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HomeMy WebLinkAboutKLEINFELDER INC.Z:� INSURANCE NOT ON FILE WORK MAY gOT PROCEED CLERK OF COUNCIL A-2021-121-02 DATE; AGREEMENT TO PROVIDE ON -CALL MATERIAL TESTING AND SPECIAL INSPECTION SERVICES THIS AGREEMENT is made and entered into this 6th day of July, 2021 by and between Kleinfelder, Inc. ("Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California / ("City"). RECITALS A. On September 2, 2020, the City issued Request for Proposal No. 20-111, by which it sought qualified consultants to provide on -call material testing and special inspection services for the City's Public Works Agency. B. Consultant submitted a responsive proposal that was among those selected by the City. Consultant represents that it is able and willing to provide the services described in the scope of work that was included in REP No. 20-111. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional contracting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES On an on -call basis, and at the City's sole discretion, Consultant shall perform the services described in the scope of work that was included in REP No. 20-111, which is attached as Exhibit A, and as more specifically delineated in Consultant's proposal, which is attached as Exhibit B and incorporated in full. 2. COMPENSATION a. City neither warrants nor guarantees any minimum or maximum compensation to Consultant under this Agreement. Consultant shall be paid only for actual services performed under this Agreement at the rates and charges identified in Exhibit C. Consultant is one of three (3) consultants selected to provide services on an on -call basis under REP No. 20-111. The total compensation for these services provided by all such consultants selected under REP No. 20-111 shall not exceed the shared aggregate amount of $1,000,000 during the term of the Agreement, including any extension periods. b. Payment by City shall be made within forty-five (45) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures, Page 1 of 8 Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals and Scope of Work, which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on July 5, 2024, unless terminated earlier in accordance with Section 17, below. The term of this Agreement may be extended for two 1-year periods upon a writing executed by the City Manager and City Attorney. 4. PREVAILING WAGES Consultant is aware of the requirements of California Labor Code Section 1720, et seq., and 1770, et seq., as well as California Code of Regulations, Title 8, Section 16000, et seq., ("Prevailing Wage Laws"), which require the payment of prevailing wage rates and the performance of other requirements on "public works" and "maintenance" projects. If the services being performed are part of an applicable "public works" or "maintenance" project, as defined by the Prevailing Wage Laws, and the total compensation is $1,000 or more, Consultant agrees to fully comply with such Prevailing Wage Laws. Consultant shall defend, indemnify and hold the City, its elected officials, officers, employees and agents free and harmless from any claim or liability arising out of any failure or alleged failure to comply with the Prevailing Wage Laws. 5. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer -employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 6. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subconsultants to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subconsultant prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Page 2 of 8 Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 7. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subconsultants, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary with respect to insurance or self-insurance programs maintained by the City; and (c) contain standard separation of insureds provisions. b. Business automobile liability insurance, or equivalent form, with a combined single limit of not less than $1,000,000 per occurrence. Such insurance shall include coverage for owned, hired and non -owned automobiles. C. Worker's Compensation Insurance. In accordance with the California Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. d. If Consultant is or employs a licensed professional such as an architect or engineer: Professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim with $2,000,000 in the aggregate. e. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. Page 3 of 8 (iii) Certificates and policies shall state that the policies shall not be cancelled or reduced in coverage or changed in any other material aspect, by Consultant, without thirty (30) days prior written notice to the City. (iv) Consultant shall supply City with a fully executed additional insured endorsement. f. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 8. INDEMNIFICATION Consultant agrees to defend, and shall indemnify and hold harmless the City, its officers, agents, employees, Consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including death, and claims for property damage, which may arise from the negligent operations of the Consultant or its subconsultants, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. Notwithstanding the foregoing, to the extent Consultant's services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant. 9. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend, indemnify and hold harmless the City, its officers, agents, representatives, and employees against any and all liability, including costs, and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright contained in the work product or documents provided by Consultant to the City pursuant to this Agreement. Page 4 of 8 10. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant under this Agreement. All such records and invoices shall be clearly identifiable. Consultant shall allow a representative of the City to examine, audit, and make transcripts or copies of such records and any other documents created pursuant to this Agreement during regular business hours. Consultant shall allow inspection of all work, data, documents, proceedings, and activities related to this Agreement for a period of three (3) years from the date of final payment to Consultant under this Agreement. 11. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 12. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interest and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 13. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) Page 5 of 8 Santa Ana, CA 92702-1988 Fax:(714) 647-6956 Executive Director Public Works Agency City of Santa Ana 20 Civic Center Plaza (M-21) P.O. Box 1988 Santa Ana, CA 92702 To Consultant: Dany Hanna, PE, MS, MBA Project Manager/Principal Agent Kleinfelder,Inc. 24411 Ridge Route Drive, Suite 225 Laguna Hills, CA 92653 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these timeframes, weekends, federal, state, County or City holidays shall be excluded. 14. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant regarding the subject matter herein, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant or the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 15. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the' City's ability to have any of the services which are the subject to this Page 6 of 8 Agreement performed by City personnel or by other Consultants retained by City. 16. WAIVER No waiver of breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement shall be effective unless it is in writing and signed by the party waiving the breach, failure, right or remedy. No waiver of any breach, failure or right, or remedy shall be deemed a waiver of any other breach, failure, right or remedy, whether or not similar, nor shall any waiver constitute a continuing waiver unless the writing so specifies. 17. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 18. NON-DISCRIMINATION Consultant shall not discriminate because of race, color, creed, relation, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities or in connection with any activities under this Agreement. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 19. JURISDICTION -VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 20. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, Page 7 of 8 permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of its inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 21. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: Y GOMEZ of the Council APPROVED AS TO FORM SONIA R. CARVALHO City Attorney By: � % -f.. JWIN M.FUNK Sr. Assistant City Attorney FOR APPROVAL SABA, PE ive Director Works Agency CITY OF SANTA ANA KRISTINE RID City Manager CONSULTANT Name: Dany Hanna Title: Vice President Page 8 of 8 EXHIBIT A Appendix ATTACHMENT 1 SCOPE OF WORK CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR TESTING AND SPECIAL INSPECTION SERVICES RFP NO.20-111 INTRODUCTIONBACKGROUND Under the City of Santa's Capital Improvement Program, a number of construction projects will take place in the next few years. These projects include street pavement, traffic signals, underground utilities, buildings, bridges and park facility improvements. The total value of construction is estimated to exceed $100 million. In order to maintain high quality of construction, the City intends to retain testing and inspection firms to provide quality assurance services for those projects. The selected firms are expected to provide testing and inspections for construction activities involving grading, soils, base material, concrete, masonry, asphalt concrete, structural steel, reinforcing steel, painting and to provide other quality assurance services when required. The purpose of this RFP is to solicit proposals from quality control consulting firms for the required services. The selected consultant is expected to enter into an agreement with the City to provide services on an as -needed basis. Prime consultant mark-ups for sub -consultant work will not be allowed. All proposals, plans, drawings, specifications, estimates, grant applications, modeling, studies, presentations, and/or reports will be subject to the final approval and satisfaction of the City. The selected consultants must have the expertise, experience, and demonstrated resources available to perform the work described in this RFP. The City desires to enter into Agreements with multiple top-ranking firms for an initial three (3)- year term, with a City option to exercise one (1), two (2)-year extension period. The annual amount to be expended under the Agreement will vary at the City's discretion and will be dependent on available funding. City of Santa Ana RFP 20-111 Page Al-1 A. SCOPE OF SERVICES The required services shall include, but not be limited to, the following: ♦ Provide field inspections and compaction tests for grading, trench backfill and asphalt concrete pavement construction according to the project special provisions, the Standard Specifications for Public Works Construction ("Green Book") and Caltrans Standard Specifications. Submit daily field reports to the City and a final report after work is completed. ♦ Provide inspections for installation of precast and cast in -place concrete, welding, high strength bolts, structural steel, masonry, painting and other types of work in accordance with the California Building Code (CBC) and the contract documents. Submit field reports to the City immediately after inspections are completed. All deputy inspectors shall register with the City's Planning and Building Agency prior to start inspection. ♦ Perform tests on various construction materials as required by the City. Available tests may include the following: o Mix Designs o Concrete o Concrete Blocks o Brick Masonry o Masonry Prisms o Mortar and Grout o Fireproofing o Soils and Aggregates o Asphalt Concrete o Reinforcing Steel o Environmental ♦ Inspectors who perform work in confined areas or at elevated levels shall be certified or trained for confined space and fall protection. ♦ Recommend testing method on defective work and advise the City of acceptance standards. ♦ Provide source inspection for concrete and asphalt concrete at mixing plants, and inspection for other materials at their source as required by the project specifications. ♦ Provide other quality control services as requested by the City. ♦ Field reports shall be submitted daily to the City. Submit and distribute typed inspection and testing reports to the City's Public Works Agency and the Planning and Building Agency in accordance with "Green Book" and "CBC" requirements and to other concerned parties within a week after the work is performed. City of Santa Ana RFP 20-111 Page Al-2 ♦ Submit a final report to the City within five working days upon completion of each project. B. SPECIAL REQUIREMENTS Since some of the city projects will be funded by Federal or State grants, the selected consulting firm must comply with requirements of Caltrans' construction manual and the following: Certificate of Personnel ♦ The personnel who will conduct the sampling and testing must be certified. They can be certified by Caltrans' District Materials Engineer, by the National Institute Certification of Engineering Technologies, or by other authority acceptable by the Construction Engineer of the City to be proficient in accepting sampling and testing. ♦ A copy of each person's certificate must be on file in the office of the Construction Engineer. The certificate shall list the type of work which the individual is authorized to perform. ♦ The testing laboratory must be under the supervision of a registered engineer with experience in inspection and testing of construction materials. This engineer shall certify the results of all tests performed by the lab personnel under his/her supervision. ♦ The selected firm must maintain the laboratory testing equipment in accordance with recognized national standards. ♦ The selected firm must have an independent assurance testing and sampling program. This program can be performed either by their own personnel not involved in the acceptance testing and sampling, or by another quality assurance organization. ♦ Correlation Testing Program: The Materials Laboratory shall be a participant in one or more of the following testing programs: ♦ AASHTO Materials Reference Laboratory (ARML) ♦ Cement and Concrete Reference Laboratory (CCRL) ♦ Caltrans' Reference Samples Program (RSP) Acceptance Testing and Sampling ♦ The selected testing laboratory shall conduct acceptance testing of materials on the first day when work is performed, and continues daily until the work is completed. City of Santa Ana RFP 20-111 Page Al-3 Reporting Test Results When aggregate sample is taken in the material source, the testing firm shall submit to the Resident Engineer results of sand equivalent, cleanness value and sieve analysis within 24 hours. When soils and aggregate samples are taken at the job site, results of these tests should be submitted within 72 hours. ♦ Results of compaction and density tests taken at the job site should be submitted within 24 hours. ♦ When samples of soils and asphalt concrete are taken at the job site, R-value and result of asphalt extraction test should be submitted within 96 hours. Independent Assurance Sampling and Testing The selected firm shall establish and maintain an Independent Sampling and Testing (ISAT) program: ♦ To verify that the project sampling and testing are performed correctly by the testers and samplers. ♦ To ensure the equipment is properly calibrated. ♦ To provide the City with a copy of the program to ensure that the program is carried out. ♦ To provide the Resident Engineer with a report indicating actions to be taken by the selected testing firm when discrepancies are found between ISAT and acceptance tests (AT). C. CITY RESPONSIBILITIES ♦ Furnish construction plans and specifications to the consultant. ♦ Coordinate with the contractor regarding work schedule and notify the consultant 24 hours in advance for the required inspections and tests. A SPECIAL REQUIREMENTS (ATTACHMENT 4) ♦ This project may utilize California Department of Transportation (Caltrans) funds and shall therefore comply with all state and federal requirements. The below referenced forms included in Attachment 4 (Additional Provisions) of the Appendix must be completed in their entirety and submitted with your proposal: • LAPM Exhibit 10-H: Sample Cost Proposal City of Santa Ana RFP 20-111 Page Al -4 • LAPM Exhibit 10-01: Consultant Proposal DBE Commitment • LAPM Exhibit 10-02: Consultant Contract DBE Commitment � LAPM Exhibit 10-K: Consultant Certification of Contract Costs and Financial management System Please reference Caltrans Local Assistance Procedure Manual, Consultant Selection, Chapter 10, for further instructions and guidelines pertaining to the completion of these forms. https://dot.ca. gov/-/media/dot-media/nrograms/local assistance/documents/lapm/ch10 pdf COMPLIANCE WITH REQUIREMENTS OF FUNDING AGENCY: This agreement may be funded with state and/or federal grant funds administered by Caltrans. Proposer shall comply with all requirements as they pertain to the use of these funds. Refer to Attachment 4 for Caltrans required forms, including Exhibit 10-H — Sample Cost Proposal (H2 for On -Call Contracts) in the Appendix of this RFP. The Agency has established a DBE goal for this Contract. Proposers are encouraged to obtain DBE participation for this contract. Refer to Exhibit 10-I — Notice to Proposers DBE Information included in the Appendix of this RFP. Proposers must submit Exhibits 10-01 & 10-02 — Consultant Proposal & Contract DBE Commitment to demonstrate compliance with Agency's DBE goal. CONSULTANT AUDIT AND REVIEW PROCESS: Prior to contract award and dependent on contract award amount, the selected Consultant shall be subject to an audit or review by Caltrans' Audit and Investigations (A&I), other state audit organizations, or the federal government. The selected Consultant shall complete Exhibit 10-K — Consultant Annual Certification of Indirect Costs and Financial Management System for all prime and sub -consultants in the Appendix of this RFP. To independently download any of the Caltrans Exhibits required per this RFP, visit: https://dot.ca.goy/programs/local-assistance/forms/local assistance procedures manual forms City of Santa Ana RFP 20-111 Page Al-5 EXHIBIT B Statement of Qualifications for MATERIAL TESTING & SPECIAL INSPECTION SERVICES RFP NO. 20-111 CITY OF SANTA ANA September 30, 2020 L KLE/NFEL SECTION 1. STATEMENT OF QUALIFICATIONS OER \\ Bright People. Fight So/uNanx a. Cover Letter September 30, 2020 Sean Thomas City of Santa Ana Public Works Agency; M-36 20 Civic Center Plaza, Ross Annex Santa Ana, CA 92701 Subject: Statement of Qualifications for Material Testing and Special Inspection Services City of Santa Ana RFP No 20-111 Dear Mr. Thomas: The Kleinfelder Team is pleased to submit our statement of qualifications (SOQ) in response to the City of Santa Ana's (City) request for qualifications (RFQ) No. 20-111 dated September 2, 2020 to provide on -call materials testing and special inspection services. Kleinfelder has been providing on -call Project Manager/Principal Agent materials testing and inspection services for public works & Single Point of Contact construction projects since the firm's inception in 1961.Our team (Legal Authority to Bind Kleinfelder) will be led by Project Manager/Principal Agent, Dany Hanna, Dany Hanna, PE, MS, MBA PE, MS, MBA, who has over 19 years of experience managing on- Kleinfelder, Inc. call contracts in southern California, maintains strong client cl 909.376.6128 relationships, understands the contract requirements, and requires el dhanna@kleinfelder.com no ramp -up time to meet the City's budget and schedule. The Kleinfelder Team offers the following to the City: • Nearly 60 years of experience successfully providing a wide range of special inspection, materials testing, and related services for local agencies and municipalities. • On -call materials testing and inspection contracts with numerous state and local agencies, including Orange County Department of Public Works, County of Los Angeles, Caltrans, and Cities of Anaheim, Long Beach, Los Angeles, Burbank, Ontario, Industry, and Pasadena. • All key personnel will be made fully available for assigned City Task Orders as needed. Our in- house multi -certified inspectors/technicians observe multiple aspects of a project from start to finish and are available to meet short -notice construction schedules/deadlines. • Our three full -service, accredited materials testing laboratories (Long Beach, Ontario, and San Diego) are under the supervision of a registered engineer and meet all American Society for Testing and Materials (ASTM) E329 requirements for testing and are inspected and certified or accredited regularly by numerous local, state and federal agencies such as Caltrans Reference Sample Program (RSP), American Association of State Highway and Transportation Officials (AASHTO) Materials Department of General Services (DGS), and the US Army Corps of Engineers (USACE). Reference Laboratory (AMRL), Concrete and Cement Reference Laboratory (CCRL), State of California • Quick turn -around time. Our depth of local resources allows us to respond quickly (within 4 hours or less) to any request for service. Kleinfelder acknowledges receipt of Q&A (Addenda) Sets 1 and 2, released September 10, 2020. Our local knowledge, combined with our vast amount of relevant experience, will enable us to provide the City with innovative solutions to assist with successfully meeting the contract requirements within the scheduled time frame and project budget. Respectfully Submitted, Kleinfelder, Inc. 7. Dany Han , PE, MS, MBA Mike orsch Project M nager / Principal Agent Quality Assurance Manager "hM1107600IP Kleinfelder 1 1 24411 Ridge Route Drive, Suite 225 -• Laguna Hills, CA 92653 4 p 1949.727.4466 4 f 1 949.727.9242 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 b. Contract Agreement Statement THIS CHANGE WAS NOT ACCEPTED BY CITY Kleinfelder would like the opportunity to add the following to the indemnity clause listed in the City contract: "Notwithstanding anything contrary to the foregoing, any obligation of Consultant to indemnify and defend City shall be based on its adjudicated proportionate negligence." c. Firm & Team Experience Profile of Kleinfelder. Inc. Headquartered in San Diego, Kleinfelder has been providing materials testing and inspection, geotechnical engineering, environmental, and technical engineering services to public and private clients in California since its founding in 1961. We have maintained a presence in Orange County since 1989. Our local southern California operations include offices and/or laboratories in Laguna Hills, Los Angeles, Long Beach, Ontario, Riverside, and three in San Diego. Metrics on Kleinfelder's firm size (offices and staff) are provided in the table below. Legal Form of Company: Private Corporation incorporated in State of California Date of Founding / Incorporation: April 1, 1961 / April 20, 1962 Number of Offices: 74 (firm -wide) 127 (California) 18 (Southern CA) Number of Staff: 1,909 (firm -wide) / 718 (California) / 406 (Southern CA) Kleinfelder is a California Corporation in good standing with the Secretary of State, and is registered with the State of California Department of Industrial Relations (DIR): 1000001733 Kleinfelder, Inc. 7/1/2019 6/30/2022 Active 467252 Kleinfelder is licensed to work in Santa Ana, so we are ready to work when the City's tasks begin. CITY OF SANTA ANA- TREASURY M-15 20 CIVIC CENTER PLAZA -PO BOX 1964 SANTAANA, CALIFORNIA 92702 PHONE (714) 647.5447 NLEINFELDER INC 55D W. C STREET N1200 SAN DIEGO, CA 92101 Qualifications and Experience THIS LICENSE MUST BE DISPLAYED AT THE PLACE OF BUSINESS BUSINESS TAX NO. 194275 TAX PERIOD: 111/2020.1213112020 BUSINESSTYPE: BUILDING, GENERAL BUSINESS ADDRESS: 550W.CSTREET01200 SAN DIEGO, CA92101 BUSINESSNAME: KLEINFELDERINC OWNERIREP: PIERSON,GEORGE-PRES EXPIRATION DATE: 1213112020 Kleinfelder has a long, successful track record of providing services on public works -related projects. For six decades, more than half of all projects completed by Kleinfelder have been in and/or for the public sector. Approximately 80% of our current projects in southern California are public works - related, either being performed directly for public agencies or through design/civil engineering firms. As a result, Kleinfelder is well versed in the requirements for timeliness and efficiency when working on public sector projects, and are knowledgeable of applicable codes, regulations, and ordinances associated with public works design and construction. On -Call Contract Experience In addition to our extensive public works experience, we are extremely effective at managing on -call contracts. We are currently providing professional services as an "on -call" consultant for many agencies. Several, relevant key public agency clients are listed on the following page. KLE/NFELDER 0no+n_""^ 001' Kleinfelder 12 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 • Orange County Transportation Authority • ciry or rsuroanK • County of Los Angeles • Los Angeles County Metropolitan • City of Long Beach Transportation Authority (METRO) • Caltrans Districts 7, 8, and 11 • City of Industry • City of Los Angeles • Los Angeles Department of Water & Power • City of Anaheim • Riverside County Transportation Department * Roadways * Landtilis - oliugrts * Water treatment facilities * Parking structures * Redevelopment areas * Airports * Libraries * Courthouses * Correctional facilities * Dams/flood control * Water conveyance facilities * Parks * Hospitals * Levees Materials Testing and Inspection Services. Kleinfelder offers materials testing and inspection services that can significantly reduce uncertainties during the construction process through consistent use of our internal "Kleinfelder Quality Management Plan" (KQMP) which includes measures to meet the Caltrans documented "Independent Sampling and Testing (ISAT) program. Adherence to the KQMP is the responsibility of our Project Manager/Principal Agent and is required to be followed by our subcontractor. Our engineers work closely with design professionals and other project team members throughout the project's duration, helping to balance the often -competing elements of time, budget, and quality. Laboratory testing is provided by our own fully accredited laboratories meeting all ASTM E329 requirements for testing, which are inspected and certified regularly by agencies that include: * City of Los Angeles * DGS DSA * CCRL * Caltrans * AASHTO-AMRL * USACE Kleinfelder provides a full scope of services for the inspection and testing of construction -related materials including: * Site grading * Concrete paving * Foundation excavations * Reinforcement * Backfill placement placement * Subgrade preparation * Batch plant inspection * Pile driving * Concrete placement * Drilled pier construction * Asphalt paving * Rock anchor placement * Soil improvement * Precast concrete inspection * Load tests * Welding inspection * Steel construction * Masonry construction * High strength bolting * Expansion bolting * Drainage systems * Field instrumentation * Underpinning * Source inspection * Fabrication shop inspection Special Inspection Services. Special inspection services are provided to verify the compliance of structural elements to project plans and specifications as set forth by the California Building Code (CBC). Theses r l f 1, of >r-� by our in-ho i o ar proved il7a;�s�:ro > who have undergone voluntary certification by the International Code Council (ICC). Their responsibilities on a project include (within the restraints and under the guidelines as set forth by the CBC): * Observing the work assigned for conformance with approved design drawings and specifications. I KLE/NFELOER Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Furnishing inspection reports to the building official, owner's representative, construction manager, and other designated persons. Bringing all discrepancies to the immediate attention of the contractor, and if uncorrected, to the attention of the construction manager and building official. Submitting a final signed report stating whether the work requiring special inspection was, to the best of our knowledge, in conformance with approved plans, specifications, and the workmanship provision of the CBC. Kleinfelder Project Team Key , sonnel Team Leads Kleinfelder has assembled a team of key professional and technical personnel to address the scope of services that are anticipated under the City's contract. c: 909.376.6128 Proiect Manager I Principal Agent DANY HANNA, PE, MS, MBA 1. . ,. • 19 years of experience as Principal -In -Charge, Program Manager, Contract Manager, and Project Engineer for multiple agency contracts, including Cities of Ontario and Long Beach, County of Los Angeles, Caltrans, and various southern California agencies. MBA, Finance; MS, Civil Engineering (Pavement); CA PE - Civil #70996 Associates -in Charge (Task Order Managers) JAMES STIADY, PhD, PE, GE Available to fully support this Contract • 20 years of technical and project management experience in pavement, geotechnical, and materials testing for various on -call contracts throughout southern California. Performs pavement condition surveys, designs pavement sections, and developstreviews pavement rehabilitation programs. G. 858-736.6412 ` PhD, Civil Engineering; California PE - Civil #66243; and GE # 2820 ROGER KHOUDESSIAN, PE Available to fully support this Contract 17 years of experience in materials engineering and with ASTM, AASHTO- AMRL, Caltrans, Greenbook, USACE, ACI, and local standards. • BS, Civil Engineering; PE - Civil No. 73806, CA; Multiple certifications - California Test California Test Methods (CTM), AWS Certified Welding Inspector, ICC Special Inspector NICET Level II, PG Binder Technician (NBT0 RICK BELL, NICET, NRMCA, RSO Available to fully support this Contract 38 years' experience with task order management and laboratory/field QA testing, which has included construction inspection, shop fabrication inspection, materials testing, batch plant inspection, and office engineering. c • NICET - Level II (field & lab); National Ready Mixed Concrete Association: c: 909.721.6639 Portland Cement Concrete (PCC); OSHA 40-Hour HAZWOPER; Certified Radiation Safety Officer (RSO) Key Personnel Resumes Resumes for our key personnel that outline their technical and design experience are included as Appendix A to this proposal. KLE/NFELDER N°`� '��'--0001P Kleinfelder 14 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Organization Chart Our Organizational Chart below provides a graphic illustration of our proposed project team members including our Project Manager/Principal Agent and Associates -in -Charge (Task Order Managers), key personnel, additional support staff resources, and their roles and responsibilities. We have also noted percentages of time that each team member will be devoted to this contract. Should the City's projects require additional support, we can easily draw upon an additional 400+ local professional and technical resources located within southern California. Health & Safety Manager SonyPheng Ali Rehman Marcus Molina Dominic Montamayor EddieJabbour Kreetha Ruben Manuel Uy Ian Snvder Manuel2avala (TM Juan Le Roy JeflreyDiaz Daniel Jimenez Kevin Oluohe Aaron Bishop ThomasRebosky Alex Garcia Sage Dempsey Shawn Mclaren Cameron Massa Julian Calderon Project Manager / Principal Agent .,: Task Order Managers James Stlady, PhD, PE, G Rick Bell Eric Kennedy Kim Byrd Jason Eckerson Robert Carman Mike Carman Jacob Collins Michael Magana Ian Snyder (TM) Juan Le Roy Adam Gardiner Chris Rice Sage Dempsey Shawn Mclaren SonyPheng Omar Molina JimmyMontermso Alex Garcia Aaron Bishop ThomasRebosky Smft Morris DominICA4ontemayor Daniel Jimenez JeflreyDiaz Vanan Deirdeirian Quality Assurance Manager Jeffrey Diaz Cameron Massa Julian Calderon Michael Magana EddieJabbour Juan Le Roy Daniel Jimenez Aaron Bishop Chris Rice David Magana Sage Dempsey Tony Gonzalez Christian Castanar Erik Klnczel Kevin Oluoha Dominic Montemayor KennedyEubsny Omar Molina Marcus Molina Alex Garcia Shawn Mclaren SonyPheng AliRehman Danielle Gray Notes: • Full resumes for bold key personnel have been Included In this submittal. • Staff availability: 100% for bold/key personnel. 90% for unbold support staff. 80% for unboid. italicized support staff. • DBE Subcontractor: TransMat. Inc. (TM) Rick Bell Roger Khoudessian, PE Jeffrey Diaz Juan Le Roy Michael Magana Varian Deirdeirian We can drew upon our professional and technical southern California resources, as well as those ofour DBE subcontractor, who are readily avallable to support the City a"eaded: • Special Inspectors • Soil Technicians • Pavement Specialists • Hazmat Technicians • Materials Engineers • Geotechnical Engineers • Construction Managers • Registered Geologists • Certified Hydrogeologists • Certified Engineering Geologists • Scientists • Planners Draftspersons/ CADD Operators • Administrators/ • ProlectControls i I KLE/NFELOER Kleinfelder 15 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 DBE Subcontractor Participation Kleinfelder has teamed with a highly qualified and experienced Disadvantaged Business Enterprise (DBE) subcontractor and we intend to exceed the City's 10 percent goal for federally funded projects. Kleinfelder has teamed with this subcontractor on similar projects, who is a local expert in their field, and will augment our capabilities to support the City's as -needed scope of services and maintain flexibility in resourcing given the often -intermittent nature of services authorized under an as -needed contract. Contact Kreetha Mekchai, CEO/President �� � Professional consulting 909.293.9186 TransMat, Inc services corporation 8966 Benson Ave. Unit B ' 'o I—, ' " _ , _' providing materials testing, Montclair, CA 91763 geotechnical engineering, and field inspection services. transmatinc@gmail.com Currently working with Kleinfelder on two Caltrans Certifications contracts. Transmat's President and founder, Mr. Kreetha DBE (CUCP) W222 Mekchai, has 20 years of experience in materials testing, Accredited Laboratory inspection, geotechnical investigation, and laboratory State of CA DIR Registered testing. TransMat employs several experienced laboratory 1000057301 (exp. 06122) and field (soils, asphalt concrete, PCC) testers and batch Established: 2017 plant inspectors. These laboratory testers and field Role: Testing & inspection technicians/inspectors are experienced with field safety, services defensive driving, and specific project safety requirements. d. Understanding of Need Kleinfelder understands that the City requires the services of a qualified firm to provide experienced field and laboratory staff on an as -needed basis to perform materials testing and inspection services for various Capital Improvement Projects within the City. Projects may include street pavement, traffic signals, underground utilities, buildings, bridges, and park facility improvements. Work is anticipated to include testing and inspections for construction activities involving grading, soils, base material, concrete, masonry, asphalt concrete, structural steel, reinforcing steel, painting and to provide other quality assurance (QA) services when required. Kleinfelder acknowledges that City projects may be funded with State and Federal grant funds administered by Caltrans. In general, the requested services may include materials testing and inspection services of the following: * Mix Designs * Masonry Prisms * Asphalt Concrete * Concrete * Mortar and Grout * Reinforcing Steel * Concrete Blocks * Fireproofing * Environmental Materials Testing and Inspection Services Work Plan * Brick Masonry * Soils * Aggregates Kleinfelder expects to furnish all personnel, laboratory facilities, transportation, materials, supplies and equipment necessary to perform services requested under this contract. Depending on the funding source, all services will be provided in accordance with the California Building Code (CBC), Standard Specifications for Public Works Construction (Green Book), Caltrans Standard Specifications, as well as OSHA Construction Industry Standards, and other applicable codes. All of our personnel who will conduct the sampling and testing will be certified by the proper authority having jurisdiction for the project, and a copy of their certifications will be on file in the office of the Construction Engineer prior to any work being performed on the project. "'w1C9, ''P Kleinfelder 6 �IIIE ER Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 The following outlines a typical work plan for materials testing and inspection services anticipated under this contract: Task 1: Project Kick -Off Meeting Our project team will meet with City representatives to initialize the project expectations, in terms of scope of services, schedule, and budget requirements. Communication controls and expectations will be clearly outlined for future activities. The primary goal is to have a mutual understanding of the City's expectations of Kleinfelder and the conduct of the construction activities. With a clear understanding of the expectations, unanticipated changes and surprises can be dramatically reduced. At this time, we will review project plans and specifications to evaluate the intended scope of services and provide alternatives for consideration. Task 2: Identification of Schedule and Budget Requirements After reviewing the plans, specifications, and schedule, we can prepare a proposed scope of services and cost estimate. The construction schedule will have a large impact on the requirements and duration of our services. It is important, both from a scheduling and accounting standpoint, to have an agreed -upon schedule and budget to follow and measure, as we proceed through the construction process. These elements will help us to provide the City with progress benchmarks, both from a financial and construction viewpoint. Once our proposal is approved by the City, we will receive a Work Authorization. Task 3: Staffing and Resource Management Plan Our Project Manager/Principal Agent will personally manage City projects and work closely with our Task Order Managers, typically the individual that attended the kickoff meeting. We will hold an internal kickoff meeting with designated staff to review documents, project scope, expectations, work practices, and schedule subconsultants as needed. Mr. Hanna will be supported by our Quality Assurance Manager, Mr. Mike Dorsch, to provide proactive testing and inspection in Eteral accordance with the project needs. Kleinfelder will develop a Peer customized Quality Assurance and Quality Control (QA/QC) Reviews I Plan for each task order under this contract. A written Project Quality Plan is the key ingredient of our QMP regardless of scope or budget. 0 A Interdisciplinary For medium to large projects where observation services are Revieves required on a full-time basis, we will assign a multi -disciplined Senior Technician to reduce the need for more than one technician for multiple operations at the site. This Senior Quality Management Technician will also coordinate resources in the field. In the event that the job sequence requires more than one technician, we will provide a supplemental technician (upon City approval) who will work at the direction of our Senior Technician. Task 4: Preparation and Review of Mix Designs Based on the discussion and information gathered from the kickoff meeting with the City staff, a Kleinfelder pavement engineer will review and/or recommend and develop concrete and asphalt mix designs considering the traffic loads, subgrade modulus, and sustainability factors. A road alignment with a weak subgrade and requiring reconstruction may be a good candidate for full depth reclamation. Typically, this approach is cost effective where long runs of pavement require replacement. Recycling the existing asphalt pavement and base material and blending it into the subgrade soils reduces hauling and disposal of material. LK E/NFELOER NI1M iG924 COt P Kleinfelder 17 �' Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Kleinfelder is capable of developing asphalt concrete mix designs for leveling course, asphalt base course, surface course, and wearing course, including rubberized asphalt concrete mixes. Kleinfelder can prepare and develop these mix designs in-house, utilizing the appropriate test methods and samples of aggregate and binder from local asphalt suppliers. In addition, we can develop mix designs for concrete pavement, full depth reclamation sections, and cement treated base materials. Task 5: Material Testing & Inspection Services We understand and are well -versed in the City's requirements for timeliness and efficiency in performing work, scheduling, and reporting results. Once notified with a time and location where our technician/inspector will be required, our centralized Kleinfelder dispatch team will schedule the appropriate certified technician/inspector for assignment. The technician/inspector will become intimately familiar with the project documents and will maintain daily records of inspection and testing which will document records of time and work performed. Our field staff will review safety protocols and safe work practices for each activity. They are equipped with appropriate personal protective equipment (PPE) for services they will provide, which include reflective safety vests, steel -toed boots, hard hats, gloves, and eye protection. They will participate in daily safety tailgate meetings prior to the start of work. They will contact our office for additional staffing and equipment, as necessary, based on communication with the City's onsite representative and the project engineer. Daily reports and test results will be provided to the project engineer and City onsite representative for review and signature and delivered to Kleinfelder's Project Manager/Principal Agent at least on a weekly basis, or daily when time -critical items are identified for immediate resolution. Reports and test results may be transmitted electronically to the project engineer and requested City team members. The technician/inspector will maintain a list of non-compliance issues and track resolution of these items. In addition, they will document and track re -inspection and re -testing so the City may back -charge the contractor for these additional costs, if desired. In addition to required inspection, testing, and sampling equipment, inspectors are . Better access to higher quality, consistent field data equipped with s ware includies,ng g Microsoftads. Improved tum-around time and communication laptops with software including Mico. Reduced risk of lost or compromised data Office (Word, Excel, and Outlook), e Reduced or eliminated manual re-entry of data Bluebeam Revu and Acrobat Reader for pdf . Efficient workflows from field to office files, and our FieldNet reporting software. . Automatically generated deliverables Kleinfelder inspectors utilize ourproprietary• Integration with GIS, LIMS, Deltek®, gINT®, EQuISTM p • Enhanced photographic documentation field reporting software, FieldNet, which . Works without an internet connection enables our staff to collect data, prepare . Enhanced GPS accuracy when required deliverables, effortlessly upload information . Custom forms can be developed by request to data management systems, and automatically generate reports using tablets in the field. FieldNet improves reporting turnaround time and offers high data quality on projects. Task 6: Laboratory Testing Samples of construction materials will be picked up and transported to our laboratory for testing and analysis by certified laboratory technicians. The laboratory manager reviews the data and distributes a typed test results report indicating whether the material did or did not meet the requirements of the project specifications. A registered engineer will review the laboratory reports and certify the test results prior to distributing them to the City's authorized representatives. The City and Kleinfelder's Project Manager/Principal Agent will be notified immediately if a sample fails to meet specifications so that an alternate plan may be implemented. DAM 05=4 Eoia Kleinfelder 18 KLE�NFELOER Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Task 7: Project Management and Controls The management of our processes will be a valuable tool for the City to assess not only the acceptability of the construction process, but also many aspects of the progress and conduct of the job. The key to success on any project begins with a strong Project Manager/Principal Agent who is available, experienced, and practices proactive communication strategies. Mr. Hanna's leadership is focused on a team approach with proactive communication to: • Provide successful project execution plan (PXP) including a detailed scope, a realistic schedule, and a mutually agreed upon budget • Strategically coordinate and allocate resources within Kleinfelder and the subcontractor team • Ensure quality at all levels of planning and design • Ensure safety • DeltekVision7.0 • Reporting • Bum • Work Forecast • Project Meetings Safety Deliverable Work Management 1 QA / QC Lead & Process Project controls is a term describing the tools, techniques, and procedures implemented by Kleinfelder's Project Manager/Principal Agent to monitor project components: scope and budget, project execution, quality, and schedule. Kleinfelder maintains a team of internal project controllers who actively work on large-scale programs with multiple subcontractors in order to reduce project owner risk through active real time tracking and reporting to the project manager regarding these items. Within Scope and Budget. The ability to keep a project within the original scope and budget is a result of defining a complete scope. Identifying a clear purpose, need for the work, and the intended outcome are critical to this task. With well -prepared task scopes and goals, budgets will be set and commitments will be made to adhere to. Progress meetings, reviews, and scheduling controls will identify work that could be out of scope or does not contribute to the desired outcome. These monitoring efforts will control the budget and eliminate out -of -scope work proceeding without proper approvals. Where a change of scope becomes necessary, the issue will be evaluated, quantified, mitigated (if possible), and communicated to the City's project manager. Kleinfelder will not exceed a project budget without getting prior authorization from the City. Task 8: Reporting and Project Closeout We will provide the City's representative and other designated team members with a copy of all results, including: • Daily field reports (upon completion of each shift) • Daily test results performed in the field (upon completion of each shift) • Project memos or clarification requests (as needed) • Budget status reports (weekly or monthly) • Any unusual or unanticipated activity or observations (as noted) �INFELOER MVV109"_V 001 P Kleinfelder 19 �" Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Laboratory test reports will be forwarded electronically to the City's representative and designated team members. Our laboratory test results will be submitted in accordance with the time frames listed in the City's RFQ Section titled Reporting Test Results. A final report will be prepared for materials testing and inspection services, summarizing the observations and testing made in the field and laboratory, and providing conclusions for suitability and recommendations. This final report will be submitted to the City within five working days upon completion of each project. Commitment to Safetv Kleinfelder employs the LPSO (Loss Prevention System) program in all of our work practices. The basis of LPS is reducing losses (both safety and financial) by identifying unsafe conditions or behaviors and providing the means to mitigate them. Kleinfelder's adoption of the LPSO system has resulted in a total recordable incident rate (TRIR) of 0.40, the lowest in Kleinfelder's history. Kleinfelder is proud to have integrated the LPSO system into our culture, and we believe it sets our firm apart from our competitors by taking a more focused and proactive approach to safe work practices and empowering each employee to identify potential hazards and make safer choices. e. Relevant Project Experience Client: OCPW Fee: $1.5M Duration: 2015 - Ongoing Reference: Vinh Tran, PE, Senior Engineer 714.955.0210 vinh.tran@ocpw.ocgov.com Relevance to this Contract: • Materials testing and inspections • Laboratory testing • Public structure improvements • Geotechnical engineering review of contractor submittals Key Staff • Dany Hanna, PE, MS, MBA • Mike Dorsch • James Stiady, PhD, PE, GE • Rick Bell • Bryan Reese, ASP • Eddie Jabbour • Juan Le Roy • Jeffrey Diaz • Cameron Massa • Ali Rehman • Tom Rebosky • Shawn McLaren • Sage Dempsey • Michael Magana • Dominic Montemayor • Christian Castanar • Edmond Jabbour Kleinfelder is currently providing construction inspection, geotechnical engineering, and materials testing and inspection services for OCPW under the management of Mr. Dany Hanna, PE, MS, MBA. Under on -call contract, Kleinfelder is providing materials testing and inspection services in support of the OCPW QA program for construction of new or rehabilitation of existing roadways, flood control channels, parks, or other infrastructure projects. All testing is performed in accordance with OCPW Standards and Procedures using CTM, ASTM, and/or AASHTO-AMRL testing. Kleinfelder complies with the County of Orange Standard Plans, Greenbook Specifications, Caltrans, ASTM, AASHTO-AMRL, and APWA Standards. In addition, Kleinfelder's material testers, inspectors, and laboratories are certified with Caltrans, CCRL, AASHTO-AMRL resource accreditation, and ASTM D3666. Kleinfelder also complies with all applicable requirements of the California Construction and General Industry Safety Orders, the California Occupational Safety and Health Act (Cal -OSHA), County of Orange's Safety and Loss Prevention Program and all applicable laws and regulations. Oso Parkway Bridge Replacement, Aliso Viejo. This project consists of the removal, relocation and adjustment of existing improvements, excavation and grading, removal and relocation of existing utilities, construction of new storm drainage and storm water pre-treatment and storage system, construction of curb, gutter and pedestrian walkways and ramps, bridge construction, roadway paving and new overhead signage and traffic control devices. Under the leadership of Task Order Manager Rick Bell, Kleinfelder has performed concrete batch plant inspections, PCC aggregate sampling and testing, and onsite flexural beam fabrication and laboratory testing per Caltrans test methods. Additionally, HMA batch plant inspections occurred and Kleinfelder materials testers sampled the HMA, binder, and aggregates for testing in our Caltrans accredited laboratories. 