HomeMy WebLinkAboutPW Service Level Agreement; Task Order No. 98.1; Freitas Parkway Multiuse Pathway Conceptual Plan; L8.0010.T98.1
v. Feb 2025 Page 1
City of San Rafael
SERVICE LEVEL AGREEMENT
DATED ____________________
WITH __________________________________________
TASK ORDER NO. _____
(Amendment to Task Order No. ____ Executed on___________________)
Subject Title: __________________________________________________
Amendment Amount: $___________
THIS AMENDMENT TO TASK ORDER No. ____ is effective on
___________________, between the City of San Rafael, a municipal corporation
("City"), and _____________________________________, ("Contractor").
AGREEMENT TO AMEND TASK ORDER
1. Section 1 entitled “Scope of Work” (as may be referred to as “Scope of Services”
in the original Task Order), is hereby amended as set forth in Exhibit A-__ of this Task
Order Amendment.
2. Section 2 entitled “Date of completion; Work hours estimate; Cost estimate and
budget; Fee schedule” is hereby amended to include the additional work, work hours
estimate, cost estimate and budget set forth in Exhibit A-___, for an amount not to exceed
$______________, changing the total not to exceed amount under the Task Order to
$___________________.
3. Except as specifically amended herein, all of the other provisions, terms and
obligations of the Task Order shall remain valid and shall be in full force.
4. Signatures. The parties have executed this Amendment as of the date first
written above.
52,100
February 14, 2024
NOVEMBER 3, 2023
98
98.1
1
1
Freitas Parkway Multiuse Pathway Conceptual Plan
2,580
PARAMETRIX, INC.
Parametrix, Inc.
2,580
98
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
June 26, 2025
L8.0010.T98.1
City of San Rafael Service Level Agreement
Amendment to Task Order
v. Feb 2025 Page 2
CITY OF SAN RAFAEL:
_________________________________
________________________________,
_________________________________
Executed on:_______________________
APPROVED AS TO FORM:
Office of the City Attorney
_________________________________
________________________________,
_________________________________
ATTEST:
City Clerk
_________________________________
________________________________,
_________________________________
CONTRACTOR:
__________________________________
By: _______________________________
Name: ____________________________
Title: ____________________________
[If Contractor is a corporation, second
corporate officer signature required]
__________________________________
By: _______________________________
Name: ____________________________
Title: _____________________________
Exhibits:
A-__ – Scope of Work Amended 1
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Parametrix, Inc.
David Parisi
Principal Consultant
Parametrix, Inc.
Senior Vice President
Nathan Johnson
Chief Assistant City Attorney
Andrea Visveshwara
City Manager
June 26, 2025
Cristine Alilovich
City Clerk
Lindsay Lara
Exhibit A – 1
SCOPE OF WORK AMENDED
The Parties hereby agree to amend the Scope of Work to add the following work:
1. Additional or Amended Services:
1.1 Task 1 – Develop long-term improvements alternative at Montecillo
Road and Manuel T. Freitas intersection
1.2 Task 2 – Attend four coordination meetings with the City
1.3 Task 3 – Develop detailed construction cost estimates for four
segments of the multi-use path
1.4 Task 4 – Develop additional improvements on eastbound side of
Freitas Parkway
DELIVERABLES
The Scope of Work amended to add the following:
2. Project Deliverables:
2.1 Long-term improvements additional plan sheet (22x34 PDF)
2.2 Attendance at four meetings
2.3 Construction estimates split by segments
2.4 Plan set package with additional improvements on eastbound side
of Freitas Parkway (22x34 PDF)
SCHEDULE
The term of this Task Order shall be extended to June 30, 2025.
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown
below.
All following documents are attached as reference material.
RESPONSIBLE PARTY DESCRIPTION COMPLETED
City Attorney’s Office Review, revise as needed, and approve agreement as to
form
Department Director Review and approve agreement
Risk Management
Email PINS insurance request to Contractor
Confirm insurance documentation is complete
Finance Review and sign off on funding availability
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department:
Project Manager:
Contractor Name:
Contractor’s Contact: Contact’s Email:
City Council Date: ☐ ___________________ or ☐ Not applicable
☐ FPPC: Check if Contractor must file Form 700
Shannon Mackle (for Mariana Sanchez)
Parametrix, Inc.
David Parisi dparisi@parametrix.com
X
Public Works
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Rev. May 2021
City of San Rafael
MASTER CONSULTANT SERVICES AGREEMENT
DATED NOVEMBER 3, 2023
WITH PARAMETRIX, INC.
