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HomeMy WebLinkAboutAgenda Report - March 2, 2016 C-07TM CITY OF LODI COUNCIL COMMUNICATION Cen7 AGENDA TITLE: Adopt Resolution Authorizing City Manager to Execute Professional Services Agreement with Terracon, of Lodi, for Construction Testing and Inspection Services ($574,610), and Amendment No. 1 to Professional Services Agreement with Michael Baker International, Inc., of Rancho Cordova, for Labor Compliance Monitoring ($24,000), for Grade Separation Harney Lane at Union Pacific Railroad Overhead Project MEETING DATE: March 2, 2016 PREPARED BY: Interim Public Works Director RECOMMENDED ACTION: Adopt resolution authorizing City Manager to execute Professional Services Agreement with Terracon, of Lodi, for construction testing and inspection services, in the amount of $574,610, and Amendment No. 1 to Professional Services Agreement with Michael Baker International, Inc., of Rancho Cordova, for labor compliance monitoring, in the amount of $24,000, for Grade Separation Harney Lane at Union Pacific Railroad Overhead Project. BACKGROUND INFORMATION: At the November 18, 2015 City Council meeting, Council awarded DeSilva Gates Construction, LP, of Dublin, a contract for construction of the Grade Separation Harney Lane at Union Pacific Railroad Overhead Project (Project). Due to the complex nature of the Project, consultants possessing specialized expertise are needed to monitor certain portions of the construction process. The Project requires construction of large overhead structures made of concrete and steel. Special inspections and materials testing of these structures is needed to assure the construction is properly performed. City staff recently solicited proposals for testing and inspection services from three qualified firms. Three proposals were received and evaluated by a selection committee made up of the Interim Public Works Director, the Interim City Engineer/Deputy Public Works Director, and the Construction Project Manager. Terracon received the highest ranking and was selected to perform the required testing and inspection services during construction. Services will be billed on a not -to -exceed, time -and -materials basis. This Project will require substantial labor compliance monitoring and reporting. Labor compliance monitoring and reporting is required on all federally funded projects. The service includes tracking all employee payroll documents as well as performing on site interviews with employees to confirm wages and benefits are in accordance with prevailing wage determinations. Michael Baker International, Inc., currently provides labor compliance services to the Public Works Transit and Neighborhood Services Divisions. Amendment No. 1 expands the existing Professional Services Agreement to provide labor compliance services related to project funding requirements for the Project. Services will be billed on a not -to -exceed, time -and -materials basis. APPROVED:c--T'f\ \? Stephen SchwabaiPer, City Manager K:\WP\PROJECTS\STREETS\HarneyGradeSeparation\Project\CAward HLGS Terracon Baker PSA doc 2/22/2016 Adopt Resolution Authorizing City Manager to Execute Professional Services Agreement with Terracon, of Lodi, for Construction Testing and Inspection Services ($574,610), and Amendment No 1 to Professional Services Agreement with Michael Baker International, Inc., of Rancho Cordova, for Labor Compliance Monitoring ($24,000), for Grade Separation Harney Lane at Union Pacific Railroad Overhead Project March 2, 2016 Page 2 Both of these services will be required during the course of construction. Minor clearing and grubbing work has started and actual construction is anticipated to begin in April 2016. Project completion is expected in October 2017. FISCAL IMPACT: Not applicable. FUNDING AVAILABLE: Funding for these items was appropriated on November 18, 2015. (30799000.77020) Jord ri Ayers Deputy City Manager/Internal Services Director Charles E. Swimley, Jr. Interim Public Works Director CES/GW/tdb Attachments cc: Gary Wiman, Construction Project Manager Terracon Michael Baker International, Inc. K:\WP\PROJECTS\STREETS\HarneyGradeSeparation\Project\CAward HLGS Terracon Baker PSA.doc 2/22/2016 AGREEMENT FOR PROFESSIONAL SERVICES ARTICLE 1 PARTIES AND PURPOSE Section 1.1 Parties THIS AGREEMENT is entered into on , 2016, by and between the CITY OF LODI, a municipal corporation (hereinafter "CITY"), and TERRACON (hereinafter "CONTRACTOR"). Section 1.2 Purpose CITY selected the CONTRACTOR to provide the services required in accordance with attached Scope of Services, Exhibit A, attached and incorporated by this reference. CITY wishes to enter into an agreement with CONTRACTOR for construction testing and inspection services (hereinafter "Project") as set forth in the Scope of Services attached here as Exhibit A. CONTRACTOR acknowledges that it is qualified to provide such services to CITY. ARTICLE 2 SCOPE OF SERVICES Section 2.1 Scope of Services CONTRACTOR, for the benefit and at the direction of CITY, shall perform the Scope of Services as set forth in Exhibit A. Section 2.2 Time For Commencement and Completion of Work CONTRACTOR shall commence work pursuant to this Agreement, upon receipt of a written notice to proceed from CITY or on the date set forth in Section 2.6, whichever occurs first, and shall perform all services diligently and complete work under this Agreement based on a mutually agreed upon timeline or as otherwise designated in the Scope of Services. CONTRACTOR shall submit to CITY such reports, diagrams, drawings and other work products as may be designated in the Scope of Services. CONTRACTOR shall not be responsible for delays caused by the failure of CITY staff to provide required data or review documents within the appropriate time frames. The review time by CITY and any other agencies involved in the project shall not be counted against CONTRACTOR's contract performance period. Also, any delays due to 1 weather, vandalism, acts of God, etc., shall not be counted. CONTRACTOR shall remain in contact with reviewing agencies and make all efforts to review and return all comments. Section 2.3 Meetings CONTRACTOR shall attend meetings as may be set forth in the Scope of Services. Section 2.4 Staffing CONTRACTOR acknowledges that CITY has relied on CONTRACTOR's capabilities and on the qualifications of CONTRACTOR's principals and staff as identified in its proposal to CITY. The Scope of Services shall be performed by CONTRACTOR, unless agreed to otherwise by CITY in writing. CITY shall be notified by CONTRACTOR of any change of Project Manager and CITY is granted the right of approval of all original, additional and replacement personnel at CITY's sole discretion and shall be notified by CONTRACTOR of any changes of CONTRACTOR's project staff prior to any change. CONTRACTOR represents it is prepared to and can perform all services within the Scope of Services (Exhibit A) and is prepared to and can perform all services specified therein. CONTRACTOR represents that it has, or will have at the time this Agreement is executed, all licenses, permits, qualifications, insurance and approvals of whatsoever nature are legally required for CONTRACTOR to practice its profession, and that CONTRACTOR shall, at its own cost and expense, keep in effect during the life of this Agreement all such licenses, permits, qualifications, insurance and approvals, and shall indemnify, defend and hold harmless CITY against any costs associated with such licenses, permits, qualifications, insurance and approvals which may be imposed against CITY under this Agreement. Section 2.5 Subcontracts Unless prior written approval of CITY is obtained, CONTRACTOR shall not enter into any subcontract with any other party for purposes of providing any work or services covered by this Agreement. Section 2.6 Term The term of this Agreement commences on April 1, 2016 and terminates upon the completion of the Scope of Services or on March 31, 2018, whichever occurs first. 2 ARTICLE 3 COMPENSATION Section 3.1 Compensation CONTRACTOR's compensation for all work under this Agreement shall conform to the provisions of the Fee Proposal, attached hereto as Exhibit B and incorporated by this reference. CONTRACTOR shall not undertake any work beyond the scope of this Agreement unless such additional work is approved in advance and in writing by CITY. Section 3.2 Method of Payment CONTRACTOR shall submit invoices for completed work on a monthly basis, or as otherwise agreed, providing, without limitation, details as to amount of hours, individual performing said work, hourly rate, and indicating to what aspect of the Scope of Services said work is attributable. CONTRACTOR's compensation for all work under this Agreement shall not exceed the amount of the Fee Proposal. Section 3.3 Costs The Fee Proposal shall include all reimbursable costs required for the performance of the Scope of Services. Payment of additional reimbursable costs considered to be over and above those inherent in the original Scope of Services shall be approved in advanced and in writing, by CITY. Section 3.4 Auditing CITY reserves the right to periodically audit all charges made by CONTRACTOR to CITY for services under this Agreement. Upon request, CONTRACTOR agrees to furnish CITY, or a designated representative, with necessary information and assistance needed to conduct such an audit. CONTRACTOR agrees that CITY or its delegate will have the right to review, obtain and copy all records pertaining to performance of this Agreement. CONTRACTOR agrees to provide CITY or its delegate with any relevant information requested and shall permit CITY or its delegate access to its premises, upon reasonable notice, during normal business hours for the purpose of interviewing employees and inspecting and copying such books, records, accounts, and other material that may be relevant to a matter under investigation for the purpose of determining compliance with this requirement. CONTRACTOR further agrees to maintain such records for a period of three -(3) -years -after- final -payment -under -this -Agreement, 3 ARTICLE 4 MISCELLANEOUS PROVISIONS Section 4.1 Nondiscrimination In performing services under this Agreement, CONTRACTOR shall not discriminate in the employment of its employees or in the engagement of any sub CONTRACTOR on the basis of race, color, religion, sex, sexual orientation, marital status, national origin, ancestry, age, or any other criteria prohibited by law. Section 4.2 ADA Compliance In performing services under this Agreement, CONTRACTOR shall comply with the Americans with Disabilities Act (ADA) of 1990, and all amendments thereto, as well as all applicable regulations and guidelines issued pursuant to the ADA. Section 4.3 Indemnification and Responsibility for Damage CONTRACTOR to the fullest extent permitted by law, shall indemnify and hold harmless CITY, its elected and appointed officials, directors, officers, employees and volunteers from and against any claims, damages, losses, and expenses (including reasonable attorney's fees and costs), arising out of performance of the services to be performed under this Agreement, provided that any such claim, damage, loss, or expense is caused by the negligent acts, errors or omissions of CONTRACTOR, any subcontractor employed directly by CONTRACTOR, anyone directly or indirectly employed by any of them, or anyone for whose acts they may be liable, except those injuries or damages arising out of the active negligence, sole negligence, or sole willful misconduct of the City of Lodi, its elected and appointed officials, directors, officers, employees and volunteers. CITY may, at its election, conduct the defense or participate in the defense of any claim related in any way to this indemnification. If CITY chooses at its own election to conduct its own defense, participate in its own defense, or obtain independent legal counsel in defense of any claim related to this indemnification, CONTRACTOR shall pay all of the costs related thereto, including without limitation reasonable attorney fees and costs. The defense and indemnification obligations required by this Agreement are undertaken in addition to, and shall not in any way be limited by the insurance obligations set forth herein. Section 4.4 No Personal Liability Neither the City Council, nor any other officer or authorized assistant or agent or City employeeshall -bepersonally--responsible for --any liability- arising_ under -this Agreement. 4 Section 4.5 Responsibility of CITY CITY shall not be held responsible for the care or protection of any material or parts of the work described in the Scope of Services prior to final acceptance by CITY, except as expressly provided herein. Section 4.6 Insurance Requirements for CONTRACTOR CONTRACTOR shall take out and maintain during the life of this Agreement, insurance coverage as set forth in Exhibit C attached hereto and incorporated by this reference. Section 4.7 Successors and Assigns CITY and CONTRACTOR each bind themselves, their partners, successors, assigns, and legal representatives to this Agreement without the written consent of the others. CONTRACTOR shall not assign or transfer any interest in this Agreement without the prior written consent of CITY. Consent to any such transfer shall be at the sole discretion of CITY. Section 4.8 Notices Any notice required to be given by the terms of this Agreement shall be in writing signed by an authorized representative of the sender and shall be deemed to have been given when the same is personally served or upon receipt by express or overnight delivery, postage prepaid, or three (3) days from the time of mailing if sent by first class or certified mail, postage prepaid, addressed to the respective parties as follows: To CITY: City of Lodi 221 West Pine Street P.O. Box 3006 Lodi, CA 95241-1910 Attn: Gary Wiman To CONTRACTOR: Terracon 902 Industrial Way Lodi, CA 95240 Attn: Troy M. Schiess Section 4.9 Cooperation of CITY CITY shall cooperate fully and in a timely manner in providing relevant information it has at its disposal relevant to the Scope of Services. Section 4.10 CONTRACTOR is Not an Employee of CITY CONTRACTOR agrees that in undertaking the duties to be performed under this Agreement, it shall act as an independent contractor for and on behalf of CITY and not an employee of CITY. CITY shall not direct the work and means for accomplishment of 5 the services and work to be performed hereunder. CITY, however, retains the right to require that work performed by CONTRACTOR meet specific standards without regard to the manner and means of accomplishment thereof. Section 4.11 Termination CITY may terminate this Agreement, with or without cause, by giving CONTRACTOR at least ten (10) days written notice. Where phases are anticipated within the Scope of Services, at which an intermediate decision is required concerning whether to proceed further, CITY may terminate at the conclusion of any such phase. Upon termination, CONTRACTOR shall be entitled to payment as set forth in the attached Exhibit B to the extent that the work has been performed. Upon termination, CONTRACTOR shall immediately suspend all work on the Project and deliver any documents or work in progress to CITY. However, CITY shall assume no liability for costs, expenses or lost profits resulting from services not completed or for contracts entered into by CONTRACTOR with third parties in reliance upon this Agreement. Section 4.12 Confidentiality CONTRACTOR agrees to maintain confidentiality of all work and work products produced under this Agreement, except to the extent otherwise required by law or permitted in writing by CITY. CITY agrees to maintain confidentiality of any documents owned by CONTRACTOR and clearly marked by CONTRACTOR as "Confidential" or "Proprietary", except to the extent otherwise required by law or permitted in writing by CONTRACTOR. CONTRACTOR acknowledges that CITY is subject to the California Public Records Act. Section 4.13 Applicable Law, Jurisdiction, Severability, and Attorney's Fees This Agreement shall be governed by the laws of the State of California. Jurisdiction of litigation arising from this Agreement shall be venued with the San Joaquin County Superior Court. If any part of this Agreement is found to conflict with applicable laws, such part shall be inoperative, null, and void insofar as it is in conflict with said laws, but the remainder of this Agreement shall be in force and effect. In the event any dispute between the parties arises under or regarding this Agreement, the prevailing party in any litigation of the dispute shall be entitled to reasonable attorney's fees from the party who does not prevail as determined by the San Joaquin County Superior Court. 6 Section 4.14 City Business License Requirement CONTRACTOR acknowledges that Lodi Municipal Code Section 3.01.020 requires CONTRACTOR to have a city business license and CONTRACTOR agrees to secure such license and pay the appropriate fees prior to performing any work hereunder. Section 4.15 Captions The captions of the sections and subsections of this Agreement are for convenience only and shall not be deemed to be relevant in resolving any question or interpretation or intent hereunder. Section 4.16 Integration and Modification This Agreement represents the entire understanding of CITY and CONTRACTOR as to those matters contained herein. No prior oral or written understanding shall be of any force or effect with respect to those matters covered hereunder. This Agreement may not be modified or altered except in writing, signed by both parties. Section 4.17 Contract Terms Prevail All exhibits and this Agreement are intended to be construed as a single document. Should any inconsistency occur between the specific terms of this Agreement and the attached exhibits, the terms of this Agreement shall prevail. Section 4.18 Severability The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. Section 4.19 Ownership of Documents All documents, photographs, reports, analyses, audits, computer media, or other material documents or data, and working papers, whether or not in final form, which have been obtained or prepared under this Agreement, shall be deemed the property of CITY. Upon CITY's request, CONTRACTOR shall allow CITY to inspect all such documents during CONTRACTOR's regular business hours. Upon termination or completion of services under this Agreement, all information collected, work product and documents shall be delivered by CONTRACTOR to CITY within ten (10) calendar days. CITY agrees to indemnify, defend and hold CONTRACTOR harmless from any liability resulting from CITY's use of such documents for any purpose other than the purpose -for -which -they -were- intended. 7 Section 4.20 Authority The undersigned hereby represent and warrant that they are authorized by the parties to execute this Agreement. Section 4.21 Federal Transit Funding Conditions ❑ If the box at left is checked, the Federal Transit Funding conditions attached as Exhibit D apply to this Agreement. In the event of a conflict between the terms of this Agreement or any of its other exhibits, and the Federal Transit Funding Conditions, the Federal Transit Funding Conditions will control. IN WITNESS WHEREOF, CITY and CONTRACTOR have executed this Agreement as of the date first above written. ATTEST: CITY OF LODI, a municipal corporation JENNIFER M. FERRAIOLO STEPHEN SCHWABAUER City Clerk City Manager APPROVED AS TO FORM: TERRACON JANICE D. MAGDICH, City Attorney By: By: Name: Troy M. Schiess Title: Materials Department Manager Attachments: Exhibit A — Scope of Services Exhibit B — Fee Proposal Exhibit C — Insurance Requirements Exhibit D — Federal Transit Funding Conditions (if applicable) Funding Source: PWST-0009.Const.ExtLabor 30799000.77020 (Business Unit & Account No.) Doc ID:K:\WP\PROJECTS\PSA's\2016\Terracon HLGS.doc CA:Rev.01.2015 8 Grade Separation Harney Lane at UPRR Overhead Project Terracon Scope of Services Exhibit A Provide Construction Testing and Inspection Services as stated in the Request For Proposal dated 10/21/15, the construction contract documents and CALTRANS requirements. 2/5/2013 CITY OF LODI DEPARTMENT OF PUBLIC WORKS REQUEST FOR PROPOSALS for Construction Testing and Inspection Services for the GRADE SEPARATION HARNEY LANE at UPRR OVERHEAD PROJECT Federal ID #STPL-5154 (040) Please Submit Proposals to: City of Lodi Public Works Department P.O. Box 3006 (221 West Pine Street) Lodi, CA 95241 (95240) Attn: Gary R. Wiman, Construction Project Manager Deadline for Submittal of Proposals No later than 5:00 n.m. on Friday, November 20. 2015 TABLE OF CONTENTS Section Pon Introduction 2 PART A Information 6 PART B Pricing Form 11 PART C Scope of Services 16 Evaluation Criteria 19 Attachments 21 1. Sample Contract with Indemnification and Insurance Requirements 2. Required Federal Form Submittals 3. Forms Required upon Execution of Agreement 4. Specification Section 01400 - Quality Control 5. Specification Section 01410 — Testing 6. Request and Approval for Testing Services (Form) 7. Detail Breakdown (Billing Report) 1 ICAWPWROJECIMSTREETNIarneyGratteSeparationTrojectWianiey Lane Grade Separation TI RPP 10-21-15.doc INTRODUCTION Harney Lane is a two-lane east -west urban collector near the City of Lodi's southem city limit. It intersects the Union Pacific Railroad approximately 3/4 miles west of State Route 99. The City of Lodi recently adopted a Specific Plan for Harney Lane which reclassified it as a four -lane divided expressway. The City of Lodi is also planning several improvement projects along the Harney Lane corridor between Lower Sacramento Road to the west and State Route 99 to the east. This combined with the improvements to Harney Lane at State Route 99 that were recently constructed will increase the usage of Harney Lane. Keeping the existing at -grade railroad crossing along Harney Lane would cause significant traffic congestion, with a compound effect on surrounding intersections and the State Route 99/ Harney Lane interchange. The construction of a railroad grade separation at this location will be an integral piece of the planned improvements to Harney Lane. The City of Lodi ("City") is soliciting sealed proposals from qualified firms to provide Construction Testing and Inspection Services for the Grade Separation Harney Lane at UPRR Overhead Project. The Scope of Services shall include, but is not limited to: the furnishing of quality assurance testing, laboratory and related inspection services during the construction. This work will include all coordination with the City of Lodi, Caltrans, Design Engineers and contractor. The purpose of this procurement is to select the most qualified firm to enter into a contract with the City to provide Constriction Testing and Inspection Services for construction of the Grade Separation Harney Lane at UPRR Overhead Project. The City is seeking consultants with previous experience in grade separation project work, depth of resources, and sensitivity to the local and regulatory issues. Firms should have knowledge of the City's Standard Plans and Design Standards, as well as knowledge of the BNSF/UPRR Guidelines for Railroad Grade Separation Projects, AASHTO Design Guidelines, Caltrans Highway Design Manual, Caltrans Bridge Design Manuals, Caltrans Standard Plans, and Caltrans Standard Specifications. RFP documents package can be obtained via email by requesting them at either gwiman@lodi.gov or Pwdepttlodi.gov. A PDF file of the RFP will be emailed SCHEDULE The City has established the following dates for this RFP: RFP released Proposals due Proposals evaluated by review team Interviews of short-listed firms (if necessary) Award recommendation to City Council Contract Execution/Work Commences October 22, 2015 November 20, 2015 November 23- December 10, 2015 December 15, 2015 January 20, 2016 February 1, 2016 This schedule is subject to change and can be affected by various intervening events. PREVAILING WAGE REQUIREMENTS The services described herein are considered "public works" as defined by California Labor Code Section 1720 et seq. Any Consultant awarded a contract as the result of this RFP shall be responsible for compliance with all applicable prevailing wage laws, as well as any and all 2 K:\wP\PROJECcS STREE S1HeraeyaradcSeparadanWrojecdHemey lane Grade Separation TI RFP 1 O-21-15.doc applicable state or federal wage laws, for services under the Consultant's contract. PROPOSAL FORMAT Each response to this RFP shall include the information described in this section. Provide the information in the order specified and use tabs to identify the different sections of your proposal. Failure to include all of the elements specified may be cause for rejection. Additional information may be provided but should be succinct and relevant to the goals of this RFP. Excessive information will not be considered favorably. Document pages shall be 8-1/2 inches by 11 inches in size or folded to such a size. Proposals shall have a maximum of 30 pages, not including the cover letter, index and resumes, and shall contain the following elements, in the order given: Cover Letter with the following information: 1. Title of this Request for Proposal 2. Name and mailing address of firm (include physical location if mailing address is a P.O. Box) 3. Contact person, telephone number, fax number and e-mail address 4. A statement that the submitting firm will perform the services as described in the Scope of Work. 5. Acknowledgement that all proposals may be considered public information. Subsequent to award of this RFP, all or part of any submittal may be released to any person or firm who may request it. Therefore, proposers shall specify in their Cover Letter if any portion of their submittal should be treated as proprietary and not releasable as public information. Proposers should be aware that all such requests may be subject to legal review and challenge. Note: Cost proposals shall be treated as proprietary and shall not be released as public information. Signatory Requirements - The Cover Letter must be signed by an officer empowered by the proposing firm to sign such material and thereby commit the proposing firm to the obligations contained in the RFP response. Further, the signing and submission of a response shall indicate the intention of the proposer to adhere to the provisions described in this RFP and a commitment to enter into a binding contract. • Proposals which are submitted on behalf of a Corporation shall have the correct corporate name thereon and the actual signature of the authorized officer of the corporation written (not typed) below the corporate name. The title of the office held by the person signing for the corporation shall appear below the signature of the officer. • Proposals which are submitted by an individual doing business under a firm name (" dba") shall be signed in the name of the individual doing business under the proper firm name and style. PROPOSAL SUBMITTAL INSTRUCTIONS • One (1) original and three (3) copies of your Proposal and one (1) copy of your Cost -Proposal in a -separate sealed envelope, shalLbe_receivedby the_City of Lodi Public Woks Department not later than -the -date an the cover 3 KAWFAPROJECISASTREEralameYeradacParationTroiecallarn67 Lane Grade Separation Tl RFP 10-21-15.doa page of this RFP. Faxed and/or emailed proposals shall not be accepted. All proposals shall be submitted in a sealed envelope or container, and clearly marked with the RFP title. • Proposals must be submitted ONLY to: City of Lodi Public Works Department Attn: Gary R. Wiman, Construction Project Manager P.O. Box 3006 (221 West Pine Street) Lodi, CA 95241-1910 (95240) • Late proposals will not be accepted or considered. The City of Lodi shall not be responsible for proposals delivered to a person or location other than that specified in this RFP. • All proposals, whether selected or rejected, shall become the property of the City of Lodi and will not be returned. • All costs associated with proposal preparation shall be borne by the proposer. • All proposals shall remain firm for one hundred eighty (180) days following the closing date for the receipt of proposals. The Project Location is identified in the project location map included herein as Figure 1. 4 KAWMPROJECTSASTREETSWarneyOradeSeparaliedtProjectliarney Lane Grade SeparMian TI RFP 10-21-t5.dac Figure 1 Vicinity Map Grade Separation: Harney Lane at Union Padflc Railroad wt,odbad i wooaenata eao Nofl1 Mame iVoO dhtaxed Woodat Ole t ..d 141116 Lad flit Paq4 L_ = aI kir Lemma IN W leo et W Einar 1.444/1410 Path 1 w tit weave Lodi (EDa Begawan La WW/Mmaf tw a Krol""'"n t" LOOMrpMk S. Plow — W Koper Project gram Magma MI M..is.sand • 5 W..Wwpaya vitae AO 12 ChMeN• Ventovi Para a Hoag Lw E LIM OM RA KAWPWROJECTS1STRERTSITIanteyaradeSeparationWrojeediarney Lone Grade Separation TI RFP 10-21-15.doe 1 It Maw la PART A Information SECTION 1. NOTICE Notice is hereby given that the City of Lodi will receive Qualification Statements and Pricing Proposals for the furnishing of quality assurance testing, laboratory and related inspection services during the construction of the Grade Separation Harney Lane at UPRR Overhead Project. Each firm is requested to provide a proposal consisting of two sealed envelopes, one marked "QUALIFICATIONS" and the other marked "RFP PRICING PROPOSAL". Questions regarding this proposal and scope of work should be directed to Gary R. Wiman, Project Manager, at (209) 333-6706. Qualifications and Proposals are due by 5:00 pm. on Friday, November 20, 2015. The Grade Separation Harney Lane at UPRR Overhead Project will be Federally funded, any Consultant awarded the contract must work with the City to be sure all required forms, certifications, licenses and documentation is cohesive with the timing and requirements as set forth in the Federal funding guidelines. RFP Documents. RFP documents package can be obtained via email by requesting them at either gwiman@lodi.gov or Pwdept@lodi.gov. A PDF file of the RFP will be emailed. SECTION 2. PROJECT SCOPE Projects contemplated tinder this agreement include the Grade Separation Harney Lane at UPRR Overhead Project, including the construction of a new three -span, cast in place, post tensioned concrete box girder approximately 248 feet long and 88 feet wide to grade separate Harney Lane at the Union Pacific Rail Road track. Work includes signal modifications (temporary & permanent), drainage and utility installation, street lighting, landscaping, construction of raised medians, curb gutter and sidewalk, and other incidental and related work, in accordance with Plans and Specifications for Grade Separation Harney Lane at UPRR Overhead Project. The project plans (drawings) and specifications and working details and other contract documents are on file with the Director of Public Works, City Hall, 221 West Pine Street, Lodi. Construction is expected to begin in February 2016, and last for approximately 18 months. Be advised that the City may elect to use the testing firm on other City construction projects during this time. Selected firm will be required to honor pricing submitted as a part of this proposal. SECTION 3. OUALIFICATION CONSULTANT The Consultant is required to demonstrate an ability to perform with a high level of expertise in order to be found qualified. Failure to submit such information will result in the rejection of the proposal. The following information must be submitted by the Consultant in a separately sealed envelope marked "QUALIFICATION". No pricing information will be included with the Qualification, but will be provided in a second separately sealed envelope marked "RFP PRICING PROPOSAL". 1. Information demonstrating adequate financial resources to perform the contract or the ability to obtain them as required for performance (example being a copy of the company financial statement). 2. Information demonstrating ability to meet the performance schedule of the contract as compared with other business commitments. Include a listing of all ongoing and planned work in addition to the Grade Separation Harney Lane at UPRR Overhead Project. List current number of employed field staff at the Office serving this project. 6 KAWMPROJECTS \STREETS WameyOradeSeparationTroject1Hamey lane (rade Sedation TI RFP 10-21-15.doc 3. Information demonstrating a satisfactory record of professionalism and performance. The Consultant will provide information answering the following questions: a. Has the Consultant ever been terminated for default? Explain. b. Has the Consultant provided testing services of similar scale and scope (list three or more equivalent projects within the last ten years)? c. Has a Caltrans approved testing laboratory (Soils, concrete and Asphalt) within 100 miles of the project. Provide date of last inspection by Caltrans. d. Has a current AMRL certification? e. Is the Consultant recognized by the ICC Joint Committee on Special Inspection? f. Who are the designated supervising staffP.E. and Project Manager? Provide resumes and an organizational chart showing all staffthat will work on the project. g. Provide resumes of currently employed certified (ICC, RCI, AWS, CALTRANS, etc.) staff inspectors who may be assigned to this project. 5. Information demonstrating a satisfactory record of integrity. Provide a list of client reference names, telephone numbers, and applicable projects. 