Loading...
HomeMy WebLinkAboutCIVIL SOURCE, INC - 2016' 0City of Santa Ana Clerk of the Council AGREEMENT TERMINATION FORM ?lal Please complete this form in its entirety when the attached agreement and all {2 amendments (if any) are no longer in effect. �Q Note: If your agreement is grant related, please ensure that all grant retention requirements CL_ - S>F;,�' j have been satisfied prior to signing the termination form. j AN Is the agreement(s) a permanent record? Yes _ No e� �C�L� Return form to the Clerk of the Council Office (M-30). Call 647-1520 if you have any questions. i Only The agreement with CN(L. �i�l�-C t/( No. fi —��� —2—k3 was completed on / rr and final payment has been made. (List all amendments. Use space below if needed.) Department: _ pliti�} — l4XElC dV Phone/Ext.: Signature: Date: Revised: I a 18-16 waURANCE ON FILE WORK MAY PROCEED A-2016-283 UNTIL INSURANCE EXPIRES ELERROFCOUNCIL AGREEMENT TO PROVIDE RIGHT-OF-WAY DATE: /l I LAA COORDINATING SERVICES ON AN ON -CALL BASIS THIS AGREEMENT is made and entered into this 4th day of October, 2016 by and between CivilSource, 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 August 3, 2016, the City issued Request for Proposal No. 16-087, by which it sought consultants to furnish right-of-way coordinating services on an on -call basis. 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 RFP No. 16-087 and attached herein as Exhibit A. 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 consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES On an as -needed basis, and at the sole discretion of City, Consultant shall furnish the services that are described in Exhibit A to this Agreement. Consultant's proposal is incorporated by reference as though fully set forth herein. 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 B. The total sum to be expended under this Agreement, including any extension period, shall not exceed $300,000. 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. Payment need not be made for work that fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date stated above and continue through October 3, 2019, unless terminated earlier in accordance with Section 16, below. The term of this Agreement may be extended for a single (2) two-year period upon a writing executed by the City Manager and the City Attorney. 4. 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. 5. OWNERSHIP OF MATERIALS This Agreement creates a non-exclusive and perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights, designs, and other intellectual property embodied in plans, specifications, studies, drawings, estimates, and other documents or works of authorship fixed in any tangible medium of expression, including but not limited to, physical drawings or data magnetically or otherwise recorded on computer diskettes, which are prepared or caused to be prepared by Consultant under this Agreement ("Documents & Data"). Consultant shall require all subcontractors to agree in writing that City is granted a non-exclusive and perpetual license for any Documents & Data the subcontractor prepares under this Agreement. Consultant represents and warrants that Consultant has the legal right to license any and all Documents & Data. Consultant makes no such representation and warranty in regard to Documents & Data which were provided to Consultant by the City. City shall not be limited in any way in its use of the Documents and Data at any time, provided that any such use not within the purposes intended by this Agreement shall be at City's sole risk. 6. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, employees, agents, volunteers and representatives as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence, with $2,000,000 in the aggregate. Such insurance shall (a) name the City, its officers, employees, agents, volunteers and representatives as additional insured(s); (b) be primary and not contributory 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. 2 C. Workers' Compensation Insurance. In accordance with the California Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for workers' 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. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved by the City. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. (iv) Consultant shall supply City with a fully executed additional insured endorsement. 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 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. 7. INDEMNIFICATION Consultant agrees to and shall indemnify, defend, 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 negligence or willful misconduct of the Consultant or its, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section I 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 ternis 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. Consultant's indemnification obligations in this section shall survive expiration of this Agreement. Notwithstanding the foregoing, to the extent Consultant's Services are subject to Civil Code Section 2782.8, the above indemnity shall be limited, to the extent required by Civil Code Section 2782.8, to claims that arise out of, pertain to, or relate to the negligence, recklessness, or willful misconduct of the Consultant 8. INTELLECTUAL PROPERTY INDEMNIFICATION Consultant shall defend, indemnify, and hold harmless City, its officers, agents, representatives, and employees against any and all liability or losses, including costs and attorney's fees, for infringement of any United States' letters patent, trademark, or copyright, alleged or contained in the work product or documents provided or used by Consultant under this Agreement. 9. RECORDS Consultant shall keep records and invoices in connection with the work to be performed under this Agreement. Consultant shall maintain complete and accurate records with respect to the costs incurred under this Agreement and any services, expenditures, and disbursements charged to the City for a minimum period of three (3) years, or for any longer period required by law, from the date of final payment to Consultant 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. 10. 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 an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 11. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with the performance of services specified under this Agreement. El 12. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by 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) P.O. Box 1988 Santa Ana, CA 92702-1988 Fax 714- 647-6956 With courtesy copies to: To Consultant: Executive Director Public Works Agency City of Santa Ana 20 Civic Center Plaza Santa Ana, CA 92702 CivilSource, Inc. 9890 Irvine Center Drive, Irvine, CA 92618 A party may change its address by giving notice in writing to the other party. Thereafter, any communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by fax, communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 13. