HomeMy WebLinkAboutJUSTICE, CA DEPT OF - SHOOTING FACILITY - 2006
.'
STATE OF CALIFORNIA
STANDARD AGREEMENT
liTO. 213-(1iIev oeJ03)
N-2006-066
AGREEMENT NUMBER
06.7595
REGISTRATION NUMBER
1. This Agreement is entered into between the State Agency and the Contractor named below:
STATE AGENCY'S NAME
DEPARTMENT OF JUSTICE
CONTRACTOR'S NAME
CITY OF SANTA ANA POLICE DEPARTMENT
2. The term of this 02101/07 through 01/31108
Agreement is:
3. The maximum amount $ 1,420.00
of this Agreement is: One Thousand Four Hundred and Twenty Dollafe and Zero Centll
4. The parties agree to comply with the terms and conditions of the following exhibits which are by this reference
made a part of the Aqreement:
Exhibit A - Scope of Work
16 Page (s)
Attachment 1
2 Page (s)
GTC306
Exhibit B - Budget Detail and Payment Provision
Exhibit C' - General Terms and Conditions
Check mark one Item below as Exhibit D:
og Exhibit D - Special Terms and Conditions (Atlacl1ed hereto as part of this agreement)
o Exhibit D' - Special Terms and Conditions
4
Page (s)
Items shown with an Asterisk (*), are hereby incorporated by reference and made part of this agreement as If attached hareto.
These documents cen be viawed al www.ols.dgs.ca.govlStandard+Language
IN WITNESS WHEREOF. this _I has been exo<;uled b the ""riles hereto.
CONTRACTOR
California Department: of O.ner&1
hrvtees USa Only
CONTRACTOR'S NAME (If o/he, than an individual, .late whether a COrpotll/ion, partnership. etc.)
~
PRINTED NAME AND TinE Of PERSON SIGNING
PAUL WALTERS, Chief
ADDRESS
60 Civic Center Plaza
Santa Ana CA 92702
-:: )
"Exempt From DGS Approval Per
DGS Exemption letter NO.52"
STATE Of CALIFORNIA
PRINTED NAME AND TinE Of SON NlNG
JOAN E. KIRTLAN, Mana er, Co tracts & Purchasing
o Exempt per:
ADDRESS
1300 I Street, 7"' Floor
Sacramento, CA 9Sll14
CITY OF SANTA ANA POLICE DEPARTMENT
Agreement Number 06.7595
Page 1 of 16
EXHIBIT A
(Standard Agreement)
SCOPE OF WORK
J. Contractor agrees to provide the use of the Santa Ana Police Department's Firing Range and Facility to the
Department of Justice (DOJ) as described herein:
The Contractor shall provide utilization of the shooting facility to approximately ten (10) special agent
personnel from the Bureau of Narcotic Enforcement (BNE) and the Criminal Intelligence Bureau (CIB), for
quarterly proficiency testing and training as mandated by the California Peace Officers Standards and
Training (POST). Contractor's services shall be in accordance with Attachment 1, "The Agreement Between
the City of Santa Ana and the California Department of Justice for Use of the Santa Ana Police Department
Shooting Facility", which is hereby incorporated into this Agreement
2. Firing range and facility is located at 60 Civic Center Plaza, Santa Ana, CA 92702.
3. The project representatives during the term of this Agreement will be:
Contractor: Santa Ana Police De t.
Name: Kim Ha en
Phone: 714 245-8088
Fax: Not Available
ATTACHMENT 1
AGREEMENT BETWEEN THE CITY OF SANTA ANA
AND THE CALIFORNIA DEPARTMENT OF JUSTICE FOR USE OF THE
SANTA ANA POLICE DEPARTMENT SHOOTING FACILITY
This Agreement is made and entered into on the by and
between the, California Department of Justice - Bureau of Narcotics Enforcement and
Criminal Intelligence Bureau (hereinafter referred to as the DOJ) and the City of Santa
Ana, a Municipal Corporation and Charter City, (hereinafter referred to as "Santa Ana").
RECITALS
1. Santa Ana has constructed and operates a police pistol range located on its
property at 60 Civic Center Drive, Santa Ana California, (hereinafter
referred to as "the Facility"); and
2. Santa Ana has employees responsible for management and operation of
the Facility (hereinafter referred to as "Santa Ana Rangemasters"); and
3. Santa Ana has promulgated certain rules and regulations (See EXHIBIT
"A" and "B"), concerning safety, hours of operation and use of the
Facility; and
4. The DOJ desires to enter into an Agreement with Santa Ana permitting the
DOl to use the Facility.
COVENANTS
NOW THEREFORE, in consideration of the mutual covenants contained herein,
the parties agree as follows:
1. Santa Ana agrees to allow those officers, employees and agents of the DOJ
- Bureau of Narcotics Enforcement and Criminal Intelligence Bureau who
are authorized by the DOl to use the Facility as specified III this
Agreement.
2. The DOl agrees to provide Santa Ana with a list of all DOl officers,
employees, and agents authorized to use the Facility. Only those persons
specified on the authorization list may use the Facility. Additions to or
deletions from the. authorization list shall be provided to Santa Ana on a
monthly basis. The DOl shall take all reasonable measures to assure that
only those persons specified on the authorization list shall be permitted to
use the Facility. The authorization list is for informational purposes only
and Santa Ana shall have no obligation to screen or to otherwise evaluate
the qualifications, other than for safety, of those persons authorized to use
the Facility. All screening procedures to qualify those who use the Facility
shall be the sole responsibility of the DOl. The DOl further agrees to
provide Santa Ana with immediate notification upon termination of an
employee.
3. All officers, employees and agents of the DOl who use the Facility, shall
strictly comply with the rules and regulations attached hereto as Exhibits
"A" and "B" (including any amendments to Exhibits "A" or "B"), and any
other order or directive of Santa Ana. Santa Ana shall supply the DOl
with a copy of all rules, regulations and amendments which are not
included in Exhibits A or B.
4. Unless otherwise agreed, the DOl shall provide a Contract Agency
Rangemaster, (hereinafter referred to as "CAR") to supervise the range
operation and conduct firearms training as required.
5. The Santa Ana Rangemaster may close the Facility at anytime for any
purpose. The Santa Ana Rangemaster may exclude any person from
using the Facility for violating any rules and regulations relating to safety.
Santa Ana reserves the exclusive right to determine the Facility's hours of
operation. The DOl may, upon prior approval of the Santa Ana
Rangemaster, use the Facility outside the hours of operation providing
there is no conflict with other agency use of the Facility.
6. The DOl agrees to pay $35.00 per hour with a minimum of two hours for
exclusive use of one of the range facilities. The DOl agrees to cancel any
previously scheduled Facility use at least 24 hours before the scheduled
date. If previously scheduled Facility time is not cancelled at least 24
hours prior, the DOl, agrees to pay a $70.00 forfeiture fee. Santa Ana
reserves the right to adjust any fees, upon 20 days prior written notice, as
necessary to cover any increased cost related to the use of the Facility.
Any fee increase shall not be greater than any increase that may be
imposed upon any other agency authorized to use the Facility.
7. Santa Ana shall supply targets, eye and ear protection, and a weapon
cleaning area only to the DOl users of the Facility.
8. Santa Ana shall submit a monthly invoice to the DOl and the DOl agrees to
make payment to Santa Ana on or before 45 days from the date of the
invoice. Delay of prompt payment may result in Facility use denial.
9. Santa Ana shall not be liable for any loss, damage or injury of any kind
whatsoever to the DOl, its property, or to any of its officers, employees,
agents, guests or invitees, or any other person, caused by any use of the
Facility, or by any defect in any building, structure or any other
improvement at the Facility or arising from any accident on the premises.
