HomeMy WebLinkAboutPW Service Level Agreement; Kimley-Horn; Task Order No. 125.2; Francisco Blvd East Mid-Block Crossing Design
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.
125
APRIL 9, 2024
August 8, 2024
2
2
125.2
92,643
Francisco Blvd East Mid-Block Crossing Design
7,000
7,000
KIMLEY-HORN AND ASSOCIATES, INC.
Kimley-Horn and Associates, Inc.
125
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
November 14, 2025
L8.0088.T125.A2
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 2
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Vice President
Kwasi Akwabi
Kimley-Horn and Associates, Inc.
Kevin Aguigui
Kevin Aguigui
Vice President
Andrea Visveshwara
Chief Assistant City Attorney
City Manager
Cristine Alilovich
November 14, 2025
Lindsay Lara
City Clerk
EXHIBIT A - 2
SCOPE OF WORK AMENDED
The Parties hereby agree to amend the Scope of Work to add the following work:
1. Additional or Amended Services:
Based on the Contractor’s proposal submitted on October 21, 2025, Contractor
shall perform the following:
Task 1 – Prepare Conformed Record Drawings: Contractor will prepare
Conformed Record Drawings using the contractor or City resident engineer mark-ups of
the project drawings. The Record Drawings incorporate the as -built information and will
be dated and signed by the Engineer(s) of Record (EOR) prior to being submitted to the
City Engineer.
Task 2 – Provide design support during construction: This task may include the
following:
1) Visits to site and observation of construction
2) Recommendations with respect to defective work
3) Clarifications and interpretations
4) Change orders
5) Shop drawings and samples
6) Substitutes and “or-equal”
7) Inspections and tests
8) Applications for payment
9) Substantial completion
10) Final notice of acceptability of the work
11) Limitation of responsibilities
DELIVERABLES
The Scope of Work is amended to add the following:
1. Project Deliverables:
2.1 Record Drawings Plan Set
2.1 Time and materials for construction support activities
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
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
X
Kimley-Horn and Associates
Public Works
chadi.chazbek@kimley-horn.com Chadi Chazbek
Shannon Mackle (for Mariana Sanchez)
X
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
kimley-horn.com 4637 Chabot Drive, Suite 300, Pleasanton, CA 94588 925 398 4840
Date: October 21, 2025
To: Mariana Sanchez, Junior Engineer
City of San Rafael
From: Akash Patel, PE
Kimley-Horn and Associates, Inc.
Subject: Francisco Blvd East Mid-Block Crossing Design (Task Order No. 125) – Additional
Service Request #2
Dear Mariana,
Kimley-Horn is currently working with the City of San Rafael to provide final design engineering
services for the Francisco Blvd East Mid-Block Crossing Design (Task Order No. 125). To date,
Kimley-Horn has prepared final construction bid documents which includes final bid plans, project
specifications, and engineer’s opinion of probable cost. Other support documentation includes a
lighting analysis at the mid-block crossing and environmental support documentation. Kimley-Horn
has also provided design services during construction, providing responses to contractor RFI’s and
approving material submittals. Kimley-Horn is submitting this Additional Service Request #2 to the
original scope of services, and Additional Service Request #1, to include the additional services as
outlined below.
Additional Scope of Services
Task 6 – Design Services During Construction (DSDC)
Kimley-Horn will continue to provide design support during construction as part of construction
support services. The proposed budget is based on an assumed scope, as described below. We
assume that all work will be performed upon authorization and direction of the City. We have
assumed an additional total of 30 hours for design services during construction (DSDC).
Effort in excess of the assumed hours is assumed to be additional work beyond this scope, and can
be performed for an additional fee, upon the City’s authorization.
Construction Support
The Kimley-Horn team will provide design support during project construction. Kimley-Horn assumes
a total effort of 30 hours for budgeting purposes, which will be performed on a time-and-materials
basis. Of the 30 hours budgeted, 10 hours is assumed for preparation of the Conformed Record
Drawings.
As part of this task, Kimley-Horn will prepare Conformed Record Drawings using the contractor or
City resident engineer mark-ups of the project drawings. The Record Drawings incorporate the as-
built information and will be dated and signed by the Engineer(s) of Record (EOR) prior to being
submitted to the City Engineer.
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Page 2
kimley-horn.com 4637 Chabot Drive, Suite 300, Pleasanton, CA 94588 925 398 4840
Kimley-Horn may perform the following construction support activities, as directed by the City, within
the hours budgeted for the task. Our proposed fee does not assume or include enough hours for us to
perform all the activities summarized below. This list is meant to be a list of services we can provide
during construction.
• Visits to site and observation of construction
• Recommendations with respect to defective work
• Clarifications and interpretations
• Change orders
• Shop drawings and samples
• Substitutes and “or-equal”
• Inspections and tests
• Applications for payment
• Substantial completion
• Final notice of acceptability of the work
• Limitation of responsibilities
FEE AND EXPENSES
Kimley-Horn proposes to provide professional services outlined in this additional scope of services Task
6 – Design Services During Construction (DSDC) for an additional amount of $7,000.
Current not to exceed task order amount: $85,643
Additional requested fee: $7,000
Revised not to exceed task order amount: $92,643
CLOSURE
If you concur in all the foregoing and wish to direct us to proceed with the services, please have
authorized persons execute this Agreement in the space provided below, retain one copy, and return
the other to us. We will commence services only after we have received a fully-executed agreement.