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant regarding the subject matter therein, 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. 14. 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 Agreement performed by City personnel or by other consultants retained by City. 15. WAIVER No waiver of a 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, 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. 16. 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, City 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 that fails to meet the standard of performance specified in the Recitals of this Agreement. 17. NONDISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities 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. 18. 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. 6 19, PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other goverrunental 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. 20, 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: Maria D. Huizar Cleric of the Council APPROVED AS TO FORM: SONIA R. CARVALHO City Attorney John P. Funk Assistant City Attorney FOR APPROVAL: pout, Executive Director Agency CITY OF SANTA 7 A David Cavazos City Manager CONSULTANT: Name: kyy4„� A"M %Y�l i Title: Z �� I CITY OF SANTA ANA RFP NO.: 16-087 ON -CALL RIGHT OF WAY COORDINATOR SCOPE OF WORT{ Introduction and Background: The City of Santa Ana is issuing this Request for Proposals (RFP) to qualified Right of Way Coordinator firms to provide right-of-way coordinating services for the City of Santa Ana Public Works Agency on an as -needed, basis, From the proposals received, it is the City's goal to select one firm. The City will enter into agreement with firm for a not to exceed amount of $900,000. Minimum Qualifications; Consultant qualifications must demonstrate the minimum qualifications as established in the California Department of Transportation (Caltrans) Right of Way Manual which can be accessed at: littp://www.dot.ca.govihq/row/rowman/mantial/index,htm. Description of Work. - Consultant under contract with the City of Santa Ana will provide support and services to City of Santa Ana staff or their designee on an as -needed basis. The Consultant shall be thoroughly familiar with the Statement of Work prior to submitting a response to this Request for Proposal (RFP). • The Consultant shall perform work to produce a hi,gb quality, professional and complete work product. • Consultant must have experience with State said Federally funded projects. All work shall be performed in conformance with all applicable regulations, policies, procedures and standards, Work may include, but not be limited to, the following: onsite review of the project area; review of existing records; conducting research and performing analysis; information gathering; negotiations; development of strategies. • The Consultant shall carry out the instructions received from the City aril shall cooperate with. the City and other agencies. The Consultant has total responsibility for the accuracy and completeness of the work produced, The work will be reviewed by the City for conformity with the requirements of the Agreement. Reviews by the City may NOT include a detailed review for the accuracy of items submitted. The responsibility for accuracy and completeness of such items remains solely that of the Consultant. 0 The Consultant shall be responsible for coordination and supervision of all work performed by its sub - consultants The Consultant shall review all work performed by its sub -consultants and the responsibility for accuracy and completeness of work performed remains solely that of Consultant. The Consultant shall have a Quality Assuranee/Qaality Control (QA/QC) plan in effect during the entire time work is performed under the Agreement. The QA/QC plan is intended to ensure that the appraisals, maps, reports, plans, studies, estimates, agreements and other documents submitted under assigned Scope of Work are complete, accurate, checked, and proofread to meet professional standard practice requirements, CITY OF SANTA ANA RFP NO.: 1 G-087 ON -CALL RICHT OF WAY COORDINATOR and to monitor work for conformance with the appropriate standards and policies. Additionally, all electronic files shall conform to the City's file naming system. • The Consultant shall diligently work on each assignment and complete each task in accordance with the schedule and accommodate the City's needs. • The Consultant's work will be subject to inspection and audit by City, County, State and Federal representatives. • Project files including copies of all correspondences, reports, documents, and electronic files shall be submitted to the City when requested and electronically updated monthly, The schedule and/or status report may require updating more frequently, • All world, including reports, analysis, data, and intellectual properties developed during the life of the Agreement shall become the properties of the City, • The Consultant will receive written notification of the award of the contract, Upon on such notification, the Consultant will proceed with the services required by the Agreement. Scone of Work: Assist City staff overseeing all the right of way and real estate services. Ensuring all work will be performed in accordance with the public agency's policies and procedures and federal, state and local regulations. Consultant shall assign one staff as Project Coordinator managing and overseeing the following tasks including, but not limited to; • Administration of all right-of-way related consultant contracts including but not limited to: 1) Property appraisal; 2) Furniture, fixture and equipment appraisal; 3) Business goodwill appraisal; 4) Acquisition/relocation and property management services; and 5) City real estate properties. • Establishment of right of way requirements for road widening projects • Review accuracy of Right of way mapping and legal descriptions • Review Title reports and identify pertinent information. • Review and comment on real estate appraisals • Review and comment on improvements pertaining to realty, furniture, fixtures and equipment appraisals • Review and comment on loss of business goodwill appraisals • Review and comment on environmental studies to meet all applicable local, federal, and state laws, regulations, rules, and other requirements. • Review and continent on acquisition tasks such as offer packages • Review and comment on relocation plan, arrange for periodic circulation support in accordance with the Uniform Act, the California Relocation Assistance and Real Property Acquisition