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RPVCCA_CC_SR_2012_12_18_C_Blackhorse_CDBG_Access_RampsCITY OF MEMORANDUM RANCHO PALOS VERDES TO: FROM: DATE: SUBJECT: HONORABLE MAYOR &CITY COUNCIL MEMBERS JIM HENDRICKSON,INTERIM DIRECTOR OF PUBLlCa~1n WORKS ~ DECEMBER 18,2012 AWARD CONSTRUCTION AND CONSTRUCTION MANAGEMENT/INSPECTION SERVICES CONTRACTS FOR THE BLACKHORSE CDBG ACCESS RAMPS - ADA COMPLIANCE PROJECT (SUPPORTS 2012 CITY COUNCIL GOAL #4,PUBLIC INFRASTRUCTURE -CITY WIDE STREET MAINTENANCE) REVIEWED:CAROLYN LEHR,CITY MANAGER ~ Project Manager:Nicole Jules,Senior Engineer '~'(\~ RECOMMENDATIONS 1)Approve the construction plans and contract documents,on file in the Department of Public Works,for the Blackhorse Road CDBG Access Ramps -ADA Compliance Project; 2)Award a construction contract to Crownline General Contractor in the amount of $60,799 for the project; 3)Award a professional services contract to Merit Civil Engineering in the amount of $5,797 for project construction management and inspection services; 4)Authorize staff to utilize an additional 5%($3,329.80)for contingency; 5)Authorize the Mayor and City Clerk to execute the agreements;and 6)Adopt Resolution No.2012-xxx,A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF RANCHO PALOS VERDES,AMENDING RESOLUTION NO.2012- 43,THE BUDGET APPROPRIATION FOR FY 2012-2013,FOR A BUDGET ADJUSTMENT OF $14,000 TO THE CITY'S COMMUNITY DEVELOPMENT BLOCK GRANT FUND. C-1 BACKGROUND The City of Rancho Palos Verdes (RPV)has participated in the Los Angeles Urban County's Community Development Block Grant (CDBG)Program since 1986.The program funds local community development projects that meet national objectives.The Blackhorse CDBG -ADA Compliance project meets the objectives of the CDBG eligible activities and has been adopted by City Council as an approved project. DISCUSSION The project scope includes upgrading and installing ADA compliant facilities,removal and reconstruction of four handicap access ramps,construction of sidewalk and curb and gutter repair and modifications to an existing wall,traffic signal equipment and signing and striping.The project improvements will upgrade existing conditions along Hawthorne Blvd near Blackhorse Road to improved public transit accessibility for the elderly and severely disabled.A project location map is included as an attachment. Construction Contract The project was publicly advertised and sealed bids were received and opened on November 8,2012.Crownline General Contractor submitted the lowest responsive bid out of the 4 bids received.The following table summarizes the bids received: Bid Amount $60,799 $66,723 $68,460 $68,480 Prior to advertising the project for public bids,the project plans were submitted to LA Metro for review and comment since the project includes relocation and modification of an existing bus stop (Metro Line 344).Metro's comments were received after the project was let for bid.Incorporating Metro's comments at this point will result in a change in scope to the project.Metro is requesting that we extend our project improvements by an additional 20 feet to the north resulting in increased sidewalk,a tree removal and additional retaining wall.The modifications as requested by Metro will be completed as a separate project (Phase 2)after funds become available for the improvements.Staff anticipates returning this item to Council at the second meeting in January to request authorization to start Phase 2. Staff has verified Crown line General Contractor's references and found their past performance on jobs of similar size and scope to be satisfactory.Crownline General Contractor has successfully completed past projects of similar scope in the Cities of Chino Hills and Redlands.The projects in the cities of Chino Hills and Redlands were CDBG funded projects.Crownline General Contractor's bid documents,bonds,and insurance certificates are in order and their contractor's license is current. C-2 Construction Management and Inspection Construction management and inspection services are needed to ensure compliance with project specifications and plans.Staff solicited professional proposals from three firms to provide construction management and inspection services.Utilizing the Quality-based Selection (QBS)for acquiring professional services,staff chose to utilize the services of Merit Civil Engineering based on their familiarity of the project scope and successful completion of the Miraleste Plaza and Vista Grande CDBG ADA Compliant Projects.A professional service contract in the amount of $5,797 is recommended for award based on Merit Civil Engineering's qualifications,service history and professional experience. CDBG Administration and Labor Compliance CDBG Administration and labor compliance services are needed to ensure compliance with the Community Development Commission's (CDC)requirements.Diana Cho and Associates (DCA)have proposed to provide this administrative function for $14,000.A professional services agreement for DCA was approved by the Council on May 15,2012 however the project budget requires an amendment to cover the cost of these services. Resolution No 2012-xxx is included as an attachment to this staff report that modifies the project budget to include CDBG administrative and labor compliance costs. The budget appropriation for this project includes $70,000 of CDBG and CIP funding. Staff has been notified by the CDC that an additional $64,000 of unallocated CDBG funds is available for use on this project.Considering Metro's request to modify the project scope and the estimated cost of the change to be approximately $52,000,the additional $64,000 of unallocated funds could be used to offset the cost.At the second meeting in January 2013,staff will request City Council's approval to authorize phase 2 of the project and utilize the unallocated CDBG funds towards the requested improvements by Metro that are not currently included in the project scope as awarded. ALTERNATIVE An alternative recommendation is to reject all bids and re-advertise the construction project.This alternative could take approximately two months to complete and may result in an increase in bids and a potential delay to the project. FISCAL IMPACT The recommended action will result in a total project authorized expenditure of $83,925.80.With adoption of Resolution No.2012-xxx,funding for the project will be increased from $70,000 to $84,000 and expended from the FY12-13 CDBG and Capital Improvements -Buidling (ADA Transition Plan Project)programs budget.The City Attorney has reviewed and approved the construction contract and the professional services agreement that are included as attachments to this report. Attachments:Resolution No.2012-xxx -Budget Adjustment request for Blackhorse Road CDBG Access Ramps -ADA Compliance Project Project Location Map C-3 Project Renderings Crownline General Contractor Construction Contract Merit Civil Engineering Professional Services Agreement C-4 RESOLUTION NO.2012-XX C-5 RESOLUTION NO.2012- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF RANCHO PALOS VERDES,AMENDING RESOLUTION 2012-43,THE BUDGET APPROPRIATION FOR FISCAL YEAR 2012-13,FOR A BUDGET ADJUSTMENT TO THE CITY'S COMMUNITY DEVELOPMENT BLOCK GRANT FUND PROGRAM WHEREAS,Section 3.32 of the Rancho Palos Verdes Municipal Code provides that all expenditures in excess of budgeted allocations must be made by supplemental appropriation of the City Council;and WHEREAS,on June 19,2012,the City Council of the City of Rancho Palos Verdes apopted Resolution 2012-43,approving a spending plan and authorizing a budget appropriation for the 2012-13 fiscal year;and WHEREAS,the City of Rancho Palos Verdes desires that the budget appropriation for the FY 2012-13 Community Development Block Grant (CDBG) program be increased;and WHEREAS,a budget increase in the Community Development Block Grant Program is necessary to authorize the expenditure of funds for the Blackhorse Road Americans with Disabilities Act (ADA)Improvements project; BE IT,THEREFORE,RESOLVED BY THE CITY COUNCIL OF THE CITY OF RANCHO PALOS VERDES: The following adjustments shall be made to the following CDBG funds: CDBG ADA Improvements-Grant Income Blackhorse Road ADA Improvements Verified by Finance:_ 31 0-3095-331-10-00 31 0-3095-461-73-00 $14,000 $14,000 PASSED,APPROVED,AND ADOPTED THIS 17th DAY OF JANUARY,2012. MAYOR ATTEST: CITY CLERK C-6 State of California ) County of Los Angeles )ss City of Rancho Palos Verdes ) I,CARLA MORREALE,City Clerk of The City of Rancho Palos Verdes,hereby certify that the above Resolution No.2012-was duly and regularly passed and adopted by the said City Council at a regular meeting thereof held on December 18,2012. CITY CLERK CITY OF RANCHO PALOS VERDES C-7 PROJECT LOCATION MAP C-8 C-9 PROJECT RENDERINGS C-10 z z w ou.. c::: W t--u..« C-11 C/)oC/)C.9«I--z--OZ 0=::o=::~w 0WwZC/»w0=::0 0=::Oe=::I--I a... 0~~·w0- c::: ....,««0 UJ UJ -10 c::: l- e=::0 u... a:l« « a...u... UJm C-12 CRO LINE CNSTRCTION CONT CT C-13 CHECKLIST FOR EXECUTION OF CONSTRUCTION CONTRACT TO BE SUBMITTED BY SUCCESSFUL BIDDER: o Two Executed Notarized Copies of the Contract (Attached) o Payment Bond in Amount of Contract (Attached) o Performance Bond in Amount of Contract (Attached) o Workers Compensation Certificate (Attached) o All Insurance Certificates in the amounts required,Naming the City as a Co-insured o Agreement to Comply with California Labor Law Requirements (Attached) o Business License with the City of Rancho Palos Verdes o Indemnification and Hold Harmless Agreement (Attached) o Additional Insured Endorsement -Comprehensive General Liability (Attached) o Additional Insured Endorsement -Automobile Liability (Attached) o Additional Insured Endorsement -Excess Liability (Attached) o Statement Acknowledging Penal &Civil Penalties Concerning Contractors'Licensing Laws (Attached) o Non-Segregated Facilities Certification (Attached) o Equal Employment Opportunity Commitment (Attached) o U.S.Department of Housing and Urban Development Report of Additional Classification and Rate (HUD Form 4230A)(Attached) o Past Performance Certification (Attached) o Fringe Benefit Payment Certification (Attached) o Los Angeles County Lobbyist Certification (Attached) o Federal Lobbyist Requirements Certification (Attached) C-14 CITY OF RANCHO PALOS VERDES AGREEMENT FOR BLACKHORSE ROAD CDBG ADA PROJECT (Community Development Block Grant Project #601491.11) THIS AGREEMENT (the "Agreement")is made and entered this 18th day of December,2012,by and between the CITY OF RANCHO PALOS VERDES,a California municipal corporation ("City")and Crownline General Contractor ("Contractor").Contractor's license number is 978079. In consideration of the mutual covenants hereinafter set forth,the parties hereto agree as follows: 1.Scope of Services.Contractor shall perform the work and provide all labor,materials,equipment and services in a good and workmanlike manner for the project identified as BLACKHORSE ROAD CDBG ADA PROJECT ("Project"),as described in this Agreement and in the Bid Documents (including the Notice Inviting Sealed Bids,the Instructions to Bidders,the General Provisions,the Special Provisions,the Proposal,Appendices I through V,and all addenda as prepared prior to the date of bid opening setting forth any modifications or interpretations of any said documents),which are on file with the Department of Public Works and incorporated herein by this reference,including miscellaneous appurtenant work.All work shall be performed in accordance with the latest edition of the Standard Specifications for Public Works Construction (commonly known as the "Greenbook"),including supplements,prepared and promulgated by the Southern California Chapter of the American Public Works Association and the Associated General Contractors of California (collectively "Standard Specifications"),which is incorporated herein by this reference.In the event of any conflict between the terms of this Agreement and incorporated documents, the terms of this Agreement shall control. 2.Extra Work.Extra work,when ordered in writing by the Director of Public Works and accepted by the Contractor,shall be paid for under written work order in accordance with the terms therein provided. Payment for extra work will be made at the unit price or lump sum previously agreed upon in writing between the Contractor and the Director of Public Works.All extra work shall be adjusted daily upon report sheet furnished by the Contractor,prepared by the Director of Public Works,and signed by both parties,and said daily report shall be considered thereafter the true records of extra work done. 3.Effective Date.This Agreement is effective as of the date listed above,and shall remain in full force and effect until Contractor has rendered the services required by this Agreement. 4.Force Majeure.Neither the City nor Contractor shall be responsible for delays in performance under this Agreement due to causes beyond its control,including but not limited to acts of God,acts of the public enemy,acts of the Government,fires,floods or other casualty,epidemics,earthquakes,labor stoppages or slowdowns,freight embargoes,unusually severe weather,and supplier delays due to such causes.Neither economic nor market conditions nor the financial condition of either party shall be considered a cause to excuse delay pursuant to this Section.Each party shall notify the other promptly in writing of each such excusable delay,its cause and its expected delay,and shall upon request update such notice. 5.Compensation.In consideration ofthe services rendered hereunder,City shall pay Contractor a not to exceed amount of sixty thousand seven hundred ninety nine dollars ($60,799.00)in accordance with the prices as submitted in Contractor's Proposal,attached hereto as Exhibit "A"and incorporated herein by this reference. 6.Payments.City shall make payments within thirty (30)days after receipt of undisputed and properly submitted payment requests from Contractor.City shall return to Contractor any payment request determined not to be a proper payment request as soon as practicable,but not later than seven (7)days, C-15 after receipt and shall explain in writing the reasons why the payment request is not proper. A payment shall be made as the City Council of the City prescribes upon estimates approved by the City Council.However,progress payments shall not be made in excess of ninety-five percent (95%)of the percentage of actual work completed plus a like percentage of the value of material delivered on the ground or stored subject to,or under the control of,the City,and unused.The City shall withhold not less than five percent (5%)of the Agreement price until final completion and acceptance of the Project.However,at any time after fifty percent (50%)of the work has been completed,if the City Council of the City finds that satisfactory progress is being made,it may,at its discretion,make any of the remaining progress payments in full for actual work completed 7.Substitute Security. a.At the written request and expense of Contractor,securities equivalent to any moneys withheld by the City to ensure performance under this Agreement shall be deposited with the City,or with a state or federally chartered bank in the State of California as the escrow agent,that shall then pay those moneys to Contractor.Upon satisfactory completion of the Agreement,the securities shall be returned to Contractor. b.Alternatively,Contractor may request that the City shall make payment of retentions earned directly to the escrow agent at the expense of Contractor.At the expense of Contractor, Contractor may direct the investment of the payments into securities,and Contractor shall receive the interest earned on the investments upon the same terms provided for securities deposited by Contractor.Upon satisfactory completion of the Agreement,Contractor shall receive from the escrow agent all securities,interest,and payments received by the escrow agent from the City,pursuant to the terms of this Section. c.Securities eligible for investment shall include those listed in California Government Code Section 16430,bank or savings and loan certificates of deposit,interest-bearing demand deposit accounts,standby letters of credit,or any other security to which Contractor and the City mutually agree in writing.Contractor shall be the beneficial owner of any securities substituted for moneys withheld and shall receive any interest thereon. d.If Contractor elects to receive interest on moneys withheld in retention by the City,it shall, at the request of any subcontractor performing more than five percent (5%)of Contractor's total bid, make that option available to the subcontractor regarding any moneys withheld in retention by Contractor from the subcontractor.Further mandatory details are provided in Public Contract Code Section 22300(d),which is incorporated herein by this reference. e.The escrow agreement for security deposits in lieu of retention shall be substantially similar to the form provided in Public Contract Code Section 22300(f),which is incorporated herein by this reference. 8.Taxes.Contractor shall calculate payment for all sales,unemployment,old age pension and other taxes imposed by local,State of California and federal law.These payments are included in the total amounts in Exhibit "B." 9.Time.Upon receipt of written Notice to Proceed from the City,Contractor shall perform with due diligence the services requested by the City as specified in the Bid Documents.Time is of the essence in this Agreement. 10.Disputes.In the event of dispute arising under this Agreement,Contractor shall notify the City promptly in writing of its contentions and submit the claim.If the dispute arises before performance of the related work,the written notice shall be submitted prior to commencing such work.In any event,Contractor C-3 C-16 shall proceed with such work in compliance with the instructions of the City and shall not be excused from any scheduled completion date provided for by the Agreement;such compliance shall not be a waiver of the Contractor's rights to make a claim,provided it has notified the City in writing as above stipulated.The disputed work will be categorized as an "unresolved dispute"and payment,if any,shall be as later determined by mutual agreement or a court of law.Contractor shall keep accurate,detailed records of all disputed work,claims and other disputed matters.Public Contract Code Sections 20104 et seq.and Rancho Palos Verdes Municipal Code chapter 3.24 ("Claims Against the City")shall govern the procedures of the claim process,and these provisions are incorporated herein by this reference. 11.Default and Remedies. a.Default shall consist of any failure by the Contractor to perform under this Agreement or written amendments thereto or any breach of any covenant,agreement,provision or warranty provided by the Contractor as a part of this Agreement.Actions which constitute a default include,but are not limited to: (1)failure to submit to the City reports which are required pursuant to this Agreement or the submission of required repor:ts that are incorrect or incomplete;(2)submission of requests for payment or reimbursement of amounts that are incorrect or incomplete;(3)the failure of Contractor to accept any additional conditions which may be required by law,by executive order,by regulation or by other policy announced by the City, the state or any federal agency;or (4)failure to perform any activity required by this Agreement. b.Upon occurrence of any default,the City shall advise Contractor in writing of the action constituting the default,and specify the actions that must be taken to cure the default.The City may suspend payment under the Agreement.If Contractor does not cure the default within thirty (30)days of receipt of written notice from the City,the City may continue the suspension or,by written notice of termination,may terminate this Agreement. c.Notwithstanding the above,Contractor shall not be relieved of liability to the City for damage sustained by the City by virtue of any default or breach of the Agreement,and the City may deduct the amount of damages from any outstanding payments to Contractor or may withhold payments until such time as the exact amount of the damages is determined. 12.Termination. a.The City may cancel this Agreement at any time with or without cause without penalty upon thirty (30)days'written notice.In the event of termination without fault of Contractor,City shall pay Contractor for all services satisfactorily rendered prior to date of termination,and such payment shall be in full satisfaction of all services rendered hereunder. b.If federal funding for this Agreement is terminated and no other funding is available for continuation of this project,the City will not be obligated to continue funding for the services contained in this Agreement and may terminate the Agreement. c.In the event of termination,all property and finished or unfinished documents,data,studies, surveys,drawings,maps,models,photographsand reports prepared by or purchased with CDBG/HOME funds by the Contractor under this Agreement shall,at the option of the City,become the City's property, and Contractor shall be entitled to receive just and equitable compensation,as determined by the City,for any work satisfactorily completed hereunder. 13.Incorporation by Reference.All of the following documents are attached hereto and incorporated herein by this reference:City of Rancho Palos Verdes Instructions for Execution of Instruments;Insurance Requirements for the City of Rancho Palos Verdes Public Works Contract;Workers'Compensation Certificate of Insurance;Indemnification and Hold Harmless Agreement and Waiver of Subrogation and C-4 C-17 Contribution;Additional Insured Endorsement (Comprehensive General Liability);Additional Insured Endorsement (Automobile Liability);Additional Insured Endorsement (Excess Liability);Non-Segregated Facilities Certification;Equal Employment Opportunity Commitment;U.S.Department of Housing and Urban Development Report of Additional Classification and Rate (HUD Form 4230A);U.S.Department of Labor Employment Standards Administration Wage and Hour Division Payroll;Contracting with Small Business Minority Firms,Women's Business Enterprise and Labor Surplus Area Firms;Federal Equal Employment Opportunity/Affirmative Action Requirements;Past Performance Certification;and Fringe Benefit Payment Certification. 14.Record-Keeping and Reporting. a.Records to be Kept.Records shall be maintained in accordance with the requirements prescribed by the Secretary of Housing and Urban Development ("HUD")or the County of Los Angeles (the "County")with respect to all matters covered by this Agreement.Except as otherwise authorized by HUD, such records shall be maintained for a period of five (5)years after receipt of the final payment under this Agreement.Additionally,pursuant to Government Code Section 8546.7,Contractor shall be subject to State Auditor exami'nation and audit at the request of the City or as part of any audit of the City,for a period of three (3)years after final payment under this Agreement. b.Documentation of Costs.All costs shall be supported by properly executed payrolls,time records,invoices,contracts,vouchers,orders or other accounting documents.All documents pertaining in whole or in part to this Agreement shall be clearly identified and readily accessible. c.Inspection of Records.At any time during normal business hours and as often as City, County,HUD and/or the Comptroller General of the United States may deem necessary,the Contractor shall make available to any of these entities for examination all of its records,with respect to all matters covered by this Agreement,and will permit any of these entities to audit,examine and make excerpts or transcripts from such records,including contracts,invoices,materials,payrolls,records of personnel, conditions of employment and any other data relating to matters covered by this Agreement. 15.Lobbying Certifications.The Los Angeles County Lobbyist Code Chapter 2.160 County Ordinance No.93-0031 Certification and the Federal Lobbyist Requirements Certification are attached hereto and incorporated herein by this reference.Consultant shall complete and file these Certifications as required by the City or the County. 16.Trenching and Excavations.If the project involves trenching more than four (4)feet deep, Contractor shall promptly and before the following conditions are disturbed notify the City in writing of any: material that Contractor believes may be material that is hazardous waste,as defined in California Health and Safety Code Section 25117,that is reqUired to be removed to a Class I,Class II,or Class III disposal site in accordance with provisions of existing law;subsurface or latent physical conditions at the site differing from those indicated;or unknown physical conditions at the site of any unusual nature,different materially from those ordinarily encountered and generally recognized as inherent in work of the character provided for in the Agreement.The City shall promptly investigate the conditions,and if the City finds that the conditions do materially differ or do involve hazardous waste and cause a decrease or increase in Contractor's cost of or the time required for performance of any part of the work,the City shall issue a change order. 17.Utilities.The City acknowledges its responsibilities under Government Code section 4215 and incorporates that section herein by this reference. 18.Location of Existing Elements.The methods used and costs involved to locate existing elements, points of connection and all construction methods are the Contractor's sole responsibility.Accuracy of C-5 C-18 information furnished,as to existing conditions,is not guaranteed by the City.Contractor,at its sole expense,must make all investigations necessary to determine locations of existing elements,which may include,without limitation,contacting U.S.A.Alert and other private underground locating firm(s),utilizing specialized locating equipment and/or hand trenching. 19.Antitrust Claims.Pursuant to Public Contract Code Section 7103.5,Contractor offers and agrees to assign to the City all rights,title,and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C.Section 15)or under the Cartwrig ht Act (Chapter 2 (commencing with Section 16700) of Part 2 of Division 7 of the California Business and Professions Code)arising from purchases of goods, services,or materials pursuant to the Agreement.This assignment shall be made and become effective at the time the City tenders final payment to Contractor without further acknowledgment by the parties. 20.Independent Contractor.Contractor is and shall at all times remain,as to the City,a wholly independent contractor.Neither the City nor any of its agents shall have control over the conduct of Contractor or any of the Contractor's employees,except as herein set forth,and Contractor is free to dispose of all portions of its time and activities which it is not obligated to devote to the City in such a manner and to such persons,firms,or corporations at the Contractor wishes except as expressly provided in this Agreement.Contractor shall have no power to incur any debt,obligation,or liability on behalf of the City,bind the City in any manner,or otherwise act on behalf of the City as an agent.Contractor shall not,at any time or in any manner,represent that it or any of its agents,servants or employees,are in any manner agents,servants or employees of City.Contractor agrees to pay all required taxes on amounts paid to Contractor under this Agreement,and to indemnify and hold the City harmless from any and all taxes, assessments,penalties,and interest asserted against the City by reason of the independent contractor relationship created by this Agreement.Contractor shall fully comply with the workers'compensation law regarding Contractor and its employees.Contractor further agrees to indemnify and hold the City harmless from any failure of Contractor to comply with applicable workers'compensation laws.The City shall have the right to offset against the amount of any compensation due to Contractor under this Agreement any amount due to the City from Contractor as a result of its failure to promptly pay to the City any reimbursement or indemnification arising under this Section. 