1147-11Igency ftepreacs"arve'a Name 13.General Manaver <br />Local Agency Flo resenimtive's TIAe 16 Prepnrer rltls+ - .... <br />DISTRIBUTION: orlyloal - Included with consultant's proposal to local agency. <br />ADANu71a31 For indlNduals with avnsery dlaabilHas. Oils annul Merit Is avallobte In allemale to?morn. Per anfurmatlnn salt (ems)s5M1 ,41tf nr'YL?U (9161 R84 <br />3800 or wide Records and Fora Murniacrnent, 1120 N Sir&et, Ma-69, 81crannenio, GA 0814, <br />Page I of t <br />July 11,2Q15 <br />25N-84 <br />