imperial county department of public works request for qualifications (rfq) design ... · ·...

Imperial County Department of Public Works

Request for Qualifications (RFQ)

Design Engineering Services for the Replacement of Forrester Road Bridge Over Westside Main Canal in Imperial County

Federal Aid No. BRLS 5958(094)

County Project No. 6320

Requested by: John A. Gay, P.E Director of Public Works

Department of Public Works 155 South 11th Street El Centro, CA 92243 Phone: (442) 265-1818 Fax: (442) 265-1858 Date: January 22, 2018 Reviewed by: M. Ortiz Assistant County Engineer Prepared by: J. Castaneda

Administrative Analyst II

Table of Contents

I. PURPOSE AND BACKGROUND ......................................1

II. PROJECT POSTING AND SCHEDULING ...............................2 Proposed Schedule of Events .....................................2

III. SCOPE OF WORK ...............................................2

IV. AUDITS AND INVESTIGATIONS ....................................5

V. RESPONSIBILITIES OF THE COUNTY ................................6

VI. PROPOSAL CONTENT AND INFORMATION ...........................7 General Requirements ..........................................7 Table of Contents .............................................8 Summary of Qualifications and Experience ...........................8

Analysis of Effort/Methodology .........................................8 Cost and Fees ................................................9 Insurance Requirements ........................................9 Caltrans Federal Forms Requirement ..............................10

VII. EVALUATION OF PROPOSALS ...................................10

VIII. CLOSING ITEMS ..............................................11

EXHIBITS A – Sample Proposal Evaluation Form B – List of Applicable Documents C – Sample Consultant Agreement and Insurance Requirements*

*No changes shall be made to consultant agreement. D – Location Maps For all Federally Funded Projects the following additional items shall also be considered part of the contract: Caltrans Local Assistance Procedures Manual (LAPM) forms can be found in digital format at: http://www.dot.ca.gov/hq/LocalPrograms/lam/forms/lapmforms.htm E – Bidder/Proposer Disadvantaged Business Enterprise (DBE) Program Requirements

• Exhibit 9-B: Local Agency DBE Annual Submittal Form • Exhibit 10-I: Notice to Proposers Disadvantages Business Enterprise Information • Exhibit –J: Standard Agreement for Subcontractor/DBE Participation

F- Required Certification by Consultant with Proposal

• Exhibit 15-H: DBE Information – Good Faith Efforts • Exhibit 10-O1: Consultant Proposal DBE Commitment • Exhibit 10-H: Sample Cost Proposal (10-H Example 1 must be submitted in

separate sealed envelope) • Exhibit10-Q: Disclosure of Lobbying Activities

G – Required Certification by Consultant and County after Contract Execution

• Exhibit10-F: Certification of Consultant, Commission & Fees • Exhibit 10-O2: Local Agency Proposer DBE Information (Consultant Contract) • Exhibit 17-F: Final Report – Utilization of DBEs • Exhibit 17-O: DBE Certification Status Change

H – Required Certification for Agreements with a Value Greater than $150,000.00 (Before Contract Execution)

• Exhibit10-K: Consultant Certification of Contract Cost and Financial Management System

• Exhibit 10-A: A&E Consultant Audit Request Letter and Checklist

*************************************************************************************************************

SPECIAL NOTICE *************************************************************************************************************

Notification of Contractor Registration Requirements (where required)

Pursuant to the requirements of California Labor Code section 1771.1, all contractors and subcontractors that wish to engage in public work through a public works contract must be registered with the Department of Industrial Relations (DIR). Beginning March 1, 2015, no contractor or subcontractor may be listed on a bid proposal for a public works project unless registered with DIR. Beginning April 1, 2015, no contractor or subcontractor may be awarded a contract for public work on a public works project unless registered with the DIR, pursuant to Labor Code section 1725.5 All contractors, including subcontractors, listed in the proposal must be registered with the DIR at the time proposals are due, and must submit proof of registration with the proposal. Any proposals received listing unregistered contractors and/or subcontractors will be deemed non-responsive. Application and renewal are completed online with a non-refundable fee of $300. Read the Public Works Reforms (SB 854) Fact Sheet for requirements. Instructions for completing the form and additional information can be found on the DIR website. This Project is subject to compliance monitoring and enforcement by the Department of Industrial Relations (DIR).

