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Local Assistance Procedures Manual Exhibit 10-K Consultant Annual Certification of Indirect Costs and Financial Management System accounts; • Ability to accumulate and segregate allowable direct costs by project, contract and type of cost; • Internal controls to maintain integrity of fnancial management system; • Ability to account and record costs consistently and to ensure costs billed are in compliance with FAR; • Ability to ensure and demonstrate costs billed reconcile to general ledgers andjob costing system; and • Ability to ensure costs are in compliance with contract terms and federal and statcrequirement Cost Reimbursements on Contracts: 1 also understand that failure to comply with 48 CFR Part 16.301-3 or knowingly charge unallowable costs to Federal -Aid Highway Program (FAIIP) contracts may result in possible penalties and sanctions as provided by the following: • Sanctions and Penalties -23 CFR Part 172.1 I(c)(41 • False Claims Act - Title 31 U.S.0 Sectirnn 3719-3733 • Statements or entries generally -Title I S U.S.0 Section Iff) I • Major Fraud Act -Tale 18U.S.('.Section 1031 All A&F. Contract information- • Total participation amount $ 00.00 on all Slate and FAIIP contracts for Architectural & Engineering services that the consultant received in the last three fiscal periods. • The number of states in which the consultant does business is 1 • Years of consultanPs experience with 48 CFR Part 31 is 1 • Audit history of the consultant's current and prior years (if applicable) ❑ Cognizant ICR Audit ❑ Local Gov't ICR Audit ❑ Caltrans ICR Audit ❑ CPA ICR Audit ❑ Federal Gov't ICR Audit I, the undersigned, certify all of the above to the best of my knowledge and belief and that I have reviewed the Indirect Cost Rate Schedule to determine that any costs which are expressly unallowable under the Federal cost principles have been removed and comply with Title 23 U.S.0 Section I I L(b)l21-48 CFR Pan It 23 CFIt Part 172, and all applicable stale and federal rules and regulations. I also certify that I understand that all documentation of compliance must be retained by the consultant. I hereby acknowledge that costs that are noncompliant with the federal and stale requirements are not eligible for reimbursement and must be returned to Caltrans. Name**: es anma 1% Title**. Executive Director Sjgnalurc"��/Af..lLt� Date of Certification(mm/dd/yyyy): tt—q Email**: jim@walkmotebikemore.org Phone Number**: 310-204-4346 "An individual ex¢ulive or nnancial onicer oflhe consullanl's ursubmnsuh:ml's organisation at a level no lower than a V ice President, u Chief financial Officer. urequivala t, who has authority to mprescnt the financial infonnalion used to establish the indincel cost rate. Note: Both prune and suhcousultanA' as parties' of a cantract must complete their own Exhibit 10-X frarnts. Caltrans will nol process local agencv'.s invoices until a complele Exhibit 10-Kfinn is accepled and approved iry Caltrmts Aetdits' and lnvcstigationy. Distribution: 1) Original - meal Agency Project File 2) Copy- Consultant 3) Copy - Cahmns Audits and Invcaligafiuns Page 2 of 2 March 2018