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HomeMy WebLinkAboutSWIFT ENGINEERING INC. 2 - 2014fflMoRMCLONOWIL NEE MW lmakff 9 UATJ ' ut `��EC,2 4 2014 ®ItTE� Agreement o, O: ctA16, W4uin . ON-THE-JOB TRAINING AGREEMENT UNDER THE WORKFORCE INVESTMENT ACT THIS AGREEMENT is made and entered into this 24th day of November, 2014 between the City of Santa Ana, a charter city and municipal corporation duly organized and existing under the Constitution and laws of the State of California (hereinafter "CITY") and Swift Engineering, Inc. (hereinafter "EMPLOYER"). WITNESSETH Recitals: A. CITY has been designated a Local Workforce Investment Area ("LWIA") pursuant to Section 116 of the Workforce Investment Act ("WIA"), P.L. 105-220, 29 USC Section 2801, to receive federal funds to promote effective delivery of job training services to local area residents. B. The State of California has created the California Workforce Investment Board pursuant to Section 111 of the Workforce Investment Act, P.L. 105-220, 29 USC 2821, to administer the WIA programs operated by the State of California. C. As a LWIA, CITY is entitled to receive federal funds to establish programs to prepare eligible unskilled youth, adults and dislocated workers for entry into the labor market, and to provide job training to those individuals who face serious barriers in obtaining productive employment ("said Program"). D. EMPLOYER is able and walling to train eligible unskilled applicants for entry into the labor market and is willing to operate said program pursuant to the WIA and applicable federal, state and local laws. WHEREFORE, for and in consideration of the respective and mutual covenants and promises hereinafter contained and made, and subject to all the terms and conditions hereof, the parties hereto do hereby agree as follows: 1. Term. The effective term of this Agreement is for the period beginning December 8'h, 2014, and ending June 30`t' 2015. The term of this Agreement may be extended upon agreement of all parties and execution of an amendment of the term. 2. Scope of Work. The EMPLOYER shall employ and train one employee (hereinafter "Trainee") in the occupation and in accordance with the OJT Training Outline set forth in Exhibit A, attached hereto and incorporated herein by this reference. 1 Said Trainee shall be referred by the City of Santa Ana W/O/R/K Center. Training must significantly raise the Trainee from his/her prior position in both level of skill and salary by the end of the training period. 3. Funding. CITY shall reimburse the EMPLOYER an amount not to exceed $6,720.00 in accordance with the Cost Computation included in Exhibit A. EMPLOYER shall bill the CITY monthly on an invoice provided by CITY for actual and reasonable cost for providing the services described in this Agreement. Reimbursement of EMPLOYER under this Agreement shall be limited to the costs incurred during the basic work week, excluding overtime and any paid holidays or sick leave. 4. Subcontracting Prohibited. The EMPLOYER shall not subcontract or assign the OJT Training. Any attempt by the EMPLOYER to delegate or assign OJT training duties under this Agreement shall void, and permit CITY to immediately terminate, this Agreement. 5. Employer Obligations. During the training, the EMPLOYER shall ensure that the - Trainee: a. is on the EMPLOYER's payroll, not paid as a contracted employee/independent contractor; and, b. receives the same benefits as EMPLOYER's other employees performing similar work; and, C. is paid the salary as indicated in Exhibit A with appropriate payroll taxes withheld and reported; and, d. is provided Worker's Compensation Insurance coverage, pursuant to state law; and, e. is provided by EMPLOYER with safety instructions and equipment necessary for reasonable protection against injury and damage. CONTRACTOR shall maintain appropriate standards for health and safety in work and training situations. Where special clothing or equipment is provided to the EMPLOYER's regular employees, EMPLOYER shall provide the same type of clothing or equipment to the Trainee performing similar work. 6. Employment of Trainee. The EMPLOYER shall employ the Trainee as a regular member of EMPLOYER's work force. If EMPLOYER wants to continue to employ the Trainee upon the successful completion of the training period under this Agreement, said employment shall be subject to the same conditions of employment applied to EMPLOYER's other regular employees, including termination for unsatisfactory perfonnance. 2 Patent, Copyrights and Rights in Data. The EMPLOYER will disclose to the CITY any invention, written product, computer program developed or data assembled as a result of performance of work under this Agreement within seventy four (74) days of invention, development or assembly. The CITY, State of California, and U.S. Department of Labor will have the right to patent any invention and copyright any written product or computer program or data generated by EMPLOYER. Upon written request, EMPLOYER will transfer all pertinent information, specifications and right, title and interest to the designated agency. 8. INVENTIONS, PATENTS AND COPYRIGHTS. A. Reporting Procedure. If any project produces patentable items, patent rights, processes, or inventions in the course of work under a U.S. Department of Labor (DOL) grant or agreement, the CONTRACTOR shall report the fact promptly and fully to the CITY. The CITY shall report the fact to the Grant Officer, at the DOL. Unless there is a prior agreement between the CITY and the DOL and its representative on these matters, the DOL shall determine whether to seek protection on the invention or discovery. The DOL and its representative shall determine how the rights in the invention or discovery, including rights under any patent issued thereon, will be allocated and administered in order to protect the public interest consistent with the "Governmental Patent Policy" (President's Memorandum for Heads of Executive Departments and Agencies, August 23, 1971, and Statement of Government Patent Policy). B. Copyright Policy. 1. Unless otherwise provided in the terms of the grant or agreement, when copyright -able material is developed in the course of or under a DOL Grant or agreement, the author and the CITY which developed the work is free to copyright material or to permit others to do so. The EMPLOYER and the Workforce Investment Board (WIB) shall have a royalty - free, nonexclusive and irrevocable license to reproduce, publish, use and to authorize others to use all copyrighted material. 2. The DOL reserves a royalty -free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for Federal Government purposes: (a) The copyright in any work developed under any grant, sub -grant, or contract under a grant or subgrant; (b) Any right of copyright to which a grantee, subgrantee or a EMPLOYER purchases ownership with grant support; and (c) EMPLOYER shall comply with the requirements of 29 CFR Part 97.34. C. Rights to Data. The DOL and the CITY shall have unlimited rights to any data first procured or delivered under this Agreement. 9. Hold Harmless. The EMPLOYER shall indemnify, defend and hold harmless CITY, and its officers, agents and employees, from and against any and all damages to property or injuries to or death of any person or persons, including property and employees or agents of CITY, and shall indemnify, defend and hold harmless CITY, and its officers, agents and employees, from any and all claims, demands, suits, actions or proceedings of any kind or nature, including, but not limited to, workers' compensation claims, resulting from or arising out of the negligent acts, errors or omissions of EMPLOYER, its employees, agents or subcontractors. 10. Insurance. The EMPLOYER shall obtain at its sole cost and file with the City of Santa Ana — Santa Ana W/O/R/K Center, upon execution of this Agreement, and maintain for the period covered by this Agreement, a policy or policies of commercial general liability insurance or a certificate of such insurance, satisfactory to the City Attorney of CITY, naming CITY, and its officers, agents and employees, as insured or additional insured (see attached Additional Insured Endorsement, Exhibit C), which provides coverage not less than that provided in the form of a comprehensive general liability insurance policy against liability for any and all claims and suits for damages or injuries to persons or property resulting from or arising out of operations of EMPLOYER, and its officers, agents, or employees. Said policy or policies of insurance shall provide coverage for both bodily injury and property damage in no less than One Million Dollars ($1,000,000). Said policy of comprehensive public liability insurance shall be endorsed to provide to CITY and to the State of California, Employment Development Department, at least thirty (30) days written notice prior to cancellation; name CITY, its officers, agents,;" employees, and volunteers, and the State of California, its officers, employees, and volunteers as additional insured; and state that such coverage is primary to any other coverage or self-insurance of the State of California and CITY. Governmental entities may substitute a certificate of self-insurance. 