Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2019-06-11 - AGENDA REPORTS - AWARD CONTR FOR BACKFLOW PREVENTION DEVICE TESTING (2)
Agenda Item: 9 DATE: June 11, 2019 SUBJECT: AWARD CONTRACT FOR BACKFLOW PREVENTION DEVICE TESTING AND REPAIRS DEPARTMENT: Neighborhood Services PRESENTER: Kevin Tonoian RECOMMENDED ACTION City Council: Award a two-year maintenance service contract to Backflow Prevention Device Tester to provide contractual maintenance for all City -owned backflow prevention devices in the annual amount of $120,000, and authorize an annual ten percent contingency in the amount of $12,000, for a total two-year contract in an amount not to exceed $264,000. 2. Authorize the City Manager or designee to execute all contracts and associated documents, or modify the awards in the event issues of impossibility of performance arise, contingent upon the appropriation of funds by the City Council in the annual budget for such fiscal year, and execute all documents subject to City Attorney approval. 3. Authorize the City Manager or designee to execute up to three annual renewal options, not to exceed the annual contract amount, plus Consumer Price Index adjustments. BACKGROUND The City of Santa Clarita (City) maintains nearly 800 cross -contamination prevention systems, commonly referred to as backflow devices, throughout our multiple Landscape Maintenance District (LMD) Zones and City -owned facilities. The devices are designed to protect our potable water supply by preventing water used for purposes such as irrigation, aquatics, and fire prevention systems from reversing its flow, backing into our local water supply, and causing contamination. Page 1 By law, the Santa Clarita Valley Water Agency and Los Angeles County Department of Public Health require annual testing of all backflow devices operated by the organization. The City is required to submit a test report to the respective water supplier that demonstrates the results of every annual backflow device test which is performed. The certification and re -certification of City -owned backflow devices, including a database of all such devices and test results, are necessary to guarantee the safety of our public water systems. In lieu of maintaining full-time employees to administer testing, the City contracts out for this specialized service. On March 5, 2019, the City published bid number LMD-18-19-33 on PlanetBids. A total of 250 vendors, including the Santa Clarita Valley Chamber of Commerce and Valley Industrial Association, were sent notifications of the bid. Thirteen companies downloaded the bid specifications during the solicitation process, with one bid received from Backflow Prevention Device Tester as of the opening date of April 1, 2019. Backflow Prevention Device Tester is a locally based business and is the City's incumbent backflow vendor. ID ICOMPANY OCATION IBASE BID AMOUNT Proposal 1 IBackflow Prevention Device Tester ISanta Clarita, CA 1 $83,504 For competitive purposes to determine the lowest bid, responders were instructed to prepare their base -bid amount to provide costs for inspecting, calibrating, and certifying 800 backflow devices. On average, the City spends approximately $115 to inspect, calibrate, and certify each backflow device annually. As part of this bid process, responders were also instructed to provide pricing for ten different as -needed repair/service scenarios identified in the bid specifications, based on the City's actual operational experiences. Under these scenarios, additional as -needed backflow service or repair needs can range from $147 to $1,900 in parts and labor, depending upon the situation. The following table identifies actual annual costs incurred by the City for backflow device re -certification, service, repairs, and installation since 2015. Year Actual Expenditure Y 2015 $ 93,308 Y 2016 $ 124,716 Y 2017 $ 102,116 Y 2018 $ 131,163 Y 2019 YTD $ 76,554 Based on this history and anticipated growth over the term of the contract, staff is recommending award of a two-year contract to Backflow Prevention Device Tester in the annual amount of $120,000 plus a ten percent contingency of $12,000 for a total two-year contract amount not to exceed $264,000. An evaluation of Backflow Prevention Device Tester's bid determined it to be responsive and responsible. Further, City staff conducted due -diligence reviews of the contractor's professional Page 2 references to ensure their performance records meet the City's high standards. Finally, it is important to note the recommended contract amount is based on the City's actual expenditure experience and is not guaranteed compensation to the contractor. Beyond the annual testing and certification of backflow devices, the contractor is not authorized to undertake any repair work until they provide City staff with a proposal for review and approval. ALTERNATIVE ACTIONS Other action as determined by the City Council. FISCAL IMPACT Adequate funds for this contract were appropriated by the City Council during the FY 2018-19 annual budget process and are located in multiple operational accounts within City departments which utilize backflow devices. Funding for the second year of this contract is contingent upon the appropriation of funds by the City Council during the FY 2019-20 budget adoption process. ATTACHMENTS Bid Request LMD-18-19-33 Backflow (available in City Clerk's Reading File) Backflow Prevention Device Tstr LMD-18-19-33 Bid Response (available in City Clerk's Reading File) Page 3 City 1 SANtA CLARITA 10[a]1[y:1110kyjII10Its 01DO The City of Santa Clarita is seeking bids from qualified vendors for certified backflow prevention devices testers to certify, service, maintain, install, and repair as necessary approximately 794 backflow devices owned by the City of Santa Clarita. TABLE OF CONTENTS Bid # LMD-18-19-33 Backflow Prevention Services Section..............................................................................................................................................Page NoticeInviting Bid...................................................................................................................................X Instructionsto Bidders............................................................................................................................X ScopeOf Work.........................................................................................................................................X Contract Agreement (Sample Only).........................................................................................................X Designation of Subcontractors................................................................................................................X Acknowledgement and Acceptance of Specifications.............................................................................X BidBond..................................................................................................................................................X ProposalBond.........................................................................................................................................X DocumentChecklist.................................................................................................................................X CITY OF SANTA CLARITA INVITATION FOR BID Backflow Prevention Services BID # LM D-18-19-33 Bids must be uploaded via PlanetBids before 11:00 AM on Monday, April 1, 2019 to the Purchasing Agent of the City of Santa Clarita. Specifications for this electronic bid may be viewed at: http://www.planetbids.com/portal/portal.cfm?CompanylD=16840# Purchasing: (661) 255-4399 1. Solicitation documents for this bid may be downloaded from the City's Purchasing PlanetBids website at http://www.planetbids.com/portal/portal.cfm?CompanylD=16840#. Please refer to the solicitation documents for complete details and bid requirements. 2. Proposer shall honor bid prices for One Hundred Twenty (120) days or for the stated contract period, whichever is longer. 