ORANGE COUNTY TRANSPORTATION AUTHORITY (OCTA) (C-6-1516)

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COOPERATIVE AGREEMENT NO. C-6-1516 EXHIBIT D The Consultant is required to complete and submit a Form 103 to the Authority by the 10th of each month until completion of the contract. The Consultant must submit its first Form 103 following the first month of contract activity. Upon completion of the contract, the Consultant must complete and submit a "Final: Monthly DBE Subconsultant Commitment and Attainment Report Summary and Payment Verification" (Form 103) to facilitate reporting and capturing actual DBE attainments at conclusion of the contract. The Form 103 must include the following information: A. General Contract Information — Including Contract Number and Name, Prime Consultant and the following: 1. Original Contract Amount 2. Running Total of Change Order Amount 3. Current Contract Amount 4. Amount Paid to Consultant during Month 5. Amount Paid to Consultant from Inception to Date 6. DBE Contract Goal 7. Total Dollar Amount of DBE Commitment 8. DBE Commitment as Percentage of Current Contract Amount B. Listed and/Proposed Consultant/Subconsultant Information — For All DBE participation being claimed either Race Neutrally or Race Consciously, regardless of tier: 1. DBE Firm Name, Address, Phone Number, DBE Type of Operation, Certification Type and Certification Number. 2. DBE Firm Contract Value Information: Original contract amount, running total of change order amount, Current contract amount, Amount paid to Consultant during month and Amount paid to Consultant to date. 2. Consultant Assurance of Full Compliance with Prompt Payment Provisions Consultant to sign the prompt payment assurance statement of compliance contained within the Form 103. Consultant is to further maintain and submit at the request of Authority a detailed running tally of related invoices submitted by DBE(s) and Non DBE(s), including dates of invoice submission, dates accepted and corresponding dates and amount of payments made. The Payment and Retention Reporting tally must also include: DBE(s) and Non DBE(s) Invoice Number, Invoice Amount, Invoice Date, Prime Consultant's Invoice Number that incorporated the corresponding DBE and Non DBE invoice(s) for billing purposes, Date of Invoice submission to Authority, Date and amount Authority paid on Prime Consultant's Invoice. The report must also reflect a breakout of retention withheld (including retention as specified in subcontract agreement(s) and disputed invoice retention) and retention payments made, check number and date paid to DBE and Non DBE. Exhibit D Page 8