11. Record Keening. CITY, the State of California and the United States government and/or their representatives shall have access for purposes of monitoring, auditing and examining of EMPLOYER'S activities, performance, books, documents, papers, and records of EMPLOYER'S subcontractors, bookkeepers and accountants, and employees and participants related to this Agreement. Such agencies or representatives shall also schedule on-site monitoring in their discretion. Monitoring activities may also include, but are not limited to, questioning employees and participants and entering any premises or onto any site in which any of the services or activities funded hereunder are conducted or in which any of the records of EMPLOYER are kept. Nothing herein shall be construed to require access to any privileged or confidential information as set forth in federal or state law. In the event EMPLOYER does not make the above -referenced documents available within the City of Santa Ana, California, EMPLOYER agrees to pay all necessary and reasonable expenses incurred by CITY in conducting any audit at the location where said records and books of account are maintained. All accounting records and evidence pertaining to all costs of EMPLOYER and all documents related to this Agreement shall be kept available at the location where EMPLOYER conducted the program, as well as in the County of Orange, for the duration of this Agreement and thereafter for three (3) years after completion of an audit. Records which relate to (a) complaints, claims, administrative proceedings or litigation arising out of the performance of this Agreement, or (b) costs and expenses of this Agreement to which CITY, the State of California or the United States Government take exception, 10 shall be retained beyond the three (3) years until resolution of disposition of such appeals, litigation, claims, or exceptions. 12. Government Funding. This Agreement is valid and enforceable only if sufficient funds are made available to the State by the United States Government for the same Fiscal Year as for this Program. In addition, this Agreement is subject to any additional restrictions, limitations, or conditions enacted by Congress or any statute enacted by Congress which may affect the provision, terms or funding of this Agreement in any manner. 13. Payment Cap. City's OJT payments to EMPLOYER shall not exceed a maximum of fifty percent (50%) of the wages paid by EMPLOYER during the training period specified in Exhibit A. 14. Amendment of Agreement. No alteration or variation of the terms of this Agreement shall be valid and/or binding unless made in writing and signed by both parties. There are no oral understandings or agreements between the parties. 15. Breach/Sanctions. If, through any cause, EMPLOYER violates any of the terms and conditions of this Agreement, or if EMPLOYER reports inaccurately or if any Audit Report makes disallowances, EMPLOYER shall promptly remedy its acts or omissions and/or repay CITY all amounts due CITY as a result of EMPLOYER's violation. For any such failures or violations, CITY. shall also have the right at its sole discretion to either: (1) discontinue program support until such time as EMPLOYER fulfills its obligations or remedies all violations of this agreement or prior agreements; and/or (2) collect outstanding amounts as determined by CITY due CITY by offsetting or debiting from current claims or invoices, if after thirty (30) days' written notice EMPLOYER has failed to repay same or a repayment schedule has not been made; and/or (3) terminate this Agreement by giving written notice to EMPLOYER of such termination in accordance the notice provision in Paragraph XVIII herein below. 16. Termination. Either party may terminate this Agreement upon thirty (30) days prior written notice to the other party. However, the CITY may immediately terminate this Agreement at such time as funds are not made available to CITY through the United States Department of Labor or the State of California Employment Development Department for the purpose of carrying out this Agreement. 17. Independent Contractor. The EMPLOYER, and any agents and employees of the EMPLOYER, in the performance of this Agreement, shall act in an independent capacity as independent contractors and not as officers, employees, or agents of the CITY. This Agreement is not intended nor shall it be construed to create an employer-employee relationship between EMPLOYER and CITY, nor a joint venture relationship. The EMPLOYER shall not subcontract in the name of the CITY. 18. Equal Employment Opportunities. The EMPLOYER warrants that it will comply with Title VI of the Civil Rights Act of 1964, and the requirements relating to equal employment opportunities set forth in Executive Order No. 11246, as amended by E.O. 5 11375 and supplemented by the requirements of 41 CFR Part 60. EMPLOYER will also comply with all applicable federal and state laws and regulations, and particularly those assurances and certifications set forth in Exhibit B attached hereto and by this reference incorporated herein. 19. Prohibitions. The EMPLOYER shall not use any of the training funds provided under this Agreement for political or sectarian activities. 20. Grievance Procedure. The EMPLOYER shall continue to operate, or shall establish and maintain a grievance or complaint handling procedure relevant to the terms and conditions of employment and the EMPLOYER's activities and programs, which shall meet at a minimum the requirements set forth in Section 101(3 1) of the Act and 663.700- 710 and regulations promulgated by the State or Federal Government. Employers that do not have a grievance or complaint handling procedure shall use the procedures prescribed by the CITY. 21:: " Guidelines. The CITY shall'inake the WIA applicable federal regulations and policy guidelines available to EMPLOYER at CITY — W/O/R/K Center, 1000 E. Santa Ana Blvd., Suite 200, Santa Ana, California 92701. The CITY shall also inform the EMPLOYER of changes in the WIA regulations or policy guidelines if such changes affect the operation of this Agreement. 22. Drug Free Work 1p ace. The EMPLOYER agrees to provide a drug-free work place and to execute a certification as set forth in Exhibit D attached hereto and incorporated herein by this reference. 23. Notices. All notices, reports and correspondence between the parties hereto respecting this Agreement shall be in writing and deposited in the United States mail, postage prepaid, addressed as follows: CITY: City of Santa Ana—Santa Ana WORK Center 1000 E. Santa Ana Blvd., Suite 200 Santa Ana, CA 92701 Attention: WORK Center Director EMPLOYER: Swift Engineering, Inc. 1141-A Via Callejon San Clemente, CA 92673 Meg Hewins 24. Debarment. To protect the public interest and ensure the integrity of Federal programs, CITY may only conduct business with responsible persons and may not make any award or permit any award to any party which is debarred or suspended or is otherwise excluded from or ineligible for participation in Federal assistance programs under Executive Order 12549, "Debarment and Suspension". See also 29 CRF Parts 97.35 and 98.510. EMPLOYER must review and sign Exhibit E "Debarment", which is attached hereto and incorporated herein by this reference. 24. Merger. This Agreement, together with the attachments hereto, expresses the total understanding of the parties. There are no oral understandings of the parties or terms and conditions other than as stated herein. 25. Validity. The invalidity in whole or in part of any provision of this Agreement shall not void or affect the validity of any other provision of this Agreement. 26. Miscellaneous Provisions. a. Each undersigned represents and warrants that its signature hereinbelow 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: Maria D. Huizar Clerk of the Council APPROVED AS TO FORM: Sonia R. Carvalho City Attorney ' By: Lisa Storck Assistant City Attorney RECOMMENDED FOR APPROVAL: Jwv-�* Kel y Reen rs Executive Director Community Development Agency CITY OF SANTA ANA David Cavazos City Manager EMPLOYER: Meg He ins HR Director Tax ID#: 33-0453114 Agreement # Exhibit A TRAINING PLAN L GENERAL 1. Name of OJT Employer: Swift Engineering 2. Address of OJT Work -site: 1141-A Via Calleion San Clemente, CA 92673 3. Phone Number: (949)492-6608 4. Training Supervisor: Nate Ogawa 5. Name of OJT Trainee: Jason Carbaial 6. Application Number of Trainee: N/A 7. Grant/Program: HIB OC Bridge 2 Engineering 8. Proportion of trainees/employees: (at time Agreement entered into) a. Total number of employer's regular employees 79 C. Cumulative number of trainees currently in OJT II. OCCUPATION AND ON-THE-JOB TRAINING OUTLINE: 1. Occupation: Composite Technician 2. Length of Time in Business: 31 Years 3. ONET Code: 51-2091.00 SVP Level: 4.0 to < 6.0 4. Hourly Starting Wage: $14.00/hour Start Date: 12/8/14 End Date: 6/30/15 Hours 960 5. State and Federal Tax I.D.: State: Federal 6. Basic Work Week Hours: 40 7. Outline of On -the -Job Training Plan and Method of Assessment: ELEMENTS OF TRAINING HOURS OF TRAINING 1. Fabrication of composite parts using pregreq epoxy resins with carbon, fiberglass, kevlar, and quartz fibers. Employee must gain knowledge of 400 using core products, such as metallic and non-metallic honeycomb. Measurement Method: Q & A, task observation and inspection. Goal is to achieve rate afproficiency within first two Months and a half of training. 