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HomeMy WebLinkAboutDESMOND, DONNA ASSOCIATES -2015A-2015-159 INS URAWE 0AY PFl0cr_ I ERK OF COUNCU, CONSULTANT AGREEMENT ` -DATE. CITY OF SANTA ANA 3 THIS AGREEMENT is made and entered into this 5`" day of August, 2015 by and between Donna 1 i Desmond and Associates, a sole ownership entity, (hereinafter "Consultant'), and the City of Santa Ana, a C 1 charter city and municipal corporation organized and existing under the Constitution and laws of the State of C! California (hereinafter "City). r� RECITALS A. The City desires to retain a consultant having special skill and knowledge in the field of Business Goodwill Appraisal Services. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected frorn a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit B. The total sum to be expended under this Agreement shall not exceed $200,000 during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals and Scope of Work, which may reasonably be expected by City. This Agreement shall commence on the date first written above and terminate on August 5, 2018, unless terminated earlier in accordance with Section 15, below. The term of this Agreement may be extended upon a writing executed by the City Manager and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, dining the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the provisions of Section 3700 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to umdertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than. $1,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. (iii) Certificates and policies shall state that the policies shall not be cancelled or reduced in coverage or changed in any other material aspect, by consultant, without thirty (30) days prior written notice to the City. (iv) Consultant shall supply City with a fully executed additional insured endorsement. f. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's Services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend and indemnify the City, its officers, agents, representatives, and employees against any and all liability, including costs, for infringement of any United States' letters patent, trademark, or copyright infringement, including costs, contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant wider this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 10. CONFIDENTL&LITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 11. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified in Certifications, Exhibit C, attached hereto and incorporated in this Agreement by reference. 12. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by fast class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 With courtesy copies to: To Consultant: Fred Mousavipour, Executive. Director Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, California 92702 Fax 714- 647-5654 Donna Desmond & Associates Donna Desmond, President 265 S. Beverly Glen Boulevard Los Angeles, CA 90024 ddesmond@domradesmond.com\ 310-475-1114 (Office) Jose Sandoval Assistant City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 Fax 714-647-6515 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terns of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 14. ASSIGNMENT hiasinuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 15. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 16. DISCRINIINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations and as farther specified in Certifications, Exhibit C, attached hereto and incorporated in this Agreement by reference. 17. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 18. PROFESSIONAL LICENSES Consultant shall, throughout the tern of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 19. MISCELLANEOUS PROVISIONS a. Additional provisions, if any are identified as Additional Provisions, Exhibit D, attached hereto and incorporated into this Agreement by reference. b. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terns of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Maria D. Huizar Cleric of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney By: Jos oval Assist'61t City Attorney APPROVAL: Works Agency CITY OF SANTA ANA J, David Cavazos City Manager pbf�l ra mond & Associates j orma Desmond, President Tax ID #95-4699391 EXHIBIT A SCOPE OF SERVICES Response • Requestfor • • • . • Right of SpecialtyWay RFP No.:15-044 (A3) Business Goodwill Appraisal Services Prepared for the City of Santa Ana Date of Response June 8, 203.5 Prepared by: HA Donna Desmond Associates 265 South Beverly Glen Boulevard Los Angeles, CA 90024 (310)475-1114 Donna Desmond A S S Q C I A T C S 265 S. Beverly Glen Blvd., Los Angeles, CA 90024 (310) 4755-1114 • ddesmond@donnadesmond.com June 8, 2015 City of Santa Ana Attn. Mr. Kenny Nguyen Public Works Agency 20 Civic Center Plaza; 31 Floor Reception, Ross Annex Santa Ana, CA 92701 Re: Response to RFP No. 15-044 for On -Call Right of Way Specialty Services - City of Santa Ana Public Works Agency Business Goodwill Appraisal Services To Whom It May Concern: Submitted herein is Donna Desmond Associates' ("DDA"), a California corporation, response to the City of Santa Ana's request for proposal for on -call right of way specialty services. DDA is responding specifically to provide (A3) Business Goodwill Appraisal Services. DDA is located at 265 S. Beverly Glen Boulevard, in Los Angeles. The contact person for this response is: Donna Desmond, ASA Donna Desmond Associates 265 S. Beverly Glen Boulevard Los Angeles, CA 90024 Tei. (310) 475-1114 ddesmond@donnadesmond.com The corporation's Federal Taxpayer ID Number is 95-4699391. Donna Desmond, ASA is the firm's President and Secretary. There are no other corporate officers. DDA is a business valuation appraisal firm that specializes in preparing goodwill loss studies. The firm has been providing transportation agencies, cities and redevelopment agencies throughout the State of California with goodwill loss appraisal services since 1997. Thank you for the opportunity to submit this response to the Request for Proposal. It is our hope to provide business and goodwill loss appraisal services to the City of Santa Ana in the future. 