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Local Assistance Procedures Manual <br />EXHIBIT 10 -F <br />Certification of Consultant, Commissions & Fees <br />Exhibit 10 -F Certification of Consultant, Commissions & Fees <br />CERTIFICATION OF CONSULTANT <br />I HEREBY CERTIFY that I am the <br />, and duly authorized <br />representative of the firm of , whose address is <br />, and that, except as hereby <br />expressly stated, neither I nor the above firm that I represent have: <br />(a) employed or retained for a commission, percentage, brokerage, contingent fee, or other consideration, <br />any firm or person (other than a bona fide employee working solely for me or the above consultant) to <br />solicit or secure this agreement; nor <br />(b) agreed, as an express or implied condition for obtaining this contract, to employ or retain the services <br />of any firm or person in connection with carrying out the agreement; nor <br />(c) paid, or agreed to pay, to any firm, organization or person (other than a bona fide employee working <br />solely for me or the above consultant) any fee, contribution, donation, or consideration of any kind, foror <br />in connection with, procuring or carrying out this agreement. <br />I acknowledge that this Certificate is to be made available to the California Department of Transportation <br />(Caltrans) in connection with this agreement involving participation of Federal -aid Highway funds, and is subject <br />to applicable state and federal laws, both criminal and civil. <br />(Date) <br />(Signature) <br />Page 10 -43 <br />LPP 06 -02 May 1, 2006 <br />