TASK ORDER NO. 98
Project title: Freitas Parkway Multiuse Pathway Conceptual Plan
Contract Amount: $49,520
THIS TASK ORDER is entered into on ________________, 202__ between the City of San
Rafael, a municipal corporation ("City"), and Parametrix, Inc. ("Consultant").
RECITALS
A. The City and Consultant have entered into a Master Consultant Services Agreement
("Agreement") dated November 3, 2023 under which Consultant has agreed to perform certain
professional consulting services for the City; and
B. Pursuant to the terms of the Agreement, the City wishes Consultant to perform certain
tasks as set forth in this Task Order, which constitute the Project;
NOW, THEREFORE, City and Consultant agree as follows:
AGREEMENT
1. Scope of services. Consultant shall provide any and all of the services set forth in Exhibit A of
this Task Order, titled Development of a Multiuse Pathway Conceptual Plan and Cost Estimate North
Side of Manuel T Freitas Parkway between Montecillo Road and Los Gamos Road, as directed by the
City.
David Parisi shall be the Project Manager for Consultant for this Task Order. Additional professional
services may be performed by other Consultant staff with prior notice and approval by City.
a. City's duties. The City will:
(1) Determine the scope of services, as set forth in Exhibit A.
(2) Make available the project plans and specifications and other City data related to the
project, including full information as to the City's requirements.
(3) Designate Nhat Phan as the person at the City responsible for monitoring performance
under this Task Order.
b. Consultant duties. The Consultant will:
(1) Provide and perform tasks identified in Exhibit A, Scope of Services.
(2) Provide miscellaneous consulting and other services related to the Project and not
stipulated elsewhere in this Task Order, when requested by the City in writing. A Task
Order Amendment is required if these additional services cannot be performed within the
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Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
City of San Rafael Master Consultant Services Agreement
Task Order
Rev. May 2021
2
Task Order budget.
2. Date of completion; Work hours estimate; Cost estimate and budget; Fee schedule.
With regard to each project given to Consultant that is subject to this Task Order, the time of completion,
work hours estimate, cost estimate and budget and fee schedule are set forth in Exhibit A to this Task Order.
3. Authorization to proceed.
The City will give Consultant authorization to proceed with the work specified in this Task Order only after
Consultant submits updated insurance certificates and endorsements, in accordance with Section 10 of the
Agreement.
4. Master Agreement terms; Conflicts.
Except as expressly otherwise provided herein, all terms of the Agreement shall apply to Consultant in the
performance of work pursuant to this Task Order. If there is a conflict between this Task Order and the
Agreement, this Task Order shall control.
4. Amendment of Task Order; Conflicts.
Except as provided in Section 1(b)(2) above, this Task Order may not be modified except by an Amended
Task Order executed and approved in the same manner as the Task Order.
5. Signatures. The parties have executed this Task Order, as of the date first written above.
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
City of San Rafael Master Consultant Services Agreement
Task Order
Rev. May 2021
3
CITY OF SAN RAFAEL
By: _____________________________
Cristine Alilovich, City Manager
Contents approved:
By: ______________________________
April Miller, Public Works Director
Reviewed By
By: ______________________________
Robert F. Epstein, City Attorney
CONSULTANT
By: __________________________
Name: ________________________
Title: _________________________
(if Consultant is a corporation, add signature
of second corporate officer)
By: __________________________
Name: ________________________
Title: _________________________
Exhibits:
A Scope of work titled Development of a Multiuse Pathway Conceptual Plan and Cost
Estimate North Side of Manuel T Freitas Parkway between Montecillo Road and Los
Gamos Road, time of completion, work hours estimate, cost estimate and budget, and fee
schedule (Consultant's current hourly rate)
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Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Attachment A
Scope of Services
Development of a Multiuse Pathway Conceptual Plan and Cost Estimate
North Side of Manuel T Freitas Parkway between Montecillo Road and Los Gamos Road
This work plan is for the preparation of conceptual design plans and planning-level cost estimates for a
new multiuse path along the north side of Manuel T Freitas Parkway between Montecillo Road and Los
Gamos Road. Parisi’s proposed work scope includes the following:
1.Topographic survey: Parisi will contract with Unico Engineering to perform a topographic survey of
the project corridor. The survey extents will be from the face of the westbound median curb to 30
feet offset from the right edge of pavement. The topographic survey will collect the locations of the
edge of pavement, utility poles, guy wires and anchors, fire hydrants, utility vaults and cabinets, and
manholes. These data will be collected using an unmanned aerial vehicle (UAV or drone); tree
location and sizes would not be provided as part of this approach.