Fees and times stated in this Agreement are valid for sixty (60) days after the date of this letter.
We appreciate the opportunity to provide these services to you. Please contact me if you have any
questions.
Sincerely,
Akash Patel, PE
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Rev. May 2013
City of San Rafael
SERVICE LEVEL AGREEMENT
DATED APRIL 9, 2024
WITH KIMLEY-HORN AND ASSOCIATES, INC.
TASK ORDER NO. 125.1
(Amendment to Task Order No. 125)
Francisco Blvd East Mid-Block Crossing Design
Amendment Amount: $16,950
THIS AMENDMENT TO TASK ORDER No. 125 is entered into on _________________,
between the City of San Rafael, a municipal corporation ("City"), and Kimley-Horn and Associates, Inc.,
("Contractor").
RECITALS
A. The City and Contractor
have entered into a Service Level Agreement ("Agreement") dated April 9, 2024 under which Contractor
has agreed to perform certain contract services for the City; and
B. Pursuant to the Agreement, on August 8, 2024, the City and Contractor entered into
125 tractor agreed to perform contract services in connection with
Francisco Blvd East Mid-Block Crossing Design for a total not to exceed $68,693;
and
C. City now requires additional services for the Project, and the Contractor is willing to
provide such services.
NOW, THEREFORE, City and Contractor agree to amend Task Order No. 125 as follows:
AGREEMENT TO AMEND TASK ORDER
1. ,
forth in Exhibit A of this Task Order Amendment.
2.
budget set forth in Exhibit A, for an amount not to exceed $16,950, changing the total not to exceed to
$85,643.
3. Except as specifically amended herein, all of the other provisions, terms and obligations of Task
Order No. 125 shall remain valid and shall be in full force.
4. Signatures. The parties have executed this Amendment as of the date first written above.
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Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Amendment to Task Order
Rev. Jan 2019
2
CITY OF SAN RAFAEL
By: _____________________________
Cristine Alilovich, City Manager
Reviewed By
By: ______________________________
Robert F. Epstein, City Attorney
CONTRACTOR
By: __________________________
Name: ________________________
Title: _________________________
(if Contractor is a corporation, add
signature of second corporate officer)
By: __________________________
Name: ________________________
Title: _________________________
Exhibits:
A Scope of Work
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Fristine Dlilovich
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
kimley-horn.com 4637 Chabot Drive, Suite 300, Pleasanton, CA 94588 925 398 4840
Date: August 13, 2024
To: April Miller, Public Works Director
City of San Rafael
From: Chadi Chazbek, P.E.
Kimley-Horn and Associates, Inc.
Subject: Francisco Blvd East Mid-Block Crossing Design (Task Order No. 125) Additional
Service Request #1
Dear April,
Kimley-Horn is currently working with the City of San Rafael to provide final design engineering
services for the Francisco Blvd East Mid-Block Crossing Design (Task Order No. 125), as noted in
the listed Task Order Scope of Services. To date, Kimley-Horn has prepared final construction bid
documents which includes
cost. Other support documentation includes a lighting analysis at the mid-block crossing and
environmental support documentation. Kimley-Horn is pleased to submit this Additional Service
Request #1 to the original scope of services, to include the additional services as outlined below.
Additional Scope of Services
Task 6 Design Services During Construction (DSDC)
Kimley-Horn will provide design support during bidding and construction as part of construction
support services. The proposed budget is based on an assumed scope, as described below. We
assume that all work will be performed upon authorization and direction of the City. We have
assumed a total of 70 hours for design services during construction (DSDC).
Each task includes an assumed number of hours. Effort in excess of the assumed hours is assumed
authorization.
Bid Support
The Kimley-Horn team will provide design support ahead of and during project advertisement by
answering contractor inquiries and preparing addenda as requested by the City.
The level of effort associated with responding to contractor inquiries, preparing addenda, and all other
requested efforts for bid support is assumed to total 30 hours for budgeting purposes; this work will
be performed on a time-and-materials basis.
Construction Support
The Kimley-Horn team will provide design support during project construction. Kimley-Horn assumes
a total effort of 40 hours for budgeting purposes; this work will be performed on a time-and-materials
basis.
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Page 2
kimley-horn.com 4637 Chabot Drive, Suite 300, Pleasanton, CA 94588 925 398 4840
As part of this task, Kimley-Horn will prepare Conformed Record Drawings using the contractor or
City resident engineer mark-ups of the project drawings. The Record Drawings incorporate the as-
built information and will be dated and signed by the Engineer(s) of Record (EOR) prior to being
submitted to the City Engineer.
Kimley-Horn may perform the following construction support activities, as directed by the City, within
the hours budgeted for the task. Our proposed fee does not assume or include enough hours for us to
perform all the activities summarized below. This list is meant to be a list of services we can provide
during construction.