6. Information demonstrating they have the necessary construction and technical equipment and facilities or ability to obtain them. List laboratory location where work for this project will be administered. List laboratory location where materials for this project will be tested. SCOPE OF WORK The Consultant shall have the ability to deliver a wide range of services including, but not limited to: Construction Inspection, testing and laboratory testing as required by the contract documents, building codes, Caltrans and funding sources. The Consultant will report to and assist the Construction Project Manager, who will act as the Resident Engineer for this project. A sample contract is provided as Attachment 1. Listed below are tasks the consultant is expected to incorporate in the proposed scope of services. It is not intended that the tasks included below comprise a comprehensive list or are the only tasks required for this project. Each consultant firm should, based on its expertise, develop a comprehensive and detailed scope of services necessary to complete the deliverables listed in this section of the RFP. Table of Contents of material included in the proposal - This index must include a clear definition of the material and be identified by sequential page numbers. Organization Chart - Provide your firm's organization chart designating specific staff members to be assigned to this contract. Include the firth's organizational structure and size variation of employees in the past five years. Also provide a project -specific organizational chart identifying services which would be completed by your firm's staff and those provided by subconsultants. Experience of Firm and References - Provide a summary of the firm's experience with similar projects, including the date and a brief description of the project. The description is to include, at a minimum, an outline of the complexities of the project, the firm's approach to the project. Related experience to high-profile, fast-track, public -sensitive, local agency projects of similar size and magnitude should be included in this summary. Provide no more than three project references for related projects, including date of project, consultant staff that worked on the 7 KAWPWROJECTASTRBETS \ThroseyGradeSeparatiooTrojectUlarney Lane Grade Separation TI RPP 1 O-21-15.doc project, contact person and phone number. Preference is given to project references that have directly worked with proposed staff. Proposed Staff - Provide a brief summary of the qualifications/experience of each team member and how the experience applies to this project, preferably not more than one page per team member, to include length of service with the firm and resume. Provide names of project manager and individuals authorized to negotiate contract on behalf of consulting firm. Required Statements - Include statements of assurance for the following requirements: • Non -substitution for the designated members of the proposed staff members without prior approval by the City • Conflict of Interest • Ability to fulfill the indemnification and insurance requirements contained in the sample contract (Attachment 1). Please note that actual Certificates of Insurance are not required as part of your submittal. • A Disadvantaged Business contract goal of 15% has been determined for this project. The required Federal forms are listed below. These forms shall be filled out and submitted with the Drowse'. Copies and instructions are provided in Attachment 2. o Exhibit 10-I Notice to Proposers DBE Information o Exhibit 10-K Certification of Financial Management System and Contract Costs o Exhibit 10-01 Local Agency Consultant DBE Commitment (Consultant Contracts) o Exhibit 10-Q Disclosure of Lobbying Activities o Exhibit 10-U Consultant in Management Position Conflict of Interest and Confidentiality Statement o Exhibit 12-B Bidder's List of Subcontractors (DBE and Non -DBE) - Part I and Part II o Exhibit 15-H UDBE Information - Good Faith Efforts • The following Federal forms are required upon execution of agreement with Consultant. Copies and instructions are provided in Attachment 3. o Exhibit 10-02 Local Agency Consultant DBE Information o Exhibit 17-F Final Report - Utilization of DBEs o Exhibit 17-0 DBE Certification Status Change SECTION 4. RFP PRICING DOCUMENTS RFP pricing shall be delivered in a separately sealed envelope marked "RFP PRICING PROPOSAL" and shall be made upon the special proposal (RFP Pricing Form) with all items completely filled out; numbers shall be stated in figures, the signature of the proposer shall be in longhand. The completed form should be without modifications, interlineations, alterations, or erasures. No qualification information will be contained in the RFP Pricing envelope. Do not qualify pricing. Qualified pricing will be rejected as non- responsive. Pricing is required to be prepared in accordance with Federal and State guidelines showing companies CPA audited overhead rates per Title 48 Code of Federal Regulations (CFR), Part 31, Contracts Cost Principles and Procedures. Each individual proposed for the project should include a —ia1 chig table per -California ADM -2033- (rev -10112) -showing -their labor- rates fringe,— overhead, and fee. Attach additional sheets as may be required to provide this information. The 8 ICAWAPROJECTS1STRERTSVIanieyGradeSeparationTrojcefflarney Lane Grade Sion TI RFP 10-21-15.doc Consultant shall perform the work contemplated with resources available within its own organization and no portion of the work shall be subcontracted without written authorization by the City Contract Manager. The City of Lodi has determined that this project falls under the guidelines for prevailing wage requirements. All personnel working on this project are entitled to the prevailing wage as set by the State of California Department of Industrial relations. By submission of this proposal: The Contractor agrees to conform to the provisions of Chapter 1, Part 7, Division 2 of the Labor Code. The Contractor and any Subcontractor will pay the general prevailing wage rate and other employer payments for health and welfare, pension, vacation, travel time, and subsistence pay, apprenticeship or other training programs. The responsibility for compliance with these Labor Code requirements is on the Contractor. The City of Lodi requires the submission of certified payroll records monthly with the billing request. Each pricing proposal shall be in accordance with the attached sample contract and scope of work, and with applicable codes. Cost Proposal- Submit one (1) copy of proposed hourly rate(s), with not -to -exceed totals for each of the tasks identified in the Scope of Work. The Cost Proposal shall be submitted in a separate sealed envelope, clearly marked with the name of your firm, the name of the project, and identified as "Cost Proposal". The Cost Proposal does not apply to the page count. Cost proposals shall be treated as proprietary and shall not be released as public information. Cost proposals of those firms not awarded the RFP shall be destroyed SECTION 5. SUBMISSION OF PROPOSALS Proposals including two separately sealed envelopes marked "QUALIFICATION STATEMENTS" and "RFP PRICING PROPOSAL" shall be submitted to the City of Lodi at the place indicated in the Request For Proposal. It is the sole responsibility of the proposer to see that his proposal is received in proper time. All proposals shall be submitted under separately sealed cover, plainly identified as "Request for Proposals for Testing Services - Grade Separation Harney Lane at UPRR Overhead Project " and addressed as directed in this Notice. Failure to do so may result in a premature opening of, ora failure to open such proposals. Proposals which are not properly marked may be disregarded. Oral, telephonic, or telegraphic proposals are invalid and will not receive consideration. The City reserves the right to reject any and all proposals and/or waive any irregularity in any proposal received. No respondent may withdraw his proposal for a period of sixty days after the date set for submission of the proposals. The proposer shall carefully examine the instructions contained herein and satisfy himself as to the conditions with which he must comply prior to submitting his proposal, and to the conditions affecting the award of contract. SECTION 6. WITHDRAWAL OF PROPOSALS Any proposal may be withdrawn at any time prior to the time fixed in the) public notice for the submission of proposals, provided that a request in writing, executed by the proposer or his duly authorized representative, for the withdrawal of such proposal is flied with the City's Public Works Department. An oral, telegraphic or telephonic request to withdraw a proposal is not acceptable. The withdrawal of a proposal shall not prejudice the right of a Consultant to file a new proposal. SECTION7. IRREGULAR PROPOSALS 9 KAWMPROJECTS1STREETS1HameyeradeSeparationTrojecaHarney Lane Grade Separation T1 RFP 10 21-15.doc Proposals may be rejected if they show any alteration of form, additions not called for, conditional bids, incomplete proposals, erasures, or irregularities of any kind. If proposal amount is changed after the amount is originally inserted, the change should be initialed. If the Qualification contains pricing information, the proposal may be rejected. Proposals demonstrating rates less than the required prevailing wage rate for a particular service will not be accepted. Rates shall include, but not be limited to, all costs associated with the service being provided, including tools, transportation and repotting. Billing will only be for hours actually on site or performing the required tests. No minimum hours will be recognized. ,SECTION 8. AWARD OF CONTRACT The right is reserved to reject any and all proposals. The award of the contract, if it is to be awarded, will be to the most qualified proposer whose proposal complies with all the requirements prescribed. Such award, if made, will be made within sixty days after the submission of the proposals. SECTION 9. EXECUTION OF CONTRACT The contract shall be signed by the successful proposer in duplicate counterpart and returned within five days of receipt, not including Saturdays, Sundays, and legal holidays. No contract shall be binding upon the City until it has been signed and executed by the Contractor and the City. Once fully executed, the City will issue a copy of the contract. End of Part A 10 KAWPWROJECTMSTRBBTS1HinseyOradeSeparetionTinjeeNinmey Lane Gado Separation 11 RFP 10-21-15.doc PART B REQUEST FOR PROPOSAL PRICING FORM proposals are due no later than 5:00 p.m. on: November 20, 2015 Location: City of Lodi Public Works Department Attn: Gary R. Wiman, Construction Project Manager 221 West Pine Street P.O. Box 3006 Lodi, CA 95241-1910 Empatm The undersigned hereby proposes and agrees to furnish any and all required labor, material, transportation, insurance, and incidentals necessary to provide quality assurance testing and inspecting services pertaining to the Grade Separation Harney Lane at UPRR Overhead Project in accordance with the terms and conditions of the Request for Proposal on filo at the City of Lodi, Public Works Department. Proposer declares that the only persons or parties interested in this proposal as principals are those named herein; that this proposal is made without collusion with any other person, firm, or corporation; that the undersigned will contract with the City of Lodi to provide these services in the manner and time prescribed; and that the undersigned will take in full payment therefore an amount based on the unit prices specified herein below for the various services, the total value of said services for the not -to -exceed sum of Dollars. It is understood and agreed that the quantities of services under each item are approximate, being given as a basis of comparison of proposals, and the right is reserved by the City to increase or decrease the amount of work under any item as may be required by the City, in accordance with this agreement. It is further understood and agreed that the total amount of money set forth for each item of work, or as the total amount proposed for the project, does not constitute an agreement to pay a lump sum for these services. The quantities may be increased or decreased depending on the job requirements. IMPORTANT NOTICE If the proposer is a corporation, state legal name of corporation, also names of president, secretary, treasurer, and manager thereof. If a co -partnership, state true name of firm. If an individual, state first and last name in full. Firm Name: By: Dated: 11 K:\WPIPROJECrS STRBEPS1HameyOradeSeparatianWrojectWuney Lane Grade Separation TI RFP 10-21-15.doc : All items must be cuml)leted for )r(»osai to be considered valid. item Description Qty. Unit Field Unit Price Lab Unit Price Total Cost 1 Soils/Asphalt Engineered Fill Observation 800 Hr. Density (Curve) Cal 216 25 Ea. Soil Compaction Testing — Nuclear gauge 800 Hr. Footing Verification Inspection 100 Hr. Road Subgrade/Agg. base compaction Testing 100 Hr. CTM 202 Sieve Analysis 10 Ea. CTM 217 Sand Equivalent 10 Ea. CTM 229 Aggregate Durability 10 Ea. CTM 301 R Value 5 Ea. CTM 382 Asphalt Content Ignition Oven 10 Ea. CTM 309 Max. Specific Gravity HMA Mix 10 Ea. CTM 308 Max. Specific Gravity of Compacted Mix 10 Ea. HMA Mix Design Review 5 Ea. Asphalt Compaction Testing - Nudear Gauge 80 Hr. CTM 375 Asphalt Compaction Testing — Field Coring 40 Hr. Subtotal 12 RAwPWROJDcrs\s REErswameyafadescpamti«n'PrOjaAHEney Lae oraee Sim TT RFP 11}-21-15.doc Item Description Unit Field Unk Price Lab Unit Price Total Cost 2 Cast -In -Place Concrete Mix Design Review - ACI 301 5 Ea. Cement Sampling - ASTM C 183 5 Ea. CTM 521 Compressive Strength Concrete Specimen 80 sets 4 cyl. Tensile/Bend Test - ASTM 615-90 40 Ea. Elongation and Yield/Tensile Strength 40 Ea. Reinforcement Placement Inspection 300 Hr. Drilled Dowel Testing (AASHTO T- 237) 237) 40 Hr. Concrete Placement inspection Including CTM 539, 540, 504, 518, 543, 556 and 557 as required 400 Hr. Concrete Core Testing - ASTM C42 (incl. coring) 10 Ea. Drilled In Anchor Testing 40 Hr. Post Tension Cable Placement 200 Hr. Post Tensioning Inspection 60 Hr. Pick Up and Delivery of samples (separate trips only) 40 Ea./Set Subtotal 13 KAWPWRaBC. SISTREEMHaineyGrade3 anWrojedWemey Lane Grade Scparation T! RFP 10-21-15.doc Item Description Qty. Unit Field Unit Price Lab Unit Price Total Cost 3 Masonry Mortar Testing - UBC Std. 21-16 25 Ea./Set Grout Testing UBC Std. 21-18 25 Ea./Set Mix Design Review/Report 3 Ea. Tensile/Bend Test ASTM 615-90 10 Ea. Masonry Placement Inspection, UBC 1701.5, 7.2 200 Hr. CMU Block or Brick Testing 4 Set of 4 Prisms - UBC Std. 21-17 4 Ea. Subtotal 4 Structural Steel Shop Visual Welding 200 Hr. Field Visual Welding 200 Hr. Shop Fabrication Inspection 200 Hr. Field Bolting (Torque) Inspection w/Reports 100 Hr. Metal Deck Welding 80 Hr. Ultrasonic Testing 100 Hr, Subtotal 5 Other NOT USED Subtotal 14 KAWMPROJECISWIREETSUiarneyGradeSoparationTroject1Haniey Lane Grads Separation T1 RFP 10-21-15.doc Item Description Qty. Unit Field Unit Price Lab Unit Price Total Cost 6 Professional Services Senior Staff Engineer 20 Hr. Field Technician 100 Hr. Lab Technician 80 Hr. Subtotal 7 Miscellaneous Premium Diff. for OT 100 40 Hr, Out -of -Town Inspection (beyond 50 miles) Hr. Mileage (beyond 50 miles) 500 Mile Subsistence (beyond 50 miles) 10 Day Subtotal Grand Total End of Part B 15 KAWMPROJECTSASTREETNIcaneythadeSeperationTrojecMarricy Land Grade Separation TI RAP 10-21-15.doc PART C SCOPE OF SERVICES A. General Requirements 1. Consultant to be a fully qualified testing laboratory meeting the requirements of ASTM E-329 Sections 3 through 8, and Section 11, and recognized by the ICC Joint Committee on Special Inspection and Approved by Caltrans. 2. Consultant shall attend all meetings and conferences as requested by the City or its agent. 3. Cost considerations are not to be considered as justification for breach of sound principles of quality assurance, inspection, and testing. 4. Consultant shall establish and maintain procedures to ensure that persons performing work are certified and skilled in methods and practices needed to assure required quality levels. Remove and replace (at no additional cost to the City) personnel who do not possess the required skills or who are not efficiently and effectively performing their assignments. Provide the Project Manager with resumes of all personnel assigned to the project. 5. Consultant shall be responsible for the quality of the services provided, and shall maintain the necessary facilities and equipment required to satisfy the testing specifications. 6. Consultant shall request a clarification from the Project Manager for missing or ambiguous information or requirements. In the case of conflict in the plans, specifications and/or codes, the more stringent inspection or testing requirement shall apply. 7. Consultant may need to subcontract for certain specialized testing or inspection services. The use of such subconsultant will require prior City approval. 8. The following attachments will form a part of this contract: • Specification Section 01400 - Quality Control • Specification Section 01410 - Testing • Request and Approval for Testing Services (Form) • Detail Breakdown (Billing Report) O. Scope 1. The scope of tests and inspections is based on the requirements of 2006 CALTRANS Standards, other referenced code requirements, and the Grade Separation Harney Lane at UPRR Overhead Project plans and specifications. The services to be provided will be as directed by the City's representative. The Consultant will meet or communicate with the representative and/or construction Contractor periodically to plan and schedule testing and inspection services. 2. The authorization to provide specific services will be issued by the Project Manager using a Testing Services Work Order (Request and Approval for Testing Services form). These work orders will be issued by the City's representative periodically throughout the construction period, as construction activities dictate. The Contractor will not be authorized to place orders directly with the testing firm. The City will not pay for the services placed by the Contractor. The Request and Approval for Testing Services form describes thc required test, location and date required_ It will be requested by the Contractor and forwarded to the City representative for approval. Upon completion of the testing/inspection, the Consultant will sign and date the forms, which will be verified by the City's representative. The Consultant will make a copy of the completed form, which will be attached to the Consultant's billing each month. These serve as the Special Inspector's Time Card and must be signed by the Project Manager each day. The time cards will be used to validate each month's hourly billing. 3. Off-site inspections are to be handled identical to the above except that Special Inspectors shall fax or electronically mail time cards to thc owner's representative each day, without exceptions. 16 KAWMPROJECTSISTREMHarneyGradeSeparalicanProject1Harnay late Grade Section 11 RFP 10 21-u.doc 4. The Consultant will maintain a monthly status report of the budget quantities and costs; quantities and costs expended through previous report period, quantities and costs this report period, and total quantities and costs to date. The status report will be submitted with the monthly billing. C. Time Services shall start upon execution of the agreement and issuance of the first work order. The duration of the Consultant contract will be for a period of TWENTY-FOUR (24) months at the established item prices. D. Notice The Consultant will be given one working day's notice prior to starting any new inspection/testing service. E. Conflict of Interest The Consultant cannot contract directly with construction Contractor for any testing services concerning this City project. F. Item Prices 1. The City is not limited to the use of funds as estimated per item. Unused funds from one item price may roll up to other items as required so long as the total contract award does not exceed 125% of the total proposal price. 2. Any service required, but not referenced in the Proposal for Services listing, to be charged to client using similar unit price for actual hours worked (not "List Price"). G. Reimbursement 1. The Consultant will only be paid for actual hours worked except for a one-hour minimum for show -up time. 2. Travel Costs: The cost of mileage and subsistence charges to and from the project site is included in the item prices. Travel and subsistence charges to factories and fabrication plants in excess of a 50 -mile radius from the job site will be reimbursable by the City only when the City has issued prior written approval thereof. The City will reimburse the Consultant for mileage or airfare whichever is less expensive. The following will apply to determine applicable costs. Travel time will be reimbursed at a field technician level. Actual costs with no overhead or profit will be reimbursed. This level of reimbursement should be reflected in the submitted Proposal for Services. 3. Reproduction and Mailing: Reproduction and mailing costs for reports and test results shall be supplied in the quantity specified in the specification and included as part of the above - listed item prices. Reproduction and shipping costs for additional copies will be reimbursed by the City at actual cost when the City has issued prior written approval therefore. H. Subconsultants Consultant's subconsultants' time shall be paid at Consultant's cost, which should be reflected in the item prices of the submitted Proposal for Services. Prevailing wage requirements must be met. L Billing 17 KAWMPROJECTS1STREFIS1HarneyeradeSeparationWrojecalarney Lane Grade separation TI RFP 10-21-15.doe The Consultant will submit to the Project Manager no later than the first of each month (for services up to the 25th) a computed "Request and Approval for Testing Services" form for all services with each billing. The Consultant will prepare a summary contract form with each billing which provides the following infomtiation for eacb line item of work and for the total contract: "Item, Description, Budgeted Quantity, Unit, Unit Price, Total Budgeted, Previously Billed Units, Current Billing Units, Total Current Billing." End of Part C 18 ICAVJAPROIRCTSISTRRSTSVEianteyaradeSeparatimTrojeadHarney Lane Grade Separation 11 RFP 10-21-15.doo EVALUATION CRITERIA The following evaluation criteria and rating schedule will be used to determine the most highly qualified firm for this project: Maximum Pants Understanding of the work to be done 15 Experience with similar kinds of work 20 Quality of staff available for the work to meet project schedule 25 Capability of Laboratory to meet project schedule 10 Familiarity with state and federal procedures 10 Financial responsibility 10 Demonstrated Technical Ability 10 Total Possible Points 100 SELECTION PROCEDURE Proposals will be reviewed for responsiveness, and responsive proposals will be screened by a selection committee in accordance with the above criteria. The top two firm(s) submitting the highest rated proposal(s) may be invited for interviews. The proposed project manager and project engineer shall represent the firm at the interview. The City reserves the right to make an award without further discussion of the submittal with the offeror. Therefore, the proposal should be submitted initially on the most favorable terms that the firm or individual might propose. The City reserves the right to award a contract to the firm that presents the best qualifications and whose proposal best accomplishes the desired results. The City reserves the right to reject any or all proposals, or to waive minor defects and/or irregularities in said proposals, or to negotiate minor deviations with the successful firm(s). The City shall be the sole judge of the materiality of any such defect or irregularity. GENERAL TERMS AND cONDmONS Exceptions: If the Proposer takes exceptions to the specifications, terms and conditions of this RFP or the Draft Contract, or as amended by any addenda subsequently issued, they must do so in writing. Said exceptions must be submitted with the Proposer's response to this RFP. Failure to do so shall signify acceptance of all specifications, terms and conditions and General Provisions of this RFP and the resulting contract. Standard Contract: Upon completion of the evaluation and recommendation for award, the selected firm will be required to execute a consultant services agreement, a sample of which is included as Attachment 1. Proposers are advised to carefully review the attached contract. Any proposed exceptions, alterations, or amendments shall be clearly specified in a separate letter in your submittal, the nature of which may affect the evaluation of your submittal and the perceived ability to successfully award a contract to your firm/individual. Independent Contractor: At all times the Consultant shall represent himself/herself to be an independent contractor offering such services to the general public and shall not represent htmself/herse or s/employ es, to -be air employee ufthe eity of Lodi. 19 KAWPWROJECTSISTREEMHanieyGradeSeparatienTrojecRliarney Lane Grade separation TI RFP 10-21-15.doc Ownership of Information: All reports, documentation, and material developed or acquired by the Consultant as a direct requirement specified herein shall become the property of the City of Lodi. The Consultant agrees and understands that all discussions with the Consultant and all information gained by the Consultant as a result of the Consultant's performance under the contract, shall be confidential and that no reports, documentation, or material prepared as required by the contract shall be released to the public without the prior written consent of the City. Non -Appropriation: The City may terminate any resulting contract at the end of any fiscal year, June 30th, without further liability other than payment of debt incurred during such fiscal year, should funds not be appropriated by its governing body to continue services for which the contract was intended. Conflict of Interest: The Consultant shall warrant that no official or employee of the City has an interest, has been employed or retained to solicit or aid in the procuring of the resulting contract, nor that any such person will be employed in the performance of such contract without immediate divulgence of such fact to the City. Non -Collusion: Firms submitting proposals shall warrant that their offer is made without any previous understanding, agreement or connection with any person, firm or corporation submitting a separate proposal for the same project and is in an respects fair, without outside control, collusion, fraud or otherwise illegal action. This condition shall not apply to proposals which are submitted by firms who have partnered with others to submit a cooperative proposal that clearly identifies a primary consultant and the associated subconsultants. Indemnification and Insurance Requirements: The indemnification and insurance requirements are provided in Attachment 1. INQUIRIES All general inquiries regarding the RFP process or proposal submission must be directed to: Gary R. Wiman, Construction Project Manager City of Lodi Public Works Department P.O. Box 3006 (221 West Pine Street) Lodi, CA 95241-1910 (95240) Email: gwiman@lodi.gov / Phone: 209-333-6706 Email is the preferred method of receiving inquiries. ATTACHMENTS 1. Sample Contract with Indemnification and Insurance Requirements 2. Required Federal Form Submittals 3. Federal Forms Required upon Execution of Agreements 4. Specification Section 01400 - Quality Control 5. Specification Section 01410 —Testing 6. Request and Approval for Testing Services (Form) 7. Detail Breakdown (Billing Report) 20 KAWP\PROJBCTS\STRBETS1HameyOradoSeparationTrojecMarriey lane Grade Separation TI RFP 10-21-J5.doc Attachment 1 Sample Contract with Indemnification and Insurance Requirements 21 KAWMPROJECTSISTREETSVIameyGradeSepaiationTrojectlflaroey Lane Grade Separation TI RFP 10-21-15.doc AGREEMENT FOR PROFESSIONAL SERVICES ARTICLE 1 PARTIES AND PURPOSE Section 1.1 Parties THIS AGREEMENT is entered into on , 2015, by and between the CITY OF LODI, a municipal corporation (hereinafter "CITY"), and (hereinafter "CONTRACTOR"). Section 1.2 Purpose CITY selected the CONTRACTOR to provide the services required in accordance with attached Scope of Services, Exhibit A, attached and incorporated by this reference. CITY wishes to enter into an agreement with CONTRACTOR for (hereinafter "Project) as set forth in the Scope of Services attached here as Exhibit A. CONTRACTOR acknowledges that it is qualified to provide such services to CITY. ARTICLE 2 SCOPE OF SERVICES Section 2.1 Scope of Services CONTRACTOR, for the benefit and at the direction of CITY, shall perform the Scope of Services as set forth in Exhibit A. Section 2.2 Time For Commencement and Completion of Work CONTRACTOR shall commence work pursuant to this Agreement, upon receipt of a written notice to proceed from CITY or on the date set forth in Section 2.6, whichever occurs first, and shall perform all services diligently and complete work under this Agreement based on a mutually agreed upon timeline or as otherwise designated in the Scope of Services. CONTRACTOR shall submit to CITY such reports, diagrams, drawings and other work products as may be designated in the Scope of Services. CONTRACTOR shall not be responsible for delays caused by the failure of CITY staff to provide required data or review documents within the appropriate time frames. The review time by CITY and any other agencies involved in the project shall not be counted against CONTRACTOR's contract performance period. Also, any delays due to weather, vandalism, acts of God, etc., shall not be counted. CONTRACTOR shall 1 remain in contact with reviewing agencies and make all efforts to review and retum all comments. Section 23 Meetings CONTRACTOR shall attend meetings as may be set forth in the Scope of Services. Section 2.4 Staffing CONTRACTOR acknowledges that CITY has relied on CONTRACTOR's capabilities and on the qualifications of CONTRACTOR's principals and staff as Identified in its proposal to CITY. The Scope of Services shall be performed by CONTRACTOR, unless agreed to otherwise by CITY in writing. CITY shall be notified by CONTRACTOR of any change of Project Manager and CITY is granted the right of approval of all original, additional and replacement personnel at CITY's sole discretion and shall be notified by CONTRACTOR of any changes of CONTRACTOR's project staff prior to any change. CONTRACTOR represents it is prepared to and can perform all services within the Scope of Services (Exhibit A) and is prepared to and can perform all services specified therein. CONTRACTOR represents that it has, or will have at the time this Agreement is executed, all licenses, permits, qualifications, insurance and approvals of whatsoever nature are legally required for CONTRACTOR to practice its profession, and that CONTRACTOR shall, at its own cost and expense, keep in effect during the life of this Agreement all such licenses, permits, qualifications, insurance and approvals, and shall indemnify, defend and hold harmless CITY against any costs associated with such licenses, permits, qualifications, insurance and approvals which may be imposed against CITY under this Agreement. Section 2.5 Subcontracts Unless prior written approval of CITY is obtained, CONTRACTOR shall not enter into any subcontract with any other party for purposes of providing any work or services covered by this Agreement. Section 2.6 Term The term of this Agreement commences on , 20 and terminates upon the completion of the Scope of Services or on , 20 , whichever occurs first. 2 ARTICLE 3 COMPENSATION Section 3.1 Compensation CONTRACTOR's compensation for all work under this Agreement shall conform to the provisions of the Fee Proposal, attached hereto as Exhibit B and incorporated by this reference. CONTRACTOR shall not undertake any work beyond the scope of this Agreement unless such additional work is approved in advance and in writing by CITY. Section 3.2 Prevailing Waste The Contractor agrees to conform to the provisions of Chapter 1, Part 7, Division 2 of the Labor Code. The Contractor and any Subcontractor will pay the general prevailing wage rate and other employer payments for health and welfare, pension, vacation, travel time, and subsistence pay, apprenticeship or other training programs. The responsibility for compliance with these Labor Code requirements is on the prime contractor. Section 3.3 Contractor Registration — Labor Code 41725.5 No contractor or subcontractor may be awarded a contract for public work on a public works project (awarded on or after April 1, 2015) unless registered with the Department of Industrial Relations pursuant to Labor Code section 1725.5. This project is subject to compliance monitoring and enforcement by the Department of Industrial Relations. Section 3.4 Method of Payment CONTRACTOR shall submit invoices for completed work on a monthly basis, or as otherwise agreed, providing, without limitation, details as to amount of hours, individual performing said work, hourly rate, and indicating to what aspect of the Scope of Services said work is attributable. CONTRACTOR's compensation for all work under this Agreement shall not exceed the amount of the Fee Proposal. Section 3.5 Costs The Fee Proposal shall include all reimbursable costs required for the performance of the Scope of Services. Payment of additional reimbursable costs considered to be over and above those inherent in the original Scope of Services shall be approved in advanced and in writing, by CITY. Section 3.6 Auditing 3 CITY reserves the right to periodically audit all charges made by CONTRACTOR to CITY for services under this Agreement. Upon request, CONTRACTOR agrees to fumish CITY, or a designated representative, with necessary information and assistance needed to conduct such an audit. CONTRACTOR agrees that CITY or its delegate will have the right to review, obtain and copy all records pertaining to performance of this Agreement. CONTRACTOR agrees to provide CITY or its delegate with any relevant information requested and shall permit CITY or its delegate access to its premises, upon reasonable notice, during normal business hours for the purpose of interviewing employees and inspecting and copying such books, records, accounts, and other material that may be relevant to a matter under investigation for the purpose of determining compliance with this requirement. CONTRACTOR further agrees to maintain such records for a period of three (3) years after final payment under this Agreement. ARTICLE 4 MISCELLANEOUS PROVISIONS Section 4.1 Nondiscrimination In performing services under this Agreement, CONTRACTOR shall not discriminate in the employment of its employees or in the engagement of any sub CONTRACTOR on the basis of race, color, religion, sex, sexual orientation, marital status, national origin, ancestry, age, or any other criteria prohibited by law. Section 4.2 ADA Compliance In performing services under this Agreement, CONTRACTOR shall comply with the Americans with Disabilities Act (ADA) of 1990, and all amendments thereto, as well as all applicable regulations and guidelines issued pursuant to the ADA. Section 4.3 Indemnification and Responsibility for Damaae CONTRACTOR to the fullest extent permitted by law, shall indemnify and hold harmless CITY, its elected and appointed officials, directors, officers, employees and volunteers from and against any claims, damages, losses, and expenses (including reasonable attorney's fees and costs), arising out of performance of the services to be performed under this Agreement, provided that any such claim, damage, loss, or expense is caused by the negligent acts, errors or omissions of CONTRACTOR, any subcontractor employed directly by CONTRACTOR, anyone directly or indirectly employed by any of them, or anyone for whose acts they may be liable, except those injuries or damages arising out of the active negligence, sole negligence, or sole willful misconduct of the City of Lodi its elected -and -appointed officials direeters offiieers,- 4 employees and volunteers. CITY may, at its election, conduct the defense or participate in the defense of any claim related in any way to this indemnification. If CITY chooses at its own election to conduct its own defense, participate in its own defense, or obtain independent legal counsel in defense of any claim related to this indemnification, CONTRACTOR shall pay all of the costs related thereto, including without limitation reasonable attorney fees and costs. The defense and indemnification obligations required by this Agreement are undertaken in addition to, and shall not in any way be limited by the insurance obligations set forth herein. Section 4.4 No Personal Liability Neither the City Council, nor any other officer or authorized assistant or agent or City employee shall be personally responsible for any liability arising under this Agreement. Section 4.6 Responsibility of CITY CITY shall not be held responsible for the care or protection of any material or parts of the work described in the Scope of Services prior to final acceptance by CITY, except as expressly provided herein. Section 4.6 Insurance Requirements for CONTRACTOR CONTRACTOR shall take out and maintain during the life of this Agreement, insurance coverage as set forth In Exhibit C attached hereto and incorporated by this reference. Section 4.7 Successors and Assigns CITY and CONTRACTOR each bind themselves, their partners, successors, assigns, and legal representatives to this Agreement without the written consent of the others. CONTRACTOR shall not assign or transfer any interest in this Agreement without the prior written consent of CITY. Consent to any such transfer shall be at the sole discretion of CITY. Section 4.8 Notices Any notice required to be given by the terms of this Agreement shall be in writing signed by an authorized representative of the sender and shall be deemed to have been given when the same is personally served or upon receipt by express or overnight delivery, postage prepaid, or three (3) days from the time of mailing if sent by first class or certified mail, postage prepaid, addressed to the respective parties as follows: 5 To CITY: To CONTRACTOR: City of Lodi 221 West Pine Street P.O. Box 3006 Lodi, CA 95241-1910 Attn: Gary Wiman Section 4.9 Cooperation of CITY CITY shall cooperate fully and in a timely manner in providing relevant information it has at its disposal relevant to the Scope of Services. Section 4.10 CONTRACTOR is Not an Employee of CITY CONTRACTOR agrees that in undertaking the duties to be performed under this Agreement, it shall act as an independent contractor for and on behalf of CITY and not an employee of CITY. CITY shall not direct the work and means for accomplishment of the services and work to be performed hereunder. CITY, however, retains the right to require that work performed by CONTRACTOR meet specific standards without regard to the manner and means of accomplishment thereof. Section 4.11 Termination CITY may terminate this Agreement, with or without cause, by giving CONTRACTOR at least ten (10) days written notice. Where phases are anticipated within the Scope of Services, at which an intermediate decision is required conceming whether to proceed further, CITY may terminate at the conclusion of any such phase. Upon termination, CONTRACTOR shall be entitled to payment as set forth in the attached Exhibit B to the extent that the work has been performed. Upon termination, CONTRACTOR shall immediately suspend all work on the Project and deliver any documents or work in progress to CITY. However, CITY shall assume no liability for costs, expenses or lost profits resulting from services not completed or for contracts entered into by CONTRACTOR with third parties in reliance upon this Agreement. Section 4.12 Confidentlallty CONTRACTOR agrees to maintain confidentiality of all work and work products produced under this Agreement, except to the extent otherwise required by law or permitted in writing by CITY. CITY agrees to maintain confidentiality of any documents owned by CONTRACTOR and clearly marked by CONTRACTOR as 'Confidential' or Proprietary, except to the extent otherwise required by law or permitted in writing by 6 CONTRACTOR. CONTRACTOR acknowledges that CITY is subject to the California Public Records Act. Section 4.13 Applicable Law. Jurisdiction. Severability. and Attorney's Fees This Agreement shall be governed by the laws of the State of Califomia. Jurisdiction of litigation arising from this Agreement shall be venued with the San Joaquin County Superior Court. If any part of this Agreement is found to conflict with applicable laws, such part shall be inoperative, null, and void insofar as it is In conflict with said laws, but the remainder of this Agreement shall be in force and effect. In the event any dispute between the parties arises under or regarding this Agreement, the prevailing party in any litigation of the dispute shall be entitled to reasonable attorney's fees from the party who does not prevail as determined by the San Joaquin County Superior Court. Section 4.14 City Business License Requirement CONTRACTOR acknowledges that Lodi Municipal Code Section 3.01.020 requires CONTRACTOR to have a city business license and CONTRACTOR agrees to secure such license and pay the appropriate fees prior to performing any work hereunder. Section 4.15 Captions The captions of the sections and subsections of this Agreement are for convenience only and shall not be deemed to be relevant In resolving any question or interpretation or intent hereunder. Section 4.16 Intearatlon and Modification This Agreement represents the entire understanding of CITY and CONTRACTOR as to those matters contained herein. No prior oral or written understanding shall be of any force or effect with respect to those matters covered hereunder. This Agreement may not be modified or altered except in writing, signed by both parties. Section 4.17 Contract Terms Prevail All exhibits and this Agreement are intended to be construed as a single document. Should any inconsistency occur between the specific terms of this Agreement and the attached exhibits, the terms of this Agreement shall prevail. 