HomeMy WebLinkAboutPW Fire Station 56 Reroofing Services; 2025.0031
v. May 2025 Page 1
CITY OF SAN RAFAEL
Public Works Contract
(For Work up to $220,000)
This public works contract (“Contract”) is entered into by and between the City of San
Rafael (“City”) and ___________________________________________ (“Contractor”),
a _____________________________________________ for work on the City’s
_____________________________________________________________ (“Project”),
and is effective on _____________________ (“Effective Date”).
The parties agree as follows:
1. Scope of Work. Contractor will perform and provide all labor, materials,
equipment, supplies, transportation, and any and all other items or services necessary
to perform and complete the work required for the Project (“Work”), as specified in
Exhibit A, Scope of Work, and according to the terms and conditions of this Contract,
including all attachments to the Contract and any other documents and statutes
incorporated by reference. To the extent that any attachment contains provisions that
conflict or are inconsistent with the terms set forth in the body of this Contract, the
Contract terms will control. This Project requires a valid California contractor’s license
for the following classification(s): _____________.
2. Compensation. As full and complete compensation for Contractor’s timely
performance and completion of the Work in strict accordance with the terms and
conditions of the Contract Documents, City will pay Contractor in accordance with the
rates and/or prices set forth in Exhibit A up to the not-to-exceed amount of
$______________ (the “Contract Price”) for all of Contractor’s direct and indirect costs
to perform the Work, including all labor, materials, supplies, equipment, taxes,
insurance, bonds and all overhead costs, in accordance with the payment provisions
contained herein.
2.1 Payment. Contractor will bill City on a monthly basis for Work Performed by
Contractor during the preceding month, itemizing labor, materials, equipment and any
incidental costs incurred by the Contractor, and subject to verification by City. The
Contractor may include subcontractor costs in its invoices, provided that such costs do
not exceed the actual amount incurred by the Contractor plus a markup not exceeding
ten percent (10%). Contractor warrants that title to all work, materials and equipment
incorporated into the Work will pass to City free of any claims, liens, or encumbrances
upon payment to Contractor.
2.2 Payment and Performance Bonds. If the Contract Price is over $25,000,
then Contractor must provide City with a payment bond and a performance bond using
the bond forms included in this Contract as Exhibit C, Bond Forms, and submit the
bonds with the executed Contract. Each bond must be issued by a surety admitted in
California. If an issuing surety cancels a bond or becomes insolvent, Contractor must
C-39
Fire Station 56 Reroof
73,400
California corporation
Wedge Roofing, Inc.
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2025.0031
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provide a substitute bond from a surety acceptable to City within seven days after
written notice from City. If Contractor fails to substitute an acceptable surety within the
specified time, City may, in its sole discretion and without prior notice to Contractor,
purchase such bond(s) at Contractor’s expense and deduct the cost from payments
otherwise due to Contractor, or terminate the Contract.
3. Contract Documents. The Contract Documents incorporated into this Contract
include and are comprised of all of the documents listed below:
3.1 Contract;
3.2 Exhibit A – Scope of Work;
3.3 Exhibit B – Insurance Requirements
3.4 Exhibit C – Bonds for Payment, Performance, and if applicable, Bid;
3.5 Exhibit D – Noncollusion Declaration;
3.6 Exhibit E – Bid Schedule, if any
3.7 Exhibit F – Subcontractor List, if any
3.8 Notice Inviting Bids, if any
3.9 Addenda, if any
4. Term of Contract. This Contract becomes effective upon the date listed as
"Effective Date" and shall remain in effect until the completion of all obligations of both
Parties hereto, or _________________ from the Effective Date, whichever comes first,
unless terminated or amended as provided herein.
4.1 Performance Time. Contractor will fully complete the Work within
_________________________ from the date the City authorizes Contractor to proceed
with the Work (“Performance Time”).
5. Liquidated Damages. If Contractor fails to complete the Work within the
Performance Time, Contractor must pay liquidated damages in the amount of
$________ per day for each day of unexcused delay in completion.
6. Standard of Care. All Work must be provided in a manner that meets or
exceeds the standard of care applicable to the same type of work in the City of San
Rafael. Contractor must promptly correct, at Contractor’s sole expense, any Work that
the City determines is deficient or defective.
7. Permits and Licenses. Contractor, at its sole expense, must obtain and
maintain during the term of this Contract, all appropriate permits, certificates and
licenses including, but not limited to, the required California contractor’s license and a
City business license.
8. Indemnification. Contractor will indemnify, defend with counsel acceptable to
City, and hold harmless to the full extent permitted by law, City, its governing body,
officers, agents, employees, and volunteers (the “Indemnitees”) from and against any
and all liability, demands, loss, damage, claims, settlements, expenses, and costs
one (1) month
one (1) month
100
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(including, without limitation, attorney fees, expert witness fees, and costs and fees of
litigation) (collectively, “Liability”) of every nature arising out of or in connection with the
acts or omissions of Contractor, its employees, subcontractors, representatives, or
agents in performing the Work of failing to comply with any obligation of Contractor
under this Contract, except such Liability caused by the active negligence, sole
negligence, or willful misconduct of an Indemnitee. This indemnification obligation is not
limited by any limitation on the amount or type of damages or compensation payable
under Workers’ Compensation or other employee benefit acts, or by insurance
coverage limits, and will survive the expiration or early termination of this Contract. City
will notify Contractor of any third-party claim pursuant to Public Contract Code section
9201.
9. Insurance. During the term of this Contract, and for any time period set forth in
Exhibit B, Contractor shall procure and maintain in full force and effect, at no cost to
City insurance policies with respect to employees and vehicles assigned to the
performance of work under this Contract with coverage amounts, required
endorsements, certificates of insurance, and coverage verifications as defined in
Exhibit B.
10. Labor Code Compliance. Unless the Contract Price is $1,000 or less, the
Contract is subject to all applicable requirements of Chapter 1 of Part 7 of Division 2 of
the Labor Code, beginning at section 1720, and the related regulations, including but
not limited to requirements pertaining to wages, working hours and workers’
compensation insurance. Contractor must also post all job site notices required by laws
or regulations pursuant to Labor Code section 1771.4.