Pre-construction conference
Visits to site and observation of construction
Recommendations with respect to defective work
Clarifications and interpretations
Change orders
Shop drawings and samples
-
Inspections and tests
Applications for payment
Substantial completion
Final notice of acceptability of the work
Limitation of responsibilities
FEE AND EXPENSES
Kimley-Horn proposes to provide professional services outlined in this additional scope of services Task
6 Design Services During Construction (DSDC) for an additional amount of $16,950.
Current not to exceed task order amount: $68,693
Additional requested fee: $16,950
Revised not to exceed task order amount: $85,643
CLOSURE
If you concur in all the foregoing and wish to direct us to proceed with the services, please have
authorized persons execute both copies of this Agreement in the spaces provided below, retain one
copy, and return the other to us. We will commence services only after we have received a fully-
executed agreement. Fees and times stated in this Agreement are valid for sixty (60) days after the
date of this letter.
We appreciate the opportunity to provide these services to you. Please contact me if you have any
questions.
Sincerely,
Chadi Chazbek, P.E.
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
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.
10/9/2024
☐
☒SM
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
10/17/2024
10/17/2024
☒ NT
☒ NT
3 Department Director Approval of final agreement form to send to
contractor
10/22/2024 ☒ AM
4 Project Manager
Forward three (3) originals of final agreement to
contractor for their signature
10/22/2024 ☒
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
12/2/2024
☒
PRINT CONTINUE ROUTING PROCESS WITH HARD COPY
6 Project Manager Forward signed original agreements to City
Attorney with printed copy of this routing form
12/12/24 SM
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: Shannon Mackle (for Mariana Sanchez) Extension: 3353
Contractor Name: Kimley-Horn
Contractor’s Contact: Chadi Chazbek Contact’s Email: chadi.chazbek@kimley-horn.com
☐ FPPC: Check if Contractor/Consultant must file Form 700
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
TO Amendment 125.1 - Francisco Blvd
Crossing Design
Final Audit Report 2024-12-13
Created:2024-12-12
By:Shannon Mackle (shannon.mackle@cityofsanrafael.org)
Status:Signed
Transaction ID:CBJCHBCAABAAnvQxPvv8A6ThcuiRB7f2fQwiu8KTVgTf
"TO Amendment 125.1 - Francisco Blvd Crossing Design" Histor
y
Document created by Shannon Mackle (shannon.mackle@cityofsanrafael.org)
2024-12-12 - 7:40:22 PM GMT- IP address: 199.88.89.34
Document emailed to Laraine Gittens (laraine.gittens@cityofsanrafael.org) for approval
2024-12-12 - 7:41:03 PM GMT
Email viewed by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
2024-12-12 - 7:44:48 PM GMT- IP address: 104.47.64.254
Document approved by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
Approval Date: 2024-12-12 - 7:45:04 PM GMT - Time Source: server- IP address: 199.88.113.8
Document emailed to rob.epstein@cityofsanrafael.org for signature
2024-12-12 - 7:45:07 PM GMT
Email viewed by rob.epstein@cityofsanrafael.org
2024-12-12 - 9:15:40 PM GMT- IP address: 199.88.114.102
Signer rob.epstein@cityofsanrafael.org entered name at signing as Robert F. Epstein
2024-12-12 - 9:15:56 PM GMT- IP address: 199.88.114.102
Document e-signed by Robert F. Epstein (rob.epstein@cityofsanrafael.org)
Signature Date: 2024-12-12 - 9:15:58 PM GMT - Time Source: server- IP address: 199.88.114.102
Document emailed to city.clerk@cityofsanrafael.org for approval
2024-12-12 - 9:16:00 PM GMT
Email viewed by city.clerk@cityofsanrafael.org
2024-12-12 - 9:33:46 PM GMT- IP address: 199.88.113.8
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Signer city.clerk@cityofsanrafael.org entered name at signing as Brenna Nurmi
2024-12-13 - 3:38:34 PM GMT- IP address: 199.88.113.8
Document approved by Brenna Nurmi (city.clerk@cityofsanrafael.org)
Approval Date: 2024-12-13 - 3:38:36 PM GMT - Time Source: server- IP address: 199.88.113.8
Document emailed to cristine.alilovich@cityofsanrafael.org for signature
2024-12-13 - 3:38:38 PM GMT
Email viewed by cristine.alilovich@cityofsanrafael.org
2024-12-13 - 9:45:22 PM GMT- IP address: 104.47.65.254
Signer cristine.alilovich@cityofsanrafael.org entered name at signing as Cristine Alilovich
2024-12-13 - 9:45:32 PM GMT- IP address: 199.88.113.8
Document e-signed by Cristine Alilovich (cristine.alilovich@cityofsanrafael.org)
Signature Date: 2024-12-13 - 9:45:34 PM GMT - Time Source: server- IP address: 199.88.113.8
Agreement completed.
2024-12-13 - 9:45:34 PM GMT
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Rev. Jan. 2023 Page 1 of 8
SERVICE LEVEL AGREEMENT
BY AND BETWEEN
THE CITY OF SAN RAFAEL
AND
KIMLEY-HORN AND ASSOCIATES, INC.
For Professional Services
THIS AGREEMENT is entered into as of ______________ (“Effective Date”) between the City
of San Rafael, a California municipal corporation (“City”), and Kimley-Horn and Associates, Inc.
(“Consultant”). The City and Consultant may be referred to individually as a “party” or collectively as the
“parties”.
RECITALS
A. The City wishes to contract for the provision of professional services, as described in
individual “Task Orders” to be issued by the City during the Term of this Agreement.