7 Section 4.18 Severability The invalidity In whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. Section 4.19 Ownership of Documents All documents, photographs, reports, analyses, audits, computer media, or other material documents or data, and working papers, whether or not in final form, which have been obtained or prepared under this Agreement, shall be deemed the property of CITY. Upon CITY's request, CONTRACTOR shall allow CITY to inspect all such documents during CONTRACTOR's regular business hours. Upon termination or completion of services under this Agreement, all information collected, work product and documents shall be delivered by CONTRACTOR to CITY within ten (10) calendar days. CITY agrees to indemnify, defend and hold CONTRACTOR harmless from any liability resulting from CITY's use of such documents for any purpose other than the purpose for which they were intended. Section 4.20 Authority The undersigned hereby represent and warrant that they are authorized by the parties to execute this Agreement. Section 4.21 Federal Transit Fundlna Conditions 0 If the box at left is checked, the Federal Transit Funding conditions attached as Exhibit D apply to this Agreement. In the event of a conflict between the terms of this Agreement or any of Its other exhibits, and the Federal Transit Funding Conditions, the Federal Transit Funding Conditions will control. IN WITNESS WHEREOF, CITY and CONTRACTOR have executed this Agreement as of the date first above written. 8 CITY OF LODI, a municipal corporation ATTEST: JENNIFER M. FERRAIOLA STEPHEN SCHWABAUER City Clerk City Manager APPROVED AS TO FORM: JANICE D. MAGDICH, City Attomey By: By: Name: Title: Attachments: Exhibit A - Scope of Services Exhibit B - Fee Proposal Exhibit C - Insurance Requirements Exhibit D - Federal Transit Funding Conditions (if applicable) Funding Source: Doc ID: CA:Rev.O1.2015 (Business Unit & Account No.) 9 'Exhibit C Insurance Renulramartts far Goreullslrt_ The Contractor shall take out and maintain during the life of this Agreement, insurance coverage es listed below. 'These Insurance policies shall protect Contractor and any subcontractor performing work covered by this Agreement from claims for daaneges for personal injury, including accidental death, es well as from claims for property damages, which may arise from Contractoes operations under this Agreement, whether such operations be by Contractor, or by any subcontractor, or by anyone directly or indirectly employed by either of them, and the amount of such insurance shell be as follows: 1. COMPREHENSIVE GENERAL UABIUTY 31,000,000 Each Occurrence $2,000,000 General Aggregate 2. COMPREHENSIVEAUTQMOBILE UABIUTY $1,000,000 Combined Single Lima Such Insurance shall cover liability arising out of any vehicle (including, owned, hired and non -hired vehicles) operated in performing any and all services pursuant to thls Agreement. Coverage shall be written on 1S0 form CA 00 01 12 90. or a later version, that provides lability coverage et least as broad as this form. All limits are to be designated strictly for the City of Lodi, Its elected and appointed boards, commissions, officers, agents, employees, end volunteers. All deductibles or self-insured retentions (SIR) must be disclosed to City's Riek Manager for approval and shall not reduce the limits of liability set forth hereinabove. Insurance policies containing any deductible or SIR provision shall provide, or be endorsed to provide, that the deductible or SIR may be satisfied by either the Named Insured(e) or the City of Lodi. It Is required that any available assurance proceeds broader than or in excess of the specified minimum Insurance coverage requirements andfor limits sat forth above, shall be available to City as an additional insured. Furthermore, the requirements for coverage and limits shall be (I) the minimum coverage and limits specified In these Insurance requirements; ar (!i) the broader coverage and maximum limits of coverage of any insurance policy or proceeds available to the Contractor, whichever is greater. Contractor agrees end stipulates that any insurance coverage provided to the City of Lodl shall provide for a clahns period following termination of overage which is at least consistent with the clans period or statutes of imitations found in the California Tort Claims Act (California Government Code Section 810 et seq.). A copy of the certificate(s) of insurance with the following endorsements shall be furnished to the Ctty: (a) Additional Named Insured Endorsement Pursuant to a separate endorsement (ISO form CO 2010 (11035) or a rater version, that provides liability coverage at least as broad as this form) such Insurance as is afforded by this policy shall also apply to the City of Lodi, its elected and appointed boards, commissions, officers, agents, employees, and volunteers as additional named insureds. An additional named insured endorsement is also required for Auto Liability. (b) Edmore and Non-Conitbutory ipsu[ance Endojsement Additional insurance coverage under the Contractor's policy shall be 'primary and non-contrlbutory and will not seek contribution from City's insurance or self -Insurance and shall be at least as broad as ISO form CG 20 01 0413. NOTE: (1) The street address of the CITY OF LODI must be shown along with (a) and (b) above: 221 West Pine Street, Lodi, California, 95240; (2) The Insurance certificate must state, on its face or as an endorsement, a description of the protect that it le insuring. (c) Waiver of Subrogation Include a waiver of subrogation against the City of Lodi, its elected and appointed boards, commissions, officers, agents, employees, and volunteers. A waiver is required for General Liability and Auto Liability. (d) (+units of Coverage The limits of Insurance coverage required may be satisfied by a combination of primary and umbrella or excess insurance. My umbrella or excess insurance of Contractor shall contain, or be endorsed to contain, a provision that such covaraga shsil sie.o apply on a primary and non-contributory basis for the benefit of the City before the City's own Insurance ar self-insurance shall be called upon to protect the City as a named insured. Page 1 i of 2 pages i Risk rev.082015 (e) Severability of Interest Clause The term `Insured" Is used severally and not collectively, but the indusion herein of more than one insured shat not operate to Increase the ling of the company's Way. (f) Notice of CCncellaifon or Chance kp Commie Endorsement This policy may not be canceled nor the coverage reduced by the company without 30 days' prior written notice of such cancelation or reduction In coverage to the Risk Manager, City of Lodi, 221 West Pine St, Lodi, CA 95240. (g) Continuity of Coverage All policies shal be In effect on or before the first day of the Term of this Agreement At least thirty (30) days prior to the expiration of each insurance policy, Contractor shal furnish a certificate(s) showing that a new or extended policy has been obtained which meets the minimum requirements of this Agreement Contractor shell provide proof of continuing Insurance on at least an annual basis during the Temp. If Contractor's insurance lapses or is discontinued for any reason, Contractor shall immediately notify the City and immediately obtain replaoement Insurance. (h) Failure to Comply If Contractor fall or refuses to obtain and maintain the required insurance, or fall to provide proof of coverage, the City may obtain the Insurance. Contactor shall reimburse the City for premiums paid, with interest on the premium paid by the City at the mamarnum alowable legal rate then in effect in California. The City shall notify Contractor of such payment of premiums within thirty (30) days of payment stating the amount paid, the name(s) of the insurer(s), and rate of Interest. Contractor shall pay such relmtxrreoment and interest on the first (1.t) day of the month following the City's notice. Notwithstanding and other provision of this Agreement, if Contractor fails or refuses to obtain or maintain Insurance as required by thls agreement, or falls to provide proof of Insurance, the City may terminate this Agreement upon such breech. Upon such termination, Contractor shall immediately cease use of the Site or facilities and commence and diligently pursue the removal of any and al of its personal property from the site or fadifles. (I) Qualified Insurerfsl M insurance required by the terms of this Agreement must be provided by insurers licensed to do business In the State of California which are rated at least 'A-, VI" by the AM Best Ratings Guide, and which are acceptable to the City. Non -admitted surplus lines carriers may be accepted provided they are Included on the most recent list of California eligible surplus lines insurers (LESU list) and otherwise meet City requirements. Workers Compensation Insuranw The Contractor shall take out and maintain during the life of this Agreement, Worker's Compensation Insurance for all of Contractor's employees employed at the site of the project and, if any work Is sublet, Contractor shall require the subcontractor similarly to provide Worker's Compensation Insurance for all of the tatter's employees unless such employees are covered by the protection afforded by the Contractor, in case any clans of employees engaged in hazardous work under this Agreement at the sits of the project is riot protected under the Workers Compensation Statute, the Contractor shall provide end shall cause each subcontractor to provide insurance for the protection of said employees. A waiver of subrogation is required for wort era compensation Insurance. This policy may not be canceled nor the coverage reduced without 30 days' prior written notice of such cancellation or reduction in coverage to the Risk Manager, City of Lodi, 221 West Pine St, Lodi, CA 95240. NOTE: The City reserves the right to obtain a full certified copy of any insurance policy or endorsements required. Failure to exercise this right shall not constitute a waiver of the City's right to exercise after the effective date. Page 2 1 of 2 pages 1 Risk: rev.082015 Attachment 2 Required Federal Forms Submittals 22 KAWPWROJECIUSTREEPSVioneyetadeSeparationTrojectWonal Lane (Inde Separation 11 RFP 1O-21d5.doc Local Assistance Procedures Manual EXABIT 104 Notice to Proposers DBE Information EXmBIT 10-I NOTICE TO PROPOSERS DBE INFORMATION The Agency has established a DBE goal for this Contract of 15 % OR The Agency has not established a goal for this Contract. However, proposers are encouraged to obtain DBE participation for this contract. 1. TERMS AS USED IN THIS DOCUMENT • The term "Disadvantaged Business Enterprise" or "DBE" means a for-profit small business concern owned and controlled by a socially and economically disadvantaged person(s) as defined in Title 49, Code of Federal Regulations (CFR), Part 26.5. • The term "Agreement" also means "Contract." • Agency also means the local entity entering into this contract with the Contractor or Consultant. • The term "Small Business" or "SB" is as defined in 49 CFR 26.65. 2. AUTHORITY AND RESPONSIBILITY A. DBEs and other small businesses are strongly encouraged to participate in the performance of Contracts financed in whole or in part with federal funds (See 49 CFR 26, "Participation by Disadvantaged Business Enterprises in Department of Transportation Financial Assistance Programs"). The Consultant must ensure that DBEs and other small businesses have the opportunity to participate in the performance of the work that is the subject of this solicitation and should take all necessary and reasonable steps for this assurance. The proposer must not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts. B. Proposers are encouraged to use services offered by financial institutions owned and controlled by DBEs. 3. SUBMISSION OF DBE INFORMATION if there is a DBE goal on the contract, Exhibit 10-01 Consultant Proposal DBE Commitment must be included in the Request for Proposal. In order for a proposer to be considered responsible and responsive, the proposer must make good faith efforts to meet the goal established for the contract. If the goal is not met, the proposer must document adequate good faith efforts. All DBE participation will be counted towards the contract goal; therefore, all DBE participation shall be collected and reported. Exhibit 10-02 Consultant Contract DBE Information must be included with the Request for Proposal. Even if no DBE participation will be reported, the successful proposer must execute and return the form. 4. DBE PARTICIPATION GENERAL INFORMATION It is the proposer's responsibility to be fully informed regarding the requirements of 49 CFR, Part 26, and the Department's DBE program developed pursuant to the regulations. Particular attention is directed to the following: A. A DBE must be a small business firm defined pursuant to 13 CFR 121 and be certified through the California Unified Certification Program (CUCP). LPP 13-01 Page 1 of 3 May 8, 2013 Local Assistance Procedures Manual EXHBIT 10-1 Notice to Proposers DBE Information B. A certified DBE may participate as a prime consultant, subconsultant, joint venture partner, as a vendor of material or supplies, or as a trucking company. C. A DBE proposer not proposing as a joint venture with a non -DBE, will be required to document one or a combination of the following: I . The proposer is a DBE and will meet the goal by performing work with its own forces. 2. The proposer will meet the goal through work performed by DBE subconsultants, suppliers or trucking companies. 3. The proposer, prior to proposing, made adequate good faith efforts to meet the goal. D. A DBE joint venture partner must be responsible for specific contract items of work or clearly defined portions thereof. Responsibility means actually performing, managing, and supervising the work with its own forces. The DBE joint venture partner must share in the capital contribution, control, management, risks and profits of the joint venture commensurate with its ownership interest. E. A DBE must perform a commercially useful function pursuant to 49 CFR 26.55, that is, a DBE firm must be responsible for the execution of a distinct element of the work and must carry out its responsibility by actually performing, managing and supervising the work. F. The proposer shall list only one subconsultant for each portion of work as defined in their proposal and all DBE subconsultants should be listed in the bid/cost proposal list of subconsultants. G. A prime consultant who is a certified DBE is eligible to claim all of the work in the Contract toward the DBE participation except that portion of the work to be performed by non -DBE subconsultants. 5. RESOURCES A. The CUCP database includes the certified DBEs from all certifying agencies participating in the CUCP. If you believe a firm is certified that cannot be located on the database, please contact the Caltrans Office of Certification toll free number 1-866-810-6346 for assistance. B. Access the CUCP database from the Department of Transportation, Office of Business and Economic Opportunity Web site at: http:l/www.dot.ca.gov/hq/bep/. 1. Click on the link in the left menu titled Disadvantaged Business Enterprise; 2. Click on Search for a DBE Firm link; 3. Click on Access to the DBE Query Form located on the first line in the center of the page. Searches can be performed by one or more criteria. Follow instructions on the screen. 6. MATERIALS OR SUPPLIES PURCHASED FROM DBES COUNT TOWARDS THE DBE GOAL UNDER THE FOLLOWING CONDITIONS: A. If the materials or supplies are obtained from a DBE manufacturer, count 100 percent of the cost of the materials or supplies. A DBE manufacturer is a firm that operates or maintains a factory, or establishment that produces on the premises the materials, supplies, articles, or equipment required under the Contract and of the general character described by the specifications. B. If the materials or supplies purchased from a DBE regular dealer, count 60 percent of the cost of the materials or supplies. A DBE regular dealer is a firm that owns, operates or maintains a store, warehouse, or other establishment in which the materials, supplies, articles or equipment of the general character described by the specifications and required under the Contract are bought, kept in stock, and regularly sold or leased to the public in the usual course of business. To be a DBE regular dealer, the firm must be an established,xegular business thatengagees, as its principal business and under its own name, LPP 13-01 Page 2 of 3 May 8, 2013 Local Assistance Procedures Manual EXHBIT 10-I Notice to Proposers DBE Information purchase and sale or tease of the products in question. A person may be a DBE regular dealer in such bulk items as petroleum products, steel, cement, gravel, stone or asphalt without owning, operating or maintaining a place of business provided in this section. C. If the person both owns and operates distribution equipment for the products, any supplementing of regular dealers' own distribution equipment shall be, by a long-term lease agreement and not an ad hoc or Agreement -by -Agreement basis. Packagers, brokers, manufacturers' representatives, or other persons who arrange or expedite transactions are not DBE regular dealers within the meaning of this section. D. Materials or supplies purchased from a DBE, which is neither a manufacturer nor a regular dealer, will be limited to the entire amount of fees or commissions charged for assistance in the procurement of the materials and supplies, or fees or transportation charges for the delivery of materials or supplies required on the job site, provided the fees are reasonable and not excessive as compared with fees charged for similar services. LPP 13-01 Page 3 of 3 May 8,2013 Local Assistance Procedures Manual EXHIBIT 10-K Consultant Certification of Contract Costs and Financial Management System EXHIBIT 1O -K CONSULTANT CERTIFICATION OF CONTRACT COSTS AND FINANCIAL MANAGEMENT SYSTEM (Note: If requesting to utilize the Safe Harbor Indirect Cost Rate submit Attachment 1 of DLA -OB 13-07 - Safe Harbor indirect Cost Rate for Consultant Contracts found at http:/lwww.doLca.gov/hq/LocalProgranu/DLA OB/DLA_OB.htm in lieu of this form.) Certification of Final Indirect Costs: Consultant Firm Name: Indirect Cost Rate: * for fiscal period _ *Fiscal period covered for Indirect Cost Rate developed (not the contract period). Local Government: Contract Number: Project Number: I, the undersigned, certify that I have reviewed the proposal to establish final indirect cost rates for the fiscal period as specified above and to the best of my knowledge and belief 1. All costs included in this proposal to establish final Indirect Cost Rates are allowable in accordance with the cost principles of the Federal Acquisition Regulations (FAR) of Title 48, Code of Federal Regulations (CFR), Part 31. 2. This proposal does not include any costs which are expressly unallowable under the cost principles attic FAR of 48 CFR, Part 31. AU known material transactions or events that have occurred affecting the fin's ownership, organization, and Indirect Cost Rates have been disclosed as of the date of proposal preparation noted above. Certification of Financial Manaeement System: I, the undersigned, certify to the best of my knowledge and belief that our Financial Management System meets the standards for financial reporting, accounting records, internal and budget control as set forth in the FAR of Title 49, CFR, Part 18.20 to the extent applicable to Consultant. Certification of Dollar Amount for all A&E Contracts: 1, the undersigned, certify that the approximate dollar amount of all A&E contracts awarded by Caltrans or a California local agency to this firm within the last three (3) calendar years for all State DOT and Local Agencies is $ and the number of states in which the firm does business is Certification of Direct Costs: I, the undersigned, certify to the best of my knowledge and belief that all direct costs identified on the cost proposal(s) in this contract are reasonable, allowable and allocable to the contract in accordance with the cost principles of the FAR of Title 48, CFR, Part 31. Allowable direct costs to a Government contract shall be: Page 1 of 2 LPP 1541 January 14, 2015 Local Assistance Procedures Manual EXHIBIT 10-K Consultant Certification of Contract Costs and Financial Management System 1. Compliant with Generally Accepted Accounting Principles (GAAP) and standards promulgated by the Cost Accounting Standards Board (when applicable). 2. Compliant with the terms of the contract and is incurred specifically for the contract 3. Not prohibited by 23 CFR, Chapter 1, Part 172 — Administration of Engineering and Design Related Service Contracts to the extent requirements are applicable to Consultant. All costs must be applied consistently and fairly to all contracts. All documentation of compliance must be retained in the project files. Subconsultants (if applicable) Proposed Contract Amount (or amount not to exceed if on-call contract): $ Prime Consultants (if applicable) Proposed Total Contract Amount (or amount not to exceed if on-call contract): $ Prime, list all subconsultants and proposed subcontract dollar amounts (attach additional page if necessary): Consultant Certifying (Print Name and Title): Name: Title: Consultant Certification Signature **: Date of Certification (mm/dd/yyyy): Consultant Contact Information: Email: Phone number: **An individual executive or financial officer of the consultant's organization at a level no lower than a Vice President or Chief Financial Officer, or equivalent, who has authority to represent the financial information utilized to establish the Indirect Cost Rate proposal submitted in conjunction with the contract. Note: Per 23 U.S.C. 112(b)(2)(B), Subconsultants must comply with the FAR Cost Princlp/es contained in 48 CFR, Part 31, 23 CFR Part 172.3 Definitions state: Consultant means the individual or firm providing engineering and design related services as a parry to the contract. Therefore, subconsultants as parties ofa contract must complete a certification and send originals to 4&l and keep copies in Local Agency Project Files. Distributk, 1) Orignisl to f alttans Audits and Investigations 2) Retained in Laval Agency Project Files Page 2 of 2 LPP 15-01 January 14, 2015 Local Assistance Procedures Manual Exhibit 10-01 Consultant Proposal DBE Commitment EXHIBIT 10-01 CONSULTANT PROPOSAL DBE COMMITMENT 1. Local Agency 2. Contract DBE Goal: _ 15 % " 3. Project Desc ripllon: 4. Project Location: 5. Consultant's Name: 7. Description of Work, Service. or Materiels Supplied 6. DBE Certification Number 6. Prime Certified DBE: ❑ 9. DBE Contact information 10. DBE% Local Agency to Complete tlrls section 17. Local Agency Contract Number. 18. Federal -Aid Project Number 19. Proposed Contract Execution Date: Local Agency certifies that all DBE certifications are valid and Information on this form is complete and accurate. 20. Local Agency Representative's Signature 21. Date 22. Local Agency Representative's Name 23. Phone 11. TOTAL CLAIMED DBE PARTICIPATION IMPORTANT: Identify all DBE firms being claimed for credit, regardless oilier. Written confirmation of each listed DBE Is required. 12. Preparers Signature 13. Date 14. Preparers Name 16. Phone 24. Local Agency Representative's Title 16. Preparers Title DISTRIBUTION: Original — Included with consultant's proposal to local agency. ADA Notice: For Individuals with sensory disabilities. this document Is available in eitemats formals. For Information cat (916) 5644410 or TDD (916) 054 :::. ... .. . - . Int 1120 N Slregl, MS•59. Sacramento. CA 95814. Page 1 of 2 July 23, 2015 Local Assistance Procedures Manual Exhibit 10-01 Consultant Proposal DBE Commitment INSTRUCTIONS — CONSULTANT PROPOSAL DBE COMMITMENT CONSULTANT SECTION 1. Local Agency - Enter the name of the local or regional agency that is funding the contract. 2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project advertisement. 3. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab, Overlay, Widening, etc.). 4. Project Location - Enter the project location as it appears on the project advertisement. 5. Consultant's Name - Enter the consultant's firm name. 6. Prime Certified DBE - Check box if prune contractor is a certified DBE. 7. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials to be provided. Indicate all work to be performed by DBEs including work performed by the prime consultant's own forces, if the prime is a DBE. If 100% ofthe item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 8. DBE Certification Number - Enter the DBE's Certification Identification Number. All DBEs must be certified on the date bids are opened. 9. DBE Contact Information - Enter the name, address, and phone number of all DBE subcontracted consultants. Also, enter the prime consultant's name and phone number, if the prime is a DBE. 10. DBE °Io - Percent participation of work to be performed or service provided by a DBE. Include the prime consultant if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation. 11. Total Claimed DBE Participation % - Enter the total DBE participation claimed. If the total % claimed is less than item "Contract DBE Goal," an adequately documented Good Faith Effort (GFE) is required (see Exhibit 15-H DBE Information - Good Faith Efforts of the LAPM). 12. Preparer's Signature - The person completing the DBE commitment form on behalf of the consultant's firm must sign their name. 13. Date - Enter the date the DBE commitment form is signed by the consultant's preparer. 14. Preparer's Name - Enter the name of the person preparing and signing the consultant's DBE commitment form. 15. Phone - Enter the area code and phone number of the person signing the consultant's DBE commitment form. 16. Preparer's Title - Enter the position/title of the person signing the consultant's DBE commitment form. LOCAL AGENCY SECTION 17. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 18. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 19. Proposed Contract Execution Date - Enter the proposed contract execution date. 20. Local Agency Representative's Signature - The person completing this section of the form for the Local Agency must sign their name to certify that the information in this and the Consultant Section of this form is complete and accurate. 21. Date - Enter the date the DBE commitment form is signed by the Local Agency Representative. 22. Local Agency Representative's Name - Enter the name of the Local Agency Representative certifying the consultant's DBE commitment form. 23. Phone - Enter the area code and phone number of the person signing the consultant's DBE commitment form. 24. Local Agency Representative Title - Enter the position/title of the Local Agency Representative certifying the consultant's DBE commitment form. Page 2 of 2 July 23, 2015 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: 2. Status of Federal Action: ❑ a. contract b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 0 a. bid/offer/application b. initial award c. post -award 3. Report Type: 0 a. initial b. material change For Material Change Only: year quarter date of last report 4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 b Subawardee, Enter Name and Address of Prime: 0 Prim ❑ Subawaniee Tier , if (mown Congressional District, if known 6. Federal Department/Ageney: 8. Federal Action Number, if known: 10. Name and Address of Lobby Entity (If individual, last name, first name, MI) Congressional District, if known 7. Federal Program Name/Deacription: CFDA Number, if applicable 9. Award Amount, if known: 11. Individuals Performing Services including address if different from No. 10a (If individual, lest name, fust name, MI) (attach Continuation Sheets) if necessary) 12. Amount of Payment (check all that apply) 14. Type of Payment (cheek all that apply) 0 actual ❑ planned 13. Form of Payment (cheek all that apply): 8 a. cash b. in-kind; specify: nature Value a. retainer b. one-time fee c. commission d. contingent fee e deferred f. other, specify . .... 15. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated In Item 11: 16. Continuation Sheet(s) attached: Yes 0 17, lnrormation requested through this form is authorized by Title 31 U S C Section 1352 This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U S C. 1352 This information will be reported to Congress semiannually and will be available for public inspection Any person who fails its file the required disclosure shall be subject to a civic penalty of not less than 510,000 and not more than 5100.000 for oach such failure Federal Use Only; No ❑ (attach Continuation Sheet(s) if necessary) Signature: __ Print Name: Title: Telephone No.: Date: Authorized for Local Reproduction Standard Form - LLL Sieiuiard l uau 1.1.L !icy [W28.% Distribution: Orig- Local Agency Project Files LPP 13-01 Page 1 May S, 2013 Local Assistance Procedures Manual EXHBIT 10-Q Dlsdosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity 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 a covered federal action. Attach a continuation sheet for addition] information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is or has been secured to influence, the outcome of a covered federal action. 2. Identify the status oldie covered federal action. 3, Identify the appropriate ciassiFic.alion ofthis rcpori. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, state, and zip code of the reporting entity. Include Congressional District if known. Check the appropriate ckLssificntion of the reporting entity that designates If it is or expects to be a prime or subaward recipient. Identify the tier of the suhuwerdec, c.g., the first suhawardec of the prince is the first tier. Subawards include but are not limited to: subcontracts, subgrants, and contract awards under grants. 5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state, and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RH') number, Invitation for Bid (IFf3) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g.. "RFP -DE -90-00l." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 18. Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11. Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (MI). 12. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made. 13. Check all boxes that apply. If payment is made through an in-kind contribution, spec* the nature and value of the in-kind payment. 14. Check ell boxes that apply. If other, specify nature. 15. Provide a specific and detailed description of the services that the lobbyist has performed or will he expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officers) or employees) contacted or the offlcct(s) cmployee(s) or Member(s) of Congress that were contacted. 16. Check whether or not a continuation sheet(s) is attached. 17. The certifying official shall sign and date the form, and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 -minutes per response. including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, U.C. 20503. SF- L.I.I-Instructions Rev. 06-04 LPP 13-01 Page 2 May8,2013 Local Assistance Procedures Manual EXHIBIT 10-U Consultant Management Conflict of Interest Statement EXHIBIT 10-U CONSULTANT IN MANAGEMENT POSITION CONFLICT OF INTEREST AND CONFIDENTIALITY STATEMENT RFP/RFQ PROCUREMENT NUMBERS: PROJECT NAME: APPLICABILITY: Applicable to local agency consultants in management positions that exercise authority over the Architect & Engineering Selection Panel from which the local agency has or plans to have one or more consultant contracts containing Federal or State fltnds. ❑ I am an employee of a consultant under contract to the local agency that is responsible for the procuring and administering of one or more consultant contracts containing either Federal or State funds. ❑ I am in a management position with the local agency, my title is listed below and I have attached my duty statement. ❑ The procedures followed to procure and execute the contract, between the local agency and the consulting firm of which I am employed, comply with all Federal and State requirements. Also this contract has a specific beginning and ending date. ❑ I hereby certify as follows: 1. I will not directly or indirectly participate in, manage, or overset any consultant selection procurement process in which the consulting firm of which I am employed is competing as a consultant or subconsultant. 2. I will not directly or indirectly influence any employee, staff member, or other individual participating in any consultant selection procurement process in which the consulting firm of which I am employed is as a consultant or subconsultant. 3. I will not directly or indirectly participate in, manage, or oversee any local agency contract that is with the consulting firm of which I am employed, regardless of whether the involvement of my employer in the contract is as a consultant or subconsultant. Among other things, this includes my not being involved in managing the work; and not approving changes in the schedule, scope, deliverables or invoices. 4. I understand that if I am involved in any local agency contract that is with the consulting firm of which I am employed, in violation of 1. or 2. above, that Local agency contract will no longer be eligible for Federal or State reimbursement because of my involvement. ❑ I certify that I have read 49 CFR 1&36(bx3) below and I agree not to participate in selection, or in the award or administration of a contract supported by Federal or State funds if a conflict of interest, real or apparent, would be involved. Note: Caltrans is the Grantee and the local agency is the sub -grantee. LPP 13-01 Page 1 of 3 May 8, 2013 Local Assistance Procedures Manual EXHIBIT 10-U Consultant Management Conflict of Interest Statement 49CFR 18.36(bX3) (3) Grantees and subgrantces will maintain a written code of standards of conduct governing the performance of their employees engaged in the award and administration of COniraGIS. Nu Cn111hnyCC, officer ur agent of the grantee or subgrantee shall participate in selection, or in the award or administration of n eoniracl supported by I cticrnl funds if n conflict of interest, real or apparent, would be involved. Such a conflict would arise when: (i) The employee, officer, or agent, (ii) Any member of his immediate family, (iii) His or her partner, or (iv) An organization which employs, or is about to employ, any of the above, has a financial or other interest in the firm selected for award. The grantee's or subgrantee's officers, employees or agents will neither solicit nor accept gratuities, favors or anything of monetary value from contractors, potential contractors, or I1articS to subagrccmcnt. Crrentee and subgrantccs may sat minimum rules where the f n:utcial imams( is nal substantial or the gift is an unsolicited item of nominal intrinsic value. To the extent perrnitted by Stets or local law or rr:gulatiuns, such standards or conduct will provide for penalties, sanctions, or other disciplinary actions for violations of such standards by the grantee's and subgrnntee's officers. employees, or agents, or by contractors or their agents. The awarding agency may in regulation provide additional prohibitions relative to real, apparent, or potential conflicts of interest. ❑ I understand that it is unlawful for a person to utilize any organization name (i.e. local agency) or auxiliary organization information, which is not a matter of public record, for personal gain. ❑ I fully understand that any violation of the above could be a basis for ineligibility of reimbursement of State or Federal project funds. Date: Signed: Name: Title: Dept./Local Agency: Employer: REVIEW BY SUPERVISOR OF CONSULTANT IN MANAGEMENT POSITION I have reviewed the foregoing "Conflict of Interest and Confidentiality Statement" and will ensure: ❑ that the foregoing named local agency consultant who is under contract and in a management position with our local agency, abides by the foregoing terms and conditions; ❑ that should the foregoing named Local agency consultant, who is under contract and in a management position with our local agency, violate any of the foregoing terms and conditions, LPP 13-01 Page 2 of 3 May 8,2013 Local Assistance Procedures Manual EXHIBIT 10-U Consultant Management Conflict of Interest Statement the Caltrans DLAE will be notified and such violation will be considered a breach of ethics and could be a basis for ineligibility of State or Federal project funds. Date: Signed: Name: Title: Dept./Local Agency: Employer: REVIEWED/CONCURRENCE BY DISTRICT LOCAL ASSISTANCE ENGINEER I have reviewed the foregoing "Conflict of Interest and Confidentiality Statement" and Supervisor's statement. ❑ Based upon the foregoing, I concur that the consultant, who is under contract and in a management position with the local agency, does not appear to present a conflict of interest. The local agency and the consultant should be considered eligible for Federal and State reimbursement. ❑ Based upon the foregoing, I do not concur as I believe that the consultant, who is under contract and in a management position with the local agency, does appear to present a conflict of interest. ❑ The consultant's time is not considered eligible for either Federal or State reimbursement. ❑ The local agency is not considered eligible for either Federal or State reimbursement. Date: (DLAE) Signed: Name: Distribution: 1) Copy to: DLAE for each Federal/State funded project 2) Copy 16 be returned to Local Agency by DiAE with signature LPP 13-01 Page 3 of 3 May B, 2,013 co N Ca ..O = o 0), Z a Do O 8 0 WA Y 9 Local Assistance Procedures Manual o a8 G .. _- t o < I.8. 0 1 till 0. ti t g 114 0 y 0 8 ba Q FI ini a pAl 0 LC, 4 1 Description of Portion of Work to be Performed i i E GP o. 1 it o w V opp a•° .E v LA V N V El <SIS million I _o to A p D <S1 million LI <S5 million 0 <S10 million , Q <SIS million o -..In LA A : a o I of Y) w VVVVA o 000p o --.-In 4.01 a V! VI VVV DOD o 0 _ oas LA ' 1 U<S15million 1 LJ > S15 million • • w a o e N Z" i 1 md� i; rel v Name fCity State ZIP N w�: N d City State ZIP 4.1 4 a o x 2, 42 C 8 O VJ 0 0 b Y c"a Local Assistance Procedures Manual liq o0 Age of Firm (Yrs.) Q D 2v R tz Agc of Firm (Yrs.) o i!i. co Q g. t 2,1 t i 00-11 0 i Boy Description of Portion of Work to be Performed _ 1 1 1 Annual Gross Receipts [�] < S1 million HIo Vy 4A V 2 44 V U <S15 million 1 .1r 44 A VI V uotlpsS>Q a O CA V ... 