1,1 --I 1'401F Kleinfelder 110 KLE/NFELOER Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Client: City of Long Beach Fee: $12M Duration: 1991-Ongoing Reference: Marc Wright, Construction Service Officer, Bureau of Engineering, Department of Public Works 562.570.5160 marc.wright@longbeach.gov Relevance to this Contract: • Special inspections • On -call services • Field testing per Greenbook and Caltrans specifications • Review of project plans & specs and submittals • Laboratory testing of construction materials • Related public improvements Key Staff • Dany Hanna, PE, MS, MBA • Mike Dorsch • Bryan Reese, ASP • Roger Khoudessian, PE • Rick Bell • Sony Pheng • Jeffrey Diaz • Michael Magana • Juan Le Roy • Cameron Massa • Danielle Grey CLIENT BENEFITS Ability to Meet Schedule. Kleinfelder utilized its large team of in- house materials testers with Caltrans certifications. This allowed the team to assist the County laboratory in load -leveling with minimal disruption to meet seasonal construction testing needs. Availability/Responsiveness. The depth of our team and local operations enabled us to identify the appropriate staff and schedule for service within hours of receiving requests. Kleinfelder has been providing on -call geotechnical, materials testing and inspection services for the City of Long Beach since 1991. Under numerous contracts, Kleinfelder has performed work on over 500 task orders for the City. The scope of work comprises the improvement for numerous city street projects (federally and locally funded), airport runways and taxiways, public works facilities (fire stations & libraries) and parks. Underthe management of Mr. Dany Hanna, PE, MS, MBA Kleinfelder has been consistently providing quality and effective on -call materials testing services, which include observation and testing for asphalt concrete, soils, base, slurry seal, full depth reclamation, cement treated base, lime treated soil, PCC testing, and special inspection services of reinforced concrete, structural masonry, structural steel welding and bolting, shotcrete, spray -applied fireproofing, pre -stressed (pre and post -tensioned) concrete, installation of adhesive and mechanical anchor bolts and dowels, HMA, PCC batch plant inspections, and soil nail installation observation. In addition to materials testing and inspection services, Kleinfelder performed batch plant inspection and reviewed HMA and PCC pavement mix designs. Kleinfelder has also performed on -call environmental services under this contract including asbestos and lead -based paint surveys and abatement oversight. CLIENT BENEFITS Rapid Local Response. Having a local laboratory resulted in cost saving to the City by minimizing travel time and sample pick up and drop off time and which indirectly yields to quick turn -around of test results, avoiding potential construction delays. Client: County of Los Angeles Kleinfelder has been providing on -call materials testing services for Department of Public Works the County of Los Angeles since 2000. Task orders have been Fee: $600,000 performed on numerous city streets, bridges, and public Duration: 2000 - Ongoing improvement projects all throughout the County. Reference: /NFELOER 11M, „ Kleinfelder 111 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Greg Johnson, PG, CEG, Laboratory Supervisor 626.458.7986 gjohnson@dpw.lacounty.gov Relevance to this Contract: • Field investigations • Construction monitoring • Laboratory testing • Evaluation • Recommendations • Materials testing & inspection • Independent assurance testing Key Staff • Dany Hanna, PE, MS, MBA • Mike Dorsch • Bryan Reese, ASP • Roger Khoudessian, PE • Rick Bell • Dominic Montemayor • Eric Kennedy • Kim Byrd • Jason Eckerson • Robert Carman • Mike Carman • Jeffrey Diaz • Cameron Massa • Julian Calderon • Michael Magana • Vartan Deirdeirian went: t anrans, uistnct t3 Fee: $3.3 Million Duration: 2017 - Ongoing Reference: Godson Anyanwu, PE, Chief Caltrans Southern Regional Lab (SRL) 951.232.3834 Godson _Anyanwu@dot. ca.gov Relevance to this Contract: • Construction materials observation • Materials testing per CTMs and Caltrans Construction Manual • Concrete and HMA batch plant inspection Under the management of Mr. Dany Hanna, PE, MS, MBA, Kleinfelder has been consistently providing quality and effective on -call materials testing services to the County. Projects include AC pavement grind and overlay, reconstruction of concrete curbs and gutters, sidewalks, median islands, curb ramps, driveway approaches, alley intersections, and other appurtenant work. Under the current contract, we have performed work on over 50 task orders. Kleinfelder services are performed in accordance with the County's Quality Assurance Plan (QAP) and Caltrans specifications. Martin Luther King, Jr. (MLK) Medical Center Campus East Parrking Structure. Kleinfelder's Team included several County certified special inspectors with past experience on post -tensioned parking structures in accordance with County and relevant requirements/specifications. Kleinfelder also provided an Inspection Coordinator to fulfill and document the contractor's inspection requests. We additionally provided multi -certified special inspectors as -needed to observe placement of reinforcing steel, post -tensioned tendons, concrete, masonry block, masonry grout, anchor bolts, epoxy dowels, and structural steel welding for this multi -story building. Arcadia Mental Health Center Replacement. Kleinfelder provided construction materials testing and special inspection services on behalf of the County to assess conformance with the project structural plans and specifications during construction. Our multi - certified, in-house technicians and inspectors provided staffing consistency and scheduling on this project, maintaning costs and maximizing efficiencies. CLIENT BENEFITS Rapid local response of nearly two dozen local, certified materials testers and inspectors through our centralized dispatching system - minimizing costs associated with travel by utilizing staff who reside near the project sites. Under the management of Mr. Dany Hanna, PE, MS, MBA, Kleinfelder is currently providing construction materials sampling and testing and batch plant (asphalt concrete/PCC) inspection services to improve the State transportation system throughout Caltrans District 8. Our services are performed by materials engineering testers holding the appropriate Caltrans, ACI and AASHTO certifications at numerous project sites and material supplier batch plants. Task Order Manager Mr. Mike Dorsch performs project scheduling and field coordination, review and distribution of daily field reports, materials documentation and information, and prepares reports to Caltrans standards and requirements. Our materials testers work together under our Lead Materials Tester Mr. Roger Khoudessian, PE. CLIENT BENEFITS Kleinfelder's multi certified Consultant Materials Testers have provided added value by being able to service multiple projects KLE/NFELOER N10v""-y�°�"F Kleinfelder1 12 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 • Field sampling of fresh concrete, HMA, soil, aggregate • Field nuclear gauge compaction testing • Materials testing services in mobile laboratories • Special materials analysis and evaluation • Materials documentation and information • Preparation of reports Key Staff • Deny Hanna, PE, MS, MBA • Mike Dorsch • Bryan Reese, ASP • Roger Khoudessian, PE • Ali Rehman • Dominic Montemayor • Eddie Jabbour • Kennedy Eubany • Jeffrey Diaz • Julian Calderon • Michael Magana • .h inn I a Rnv Client: City of Ontario Fee: $200,000 to date Duration: 2014 - Ongoing Reference: Tricia Espinoza, City Engineer 909.395.2000 tespinoza@ci.ontario.ca.us Relevance to this Contract: • Preliminary geotechnical investigations • Geotechnical observations/testing and report preparation • Materials testing and inspection services per ASTM, ACI, and Caltrans test methods • Review of project plans, specs, and submittals • Laboratory testing of construction materials • Related public improvements Key Staff • Dany Hanna, PE, MS, MBA • Mike Dorsch • Bryan Reese, ASP • Rick Bell • Sony Pheng and scopes of work within the same shift resulting in a cost savings to Caltrans. Continuity and Depth of Expertise. Our team's existing knowledge with Caltrans staff, equipment, and processes means we require no training and have no learning curve. This results in high levels of quality assurance. Local Response/Efficiency from Dispatch to Report Distribution. Kleinfelder was able to draw upon a team of nearly two dozen materials staff with current Caltrans TL-0111 certifications. This large pool of materials engineering testers allows the team to assist the Caltrans staff in load -leveling with minimal disruption to meet their construction testing needs. Cost Savings. The Kleinfelder team utilized multiple laboratory facilities for equipment storage and materials testing services to minimize travel time and provide quicker laboratory testing turn- around times. Kleinfelder is currently performing as -needed l� geotechnical engineering and r IFmaterials testing and Inspection services as ( an extension to the city t engineering department. Our services have included multiple task orders requesting materials testing and inspection services during the rehabilitation of multiple residential streets and main commuter routes with the city. Typical task orders have included construction observation and field and laboratory testing of engineered fill soils and backfill, aggregate base rock, asphalt concrete and PCC utilized during utility and street improvement projects. CLIENT BENEFITS Staff Expertise/Quality Work: Kleinfelder's local staff hold certifications by the Asphalt Institute, AWSICWI, NACE, ACI, ICC as well as Caltrans proficiency. These certifications along with our local knowledge of the geology, material suppliers and sources allowed us to provide our client with a team possessing the most recent and relevant knowledge during construction activities. MNp 1052q JJ1 V �KLE/NFELOER Kleinfelder 113 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 • Thomas Rebosky Ability to Meet Schedule: Kleinfelder utilized our team of local, • Jeffrey Diaz certified staff. to assist the city with minimal disruption to the traveling • Juan Le Roy public. • Cameron Massa • Shawn McLaren Cost Savings/Local Office: Kleinfelder utilized our staff and laboratory • Michael Magana located in the City of Ontario to minimize costs associated with travel and increase laboratory testing and reporting time. Availability/Responsiveness: The depth of our team and local operation enabled us to identify the appropriate in-house staff and schedule for service within hours of receiving requests. f. References The following includes select examples of our project experience with references for three public entities for which Kleinfelder has performed similar work within the past five years. These projects are detailed in Section e. Relevant Project Experience. Orange County Public Works (OCPW) City of Long Beach As -Needed Materials Testing & Inspection and Geotechnical Engineering Services On -Call Materials Testing and Geotechnical Services i Reference Vinh Tran, PE, Senior Engineer 714.955.0210 vinh.tran@ocpw.ocgov.com Marc Wright, Construction Service Officer, Bureau of Engineering, Department of Public Works 562.570.5160 marc.wright@longbeach.gov County of Los County of Los Angeles Greg Johnson, PG, CEG, Angeles As -Needed Materials Testing, Laboratory Supervisor Inspection, and Geotechnical 626.458.7986 Engineering Services for Various Street gjohnson@dpw.lacounty.gov Improvement Projects N10�105"'51P Kleinfelder 1 14 ��`�`DER Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 SECTION 2. SCOPE OF SERVICES AND SCHEDULE Materials Testing and Special Inspection Services Kleinfelder offers materials testing and inspection services that can significantly reduce uncertainties during the construction process. Our engineers work closely with design professionals and other project team members throughout the project's duration, helping to balance the often -competing elements of time, budget, and quality. Kleinfelder plans to perform materials testing and inspection services to assist the City and on -site construction personnel, in maintaining awareness that workmanship is being performed to the project specifications and that construction materials utilized meet minimum project specifications. The depth of our local team and dispatch system enables us to identify the appropriate staff and schedule to respond quickly (within 4 hours or less) and provide the City with quick turn -around time. Our team is experienced with on -call project demands and works 24 hours a day, 365 days a year to meet project needs. Materials testing and inspection services will be performed by knowledgeable individuals familiar with local soil conditions and construction materials standards and attributes. These services are intended to complement and assist the City throughout construction -related activities and our staff will be responsible for: • Observing the work assigned for conformance with approved design drawings and specifications. • Registering deputy inspectors with the City's Planning and Building Agency prior to the start of inspection. • Furnishing typed field reports daily to the City, building official, owner's representative, construction manager, and other designated persons. • Submitting typed inspection and testing reports to the City's Public Works Agency and the Planning and Building Agency in accordance with Greenbook and CBC requirements within a week after the work is performed. • Bringing all discrepancies to the immediate attention of the contractor, and if uncorrected, to the attention of the construction manager and City representative. • Submitting a final signed report stating whether the work was to the best of our knowledge, in conformance with approved plans and specifications. Kleinfelder has in-house technicians and inspectors that have been certified by the following agencies: * County of Los Angeles + City of Los Angeles * Caltrans * American Welding Society (AWS) * DGS/DSA for Masonry and Shotcrete Inspection * International Code Council ([CC) * National Institute for the Certification of Engineering Technologies (NICET) * American Construction Inspectors Association (ACIA) * American Concrete Institute (ACI) Kleinfelder provides QA inspection and testing services during construction of numerous projects including public works projects, commercial structures, bridges, mines, roadways, and airport runways. Our supervisory staff under the direction of our Project Manager/Principal Agent will be involved in all aspects of our materials testing and inspection services as well as the safety of our field staff. Mr. Hanna will work with our Health & Safety Manager Mr. Bryan Reese to ensure that our inspectors who perform work in confined areas or at elevated levels shall be certified or trained for confined space entry and have the proper fall protection and training. Our in-house team can provide the full scope of services listed for the materials testing and inspection of construction -related materials including: N1Vb"IC?2Y 'P Kleinfelder 115 KvE/NFELDER Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 * Site grading * Foundation excavations * Backfill placement * Subgrade preparation * Pile driving * Drilled pier construction * Rock anchor placement * Precast concrete inspection * Welding inspection * Concrete paving * Reinforcement placement * Batch plant inspection * Concrete placement * Asphalt paving * Soil improvement * Load tests * Steel construction * Painting * Masonry construction * High strength bolting * Expansion bolting * Drainage systems * Field instrumentation * Underpinning * Source inspection * Fabrication shop inspection Listed below are the standard materials testing and inspection services which we expect to perform on this contract and have provided for similar on -call contracts: Soil and Agaregate Sampling and Testing. Our certified technicians will sample soil and aggregate using ASTM Standard Practice D75 for the appropriate laboratory testing, which may include sieve analysis, sand equivalent, cleanness value, R-value, maximum density, specific gravity, durability, soundness, and expansion potential. Bituminous Mixture Sampling and Testing. Our certified technicians will sample asphalt concrete mixtures in the field or at the batch plant using ASTM D979 for laboratory testing which may include maximum theoretical unit weight, asphalt extraction, stability, moisture and rutting susceptibility, and gradation analysis. Soil and Base Compaction Testing. Our certified technicians observe placement of soils and aggregate base material and conduct field testing using a nuclear gauge device or sand cone to evaluate the in -place density and moisture of the material and to calculate relative compaction. Results of soil and aggregate base compaction and density testing taken at the job site will be submitted to the City's designated representatives within 24 hours. Micro -surfacing and Slurry Seal. Our certified technicians observe the placement of slurry seal, scrub seal and micro -surfacing materials for resurfacing of the existing roadways. They check for oversize material, monitor mix temperature, proper mixing, and blending of the mix. Our inspectors can also collect samples of slurry seal for wet -track abrasion testing. Asphalt Compaction Testing. Our certified technicians observe placement and compaction of HMA material using nuclear density gauges in accordance with California Test Method 375. Results of asphalt compaction and density testing taken at the job site will be submitted to the City's designated representatives within 24 hours. Asphalt Batch Plant Inspection. Our certified technicians routinely provide batch plant inspection during paving operations to observe and document material quantities, mixing temperatures, binder type and temperatures. They collect samples of asphalt and aggregates and conduct moisture tests and grain size analysis. They also ticket the load for identification by the field inspector. Concrete Batch Plant Inspection. Our certified technicians perform observation and documentation of procedures used in concrete batching. At the batch plant, the inspector monitors and records weights of ingredients for concrete, including admixtures. They also monitor mixing of concrete, slump, addition of water, and adherence to the approved mix design. They will ticket the load for identification by the field inspector. Inspection of Reinforcing Steel at the Fabrication Plant. Our deputy inspectors identify and sample reinforcing steel at the fabrication plant and tag the steel for recognition upon arrival at the project site. We also collect samples of reinforcing steel which are transported to our facility for laboratory testing (bend and tensile) as required by the project plans and specifications. /QE/NFELOER MNn_ insz4 srl Kleinfelder 116 �' Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Placement of Reinforcing Steel Our deputy inspectors will verify the reinforcing steel placement prior to placement of concrete. Reinforcing steel is observed for size, spacing, type, grade, identification, placement, and configuration. Concrete Placement. Our deputy inspectors will observe placement of reinforced concrete and sample the concrete during placement. Our field services will include casting cylinders for compression testing, monitoring of slump, temperature, mixing time, mix design identification, and other field testing required by the plans/specifications. Welding of Structural Steel Our deputy inspectors or an American Welding Society (AWS) Certified Welding Inspector (CWI) observe welding operations during structural steel erection and connection at the project location. This is done on both a continuous and periodic basis as dictated by the approved drawings and applicable codes. Our services include the observation of welder certifications, material identification, joint fit -up, pre/post-weld heat treatment, and general compliance of structural steel construction to the project requirements and applicable codes. Installation & Tightening of High -Strength Bolts Our deputy inspectors observe the installation and tightening of high strength bolts as dictated on the project plans. We perform sampling and tension/torque testing of high strength bolts in accordance with applicable codes and project documents. Non -Destructive Testing of Welds Our deputy inspectors certified by ASNT in Ultrasonic Testing (UT), Magnetic Particle Testing (MT), Dye Penetrant Testing (DT), or Radiographic Testing (RT) procedures perform nondestructive testing as required by the project plans, specifications, and applicable codes. Structural Steel Fabrication Shop Inspection Our deputy inspectors or AWS-CWI will observe welding operations during fabrication shop welding prior to shipment of structural members to the project site. This is done on both a continuous and periodic basis as dictated by the approved drawings and applicable codes. Our services include the observation of welder certifications, material identification, joint fit -up, pre/post-weld heat treatment, and general compliance of structural steel construction to the project requirements and applicable codes. Installation & Testing of Drilled -In -Anchors Our deputy inspectors observe the installation of reinforcing steel/anchor bolts using either a chemical epoxy or mechanical anchor, as specified. Our field services will include verification of the size, depth, spacing, and cleanliness of holes to receive the reinforcing steel/anchors. We will also verify adherence with the manufacturer's specifications for the chemical epoxy/mechanical anchor and conduct proof testing of drilled -in -anchors using approved methods (tension load/torque testing). Masonry Construction. Our deputy inspectors perform continuous inspection of the placement of concrete masonry units, mortar, reinforcing steel, concrete grout, and items embedded in masonry. We will also sample and test construction materials including pre -construction masonry prisms, grout, and mortar for compression testing, as required by the project specifications. Spray -Applied Fireproofing. Our deputy inspectors visually inspect the condition of surfaces of structural steel to receive fireproofing. The contractor's method of mixing and application and perform thickness testing, density testing, and adhesion/cohesion testing in accordance with the project specifications is verified and the samples are transported to our laboratory for appropriate testing. Post -Tensioned Concrete. Our deputy inspectors observe the placement of post -tensioning tendons, monitoring of tendon profile, and placement of reinforcing steel and concrete. We also measure and record elongation of the post -tensioning tendons during stressing operations. mrov_n1�z: cmF Kleinfelder 117 KLE�NFELOEq Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 Shotcrete. Our deputy inspectors will observe shotcrete placement and sample shotcrete materials for appropriate testing. They will observe cores of test panels looking for voids, sand lenses, rebound, or other evidence of inadequate application. Source Inspection. Our deputy inspectors will observe source inspection for concrete and asphalt concrete at mixing plants, and inspection for other materials at their source as required by the project specifications. Painting. Our deputy inspectors will visually observe painting/coatings and/or corrosion protection as required by the project specifications. This inspection may include non-destructive testing of the painting coating thickness and/or non-destructive testing which may include holiday testing to verify materials meet the project requirements. In addition to the standard materials testing and inspections listed above, we can provide other quality control services as requested by the City. The Kleinfelder Team has a team of registered engineers and professionals who can work with the City's staff to recommend test methods on defective work and advise the City of acceptance standards. Independent Assurance Sampling and Testing (IAST) Program Kleinfelder's KQMP is designed to be consistent with the requirements of ANSI/ISO/ASQ Q9001-2008, "Quality Management Systems - Requirements", Title 10 of the Code of Federal Regulations, Part 830, Subpart A — "Quality Assurance Requirements" (10CFR830, Subpart A) and implementation guidance provided Department of Energy Order 414.1 D, "Quality Assurance" (DOE O 414.1 D). Our KQMP is generally compliant with other quality requirement documents such as QC-1 (cited in Requests for Proposals by the Department of Defense) and meets Caltrans ISAT program. Our plan is typically invoked on Kleinfelder projects that require sampling/testing other than ANSI/ISO/ASQ Q9001-2008, or 1 OCFR830 Subpart A and Caltrans criteria, with no or minimal modification. Our KQMP consists of two parts which include a written overview of Kleinfelder's quality expectations and the specific endorsed Kleinfelder Quality Procedures (KQPs). This plan will be utilized to verify sampling and testing is performed correctly and to ensure that all equipment is properly calibrated and labelled. Additionally, the plan includes our processes to ensure that actions are immediately taken when test results are questionable or when discrepancies are found, and the corrective actions taken upon findings. Our KQMP also includes a continuous review and as needed modifications, to our processes to stay up to date with industry changes and best practices that can benefit Kleinfelder and our clients. Laboratory Accreditations Kleinfelder maintains three southern California laboratories: Ontario, Long Beach, and San Diego. Kleinfelder's laboratories are fully equipped for testing construction materials. Kleinfelder has an in-house QA program to maintain a high level of accuracy and reproducibility in testing services performed by the firm. Experienced technicians perform the laboratory tests under the supervision of a registered professional engineer who will review all test results prior to distribution. Our laboratory will conduct acceptance testing of the materials on the first day when work is performed, and will continue to perform testing until the work is completed. All gauges, proving rings, scales, and other equipment used for testing are maintained and calibrated on a bJV'r 1 w24 &SI P /NFELOEF Kleinfelder 118 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 regular basis by certified independent agencies in accordance with recognized national standards. Kleinfelder's own QA program is supplemented with regular inspection by governmental agencies. The most significant outside CIA inspection of our firm is by the National Bureau of Standards through the Commercial Testing Laboratory Accreditation Program administered by AASHTO-AMRL. All of our laboratories participate in correlation testing programs including CCRL and AASHTO-AMRL proficiency testing programs, also administered by the National Bureau of Standards and the reference sample programs offered by Caltrans. Kleinfelder is one of the few commercial testing facilities in the state to participate in all of the programs, which are accepted as the most rigorous evaluation available in the field of materials testing. Kleinfelder's accredited laboratories are inspected and certified regularly by agencies that include: * City of Los Angeles * DGS DSA * CCRL * Caltrans * AASHTO-AMRL * USACE Kleinfelder laboratory facilities offer state-of-the-art capabilities in PCC, asphalt concrete, steel, masonry, and soils. Our facilities meet all ASTM E329 requirements for testing of concrete, soil, masonry, and bituminous materials. Our laboratory and field-testing capabilities include the use of specialized equipment not found with many firms. Another value-added service Kleinfelder offers is self-contained mobile laboratories to conduct a variety of soils, materials, and concrete testing on site. All mobile laboratories undergo appropriate reviews, inspections, and certifications prior to commencement of construction. The Kleinfelder team is committed to reporting laboratory test results to the City and its designated representatives in a timely fashion. Results of sand equivalent, cleanness value, and sieve analysis material sampled from the material source will be submitted to the Resident Engineer within 24 hours of sampling. Similarly, results for these tests for soil and aggregate material sampled from the job site will be submitted in accordance with the City's RFQ Section titled Reporting Test Results. The Kleinfelder Team staffs its laboratories around -the -clock and will meet the City's demands to report laboratory test results. Our DBE subcontractor TransMat, Inc. also maintains an accredited laboratory that will be available as needed and will adhere to the same laboratory reporting timelines. Please see Appendix B for copies of laboratory accreditations. Kleinfelder 119 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Education Dany Hanna, PE, MS, MBA MBA, Concentration in Project Manager I Principal Agent Finance Mr. Hanna has 19 years of experience serving as Principal -in - MS, Civil Engineering Charge, Operations Manager, Project Manager, Program Manager, (Materials Engineering) and Contract Manager for multiple agency contracts, including Cities BS, Civil Engineering of Long Beach and Los Angeles, Counties of Orange and Los Angeles, Caltrans, and various southern California agencies. He has License I Certification a successful history of managing large public agency contracts and Professional Engineer— on -calls with numerous task orders occurring simultaneously. He Civil, CA No. 70996 understands the need for continuous communication with the client in order to exceed the client's needs, and sense of urgency to Special Training provide qualified and committed individuals to successfully complete Loss Prevention System the work on time and within budget. At California State University Safety Training Long Beach, he taught civil engineering students on materials Defensive Driver Training/ engineering. Driver's License Relevant Project Experience Years of Experience Orange County Public Works (OCPW), As -Needed Materials 19 years total Testing $ Inspection and Geotechnical Engineering and 19 years with Kleinfelder Services, Orange County, CA. As Contract Manager, Mr. Hanna currently oversees this on -call contract for materials testing and inspection and geotechnical engineering services for OCPW. Kleinfelder is providing materials testing and inspection services in V would like to support of OCPW's Quality Assurance (QA) program for construction Personally commend of new or rehabilitation of existing roadways, flood control channels, Mr. Dany Hanna, parks, or other infrastructure projects. Kleinfelder complies with and Project Manager... for all testing is performed in accordance with OCPW Standards and high level of Procedures, Greenbook Specifications, Caltrans Standards, ASTM professionalism efforts Standards, AASHTO Standards, and APWA Standards. In addition, to maintain quality at a Kleinfelder's material testers and laboratories are certified CCRL, superior standard on AASHTO resource accreditation, and ASTM D3666. A recent project projects. [His] is the Oso Parkway Bridge Replacement Project in Aliso Viejo. The dedication to provide project consists of the removal, relocation and adjustment of existing competent staff improvements, excavation and grading, removal and relocation of directly affected the existing utilities, construction of new storm drainage and storm water completion of these pre-treatment and storage system, construction of curb, gutter and projects on time under pedestrian walkways and ramps, bridge construction, roadway paving extreme time and new overhead signage and traffic control devices. Services constraints." include concrete batch plant inspections, PCC aggregate sampling — Charles R. Ramey, Chief and testing, onsite flexural beam fabrication, and laboratory testing. Construction Inspector City of Long Beach City of Long Beach, On -Call Materials Testing and Inspection Services for Street Improvements, Long Beach, CA. Program Manager currently overseeing this on -call materials testing and inspection contract that has included 100+ task orders to date. Projects have included soils, aggregate base, asphalt concrete, laboratory testing, PCC, masonry, welding and fireproofing testing and inspection services for capital facility projects, street rehabilitationfimprovements, bus pad repairs, construction of concrete curbs and gutters, sidewalk repairs, bridge repairs, and installation of traffic signals. Mr. Hanna oversees the field NOW-.10924001r Dany Hanna 11 'xcsnviceca�la Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A observation and testing, plant inspection, and laboratory testing services for the soils, base, Portland cement concrete, and asphalt concrete. County of Los Angeles, As -Needed Materials Testing and Inspection Contracts, County of Los Angeles, CA. Serves as Program Manager and oversees four on -call contracts with the County for as -needed materials testing and inspection services (50+ task orders to date). Typical projects have included soils, aggregate base, asphalt concrete, PCC, masonry, welding and fireproofing testing and inspection, and laboratory testing services for street improvement projects, capital facility projects, repair of earthquake and non -earthquake facility damage, and facility alteration at sites located throughout Los Angeles County. County of Los Angeles, As -Needed Materials Testing Services for Federally/Non-Federally Funded Projects, Los Angeles County, CA. Contract Manager. Currently oversees this as -needed materials testing and inspection contract that has included 20+ task orders to date. Typical projects have included soils, base, asphalt concrete, laboratory testing, PCC, masonry, welding and fireproofing testing and inspection services for street improvement projects, capital facility projects, repair of earthquake and non -earthquake facility damage, and facility alteration throughout the county. Caltrans District 8 (Contract 08A2768), On -Call Construction Materials Sampling and Testing Services, Riverside and San Bernardino Counties, CA. As Contract Manager, Mr. Hanna currently oversees this three-year, $3.3 million on -call contract for construction field materials testing services throughout Caltrans District 8. Our services are being performed at numerous project sites and material supplier batch plants. Our scope of services include the following: construction materials observation; materials testing per Caltrans Test Methods (CTMs) and Caltrans Construction Manual; concrete and HMA batch plant inspection; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; special materials analysis and evaluation; materials documentation and information; and preparation of reports to Caltrans Standards and requirements. City of Ontario, As -Needed Materials Testing and Geotechnical Engineering Services, Ontario, CA. As Contract Manager, Mr. Hanna currently oversees the materials testing and inspection and geotechnical engineering services performed on an as -needed basis as an extension to the city engineering department. Services have included multiple task orders requesting materials testing and inspection services during the rehabilitation of multiple residential streets and main commuter routes with the city. Typical task orders have included construction observation and field and laboratory testing of engineered fill soils and backfill, aggregate base rock, asphalt concrete and PCC utilized during street improvement projects. Caltrans District 7, Contract 07A4733 (Prior Contract 07A4077), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Contract Manager. Currently oversees this three-year, $5.0 million contract for on -call construction materials sampling and testing services to improve the State transportation system throughout Caltrans District 7. Our services are being performed at numerous project sites, and our scope of services includes the following: construction materials observation; materials testing per Caltrans test methods and Caltrans construction manual; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; and special materials analysis and evaluation. Caltrans SRL, Contract 08A2958 (Prior Contracts 08A2541 and 08A2218), On -Call Sampling and Testing of HMA and Asphalt Binder, Projects Located in Caltrans Districts 7, 8, and 12, CA. As Contract Manager, Mr. Hanna oversees this three-year, $4.6M on -call sampling and testing services contract for HMA (including HVEEM and Superpave), metals, PCC, aggregates, and other related construction materials. As Caltrans' single point -of -contact, provides consistent communication and 24-hour availability. Coordinates resources and provides materials testers to perform laboratory testing services at Caltrans' SRL for highway/street improvements, and bridge repairs. Ensures timely delivery of task orders and maintains budget, schedule, and safety objectives. (, �HtEINF£LD£R MW210924001P Dany Hanna 12 `-' Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Education James Stiady, PhD, PE, GE PhD, Civil Engineering Task Order Manager MS, Civil Engineering Dr. Stiady has 20 years of technical and project management BS, Civil Engineering experience in pavement, geotechnical, and materials testing. He has managed geotechnical testing and special inspection for License / Certification various on call contracts throughout southern California. He Professional Engineer— performs Pavement Condition Surveys, designs pavement Civil, CA No. 66243 sections for highway and airfields, and develops and reviews Geotechnical Engineer, CA Pavement rehabilitation programs. He developed mix designs for No. 2820 Roller Compacted Concrete (RCC), conventional concrete, Superpave, and conventional hot mix asphalt. He obtained and Special Training maintained AASHTO accreditation, developed laboratory software, Loss Prevention System and implemented QA/QC plans. Safety Training Relevant Project Experience Defensive Driv T ' ; / er raining Orange County Public Works (OCPW), As-Needed Materials Driver's License Testing & Inspection and Geotechnical Engineering and Years of Experience Services, Orange County, CA. Materials Testing Engineer. Cn- 20 years total call contract for materials testing and inspection and geotechnical engineering services for OCPW. Kleinfelder is providing materials 13 years with Kleinfelder testing and inspection services in support of OCPW's Quality Assurance (QA) program for construction of new or rehabilitation of existing roadways, flood control channels, parks, or other infrastructure projects. Kleinfelder complies with and all testing is performed in accordance with OCPW Standards and Procedures, Greenbook Specifications, Caltrans Standards, ASTM Standards, AASHTO Standards, and APWA Standards. In addition, Kleinfelder's material testers and laboratories are certified CCRL, AASHTO resource accreditation, and ASTM D3666. A recent project is the Oso Parkway Bridge Replacement Project in Aliso Viejo. The project consists of the removal, relocation and adjustment of existing improvements, excavation and grading, removal and relocation of existing utilities, construction of new storm drainage and storm water pre-treatment and storage system, construction of curb, gutter and pedestrian walkways and ramps, bridge construction, roadway paving and new overhead signage and traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. County of San Diego As -Needed Materials Testing and Geotechnical Consulting for Non - Federally Funded Projects, San Diego County, CA. Project Manager and Materials Testing Engineer. Manages materials testing and geotechnical engineering task orders; coordinates field and laboratory testing activities; provides supervision and quality assurance of testing procedures and test results for slurry seal, chip seal, and AC overlay projects; and coordinated swift response on an emergency repair road project. Caltrans District 11, Construction Materials Sampling and Testing Services, Contract EA- 11A2364 and 11A2365 (continued from prior Contract EA-11A2025), Imperial Valley, CA. Project Manager and Lead Material Engineering Tester. Manages up to 8 full-time field and laboratory technicians. Coordinates field and laboratory activities and provides consultation with Caltrans Resident and Materials Engineers. Services have included compaction testing, concrete sampling, HMA batch plant inspections, HMA sampling, oil sampling, and aggregate sampling. Laboratory testing included mix design verification, soil and base maximum density, Caltrans- required aggregate quality testing, gradation, sand equivalent, Superpave gyratory compactor maximum density, Hamburg Wheel Track testing, tensile strength ratio, concrete compression, and flexural beam strength testing. "1N2 t043001P James Stiady 11 fCGElNFFLOFR Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Caltrans District 11, Construction Materials Sampling and Testing Services, Contract EA- 11A2466 & 11A2479 (continued from prior EA-11A2026), San Diego County, CA. Project Manager and Lead Material Engineering Tester. Manages and coordinates field and laboratory activities and provides consultation with Caltrans Resident and Materials Engineers. Services have included sampling of subgrade soils, aggregates, HMA, oil, and concrete; batch plant inspections for HMA and concrete plants, and laboratory testing. Our materials testers perform soils, aggregate base, HMA, concrete sampling and testing in the field on various EA, and perform HMA testing in our AASHTO and Caltrans-accredited laboratory; augmenting the Caltrans District 11 laboratory. Imperial County Department of Public Works, On -Call Soils and Geotechnical Engineering and Materials Testing, Imperial County, CA. Geotechnical Engineer responsible for developing Quality Assurance Plans, review of AC mix designs, preparation of AC and aggregate lab testing programs, and pavement consultation during roadway construction projects. City of Long Beach, Runway 7R-25L, 811-26L, R12-30, Long Beach, CA. Oversaw QA Testing and Inspection Services for improvements to various runways and performed Phase II Pavement Condition Surveys. Designed pavement sections for highway and airfields and developed and reviewed pavement rehabilitation programs. County of Imperial, On -Call Services, LTA Phase 1 AC Overlay, Imperial County, CA. Project Manager/Pavement Engineer. Managed the repair of pavement failure, placement of two -inches of AC hot mix overlay, and placement of Type 2 slurry seal coat at 13 locations. Responsible for oversight and coordination of field and laboratory testing for subgrade, base, AC overlay, chip seal, and slurry seal. Provided recommendations for pavement section and subgrade stabilization at Horne Road. Implemented QC program for chip seal, slurry seal, cold -in -place recycling, and AC overlay. University of California, San Diego (UCSD), Various Projects, San Diego and La Jolla, CA. Project Manager for construction materials testing and special inspection services for various UCSD projects including UCSD 5079 Mesa Pedestrian Bridge, 4981 MCLJ EVS, 5020 ED RIC, 5240 Soccer Field Conversion, 4930 EMF Building, 5094 Thornton Endoscopy Renovation, 5085 Muir Biology Building Renovation, 5250 Price Center West Renovation, 5166 Barreiro Laboratory Renovation, 5262 Outback Adventures, 4484 MCLJ Outpatient, MC18111 JMC Family Lounge, MC18144 Network Antenna, MC 18070 JMC SPD Remodel, MC 17110 SCVC. University of California, San Diego (UCSD) Jacobs Medical Center, Various Projects, La Jolla, CA. Deputy Project Manager, providing engineering and management support for field inspectors and material testers. He provided training for field personnel in utilizing UCSD's cloud system. Dr. Stiady oversaw the special inspection for structural welding and high strength bolting activities, concrete placement inspection and testing, and rebar inspection, sampling, and testing. San Diego Community College District, Building A, D, T Renovation, San Diego, CA. Deputy Project Manager managing inspection activities with contractor work in -progress and building rapport with the Inspector of Record. Project scope includes special inspection for structural welding, high strength bolting, fiber -reinforced polymer (FRP) installation, concrete placement, rebar inspection, post -installed anchors, ceiling wires, and masonry placement. The renovation of the "A" building upgraded 52,000 square feet of Student Services and Administration Office space. Renovations included seismic and structural upgrades, removal of portions of the original structure to enhance the new plaza area, full interior demo and modernization build -out. The "D" building component of the project replaced the existing roof deck with a new rooftop deck, existing planters, and raised areas of the roof will be transformed into student and faculty gathering areas. The renovation of the "T" building involved approximately 77,000 square feet of space, creating new homes for the engineering department and other technical specialties. Renovations included seismic and structural upgrades, full interior demo and