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Local Assistwce Procedures Manual Exhibit 15-01 <br />C'owultiat Fropo sal DBE C amaadtment <br />EDIT 10-01 CONSLITA}T PROPOSAL DBE C O!NaML 1E11 <br />1. LocalAWnoyc City of Santa Ana 2. Contest 0e3�e 15% <br />3. Project Des[rip[cue <br />Geotectillical, inspection (VY r lalma esling totPLINic Wore Agency Capitol improvement <br />+ Project Location: City of Santa Ana <br />5. ConsuPtanPa Name: Diaz Consultants, Inc, (DiazYournian&Associates) a. PrimeCer6fi�"GO�iS <br />7. De &p+tion or Work, Serjim, or Materials <br />Suppled <br />S. DEE <br />Cedlio-wllon <br />Nurr&er <br />0. DEE Contact Inicumalion <br />10, DEE'.+F <br />,eotechnjcal, Inspection & Material <br />20160 <br />Chris Diaz <br />15�>% <br />esting for Public Works Agency <br />.apitol Improvement <br />Local Agency to Complete this Section <br />17. Lacd Agency Ccctt-xt Number: <br />11. TOTAL CLAIrAEO DEE FpdtTHCBPA'110N <br />1$ % <br />$8. Federal -Aird Prpject Nurnbec: <br />12- Proposed Contract Execution Date: <br />IMPORTANT: Identdy all DBE firms ce Ing claimed for credit, <br />Local Agenuyr oertifts that a'8 DEE certilcati ins are valid and information an <br />this form is ooariplete and accsrrve. <br />regardless d tip. Milan cordinaton of each Inted DEE s <br />required. <br />v� 02-01-2016 <br />20. Local Agency ReFre'Entative5 eignmure 21. Date <br />12 caparw's Sinature 11. Date <br />ay Alaed 714-375-3830 <br />Locou Agency Rs,,resenlaoroes amore .,. ani s -- <br />.a2rs ane ,. .enTz`F� <br />President <br />'M- Local Agency Repremlla6ve's Title <br />16. F•na+pamr s Title <br />DISTRignOti: ^Driginal— Included with ocensultanfs prorosal to local agency <br />.u62_naoss: POr lndvouas mul Eenwry d1aaL9lnNe,LI dY.Ur1anta asLID(e In alienate iCfrM19'S. Pcriifc-n Ua10.Tl {516'; 6.4-F410 of TDD I191-jEE-.- <br />WEDore;.2eRe+:Grd6and Forr%, Nanag-sTant,1120 NOtre=t VS.Ea, aarrarn=-nto, CA 55311. <br />Page I of 2 <br />juiT! ,i, 3111= <br />ami�r-mown s_.� <br />City of Santa Ana RFP 15-055 <br />Paan Aa 11 <br />