44 V = P., 44 A �qga .. 49 V ❑ ., 49 V 44 V rte. 49 V ° 0 .1 44 A ra Y! V 0 uorlliar 5$ > 0 I 1 D <S10 million 1 ❑ < $15 million o 0 .fin iA A (3 a 0 a z1g w U Address City State ZIP Name Address City State ZIP N 0 City State ZIP l- l i w i 8 F 0 0 0 DLA -OB 13-06 Local Assistance Procedures Manual Exhibit 15-H DBE Ieformadon - Good Faith Effort EXHIBIT 15-11 DBE INFORMATION —GOOD FAITH EFFORTS DBE INFORMATION - GOOD FAITH EFFORTS Federal -aid Project No. The Bid Opening Date established a Disadvantaged Business Enterprise (DBE) goal of for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the "Local Agency Bidder DBE Commitment" form indicates that the bidder has met the DBE goal. This will protect the bidder's eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the "Local Agency Bidder DBE Commitment" form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled "Submission of DBE Commitment" of the Special Provisions: A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication): Publications Dates of Advertisement B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.): Names of DBEs Solicited Date of Initial Follow Up Methods and Dates Solicitation OB 12-04 Page 15-1 June 29, 2012 Exhibit 15-11 Local Assistance Procedure' Manual DBE Information -Good Faith Effort C. The items of work which the bidder made available to DBE firms including, where appropriate, any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms. Items of Work Bidder Normally Breakdown of Amount Percentage Performs Item Items ($) Of (y/N) Contract D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE: Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection of the DBEs: Names, addresses and phone numbers of firms selected for the work above: E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs: Page 15-2 June 29, 2012 OB 12-04 Local Assistance Procedures Manual Eablblt 15-H DBE Information - Good Falth Effort F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: G. The names of agencies, organizations or groups contacted to provide assistance in contacting, recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.): ' Name of Agency/Organization Method/Date of Contact Results H. Any additional data to support a demonstration of good faith efforts (use additional sheets if necessary): NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY. OB 12-04 Page 15-3 June 29, 2012 Attachment 3 Federal Forms Required upon Execution of Agreements 23 KAWPWROJECTSVIREITTSUIffirneyGradeSeperstionTrojecftlitiney Loc Grade Separation TI RPP 10-21-15.doc Local Assistance Procedures Mongol Exhibit 10-02 Consultant Contract DBE Commitment 1. Local Agency: _- 3. Project Description: 4. Project Location: — 5. Consultant's Name: EXHIBIT 10-02 CONSULTANT CONTRACT DBE COMMITMENT 2. Contract DBE Goal: (5,' 6. Prime Certified DBE: 0 7. Total Contract Award Amount 8. Total Dollar Amount for SLI Subconsultante: 9. Total Number of ALL Subcanslrltants: 10. Description of Work, Service, or Materials Supplied 11. DBE Certification Number 12. DBE Contact Information 13. DBE Dollar Amount Local Agency to Completo this Section 20 Local Agency Contract N. .mhar 21. Federal-AId Project Nranber. 22. Contract Execution mo Local Agency certifies that alt DBE certification are valid and Information on this form is complete and accurate. 23. Local Agency Representative's Signature 24. Date 25. Local Agency Representative's Name 26. Phone 27. Local Agency Representative's Title 14. TOTAL CLAIMED DBE PARTICIPATION IMPORTANT: Identify all DBE firms being claimed for credit, regardless of tier. Written confirmation of each listed DBE Is required. 15. Preparers Signature 16. Date 17. Preparers Name 18. Phone 19. Preparers Title DISTRIBUTION: 1. Original — Local Agency 2. Copy — Caltrans District Local Assistance Engineer (DLAE). Failure to submit to DLAE within 30 days of contract execution may result In de.obllgation of federal funds on contract ADA Noyes: For IndWiduala with sonsory disabildlea. this document Is available In,atternate formats. For Infomhallen clay (918) 854-8410 or TDD (918)854- U-99 or ming Records end Forma Management,1120 N Steal, MS -89, Saasmento, CA 95814. Page l of 2 July 23, 2015 Local Assistance Procedures Manual Exhibit 10-02 Consultant Contract DBE Commitment INSTRUCTIONS — CONSULTANT CONTRACT DBE COMMITMENT CONSULTANT SECTION 1. Local Agency - Enter the name of the local or regional agency that is funding the contract. 2. Contract DBE Goal - Enter the contract DBE goal percentage as it appears on the project advertisement. 3. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab, Overlay, Widening, etc). 4. Project Location - Enter the project location as it appears on the project advertisement. 5. Consultant's Name - Enter the consultant's firm name. 6. Prime Certified DBE - Check box if prime contractor is a certified DBE. 7. Total Contract Award Amount - Enter the total contract award dollar amount for the prime consultant. 8. Total Dollar Amount for ALL Subconsultants — Enter the total dollar amount for all subcontracted consultants. SUM = (DBEs + all Non -DBEs). Do not include the prime consultant information in this count. 9. Total number of ALL subconsultants —Enter the total number of all subcontracted consultants. SUM = (DBEs + all Non -DBEs). Do not include the prime consultant information in this count. 10. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials to be provided. Indicate all work to be performed by DBEs including work performed by the prime consultant's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DISE, describe the exact portion to be performed or furnished by the DBE. Sec LAPM Chapter 9 to determine how to count the participation of DBE firms. 11. DBE Certification Number - Enter the DBE's Certification Identification Number. All DBEs must be certified on the date bids are opened. 12. DBE Contact Information - Enter the name, address, and phone number of all DBE subcontracted consultants. Also, enter the prime consultant's name and phone number, if the prime is a DBE. 13. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime consultant if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation. 14. Total Claimed DBE Participation - 8: Enter the total dollar amounts entered in the "DBE Dollar Amount" column. %: Enter the total DBE participation claimed ("Total Participation Dollars Claimed" divided by item "Total Contract Award Amount"). If the total % claimed is less than item "Contract DBE Goal," an adequately documented Good Faith Effort (GFE) is required (see Exhibit 15-H DBE Information - Good Faith Efforts of the LAPM). 15. Preparer's Signature - The person completing the DBE commitment form on behalf of the consultant's firm must sign their name. 16. Date - Enter the date the DBE commitment form is signed by the consultant's preparer. 17. Preparer's Name - Enter the name of the person preparing and signing the consultant's DBE commitment form. 18. Phone - Enter the area code and phone number of the person signing the consultant's DBE commitment form. 19. Preparer's Title - Enter the position/title of the person signing the consultant's DBE commitment form. LOCAL AGENCY SECTION 20. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 21. Federal -Aid Project Number - Enter the Federal -Aid Project Number, 22. Contract Execution Date - Enter the date the contract was executed. 23. Local Agency Representative's Signature - The person completing this section of the form for the Local Agency must sign their name to certify that the information in this and the Consultant Section of this form is complete and accurate. 24. Date - Enter the date the DBE commitment form is signed by the Local Agency Representative. 25. Local Agency Representative's Name - Enter the name of the Local Agency Representative certifying the consultant's DBE commitment form. 26. Phone - Enter the area code and phone number of the person signing the consultant's DBE commitment form. 27. Local Agency Representative Title - Enter the position/title of the Local Agency Representative certifying the consultant's DBE commitment form. Page 2 of 2 July 23, 2015 A e r as 2 c3 ri EOE a hi (44 i i T O • i° P4 kc 1 E 10. Company Name and Business Address 8. Centrad 9. Description of Work, Service, or Item Materials Supplied Number N 8 2 8 iY U ri FL 1 1 1 Local Assistance Procedures Manual Exhibit 17-F Final Report-Utllizatlon of Disadvantaged Business Enterprises (DBE) and First -Tier Sibcontracton INSTRUCTIONS — FINAL REPORT -UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE) AND FIRST-TIER SUBCONTRACTORS 1. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 2. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 3. Local Agency - Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date - Enter the date the contract was completed. 5. Contractor/Consultant - Enter the contractor/consultant's firm name. 6. Business Address - Enter the contractor/consultant's business address. 7. Final Contract Amount - Enter the total final amount for the contract. 8. Contract Item Number - Enter contract item for work, services, or materials supplied provided. Not applicable for consultant contracts. 9. Description of Work, Services, or Materials Supplied - Enter description of work, services, or materials provided. Indicate all work to be performed by DBEs including work performed by the prime contractor/consultant's own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the 013E, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms. 10. Company Name and Business Address - Enter the name, address, and phone number of all subcontracted contractors/consultants. Also, enter the prime contractor/consultant's name and phone number, if the prime is a DBE. 11. DBE Certification Number - Enter the DBE's Certification Identification Number. Leave blank if subcontractor is not a DBE. 12. Contract Payments - Enter the subcontracted dollar amount of the work performed or service provided. Include the prime contractor/consultant if the prime is a DBE. The Non -DBE column is used to enter the dollar value of work performed by firms that are not certified DBE or for work after a DBE becomes decertified. 13. Date Work Completed - Enter the date the subcontractor/subconsultant's item work was completed. 14. Date of Final Payment - Enter the date when the prime contractor/consultant made the final payment to the subcontractor/subconsultant for the portion of work listed as being completed. 15. Original DBE Commitment Amount - Enter the "Total Claimed DBE Participation Dollars" from Exhibits 15-6 or 10-02 for the contract. 16. Total - Enter the sum of the "Contract Payments" Non -DBE and DBE columns. 17. Contractor/Consultant Representative's Signature - The person completing the form on behalf of the contractor/consultant's firm must sign their name. 18. Contractor/Consultant Representative's Name - Enter the name of the person preparing and signing the form. 19. Phone - Enter the area code and telephone number of the person signing the form. 20. Date - Enter the date the form is signed by the contractor's preparer. 21. Local Agency Representative's Signature - A Local Agency Representative must sign their name to certify that the contracting records and on-site performance of the DBE(s) has been monitored. 22. Local Agency Representative's Name - Enter the name of the Local Agency Representative signing the form. 23. Phone - Enter the area code and telephone number of the person signing the form. 24. Date - Enter the date the form is signed by the Local Agency Representative. Page 2 of 2 July 23, 2015 Z pi Z G.442 Z ILL ilV . s G. n 1 1 m I U ai !I 1 ! 10. DBE 11. Amount Paid 9. DBE Contact Infonnatlon i Certification While CeRllfad Number .. 1 9. Contract Item Number 1 1 1 1 1 a 1 1 i w I I hi 16 Local Assistance Procedures Manual Exhibit 17-0 Disadvantaged Business Enterprises (DBE) Certification Status Cbange INSTRUCTIONS -DISADVANTAGED BUSINESS ENTERPRISES (DBE) CERTIFICATION STATUS CHANGE 1. Local Agency Contract Number - Enter the Local Agency contract number or identifier. 2. Federal -Aid Project Number - Enter the Federal -Aid Project Number. 3. Local Agency - Enter the name of the local or regional agency that is funding the contract. 4. Contract Completion Date - Enter the date the contract was completed. 5. Contractor/Consultant - Enter the contractor/consultant's firm name. 6. Business Address - Enter the contractor/consultant's business address. 7. Final Contract Amount - Enter the total final amount for the contract. 8. Contract Item Number - Enter contract item for work, services, or materials supplied provided. Not applicable for consultant contracts. 9. DBE Contact Information - Enter the name, address, and phone number of all DBE subcontracted contractors/consultants. 10. DBE Certification Number - Enter the DBE's Certification Identification Number. 11. Amount Paid While Certified - Enter the actual dollar value of the work performed by those subcontractors/subconsultants during the time period they are certified as a DBE. 12. Certification/Decertification Date (Letter Attached) - Enter either the date of the Decertification Letter sent out by the Office of Business and Economic Opportunity (OBEO) or the date of the Certification Certificate mailed out by OBEO. 13. Comments - If needed, provide any additional information in this section regarding any of the above certification status changes. 14. Contractor/Consultant Representative's Signature - The person completing the form on behalf of the contractor/consultant's firm must sign their name. 15. Contractor/Consultant Representative's Name - Enter the name of the person preparing and signing the form. 16. Phone - Enter the area code and telephone number of the person signing the form. 17. Date - Enter the date the form is signed by the contractor's preparer. 18. Local Agency Representative's Signature - A Local Agency Representative must sign their name to that contracting records and on-site performance of the DBE(s) has been monitored. 19. Local Agency Representative's Name - Enter the name of the Local Agency Representative signing the form. 20. Phone - Enter the area code and telephone number of the person signing the form. 21. Date - Enter the date the form is signed by the Local Agency Representative. Page 2 of 2 July 23, 2015 Attachment 4 Specification Section 01400 Quality Control 24 KAWPWROJECISNSTREETSaaneyGradeSeparationTrojeertHamey Lane Grade Separation TI RFP 1x21 -l5 doe City ofLodi MADE SEPMAIION HARNEY LANE AT WAR 01400 Quality Control SECTION 01400 - QUALITY CONTROL PART 1- GENERAL 1.01 DESCRIPTION A. This Section dcsaribes the requirements nor quality control. IA2 DUTIES AND RESPONSIBILITIES OF OWNER'S REPRESENTATIVE A. The OwneVs Repreahmive and the Owner have the right, bat not the duty, to monitor and inspect all wok parkland by the Contractor to ensure panorama of the work to the Contrast Documents and Specitiationa. MI wok deal be subject to inspection and test by the Ownet:s Representative and the Owner at all reasonable times and at all pines prior to acceptance. Art such inspection and test is for the sole benefit of the Owner and shall not relieve the Contractor of responsibility ibr providing quality control measures to assure that the wade strictly complies with the contract requirements. No inspection or test by the Owner or Owner's Representative shall be construed u oonatidding or implying an *molten= 1.03 CONT'RACTOR'S DUTIES AND RESPONSIBLITIES A. The Contractor is responsible kr the quality of the work pertbnned under this Contract as well as the quality dike materiel. equipment, and supplies finished by it to be incorporated lido the work. 'hien Contractor will provide. fbr approval, a quality.00nt of plan within 30 days ager the Notice to Proceed fir approval by the Owner. The plan will include but not be limbed to procurement, delivery tad insallatioa of material and equipment. The plan will provide specific teats and per6onmanoe testing requitement, ibr each stage kr each subcontractor and the General Contractor. Lop and !breis nor tracking all seeps will be provided and will be signed by the inspectors. B. The Contractor shall deslgaate a Quality Castrol Rapresai4dve who will be on aloe at all times while the respective Coate toys work is in progress and will haus the authodtr and responsibility to accept or ngject Items of watt. The C.ontnctoe's Quality Control Representative may delegate his dates but the prlmdy responsibility and authority reds wlh the Contra tor. C. The Cradraoto' Quality Control Repaesadstivo dap coordinate the submittal of all shop drawings. product dstei sad samples to the Owner's Representative. Any submittal that is a change to the Contract requirements shall be identified as such and transmitted to the Owner's Representative. No work requiring submittal of a shop drawing, product data. or sample shill be commenced until the submittal has been reviewed and accepted by the Owaes's Rep+asenprtive and the Engineer. My &Lodi (Rewind 09116113) Quaky Control 01400 - 236 City of Lodi GRACE SEPARATION HARNEY LANE AT IIPRR 01400 Quaky Control D. The Contractor shall cooperate with an approved material besting tshorsixxy to perforin testing of materials as required by the Contract Drawings end Specifications, or the Ownees Representative, The Contractor shall provide e two -working -clay notice when testing/inspection Is required. The Contractor will request all tests and inapectloos in accordance with the Specifications and the Owner's Representative fbr requesting testa and inspections. The Contractor will not contact tate testing firmest directly without going through time Owner's Representative. B. The Contractor's Quality Control Representative bull review Ince drawings, procurement documents, and C.oa nanob to ensure that the technical Munition provided and all work perfbrmed is h accordance with the latest revisions of the Contrast Drawings and Specifications. F. The Cantraoloa's Quality Control Repsesaet rive dell pert= an inspection upon receipt at the site of all materials, equipment, and supplies. Items which are damaged or not In oanfbroranee with the respective submittals, quality standards, Contract Drawings and Specifications will be Identified and segregated ROM accepted items. Items thus identified shall not be incorporated into the work until corrective action acceptable to the Owner's RepesentativetOvner is completed. Items detenmhed mwlvsgeable will be removed from the job site. O. The Contractor will establish a peribrmanoe-testing plan tbe all egnipme t and eioctricaI systems. The testing plan will include teat and report firma icor each type of application and will be approved by the O'wner's Representative. The peribmtattce testing of the equipment and system will be documented and approved by the OMnaees Representative. Copies of the approved performance tests will be required for project closeout ae required by Section 01700 - Project Closeout. H. The Contractor's Quality Control Reprostatativo and subcontractors will attend a weekly Quality Control (QC) meeting. The Contract"' will provide a list of current controlling activities for that week and bring an outlined speoitioatio n section to the meeting noting arca applicable fbr impaction/testing fbr the controlling activities. All requests for testing will be provided titer the current week and all notices of nen oomplisaoe will be reviewed. 1. The Contractor will provide copies of his quality control inspection reports each day. Format 011ie report will be aptxoved by the Owns The Contractor will maintain a photo record of at least six locations plus special areas of interest each week. The photos will be provided to the Owner's Representative the following Monday of earth week. 1.04 INSPECTION AND TESTING City 'aALaodt (Revised 09/W15) Quality Cantu! 01400 - 237 Cibl of Lodi MAIM IEPARA1ION IIARIEV LANE AT UM 01400 Quality Control A. inspection Plan: The Contractor will use a 11 point inspecdon pram tier each separate feature of went to be peribnmed under this Contract; Le., work described by each section of the toalminal provisions section of the Specifications. This plat consists of the followinr 1. Preparatory inspeadon: Prior to commencing the work. the Quality Cosset !toren:401 ve shall meet with the Owner's R epreastadvs mud drat the following items as a minimum for ocmfbrmanow a. Approval of shop drawings and submittals. b. Approval of hapeclon and test reports of materials and equtpoteat to be utilized. o. Comptedoa of previous operation. d. Availability ofmaterials and equipment required. e. Nadflomtion ofOwner's Representative. when applicable. f. Other paparmory steps dependent upon the partiouler g. Quality h. S&M y or environmental precautions to be observed. 2. laitW hdpeclion: Upon oompldioa of a repiesentative sample of a given Stature await. the Contractor's Quality Control Representative shall meet with the Owne't Representative and check the tbllowimg items as a minimum ibr cos romance: a. Wodammaddp to eetablbhed quality sander& b. Configuration to Contract Dnhwhrga and Specifications. a Ooastmodon methods, equipment. and tools utilized. d. Mateiab and adobe utilized. e. Adequacy of teeting methods. f. Adequacy of shop drawings. g. Amy ofaailrar environmental premodern Cky of t odi (Revised oDwlb/ls) Quality Cartrol 01400 - 238 City ofLndi�Y _ GRADE t AIRATION IIA EY UNE AT UPRR 01400 Q1.Ut/ Control 3. Follow-up Inspections: The Contractor'. Quality Control Representative shall inspect the work daily to assure the oaatiauhrg conibensunoe of the work to the workmanship standards established daring the prepentory and initial inspections. Follow-up inspections will be on a daily baala. If the Contractor hu not complied with the inspection a tI#ication u to def active work, the Ownees Representstive will issue a notice of notrcontplluaoe. 4. Completion Inspection: Upon completion of a given kedsao of the link' the Cantradoe's Quality Control Repruenutive shall meat with the Owner's Representative shad City of Lodi Public Works Inspector to perfirra an impaction of the completed worst. At hunt 24 hours notice will be required ihr inspections. Nonooni rming shams !hail be Identified and corrected prier to ooramenoentant of the mart operation. B. Should the Contractor NI to correct work in a reasonable time, the Owner's Representative will ISM a Notice of Nanoemplianoe. This is a two-part notice/reply %rm. The Ownxs'a Representetive will specify the noncompllont Hem on Part One and the Contractor shall respond on Part Two, indicating the fix once ft has been accomplished. The Calor will maintain a log of all notices of noncompliance which shall contain the fbilowing information: Notice number, description, specification section, date issued, date response Horn the Cantraetor, date corrected, number of days to correct, and remarks. The Contractor' will present tax copies of this log at the weekly meetings and shall keep it uuurently upped. Upon oompl mance with the notice of noncompliance, the Owner's Representative will officially notify the Contractor. C. Operation and Check Out Testing: The Contractor than provide personnel and equipment to perfbrm the opemfonal tests and checkout of the equipment, fitcilities, or equipment constructed, Marketed, or fastrdbd order this Confront The Owner's Rcpresentadve will coordinate and witness all such teats. Notification shall be gives at lout two days in advance of the scheduled tests. Rehr to rnquirarnente for operating and maintenance dad and traindng speoifed le Section 01730. D. Substantial and Final inspection. The Owner's Representative will coordinate all final inspections of the work. Request far fin&ka ag portions of the work perfumed under this Contract shall be made to the Owner's Representative at least 15 days in advance of the inspection. Prior to requesting a substantial ocmpletlon inrpectIon, all tests ofthc oqudpment and systems anti training shall be oomplebd. Refer tQ Section 01700 iitr detailed requirements Ibr subatantial completion and final completion inapectlona Por project cioaoout. The Contractor will bo provided with a punch list from the Owner indicating Items aver and above those shown on the Contractor's punch list. The Omer will only provide Chy of Lodi (Revised OW16/15) Quality (control 01400 - 239 Cit/ of Lodi GRADE SEPARATION WNW LANK AT UPIIR 01400 Wily Control two nnpeodons; misleads' (implosion and find completion. Others will be at dm Cantaalor's mcpane. The Owner will provide a handwritten punch dist to the Ccntrador. The Contractor will enter and maintain a computerized punch fist based on the Owner's pumob list in a Homme approved by the Owner's Representative with one Dopy of the omnputerked lit within five working ds ys upon receipt oftho Owner's lit and update it an a weekly bads. The Contractor will at each weekly meeting dining the closeout period provide m amwtsbsd pumoh lint Indicating those hems width have been completed and are reacts tor inspection. The Cantraosor will maintain aid beep this Ilt emelt and provide a soppy to the Owner's Representative cash week until all kerns are complete. Prior to the request lar adertmtW completion and throughout the 11th of the prgjeot, the Comrsator will maintain a tering and %specula schedule. This schedule will be provided at each weekly meeting Moat* the tests or impetration: which win be regiudeed durbaQ the Mowing week. Based on this schedule, the Contractor will provide the Required Request fbr 'Ming isms. 1.05 VERIFICATION OF TM REPORTS A. The Testing Laboratory will submit a verified report in duplicate covering all of the tests which are required to be made during the progress of the Project. Such report shall be throbbed at least quarterly and each time that work an tie Protect is suspended, covering the bests sup to that dme and at the completion of the Pulled, covering all tests. 1.06 OWNER'S INSPECTOR A. An inspector employed by the Owner in anconbnoe with the requirements rdierenoed mq► be assigned to the work. B. The work of cons ruction in all stages of progress will be subject to the personal, cont tuous observation of the Inspector. He shall have five somas to any and all pets of the work M any times Furnish the Inspector reasonable fiailities fir obtahtthrg such intbrmabion as necessary to keep him folly informed, resp oting the progress and manner of the work and the character of the materi& lespeodon of the work shall not relieve the Contractor from sty obligation to fi lfill this contract. 1.07 SPECIFIC TESTS AND INSPECTIONS A. As required by code, as specified ht individual sections and section 01410. I ND OF SUCTION air of Lodi (Revised OWI915) Quality Castrol 01400 - 240 Attachment 5 Specification Section 01410 Testing 25 K.AWAPROJECTSWIREEISIHmagyaredeScparationTsojecNianiey Lane clsde Sepan don TI RIP 10-21.15.doo ofLodl GRADE SEPARAiION HARNEY LAM AT UPRR - 01410 "renting SECTION 01410 - TESTING PART 1- GENERAL 1.01 DESCRIPTION: A. This Section summarises which tests and inspeodoas will be performed by the Contractor, and which will be performed by the Owner's Reprc.entrdives. The detailed tests and inspections required to be performed by the Contractor may be found in the Individual Sections of these Specifications. 1.02 OWNER'S TESTING AGENCY: A. For the purpose of meeting Architect/Engineer and City requlrcmc hs, the OWNER will employ and pay for a testing agency, identified in the various Specifications Sections as "the "Testing Agency", to perform tests, inspections, and sampling of the following work ager start of construction: 1. Concrete Sampling and Testing 2. Soils sampling and compaction Testing 3. Asphalt Sampling, compaction and testing 4. CMU (Masonry) sampling and testing S. other as required B. Tire OWNFR's employment ofthe testing agency shall in no way relieve the Contactor of his obligations to perforin the wont in accordance with Contract requirements (see 1.05). C. The Owner will badroisrge the Contractor for costs incurred ht the event the Cenhactor's poor quality control of any material requhes excessive repeated testing by the Owner's Testing Agency. 1.03 QUALITY ASSURANCE: A. Qualification of Testing Agents: Agencies, buneaua, or laboratories shall be acceptable to the Architect and meet the requirements ASTM E-329. Failure of Materials and Equipment Tested or Inspected: 1. The Contractor shall be charged for retesting and reinspection resulting from the Contractor's noncompliance with the Contract as evidenced by tests and inspections by the Owner's Testing Agency. 1.04 TESTING AGENCY'S DUTIES: A. Cooperate with Owner's Representative and the Contractor. Provide qualified personnel promptly upon notice. B. Perforin required inspection, sampling and testing of materials and methods of oonstrucdon. a of Lodi (Revised 9/16/2015) Tmaeg 01410 - 241 at/ ofLodi GRADE O'MATION I ARNEY LANE AT UM 01410 Taman 1. • Comply with specified standards, other recognized authorities as specified. 2. Check For compliance with Contract Documents. C. Promptly notify the Owner's Representative and the Contactor of observed irregularities or deficiencies in the wort. D. Prompdy submit marls to the following: 1. One (1) copy to the Owner's Representative. 2. One (1) copy to the City of Lodi Public wort Deputment. E. Reports dell include the dab issued and date of test, project title and number, testing agency's name and address, name and signature of inspector. date of inspection or samplingoecord ofiempaature and weather, identification of product and Specification Section, location in Project, type of inspection or tat, reference tv applicable standards and codes, and observation regarding compliance with Contract Documents. F. Perform addidonal services as required by the Owner. G. The luting agency is not authorized to release, revoke, alter or enlarge on the sequhements ofthe Contract Documents, approve or accept any portion of the work, or peribrm any of the Contractor's dada. 1.05 CONTRAC'IOR'S : A. Initiate and coordinate tests and imspeodons required by Contract Documents and public authorities having jurisdiction ofthe *rook. B. Notify the OWNER'S Testing Agency through the Owner's Representative in sufficient time In advance so that the Laboratory may arrange for inspection or testing. C. When changes of cion schedule are necessary during construction, coordinate an such changes with the Testing Agency as required. E. Provide access, facilide% tools, and labor necessary nor duties to be pertbrmed at the site by the Telling Agency and Inspector, including furnishing ladders, hoisting, lighting, water supply and like services. F. Provide and maintain, for the sole use of the Testing Agency, adequate fhclllties for the snit storage ofmaterials. aty of Lodi (Revised 91164015) Toting 01410-242 Cloy of Lodi GRADE SEPARATION HARNEY LANE AT UPRR 01410 Toting G. Furnish and deliver samples of materials to be tested at no extra cost to Owner. Test samples will be selected by the Inspector or Testing Agency and not by the Contractor. IL Reports: 1. Have the Testing Inn independently Vanish copies of each test and inspection report, signed and certified by the Testing Agency Supervising Engisne;er as follows: a. Owner's Representative two (2) copies. 2. Promptly process and dbtribute (within 48 hours) regained copies oftest reports and related instructions to assure necessary retesting and replacement of materials with the least possible delay in progress of the work. 3. The reports shall include detailed infinmatian relative to progress and condition of work, including variances from the Contract Documents, and stipulating dates, hours, locations ofthe tenet and inspections, as applicable. I. Records: 1. Maintain correct records on an appropriate form for all inspections and tests perib med, instructions received from the Owner or testing agency, and actions taken as a result of those instructions. 2. These records shall include evidence that the required inspections or tests have been performed (including type and number of inspections or tests, nature of defects„ causes for rejection, etc.). proposed or directed remedial action, and corrective action taken. 3. Document inspections and tests as required by eadr Section ofthe Specifications. J. If laws, ordinances, rules, regulations, or orders of public agency having jurisdiction require work to be inspected, tested or approved by some authority otherthan the Owner, or Contractor, the Contractor shall give required notices and make arrangements, deliver to the Owner the certificates of inspection, test, or approval of such public agency, and pay costs therefore unless otherwise provided in the Contract Documents. K. Completed Work: Should the Owner require tests and Inspections for work completed before final acceptance of entire work, burnish necessary facilities, labor, and materials to uncover or remove work in queetion to extent necessary. 1. If such work is found defbctive due to fault of the Contractor, the Contactor shall defray expense of removal, test, and inspections, and satialhotory reconstruction. Time extension may not be granted. Cagy of Lodi (Revlred 9/16/2015) Tata 01410 -243 C1tr &FLedi GRADE SEPARATION HAR1EY LANE AT UPRR 01410 Troll$ 2. If such work b found to confbrm with requirements of duo Contract. the Contractor shall be reimbursed by the Owner for facilities, labor and materials required for removal, mid casts of satisfactory reconstruction in aoconlanvo with Contract amounts lbr extra woke. Reasonable time extension shall be stunted. 1.06 TEST PROCEDURES: A. Testing: 1. Testing Agency will perform tests according to mefhod(s) of test specified in these Specification or required by current rules and regulations. 2. If no procedure or teat method is specified, testing shall conibnn to .nate-611 specification references unless odseiwise directed by the Owner. 3. The Testing Agency will tag. seal, label, record, or otherwise suitably Identify the materials for toting. No materials shall be used in the work until the test reports are submitted and approved. accepting only the materials specified to be placed or installed prior to testing. B. Retesting: 1. Repeat applicable tests at specified intervals, when: a. The source of supply is changed. b. The characteristics of the materials cluing° or vary. c. Umetis tory tat results me received. 2. Quantity and nature ofadditionsl testing. if required, will be determined by the Owner. 3. Additional tests shall be taken in the presence ofthe Owner's Engineer. 4. Proof ofnon-compliance will make the Contractor liable fbr any corrective melon which the Owner (bels is prudent, including complete removal and replacement of delbctive materials. 5. Nothing contained herein is intended to imply that the Contractor does not have the night to have tests performed an any material at any time for his own information and job control so long as the Owner does not assume responsibility for costs or for giving them consideration when appraising quality of materials. 1.07 NOT USED OW &Lodi (Revised W1612015) Tatting 01410.244 city °Mods GRADE SEPARATION HAMMY LANE AT MIR 01410 Test 1.08 CODE COMPLIANCE TESTING: A. Inspections and tests required by codes or ordinanoes, or by a plan approval authority, and which aro made by a legally constituted authority, shall be the responsibility of and shall be backcbarged 10 the Contractor. 1.09 CONTRACTOR'S CONVENIENCE TESTING: A. Inspection and testing performed exclusively for the Contractor's convenience shall be the sole responsibility ofthe Contractor. PART 2 - PRODUCTS: Not used. PART 3 - EXECUTION: Not used. Forms: Inspection Request Form END OF SEC1ZON aty of Lodi (Revised 9/162015) Tem 01410 - 245 Attachment 6 Request For Testing Services Form 26 K.IWPIPROJECIMSTRIRBTSViatneyareda9cperatiesft je Allamey Lone Grade Swim TI RFP 10-21-15.doa CITY OF LODI REQUEST AND APPROVAL FOR TESTING/INSPECTION SERVICES PROJECT: GRADE SEPARATION HARNEY LANE AT UPRR DATE: TESTING/INSPECTION AGENCY: SPEC. REF: CONTRACTOR: DWG. REF: REQUESTED BY: Federal Project # STPL-5154 (040) ITEM TYPE OF TEST/INSPECTION LOCATION, TIME & DATE RESULTS 1. 2. I have personally checked for compliance with contract documents and certify this to be ready for inspection: Signature Date: Cofactor Representative TEST/INSPECTIONS PERFORMED BY: Signature Date: 'f esting/iitspectian Agency Representative COMMENTS: CITY AUTHORIZATION: TOTAL HOURS (City We Only) Attachment 7 Detail Breakdown (Billing Report) 27 KAWMPROJECTASTRREITSVIemayaradefieparationProjectRIamey Lame &ado Separation T1 RFP 10-21-15.doc Exhibit B I A b i V 1 ii os To i4 _ IIM it 1 11 Ho L Mil a mm MM MrlrICI M i1 rrr M M Ail 4 cyL il IIM M M O N 8 100 222 h O O O h 80 h h !�4p 00 cF o tt � M p 'V Ii Ar% i A Engineered Fill Observation Density (Curve) Cal 216 Soil Compaction Testing — Nuclear O k g f w Road Subgrade/Agg. base compaction Testing CTM 202 Sieve Analysis CTM 217 Sand Equivalent 1 it 1Pi a CTM 301 R Value CTM 382 Asphalt Content Ignition Oven CTM 309 Max. Specific Gravity HMA Mix o i' ) 1 Iv.a ti 1,11 g ' Cd C7 Av CTM 375 Asphalt Compaction Testing — Field Coring y i C ; Mix Design Review - ACI 301 Cement Sampling - ASTM C 183 CTM 521 Compressive Strength Concrete Specimen Tensile/Bend Test - ASTM 615-90 Elongation and Yield/ Tensile Strength 0 1 1 1 c`� Dnlied Dowel Testing (AASHTO T- 237) Concrete Placement Inspection including CTM 539, 540, 504, 518, 543, 556 and 557 as required L N Total Current Billing Due J d § . 11 , 1 22 m p FI A M M `A J A J 4 11 A Set of 4 11 MMM MMM MMM g 10 4% S $ ici m m S FiwrtK 200 200 § 80 § 1 20 § 80 O Mg`i Concrete Core Testing - ASTM C42 (incl. coring) 1 i Post Tension Cable Placement 1 I 1 Pick Up and Delivery (separate trips only) 1 k 2 Mortar Testing - UBC Std. 21-16 Grout Testing UBC Std. 21-18 \ , :41 rz a qB 2 Tensile/Bend Test ASTM 615-90 1 Masonry Placement Inspection, UBC 1701.5, 7.2 LCMU Block or Brick Testing Prisms - UBC Std. 21-17 Subtotal L Structural Steel - _ _ Shop Visual Welding 1 Field Visual Welding ° 1.