10.1 Prevailing Wages. Each worker performing Work under this Contract is
covered under Labor Code section 1720 or 1720.9, must be paid at a rate not less than
the prevailing wage as defined in sections 1771 and 1774 of the Labor Code. The
prevailing wage rates are on file with the City Engineer’s office and are available online
at http://www.dir.ca.gov/DLSR. Pursuant to Labor Code section 1775, Contractor and
any subcontractor will forfeit to City as a penalty up to $200 for each calendar day, or
portion of a day, for each worker paid less than the applicable prevailing wage rate, in
addition to paying each worker the difference between the applicable wage rate and the
amount actually paid.
10.2 Working Day. Pursuant to Labor Code section 1810, eight hours of labor
consists of a legal day’s work. Pursuant to Labor Code section 1813, Contractor will
forfeit to City as a penalty the sum of $25 for each day during which a worker employed
by Contractor or any subcontractor is required or permitted to work more than eight
hours during any one calendar day, or more than 40 hours per calendar week, unless
such workers are paid overtime wages under Labor Code section 1815. All Work must
be carried out during regular City working days and hours unless otherwise specified in
Exhibit A or authorized in writing by City.
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10.3 Payroll Records. Contractor and its subcontractors must maintain certified
payroll records in compliance with Labor Code sections 1776 and 1812, and all
implementing regulations promulgated by the Department of Industrial Relations (“DIR”).
For each payroll record, Contractor and its subcontractors must certify under penalty of
perjury that the information in the record is true and correct, and that it has complied
with the requirements of Labor Code sections 1771, 1811, and 1815. Unless the
Contract Price is under $25,000, Contractor must electronically submit certified payroll
records to the Labor Commissioner as required under California law and regulations.
10.4 Apprentices. If the Contract Price is $30,000 or more, Contractor must
comply with the apprenticeship requirements in Labor Code section 1777.5.
10.5 DIR Monitoring, Enforcement, and Registration. Project is subject to
compliance monitoring and enforcement by the DIR pursuant to Labor Code section
1725.5, and, subject to the exception set forth below, Contractor and any
subcontractors must be registered with the DIR to perform public works projects. The
registration requirements of Labor Code section 1725.5 do not apply if the Contract
Price is for under $25,000.
11. Workers’ Compensation Certification. Under Labor Code section 1861, by
signing this Contract, Contractor certifies as follows: “I am aware of the provisions of
Labor Code section 3700 which require every employer to be insured against liability for
workers’ compensation or to undertake self-insurance in accordance with the provisions
of that code, and I will comply with such provisions before commencing the performance
of the Work on this Contract.”
12. Termination.
12.1 Termination for Convenience. City reserves the right to terminate all or
part of the Contract for convenience upon written notice to Contractor. Upon receipt of
such notice, Contractor must: immediately stop the Work, including under any terms or
conditions that may be specified in the notice; comply with City’s instructions to protect
the completed Work and materials; and use its best efforts to minimize further costs. In
the event of City’s termination for convenience, Contractor waives any claim for
damages, including for loss of anticipated profits from the Project. If City terminates the
Contract for convenience, City will only owe Contractor payment for the Work
satisfactorily performed before Contract termination, as well as five percent of the total
value of the Work performed as of the date of notice of termination or five percent of the
value of the Work yet to be completed, whichever is less, which is deemed to cover all
overhead and profit to date.
12.2 Termination for Default. The City may terminate this Contract for cause
for any material default. Contractor may be deemed in default for a material breach of
or inability to perform the Contract, including Contractor’s refusal or failure to supply
sufficient skilled workers, proper materials, or equipment to perform the Work within the
Performance Time; refusal or failure to make prompt payment to its employees,
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subcontractors, or suppliers or to correct rejected work; disregard of laws, regulations,
ordinances, rules, or orders of any public agency with jurisdiction over the Project; lack
of financial capacity to complete the Work within the Performance Time; or responsibility
for any other material breach of the Contract requirements. If City terminates the
Contract for cause, City will only owe Contractor payment for the Work satisfactorily
performed before Contract termination. In the event a termination for default is later
determined to have been made wrongfully or without cause, then the termination shall
be treated as a termination for convenience, and the Contractor shall have no greater
rights than it would have had following a termination for convenience.
13. Dispute Resolution. Any dispute arising under or related to this Contract is
subject to the dispute resolution procedures of Public Contract Code sections 9204 and
20104 et. seq., which are incorporated by reference.
14. Waiver. A waiver by City of any breach of any term, covenant, or condition in
this Contract will not be deemed a waiver of any subsequent breach of the same or any
other term, covenant, or condition contained herein, regardless of the character of any
such breach.
15. Warranty. Contractor guarantees and warrants the Work and the materials used
or provided for the Project for a period of one year, beginning upon City’s acceptance of
the Work for the Project as complete (“Warranty Period”). During the Warranty Period,
upon notice from the City of any defect in the Work or the materials, Contractor must, at
its sole expense, promptly repair or replace the defective Work or materials, including
repair or replacement of any other Work or materials that is or are displaced or
damaged during the warranty work, excepting any damage resulting from ordinary wear
and tear.
16. Worksite Conditions.
16.1 Clean and Safe. Contractor must maintain the Work site and staging and
storage areas in a clean and neat condition and must ensure it is safe and secure. On
a daily basis the Contractor must remove and properly dispose of debris and waste
materials from the Work site.
16.2 Inspection. Contractor will make the Work accessible at all times for
inspection by the City.
16.3 Hazardous Materials. Unless otherwise specified in the Contract
documents, this Contract does not include the removal, handling, or disturbance of any
asbestos or other hazardous materials, as identified by any federal, state, or local law or
regulation. If Contractor encounters materials on the Project site that Contractor
reasonably believes to be asbestos or other hazardous materials, and the asbestos or
other hazardous materials have not been rendered harmless, Contractor may continue
Work in unaffected areas reasonably believed to be safe, but must immediately cease
Work on the area affected and report the condition to City. No asbestos, asbestos-
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containing products or other hazardous materials may be used in performance of the
Work.
