HomeMy WebLinkAboutStaff Report 5.B 01/25/2016DATE:
TO:
FROM:
Agenda Item #5.B
January 25, 2016
Honorable Mayor and Members of the City Council through City Manager
Dan St. John, RASCE — Director, Public Works & Utilities
Joe Rye — Transit Division Manager, Public Works & Utilities
SUBJECT: Resolution Awarding a Three -Year Contract with C.A.R.E. Evaluators, Inc. for
Americans with Disability Act (ADA) Paratransit Eligibility Determination
Services and Authorizing the City Manager to Execute the Agreement
RECOMMENDATION
It is recommended that the City Council adopt a Resolution Awarding a Three -Year Contract
with C.A.R.E. Evaluators, Inc. for Americans with Disability Act (ADA) Paratransit Eligibility
Determination Services and Authorizing the City Manager to Execute the Agreement.
BACKGROUND
Since 2011, Petaluma has partnered with Santa Rosa CityBus and Sonoma County Transit to
utilize the services of C.A.R.E. Evaluators, Inc. (C.A.R.E.) to assess the eligibility of new ADA
applicants to Petaluma Paratransit. Because paratransit is an extremely expensive service to
provide, it is critical to ensure that only those who are fully qualified under the definitions for
paratransit eligibility as determined by the ADA and the Federal Transit Administration (FTA)
are allowed to use the service. The City has utilized C.A.R.E. in this intake role since 2011 under
a joint procurement led by the City of Santa Rosa.
C.A.R.E conducts eligibility assessments every Wednesday at the Petaluma Community Center.
The disabilities that prevent an applicant from using the fixed route Petaluma Transit system are
assessed. If the applicant is determined eligible, a Petaluma Paratransit ID card is issued.
Applicants may arrange their own transportation to the Community Center, or may be
transported via Petaluma Paratransit at no charge. The interview may include a "transit walk ",
where applicants walk out to the bus stop with C.A.R.E evaluating their ability to safely access
the bus stop including crossing streets, boarding the fixed route buses, and other necessary riding
skills.
The current three -year contract with C.A.R.E. Evaluators, Inc. was extended by 6 months in June
2015 to allow the Cities of Santa Rosa and Petaluma time to conduct a Request For Proposals
(RFP) process. Sonoma County Transit opted out of participation because they are bringing
ADA evaluations back in -house and will only utilize C.A.R.E. for software and occasional
interviews.
DISCUSSION
C.A.R.E. Evaluators, Inc. submitted the only proposal in response to the 2015 RFP issued by
City of Santa Rosa. Their proposed fees have increased significantly over their last contract for
each of the next three years, as shown in the cost proposal (Attachment 2). The proposed year
one rate of $43,798 represents an estimated cost of $175 per evaluation, which is an increase of
211% over the average rate of $56 per evaluation paid to date.
Much of the public transit industry in the United States has migrated to this "face to face" ADA
eligibility model to improve quality and control costs by limiting use of expensive paratransit
services to those who truly need the service. With even a highly productive paratransit service
like Petaluma Paratransit, the agency cost per rider easily exceeds $30 per trip whereas the same
trip on fixed route costs the City around $3 per trip. With this dramatic difference in cost per trip,
and the lack of additional operating funding to cover paratransit costs, transit agencies need to
ensure that only those whose disability truly prevents them from using the fixed route service at
least some of the time are certified to utilize paratransit.
Having a face -to -face interview during the evaluation process benefits the transit system by:
• Personalizing the process, this allows staff to get to know the applicants.
• Deterring those who may not be qualified reserves the service for those who are
qualified.
• Issuing the applicant an ID card, allowing free travel on the fixed route to those who can
use fixed route for some of their travel.
Since January 2013, a total of 667 applicants have been interviewed out of 762 applications, with
65% approved as unrestricted and 13 approved with restrictions. Only 14 clients were denied and
immediately referred to Petaluma Transit's Travel Training program for lessons on using the
fixed route system. These denials would have been difficult to determine without face -to -face
interviews. Approximately 20% of potential customers who initiated the program did not end up
completing the ADA application process. It is believed that this is an indicator of the self -
policing effect that a face -to -face evaluation has during the application process. A summary of
the ADA Paratransit eligibility process is summarized below:
ADA Paratransit Applications: 1/1/2013 — 11/19/2015
Approval Status
Total
Percentage
Conditional
23
3.02%
Denied
14
1.84%
Incomplete
151
19.82%
Temporary
67
8.79%
Trip -By -Trip
10
1.31%
Unrestricted
497
65.22%
Grand Total
762
100.00%
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Since August 2014, applicants who are eligible for paratransit are also permitted to travel on the
fixed route system free of charge by showing their Paratransit ID cards. In the past year, 7,121
free trips on fixed route have been provided to paratransit patrons, which represent a cost savings
of over $192,000 to the City when compared to the same number of paratransit trips. The annual
cost of the evaluation process is 23% of this estimated savings.
This item was discussed by the Transit Advisory Committee (TAC) at their December 3, 2015
meeting and the TAC recommends that City Council award this contract as proposed.
FINANCIAL IMPACTS
The new contract pricing is projected to increase annual costs of ADA evaluations by
approximately $30,000 compared to services in FYI 5. However, continuing to provide face -to-
face evaluations that assure that only eligible persons are allowed to utilize Petaluma Paratransit
will save more than that amount in deferred Paratransit trips. The funds for this agreement are
contained in Petaluma Paratransit's operating budget for FYI 6.
ATTACHMENTS
1. Resolution
2. Professional Services Agreement
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RESOLUTION AWARDING A THREE YEAR CONTRACT TO C.A.R.E.
EVALUATORS, INC. FOR AMERICANS WITH DISABILITIES ACT PARATRANSIT
ELIGIBILITY DETERMINATION SERVICES AND AUTHORIZING THE CITY
MANAGER TO EXECUTE THE AGREEMENT
WHEREAS, the City of Petaluma strives to provide a high quality fixed route and
paratransit services to the community while being constrained by limited operating funds,
making efficiency critical to the sustainability of Petaluma Transit; and
WHEREAS, the regional transportation planning agency for the Bay Area, the
Metropolitan Transportation Commission (MTC), encourages the independent transit agencies in
the region to work cooperatively, including participation in joint procurements to obtain
economies of scale and avoid duplication of effort; and
WHEREAS, the City of Petaluma joined with the City of Santa Rosa serving as the lead
agency in a joint procurement partnership to obtain and share an Americans with Disabilities Act
Eligibility Determination contractor that would serve a vital function for both agencies in
conducting eligibility determination services; and
WHEREAS, C.A.R.E. Evaluators, Inc. have been performing satisfactorily for 3 years
under the current joint procurement agreement with the cities of Petaluma and Santa Rosa, and
the County of Sonoma; and
WHEREAS, C.A.R.E. Evaluators, Inc., the only proposer to the RFP issued by the City
of Santa Rosa on September 24, 2015, has submitted a competitive proposal for the three -year
plus contract period which includes cost increases required by C.A.R.E. Evaluators, Inc. to
ensure that the current face -to -face evaluation process is continued.
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Petaluma
that the City Council does hereby award a three -year contract for ADA Paratransit Eligibility
Determination Services to C.A.R.E. Evaluators, Inc. and authorizes the City Manager to execute
the requisite professional services agreement.
M
Exhibit A to Resolution
PROFESSIONAL SERVICES AGREEMENT
Functional Assessments to Determine Eligibility for ADA Paratransit Services
(Title of Project)
FY 16
Fund # 6500
Cost Center 65300
Object Code 54110 Project #
Amount $18,930
For multi -year contracts or contracts Nvitb multiple accounts:
FY 17
Fund # 6500
Cost Center 65300
Object Code 54110 Proiect #
Amount $43,165
FY 18
Fund # 6500
Cost Center 65300
Object Code 54110 Proiect #
Amount $44,460
FY 19
Fund # 6500
Cost Center 65300
Object Code 54110 Project #
Amount $26.383
FY
Fund #
Cost Center
Object Code Proiect #
Amount $
FY
Fund #
Cost Center
Object Code Proiect #
Amount $
THIS PROFESSIONAL SERVICES AGREEMENT ( "Agreement ") is entered into and effective
as of , 20 ( "Effective Date "), by and between the City of Petaluma, a
(city use on y)
municipal corporation and a charter city ( "City ") and C.A.R.E. Evaluators, Inc., a Corporation
( "Consultant ") (collectively, the "Parties ").
WHEREAS, the Parties enter into this Agreement for the purpose of Consultant providing
professional services to City under the terms and conditions set forth herein.
THEREFORE, in consideration of the mutual covenants contained in this Agreement, the Parties
agree as follows:
2.
Services. Consultant shall provide the services as described in and in accordance with
the schedule set forth in Exhibit "A" attached hereto and incorporated herein
( "Services ").
Compensation; Business Tax Certificate.
A. For the full performance of the Services as described herein, City shall
compensate Consultant in accordance with the rates specified in Exhibit A.
B. Consultant shall submit detailed monthly invoices reflecting all services
performed during the preceding month, and including a revised schedule for
performance and additional documentation requested by City, as applicable.
C. Consultant shall be compensated for services in addition to those described in
Exhibit A, only if Consultant and City execute a written amendment to this
Agreement describing the additional services to be performed and the
compensation to be paid for such services. In no case shall the total compensation
tinder this Agreement exceed $132,937 without prior written authorization of the
City Manager. Further, no compensation for a section or work program
component attached with a specific budget shall be exceeded without prior written
authorization of the City Manager.
D. Notwithstanding any provision herein, Consultant shall not be paid any
compensation until such time as Consultant has on file with the City Finance
Department a current W -9 form available fi•om the IRS website (www.ii-s.g,_ov)
and has obtained a currently valid Petaluma business tax certificate.
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E. City's obligation to pay compensation to Consultant as provided herein is
contingent upon Consultant's performance of the Services pursuant to the terms
and conditions of this Agreement and any amendments thereto.
3. Term. The term of this Agreement commences on the Effective Date, and terminates on
January 31, 2019, unless sooner terminated in accordance with Section 4. Upon
termination, any and all of City's documents or materials provided to Consultant and any
and all of the documents or materials prepared for City or relating to the performance of
the Services, shall be delivered to the City as soon as possible, but not later than fourteen
(14) days after termination of the Agreement.
4. Termination. City may terminate this Agreement without cause upon ten (10) days'
written notice. City may immediately terminate or suspend this Agreement for cause.
Cause for immediate termination or suspension shall include, but not be limited to, any
breach of this Agreement by Consultant or Consultant's bankruptcy or insolvency. Upon
receipt of notice of termination or suspension for cause, Consultant shall immediately
stop all work in progress under this Agreement. In the event of early termination of this
Agreement by City, Consultant shall be entitled to payment for all Services performed to
the date of termination to the extent such Services were performed to the satisfaction of
City in accordance with the terms and conditions of this Agreement. If City terminates
this Agreement for cause, Consultant shall be liable to City for any excess cost City
incurs for completion of the Services.