21.Workers'Compensation Insurance.California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees.In accordance with the provisions of California Labor Code Section 1861,the Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers'compensation or to under take self-insurance in accordance with the provisions of that code,and I will comply with such provisions before commencing the performance of the work of this contract." 22.Subcontracting.Contractor shall adhere to all provisions of the Subletting and Subcontracting Fair Practices Act,Public Contract Code Section 4100 et seq.,which is incorporated herein by this reference. 23.Debarred,Suspended or Ineligible Contractors.Contractor shall not be,and shall ensure all subcontractors are not,debarred,suspended or placed in eligibility status under the provisions of 24 C.F.R. Part 24 throughout the duration of this Agreement.Contractor shall not perform work with debarred subcontractor pursuant to California Labor Code sections 1777.1 or 1777.7. 24.Anti-Discrimination.Contractor shall adhere to all federal discrimination requirements,including Executive Order 11246,as listed in the Federal Discrimination Provisions,which is attached hereto and incorporated herein by this reference.Contractor shall also adhere to the Equal Employment Opportunity Regulations for Federally Assisted Construction Contracts,which is attached hereto and incorporated herein C-6 C-19 by this reference.Contractor shall ensure equal opportunity to all persons without regard to race,color, gender,sexual orientation,religion,national origin,ancestry,age,marital status,or disability. 25.Conflicts of Interest. a.Contractor agrees not to accept any employment or representation during the term of this Agreement or within twelve (12)months after completion of the work under this Agreement which is or may likely make Contractor "financially interested ,"as provided in Government Code Section 1090 and 87100,in any decisions made by City on any matter in connection with which Contractor has been retained pursuant to this Agreement. b.No official,officer,employee,or agent of the City or Contractor shall have any financial interest,direct or indirect,in any contract or subcontract,or the proceeds thereof,for work to be performed in connection with the program assisted under this Agreement. Immediate family members of said officials, officers,employees,and agents are similarly barred from having any financial interest in the program. c..No person who exercises,or has exercised any function or responsibilities with respect to CDBG activities,or who is in a position to participate in a decision making process or gain inside information with regards to such activities,may obtain a financial interest or benefit from a CDBG-assisted activity,or have a financial interest in any contract,subcontract,or agreement with respect to a CDBG-assisted activity, or with respect to the proceeds of the CDBG-assisted activity,either for themselves or those with whom they have business or immediate family ties,during their tenure or for one year thereafter. d.Contractor shall take appropriate steps to assure compliance with paragraph (b)of this Section and will incorporate the following provision into every subcontract: "Interest of Subcontractor and Employees.The Subcontractor covenants that no person who presently exercises any functions or responsibilities in connection with the Community Development Block Grant Program has any personal financial interest, direct or indirect,in this Contract.Any interest on the part of the Subcontractor or his employees must be disclosed to the Recipient and the City,provided,however,that this paragraph shall be interpreted in such a manner so as not to unreasonably impede the statutory requirement that maximum opportunity be provided for employment of and participation by residents of the area." 26.Third Party Claims.City shall have full authority to compromise or otherwise settle any claim relating to the Agreement at any time.City shall timely notify Contractor of the receipt of any third-party claim relating to the Agreement.City shall be entitled to recover its reasonable costs incurred in providing this notice. 27.Davis-Bacon Act.Copeland Anti-Kickback Act.and Prevailing Wages.City and Contractor acknowledge that this project is a public work to which prevailing wages apply.City and Contractor acknowledge that this is a federally assisted construction contract and that federal labor standards provisions,including prevailing wage requirements of the Davis-Bacon Act «40 U.S.C.276 a to a.7)as supplemented by Department of Labor Regulations (29 CFR Part 5))and related acts,are incorporated by this reference and will be enforced.Contractor understands that in the event of a conflict between the Federal General Wage Decision as established by the United States Department of Labor (available at www.access.gpo.gov/davisbacon/ca.html)and the State General Prevailing Wage Determination as established by the California Department of Industrial Relations (available at http://www.dir.ca.gov/DLSRlPWD/index.htm).the higherofthe two will prevail.The rates perdiem for each type of worker are on file with the Public Works Director at City Hall at the address listed below,and are available to anyone upon request.The documents titled U.S.Department of Housing and Urban Development Office of Labor Relations Federal Labor Standards Provisions and Agreement to Comply with C-7 C-20 California Labor Law Requirements are attached hereto and incorporated herein by this reference.Eight hours of labor constitutes a legal day's work.The Copeland "Anti-Kick Back Act"(18 U.S.C.876),as supplemented in Department of Labor regulations (29 CFR Part 3),shall apply,and Contractor shall not induce,by any means,any person employed in this Project to give up any part of the compensation to which he or she is otherwise entitled. 28.Contract Work Hours and Safety Standards Act.In employing mechanics or laborers,Contractor shall comply with the Contract Work Hours and Safety Standards Act (40 USC §§327 et seq.),as supplemented by Department of Labor Regulations contained in 29 C.F.R.Parts 3,5 and 5a.Contractor shall not require or permit any laborer or mechanic,in any workweek in which the laborer or mechanic is employed on that work,to work more than forty (40)hours in that workweek,except as provided in the Contract Work Hours and Safety Standards Act.When a violation occurs,Contractor is liable to the affected employee for the employee's unpaid wages and to the City for liquidated damages equal to ten dollars ($10) for each calendar day on which the individual was required or permitted to work in excess of the standard workweek without payment of the overtime wages required by this chapter. 29.Compfiance with Laws.Contractor shall comply with all applicable federal,state and local laws, ordinances,codes and regulations in force at the time Contractor performs pursuant to this Agreement, including those governing the funds provided under this Agreement. 30.Bonds.Contractor shall obtain faithful performance and payment bonds,each in an amount that is not less than the total compensation amount of this Agreement,and nothing in this Agreement shall be read to exculSe this requirement.The required forms entitled Payment Bond (Labor and Materials)and Performance Bond are attached hereto and incorporated herein by this reference.Contractor shall also obtain a one-year warranty bond in an amount that is not less than the total compensation amount of this Agreement and in a form approved by the City Attorney and shall deliver this bond to the City before the City's acceptance of the project;alternatively,the Contractor shall submit written evidence from the surety of an extension to its performance bond,to be effective for a year after acceptance by the City,and shall submit this extension before the City's acceptance of the Project. 31.Contractor's Representations.Contractor represents,covenants and agrees that:a)Contractor is licensed,qualified,and capable of furnishing the labor,materials,and expertise necessary to perform the services in accordance with the terms and conditions set forth in this Agreement;b)there are no obligations, commitments,or impediments of any kind that will limit or prevent its full performance under this Agreement; c)there is no litigation pending against Contractor,and Contractor is not the subject of any criminal investigation or proceeding;and d)to Contractor's actual knowledge,neither Contractor nor its personnel have been convicted of a felony. 32.Non-Assignability:Subcontracting.Contractor shall not assign or transfer any interest in this Agreement nor any part thereof,whether by assignment or novation,without the City's prior written consent. Any purported assignment without written consent shall be null,void,and of no effect,and Contractor shall hold harmless,defend and indemnify the City and its officers,officials,employees,agents and representatives with respect to any claim,demand or action arising from or relating to any unauthorized assignment. 33.Applicable Law.The validity,interpretation,and performance of this Agreement shall be controlled by and construed under the laws of the State of California,excluding California's choice of law rules.Venue for any such action relating to this Agreement shall be in the Los Angeles County Superior Court. 34.Attorneys'Fees.If any legal action or other proceeding,including action for declaratory relief,is brought for the enforcement of this Agreement or because of an alleged dispute,breach,default or misrepresentation in connection with this Agreement,the prevailing party shall be entitled to recover C-8 C-21 reasonable attorneys'fees,experts'fees,and other costs,in addition to any other relief to which the party may be entitled. 35.Titles.The titles used in this Agreement are for convenience only and shall in no way define,limit or describe the scope or intent of this Agreement or any part of it. 36.Authority.The person executing this Agreement on behalf of Contractor warrants and represents that he or she has the authority to execute this Agreement on behalf of Contractor and has the authority to bind Contractor to the performance of its obligations hereunder. 37.Entire Agreement.This Agreement,including any other documents incorporated herein by specific reference,represents the entire and integrated agreement between City and Contractor.This Agreement supersedes all prior oral or written negotiations,representations or agreements. 38.Amendment.The City or Contractor may only modify or amend this Agreement or any provision herein in a writing signed by both parties which expressly refers to this Agreement.The City may,at its discretion,amend this Agreement to conform with federal,state or local governmental guidelines,policies and available funding amount,or for other reasons.If such amendments result in a change in the funding, the scope of services,or schedule of the activities to be undertaken as a part of this Agreement,such modifications will be incorporated only by written amendments signed by both the City and Contractor. 39.Construction.In the event of any asserted ambiguity in,or dispute regarding the interpretation of any matter herein,the interpretation of this Agreement shall not be resolved by any rules of interpretation providing for interpretation against the party who causes the uncertainty to exist or against the party who drafted the Agreement or who drafted that portion of the Agreement. 40.Non-waiver of Terms,Rights and Remedies.Waiver by either party of anyone or more of the conditions of performance under this Agreement shall not be a waiver of any other condition of performance under this Agreement.In no event shall the making by the City of any payment to Contractor constitute or be construed as a waiver by the City of any breach of covenant,or any default which may then exist on the part of Contractor,and the making of any such payment by the City shall in no way impair or prejudice any right or remedy available to the City with regard to such breach or default. 41.Notice.Except as otherwise required by law,any notice or other communication authorized or required by this Agreement shall be in writing and shall be deemed received on (a)the day of delivery if delivered by hand or overnight courier service during Contractor's or City's regular business hours or (b)on the third business day following deposit in the United States mail,postage prepaid,to the addresses listed below,or at such other address as one party may notify the other: To CITY: Mr.Jim Hendrickson,Interim Director of Public Works City of Rancho Palos Verdes 30940 Hawthorne Blvd. Rancho Palos Verdes,CA 90275 To CONTRACTOR: The address listed in Exhibit "A." 42.Counterparts.This Agreement may be executed in counterpart originals,duplicate originals,or both, each of which is deemed to be an original for all purposes. C-9 C-22 43.Severability,If any term or portion of this Agreement is held to be invalid,illegal,or otherwise unenforceable by a court of competent jurisdiction,the remaining provisions of this Agreement shall continue in full force and effect. IN WITNESS WHEREOF,the parties hereto have executed the within Agreement the day and year first above written. CITY OF RANCHO PALOS VERDES By:_ Mayor ATTEST: By:....,-_ City Clerk CONTRACTOR: By:_ Printed Name:_ Date:_ By:_ Printed Name:_ Date:_ C-IO C-23 CITY OF RANCHO PALOS VERDES INSTRUCTIONS FOR EXECUTION OF INSTRUMENTS THIS IS INSTRUCTION ONLY -IT IS NOT TO BE SIGNED OR USED IN CONJUNCTION WITH THE AGREEMENT OR ANY OTHER FORMS THAT MUST BE TURNED INTO THE CITY OF RANCHO PALOS VERDES -IT IS SIMPLY A FORMAT TO USE WHEN FILLING OUT DOCUMENTS. 1.By an Individual.The individual must sign the instrument,and if he/she is doing business under a fictitious name,the fictitious name must be set forth.The signature must be acknowledged before a Notary Public.using the proper form of acknowledgment. 2.Bya Partnership.The name of the partnership must be set forth followed by the signatures of less than all of the partners will be acceptable only if submitted with evidence of authority to act on behalf of the partnership.The signatures must be acknowledged before a Notary Public. using the proper form of acknowledgment. 3.Bya Corporation.The name of the corporation must be set forth,followed by the signatures of the President or Vice President and Secretary or Assistant Secretary.The signatures must be acknowledged before a Notary Public, using in substance the following form of acknowledgment. 4.Bya Surety.The name of the surety must be set forth,followed by an authorized signature.The signatures must be acknowledged before a Notary Public,using the proper form of acknowledgment. STATEOF ) )55. COUNTY OF ) On ,20__,before me,the undersigned,appeared known to me to be the President or Vice President and known to be to be the Secretary or Assistant Secretary of the corporation that executed the within instrument,and acknowledged to me that such corporation executed the within instrument pursuant to its by-laws or a resolution of its City Council. WITNESS my signature and seal. Notary Public (Seal) C-ll C-24 INSURANCE REQUIREMENTS FOR CITY OF RANCHO PALOS VERDES PUBLIC WORKS CONTRACT The Contractor shall at all times,during the term of this contract,carry,maintain and keep in full force and effect,a policy or policies of comprehensive public liability insurance with an insurance company admitted to write insurance in California,or carriers with a rating of,or equivalent to,A:Vll by A.M.Best &Company to,and approved by,the Director of Public Works and City Attorney, within minimum limits of one Million Dollars ($1 ,000,000.00)combined single limit coverage with an aggregate of Two Million Dollars ($2,000,000.00)against any injury,death,loss or damage as a result of wrongful or negligent acts or omissions by the Contractor,its officers,employees,agents, and independent contractors in performance of services under this agreement;(2)Automotive liability insurance with a minimum combined single limits coverage of One Million Dollars ($1,000,000.00)with an aggregate of Two Million Dollars ($2,000.000.00);and (3)workers' compensation insurance as required by law.The contractor shall at all times during the term of this contract carry,maintain and keep in full force and effect a policy or policies of workers' compensation insurance and shall provide to the City evidence of such coverage in the form set forth herein.The City,its officers,employees,attorneys,and volunteers shall be named as additional insured on the policy (ies)as to comprehensive general liability,automotive liability,and worker's compensation coverages. a)All insurance policies shall provide that the insurance coverage shall not be non- renewed,canceled,reduced,or otherwise modified (except through the addition of additional insured to the policy)by the insurance carrier without the insurance carrier giving the City thirty (30)day's prior written notice thereof.The Contractor agrees that it will not cancel,reduce,or otherwise modify said insurance coverage. b)The Contractor agrees that if it does not keep the aforesaid insurance in full force and effect, and such insurance is available at a reasonable cost,the City may take out the necessary insurance and the pay the premium thereon,and the repayment thereof shall be deemed an obligation of the Contractor and the cost of such insurance may be deducted,at the option of the City,from payments due to the Contractor. c)The Contractor shall submit to the City (1)insurance certificate indicating compliance with the minimum worker's compensation insurance requirements above,and (2) insurance policy endorsements above,not less than one (1)day prior to beginning of performance under this Agreement.Endorsements must be executed on the City's appropriate standard forms entitled "Additionallnsured Endorsement,"copies of which are attached hereto. C-12 C-25 Bond No._ PAYMENT BOND (LABOR AND MATERIALS) KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Rancho Palos Verdes,California ("Public Agency")has awarded to __ (Name and address of Contractor) ("Principal"),a contract (the "Contract"),which is incorporated herein by this reference,for the work described as follows: BLACKHORSE ROAD CDBG ADA PROJECT (Community Development Block Grant Project #601491·11) WHEREAS,Principal is required under the terms of the Contract and the California Civil Code to file a good and sufficient payment bond with the Public Agency to secure the payment of claims of laborers,mechanics, material persons,and other persons as provided by law. NOW,THEREFORE,we,the undersigned Principal,and _ (Name and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California,as Surety,are held and firmly bound unto the Public Agency and all subcontractors,laborers,material persons,and other persons employed in the performance of the Contract in the penal sum of _ Dollars ($)(the "Penal Sum"),this amount being not less than one hundred percent (100%)of the total Contract price,in lawful money of the United States of America,for the payment of which sum well and truly to be made,we bind ourselves,our heirs,executors,administrators, successors,and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,heror its heirs,executors,administrators,successors or assigns,or subcontractors shall fail to pay any of the persons named in Section 9100 of the California Civil Code,or any amounts due under the Unemployment Insurance Code with respect to work or labor performed under the Contract,or for any amounts required to be deducted,withheld,and paid over to the Employment Development Department from the wages of employees of the Principal and subcontractors pursuant to Section 13020 of the Unemployment Insurance Code,with respect to work or labor performed under the Contract,the Surety will pay for the same in an amount not exceeding the Penal Sum specified in this bond;otherwise,this obligation shall become null and void. This bond shall inure to the benefit of any of the persons named in Section 9100 of the California Civil Code so as to give a right of action to such persons or their assigns in any suit brought upon the bond.In case suit is brought upon this bond,Surety further agrees to pay,in addition to the Penal Sum,all costs and C-13 C-26 reasonable expenses and fees,including reasonable attorneys'fees,incurred by the Public Agency in successfully enforcing such obligation,all to be taxed as costs and included in any judgment rendered. Further,the Surety,for value received,hereby stipulates and agrees that no change,extension of time, alteration,addition or modification to the terms of the Contract,or of the work to be performed there under, or the specifications for the same,shall in any way affect its obligations under this bond,and it does hereby waive notice of any such change,extension of time,alteration,addition,or modification to the terms of the Contract or to the work or to the specifications there under.Surety hereby waives the provisions of California Civil Code sections 2845 and 2849. IN WITNESS WHEREOF,two (2)identical counterparts of this instrument,each of which shall for all purposes be deemed an original hereof,have been duly executed by Principal and Surety,on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated:----------- "Principal" By:_ Its By:_ Its (Seal) APPROVED AS TO SURETY AND PRINCIPAL AMOUNT By:_ Insurance Administrator "Surety" By:_ Its By:_--:-_ Its (Seal) APPROVED AS TO FORM: RICHARDS,WATSON &GERSHON A Professional Corporation By:_ Public Agency Attorney Note:This bond must be executed in duplicate and dated,all signatures must be notarized,and evidence of the authority ofanyperson signing as attorney-in-fact must be attached. C-14 C-27 Bond No._ PERFORMANCE BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the City of Rancho Palos Verdes,California ("Public Agency")has awarded to __ (Name and address of Contractor) ("Principal"),a contract (the "Contract")for the work described as follows: BLACKHORSE ROAD CDBG ADA PROJECT (Community Development Block Grant Project #601491·11) WHEREAS,Principal is required under the terms of the Contract to furnish a bond for the faithful performance of the Contract. NOW,THEREFORE,we,the undersigned Principal,and _ (Name and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California,as Surety,are held and firmly bound unto the Public Agency in the penal sum of _ Dollars ($),this amount being not less than the total contract price,in lawful money of the United States of America,for the payment of which sum well and truly to be made,we bind ourselves,our heirs,executors, administrators,successors,and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal,his,heror its heirs,executors,administrators,successors or assigns,shall in all things stand to and abide by,and well and truly keep and perform all the undertakings,terms,covenants,conditions and agreements in the Contract and any alteration thereof made as therein provided,on the Principal's part to be kept and performed,all within the time and in the manner therein specified,and in all respects according to their true intent and meaning,and shall indemnify and hold harmless the Public Agency,its officers,agents,and others as therein provided,then this obligation shall become null and void;otherwise,it shall be and remain in full force and effect. In case suit is brought upon this bond,Surety further agrees to pay all court costs and reasonable attorneys' fees in an amount fixed by the court. FURTHER,the Surety,for value received,hereby stipulates and agrees that no change,extension of time, alteration,addition or modification to the terms of the Contract,orofthe work to be performed there under, or the specifications for the same,shall in any way affect its obligations under this bond,and it does hereby waive notice of any such change,extension of time,alteration,addition,or modification to the terms of the Contract or to the work or to the specifications there under.Surety hereby waives the provisions of California Civil Code sections 2845 and 2849.The City is the principal beneficiary of this bond and has all rights of a party hereto. C-15 C-28 IN WITNESS WHEREOF,two (2)identical counterparts of this instrument,each of which shall for all purposes be deemed an original hereof,have been duly executed by Principal and Surety,on the date set forth below,the name of each corporate party being hereto affixed and these presents duly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated:_ "Principal" By:_ Its By:_ Its. (Seal) APPROVED AS TO SURETY AND PRINCIPAL AMOUNT By:_ Insurance Administrator "Surety" By:_ Its By:_~------------ Its (Seal) APPROVED AS TO FORM: RICHARDS,WATSON &GERSHON A Professional Corporation By:_ Public Agency Attorney Note:This bond must be executed in duplicate and dated,al/signatures must be notarized,and evidence ofthe authority ofany person signing as attorney-in-fact must be attached C-16 C-29 Workers'Compensation Certificate of Insurance WHEREAS,the City of Rancho Palos Verdes has required certain insurance to be provided by: NOW THEREFORE,the undersigned insurance company does hereby certify that it has issued the policy or policies described below to the following named insured and that the same are in force at this time: 1.This certificate is issued to: City of Rancho Palos Verdes City Hall 30940'Hawthorne Boulevard Rancho Palos Verdes,California 90275 2.The insured under such policy or policies are: 3.Workers'Compensation Policy or Policies in a form approved by the Insurance Commissioner of California covering all operations of the named insured as follows: Policy Number Effective Date Expiration Date 4.Said policy or policies shall not be canceled,nor shall there be any reduction in coverage or limits of liability,unless and until thirty days'written notice thereof has been served upon the City Clerk of the City of Rancho Palos Verdes By:--------- Its Authorized Representative C-17 C-30 AGREEMENT TO COMPLY WITH CALIFORNIA LABOR LAW REQUIREMENTS The undersigned Contractor certifies that it is aware of and hereby agrees to fully comply with the following provisions of California law: 1.Contractor acknowledges that this contract is subject to the provisions of Division 2,Part 7,Chapter 1 (commencing with Section 1720)of the California Labor Code relating to public works and the awarding public agency ("Agency")and agrees to be bound by all the provisions thereof as though set forth in full herein. 2.Contractor agrees to comply with the provisions of California Labor Code Section 1773.8 which requires the payment of travel and subsistence payments to each worker needed to execute the work to the extent required by law. 3.Contractor agrees to comply with the provisions of California Labor Code Sections 1774 and 1775 concerning the payment of prevailing rates of wages to workers and the penalties for failure to pay prevailing wages.The Contractor shall,as a penalty to the Agency,forfeit not more than one hundred dollars ($100)for each calendar day,or portion thereof,for each worker paid less than the prevailing rates as determined by the Director of Industrial Relations for the work or craft in which the worker is employed for any public work done under the contract by Contractor or by any subcontractor. 4.Contractor agrees to comply with the provisions of California Labor Code Section 1776 which require Contractor and each subcontractor to (1)keep accurate payroll records,(2)certify and make such payroll records available for inspection as provided by Section 1776,and (3)inform the Agency of the location of the records.The Contractor is responsible for compliance with Section 1776 by itself and all of its subcontractors. 