Parisi and Unico can provide for additional cost an alternate topographic survey approach using
terrestrial LiDAR scanning that would provide additional detail such as tree locations and sizes.
2.Conceptual Plan: Parisi will develop a two-way multiuse path conceptual plan using the topographic
survey data as a base map. The conceptual plan set will be developed to the Caltrans PSR-PDS
standard, sufficient for ATP and other grant program applications, and will include a title sheet,
typical cross sections, and plan layout. The base map for the plan layout will be the topographic
survey collected in the prior task. Public right of way will be assumed as the fence line captured from
the aerial survey.
The path design will follow these assumptions:
a.The path alignment will run parallel to westbound Freitas Parkway, which will remain at two
through lanes within the project extents. Existing vehicle lanes wider than 11 feet will be
considered for width reduction where needed to accommodate the path. The multiuse path
will be designed to California Highway Design Manual (HDM) standards pertaining to width,
offset from roadways, and clearance from obstructions (Ch. 1000). Shoulder widths will
follow AASHTO guidelines for minimum (2 foot) and preferred (6 to 8 foot) widths (AASHTO
Green Book Section 4.4.2). Parisi will identify areas where the path alignment may not fully
satisfy CA HDM or AASHTO standards. Proposed improvements will be limited to the
westbound side of Freitas Parkway only.
The conceptual plan will propose new curb and gutter for the right side of the westbound
travel lanes. The conceptual plan will identify conflicting above-ground utilities with the
presumption that utility poles, vaults, and cabinets will remain in place and the multiuse
path routed around these features. Parisi will identify conflicting trees in constrained areas.
Parisi will provide these plans as a typical cross-section within each block and a plan view
path alignment. Plans will be provided as single panels at 1”=20’ scale on a 22”x34” sheet.
Exhibit ADocusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
b.Parisi will provide intersection detail sheets at five intersections (Los Gamos Road, Las
Gallinas Avenue, Los Pavadas Avenue, Del Ganado Road, and Montecillo Road). Existing right
turn channels or “slip lanes” may be proposed for removal where needed to accommodate
the path. Parisi will incorporate the latest best practices for multimodal safety at
intersections, which may include “protected” intersection features, pavement markings, and
signs. Proposed improvements will be limited to the westbound side of Freitas Parkway
only. Parisi will test protected intersection designs for design vehicle (frequently present)
and control vehicle (occasionally present) turns using AutoCAD Vehicle Turns software.
At the Las Gallinas Avenue intersection, the conceptual plans will show proposed new traffic
signal phasing and equipment needed to accommodate two-way bicycle traffic on the
westbound side of Freitas Parkway.
Plans will be provided for each intersection at maximum 1”=20’ scale on a 22”x34” sheet.
3.Planning-Level Cost Estimate. Parisi will develop construction cost estimates for the pathways
on a linear foot basis and will account for elements contained in the standard cross-sections
developed in Task 2 Conceptual Plan. The basis for estimate for discrete civil elements, such as
curb ramps, utility relocations, crossings, and signal and lighting systems, will be for each
element contained in the plan. Lump sum items will be limited to those items listed as
“allowable lump sum items” in the ATP Cycle 6 project estimate template.
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Attachment B
Schedule and Estimate
Development of a Multiuse Pathway Conceptual Plan and Cost Estimate
North Side of Manuel T Freitas Parkway between Montecillo Road and Los Gamos Road
Parisi Transportation Consulting (Parisi) will complete the tasks described in Attachment A in accordance
with the following schedule: •Task 1: Topographic Survey: 4 weeks from authorization to proceed.•Task 2/3A: Draft Conceptual Plan and Cost Estimate: 8 weeks from completed topographic
survey•Task 2/3B: Revised Conceptual Plan: 3 weeks from one round of City review.
Tasks described in Attachment A will be completed by June 30th 2024. Parisi’s proposed budget for the scope of
work is $49,520, as shown below:
Staff Hourly Rate Hours Subtotal
Survey Crew – aerial survey only* $10,000
Principal Consultant $310 16 $4,960
Managing Consultant $230 32 $7,360
Associate Consultant II $165 64 $10,560
Associate Consultant I $130 128 $16,640
Labor Total 240 $49,520
*Cost for ground survey provided upon request
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Attachment C
Fee Schedule
Development of a Multiuse Pathway Conceptual Plan and Cost Estimate
North Side of Manuel T Freitas Parkway between Montecillo Road and Los Gamos Road
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below.