The DOl waives, all claims and demands against Santa Ana for any such
loss, damage, or injury. The DOl hereby agrees to defend and indemnify,
save and hold Santa Ana free and harmless from any liability for any loss,
damage or injury to the DOl officers, employees, and agents, other
persons or property, and from all costs, expenses and other charges arising
from the DOJ use of the Facility in connection with this Agreement,
except the DOJ shall not be required to indemnify for any loss, damage,
injury or claim arising from the willful acts or negligence of Santa Ana, its
officers, employees, or agents.
10. The DOJ agrees and represents that all of its officers, employees, agents,
or other personnel that may utilize the Facility are doing so within the
course and scope of their duties as an employee, officer, or agent of the
DOJ and are in no way employees of Santa Ana. Should any officer,
employee, agent or other personnel of the DOJ submit a claim for any
injury or damages relating to the use of the Facility, the DOJ agrees to
indemnify Santa Ana from any and all such claims whether made by way
of civil litigation, arbitration or by the workers' compensation forum
except that the DOJ shall not indemnify Santa Ana for any loss, damage,
injury, or claim arising from the willful acts or negligence of Santa Ana,
its officers, employees or agents.
II. Santa Ana agrees and acknowledges its obligation to inspect, regulate, and
operate the Facility such that it complies with all state and federal laws,
including but not limited to the following environmental laws, the
Carpenter-Presley-Tanner Hazardous Substances Act ("CPTHSA"),
California Health and Safety Code Section 25300, et seq., the
Comprehensive Environmental Response Compensation and Liability Act
("CERCLA"), 42 use Section 9610, et seq., and the Resource
Conservation and Recovery Act ("RCRA"), 42 USC Section 6901
(collectively referred to herein as "Environmental Laws". Santa Ana
agrees that, as between itself and DOJ, the use of the Facility by DOJ
pursuant to paragraph 1 of this Agreement shall not subject DOJ to any
liability whatsoever under the Environmental Laws. Santa Ana
additionally agrees to properly dispose of any and all waste left by DOJ at
the Facility when DOl is acting within the scope and course of this
Agreement, and warrants to DOl that Santa Ana shall be the "generator"
(as that word is defined in RCRA) of any and all "hazardous waste" that
may be transferred from the Facility to any "treatment, storage or disposal
facility (TSDF)" (as those terms are defined in RCRA). Finally, Santa
Ana warrants to DOl that it hereby fully releases and discharges DOl from
any and all liability relating to any future claims that the Facility must
undergo remediation activities pursuant to the Environmental Laws.
12. Either party may terminate this Agreement at anytime, without cause upon
30 days prior written notice.
13. The persons executing this Agreement on behalf of the DOl and Santa Ana
warrant that (i) they are duly authorized to execute and deliver this
Agreement, (ii) formally bound to the provisions of this Agreement, and
(iii) the entering into this Agreement does not violate any provisions of
any other agreement to which the party is bound.
IN WITNESS WHEREOF, the parties have executed and entered into this
Agreement by their authorized representatives.
Date:
CITY OF SANTA ANA
"
tWJ:2~
ATTEST: .
// ) "~Y
ATR~i;i~~trd' c_~ \;
City Clerk
DAVID N. REAM
City Manager
APPROVED AS TO FORM:
JOSEPH W. FLETCHER
Ci~1Z
By: . CW1a CdPfVt ()/'-.-'
Paula J. Coleman
Assistant City Attorney
CALIFORNIA DEPARTMENT
OF JUSTICE
Date:
>\ i\0r
/~
Date: ") Ii ) \) ')
Cra' Buehler, Bureau Chief
C minal Intelligence Bureau
EXHIBIT "A"
To Pistol Range Agreement
1. REGULATIONS FOR USE OF THE SANTA ANA POLICE DEPARTMENT
SHOOTING RANGES BY DOJ PERSONNEL.
a. All DOJ personnel shall sign-in prior to using the facility.
b. DOJ personnel shall be authorized to use the facility under the following
conditions: (I) the DOJ must provide a CAR Rangemaster to supervise and
conduct all firearms training; and (2) all DOJ personnel are restricted to the area
in and around the range facility.
c. Facility hours will be by mutual consent and arranged at least 72 hours prior to
use (exceptions can be made by Santa Ana Police Department Rangemaster).
d. Parking is limited and the DOJ personnel must either park off the facility or
arrange to pool using a DOJ vehicle. DOJ vehicles allowed into the facility may
only park adjacent to the gas pumps in a parking slot approved by the Santa Ana
Rangemaster.
e. All DOJ personnel who come to the Facility by vehicle shall enter through the 6th
Street Gate.
f. All DOJ personnel who come to the Facility by any other means shall enter
through the Police Facility main entrance and be escorted to the Range.
g. All DOJ personnel who are not in uniform shall wear a visible police badge or
l.D. card at all times while in the Police Facility.
2. CONTRACT RANGE OPERATION CONDITIONS
a. A Santa Ana Police Department Santa Ana Rangemaster will be present during all
operations of the Facility and will have ultimate range authority over all users.
b. Santa Ana Police Department Rangemasters may provide remediation of
marksmanship related shooting problems as needed if desired, and as time
permits.
c. Santa Ana Police Department shall approve all ammunition used on the Facility
prior to it being fired. No centerfire rifle caliber ammunition shall be permitted.
d. Santa Ana Police Department may supply targets.
e. Santa Ana Police Department will supply ear and eye protection.
f. Santa Ana Police Department will supply weapon-cleaning facilities.
g. Santa Ana Police Department may provide secure storage for DOJ ammunition
and cleaning supplies.
h. It shall be the responsibility of the CAR to ensure all weapons used at the facility
are safe and in serviceable condition.
3. DEPARTMENT POLICIES
All DOJ personnel shall comply with all applicable provisions of the City of Santa Ana
Police Department Firing Range Safety Policy attached hereto as Exhibit "B" and all
subsequent amendments.
EXHIBIT "B"
to Pistol Range Facility Agreement
FIRING RANGE SAFETY, POLICY AND PROCEDURES
PURPOSE
The purpose of this memorandum is to institute policy and procedural guidelines for the
use of the Santa Ana Police Shooting Ranges. Additionally, it establishes the following:
I. Provides for the highest level of safety and protection for all users of the Santa
Ana Shooting Ranges; and
2. Furnish a safe environment to allow for a professional training experience.
DEPARTMENT POLICIES
All personnel shall comply with all applicable provisions of the City of Santa Ana Police
Department Firing Range Safety Policy as outlined herein and attached hereto as Exhibit
"A" and all subsequent amendments. The following policy is established for use of the
Firing Facility:
I. A Santa Ana Rangemaster will be physically present at the Facility at all
times.
2. The Santa Ana Rangemaster will brief and sign-out the Facility to the
agency CAR who will be responsible for the training session and Facility
property. At the completion of training the Santa Ana Rangemaster will
inspect the Facility for cleanliness and serviceability in the presence of the
CAR noting any significant new damage to any equipment or Facility
property. Santa Ana will also:
a. Provide ear and eye protection.
b. Provide appropriate paper targets for the Caswell Cas-rail
target retrieval system.
c. Provide the outside agency with a secure ammunition
storage area.
d. Provide the outside agency the use of a weapons cleaning
room and secure storage for cleaning equipment.
e. Approve all outside agency courses of fire before shooting.