5.Contractor agrees to comply with the provisions of California Labor Code Sections 1777.5,1777.6 and 1777.7 and California Administrative Code title 8,section 200 et seq.concerning the employment of apprentices on public works projects,and further agrees that Contractor is responsible for compliance with the aforementioned sections by itself and all of its subcontractors. 6.Contractor agrees to comply with the provisions of California Labor Code Section 1813 concerning penalties for workers who work excess hours.The Contractor shall,as a penalty to the Agency, forfeit twenty-five dollars ($25)for each worker employed in the execution of the contract by the Contractor or by any subcontractor for each calendar day during which such worker is required or permitted to work more than 8 hours in anyone calendar day and 40 hours in anyone calendar week in violation of the provisions of Division 2,Part 7,Chapter 1,Article 3 of the California Labor Code. 7.California Labor Code Sections 1860 and 3700 provide that every contractor will be required to secure the payment of compensation to its employees.In accordance with the provisions of California Labor Code Section 1861,Contractor hereby certifies as follows: "I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers'compensation or to undertake self-insurance in accordance with the provisions of that code,and I will comply with such provisions before commencing the performance of the work of this contract." Date _Signature _ C-18 C-31 INDEMNIFICATION AND HOLD HARMLESS AGREEMENT AND WAIVER OF SUBROGATION AND CONTRIBUTION ContractlAgreementlLicense/Permit No.or description:_ Indemnitor(s)(list all names): To the fullest extent permitted by law,Indemnitor hereby agrees,at its sole cost and expense,to defend, protect,indemnify,and hold harmless the City of Rancho Palos Verdes and its elected officials,officers, attorneys,agents,employees,volunteers,successors,and assigns (collectively "Indemnitees")from and against any and all damages,costs,expenses,liabilities,claims,demands,causes of action,proceedings, expenses,judgments,penalties,liens,and losses of any nature whatsoever,including fees of accountants, attorneys,or other professionals and all costs associated therewith (collectively "Liabilities"),arising or claimed to arise,directly or indirectly,out of,in connection with,resulting from,or related to any act,failure to act,error,or omission of Indemnitor or any of its officers,agents,servants,employees,subcontractors, material persons,suppliers or their officers,agents,servants or employees,arising or claimed to arise, directly or indirectly,out of,in connection with,resulting from,or related to the above-referenced contract, agreement,license,or permit (the "Agreement")or the performance or failure to perform any term, provision,covenant,or condition of the Agreement,including this indemnity provision.This indemnity provision is effective regardless of any prior,concurrent,or subsequent active or passive negligence by Indemnitees and shall operate to fully indemnify Indemnitees against any such negligence.This indemnity provision shall survive the termination of the Agreement and is in addition to any other rights or remedies which Indemnitees may have under the law.Payment is not required as a condition precedent to an Indemnitee's right to recover under this indemnity provision,and an entry of judgment against an Indemnitee shall be conclusive in favor of the Indemnitee's right to recover under this indemnity provision.Indemnitor shall pay Indemnitees for any attorney's fees and costs incurred in enforcing this indemnification provision. Notwithstanding the foregoing,nothing in this instrument shall be construed to encompass (a)Indemnitees' sole negligence or willful misconduct to the limited extent that the underlying Agreement is subject to Civil Code 2782(a)or (b)the contracting public agency's active negligence to the limited extent that the underlying Agreement is subject to Civil Code 2782(b).This indemnity is effective without reference to the existence or applicability of any insurance coverage which may have been required under the Agreement or any additional insured endorsements which may extend to Indemnitees. Indemnitor,on behalf of itself and all parties claiming under or through it,hereby waives all rights of subrogation and contribution against the Indemnitees,while acting within the scope of their duties,from all claims,losses and liabilities arising out of or incident to activities or operations performed by or on behalf of the Indemnitor regardless of any prior,concurrent,or subsequent active or passive negligence by the Indemnitees. In the event there is more than one person or entity named in the Agreement as an Indemnitor,then all obligations,liabilities,covenants and conditions under this instrument shall be joint and several. "Indemnitor" Name._ By:_ Its C-19 Name _ By:_ Its C-32 ADDITIONAL INSURED ENDORSEMENT COMPREHENSIVE GENERAL LIABILITY Name and address of named insured (''Named Insured'): Name and address of Insurance Company ("Company'): General description of agreement(s),permit(s),license(s),and/or activity (ies)insured: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows: 1.The ~~--:---:::--:-:---::::--:-:--:--__--:---:-_ ("Public Agency"),its elected officials,officers,attorneys,agents,employees,and volunteers are additional insured (the above named additional insured are hereafter referred to as the "Additional Insured")under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured.The Additional Insured have no liability for the payment of any premiums or assessments under the Policy. 2.The insurance coverage afforded the Additional Insured under the Policy shall be primary insurance,and no other insurance maintained by the Additional Insured shall be called upon to contribute with the insurance coverage provided by the Policy. 3.Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4.Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy.All such claims shall be covered as third-party claims,Le.,in the same manner as if separate policies had been issued to each insured.Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5.The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance)includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s)contained in or executed in conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and the Additional Insured. 6.The policy to which this endorsement is attached shall not be subject to cancellation,change in coverage,reduction of limits (except as the result of the payment of claims),or non-renewal except after written notice to Public Agency,by certified mail,return receipt requested,not less than thirty (30)days prior to the effective date thereof.In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7.Company hereby waives all rights of subrogation and contribution against the Additional Insured,while acting within the scope of their duties,from all claims,losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,or subsequent active or passive negligence by the Additional Insured. C-20 C-33 8.It is hereby agreed that the laws of the State of California shall apply to and govern the validity,construction,interpretation,and enforcement of this contract of insurance. 9.This endorsement and all notices given hereunder shall be sent to Public Agency at: City of Rancho Palos Verdes 10.Except as stated above and not in conflict with this endorsement,nothing contained herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH THIS ENDORSEMENT ATTACHES POLICY PERIOD FROMITO LIMITS OF LIABILITY 11.Scheduled items or locations are to be identified on an attached sheet.The following inclusions relate to the above coverage.Includes: o Contractual Liability o Owners/LandlordslTenants o Manufacturers/Contractors o Products/Completed Operations o Broad Form Property Damage o Extended Bodily Injury o Broad Form Comprehensive General Liability Endorsement o Explosion Hazard o Collapse Hazard o Underground Property Damage o Pollution Liability o Liquor Liability o _ 0 _ o _ 12.A 0 deductible or 0 self-insured retention (check one)of $_ applies to all coverage(s)except:-:-_~--:--:-----:-_:__-------~---_:__­ (if none,so state).The deductible is applicable 0 per claim or 0 per occurrence (check one). 13.This is an 0 occurrence or 0 claims made policy (check one). 14.This endorsement is effective on at 12:01 a.m.and forms a part of Policy Number _ I,(print name),hereby declare under penalty of perjury under the laws of the State of California,that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20_ Signature of Authorized Representative Telephone No.:(_ c-21 (Original signature only;no facsimile signature or initialed signature accepted) C-34 ADDITIONAL INSURED ENDORSEMENT AUTOMOBILE LIABILITY Name and address of named insured (''Named Insured'):_ Name and address of Insurance Company ("Company'):_ General description of agreement(s),permit(s),license(s),and/or activity(ies)insured: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy")or in 'any endorsement now or hereafter attached thereto,it is agreed as follows: 1.The _-:--_~~---::_:__--------~--------- ("Public Agency"),its elected officials,officers,attorneys,agents,employees,and volunteers are additional insured (the above named additional insured are hereafter referred to as the "Additional Insured")under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured.The Additional Insured have no liability for the payment of any premiums or assessments under the Policy. 2.The insurance coverage afforded the Additional Insured under the Policy shall be primary insurance,and no other insurance maintained by the Additional Insured shall be called upon to contribute with the insurance coverage provided by the Policy. 3.Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought except with respect to the limits of the Company's liability. 4.Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy.All such claims shall be covered as third-party claims,Le.,in the same manner as if separate policies had been issued to each insured.Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5.The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance)includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s)contained or executed in conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and the Additional Insured. 6.The policy to which this endorsement is attached shall not be subject to cancellation,change in coverage,reduction of limits (except as the result of the payment of claims),or non-renewal except after written notice to Public Agency,by certified mail,return receipt requested,not less than thirty (30)days prior to the effective date thereto.In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force·and effect until compliance with this notice requirement. 7.Company hereby waives all rights of subrogation and contribution against the Additional Insured,while acting within the scope of their duties,from all claims,losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to C-22 C-35 operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,or subsequent active or passive negligence by the Additional Insured. 8.It is hereby agreed that the laws of the State of California shall apply to and govern the validity,construction,interpretation,and enforcement of this contract of insurance. 9.This endorsement and all notices given hereunder shall be sent to Public Agency at: City Manager City of Rancho Palos Verdes 30940 Hawthorne Boulevard Rancho Palos Verdes,California 90275 10.Except as stated above and not in conflict with this endorsement,nothing contained herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to which this endorsement,is attached. TYPE OF COVERAGES TO WHICH THIS ENDORSEMENT ATTACHES POLICY PERIOD FROMfTO LIMITS OF LIABILITY 11.Scheduled items or locations are to be identified on an attached sheet.The following inclusions relate to the above coverage.Includes: i Any Automobiles i All Owned Automobiles i Non-owned Automobiles i Hired Automobiles i Scheduled Automobiles i Garage Coverage i Truckers Coverage i Motor Carrier Act i Bus Regulatory Reform Act i Public Livery Coverage i i 12.A 0 deductible or 0 self-insured retention (check one)of $8RJiesb all coverage(s)except:(if none,so state).The deductible is applicable G per claim or G per occurrence (check one). 13.This is an 0 occurrence or 0 claims made policy (check one). 14.This endorsement is effective on at 12:01 a.m.and forms a part of Policy Number I,(print name),hereby declare under penalty of perjury under the laws of the State of California,that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20_ Telephone No.:(__)_ C-23 Signature of Authorized Representative (Original signature only;no facsimile signature or initialed signature accepted) C-36 ADDITIONAL INSURED ENDORSEMENT EXCESS LIABILITY Name and address of named insured (''Named Insured''): Name and address of Insurance Company ("Company''): General description of agreement(s),permit(s),license(s),and/or activity(ies)insured: Notwithstanding any inconsistent statement in the policy to which this endorsement is attached (the "Policy")or in any endorsement now or hereafter attached thereto,it is agreed as follows: 1..The ~-=---:---:--::=-:,--:----==--_~-,-_--:--=---,--,-_ ("Public Agency"),its elected officials,officers,attorneys,agents,employees,and volunteers are additional insured (the above named additional insured are hereafter referred to as the "Additional Insured")under the Policy in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured.The Additional Insured have no liability for the payment of any premiums or assessments under the Policy. 2.The insurance coverage afforded the Additional Insured under the Policy shall be primary insurance,and no other insurance maintained by the Additional Insured shall be called upon to contribute with the insurance coverage provided by the Policy. 3.Each insurance coverage under the Policy shall apply separately to each Additional Insured against whom claim is made or suit is brought,except with respect to the limits of the Company's liability. 4.Nothing in this contract of insurance shall be construed to preclude coverage of a claim by one insured under the policy against another insured under the policy.All such claims shall be covered as third-party claims,Le.,in the same manner as if separate policies had been issued to each insured.Nothing contained in this provision shall operate to increase or replicate the Company's limits of liability as provided under the policy. 5.The insurance afforded by the Policy for contractual liability insurance (subject to the terms, conditions and exclusions applicable to such insurance)includes liability assumed by the Named Insured under the indemnification and/or hold harmless provision(s)contained in or executed in conjunction with the written agreement(s)or permit(s)designated above,between the Named Insured and the Additional Insured. 6.The policy to which this endorsement is attached shall not be subject to cancellation,change in coverage,reduction of limits (except as the result of the payment of claims),or non-renewal except after written notice to Public Agency,by certified mail,return receipt requested,not less than thirty (30)days prior to the effective date thereto.In the event of Company's failure to comply with this notice provision,the policy as initially drafted will continue in full force and effect until compliance with this notice requirement. 7.Company hereby waives all rights of subrogation and contribution against the Additional Insured,while acting within the scope of their duties,from all claims,losses and liabilities arising out of or incident to the perils insured against in relation to those activities described generally above with regard to operations performed by or on behalf of the Named Insured regardless of any prior,concurrent,or subsequent active or passive negligence by the Additional Insured. C-24 C-37 8.It is hereby agreed that the laws of the State of California shall apply to and govern the validity,construction,interpretation,and enforcement of this contract of insurance. 9.This endorsement and all notices given hereunder shall be sent to Public Agency at: City Manager City of Rancho Palos Verdes 30940 Hawthorne Boulevard Rancho Palos Verdes,California 90275 10.Except as stated above and not in conflict with this endorsement,nothing contained herein shall be held to waive,alter or extend any of the limits,agreements,or exclusions of the policy to which this endorsement is attached. TYPE OF COVERAGES TO WHICH THIS ENDORSEMENT ATTACHES POLICY PERIOD FROMfTO LIMITS OF LIABILITY D Following Form D Umbrella Liability D _ 11.Applicable underlying coverage: .INSURANCE COMPANY POLICY NO.AMOUNT 12.The following inclusions,exclusions,extensions or specific provisions relate to the above coverage: 13.A D deductible or D self-insured retention (check one)of $_ applies to all coverage(s)except:__--::':"~-----:-~-------~-_:__-~­ (if none,so state).The deductible is applicable D per claim or D per occurrence (check one). 14.This is an D occurrence or D claims made policy (check one). 15.This endorsement is effective on at 12:01 a.m.and forms a part of Policy Number _ I,(print name),hereby declare under penalty of perjury under the laws of the State of California,that I have the authority to bind the Company to this endorsement and that by my execution hereof,I do so bind the Company. Executed ,20_ Telephone No.:(_ Signature of Authorized Representative (Original signature only;no facsimile signature or initialed signature accepted) C-25 C-38 FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION Name of Firm:Date:_ Address:_ State:Zip Code:Phone No.:_ Acting on behalf of the above named firm,as its Authorized Official,I make the following Certification to the Department of Housing and Urban Development (HUD)and the Community Development Commission,County of Los Angeles: 1.No Federal appropriated funds have been paid,by or on behalf of the above named firm to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of and Federal grant,loan or cooperative agreement,and any extension,continuation,renewal, amendment,or modification thereof,and; 2.If any funds other than Federal appropriated funds have paid or will be paid to any person for influencing or attempting to influence an officer or employee or any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with this Federal contract,grant loan,or cooperative agreement,the above named firm shall complete and submit Standard Form-LLL,"Disclosure Form to Report Lobbying",in accordance with its instructions,and: 3.The above name firm shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts,sub-grants,and contracts under grants,loans,and cooperative agreement)and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into.Submission of this certification is a prerequisite for making or entering into the transaction imposed by Section 1352 Title 31,U.S.Code.Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Authorized Official: Name:Title:_ Signature:Date:_ Federal Lobbying Requirements Certification Form C-26 Revised 09/30/05 C-39 FEDERAL DISCRIMINATION PROVISIONS Contractors shall comply with all relevant requirements of the following federal laws and regulations dealing with discrimination in federally assisted programs: A.Titles VI and VII of the Civil Rights Act of 1964 (42 U.S.C.20000d),as amended by the Equal Employment Opportunity Act of 1972,which provide that no person shall,on the ground of race,color, national origin,or sex,be excluded from employment or participation in,be denied the benefits of,or be subjected to discrimination under any program or activity receiving federal financial assistance. B.Section 109 of Title I of the Housing and Community Development Act of 1974,as amended (42 U.S.C.5309)and regulations at CFR 570.602 which provide that no person shall on the grounds of race, color,national origin,or sex,be excluded from participation in,be denied the benefits of,be denied employment in,or be subjected to discrimination under any CDBG/HOME program or activity. C.Section 504 of the Rehabilitation Act of 1973,as amended,(29 U.S.C.794)which provides that no otherwise qualified handicapped individual shall,solely by reason of his/her handicap,be excluded from the participation in,be denied the benefits of,be denied employment in,or be discriminated against under any program or activity receiving federal assistance,and Section 503 of the Rehabilitation Act of 1973, which provides for affirmative action to employ and advance qualified disabled people D.Age Discrimination Act of 1975,as amended (42 U.S.C.6101)which provides that no person shall,on the basis of age,be excluded from participation in,be denied the benefits of,or be subjected to discrimination under any program or activity receiving federal assistance. E.Americans with Disabilities Act of 1990,as amended,(42 U.S.C.12101)and regulations at 28 CFR Part 35 and 29 CFR Title 1630,which provides prohibits discrimination based on disability,and Architectural Barriers Act of 1968,which requires buildings assigned for public use to be designed, constructed and altered so as to be accessible to and usable by persons with physical disabilities. F.Executive Order 11246,as amended by Executive Order 12086,and regulations in 41 CFR 60,which provides that no person shall be discriminated against on the basis of race,color,religion,sex,or national origin in all phases of employment during the performance of federally-assisted construction contracts and subcontracts.Contractors and subcontractors shall take affirmative action to ensure fair treatment in employment,including recruitment,training,promotion,demotion,transfer,layoff,termination,and pay. 1.The Contractor will not discriminate against any employee or applicant for employment because of race,color,religion,sex,or national origin.The Contractor will take affirmative action to ensure that applicants are employed,and that employees are treated during employment,without regard to their race,color,religion,sex,or national origin.Such action shall include,but not be limited to the following:Employment,upgrading,demotion,or transfer;recruitment or recruitment advertising;layoff or termination;rates of pay of other forms of compensation;and selection for training,including apprenticeship.The Contractor agrees to post in conspicuous places,available to employees and applicants for employment,notices to be provided by the contracting officer setting forth the provisions in this nondiscrimination clause. 2.The Contractor will,in all solicitations or advertisement for employees placed by or on behalf of the Contractor,state that all qualified applicants will receive consideration for employment without regard to race,color,religion,sex or national origin. 3.The Contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding,a notice,to be provided by the agency contracting officer,advertising the labor union or worker's representative of the Contractor's commitments under section 202 of Executive Order 11246 of September 24,1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. C-27 C-40 4.The Contractor will comply with all provisions of Executive Order No.11246 of September 24, 1965,and of the rules,regulations,and relevant orders of the Secretary of Labor. 5.The Contractor will furnish all information and reports required by Executive Order No.11246 of September 24,1965,and by the rules,regulations,and orders of the Secretary of Labor,or pursuant thereto,and will permit access to his books,records,and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules,regulations and orders. 6.In the event of the Contractor's noncompliance with the nondiscrimination clauses of this contract or with any of such rules,regulations,and orders,this contract may be canceled,terminated,or suspended in whole or in part and the Contractor may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order 11246 of September 24,1965,or by rule,regulation,or order of the Secretary of Labor,or as otherwise provided by law. 7..The Contractor will include the provisions of paragraphs (1)through (7)in every subcontract or purchase order unless exempted by rules,regulations or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order No.11246 of September 24,1965,so that such provisions will be binding upon each subcontractor or vendor.The Contractor will take such action with respect to any subcontractor or purchase order as the contracting agency,and may direct the subcontractor or vendor as a means of enforcing such provisions including sanctions for noncompliance.Provided,however,that in the event the contract becomes involved in,or threatened with,litigation with a subcontractor or vendor as a result of such direction by the contracting agency,the Contractor may request the United States to enter into such litigation to protect the interest of the United States. C-28 C-41 Equal Employment Opportunity Regulations NONDISCRIMINATION: (Applicable to all Federal-aid construction contracts and to all related subcontracts of $10,000 or more) Equal employment opportunity (EEO)requirements not to discriminate and to take affirmative action to assure equal opportunity as set forth under laws,executive orders,rules,regulations (28 CFR 35,29 CFR 1630 and 41 CFR 60)and orders of the Secretary of Labor as modified by the provisions prescribed herein,and imposed pursuant to 23 U.S.C.140 shall constitute the EEO and specific affirmative action standards for the contractor's project activities under this contract.The Equal Opportunity Construction Contractor Specifications set forth under 41 CFR 60-4.3 and the provisions of the American Disabilities Act of 1990 (42 U.S.C.12101 et seq.)set forth under 28 CFR 35 and 29 CFR 1630 are incorporated by reference in this contract.In the execution of this contract,the contractor agrees to comply with the following minimum specific requirement activities of EEO. The contractor will work with the awarding agency and the Federal Government in carrying out EEO obligations and in their review of his/her activities under the contract. The contractor "'(ill accept as his operating policy the following statement "It is the policy of this Company to assure that applicants are employed,and that employees are treated during employment, without regard to their race,religion,sex,color,national origin,age or disability.Such action shall include:employment, upgrading,demotion,or transfer,recruitment or recruitment advertising;layoff or termination;rates of payor other forms of compensation;and selection for training,including apprenticeship,preapprenticeship,and/or on-the-job training." EEO OFFICER: The contractor will designate and make known to the awarding agency an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active contractor program of EEO and who must be assigned adequate authority and responsibility to do so. DISSEMINATION OF POLICY: All members of the contractor's staff who are authorized to hire,supervise,promote,and discharge employees,or who recommend such action,or who are substantially involved in such action,will be made fully cognizant of,and will implement, the contractor's EEO policy and contractual responsibilities to provide EEO in each grade and classification of employment. To ensure that the above agreement will be met,the following actions will be taken as a minimum: Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not less often than once every six months,at which time the contractor's EEO policy and its implementation will be reviewed and explained.The meetings will be conducted by the EEO officer. All new supervisory or personnel office employees will be given a thorough indoctrination by the EEO Officer,covering all major aspects of the contractor's EEO obligations within thirty days following their reporting for duty with the contractor. All personnel who are engaged in direct recruitment for the project will be instructed by the EEO Officer in the contractor's procedures for locating and hiring minority employees. Notices and posters identifying the contractor's EEO policy will be placed in areas readily accessible to employees,applicants for employment and potential employees. The contractor's EEO policy and the procedures to implement such policy will be brought to the attention of employees by means of meetings,employee handbooks,or other appropriate means. RECRUITMENT OF EMPLOYEES: When advertising for employees,the contractor will include in all advertisements for employees the notation:"An Equal Opportunity Employer."All such advertisements will be placed in publications having a large circulation among minority groups in the area from which the project work force would normally be derived. The contractor will,unless precluded by a valid bargaining agreement,conduct systematic and direct recruitment through public and private employee referral sources likely to yield qualified minority group applicants.To meet this requirement,the contractor will identify sources of potential minority group employees,and establish with such identified sources procedures C-29 C-42 whereby minority group applicants may be referred to the contractor for employment consideration. In the event the contractor has a valid bargaining agreement providing for exclusive hall referrals,he is expected to observe the provisions of that agreement to the extent that the system permits the contractor's compliance with EEO contract provisions.