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Local Assistance Procedures Manual EXHIBIT 10 -01 <br />Consultant Proposal DBE Commitment <br />EXI -IIBIT 10 -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 />4a- 1 uih(1.C_ (Odrks A jegcet <br />1. Local Agency Name: � d <br />f+�4rlv`CzL <br />2. Project Location: � � \ <br />( r J it <br />3. Project Description: <br />(\ <br />-t <br />4. Consultant Name: \�.e C>Aff�� <br />5. Contract DBE Goal %: _q_— <br />DBE Commitment Information <br />6. Description of Services to be Provided <br />7. DBE Firm <br />Contact Infomotion <br />8. DBE Ccrt, <br />Number <br />9. DBE <br />°c'a nom° ;F mvm 1efi f o sli0g>w r._ -..',„ <br />— EaVda ? ' :."' . _ - 16. Local Agency Contract Number. D.Fedeml -aid Project Number: 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 />jPmparc,"s <br />N\ Gc `•' Mix U6 0.0 <br />�f 1 ��f k'' <br />12. Preparer's Name (Print) <br />fb_i—! . e (— <br />19. Lacol Agency Representative Name (Print) <br />20.Local Agency Representative Signature 2t. Date <br />13. Pmparer's Title <br />/No. <br />14. Dat '15. (Area Code) Tel . <br />22. Local Agency Representative Title 23. (Area Cade) Tel. No <br />Distribution: (1) Original - Consultant submits to local agency with proposal <br />(2) Copy -Local Agency files <br />LPP 13 -01 <br />25L -90 <br />Page 1 of 2 <br />May 8, 2013 <br />