5. Consultant's Representation; Independent Contractor. Consultant represents that
Consultant possesses distinct professional skills in performing the Services. City has
relied upon said representation as a material inducement to enter into this Agreement.
Consultant shall, therefore, provide properly skilled professional and technical personnel
to perform all Services under this Agreement. It is expressly understood that Consultant
and its agents and employees, shall act in an independent capacity and as an independent
contractor and not as officers, employees or agents of City. This Agreement shall not be
construed as an agreement for employment.
6. Facilities and Equipment. Consultant shall, at its sole cost and expense, fi►rnish all
facilities and equipment that may be required for furnishing Services pursuant to this
Agreement. City shall furnish to Consultant no facilities or equipment, unless the City
otherwise agrees in writing to provide the same.
7. Licenses Permits Etc. Consultant shall, at Consultant's sole cost and expense, keep in
effect at all times during the term of this Agreement any licenses, permits or other such
approvals which are legally required for performing the Services.
8. Time. Consultant shall devote such time to the performance of the Services as may be
reasonably necessary for satisfactory performance of Consultant's obligations pursuant to
this Agreement.
9. Inspection. Consultant shall provide the City every reasonable opportunity to ascertain
that the Services are being performed in accordance with the requirements and intentions
of this Agreement. All work done and materials furnished, if any, shall be subject to
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inspection and approval by the City. The inspection of such work shall not relieve
Consultant of any of its obligations pursuant to this Agreement.
10. Progress Reports. Upon the City's request, Consultant shall provide, in a form
acceptable to City, written progress reports of all oral and written observations, opinions,
recommendations, analyses, progress and conclusions related to Consultant's
performance of the Services.
11. Confidentiality. In the course of Consultant's employment, Consultant may have access
to trade secrets and confidential information, disclosure of which is protected or limited
by law. Consultant shall not directly or indirectly disclose or use any such confidential
information, except as required for the performance of the Services.
12. Conflict of Interest. Consultant represents that it presently has no interest, and
covenants that it shall not acquire any interest, direct or indirect, financial or otherwise,
which would conflict in any manner or degree with the performance of the Services
hereunder. Consultant further covenants that, in the performance of this Agreement, it
shall not employ any subcontractor or person having such a conflict of interest.
Consultant represents that no one who has or will have any financial interest under the
Agreement is an officer or employee of City. If such conflict of interest arises during this
Agreement or any extension, Consultant will immediately advise City and City may, at
its sole discretion, immediately terminate this Agreement. Certain Consultants are
subject to the requirements, including the disclosure and reporting requirements, of the
City's Conflict of Interest Code adopted pursuant to the Political Reform Act. Such
Consultants subject to the City's Conflict of Interest Code include those whose work may
involve: making government decisions regarding approval or adoption of rates, rules, or
regulations, action on permits or other applications, authorization to enter into or modify
contracts, or approval of plans, designs, reports, or studies. Consultant agrees to comply
frilly with all such requirements to the extent they apply to Consultant's performance of
the Services.
13. Consultant No Agent. Except as City may specify in writing, Consultant shall have no
authority, express or implied, to act on behalf of City in any capacity whatsoever as an
agent. Consultant shall have no authority, express or implied, pursuant to this Agreement
to bind City to any obligation whatsoever.
14. Standard of Performance. Consultant shall perform all the Services in a manner
consistent with the standards of Consultant's profession. All instruments of service of
whatsoever nature, which Consultant delivers to City pursuant to this Agreement, shall be
prepared in a substantial, workmanlike manner and conform to the standards of
Consultant's profession. All such instruments 'of service shall become the sole and
exclusive property of City upon delivery of the same.
15. Assignment /Transfer. No assignment or transfer in whole or in part of this Agreement
shall be made without the prior written consent of City.
16. Subcontractors. Consultant shall directly perform all Services, and shall not subcontract
any portion of performance of the Services without the prior written consent of City.
Any such subcontractors shall be required to comply, to the full extent applicable, with
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the terms and conditions of this Agreement, including but not limited to, procuring and
maintaining insurance coverage as required herein and which shall name. City as an
additional insured.
17. Compliance With All Laws. Consultant shall fully comply with all applicable local,
state and federal rules, laws, regulations and ordinances pertaining to the performance of
the Services required hereunder, including but not limited to, the California Building
Standards Code as in effect in the City, the Americans with Disabilities Act, and any laws
and regulations related to any copyright, patent, trademark or other intellectual property
right involved in performance of the Services. Consultant's failure to comply with any
law(s) or regulation(s) applicable to the performance of the Services hereunder shall
constitute a material breach of this Agreement. To the extent that any other government
agency or entity provides compensation for any Services, Consultant shall comply with
all rules and regulations applicable to such fiscal assistance.
18. Living Wage Ordinance. Without limiting the foregoing Section 17, Consultant shall
comply fully with all applicable requirements of Petaluma Municipal Code, Chapter 8.36,
Living Wage (the "Living Wage Ordinance "), as the same may be amended from time to
time. Upon the City's request Consultant shall promptly provide to the City documents
and information verifying Consultant's compliance with the requirements of the Living
Wage Ordinance, and shall within fifteen (15) calendar days of the Effective Date of this
Agreement, notify each of its affected employees as to the amount of wages and time off
that are required to be provided to them pursuant to the Living Wage Ordinance. The
Acknowledgement and Certification Pursuant to City of Petaluma Living Wage
Ordinance, attached to this Agreement as Exhibit C, shall be a part of this Agreement for
all purposes, and Consultants that are subject to Living Wage Ordinance requirements, as
determined by the City, must provide a properly completed Exhibit C in accordance with
the requirements of the Living Wage Ordinance. Consultant's noncompliance with the
applicable requirements of the Living Wage Ordinance shall constitute cause for City's
termination of this Agreement pursuant to Section 4 hereof.
19. Discrimination. During the performance of this Agreement, Consultant shall not
discriminate against any employee or applicant for employment because of race, religion,
creed, color, national origin, ancestry, gender, sexual orientation, age or physical or
mental disability in violation of any applicable law.
20. Notice. Except as otherwise specified in this Agreement, all notices to be sent pursuant
to this Agreement shall be made in writing, and sent to the Parties at their respective
addresses specified below or to such other address as a Party may designate by written
notice delivered to the other Party in accordance with this Section. All such notices shall
be sent by:
(i) personal delivery, in which case notice is effective upon delivery;
(ii) certified or registered mail, return receipt requested, in which case notice shall be
deemed delivered on receipt if delivery is confirmed by a return receipt;
(iii) nationally recognized overnight courier, with charges prepaid or charged to the
sender's account, in which case notice is effective on delivery if delivery is
confirmed by the delivery service; or
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(iv) facsimile transmission, in which case notice shall be deemed delivered upon
transmittal, provided that (a) a duplicate copy of the notice is promptly delivered
by first -class or certified mail or by overnight delivery, or (b) a transmission
report is generated reflecting the accurate transmission thereof. Any notice given
by facsimile shall be considered to have been received on the next business day if
it is received after 5:00 p.m. recipient's time or on a nonbusiness day.
City: City Cleric
City of Petaluma
Post Office Box 61
Petaluma, California 94953
Phone: (707) 778 -4360
Fax: (707) 778 -4554
Email: cityclerk@ci.petalunia.ca.us
ci.petaluma.ca.us
And:
Joseph Rve, Transit Division Manaaer
City of Petaluma, Public Works Department
555 N. McDowell Blvd.
Petaluma, CA 94954
Phone: 707 - 778 -4421
Fax: 707 - 776 -3799
Email: jrya,ci.petaluma.ca.us
Consultant: David T.W. Lee, P.T., C.E.O.
C.A.R.E. Evalutaors, Inc.
27772 Manor Hill Road
Laguna Niguel, CA 92677
Phone: 949 - 230 -1792
Fax: 949 - 448 -80037
Email: david@careevaluators.com
21. Ownership of Documents. All original papers, documents or computer material on disk
or microfilm, and copies thereof, produced as a result of this Agreement, shall be the
property of City and may not be used by Consultant without the written consent of City.
Copies of such documents or papers shall not be disclosed to others without the written
consent of the City Manager or his or her designated representative.
22. Indemnification. To the maximum extent permitted by law, Consultant shall, at its own
expense, indemnify, defend with counsel acceptable to the City, (which acceptance will
not be unreasonably withheld), and hold harmless City and its officers, officials,
employees, agents and volunteers ( "Indemnitees ") from and against any and all alleged
liability, loss, damage, claims, suits, actions, arbitration proceedings, administrative
proceedings, regulatory proceedings, civil penalties and fines, expenses and costs
(including, without limitation, claims expenses, attorney's fees and costs and fees of
litigation) (collectively, "Liability ") of every nature, whether actual, alleged or
threatened, arising out of or in connection with the Services or Consultant's failure to
comply with any of the terms of this Agreement, regardless of any fault or alleged fault
of the Indemnitees.
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The Consultant's obligation to indemnify, defend and hold harmless under this provision
shall not be excused because of the Consultant's inability to evaluate Liability, or because
the Consultant evaluates Liability and determines that the Consultant is not or may not be
liable. The Consultant must respond within 30 calendar days to any tender for defense
and indemnity by the City, unless the time for responding has been extended by an
authorized representative of the City in writing. If the Consultant fails to accept tender of
defense and indemnity within 30 calendar days, in addition to any other remedies
authorized by law, so much of the money due or that may become due the Consultant
under this Agreement as shall reasonably be considered necessary by the City, may be
retained by the City until disposition has been made of the matter subject to tender, or
until the Consultant accepts the tender, whichever occurs first. In the event that the City
must file responsive documents in a matter tendered to Consultant prior to Consultant's
acceptance of tender, Consultant agrees to fully reimburse all costs, including but not
limited to attorney's fees and costs and fees of litigation, incurred by the City in filing
such responsive documents.
The Consultant waives any and all rights to express or implied indemnity against the
Indemnitees concerning any Liability of the Consultant arising out of or in connection
with the Services or Consultant's failure to comply with any of the terms of this
Agreement. The Consultant's responsibility of such defense and indemnity obligations
shall survive the termination or completion of this Agreement for the full period of time
allowed by law. The defense and indemnification obligations of this Agreement are
undertaken to, and shall not in any way be limited by, the insurance obligations contained
in this Agreement.
Notwithstanding the foregoing, to the extent this Agreement is a "construction contract"
as defined by California Civil Code Section 2783, as may be amended fi•om time to time,
Consultant's duty to indemnify under this provision shall not apply when to do so would
be prohibited by California Civil Code Section 2782, as may be amended from time to
time.
Notwithstanding the foregoing, to the extent that the Services include design professional
services subject to California Civil Code Section 2782.8, as may be amended from time
to time, Consultant's duty to indemnify shall only be to the maximum extent permitted by
California Civil Code Section 2782.8.
23. Insurance. Consultant shall comply with the "Insurance Requirements for Consultants"
in Exhibit B -2, attached hereto and incorporated herein by reference. [Indicate attached
exhibit, e.g., `B -1, " "B -2, " `B -3, " or "B -4. "]
24. Amendment. This Agreement may be amended only by a written instrument executed
by both Parties.
