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Local Assistance Procedures Manual Exhibit 10-02 <br />Consultant Contract DBE Commitment <br />Examff 10-02 CONSULTANT CONTRACT DBE COMMITMENT <br />1. Local Agency: City of Santa Ana 2. Contract DBE Goal: 13% <br />3. Project Description: <br />4. Project Location: i <br />SR-661RitcheyWater Improvement Project- CM and Inspection Services <br />Choy Street, City of Santa Ana <br />5. Consultant's Name: Berg & Associates, Inc. 6. Prime Certified DBE: 9 7. Total Contract Award Amount: TBD <br />8. Total Dollar Amount for ALL Subconsultants: 9. Total Number of ALL Subconsullanls: 0 <br />10. Description of Work, Service, or Materials <br />Supplied <br />11. DBE <br />Certification <br />Number <br />Q. DBE Contact Information <br />13. DBE <br />Dollar <br />Amount <br />Construction Management and <br />Inspection Services <br />#28963 <br />Berg & Associates, Inc.CUCP <br />302 W. 5th Street, Suite 210 <br />San Pedro CA 90731 310 548-9292 <br />TBD <br />;..: Local Agency to Complete this Section <br />$ TBD <br />20. Local Agency contract <br />Numhar' <br />14. TOTAL CLAIMED DBE PARTICIPATION <br />100 % <br />21. Federal -Aid Project Number: <br />22. Contract Execution <br />nata• <br />Local Agency certifies that all DBE certifications are valid and Information on <br />IMPORTANT: Identify all DBE firms being claimed for credit, <br />this form is complete and accurate. <br />regardless of tier. Written confirmation of each listed DBE Is <br />required. <br />08/1612021 <br />23. Local Agency Representative's Signature 24, Date <br />15. reparer's igimtar 16. Date <br />Alicia Berg (310) 548-9292 <br />26. Local Agency Representative's Name 26. Phone <br />17. Preparees Name 18. Phone <br />VP/Director of Research and <br />27. Local Agency Representative's Title <br />19. Preparer's Title <br />DISTRIBUTION: 1. Original — Local Agency <br />2, Copy— Caltrans 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 individuals with sensory dlsabllitles, this document Is available In alternate formals. For Informotlon call (016) 654-6410 or TDD (916) 654- <br />3880 or wrlte Records and Forms Management, 1120 N Street, M&39, Sacramento, CA 95814. <br />Page I of 2 <br />July 23,2015 <br />