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LocaLAssistance Pirocedures Manual Exttibitlfl-tit <br />Consultant Contract DBE Commitment <br />Dalign I0-02:C CONSULTANT CONTRACT DBE Ct1MMTMElNT <br />1. Local Agency. City of Santa Ana <br />3. Project oescrlption: First Street Pe <br />4. Project Location: Elovdef Street to Standard <br />2, contract DBF 00al: :4.2ela <br />California <br />5. Consultants Name: Tetra Tech, Inc. 6,Prime Cartified DBE:- ❑ 7. Total Contract Award Amount:.. <br />8 Total Dollar Amount for "Li SubGOnsuitants; $59>0()0 o. Total Number of ALL, Suboopsultanls:. 1 <br />1D. Description of work, Service, or Materials <br />supplied <br />11,.DBE <br />Number <br />Number <br />12. DEE Ganfact information <br />13, DBE <br />Dollar <br />Amount <br />The Alliance Group Enterprise, Inc. to <br />provide traffic signal design:, <br />91'797 <br />Andy Mom PIE <br />213 505-0295 <br />$690A0 <br />Agency,to m Coplefe this Section <br />$ 5g000 <br />20, Local Agency Contract <br />Nirmher• <br />14. TOTAL CLAIMED DOE PAR nCIPATION <br />14.75^ia <br />21.Fedeial-AldProject Number: ATPSB1L-5063(191)':: <br />22. Contract Execution 01/2�1/2020 <br />nata - <br />Local Agency cerftfies that all DEE'corhfications are valid and Information on <br />this form is complete and accurate, <br />IMPORTANT: Identify all DBE firms being claimed for credit, <br />regardless of tier. )Nritten, lion of oach fisted DBE is <br />required. <br />'01107120 <br />1'2f2012019 <br />'29.tocal Agency Representative's:Signature 24. Date - <br />15,. Preparors Signature. 16, Date <br />Hayley Gilbert 714 647-5059 <br />MauricidArgente 805 542-9052 <br />25, Local Agency: Representative's Name 26. Phone <br />17, Preparer's Name 16. Phone <br />Management Analyst <br />Vice President <br />27,Local Agency Representatives Title <br />19,.Preparefs, Title <br />DISTRIBUTION: 1. Original —Local Agency <br />'2. Copy— Cellists District Local 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 Notice: For indivlduais with sensory disabilities, this document is available in alternate formats, for information call (910) 664.6410 or TAD (916) 664, <br />3880 or wide Records and. Forms Management, 1120 N Street, MS-89, Sacramento, GA 95814, <br />Inge I of 2 <br />26K-64 July 23, 2015 <br />