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City of Santa Ana <br />Planning and Building Agency <br />Environmental Consultant <br />Authorization Form <br />Project Name: World Oil Queuing Intrusion Study (amendment) <br />Project Address (if applicable): <br />Consultant Name: Kimley-Horn Associates <br />Agreement No. (if applicable): A-2008-120-002/3 <br />Staff has carefully reviewed the Scope of Work proposal by the above-mentioned consultant <br />dated September 2, 2010 (attached). <br />We do hereby authorize the above-mentioned consultant to commence work as indicated within <br />the terms and conditions of this proposal. <br />® Environmental Consultant Services Special Account Balance: <br />Staff has confirmed that the total aggregate amount ($2,000,000) of the special deposit <br />account for contracted environmental services (account no. 98-01-3612) has not been <br />overdrawn for fiscal year 2008-2009. <br />® Amount of Contract: (amendment) $6,400 <br />® Funding Source <br />❑ Private (Developer) — Account No.: <br />® Public (City Agency) — Account No.: PWA <br />❑ x <br />Date <br />® Agreement, Liability Insurance and Workers Consa n Insurance <br />Staff has confirmed that all required agreement liabi ty insurance and workers <br />compensation insurance has been submitted and is current. <br />® Developer/Applicant Consultant Authorization <br />Staff has obtained authorization from developer/applicant/City Agency to hire the above- <br />mentioned consultant firm (attach authorization letter from developer/applicant). <br />Project Plan Manager Date <br />1' <br />epartment Manager Date <br />Authorization: Jay Trevino, Executive Director, City of Santa Ana Planning & Building Agency <br />Signature Date �' `3 <br />