Step RESPONSIBLE
DEPARTMENT
DESCRIPTION COMPLETED
DATE
REVIEWER
Check/Initial
1 Project Manager
a. Email PINS Introductory Notice to Contractor
b. Email contract (in Word) and attachments to City
Attorney c/o Laraine.Gittens@cityofsanrafael.org
Click here to
enter a date.
11/17/2023
☐
☒NT
2 City Attorney
a. Review, revise, and comment on draft agreement
and return to Project Manager
b. Confirm insurance requirements, create Job on
PINS, send PINS insurance notice to contractor
11/17/2023
11/17/2023
☒ NT
☒ NT
3 Department Director Approval of final agreement form to send to
contractor
11/17/2023 ☒ AM
4 Project Manager
Forward three (3) originals of final agreement to
contractor for their signature
11/21/2023 ☒
5 Project Manager When necessary, contractor-signed agreement
agendized for City Council approval *
*City Council approval required for Professional Services
Agreements and purchases of goods and services that exceed
$75,000; and for Public Works Contracts that exceed $175,000
Date of City Council approval
☒ N/A
Or
Click here to
enter a date.
☒
PRINT CONTINUE ROUTING PROCESS WITH HARD COPY
6 Project Manager Forward signed original agreements to City
Attorney with printed copy of this routing form
7 City Attorney Review and approve hard copy of signed
agreement
8 City Attorney Review and approve insurance in PINS , and bonds
(for Public Works Contracts)
9 City Manager / Mayor Agreement executed by City Council authorized
official
10 City Clerk Attest signatures, retains original agreement and
forwards copies to Project Manager
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department: Public Works
Project Manager: Nataly Torres (for Nhat Phan) Extension: 3353
Contractor Name: Parametrix, Inc.
Contractor’s Contact: Shannon Ihlen Contact’s Email: SIhlen@parametrix.com
☐ FPPC: Check if Contractor/Consultant must file Form 700
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Task Order no. 98 - Parametrix, Inc. - Freitas
Parkway MUP
Final Audit Report 2024-02-14
Created:2023-11-21
By:Nataly Torres (nataly.torres@cityofsanrafael.org)
Status:Signed
Transaction ID:CBJCHBCAABAALrEZ4OX4oehDBbK2rma4VHTqghwafAV3
"Task Order no. 98 - Parametrix, Inc. - Freitas Parkway MUP" Hi
story
Document created by Nataly Torres (nataly.torres@cityofsanrafael.org)
2023-11-21 - 11:49:17 PM GMT
Document emailed to Nathan Johnson (njohnson@parametrix.com) for signature
2023-11-21 - 11:51:57 PM GMT
Email viewed by Nathan Johnson (njohnson@parametrix.com)
2023-11-22 - 1:19:20 AM GMT
Document e-signed by Nathan Johnson (njohnson@parametrix.com)
Signature Date: 2023-11-22 - 1:19:39 AM GMT - Time Source: server
Document emailed to Dave Pennington (dpennington@parametrix.com) for signature
2023-11-22 - 1:19:40 AM GMT
Email viewed by Dave Pennington (dpennington@parametrix.com)
2023-11-22 - 4:52:06 PM GMT
Document e-signed by Dave Pennington (dpennington@parametrix.com)
Signature Date: 2023-11-22 - 4:52:21 PM GMT - Time Source: server
Document emailed to APRIL MILLER (april.miller@cityofsanrafael.org) for signature
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Document e-signed by APRIL MILLER (april.miller@cityofsanrafael.org)
Signature Date: 2023-11-27 - 3:12:42 PM GMT - Time Source: server
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Document emailed to Laraine Gittens (laraine.gittens@cityofsanrafael.org) for approval
2023-11-27 - 3:12:43 PM GMT
Email viewed by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
2023-11-27 - 5:55:08 PM GMT
Document approved by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
Approval Date: 2023-11-27 - 5:56:47 PM GMT - Time Source: server
Document emailed to Genevieve Coyle (genevieve.coyle@cityofsanrafael.org) for signature
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Email viewed by Genevieve Coyle (genevieve.coyle@cityofsanrafael.org)
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Document e-signed by Genevieve Coyle (genevieve.coyle@cityofsanrafael.org)
Signature Date: 2024-01-22 - 5:26:52 PM GMT - Time Source: server
Document emailed to city.clerk@cityofsanrafael.org for approval
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Email viewed by city.clerk@cityofsanrafael.org
2024-01-22 - 5:31:43 PM GMT
Signer city.clerk@cityofsanrafael.org entered name at signing as Brenna Nurmi
2024-01-22 - 5:31:54 PM GMT
Document approved by Brenna Nurmi (city.clerk@cityofsanrafael.org)
Approval Date: 2024-01-22 - 5:31:56 PM GMT - Time Source: server
Document emailed to cristine.alilovich@cityofsanrafael.org for signature
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Email viewed by cristine.alilovich@cityofsanrafael.org
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Email viewed by cristine.alilovich@cityofsanrafael.org
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Signer cristine.alilovich@cityofsanrafael.org entered name at signing as Cristine Alilovich
2024-02-14 - 3:29:25 PM GMT
Document e-signed by Cristine Alilovich (cristine.alilovich@cityofsanrafael.org)
Signature Date: 2024-02-14 - 3:29:27 PM GMT - Time Source: server
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Agreement completed.
