HomeMy WebLinkAboutCM Strategic Planning Services; 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
JACOB GREEN & ASSOCIATES, INC
For City Clerk Use Only: 06/30/2025
P01999
1
February 11, 2025
June 30, 2026
STRATEGIC PLANNING SERVICES
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November 25, 2025
L8.0095.A1
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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: _____________________________
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Jacob Green
President & CEO
President & CEO
Chief Assistant City Attorney
Andrea Visveshwara
November 25, 2025
Cristine Alilovich
City Manager
City Clerk
Lindsay Lara
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
Jacob Green and Associates
City Manager's Office
jacob@jacobgreenandassociates.com
X
X
Jacob Green
John Stefanski
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AGREEMENT FOR PROFESSIONAL SERVICES
BY AND BETWEEN
THE CITY OF SAN RAFAEL
AND
JACOB GREEN & ASSOCIATES, INC
FOR STRATEGIC PLANNING SERVICES
This Agreement is made and entered into as of ________________________ (the “Effective
Date”), by and between the CITY OF SAN RAFAEL, a chartered California municipal corporation
hereinafter "CITY"), and JACOB GREEN & ASSOCIATES, INC, a California Corporation
hereinafter "CONSULTANT"). CITY and CONSULTANT may be referred to individually as
a “Party” or collectively as the “Parties” or the “Parties to this Agreement.”
RECITALS
A. CITY desires to secure professional services more fully described in this
Agreement, at Exhibit A, entitled “SCOPE OF SERVICES”; and
B. CONSULTANT represents that it, and its subcontractors, if any, have the
professional qualifications, expertise, and necessary licenses and desire to provide certain goods
and/or required services of the quality and type which meet objectives and requirements of CITY;
and
C. The Parties have specified herein the terms and conditions under which such
services will be provided and paid for.
NOW, THEREFORE, the parties hereby agree as follows:
AGREEMENT
1. SERVICES TO BE PROVIDED.
Except as otherwise may be expressly specified in this Agreement, CONSULTANT shall
furnish all technical and professional services, including labor, material, equipment,
transportation, supervision and expertise (collectively referred to as “Services”) to satisfactorily
complete the work required by CITY at its sole risk and expense. Services to be provided to CITY
are more fully described in Exhibit A entitled “SCOPE OF SERVICES.” CONSULTANT
acknowledges that the execution of this Agreement by CITY is predicated upon representations
made by CONSULTANT in that certain proposal, dated December 19, 2024 (“Proposal”) set forth
in Exhibit A, which constitutes the basis for this Agreement.
2. COMPENSATION.
In consideration for CONSULTANT’s complete performance of Services, CITY shall pay
CONSULTANT for all materials provided and services rendered by CONSULTANT fixed fees
in the amounts of $24,000 for council goal setting and $63,500 for work planning and at the unit
Feb 11, 2025
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rates for travel and materials, as further described in Exhibit A, provided that the total amount
payable under this Agreement does not to exceed $90,000.
CONSULTANT will bill City on a monthly basis for Services provided by
CONSULTANT during the preceding month, subject to verification by CITY. CITY will pay
CONSULTANT within thirty (30) days of City’s receipt of invoice.
3. TERM OF AGREEMENT.
Unless otherwise set forth in this Agreement or unless this paragraph is subsequently
modified by a written amendment to this Agreement, the term of this Agreement shall begin on
the Effective Date of this Agreement and terminate on December 31, 2025.
4. PROJECT COORDINATION.
A. CITY’S Project Manager. John Stefanski is hereby designated the PROJECT
MANAGER for the CITY and said PROJECT MANAGER shall supervise all aspects of the progress
and execution of this Agreement.
B. CONSULTANT’S Project Director. CONSULTANT shall assign a single
PROJECT DIRECTOR to have overall responsibility for the progress and execution of this
Agreement for CONSULTANT. Jacob Green is hereby designated as the PROJECT DIRECTOR
for CONSULTANT. Should circumstances or conditions subsequent to the execution of this
Agreement require a substitute PROJECT DIRECTOR, for any reason, the CONSULTANT shall
notify the CITY within ten (10) business days of the substitution.
5. TERMINATION.
A. Discretionary. Either party may terminate this Agreement without cause upon thirty
30) days written notice mailed or personally delivered to the other party.
B. Cause. Either party may terminate this Agreement for cause upon fifteen (15) days
written notice mailed or personally delivered to the other party, and the notified party's failure to cure
or correct the cause of the termination, to the reasonable satisfaction of the party giving such notice,
within such fifteen (15) day time period.
C. Effect of Termination. Upon receipt of notice of termination, neither party shall
incur additional obligations under any provision of this Agreement without the prior written consent
of the other.
D. Return of Documents. Upon termination, any and all CITY documents or materials
provided to CONSULTANT and any and all of CONSULTANT's documents and materials
prepared for or relating to the performance of its duties under this Agreement, shall be delivered to
CITY as soon as possible, but not later than thirty (30) days after termination.
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6. OWNERSHIP OF DOCUMENTS.
The written documents and materials prepared by the CONSULTANT in connection with
the performance of its duties under this Agreement, shall be the sole property of CITY. CITY may
use said property for any purpose, including projects not contemplated by this Agreement.
7. INSPECTION AND AUDIT.
Upon reasonable notice, CONSULTANT shall make available to CITY, or its agent, for
inspection and audit, all documents and materials maintained by CONSULTANT in connection with
its performance of its duties under this Agreement. CONSULTANT shall fully cooperate with CITY
or its agent in any such audit or inspection.