SOURCES OF INFORMATION

INFORMATION WEBSITE Department of Industrial Relations

(Public Works) http://www.dir.ca.gov/Public-Works/PublicWorks.html

SB 854 Fact Sheet http://www.dir.ca.gov/Public-Works/PublicWorksSB854.html

Senate Bill 854 Compliance http://www.dir.ca.gov/Public-Works/SB854.html

Public Works Contractor (PWC) Registration https://efiling.dir.ca.gov/PWCR/

Classifications and Minimum Labor Rates http://www.dir.ca.gov/OPRL/Pwd/

1 | P a g e Posted to County Webpage January 22, 2018, Proposals Due February 22, 2018 by 4:00 P.M. .

Request for Qualifications (RFQ) Design Engineering Services for the Replacement of Forrester Road Bridge Over Westside Main Canal

in Imperial County; Federal Aid No. BRLS 5958(094); County Project No. 6320

January 22, 2018

I. PURPOSE AND BACKGROUND The Imperial County Department of Public Works (ICDPW) is requesting proposals from qualified and experienced Civil Design Engineering Firms with Focus on Bridge Design to provide development and bridge design services for the above referenced federally funded project in Imperial County. One firm will be selected from this request for proposal (based on ranking and responsiveness). The purpose of the Request for Qualifications (RFQ) is to provide the Department of Public Works with the assurance that this County administered project is developed in compliance with all local, state, and federal provisions (where applicable) which may be required due to the specific funding requirements are adhered to. The focus of the selected firm is to provide a high level of bridge design services through appropriate documentation and workflow methodology in the most cost-effective manner possible. Qualified entities are invited to submit written proposals for consideration in accordance with this request. These services will be conducted under a contract with the County of Imperial, hereinafter referred to as "County" and the consultant entity, hereinafter referred to as "Consultant". The contract will be regulated according to the provisions of all federal, state and local laws and ordinances that are applicable. This includes compliance with prevailing wage rates and their payment in accordance with California Labor Code, Section 1775. Disadvantaged Business Enterprises (DBE), Minority Business Enterprise (MBE), Women Business Enterprise (WBE) and Veteran Owned Businesses (VOB) are encouraged to participate. The DBE goal for this project is 8%. Services that are partially funded with Federal funds are subject to Part 26, Title 49, Code of Federal Regulations entitled “Participation by Disadvantaged Business Enterprises (DBE) in the Department of Transportation Financial Assistance program.” Caltrans DBE program information can be found here: http://www.dot.ca.gov/hq/LocalPrograms/DBE_CRLC.html Forrester Road is one of the most heavily traveled County roads within Imperial County since the NAFTA treaty was signed. Forrester Road at this bridge location handles approximately 12,000 vehicles per day with 31% trucks. In 1995, the County submitted the Forrester Road Bridge at Westside Main Canal (Forrester Road Bridge) Project as a Rehabilitation Project under the Highway Bridge Replacement and Rehabilitation (HBRR) Program. After several strategy meetings with Caltrans, the Forrester Road Bridge was scheduled to provide a strategy report for rehabilitation under the HBRR program and