1 of 8 Response to the City of Santa Ana's RFP for On -Call Right of Way Specialty Services IML Mr. Kenny Nguyen June 8, 2015 Respectfully submitted, DONNA DESMOND ASSOCIATES Donna Desmond, ASA Enclosures 2of8 Response to the City of Santa Ana's RFP for On -Call Right of Way Specialty Services EA experienced staff members are not performing appraisal tasks or billing hours for bringing the responsible appraiser up to speed. Ms. Desmond performs all site inspections, owner interviews and meetings with the client and their agents. Unnecessary additional staff members do not provide these services, avoiding duplicative billing. As a result, the appraisal process is streamlined, typically resulting in a more cost effective fee structure for appraisal services, quicker turnaround time and a high level of quality. Fees are included within the separate envelope labeled FEE PROPOSAL. SCOPE OF SERVICES & SCHEDULE In providing goodwill loss appraisal services, DDA proposes the following work process for each appraisal assignment; ❑ Meet with project team to gain an understanding of the project and potential impacts; ❑ Provide preliminary estimates of goodwill for budgetary purposes within two weeks of authorization to proceed; ❑ Inspect the business facility; ❑ Interview the business owner and management to determine history of operations and relocation needs; ❑ Review business' historical financial statements, tax returns and lease agreements; ❑ Review all parcel appraisal reports and coordinate with real estate and fixtures and equipment appraisers to avoid duplication of compensation; ❑ Coordinate with agency staff and legal counsel to discuss strategy and approach; ❑ Coordinate with relocation agents to determine relocation options, feasibility of relocation, mitigation issues and to avoid duplication of compensation; ❑ Perform market research to determine the business' marketability and external influences; ❑ Implement valuation methodology, including market based and income based approaches, to determine the business' goodwill value in the before condition; ❑ Inspect potential or actual relocation site(s); ❑ Review all relevant and available documentation from relocation sites, including leases, financial statements and unreimbursed capital expenditures; ❑ Implement valuation methodology to determine the loss of goodwill suffered by the business, including giving consideration to betterment, if any; ❑ Prepare a full or summary narrative appraisal report or declaration of value; and ❑ Provide support in negotiations and litigation (as needed). 7of8 Response to the City of Santa Ana's RFP for On -Call Right of Way Specialty Services All of the above tasks would be completed by Donna Desmond. Budgetary estimates of goodwill loss can be completed within one week of request. Appraisal reports can be completed within four to six weeks of receiving all applicable documentation from the business owners. Goodwill loss appraisals are often delayed by business owners' reluctance to provide financial documents, including income tax returns. DDA works closely with project staff and the relocation consultants to ensure business owners understand the necessity of providing such documentation. Further, DDA continues to engage the business owners in order to provide a level of comfort with the process. CERTIFICATIONS Attachment 3-1: Non -Collusion Affidavit Attachment 3-2: Non -Lobbying Certification Attachment 3-3: Non -Discrimination Certification 8of8 Response to the City of Santa Ana's RFP for On -Call Right of Way Specialty Services II.`�:'; FEE PROPOSAL Gonna Desmond A S S 0 C I A T E S 265 S. Beverly Glen Blvd., los Angeles, CA 90024 (310) 475-1114 • ddesmond@donnadesmond.com Donna Desmond Associates' Fee Proposal COST & PRICING DATA Donna Desmond Associates bills for appraisal services based upon hourly rates. The 2015/2016 hourly rates are as follows: Appraisal Preparation $325.00 Litigation Support $325.00 Deposition and Court Testimony $425.00 The hourly rate will increase 2.5% per year during the duration of the contact. PRICING DETAIL Goodwill loss appraisal fees are based on the relative complexity of the assignment and litigation requirements. Goodwill loss appraisal fees for various types of businesses are as follows: Business Type/Complexity Budgetary Estimate of Goodwill Loss Small Sole Proprietorship (i.e. accountant, hair salon, liquor store) Retail Type Business (i.e. restaurant, gasoline station, 990 Store) Larger Industrial/Manufactluing Typical Appraisal Fee $2,500 $3,500 - $5,500 $4,500 — $6,500 $6,500 - $12,500 Actual appraisal fees could vary for individual appraisal assignments, depending on the facts surrounding the matter. No subconsultant costs would be incurred. PROPOSED RE' IMBURSABLES Donna Desmond Associates does not charge for any costs, with the exception of trial exhibits produced by an outside firm. However, these costs are typically paid for by legal counsel. EXHIBIT C CERTIFICATIONS APPENDIX FA'FTACYY3MENT 3-1: NONN -COLLUSION AFFIDAVIT CERTIFICATIONS CITY OF SANTA ANA RE, QUEST FOR PROPOSALS FOR ON-CALL RIGTIT OF WAY SPECIALTY SERVICES RFP NO.: 15-044 NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS In accordance with Title 23 United States Code Section 112 and Public Contact Code 7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has. not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or Indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in fire bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof; or divulged information or data relative thereto, or paid, and will not pay, any fee to arty corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or share bid. Note: The above on -collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall ars cnstiaute signature of this Non -collusion Affidavit. BIDDERS are an that malting a false certification y I tdteyeertifierto criminal prosecution. Signed State of California k / `" County of Los Angeles Subscribed and sworn to (or affirmed) before me on this •• ° 74 day oft,� 20th by 1) ,1 vi n proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Notary-Pulihc Signature FARAWHOLANDMUR Couaninlan M rr108446 x WWy Public - California Notary Public SealOT Los Anon CMMV A Calm Eb Ma 27 �16� City of Santa Ana RFP 16-044 Page 28 L A ; C >r APPENDIX -- ATTACHMENT 3-2a NON -LOBBYING CERTIFICATION CERTIFICATIONS CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR ON-CALL RIGHT OF WAY SPECIALTY SERVICES RFP NO.: 19-044 The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1. No federal appropriated funds have been paid or will I be paid, by or on behalf ofthe undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence any officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of'a Member of Congress in connection with this federal contract, grant loan, loan or cooperative agreement, the undersigned shall complete and submit a "Disclosure of Lobbying Activities". 