2024-02-14 - 3:29:27 PM GMT
Docusign Envelope ID: C8C76609-FEB9-4F24-BA43-62E62F30106C
Certificate Of Completion
Envelope Id: C8C76609-FEB9-4F24-BA43-62E62F30106C Status: Completed
Subject: DocuSign: Task Order Amendment with Parametrix, Inc for Freitas Parkway MUP Conceptual Plan
Source Envelope:
Document Pages: 15 Signatures: 5 Envelope Originator:
Certificate Pages: 5 Initials: 4 Shannon Mackle
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
111 Morphew St
San Rafael, CA 94901
shannonm@cityofsanrafael.org
IP Address: 199.88.113.8
Record Tracking
Status: Original
6/9/2025 9:25:40 AM
Holder: Shannon Mackle
shannonm@cityofsanrafael.org
Location: DocuSign
Signer Events Signature Timestamp
Nataly Torres
NatalyT@cityofsanrafael.org
Administrative Analyst
City of San Rafael
Signing Group: City Attorney's Office
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address:
2600:1700:9750:3df0:2184:1d54:4bf3:8cdf
Sent: 6/11/2025 11:02:03 AM
Viewed: 6/11/2025 11:02:31 AM
Signed: 6/11/2025 11:02:40 AM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
April Miller
aprilm@cityofsanrafael.org
Public Works Director
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 199.88.89.34
Sent: 6/11/2025 11:02:42 AM
Viewed: 6/11/2025 11:03:15 AM
Signed: 6/11/2025 11:03:30 AM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Van Bach
vanb@cityofsanrafael.org
Accounting Manager
City of San Rafael
Signing Group: Finance
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 6/11/2025 11:02:42 AM
Viewed: 6/13/2025 8:53:40 AM
Signed: 6/13/2025 8:54:04 AM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
David Parisi
dparisi@parametrix.com
Principal Consultant
Parametrix, Inc.
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address:
2600:1700:a700:e0f0:1d6d:fc86:3cc3:f1e9
Sent: 6/13/2025 8:54:06 AM
Viewed: 6/13/2025 8:58:36 AM
Signed: 6/13/2025 8:59:19 AM
Electronic Record and Signature Disclosure:
Accepted: 6/13/2025 8:58:36 AM
ID: eb46b6f6-42cc-470a-9b4c-2eaaacf72f94
Signer Events Signature Timestamp
Nathan Johnson
njohnson@parametrix.com
Senior Vice President
Parametrix, Inc.
