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HomeMy WebLinkAboutCC Resolution 12904 (Pickleweed Park Synthetic Field)RESOLUTION NO. 12904 RESOLUTION AUTHORIZING THE DIRECTOR OF PUBLIC WORKS TO EXECUTE A PROFESSIONAL SERVICES AGREEMENT WITH CARDUCCI AND ASSOCIATES, INC. FOR DESIGN, PREPARATION OF FINAL PLANS, SPECIFICATIONS AND ESTIMATE IN THE AMOUNT OF $78,525.00, AND ANY ADDITIONAL SERVICE ON A TIME AND MATERIAL BASIS, AS REQUIRED, NOT TO EXCEED $21,475.00 FOR `PICKLEWEED PARK SYNTHETIC FIELD DESIGN' PROJECT WHEREAS, the `Pickleweed Park Synthetic Field Design' project is for installation of all-weather synthetic turf soccer fields at Pickleweed Park; and WHEREAS, the project will also involve designing proper drainage and irrigation systems to support the natural and synthetic surfaces; in the portion of the site that remains natural turf, the project may convert the existing Bermuda grass turf to a cool season rhizomatous fescue turf, and WHEREAS, the City will apply for Proposition 84 grant funding for the construction phase of this project in early 2010; and WHEREAS, the City staff found that design services from a qualified consultant will be required for this project; and WHEREAS, the design phase of the project will require development of preliminary design concepts, and preparation of final plans, specifications and estimates (complete PS&E package) for construction from the selected design consulting team; and WHEREAS, California Government Code Section 4926 requires that the selection of Engineers, Architects and Landscape Architects for design professional services be based only on qualification and not on proposed fee; the Code also states that the fee be negotiated with the most qualified firm; and WHEREAS, staff distributed the request for proposal in October of 2009 among six (6) pre -qualified Landscape Architects; and WHEREAS, staff and other public agencies reviewed and ranked the proposals based on a pre -established scoring system for an objective and unbiased selection process; and WHEREAS, Carducci and Associates, Inc. received the highest score; and WHEREAS, Carducci and Associates, Inc. proposed the lowest fee among all other proposals received; and WHEREAS, the Director of Public Works adjusted the requested total fee to include fees for only the tasks that are required for design phase (the total fee excluded fees for bidding assistance/addenda and construction administration tasks as those will be paid for on a time and materials basis and will be determined and controlled by staff); and WHEREAS, staff determined that Carducci and Associates, Inc. is the most qualified consulting team for this project; and WHEREAS, staff recommends Carducci and Associates, Inc. for design, preparation of final plans, specifications and estimate in the amount of $78,525.00, and any additional service on a time and material basis, as required, not to exceed $21,475.00 for'Pickleweed Park Synthetic Field Design' project. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of San Rafael that it: 1. Approves the Professional Scope of Services for Carducci & Associates, Inc., as stated on Exhibit A attached hereto; and 2. Authorizes the Director of Public Works to enter into a Professional Services Agreement, in a form approved by the City Attorney, with Carducci & Associates, Inc., for design, preparation of final plans, specifications and estimate in the amount of $78,525.00, and any additional professional services as presented on Exhibit A on a time and material basis, as required, not to exceed $21,475.00 for the `Pickleweed Park Synthetic Field Design' project; and 3. Authorizes the Director of Public Works to take all necessary actions to complete the project. 