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Local Assistance Procedures Manual EXHIBIT 10-K Consultant Certification of Contract Costs and Financial Management System 1. Compliant with Generally Accepted Accounting Principles (GAAP) and standards promulgated by the Cost Accounting Standards Board (when applicable). 2. Compliant with the terms of the contract and is incurred specifically for the contract. 3. Not prohibited by 23 CFR, Chapter 1, Patz 172 — Administration of Engineering and Design Related Service Contracts to the extent requirements are applicable to Consultant. All costs must be applied consistently and fairly to all contracts, All documentation of compliance must be retained in the project files. Subconsultants (if applicable) Proposed Contract Amount (or amount not to exceed if on-call contract): $ Prime Consultants (if applicable) ^t � Proposed Total Contract Amount (or amount not to exceed if on-call contract): Prime, list all subconsultants and proposed subcontract dollar amounts (attach additional page if necessary) $ Consultant Certifying (Print Name and Title). Name: Title: Consultant Certification Signature **: Date of Certification (mmJddtyyyy): Consultant Contact information: Email: Phone number: _T1y_:ltr456 *An individual executive or financial officer of the consultant's organization at a level no lower than a Vice President or Chief Financial Officer, or equivalent, who has authority to represent the financial information utilized to establish the Indirect Cost Rate proposal submitted in conjunction with the contract. Note: Per 23 t1.S.0 112(b)(2,(H), Subconvlltants trust Comply a ah the (=AR Cost principles contained in 48 CFR, Pan 31. 23 CFR Part 1712.3 Definitions state: Consxttata means the individual orfirnt providing engineering and designe related services as a party to the contrast. Therefore, subconsodiants as parties of a contract toast complete a: certification and send originals to A&1 and keels copies in !Ultra! Agency Project Files. Distribution: q Original to Caltrans Audits and Investigations 2) Retained in Local Agency Project Piles Page 2 of 2 LPP 15-01 January 14, 2015