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Local Assistance Procedllre6 Manual Exhibit 10 -01 <br />Cmtsultmu Proposal AAE Conandtment <br />EXM]31'1' 10 -01 CONSULTANT PROPOSAL DBE COMAUTMCNT <br />1. Local Agency: City of Santa Ana 2, Contract DBE Goal: 9% <br />3. Project Description: Construclabilily Review for Capital Improvement Program <br />4. Project Locallon: City of Sanla Ana <br />B. Consultant's Name: KPFF <br />6, Prime Certified DOE: ❑ <br />7. Description of work, Service, or Materials <br />Supplied <br />8. DBE <br />Cortiflcatlon <br />9. DOE Genteel Information <br />110. DOE °k <br />Number <br />LCI, Inc - Landscape Architectural 39150 (Caltrans) Lynn Capouya (949) 756 -0150 <br />1 <br />Review Services 9% <br />5093 LA County Metropolitan <br />"Transportation Authority <br />Local Agency to Complete this eeellon <br />17. Local Agency Contract Number: <br />11. TOTAL CLAIMED DBE PARTICIPATION <br />9% <br />10. Federal -Aid Project Number, <br />19. Proposed Contract Execution Date: <br />IMPORTANT: Identify all DOE firms being claimed forcrodil, <br />Local Agency carli8es that all DBE carUBoaltons are valid and Information on <br />this form Is complete and accurate, <br />regardless of tier. Written confirmation of each listed DOE is <br />required. <br />20, Local Agewy Repressn(alWa's Signature 21. Date <br />12, Preparer's Signature 13, Dale <br />22. Local Agency Representative's Name 23, Phone <br />14. Preparer's Name 13. Phone <br />24. Local Agency Representative's Title <br />18. Preperel'sTllle, <br />DISTRIBUTION; Odgfnal — Included with consultant's proposal to local agency. <br />ADA Notice; For Indlvldoais eAth sensory disalglNee. Ibis document Is ovalloble in ollomule formats. For role nnolloo call (616) 654 -6410 or TOD (Of 6) 654. <br />9896 or vrilo Records and Foans Monoaomont, 1126 N Street, M&89, Saaemenle, CA 90614. <br />Page 1 of 2 <br />25C -34 3a' "2''2015 <br />