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HomeMy WebLinkAboutAgenda Bill 2.B 05/03/2004Mr o l 90 I C r] -• CITY OF PETALUMA; CALIFORNIA d [ [(� y�� N Aun'da Title „ ' ' Meeting Date: Resolution Approving the Award of the Sonoma -Mann Fair Law', M May •3, 2004 Enforcement Service Contract on June 16 through June 20; 2004.to the Petaluma Police Department. M Meeting Time 3:00 PM ❑ 7:00 PM Category (check one) ® Consent Calendar ❑ Public. Hearing ❑ New Business ❑ Unfinished Business ❑ Presentation Department D Director 1 C Contact Perso ,. h hone Number Police Department C Chief S S Sgt. Tim ' yons , / j j' 78 -4596 Cost of Proposal A Account Number $34,999.99 (Contract Overtime) 4 4080 -51240 Amount Budgeted 0 N Name of Fund: Overtime Contract Attachments to Agenda PacketItem A. Staff Report B. Resolution j C. Sonoma- Marin,Fair Standard.Contract CITE' OF PETALUMA, CALIFORNIA MAY 3, 2004 • AGENDA REPOR T FOR Resolution Approving the Award of the Sonoma -Morin Fair Law Enforcement Service Contract on June 16 through June 20, 2004 to, the Petaluma Police Department. EXECUTIVE SUMMARY The Petaluma ''Police Department was awarded the Sonoma -Mann Fair Law Enforcement Services Contract. The contract provides for reimbursement of costs in the amount of $34,999.99. The Fair Board requires a City Council resolution to complete the contract. It is recommended the Council adopt the resolution. 2. BACKGROUND The annual Sonoma -Marin Fair is considered one of the major events taking place in the Bay Area this week, and is the largest event to take•place in Petaluma. The 2004 event will be the 65th annual. The fair runs for 5 days. The fair takes place on the Sonoma- Marin. Fairgrounds a 54 acre facility. Recent Fair attendance figures have been relatively steady, with approx. 61,000 attendees each year. The primary entertainment venue is the Budweiser Gardenway Stage, featuring premier entertainers every evening of the fair. Smaller, auxiliary stages are spread through out the grounds and provide a wide variety of entertainment. The fair hosts a major carnival, and. features a variety of foods, alcoholic beverages, commercial products competitions open to the public and livestock displays. There are Destruction Derbys taking place at the; "racetrack on four days. The Sonoma -Mann fair attracts a large number of people to a relatively small area. It is necessary to provide high visible law enforcemerit,presence to prevent criminal behavior and apprehend violators. Three years ago the Petaluma Police Department was awarded the contract. The contract was again awarded to us this year without a bid process. The Petaluma Police Department received several compliments on the service we provided. Sworn Officer Duties: Officers will be assigned to teams with a minimum of two officers per team. Officers will conduct high profile patrols of the fairgrounds area. Most of the patrols will be on foot, however up to four officers may use bikes each day. Officers will be primarily responsible for preserving the peace and. safety for fair attendees. This may include patrolling the entrance gates, racetrack grandstands, music stages; aivestock areas, car ival and areas where'alcohol is sold. ALTERNATIVES Not approve resolution. 4 FINANCIAL IMP.ACTS The contract awardedwill:have a cost to the City of Petaluma which will be reimbursed by the Sonoma - Marin Fair. All personnel working the fair will be working on an overtime basis. The contract includes compensation , for supervisor .overtime, pre -fair organizational efforts, meetings, officer overtime, dispatcher overtime, orientation for officers and dispatchers, financial processing time and a cost per police vehicle, per See attached estimated biidgef proposal. _ 5,., CoNCLUsioN In order for the Sonoma -Marin Fair Law Enforcement Services Contract to be completed a Resolution approving the awarding of the contract must be come from the City Council. 6. OUTCOMES OR PERFORMANCE MEASUREMENTS'THAT VILL IDENTIFY SUCCESS OR COMPLETION: Review of contract and operational costs after the completion of the fair. Input from Sonoma -Marin Fair on our performance. 7. RECOMMENDATION Approval of a Resolution supporting the awarding of the contract to the Petaluma Police Department. g1forms /2003 agenda bill • • PETALUMA POLICE bE'PARTMENT 2004 ESTIMATED BUDGET ESTIMATED PERSONNEL COSTS Sgt. hou 'r at the Fair 40 hours Sgt. hours of preparation 40 hours TOTALS 80 .hours @ $ per hour = $ 4,906.40 Officers hours at the fair 424 hours Officer orientation 20 hours TOTALS 444 hrs @ $ 51.62 per hour = $ 22,919.28 Dispatcher..hours at the Fair 40 hours Dispatch orientation 3 hours TOTALS. 43 hours @: per hour = $1,717.42 TOTAL PERSONNEL COSTS $ 29,543.31 ADMIN %FINANCE PROCESSING $293.32 TOTAL ESTIMATED VEHICLE COSTS 150 hours @ $ 2.75 per mile = $ 412.50 TOTAL HOURS TO BE PAID BY KIWANIS CLUB 80 Hours @ $ 51.62 per hour= $4,129.60 TOTAL HOURS TO BE PAID BY GLAD ENTERPRISES 12 Hours @ $:'51.62 per hour = $ 619.44 TOTAL ESTIMATED COSTS OF PERSONNEL & VEHICLE $ 34,998.17 Page 1 • RESOLUTION APPROVING THE AWARDING OF THE SONOMA -MARIN FAIR LAW ENFORCEMENT SERVICES CONTRACT ON JUNE 16 THROUGH JUNE 20, 2004 TO THE PETALUMA POLICE DEPARTMENT. WHEREAS, the Petaluma Police Department was. awarded the Sonoma -Marin Fair 2004 Law Enforcement Services Contract; and and WHEREAS, the Sonoma -Marin Fair Board requires a .City Council Resolution to complete the contract; WHEREAS, the .Petaluma Police Department will provide Law Enforcement services for the Sonoma - Marin Fair on June 16 through June 20; and NOW, THEREFORE, BE IT RESOLVED that the Petaluma Police Department is authorized to enter into a contractual agreement with the Sonoma- Marin Fair Board to provide law enforcement services at the 2004 Sonoma -Mahn Fair, June 1.6 through 20, 2004. • STATE,OF;CAL" IFORNIA SNORT FORM CONTRACT (For:agreements !ups to $9,999;;99) STD.