8. ASSIGNABILITY.
The parties agree that they shall not assign or transfer any interest in this Agreement nor the
performance of any of their respective obligations hereunder, without the prior written consent of the
other party, and any attempt to so assign this Agreement or any rights, duties or obligations arising
hereunder shall be void and of no effect.
9. INSURANCE REQUIREMENTS.
During the term of this Agreement, and for any time period set forth in Exhibit B,
CONSULTANT 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 Services under this
Agreement with coverage amounts, required endorsements, certificates of insurance, and coverage
verifications as defined in Exhibit B.
10. INDEMNIFICATION.
A. Except as otherwise provided in subparagraph B of this section, 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 “CLAIMS”), 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,
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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 and its officers, officials, and employees (collectively City Indemnitees) from and against
damages, liabilities or costs (including incidental damages, Court costs, reasonable attorney’s fees
as may be determined by the Court, litigation expenses and fees of expert witnesses incurred in
connection therewith and costs of investigation) 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
collectively Liabilities). 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.
11. NONDISCRIMINATION.
CONSULTANT shall not discriminate, in any way, against any person on the basis of age,
sex, race, color, religion, ancestry, national origin or disability in connection with or related to the
performance of its duties and obligations under this Agreement.
12. COMPLIANCE WITH ALL LAWS.
CONSULTANT shall observe and comply with all applicable federal, state and local laws,
ordinances, codes and regulations, in the performance of its duties and obligations under this
Agreement. CONSULTANT shall perform all services under this Agreement in accordance with
these laws, ordinances, codes and regulations. CONSULTANT shall release, defend, indemnify and
hold harmless CITY, its officers, agents and employees from any and all damages, liabilities,
penalties, fines and all other consequences from any noncompliance or violation of any laws,
ordinances, codes or regulations.
13. NO THIRD PARTY BENEFICIARIES.
CITY and CONSULTANT do not intend, by any provision of this Agreement, to create in
any third party, any benefit or right owed by one party, under the terms and conditions of this
Agreement, to the other party.
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14. NOTICES.
All notices and other communications required or permitted to be given under this Agreement,
including any notice of change of address, shall be in writing and given by personal delivery, or
deposited with the United States Postal Service, postage prepaid, addressed to the parties intended to
be notified. Notice shall be deemed given as of the date of personal delivery, or if mailed, upon the
date of deposit with the United States Postal Service. Notice shall be given as follows:
To CITY’s Project Manager:
John Stefanski, Assistant City Manager
1400 Fifth Avenue
San Rafael, CA 94901
To CONSULTANT’s Project Director:
Jacob Green
13217 Jamboree Rd., #248
Tustin, CA 92782
15. INDEPENDENT CONTRACTOR.
For the purposes, and for the duration, of this Agreement, CONSULTANT, its officers,
agents and employees shall act in the capacity of an Independent Contractor, and not as employees of
the CITY. CONSULTANT and CITY expressly intend and agree that the status of
CONSULTANT, its officers, agents and employees be that of an Independent Contractor and not
that of an employee of CITY.
16. ENTIRE AGREEMENT -- AMENDMENTS.
A. The terms and conditions of this Agreement, all exhibits attached, and all documents
expressly incorporated by reference, represent the entire Agreement of the parties with respect to the
subject matter of this Agreement.
B. This written Agreement shall supersede any and all prior agreements, oral or written,
regarding the subject matter between the CONSULTANT and the CITY.
C. No other agreement, promise or statement, written or oral, relating to the subject
matter of this Agreement, shall be valid or binding, except by way of a written amendment to this
Agreement.
D. The terms and conditions of this Agreement shall not be altered or modified except
by a written amendment to this Agreement signed by the CONSULTANT and the CITY.
E. If any conflicts arise between the terms and conditions of this Agreement, and the
terms and conditions of the attached exhibits or the documents expressly incorporated by reference,
the terms and conditions of this Agreement shall control.
17. SET-OFF AGAINST DEBTS.
CONSULTANT agrees that CITY may deduct from any payment due to CONSULTANT
under this Agreement, any monies which CONSULTANT owes CITY under any ordinance,
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agreement, contract or resolution for any unpaid taxes, fees, licenses, assessments, unpaid checks or
other amounts.
18. WAIVERS.
The waiver by either party of any breach or violation of any term, covenant or condition of
this Agreement, or of any ordinance, law or regulation, shall not be deemed to be a waiver of any
other term, covenant, condition, ordinance, law or regulation, or of any subsequent breach or violation
of the same or other term, covenant, condition, ordinance, law or regulation. The subsequent
acceptance by either party of any fee, performance, or other consideration which may become due or
owing under this Agreement, shall not be deemed to be a waiver of any preceding breach or violation
by the other party of any term, condition, covenant of this Agreement or any applicable law, ordinance
or regulation.
19. COSTS AND ATTORNEY'S FEES.
The prevailing party in any action brought to enforce the terms and conditions of this
Agreement, or arising out of the performance of this Agreement, may recover its reasonable costs
including claims administration) and attorney's fees expended in connection with such action.
20. CITY BUSINESS LICENSE / OTHER TAXES.
CONSULTANT shall obtain and maintain during the duration of this Agreement, a CITY
business license as required by the San Rafael Municipal Code, and CONSULTANT shall pay any
and all state and federal taxes and any other applicable taxes. CITY shall not be required to pay for
any work performed under this Agreement, until CONSULTANT has provided CITY with a
completed Internal Revenue Service Form W-9 (Request for Taxpayer Identification Number and
Certification).