Once approved, no deviation from the approved course will
be authorized without prior approval.
f. May provide a Santa Ana Rangemaster to supervise the
operation of the Facility when outside agencies do not have
a CAR, and have made additional contractual agreements
to train in the Facility. Shooters so authorized can only
shoot a course of fire, which has been approved by their
agency and that, can be fired from the static firing
positions. Supervision will be limited to ensuring
compliance with procedures, policy, and safety. Shooters
in this category will not normally be allowed to train
forward of the firing line.
g. Provide a list of rules and regulations to outside agencies
concerning the safety and operation of the Facility
complex.
h. Require a minimum of 24- hour notice of cancellation of
range training in order not to forfeit Facility fees.
1. Establish a point of contact for each agency for the purpose
of coordination concerning the Facility scheduling, parking
and access control.
RANGE OPERATION
The Facility shall be operated in accordance with the following:
I. The Santa Ana Rangemaster shall have the sole authority on the Facility
and is responsible for its safe and efficient operation.
2. All persons entering the Facility shall follow the directions of the Santa
Ana Rangemaster and shall adhere to the posted rules.
3. The SAPO Rangemasters Office, SAPO Ammunition Storage Room, and
the Weapons Repair Room are strictly off-limits to unauthorized personnel
for security and safety reasons.
4. The Facility is for the use of the Santa Ana Police Department Officers,
Reserves, contract agencies, and others as approved by the Chief of Police,
Administration and Support Captain or the Training Commander.
5. The Facility shall only be used under the supervision of an approved Santa
Ana Rangemaster, or another qualified instructor as approved in writing
by the Training Commander.
6. The Facility is available, by appointment with the Santa Ana Rangemaster,
for retired Santa Ana Police Department officers to comply with Penal
Code provisions for CCW permits.
7. All weapons cleaning will he carried out in the designated cleaning rooms.
8. No unsafe practices will be tolerated. Weapons shall be cleared and
checked, using the firing lines under the supervision of an approved
Rangemaster, or the weapon-clearing barrel before cleaning. The
loading/unloading of firearms shall only be carried out using one of the
safety barrels located in the Range, cleaning rooms, or on the firing line
under the supervision of a Rangemaster.
9. Personnel entering the Facility shall immediately report to the Santa Ana
Rangemaster and shall adhere to the following procedures:
a. Sign in or check in.
b. Receive and follow the Rangemaster'.s instructions regarding the
preparation and conduct of the course of fire or training to be
conducted; and complete it as directed.
c. Once the course of fire is completed, follow the Santa Ana
Rangemaster instructions regarding cleaning, and lubricating and
or reloading of the weapon for duty.
d. Reload the weapon before returning to duty using one of the safety
barrels located in the cleaning rooms or reload on the firing line at
the direction and under the supervision ofthe Santa Ana
Rangemaster.
WEAPONS
The following policy and procedures apply to all weapons used in the Facility:
I. The Santa Ana Rangemaster shall inspect all weapons that are being shot
for the first time before they are fired on the Range. In the case of Santa
Ana officers, the weapon must also have an Authorization slip on file.
2. While shooting on the Range, or while in the immediate vicinity of an in-
progress firearms course, all personnel shall wear eye and ear protection.
3. Once weapons are loaded in preparation for shooting, they shall be de-
cocked and remain holstered unless on the firing line ready to shoot and/or
participating in a course of fire. (Hot Range Format)
4. Only authorized weapons and ammunition shall be fired in the ranges. If
there is any doubt or question as to whether a specific type of weapon or
ammunition can be used, it shall be referred to the Department Santa Ana
Rangemaster/ Armorer for authorization before shooting.
5. The following equipment restrictions apply:
a. Authorized weapons are handguns up to and including .45 cal.
b. No centerfire rifle caliber ammunition is authorized to be fired
in the lower range.
c. Magnum ammunition, tracer, incendiary, or armor piercing
ammunition is strictly prohibited from being used in the ranges.
RESPONSIBILITIES
Santa Ana Rangemasters and CAR's shall abide by the following:
1. All Instructors shall demonstrate a proactive safety attitude and exhibit a
professional demeanor at all times while in the Facility.
2. Allow no one to use the Facility that has a pre-existing injury or
condition(s), which may affect their ability to safely use the Facility or
participate in firearms training.
3. Any intentional violation of safety guidelines, gross displays of improper
range procedures or lack of sound judgment, which in the Rangemasters
opinion places others at risk of injury, shall result in the immediate
removal of the individual(s) from the Facility.
4. The Santa Ana Rangemaster on duty shall be responsible for inspecting
the Facility before and after use by an outside agency. This inspection
will include cleanliness and serviceability of equipment. Damage and or
cluttered conditions will be brought to the attention of the CAR for
correction.
FIREARMS TRAINING
Firearms training shall be conducted under the following conditions:
I. Santa Ana Police Department personnel shall only be trained using
approved Firearms Training Courses and or Training Scenarios which
have been approved by the Training Commander.
2. Firearms Training which falls outside the normally scheduled training
shall be approved by the Training Commander before being conducted.
3. SWAT tactical training will not be conducted in the Facility unless it has
the prior approval of the Training Commander and is conducted under the
direct supervision of the SWAT Commander or his designee.
4. Contract agencies authorized to use the Range Facility shall have their
courses of fire approved by the Santa Ana Rangemaster before shooting.
Santa Ana Police Department reserves the right to deny or request
modification to any course of fire if it is determined the course may be
dangerous to personnel or damaging to range property and or equipment.
5. The Santa Ana Rangemasters are the ultimate authority concerning range
safety, policy, and use. Decisions made by any Santa Ana Rangemaster
shall be followed. Disputes and or controversial decisions may be referred
to the Department's full time Santa Ana Rangemaster for resolution.
Matters beyond the Rangemaster's authority shall be referred to the
Training Commander during daytime working hours or the Watch
Commander after hours.
EXCEPTIONS
Waivers or exceptions to the above policies and guidelines shall only be authorized by
the Chief of Police, Administrative and Support Division Captain, Training Commander,
or the permanently assigned Santa Ana Rangemaster. Exceptions, when granted, shall be
on a one time only basis and must be requested again, each time it is necessary, before
conducting the training for which a waiver is required. Any and all exceptions shall be
documented.
SANTA ANA POLICE DEPARTMENT
INDIVIDUAL WAIVER OF LIABILITY
The City of Santa Ana and the Santa Ana Police Department assume no obligation in
offering the use of its Shooting Range Facility to the general public or other public
agencies. There is a real possibility of injury occurring when using the Shooting Range
Facility, or while on the premises while others are using the Shooting Facility. The
undersigned acknowledges that the handling of firearms, or being in the proximity of
others using or handling firearms involves a significant risk of serious physical injury
including the possibility of death regardless of the skill of the user or the adequacy of
supervision or the instructions given. I understand that my signature constitutes a request
for permission to use the Shooting Range Facility with knowledge and understanding that
I assume the risk that I could be injured. I also understand that the City of Santa Ana
would not allow the use of the Shooting Range Facility unless I agree to waive any and
all rights, claims, demands, causes of actions including the right to sue the City of Santa
Ana or its officers, agents, employees, elected or appointed officials and the Santa Ana
Police Department.
I understand that by signing this form:
A. I am agreeing to assume all risks of physical injury arising out of
my use of firearms and other related equipment or participation in the activities
offered by the City of Santa Ana;
B. I am waiving my rights with respect to any injury or damage I may
sustain as a result of or in any way related to my use of the Shooting Range
Facility, or while on premises when others are using the Shooting Range Facility.
By way of illustration, I am giving up my right to sue for inadequate instruction,
inadequate supervision, faulty equipment, or dangerous condition of the premises.
My agreement to give up the right to sue the City of Santa Ana does not extend to
fraud or intentional misconduct of the City of Santa Ana or their officers, agents,
employees and representatives;
C. I agree to indemnify, defend and hold harmless the City of Santa
Ana or its officers, agents, employees, elected or appointed officials and the Santa
Ana Police Department from any and all damages, claims or losses caused by my
use of any equipment, my actions while participating or being on premises while
others are participating in the program.
