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Local Assistance Procedures Manual Exhibit 10-02 <br />Consultant Contract DBE Commitment <br />EXH1BTf 10-02 CONSULTANT CONTRACT DBE COMMITMENT <br />1. Local Agency: City of Santa Ana <br />3. Project Description: Al- Environmental Site Assessment <br />4. Project Location: Various <br />2. Contract DBE Goal: TBD <br />5. Consultant's Name: Nlnyo & Moore 6. Prime Certified DBE: ❑ 7. Total Contract Award Amount: $45,219.55 <br />8. Total Dollar Amount for L,Lt Subconsultants: TBD 9. Total Number ofLLLL Subconsultants: TBD <br />10. Description of Work, Service, or Materials <br />11. DBE <br />13. DBE <br />Supplied <br />Certificatlon <br />12. DBE Contact Information <br />Dollar <br />Number <br />Amount <br />Subconsultant 1: Drillers <br />TBD <br />Subconsultant 2: Heavy Equipment <br />Contractors <br />TBD <br />Subconsultant 3: Geophysical Surveyors <br />TBD <br />Subconsultant 4: Fixed -Base <br />Laboratories <br />TBD <br />Subconsultant 5: Mobile Laboratories <br />TBD <br />Subconsultant 6: Land Surveyors <br />TBD <br />Subconsultant 7: Waste Disposal <br />Subconsultant 8: Traffic Control <br />TBD <br />`' i•' ' ` Eocal Agene'y:to Cortlplete:EtIIB$,eotiofl <br />$ TBD <br />20 Local Agency Contract <br />M. -h- <br />14. TOTAL CLAIMED DBE PARTICIPATION <br />21. Federal-Ald Project Number. <br />22. Contract Execution <br />TBD % <br />nae.,• <br />IMPORTANT: Identify all DBE firms being claimed for credit, <br />Local Agency certifies that at DBE certifications are valid and Information an <br />this form Is complete and accurate, <br />regardless of tier. Written ccnflrnatlon of each listed DBE Is <br />required. <br />( C/h 8/3/2018 <br />23. Local Agency Representative's Signature 24. Date <br />pacers <br />96. Preparers§ tin ur 18. Date <br />Anthony J. Lizzi, PG, CHG 949.753.7070 <br />25, Local Agency Representative's Name 26. Phone <br />17, Preparers Name 18. Phone <br />Principal Geologist <br />27. Local Agency Representative's Title <br />19. Preparers Title <br />DISTRIBUTION: 1. Original — Local Agency <br />2. Copy— Caltrans District Loral Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract <br />execution may result In de -obligation of federal funds on contract <br />ADA Noece: For Individuals with sensory disabllitles, this document Is available in alternate formats. For Intonation call (916) 654-6410 or TDD (916) 654. <br />388D or write Records end Forms Management, 1120 N Street, MS -89, Sacramento, CA 95814. <br />Page 1 of 2 <br />July 23, 2015 <br />25F-63 <br />