21. SURVIVAL OF TERMS.
Any terms of this Agreement that by their nature extend beyond the term (or termination) of
this Agreement shall remain in effect until fulfilled and shall apply to both Parties’ respective
successors and assigns.
22. APPLICABLE LAW.
The laws of the State of California shall govern this Agreement.
23. COUNTERPARTS AND ELECTRONIC SIGNATURE.
This Agreement may be executed by electronic signature and in any number of counterparts,
each of which shall be deemed an original, but all of which together shall constitute one document.
Counterpart signature pages may be delivered by telecopier, email or other means of electronic
transmission.
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Signatures are on the following page.]
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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: ROBERT F. EPSTEIN, 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: ____________________________
Jacob Green (Jan 7, 2025 09:55 EST)
Jacob Green
President and CEO
Jacob Green & Associates, Inc.
Jacob Green
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Rev. 08.22 A-1
EXHIBIT A
SCOPE OF SERVICES
The Services to be performed for CITY by CONSULTANT under this Agreement are more fully
described in CONSULTANT’s proposal, which is attached to this Exhibit A.
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Proposal for
Strategic Planning
Services
13217 Jamboree Rd., #248Tustin, CA92782888.4.JGA.1STJacobGreenAndAssociates.com
DECEMBER
2024
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LETTER FROM CEO JACOB GREEN
TABLE OF
CONTENTS
SCOPE OF SERVICES
COST PROPOSAL
YOUR TEAM
Page 1
Section
C
Section
B
Section
A
Cover
Letter
Pages 2 - 6
Pages 7 - 11
Pages 12 - 13
CI
T
Y
O
F
SA
N
R
A
F
A
E
L
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Jacob GreenPresident & CEO
1.888.4.JGA.1ST | INFO@JACOBGREENANDASSOCIATES.COM
December 19, 2024CristineAlilovich, CityManagerCityofSanRafael1400FifthAvenueSanRafael, CA94901DearCityManagerAlilovich,
Thank you very much for your interest in having Jacob Green & Associates (JGA) provide StrategicPlanningServicesfortheCityofSanRafael. Our menu style proposal outlines our comprehensive Strategic Planning Services to include:
Service #1: Council Goal Setting
Service #2: Work Planning
Optional: Work Plan Maintenance & UpdateTheJGAteamcomprisesdiverse, veteran local government leaders with over 600 years of combinedmunicipalexperience. JGA provides comprehensive local government services that focus on helpingorganizationsachievelong-term impact. We provide tailored services by developing a deepunderstandingofourclients' needs, fostering authentic and trusted relationships, and focusing onsolutionsandoutcomesthatconsistentlyexceedexpectations.We look forward to continuing our partnership with the City of San Rafael.Sincerely,
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SCOPE OFSERVICESSECTIONA
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SERVICE #1: COUNCIL GOAL SETTING
STEP 1: ONE-ON-ONE INTERVIEWS WITH THE CITY MANAGEMENT
TEAM AND COUNCILMEMBERSOurteamwillconductone-on-one interviews with the City Management team and each Council Memberinadvanceoftheworkshop. The purpose of these one-hour conversations is to build rapport and ensurethat, by working with the City Management team, we create a customized experience to meet theCouncil's individual and collective interests. These sessions will focus on gathering the individualCouncilMember’s Vision, Strategic Priorities, and expectations for staff performance. Following theinterviews, our team will meet with the City Manager and Mayor to align on retreat content based on theinterviewfindings.
STEP 2: OPEN SESSION ALIGNMENTTRAININGTheconsultantteamwillprovideaone-hour open session training to include, but not limited to, thefollowingtopics:
1.AEM-Cube CognitiveDiversity2.Building a Highly EffectiveTeam3.Roles and Responsibilities in a MunicipalOrganization4.Vision, Mission, Goals/Objectives, and Values
STEP 3: CLOSED SESSION FACILITATION (OPTIONAL)
The consultant will facilitate a closed session to solidify the Council's Goals and Strategic Priorities. ThiswillbetiedtotheCityManager's performance expectations.Facilitators will create a safe and respectful environment for the Council to discuss the Vision andStrategicPrioritiesfortheorganizationastheyrelatetotheCityManager's performance expectations. The facilitators will present a rough Vision statement based on the one-on-one interviews and seekCouncilmodificationand/or adoption to guide the organization's future direction. Additionally, theconsultantswillprovideacomprehensivelistofallStrategicPrioritiesfortheCounciltomodifyand/orfinalizebasedonexercisesfacilitatedbytheconsultantteam. This draft Vision and set of StrategicPrioritieswillalsobecraftedwithinputandfeedbackfromtheCityManager. The Council will leave thesessionwithanopportunitytobringtheVisionandStrategicPrioritiesforapprovalatapublicmeeting.This component of the facilitation will be conducted in closed session under California GovernmentCodeSection54954.5 - Public Employee Performance Evaluation – City Manager. The purpose of thesessionistoestablishGoalsandObjectivestoenabletheCityManager’s performance to be evaluated inthefuture. The closed session environment will allow for candid and comprehensive discussion.