'Phis certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Firm DotmaDesmondAssociates Signed and Printed Name: Title President 4 Date City of Santa Ana RFP 15-044 Paye 29 APPENDIX ATTACHMENT 3-3: NON-DISCRIMINATION CERTIFICATION L._ CERTIFICATIONS CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR ON-CALL RIGHT OF WAY SPECIALTY SERVICES RFP NO.: 15-044 The undersigned consultant or corporate officer, during the performance of this contract, certifies as follows: The Consultant shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin, The Consultrant shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Consultant agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Consultant shall, in all solicitations or advertisements for employees placed by or on behalf of the Consultant, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Consultant shall send to each labor union or representative of workers with which lie/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Consultant's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Consultant shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Consultant shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Consultant's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Consultant may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. 7. The Consultant shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of City of Santa Ana RFP 15-044 Page 30 September 24, 1965, so that such provisions will be binding upon each su%cottr4a or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Consultant becomes involved in, or is threatened with, litigation with a subconsultant or vendor as a result of such direction by the administering agency, the Consultant may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, No discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provid in Section 1 20,0d any contractor of public works violating this Section is subject to all the penalties im ee� foy ra oG lation of the Chapter. Signed: _ Title: President Firm_ Donna Desmond Associates Date: 6!8/2015 City of Santa Ana RFP 15-044 Page 31 EXHIBIT D ADDITIONAL PROVISIONS Local Assistance Procedures Manual EXHIBIT 10-K Consultant Certification of Contract Costs and Financial Management System EXHIBrr 10-I{ CONSULTANT CERTIFICATION OF CONTRACT COSTS AND FINANCIAL MANAGEMENT SYSTEM (Note: If requesting to utilize the Safe Harbor Indirect Cost Rate submit Attachment I of DLA -OB I3-07- Safe Harbor Indirect Cost Rate for Consultant Contracts found at ftitp:/fwwwdoteagoc/hq/LocalProgram&DLA OB17)LA OB.himinlieuofthisform.) Certification of Final Indirect Costs: Consultant Firm Name: Donna Desmond Associates Indirect Cost Rate: 40% — * for fiscal period 7/1/2014 through 6/30/2015 *Fiscal period covered for Indirect Cost Rate developed (not the contract period). Local Government: City of Santa Ana Contract Number: RFP -15-044 PrqjectNumber: Unknown 1, 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: I. 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 of the FAR of 48 CFR, Part 31. All known material transactions or events that have occurred affecting the firm's ownership, organization, and Indirect Cost Rates have been disclosed as of the date of proposal preparation noted above. Certification of Financial Mananeluent 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 SAM 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 $ 853,000.00 and the number of states in which the firm does business is 3 Certifleatign of Direct Costs: 1, 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 I of 2 LPP 15.01 January 14, 2015 Local Assistance Procedures Manual EXHIBIT 10 -IC 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 CRR, 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): $ 200,000.00 Prime, list all subconsultants and proposed subcontract dollar amounts (attach additional page if necessary): 0 Consultant Certifying (Print Name and Title): Name: Donna Desmond Title: President Consultant Certification Signal= **: Date of Certification (mm/dd/yyyy): 6/26/2015 Consultant Contact Information: Email: ddesmond@donnadesmond,com Phone number: (310) 475-1114 **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), 5ubconsultants must comply with the FAR Cost Principles contained in 48 CFR, Part 31, 23 CFR Part 172.3 Definitions state: Consultant means the individual or firmproviding engineering and design related services as aparty m the contract Therefore subconsultants aspartles ofa contract must complete a certiflcatlon and send originals to A&1 and keep copier m Local Agency lerofectFiles. Distribution: 1) Original to Caltrans Audits and Investigations 2) Retained in Local Agency Project Files Page 2 of 2 LPP 15-01 January 14,2015 Local Assistance Procedures Manual EXHBIT 10-I Notice to Proposers DBE Information Emilia r 10-I NOTICE TO PROPOSERS DBE INFORMATION The Agency has established a DBE goal for this Contract of 4.00 % 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 most 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 DEE 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). Page 1 of 3 LPP 13-01 May 8, 2013 Local Assistance Procedures Manual EXUBIT 10-I Notice to Proposers BBE 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 DEE proposer not proposing as a joint venture with a non -DBE, will be required to document one or a combination of the following: 1. 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 roust 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 bidicost proposal list of subconsultants. O. 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://www.dot.ca.gov/hq/bep/. 