1, ESTHER C. BEIRNE, Clerk of the City of San Rafael, hereby certify that the foregoing resolution was duly and regularly introduced and adopted at a regular meeting of the Council of said City on the 4 1h day of January, 2010, by the following vote, to wit: AYES: COUNCILMEMBERS: Brockbank, Connolly, Heller, Levine & Mayor Boro NOES: COUNCILMEMBERS: None ABSENT: COUNCILMEMBERS: None "'t.5 ESTHER C. BEIRNE, City Clerk File No.: 06.07.11 AGREEMENT FOR PROFESSIONAL SERVICES WITH CARDUCCI AND ASSOCIATES, INC. FOR `PICKLEWEED PARK SYNTHETIC FIELD DESIGN' PROJECT This Agreement is made and entered into this 5`h day of January, 2010 by and between the CITY OF SAN RAFAEL [hereinafter "CITY"], and Carducci and Associates, Inc. (hereinafter "CONSULTANT). RECITALS WHEREAS, the CITY has determined that certain specialized professional services for design are required for the Pickleweed Park Synthetic Field Design project (hereinafter "PROJECT"); and WHEREAS, the CONSULTANT has offered to render such specialized professional services in connection with this Proiect. AGREEMENT NOW, THEREFORE, the parties hereby agree as follows: 1. DEFINITIONS. Not applicable. 2. PROJECT COORDINATION A. CITY. The City Manager shall be the representative of the CITY for all purposes under this Agreement. The City Engineer 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. CONSULTANT shall assign a single PROJECT DIRECTOR to have overall responsibility for the progress and execution of this Agreement for CONSULTANT. William E. Fee, ASLA, AICP, 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. 3. DUTIES OF CONSULTANT CONSULTANT agrees to perform the services as a Landscape Architect to prepare design documents, including preliminary concept plans and final (100%) plans, specifications and estimate (complete PS&E package) associated with the Pickleweed Park Revised 4/21/09 Synthetic Field Design project, as outlined in the proposal from CONSULTANT dated 24`h December of 2009 marked Exhibit "A" attached hereto, and incorporated herein by this reference. CONSULTANT agrees to be available and perform the work specified in this Agreement in the time frame as specified and as shown in Exhibit "A". 4. DUTIES OF THE CITY CITY shall perform the duties as described in Exhibit "A" attached hereto and incorporated herein. 5. COMPENSATION For the frill performance of the services described herein by CONSULTANT, CITY shall pay CONSULTANT on a time and materials basis for services rendered in accordance with the rates shown on the Design Services Fee Proposal as described in Exhibit "B" attached and incorporated herein. The total payment made for any individual work task will not exceed the amounts shown on the Design Services Fee Proposal, set out in Exhibit "B". Payment will be made monthly upon receipt by PROJECT MANAGER of itemized invoices submitted by CONSULTANT. Any additional services required, such as bidding assistance/addenda and construction administration, will be determined and controlled by City and will be paid for on a time and material basis in accordance with the rates in the Construction Services Fee Proposal from CONSULTANT dated December of 2009 described as Exhibit "C" attached and incorporated herein. is complete. 6. TERM OF AGREEMENT The term of this Agreement shall be from the date of execution until the Project 7. 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 ten (10) 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 notice, to the reasonable satisfaction of the party giving such notice, within thirty (30) days of the receipt of said notice. 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. Agreement • 2 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. 8. 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. 9. 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. 10. 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. 11. INSURANCE A. During the term of this Agreement, CONSULTANT, shall maintain, at no expense to CITY, the following insurance policies: 1. A comprehensive general liability insurance policy in the minimum amount of one million ($1,000,000) dollars per occurrence for death, bodily injury, personal injury, or property damage; 2. An automobile liability (owned, non -owned, and hired vehicles) insurance policy in the minimum amount of one million ($1,000,000) dollars per occurrence; 3. 