modernization build -out. �J[LEINFELQFR M'N210924,001P James Stiady 12 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A License / Certification Roger Khoudessian, PE, NICET, ICC, CTMs, AASHTO Professional Engineer - Task Order Manager Civil, CA No. 73806 Mr. Khoudessian is a registered Professional Engineer with 17 Caltrans Test Methods years of experience as a materials engineer, laboratory manager, Certified PG Binder and project and field manager. He is experienced with Technician communicating and coordinating with Project Managers and NBTC No. AI227; DSR, responsible for the daily operations and tasks associated with BBR, DTT directing, reviewing, and monitoring work performed by Kleinfelder inspectors. He is also experienced with overseeing, coordinating, ICC Special Inspector: and scheduling based on each tester's experience and expertise. Structural Welding; Structural Steel/Bolting He currently serves as HMA Laboratory Lead Tester conducting NICET Level II: tests per Caltrans and AASHTO test methods, operating daily Aggregate, Asphalt, onsite at the Caltrans SRL under Contract 08A2958. Soils His laboratory experience in soils and aggregates includes Assistant Radiation Safety modified proctor compaction for different types of soils and Officer particles size analysis through sieving and hydrometer, durability AWS - Certified Welding index, cleanness value, sand equivalent, organic impurities, sulfate soundness, unit weight, LA abrasion, consolidation, direct shear Inspector and remolded shear. He has performed laboratory testing on HMA AASHTO: HMA, Asphalt including stability and flow, Hveem and Marshall compaction Binder, Soil, Aggregate, methods, oil content (by ignition oven and extraction by solvent), PCC calibrating ignition ovens for binder and aggregate correction IATA Certification factors, Superpave gyratory compaction, indirect tensile strength, (Hazardous Materials Hamburg Wheel testing and analysis, core densities and Transport) preparation of AC mix designs. Mr. Khoudessian has performed Special Training laboratory testing on PCC including entrained air voids, slump test, Kelly ball test, unit weight, compressive and flexural strength, field Nuclear Gauge Operator sampling, and curing. He has performed HMA batch and drum Training plant inspections, and PCC batch plant inspections. He is Loss Prevention System extensively familiar with ASTM, AASHTO, Caltrans, Greenbook, Safety Training US Army Corps of Engineers, AWS, and ACI standards. His Defensive Driver Training/ managing experience in the special inspection field includes Driver's License reinforced concrete and masonry, structural steel and bolting, structural welding, fireproofing, Pre -stressed (Post -Tension and Years of E>; - ',gnce Pre -Tension concrete), and pervious concrete. He is familiar with 17 years total the design and testing of PCC pavements including Lean Concrete 17 years with Kleinfelder Base (LCB), as well as the review and verification of Emulsion Aggregate Slurry, Treated Aggregate Base, PCC and HMA mix designs. Relevant Project Experience City of Long Beach, On -Call Soils and Material Testing and Inspection Services for Street Improvements, Long Beach, CA. For 17 years, Mr. Khoudessian managed numerous as - needed soils and materials testing services on continued contracts. Projects included lime and cement full depth reclamation of soils, AC field testing and inspection, AC batch plant inspection, slurry seal testing and placement observation, PCC placement observation, field percolation testing, installation of French drains, and managing special inspections. Projects followed Greenbook specifications, CBC, and Caltrans Standard Specifications. (2.11.. NVN, 10924 0° I P Roger Khoudessian 11 �_ Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A County of Los Angeles, As -Needed Materials Testing Services for Federally and Non - Federally Funded Projects (Contract PW13972), Los Angeles County, CA. Mr. Khoudessian serves as Supervisor of Laboratory and/or Field Technicians under our on -call contract with the County of Los Angeles for federally and non -federally funded projects. Kleinfelder provides materials observation and testing services for various street improvement projects. The federally funded projects consist of AC pavement grind and overlay, reconstruction of concrete curbs and gutters, sidewalks, median islands, curb ramps, driveway approaches, alley intersections, and other appurtenant work. Caltrans District 8, (Contract 08A2768), On -Call Construction Materials Sampling and Testing Services, Riverside and San Bernardino Counties, CA. Consultant Supervisor of Laboratory and/or Field Technicians/Lead Materials Engineering Tester. Mr. Khoudessian is providing on -call construction field materials testing services to improve the State transportation system throughout Caltrans District 8 (covering Riverside and San Bernardino Counties). Our services are being performed at numerous project sites and material supplier batch plants. Our scope of services include the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; concrete and hot mix asphalt batch plant inspection; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; special materials analysis and evaluation; providing materials documentation and information; and preparation of reports to Caltrans standards and requirements. Caltrans District 7 (Contract 07A4077), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Mr. Khoudessian serves as Consultant Supervisor of Laboratory and/or Field Technicians/Lead Materials Engineering Tester for this contract which includes as -needed construction field materials testing services to improve the State transportation system throughout Caltrans District 7 at numerous project sites. Services include the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; special materials analysis and evaluation; materials documentation and information; and preparation of reports to Caltrans Standards and requirements. Caltrans SRL, Contract 082958, and Prior 08A2541/08A2218, On -Call Sampling and Testing of HMA and Asphalt Binder, Districts 7, 8, and 12, CA. Mr. Khoudessian acted as HMA Laboratory Lead Tester conducting tests per Caltrans and AASHTO test methods. Tests included: HVEEM stability and unit weight, rice density, ignition oven and gradation on extracted aggregate, correction factor determination, Gyratory compaction for superpave briquettes, moisture susceptibility test per AASHTO T283, and Hamburg Wheel testing per AASHTO T324. �FLElMFELpFRt Mw210024.001P Roger Khoudessian 12 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A License/Certification Rick Bell, NICET, NRMCA, RSO NICET: Task Order Manager - Field, Level II Mr. Bell has 38 years of experience with task order management and - Laboratory, Level II laboratory and Feld quality assurance testing, including construction National Ready Mixed inspection, shop fabrication inspection, materials testing, batch plant Concrete Association: inspection, and office engineering. He performs/oversees inspection and Portland Cement materials testing for various aspects of roadway, highway and bridge Concrete projects, including drainage, structures, subgrades, embankments, and OSHA 40-Hour pavement. Materials testing experience includes soils, aggregate, HAZWOPER asphalt, concrete, and structural steel; inspection experience includes implementation of project plans and specifications, documentation, and Certified Radiation Safety processing of change orders and pay estimates during the construction Officer (RSO) process. Mr. Bell is knowledgeable with the requirements of Caltrans, Special Training FHWA, AASHTO, and ASTM, and is experienced with design of pavements, sampling, and field testing according to Caltrans Nuclear Gauge Operator specifications, FAA Standards and local agency specifications. Training Loss Prevention System Relevant Prol- - Safety Training Orange County Public Works, As -Needed Geotechnical Defensive Driver Training/ Engineering and Materials Testing & Inspection Services, Orange Driver's License County, CA. Project Manager. On -call contract for materials testing and inspection and geotechnical engineering services for OCPW. Years of Experience Kleinfelder is providing materials testing and inspection services in 38 years total support of OCPW's Quality Assurance (QA) program for construction of 31 years with Kleinfelder new or rehabilitation of existing roadways, flood control channels, parks, or other infrastructure projects. Kleinfelder complies with and all testing is performed in accordance with OCPW Standards and Procedures, Greenbook Specifications, Caltrans Standards, ASTM Standards, AASHTO Standards, and APWA Standards. In addition, Kleinfelder's material testers and laboratories are certified CCRL, AASHTO resource accreditation, and ASTM D3666. A recent project is the Oso Parkway Bridge Replacement Project in Aliso Viejo. The project consists of the removal, relocation and adjustment of existing improvements, excavation and grading, removal and relocation of existing utilities, construction of new storm drainage and storm water pre-treatment and storage system, construction of curb, gutter and pedestrian walkways and ramps, bridge construction, roadway paving and new overhead signage and traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. County of Los Angeles, As -Needed Materials Testing Services for Federally/Non-Federally Funded Projects, Los Angeles County, CA. Materials Task Order Manager since 2010 on this ongoing contract. Kleinfelder provides materials testing and inspection services for various projects for the County of Los Angeles. These projects consisted of roadway improvements, airport rehabilitations, ADA upgrades, park beautifications, and modifications of miscellaneous County facilities. Typical services have included soils, aggregate base, AC, PCC, masonry, welding, fireproofing, and laboratory testing services for street improvement projects, capital facility projects, repair of earthquake and non - earthquake facility damage, and facility alteration at sites located throughout the County. City of Ontario, As -Needed Geotechnical Engineering and Materials Testing and Inspection Services, Ontario, CA. Project Manager for numerous projects under this contract. Services have included multiple task orders requesting materials testing and inspection services during the rehabilitation of multiple residential streets and main commuter routes. Managed the recent Recycled Water Improvements for Riverside Drive (OMUC), which included four "Bid Schedules" A-D during construction activities. Each of the bid schedules included installation of various diameter PVC and/or s PAPA 2vusa_I'll ic Rick Bell 11 �tEimvEco¢n Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A CML/CMC water pipe as well as installation of various fire hydrants, butterfly valves, blow -off assemblies and air release and vacuum valve assemblies which required saw cutting and removal of existing AC pavement, trench excavation, pipe and assembly installation and backfill and placement of new AC pavement. The finished roadway within the utility trench consisted of 8 inches of AC over a 10- inch section of aggregate base. The project was completed on time and within budget. Caltrans SRL, Contract 08A2958 (Prior Contract 08A2541), On -Call Materials Sampling and Testing Support Services for Projects Located in Caltrans Districts 7, 8, and 12, Southern CA. Consultant Task Order Manager/QA Manager. Three-year on -call contract for sampling and laboratory testing of HMA and aggregate materials. Mr. Bell oversees the Kleinfelder team internal training and certification process and assists Kleinfelder's contract manager with monthly billing and staffing projections. In addition, Mr. Bell developed a project -specific safety program to be used in conjunction with Caltrans safety procedures for testers working at Caltrans' SRL. City of Burbank, Annual Street Rehabilitation Program - Construction Inspection, Burbank, CA. Quality Assurance Manager/Project Manager. Oversaw construction inspection services during rehabilitation of 27 lane miles of residential streets. The project comprised construction of new ADA ramps to meet code requirements, a 1.5-inch grind and overlay of existing asphalt concrete pavement, and removal and replacement of curb and gutter at various locations. Documented daily construction activities and performed quantity calculations and pay application reviews on behalf of the city for final acceptance by the city engineer. Mr. Bell provided recommendations on how best to utilize the project bid item for contractor quality control, and the city utilized these recommendations as suggested to monitor the contractor's means and methods during construction activities. Caltrans District 7, Contract 07A4733 (Prior Contract 07A4077), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Quality Assurance Manager for as - needed services to improve the State transportation system throughout Caltrans District 7. Performs and oversees construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; special materials analysis and evaluation; materials documentation and information; and preparation of reports to Caltrans Standards and requirements. County of Riverside Transportation Department, On -Call Highway Geotechnical Engineering and Materials Evaluation and Testing Services, Riverside County, CA. Project Manager/Quality Assurance Manager responsible for construction inspection and materials testing oversight, training, and cost controls. Maintains communications with County project Resident Engineers and inspection staff to identify project -specific needs during construction activities for projects falling under Caltrans jurisdiction. Assists the County with scheduling and dispatching of appropriate Kleinfelder testers and inspectors and maintains summaries of QA test results for ongoing projects involving Kleinfelder laboratories and materials testers. Additionally, Mr. Bell has assisted the County's project Resident Engineer during the preparation and approval processes associated with a required Source Inspection Quality Management Plan (SIQMP) and project closeout reports. Asphalt Rubber HMA (ARHM) Designs, County of Los Angeles Department of Public Works, CA. Quality Assurance Manager. Provided laboratory ARHM-GG-C mix proportions (with and without 15% RAP) on materials collected from three separate Los Angeles County material suppliers. The purpose was to verify existing ARHM-GG-C job mix formula (JMF) proportions currently being provided to the County; investigate the suitability of a 15% recycled asphalt pavement (RAP) replacement in each JMF, and check the binder properties of the RAP collected from each of the three plant locations sampled. Provided material sampling and laboratory mix proportion utilizing aggregates, RAP, and PG 64-16 asphalt rubber binder collected during routine production of ARHM asphalt concrete at each of the three batch plants selected. Laboratory testing included California Test Numbers 304, 308, 309, and 366. �lttEINFELPFR Mw2ID92.4001P Rick Bell 12 ``-' Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Education Mike Dorsch AA, General Education Quality Assurance Manager License / Certification Mr. Dorsch brings 13 years of experience in construction materials Quality Assurance/Quality Control (QA/QC) consisting of Radiation Safety Officer production and placement of HMA, PCC, soil, and aggregate Training materials. He is responsible for the daily interaction with clients Special Training consisting of Caltrans, public works agencies, and contractors. Nuclear Gauge Operator Instrumental in providing QA/QC management for projects Training consisting of field inspection, laboratory report review, project field supervision, and providing technical support to the project team. Loss Prevention System Safety Training Mr. Dorsch is currently Kleinfelder's QA Manager and/or Task Defensive Driver Training/ Order for Orange County Public Works, County of Los Angeles, Driver's License Caltrans District 8 (08A2768), SRL (08A2958), and District 7 (07A4733) on -call contracts. He ensures the timely delivery of task Years of Experience order requests throughout the project duration, scrutinizes budgets, 13 years total and maintains scheduling and safety objectives. He provides 3 years with Kleinfelder oversight of field testing services at project sites and material supplier batch plants, performs project scheduling and field coordination, review and distribution of daily field reports, materials documentation and information, report preparation according to Caltrans and local agency standards and requirements, and writes and implements quality assurance plans for various types of projects under the jurisdiction of local agencies, FAA, Caltrans, and DSA. Relevant Project Experience Orange County Public Works (OCPW), As -Needed Geotechnical Engineering and Materials Testing & Inspection Services, Orange County, CA. QA Manager. On -call contract for materials testing and inspection and geotechnical engineering services for OCPW. Kleinfelder is providing materials testing and inspection services in support of OCPW's QA program for construction of new or rehabilitation of existing roadways, flood control channels, parks, or other infrastructure projects. Kleinfelder complies with and all testing is performed in accordance with OCPW Standards and Procedures, Greenbook Specifications, Caltrans Standards, ASTM Standards, AASHTO Standards, and APWA Standards. In addition, Kleinfelder's material testers and laboratories are certified CCRL, AASHTO resource accreditation, and ASTM D3666. A recent project is the Oso Parkway Bridge Replacement Project in Aliso Viejo. The project consists of the removal, relocation and adjustment of existing improvements, excavation and grading, removal and relocation of existing utilities, construction of new storm drainage and storm water pre-treatment and storage system, construction of curb, gutter and pedestrian walkways and ramps, bridge construction, roadway paving and new overhead signage and traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. City of Long Beach, On -Call Materials Testing and Inspection Services for Street Improvements, Long Beach, CA. Task Order Manager. Mr. Dorsch serves as Task Order Manager for this three-year on -call materials testing and inspection contract with the City of Long Beach that has included more than 100 task orders to date. Projects have included soils, base, AC, laboratory testing, PCC, masonry, welding and fireproofing testing and inspection services for capital facility projects, street rehabilitation/improvements, bus pad repairs, construction of concrete curbs and gutters, sidewalk repairs, bridge repairs, and installation of traffic signals. He has daily interaction with our team of inspectors and weekly review and tracking of budgets. County of Los Angeles, As -Needed Materials Testing Services for Federally and Non - Federally Funded Projects (Contract PW13972), Los Angeles County, CA. Mr. Dorsch serves Mike Dorsch 11 �x`smvEcoEp Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A as Task Order Manager for this as -needed contract with the County of Los Angeles for federally and non -federally funded projects. Kleinfelder provided materials observation, field inspection and testing, and laboratory testing services for various projects throughout the County of Los Angeles. The federally funded projects consisted of asphalt concrete pavement grind and overlay, reconstruction of concrete curbs and gutters, sidewalks, median islands, curb ramps, driveway approaches, alley intersections, and other appurtenant work. Kleinfelder's services were performed in accordance with the County of Los Angeles QA Plan and the Caltrans Specification Section 39 (asphalt concrete). Kleinfelder provided asphalt concrete observation and testing services at the production plant and job site, as well as construction materials laboratory testing services at our laboratory facilities. Caltrans District 8, (Contract 08A2768), On -Call Materials and Testing Services, Riverside and San Bernardino Counties, CA, Mr. Dorsch serves as Task Order Manager responsible for QA materials testing and inspection services to improve the State transportation system throughout Caltrans District 8 (covering Riverside and San Bernardino Counties). He provides oversight of field- testing services performed at numerous project sites and material supplier batch plants. Mr. Dorsch is responsible for project scheduling and field coordination, review and distribution of daily field reports, providing materials documentation and information, and preparation of reports to Caltrans Standards and requirements. He reviews and processes timesheets and expense reports directly relating to the implemented Caltrans procedures for the contract. 1-405 Sepulveda Pass Widening, Los Angeles, CA. Mr. Dorsch served as QA Project Manager tasked with the oversight of field and batch plant inspectors for the design -build project which involved constructing one 10-mile high -occupancy vehicle (HOV) lane northbound on Interstate-405 from Interstate-10 to US-101. The project realigned existing on and off ramps, reconstructed 23 bridges and ramp structures, built approximately 18 miles of retaining walls, and added road improvements on the adjacent city streets. He was responsible for review and distribution of daily field reports, tracking material quantities, and implementing the laboratory testing program. Mr. Dorsch dispatched and scheduled inspectors for multiple scopes of work. Los Angeles World Airports (LAWA) Specialty Staff and Materials Testing Services, Los Angeles, CA. Mr. Dorsch serves as Operations Manager and the primary point -of -contact to coordinate Kleinfelder's services with LAWA's Quality Assurance Program Manager and the Quality Assurance & Construction Inspection Division for this large-scale $14B construction program. He is responsible for the performance of the Kleinfelder Team which includes a group of 19 subconsultants who act as an extension of LAWA's QACID by providing inspectors and specialty staff to augment LAWA's inspection group under the direction of Chief Construction Inspector Mr. Gerardo Lopez and his assigned Principal Inspectors. The Kleinfelder Team worked around -the -clock performing Deputy Building Inspection, MEP Inspection, Security Inspection, Construction Escort Staffing, Project Inspection Office Engineering, Knowledge Management, and providing Construction Management Interns to help achieve LAWA's overall goal of delivering these complex projects on schedule and within budget. Caltrans District 7 (Contract 07A4733), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Mr. Dorsch serves as Consultant Task Order Manager for this contract which includes as -needed construction field materials testing services to improve the State transportation system throughout Caltrans District 7 at numerous project sites. Services include the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; special materials analysis and evaluation; materials documentation and information; and preparation of reports to Caltrans Standards and requirements. Mr. Dorsch ensures the timely delivery of task order requests throughout the project duration, scrutinizes budgets, and maintains scheduling and safety objectives. fKLflNFELOSR NIW210924001P Mike Dorsch 12 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Education Bryan Reese, ASP BS, Biology Health & Safety Manager License / Certification Mr. Reese serves as the Health and Safety (H&S) Manager for Board of Certified Safety Kleinfelder's Western United States operation. In this position he Professionals Associate is responsible for pre -proposal scope of work review to anticipate Safety Professional and develop strategies to reduce H&S risks, prepare/review site - (ASP) specific H&S plans, audit of safe work practices and procedures In Progress: BCSP at Kleinfelder work sites and laboratories, investigation of near - incidents to identify causal factors, root causes, and solutions to Certified Safety reduce potential reoccurrence, and analysis of safe performance Professional (CSP) leading indicators for various projects across Kleinfelder's Special Training technical disciplines and market sectors. Mr. Reese commonly leads health and safety planning efforts for high -risk activities OSHA 30-Hour Construction Industry such as confined space entry, work over water, work at heights, Outreach Training and excavation/heavy equipment to ensure that work practices implemented in the field meet applicable occupational safety and Kleinfelder Certified Loss health regulations and the policies described in Kleinfelder' Injury Prevention System and Illness Prevention Plan. Mr. Reese participates with the Certified Health and development, improvement, and implementation of over -arching Safety Trainer corporate health and safety management system initiatives and First Aid & CPR Training leads H&S training and mentoring efforts with Kleinfelder Defensive Driver Training/ employees within his span. Driver's License Relevant Proiect Experience Years of Experience Orange County Public Works, As -Needed Geotechnical 15 years total Engineering and Materials Testing & Inspection Services, 13 years with Kleinfelder Orange County, CA. H&S Manager. On -call contract for materials testing and inspection and geotechnical engineering services for OCPW. Kleinfelder is providing materials testing and inspection services in support of OCPW's Quality Assurance (QA) program for construction of new or rehabilitation of existing roadways, flood control channels, parks, or other infrastructure projects. Kleinfelder complies with and all testing is performed in accordance with OCPW Standards and Procedures, Greenbook Specifications, Caltrans Standards, ASTM Standards, AASHTO Standards, and APWA Standards. In addition, Kleinfelder's material testers and laboratories are certified CCRL, AASHTO resource accreditation, and ASTM D3666. A recent project is the Oso Parkway Bridge Replacement Project in Aliso Viejo. The project consists of the removal, relocation and adjustment of existing improvements, excavation and grading, removal and relocation of existing utilities, construction of new storm drainage and storm water pre- treatment and storage system, construction of curb, gutter and pedestrian walkways and ramps, bridge construction, roadway paving and new overhead signage and traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. Caltrans, West End Viaduct, CA. H&S Officer. The project involved the advancement and sampling of several geotechnical borings along the proposed alignment of a viaduct expansion. For the implemented field activities, Mr. Reese managed preliminary hazard identification and risk assessment, and planned for safe work practices and procedures in accordance with regulatory, client, and Kleinfelder H&S standards. Also provided oversight for implementation of safe work practices, subcontractor H&S management, and management of change. bPN2uia=_a 001P Bryan Reese 1 xcEnvcEca�a Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A County of Los Angeles Department of Public Works, Rancho Los Amigos Rehabilitation Hospital, Site 1 Demolition and Make -Ready Project, Downey, CA. H&S Officer. Kleinfelder is providing building inspections, materials testing, geotechnical engineering, IOR, and hazardous materials abatement monitoring. Mr. Reese managed the abatement oversight of hazardous building materials, including asbestos -containing materials (ACM) and lead -based paints/materials for various facility buildings at the Rancho Los Amigos facility prior to demolition for the Site 1 Make -Ready Project. Also was responsible for coordinating internal and subcontracted resources, review of analytical and H&S containment data, preparation of post - abatement close-out reports, and coordination with client and project stakeholders. LA County METRO, Site -Specific H&S Plan for Division 20 Portal Widening, Los Angeles County, CA. H&S Officer. The project included the oversight of the demolition of existing buildings, including the evaluation and removal of hazardous building materials, and excavation of environmentally impacted soil resulting from industrial activities performed by prior property owners. Mr. Reese participated in the preparation of the Site -Specific H&S Plan, provided consult for managing safety -related change in condition and performed periodic audits of Kleinfelder safe work behavior to verify compliance with applicable occupational safety and health regulations and Kleinfelder's Injury and Illness Prevention Plan. Riverside County Transportation Commission, Irvine Corona Expressway, Orange and Riverside County, CA. H&S Officer. Mr. Reese provided periodic support as a field scientist for feasibility -level geotechnical investigation for 10-mile long transportation corridor for twin 50 ft. diameter tunnels through the Santa Ana Mountains. The investigation included five (5) deep rock core borings up to 1,500 feet deep to evaluate rock mass characteristics, groundwater conditions and hydraulic conductivity, and preparation of geotechnical data and assessment reports. Specific project duties included: H&S monitoring and oversight, assistance with core sample preparation, and monitoring for compliance with US Forest Service and other applicable project permits. City of Los Angeles, Department of Water and Power, Streetlight, Los Angeles, CA. H&S Officer. Mr. Reese managed a human health risk assessment project which evaluated the potential intrusion of PCE vapors into indoor air within office buildings. Responsibilities included development of experimental design, establishing laboratory reporting limits, oversight of subcontractor installation of sub -slab soil vapor probes, collection of sub -slab soil vapor and air samples, and preparation of assessment report and Tier 1 HHSE. City of Los Angeles, Department of Water and Power, Former DKR Lease Site, Los Angeles, CA. H&S Officer. Mr. Reese was responsible for implementing a shallow soil, soil vapor, sub -slab soil vapor, and indoor/outdoor air sampling program associated with a release from a gasoline UST. Responsibilities included scoping field sampling approach, establishing laboratory reporting limits, oversight of subcontractor installation of soil gas and sub -slab soil vapor probes, collection of soil, soil vapor, and air samples, and preparation of assessment report and Tier 1 HHSE. City of Long Beach, Long Beach Airport Cover Street Stockpile Sampling, CA. H&S Officer. Managed the assessment and environmental testing of a 66,000 cubic yard stockpile of soil and construction debris accumulated from multiple construction projects at the airport. The stockpile constructed of discontinuous strata of soil, concrete, and asphalt was not structurally sound and Mr. Reese created an assessment plan consisting of a combination of excavation and limited access hollow -stem auger drilling to fully assess the stockpile. Responsible for creating an experimental design and analytical testing regiment, H&S plan, submitting a FAA 7460 notification, subcontractor management, and preparing an environmental assessment report used by the City to prepare bid documents for disposal of the stockpile. �Hssnvr-�cos+a Bryan Reese 2 nnwzmszaomry� P I Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A License / Certification Sony Pheng, ACI, CTMs, ICC ICC Special Inspector: Technician/Inspector - Soils Mr. Pheng has six years of experience in the construction materials - Spray -applied testing and inspection industry and is currently certified in various Fireproofing ICCs and CTMs. He has recently worked on various municipal ACI Field Testing public works projects including various highway pavement Technician, Grade 1 rehabilitations, storm drain repairs, and taxiway/runway ACI Concrete Strength improvements. He has worked with clients throughout southern Testing Technician, California including Counties of Orange, Riverside, San Bernardino, and the Greater Los Angeles Region. CTM Certified: 105, 125, 201, 202, 205, 216, 217, Relevant Project Experience 226, 227, 229, 231, 504, City of Long Beach, On -Call Materials Testing and Inspection 518, 521, 523, 524, 533, 539, 540, 543, 552, 556, Services for Street Improvements, Long Beach, CA. Mr. Pheng performed various testing and inspection services for street 557 improvements. The work consisted of pavement reconstruction Special Training and overlays, constructing PCC curbs, gutters, driveways, curb Nuclear Gauge Operator ramps, and sidewalks. Training City of Ontario, As -Needed Materials Testing and Loss Prevention System Geotechnical Engineering Services, Ontario, CA. Services Safety Training have included multiple task orders requesting materials testing Defensive Driver Training/ and inspection services during the rehabilitation of multiple Driver's License residential streets and main commuter routes within the city. Mr. Pheng performed work on task orders which have included Years of Experience construction observation and field and laboratory testing of 6 years total engineered fill soils and backfill, aggregate base, AC, and PCC utilized during street improvement projects. 3 years with Kleinfelder Caltrans District 7 (Contract 07A4733), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Mr. Pheng is currently providing as needed construction field materials testing services to improve the State transportation system throughout Caltrans District 7 (covering Los Angeles and Ventura Counties). Our services are being performed at numerous project sites, and our scope of services include the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; and special materials analysis and evaluation County of Riverside Transportation Department, On -Call Highway Geotechnical Engineering and Materials Evaluation and Testing Services, Riverside County, CA. Mr. Pheng has provided sampling and testing of subgrade soils, cellular concrete backfill, and PCC for various projects under this current on -call contract. Kleinfelder has been providing on -call materials and geotechnical testing services for County of Riverside on multiple roadway construction projects for several years, including three years as a prime consultant. A recent project Mr. Pheng worked on was the Clinton Keith Road Extension (Phase 2) in Murrieta, CA, which comprised of the new construction of a four -lane roadway, median, two new bridge structures, and traffic signals. Various On -Call and Materials Testing & Inspection Contracts, Counties of Orange, Riverside, San Bernardino, and the Greater Los Angeles Region, CA. Mr. Pheng has performed inspection for pull testing, torque testing, coring, nuclear gauge testing, trench backfill, sampling of concrete and soils for numerous projects for County of Los Angeles, Ontario International Airport, John Wayne Airport, Southern California Edison, and Eastern Municipal Water District. HLEINF£LOER mrma1ce24_001 P Sony Pheng 11 __ Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Ali Rehman, ACI, CTMs, AASHTO Education Technician AA, Multi -/interdisciplinary Studies Mr. Rehman is a Civil Engineering student from California State Ongoing Coursework, Civil University of Fullerton. He has worked as a Materials Tester for 13 He started working in a lab and assisting administration, and Engineering, California years. by the end of his first year he acquired his Caltrans and ACI State University, Fullerton certifications. He has working as a Field Technician throughout License / Certification southern California and has performed materials testing on most of ACI Concrete Field Testing the freeways in the area. Mr. Rehman has worked in the field and as well as in the lab. He has knowledge in calibrating lab/field equipment Technician, Level I and nuclear gauges. He has worked with soils, grout, concrete, Caltrans Test Methods: aggregate, polymer, rebar, masonry blocks, and asphalt. He has 105, 106, 125, 201, 202, experience with organizations such as Caltrans, Los Angeles County 205, 206, 207, 211, 216, Public Works, Union Pacific, and ACE. He has the ability to work 217, 226, 227, 231, 504, under pressure and extreme conditions. He has worked for Caltrans 518, 521, 523, 524, 531, District 7 as an on -call Materials Tester, Caltrans Southern Regional 533, 539, 540, 543, 552, Lab in Fontana, ACE, and Union Pacific grade separation projects. 556,557 AASHTO Methods Relevant Project Experience TWIC Orange County Public Works As -Needed Geotechnical Special Training Engineering and Materials Testing & Inspection Services, Orange County, CA, Field Materials Tester/Plant Inspector. On -call Nuclear Gauge Operator contract for materials testing and inspection and geotechnical Training engineering services for OCPW. Kleinfelder is providing materials Loss Prevention System testing and inspection services in support of OCPW's Quality Safety Training Assurance (QA) program for construction of new or rehabilitation of Defensive Driver Training/ existing roadways, flood control channels, parks, or other infrastructure Driver's License projects. Kleinfelder complies with and all testing is performed in accordance with OCPW Standards and Procedures, Greenbook Years of Experience Specifications, Caltrans Standards, ASTM Standards, AASHTO 13 years total Standards, and APWA Standards. In addition, Kleinfelder's material 2 years with Kleinfelder testers and laboratories are certified CCRL, AASHTO resource accreditation, and ASTM D3666. Mr. Rehman has worked on the recent Oso Parkway Bridge Replacement Project in Aliso Viejo. The project consists of the removal, relocation and adjustment of existing improvements, excavation and grading, removal and relocation of existing utilities, construction of new storm drainage and storm water pre-treatment and storage system, construction of curb, gutter and pedestrian walkways and ramps, bridge construction, roadway paving and new overhead signage and traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. City of Long Beach, On -Call Materials Testing and Inspection Services for Street Improvements, Long Beach, CA. Materials Tester. Mr. Rehman performs soils, concrete, and asphalt concrete testing per Caltrans Standards and test methods. Caltrans District 8 (Contract 08A2219), On -Call Materials Sampling and Testing Services for Concrete, Aggregates, and Soils at SRL Districts 7, 8, and 12, Fontana, CA. Material Tester. Provided laboratory materials testing services for soils, aggregates and concrete testing per Caltrans Standards and test methods. Caltrans SRL (Contract 08A2541), On -Call Sampling and Testing of Hot Mix Asphalt and Asphalt Binder, Projects Located in Caltrans Districts 7, 8, and 12, CA. Materials Tester. Mr. rXLEINFELOEF nnwz,o92aoo1P Ali Rehman 1 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Rehman provided laboratory testing services for Districts 7, 8, and 12 at SRL. The projects included providing laboratory testing per Caltrans test methods for soils, concrete, and aggregates. The scope of work included job mix formula verification during paving, source testing of aggregates and soils, as well as PCC mix design verifications. Caltrans District 7 (Contract 07A4733), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Material Tester. Currently providing as needed construction field materials testing services to improve the State transportation system throughout Caltrans District 7 (covering Los Angeles and Ventura Counties). Our services are being performed at numerous project sites, and our scope of services include the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; and special materials analysis and evaluation. County of Riverside Transportation Department On -Call Highway Geotechnical Engineering and Materials Evaluation and Testing Services, Riverside County, CA. Kleinfelder is currently providing on -call materials and geotechnical testing services under on -call contract for the County of Riverside Transportation Department on multiple roadway construction projects. Mr. Rehman has provided sampling and testing of subgrade soils, cellular concrete, backfill and PCC for various projects under this current on -call contract. A project Mr. Rehman worked on was the Clinton Keith Road Extension (Phase 2) in Murrieta, CA, which comprised of the new construction of a four -lane roadway, median, two new bridge structures, and traffic signals. Services included batch plant inspection for AC and PCC, and field and laboratory testing of AC, PCC, Class 2 aggregate base, imported borrow and embankment soil, and structural backfill. Laboratory testing was performed in Kleinfelder's Caltrans-accredited laboratory. Caltrans District 7 (Contract 07A3126), A&E On -Call Material Testing and Plant Inspection Services, Los Angeles and Ventura Counties, CA. Material Tester. Mr. Rehman performed soils, concrete, and asphalt concrete testing per Caltrans Standards and test methods. The major projects on which Mr. Rehman has provided materials testing services include LA 10, LA 710, LA 5/14, VEN 101, LA 5, LA 14, LA 47, LA 60 and LA 110. Caltrans District 7, Prior Contracts, On -Call Material Testing, Various Locations, CA. Materials Tester. Mr. Rehman performed on -call material testing throughout District 7. From Ojai to Highway 39 to Schuyler Heim Bridge Long Beach. He performed compaction test such as soil and polymer. He also performed concrete testing of PCC, fast -set, and grout. Mr. Rehman would receive dispatch requests and contact the inspector for requested material tests. He would perform tests and send out reports, finish daily logs, necessary reports, and timesheet, daily. He worked on most District 7 projects during this period. Specifically, he worked on the 55-hour closure projects on the Long Beach, 710 Freeway. Union Pacific Railroad, Various Locations, CA. Materials Tester. Mr. Rehman performed material testing for various contracts/projects with Union Pacific Railroad such as 5th Track Temple Street, Fairway Grade Separation, and Sunset Grade Separation project. Mr. Rehman would test materials under railroad and county specifications. He performed concrete, grout, soil, and asphalt testing per ASTM and CTM test methods. Nogales Grade Separation, City of Industry, CA. Mr. Rehman has performed as a Quality Assurance Materials Tester for the Nogales Grade Separation Project (Alameda Corridor extension) located near the 60 Freeway and Nogales. He was requested to attend safety meetings and job briefings by Union Pacific Railroad safety inspector in the morning. He performed material testing of concrete, performed soil compaction using ASMT and CSTM methods, and met specified deadlines. MW210924,001P Ali Rehman 12 rfCLE'NFEtOEM Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Marcus Molina, ACI, CTMs License/Certification Technician ACI Concrete Field Testing Technician, Grade I Mr. Molina has four years of experience performing observation, CTMs under Caltrans IA/JTCP: testing, documentation, and reporting on work performed by 105, 125, 201, 202, 205, 216, contractors involved in earthwork grading, drilling, and 217, 226, 227, 229, 231, 504, excavation operations on -site. He is also certified in various CTMs and has worked on the Caltrans District 7 contract as well 518, 521, 523, 524, 533, 539, 540, 543, 552, 556, 557 as various public agency projects in southern California. TWIC Relevant Proiect Experience Special Training City of Ontario, As -Needed Geotechnical Engineering and Nuclear Gauge Operator Materials Testing and Inspection Services, Ontario, CA. Training Field Materials Tester. Kleinfelder is currently performing as - needed geotechnical engineering and materials testing and Loss Prevention System inspection services as an extension to the City engineering Safety Training department. Our services have included multiple task orders Defensive Driver Training/ requesting materials testing and inspection services during Driver's License the rehabilitation of multiple residential streets and main Years of Experience commuter routes. Typical task orders have included construction observation and field and laboratory testing of 4 years total engineered fill soils and backfill, aggregate base, AC, and 2 years with Kleinfelder PCC utilized during street improvement projects. Mr. Molina performs materials testing per CTMs and standards. Caltrans District 7 (Contract 07A4733), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Field Materials Tester. Mr. Molina is currently providing as needed services at numerous project sites performing the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; and field nuclear gauge compaction testing. County of Riverside Transportation Department On -Call Highway Geotechnical Engineering and Materials Evaluation and Testing Services, Riverside County, CA. Field Materials Tester. Mr. Molina has provided sampling and testing of soils and concrete for various projects under this current on -call contract. Kleinfelder has been providing on -call materials and geotechnical testing services for County of Riverside on multiple roadway construction projects for several years — including three years as a prime consultant. Perimeter Wall and Pavement Replacement for Vincent Substation 2201600 kV, 33301 Angeles Forest Highway, Palmdale, CA. Kleinfelder is providing soils and materials observation and testing services for a perimeter wall and pavement replacement project within the existing Vincent Substation in Palmdale located on the Angeles Forest Highway. Scope of services includes testing and inspection services during soils compaction, concrete placement and concrete masonry wall construction, laboratory testing, preparation of a final observation and testing report, and project management. Mr. Molina's duties include on -site soil observation and testing utilizing a nuclear gauge. KLE/NFELOE/i MNP_ I J32J Gpt F Marcus Molina i 1 �=' Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A License / Certification Dominic Montemayor, ACI, ICC, CTMs ACI Concrete Field Testing Technician/Inspector Technician, Grade I Mr. Montemayor is experienced in sampling and testing soils, ICC Soils Special Inspector asphalt, and concrete per CTMs, and has 15 years' experience CTMs under Caltrans IA/JTCP: performing observation, testing, documentation, and reporting on 105, 125, 201, 202, 205, 216, work performed by contractors involved in earthwork grading as 217, 226, 227, 229, 231, 504, well as foundations, pavement, utility, and wall construction. As an 518, 521, 523, 524, 533, 539, ACI Concrete Field Testing Technician Grade I, his duties include 540, 543, 556, 557 routinely sampling, testing, and making concrete test specimens AASHTO Certified on concrete placed for slabs -on -grade, pilasters, and other TWIC concrete structures. He regularly performs density/moisture tests of soils and pavement materials by use of nuclear density gauge Special Training and/or sand cone. Additionally, he has in-depth knowledge of Nuclear Gauge Operator Caltrans testing and roadway/highway projects and current Training experience with local District 7, 8, and SRL projects. Loss Prevention System Relevant Project Experience Safety Training Orange County Public Works (OCPW), As -Needed Materials Defensive Driver Training/ Testing & Inspection and Geotechnical Engineering and Driver's License Services, Orange County, CA. Material Tester. On -call contract for materials testing and inspection and geotechnical engineering Years of Experience services for OCPW. Kleinfelder is providing materials testing and 15 years total inspection services in support of OCPW's Quality Assurance (QA) 4 years with Kleinfelder program for construction of new or rehabilitation of existing roadways, flood control channels, parks, or other infrastructure projects. Kleinfelder complies with and all testing is performed in accordance with OCPW Standards and Procedures, Greenbook Specifications, Caltrans Standards, ASTM Standards, AASHTO Standards, and APWA Standards. In addition, Kleinfelder's material testers and laboratories are certified CCRL, AASHTO resource accreditation, and ASTM D3666. A recent project is the Oso Parkway Bridge Replacement Project in Aliso Viejo. The project consists of the removal, relocation and adjustment of existing improvements, excavation and grading, removal and relocation of existing utilities, construction of new storm drainage and storm water pre-treatment and storage system, construction of curb, gutter and pedestrian walkways and ramps, bridge construction, roadway paving and new overhead signage and traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. County of Los Angeles, As -Needed Materials Testing Services for Federally/Non-Federally Funded Projects, Los Angeles County, CA. Material Tester. Mr. Montemayor is providing as -needed materials testing and inspection contract with the County of Los Angeles that has included more than 20 task orders to date. Typical projects have included soils, base, asphalt concrete, laboratory testing, PCC, masonry, welding and fireproofing testing and inspection services for street'improvement projects, capital facility projects, repair of earthquake and non -earthquake facility damage, and facility alteration at sites located throughout Los Angeles County. Caltrans District 8 (Contract 08A2768), On -Call Construction Materials Sampling and Testing Services Riverside and San Bernardino Counties, CA. Field Materials Tester/Plant Inspector. Mr. Montemayor is providing materials testing services for our on -call contract to improve the State transportation system. He has worked on eight task orders since October 2017. Our services are being performed at numerous project sites and material supplier batch plants. Services include: construction materials observation; materials testing per Caltrans Test Methods and Caltrans Construction Manual; concrete and HMA batch plant inspection; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; and special materials analysis and evaluations. HLEINFELOEA r,vvzioaz1.osia Dominic Montemayor 11 __ Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Edmond Jabbour, ACI, CTMs Education Technician AA, Accounting An expert in HMA, soils and construction materials testing, Mr. Jabbour License /Certification has the ability to take a project from start to finish: from soils grading ACI Concrete Field Testing and backfill, through ACI testing of building materials, and then Technician, Level I placement of asphalt and Caltrans roadwork. He has in-depth ACI Concrete Strength knowledge of public works agency on -call projects, as well as Caltrans Testing Technician testing and roadway/highway projects with current experience at District CTMs under Caltrans 7, 8, and numerous SRL projects. IA/JTCP: Relevant Project Experience 105, 106, 125, 201, 202, Orange County Public Works (OCPW), As -Needed Materials 205, 216, 217, 226, 227, Testing & Inspection and Geotechnical Engineering and Services, 229, 231, 504, 518, 521, Orange County, CA. Materials Tester. On -call contract for materials 523, 524, 533, 539, 540, testing and inspection and geotechnical engineering services for 543, 552, 556, 557 OCPW. Kleinfelder is providing materials testing and inspection AASHTO by JTCP: T11, services in support of OCPW's Quality Assurance (QA) program for T27, T166, T176, T209, construction of new or rehabilitation of existing roadways, flood control T269, T275, T308 channels, parks, or other infrastructure projects. Kleinfelder complies TWIC with and all testing is performed in accordance with OCPW Standards and Procedures, Greenbook Specifications, Caltrans Standards, ASTM Special Training Standards, AASHTO Standards, and APWA Standards. In addition, Nuclear Gauge Operator Kleinfelders material testers and laboratories are certified CCRL, Training AASHTO resource accreditation, and ASTM D3666. A recent project is Loss Prevention System the Oso Parkway Bridge Replacement Project in Aliso Viejo. The Safety Training project consists of the removal, relocation and adjustment of existing Defensive Driver Training/ improvements, excavation and grading, removal and relocation of Driver's License existing utilities, construction of new storm drainage and storm water pre-treatment and storage system, construction of curb, gutter and Years of Experience pedestrian walkways and ramps, bridge construction, roadway paving 7 years total and new overhead signage and traffic control devices. Services include 7 years with Kleinfelder concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. Caltrans District 8 (Contract 08A2768), On -Call Construction Materials Sampling and Testing Services Riverside and San Bernardino Counties, CA. Field Materials Tester/Plant Inspector. Mr. Jabbour is providing materials testing services for our on -call contract to improve the State transportation system. He has worked on all ten orders since August 2017. Our services are being performed at numerous project sites and material supplier batch plants with various construction materials observation and materials testing services per CTMs and the Caltrans Construction Manual. City of Industry On -Call Geotechnical Observation and Testing Services, City of Industry, CA. Mr. Jabbour has been providing inspection duties to Caltrans testing specifications for roadways and sidewalks along with ASTM nuclear gauge testing for parking lots and ADA ramp stalls. Caltrans SRL Contract 08A2958 (Prior Contract 08A2541), On -Call Materials Sampling and Testing Support Services for Projects Located in Caltrans Districts 7, 8, and 12, Various Counties in Southern CA. Materials Tester. For five years, Mr. Jabbour has been conducting laboratory testing services on HMA materials at SRL on numerous Caltrans projects located in Los Angeles, Riverside, San Bernardino, Ventura, and Orange Counties. He has been providing laboratory testing such as unit weights, Hamburg Wheel, Rice, SSD, compaction, and stability testing. Mr. Jabbour's performance was also recognized by the Caltrans Laboratory Manager. 