(The DOL has held that where implementations of such agreements have the effect of discriminating against minorities or women,or obligates the contractor to do the same,such implementation violates Executive Order 11246,as amended.) The contractor will encourage his present employees to refer minority group applicants for employment.Information and procedures with regard to referring minority group applicants will be discussed with employees. SELECTION OF SUBCONTRACTORS,PROCUREMENT OF MATERIALS AND LEASING OF EQUIPMENT: The contractor shall not discriminate on the grounds of race,color,religion,sex,national origin,age or disability in the selection and retention of subcontractors,including procurement of materials and leases of equipment. The contractor shall notify all potential subcontractors and suppliers of his/her EEO obligations under this contract. Disadvantaged business enterprises (DBE)as defined in 49 CFR 23,shall have equal opportunity to compete for and perform subcontracts which the contractor enters into pursuant to this contract.The contractor will use his best efforts to solicit bids from and to utilize DBE subcontractors or subcontractors with meaningful minority group and female representation among their employees. The contractor will use his best efforts to ensure subcontractor compliance with their EEO obligations. EEO RECORDS AND REPORTS: The contractor shall keep such records as necessary to document compliance with the EEO requirements.Such records shall be retained for a period of three years following completion of the contract work and shall be available at reasonable times and places for inspection by authorized representatives.The records kept by the contractor shall document the following: The number of minority and non-minority group members and women employed in each work classification on the project; The progress and efforts being made in cooperation with unions,when applicable,to increase employment opportunities for minorities and women; The progress and efforts being made in locating,hiring,training,qualifying,and upgrading minority and female employees; and The progress and efforts being made in securing the services of DBE subcontractors or subcontractors with meaningful minority and female representation among their employees. NONSEGREGATED FACILITIES: Applicable to all Federal-aid construction contracts and to all related subcontracts of $10,000 or more. By the execution of this contract or subcontract,or the consummation of this material supply agreement or purchase order,all parties certify that the firm does not maintain or provide for its employees any segregated facilities at any of its establishments,and that the firm does not permit its employees to perform their services at any location under its control, where segregated facilities are maintained.The contractor agrees that a breach of this certification is a violation of the EEO provisions of this contract.The contractor further certifies that no employee will be denied access to adequate facilities on the basis of sex or disability. As used in this certification,the term "segregated facilities"refers to facilities provided for employees which are segregated by explicit directive,or on the basis of race,color,religion,national origin,age or disability,because of habit,local custom,or otherwise.The only exception will be for the disabled when the demands for accessibility override,(e.g.disabled parking). The contractor agrees that it has obtained or will obtain identical certification from proposed subcontractors or material suppliers prior to award of subcontracts or consummation of material supply agreements of $10,000 or more and that it will retain such certifications in its files. FALSIFICATION OF DOCUMENTS: C-30 C-43 The falsification of any of the above certifications may subject the contractor to civil or criminal prosecution under 18 U.S.C. 1001 and 31 U.S.C.231. The contractor or subcontractor shall make the records required available for inspection,copying,or transcription by authorized representatives of the awarding agency or the DOL,and shall permit such representatives to interview employees during working hours on the job.If the contractor or subcontractor fails to submit the required records or to make them available,the awarding agency,HUD or DOL,or all may,after written notice to the contractor,sponsor,applicant,or owner, take such actions as may be necessary to cause the suspension of any further payment,advance,or guarantee of funds. Furthermore,failure to submit the required records upon request or to make such records available may be grounds of debarment action pursuant to 29 CFR 5.12 C-31 C-44 Community Development Commission County of Los Angeles COUNTY LOBBYIST CODE CHAPTER 2.160 COUNTY ORDINANCE NO.93-0031 CERTIFICATION NameofFirm:_ Address:_ State:___Zip Code:___Telephone Number:( Acting on behalf of the above named firm,as its Authorized Official,I make the following Certification to the County of Los Angeles and the Community Development Commission,County of Los Angeles. 1)It is understood that each person/entity/firm who applies for a Community Development Commission contract,and as part of that process,shall certify that they are familiar with the requirements ofthe Los Angeles County Code,Chapter 2.160 (Los Angeles County Ordinance 93-0031)and; 2)That all persons/entities/firms acting on behalf ofthe above named firm have and will comply with the County Code,and; 3)That any person/entity/firm who seeks a contract with the Community Development Commission shall be disqualified therefrom and denied the contract and,shall be liable in civil action,if any lobbyist,lobbying firm,lobbyist employer or any other person or entity acting on behalf of the named firm fails to comply with the provisions of the County Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into.Submission of this certification is a prerequisite for making or entering into contract with the Los Angeles County and the Community Development Commission,County of Los Angeles. Authorized Official: (Signature) By:-------~--,---:---------(Contractor/Subcontractor) (Date)(Title) C-45 CONTRACTING WITH SMALL BUSINESS MINORITY FIRMS,WOMEN'S BUSINESS ENTERPRISE AND LABOR SURPLUS AREA FIRMS 1.It is national policy to award a fair share of contracts to Small Business and Minority Firms. Accordingly,affirmative steps must be taken to assure that Small Business and Minority Firms are utilized,when possible,as sources of supplies,equipment,construction and services.Affirmative steps include the following: a.Including qualified Small Business and Minority Firms on solicitation lists. b.Assuring that Small Business and Minority Firms are solicited whenever they are potential sources. c.When economically feasible,dividing total requirements into smaller tasks or quantities so as to permit maximum Small Business and Minority Firm participation. d.Where the requirement permits,establishing delivery schedules which will encourage participation by Small Business and Minority Firms. e.Using the services and assistance of the Small Business Administration and the Minority Business Development Agency of the Department of Commerce,as required. f.If any subcontracts are to be let,requiring the prime contractor to take the affirmative steps in 1a through 1e above. 2.Grantees shall take similar appropriate affirmative action in support of Women's Business Enterprises. 3.Grantees are encouraged to procure goods and services from Labor Surplus Areas. C-46 FEDERAL EQUAL EMPLOYMENT OPPORTUNITY I AFFIRMATIVE ACTION REQUIREMENTS 1.EQUAL OPPORTUNITY CLAUSE.During the performance of this contract,the contractor agrees as follows: a.The contractor will not discriminate against any employee or applicant for employment because of race,color,religion,sex,or national origin.The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race,color,religion,sex,or national origin.Such action shall include,but not be limited to the following:employment,upgrading,demotion,or transfer; recruitment or recruitment advertising;layoff or termination;rates of payor other forms of compensation;and selection for training,including apprenticeship.The contractor agrees to post in conspicuous places, available to employees and applicants for employment,notices to be provided setting forth the provisions of this nondiscrimination clause. b.The contractor will,in all solicitations or advertisements for employees placed by or on behalf of the contractor,state that all qualified applicants will receive consideration for employment without regard to race,color,religion,sex,or national origin. c.The contractor will send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding,a notice to be provided,advising the said labor union or workers'representative of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. d.The contractor will comply with all provisions of Executive Order 11246 of September 24,1965,and of the rules,regulations,and relevant orders of the Secretary of Labor. e.The contractor will furnish all information and reports required by Executive Order 11246 of September 24,1965,and by the rules,regulations,and orders of the Secretary of Labor,or pursuant thereto,and will permit access to his/her books,records,and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules,regulations,and orders. f.In the event of the contractor's noncompliance with the nondiscrimination clause of this contract or with any of the said rules,regulations,or orders, this contract may be canceled,terminated,or suspended in whole,or in part,and the contractor may be declared ineligible for further government 1 C-47 contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24,1965, or by rule,regulation,or order of the Secretary of Labor,or as otherwise provided by law. g.The contractor will include the provisions of Paragraph 1a through 1g in every subcontract or purchase order unless exempted by rule,regulations,or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24,1965,so that such provisions will be binding upon each subcontractor or vendor.The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions,including sanctions for noncompliance.Provided,however,that in the event a contractor becomes involved in,or is threatened with,litigation with a subcontractor or vendor as a result of such direction by the administering agency,the contractor may request the United States to enter into such litigation to protect the interests of the United States. 2.NOTICE OF REQUIREMENT FOR AFFIRMATIVE ACTION TO ENSURE EQUAL EMPLOYMENT OPPORTUNITY (Executive Order 11246) a.The Offeror's or Bidder's attention is called to the Equal Opportunity Clause and the Standard Federal Equal Employment Specifications set forth herein. b.The goals and timetables for minority and female participation,expressed in percentage terms for the contractor's aggregated work force in each trade on all construction work in the covered area,are as follows: Timetables Goals for Minority Participation for Each Trade 28.3% Goals for Female Participation in Each Trade 6.9% These goals are applicable to all the contractor's construction work (whether or not it is Federal orfederally assisted)performed in the covered area.If the contractor performs construction work in a geographical area located outside of the covered area,it shall apply the goals established for such geographical area where the work is actually performed.With regard to this second area, the contractor also is subject to the goals for both its federally involved and non-federally involved construction. The contractor's compliance with the Executive Order and the regulations in 41 CFR Part 60-4 shall be based on its implementation of the Equal Opportunity Clause,specific affirmation action obligations required by the specifications set forth in 41 CFR Part 60-4.3(a),and its efforts to meet the 2 C-48 goals.The hours of minority and female employment and training must be substantially uniform throughout the length of the contract and in each trade, and the contractor shall make a good faith effort to employ minorities and women evenly on each of its projects.The transfer of minority or female employees or trainees from contractor to contractor or from project to project for the sole purpose of meeting the contractor's goals shall be a violation of the contract,the Executive Order,and the regulations of 41 CFR Part 60-4. Compliance with the goals will be measured against the total work hours performed. c.The contractor shall provide written notification to the Director of the Office of Federal Contract Compliance Programs within ten (10)working days of award of any construction subcontract in excess of $10,000 at any tier for construction work under the contract resulting from this solicitation.The notification shall list.the name,address,and telephone number of the subcontractor;employer identification number of the subcontractor;estimated dollar amount of the subcontract;estimated starting and completion dates of the subcontract;and the geographical area in which the contract is to be performed. d.As used in this notice,and in the contract resulting from this solicitation,the covered area is the Standard Metropolitan Statistical Area of Los Angeles- Long Beach,specifically the County of Los Angeles,State of California. 3.STANDARD FEDERAL EQUAL EMPLOYMENT SPECIFICATIONS (Executive Order 11246). a.As used in these specifications: (1)Covered area means the geographical area described in the solicitation from which this contract resulted; (2)Director means Director,Office of Federal Contract Compliance Programs,United States Department of Labor,or any person to whom the Director delegates authority; (3)Employer Identification Number (EIN)means the Federal Social Security Number used on the Employer's Quarterly Federal Tax Return,United States Treasury Department Form 941. (4)Minority includes: (a)Black (all persons having origins in any of the Black African racial groups not of Hispanic origin) (b)Hispanic (all persons of Mexican,Puerto Rican,Cuban,Central 3 C-49 or South American or other Spanish culture or origin, regardless of race); (c)Asian and Pacific Islander (all persons having origins in any of the original peoples of the Far East,Southeast Asia,the Indian Subcontinent,or the pacific Islands);and (d)American Indian or Alaskan Native (all persons having origins in any ofthe original peoples of North America and maintaining identifiable tribal affiliations through membership and participation or community identification). b.Whenever the contractor,or any subcontractor at any tier,subcontracts a portion of the work involving any construction trade,it shall physically include in each subcontract in excess of $10,000 the provisions of these specifications and the notice which contains the applicable goals for minority and female participation and which is set forth in the solicitations from which this contract resulted. c.If the contractor is participating (pursuant to 41 CFR Part 60-4.5)in a Hometown Plan approved by the United States Department of Labor in the covered area either individually or through an association,its affirmative action obligations on all work in the Plan area (including goals and time tables)shall be in accordance with that Plan for those trades which have unions participating in the Plan.Contractors must be able to demonstrate their participation·in and compliance with the provisions of any such Hometown Plan.Each contractor or subcontractor participating in an approved Plan is individually required to comply with its obligations under the EEO Clause,and to make a good faith effort to achieve each goal under the Plan in each trade in which it has employees.The overall good faith performance by other contractors or subcontractors toward a goal in an approved Plan does not excuse any covered contractor's or subcontractor's failure to take good faith efforts to achieve the Plan goals and timetables. d.The contractor shall implement the specific affirmative action standards provided in paragraphs 3g (1)through 3g (16)of these specifications.The goals set forth in the solicitation from which this contract resulted are expressed as percentages of the total hours of employment and training of minority and female utilization the contractor should reasonable be able to achieve in each construction trade in which it has employees in the covered area.Covered construction contractors performing construction work in geographical areas where they do not have a Federal or federally assisted construction contract shall apply the minority and female goals established for the geographical area where the work is being performed.Goals are published periodically in the Federal Register in notice form,and such notices may be obtained from any Office of Federal Contract Compliance Programs 4 C-50 office or from Federal procurement contracting officers.The contractor is expected to make substantially uniform progress in meeting its goals in each craft during the period specified. e.Neither the provisions of any collective bargaining agreement nor the failure by a union with whom the contractor has a collective bargaining agreement, to refer either minority or women shall excuse the contractor's obligations under these specifications,Executive Order 11246,or the regulations promulgated pursuant thereto. f.In order for the nonworking training hours of apprentices and trainees to be counted in meeting the goals,such apprentices and trainees must be employed by the contractor during the training period,and the contractor must have made a commitment to employ the apprentices and trainees at the completion of their training,subject to the availability of employment opportunities.Trainees must be trained pursuant to training programs approved by the United States Department of Labor. g.The contractor shall take specific affirmative actions to ensure equal employment opportunity.The evaluation ofthe contractor's compliance with these specifications shall be based upon its effort to achieve maximum results from its actions.The contractor shall document these efforts fully, and shall implement affirmative action steps at least as extensive as the following: (1)Ensure and maintain working environment free of harassment, intimidation,and coercion at all sites,and in all facilities at which the contractor's employees are assigned to work.The contractor,where possible,will assign two or more women to each construction project. The contractor shall specifically ensure that all foremen, superintendents,and other on-site supervisory personnel are aware of and carry out the contractor's obligation to maintain such a working environment,with specific attention to minority or female individuals working at such sites or in such facilities. (2)Establish and maintain a current list of minority and female recruitment sources,provide written notification to minority and female recruitment sources and to community organizations when the contractor or its unions have employment opportunities available,and maintain a record of the organization's responses. (3)Maintain a current file of the name,address,and telephone numbers of each minority and female off-the-street applicant and minority or female referral from a union,a recruitment source,or community organization and of what action was taken with respect to each such individual.If such individual was sent to the union hiring hall for 5 C-51 referral and was not referred back to the contractor by the union or,if referred,not employed by the contractor,this shall be documented in the file with the reason therefore,along with whatever additional actions the contractor may have taken. (4)Provide immediate written notification to the Director when the union or unions with which the contractor has a collective bargaining agreement has not referred to the contractor a minority person or woman sent by the contractor,or when the contractor has other information that the union referral process has impeded the contractor's efforts to meet its obligations. (5)Develop on-the-job training opportunities and/or participate in training programs for the area which expressly include minorities and women, including upgrading programs and apprenticeship and trainee programs relevant to the contractor's employment needs,especially those programs funded or approved by the Department of Labor.The contractor shall provide notice of these programs to the sources compiled under 3g (2)above. (6)Disseminate the contractor's EEO policy by providing notice of the policy to unions and training programs and requesting their cooperation in assisting the contractor in meeting its EEO obligations; by including it in any policy manual and collective bargaining agreement;by publicizing it in the company newspaper,annual report, etc.;by specific review of the policy with all management personnel and with all minority and female employees at least once a year;and by posting the company EEO policy on bulletin boards accessible to all employees at each location where construction work is performed. (7)Review,at least annually,the company's EEO policy and affirmative action obligations under these specifications with all employees having any responsibility for hiring,assignment,layoff,termination or other employment decisions including specific review of these items with on-site supervisory personnel such as Superintendents,General Foremen,etc.,prior to the initiation of construction work at any job site.A written record shall be made and maintained identifying the time and place of these meetings,persons attending,subject matter discussed,and disposition of the subject matter. (8)Disseminate the contractor's EEO policy externally by including it in any advertising in the news media,specifically including minority and female news media,and providing written notification to and discussing the contractor's EEO policy with other contractors and subcontractors with whom the contractor does or anticipates doing business. 6 C-52 (9)Direct its recruitment efforts,both oral and written,to minority,female, and community organizations;to schools with minority and female students;and to minority and female recruitment and training organizations serving the contractor's recruitment area and employment needs.Not later than one month prior to the date for the acceptance of applications for apprenticeship or other training by any recruitment sources,the contractor shall send written notification to organizations such as the above,describing the opening,screening procedures,and tests to be used in the selection process. (10)Encourage present minority and female employees to recruit other minority persons and women and,where reasonable,provide after school,summer,and vacation employment to minority and female youth,both on the site and in other areas of a contractor's work force. (11)Validate all tests and other selection requirements where there is an obligation to do so under 41 CFR Part 60-3,Uniform Guidelines on Employee Selection Procedures. (12)Conduct,at least annually,an inventory and evaluation at least of all minority and female personnel for promotional opportunities and encourage these employees to seek or to prepare for,through appropriate training,etc.,such opportunities. (13)Ensure that seniority practices,job classifications,work assignments, and other personnel practices do not have a discriminatory effect by continually monitoring all personnel and employment-related activities to ensure that the EEO policy and the contractor's obligations under these specifications are being carried out. (14)Ensure that all facilities and company activities are non-segregated except that separate or single-user toilet and necessary changing facilities shall be provided to assure privacy between the sexes. (15)Document and maintain a record of all solicitations of offers for subcontracts from minority and female construction contractors and suppliers,including circulation of solicitations to minority and female contractor associations and other business associations. (16)Conduct a review,at least annually,of all supervisors'adherence to and performance under the contractor's EEO policies and affirmative action obligations. h.Contractors are encouraged to participate in voluntary associations which assist in fulfilling one or more of their affirmative action obligations 3g(1) 7 C-53 through (16).The efforts of a contractor association,joint contractor-union, contractor-community,or other similar group of which the contractor is a member and participant,may be asserted as fulfilling anyone or more of its obligations under 3g(1)though (16)of these specifications provided that the contractor actively participates in the group,makes everyeffort to ensure that the group has a positive impact on the employment of minorities and women in the industry,ensures that the concrete benefits of the program are reflected in the contractor's minority and female work force participation, makes a good faith effort to meet its individual goals and timetables,and can provide access to documentation which demonstrates the effectiveness of actions taken on behalf of the contractor.The obligation to comply,however, is the contractor's,and failure of such a group to fulfill an obligation shall not be a defense for the contractor's noncompliance. I.A single goal for minorities and a separate single goal for women have been established.The contractor,however,is required to provide equal employment opportunity and to take affirmative action for all minority groups, both male and female,and all women,both minority and non-minority. Consequently,the contractor may be in violation of the Executive Order if a particular group is employed in a substantially disparate manner (for example,even though the contractor has achieved its goals for women generally,the contractor may be in violation of the Executive Order if a specific minority group of women is underutilized). j.The contractor shall not use the goals and timetables of affirmative action standards to discriminate against any person because of race,color,religion, sec or national origin. k.The contractor shall not enter into any subcontract with any person or firm debarred from Government contracts pursuant to Executive Order 11246. I.The contractor shall carry out such sanctions and penalties for violation of these specifications and of the Equal Opportunity Clause,including suspension,termination,and cancellation of existing subcontracts as may be imposed or ordered pursuant to Executive Order 11246,as amended,and its implementing regulations,by the Office of Federal Contract Compliance Programs.Any contractor who fails to carry out such sanctions and penalties shall be in violation of these specifications and Executive Order 11246,as amended. m.The contractor,in fulfilling its obligations under these specifications,shall implement specific affirmative actions steps,at least as extensive as those standards prescribed in Paragraph 3g of these specifications,so as to achieve maximum results from its efforts to ensure equal employment opportunity.If the contractor fails to comply with the requirements of the Executive Order,the implementing regulations,or these specifications,the 8 C-54 Director shall proceed in accordance with 41 CFR Part 60-1.8 (Show Cause Notice). n.The contractor shall designate a responsible official to monitor all employment related activity to ensure that the company EEO policy is being carried out,to be required by the Government and to keep records.Records shall at least include for each employee the name,address,telephone numbers,construction trade,union affiliation,if any,employee identification number when assigned,social security number,race,sex,status (e.g., mechanic,apprentice,trainee,helper,or laborer),dates of changes in status, hours worked per week in the indicated trade,rate of pay,and locations at which the work was performed.Records shall be maintained in an easily understandable and retrievable form;however,to the degree that existing records satisfy this requirement,contractors shall not be required to maintain separate records. o.Nothing herein provided shall be construed as a limitation upon the application of other laws which establish different standards of compliance or upon the application of requirements for the hiring of local or other area residents (e.g.,those under the Public Works Employment Act of 1977 and the Community Development Block Grant Program). p.The Director,from time to time,shall issue goals and timetables for minority and female utilization which shall be based on appropriate work force, demographic or other relevant data and which shall cover construction projects or construction contracts performed in specific geographic areas. The goals,which shall be applicable to each construction trade in a covered contractor's or subcontractor's entire work force which is working in the area covered by the goals and timetables,shall be published as notices in the Federal Register,and shall be inserted by the contracting officers and applicants,as applicable,in the Notice required by 41 CFR 60-4.2. 