3. Bids must include this invitation for bid form and be signed by the contractor's authorized representative. This signature acknowledges the proposer has read and understands the requirements contained on pages X to X , attachments X to X, and exhibits X to X. 4. The last day for questions will be March 20, 2019, 10:00 AM. Questions should be submitted electronically via PlanetBids: http://www.planetbids.com/portal/portal.cfm?CompanylD=16840# 5. The vendor is responsible for the accuracy and completeness of any solicitation form not obtained directly from the City. 6. The specifications in this notice shall be considered a part of any contract made pursuant thereto. I have, read, understood, and agree to the terms and conditions on all pages of this invitation for bid. The undersigned agrees to furnish the commodity or service stipulated on this bid as stated above. Company: Name (Print): Signature: Title of Person Signing Proposal: Address: Company Phone No.: A. BID INSTRUCTIONS Bid # LMD-18-19-33 Backflow Prevention Services ADDENDA. The City will not accept responsibility for incomplete packages or missing addenda. It is the vendors responsibility to monitor PlanetBids for release of the addenda prior to submission of the quote to make certain the package is complete and all required addenda are included. This information will be available via PlanetBids. Vendors are cautioned against relying on verbal information in the preparation of bid responses. All official information and guidance will be provided as part of this solicitation or written addenda. Addenda, if issued by the Agency, will be transmitted via PlanetBids. Addenda must be digitally acknowledged through PlanetBids in addition to a printed and signed version submitted with the bid. If addenda are not signed and submitted with the quote response, the bid may be deemed non-responsive and rejected. 2. AWARDS. 2.1. The City reserves the right waive any informality in any bid. 2.2. The City will award in accordance with S.C.M.C. § 3.12.205 (Support of Santa Clarita Businesses) unless this bid is identified as public works, a professional services, or is federally funded. 2.3. Qualifications of responsibility will be in accordance with the S.C.M.C. Lowest cost is the lowest total cost to the City to acquire the goods and/or services resulting from this solicitation. 2.4. The City may make an award based on partial items unless the bid submitted is marked "All or none." Where detailed specifications and/or standards are provided the City considers them to be material and may accept or reject deviations. The results of the bid will be posted on PlanetBids, normally within 24 hours. BRAND NAMES, ALTERNATIVES, OR EQUIVALENTS. 3.1. In the bid documents, the use of a specific manufacturer, brand or make does not restrict bidders in in their proposed solution wHen brand names are used it indicates the quality and utility of the article desired; thus the bids submittial shall in all cases propose goods equal in quality and utility. to those referred to. 3.2. Materials differing from stated specifications may be considered, provided such differences are clearly noted and described. The Agency shall make the final determination of compliance with the specifications. 3.3. If proposing with an alternative or equivalent product, provide the cut sheet/spec sheet or detailed product description for the proposed product via the PlanetBids Q&A section prior to the last day for questions. For each product proposed documentation provided must include a description reflecting the characteristics and level of quality that will satisfy the salient physical, functional, or performance characteristics of "equal" products specified in the solicitation. The proposal must also clearly identify the item by brand name (if any), and make/model number. In addition, the proposal may include descriptive literature such as illustrations, drawings, or a clear reference to previously furnished descriptive data or information available to the City, and clearly describe any modifications the offeror plans to make in a product to make it conform to the solicitation requirements. 3.4. The City has the option of accepting or rejecting any alternative or equivalent product. Exception is made on those items wherein identical supply has been determined a necessity and the notation NO SUBSTITUTE has been used in the specification section. 4. BONDS. 4.1. When deemed necessary by the City, bid bonds shall be furnished by all bidders in the amount of at least 10% of the total value of the bid OR 10 % of the value of the 1st year of service for service bids, to guarantee that bidders will enter into contract to furnish goods or services at prices stated. The bonding company must be listed on Treasury Circular 570 and licensed to operate in the state of California. 4.2. No Performance Bond and/or Material and Labor bonds shall be required of the successful bidder. 4.3. Original Bond or Cashier's Check MUST be received AT CITY HALL, 23920 Valencia Blvd., Santa Clarita, CA 91355, ATTENTION SUITE 120 and marked with the words "BID BOND FOR" and the bid #, "NO LATER THAN the bid due date and time, for the vendor to be considered responsive. COOPERATIVE BIDDING. Other public agencies may be extended the opportunity to purchase off this solicitation with the agreement of the successful vendor(s) and the City of Santa Clarita. The lack of exception to this clause in vendor's response will be considered agreement. However, the City of Santa Clarita is not an agent of, partner to or representative of these outside agencies and is not obligated or liable for any action or debts that may arise out of such independently negotiated "piggy -back" procurements. DELIVERY. Unless otherwise specified, delivery shall be D.D.P., the City of Santa Clarita, site of user division and contract delivery may begin no later than fifteen (15) calendar days from receipt of order. 7. INVOICES. Invoices will be forwarded to: City of Santa Clarita Attention: Melanie Theisgen NS - Special Districts 23920 Valencia Blvd. Ste. 295 Santa Clarita, CA 91355-2196 Invoices will reflect the purchase order # and goods or service delivered in accordance with the terms of the contract. Invoice processing begins on receipt of the material or invoice, whichever is later. Labor Compliance Program. All Public Works projcest are subject to the City's Labor Compliance Program. The Contractor shall further adhere to the requirements contained in the City of Santa Clarita's Labor Compliance Program, approved by the DIR for projects with a Solicitation Advertiseement Date of November 20, 2003 or later, and which will become part of the conformed documents. All pertinent California statutes and regulations, including, but not limited to those referred to in the City's Labor Compliance Program, are incorporated herein by reference as though set forth in their entirety. Additionally, the Contractor is responsible for obtaining a current edition of all California statutes and regulations and adhering to the latest editions of such. Contractor shall submit certified copy of all Certified Payroll Records (CPRS) with the progress payment on at least monthly basis to the City. PREPARATION. All bids must be submitted via PlanetBids. All forms must be uploaded as laid out in the PlanetBids General Attachments Section. 10. REJECTION. The City reserves the right to reject any or all bids and to waive any informality in any quote. The City may reject the bid of any vendor who has previously failed to perform properly, or complete on time, contracts of a similar nature, or to reject the quote of a vendor who is not in a position to perform such a contract satisfactorily. The City may reject the bid of any vendor who is in default of the payment of taxes, licenses or other monies due to the City of Santa Clarita. 11. RENEWAL AND PRICING ADJUSTMENT. Contracts entered into pursuant to this Invitation to Bid shall be for an initial two years and may be renewed annually, up to three times, in accordance with the terms of the contract. If not otherwise stated, the contract may be renewed if the new pricing of the contract does not change more than the Consumer Price Index identified in the most recently City Council approved City of Santa Clarita Combined Engineer's Report for Landscape Maintenance Districts. 12. STATE CONTRACTOR'S LICENSE. If requested and in accordance with the provisions of California Public Contract Code Section 3300, the successful vendor shall submit proof of a State Contractor's License with bid response. Failure to possess the specified license shall render the bid as non-responsive and shall act as a bar to award the contract to any bidder not possessing said license at the time of award. As provided for in Section 22300 of the California Public Contract Code, the Contractor may substitute securities for monies withheld by the City to ensure performance under the contract. THE FOLLOWING LICENSE(S) ARE REQUIRED TO SUBMIT A QUOTE FOR THIS PROJECT: (A) General Engineering Contractor 13. STATE PREVAILING WAGE. This contract is subject to the State prevailing wage requirements of the California Labor Code including Sections 1770, 1771.5, 1773, 1776 and 1777.5. Pursuant to Section 1773 of the Labor Code, the general prevailing wage rates in the county, or counties, in which the work is to be done have been determined by the Director of the California Department of Industrial Relations. These wages are set forth in the General Prevailing Wage Rates for this project, available from the California Department of Industrial Relations' Internet web site at http://www.dir.ca.gov/dlsr/pwd. Future effective general prevailing wage rates which have been predetermined and are on file with the California Department of Industrial Relations are referenced but not printed in the general prevailing wage rates. A copy of the prevailing rate of per diem wages shall be posted at the job site. 14. SUBCONTRACTORS. For all public projects, the vendor must list any subcontractors that will be used, the work to be performed by them, and total number of hours or percentage of time they will spend on the project. 