also to be seismically retrofitted with funding from the Seismic Retrofit Program. The intent of the combined rehabilitation and retrofit was to ensure the structure and substructure met current standards as well as to widen the bridge and bring the approach rail and guardrail to current standards. The engineering report concluded that the retrofit and widening of the bridge was costly and would not be the most effective and economic long-term solution for this structure. Caltrans approved the seismic retrofit strategy report’s recommendation of bridge replacement as the most cost effective solution to the Forrester Road Bridge deficiencies. II. PROJECT POSTING AND SCHEDULING This RFQ is being distributed over the internet and is posted at the County of Imperial Department of Public Works website at the following address: http://www.co.imperial.ca.us/publicwork/default.htm under “Projects out to Bid.” Consultants wishing to propose in response to this RFQ must obtain this document from our website. Due to the fact that anyone can download the RFQ and the County has no method for tracking the distribution, the County is not able to maintain a list of potential consultants and/or proposers and cannot provide individual notification of amendments or addendums to this RFQ. The County will therefore post any addendums to the RFP on the above mentioned website. All consultants shall refer to the website to verify all addendums that have been issued and that they have acknowledged all such addendums in their proposal. Proposed Schedule of Events Issue Request for Proposals January 22, 2018 Requests for clarification must be submitted February 15, 2018 Proposals Due February 22, 2018 Consultant Selection (interviews TBD) March 2018 County Awards Contract April 2018 Notice to Proceed May 2018 III. SCOPE OF WORK The project is scheduled to be completed in a multiphase agreement. The project currently has allocated federal funding; however, the allocated funding is not enough to complete all phases of the project. The successful firm will be required to support the county in processing requests for future phase funding for the replacement of the bridge. The selected consultant will also support the County in exploring funding alternatives including federal funds for the forty food widening of the bridge and road realignment. The expected phases are as follows:


1. Bridge type selection report. 2. Environmental studies and Permitting 3. Design

The Consultant shall provide all necessary design and engineering services to prepare a bridge replacement implementation plan. The successful firm will analyze all prior historical bridge plans, reports and data, and conduct any necessary engineering studies (including environmental for NEPA and CEQA). The successful firm will ensure that the new structure and substructure meet current design and seismic standards, as well as to analyze the widening the existing bridge to 40 feet minimum with new guardrail and bridge railing. The Implementation plan will analyze the replacement of the structure so that the most cost effective method can be selected. It must also consider a bridge road alignment that will minimize detour time which may require a new alignment designed for a 55 mph speed to correct the current S curve deficiencies. The Scope of Work details additional requirements and deliverables. The firm will review available funding and develop a funding strategy which will be required to include Federal Funds for future phases of work. Typical engineering studies will include right of way reports and assessment, environmental studies, field review reports, seismic analysis reports, geotechnical reports, hydrology and hydraulic studies, coordination with regulatory agencies including Imperial Irrigation District, County, Caltrans, RWQCB, California Department of Fish and Game, U. S. Fish and Wildlife Service, and U. S. Army Corps of Engineers. All work shall be in accordance with Chapter 6, “Highway Bridge Replacement and Rehabilitation Program (HBRRP)” of Caltrans’ Local Assistance Program Guidelines. All work and reports, studies and deliverables must meet Caltrans current bridge and road related standards, guidelines, and policies and are subject to County, Caltrans and FHWA review and approval. This plan should also include engineered plans to the PS&E stage with sufficient detail of the new replacement bridge and realignment issues at a concept level which will culminate in final construction after all Caltrans and FHWA approvals. TASK 1- Review Existing Documentation, Kick Off Meeting

• Review existing photos, plans, bridge reports, documents, and prior reports from County. • Participate in Field Review meeting with County, Caltrans and other interested parties. • Participate in Kick off Meeting with County and review project goals, scope, and

deliverables. • Introduce key staff. Review responsibilities of both County and Consultant. • Meetings may occur in Imperial County, Caltrans District 11 office in San Diego, and/or at

the Caltrans headquarters office in Sacramento. TASK 2- Initiate Study, which should include:

• Ongoing scheduling and project schedule monitoring • Site visits as appropriate. • Analysis of existing plans, bridge reports, and other reports and correspondence

available for seismic retrofit, rehabilitation and replacement recommendations. • Provide bridge alternatives and roadway alignment alternatives to meet County and


Caltrans approval. Special consideration must be given to Imperial Irrigation District project requirements.

• The consultant will be responsible for the preparation and submission of funding applications to Caltrans in order to secure funding for pending project phases.

• Prepare report and documents, PS&E packages. • Provide quantity and cost estimates. • Provisions for attending and participating in “Strategy Meeting” in Sacramento with

Division of Structures. • Corrections required by Caltrans’ Division of Structures and Imperial County. • Report shall also include completion of exhibits 6A and 6B of the Caltrans Local

Assistance Program Guidelines for a bridge replacement, both on the same alignment as well as on an alternative alignment in order to permit minimal traffic detour impacts and a safe geometric alignment of the roadway.