4.SPECIFIC EEO REQUIREMENTS.For a federally assisted construction contract in excess of $10,000,the contractor/subcontractor shall: a.Forward the following EEO certification forms to the contract awarding authority prior to contract award:Certification of Non-segregated Facilities and Certification with Regard to the Performance of Previous Contracts or Subcontracts Subject to the Equal Opportunity Clause and the Filing of Required Reports. b.Submit a notification of subcontracts awarded to the Director,Office of Federal Contract Compliance Programs,United States Department of Labor- ESA,200 Constitutional'Avenue,NW,Room C3325,Washington,D.C., 20210,within 10 working days of award of any subcontract in excess of $10,000,listing the name,address,and telephone number of the 9 C-55 subcontractor;employer identification number;estimated dollar amount of the subcontract;estimated starting date and completion dates ofthe subcontract; and the geographical area in which the contract is to be performed. c.Send a notice of the contractor's commitment to equal employment opportunity to labor unions or representatives of workers prior to commencement of construction work. d.Display an equal employment opportunity poster in a conspicuous place available to employees and applicants for employment. e.For contracts in excess of $1 0,000,bind subcontractors to the Federal Equal Employment Opportunity requirements by including the provisions of Paragraphs 1 through 3,above,in the subcontract. f.Upon commencement of construction work and until the work is completed, forward the Monthly Employment Utilization Report (Form CC-257)to the contract awarding authority by the end of each work month.With the initial monthly report,the contractor/subcontractor shall attach the Contractor's List of Federal and Non-Federal Work in Bid Condition Area to the monthly report. 5.CIVIL RIGHTS ACT OF 1964.Under Title VI of the Civil Rights Act of 1964,no person shall,on the grounds of race,color,or national origin,be excluded from participation in,be denied the benefits of,or be subjected to discrimination under any program or activity receiving Federal financial assistance. 6.SECTION 109 OF THE HOUSING AND COMMUNITY DEVELOPMENT ACT OF 1974.No person in the United States on the grounds of race,color,national origin, or sex be excluded from participation in,be denied the benefits of,or be subjected to discrimination under any program or activity funded in whole or in part with funds made available under this title. 7.THE AGE DISCRIMINATION ACT OF 1975.No person in the Unites States shall, on the basis of age,be excluded from participation in,be denied the benefits of,or be subjected to discrimination under any program or activity receiving Federal financial assistance. 8.REHABILITATION ACT OF 1973.No otherwise qualified individual with handicaps in the United States shall,solely by reason of his or her handicap,be excluded from the participation in,be denied the benefits of,or be subjected to discrimination under any program or activity receiving Federal assistance. 10 C-56 u.s.Department of Labor Employment Standards Administration Wage and Hour Division PAYROLL (For Contractor's Optional Use;See Instructions at www.dol.gov/esalwhdlformslwh347instr.hbn) Persons are not required to respond to the collection of information unless it displays a currently valid OMS control number. 5IIHD U.S.Wage and Hour Division Rev.Dec.2008 NAME OF CONTRACTOR 0 OR SUBCONTRACTOR 0 ADDRESS I OMS No.:1215-0148 Expires:12/31/2011 PAYROLL NO.FOR WEEK ENDING PROJECT AND LOCATION PROJECT OR CONTRACT NO. (1)(2)(3)(4)DAY AND DATE (5)(6)(7)(9) (8) DEDUCTIONS NET NAME AND INDIVIDUAL IDENTIFYING NUMBER u.GROSS WITH-WAGES (e.g.,LAST FOUR DIGITS OF SOCIAL SECURITY 0 WORK TOTAL RATE AMOUNT HOLDING TOTAL PAIDdNUMBERIOFWORKERzCLASSIFICATIONHOURSWORKEDEACHDAYHOURSOFPAYEARNEDFICATAXOTHERDEDUCTIONSFORWEEK 0 1/s 0 Vs 0 1/s 0 Vs 0 1/s 0 Vs 0 /s 0 /s While completion of Form WH-347Is optional,it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R.§§3.3,5.5(a).The Copeland Act (40 U.S.C.§3145)contractors and subcontractors performing work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee during the preceding week.·U.S.Department of Labor (DOL)regulations at 29 C.F.R.§5.5(a)(3)(i1)require contractors to submit weekly a copy of an payrolls to the Federal agency contracting for or financing the construction project,accompanied by a signed ·Statement of Compliance·indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed.DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits. Public Burden Statement We estImate that is will take an average of 55 minutes to complete this collection,including time for reviewing inslructions,searching existing data sources,gsthering and maintaining the data needed,and completing and reviewing the collection of information.If you have any comments regarding these estimates or any other aspect of this conection,Including suggestions for reducing this burden,send them to the Administrator,Wage and Hour Division,ESA,U.S.Department of Labor,Room 53502,200 Consmution Avenue,N.W. Washington,D.C.20210 (over) C - 5 7 in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll,payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees,except as noted in section 4(c)below. Date _ I,--:::-:--_-::-::::----:----:::--:-:--=:~----- (Name of Signatory Party)(Title) do hereby state: (1)That I payor supervise the payment of the persons employed by ___________-"..-=--:.".-;----:..,.--.---------------on the (Contractor or Subcontractor) _____--,---,-;that during the payroll period commencing on the (Building or Work) ___day of , ,and ending the day of , ' all persons employed on said project have been paid the full weekly wages earned,that no rebates have been or will be made either directly or indirectly to or on behalf of said ____________________---,-from the full (Contractor or Subcontractor) weekly wages eamed by any person and that no deductions have been made either directly or indirectly from the full wages eamed by any person,other than permissible deductions as defined in Regulations,Part 3 (29 C.F.R.Subtitle A),issued by the Secretary of Labor under the Copeland Act,as amended (48 Stat.948, 63 Start.108,72 Stat.967;76 Stat.357;40 U.S.C.§3145),and described below: (2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete;that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract;that the classifications set forth therein for each laborer or mechanic conform with the work he performed. (3)That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training,United States Department of Labor,or if no such recognized agency exists in a State,are registered with the Bureau of Apprenticeship and Training,United States Department of Labor. (4)That: (a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS,FUNDS,OR PROGRAMS D (b)WHERE FRINGE BENEFITS ARE PAID IN CASH D -Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll,an amount not less than the sum of the applicable basic Murly wage rate plus the amount of the required fringe benefits as listed in the contract,except as noted in section 4(c)below. (c)EXCEPTIONS EXCEPTION (CRAFT)EXPLANATION REMARKS: NAME AND TITLE SIGNATURE THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION.SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE. C - 5 8 FRINGE BENEFIT PAYMENT CERTIFICATION PROJECT NAME Location:_ LOCAL CONTRACTING AGENCY CDSG Project Number:_ Work Classification HOURLY FRINGE BENEFITS PROVIDED Health &Welfare Name,Address,and Telephone Number of the Approved Plan,Fund,or Program I Certify under penalty of pedury that: D I make payments to approved fringe benefit plans,funds,or programs as listed above. OR D I DO NOT make payments to approved fringe benefit plans,funds,or programs. Benefits are added to hourly rates and paid each week to the employees. (Print Company Name) Contractor License Number:_ Date:_ (Print Name of Person Authorized to Sign) By:_ Title:_ C-59 U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT HUD FORM 4230A REPORT OF ADDITIONAL CLASSIFICATION AND RATE OMB Approval Number2501.{)011 (Exp.0913012005) 1.FROM (name and address of requesting agency)2.PROJECT NAME AND NUMBER 3.LOCATION OF PROJECT (City,County and State) 4.BRIEF DESCRIPTION OF PROJECT 5.CHARACTER OF CONSTRUCTION 0 Building o Residential 0 Heavy o Other (specify) 0 Highway 6.WAGE DECISION NO.(include modification number,if any)7.WAGE DECISION EFFECTIVE DATE 0 COPY ATTACHED 8.o WORK CLASSIFICATION(S)HOURLY WAGE RATES BASIC WAGE FRINGE BENEFIT(S)(if any) 9.PRIME CONTRACTOR (name,address)10.SUBCONTRACTOR/EMPLOYER,IF APPLICABLE (name,address) ICheck All That Apply:1 0 The work to be performed by the additional classification(s)is not performed by a classification in the applicable wage decision. 0 The proposed classification is utilized in the area by the construction industry. 0 The proposed wage rate(s),including any bona fide fringe benefits,bears a reasonable relationship to the wage rates contained in the wage decision. 0 The interested parties,including the employees or their authorized representatives,agree on the classification(s)and wage rate(s). 0 Supporting documentation attached,including applicable wage decision. ICheck One:1 0 Approved,meets all criteria.DOL confirmation requested. 0 One or more classifications fail to meet all criteria as explained in agency referral.DOL decision requested. FOR HUe USE ONLY LR2000: Agency Representative Date (Typed name and signature)Log in: Log out: Phone Number HUD-4230A (8'{)3)PREVIOUS EDITION IS OBSOLETEC-60 Federal Labor Standards Provisions Applicability The Project or Program to which the construction work covered by this contract pertains is being assisted by the United States of America and the following Federal Labor Standards Provisions are included in this Contract pursuant to the provisions applicable to such Federal assistance. A.1.(i)Minimum Wages.All laborers and mechanics employed or working upon the site of the work,will be paid unconditionally and not less often than once a week,and without subsequent deduction or rebate on any account (except such payroll deductions as are permitted by regulations issued by the Secretary of Labor under the Copeland Act (29 CFR Part 3),the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment com puted at rates not less than those contained in the wage determination of the Secretary of Labor which is attached hereto and made a part hereof,regardless of any contractual relationship which may be alleged to exist between the contractor and such laborers and mechanics.Contributions made or costs reasonably anticipated for bona fide fringe benefits under Section l(b )(2)of the Davis-Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics,subject to the provisions of 29 CFR 5.5(a)(1 )(iv);also,regular contributions made or costs incurred for more than a weekly period (but not less often than quarterly)under plans,funds,or programs,which cover the particular weekly period,are deemed to be constructively made or incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage rate and fringe benefits on the wage determination for the classification of work actually performed,without regard to skill,except as provided in 29 CFR 5.5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each classification for the time actually worked therein: Provided,That the employer's payroll records accurately set forth the time spent in each classification in which work is performed.The wage determination (including any additional classification and wage rates conformed under 29 CFR 5.5(a)(1)(ii)and the Davis-Bacon poster (WH- 1321)shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and accessible,place where it can be easily seen by the workers. (ii)(a)Any class of laborers or mechanics which is not listed in the wage determination and which is to be em ployed under the contract shall be classified in conformance with the wage determination.HUD shall approve an additional classification and wage rate and fringe benefits therefor only when the following criteria have been met: u.s.Department of Housing and Urban Development Office of Labor Relations (1)The work to be performed by the classification requested is not performed by a classification in the wage determination;and (2)The classification is utilized in the area by the construction industry;and (3)The proposed wage rate,including any bona fide fringe benefits,bears a reasonable relationship to the wage rates contained in the wage determination. (b)If the contractor and the laborers and mechanics to be employed in the classification (if known),or their representatives,and HUD or its designee agree on the classification and wage rate (including the amount designated for fringe benefits where appropriate),a report of the action taken shall be sent by HUD or its designee to the Administrator of the Wage and Hour Division, Employment Standards Administration,U.S.Department of Labor,Washington,D.C.20210.The Administrator,or an authorized representative,will approve,modify,or disapprove every additional classification action within 30 days of receipt and so advise HUD or its designee or will notify HUD or its designee within the 30-day period that additional time is necessary.(Approved by the Office of Management and Budget under OMB control number 1215- 0140.) (c)In the event the contractor,the laborers or mechanics to be employed in the classification or their representatives,and HUD or its designee do not agree on the proposed classification and wage rate (including the amount designated for fringe benefits,where appropriate), HUD or its designee shall refer the questions,including the views of all interested parties and the recommendation of HUD or its designee,to the Administrator for determination.The Administrator,or an authorized representative,will issue a determination within 30 days of receipt and so advise HUD or its designee or will notify HUD or its designee within the 30-day period that additional time is necessary.(Approved by the Office of Management and Budget under OMB Control Number 1215-0140.) (d)The wage rate (including fringe benefits where appropriate)determined pursuant to subparagraphs (1)(ii)(b)or (c)of this paragraph,shall be paid to all workers performing work in the classification under this contract from the first day on which work is performed in the classification. (iii)Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate,the contractor shall either pay the benefit as stated in the wage determ ination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. (iv)If the contractor does not make payments to a trustee or other third person,the contractor may consider as part Previous editions are obsolete Page 1 of 5 form HUD-4010 (06/2009) ref.Handbook 1344.1 C-61 of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program,Provided,That the Secretary of Labor has found,upon the written request of the contractor,that the applicable standards of the Davis- Bacon Act have been met.The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program.(Approved by the Office of Management and Budget under OMB Control Number 1215-0140.) 2.Withholding.HUD or its designee shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld from the contractor under this contract or any other Federal contract with the same prime contractor,or any other Federally-assisted contract subject to Davis-Bacon prevailing wage requirements, which is held by t)1e same prime contractor so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics,including apprentices,trainees and helpers,employed by the contractor or any subcontractor the full amount of wages required by the contract In the event of failure to pay any laborer or mechanic,including any apprentice,trainee or helper,employed or working on the site of the work,all or part of the wages required by the contract,HUD or its designee may,after written notice to the contractor, sponsor,applicant,or owner,take such action as may be necessary to cause the suspension of any further payment,advance,or guarantee of funds until such violations have ceased.HUD or its designee may,after written notice to the contractor,disburse such amounts withheld for and on account of the contractor or subcontractor to the respective employees to whom they are due.The Com ptroller General shall make such disbursements in the case of direct Davis-Bacon Act contracts. 3.(i)Payrolls and basic records.Payrolls and basic records relating thereto shall be maintained by the contractor during the course of the work preserved for a period of three years thereafter for all laborers and mechanics working at the site of the work.Such records shall contain the name,address,and social security number of each such worker,his or her correct classification,hourly rates of wages paid (including rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of the types described in Section l(b)(2)(B)of the Davis-bacon Act),daily and weekly number of hours worked,deductions made and actual wages paid.Whenever the Secretary of Labor has found under 29 CFR 5.5 (a)(1 )(iv)that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in providing benefits under a plan or program described in Section l(b)(2)(B)of the Davis- Bacon Act,the contractor shall maintain records which show that the commitment to provide such benefits is enforceable,that the plan or program is financially responsible,and that the plan or program has been communicated in writing to the laborers or mechanics affected,and records which show the costs anticipated or the actual cost incurred in providing such benefits. Contractors employing apprentices or trainees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs,the registration of the apprentices and trainees,and the ratios and wage rates prescribed in the applicable programs.(Approved by the Office of Management and Budget under OMB Control Numbers 1215-0140 and 1215-0017.) (ii)(a)The contractor shall submit weekly for each week in which any contract work is performed a copy of all payrolls to HUD or its designee if the agency is a party to the contract,but if the agency is not such a party,the contractor will submit the payrolls to the applicant sponsor,or owner,as the case may be,for transmission to HUD or its designee.The payrolls submitted shall set out accurately and completely all of the information required to be maintained under 29 CFR 5.5(a)(3)(i)except that full social security numbers and home addresses shall not be included on weekly transmittals.Instead the payrolls shall only need to include an individually identifying number for each employee (e.g.,the last four digits of the employee's social security number).The required weekly payroll information may be submitted in any form desired. Optional Form WH-347 is available for this purpose from the Wage and Hour Division Web site at http://www.dol.gov/esa/whd/forms/wh347instr.htm or its successor site.The prime contractor is responsible for the submission of copies of payrolls by all subcontractors. Contractors and subcontractors shall maintain the full social security number and current address of each covered worker,and shall provide them upon request to HUD or its designee if the agency is a party to the contract,but if the agency is not such a party,the contractor will submit the payrolls to the applicant sponsor,or owner,as the case may be,for transmission to HUD or its designee,the contractor,or the Wage and Hour Division of the Department of Labor for purposes of an investigation or audit of compliance with prevailing wage requirements.It is not a violation of this subparagraph for a prime contractor to require a subcontractor to provide addresses and social security numbers to the prime contractor for its own records,without weekly submission to HUD or its designee.(Approved by the Office of Management and Budget under OMB Control Number 1215-0149.) (b)Each payroll submitted shall be accompanied by a ·Statement of Compliance,·signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (1)That the payroll for the payroll period contains the information required to be provided under 29 CFR 5.5 (a)(3)(ii),the appropriate information is being maintained under 29 CFR 5.5(a)(3)(i),and that such information is correct and complete; Previous editions are obsolete Page 2 of5 form HUD-4010 (06/2009) ref.Handbook 1344.1 C-62 (2)That each laborer or mechanic (including each helper, apprentice,and trainee)employed on the contract during the payroll period has been paid the full weekly wages earned,without rebate,either directly or indirectly,and that no deductions have been made either directly or indirectly from the full wages earned,other than permissible deductions as set forth in 29 CFR Part 3; (3)That each laborer or mechanic has been paid not less than the applicable wage rates and fringe benefits or cash equivalents for the classification of work performed,as specified in the applicable wage determ ination incorporated into the contract. (c)The weekly submission of a properly executed certification set forth on the reverse side of Optional Form WH-347 shall satisfy the requirement for subm ission of the "Statement of Compliance"required by subparagraph A.3.(ii)(b). (d)The falsification of any of the above certifications may subject the contractor or subcontractor to civil or crim inal prosecution under Section 1001 of Title 18 and Section 231 of Title 31 of the United States Code. (iii)The contractor or subcontractor shall make the records required under subparagraph A.3.(i)available for inspection,copying,or transcription by authorized representatives of HUD or its designee or the Department of Labor,and shall permit such representatives to interview employees during working hours on the job.If the contractor or subcontractor fails to submit the required records or to make them available,HUDor its designee may,after written notice to the contractor,sponsor, applicant or owner,take such action as may be necessary to cause the suspension of any further payment,advance, or guarantee of funds.Furthermore,failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5.12. 4.Apprentices and Trainees. (i)Apprentices.Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program registered with the U.S.Department of Labor, Employment and Training Administration,Office of Apprenticeship Training,Employer and Labor Services,or with a State Apprenticeship Agency recognized by the Office,or if a person is employed in his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program,who is not individually registered in the program,but who has been certified by the Office of Apprenticeship Training,Employer and Labor Services or a State Apprenticeship Agency (where appropriate)to be eligible for probationary employment as an apprentice.The allowable ratio of apprentices to journeymen on the job site in any craft classification shall not be greater than the ratio permitted to the contractor as to the entire work force under the registered program.Any worker listed on a payroll at an apprentice wage rate,who is not registered or otherwise employed as stated above, shall be paid not less than the applicable wage rate on the wage determ ination for the classification of work actually performed.In addition,any apprentice performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed.Where a contractor is performing construction on a project in a locality other than that in which its program is registered,the ratios and wage rates (expressed in percentages of the journeyman's hourly rate)specified in the contractor's or subcontractor's registered program shall be observed.Every apprentice must be paid at not less than the rate specified in the registered program for the apprentice's level of progress, expressed as a percentage of the journeymen hourly rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in accordance with the provisions of the apprenticeship program.If the apprenticeship program does not specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage determination for the applicable classification.If the Administrator determines that a different practice prevails for the applicable apprentice classification,fringes shall be paid in accordance with that determination.In the event the Office of Apprenticeship Training,Employer and Labor Services,or a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship program,the contractor will no longer be permitted to utilize apprentices at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (ii)Trainees.Except as provided in 29 CFR 5.16, trainees will not be permitted to work at less than the predetermined rate for the work performed unless they are employed pursuant ',to and individually registered in a program which has received prior approval,evidenced by formal certification by the U.S.Department of Labor, Employment and Training Administration.The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration.Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination.Trainees shall be paid fringe benefits in accordance with the provisions of the trainee program.If the trainee program does not mention fringe benefits,trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour Division determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices.Any em ployee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by Previous editions are obsolete Page 3 of5 form HUD-4010 (06/2009) ref.Handbook 1344.1 C-63 the Employment and Training Administration shall be paid not less than the applicable wage rate on the wage determination for the work actually performed.In addition, any trainee performing work on the job site in excess of the ratio permitted under the registered program shall be paid not less than the applicable wage rate on the wage determination for the work actually performed.In the event the Employment and Training Administration withdraws approval of a training program,the contractor will no longer be permitted to utilize trainees at less than the applicable predetermined rate for the work performed until an acceptable program is approved. (iii)Equal employment opportunity.The utilization of apprentices,trainees and journeymen under 29 CFR Part 5 shall be in conformity with the equal employment opportunity requirements of Executive Order 11246,as amended,and 29 CFR Part 30. 