D. I agree to comply with all posted rules and regulations and all
orders of the Santa Ana Rangemaster.
I have carefully read this form and fully understand its content. I am voluntarily
signing this waiver with knowledge of the rights I am giving up and the dangers involved
in the activity.
Printed Name
Badge #
Participant Signature
Witness:
Date:
Agency
Santa Ana Police Department Waiver
I, , on my own behalf, hereby assume all risks and hazards
incidental to the conduct of the activities and transportation to and from the activity and
hereby waive any and all claims, demands or causes of action I may have or eventually
have against, and also hereby release and hold harmless, the City of Santa Ana and/or any
officer, agent, employees, elected or appointed officials, or volunteers and the Santa Ana
Police Department therefore from any injuries, losses, damages, costs, and expenses
allegedly or actually arising out of the use of the Shooting Range Facilities.
Date
Signed
Date:
Witness:
CITY OF SANTA ANA POLICE DEPARTMENT
Agreement Number 06.7595
Page 1 of 2
EXHIBIT B
(Standard Agreement)
BUDGET DETAIL AND PAYMENT PROVISIONS
Pavment. For full and satisfactory performance of the services provided pursuant to this Agreement, the
Department of Justice shall pay the Contractor at a rate not to exceed $35.00/per hour (with a minimum of two
hours) per man shoot for approximately ten (10) agents who will use the range an estimated four (4) time per
year (qualifications). The total amount which may be paid under this Agreement shall not exceed $1,420.00 with
the actual amount being dependent upon the extent of the Contractor's services required by the Department of
Justice.
Travel and per diem expenses necessarily incurred in performance of the services rendered shall be reimbursed
in accordance with the current State of California, Department of Personnel Administration Regulations applicable
to State of California employees. No travel outside the State of California shall be reimbursed unless prior wntten
authorization is obtained from the Department of Justice.
The Contractor understands that no Federal or State income tax shall be withheld from the payments under this
Agreement. However, the State of California is required to report all payments to the Internal Revenue Service
and Franchise Tax Board for tax purposes.
InvoicinQ. The Contractor shall submit quarterly invoices in triplicate, in arrears, noting Agreement Number,
Service Period and Charges to:
DEPARTMENT OF JUSTICE
Divisions of Law Enforcement
Mission Support Branch
P.O. Box 161089
Sacramento, CA 95816-1089
Attn: Contracts-BNE
For all expenses incurred, each invoice must include necessary supporting documents and/or substantiation of
travel and per diem costs, except mileage. -
BudQet ContinQencv Clause. It is mutually agreed that if the Budget Act of the current year and/or any
subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this
Agreement shall be of no further force and effect. In this event, the State shall have no liability to pay any funds
whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be
obligated to perform any provisions of this Agreement.
If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State shail
have the option to either cancel this Agreement with no liability occurring to the State, or offer an agreement
amendment to Contractor to reflect the reduced amount.
Prompt Pavment Clause. Payment will be made in accordance with the provisions of the California Prompt
Payment Act, Government Code section 927, et seq. Unless expressly exempted by statute, the Act requires
state agencies to pay properly submitted, undisputed invoices not more than 45 days after (a) the date of
acceptance of goods or performance of services; or (b) receipt of an undisputed invoice - whichever is later
CITY OF SANTA ANA POLICE DEPARTMENT
Agreement Number 06.7595
Page 1 of 1
EXHIBIT C
(Standard Agreement)
GENERAL TERMS AND CONDITIONS
PLEASE NOTE: The General Terms and Conditions will be included in the agreement by reference to Internet
site: www.ols.dQs.ca.!lov and click on Standard Language. Please read the terms and conditions that are
applicable to this Agreement by accessing the above-referenced website. (Please note that there may be several
different versions of the Terms and Conditions on the website. Refer to page one of this Agreement to find the
number of the Terms and Conditions that are applicable to this Agreement). By signing this Agreement you are
agreeing to be bound by these Terms and Conditions, except as superseded by other terms or provisions of this
Agreement.
If you do not have access to the Internet, please contact the Department of Justice contact person listed
in Exhibit A to this Agreement and a copy of the General Terms and Conditions will be sent to you.
CITY OF SANTA ANA POLICE DEPARTMENT
Agreement Number 06-7595
Page 1 of 4
EXHIBIT D
(Standard Agreement)
SPECIAL TERMS AND CONDITIONS
Control and Direction. The Department of Justice shall at all times maintain control and direction over the
scope of work being performed under this Agreement. The Department of Justice reserves the right to change
the tasks as defined within the general scope of the work to be performed by the Contractor. These changes
shall be accomplished by written amendment to this Agreement.
Termination. The Department of Justice reserves the right to terminate this Agreement when such termination is
in the best interest of the Department. Such termination is subject to 30 days written notice to the Contractor
Any such termination shall be effected by delivery to the Contractor of a notice of termination specifying whether
termination is for default of the Contractor or for the convenience of the Department of Justice, the extent to which
performance of services under this Agreement is terminated, and the date upon which such termination becomes
effective. After receipt of a notice of termination and except as otherwise directed by the Department of Justice,
the Contractor shall:
o Stop work under this Agreement on the date and to the extent specified in the notice of termination:
o Transfer title to the Department of Justice (to the extent that title has not already been transferred) and
deliver in the manner, at the times, and to the extent directed by the Department of Justice the work in
process, completed work and other material produced as a part of, or acquired in respect of the
performance, the work terminated.
Contractor may submit a written request to terminate this Agreement only if the State should substantially fail to
perform its responsibilities as provided herein.
Confidentialitv of Data. All financial, statistical, personal, technical, and other data and information relating to
the Department of Justice's operations which are designated confidential by the Department of Justice and made
available to the Contractor in order to carry out this Agreement, or which becomes available to the Contractor in
carrying out this Agreement, shall be protected by the Contractor from unauthorized use and disclosure. If the
methods and procedures employed by the Contractor for the protection of the Contractor's data and information
are deemed by the Department of Justice to be adequate for the protection of the Department of Justice's
confidential information, such methods and procedures may be used, with the written consent of the Department
of Justice, to carry out the intent of this paragraph. The Contractor shall not be required under the proviSions of
this paragraph to keep confidential any data or information which is or becomes publicly available, is already
rightfully in the Contractor's possession, is independently developed by the Contractor outside the scope of thiS
Agreement, or is rightfully obtained from third parties.
CopvriClhts and Riahts in Data. The Department of Justice reserves the right to use, to authorize others to use,
duplicate and disclose, in whole or in part, in any manner for any purpose whatsoever, the activities supported by
this Agreement that produce original computer programs, writings, sound recordings, pictorial reproductions,
drawings, or other graphical representation and works of any similar nature (the term computer programs
includes executable computer programs and supporting data in any form). The Department of Justice reserves
its right to any original materials produced pursuant to this Agreement.
Publications. Before publishing any materials produced by activities supported by this Agreement, the
Contractor shall notify the Department of Justice ninety (90) days in advance of any such intended publication
and shall submit twenty (20) copies of the materials to be published. Within sixty (60) days after any such
materials have been received by the Department of Justice, the Department of Justice shall submit to the
Contractor its comments with respect to the materials intended to be published.
CITY OF SANTA ANA POLICE DEPARTMENT
Agreement Number 06-7595
Page 2 of 4
EXHIBIT D (ConI.)
(Standard Agreement)
SPECIAL TERMS AND CONDITIONS
Publications. (Cont.)