25. Litigation. If litigation ensues which pertains to the subject matter of Consultant's
services hereunder, Consultant, upon request from City, agrees to testify therein at a
reasonable and customary fee.
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26. Construction. This Agreement is the product of negotiation and compromise on the part
of both Parties and that the Parties agree that, notwithstanding Civil Code Section 1654,
any uncertainty in the Agreement shall not be construed against the drafter of the
Agreement.
27. Governing Law; Venue. This Agreement shall be enforced and interpreted tinder the
laws of the State of California and the City of Petaluma. Any action arising from or
brought in connection with this Agreement shall be venued in a court of competent
jurisdiction in the County of Sonoma, State of California.
28. Non - Waiver. The City's failure to enforce any provision of this Agreement or the
waiver thereof in a particular instance shall not be construed as a general waiver of any
part of such provision. The provision shall remain in frill force and effect.
29. Severability. If any term or portion of this Agreement is held to be invalid, illegal, or
otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of
this Agreement shall continue in full force and effect.
30. No Third Party Beneficiaries. The Parties do not intend to create, and nothing in this
Agreement shall be construed to create any benefit or right in any third party.
31. Mediation. The Parties agree to make a good faith attempt to resolve any dispute arising
out of this Agreement through mediation prior to commencing litigation. The Parties
shall mutually agree upon the mediator and shall divide the costs of mediation equally.
32. Consultant's Books and Records.
A. Consultant shall maintain any and all ledgers, books of accounts, invoices,
vouchers, canceled checks, and other records or documents evidencing or relating
to charges for services, or 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 pursuant to this Agreement.
B. Consultant shall maintain all documents and records which demonstrate
performance under this Agreement for a mininnnn period of three (3) years or for
any longer period required by law, from the date of termination or completion of
this Agreement.
C. Any records or documents required to be maintained pursuant to this Agreement
shall be made available for inspection or audit, at any time during regular business
hours, upon written request by the City Manager, City Attorney, City Finance
Director, or a designated representative of these officers. Copies of such
documents shall be provided to the City for inspection at Petaluma City Hall
when it is practical to do so. Otherwise, unless an alternative is mutually agreed
upon, the records shall be available at Consultant's address indicated for receipt
of notices in this Agreement.
D. Where City has reason to believe that such records or documents may be lost or
discarded due to dissolution, disbandment or termination of Consultant's
business, City may, by written request by any of the above -named officers,
require that custody of the records be given to the City and that the records and
documents be maintained in Petaluma City Hall. Access to such records and
documents shall be granted to any party authorized by Consultant, t, Consultant's
representatives, or Consultant's successor in interest.
31 Headings, The headings used in this Agreement are for convenience only and are not
intended to affect the interpretation or construction of any provisions herein.'
ail. Sumival. All.obligations arising prior to the termination or expiration of this Agreement
and all provisions of this Agreement allocating liability between City and Consultant
shall survive the termination or expiration of this Agreement.
35. Entire Agreement. This Agreement, including the exhibits attached hereto and
incorporated herein, constitutes the entire agreement between the Parties With TCSPeCt to
the Services, and supersedes all prior agreement.,; or understandings, oral or written..
between the Parties in this regard,
IN WITNESS WHEREOF, the parties hereto have executed this document the day, month and
year first above written.
CITY OF PETALUMA
El —,Y-Ki-an age —r
ATTEST:
City Clerk
APPROVED AS TO FORM:
City Attorney
APPROVED:
Department Director
APPROVED:
Risk- Manager
APPROVED:
Finance Director
CONSULTANT
Bly, pwlle�- -
Title
Address
city L/ State Zip
Taxpayer I.D. Number
4avp.4 A 02
Petaluma Business Tax Certificate Nninber
PROFESSIONAL SERVICES AGRUTMENU
0,x91` 1) Augt6l 201 i
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Exhibit A -1: Services
Scope of Work
Three Part Process Overview: In- Person Evaluation
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The process begins when a potential applicant contacts the Call Center. At this stage, initial
information is exchanged between a client and C.A.R.E. Evaluator staff. C.A.R.E. takes the time
for excellent customer service at the Call Center, so that customers are thoroughly informed of
the evaluation process and can decide to either make an appointment or discontinue the
appointment process. This results in time savings for clients and cost savings for Petaluma.
All applicants are evaluated individually. In- person functional assessments are performed by
Evaluators. The In- Person Evaluation consists of three stages: Stage I Initial Processing, Stage II
Interview, and Stage III Functional Testing. Evaluators continue with the transit evaluation until
they have sufficient information to make an eligibility determination. Once the Evaluator has
sufficient information, the in- person evaluation and fimctional testing are complete and on -site
processing are complete. Under this proposal, Petaluma agrees to provide facilities, whether the
current facilities or another, that are ADA compliant and mutually agreed upon
After the conclusion of the three in- person stages, a determination for services is made by the
Evaluator. Once the determination is made, an internal Quality Assurance review is conducted
by C.A.R.E. For Petaluma only, after the determination is complete, Petaluma staff are informed
through email that the day's batch is ready for their review through ASMS. Once approved or
modified, Petaluma inputs the determination into the Regional Eligibility Database (RED). The
newly established ID for the customer is then input by the C.A.R.E. customer service department
into ASMS, and the determination letter and ID Cards are generated and sent.
For the Recertification process, C.A.R.E. sends a 45 day notice of expiration as a contact to
reschedule for evaluation for all determination types. With the exception of Temporary
designation, this will occur three years after they were determined eligible. Applicants are
instructed to contact the Call Center to make an appointment for in- person evaluation.
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Exhibit A -2: Proposal
2015 Paratransit Eligibility Assessment Proposal
Best and Final Offer
Submitted to:
Matthew Wilcox, Transit Planner
100 Santa Rosa Avenue, Room 6
Santa Rosa, CA 95404
Best and Final Offer Submitted on:
January 8, 2016
Submitted By:
C.A.R.E. Evaluators, Inc.
27772 Manor Hill Rd.
Laguna Niguel, CA 92677
(949) 230 -1792
Fax (949) 448 -8037
david a,careevaluators.com
Contact: David T.W. Lee, P.T., C.E.O.
14
Contents
Profile of C.A.R.E. Evaluators, Inc ..................... ...............................
General Information ............................ ...............................
FinancialCapacity ................................ ...............................
Customer References .......................... ...............................
Company Experience ........................... ...................... .I........
Staff Experience .................................. ...............................
Process........................................ ...............................
Recertification............................. ...............................
CurrentStaff ................................ ...............................
Facility Location ........................... ...............................
CostProposal .................................................. ...............................
Additional Information .................................... ...............................
Reporting Process ............................... ...............................
Emergency Procedures ........................ ...............................
Attachments.................................................... ...............................
.................... ............................... 3
................. ..............................3
................. ..............................4
................. ..............................9
................. ..............................9
................ .............................11
................ .............................12
................ .............................13
................ .............................13
................ .............................15
.................... .............................17
.................. ............................... 26
................ .............................26
................ .............................29
q1
15
Profile of C.A.R.E. Evaluators, Inc.
General Information
The C.A.R.E. Evaluators, Inc. philosophy is embedded in the name of the company itself:
Care. Founder David Lee believes deeply in the civil rights and empowerment of those
with disabilities. It is in that belief that C.A.R.E. promotes treating paratransit applicants,
travel training trainees, and all customers with caring and dignity to allow them full
participation in the community. In- person evaluation combined with functional testing
and observation by a trained Evaluator affords an opportunity to understand the
applicant's transit needs and abilities, which yields more accurate determinations and
transit referrals so each applicant can be well - served. Transportation in particular opens
up the world and allows people independence in life necessities such as traveling to the
doctor and shopping for food. It enables participation in that which creates a full life,
such as visiting family and friends or attending a place of worship.
C.A.R.E. also recognizes that governmental financial limitations necessitate ensuring that
travelers use the most appropriate services to ensure their maximum independence. It is
through the high standard of customer service and high quality paratransit determinations
that C.A.R.E. distinguishes itself.
C.A.R.E. Evaluators, Inc. was founded by David T.W. Lee, Physical Therapist and Chief
Executive Officer. C.A.R.E. Evaluators, LLC was created in January 2003 to consolidate
C.A.R.E. Physical Therapy and C.A.R.E. Worksite Evaluators, which had been operating
for the prior fifteen years and seven years respectively. C.A.R.E. Evaluators incorporated
in January 2015. C.A.R.E. is a certified Disadvantaged Business Enterprise (DBE), Small
Business Enterprise (SBE), and Minority Business Enterprise (MBE).
C.A.R.E. entered the mobility management industry when it obtained its first contract for
ADA Paratransit Eligibility Appeals in 1994. C.A.R.E. obtained its first ADA Paratransit
Evaluations contract in 2004 and its first Travel Training contract in 2005 with Access
Services, Los Angeles, CA. C.A.R.E. has grown since that time to become the industry
leader in mobility management services and software.
C.A.R.E.'s mailing address is 27068 La Paz Rd. Unit 415, Aliso Viejo, CA 92656.
C.A.R.E.'s corporate address is 27772 Manor Hill Rd., Laguna Niguel, CA 92677.
C.A.R.E. performs work at several primary and off -site locations in throughout California
and Arizona.
The Northern California office, which has been open since July 2013, is at 890 Cowan
Rd. Suite J, Burlingame, CA 94010. C.A.R.E. currently provides paratransit services for
Santa Rosa at the Transit Center 45 Stoney Point Road, Santa Rosa, CA 95401 and for
Petaluma at the Petaluma Community Center 320 N. McDowell Blvd., Petaluma, CA
94954.
9R
C.A.R.E. has performed over a half million functional assessments including applicant
recertification evaluations since July 2004. We continuously strive to improve the
quality and efficiency of our eligibility assessment and determination process.
A corporate organization chart with staff associated with the Santa Rosa and Petaluma
contracts is included below.
�y�w^
L Business Manager
& Andrea Dee
r
Bo-okkeepn�
John Low
I
fhtefCperairons � ��d Techm I SnNub—
E� Cfficar AMC J Iilumtnou�
Cynthia Bullcci.
y Executive
z Admimst trve Assistant
Supernsor
Jesse Bullack
April Kelley
Financial Capacity
Chief Exetutive
Dicer
David Lee
Regional Dtf-
Manager
Christine Cuevas
Evaluator Evaluator.
Valerie'Raven" Danielle'Forest`
Mchtler. EGestnne
s
Independent .. Human Resources Conirarted �
Accountant Idamneo EnG �� Legal
Chns t•N r Russ I Davrs �� Vtilham Glasser i
Customerservice Lead COStomer
Service
Cheryl Macaraeg Karis Zaldivar
C.A.R.E. considers company financial information that supports financial stability to be
confidential to C.A.R.E. and to the authorized proposal evaluators only. Therefore, the
financial information is submitted as a separate attachment, "C.A.R.E. Confidential
Appendix A ", that we request be held in confidence and that we designate as to not be
publicly shared without written permission fi-om C.A.R.E. The attachment for C.A.R.E.
contains a financial compilation completed by Independent Certified Public Accountant
Chris Mizar for the final year before incorporation for C.A.R.E. Evaluators LLC and
includes January — December, 2014. In addition, the C.A.R.E. tax return Schedule C
(Profit and Loss for Business — Sole Proprietorship) for 2013 is included.
