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Local Assistance Procedures Manual <br />Exhibit 10-02 <br />Consultant Contract DBE Commitment <br />EXHIBIT 10-02 CONSULTANT CONTRACT DBE Co-mMITMENT <br />1. Local Agency: City of Santa Ana <br />3. Project Description: Right of Way On -Call Bench <br />4. Project Location: City of Santa Ana <br />5. Consultant's Name: Monument ROW, Inc. <br />8. Total Dollar Amount for ALL Subconsultants: <br />$ 0.00 <br />a <br />2. Contract DBE Goal: ° <br />6. Prime Certified DBE: R( 7. Total Contract Award Amount: $149,500 <br />9. Total Number of ALL Subconsultants: 0 <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 />Right of Way Services, including property <br />acquisition and relocation assistance <br />46456 <br />Monument ROW, Inc. <br />200 Spectrum Center, Suite 300 <br />149,500.Oi <br />r+A n'1004 <br />Local Agency to Complete this <br />Section <br />$149500 <br />20_ Local Agency Contract <br />Niimhar <br />14. TOTAL CLAIMED CBE PARTICIPATION <br />23_ Fedefal-Aid Project Number: <br />22. Contract Execution <br />nAtP- <br />Local Agency certifies that all DBE certifications are valid and information obi <br />IMPORTANT: Identify all DBE firms being claimed for credit, <br />this form is complete and accurate. <br />re"ardlesser. Written confirmation of each listed DBE is <br />re9/27/21 <br />23. Local Agency Representative's Signature 24_ Date <br />Signature 16. Date <br />Amber Costello 562-260-0507 <br />25. Local Agency Representative's Name 26_ Phone <br />17. Preparers Name 18. Phone <br />President <br />27. Local Agency Representative's Title <br />19. Preparers Title <br />DISTRIBUTION: t. 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, his document is available in altemate formats. For information call (916) 654-6410 orTOD (916) 654- <br />3880 or write Records and Forms Management, 1120 N Street, MS-69, Sacramento, CA 95814. <br />Page 1 of 2 <br />July 23, 2015 <br />