--:,. § 1' 'hill Hill 0 0 •� � t I : Subtotal g NOT USED 7 2 I 1 ll PEI2 Lab Technician 7 Qj im v .. tO v 1 gg J k A.f O 1 A 1 z U iiip JA 11 'd F PR M ON M O O g rl h ~ Premium Diff. for OT Out -of -Town Inspection (beyond 50 miles) n Grand Total Ow O V'! M D OO v'1 g IAII FARTB REQUEST FOR PROPOSAL PRICING FORM Proposals are due no later than 5:00 p.m. on: November 20, 2015 Location: City of Lodi Public Works Department Attn: Gary R. Wiman, Construction Project Manager 221 West Pine Street P.O. Box 3006 Lodi, CA 95241-1910 Proposer:. The undersigned hereby proposes and agrees to furnish any and all required labor, material, transportation, insurance, and incidentals necessary to provide quality assurance testing and inspecting services pertaining to the Grade Separation Harney Lane at UPRR Overhead Project in accordance with the terms and conditions of the Request for Proposal on file at the City of Lodi, Public Works Department. Proposer declares that the only persons or parties interested in this proposal as principals are those named herein; that this proposal is made without collusion with any other person, firm, or corporation; that the undersigned will contract with the City of Lodi to provide these services in the manner and time prescribed; and that the undersigned will take in full payment therefore an amount based on the unit prices specified herein below for the various services, the total value of said services for the not to -exceed sum of 514 62 10 • D D Dollars. It is understood and agreed that the quantities of services under each item are approximate, being given as a basis of comparison of proposals, and the right is reserved by the City to increase or decrease the amount of work under any item as may be required by the City, in accordance with this agreement. It is further understood and agreed that the total amount of money set forth for each item of work, or as the total amount proposed for the project, does not constitute an agreement to pay a lump sum for these services. The quantities may be increased or decreased depending on the job requirements. IMPORTANT NOTICE If the proposer is a corporation, state legal name of corporation, also names of president, secretary, treasurer, and manager thereof. If a co -partnership, state true name of firm. If an individual, state first and last name in full. Firm Name: terra -Uf By:(�,cilrtkI Ott Dated: II/ i a= l Y_ 11 K:IwPWROJECfSISTRRETS1HameyGradeSeparstionlProjax4Hamey Lane Grade Separation TI RFP 10 21-15.doc lierracon Item Description 1 Soil/Asphalt Qty Unit Field Unit Lab Unit Total Cost Price Price Engineering Fill Observation Density (Curve) Cal 216 Soil Compaction Testing -Nuclear Gauge Footing Verification Inspection Road SubgradelAgg Base Compaction Testing CTM 202 Sieve Analysis CTM 217 San Equivalent CTM 229 Aggregate Durability CTM 301 R Value CTM 382 Asphalt Content Ignition Oven CTM 309 Max Specific Gravity HMA Mix CTM 308 Max Specific Gravity of Compacted Mix HMA Mix Design Review Asphalt Compaction Testing - Nuclear Gauge CTM 375 Asphalt Compaction Testing - Field Coring 800 25 800 100 100 10 10 10 5 10 10 10 5 80 40 Hr, Ea Hr. Hr. Hr. Ea. Ea. Ea. Ea. Ea. Ea. Ea. Ea. Hr. Hr. $ 120.00 $ 120.00 $ 130.00 $ 120.00 $ 120.00 $ 165.00 $ 200.00 $ 75.00 $ 120.00 $ 160.00 $ 270.00 $ 160.00 $ 165.00 $ 50.00 $ 250.00 $ 96,000.00 $ 5,000.00 $ 96,000.00 $ 13,000.00 $ 12,000.00 $ 750.00 $ 1,200.00 $ 1,600.00 $ 1,350.00 $ 1,600.00 $ 1,650.00 $ 500.00 $ 1,250.00 $ 9,600.00 $ 6,600.00 Subtotal $ 248,100.00 lierracon Item Description Qty Unit Field Unit Price Lab Unit Price Total Cost 2 Cast -in -Place -Concrete Mix Design Review - ACI 301 5 Ea. $ 200.00 $ 1,000.00 Cement Sampling - ASTM C 183 5 Ea. $ 200.00 $ 1,000.00 CTM 521 Compressive Strength Concrete Specimen 80 sets 4 cyl. $ 112.00 $ 8,960.00 Tensile/Bend Test - ASTM 615-90 40 Ea. $ 145.00 $ 5,800.00 Elongation and Yield/Tensile Strength 40 Ea. $ 20.00 $ 800.00 Reinforcement Placement Inspection 300 Hr. $ 130.00 $ 39,000.00 Drilled Dowel Testing (AASHTO T-237) 40 Hr. $ 130.00 $ 5,200.00 Concrete Placement Inspection including: CTM 539,540,504,518,543,556,and 557 as required. 400 Hr. $ 130.00 $ 52,000.00 Concrete Core Testing - ASTM C42 (Including coring) 10 Ea. $ 120.00 $ 1,200.00 Drilled in Anchor Testing 40 Hr. $ 130.00 $ 5,200.00 Post Tension Cable Placement 200 Hr. $ 130.00 $ 26,000.00 Post Tensioning Inspection 60 Hr. $ 130.00 $ 7,800.00 Pickup and Delivery of Samples (separate trips only) 40 Ea./set $ 5.00 $ - $ 200.00 Subtotal $ 154,160.00 lierracon Item 3 Item 4 Item Description Masonry Mortar Testing - UBC STd. 21-16 Grout Testing UBC Std. 21-28 Mix Design Review/Report Tensile Bend Test ASTM 615-90 Masonry Placement Inspection, UBC 1701.5, 7.2 CMU Block or Brick Testing Prisms - UBC Std. 21-17 Description Structural Steel Shop Visual Welding Field Visual Welding Shop Fabrication Inspection Field Bolting (Torque) Inspection w! Reports Metal Deck Welding Ultrasonic Testing 5 NOT USED Description QtY 25 25 3 10 200 4 4 Qty 200 200 200 100 80 100 Qty Unit Set Set Ea. Ea. Hr. Set of 4 Ea. Unit Hr. Hr. Hr. Hr. Hr. Hr. Unit Field Unit Lab Unit Price Price $ 130.00 Field Unit Price $ 105.00 $ 130.00 $ 105.00 $ 130.00 $ 130.00 $ 130.00 Field Unit Price $ 84.00 $ 84.00 $ 200.00 $ 165.00 $ 740.00 $ 185.00 Subtotal Lab Unit Price Subtotal Lab Unit Price Total Cost $ 2,100.00 $ 2,100.00 $ 600.00 $ 1,650.00 $ 26,000.00 $ 2,960.00 $ 740.00 $ 36,150.00 Total Cost $ 21,000.00 $ 26,000.00 $ 21,000.00 $ 13,000.00 $ 10,400.00 $ 13,000.00 $ 104,400.00 Total Cost Terracon Item Description Qty Unit Field Unit Price Lab Unit Price Total Cost 6 Professional Services Senior Staff Engineer 20 Hr. $ 145.00 $ 2,900.00 Field Technician 100 Hr. $ 120.00 $ 12,000.00 Lab Technician 80 Hr. $ 95.00 $ 7,600.00 Subtotal $ 22,500.00 Item Description Qty Unit Field Unit Price Lab Unit Price Total Cost 7 Miscellaneous Premium Diff. For OT 100 Hr. $ 40.00 $ 4,000.00 Out -of -Town Inspection (beyond 50 miles) 40 Hr. $ 90.00 $ 3,600.00 Mileage (beyond 50 miles) 500 Mile $ 0.70 $ 350.00 Subsistenance (beyond 50 miles) 10 Day $ 135.00 $ 1,350.00 Subtotal $ 9,300.00 Grand Total $ 574,610.00 lrerracon 4 February 2016 Proposal Number: PNA150413 Mr. Gary Wiman Construction Project Manager City of Lodi 221 W. Pine Street Lodi, CA 95240 Re: Proposal to Provide Construction Materials Testing and Inspection Services Dear Mr. Wiman: Terracon is pleased to submit a proposal to provide materials testing and inspection services for the Grade Separation Hamey Lane at UPRR Overhead project located in Lodi, Califomia. We have extensive experience providing construction materials testing and inspection services. Terracon has offices based in Lodi, Sacramento, and Concord, California, and provides a wide range of engineering services induding geotechnical, materials, foundation and structural engineering, geophysical exploration, environmental and geosciences, forensic investigations, pod engineering, and aquatic design. We continue to view our company as a vital and growing consulting firm of engineers and scientists, providing multiple related service lines to clients at local, regional, and national levels. M of our services are delivered on a timely basis with high value and attention to client needs. Benefits to working with Terracon include: Responsiveness: Acting quickly to meet your deadlines, our employee owners are always available to you. With convenient locations across the country, were able to qtiddy mobilize a workforce to respond to accelerated schedules and your changing needs. Resourcefulness: Applying new processes, methodologies, and techniques allows us to take a proactive approach to solving project challenges and deliver your projects better and faster. With our nationwide network of offices, we can initiate services easily on one or multiple projects simultaneously. Reliability: With vast experience working in local conditions, Terracon is a dependable partner throughout the fife of your project. We delver practical and constructible solutions, while avoiding delays, surprises, and costly mistakes down the road. We are confident that Terracon will provide the City of Lodi with a high level of service and look forward to working with you. Should you have any questions regarding the attached proposal, please contact me at (209) 367-3701 or email me at tmschiess@terracan.com. Thank you for your time and consideration. Sincerey, Terracon, Troy M. Schiess, PE 71404 Materials Department Manager Terracon 902 Industrial Way Lodl, CA 95240 Main (209) 367-3701 Fax (209) 333-8303 Dispatch (209) 263-0600 terracon.com Environmental • Facilities • GHntcchr ICaI • Materials Environmental ■ Facilities • Geotechnical ■ Material■ Pool Engineering Project Name: Grade Separation Hamey Lane at UPRR Overhead Proposal No. PNA150413 Service Rate G QUD 1 Lead Project Inspector — Regular Time (8hr shift) $1080/shift Lead Project Inspector - Overtime $164/hour Lead Project Inspector — Double-time $195/hour Group 2 Building/Construction Inspector — Regular Time (8hr shift) $1030/shift $160/hour Building/Construction Inspector —Overtime Building/Construction Inspector — Double-time $192/hour Group 3 Inspector/Technidan — Regular Time (8hr shift) $910/shift Inspector/Technician — Overtime $137/hour Inspector/Technidan — Double-time $161/hour Additional services requested beyond what is outlined in the above proposal will be invoiced per our attached fee schedule. Time shall be billed from portal to portal. Weekends and holidays will be charged in 4 and / hour increments. Overtime and doublet -time, if any, will be applied per the Califomia Labor Law Prevailing Wage Requirement: Public works contract provisions require the Contactor and its subcontractors 10 pay aN workers employed on the project no less than the specified general prevailing wage rates for the work classification in which they are performing. Terracon 902 Industrial Way Lodi, CA 95240 Main (209) 367-3701 Fax (209) 333-8303 Dispatch (209) 263-0600 terracon.com Environmental • Facilities • Geotecl1nicaI • Materials lTerracDn I 59 2016 Schedule of Services and Fees Environmental, Geotechnical, Structural, Pool Engineering, Aquatic Design, and Materials Services ENGINEERING SERVICES Senior Principal Engineer 250.00/hr Principal Engineer/Geologist 225.00/hr Associate Engineer/Geologist 190.00/hr Senior Engineer / Geologist / Sdentist 175.00/hr Project Engineer / Geologist/ Scientist 165.00/hr Staff Engineer / Geologist / Scientist 135.00/hr Expert Consulting 275.00/hr Expert Testimony 495.00/hr Asphalt Concrete Consulting 145.00/hr ICC Inspector (Reinfordng Steel, Masonry, Concrete, Structural Steel, Post Tension, Fireproofing) 85.00/hr AC/Soils Inspedor with Nuclear Gauge 89.00/hr Certified Fietd/Shop Welding Inspector (AWS/CWI) 105.00/hr DSA Masonry Inspector 105.00/hr CAD Designer 100.00/hr CAD Drafter 88.00/hr Accountant 95.00/hr Administrative Assistant 65.00/hr HOT MIX ASPHALT (HMA) SERVICES HMA Placement Inspector 92.00/hr HMA Density Process Control 92.00/hr HMA Density Cores 110.00/hr HMA Data Cores 110.00/hr HMA Production Inspector 92.00/hr HMA Design Review 200.00/ea Lead Project Inspector Request Quote Building/Construction Project Inspector Request Quote Caltrans Certified Laboratory Technician 92.00/hr CTM125 Sample Hwy Material 92.00/hr Quality Control Manager 150.00/hr Quality Control Plan 500.00/ea EXPLORATION GEOPHYSICAL Seismic Refraction 1D -3D, Seismic Source DAQlink III, 24 Channel Acquisition System, 2 man crew Multi -Channel Analysis of Surface Waves 1D -3D, Seismic Source DAQlink III, 24 Channel Acquisition System, 2 man crew Ground Penetrating Radar, special antennas may warrant additional charge In-situ Soil Resistivity Testing, Mini -nes tester Post Processing and Analysis pitm ING Drilling/Sampling (Track mounted rigs, 2 -person crew) Drilling/Sampling (Simon 2400 and Mobile B24 truck mounted, Minute Man, 2 person aew) Drilling/Sampling (CME75 Auger) Drilling/Sampling (CME75 Mud Rotary w/desander) Drilling and Sampling (CME75 Rock Coring) Borehole Grouting Responsive 0 Resourceful 0 Reliable 280.00/hr 280.00/hr 225.00/hr 185.00/hr 165.00/hr 275.00/hr 225.00/hr 285.00/hr 325.00/hr Request Quote 285.00/hr Page 1 of 6 902 Industrial Way Lodi, CA 95240 ♦ 50 Goldenland Ct #100 Sacramento, CA 95834 • 5075 Commercial Circle Unit E Concord, CA 94520 lTerracon I 54.10. 2016 Schedule of Services and Fees (Continued) Hand -Auger Soil Sample (1 -person Crew) 135.00/hr Coring 1 Man Crew w/o Trailer (Quote will be given upon request for second operator) 145.00/hr Coring 1 Man Crew w/Trailer (Quote will be given upon request for second operator) 165.00/hr Bit Charges per 6" max core length, 4" max core diameter 34.00/ea Support Truck not induding mileage (500 gallon water tank) 250.00/day 2'5c6" Stainless -Steel Tubes and Caps, recycled 10.00/each Permitting Fees Cost + 20% Bailers (disposable) 10.00/ea Sampling Supplies (gloves, water, rope, etc.) 25.00/day Photo -ionization Detector (PID) 125.00/day Water Level Indicator 30.00/day ph/Conductivity/Temp Meter 50.00/day Dissolved Oxygen Meter 50.00/day Steam Cleaner 100.00/day Cement Pump and Mixer 100.00/day Drums 75.00/ea Drilling Supplies Cost + 25% Laboratory Analysis Cost + 30% GEOTECHNICAL SOILS AND AGGREGATES Direct Shear Test: Unconsolidated - Undrained 140.00/pant Consolidated - Undrained 165.00/point Consolidated - Drained 185.00/pant Triaxial Compression Test Unconsolidated Undralned Triax D2850 185.00/point Consolidated Undrained Triax D4767 Request Quote Consolidated - Drained Request Quote Consolidated - Undrained with Pore Pressure Measurements Request Quote Consolidation Test: Swell Only 200.00/ea Consolidation without lime Rate 340.00/ea Consolidation with Time Rate, per Toad inaement (additional charge) 120.00/ea LABORATORY HOT MIX ASPHALT (HMA) Job Mix Formula (Reduced Rate for Multiple JMF's) Request Quote CTM 202 Sieve Course Agg 60.00/ea CTM 202 Sieve Rne Agg 75.00/ea CTM 202 Sieve Ignition Sample 140.00/ea CTM 202 Batch Plant Gradation Report 50.00/ea CTM 204 Plasticity Index 125.00/ea CTM 205 Determining % Crushed Particles 185.00/ea CTM 206 Bulk SpG & Absor Coarse Agg 70.00/ea CTM 207 Bulk SpG (SDD) Fine Agg 90.00/ea CTM 211 LA Rattler Request Quote CTM 214 Sodium Sulfate Soundness (per Sieve) 150.00/ea CTM 217 Sand Equivalent 140.00/ea CTM 226 Moisture Content of Aggregates by oven drying 40.00/ea Responsive D Resourceful 0 Reliable Page 2 of 6 902 Industrial Way Lodl, CA 95240 ♦ 50 Goldenland Ct #100 Saaamento, CA 95834 • 5075 Commeraal Circle Unit E Concord, CA 94520 lierracon 2016 Schedule of Services and Fees (Continued) CTM 227 Cleanness Coarse Agg CTM 229 Durability Index CTM 234 - AASHTO T304 Fine Angularity CTM 235 - ASTM D4791 Flat and Elongated Particles CTM 304 AC Sample Preparation CTM 308 Bulk Spec Gray Bit Mix (Cores and Briquettes) CTM 309 Theo Spec Gav Bit Mix CTM 366 Stabilometer Value (Set of 3) CTM 370 Moisture Content of Bit Mix by Microwave CTM 371 Tensile Strength Ratio Reid Mix CTM 382 Ignition Fumaoe Asphalt Content CTM 382 Ignition Furnace Calibration (1 per new source) CTM 382 Ignition Fumaoe Calibration with Time LP -1 Theo Max SpG Mix with Dif AC Cont LP -2, 3, & 4 - HMA Volumetrics (VMA, VFA, DP) Calculations Report LP -10 Sampling and Testing CRM ASTM D2974 Organic Matter ASTM D5334 Thermal Resistivity MARSHALL MDC DESIGN Marshall Mix Design ASTM D1559 Stability & Flow ASTM D1075 Immersion & Compression Retained Strength ASTM D2726 Unit Weight ASTM D2172 Extraction ASTM D2172 Extraction with Gradation ASTM D2041, D2172 Max. Specific Gravity of Bituminous Mix. AGGREGATES ASTM C88 Sodium or Magnesium Sulphate Soundness (per sieve size) ASTM C40 Injurious Impurity Matter ASTM C29 Unit Weight (aggregate) CTM 212 Unit Weight (aggregates) CTM 217 Sand Equivalent Test C128 Specific Gravity, Fine C127 Specific Gravity, Coarse C535 Los Angeles Rattler Test (500 revolutions) CTM 227 Cleanness Value, Coarse Aggregate CTM 229 Durability Index: Rne & Coarse Aggregate C142 Percent Friable Particles Cal Trans Class II Aggregate Base Conformance Test (R -Value, Gradation, SE, Durability) SOILS Atterberg Limit 04318 Permeability Falling Head Specific Gravity Determination ASTM D854 C136 Sieve Analysis Fine C136 Sieve Analysis Course Wash 200 D1140 Hydrometer ASTM D422 Responsive 0 Resourceful D Reliable 165.00/ea 200.00/ea 200.00/ea 200.00/ea 50.00/ea 30.00/ea 165.00/ea 300.00/ea 50.00/ea 850.00/ea 160.00/ea 400.00/ea 500.00/ea 150.00/ea 75.00/ea 200.00/ea 80.00/ea 600.00/ea Request Quote 110.00/ea 110.00/ea 30.00/ea 300.00/ea 440.00/ea 150.00/ea 135.00/ea 75.00/ea 80.00/ea 80.00/ea 120.00/ea 70.00/ea 90.00/ea 300.00/ea 165.00/ea 200.00/ea 165.00/ea 695.00/ea 125.00/ea 280.00/ea 90.00/ea 115.00/ea 80.00/ea 230.00/ea Page 3 of 6 902 Industrial Way Lodi, CA 95240 ♦ 50 Goidenland Ct #100 Sacramento, CA 95834 • 5075 Commerdal arde Unit E Concord, CA 94520 lrerracon 2016 Schedule of Services and Fees (Continued) Laboratory Maximum Dry Density/Optimum Moisture Content Determination 4" mold AASHTO T99, ASTM D698 6" mold AASHTO T99, ASTM D698 4" mold AASHTO T180, ASTM D1557 6" mold AASHTO T180, ASTM D1557 CTM 216 Relative Compaction, Untreated and Treated Soils CTM 301 R -Value Untreated Samples CTM 301 R -Value Treated Samples pH Test pH -Lime Determination Test Resistivity and pH Test CTM 643 Swell Test (Expansion Index) ASTM D4829 CTM 373 Unconfined Compressive Lime treated Specimen Compressive Strength Cement Compressive Strength Lime Percent Lime/Cement Design, based on compressive strength (includes R -value, pH Lime Determination and Unconfined Compressive Strength) Unconfined Compression Test ASTM D2166 MASONRY BRICK/BLOCK/T=L Compression Tests on Core Specimens (includes prep) ASTM C42 Shear Tests Masonry Cone Compression Tests: (Same price for untested "hold" spedmens) Compression Test Grout Molds Compression Test Mortar Cylinder Compression 2"x4" Cylinder Molds Compression Masonry Prism (2 -block, mortared & grouted) Concrete Masonry Unit:: (Same price for untested "hold" spedmens) Compression Test Masonry Unit 8"x5 x16" Masonry Absorption Tests ASTM C140 Masonry Shrinkage (Volume Change) Masonry Lineal Shrinkage with Absorption Masonry Shrinkage with Absorption and Compression CONCRETE Concrete Mix Design Review Additional Concrete Mix Design (using same materials) Concrete Mix Design with Trial Batch & Concrete Cylinder Compression Tests Floor Flatness Testing Floor Flatness Report Unit Weight Fireproofing Compression Test Concrete Cylinders (same pride for untested "hold" specimens) Flexural Strength, Concrete Beams, 6"x6"x24 ASTM C78 Cylinder Molds (6"x12") Cement Content of Hardened Portland Cement Concrete ASTM C85 Shrink Bar Testing (3 bars per set) ASTM C157 Compression Tests on Core Specimens (indudes prep) ASTM C42 Calcium Chloride Moisture Test Kit (includes calculations) Responsive U Resourceful 0 Reliable 235.00/ea 245.00/ea 235.00/ea 245.00/ea 220.00/ea 325.00/ea 325.0%a 60.00/ea 175.00/ea 200.00/ea 215.0%a 300.00/ea 300.00/ea 300.00/ea 1600.0%a 120.00/ea 75.00/ea 145.00/ea 28.0%a 28.00/ea 15.0%a 185.00/ea 185.00/ea 105.00/ea 185.00/ea 260.00/ea 420.00/ea 200.00/ea 150.00/ea Request Quote 135.00/hr 450.00/ea 50.00/ea 28.00/ea 125.00/ea 7.00/ea Request Quote 420.00/set 75.0%a 80.00/ea Page 4 of 6 902 Industrial Way Lodi, CA 95240 ♦ 50 Goldenland Ct #100 Sacramento, CA 95834 ♦ 5075 Commerdal Circle Unit E Concord, CA 94520 lrerracon I 59 2016 Schedule of Services and Fees (Continued) STEEL AWS/ASTM/ASME/ANSI/API Structural Steel Tensile & Bend Tests: Reinforcement Steel Tensile & Bend <5 Reinforcement Steel Tensile & Bend 6 to 9 Reinforcement Steel No. 10 and larger High-strength Bolt, Nut & Washer Testing Rockwell Hardness Test HSB Torque Wrench Calibration Welder Qualification and Weld Procedure Qualifications: Weld Procedure Qualifications Welder Qualification Plate Groove Weld- 1G, 2G, 3G, 4G Welder Qualification Pipe Groove Weld - 1G, 2G, 5G, 6G, 6GR Welder Qualification Plate Fillet Weld - 1F, 2F, 3F, 4F Welder Qualification Pipe Fillet Weld - 1F, 2F, 4F, 5F WPS Test Plate (set) WPS Test Pipe (set) NON-DESTRUCTIVE TESTING High Strength Bolt (HSB) Testing Bolt Pull/Load Testing Rebar Pull Testing Ceiling Wire Pull Testing NDT GPR (for reinforcement locating only, other uses refer to Geophysical services) Pachometer STANDARD POOL ENGINEERING SERVICES The fees quoted indude response to plan check. Remodel Pian [Engineer site visit may be required] Remodel Pool Plan (typical in -ground) [Engineer excavation inspection required] Residential Pool Plan (drilled piers) [Geotechnical investigation report required] Commercial Pool Plan (typical in -ground) [Geotechnical investigation report required] Commercial Fool Plan (drilled pier) [Geotechnical investigation report required] Commerdal/Vault Pool Plan On -Site Steel and/or Excavation Observation Custom Swimming Pool Detail Custom Retaining Wall Design (1 height) Additional Heights Structural Design Computation copies Additional Plan Sheets Consulting Letter Patio Comer/Trellis Design Forensic Site Visit Full Service Aquatic Design Epoxy Injection Responsive 0 Resourceful 0 Reliable 135.00/ea 165.00/ea 205.00/ea, plus machining cost +20% 350.00/set 70.00/ea 320.00/ea 750.00/ea 130.00/ea 225.00/ea 75.00/ea 95.00/ea 65.00/ea 85.00/ea 125.00/hr 115.00/hr 115.00/hr 140.00/hr 165.00/hr 140.00/hr 800.00/min 800.00/min Request Quote 3,100.00/min Request Quote 1,500.00/min Request Quote 3,500.00/min Request Quote 2,000.00/min 400.00/min 500.00/min 500.00/min 200.00/ea 20.00/ea 15.00/ea 185.00/min Request Quote 900.00/min Request Quote 600.00/min Request Quote 1,800/min first 10', 60.00/ft. after Page 5 of 6 902 Industrial Way Lodi, CA 95240 ♦ 50 Goldenland Ct #100 Sacramento, CA 95834 ♦ 5075 Commerdal Orde Unit E Concord, CA 94520 lrerracon 1 50. 2016 Schedule of Services and Fees (Continued) MISCELLANEOUS Automobile Mileage Subsistence and Lodging Equipment Rental Field Report Preparation Pad Certification Report Final Letter (Testing/Inspections) Additional Copy of Report (wet -signed) Miscellaneous Item Charge Air & Ground Transportation CAD — Prints Responsive 0 Resourceful 0 Reliable 0.90/mile cost + 20% cost + 20% 50.00/each 150.00/each 200.00/each 50.00/each Cost +20%/each Cost +20%/each 10.00/sheet Page 6 of 6 902 Industrial Way Lodi, CA 95240 ♦ 50 Goldenland Ct #100 Sacramento, CA 95834 ♦ 5075 Commerdal Circle Unit E Concord, CA 94520 Exhibit C Insurance Reouiremonts fgr Consultant The Contractor shall take out and maintain during the life of this Agreement, insurance coverage as listed below. These insurance policies shall protect Contractor and any subcontractor performing work covered by this Agreement from daims for damages for personal injury, including accidental death, as well as from daims for property damages, which may arise from Contractor's operations under this Agreement, whether such operations be by Contractor, or by any subcontractor, or by anyone directly or indirectly employed by either of them, and the amount of such insurance shall be as follows: 1. COMPREHENSIVE GENERAL LIABILITY $1,000,000 Each Occurrence $2,000,000 General Aggregate 2. COMPREHENSIVE AUTOMOBILE LIABILITY $1,000,000 Combined Single Limit Such insurance shall cover liability arising out of any vehicle (including, owned, hired and non -hired vehicles) operated in performing any and all services pursuant to this Agreement. Coverage shall be written on ISO form CA 00 01 12 90, or a later version, that provides liability coverage at least as broad as this form. All limits are to be designated strictly for the City of Lodi, its elected and appointed boards, commissions, officers, agents, employees, and volunteers. All deductibles or self-insured retentions (SIR) must be disclosed to City's Risk Manager for approval and shall not reduce the limits of liability set forth hereinabove. Insurance policies containing any deductible or SIR provision shall provide, or be endorsed to provide, that the deductible or SIR may be satisfied by either the Named Insured(s) or the City of Lodi. It is required that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits set forth above, shall be available to City as an additional insured, Furthermore, the requirements for coverage and limits shall be (i) the minimum coverage and limits specified in these insurance requirements; or (ii) the broader coverage and maximum limits of coverage of any insurance policy or proceeds available to the Contractor, whichever is greater. Contractor agrees and stipulates that any insurance coverage provided to the City of Lodi shall provide for a claims period following termination of coverage which is at least consistent with the daims period or statutes of limitations found in the Califomia Tort Claims Act (Califomia Government Code Section 810 et seq.). A copy of the certificate(s) of insurance with the following endorsements shall be fumished to the City: (a) Additional Named Insured Endorsement Pursuant to a separate endorsement (ISO form CG 2010 (11/85) or a later version, that provides liability coverage at least as broad as this form) such insurance as is afforded by this policy shall also apply to the City of Lodi, its elected and appointed boards, commissions, officers, agents, employees, and volunteers as additional named insureds. An additional named insured endorsement is also required for Auto Liability. (b) Primary and Non -Contributory Insurance Endorsement Additional insurance coverage under the Contractor's policy shall be "primary and non-contributory" and will not seek contribution from City's insurance or self-insurance and shall be at least as broad as ISO form CG 20 01 0413. NOTE: (1) The street address of the CITY OF LODI must be shown along with (a) and (b) above: 221 West Pine Street, Lodi, California, 95240; (2) The insurance certificate must state, on its face or as an endorsement, a description of the proiect that it is insuring. (c) Waiver of Subrogation Include a waiver of subrogation against the City of Lodi, its elected and appointed boards, commissions, officers, agents, employees, and volunteers. A waiver is required for General Liability and Auto Liability. (d) Limits of Coverage The limits of insurance coverage required may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess insurance of Contractor shall contain, or be endorsed to contain, a provision that such coverage shall also apply on a primary -and -non -co 'butory basis for the benefit of the City before the City's own insurance or self-insurance shall be called upon to protect the City as a named insured. Page 11 of 2 pages .- Risk: rev.08.2015 (e) Severabilitv of Interest Clause The term "insured' is used severally and not collectively, but the inclusion herein of more than one insured shall not operate to increase the limit of the company's liability. (f) Notice of Cancellation or Change in Coverage Endorseme ( This policy may not be canceled nor the coverage reduced by the company without 30 days' prior written notice of such cancellation or reduction in coverage to the Risk Manager, City of Lodi, 221 West Pine St., Lodi, CA 95240. (g) Continuity of Coverage All policies shall be in effect on or before the first day of the Term of this Agreement. At least thirty (30) days prior to the expiration of each insurance policy, Contractor shall fumish a certificate(s) showing that a new or extended policy has been obtained which meets the minimum requirements of this Agreement. Contractor shall provide proof of continuing insurance on at least an annual basis during the Term. If Contractor's insurance lapses or is discontinued for any reason, Contractor shall Immediately notify the City and immediately obtain replacement insurance. (h) Failure to Comply If Contractor fails or refuses to obtain and maintain the required insurance, or fails to provide proof of coverage, the City may obtain the insurance. Contractor shall reimburse the City for premiums paid, with interest on the premium paid by the City at the maximum allowable legal rate then in effect in California. The City shall notify Contractor of such payment of premiums within thirty (30) days of payment stating the amount paid, the names) of the insurer(s), and rate of interest. Contractor shall pay such reimbursement and interest on the first (1°) day of the month following the City's notice. Notwithstanding and other provision of this Agreement, if Contractor fails or refuses to obtain or maintain insurance as required by this agreement, or fails to provide proof of insurance, the City may terminate this Agreement upon such breach. Upon such termination, Contractor shall immediately cease use of the Site or facilities and commence and diligently pursue the removal of any and all of its personal property from the site or facilities. (i) Qualified Insurers) All insurance required by the terms of this Agreement must be provided by insurers licensed to do business in the State of Califomia which are rated at least "A-, VI" by the AM Best Ratings Guide, and which are acceptable to the City. Non -admitted surplus lines carriers may be accepted provided they are included on the most recent list of Califomia eligible surplus lines insurers (LESLI list) and otherwise meet City requirements. Workers Compensation Insurance The Contractor shall take out and maintain during the life of this Agreement, Worker's Compensation Insurance for all of Contractor's employees employed at the site of the project and, if any work is sublet, Contractor shall require the subcontractor similarly to provide Worker's Compensation Insurance for all of the latter's employees unless such employees are covered by the protection afforded by the Contractor. In case any class of employees engaged in hazardous work under this Agreement at the site of the project is not protected under the Worker's Compensation Statute, the Contractor shall provide and shall cause each subcontractor to provide insurance for the protection of said employees. A waiver of subrogation Is required for workers compensation insurance. This policy may not be canceled nor the coverage reduced without 30 days' prior written notice of such cancellation or reduction in coverage to the Risk Manager, City of Lodi, 221 West Pine St., Lodi, CA 95240. NOTE: The City reserves the right to obtain a full certified copy of any insurance policy or endorsements required. Failure to exercise this right shall not constitute a waiver of the City's right to exercise after the effective date. Page 21 of 2 pages I Risk: rev.08.2015 AMENDMENT NO. 1 Michael Baker International, Inc. Professional Services Agreement THIS AMENDMENT NO. 1 TO PROFESSIONAL SERVICES AGREEMENT, is made and entered this day of , 2016, by and between the CITY OF LODI, a municipal corporation (hereinafter "CITY"), and MICHAEL BAKER INTERNATIONAL, INC. (hereinafter "CONSULTANT"). WITNESSETH: 1. WHEREAS, CONSULTANT and CITY entered into a Professional Services Agreement (Agreement) on May 26, 2015, and Consent to Assign on January 27, 2016, as set forth in Exhibit 1 (attached); and 2. WHEREAS, CITY requested to amend the Scope of Services as set forth in Exhibit 2 (attached); and 3. WHEREAS, CITY requested to amend the fees to increase the existing not to exceed amount by $24,000, for a total, not to exceed $43,999, as set forth in Exhibit 3 (attached); and 4. WHEREAS, CITY requested to amend said Agreement to extend the term through March 30, 2018; and 5. WHEREAS, CONSULTANT agrees to said amendment. NOW, THEREFORE, the parties agree to amend the Scope of Services, Fees, and Term of the Agreement. All other terms and conditions of the Agreement remain unchanged. IN WITNESS WHEREOF, CITY and CONSULTANT have executed this Amendment No. 1 on , 2016. CITY OF LODI, a municipal corporation MICHAEL BAKER INTERNATIONAL, INC. Hereinabove called "CITY" Hereinabove called "CONSULTANT" STEPHEN SCHWABAUER City Manager Attest JENNIFER M. FERRAIOLO, City Clerk Approved as to Form: JANICE D. MAGDICH City Attorney Name: Title: Exhibit 1 CONSENT TO ASSIGNMENT- CONTRACT #6460 MICHAEL BAKER INTERNATIONAL, INC.— PAYROLL AND LABOR COMPLIANCE REVIEW SERVICES THIS CONSENT TO ASSIGNMENT OF PROFESSIONAL SERVICES AGREEMENT, is made and entered this Jitil day of , 2016, by and between the CITY OF LODI, a municipal corporation (hereinafter "CITY"), MICHAEL BAKER INTERNATIONAL, INC., (hereinafter "CONSULTANT"). WITNESSETH: 1. WHEREAS, Pacific Municipal Consultants and CITY entered into a Professional Services Agreement (Agreement) on March 24, 2015, as set forth in Exhibit 1 (attached); 2. WHEREAS, Pacific Municipal Consultants wishes to assign the Agreement to Michael Baker International, Inc.; and 3. WHEREAS, CITY consents to said assignment; NOW, THEREFORE, the City provides approval to Pacific 'Municipal Consultants to assign and agrees to and CONSULTANT accepts the assignment of the Agreement set forth in Exhibit 1. All other terms and conditions, including compensation, shall remain as set forth in the Agreement as set forth in Exhibit 1. IN WITNESS WHEREOF, CITY and CONSULTANT have executed this Amendment No. 1 on 1 A.nukt, c- Y) , 2016. CITY OF LODI, a municipal corporation MICHAEL BAKER INTERNATIONAL, INC. hereinabove called "CONSULTANT" STEPH SCHWA City Manager 'me: ACevcr' G,�� r Title: v tce efcsrae(* Attest: PACIFIC MUNICIPAL CONSULTANTS NIFER 11 FERR IOLO PHILIP O. CARTER i y Clerk Vice -President w-_ Approved as to Form: JANICE O.' MAGDICH City Attorney AGREEMENT FOR PROFESSIONAL SERVICES ARTICLE 1 PARTIES AND PURPOSE Exhibit 1 =�> .;��, Section 1.1 Parties THIS AGREEMENT is entered into on (fV f h 2 , 2015, by and between the CITY OF LODI, a municipal corporation (hereinafter "CITY"), and Pacific Municipal Consultants (PMC) (hereinafter "CONSULTANT"). Section 1.2 Purpose CITY selected the CONSULTANT to provide the services required in accordance with attached Scope of Services, Exhibit A, attached and incorporated by this reference. CITY wishes to enter into an agreement with CONSULTANT for assistance in documenting and ensuring contract compliance with State and Federal regulations (hereinafter "Project") as set forth in the Scope of Services attached here as Exhibit A. CONSULTANT acknowledges that it is qualified to provide such services to CITY. ARTICLE 2 SCOPE OF SERVICES Section 2.1 Scope of Services CONSULTANT, for the benefit and at the direction of CITY, shall perform the Scope of Services as set forth in Exhibit A. Section 2.2 Time For Commencement and Completion of Work CONSULTANT shall commence work pursuant to this Agreement, upon receipt of a written notice to proceed from CITY or on the date set forth in Section 2.6, whichever occurs first, and shall perform all services diligently and complete work under this Agreement based on a mutually agreed upon timeline or as otherwise designated in the Scope of Services. CONSULTANT shall submit to CITY such reports, diagrams, drawings and other work products as may be designated in the Scope of Services. CONSULTANT shall not be responsible for delays caused by the failure of CITY staff to provide required data or review documents within the appropriate time frames. The review time by CITY and any other agencies involved in the project shall not be counted against CONSULTANT's contract performance period. Also, any delays due to weather, vandalism, acts of God, etc., shall not be counted. CONSULTANT shall 1 remain in contact with reviewing agencies and make all efforts to review and return all comments. Section 2.3 Meetings CONSULTANT shall attend meetings as may be set forth in the Scope of Services. Section 2.4 Staffing CONSULTANT acknowledges that CITY has relied on CONSULTANT's capabilities and on the qualifications of CONSULTANT's principals and staff as identified in its proposal to CITY. The Scope of Services shall be performed by CONSULTANT, unless agreed to otherwise by CITY in writing. CITY shall be notified by CONSULTANT of any change of Project Manager and CITY is granted the right of approval of all original, additional and replacement personnel at CITY's sole discretion and shall be notified by CONSULTANT of any changes of CONSULTANT's project staff prior to any change. CONSULTANT represents it is prepared to and can perform all services within the Scope of Services (Exhibit A) and is prepared to and can perform all services specified therein. CONSULTANT represents that it has, or will have at the time this Agreement is executed, all licenses, permits, qualifications, insurance and approvals of whatsoever nature are legally required for CONSULTANT to practice its profession, and that CONSULTANT shall, at its own cost and expense, keep in effect during the life of this Agreement all such licenses, permits, qualifications, insurance and approvals, and shall indemnify, defend and hold harmless CITY against any costs associated with such licenses, permits, qualifications, insurance and approvals which may be imposed against CITY under this Agreement. The City acknowledges and agrees that the Consultant has invested considerable time and money that would be difficult to quantify in the training and development of Consultant's employees. Therefore, without receiving the Consultant's written permission, the City agrees not to hire, retain or contract with any employee of Consultant who performs services for the City under this Agreement for a period of one year from the date this Agreement is terminated. Section 2.5 Subcontracts Unless prior written approval of CITY is obtained, CONSULTANT shall not enter into any subcontract with any other party for purposes of providing any work or services covered by this Agreement. 