The URL can be used to link to this page

Home My WebLink AboutCM Immediate Relocation Assistance for Displaced Individuals; A1 v. Feb 2025 Page 1 AMENDMENT TO CONTRACT BY AND BETWEEN THE CITY OF SAN RAFAEL AND ________________________________ FOR ________________________________________________________ Original Contract Execution Date: ________________, Contract No._______________________ Amendment No. ___ THE ABOVE-NAMED CONTRACT is hereby amended by the parties as set forth herein by the checked boxes below and is effective on _____________________. ☐ SCOPE OF WORK: The Scope of Work is hereby amended in Exhibit A-__, attached hereto and incorporated by reference. ☐ COMPENSATION: The parties agree to increase the not-to-exceed amount by $____________, and to increase the total not-to-exceed amount under the Contract to $_________________. ☐ TERM OF CONTRACT: For Contractor to perform the additional or amended work described herein, the term of this Contract shall be extended to ______________________. Except as specifically amended herein, all other provisions, terms and obligations of the Contract between the parties shall remain valid and shall be in full force. X 50,000 For City Clerk Use Only: Exp. 02/22/2026 Canal Alliance 2025.0029 1 1 Immediate Relocation Assistance for Displaced Individuals August 22, 2025 X 25,000 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 November 13, 2025 2025.0029.A1 v. Feb 2025 Page 2 IN WITNESS WHEREOF, the parties have executed this Amendment on the day, month, and year first specified 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: _____________________________ Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 CEO Omar Carrera Omar Carrera Andrea Visveshwara Chief Assistant City Attorney Cristine Alilovich City Manager November 13, 2025 Lindsay Lara City Clerk EXHIBIT A – 1st Amendment SCOPE OF WORK AMENDED The Parties hereby agree to amend the Scope of Work to add the following work: 1. Additional or Amended Services: The compensation is amended so that contractor can continue providing immediate relocation assistance. Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 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 Canal Alliance X Omar Carrera Angela Robinson Piñon City Manager's Office X omarc@canalalliance.org Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Docusign Envelope ID: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Certificate Of Completion Envelope Id: 1ACAC700-90E2-45D5-89A8-9B2BA3677FC3 Status: Completed Subject: DocuSign: Amendment with Canal Alliance for Relocation Assistance Source Envelope: Document Pages: 23 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 4 Walter Gonzalez AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-08:00) Pacific Time (US & Canada) 111 Morphew St San Rafael, CA 94901 Walter.Gonzalez@cityofsanrafael.org IP Address: 199.88.113.8 Record Tracking Status: Original 10/29/2025 5:35:05 PM Holder: Walter Gonzalez Walter.Gonzalez@cityofsanrafael.org Location: DocuSign Signer Events Signature Timestamp Angela Robinson Piñon Angela.RobinsonPinon@cityofsanrafael.org Acting City Manager City of San Rafael Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 199.88.113.8 Sent: 10/30/2025 5:07:37 PM Viewed: 10/30/2025 5:08:29 PM Signed: 10/30/2025 5:08:50 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: 10/30/2025 5:08:52 PM Viewed: 10/30/2025 5:12:58 PM Signed: 10/30/2025 5:13:09 PM Electronic Record and Signature Disclosure: Not Offered via Docusign Van Bach vanb@cityofsanrafael.org Signing Group: Finance Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 199.88.113.8 Sent: 10/30/2025 5:08:52 PM Resent: 11/3/2025 11:28:57 AM Viewed: 11/3/2025 1:18:53 PM Signed: 11/3/2025 1:30:21 PM Electronic Record and Signature Disclosure: Accepted: 11/3/2025 1:18:53 PM ID: 19234de1-8075-4ad0-ae7d-5b06f3d410e1 Omar Carrera omarc@canalalliance.org CEO Omar Carrera Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 2a09:bac5:665e:1250::1d3:41 Sent: 11/3/2025 1:30:24 PM Viewed: 11/3/2025 3:48:23 PM Signed: 11/3/2025 3:48:31 PM Electronic Record and Signature Disclosure: Accepted: 11/3/2025 3:48:23 PM ID: 3eb9c8b4-323b-484a-8459-b701d8c77a5e Signer Events Signature Timestamp 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: 199.88.113.8 Sent: 11/3/2025 3:48:34 PM Viewed: 11/10/2025 9:06:42 AM Signed: 11/10/2025 9:07:00 AM Electronic Record and Signature Disclosure: Not Offered via Docusign Heather Davis Heather.Davis@cityofsanrafael.org Risk Manager City of San Rafael Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 199.88.113.8 Sent: 11/3/2025 3:48:35 PM Viewed: 11/4/2025 12:29:48 PM Signed: 11/4/2025 12:30:35 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: 71.198.110.147 Sent: 11/10/2025 9:07:03 AM Viewed: 11/13/2025 9:33:08 PM Signed: 11/13/2025 9:33:17 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: 73.93.107.4 Sent: 11/13/2025 9:33:20 PM Viewed: 11/14/2025 9:06:25 AM Signed: 11/14/2025 9:06:50 AM 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: 10/29/2025 5:43:00 PM Viewed: 10/30/2025 5:00:04 PM Completed: 10/30/2025 5:07:36 PM 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 10/29/2025 5:43:00 PM Envelope Updated Security Checked 10/30/2025 5:07:36 PM Envelope Updated Security Checked 10/30/2025 5:07:36 PM Envelope Updated Security Checked 10/30/2025 5:07:36 PM Envelope Updated Security Checked 10/30/2025 5:07:36 PM Certified Delivered Security Checked 11/14/2025 9:06:25 AM Signing Complete Security Checked 11/14/2025 9:06:50 AM Completed Security Checked 11/14/2025 9:06:50 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: Van Bach, Omar Carrera, Cristine Alilovich 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.