15. SUBMITTING BIDS. 15.1.The bid response must be submitted on this form and include all forms provided or information requested or required by the scope of work or specifications, (uploaded via PlanetBids) 15.2. All documentation of unit pricing or other cost breakdowns as outlined in this quote must be submitted to support the total bid price. 15.3. Bids/corrections received after the closing time will not be accepted. The City will not be responsible for bids not properly or timely, uploaded. Upon award, all submissions become a matter of public record. 16. TERMINATION. The City may terminate any purchase, service or contract with or without cause either verbally or in writing at any time without penalty. The City of Santa Clarita's "Terms and Conditions" is found on a separate attachment in Planet Bids. B. SCOPE OF WORK Bid # LMD-18-19-33 Backflow Prevention Services EVENT Solicitation advertisement Last day for questions Return of proposals Contract award March 1, 2019 March 20, 2019 April 1, 2019 April 23, 2019 DATE The City of Santa Clarita is soliciting electronic sealed bids from certified backflow prevention devices testers to certify, service, maintain, install, and repair as necessary approximately 794 backflow devices owned by the City of Santa Clarita, (ATTACHMENT A) including those devices located within the Special Districts area of responsibility (Landscape Maintenance Districts, LIVID and Urban Forestry, UF), City Parks, and City Facilities. The successful bidder shall have the knowledge, tools, and a minimum of five years' experience servicing and installing backflow prevention devices, automatic control valves, backflow irrigation controls stations (BIC), BIC commissioning, pressure regulators, fire service backflow apparatus, concrete pad installation and repair, and all aspects of backflow prevention devices used for municipal water delivery. The Backflow Prevention Device contractor is asked to provide a detailed cost response for maintenance, repair, and related services associated with backflow appurtenances within the City of Santa Clarita. (EXHIBIT 1) The response should include the bid completely filled out and to include all handling, miscellaneous charges and sales tax. Valid Class A - General Engineering Contractors License, American Water Works Association, (AWWA) Cross Connection Certification License, and Los Angeles County Dept. of Health Services Backflow Prevention Certification is required and shall be included with bid submission. The awarded vendor will enter into a two year contract with three possible renewals of one year each. General Provisions: 1) The contractor must possess the following license and certification at time of bid submission Class A - General Engineering Contractors License, AWWA Cross Connection Certification License, and Los Angeles County Dept. of Health Services Backflow Prevention Certification. The bidder shall submit a copy of the licenses with bid submission. 2) The contractor shall be required to have no less than five years' experience in certification, servicing, maintaining, installing, and repairing all types backflow prevention devices including but not limited to fire service apparatus (ATTACHMENT B). Additionally, contractor must have been in business and certified as a backflow prevention device tester for at least five consecutive years. 3) No work will be performed on City Legal Holidays unless authorized by Special Districts Administration. (ATTACH ME NT C). 4) The contractor shall be required to provide five references for jobs similar in scope to the specifications provided. See EXHIBIT 1. 5) The hours of work shall be from 7:00 a.m. to 3:30 p.m. Monday through Friday. 6) Blowers, generators, demolition hammers, or other mechanical equipment with a decibel level above 65 decibels cannot be used before 7:00 a.m., Monday through Friday within the City of Santa Clarita. 7) Contractor is responsible for following all street traffic rules while driving within the City of Santa Clarita. The awarded vendor shall provide safe and adequate pedestrian and vehicular movement at all work sites. Contractor is responsible for any/all traffic control and is subject to "Watch Manual" rules and regulations regarding traffic control within City limits. 8) Damage to irrigation lines, sprinklers, plant material, concrete walkways, light poles, fencing, or any public or private property due to contractor's negligence shall be the responsibility of the contractor for repair. Repairs shall be completed within (48) forty eight hours. 9) The awarded vendor shall enter into a Maintenance Agreement Contract with the City of Santa Clarita for the period of two, (2) years with three, (3) option years renewed annually contingent upon acceptance from The City of Santa Clarita and the Contractor. 10) Contractor shall at all times exhibit good customer service to City staff, City contracted staff, residents and others throughout term of this contract. All communication will be professional in manner between all parties. Unsatisfactory communication and service may be cause for contract termination. 11) This contract is subject to the State prevailing wage requirements of the California Labor Code including Sections 1770, 1771.5, 1773, 1776 and 1777.5. Pursuant to Section 1773 of the Labor Code, the general prevailing wage rates in the county, or counties, in which the work is to be done have been determined by the Director of the California Department of Industrial Relations. These wages are set forth in the General Prevailing Wage Rates for this project, available from the California Department of Industrial Relations' Internet web site at http://www.dir.ca.gov/OPRL/ DPreWageDetermination. htm. Future effective general prevailing wage rates which have been predetermined and are on file with the California Department of Industrial Relations are referenced but not printed in the general prevailing wage rates. A copy of the prevailing rate of per diem wages shall be posted at the job site. 12) This bid is subject to SB 854 and SB -96. See Instruction to Bidders for details. Contractor shall comply with California prevailing wage laws including, to the extent applicable, Labor Code Section 1720.9. 13) Contractor shall further adhere to the requirements contained in the City of Santa Clarita's Labor Compliance Program, approved by the DIR for projects with a Bid Advertise Date of November 20, 2003 or later, and which will become part of the conformed documents. All pertinent California statutes and regulations, including, but not limited to those referred to in the City's Labor Compliance Program, are incorporated herein by reference as though set forth in their entirety. Additionally, the Contractor is responsible for obtaining a current edition of all California statutes and regulations and adhering to the latest editions of such. Special Provisions The Specific provisions for work shall include and not be limited to: 1) Contractor shall perform one hundred percent of the backflow prevention device repairs, certifications, and services identified in these specifications. Subcontracted work (other work) may be accepted on an as needed basis and is subject to prior approval from the City of Santa Clarita. 2) Contractor shall possess an American Water Works Association, (AWWA) Cross Connection Certification License and Los Angeles County Department of Public Health, Environmental Health backflow license to conduct backflow testing, certifications, and repairs. 3) Contractor shall complete and submit the required testing and certification forms to the respective water supplier and City of Santa Clarita within 14 days of test date. (ATTACHMENTS D1, D2, D3, D4) 4) Contractor shall have the tools and experience necessary to perform maintenance and repairs on all types of direct acting type pressure regulators. 