2 Section 2.6 Term The term of this Agreement commences on March 30, 2015 and terminates upon the completion of the Scope of Services or on March 30, 2017, whichever occurs first. Section 2.7 Option to Extend Term of Agreement At its option, City may extend the terms of this Agreement for an additional two (2) one (1) -year extensions; provided, City gives contractor no Tess than thirty (30) days written notice of its intent prior to expiration of the existing term. In the event City exercises any option under this paragraph, all other terms and conditions of this Agreement continue and remain in full force and effect. The total duration of this Agreement, including the exercise of any option under this paragraph, shall not exceed four (4) years. ARTICLE 3 COMPENSATION Section 3.1 Compensation _ CONSULTANT's compensation for all work under this Agreement shall conform to the provisions of the Fee Proposal, attached hereto as Exhibit B and incorporated by this reference. CONSULTANT shall not undertake any work beyond the scope of this Agreement unless such additional work is approved in advance and in writing by CITY. Section 3.2 Method of Payment CONSULTANT shall submit invoices for completed work on a monthly basis, or as otherwise agreed, providing, without limitation, details as to amount of hours, individual performing said work, hourly rate, and indicating to what aspect of the Scope of Services said work is attributable. CONSULTANT's compensation for all work under this Agreement shall not exceed the amount of the Fee Proposal. CITY shall make payment within thirty (30) days receipt of each properly submitted invoice. Section 3.3 Costs The Fee Proposal shall include all reimbursable costs required for the performance of the Scope of Services. Payment of additional reimbursable costs considered to be over and above those inherent in the original Scope of Services shall be approved in advanced and in writing, by CITY. 3 Section 3.4 Auditing CITY reserves the right to periodically audit all charges made by CONSULTANT to CITY for services under this Agreement. Upon request, CONSULTANT agrees to furnish CITY, or a designated representative, with necessary information and assistance needed to conduct such an audit. CONSULTANT agrees that CITY or its delegate will have the right to review, obtain and copy all records pertaining to performance of this Agreement. CONSULTANT agrees to provide CITY or its delegate with any relevant information requested and shall permit CITY or Its delegate access to its premises, upon reasonable notice, during normal business hours for the purpose of interviewing employees and inspecting and copying such books, records, accounts, and other material that may be relevant to a matter under investigation for the purpose of determining compliance with this requirement. CONSULTANT further agrees to maintain such records for a period of three (3) years after final payment under this Agreement. ARTICLE 4 MISCELLANEOUS PROVISIONS Section 4.1 Nondiscrimination In performing services under this Agreement, CONSULTANT shall not discriminate in the employment of its employees or in the engagement of any sub CONSULTANT on the basis of race, color, religion, sex, sexual orientation, marital status, national origin, ancestry, age, or any other criteria prohibited by law. Section 4.2 ADA Compliance In performing services under this Agreement, CONSULTANT shall comply with the Americans with Disabilities Act (ADA) of 1990, and all amendments thereto, as well as all applicable regulations and guidelines issued pursuant to the ADA. Section 4.3 Indemnification and Responsibilitv for Damage CONSULTANT to the fullest extent permitted by law, shall indemnify and hold harmless CITY, its elected and appointed officials, directors, officers, employees and designated volunteers from and against any claims, damages, losses, and expenses (including reasonable attorney's fees), arising out of performance of the services to be performed under this Agreement, to the extent any such claim, damage, loss, or expense is caused by the negligent acts, errors or omissions of CONSULTANT, any subcontractor employed directly by CONSULTANT, anyone directly or indirectly employed by any of them, or anyone for whose acts they may be liable, except those 4 injuries or damages arising out of the active negligence or willful misconduct of the City of Lodi or its officers or agents. Section 4.4 No Personal Liability Neither the City Council, nor any other officer or authorized assistant or agent or City employee shall be personally responsible for any liability arising under this Agreement. Section 4.5 Responsibility of CITY CITY shall not be held responsible for the care or protection of any material or parts of the work described in the Scope of Services prior to final acceptance by CITY, except as expressly provided herein. Section 4.6 Insurance Requirements for CONSULTANT CONSULTANT shall take out and maintain during the life of this Agreement, insurance coverage as set forth in Exhibit C attached hereto and incorporated by this reference. Section 4.7 Successors and Assigns CITY and CONSULTANT each bind themselves, their partners, successors, assigns, and legal representatives to this Agreement without the written consent of the others. CONSULTANT shall not assign or transfer any interest in this Agreement without the prior written consent of CITY. Consent to any such transfer shall be at the sole discretion of CITY. Section 4.8 Notices Any notice required to be given by the terms of this Agreement shall be in writing signed by an authorized representative of the sender and shall be deemed to have been given when the same is personally served or upon receipt by express or overnight delivery, postage prepaid, or three (3) days from the time of mailing if sent by first class or certified mail, postage prepaid, addressed to the respective parties as follows: To CITY: To CONSULTANT: City of Lodi 221 West Pine Street P.O. Box 3006 Lodi, CA 95241-1910 Attn: Julia Tyack, Transportation Planner Pacific Municipal Consultants (PMC) Attn: Philip O. Carter, President 2729 Prospect Park Drive, Suite 220 Rancho Cordova, CA 95670 5 Section 4.9 Cooperation of CITY CITY shall cooperate fully and in a timely manner in providing relevant information it has at its disposal relevant to the Scope of Services. Section 4.10 CONSULTANT is Not an Employee of CITY CONSULTANT agrees that in undertaking the duties to be performed under this Agreement, it shall act as an independent CONSULTANT for and on behalf of CITY and not an employee of CITY. CITY shall not direct the work and means for accomplishment of the services and work to be performed hereunder, CITY, however, retains the right to require that work performed by CONSULTANT meet specific standards without regard to the manner and means of accomplishment thereof. Section 4.11 Termination CITY or CONSULTANT may terminate this Agreement, with or without cause, by giving the other party at least ten (10) days written notice. Where phases are anticipated within the Scope of Services, at which an intermediate decision is required concerning whether to proceed further, CITY may terminate at the conclusion of any such phase, Upon termination, CONSULTANT shall be entitled to payment as set forth in the attached Exhibit B to the extent that the work has been performed. Upon termination, CONSULTANT shall immediately suspend all work on the Project and deliver any documents or work in progress to CITY. However, CITY shall assume no liability for costs, expenses or lost profits resulting from services not completed or for contracts entered into by CONSULTANT with third parties in reliance upon this Agreement. Section 4.12 Confidentiality CONSULTANT agrees to maintain confidentiality of all work and work products produced under this Agreement, except to the extent otherwise required by law or permitted in writing by CITY. CITY agrees to maintain confidentiality of any documents owned by CONSULTANT and clearly marked by CONSULTANT as "Confidential" or "Proprietary", except to the extent otherwise required by law or permitted in writing by CONSULTANT. CONSULTANT acknowledges that CITY is subject to the California Public Records Act. Section 4.13 Applicable Law. Jurisdiction, Severability, and Attorney's Fees This Agreement shall be governed by the laws of the State of California. Jurisdiction of litigation arising from this Agreement shall be venued with the San Joaquin County Superior Court. If any part of this Agreement is found to conflict with applicable laws, such part shall be inoperative, null, and void insofar as it is in conflict witl�aid laws, but the remainder ofthis Agreement shall be in force and effect. In the 6 event any dispute between the parties arises under or regarding this Agreement, the prevailing party in any litigation of the dispute shall be entitled to reasonable attorney's fees from the party who does not prevail as determined by the San Joaquin County Superior Court. Section 4.14 City Business License Requirement CONSULTANT acknowledges that Lodi Municipal Code Section 3.01.020 requires CONSULTANT to have a city business license and CONSULTANT agrees to secure such license and pay the appropriate fees prior to performing any work hereunder. Section 4.15 Captions The captions of the sections and subsections of this Agreement are for convenience only and shall not be deemed to be relevant in resolving any question or interpretation or intent hereunder. Section 4.16 Integration and Modification This Agreement represents the entire understanding of CITY and CONSULTANT as to those matters contained herein. No prior oral or written understanding shall be of any force or effect with respect to those matters covered hereunder. This Agreement may not be modified or altered except in writing, signed by both parties. Section 4.17 Contract Terms Prevail All exhibits and this Agreement are intended to be construed as a single document. Should any inconsistency occur between the specific terms of this Agreement and the attached exhibits, the terms of this Agreement shall prevail. Section 4.18 Severability. The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. Section 4.19 Ownership of Documents All documents, photographs, reports, analyses, audits, computer media, or other material documents or data, and working papers, whether or not in final form, which have been obtained or prepared under this Agreement, shall be deemed the property of CITY. Upon CITY's request, CONSULTANT shall allow CITY to inspect all such documents during CONSULTANT's regular business hours. Upon termination or completion of services under this Agreement, all information collected, work product and documents shall be delivered by CONSULTANT to CITY within ten (10) calendar days. CITY agrees to indemnify, defend and hold CONSULTANT harmless from any liability resulting from CITY's use of such documents for any purpose other than the purpose for which they were intended. 7 Section 4.20 Authority The undersigned hereby represent and warrant that they are authorized by the parties to execute this Agreement. Section 4.21 Federal Transit Funding Conditions ® If the box at left is checked, the Federal Transit Funding conditions attached as Exhibit D apply to this Agreement. In the event of a conflict between the terms of this Agreement or any of its other exhibits, and the Federal Transit Funding Conditions, the Federal Transit Funding Conditions will control. IN WITNESS WHEREOF, CITY and CONSULTANT have executed this Agreement as of the date first above written. ATTEST. CITY OF LODI, a municipal corporation NIFER FERRAIOLOTEPHEN SCHWABAU Clerk 644ityyManager APPROVED AS TO FORM: JANICE D. MAGDICH, City Attorney By ; _ PACIFIC MUNICIPAL CONSULTANTS (PMC) By: Name: PHILIP O. CARTER Title: -President Attachments: Exhibit A — Scope of Services Exhibit B — Fee Proposal Exhibit C — Insurance Requirements Exhibit D — Federal Transit Funding Conditions (if applicable) Funding Source: Various Federal Proiect Accounts (Business Unit & Account No.) Doc ID:WP\Projects\PSAs\PMC2015 CA:rev.01.201S 8 Exhibit A/B PM C6 January 28, 2015 Julia Tyack, Transportation Planner CITY OF LODI 221 West Pine Street Lodi, CA 95240 Jtyack@lodl.gov RE: ' REQUEST FOR PROPOSALS — PAYROLL AND LABOR COMPLIANCE REVIEW Dear Ms. Tyack: Thank you for your request for PMC's qualifications to provide labor compliance services to the City of Lodi In its state- and federally funded public works projects. PMC Is an experienced consultant that provides talented and hard-working staff to supplement local resources. PMC has supported the City's Community Development Block Grant (CDBG) program since 2006. This includes providing labor compliance monitoring services. PROJECT UNDERSTANDING AND SCOPE OF WORK PMC would be pleased to provide the scope of labor compliance services as described In your request dated January 21, 2015. This will include documenting and ensuring contractor compliance with state and federal regulations, Including Davis Bacon prevailing wage requirements on City capital improvement projects. Tasks may include but are not limited to employee Interviews (using HUD -II), payroll review for compliance with prevailing wages, and timely communication with the prime contractor to obtain correct documents from both the prime contractor and subcontractors. PMC will also attend preconstructlon meetings as requested to prepare the prime contractor for required payroll compliance documents. If desired, PMC will also assist with selecting and providing wage decisions, collecting and reviewing the required 10 -day documentation, calculating and ordering wage restitution, and compiling Information for and completing any required reports. Site visits by PMC will be scheduled to Interview employees and also to observe and note the work being completed. Employee Interviews and site visit notes will be used to examine certified payroll reports. PROJECT PERSONNEL The staff describe below will be providing services to the City. JENNIFER GASTELUM1 SERVICE AREA LEAD Ms. Gastelum has more than 14 years of experience in housing, planning, and project management. As the service area lead for housing and community development, she will provide general oversight 2729 Prospect Park Drive, Suite 220 • Rancho Cordova, CA 95670 • P: (916) 3614384 • F: (910) 381-1574 s r I e, e r AO CITY OF LODI RE: REQUEST FOR PROPOSALS - PAYROLL AND LABOR COMPLIANCE REVIEW Page 2 ROB SRONCE, PROJECT MANAGER AND LABOR COMPLIANCE OFFICER Mr. Sronce has over 20 years of housing and community development experience, with 11 years of direct experience working with HUD and HCD staff to administer federal and state housing and community development grants. In that time, he has designed, developed, and Implemented housing programs for several agencies as an employee and as a consultant, Mr. Sronce currently provides on-site assistance to the City of Lodi's CDBG program including labor compliance monitoring. He also provides labor compliance services to the City of Rancho Cordova. RELEVANT FIRM EXPERIENCE PMC has provided labor compliance services to the following clients: • City of Lodi • City of Rancho Cordova • The Wayfarer Center of Woodland • City of Elk Grove • City of Corona (third -party review) • County of Monterey (third -party review) • City of Walnut Creek • City of Citrus Heights • City of Rio Vista REFERENCES Please find below three references for labor compliance services. Additional references are available on request. Joseph Wood, Manager Neighborhood Services Division City of Lodi (209) 333-67I 1 Scott Thurmond, Executive Director Friends of the Mission, Woodland (916) 416-0901 Jessica Hayes, Housing Services and Development Specialist City of Rancho Cordova (916) 851-8761 HOURLY RATES Below are hourly billing rates for the listed personnel. PMC bills In quarter-hour increments and Invoices on a monthly basis. • Jennifer Gastelum, Service Area Lead $135 • Rob Sronce, Project Manager and Labor Compliance Officer $110 Sincerely, Philip O. Carter Robert Sronce President Project Manager POC: rs: sw:jm P:1Californla, Sate oRLodi, City ot\P13.1047 Labor Compliance Not to Exceed $19,999 JENNIFER GASTELUM Service Area Lead tiAs E well im 'fir irigS over 13 vers CN experience (o projects throughout C , Ilrol'rllc, i4c''vada. and Washington She is experience_, in managing I_hs' preparation of 1-.ousing Elements, I loos uq Condition tSu'vev Repoits, olirlArrr7 1�1,3n�, A.rtior flans, Analysis of :r71pcdime nts io Fair f lousing Choice, and (sr`ler hoJS'.g g polity doctirvi ri s, Her most recent housing expel enc e int hides Housing Flergent updates to, over CMO doled :.dl'TO"'ia:a cities as ,bell dS Consul dated Plan') for many Jurisdictions thio ighotit : all'Jrrltii. f.IS. t rdSCElUnI :'e ently serveo as the iabcr corrplialce o ficer on The Crossings @ New Rancho pioject, an ](-unit muIrfamily affordable rental construction project_ and is currently overseeing Enemy Cfficiency and Conservation Block `,rant I.FFCB(5) program monitoring and reporting assistance for the Clay of Elk Grove. RELEVANT PROJECT EXPERIENCE imperial County, HOME Grant Administration. Currently manages Imperial County's HOME -Funded First -Time Homebuyers Program. City of Rancho Cordova, CDBG. Provides as -needed technical assistance and guidance To the City in the adminisl ration of its horsing and community development programs, induding programs funded by CDBG and housing impact fees. City of Citrus I leights, CDBG. Provides on-call technical assistance to the City for Its CDBG and housing programs, including guidance on eligibility, environmental review, and reporting. Monterey County, CDBG, NSP, HOME, Calf IOME. Provides technical assistance and guidance to the County on irs state housing and community dcvclopmenc grants. Efforts include record-keeping and reporting systems, compliance., and program development. EDUCATION BS, City and Regional Planning College of Archirecture ani Erlwior'mental Design, California Polytechnic State University, San Luis Obispo AA, American River Junior College, Sacramento PROFESSIONAL AFFILIATIONS AND AWARDS American Planning Associarion (APA) California Chapter of the American Planning Association (CCAPA) Parsons Infrasuuctuie and Technology, Inc., Excellence rn Action Award, September 2003 American Planning Association, 2000 Student Project Award, City of Atascadero Draft General Plan, 2000 ROBERT S. SRONCE Project Manager and Labor Compliance Officer !v''.1 Sconce. l'a': srS Cfi 11ou51ric iLuId con?. riunity deve.opm,2ht _•r::, with 10 'fc�rAirccr ; x crienCn wcrkil lg with l G X11ICD stilt to adrr' nis ei Inder:11 and 'irate housing and community development 9.r:ant-;, li` 0' it time, he 'ias dosieiiled, developed, and Irnplemen ed nous:ng Droclrams'or several ag ncies as an employee and as a ConSUltunl RELEVANT PROJECT EXPERIENCE City of Lodi. Ou-site staffing to support the City's CDBG program including labor compliance services. This includes day-to-day management nF subrec:ipienrs, reporting, planning and compliance. Currently provides labor compliance monitoring services to the City. City of Rancho Cordova, Provides as -needed rechnical assistance and guidance to the City in the administration of its housing and community developnienr programs, including programs funded by CDBG and housing impact fees. Currendy provides labor compliance services. 'Wayfarer Center of Woodland. Provided labor compliance monitoring services for the rehabilitation of rhe commercial kitchen at Walter's House, a mission of the Wayfarer Center, Walters House provides residential treatment for alcoholism and drug addiction. City of Corona. Provided technical assistance and program support in support of the City's NSP, CDBG, and HOME programs, including oversight and managemenr ofsuhgranrees as well as compliance, research, planning, and implementation. Reviewed labor compliance done by a third party. City of Elly Grove, Provided. as -needed technical assistance and guidance co the City in the administration of its housing and community development programs. Part of rhe team assisting the. City to implement ics federal NSP -funded programs. Monterey County. Provided technical assistance and guidance to the County on its scare housing and community development grants. Efforts induded record-keeping and reporting systems, compliance, and program development. Reviewed labor compliance dont by a Third party. EDUCATION BS, Community Studies, University of California, Davis 1IUD-Cartified HOME Program Specialise EXHIBIT C Jnsurance Rggulrements for Consultant The Consultant shall take out and maintain during the life of this Agreement, Insurance coverage as listed below. These insurance policies shall protect Consultant and any subcontractor performing work covered by this Agreement from claims for damages for personal injury, including accidental death, as well as from claims for property damages, which may arise from Consultants operations under this Agreement, whether such operations be by Consultant, or by any subcontractor, or by anyone directly or indirectly employed by either of them, and the amount of such insurance shall be as follows: 1, COMPREHENSIVE GENERAL LIABILITY $1,000,000 Each Occurrence $2,000,000 Aggregate 2. COMPREHENSIVE AUTOMOBILE LIABILITY $1,000,000 Combined Single Limit Such insurance shall cover habillty arising out of any vehicle (including, owned (if any), hired and non -hired vehicles) operated in performing any and all services pursuant to this Agreement. Coverage shall be written on ISO form CA 00 01 12 90, or a later version of this form, or an equivalent form providing equivalent liability coverage. 3. PROFESSIONAL LIABILITY / ERRORS AND OMISSIONS $1,000,000 Per Claim All limits are to be designated strictly for the City of Lodi, its elected and appointed boards, commissions, officers, employees, and designated volunteers. All deductibles or self-insured retentions (SIR) must be disclosed to City's Risk Manager for approval and shall not reduce the limits of liability set forth herelnabove. Insurance policies containing any deductible or SIR provision shall provide, or be endorsed to provide, that the deductible or SIR may be satisfied by either the Named Insured(s) or the City of Lodi. It is required that any available insurance proceeds broader than or In excess of the specified minimum insurance coverage requirements and/or limits set forth above, shall be available to City as an additional Insured. Furthermore, the requirements for coverage and limits shall be (1) the minimum coverage and limits specified in these insurance requirements; or (ii) the broader coverage and maximum limits of coverage of any insurance policy or proceeds available to the Consultant; whichever is greater. Consultant agrees and stipulates that any insurance coverage provided to the City of Lodi shall provide for a claims period following termination of coverage which is at least consistent with the claims period or statutes of limitations found in the California Tort Claims Act (California Govemment Code Section 810 et seq.). A copy of the certificate(s) of insurance with the following endorsements shall be furnished to the City: (a) Additional Named Insured Endorsement Pursuant to a separate endorsement (ISO form CG 2010 (11185) or equivalent form) such insurance as is afforded by this policy shall also apply to the City of Lodi, its elected and appointed boards, commissions, officers, employees, and designated volunteers as additional named insureds. (b) Primary and Non-Contrbutory Insurance Endorsement Additional Insurance coverage under the Consultant's policy shall be "primary and non-contributory" and will not seek contribution from City's insurance or self-insurance and shall be at least as broad as ISO form CG 20 01 04 13. NOTE: (1) The street address of the CITY OF LODI must be shown along with (a) and (b) above: 221 West Pine Street, Lodi, California, 95240; (2) The insurance certificate must state, on its face or as an endorsement, a description of the project that it is insuring. Page 1 I of 2 pages •••• Risk: rev.03.2014 Insurance Requirements for Consultant (continued) (c) Limits of Coverage The limits of insurance coverage required may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or excess Insurance of Consultant shall contain, or be endorsed to contain, a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of the City before the City's own insurance or self-insurance shall be called upon to protect the City as a named insured. (d) Completed Operations Endorsement For three years after completion of project, a certificate of insurance with a Completed Operations Endorsement, CG 20 37 07 04, will be provided to the City of Lodi. (e) Severability of Interest Clause The term "insured" is used severally and not collectively, but the inclusion herein of more than one insured shall not operate to increase the limit of the company's liability. (f) Notice of Cancellation or Chanae in Coveraae Endorsement This policy may not be canceled nor the coverage reduced by the company without 30 days' prior written notice of such cancellation or reduction in coverage to the Risk Manager, City of Lodi, 221 West Pine St., Lodi, CA 95240. (g) Continuity of Coverage All policies shall be in effect on or before the first day of the Term of this Agreement At least thirty (30) days prior to the expiration of each insurance policy, Consultant shall fumish a certificate(s) showing that a new or extended policy has been obtained which meets the minimum requirements of this Agreement. Consultant shall provide proof of continuing insurance on at least an annual basis during the Term. If Consultant's insurance lapses or is discontinued for any reason, Consultant shall immediately notify the City and immediately obtain replacement insurance. (h) Failure to Comply If Consultant fails or refuses to obtain and maintain the required insurance, or fails to provide proof of coverage, the City may obtain the insurance. Consultant shall reimburse the City for premiums paid, with interest on the premium paid by the City at the maximum allowable legal rate then in effect in California. The City shall notify Consultant of such payment of premiums within thirty (30) days of payment stating the amount paid, the names) of the insurer(s), and rate of interest. Consultant shall pay such reimbursement and interest on the first (1g) clay of the month following the City's notice. Notwithstanding and other provision of this Agreement, if Consultant fails or refuses to obtain or maintain insurance as required by this agreement, or fails to provide proof of insurance, the City may terminate this Agreement upon such breach. Upon such termination, Consultant shall immediately cease use of the Site or facilities and commence and diligently pursue the removal of any and all of its personal property from the site or facilities. (i) Qualified Insurer(s) All insurance required by the terms of this Agreement must be provided by insurers licensed to do business in the State of California which are rated at least "A-, VI" by the AM Best Ratings Guide, and which are acceptable to the City. Non -admitted surplus lines carriers may be accepted provided they are included on the most recent list of California eligible surplus lines insurers (LESLI list) and otherwise meet City requirements. Workers Compensation Insurance The Consultant shall take out and maintain during the life of this Agreement, Worker's Compensation Insurance for all of Consultant's employees employed at the site of the project and, if any work is sublet, Consultant shall require the subcontractor similarly to provide Worker's Compensation Insurance for all of the latter's employees unless such employees are covered by the protection afforded by the Consultant. In case any lass of employees engaged in hazardous work under this Agreement at the site of the project is not protected under the Worker's Compensation Statute, the Consultant shall provide and shall cause each subcontractor to provide insurance for the protection of said employees. A waiver of subrogation is required for workers compensation insurance. This policy may not be canceled nor the coverage reduced without 30 days' prior written notice of such cancellation or reduction in coverage to the Risk Manager, City of Lodi, 221 West Pine St , Lodi, CA 95240. NOTE: The City reserves the right to obtain a full certified copy of any insurance policy or endorsements required. Failure to exercise this right shall not constitute a waiver of the City's right to exercise after the effective date. Page 2 of 2 pages j Risk: rev.03.2014 Exhibit D Services — Federal Clauses (under $25,000) The following clauses are included with the City of Lodl Professional Service Agreement. 1. Access to Records The following access to records requirements apply to this Contract: Where the Purchaser is not a State but a local government and is the FTA Recipient or a subgrantee of the FTA Recipient in accordance with 49 C.F.R. 13.36(i), the Contractor agrees to provide the Purchaser, the FTA Administrator, the Comptroller General of the United States or any of their authorized representatives access to any books, documents. papers and records of the Contractor which are directly pertinent to this contract for the purposes of making audits, examinations, excerpts and transcriptions. Contractor also agrees, pursuant to 49 C.F.R. 633.17 to provide the FTA Administrator or his authorized representatives including any PMO Contractor access to Contractor's records and construction sites pertaining to a major capital project, defined at49 U.S.C. 5302(a)1, which is receiving federal financial assistance through the programs described at 49 U.S.C. 5307, 5309 or 5311. II Where the Purchaser is a State and is the FTA Recipient or a subgrantee of the FTA Recipient in accordance with 49 C.F.R. 633.17, Contractor agrees to provide the Purchaser, the FTA Administrator or his authorized representatives, including any PMO Contractor, access to the Contractor's records and construction sites pertaining to a major capital project, defined at 49 U.S.C. 5302(a)1, which is receiving federal financial assistance through the programs described at 49 U.S.C. 5307, 5309 or 5311. By definition, a major capital project excludes contracts of less than the simplified acquisition threshold currently set at $100,000. III. Where the Purchaser enters into a negotiated contract for other than a small purchase or under the simplified acquisition threshold and is an institution of higher education, a hospital or other non-profit organization and is the FTA Recipient or a subgrantee of the FTA Recipient in accordance with 49 C.F.R. 19.48, Contractor agrees to provide the Purchaser, FTA Administrator, the Comptroller General of the United States or any of their duly authorized representatives with access to any books, documents, papers and record of the Contractor which are directly pertinent to this contract for the purposes of making audits, examinations, excerpts and transcriptions. N, Where any Purchaser which is the FTA Recipient or a subgrantee of the FTA Recipient in accordance with 49 U.S.C. 5325(a) enters into a contract for a capital project or improvement (defined at 49 U.S.C. 5302(a)1) through other than competitive bidding, the Contractor shall make available records related to the contract to the Purchaser, the Secretary of Transportation and the Comptroller General or any authorized officer or employee of any of them for the purposes of conducting an audit and inspection. V. The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed. VI The Contractor agrees to maintain all books, records, accounts and reports required under this contract for a period of not less than three years after the date of termination or expiration of this contract, except in the event of litigation or settlement of claims arising from the performance of this contract, in which case Contractor agrees to maintain same until the Purchaser, the FTA Administrator, the Comptroller General, or any of their duly authorized representatives, have disposed of all such litigation, appeals, claims or exceptions related thereto. Reference 49 CFR 18.36(l)(11). VII. FTA does not require the inclusion of these requirements in subcontracts 2. Federal Changes CONTRACTOR shall at all times comply with all applicable FTA regulations, policies, procedures and directives, including without limitation those listed directly or by reference in the Department of Transportation, Federal Transit Administration. Master Agreement (FTA MA (20) dated October 1, 2013), between Purchaser and FTA, es they may be amended or promulgated from time to time during the term of this contract. CONTr:e' C i L:a-ri :eelui s to ail .:-amply She ll constitute r P c Y y O a material breach of this contract. 3. No Government Obligation to Third Parties I CITY OF LODI and CONTRACTOR acknowledge and agree that, not withstanding any concurrence by the Federal Government in or approval of the solicitation or award of the underlying contract, absent the express written consent by the Federal Government, the Federal Government is not a party to this contract and shall not be subject to any obligations or liabilities to CITY OF LODI , CONTRACTOR, or any other party (whether or not a party to that ^ontract) pertaining to any matter resulting from the underlying contract. II The CONTRACTOR agrees to include the above clause in each subcontract financed In whole or in part with Federal assistance provided by FTA. It is further agreed that the clause shall not be modified, except to identify the SUBCONTRACTOR who will be subject to its provisions_ 4. Program Fraud and False or Fraudulent Statements or Related Acts. I. The CONTRACTOR acknowledges that the provisions of the Program Fraud Civil Remedies Act of 1988, as amended, 31 U.S.C. § 3801 et seq . and U.S. DOT regulations, "Program Fraud Civil Remedies," 49 G.F.R. Part 31, apply to Its actions pertaining to this Project. Upon execution of the underlying contract, the CONTRACTOR certifies or affirms the truthfulness and accuracy of any statement it has made, it makes, it may make, or causes to be made, pertaining to the underlying contract or the FTA assisted project for which this contract work is being performed. In addition to other penalties that may be applicable, the CONTRACTOR further acknowledges that if it makes. or causes to be made, a false, fictitious, or fraudulent claim, statement, submission, or certification, the Federal Govemment reserves the right to impose the penalties of the Program Fraud Civil Remedies Act of 1986 on the CONTRACTOR to the extent the Federal Government deems appropriate. II. The CONTRACTOR also acknowledges that if it makes, or causes to be made, a false, fictitious, or fraudulent claim, statement, submission, or certification to the Federal Government under a contract connected with a project that is financed in whole or in part with Federal assistance originally awarded by FTA under the authority of 49 U.S.C. § 5307, the Government reserves the right to impose the penalties of 18 U.S.C. § 1001 and 49 U.S.C. § 5307(n)(1) on the CONTRACTOR, to the extent the Federal Government deems appropriate. til. The CONTRACTOR agrees to include the above two clauses in each subcontract financed in whole or in part with Federal assistance provided by FTA, It is further agreed that the clauses shall not be modified. except to identify the SUBCONTRACTOR who will be subject to the provisions. 5. Civil Rights The following requirements apply to the underlying contract: I. - In accordance with Title VI of the Civil Rights Act, as amended, 42 U.S C. § 2000d. soi1km 303 of the Age Discrimination Act of 1.975, as amended, 42 U.S.C. § 6102, section 202 of the Americans with Disabilities Act of 1990, 42 U.S.C. § 12132, and Federal transit law ai U.S C § 5332, the CONTf3.ACTOR agrees that it will not discriminate against any employee or applicant for employment because of race, color, creed, national origin, sex, age, or disability. In addition, the CONTRACTOR agrees to comply with applicable Federal implementing regulations and other implementing requirements FTA may issue 2 II, Eaual Employment Opportunity - The following equal employment opportunity requirements apply to the underlying contract: • Race, Color. Creed. National Origin, Sex - In accordance with Title VII of the Civil Rights Act, as amended, 42 U.S.C. § 2000e, and Federal transit laws at 49 U.S.C, § 5332, the CONTRACTOR agrees to comply with all applicable equal employment opportunity requirements of U.S. Department of Labor (U.S. DOL) regulations, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor," 41 C.F.R. Parts 60 et seq ., (which implement Executive Order No. 11246, "Equal Employment Opportunity," as amended by Executive Order No. 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," 42 U.S.C. § 2000e note), and with any applicable Federal statutes, executive orders, regulations, and Federal policies that may in the future affect construction activities undertaken in the course of the Project. The CONTRACTOR agrees to take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, creed, national origin, sex, or age. 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 or other forms of compensation; and selection for training, including apprenticeship. In addition, the CONTRACTOR agrees to comply with any implementing requirements FTA may issue. • Age - In accordance with section 4 of the Age Discrimination in Employment Act of 1967, as amended, 29 U.S.C. § 623 and Federal transit law at 49 U.S.C. § 5332, the CONTRACTOR agrees to refrain from discrimination against present and prospective employees for reason of age. In addition, the CONTRACTOR agrees to comply with any implementing requirements FTA may issue. • Disabilities - In accordance with section 102 of the Americans with Disabilities Act, as amended, 42 U.S.C. § 12112, the CONTRACTOR agrees that it will comply with the requirements of U.S. Equal Employment Opportunity Commission, "Regulations to Implement the Equal Employment Provisions of the Americans with Disabilities Act," 29 C.F.R. Part 1630, pertaining to employment of persons with disabilities. In addition, the CONTRACTOR agrees to comply with any implementing requirements FTA may issue. III. The CONTRACTOR also agrees to include these requirements in each subcontract financed in whole or in part with Federal assistance provided by FTA, modified only if necessary to identify the affected parties. 