1CLElN . MIR210934.001P Edmond Jabbour 11 1 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Education Kennedy Eubany, ACI, CTMs BA, Corporate Managerial Technician Administration Mr. Eubany is qualified for this project due to his 13 years of License / Certification experience with Caltrans in various Districts. He is currently ACI Concrete Field Testing 9 providing field and laboratory materials testing services for Technician, Level I soils, concrete, and asphalt concrete testing per Caltrans Standards and CTMs for the current Caltrans District 7 and 8 CTMs under Caltrans contracts. IA/JTCP: 105, 125 , 201, 202, 205, Relevant Project Experience 216, 217, 226, 227, 229, Caltrans District 8 (Contract 08A2768), On -Call 231, 504, 518, 521, 523, Construction Materials Sampling and Testing Services 533, 539, 540, 543, 556, Riverside and San Bernardino Counties, CA. Field Materials 557 Tester/Plant Inspector. Mr. Eubany is providing materials Special Training testing services for our on -call contract to improve the State transportation system. He has worked on ten orders to date Nuclear Gauge Operator since August 2017. Our services are being performed at Training numerous project sites and material supplier batch plants. Loss Prevention System Services include: construction materials observation; materials Safety Training testing per CTMs and Caltrans Construction Manual; concrete Defensive Driver Training/ and hot mix asphalt batch plant inspection; field sampling of Driver's License fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; special materials analysis and evaluation; Years of Experience providing materials documentation and information; and 13 years total preparing reports to Caltrans standards and requirements. 3 years with Kleinfelder Caltrans District 7 (Contract 07A4733), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Field Materials Tester. Mr. Eubany provides as needed services at numerous project sites performing the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; and field nuclear gauge compaction testing. Materials Testing and Inspections, Numerous Roadways (Caltrans Jurisdiction), Southern CA. Field Materials Tester/Plant Inspector. Mr. Eubany has provided testing and inspection services for numerous roadway projects under Caltrans jurisdiction, including D" and "E" St. Reconstruction, Stoddard Wells RD IC 15 Freeway, and Highway 138 Realignment/Construction. He has performed soil compaction observation and testing in accordance to Caltrans specifications. During the Stoddard Wells project, Mr. Eubany provided soil compaction testing services in accordance to Caltrans specifications. For Highway 138, he provided compaction testing, plant inspection for both PCC and asphalt, concrete, and performed various laboratory testing in accordance to Caltrans specifications. rmna m�e-.:MP Kennedy Eubany 11 ycE�,v�cosA Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Eric Kennedy, ACI, ICC License/Certification Technician/inspector ACI Field Testing Technician Mr. Kennedy has 18 years of experience with multiple County of ACNM Nuclear Moisture Los Angeles and ICC certifications, and is also is an On -Site Senior Individual Team Leader/Senior Level Inspector. This Density Gauges provides a significant benefit to projects as he begins work Certification beneath the foundations and works through project completion. ICC Special Inspector: He has performed the role of On -Site Senior Individual Team Structural Masonry; Leader/Senior Level Inspector for Kleinfelder on large complex Structural Steel and projects with construction values over $150M, which have also Bolting, Prestressed included stone column rigs with loaders. Concrete, Spray -applied Fireproofing, and In his role as Lead Inspector on numerous projects, Mr. Reinforced Concrete Kennedy coordinates all special inspection activities and County of Los Angeles monitor activities for compliance with local and national building Deputy Special Inspector: codes and in accordance with County/client and relevant Structural Steel/Welding, requirements/specifications. Mr. Kennedy has extensive experience working in the field on heavy construction areas for Reinforced Concrete Masonry, and large, complex projects with teams of numerous Prestressed Concrete inspectors/technicians/contractors/clients/stakeholders. He has extensive knowledge of nonresidential construction and TWIC inspection processes, building code materials, testing, Special Trainino construction nomenclature, construction documents, Nuclear Gauge Operator construction quality control principles and practices, access compliance requirements of Title 24, and construction safety. Training Loss Prevention System Relevant Proiect Experience Safety Training Defensive Driver Training/ Orange County Transportation Authority, Santa Ana Bus Driver's License Maintenance Facility, Santa Ana, CA. Mr. Kennedy performed special inspection and materials testing services Years of Experience during the construction of a bus maintenance facility consisting 18 years total of multiple buildings, multi -story construction, and concrete paving. Special inspection and materials testing services 18 years with Kleinfelder performed include: fabrication shop inspection of reinforcing steel, drill -in -anchors, placement of reinforcing steel, structural masonry construction, concrete placement, structural steel erection, structural welding of reinforcing steel, structural welding of steel connections, installation and tightening of high - strength bolts, application and testing of spray -applied fireproofing, and installation of stone columns for soil stabilization. On this project Mr. Kennedy acted as our lead inspector coordinating all special inspection and materials testing activities and acting as the primary liaison between Kleinfelder and the contractor and construction management staff. County of Los Angeles Experience: Numerous As -Needed Materials Testing and Special Inspection Contracts, Los Angeles County, CA. Since 2013, Mr. Kennedy has served as Lead Inspector and Special Inspector/Technician on numerous County as -needed, multi -year contracts. Under these contracts, Kleinfelder has provided materials observation and testing services for various public works facilities, hospitals, ADA upgrades, other improvements. Relevant facility projects have included: • Harbor UCLA Medical Center Data Center Upgrade and Infrastructure Upgrades • MLK Medical Center Campus, Online Realtime Centralized Health Information Database (ORCHID) Project, CP 87221 (21111F£L0£A MW2 it]924A01P Eric Kennedy 11 Kleinfe/der Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A • MLK Medical Center Campus, Outpatient Center Central Sterile Renovation Project • Agricultural Commissioning Weights and Measures (ACWM) Carport Facility/Shelter Martin Luther King, Jr. (MILK) Medical Center Campus, East Parking Structure, Los Angeles County, CA. Mr. Kennedy served as Special Inspector/Technician on this 6-level parking garage project with 1,400 parking spaces to meet current parking challenges, constructed of cast -in place concrete with post -tensioned decks and beams. Kleinfelder provided special inspection and materials testing for the project. Rancho Los Amigos National Rehabilitation Center (RLANC), Los Angeles County, CA. Mr. Kennedy served as Kleinfelder's Lead Project Inspector. The $418M project includes new elements and upgrades to existing structures. The County of Los Angeles required IOR for OSHPD and jurisdictional inspection services at the project site, which were included as a part of our contract. On -site work has included coordination of inspection staff and laboratory testing of construction materials and workmanship, including soils, reinforced concrete, prestressed/post-tensioned concrete, structural masonry, spray -applied fireproofing, structural bolting and structural steel and welding. Additionally, the project includes demolition of existing aged structures. As Lead Project Inspector, Mr. Kennedy coordinated all special inspection activities and provides technical support and documentation to contractors when issues arise during construction. Administrative Office of the Courts, San Bernardino Courthouse, San Bernardino, CA. Mr. Kennedy served as the Lead Inspector for the construction of a new, 11-story courthouse that occupies approximately seven acres of land. Special inspection services included reinforced concrete, reinforcing steel, observation during placement of drilled in anchors and epoxy rebar, structural masonry, spray applied fire resistant materials, structural steel and welding. As the Lead Inspector, Mr. Kennedy proved to be a valuable resource, not only coordinating all special inspection activities but also providing technical support and documentation to contractors when issues arose during construction. Site 1 Demolition and Make -Ready Project at the RLANC, Los Angeles County, CA. Mr. Kennedy served as Kleinfelder's Lead Project Inspector. The project included the demolition of existing OSHPD facilities and reconstruction of several new buildings and expansion of the existing parking structure. As Lead Project Inspector, Mr. Kennedy coordinated all special inspection activities. ryrti MW210924.001P Eric Kennedy 12 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Kim Byrd, ICC, ACI License / Certification Inspector ACI Field Testing Technician Mr. Byrd has 38 years of experience in construction related ICC Special Inspector: employment including 20 years as a certified special inspector Reinforced Concrete, with substantial knowledge of building code interpretation/ Prestressed Concrete, enforcement in structural steel welding, structural masonry, Structural Masonry, reinforced concrete, post-tensioned/pre-stressed concrete, Structural Steel and concrete sampling and testing, and ASTM standards. He has Bolting immense experience with OSHPD-related and facility renovation projects. Mr. Byrd has worked on the CMSC campus for the last County of Los Angeles 12 years as Lead Special Inspector. Additionally, Mr. Byrd has Special Inspector: held a current County of Los Angeles Special Inspector Reinforced Concrete, Structural Steel/Welding Certificate since 2002. City of Los Angeles Deputy Mr. Byrd has worked on numerous public works facilities and Inspector: Concrete, related structures projects over the past several decades. Drilled in Anchors, Masonry, Steel/Welding Relevant Project Experience WABO Special Inspection County of Los Angeles, Numerous As -Needed Materials Field Supervisor: Testing and Special Inspection Contracts, Los Angeles Prestressed Concrete, County, CA. Since 2002, Mr. Byrd has served as Special Reinforced Concrete, Inspector/Technician on several County of Los Angeles as - Structural Masonry, needed, multi -year contracts. Additionally, Mr. Byrd has held a Structural Steel and current County of Los Angeles Special Inspector Certificate since Bolting, Structural 2002. Under these contracts, Kleinfelder provided materials Welding observation and testing services for various public works facilities. Relevant public works and facility projects have included: Special Training Camp Miller, Juvenile Detention Center. Provided structural Loss Prevention System steel welding, reinforced concrete, and structural masonry. Safety Training Defensive Driver Training/ Central Juvenile Hall. Provided structural steel welding, Driver's License reinforced concrete, and structural masonry. Years of Experience 0Los Padrinos Juvenile Hall. Provided structural steel welding, 38 years total reinforced concrete, structural masonry. 20 years with Kleinfelder 0Los Angeles County Courthouse, Santa Monica. Senior Inspector who provided structural steel welding, reinforced concrete, and structural masonry testing and inspection. Cedars -Sinai Medical Center (CSMC), Numerous Projects, Los Angeles, CA. Since 2008, Mr. Byrd has been the Lead Special Inspector on 150+ projects at the CSMC campus for various facilities totaling a construction value of $450M to date. He works full-time on the campus on new construction and facility renovation projects. As Lead Special Inspector, he also serves at the Point of Contact. He has worked closely with the [OR team to cover all work on the campus and directed additional special inspectors as necessary. Many of the projects fall in the jurisdiction of the OSHPD. Westfield Santa Anita Mall, Santa Anita, CA. Inspector -in -Charge, performing materials testing and inspection services for the mall expansion project. The project consisted of the construction of a parking structure and the addition of a new food court and retail stores. Kleinfelder provided deputy inspectors, and Mr. Byrd was the lead, coordinating a staff of 3 to 4 inspectors throughout the project. KLEINF£L Mw210924001P Kim Byrd 11 1 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A License / Certification Jason Eckerson, ACI, ICC ACI -Concrete Field Testing Technician/Inspector Technician, Level I Mr. Eckerson has 11 years of experience with various ICC Master of Special construction projects in southern California. These projects have Inspection included hospitals, public works facilities, parking structures, ICC Special Inspector: commercial, and tilt -ups. He is uniquely qualified for this contract Structural Welding; due to his overall project experience and extensive variety of Structural Steel and inspections he has conducted. Mr. Eckerson is thorough in Bolting; Structural preparing documentation and is professional and effecting in his Masonry; Pre -Stressed interactions with clients. Mr. Eckerson has worked on numerous Concrete; Reinforced public works agency projects, provided materials testing and Concrete; Spray -Applied special inspection services for medical center campuses, Fire Proofing; Soils facilities, and parking structures. County of Los Angeles Relevant Proiect Experience Deputy Special Inspector: Reinforced Concrete; County of Los Angeles, Numerous As -Needed Materials Masonry; Pre Testing and Special Inspection Contracts, Los Angeles Concrete; Welding ding County, CA. Since 2018, Mr. Eckerson has served as Senior City of Los Angeles Deputy Special Inspector/Technician on several County of Los Angeles Special Inspector: Grading; as -needed, multi -year contracts. Under these contracts, Kleinfelder provided materials observation and testing services for Concrete Construction; Drilled In Anchors various public works facilities, hospitals, ADA upgrades, park beautifications, and street improvement projects. Relevant public City of Long Beach Special works and facility projects have included: Inspector: Reinforced Concrete; Concrete; Masonry MLK Medical Center Campus: Augustus F. Hawkins Air - Handler Units Replacement Project; Outpatient Center Central Sterile Renovation Project Special Training . Harbor -UCLA Medical Center, Psychiatric Emergency Nuclear Gauge Operator Services Expansion Project Training Loss Prevention System Olive View -UCLA Medical Center, Emergency Generators Safety Training Online Realtime Centralized Health Information Database (ORCHID) Project Defensive Driver Training/ Driver's License aCamp Kilpatrick Replacement Project Years of Experience Martin Luther King, Jr. (MILK) Medical Center Campus, East Parking Structure, Los Angeles County, CA. Mr. Eckerson 11 years total served as a Senior Special Inspector and provided post -tensioned 3 years with Kleinfelder inspection, concrete, and masonry services on this 6-level parking garage project with 1,400 parking spaces to meet current parking challenges, constructed of cast -in place concrete with post -tensioned decks and beams. Kleinfelder provided special inspection and materials testing. Cedars -Sinai Medical Center (CSMC), Numerous Projects, Los Angeles, CA. Since 2018, Mr. Eckerson has served as Senior Special Inspector/Technician for construction materials testing and inspection services on several projects at CSMC. Rancho Los Amigos North Campus (RLANC), Los Angeles County, CA. Mr. Eckerson has served as Senior Special Inspector providing structural steel welding, post tension inspection and reinforced concrete testing and inspection services for various projects for the $418M RLANC subject to IOR for OSHPD and jurisdictional inspections. XLE/NF£LOEq Mwam�,a oo1N Jason Eckerson i 1 _- Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Robert Carman, ACI, ICC License / Certification Tech nicianllnspector ACI Field Testing Technician, Level I Mr. Carman has 21 years of experience providing special ICC Special Inspector: inspection services on a variety of projects in southern California. Structural Welding, He is uniquely qualified for this contract due to the wide variety of Structural Masonry, his special inspection certifications and past experiences over the Spray -applied past two decades working on numerous southern California public Fireproofing, Prestressed work agency projects. Concrete, Reinforced Relevant Project Experience Concrete County of Los Angeles County of Los Angeles, Numerous As -Needed Materials Special Inspector: Testing and Special Inspection Contracts, Los Angeles Reinforced Concrete, County, CA. Since 2002, Mr. Carman has served as Special Masonry, and Structural Inspector/Technician on several County of Los Angeles as- Steel/Welding needed, multi -year contracts. Under these contracts, Kleinfelder provided materials observation and testing services for various City of Long Beach Deputy public works facilities. Relevant public works and facility projects Inspector: Reinforced have included: Concrete, Masonry, and Welding MILK Medical Center Campus: Make Ready Projects; TWIC Augustus F. Hawkins Air -Handler Units Replacement Project; Inpatient Tower Lease Agreement, Sterile Special Training Processing Dept. Humidifier Project Nuclear Gauge Operator Harbor UCLA Data Center Upgrade. Central Juvenile Hall, Training 2002-2004. Los Padrinos, 2002-2005. MILK Medical Center Loss Prevention System Campus: Augustus F. Hawkins Air -Handler Units Safety Training Replacement Project; Outpatient Center Central Sterile Defensive Driver Training/ Renovation Project Driver's License Martin Luther King, Jr. (MILK) Medical Center Campus, East Years of Experience Parking Structure, Los Angeles County, CA. Mr. Carman served 21 years total as the Lead Special Inspector and also provided post -tensioned masonry, concrete, and welding inspection services on this 6-level 20 years with Kleinfelder parking garage project with 1,400 parking spaces to meet current parking challenges, constructed of cast -in place concrete with post - tensioned decks and beams. Kleinfelder provided special inspection and materials testing for the project. Additionally, Mr. Carman provided inspection at the adjacent childcare center and Hawkins building at the conclusion of work at the parking structure. Arcadia Mental Health Center Replacement, Los Angeles County, CA. Mr. Carman served as Special Inspector/Technician on the project, which consisted of demolishing the current structure and construction of a new structure and parking lot on the existing site. The new building is proposed to be single story and approximately 10,365 square feet. Kleinfelder provided construction materials testing and special inspection services by our multi -certified, in-house technicians and inspectors, and served as the Geotechnical Engineer of Record to assess conformance with the project structural plans and specifications during construction. Rancho Los Amigos North Campus (RLANC), Los Angeles County, CA. Mr. Carman has served as Special Inspector providing inspection in many areas including a post tension parking structure along with welding, concrete, and masonry inspection for various projects for the $418M RLANC subject to IOR for OSHPD and jurisdictional inspections. ;1111£LDEA "W", IU4^4 0C I Robert Carman 11 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Education Mike Carman, ASNT, CWI, ICC Courses: San Diego Inspector Community College, Cement Mr. Carman has 30 years of experience as an inspector. He is Mason Apprenticeship knowledgeable in structural steel/welding/piping/bolting/coatings/ Courses: South Bay Trade NDT (MT, UT, PT) testing. His experience includes oil refineries, School, Marine Pipefitter power plants, schools, Caltrans specifications, bridges, industrial Training facilities, hospitals, and other public works projects. Prior to working at Kleinfelder, Mr. Carman worked in oil refineries, offshore oil rigs, License / Certification and power plants performing pipe inspection for 15 years. Certified Welding Inspector, American Welding Society Relevant Project Experience County of Los Angeles Special County of Los Angeles, Numerous As -Needed Materials Inspector -Welding Testing and Special Inspection Contracts, Los Angeles City of LA Deputy Inspector County, CA. Since 2007, Mr. Carman has served as Special - Drilled in Anchors Inspector/Technician on several County of Los Angeles as- needed, multi -year contracts. Under these contracts, Kleinfelder - Steel Construction provided materials observation and testing services for various ICC Special Inspector public works facilities. Relevant public works and facility projects - Structural Steel & Bolting have included: - Structural Welding Public Works Headquarters Building, Alhambra ASNT NDT: Ultrasonic, Level MLK Medical Center Campus, East Parking Structure 1/II, Liquid Penetrant, Level Project 1/II, Magnetic Particle, Level MILK Medical Center Campus: Numerous projects 1/II Harbor UCLA Data Center Upgrade TWIC City of Long Beach Inspector Arcadia Mental Health Center Replacement, Los Angeles County, CA. Mr. Carman served as Special - Epoxy Inspector/Technician on the project, which consisted of - Structural Steel & Welding demolishing the current structure and construction of a new structure and parking lot on the existing site. The new building is Special Training proposed to be single story and approximately 10,365 square Loss Prevention System feet. Kleinfelder provided construction materials testing and Safety Training special inspection services by our multi -certified, in-house Defensive Driver Training/ technicians and inspectors, and served as the Geotechnical Driver's License Engineer of Record to assess conformance with the project structural plans and specifications during construction. Years of Experience Rancho Los Amigos National Rehabilitation Center 30 years total (RLANRC), Downey, CA. Mr. Carman has served as Special 13 years with Kleinfelder Inspector, conducting welding inspections and UT, MT, and PT (NDT). The $418M project includes new elements and upgrades to existing structures. The County of Los Angeles required ]OR for OSHPD and jurisdictional inspection services at the project site, which were included as a part of our contract. On -site work included inspection and laboratory testing of construction materials and workmanship, including soils, reinforced concrete, prestressed/post-tensioned concrete, structural masonry, spray -applied fireproofing, structural bolting and structural steel and welding. Additionally, the project includes demolition of existing aged structures. Caltrans, Street, Off -ramps and Bridges, Northern and Southern CA. Senior Inspector. Provided source inspection of welding, structural steel, rebar ultimate welded hoops, headed rebar, PTFE spherical bearings and coatings on several projects including; Seaside Way pedestrian bridge, Port of 'KL£fNFELD£q a,rvvaic9.aoo!a Mike Carman Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No, 20-111 APPENDIX A Los Angeles C St. / 1-110 freeway, SR-4 widening, 180 Yerba Buena ramps, Hegeman Gulch bridge, I- 280 and Wolfe Rd. off -ramps, Apple 1-180 corridor, Puente Ave. grade, South San Francisco and other smaller projects. Cedars -Sinai Medical Center (CSMC), Numerous Projects, Los Angeles, CA. Since 2011, Mr. Carman has served as a Special Inspector on 70+ projects at the CSMC campus on new construction and facility renovation projects. Many of the projects fall in the jurisdiction of the OSHPD. • Saperstein Critical Care Tower Construction Value: $125M. Mr. Carman conducted welding inspections and ultrasound testing. The 11-level building has a total of 250,000 square feet with an additional 13,700 square feet for enclosed pedestrian bridges linking the new structural with the existing structure. Kleinfelder supplied deputy inspectors for the structural steel fabrication, which was being fabricated in Stockton, California. Kleinfelder also provided inspections for all on site work, concrete, steel, welding, masonry, fireproofing, and epoxy grouted anchors. The new facility fell under OSHPD guidelines and Kleinfelder was under the direction of the project inspector of record, the architect of record, and the officers of OSHPD. • The Angeles Clinic (TAC) Renovation and Expansion. Provided special inspection and testing Tor this three-story building project. Construction will include the renovation of approximately 40,000 square -feet of clinical and public area to an OSHPD 3 facility, with numerous departments, urgent care, a cafe, and clinical spaces. UCSD Jacobs Medical Center, Various Projects, La Jolla, CA. Mr. Carman served as a Special Inspector for materials testing portion of this project that involved fabrication shop inspection for various reinforcing steel and precast elements in various parts of the country, along with inspection services of bolting, high strength grout, concrete, light weight concrete, and laboratory testing. San Bernardino Courthouse, State of California Judicial Council of California (formerly Administrative Office of the Courts), San Bernardino, CA. Special Inspector. On -site work included coordination of inspection staff and laboratory testing of construction materials and workmanship, including reinforced concrete, spray -applied fireproofing, base plate grouting, structural masonry, structural bolting and structural steel and welding. Project also included mock-up wall testing and laboratory testing of stone. Port of Los Angeles, Street/1-110 Freeway Interchange Materials Testing and Source Inspections, Los Angeles, CA. Construction activities included new retaining walls, steel pipe piling, embankment and structure fills, structural concrete, asphalt and Portland cement concrete pavements, new roadway signage and electrical systems, for this project that comprised a new interchange - including two bridges. Services included source inspections and quality assurance testing and inspections of construction materials utilized within the Caltrans right-of-way. Mr. Carman performed source inspection during welding structural steel, rebar ultimate welded hoops, steel pipe piling and manufacturing of light standards. Also provided welding quality system (WQS) reviews and source inspection of PT strands and PTFE spherical bearing pads. liGSINF£G1l�R Mwzios 4MW Mike Carman 12 `�- Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Jacob Collins, ACI, ICC License / Certification ACI Concrete Field Testing Technician/Inspector Technician, Level I Mr. Collins has 2 years of experience as an Inspector/Technician [CC Special Inspector: and multiple certifications in concrete, soils, structural masonry, - Reinforced Concrete reinforced concrete, structural steel & bolting, USDOT Hazmat, and Spray -applied spray -applied fireproofing. He has provided inspection work for a Fireproofing variety of projects and clients, ranging from public works agencies to business centers and has experience in a variety of large projects in - Structural Masonry southern California. Mr. Collins has extensive experience working in - Structural Steel and the field on heavy construction areas for large, complex projects with Bolting teams of numerous inspectors/technicians/contractors/clients/ - Structural Welding stakeholders. He has extensive knowledge of nonresidential OSHA 30 construction and inspection processes, building code materials, testing, construction nomenclature, construction documents, Special Training construction quality control principles and practices, access Nuclear Gauge Operator compliance requirements of Title 24, and construction safety. Training Relevant li' i-.c F­ n ­i-nce Loss Prevention System Safety Training City of Ontario, As -Needed Materials Testing and Defensive Driver Training/ Geotechnical Engineering Services, Ontario, CA. Driver's License Technician/Inspector. Services have included multiple task orders requesting materials testing and inspection services during the " Experience rehabilitation of multiple residential streets and main commuter 2 years total routes within the city. Mr. Collins has also worked on several 2 years with Kleinfelder projects for the city, including Fire Station No. 9, Anthony Munoz Community Center, and Merrill Avenue Storm Drain. He has performed work on task orders which have included construction observation and field and laboratory testing of engineered fill soils and backfill, aggregate base, AC, and PCC utilized during street improvement projects as well as providing reinforced concrete, structural masonry, structural steel and bolting and structural welding inspections. City of Long Beach, On -Call Materials Testing and Inspection Services for Street Improvements, Long Beach, CA. Mr. Collins performed various testing and inspection services for street improvements. The work consisted of pavement reconstruction and overlays, constructing PCC curbs, gutters, driveways, curb ramps, and sidewalks. Various On -Call and Materials Testing & Inspection Contracts, Counties of Orange, Riverside, San Bernardino, and the Greater Los Angeles Region, CA. Mr. Collins has performed inspection for pull testing, torque testing, coring, nuclear gauge testing, trench backfill, sampling of concrete and soils for numerous projects throughout Riverside, San Bernardino, Los Angeles, and Orange Counties for clients such as Southern California Edison and Eastern Municipal Water District. Cedars -Sinai Medical Center (CSMC), Numerous Projects, Los Angeles, CA. Mr. Collins serves as a Special Inspector and has worked on over 10 projects to date at various locations throughout Cedars -Sinai Medical Center campuses. Special inspection services included reinforced concrete, reinforcing steel, observation during placement of drilled in anchors and epoxy rebar, structural masonry, spray applied fire resistant materials, and structural steel and welding. ,Y. 'NL£/NFELOEA nnww�ez�cu,P Jacob Collins I 1 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A License / Certification Jeffrey Diaz, NICET, ICC, ACI, RSO, CTMs NICET Level II: Asphalt, Technician/inspector Soils, Concrete Mr. Diaz has 14 years of field testing, inspection and laboratory ACI Aggregate Testing experience with various construction projects throughout southern Technician Level I & Level California, including government, commercial, retail, industrial, II: Concrete Field roadways, and public utilities. Mr. Diaz is currently the Lab Technician Level 1, Supervisor for our certified Ontario and Long Beach laboratories. Concrete Strength Relevant Proiect Experience Technician, Aggregate Base Technician Orange County Public Works (OCPW), As -Needed Materials ICC Special Inspector: Testing & Inspection and Geotechnical Engineering and Structural Masonry; Services, Orange County, CA. Materials Tester. On -call contract for Reinforced Concrete; materials testing and inspection and geotechnical engineering Spray -Applied Fire services for OCPW. Kleinfelder is providing materials testing and Proofing; Soils inspection services in support of OCPW's Quality Assurance (QA) program for construction of new or rehabilitation of existing roadways, Southwest Calibration & flood control channels, parks, or other infrastructure projects. Training Radiation Safety Kleinfelder complies with and all testing is performed in accordance Officer Course No. 7567-36 with OCPW Standards and Procedures, Greenbook Specifications, CTM Certified: 105, 106, Caltrans Standards, ASTM Standards, AASHTO Standards, and 125, 201, 202, 206, 207, APWA Standards. In addition, Kleinfelder's material testers and 216, 217, 226, 227, 229, laboratories are certified CCRL, AASHTO resource accreditation, and 231, 301, 304, 308, 309, ASTM D3666. A recent project is the Oso Parkway Bridge 366, 370, 382, 504, 518, Replacement Project in Aliso Viejo. The project consists of the 521, 523 524, 533, 539, removal, relocation and adjustment of existing improvements, 540, 543, 556, 557 excavation and grading, removal and relocation of existing utilities, AASHTO Test Methods: construction of new storm drainage and storm water pre-treatment T11, T27, R47, R76, T176, and storage system, construction of curb, gutter and pedestrian T255, T329, T335 walkways and ramps, bridge construction, roadway paving and new 40 Hour HAZWOPER overhead signage and traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and Special Training testing, onsite flexural beam fabrication, and laboratory testing. Loss Prevention System City of Long Beach, On -Call Materials Testing and Inspection Safety Training Services, Long Beach, CA. Mr. Diaz serves as a Materials Defensive Driver Training/ Technician/Inspector for this on -call materials testing and inspection Driver's License contract which includes more than 100 task orders to date. Nuclear Gauge Operator County of Los Angeles, As -Needed Geotechnical Engineering Training and Materials Testing and Inspection Services, Los Angeles County, CA. Mr. Diaz serves as a Materials Technician/Inspector Years of Experience for various projects consisting of roadway improvements, airport 14 years total rehabilitations, ADA upgrades, park beautifications, and 14 years with Kleinfelder modifications of miscellaneous County facilities and sites located throughout Los Angeles County. County of Los Angeles, Asphalt Rubber Hot Mix Designs, County of Los Angeles, CA. As a Materials Tester, Mr. Diaz provided laboratory ARHM-GG-C mix proportions (with and without 15% RAP) on materials collected from three separate County material suppliers. The purpose was to: • Verify existing (ARHM-GG-C)job mix formula (JMF) proportions currently being provided to the county • Investigate the suitability of a 15% recycled asphalt pavement (RAP) replacement in each JMF ' JCLE/NFELO£R MWW2101,24c01P Jeffrey Diaz 11 ti.� Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A • Check the binder properties of the RAP collected from each of the three plant locations sampled Mr. Diaz provided material sampling and laboratory mix proportion utilizing aggregates, RAP, and PG 64- 16 asphalt rubber binder collected during routine production of ARHM asphalt concrete at each of the three batch plants selected. Laboratory testing included California Test Numbers 304, 308, 309, and 366 (test for preparation of Hot Mix Asphalt for Test Specimens, Specific Gravity of Compacted HMA Specimens, Theoretical Maximum Specific Gravity and Density of Hot Mix Asphalt and Test for Stabilometer Value, respectively). Caltrans District 8 (Contract 08A2768), On -Call Construction Materials Sampling and Testing Services, Riverside and San Bernardino Counties, CA. Materials Tester/Plant Inspector. Mr. Diaz is providing materials and testing services for our on -call contract to improve the State transportation system. Services are being performed at numerous project sites and material supplier batch plants. Mr. Diaz is performing construction materials observation; materials testing per CTMs and Caltrans Construction Manual; concrete and HMA batch plant inspection; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; special materials analysis and evaluation; materials documentation and information; and preparation of reports to Caltrans standards and requirements. City of Ontario, As -Needed Geotechnical Engineering and Materials Testing and Inspection Services, Ontario, CA. Field Materials Tester. Kleinfelder is currently performing as -needed geotechnical engineering and materials testing and inspection services as an extension to the City engineering department. Our services have included multiple task orders requesting materials testing and inspection services during the rehabilitation of multiple residential streets and main commuter routes. Typical task orders have included construction observation and field and laboratory testing of engineered fill soils and backfill, aggregate base, AC, and PCC utilized during street improvement projects. Caltrans SRL Contract 08A2958 (Prior Contract 08A2541), On -Call Materials Sampling and Testing Support Services for Projects Located in Caltrans Districts 7, 8, and 12, Various Counties in Southern CA. Materials Tester. Mr. Diaz has performed laboratory testing services on HMA and aggregate materials on numerous Caltrans projects located in Los Angeles, Riverside, San Bernardino, Ventura, and Orange Counties under the subject on -call contracts. He has routinely performed Caltrans and ASTM test procedures for soil, asphalt, concrete, masonry, grout, and reinforcing steel utilizing the laboratory safety manual, standard plans and specifications. Caltrans District 7 (Contract 07A4733) On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Materials Tester. Mr. Diaz provides as needed services at numerous project sites performing the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; and field nuclear gauge compaction testing. County of Riverside, Transportation Department On -Call Highway Geotechnical Engineering and Materials Evaluation and Testing Services, Riverside County, CA. Field Materials Tester. Kleinfelder is currently providing on -call materials and geotechnical testing services under on -call contract for the County of Riverside Transportation Department on multiple roadway construction projects. Services include sampling and testing of subgrade soils, cellular concrete, backfill and PCC for various projects under this current on -call contract. Projects that Mr. Diaz worked on include the Airport Blvd. Grade Separation and the Clinton Keith Road Extension in Murrieta, CA, which comprised of the new construction of a four -lane roadway, median, two new bridge structures, and traffic signals. Laboratory testing was performed in Kleinfelder's Caltrans-accredited laboratory. Cedars -Sinai Medical Center (CSMC), Numerous Projects, Los Angeles, CA. Served as a Materials Tester for the laboratory service portion on over 180 projects at CSMC to date. Testing included reinforcing steel, spray applied fire resistive material, and concrete. �SCLE/NF£LOER mw210924.001v Jeffrey Diaz 12 �_ Kleintelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Education Cameron Massa, ACI, CTM BS, Computer Science, Technician University of La Verne, Mr. Massa has five years of experience as a field and laboratory California, 2017 technician. He is responsible for a wide variety of laboratory License / Certification materials testing on soils, concrete, asphalt, reinforcing steel, and masonry products for multiple projects. Mr. Massa is experienced ACI Concrete Strength in logging, processing, and testing samples in accordance to Testing Technician Caltrans and ASTM standards and procedures. He is currently working on laboratory testing for numerous projects throughout CTM Certified: 105, 125, southern California including Counties of Orange, Riverside, San 201, 202, 205, 216, 217, Bernardino, and the Greater Los Angeles Region. He also has 226, 227, 229 experience working on projects subject to Caltrans and local Special Training agency standards and jurisdictions. Loss Prevention System Relevant Project Experience Safety Training Orange County Public Works As -Needed Geotechnical Defensive Driver Training/ Engineering and Materials Testing & Inspection Services, Driver's License Orange County, CA. Materials Tester/Laboratory Technician. Mr. Years of Experience Massa is instrumental in providing materials testing for this contract in which Kleinfelder is providing materials testing and inspection 5 years total services in support of the County/District's CIA program for 5 years with Kleinfelder construction of new or rehabilitation of existing roadways, flood control channels, parks, or other infrastructure projects. Services include concrete batch plant inspection, PCC aggregate sampling and testing, and onsite flexural beam fabrication and laboratory testing per CTMs. County of Los Angeles, As -Needed Materials Testing Services for Federally/Non-Federally Funded Projects, Los Angeles County, CA. Materials Tester/Laboratory Technician. Mr. Massa is providing as -needed materials testing for this contract with the County of Los Angeles that has included more than 20 task orders to date. Typical projects have included soils, base, asphalt concrete, laboratory testing, PCC, masonry, welding and fireproofing testing and inspection services for street improvement projects, capital facility projects, repair of earthquake and non -earthquake facility damage, and facility alteration at sites located throughout Los Angeles County. County of Riverside Transportation Department On -Call Highway Geotechnical Engineering and Materials Evaluation and Testing Services, Riverside County, CA. Materials Tester/Laboratory Technician. Mr. Massa is providing materials testing for subgrade soils, cellular concrete, backfill, and Portland cement concrete for various projects under this current on -call contract. Kleinfelder has been providing on -call materials and geotechnical testing services for County of Riverside on multiple roadway construction projects for several years, including three years as a prime consultant. Services provided under this contract have included batch plant inspection for AC and PCC, and field and laboratory testing of AC, PCC, Class 2 aggregate base, imported borrow and embankment soil, and structural backfill. Laboratory testing was performed in Kleinfelder's Caltrans-accredited laboratory. Ontario International Airport Authority (OIAA), On Call Consulting Services Contract, Phase IV Taxiway W Panel Replacement, Ontario, CA. Mr. Massa observed LCB (Lean Concrete Base) placement, performed testing according to specifications, and prepared a daily fields report. He marked discrepancies, notified contractor, observed concrete grinder services, and re -observed areas to meet specifications. lNF£LDER ro+wa I X24 00+r' Cameron Massa 11 Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Julian Calderon, ACI, CTMS License / Certification Technician ACI Concrete Strength Testing Technician, Level I Mr. Calderon has four years of experience as a field and laboratory CTM Certified: 521, 523, technician. He has a nuclear gauge, ACI, and Caltrans certifications 524 and is responsible for a wide variety of laboratory testing which includes soils, concrete, asphalt, reinforcing steel, and masonry Special Training products for multiple projects. He is responsible for logging and Nuclear Gauge Operator processing the samples in accordance with laboratory standards Training and procedures. He is currently working on laboratory testing for Loss Prevention System numerous projects throughout southern California including Safety Training Counties of Orange, Riverside, San Bernardino, and the Greater Los Angeles Region. He also has experience working on projects Defensive Driver Training/ subject to Caltrans and local agency standards and jurisdictions. Driver's License Relevant Project Experience Years of Experience County of Los Angeles, As -Needed Materials Testing Services 4 years total for Federally/Non-Federally Funded Projects, Los Angeles 4 years with Kleinfelder County, CA. Laboratory Technician. Mr. Calderon has provided laboratory materials testing services for this as -needed materials testing contract with the County of Los Angeles that has included more than 20 task orders to date. Typical projects have included soils, base, asphalt concrete, laboratory testing, PCC, masonry, welding and fireproofing testing and inspection services for street improvement projects, capital facility projects, repair of earthquake and non -earthquake facility damage, and facility alteration at sites located throughout Los Angeles County. County of Riverside Transportation Department On -Call Highway Geotechnical Engineering and Materials Evaluation and Testing Services, Riverside County, CA. Materials Tester/Laboratory Technician. Mr. Calderon is providing materials testing for subgrade soils, cellular concrete, backfill, and Portland cement concrete for various projects under this current on -call contract. Kleinfelder has been providing on -call materials and geotechnical testing services for County of Riverside on multiple roadway construction projects for several years, including three years as a prime consultant. Services provided under this contract have included batch plant inspection for AC and PCC, and field and laboratory testing of AC, PCC, Class 2 aggregate base, imported borrow and embankment soil, and structural backfill. Laboratory testing was performed in Kleinfelder's Caltrans-accredited laboratory. City of Long Beach, On -Call Materials Testing and Inspection Services, Long Beach, CA. Mr. Calderon serves as a Laboratory Technician for this on -call materials testing and inspection contract which includes more than 100 task orders to date. Typical laboratory testing for this contract has consisted of sieve analysis, moisture content determination, maximum density determination, permeability of soils, direct shear of soils, specific gravity of fine/coarse aggregate, durability index of aggregate, sand equivalent, concrete compression testing, flexural strength testing of concrete, asphalt content by ignition oven/microwave oven, cleanness of aggregates and abrasion of coarse aggregate, amongst many others. Mr. Calderon is responsible for logging in the samples, assigning the necessary laboratory testing, performing the testing in the laboratory and inputting the data and distributing laboratory reports to the client. lClEINFELDER MIN,iJulian Calderon 11 �- Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A License/Certification Michael Magana, ICC, NICET, ACI, CTMs ICC Special Inspector: Technician/Inspector Structural Masonry, Soils, Mr. Magana has 22 years of experience performing construction Reinforced Concrete materials testing in the field and laboratory. An expert in HMA, soils NICET Level III: Asphalt, and construction materials testing, projects have included grading, Soils, Concrete paving, concrete/asphalt batch plant inspections, concrete/asphalt ACI Testing Technician, placement and utilities. He is experienced in laboratory testing Level I: Aggregate, utilizing ASTM, ACI, AASHTO and Caltrans specifications including Concrete Field, Concrete sieve analysis, moisture content determination, maximum density Lab, Masonry Lab determination, permeability of soils, direct shear of soils, specific AASHTO: Hot Mix Asphalt, gravity of fine/coarse aggregate, durability index of aggregate, sand PCC, Asphalt Binder, Soil, equivalent, concrete compression testing, flexural strength testing of Aggregate, Hydraulic concrete, asphalt content by ignition oven/microwave oven, Cement, Masonry cleanness of aggregates and abrasion of coarse aggregate, CTM Certified: 105, 106, amongst many others. 