• Replacement considerations include but are not limited to consideration of seismic, geotechnical, widening to accommodate a 40 foot wide bridge which will need Caltrans approval for funding, barriers, guardrail, bridge rail, existing abutments, scour issues, right of way, utility relocation, road approach and tapers, rehabilitation staging of construction and impacts including detour.

TASK 3- Draft Deliverables

• Submit draft report for County review. Submittal should include all items requested for Task 2. Five (5) hard copies with one (one) thumb drive with complete report shall be provided.

• Attend meeting(s) with Caltrans and County of Imperial for presentations. • Revise draft documents to include review responses into Final Draft and deliver to County.

TASK 4- Final Documents Deliverables

• Upon concurrence with Caltrans, the County shall notify Consultant to prepare final document deliverables. The originals and copies shall be provided as identified in the RFQ. This includes coordination with agencies as necessary.

Throughout the course of the project, Consultant will maintain orderly project files. All tracings, plans, specifications and maps prepared or obtained under the terms of the agreement with County shall be delivered to and become property of the County; and basic survey notes and sketches, charts, computations and other data prepared or obtained under such agreement shall be made available upon request to the County without restriction or limitation on their use. At the conclusion of the project, Consultant shall submit to the County a project completion file which contains the required information, test results, forms, certifications, communications, and other information pertaining to the project. The report will be clearly labeled with the title: Design Engineering Services for the Replacement of the Forrester Road Bridge at Westside Main Canal in Imperial County : Federal Aid No. CML 5958(094); County Project No. 6320. Document will serve as a record of the project. Additionally, a copy of the record of the project is to


be provided in Portable Document Format (PDF) on one (1) USB thumb drive. The required project file will need to be submitted before the final payment and retention will be released. The County of Imperial Disadvantaged Business Enterprise (DBE) Program affirms the utilization and participation of qualified disadvantaged business firms in its contracting and procurement activities. The County encourages general and prime contractors to afford competitive subcontracting opportunities to disadvantaged firms, where possible, in their contracting and procurement activities with the County of Imperial. Services that are partially funded with Federal funds are subject to Part 26, Title 49, Code of Federal Regulations entitled “Participation by Disadvantaged Business Enterprises (DBE) in the Department of Transportation Financial Assistance program.” Firms submitting a proposal shall be fully informed of the requirements of the regulations and the County’s Disadvantaged Business Enterprise (DBE) program developed pursuant to the regulations. The County of Imperial’s DBE goal for this project is 8%. IV. AUDITS AND INVESTIGATIONS All proposed Architectural and Engineering contracts and supporting documents are subject to audit or review by Caltrans, Audits and Investigations (A&I), other state audit organizations, or the federal government. Not all proposed contracts will be audited or reviewed; they will be selected n a risk-based approach. Whether a proposed contract or consultant is selected for audit review through A&I’s risk-based approach is dictated by the dollar thresholds of the proposed contract, and other risk factors. Dollar thresholds for audits or reviews are stratified as follows:

• Less than $150K – no audit or review is required, but is optional; • Between $150K and $1M; • Between $1M and $3.5M; • $3.5M and above

Summary of Contracts to be Audited

Proposed Contract Amount

Documents Required

Conformance Letter

Required?

Audit/Review Performed?

If Audited or Reviewed will

Cognizant Letter of Approval be

Issued?Small Purchase

Procedure Less than $150K

None No Audit/review optional

N/A

Case 1. Between $150K

and $1M

Certification by Consultants

(Exhibit 10-K)

No May be selected for Audit or

Review.

If Indirect Cost Rate (ICR)

Audit is performed.

Case 2. Between $1M and $3.5M

Proposed contract,

Yes May be selected for ICR Audit.

Yes


certifications, Internal Control Questionnaire,

etc. (see Exhibit 10-A.)

Case 3. $3.5M or greater

Proposed contract,

certifications, Internal Control Questionnaire,

etc. AND

CPA Audited ICR.

(see Exhibit 10-A.)