Guidelines, CITY's Real Property Polioies and Procedures and any other applicable regulations. • Monitor negotiations done by other consultants • Review relocation claim and monitor status of relocation and eviction efforts in accordance with the Uniforrn Relocation and Real Property Acquisition Act of 1970 (Uniform Act); the California CITY OF SANTA ANA RFP NO.: 16-087 ON -CALL RIGHT OF WAY COORDINATOR Relocation Assistance and Real Property Acquisition Guidelines; CITY's Real Properly Policies slid Procedures and any other applicable regulations. • Prepare documentation for administrative settlements • Provide Condemnation support • Monitor Demolition activities • Prepare documentation for Right of way disposition • Attend neighborhood and Council meetings, make public presentations to individuals and organizations and represent CITY in presentations and public hearing on all matters pertaining to the right of way process, • The overseeing Right of Way Coordinator shall be currently and validly licensed to practice the business of Real Estate in the State of California, The Proposal shall include the Right of Way Coordinator's Broker License Nrunber as issued by the California Department of Consumer affairs Bureau of Real Estate. All right of way activities shall be in accordance with CITY's Real Property Policies and Procedures Manual, and Federal, State and local regulations • The Coordinator shall also have fall time experience conducting same work as those required by this RFP for at least the past 5 years. • Review title and escrow services necessary for the acquisition of real property, which include, but are not limited to, preliminary title reports, litigation guarantees, policies of title, title searches, document searches, document preparation, estimates of closing costs, escrow instruclious, and other documents. • Review all documents for submission and delivery to escrow companies; review title and escrow documents; ensure that CITY is acquiring good title and/or the property rights needed for the completion of the PROJECT, free and clear of any and all encumbrances that may affect or hinder the development of future consideration; coordinate escrow closings and file all applicable forms and documents with the County Assessor's Office. • Coordinate and provide support to CITY legal staff to clear title, if necessary. • Prepare all necessary documents to the title aid escrow companies for approval by CITY. CONSULTANT will be responsible for managing and monitoring the title and escrow companies to ensure timely delivery. • Advise CITY of any Preliminary Title Reports/Litigation Guaranties, determine title deficiencies, develop a plan to resolve and cure title deficiencies and clear liens and enewrrbrances. • Upon completion of Project, advise CITY of any Policy of Title insurance, American. Land Title Association (ALTA) or California Land Title Association (CLTA) extended -coverage owner's policy based on the value of the property provided by CITY. • Market for sale properties via traditional and non-traditional methods • Review design plans, construction plans, appraisal, appraisal maps, legal descriptions, and, if necessary, environmental site assessments. • Coordinate Phase I Enviromnental Soil Assessment Repots and, if required, provide Phase II assessments, )-Hazardous .Materials Disclosure Documents (HMDD) and Request to Acquire Contaminated Property (RACP) if required. • Advise for the submittal of any approval, certification or other similar document that any jurisdictional agency may require, and obtain approval/acceptance from said jurisdictional agency. • Recommend amount of just compensation. The CITY shall make the final determination of just compensation. • Review and maintain a parcel negotiator's log (parcel diary) for each parcel. CITY OF SANTA ANA RFP NO.; 16-087 ON -CALL RIGHT OF WAY COORDINATOR • Advise in the preparation of the Informational Letter and Offer Letter • Maintain a Record of Negotiations documenting that all elements of the acquisition process acid transactions were performed in accordance with applicable Federal, State, and local laws and regulations. • Establish and maintain an acquisition file for each property owner or property interest acquired and maintain a file checldist pursuant to CITY's policies and procedures. Secure Agreements for Possession and Use, Right of Entries, and licenses or permits from property owners for purposes of performing hazardous waste, archeological and other inspections. If needed, provide support to CITY legal staff. • Perform any other normal procedures and processes to implement the acquisition assignment and shall provide any other supporting information and/or correspondence required by CITY • Provide bilingual acquisition agents as needed, • Assist CITY in achieving California Department of Transportation (Caltrans) Right Of Way Certification. • Assist CITY in Eminent Domain Support. If requested, CONSULTANT shall provide expert testimony in any court or administrative proceedings, and assist as required in legal matters as directed by CITY legal staff, especially in the litigation of cases for or against CITY, including but not limited to gathering of documents and information. • Responsible for coordinating the identification, relocation, protection, and abandonment of all utilities required by the PROJECT. • Review existing leases, licenses, franchises, easements, permits and other agreements for the subject properties, • Set-up ,procedure to sell surplus property The firm must have its own office space with all equipmcnt and supplies necessary to carry out the Right of Way Coordination Services. The Project Manager may at times need to work at the City alongside with City staff. The City will provide a work station for the Project Manager to use for ho more than 20 hours a week. Consultant Responsibilities: Consultant Audit acid Review Process: Prior to awarding the contract, the selected Consultant shall be subject to an audit or review by Caltrans' Audits and Investigations (A&I), other state audit organizations, or the federal government. The selected Consultant shall complete Exhibit 10-K — Consultant Certification Contract Costs and Financial, in the Appendix of this RFP as Attachment 4. City .Responsibilities: The City will provide information in its possession relevant to preparation of required information in RFP. The City will provide only the staff assistance and documentation specifically referred to herein. Special Requirements (A.ttachnient 4): • Compliance with Requirements of Funding Agency; o Consultant Aurlit and Review Process (Caitrarrs funded contract) o This project is funded through Federal and Measure M2 and shall comply with all requirements of Caltrans and OCTA CITY OF SANTA ANA RFP NO.: 16-087 ON -CALL RIGHT OF WAY COORDINATOR The attached forms must be completed in their entirety and submitted with your proposal: • LAPM Exhibit 10-14 : Fee Proposal • LAPM Exhibit 10-1: Notice to Proposers, DBE Information • LAPM Exhibit 10-K: Consultant Certification of Contraot Costs and Financial management System ■ LAPM Exhibit 10-01: Consultant Proposal DBE Commitment o This project will be financed by federal funds. Consultant shall meet all required federal requirements included in this request for proposal. Consultants are advised that, as required by federal Iaw, the City of Santa Ana is implementing the new Race Conscious Disadvantaged Business Enterprise (DBE) Program. The DBE goal for this contract is 4.0%. r * *16-087 • OF WAY COORDINATOR SPECIALTY SERVICES HOURLY RATE PROJECT DIRECTOR/QUALITY CONTROL MANAGER $155 PROJECT MANAGER/PRINCIPAL AGENT $155 P (ALTERNATE) PP03ECT'MANAGER $130 TECHNICAL/ADMINISTRATIVE SUPPORT STAFF $75.45 t') G6TC PROCESSING FORM Agreements / Amendments / Deeds TO: CLERK OF THE COUNCIL OFFICE FROM: DEPT.: Design Engineering PROJECT MANAGER: Mindv Lv V16 QCT 31 h1 it, 113 ROF U ANTA NIN O MAIL STOP: M-36 EXT.: 5665 AGREEMENT NUMBER (if amendment): A / N ON -CALL APPRAISAL & R/W COORDINATOR AGREEMENTS AMENDMENT NUMBER (if applicable): ❑ 1ST ❑ 2ND F1 3RD ❑ NAME OF CONSULTANT / PARTY: Bender Rosenthal li Source Inc. AMOUNT: ❑ * OVER $25,000 — (A) ❑ *UP TO $25,000 (N) Note: If your agreement with a vendor exceeds $25,000 within a Fiscal Year, then you will need to obtain Council Approval. ❑ 1) NOT approved by council. ❑ 2) Approved by council. COUNCIL APPROVAL DATE: October 04, 2016 ITEM #: TERM OF AGREEMENT- EFFECTIVE DATE: October 04, 2016 TERMINATION DATE: SIGNATURES REQUIRED: ❑ VENDOR PJAGENCY ❑ CITY ATTORNEY ❑ OTHER October 03, 2019 (INSURANCE APPROVAL REQUIRED BY CAD PRIOR TO 'SUBMITTING TO COTC), INSURANCE REQUIRED: © YES ❑ NO (Provide City Attorney Office approval) ® AUTO Z CGL (Commercial General Liability) ❑ PROFESSIONAL LIABILITY ® WORKERS COMPENSATION COMMENTS: Please contact Mona lskandar for pickup X5013 or miskandar@santa-ana.org, * Charter amendment effective December 21, 2006 for City Manager contract authority increase; NS-2717 I:tAgreements\Fon -AGREEMENT PROCESSING FORM_canary.doc Revised: 1/17/2012 ACCOR" CERTIFICATE OF LIABILITY INSURANCE $/8/2017/DD/YYYY) THISSCCERTIFICATE 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 endorsements . PRODUCER CONTNAME: Certificate Department Cavignac & Associates 450 B Street, Suite 1800 PHONE FAX 619 -744 0574 _(ALGYNo.,_Ext619-234-8601 p (A C No A AIcertificates@cavignac.com San Diego CA 92101 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Insurance Corporation 42404 INSURED NV51NCO-01 _ INSURER B: Travelers Property & Casualty Co_m a !25674 CivilSource, Inc. INSURER C: Berkley Insurance Company 32603 9890 Irvine Center Drive INSURERD:The First Liberty Insurance Corpora 33588 Irvine, CA 92618 — INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 1667747583 REVISION NtIMRFR- 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 POLICIIUES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ABIDELTR INSD SBIR WVD POLICY NUMBER MMIDDYIYYYYI (MMIDDfYYYYI LIMITS B X COMMERCIAL GENERAL LIABILITY Y Y 6809H706339 5/1/2017 5/1/2018 EACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑X OCCUR DAMAGES( RENTED PREMISES Ea occurrence) $1,000,000 MED EXP (Any one person) $10,000 X Cross Liab/Sevin X 0 Deductible PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY PE 1XI LOC PRODUCTS - COMP/OP AGG _ $2,000,000 Stop Gap Liability $1,000,000 OTHER: A AUTOMOBILE LIABILITY Y Y AS7Z91462442027 5/1/2017 5/1/2018 COMBINED SINGLE LIMIT Ea accident $1,000,000 X ANY AUTO BODILY INJURY (Per person) $ AUTOWNED SCHEDULED '.. HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY -DAMAGE Per accident $ - $ A X ! UMBRELLA LIAB X OCCUR TH7Z91462442037 5/1/2017 5/1/2018 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 I EXCESS LIAB �I, CLAIMS -MADE DED X I RETENTION $0 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N y WC6Z91462442047 5/l/2017 5/1/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $1,000,000 ANY OFFICERPRIIMBOR/EXCLUDED?ECUTIVE N N/A E.L. DISEASE - EA EMPLOYEE $1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $1,000,000 C Professional Liability AEC901463201 5/1/2017 5/1/2018 Each Claim $5,000,000 Aggregate $10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Re: A-2015-163 OnCall & A-2015-237 OnCall, A-2016-283, RFP #17-034 Construction Engineering -Walnut Pump Station Building upgrade and San Lorenzo Sewage Lift Station. Additional Insured coverage applies to General Liability and Automobile Liability for City of Santa Ana and their officers, agents and employees per policy form. Waiver of subrogation applies to General Liability, Automobile Liability, and Workers Compensation per policy form. If the insurance company elects to cancel or non -renew coverage for any reason other than nonpayment of premium Cavignac & Associates will provide 30 days notice of such cancellation or nonrenewal. Professional Liability�Claim ade form, defense costs included See Attached... REVIEWED BY: EUNICE HEREDIA (PC, ) OF ) 0104 1I Iiii i.9]1 IME i RAJ Ak City of Santa Ana 20 Civic Center Plaza Santa Ana CA 92701 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ff� x� @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: NV51NCO-01 LOC #: Page 1 of 1 AGENCY Cavignac & Associates POLICY NUMBER CARRIER ADDITIONAL REMARKS NAIC CODE NAMED INSURED CivilSource, Inc. 9890 Irvine Center Drive Irvine, CA 92618 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE within limit. Excess/Umbrella policy follows form over underlying policies: General Liability, Auto Liability & Employers Liability (additional insured and waiver of subrogation apply). Primary coverage applies to General Liability per policy form. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD REV€EUVEIk C Y: 0, FLIN F( DI'E HEREA PG CJF` ) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFO 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be % of the California workers' compensation premium otherwise due on such remuneration. Schedule Additional premium is a percent of the California Manual Workers Compensation premium. Subject to a minimum premium charge of $ Person or Organization Job Description ANY PERSON OR ORGANIZATION FOR WHICH THE NAMED iNSURED 11AS AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO THE ACCIDENT OR LOSS TO FURNISH THIS WAIVER. For attachment to Policy No. WC6Z91462'442047 WC 04 03 06 Ed: 04/1984 Effective Date 05/0I/20I r Premium $ Page 1 of 1 �,__..e._..._____ _ � C:i.1d�dICC Fll�f�t:C�IA 6 C 06= _._ 11-iis endorsernent modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fiedbythieendomemenL This endorsement identifies organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. mmu��� Name of Person(s) or Organization(s): Any person or organization where the named iosorad has anzeed uy written contract to incli.1de s�jch person or organization as a desiqna�ed insured. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations asapplicable tothe endorsemenL) Each person or organization shown in the Schedule is an "insured" for Liability Coveraga, but only to the extent that person or organization qualifies as an "insured" under, the Who Is An Insured Provision contained in Section 11 of the Coverage Form. Policy No: xs7Ze1462442027 Issued By: Liberty Insurance Corp. Effective Date: 05m1o017 Expiration Date: nsm/am1n CA 2048 02 99 Copyright, Insurance Services Office, km 1998 Page 1of1 Policy Number AS7Z91*62442027 Issued by Liberty Insurance Corp. A. Coverage 1. ParagnaphB.7.of SECTION K/-BUSINESS AUTO CONDITIONS iaamended bythe addition ofthe The coverage territory isextended hzinclude Mexico but only ifall mfthe following criteria are met: a, The "accidents" or "loss" occurs within 25 miles of the United States border; and b. Whileon a trip into Mexicofor 10 days or less. 2. For coverage provided by this section of the endorsement, Paragraph B.5. Other Insurance in SECTION IV - BUSINESS AUTO CONDITIONS is replaced by the following: The insurance provided by this endorsement will be excess over any other collectible insurance. B. Physical Damage Coverage isamended by the addition of the following: V m "loss" to a covered "auto" occurs in Mexico, we will pay for such "loss" in the United States. If the covered "auto" must be repaired in Mexico in order to be driven, we will not pay more than the actual cash value of such "loss" at the nearest United States point where the repairs can be made. C. Additional Exclusions The following additional exclusions are added: This insurance does not apply: 1- If the covered "auto" is not principally garaged and principally used in the United States. 2. Tuany ^inaured''who ianot aresident ofthe United States. XXU.WAIVER OFSUBROGATION Paragraph A.5. in SECTION |V - BUSINESS AUTO CONDITIONS does not apply to any person or organization where the Named Insured has agreed, by written contract executed prior to the doba of ^oocident".howaive rights ofrecovery against such person ororganization. AC84O7O713 CD2O13Liberty Mutual Insurance. All rights reserved. Page 1Uof11 Includes copyrighted material of Insurance Services Office, Inc., Policy No. 6809H706339 This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART t The following is added to SECTION U—VVHO IS AN|NSURED: Any person or organization that you agree in o "written contract requiring insurance" to include as anadditional insured onthis Coverage Part, but: a. Only with respect to liability for "bodily injury''. ^pvopertydamage" or"personal iniury'';and b. U. and only to the extent that, the injury o/ damage is caused by acts o/ omissions of you or your subcontractor in the performance of ''your work" to which the "written contract requiring insurance" app|ies, or in connection with premises owned byorrented boyou. The person or organization does not qualify as an additional insured: c. With respect to the independent acts or omissions ofsuch person ororganization; or d. For "bodily injury". "property damage" or .,personal injury" for which such person or organization has assumed liability in a contract oragreement. The insurance provided tosuch additional insured is limited as follows: e. This insurance does not apply on any basis to any person or organization for which coverage as an additional insured specifically is added by another endorsement to this Coverage Part. t This insurance does not apply to the rendering of or failure to vender any ,.professional services". g. In the event that the Limits of Insurance of the Coverage Part shown in the Declarations exceed the limits of liability required by the .,written contract requiring insurance'', the insurance provided to the additional insured shall be limited to the limits of liability required bythat "written contract requiring insurance" This endorsement does not increase the limits of insurance described in Section ||| — Limits [VInsurance. COMMERCIAL GENERAL LIABILITY h. This insurance does not apply to "bodily injury" or "property damage" caused by "Your *mrk" and included in the "products - completed operations hazand" unless the "written contract requiring insunance" specifically requires You to provide such coverage for that additional insuned, and then the insurance provided to the additional insured applies only bosuch "bodily injury" or "property damage" that occurs before the end of the period of time for which the "written contract requiring insurance" requires you to provide such coverage or the end of the policy period, whichever isearlier. 2. The following is added to Paragraph 4.a. of SECTION |V — [OK4MERO8[ GENERAL LIABILITY CONDITIONS: The insurance provided tothe additional insured is excess over any valid and collectible other insurance, whether primary, excess, contingent or on any other basis, that is available to the additional insured for a loss wecover. However. J you specifically agree in the "written cont/act requiring insurance^that this insurance provided to the additional insured under this Coverage Part must apply on o primary basis ora primary and non-contributory basis, this insurance is primary to other insurance available to the additional insured which covers that person o/organizations as named insured for such |oss, and wewill not share with the other insurance, provided that: (1) The "bodily injury" or "property damage" for which coverage issought occurs; and (2) The "personal injury" for which coverage is sought arises out ofanoffense committed; after you have signed that "written contract requiring insurance"But this insurance provided to the additional insured still is excess over valid and collectible other insurance, whether primary, exress, contingent or on any other basis, that is available to the additional insured when that person or organization is an additional insured under any other insurance. CG D3 81 09 15 (")uomThe rove I ers I ride ninity Conip any. Al I rig tits reserved, Page 1 of COMMERCIAL GENERAL LIABILITY 3. The following is added to Paragraph 8L' Transfer Of Rights 0fRecovery Against Others To Ds' of SECTION |V — COMMERCIAL GENERAL LIABILITY CONDITIONS: We waive any right of recovery we may have against any person or organization because of payments we make for "bodily injury", "property damage" or "personal injury" arising out of "your mm/k^ performed by YOU, or or) Your behalf, dune under ''written contract requiring insunance''with that person or organization. We waive this right only where you have agreed to do so as part of the "written contract requiring insurance" with such person or organization signed by you before, and in effect when. the "bodily injury" or "property damage" occurs. or the "personal injury" offense iscommitted. 