•210 (Revised 61 20 03) Invoice must 'show contract number, itemi _ed ezpens =date"s,:wendor name,.addressand phone number. S613MIT'INVOICE IN TRIPLICATE TO: SO4 -1.4 NUMBER TION NUMBER service FOR STATE USE ONLY 94- 6000392 Phone: (707) 778 -4332 STD. 204 _❑ N /A. ❑ ON _FILE; ® ATTACHED ❑ CERTIFIED SMALL BUSINESS CCCs []:N/A [] FILE `N ATTACHED CERTIFICATE NUMBER ❑ DVBE %.. [] /A ❑ GFE ❑ Late reason ❑ Public Works Contractor's License Z Exempt from bidding 1. The parties to this agreement are: STATE AGENCY'S NAME, hereafter called'the'State. CONTRACTOR'S NAME, hereafter called the Contractor. ral Associati Petaluma- Police .D"epartment 2. The agreement term, is from June 16, 2004. through June 20, 2004 3. The maximum amount payable is $ not toiexceed 35,000.00 pursuant -to the following charges: Wages /Labor $ Parts /Supplies $ Taxes $ Other $n 35 ,000. 00 (Attach list if applicable.) 4. Payment Terms (Note: All payments are in arrears F E] TIME PAYMENT (Lump sum) MONTHLY ❑QUARTERLY ❑ ITEMIZED INVOICE p, _ p ry �p � OTHER Lulu sum upon satisfacto_ com letion of services as outlined in Exhibit "A" 5. The Contractor agrees to furnish all labor, equipment and materials necessaryto perform the services described herein and agrees to comply with the terms and conditions identified below which are made -a part hereof by this reference. (Outline in exact detail what is-to be done, where: it is to be done= and include work specifications, if applicable.) ADDITIONAL ATTACHED Please see Exhibit A, Scope of Work State may terminate this contract for cause by giving the Contractor written notice hereof. In the event the services of the Contractor are terminated, payment shall be made on an hourly /daily rate. for the portion actually worked up to the date and time of termination which shall be prorated on the number of hours /days of service performed by the Contractor in relation to the total amount of the financial consideration stated in the contract. EXHIBITS (Items checked in this box are hereby incorporated by reference and made a, part•ofthis Agreement by this reference as if attached hereto.) GTC *SF View Onlin ❑ GIA* If not attached, view at www.dqs.ca.gov/contracts/ Other °Exhibits (List) Exhibit E, Insurance Requirements and Exhibit E1, Workers Compensation are incorporated herein and made a part of this agreement. In Witness Whereof. ahis agreement' has been executed by the parties identified below:. STATE OF'CALIF.ORNIA _ _ CONTRACTOR AGENCY NAME CONTRACTOR'S NAME (Ifotherthan an individual, state whether corporation, partnership, etc.) 4 District Agricultural Association' City of Petaluma- Police De artment BY (Authorized Signature) DATE SIGNED BY (Authorized Signature) DATE SIGNED PRINTED NAME AND TITLE OF PERSON SIGNING PRINTED NAME AND TITLE OF PERSON SIGNING TAWNY TESCONI City of Petaluma:- Police Department ADDRESS ADDRESS JiU Fair rounds Drive, Petaluma, CA 94952 969 Petaluma Blvd. , North, Petaluma, CA 94952 TITLE ITEM FISCAL YEAR CHAPTER STATUTE OBJECT CODE 562 Fair Phone,: (707 2004 SIGNATURE OF ACCOUNTING OFFICER DATE SIGNED I hereby certify upon my own personal knowledge that'6udgeted,funds are available for the period purpose, of the •expenditure stated'above. AM. NO. FEDERAL' TAXPAYER ID. NUMB Scope of Work SO4 -14 AGREES: In accordance with laws that allow Contractor to provide law enforcement services in addition to the levels of protection usually and customarily provided, Contractor agrees: To furnish the State, Sonoma -Marie `Fair, located in. Petaluma, California with the services of such law enforcement personnel under the command of the Petaluma Police Department as may',be, necessary to provide for the safety of the public and protection' of the facilities of the 4` District Agricultural .Association 'from June 16, 2004 to June 20, 2004 on the fairgrounds (Payran Street and Fairgrounds Drive). Contractor must provide proof of insurance per Exhibit "B ". THE STATE AGREES: To pay the contractor a sum not to exceed thirt y -five thousand and no cents (35,000.00) for additional security services during Fair. Services rendered pursuant to this agreement represent an estimate °of'need and are based upon past experience for the Sonoma -Ma Fair event ContractorshaWendeavor to mitigate costs to the State by sending assigned security personnel home early should circumstances and events dictate less security requirements. Conversely, contractor reserves the authority to add additional security personnel should circumstances dictate such need. Contractor must have approval of Fair Management before adding additional security personnel. Services provided under this agreement are limited to the normal operating hours of the fair. Such hours are 0 . defined as beginning each day of the fair,,starting June 16, 2004 at approximately 12:00 noon and ending each day'at approximately 1:00 A.M., through June 20 2004. APPROVAL REFLECTED BY ORIGINAL SIGNATURES (NO STAMPED SIGNATURES): 4TH DISTRICT AGRICULTURAL ASSOCIATION :CITY OF PETALUMA BY: L:� David Glass, Mayor Tawny Tesconi, CEO Date APPROVED AS TO FORM: OFFICE OF CITY COUNSEL 1 -YA Date TEST: Gayle Petersen City Clerk Date PETALUMA POLICE DEPARTMENT APP.ROVED.AND RECOMMENDED BY: Chiefv E-�CTj Date Date STANDARD AGREEMENT SO4 -14 4TH DAA AND CITY OF PETALUMA ESTIMATED BUDGET ESTIMATED OERSO.NNEL COSTS Sgt hours at the'Fair Sgt. hours of preparation TOTALS 80 hours x $64.34 per hour = $5,1.47.20 Officer hours at the Fair Officer orientation TOTALS 431 hours x $52.07 per = $22,442.17 Dispatcher hours at Fair Dispatcher orientation - TOTALS 43 hours x $42.86 per hour = $1,842;98' TOTAL PERSONNEL COSTS TOTAL ESTIMATED VEHICLE COSTS 150 x $2.75 per mile = TOTAL ESTIMATED HOURS TO BE PAID BY KIWANIS CLUB 80 hours @ $52.07 TOTAL ESTIMATED HOURS TO BE PAID BY GLAD ENTERPRISES 1.2 hours @ $52.07 TOTAL ESTIMATED COSTS OF PERSONNEL & VEHICLES EXHIBIT "C" $29,432.35 $412.50 $4,165.60 $ 624.84 $34,635.29 0 • ��z California Fair Services Authority Exhibit "E" INSURANCE' REQUIREMENTS I. Evidence of Coverage The contractor /renter shall provide a signed 'original evidence of , coverage for the term of the agreement protecting the legal liability of the State of California, District Agricultural Associations, County Fairs; Counties in which County Fairs are located, Citrus Fruit Fairs, or California Exposition and ,State Fair, their directors; officers, agents, servants, and employees, from occurrences related to operations under'the contract. This may be provided by: A. Insurance Certificate - The contractor /renter provides the fair-With ,a_signed original certificate of insurance (the ACORD form is acceptable), lawfully transacted, which sets forth the following: List as the Additional Insured "That the State'of California, the District Agricultural Association, County Fair, the County in which the County Fair 'is located, Citrus Fruit Fair, or California Exposition and State Fair, their directors, officers agents, servants, and employees are made additional insured, but only insofar as the operations under this contract are concerned. Dates The dates of inception "and expiration of the insurance. For individual events, the specific event dates must be listed, along with,all set -up and tear down dates: Coverages a. General Liability - Commercial General Liability coverage, on an occurrence basis, at least as broad as the current Insurance: Service Qff ce „(ISO). policy form #CG 000 L Limits shall be not less than $5,000,000 combined single limits-per occurrence for Fairtime Carnival Rides; $3,00.0 000 combined single limits per occurrence for Motorized Events All Types; $_3,000;000 combined single limits per occurrence for Rodeo Events All Types with a paid gate and any'Rough Stock;events;$2;000,000 combined single limits per occurrence for Rodeo Events All Types without a paid;gate and any Rough Stock events; $1,000;000 combined single limits per occurrence for Rodeo Events All Types.without.any`Rough Stock Events; $2;000,000 combined single limits per occurrence for Interim Carnival Rides; Concerts'with over 5,000 attendees, Raves All Types, Mechanical_ Bulls, Extreme Attractions All Types', Orbitrons, arid.Simulators; $1,000,000'for all other contracts for which liability insurance (and liquor liability, if applicable) is required. b. Automobile Liability Commercial Automobile Liability coverage, on a per accident basis at least as broad as the current ISO policy form #''CA 0001, Symbol #1 (AnyAut9) with.limits of not less than $1,000,000 combined single limits per`accidentfor contracts involving use of contractor vehicles (autos, trucks or other licensed vehicles) on fairgrounds. c. Workers' Compensation Workers' Compensation coverage shall'be maintained whenever contractor /renter has employees, as required'by Taw. d. Medical Malpractice Medical Malpractice coverage with limits ofnot less than $1,000,000 per occurrence shall b6�maintained for contracts involving medical services. Liquor Liability — 'Liquor Liability coverage with limits of not less than'$ 1,000,000 per occurrence should be maintained for contracts involving the sale of alcoholic beverages. 4. Cancellation Notice A statement by the insurance company thafit will not cancel or reduce the limits or coverages of said, policy or'policies without giving 30 days prior written notice to the named certificate holder. 5. Certificate Holder For Individual Events Only - Fair, along with fair's address, is listed as the certificate holder. For Master Insurance, Certificates Only - California Fair Services Authority Attn: Risk Management, 1776 Tribute Road Suite 100, Sacramento, CA 95815 is listed as the' certificate holder. —1— Insurance Company The company providing insurance coverage must be acceptable to"the California Department of Insurance. OR B. CFSA_ Special Events Program - The. contractor /renter obtains liability protection through the California Fair Services .Authority (CFSA) Special'Events Program, when applicable. OR C. Master Certificates A current master certificate of in'surance.for the: contractor/ renter -has been approved byand'is on file with California Fair Services Authority OR D.. Self:Insurance - The contractor /renter is self - 'insured and acceptable evidence of self - insurance has been approved by California Fair'Services Authority (CFSA). II. General Provisions A. Maintenance of Coverage The contractor /renter agrees thatthe commercial.,general'liability (and