B. Consultant represents that it, and its subcontractors, if any, have the professional
qualifications, expertise, and necessary licenses and desire to provide professional services of the quality
and type which meet objectives and requirements of the City and that are within the scope of services to
be performed under this Agreement.
NOW, THEREFORE, in consideration of the terms and conditions contained in this Agreement,
the City and Consultant agree as follows:
AGREEMENT
1. Services. Subject to the terms and conditions set forth in this Agreement, Consultant shall
provide the professional services, to include civil engineering, electrical design, land development and
transportation design and review services, as requested and described in a Task Order issued for such
services by the City, and shall coordinate activities so the project that is the subject of each Task Order is
completed according to the City’s requirements.
a. Task Orders. It is understood and agreed that each Task Order shall list the scope
of services to be performed, the schedule for performance, any special conditions, and the form,
amount, and conditions of compensation for services. A Task Order is effective only when
signed by authorized representatives of Consultant and the City. The City shall designate a
Project Manager who shall be fully acquainted with the project and have authority within the
limits of City policy to render decisions promptly. Each Task Order, when issued, shall become a
part of and incorporated into this Agreement.
The City will cooperate with Consultant and provide reasonable access to the site. Upon
written request, the City shall provide all reasonably available information including reports,
preliminary plans, maps, surveys, and other related information regarding its requirements for a
project that is the subject of a Task Order. Consultant may reasonably rely on the accuracy and
completeness of the information provided.
b. Performance. Consultant shall perform the services described in the Task Order.
The time of performance of the services under this Agreement is important to the City, and all
time deadlines identified in the Task Order shall be strictly construed.
04/09/2024
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Rev. Jan. 2023 Page 2 of 8
2. Compensation and Payment.
a. Compensation. As consideration for services, City agrees to pay Consultant, and
Consultant agrees to accept from City as full compensation for the services, a fee that does not
exceed the total budgeted amount detailed in each Task Order. Each Task Order may reflect
either a fixed fee amount or an hourly rate. The rates shall include all direct and indirect charges
to each Task Order, except as noted in the Task Order. Consultant may not adjust their hourly rate
schedule more than once annually, such adjustment to be approved by the City in Task Order(s).
b. Payment. Consultant shall bill City monthly, and City agrees to pay the invoice
within 30 days of receipt. Each payment shall be for the invoiced amount, with no retention.
3. Term; Termination.
a. Term. The term of this Agreement shall be three (3) years beginning on the
Effective Date of this Agreement.
b. Termination. Either party may terminate the Agreement by giving seven days
written notice to the other party. If City sends a termination notice, Consultant shall stop work at
the stage directed by the City, and shall deliver all drawings, specifications, and documentation
developed as of that time. Consultant shall accept as full payment either: (i) if the Task Order
indicated an hourly rate, payment based on the hours worked up to the time of termination; or (ii)
if the Task Order indicated a fixed fee, a pro-rata share of the total Agreement based on the
portion of work actually performed.
4. Professional Efforts; Responsible Personnel. Consultant shall perform all services
required under this Agreement in the manner and according to the standards observed by a competent Bay
Area practitioner of the profession in which Consultant is engaged. All products that Consultant delivers
to City shall conform to the standards of quality normally observed by a person practicing in Consultant’s
profession. The City shall be the sole judge as to whether the product of the Consultant is satisfactory.
Consultant shall be liable and, upon demand, shall reimburse City for additional costs incurred by the
City as a result of Consultant’s errors or omissions. Consultant makes no other warranty, express or
implied.
Consultant represents that it and its employees are fully qualified to perform the services under
this Agreement. Consultant represents and warrants to the City that Consultant has, and at all times during
the performance of this Agreement shall maintain, all licenses, permits, qualifications, and approvals that
are required for Consultant to practice Consultant’s profession. Consultant shall assign only competent
personnel to perform services under this Agreement. If the City, in its sole discretion, at any time, desires
the removal of any person or persons assigned by Consultant to perform services under this Agreement,
Consultant shall remove any such person immediately upon receiving notice from the City.
Consultant shall, at its sole cost, expense, and liability, furnish all facilities and equipment that
may be required for furnishing services under this Agreement.
5. Independent Contractor. Consultant, its agents, employees and independent contractors are
and shall at all times remain, as to the City, wholly independent contractors. Neither the City nor any of
its officers or employees shall have any control over the manner by which the Consultant performs this
Agreement and shall only dictate the results of the performance. Consultant shall not represent that
Consultant, or its agents, employees or independent contractors, are agents or employees of the City.
Consultant is responsible for the payment of all taxes, workers’ compensation insurance and
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Rev. Jan. 2023 Page 3 of 8
unemployment insurance. Consultant shall obtain no rights to retirement benefits or other benefits that
accrue to City’s employees, and Consultant hereby waives any claim it may have to any such rights.
Except as the City may specify in writing, Consultant shall have no authority, express or implied,
to act on behalf of the City or to bind the City to any obligation.
6. Interest of Consultant. Consultant (including principals, associates and professional
employees) covenants and represents that it does not now have any investment or interest in real property
and shall not acquire any interest, direct or indirect, in the geographical areas like ly to be covered by this
Agreement, or any other source of income, interest in real property or investment that would be affected
in any manner or degree by the performance of Consultant’s services under this Agreement. Consultant
further covenants and represents that, in the performance of its duties, no person having any such interest
shall perform any services under this Agreement.