4. The following definition is added to the DEFINITIONS Section: "Written contract requiring insurance" means that part o[any written contract under which you are required toinclude aperson ororganization asan additional insured on this [overage Part, provided that the "bodily injury" and "property damage" occurs and the "personal injury" is caused byanoffense committed: a. After you have signed that written contract; b. While that part of the written contract is in effect; and c. Before the end of the policy period. Page of 02015TheTravo All [G Includes the copyrighted material o,m°uranoeServices Office, |ncwith its perrp, ission AC RO® CERTIFICATE OF LIABILITY INSURANCE DATE MMIDD8 fYYYY) 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 Cavignac & Associates 450 B Street, Suite 1800 San Diego CA 92101 CONTACT Certificate Department PHONE FAx _(A/c. No Ext)• 619-744-0574 IA/c No): 619-234-8601 ADDRESS: certificates@cavignac.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Company 20508 INSURED NV51NCO-01 CivilSource, Inc. 9890 Irvine Center Drive INSURER B: Continental CasualtyCo. 20443 INSURERC: Continental Insurance Company 35289 INSURERD: National Fire Ins. Hartford 20478 Irvine, CA 92618 INSURER E : Berkley Insurance Company j 32603 INSURER F : COVERAGES CERTIFICATE NUMBER:412150774 REVISION NUMBFR- 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. ILTR TYPE OF INSURANCE IN Dp 'C 'go POLICY NUMBER MMI DY EFF POLICYEXP I LIMITS MM DD A X X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ; OCCUR Cross Liab/Sevin Y Y 6057040530 5/1/2018 5/1/2019 I�, ;EACH OCCURRENCE DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 $ 1,000,000 MED EXP (Any one person) $ 15,000 P$0 Deductible PERSONAL & ADV INJURY $ 1,000,000 'LAGGREGATE LIMIT APPLIES PER: POLICY X JE' '[E LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Stop Gap Liability $ 1,000,000 OTHER: i B AUTOMOBILE LIABILITY Y'. Y 6057040575 5/1/2018 5/1/2019 COMBINED SINGLE LIMIT (Ea accident) $ 1 000 000 - BODILY INJURY (Per person) $ ANY AUTO i ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ C X UMBRELLA LIAB X OCCUR 6057187219 5/1/2018 5/1/2019 EACH OCCURRENCE I $ 20,000,000 AGGREGATE $ 20,000,000 EXCESS LIAB �I CLAIMS-MADE DED I X RETENTION $() $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F N / A Y 6057040558 5/1/2018 5/1/2019 X I SPER TATUTE I 1OTRH- . E.L. EACH ACCIDENT $ 1,000,000 j (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1.000,000 E Professional Liability AEC902036802 1/1/2018 5/1/2019 Each Claim $10,000,000 Aggregate $20,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: A-2015-163 OnCall & A-2015-237 OnCall, A-2016-283, A-2018-159-05, A-2018-160-04, RFP #17-034 Construction Engineering -Walnut Pump Station Building upgrade and San Lorenzo Sewage Lift Station. Additional Insured coverage applies to General Liability and Automobile Liability for City of Santa Ana and their officers, agents and employees per policy form. Waiver of subrogation applies to General Liability, Automobile Liability, and Workers Compensation per policy form. Professional Liability - Claims made form, defense costs included within limit. Excess/Umbrella policy follows form over underlying policies: General Liability, Auto Liability & Employers Liability (additional insured and waiver of subrogation apply). Primary coverage applies to General Liability per policy form. If the insurance company elects to cancel or non -renew coverage for any reason other than nonpayment of premium they will provide 30 days notice of such cancellation or nonrenewal. r CivilSource, Inc. is a named insured on NV5 Global, Inc Master insurance policy coverages. P9_ of CERTIFICATE HOLDER CANCELLATION REVIEWSBy Margaret Mercer a t1f:05am,Aug08,201s SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Blanket Additional Insured - Owners, Lessees or Contractors -with Products -Completed Operations Coverage Endorsement With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. 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 effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. Pg. of CNA75079XX (10-16) Page 2 of 2 REVIEWE By Margaret Merc rat 1:05 am, Aug O8, 2018 Policy NO: 6057040530 Effective Date: 05/01/2018 Insured Name: Nv5 Global, Inc. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA CNA PARAMOUNT Amendment to Policy Declarations — Named Insured Endorsement It is understood and agreed as follows: The Policy Declarations is amended as follows: A. Addition of Named Insureds: The following are added as Named Insureds: Name and Address of Named Insured NV5 GLOBAL, INC. CNA6270OXX 09-12 pg. J" of 1 Page 1 of 2 REVIEWS VALLEY FORGE INSURANCE COMPANY By Margaret Mercer at 11:05 am, ".9.111. Insured Name: NV5 GLOBAL, INC. Policy No: 6057040530 Endorsement No: 21 Effective Date: 0 5 / 01 / 2 018 Copyright CNA All Rights Reserved. ADDITIONAL INSURED ENDORSEMENT — CONTRACTUAL OBLIGATION It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Person Or Organization Any person or Organization for whom you are performing operations when you and such person (s) or organization (s) have agreed in writing in a contract or agreement that such person (s) or organization (s) be added as Additional Insured on your policy. Paragraph A.1. Who Is An Insured of Section II — LIABILITY COVERAGE is amended to include as an additional insured the person or organization scheduled above, but only if you are required by "written contract" to make that person or organization an additional insured under this policy. The insurance provided to the additional insured is limited as follows: a. The person or organization is an additional insured only with respect to "bodily injury" or "property damage" arising out of a covered "auto" and caused by your negligent acts or omissions or the negligent acts or omissions of someone, other than the additional insured, for whom you are legally liable. b. The person or organization is not an additional insured for the person or organization's own acts or omissions, nor those of anyone, other than you, for whom the person or organization is legally liable. C. We will not provide the additional insured any broader coverage or any higher limit of liability than the least that is: (1) Required by the "written contract"; or (2) Afforded to you under this policy. 3. Condition 2. Duties In the Event of Accident, Claim, Suit or Loss of Section IV — BUSINESS AUTO CONDITIONS is amended to add the following conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: a. Give us written notice of an "accident" which may result in a claim or "suit" under this insurance, and of any claim or "suit" that does result; b. Agree to make available any other insurance the additional insured has for a loss we cover under this policy; C. Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or "suit"; and d. Tender the defense and indemnity of any claim or "suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this policy. But if the "written contract" requires this insurance to be primary and non-contributory, this provision d. does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a "suit". 4. Only for the purpose of the insurance provided by this endorsement, SECTION V — DEFINITIONS is amended to add the following definition: "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured under this policy, provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this policy; and 2. Was executed prior to 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 effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. q Of p A CNA71526XX (10-12) Page 1 REVIEWE By Margaret Mercer at 1: 5 am, ug 08, 2018 Policy NO: 6057040575 Endorsement No: Effective Date: 05/01/201E Insured Name: © CNA All Rights Reserved. A -NOTICE OF CANCELLATION TIMM, It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. 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. pg.,? of r 1 REVIEWEO I0,'l�2018 By Margaret Marc rat 1:5 a ,Aug 0 , Form No: CNA68021 XX (02-2013) Policy No: 6057040530; 6057040575; 6057187219 Endorsement Effective Date: 05/01/2018 ° Copyright CNA All Rights Reserved. Workers' Compensation 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. P9• Of REVIEWE By Margaret Mercer at 11:05 am, Aug 08, 2018 Form No: G-19160-B (11-1997) Policy No: 6057040558 Endorsement Effective Date: 05/01/2018 ° Copyright CNA All Rights Reserved. AC RO® CERTIFICATE OF LIABILITY INSURANCE DATE MMIDD8 fYYYY) 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 Cavignac & Associates 450 B Street, Suite 1800 San Diego CA 92101 CONTACT Certificate Department PHONE FAx _(A/c. No Ext)• 619-744-0574 IA/c No): 619-234-8601 ADDRESS: certificates@cavignac.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Valley Forge Insurance Company 20508 INSURED NV51NCO-01 CivilSource, Inc. 9890 Irvine Center Drive INSURER B: Continental CasualtyCo. 20443 INSURERC: Continental Insurance Company 35289 INSURERD: National Fire Ins. Hartford 20478 Irvine, CA 92618 INSURER E : Berkley Insurance Company j 32603 INSURER F : COVERAGES CERTIFICATE NUMBER:412150774 REVISION NUMBFR- 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. ILTR TYPE OF INSURANCE IN Dp 'C 'go POLICY NUMBER MMI DY EFF POLICYEXP I LIMITS MM DD A X X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ; OCCUR Cross Liab/Sevin Y Y 6057040530 5/1/2018 5/1/2019 I�, ;EACH OCCURRENCE DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 $ 1,000,000 MED EXP (Any one person) $ 15,000 P$0 Deductible PERSONAL & ADV INJURY $ 1,000,000 'LAGGREGATE LIMIT APPLIES PER: POLICY X JE' '[E LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Stop Gap Liability $ 1,000,000 OTHER: i B AUTOMOBILE LIABILITY Y'. Y 6057040575 5/1/2018 5/1/2019 COMBINED SINGLE LIMIT (Ea accident) $ 1 000 000 - BODILY INJURY (Per person) $ ANY AUTO i ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ $ C X UMBRELLA LIAB X OCCUR 6057187219 5/1/2018 5/1/2019 EACH OCCURRENCE I $ 20,000,000 AGGREGATE $ 20,000,000 EXCESS LIAB �I CLAIMS-MADE DED I X RETENTION $() $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? F N / A Y 6057040558 5/1/2018 5/1/2019 X I SPER TATUTE I 1OTRH- . E.L. EACH ACCIDENT $ 1,000,000 j (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1.000,000 E Professional Liability AEC902036802 1/1/2018 5/1/2019 Each Claim $10,000,000 Aggregate $20,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: A-2015-163 OnCall & A-2015-237 OnCall, A-2016-283, A-2018-159-05, A-2018-160-04, RFP #17-034 Construction Engineering -Walnut Pump Station Building upgrade and San Lorenzo Sewage Lift Station. Additional Insured coverage applies to General Liability and Automobile Liability for City of Santa Ana and their officers, agents and employees per policy form. Waiver of subrogation applies to General Liability, Automobile Liability, and Workers Compensation per policy form. Professional Liability - Claims made form, defense costs included within limit. Excess/Umbrella policy follows form over underlying policies: General Liability, Auto Liability & Employers Liability (additional insured and waiver of subrogation apply). Primary coverage applies to General Liability per policy form. If the insurance company elects to cancel or non -renew coverage for any reason other than nonpayment of premium they will provide 30 days notice of such cancellation or nonrenewal. r CivilSource, Inc. is a named insured on NV5 Global, Inc Master insurance policy coverages. P9_ of CERTIFICATE HOLDER CANCELLATION REVIEWSBy Margaret Mercer a t1f:05am,Aug08,201s SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Santa Ana 20 Civic Center Plaza AUTHORIZED REPRESENTATIVE Santa Ana CA 92701 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Blanket Additional Insured - Owners, Lessees or Contractors -with Products -Completed Operations Coverage Endorsement With respect to other insurance available to the additional insured under which the additional insured is a named insured, this insurance is primary to and will not seek contribution from such other insurance, provided that a written contract requires the insurance provided by this policy to be: 1. primary and non-contributing with other insurance available to the additional insured; or 2. primary and to not seek contribution from any other insurance available to the additional insured. But except as specified above, this insurance will be excess of all other insurance available to the additional insured. VI. Solely with respect to the insurance granted by this endorsement, the section entitled COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: The Condition entitled Duties In The Event of Occurrence, Offense, Claim or Suit is amended with the addition of the following: Any additional insured pursuant to this endorsement will as soon as practicable: 1. give the Insurer written notice of any claim, or any occurrence or offense which may result in a claim; 2. send the Insurer copies of all legal papers received, and otherwise cooperate with the Insurer in the investigation, defense, or settlement of the claim; and 3. make available any other insurance, and tender the defense and indemnity of any claim to any other insurer or self -insurer, whose policy or program applies to a loss that the Insurer covers under this coverage part. However, if the written contract requires this insurance to be primary and non-contributory, this paragraph 3. does not apply to insurance on which the additional insured is a named insured. The Insurer has no duty to defend or indemnify an additional insured under this endorsement until the Insurer receives written notice of a claim from the additional insured. VII. Solely with respect to the insurance granted by this endorsement, the section entitled DEFINITIONS is amended to add the following definition: Written contract means a written contract or written agreement that requires you to make a person or organization an additional insured on this coverage part, provided the contract or agreement: A. is currently in effect or becomes effective during the term of this policy; and B. was executed prior to: 1. the bodily injury or property damage; or 2. the offense that caused the personal and advertising injury; for which the additional insured seeks coverage. Any coverage granted by this endorsement shall apply solely to the extent permissible by law. 