automobile liability, workers' comp'ensation,:medical malpractice and /or liquor liability, if applicable) insurance coverage herein;provided for shall be in effect atalltimes during the term'of this contract. In the event said insurance coverage expires at any time or times prior to or duringthe term of this contract, contractor /renter agrees to provide the fair prior tossaid expirationdate, a new certificate of insurance evidencing insurance coverage as provided for herein;for not;less than the remainder of the term of ih6contract,. or for a;period,ofnot less than one "(1) year. New certificates ofinsurance are subject to the approval of Califomia`.Fair Services Authority; and contractor /renteriagrees that no work or services;shall be performed prior to the giving of'such approval. In the event`the /renter fails to keep in effect at all .times insurance coverage as herein_" provided, the fair may, in additionto any other remedies it may have take any, of the following:actions: (1) declare a material breach Wcontractor /renter and terminate this contract; (2) withhold.all payments due to contractor /renter until notice;is received that such insurance coverage is in effect; and (3).obtain such insurance coverage and deduct premiums for same from any sums due or which become due to contractor /renter under theaerms of this contract. B- Primary Coverage - The contractor /renter's insurance coverage shall be primary and any separate coverage or protection, available to the fair or any other additional insured,shall be secondary. C. Contractor'!s. Responsibility — Nothing here shall be construed as limiting in any way' the extent to which contractor /rentermay be held responsible for damages resulting from contractor /renter's operations, acts omissions or negligence. Insurance coverage obtained inthe�minimum amounts specified above shall - hot relieve contractor /renterof liability, in excess of such m'inim'um, coverage; :nor shall itpreclude the fair from taking other,actions available to it under contract documents or by law, including, but not limited` "to, actions pursuant to contractor /renter's indemnity obligations. D. Certified Copies of Policies Upon request by fair, contractor /renter shall immediately furnish a complete copy of any policy required hereunder, with said copy certified by the,underwriterto be a true and correctcopy of the original policy. 1I1. Participant Waivers For hazardous participant events, "the contractor / renter agrees to obtain a properly executed Release and Waiver of Liability Agreement (CFSA Form "Release. Lib ") from each participant prior to his/her participation in the events sponsored by contractor /renter: Hazardous participant events include but are not limited to any event within the following broad categories: Athletic Team Events•, Equestrian- related Events; Motorized Events; Rodeo Events; and Wheeled_Events, includinggbi cycle, skates, skateboard, or scooter. Contact California Fair Services Authority at (916) 921 -2213 for further information. S:\shared\Mary\CONTRACT\Ins_Req.doc Revised 10/1/03 -2- • EXHIBIT B'IT "E1 " ALL CONTRACTORS WORKING FOR THE FOURTH DISTRICT AGRICULTURAL ASSOCIATION, SONOMA- MARIN FAIR, COVERED BY WORKERS' COMPENSATION,.ARE REQUESTED TO SUBMIT A CERTIFICATE OF WORKER'S COMPENSATION INSURANCE TO THE FAIR ADMINISTRATION OFFICE ALONG WITH THE ENCLOSED STANDARD AGREEMENT. PLEASE CHECK THE APPROPRIATE LINE: I HAVE` WORKERS' COMPENSATION INSURANCE. I HAVE ENCLOSED A COPY OR WILL REQUEST ONE BE SENT TO THE FAIR. I HEREBY CERTIFY'THAT.I AM AN INDEPENDENT CONTRACTOR AND HAVE NO PAID'OR VOLUNTEER EMPLOYEES AND THEREFORE, WORKERS' COMPENSATION INSURANCE WHICH IS REQUIRED FOR EACH CONTRACT AS STATED IN. ITEM ' #18 ON STD:SCTC, (STANDARD - CONTRACT TERMS AND. CONDITIONS), DOES NOT APPLY TO ME. I AM AWARE THAT THIS STATEMENT IS FOR THE INTERNAL USE OF CFSA AND THE SONOMA MARIN FAIR AND DOES NOT ALTER THE WORKERS'' COMPENSATION REQUIREMENTS IN THE LABOR CODE OF THE STATE OF CALIFORNIA DEFINING "EMPLOYEES ". CITY OF PETALUMA- PETALUMA POLICE DEPARTMENT S NAME ON STANDARD AGREEMENT SIG`NA R PETALUMA POLICE DEPT. DAt • CCC -103 ® CERTIFICATION I, the official named below, CERTIFY UNDER PENALTY OF PERJURY'that I am duly authorized to, legally bind the, prospective Contractor to -the clause(s) listed below. This certification is made under the laws of the State of California. Contractoz /Bidder Firnz Name '(Printed) Federal ID Number CITY OF PETAL UMA- POLICE DEPARTMENT' 94- 1579875 By (Authorized Signature) E nted Name and Title of. Person Signing TY OF PETAL UMA POLICE DEPARTMENT ____ Date Executed Executed in the County of SONOIMIA CONTRACT OIR CER'T'IFICATION CLAUSES 1. STATEMENT OF COMPLIANCE Contractor has, unless exempted, complied with the nondiscrimination program requirements.. (GC 1'2990 (g-fl and CCR, Title 2, Section 8103) (Not applicable Ito public' entities.) 