1. Click on the link in the left menu titled Disadvantasred Business Enterprise; 2. Click on Search for a DEE 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 DEE 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, regular business that engages, as its principal business and under its own name, in the Page 2 of 3 LPP 13-01 May S, 2013 Local Assistance Procedures Mannas EXRBIT 10-1 Notice to Proposers DBE Information purchase and sale or lease 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 lots 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. Page 3 of 3 LPP 13-01 May 8, 2013 Local Assistance Procedures Manual EXHIBIT 10-H Sample Cost Proposal EXHIBIT 10-H[ SAMPLE COST PROPOSAL (EXAMPLE #1) Paget oft ACTUAL COST -PLUS -FIXED FEE OR LUMP SUM (FIRM FIXED PRICE) CONTRACTS (DESIGN, ENGINEERING AND ENVIRONMENTAL STUDIES) Consultant Donna Desmond Associates DIRECT LABOR Contract No. RFP 15-044 Date 6/26/2015 Classification/Title Name Hours Actual Hourly Rate Total (Project Manager) Donna Desmond unknown $ 325.00 $ unknown (Sr. Civil Engineer) $ 0 in) $ $ (Envir. Scientist) (Jr. Highway Engr) n) Permit Fees (itemize), Plan sheets (each), Test $ $ Holes (each), etc. $ $ o) Subconsultant Costs (attach detailed cost proposal in same format as prime consultant estimate for each subconsultant) LABOR COSTS a) Subtotal Direct Labor Costs $ 174 per hour b) Anticipated Salary Increases (seepage 2 for sample) $ 55 per hour c) TOTAL DIRECT LABOR COSTS [(a) + (b)] $ 179 per hour FRINGE BENEFITS d) Fringe Benefits (Rate: 25 %) e) TOTAL FRINGE BE, [(c) x (d)] $ 44.84 INDIRECT COSTS f) Overhead (Rate: 20 pa) g) Overhead [(c) x (f)] $ 35.80 h) General and Administrative (Rate: 20 %) i) Gen & Admin [(c) x (b)] $ 35.80 j) TOTAL INDIRECT COSTS [(e) + (g) + (i)] $ 295.44 per hour FEE (Profit) q) (Rate: 10 %) k) TOTAL FIXED PROFIT [(c) + (j)] x (q)]$ 29.54 per hour OTHER DIRECT COSTS (ODC) p) TOTAL OTHER DIRECT COSTS [(i) + (m) + (n) + (o)] $ TOTAL COST [(c) + (j) + (k) + (p)] $ 325 per hour NOTES: • Employees subject to prevailing wage requirements to be marked with an *. • ODC items should be based on actual costs and supported by historical data and other documentation. • ODC items that would be considered "tools of the trade" are not reimbursable. • ODC items should be consistently billed directly to all clients, not just when client will pay for them as a direct cost. • ODC items when incurred for the same propose, in like circumstances, should not be included in any indirect cost pool or in overhead rate. Page 1 of 5 LPP 15-01 January 14, 2015 Description Unit(s) Unit Cost Total 1) Travel/Mileage Costs (supported by consultant actual costs) $ $ 0 in) Equipment Rental and Supplies (itemize) $ $ p n) Permit Fees (itemize), Plan sheets (each), Test Holes (each), etc. $ $ 0 o) Subconsultant Costs (attach detailed cost proposal in same format as prime consultant estimate for each subconsultant) $ $ 0 p) TOTAL OTHER DIRECT COSTS [(i) + (m) + (n) + (o)] $ TOTAL COST [(c) + (j) + (k) + (p)] $ 325 per hour NOTES: • Employees subject to prevailing wage requirements to be marked with an *. • ODC items should be based on actual costs and supported by historical data and other documentation. • ODC items that would be considered "tools of the trade" are not reimbursable. • ODC items should be consistently billed directly to all clients, not just when client will pay for them as a direct cost. • ODC items when incurred for the same propose, in like circumstances, should not be included in any indirect cost pool or in overhead rate. Page 1 of 5 LPP 15-01 January 14, 2015 Local Assistance Procedures Manual EXHIBIT 10-H Sample Cost Proposal Consultant EXHIBIT 10-H SAMPLE COST PROPOSAL (EXAMPLE #1) Page 2 of 2 ACTUAL COST-PI.Us-FIXER FEE OR LUMP SUM (FIRM Finn PRICE) CONTRACTS (SAMPLE CALCULATIONS FOR ANTICIPATED SALARY INCREASES) Contract Date 1. Calculate Average Hourly Rate for 1st year of the contract (Direct Labor Subtotal divided by total hours) Direct Labor Total Hours per Avg 5 Year Subtotal per Cost Cost Proposal Hourly Contract Proposal Rate Duration $250,000.00 5000 = $50.00 Year 1 Avg Hourly Rate 2. Calculate hourly rate for all years (Increase the Average Hourly Rate for a year by proposed escalation %) 4. Calculate Total Costs including Escalation (Multiply Average Hourly Rate by the number of hours) Avg Hourly Rate Year Proposed Escalation Year 1 $50.00 * 1000 Year 1 $50.00 + 2% _ $51.00 Year 2 Avg Hourly Rate Year 2 $51.00 + 2% _ $52.02 Year 3 Avg Hourly Rate Year 3 $52.02 + 2% _ $53.06 Year 4 Avg Hourly Rate Year 4 $53.06 + 2% _ $54.12 Year 5 Avg Hourly Rate 3. Calculate estimated hours per year (Multiply estimate % each year by total. hours) Estimated % Completed Total Hours per Cost Total Hours per Each Year Proposal Year Year 1 20.0% * 5000 = 1000 Estimated Hours Year 1 Year 2 40.0% * 5000 — 2000 Estimated Hours Year 2 Year 3 15.0% * 5000 = 750 Estimated Hours Year 3 Year 4 15.0% * 5000 = 750 Estimated Hours Year 4 Year 5 10.0% * 5000 = 500 Estimated Hours Year 5 Total 100% Total = 5000 4. Calculate Total Costs including Escalation (Multiply Average Hourly Rate by the number of hours) Cost per Avg Hourly Rate Estimated hours Year (calculated above) (calculated above) Year 1 $50.00 * 1000 Year $51.00 * 2000 Year $52.02 * 750 Year $53.06 * 750 Year 5 $54.12 * 500 — $257,871.10 Total Direct Labor Cost with Escalation _ $250,000.00 Direct Labor Subtotal before Escalation = Estimated total of Direct Labor Salary $7,871.10 Increase Cost per Year _ $50,000.00 Estimated Hours Year 1 _ $102,000.00 Estimated Hours Year 2 _ $39,015.00 Estimated Hours Year 3 _ $39,795.30 Estimated Hours Year 4 _ $27,060.80 Estimated Hours Year 5 — $257,871.10 _ $250,000.00 = Transfer to Page 1 $7,871.10 NOTES; • This is not the only way to estimate salary increases. Other methods will be accepted if they clearly indicate the % increase, the # of years of the contract, and a breakdown of the labor to be performed each year. • An estimation that is based on direct labor multiplied by salary increase % multiplied by the # of years is not acceptable. (i.e. $250,000 x 2% x 5 yrs = $25,000 is not an acceptable methodology) • This assumes that one year will be worked at the rate on the cost proposal before salary increases are granted. Page 2 of 5 LPP 15-01 January 14, 2015 w W 0 IA z II E" V U 0 0 0 � � o 0 0 0 0 0 0 V .ro EA 69 H9 f9 V1 69 O y 7 W y ' E 69 FA 6n z G U ZO V � 6 N U v w � V 5Oqs d L� + Q Q Q V U a xwoz z z o G Q o� a s b O b � C O O O an O O .e O O 0 0 > w N 69 W ® c O O O O 0 II' O O Q 4 m N n � N ac o. 