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SERVICE #2: WORK PLANNING
Effective work planning plays a crucial role in successfully implementing strategic planning bytranslatingstrategicgoalsintotangibletasks, timelines, and resource allocations that drive desiredoutcomes. JGA is committed to guiding the City through the following steps, providing comprehensivesupportforworkplanningandstrategicplanimplementation. Our aim is to enable the City of San Rafaeltoeffectivelyconvertstrategicgoalsintoactionabletasks, allocate resources appropriately, and monitorprogresstowardachievingdesiredoutcomes.
STEP 1: KICKOFFMEETINGMarkingthebeginningoftheworkplanning facilitation process, JGA will host a virtual meeting for therelevantstaffandstakeholders. This kickoff meeting will set the stage to ensure the team is aligned andreadytomoveforwardwithworkplandevelopment.
STEP 2: WORK PLAN INPUTJGAwillcollaboratecloselywithstaffto develop or update work plan content that aligns with strategicgoals. Through virtual working sessions with staff, JGA will define and document actionable tasks, milestones, realistic timelines, owners, budget sources, and any additional information to be included inthefinalworkplandeliverable.
STEP 3: WORK PLANDELIVERYJGAwillprovidetheCitywithafinalwork plan document. Upon request, the content can alsobeprovidedinExcelformatforuseorintegrationintotheCity’s internal project tracking software.
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OPTIONAL: WORK PLAN MAINTENANCE &
JGA will guide the City of San Rafael through the next step of the Work Plan Implementation process byensuringcontinuedvisibility. This process of monitoring and follow-up not only keeps the project ontrackbutalsofostersacultureofcontinuousimprovement, leading to more reliable and sustainableoutcomes. JGA will provide the following:
Facilitate quarterly updates to the work plan document and dashboard from staff usingtheprocessestablishedduringtheimplementationphase.Make as-needed modifications to the work plan document based on input from your team.
UPDATE
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Confidentiality: Maintain strict confidentiality and abide by all JGA confidentiality requirements.
Clear Objectives: Define and communicate project goals, expectations, and deliverables clearlyattheproject's outset.
Active Participation: Engage in regular meetings and provide necessary feedback to ensuretheprojectstaysontrackandalignswithexpectations.
Resource Allocation: Ensure the availability of internal resources, including key personnel, data,and tools, required for the project.
Open Communication: Maintain open and honest communication with the Consultant,addressing any concerns or changes in scope as soon as they arise.
Decision-Making: Facilitate timely decision-making processes to avoid delays and ensureprojectprogress.
Access Provision: Provide the Consultant with necessary access to relevant systems,documentation, and facilities.
Respect Timelines: Adhere to agreed-upon timelines for reviews, approvals, andinformationrequeststomaintainprojectmomentum.
Change Management: Collaborate on managing any changes in project scope, requirements, ortimelines, ensuring mutual agreement on modifications.
Partnership Approach: Foster a collaborative and respectful working relationship, recognizingthatsuccessfuloutcomesdependonbothparties' commitment and cooperation.
Timely Payment: Pay invoices pursuant to contract terms and communicate any paymentissuespromptlywiththeConsultant.
San Rafael's ProjectCommitmentSuccessfulprojectoutcomesrelyonastrongpartnershipbetweenourteamandyours. To ensure thebestresults, we've outlined key client responsibilities that foster effective collaboration and projectefficiency. By fulfilling these roles, you actively contribute to the project's success, helping us deliverhigh-quality work on time and within scope. This mutual commitment not only improves projectoutcomesbutalsomaximizesthevalueandimpactofourcombinedefforts.
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YOURTEAMSECTIONB
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JGA’s Team Video Link: Jacob Green and Associates - JGA - Your First Call
JACOB GREEN, MPAPresident & CEOJacobisanationally recognized local government expert in organization andleadershipdevelopment. As an Assistant City Manager for the City of San JuanCapistranoandtheCityofOntario, he has managed hundreds of employees andnumerousgovernmentdepartments. As a trainer, keynote speaker, facilitatorandcoach, Jacob has worked with municipal clients, as well as commercialclientssuchasMattel, FedEx, Hyundai Capital, ADP, and many others. In 2019, Jacob distilled his personal and professional experiences into an Amazon best-selling book: See Change Clearly: Leveraging Adversity to Sharpen Your Vision
and Build Resilient Teams. Jacob has received numerous awards for hisleadership, including the National Caring Award, the Orange County HumanRelationsAward, the Most Inspiring Student at UC Irvine, and is the youngestrecipientoftheGeneLentznerHumanitarianAward. Jacob has his Bachelor ofArtsinSocialScienceswithaMinorinManagementfromtheUniversityofCalifornia, Irvine, his Master of Public Administration (MPA) degree fromCaliforniaStateUniversity, Long Beach, and was recently awarded an honorarydoctoratefromWesternUniversitySchoolofHealthSciences.
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DAVEBROWNDirectorofClientSuccessChiefDaveBrown (ret.) is passionate about helping public sector executivesandorganizationssucceedinadynamicandchallengingenvironment, especially when facing leadership, political, or personnel challenges. ChiefBrownhasheldcommandpositionsineverydivisionoflawenforcement, including many years as a Chief of Police. He has also served as Director ofPublicSafety, Assistant City Manager, and held several stints as Interim CityManager. In 2017, Chief Brown was recruited by the City of Menifee, California, to spearhead the creation of the Menifee Police Department. Over the nextthreeyears, Brown created and implemented a robust, data-driven strategy, successfully launching the new Menifee Police Department on July 1, 2020. More recently, Dave served as the Executive Director of the Riverside SheriffsAssociation (RSA), one of the largest law enforcement labor organizations inthecountry.