2. DRUG -FREE WORKPLACE REQUIREMENTS 'Contractor will'comply with the requirements of the Drug -Free WorkplaceAct of 1990 and will `provide a drug -free workplace by taking,the following actions: a. Publish a statement notifying employees that unlawful manufacture, distribution, dispensation, possession or use of a controlled substance is prohibited and specifying actions to be taken against employees for violations. b. Establish.a Drug - Free.: Awareness Program to inform employees about: 1) the dangers of drug abuse -in the, workplace; 2) the person's' or organization's policy of maintaining a drug -free workplace; 3) any available counseling, rehabilitation and employee assistance - programs; and, 4) penalties that' may be imposed upon employees for drug: abuse violations. - c. Every employee who works on the proposed Agreement will' 1) receive a copy of the company's drug -free workplace policy statement; and, 2) agree to abide by the terms of 'company's statement as a condition of employment on the. Agreement Failure to comply with these requirements may result in suspension of payments under the Agreement or termination of the Agreement. or both and Contractor may be ineligible for award_ of any future State agreements if the department determines that any of the following has occurred: (1) the - Contractor has,rnade false certification, or violated the certification by failing to carry. out the requirements as noted above. (.GC' 8350 et seq.) 3. NATIONAL LABOR RELATIONS BOARD CERTIFICATION Contractor certifies that no more than one (1) final unappealable finding of contempt of court by a Federal court has been issued against Contractor within the immediately preceding two -year period because of Contractor's failure to comply with an order of a Federal court, which orders Contractor to comply with an order of the National "Labor Relations Board: ;(PCC 10296) (Not applicable to public entities.) 4. UNION ORGANIZING: Contractor hereby 'certifies that no requestfor reimbursement under this agreement, will seek reimbursement for costs incurred to assist, promote or deter union organizing. 5. CONTRACTS FOR LEGAL SERVICES $50,000 OR MORE PRO BONO REQUIREMENT: Contractor hereby certifies that contractor will comply with the requirements of Section 6072 of Business and Professions Code, effective January 1, 2003. Contractor agrees to make a good faith effort to provide a minimum number of Hours of pro bono legal services during, each year o f the contract equal to the lessor of 30 multiplied by the number of full time attorneys in the firm's offices in the State„ with the. number of hours prorated on an actual day basis for. any contract period of less than a full year or 10% of its contract with the State. . Failure to,make, a. good faith_ effort may be cause for non - renewal of a.state contract for • legal services, and may be taken into account when determining the award .of future contracts with the State for legal :services, DOING BUSINESS WITH THE STATE OF CALIFORNIA The following laws apply to persons or entities doing business with the State of California. 1. CONFLICT OF INTEREST. Contractor needs to be aware of the following_ provisions regarding current or former state employees. If Contractor has any questions on the status of any person rendering or.involved with the Agreement, the awarding agency must be contacted immediately for clarification. Current State Employees (PCC 10410): 1). No officer or employee shall engage in any employment, activity or enterprise from which the officer or employee receives compensation or has ,a financial interest: and Which is­ sponsored or funded by any state agency, unless the: employment, activity or enterprise is required as a condition of regulaf state employment. 2). No officer or employee shall, contract . on his or her own behalf as an independent contractor with any state:agency to provide goods or services. Former. State Employees (PCC 10411): 1). For the .two =year' period from the date he or she left state employment, no former state • officer or employee may enter into a contract'invhich he or she engaged in any of the negotiations, transactions, planning; arrangements or any part of the decision - making process relevant to the contract while employed in any capacity by any state agency. 2): For the twelve -month period from ,the date he or she left state employment, no former state officer or employee may enter into a contract with any state agency if he or she was employed by that state agency in a policy - making position in the same general subject area as the proposed contract within the 12 -month period prior to ;his or her leaving state service. If Contractor violates any provisions of above paragraphs, such action by Contractor shall render this Agreementwoid. (PCC 1;0420) Members of boards and commissions are exempt from. this section if they do not receive payment other than payment of each meeting of the board or commission, payment for preparatory time and payment for per diem. (PCC 10430 (e)) 2. LABOR CODE /WORKERS' COMPENSATION Contractor,needs to be aware of the provisions which require every' °employer to be insured. against liability for Worker's Compensation or to undertake self - insurance .in accordance with the provisions, and Contractor affirms to comply with such provisions before commencing the performance of the work of this Agreement. (Labor Code Section 3700) 3. AMERICANS WITH DISABILITIES ACT :- Contractor assures the State that it complies with the Americans with Disabilities Act (ADA) of 1990, which prohibits discrimination on the basis of disability, as well as all applicable regulations and guidelines issued pursuant to the ADA. (42 U.S.C. 12101 et seq.) 4. CONTRACTOR NAME' CHANGE An amendment is required to change the Contractor's name as listed on this Agreement. Upon receipt of legal documentation of the name change the State will',process the amendment. Payment of invoices presented with a new name. cannot, be paid prior to approval of said amendment. 