2. Lamination of prepreq materials as well as planning, lay -out, fabrication and building adhesive bonded assemblies of metallic and 120 non metallic composite materials. Measurement Method. Q & A, task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 3. Fabricating composite and metal parts into subassemblies using bonding and hardware installation for curing in presses, ovens, and 120 autoclaves. Measurement Method. Q & A task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 4. Reading and interpreting work instructions, specifications sketches, job travelers, planning documents and engineering drawings. 120 Measurement Method. Q & A task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. 5. Training will be required on use of autoclave, pneumatic tools for trimming, drilling and bonding of hardware, use of technical devices for 200 measurements, and gerber/ply cutting equipment. In addition, the employee will need to have a strong understanding and knowledge of safety procedures for equipment utilized including: Vacuum pumps, heat sources, special hand tools, ladders, stands, mechanical stands, hi -reach lifts. Measurement Method., Q & A task observation and inspection. Goal is to achieve rate of proficiency within subsequent three and a half months. RATING LEVELS: Measurement method: how will it be determined if OJT participant acquired the skill? Q&A, observation, product review/inspection, etc. PROFICIENT MODERATE MARGINAL II. COST COMPUTATION Hourly Reimbursement: $7.00/hour (50% of $14.00/hour) Training Hours: 960 Cost Per Trainee (Hourly Reimbursement X Training Hours) _ $ 6,720 III. Person(s) authorized to sign payment invoices for EMPLOYER: A X'4t,1A Print Name Print Nlamc Sii\gnatur Signa re j)I9n:70 Z OF rp S Title ��( 0� I Title ll�/l� Date DC Dae 2 ASSURANCES A. The EMPLOYER assures that: 1. It will comply with the requirements of the Workforce Investment Act (WIA), the California Unemployment Insurance Code, as amended, and the regulations and policies promulgated thereunder. 2. No OJT participant displaces a regular employee nor shall an OJT participant fill a position of a person who has been laid off from the same or similar position. 3. No current employees are receiving unemployment insurance benefits as a result of layoffs or work reductions. 4. No person in the United States shall on the grounds of race, color, sex, religion, national origin, age, disability, sexual orientation, or marital status be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the applicant receives federal financial assistance and will immediately take any measure necessary to effectuate this Agreement. 5. It will comply with provisions of the Hatch Act, if applicable, which limits the political activities of employees. 6. Individuals receiving training on the job shall be compensated by the EMPLOYER at such rate, including periodic increases, as may be deemed reasonable under regulations prescribed by the Secretary of Labor, but in no event at a rate less than that specified in Section 6 (a) (1) of the Fair Labor Standards Act of 1938 or, if higher, under the applicable State or local minimum wage law. 7. Services and activities provided under this Agreement will be administered by or under the supervision of the EMPLOYER. 8. No relative by blood, adoption or marriageu of the EMPLOYER may be trained under this Agreement. 9. Appropriate standards for health and safety in work and training situations will be maintained. 10. Conditions of employment or training are appropriate and reasonable with regard to the type of work, the geographical region, and the proficiency of the trainee. 11. Training will not be for any occupation which requires less than six weeks of training according to the Specific Vocational Preparation Table (SVP Code). 12. Training will, to the maximum extent practicable, be consistent with every individual's fullest capabilities and lead to employment possibilities. 13. The program will, to the maximum extent feasible, contribute to the occupational development or upward mobility of individual participants. 14. Training will be in accordance with the training plan, which plan incorporates documentation that must be completed by EMPLOYER before end of contract. EXHIBIT B 15. *Dot and **SVP code books will be used to determine length of OJT period. The training time may not be longer than the SVP Code allows; however, contractors are encouraged to negotiate shorter training periods whenever applicable. 16. OJT trainees shall not number more than 40% of the EMPLOYERS work force. 17. All EMPLOYER training payments (reimbursements) must be exclusive of any and all EMPLOYER fringe benefits, paid holidays, paid sick days and overtime compensation. 18. The participating EMPLOYER must keep an accurate and up-to-date time sheet for the OJT trainee. 19. Payroll records, time and attendance records and job duties retained on file by the participating EMPLOYER for each OJT trainee are subject to review. NO W1f", 1�Imila���� Empl yer Signature Date EXHIBIT B A!eo® CERTIFICATE OF LIABILITY INSURANCE DAT 11/S/2014Yv) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Wood -Gutmann & Bogart/11113 940 Calle Negocio, Ste. 240 San Clemente, CA 92673 CONTACT PHONE 049 542-7800 ac No; 949 542-7804 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC N 36001513 INSURER A: Federal Insurance Company A++ XV 20281 www.lntegrityint.com INSURED Swift Eng, Inc. 1141 - NaA ViCal lI INSURER a : Hartford Fire Insurance Company A XV INSURER C: INSURER D: San Clemente CA 92673 INSURER E: PERSONAL &ADV INJURY $ 1,000,000 INSURER F: GENERAL AGGREGATE $ 2,000,000 COVERAGES CERTIFICATE NUMBER: 22251611 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IR LT LTR TYPE OF INSURANCE ADDLSUBR AUTHORIZED REPRESENTATIVE POLICY NUMBER POLICY EFF MM DD YY POLICY EXP MM/DDIYYYY LIMITS A GENERAL LIABILITY CL AIMS -MAGE OCCUR ✓ ✓ 36001513 4/1/2014 4/1/2015 EACH OCCURRENCE $ 1,000,000 �COMMERCIAL DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 GEN'L MED UP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- ❑ LpC ECT OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ EXCLUDED Em .Benefits $ 11000,000 A AUTOMOBILE ✓ ✓ LIABILITY ANYAUTO ALL OWNEDSCHEDULED AUTOS AUTOS NON -OWNED HIREOAUTOS V, AUTOS 73583614 4/1/2014 4/1/2015 CM Ee accident SINGLE LIMIT $ 1,000,()00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accIdent Como/Coll Ded 1000 $ A UMBRELLA LIAR EXCESS LIAR ,/ OCCUR CLAIMS -MADE 79690517 4/1/2014 4/1/2015 EACH OCCURRENCE $ 51000,000 AGGREGATE $ 5,000,()00 DED ✓ RETENTION$10,000 $ B WORKERS COMPENSATION EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? F� (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 72WEEX7404 7/1/2014 7/1/2015�/ STATUTE ETH AND E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYE $ 1,0oo,()OO EL.DISEASE - POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate holder, its officers, agents, and employees are named as Additional Insuerd with respect to General Liability per the attached carrier endorsement. �9 A *60 Day Notice of cancellation (20 Days for Non -Payment of premium), .� � /�10 yam' Jam( ri/ CERTIFICATE HOLDER CANCELLATION _ 71 Cit of Santa Ana City an Attn: Purchasing Department 20 Civic Center Plaza SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Santa Ana CA 92701 AUTHORIZED REPRESENTATIVE Dan Gorman ©1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD CER'P NO.: 22231611. Vail Brady Roe 11/5/2014 10:29:26 AM (PST) Page 1 of 1 EXHIBIT C ADDITIONAL INSURED ENDORSEMENT Insurance Company )�� L W Y&/Y)ck `-" ' ' y"`%P This endorsement modifies such insurance as is afforded by the provisions of Policy # - ;5l 6tt) �� l relating to the following: 1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702; its officers, employees, agents and volunteers are named as additional insureds ("additional insureds") with regard to liability and defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be canceled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92702. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy # D Issued to 1 119 this endorsement form as a part of Nahied Insured Countersigned by Authorized Representative �� Liability Insurance Schedule of Forms Policy Period APRIL 1, 2014 TO APRIL 1, 2015 Effective Date OCTOBER 14, 2014 Policy Number 3600-15-13 NBO Insured SWIFT ENGINEERING INC Name of Company FEDERAL INSURANCE COMPANY Date Issued OCTOBER 29, 2014 The following is a schedule of forms issued as of the date shown above: Form Number Edition Date Form Name Effective Date Date Issued 80-02-2367 8-04 ADDL INS - SCHEDULED PERSON OR ORGANIZATION 10/14/14 10/29/14 80-02-6400 12-07 EXCLUSION OF CERTIFIED ACTS OF TERRORISM 04/01/14 04/23/14 80-02-0010 4-94 LIABILITY DECLARATIONS 10/14/14 10/29/14 80-02-2002 4-01 PREMISES/OPERATIONS 04/01/14 04/23/14 80-02-2012 6-98 EMPLOYEE BENEFITS ERRORS OR OMISSIONS 04/01/14 04/23/14 80-02-2328 4-01 CUMIS-CALIFORNIA 04/01/14 04/23/14 80-02-2651 4-01 CUNES-CALIFORNIA 04/01/14 04/23/14 80-02-2658 4-01 EXCLUSION -PRIVACY 04/01/14 04/23/14 80-02-2672 10-01 EXCL-DAMAGE TO ALIENATED PREMISES/WORK/RECALL 04/01/14 04/23/14 80-02-6428 8-04 EXCLUSION-PROFESSIONALLIABILITY,TOTAL 04/01/14 04/23/14 80-02-6528 1-13 EXCL-INFO LAWS INCL UNAUTHORUNSOLICTCOMMUN 04/01/14 04/23/14 80-02-6541 3-05 CONDITION -PREMIUM AUDIT 04/01/14 04/23/14 80-02-6552 5-05 EXCLASBESTOS,SILICA,SIMCMPDINCL MIXED DUST 04/01/14 04/23/14 80-02-6560 4-04 EXCLUSION -BIOLOGICAL AGENTS, TOTAL 04/01/14 04/23/14 80-02-6563 4-04 EXCLUSION-LEAD,TOTAL 04/01/14 04/23/14 80-02-6595 5-06 DEDUCTIBLES 04/01/14 04/23/14 Deference Copy last page Form 80-02-2999 (ED. 6-95) Schedule of Forms Page 1 Liability