Exhibit 10-K - Consultant Certification Of Contract Costs And Financial Management System Form
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2Local Assistance Procedures Manual
EXHIBIT 10-K
Consultant Certification of Contract Costs and Financial Management System
E
10-K C
C
C
C
F
XHIBIT
ONSULTANT
ERTIFICATION OF
ONTRACT
OSTS AND
INANCIAL
M
S
ANAGEMENT
YSTEM
(Note: If requesting to utilize the Safe Harbor Indirect Cost Rate submit Attachment 1 of
DLA-OB 13-07 - Safe Harbor Indirect Cost Rate for Consultant Contracts found at
in lieu of this form.)
Certification of Final Indirect Costs:
Consultant Firm Name: _____________________________________________________
Indirect Cost Rate: _______________ * for fiscal period _____________________________________
*Fiscal period covered for Indirect Cost Rate developed (not the contract period).
Local Government: ____________________________________
Contract Number: _______________________
Project Number: _________________________
I, the undersigned, certify that I have reviewed the proposal to establish final indirect cost rates for the fiscal
period as specified above and to the best of my knowledge and belief:
1. All costs included in this proposal to establish final Indirect Cost Rates are allowable in
accordance with the cost principles of the Federal Acquisition Regulations (FAR) of Title 48,
Code of Federal Regulations (CFR), Part 31.
2. This proposal does not include any costs which are expressly unallowable under the cost
principles of the FAR of 48 CFR, Part 31.
All known material transactions or events that have occurred affecting the firm’s ownership, organization, and
Indirect Cost Rates have been disclosed as of the date of proposal preparation noted above.
Certification of Financial Management System:
I, the undersigned, certify to the best of my knowledge and belief that our Financial Management System meets
the standards for financial reporting, accounting records, internal and budget control as set forth in the FAR of
Title 49, CFR, Part 18.20 to the extent applicable to Consultant.
Certification of Dollar Amount for all A&E Contracts:
I, the undersigned, certify that the approximate dollar amount of all A&E contracts awarded by Caltrans or a
California local agency to this firm within the last three (3) calendar years for all State DOT and Local Agencies
is $________________________ and the number of states in which the firm does business is ________.
Certification of Direct Costs:
I, the undersigned, certify to the best of my knowledge and belief that all direct costs identified on the cost
proposal(s) in this contract are reasonable, allowable and allocable to the contract in accordance with the cost
principles of the FAR of Title 48, CFR, Part 31. Allowable direct costs to a Government contract shall be:
Page 1 of 2
LPP 15-01
January 14, 2015
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