5. CORPORATE QUALIFICATIONS TO DO BUSINESS IN CALIFORNIA: a. When agreements are to be performed in the state by corporations, the contracting agencies will be verifying that the contractor is currently qualified to do business in California in order to ensure that all obligations due to the state, are fulfilled. b. "Doing business" is defined in R &TC Section 21101 as actively engaging in any transaction for the purpose of financial or pecuniary gain or prof t. Although there are some statutory exceptions' to taxation, rarely will a corporate contractor performing within the 'state not be subject to the franchise tax. c. Both domestic and foreign corporations (those incorporated outside of California) must be in good standing in order to be qualified to do `business in California. Agencies will determine whether a corporation is in good standing by calling the Office. of the Secretary • of State. b. RESOLUTION . A county,, city, district, or other local. public .body must provide the State with a copy of a resolution, order, motion, or ordinance of the local governing body • which by law has authority to enter into an agreement, authorizing execution of the agreement. 7. AIR OR WAT,ERTOLLUTION VIOLATION Under the State; laws, the Contractor shall not be. (1) in violation. of any order 'or or resolution. not subject to "review promulgated by the State Air Resources Board or an air pollution control district; (2) subject 'to cease. and desist order not,subject to review issued pursuant to Section 13301 of the Water Code for - violation >of waste discharge requirements or discharge prohibitibns; or (3) finally determined to be in violation of provisions of federal law relating to air or water pollution. 8. PAYEE DATA. RECORD FORM STD. 204: This form must be completed by all contractors that are not another state agency or other government entity. • • STATE - w 'PAYEE DATA 'RECORD (Required in lieu of IRS W4 When doing business with the State of California) STD 204(REV.2.9 )__— •- `- ;._-,�� OTE: Governmental federal, local districts) 'for entities, state,•and (including school are not required to submit this SECTION 1 must be completed by the,requesting state agency before forwarding to the payee ' DEPARTMENT /OFFICE - - - ........... 4TH_DISTRICT AG: ASSN:, SONOMA -MARIN FAIR PURPOSE:. Information contained in this form will be used by state agencies to prepare information STREET`ADDRESS'. PLEASE 175 FAIRGROUNDS DRIVE -- Returns (Form 1099) and for withholding on RETURN payments to nonresident payees. P mpt return of CITY, STATE, ZIP CODE - To: PETALUMA, CA 94952; this fully completed form will pr ent delays when processing payments. TELEPHONE NUMBER (707) 283 -3247 (See Privacy Sta ent on reverse) O PAYEE'S BUSINESS NAME - - SOLE PROPRIETOR- -ENTER OWNER'S FULL NAME HERE•(Last,.First, M.I.) MAILING ADDRESS (Numberarid Street or P. O..Box`Nuniber) - (City, Slate and Z;p Code) CHECK ONE BOX ONLY NOTE: State and PAYEE MEDICAL CORPORATIO pnciudingdenNstry; po iatry, El PART RSHIP local governmental psychotherapy, optometry, chiropra_ of etc.j entities, including ENTITY TYPE school districts are EXEMPT'CORPORATION •(N 'Ofit) ESTATE O ?RUST not required to submit this form. 4 k4 .ALL OTHER CORPORATIONS . INDIVIDUAL/SOLE PROPRIETOR SOCIAL SECURItYAUMBER REQUI FOR INDI IDUALA LE PROPRIETOR BY AUTHORITY OF THE REVENUE AND TAXATION CODE SECT 18646, ee revers NOTE: Payment will not be PAYEE'S processed without TAXPAYER FEDERAL EMPLOYERS" IDENTIFICATIONNUMBER,(F N) _ SOCIAL SECURITY' NUMBER an accompanying I.D. NUMBER taxpayer I.D. number. IF PAYEE ENTITY TYPE,IS A CORPORATION,P NE IF PAYEE ENTITY TYPE IS INDIVIDUAL/SOLE SHIP, ESTATE OR TRUST, ENTER,FEIN. PROPRIETOR, ENTEWSSAN, 7 CHECK APPROPRIATE BOX(ES) NOTE: a. An estate is a El 'California Resident Qualified to;do basin ssin CA or a perrnanent`place of resident if business,in •CA.. decedent was a PAYEE California resident RESIDENCY a Nonresident ee Reverse) Payments to nonresidents for'services maybe subject at time of•death: STATUS to state w' .holding 6. A trust is a. ❑ IVER OF STATE WITHHOLDING FROWFRANCHISE -TAX BOARD ATTACHED resident If at least _ one trustee is a California resident. - SERVICES PERFORMED'.OUTSIDE OF CALIFORNIA (See reverse) I- hereby certify under penalty of•perjury•thaf the information provided on "this document is true and correct. If my residency status 'should change, l will promptly inform you. CERTIFY' G AUTHORIZED PAYEE '• REP.RES_ENTATIVE'S`NAME (TypeprPrint) TITLE SIGNAT E SIGNATURE. DATE. TELEPHONE NUMBER 204PRT.FRP STATE OF CALIFORNIA PAYEE DATA RECORD STD. 204 (REV. 2.99 (REVERSE) ARE YOU A RESIDENT OR ANONRESIDENT? ARE YOU SUBJECT TO NONRESIDENT WITHHOLDING? Each corporation, individual /sole proprietor,. partnership, estate or trust doing, business with the of Califomia must indicate their residency status along with their, taxpayer identification number. A corporation will be considered a "resident' if it, has a permanent place, of business in California: The corporation has a permanent place of business •in California if it is organized rand existing under the laws of this state or, if a foreign corporation has qualified to transact 'intrastate business. A corporation that has not qualified to transact intrastate business (e.g;, a corporation engaged exclusively in interstate commerce) will, be considered as having a permanent place of business in this state only if