If Consultant is determined to be a “Consultant” or a “designated employee” within the meaning
of the Political Reform Act, Consultant will comply with the requirements of that Act by submitting a
Statement of Economic Interest Form 700. (2 Cal. Code of Regs.§18701(a)(2).)
7. Accounting Records. The Consultant agrees to maintain all records and other evidence
pertaining to costs incurred and work performed under this Agreement and shall make them available at
the Consultant’s office during the Agreement period and thereafter for a period of three years from the
date of receipt of final payment.
8. Ownership of Documents and Data. All data, maps, photographs, and other material
collected or prepared under this Agreement, and all documents of any type developed or obtained by
Consultant in the performance of this Agreement, shall become the property of the City. Any re -use of
designs without Consultant's written authorization will be at the City's risk.
9. Indemnification.
a. Except as otherwise provided in subparagraph b., Consultant shall, to the fullest
extent permitted by law, indemnify, release, defend with counsel approved by City, and hold
harmless City, its officers, agents, employees and volunteers (collectively, the “City
Indemnitees”), from and against any claim, demand, suit, judgment, loss, liability or expense of
any kind, including but not limited to attorney's fees, expert fees and all other costs and fees of
litigation (collectively “Liabilities”), arising out of Consultant’s performance of its obligations or
conduct of its operations under this Agreement. The Consultant’s obligations apply regardless of
whether or not a liability is caused or contributed to by the active or passive negligence of the
City Indemnitees. However, to the extent that liability is caused by the active negligence or
willful misconduct of the City Indemnitees, the Consultant’s indemnification obligation shall be
reduced in proportion to the City Indemnitees’ share of liability for the active negligence or
willful misconduct. In addition, the acceptance or approval of the Consultant’s work or work
product by the City or any of its directors, officers or employees shall not relieve or reduce the
Consultant’s indemnification obligations. In the event the City Indemnitees are made a party to
any action, lawsuit, or other adversarial proceeding arising from Consultant’s performance of or
operations under this Agreement, Consultant shall provide a defense to the City Indemnitees or at
City’s option reimburse the City Indemnitees their costs of defense, including reasonable
attorneys’ fees, incurred in defense of such claims.
b. Where the services to be provided by Consultant under this Agreement are design
professional services to be performed by a design professional as that term is defined under Civil
Code Section 2782.8, then, to the extent permitted by law including without limitation, Civil
Code sections 2782, 2782.6 and 2782.8, Consultant shall indemnify and hold harmless the City
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Rev. Jan. 2023 Page 4 of 8
Indemnitees from and against any Liabilities, to the extent they are caused by the negligence,
recklessness, or willful misconduct of Consultant, or any subconsultants, or subcontractor or
anyone directly or indirectly employed by them, or anyone for whom they are legally liable.
Such obligation to hold harmless and indemnify any indemnity shall not apply to the extent that
such Liabilities are caused in part by the negligence or willful misconduct of such City
Indemnitee.
c. The defense and indemnification obligations of this Agreement are undertaken in
addition to, and shall not in any way be limited by, the insurance obligations contained in this
Agreement, and shall survive the termination or completion of this Agreement for the full period
of time allowed by law.
10. Insurance. Consultant shall procure and maintain at its sole cost for the duration of this
Agreement the following insurance:
a. Minimum Scope of Insurance. Coverage shall be at least as broad as:
(1) Insurance Services Office Commercial General Liability coverage
(“occurrence” form CG 0001).
(2) Insurance Services Office form number CA 0001 covering Automobile
Liability, code 1 (any auto).
(3) Workers’ Compensation insurance as required by the Labor Code of the
State of California and Employers Liability insurance.
(4) Errors and omissions/Professional liability insurance for all design
professionals such as architects, landscape architects or engineers.
b. Minimum Limits of Insurance. Consultant shall maintain policy limits of no less
than:
(1) Commercial General Liability: $1,000,000 per occurrence/$2,000,000
aggregate, for death, bodily injury, personal injury, or property damage.
(2) Automobile Liability: $1,000,000 combined single limit per accident for
bodily injury and property damage.
(3) Workers’ Compensation and Employers Liability: If it employs any
person, Consultant shall maintain workers’ compensation insurance, as required
by the State of California, with statutory limits, and employer’s liability
insurance with limits of no less than one million dollars ($1,000,000) per
accident for bodily injury or disease. Consultant’s workers’ compensation
insurance shall be specifically endorsed to waive any right of subrogation against
the City.
(4) Errors and Omissions/Professional Liability: $1,000,000 per
occurrence/$2,000,000 aggregate.
c. Deductibles and Self-Insured Retention. Any deductibles or self-insured
retention must be declared to and approved by the City. At the option of the City, either: the
insurer shall reduce or eliminate such deductibles or self-insured retention as respects the City, its
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Rev. Jan. 2023 Page 5 of 8
officers, officials, employees and volunteers; or Consultant shall procure a bond guaranteeing
payment of losses and related investigations, claim administration and defense expenses.
d. Other Insurance Requirements. The insurance coverage required of Consultant
shall also meet the following requirements:
(1) Except for professional liability insurance or workers’ compensation
insurance, the insurance policies shall be specifically endorsed to include the City,
its officers, agents, employees, and volunteers, as additional insureds (for both
ongoing and completed operations) under the policies.