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DIRECT LABOR Hours Hourly Total ($) Billing Rate ($) Professional (Classification) Sub-professional/Technical* EQUIPMENT (with Operator) OTHER DIRECT COST Description Unit(s) Unit Cost Mobilization/De-mobilization $ Supplies/Consumables (Itemize) Travel/Mileage T $ Report (if applicable) $ _ TOTAL COST PER UNIT OF WORK NOTES: • Denom labor subject to prevailing wage with asterisk (*}. • Hourly. billing rates should include prevailing wage rates and be consistent with publicly advertised rates charged to all clients (Commercial, Private or Public). • Hourly billing rates include hourly wage rate, net fee/profit, indirect cost rate, and actual direct equipment rate. • Mobilization/De-mobilization is based on site location and number and frequency of testslitems. • ODC items should be based on actual costs and supported by historical data and other documentation. ODC items that would be considered "tools of the trade" are not reimbursable. Page 5 of 5 LPP 15-01 January 14, 2015 A A Local Assistance Procedures Manual EXHIBIT 10-01 Consultant Proposal DBE Commitment EXHIBIT 10-01 CONSULTANT PROPOSAL DBE COMMITMENT (Inclusive of all DBEs listed at bid proposal. Refer to instructions on the reverse side of this form) c®Bsaltaut t®C®mgr thts �ec�+n11 1. Local Agency Name: City of Sema A[1a 2. Project Location: City of Santa Ana 3. Project Description: On Call Right of Way Services 4. Consultant Name: Donna Desmond Associates 5. Contract DBE Goal %: 4% DBE Commitment Information 6. Description of Services to be Provided 7. DBE Firm Contact Information S. DBE Cert. Number 9. DBE % Goodwill Appraisal services Donna Desmond Associates, Donna Desmon 039212 100% 265 S. Beverly Glen BIW. Los Angeles. CA 90024 _ 310 476-1114 Local Ajency lits Complete this Sectlnn - 16, Total h CAabned 1NO % 16. Local Agency Contract Nmnber. 17. Perioral -aid Project Number: M Proposed Contract Execution Date: Local Agency certifies that all DBE certifications are valid and the information on this form is complete and accurate: - it. Preparer's Signature Donna Desmond 12. Preparer's Name (Print) President 19. Local Agency Representative Name (Print) 20. Ural Agency Representative Signature 21. Dade 22. Local Agency Representative Title 23. (Area Code) Tel. No. 13. Preparer's Title 6/2612015 (310) 475-1114 14. Date 15. (Area Code) Tel, No. Distribution: (1) Original— Consultant submits to local agency with proposal (2) Copy— Local Agency files Page 1 of 2 LPP 13-01 May 8, 2013 Local Assistance Procedures Manual EXR111rr 10-01 Consultant Proposal DBE Commitment INSTRUCTIONS - CONSiTLTANT PROPOSAL DBE COMMITMENT Consultant Section The Consultant shall: 1. Local Agency Name— Enter the name of the local or regional agency that is funding the contract. 2. Project Location - Enter the project location 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, W idenhl& etc.). 4. Consultant Name- Enter the consultant'sfirm name. S. Contract DRE Goal % - Enter the contract DBE goal percentage, as it was reported on the Exhibit 10-I Notice kr Proposers DBElrijbrmalion form. See LAPM Chapter 10. 6. Description of Services to be Provided - Enter item of work description of services to be provided. Indicate ail 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 DEE, 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. 7. DBE Firm Contact Information - Enter the name and telephone number of all DBE subcontracted consultants. Also, enter the prime consultant's name and telephone number, if the prone is a DBE. 8. DBE Cert. Number - Enter the DBEs Certification Identification Number. All DBEs must: be certified on the date bids are opened. (DBE subcontracted consultants should notify the prime consultant in writing with the date of the decertification if their status should change dining the course of the contract.) 9. DBE ate - Percent participation ofweek 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. 10. Total % Claimed — Enter the total DBE participation claimed. If the Total %Claimed is loss than Hera 6. Contract DBE Goal", all adequately documented Good Faith Effort (GFH) is required (see Exhibit 15-14 DBE lrrformalmn - Good Falth Efforts of the LAPM). 11, Preparer's Signature — The person completing this section of the form for the consultant's firm must sign their name. 12. Preparer's Name (Print) — Clearly enter the nine of the person signing this section of the form for the consultant. 13. Preparer's Title - Enter the position/title of the person signing this section of the form for the consultant. 14, Date - Enter the date this section of the form is signed by the preparer. 15. (Alva Code) Tel. No. - Enter the area code and telephone number of the person signing this section of the form for the consultant. Local Aeencv Section: The Local Agency representative shall: 16. Local Agency Contract Number - Enter the, Local Agency Contract Numben 17. Fedcrah-Aid Project Number - Enter the Federal -Aid Project Number. I& Contract Execution Date - Enter date the contract was executed and Notice to Proceed issued. See LAPM Chapter 10, page 23. 19. Local Agency Representative Name (Print) - Clearly enter the name of the person completing this soman. 20. Local Agency Representative 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 Local Agency Representative signs the form. 22. Local Agency Representative Title - Enter the position/title of the person signing this section of the form. 23. (Area Code) Tel. No. - Enter the area code and telephone number of the Local Agency representative signing this seetion of the form. Page 2 of UP 13-01 May 8, 2013 DESMO-1 OP ID; SG -DATE JMMIDWYYYY) CERTIFICATE OF LIABILITY INSURANCE 4702/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must- be endorsed. If SUBROGATION IS WAIVED:, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statemBrit on this certificate does not confer rights to the certificate holder in lieu of such endorsement(sl- PRODUCERCONTACT John J. Matsock & Assoc. Inc, 1750 N Washington Street Naperville, IL 60563 �NAM Steven L. Monteith _Wj_ E. PHONE A_M_NR,..Egt(330-505-7888 E-MAIL Steven L. Monteith -ARDRESS: INSURER A: Travelers Prop Cas CID 25674 INSURED Donna Desmond Associates �NSURER a: of America Phone #310-475-1114 