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Local Assista ace Procedures Manual EXHIBIT 10-01 <br />Consultant Proposal DBE Commitment <br />lu+ XIIIBIT t Q -Ol CONSULTANT PROPOSAL DBE COMI[MITMENT <br />(Inclusive of all DBEs fisted at bid proposal, Refer to instructions on the reverse side or this form) <br />Consultant to Co111plete this Section <br />I. [.coal Agency Name: <br />3. Project Locatie'nt <br />, ry <br />3, Project Description: _a=' <br />A. Consultant Name: ccx t� jt1A <br />3. Contract DBE Goal %:. <br />DBE Commitment Information <br />6, Ih dIalon of Services t oN frov Wed <br />7,1)BE Firm <br />S. DBE Crat. <br />91 D9E 9S <br />Contact information <br />Number <br />�i <br />Local Agency to Complete this Section <br />Io. Tn al <br />- - <br />°/a Ctaimed <br />16. Local Agency Contract Number: <br />17.federal -aid ProjcONumber:. <br />18. Proposed Contract Execution Date: . <br />Local Agency certifies that all DBE certifications are valid and the <br />IL Prelimer S -nature <br />Information on this form is complete and accurate; <br />p <br />72, Preparor's Namo (Fria } <br />I9, t.ocal Agency Representative Name (Print) <br />tt <br />�..._. <br />13. Prepa r`s Title <br />20.LoW Agency Representative Signature <br />tA, Datc IS. (Area Code)Tel. No. <br />22,L00atAgency Representative TItic � 23, (Area Code) Tel. No." <br />Distribution: (1) Original - Consultant sulmata to loml agency with proposal <br />(2) Copy — Local Agency files <br />LPP 13.01 <br />25L -31 <br />Page I o1`2 <br />May $s 2013 <br />