Insurance Declarations Named Insured and Mailing Address SWIFT ENGINEERING INC 1141A VIA CALLEJON SAN CLEMENTE, CA 92673 Chubb Group of Insurance Companies 15 Mountain View Road Warren, NJ 07059 Policy Number 3600-15-13 NBO Effective Date OCTOBER 14, 2014 Issued by the stock insurance company indicated below, herein called the company. FEDERAL INSURANCE COMPANY Producer No. 0010318 Incorporated under the laws of INDIANA Producer WOOD GUTMANN & BOGART INSURANCE BROKERS 15901 RED HILL AVE, #100 TUSTIN, CA 92780-0000 Policy Period From: APRIL 1, 2014 To: APRIL 1, 2015 12:01 A.M. standard time at the Named Insured's mailing address shown above. Liability Coverage Limit Of Insurance PREMISESIOPERATIONS GENERAL AGGREGATE I = $ 2,000,000 EACH OCCURRENCE LEVITT $ 1,000,000 ADVERTISING INJURY AND $ 1,000,000 PERSONAL INJURY AGGREGATE LIMIT DAMAGE TO PREMISES $ 1,000,000 RENTED TO YOU I= MEDICAL EXPENSES LIMIT $ 10,000 Reference Copy Liability Insurance Issue Date: OCTOBER 29, 2014 214�eoeVb � continued Form 80-02-0010 (Ed. 4-94) Declarations Page 1 Liability Coverage (continued) EMPLOYEE BENEFITS ERRORS OR OMISSIONS AGGREGATE LIMIT EACH CLAIM LIMIT DEDUCTIBLE - EACH CLAIM RETROACTIVE DATE STATE: CALIFORNIA Limit Of Insurance $ 1,000,000 $ 1,000,000 $ 1,000 APRIL 1, 2014 l = .P..1LL�A4�,'-� RATING INFORMATION COVERAGE NAME: PREM OPS CLASSIFICATION CODE NUMBER: 00184 CLASSIFICATION DESCRIPTION: METAL PRODUCTS FABRICATING NOC - LOW PREMIUM BASIS: GROSS SALES: $10,250,000 RATE: - 0,757 STATE: CALIFORNIA EMPLOYEE BENEFITS CLASSIFICATION CODE NUMBER: CLASSIFICATION DESCRIPTION: EMPLOYEE BENEFITS E&0 PREMIUM BASIS: NUMBER OF EMPLOYEES: RATE: Reference Copy Liability Insurance Issue Date: OCTOBER 29, 2014 00176 43 6.977 ? U last page Form 80-02-0010 (Ed. 4-94) Declarations Page 2 Liability Insurance Endorsement Policy Period APRIL 1, 2014 TO APRIL 1, 2015 Effective Date OCTOBER 14, 2014 Policy Number 3600-15-13 NBO Insured SWIFT ENGINEERING INC Name of Company FEDERAL INSURANCE COMPANY Date Issued OCTOBER 29, 2014 "'%:.ntiJ/// \�/'_'FiU%N\"- .�:RN✓//p/„`PU II /O.\OU//q- /"O\�/aa\//M\.Hl:i�"n/N//l". �. /i/irll\Vi/. \ /i <QOYYlh'A ✓//�S SYMm:I\'/ \\�C'%q.�ti\✓///i' V b1�\%///n\\VN.G This Endorsement applies to the following forms: PREMISES/OPERATIONS _..� .,,. ,,�..> _ ��,,� ✓ ..�.. -- .,.,�. ..��, ,m..,� _ � ..�.. �....., . �,,., �.. a.,, Pau.., Under Who Is An Insured, the following provision is added: Who Is An Insured Scheduled Person Or Subject to all of the terms and conditions of this insurance, any person or organization shown in the Organization Schedule, acting pursuant to a written contract or agreement between you and such person or organization, is an insured; but they are insureds only with respect to liability arising out of your operations, or your premises, if you are obligated, pursuant to such contract or agreement, to provide them with such insurance as is afforded by this policy. However, no such person or organization is an insured with respect to any: assumption of liability by them in a contract or agreement. This limitation does not apply to the liability for damages for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement, damages arising out of their sole negligence. Schedule CITY OF SANTA ANA, ITS OFFICERS, AGENTS AND EMPLOYEES 20 CIVIC CENTER PLAZA SANTA ANA CA 92701 fid,'. Reference Copy Liability Insurance Additional Insured- Scheduled Person Or Organization continued Form 80-02-2367 (Rev. 8-04) Endorsement Page 1 Liability Endorsement (continued) Liability Insurance Form 80-02-2367 (Rev. 8-04) All other terms and conditions remain unchanged. Authorized Representative Vc---.AV.__a Reference Copy Additional Insured - Scheduled Person Or Organization Endorsement ' B '71 / Atz; J lastpage Certification Regarding Drug -Free Workplace Requirements The certification set out below is a material representation upon which reliance is placed by the U.S. Department of Housing and Urban Development in awarding the grant. If it is later determined that the contractor knowingly rendered a false certification, or otherwise violates the requirements of the Drug -Free Workplace Act, the U.S. Department of Housing and Urban Development, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug -Free Workplace Act. CERTIFICATION A. The contractor certifies that it will provide a drug-free workplace by: (a) Publishing a statement notifying employees that the unlawful manufacture; distribution, dispensing, possession or use of a controlled substance is prohibited in the contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; (b) Establishing a drug-free awareness program to inform employees about - (1) The dangers of drug abuse in the workplace; (2) The contractor's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance program; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; (c) Making it a requirement that each employee who will be engaged in the performance of the grant be given a copy of the statement required by paragraph (a); (d) Notifying the employee in the statement required by paragraph -(a) that, as a condition of employment under the contract, the employee will - Pg. 2 (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction. EXHIBIT D (e) Notifying the U.S. Department of Housing and Urban Development within ten days after receiving notice under subparagraph (d)(2) from an employee or otherwise receiving actual notice of such conviction; (f) Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(2), with respect to any employee who is so convicted - ( 1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; (g) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (a), (b), (c), (d), (e) and (f). B. The contractor shall insert in the space provided on the attached "Place of Performance" form the site(s) for the performance of work to be carried out with the grant funds (including street address, city, county, state, and zip code) .the contractor further certifies that, if it is subsequently determined that additional sites will be used for the performance of work under the contract, it shall notify the U.S. Department of Housing and Urban Development immediately upon the decision to use such additional sites by submitting a revised "Place of Performance' form. Dated: �o Q1 ki�)1 L Employer Signature EXHIBIT D �FTi-i it I _.Ft'IM- 0, l k9�qll I IVLyr DIVISION OF EMPLOYMENT SERVICES PLACE OF PERFORMANCE FOR CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Date: I l_ ?r0 __WIC The Contractor shall insert in the space provided below the site(s) expected to be used for the performance of work under the contract covered by the certification: Place of Performance (include street address, city, county, state, zip code for each site): Swift Engineering Inc. Human Kesources 1141A Via Call '� n ��I£lemente-�.r-2673 Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions This certification is required by the regulations implementing Executive Order 12549, Debarment and Suspension, 29 CFR Part 98, Section 98.510, Participants' responsibilities. The regulations were published as Part VII of the May 26,1988 Federal Register (pages 19160-19211). (BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS FOR CERTIFICATION - Attached) _(1) The prospective recipient of federal assistance finds certifies, by submission of this proposal, that - - neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department or agency. (2) Where the prospective recipient of federal assistance funds is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Name and Titld of Authorized Representative Signature IDate EXHIBIT E INSTRUCTIONS FOR CERTIFICATION By signing and submitting this proposal, the prospective recipient of federal assistance funds is providing the certification as set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective recipient of federal assistance funds knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the Department of Labor (DOL) may pursue available remedies, including suspension and/or debarment. 3. The prospective recipient of federal assistance funds shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective recipient of federal assistance funds learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms 'covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective recipient of federal assistance funds agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the DOL. 6. The prospective recipient of federal assistance funds further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and voluntary exclusion - Lower Tier Covered Transactions," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to check the List of Parties Excluded from Procurement or Non - Procurement Programs. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded fiom participation in this transaction, in addition to other remedies available to the Federal Government, the DOL may pursue available remedies, including suspension and/or debannent. EXHIBIT E SANTA ANA CENTER AMERICANS WITH DISABILITY ACT (ADA) AND EQUAL OPPORTUNITY (EO) LAW I. Is there a minimum of 2 designated disabled parking slots? Per Dept. of Rehab Sect. 504 YES NO❑ II. Are parking slot occupants able to reach the building's entrance for the disabled without having to go behind any other cars, or any other barriers (curb, sidewalks, etc.)