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NICOLE BEACH, CCMPDirectorofStrategicInitiativesNicoleBeachisaprojectmanagement and strategy delivery leader whospecializesinassistingorganizationsinrealizingvaluebyaligningstrategywithexecution. Nicole collaborates closely with our clients to develop work plansthatensuretheirsuccessinexecutingstrategicgoalsandprovidesprojectmanagementoversightacrossallprojects. Before joining JGA, Nicole amassed awealthofexperienceleadingcomplextechnology, organizational, and strategicprojects, including M&A integrations, ERP implementations, and processimprovementinitiatives. Most recently, she oversaw Project ManagementOfficesandStrategicPortfolioManagementforSAFEbuilt, Citrix, and SportClips. Nicole holds certifications as a Project Management Professional (PMP) and Lean Six Sigma Green Belt. She also earned an MBA with a concentration inProcessImprovementfromNovaSoutheasternUniversity.
KATHRYNHAMELSeniorAdvisorKathrynHamel, Ph.D., is a seasoned executive with over 28 years of experienceinthepublic, non-profit, and private sectors. She previously worked as a Vice-President and Chief Executive Officer for two non-profit mental healthorganizations. Before transitioning into nonprofit leadership, she served as theSeniorVicePresidentofHumanResourcesandOrganizationalDevelopmentforaprivate, accredited international university. She also served her communityfornearly25yearsasalawenforcementprofessionalfortwomid-sizedmunicipalpolicedepartmentsandretiredasapolicelieutenantin2019. Inadditiontoherprofessionalaccomplishments, Dr. Hamel is chairperson of theInternationalAssociationofChiefsofPoliceEngagementandEducationSubcommittee, a subcommittee of the Human and Civil Rights Committee. ShewasrecognizedastheAdvocateoftheYearbytheGreaterIrvineChamberofCommercein2023, and the Mental Health Professional of the Year from theMentalHealthAssociationofOrangeCountyin2022. She is pursuing a Master'sDegreeinClinicalPsychology, projected to be completed in late 2024. Inaddition, she holds a Doctoral Degree in Organizational Public SafetyLeadership & Criminal Justice from Capella University, a Master's Degree inCriminalJusticefromChapmanUniversity, and a Bachelor's Degree inVocationalEducationandOccupationalStudiesfromCaliforniaStateUniversity, Long Beach. Dr. Hamel also holds two professional certifications intraumaandresilienceandathirdprofessionalcertificationinthepreventionofhumantraffickingfromFloridaStateUniversity. She is the author of Body, Mind,
and Badge: Strategies for Navigating Law Enforcement Trauma and Resilienceandco-author of A Trauma-Informed Approach to Labor & Sex Trafficking, published in Police Chief magazine in 2023.
PAGE 9
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
TERILEDOUXSeniorAdvisorTeriLedouxservedin local government for over 25 years. Starting as an unpaidinternintheCityManager's Office, Teri quickly realized a passion forservingthecommunitythroughproblemsolving, analysis, and mostimportantlythroughteamwork. Holding positions as Analyst, Assistant to theCityManager, Director of Administrative Services, Assistant City Manager andCityManagerin3cities (within 3 different counties) over her career providedTeriwiththeopportunitytoconstantlylearnandgrow. While Teri's CityManagerpositioncamerelativelylateinhercareer, she was able to take yearsofwatchingandlearningfromotherstoworksidebysidewithherteamtoaccomplishwhatseemedtobeimpossible. Teri worked in cities with large andsmallpopulations, cities with healthy and not so healthy budgets, and citieswithverydifferentissues. This journey led Teri to return home to the City ofSanBernardinolateinhercareerwhereshewasabletoleadtheCitythroughthefinalstepsofbankruptcy. Her major accomplishment during this time wassuccessfullyleadingthecommunityengagementefforttoreplacetheexpiring .25 ($9M) sales tax measure with a 1% ($40M) sales tax measure. TheimportanceofgivingbacktoourupcomingleadersisapriorityforTeri. TeriholdsaBachelor's Degree in Business Administration and a Master'sDegreeinPublicAdministration.
JOHNANDREWSSeniorAdvisorJohnAndrewsspentmorethan 37 years serving in various capacities with fourdifferentSouthernCaliforniamunicipalagencies. From January 2009 toSeptember2020, he served as Director of Economic Development & Redevelopment for the City of Ontario, responsible for the oversight andimplementationofOntario's Economic Development, Business RetentionandAttraction, and Communications/Marketing programs. John spent most ofhislocalgovernmentcareerwiththeCommunityDevelopmentCommissionoftheCityofPasadena. He also served as Director of Economic Development/Redevelopment for the City of Azusa, and Downtown Development Manager fortheCityofRiverside. John has represented two local agencies on BusinessImprovementDistrictboardsandparticipatedinthedevelopmentandimplementationofcomprehensivedowntownrevitalizationstrategies. HeservedasamemberoftheSanBernardinoCountyWorkforceDevelopmentBoardandcurrentlyservesasaneconomicdevelopmentadvisortotheCityofOntario. John holds a Bachelor of Science Degree in Urban and RegionalPlanningfromCaliforniaStatePolytechnicUniversity, Pomona, and hascompletedgraduatestudiesinPublicAdministrationatCaliforniaStateUniversity, Northridge.