C.A.R.E. Evaluators Inc. and C.A.R.E. Evaluators, LLC have had no bankruptcies, no
contract defaults, and no violations of regulatory acts.
17
Below please find copies of letters of credit reference showing C.A.R.E. in good standing
with three of C.A.R.E.'s largest vendors: Illuminous, AMC, and Thrive Now Consulting.
W
illuminous
ENTERPRISES
To whom ft may oorimn,
Ad*ftsl
I am used to provide information m9arding the credit account of CARE Evaluators Inc- (CARF) located
at 27068 La Paz Rd, Unit 415s Allso Mejo, CA, 92656.
CARE has been a great custornor with an a)rwlAnt ctoditfilatoly with us, IllumWoj
s Enterprises, Irw. haB
been wracing QARE's scfhh-are development and support needs for over 10 years (skies 2004). CARE
has been inn exempbry customrviho has always paid em time-
Our proceeds from CARE have exreaded $100,000 annually (of- at least the past five {6} years,
Please lot me know If you have any question'
Sincerely,
Samson Kung
President
wQtx
;15ij VO4;trO
19
�04w-
BUSINESS BUILDING TECH NOI GY.
October 19,2015
To Whom It May Concern;
I any pleased to provide a credit reference for Care. Evaluators,
Care is one of our mostrespected andrallable clients. We have had a working relationship
since 2013 at-which time we became their full service IT partaer. We view this account
favorably and are confident theyare a reliable customer.
As the services provided to fliern have increased, so has their
.Pnthly invoiced amount and
currently they are Invoiced over $7,000 per month and have always paid their Invoices
promptly and on time,
I strongly recommend Care Evaluators as a candidate for any credit opportunities,
Sincerely
Anthony Chiappetta
President
Advanced Microcomputing Concepts, Inc.
550 W. Cienega Ave, Sultel-I 1 San DIMS, CA 91-773 IT.909,592,0222 JR909592.0210
20
Credit Reference Letter
Date! 10/18/15
R& CrEdit Reference forCUE Evaluators, LLC
To whom It may concern,
Since 2008,1 have personally worked with David Lee of CA 13F Evaluators an various is format
print and Insta.11ation projects throughout several major cities.. for each of these projects, the
total Invoice amounts have always ennded $26,000. My client fialbeen extended a line of
credit exceeding the total Invoice amounts.
in goer seven years working with David Lee of CARE Evaluators My company has never had a
problem in receiving payments for invoices. in fact, his careful attention to prompt payment
has made a naficeaole Wifference in comparison with other clients.
If ycu need any invoices or records, I would be happy to help assist you 16 the matter,
Best regards,.
Cary Bray
Chief Ex�utive GMw, Thriw Now CoristAting
(714) 865-724S I thTiVenOWCOAS? .liting@RMail.COM
,thrive Now Consulting I Cory Bray, Chief Of Execulive
I ffievir
thriv(,,novvconsultii3q@gtnaii,com I wk�v .tlirivetioNconsultiriq,c-om
Direct: (714) 865-7248
21
Customer References
Access Paratransit
Geoffrey 01<amoto, Eligibility Manager
633 W. 5th Street
Los Angeles, CA 90071
(213) 270 -6000
Paratransit Evaluation, Marking and Tethering, Call Center (concluded), Travel training
(concluded), ASMS software
Current contract 2008, three years with seven one -year options
Original Contract 2004 — 2007
SamTrans
Tina Dubost, ADA Paratransit Administrator
1250 San Carlos Ave.
San Carlos, CA 94070
(650) 508 -6247
Paratransit Evaluation, Marking and Tethering, Call Center, Travel Training identification, ASMS
software
Current Contract 2015 -2020
Prior contract 2010 -2015
OCTA ACCESS
Gracie Davis, Eligibility Administrator
550 S. Main Street, 11th Floor
Orange, CA 92863
(714) 560 -5641
Paratransit Evaluation, Call Center, Travel Training referral, ASMS software
Current Contract 2006, five years with three one -year options
Company Experience
C.A.R.E. is a consulting company specializing in providing functional and health related
evaluations and services for public and private organizations in the following areas:
Paperless in- person paratransit eligibility evaluations services for
• Access Services Los Angeles County, CA since 2004 at a 19,000 square foot
facility
IIX
• SamTrans in the Sam Mateo County, CA since 2010 with a continuation of
services with a new 5 year contract award in 2015 at a 4,500 square foot
facility
• Orange County Transportation District (OCTA), CA Evaluation Center since
2006 at a 7,600 square foot facility
• Valley Metro in the City of Phoenix, AZ since 2011 at 9,000 square foot
facility
• Sonoma County, CA since 2012
• Solano Transportation, CA since 2013
C.A.R.E. is the current provider of paratransit services for the City of Santa
Rosa, MV Transportation Paratransit Evaluation Center, CA since 2007 and
City of Petaluma, CA since 2013.
Marking and Tethering for:
• Access Services since 2008
• Valley Metro since 2014
Travel Training for:
• Valley Metro since 2011
• Access, Los Angeles 2005 -2007
C.A.R.E. also provides evaluations and training for public and private
organizations to provide corrective measures that improve their employees'
comfort and ability to perform their work duties. Our clients include the City of
Glendale, the City of Long Beach and other private and public entities.
C.A.R.E.'s transit skill functional evaluations are comprehensive, ADA compliant, and
reliable using an internally developed standardized protocol. This unique protocol
produces functional assessments that are reproducible in any setting or location.
C.A.R.E.'s eligibility determinations are reported within the ADA time fi•ame and are
legally defensible.
C.A.R.E. uses a custom- designed software system, Access Services Management System
(ASMS), to manage its operational and administrative processes relating to paratransit
eligibility. This custom software enhances data management capabilities, allowing the
ability to review cases and eligibility decisions in each category. C.A.R.E.'s ASMS
software keeps each applicant's documentation and information in electronic files,
enabling a streamlined environmentally responsible paperless system. This system
allows customers to manage, review, or print applicant - related information at their
desktop.
C.A.R.E. has a long history of successful reviews by the Federal Transportation
Administration. C.A.R.E. recently underwent a routine FTA review at one of its facilities.
23
The FTA reviewers gave a glowing report on C.A.R.E.'s process and remarked several
times about the high quality of customer service and the caring and connection that the
C.A.R.E. employees demonstrated with the applicants.
Staff Experience
Our highly qualified Evaluator staff possesses extensive training and experience working
with people with disabilities. Each evaluator undergoes an extensive training program on
certification processes so that each staff member possesses a thorough understanding of
ADA requirements, the Santa Rosa and Petaluma ADA eligibility certification process,
and the transit needs of the community.
C.A.R.E. currently provides paratransit eligibility services for Santa Rosa at the Transit
Center and for Petaluma at the Community Center.
24
Process
Three Part Process Overview
In- Person Evaluation
z
The process begins when a potential applicant contacts the Call Center. At this
stage, initial information is exchanged between a client and C.A.R.E. Evaluator
staff. C.A.R.E. takes the time for excellent customer service at the Call Center, so
that customers are thoroughly informed of the evaluation process and can decide
to either make an appointment or discontinue the appointment process. This
results in time savings for clients and cost savings for Santa Rosa and Petaluma.
All applicants are evaluated individually. In- person functional assessments are
performed by Evaluators. The In- Person Evaluation consists of three stages:
Stage I Initial Processing, Stage II Interview, and Stage III Functional Testing.
Evaluators continue with the transit evaluation until they have sufficient
information to make an eligibility determination. Once the Evaluator has
sufficient information, the in- person evaluation and functional testing are
complete and on -site processing are complete.
After the conclusion of the three in- person stages, a determination for services is
made by the Evaluator. Once the determination is made, an internal Quality
Assurance review is conducted by C.A.R.E. For Petaluma only, after the
determination is complete, Petaluma staff are informed through email that the
day's batch is ready for their review through ASMS. Once approved or modified,
Petaluma inputs the determination into the Regional Eligibility Database (RED).
For Santa Rosa, C.A.R.E. inputs the determination into the Regional Eligibility
Database (RED) and a report is emailed to the transit provider. The newly
established ID for the customer is then input by the C.A.R.E. customer service
department into ASMS, and the determination letter and ID Cards are generated
and sent.
P41
Recertification
Santa Rosa
The current process of renewal -by -mail for Unrestricted, Conditional, and Trip -
by -trip will be changed under the direction of the RFP page 15 to In- person
evaluation for these determination types. Under this process, C.A.R.E. will send a
45 day notice before the expiration date. With the exception of Temporary
designation, this will occur three years after they were determined eligible.
Applicants will be instructed to contract the Call Center to make an appointment
for in- person evaluation.
Petaluma
C.A.R.E. sends a 45 day notice of expiration as a contact to reschedule for
evaluation for all determination types. With the exception of Temporary
designation, this will occur three years after they were determined eligible.
Applicants are instructed to contact the Call Center to make an appointment for
in- person evaluation.
Current Staff
Regional Program Manager
The Regional Program Manager is based in the Burlingame office and is
responsible for day -to -day operations. They maintain consistent and sufficient
communication with Santa Rosa and Petaluma to ensure smooth coordination.
They work with C.A.R.E's CEO, COO, and Business Manager to receive support
for the implementation of the project. They demonstrate competency in the
eligibility process including knowledge ofADA rules and regulations, ASMS
functionality, and workflow. They supervise staff and allocate resources for
performance of the work. The Regional Program Manager is responsible for
recruiting, hiring, and gaining or arranging staff training.
Current Regional Program Manager — Christine Cuevas
Transit Evaluators
C.A.R.E. provides qualified Evaluators to meet the requirements involved with
conducting paratransit eligibility evaluations. Evaluators possess excellent
interaction skills with people of varying cognitive and physical abilities,
documentation skills, and excellent written and oral communication skills.
Tasks include:
Ii
I. Greeting applicants as they arrive and also ensure that they depart
safely.
2. Conducting check -in process (collect and scan documents, verify
identification, take photo, process consent forms).
3. Conducting in- person interview of applicants to identify their
functional transit abilities.
4. When appropriate, perform in- person functional evaluation of the
applicant's ability to use public transportation.
5. Providing recommendation of the eligibility determination for
paratransit for the applicant based upon physical, visual, and cognitive
evaluation.
6. Providing a report that clearly documents the eligibility determination
and includes supportive information.
7. Conducting peer review for duality of determination.
Qualifications include:
I. An associate or bachelor's degree in an allied health, mental or
behavioral health, or special education field, or a degree in Orientation
and Mobility.