? Per Dept. of Rehab. Sect. 504 YESSO NOF -1 III. Is there a front door labeled with the international wheelchair access sign? Per Dept. of Rehab. Sect. 504 YES NOF -1 IV. Is the labeled entrance's threshold not higher than V2 inch tWallow for wheelchair access? Per Dept. of Rehab. Sect. 504 YESFA NOF-] V. Is the door -handle to the labeled wheelchair entrance door, a lever handle (not a round doorknob)? Per Dept. of Rehab. Sect. 504 YE1y NOF -1 VI. If any services are available on second floor, does the build' g have an elevator? Per Dept. of Rehab. Section 504 YES` NO❑ NAF -1 VII. Does the classroom, working area, and break -room have enough room to maneuver a wheelchair and/or crutches? Per Dept, of Rehab. Sect. 504 YES[ NOR VIII. Does the school catalog / employee manual, contain the organization's Grievance Policy? Per CFR Title 20, 29, 41 YES NO❑ IX. Is Grievance Procedure and contact person made available in writing to the participant on first day of attendance? Per CFR Title 20,29,41 YEN NO❑ X, If seining any Limited English individuals is the grievance procedure and procedures available in their language? Per CFR Title 20,29,41 YES❑ NO[:] NAE)O XI. Is assessment used in a non-discriminatory way? (used to determine suitability for training and/or employment based on industry recognized required skills)? Per CFR Title 20,29,41 YE97 NOF] XII. Is there at least one internationally labeled accessible restroom for the disabled? Per Dept. of Rehab. Sect. 504 YES❑ NO❑ XIII. Does toilet stall for the disabled have bars on each side of wall? Per Dept. of Rehab. Sect. 504 YESP NO❑ XIV. Is there a telephone reasonably accessible to handicap individuals? Per Dept, of Rehab. Sect. 504 YES® NO❑ XV. Is there a water fountain reasonably accessible to disabled '- dividuals? Per Dept. of Rehab. Sect. 504 YESIM NOF -1 XVI. Are auxiliary (supplementary) aides available when requested by the individual? Per CFR Title 20,29,41 YE NOF -1 XVII. Do all contracts and agreements signed by the individual contain Employer Equal opportunity employer language? CFR Title 20,29,41 YES[ NOF I certify that I have validated all Service Provider Information: WV i First Na e Service P ovrder Signature Business Address Business Phone Number responses: O/ K r S1 Date �kw6U Last Name 1t -x- I4 Date COMPLIANCE STATUS Summary Sheet Reviewer: / r r Site Visit Date: 1 f moll'- f Contract/Vendor Informatio Director/Supervisor Name: �a�l 011 _ HK— � 1P Business Name: inecrinn Inr Address: Human Resourcm Phone #: Clemente Program Element Compliance Status I Person Responsible Mods. Mod. Cost Time Frame Location Based on site visit and survey responses the site does not have any ADA or EO issues to correct. ❑ Currently ADA accessibility not fully available. WIA funds will not be released until the facility corrects issues to meet applicable Dept. of Rehab. Section 504 requirements? ❑ Currently EO issue exist. WIA funds will not be released until the organization corrects EO issues to meet applicable CFR 20, 29, 41 requirements. I have been informed of the ADA & EO site visit review outcome(s). Director/ upervisor Date Certification Regarding the Americans with Disabilities Act This certification is required by the regulation 101-336 (42 U.S.C. 512101) enforced through the Department of Rehabilitation and mandated by the Governor of California. ADA has been in effect since 1990, with the mission to provided equal protection to individuals with disabilities in the public and private sector services, transportation, communications and employment. I hereby certify that the following statement is correct and honestly states that our program facility is in compliance with the Americans Act with Disabilities (ADA). I understand that Title I — V of the Act also applies to Workforce Investment Act (WIA) participants entering training under the Workforce Investment Board / Youth Council funding. Ko -q Se ice Provider Signature Ike 6 .,- Print First Name Organization Date )� eu)�'A's Print Last Name Ryfiff rga fIbhw.0 "'v' Human esources 1141A Via Callejon, San Clemente CA, 92673 D j Swift Engineering Inc. 1.02 EMPLOYEE RELATIONS Swift believes that the work conditions, wages, and benefits it offers to its employees are competitive with those offered by other employers in this area and in this industry. If employees have concerns about work conditions or compensation, they are strongly encouraged to voice these concerns directly to their supervisor, the Controller or the Executive Vice President. Our experience has shown that when employees deal openly and directly with the supervisors and managers at swift, the work environment can be excellent, communications can be clear, and attitudes can be positive. 10 Form �M9 Request for Taxpayer Give Form to the (Rev. August2073) Identification Number and Certification resident alien, sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other requester. Do not send to the IRS. Depanment Internal of the Treasury Revenue Service TM _ m _ entitles, It Is your employer Identification number (EIN). if you do not have a number, see How to get a Name (as shown on your income tax return) Cf Business name/disregarded entity name, If different from above Note. If the account is In more than one name, see the chart on page 4 for guidelines on whose m Swl« rct�1C INC—fir (t�fr INC. Under penalties of perjury, I certify that: The number shown on this form Is my correct taxpayer Identification number (or I am waiting for a number to be Issued to me), and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and S. I am a U.S. citizen or other U.S, person (defined below), and 4. The FATCA code(s) entered on this form (If any) Indicating that I am exempt from FATCA reporting Is correct. Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interesI nd dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Instructions on Dace 3. Sign Signature of Here I U.S.person► Dole General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. The IRS has created a page on IRS.gov for information about Form W-9, at www.lrs.gov/w9. Information about any future developments affecting Form W-9 (such as legislation enacted after we release It) will be posted on that page. Purpose of Form A person who is required to file an Information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, Income paid to you, payments made to you in settlement of payment card and third party network transactions, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA, Use Form W-9 only if you are a U.S. parson (Including a resident alien), to provide your correct TIN to the person requesting It (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (oryou are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding If you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership Income from a U.S, trade or business Is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA sepals) entered on this form (if any) Indicating that you are exempt from the FATCA reporting, is correct. Note. If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form If it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien, • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, • An estate (other than a foreign estate), or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United Stales are generally required to pay a withholding tax under section 1446 on any foreign partners' share of effectively connected taxable Income from such business. Further, in certain cases where a Forth W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner In a partnership conducting a trade or business in rho United States, provide Form W-9 to the partnership to establish your US, status and avoid section 1446 withholding on your share of partnership Income. Cat. No. 10231X Form W-9 (Rev. 8-2013) Form W-9 (Rev. 8-2013) In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net Income from the partnership conducting a trade or business in the United States: • In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity, • In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S, grantor or other U.S. owner of the grantor trust and not the trust, and • In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person athe U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Publication 515, Withholding otTax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien Individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of Income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of Income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of Income, you must attach a statement to Form W-9 that specifies the following five items: 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. -2. The treaty article addressing the income. -3. The article number (or location) In the tax treaty that contains the saving clause and its exceptions, 4. The type and amount of Income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China Income tax treaty allows an exemption from tax for scholarship Income received by a Chinese student temporarily present In the United States. Under U.S. law, this student will become a resident alien for tax purposes If his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even atter the relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity, give the requester he appropriate completed Pon W-8 or Form 8233. What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS a percentage of such payments. This Is called "backup withholding." Payments that may be subject to backup withholding Include interest, tax-exempt Interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you resolve