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<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Local Agency A&E Professional Services <br />Cost Plus Fixed Fee Consultant Agreement <br />Agreement Number: <br />Firm/Organization Legal Name (do not use dba’s): <br />Address Federal Aid Number <br />UBI Number Federal TIN or SSN Number <br />Execution Date Completion Date <br />1099 Form Required <br />Yes No <br />Federal Participation <br />Yes No <br />Project Title <br />Description of Work <br />Yes No DBE Participation <br />Yes No MBE Participation <br />Yes No WBE Participation <br />Yes No SBE Participation <br />Total Amount Authorized: <br />Management Reserve Fund: <br />Maximum Amount Payable: <br />Index of Exhibits <br />Exhibit A <br />Exhibit B <br />Exhibit C <br />Exhibit D <br />Exhibit E <br />Exhibit F <br />Exhibit G <br />Exhibit H <br />Exhibit I <br />Exhibit J <br />Scope of Work <br />DBE Participation <br />Preparation and Delivery of Electronic Engineering and Other Data <br />Prime Consultant Cost Computations <br />Sub-consultant Cost Computations <br />Title VI Assurances <br />Certification Documents <br />Liability Insurance Increase <br />Alleged Consultant Design Error Procedures <br />Consultant Claim Procedures Agreement Number: <br />Page 1 of 14 Local Agency A&E Professional Services Cost Plus Fixed Fee Consultant Agreement <br />Revised 02/01/2021