The Contractor shall determine, within ten (10) days after receipt of any such comments, whether or not to revise
the materials to incorporate the comments of the Department of Justice and shall advise the Department of
Justice of its determination within fifteen (15) days after such comments have been received by the Contractor If
the Contractor determines not to incorporate any of the comments of the Department of Justice into the text of the
materials, it may publish the materials provided that the initial preface of introduction to these materials as
published contain the following:
o A disclaimer statement reading as follows: "The opinions, findings, and conclusions in this publication
are those of the author and not necessarily those of the Department of Justice. The Department of
Justice reserves a royalty-free, nonexclusive, and irrevocable license to reproduce, publish, and use and
to authorize others to use these materials."
o The comments of the Department of Justice are full, unabridged, and unedited.
If the Contractor wishes to incorporate some or any of the comments of the Department of Justice In the text of
the matenals, it shall revise the materials to be published and resubmit them to the Department of Justice which
shall prepare comments on the resubmitted data within thirty (30) days after receipt thereof. Within ten (10) days
after receipt of these comments, the Contractor shall determine whether or not to accept or adopt any of the
comments on the revised materials as resubmitted to the Department of Justice and shall advise the Department
of Justice of this determination within fifteen (15) days after receipt of the comments of the Department of Justice.
Thereafter, the materials may be published or revised in accordance with the procedures set forth above for the
publication of materials on which the Department of Justice has submitted the comments to the Contractor
If the Department of Justice has not submitted its comments on any materials submitted to it within ninety (90)
days after the Department of Justice has received any such materials, the Contractor may proceed to publish the
materials in the form in which they have been submitted to the Department of Justice but shall include the credit
statement and the disclaimer statement set forth above, but without any further comments.
Patents. If any discovery or invention arises or is developed in the course of or as a result of work performed
under this Agreement, the Contractor shall refer the discovery or invention to the Department of Justice. The
Contractor hereby agrees that determinations of rights to inventions or discoveries made under this Agreement
shall be made by the Department of Justice, or its duly authorized representative, who shall have the sole and
exclusive powers to determine the disposition of all rights in such inventions or discoveries, including title to and
license rights under any patent application or patent which may issue thereon. The determination of the
Department of Justice, or its duly authorized representative, shall be accepted as final. The Contractor agrees
and otherwise recognizes that the Department of Justice shall acquire at least an irrevocable, nonexclusive, and
royalty-free license to practice and have practiced throughout the world for governmental purposes and invention
made in the course of or under this Agreement.
AssiQnment or SubcontractinQ. It is the policy of the Department of Justice to withhold consent from proposed
assignments, subcontractors, or novations when such transfer of responsibility would operate to decrease the
Department of Justice's likelihood of receiving performance on this Agreement. No performance of this
Agreement or any portion thereof may be assigned or subcontracted by the Contractor without the express written
consent of the Department of Justice and any attempt by the Contractor to assign or subcontract any performance
of this Agreement without the express written consent of the Department of Justice shall be void and shall
constitute a breach of this Agreement.
Whenever the Contractor is authorized to subcontract or assign, all the terms of this Agreement shall be included
in such subcontract or assignment.
I
CITY OF SANTA ANA POLICE DEPARTMENT
Agreement Number 06-7595
Page 3 of 4
EXHIBIT D (Con!.)
(Standard Agreement)
SPECIAL TERMS AND CONDITIONS
Covenant AClainst ContinClent Fees. The Contractor warrants that no person or selling agency has been
employed or retained to solicit or secure this Agreement upon an agreement or understanding for a commission,
percentage, brokerage, or contingent fee, excepting bona fide employees or bona fide established commercial or
selling agencies maintained by the Contractor for the purpose of securing business. For breach or violation of
this warranty, the Department of Justice shall have the right to terminate this Agreement in accordance with the
termination clause and, in its sole discretion, to deduct from this Agreement's price or consideration, or otherwise
recover, the full amount of such commission, percentage, brokerage, or contingent fee.
Disputes. Any dispute concerning a question of fact arising under the terms of this Agreement which is not
disposed of within fifteen (15) days by the Contractor and the Department of Justice employees normally
responsible for the administration of this Agreement shall be brought to the attention of the Chief Executive
Officer (or designated representative) of each organization for joint resolution.
Consultant Services. (Applies Only to Consultant Services Contracts) The Contractor is advised that the
provisions of Public Contract Code sections 10335 through 10381 pertaining to the duties, obligations, and rights
of a consultant service Contractor are applicable to this Agreement. Within sixty (60) days after completion of this
Agreement, the Contract Manager shall complete a written evaluation of Contractor's performance under this
Agreement. If Contractor did not satisfactorily perform the work, a copy of the evaluation will be sent to the State
Department of General Services, Office of Legal Services, and to Contractor within fifteen (15) working days of
the completion of the evaluation (PCC 10369). This evaluation shall not be a public record
Outside LeClal Counsel. (Applies Only to Outside Legal Counsel Contracts) The Contractor shall agree to
adhere to legal costs, billing guidelines, litigation plans, and case phasing of activities designated by the
Department of Justice. The Contractor shall also submit and adhere to legal budgets as designated by the
Department and shall maintain legal malpractice insurance in an amount not less than $100,000.00 The
Contractor shall also submit to legal bill audits and law firm audits if requested by the Department. The audits
may be conducted by employees or designees of the Department of Justice or by legal cost control providers
retained by the Department for that purpose. A contractor may be required to submit to a legal cost and utilization
review, as determined by the Department.
Conflict with ExistinCl Law. The Contractor and the Department of Justice agree that if any provision of this
Agreement is found to be illegal or unenforceable, such term or provision shall be deemed stricken and the
remainder of this Agreement shall remain in full force and effect. Either party having knowledge of such terms or
provision shall promptly inform the other of the presumed nonapplicability of such provision. Should the offending
provision go to the heart of this Agreement, this Agreement shall be terminated in a manner commensurate with
the interest of both parties, to the maximum extent reasonable.
Prevailina Waae. (Applies Only to Moving, Courier, Security, Video Services) No Contractor or
subcontractor performing hereunder shall pay any employee actually engaged in the moving and handling of
goods being relocated under such contract less than the prevailing wage rate, as prescribed by California by
California Government Code Section 14920.
It is hereby mutually agreed that the Contractor shall forfeit to the Department a penalty of twenty-five dollars for
each calendar day, or portion hereof, for each worker paid by him, or subcontractor under him, less than the
prevailing wage so stipulated; and in addition, the Contractor further agrees to pay to each worker the difference
between the actual amount paid for each calendar day, or portion thereof, and the stipulated prevailing wage rate
for the same. Upon the request of the Department of Industrial Relations, these penalties shall be withheld from
progress payment due.
.
CITY OF SANTA ANA POLICE DEPARTMENT
Agreement Number 06.7595
Page 4 of 4
EXHIBIT D (Cant.)
(Standard Agreement)
SPECIAL TERMS AND CONDITIONS
Emplovee Benefits. (Applies Onlv to Janitorial and Security Guard Services) The Contractor shall comply
with Government Code (GC) section 19134, which requires Contractors to provide employee benefits that are
valued at least 85% of the state employer cost of benefits provided to state employees for performing similar
duties. Employee benefits include health, dental and vision. The benefit rate is published by the Department of
Personnel Administration (DPA) February 1" of each year and is effective until January 31" of the following year.
Contractor may either provide benefits as described above or cash.in.lieu payments for each hour of service
employees perform on the covered state contract (excluding overtime). Failure to comply with the provisions of
GC S 19134 will be deemed a material breach of this contract, which may result in contract termination at the
state's sole discretion. Contractor may access rates and information at wY>Lw.~l:;a.Qo\l'
THIS AGREEMENT IS OF NO FORCE AND EFFECT UNTIL SIGNED BY BOTH PARTIES
AND APPROVED BY THE DEPARTMENT OF GENERAL SERVICES, IF REQUIRED.