5) Contractor shall have the tools and experience necessary to perform maintenance and repairs on all types of Automatic Control Valves (ACV'S). 6) Contractor shall have the ability to certify, troubleshoot, maintain, commission and repair BIC -1000 (ATTACHMENTS E1, E2, E3) stations throughout the City. This includes but not limited to the backflow prevention device and its components, regulator, master valve, pressure switch, flow switch, and solenoid on/off valve. 7) Contractor shall acknowledge City emergencies to the LIVID Monitor, Inspector, and/or Special Districts' staff within fifteen (15) minutes of being notified during working hours, (7:00am to 3:30pm), and acknowledge within thirty minutes (30) outside of working hours. The contractor must have necessary resources available within two (2) hours. Upon arriving at an emergency situation, it shall be the responsibility of the contractor to eliminate all unsafe conditions which would adversely affect the health, safety, or welfare of the public. 8) Contractor shall respond and complete repairs within 24-48 hours for standard service calls. 9) Contractor shall provide original backflow reports/certification forms to the designated water agency(s) and must provide a copy of each report to the City. (ATTACHMENTS D1, D2, D3, D4) 10) Contractor shall perform compliance (certification) testing following any dismantling, manipulation, or repair of any backflow prevention device, at time of repair (regardless of annual test date). Confirmation of readings shall be included with invoicing. 11) Contractor shall provide the physical location/address, time/date of testing, pressure reading, and water meter numbers on all backflow test forms, even if not required by the water agency. 12) Contractor shall maintain a current contractor's license (A - General Engineering) at all times during the term(s) of the agreement. 13) Contractor shall perform annual calibration test completed on all backflow gauges used. 14) Mark-up on material(s) shall not exceed 15%. Contractor shall provide copies of materials invoices upon request. Additional Attachments for informational purposes: (ATTACHMENT F) BIC -1000 and ACV Spreadsheet (ATTACHMENT G) Enclosures B. SAMPLE CONTRACT MAINTENANCE AGREEMENT (SAMPLE) BETWEEN THE CITY OF SANTA CLARITA AND FOR THIS MAINTENANCE AGREEMENT ("Agreement") is made by and b general law city and municipal corporation ("CITY") and ("CONT The Parties agree as follows: CONSIDERATION. A. B. C. As partial consideration, SERVICES, below; and As additional consideration, C( conditions contained in this Ag As additional considE forth in the attached services. CITY will 1 CONTRACTOR's,,i,n� 2. TERM. The term of this Agreer7 be renewed upon mutual consent of 3. SCOPE OF SERVI A. C CITY OF SANTA CLARITA, to perform the work listed in the SCOPE OF CITY agree to abide by the terms and es to pay CONTRACTOR on a basis an amount set which is incorporated by reference, for CONTRACTOR's promptly, but not later than thirty (30) days after receiving The Agreement may CONTRACTOR°SWI, in a workmanlike manner, furnish all of the labor, technical, administrative, professional and other personnel, all supplies and materials, equipment, printing, vehicles, transportation, office space and facilities, and all tests, testing and analyses, calculation, and all other means whatsoever, except as herein otherwise expressly specified to be furnished by CITY, necessary or proper to perform and complete the work and provide the professional services required of CONTRACTOR by this Agreement. 4. PREVAILING WAGES. A. If required by applicable state law including, without limitation Labor Code §§ 1720 (as amended by AB 975 (2001)), 1771, 1774, 1775, and 1776, CONTRACTOR must pay its workers prevailing wages. It is CONTRACTOR's responsibility to interpret and implement any prevailing wage requirements and CONTRACTOR agrees to pay any penalty or civil damages resulting from a violation of the prevailing wage laws. In accordance with Labor Code § 1773.2, copies of the prevailing rate of per diem wages are available upon request from CITY's Engineering Division or the website for State of California Prevailing Wage Determination at www.dir.ca.gov/DLSR/PWD. A copy of the prevailing rate of per diem wages must be posted at the job site. B. If this contract is subject to state prevailing wage requirements of the California Labor Code including Sections 1770 and 1773, and the City's California Department of Industrial Relations (DIR) approved Labor Compliance Program. All covered work classifications required in performance of this contract will be subject to prevailing wage provisions. The Contractors and its subcontractors shall pay not less than the state wage rates. Contractor shall further adhere to the requirements contained in the City of Santa Clarita's Labor Compliance Program. A copy of the Labor Compliance Program is available for review upon request at the Office of the City Clerk. All pertinent state statues and regulations, including, but not limited to those referred to in this contract and in the City's Labor Compliance Program, are incorporated herein as though set forth in their entirety. Additionally, the Contractor is responsible for obtaining a current edition of all applicable state statues and regulations and adhering to the latest editions of such. C. Protection of Resident Workers The City of Santa Clarita actively supports the IiyrancilationalityAct (INA), which includes provisions addressing employment eligibilit ,mentrification, and nondiscrimination. Under the INA, employers may hire only personsi ay gally work in the United States (i.e., citizens and nationals of the U.S.) and aliens authorize'dol work in the U.S. The employer must verify the identity and employment eligg' ility of anyor to; 6e hired, which includes completing the Employment Eligibility Verifications (I-9). T Contractor shall establish appropriate ��� procedures and controls so no service //,trod �s under the Contract Documents will be "A ter t legally eligible to perform such services or performed or manufactured by �A ter w - � g Y g employment. 5. FAMILIARITY WITH WORK. A. By executing this Agreem Thoroughly represents that CONTRACTOR has: idered the scope of services to be performed; and ii. Carefully cons`fdJ"1Y' e services should be performed; and iii. Understands the faci' s, difficulties, and restrictions attending performance of the ra servi" is A eement. B. If services invol y ork u{ on any site, CONTRACTOR warrants that CONTRACTOR has or will invest— the sib -,h and is or will be fully acquainted with the conditions there existing, before co �encing the s es hereunder. Should CONTRACTOR discover any latent or unknown co �ition�� J'JJq materially affect the performance of the services, CONTRACTOR will imrr" ('� infoi CITY of such fact and will not proceed except at CONTRACTOR's own risk until written insttions are received from CITY. 6. INSURANCE. A. Before commencing performance under this Agreement, and at all other times this Agreement is effective, CONTRACTOR will procure and maintain the following types of insurance with coverage limits complying, at a minimum, with the limits set forth below: Type of Insurance Commercial general liability: Business automobile liability Workers compensation Limits (combined single) $1,000,000 $1,000,000 Statutory requirement B. Commercial general liability insurance will meet or exceed the requirements of ISO -CGL Form No. CG 00 01 11 85 or 88. The amount of insurance set forth above will be a combined single limit per occurrence for bodily injury, personal injury, and property damage for the policy coverage. Liability policies will be endorsed to name City, its officials, and employees as "additional insureds" under said insurance coverage and to state that such insurance will be deemed "primary" such that any other insurance that may be carried by City will be excess thereto. Such insurance will be on an "occurrence," not a "claims made," basis and will not be cancelable or subject to reduction except upon thirty (30) days prior written notice to City. C. Automobile coverage will be written on ISO Business Auto Coverage Form CA 00 01 06 92, including symbol 1 (Any Auto). D. CONTRACTOR will furnish to City duly autf nticaf9d Certificates of Insurance evidencing maintenance of the insurance required under � AgrOhnent,, endorsements as required herein, and such other evidence of insurance or copi, �sjfJ�l cies ay be reasonably required by City /, from time to time. Insurance must be placed with in �� wit.'a current A.M. Best Company Rating equivalent to at least a Rating of"A:VII." ertificate(s)' �Yeflect that the