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 ($1,000,000) dollars to cover any claims arising out of the CONSULTANT's performance of services under this Agreement. B. The insurance coverage required of the CONSULTANT by Section 11. A., shall also meet the following requirements: Agreement • 3 1. The insurance shall be primary with respect to any insurance or coverage maintained by CITY and shall not call upon CITY's insurance or coverage for any contribution; 2. Except for professional liability insurance, the insurance policies shall be endorsed for contractual liability and personal injury; 3. Except for professional liability insurance, the insurance policies shall be specifically endorsed to include the CITY, its officers, agents, and employees as additionally named insureds under the policies; 4. CONSULTANT shall provide to PROJECT MANAGER, (a) Certificates of Insurance evidencing the insurance coverage required herein, and (b) specific endorsements naming CITY, its officers, agents and employees, as additional insureds under the policies; 5. The insurance policies shall provide that the insurance carrier shall not cancel, terminate or otherwise modify the terms and conditions of said insurance policies except upon thirty (30) days written notice to CITY's PROJECT MANAGER; 6. 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; 7. The insurance policies shall provide for a retroactive date of placement coinciding with the effective date of this Agreement; 8. The liability insurance provided to CITY by CONSULTANT under this contract shall be primary and excess of any other insurance available to the CITY. 9. The insurance shall be approved as to form and sufficiency by PROJECT MANAGER and the CITY's Attorney. C. If it employs any person, CONSULTANT shall maintain worker's compensation and employer's liability insurance, as required by the State Labor Code and other applicable laws and regulations, and as necessary to protect both CONSULTANT and CITY against all liability for injuries to CONSULTANT's officers and employees. D. Any deductibles or self-insured retentions in CONSULTANT's insurance policies must be declared to and approved by the PROJECT MANAGER and the City Attorney. 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. Agreement • 4 12. INDEMNIFICATION (a) Except as provided in Paragraph (b), CONSULTANT shall indemnify, release, defend and hold harmless CITY, its officers, and employees, against any claim, demand, suit, judgment, loss, liability or expense of any kind, including attorney's fees, arising out of or resulting in any way, in whole or in part, from any acts or omissions, intentional or negligent, of CONSULTANT or CONSULTANT's officers, agents and employees in the performance of their duties and obligations under this Agreement. (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, CONSULTANT shall, to the fullest extent permitted by law, indemnify, release, defend and hold harmless CITY, its officers, and employees, against any claim, demand, suit, judgment, loss, liability or expense of any kind, including attorney's fees, that arises out of, pertains to, or relates to the negligence, recklessness, or willful misconduct of CONSULTANT in the performance of its duties and obligations under this Agreement. 13. 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. 14. 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, ordinance, codes or regulations. 15. 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. 16. 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 Agreement • 5 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: Parviz Mokhtari, (Project Manager) City of San Rafael 111 Morphew Street P.O. Box 151560 San Rafael, CA 94915-1560 TO CONSULTANT: William E. Fee, ASLA, AICP Carducci and Associates, Inc. 555 Beach Street Fourth Floor San Francisco, CA 94133 17. INDEPENDENT CONSULTANT For the purposes, and for the duration, of this Agreement, CONSULTANT, its officers, agents and employees shall act in the capacity of an Independent Consultant, 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 Consultant and not that of an employee of CITY. 18. 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. Agreement • 6 19. 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, agreement, contract or resolution for any unpaid taxes, fees, licenses, assessments, unpaid checks or other amounts. 20. 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. 