it;maintains,..a permanent office in this state that is permanently staffed by its employees. For individuals /sole proprietors, the term "resident' includes I very individual whods in California,for. other than a temporary or transitory purpose and any;individual domiciled in California who is•absent for a temporary 6r transitory purpose. Generally, an individual who comes to California for a purpose which will extend over, a long or indefinite period will be considered a resident. However,, ant individual who comes: to perform a particular' contract Of short duration will be considered a nonresident. For withholding. purposes, 'a partnership is considered a resident partnership if - it has a permanent place of business in California_. An "estate is considered a California estate if the decedent was a California resident at ,the time of death and ; a trust is considered a California trust if at least one trustee is a California resident. More information on residency status can:be obtained by calling the Franchise Tax Board at the numbers listed below: Frommithin the United States, call ...... 1 -800- 852 -5711 From outsi&the'United States, call ... :.1- 916- 845 -6500 For, hearing: impaired with TDD, call.... L-80.0-M-626 Payments made to nonresident payees, .'including corporations, individuals, partnerships, estates and trusts, are 'subject to withholding. Nonresident payees 'performing services in California or receiving rent,. lease or royalty 'payments from property (real or personal) located in California will have 7 %of their total payments withheld for state income taxes. However, no withholding is required• if; total payments to the. payee are $1500 or less for the calendar year. A nonresident payee may;requestthat taxes be withheld at a lower rate or waived by sending;a completed form FTB 588 to the address below. A waiver will,generally be granted when a payee has a history of filing California returns and making timely estimated payments. If the payee activity is, carried on outside of California or partially outside of Califomia waiver or reduced withholding rate may be granted. For more information, contact: Franchise Tax Board Nonresident Withholding ?Section Attention: State Agency. Withholding, Coordinator P.O: Box 651 Sacramento, CA 95842 -0651 Telephone: (916),845 -4900. FAX: (916) 845 -4831 If a reduced rate of withholding or waiver has been authorized by the Franchise Tax Board, attach a copy to this form. PRIVACY STATEMENT Section O Privacy Act of 197.4 (Public Law 93- 5791) requires that•_any federal,, state, or local governmental agency which :requests an individual to disclose hi's social security account number shall inform that individual whether that disclosure is mandatory or voluntary„ by which statutory or, other authority such number is solicited, and what uses will be made of it. The .State of Califomia requires that all ;parties entering into business transactions, that may - lead to payment(s) from the State must provide their Taxpayer Identification Number (TIN) as °required by the State Revenue and Taxatioti' Code, Section 18646 to facilitate.' tax, compli ance enforcement activities and to facilitate the�preparatiori of Form 1099 and other information returns as'.required`by the Internal:Revenue Code, Section 6109(a). The TIN for'individual and'.: sole :proprietorships is the Social Security Number (SSN). It is mandatory to fumish the information requested. Federal law requires that payments for which the requested information is.not'provided be subject to a 3 - -1% withholding and state, law, imposes noncompliance penalties of up to $20,000. • You:have the right to access °records containing your personal information, such as your SSN. To exercise that right, please contact the business services . unit or the accounts payable unit of the state ageney(ies) with which you transact that business. Please call the Department of Finance Fiscal Systems and Consulting Unit at (916) 324 -0385 if, you have any questions regarding this Privacy Statement. Questions .related to residency or withholding should' be referred to the telephone numbers listed above. All other questions; should be referred to. the requesting agency listed in Section 1. :204PRT.FRP Attachment 11 3 " Recycled Content Certification (CIWMB 74C) • The, attached Recycled Content Certification (CIWMB 74C) is the form. to be completed by all contractors (Standard Agreements) to fulfill the requirements for contractor; recycling,certificatioii,(See item 7 of the SCTC, Std,2). For`further information regarding recycling requirements or the completion of the certification form, please contact Kathy Marsh, Integrated. Waste Management'Board, at (919). 341- 6482, kmarsh @c wmb.ca.gov STATE OF CALIFORNIA RECYCLED- CONTENT CERTIFICATION California Integrated Waste Management Board CIWMB 74C (Revised 2/03 for Contracts) Contract # Recycled - Content Certification for Contracts ❑ Check this box if no products, materials, goods, or supplies were purchased with contract dollars and submit to your CNJMB contract manager. This form may be completed by contractor, vendor, bidder, buyer, state - contracting officer, or state purchasing agent. The form must be completed and returned to the, CIWMB with a row completed for each product purchased with contract dollars. Attach additional sheets if necessary. Information must be included, even if the product does not contaj 1 recycled - content m -terial. Product labels, catalog /website descriptions, or bid specifications may be attached this form as a method of providing that inforr Un. Contractor's Name � / Date d o J , .. f, Address 1 f Phone ' Fax - - 2 2 � � � E -mail Web site Item/Row Quantity Unit`of Dollars Product Product Description Product Postconsumer Secondary Virgin Total Number Measure Manufacturer Category t Material Material Material Percent and number (Percent) 2 (Percent) (Percent) 4 100% 100% 100% 100% 100% 100% Total: .,�._ �, ,fix �� '' -..;, sE ., *.fir +.y2�,,,.