16.4 Utilities, Trenching and Excavation. As required by Government Code
section 4215, if, during the performance of the Work, Contractor discovers utility
facilities not identified by City in the Contract documents, Contractor must immediately
provide written notice to City and the utility. In performing any excavations or trenching
work, Contractor must comply with all applicable operator requirements in Government
Code sections 4216 through 4216.5. If the trenching or excavation extends deeper than
four feet below the surface, then it must also comply with Public Contract Code section
7104.
17. Records. Unless otherwise specified in Exhibit A, Contractor must maintain and
update a separate set of as-built drawings while the Work is being performed, showing
changes from the Work as planned in Exhibit A, or any drawings incorporated into this
Contract. The as-built drawings must be updated as changes occur, on a daily basis if
necessary.
18. Conflicts of Interest. Contractor, its employees, subcontractors and agents,
may not have, maintain or acquire a conflict of interest in relation to this Contract in
violation of any City ordinance or policy or in violation of any California law, including
under Government Code section 1090 et seq. and under the Political Reform Act as set
forth in Government Code section 81000 et seq. and its accompanying regulations. Any
violation of this Section constitutes a material breach of the Contract.
19. Non-Discrimination. No discrimination will be made in the employment of
persons under this Contract because of the race, color, national origin, ancestry,
religion, gender or sexual orientation of such person.
20. Independent Contractor. City and Contractor intend that Contractor will
perform the Work under this Contract as an independent contractor. Contractor is solely
responsible for its means and methods in performing the Work. Contractor is not an
employee of City and is not entitled to participate in health, retirement or any other
employee benefits from City.
21. Assignment of Unfair Business Practice Claims. Under Public Contract Code
section 7103.5, Contractor and its subcontractors agree to assign to City all rights, title,
and interest in and to all causes of action it may have under section 4 of the Clayton Act
(15 U.S.C. section 15) or under the Cartwright Act (Chapter 2 (commencing with section
16700) of Part 2 of Division 7 of the Business and Professions Code), arising from
purchases of goods, services, or materials pursuant to the Contract or any subcontract.
This assignment will be effective at the time City tenders final payment to Contractor,
without further acknowledgement by the parties.
22. Notice. Any notice, billing, or payment required by or pursuant to the Contract
documents must be made in writing, signed, dated and sent to the other party by
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personal delivery, U.S. Mail, a reliable overnight delivery service, or by email as a PDF
(or comparable) file. Notice is deemed effective upon delivery unless otherwise
specified. Notice for each party must be given as follows:
City:
Address: _______________________
City/State/Zip: San Rafael, CA 94901
Phone: _______________________
Attn: _______________________
Email: _______________________; CC public.works@cityofsanrafael.org
Contractor:
Name: _______________________
Address: _______________________
City/State/Zip: _______________________
Phone: _______________________
Attn: _______________________
Email: _______________________
23. General Provisions.
23.1 Compliance with All Laws. Contractor will comply with all applicable
federal, state, and local laws and regulations including, but not limited to, unemployment
insurance benefits, FICA laws, conflict of interest laws, and local ordinances. Work may
only be performed by qualified and experienced workers who are not employed by the
City and who do not have any contractual relationship with City, with the exception of
this Contract.
23.2 Provisions Deemed Inserted. Every provision of law required to be
inserted in the Contract is deemed to be inserted, and the Contract will be construed and
enforced as though such provision has been included. If it is discovered that through
mistake or otherwise that any required provision was not inserted, or not correctly
inserted, the Contract will be deemed amended accordingly.
23.3 Assignment and Successors. Contractor may not assign its rights or
obligations under this Contract, in part or in whole, without City’s written consent. This
Contract is binding on Contractor’s and City’s lawful heirs, successors and permitted
assigns.
23.4 Third Party Beneficiaries. There are no intended third-party beneficiaries
to this Contract.
23.5 Governing Law and Venue. This Contract will be governed by California
law and venue will be in the Superior Court of Marin County, and no other place.
courteney@wedgeroofing.com
Petaluma, CA 94954
Courteney Defaria
111 Morphew Street
(415) 458-5348
omarg@cityofsanrafael.org
Omar Garcia, Facility Repair Supervisor
5 Casa Grande Road
707-763-5475
Wedge Roofing, Inc.
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23.6 Amendment. No amendment or modification of this Contract will be
binding unless it is in a writing duly authorized and signed by the parties to this
Contract. Change orders requested by Contractor must be submitted and approved in
writing by the City prior to work commencing.
23.7 Integration; Severability. This Contract and the Contract documents
incorporated herein, including authorized amendments or change orders thereto,
constitute the final, complete, and exclusive terms of the contract between City and
Contractor. If any provision of the Contract documents, or portion of a provision, is
determined to be illegal, invalid, or unenforceable, the remaining provisions of the
Contract documents will remain in full force and effect.
23.8 Authorization. Each individual signing below warrants that he or she is
authorized to do so by the party that he or she represents, and that this Contract is
legally binding on that party. If Contractor is a corporation, signatures from two officers
of the corporation are required pursuant to California Corporation Code section 313.
[Signatures are on the following page.]
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The parties agree to this Contract as witnessed by the signatures below:
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: _____________________________
Contractor’s California License Number(s)
and Expiration Date(s) (required under
Section 7 of the Contract):
___________________________________
___________________________________
Exhibit A: Scope of Work
Exhibit B: Insurance Requirements
Exhibit C: Bond Forms
Exhibit D: Noncollusion Declaration
Exhibit E: Bid Schedule (when applicable)
Exhibit F: Subcontractor List
END OF CONTRACT
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Wedge Roofing Inc.