21. 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. 22. 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. 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). CONSULTANT'S taxpayer identification number is 94-2363816, and CONSULTANT certifies under penalty of perjury that said taxpayer identification number is correct. 23. APPLICABLE LAW The laws of the State of California shall govern this Agreement. Agreement • 7 IN WITNESS WHEREOF, the parties have executed this Agreement as of the day, month and year first above written. CITY OF SAN RAFAEL P4VLZ'd0 A 1, Public Works Director ATTEST: ESTI ER C. BEIRNE, City Clerk APPROVED AS TO FORM: �� ) ?ZV;-v �, R- /'^ 6 - ROBERT F. EPSTEIN, City Attorney File No.: 06.07.11 CARDUCCI AND ASSOCIATES, INC. Title: v/& — Agreement 9 8 EXHIBIT A TO PROFESSIONAL SERVICES AGREEMENT PROFESSIONAL SCOPE OF SERVICES The City is considering re -designing the playing field at Pickleweed Park site to incorporate the installation of all weather synthetic turf soccer fields while maintaining the natural turf on a portion of the site. This project will involve designing proper drainage and irrigation systems to support the natural and synthetic surfaces. In the portion of the site that remains natural turf, the City will consider proposals to convert the existing Bermuda grass turf to a cool season rhizomatous fescue turf. 1.0 General - Coordinate design effort with the City of San Rafael for the renovation of two existing Bermuda grass soccer fields at Pickleweed Park into two synthetic turf soccer fields in order to extend recreation opportunities, conserve water and reduce ongoing maintenance resources required to maintain the fields. Assist the City of San Rafael with efforts to apply for State of California Proposition 84 grant funding for field improvements. Provide analysis and recommendations based on expertise and experience of synthetic turf systems and engineered base systems for the project and related geotechnical and civil assessments. Soccer fields would be 300' x 180' at minimum with ability to change play direction or break fields up for multiple users (prefer 330' x 195) 1.1 Attend project kick-off and other meetings)/consultation 1.2 Site assessment/Prop 84 Design Report 1.3 Sustainability/concept plan 1.4 Conceptual plans & estimates 1.5 Attend up to eight (8) meetings with City 1.6 Synthetic Turf Report and recommendations for City 2.0 Surveying Compile base map in AutoCAD to document the existing conditions 2.1 Surveys/Base Mapping/Data Gathering 2.2 Review existing record drawings and documents. 2.3 Prepare topographic survey and base maps documenting existing conditions 3.0 Geotechnical Assessment Provide a geotechnical assessment and recommendations including collection of up to four soil samples in area of work. Provide geotechnical recommendations for the field design of two synthetic turf fields. 3.1 Evaluation 3.2 Consultation for synthetic turf 3.3 Construction Documents 50% 3.4 Construction Documents 100% 4.0 Civil Site Assessment Prepare a stormwater biofiltration and detention system that meets the County of Marie's stormwater management goals and recommendations and follows best management practices. Consider some areas for on-site detention within the field's drainage system. Provide protection from groundwater and tidal influences on site. Connect to existing storm drainage system. 4.1 Civil Assessment 4.2 Demolition/recycle plan 4.3 Grading & Drainage Plan & SWPPP 4.4 Storm Water Management Report & Calculations 5.0 Construction Document, Specifications & Cost Estimates Provide complete construction documents package including drawings, technical specifications/special provisions and engineers estimate for the field project. Coordinate with City of San Rafael for incorporation of construction documents package into submittal to State of California Proposition 84 application and bid package. The City of San Rafael will prepare the grant application. 