Yes May be selected for Review of CPA’s work

papers of audited ICR

Yes

Exhibit 10-K must be submitted along with the cost proposal (see cost proposal section) in a sealed envelope. The remaining audits and investigation documents and certifications listed above must be submitted prior to award of contract and are not required to be submitted with the proposal. For questions on the auditing process, please refer to Caltrans Local Assistance Procedures Manual – Chapter 10 – section 10.3 A&E Consultant Audit and Review Process. Risk factors considered include the consultant’s:

• History of satisfactory performance; • Prior FAR compliant history and audit frequency; • Financial stability; • Conformance to terms and conditions of previous contracts; • General responsiveness and responsibility; • The approximate dollar amount of all A&E contracts awarded to the consultant by

Caltrans or a local agency in California within the last three calendar years; • The number of states in which the consultant does business; • The type and complexity of the consultant’s accounting system; • The relevant professional experience of any CPA performing audits of the consultant’s

indirect cost rate (ICR); • Responses to internal control questionnaire (ICQ), see AASHTO Audit Guide, Appendix

B; • Changes in the organizational structure.

V. RESPONSIBILITIES OF THE COUNTY

1. This RFP is being conducted in accordance with the “Two Step RFP” as per Chapter 10, “Consultant Selection”, of the Caltrans Local Assistance Procedures Manual.

2. The County will direct the development of the project, provide management oversight,


and conduct administrative arrangements only.

3. The County will pay an agreed upon amount normally within 30 days after receipt of an invoice. County will retain 5% of each invoice until completion of project. Completion of project is when a Notice of Completion is recorded by the County Clerk/Recorder for the construction acceptance by the County.

4. The County will not provide dedicated workspace facilities, but upon request will provide a conference room for meetings with the Department and the Contractor.

5. The County reserves the right to perform any portion of the scope of work by County personnel or other consultants should the County determine it would be in the best interest of the County to do so.

VI. PROPOSAL CONTENT AND INFORMATION Proposal should be typed, organized and concise, yet comprehensive. General Requirements

1. Provide a cover letter.

2. State the interpretation of the work to be performed. State a positive commitment to perform the work in the required manner and time frame; include a basic summary; and demonstrate an understanding of the project. Provide a statement that the offer is valid for at least a ninety (90) day period.

3. Provide the name(s) of the primary and/or alternate individuals authorized to

respond to this RFP. Include titles, addresses, e-mail, and phone numbers.

4. The Consultant is representing itself as a qualified professional in Resident Engineer and Construction Management and Inspection Services. Therefore, it is acceptable to submit recommendations and comments for consideration on format, process, schedule, and additional content of projects. The County will consider comments and recommendations; however is not required to select any of the recommendations or comments.

5. Expensive bindings, colored displays, promotional materials, etc., are neither

necessary nor desired. Emphasis should be concentrated on conformance to the RFP instructions, responsiveness to the RFP requirements, and on completeness and clarity of content.

6. If any subcontractors are utilized, the lead Consultant must submit a description

of the firm, the portion of work to be done, and cost of each subcontractor. All subcontracts exceeding $25,000 in cost shall contain all required provisions of the prime contract.


7. Provide information about the Consultant’s use of Disadvantaged Business Enterprises (DBEs). Consultant must give consideration to DBE firms as specified in 23 CFR 177.5(b), 49 CFR Part 26, and in Exhibit 10-1, Notice to Bidders/Proposer Disadvantaged Business Enterprise information, elsewhere in this RFP. The provisions of 49 CFR, Part 26 require that a local agency receiving federal-aid funds comply with the Disadvantaged Business Enterprise (DBE) program, and that DBE firms have the opportunity to participate in the projects (see Chapter 9, “Civil Rights and Disadvantaged Business Enterprises”, of the LAPM including any updates). Such steps include the considering of DBE firms by the proposing consultants. When feasible, organize the project schedule and task requirements to encourage participation in the contract by DBE firms. Local agencies should be fully aware of all of the subcontracting opportunities in their consultant contracts. The consultant shall ensure that certified DBE firms have the opportunity to participate in the performance of the contract and will be able to demonstrate a good faith effort (good faith effort documentation must be included with proposal).

