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Local Assistance Procedures Manual EXHIBIT 10 -K <br />Consultant Certification of Contract Costs and Financial Management System <br />1, Compliant with Generally Accepted Accounting Principles (GAAP) and standards promulgated <br />by the Cost Accounting Standards Board (when applicable), <br />2. Compliant with the terms of the contract and is incurred specifically for the contract. <br />3, Not prohibited by 23 CFR, Chapter 1, Part 172 — Administration of Engineering and Design <br />Related Service Contracts to the extent requirements are applicable to Consultant, <br />All costs must be applied consistently and fairly to all contracts, All documentation of compliance must be <br />retained in the project files. <br />Subconsultants (if applicable) <br />Proposed Contract Amount (or amount not to exceed if on -call contract): <br />Prime Consultants (if applicable) D d <br />Proposed Total Contract Amount (or amount not to exceed if on -call contract): $ z 0 00 <br />Prime, list all Subconsultants and proposed subcontract dollar amounts (attach additional page if necessary): <br />—T <br />Consultant Certifying (Print Name and Title): <br />Name: � �o TT flt L. t p 6 fir / r_') t �G .✓/ <br />^7 r� r <br />Title: e , /c,i / /),-� <br />Consultant Certification Signature * *: <br />Data of Certification(mnVdd/yyyy): -J—V yr.51- /E'f <br />Consultant Contact Information: <br />Email: 5'ez - 62 G r 0`At -A Q,11 C . G'o . q <br />Phone number: A-0 X 33 °8 FYI <br />* *An individual executive or financial officer of the consultant's organization at a level no lower than a Vice <br />President or Chief Financial Officer, or equivalent, who has authority to represent the financial information <br />utilized to establish the Indirect Cost Rate proposal submitted in conjunction with the contract. <br />Note: Per 23 U.S.C. 112(b)(2)(B), Subconsultants more comply svah the FAR Cost Principles contained in 48 UP Part 31. <br />13 CFR Part 172.3 Definitions state: Consultant means the individual orjtrmproviding engineering and design related services as aparry <br />to the contract Therefore, subconsultants as parties ofa contract must complete a certificatton and send originals to A&1 and keep copies <br />in Local Agency Project Files. <br />Distribution 1) Original to Caltrans Audits and Investigations <br />2) Retained in Local Agency Project Files <br />LPP 15 -01 <br />25L -61 <br />Page 2 of 2 <br />January 14,2015 <br />