5.1 50% Construction Documents 5.2 100% Construction Documents 5.3 List of Deliverables (the following sheets will be included at a minimum) L01 Project Cover Sheet L02 Topographic Survey L03 Site Demolition Plan L04 Site Sustainability Plan / Scope of Work Plan L05 Site Materials Plan L06 Site Layout Plan L07 Landscape Plan L08 Irrigation Plan L09 Synthetic Turf Plan L10 Synthetic Turf Details Lll Construction Details C01 Grading and Drainage Plans CO2 SWPPP Plan Technical Specifications/Special Provisions Cost Estimate Final signed and stamped documents Exclusions: The following exclusions are available as additional services Structural, electrical, and mechanical engineering Off-site improvements in a public Right of Way Water features or fountains • Green roofs LEED certification • Custom design of structures • Scoreboards • Sports lighting Flood analysis / improvements Wetlands, creek restoration Outside agency permits Design with recycled water Final printing for required submittals and bidding (by city printer) Soil testing beyond initial soil test included in fee Community meetings with residents Expansion of scope outside of fenced field Public art design and coordination Spanish-speaking facilitator Construction administration services of Miller Pacific Engineering Group • Bidding and construction administration services CEQA services !A M H N i o 0 5'I I AdMM i� Ii M o s o ,pie Q10 �s L/ of w v: 0.il s'iC __ O C P ._ p �• � i� a �Cer"b' {N� L 4 O A i' t7 >0 n ai p•i0 � m ba w dip i� i . 1L'�` LO) i �I p. n jX Ibi hi IRn� O C � o o .. 3ts C �G N •' N 2 faj ]� N :n N S1 L O I g Gootech Engineer i ? i � •! t r.00 l 0) N) A a i � i � � : (• I � j Ni `N? o•o A N1 i TOTAL FEE F' O : f! OHO O (N A A OIAI I I W N1:1-N!WI O169WN U1 m N S i�O 8 •p .. o 0 iOOiO OO OO S O 0:10 i0i 01000 v UT w w w w W A w iv toN of ' wal.- o r^rAp >'h��.. ti •.� I!+ O t�•'t� yl a In +aiw ivo i~'` En r,lwa Ii; Nj iN!N;N, •p .. o C' tip2 Z 'P S �Ip o m :, C p ri pggg Civil Survey :- to C1 0 o i°(.� � o o .. 3ts C �G N •' N 2 faj ]� N :n N S1 L O I g Gootech Engineer i ? a F � O I �I N 4) A O) N t. SSa�g TOTAL FEE O i ti is Landscape b o Principal ra 4Q;A W N O A10' Landscape Associate/CAD _ iYiA-t1UI0 i0 Aim �_ t '" Landscape Clerical i'o N ro N 77 . O Civil Engineer AN A In N rl NA AN0I F A, N: � NqA: W• o 'o �Z]�O'SIRSplp1OS; '`ni i Cio IO.iO �S IOIOi Lc?! O Ii; Nj iN!N;N, p Civil Survey :- o Geotech Principal I g Gootech Engineer i ? a F i I �I N 4) A O) N t. SSa�g TOTAL FEE N O O t0 N N A n x ro 1CL v rn D Q W =1 n U N t v�. � $v caw cry cn�p _: iaim I� g• � C O " S• ^ �' `^ Landscape ✓rye —__ g _ i i j 1 Principal 77 r _ N H. fAO TOTAL FEE oloio o. a ra Landscape ; i i o Principal c ' _- Landscape 1 i Associate/CAD t '^ Landscape Clerical A 1 ! C 1 txg n a Civil Engineer R. {_ Cl o Survey s m P Civil _ •s i j i $ rn I { € �Z'1:1 -_ — In Geotech Principal M g � i i f J o Geotech Engineer ji 77 r _ N H. fAO TOTAL FEE oloio o. a aarl u r cutu -7; .r •t Mr LNZ3r-KJC, I rhA CITY OF SAH WAG. SAN lWXw AR, CA 94911818 TERMINAL I1: 991968159 WKIANT M ° 294294683997 MC SALE XXXXXXXXXXXx2671 MICHi 819691 INVOICE= 947949 GATE: JAN v, 11 1I1Eo 89139 W. III OWN NG: 197812 TOTAL At 157.99 CUSTOMER COPY p.l t*oesr tz�*�+t rn•�xssr*�ts�t*#�+tt�#tr CITY OF SAN RAFAEL FINANCE DEPARTMENT CITY HALL 1400 FIFTH AVENUE SAN RAFAEL CA 94901 Reg# */Rcpt#: 002-00058346 [ MG 1 Accounting Date; Thu, Jan 7, 2010 Date/Time: Thu, Jan 7, 2010 9:39 AM 5050/BL-LICENSE TAX REF #;CARDUCCI ASSOCIATES INC FEE AMOUNT: $157.99 ---------------------- RECEIPT TOTAL = $157.99 Payment Data: Peat# :1 Payer: VINCENT P LATTANZIO/CARDUCCI/A Method: CREDIT Ref#: 2571 AMOUNT - $157.99 RECEIPT SUMMARY TOTAL TENDERED = $157.98 RECEIPT TOTAL - $157.99 ------------------ CHANGE DUE = $0.00 City of San Rafael 1400 FfRh Avenue, San Rafael, CA 94901 Phone (415) 485-3051-FAX(415) 485-3100 BUSINESS LICENSE APPLICATION - OUT OF TOWN PLEASE TYPE OR PRINT CLEARLY Official Use Only L Business Name CAP-, A �SS'Oa/ . I� lNGt Corporate Name Cioikoocee, A s;sn 61 ,AFI Iris IA[c . Business Location 5-15 5 13EAC*1 67MA&r +M f:IWY- (NO P. 0.9aoc) City S AN FiQAArC49*GfJ State i:�A— Zip,1+133 Mailing Address/`"`^ (ItD amt) City State Zip Start Date in San Rafael) Description of Business 1 i 5120101 LANDsCAPa Ae644 t TSC, -V1' -:F-- Business License No. Expiration Date Bus. Phone (if iv) (P-7+- o Qqy Bus. Fax (4(% 6 7g- - Q 9 g 9 Ownership: 'A Corporation ❑ Ltd Liability Corp O Sole Proprietor Cl Partnership Cl Trust State LIC. Non License Type Expiration Date Resale No Federal Tax I.D. 3g ((,, State Tax 1. IN ENTER BELOW NAMES OF OWNERS, PARTNERS, OR CORPORATE OFFICERS - Attach additional page it naeesaary Owner Name V IACD jdgr& .2t0 Title8f-r-AZlQa:r_ Phone#15) 674- 0q�J'fJ Home Address• DOM eel mar Yx wvs_ Ivw_ Celt Phone (%) 157748' 36, City �) State -C Zip—q-9: r �, � Social Security No. 1916!