If you give the requester your correct TIN, make the proper certifications, and report all your taxable Interest and dividends on your tax return. Payments you receive will be subject to backup withholding If - 1. You do not furnish your TIN to the requester, 2. You do not cerci fy your TIN when required (see the Part if instructions on page 3 for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable Interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under above (for reportable Interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. Sae Exempt payee code on page 3 and the separate Instructions for the Requester of Form W-9 for more information. Also see Special miss for partnerships on page 1. What Is FATCA reporting? The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial Institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code on page 3 and the Instructions for the Requester of Form W-9 for more information. Page 2 Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee If you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated Information If you are a C corporation that elects to be an S corporation, or If you no longer are tax exempt. In addition, you must furnish a new Form W-9 If the name or TIN changes for the account, for example, If the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure Is due to reasonable cause and not to willful neglect. Civil penalty, for false Information with respect to withholding, If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Criminal penalty forfalsifying Information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or Imprisonment. Misuse of TINs. If the requester discloses or uses TINS in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Name If you are an individual, you must generally enter the name shown on your income tax return. However, if you have changed your last name, for instance, due to marriage without Informing the Social Security Administration of the name change, enter your first name, the last name shown on your social security card, and your new last name. If the account Is in joint names, list first, and then clmle, the name of the person or entity whose number you entered in Part I of the form. Sole proprietor. Enter your individual name as shown on your Income tax return on the "Name" line. You may enter your business, trade, or "doing business as (DBA)" name on the "Business name/disregarded entity name" line. Partnership, C Corporation, or S Corporation. Enter the unity's name on the "Name" line and any business, trade, or "doing business as (DBA) name" on the "Business nameldisregarded entity name" line. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a "disregarded entity." See Regulation secllon 301.7701-2(c)(2)(ili). Enter the owner's name on the "Name" fine. The name of the entity entered on the "Name" line should never be a disregarded entity. The name on the "Name" line must be the name shown on the Income tax return on which the Income should be reported. For example, if a foreign LLC that Is treated as a disregarded entity for U.S, federal tax purposes has a single owner that is a U.S. person, the U.S, owner's name Is required to be provided on the "Name' fine. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on the "Business name/disregarded entity name' line. If the owner of the disregarded entity Is a foreign person, the owner must complete an appropriate Form W-8 Instead of a Form W-9. This Is the case even if the foreign person has a U.S. TIN. Note, Check the appropriate box for the U.S. federal tax classification of the person whose name is entered on the "Name" line (Ini ividualhole proprietor, Partnership, C Corporation, S Corporation, Trust/estate). Limited Liability Company (LLC). If the person Identified on the "Name" line is an LLC, check the "Limited liability company" box only and enter the appropriate code for the U.S. federal tax classification in the space provided. If you are an LLC that Is treated as a partnership for U.S. federal tax purposes, enter "P" for partnership, It you are an LLC that has filed a Form 8832 or a Form 2553 to be taxed as a corporation, enter "C" for C corporation or "S" for S corporation, as appropriate. If you are an LLC that is disregarded as an entity separate from its owner under Regulation section 301-7701-3 (except for employment and excise tax), do not check the LLC box unless the owner of the LLC (required to be Identified on the "Name" line) Is another LLC that Is not disregarded for U.S. federal lax purposes. If the LLC Is disregarded as an entity separate from its owner, enter the appropriate tax classification of the owner identified on the "Name" line. Other entities. Enter your business name as shown on required U.S. federal tax documents on the "Name" line. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on the "Business name/disregarded entity name" line. Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter In the Exemptions box, any castle) that may apply to you. See Exempt payee code and Exemption from FATCA reporting code on page 3. Form W-9 (Rev. B-2013) Exempt payee code. Generally, Individuals (including sole proprietors) are not exempt from backup withholding. Corporations are exempt from backup withholding for certain payments, such as interest and dividends. Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. Nota. It you are exempt from backup withholding, you should still complete this farm to avoid possible erroneous backup withholding. The following codes identify payees that are exempt from backup withholding: 1 -An organization exempt from tax under section 501(a), any IPA, or a custodial account under section 403(6)(7) It the account satisfies the requirements of section 407(1)(2) 2 -The United States or any of its agencies or instrumentalities 3-A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or Instrumentalities 4-A foreign government or any of Its political subdivisions, agencies, or Instrumentalltles 5-A corporation 6-A dealer In securities oocommoditles required to register In the United Slates, the District of Columbia, or a possession of the United States 7-A futures commission merchant registered with the Commodity Futures Trading Commission 8-A real estate investment trust 9 -An entity registered at all times during the tax year under the Investment Company Act of 1940 10-A common trust fund operated by a bank_ under section 51 -11 -A financial institution ' 12-A middleman known In the investment community as a nominee or custodian 13-A trust exempt from tax under section 664 or described in section 4947 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for... THEN the payment is exempt for... Interest and dividend payments - - All exempt payees except for 7 Broker transactions Exempt payees 1 through 4 and e through i i and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012. Barter exchange transactions and Exempt payees 1 through 4 patronage dividends Payments over $600 required to be Generally, exempt payees reported and direct sales over $5,000' 1 through 5' Payments made In settlement of Exempt payees 1 through 4 payment card or third party network transactions i See Form 1099-MISC, Miscellaneous Income, and its instructions, 'However, the following payments made to a corporation and reportable on Form 1099-MISO are not exempt from backup withholding: medical and health care payments, attorneys' tees, gross proceeds paid to an attorney, and payments for services paid by a federal executive agency, Exemption from FATCA reporting code. The following codes identify payees that we exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United Slates by certain foreign financial Institutions. Therefore, If you are only submitting this form for an account you hold In the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain it the financial Institution Is subject to these requirements, A -An organization exempt from tax under section 501(a) or any Individual retirement plan as defined In section 7701(a)(37) 13 -The United States or any of Its agencies or Instrumentalities C -A state, the District of Columbia, a possession of the United States, or any of their political subdivisions or instrumentalRies D -A corporation the stock of which Is regularly traded on one or more established securities markets, as described in Reg. section 1.1472-1(e)(1)(i) E-A corporation that is a member of the same expanded affiliated group as a corporation described In Reg. section 1.1472-ife)(1)(9 F -A dealer In securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that Is registered as such under the laws of the United States or any state Page 3 G -A real estate Investment trust H -A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I -A common trust fund as defined in section 684(a) J -A bank as defined in section 581 K -A broker L-A trust exempt from tax under section 664 or described In section 4947(a)(1) M -A tax exempt trust under a section 403(6) plan or section 457(9) plan Part I. Taxpayer Identification Number (TIN) Enter your TIN In the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (iTIN). Enter it In the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your BEN or EIN. However, the IRS prefers that you use your SEN. If you are a single -member LLC that is disregarded as an entity separate from its owner (see Limited Liability Company /LLC) on page 2), enter the owner's SSN (or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN. Note. See the chart on page 4 for further clarification of name and TIN combinations. How to get a TIN. It you do not have a TIN, apply for one immediately. To apply for an BEN, get Form SS -5, Application for a Social Security Card, from your local Social Security Administration office or get this form online at www.sm.gov. You - may also get this form by calling 1-800-772-1213. Use Form W-7, Application for - IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form Si Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.insgowbusinamas and clicking on Employer Identification Number (EIN) under Starting a Business. You can get Forms W-7 and 8S-4 from the IRS by visiting IRS.gov or by calling 1 -800 - TAX -FORM (1-800-829.3676). If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write "Applied For" in the space for the TIN, sign and date the form, and give It to the requester. For Interest and dividend payments, and certain payments made with respect to readily tradable Instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60 -day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note. Entering "Applied For" means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8. Part II. Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if items 1, 4, or 5 below Indicate otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on the "Name" line must sign. Exempt payees, see Fxempfpayee code eadler. Signature requirements. Complete the certification as indicated in items 1 through 5 below. 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1981 You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the term. 3. Real estate transactions. You must sign the certification. You may cross out Item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an Incorrect TIN, "Other payments" Include payments made In the course of the requester's trade or business for rents, royalties, goods (other than bills far merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made In settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). S. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 629), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. Form W-9 (Rev. 8-2013) Page 4 What Name and Number To Give the Requester For this type o1 account Give name and SSN of: 1. Individual The individual 2. Two or more Individuals (joint The actual owner of the account or, account) if combined funds, the first Individual on the account' 3, Custodian account of a minor The minor` (Uniform Gift to Minors Act) 4. a. The usual revocable savings The grantor -trustee' trust (grantor is also trustee) b. So-called trust account that is The actual owner' not a legal or valid trust under stale law S. Sete proprietorship or disregarded The owner' entity owned by an Individual 6. Grantor trust filing under Optional The grantor' Form 1099 Filing Method 1 (see Regulation section 1.6714(b)(2)(t)(A)) For this typo of account Give name and EIN of. 7. Disregarded entity not owned by an The owner Individual B.A valid trust, estate, or pension trust Legal entity' 9. Corporation or LLC electing The corporation corporate status on Form 8832 or Form 2553 10. Associa0on, club, religious, The organization charitable, educational, or other tax-exempt organization 11. Partnership or multi -member LLC The partnership 12. A broker or registered nominee The broker or nominee 13. Account with the Department of The public entity Agriculture In the name of a public- entity (such as a state or local government, school district, or prison) that receives agricultural - - program payments 14. Grantor trust filing under the Form The trust 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulation section 1.671-4(b)(2)(ii(B)) ' list first and circle the name of the parson whose number you furnish. If only one person on a Joint account has an SSN, that person's number must be furnished. ' Circle the minors name and fumish the minor's SSN. c You must show your Individual name and you may also enter your business or °DBA" name on the 'Business naraddisregarded entity" name line. You may use either your SSN or GIN Of you have one), but the IRS encourages you to use your SSN. ' Ust first and circle the name of the best, estate, or penslon fust. (Da not fumish the TIN of the personal representative or trustee unless the legal evilly Itself is not designated in the account filo.) Also sea Special rules lorpartnerships on pogo 1. 'Nota. Grantor also must provide a Form W-9 to trustee of trust. Privacy Act Notice Section 6100 of the Internal Note. If no name Is circled when more than one name Is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records from Identity Theft Identity theft occurs when someone uses your personal Information such as your name, social security number (SSN), or other identifying information, without your permission, to commit fraud or other crimes. An Identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: • Protect your SSN, • Ensure your employer Is protecting your SSN, and • Be careful when choosing atax preparer. If your tax records we affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by Identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039. For more Information, see Publication 4535, Identity Theft Prevention and Victim Assistance. Victims of Identity theft who are experiencing economic harm or a system problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance, You can reach TAS by calling the TAS toll-free was intake line at 1-877-7774778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious emails or phishing schemes, Phishing Is the - - creation and use of email and websites designed to mimic legitimate business smells and websites. The most common act Is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private Information that will be used for Identity theft. The IRS does not initiate contacts with taxpayers via entails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers,passwords, or similar secret access information for their credit card, - - bank,orotherfinancialaccounts. - If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing®irs.gov. You may also report misuse of the IRS name, 1090, _ or other IRS property to the Treasury Inspector General for Tax Administration at 1-800-366-4484. You can forward suspicious emails to the Federal Trude Commission at spam®uce.gov or contact them at www.Ragovlldtheft or 1-877- IDTHEFT (1-877-438-4338). Visit RS.gov to learn more about identity theft and how to reduce your risk are of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person col [acting this form uses the Information on the form to file Information returns with the I reporting the above Information. Routine uses of this information Include giving It to the Department of Justice for civil and criminal litigation and to cities, states, the DI of Columbia, and U.S. commonwealths and possessions for use In administering their laws, The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terodsm. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information. Electronic Funds Transfer (EFT or ACH) Program Guidelines for Participants These guidelines apply to payees who elect to participate in the Electronic Funds Transfer (EFT or ACH) program offered by the City of Santa Ana. If you elect to participate in the City of Santa Ana's Electronic Funds Transfer program, payments formerly made by check will be made by electronic funds transfer through the Automated Clearing House (ACH) network. Use of Electronic Funds Transfer as a form of payment means funds will be available in your account within two business days from the date of payment. Identifying Your Bank Account • You must complete the Electronic Payment (ACH) Enrollment Form on page two and print it on your organization's letterhead. • The Payee/Company Information section must be signed and dated by an authorized individual in your organization. • The Bank/Financial Institution Information section must be signed by an authorized officer of the bank/financial institution. Setting Up Electronic Payments • Upon City of Santa Ana's receipt of the Electronic Payment (ACH) Enrollment Form, please allow up to two weeks for completion of enrollment process. Changing Electronic Payments If the account designated for electronic payments has changed, please submit a new Electronic Payment (ACH) Enrollment Form, as soon as possible, using the same procedures and form as the original document. If an electronic payment (ACH) is returned to the City of Santa Ana due to unreported change of a bank or bank account, the payment will be re -issued once the updated/correct bank information has been received and processed. Withdrawing from the Program If you choose to cancel your electronic payment (ACH) enrollment, the City of Santa Ana roust be notified, in writing, on your organization's letterhead. After receipt of your withdrawal notification, it may take up to one week to process the request. All correspondence relating to the City of Santa Ana's Electronic Payments program should be directed to: City of Santa Ana, 4th floor- Purchasing, M16 20 Civic Center Plaza -Santa Ana, CA 92701 (714)647-5460 E-mail: PURCHASING_AP@santa-ana.org JASON CARBAJAL Santa Ana, CA 92701 • 9 (909) 395-6255 NJ jason.carbajal@yahoo.com OBJECTIVE: A position with an engineering firm that leverages my diverse experience and skills attained through a combination of challenging positions in both private industry