PAGE 10
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
MEGHANMURRAYProjectSpecialistMeghanMurrayhasover24 years of experience in Operations Management, Program Management, Personnel Management, Executive Communication, andContinuousProcessImprovement. Meghan served in the Air Force for 22 yearsandhasextensivebackgroundinOrganizationalDevelopment. Meghan excelledinoverseeingoperations, professional development, and personnel programsfororganizationsandhasdirectedmultipleprogramsvaluedat $1B whilemanagingrisk, safety, and compliance. Meghan holds a Masters of SciencedegreewithaspecialtyinHumanResourceManagementbringingtotheteamanextensiveknowledgeinteamleadership, strategic planning, and data drivendecisionmaking. One of Meghan’s most notable projects was being a strategicteamleadoftheOrganizationoftheFuturethatledtothebuildingofthelatestbranchofthemilitary, the United States Space Force. As a Project SpecialistwithJGA, Meghan supports the Organizational Development and EmergencyManagementDepartmentsbycoordinatingprojects, managing timelines, andensuringthesuccessfulexecutionofdepartmentinitiatives.
PAGE 11
NICOLIHILSCHERSeniorProjectManagerNicoliHilscherbringsover 23 years of expertise in OrganizationalDevelopment, Leadership Development, Training, Facilitation, and ProjectManagement. A retired Senior Master Sergeant from the United States AirForce, she distinguished herself in the top two percent of the active enlistedforce. Nicoli's extensive background includes leading positions internationally, where she drove long-term organizational growth in diverse and fast-pacedenvironments. She excelled in overseeing operations, professionaldevelopment, and recognition programs for organizations ranging from 20 to300personnel. As a Senior Project Manager with Jacob Green and Associates, Nicoli plays a pivotal role in managing Organizational Development projects; such as Teambuildings, Retreats, Leadership Academies, OrganizationalAssessments, Strategic Planning, and supporting our Work Planning teams. Known for her ability to keep teams on task and on-time, Nicoli ensures thehighestqualityofservicedeliverytoallJGAclients.
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
PAGE 12
COST PROPOSALSECTIONC
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
PAGE 1 3
COST PROPOSAL
Description Cost
Service #1: Council Goal Setting $63,500 $2,200 / quarterlyupdateService #2: Work Planning
Optional: Work Plan Maintenance & Update
Travel Invoiced at cost
Printed Materials Invoiced at cost
24,000
JacobGreenAndAssociates.comThecostsoutlinedinthisproposalareconsideredvalidandbindingforaperiodof90days, commencingfromthedateoftheproposal's issuance. During this timeframe, the provided pricing and estimates forproducts, services, and associated expenses will remain unchanged, subject to the terms and conditionsspecifiedintheproposaldocument. Any modifications or alterations to the proposal, as well asadjustmentstothecosts, will require mutual agreement between the involved parties.
ExclusionsThefollowingprogram expenses are not included in consultant fees and are the responsibility of theCity, if necessary.Venue rental fees for the workshopFoodandbeveragesfortheworkshopMaterials/supplies for the workshop
Invoicing Schedule: 15% upon execution of the contract and monthly percentage progress payments.
Late Payment FeeAllinvoicesaredueandpayable within 30 days of the invoice date. Any invoice not paid within 30 dayswillbesubjecttoalatepaymentfee. A fee of 1.5% per month will be added to the outstanding balanceuntiltheinvoiceispaidinfull.
The prices, specifications, and conditions covered within this proposal are satisfactory and herebyaccepted. JGA is authorized to do the work as specified.
Signature:_________________________________
Name/Title:_______________________________
Date:_______________________________________
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
Rev. 08.22 B-1
EXHIBIT B
INSURANCE REQUIREMENTS
During the term of this Agreement, and for any time period set forth below,
CONSULTANT 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 Services under this
Agreement with coverage amounts, required endorsements, certificates of insurance, and coverage
verifications as defined in this Exhibit B.
A. Scope of Coverage. During the term of this Agreement, CONSULTANT shall
maintain, at no expense to CITY, the following insurance policies:
1. Commercial general liability. A commercial general liability insurance
policy in the minimum amount of one million dollars ($1,000,000) per occurrence/two million dollars
2,000,000) aggregate, for death, bodily injury, personal injury, or property damage.
2. Automobile liability. An automobile liability (owned, non-owned, and hired
vehicles) insurance policy in the minimum amount of one million dollars ($1,000,000) per
occurrence.
3. Professional liability. If any licensed professional performs any of the
services required to be performed under this Agreement, a professional liability insurance policy in
the minimum amount of one million dollars ($1,000,000) per occurrence/two million dollars
2,000,000) aggregate, to cover any claims arising out of the CONSULTANT's performance of
services under this Agreement. Where CONSULTANT is a professional not required to have a
professional license, CITY reserves the right to require CONSULTANT to provide professional
liability insurance pursuant to this section.
4. Workers’ compensation. 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 CITY.
B. Other Insurance Requirements. The insurance coverage required of the
CONSULTANT in subparagraph A of this section above 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
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
v 08.22 B-2
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.
9. CONSULTANT agrees to ensure that subcontractors, and any other party
involved with the Services, who is brought onto or involved in the performance of the Services by
CONSULTANT, provide the same minimum insurance coverage required of CONSULTANT,
except as with respect to limits. CONSULTANT agrees to monitor and review all such coverage
and assumes all responsibility for ensuring that such coverage is provided in conformity with the
requirements of this Agreement. CONSUTLANT agrees that upon request by CITY, all
agreements with, and insurance compliance documents provided by, such subcontractors and
others engaged in the performance of Services will be submitted to CITY for review.
