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Local Assistance Procedures Manual Exhibit 10-02 <br />Consultant Contract DBE Commitment <br />EXHIBIT 10-02 CONSULTANT CONTRACT DBE COMMITMENT <br />t. Local Agency: City of Santa Ana 2. Contract DBE Goal: Unknown <br />3. Project Description: On Call Right of Way Services <br />4. Project Location: City of Santa Ana, California <br />5. Consultant's Name: Donna Desmond Associates 6. Prime certified DBE: ❑ 7. Total Contract Award Amount: unknown <br />8. Total Dollar Amount for ALL Subconsultants: 9, Total Number of ALL Subconsuftants: <br />10. Description of Work. Service, or Materials <br />Supplied <br />11. DBE <br />Certification <br />Number <br />12. DBE Contact information <br />13. DBE <br />Dollar <br />Amount <br />1WOO <br />039212 <br />Donna Desmond, Donna Desmond <br />Associates (310) 475-1114, <br />$148,00 <br />Local Agency to Complete this Section <br />14. TOTAL CLAIMED DBE PARTICIPATION <br />$ <br />148,00 <br />20. Local Agency Contract <br />N� imh— <br />21. Federal -Aid Project Number <br />22. Contract Execution <br />nAtp. <br />% <br />100 <br />IMPORTANT7 Identify all DBE firms being claimed for cred t, <br />Local Agency certifies that all DBE certifications are valid and information on <br />this form is complete and accurate. <br />regardless of tier. Written confirmalion of each listed DBE is <br />require4,,,r`�,Si�gntwe <br />08/2021 <br />23. Local Agency Representative's Signature 24. Dale <br />15. 16. Date <br />310-475-1114 (310) 475-1114 <br />25. Local Agency Representative's Name 26. Phone <br />17. Preparees Name 18. Phone <br />President <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 disabilities, this document is available in alternate formats. For information call (916) 654-6419 orTDD (916) 654- <br />3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814. <br />Page 1 of 2 <br />July 23, 2015 <br />&nbsp; <br />City Council <br />&nbsp;28 &ndash;&nbsp;94 <br />5/ 17/2022 <br />&nbsp; <br />