Security Level: Email, Account Authentication
(None)
Signature Adoption: Uploaded Signature Image
Using IP Address:
2600:8801:fb05:9e00:ecd8:2cd4:a5b0:47ef
Sent: 6/13/2025 8:59:27 AM
Viewed: 6/13/2025 9:03:53 AM
Signed: 6/13/2025 9:06:12 AM
Electronic Record and Signature Disclosure:
Accepted: 6/13/2025 9:03:53 AM
ID: cb4a650c-e8b5-4173-9941-3f7fd4ef0300
Andrea Visveshwara
andreav@cityofsanrafael.org
Chief Assistant City Attorney
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address:
2601:645:b00:cd60:ddcf:9542:2456:ea81
Sent: 6/13/2025 9:06:15 AM
Viewed: 6/13/2025 12:16:36 PM
Signed: 6/18/2025 3:44:37 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Nataly Torres
NatalyT@cityofsanrafael.org
Administrative Analyst
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 6/13/2025 9:06:15 AM
Viewed: 6/26/2025 3:52:11 PM
Signed: 6/26/2025 3:53:19 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Cristine Alilovich
cristinea@cityofsanrafael.org
City Manager
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address:
2601:645:e82:6d80:4d00:4c62:eec9:8aed
Sent: 6/26/2025 3:53:21 PM
Viewed: 6/26/2025 8:57:40 PM
Signed: 6/26/2025 8:57:56 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Lindsay Lara
lindsayl@cityofsanrafael.org
City Clerk
City of San Rafael
Signing Group: City Clerk
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 6/26/2025 8:57:59 PM
Viewed: 7/3/2025 10:34:59 AM
Signed: 7/3/2025 10:36:08 AM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Editor Delivery Events Status Timestamp
Nataly Torres
natalyt@cityofsanrafael.org
Administrative Analyst
City of San Rafael
Security Level: Email, Account Authentication
(None)
Using IP Address:
2600:1700:9750:3df0:2184:1d54:4bf3:8cdf
Sent: 6/11/2025 9:54:29 AM
Viewed: 6/11/2025 10:48:33 AM
Completed: 6/11/2025 11:02:01 AM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Nataly Torres
NatalyT@cityofsanrafael.org
Administrative Analyst
City of San Rafael
Signing Group: City Attorney's Office
Security Level: Email, Account Authentication
(None)
Using IP Address:
2600:1700:9750:3df0:2184:1d54:4bf3:8cdf
Sent: 6/11/2025 11:02:43 AM
Viewed: 6/11/2025 11:03:07 AM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 6/11/2025 9:54:29 AM
Envelope Updated Security Checked 6/11/2025 11:02:02 AM
Envelope Updated Security Checked 6/11/2025 11:02:02 AM
Envelope Updated Security Checked 6/11/2025 11:02:02 AM
Envelope Updated Security Checked 6/11/2025 11:02:02 AM
Envelope Updated Security Checked 6/11/2025 11:02:02 AM
Envelope Updated Security Checked 6/11/2025 11:02:02 AM
Certified Delivered Security Checked 7/3/2025 10:34:59 AM
Signing Complete Security Checked 7/3/2025 10:36:08 AM
Completed Security Checked 7/3/2025 10:36:08 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of San Rafael (we, us or Company) may be required by law to provide to you certain written
notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures
electronically through the DocuSign system. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to this Electronic Record and Signature Disclosure
(ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and
signatures’ before clicking ‘CONTINUE’ within the DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available electronically to you by us.
You will have the ability to download and print documents we send to you through the DocuSign system during and
immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a
limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a $0.00 per-page fee. You may
request delivery of such paper copies from us by following the procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us
that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your
decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and
disclosures electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can
complete certain steps in transactions with you and delivering services to you because we will need first to send the
required notices or disclosures to you in paper format, and then wait until we receive back from you your
acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the
DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from
us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you
through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents
that are required to be provided or made available to you during the course of our relationship with you. To reduce the
chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and
disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the
disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with
this process, please let us know as described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures electronically from us.
How to contact City of San Rafael:
You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies
of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as
follows: To contact us by email send messages to: city.clerk@cityofsanrafael.org
To advise City of San Rafael of your new email address
To let us know of a change in your email address where we should send notices and disclosures electronically to you, you
must send an email message to us at city.clerk@cityofsanrafael.org and in the body of such request you must state: your
Electronic Record and Signature Disclosure created on: 5/22/2025 12:46:43 PM
Parties agreed to: David Parisi, Nathan Johnson
previous email address, your new email address. We do not require any other information from you to change your email
address.
If you created a DocuSign account, you may update it with your new email address through your account preferences.
To request paper copies from City of San Rafael
To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically,
you must send us an email to city.clerk@cityofsanrafael.org and in the body of such request you must state your email
address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with City of San Rafael
To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:
i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box
indicating you wish to withdraw your consent, or you may;
ii. send us an email to city.clerk@cityofsanrafael.org and in the body of such request you must state your email, full name,
mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The
consequences of your withdrawing consent for online documents will be that transactions may take a longer time to
process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The current system
requirements are found here: https://support.docusign.com/guides/signer-guide-signing-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to other electronic notices and
disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on
paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to
an email address where you will be able to print on paper or save it for your future reference and access. Further, if you
consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-
box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.
By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:
You can access and read this Electronic Record and Signature Disclosure; and
You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and
Disclosure to a location where you can print it, for future reference and access; and
Until or unless you notify City of San Rafael as described above, you consent to receive exclusively through
electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required
to be provided or made available to you by City of San Rafael during the course of your relationship with City of
San Rafael.