Gary Harvey
416737
01/31/2026
President
Officer
Shena Harvey
Wedge Roofing IncAndrea Visveshwara
Chief Assistant City Attorney
Cristine Alilovich
City Manager
August 28, 2025
Lindsay Lara
City Clerk
EXHIBIT A
SCOPE OF WORK
This is an Exhibit attached to, and made a part of the Contract by and between
Contractor and the City providing for the referenced services. The Scope of Work
includes:
1. Description of the Work:
Section 1.01 Description: Wedge Roofing will provide services for the reroofing of
Fire Station 56 for the City of San Rafael.
2. Specific Tasks:
As part of the Scope of Work, the Contractor shall perform the following tasks:
Section 1.02 Task 1 – Wedge Roofing will remove two (2) existing roof layers down to
wood sheathing, where possible.
Section 1.03 Task 2 – Wedge Roofing will furnish and install ½" sheetrock for code
complaint fire barrier.
Section 1.04 Task 3 – Wedge Roofing will install primer to all areas receiving foam,
and apply (2.8 lb) spray polyurethane foam with average thickness of one and one half
(1½) inches and apply (2.8 lb) spray polyurethane foam on ducting with average
thickness of one half (½) inch.
Section 1.05 Task 4 – Wedge Roofing will apply CA Title 24 compliant premium white
high solid content silicone coating applied as per manufacturer's recommendations.
Including on top and inside of edge of cap metal. This includes installation of granules
to roof surface for increased durability and longevity in addition to providing added
traction as silicone coating is extremely slippery when wet.
DELIVERABLES
Contractor’s deliverables under the Contract are enunciated throughout the Contract and
include but are not limited to the following:
1. Project Deliverables:
1. Establish rooftop live stream video for safety and quality compliance for duration
of work.
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2. Establish Cal/OSHA fall protection system for all personnel.
3. Includes 15-Year Manufacturer’s Complete System Warranty.
4. All workmanship and materials guaranteed against defect for three years from
completion date.
5. Certification: This roofing has a Class A fire rating
METHOD OF PAYMENT
Subject to the terms and conditions of this Contract, Contractor shall be paid on a basis
set forth herein by the checked boxes below:
☒ A fixed fee for the work performed
☐ An hourly rate for the work performed based on the following hourly rates:
List Methods of Payment
SCHEDULE
Wedge Roofing will complete services in approximately one month.
Time for completion may be extended by City based on weather.
– END OF EXHIBIT A –
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v. May 2025 Exhibit B
Exhibit B
INSURANCE REQUIREMENTS
Contractor will, at all times under this Contract, maintain the insurance
coverage required in this Exhibit B to cover the activities of Contractor and any
subcontractors relating to or arising from performance of the Work. Each policy
must be issued by a company licensed to do business in California, and with a
strength and size rating from A.M. Best Company of A-VIII or better. Contractor
must provide City with certificates of insurance and required endorsements as
evidence of coverage with the executed Contract, or through the PINSAdvantage
website https://www.pinsadvantage.com/ upon request by the City, and before
the City authorizes Contractor to proceed with the Work.
1. Workers’ Compensation. Statutory coverage is required by the
California Workers’ Compensation Insurance and Safety Act. If Contractor is
self-insured, it must provide its duly authorized Certificate of Permission to
Self-Insure. In addition, Contractor must provide employer’s liability
insurance with limits of no less than one million dollars ($1,000,000) per
accident for bodily injury or disease.
2. Liability. Commercial General Liability (“CGL”) insurance issued
on an occurrence basis, including coverage for liability arising from
Contractor’s or its subcontractor’s acts or omissions in performing the Work,
including Contractor’s protected coverage, blanket contractual, products and
completed operations, broad form property damage, vehicular coverage, and
employer’s non-ownership liability coverage, with limits of at least $1,000,000
per occurrence and $2,000,000 general aggregate.
3. Automotive. Commercial automotive liability coverage for owned,
non-owned and hired vehicles must provide coverage of at least $1,000,000
combined single limit per accident for bodily injury, death, or property
damage.
4. Subrogation Waiver. Each required policy must include an
endorsement that the insurer waives any right of subrogation it may have
against the City or the City’s insurers.
5. Required Endorsements. The CGL policy and the automotive liability
policy must include the following specific endorsements:
(1) The City, including its Council, officials, officers, employees,
agents, volunteers and consultants (collectively, “Additional Insured”)
must be named as an additional insured for all liability arising out of
the operations by or on behalf of the named insured, and the policy
must protect the Additional Insured against any and all liability for
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personal injury, death or property damage or destruction arising
directly or indirectly in the performance of the Contract.
(2) The inclusion of more than one insured will not operate to impair
the rights of one insured against another, and the coverages afforded
will apply as though separate policies have been issued to each
insured.
(3) The insurance provided is primary and no insurance held or
owned by City may be called upon to contribute to a loss (“primary
and non-contributory”).
(4) Any umbrella or excess insurance must contain or be endorsed to
contain a provision that such coverage will also apply on a primary or
non-contributory basis for the benefit of City before the City’s own
insurance or self-insurance will be called upon to protect it as a
named insured.
(5) This policy does not exclude explosion, collapse, underground
excavation hazard, or removal of lateral support.
Failure to comply with these requirements shall be considered a material
breach of contract.
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v. May 2025 Bond Forms
Exhibit C
BOND FORMS
Required for contracts over $25,000.
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Payment Bond
City of San Rafael (“City”) and ______________________ (“Contractor”) have
entered into a contract, dated Effective Date as listed in the attached contract
(“Contract”) for work on the “Project” as listed in the attached contract. The
Contract is incorporated by reference into this Payment Bond (“Bond”).
1. General. Under this Bond, Contractor as principal and
____________________________, its surety (“Surety”), are bound to City
as obligee in an amount not less than $_________________, under
California Civil Code sections 9550, et seq.