10. CONSULTANT agrees to be responsible for ensuring that no contract used
by any party involved in any way with the Services reserves the right to charge CITY or
CONSULTANT for the cost of additional insurance coverage required by this Agreement. Any
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
v 08.22 B-3
such provisions are to be deleted with reference to CITY. It is not the intent of CITY to reimburse
any third party for the cost of complying with these requirements. There shall be no recourse
against CITY for payment of premiums or other amounts with respect thereto.
C. Deductibles and SIR’s. Any deductibles or self-insured retentions in
CONSULTANT's insurance policies must be declared to and approved by the CITY and shall not
reduce the limits of liability. Policies containing any self-insured retention (SIR) provision shall
provide or be endorsed to provide that the SIR may be satisfied by either the named insured or CITY
or other additional insured party. At CITY's option, the deductibles or self-insured retentions with
respect to CITY shall be reduced or eliminated to CITY's satisfaction, or CONSULTANT shall
procure a bond guaranteeing payment of losses and related investigations, claims administration,
attorney’s fees and defense expenses.
D. Proof of Insurance. CONSULTANT shall provide to the PROJECT MANAGER
all of the following: (1) Certificates of Insurance evidencing the insurance coverage required in this
Agreement; (2) a copy of the policy declaration page and/or endorsement page listing all policy
endorsements for the commercial general liability policy, and (3) excerpts of policy language or
specific endorsements evidencing the other insurance requirements set forth in this Agreement.
CITY reserves the right to obtain a full certified copy of any insurance policy and endorsements from
CONSULTANT. Failure to exercise this right shall not constitute a waiver of the right to exercise it
later. The insurance shall be approved as to form and sufficiency by the CITY.
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
Jacob Green and Associates G&O Final PSA
Final Audit Report 2025-01-07
Created:2025-01-07
By:Walter Gonzalez Valdez (walter.gonzalez@cityofsanrafael.org)
Status:Signed
Transaction ID:CBJCHBCAABAA3Z4fvt_1NDd0HDZ0Nva0luKiiY7W7Grt
Jacob Green and Associates G&O Final PSA" History
Document created by Walter Gonzalez Valdez (walter.gonzalez@cityofsanrafael.org)
2025-01-07 - 1:16:52 AM GMT
Document emailed to Jacob Green (jacob@jacobgreenandassociates.com) for signature
2025-01-07 - 1:17:03 AM GMT
Email viewed by Jacob Green (jacob@jacobgreenandassociates.com)
2025-01-07 - 2:52:31 PM GMT
Document e-signed by Jacob Green (jacob@jacobgreenandassociates.com)
Signature Date: 2025-01-07 - 2:55:08 PM GMT - Time Source: server
Agreement completed.
2025-01-07 - 2:55:08 PM GMT
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
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.
1/2/2025
for JS
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
1/2/2025
1/2/2025 NT
NT
3 Department Director Approval of final agreement form to send to
contractor
1/6/2025 _WG
for JS___
4 Project Manager Forward three (3) originals of final agreement to
contractor for their signature
1/6/2025
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
1/21/2025
PRINT CONTINUE ROUTING PROCESS WITH HARD COPY
6 Project Manager Forward signed original agreements to City
Attorney with printed copy of this routing form
2/10/25 X
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: City Manager’s Office
Project Manager: John Stefanski Extension: 3475
Contractor Name: Jacob Green and Associates
Contractor’s Contact: Jacob Green Contact’s Email: jacob@jacobgreenandassociates.com
FPPC: Check if Contractor/Consultant must file Form 700
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
PSA - Jacob Green & Associates - Strategic
Planning Services
Final Audit Report 2025-02-12
Created:2025-02-10
By:Nataly Torres (nataly.torres@cityofsanrafael.org)
Status:Signed
Transaction ID:CBJCHBCAABAAwXqGol7LK2mV8cQNt-sWWTrr8CCEpPgL
PSA - Jacob Green & Associates - Strategic Planning Services"
History
Document created by Nataly Torres (nataly.torres@cityofsanrafael.org)
2025-02-10 - 11:52:14 PM GMT- IP address: 199.88.113.8
Document emailed to Laraine Gittens (laraine.gittens@cityofsanrafael.org) for approval
2025-02-10 - 11:55:08 PM GMT
Email viewed by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
2025-02-10 - 11:56:31 PM GMT- IP address: 104.47.64.254
Document approved by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
Approval Date: 2025-02-10 - 11:59:37 PM GMT - Time Source: server- IP address: 199.88.113.8
Document emailed to andrea.visveshwara@cityofsanrafael.org for signature
2025-02-10 - 11:59:41 PM GMT
Email viewed by andrea.visveshwara@cityofsanrafael.org
2025-02-11 - 0:00:06 AM GMT- IP address: 104.47.65.254