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 effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. Pg. of CNA75079XX (10-16) Page 2 of 2 REVIEWE By Margaret Merc rat 1:05 am, Aug O8, 2018 Policy NO: 6057040530 Effective Date: 05/01/2018 Insured Name: Nv5 Global, Inc. Copyright CNA All Rights Reserved. Includes copyrighted material of Insurance Services Office, Inc., with its permission. CNA CNA PARAMOUNT Amendment to Policy Declarations — Named Insured Endorsement It is understood and agreed as follows: The Policy Declarations is amended as follows: A. Addition of Named Insureds: The following are added as Named Insureds: Name and Address of Named Insured NV5 GLOBAL, INC. CNA6270OXX 09-12 pg. J" of 1 Page 1 of 2 REVIEWS VALLEY FORGE INSURANCE COMPANY By Margaret Mercer at 11:05 am, ".9.111. Insured Name: NV5 GLOBAL, INC. Policy No: 6057040530 Endorsement No: 21 Effective Date: 0 5 / 01 / 2 018 Copyright CNA All Rights Reserved. ADDITIONAL INSURED ENDORSEMENT — CONTRACTUAL OBLIGATION It is understood and agreed that this endorsement amends the BUSINESS AUTO COVERAGE FORM as follows: SCHEDULE Name of Additional Insured Person Or Organization Any person or Organization for whom you are performing operations when you and such person (s) or organization (s) have agreed in writing in a contract or agreement that such person (s) or organization (s) be added as Additional Insured on your policy. Paragraph A.1. Who Is An Insured of Section II — LIABILITY COVERAGE is amended to include as an additional insured the person or organization scheduled above, but only if you are required by "written contract" to make that person or organization an additional insured under this policy. The insurance provided to the additional insured is limited as follows: a. The person or organization is an additional insured only with respect to "bodily injury" or "property damage" arising out of a covered "auto" and caused by your negligent acts or omissions or the negligent acts or omissions of someone, other than the additional insured, for whom you are legally liable. b. The person or organization is not an additional insured for the person or organization's own acts or omissions, nor those of anyone, other than you, for whom the person or organization is legally liable. C. We will not provide the additional insured any broader coverage or any higher limit of liability than the least that is: (1) Required by the "written contract"; or (2) Afforded to you under this policy. 3. Condition 2. Duties In the Event of Accident, Claim, Suit or Loss of Section IV — BUSINESS AUTO CONDITIONS is amended to add the following conditions applicable to the additional insured: An additional insured under this endorsement will as soon as practicable: a. Give us written notice of an "accident" which may result in a claim or "suit" under this insurance, and of any claim or "suit" that does result; b. Agree to make available any other insurance the additional insured has for a loss we cover under this policy; C. Send us copies of all legal papers received, and otherwise cooperate with us in the investigation, defense, or settlement of the claim or "suit"; and d. Tender the defense and indemnity of any claim or "suit" to any other insurer or self insurer whose policy or program applies to a loss we cover under this policy. But if the "written contract" requires this insurance to be primary and non-contributory, this provision d. does not apply to insurance on which the additional insured is a Named Insured. We have no duty to defend or indemnify an additional insured under this endorsement until we receive from the additional insured written notice of a "suit". 4. Only for the purpose of the insurance provided by this endorsement, SECTION V — DEFINITIONS is amended to add the following definition: "Written contract" means a written contract or written agreement that requires you to make a person or organization an additional insured under this policy, provided the contract or agreement: 1. Is currently in effect or becomes effective during the term of this policy; and 2. Was executed prior to 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 effective date of said Policy at the hour stated in said Policy, unless another effective date is shown below, and expires concurrently with said Policy. q Of p A CNA71526XX (10-12) Page 1 REVIEWE By Margaret Mercer at 1: 5 am, ug 08, 2018 Policy NO: 6057040575 Endorsement No: Effective Date: 05/01/201E Insured Name: © CNA All Rights Reserved. A -NOTICE OF CANCELLATION TIMM, It is understood and agreed that: If you have agreed under written contract to provide notice of cancellation to a party to whom the Agent of Record has issued a Certificate of Insurance, and if we cancel a policy term described on that Certificate of Insurance for any reason other than nonpayment of premium, then notice of cancellation will be provided to such Certificateholders at least 30 days in advance of the date cancellation is effective. If notice is mailed, then proof of mailing to the last known mailing address of the Certificateholder on file with the Agent of Record will be sufficient to prove notice. Any failure by us to notify such persons or organizations will not extend or invalidate such cancellation, or impose any liability or obligation upon us or the Agent of Record. 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. pg.,? of r 1 REVIEWEO I0,'l�2018 By Margaret Marc rat 1:5 a ,Aug 0 , Form No: CNA68021 XX (02-2013) Policy No: 6057040530; 6057040575; 6057187219 Endorsement Effective Date: 05/01/2018 ° Copyright CNA All Rights Reserved. Workers' Compensation 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. P9• Of REVIEWE By Margaret Mercer at 11:05 am, Aug 08, 2018 Form No: G-19160-B (11-1997) Policy No: 6057040558 Endorsement Effective Date: 05/01/2018 ° Copyright CNA All Rights Reserved.