2. Surety’s Obligation. If Contractor or any of its subcontractors fails to pay
any of the persons named in California Civil Code section 9100 amounts
due under the Unemployment Insurance Code with respect to work or labor
performed under the Contract, or for any amounts required to be deducted,
withheld, and paid over to the Employment Development Department from
the wages of employees of Contractor and its subcontractors, under
California Unemployment Insurance Code section 13020, with respect to the
work and labor, then Surety will pay for the same.
3. Beneficiaries. This Bond inures to the benefit of any of the persons named
in California Civil Code section 9100, so as to give a right of action to those
persons or their assigns in any suit brought upon this Bond. Contractor must
promptly provide a copy of this Bond upon request by any person with legal
rights under this Bond.
4. Duration. If Contractor promptly makes payment of all sums for all labor,
materials, and equipment furnished for use in the performance of the Work
required by the Contract, in conformance with the time requirements set
forth in the Contract and as required by California law, Surety’s obligations
under this Bond will be null and void. Otherwise, Surety’s obligations will
remain in full force and effect.
5. Waivers. Surety waives any requirement to be notified of alterations to the
Contract or extensions of time for performance of the Work under the
Contract. Surety waives the provisions of Civil Code sections 2819 and
2845. City waives requirement of a new bond for any supplemental contract
under Civil Code section 9550. Any notice to Surety may be given in the
manner specified in the Contract and delivered or transmitted to Surety as
follows:
Attn: ___________________________________________
Address: _______________________________________
City/State/Zip: ___________________________________
Phone: _________________________________________
Fax: ___________________________________________
Email: _________________________________________
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v. May 2025 Bond Forms
6. Law and Venue. This Bond will be governed by California law, and any
dispute pursuant to this Bond will be venued in the Superior Court of Marin
County, and no other place. Surety will be responsible for City’s attorneys’
fees and costs in any action to enforce the provisions of this Bond.
7. Effective Date; Execution. This Bond is entered into and effective on
Effective Date as listed in the attached contract (“Contract”) for work.
Three identical counterparts of this Bond, each of which is deemed an
original for all purposes, are hereby executed and submitted.
SURETY: ______________________________________________________
Business Name
s/ ________________________________________________
__________________________________________________
Name/Title
(Attach Acknowledgment with Notary Seal and Power of Attorney)
CONTRACTOR: ___________________________________________________
Business Name
s/ _______________________________________________
_________________________________________________
Name/Title
s/ _______________________________________________
_________________________________________________
Name/Title
APPROVED BY CITY:
s/ ___________________________________ ______________________________
ROBERT F. EPSTEIN, City Attorney Date
END OF PAYMENT BOND
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
v. May 2025 Bond Forms
Performance Bond
City of San Rafael (“City”) and ________________________ (“Contractor”) have
entered into a contract, dated Effective Date as listed in the attached contract
(“Contract”) for work on the ”Project” as listed in the attached contract. The Contract is
incorporated by reference into this Performance Bond (“Bond”).
1. General. Under this Bond, Contractor as Principal and
___________________________, its surety (“Surety”), are bound to City as
obligee for an amount not less than $__________________ to ensure Contractor’s
faithful performance of its obligations under the Contract, including its warranty
obligations under the Contract. By executing this Bond, Contractor and Surety
bind themselves and their respective heirs, executors, administrators, successors
and assigns, jointly and severally, to the provisions of this Bond.
2. Surety’s Obligations; Waiver. If Contractor fully performs its obligations under
the Contract, including its warranty obligations under the Contract, Surety’s
obligations under this Bond will become null and void upon City’s acceptance of
the Project, provided Contractor has timely provided a warranty bond as required
under the Contract. Otherwise Surety’s obligations will remain in full force and
effect until expiration of the one year warranty period under the Contract. Surety
waives any requirement to be notified of and further consents to any alterations to
the Contract made under the applicable provisions of the Contract documents,
including changes to the scope of Work or extensions of time for performance of
Work under the Contract. Surety waives the provisions of Civil Code sections
2819 and 2845.
3. Application of Contract Balance. Upon making a demand on this Bond for
completion of the Work prior to acceptance of the Project, City will make the
Contract Balance available to Surety for completion of the Work under the
Contract. For purposes of this provision, the Contract Balance is defined as the
total amount payable by City to Contractor as the Compensation minus amounts
already paid to Contractor, and minus any liquidated damages, credits, or
backcharges to which City is entitled under the terms of the Contract.
4. Contractor Default. Upon written notification from City that Contractor is in
default under the Contract, time being of the essence, Surety must act within
seven calendar days of receipt of the notice to remedy the default through one of
the following courses of action:
4.1 Arrange for completion of the Work under the Contract by Contractor, with
City’s consent, but only if Contractor is in default solely due to its financial
inability to complete the Work;
4.2 Arrange for completion of the Work under the Contract by a qualified
contractor acceptable to City, and secured by performance and payment bonds
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
v. May 2025 Bond Forms
issued by an admitted surety as required by the Contract documents, at Surety’s
expense; or
4.3 Waive its right to complete the Work under the Contract and reimburse
City the amount of City’s costs to have the remaining services completed.
5. Surety Default. If Surety defaults on its obligations under the Bond, City will be
entitled to recover all costs it incurs due to Surety’s default, including legal, design
professional, or delay costs.
6. Notice. Notice to Surety must be given or made in writing and sent to the Surety
via personal delivery, U.S. Mail, or a reliable overnight delivery service, or by email
as a PDF (or comparable) file. Notice is deemed effective upon delivery unless
otherwise specified. Notice for the Surety must be given as follows:
Attn: ___________________________________________
Address: ________________________________________
City/State/Zip: ____________________________________
Phone: _________________________________________
Fax: ___________________________________________
Email: __________________________________________
7. Law and Venue. This Bond will be governed by California law, and any dispute
pursuant to this Bond will be venued in the Superior Court of Marin County, and no
other place. Surety will be responsible for City’s attorneys’ fees and costs in any
action to enforce the provisions of this Bond.
8. Effective Date; Execution. This Bond is entered into and effective on Effective
Date as listed in the attached contract (“Contract”) for work. Three identical
counterparts of this Bond, each of which is deemed an original for all purposes, are
hereby executed and submitted.
