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Local Assistance Procedures Manual EXHIBIT to -OI <br />Consultant Proposal DBE Commitment <br />P+XHIBIT 10-01 CONSULTANT PROPOSAL DBE COMMITMENT <br />(Inclusive of all DBEs lis led al bid proposal. Refer to instructions on the reverse side of this form) <br />!N jk'kl'-I 4.i `4i`fs RJR <br />Oilu3faritf'RE v':,. <br />1. Local Agency Name; <br />2.Project Location: i..7 -- Ca.1— <br />,r� 6 <br />3. Project Description: l J 1(\(�,�jt <br />I <br />A. Consultant Name: \ 'y\ ) CjYpt\ `✓ , 4��Qu C Q. (I <br />-.. <br />U + r bti'lSa �dar <br />S. Contract DBE Goal %:� <br />DBE Commitment Information <br />h. Description ofServices to be Provided 7. DBE Finn <br />Contact Warmation <br />B. DBE Cert, 9. DBE % <br />Number <br />M Loan) Agency Cantraot Nmnbec <br />I7. hedoml-aid Project Number, <br />I8. Proposed Contract Execution Date: J, <br />Local Agency certifies that all DBE certifications are valid and the <br />infa'tnation on this form is complete and accurate: <br />19. Local Agency Representative Name (Print) mm <br />2(I.Looal Agency Representative Signature 21. Date <br />22. Local Agency Representative Title 21 (Arm Cade) Tel. No. <br />)5 <br />v t <br />M <br />µ <br />i1. Preperer's sign.wr <br />@� �p <br />4`+\d. G�"F.1'et,nE Iv\0. V4\0.CLk'I <br />12. Preparer's Name (Print) <br />�1 <br />I Cit. t(""\ e- k- <br />13. preparer's Title <br />f %, J _ >10) at! AI <br />i5. <br />id - Date (thea Code)'I el No. - <br />fustribafian'. (I)Original - Consultant submits to local agency with proposal <br />(2) Copy- Local Agency files <br />Pagel ul'2 <br />L,PP '13-01 May 8, 2013 <br />