Loading...
PW Funding Request Certification; CalRecycleA Recycle San Rafael Funding Request Cycle: FY 2016-2017 Program Requirements Beverage Container Recycling City/County Payment Program City/County Annual Payment and Reporting System Funding Request Certification Type: Individual Eligible Funds ($): 15,374 1) Provide a brief description of the proposed project(s) that you plan to implement with city/county payment program funds. Public Resources Code 14581 (a)(3)(B). Project Description: San Rafael's goal is to maximize the amount of recyclable material that will be processed through the local landfill recycling center. Our secondary goal is litter abatement. For FY 16/17, our goal will be to maintain the current ratio of recyclable versus non -recyclable material at 80% for all California Refund Value (CRV) beverage containers collected from City streets, parks and other public spaces. The primary means of determining that ratio is by measuring the change of volume of beverage containers and other recyclable materials, as determined by pre/post tonnage reports generated by landfill personnel. 2) Please specify supermarket siting information pursuant to Public Resources Code 14581 (a)(3)(F). Have you prohibited the siting of a supermarket site? No Have you caused a supermarket to close its business? No Have you adopted a land use policy that restricts or prohibits the siting of a supermarket site within your jurisdiction? No 3) Are you currently participating in mediation mandated by AB 506? Have you attempted to initiate such mediation or have you declared a fiscal emergency within the last 12 months? Note: The answer is for informational purposes and will not be used to determine eligibility for payment funding. No 4) These funds shall not be used for activities unrelated to beverage container recycling or litter reduction, Public Resources Code 14581 (a)(4)(C). Yes, I Accept Contacts - Name Contact Type Title Phone Mr. Jim Schutz Signature Authority City Manager (415) 485-3070 Ms. Christine Foster Ms. Talia Smith Addresses Address P.O. Box 151560 1400 Fifth Ave. San Rafael, 94915 San Rafael Secondary Secondary, Primary (Funding Request) Administrative Assistant Senior Administrative Analyst Address Type (415) 485-3352 (415) 485-3354 Physical, Mailing, Payment Page 1 of 2 Email city. man ag er@cityofsa n rafael. org christine.foster@cityofsanrafa el.org talia.smith@cityofsanrafael.or 9 County Marin Printed: 4/27/2017 Beverage Container Recycling City/County Payment Program Recycle City/County Annual Payment and Reporting System Funding Request Certification Documents Document Type Date Title Resolution 05/16/2016 San Rafael City Council Resolution #142120 Activity ExpenTituces Current Activity Group Current Activity Item Budgeted Funds ($) Public Parks / Recreational Areas Litter Clean-up Roadways 15,374 Community Events Equipment / Supplies Total: 15,374 Penalty of Perjury Statement: "I certify under penalty of perjury, under the laws of the State of California that I am authorized to sign this Funding Request on behalf of Recipient, th hav read the City/County Payment Program Guidelines and that to the best of my knowledge and belief thar`informati n drov ed i is funding Request is true and correct." 1 Signature of Sig ture Authority (as a tho ized in Resolution) or Date Authorized Designee (as authorized in er of Designation) Jim Crhiit7 Print Name f:ity ManagPr, ritg of Can RafaP1 Print Title IMPORTANT! Recipient must print out this page, obtain signature of Signature Authority, upload signed document to the City/County Annual Payment and Reporting System, and retain the original document in the Recipient's cycle file. San Rafael Page 2 of 2 Printed: 4/27/2017 CONTRACT ROUTING FORM INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below. TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER: Contracting Department: Public Works Project Manager: Talia Smith Extension: 3354 Contractor Name: CalRecyle grant — needs City Manager signature to submit Contractor's Contact: n/a Contact's Email: n/a ❑ FPPC: Check if Contractor/Consultant must file Form 700 Step RESPONSIBLE DESCRIPTION DEPARTMENT 1 Project Manager a. Email PINS Introductory Notice to Contractor 9 City Clerk Attest signatures, retains original agreement and forwards copies to Project Manager COMPLETED DATE n/a 4/27/2017 en'te`r da%. �i Clic�}t,to enter a ate. Click here to enter a date. ❑ N/A Or t d 7/x/1 7 REVIEWER Check/Initial ®TS 54- pQ__ El El 1� b. Email contract (in Word) & attachments to City Atty c/o Laraine.Gittens@cityofsanrafael.org 2 City Attorney a. Review, revise, and comment on_ifaftegreement and return to Project Manager f b. Confirm insurance requirements, create PINS, send PINS insurance notice to contractor 3 Project Manager Forward three (3) originals of final agreement to contractor for their signature 4 Project Manager When necessary, * contractor -signed agreement agendized for Council approval *PSA > $20,000; or Purchase > $35,000; or Public Works Contract > $125,000 Date of Council approval PRINT CONTINUE ROUTING PROCESS WITH HARD COPY 5 Project Manager Forward signed original agreements to City Attorney with printed copy of this routing form 6 City Attorney Review and approve hard copy of signed agFE'@m—A, r"",dj.5.nccr -JYr 1`'��r ct� Pier. 7 City Attorney Review and approve insurance in PINS, and bonds (for Public Works Contracts) 8 City Manager/ Mayor Agreement executed by Council authorized official 9 City Clerk Attest signatures, retains original agreement and forwards copies to Project Manager COMPLETED DATE n/a 4/27/2017 en'te`r da%. �i Clic�}t,to enter a ate. Click here to enter a date. ❑ N/A Or t d 7/x/1 7 REVIEWER Check/Initial ®TS 54- pQ__ El El 1