SURETY: _____________________________________________
Business Name
s/ ___________________________________________________
_____________________________________________________
Name/Title [print]
(Attach Acknowledgment with Notary Seal and Power of Attorney)
CONTRACTOR: ________________________________________
Business Name
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
v. May 2025 Bond Forms
s/ ___________________________________________________
_____________________________________________________
Name/Title
s/ ___________________________________________________
_____________________________________________________
Name/Title
APPROVED BY CITY:
s/ ___________________________________ ______________________________
ROBERT F. EPSTEIN, City Attorney Date
END OF PERFORMANCE BOND
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
v. May 2025 Bond Forms
Bid Bond
________________________________________(“Bidder”) has submitted a bid, dated
_________________________ (“Bid”), to the City of San Rafael (“City”) for work on the
_____________________________________________________________ (“Project”).
Under this duly executed bid bond (“Bid Bond”), Bidder as Principal and
_____________________________, its surety (“Surety”), are bound to City as obligee
in the penal sum of ten percent of the maximum amount of the Bid (the “Bond Sum”).
Bidder and Surety bind themselves and their respective heirs, executors, administrators,
successors and assigns, jointly and severally, as follows:
1. General. If Bidder is awarded the Contract for the Project, Bidder will enter into
the Contract with City in accordance with the terms of the Bid.
2. Submittals. Within ten days following issuance of the Notice of Award to Bidder,
Bidder must submit to City the following:
2.1 Contract. The executed Contract, using the form provided by City in the
Project contract documents (“Contract Documents”);
2.2 Payment Bond. A payment bond for 100% of the maximum Contract Price,
executed by a surety licensed to do business in the State of California using
the Payment Bond form included with the Contract Documents;
2.3 Performance Bond. A performance bond for 100% of the maximum
Contract Price, executed by a surety licensed to do business in the State of
California using the Performance Bond form included with the Contract
Documents; and
2.4 Insurance. The insurance certificate(s) and endorsement(s) required by the
Contract Documents, and any other documents required by the Instructions to
Bidders or Notice of Award.
3. Enforcement. If Bidder fails to execute the Contract and to submit the bonds and
insurance certificates as required by the Contract Documents, Surety guarantees
that Bidder forfeits the Bond Sum to City. Any notice to Surety may be given in the
manner specified in the Contract and delivered or transmitted to Surety as follows:
Attn: ___________________________________________
Address: ________________________________________
City/State/Zip: ____________________________________
Phone: _________________________________________
Fax: ___________________________________________
Email: __________________________________________
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
v. May 2025 Bond Forms
4. Duration and Waiver. If Bidder fulfills its obligations under Section 2, above, then
this obligation will be null and void; otherwise it will remain in full force and effect
for 60 days following the bid opening or until this Bid Bond is returned to Bidder,
whichever occurs first. Surety waives the provisions of Civil Code §§ 2819 and
2845.
This Bid Bond is entered into and effective on ________________________.
SURETY:
___________________________________
Business Name
s/__________________________________
______________________________
Date
___________________________________
Name, Title
(Attach Acknowledgment with Notary Seal and Power of Attorney)
BIDDER:
___________________________________
Business Name
s/__________________________________
______________________________
Date
___________________________________
Name, Title
END OF BID BOND
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
v. May 2025 Exhibit D
Exhibit D
NONCOLLUSION DECLARATION
TO BE EXECUTED BY CONTRACTOR AND SUBMITTED WITH BID
The undersigned declares:
I am the _________________ of ____________________________, the party making
the foregoing bid.
The bid is not made in the interest of, or on behalf of, any undisclosed person,
partnership, company, association, organization, or corporation. The bid is genuine and
not collusive or sham. The bidder has not directly or indirectly induced or solicited any
other bidder to put in a false or sham bid. The bidder has not directly or indirectly
colluded, conspired, connived, or agreed with any bidder or anyone else to put in a
sham bid, or to refrain from bidding. The bidder has not in any manner, directly or
indirectly, sought by agreement, communication, or conference with anyone to fix the
bid price of the bidder or any other bidder, or to fix any overhead, profit, or cost element
of the bid price, or of that of any other bidder. All statements contained in the bid are
true. The bidder has not, directly or indirectly, submitted his or her bid price or any
breakdown thereof, or the contents thereof, or divulged information or data relative
thereto, to any corporation, partnership, company, association, organization, bid
depository, or to any member or agent thereof, to effectuate a collusive or sham bid,
and has not paid and will not pay, any person or entity for such purpose.
This declaration is intended to comply with California Public Contract Code § 7106 and
Title 23 U.S.C § 112.
I declare under penalty of perjury under the laws of the State of California that the
foregoing is true and correct and that this declaration is executed on _______________
[date], at __________________________________ [city], _______ [state].
s/________________________________________
__________________________________________
Name [print]
END OF NONCOLLUSION DECLARATION
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
Wedge Roofing Inc.
August 18, 2025
President
Gary Harvey
CAPetaluma
v. May 2025 Exhibit E
Exhibit E
BID SCHEDULE
This Bid Schedule must be completed in ink and included with the sealed Bid Proposal.
Pricing must be provided for each Bid Item as indicated. Items marked “(SW)” are
Specialty Work that must be performed by a qualified Subcontractor. The lump sum or
unit cost for each item must be inclusive of all costs, whether direct or indirect, including
profit and overhead. The sum of all amounts entered in the “Extended Total Amount”
column must be identical to the Base Bid price entered in Section 1 of the Bid Proposal
form.
AL = Allowance CF = Cubic Feet CY = Cubic Yard EA = Each LB = Pounds
LF = Linear Foot LS = Lump Sum SF = Square Feet TON = Ton (2000 lbs.)
BID
ITEM
NO. ITEM DESCRIPTION EST. QTY. UNIT
UNIT
COST
EXTENDED
TOTAL
AMOUNT
TOTAL BASE BID: Items 1 through _____ inclusive $___________________________
Note: The amount entered as the “Total Base Bid” should be identical to the Base Bid
amount entered in Section 1 of the Bid Proposal form.