5.Compliance with Copeland Act requirements.The contractor shall comply with the requirements of 29 CFR Part 3 which are incorporated by reference in this contract 6.Subcontracts.The contractor or subcontractor will insert in any subcontracts the clauses contained in subparagraphs 1 through 11 in this paragraph A and such. other clauses as HUD or its designee may by appropriate instructions require,and a copy of the applicable prevailing wage decision,and also a clause requiring the su bcontractors to include these clauses in any lower tier subcontracts.The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in this paragraph. 7.Contract termination;debarment.A breach of the contract clauses in 29 CFR 5.5 may be grounds for termination of the contract and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. 8.Compliance with Davis-Bacon and Related Act Requirements. All rulings and interpretations of the Davis-Bacon and Related Acts contained in 29 CFR Parts 1,3,and 5 are herein incorporated by reference in this contract 9.Disputes concerning labor standards.Disputes arising out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract.Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR Parts 5,6,and 7.Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors)and HUD or its designee,the U.S.Department of Labor,or the employees or their representatives. 10.(i)Certification of Eligibility.By entering into this contract the contractor certifies that neither it (nor he or she)nor any person or firm who has an interest in the contractor's firm is a person or firm ineligible to be awarded Government contracts by virtue of Section 3(a)of the Davis-Bacon Act or 29 CFR 5.12(a)(1)or to be awarded HUD contracts or participate in HUD programs pursuant to 24 CFR Part 24. (ii)No part of this contract shall be subcontracted to any person or firm ineligible for award of a Government contract by virtue of Section 3(a)of the Davis-Bacon Act or 29 CFR 5.12(a)(1)or to be awarded HUD contracts or participate in HUD programs pursuant to 24 CFR Part 24. (iii)The penalty for making false statements is prescribed in the U.S.Criminal Code,18 U.S.C.1001.Additionally, U.S.Criminal Code,Section 1 01 0,Title 18,U.S.C., "Federal Housing Administration transactions',provides in part:"Whoever,for the purpose of influencing in any way the action of such Administration makes,utters or publishes any statement knowing the same to be false ..... shall be fined not more than $5,000 or imprisoned not more than two years,or both." 11.Complaints,Proceedings,or Testimony by Employees.No laborer or mechanic to whom the wage, salary,or other labor standards provisions of this Contract are applicable shall be discharged or in any other manner discriminated against by the Contractor or any subcontractor because such employee has filed any complaint or instituted or caused to be instituted any proceeding or has testified or is about to testify in any proceeding under or relating to the labor standards applicable under this Contract to his employer. B.Contract Work Hours and Safety Standards Act.The provisions of this paragraph B are applicable where the amount of the prime contract exceeds $100,000.As used in this paragraph,the terms "laborers"and "mechanics'include watchmen and guards. (1)Overtime requirements.No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which the individual is employed on such work to work in excess of 40 hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of 40 hours in such workweek. (2)Violation;liability for unpaid wages;liquidated damages.In the event of any violation of the clause set forth in subparagraph (1)of this paragraph,the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages.In addition,such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory,to such District or to such territory),for liquidated damages.Such liquidated damages shall be computed with respect to each individual laborer or mechanic,including watchmen and guards, employed in violation of the clause set forth in subparagraph (1)of this paragraph,in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of 40 hours without payment of the overtime wages required by the clause set forth in sub paragraph (1)of this paragraph. Previous editions are obsolete Page 4 of5 form HUD-4010 (06/2009) ref.Handbook 1344.1 C-64 (3)Withholding for unpaid wages and liquidated damages.HUD or its designee shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contract, or any other Federally-assisted contract subject to the Contract Work Hours and Safety Standards Act which is held by the same prime contractor such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in subparagraph (2)of this paragraph. (4)Subcontracts.The contractor or subcontractor shall insert in any subcontracts the clauses set forth in subparagraph (1)through (4)of this paragraph and also a clause requiring the subcontractors to include these clauses in any 'Iower tier subcontracts.The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in subparagraphs (1)through (4)of this paragraph. C.Health and Safety.The provisions of this paragraph Care applicable where the amount of the prime contract exceeds $100,000. (1)No laborer or mechanic shall be required to work in surroundings or under working conditions which are unsanitary,hazardous,or dangerous to his health and safety as determined under construction safety and health standards promulgated by the Secretary of Labor by regulation. (2)The Contractor shall comply with all regulations issued by the Secretary of Labor pursuant to Title 29 Part 1926 and failure to comply may result in imposition of sanctions pursuant to the Contract Work Hours and Safety Standards Act,(Public Law 91-54,83 Stat 96).40 USC 3701 et seq. (3)The contractor shall include the provisions of this paragraph in every subcontract so that such provisions will be binding on each subcontractor.The contractor shall take such action with respect to any subcontractor as the Secretary of Housing and Urban Development or the Secretary of Labor shall direct as a means of enforcing such provisions. Previous editions are obsolete Page 5 of5 form HUD·4010 (06/2009) ref.Handbook 1344.1 C-65 CERTIFICATION WITH REGARD TO THE PERFORMANCE OF PREVIOUS CONTRACTS OR SUBCONTRACTS SUBJECT TO THE EQUAL OPPORTUNITY CLAUSE AND THE FILING OF REQUIRED REPORTS The Dbidder,Dproposed sub-contractor,hereby certifies that he/she Dhas,Dhas not,participated in a previous contract or subcontract subject to the Equal Opportunity Clause,as required by Executive Orders 10925,11114,or 11246,and that he/she Dhas,Dhas not,filed with the Joint Reporting Committee,the Director of the Office of Federal Contract Compliance,a Federal Government contracting or administering agency,or the former President's Committee on Equal Employment Opportunity,all reports due under the applicable filing requirements. Date:Project Number:_Contract Award:$_ Awarding Agency:_ Contractor Name:Total Number of Employees _ Affiliate Company:-------- By:_ Title:_ NOTE:The above certification is required by the Equal Employment Opportunity Regulations of the Secretary of Labor (41 CFR 60-1.7(b)(1),and must be submitted by bidders and proposed subcontractors only in connection with contracts and subcontracts which are subject to the equal opportunity clause.Contracts and subcontracts which are exempt from the equal opportunity clause are set forth in 41 CFR 60-1.5 (Generally only contracts or subcontracts of $1 0,000 or under are exempt). Proposed prime contractors and subcontractors who have participated in a previous contract or subcontract subject to the Executive Orders and have notfiled the required reports should note that 41 CFR 60-1.7(b)(1)prevents the award of contracts and subcontracts unless such contractor submits a report covering the delinquent period or such other period specified by the U.S.Department of the Interior or by the Director,Office of Federal Contract Compliance,U.S. Department of Labor. SF-100 (EEO-1)must be filed by; (A)All private employers who are: (1)Subject to Title VII of the Civil Rights Act of 1964 (as amended)with 100 or more employees. (2)Subject to Title VII who has fewer than 100 employees,if the company is owned or affiliated with another company,or there is centralized ownership, control or management so that the group legally constitutes a single enterprise,and the entire enterprise employs a total of 100 or more employees. (B)All federal contractors (private employers),who: (1)Are not exempt as provided for by 41 CFR 60-1.5 (2)Have 50 or more employees,and a.Are prime contractors or first-tier subcontractors,and have a contract,subcontract,or purchase order amounting to $50,000 or more;or b.Serve as a depository of Government funds in any amount,or c.Is a financial institution,which is an issuing,and paying agent for U.S.Savings Bonds and Notes. C-66 NON-SEGREGATED FACILITIES CERTIFICATION FEDERALLY-ASSISTED CONSTRUCTION PROJECTS The federally-assisted construction contractor certifies that he/she DOES NOT and WILL NOT: 1.Maintain or provide,for his/her employees,any segregated facilities at any of his/her establishments. 2.Permit his/her employees to perform their services at any location,under his/her control,where segregated facilities are maintained. The federally-assisted contractor agrees that a breach of this certification is a violation of the Equal Opportunity Clause in this contract.As used in this certification,the term segregated facilities means any waiting room,work areas,restrooms and washrooms,restaurants and other eating areas,time clocks, locker rooms and other storage or dressing areas,parking lots,drinking fountains,recreation or entertainment areas,transportation,and housing facilities provided for employees which are segregated by explicit directive or are in fact segregated on the basis of race,creed,color,or national origin,because of habit,local custom,or otherwise. The federally-assisted contractor agrees that (except where he/she has obtained identical certifications from proposed subcontractors for specific time periods)he/she will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause,and that he/she will retain such certifications in his/her files. NOTE:The penalty for making false statements in offers is prescribed in 18 U.S.C.1001. Date:_Project Number:_ Company:_ Address:_ By:_ Title:_ C-67 EQUAL EMPLOYMENT OPPORTUNITY COMMITMENT TO: (Name of Labor Union,Workers Representative,etc. (Address) Project Number:_ Name of Business (Contractor):_ Project Name:_ The Undersigned currently holds a contract with ,involving funds of the U.S.Government,or a subcontract with a prime contractor holding such contract. You are advised that under the provisions of the above contract or subcontract,and in accordance with Executive Order 11246,the undersigned is obligated not to discriminate against any employee or applicant for employment because of race,color,religion,sex or national origin.This obligation not to discriminate in employment includes,but is not limited to the follow: 1.Hiring,placement,upgrading,transfer or demotion; 2.Recruitment,advertising or solicitation for employment; 3.Treatment during employment; 4.Rates of payor other forms of compensation; 5.Selection for training,including apprenticeship;and 6.Layoff or termination. This notice is furnished to you pursuant to the provisions of the above contract or subcontract and Executive Order 11246.Copies of this notice will be posted by the undersigned in conspicuous places available to employees or applicants for employment. (Signature). By:-------,..,---.,--------(Print Name) (Date)(Title) C-68 PROPOSAL CITY OF RANCHO PALOS VERDES BLACKHORSE ROAD CDBG ADA PROJECT (Community Development Block Grant Project #601461·11) TO THE DIRECTOR OF PUBLIC WORKS CITY OF RANCHO PALOS VERDES The undersigned,as bidder,declares that:(1)this proposal is made without collusion with any other person,firm or corporation,and that the only persons or parties interested as principals are those named herein;(2)bidder has carefully examined the project plans,specifications,instructions to bidders,proposal, notice to contractors and all other information furnished therefore and the site of the proposed work;(3) bidder has investigated and is satisfied as to the conditions to be encountered,the character,quality and quantities of'work to be performed and materials to be furnished.Furthermore,bidder agrees that submission of this proposal shall be conclusive evidence that such examination and investigation have been made and agrees,in the event this contract be awarded to bidder,to enter into a contract with the CITY OF RANCHO PALOS VERDES,to perform said proposed work in accordance with the plans,if any,and the terms of the specifications,in the time and manner therein prescribed,and to furnish or provide all materials,labor,tools,equipment,apparatus and other means necessary so to do,except such thereof as may otherwise be furnished or provided under the terms of said specifications,for the following stated unit prices or lump-sum price as submitted on the Schedule attached hereto: The bidder shall submit as part of this proposal a completed copy of the Contractor's Industrial Safety Record. Accompanying this proposal is (Insert)"$"cash,""Cashie~sCheck," "certified check,"or "Bid Bond,"as the case may be)in the amount equal to at least ten percent (10%)of the total aggregate bid price hereof based on the quantities shown and the unit prices quoted in the Bid Sheets. The undersigned further agrees that should he/she be awarded the contract on the basis hereof and thereafter,defaults in executing the required contract,with necessary bonds and documents,within ten (10) days,not including Sundays and legal holidays,after having received notice that the contract has been awarded and is ready for signature,the proceeds of the security accompanying his bid shall become the property of the CITY OF RANCHO PALOS VERDES and this proposal and the acceptance thereof may be considered null and void. Licensed in accordanc.~..................~~, License No._Q;....;1'-""-"01'-'-"_----"" Signature(s)of bidder:Ifanind~idual,sostate~.~I~fa~fir;m~o~rc~-;p~rt~~~~~jt~e~fmir;m~n~a~m~e~an~d~gi~ve~th~e~n~a~m~e~s~o~f~a~ll~ind~~u~ co-partners composing the firm.If a orpora ion,s arne of corporation,also names of president, secretary,treasurer,and manager hereof.Two notarized officer's signatures and the corporate seal are required for corporations. P -1 C-69 Legal Business Name:~OD\NNUNE C1~Ne(2AL WTAACTOJ2. Address:130 fCl ?E:'frt>W DBtVE.SCAI C?C #"1.3~C.HUlD HUclS Telephone:G(og·qOY -5112- Contact:P-AUJ{.4 caO~'ZAkf-2. Proposals which do not show the number and date of the Bidder's License under the provisions of Chapter 9 of Division 3 of the Business &Professional Code will be rejected.To be submitted with each bid to contract for the BLACKHORSE ROAD CDBG ADA PROJECT Project (Community Development Block Grant Project #601461-11 ) Bid Date _ This information must include all construction work undertaken in the State of California by the bidder and partnership joint venture or corporation that any principal of the bidder participated in as a principal or owner for the last five calendar years and the current calendar year prior to the date of bid submittal.Separate information shall be submitted for each particular partnership,joint venture,corporate or individual bidder. The bidder may attach any additional information or explanation of data which bidder would like to be taken into consideration in evaluating the safety record.An explanation must be attached of the circumstances surrounding any and all fatalities. P·2 C-70 CITY OF RANCHO PALOS VERDES BID SHEET BLACKHORSE ROAD CDBG ADA PROJECT (Community Development Block Grant Project #601461-11) NAME OF COMPANY:U:zo~~U~E (QE~E;C2AL (o..:?J12PqDQ.. To the Honorable Mayor and Members of the City Council: In compliance with the Notice Inviting Sealed Bids,the undersigned hereby agrees to enter into a contract to furnish all labor, materials,equipment and supplies for the project identified as BLACKHORSE ROAD CDBG ADA PROJECT in accordance with the specifications and plans for demolition,construction and installation in the Contract Documents which are on file in the office of the Director of Public Works of the City of Rancho Palos Verdes to the satisfaction and under thedirection of the Director of Public W k t th f II'.or sa e 0 oWlnQ prices: Item Description Estimated Unit Unit Price Extended No.Quantity Meas.Amount 1 Clearing and Grubbing 1 LS ~qJ avD.(X)I~Cf ,3[PD.CO 2 Traffic Control/Mobilization/Best Management Practices 1 LS B,SOD.(i)I~6.:-AD.00 Remove E~isting and Construct Portland Cement Concrete Curb and l;'f,4 1 J.ro.CD3GutterwithAsphaltConcreteSlotPatchOver6"Crushed 80 LF '6~-?O Miscellaneous Base 4 Remove Existing And Construct Portland Cement Concrete Integral 10 LF $52.t,)o ~0'25.00CurbOver6"Crushed Miscellaneous Base Remove Existing and Construct Portland Cement Concrete Drive i 13.:;.0 $2,QQLt.OO5ApproachwithAsphaltConcreteSlotPatchOver6"Crushed 220 SF Miscellaneous Base 6 Remove EXisting and Construct 4"Portland Cement Concrete 300 SF ~S.CjS f2,/tJ8S.CDSidewalkOver3"Crushed Miscellaneous Base Remove EXisting And Construct 4"Portland Cement Concrete Curb t~,Io50ro7AccessRampwithRetainingCurband3'X4'Detectable Warning 4 EA $\0 loCO.OJ Surface Over 3"Crushed Miscellaneous Base . 8 Remove EXisting And Construct Segmental Block Retaining Wall 50 SF of $70.00 $3,f;O)·WIncludingCrushedMiscellaneousBaseandBackfillFace 9 Block Wall Cap Units,Epoxy in Place,W=24"40 EA ~20.00 $$:n.oo 10 Relocate Post Office Mailbox,Including Portland Cement Concrete 1 LS $&:0.00 $?:J:O.ooFoundationandBolts;Adiust Manhole Cover to Grade 11 Traffic Signal Pedestrian Head,Push Button,Pole,Conduits,and 1 LS $8.8SS.cn ~88SS.roConductorsCompleteinPlace, 12 Remove Existing Striping and Reflective Markers 1 LS ~Z,5~.ro ~2.,5~O.OD 13 Striping and Marking 1 LS ~J.,-&0.0 0 :t>:2.,~(b-DO 14 Grade to Match New Construction;Sleeving 1 LS ~L 2W.OO '\.200.00 15 Root Pruning 1 LS 1~.OO ~500.ro 16 Remove Existing and Install New Sign Post 1 EA $5LlO.OO 15-/0.00 17 Insurance Requirements for Operating Agency 1 LS $L~l}OO ~I.'COD .DO TOTAL BID SCHEDULE $ltO l 'QCl.en TOTAL BID SCHEDULE IN WORDS:SIYT'/-T~OVSA~D SF-lEN -H\JND~ID NIN'E;t'(-~\~E OO~ P·3 C-71 INFORMATION REQUIRED OF BIDDER The bidder is required to supply the following information:(Additional sheets may be attached if necessary.) (1 ) (2) Address:r~ogc{t!=:"hDN Di2-"IG •f2u lie <:..#13,s-cMrJO titus cAv1 Telephone:qD1 'Itil -SI/1- (3)Type of firm -Individual,Partnership,or Corporation: (4) (5) (6) (7) (8) Corporation organized under the laws of the State of I\A ~t.J.:.Ll=.ifQ~f?N~'A+--_ Contractor's license number and class: ct1801Oj . List the names and addresses of all members of the firm or names and titles of all officers of the corporation: J<AfAEI f70~)ZAL.E;2-,MAN4~n=f2.:-I ~:..:...I-"""""-"";;'--------------- Number of years experience as a contractor in construction work _t::r List at least three similar projects completed as of recent date: Contract Amount Class of Work Date Completed Name,Address of Owner,&Telephone No. (9)List the name and address of such subcontractor who will perform work in or about the work of improvement and indicate what part of the work will be done by each such contractor (If needed, attach additional sheets): NAME TYPE OF WORK _ ADDRESS _ P·4 C-72 NAME TYPE OF WORK _ ADDRESS _ NAME,TYPE OF WORK _ ADDRESS _ NAME,TYPE OF WORK _ ADDRESS _ (10)List the name of the person who inspected the site of the proposed work for your firm: RAfAEl GbN 2A LE3. (11)NOTE:Upon request of the City,the bidder shall furnish evidence showing a notarized financial statement,financial data,construction experience,or other information. (12)Bidder shall be properly licensed in accordance with Business and Professional Code Section 7028 at the time of the Business and Professional Code shall be considered non-responsive and his bid shall be rejected. P-s C-73 STATEMENT ACKNOWLEDGING PENAL AND CIVIL PENALTIES CONCERNING THE CONTRACTORS'LICENSING LAWS [Business &Professions Code 7028.15] [Public Contract Code 20103.5] I,the undersigned,certify that I am aware of the following provisions of California law and that I,or the entity on whose behalf this certification is given,hold a currently valid California contractor's license as set forth below: Business &Professions Code 7028.15: (a)It is a misdemeanor for any person to submit a bid to a pUblic agency in order to engage in the business or act in the capacity of a contractor within this state without having a license therefore,except in any of the following cases: (1)The person is particularly exempted from this chapter. (2)The bid is submitted on a state project governed by Section 10164 of the Public Contract Code or on any local agency project governed by Section 20104 [now I 20103.5]of the Public Contract Code. (b)If a person has been previously convicted of the offense described in this section,the court shall impose a fine of 20 percent of the price of the contract under which the unlicensed person performed contracting work,or four thousand five hundred dollars ($4,500), whichever is greater,or imprisonment in the county jail for not less than 10 days nor more than six months,or both. In the event the person performing the contracting work has agreed to furnish materials and labor on an hourly basis,"the price of the contractU for the purposes of this subdivision means the aggregate sum of the cost of materials and labor furnished and the cost of completing the work to be performed. (c)This section shall not apply to a joint venture license,as required by Section 7029.1. However,at the time of making a bid as a joint venture,each person submitting the bid shall be sUbject to this section with respect to his or her individuallice~sure. (d)This section shall not affect the right or ability of a licensed architect,land surveyor,or registered professional engineer to form joint ventures with licensed contractor to render services within the scope of their respective practices..' (e)Unless one of the foregoing exceptions applies,a bid submitted to a public agency by a contractor who is not licensed in accordance with this chapter shall be considered non- responsive and shall be rejected by the public agency.Unless one of the foregoing exceptions applies,a local public agency shall,before awarding a contract or issuing a purchase order,verify that the contractor was properly licensed when the contractor submitted the bid.Notwithstanding any other provision of law,unless one of the foregoing exceptions applies,the registrar may issue a citation to any public officer or employee of a public entity who knowingly awards a contract or issues a purchase order to a contractor who is not licensed pursuant to this chapter.The amount of civil penalties,appeal,and finality of such citations shall be subject to Sections 7028.7 to 7028.13 inclusive.Any contract awarded to,or any purchase order issued to,a contractor who is not licensed pursuant to this chapter is void. P-6 C-74 (f)Any compliance or noncompliance with subdivision (e)of this section,as added by Chapter 863 of the Statutes of 1989,shall not invalidate any contract or bid awarded by a public agency during which time that subdivision was in effect. (g)A public employee or officer shall not be sUbject to a citation pursuant to this section if the public employee,officer,or employing agency made an inquiry to the board for the purposes of verifying the license status of any person or contractor and the board failed to respond to the inquiry within three business days.For purposes of this section,a telephone response by the board shall be deemed sufficient. Public Contract Code 20103.5: In all contracts subject to this part where federal funds are involved,no bid submitted shall be invalidated by the failure of the bidder to be licensed in accordance with the laws of this state. However,at the time the contract is awarded,the contractor shall be properly licensed in accordance with the laws of this state.The first payment for work or material under any contract shall not be made unless and until the Registrar of Contractors verifies to the agency that the record,S of the Contractor's State License Board indicate that the contractor was properly licensed at the time the contract was awarded.Any bidder or contractor not so licensed shall be subject to all legal penalties imposed by law including,but not limited to,any appropriate disciplinary action by the Contractor's State License Board.The agency shall include a statement to that effect in the standard form of prequalification questionnaire and financial statement.Failure of the bidder to obtain proper and adequate licensing for an award of a contract shall constitute a failure to execute the contract and shall result in the forfeiture of the security of the bidder. License No.:_Q;...;1..;:6;.:::O;...:19..........._ Class:_--'-A"'--_ Expiration Date:~..!o:O:..!.1 +(:;;..ZO~I"-'1L...-_ Date:10 Signature:--J:;;.~Me..-'?~2:===-----===----- P-7 C-75 DESIGNATION OF SUBCONTRACTORS [Public Contract Code 4104] Public Contract Code 4104 provides as follows: Any officer,department,board or commission taking bids for the construction of any public work or improvement shall provide in the specifications prepared for the work or improvement or in the general conditions under which bids will be received from the doing of the work incident to the public work or improvement that of any person making a bid or offer to perform the work,shall,in his or her bid or offer,set forth: (a)The name and the location of the place of business of each subcontractor who will perform work or labor or render service to the prime contractor in or about the construction of the work or improvement,or a subcontractor licensed by the State of California who,under subcontract to the prime contractor,specially fabricates and installs a portion of the work or improvement according to detailed draWings contained in the plans and specifications,in an amount in excess of one-half of 1 percent of the prime contractor's total bid or,in the case of bids or offers for the construction of streets or highways,including bridges,in excess of one- half of 1 percent of the prime contractor's total bid or ten thousand dollars ($10,000), whichever is greater. (b)The portion of the work which will be done by each subcontractor under this act.The prime contractor shall list only one subcontractor for each portion as is defined by the prime contractor in his or her bid. Subcontractor's Name and Contract Name Address and Telephone No. 5ArJ 01 MAS I CA bps A~(£lf©SIbf>}~DN Clog -~9 -220 I Lot--lt!l fbe1tCH j CA PCl,-5<e2 -2\9)-050L/ P-8 Portion of Work and Percent of Total Bid J¥.A=fJG ~bNA L I?-.(P(P'7o i:np.l e\NC£!-t-\t,IN 01-0e1Q\1 A (.,l·lo SOl., C-76 CONTRACTOR'S INDUSTRIAL SAFETY RECORD - ----------- - - - - ------- Year of Recor~20-lL-20_20_20_20_Total Current Year I II 1.No.of contracts 3> 2.Total dollar amount of contracts (in ~q(),noOthousandsof$) *3.No.of fatalities (J *4.No.of lost workday cases 0 *5.No.of lost workday cases involving (} permanent transfer to another job or termination of employment The information required for these items is the same as required for Columns 3 to 6,Code 10,Occupational Injuries,Summary- Occupational Injuries and Illnesses No.1 02. Signature State Contractor's Lie.#:&Classification Q7g079 Telephone qf)'r Cfoy -51ft- ~""NluJE Hb.~elZAk CoN1F=Ac.:tt>xz-. Name of Bidder (print) t;o~tt PE.