� i 3 Drivers License No. - !! gCl9 Payment can now be made using Visa or MasterCard! If you choose, please provide the following information and mail or fax with your completed application. Fax No. (415) 485-3100 Cardholder Name: Vin CeOf P_ LAc(i%MiZ4 n /C zDcJCGt i de / rd Type: /1'�4sei-- ae-W Cardholder Number: S 6 3!j 0 ' a g4 - 2lo T / Expiration Date: /0// D NOTE TO CONTRACTORS WITH SUBCONTRACTORS: All subcontractors performing work within the City must have a valid San Rafael business license and a current State Contractors' License. To determine your tax rate, please subtract the amount paid to your subcontractors from the total job valuation as they will be licensed separately. Submit your payment along with your completed business license application and a list of your subcontractors. A form is available for your use. PLEASE FILL IN THE APPROPRIATE BOXES, READ AND SIGN. Bask Tax 1$ 1 S 7. ,-71 Estimated Gross Receipts $ /IA No. of Employees Part Time"� Full Time working in San Rafael �fU No. of Vending f ,rr71 Machines No. of Music/Video Machines Employee Fee I $ (if applicable) Other Fee (f applicable) Is �'f Penalty % i $ (if applicable) TOTAL AMOUNT DUE 1$ / C-7 .. 19 I declare under penalty of pe ry that to the best of my knowledge the information contained above is true and correct. Legal Signature / Title P?654766/1. Print Name Y//UGENj'- • _�47 N' 2.10 Date rm. do .2c9lC� RETURN COMPLETED APPLICATION FORM TO ABOVE ADDRESS AND MAKE CHECK PAYABLE TO THE CITY OF SAN RAFAEL Thank you for doing business in the City of San Rafael! Client#: 57 CA, JASSO CERTIFICATE OF LIABILITY INSURANCE I M/DOlYY) �+ 011/07//0712010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dealey, Renton & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P. O. Box 12675 Attn: KXC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Oakland, CA 94604-2675 510 465-3090 INSURERS AFFORDING COVERAGE INSURED CarINSURERA: Hartford Casualty Insurance Co. 555 Beach Street, 4th Floor ci & Associates, Inc. I INSURER S: Travelers Casualty Ins. Co. of Ameri 555 Be San Francisco, CA 94133 I INSURERc: Evanston Insurance Company INSURER D: I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 'POLICY EFFECTIVE 'POLICY EXPIRATION J7R TYPE OF INSURANCE POLICY NUMBER DATE fMMIDD/YYI DATE (MM/DO/YY► LIMITS A GENERAL LIABILITY 57SBAAU4156 05/05/09 05105/10 EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIAB ILITY IFIRE DAMAGE (My oneGra) $500,000 CLAIMS MADE NIOCCUR I MED EXP (My one person) $10,000 PERSONAL & ADV INJURY $2,000,000 GENERAL AGGREGATE $4,000,000 GEN'LAGGREGGATTELIMITAPPLIES PER: I PRODUCTS -COMP/OPAGG $4,000,000 POLICY 111 I lFf!T F1 LOC A AU-OMDBILE LJABILITY 57SBAAU4156 05/05109 05/05110 COMBINED SINGLE LIMIT $2,000,000 _ ANY AUTO (Ea accident) _ ALL OWNED AUTOS BODILY INJURY $ I SCHEDULED AUTOS (Per pereon) X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANYAUTO OTHER THAN EAACC $ AUTO ONLY: AGO $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE I AGGREGATE $ $ DEDUCTIBLE .......................... 9 RETENTION $ $ WORKERS COMPEN9ATDNANO UB7082Y434 09101109 09101 X I0VL,I IDERB ,M. EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $1,000,000 IE.L.DISEASE- EAEMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 C OTHER Professional AE818531 12128109 12/28110 $1,000,000 per claim Liability $2,000,000 anni aggr. DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS General Liability policy excludes claims arising out of the performance of professional services. RE: Pickleweed Park Synthetic Field Design Project -Next Steps (See Attached Descriptions) CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER. City of San Rafael, Dept of