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TRCAPLEA000282.2024 City of Redwood City | FORMS <br />ROOSEVELT AVENUE PERMANENT TRAFFIC CALMING PROJECT ENGINEERING DESIGN <br />RFP #ENG24-12 <br />Local Assistance Procedures Manual EXHIBIT 10-U <br />Consultant Management Conflict of Interest Statement <br />□I have read and fully understand all of the above. <br />Date: __________________ Signature: ________________________________________ <br />Name: ___________________________________________ <br />Title: ____________________________________________ <br />Consultant Firm/Sole Proprietor: _____________________________ <br />REVIEWED BY PUBLIC WORKS DIRECTOR OR AUTHORIZED LOCAL AGENCY <br />REPRESENTATIVE <br />I have reviewed the foregoing “Conflict of Interest and Confidentiality Statement” and will ensure: <br />□That the foregoing named local agency consultant who is under contract and in a management <br />support role with our local agency, abides by the foregoing terms and conditions; <br />□That should the foregoing named local agency consultant, who is under contract and in a <br />management support role with our local agency, violate any of the foregoing terms and <br />conditions, the Caltrans DLAE will be notified and such violation will be considered a breach <br />of ethics and could be a basis for ineligibility of State or Federal project funds. <br />□The procedures followed to procure and execute the contract, between the local agency and the <br />consulting firm of which I am employed, comply with all federal and state requirements. Also <br />this contract has a specific date from to . <br />Date: __________________ Signature: ________________________________________ <br />Name: ___________________________________________ <br />Title: ____________________________________________ <br />Department/Local Agency: _____________________________ <br />Page 2 of 3 <br />January 2018 <br />Michael S. Mowery, PE <br />Senior Vice President <br />Kimley-Horn and Associates, Inc. <br />June 19, 2024 <br />ATTY/AGR.2024.181/KImley-Horn (Roosevelt Ave Permanent Traffic Calming Project De (Page 41 of 42) <br />6.B. - Page 45 of 46 <br />70