Table of Contents Include a table of contents with identification of each section and page number. Summary of Qualifications and Experience

1. State whether the firm is local, regional, national or international.

2. Identify the owner(s) of the firm and legal status (sole proprietor, corporation, etc.)

3. Give the location of the office from which work is anticipated to be done and the

number of employees of the company.

4. Identify the qualifications and resumes of all individuals who will be associated with this service. Include professional registrations and affiliations.

5. Summarize specific experiences and qualification for similar and related projects, both federally funded and locally funded. Describe the services previously performed such as studies, reports, etc. List at least three (3) references with telephone numbers and email contact addresses (if available).

Analysis of Effort/Methodology

1. Describe the approach for how the work will be performed. The proposal shall indicate any specific techniques or methodology to be utilized.

2. The proposal shall include a sample project timeline with specific tasks envisioned for this

project, including staffing. Caltrans contract details the requirement for a contract end date. The Consultant will keep this in mind and make a conservative time schedule based on the tasks required to complete the work thru construction.


3. Indicate what participation, data and products will be requested from the County.

4. Indicate deliverables to be provided and when.

Cost and Fees Cost Proposals (Caltrans LAPM Exhibit 10-H Example 1) must be submitted with the proposal in a separate sealed and clearly marked envelope (include project title and submitting firm). Cost proposals shall take into account the following:

1. Develop costs and fees for the services requested. Submit a not to exceed fee proposal based on anticipated fully burdened hourly rates.

2. When preparing cost and fees consider the scope of work involving project kick off and

review of available documentation, material submittals, project documentation and prepare a lump sum fixed fee breakdown based on anticipated staff and hours. Costs should be organized for full time hourly rates. Such hourly rates should be fully burdened or loaded, including full compensation for all overhead and profit. Billing rates shall include provision for normal office costs, including but not limited to office rental, utilities, insurance, cell phone or radio, equipment, normal supplies and materials, in-house reproduction services, and local travel costs. As much as possible, a fixed fee lump sum breakdown by phase of the construction based on billable hours is desirable for preconstruction and post construction.

3. Breakdown shall include preconstruction services and construction services (Request for

information/clarification). No subcontractors shall be utilized without prior authorization by the County and modification to submitted DBE subcontractor’s list or goal is discouraged and may lead to project funding issues.

4. Executable copies of Exhibit 10-H and all other updated LAPM forms can be found here: http://www.dot.ca.gov/hq/LocalPrograms/lam/forms/lapmforms.htm . Not meeting the requirements of Exhibit 10 H will result in non-responsive submission.

5. A separate 10-H example 1 must be submitted with the cost proposal for each sub consultant under this agreement. All sub consultant 10-H forms must be totaled and included in the 10-H form of the Prime Consultant.

Insurance Requirements Prior to execution of the agreement with the County, the successful firm must provide evidence of insurance coverages as noted in the sample contract and insurance requirements exhibit. The successful firm will be required to maintain the required coverages, at its sole cost and expense, throughout the entire term and any subsequent modification terms of the contract. Insurance requirements noted in sample contract and insurance exhibit are based on projected county estimates. Insurance requirements may be adjusted once the final cost and fees proposal is reviewed.


Caltrans Federal Forms Requirement Caltrans forms and exhibits listed in the table of contents section are required for this project. Failure to submit the required forms at the required intervals will render a bid non-responsive. Failure to submit the required forms at any of the intervals may result in loss of federal funding on the project and may leave the successful firm in an actionable position.