2. Two years of experience in rehabilitation, or a job related to evaluating
the functional abilities of individuals with varying disabilities.
3. Familiarity with functional and cognitive abilities, their prognosis and
medications.used to treat individuals with a wide range of disabilities.
4. Ability to assess the individual's interaction with environmental
barriers.
5. Ability to assess the individual's interaction with the various
components of a transit system required for successful access and use
of fixed -route services, fare boxes, timetables, and route descriptions.
6. Knowledge of ADA paratransit eligibility criteria and service
requirements.
7. Familiarity with all fixed -route services.
8. Sensitivity to people with disabilities, including physical and cognitive
disabilities.
9. Ability to communicate effectively in- person and in writing.
Current Staff:
o Valerie "Raven" Wachtler
• Danielle "Forest" Firestone
Customer Service Representative
Call Center
1. Receive calls from individuals seeking appointments.
27
2. Determine if language accommodations are needed and, if so, schedule
interpreter service.
3. Maintain the schedule and provide callers with an initial morning or
afternoon appointment time.
4. Work with the transportation provider(s) to arrange transportation to and
from the Evaluation Facility.
5. Monitor the status of scheduled rides, and work with the transportation
provider(s) dispatchers and staff as needed.
6. Appointment verification calls when necessary.
7. Assist with other administrative tasks as needed.
8. Reviews all eligibility evaluations to ensure complete and well - supported
documentation of evaluation reports.
Records
1. Create ID card.
2. Mail determination letter and ID card.
3. Provide backup and break coverage for the Call Center.
4. Provide backup for Stage 1 Evaluation in case of unexpected staff
absence.
Current Staff:
o Cheryl Macaraeg (Call Center)
o Karis Zaldivar (Lead)
Facility Location
C.A.R.E. currently conducts in- person Rinetional assessments at the Santa Rosa
Transit facility located at 45 Stony Point Road, Santa Rosa, CA 95401 and at
Petaluma Community Center 320 N. McDowell Blvd., Petaluma, CA 94954.
These facilities meet ADA requirements and provide the following:
1. One room for registration and application data intake, and one room to
conduct private interviews with paratransit applicants during the in- person
functional assessment
2. A large parking area, including convenient handicapped parking that can
accommodate delivery and pick up of applicants
3. A fi•ont lobby that can be used as a comfortable waiting area, with ADA
compliant restrooms, where applicants can wait before and after their in-
person functional assessments
4. An overall safe, professional, and clean facility and environment
5. Testing environments located around the buildings that can be used to safely
test transit skills
6. Air conditioning and heating for the comfort of the applicants and our
employees
28
C.A.R.E. currently equips the evaluation site with all necessary testing
equipment for in- person interviews and outdoor functional testing
assessments.
Under this proposal, Santa Rosa and Petaluma agree to provide facilities,
whether the current facilities or another, that are ADA compliant and mutually
agreed upon.
AN
Cost Proposal
Attachment B -1: Cost Proposal for City of Santa Rosa
Year One Annual Total
a. Monthly Administrative Costs (fixed Costs)
$ 4,907 per month x 12 months $ 58,888
One -Time Cost $ 1,750
b. Variable Costs (Operations)
$ 1,275 Per month x 12 months $ 15,303
SUBTOTAL FOR YEAR ONE $ 75,941
The cost proposal must include all costs incurred by Contractor in providing
the services contemplated under this Agreement.
Authorized Signature
Title Chief Executive Officer
C.A.R.E. Evaluators, Inc.
Date October 26, 2015
Phone Number 949.230.1792
Email david @careevaluators.com
Fax Number 949.448.8037
30
Attachment B -1: Cost Proposal for City of Santa Rosa
Year Two Annual Total
a. Monthly Administrative Costs (fixed Costs)
$ 5,055 per montl x 12 months $ 60,655
One -Time Cost $ -
b. Variable Costs (Operations)
$ 1,314 Per month x 12 months $ 15,762
SUBTOTAL FOR YEAR TWO $ 76,417
The cost proposal must include all costs incurred by Contractor in providing
the services contemplated underthis Agreement.
Authorized Signature
Title Chief Executive Officer
C.A.R.E. Evaluators, Inc.
Date October 26, 2015
Phone Number 949.230.1792
Email davidl@careevaluators.com
Fax Number 949.448.8037
31
Attachment B -1: Cost Proposal for City of Santa Rosa
Year Three Annual Total
a. Monthly Administrative Costs (fixed Costs)
$ 5,206 per montr x 12 months $ 62,475
One -Time Cost $ -
b. Variable Costs (Operations)
$ 1,353 Per montl x 12 months $ 16,235
SUBTOTAL FOR YEAR THREE $ 78,710
The cost proposal must include all costs incurred by Contractor in providing
the services contemplated underthis Agreement.
Authorized Signature
Title Chief Executive Officer
C.A.R.E. Evaluators, Inc.
Date October 26, 2015
Phone Number 949.230.1792
Email david(@careevaluators.com
Fax Number 949.448.8037
32
Cost Proposal Detail for City of Santa Rosa - BAFO
Fixed Costs
Management Wages
Management Benefits
Evaluation Staff Wages
Evaluation Staff Benefits
Customer Service Staff Wages
Customer Service Staff Benefits
Performance Bond
Office Supplies
Materials and Supplies
Facility Costs
Other Equipment
IT, Transportation & Travel, Telephone, Translation, Recruiting, Utilities
Year One Year Two Year Three Total
$ 6,609
$
6,807
$
7,012
$
$ 1,069
$
1,101
$
1,135
$
$ 864
$
890
$
917
$
$ 277
$
285
$
294
$
$ 13,570
$
13,977
$
$ 3,010
$
3,100
$
5,360
335
$
977
$ 1,734
$
1,786
$
$ 316
$
325
$
$ 168
$
173
$
$ 16,531
$
17,027
$
20,428
3,305
2,671
855
41,944
3,193
$
9,303
36.79 1
$
37.89 1
1,840
$
5,360
335
$
977
178
$
519
17,538
$
51,096
Insurance $ -
One -Time Start -up Costs - ID card machine $ 1,750 $ - $ - $ 1,750
Management Fee & Profit $ 14,740 $ 15,183 $ 15,638 $ 45,561
Subtotal - Fixed Costs $ 60,638 $ 60,655 $ 62,475 $ 183,768
Hourly rate for Evaluators
1
$
36.79 1
$
37.89 1
$
39.03
Variable Budget
1
$
15,3031
$
15,762 1
$
16,235 1
$ 47,300
Total Budget
$
75,941
$
76,417
$
78,710 $ 231,068
Monthly Fixed
$
4,907
$
5,055
$
5,206
Assumes 300 -500 applications per year for each year
is]
Cost Proposal Detail for City of Santa Rosa
Fixed Costs Year One Year Two
Year Three
Total
Management Wages
$
6,609
$
6,807
$
7,012
$
20,428
Management Benefits
$
1,069
$
1,101
$
1,135
$
3,305
Evaluation Staff Wages
$
864
$
890
$
917
$
2,671
Evaluation Staff Benefits
$
277
$
285
$
294
$
855
Customer Service Staff Wages
$
17,844
$
18,379
$
18,930
$
55,152
Customer Service Staff Benefits
$
3,955
$
4,074
$
4,196
$
12,225
Performance Bond
$
-
$
-
$
-
$
-
Office Supplies
$
1,734
$
1,786
$
1,840
$
5,360
Materials and Supplies
$
316
$
325
$
335
$
977
Facility Costs
$
168
$
173
$
178
$
519
Other Equipment
$
16,531
$
17,027
$
17,538
$
51,096
IT, Transportation & Travel, Telephone, Translation, Recruiting, Utilities
Insurance
$
-
One -Time Start -up Costs - ID card machine
$
1,750
$
-
$
-
$
1,750
Management Fee & Profit
$
16,468
$
16,962
$
17,471
$
50,901
Subtotal - Fixed Costs
$
67,585
$
67,810
$
69,844
$
205,239
Variable Costs
Hourly rate for Evaluators
$
36.79 1
$
37.89 1
$
39.03
Variable Budget
$
15,303 1
$
15,7621
$
16,235
1 $
47,300
Total Budget
Monthly Fixed
Assumes 300 -500 applications peryearfor each year
$
$
82,888
5,486
$
$
83,572
5,651
$
$
86,079
5,820
$
252,540
34
Attachment 13-1: Cost Proposal for City of Petaluma
Best and Final Offer
Year One Annual Total
a. Monthly Administrative Costs (fixed Costs)
$ 2,596 per month x 12 months $ 31,154
One -Time Cost $ 1,166
b. Variable Costs (Operations)
$ 956 Per month x 12 months $ 11,477
SUBTOTAL FOR YEAR ONE $ 43,798
The cost proposal must include all costs incurred by Contractor in providing
the services contemplated underthis Agreement.
Authorized Signature
Title Chief Executive Officer
C.A.R.E. Evaluators, Inc.
Date October 26, 2015
Phone Number 949.230.1792
Email david(@careevaluators.com
Fax Number 949.448.8037
35
Attachment B -1: Cost Proposal for City of Petaluma
Best and Final Offer
Year Two Annual Total
a. Monthly Administrative Costs (fixed Costs)
$ 2,674 per montl x 12 months $ 32,089
One -Time Cost $ -
b. Variable Costs (Operations)
$ 985 Per montf x 12 months $ 11,822
SUBTOTAL FOR YEAR ONE $ 43,911
The cost proposal must include all costs incurred by Contractor in providing the
services contemplated underthis Agreement.
Authorized Signature
Title Chief Executive Officer
C.A.R.E. Evaluators, Inc.
Date October 26, 2015
Phone Number 949.230.1792
Email david(@careevaluators.com
Fax Number 949.448.8037
Attachment B -1: Cost Proposal for City of Petaluma
Best and Final Offer
Year Three Annual Total
a. Monthly Administrative Costs (fixed Costs)
$ 2,754 per montl x 12 months $ 33,052
One -Time Cost $ -
b. Variable Costs (Operations)
$ 1,015 Per montl x 12 months $ 12,176
SUBTOTAL FOR YEAR ONE $ 45,228
The cost proposal must include all costs incurred by Contractor in providing the
services contemplated under this Agreement.
jAuthorized Signature
Title Chief Executive Officer
C.A.R.E. Evaluators, Inc.
