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Local Assistance Procedures Manual Fxhibit 10-01 <br />Consoltarit Proposal DBE Commitment <br />EXHIBI'I'10-01 CONSULTANT PROPOSAL DBE Corsi miTNIENT <br />1. Local Agency: Gily of Santa Ana <br />2, Contract DBE Goal: 15% <br />3. project Description: GootachniCal, Special Inspootion &Material Testing, Public Works Capitol Improvement Program <br />a. Project Location. Santa Ana, CA <br />r. Consultant's Were: United Imspection and I <br />7 Description of work, Service, or Materials U. DEE <br />SuppliedOprIlfloation <br />I Number <br />Materials Testing and Inspection 1 33641 <br />17. Local Agency Contract Number: <br />18. Pederal-Aid Project Number: <br />% Proposed Con [met Execution Date: <br />Local Agency usualles that all DBE confloations are valid and Information on <br />this form Is complete and accurate. <br />F0, 81�oalufe H Daly <br />22. 40Cal Agency Repreoerfagve. Name 23,Phodo <br />24LocalAgericy Representative's Title <br />6. Prime Certified DBE: 0 <br />9. DBE Contact firforawfion 1 10.1)311% <br />Axiom Corporation - Johnathan Hou <br />P - 714.247.1002 <br />DISTRIBUTION; Original — Included with consultant's proposal to local agency. <br />11. TOTAL CLAIMED DEE PARTICIPATION 1 15% <br />IMPORTANT; Identify all ONE fins tieing claimed for asal <br />regardless of bar, w5slri confirmation of each listed ONE is <br />///126 2016 <br />12. Preparer's Signature 13. Date <br />Martin S. Lowenthal 951-697-4777 <br />14, Pieparer's Name 15. phone <br />General Manager <br />16. Preparprs,riiki <br />ADANonica; For lndmdualS We sensory d1sabililies, this d"umure fa available in aftsmatfl farmers For Information efal (916)654-6410 ormQ (918) 6543h1z;9 ar wrl;e Rcrorrds snit P'r�'rns Ffir�nagern�nt, 192p N Sleet, MS•89, Sanrerr�ento, CA 95814. <br />- <br />Page 101`2 <br />July 23, 2015 <br />