125, 201, 202, 206, 207, Additionally, he has in-depth knowledge of Caltrans testing and 216, 217, 226, 227, 229, roadway/highway projects and current experience with numerous 231, 301, 304, 308, 309, District 7, 8, and SRL projects. 366, 370, 382, 504, 518, 521, 523 524, 533, 539, Relevant Project Experience 540, 543, 556, 557 Orange County Public Works (OCPW), As -Needed Materials City of Los Angeles Deputy Testing & Inspection and Geotechnical Engineering and Building Inspector, Services, Orange County, CA. Materials Tester. On -call contract for P031445 materials testing and inspection and geotechnical engineering services for OCPW. Kleinfelder is providing materials testing and Special Training inspection services in support of OCPW's Quality Assurance (QA) Nuclear Gauge Operator program for construction of new or rehabilitation of existing Training roadways, flood control channels, parks, or other infrastructure Caltrans plant inspection projects. Kleinfelder complies with and all testing is performed in safety video accordance with OCPW Standards and Procedures, Greenbook OSHA: HAZWOPER Trainer Specifications, Caltrans Standards, ASTM Standards, AASHTO Standards, and APWA Standards. In addition, Kleinfelder's material Loss Prevention System testers and laboratories are certified CCRL, AASHTO resource Safety Training accreditation, and ASTM D3666. A recent project is the Oso Parkway Defensive Driver Training/ Bridge Replacement Project in Aliso Viejo. The project consists of the Driver's License removal, relocation and adjustment of existing improvements, Years of Experience excavation and grading, removal and relocation of existing utilities, construction of new storm drainage and storm water pre-treatment 22 years total and storage system, construction of curb, gutter and pedestrian 12 years with Kleinfelder walkways and ramps, bridge construction, roadway paving and new overhead signage and traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. County of Los Angeles, As -Needed Materials Testing Services for Federally/Non-Federally Funded Projects, Los Angeles County, CA. Field Materials Tester/Inspector. Mr. Magana is providing as -needed materials testing and inspection services for this contract with the County of Los Angeles that has included more than 20 task orders to date. Typical projects have included soils, base, AC, laboratory testing, PCC, masonry, welding and fireproofing testing and inspection services for street improvement projects, capital facility projects, repair of earthquake and non -earthquake facility damage, and facility alteration at sites located throughout Los Angeles County. �KLEINFELD£q nn'Nzm,aaDoi F Michael Magana I 1 � Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A City of Long Beach Airport, On -Call Materials Testing Services for Airport Terminal Area Improvements, Long Beach, CA. As part of Kleinfelder's on -call services contract with the City of Long Beach, Mr. Magana provided observation and testing and inspection services in order to assess compliance with the project plans and specifications during construction of this airport terminal. Caltrans District 8 (Contract 08A2768), On -Call Construction Materials Sampling and Testing Services, Riverside and San Bernardino Counties, CA. Field Materials Tester/Plant Inspector. Mr. Magana is providing materials and testing services for our on -call contract to improve the State transportation system. Tester at numerous project sites and material supplier batch plants. Services include construction materials observation; materials testing per CTMs and Caltrans Construction Manual; concrete and HMA batch plant inspection; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; and special materials analysis and evaluations. Caltrans SRL Contract 08A2958 (Prior Contract 08A2541), On -Call Materials Sampling and Testing Support Services for Projects Located in Caltrans Districts 7, 8, and 12, Various Counties in Southern CA. Materials Tester. Mr. Magana is currently performing laboratory testing services on HMA materials at the Caltrans SRL on numerous Caltrans projects located in Los Angeles, Riverside, San Bernardino, Ventura, and Orange Counties under the subject three-year on -call contract. He has performed Caltrans and AASHTO test procedures for soil, aggregates, asphalt, and concrete, utilizing the laboratory safety manual, standard plans and specifications. Mr. Magana is currently working on several Task Orders in the aggregate lab at the Caltrans SRL. Caltrans District 7 (Contract 07A4733), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Material Tester. Mr. Magana is currently providing as needed services at numerous project sites performing the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; and field nuclear gauge compaction testing. Our services are being performed at numerous project sites and we have been integral in problem solving when assistance is requested by the Resident Engineer and field offices from 1-5, 1-405, to I-10, and 1-210. Additionally Kleinfelder has supported numerous prior District 7 contracts from 2016-2019, including 07A4077, 07A3126, 07A2485, and 07A2114. County of Riverside Transportation Department On -Call Highway Geotechnical Engineering and Materials Evaluation and Testing Services, Riverside County, CA. Field Materials Tester. Kleinfelder is currently providing on -call materials and geotechnical testing services under on -call contract for the County of Riverside Transportation Department on multiple roadway construction projects. Mr. Magana has provided sampling and testing of subgrade soils, cellular concrete, backfill, and PCC for various projects under this current on -call contract. A recent project Mr. Magana worked on was the Clinton Keith Road Extension (Phase 2) in Murrieta, CA, which comprised of the new construction of a four -lane roadway, median, two new bridge structures, and traffic signals. Services included batch plant inspection for AC and PCC, and field and laboratory testing of AC, PCC, Class 2 aggregate base, imported borrow and embankment soil, and structural backfill. Laboratory testing was performed in Kleinfelder's Caltrans- accredited laboratory. City of Long Beach Airport, QA Testing and Inspection Services for improvements to Runway 7R- 25L, 8R-26L, R12-30, and the Phase II Terminal Improvements Project, Long Beach, CA. Materials Tester/Special Inspector. Runway construction activities included demolition and removal of the existing structural section, preparation and compaction of the subgrade soils, placement of a new structural section consisting of lime treated subgrade, placement of aggregate base, and AC pavement as well as improvement to lighting and placement of new stripping. Kleinfelder has provided QA testing and inspection services that include observation and testing during earthwork, lime treatment, base rock placement; observation and testing of AC, PCC, and CLSM; and in -place density testing and laboratory test results on construction materials utilized during construction activities. txc€iu�caeq MW210924001P Michael Magana 12 '--- Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A License/Certification Juan Le Roy, ICC, NICET, AASHTO, ACI, CTMs ICC Special Inspector: Technician/Inspector - Prestressed/Post Mr. Le Roy has been in the construction industry performing tensioned construction materials testing, inspections, and project - Reinforced Concrete management oversight on projects as a supervisor for laboratory - Soils and Feld services for over 19 years. He has a wide range of -Spray-applied experience in testing soils, asphalt, concrete, steel, and masonry. Fireproofing In his current role as Operations Manager, he supervises and - Structural Masonry trains field materials testers and plant inspectors on Caltrans, - Structural Steel and AASHTO, ASTM, USACE, and DSA Standards. Mr. LeRoy has Bolting held over 40 Caltrans certifications before the integration of NICET Soils, Concrete, AASHTO into Caltrans, and has been performing Caltrans Asphalt, Level II materials testing and plant inspections since 2002 in Districts 7, 8, 11, and 12. He served in a field supervisor role from 2009 until AASHTO Methods: T166, 2018 when he took on an operations/project management role T209, T269, T275, T308 responsible for providing QA/QC management for projects ACI Concrete Strength and consisting of field inspection, laboratory report review, project field Field Testing Technician, supervision, and providing technical support to the project team. Level I CTM Certified: 105, 106, Relevant Project Experience 125, 201, 202, 206, 207, Orange County Public Works (OCPW), As -Needed Materials 216, 217, 226, 227, 229, Testing & Inspection and Geotechnical Engineering and 231, 301, 304, 308, 309, Services, Orange County, CA. Materials Tester. On -call contract 366, 370, 382, 504, 518, for materials testing and inspection and geotechnical engineering 521, 523 524, 533, 539, services for OCPW. Kleinfelder is providing materials testing and 540, 543, 556, 557 inspection services in support of OCPW's Quality Assurance (QA) program for construction of new or rehabilitation of existing Special Training roadways, flood control channels, parks, or other infrastructure Nuclear Gauge Operator projects. Kleinfelder complies with and all testing is performed in Training accordance with OCPW Standards and Procedures, Greenbook Loss Prevention System Specifications, Caltrans Standards, ASTM Standards, AASHTO Safety Training Standards, and APWA Standards. In addition, Kleinfelder's Defensive Driver Training/ material testers and laboratories are certified CCRL, AASHTO Driver's License resource accreditation, and ASTM D3666. A recent project is the Oso Parkway Bridge Replacement Project in Aliso Viejo. The OSHA 10-Hour project consists of the removal, relocation and adjustment of (Construction) existing improvements, excavation and grading, removal and Confined Space Entry relocation of existing utilities, construction of new storm drainage Years of Experience and storm water pre-treatment and storage system, construction of curb, gutter and pedestrian walkways and ramps, bridge 19 years total construction, roadway paving and new overhead signage and 4 years with Kleinfelder traffic control devices. Services include concrete batch plant inspections, PCC aggregate sampling and testing, onsite flexural beam fabrication, and laboratory testing. City of Long Beach, On -Call Materials Testing and Inspection Services, Long Beach, CA. Materials Tester. Performs soils, concrete, and AC inspection and testing per Caltrans standards and test methods for various street improvements. The work consists of pavement reconstruction and overlays, constructing PCC curbs, gutters, driveways, curb ramps, and sidewalks. �/NFELOER MW21011+0ciP Juan Le Roy 11 �- Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Caltrans District 8 (Contract 08A2768), On -Call Construction Materials Sampling and Testing Services, Riverside and San Bernardino Counties, CA. Field Materials Tester/Plant Inspector. Services include construction materials observation; materials testing per CTMs and Caltrans Construction Manual; concrete and HMA batch plant inspection; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; preparation of reports to Caltrans standards and requirements. Mr. Le Roy is currently aiding dispatch, maintaining scheduling and safety objectives, and training staff on codes of conduct as well as procedural changes. City of Ontario As -Needed Geotechnical Engineering and Materials Testing and Inspection Services, Ontario, CA. Assistant Project Manager/Operations Manager. Kleinfelder is currently performing as -needed geotechnical engineering and materials testing and inspection services as an extension to the City engineering department. Our services have included multiple task orders requesting materials testing and inspection services during the rehabilitation of multiple residential streets and main commuter routes. Mr. Le Roy aids Project Manager Rick Bell on numerous items on this contract to ensure project success. Mr. Le Roy is vital to the project and provides proper staffing for the various testing for soil compaction and backfilling, asphalt pavements, roadway slurry, concrete QA testing oversight, and batch plant inspection oversight. Mr. Le Roy helps train and mentor our staff, implements City requirements and guidelines to staff, provides quality control of reporting, assists with punch list items for non -conformities, report distribution, and aids in construction best practices to help find ways for project efficiencies. Caltrans SRL Contract 08A2958 (Prior Contract 08A2541), On -Call Materials Sampling and Testing Support Services for Projects Located in Caltrans Districts 7, 8, and 12, Various Counties in Southern CA. Materials Tester. Conducted laboratory testing services on HMA materials at SRL on numerous Caltrans projects located in Los Angeles, Riverside, San Bernardino, Ventura, and Orange Counties under the subject three-year on -call contracts. Mr. Le Roy is currently working on a Task Order that began in July 2018 at SRL for Contract 08A2958. Mr. Le Roy has also provided laboratory testing such as unit weights, Rice, SSD compaction, aggregate conformance testing, mix design batching, and stability testing. Caltrans District 7 (Contract 07A4733), On -Call Construction Materials and Testing Services, Los Angeles and Ventura Counties, CA. Field Materials Tester. This contract which includes as -needed construction field materials testing services to improve the State transportation system throughout Caltrans District 7 at numerous project sites. Services include the following: construction materials observation; materials testing per CTMs and Caltrans Construction Manual; field sampling of fresh concrete, HMA, soil, and aggregate; field nuclear gauge compaction testing; special materials analysis and evaluation; materials documentation and information; and preparation of reports to Caltrans Standards and requirements. Caltrans District 11, Contract 11A3016 (Prior Contracts 11A2364/11A2365), Construction Materials Sampling and Testing Services, Imperial Valley, CA. Assistant RE/Assistant Task Order Manager/Field Materials Tester. Since July 2015, Mr. Le Roy provided all of these testing services including assuming a role as Assistant RE/Assistant Consultant Task Order Manager for the 1-8 project at segments 3-5. As the acting Assistant RE for those segments, Mr. Le Roy had materials testing results oversight for QA, project filing, testing audits and findings summaries, compaction summary reporting, acting lab manager for a project mobile lab, and attended weekly project meetings and maintained project progress and punch list items for materials testing and inspection services. WN210924001P '�XLEIfJF£tDER Juan Le Roy 12 .v Kleinfelder Statement of Qualifications for On -Call Material Testing and Special Inspection Services for City of Santa Ana, RFP No. 20-111 APPENDIX A Vartan Deirdeirian, ACI, ICC, NICET License/Certification ACI Concrete Field Testing Technician/Inspecto: Technician, Level I Mr. Deirdeirian has 31 years of experience in various fields of ICC Special Inspector: construction. His experience includes mass grading and Reinforced Concrete, excavations; various foundations such as conventional, deep or Prestressed Concrete, specialized, as well as drilled piers, driven piles, underpinning, and Structural Masonry, Soils retrofitting; ground improvements include soil mixing and stone columns; and Caltrans bridge retrofitting inspections, new bridge County of Los Angeles construction, and highways. Special Inspector Concrete, Masonry, Mr. Deirdeirian has served as Lead Inspector for reinforced Prestressed Concrete, concrete, reinforced masonry, prestressed concrete, and is Welding knowledgeable with methane mitigation system inspection. He has NICET: Asphalt, Level II; been certified as a County of Los Angeles Special Inspector for 16 Soils, Level 11; Concrete, years, working over various public works agency projects over the Level II past two decades. City of Los Angeles Deputy Relevant Project Experience Inspector Concrete, County of Los Angeles, Numerous As -Needed Materials Testing Grading, Masonry, Drilled and Special Inspection Contracts, Los Angeles County, CA. in Anchors Since 2004, Mr. Deirdeirian has performed materials testing Special Training services for various projects, consisting of roadway improvements, Nuclear Gauge Operator airport rehabilitations, ADA upgrades, park beautifi cations, and Training modifications of miscellaneous County facilities and sites located throughout Los Angeles County. He has been certified as a County Loss Prevention System of Los Angeles Special Inspector for 16 years. Safety Training Defensive Driver Training/ Camp Vernon Kilpatrick Replacement Project, Malibu, 2016- Driver's License 2018. Mr. Deirdeirian provided as -needed special inspection and soils and concrete testing services. The new replacement Years of Experience juvenile probation camp consists of 65,000 square -feet of 2-story 31 years total administrative building, education center, cottages with 24 years with Kleinfelder dormitory housing, gym/multipurpose room, kitchen, and additional building facilities, site improvements, fencing, and parking. Los Angeles World Airports (LAWA) Specialty Staff and Materials Testing Services, Los Angeles, CA. Mr. Deirdeirian serves as Special Inspector/Technician. Kleinfelder is providing field and batch plant inspectors for the contract which supports the construction of capital improvement and maintenance projects at the Los Angeles International Airport (LAX) and Van Nuys Airport (VNY). Kleinfelder's inspection projects have included Landside Access Modernization Program, LAX Terminals 2 & 3 Modernization Project, and the Midfield Satellite Concourse as well as smaller projects such as Runway Safety Area (RSA) improvements and rehabilitation to meet federal government requirements, and construction of ramps, service roads, and new utility infrastructure. Recently, from August -December 2019, Mr. Deirdeirian worked as a Deputy Inspector in support of LAWA's Capital Improvement Plan (CIP) and non-CIP construction projects. Cedars -Sinai Medical Center (CSMC), Numerous Projects, Los Angeles, CA. Construction Value: $450M to date, Various Facilities; Project Duration: 2012 - Ongoing. Since 2012, Mr. Deirdeirian has served as a Special Inspector on 50+ projects at the CSMC campus on new construction and facility renovation projects. Many of the projects fall in the jurisdiction of the OSHPD. IKLElNF£LD£R Mw210921001P Vartan Deirdeirian] 1 `�- SIAD TL-0113: CALTRANS ACCREDITATION LABORATORY INSPECTION REPORT STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION i _.. CALTRANS ACCREDITATION LABORATORY INSPECTION REPORT Expiration Date: 2020-12-20 Inspected By: Robby Rodriguez IA No.: 74 Phone:916-240-3821 RSP #: 94 File: Material Category 500 Laboratory: Kleinfelder, Inc. -Ontario Address: 620 South Magnolia Building G Ontario CA, 91762 Lab QC Mgr.: Mike Dorsch E-mail: mdorsch@kleinfelder.00m Telephone: 909-657-1716 Fax #.: 909-988-0185 A certified Independent Assurance (LA) visited this laboratory on 2019-12-20 Only the equipment to be used on Caltrans Construction projects andfor local construction projects on the National Highway System was checked for qualification. At the time of Caltrans Accreditation, this laboratory had all necessary equipment to perform the test methods indicated below. Testing personnel shall be Caltrans Qualified and possess a current Caltrans Certification Form TL-0111 or AASHTO Proficiency Form TL-0115 prior to performing any sampling or testing. AASHTO Tt 1 AASHTO T27 AASHTO R47 AASHTO T84 AASHTO T85 AASHTO T96 AASHTO T166 AASHTO T176 AASHTO T255 AASHTO T269 AASHTO T275 AASHTO T283 AASHTO T304 AASHTO T308 AASHTO T335 ASTM D4791 CT 106 CT 106 CT 125 ADMIX CT 125 AGG CT 125 BIT CT 125 GEN CT 125 HMA CT 125 PCC CT 201 CT 202 CT 204 CT 205 CT 206 CT 207 CT 208 CT 209 CT 211 CT 216 CT 217 CT 226 CT 227 CT 229 CT 231 CT 234 CT 235 CT 301 CT 304 CT 308 CT 309 CT 366 CT 370 CT 371 CT 375 CT 382 CT 504 CT 518 CT 521 CT 523 CT 524 CT 531 CT 533 CT 539 CT 540 CT 552 CT 556 CT 557 A visual check was performed and documents provided as necessary for the following items ✓ Facility Safety Manual ✓ Copies of current applicable test procedures ✓ Laboratory Procedures Manual ✓ Calibration and service documentation ✓ Laboratory Quality Control Manual ✓ Calibration stickers allied to test equipment ✓ Proper test equipment (dated within the 12 months) On 2019-12-20 , this laboratory was Caltrans Qualified by: Robby Rodriguez IA#74 \ f (Printed name of IA person) (Signature of IA person) Please verify lab accreditation by visiting SIAD website: https:/Isia.dot.ca.gov —T A C C R E D I T E D CERTIFICATE OF ACCREDITATION Kleinfelder, Inc. in Ontario, California, USA has demonstrated proficiency for the testing of construction materials and has conformed to the requirer AASHTO R 18 and the AASHTO Accreditation policies established by the AASHTO Committee on Mater The scope of accreditation can be viewed on the Directory of AASHTO Accredited Laboratories (aasf Tymon, AASHTO Executive Director Moe Jamshidi, AASHTO COA This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation stE aashtoresource.org/aap/accreditation-directory SCOPE OF AASHTO ACCREDITATION F Kleinfelder, Inc. AASH ❑ in Ontario, California, USA A C C R E O 1 T E D Qf.Y Af rfl• C1077 (Aggregate) C1077 (Concrete) C1093 (Masonry) D3666(Aggregate) D3666 (Asphalt Mixture) D3740 (Soil) E329 (Aggregate) E329 (Asphalt Mixture) E329 (Concrete) E329 (Masonry) E329 (Soil) Quality Management System Establishing and Implementing a Quality System for Construction Materials I esting Laooratones Laboratories Testing Concrete and Concrete Aggregates Laboratories Testing Concrete and Concrete Aggregates Accreditation of Testing Agencies for Unit Masonry Minimum Requirements for Agencies Testing and Inspecting Road and Paving Materials Minimum Requirements for Agencies Testing and Inspecting Road and Paving Materials Minimum Requirements for Agencies Engaged in Testing and/or Inspection of Soil and Rock as Used in Engineering I Standard Specification for Agencies Engaged in the Testing and/or Inspection of Materials Used in Cons Standard Specification for Agencies Engaged in the Testing and/or Inspection of Materials Used in Cons Standard Specification for Agencies Engaged in the Testing and/or Inspection of Materials Used in Cons Standard Specification for Agencies Engaged in the Testing and/or Inspection of Materials Used in Cons Standard Specification for Agencies Engaged in the Testing and/or Inspection of Materials Used in Cons E329 (Sprayed Fire -Resistive Material) Standard Specification for Agencies Engaged in the Testing and/or inspection ,of Materials Used in Cons Page 1 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation ste aashtoresource.org/aap/accreditation-directory SCOPE OF AAS HTO ACCREDITATION Kleinfelder, Inc. AASH ❑ in Ontario, California, USA Asphalt Mixture Standard: R47 Reducing Samples of Hot -Mix Asphalt to Testing Size R68 Preparation of Asphalt Mixtures by Means of the Marshall Apparatus T30 Mechanical Analysis of Extracted Aggregate T166 Bulk Specific Gravity of Compacted Hot Mix Asphalt Using Saturated Surface -Dry Specimens T209 Maximum Specific Gravity of Hot Mix Asphalt Paving Mixtures T245 Resistance to Plastic Flow of Asphalt Mixtures Using Marshall Apparatus T269 Percent Air Voids In Compacted Dense and Open Bituminous Paving Mixtures T275 Bulk Specific Gravity of Compacted Bituminous Mixtures Using Paraffin -Coated Specimens T283 Resistance of Compacted Mixtures to Moisture Induced Damage T308 Determining the Asphalt Content of Hot Mix Asphalt (HMA) by the Ignition Method D979 Sampling Bituminous Paving Mixtures D1188 Bulk Specific Gravity of Compacted Bituminous Mixtures Using Paraffin -Coated Specimens D1560 (Stability) Resistance to Deformation of Bituminous Mixtures by Means of Hveem Apparatus D1561 Preparation of Test Specimens of Bituminous Mixtures by Means of California Kneading Compactor 02041 Maximum Specific Gravity of Hot Mix Asphalt Paving Mixtures D2172 Quantitative Extraction of Asphalt Binder from Hot Mix Asphalt (HMA) D2726 Bulk Specific Gravity of Compacted Hot Mix Asphalt Using Saturated Surface -Dry Specimens D2950 Density of Bituminous Concrete In Place by Nuclear Methods D3203 Percent Air Voids in Compacted Dense and Open Bituminous Paving Mixtures D4867 Resistance of Compacted Mixtures to Moisture Induced Damage D5444 Mechanical Analysis of Extracted Aggregate D6307 Determining the Asphalt Content of Hot Mix Asphalt (HMA) by the Ignition Method D6926 Preparation of Asphalt Mixtures by Means of the Marshall Apparatus Page 2 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation Ste aashtoresource.org/aap/accreditation-directory F SCOPE OF AASHTO ACCREDITATION F Kleinfelder, Inc. AASH O in Ontario, California, USA ACCREDITED Asphalt Mixture (Continued) Standard: D6927 Resistance to Plastic Flow of Asphalt Mixtures Using Marshall Apparatus Page 3 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation sta aashtoresource.org/aap/accreditation-directory SCOPE OF AASHTO Kleinfelder, Inc. AASH o in Ontario, California, USA Standard: ACCREDITATION Soil T99 The Moisture -Density Relations of Soils Using a 5.5lb [2.5 kg] Rammer and a 12 in. [305 mm] Drop T134 Moisture -Density Relations of Soil -Cement Mixtures T180 Moisture -Density Relations of Soils Using a 10 lb [4.54 kg] Rammer and an 18 in. 1457 mm] Drop T265 Laboratory Determination of Moisture Content of Soils D421 Dry Preparation of Disturbed Soil and Soil Aggregate Samples for Test D422 Particle Size Analysis of Soils by Hydrometer D558 Moisture -Density !Relations of Soil -Cement Mixtures D698 The Moisture -Density Relations of Soils Using a 5.5 lb [2.5 kg] Rammer and a 12 in. [305 mm] Drop D1140 Amount of Material in Soils Finer than the No. 200 (75-pm) Sieve D1556 Density of Soil In -Place by the Sand Cone Method D1557 Moisture -Density Relations of Soils Using a 10lb [4.54 kg] Rammer and an 18 in. [457 mm] Drop D2166 Unconfined Compressive Strength of Cohesive Soil D2216 Laboratory Determination of Moisture Content of Soils D2434 Permeability of Granular Soils (Constant Head) D2435 One -Dimensional Consolidation Properties of Soils Using Incremental Loading D2487 Classification of Soils for Engineering Purposes (Unified Soil Classification System) D2488 Description and Identification of Soils (Visual -Manual Procedure) D2844 Resistance R-Value and Expansion Pressure of Compacted Soils D2974 Determination of Organic Content in Soils by Loss on Ignition D3080 Direct Shear Test of Soils Under Consolidated Drained Conditions D4318 Determining the Liquid Limit of Soils (Atterberg Limits) D4318 Plastic Limit of Soils (Atterberg Limits) D4718 Oversize Particle Correction Page 4 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation sta aashtoresource.org/aap/accreditation-directory F SCOPE OF AAS HT❑ ACCREDITATION Kleinfelder, Inc. AA— 5T in Ontario, California, USA ACCREDITED Soil (Continued) Standard D4829 Expansion Index of Soils D6913 Particle -Size Distribution (Gradation) of Soils Using Sieve Analysis D6938In-Place Density and Moisture Content of Soil and Soil -Aggregate by Nuclear Methods (Shallow Depth) Page 5 of 11 F This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation sta aashtoresource.org/aap/accreditation-directory AASH O ACCREDITED Standard: SCOPE OF AASHTO ACCREDITATION F Kleinfelder, Inc. in Ontario, California, USA Aggregate R76 Reducing Samples of Aggregate to Testing Size R90 Sampling Aggregate T11 Materials Finer Than 75-pm (No. 200) Sieve in Mineral Aggregates by Washing T19 Bulk Density ("Unit Weight") and Voids in Aggregate T27 Sieve Analysis of Fine and Coarse Aggregates T84 Specific Gravity (Relative Density) and Absorption of Fine Aggregate T85 Specific Gravity and Absorption of Coarse Aggregate T96 Resistance to Abrasion of Small -Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine T104 Soundness of Aggregate by Use of Sodium Sulfate or Magnesium Sulfate T112 Clay Lumps and Friable Particles in Aggregate T176 Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test T255 Total Moisture Content of Aggregate by Drying T304 Uncompacted Void Content of Fine Aggregate (influenced by Shape, Texture, and Grading) T335 Determining the Percentage of Fractured Particles in Coarse Aggregate C29 Bulk Density ("Unit Weight') and Voids in Aggregate C88 Soundness of Aggregate by Use of Sodium Sulfate or Magnesium Sulfate C117 Materials Finer Than 75-pm (No. 200) Sieve in Mineral Aggregates by Washing C127 Specific Gravity and Absorption of Coarse Aggregate C128 Specific Gravity (Relative density) and Absorption of Fine Aggregate C131 Resistance to Abrasion of Small -Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine C136 Sieve Analysis of Fine and Coarse Aggregates C142 Clay Lumps and Friable Particles in Aggregate C535 Resistance to Degradation of Large -Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine Page 6 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation ste aashtoresource.org/aap/accreditation-directory SCOPE OF AAS HTO ACCREDITATION F Kleinfelder, Inc. AA— Hr in Ontario, California, USA ACCREDITED Aggregate (Continued) Standard: C566 Total Moisture Content of Aggregate by Drying C702 Reducing Samples of Aggregate to Testing Size C1252 Uncompacted Void Content of Fine Aggregate (Influenced by Shape, Texture, and Grading) D75 Sampling Aggregate D2419 Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test D3744 Aggregate Durability Index D4791 Flat Particles, Elongated Particles, or Flat and Elongated Particles in Coarse Aggregate D5821 Determining the Percentage of Fractured Particles in Coarse Aggregate Page 7 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation sta aashto resource. org/aap/accred itation-d i rectory AASH ❑ ACCREDITED Standard: SCOPE OF AAS HTO ACCREDITATION F Kleinfelder, Inc. in Ontario, California, USA Sprayed Fire -Resistive Material E605 Thickness and Density of Sprayed Fire -Resistive Material(SFRM) Applied to Structural Members E736 Cohesion/Adhesion of Sprayed Fire -Resistive MaterialsApplied to Structural Members Page 8 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation sta aashtoresource.org/aap/accreditation-directory SCOPE OF AASHTO ACCREDITATION F Kleinfelder, Inc. Aa.sT in Ontario, California, USA ACCREDITED Iron and Steel Standard: A615-A370 Carbon -Steel Bars, Deformed and Plain: Tension (Elongation) A615-A370 Carbon -Steel Bars, Deformed and Plain: Tension (Ultimate Tensile Strength) A615-A370 Carbon -Steel Bars, Deformed and Plain: Tension (Yield Strength) A615-E290 Carbon -Steel Bars, Deformed and Plain: Bend Test A706-A370 Low Alloy Steel Bars, Deformed and Plain: Tension (Elongation) A706-A370 Low Alloy Steel Bars, Deformed and Plain: Tension (Ultimate Tensile Strength) A706-A370 Low Alloy Steel Bars, Deformed and Plain: Tension (Yield Strength) A706-E290 Low Alloy Steel Bars, Deformed and Plain: Bend Test Page 9 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation ste aashtoresource.org/aap/accreditation-directory SCOPE OF AASHTO ACCREDITATION Kleinfelder, Inc. AASH O in Ontario, California, USA ACCREDITED Concrete Standard: C31 Making and Curing Concrete Test Specimens in the Field C39 Compressive Strength of Cylindrical Concrete Specimens C42 Obtaining and Testing Drilled Cores and Sawed Beams of Concrete C78 Flexural Strength of Concrete (Using Simple Beam with Third -Point Loading) C138 Density (Unit Weight), Yield, and Air Content of Concrete C143 Slump of Hydraulic Cement Concrete C157 Length Change of Hardened Hydraulic -Cement, Mortar, and Concrete C172 Sampling Freshly Mixed Concrete C173 Air Content of Freshly Mixed Concrete by the Volumetric Method C192 Making and Curing Concrete Test Specimens in the Laboratory C231 Air Content of Freshly Mixed Concrete by the Pressure Method C511 Moist Cabinets, Moist Rooms, and Water Storage Tanks Used in the testing of Hydraulic Cements and Concretes C617 (8000 psi and below) Capping Cylindrical Concrete Specimens C1064 Temperature of Freshly Mixed Portland Cement Concrete C1231 (7000 psi and below) Use of Unbonded Caps in Determination of Compressive Strength of Hardened Concrete Cylinders C1542 Measuring Length of Concrete Cores Page 10 of 11 F This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation sta aashtoresource.org/aap/accreditation-directory SCOPE OF AAS HTO ACCREDITATION F Kleinfelder, Inc. AASH O in Ontario, California, USA ACCREDITED Masonry Standard: C140 (Concrete Masonry Units) Sampling and Testing Concrete Masonry Units and Related Units C511 Moist Cabinets, Moist Rooms, and Water Storage Tanks Used in the testing of Hydraulic Cements and Concretf C780 (Annex 6) Preconstruction and Construction Evaluation of Mortars for Plain and Reinforced Unit Masonry - Compressive S C1019 Sampling and Testing Grout C1314 Compressive Strength of Masonry Prisms C1552 Capping Concrete Masonry Units, Related Units and Masonry Prisms for Compression Testing Page 11 of 11 This certificate was generated on 03/19/2020 at 3:48 PM Eastern Time. Please confirm the current accreditation ste aashtoresource.org/aap/accreditation-directory Department Of BL a Material Control R ` 221 N. Figueroa , 7th . I� Los Angeles, CA 9001k "'warp} Tel. (213) 482-0315 elvailaacibs materialscontrwdolacitv.orc www.LADBS.org TESTING AGENCY CERTIFICATE OF APPROVAL Kleinfelder West, Inc. Shop Location Jeff Diaz 620 South Magnolia Avenue, 'G' Ontario, CA 91762 Approval No: TA23149 Branch No: N/A Expiration Date: 5/1/2021 620 South Magnolia Avenue, 'G' Ontario, CA 91762 Approval Type: CONCRETE / MASONRY / STEEL / AGGREGATES / SOILS /'NDT' / FIREPROOFING / METHANE TESTING / REBAR You are herby notified that your certificate of approval is valid until the expiration date shown above under the provisions of the City Of Los Angeles Municipal Code, section 98.0503 and Information Bulletin P/GI 2014-28 (Part II). Materials Control Section (213)482-7097 Renewal is in process Division of the State r hi CA,11`00NIA OEPARTMENT OE GENERAL SCOVICES February 14, 2017 Jeremy Larsen Kleinfelder West, Inc. 620 South Magnolia Avenue, Building G Ontario, CA 91762 1102 Q Street, Suite 51001 916,446.8100 Sacramento, CA 95811 I 916.446.3521 www.dsa.dgs.ca.gov A I« Dear Mr. Larsen: This letter is to inform you of the renewal of acceptance by the Division of the State Architect (DSA) of the facility referenced above into the Laboratory Evaluation and Acceptance (LEA) program. The referenced facility may provide the construction material testing and inspection services indicated on the attached list for projects under the jurisdiction of the DSA, which includes public schools (grades K-12 and community colleges) and State-owned or leased essential service buildings. LEA information for your facility will be posted on the DSA website (www.app.dgs,ca,gov/tracker/apptovedLabs.aspx). Please take time to review this correspondence with members of your staff that might be unfamiliar with our requirements. This acceptance Is valid until July 1, 2020 and Is contingent on continued compliance with the following LEA program requirements. 1. Eric Noel (RCE# 53613) is the approved full-time engineering manager responsible for the testing and inspection services listed on the enclosed. You must notify the DSA prior to any change in engineering managerial responsibility. 2a.The facility shall continue to receive biennial assessments by AASHTO Materials Reference Laboratory (AMRL) and the Cement and Concrete Reference Laboratory (CCRL) as applicable to the services offered at the facility. Future reports and evidence of corrective action shall be submitted to the DSA. 2b.The facility shall maintain current participation in AMRL and CCRL proficiency sample programs (PSP). Future PSP reports and explanations of any low ratings shall be submitted to the DSA. 3. If the subject laboratory has granted DSA "Specifier" privileges with AMRL, written reports do not need to be sent to the DSA. 4. The facility shall maintain all test equipment and records in accordance with applicable, current American Society for Testing and Materials (ASTM) standards. 1102 Q Street, Suite 5200 1515 Clay Street, Suite 1201 700 N. Alameda St., Suite 5-500 Les Angeles, CA 90012 10920 Via Fronten, Suite 300 San Diego, CA 92127 Sacramento, CA 958"11 Oakland, CA 94612 213,897,3995 858.674,5400 916.445.$730 510,622.3101 Jeremy Larsen -2- February 14, 2017 Kleinfelder West, Inc, 5. The facility shall provide laboratory and field testing personnel who are adequately trained, supervised and currently certified as required by the latest ASTM or other recognized standards. 6. Masonry inspectors assigned to projects under DSA jurisdiction shall have passed DSA's masonry inspector examination and be specifically approved for each project by the DSA field engineer. 7. Welding inspectors assigned to projects under DSA jurisdiction shall hold current American Welding Society (AWS) Certified Welding Inspector (CWI) or Senior CWI certification and be specifically approved for each project by the DSA field engineer. 8. The facility's Nondestructive Testing (NDT) program shall be supervised by an individual currently certified by the American Society for Nondestructive Testing (ASNT) as NDT Level III in applicable methods. Such certification shall have been obtained through ASNT by testing, not by employer or self -certification. 9. The facility's NDT written practice and procedures shall conform to the requirements of ANSI/ASNT CP-189, 2006, and be approved by the supervising Level III. All NDT technicians assigned to projects under DSA jurisdiction shall hold current Level II or greater certification, in accordance with the requirements of CP-189. 10. The laboratory facility shall provide test, inspection and verified reports In accordance with the requirements of the 2016 California Building Standards Administrative Code (CBC) Title 24, Part 1. Report format shall comply with LEA Program requirements and applicable ASTM standards. 11. The physical location of the facility, including but not limited to laboratory equipment and personnel, shall not change without prior notification to the DSA. Please be aware that failure to comply with any of the requirements of the LEA Program may result in this acceptance being revoked. A facility with a revoked acceptance may be reinstated when it demonstrates all deficiencies cited by the DSA have been corrected. Fees may be charged. If you wish to continue DSA acceptance beyond your current expiration date, you must submit a renewal application package at least 30 days prior to that date. The application (form DSA 100-PRE) and detailed instructions outlining submittal requirements can be downloaded from the DSA website, When we have received all required information, we will schedule an on -site evaluation of your facility. Thank you for participating in the Division of the State Architect's LEA program. Should you have any questions regarding the LEA program requirements please feel free to contact me at (916) 445-2193 or e-mail me at eric,france@dgs.ca.gov. Sincerely, Eric H. France Division of the State Architect Laboratory Evaluation and Acceptance Program Enclosure: Kleinfelder West, Inc. LEA 082 TESTING SERVICES INSPECTION SERVICES ACCEPTED ACCEPTED Earthwork Lab Earthwork Field Earthwork Soil Soil Com action Fill Placement A re ate Foundation As halt Concrete KIA Caissons/Piles Reinforcin Steel Reinforcin Steel Re -Bar Tension and Bend Welding Multi -Wire Strand Chemical Analysis Concrete Batch Plant - - Concrete -- ------------- ®Re - Bar and Concrete Sampling Makin / Curin s ecimens Pre -Stressed Concrete Drilled Cores / Beams ❑ Shotcrete Com ressive Strength Fiber Reinforced Concrete Length Change E ox injection Flexural Stren th Reinforced Gypsum ® Li htwei ht Concrete ® Post Installed Anchors Mix Desi n Review ❑ Splitting Tensile Masonry Past Installed Anchors ® Batch Plant Tor ue Proof Load Masonry Placement ® Post Installed Anchors Masonry Makin / Curing Specimens Structural Metals ® Grout Compressive Strength ® Weldin Prism Compressive Stren th High Strength Bolting Unit Com r, Stren in Absor tion N Spray-Appilea Fire roefin Dimensions Mason Shear Dr in Shrinkage Other Inspection Services: Metals/Lab Meta ls/Fie ld-N.D.T Structural Steel LI uid Penetrant Tension Ma netic Particle Bend Ultrasonic ® Density of SFRM High Strength Bolt ❑ Radiographic El Tension Other Tests: ❑ Hardness Charpy V - Notch Roofing ❑Tiles ❑ Built-U Approved by: ate: February 14, 2017 Division of the State Architect LEA Acceptance for Kleinfelder West, Inc., LEA# 082 is effective until July 1, 2020. 