Date October 26, 2015
Phone Number 949.230.1792
(Email david(@careevaluators.com
Fax Number 949.448.8037
9YA
Cost Proposal City of Petaluma - BAFO Restructred and Summarizeds by Fiscal Year
91,11
FY 16
FY 17
FY 18
FY 19
Feb. 1, 2016-
June 30, 2016
July 1, 2016-
June 30, 2017
July 1, 2017-
June 30, 2018
July 1, 2018 -
Jan. 31, 2019
Total
Fixed Costs
Management Wages
$ 1,652
$ 4,015
$ 4,136
$
2,454
$
12,257
Management Benefits
$ 262
$ 637
$ 656
$
389
$
1,945
Evaluation Staff Wages
$ 180
$ 437
$ 451
$
267
$
1,335
Evaluation Staff Benefits
$ 58
$ 140
$ 144
$
86
$
428
Customer Service Staff Wages
$ 3,070
$ 7,461
$ 7,685
$
4,560
$
22,777
Customer Service Staff Benefits
$ 684
$ 1,662
$ 1,712
$
1,016
$
5,074
Performance Bond
$ -
$ -
$ -
$
-
$
-
Office Supplies
$ 463
$ 1,125
$ 1,159
$
688
$
3,435
Materials and Supplies
$ 83
$ 200
$ 206
$
123
$
612
Facility Costs
$ 57
$ 139
$ 143
$
85
$
423
Other Equipment
$ 3,214
$ 7,809
$ 8,044
$
4,773
$
23,840
IT, Transportation& Travel, Telephone, Translation, Recruiting, Utilities
$ -
$ -
$ -
$
-
$
-
Subtotal
$ 9,723
$ 23,627
$ 24,335
$
14,441
$
72,126
Insurance
$ -
$ -
$ -
$
$
-
One -Time Start-up Costs- ID Card Machine
$ 1,166
$
$ -
$
$
1,166
Management Fee & Profit
$ 3,258
$ 7,918
$ 8,155
$
4,839
$
24,170
Subtotal - Fixed Costs
$ 14,148
$ 31,544
$ 32,490
$
19,280
$
97,462
Variable Costs
$ -
$ -
$ -
$
-
$
Hourly rate for Evaluators
$ 37
$ 75
$ 77
$
39
$
227
Variable Budget
$ 4,782
$ 11,621
$ 11,969
$
7,103
$
35,475
Total Budget
$ 18,930
$ 43,165
$ 44,460
$
26,383
$
132,937
91,11
Cost Proposal Detail for City of Petaluma - BAFO Restructured
Quote Year 1 1 Quote Year 2 Quote Year 3
FY 16 FY 17 FY 18 FY 19
Feb. 1, 2016- July 1, 2016- Feb. 1, 2017- July 1, 2017- Feb 1, 2018- July 1, 2018 -
June 30, 2016 Jan. 31, 2017 June 30, 2017 Jan. 31, 2018 June 30, 2018 Jan. 31, 2019
Fixed Costs 5 months 7 months 5 months 7 months 5 months 7 months
Total
Management Wages
$
1,652
$
2,313
$ 1,702
$
2,383
$
1,753
$ 2,454
$ 12,257
Management Benefits
$
262
$
367
$ 270
$
378
$
278
$ 389
$ 1,945
Evaluation Staff Wages
$
180
$
252
$ 185
$
260
$
191
$ 267
$ 1,335
Evaluation Staff Benefits
$
58
$
81
$ 59
$
83
$
61
$ 86
$ 428
Customer Service Staff Wages
$
3,070
$
4,299
$ 3,163
$
4,428
$
3,257
$ 4,560
$ 22,777
Customer Service Staff Benefits
$
684
$
958
$ 705
$
986
$
726
$ 1,016
$ 5,074
Performance Bond
$
-
$
-
$ -
$
-
$
-
$ -
$ -
Office Supplies
$
463
$
648
$ 477
$
668
$
491
$ 688
$ 3,435
Materials and Supplies
$
83
$
116
$ 85
$
119
$
88
$ 123
$ 612
Facility Costs
$
57
$
80
$ 59
$
82
$
60
$ 85
$ 423
Other Equipment
$
3,214
$
4,499
$ 3,310
$
4,634
$
3,409
$ 4,773
$ 23,840
IT, Transportatlon & Travel, Telephone, Translation, RecruAing, Ulif6es
Subtotal
$
9,723
$
13,612
$ 10,015
$
14,020
$
10,315
$ 14,441
$ 72,126
Insurance
One -Time Start -up Costs- ID Card Machine
$
1,166
$
-
$ -
$
$
-
$ -
$ 1,166
Management Fee & Profit
$
3,258
$
4,562
$ 3,356
$
4,698
$
3,456
$ 4,839
$ 24,170
Subtotal - Fixed Costs
$
14,148
$
18,174
$ 13,371
$
18,719
$
13,771
$ 19,280
$ 97,462
Variable Costs
Hourly rate for Evaluators
$
36.79
$
36.79
$ 37.89
$
37.89
$
39.03
$ 39.03
Variable Budget
$
4,782
$
6,695
$ 4,926
$
6,896 1
$
5,073 1
$ 7,1031
$ 35,475
Total Budget $ 18,930
Monthly Fixed $ 2,596
Assumes 200 -300 applications peryearfor each year per page 23
$
$
24,869
2,596
$ 18,296
$ 2,674
$
$
25,615
2,674
$
$
18,845
2,754
$ 26,3831
$ 2,754
$ 132,937
Additional Information
Reporting Process
C.A.R.E. communicates through email with Petaluma when a batch of evaluations is
ready to review. Authorized managers may review applicant materials through a
dedicated and password secured website using C.A.R.E.'s ASMS system.
The Client Determination report generated from the Regional Edibility Determination
(RED) system is eJnailed to, the transit provider after each upload.
39
C.A.R.E. prepares a Management Statistical report which is included with the monthly
invoice. Authorized managers at Santa Rosa and Petaluma have access to ASMS for
generation of ad hoc reporting at any time.
Management Statistical Report
The Management Statistical Report is currently submitted in hard copy with the invoice.
The report includes:
• Number of applicants interviewed
• Number of new, re- certifying and "renew -by -mail" applicants processed
• Number of each type of determination
• Number of applicants referred to Travel Training
• Number of applicants for whom an environmental analysis was performed
• Average processing time
Upload Table
C.A.R.E. also provides monthly an electronic copy of the Upload Table to Petaluma with
the invoice. The Upload Table shows the daily number of evaluations completed and
uploaded. This report can also be downloaded at any time.
Please see samples of these reports under the separate C.A.R.E. Confidential Appendix
A.
C.A.R.E. prepares and submits a completed evaluation for each application processed
and /or applicant interviewed. Each completed evaluation includes complete answers to
each evaluation question asked by the Evaluator during the in- person functional
assessment, a detailed written explanation of the basis for the eligibility determination,
and the eligibility recommendation. The completed evaluation report is in a .pdf format
and may be accessed by authorized managers through a dedicated and password - secured
website using C.A.R.E.'s ASMS system.
Santa Rosa and Petaluma each have their own dedicated database of ASMS.
C.A.R.E. is responsible for preparing the letters of determination to be mailed to each
applicant using the currently provided format and text for the determination letters.
C.A.R.E. mails the letters of determination and photo ID cards (for approved applicants
only) to the applicants.
Rider Profile Report
IN
The Rider Profile Report is submitted electronically via ASMS and is accessible at any
time upon completion of evaluation. The Rider Profile Report includes the following
information:
• Applicant name
• Applicant ID number
• Application home address, phone, email
• Applicant mailing address
• Applicant emergency contract
• Date interviewed
• Eligibility determination (expiration date, type)
• Mobility device
• Attendant permitted or not
• Special customer needs
• Disability code
• Eligibility detail
• List of people eligible to renew by mail
• List of people referred to travel training
• Summary of customer determination
• Telephone system report
Eligibility Detail Report
An Eligibility Detail Report is submitted electronically via ASMS and is accessible at
any time upon completion of evaluation. This report is commonly referred to as "The
Evaluation ".
The following is included in the Eligibility Detail Report:
• Client code
• Client name
• Type of applicant (new, renewal, renew by mail)
• Interview Date
• Eligibility determination (unconditional, temporary, denied, trip -by -trip,
conditional)
• Renewal by mail designation
• Travel gaining referral
• Eligibility expiration date
• The date the letter was mailed is the same date as printed
In addition to these, there are numerous reports that are available at any time to
authorized account users. Upon request, custom reports can be created querying any of
the fields as currently programmed in ASMS for no additional fee.
Custom reports that require software modification can be created for an additional
programming fee.
41
Emergency Procedures
Applicant Injin-y
After the initial assessment of the severity of an injury, the Evaluator will ask the
applicant if they need further assistance. Only minor first aid will be provided by the on-
site staff member. The Evaluator will contact 911 should further assistance be needed. If
the applicant refuses professional assistance though the Evaluator believes it may be
needed, a Release of Medical Assistance form will be presented to the applicant. The
Evaluator is authorized to contact emergency services based upon their own judgement
regardless of refusal of emergency services. All injuries are immediately reported to the
Regional Program Manager by phone and then followed up with a written Incident
Report. The Incident Report is forwarded by the Manager to the Petaluma Senior Transit
Specialist, and at Santa Rosa to the Transit Division Manager.
Evacuation Emergency
Staff follows the building protocol at the location. C.A.R.E. requests inclusion in safety
drills when possible. The staff is aware of exit routes. The Region Program Manager is
immediately contacted and a written Incident Report is completed. If there are no
injuries, all applicants are released immediately. If there are applicant injuries, the
Applicant Injury procedure is followed.
42
Name Of Persons Involved (Inctu" 1D# of Applicant);
I Location Of Inddent:
(De--v-ribe In Detail):
1911 Called- 0
vibe in Detail); . . .
I Name- - -- - 11h;
Refuwd by Applicant El
Name'.. Phone,
54griature of Person Filing Report: Date:
Signature of Manager,. Date:
Signature of SarnTrans ADA Admi0strator, Date:
43
Attachments
'J. RFP CHECKLIST FORM
L,4W below are -a (IMMents that are required to be submitted as part of a
questfor proposal. Mte "yW onme blank space. if you have
Included those items forsubmittal of your RFP.
-yes Cost Proposal for City of Santa Rosa (ATTACHMENT B-1)
—, — , , oposal worksbeet for City of Santa Rosa (ATTACHMENT B
�fts cost Proposal for City of Petaluma (AiTACHMEINT B-2)
Y6 Cost Rropo"I Workshett for City of Petaluma (ATTACHMENT 0-2)
�n�roposees Designated Contact List tATTACCHMENT F)
—Receipt of Addenda Form (if issued)
Y" Technical Information RelatWa to RFP
to insurance requirements as outlined In ATTACHMENT C-1
eement to insurance requirements as outlined in ATTACHMENT C-2
��Dlsclosure- ofSovernmental Positions (ATTACHMENT G)
44
Attachment C -1
C.A.R.E. Evaluators shall maintain insurance as specified in the contract with the City of Santa
Rosa during the period of performance specified. Proof of insurance is available upon request
for the following:
• General Liability including products liability and completed operations, and contractual
liability coverage $1,000,000
• Worker's compensation
• Professional Liability; $1,000,000
• Business Automobile Insurance; covered under general liability
• Deductible /Self- Insurance Retention — Bond will be procured after contract award
David Lee — C.E.O. C.A.R.E. Evaluators, Inc.