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
v. May 2025 Exhibit E
This Bid Proposal is hereby submitted on _________________________, 20______.
s/ ___________________________________ ______________________________________
Name and Title
s/ ___________________________________ ______________________________________
Name and Title
_____________________________________ ______________________________________
Company Name License, Expiration Date, and
Classification
_____________________________________ ______________________________________
Address DIR Registration #
_____________________________________ ______________________________________
City, State, Zip Phone
_____________________________________ ______________________________________
Contact Name Contact Email
Addenda. Bidder agrees that it has confirmed receipt of or access to, and reviewed, all
addenda issued for this Bid. Bidder waives any claims it might have against the City
based on its failure to receive, access, or review any addenda for any reason. Bidder
specifically acknowledges receipt of the following addenda:
Addendum: Date Received: Addendum: Date Received:
#01 _____________ #05 _____________
#02 _____________ #06 _____________
#03 _____________ #07 _____________
#04 _____________ #08 _____________
END OF BID SCHEDULE
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
v. May 2025 Exhibit F
Exhibit F
SUBCONTRACTOR LIST
For each Subcontractor that will perform a portion of the Work in an amount in excess of
one-half of 1% of the bidder’s total Contract Price,1 the bidder must list a description of
the Work, the name of the Subcontractor, its California contractor license number, the
location of its place of business, its DIR registration number, and the portion of the Work
that the Subcontractor is performing based on a percentage of the Base Bid price.
DESCRIPTION
OF WORK
SUBCONTRACTOR
NAME
CALIFORNIA
CONTRACTOR
LICENSE NO.
LOCATION OF
BUSINESS
DIR REG. NO. PERCENT
OF
WORK
END OF SUBCONTRACTOR LIST
1 For street or highway construction this requirement applies to any subcontract of $10,000 or more.
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
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
Project Manager Email PINS insurance request to Contractor ☐
City Attorney’s Office Review, revise as needed, and approve agreement as to
form
Department Director Review and approve agreement
Risk Management 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 Omar Garcia)
lalyn@wedgeroofing.com
Public Works
X
X
Lalyn Pruett
Wedge Roofing, Inc.
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
Signature Date Signature Date
Proposal Submitted to:
Street
City, State and Zip
Phone Date
Job Name
Job Location
Corporate Signature Note: This proposal may be withdrawn by us if not accepted within 5 days.
This estimate does not constitute a contract until endorsed by a corporate signature.
is due upon completion of work.
NON-REFUNDABLE DEPOSIT Initial Initial
FOAM ROOF - 2022 CA ENERGY CODE COMPLIANT R-10 CONTINUOUS INSULATION
LOW SLOPE ROOF AREAS ONLY
1. Establish rooftop live stream video for safety and quality compliance for duration of work.
2. Establish Cal/OSHA fall protection system for all personnel.
3. Remove two (2) existing roof layers down to wood sheathing, if possible.
4. Furnish and install ½" sheetrock for code complaint fire barrier.
5. Apply primer to all areas receiving foam if required.
6. Apply (2.8 lb) spray polyurethane foam with average thickness of one and one half (1½) inches.
7. Apply (2.8 lb) spray polyurethane foam on ducting with average thickness of one half (½) inch.
8. Apply CA Title 24 compliant premium white high solid content silicone coating applied as
per manufacturer's recommendations. Including on top and inside of edge of cap metal.
9. Includes installation of granules to roof surface for increased durability and longevity in addition
to providing added traction as silicone coating is extremely slippery when wet.
10. Includes 15-Year Manufacturer ’s Complete System Warranty.
11 . All workmanship and materials guaranteed against defect for three years from completion date.
12. Certification: This roofing has a Class A fire rating.
PRICE FOR ROOF, steps #1 through #12.....$73,400.00
Above cost assumes two (2) roof layers are present, if more roof layers are discovered during
preparation phase, there may be an additional cost per layer for removal.
If stucco repair is needed, additional cost will be added to contract price.
Others to move metal grates and antenna frame.
Option #1: Replace existing cap metal with new galvanized custom flat cap metal. Furnish
and install peel and seal waterproof membrane under new cap metal.
Cost is additional $20.00 per lineal foot YES [ ] NO [ ]
PA GE 1 OF 2
CONTRACT INCLUDES TERMS ON FOLLOWING PAGE
EST. 1976
P.707.763.5475 F.707.778.8417 CA License: 416737 WedgeRoofing.com 5 Casa Grande Road, Petaluma, CA 94954
Accounts not paid upon completion will have an added charge of 1½% monthly on past due balance or minumum of $10.00
GARY HARVEY, PRESIDENT
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
Signature Date Signature Date
Proposal Submitted to:
Street
City, State and Zip
Phone Date
Job Name
Job Location
Corporate Signature Note: This proposal may be withdrawn by us if not accepted within 5 days.
This estimate does not constitute a contract until endorsed by a corporate signature.
is due upon completion of work.
NON-REFUNDABLE DEPOSIT Initial Initial
(continued)
If your property is in the W ildland Urban Interface (W UI) gutter guards may be required. If
required, the permit will not be signed off without gutter guards. You may supply and install
your own screens if you wish.
Requires NON-REFUNDABLE deposit of 10% of contract or $1,000.00 - whichever is LESS.
*** W ith current backlog of work on hand, work may not be completed up to 3-5 weeks
from proposal acceptance, dependent on both weather and project type.
Warranties may be transferable upon prior notification, registration, and additional fees.
Additional charge for permit if required by city or county, including $100.00 administrative and
procurement cost. Visa & MasterCard accepted, 3% convenience fee.