insurer will provide thirty (30) day notice of any cancellation of c 'verage. COITFACTOR will require its insurer to modify such certificates to delete any exculp r',� , ording st 'fig that failure of the insurer to mail written notice of cancellation imposes no obli atiof d to fete the word "endeavor" with regard to any notice provisions. jfj E. Should CONTRACTOR, forfail to obtain and maintain the insurance required by this Agreement, City may obtai such�ge at CONTRACTOR's expense and deduct the cost of such insurance from paym� due t' RACTOR under this Agreement or terminate. In the alternative, should CONTR . I. , fail t meet any of the insurance requirements under this agreement, '1004. F. G. Should Contractor's insur6ace required by this Agreement be cancelled at any point prior to expiration of -the oolicv. COACTOR must notifv Citv within 24 hours of receipt of notice of CONTRACTOR ft4t ensure that there is no lapse in coverage, 7. TIME FOR PER, dRMANCE. G NTRACTOR will not perform any work under this Agreement until: A. CON,,T TOR f4rnishes proof of insurance as required under Section 6 of this Agreement; and B. CITY gives `C*'NTRACTOR a written Notice to Proceed. C. Should CONTRACTOR begin work in advance of receiving written authorization to proceed, any such professional services are at CONTRACTOR's own risk. 8. TERMINATION. A. CITY may terminate this Agreement at any time with or without cause. B. CONTRACTOR may terminate this Agreement upon providing written notice to CITY at least thirty (30) days before the effective termination date. C. Should the Agreement be terminated pursuant to this Section, CITY may procure on its own terms services similar to those terminated. D. By executing this document, CONTRACTOR waives any and all claims for damages that might otherwise arise from CITY's termination under this Section. 9. INDEMNIFICATION. CONTRACTOR agrees to indemnify and hold CITY harmless from and against any claim, action, damages, costs (including, without limitation, attorney's fees), injuries, or liability, arising out of the performance of this agreement by CONTRACTOR. Should CITY be named in any suit, or should any claim be brought against it by suit or otherwise, arising out of performance by CONTRACTOR of services rendered pursuant to this Agreement, CONTRACTOR will defend CITY (at CITY's request and with counse�tocor fsfactory to CITY) and will indemnify CITY for any judgment rendered against it or any sums paid out in settler cpsts incurred in defense otherwise. 10. INDEPENDENT CONTRACTOR. CITY and CONTRACTO thatONTRACTOR will act as an independent contractor and will have control of all work and the manne��' ic,s it performed. CONTRACTOR will be free to contract for similar service to be performed for other empl while under contract with CITY. CONTRACTOR is not an agent or employee of CITY and is t entitled to parti pate in any pension plan, insurance, bonus or similar benefits CITY provides for its employees.//� q�ovision in"'' is Agreement that may appear to give CITY the right to direct CONTRACTOR as to the details of doirf� wor r to exercise a measure of control over the work means that CONTRACTOR will follow the dir f the as to end results of the work only. 11. NOTICES./////j A. All notices given or required to�� iven p to this Agreement will be in writing and may be ri given by personal delivery or by `d� ����otice nt by mail will be addressed as follows: To CITY: City of Sarfv Clafl ;i,, aoulevard, Suite 300 S 6 91355 To CONTRACTOR: Name B. When add" fed in ac°Oprdance with this paragraph, notices will be deemed given upon deposit in the Unit States mail, { Iage prepaid. In all other instances, notices will be deemed given at the time of ctua r"� r /���„ ,j C. Changes may be m e in the names or addresses of persons to whom notices are to be given by giving notice iri° anner prescribed in this paragraph. 12. TAXPAYER IDENTIFICATION NUMBER. CONTRACTOR will provide CITY with a Taxpayer Identification Number. 13. WAIVER. A waiver by CITY of any breach of any term, covenant, or condition contained in this Agreement will not be deemed to be a waiver of any subsequent breach of the same or any other term, covenant, or condition contained in this Agreement, whether of the same or different character. 14. CONSTRUCTION. The language of each part of this Agreement will be construed simply and according to its fair meaning, and this Agreement will never be construed either for or against either party. 15. SEVERABLE. If any portion of this Agreement is declared by a court of competent jurisdiction to be invalid or unenforceable, then such portion will be deemed modified to the extent necessary in the opinion of the court to render such portion enforceable and, as so modified, such portion and the balance of this Agreement will continue in full force and effect. 16. CAPTIONS. The captions of the paragraphs of this Agreement are for convenience of reference only and will not affect the interpretation of this Agreement. 17. WAIVER. Waiver of any provision of this Agreement will not be deemed to constitute a waiver of any other provision, nor will such waiver constitute a continuing waiver. 18. INTERPRETATION. This Agreement was drafted in, and wi, ibe construed in accordance with the laws of the State of California, and exclusive venue for any action involvin2,is agrktne,.will be in Los Angeles County. 19. AUTHORITY/MODIFICATION. This Agreement may be to fid conditioned upon approval and ratification by the Santa Clarita City Council. This Agreement is not biupon CITY until executed by the City Manager. The Parties represent and warrant that all nec ssary action fps een taken by the Parties to authorize the undersigned to execute this Agreement and to engage actions' scribed herein. This Agreement may be modified by written agreement. CITY's City Manager may a Ite an uch amendment on behalf of CITY. 20. ACCEPTANCE OF FACSIMILE SIGNATU S. TParties' gree that this Agreement, agreements ancillary to this Agreement, and related documents to 0�re into in connection with this Agreement will be considered signed when the signature of a party is deliv�e ed by'F�ile transmission. Such facsimile signature will be treated in all respects as having the same effect a griginal M60*re. 21. EFFECT OF CONFLICT. In the event of aft ce;1at inconsistency, or incongruity between any provision of this Agreement, its attachments, the purchase order�,,r n � 'e to proceed, the provisions of this Agreement will govern and control. ��%%%///%%/G%///iii ,,,,,,';. 22. FORCE MAJEURE. Should performdft—�p of this Agreement be prevented due to fire, flood, explosion, war, terrorist act, embargo, government action, ci ���r military authority, the natural elements, or other similar causes beyond the Parties' control, tl ° K t will immediately terminate without obligation of either party to the other. . 23. ENTIRE AGREEM],,`;T. This' greement and its one attachment constitutes the sole agreement between CONTRACTOR an V ITY'resp ectii' maintenance. To the extent that there are additional terms and conditions containein E fJ/�� "that are not in conflict with this Agreement, those terms are incorporated as if fully set forth abou a ars o other understandings, terms or other agreements expressed or implied, oral or written. 24. CONFLICT OF INTEREST. CONSULTANT will comply with all conflict of interest laws and regulations including, without limitation, CITY's conflict of interest regulations. (SIGNATURES ON NEXT PAGE) IN WITNESS WHEREOF, the parties hereto have executed this contract the day and year first hereinabove written. FOR CONTRACTOR: By: Print Ne Date: FOR Cl KENNE By: Date: ATTES" By: Date: APPRC JOSEPI By: City Attorney Date: DESIGNATION OF SUBCONTRACTORS Bid # LMD-18-19-33 Backflow Prevention Services City of Santa Clarita, California Subcontractor DBE STATUS: Age of firm: Certifying Agency: Dollar Value of Work Annual Gross Receipts: Location and Place of Business Bid Schedule Item Nos: Description of Work License No. Exp. Date: / / Phone ( ) Subcontractor DBE STATUS: Age of firm: Certifying Agency: Dollar Value of Work Annual Gross Receipts: Location and Place of Business Bid Schedule Item Nos: Description of Work License No. Exp. Date: / / Phone ( ) Subcontractor DBE STATUS: Age of firm: Certifying Agency: Dollar Value of Work Annual Gross Receipts: Location and Place of Business Bid Schedule Item Nos: Description of Work License No. Exp. Date: / / Phone ( ) NOTE: A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5 of the Labor Code. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 of the Labor Code at the time the contract is awarded. BID SECURITY FORMS FOR CHECK OR BOND TO ACCOMPANY BID Bid # LM D-18-19-33 Backflow Prevention Services NOTE: The following form shall be used in case check accompanies bid. Accompanying this Proposal is a *certified/cashier's check payable to the order of the City of Santa Clarita for: dollars ($ ), this amount being not less than ten percent (10%) of the total amount of the first contract year (365 days) of this bid. The proceeds of this check shall become the property of said AGENCY provided this Proposal shall be accepted by said AGENCY through action of its legally constituted contracting authorities, and the undersigned shall fail to execute a contract and furnish the required bonds within the stipulated time; otherwise, the check shall be returned to the undersigned. Project Name: Backflow Prevention Services Bidder's Signature CONTRACTOR Address City, State, Zip Code * Delete the inapplicable work. NOTE: If the bidder desires to use a bond instead of a check, the following form shall be executed. The sum of this bond shall be not less than ten percent (10%) of the total amount of the bid. PROPOSAL GUARANTEE BID BOND Bid # LM D-18-19-33 Backflow Prevention Services City of Santa Clarita, California KNOW ALL MEN BY THESE PRESENTS that ,as BIDDER, and , as SURETY, are held and firmly bound unto the City of Santa Clarita, as AGENCY, in the penal sum of dollars ($ ), which is ten percent (10%) of the total of first contract year (365 days) amount which is bid by BIDDER, to AGENCY for the above -stated project, for the payment of which sum, BIDDER and SURETY agree to be bound, jointly and severally, firmly by these presents. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that, whereas BIDDER is about to submit a bid to AGENCY for the above -stated project, if said bid is rejected, or if said bid is accepted and the contract is awarded and entered into by BIDDER in the manner and time specified, then this obligation shall be null and void, otherwise it shall remain in full force and effect in favor of AGENCY. IN WITNESS WHEREAS, the parties hereto have set their names, titles, hands, and seals, this day of 20_. SURETY* Subscribed and sworn to this day of 20 NOTARY PUBLIC *Provide BIDDER and SURETY name, address, and telephone number and the name, title, address, and telephone number for authorized representative. IMPORTANT - Surety Companies executing Bonds must appear on the Treasury Department's most current list (Circular 570, as amended) and be authorized to transact business in the State where the project is located. DOCUMENTS CHECKLIST Bid # LMD-18-19-33 Backflow Prevention Services In addition to the items requested for the bid the following documents are required to be completed and submitted by the proposer. • Request for Proposal Invitation page filled out • Any addendum published through Planetbids — signed form and acknowledgement through planet bids • Bidder's Bond - MUSTbe received at City Hall prior to bid due date • Designation of Subcontractors form — if none, write "n/a'; Do NOT leave blank • Required certificates/licenses - see Statement of Work and Format • References • Pricing Page CITY OF SANTA CLARITA INVITATION FOR BID BmckMqw Prevention Services Bids must be uploaded via PlanetBidbbefore 11:00 AMonMonday, April 1, 2019 to the Purchasing Agent ofthe City of Santa Clarha. Specifications for this electronic bid may beviewed at: Purchasing: (661)2554399 I. Solicitation documents for this bid may be downloaded from the City's Purchasing Planet0do website at �W 16840#. Please refer to the solicitation documents for complete details and bid requirements. I Proposer shall honor bid prices for One Hundred Twenty (120) days orfor the stated contract period, whichever is |mnger. I Bids must include this invitation forbid form and be signed bythe contractor's authorized representative. This signature acknowledges the proposer has read and understands the requirements contained on pages l to 19 , attachments A to H, and exhibits I to 2. 4� The last day for questions will be March 20, 2015\ 10:00 AM. Questions should be submitted electronically via P|anetBids: S. The vendor is responsible for the accuracy and completeness of any solicitation form not obtaineddirecdyfromthe City. 6. The specifications in this notice shall be considered a part of any contract made pursuant thereto. |have read, understood, and agreetothetermsandmonditkonsonaUpagesmf1hbinxitatinnforbid.Theundernignedmgrees tofurnish the commodity orservice stipulated onthis bid asstated above. Connpm res : Name (Print): Company Phone No.:ULZqq:]��. Title ofPerson Signing Proposal: BID ouwo'10-1*-3a W N N O w z, g ga. � A �r-� o 0 -moi T OMO X _c:z m mn-i rn� F)(n Z�, cnOvi Z mD < z v n m < 10% CONTRACTORS STATE UCENSE BOARD Contractor's License Detail for License # 658504 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. Per B&P 7071.17 , only construction related civil judgments reported to the CSLB are disclosed. Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. Business Information BACKFLOW PREVENTION DEVICE TESTER P O BOX 220114 NEWHALL, CA 91322-0114 Business Phone Number:(661) 294-0901 his license is current and active. information below should be reviewed. Entity Sole Ownership Issue Date 11/16/1992 Expire Date 11/30/2020 License Status Classifications Data current as of 3/21/2019 1:47:37 PM i - GENERAL ENGINEERING CONTRACTOR license filed a Contractor's I Number: 237341 1 Amount: $15,000 :tive Date: 06/03/2016 actor's Bond History Bonding Information Contractor's Bond SURETEC IN Workers�Compensation This license has workers compensation insurance with the SOUTHERN INSURANCE COMPANY Policy Number:OWC1007649 Effective Date: 05/01/2018 Expire Date: 05/01/2019 /Workers' Compensation History mkk k§k •`� . \ z f [ ( . . { o m §0 m . { ` t m o » \ X22 m � � � n .z "� n ` �k/k Q %r m z 0 j ( k G � I -4 m °a#©- rmQ m jto 2 0 , < . 19 lal 11 Cotlitr"rriiow"aurJa°c.Giri April 20, 2017 Doug Tigert P.O. Box 220114 Newhall, CA 91322 RE: Backflow Prevention Assembly Certification Exam Results Dear Doug: We are pleased to inform you that you have passed your examination for Certification with the California -Nevada Section, American Water Works Association, on February 18, 2017, with scores of: 100 for part A 96 for part B and successfully passing the Hands -On performance. Enclosed you will find a wall certificate and wallet card which shows that you have officially obtained this certification. Contact the California -Nevada Section of the American Water Works Association for additional information or if you have questions/concerns. Congratulations! Sincerely, Debra L. Kaye Certification Director Enclosure Attach the upper portion of this card to your certificate. For grade information, exam location and dates, address changes or payment information, contact: CA -NV Section, AWWA 10435 Ashford St. Rancho Cucamonga, CA 91730 Off.: 909-481-7200 Fax: 909-481-4688 IQ C;AL[ f Ck R.N t ASN E VA DAS.E....:...TION Fife with your certificate ..m._.,..... C American Water Works Association Backflow Prevention Assembly Tester Cert. No.: 09274 Exp. Date 04/30/2020 Certification Director 0 rn 0) DESIGNATION OF SUBCONTRACTORS Bid # LMD-18-19-33 Backflow Prevention Services City of Santa Clarita, California NOTE: A contractor or subcontractor shall not be qualified to bid on, be listed in a bid proposal, subject to the requirements of Section 4104 of the Public Contract Code, or engage in the performance of any contract for public work, as defined in this chapter, unless currently registered and qualified to perform public work pursuant to Section 1725.5 of the Labor Code. It is not a violation of this section for an unregistered contractor to submit a bid that is authorized by Section 7029.1 of the Business and Professions Code or by Section 10164 or 20103.5 of the Public Contract Code, provided the contractor is registered to perform public work pursuant to Section 1725.5 of the Labor Code at the time the contract is awarded. BID # LMD-18-19-33 15 EXHIBIT 2 Scenarios Oease include res A. 2" Febco 825Y backflow assembly had a relief valve opening of 1.2lbs. Provide pricirl for a relief valve rubber repair kit (Part # 905-054) to repair the backflow and complete a M B. 6" Ames 300OSS backflow assembly has a #1 check leak at the time of testing; provicl pricing to repair the backflow's #1 check (Part # 7010098), #2 check (Part # 701010 1), s, 602, IL2 C. 1.5" Wafts 009M2PCQT backflow assembly has been stolen and only the brass inlet/outlet riser and concrete pad remain. Provide price to install a new 1.5" Wafts D. 1" Wafts 009M2PCQT backflow assembly has a #1 ball valve that has freeze damage and needs to be replaced with a new Watts ball valve (Part # LFFBV-01 25028). %\N 0 �\z- 0 5DA S E. 10" Wafts 774 backflow assembly has a #2 gate valve leaking, provide pricing to repair the gate valve packing. U00ir 6? Z 15 EXHIBIT 2 (con't) assembly is leaking and needs a complete rubber repair kit (Fart # 0667547) to be repaired by 6e00pm G. A 2" Watts 115 regulator is not regulating properly and needs a new mein body rubber kit (Fart ## 5346-01) and pilot rubber kit (Fart #5138-06).