Attachment C -2
C.A.R.E. Evaluators shall maintain insurance as specified in the contract with the City of
Petaluma during the period of performance specified. Proof of insurance is available upon
request for the following:
• General Liability including products liability and completed operations, and contractual
liability coverage $1,000,000
• Worker's compensation
• Professional Liability; $1,000,000
• Business Automobile Insurance; covered under general liability
• Deductible /Self- Insurance Retention — Bond will be procured after contract award
David Lee — C.E.O. C.A.R.E. Evaluators, Inc.
45
ATTACHMENT E.- PROPOSERS REFERENCE FORM
)Uorklaccumplished by (twowbO best fflluaraies culip-ol qualfficAtiorls relevant 10 W3. PLDJeM
Job Desvipljup
Time to Cotta #eee tob--
,w 15 to 20n
'iliall
fjt Tmm
t� 8" �Nlat t, GA
Contact Marie and TWePhone No,
,itf!#DuboM; AOA PWalranI4 6W 508 6Z47
job Nurlptivn
ey4kigations, ?Awj -T), wid AS!
far's ant? jMA MS SQAwW#
-ContrattAropuot
papttf:apso 22 fr-Wwm NAAT 1, 1 miWon
time w coniplete Job
Owner and Lutalion
Accom RwaivatA, LL-� Anq&Ws. GA
"am* and'relephone No,
?e7
651 M98
Job Descliptlamn
PatamamA, ilvaju*ws, —
CoatoctAmwnl
il-f—Affiorl
Time to compketi, Job
2011 to 2016
uwnt-r and irptat'on
Q4�TA ACCESS, Aruinvrn CA
Con.ta,d, Name and Telephone No,
Gf aci# 0&4, SlgibiltyAdM ittri%F 714 W-0 W I
U 01 n
job Delcript�on
Pivoraftsix and Trawl TeWnft
Z;Wact A. Unt
S311 W"n
To to to "mplaae Job
2>010 to 9017
aw-ne and wn-atkm
Vgli%q M�jo, FlbovOx , AZ
Coplal Name alit! T*!,,phone No
K7,n-V4Qv+.s, 1 tune t, € 710 2107
Nolk. Itillimponami tho On Platt be camovud Ar'd sru�ntltttd Wilh Your pfopowl. fallwo to pfo*we th* ahave
Lnf0rMA-14&ft 1"rumplete Moll May fAfwif lr* vovr bid n0,lq*lp0aAvC
Irl
ATTACHMENT F-1- PROPOSERS DESIGNATED CONTACTS LIST
Proposers are requfred to indicate In Itle Space provided below the &5ignated tontan
ln.diViduaes name-,
CITY'OF SANTA ROSA
Matthew Wilcox, Transit Planner
Department of Transportation and Public Works, Ttanjif 13iv1sicil
100 Santa 1105a Avenue-, Room 6
Santa RosgA, CA 95404
Phone,' (707) 543,3335
Fax-1 (707) 543 -332&
Email: mwil
CON"Ma0ft
Name/Title:
Corhpany. Ja A-R E E,4,qalors fncv,
0 R-0 , 5
Strut: ad,U-41-
City, State, Zip. Arlso Vvia, CA M56-�N I
Phone, $,-6 40 i7oP
FaX, R49 448 8&37
Email:
Co m p a n -
y
Street!
city, state Zip:
Mono,, '32MM9445
Email;
N.arne/nt4e, Andma Dee-, financialhianager
compziny. 'CA-RE
Street: 27 LA Paz AOM� Ljnit 1115
City, State, zip- AwVWo, OA026i joii
Phone.
Fax�
Email.
47
ATTACHMENT F- 2: PROPOSERS DESIGNATED CONTACTS LIST
Propol-wis are required to indicate In the space piovidud below the designated contact
individual's name:
CITY OF SANTA ROSA
Emily Betts. Senior Transit Specialist
Department of Public Wlork�-, Transit Division
SS5 N. McDowell Fflvd
Petaluma. CA 94954
Phone. (707) 776-3711
Fax: (701) 4162325
FMOH_t!�I�tj�LWQ e't I
a 41
CONTPACTOR
Company. CA R _ EvaluaLms- kn
Street.
City, State, Zip: k-.aaLyr CASMF_30 1
Phone, i 17
Fax:.94944880a-f
Email:
J71 f
MOP_ _5,14apa'QW
C o mpany;
I - . __ _G&R E_ Evatualom Irv-,
stfeetA a9tio C-0-44n 84ag j
City! -State, ZIP: RUMIDQ31r,%i LALI
Phone-. 12114'05445
Fax;
Email,,
Name/Title:
Company, 0 ARE. Evaluatoss, Inc
city_ State� Zlp a n CA 65e 041
Phone, 714�D_',7158
48
Inraloner"grIT altemving to 4)(juome an
vmplcyce AM --ployce of rfiealLi'? Ill confw-(O�n w4'1 Cbtalninx joy � F24pejq
cuntfat:l' gaw al any Ow tvaid Cilvered by 3.1 US,C, 13S2. ta�h Vei joatil akti di,.trose, thit- nlln.e 01, _mq
NVMFOnt %1AdVf lh.a l0blDVing D!FrfaWu� A(l of 15 -95 wh,, has rmdi-i fribUyi.q cbm')'M, an Its aahWvolh nqn-
rejetal rond% with rc-spctt to th-U redzI611 cOn"l at' F'4A-nt'D1 covc,?tW 4y at U<SL: 1352, 'Soch tti€tj-pw'cs
Tare tarwpuw from tief 16 V-8r up tai the fi�r=pknt,
C601000OFT fear COMMU, UFMOS, IVA Cooperathd� AgretMen-ts
the unctefn'tped (conuattot] the bet-tat hh 0" nor VIOML'diru, and bOiO, M*v
No funds have be, cri pa�',J ui rep bt, paricb by or cats b4jh3il o f th JaAf'y
e
vu vv for MuAnting or altemplOV, to rllfusnce .-n Offcer of etnplflypk; of an mi'�Mhef *1 Ccojtlg5t' an
affxpror employee of an emplaper. wa "'Arm 4!�f Ofcongrt-'sin rannettion wilh il* tcv,,4rd tanV
F
Federal contract, iha mg -aff ia t In A Nity 3f Any r e�'�j eral lean, ;f v� or ef Ing � r, to of a ny
kjpIt of 3.1y te , if efAn"
coopera t i Vp alif fient? nt, and the &* tcns ion, "'nli. Lt. ti nn' ran Pik, t, atninid mtht. cri a q Q d i fkai t+o (i of a tly f rat
grant, loa' or coop"t-ativc agfeutu-M.
(21 If any fw1d; other 114,40 £e oral apptopflated fijnk e, hiwt�l beto Paid :)r wint be p" d lu mw P-t wm lot making
lobb,,Ing Lantac%la An offiti*t or ernproyce ofaAyagency, 41 NUmber Dico'n'gri-55, Tq offce( of emplVieeof
OfCorwau ia rag ttftbnftwiIh this, fed-2ral contract, RIAM, i64ft, W
CuOpefatiw agfgem Plitt than ccmpflotR' s-t -,,Awmit Standard Vwm-LIL,
Rt,poitLubbTmg," in accrITOnce With ft$ inslTuctlotis ja5 Amwwk Y,'j `r#3 rpi Pment wfd�e r-50,J111ce for New
ff itnc�ttc 15 ii LaWylifog,' 61 FA, Reg, 1433 (1119196). biaI(` Uqr ttajge Irt puagraph (2) h f,citj has bt-on fna
1n,)cfordaag,o e,,jth 5ocliun to
ofth- LDbbylng MAE, Vitae A t of iPA, H14-65, to bk# at
IOL
(1) 7hp undeWpcd AA f,cocard That thL. lanfflijagL. of thL1 t lj;j
udt d in tits awmd dinswrwrft' for Alf
wbaward at ail tion (IoNuding wbrontfacts, suligrw
A . O
Ond thm WI wbro-cipleats shall ceri Ify and dm;farg a ccufdingfy
Tbis iv lifitation is nifile:65f c if 1�ct upon whxh i Eharur+ pkK'ed wh4l 04 Lt'ansa"lon Wai
into.
tot cach wd farlufe�
(Noko pogwAnt to 31 1,Mc- § 1152()Jjl) (2)tA), arty vt,,5un whu makes a pints bitcd owp-Aditure of 61h, Wile or
wend a rtquotd crutificalron of d[Wolule fa fin shah b# wb�iig,-k to a Civil penalty of not l"s Inon S10,00ujrA not
M,DTe than �IQOQW (Of 0-acil 5imh expendiiwo cat fadur?,j
Th# eonlfactorj�_�^i;R F_ �,,aluatqfj,. f__ celffwi or affirini tw And'ururacy at
eadh 5t•vner"t of il,'l 1st-6fication aAd disclawip, d Any, In acidiflon, the Contractor and ajb"'gs that
thtt ptovWens of at U8,C A 3901, ct Itu" appW to th33 roffifiration and okdapjfc= if afty.
Ind 1111c, of Cov,VAct*t'4 Authofilf,-d Offibal
U1'AW5'T'O'RKq
40 U.SX. 53 5
1B UR M36 (1)
49 CYR 633,17
Access to gegofdt - IN IWAw-Mrri atcp,,• to rp-'Ord'x fr jaaia r,a t .Vrdy Ira I hit rnm Farl
L W be ( 0 1 he flu f Ot*wr I , not 'T SE a3 p b t it a I ofal g avef nrn e n t km d i, tk,. e FT A R p " f"'I t of -1 W Ik I & n I i„ e 0f t hI # I IA
IS 3fli), the iaaiee, jhi;jTA
Atminbu Mar, the Cmplto"Ier Gepoo.l Of tit= un:'jed Swwn *1 qn V of ttw.-,r ioo 11jurived i rpry iir%I;Oiviq +_fc: %o
All j b' 00ks, pllltrry and W fcr thp
purposes offmik:nz auaru, at"d tfar*uip"�apli canv-artot a1w agrpies' PuMuLnt 1049
49
ATTACHMENT G: DISCLOSURE FORM
DISCLOSURE OF r -RNN4[ itAl-POSITiONS
ygY
j- N
The Prospective Contractor hereby dlsclose5 that the following o fivers and empjayeei
, of tke
Contractor currently hold the following positionswt1h the Identified government.41 agency of
hQl-d iuch Pci,,Otlori in the past 12 months
Name of OwnerlEmployee None
Narne of the Governmental Agency UM
Complete Addre-is of Gov@romerit A
gency q1A
Governmental position, (e•g' Director, officer and i0nployee) WA
Firm: N/A
TiTW WA
Date: NIA
DISQUALIFICAWN QUESTIONNAIRE
The Contractor shall complete, under penalty of perjury, the following (100'stionnalre, Has the
Contractor, any officer of Ibt ConkfaLtM orariVeMP10YO ofthe Contractorwho has proprietary
Interest in the Contractor, everT)een disqualified, removal, or otherwk;e prevented from bidding
on, or completing a federal, state, of fecal govaromprIt project because of a Viulation of law or
e af ety regulatio-n?
yes
No x
If the answer is Yes, eXpJain the circuiustartces in the following spate.