VII. EVALUATION OF PROPOSALS Sample evaluation criteria for proposals are attached for your information as Exhibit A. The County will utilize a one-step selection process. The County reserves the right to include an oral interview process component. If an oral interview is considered, selected firms will be notified. Proposals will be reviewed by an evaluation committee. The evaluation committee’s assessment and recommendations shall be forwarded to the Director of Public Works for review. The Director shall provide a report of the committee’s evaluation and recommendations, along with his recommendation, for the selection of a firm to the Board of Supervisors for final review and approval to enter into negotiations for an agreement. Please take note that the County reserves the right to select any consultant who is determined qualified and may not correlate to a number 1, number 2 or even number 3 ranked consultant. Per Federal Aid Project guidelines, if an agreement cant be completed with the top 3 ranked firms the County will need to re-advertise the project. Please see LAPM Chapter 10 for procedure details. Additionally, the County reserves the right to reject any and all proposals submitted and/or request additional information for clarification. Consultants are to submit one (1) original, three (3) copies, and one (1) electronic copy in Portable Document Format (PDF) on a USB Thumb Drive of the proposal to the appropriate submission place on the specified date and time. Proposal must be clearly titled: Request for Qualifications (RFQ) Feasibility Study and Implementation Plan for the Replacement of Forrester Road Bridge Over Westside Main Canal in Imperial County; Federal Aid No. BRLS 5958(094); County Project No. 6320 Proposals are to be delivered in a sealed envelope, no later than 4:00 P.M. on February 22, 2018 and addressed as follows: John A. Gay, P.E. Director of Public Works County of Imperial Department of Public Works Attn: Jose Castaneda – Administrative Analyst II 155 S. 11th Street El Centro, California 92243


VIII. CLOSING ITEMS A pre-proposal conference will not been scheduled for this project. Clarification desired by a respondent relating to definition or interpretation shall be requested in writing with sufficient time to allow for a response and prior to the RFP due date. Oral explanation or instructions shall not be considered binding on behalf of the County. Any modifications to this solicitation will be issued by the County as a written addendum. The County will not consider proposals received after the specified date and time. An amendment is considered a new proposal and will not be accepted after the specified date and time. Any contract resulting from this RFP will be financed with funds available to the County from local County and/or Federal Aid or other grant funds. This RFP does not commit the County of Imperial to award a contract or pay any costs associated with the preparation of a proposal. The County reserves the right to cancel, in part or in its entirety, this solicitation should this be in the best interest of the County. Questions concerning this RFP are to be directed to Jose Castaneda, Administrative Analyst II, with the Imperial County Department of Public Works via electronic mail to [email protected]

A

EXHIBIT

FEASIBILITY STUDY AND IMPLEMENTATION PLAN FOR THE REPLACEMENT OF FORRESTER ROAD BRIDGE OVER WESTSIDE MAIN CANAL IN IMPERIAL; BRLS-5958(094), COUNTY PROJECT

NO. 6320

SAMPLE PROPOSAL EVALUATION FORM

PROPOSAL EVALUATION FORM

Feasibility Study and Implementation Plan for the Replacement of Forrester Road Bridge Over Westside Main Canal in Imperial County; Federal Aid No. BRLS 5958(094); County Project No. 6320

Prepared July 5, 2017 by J. Castaneda

DATE: RATING POINTS: EVALUATOR: 5 = excellent 4 = good RESPONDENT: 3 = above average 2 = average 1 = below average 0 = unsatisfactory CRITERIA WEIGHT FACTOR X RATING = WEIGHTED RATING A. Technical Approach 0.35

• Responsiveness & understanding (0.20) _____ _____ of work to be done, (i.e. scope of work)

• Specific experience with similar (0.15) _____ _____ Bridge Projects B. Project Management 0.30

• Capacity to perform the scope of (0.20) _____ _____ work and the ability to conclude in a timely manner

• Quality of staff based on recent (0.10) _____ _____ experience

C. References (0.05) _____ _____ D. Familiarity and/or specific experience (0.25) _____ _____ with local, state and federal project procedures using LAPM for local agency advertised projects. E. Overall quality of proposal, including (0.05) _____ _____

qualifications and thoroughness. Subtotal Score _____ F. Previous Experience and Performance working with County of Imperial Department of Public Works _____ (0 to -5) Total Score _____ Note: Positive previous experience and no previous experience will constitute a score of zero (0). Negative experience points will be deducted from the overall score. Comments:

B

EXHIBIT

FEASIBILITY STUDY AND IMPLEMENTATION PLAN FOR THE REPLACEMENT OF FORRESTER ROAD BRIDGE OVER WESTSIDE MAIN CANAL IN IMPERIAL; BRLS-5958(094), COUNTY PROJECT NO. 6320