1102 0 Street, Suite 5100 • Sacramento, California 95811 - (916) 445-8100 Renewal is in process OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT G�gl�y�ip FACILITIES DEVELOPMENT DIVISION APPLICATION FOR OSHPD PREAPPROVED AGENCY (OPAA) For Office Use Only FOR STRUCTURAL TESTS AND SPECIAL INSPECTIONS OPAA-0010-16 Approved Agency City County State ZIP Code Kleinfelder Inc. Ontario San Bernardino CA 91762 APPLICATION TYPE / FEE Application Type New Application Fee Renewal Fee (Fees are Nonrefundable) (Fees are Nonrefundable) ® Combined Testing AND Special Inspection Agency ❑ $1,000.00 Z $500.00 ❑ Testing Agency ONLY ❑ $500.00 ❑ $250.00 ❑ Special Inspection Agency ONLY ❑ $500.00 ❑ $250.00 APPLICANT INFORMATION Applicant Name Jeffrey Diaz Position in the Organization Ontario Laboratory Supervisor Agencys Local Name Kleinfelder West, Inc Application Date 3t9i2017 Phone Number E-Mail (909) 657-1716 jmdiaz@kieifnetder.com Applicant certifies that all information provided in this application are accurate. Applicant Signature Address of Facility Location (Each facilitylocation requires separate application.) Street 620 South Magnolia Avenue, Building'G' City: Count Ontario San Bernardino CAte. Zip Cade: 91762 Facility Mailing Address (If different from facility address above.) Street City: State: Zip Code: KEY AGENCY PERSONNEL (Attach additional pages if needed.) Engineering Manager (or equivalent) — Name CA Registration Number Eric Noel C 53513 Expiration Date Title in the Organization Phone Number 6-30-2017 Project Manager III (951) 801-3723 FAX Number E-Mail ENoel@kleinfelder.com Alternate to Engineering Manager (if any) — Name CA Registration Number Expiration Date Title in the Organization Phone Number Alternate Phone Number E-mail Access to Safe. Duality Healthcare Environments that Meet Califome's Diverse and 0mamic Needs OSHPD STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) 3/28/2017 OPAA-0010-16 Page 1 of 19 1! OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION KEY TESTING PERSONNEL (Attach additional pages if needed.) CA Registration Number (if any) Expiration Date Testing Supervisor — Name Jeremy Larsen Title in the Organization Phone Number Vice Pres Const. Materials Eng. & Test Div Manager (909) 657-1716 Alternate Phone Number E-Mall JLarsen@Kleinfelder.com CA Registration Number (if any) Expiration Date Field Testing Supervisor— Name Jeremy Larsen Phone Number Title in the Organization Vice Pres Const. Materials Eng. &Test Div Manager (909) 657-1716 Alternate Phone Number E-mail JLarsenQkleinfelder.com KEY SPECIAL INSPECTIONS PERSONNEL (Attach additional pages if needed.) CA Registration Number (if any) Expiration Date Special Inspections Supervisor — Name Jeremy Larsen Title in the Organization Phone Number (909) 657-1716 Vice Pres Const. Materials Eng. & Test Div Manager Alternate Phone Number E-Mail JLarsen@klein6eder.com CA Registration Number (if any) Expiration Date Field Special Inspection Supervisor— Name Jeremy Larsen Title in the Organization Vice Pres Const. Materials Eng. &Test Div Manager Phone Number (909) 6578-1716 E-mail JLarsenQKleinfelder.com Alternate Phone Number OSH PD "Access to Safe, Cxualily Healthcare Ewri rmenls that Meet Gallfomla's Diverse and Dvnamin Naetls STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (&24I2016) Page 2 of 19 3I2W2017 OPAA-0010-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT _4VV,nN\iw FACILITIES DEVELOPMENT DIVISION ACCREDITATION AND QUALIFICATIONS Agency currently holds accreditation by: (Attach a copy of current accreditation details.) N AASHTO Accreditation Program (AAP) ❑ National Voluntary Laboratory Accreditation Program (NVLAP) ❑ International Accreditation Service (IAS) ❑ American Association of Laboratories Program (A2LA) ❑ Laboratory Accreditation Program (LAB) ❑ Construction Materials Engineering Council (CMEC) ❑ ANSI-ASQ National Accreditation Board ❑ Other Latest Expiration Date (if any) Is this Agency accepted in the Division of the State Architect Laboratory Evaluation and Acceptance Program, DSA-LEA? ❑ No M Yes Expiration Date: July 1, 2020 Basis for accreditation (Check all that apply): ❑ ISO/IEC 17025: General requirements for competence of testing and calibration laboratories ❑ ISO/IEC 17020: General requirements for the operation of various types of bodies performing inspection ❑ NISTIR 7012: Technical requirements for construction materials testing N AASHTO R18: Standard Recommended Practice for Establishing and Implementing a Quality System for Construction Materials Testing Laboratories N ASTM E 329: Specification for Agencies Engaged in the Testing and/or Inspection of Materials Used in Construction N ASTM C 1077: Practice for Laboratories Testing Concrete and Concrete Aggregates for Use in Construction and Criteria for Laboratory Evaluation N ASTM D 3666: Specification for Minimum Requirements for Agencies Testing and Inspecting Bituminous Paving Materials N ASTM D 3740: Practice for Evaluation of Agencies Engaged in Testing and/or Inspections of Soils and Rock as Used Engineering Design and Construction N ASTM C 1093: Practice for Accreditation of Testing Agencies for Unit Masonry ❑ ASTM E 1212: Practice for Quality Management Systems for Nondestructive Testing (NDT) Agencies ❑ ASTM E 543: Specification for Agencies Performing Nondestructive Testing (NDT) ❑ ]AS AC 291: Accreditation Criteria for Special Inspection Agency Basis for Test Technician/Special Inspector Qualification (Check all that apply): ❑ Hospital inspector class "An, "B", or "C" certification N DSA-LEA approval as test Technician/special inspector ❑ Certification listed in [AS AC 291 Table 1: Minimum Qualifications for Special Inspectors N Welding inspectors satisfying the requirements of the CBC 2016 Section 1705A.2.5 N California licensed engineer qualified to be test technician/special inspector Access to Safe, Duality Healthcare Environments that Meet Callfomia's Diverse and Dynamic Needs OSHPD STATE OF CALIFORNIA— HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) 3/28/2017 OPAA-0010-16 Page 3 of 19 �?8 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT 44i FACILITIES DEVELOPMENT DIVISION APPLICABLE TEST STANDARDS FOR WHICH AGENCY IS APPROVED By checking `yes" in Tables 1 through 6 below, the applicant verifies that the agency has the equipment and qualified personnel to perform the indicated testing. ONLY mark tests that are listed in accreditation certificate or DSA-LEA. SOILS AND FOUNDATIONS Tests Yes Standard Test Procedure Yes Standard Test Procedure ® a. ASTM D 421 Dry Prep of Soil N b. ASTM D 422 Particle Size Analysts Moisture Density of Soil Cement ® d, ASTM D 698 Compaction of Soil -Standard El C. ASTM D 558 Mixtures ❑ e. ASTM D 854 Specific Gravity of Soil ® f. ASTM D 1140 No. 200 Wash Elg. ASTM D 1143 Deep Foundations —Axial Compression ® h. ASTM D 1556 Density of Soils —Sand Cone ® I. ASTM D 1557 Soil Compaction — Modified ❑ j. ASTM D 1883 CBR Lab. Compacted Soils ® k. ASTM D 2166 Unconfined Compressive ® I. ASTM D 2216 Water Content of Soil Strength/Moisture content ® m. ASTM D 2419 Sand Equivalent Value ® n. ASTM D 2434 Permeability of Granular Soils ® o. ASTM D 2435 Consolidation Test ® p. ASTM D 2487 Classification of Soils ® q. ASTM D 2488 Identification of Soil Visual ® r. ASTM D 2844 Resistance R-Value & Ex . Pressure ❑ s. ASTM D 2850 Unconsolidated, Undrained Triaxial 1 ❑ t. ASTM D 2974 Organic Content ® u. ASTM D 3080 Direct Shear ❑ v. ASTM D 3441 Cone Penetration Test (CPT) Elw. ASTM D mm Deep Foundations — Axial Tension 3744 Durability Index ❑ y. ASTM D 3966 Deep Foundations —Lateral Loads IN A. ASTM D 4318 IlLiquid I Plastic Limit ❑ aa. ASTM D 4546 Swell or Collapse Test ❑ bb. ASTM D 4643 Microwave Moisture of Soils ❑ cc. ASTM D 4718 Oversize Rock Correction ❑ dd. ASTM D 4767 Triaxial Compression ® ee. ASTM D 4829 Expansion Index ❑ ff. ASTM D 4945 Deep Foundations — Dynamic Testing Friction Cone and Piezocone Penetration ❑ gg. ASTM D 5084 Permeability of Soils ❑ hh. ASTM D 5778 Fast ❑ it. ASTM D 6913 Gradation of Soil Using Sieve Analysis ® jj. ASTM D 6938 Density of Soils —Nuclear Gage ❑ riaxial Compressive Strength of Rock ❑ II. kk. ASTM D 7012 Core Specimens ❑ mm. ❑ nn. Tests that are in the lab's scope but are not listed above should be provided in the space(s) below. Yes Standard Test Procedure Yes Standard Test Procedure ❑ a ❑ b. ❑ c ❑ d. ❑ e ❑ f. OSH PD "Access to Safe. Quality Healthcare Environments that Meet Califomia's Diverse and Dvnamic Needs STATE OF CALIFORNIA —HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/2412016) OpgA-0010-16 Page 4 of 19 3f28I2017 ■`\ OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION 2 CONCRETE Tests Yes Standard Test Procedure Yes Standard Test Procedure ❑ a. AASHTO M 201 Moisture Rooms ❑ b. ACI 355.2 Post -Installed Mechanical Anchors ❑ c. ACI 355.4 Adhesive Anchors ❑ d. ACI 374.1 Moment Frames ❑ e. ACI ITG-5.1 Post -Tensioned Precast Special Walls Elf, ASTM A 416 Steel Strand N 9. ASTM A 615 Tension Test N h. ASTM A 706 Tension and Bend ❑ I. ASTM A 970 Headed Steel Bars - Bend ❑ J. ASTM A 1034 Reber Mechanical Splices ® k. ASTM C 29 Unit Weight I Voids ® I. ASTM C 31 Concrete Sampling - Field ® M. ASTM C 39 Compressive Strength ❑ n. ASTM C 40 Organic Impurities © ® o. q. ASTM C 42 ASTM C 88 Concrete Core Sodium Sulfate Soundness N P. r. ASTM C 78 ASTM C 117 Flexural Strength No. 200 Wash ® S. U. ASTM C 127 ASTM C 131 Specific Gravity - Coarse Degradation of Aggregate ® ® t. V. ASTM C 128 ASTM C 136 Specific Gravity -Fine Sieve Analysis Course I Fine N w. ASTM C 138 Density I Yield I Air Content N x. ASTM C 142 Clay I Friable Particles N Y. ASTM C 143 Slum p N z. ASTM C 157 Length Change N aa. ASTM C 172 Sampling Freshly Mixed Concrete N bb. ASTM C 173 kir Content ❑ cc. ASTM C 174 Measuring Thickness Using Drilled Concrete Cores ® dd. ASTM C 192 Makin I Curing Specimens -Lab 9 9 P N ❑ N ee. gg. H. ASTM C 231 ASTM C 495 ASTM C 511 Nir Content (P) Lightweight Concrete Moist Cure Rooms ranks ❑ ❑ N ff. hh. J1- ASTM C 295 ASTM C 496 ASTM C 535 Petrographic Analysis Splitting Tensile LA Abrasion N ® N kk, mm. oo. ASTM C 566 ASTM C 617 ASTM C 1064 Moisture Content of Aggregate Capping Concrete Specimens Temperature ❑ N ❑ it. nn. pp, ASTM C 567 ASTM C 702 ASTM C 1140 Density of Lightweight Aggregate Reducing Aggregate Samples Shotcrete Compression ® qq. ASTM C 1231 Unbonded Caps N rr. ASTM C 1252 Uncompacted Void Content ❑ ss. ASTM C 1260 Alkali Reactivity of Aggregate El tt. ASTM C 1293 Length Change due to Alkali -Silica Reaction ® uu. ASTM C 1542 Measuring Length of Cores ❑ vv. ASTM C 1602 Water ❑ ww. ASTM C 1604 Shotcrete Core N xx. ASTM D 75 Sampling Aggregate N N yy. aaa. ASTM D 1560 ASTM D 2041 Stabilometer Value Maximum Theo. Specific Gravity N N zz. bbb. ASTM D 5561 ASTM D 2419 Prep for HMA Test Specimens Sand Equivalent Value ® ❑ ccc. eee. ASTM D 2726 ASTM D 3039 Specific Gravity of Marshall Sample Tensile Strength of FRP ❑ N ddd. fff. ASTM D 2950 ASTM D 3203 In -Situ Density with Nuc. Gauge Percent Air Voids ® ggg. ASTM D 3744 Aggregate Durability Index ❑ hhh. ASTM D 4541 Pull of Strength of FRP EEI M. ASTM D 4791 Flat Elongated Pieces in Aggregate® B. ASTM D 5444 Sieve Analysis of Extracted Aggregate kkk. ASTM D 5821 Percent Crushed ParticlesIII. ASTM D 6307 sphalt Content by Ignition mmm. ASTM D 6926 lPrep for Marshal test Specimen ❑ nnn. ASTM D 6927 Marshall Stability & Flow, Air Voids "Access to Safe, Quality Healthcare EnN.nments PUat Meel California's Diverse and Dvnamic Need. - OSHPD STATE OF CALIFORNIA—HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (612412016) 3/2812017 OPAA-0010-16 Page 5 of 19 jig� OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION 2 CONCRETE (Continued) Tests Yes Standard Test Procedure Yes Standard Test Procedure ❑ 000. ASTM E 488 Strength of Anchors ASTM E 1190 Power Actuated Fasteners ❑ qqq. ASTM E 1512 Bond Strength of Anchors IMES AC 193 chars in Concrete ❑ sss. ICC-ES AC 232 Anchor Channels in Concrete rEl I IMES AC 308 dhesive Anchors in Concrete ❑ uuu. ICC-ES AC 395 Headed Shear Stud Reinforcement IMES AC 398 Cold Formed Steel Connectors in Concrete for Li ht-Frame Construction ❑ VA". IMES AC 399 Cast -in -Place Bolts in Concrete for Light -Frame Construction ❑ YYY� ❑ zu. Tests that are in the lab's scope but are not listed above should be provided in the space(s) below. Yes Standard Test Procedure Yes Standard Test Procedure ❑ ❑ ❑ a c e ❑ ❑ ❑ b. d. f. OSH PD "Access to Safe. Quality Healthcare Environments that Meet Collfcmia's Diverse and Dvnamic Needs" STATE OF CALIFORNIA— HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6124/2016) Page 6 of 19 3/28I2017 OPAA-0010-16 9 01OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION 3 MASONRY Tests Yes StandardlCode Reference Test Procedure Yes Standard/Code Reference Test Procedure ® a. ASTM C 39 Core Compressive Strength ❑ b. © C. ASTM C 140 Absorption, Compressive Strength, Unit Weight, Dimensions & Moisture Content ❑ d. ❑ e. ASTM C 426 Linear Drying Shrinkage ® f. ASTM C 780 Mortar Compressive Strength ® g. ASTM C 1019 Sampling and Testing Grout (Compressive Strength) Z h. ASTM C 1314 Prism Sam lin & Compressive Sampling p Strength ❑ ® j. ASTM C 1552 Capping Masonry ❑ k. ASTM E 384 Micro -indentation Hardness ❑ I. ® m. CBC 2105A Mortar Sampling M n. CBC 2105A Core Shear ❑ o. ICC-ES AC 01 Anchor in Masonry ❑ P. ICC-ES AC 58 Adhesive Anchors ❑ q. ICC-ES AC 106 Screw Anchors in Masonry ❑ r. ❑ s• ❑ t. Tests that are in the lab's scope but are not listed above should be provided in the space(s) below. Yes StandardlCode Reference Test Procedure Yes Standard/Code Reference Test Procedure ❑ a. ❑ b. ❑ c. ❑ d. ❑ e. ❑ f. "Access to Safe. Quality Healthcare Envlmnments that Meel California's Diverse and Dynamic Neetls" OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) 3/28/2017 OPAA-0010-16 Page 7 of 19 !JON OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT 1:47111_1 FACILITIES DEVELOPMENT DIVISION 4 STEEL Tests Yes StandardlCode Reference Test Procedure Yes Standard/Code Reference Test Procedure ❑ a. AISC 341 Section K2 Beam to Column Moment & EBF Connections Cyclic Tests ❑ b. AISC 341 Section K3 BRBF Cyclic Tests ❑ c. ASTM A 90 Weight of Coating ❑ d. N e. ASTM A 370 Tension & Bend Test ❑ f. I ASTM A 970 Headed Steel Bars Bend Test ❑ g. ASTM A 1061 Uncoated Seven -Wire Tension ❑ h. ASTM A 1064 Steel Wire Tension & Bend Test ❑ L ASTM E 10 Brinell Hardness ❑ j. ASTM E 18 Rockwell Hardness ❑ k. ASTM E 23 Charpy V - Notch ❑ I. ASTM E 94 Radiographic ❑ m. ASTM E 164 Ultrasonic ❑ n. ASTM E 165 Liquid Penetrant ❑ o. ASTM E 190 Guided Bend IN P. ASTM E 290 Bend Test N q. ASTM E 605 Density of SFRM ❑ r. ASTM E 1444 Magnetic Particle ❑ s. ASTM F 606 Bolt Tension Test N t. CBC 2203A Material Identification ❑ u. ICC-ES AC 318 Tapping Screw Fasteners ❑ V. ICC-ES AC 322 Cold -formed Steel Vertical Assemblies Tests that are in the lab's scope but are not listed above should be provided in the space(s) below. Yes Standard/Code Reference Test Procedure Yes Standard/Code Reference Test Procedure N ❑ ❑ a. C. e ASTM E736 SFIRM Adhesive ❑ ❑ ❑ b• d. f. 5 Wood and Roof Assemblies Tests Yes Standard Test Procedure Yes standard Test Procedure ❑ a. ASTM C 67 Brick and Structural Clay Roof Tiles ❑ b. ASTM D 1761 Fasteners in Wood Elc. ASTM D 2395 Density/Sp. Gr. Of Wood Eld. ASTM D 3617 Analysis of Built -Up Roof Systems ❑ e. ASTM D 4442 Moisture Content of Wood ❑ f. ASTM D 7147 Joist Hangers Elg. ASTM E 72 Panel Testing Elh. ASTM E 2126 Cyclic Testing of Panel for Shear ❑ I. ICC-ES AC 130 Wood Shear Panels ❑ j. ICC-ES AC 155 Hold -Down for Woods El It. ICC-ES AC 233 Alternate Dowel -Type Threaded Fasteners ❑ I. ]CC -ES AC 283 Plate Connector for Wood Trusses ❑ m ❑ n. Tests that are in the lab's scope but are not listed above should be provided in the space(s) below. ❑ 1 a ❑ I b. ❑ C. ❑ d. ❑ e ❑ f. 'Access to Safe. Quality Healthcare Environments that Meet Callforem's Diverse and Dvnamic Neetls" OSH PD STATE OF CALIFORNIA— HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) 3/28/2017 OPAA-0010-16 Pace 8 of 19 ���7 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT 1�yl��r7f�.;1, FACILITIES DEVELOPMENT DIVISION 6 COMPONENT, ASSEMBLY, PROTOTYPE & MISCELLANEOUS TESTING Tests Yes Standard/Code Reference Test Procedure Yes Standard/Code Reference Test Procedure ❑ a. AAMA 501.4 Static Test for Curtain Wall and Storefront Systems ❑ b AAMA 501.6 Dynamic Test for Curtain Wall and Storefront Systems ❑ c. ]CC -ES AC 156 Shake Table Test ❑ d. FM 1950 Seismic Sway Brace Testing ❑ e. ❑ f. ❑ g. ❑ In. ❑ i. ❑ 1 Tests that are in the tab's scope but are not listed above should be prMovided in the s ace s below. El a. El El El El d. ❑ a. ❑ f. "Access to Safe. Q..11W Healthcare Environments that Meet California's Diverse and DVIeri Needs' OSH PD STATE OF CALIFORNIA— HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) 128/'2017 OPAA-0010-16 Page 9 of 19 �i AND DEVELOPMENT OFFICE OF STATEWIDE HEALTH PLANNING hl FACILITIES DEVELOPMENT DIVISION 7 TEST TECHNICIANS Provide Following Information for Each Test Technician Employed by the Agency (Attach additional sheets if needed) *To update expiration date a renewal application for CIPAA and proof of renewal for certificationAicense shall be required Test Technician's Certification) Certification/ Certification/ Expiration Date* Comments Name License Type Licensing Agency License Number NICET LEVEL III NICET 129413 06-01-19 Soils NICET Level III NICET 129413 06-01-19 s halt NICET Level III NICET 129413 06-01-19 Michael Magana Concrete ACI 01112801 12-20-21 Updated since DSA App CI Aggregate CI Field Testing CI 01112801 03-17-17 ech CI Strength CI 01112801 08-13-19 estin Tech Caltrans - Soils Caltrans Na 1-31-19 Updated since DSA App Updated Since DSA Michael Magana Caltrans - Concrete Caltrans Na 12-2-18 PP Caltrans- Asphalt Caltrans Na 9-17-17 Mario Sanchez CI Strength CI 0138403 11/10/21 estin Tech CI Field Testing CI na 5-12-17 Eric Finley ech HMA / SOILS / PCC Caltrans Na 12-31-17 CI Field Testing CI Na 12-14-18 Tech EdmondJabbour ACI Strength Test CI Na 11-14-18 Tech HMA / SOILS / PCC Caltrans Na 1-31-19 Curtis Bullis CI Field Testing CI Na 3-17-17 ech ClFieldTesting CI Na 1-17-20 Dominic Montemayor ech Soils / PCC Caltrans Na 5-9-17 Cl Field Testing Cl 00988756 3-16-18 ech Thomas Rebosky ICC Soils ICC B083156 10-18-19 Soils, Concrete NICET 130583 10-1-2019 s halt Jeffrey Diaz Soils, Concrete, Caltrans na arious s halt Reinforced Conic, Mas, ICC 5320836 2-07-2018 Fire roofin , Soils, Ani IU.IfA ACI 01074782 Various "Access to Safe, QualllV Healthcare Environments that Meet Callfomla's Diverse and Dynamic Neetls" (th m OSH PD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (612412016) Page 10 of 19 3/28/2017 OPAA-0010-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT LaB� lk, FACILITIES DEVELOPMENT DIVISION 7 TEST TECHNICIANS (Continued) Provide Following Information for Each Test Technician Employed by the Agency (Attach additional sheets if needed) *To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required Test Technician's Certification/ Certification/ Certification/ Name License Type Licensing Agency License Number Expiration Date* Comments Test Technicians wit17 expired license shaft not be permitted to perform Tests. Access to Safe. Quality Healthcare Environments that Meet CaMmia's Diverse antl Dvnamlc Needs OSH PD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) 3/28/2017 OPAA-0010-16 Page 11 of 19 I/! OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT �`T m FACILITIES DEVELOPMENT DIVISION INSPECTIONS FOR WHICH AGENCY IS APPROVED APPLICABLE SPECIAL By checking 'yes" in Tables 7 through 12 below, the applicant verifies that the agency has the equipment and qualified personnel to perform the indicated special inspections. ONLY mark tests that are listed in accreditation certificate or DSA-LEA. g SOILS AND FOUNDATIONS Special Inspections Yes CodelStandard Field and Types of Inspection Yes Code/Standard Field and Types of Inspection ® a. CBC 1705/1705A Cast -in -place Deep Foundations N b. CBC 1705/1705A Driven Deep Foundations ® c. e. CBC 170511705A CBC 1813A Soils Excavations and Fills Ground Improvement ® ❑ d. T. CBC 1812A Shoring ® ❑ 9• ❑ h. Special Inspections that are in the agency's scope but are not listed above should be provided in the space(s) below. Yes Code/Standard Field and Types of Inspection Yes CodelStandard Field and Types of Inspection ❑ a ❑ b. ❑ C ❑ d. ❑ e ❑ f. 9 CONCRETE Special Inspections Yes CodelStandard Field and Types of Inspection Yes CodelStandard Field and Types of Inspection N a. CBC 1705/1705A Post -Installed Anchors N b. CBC 1705/1705A Shotcrete ® CBC 170511705A & Pre -Stressed Concrete ® d CBC 1705/1705A & ACI 318 Reinforced Cast -In -Place Concrete c, ACI 318 ® a' CBC 170511705A & Reinforced Pre -Cast Concrete ® f CBC 1705/1705A and ASTM C94 Batch Plant ACI 318 CBC 170511705A & El h CBC 1911 A & ICC- Fiber Reinforced Polymer (FRP) ® g' AWS D1.4 Rebar Weldin 9 ES AC 178 Composites ❑ i. ❑ I. Special Inspections that are in the agency's scope but are not listed above should be provided in the space(s) below. Yes CodelStandard I Field and Types of Inspection Yes CodelStandard Field and Types of Inspection ❑ a ❑ b. ❑ C. ❑ d. ❑ e ❑ f. OSHPD 'Access to Safe. Quality Healthcare Fawronmenls [hat Meet Califarnia's Diverse and Dynamic Needs STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6124/2016) Page 12 of 19 3/2812017 OPAA-0010-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT �YiyN%w FACILITIES DEVELOPMENT DIVISION 10 MASONRY Special Inspections Yes CodelStandard Field and Types of Inspection Yes Code/Standard Field and Types of Inspection ® 5A & AWS Rebar WeldingCBC 170511705A & TMS a CBC 17 DI A ® b' D1.4 Masonry Placement 602 El C. ❑ d. ❑ e' ❑ f. Special Inspections that are in the agency's scope but are not listed above should be provided in the space(s) below. Yes Code/Standard Field and Types of Inspection Yes Code/Standard Field and Types of Inspection ❑ a. ❑ b. ❑ C. ❑ d. ❑ e. ❑ f. 11 STEEL Special Inspections Yes ® Code/Standard a. CBC 1705/1705A Field and Types of Inspection Fireproofing Yes ® Code/Standard b. CBC 1705/1705A Field and Types of Inspection Structural Cold -Formed Steel ® c CBC 1705/1705A, AISC 360 & 341 High Strength Bolts ® d CBC 1705/1705A, AISC 360 & 341 Steel Fabrication & Erection ® e. CBC 1705/1705A, AWS QC1, AISC 360 & 341 Welding ❑ f. ❑ g' ❑ h. Special Inspections that are in the agency's scope but are not listed above should be provided in the space(s) below. Yes Code/Standard Field and Types of Inspection Yes Code/Standard Field and Types of Inspection ❑ a' ❑ b. ❑ C. ❑ d. ❑ e. ❑ f. 'Access to Safe. Quality Healthcare Environments that Meet California's Diverse and Dynamic Needs OSHPD STATE OF CALIFORNIA —HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) 3/28/2017 OPAA-0010-16 Page 13 of 19 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT wTA� 1' FACILITIES DEVELOPMENT DIVISION 12 Wood and Roof Assemblies Special Inspections Yes CodelStandard Field and Types of Inspection Yes CodelStandard Field and Types of Inspection ❑ a. CBC 1705/1705A Wood Construction ❑ b. ❑ C. ❑ d. ❑ e. ❑ f. ❑ g. ❑ h. Special Inspections that are in the agencys scope but are not listed above should be provided in the space(s) below. ❑ a ❑ b. Elc ❑ d. ❑ a ❑ f. NONSTRUCTURAL COMPONENTS AND MISCELLANEOUS SPECIAL INSPECTIONS 13 Special Inspections Yes CodelStandard Field and Types of Yes CodelStandard Field and Types of inspection Nonstructural Components, ❑ a. CBC 170511705A Damping System ❑ b. CBC 1705/1705A Supports and Attachments ❑ c. CBC 1705/1705A Seismic Isolation System ❑ d. CBC 2003 & AWS D1.2 Aluminum/Aluminum Welding Structural Silicone Glazing ❑ f ❑ e. CBC 2410 SSG S ecial Ins ections that are in the a enc s scope but are not listed above should be it in the s aces below. ❑ a . ❑ b. ❑ c ❑ d. ❑ e. ❑ f. OSH PD -Access to Safe. Quality Healthcare Environments that Meet California's Olverse and DVnamic Needs STATE OF CALIFORNIA— HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6I2412016) Page 14 of 19 3/28/2017 OPAA-0010-16 4 / OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT M FACILITIES DEVELOPMENT DIVISION 14 Provide Following Informa additional sheets if needed) *To update expiration date a Inspector's Name Certification/ License Type Fireproofing Jeffrey Diaz Reinforced Concrete Kim Byrd Troy Degener Eric Kennedy Robert Carman Concrete I Concrete Concrete Concrete I Concrete I Concrete Concrete Dennis Brown Prestressed Concrete elding Reinforced Concrete Jesse Maddox elding Reinforced Concrete Masonry Reinforced Concrete Vartan Deirdeirtan Prestressed Concrete not SPECIAL INSPECTORS n for Each Special Inspector Em ewal application for OPAA and proof of renews Certification) Certification/ jUcensing Agency License Number 5320836 53201836 5320836 5320836 1106095 1106095 1106095 1109095 5114248 5114248 5114248 S114248 5114248 5077705 5077705 507770S 5077705 507770S 5006860 5006860 5006860 S006860 5006860 1066095 1066095 106609S 1066095 5223743 S223743 1 5223743 1 1026139 E 1026139 1026139 5 'ity P009633 n Access to Safe, nuallly n.Iftare Environments that Meet Galifornla's Diverse and Dynamic Needs led by the Agency (Attach certification/license shall be required Expiration Date* Comments i-2018 Correct Exp Date i-2018 Correct Exp Date i-2018 Correct Exp Date i_2018 Correct Exp Date 13-2017 13-2017 13-2017 -20-2019 7 7 7 -2-2020 -24-2019 -24-2019 14-2019 14-2019 14-2019 ICC ID ICC ID ICC ID ICC ID ICC ID OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY 1 OSH-FD-OPAA-100 (6/24/2016) 3/28/2017 OPAA-0010-16 Page 15 of 19 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT Tim FACILITIES DEVELOPMENT DIVISION �'ll�uidt' 14 SPECIAL INSPECTORS (Continued) Provide Following Information for Each Special Inspector Employed by the Agency (Attach additional sheets if needed) *To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required Inspector's Name Certification/ License Type Certification/ Licensing Agency Certification/ License Number Expiration Date* Comments Soils ICC 8324546 1-24-2018 Zach Roush Steel and Bolting ICC 8324546 12-8-2018 Reinforced Concrete ICC 8324546 -26-2019 Michael Carman Wing & Bolting ICC 5032377 5-25-2018 Special Inspectors with expired license shall not be permitted to perform Special Inspections. Access t- Safe, Qaality Healthcare En*anmants that Meal Califbmia's Divers- and Dynamic Needs OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (612412016) 3/28/2017 OPAA-0010-16 Page 16 of 19 90 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT jrIhV ifI FACILITIES DEVELOPMENT DIVISION 14 SPECIAL INSPECTORS (Continued) Provide Following Information for Each Special Inspector Employed by the Agency (Attach additional sheets if needed) *To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required Inspector's Name Certification/ License Type Certification/ Licensing Agency Certification/ License Number Expiration Date* Comments S ecial Ins ectors with expired license shall not be permifted to perform Special Inspections. "Access to S.M. Qu.Fty Healthcare Eavironmenls that Meet Galifomia's Diverse and Ovnamic Needs" OSHPD STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24,2016) 3/28/2017 OPAA-0010-16 Page 17 of 19 ,AN OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT ��Triy FACILITIES DEVELOPMENT DIVISION SUMMARY OF AGENCY'S TESTING AND SPECIAL INSPECTION SERVICES 15 Structural Tests & Special Inspections (Check all that apply) Yes Structural Tests Yes Structural Special Inspections N Soil N Earthwork N ggregate N Batch Plant N Reinforcing Steel N Reinforced Concrete N Concrete N Pre -Stressed Concrete N Post -Installed Anchors N Post -Installed Anchors N Concrete Specialty Inserts N Pre -Cast Concrete N Shotcrete N Shotcrete N Masonry N Masonry N Steel N Steel Welding N High -Strength Bolts and other Fasteners N High -Strength Bolts and other Fasteners N Non -Destructive Testing (NDT) N Spray Applied Fireproofing ❑ ood ❑ Nood N luminum/Aluminum Welding ® luminum/Aluminum Welding ❑ Fiber Reinforced Polymer (FRP) Composites ❑ Fiber Reinforced Polymer (FRP) Composites N Deep Foundations N Deep Foundatons N Nonstructural Components, Supports and Attachments N Nonstructural Components, Supports and Attachments N Structural Elements and Connections ❑ Base Isolators ❑ IShake Table Tests ❑ Dampers Tests and S ecial Inspections that are in the Agency's scope but are not listed above should be provided in the s aces below. ❑ ❑ ❑ ❑ ❑ ❑ OSH PD Access to Safe. OualiN Healthcare Environments that Meet Califomia's Diverse and Dvnamlc Needs STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) Page 18 of 19 3/28/2017 OPAA-0010-16 T� OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION List of Attachments Supporting the Agency's Approval (Check all that apply) Yes Enclosure Type ® OSHPD Facilities Development Division (FDD) Payment Form (OSH-AD-367): hfti?://oshpd.ca.gov/FDD/Forms/eSPForms/OSH-FD 367-FacDvmtDivPmtForm. ® df DSA-LEA Laboratory Qualification as posted at DSA website: hftps://www.apps.dgs.ca-gov/tracker/ApgrovedLabs.asg)x Latest Copy of DSA 100: LEA Program Application as Submitted to DSA ® ® Latest copy of DSA 220: LEA Program On -Site Assessment Report ® Latest copy of DSA acceptance letter of the Agency8gency into the LEA program. M Current Accreditation Certificates including List of Tests and Special Inspections for which the Agency is Accredited ® Copy of Test Technician/Individual Special Inspectors License/Certification showing expiration date(s) ® OPL Number for Conversion of OPL to OPAA only: OPL-0045-10 El OPAA Number for Conversion/Renewal of OPAA only: El Other Please Specify): 11 Other Please Specify): Other Please Specify): El Other Please Specify): OSHPD Approval (For Office Use Only) Signature: ���/�v �_i Approval Date: 3/28/17 Print Name: M. R. Karim Title: SHFR Condition of approval (if applicable): "Access to Safe. Quality Heal[hcare Environments that Mee[ COtfi mla'0 Diverse and Dynamic Neetls" Approval Expiration Date: July 1, 2020 OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (6/24/2016) 3/28/2017 OPAA-0010-16 Page 19 or 19 USACE CERTIFICATE MTC OF MATERIALSTESTING LABORATORY VALIDATION 0 CENTER ERDC Kleinfelder 620 South Magnolia Ave Ontario, CA, United States Jeffrey Diaz (909) 657-1716 has demonstrated, by abbreviated audit of its AASHTO accreditation, or by inspection of required records, equipment, procedures, facilities, and/or final reports, its proficiency to perform testing of construction materials, as established by the quality standards of AASHTO R 18 guidance and the requirements of the applicable ASTM standards. THIS USACE CERTIFICATE OF LABORATORY VALIDATION IS ACCURATE AS OF ITS DATE AND TIME OF GENERATION: 07 FEB 2020 AT 15:30 HOURS ALL METHODS LISTED ON THIS CERTIFICATE OF VALIDATION WILL EXPIRE ON 02/07/2022 PLEASE CONFIRM THE CURRENT VALIDATION STATUS OF THIS LABORATORY USING THE SEARCH FEATURE ON OUR PUBLIC WEBSITE: https,//mtc.erdc.dren.mil Chad A. Carrell, PE, Director USACE Materials Testing Center Vicksburg, Mississippi, USA AGGREGATE 1 Aggregate - C 29 - Opt - Unit Weight and Voids in Aggregate Aggregate - D 75 - Opt - Sampling Aggregate - C 88 - Opt - Sulfate Soundness Aggregate - C 117 - Req - Material Finer than 75 pm (No. 200) Sieve Aggregate - C 127 - Req - Specific Gravity & Absorption in Coarse Aggregate Aggregate - C 128 - Req - Specific Gravity & Absorption in Fine Aggregate Aggregate - C 131 - Opt - Los Angeles Abrasion Resistance on Small -Size Coarse Aggregate Aggregate - C 136 - Req - Sieve Analysis of Aggregates Aggregate - C 142 - Opt - Clay Lumps Aggregate - C 535 - Opt - Los Angeles Abrasion Resistance on Large Size Coarse Aggregate Aggregate - C 566 - Opt - Total Moisture Content Aggregate - C 702 - Opt - Reducing Samples to Testing Size Aggregate - C 1077 - Opt - Concrete and Concrete Aggregate Testing Standards (Quality Standards) Aggregate - C 1252 - Opt - Uncompacted Void Content of Fine Aggregate (as influenced by particle shape, surface texture, and grading) Aggregate - D 2419 - Opt - Sand Equivalent Value Aggregate - D 3666 - Opt - Minimum Requirements for Agencies Testing and Inspecting Road and Paving Materials Aggregate - D 3744 - Opt - Aggregate Durability Index Aggregate - D 4791 - Opt - Flat and Elongated Particles in Course Aggregate Aggregate - D 5821 - Opt - Percentage of Fractured Particles in Coarse Aggregate BITUMINOUS Bituminous - D 979 - Req - Sampling Bituminous raving uouuiea Bituminous - D 1188 - Req - Bulk Specific Gravity & Density Using Coated Samples Bituminous - D 1560 - Req - Resistance to Deformation & Cohesion by Hveem Bituminous - D 1561 - Req - Preparation by CA Kneading Compactor Bituminous - D 2041 - Req - Theoretical Maximum Specific Gravity & Density (Rice) Bituminous - D 2172 - Req - Quantitative Extraction Bituminous - D 2726 - Req - Bulk Specific Gravity and Density Bituminous - D 2950 - Req - Density of Bituminous Concrete in Place by Nuclear Methods Bituminous - D 3666 - Opt - Minimum Requirements for Agencies Testing and Inspecting Road and Paving Materials Bituminous - D 5444 - Req - Mechanical Size Analysis of Extracted Aggregate Bituminous - D 6307 - Req - Asphalt Content of Hot -Mix Asphalt by Ignition Method Bituminous - D 6926 - Req - Preparation of Bituminous Specimens using Marshall CONCRETE Concrete - C 31 - Req - Making and Curing Test Specimens in the Field Concrete - C 39 - Req - Compressive Strength of Cylindrical Specimens Concrete - C 42 - Opt - Drilled Cores and Sawed Beams Concrete - C 78 - Opt - Flexural Strength by Third Point Loading Concrete - C 138 - Req - Unit Weight and Air Content by Gravimetric Concrete - C 143 - Req - Slump Concrete - C 157 - Opt - Length Change of Concrete and Mortars Concrete - C 172 - Req - Sampling Concrete - C 173 - Req - Air Content by Volumetric —required if C231 not performed — Concrete - C 192 - Opt - Making and Curing Test Specimens in Laboratory Concrete - C 231 - Req - Air Content by Pressure —required if C173 not performed — Concrete - C 511 - Opt - Moist Cabinets, Moist Rooms, Water Storage Tanks Concrete - C 617 - Opt - Capping Cylindrical Specimens Concrete - C 1064 - Req - Temperature of Concrete Concrete - C 1077 - Opt - Concrete and Concrete Aggregate Testing Standards (Quality Standards) Concrete - C 1231 - Opt - Unbonded Caps Concrete - C 1542 - Opt - Measuring Length of Concrete Cores MASONRY Masonry - C 140 - Req - Sampling and Testing Concrete Masonry and Related Units Masonry - C 511 - Opt - Mixing Rooms, Moist Cabinets, Cure Tanks Masonry - C 780 - Req - Evaluation of Mortars for Plain and Reinforced Unit Masonry Masonry - C 1019 - Req - Sampling and Testing Grout Masonry - C 1093 - Opt - Masonry Testing Standard (Quality Standards) Masonry - C 1314 - Opt - Compressive Strength of Masonry Prisms Masonry - C 1552 - Opt - Capping Concrete Masonry Units and Related for Compression Testing Soils - D 421 - Req - Dry Preparation for Particle Size Distribution & Soil Constants Soils - D 422 - Req - Particle Size Analysis Soils - D 558 - Req - Moisture -Density of Soil -Cement Soils - D 698 - Req - Compaction Characteristics by Standard Effort Soils - D 1140 - Req - Material Finer than 75 m (No. 200) Sieve Soils - D 1556 - Req - Density & Unit Weight by Sand Cone Soils - D 1557 - Req - Compaction Characteristics by Modified Effort Soils - D 2166 - Req - Unconfined Compressive Strength Soils - D 2216 - Req - Water Content Soils - D 2434 - Opt - Permeability of Granular Soils (Constant Head Method) (Withdrawn 2015) Soils - D 2487 - Req - Classification of Soils Soils - D 2488 - Req - Description & Identification of Soils (Visual -Manual Procedure) Soils - D 2844 - Opt - Resistance R-Value and Expansion Pressure of Compacted Soils Soils - D 2974 - Req - Moisture, Ash, & Organic Matter of Peat & Other Organic Soils Soils - D 3080 - Req - Direct Shear Test in Consolidated Drained Conditions Soils - D 3740 - Opt - Soil and Rock Testing Standards (Quality Standard) Soils - D 4318 - Req - Liquid & Plastic Limits & Plasticity Index Soils - D 4718 - Opt - Correction of Unit Weight and Water Content for Soils Containing Oversize Particles Soils - D 4829 - Opt - Expansion Index of Soils Soils - D 6913 - Req - Particle -Size Distribution of Soils Using Sieve Analysis Soils - D 6938 - Req - Density and Water Content by Shallow Depth Nuclear Method SPRAYED FIRE RESISTIVE Sprayed Fire Resistive - E 329 - Opt - Standard Specification for Agencies Engaged in Construction Inspection, Testing, or Special Inspection Sprayed Fire Resistive - E 605 - Opt - Thickness and Density of Sprayed Fire Resistive Material (SFRM) Applied to Structural Members Sprayed Fire Resistive - E 736 - Opt - Cohesion Adhesion of Sprayed Fire Resistive Materials Applied to Structural Members State of California -Health and Human Services Agency California Department of Public Health Page 1 of 4 pages RADIOACTIVE MATERIAL LICENSE Pursuant to the California Code of Regulations, ahrislon 9, Title 17, Chapter 6, Subchapter 4, Group 2, Licensing of Radioactive Material, and In reliance on statements and representations heretofore made by the licensee, a license Is hereby Issued authorizing the licensee to receive, possess, or radioactive smaterial listed and to use radioactive material r the D and at the placedsgnated below. Me licenseIssubjecttoall applicableules, regulations, and of the CaliforniaCapartment Of Public Health now or hereafter In effect and to any standard ar speclllc condition specified in this license. f. Licensee: Kleinfeider West, Inc. 3. License Number. 6852-19 Amendment Number.l7 4. Expiration Date: 2. Address: 620 S. Magnolia Avenue, Bldg. 0 January 2, 2023 (5) Ontario, CA 91762 Attention: Jeffery Diaz 5, Inspection Agency Radiologic Health Branch License Number 6852-19 is hereby amended as follows: 6. Nuclide 7. Form 8. Possession Limit A. Cesium -137/ A. Sealed sources (CPN #131) A. 29 source pairs not to exceed 370.0 MBq (10 mCi) Americium-241:Be of Cesium-137 and 1.9 GBq (50 mCi) of Americium-241 each. 'B. Cesium-137/ B. Sealed sources (Troxler Dwg. B. 12 source pairs not to exceed 333.0 MBq (9 mCi) of Americium-241:Be No. A-102112 and A-102451) Cesium-137 and 1.6 GBq (44 mCi) of Americium- 241 each. C. Cesium-137 C. Sealed sources (Troxler Dwg. C. 2 sources not to exceed 333.0 MBq (9 mCi) each. No. A-102)12) D. Cesium-137/ D. Sealed sources (HSI Dwgs. D. 2 source pairs not to exceed 407.0 MBq (I I mCi) of Americium-241:13e 2200064 and 2200067) Cesium-137 and 1.6 GBq (44 mCi) of Americium- 241 each. E. Cesium-137/ E. Sealed sources (Troxler Dwg. E. I source not to exceed 370.0 MBq (10 mCi) of Americium-241:13e No. A-100281) Cesium-137 and 1.9 GBq (50 mCi) of Americium- 241. 9, Authorized Use A. To be used as components of gauges, CPN Corporation Models A, Bit, MC, or $00 series, for determination of moisture/density in engineering materials. B. To be used as components of gauges, Troxler Model 3400 series, for determination of moisture/density in engineering materials. C. To be used as components of gauges, Troxler Model 4640 series, for determination of surface density in engineering materials. D. To be used as components of gauges, Humboldt Scientific, Inc. Model 5006 Series, for determination of moistureldensity in engineering materials. E. To be used as components of gauges, Troxler Model 2401 for determination of moistureldensity in engineering materials (for storage only). State of Callfornia•Health and Human Services Agency California Department of Public Health Page 2 of 4 pages RADIOACTIVE MATERIAL LICENSE License Number: 6852.19 Amendment Number: 17 LICENSE CONDITNS 10. Radioactive materials may be used at temporary job sites of the licensee in areas not under exclusive federal jurisdiction throughout the State of California (see Condition 23). Radioactive materials may be permanently stored only at: (a) 620 S. Magnolia Avenue, Bldg. G, Ontario, CA. (b) 2 Ada, Suite 150, Irvine, CA. (c) 20411 South Susana Road, Suite E, Long Beach, CA. 11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at any one time as specified in Items 6, 7, 8 and 9 of this license. The annual fee for this license is required by and computed in accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also subject to an annual cost -of -living adjustment pursuant to Section 100425 of the California health and Safety Code, 12. Radioactive material may be used only by, or under the supervision and in the physical presence of, individuals who: (a) Have satisfactorily completed a course, accepted by the Department as adequate, in safe use of soil/asphalt content gauges containing radioactive material and also; (b)• Have been provided with a statement, signed by the Radiation Safety Officer, which designates that individual as an authorized user qualified to use radioactive material under this license. Copies of these documents shall be maintained for inspection by the Department, 13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material described in Items 6, 7, 8 and 9 of this license in accordance with the statements, representations, and procedures contained in the documents listed below. The Department's regulations shall govern unless the statements, representations, and procedures in the licensee's application and correspondence are more restrictive than the regulations. (a) The renewal application with attachments dated November 13, 2007, signed by Julie Ster, Corporate Radiation Safety Officer, as modified by the letter with attachments, dated July 9, 2009, signed by Julie Ster, Corporate Radiation Safety Officer, the email with attachments received from Julie Ster, Corporate Radiation Safety Officer, on March 15, 2011, and the letter with attachments, dated January 18, 2013, signed by David Robinson, Radiation Safety Officer. (b) The e-mails, both with attachments, received on July 23, 2015 and June 8, 2016, both from Julie Ster, Corporate Radiation Safety Officer, and the letters, both with attachments, dated March 6, 2016 and March 24, 2016, both signed by Julie Ster, Corporate Radiation Safety Officer, in regards to adding 20411 South Susana Road, Suite E, Long Beach, CA, as a permanent storage location, releasing 620 West 16 Street, Unit 1F, Long Beach, CA, for unrestricted use, Duties and Responsibilities and Delegation of Authority for the Radiation Safety Officer, updated Emergency Contact List, and updated Organizational Chart. 14. (a) The Radiation Safety Officer in this program shall be Jeffery Diaz. (b) The Alternate Radiation Safety Officer in this program for Long Beach shall be Roger Khoudessian. (c) The Alternate Radiation Safety Officer in this program for Irvine shall be Farid Ghaheri. 15. Sealed sources contained in CPN, Troxler and Humboldt Scientific soil/asphalt gauges shall be tested for leakage and/or contamination at intervals not to exceed twelve (12) months. State of California -Health and Human Services Agency California Department of Publle Health Page 3 of 4 pages RADIOACTIVE MATERIAL LICENSE License Number: 68 2-1 Amendment Number: 17 16, The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license using leak test kits acceptable to the California Department of Public Health: (a) The Radiation Safety Officer (b) Qualified individuals designated in writing by the Radiation Safety Officer 17. Quantitative analytical assays for the purpose of tests for leakage and/or contamination of sealed sources shall be performed only by persons specifically authorized to perform that service. 18. Records of leak test results shall be kept in units of becquerls (microcuries) and maintained for inspection, Records may be disposed of following Department inspection. Any leak test revealing the presence of 185 Bq (0.005 µCi) or more of removable radioactive material shall be reported to the California Department of Public Health, Radiologic Health Branch, MS 7610, P.O. Box 997414, Sacramento, CA 95899-7414, within five days of the test. This report shall include a description of the defective source or device, the results of the test, and the corrective action taken. 19. Maintenance and repair of soil/asphalt content gauges shall be performed only by persons specifically authorized to perform those services. 20. At any time the licensee is engaged in making measurements by authority of this license at either a permanent or temporary job site, the licensee shall have a current copy of each of the following documents available for inspection at the job site: (a) A statement authorizing each qualified individual to use radioactive material (See Condition 12). (b) This license. (c) The manufacturer's instruction manual with appropriate emergency procedures. 21. The licensee shall comply with all requirements of Title 17, California Code of Regulations, Section 30373 when transporting or delivering radioactive materials to a carrier for shipment. These requirements include; packaging, marking, labeling, loading, storage, placarding, monitoring, and accident reporting. Shipping papers shall be maintained for inspection pursuant to the U.S. Department of Transportation requirements (Title 49, Code of Federal Regulations, Part 172, Sections 172.200 through 172.204). 22. The licensee shall conduct a physical inventory every six months to account for all sealed sources and/or devices received and possessed under the license. Records of the inventories shall be maintained for inspection, and may be disposed of following Department inspection. 23. Before radioactive materials may be used at a temporary job site at any federal facility, the jurisdictional status of the job site must be determined. If the jurisdictional status is unknown, the federal agency should be contacted to determine if the job site is under exclusive federal jurisdiction. A response shall be obtained in writing or a record made of the name and title of the person at the federal agency who provided the determination and the date that it was provided. Authorization for use of radioactive materials at the job sites under exclusive federal jurisdiction shall be obtained either by: (a) Filing an NRC Form-241 in accordance with the Code of Federal Regulations, Title 10, Part 150.20 (b), "Recognition of Agreement State Licenses", or (b) By applying for a specific NRC license. Before radioactive material can be used at a temporary job site in another State, authorization shall be obtained from the State if it is an Agreement State, or from the NRC for any non -Agreement State, either by filing for reciprocity or applying for a specific license. State of California -Health and Human Services Agency California Department of Public Health Page 3 of 4 pages RADIOACTIVE MATERIAL LICENSE ucenseNumber: 6852"19 Amendment Number: 17 16. The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license using leak test kits acceptable to the California Department of Public Health: (a) The Radiation Safety Officer (b) Qualified individuals designated in writing by the Radiation Safety Officer 17, Quantitative analytical assays for the purpose of tests for leakage and/or contamination of sealed sources shall be performed only by persons specifically authorized to perform that service. 18. Records of leak test results shall be kept in units of becquerels (microcuries) and maintained for inspection. Records may be disposed of following Department inspection. Any leak test revealing the presence of 185 Bq (0.005 µCi) or more of removable radioactive material shall be reported to the California Department of Public Health, Radiologic Health Branch, MS 7610, P.O. Box 997414, Sacramento, CA 95899-7414, within five days of the test. This report shall include a description of the defective source or device, the results of the test, and the corrective action taken. 19. Maintenance and repair of soil/asphalt content gauges shall be performed only by persons specifically authorized to perform those services. 20. At any time the licensee is engaged in making measurements by authority of this license at either a permanent or temporary job site, the licensee shall have a current copy of each of the following documents available for inspection at the job site: (a) A statement authorizing each qualified individual to use radioactive material (See Condition 12). (b) This license. (c) The manufacturer's instruction manual with appropriate emergency procedures. 21. The licensee shall comply with all requirements of Title 17, California Code of Regulations, Section 30373 when transporting or delivering radioactive materials to a carrier for shipment. These requirements include; packaging, marking, labeling, loading, storage, placarding, monitoring, and accident reporting. Shipping papers shall be maintained for inspection pursuant to the U.S. Department of Transportation requirements (Title 49, Code of Federal Regulations, Part 172, Sections 172.200 through 172.204). 22. The licensee shall conduct a physical inventory every six months to account for all sealed sources and/or devices received and possessed under the license. Records of the inventories shall be maintained for inspection, and may be disposed of following Department inspection. 23. Before radioactive materials may be used at a temporary job site at any federal facility, the jurisdictional status of the job site must be determined. If the jurisdictional status is unknown, the federal agency should be contacted to determine if the job site is under exclusive federal jurisdiction. A response shall be obtained in writing or a record made of the name and title of the person at the federal agency who provided the determination and the date that it was provided. Authorization for use of radioactive materials at the job sites under exclusive federal jurisdiction shall be obtained either by: (a) Filing an NRC Form-241 in accordance with the Code of Federal Regulations, Title 10, Part 150,20 (b), "Recognition of Agreement State Licenses", or (b) By applying for a specific NRC license. Before radioactive material can be used at a temporary job site in another State, authorization shall be obtained from the State if it is an Agreement State, or from the NRC for any non -Agreement State, either by filing for reciprocity or applying for a specific license, State of California -Health and Human Services Agency California Department of Public Health Page 4 of 4 pages RADIOACTIVE MATERIAL LICENSE license Number: 6852-19 Amendment Number: 17 24. The Radiation Safety Officer shall establish measures for the security of devices possessed and transported under authority of this license. The Radiation Safety Officer shall ensure security measures required by this license meet the following minimum standards: (a) Transport vehicles must be equipped to provide security of the transport case. The method selected must provide for a fixed and permanent attachment to vehicle frame. When secondary containers are used for the Type A package they shall be attached to the vehicle with the use of tamper resistant fasteners to the frame of the transport vehicle. (b) A minimum of two locks shall be placed between radioactive sources and the public when the device is being transported, in addition to the locks securing the Type A package to the vehicle. (c) Transport vehicles must be equipped with a security device (such as an alarm system) capable of deterring unauthorized entry, access and use of the vehicle. (d) Local law enforcement shall be notified immediately in the event of loss or theft. 