PA GE 2 OF 2
CONTRACT INCLUDES TERMS ON FOLLOWING PAGE
EST. 1976
P.707.763.5475 F.707.778.8417 CA License: 416737 WedgeRoofing.com 5 Casa Grande Road, Petaluma, CA 94954
Accounts not paid upon completion will have an added charge of 1½% monthly on past due balance or minumum of $10.00
GARY HARVEY, PRESIDENT
Docusign Envelope ID: 36DE66ED-D241-4367-B1FD-6F91639A2C05
Certificate Of Completion
Envelope Id: 36DE66ED-D241-4367-B1FD-6F91639A2C05 Status: Completed
Subject: DocuSign: Public Works Contract with Wedge Roofing for Fire Station 56 Reroof
Source Envelope:
Document Pages: 28 Signatures: 6 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
Shannon.Mackle@cityofsanrafael.org
IP Address: 69.181.69.46
Record Tracking
Status: Original
7/30/2025 1:48:50 PM
Holder: Shannon Mackle
Shannon.Mackle@cityofsanrafael.org
Location: DocuSign
Signer Events Signature Timestamp
April Miller
April.Miller@cityofsanrafael.org
Public Works Director
Security Level: Email, Account Authentication
(None)Signature Adoption: Uploaded Signature Image
Using IP Address:
2601:645:e7c:a540:9c2:b527:481a:f2d
Sent: 8/12/2025 2:44:58 PM
Viewed: 8/12/2025 2:45:29 PM
Signed: 8/12/2025 2:46:11 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Nataly Torres
Nataly.Torres@cityofsanrafael.org
Legal Assistant
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 8/12/2025 2:46:13 PM
Viewed: 8/12/2025 2:48:58 PM
Signed: 8/12/2025 2:49:10 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Van Bach
Van.Bach@cityofsanrafael.org
Signing Group: Finance
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 8/12/2025 2:46:14 PM
Viewed: 8/18/2025 2:08:04 PM
Signed: 8/18/2025 2:08:15 PM
Electronic Record and Signature Disclosure:
Accepted: 8/18/2025 2:08:04 PM
ID: 2e042fc9-3b36-4f76-b4b0-167275f72913
Gary Harvey
gary@wedgeroofing.com
President
Wedge Roofing Inc.
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 50.242.104.65
Sent: 8/18/2025 2:08:18 PM
Viewed: 8/18/2025 2:24:54 PM
Signed: 8/18/2025 2:29:36 PM
Electronic Record and Signature Disclosure:
Accepted: 8/18/2025 2:24:54 PM
ID: 46d4b45d-ca8f-4991-a496-11283e396335
Signer Events Signature Timestamp
Shena Harvey
shena@wedgeroofing.com
Officer
Wedge Roofing Inc
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 50.242.104.65
Sent: 8/18/2025 2:29:39 PM
Resent: 8/19/2025 2:36:24 PM
Resent: 8/19/2025 3:22:42 PM
Viewed: 8/19/2025 3:26:21 PM
Signed: 8/19/2025 3:27:45 PM
Electronic Record and Signature Disclosure:
Accepted: 8/19/2025 3:26:21 PM
ID: e5c2bf64-7e9f-483a-bd39-2f23f7b265e1
Andrea Visveshwara
Andrea.Visveshwara@cityofsanrafael.org
Chief Assistant City Attorney
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 157.131.81.146
Sent: 8/19/2025 3:27:48 PM
Viewed: 8/22/2025 5:55:52 PM
Signed: 8/22/2025 5:56:31 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Nataly Torres
Nataly.Torres@cityofsanrafael.org
Legal Assistant
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 8/19/2025 3:27:48 PM
Viewed: 8/25/2025 3:09:56 PM
Signed: 8/25/2025 3:10:28 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Cristine Alilovich
cristine.alilovich@cityofsanrafael.org
City Manager
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 73.71.170.135
Signed using mobile
Sent: 8/25/2025 3:10:31 PM
Resent: 8/28/2025 9:56:15 AM
Viewed: 8/28/2025 12:35:36 PM
Signed: 8/28/2025 12:35:41 PM
Electronic Record and Signature Disclosure:
Accepted: 8/8/2025 5:50:59 PM
ID: 92734b64-c5dc-4308-af7f-b0f4b9ffd306
Lindsay Lara
Lindsay.Lara@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: 8/28/2025 12:35:45 PM
Viewed: 8/28/2025 1:32:27 PM
Signed: 8/28/2025 1:33:04 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Nataly Torres
Nataly.Torres@cityofsanrafael.org
Legal Assistant
City of San Rafael
Security Level: Email, Account Authentication
(None)
Using IP Address: 199.88.113.8
Sent: 8/7/2025 2:17:59 PM
Viewed: 8/12/2025 2:39:55 PM
Completed: 8/12/2025 2:44:57 PM
Editor Delivery Events Status Timestamp
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 8/7/2025 2:17:59 PM
Envelope Updated Security Checked 8/11/2025 12:12:14 PM
Envelope Updated Security Checked 8/12/2025 2:44:58 PM
Envelope Updated Security Checked 8/12/2025 2:44:58 PM
Envelope Updated Security Checked 8/19/2025 2:36:23 PM
Envelope Updated Security Checked 8/19/2025 2:36:23 PM
Envelope Updated Security Checked 8/19/2025 3:22:42 PM
Envelope Updated Security Checked 8/19/2025 3:22:42 PM
Envelope Updated Security Checked 8/21/2025 9:13:29 AM
Envelope Updated Security Checked 8/21/2025 9:13:29 AM
Envelope Updated Security Checked 8/25/2025 2:18:38 PM
Envelope Updated Security Checked 8/25/2025 2:18:38 PM
Certified Delivered Security Checked 8/28/2025 1:32:27 PM
Signing Complete Security Checked 8/28/2025 1:33:04 PM
Completed Security Checked 8/28/2025 1:33:04 PM
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
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Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you
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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
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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: Van Bach, Gary Harvey, Shena Harvey, Cristine Alilovich
previous email address, your new email address. We do not require any other information from you to change your email
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To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically,
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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
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The minimum system requirements for using the DocuSign system may change over time. The current system
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To confirm to us that you can access this information electronically, which will be similar to other electronic notices and
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consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-
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By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:
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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.