CONTRACTOR MAY NOT COMMENCE PERFORMANCE UNTIL SUCH APPROVAL HAS
BEEN OBTAINED AND ANY COMMENCEMENT OF PERFORMANCE PRIOR TO
AGREEMENT APPROVAL SHALL BE DONE AT THE CONTRACTOR'S OWN RISK.
~.
~ ......
.
!. ..
State of California ~
DEPARTMENT OF JUSTICE '
EDMUND G. BROWN JR,
Attorney General
1300 I STREET, 8TH FLOOR
SACRAMENTO, CA 95814
Public: (916) 322-5596
Facsimile: (916) 324-0680
joan.kirtlan@doj.ca.gov
City of Santa Ana Police Department
60 Civic Center Plaza
Santa Ana, CA 92702
Altn: Paul Walters, Chief
RE: Standard Agreement No.06-7595
Dear Chief Walters:
Enclosed is your approved copy of Standard Agreement Number 06-7595 for services to be performed for the
Department of Justice. Please proceed in accordance with the terms and conditions of the enclosed Agreement.
To ensure prompt service and payment, include the above Agreement Number on all correspondence and
invoices. When information relative to an invoice, problem, or assistance is needed regarding payment of invoices, Mr.
Alfredo Morales, Accounts Payable at (916) 324-5083 should be contacted.
J~t:~--:,
tf!~-;"N K TLAN
Manager, Contracts and Purchasing Unit
BILL LOCKYER
Attornev General
Stllte oj Clllifornill
DEPARTMENT OF JUSTICE "
1300 J STRICt:l, SUITE 740
SACRAMeNTO. CA 958]4
Public: (916) 322-5596
Facsimile: (916) 324-06RO
joan.kirtlan@duj.ca.gov
June 2, 2006
City of Santa Ana
60 Civic Center Plaza
Santa Ana, CA 92702
Attn: Kim Hagen
Subject: Standard Aareement No. 05-7595
Dear Ms. Hagen:
In an effort to streamline the way the State of California conducts business, we are in the process of standardizing
current contracting procedures and formats. The first step toward achieving this goal is to eliminate unnecessary
duplication of agreement language and documentation. You will note that in the new format of the Standard
Agreement (STD 213), a copy of the General Terms and Conditions (GTe) is not provided. The GTC are availab]e
on the Internet at wvvw.ols.dasca.aov and may be downloaded and printed for your files. However, if you do nat have
Internet capabilities, you may request a hard copy by contacting the person listed in the paragraph below.
This Agreement cannot be considered binding on either party until approved by appropriate authorized
state agencies. No services should be provided prior to approval, as the State IS not obligated to make any payments
on any agreement prior to final approval. Expeditious handling of this Agreement is appreciated. For inquiries
regarding this Agreement, please contact me at the telephone number or a-mail address above
Complete the following item(s) and return to the address stated above:
Standard Aareement (STD 213\ with attached exhibits. Enclosed are five copies ofthe (STD 213) for each contract:
Please have each of these signed by the authorized Individual and return all copies for further processing as soon
as possible. (NOTE: Failure to return this signed contract and all caples by the due date will cause this
contract to be canceled due to non-response.)
Contractor Certification Clauses (GGG) The GGC package contains clauses and conditions that may apply to your
agreement and to persons doing business with the State of California. It is available on the Internet site referenced
in paragraph one above. Please sign and return the first page of the current GGG Failure to do so will prohibit the
State of California from doing business with your company.
Pavee Data Record. Enclosed is a Payee Data Record form, please complete, have it signed by the authorized
individual and return with the STD 213.
Voluntarv Statistical Data. The completion of this form is strictly voluntary.
If you have any questions, please contact me at the telephone number or e-mail address above.
Sincerely,
J~~~ J
a ~~nager, Gontracts and Purchasing Unit
For BILL LOGKYER
Attorney General
(;:nclosures
cc: Tanya Marcellana
CCC-I005
CEIUIFICA TION
I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that I am duly
authorized to legally bind the prospective Contractor to the clause(s) listet! below. This
certification is made undcr the laws of the State of California.
Firm Name (Printed)
ID Number
Signature)
Name and Title ofFerson Signing
lixecuted in the County of
CONTRACTOR CERTIFICATION CLAUSES
1. STATEMENT OF COMPLIANCE: Contractor has, unless exempted, complied with
the nondiscrimination program requircments. (Gov. Code 12990 (a-f) and CCR, Title 2,
Section 8103) (Not applicable to public entities.)
2. DRUG-FREE WORKPLACEREQUIREMENTS: Contractor will comply with the
requirements of the Drug-Free Workplace Act of 1990 and will provide a drug-free
workplace by taking the following actions:
a. Publish a statement uotifying employees that unlawful manufacture, distribution,
dispensation. possession or use of a controlled substance is prohibited and specifying
m:tions to be taken against employees for violations.
b. Estahlish a Drug-Free Awareness Program to inform employees about:
I) the dangers of drug sbuse in the workplace:
2) the person's or organization's policy of maintaining a drug-free workplace;
3) any available counseling, rehabilitation and employee assistance programs; and,
4) penalties that may be imposed upon employees for drug abuse violations.
c. Every employee who works on the proposed Agreement will:
I) receive a copy of the company's drug-free workplace policy statement; and,
2) agree to abide by the terms of the company's statement as a condition of employment
on the Agreement.
Failure to comply wilh these requirements may result in suspension of payments under
the Agreement or termination of the Agreement or both and Contractor may be ineligible
for award of any future State sgreements if the department determines that any of the
lollowing has occurrcd: the Contractor has made false certification, or violated the
certification by failing to carry out the requirements as noted above. (Gov. Code 8350 et
seq.)
3. NATIONAL LABOR REI A nONS BOARD CERTIFICATION: Contractor certifies
that no more than one (1) fmal unappealable finding of contempt of court by a Federal
court has been issued against Contractor within the immediately prcceding two-year
period bccause of Contractor's failure to comply with an order of a Federal court, which
orders Contractor to comply with an order of the National Lahar Relations Board. (Pub.
Contract Code 10296) (Not applicable to public entities.)
4. CONTRACTS FOR LEGAL SERVICES $50.000 OR MORE- PRO BONO
REOUIREMENT: Contractor hereby certifIes that contractor will comply with the
requirements of Section 6072 of the Business and Professions Code, effective January 1,
2003.
Contractor agrees to make a good faith effort to provide a minimum number of hours of
pro bono legal services during each year of the contract equal to the lessor of30
multiplied by the number of full time attorncys in the Ilrm's offices in the State, with the
numbcr of hours proratcd on an actual day basis for any contract period ofless than a full
year or 10% of its contract with the State.
Failure to make a good jClith effort may be cause for non-renewal of a state contract for
legal services, and may be taken into account when determining thc award of future
contracts with the State for lega 1 services.
5. EXP A TRIA TE CORPORATIONS: Contractor hereby declares that it is not an
expatriate corporation or subsidiary of an expatriate corporation within the meaning of
Public Contract Code Section 10286 and 10286.1, and is eligible to contract with the
State of California.