25. At least 30 days prior to vacating any address of use listed in Condition 10 of this license, the licensee shall provide written notification of intent to vacate to the California Department of Public Health, in accordance with Title 17, California Code of Regulations, Section 30256 (b). Control of all licensed areas must be maintained until such areas are released by the Department for unrestricted use or the license is terminated, in accordance with Title 17, California Code of Regulations, Section 30256 Q). 26, The licensee will provide the Low Level Radioactive Waste (LLRW) reports specified in the California Health and Safety Code section 115000.1(h) to the California Department of Public Health (CDPH) on an annual basis for both shipped and stored LLRW. Alternatively, LLRW shipment information may be provided on a per shipment basis. LLRW shipment information and annual reports shall be mailed to: Attn: LLRW` Tracking Program California Department of Public Health Radiologic Health Branch MS 7610 P.O. Box 997414 Sacramento, CA 95899-7414 27. A copy of this license and a copy of all records and documents pertaining to this license shall be maintained available for inspection at 620 S. Magnolia Avenue, Bldg. G, Ontario, CA. Date: August 8, 2016 By: State ofgalifornia Department of Public Health INS 7610, P.O. Box 997414 Sacramento, CA 95899-7414 ;IAD TL-0113: CALTRANS ACCREDITATION LABORATORY INSPECTION REPORT STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION CALTRANS ACCREDITATION LABORATORY INSPECTION REPORT Expiration Date:2020-11-21 Inspected By: Ashley Shaw IA No.: 68 Phone: 949-279-8731 RSP #: 206 File: Material Category 500 Laboratory: Kleinfelder, Inc. Address: 20411 South Susana Road Unit E Long Beach CA, 90810 Lab QC Mgr.: Mike Dorsch E-mail: mdorsch@kleinfelder.com Telephone: 909-657-1716 Fax #.: 662-432-1796 A certified Independent Assurance (IA) visited this laboratory on 2019-11-21 Only the equipment to be used on Caltrans Construction projects and/or local construction projects on the National Highway System was checked for qualification. At the time of Caltrans Accreditation, this laboratory had all necessary equipment to perform the test methods indicated below. Testing personnel shall be Caltrans Qualified and possess a current Caltrans Certification Form TL-0111 or AASHTO Proficiency Form TL-0115 prior to performing any sampling or testing. CT 105 CT 106 CT 125 ADMIX CT 125 AGG CT 125 BIT CT 125 GEN CT 125 HMA CT 125 PCC CT 201 CT 202 CT 205 CT 206 CT 216 CT 217 CT 226 CT 227 CT 229 CT 231 CT 301 CT 304 CT 308 CT 309 CT 366 CT 370 CT 375 CT 382 CT 504 CT 518 CT 521 CT 523 CT 524 CT 533 CT 539 CT 540 CT 552 CT 556 CT 557 A visual check was performed and documents provided as necessary for the following items: ✓ Facility Safety Manual ✓ Laboratory Procedures Manual ✓ Laboratory Quality Control Manual ✓ Proper test equipment ✓_Copies of current applicable test procedures ✓_Calibration and service documentation ✓_Calibration stickers allied to test equipment (dated within the 12 months) On 2019-11-21 , this laboratory was Caltrans Qualified by: Q 1 Ashley R. Shaw Rr jf�' { L , J ' (Printed name of IA person) (Signature o AA person) Please verify lab accreditation by visiting SIAD website: https://sia.dot.ca.gov/ Page 1/1 AASH O A C C R E❑ t T E D CERTIFICATE OF TRi ACCREDITATION 7 Kleinfelder, Inc. in Long Beach, California, USA has demonstrated proficiency for the testing of construction materials and has conformed to the requirer AASHTO R 18 and the AASHTO Accreditation policies established by the AASHTO Committee on Meter The scope of accreditation can be viewed on the Directory of AASHTO Accredited Laboratories (aasl 66 Tymon, AASHTO Executive Director Moe Jamshidi AASHTO COP This certificate was generated on 10/03/2019 at 12:08 PM Eastern Time. Please confirm the current accreditation st aashtoresource.org/aap/accreditation-directory SCOPE OF AASHTID ACCREDITATION Kleinfelder, Inc. AASH ❑ in Long Beach, California, USA ACCREDITED Quality Management System Standard: Kid Establishing and Implementing a Quality System for Construction Materials Testing Laboratories 03666 (Aggregate) Minimum Requirements for Agencies Testing and Inspecting Road and Paving Materials D3666 (Asphalt Mixture) Minimum Requirements for Agencies Testing and Inspecting Road and Paving Materials Page 1 of 4 F This certificate was generated on 10/03/2019 at 12:08 PM Eastern Time. Please confirm the current accreditation st aashtoresource.org/aap/accreditafion-directory SCOPE OF AAS HTO ACCREDITATION Kleinfelder, Inc. AASHIO in Long Beach, California, USA ACC RE OITE0 Asphalt Mixture Standard: R47 Reducing Samples of Hot -Mix Asphalt to Testing Size R68 Preparation of Asphalt Mixtures by Means of the Marshall Apparatus T30 Mechanical Analysis of Extracted Aggregate T166 Bulk Specific Gravity of Compacted Hot Mix Asphalt Using Saturated Surface-DrySpecimens T168 Sampling Bituminous Paving Mixtures T209 Maximum Specific Gravity of Hot Mix Asphalt Paving Mixtures - T245 Resistance to Plastic Flow of Asphalt Mixtures Using Marshall Apparatus T269 Percent Air Voids in Compacted Dense and Open Bituminous Paving Mixtures T275 Bulk Specific Gravity of Compacted Bituminous Mixtures Using Paraffin -Coated Specimens T308 Determining the Asphalt Content of Hot Mix Asphalt (HMA) by the Ignition Method D979 Sampling Bituminous Paving Mixtures D1188 Bulk Specific Gravity of Compacted Bituminous Mixtures Using Paraffin -Coated Specimens D2041 Maximum Specific Gravity of Hot Mix Asphalt Paving Mixtures D2726 Bulk Specific Gravity of Compacted Hot Mix Asphalt Using Saturated Surface -Dry Specimens D2950 Density of Bituminous Concrete In Place by Nuclear Methods D3203 Percent Air Voids in Compacted Dense and Open Bituminous Paving Mixtures D5444 Mechanical Analysis of Extracted Aggregate D6307 Determining the Asphalt Content of Hot Mix -Asphalt (HMA) by the Ignition Method D6926 Preparation of Asphalt Mixtures by Means of the Marshall Apparatus D6927 Resistance to Plastic Flow of Asphalt Mixtures Using Marshall Apparatus Page 2 of 4 F9 This certificate was generated on 10/03/2019 at 12:08 PM Eastern Time. Please confirm the current accreditation si aashtoresou rce.org/aap/accreditation-directory SCOPE OF AASHTO ACCREDITATION Kleinfelder, Inc. AASH O in Long Beach, California, USA ACCREDITED Soil Standard: T99 The Moisture -Density Relations of Soils Using a 5.5 Ib [2.5 kg] Rammer and a 12 in. [305 mm] Drop T180 Moisture -Density Relations of Soils Using a 10 lb [4.54 kg] Rammer and an 18 in. [457 mm] Drop T265 Laboratory Determination of Moisture Content of Soils D698 The Moisture -Density Relations of Soils Using a 5.5 lb [2.5 kg] Rammer and a 12 in. (305 mm] Drop D1140 Amount of Material in Soils Finer than the No. 200 (75-pm) Sieve D1557 Moisture -Density Relations of Soils Using a 10 lb [4.54 kg] Rammer and an 18 in. [457 mm] Drop D2216 Laboratory Determination of Moisture Content of Soils D6938 In -Place Density and Moisture Content of Soil and Soil -Aggregate by Nuclear Methods (Shallow Depth) Page 3 of 4 F This certificate was generated on 10/03/2019 at 12:08 PM Eastern Time. Please confirm the current accreditation si aashtoresource.org/aap/accreditation-directory SCOPE OF AAS HTO ACCREDITATION F Kleinfelder, Inc. AA�O in Long Beach, California, USA ACCREDITED Aggregate Standard: R76 Reducing Samples of Aggregate to Testing Size T11 Materials Finer Than 75-pm (No. 200) Sieve in Mineral Aggregates by Washing T27 Sieve Analysis of Fine and Coarse Aggregates T85 Specific Gravity and Absorption of Coarse Aggregate T176 Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test T210 Aggregate Durability Index C117 Materials Finer Than 75-pm (No. 200) Sieve in Mineral Aggregates by Washing C127 Specific Gravity and Absorption of Coarse Aggregate C136 Sieve Analysis of Fine and Coarse Aggregates C702 Reducing Samples of Aggregate to Testing Size D75 Sampling Aggregate D2419 Plastic Fines in Graded Aggregates and Soils by Use of the Sand Equivalent Test D3744 Aggregate Durability Index Page 4 of 4 This certificate was generated on 10/03/2019 at 12:08 PM Eastern Time. Please confirm the current accreditation si aashtoresource.org/aap/accreditation-directory CERTIFICATE OF r ACCREDITATION E D Kleinfelder, Inc. In San Diego, California, USA AA5HT0 ed proficiency for the testing of construction materials and has conformed to the requirements established in ind the AASHTO Accreditation policies established by the AASHTO Committee on Materials and Pavements. f accreditation can be viewed on the Directory of AASHTO Accredited Laboratories (aashtoresource.org). ci ive Director Arc. zwnt,1. Moe Jamshidi, AASHTO COMP Chair generated on 05105/2020 at 5:30 PM Eastern Time. Please confirm the current accreditation status of this laboratory at aashtoresaurce.org/aap/accreditation-directory OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT h` FACILITIES DEVELOPMENT DIVISION APPLICATION FOR OSHPD PREAPPROVED AGENCY (OPAA) For Office use only FOR STRUCTURAL TESTS AND SPECIAL INSPECTIONS OPAA — 0042-16 Approved Agency City County State ZIP Code Kleinfelder, Inc. San Diego San Diego CA 92111 APPLICATION TYPE / FEE New Application Fee Renewal Fee Application Type (Fees are Nonrefundable) (Fees are Nonrefundable) M Combined Testing AND Special Inspection Agency ❑ $1,000.00 ® $500.00 ❑ $500.00 ❑ $250.00 ❑ Testing Agency ONLY ❑ Special Inspection Agency ONLY ❑ $500.00 ❑ $250.00 APPLICANT INFORMATION Position in the Organization Applicant Name James L. 58ady Project Manager 9 Application Date Agency's Local Name 12111/18 Kleinfelder, Inc. Phone Number E-Mail jstiady@kleirfeldeocom 858-223-8500 Applicant certifies that all information provided in this application are accurate. Applicant Signature �f Address of Facility Location (Each facility location requires separate application.) Street 5761 Copley Drive. Suite 100 County State: Zip Code: City: San Diego CA 92111 San Diego Facility Mailing Address (if different from facility address above.) Same as above Street State: Zip Code: GIIY: KEY AGENCY PERSONNEL (Attach additional pages if needed.) Engineering Manager (or equivalent) -Name CA Registration Number Expiration Date 06130/2020 James L. Shady C66243 - GE2820 Phone Number Title in the Organization 58500 Project Manager II E-Mail FAX Number jstiady@kleinfelder.com 858-223-8499 Alternate to Engineering Manager (if any) - Name CA Registration Number Expiration Date C59908 12/31/2019 Chad Davis Title In the Organization Phone Number CoMET Team Leader 858-223-8500 Alternate Phone Number E-mail cmdavis@kleinfelder.com mac- a nr� -Access to Safe, Quality Healthcare Environments that Meet California's Diverse and Dynamic Needs STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (0310l/2018) 516/2019 OPAA-0042-16 Page 1 of 19 �IN�� OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT 'III�"fir'11' FACILITIES DEVELOPMENT DIVISION KEY TESTING PERSONNEL (Attach additional pages if needed.) Testing Supervisor —Name Lee Bainer CA Registration Number (i/any) Fxpination Date N/A N/A Title in the Organization Laboratory Manager Phone Number 8-8500 Alternate Phone Number E-Mail-Mail lbainer@klejnfelder.com Field Testing Supervisor— Name Nikki Mangold CA Registration Number (if any) Expiration Date N/a N/A Title in the Organization Materials Operations Supervisor Phone hone Num Number Num 85 8500 Alternate Phone Number E-mail nmangold@kleinfelder.com KEY SPECIAL INSPECTIONS PERSONNEL (Attach additional pages if needed.) Special Inspections Supervisor — Name Robert Turchick CA Registration Number (if any) Expiration Date N/A 10/06/2021 Title In the Organization Senior Special Inspector Phone Number 858-736-6423 Alternate Phone Number E-mail rturchick@kleinfelder.com Field Special Inspection Supervisor— Name Robert Turchick CA Registration Number (if any) Expiration Date Title I the Organization N/A 10/06/2021 Seniorr Special Inspector Phone Number 58-736-6423 Alternate Phone Number E-mail nurchick@kleinfelder.com Access to Safe, Qeality Healthcare Environments that Meet Calilomla's Diverse and Dvnamic Needs" OSH PD STATE OF CALIFORNIA— HEALTH AND HUMAN SERVICES AGENCY OS H-FD-OPAA-100 103/01 /2018 5/6/2019 OPAA-0042-16 Page 2 of 19 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION ACCREDITATION AND QUALIFICATIONS Agency currently holds accreditation by: (Attach a copy of current accreditation details.) ❑ National Voluntary Laboratory Accreditation Program (NVLAP) ❑ American Association of Laboratories Program (A2LA) ❑ Construction Materials Engineering Council (CMEC) ❑ Other N AASHTO Accreditation Program (AAP) ❑ International Accreditation Service (IAS) ❑ Laboratory Accreditation Program (LAB) ❑ ANSI-ASQ National Accreditation Board Latest Expiration Date (if any) 09/2512022 Is this Agency accepted in the Division of the State Architect Laboratory Evaluation and Acceptance Program, DSA-LEA? ❑ No N Yes Expiration Date: 09/25/2022 Basis for accreditation (Check all that apply): ❑ ISO/IEC 17025: General requirements for competence of testing and calibration laboratories ❑ ISO/IEC 17020: General requirements for the operation of various types of bodies performing inspection ❑ NISTIR 7012: Technical requirements for construction materials testing N AASHTO R18: Standard Recommended Practice for Establishing and Implementing a Quality System for Construction Materials Testing Laboratories N ASTM E 329: Specification for Agencies Engaged in the Testing and/or Inspection of Materials Used in Construction N ASTM C 1077: Practice for Laboratories Testing Concrete and Concrete Aggregates for Use in Construction and Criteria for Laboratory Evaluation N ASTM D 3666: Specification for Minimum Requirements for Agencies Testing and Inspecting Bituminous Paving Materials N ASTM D 3740: Practice for Evaluation of Agencies Engaged in Testing and/or Inspections of Soils and Rock as Used Engineering Design and Construction N ASTM C 1093: Practice for Accreditation of Testing Agencies for Unit Masonry ❑ ASTM E 1212: Practice for Quality Management Systems for Nondestructive Testing (NDT) Agencies ❑ ASTM E 543: Specification for Agencies Performing Nondestructive Testing (NDT) ❑ AS AC 291: Accreditation Criteria for Special Inspection Agency Basis for Test Technician/Special Inspector Qualification (Check all that apply): ❑ Hospital inspector class "A", "B", or "C" certification N DSA-LEA approval as test Technician/special inspector ❑ Certification listed in IAS AC 291 Table 1: Minimum Qualifications for Special Inspectors ❑ Welding inspectors satisfying the requirements of the CBC 2016 Section 1705A.2.5 ❑ California licensed engineer qualified to be test technician/special inspector OSH PD "Access to Safe. Duality Healthcare EWroaments that Meet Galifarela's Divam and Dvnamic Needs" STATE OF CALIFORNIA— HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/01/2018) Page 3 of 19 5/6/2019 OPAA-0042-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION APPLICABLE TEST STANDARDS FOR WHICH AGENCY IS APPROVED By checking 'Yes" in Tables f through 6 below, the applicant verifies that the agency has the equipment and qualified personnel to perform the indicated testing. ONLY mark tests that are fisted in accreditation certificate or DSA-LEA. SOILS AND FOUNDATIONS Tests Yes Standard Test Procedure Yes Standard Test Procedure ❑ a. ASTM D 421 Dry Prep of Soil N b. ASTM D 422 Particle Size Analysts ® c. ASTM D 558 Moisture Density of Soil Cement ® d. Mixtures ASTM D 698 Compaction of Soil -Standard ® e. ASTM D 854 Specific Gravity of Soil ® f. ASTM D 1140 No. 200 Wash ❑ g. ASTM D 1143 Deep Foundations —Axial Compression ❑ h. ASTM D 1556 Density of Soils —Sand Cone ® i. ASTM D 1557 Soil Compaction — Modified ❑ j. ASTM D 1883 CBR Lab. Compacted Soils ® k. ASTM D 2166 Unconfined Compressive Strength/Moisture content I. ASTM D 2216 ater Content of Soil ® m. ASTM D 2419 Sand Equivalent Value ❑ n. ASTM D 2434 Permeability of Granular Soils ® o. ASTM D 2435 Consolidation Test ❑ ASTM D 2487 Classification of Soils ❑ q. ASTM D 2488 Identification of Soil Usual ® r. ASTM D 2844 Resistance R-Value & Exp. Pressure ❑ s. ASTM D 2850 Unconsolidated, Undrained Triaxial ❑ t. J ASTM D 2974 Organic Content N U. ASTM D 3080 Direct Shear ❑ v. ASTM D 3441 one Penetration Test CPT ❑ w. ASTM D 3689 Dee Foundations —Axial Tension ❑ x. ASTM D 3744 Durabilit Index ❑ y. ASTM D 3966 Dee Foundations —Lateral Loads N z. ASTM D 4316 Liquid I Plastic Limit ❑ aa. ASTM D 4546 Swell or Collapse Test ❑ bb. ASTM D 4643 Microwave Moisture of Soils ❑ cc. ASTM D 4718 Oversize Rock Correction ❑ dd. ASTM D 4767 riaxial Compression N el ASTM D 4829 Expansion Index ❑ ff. ASTM D 4945 Deep Foundations — Dynamic Testing ❑ gg. ASTM D 5084 Permeability of Soils ❑ hh. ASTM D 5778 Friction Cone and Piezocone Penetration Test N ii. ASTM D 6913 Gradation of Soil Using Sieve Analysis ® ASTM D 6938 Density of Soils— Nuclear Gage ❑ kk. ASTM D 7012 Triaxial Compressive Strength of Rock ❑ Core Specimens IL ❑ min. ❑ nn. Tests that are in the lab's scope but are not listed above should be provided in the spaces) below. Yes Standard Test Procedure Yes Standard Test Procedure ❑ a' ❑ b. ❑ c' ❑ d. El ❑ f. "Access to Safe. Quality Healthcare Environments that Meal California's Diverse and Dynamic Needs' OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/0V2018) 5/6/2019 OPAA-0042-16 Page 4 of 19 11, OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION 2 CONCRETE Tests Yes Procedure Yes Standard Test Procedure a. M 201 Moisture Rooms ❑ b. ACI 355.2 Post -Installed Mechanical Anchors ❑ ❑ c.5.4 dhesive Anchors ❑ d. ACI 374.1 Moment Frames ❑ e.-5.1 Post -Tensioned Precast Special ❑ f. ASTM A 416 Steel Strand Walls ❑ g. 615 MeTest Tension Test ® h. ASTM A 706 Tension and Bend ❑ L 970 Headed Steel Bars - Bend ❑ j. ASTM A 1034 Rebar Mechanical Splices❑ k. 29 Unit Weight I Voids ® I. ASTM C 31 Concrete Sampling - Field BC Evaluating Potential for Deleterious❑ m .5(1); Expansion Due to Alkali Reactivity of M n. ASTM C 39 Compressive Strength ASTM C33 an Aggregate. Appendix X1.3 ❑ o. ASTM C 40 Organic Impurities ❑ P. ASTM C 42 Concrete Core ® q. ASTM C 78 Flexural Strength ® r. ASTM C 88 Sodium Sulfate Soundness FA s. ASTM C 117 No. 200 Wash ® t. ASTM C 127 Specific Gravity - Coarse ® u. ASTM C 128 Specific Gravity - Fine ❑ v. ASTM C 131 Degradation of Aggregate ® w. ASTM C 136 Sieve Analysis Course I Fine ® X. ASTM C 138 Density I Yield I Air Content ❑ Y. ASTM C 142 Clay I Friable ParticlesM Z. ASTM C 143 Slump ❑ ASTM C 157 Length Change ® bb. ASTM C 172 Sampling Freshly Mixed Concrete aa. ❑ Measuring Thickness Using Drilled ❑ cc. ASTM C 173 it Content (V) dd. ASTM C 174 Concrete Cores ® as. ASTM C 192 Making I Curing Specimens - Lab ® ff. ASTM C 231 kir Content (P) ❑ gg. ASTM C 295 Petrographic Analysis ❑ hh. ASTM C 495 Lightweight Concrete ❑ ii. ASTM C 496 Splitting Tensile M jj. ASTM C 511 Moist Cure RoomslTanks ❑ kk. ASTM C 535 LA Abrasion ® it. ASTM C 566 Moisture Content of Ag regale ❑ mm. ASTM C 567 Density of Lightweight Aggregate ® nn. ASTM C 617 Capping Concrete Specimens ❑ oo. ASTM C 702 Reducing Aggregate Samples ® pp. ASTM C 1064 emperature ❑ qq. ASTM C 1140 Shotcrete Compression ® rr. ASTM C 1231 Unbonded Caps ® ss. ASTM C 1252 Uncompacted Void Content ❑ tt. ASTM C 1260 Ikali Reactivity of Aggregate Length Change due to Alkali -Silica ❑ vv. ASTM C 1542 Measuring Length of Cores ❑ uu. ASTM C 1293 Reaction ❑ ww. ASTM C 1602 Water ❑ xx. ASTM C 1604 Shotcrete Core Elyy. ASTM D 75 Sampling Aggregate ® u• ASTM D 1560 Stabilometer Value ® aaa. ASTM D 1561 Prep for HMA Test Specimens ® bbb. ASTM D 2041 Maximum Theo. Specific Gravity ® ccc. ASTM D 2419 Sand Equivalent Value ® coal. ASTM D 2726 Specific Gravity of Marshall Sample ❑ eee. ASTM D 2950 In -Situ Density with Nuc. Gauge ❑ fff. ASTM D 3039 Tensile SVength of FRP OSHPD "Access to Safe. Ouafty Healthcare Environments that Meet Califcmla's Diverse and Dvnamic Needs STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/0112018) Page 5 of 19 5/6/2019 OPAA-0042-16 iOFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT 11A il,Xl FACILITIES DEVELOPMENT DIVISION L I CONCRETE (Continued) Tests Yes Standard M ggg. ASTM D 3744 ❑ iii. ASTM D 4541 ® kkk. ASTM D 4791 ® Immm.1 ASTM D 5821 ® cao. ASTM D 6926 ❑ Q44• ASTM D 7522 ❑ sss. ASTM E 1190 ❑ uuu. ICC-ES AC 193 ❑ www. ICC-ES AC 308 ❑Iyyyl ICC-ES AC 398 Test Procedure regale Durability Index of Strength of FRP Elongated Pieces in Ac test If Strength for FRP Lan is Bonded to Concrete atel Actuated Fasteners Anchors in Concrete ned Steel Connectors for Light -Frame Yes Standard ® hhh. ASTM D 3203 ® jjj. ASTM D 5444 ® III. ASTM D 6307 ® nnn. ASTM D 6927 ❑ PPP• I ASTM D7565 ❑ rrr. ASTM E 488 ❑ Kt. ASTM E 1512 ❑ vvv. ICC-ES AC 232 ❑ xxx. ICC-ES AC 395 °I�I ICC-ES AC 399 ❑ aaaa. ICC-ES AC 446 Headed Cast -In Specialty Inserts in ❑ Concrete Tests that are in the lab's scope but are not listed above should be provided in the Yes Standard Test Procedure Yes ® Sieve Analysis of Mineral Filler for a. STM D 546 Asphalt Paving Mixture C. STM D4867 e. STM D6931 of Moisture of Asphalt ate Paving Mixtures :t Tensile (IDT) Strength of It Mixtures Access to S.M. Duality Healthcare Environments that Meet C-Ihamia's Diverse.nd Dynamic Neetla" lace(s) below. Standard b. ASTM D1188 d. STM D6925 f Test Procedure Air Voids nalysis of Extracted Aggregate Content by Ignition I Stability & Flow, Air Voids ping Tensile Properties of FRP omposites Used for ening of Civil Structures trength of Anchors Channels in Concrete Shear Stud Reinforcement Place Bolts in Concrete for ame Construction Test Procedure Specific Gravity and Density of aacted Bituminous Mixture Using ad Samples aration and Determination of the ive Density of Asphalt Mix imens by Means of the Superpave ory Compactor OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/01/2018) 5/6/2019 OPAA-0042-16 Page 6 of 19 /! OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT ti �� FACILITIES DEVELOPMENT DIVISION 3 MASONRY Yes Tests Standard/Code Procedure Yes StandardlCode Reference Test Procedure Absorption, Compressive Strength, ®I� a. ASTre Compressive Strength b. ASTM C 140 Unit Weight,Dimensions & Moisture Cont ❑ c. ASTMear Drying Shrinkage ® d. ASTM C 780 Mortar Compressive Strength ® ATestTest mpling and Testing Grout f, ASTM C 1314 Compressive Strength ofMasonry e. ASTMompressive Strength) Prism pping CMU, Related Units & ASTMsonry Prisms for Compression h. ASTM E 384 Micro -indentation Hardness g. stingCBCortar Sampling ❑ j. CBC 2105A Core Shear ❑ k. ICC-ES AC 01 Anchor in Masonry El I. ICC-ES AC 58 Adhesive Anchors ❑ m. ICC-ES AC 106 Screw Anchors in Masonry ❑ n' ❑ o• ❑ P. ❑ Q• ❑ r. ❑ S. ❑ t. Tests that are in the lab's scope but are not listed above should be provided in the space(s) below. Yes Standard/Code Reference Test Procedure Yes StandardlCode Reference Procedure El a. ❑ b. FTest Elc ❑ d. Ele ❑ f. OSHPD "Access to Safe. Qaej,ty Healthcare Environments that Meet Oallfomie's Memo and Ovnamic Need, STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/01/2018) Page 7 of 19 5/6/2019 OPAA-0042-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT �110:4-1n, FACILITIES DEVELOPMENT DIVISION 4 STEEL Tests Yes Standard/Code Reference Test Procedure Yes Standard/Code Reference Test Procedure ❑ a. AISC 341 Section K2 Beam to Column Moment & EBF Connections Cyclic Tests El b. AISC 341 Section K3 BRBF Cyclic Tests M A 90 Weight of Coating E d. ASTM A 370 Tension & Bend Test RE] !ASTMA 970 A 1064 Headed Steel Bars Bend Test Steel Wire Tension & Bend Test ❑ ❑ f. h. ASTM A 1061 ASTM E 10 Uncoated Seven -Wire Tension Brinell Hardness M E 18 Rockwell Hardness❑ j. ASTM E 23 Charpy V -Notch M E 94 Radiographic ❑ I. ASTM E 164 Ultrasonic E Elq. .ASTM o. E 165 ASTM E 290 ASTM E 1444 Liquid Penetrant Bend Test Magnet c Particle ❑ ® ® n. p. r. ASTM E 190 ASTM E 005 ASTM F 006 Guided Bend Density of SFRM Bolt Tension Test ❑ ❑ S. U. CBC 2203A ICC-ES AC 322 Material Identification Cold -formed Steel Vertical ssemblies ❑ ❑ t. v. ICC-ES AC 318 Tapping Screw Fasteners Tests that are in the lab's scope but are not listed above should be provided in the space(s) below. Yes E Standard/Code Reference a. ASTM E 736 Test Procedure Cohesion/Adhesion of Sprayed Fire -Resistive Materials Applied to Structural Members Yes ❑ Standard/Code Reference b. Test Procedure ❑ C. ❑ d. ❑ e. ❑ f. 5 Wood and Roof Assemblies Tests Yes Standard Test Procedure Yes Standard Test Procedure ❑ a. ASTM C 67 Brick and Structural Clay Roof Tiles ❑ b. ASTM D 1761 Fasteners in Wood ❑ C. ASTM D 2395 Density/Sp. Gr. Of Wood ❑ d. ASTM D 3617 Analysis of Built -Up Roof Systems ❑ e. ASTM D 4442 Moisture Content of Wood ❑ f. ASTM D 7147 Joist Hangers ❑ ❑ g. i. ASTM E 72 ICC-ES AC 130 Panel Testing Wood Shear Panels ❑ ❑ h. j. ASTM E 2126 ICC-ES AC 155 Cyclic Testing of Panel for Shear Hold -Down for Woods ❑ k. ICC-ES AC 233 Alternate Dowel-TypFastenersers Threaded Fasteners El I. ICC-ES AC 283 Plate Connector for Wood Trusses ❑ M. ❑ n. Tests that are in the lab's scope but are not listed above should be provided in the space(s) below. El a. 1:1 1 b. 1 ::::771 • �-_��.. � �=o.., �.a�e ���.n ueeierns mai meal canromia s urverse antl pvnamic Neetls" vIj iiry STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/0112018) 5/6/2019 OPAA-0042-16 Page 8 of 19 jo,e® OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT ii,Y FACILITIES DEVELOPMENT DIVISION ❑ d. ❑ c ❑ f. ❑ e 6 COMPONENT, ASSEMBLY, PROTOTYPE & MISCELLANEOUS TESTING Tests Yes Standard/Code Reference Test Procedure Yes Standard/Code Reference Test Procedure Static Test for Curtain Wall and b. AAMA 501.6 Dynamic Test for Curtain Wall ❑ a. AAMA 501.4 Storefront Systems and Storefront Systems ❑ c. ICC-ES AC 156 Shake Table Test rEl d. FM 1950 Seismic Sway Brace Testing Ele f. Elg. h. El Tests that are in the lab's sco a but are not listed above should be rovided in the s ace s below. ❑ a ❑ b. ❑ c ❑ d. ❑ e ❑ f. OSH PD 'Access to Safe. Quality Healthcare Environments that Meet California's Diverse and Dynamic Needs" STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03101/2018) Page 9 of 19 5/6/2019 OPAA-0042-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT st, FACILITIES DEVELOPMENT DIVISION 7 TEST TECHNICIANS Provide Following Information for Each Test Technician Employed by the Agency (Attach additional sheets if needed) *To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required Test Technician's Certification/ Certification/ Certification/ Name License Type Licensing Agency License Number Expiration Date* Comments Robert Frazer Concrete Field Testing Tech — Grade I ACI 1370226 06/18/2021 FT Carl De La Torre Concrete Field Testing Tech — Grade I ACI 1395396 04/29/2022 FT Felipe Cisneros Concrete Field Testing Tech — Grade I ACI 24939 03/14/2020 FT Nuclear Gauge CPN International, Inc. 39339 N/A FT Geoff Swink Concrete Field Testing Tech —Grade I ACI 103546 09/29/2023 FT Nuclear Gauge Boart Longyear Co. 28883 N/A FT Jesse Gastelum Concrete Field Testing Tech —Grade ACI 986950 09/29/2023 FT Jonathan Taylor Concrete Field Testing Tech — Grade I ACI 1302268 09l20/2019 FT Neil Care y Concrete Field Testing ACI 57544 Tech — Grade I 09/29/2023 FT Robert Turchick Concrete Field Testing ACI 25680 Tech — Grade I 02/10/2023 FT James Reeves Concrete Field Testing Tech — Grade ACI 1 370228 08/13/2021 FT Randall Lewis Concrete Field Testing Tech — Grade I ACI 00088722 12/1212020 FT Test Technicians with expired license shall not be permitted to perform Tests. Access to Safe, Q.alliv Healthcare Environments that Meet CalifhMia's Diverse and Dynamic Na.&s OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03,'01/2018) 5/6,2019 OPAA-0042-16 Page 10 of 19 =i OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT rht�TV ' FACILITIES DEVELOPMENT DIVISION 7 TEST TECHNICIANS (Continued) Provide Following Information for Each Test Technician Employed by the Agency (Attach additional sheets if needed *To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required Test Technician's Certification/ Certification/ Certification/ Expiration Date* Comments Name License Type Licensing Agency License Number Test Technicians with expired license shall not be permitted to perfonn Tests. OSNPD -Access to Safe, Quality Healthcare Environments that Meet California's Diverse and Dynamic Needs STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY 1 1 " OSH-FD-OPAA-100 (03/01 /2018) Page 11 of 19 5l6/2019 OPAA-0042-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION APPLICABLESPECIAL INSPECTIONS FOR WHICH AGENCY IS APPROVED By checking `yerough 13 below, the applicant verifies that the agency has the equipment and qualified personnel to pered special inspections. ONLY mark tests that are listed in accreditation certificate or DSA-LEA. 8 SOILS AND FOUNDATIONS Yes Special Inspections (Qualified Representative of Responsible Geotechnical Engineer) Code/Standard Field and Types of Inspection Yes Code/Standard Field and Types of Inspection ® a. CBC 1705/1705A Cast -in -place Deep Foundations ® b. CBC 1705/1705A Driven Deep Foundations ® c. CBC 1705/1705A Soils Excavations and Fills m d. CBC 1812A Shorin ® e. CBC 1813A Ground Improvement ❑ f, ❑ g' ❑ h. Special Inspections that are in the agency's scope but are not listed above should be provided in the space(s) below. Yes Code/Standard Field and Types of Inspection Yes CodelStandard Field and Types of Inspection ❑ a' ❑ b. ❑ c' ❑ d. ❑ a' ❑ f. g CONCRETE Special Inspections Yes code/Standard Field and Types of Inspection YesF1705/1705A Code/Standard Field and Types of Inspection ® a. CBC 1705/1705A Post -Installed Anchors M1705A Shotcrete ® c CBC 1705/1705A & 318 Pre -Stressed Concrete ® 705A &ACI Reinforced Cast -In -Place Concrete 8 e CBC 1705/1705A & ACI 318 Reinforced Pre -Cast Concrete 705A Batch Plant C94 ® g CBC 1705/1705A & AWS D1.4 Rebar Welding ❑ h CBC 1911A & ICC- Fiber Reinforced Polymer (FRP) ES AC 178 Composites ❑ i. ❑ 1 Special Inspections that are in the agency's scope but are not listed above should be provided in the space(s) below. Yes CodelStandard Field and Types of Inspection Yes Code/Standard Field and Types of inspection El a. El Elb. Elc' El Ele' ❑ I f. ji 'Access to Safe, Quality Healthcare Environments that Meat Colifomla's Diverse wd Dynamic Neetls' OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03MV2018) 5/6/2019 OPAA-0042-16 Page 12 of 19 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT 04 FACILITIES DEVELOPMENT DIVISION 10 MASONRY Special Inspections Yes CodetStandard Field and Types of Inspection Yes CodetStandard Field and Types of Inspection ® CBC 1705/1705A & ® b CBC 1705/1705A & TMS Masonry Placement a. AWS D1.4 Rebar Welding 602 ❑ d. C. Rs�pecial ❑ f. ions that are in the agency's scope but are not listed above should be provided in the space(s) below. Yes Code/Standard Field and Types of Inspection Yes code/Standard Field and Types of Inspection Ela ❑ b. ❑ C ❑ d. ❑ e ❑ f. 11 STEEL Special Inspections Yes CodelStandard Field and Types of Inspection Yes Code/Standard Field and Types of Inspection © a. CBC 1705/1705A Fireproofing b. CBC 170511705A Structural Cold -Formed Steel ® C. CBC 1705/1705A, High Strength Bolts rE1 d• CBC 1705/1705A, AISC 360 & 341 Steel Fabrication & Erection AISC & 341 CBC 1705/1705A, ® e. AWS QC1, AISC 360 Welding f• & 341 ❑ 9• ❑ h. Special Inspections that are in the agency's scope but are not listed above should be provided in the space(s) below. Yes Code/Standard Field and Types of Inspection Yes Code/Standard Field and Types of Inspection ❑ a ❑ b. ❑ c ❑ d. ❑ e ❑ f. OSHPD 'Access to Safe. Quality Heallhcare Environments [hat Meet Galifornla's Diverse and Dvnamic Needs' STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/01/2018) Page 13 of 19 5/6/2019 OPAA-0042-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT /' ui FACILITIES DEVELOPMENT DIVISION =�14K� 12 Wood and Roof Assemblies Special Inspections Yes ❑ Code/Standard a. CBC 170511705A Field and Types of Inspection Wood Construction Yes ❑ Code/Standard b, Field and Types of Inspection ❑ C. ❑ d. ❑ e. ❑ f. ❑ g' ❑ h. Special Inspections that are in the agency's scope but are not listed above should be rovided in the s ace(s) below. ❑ a. ❑ b. ❑ C. ❑ I d. ❑ e. ❑ f. 13 NONSTRUCTURAL COMPONENTS AND MISCELLANEOUS SPECIAL INSPECTIONS Special Inspections Yes Code/Standard Field and Types of YesE2003 Code/StandardField and Types of Inspection ❑ a. CBC 1705/1705A Damping System ❑Nonstructural Components, ❑ c. CBC 1705/1705A Seismic Isolation System ❑Aluminum/Aluminum SEports and Attachments Welding ❑ e. CBC 2410 Strructural Silicone Glazing ❑ S ecial Ins ections that are in the a enc 's sco a but are not listed above should be rovided in the s aces below. ❑ a. ❑ b. ❑ c' ❑ d. ❑ e. ❑ f. "access to Safe, Duality Healthcare Errviroomenta that Meet Calif.mwa Diverse and Dvnamic Needs" STATE OF CALIFORNIA—HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (0310112018) 5/6/2019 OPAA-0042-16 OSHPD Page 14 of 19 />9 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION 14 SPECIAL INSPECTORS Provide Following Information for Each Special Inspector Employed by the Agency (Attach additional sheets if needed for OPAA and of renewal for certification/license shall be required *To update expiration date a renewal application proof Certification/ Certification/ Certification/ Expiration Date* Comments Inspector's Name License Type Licensing Agency License Number Spray Applied ICC 1138578 10/06/2021 FT Fireproofing Structural Steel & ICC 1138578 10/06/2021 FT Welding Structural Steel and ICC 1138578 10/06/2021 FT bolting Prestressed Concrete ICC 1138578 10/06/2021 FT Reinforced Concrete ICC 1138578 10/06/2021 FT Robert Turchick Structural Masonry ICC 1138578 10/06/2021 FT Certified Welding AWS 13011121 01/31/2022 FT Inspector Shotcrete DSA 5675 12/31/2019 FT Class 2 DSA 3729 03/17/2021 FT Masonry DSA 5399 02/23/2021 FT Soils ICC 8164532 10/0812020 FT Spray Applied ICC 8164532 06/16/2021 FT Fireproofing Torre Reinforced Concrete ICC 8164532 08/20/2021 FT Carl De La Prestressed Concrete ICC 8164532 10113/2021 FT Structural Masonry ICC 8164532 1012812021 FT Structural Steel and ICC 8164532 11/17/2021 FT bolting Spray Applied ICC 5119934 03/1212021 FT Fireproofing Structural Welding ICC 5119934 02/09/2020 FT Chris Shipp Structural Steel and ICC 5119934 0210912020 FT bolting Certified Welding AWS 02040121 04/30/2020 FT Inspector special inspectors with expired license shall not be permitted to perform Special Ins ections. U�i VU Access to Safe, Quality Healthcare Environments that Meet Callfemia's Diverse and Dvnamic Needs" STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/01/2018) Page 15 of 19 5/6/2019 OPAA-0042-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT 1r�\ FACILITIES DEVELOPMENT DIVISION 14 SPECIAL INSPECTORS (Continued) Provide Following Information for Each Special Inspector Employed by the Agency (Attach additional sheets if needed 'To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required Inspector's Name Certification/ Certification/ Certification/ License Type Licensing Agency License Number Expiration Date Comments Reinforced Concrete ICC 8715595 08/29/2020 FT James Reeves Structural Masonry ICC 8715595 03/22/2021 FT Spray Applied Fireproofing ICC 8375377 01/28/2023 FT Jonathan Taylor Soils ICC 8375377 01/282023 FT Soils ICC 8017636 07/22/2020 FT Spray Applied Fireproofing ICC 8017636 07/22/2020 FT Reinforced Concrete ICC 8017636 07/22/2020 FT Felipe Cisneros Prestressed Concrete ICC 8017636 07122/2020 FT Structural Masonry ICC 8017636 07/2212020 FT Structural Steel and bolting ICC 8017636 12/26/2020 FT Robert Frazer Soils ICC 8418831 04/24/2022 FT Neil Carey Soil ICC 8803597 08/11/2020 FT William Woltman Soil ICC 8897104 07/27/2021 FT Certified Welding Inspector AWS O4090271 09/01/2020 FT Adhesive Anchor Inspector/Installer ACI 00088722 01/23/2021 FT Spray Applied Fireproofing ICC 5098547 04/18/2020 FT Randall Lewis Structural Welding ICC 5098547 04/18/2020 FT Structural Steel and bolting ICC 5098547 04/1812020 FT Prestressed Concrete ICC 5098547 04/18/2020 FT Reinforced Concrete ICC 5098547 04/18/2020 FT Special Inspectors with expired license shall not be permitted to perform Special Inspections. 'Access to Safe, Quality Healthcare Environments that Meet Callfomia's Diverse and Dvnamlc Needs' OSHPD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/Ot/2018) 5/6/2019 OPAA-0042-16 Page 16 of 19 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT 4T u FACILITIES DEVELOPMENT DIVISION I�VI r 14 SPECIAL INSPECTORS (Continued) Provide Following Information for Each Special Inspector Employed by the Agency (Attach additional sheets if needed *To update expiration date a renewal application for OPAA and proof of renewal for certification/license shall be required Structural Masonry ICC 5098547 04/18/2020 FT Randall Lewis Master of Special ICC 5098547 04/1812020 FT Inspection Special Inspectors with expired license shall not be permitted to perform Special Inspections. OSH PD "Access to Safe. t]uality Healthcare Environments that Meal California's Diverse and Dvnamic Needs" STATE OF CALIFORNIA— HEALTH AND HUMAN SERVICES AGENCY I 1 " OSH-FD-OPAA-100 (0310 V2018) Page 17 of 19 502019 OPAA-0042-16 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT FACILITIES DEVELOPMENT DIVISION 15 SUMMARY OF AGENCY'S TESTING AND SPECIAL INSPECTION SERVICES Structural Tests & Special Inspections (Check all that apply) Yes Structural Tests Yes Structural Special Inspections N Soil N Earthwork ® Aggregate N Batch Plant N Reinforcing Steel N Reinforced Concrete N Concrete N Pre -Stressed Concrete N Post -Installed Anchors N Post -Installed Anchors ❑ Concrete Specialty Inserts N Pre -Cast Concrete N Shotcrete N Shotcrete N Masonry N Masonry N Steel N Steel Welding N High -Strength Bolts and other Fasteners N High -Strength Bolts and other Fasteners N Non -Destructive Testing (NDT) N Spray Applied Fireproofing ❑ Wood ❑ Wood ❑Aluminum/Aluminum Welding ❑Aluminum/Aluminum Welding ❑ Fiber Reinforced Polymer (FRP) Composites N Fiber Reinforced Polymer (FRP) Composites ❑ Deep Foundations N Deep Foundations N Nonstructural Components, Supports and Attachments M Nonstructural Components, Supports and Attachments N Structural Elements and Connections ❑ Base Isolators ❑ Shake Table Tests ❑ Dampers Tests and Special Inspections that are in the Agency's scope but are not listed above should be provided in the s aces below. ❑ ❑ ❑ ❑ ❑ ❑ 'Access to Safe, Quality Healthcare Environments that Most Callfomla's Diverse and Dvnamic Needs' OSH PD STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03/01/2018) 5/6/2019 OPAA-0042-16 Page 18 of 19 �� OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT T��� FACILITIES DEVELOPMENT DIVISION �4�"r List of Attachments Supporting the Agency's Approval (Check all that apply) Yes Enclosure Type ® OSHPD Facilities Development Division (FDD) Payment Form (OSH-AD-367): http://oshi)d.ca.gov/FDD/Forms/eSPForms/OSH-FD 367-FacDvmtDivPmtForm. df ® DSA-LEA Laboratory Qualification as posted at DSA website: https://www.apps2.dgs.ca.gov/DSA/Tracker/ApprovedLabs.aspx ® Latest Copy of DSA 100: LEA Program Application as Submitted to DSA ® Latest copy of DSA 220: LEA Program On -Site Assessment Report Latest copy of DSA acceptance letter of the Agency into the LEA program. ® Current Accreditation Certificates including List of Tests and Special Inspections for which the Agency is Accredited ® Copy of Test Technician/Individual Special Inspector's License/Certification showing expiration date(s) ® OPL Number for Conversion of OPL to OPAA only: OPL-0042-15 OPAA Number for Conversion/Renewal of OPAA only: Other Please Specify): Other Please Specify): Other Please Specify): Other Please Specify): OSHPD Approval (For Office Use Only) Signature: y Approval Date: 5/6/2019 Print Name: Jeffrey Kikumoto Approval Expiration Date: 9/25/2022 Title: SE Condition of approval (if applicable): 'Access to Safe. Quality Healthcare Environments that Meet Gelfornia's Diverse and Dvnamic Needs" Abu O S i" f P D STATE OF CALIFORNIA — HEALTH AND HUMAN SERVICES AGENCY OSH-FD-OPAA-100 (03101 /2018) 5/6/2019 OPAA-0042-16 Page 19 of 19 iifications elder Copley Drive, Suite 100 U DSA City:San Diego Phone:(858J223-8500 IQD18 Expiration — Date 109l23/2022 S Shady NDT Level III Administrato , Clete Henke Y@kleintekkrcom 3ainer -- Fiat supervisorts�RobettTurcMck rural Test Qualifications Is v Concrete -' Structural Steel tregates ✓ Shotcrele ✓ High Strength Bolts nforcing Steel ✓ Structural Masonry d Non Destructive (NDT) ;t Installed Anchors V Other ArC. SFRM at Inspection Qualifications thwork Shotcrete y High Strength Bolting nforced Concrete ;e Structural Masonry J Spray -Applied Fireproofing stressed Concrete 4 Structural Welding ✓ Batch Plant (Continuous) ;I Installed Anchors Other DGS Links • DGS Home • DSA 1, l • DSA News Tracker Links Materials Testing Lab's for Meinfelder !\ i Kteinrelder Lee Bainer @ainer@ldeinfelder. Cotn 858-223-8500 858-277-1035 5761 Copley Drive, Suite 100, San Diego, CA 92111 92111 Private 11 ;opley Dnve Suite 100, San Diego; CA 92111 SIAD TL-0113: CALTRANS ACCREDITATION LABORATORY INSPECTION REPORT STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION CALTRANS ACCREDITATION LABORATORY INSPECTION REPORT Expiration Date:2021-04-01 Inspected By: Majid Fahrtosh IA No.:112 Phone:562-345-3147 RSP #:1733 File: Material Category 500 Laboratory: TransMat, Inc. Address: 8966 Benson Ave. Unit B Montclair CA, 91763 Lab QC Mgr.: Kreetha Mekchai E-mail: transmatinc@gmail.com Telephone: 626-532-7705 Fax #.: A certified Independent Assurance (IA) visited this laboratory on 2020-04-01 Only the equipment to be used on Caltrans Construction projects and/or local construction projects on the National Highway System was checked for qualification. At the time of Caltrans Accreditation, this laboratory had all necessary equipment to perform the test methods indicated below. Testing personnel shall be Caltrans Qualified and possess a current Caltrans Certification Form TL-0111 or AASHTO Proficiency Form TL-0115 prior to performing any sampling or testing. AASHTO T11 AASHTO T27 AASHTO R47 AASHTO R76 AASHTO T84 AASHTO T85 AASHTO T166 AASHTO T176 AASHTO T209 AASHTO T255 AASHTO T275 AASHTO T308 AASHTO T329 AASHTO T335 CT 105 CT 106 CT 125 ADMIX CT 125 AGG CT 125 BIT CT 125 CEM CT 125 GEN CT 125 HMA CT 201 CT 202 CT 205 CT 206 CT 207 CT 209 CT 216 CT 217 CT 226 CT 227 CT 229 CT 231 CT 234 CT 235 CT 308 CT 309 CT 382 CT 384 CT 504 CT 518 CT 523 CT 524 CT 533 CT 539 CT 540 CT 552 CT 556 CT 557 A visual check was performed and documents provided as necessary for the following items: ✓ Facility Safety Manual ✓ Copies of current applicable test procedures ✓ Laboratory Procedures Manual ✓ Calibration and service documentation ✓ Laboratory Quality Control Manual ✓ Calibration stickers affied to test equipment ✓ Proper test equipment (dated within the 12 months) On 2020-04-01 this laboratory was Caltrans Qualified by: Majid Fahrtosh- IA112 m ' �i✓ (Printed name of IA person) (Ngnaturedf IA person) Please verify lab accreditation by visiting SIAD website: hftps://sia.dot.ca.gov/ Page 1/1 CERTIFICATE OF ACCREDITATION TransMat, Inc. in Montclair, California, USA AMERICAN ASSOCIATION or STATE HIGHWAY e10 TRANSPORTATION OFFICIALS AASH1 roficiency for the testing of construction materials and has conformed to the requirements established in he AASHTO Accreditation policies established by the AASHTO Committee on Materials and Pavements. ;reditation can be viewed on the Directory of AASHTO Accredited Laboratories (aashtoresource.org). /av�&' k Moe Jamshidi, ie Director AASHTO COMP Chair aerated on 03/1312020 at 8:18 PM Eastern Time. Please confirm the current accreditation status of this laboratory at aashtoresource.org/aap/accreditation-directory E OF AAS HTO ACCREDITATION FOR: Inc. ir, California, USA Quality Management System Accredited Since: I Implementing a Quality System for Construction Materials Testing Laboratories 01/18/2019 ements for Agencies Testing and Inspecting Road and Paving Materials 01/1812019 ements forAgencies Engaged in Testing and/or Inspection of Soil and Rock as Used in Engineering Design and Construction 04/11/2019 ication for Agencies Engaged in the Testing and/or Inspection of Materials Used in Construction 01/18/2019 Page 1 of 4 aerated on 03/13/2020 at 8:18 PM Eastern Time. Please confirm the current accreditation status of this laboratory at aashtoresource.org/aap/accreditation-di rectory E OF AAS HTO ACCREDITATION FOR: Inc. ir, California, USA Asphalt Mixture Accredited Since: Aix Asphalt to Testing Size 01/1812019 'acted Aggregate 01/18/2019 npacted Hot Mix Asphalt Using Saturated Surface -Dry Specimens (Cores) 01/18/2019 A Hot Mix Asphalt Paving Mixtures 01/18/2019 acted Dense and Open Bituminous Paving Mixtures 01/1812019 npacted Bituminous Mixtures Using Paraffin -Coated Specimens (Cores) 01/18/2019 intent of Hot Mix Asphalt (HMA) by the Ignition Method 01/18/2019 acted Aggregate 01/18/2019 intent of Hot Mix Asphalt (HMA) by the Ignition Method 01/18/2019 Page 2 of 4 aerated on 03/13/2020 at 8:18 PM Eastern Time. Please confirm the current accreditation status of this laboratory at aashtoresource.org/aap/accreditation-directory E OF AAS HTO ACCREDITATION Inc. ir, California, USA SOII FOR: Accredited Since: and Soil Aggregate Samples for Test 01/18/2019 Soils Using a 5.5 lb [2.5 kg] Rammer and a 12 in. [305 mm] Drop 01/18/2019 han the No. 200 (75-pm) Sieve 01/18/2019 s Using a 10lb [4.54 kg] Rammer and an 18 in. [457 mm] Drop 01/18/2019 ure Content of Soils 01/1812019 Page 3 of 4 aerated on 03/13/2020 at 8:18 PM Eastern Time. Please confirm the current accreditation status of this laboratory at aashtoresource.org/aap/accreditation-directory E OF AAS HTO ACCREDITATION FOR: Inc. ir, California, USA Aggregate Accredited Since: 01/18/2019 o Testing Size 01/18/2019 01/18/2019 ?00) Sieve in Mineral Aggregates by Washing 01/18/2019 Aggregates 01/18/2019 and Absorption of Fine Aggregate 01/18 Coarse Aggregate 01/18//20192019 is and Soils by Use of the Sand Equivalent Test Ot/18/2019 its by Drying 01/18/2019 e Aggregate (Influenced by Shape, Texture, and Grading) 01/18/2019 3ctured Particles in Coarse Aggregate 01/18/2019 ?00) Sieve in Mineral Aggregates by Washing 01/18/2019 Coarse Aggregate 01/18/2019 and Absorption of Fine Aggregate Ot/18/2019 Aggregates 01/18/2019 its by Drying 01/1812019 o Testing Size 01/18/2019 e Aggregate (Influenced by Shape, Texture, and Grading) 01/18/2019 01 /18 2019 is and Soils by Use of the Sand Equivalent Test 01/18//2019 or Flat and Elongated Particles in Coarse Aggregate , 01/18/2019 ictured Particles in Coarse Aggregate Page 4 of 4 aerated on 03/13/2020 at 8:18 PM Eastern Time. Please confirm the current accreditation status of this laboratory at aashtoresource.org/aap/accreditation-directory State of California -Health and Human Services Agency California Department of Public Health RADIOACTIVE MATERIAL LICENSE Page 1 of 3 pages Pursuant to the California Code of Regulations, Division 1, Title 17, Chapter 5, Subchapter 4, Group 2, Licensing of Radioactive Material, and In reliance on statements and representations heretofore made by the licensee, a license is hereby issued authorizing the licensee to receive, use, possess, transfer, or dispose of radioactive material listed below; and to use such radioactive material for the purpose(s) and at the places) designated below. This license Is subject to all applicable rules, regulations, and orders of the California Department of Public Health now or hereafter in effect and to any standard or specific condition specified in this license. 