Public Works Attn: Suvra Chakrabarti 111 Morphew Street San Rafael, CA 94901 I ACORD 25-S (7197)1 of 2 #M262147 CANCELLATION SHOULD ANYOF TH EABOVE DESCRIBED POLICIESSE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30_DAYSWRITTEN NOTICETOTHE CERTIFICATE HOLDER NAMED TOTH E LEFT, BUTFAILURE TODOSOSHALL IMPOSE NO OBLIGATION OR LIABILITYOF ANYKIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE � ,/,t ✓� n A4 , /. Llllt/1. o .GC.J NMB © ACORD CORPORATION 1988 DESCRIPTIONS (Continued from Page 1) GENERAL LIABILITY ADDITIONAL INSUREDS: City of San Rafael, its officers, agents and employees Insurance is primary and non-contributory, per policy wording BUSINESS LIABILITY, NON -OWNED and HIRED AUTOMOBILE LIABILITY ADDITIONAL INSURED: The Certificate Holder and any other person named in the written contract between the Named Insured and the Certificate Holder. The coverage afforded is pursuant to Section C., Who Is An Insured, Sub Section 6., Additional Insureds When Required By Written Contract, Written Agreement Or Permit, Subsection f. Any Other Party of the Business Liability Coverage Form, Form No. SS 00 08. AMS 25.3 (07197) 2 of 2 #M262147 Carducci & Associates, Inc. Policy #57SBAAU4156 EXCERPTS FROM: Hartford Form SS 00 08 04 05 BUSINESS LIABILITY COVERAGE FORM C. WHO IS AN INSURED S. Additional Insureds When Required By Written Contract, Written Agreement Or Permit The person(s) or organization(s) identified in Paragraphs a. through f. below are additional insureds when you have agreed, in a written contract, written agreement or because of a permit issued by a state or political subdivision, that such person or organization be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement, or the issuance of the permit. A person or organization is an additional insured under this provision only for that period of time required by the contract, agreement or permit. f. Any Other Party (1) Any other person or organization who Is not an insured under Paragraphs a. through e. above, but only with respect to liability for "bodily injury, "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a) In the performance of your ongoing operations; (b) In connection with your premises owned by or rented to you; or (c) In connection with "your work" and included within the "products- completed operations hazard but only if (i) The written contract or written agreement requires you to provide such coverage to such additional insured; and (Ii) This Coverage Part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard. (2) With respect to the insurance afforded to these additional insureds, this insurance does not apply to: "Bodily injury, "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to render, any professional architectural, engineering or surveying services, including: inspection, or engineering E.5. Separation of Insureds Except with respect to the Limits of Insurance, and any rights or duties specifically assigned in this policy to the first Named Insured, this insurance applies: a. As If each Named Insured were the only Named Insured; and b. Separately to each insured against whom a claim is made or "suit" is brought. E.7.b.(7).(b) Primary And Non -Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement or permit that this insurance is primary and non-contributory with the additional Insured's own insurance, this insurance is primary and we will not seek contribution from that other insurance, E.8.b. Waiver Of Rights Of Recovery (Waiver Of Subrogation) If the insured has waived any rights of recovery against any person or organization for all or part of any payment, including Supplementary Payments, we have made under this Coverage Part, we also waive that right, provided the insured waived their rights of recovery against such person or organization in a contract, agreement or permit that was executed prior to the injury or damage. EXCERPT FROM Hartford Form SS 04 38 06 01 HIRED AUTO AND NON -OWNED AUTO B. With respect to the operation of a "non -owned auto", WHO IS AN INSURED is replaced by the following: The following are "insureds": d. Anyone liabile for the conduct of an "insured", but only to the extent of that liability.