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Local Assistance Procedures Manual EXHIBIT 10-01 <br />Consultant Proposal DBE Commitment <br />EXHIBIT 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 />Consultant to Complete this Section <br />1. Local Agency Name: <br />2. Project Location: <br />3. ProjectDeseription:„yZ,/1,Z,l� ,r`VxCP_ <br />4. Consultant Name: ,Llkf_s_�.__S._ix3Yll,t,--.11:. d'3______ <br />5. Contract DBE Goal %: I 0 D'� <br />DBE Commitment Information <br />6. Description of Services to be Provided <br />7, DBE Firm <br />Contact Information <br />8. DBE Con. 9. DBE % <br />Number <br />r� <br />Recrii- <br />4 10—�S.2r i�t�,.S'1a'a <br />�G-iJ 100 `(+ <br />v _— <br />Local Agency to Complete this Section <br />to. Total <br />% Claimed <br />lab % <br />16. Local Agency Contract Number: <br />17. Federal -aid Project Number: <br />18. Proposed Contract Execution Date; _,,,_�_, <br />Local Agency certifies that all DBE certifications are valid and the <br />information oil this form is complete and accurate: <br />-�--------- -- - ------ <br />11. Pepin r .y nature <br />i zer's Na , (Print) t <br />12. PreparaPs Name (Print) <br />19. Local Agency Representative Name (Print) �. <br />20. Local Agency Representative Signature 21, Dale <br />22. Local Agency Representative Title 23, (Area Code) Tel. Noa <br />13. Preparer's Title <br />I1 <br />{q1 L7ii,5114 �F,-GsS�S <br />14. Date 15. (Area Coda) Tal. No. <br />Distribution: (1) Original- Consultant submits to local agency with proposal <br />(2) Copy- Local Agency files <br />Page I of 2 <br />LPP 13-01 May 8, 2013 <br />