(2) The additional insured coverage under Consultant’s insurance policies shall
be “primary and noncontributory” with respect to any insurance or coverage
maintained by City and shall not call upon City’s insurance or self-insurance
coverage for any contribution. The “primary and noncontributory” coverage in
Consultant’s policies shall be at least as broad as ISO form CG20 01 04 13.
(3) Except for professional liability insurance or workers’ compensation
insurance, the insurance policies shall include, in their text or by endorsement,
coverage for contractual liability and personal injury.
(4) By execution of this Agreement, Consultant hereby grants to City a
waiver of any right to subrogation which any insurer of Consultant may acquire
against City by virtue of the payment of any loss under such insurance.
Consultant agrees to obtain any endorsement that may be necessary to effect this
waiver of subrogation, but this provision applies regardless of whether or not
City has received a waiver of subrogation endorsement from the insurer.
(5) If the insurance is written on a Claims Made Form, then, following
termination of this Agreement, said insurance coverage shall survive for a period of
not less than five years.
(6) The insurance policies shall provide for a retroactive date of placement
coinciding with the effective date of this Agreement.
(7) The limits of insurance required in this Agreement may be satisfied by a
combination of primary and umbrella or excess insurance. Any umbrella or excess
insurance shall contain or be endorsed to contain a provision that such coverage
shall also apply on a primary and noncontributory basis for the benefit of City (if
agreed to in a written contract or agreement) before City’s own insurance or self-
insurance shall be called upon to protect it as a named insured.
(8) It shall be a requirement under this Agreement that any available insurance
proceeds broader than or in excess of the specified minimum insurance coverage
requirements and/or limits shall be available to City or any other additional insured
party. Furthermore, the requirements for coverage and limits shall be: (1) the
minimum coverage and limits specified in this Agreement; or (2) the broader
coverage and maximum limits of coverage of any insurance policy or proceeds
available to the named insured, whichever is greater. No representation is made that
the minimum insurance requirements of this agreement are sufficient to cover the
obligations of the Consultant under this agreement.
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Rev. Jan. 2023 Page 6 of 8
e. Acceptability of Insurers. Insurance is to be placed with insurers with a Best’s
rating of no less than A: VII.
f. Verification of Coverage. Consultant shall furnish the City with certificates of
insurance and with original endorsements effecting coverage required by this clause. The
certificates and endorsements for each insurance policy are to be signed by a person authorized
by that insurer to bind coverage on its behalf. All certificates and endorsements are to be
received and approved by the City before work commences. The City reserves the right to
require complete certified copies of all required insuranc e policies, at any time.
11. Miscellaneous provisions.
a. Notice. Any notice to be given under this Agreement shall be given by enclosing
it in a sealed envelope, first-class postage prepaid, and depositing it in the United States mail,
addressed to the party at the following address. Notice shall be deemed received three business
days after mailing, or upon personal delivery.
CITY: City of San Rafael
Attn: Joanna Kwok, Assistant Director of Public Works
111 Morphew Street
San Rafael, CA 94901
CONSULTANT: Kimley-Horn and Associates, Inc.
Attn: Kevin Aguigui
1300 Clay Street, Suite 325
Oakland, CA 94612
b. Assignment. This Agreement contemplates the personal services of Consultant
and its employees and it is understood by both parties that a substantial inducement to City for
entering into this Agreement was, and is, the professional reputation and competence of
Consultant. Consultant shall not assign or otherwise transfer any rights or obligations under this
Agreement without the prior written consent of the City.
c. Business License. Consultant shall obtain a City business license before
beginning work under this Agreement.
d. Prohibited Interests. No officer or employee of the City shall have any direct
financial interest in this Agreement. This Agreement shall be voidable at the option of the City if
this provision is violated.
e. Governing Law; Litigation Expenses. California law shall govern this
Agreement. Any action to enforce or interpret this Agreement shall be brought in a court of
competent jurisdiction in the County of Marin, California.
f. Incorporation. The Preamble, the Recitals, Exhibits, and Task Orders issued
hereunder are incorporated into this Agreement by this reference. If there is a conflict between
the body of this Agreement and an exhibit prepared by Consultant, the body of the Agreement
shall control.
g. Severability. Should any part of this Agreement be declared unconstitutional,
invalid, or beyond the authority of either party to enter into or carry out, such decision shall not
affect the validity of the remainder of this Agreement, which shall continue in full force and
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Rev. Jan. 2023 Page 7 of 8
effect; provided that, the remainder of this Agreement can, absent the excised portion, be
reasonably interpreted to give effect to the intentions of the parties.
h. Authority. All parties executing this Agreement represent and warrant that they
are authorized to do so.
i. Entire Agreement; Amendments. This Agreement is the entire Agreement
between the parties and supersedes all prior negotiations, representations, or agreements, whether
written or oral. This Agreement may be amended only by written agreement signed by both
parties.
j. Non-waiver. A party's waiver of any term shall not be deemed a continuing
waiver or a waiver of any other term.
k. Counterparts. This Agreement may be executed in counterparts.
[Signatures are on the following page.]
