Laserfiche WebLink
Local Assistance Procedures Manual ri XHIBIT 10-K <br />Consultant Certification of Contract Costs and Financial Management System <br />1. Compliant with Generally Accepted Accounting Principles (GAAP) and standards promulgated <br />by the Cost Accounting Standards Board, (when applicable). <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, Tait 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 />Subconsuitants (if applicable) <br />Proposed Contract Amount (or amount not to exceed if on -call contract): $ <br />Prime Consultants (if applicable) <br />Proposed Total Contract Amount (or amount not to exceed if on -call contract): $a? <br />Prime, list all subconsultants and proposed subcontract dollar amounts (attach additional page if necessary): <br />■ ■i ) Yw1e, <br />l'Co's � �� <br />Consultant Certifying (Print Name and Title): <br />Name: <br />Title: <br />Consultant Certification Signature * *: <br />Date of Certification (mm/ddiyyyy): <br />Consultant Contact Information: <br />Email: <br />0 <br />Phone minber: 'i_/) �- Fj j <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 USW, 112(b)(2)(B), Wcons:dtants must comply with the FBI R Cost Principles contained in 48 CFR, Part 31, <br />23 CFR Part 1723 Definitions state: Consultant means the individual or firm providing engineering and design related .servtoes as aparty <br />to the contract, Therefore, subconsullams as parties ofa contract must complete a certification and sand originals to W and beep copies <br />In 1x 1Agency Project Files. <br />Distribution: r) Original to Caltrans Audits and Investigations <br />2) Retained in Local Agency Project Files <br />Page 2 of 2 <br />UP 15 -01 January lit, 2015 <br />