Signer andrea.visveshwara@cityofsanrafael.org entered name at signing as Andrea Visveshwara for
2025-02-11 - 1:02:51 AM GMT- IP address: 199.88.113.8
Document e-signed by Andrea Visveshwara for (andrea.visveshwara@cityofsanrafael.org)
Signature Date: 2025-02-11 - 1:02:53 AM GMT - Time Source: server- IP address: 199.88.113.8
Document emailed to city.clerk@cityofsanrafael.org for approval
2025-02-11 - 1:02:56 AM GMT
Email viewed by city.clerk@cityofsanrafael.org
2025-02-11 - 6:58:26 PM GMT- IP address: 199.88.113.8
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
Signer city.clerk@cityofsanrafael.org entered name at signing as Lindsay Lara
2025-02-11 - 7:00:19 PM GMT- IP address: 199.88.113.8
Document approved by Lindsay Lara (city.clerk@cityofsanrafael.org)
Approval Date: 2025-02-11 - 7:00:21 PM GMT - Time Source: server- IP address: 199.88.113.8
Document emailed to cristine.alilovich@cityofsanrafael.org for signature
2025-02-11 - 7:00:24 PM GMT
Email viewed by cristine.alilovich@cityofsanrafael.org
2025-02-11 - 9:25:50 PM GMT- IP address: 104.47.65.254
Signer cristine.alilovich@cityofsanrafael.org entered name at signing as Cristine Alilovich
2025-02-11 - 9:25:59 PM GMT- IP address: 199.88.113.8
Document e-signed by Cristine Alilovich (cristine.alilovich@cityofsanrafael.org)
Signature Date: 2025-02-11 - 9:26:01 PM GMT - Time Source: server- IP address: 199.88.113.8
Document emailed to city.clerk@cityofsanrafael.org for signature
2025-02-11 - 9:26:04 PM GMT
Email viewed by city.clerk@cityofsanrafael.org
2025-02-12 - 0:24:38 AM GMT- IP address: 199.88.113.8
Signer city.clerk@cityofsanrafael.org entered name at signing as Lindsay Lara
2025-02-12 - 0:24:49 AM GMT- IP address: 199.88.113.8
Document e-signed by Lindsay Lara (city.clerk@cityofsanrafael.org)
Signature Date: 2025-02-12 - 0:24:51 AM GMT - Time Source: server- IP address: 199.88.113.8
Agreement completed.
2025-02-12 - 0:24:51 AM GMT
Docusign Envelope ID: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4
Certificate Of Completion
Envelope Id: A58064DD-63D1-400D-BA60-0C8DA8D7FCA4 Status: Completed
Subject: DocuSign: Amendment with Jacob Green and Associates for Strategic Planning Services
Source Envelope:
Document Pages: 34 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
11/18/2025 12:47:17 PM
Holder: Walter Gonzalez
Walter.Gonzalez@cityofsanrafael.org
Location: DocuSign
Signer Events Signature Timestamp
John Stefanski
John.Stefanski@cityofsanrafael.org
Acting City Manager
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 50.232.209.186
Sent: 11/18/2025 4:28:35 PM
Viewed: 11/18/2025 4:36:54 PM
Signed: 11/18/2025 4:37:05 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: 11/18/2025 4:37:08 PM
Viewed: 11/18/2025 5:11:46 PM
Signed: 11/18/2025 5:11:53 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: 11/18/2025 4:37:08 PM
Viewed: 11/18/2025 4:51:25 PM
Signed: 11/18/2025 4:51:37 PM
Electronic Record and Signature Disclosure:
Accepted: 11/18/2025 4:51:25 PM
ID: 834cbfe7-5564-4b99-9527-cb93cdf3264b
Jacob Green
jacob@jacobgreenandassociates.com
President & CEO
President & CEO
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address:
2600:6c50:5f0:d890:e010:8717:cc:e153
Sent: 11/18/2025 5:11:56 PM
Viewed: 11/19/2025 8:52:21 AM
Signed: 11/19/2025 11:10:11 AM
Electronic Record and Signature Disclosure:
Accepted: 11/19/2025 8:52:21 AM
ID: cc0c92bb-dae2-4d10-aa38-cb6406d2c28d
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:
2600:6c52:7800:439:80f9:954:dd8a:852c
Sent: 11/19/2025 11:10:14 AM
Viewed: 11/24/2025 11:41:03 AM
Signed: 11/24/2025 11:41:21 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: 11/19/2025 11:10:15 AM
Viewed: 11/25/2025 2:53:07 PM
Signed: 11/25/2025 2:53:13 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: 209.214.137.130
Sent: 11/25/2025 2:53:17 PM
Viewed: 11/25/2025 3:17:54 PM
Signed: 11/25/2025 3:18:02 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: 11/25/2025 3:18:05 PM
Viewed: 12/1/2025 12:54:29 PM
Signed: 12/1/2025 12:55:39 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: 11/18/2025 4:02:21 PM
Viewed: 11/18/2025 4:22:32 PM
Completed: 11/18/2025 4:28:34 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 11/18/2025 4:02:21 PM
Envelope Updated Security Checked 11/18/2025 4:28:34 PM
Envelope Updated Security Checked 11/18/2025 4:28:34 PM
Envelope Updated Security Checked 11/18/2025 4:28:34 PM
Envelope Updated Security Checked 11/18/2025 4:28:35 PM
Envelope Updated Security Checked 11/18/2025 4:28:35 PM
Envelope Updated Security Checked 11/18/2025 4:28:35 PM
Envelope Updated Security Checked 11/18/2025 4:28:35 PM
Certified Delivered Security Checked 12/1/2025 12:54:29 PM
Signing Complete Security Checked 12/1/2025 12:55:39 PM
Completed Security Checked 12/1/2025 12:55:39 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
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, Jacob Green, 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.