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
City of San Rafael Service Level Agreement
Rev. Jan. 2023 Page 8 of 8
IN WITNESS WHEREOF, the parties have executed this Agreement as of the day, month and year
first above written.
CITY OF SAN RAFAEL:
_________________________________
CRISTINE ALILOVICH, City Manager
APPROVED AS TO FORM:
Office of the City Attorney
_________________________________
By: GENEVIEVE COYLE,
Assistant City Attorney
ATTEST:
City Clerk
_________________________________
LINDSAY LARA, City Clerk
CONSULTANT:
__________________________________
By: ____________________________
Name: ____________________________
Title: ____________________________
[If CONSULTANT is a corporation, add signature
of second corporate officer]
__________________________________
By: ____________________________
Name: ____________________________
Title: ____________________________
2 . $ & 2 $ — + - G v A ? A C A A w A @ ˜
Kimley-Horn and Associates, Inc.
Kwasi Akwabi
Vice President
Kevin Aguigui (Apr 8, 2024 22:50 PDT)
Kevin Aguigui
Kimley-Horn and Associates
Kevin Aguigui
Vice President
ri./ine A'i'*vi # (Apr ш, 2024 0ш:5т PDT)
)UiVWine AOiORviFK
renn ur(i (!*r) (Apr ш, 2024 р0:04 PDT)
(UennD 4uUPi IRU
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
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.
7/27/2023
☐
☒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
7/27/2023
7/27/2023
☒ NT
☒ NT
3 Department Director Approval of final agreement form to send to
contractor
7/31/2023 ☒ AM
4 Project Manager
Forward three (3) originals of final agreement to
contractor for their signature
8/17/2023 ☒
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 Joanna Kwok) Extension: 3353
Contractor Name: Kimley-Horn and Associates, Inc.
Contractor’s Contact: Kevin Aguigui Contact’s Email: Kevin.Aguigui@kimley-horn.com
☐ FPPC: Check if Contractor/Consultant must file Form 700
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Kimley Horn - 2023 Master Services Agreement
Final Audit Report 2024-04-09
Created:2024-04-02
By:Shannon Mackle (shannon.mackle@cityofsanrafael.org)
Status:Signed
Transaction ID:CBJCHBCAABAAcpk10M7oTpgAzYmNCJw5uCbLFD4iSB79
"Kimley Horn - 2023 Master Services Agreement" History
Document created by Shannon Mackle (shannon.mackle@cityofsanrafael.org)
2024-04-02 - 10:51:52 PM GMT
Document emailed to Kwasi Akwabi (kwasi.akwabi@kimley-horn.com) for signature
2024-04-02 - 10:51:57 PM GMT
Document shared with eugelyn.lopez@cityofsanrafael.org by Shannon Mackle
(shannon.mackle@cityofsanrafael.org)
2024-04-02 - 10:52:32 PM GMT
Document shared with Jonathan Schellin (jonathans@cityofsanrafael.org) by Shannon Mackle
(shannon.mackle@cityofsanrafael.org)
2024-04-02 - 10:52:32 PM GMT
Email viewed by Kwasi Akwabi (kwasi.akwabi@kimley-horn.com)
2024-04-09 - 5:20:28 AM GMT
Document e-signed by Kwasi Akwabi (kwasi.akwabi@kimley-horn.com)
Signature Date: 2024-04-09 - 5:21:01 AM GMT - Time Source: server
Document emailed to kevin.aguigui@kimley-horn.com for signature
2024-04-09 - 5:21:03 AM GMT
Email viewed by kevin.aguigui@kimley-horn.com
2024-04-09 - 5:49:06 AM GMT
Signer kevin.aguigui@kimley-horn.com entered name at signing as Kevin Aguigui
2024-04-09 - 5:50:09 AM GMT
Document e-signed by Kevin Aguigui (kevin.aguigui@kimley-horn.com)
Signature Date: 2024-04-09 - 5:50:11 AM GMT - Time Source: server
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Document emailed to Laraine Gittens (laraine.gittens@cityofsanrafael.org) for approval
2024-04-09 - 5:50:12 AM GMT
Email viewed by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
2024-04-09 - 3:34:17 PM GMT
Document approved by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
Approval Date: 2024-04-09 - 3:36:03 PM GMT - Time Source: server
Document emailed to Genevieve Coyle (genevieve.coyle@cityofsanrafael.org) for signature
2024-04-09 - 3:36:05 PM GMT
Email viewed by Genevieve Coyle (genevieve.coyle@cityofsanrafael.org)
2024-04-09 - 4:04:01 PM GMT
Document e-signed by Genevieve Coyle (genevieve.coyle@cityofsanrafael.org)
Signature Date: 2024-04-09 - 4:04:44 PM GMT - Time Source: server
Document emailed to city.clerk@cityofsanrafael.org for approval
2024-04-09 - 4:04:46 PM GMT
Email viewed by city.clerk@cityofsanrafael.org
2024-04-09 - 4:10:05 PM GMT
Signer city.clerk@cityofsanrafael.org entered name at signing as Brenna Nurmi
2024-04-09 - 4:10:15 PM GMT
Document approved by Brenna Nurmi (city.clerk@cityofsanrafael.org)
Approval Date: 2024-04-09 - 4:10:17 PM GMT - Time Source: server
Document emailed to Cristine Alilovich (cristine.alilovich@cityofsanrafael.org) for signature
2024-04-09 - 4:10:19 PM GMT
Email viewed by Cristine Alilovich (cristine.alilovich@cityofsanrafael.org)
2024-04-09 - 4:53:05 PM GMT
Document e-signed by Cristine Alilovich (cristine.alilovich@cityofsanrafael.org)
Signature Date: 2024-04-09 - 4:53:27 PM GMT - Time Source: server
Document emailed to city.clerk@cityofsanrafael.org for signature
2024-04-09 - 4:53:29 PM GMT
Email viewed by city.clerk@cityofsanrafael.org
2024-04-09 - 5:03:52 PM GMT
Signer city.clerk@cityofsanrafael.org entered name at signing as Brenna Nurmi (for)
2024-04-09 - 5:04:06 PM GMT
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Document e-signed by Brenna Nurmi (for) (city.clerk@cityofsanrafael.org)
Signature Date: 2024-04-09 - 5:04:08 PM GMT - Time Source: server
Agreement completed.