�r �, .. , >�,. •� _. .: «a .s , � ice:_ Rm�, -a a„e .,..,ss`�a \: <,��va Public Contract Code sections 10233, '1008.5, and 10354 require all vendors and Public Contract Code section 12205 (a) re contractors to certify in writing, under penalty of perjury, to the State agency awarding a contractors to certify in writing, under penal contrdcct, Hie minimum, if not the exact, percentage of Postconsumer and secondary percentage, of postconsumer-and secondary material in the products, mat rials, goods,,.or supplies offered or s or supplies offered or sold: Print d flame /of person co nySletu�g`Iorm Title (See footnotes on the back of this page.) 1 � cas=e State agencies to require all of rjury, the minimum, if not the exact to ial in_the products, materials, goods, Signature of person completing form • - Y v�.�, r Print d flame /of person co nySletu�g`Iorm Title (See footnotes on the back of this page.) 1 � cas=e State agencies to require all of rjury, the minimum, if not the exact to ial in_the products, materials, goods, Signature of person completing form • - • RECYCLED - CONTENT CERTIFICATION Footnotes Product category refers to one of the product categories listed below, into which the reportable purchase falls. For products,made from multiple materials, choose the category that comprises most of the product by cost, . weight, or volume. If the product does not riUl nto any ofthe product categories, put "N /A." CommoqN /A prod ucts 'include`wood products, texfiles,.aggregate, conerete,,electronics su " c h as computers; TV, software on a.disk, telephone systems,.printers,- copiers, fax machines:: Product category State's recycled content requirements compost and co= ..compost (CO) landscaping;materia erosion 5:0 TR control, weed control, decomposed organic yard, or food materials 10 % PC glass products (GL) windows, fiberglass (insulation), .tiles, 50 % TR construction blocks, and flat glass sheets 10 % PC - lubricating oils (LO) motor, transmission fluids, power steering, 50% TR crankcase, transformer dielectric fluids, gear, hydraulic, industrial 10% PC fluids, base stock, for tractors, vehicles cars, trucks, and buses paint (PT) latex paint, interior /exterior, maintenance 5.0 %o TR 10% PC paper products (PP) paper janitorial supplies, corrugated boxes, 50% TR paperboard (boxes, cartons, wrapping), hanging_ files, file boxes_, 10 % PC building insulation, containers plastic products (PL) toner cartridges, carpet, office products, 50 %0. TR plastic (-`umber, buckets; waste baskets benches, tables„ fencing, • .10% o PC clothing, packaging, signs, posts, binders, and buckets printing and writing paper (PW) xerographic, and higher -grade 30 % PC papers, high -speed copier;paper, offset paper ,.forms, carbonless' paper, ruled tablets, calendars, posters,, manila file folders, index cards; white wove envelopes, and cover stock solvents (SO) heavy printer cleaner, auto degreaser, parts cleaner 50 % TR 10 % PC steel products (ST) For steel products complete only dollars, 25% TR product description, and product category column. Common steel 10% PC products include automobiles, trucks, staplers, paper, clips, steel furniture, scissors, pipe, plumbing fixtures, chairs, ladders, shelving tire- derived products (TD) flooring, wheelchair.ramps, 50% PC playground cover, parking bumpers, truck -bed liners, pads, walkways, tree ties, road surfacing, wheel chocks, rollers, traffic control products, tumid flaps, posts tires (TI) passenger., truck; bus, trailer /equipment tires. 50% TR 10% PC TR = total recycled - content PC = postconsumer 2. Postconsumer material is material derived from used or recycled material. Postconsumer material is. generally any product that was bought by the consumer" used, and them recycled into another product. 3. Sec ondary,material is material derived from fi fished products or fragments of finished products of a manufacturing process that have not been used. An,exarnple would be a manufacturer's paper trimmings put . back into the manufacturing process for new products. Secondary material is generally any material (product) that did..not get to the consumer or was never used prior to being recycled. Secondary material °does not include postconsumer material., Example: If copy paper contained 20 percent postconsumer material, the remainder'will be virgin material. Indicate 20 percent in the Postconsumer column and'.80 percent in the Virgin Material column.. If it contained 20 percent postconsumer material and 40 percent secondary material, indicate 20 percent in the Postconsumer column, 40 percent in the Secondary Material column, and 40'percent in the Virgin Material:column. 4. Virgin material. is that portion of the product made from new or non - recycled material. Tlie material is, neither secondary'nor postconsumer material. 5. The sum of°the postconsumer column, the secondary column, and the virgin column must equal 100 percent.