6. SWEATFREE CODE OF CONDUCT:
a. All Contractors contracting for thc procurement or laundering of apparel, garments or
corresponding accessorics, or the procurement of equipment, materials, or supplies, other
than procurement relatcd to " public works contract, declare under penalty of perjury that
no appareL garments or corresponding accessories, equipment. materials, or supplies
furnished to thc state pursuant to the contract have been laundered or produced in whole
or in part by sweatshop labor. forced labor, convict labor. indentured labor under penal
sanction, ahusive forms of child lahar or exploitation of children in sweatshop labor, or
with the benefit of sweatshop labor, forced labor, convict labor, indentured labor under
penal sanction, abusivc forms of child labor or exploitation of children in sweatshop
labor. The contractor further lleclares under penalty of perj ury that they adberc to the
Sweatfrec Code of Conduct as set forth on the Calirornia Department of Industrial
Relations websitc locatcd at www.dir.ca.gov. and Public Contract Code Section 6108.
b. The contractor agrees La cooperate fully in providing reasonable access to tbe
contractor" s records, documents, agents or employees, or premises if reasonably required
by authorized officials orthc contracting agency, the Department ofIndustriaI Relations,
or the Depaltment of Justice to determine the contractor's compliance with the
requirements under paragraph (a).
7. DOMESTIC PARTNERS: For contracts exccuted nr amended after July 1,2004, the
contractor may elect to ofler domcstic pmtner benefits to the contractor's employees in
accordance with Public Contract Code section 10295.3. However, the contractor Calmot
require an employt:e to cover the costs of providing any benefits which have otherwise
been provided to all employees regardless of marital or domestic partner status.
DOING BUSINESS WITn THE STATE OF CALIFORNIA
The lollowing laws apply to persons or entities doing business with the State of
California.
1. CONFLICT OF INTEREST: Contractor needs to be aware of the following provisions
regarding current or lemner stalc employees. If Contraetnr has any questions on the
status of any person rend~ring services or involved with lhe Agreement, the awarding
agency must be contacted immediately for clarificalion.
Current State Employees (Pub. Contract Code 10410):
I). No umcer or employee shall engage in allY employment, activity or enterprise from
which the onicer or employee receives compensation or has a Jinallcial interest and
which is sponsored nr fumled by any state agency, unless the employment, activity or
enterprise is required as a condition of regular state employment.
2). No officer or employee shall contract on his or her own behalf as an independent
contractor with any stale agency to provide goods or services.
Former State Employees (Pub. Contract Code 1041\):
1). For the two-year period from the date he or she left state employment, no former state
officer or employce may enter into a contract in which he or she engaged in any of the
negotiations, transactions, planning, arrangements or any part of the decision-making
process relevant to the contract while employed in any capacity by any state agency.
2). For the twelve-month period ii'mn the date he or she left state employment, no former
state officer or employee may enter into a contract with any state agency ifhe or she was
employed by that stalc agcncy in a policy-making position in the same general subject
area as the proposed contract within the 12-month period prior to his or her leaving state
scn/lce.
If Contractor violates any provisions of ahove paragraphs, such action by Contractor shan
render this Agreement void. (Pub. ~ontract Code 10420)
Members of hoards and commissions are exempt from this section if they do not receive
payment other than paymcnt of each meeting of the board or commission, payment for
preparalory time and payment for per diem. (Pub. Contract Code 10430 (e))
2. LABOR CODE/WORKERS' COMPENSATION: Contractor needs to be aware of the
provisions which require every employer to be insured against liability for Worker's
Compensation or to undertake self-insurance in accordance with the provisions, and
Contractor affirms to comply with such provisions before commencing the performance
of the work "fthis Agreement. (Labor Code Section 3700)
3, AMERICANS WITH DISAI31LlTIES ACT: Contractor assures the State that it
complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits
discrimination on the basis of disability, as well as all applicable regulations and
guidelines issued pursuant to the ADA. (42 U.S,c. 12101 et seq,)
4. CONTRACTOR NAME CHANGE: An amendment is required to change the
Contractor's name as listed on this Agreement. Upon receipt oflegal documentation of
the name change the Slate will process the amendment. Payment of invoices presented
\vith a new' name cannot be paid prior to approval of said amendment.
5, CORPORATE OUAI ,I FICA "[IONS TO DO BUSINESS IN CALIFORNIA:
a. When agreements arc to be performed in the state by corporations, the contracting
agencies will be verifying that the contractor is currently qualified to do business in
California in ordcr to ensure that all obligations due to the state are fulfilled.
b. "Doing business" is dclined in R&TC Section 23 I 0 I as actively engaging in any
transaction for thc purpose of linancial or pecuniary gain or prollt, Although thcrc are
some statutory exceptions to taxation, rarely will a corpurate contractor performing
within the state not be subject to the franchise tax,
c, Both domestic and foreign corporations (thosc incorporated outside of California) must
be in good standing in order to be qualificd to do business in California. Agencies will
determine whether a corporation is in good standing by calling the Omce of the Secretary
of State,
6, RESOLUTION: A county, city, district, or ather local public body must provide the
Statc with a copy of a resolution, order, motion, or ordinance of the local governing body
which by law has authority to enter into an agreement, authorizing execution of the
agreement.
7, AIR OR WATER POLLUTION VIOLATION: Under the State laws, the Contractor
shall not be' (I) in violation of any order orresolution not subject to review promulgated
by the State Air Resourccs Board or an air pollution control district; (2) subject to ceasc
and desist ordcr not subjcct to review issued pursuant to Section 13301 of the Watcr
Code for violation of waste discharge requiremcnts ar discharge prohibitions; or (3)
lInally detcrmined to be ill VIOlation ofprovisians of federal law relating to air or water
pollution.
8, PA YbE DATA RECORD FORM STD, 204: This form must be completed by all
contractors that are not another state agency or other guvernmental entity.
S :IADMlNIHOMEP AGEICCCICCC-J 005 .doc
CALIFORNIA DEPARTMENT OF JUSTICE
Office of the Attorney General
1300 I Street, Suite 740
Sacramento, CA 95814
Attn. Contracts & Purchasing Unit
VOLUNTARY STATISTICAL DATA
INFORMATION TO BE USED FOR REPORTING PURPOSES ONLY
Please return this form with your signed contract OR fax to (916) 324-0680.
Public Contract Code section 10116 requires state agencies to capture infonnation on cthnicity, race, and gt:mler of business owners
on all awarded contracts and procurements. Government Code section 11139.8 and Public Contract Code section 10115.5 require state
agencies to capture infonnation on the participation level of minority, women, and disabled veteran-owned business enterprises in
awarded contracts and procurements The awarding department is prohibited from using this data to discriminate or provide a
preference in the solicitation or acceptance of bids, quotes, or estimates for goods, services, and/or construction. Ths information
shall not bc collected until after the:: contract award i~ made, The completion of this form is strictly voluntarv.
The data you provide on this form should best describe the ownership of your busines,o;. Ownership of a business should be
determined as follows:
. For a business that is an individual proprietorship, partnership, corporation, or joint venture at least 51 percent is owned by
one or more individuals in a classificatiou designated below or, in the case of any business whose stock is publicly held, at
least 51 percent of the stock is owned by one or more individuals in a designated classification, or
. For other business entities, the owner is the person controlling management and daily operations and who "owns" the
business.
For purposes of this report, respond only if the business has its home office in the United States and which is not a hranch or
subsidiary of aforeign corporation, finn, or other business.
,
~
LVendor Information
Compaoy Name:
Contract Number:
(NOTE: The Contract Number will be provided by the DOJ Contracts Unit)
l Genuer Classificatio~---
Female, 0
LRace Classification
Male: 0
As identified by the U.S. Census Bureau
---,
~
o American Indian or Alaska Native
o Black or African American
o Other
o Asian
o Native Hawaiian or Other Pacific Islander
o White
EthnicitylMinority Classification
As defined in Public Contract Code Section 10115.1
D
o
o
o
o
o
Asian-Indian- A per.son whose origins are from India, Pakistan, or Bangladesh.