2024-04-09 - 5:04:08 PM GMT
Docusign Envelope ID: 497CA10F-F10A-4E4A-AAD5-61768194BE07
Certificate Of Completion
Envelope Id: 497CA10F-F10A-4E4A-AAD5-61768194BE07 Status: Completed
Subject: DocuSign: Task Order Amendment with Kimley-Horn for Francisco Blvd East Mid-Block Crossing Design
Source Envelope:
Document Pages: 26 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
Shannon.Mackle@cityofsanrafael.org
IP Address: 199.88.89.34
Record Tracking
Status: Original
10/27/2025 9:24:59 AM
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: 199.88.89.34
Sent: 11/5/2025 2:36:33 PM
Viewed: 11/5/2025 4:22:35 PM
Signed: 11/5/2025 4:22:47 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: 11/5/2025 4:22:50 PM
Viewed: 11/6/2025 9:28:05 AM
Signed: 11/6/2025 9:28:13 AM
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: 11/5/2025 4:22:50 PM
Viewed: 11/5/2025 4:42:48 PM
Signed: 11/5/2025 4:43:17 PM
Electronic Record and Signature Disclosure:
Accepted: 11/5/2025 4:42:48 PM
ID: f1a9c6e1-dda6-458f-966c-af6c1f64aef7
Kwasi Akwabi
kwasi.akwabi@kimley-horn.com
Vice President
Kimley-Horn and Associates, Inc.
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 134.238.198.140
Sent: 11/6/2025 9:28:16 AM
Viewed: 11/8/2025 12:45:59 AM
Signed: 11/12/2025 2:31:45 PM
Electronic Record and Signature Disclosure:
Accepted: 11/8/2025 12:45:59 AM
ID: 54a18535-3d7e-4bbf-b3f5-2b12f0d434d8
Signer Events Signature Timestamp
Kevin Aguigui
kevin.aguigui@kimley-horn.com
Vice President
Kevin Aguigui
Security Level: Email, Account Authentication
(None)
Signature Adoption: Drawn on Device
Using IP Address: 134.238.198.140
Sent: 11/12/2025 2:31:48 PM
Viewed: 11/12/2025 2:33:38 PM
Signed: 11/12/2025 2:34:12 PM
Electronic Record and Signature Disclosure:
Accepted: 11/12/2025 2:33:38 PM
ID: 34b6adc9-9e34-4ddf-a0b4-fd02fa5e6533
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: 11/12/2025 2:34:15 PM
Viewed: 11/12/2025 3:40:22 PM
Signed: 11/12/2025 3:40:30 PM
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:
2601:205:4b01:1550:c05c:4254:819b:48ea
Sent: 11/12/2025 2:34:15 PM
Viewed: 11/14/2025 8:02:41 AM
Signed: 11/14/2025 8:07:34 AM
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: 11/14/2025 8:07:37 AM
Viewed: 11/14/2025 8:35:25 AM
Signed: 11/14/2025 8:35:38 AM
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: 11/14/2025 8:35:41 AM
Viewed: 11/14/2025 8:37:39 AM
Signed: 11/14/2025 8:53:47 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
Nataly.Torres@cityofsanrafael.org
Legal Assistant
City of San Rafael
Security Level: Email, Account Authentication
(None)
Using IP Address:
2600:1700:9750:3df0:ca9:581c:7600:d967
Sent: 10/30/2025 12:05:16 PM
Viewed: 11/5/2025 2:32:58 PM
Completed: 11/5/2025 2:36:31 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 10/30/2025 12:05:16 PM
Envelope Updated Security Checked 11/5/2025 2:36:32 PM
Envelope Updated Security Checked 11/5/2025 2:36:32 PM
Envelope Updated Security Checked 11/5/2025 2:36:32 PM
Envelope Updated Security Checked 11/5/2025 2:36:32 PM
Envelope Updated Security Checked 11/5/2025 2:36:32 PM
Envelope Updated Security Checked 11/5/2025 2:36:32 PM
Certified Delivered Security Checked 11/14/2025 8:37:39 AM
Signing Complete Security Checked 11/14/2025 8:53:47 AM
Completed Security Checked 11/14/2025 8:53:47 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, Kwasi Akwabi, Kevin Aguigui, 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.