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Local Assistance Procedures Manual Exhibit 10-01 <br />Consultant Proposal DOE Commitment <br />EXHIBIT 10-01 CONSULTANT PROPOSAL DBE COMIIDTMCNT <br />1, Local Agency: City of Santa Ana 2, contract DBE Goal: 9% <br />3, Project Description; Constructability Review for Capital Improvement Program <br />4, Project Location: City of Santa Ana <br />6, Consultant's Name: KPFF 6, Prime Certified DBE: ❑ <br />7. Description of Work, Service, or Materials <br />8, DBE <br />Certification <br />9, DBE Contact Information <br />o <br />10, DBE k <br />Supplied <br />Nutter <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 Section <br />V. Local Agency Contract Number: <br />91. TOTAL CLAIMED DBE PARTICIPATION <br />$°10 <br />18. Federal -Aid Project Number. <br />19. Proposed Contract Execution Dale: <br />IMPORTANT: Identify all DBE firms being claimed for credit, <br />Local Agency certifies that all DBE certifications are valid and Information on <br />this form Is complete and accurate, <br />regardless of tier. Written confirmation of each listed DBE Is <br />required. <br />20. Local Agency Representative's Signature 21. Dale <br />—rv........_ <br />72. Preparot's Signature 13. Dale <br />22. Local Agency Representafive's Name 23. Phone <br />14. Preparer's Name 15. Phone <br />24. Local Agency Representative's Title <br />16. Preparers Title <br />DISTRIBUTION: Original- Included with consultant's proposal to local agency. <br />AUANotico; For lndr4duals Win sensory disabilities, thls dominient is available in alternate annals. F"ir)fnnadong11(916)654-&Il00fTDD(J16)654- <br />5869 or mile Rocords and Form Mananninenl, 1120 N Slreel, MS -89, Sacramento, CA 95014. <br />Page I of 2 <br />July 23, 2015 <br />