DBE Dollar Amount. Local Agency to Complete this Section 13. Total Dollars Claimed $ 20. Local Agency Contract Number: 21. Federal-aid Project Number: 22. Contract Execution Date: Local Agency certifies that all DBE certifications are valid and the information on this form is complete and accurate: 23. Local Agency Representative Name (Print) 24. Local Agency Representative Signature 25. Date 26. Local Agency Representative Title 27. (Area Code) Tel. No.
Appears in 5 contracts
Samples: Professional Services Agreement, Professional Services Agreement, Sample Consultant Agreement