265 South Beverly Glen Blvd. Los Angeles, CA 90024 MNSURBE D., . ...... INSURER E IINSURER F: COVERAGES CFRTIFIr.ATF NI]MRF=R: r%"wi71Vry rquivior-m; THIS 13 TO CERTIFY THAT THE POUCIPS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEc-r TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I NSR _A155 —POLICY-ETF� _POUCY EXP TR TYPE OF INSURANCE wVn IN POLICY NUMBER (MMIDDNYYY) (MMIDDIYYYYI LIMITS GENERAL LIABILITY A x ! COMMERCIAL GENERAL LIABILITY x I, 680-1 B716605 1210112015 12101/2016 EACH OCCURRENCE 1,000,000 AIiAGE To RE --I' 5;�] MAIMS -MADE LA J OCCUR PIiEMI5E5 Ea MED F)�P (Ary ane person} 300,000 10,000, A Ind Contractors 680-1 B716605 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPYOP AGG $ 2,000,000 POLICY El 1211i LOC AUYOM0131LE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ A 680-1 BODILY INJURY (Per person) $ ANY AUTO B716605 1210112015 12101/2016 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED I N RED AUTOS X AUTOS P-R-(YPE _RTYOAMAZ_�_ $ �x UMBRELLA LIAB OCCUR TILCIA111 -A F OCCLIRR�ENCE. $ EXCESS LIAR MADE AGGREGATE $ 0EDE_ 7111ENTiON $ WORKERS COMPENSATION -7- vvc sTATu- i IoTH- AND EMPLOYERS' LIABILITY Y/N E L.. EACH ACCIDENT I ED) E N�� $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER JMFMHFR EXCLUDED? F /A DISEASE - EA EMPLOYEF. ---- $ (Mandatory In NHI yes, describe undef E. L. DISEASE -POLICY LIMIT DESCRIPTION DESCRIPTION OF OPERATIONS below A lProperty Section 680-18716605 5 12101/2016 CESCWPTION OF OPERATIONS / LOCATIONS I VEHICLES(Attach ACORD tial, AddItIonal Remarks Schedule, if more space is required) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEtRS AND RE PRE SENTATTVRS / /ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY AGREEMENT NUMBERS A-2011-070; A-2014-038 & A-2015-159//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY, TERMS AND CONDITION EUNKE I IEREDJA (PG OF SANTAAN CITY OF SANTA ANA PUBLIC WORKS AGENCY ATTN: JASON GABRIEL 20 CIVIC CENTER PLAZA M-36 SANTA ANNA, CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATWE P. vI v 00'4U` IU ALUKL) tUKVUKA I NUN. Ali rights reserved, ACID RD 25 (2010105) The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED END0RSEjvjENLr FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Company' --k, This endorsement modifies such insurance as is afforded by the provisions of Policy relating to the following: I . The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701 x its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and defense Of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or On behalf of the named insured, such insurance as is afforded by this policy is Primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included, 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endonserrielit effective.) Effective �-IaC, , this endorsement form as a part of Policy # - Issued to Narned Insured Countersigned by —s Author ed Representative ------ ---------- --- - - ...... WORICERS'QQMLENS&�FJQN DECLARAILON I Donna Desmond, President hereby affirin undcr penalty of perjury, the (Narie/Title) fol I owing declaration: I certify on behalf of Donna Desmond Associates —that during the ten -n of my (Consultant/Company Name) contractfior Goodwill Loss Appraisal serviceswith the City of Santa Ana, I will not employ any person in any manner so as to become siibject to the workers' compensation laws of California, and agree that if I sho-uld become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions and provide proof of workers' compensation coverage, 1230/2015 DATE. / CONT AC #: A-201 4/679 andA-2015-159 Nalne: Donna Desmond Title: President Teleplhone: , (310)475-111,4 WARNING" FAILURE TO SECURE WONIERS' COMPENSATION COVERAGE IS 'UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO (.-MIMINAL PENALTIES AND CIVIL FINES UPTO ONE HUNDRED THOUSkND DOLLARS (S 100,000). M ADMION TO THE COST F COMPENSATION, DAMAGESAS PROVIDED FOR IN SECTION 3706 OF THE, LIWOR CODE, INTERI,ST, AND ATTORNEYS FEES. REVIEVVE) BY' , EUNICE B'ERELAA (P(r",V501F,w �) /4��Rr 7 0 `CO CERTIFICATE ®F LIABILITY INSURANCE DATE (MMIDDIYYYY) 5/22/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER LT$$C Insurance $erV] oe3 #OF13098 1820 E. First Street, Ste 500 Santa Ana CA 92705 COAME: TACT Jeanette Mueller N PHONE (714) 569-2700 (AICNo pIC (714)569-3099 E•MAL ODRE S: Jeanette.mueller@hubinternational,com INSURERS AFFORDING COVERAGE NAIC # INSURER A:Technology Insurance Company 042376 INSURED Desmond, Marcello & Amster, LLC 6060 Center Drive, Suite #825 Los Angeles CA 90045 INSURER B: INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2017 WC REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INAR S BR WVQ POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY _ D A ESD PREMISES Ea occurrence $ CLAIMS -MADE ElOCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ POLICY PRO- LOC IFr,T $ —1AUTOMOBILE LIABILITY OMBIN D SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS ON BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident OWNED HIRT DSAUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITYTORY YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA WC3619792 4/29/2017 9/29/2018 X WC STATU• OTH- LIMITS FR E.L. EACH ACCIDENT $ 1,000,000 E,L.DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required) RE: Contract # A-2011-069, A-2015-157 and A-2015-160. REVIEWED BY: EUNICE HEREDIA (PG f OF 0 L:tK I It-IL+A It HULUtK L:ANL:tLLA I IUN City of Santa Ana 20 Civic Center Plaza M-36 Santa Ana, CA 92701 ORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE s Monahan/JUBAE O 1988-2010 ACORD CORPORATION. All rights reserved, INS(1125 r7n1nnfil n1 Tha Ar`.r)Pr) name nnrl Innn nra ranletararl mark¢ of ArOPr) DESMO-1 OP ID: SG —.ATE CERTIFICATE OF LIABILITY INSURANCE 11/28/2016 Y} 11!28!2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER John J. Matsock & Assoc. Inc. 1750 N Washington Street Naperville, IL 60563 Steven L. Monteith CONTACT NAME: Steven L. Monteith _......- AH] N Ext,630-505-7888` aC Na, E-MAIL ADDRESS;__, INSURER(S) AFFORDING COVERAGE Al. It INSURER A: Travelers Prop Cas CO F2574 INSURED Donna Desmond Associates INSURER B: of America A Phone #310-475-1114 X 265 South Beverly Glen Blvd. INSURER C: 12/01/2017 DAMAGE TO RENTED -----.._... PREMISES Ea occurrence $ 300,00 MED EXP Ani ane person) $ 10,00 Los Angeles, CA 90024 INSURER D: INSURER E: 680-18716605 INSURER F: PERSONAL & ADV INJURY $ 1,000,00 COVERAGES CERTIFICATE NIIMRFR' PPV[Czlnm NI IMRr-0. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE AI)OL 5 B POLICY NUMBER pOtICY EFF MWDD/YYYY —POLICY EXP MMIDDIYYYY '- LIMITS 20 CIVIC CENTER PLAZA M-36, GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY _...._ CLAIMS -MADE � OCCUR X 680-16716606 1210112016 12/01/2017 DAMAGE TO RENTED -----.._... PREMISES Ea occurrence $ 300,00 MED EXP Ani ane person) $ 10,00 A X Ind Contractors 680-18716605 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,00_0,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PROJE,- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 O00 ,000 Ea acpLct ) $ ., _ BODILY INJURY (Per person) $ A ANY AUTO 680-1 B716606 12101/2016 12/01/2017 'X ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident $ ( ) HIRED AUTOS X NON -OWNED AUTOS - PROPERTY DAMAGE -� ER ACCIDE T}_,__ _ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE DED I I RETENTION $ $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Y / N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA WC STATU-OTH- T_Q U _ 1 '-- E.L. EACH ACCIDENT $ - E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) Ifs, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Property Section 680-1B716605 12/01/2016 12/01/2017 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, EMPLOYEES, AGENTS, VOLUTEERS AND REPRESENTATIVES//ADDITIONAL INSURED IS PRIMARY AND NON CONTRIBUTORY AGREEMENT NUMBERS A-2011-070; A-2019-038 & A-2015-159//AS REQUIRED BY WRITTEN CONTRACT, CERTIFICATES ARE SUBJECT TO ALL POLICY TERMS AND CONDITION REVCEIPVELt F LAY: Et.OI IICE IEFdEDIA (PGG OF ) E CFRT1FIr:ATP I-Ir1[ 111;0 !1Ak1r%M1 i A"^&I V V e SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PUBLIC WORKS AGENCY ATTN: JASON GABRIEL AUTHORIZED REPRESENTATIVE 20 CIVIC CENTER PLAZA M-36, SANTA ANNA, CA 92701 ACORD 25 (2010/06) U 1958-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD HOLDER CODE SANTAAN DESMO-1 PAGE 2 NOTEPAD. INSURED'S NAME Donna Desmond Associates OP ID: SG Date 11/28/2016 CONDITIONS OF SUCH POLICIES REVIEWED BY. WIN EM110E HEREDIA (PGOF COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED -OWNERS, LESSEE OR CONTRACTORS I This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS: 1. WHO |SANINSURED (SECTION U>isamended toinclude aaaninsured any person ororganiza- tion (oeUod hereafter "additional insured") whom you have agreed in a written contraot, executed prior to loss, to name as additional insured, but only with respect to liability arising out of "your work" or your ongoing operations for that addi- tional insured performed byyou nrfor you. 2. With respect tothe insurance afforded hzAddi- tional Insureds the following conditions apply: m. Limits of |nsuranoe—ThefoUmwing limits of liability apply: 1. The limits which you agreed (oprovide; or 2. The limits shown onthe declarations, whichever ieless. b. This insurance is excess over any valid and collectible insurance unless you have agreed in a written contract for this insurance to apply onaprimary orcontributory basis. 3. This insurance does not apply: o. on any basis to any person or organization for whom you have purchased on Owners and Contractors Protective policy. b. to "bodily injury." "property damage." "per- sonal pmp sono| injury," or "advertising injury" arising out ofthe rendering oforthe failure torender any professional services by or for you. in- cluding: 1. The pnepohng, approving or failing to prepare or approve mapo, dnavvinga, opinione, reports, aurveye, change or- ders, designs or specifications; and r-dem.deeignoorapeoificoUone;mnd 2. Supemieory, inspection or engineering services. CG Di 05 0494 Copyright, The Travelers Indemnity Company. 1804. Page 1 of 1 AC'QR®® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) �,,. 12/2/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Megan Lindquist-Obrotka PL Risk Advisors Inc. PHONE (201)847-9165 FAX (201) 847-9174 _(A/C, No, Ext): _._ ._. __. _. _(A/C, No): 795 Franklin Avenue, Suite 204 E-MAIL mlind ast@ lrisk.com ADDRESS: P PERSONAL & ADV INJURY $ INSURER(S) AFFORDING COVERAGE NAIC # Franklin Lakes NJ 07417 INSURERA:Ace American Ins Company 22667 INSURED INSURER B: Donna Desmond Associates INSURER C : 265 S. Beverly Glen Blvd INSURER D: (Ea accident) INSURER E: LOS Angeles CA 90024 INSURER F COVERAGES CERTIFICATE NUMBER:CL1612206667 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X CLAIMS -MADE OCCUR DAMAGE TO RENTED .PREMISES (Ea occurrence) $ X Errors & Omissions G27931546 002 12/4/2016 12/4/2017 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED ..._._.._ AUTOS ............ AUTOS BODILY INJURY (Per accident) $ NON -OWNED PROPERTY DAMAGE $ HIRED AUTOSAUTOS (Per accident) UMBRELLA LIAB OCCUR', EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE', AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION PER OTH- -AND EMPLOYERS' LIABILITY Y / N ' STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH)--- E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Coverage applies solely for the insured performance of professional services as a business valuation service provider for others REVIEWED BY: EUNICE HEREDIA (PG VOF CERTIFICATE HOLDER CANCELLATION ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Ana THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20 Civic Center Plaza (M-37) ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1988 AUTHORIZED REPRESENTATIVE Santa. Ana, CA 92702 Alice Sroga/ALICE -" ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DESMOA Op Inr SC 16- c ' CERTIFICATE OF LIABILITY INSURANCE DATE 1/151201 YY) 11/1512017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDIER. THIS CERTIFICATE DOES NOT AF'F'IRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES. NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder I$ an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). John J Matsock& Assoc. Inc. 1760NWashingtonStreet Naperville, IL 60663DPD Steven L. Monteith A Steven L. Monteith B ;630-505.7888 c ss. INSURER AFFORDINP COVERAO. 