$ t3 � It H. 1.5" BIG -1000 station is turning off because the ACV orifice (Fart## 2691-27) is inoperable. Cost to repair and re®certify, 1. A 1.5" Watts 223 regulator located on the inlet riser is not working and needs to be replaced with a Watts LF -223 (Fart## 0293569), stolenJ. A 2" backflow was 4 adapt to needed,a backflow are needed. Please provide a cost to install a new backflow assembly and the backflow being r should EXHIBIT 3 Backflow Prevention Device Testing, Certification, Maintenance, and Repair Throughout Various City of Santa Clarita Maintained Areas 4-GaiPjm-J-RTPi ALL LINE ITEMS TO BE PROVIDED AND INSTALLED COMPLETE (INCLUDES LABOR, MOBILIZATION, MATERIALS, EQUIPMENT, ETC.) - - - ..m LINE DESCRIPTION MEASURE (EA, Sq Ft, EST QTY UNIT PRICE EXTENDED PRICE Lump Sum, (Total) . . . . ...... 1. Backflow testing fee for initial test and certification EA 800 's 2. .......... ---11,11- . .............. . . .......... Backflow re -testing fee for .......... . . . . ......... ........... . . . ...... . . . - ----- additional testing (if needed due to initial EA 350 test failure) 3. Automatic Control Valve (ACV) inspection and pressure EA 10 ....... . . .... . calibration ..... . . . . .... ............ - ---- - - ........... 4. Backflow Irrigation Control (BIC) station commissioning EA . . . ........... . 20 .................... - ------ 'ajp� . . . . ..... . .... - ........ ........... . . . . z, 300 5. Direct acting regulator inspection EA 300 3`4,5-00 . . . . ............... . and pressure calibration . ..... . --- . . ..... 6. ....... . . . . . ......... ...... ..... After hours response . ...... .. . . . . ................. . HR . . ..... - -------- 2 . ..... ....... . . ........ . .... V5 ..... . ................ . . . . . ....... . . . . ...... . . 4 7. See Scenario A. . ...... . .......... . . . . . ..... - - — ---------- - - . ........... . . . . ......... EA . ........ — - - ------- . . ..... . .... ...... . . ... --- &ftrIC4 - --- . ......... RPS 08 . . .... EXHIBIT 3 PRICING con't 8. ....... ..... .......— S ........— ...... .. _ _ ......... Scenario EA 1 I .....�. ......_ ............ 9.ee X10 Scenario� C. EA 1 .5® 1 �....... _— ._... .._. - ....... _. 10. tAbCA'A I t9 See Scenario D. EA 1 VaWfA 2,% g-, 11. See Scenario E. EA 1 � 12. . ....._.. ........ ......._ _.......,.. See Scenario F. EA 1&31bty 13. See Scenario G. EA 1 a 14. See Scenario H. EA 1 Albs- �l 15. See Scenario I. EA 1 ,, t 16. See Scenario J. EA 1 1 f Please continue to next page EXHIBIT 3 PRICING, (con't.) In Numbers: TOTAL Line Items I - 16 In Words: Rve, kna" Fax l(lars ALL QUOTES SHALL BE BASED ON PREVAILING WAGE RgQy!qgggM COMPANY NAME-, CONTACT NAME: ADDRESS. - DATE:: LICENSE NO (CLASS A):_, PHONE NO:: 4a)-1 EXHIBIT 1 REFERENCES CERTIFICATION, SERVICE AND REPAIR OF BACKFLOW PREVENTION DEVICES LMD-18-19-33 City of Santa Clarita, California The following are the names, addresses, and telephone numbers of three public agencies for which BIDDER has performed work of a similar scope and size within the past 3 years: CHSameU)A—dd�ressbfOwni4llae�ncv" 0021 M SMI Name an -&Address 6? Owner/ AgencV ME Name and Address R", u Cit r - Type of Work 5. N a m e n d T e., I e �p Yo n A u m b -e -r - (o-Qf- P e ri—o-:n: UFa 2i I ia ariv i t h Fr 0 Date i +, Cate Completed The following are the names, addresses, and telephone numbers of all brokers and sureties from whom BIDDER intends to procure insurance bonds: s Formwiii"9 (Rev. October 20 18) Department of the Treasury Interns! Revenue Service Request for Taxpayer Teti entiflcation Number and Certification M IMMMEVIUMMMIII-7 21 individuaLlsole proprietor or El C Corporation El 8 Corporation El Partnership El Trust/estate single -member LLC E] Umited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) Ir, _ Notitr; Check the appropriate box in liho line above for the tax classification of the single-imember owner. Do not check LLC if the LLG is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLG is another ILLC that is not disregarded from the owner for ILL& federal tax purposes. Otherwise, a single -member LL0 thw is disregarded from the owner should check the appropriate box for the tax classification of its owner. Other (see instructions) dress mber, street, and apt. or NEWHALL, CA 91322 4 Exemptions (codes apply only to certain entities, not individuals; a" instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (APPIM to accounts me/Mained WWde the U.S.) name and JiUM_", Jaxpayer identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line I to avoid 7g..w -...'ity .I backup withholdFor individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a 01] - M T 37N, later. or r Identification number NoI 11 the account is in more than one name, see the instructions for line 1 Also see What Name and R�� Number To Give the Requester for guidelines on whose number to enter. i-=i ff�r 915; 4: 0l 6 1 6 0 1 I3 i Inder pWnaiiiesi lberiury, I certify that: 1, The number shown an 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 noted by the Internal Revenue Service (IRS) that I am sub*t to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I no longer subject to backup withholding; and 3. 1 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. Sign _'� Signature of Here I III .0 41 Date 0- j 0 Ir General Instructions Section references are to the Internal Revenue Code unless otherwise noted, Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to wvvwJrs.gov1Fomri Purpose of Form F An individual or entity (Form W-9 requester) who Is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption amount reportable on an information return. Examples of information returns include, but are not limited to, the following, o Form 1099-1 NT (interest earned or paid) Form 1099 -DIV (dividends, including those from stocks or mutual funds) proceeds) * Form 101,49-B (stock or mutual fund sales and certain other transactions by brokers) Form 1099-S (proceeds from real estate transactions) Form 1099-K (merchant card and third party network transactions) 1098-T (tuition) * Form 1 M9 -C (canceled debt) * Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form II to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No, 10231X Form W-9 (Rev. 10-2018) A' aArE (rwxnanrvvYY— 03/21/2019 I CERTIFICATE F LIABILITY IL I � j _ __ J CERTIFICATE D _.._,m....,__. _ BELOW, THIS CERTIFICATE QF INSURANCE CIES NOT AFFIRMATIVELY OR NEGATIVELY AMEND EXTEND OR ALTER THE TE IS ISSUED AS A MATTER OF INFORMATION ONLY A CONFERS NO RIGHTS EiPON THE CERTIFICATE kOLDER. TkiS COVERAGE AFFORDED BY THE POLICIES DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED If SU he certlflcate ho der is an AD -M-6-N t:ti HOLDER... .� IMPORTANT. � t REPRESENTATIVE OR PRODUCE AND THE D�Q�AL INSURED the �oll .m _ SUBROGATION IS WAIVED subject to the terms and conditions of the policy, certaiPoliciesmay require an endorsement w statement o m � , � _ cy(imust hprovisions or be endorsed. A statement on endorsement(s). t Is certtftcate does not confer rl hts Its the certtflcate holder In 1'teel of such g _'_. _.... _ �_._.. m.. PRODUCER "i,......JNAM im Young James Youn ,A Agent Ilm.yaun .b9cu statefa — , 81 &98G-614 r 17200 Ventura Blvd. #117 ��, tIr: 1 pAtc Nu): 818 986-1586 9 C� rrrl Com _... .. Encino - w� � ... INSUREpT�S)AFFORDING COVERAGE y 25 CA 91316 �Nsuga A : State Farm General Insurance Corn n 5q INSURED �. Bernard D Clarke, DBA Backflow Prevention INSURERS 6NSURER ..,.,.. C! Device Tester P O Box 220114 husyRER o Newhall INSURER E CA 91322 tnlsuRERF COVERAGES __. C ES' IFICATE NUMiER .. OF INSURANCE LISTED BELOW HAVE _. -,. -. A UMBER INDICATED. NOTWITHSTANDING ANY w.. THIS IS TO CERTIFY THAT THE POIREQUIREMENT, TERM OR CONDITIONOF A BEEN ISSUED TO THE RT .. N VE 8 NY CONTRACT OR OTHERINSURED NAM EN WITH RESPECT TO WHICH THIS BONE FOR THE POLICY PERIOD Y DOCUMENT CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, N5R EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT6 .... TYPE OF INSURANCE NUMBER "POLICY EFF POLICY E)(P � . OM pus �,_...,..._„_ .�,,.,,_....._.._,.....,,,..__.,..._..,..w....�... w.,..,,._.,,,._ .�........ .MtDarrYYr� MASo.APMYi^I .w...,m. tJMiTs .. COMMERCIAL GENERAL LIABILITY POLfCV,w„.. ,... EACH OCCURRENCE g CLAIMS -MADE 11 OCCUR � ... ; PERATtOAIS I LOCATIONS t VEHICLES tACORD 101, Additional Remarks Schedule, may be attached if more space Is required) DESCRIPTION OF CANCELLATION __.... w ........... ...m. SHOULD ANY OF THE ABOVE. DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELAMRED IN City Of Santa Clarita ACCORDANCE MTH THE POLICY PROVISIONS. 23920 Valencia Blvd. #260 Valencia AUTHORIZED REPRESENTATIVE_ CA 91355Rt 11/2,,/-t, � a The ACORD name and logo are registered marks of ACO.... �^ ACORD 25 2018/03 4tATION. All rights reserved. RD 1001486 132849.12 03-56,2016 PREMIS=ES (Ea ocwrrencel $ e MED EXP (Any one Person I � $ Y , GENL.AGGREGATE DMIAPPLIES PER PERSONAL & AD RY JTPOLICY EC. LO GENERAL AGGREGATE.„ $$ OTHER PRODUCTSAGG � $ _ AUTOMOBILE LIABILITY .." Y Y P76 8515 C06 75Z mmW mF 03106i2019 f 09f06t2019 ANY ura 1,O00W ,000 OWNE SCHEDULED �IuRY�perLlMperisTan) $ AUTOS ONLY AUTOS HIRED at �' NON -OWNED (arsoddent) $ -.. BODILY INJURYP AUTOS ONLY v w AUTOS ONLY ' ERTY DA t dt '�"�m..�....�...,� J;ZCb I ,,Pera�denti ,.... ... UMBRELLA UAB A " _. $ . n — ... —.. ..._�.�.. , ,OCCUR EXCESS LtAa CLAIMS -MADE EACH OCCURRENCE $ DED RETENTKINS AGGREGATE g WORKERjib tl` .... 1 _ AND LOYERS LIA Y Yl N ER ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICEROEMBER EXCLUDED? ❑ N / A I „TATUTE E.L. EACH ACCIDENT j - .... (Mandatory In NH U es, describe under D CRIPTION qF OPJrFdAT1ON5 bel _j,,,,....Sw.„ rxv E L DISEASE EA EMPI OYEI', E $ ,._._....._ _� ... �_.�.N m... w�m��.. _...._ ...��..-�.w� �E L DISEASE - POLICY LIMIT � $ ... ; PERATtOAIS I LOCATIONS t VEHICLES tACORD 101, Additional Remarks Schedule, may be attached if more space Is required) DESCRIPTION OF CANCELLATION __.... w ........... ...m. SHOULD ANY OF THE ABOVE. DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELAMRED IN City Of Santa Clarita ACCORDANCE MTH THE POLICY PROVISIONS. 23920 Valencia Blvd. #260 Valencia AUTHORIZED REPRESENTATIVE_ CA 91355Rt 11/2,,/-t, � a The ACORD name and logo are registered marks of ACO.... �^ ACORD 25 2018/03 4tATION. All rights reserved. RD 1001486 132849.12 03-56,2016 BACKPRE-01 GRAMIREZ ACOROa DATE (MMIDDIYYYY) ATE OF LIABILITY INSURANCE 11/15/2018 ---_... , ..1.111. CERTIFICATE ����,, �.. m��_ 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. 11.1,1.. ...... _....... _ . ......... ------------ ----- � ........— ......-- .... ......---.-,.._ IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on is certificate does s no confer rights to the certificate older in lieu of such endorsements) .... ._. 1111.. License# OE02096 _ _ CONTACT PRODUCER NAME: Gracie Ramirez - Gracie.ramrei@dibu.com DiBuduo & DeFendis Insurance Brokers, LLC PHONEr, Ext 661 322-9993 FAx P.O. Box 9548 ( ): ( (A/C, No): (661) 322-9714 Bakersfield, CA 93389-9548 E-MAIL ADDRE$.a: INSURERS) AFFORDING COVERAGE NAIC A INSURER A: Admiral Insurance Company24856 INSURED INSURER B: Backfiow Prevention Device Tester INSURER C : P.O. BOX 220114 INSURER D Newhall, CA 91322 INSURER E: INSURER_ F COVE -RAGES---- CERTIFICATE NUMBER:REVISION BELOW HAVE BEEN ISSUE my .. ...... D TO THE INSURED NAMED NUMBER ... C THIS IS TO CERTIFY THAT THE POLICIES OF INSURANC ---- REVISION ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP SST TYPE OF INSURANCE IN yyV POLICY NUMBER I l r. YYYY LIMITS ii�� f 1 JMMlkP�yY .1 - 1111_ YY ABILITY EACH OCCURRENCE $ 00,000 A X COMMERCIAL S-MADEER� [OCCUR FEIECC1131106 11!30/2018 11/3012019 DAMAGETOE EoNTED nce; $ 1050,000 X Pollution & Profess/ 5,000' MED EXP iAny one person $ 1,000,000 PERSONAL & ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE '_„ 2000'000 X POLICY ❑ PROjE r7 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER: 1111. �..., 1111... ............. ----._.._.,,,, .., .,.,_........ .................................................. ...... 1111., ®_ 1111.. -..._ ..... ------- -- 1111. m,,,,, ... ................ ......--- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ey,a ��ccid7,nt.!" $ ANY AUTO BODILY INJU RY Per person i $ OWNED SCHEDULED " AUTOS ONLY ,. AUTOS BODILY INJURY Per accident, $ HIRED NON -OWNED PROPERTY DAMAGE $ AUTOS ONLY .. AUTOS ONLY Per accident .....111.., m... .... - ..... m 1111 --...._,._.. ������.�. _............... ...-----.......... ..$ „ m„ . ...�,,, „�,,,,,,, 1111.. _—..-.-.- ......... UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED RETENTION $ .,.,, . , ....... _- .YIN ......, 1111,.. .............. _ . .,,,,,,, ...-.- 1111... 1111 WORKERS COMPENSATION PER 0TH - AND EMPLOYERS' LIABILITY ,;,TATt [TE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA - - (Mandatory in NH) E.L. DISEASE - EA EMPLOYE[, - If yes, describe under DESCRIPTIONOF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS � . CORD ,,,,ion ,, , ......... Y........—._. ,,,_ _-----------------_ 1 LOCATIONS I VEHICLES ACORD 701, Additional Remarks Schedule, may be attached if more space is required) ....�,,, ,,,,,,,,, ........ .................- ----------- .__. ............._ 1111. ----- 1111_ emm. 1111 ..,,,... CERTIFICATE HOLDER rANrFl I ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Santa Clarita THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 23920 Valencia Blvd #260 Santa Clarita, CA 91355 .... ----- ............. _......,.,.,. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD .a►cc'Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) �....-� 03122/2019 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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 (858) 643-9263 (858) 643-9297 NAME: W Ll ht Insurance Agency Inc. Light Insurance Agency Inc, "rc°1N eyt) ,(858) 643-9263 j FAX , No): 858 643-92- �42A L x - 5677 Oberlin. Dr. #206 ADDRESS dioniir htlirhtinsuranceus.corn San Diego, CA 92121 INSURERS) AFFORDING COVERAGE MAIC s Lie 0E27837 .. INsuRERA Southern Insurance Company INSURED INSURERB: Backflow Prevention Device Tester INSURER P.O. Box 220114 INSURERD: Newhall, CA 91322-0114 INSURER : INSURER F : COVERAGES CERTIFICATE NUMBER: 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSRI Am-' dD90! .... POLICY— POLICY EXP LTR TYPE OF iNSURAI�E POLICY NUMBER MMlDDIYYYY MMIDt•� yN, LIMITS ................ I_._C N� GENERAL LIABILITY _ ... EACH OCCURRENCE SI G COMMERCIAL GENERAL LIABILITY L' ❑ OCCUR MPREMISES (Ea' occurrence $ CLAIMS-MADE ED EXP (Any one person) $ ®e....e . PERSONAL & ADV INJURY I $ ........ ..... . _ ......... -------- �GENERALAGGREGATE $ GEN'LAGGREGATELIMIT APPLIES PER PRODUCTS-COMPlOPAGG I$ PE, PRO- .. POLICY .... 11 �C.. $. ..... AUTOMOBILE LIABILITY N�31 dentj, NGLE LIJIi _ Ea acadent $ ANY AUTO BODILY INJURY (Per person) $ ALL AUTOS ( AUTOEDULED BODILY INJURY (Per aooldent) $ NON-OWNED IPROP TYDAMAG'E HIREDAUTOS AUTOS [ 1Pera" entl $ .,. $ ...... ..... ... ........., ................ ...........�... .............._. ........___... w............... .m. .........�.�. ......�.......... LIMBRE LA LLAS OCCUR 1 EACH OCCURRENCE EXCESS $ LIAB CLAIMS-MADE AGGREGATE $ MADE RETENTION t ........... _. w. ., .,, $ _ ... . WORKERSCOMPENSATION WCSFATU jO""TH AND EMPLOYERS' LIABILITY YIN � TORY LIMITS ER ANY PROPRIETOR/PARTNERIEXECUIVEE.L.ACH ACCIDENT $ 1'00n 000 A OFFICERIMEMBER-EXCLUDED? NIAa (Mandatory yIn NH) � E DISEASE EA EMPLOYE;$ 1 000 000 Ye ❑ ✓ oWC1on7649 Q5/01/2018 05101!2019 DESCRIPTION OF OPERATIONS below......,.E.L DISEASE-POLICY LIMIT J $,1 onnnn 0 ............. . DESCRIPTION OFOPf32AT10N31.._w.............m�.m....Wmmw _N.w.....,.�.,.�,:,....,. ..,,............._.. �,...,.,_,.. .......... ......m LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space is required) �30 day notice of Cancellationand 10 day notice for non-payment .�. . , .. CERTIFICATE HOLDER CANCELLATION City of Santa Clarita SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 23920 Valencia Blvd #295 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Santa Clarita, CA 91355 AUTHORIZED REPRESENTATIVE Dion Light 1988-2010 ACORD CORPORATION. AIF rights reserved, ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) WAIVER Ot OUR RIGHT To RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA 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.promium For this endorsement shalt be 2.5% Of the California workers` compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description Any person or organization as required by vvritten contract. This endorsement changes the policy to which' it is attached and Is effective on the data issued unless otherwise stated. (The Inform stion below is required only when this endorsertment to issued subsequent to preparation of the policy.) Endorsement Effective 5/1/2018 Policy No. OWC1007649 Endorsement. No. 0 Insured Clarks, Bernard (AN INDIVIDUAL) Premium $ 16847 Insurance Company Southern Insurance Company Countersigned by .... WC 04 03 06 (Ed. 04-84)