Black-Persons having origin~ in any of the black racial groups of Africa.
Hispanic-Persons of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish or Portuguese
culture or origin, regardless of race.
Native American- An American Indian, Eskimo, Aleut, or Native Hawaiian.
Pacific-Asian _ A person whose origins are from Japan, China, Taiwan, Korea, Vietnam, Laos, Cambodia, the
Philippines, Samoa, Guam, or the United States Trust Territories oftbe Pacific including tbe Northern Marianas.
Other Any other group of natural persons identified as minorities in the respective project specifications of
an awarding department or participating local agency.
STATE OF CALIFORNIA
PP,YEE [jATA RECORD
(Required in lieu of IRS W-9 when doing business with the State of California,
STD. 204 (REV 2-2000)
NOTE: Governmental entities, federal, state, and local (including school districts) are not required to submit this form.
DE"A 'CE I PURPOSE: Information contained in this form will I
1 DEPARTMENT OF JUSTICE/OFFICE OF THE ATTORNEY GENERAL be used by state agencies to prepare Information
STREET ADDRESS Returns (Forms 1099) and for withholding on payments
PLEASE 1300 I STREET, 8TH FLOOR to nonresident payees. Prompt return of this fully
RETURN CITY STATE ZIf' CODE completed form will prevent delays when processing
TO:
SACRAMENTO, CA 95814 ATTN: JOAN E. KIRTLAN payments,
TElEPHONl::NUMBER (See Privacy Statement on reverse)
(916) 322-5596
, , "ME
2
MAiliNG ADDRCSS (Numbor ~nd Simer or P 0 tk.. Numoerj
rCily, Stille, and Zip Code;
CHECK ONF BOX ONLY
3 NOTE: State and
o LEGAL CORPORATION local governmental
entities, including school
VENDOR districts are
ENTITY not required to
INFORMATION o MEDICAL CORPORATION o PARTNERSHIP submit this form
o EXEMPT CORPORATION (Non-profit) o ESTATE OR TRUST
o ALL OTHER CORPORATIONS NOTE: Payment
FEDl::KAl EMPlOYFR'S IDENTIFICATION NUMIJI::R (FEIN) will not be
processed without
U ~ '=LLL.LL.LJ ~ an accompanying
taxpayer 1.0. number
o INDIVIDUAUSOLE PROPRIETOR
SOr.IAl SECURITY NUMBE-k OF OWNER OWNER'S f-Ull NAME (Plint)
U~J~~-.J-.J~-.J-.J-.J
CHECK APPROI-'''IATf FlOX=S
4 NOTE:
0 California Resident - Qualified to do business in CA or a permanent place of business in a. An estate is a
PAYEE CA resident if decedent
was a California
RESIDENCY resident at time of
STATUS 0 Nonresident (See Reversa) Payments to nonresidents may be subject to state death
withholding b. A trust is a resident
o WAIVER or STATE WITHHOLDING FROM FRANCHISE TAX BOARD ATTACHED if at ieast one
trustee is a
o SERVICES PERFORMED OUTSIDE OF CALIFORNIA/GOODS ONLY SOLO TO CALIFORNIA California resident.
(See reverse)
5 I hereby certify under penalty of perjury that the informatIon provided on this document is true and
correct. If my residency status should change, I will promptly inform you.
CERTIFYING AUTHORIZED PAYEEREPRES"N1AIIV~'SNAM:. [Type orPrinl) TITLE
SIGNATURE
SIGl"ATURF M" TElEPIIONENUM8Ei{
1<<U ,
SECTION 1 must be completed b~ the requestinq state agency before forwardinq to the payee
SlA I E OF CAliFORNIA
PAYEEpATA RECORD
SID. 204 ~EV 2-2000) (REVERSE)
ARE YOU A RESIDENT OR A NONRESIDENT?
ARE YOU SUBJECT TO NONRESIDENT
WITHHOLDING?
Each corporation, individual/sole proprietor, partnership, estate
or trust doing business with the State of California must indicate
theif residency status along with their taxpayer identification
number.
A corporation will be considered a "resident" if it has a
permanent place of business in California. The corporation has
a permanent place of business in California if it is organized and
existing under the laws of this state Of, if a foreign corporation,
has qualified to transact intrastate business. A corporation that
has not qualified to transact intrastate business (e.g., a
corporation engaged exclusively in interstate cornmerce) will be
considered as having a permanent place at business in this
state only if it maintains a permanent office in this state that is
permanently staffed by its employees.
Payments made to nonresident payees, including corporations,
individuals, partnerships, estates and trusts, are subject to
withholding. Nonresident payees performing services in California
or receiving rent, lease or royalty payments from property (real or
personal) located in California will have 7% of their total payments
withheld for state income taxes. However, no withholding is
required if total payments to the payee are $1500 or less for the
calendar yeaL
For individuals/sole proprietors, the term "resident" includes
every individual who is in California for other than a temporary
or transitory purpose and any individual domiciled in California
who is absent for a temporary or transitory purpose. Generally,
an individual who comes to California for a purpose which will
extend over a long or indefinite period will be considered a
resident. However, an individual who comes to perform a
particular contract of short duration will be considered a
nonresident
A nonresident payee may request that income taxes be withheld
at a lower rate or waived by sending a completed form FTB 588
to the address listed below. A waiver will generally be granted
when a payee has a history of filing California returns and making
timely estimated payments If the payee activity is carried on
outside of California or partially outside of California, a waiver or
reduced withholding rate may be granted. For more information,
contact:
Franchise Tax Board
Nonresident Withholding Section
Attention: State Agency Withholding Coordinator
P.O Box 651
Sacramento, CA 95812-0651
Telephone: (916) 845-4900
FAX: (916) 845-4831
For withholding purposes, a partnership is considered a
resident partnership if it has a permanent place of business in
California. An estate is considered a California estate if the
decedent was a California resident at the time of death and a
trust is considered a California trust if at least one trustee is a
California resident
If a reduced rate of withholding or waiver has been
authorized by the Franchise Tax Board, attach a copy to this
form,
More information on residency status can be obtained by calling
the Franchise Tax Board at the numbers listed below:
From within the United States call.
From outside the United States, call
For hearing impaired with TOO, call
1-800-852-5711
1-916-845-6500
1-800-822-6268
PRIVACY STATEMENT
Section 7(b) of the Privacy Act of 1974 (Public Law 93-5791) requires that any federal, state, or local governmental agency which requests an
individual to disclose his social security number shall inform that individual whether that disclosure is mandatory or voluntary, by which statutory
or other authority such number is solicited, and what uses will be made of it.
The State of California requires that all parties entering into business transactions that may lead to payment(s) from the State must provide ttJeir
Taxpayer Identification Number (TIN) as required by tlle State Revenue and Taxation Code, Section 18646 to facilitate tax compliance
enforcement activities and to facilitate the preparation of Form 1099 and other information returns as required by the Internal Revenue Code,
Section 6109(a). The TIN for individual and sole proprietorships is the Social Security Number (SSN).
It is mandatory to furnish the informatioll requested. Federal law requires that payments for which the requested information is not provided
be subject to 31 %> withholding and slate law imposes noncompliance penalties of up to $20,000.
You have the right to access records contLlining your personal information, such as your SSN. To exercise that right, please contact the
business services unit or the accounts payable unit of the state agency(ies) with which you transact that business.
Please call the Department of Finance, Fiscal Systems and Consulting Unit at (916) 324~0385 if you have any questions regarding this Privacy
Statement. Questions reiated to residency or withholding should be referred to the telephone numbers listed above. All other questions should
be referred to the reques1ing agency listed in Section 1