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Local Assistance Procedures Manual Exhibit 10-01 <br />Consultant Proposal DBE Commitment <br />ExHmIT 10-01 Co sULTANT PRoposAL DBE COMMITMENT <br />1- Local Agency: City of Santa Ana 2- Contract DBE Goal- <br />3- Project Description: <br />4- Project Location: <br />5- Consultant's Name: Monument ROW, Inc <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 />Right of Way Services <br />46456 <br />Monument ROW, Inc <br />Irvine, CA92613 raterome, Suite MO <br />562.2600507 <br />1 00% <br />VV <br />Local Agency to Complete this Section <br />11. TOTAL CLAIMED DBE PARTICIPATION <br />1 00 °I° <br />IT Locat Agency Contract Numbef: <br />18- Federal -Aid Project Number: <br />19. Proposed Contract Execution Date: <br />20- Consultant's Ranking after Evaluation: <br />IMPORTANT: Identify all DBE firms being claimed for credit; <br />Local Agency certifies that all DBE certifications are valid and infomlation on <br />regardless of tier- Written confirmation of each listed DBE is <br />this form is complete and accurate- <br />712712021 <br />12- Preparer's Signature 13- Date <br />Amber Costello 562.260.0507 <br />14- Preparer's Name 15- Phone <br />President <br />16- Preparer's Title <br />DISTRIBUTION: Original — Included with consultant's proposal to local agency- <br />ADA Notice: For individuals with sensory disabili ies, this document is available in altemate formats- For information call (916)654-641 Q orTDD (916) 654- <br />3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95614- <br />LPP 18-01 Page 1 of 2 <br />January 2019 <br />