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Local Assistance Procedures Manual <br />Exhibit 10-02 <br />Consultant Contract DBE Commitment <br />EXHIBIT 10-02 CONSULTANT CONTRACT DBE COMMITMENT <br />1. Local Agency: City of Santa Ana 2. Contract DBE Goal: 0.5% <br />3. Project Description: On -Cali Professional Land Surveying Services <br />4. Project Location: Citywide (Santa Ana, California) <br />5. Consultant's Name: TOWIII, Inc. 6. Prime Certified DBE, ❑ 7. Total Contract Award Amount: TBD <br />8. Total Dollar Amount for ALL Subconsultants: TBD <br />9. Total Number of ALL Subconsultants: TBD <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 />Field surveying support <br />y 9 pp <br />3110 <br />Chaudhary & Associates, 707.265.2729 <br />211 Gateway Road W, Suite 204 <br />TBD <br />Napa, CA 94558 <br />Local Agency to Complete this Section <br />$ TBD <br />20. Local Agency Contract <br />14. TOTAL CLAIMED DBE PARTICIPATION <br />21. Federal -Aid Project Number: <br />22, Contract Execution <br />10 % <br />na+e <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 />:air.. kr,'lku cti 10/18/2019 <br />23. Local Agency Representative's Signature 24. Date _ <br />15. Preparer's Signature 16. Date <br />Aaron Badavinac 925.682.6976 <br />25. Local Agency Representative's Name 26. Phone <br />17, Preparer's Name 18. Phone <br />Chief Financial Officer <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) 654-6410 or TDD (916) 654- <br />3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95614, <br />Page 1 of 2 <br />28 duly 23, 2015 <br />