and the United States military. Highly motivated, results -oriented individual currently in the U.S. Army Reserves with experience managing military Soldiers utilizing exceptional time management skills. SKILLS SUMMARY: • Strong leadership while reinforcing a cohesive team work environment with subordinates and coworkers alike • Exceptional analytical skills • Extremely organized and detail oriented • Bilingual in English and Spanish MILITARY EXPERIENCE: United States Army Reserves Various Locations Proud member of the United States Army Reserves, currently assigned to the 314`h Military Police Company, based in Tustin, CA. Army leadership training courses attended include: Warrior Leadership Course, at Fort Lewis, WA and Advanced Leadership Phase I. Military awards and citations include: Afghanistan Campaign Medal with Campaign Star, NATO Afghanistan Service Medal, Meritorious Service Medal, Army Achievement Medal (4th Award), Army Good Conduct Medal, Army Reserve Components Achievement Medal (3d Award); National Defense -Service Medal, Global War on Terrorism Expeditionary Medal, Global War on Terrorism Service Medal, Non Commissioned Officer Professional Development Ribbon, Overseas Service Ribbon (2"d Award), - Armed Forces Reserve Medal with Mobile Device. Specific duty assignments include: 314"' Military Police Company, US Army Reserve Tustin, CA Platoon SergeantlSquad Leader - - - - September, 2010 -Present Responsible for providing administrative support, counseling, training, evaluation and welfare of 12 soldiers. • 2014 Fort Hunter Liggett Annual Training NCOIC 304"' Combat Support Sustainment, US Army Reserve Riverside, CA Platoon SergeantlSquad Leader December, 2009 -October, 2010 Provided administrative support, counseling, training, evaluation and welfare of 30 soldiers. • Completed re-classification to Military Police Officer • Honor Graduate at re -class school 158th Combat Support Sustainment Battalion Kandahar, Afghanistan Battle Non Commissioned Officer [December, 2009] -[October, 2010] Served as Battalion Battle NCO for medium truck company conducting gun truck operations. Deployed to Kandahar, Afghanistan; responsible for the accountability, tracking and recovery operations. • Recipient of highest award for overall job performance in a combat zone out of 145 Soldiers • In charge of logistical improvements to RC South Afghanistan by building the Kandahar Transshipment Yard 163rd Ordnance Company Irvine, CA Ammunition Specialist December 2000 -April 2003; April 2004 -October 2009 Received, stored, and issued conventional ammunition, guided missiles, large rockets, explosives, and other ammunition and explosive related items. • 2008 Camp Roberts training for Rough Terrain Container Handler NCOIC • Lead ammunition handler during Operation Bright Star during Phase III • Advanced three times in rank within a two year period from Private to Specialist 163rd Ordnance Company Camp Arifj an, Kuwait Ammunition Specialist April 2003 -April 2004 Worked as a part of blocking/bracing team in which was held responsible for loading and transportation of multi -launch rocket systems. Collaborated with EOD to demilitarize unexploded ordnance. • Assisted in receipt, storage, issue, maintenance, modification, destruction, demilitarization of explosive items • Performed ammunition supply stock control and accounting duties using both automated and manual procedures Jason Corbafaf PROFESSIONAL EXPERIENCE Page 2 oft Nordic Security Services Costa Mesa, CA Arined Patrol Officer August 2013 -November 2013 Armed Patrol Officer conducting community patrols and working with dispatch over radios; including data entry and on-call response. First American Corporation Yorba Linda, CA Asset Specialist September 2008 -August 2009 Managed foreclosure, and eviction process for foreclosed properties, including marketing properties for re -sale. In addition, performed periodic analyses and review of data and investigated questionable data. OOMC/AMSHI Irvine, CA Marketing Coordinator March 2008 -September 2008 Managed and coordinated the activities of real estate owned properties from foreclosure to listing in the marketplace. Built and maintained effective relationships with realtors, attorneys, title companies and vendors. Northrop Grumman Corporation Ft Irwin, CA Auununitlon Handler June 2006 -March 2008 Logistical support for army training units by keeping inventory, shipping products and receiving ammunition. Worked alongside contractors, military members, and other private vendors: while being responsible for assisting supply of over 5000 Soldiers per year. - EDUCATION Santa Ana College Santa Ana, CA Associate of Arts Degree CURRENT ACTIVITIES Bridge 2 Engineering Cohort 1 Engineering Club Vice President • Currently working on Camera into Space Project Society of Women Engineers Member Swift Engineering Composite Technician Job Description Description: Composite Technician FLSA Status: Non -Exempt Reports to: Director of Product Development Services Supervises: N/A Composite Manufacturing Job Purpose: Composite Technician will be producing parts and assemblies for the aerospace, unmanned aerial vehicle (UAV), motorsport, and other product line industries that are developed at our facility. Work shifts start as early as 6:00 am, 30 minute lunch. It is preferable that personnel be willing to work night shifts, if needed. Duties and Responsibilities: Apply advanced technical skills and knowledge to fabricate composite parts using pregreg epoxy resins with carbon, fiberglass, kevlar, and quartz fibers. Knowledge of using core products, such as metallic and non-metallic honeycomb, is necessary as well. Daily tasks are in lamination of prepreg materials as well as to plan, lay -out, fabricate and build adhesive bonded assemblies of metallic and non metallic composite materials. Additional responsibilities are in fabricating composite and metal parts into subassemblies using bonding and hardware installation for curing in presses, ovens, and autoclaves. It is preferred that the candidate have experience in reading and interpreting work instructions, specifications sketches, job travelers, planning documents and engineering drawings. Work under standard supervision applying trained procedures and collaborative solutions to meet work requirements. Priorities are determined by management. Qualifications: • Requires a High School Diploma or GED • Experience in working with laminating advance composite materials. • Knowledge of releases, prepegs, resins, composite bagging, adhesives, usage of bonding jigs, drill, trim fixtures, oven, autoclave and clean room procedures. • Fabricate composite molds and parts as per instructions and drawings. • Speak, listen and write in a clear, through and timely manner • Take responsibility for workmanship and productivity • Teamwork: Work with other people in cooperation and as a good team member. • Not required but preferred expertise with running autoclave, use pneumatic tools for trimming, drilling and bonding of hardware, use of technical devices for measurements, gerber/ply cutting equipment H:\jobdescription\compositelech\mrh \8-19-2014 All experience levels are needed. Must have strong mechanical aptitude in mechanical assemblies. Industries such as marine, automotive, motorsport, aviation, aerospace and energy are relevant fields of experience. 2-5 years minimum in composites, preferably in aerospace or motorsport industries Tiers for composite technicians: Composite Trainee — Experienced in manufacturing skills set is limited. Require training and experience performing work before they are approved to work on any projects independently. Must be supervised by another composite technician in performing work. Composite Technician — Performs work that does not require lead composite technicians. Require full supervision in aid in NADCAP process of manufacturing. Advanced Composite Technician — NADCAP qualified personnel or working directly with qualified personal as training. Work in the cutting area would require a lead technician oversight. Lead Composite Technician — NADCAP Qualified Capabilities — Can perform any composite task to a qualified level. This would include lamination, finish work and bonding. Works with little supervision and supervises other composite technicians to make sure they are adhering to the required process to meet part requirements. Can work on any level of part requirements and prototype projects. This also includes performing the functions in the cutting of materials without supervision. Leads must have the experience and ability to work independently and lead in the build of complex developmental composites preferred. Provide technical support utilizing planning, engineering drawing and specification to build complex composite parts. WORKING CONDITIONS Physical Demands: While performing the duties of this job, the employee is regularly required to stand and talk or hear. The employee is occasionally required to sit; walk; use hands to finger, handle, or feel; reach with hands and arms; climb or balance and stoop, kneel, bend, crouch, or crawl. The employee must frequently lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Requires eye -hand coordination and manual dexterity. Requires corrected vision and hearing to normal range. Equipment Operated: Vacuum pumps, heat sources, special hand tools, ladders, stands, mechanical stands, hi -reach lifts. H:\jobdescription\compositetech\mrh \8-19-2014