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Local Assistance Procedures Manual EXHIBIT 10 -01 <br />Consultant Proposal DBE Commitment <br />EXHIBIT ].0 -01 CONSULTANT PROPOSAL DBE COMMITMENT <br />(Inclusive of all DBEs listed at bid proposal. Refer to instructions on the reverse side of this form) <br />Consultant to this Section ' <br />gCoomplete <br />1. Local Agency Name: ��n7A 1'"/p��JA CA I y —� 6A <br />2.Project Location: J YT V\ 1' f%} 1 n L L (-(Jt�/41.i1 J <br />r�,,''Vt <br />nnCd <br />3. Project Description: 1C. L-Vf' 0 W t(# N 17 C. -�V4S 1%� ` `�70151Z W PP6A I yy1 <br />a. ConsultantNama: �fe <br />LV AG U w 1 <br />1-1,014 <br />S. Contract DBE Goal %: <br />DBE Commitment Information <br />6. Description of Services to be Provided <br />7. DBE Firm <br />Contact Information <br />a. DBE Cent. <br />Number <br />9. DBE % <br />DT <br />Su G <br />Local Agency. to Complete: this section <br />10. Total <br />V. Claimed <br />16. Local Agency Contract Number: <br />17. Federal -aid Project Number: <br />18. Proposed Contract Execution Date: <br />Local Agency certifies that all DBE certifications are valid and the <br />information on this form is complete and accurate: <br />_ <br />11. Preparer's Signature <br />12. Preparer's Name (Print) <br />19. Local Agency Representative Name (Print) <br />20. Local Agency Representative Signature 21. Date <br />22. Local Agency Representative Title 23. (Area Code) Tel. No. <br />13. Preparer's Title <br />14. Date 15. (Area Code) Tel. No, <br />Distribution: (l) Original — Consultant submits to Local agency with proposal <br />(2) Copy — Local Agency files <br />LPP 13 -01 <br />25L -123 <br />Page 1 of 2 <br />May 8, 2013 <br />