6. Disadvantaged Business Enterprise (DBE) City of Lodi Assurance The CITY OF LODI shall not discriminate on the basis of race, color, national origin, or sex in the award and performance of any U.S. Department of Transportation (DOT) assisted contract or in the administration of its Disadvantaged Business Enterprise (DBE) program or the requirements of 49 CFR part 26. The CITY OF LODI will take all necessary and reasonable steps under 49 CFR Part 26 to ensure nondiscrimination in the award and administration of DOT -assisted contracts. It is the policy of the CITY OF LODI to ensure nondiscrimination in the award and administration of DOT - assisted contracts and to create a level playing field on which DBEs can compete fairly for contracts and subcontracts relating to the CITY OF LODI construction, procurement and professional services activities. Contractor Assurance Pursuant to 49 CFR Part 26, the CONTRACTOR is required to make the following assurance in its agreement with the CITY OF LODI and to include this assurance in any agreements it makes with subcontractors in the performance of this contract: "The Contractor or Subcontractor shall not discriminate on the basis of race, color, national origin or sex in the performance of this contract. The Contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT assisted contracts. Failure of the 3 Contractor or Subcontractor to carry out these requirements is a material breach of contract, which may result in the termination of contract by the CITY OF LODI, or any such remedy the CITY OF LODI may deem appropriate." The City's DBE Program, as required by 49 CFR Part 26, as approved by DOT, is incorporated by reference in this section. Implementation of this DBE Program is a legal obligation and failure to carry out its tem -is shall be treated as a violation of this contract, Upon .notification of failure to_cary out its approved program, the DOT and/or the Federal Transit Administration (FTA) may impose sanctions as provided for under Part 26 and may, in appropriate cases, refer the matter for enforcement under 18 U.S.C. 1001 and/or the Program Fraud Civil Remedies Act of 1986 (31 U.S.C. 3801 et seq). 7. Prompt Payment Prompt Progress Payment to Subcontractors Attention is directed to the provisions in Federal Regulations (49 CFR 26.29) concerning payment to subcontractors. The contractor shall make prompt and regular incremental acceptances of portions, as determined by the CITY OF LODI of the contract work and pay retainage to the prime contractor based on these acceptances. II. Prompt Payment of Payment of Withheld Funds to Subcontractors The contractor shall return all monies withheld in retention from all subcontractors within thirty (30) days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the CITY OF LODI. Federal Regulation (49 CFR 26.29) requires that any delay or postponement of payment over 30 day may take place only for good cause and with the CITY OF LODI's prior written approval. Any violation of this provision shall subject the violating contractor or subcontractor to the penalties, sanctions, and other remedies specified in Section 7108.5 of the California Business and Professions Code. This requirement shall not be construed to limit or impair any contractual, administrative, or judicial remedies, otherwise available to the contractor or subcontractor in the event of: a dispute involving late payment or nonpayment by the contractor; deficient subcontractor performance; and/or noncompliance by a subcontractor. This provision applies to both DBE and non -DBE subcontractors 8. Incorporation of FTA 4220.1F Terms The preceding provisions include, in part, certain Standard Terms and Conditions required by DOT, whether or not expressly set forth in the preceding contract provisions. All contractual provisions required by DOT, as set forth in FTA Circular 4220.1F, are hereby incorporated by reference. Anything to the contrary herein notwithstanding, all FTA -mandated terms shall be deemed to control in the event of a conflict with other provisions contained in this Agreement. The CONTRACTOR shall not perform any act, fail to perform any act, or refuse to comply with any CITY OF LODI request, which would cause CITY OF LODI to be in violation of the FTA terms and conditions. 9. Termination Upon written notice, CONTRACTOR agrees that the Federal Government may suspend or terminate all or part of the Federal financial assistance provided herein if CONTRACTOR has violated the terms of the Grant Agreement or Cooperative Agreement, or if the Federal Govemment determines that the purposes of the statute authorizing the Project would not be adequately served by the continuation of Federal financial assistance for the Project. Any failure to make reasonable progress on the Project or other violation of the Grant Agreement or Cooperative Agreement that endangers substantial performance of the Project shall provide sufficient grounds for the Federal Government to terminate the Grant Agreement or Cooperative Agreement. Termination of any Federal financial assistance for the Project will not invalidate obligations properly incurred by CONTRACTOR before the termination date, to the extent those obligations cannot be canceled. If, however, the Federal Government determines that CONTRACTOR 4 has willfully misused Federal assistance funds by failing to make adequate progress, failing to make reasonable and appropriate use of the Project real property, facilities, or equipment, or has failed to comply with the terms of the Grant Agreement or Cooperative Agreement, the Federal Government reserves the right to require CONTRACTOR to refund the entire amount of Federal funds provided for the Project or any lesser amount as the Federal Government may determine. Expiration of any Project time period established for the Project does not, by itself, constitute an expiration or termination of the Grant Agreement or Cooperative Agreement I. Termination for Convenience: CITY OF LODI may terminate this contract, in whole or in part, at any time by written notice to the CONTRACTOR. The CONTRACTOR shall be paid its costs, including contract closeout costs, and profit on work performed up to the time of termination. The CONTRACTOR shall promptly submit its termination claim to CITY OF LODI to be paid the CONTRACTOR. If the CONTRACTOR has any property in its possession belonging to CITY OF LODI, the CONTRACTOR will account for the same, and dispose of it in the manner CITY OF LODI directs. 11. Termination for Default: If the CONTRACTOR does not deliver supplies in accordance with the contract delivery schedule, or, if the contract is for services, the CONTRACTOR fails to perform in the manner called for in the contract, or if the CONTRACTOR fails to comply with any other provisions of the contract, CITY OF LODI may terminate this contract for default. Termination shall be effected by serving a notice of termination on the CONTRACTOR setting forth the manner in which the CONTRACTOR is in default. The CONTRACTOR will only be paid the contract price for supplies delivered and accepted, or services performed in accordance with the manner of performance set forth in the contract. If it is later determined by CITY OF LODI that the CONTRACTOR had an excusable reason for not performing, such as a strike, fire, or flood, events which are not the fault of or beyond the control of the CONTRACTOR, CITY OF LODI, after setting up a new delivery of performance schedule, may allow the CONTRACTOR to continue work, or treat the termination as a termination for convenience. III. Termination for Cost -Type Contracts: CITY OF LODI may terminate this contract, or any portion of it, by serving a notice of termination on the CONTRACTOR. The notice shall state whether the termination is for convenience of CITY OF LODI or is for the default of the CONTRACTOR. If the termination is for default, the notice shall state the manner in which the CONTRACTOR has failed to perform the requirements of the contract. The CONTRACTOR shall account for any property in its possession paid for from funds received from CITY OF LODI, or property supplied to the CONTRACTOR by CITY OF LODI. If the termination is for default, CITY OF LODI may fix the fee, if the contract provides for a fee, to be paid the CONTRACTOR in proportion to the value, if any, of the work performed up to the time of termination. The CONTRACTOR shall promptly submit its termination claim to CITY OF LODI and the parties shall negotiate the termination settlement to be paid the CONTRACTOR. 10. Energy Conservation CONTRACTOR agrees to comply with 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, 42 U.S.C. §§ 6321 et seq. 11. Access Requirements for Persons with Disabilities CONTRACTOR agrees to comply with all applicable requirements of the Americans with Disabilities Act (ADA) of 1990. as amended, 42 U.S.C. 12101 et. seq., Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794; 49 U.S.C. 5301(d); and all regulations promulgated to implement the ADA and Section 504 of the Rehabilitation Act of 1973, as amended, as may be applicable to CONTRACTOR. 5 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES /V I b r COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352 1. Type of Federal Action: ❑ a. contract - b. grant c. cooperative agreement d. loan e. loan guarantee f. loan insurance 4. Name and Address of Reporting Entity 0 Prime ❑ Subawardee Tier , if known 2. Status of Federal Action: ❑ a. bid/offer/application b. initial award c. post -award Congressional District, if known 6. Federal Department/Agency: 8. Federal Action Number, if known: 10. Name and Address of Lobby Entity (If individual, last name, first name, MI) 3. Report Type: 0 a. initial b. material change Fur Material Change Only: year quarter date of last report 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Congressional District, if known 7. Federal Program Name/Description: CFDA Number, if applicable 9. Award Amount, if known: 11. Individuals Performing Services (including address if different from No. l0a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary) 12. Amount of Payment (check all that apply) 0 actual ❑ planned 13. Form of Payment (check all that apply): a cash b. in-kind; specify: nature Value 14. Type of Payment (check all that apply) a. retainer b. one-time fee c. commission d. contingent fee e deferred f. other, specify 15. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), cmployee(s),or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Shcet(s) if necessary) 16. Continuation Sheet(s) attached: Yes ❑ 17. Information requested through this form is authorized by Title 31 U.S.0 Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C, 1352 This information will be reported to Congress semiannually and will be available for public inspection Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Federal Use Only: No ❑ Signature: t1 I - f Print Nsine: t 1 i ,) (• i s i LY l -v _l Telephone No.: ': 10). ; f; 4'r Date' - Authorized for Local Reproduction Standard Form - LLL Standned Pnrin 1.1 1. Ra. 111. tti•al. Distribution: Orig- Local Agency Project Files LPP 13-01 Page 1 May 8, 2013 Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OFLOBBYING ACTIVITIES This disclosure fonn shall be completed by the reporting entity, whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352, The filing of a form is required for such payment or agreement to make payment to lobbying entity 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 a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered federal action for which lobbying activity is or has been secured to influence. the outcome of a covered federal action. 2. Identify the status of the covered federal action. 3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the informationpreviously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action. 4. Enter the full name, address, city, state, and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e g., the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts, subgrants, and contract awards under grants. 5. If the organization filing the report in Item 4checks "Subawardee" then enter the full name, address, city, state, and zip code of the prime federal recipient. Include Congressional District, if known. 6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, ifknown. For example, Department of Transportation, United States Coast Guard. 7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments. 9, Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) aumber, Invitation for Bid (11 d) number. grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., 'RFP -DE -90-001." 9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5. 10. Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action. 11. Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle initial (Ml). 12. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be muds (planned). Check all boxes that apply. Ifthis is a material change report, enter the cumulative amount of payment made or planned to be made. 13. Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 14. Check all boxes that apply. If other, specify nature. 15. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials_ Identify the federal officer(s) or employee(s) contacted or the officer(s) employees) or Member(s) of Congress that were contacted. 16. Check whether or not a continuation sheet(s) is attached. 17. The certifying official shall sign and date the form, and print his/her name title and telephone number. Public reporting burden for this collection of information is estimated to average 30 -minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing-this-burden,—t.o-the Offree-of-Management-and-BudgatT1 aperwor-k -Reduction-Projects-0348-0046); Washington D C. 20503.SF- -L-L fnstruetions--Rev.06- LPP 13-01 Page 2 May 8, 2013 Local Assistance Procedures Manual Exhibit 12.G Required Federal -aid Contract Language II. III, IV. V. VI. VII. VIII. IX. X. XI. FHWA-1273 — Revised May 1, 2012 REQUIRED CONTRACT PROVISIONS FEDERAL -AID CONSTRUCTION CONTRACTS General Nondiscrimination Nonsegregated Facilities Davis -Bacon and Related Act Provisions Contract Work Hours and Safety Standards Act Provisions Subletting or Assigning the Contract Safety: Accident Preventon False Statements Concerning Highway Protects Implementation of Clean Air Act and Federal Water Pollution Control Act Compliance with Governmentwlde Suspension and Debarment Requirements Certification Regarding Use of Contract Funds for Lobbying ATTACHMENTS A, Employment and Materials Preference far Appalachian Development Highway System or Appalachian Local Access Road Contracts (Included in Appalachian contracts only) I. GENERAL 1, Form FI IWA-1273 roust be physically incorporated In each construction contract funded under Tiile 23 (excluding emergency contracts solely Intended for debris removal). The contractor (or subcontractor) must insert this form in each subcontract and further require Its Inclusion In all lower tier subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services) The applicable requirements of Form FHWA-1273 are incorporated by reference for work done under any purchase order, rental agreement or agreement for other services. The prime contractor shell be responsible for compliance by any subcontractor, lower -tier subcontractor or service provider. Form FHWA-1273 must be Included to all Federal -aid design -build contracts, In all subcontracts end in lower tier subcontracts (excluding subcontracts for design services, purchase orders, rental agreements and other agreements for supplies or services). The design -builder shall be responsible for compliance by any subcontractor. lower -tier subcontractor or service provider. Contracting agencies may reference Form FHWA-1273 In bid proposal or request for proposal documents, however, the Form FHWA-1273 must be physically Incorporated (not referenced) In all contracts, subcontracts and lower-ller subcontracts (excluding purchase orders, rental agreements and other agreements for supplies or services related to a construction contract). 2. Subject to the applicability crkerla noted in the following sections, these contract provision° shall apply to all work performed on the contract by the contractor's own organization and with the assistance of workers under the contractor's Immediate superintendence and to all work performed on the contract by piecework, station work, or by subcontract 3. A breach of any of the stipulations contained In these Required Contract Provisions may be sufficient gra undo for withholding of progress payments, withholding of final payment, termination of the contract, suspension / debarment or any other action determined to be appropriate by the contracting agency and FHWA. 4. Selection of Labor. During the performance of this contract, the contractor shall not use convict labor for any purpose within the limits of a construction project on a Federal-ald highway unless It Is labor performed by convicts who are on perole, supervised release, or probation. The tens Federal -aid highway does not Include roadways functionally classified as local roads or rural minor collectors. DLA -OB 13-06 11. NONDISCRIMINATION The provisions of this section related to 23 CFR Part 230 are applicable to el! Federal -aid construction contracts end to all related construction subcontracts of 310,000 or more, The provisions of 23 CFR Part 230 are not applicable to material supply, engineering, or architectural service contracts. In addition, the contractor and all subcontractors must comply with the following policies: Executive Order 11246, 41 CFR 60, 29 CFR 1625- 1627. Title 23 USC Section 140, the Rehabilitation Acl of 1973, es amended (29 USC 794), Title VI of the Civil Rights AG of 1964, as amended, and related regulations Including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The contractor end all subcontractors must comply with: the requirements of the Equal Opportunity Clouse in 41 CFR 60-1.4(b) and, for all construction contracts exceeding $10,000, the Standard Federal Equal Employment Opportunity Construction Contract Specifications in 41 CFR 604.3. Note: The U.S. Department of Labor has exclusive authority to determine compliance with Executive Order 11246 and the policies of the Secretary of Labor including 41 CFR 60, and 29 CFR 1625-1627. The contracting agency and the FHWA have the authority and the responsibility to ensure compliance with Tlfle 23 USC Section 140, the Rehabilitation Act of 1973, as amended (20 USC 794), and Title VI of the Civil Rights Act of 1964, as amended, and related regulations Including 49 CFR Parts 21, 26 and 27; and 23 CFR Parts 200, 230, and 633. The following provision is adopted from 23 CFR 230, Appendix A, with appropriate revisions to conform to the U.S. Department of Labor (US DOL) and FHWA requirements. 1. Equal Employment Opportunity: Equal employment opportunity (EEO) requirements not to discriminate and to take affirmative action to assure equal opportunity es set forth under laws, executive orders, rules, regulations (28 CFR 35, 29 CFR 1630, 29 CFR 1625-1627, 41 CFR 60 and 49 CFR 27) end 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 provisions of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) set forth under 28 CFR 35 and 29 CFR 1830 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: a. The contractor will work with the contracting agency and the Federal Government to ensure that It has made every good faith effort to provide equal opportunity with respect to all of Its terms and conditions of employment and in their review of activities under the contract. b. The contractor will accept as Its operating policy the following statement "It is the policy of thla 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 pay or other forns of compensation; and selection for training, Including apprenticeship, preapprenticeshlp, andlor on - the -Job training." 2. EEO Officer: The contractor will designate and make known to the contracting officers an EEO Officer who will have the responsibility for and must be capable of effectively administering and promoting an active EEO program and who must be assigned adequate authority and responsibility to do so Page 8of2.2 Altgust 12, 2013 e1, Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 3, Dissemination of Policy: All members of the cnnlractor's staff who are authorized to h}re, supervise, promote, and discharge employees, or who recommend such action, orwho 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: a. Periodic meetings of supervisory and personnel office employees will be conducted before the start of work and then not fess often than once every six months, at which time the contractor's EEO policy and its Implementation will be reviewed and explained. The meetings wilt be conducted by the EEO Officer, b. Ail new supervisory or personnel office employees wilt be given a thorough Indoctrination by the EEO Officer, covering ati major aspects of the contractor's EEO obligations within thirty days following their reporting for duty with the contractor. c. 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 minorities and women d. Notices and posters setting forth the contractors EEO policy will be placed In areas readily accessible to employees, applicants for employment and potential employees. e. The contractor's EEO policy end the procedures to implement such policy will be brought to the attention of employees by means of meetings, employee handbooks, or other appropriate means. 4, Recruitment: When advertising for employees, the contractor will include In all advertisements for employees the notation: "An Equal Opportunity Employer." Al! such advertisements will be pieced In publications having a large circulation among minorities and women In the area from which the project work force would normally be derived. a. 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 inrriorities and women To meet this requirement, the contractor will identify sources of potential minority group employees, and establish with such identified sources procedures whereby minority and women applicants may be referred to the contractor for employment consideration. b. In the event the contractor has a valid bargaining agreement providing for exclusive hiring hall referrers, the =erector Is expected to observe the provisions of shat agreement to the extent Ilial the system meets the contractor's comptiancn with EEO oontrael provisions. Whore implementation of such an agreement has the effect of discriminating against minorities or women, or obligates the contractor to do the same, such implementation violates Federal nondiscrimination provisions. c The contractor will encourage its present employees to refer minorities and women as applicants for employment. information and procedures with regard to referring such applicants will be discussed with employees. 5. Personnel Actions: Wages, working conditiona, and employee benefits shall be established and administered, and personnel actions of every type, Including hiring, upgrading, promotion, transfer, demotion, layoff, and termination, shall be taken without regard to rate, color, religion, sex, national origin, age or disability. The following procedures shall be followed: a. The contractor will conduct periodic inspections of project sites to insure That working conditions and employee facilities do not indicate discriminatory treatment of project site personnel. b. The contractor will periodically evaluate the spread of wages paid within each classification to determine any evidence of discriminatory wage prectices c, The contractor will periodically review selected personnel actions In depth to determine whether there Is evidence of discrimination, Where evidence is found, the contractor will promptly take corrective action. If the review Indicates that the discrimination may extend beyond the actions reviewed, such corrective action shall include all affected persons. d. The contractor will promptly Investigate all complaints of alleged elscriminatlon made to Ilse contractor in connection wrth its obligations under this contract, will °itempl to resolve such complaints, and will take appropriate cnrreutive action within a reasonable time If he Investigation indicates that the discrimination may affect persons other then the complainant, such corrective action shall include such other persons. Upon completion of each Investigation, the contractor will Inform every complainant of all of their avenues of appeal. 6. Training and Promotion: a. The contractor will assist In locating, qualifying, and Increasing the skills of minorities and women who are applicants for employment or current employees. Such efforts should be aimed at developing full joumey level status employees In the type of trade or Job classification involved. b. Consistent with the contractors work force requirements and as permissible under Federal and State regulations, the contractor shall make Tull use of training programs, I.e„ apprenticeship, and on- tha-job training programs for the geographical arca of contract performance. in the event a special provision for training is provided under this contract, this subparagraph will be superseded as indicated In the special provision. The contracting agency may reserve training posttlons for persons who receive welfare assistance In accordance with 23 U.S.C. 140(a), c. The contractor will advise employees and applicants for employment of available training programs and entrance requirements for each. d. The contractor will periodically review the training and promotion potential of employees who are minorities and women and will encourage eligible employees to apply for such training and promotion. 7. Unions: If the contractor relies in whole or in part upon unions as a source of employees, the contractor will use good faith efforts to obtain the cooperation of such unions to increase opportunities for minorities and women. Actions by the contractor, either directly or through a contractors association acting as agent, will include the procedures set forth below: a, The contractor will use good faith efforts to develop, in cooperation with the unions, iolnl training programs aimed toward qualifying more minorities and women for membership in the unions and increasing the skills of minorities and women so that they may qualify for higher paying employment, b. The contractor will use good faith efforts to incorporate an EEO clause into each union agreement to the end that such unlon will be contractually bound to refer applicants without regard to their race, color, religion, sex, national origin, age or disability. c. The contractor Is to obtain information as to the referral practices and policies of the labor union except that to the extent such Information is within the exclusive possession of the labor union and such labor union refuses to furnish such information to the contractor, the contractor shall so certify to the contracting agency DLA -OB 13-06 Page 9 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language and shall set forth what efforts have been made to obtain such information. d. In the event the union Is unable to provide the contractor with a reasonable flow of referrals within the time limit set forth in the collective bargaining agreement, the contractor will, through Independent recruitment efforts, fill the employment vacancies without regard to race, color, religion, sex, national origin, age or disability; making full efforts to obtain qualified and/or qualifiable minorities and women The failure of a union to provide sufficient referrals (even though It is obligated to provide exclusive referrals under the terms of a collective bargaining agreement) does not relieve the contractor from the requirements of this paragraph. In the event the union referral practice prevents the contractor from meeting the obligations pursuant to Executive Order 11248, as amended, and these special provisions, such contractor shall immediately notify the contracting agency. 8. Reasonable Accommodation for Applicants f Employees with Disabilities: The contractor must be familiar with the requirements for and comply with the Americans with Disabilities Act and all rules and regulations established there under. Employers must provide reasonable accommodation in all employment activities unless to do so would cause an undue hardship. 9. 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 take all necessary and reasonable steps to ensure nondiscrimination in the administration of this contract a. The contractor shall notify all potential subcontractors and suppliers and lessors of their EEO obligations under this contract b. The contractor will use good faith efforts to ensure subcontractor compliance with their EEO obligations. 10. Assurance Required by 49 CFR 26.13(b): a. The requirements of 49 CFR Part 26 and the Stats DOT's U.S, DOT -approved DBE program are incorporated by reference. b. The contractor or subcontractor shall not discriminate on the basis of race, color, national origin, or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 In the award and administration of OOT -assisted contracts. Failure by the contractor to carry out these requirements is a material breach of this contract, which may result In the termination of this contract or such other remedy as the contracting agency deems appropriate. 11. 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 the date of the final payment to the contractor for all contract work and shall be available at reasonable times and places for Inspection by authorized representatives of the contracting agency and the FHWA. a. The records kept by the contractor shall document the following: (1) The number and work hours of minority end non -minority group members and women employed in each work classification on the protect; (2) The progress and efforts being made in cooperation with unions, when applicable, to Increase employment opportunities for minorities and women; and (3) The progress and efforts being made In locating, hiring, training, qualifying, and upgrading minorities and women; b. The contractors and subcontractors will submit an annual report to the contracting agency each July for the duration of the project, indicating the number of minority, women, and non -minority group employees currently engaged In each work classification required by the contract work. This Information Is to be reported on Fenn FRWA-1391 The staffing data should represent the project work force on board in all or any part of the last payroll period preceding the end of July. If on-the-job training Is being required by special provision, the contractor will be required to collect and report training data. The employment date should reflect the work force on board during all or any part of the last payroll period preceding the end of July. III. NONSEGREGATED FACILITIES This provision Is applicable to all Federal -aid construction contracts and to all related construction subcontracts of $10,000 or more, The contractor must ensure that facilities provided for employees are provided in such a manner that segregation on the basis of race, color, religion, sex, or national origin cannot result. The contractor may neither require such segregated use by written or oral policies nor tolerate such use by employee custom. The contractor's obligation extends further to ensure that Its employees are not assigned to perform their services at any location, under the contractors control, where the facilities are segregated. The term "facilities" Includes waiting rooms, work areas, restaurants and other eating areas, time clocks, restrooms, washrooms, locker rooms, and other storage or dressing areas, parking Tots, drinking fountains, recreation or entertainment areas, transportation, and housing provided for employees. The contractor shall provide separate or single -user restrooms and necessary dressing or sleeping areas to assure privacy between sexes. IV. DAVIS-BACON.AND RELATED ACT PROVISIONS This section is applicable to all Federal -aid construction projects exceeding $2,000 and to all related subcontracts and lower -tier subcontracts (regardless of subcontract size). The requirements apply to all protects located within the right-of-way of a roadway that Is functionally classified as Federal -aid highway. This excludes roadways functionally classified as local roads or rural minor collectors, which are exempt Contracting agencies may elect to apply these requirements to other projects. The following provisions are from the U.S. Department of Labor regulations In 29 CFR 5.5 "Contract provisions and related matters" with minor revisions to conform to the FHWA-1273 format and FHWA program requirements. 1. Minimum wages a. 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 pert 3)), the full amount of wages and bona fide fringe benefits (or cash equivalents thereof) due at time of payment computed 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 1s rers and megghanics, DLA -OB 13-06 Page 10 of 22 August 12, 29.0 Local Assistance Procedures Manual Exhibit 12-6 Required Federal -aid Contract Language Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2) of the Davis -Bacon Ac( on behalf of laborers or mechanics are considered wages paid to such laborers or mechanics, subject to the provisions or paragraph 1.d. of this section; also, regular contributions made or costs incurred for more then 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 tho rate specified for each classlfcailon for the lime actually worked therein: Provided. That the employer's payroll records accurately set forth the lime spent in each classification In which work is performed. The wage delorminatien (including any addiIicnai detail -lc -aeon and wage rater c;ontarmed under paragraph 1.b. of this section) and the Cavis aeon poster (WH -1321) shall be posted at all limes 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. b. (1) The contracting officer shall require that any class of laborers or mechanics, including helpers, which Is not listed in the wage determination and which is to be employed under the contract shall be classified in conformance with the wage determination. The contracting officer shall approve an additional classification and wage rate end fringe benefits therefore only when the following criteria have been met: (I) The work to be performed by the classification requested Is not performed by a classification in the wage determination; and (h) The classification Is utilized in the area by the construction industry; and (11I) The proposed wage rate, Including any bona fide fringe benefits, bears a reasonable relationship to the wage rates contained In the wage determination. (2) If the contractor and the laborers and mechanics to be employed in the classification (Ifknown), or their representatives. and the contracting officer 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 the contracting officer to the Administrator of the Wage and Hour Division, Emptoyment Standards Administration, teS. Department of Labor, Washington. DC 20210. The Administrator, or an authorized representative, will approve, modify, or disapprove every additional classification action within 30 days of receipt end so advise the contracttng officer or will notify the contracting officer within the 30 -day period that additional time Is necessary. (3) In the event the contractor, the laborers or mechanics to be employed In the ctassificatlon or their representatives, and the contracting officer do not agree on the proposed classification and wage rate (Including the amount designated for fringe benefits. where appropriate), the contracting officer shall refer the questions. Including the views of all interested Deities and the recommendellon al the contracting officer, 10 the Wage and Hour Administrator for determination. The Wage and Hour Administrator, or an authorized representative, will issue a determination within 30 days of receipt and so advise the contracting officer or will notify the contracting officer within the 30 - day period that additional time Is necessary. (4) The wage rate (Including fringe benefits where appropriate) determined pursuant to paragraphs 1.b.(2) or 1.b.(3) of this section, shall be pald to all workers performing work in the classification under this contract from the first day on which work is performed In the classification. c. Whenever the minimum wage rate prescribed in the contract for e 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 determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. d. lithe contractor does not make payments to a trustee or other third person. the conlraClar may consider as part of the wages of any laborer or mechanic the amount of any costs leasanably anticipated in providing bona fide trirugv benefits under a plan 01 program, Provitted. Thal the Secretary of Labor has found. upon the written request of the contracloi. that the applicable standards of the Davis -Bacon Act have been mel 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 2, Withholding The contracting agency 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 the same orime 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, the contracting agency may, after written notice to the contractor, 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. 3. Payrolls and basic records n. Payrolls and basic records relating thereto shall be maintained by the contractor during the course of Ilse work and preserved for a period of three years thereaftor 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, lila or her correct classification, hourly rates of wages paid (including rates of contributions or costs enticlpated for bona fide fringe benefits or cath equivalents thereof of the types doscrlbed In section t(b)(2)(B) of the Davis -Bacon Act), daily and weekly number of hours worked, deductions made and acteal 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 1(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 ur 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 sue)! benefits Contractors employing apprentices or trainees under approved programs shalt 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. DLA -OB 13-06 Page 11 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language b. (1) The contractor shall submit weekly for each week In which any contract work is performed a copy of all payrolls to the Contracting agency. 