9 NAIL # A A INSURERA:TraveI9jrs;.Prop Cas Co 25674 INSURED Donna Desmond Assoc fates Phone #310-475-1114 265 South Beverly Glen Blvd, INSURER e: of America INPUREB C: INSURER a Los Angeles, CA 90024 INSURER E r R F TO D n a 'ir nce $ 300,00 INSURER F CO THIS IS TO CERTIFY TWAT THE POLICIES O� INSURANCE LISTED BELOW HAVE SEEN ISSUED Tp THE INSURED NAMED A6(?VE FOR TWC POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS -..--CERTIFICATE -MAY.. BE ISSUED OR MAY PERTAIN, THE INSURANCE. AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 7O ALL' THE TERMS, EXCLWSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1S -TYPt OPINSURANCg BuellCLIP POLICY NUMBER EFP O IQY P LIMIYa A A GENERAL LIABILITY X OMOLAIMIS -MADAL E X AOCCUR X Ind Contractors X 6tt0�18716605 660-1B716605 1210912017 12/U112018 EAOH OCCURRENCE $ 1,000,00 R F TO D n a 'ir nce $ 300,00 MED EXp An ale arson) $ 10,00 PERSONAL AADVINJURY $ 1,000100 GENERAL AGGRGATE $ 2,000,00 f�EN'L AGGREGATE I.IMITAPPLIt S PER X1 POLICY ::- LOO PRODUCTS - OMPIOP AGa $ 2+000,00 $ A AUTOMOBILE X LIABILITY ANY AUTO- ALI. gWNIED SCHEDULED AUTOS AUTOS ,HIREDAUTOS X NON -OWNED AUTOS 680.1 B716606 1210112017 12/011.2018 CQM EDLE LIMIT Ea amide 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY per accident $ . ( � CID $ $ HEXCESS UMBRELLA LJAU LIA13 OCCUR CLAIM$ MAGE EACH OCCURRENCE M AGGREGATE $ "D�D RET NTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY I ANY PROPRIETORIPARTNERIEXECUnVU-M OFFIaRIMEMBER EXCLUDED? � (Mralda0scr In NH) WRIfes doscribe uncia, IP OP RA IO $ bel NIA WC TA - OTH E.L EACIIACCIDENT $ P.L. DISEASE • EA EMPLOYEE $ E,L, DISEASE -POLI Y LIMIT A Property Secklon _ - 680.18716605 12101/2017 1210112018 DESCRIPTION OP OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Romadce Sohadulo, if more spsoois requirod) ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABILITY: CITY OF SANTA ANNA,ITS OFFICERS, ZNPLOYZt$, AGEINTS, t1OLUTEERS ,AND REPAUS9NTATIVAS//ADlD1T'XONA1 INSURED IS PRX Y AND NON CONTRIBUTORY AGREEMENT NIMBRS A--2011-0701 A-2014-038 & A^-201.5.159//AS REQUIRED BY WRITT�4N CONTRACT, CERTIE'TCATHS ARM SUBJECT TO ALL POLICY TERMS AND CONDIPqN REVIEWED BY: EUNICE. H :REDIA (PG OF ) itsr:rvr�r v v rc t,:AlNVr_L,L.A1 VN SANTAAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF SANTA ANA THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, PUBLIC WORKS AGENCY ATTN: JASON GABRIEL AUTHORIZEDREPR9SENTATIVF 20 CIVIC CENTER PLAZA M-36 SANTA ANNA, CA 92701 V IUUU-201U AUUKU GORI'OKA7'ION, All rights reserved, ACORD 26 (2010106) The ACORD name and Toga are registered marks of ACORD NOTEPAD, HOLDER C06F SANTAAN ' INSURED'S NAMS Donna Desmond Associates CONDMON9 OV SUCH P0LXCXES DCSM0.1 PAGE 2 OP ID: SG Dare 11/15/2017 REVIEWED BY: Ij EUNICE HEREDIA (PG Donna Desmond Associates': -- Policy #680-1 B716605 COMMERGIAI. GENERAL LIABILITY THIS ENDORSEMENT CHANCES THE POLICY. PLEASE DEAD IT CAREFULLY, BLANKET ADDITIONAL INSURED - a NER LESSEES � � OR CONTRACTORS - This endorsement modifies insurance provided under the following; COMMERCIAL GENERAL LIABILITY COVERAGE PART i PROVISIONS: g 9, WHO IS AN INSURM (SECTION 11) is amended in a written contract for this Insurance to -to include as an insured any person or organixa- - apply on a primary or contributory basis. tion (caged hereafter "additional insured"} whom you have agread In a written contract, executed 3. This insurance does not applyi y prior.,to loss, to name as additional: insured, but a. on any basis: t4 any person: or organization only :with respect to nobility-arisIng.out of "your for whom you have "purchased an Owners work'_` or, your ongoing operations for that add!- and Contractors Protective policy. tlonal- insured performed by you or far you. b. to "bodily injury," "property :damage," , °per 2: With respect to the insurance afforded to Adds- sonal injury;" or "advertisln ,� g g injury arising tlonal insureds the following conditions apply: out of the rendering of or the failure to render a. Limits of Insurance -� The following limits of any professional services by or for you, inW In- ciuding; liability apply Tho limits which you agreed to provide; 1" The preparing, approving or fading to i - or -- - -:- prepare or approve maps, drawings, opinions, reports, surveys, change or. 2. The limits shown on the declarations, ders, designs or specifications; and Whichever is less, 2. Supervisory, Inspection or engineering b. This Insurance Is excess over any valid and services, collectible Insurance unless you have agreed CC D1 oa 04 94 Copyright, The Travelers Indemnity Company, 1994, Page 1 of 1 Includes Copyrighted Material from Insurance Services Office, Inc. REVIEWED BY: FUNICE HEREDIA (PG OF;, } Donna Desmond Associates - - Policy #680-1 B716605 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ iT CAREFULLY, UHER INSURANCE - ADDITIONAL INSUREDS GG DO 37 04 05 Copyright 2006 The St. Paul Travelers Companies, Inc, All rights reserved, Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (Pe OF � This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROVISIONS b. The "personal Injury" or "advertising injury„ for COMMERCIAL GENERAL LIABILITY CONDITIONS which coverage Is sought arises out of an of ' (Section IV), paragraph 4. (Other Insurance), is fense committed amended as follows; Subsequent to the signing and execution of that `I -The -,following-Is added to Paragraph a, Prlmary contract or agreement by you. _ _lnsuranca: 2. The first Subparagraph (2) -of Paragraph- b. Ex. However, if you specifically agree in a written con, cess insurance regarding any other primary In - tract or -written agreement that the Insurance pro- surance nvdilable to.you is deleted. vlded toan ; a�d)tlor- Insured under this Coverage (part must apply oh a primary basls,-or 3. The following Is added to Paragraph b, Excess insurance, as an additional subparagraph under a primary and _non-contributory basis, this insur- Subparagraph (1): anco Is primary to other insurance -that. Is avall. "able tp'suah `additional Insured which covers such That is available to the insured when the insured. additional Insured as a named Insured, and we is added as an additional Insured under any other policy, including any umbrella or excess policy, f will not share with that other Insurance, provided f that, ; a, The "bodily injury" or "property damage" fbr which coverage is sought occurs; and I i, i GG DO 37 04 05 Copyright 2006 The St. Paul Travelers Companies, Inc, All rights reserved, Page 1 of 1 REVIEWED BY: EUNICE HEREDIA (Pe OF �