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<br /> <br /> Local Assistance Procedures Manual EXHIBIT 10-G <br /> Certification of Local Agency <br /> <br /> Exhibit 10-G Certification of Local Agency <br /> <br /> <br /> <br /> CERTIFICATION OF LOCAL AGENCY <br /> <br /> <br /> <br /> <br /> <br /> <br /> I HEREBY CERTIFY that I am the of the <br /> (local agency) ,and that the consulting firm of <br /> ,or its representative has not been required (except <br /> <br /> as herein expressly stated), directly or indirectly, as an express or implied condition in connection <br /> with obtaining or carrying out this Agreement to: <br /> (a) employ, retain, agree to employ or retain, any firm or person, or <br /> <br /> (b) pay or agree to pay, to any firm, person or organization, any fee, contribution, donation, or <br /> consideration of any kind. <br /> <br /> <br /> <br /> <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 offederal-aid highway funds, and is <br /> <br /> subject to applicable state and federal laws, both criminal and civil. <br /> <br /> <br /> <br /> (Date) (Signature) <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> Page 10-45 <br /> LPP 06-02 25G-56 May 1, 2006 <br />