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25M - AGMT - ON-CALL ENGINEERING SRVS
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Last modified
8/3/2015 10:37:58 AM
Creation date
7/30/2015 5:17:08 PM
Metadata
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Public Works
Item #
25M
Date
8/4/2015
Destruction Year
2020
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Local Assistance Procedures Manual <br />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 />I 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): $ TBD (On -Cali) <br />Prime Consultants (if applicable) <br />Proposed Total Contract Amount (or amount not to exceed if on-call contract): $ <br />Prime, list all subconsultants and proposed subcontract dollar amounts (attach additional page if necessary) <br />Consultant Certifying (Print Name and Title): <br />Name: Robert H. McCann <br />Title: President Al <br />CX/ <br />Consultant Certification Signature": <br />Date of Certification (mirilddlyyyy): 0113012015 <br />Consultant Contact Information: <br />Email: Rob,McCaxm@lsa-tissoc.com <br />Phone number: 949-553-0666 <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: Per23 U.S.C, 112(b)(2)(8), Subconsullants inust comply with the FAR Cmi Principles contained in 48 CFR, Part 31, <br />13 CFR Part 1723 Definillonsstacc, Consultant means the Individual orfirwiproviding engineering and design related services as aparly <br />to the contract, 1herelere, saboonsuttancts as parries of contract mast complete a Certification andsend originals to Ml and keep copies <br />in Local Agency Project Files. <br />Distributiout 1) Original to Caltrans Audits and Investigations <br />2) Retained in Local Agency Project Fito <br />Page 2 of 2 <br />11PP is-of 25M-47 January 14, 2015 <br />
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