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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
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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 FXHBIT 10 -K <br />Consultant Certification of Contract Costs and Financial Management System <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): $ TED <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 Certification Signature: S—krr 7r 2. X Av06aAeA <br />Consultant Certifying (Print Name and Title): <br />Name: Tamera Richards <br />Title: <br />Consultant Contact Information: <br />Email: <br />trichardsna ninyoandmoore.corn <br />Phone number: 858/576.1000 <br />Date of Certification (mm /dd /yyyy): 01/30/2015 <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.SC 112(6)(2)(13), Subconsultants must comply with the FAR Cost Principles contained in 48 CFR, Part 31, <br />23 CFR Part 172.3 Definitions state: Consultant means the individual or firm providing engineering and design related services as aparty <br />to the contract, Therefore, subconsultants as parties ofa contract must complete a certification and send originals to A &1 and keep copies <br />in Local Agency Project Files. <br />Distribution: t) original to Caltrans Audits and Investigations <br />2) Retained in Local Agency Project Piles <br />Page 2 <br />25M-56 January 14, 2015 <br />
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