\{l1>~J&\"~Sw,,;~#'~7 Ad~~?ss---'-'±ll ~\)ld-H.t?c.A -'!t .q.rJ!2j__ City Zip Code The above information was compiled from the records that are available to me at this time,and I declare under penalty of perjury that the information is'true and accurate within the limitations of those records. P-9 C - 7 7 Bond No. BID BOND KNOW ALL PERSONS BY THESE PRESENTS that: WHEREAS the _ ("Public Agency"),has issued an invitation for bids for the work described as follows: BLACKHORSE ROAD CDBG ADA PROJECT (Community Development Block Grant Project #601461-11) WHEREAS _ (Name and address of Bidder) ("Principal"),desires to submit a bid to Public Agency for the work. WHEREAS,bidders are required under the provisions of the California Public Contract Code to furnish a form of bidder's security with their bid. NOW,THEREFORE,we,the undersigned Principal,and _ (Name and address of Surety) ("Surety")a duly admitted surety insurer under the laws of the State of California,as Surety,are held and firmly bound unto the Public Agency in the penal sum of Dollars ($),being not less than ten percent (10%)of the total bid price,in lawful money of the United States of America,for the payment of which sum well and truly to be made,we bind ourselves,our heirs,executors,administrators,successors,and assigns,jointly and severally,firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH THAT,if the hereby bounded Principal is awarded a contract for the work by the Public Agency and,within the time and in the manner required by the bidding specifications,enters into the written form of contract included with bidding specifications,furnishes the required bonds,one to guarantee faithful performance and the other to guarantee payment for labor and materials,and furnishes the required insurance coverage,then this obligation shall become null and void; otherwise,it shall be and remain in full force and effect. In case suit is brought upon this bond,Surety further agrees to pay all court costs incurred by the Public Agency in the suit and reasonable attorneys'fees in an amount fixed by the court.Surety hereby waives the provisions of California Civil Code 2845. P -10 C-78 BondNo.N/A BID BOND ~l>}(,NOW ALL PERSONS BY THESE PRESENTS that: {::Wf;EREAS the CITY OF -RANCHO PALOS VERDES ··~:<i~PUbIiC Agency"),has issued an invitation for bids for the work described as follows: BLACKHORSE ROAD CDBG ADA PROJECT (Community Development Block Grant Project #601461-11) WHEREAS CROWNLINE GENERAL CONTRACTOR 13089 PEYTON DR.#C-13S,CHINO HILLS CA 91709 (Name and address ofBidder) -;'-("Princlpal"),desires to submit a bid to Public Agency for the work. WHEREAS,bidders are required under the provisions of the California Public Contract Code to fumish a of bidder's security with their bid. NOW,THEREFORE,we.the undersigned Principal,and _ THE OHIO CASUALTY INSURANCE COMPANY 790 THE CITY DR.SO STE 200,ORANGE CA 92868 (Name-and address of Surety) ("Surety")a dUly admitted surety insurer under the laws of the State Of California,as Surety,are held and \_flrmly bound unto the Public Agency in the penal sum of TEN PERCENT OF THE AMT.BID \:ollars($10%OF BID AMT.),belngnotlessthantenpercent(10%)ofthe I bid price,in lawful money of the United States of America,for the payment of which sum well and truly e made,we bind-ourselves,our heirs,executors,administrators,successors,and assigns.jointly and ,~talJy,firmly by these presents. -yONDITION OF THIS 0B.L/GATION IS SUCH THAT,if the hereby bounded Principal is awarded a _ot for the work by the Public Agency and,within the time and in the manner required by the bidding lfications,enters Into the written form of contract included with bidding specifications,furnishes the d bonds,one to guarE!-ntee faithful performance and the other to guarantee payment for labor and Is,and furnIshes the required Insurance cov~rage.then this obligation shall become null and void; _-e,it shall be and remain in full force and effect. '~Ult Is brought upon this bond,Surety further agrees to pay all court costs incurred by the Public __the suit and reasonable attorneys'fees in an amountfixed by the court.Surety hereby waives the _~_(If California CMICoge 264.5-, P ·10 C-79 Page Intentionally Left Blank C-80 ...... P·ll Note:This bond must be d.t!ler:!,~I slgnalurss must be notartzlltJ,and ell.fdence()f the auJ1:lorllyof any person signlClg asel1o.mey-/n-faOl must be attaohed. .....,.,. .,........,..'.,. (Seal) By:._-,--_~....__--_--_ Its «Surety" THE OHIO CASUALTY INSURANCE COMPANY (Seal) By:_..,---.....~ Its pated:,,__N_O....V_E_MB_E.R_l...;,_2_0_12_,.,.;..,.._ '''Principal" CROWNLINE GENERAL CONTRACTOR ~;.:'::. t::'lN WITNESS WHEREOF,this instrument has been duly executed by Principal and Surety,on the date set ,.".,forth below,the name of each corporate party being hereto affixed and these present$duly signed byns .·underslgned representative(s)pursuant to authority of Its 'gQyernlnl;l body. C-81 CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT State of California County of _---=R;.;,;I:;.;V~E;,;;,;R..;;;.S.::.;ID:;.;E___=_ before me,R_._NAP_P--:7I::--.,..-~'-'N-O-T_;"AR":":7Y__:':P:_U-B_=L;_IC~"_ (Here insert name and title of the officer) personally appeared __J_E_R_E_MY_P_E_ND_E_R_G_A_ST _ who proved to me on the basis of satisfactory evidence to be the person~whose name~is/aFe"'Subscribed to the within instrument and acknowledged to me that he/sbe/tHe;y executed the same in his/bel:/tbeif authorized capacity(~,and that by his/herltheir signature~on the instrument the person(.8r,"or the entity upon behalf of which the person~acted,executed the instrument. 1 certify under PENALTY OF PERJURY under the laws ofthe State of California that the foregoing paragraph is true and correct. • WlTNESS my hand and official seal.i?A . Signature of Notary PubIiC~(Notary Seal) R.NAPPI COMM ••1977782 NOTARY PUBIJC •CN.1F0fUiIA fUllERS/DE COUNTY IMyCGnlm.o~JlN1.aa18 a • (Title or description ofattached document) (Title or description ofnttached document continued) DESCRIPTION OF TIlE ATTACHED DOCUMENT ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Any acknowledgment completed in California must coma/n ,'erbiage exactly as appears above in lhe notary section or Q separate acknowledgment/oml must be properly completed and aI/ached to lhal document.The anI)'excepdon is Ij a document Is /0 be recorded outside o/Carljomia.In such instances.an)'allematil'e acknowledgment ,'erbiage as moy be printed all such a document so long as ti,e \'erbiage does not require the nOIQlj'10 do something that is illegal/or a notary in California (i.e.certllYing lhe audlori:ed capacity a/the signer).Please check dIe document core/ullyfor proper nO/arialwording and Quach this/onll ifrequired Number ofPages __Document Date._ (Additional information) CAPACITY CLAIMED BY THE SIGNER D Individual (s) D Corporate Officer (Title) D Partner(s) D Attorney-in-Fact D Tmstee(s)o Other _ •State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. •Date ofnotarization must be the date thot the signer(s)personally appeared which must nlso be the same dote the acknowledgment is completed. o The notary public must print his or her name as it appears within his or her commission followed by a comma and then your title (notary public). •Print the name(s)of document signer(s)who personally appear at the time of notarization. •Indicate the correct singular or pluml forms by crossing off incorrect forms (i.e. fie/she/~is 1_)or circling the correct fonns.Failure to correctly indicate this information may lead to rejection ofdocument recording. •The notary senl impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a sufficient area pennits,olherwise complete a different acknowledgment form. o Signature of the notary public must match the signature on file with the office of the county clerk. .)Additional information is not required but could help to ensure this acknowledgment is not misused or attached to a different document. ,.Indicate title or type ofottnched document,number of pages and dote. .:.Indicate the capacity claimed by the signer.If lhe claimed capacity is a corporate officer,indicate the title (i.e.CEO,CFO.Secretary). •Securely attach this document to the signed document 2008 Version CAPAv12.1 0.07 800-873-9865 www.NotaryClasses.com C-82 'FHIS POWER OF ATTORNEY IS NOT VALID UNLESS IT IS PRINTED ON RED BACKGROUND.5309047 This Power of Attorney limits the acts of those named herein,and they have no authority to bind the Company except in the manner and to the extent herein stated. Certificate No. American Fire and Casualty Company The Ohio Casualty Insurance Company West American Insurance Company Liberty Mutual Insurance Company Peerless Insurance Company POWER OF ATTORNEY KNOWN ALL PERSONS BY THESE PRESENTS:That American Fire &Casualty Company and The Ohio Casualty Insurance Company are corporations duly organized under the laws of the State of Ohio,that Liberty Mutual Insurance Company is a corporation dUly organized under the laws of the State of Massachusetts,that Peerless Insurance Company is a corporation dUly organized under the laws of the State of New Hampshire,and West American Insurance Company is a corporation duly organized under the laws of the State of Indiana (herein collectively called the "Companies"),pursuant to and by authority herein set forth,does hereby name,constitute and appoint,ROSEMARY NAPPI,JEREMY PENDERGAST,MICHAEL D.STONG, all of the city of RIVERSIDE ,state of CALIFORNIA each individually if there be more than one named,its true and lawful attomey-in-fact to make,execute,seal,acknowledge and deliver,for and on its behalf as surety and as its act and deed,any and all undertakings,bonds,recognizances and other surety obligations,in pursuance of these presents and shall be as binding upon the Companies as if they have been duly signed by the president and attested by the secretary of the Companies in their own proper persons. American Fire and Casualty Company The Ohio Casualty Insurance Company Liberty Mutual Insurance Company Peerless Insurance Company West American Insurance Company By:-::::-~_~~:--__-:-::'4":''-"'7"'7...-..,.--=---:_ Gregory W.Davenport,Assistant Secretary55 ARTICLE XIII-Execution of Contracts -SECTION 5.Surety Bonds and Undertakings.Any officer of the Company authorized for that purpose in writing by the chairman or the president, and SUbject to such limitations as the chairman or the president may prescribe,shall appoint such attorneYS-in-fact,as may be necessary to act in behalf of the Company to make,execute, seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations.Such attomeys-in-fact subject to the limitations set forth in their respective powers of attomey,shall have full power to bind the Company by their signature and execution of any such instruments and to attach thereto the seal of the Company.When so executed such instruments shall be as binding as if signed by the president and attested by the secretary. IN WITNESS WHEREOF,this Power ofAttorney has been subscribed by an authorized officer or official ofthe Companies and the corporate seals ofthe Companies have been affixed thereto this ..!!!!:L day of April ,~. ~ ~ Co CI) "C.~II) cCI)CIS.! ,QC J l!STATE OF WASHINGTON=g ~COUNTY OF KING...ene.>CI)On this -ill!!-day of April ,2!!1L,before me personally appeared Gregory W.Davenport,who acknowledged himself to be the Assistant Secretary of American Fire and '0.2 Casualty Company,Liberty Mutual Insurance Company,The Ohio Casualty Company,Peerless Insurance Company and West American Insurance Company,and that he,as such,being:G!:authorized so to do,execute the foregoing instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer. :;~IN WITNESS WHEREOF,I have hereunto subscribed my name and affixed my notarial seal at Seattl~,):y'~~~ington,on the day and year first above written. -.."'C ........\......\\~'?,.f3.!~~".(',,{.., c·-".··,."V.M.k;·..S 1/t-...o.,~CIS II);.v"""<0."f-.A...)[A.o e ...NOTARY '-By:-:-::::-::,.,,---:.,..-T+~-:--------- -...~.PUBLIC .KD Riley,Not Public ~~~~9 C l!This Power of Attorney is made and executed pursuant to and by authority of the following By-laws anci'Aull1ori~tions of American Fire and Casualty Company,The Ohio Casualty Insuranceg;U)Company,Liberty Mutual Insurance Company,West American Insurance Company and Peerless Insurance Company,which resolutions are now in full force and effect reading as follows: ClSe~.!ARTICLE IV -OFFICERS -Section 12.Power of Attomey.Any officer or other official of the Corporation authorized for that purpose in writing by the Chairman or the President,and subject 0.5 to such limitation as the Chairman or the President may prescribe,shall appoint such attomeys-in-fact,as may be necessary to act in behalf of the Corporation to make,execute,seal, E ~acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations.Such attomeys-in-fact,subject to the limitations set forth in their respective~-!powers of attomey,shall have full power to bind the Corporation by their signature and execution of any such instruments and to attach thereto the seal of the Corporation.When so .......executed,such instruments shall be as binding as if signed by the President and attested to by the Secretary.Any power or authority granted to any representative or attomey-in-fact under;g ~the provisions of this article may be revoked at any time by the Board,the Chairman,the President or by the officer or officers granting such power or authority. ClSC>e0:; Ze.> Certificate of Designation -The President of the Company,acting pursuant to the Bylaws of the Company,authorizes Gregory W.Davenport,Assistant Secretary to appoint such attorney-in-fact as may be necessary to act on behalf of the Company to make,execute,seal,acknowledge and deliver as surety any and all undertakings,bonds,recognizances and other surety obligations. Authorization -By unanimous consent of the Company's Board of Directors,the Company consents that facsimile or mechanically reproduced signature of any assistant secretary of the Company,wherever appearing upon a certified copy of any power of attomey issued by the Company in connection with surety bonds,shall be valid and biding upon the Company with the same force and effect as though manually affixed. fJ~o~. BY:~~ David M.Carey,Assistant Secretary POA-AFCC,LMIC,OCIC.PIC &WAIC LMS_12873_041012 C-83 IN WITNESS WHEREOF,this instrument has been duly executed by Principal and Surety,on the date set forth below,the name of each corporate party being hereto affixed and these presents dUly signed by its undersigned representative(s)pursuant to authority of its governing body. Dated:_ "Principal" By:...,.-_ Its By:_ Its (Seal) "Surety" By:_~----------- Its By:_ Its (Seal) Note:This bond must be dated,all signatures must be notarized,and evidence of the authority ofany person signing as attorney-in-fact must be attached. P -11 C-84 NONCOLLUSION AFFIDAVIT TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID [Public Contract Code 7106] State of California County of ~It\l2u,yo l1d':J 14 ) )ss. ) J2.ArAEl-GoN'ZA u;:-z...-,being first duly sworn,deposes and says that he or she is ~AhE2 of ~vJNL,J,NS the party making the foregoing bid,that the bid is not made in the interest of,or on behalf of,any undisclosed person,partnership,company,association,organization,or corporation;that the bid is genuine and not collusive or sham;that the bidder has not directly or indirectly induced or solicited any other bidder to put in a fal~e or sham bid,and has not directly or indirectly colluded,conspired,connived,or agreed with any bidder or anyone else to put in a sham bid,or that anyone shall refrain from bidding;that the bidder has not in any manner,directly or indirectly,sought by agreement,communication.or conference with anyone to fix the bid price of the bidder or any other bidder,or to fix any overhead,profit.or cost element of the bid price,or of that of any other bidder,or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract;that all statements contained in the bid are true;and, further,that the bidder has not,directly or indirectly,submitted his or her bid price or any breakdown thereof, or the contents thereof,or divulged information or data relative thereto,or paid,and will not pay,any fee to any corporation,partnership.company association,organization.bid ep sitory,or to any member or agent thereof to effectuate a collusive or sham bid. " ",'LAURA CHANG ' /I:Commission No.1951733 iii 0:'NOTARY PUBLIC.cALIFOPlNlf,~ SAN BERNARDINO COUNlY "~IL.~./My-Comm.Expir••SEPTEMBER ';,2015 State of California J) County of Sh IA &r\LA,r~ Subscribed and sworn to or affirmed)before me on this t+hday ofN6v'e~kr ,20tl,by \11'\.0\0:\t k c:,personally known to me or proved to me on the basis of satisfacto evidence 0 e the person who appeared before me. (Notary Seal) P -12 C-85 ADDENDUM #1 BLACKHORSE ROAD CDBG ADA PROJECT C-86 CITYOF RANCHO PALOS VERDES PUBLIC WORKS DEPARTMENT ADDENDUM NO.1 TO THE CONTRACT DOCUMENTS,SPECIFICATIONS,&STANDARD DRAWINGS FOR THE BLACKHORSE ROAD CDBG ADA PROJECT COMMUNITY DEVELOPMENT BLOCK GRANT PROJECT #601461-11 FISCAL YEAR 2012-2013 CITY OF RANCHO PALOS VERDES In accordance with "Addenda"on page 1-1 of the "Instructions to Bidders",the following changes (revisions, additions,and/or deletions)as noted below,are hereby incorporated and made a part of the subject plans, specifications and contract documents for this project.Portions of the Contract,not specifically mentioned in the Addendum,remain in force.All trades affected shall be fully advised of these revisions,deletions,and additions. This Addendum forms a part of the Contract Documents for the above-identified project and modifies the original specifications and Contract Documents. Each bidder shall be responsible for ascertaining,prior to submitting a Bid,that it has received all issued Addenda and shall ACKNOWLEDGE RECEIPT OF THIS ADDENDUM IN THE SPACE PROVIDED BELOW. A bidder's failure to address the requirements of this addendum or failure to acknowledge the receipt of this addendum may result in that Bid being rejected as nonresponsive. The subject contract documents are hereby amended as follows: Replace the Federal Prevailing Wage Rate Decision in the project specifications,with the attached Federal Wage Rate Decision CA120033,Modification Number 13,Dated 10/19/2012.This decision is also available at:http://www.wdol.gov/wdol/scafiles/davisbacon/CA33.dvb?v=13 End of Addendum NO.1 Any questions regarding this Addendum should be directed to (310)544-5275. Manager,Nicole Jules,P.E.at s Addendum No.1 and accept the aforementioned. Please sign a ove and include this signed addendum in the Bid package.Failure to do so may result in that Bid being rejected as non-responsive. Page 1 of 1 30940 HA\'VTtfORl"f"BCULE\NID I RAN;HO 8'-IL.06 VERDES CA 90275·5391 1 (310)&44'b2&~I r,\x (310,544·52921 W.....WPi\LOSv['lOEt'.cOM/r~pv C-87 PAGE 01/03 ADDENDUM #2 BLACKHORSE ROAD COBG ADA PROJECT COBG PROJECT #601461 FY 2012-2013 C-88 11/07/2012 17:43 13105445292 PUBLIC WORKS PAGE 02/03 CITVOF PLELIC WORKS DEPARTMENT ADDENDUM NO,2 TO THE CONTRACT DOCUMENTS,SPECIFICATIONS,&STANDARD DRAWINGS FOR THE BLACKHORSE ROAD CDBG ADA PROJECT COMMUNITY DEVELOPMENT BLOCK GRANT PROJECT #601461-11 FISCAL YEAR 2012..2013 CITY OF RANCHO PALOS VERDES In accordance with "Addenda"on page 1-1 of the "Instructions to Bidders",the following changes (revisions, additions,and/or deletions)as noted below,are hereby incorporated and made a part of the subject plans, specifications and contract documents for this project.Portions of the Contract,not specifically mentioned in the Addendum,remain in force.All trades affected shall be fully advised of these revisions,deletions,and additions. This Addendum forms a part of the Contract Documents for the above-identified project and modifies the original specifications and Contract Documents. Eaoh bidder shall be responsible for ascertaining,prior to submitting a Bid,that it has received all issued Addenda and shall ACKNOWLEDGE RECEIPT OF THIS ADDENDUM IN THE SPACE PROVIDED BELOW, A bidder's failure to address the requirements of this addendum or failure to acknowledge the receipt of this addendum may result in that Bid being rejected as nonresponsive. The subject contract documents are hereby amended as follows: Revise Plan Sheet 2 to delete Note 17 and add Note 18 to depict work at the driveway location.See attached plan for reference. End of Addendum NO.2 Any questions regarding this Addendum should be directed to th (310)544-5275. t Manager,Nicole Jules,P.E.at I acknowedge receipt of this A dendum No.2 and accept the aforementioned_ Date Please sign above and include this,slgned addendum In tb-Bid package,F~i1ure to do so may result In that Jiid being relected 4lI!!:I0n-rosponslve. Page 1 of 2 30940 ~Bcul~I ~:H(.'~LDS \II;Ror;s.eA QO:?75-53{:lt I t~lO)644·S?6?'1 F<\X 13101 544-52921 WlNWJmOOV~.<.XJM/IP"I C-89 11/07/2012 17:43 13105445292 PUBLIC WORKS PAGE 03/03 .~ z'6.~ I J I ~ ·R.~dper ·Addendurtdl2... I C-90 Check a License -License Detail -Contractors State License Board •• Page 1 of2 DEPARTMENT OF CONSUMER AFFAIRS Contractors State License Board Contractor's License Detail -license #978079 &DISCLAIMER:A license status check provides information taken from the CSLB license database.Before relying on this information,you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7124.6)If this entity is subject to pUblic complaint disclosure,a link for complaint disclosure will appear below.Click on the link or button to obtain complaint and/or legal action information. Per B&P 7071.17 ,only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload,there may be relevant information that has not yet been entered onto the Board's license database. License Number Business Information Entity Issue Date Expire o.ate 978079 CROWNLINE GENERAL CONTRACTOR Business Phone Number:(909)904-5112 11973 GLACIER COURT '(Ug~I'p,!\,c,f:..92~99 Sole OWllership 10/24/2012.'~,.,,-...,- 10/31/2014 Extract Date 11/11/2012 License Status ACTIVE This license is current and active.All information below should be reviewed. Classifications CLASS A DESCRIPTION GENERAL ENGINEERING CONTRACTOR Bonding Workers'Compensation CONTRACTOR'S BOND This license filed a Contractor's Bond with AMERICAN CONTRACTORS INDEMNITY COMPANY. Bond Number:100207949 Bond Amount:$12,500 Effective Date:10/18/2012 WORKERS'COMPENSATION This license is exempt from having workers compensation insurance;they certified that they have no employees at this time. Effective Date:10/24/2012 Expire Date:None Personnel List https://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetail.aspx?LicNum=9...11/11/2012C-91 Check a License -License Detail -Contractors State License Board Conditions of Use I Privacy Policy Copyright ©2010 State of California Page 2 of2 https:/Iwww2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetai1.aspx?LicNum=9...11 III 120 12C-92 Personnel List -Contractor State License Board Page 1 of 1 OEPAFCfMEW'f OF CONSUMER AFFAIRS Contractors State License Board Contractor's License Detail (Personnel List) Contractor License #:978079 Contractor Name:CROWNLINE GENERAL CONTRACTOR Click on the person's name to see a more detailed page of information on that person NAME TITLE ASSOCIATION DISASSOCIATION .MORE DATE DATE CLASS CLASS RAFAEL GONZALEZ SOLE OWNER 10/24/2012 A Conditions of Use I Privacy Policy Copyright ©2010 State of California https://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/PersonneIList.aspx?LicNum=9...11/1112012C-93 Contractor's License Personnel Detail -Contractor State License Board Contractor's License Personnel Detail Contractor License #:978079 Contractor Name:CROWNLINE GENERAL CONTRACTOR Name:RAFAEL GONZALEZ Page 1 of 1 Title and Class History TITLE SOLE OWNER CLASS A GENERAL ENGINEERING CONTRACTOR print I »c1ose window « ASSOCIATION DATE 10/24/2012 DISASSOCIATION DATE https://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/PersonnelDetail.aspx?LicNum...11/11/2012C-94 MERIT PROF SRVC AGREEMENT C-95 PROFESSIONAL SERVICES AGREEMENT THIS PROFESSIONAL SERVICES AGREEMENT ("Agreement")is made and entered into this 18th day of December,2012,by and between the City of Rancho Palos Verdes,hereinafter referred to as "CITY,"and Merit Civil Engineering,Inc.,hereafter referred to as "CONSULTANT." IN CONSIDERATION of the covenants hereinafter set forth,the parties hereto mutually agree as follows: ARTICLE 1 SCOPE OF SERVICES 1.1 Project Description The Project is described as the BLACKHORSE RD CDBG -ADA COMPLIANCE PROJECT. 1.2 Description of Services CONSULTANT shall provide Construction Management and Inspection services as described in the Scope of Contract Services,attached hereto as Exhibit "A" and incorporated herein by this reference. 1.3 Schedule of Work Upon receipt of written Notice to Proceed from the CITY,CONSULTANT shall perform with due diligence the specific services requested by the CITY and included in Exhibit "A."No work shall be done on any item of Exhibit "A"for which CONSULTANT has not received a written Notice to Proceed.Time is of the essence in this Agreement. CONSULTANT shall not be responsible for delay,nor shall CONSULTANT be responsible for damages or be in default or deemed to be in default by reason of strikes,lockouts,accidents,or acts of God,or the failure of CITY to furnish timely information or to approve or disapprove CONSULTANT's work promptly,or delay or faulty performance by CITY,other consultants/contractors,or governmental agencies,or any other delays beyond CONSULTANT's control or without CONSULTANT's fault. ARTICLE 2 COMPENSATION 2.1 Fee CITY agrees to compensate CONSULTANT for services that CITY has issued to CONSULTANT a Notice to Proceed amounts as set forth in Exhibit "A,"and in any case a total amount not to exceed five thousand seven hundred ninety seven dollars Page 1 oflO R6876-0001\1410334v2.doc C-96 ($5,797.00),which are partially paid from Community Development Block Grant ("CDBG") funds that come from the United States Department of Housing and Urban Development ("HUD").The amounts in Exhibit "A"shall be in effect through the end of this Agreement. 2.2 Payment Address All payments due CONSULTANT shall be paid to: Merit Civil Engineering Inc. 12391 Lewis Street,Suite 201 Garden Grove,CA 92840 2.3 Terms of Compensation CONSULTANT shall submit monthly invoices for the percentage of work completed in the previous month.CITY agrees to authorize payment for all undisputed invoice amounts within thirty (30)days of receipt of each invoice.CITY agrees to use its best efforts to notify CONSULTANT of any disputed invoice amounts or claimed completion percentages within ten (10)days of the receipt of each invoice.However, CITY's failure to timely notify CONSULTANT of a disputed amount or claimed completion percentage shall not be deemed a waiver of CITY's right to challenge such amount or percentage. Additionally,in the event CITY fails to pay any undisputed amounts due CONSULTANT within forty-five (45)days after invoices are received by CITY then CITY agrees that CONSULTANT shall have the right to consider said default a total breach of this Agreement and be terminated by CONSULTANT without liability to CONSULTANT upon ten (10)working days advance written notice. 2.4 Term of Agreement This Agreement shall commence on the day it is executed,provided that Certificates of Insurance are current on that date,and this Agreement shall terminate on December 30,2013,unless earlier terminated pursuant to Article 4 of this Agreement. ARTICLE 3 INDEMNIFICATION AND INSURANCE 3.1 Indemnification CONSULTANT shall defend,indemnify,and hold the CITY,its officials, officers,employees,agents and independent contractors serving in the role of CITY officials,and volunteers (collectively "Indemnitees")free and harmless from any and all claims,demands,causes of action,costs,expenses,liabilities,losses,damages or injuries, in law or equity,to property or persons,including wrongful death (collectively "Claims"),in any manner arising out of or incident to any acts or omissions of CONSULTANT,its Page 2 ofl0 R6876-0001\1410334v2.doc C-97 officials,officers,employees or agents in connection with the performance of this Agreement,including without limitation the payment of all consequential damages, attorneys'fees,and other related costs and expenses,except for such Claims arising out of the sole negligence or willful misconduct of the Indemnitees.With respect to any and all such Claims,CONSULTANT shall defend Indemnitees at CONSULTANT's own cost, expense,and risk and shall pay and satisfy any judgment,award,or decree that may be rendered against Indemnitees.CONSULTANT shall reimburse Indemnitees for any and all legal expenses and costs incurred by each of them in connection therewith or in enforcing the indemnity herein provided.CONSULTANT's obligation to indemnify shall not be restricted to insurance proceeds,if any,received by CONSULTANT or Indemnitees.All duties of CONSULTANT under this Section shall survive termination of this Agreement. 