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Local Assistance Procedures Manual Exhibit 10-01 <br />Consultant Proposal DBE Commitment <br />Exii[RIT 10-01 CONSULTANT PROPOSAL DBE COMMITMENT <br />1. Local Agency: City or Santa Ana <br />3. Project Description: W illiis Street Safe Routes to School <br />4. Project Location: Smile Ana, CA <br />5. Consultant's Name: Walk'n Rollers <br />2. Contract DBE Goal: 0.0% <br />6. Prime Certified DBE: <br />7. Description of Work, Service, or Materials <br />Supplied <br />8. DBE <br />Certification <br />Number <br />9. DBE Contact Information <br />10. DBE <br />Local Agency to Complete this Section <br />17. Local Agency Contract Number: <br />18, PederatAid Project Number. <br />11. TOTAL CLAIMED DEE PARTICIPATION <br />0.0 Y <br />19, Proposed Contract Execution Date: <br />20. Consultant's Ranking after Evaluation: <br />IMPORTANT: Identify all DBE firths being claimed for credit, <br />Local Agency certifies that all DBE certifications are valid and information on <br />regardless of tier. W nrpt\finnation of each listed DBE is <br />this form is complete and accurate. <br />requir i <br />6 1 1 /09/2021 <br />_ <br />repare s Si halure 13. Date <br />James Shauman 310-2044346 <br />14. Preparees Name 15. Phone <br />Executive Dimctur <br />16. Preparer's Title <br />DISTRIBUTION: Original —Included with consultant's proposal to local agency. <br />ADA Notice: For individuals with sensorydisabilities, this document is available in aitemate formals. For informalim call (916) 654-6410 ar TDD (916) 654 <br />3880 or wmle Recards and Fonns Management 1120 N Slmel, MS-89, Sacramento, CA 95814. <br />LPP 15-01 Page 1 of 2 <br />January 2019 <br />