1. Licensee: Transmat, Inc. 3. License Number: 8313-36 Amendment Number: 1 2. Address: 8966 Benson Avenue, Suite B 4. Expiration date: Montclair, CA 91763 September 5, 2029 (5) Attention: Kreetha Mekchai 5. Inspection agency., Radiologic Health Branch Radiation Safety Officer South License Number 8313-36 is hereby administratively corrected as follows: 6. Nuclide 7. Form 8. Possession Limit A. Cesium-137/Americium-241:Be A. Sealed sources (Troxler A. 2 source pairs not to exceed Drawing No. A-102112 and 333.0 MBq (9 mCi) of A-102451) cesium-137 and 1.6 GBq (44 mCi) of americium-241 each. Total not to exceed 3.9 GBq (106 mCi). 9. Authorized Use A. To be used as components of gauges, Troxler Electronic Laboratories Model 3400 Series, for determination of moisture/density in engineering materials. LICENSE CONDITIONS 10. Radioactive materials may be used at temporary job sites of the licensee in areas not under exclusive federal jurisdiction throughout the State of California (see Condition 15). Radioactive materials may be permanently stored only at the following approved location: (a) 8966 Benson Avenue, Suite B, Montclair, CA. 11. This license is subject to an annual fee for sources of radioactive material authorized to be possessed at anyone time as specified in items 6, 7, 8 and 9 of this license. The annual fee for this license is required by and computed in accordance with Title 17, California Code of Regulations, Sections 30230-30232 and is also subject to an annual cost -of -living adjustment pursuant to Section 100425 of the California Health and Safety Code. 12. Radioactive material maybe used only by, or under the supervision and in the physical presence of, individuals who: (a) Have satisfactorily completed a course, accepted by the Department as adequate, in safe use of soil/asphalt content gauges containing radioactive material and also; (b) Have been provided with a statement, signed by the Radiation Safety Officer, which designates that individual as an authorized user qualified to use radioactive material under this license. Copies of these documents shall be maintained for inspection by the Department. State of California -Health and Human Services Agency California Department of Public Health Page 2 of 3 pages RADIOACTIVE MATERIAL LICENSE License Number: 8313-36 Amendment Number: 1 13. Except as specifically provided otherwise by this license, the licensee shall possess and use radioactive material described in Items 6, 7, 8 and 9 of this license in accordance with the statements, representations, and procedures contained in the documents listed below. The Department's regulations shall govern unless the statements, representations, and procedures in the licensee's application and correspondence are more restrictive than the regulation. (a) The license application, with attachments, dated March 29, 2019, and the letter, with attachments, dated July 24, 2019, both signed by Kreetha Mekchai, Radiation Safety Officer. 14. The Radiation Safety Officer in this program shall be Kreetha Mekchai. 15. Before radioactive materials may be used at a temporary job site at any federal facility, the jurisdictional status of the job site must be determined. If the jurisdictional status is unknown, the federal agency should be contacted to determine if the job site is under exclusive federal jurisdiction. A response shall be obtained in writing or a record made of the name and title of the person at the federal agency who provided the determination and the date that it was provided. Authorization for use of radioactive materials at the job sites under exclusive federal jurisdiction shall be obtained either by: (a) Filing an NRC Form-241 in accordance with the Code of Federal Regulations, Title 10, Part 150.20 (b), "Recognition of Agreement State Licenses", or (b) By applying for a specific NRC license. Before radioactive material can be used at a temporary job site in another State, authorization shall be obtained from the State if it is an Agreement State, or from the NRC for any non -Agreement State, either by filing for reciprocity or applying for a specific license. 16. Sealed sources contained in soil/asphalt gauges shall be tested for leakage and/or contamination at intervals not to exceed 12 months. 17. Quantitative analytical assays for the purpose of tests for leakage and/or contamination of sealed sources shall be performed only by persons specifically authorized to perform that service. 18. The following individuals are authorized to collect wipe test samples of sealed sources possessed under this license using leak test kits acceptable to the California Department of Public Health: (a) The Radiation Safety Officer (b) Qualified individuals designated in writing by the Radiation Safety Officer 19. Records of leak test results shall be kept in units of becquerels (microcuries) and maintained for inspection. Records may be disposed of following Department inspection. Any leak test revealing the presence of 185 Bq (0.005 µCi) or more of removable radioactive material shall be reported to the California Department of Public Health, Radiologic Health Branch MS 7610, P.O. Box 997414, Sacramento, CA 95899-7414, within five days of the test. This report shall include a description of the defective source or device, the results of the test, and the corrective action taken. 20. The licensee shall conduct a physical inventory every six months to account for all sealed sources and/or devices received and possessed under the license. Records of the inventories shall be maintained for inspection, and may be disposed of following Department inspection. 21. Maintenance and repair of soil/asphalt content gauges shall be performed only by persons specifically authorized to perform those services. State of California -Health and Human Services Agency California Department of Public Health Page 3 of 3 pages RADIOACTIVE MATERIAL LICENSE License Number: 8313-36 Amendment Number: 1 22. At any time the licensee is engaged in making measurements by authority of this license at either a permanent or temporaryjob site, the licensee shall have a current copy of each of the following documents available for inspection at the job site: (a) A statement authorizing each qualified individual to use radioactive material (see Condition 12). (b) This license. (c) The manufacturer's instruction manual with appropriate emergency procedures. 23. The licensee shall comply with all requirements of Title 17, California Code of Regulations, Section 30373 when transporting or delivering radioactive materials to a carrier for shipment. These requirements include; packaging, marking, labeling, loading, storage, placarding, monitoring, and accident reporting. Shipping papers shall be maintained for inspection pursuant to the U.S. Department of Transportation requirements (Title 49, Code of Federal Regulations, Part 172, Sections 172.200 through 172.204). 24. The Radiation Safety Officer shall establish measures for the security of devices possessed and transported under authority of this license. The Radiation Safety Officer shall ensure security measures required by this license meet the following minimum standards: (a) Transport vehicles must be equipped to provide security of the transport case. The method selected must provide for a fixed and permanent attachment to vehicle frame. When secondary containers are used for the Type A package they shall be attached to the vehicle with the use of a tamper resistant fasteners to the frame of the transport vehicle. (b) Each portable gauge licensee shall use a minimum of two independent physical controls that form tangible barriers to secure portable gauges from unauthorized removal, whenever portable gauges are not under the control and constant surveillance of the licensee. (c) Transport vehicles must be equipped with a security device (such as an alarm system) capable of deterring unauthorized entry, access and use of the vehicle. (d) Local law enforcement shall be notified immediately in the event of loss or theft. 25. At least 30 days prior to vacating any address of use listed in Condition 10 of this license, the licensee shall provide written notification of intent to vacate to the California Department of Public Health, in accordance with Title 17, California Code of Regulations, Section 30256 (b). Control of all licensed areas must be maintained until such areas are released by the Department for unrestricted use or the license is terminated, in accordance with Title 17, California Code of Regulations, Section 30256 0). 26. In accordance with California Health and Safety Code Section 115000.1(h), the licensee shall annually report the radioactive waste inventory held in storage on December 31 of each year and all manifests of Low Level Radioactive Waste (LLRW) shipments to licensed LLRW disposal facilities made during the year to the Department via the online LLRW Tracking System at httos://Ilrwts.cdoh.ca.eov/. 27. A copy of this license and a copy of all records and documents pertaining to this license shall be maintained available for inspection at 8966 Benson Avenue, Suite B. Montclair, CA. Issued for the State of California Department of Public Health Date: September 18, 2019 By: P.O. Bois 997414, M.S. 7610 Sacramento, CA 95899-7414 Appendix ATTACHMENT 3-1: NON -COLLUSION AFFIDAVIT CERTIFICATIONS NON -COLLUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA DEPARTMENT OF PUBLIC WORKS In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the BIDDER declares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the BIDDER has not directly or indirectly induced or solicited any other BIDDER to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived or agreed with any BIDDER or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the BIDDER has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of the BIDDER or any BIDDER, or to fix any overhead, profit, or cost element of the bid price, or of that of any other BIDDER, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the BIDDER has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid. Note: The above Non -collusion Affidavit is part of the Proposal. Signing this Proposal on the signature portion thereof shall also constitute signature of this Non -collusion Affidavit. BIDDERS are cautioned that making a false certification may subject the certifier to criminal prosecution. Signed State of California County of Riverside Subscribed and sworn to (or affirmed) before me on this 2b day of W 20�20 by 1\1 D•Usi f Fi ✓'a> proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. 4Noryc Signature NAUSIR MANMOUD 1RAS Notary Public , California I+.v>; Riverside County Commission N 2281654 My Comm. Expires Mar 19. 2023 Notary Public Seal City of Santa Ana RFP Page A3-1 Appendix ATTACHMENT 3-2: NON -LOBBYING CERTIFICATION CERTIFICATIONS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: 1. No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence any officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant loan, loan or cooperative agreement, the undersigned shall complete and submit a "Disclosure of Lobbying Activities". This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Firm Kleinfelder, Inc. Signed and Printed Name: Title Project Manager / Priryelpal Agent Date September 30, 2020 Hanna, PE City of Santa Ana RFP Page A3-2 Appendix ATTACHMENT 3-3: NON-DISCRIMINATION CERTIFICATION CERTIFICATIONS The undersigned consultant or corporate officer, during the performance of this contract, certifies as follows: 1. The Consultant shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Consultant shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Consultant agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Consultant shall, in all solicitations or advertisements for employees placed by or on behalf of the Consultant, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Consultant shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Consultant's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Consultant shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Consultant shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Consultant's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Consultant may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. 7. The Consultant shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted City of Santa Ana RFP Page A3-3 by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Consultant becomes involved in, or is threatened with, litigation with a sub -consultant or vendor as a result of such direction by the administering agency, the Consultant may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, No discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any consultant of public works violating this Section is subject to all the penalties imposed for a violation of the Chapter. Signed: Title: Firm: Proj ct Manager / Principal Agent Kleinfelder, Inc. Date: September 30, 2020 City of Santa Ana RFP Page A3-4 Appendix ATTACHMENT 3-2: NON -LOBBYING CERTIFICATION CERTIFICATIONS The prospective participant certifies, by signing and submitting this bid or proposal, to the best of his or her knowledge and belief, that: No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 2. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence any officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant loan, loan or cooperative agreement, the undersigned shall complete and submit a "Disclosure of Lobbying Activities". This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U. S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his or her bid or proposal that he or she shall require that the language of this certification be included in all lower tier subcontracts, which exceed $100,000 and that all such sub recipients shall certify and disclose accordingly. Firm Signed and Printed Name: Title Date City of Santa Ana RFP Page A3-2 Appendix ATTACHMENT 3-3: NON-DISCREMNATION CERTIFICATION CERTIFICATIONS The undersigned consultant or corporate officer, during the performance of this contract, certifies as follows: 1. The Consultant shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The Consultant shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Consultant agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. The Consultant shall, in all solicitations or advertisements for employees placed by or on behalf of the Consultant, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. The Consultant shall send to each labor union or representative of workers with which he/she has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the Consultant's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The Consultant shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The Consultant shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of the Consultant's non-compliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and the Consultant may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Execution Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. 7. The Consultant shall include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted City of Santa Ana RFP Page A3-3 by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering agency may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event the Consultant becomes involved in, or is threatened with, litigation with a sub -consultant or vendor as a result of such direction by the administering agency, the Consultant may request that the United States enter into such litigation to protect the interests of the United States. 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1939, and as amended, No discrimination shall be made in the employment of persons upon public works because of race, religious creed, color, national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any consultant of public works violating this Section is subject to all the penalties imposed for a violation of the Chapter. Signed: 41zl� Title: CEO/President Firm: TransMat Inc. Date: 09-24-2020 City of Santa Ana RFP Page A3-4 EXHIBIT C PROFESSIONAL / ADMIMSTRATIVE STAFF RATES PProjectManager...................................................................................................................... $ 186.95 / hr. roject Administrator............................................................................................................... $ 115.91 / hr. TECHNICAL STAFF RATES Field Soils & Materials Tester: Prevailing Wage Group 1.................................. . $ 1.89 / hr. Special Inspection &Batch Plant: Prevailing Wage Group 2................................................... $ 17373.76 / hr. Non-destructive Testing: Prevailing Wage Group 3.............................................. 79.46 Special Inspector & Materials Tester: Non -Prevailing Wage .................................................... $ 194.25 / hr. *Please see the attached Basis of Charges for all additional fee schedule information. Kleinfelder Fee Schedule for the City of Santa Ana Revised 05/2021 BASIS OF CHARGES 1. A two-hour show up minimum charge will be made for all field services where work is cancelled less than two hours prior to the requested start time. A four-hour minimum charge will be made for any field services in excess of two hours. An eight -hour minimum charge will be made for field services in excess of four hours per day. 2. Time worked in excess of 8 hours per day (Monday - Friday) and up to 12 hours per day on Saturday will be charged at 1.5 times the hourly rate. Time worked in excess of 12 hours per day (Monday — Saturday) and all time worked on Sundays and holidays will be charged at 2 times the hourly rate. 3. Per diem will be charged at cost for all projects in excess of 50 miles from the nearest Kleinfelder office. 4. Office support staff, field inspection non -prevailing wage staff, and laboratory testing rates will be escalated 3% annually on October 1st for the duration of the contract. 5. Field inspection staff subject to prevailing wages per the DIR will be escalated 3% annually on July 15t for the duration of the contract. 6. Vehicle mileage will be charged at the current IRS reimbursement rate portal-to-portal from the nearest Kleinfelder office. 7. The proposed fee includes standard invoicing with time detail summary. Additional administrative time will be charged if invoice backup information (timesheets, daily field reports, or work summaries) is requested. B. Certified payroll for prevailing wage projects will be provided only if requested and will be subject to additional charges for administrative time for each pay period. Revised Kleinfelder Basis of Charges for the City of Santa Ana SOIL TESTS SOIL CLASSIFICATION AND INDEX TESTS Test Visual Classification Standard Test Methodt Fee Sieve Anal sis, % Finer than 200 Sieve D2488 D1140 $ 30 each Sieve Anal sis Fine D422, D6913, T88 $ $ 90 each Sieve Anal sis, Coarse D422, D6913,T88 $ 130 each Sieve Anal sis, Coarse and Fine D422, D6913, T88 $ 130 each H drometerAnail SIS Re uiresaSieveAnal sis, not include d D422, D7928 $ 165 each Water Content D2216, D4363, T265 $ 185 25 each Water Content and D Unit Wei ht D2216, D2937, D7263 $ each Atterber Limits, Sin le Point D4318-B T89, T90 $ 45 each Atterber Limits, Multi Is Point , D4318-A, T89, T90 $ 120 each Atterber Limits, Liquid Limit Onl D4318, T90 185 each Soil S eciic D854, T100 $ 115 each Soil Organic CContent Content D2974-C $ 225 each Fiberr Content of Peat Soils 1997 $ 125 eachD Pinhole Dis ersion Classification D1997 $ 270 each Soil H D4972, G51 $ $ 525 each Double H drometer for Dis ersive Soils D4221 60 each Soil Resistivity G187 $ 275 each Chloride Content $ 160 each Sulfate Content $ 70 each Thermal Resistivity, Per Point D5334, IEEE 422 $ $ 60 each Thermal Resistivity, Dry -Out Curve D5334, IEEE 422 325 each $ 950 each SOIL BEARING PRESSURE TESTS Test Standard Test Methods Fee California Bearing Ratio, Sin le pint (proctor not included) D1883, T193 California Bearin Ratio, 3 Points $ 350 each (proctornot included) D1883, T193 $ 650 each and DOT test Those beginning with A, B, C, D, E, F, or G are ASTM methods. Page 1 of 8 All rates are subject to a 3% annual increase beginning October 1, 2021. SOIL TESTS (continued) tCom•mon ASTM, AASHTO and DOT test methods. Those beginning with A, B, C, D, E, F, or G are ASTM methods• . Those beginning with T are AASHTO methods. Page 2 of 8 All rates are subject to a 3% annual increase beginning October 1, 2021. 'AGGREGATE TESTS FILTER MEDIA TESTS mmon Ab t M, AASHTO and DOT test methods. • Those beginning with A, B, C, D, E, F, or G are ASTM methods. • Those beginning with Tare AASHTn mnrh,,i, Page 3 of 8 All rates are subject to a 3% annual increase beginning October 1, 2021. CONCRETE TESTS ROLLER COMPACTED CONCRETE TESTS MASONRY TESTS tCommon ASTM, AASHTO and DOT test methods. • Those beginning with A, B, C, D, E, F, or G are ASTM methods. • Those beginning with T are AASHTO methods. Page 4 of 8 All rates are subject to a 3% annual increase beginning October 1, 2021. ROCK TESTS ASPHALT TESTS uuu vW 1 LWDL Those beginning with A, B, C, D, E, F, or G are ASTM methods. Those beginninq with T are AASNTn .,,.fh-A- Page 5 of 8 All rates are subject to a 3% annual increase beginning October 1, 2021. ASPHALT TESTS (continued) VVIIIIIIVII/' Ivy Those beginning with A, B, C, D, E, F, or G are ASTM methods. •• Those beginning with T are AASHTO methods. Page 6 of 8 All rates are subject to a 3% annual increase beginning October 1, 2021. METAL TESTS T "An 'assembly' is one bolt one nut and one washer. The suite consists of a bolt wedge tensile test, bolt and nut proof load tests, and hardness tests on all three pieces aIw uV i test Those beginning with A, B, C, D, E, F, or G are ASTM methods. Those beginning with T are AASHTn mnfk-A- Page 7 of 8 All rates are subject to a 3% annual increase beginning October 1, 2021. DIMENSION STONE AND ROOFING MATERIAL TESTS MISCELLANEOUS TESTS SAMPLE PREPARATION (Com•mon ASTM, AASHTO and DOT test methods. Those beginning with A, B, C, D, E, F, or G are ASTM methods. • Those beginning with T are AASHTO methods. Page 8 of 8 All rates are subject to a 3% annual increase beginning October 1, 2021. A`oRo° CERTIFICATE OF LIABILITY INSURANCE DATE 04/09/2026/2026IYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Marsh Risk&Insurance Services NAME: Jan Mitchell CA License#0437153 AICON No, Ext: 602 337 6295 F4Ic,No 633 W.Fifth Street,Suite 1200 E-MAIL Los Angeles,CA 90071 ADDRESS: janet.k.mitchell@marsh.com INSURER(S)AFFORDING COVERAGE NAIC# CN 101 600557-TKG-GAUW-26-27 ALL INSURERA: Continental Insurance Company 35289 INSURED The Kleinfelder Group,Inc INSURER B: American Casualty Company Of Reading,Pa 20427 770 First Avenue,Suite 400 INSURER C: See Additional Page for Participating Carriers San Diego,CA 92101 INSURER D: Continental Casualty Company 20443 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: LOS-002737505-14 REVISION NUMBER: 8 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LTR MM/DDIYYYYI iMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 8038020148 04/01/2026 04/01/2027 EACH OCCURRENCE $ 2,000,000 RENTEDDAMAGE TO CLAIMS-MADE X� OCCUR FIR SES Ea occurre... $ 1,000,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY PE� LOC PRODUCTS-COMP/OPAGG $ 4,000,000 OTHER: $ D AUTOMOBILE LIABILITY 8038020103 04/01/2026 04/01/2027 COMBINED SINGLE LIMIT $ 2,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident L $ A X UMBRELLALIAB X OCCUR 8038136207 04/01/2026 04/01/2027 EACH OCCURRENCE $ 3,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED RETENTION$ $ A WORKERS COMPENSATION 8038020120(AOS) 04/01/2026 04/01/2027 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B YIN 8038020134(CA) 04/01/2026 04/01/2027 1,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Env.Contractor Poll/Prof E&O FINPA2650034 04/01/2026 04/01/2027 Each Claim 2,000,000 Claims-Made Policy Aggregate 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: On-Call material testing and special inspection services for the City's Public Work Agency,Agreement No.A2021-121-02. RFP#20-111 City of Santa Ana,its officers,agents,employees,volunteers and representatives are included as Additional Insured where required by written contract with respects to the General Liability and Automobile Liability policies. General Liability policy evidenced herein is Primary and Non-Contributory to other insurance available to Additional Insured,but only in accordance with the policy's provisions. A Waiver of Subrogation is granted in favor of Certificate Holder where required by written contract. APPROVED CERTIFICATE HOLDER CANCELLATION ByTuTranNguyenat9:26am,Apro9,2026 City of Santa Ana SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attention:Public Works Agency THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CIP/Design Engineering ACCORDANCE WITH THE POLICY PROVISIONS. 20 Civic Center Plaza Santa Ana,CA 92701 M-36 AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101600557 LOC#: Los Angeles ACCOR o ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY NAMED INSURED Marsh Risk&Insurance Services The Kleinfelder Group,Inc 770 First Avenue,Suite 400 POLICY NUMBER San Diego,CA 92101 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance The Environmental Contractor Poll/Prof[E&O]policies Carriers: Convex Ins UK Limited(33.33%)NAIC#AA1120191 Allied World Surplus Lines Ins Co(25.83%)NAIC 24319 WRB London(26.67%)NAIC K2 Financial Limited(7.5%) Mosaic London(6.671/o) Retroactive Date:4/20/1962 NAMED INSURED SCHEDULE THE KLEINFELDER GROUP,INC. KLEINFELDER GROUP PARENT GP LLC KLEINFELDER GROUP PARENT LP KLEINFELDER GROUP HOLDINGS LLC KLEINFELDER INTERMEDIATE LLC KLEINFELDER PARENT,INC KLEINFELDER MANAGEMENT HOLDINGS LLC KLEINFELDER EAST,INC.(FORMERLY KNOWN AS GSC/KLEI N FELDER,INC.AND POWELL-HARPSTEAD,INC.) KLEINFELDER,INC. KLEINFELDER WEST,INC.GSC/KLEINFELDER,INC.AND SQUIRE/KLEINFELDER,INC. KLEINFELDER CENTRAL,INC.(FORMERLY KNOWN AS GEOSYSTEMS ENGINEERING,INC.AND TRINITY ENGINEERING TESTING CORPORATION(TEfCO))MERGED INTO KLEINFELDER,INC.8/1/16 KLEINFELDER ENGINEERING AND GEOLOGY,P.C.(FORMERLYJUSTIN R.MOSES&ASSOCIATES ENGINEERING,PC KLEINFELDER USA,INC.(KUSA)CLOSED 11/30/2011 KLEINFELDER SOUTHEAST,INC.(FORMERLY KNOWN AS TRIGON/KLEI N FELDER,INC. TRINITY ENGINEERING TESTING CORPORATION(TETCO) TRIGON ENVIRONMENTAL SERVICES,INC. ERG,LLC CE2 KLEINFELDER ADANTA-KLEINFELDER MP JV KLEINFELDER ASSOCIATES(KFI SQUI ER/KLEIN FELDER,LLC SPECTRUM EXPLORATION,INC. KLEINFELDER DRILLING,INC. KLEINFELDER TEXAS 100 LLC NODARSE-KLEINFELDERA JOINTVENTURE LLC KLEINFELDER GUAM 101,LLC KLEINFELDER UTAH 100,LLC KLEINFELDER COLORADO 100,LLC KLEINFELDER KANSAS 100,LLC KLEINFELDER OKLAHOMA 100,LLC KLEINFELDER OKLAHOMA 200,LLC KLEINFELDER NEW MEXIC0100,LLC KLEINFELDER TEXAS 200,LLC KLEINFELDER INTERNATIONAL,INC. KLEINFELDER ACQUISITION I CORP. KLEINFELDER ACQUISITION II CORP ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CN101600557 LOC#: Los Angeles ACCOR o ADDITIONAL REMARKS SCHEDULE Page 3 of 3 AGENCY NAMED INSURED Marsh Risk&Insurance Services The Kleinfelder Group,Inc 770 First Avenue,Suite 400 POLICY NUMBER San Diego,CA 92101 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance CORRIGAN ACQUISITION ECOBI OLOGICAL PTY LTD LITTORIA PTY LTD LERISTA PTYLTD LPG ENVIRONMENTAL&PERMITTING SERVICES,INC. SEA CONSULTANTS,INC.-KLEINFELDER ARCHITECTURE NORTHEAST,INC.- NOW KLEINFELDER NORTHEAST,INC.(AS OF 4/2012) KOWALSKI ENGINEERING,INC. WELLS ENVIRONMENTAL SERVICES,PTY LTD ALLIANCE ENVIRONMENTAL ENGINEERING&CONSULTING PTY LTD BUYS AND ASSOCIATES INSITE ENVIRONMENTAL,INC. OMNI ENVIRONMENTAL,LLC Al SURVEYING KLEINFELDER CONSTRUCTION SERVICES,INC.(FORMERLY SIMON WONG ENGINEERING,INC. OEI CONSULTANTS,INC. RED DOG TECHNICAL SERVICES,INC. HOOD TECHNICAL SERVICES,INC. HOOD RESOURCES CORP. 927278 ALBERTA LTD. 943739 ALBERTA LTD O/A HOOD ENGINEERING KLEINFELDER ARCHITECTURE,INC. DOUCET&ASSOCIATES INC CHAN&PARTNERS ENGINEERING LLC DOUCET&ASSOCIATES,INC.DBA DOUCET+CHAN CMWorks,INC. KLEINFELDER CANADA,INC. KLEINFELDER AUSTRALIA PTY LTD DESIGN ENGINEERS&CONSULTING ASSOCIATES,INC. INDUSTRIAL FLUID MANAGEMENT,INC. CENTURY ENGINEERING OF NORTH CAROLINA,LLC GAS TRANSMISSION SYSTEMS,INC.(GTS) CENTURY ENGINEERING,LLC VEENSTRA&KIMM,INC. ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD G* Marsh Marsh specialty B0509FINPA2650034 Page 18 of 48 8. NAMED ASSURED AS AGENT The first Named Assured specified in Item 1 of the Declarations shall be considered the agent of all Assureds with respect to the giving of or receipt of all notices pertaining to this Policy and shall be responsible for the payment to the Insurers of all premiums and for payment of the Retention. 9. PREMIUM The premium for this Policy shall be the amount specified in Item 5 of the Declarations. 10. SUBROGATION In the event of any Claim under this Policy, the Insurers shall be subrogated to all of the Assured's rights of recovery against any person or entity, and the Assured shall execute and deliver to the Insurers any and all necessary documentation, instruments and records and do whatever else is necessary to secure and enforce such rights.The Assured shall take no action after such Claim is made against it which prejudices such rights of Insurers. The Insurers agree to waive their rights of recovery against any client of the Named Assured for a Claim to the extent the Named Assured had, prior to such Claim,a written agreement to waive such rights. 11. ASSIGNMENT No assignment or transfer of any Assured's rights under this Policy shall bind the Insurers. If an Assured shall die or be adjudged incompetent, such insurance shall cover that Assured's legal representative as an Assured as would be permitted by this Policy. 12. MERGERS AND ACQUISITIONS In the event that the Named Assured: a) acquires any other entity or acquires substantially all the assets of another entity, or b) merges with another entity such that the Named Assured is the surviving entity,or c) creates or acquires a Subsidiary after the effective date of this policy, no coverage shall be afforded under this policy for any Claim arising out of Professional Services or Contracting Services performed by or alleged to have been performed by such entity acquired or merged with or such Subsidiary created, unless and until: i) The Named Assured provides written notice to the Insurers of such transaction or event not more than ninety (90) days after the effective date of such transaction, or event,and ii) The Named Assured promptly provides the Insurers with such information in connection therewith as the Insurers may reasonably deem necessary,and iii) The Insurers at their reasonable discretion specifically agree in writing to provide such coverage,such agreement not to be unreasonably withheld by the Insurers Except that this Condition 12.shall not apply to, and the coverage under this Policy shall apply automatically for, any such entity acquired or merged with the Named Assured where(a)the total,gross,annual revenues of such entity are less than or equal to 15%of the Named Assured's revenues used to determine the premium for this Policy and if requested by the Named Assured, shall include a Retroactive Date equivalent to that contained in such entity's insurance in effect prior to the acquisition If the Named Assured merges into or consolidates with another entity such that the A business of Marsh McLennan CNA Business Auto Policy Policy Endorsement TRANSFERWAIVER OF OF AGAINSTOTHERS TO US (WAIVER O SUBROGATION) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: The Kleinfelder+Group Inc. Endorsement Effective Date: 04/01/2026 SCHEDULE Names)Of Person(s)Or Organization(s). ANY PERSON OR ORGANIZAIION FOR WHOiM Olt WHICH YOU ARE REQUIRED BY WRIT"1'EN CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US.YOU MUST AGREE TO THAT REQUIREMENT PRIOR 1'O LOSS. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization. Form No: CA 04 44 10 13 Policy No: BUA 8038020103 Endorsement Effective Date: Policy Effective Date: 04/01/2026 Page: 1 of 1 Policy Page: 1 of I Underwriting Company: Continental Casualty Company,151 N Franklin St,Chicago,IL 60606 Copyright insurance Services Office, Inc., 2011 Business Auto Polity NAPolicy Endorsement ADDITIONAL r AND • r NTRIBU TORY It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Persons Or Organizations "Any person or organization that you are required by written contract to make an additional insured under this insurance is an "insured",but only with respect to that person or organization's legal liability for acts or omissions of a person who qualifies as an "insured"for Liability Coverage under Section II-Who Is An Insured of this Coverage Form." 1. In conformance with paragraph A.1.c. of Who Is An Insured of Section II - LIABILITY COVERAGE, the person or organization scheduled above is an insured under this policy. 2. The insurance afforded to the additional insured under this policy will apply on a primary and non- contributory basis if you have committed it to be so in a written contract or written agreement executed prior to the date of the "accident" for which the additional insured seeks coverage under this policy. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. Form No: CNA71527XX (10-2012) Policy No: BUAS038020103 Endorsement Effective Date: Policy Effective Date: 04101/2026 Page: 1 of 1 Policy Page: 1 of 1 Underwriting Company: Continental Casualty Company,151 N Franklin St,Chicago,IL 60606 ti Copyright CNA All Rights Reserved. CNA CNA PARAMOUNT Architects, Engineers and Surveyors General Liability Extension Endorsement 1. ADDITIONAL INSUREDS a. WHO IS AN INSURED is amended to include as an Insured any person or organization described in paragraphs A. through I. below whom a Named Insured is required to add as an additional insured on this Coverage Part under a written contract or written agreement, provided such contract or agreement: (1) is currently in effect or becomes effective during the term of this Coverage Part; and (2) was executed prior to: (a) the bodily injury or property damage; or (b) the offense that caused the personal and advertising injury, for which such additional insured seeks coverage. b. However, subject always to the terms and conditions of this policy, including the limits of insurance, the Insurer will not provide such additional insured with: (1) a higher limit of insurance than required by such contract or agreement; or (2) coverage broader than required by such contract or agreement, and in no event broader than that described by the applicable paragraph A.through I. below. Any coverage granted by this endorsement shall apply only to the extent permissible by law. A. Controlling Interest Any person or organization with a controlling interest in a Named Insured, but only with respect to such person or organization's liability for bodily injury, property damage or personal and advertising injury arising out of: 1. such person or organization's financial control of a Named Insured; or 2. premises such person or organization owns, maintains or controls while a Named Insured leases or occupies such premises; provided that the coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. B. Co-owner of Insured Premises A co-owner of a premises co-awned by a Named Insured and covered under this insurance but only with respect to such co-owner's liability for bodily injury, property damage or personal and advertising injury as co-owner of such premises. C. Engineers, Architects or Surveyors Engaged By You An architect, engineer or surveyor engaged by the Named Insured, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused in whole or in part by the Named Insured's acts or omissions, or the acts or omissions of those acting on the Named Insured's behalf: a. in connection with the Named Insured's premises; or b. in the performance of the Named Insured's ongoing operations. But the coverage hereby granted to such additional insureds does not apply to bodily injury, property damage or personal and advertising injury arising out of the rendering of or failure to render any professional services by, on behalf of, or for the Named Insured, including but not limited to: 1. the preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or 2. supervisory, inspection, architectural or engineering activities. D. Lessor of Equipment CNA74858XX(1-15) Policy No: GL8038020148 Page 2 of 16 Continental Casualty Company Effective Date: 04/01/2026 Insured Name:The Kleinfelder Group Inc. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc.,with its permission. CNA CNA PARAMOUNT Architects, Engineers and Surveyors General Liability Extension Endorsement Any person or organization from whom a Tamed Insured leases equipment, but only with respect to liability for bodily injury, property damage or personal and advertising injury caused, in whole or in part, by the famed Insured's maintenance, operation or use of such equipment, provided that the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease. E. Lessor of Land Any person or organization from whom a Named Insured leases land but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such land, provided that the occurrence giving rise to such bodily injury, property damage or the offense giving rise to such personal and advertising injury takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. F. Lessor of Premises An owner or lessor of premises leased to the Named Insured, or such owner or lessor's real estate manager, but only with respect to liability for bodily injury, property damage or personal and advertising injury arising out of the ownership, maintenance or use of such part of the premises leased to the Named Insured, and provided that the occurrence giving rise to such bodily injury or property damage, or the offense giving rise to such personal and advertising injury, takes place prior to the termination of such lease. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. G. Mortgagee, Assignee or Receiver A mortgagee, assignee or receiver of premises but only with respect to such mortgagee, assignee or receiver's liability for bodily injury, property damage or personal and advertising injury arising out of the Named Insured's ownership, maintenance, or use of a premises by a Named Insured. The coverage granted by this paragraph does not apply to structural alterations, new construction or demolition operations performed by, on behalf of, or for such additional insured. H. State or Governmental Agency or Subdivision or Politiical Subdivisions— Permits A state or governmental agency or subdivision or political subdivision that has issued a permit or authorization but only with respect to such state or governmental agency or subdivision or political subdivision's liability for bodily injury, property damage or personal and advertising injury arising out of: 1. the following hazards in connection with premises a Named Insured owns, rents, or controls and to which this insurance applies: a. the existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk vaults, street banners, or decorations and similar exposures; or b. the construction, erection, or removal of elevators; or c. the ownership, maintenance or use of any elevators covered by this insurance; or 2. the permitted or authorized operations performed by a Named Insured or on a Named Insured's behalf. The coverage granted by this paragraph does not apply to: a. Bodily injury, property damage or personal and advertising injury arising out of operations performed for the state or governmental agency or subdivision or political subdivision; or b. Bodily injury or property damage included within the products-completed operations hazard. CNA74858XX(1-15) Policy No: GL8038020148 Page 3 of 16 Continental Casualty Company Effective Date: 04/01/2026 Insured Name:The Kleinfelder Group Inc. Copyright CNA All Rights Reserved. includes copyrighted material of Insurance Services office,Inc.,with its permission. CNA DNA PARAMOUNT Architects, Engineers and Surveyors General Liability Extension Endorsement With respect to this provision's requirement that additional insured status must be requested under a written contract or agreement, the Insurer will treat as a written contract any governmental permit that requires the Named Insured to add the governmental entity as an additional insured. I. Trade Show Event Lessor 1. With respect to a Named Insured's participation in a trade show event as an exhibitor, presenter or displayer, any person or organization whom the Named Insured is required to include as an additional insured, but only with respect to such person or organization's liability for bodily injury, property damage or personal and advertising injury caused by: a. the Named Insured's acts or omissions; or b. the acts or omissions of those acting on the Named Insured's behalf, in the performance of the Named Insured's ongoing operations at the trade show event premises during the trade show event. 2. The coverage granted by this paragraph does not apply to bodily injury or property damage included within the products-completed operations hazard. 2. ADDITIONAL INSURED -PRIMARY AND NON-CONTRIBUTORY TO ADDITIONAL INSURED'S INSURANCE The Other Insurance Condition in the COMMERCIAL GENERAL LIABILITY CONDITIONS Section is amended to add the following paragraph: If the Named Insured has agreed in writing in a contract or agreement that this insurance is primary and non- contributory relative to an additional insured's own insurance, then this insurance is primary, and the Insurer will not seek contribution from that other insurance. For the purpose of this Provision 2., the additional insured's own insurance means insurance on which the additional insured is a named insured. Otherwise, and notwithstanding anything to the contrary elsewhere in this Condition, the insurance provided to such person or organization is excess of any other insurance available to such person or organization. 3. ADDITIONAL INSURED—EXTENDE❑ COVERAGE When an additional insured is added by this or any other endorsement attached to this Coverage Part, WHO IS AN INSURED is amended to make the following natural persons Insureds. If the additional insured is: a. An individual, then his or her spouse is an Insured; b. A partnership or joint venture, then its partners, members and their spouses are Insureds; c. A limited liability company, then its members and managers are Insureds; or d. An organization other than a partnership, joint venture or limited liability company, then its executive officers, directors and shareholders are Insureds; but only with respect to locations and operations covered by the additional insured endorsement's provisions, and only with respect to their respective roles within their organizations. Please see the ESTATES, LEGAL REPRESENTATIVES, AND SPOUSES provision of this endorsement for additional coverage and restrictions applicable to spouses of natural person Insureds. 4. BOATS Under COVERAGES, Coverage A — Bodily Injury And Property Damage Liability, the paragraph entitled Exclusions is amended to add the following additional exception to the exclusion entitled Aircraft, Auto or Watercraft: This exclusion does not apply to: CNA74858XX(1-15) Policy No: GL8038020148 Page 4 of 16 Continental Casualty Company Effective Date: 04/01/2026 Insured Name:The Kleinfelder Group Inc. Copyright C N A All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc.;with its permission. CNA CNA PARAMaLJNT Architects, Engineers and Surveyors General Liability Extension Endorsement services performed for the Named Insured under the Named Insured's direct supervision. All limitations that apply to employees and volunteer workers also apply to anyone qualifying as an Insured under this Provision. 24. SUPPLEMENTARY PAYMENTS The section entitled SUPPLEMENTARY PAYMENTS—COVERAGES A AND B is amended as follows: A. Paragraph 1.b. is amended to delete the $250 limit shown for the cost of bail bonds and replace it with a $5,000. limit; and B. Paragraph 1.d. is amended to delete the limit of $250 shown for daily loss of earnings and replace it with a $1,000. limit. 25. UNINTENTIONAL FAILURE TO DISCLOSE HAZARDS If the Named Insured unintentionally fails to disclose all existing hazards at the inception date of the Named Insured's Coverage Part, the Insurer will not deny coverage under this Coverage Part because of such failure. 26. WAIVER OF SUBROGATION - BLAN KET Under CONDITIONS, the condition entitled Transfer Of Rights Of Recovery Against Others To Us is amended to add the following: The Insurer waives any right of recovery the Insurer may have against any person or organization because of payments the Insurer makes for injury or damage arising out of: 1. the Named Insured's ongoing operations; or 2. your work included in the products-completed operations hazard. However, this waiver applies only when the Named Insured has agreed in writing to waive such rights of recovery in a written contract or written agreement, and only if such contract or agreement: 1. is in effect or becomes effective during the term of this Coverage Part; and 2. was executed prior to the bodily injury, property damage or personal and advertising injury giving rise to the claim. 27. WRAP-UP EXTENSION: OCIP,CLIP, OR CONSOLIDATED (WRAP-UP) INSURANCE PROGRAMS Note: The following provision does not apply to any public construction project in the state of Oklahoma, nor to any construction project in the state of Alaska, that is not permitted to be insured under a consolidated (wrap-up) insurance program by applicable state statute or regulation. If the endorsement EXCLUSION — CONSTRUCTION WRAP-UP is attached to this policy, or another exclusionary endorsement pertaining to Owner Controlled Insurance Programs (O.C.I.P.) or Contractor Controlled Insurance Programs (C.C.I.P.) is attached, then the following changes apply: A. The following wording is added to the above-referenced endorsement: With respect to a consolidated (wrap-up) insurance program project in which the Named Insured is or was involved, this exclusion does not apply to those sums the Named Insured become legally obligated to pay as damages because of: 1. Bodily injury, property damage, or personal or advertising injury that occurs during the Named Insured's ongoing operations at the project, or during such operations of anyone acting on the Named Insured's behalf; nor 2. Bodily injury or property damage included within the products-completed operations hazard that arises out of those portions of the project that are not residential structures. B. Condition 4.Other Insurance is amended to add the following subparagraph 4.b.(1)(c): This insurance is excess over: CNA74858XX(1-15) Policy No: GL8038020148 Page 15 of 16 Continental Casualty Company Effective Date: 04/01/2026 Insured Name:The Kleinfelder Group Inc. Copyright CNAAII Rights Reserved. Includes copyrighted material cf Insurance Services Office, Inc.,with its permission. Workers Compensation And Employers Liability Insurance CNAPolicy Endorsement WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule The premium charge for the endorsement is reflected in the Schedule of Operations. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: WC 00 03 13 (04-1984) Policy No:WC 8 38020120 Endorsement Effective bate: Endorsement Expiration bate: Policy Effective Date:04/01/2026 Page: 1 of 1 Policy Page: 1 of 1 Underwriting Company: American:Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 Copyright 1983 Nationalounce on Lompensation Insurance. Workers Compensation and Employers Liability Insurance CNAPolicy Endorsement BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS This endorsement changes the policy to which it is attached. It is agreed that Part One - Workers' Compensation Insurance G. Recovery From Others and Part Two - Employers' Liability Insurance H. Recovery From Others are amended by adding the following: We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) PREMIUM CHARGE - Refer to the Schedule of Operations The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California exposure. The amount is Blanket Waiver of Subrogation Percentage Charge%. All other terms and conditions of the policy remain unchanged. This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below. Form No: G-19160-B (1 1-1997) Policy No: WC 8038020134 Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date: Page: 1 of 1 04/01/2026 Policy Page: 1 of 1 Underwriting Company: Confinental Insurance Company,151 N Franklin St,Chicago, IL 60606 Copyright CNA All Flights Reserved.