Page 75 of 57
III]
INSURANCE REQUIREMENTS
EXHIBIT B -2
Consultant's performance of the Services under this Agreement shall not commence until
Consultant shall have obtained all insurance required under this paragraph and such insurance
shall have been approved by the City Attorney as to form and the Risk Manager as to carrier and
sufficiency. All requirements herein provided shall appear either in the body of the insurance
policies or as endorsements and shall specifically bind the insurance carrier.
Consultant shall procure and maintain for the duration of the contract all necessary insurance
against claims now and in the fixture for injuries to persons or damages to property which may
arise from or in connection with the performance of the Services by the Consultant, the
Consultant's agents, representatives, employees and subcontractors. Required professional
liability insurance shall be maintained at the level specified herein for the duration of this
Agreement and any extension thereof and for twelve additional months following the Agreement
termination or expiration.
A. Minimum Scope of Insurance
Coverage shall be at least as broad as:
1. Insurance Services Office Commercial General Liability coverage:
a. Personal injury;
b. Contractual liability.
2. Insurance Services Office form covering Automobile Liability, code 1 (any auto).
3. Workers' Compensation insurance as required by the State of California and
Employer's Liability Insurance.
4. Professional Liability insurance.
5. Such other insurance coverages and limits as may be required by the City.
B. Minimum Limits of Insurance
Consultant shall maintain limits no less than:
I. General Liability: $1,000,000 per occurrence for bodily injury, personal injury
and property damage. If Commercial General Liability Insurance or other form
with a general aggregate liability is used, either the general aggregate limit shall
apply separately to this Agreement or the general aggregate limit shall be twice
the required occurrence limit.
2. Automobile Liability: $1,000,000 per accident for bodily injury and property
darnage.
3. Employer's Liability: Bodily Injury by Accident - $1,000,000 each accident.
Bodily Injury by Disease - $1,000,000 policy limit.
Bodily Injury by Disease - $1,000,000 each employee.
4. Professional Liability insurance: $1,000,000.
5. Such other insurance coverages and limits as may be required by the City.
C. Deductibles and Self - Insured Retentions
Any deductibles or self - insured retentions must be declared to and approved by the City.
At the option of the City, either: the insurer shall reduce or eliminate such deductibles or
51
self - insured retentions as respects the City, its officers, officials, employees, and
volunteers; or the Consultant shall procure a bond guaranteeing payment of losses and
related investigations, claim administration and defense expenses.
D. Other Insurance Provisions
The required general liability and automobile policies are to contain, or be endorsed to
contain the following provisions:
1. The City, its officers, officials, employees, agents and volunteers are to be
covered as Additional Insureds as respects: liability arising out of activities
performed by or on behalf of the Consultant; products and completed operations
of the Consultant; premises owned, occupied or used by the Consultant; or
automobiles owned, leased, hired or borrowed by the Consultant. The coverage
shall contain no special limitations on the scope of protection afforded to the City,
its officers, officials, employees, agents or volunteers.
2. For any claims related to this project, the Consultant's insurance coverage shall be
primary insurance as respects the City, its officers, officials, employees, agents
and volunteers. Any insurance or self - insurance maintained by the City, its
officers, officials, employees, agents or volunteers shall be excess of the
Consultant's insurance and shall not contribute with it.
3. Any failure to comply with reporting or other provisions of the policies including
breaches of warranties shall not affect coverage provided to the City, its officers,
officials, employees, agents or volunteers.
4. The Consultant's insurance shall apply separately to each insured against whom
claim is made or suit is brought except, with respect to the limits of the insurer's
liability.
5. Each insurance policy required by this clause shall be endorsed to state that
coverage shall not be suspended, voided, canceled by either party, reduced in
coverage or in limits except after thirty (30) days' prior written notice by certified
mail, return receipt requested, has been given to the City.
6. Consultant agrees to waive subrogation rights against City regardless of the
applicability of any insurance proceeds, and to require all contractors,
subcontractors or others involved in any way with the Services to do likewise.
7. It shall be a requirement under this Agreement that any available insurance
proceeds broader than or in excess of the specified minimum insurance coverage
requirement and/or limits shall be available to the additional insured.
Furthermore, the requirement for coverage and limits shall be (1) the minimum
coverage and limits specified in this Agreement, or (2) the broader coverage and
maximum limits of coverage of any insurance policy or proceeds available to the
named insured; whichever is greater.
8. The limits of insurance required in this Agreement may be satisfied by a
combination of primary and umbrella or excess insurance. Any umbrella or excess
insurance shall contain or be endorsed to contain a provision that such coverage
shall also apply on a primary and non - contributory basis for the benefit of the City
of Petaluma before the City of Petaluma's own insurance or self - insurance shall
be called upon to protect it as a named insured.
52
E. Acceptability of Insurers
hnsurance is to be placed with insurers with a current A.M. Best's rating of no less than
ANII.
F. Verification of Coverage
Consultant shall furnish the City with original endorsements effecting coverage required
by this clause. The endorsements are to be signed by a person authorized by that insurer
to bind coverage on its behalf. All endorsements are to be received and approved by the
City before the Services commence.
6193
EXHIBIT C
ACKNOWLEDGENIENTAND CERTIFICATION PURSUANT TO
CITY OF PETALUMA LIVING WAGE ORDINANCE
PETALUMA MUNICIP.ML CODE CHAPTER 8.36
The City of Petaluma Living Wage Ordinance ("Ordinance"), Petaluma I'vlarticipal Code Chapter
8.36, applies to certain service contracts, leases, franchises and other agreements or funding
mechanisms providing financial assistance (referred to hereafter as an "Agreernent") between
the City of Petaluma ("City") and/or the Petaluma Community Development Commission
(",PCDC") and contractors, lessees, franchisees, and/or recipients of City and/or PCIJC funding
or financial benefits ( "covered entities").
Pursuant to Petaluma Municipal Code, Section 8.30.120, as part of any bid, application or
proposal for any Agreement subject to the Ordinance, the covered entity shall:
• Acknowledge that the covered entity is aware of the Ordinance and intends to comply
with its provisions.
Complete the Report of Charges, Complaints, Citations and/or Findings contained in this
Acknowledgement and Certification by providing information, including the date, subject
matter and manner of resolution, if any, of all wage, hour, collective bargaining,
workplace safety, environmental or consumer protection charges, complaints, citations,
and/or findings of violation of law or regulation by any regulatory agency or court
including but not limited to the California Department of Fair LEniployment and Housing,
Division, of Occupational Safety and Health (OSHA), California Department or Industrial
Relations (Labor Commissioner), Frivironmental Protection Agency and/or National
Labor Relations Board, which have been filed or presented to the covered entity within
the ten years immediately prior to the bid, proposal, submission or request.
pursuant to Petaluma Municipal Code Section 8,36.120, before the beginning of the term of any
covered Agreement, or prior to the execution of said Agreement by tile City or the PCDC, each
covered entity shall certify that its employees are paid a living wage that is consistent with
Petaluma Municipal Code Chapter 8.36.
By executing this Acknowledgement and Certification, the covered entity (i) acknowledges that
it is aware of the Ordinance and intends to comply with its provisions, (ii) attests to the accuracy
and completeness of information provided in the Report of Charges, Complaints, Citations
andfor Findings contained herein, (iii) certifies that it pays its covered employees a Living Wage
as defined in Petal urnaMunicipal Code Chapter 836 and (iv) attests that the person executing
this Acknowledgement and Certification is authorized to bind the covered entity as to the matters
covered in this Acknowledgment and Certification,
Page I of')
)AVING WAGJF ACKNOWI.FDOFNIEN1
AND CERTIFICATION
(163&697 2) Nov 2012
54
SO ACKNOWLEI)GED and CERTIFIED:
Project or Contract LD: FUNCTION AL ASSESSNME.- N T ST0,01; ITRXIINF - EI,IGIBILITY
FOR ADA PARATRANSITSERVICES FOR'III; CITY OF PETALUNIA
r'. ` q. ko. F-, al't /up 4 ry, z C,. Date: —1,44,11
(Print Name of Covered Entity/Business Capacity)
- d
By Do tz '11,
(Print Name)
(Signature)
(Title /Capacity of Authorized Signer)
Page 2 of 3
HVMG WA(W
AND CERTIFICATION
(163,8697.') NNO v 2 Of -)
55
REPORT OF CHARGES, COMPLAINTS, CITATIONS AND OR FINDINGS
PURSUANT TO PETALUNIA MUNICIPAL CODE SECTION 8.36.120
FoRj.,A(,'Il WAGE, HOUR, COLLECTIVE , BARGAINING. WORK PI A('!-.' SAFETY, •NVIRO'NM ENTAL OR
CONSIJIMER PROTECTION C1 IAR(113, CONOPLAINT, CITATION, AND/Olt FINDING OV VIOLATION OF LAW
OR REGULATION BYANYREGULATORY AGENCYtilt COURT, INCLUDING BUT NOT LIMITED TO THE
CALIFORNIA DE PART NIENTOF FAIR EmPi,oY\,.jj-'N1- AND HOUSING, DivistoiN OF OCCUPATIONAL
SAFFTY AND HEALTH (OSHA). CALIFORNIA DvIART?A1-N'T OF INDUSTRIAL Rr-LATIONS (LABOR
CONE'vIISSIONER), ENVIRONMENTAL PROTE.CTION A(ji--,NCY AND/OR NIA-HONAL LABOR RELATIONS
BOARD, WHICH:
At�rcus YOU AS A PROSPE'C'I'IVE CONTRACTOR.SUIX FRANCHISEE
AND/OR PARTY TO ANY CITY OF PLI'AL1j,\IA ANWOR Pr-TALUNIA CONEmUNITY
AGREENIENT OR nv\rFIT SUBJECT' TO Pti]'AnAmA
MUNICIPAL CODE CIIAl"IT"It $36 (LiVINO WAGE, ORDINANCE), ANa)
HAS, BEEN FILED OR I'Rf-',.OI-'NTEDTOYOU WITHINTI-IF TENYE'ARS IkINIF.DIATELY PRIOR'Vwnit:
Bit), PROPOSAL, SUBMISSION Oft REQUEST FOR witic-ii,nits ACKNOWI.rww"i'VIENT AND
CERTn-,JCATION IS MADE,
PLEASE PROVIDE Ti DATL. THE REGULATORY AGE'NCY OR COURT` MA KING THE CIJARGE
COMPLAINT, CITATION OR FINDING, THE SUBJECT MATTER AND'I'lit', MVm\,-ER 01, Rt,.SOLtJTIQ-", IF
ANY, FOR RACH SUCH CHARGE CON PLAINT, CITATION OR FINDING,
IF NONE, PLEASLs'r.ivm- "NO\�'E":'w -ON E -
Ari'ACTI ADDITIONAL PAGES IF NEEDED.
Date:
Regulatory Agency or Court:
Subject Matter:
Resolution, if any..
Expected re.iolution, if known:
page 'I o 1' 3 u V1 N.G WAGE. ACKNOWLI'DOEMENN'
AND CMIFICATION
(1638697,2)Ncw 2012
56