3.2 General Liability CONSULTANT shall at all times during the term of the Agreement carry, maintain,'and keep in full force and effect,a policy or policies of Commercial General Liability Insurance,with minimum limits of one million dollars ($1,000,000)for each occurrence and two million dollars ($2,000,000)general aggregate for bodily injury,death, loss or property damage for products or completed operations and any and all other activities undertaken by CONSULTANT in the performance of this Agreement.Said policy or policies shall be issued by an insurer admitted to do business in the State of California and rated in A.M.Best's Insurance Guide with a rating of A:VII or better. 3.3 Professional Liability CONSULTANT shall at all times during the term of this Agreement,carry, maintain,and keep in full force and effect a policy or policies of professional liability insurance with a minimum limit of one million dollars ($1,000,000)per claim and aggregate for errors and/or omissions of CONSULTANT in the performance of this Agreement.Said policy or policies shall be issued by an insurer admitted to do business in the State of California and rated in Best's Insurance Guide with a rating of A:VII or better.If a "claims made"policy is provided,such policy shall be maintained in effect from the date of performance of work or services on the CITY's behalf until three (3)years after the date of work or services are accepted as completed.Coverage for the post-completion period may be provided by renewal or replacement of the policy for each of the three (3)years or by a three-year extended reporting period endorsement,which reinstates all limits for the extended reporting period.If any such policy and/or policies have a retroactive date,that date shall be no later than the date of first performance of work or services on behalf of the CITY.Renewal or replacement policies shall not allow for any advancement of such retroactive date. 3.4 Automobile Liability CONSULTANT shall at all times during the term of this Agreement obtain, maintain,and keep in full force and effect,a policy or policies of Automobile Liability Insurance,with minimum of one million dollars ($1,000,000)per claim and occurrence and Page 3 of 10 R6876-0001\1410334v2.doc C-98 two million dollars ($2,000,000)in the aggregate for bodily injuries or death of one person and five hundred thousand dollars ($500,000)for property damage arising from one incident. 3.5 Worker's Compensation CONSULTANT shall at all times during the term of this Agreement obtain, maintain,and keep in full force and effect worker's compensation insurance as required by the law.CONSULTANT shall require any subcontractor similarly to provide such compensation insurance for their respective employees. 3.6 Notice of Cancellation (a)All insurance policies shall provide that the insurance coverage shall not be cancelled by the insurance carrier without thirty (30)days prior written notice to CITY,or'ten (10)days notice if cancellation is due to nonpayment of premium. CONSULTANT agrees that it will not cancel or reduce said insurance coverage. (b)CONSULTANT agrees that if it does not keep the aforesaid insurance in full force and effect,CITY may either immediately terminate this Agreement or,if insurance is available at a reasonable cost,CITY may take out the necessary insurance and pay,at CONSULTANT's expense,the premium thereon. 3.7 Certificate of Insurance At all times during the term of this Agreement,CONSULTANT shall maintain on file with the CITY Clerk a certificate of insurance showing that the aforesaid policies are in effect in the required amounts.The commercial general liability policy shall contain endorsements naming the CITY,its officers,agents and employees as additional insureds. 3.8 Primary Coverage The insurance provided by CONSULTANT shall be primary to any coverage available to CITY.The insurance policies (other than workers compensation and professional liability)shall include provisions for waiver of subrogation. ARTICLE 4 TERMINATION 4.1 Termination of Agreement (a)This Agreement may be terminated at any time,with or without cause, by the CITY upon thirty (30)days prior written notice or by CONSULTANT upon ninety (90) days prior written notice.Notice shall be deemed served if completed in compliance with Section 6.14. Page 4 oflO R6876-0001\1410334v2.doc C-99 (b)In the event of termination or cancellation of this Agreement by CONSULTANT or CITY,due to no fault or failure of performance by CONSULTANT, CONSULTANT shall be paid compensation for all services performed by CONSULTANT, in an amount to be determined as follows:for work satisfactorily done in accordance with all of the terms and provisions of this Agreement,CONSULTANT shall be paid an amount equal to the percentage of services performed prior to the effective date of termination or cancellation in accordance with the work items;provided,in no event shall the amount of money paid under the foregoing provisions of this paragraph exceed the amount which would have been paid to CONSULTANT for the full performance of the services described in this Agreement. ARTICLE 5 DOCUMENTS 5.1 Ownership of Documents and Work Product All documents,plans,specifications,reports,information,data,exhibits, photographs,images,video files and media created or developed by CONSULTANT pursuant to this Agreement ("Written Products")shall be and remain the property of the CITY without restriction or limitation upon its use,duplication or dissemination by the CITY. All Written Products shall be considered "works made for hire,"and all Written Products and any and all intellectual property rights arising from their creation,including,but not limited to,all copyrights and other proprietary rights,shall be and remain the property ofthe CITY without restriction or limitation upon their use,duplication or dissemination by the CITY.CONSULTANT shall not obtain or attempt to obtain copyright protection as to any Written Products. CONSULTANT hereby assigns to the CITY all ownership and any and all intellectual property rights to the Written Products that are not otherwise vested in the CITY pursuant to the paragraph directly above this one. CONSULTANT warrants and represents that it has secured all necessary licenses,consents or approvals to use any instrumentality,thing or component as to which any intellectual property right exists,including computer software,used in the rendering of the services and the production of all Written Products produced under this Agreement, and that the CITY has full legal title to and the right to reproduce the Written Products. CONSULTANT shall defend,indemnify and hold the CITY,and its elected officials,officers, employees,servants,attorneys,designated volunteers,and agents serving as independent contractors in the role of CITY officials,harmless from any loss,claim or liability in any way related to a claim that CITY's use of any of the Written Products is violating federal,state or local laws,or any contractual provisions,or any laws relating to trade names,licenses, franchises,copyrights,patents or other means of protecting intellectual property rights and/or interests in products or inventions.CONSULTANT shall bear all costs arising from the use of patented,copyrighted,trade secret or trademarked documents,materials, equipment,devices or processes in connection with its provision of the services and Page 5 ofl0 R6876-0001\1410334v2.doc C-100 Written Products produced under this Agreement.In the event the use of any of the Written Products or other deliverables hereunder by the CITY is held to constitute an infringement and the use of any of the same is enjoined,CONSULTANT,at its expense, shall:(a)secure for CITY the right to continue using the Written Products and other deliverables by suspension of any injunction,or by procuring a license or licenses for CITY; or (b)modify the Written Products and other deliverables so that they become non- infringing while remaining in compliance with the requirements of this Agreement.This covenant shall survive the termination of this Agreement. Upon termination,abandonment or suspension of the Project,the CONSUL TANT shall deliver to the CITY all Written Products and other deliverables related to the Project without additional cost or expense to the CITY.If CONSULTANT prepares a document on a computer,CONSULTANT shall provide CITY with said document both in a printed format and in an electronic format that is acceptable to the CITY. 5.2 Record-Keeping and Reporting (a)Pursuant to 24 C.F.R.Section 85.36(i)(1 0),the CONTRACTOR shall maintain all books,documents,papers,and records that are directly pertinent to the Agreement for the purpose of making audits,examinations,excerpts and transcripts. (b)Pursuant to 24 C.F.R.Section 85.36(i)(11)and the Los Angeles County Development Commission's Project Description and Activity Budget for Contract 70741 (Project No.096691-09),CONTRACTOR shall retain all required records for a period of five (5)years after the CITY makes final payments and all other pending matters are closed. (c)Pursuant to 24 C.F.R.Section 85.36(i)(7),CONTRACTOR shall provide to the CITY all requested documentation resulting throughout the course of or under this Agreement. ARTICLE 6 GENERAL PROVISIONS 6.1 Representation The CITY representative shall be the Director of Public Works or his or her designee,and CONSULTANT shall notify CITY of CONSULTANT's designated representative.These individuals shall be the primary contact persons for the parties regarding performance of this Agreement. 6.2 CDBG Regulations CONSULTANT agrees to comply with the requirements of Part 570 of Title 24 of the Code of Federal Regulations,which states the U.S.Department of Housing and Page 6 of 10 R6876-0001\1410334v2.doc C-101 Urban Development's regulations concerning CDBG,and all federal regulations and policies issued pursuant to these regulations.Furthermore,CONSULTANT shall comply with all applicable equal employment provisions of the Civil Rights Act of 1964 (42 U.S.C. sections 200e-217)and the Americans with Disabilities Act of 1992 (42 U.S.C.section 11200,et seq.). 6.3 Personnel CONSULTANT represents that it has,or shall secure at its own expense,all personnel required to perform CONSULTANT's services under this Agreement.Any person who performs engineering services pursuant to this Agreement shall be licensed as a Civil Engineer and/or licensed in the appropriate discipline of Engineering for the work being conducted by the State of California and in good standing.CONSULTANT shall make reasonable efforts to maintain the continuity of CONSULTANT's staff who are assigned ,to perform the services hereunder and shall obtain the approval of the Director of Public Works of all proposed staff members who will perform such services. CONSULTANT may associate with or employ associates or subcontractors in the performance of its services under this Agreement,but at all times shall CONSULTANT be responsible for its associates or subcontractors'services. 6.4 CONSULTANT's Representations CONSULTANT represents,covenants and agrees that:a)CONSULTANT is licensed,qualified,and capable offurnishing the labor,materials,and expertise necessary to perform the services in accordance with the terms and conditions set forth in this Agreement;b)there are no obligations,commitments,or impediments of any kind that will limit or prevent CONSULTANT's full performance under this Agreement;c)to the extent required by the standard of practice,CONSULTANT has investigated and considered the scope of services performed,has carefully considered how the services should be performed,and understands the facilities,difficulties and restrictions attending performance of the services under this Agreement. 6.5 Labor Standards and Civil Rights CONTRACTOR agrees to comply with the requirements of the Secretary of Labor and the latest amendments to:Executive Orders 11246 and 11375,as supplemented in Department of Labor regulations (41 C.F.R.chapter 60);the Copeland "Anti-Kickback"Act (18 U.S.C.847)as supplemented in Department of Labor regulations (29 C.F.R.part 3);Section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C.1701 et seq.);Title VI of the Civil Rights Act of 1964 (42 U.S.C.2000);Section 109 of Title I of the Housing and Community Development Act of 1974 (42 U.S.C.5301 et seq.);the Age Discrimination Act of 1975 (42 U.S.C.6101 et seq.);and Section 504 ofthe Rehabilitation Act of 1973 (29 U.S.C.701 et seq.).CONTRACTOR agrees to comply with the requirements of all other applicable federal,state and local laws and regulations pertaining to labor standards or civil rights insofar as those acts apply to the performance of this Agreement. Page 7 oflO R6876-0001\1410334v2.doc C-102 6.6 Environmental Conditions Pursuant to 24 C.F.R.Section 85.36(i)(13),CONTRACTOR agrees to comply with the mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act (Pub.L.94-163,89 Stat.871). 6.7 Lobbying Certifications (a)The Los Angeles County Lobbyist Code Chapter 2.160 County Ordinance No.93-0031 Certification is attached hereto as Exhibit "B"and incorporated herein by this reference.CONSULTANT shall complete and file this Certification as required. (b)The Federal Lobbyist Requirements Certification is attached hereto as Exhibit "C"and incorporated herein by this reference.CONSULTANT shall complete and file this Certification with the CITY. 6.8 Conflicts of Interest CONSULTANT agrees not to accept any employment or representation during the term of this Agreement or within twelve (12)months after completion of the work under this Agreement which is or may likely make CONSULTANT "financially interested" (as provided in California Government Code Sections 1090 and 87100)in any decisions made by CITY on any matter in connection with which CONSULTANT has been retained pursuant to this Agreement. 6.9 Legal Action (a)Should either party to this Agreement bring legal action against the other,the validity,interpretation,and performance of this Agreement shall be controlled by and construed under the laws of the State of California,excluding California's choice of law rules.Venue for any such action relating to this Agreement shall be in the Los Angeles County Superior Court. (b)If any legal action or other proceeding,including action for declaratory relief,is brought for the enforcement of this Agreement or because of an alleged dispute, breach,default or misrepresentation in connection with this Agreement,the prevailing party shall be entitled to recover reasonable attorneys'fees,experts'fees,and other costs,in addition to any other relief to which the party may be entitled. (c)Should any legal action about a project between CITY and a party other than CONSULTANT require the testimony of CONSULTANT when there is no allegation that CONSULTANT was negligent,CITY shall compensate CONSULTANT for its testimony and preparation to testify at reasonable hourly rates. Page 8 oflO R6876-0001\1410334v2.doc C-103 6.10 Assignment Neither this Agreement nor any part thereof shall be assigned by CONSULTANT without the prior written consent of the CITY.Any such purported assignment without written consent shall be null and void,and CONSULTANT shall hold harmless,defend and indemnify the CITY and its officers,officials,employees,agents and representatives with respect to any claim,demand or action arising from any unauthorized assignment. Notwithstanding the above,CONSULTANT may use the services of persons and entities not in CONSULTANT's direct employ,when it is appropriate and customary to do so.Such persons and entities include,but are not necessarily limited to,surveyors, specialized consultants,and testing laboratories.CONSULTANT's use of subcontractors for additi.onal services shall not be unreasonably restricted by the CITY provided CONSULTANT notifies the CITY in advance. 6.11 Independent Contractor CONSULTANT is and shall at all times remain,as to the CITY,a wholly independent contractor.Neither the CITY nor any of its agents shall have control over the conduct of CONSULTANT or any of the CONSULTANT's employees,except as herein set forth,and CONSULTANT is free to dispose of all portions of its time and activities which it is not obligated to devote to the CITY in such a manner and to such persons,firms,or corporations as the CONSULTANT wishes except as expressly provided in this Agreement. CONSULTANT shall have no power to incur any debt,obligation,or liability on behalf of the CITY or otherwise act on behalf of the CITY as an agent.CONSULTANT shall not,at any time or in any manner,represent that it or any of its agents,servants or employees,are in any manner agents,servants or employees of CITY.CONSULTANT agrees to pay all required taxes on amounts paid to CONSULTANT under this Agreement,and to indemnify and hold the CITY harmless from any and all taxes,assessments,penalties,and interest asserted against the CITY by reason of the independent contractor relationship created by this Agreement.CONSULTANT shall fully comply with the workers'compensation law regarding CONSULTANT and its employees.CONSULTANT further agrees to indemnify and hold the CITY harmless from any failure of CONSULTANT to comply with applicable workers'compensation laws.The CITY shall have the right to offset against the amount of any fees due to CONSULTANT under this Agreement any amount due to the CITY from CONSULTANT as a result of its failure to promptly pay to the CITY any reimbursement or indemnification arising under this Article. 6.12 Titles The titles used in this Agreement are for general reference only and are not part of the Agreement. Page 9 ofl0 R6876-0001\1410334v2.doc C-104 6.13 Entire Agreement This Agreement,including any other documents incorporated herein by specific reference,represents the entire and integrated agreement between CITY and CONSULTANT and supersedes all prior negotiations,representations or agreements, either written or oral.This Agreement may be modified or amended,or provisions or breach may be waived,only by subsequent written agreement signed by both parties. 6.14 Construction In the event of any asserted ambiguity in,or dispute regarding the interpretation of any matter herein,the interpretation of this Agreement shall not be resolved by any rules of interpretation providing for interpretation against the party who causes the uncertainty to exist or against the party who drafted the Agreement or who drafted t~at portion of the Agreement. 6.15 Non-Waiver of Terms,Rights and Remedies Waiver by either party of anyone or more of the conditions of performance under this Agreement shall not be a waiver of any other condition of performance under this Agreement.In no event shall the making by the CITY of any payment to CONSULTANT constitute or be construed as a waiver by the CITY of any breach of covenant,or any default which may then exist on the part of CONSULTANT,and the making of any such payment by the CITY shall in no way impair or prejudice any right or remedy available to the CITY with regard to such breach or default. 6.16 Severability If any term or portion of this Agreement is held to be invalid,illegal,or otherwise unenforceable by a court of competent jurisdiction,the remaining provisions of this Agreement shall continue in full force and effect. 6.17 Notice Except as otherwise required by law,any notice or other communication authorized or required by this Agreement shall be in writing and shall be deemed received on (a)the day of delivery if delivered by hand or overnight courier service during CONSULTANT's or CITY's regular business hours or (b)on the third business day following deposit in the United States mail,postage prepaid,to the addresses listed below, or at such other address as one party may notify the other: To CITY: Mr.Jim Hendrickson,Interim Director of Public Works City of Rancho Palos Verdes 30940 Hawthorne Blvd. Rancho Palos Verdes,CA 90275 PagelOoflO R6876-0001\1410334v2.doc C-105 To CONSULTANT: Mr.Bob Merrell,President Merit Civil Engineering,Inc. 12391 Lewis Street,Suite 201 Garden Grove,CA 92840 IN WITNESS WHEREOF,the parties hereto have executed this Agreement as of the date and year first above written. Dated:_ Dated:_ ATTEST: By:_ City Clerk MERIT CIVIL ENGINEERING,INC. ("CONSULTANT") By:_ Printed Name:_ Title:_ By:-'--_ Printed Name:_ Title:_ CITY OF RANCHO PALOS VERDES ("CITY") Mayor APPROVED AS TO FORM: By:_ City Attorney Page 11 of 10 R6876-0001\1410334v2.doc C-106 \'All Municipal Engineering land Surveying Infrastructure November 10,2012 Mr.Nicole Jules Department of Public Works City of Rancho Palos Verdes 30940 Hawthorne Boulevard Rancho Palos Verdes,CA 90275 Subject: Dear Nicole: Field Engineering Services Proposal -Blackhorse Road ADA Ramp Improvements In respdnse to the Request for Proposal,Merit Civil Engineering is pleased to submit our proposal to provide field engineering services for the Blackhorse Road ADA ramp project.This proposal will outline our recommendation for inspection activities for the project,proposed scope of services,schedule and the level of coverage anticipated. PROJECT UNDERSTANDING The Blackhorse Road CDBG ADA project includes four access ramps that are located at the intersection of Hawthorne Boulevard and Blackhorse Road,a location that will present traffic control challenges during the construction.The work will be concentrated at the intersection and in the parkways but will still be subject to intermittent access issues.It will be important to ensure the contractor provides adequate traffic control and access during work hours. The following activities are recommended to manage the ramp construction: •Adequate BMP installations to control surface water and construction debris •Effective traffic control monitoring •Traffic signal modification inspection •Site and construction inspection on a frequent basis including daily reports •Construction staking •As built drawings in PDF format. The contract time for the ramp project is 15 working days.I believe the number of days that will require inspection will probably be 13 or so and even then,most of the days would require something less than full time inspection and my being in the area,the budget for this project can be minimized.Therefore,the inspection time estimated to establish a budget for the actual inspection of the project is 13 days at 2-3 hours per day.I plan to be the Construction Manager and primary Inspector with Joe Buckner,P.E.,P.L.S.assigned as the fill-in inspector,if needed. Construction surveys will be needed and are part of this proposal.An estimated 8 hours are Merit Civil Engineering,Inc. 12391 Lewis Street,Suite 201 Garden Grove,CA 92840 Office:(714)748-0531 Fax:(714)748-0681 C-107 Proposal to City of Rancho Palos Verdes Blackhorse Road ADA Ramps November 10,2012 Page 2 of 2 anticipated to complete the various staking elements and are included in the estimated fee.These hours may be kept separate from this authorization if desired by the City. SCHEDULE The pre-construction meeting will be the first activity followed with any coordination necessary with the utility companies. COMPENSATION The proposed total Not-to-Exceed fee for the above-described services is detailed on the attached Fee Breakdown spreadsheet.The total Not-to-Exceed fee is $5,797.00 Incidental costs relative to the assignment for office supplies,travel,phone calls,etc.are included in the above quoted Not-to-Exceed fee. We look forward to assisting you on this assignment.Please contact me with any questions you may have. Respectfully, MERIT CIVIL ENGINEERING,INC. Robert Merrell,P.E. President 2 Merit Civil Engineering,Inc C-108 City of Rancho Palos Verdes Blackhorse Road ADA Ramp Inspection Fee Breakdown Proposal Submittal November 10.2012 Classification Project Project Constr.Z-Man Manaaer Enaineer Insoection Clerical Crew Total Billing Rate Outside Hourlv Billina Rate $170 $148 $105 $82 $245 Hours Summary Costs Comments TASK BREAKDOWN l Construction Inspection 1.Pre-construction Meeting 2 2 $296 2.Field Surveys 3 8 11 $2,404 3.Utility Coordination and As builts 2 2 $210 4.On-site Construction Inspection 1 24 2 27 $2,832 $55 Reproduction Subtotals 0 6 26 2 8 42 $5,742 $55 Hours 0 6 26 2 8 42 - - TOTAL NTE FEE TOTALS Cost $0 $888 $2,730 $164 $1,960 -$5,742 $55 $5,797.00 Blackhorse Ramp Inspection fee v2.xls MERIT CIVIL ENGINEERING,INC.11/10/2012 C - 1 0 9 Exhibit "B": Community Development Commission County of Los Angeles COUNTY LOBBYIST CODE CHAPTER 2.160 COUNTY ORDINANCE NO.93-0031 CERTIFICATION Name of Firm:_ Address:_ State:_Zip Code:_Telephone Number:( Acting on'behalf of the above named firm,as its Authorized Official,I make the following Certification to the County of Los Angeles and the Community Development Commission,County of Los Angeles. 1)It is understood that each person/entity/firm who applies for a Community Development Commission contract,and as part of that process,shall certify that they are familiar with the requirements of the Los Angeles County Code,Chapter 2.160 (Los Angeles County Ordinance 93-0031)and; 2)That all persons/entities/firms acting on behalf ofthe above named firm have and will comply with the County Code,and; 3)That any person/entity/firm who seeks a contract with the Community Development Commission shall be disqualified therefrom and denied the contract and,shall be liable in civil action,if any lobbyist,lobbying firm,lobbyist employer or any other person or entity acting on behalf of the named firm fails to comply with the provisions of the County Code. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into.Submission of this certification is a prerequisite for making or entering into contract with the Los Angeles County and the Community Development Commission, County of Los Angeles. Authorized Official: (Contractor/Subcontractor) (Date) R6876-000 1\141 0334v2 .doc By:-=:----:---,----_ (Signature) (Title) C-110 Exhibit "e": FEDERAL LOBBYIST REQUIREMENTS CERTIFICATION Name of Firm:Date:_ Address:_ State:Zip Code:Phone No.:_ Acting on behalf of the above named firm,as its Authorized Official,I make the following Certification to the Department of Housing and Urban Development (HUD)and the Community Developm~nt Commission,County of Los Angeles: 1.No Federal appropriated funds have been paid,by or on behalf of the above named firm to any person for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of and Federal grant,loan or cooperative agreement,and any extension,continuation,renewal, amendment,or modification thereof,and; 2.If any funds other than Federal appropriated funds have paid or will be paid to any person for influencing or attempting to influence an officer or employee or any agency,a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with this Federal contract,grant loan,or cooperative agreement,the above named firm shall complete and submit Standard Form-LLL,"Disclosure Form to Report Lobbying",in accordance with its instructions,and: 3.The above name firm shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including subcontracts,sub-grants,and contracts under grants,loans,and cooperative agreement)and that all sub-recipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into.Submission of this certification is a prerequisite for making or entering into the transaction imposed by Section 1352 Title 31,U.S.Code.Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Authorized Official: Name:,Title:,_ Signature:Date:_ Federal Lobbying Requirements Certification Form R6876-0001\1410334v2.doc Revised 09/30/05 C-111