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/ese/whdrforms/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 the contracting agency for transmission to the State DOT, the FI -MIA 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 section for a prime contractor to require a subcontractor to provide addresses and social security numbers to the prime contractorfor Its own records, without weekly submission to the contracting agency.. (2) 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: (i) That the payroll for the payroll period contains the information required to be provided under §5.5 (a)(3)01) of Regulations, 29 CFR part 5, the appropriate information is being maintained under §5.5 (a)(3)(i) of Regulations. 29 CFR part 5, and that such information Is correct and complete; (ii) 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 Regulations, 29 CFR part 3; (iii) 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 determination incorporated into the contract. (3) The weekly submission of a properly executed certification set forth on the reverse side of Optional Forn WH -347 shall satisfy the requirement for submission of the "Statement of Compliance" required by paragraph 3.b.(2) of this section. (4) The falsification of any of the above certifications may subject the contractor or subcontractor to civil or criminal prosecution under section 1001 of title 18 and section 231 of title 31 of the United States Code. c. The contractor or subcontractor shall make the records required under paragraph 3.a. of this section available for Inspection, copying, or transcription by authorized representatives of the contracting agency, the State DOT, the FHWA, or the Dopartment of Labor, and shall permit such representatives to interview employees during working hours on the job. If the contractor or subcontractor fails to submll the required records or to make thern avar a aferwritten notice to the contractor, the contracting agency or the State DOT, 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 a, Apprentices (programs of the USDOL). 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 en 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 determination 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 en acceptable program Is approved. b, Trainees (programs of the USDOL). 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. Page 12 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language The ratio of trainees to joumeymen 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 determtnalion which provides for less than full fringe benefls for apprentices Any employee listed on the payroll at a trainee rate who is not registered and participating in a training plan approved by the Employment and Training Administration she bo paid not less than the applicable wage rate on the wage determination for the classification of 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. c. Equal employment opportunity The utilization of apprentices, trainees and joumeymen under this pert ehair he In conformity with the equal employment opportunity requirements of Executive Order 11246, es amended, and 29 CFR part 30. d. Apprentices and Trainees (programs of the U.S, DOT), Apprentices and trainees working under apprenticeship and skill training programs which have been certified by the Secretary of Transportation as promoting EEO in connection with Federal -aid highway construction programs are not subject to the requirements of paragraph 4 or this Section IV. Thu straight time hourly wage rates for apprentices and trainees under such programs well be established by the particular programs. The ratio of apprentices and !minces lo journeymen shall not be greater than permitted by the terms of the particular program. 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 shall insert Form FHWA-1273 in any subcontracts and also require the subcontractors to include Form FHWA-1273 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 29 CFR 5.5. 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 Davls-Bacon and Related Acts contained in 29 CFR parts 1, 3, and 5 are herein Incorporated by reference in this contrail, 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 the contracting agency, the U.S. Department of Labor, or the employees or their representatives. 10. Certification of eligibility. a. 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). b. 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). c. The penalty for making false statements Is prescribed In the U $ Criminal Code, 18 U.S.C. 1001. V. CONTRACT WORK HOURS AND SAFETY STANDARDS ACT The following clauses apply to any Federal -aid construction contract in an amount in excess of $100,000 and subject to the overtime provisions of the Contract Work Hours and Safety Standards Act. These clauses shall be Inserted In addltion to the clauses required by 29 CFR 5.5(a) or 29 CFR 4.6. 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 he or she is employed on such work to work in excess of Forty 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 forty hours In such workweek. 2. Violation; liability for unpaid wages; liquidated damages, In the event of any violation of the clause set forth in paragraph (1.) of this section, 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 paragraph (1.) of this section, 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 forty hours without payment of the overtime wages required by the clause set forth In paragraph (1.) of this section. 3, Withholding for unpaid wages and liquidated damages. The FHWA or the contacting agency 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 DLA -OB 13.06 Page 13 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-C Required Federal -aid Contract Language prime contractor, 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 paragraph (2.) of this section 4. Subcontracts. The contractor or subcontractor shall Insert In any subcontracts the clauses set forth in paragraph (1.) through (4.) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1.) through (4.) of this section. VI. SUBLETTING OR ASSIGNING THE CONTRACT This provision is applicable to all Federal -aid construction contracts on the National Highway System. 1. The contractor shall perform with Its own organization contract work amounting to not less than 30 percent (or a greater percentage if specified elsewhere In the contract) of the total original contract price, excluding any specialty items designated by the contracting agency. Specialty ttems may be performed by subcontract and the amount of any such specialty items performed may be deducted from the total original contract price before computing the amount of work required to be performed by the contractors own organization (23 CFR 635 116). a. The term "perform work with its own organization" refers to workers employed or leased by the prime contractor, and equipment owned or rented by the prime contractor, with or without operators. Such term does not include employees or equipment of a subcontractor or lower tier subcontractor, agents of the prime contractor, or any other assignees. The term may Include payments for the costs of hiring leased employees From an employee leasing firm meeting all relevant Federal and State regulatory requirements, Leased employees may only be included In this term If the prime contractor meets all of the following conditions; (1) the prime contractor maintains control over the supervision of the day -today activities of the leased employees; (2) the prime contractor remains responsible for the quality of the work of the leased employees; (3) the prime contractor retains all power to accept or exclude Individual employees from work on the project; and (4) the prime contractor remains ultimately responsible for the payment of predetermined minimum wages, the submission of payrolls, statements of compliance and all other Federal regulatory requirements. b. "Specialty Items" shall be construed to be limited to work that requires highly specialized knowledge, abilities, or equipment not ordinarily available in the type of contracting organizations qualified and expected to bld or propose on the contract as a whole and In general are to be limited to minor components of the overall contract. 2. The contract amount upon which the requirements set forth in paragraph (1) of Section VI is computed includes the cost of material and manufactured products which are to be purchased or produced by the contractor under the contract provisions. 3 Therontractor-shall-fumlah-(a)-a-competent-superintend or aupendsor who ls-employedby the-fam, has -full authority -to-diroctperformance of the work In accordance with the contract requirements, and is in charge of all construction operations (regardless of who performs the work) and (b) such other of Its own organizational resources (supervision, management, and engineering services) as the contracting officer determines Is necessary to assure the performance of the contract 4. No portion of the contract shall be sublet, assigned or otherwise disposed of except with the written consent of the contracting officer, or authorized representative, and such consent when given shall not be construed to relieve the contractor of any responsibility for the fulfillment of the contract. Written consent will be given only after the contracting agency has assured that each subcontract is evidenced in writing and that it contains all pertinent provisions and requirements of the prime contract. 5. The 30% self -performance requirement of paragraph (1) Is not applicable to design -build contracts; however, contracting agencies may establish their own self -performance requirements. VII. SAFETY: ACCIDENT PREVENTION This provision is applicable to all Federal -aid construction contracts and to all related subcontracts. 1. In the performance of this contract the contractor shall comply with all applicable Federal, State, and local laws governing safety, health, and sanitation (23 CFR 635). The contractor shall provide all safeguards, safety devices and protective equipment and take any other needed actions as It determines, or as the contracting officer may determine, to be reasonably necessary to protect the life and health of employees on the job and the safety of the public and to protect property in connection with the performance of the work covered by the contract. 2. It Is a condition of this contract, and shall be made a condition of each subcontract, which the contractor enters into pursuant to this contract, thal the contractor and any subcontractor shall not permit any employee, In performance of the contract, to work in surroundings or under conditions which are unsanitary, hazardous or dangerous to his/her health or safety, as deterrnined under construction safety and health standards (29 CFR 1926) promulgated by the Secretary of Labor, in accordance with Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 3704). 3. Pursuantto 29 CFR 1926.3, it is a condition of this contract that the Secretary of Labor or authorized representative thereof, shall have right of entry to any site of contract performance to inspect or investigate the matter of compliance with the construction safety and health standards and to carry out the duties of the Secretary under Section 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C.3704). VIII. FALSE STATEMENTS CONCERNING HIGHWAY PROJECTS This provision is applicable to all Federal -aid construction contracts and to all related subcontracts In order to assure high quality and durable construction In conformity with approved plans and specifications and a high degree of reliability on statements and representations made by engineers, contractors, suppliers, and workers on Federal-ald highway protects, It Is essential that all persons concerned with the protect perform their functions as carefully, thoroughly, and honestly as possible. Willful falsification, distortion, or misrepresentation with respect to any facts related to the project is a violation of Federal law. To prevent any misunderstanding regarding the seriousness of these and -simUar-acts,Eomt-FHWA! 022 shall-be-posted-on-saoh Federal -ad -highway -project -(23-CFR635)-in- one -or-more places -- Page 14 of 22 August 124D13_ Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language where It is readily available to all persons concemed with the protect: 18 U.S.0 1020 reads as follows: Whoever, being an officer, agent, or employee of the United States, or of any State or Territory. or whoever, whether a person, association, firm, or corporation, knowingly maks any false statement false representation, or false report es to the character, quality. quantity, or cost of the material used or to be used, or the quantity or quality of the work performed or to be performed, or the cost thereof in connar'tiurr with the submission of plans, maps, specifications, contracts, or costs of construction on any highway or related protect submitted for approval to the Secretary of Transportation; or Whoever knowingly makes any false statement. false representation. terse report or false claim with respect to the character, quality. quantity, or cost of any work performed or to be performed. or rneteriaie furnished or to be furnished, In connection with the Conetru[ noir of any highway or related project approved by the Secretary of Transportation; or Whoever knowingly makes any false statement or false representation as to material fact in any statement, certificate, or report submitted pursuant to provisions of the Federal -aid Roads Act approved July 1, 1916, (39 Stat. 355), as amended and supplemented; Shall be fined under this title or imprisoned not more than 5 years or both." IX. IMPLEMENTATION OF CLEAN AIR ACT AND FEDERAL WATER POLLUTION CONTROL ACT This provision is applicable to ell Federal -aid construction contracts and to all related subcontracts. By submission of this bidrproposal or the execution of this contrail, or subcontract, as appropriate, the bidder, proposer. Federal -aid construction contractor, or subcontractor, as appropriate, will be deemed to have stipulated as follows: 1. That any person who is or will be utifired In the performence of this contract is not prohibited from receiving an award due to a violation of Section 508 of the Cleary Water Act or Section 306 of the Clean Air Act 2. That the contractor agrees to include or cause to be included the requirements of paragraph (1) of this Section X in every subcontract, and further agrees to take such action as the contracting egency may direct as a means of enforcing such requirements. X. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION This provision is applicable to all Federal -aid construction Contracts, design build contracts. subcontracts. lower -tier subcontracts, purchase orders, lease agreements, consultant contracts or any other covered transaction requiring FHWA eporovat or that i8 estimated to cost $25,000 or more -- as defined In 2 CFR Parts 190 and 1200. 1. Instructions for Certification — First Tier Participants: a: By signing and submitting this proposal, the prospective first tier part c print rs providing the certification set out below. b. The inability of a person to provide the certification set out below will not necessarily result In dental of participation In this covered transaction. The prospective first tier participant shell submit an explanation of why R cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective first tier participant to furnish a certification or an explanation shall disqualify such a person from participation in thls transaction. c. The certification in this clause Is a material representation of fact upon which reliance was placed when the contracting agency determined to enter into this transaction. If it Is later determined that the prospective participant knowingly rendered an erroneous certfication. In addition to other remedies available to the Federal Government, the contracting agency may terminate this transaction for cause of default. d, The prospective first tier participant shall provide Immediate written notice to the contracting agency to whom this proposal is submitted if any time the prospective first tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. e. The terms "covered transaction," "debarred,' "suspended," "ineligible, "participant,' "person," "principal,' and "voluntarily excluded," as used in this clause, are defined in 2 CFR Parts 180 and 1200. 'First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal Funds and a parttclpent (such as the prime or general contract). "Lower Tier Covered Transactions" refers to any covered transaction under a First Tier Covered Transaction (such es subcontracts). "First Tier Particrpanr refers to the partfcfpan! who hoe entered into a covered transaction with a grantee or subgrantee of Federal funds (such as the prirne or general contractor). "Lower Tier Participant" refers any participant who has entered into a covered transaction With a First Tier Participant Or other Lower Tier Participants (such aa subcontractors and suppliers). f. The prospective first tier participant agrees by submitting this proprsa! that, should the proposed Covered transaction be entered into, it shall mol knowingly enter into any lower tier covered Ironsaetion with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation In this covered transaction, unless authorized by the department or agency entering into this transection. g. The prospect'vs first tier participant further agrees by Submitting this proposal Ilial it will include the clause titled "Certification Regarding Debarment, Suspension, Inellgibllily and Voluntary Exclusion -Lower Tier Covered Transactions, provided by Silo department or contracting agency, entering into his covered transaction, without modWfrcatlon, in ail lower tlsr covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. h. A participant in a covered transaction may rely upon a certification of a prospective participant In a lower tier covered transaction that Is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant Is responsible for ensuring that its principals ere not suspended, debarred, or otherwise Ineligible to participate In covered transactions. To verify the eligibility of its principals. as wall as the eligibility of any lower tier prospective participants, 08011 particlpant may, but is not required to, check the Excluded Parties Lisl System weeslle (httns://www.eels.nov/), which is complied by the General Services Administration. I Nothing contained in the foregoing shall be construed to require the establishment of a syatem of records in order to render in good faith the certification required by this clause. The knowledge and DLA -OB 13-06 Page 15 of 22 August 12, 2013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language Information of the prospective participant Is not required to exceed that which Is normally possessed by a prudent person in the ordinary course of business dealings. j. Except for transactions authorized under paragraph (f) of these Instructions, If a participant in a covered transaction knowingly enters Into a lower tier covered transaction with a person who Is suspended, debarred, Ineligible, or voluntarily excluded from participation in thls transaction, In addition to other remedies available to the Federal Government, the department or agency may terminate this transaction for cause or default, 2. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion — First Tier Participants: a. The prospective first tier participant certifies to the best of its knowledge end belief, that It and its principals: (1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participating In covered transactions by any Federal department or agency; (2) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (3) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (a)(2) of this certification; and (4) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local) terminated for cause or default. b. Where the prospective participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. 2. Instructions for Certification - Lower Tier Participants: (Applicable to all subcontracts, purchase orders and other lower tier transactions requiring prior FHWA approval or estimated to cost $25,000 or more -2 CFR Parts 180 and 1200) a. By signing and submitting this proposal, the prospective lower tier is providing the certification set out below. b. The certification In this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If It is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department, or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. c. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal Is submitted if at any time the prospective lower tier participant learns that its certification was erroneous by reason of changed circumstances. d. The terms "covered transaction," "debarred,' "suspended," "ineligible;" "participant," "person," "principal," and "voluntarily excluded," as used in this clause, ere defined in 2 CFR Parts 180 and 1200. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations, "First Tier Covered Transactions" refers to any covered transaction between a grantee or subgrantee of Federal funds and a participant (such es the prime or general contract). "Lower Tier Covered Transactions' refers to any covered transaction under a First Tier Covered Transaction (such as subcontracts). "First Tier Participant' refers to the participant who hes entered Into a covered transaction with a grantee or subgrantee of Federal funds (such as the prime or general contractor). "Lower Tier Participant' refers any participant who has entered Into a covered transaction with a First Tier Participant or other Lower Tier Participants (such as subcontractors and suppliers), e. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, It shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. f. The prospective lower tier participant further agrees by submitting this proposal that It will Include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions exceeding the $25,000 threshold. g. A participant in a covered transaction may rely upon a certification of a prospective participant In a tower tier covered transaction that is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that Its principals are not suspended, debarred, or otherwise Ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any lower tier prospective participants, each participant may, but is not required to, check the Excluded Parties List System website (https'Owww,eols,goy/), which is compiled by the General Services Administration. h. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by thls clause. The knowledge and information of participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 1. Except for transactions authorized under paragraph e of these Instructions, if a participant in a covered transaction knowingly enters Into a lower liar covered transaction with a person who Is suspended, debarred, Ineligible, or voluntarily excluded from parllcipallon in this transaction. in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension endror debarment. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Excluslon--Lower Tier Participants: 1. The prospective lower her participant certifies, by submission of this proposal, that neither it nor its principals Is presently debarred, suspended. proposed for debarment, declared Ineligible, or voluntarily excluded from participating in covered transactions by any Federal department or agency. DLA -OB 13-06 Page 16 of 22 August 12,1013 Local Assistance Procedures Manual Exhibit 12-G Required Federal -aid Contract Language 2. Where the prospective lower tier participant Is unable to certify to any of the statements in this certification, such prospective participant ahall attach an explanation to this proposal. XI. CERTIFICATION REGARDING USE OF CONTRACT FUNDS FOR LOBBYING Thle provision is applicable to all Federal -aid construction contracts and to all related subcontracts which exceed $100,000 (49 CFR 20). 1. The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: a. No Federal appropriated funds have been paid or will be paid, try et on behalf of the undersigned, to any °arsion fol ionuenc' J of sltcmplinq to influence an officer or employee of any Federal agency, a Member of Congress. an officer or employee of Congress. or an employee or a Member of Congress in connection with the awarding or any �&cJer t contract tile making of any Federal greet. the mating of oily Federal loan. the entering into or nny cooperative agreement, and the extension. conllneetfon, renewal, amendment, or modification of any Federal contract. gime lean. or Cooperative agreement. 0 If any funds teller tflan Federal appropriated funds have been paid Or will oe paid l3 ally person for influencing or intempling to Influence an officer or employee of any Fatten -it agency. a Member of Congress. an officer or employee of ColyreSS of an employee or a Member of Congress in connection with trite Federal Contract. grant, loan, or cooperative agreement. the undersigned shall complete and eubmlt Standard Fonn•LLL, "Disclosure Farm to Report Lobbying," In accordance with Its Instructions. 2. This Certification is a material representation of fact upon which reliance was placed when this transaction was made or entered Into. Submission of this certifleation Is a prerequisite for making or entering Into this Vette activn imposed by 31 U.S.C, 1352. Any person who falls to NO the repuile 1 certification shall ba subject to a civil penalty of not lass than $10,000 and not more than $100,000 for each such failure. 3. The prospective participant also agrees by submitting Its bid or proposal that the participant shaii require that the language of this certification be Included in all lower tlor subcontracts, which exceed $100,000 and that all such recipients shall certify and disclose accordingly. DLA -OB 13-06 Page 17 of 22 August 12, 2013 RECOMMENDATION FOR CONTRACT AWARD PROJECT NAME: City of Lodi Public Works Dept. Payroll & Labor Compliance Review Assistance DEPARTMENT: Public Works CONTRACTOR Pacific Municipal Consultants (PMC) AWARD AMOUNT: $19,999.00 DATE OF RECOMMENDATION: 2/13/15 BIDS OR PROPOSALS RECEIVED: Pacific Municipal Consultants (PMC) Contractor Compliance & Monitoring, Inc. (CCMI) "NO BID" or NO RESPONSE RECEIVED: PrevailingWageExperts.com Vistacore.com Labor Compliance Services, LLC Gonzales -White Consulting Service, LLC $110.00 Per Hour $85.00-$120.00 Per Hour BACKGROUND INFORMATION & BASIS FOR AWARD: Transportation Planner discussed the project scope with staff from each company. In addition, a Scoring Committee (Transportation Manager, Deputy Public Works Director, and Transportation Planner) reviewed each bidder based on experience/ size of staff/ references; project understanding and scope of work; as well as proposed cost. To clarify, the cost for the main staff member on the project from each firm would be $110/hr (PMC) and $85-120/hr (CCMI). After full analysis, it was determined that Pacific Municipal Consultants (PMC) was the preferred consultant. FUNDING: Various Federal Project Accounts Prepared by: Julia Tyack Title: Transportation Planner Reviewed by: P •r� Michael Baker INTERNATIONAL February 4, 2016 Julia Tyack, Transportation Planner CITY OF LODI 221 West Pine Street Lodi, CA 95240 jtyack@lodi.gov Exhibit 2 We Make a Difference RE: HARNEY LANE GRADE SEPARATION — LABOR COMPLIANCE Dear Ms. Tyack: Michael Baker International is pleased to provide this proposal to assist with the Harney Lane grade separation. The following is a list of tasks that we will complete. SCOPE OF WORK TASK 1. ATTEND PRECONSTRUCTION MEETINGS AND VERIFY CONTRACTOR'S LICENSE STATUS. Michael Baker will attend the preconstruction meeting to provide contractors and their subcontractors with materials and information on applicable federal and state labor standards requirements and to answer questions regarding labor standards monitoring procedures and required forms. Michael Baker will also take this opportunity to gather contact information from all of the contractors to ensure regular communication throughout the course of the project. We will obtain verification that all contractor licenses are current and confirm that contractors are excluded from the federal debarment list. TASK 2. CONDUCT EMPLOYEE INTERVIEWS. Once the project is under way, Michael Baker will conduct Exhibit 16-N employee interviews to verify worker classifications and wage payments. These interviews must be completed regularly throughout the course of the project. We will coordinate these interviews with the contractors and subcontractors at the work site to minimize the downtime associated with employee interviews. TASK 3. MONITOR LABOR STANDARDS COMPLIANCE ON THE PROJECT. Michael Baker will ensure that the City is in compliance with all requirements regarding labor standards, including compliance with federal and state prevailing wage requirements. Michael Baker will work closely with contractors and subcontractors (especially those unfamiliar with prevailing wage requirements) throughout the project. Michael Baker staff will review all certified payroll reports. Where deficiencies are found, Michael Baker is available to work directly with the contractor to make corrections and confirm restitution. We will inform the City whenever a contractor or subcontractor is found to be out of compliance. MBAKERINTL.COM 2729 Prospect Park Drive, Suite 220 Rancho Cordova, CA 95670 P: (916) 361-8384 F: (916) 361-1574 CITY OF LODI RE: HARNEY LANE GRADE SEPARATION - LABOR COMPLIANCE Page 2 TASK 4. MAINTAIN LABOR STANDARDS COMPLIANCE DOCUMENTATION. Michael Baker will maintain the files in accordance with the requirements of the program. We will monitor any changes or developments regarding federal or state labor standards that may occur during the term of the project, and will immediately inform the City and contractors of any changes that occur. TASK S. ASSIST WITH PROGRESS PAYMENTS. When a progress or final payment is requested by the contractor, Michael Baker will coordinate with the City to ensure that all weekly payrolls have been reviewed for labor standards and prevailing wage compliance before a payment is made to the contractor. This ensures that there are no surprises when the contractor makes a retention request. TASK 6. RESPOND TO REQUESTS FOR INFORMATION. Michael Baker staff will be available to the City and the contractors to answer any requests for information that may arise pertaining to federal and state labor standards compliance. Michael Baker staff is knowledgeable on labor standards law, and will try to provide contractors with all the information they need throughout the project. PROJECT TEAM JENNIFER GASTELUM, PROJECT DIRECTOR Ms. Gastelum has more than 15 years of experience in housing, planning, and project management. She is experienced in administering various federal grant programs, including CDBG, Neighborhood Stabilization Program, CalHome, and HOME. Ms. Gastelum will provide general oversight to the project. CYNTHIA WALSH, PROJECT MANAGER AND LABOR COMPLIANCE OFFICER Ms. Walsh is experienced with state and federal grant programs and specializes in labor standards compliance. She possesses extraordinary administrative and organizational skills, a necessity for labor compliance. Ms. Walsh will serve as the project manager and, as primary contact for the City, will also be responsible for monitoring labor compliance through the review of certified payroll reports. She will also be the primary point of contact for the prime contractor, and will be responsible for reporting, coordination, and record-keeping. JESSICA HAYES, ASSISTANT PROJECT MANAGER AND SENIOR GRANTS MANAGEMENT SPECIALIST Ms. Hayes is experienced with state and federal grant programs and will serve as the assistant project manager for the City. She will assist Ms. Walsh with monitoring labor compliance through the review of certified payroll reports. PATRICE CLEMONS, ASSOCIATE LABOR COMPLIANCE SPECIALIST Ms. Clemons currently manages CDBG programs for the cities of Lodi and Grass Valley. Her duties include preparing reports, processing financial requests, maintaining records, tracking expenses and revenue, and monitoring. Additionally, Ms. Clemons has conducted HUD -11 employee interviews and reviewed certified payroll reports for compliance with federal standards. CITY OF LODI RE: HARNEY LANE GRADE SEPARATION - LABOR COMPLIANCE Page 3 Exhibit 3 FEE Michael Baker will provide the proposed scope of services for a fee of $24,000. BILLING AND PAYMENT Michael Baker will bill according to the percentage of work completed. Progress billing will be monthly, with payment due on receipt. HOURLY RATES Staff Hourly Rate Jennifer Gastelum, Project Director/Service Area Lead $135 Cynthia Walsh, Protect Manager/Labor Compliance Officer $110 Jessica Hayes, Assistant Project Manager/Senior Grants Management Specialist $105 Patrice Clemons, Associate Labor Compliance Specialist $85 If you have any questions regarding this proposal, please contact Jennifer Gastelum at (916) 231-2268. Sincerely, Kevin Gusto ; PE Vice President JifeV Gastelum Service Area Lead RESOLUTION NO. 2016-27 A RESOLUTION OF THE LODI CITY COUNCIL AUTHORIZING THE CITY MANAGER TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT WITH TERRACON, OF LODI, FOR CONSTRUCTION TESTING AND INSPECTION SERVICES AND AMENDMENT NO. 1 TO THE PROFESSIONAL SERVICES AGREEMENT WITH MICHAEL BAKER INTERNATIONAL, INC., OF RANCHO CORDOVA, FOR LABOR COMPLIANCE MONITORING FOR GRADE SEPARATION HARNEY LANE AT UNION PACIFIC RAILROAD OVERHEAD PROJECT WHEREAS, at the November 18, 2015 City Council meeting, Council awarded DeSilva Gates Construction, LP, of Dublin, a contract for construction of the Grade Separation Harney Lane at Union Pacific Railroad Overhead Project; and WHEREAS, City staff solicited Request for Qualification and Proposals for testing and inspection services and Terracon received the highest marks and was selected to perform the required testing and inspection services during construction; and WHEREAS, Michael Baker International, Inc., currently provides labor compliance services to the Public Works Transit and Neighborhood Services Divisions; and WHEREAS, these services will be required during the course of the construction project, which is anticipated to begin in April 2016, with completion in October 2017; and WHEREAS, staff recommends authorizing the City Manager to execute a Professional Services Agreement with Terracon, of Lodi, for construction testing and inspection services, in the amount of $574,610; and WHEREAS, staff recommends authorizing the City Manager to execute Amendment No. 1 to the Professional Services Agreements with Michael Baker International, Inc., of Rancho Cordova, for labor compliance monitoring, in the amount of $24,000. NOW, THEREFORE, BE IT RESOLVED that the Lodi City Council does hereby authorize the City Manager to execute a Professional Services Agreement with Terracon, of Lodi, California, for construction testing and inspection services, in the amount of $574,610, for Grade Separation Harney Lane at Union Pacific Railroad Overhead Project; and NOW, THEREFORE, BE IT FURTHER RESOLVED that the Lodi City Council does hereby authorize the City Manager to execute Amendment No. 1 to the Professional Services Agreement with Michael Baker International, Inc., of Rancho Cordova, California, for labor compliance monitoring, in the amount of $24,000, for Grade Separation Harney Lane at Union Pacific Railroad Overhead Project. Dated: March 2, 2016 I hereby certify that Resolution No. 2016-27 was passed and adopted by the City Council of the City of Lodi in a regular meeting held March 2, 2016, by the following vote: AYES: COUNCIL MEMBERS — Johnson, Kuehne, Mounce, Nakanishi, and Mayor Chandler NOES: COUNCIL MEMBERS — None ABSENT: COUNCIL MEMBERS — None ABSTAIN COUNCIL MEMBERS — None NIFER FERRAIOLO City Clerk 2016-27 CITY COUNCIL MARK CHANDLER, Mayor DOUG KUEHNE, Mayor Pro Tempore BOB JOHNSON JOANNE MOUNCE ALAN NAKANISHI CITY OF LODI CITY HALL, 221 WEST PINE STREET P.O. BOX 3006 LODI, CALIFORNIA 95241-1910 (209) 333-6706 / FAX (209) 333-6710 EMAIL: pwdept@lodi.gov www _Iodi.goy February 26, 2016 STEPHEN SCHWABAUER City Manager JENNIFER M. FERRAIOLO City Clerk JANICE D. MAGDICH City Attorney CHARLES E. SWIMLEY, JR. Interim Public Works Director SUBJECT: Adopt Resolution Authorizing City Manager to Execute Professional Services Agreement with Terracon, of Lodi, for Construction Testing and Inspection Services ($574,610), and Amendment No. 1 to Professional Services Agreement with Michael Baker International, Inc., of Rancho Cordova, for Labor Compliance Monitoring ($24,000), for Grade Separation Harney Lane at Union Pacific Railroad Overhead Project Enclosed is a copy of background information on an item on the City Council agenda of Wednesday, March 2, 2016. The meeting will be held at 7 p.m. in the City Council Chamber, Carnegie Forum, 305 West Pine Street. This item is on the consent calendar and is usually not discussed unless a Council Member requests discussion. The public is given an opportunity to address items on the consent calendar at the appropriate time. If you wish to write to the City Council, please address your letter to City Council, City of Lodi, P. O. Box 3006, Lodi, California, 95241-1910. Be sure to allow time for the mail. Or, you may hand -deliver the letter to City Hall, 221 West Pine Street. If you wish to address the Council at the Council Meeting, be sure to fill out a speaker's card (available at the Carnegie Forum immediately prior to the start of the meeting) and give it to the City Clerk. If you have any questions about communicating with the Council, please contact Jennifer M. Ferraiolo, City Clerk, at (209) 333-6702. If you have any questions about the item itself, please call Gary Wiman at (209) 333- 6706. z: r Chajes E. Swimley, Jr. Interim Public Works Director CES/tdb Enclosure cc: City Clerk