LIST OF APPLICABLE DOCUMENTS

List of Applicable Documents

1. The Local Assistance Procedure Manual

• Chapter 15 “Advertise and Award Project” • Chapter 16 “Administer Construction Contracts” • Chapter 17 “Project Completion” •

These chapters can be found at http://www.dot.ca.gov/hq/LocalPrograms/lam/lapm.htm

2. Caltrans Latest Editions of:

• Standard Plans and Standard Specifications • Construction Manual

3. Bidding Documents (Notice to Contractors) and plans and specifications for the

construction work referred to for this project are available on the Public Works website that can be found at: http://www.co.imperial.ca.us/publicwork/

4. County of Imperial Quality Assurance Program (QAP)

http://www.co.imperial.ca.us/publicwork/FormsAndGuidelines/Forms&Guidelines/Quality%20Assurance%20Program%202010.pdf

http://www.dot.ca.gov/hq/LocalPrograms/lam/lapm.htm

http://www.co.imperial.ca.us/publicwork/



C

EXHIBIT


SAMPLE CONSULTANT AGREEMENT

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AGREEMENT FOR SERVICES

THIS AGREEMENT FOR SERVICES (“Agreement”), made and entered into effective the

day of , 2014, by and between the COUNTY OF IMPERIAL, a political

subdivision of the State of California, by and through its Department of Public Works (“COUNTY”) and

[business name], [business type] (“CONSULTANT”) (individually, “Party;” collectively, “Parties”).

W I T N E S S E T H

WHEREAS, COUNTY desires to retain a qualified individual, firm or business entity to provide

professional services for [specify services], (“the Project”); and

WHEREAS, CONSULTANT represents that it is qualified and experienced to perform the

services; and

WHEREAS, COUNTY desires to engage CONSULTANT to provide services by reason of its

qualifications and experience for performing such services, and CONSULTANT has offered to provide

the required services for the Project on the terms and in the manner set forth herein.

NOW, THEREFORE, in consideration of their mutual covenants, COUNTY and

CONSULTANT have and hereby agree to the following:

1. DEFINITIONS.

1.1. “Request for Proposal” or “RFP” shall mean that document that describes the Project and

project requirements to prospective bidders entitled [name of RFP], dated [date of RFP]. The Request for

Proposal [and other documents if any] are attached hereto as Exhibit “A” and incorporated herein by this

reference.

1.2. “Proposal” shall mean CONSULTANT’s document entitled [name of Proposal], dated

[date of Proposal] and submitted to COUNTY’s Department of Public Works. The Proposal is attached

hereto as Exhibit “B” and incorporated herein by reference.

2. CONTRACT COORDINATION.

2.1. The Director of Public Works or his/her designee shall be the representative of

COUNTY for all purposes under this Agreement. The Director of Public Works or his/her designee is

hereby designated as the Contract Manager for COUNTY. He/she shall supervise the progress and

execution of this Agreement.

jenellguerrero

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SAMPLE

jenellguerrero

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jenellguerrero

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2.2. CONSULTANT shall assign a single Contract Manager to have overall responsibility for

the progress and execution of this Agreement. Should circumstances or conditions subsequent to the

execution of this Agreement require a substitute Contract Manager for any reason, the Contract Manager

designee shall be subject to the prior written acceptance and approval of COUNTY’s Contract Manager.

3. DESCRIPTION OF WORK.

CONSULTANT shall provide all materials and labor to perform this Agreement consistent with

the RFP and the Proposal, as set forth in Exhibits “A” and “B.” In the event of a conflict amongst this

Agreement, the RFP, and the Proposal, the RFP shall take precedence over the Proposal and this

Agreement shall take precedence over both.

4. WORK TO BE PERFORMED BY CONSULTANT.

4.1. CONSULTANT shall comply with all terms, conditions and requirements of the Proposal

and this Agreement.

4.2. CONSULTANT shall perform such other tasks as necessary and proper for the full

performance of the obligations assumed by CONSULTANT hereunder.

4.3. CONSULTANT shall:

4.3.1. Procure all permits and licenses, pay all charges and fees, and give all notices

that may be necessary and incidental to the due and lawful prosecution of the services to be performed

by CONSULTANT under this agreement;

4.3.2. Keep itself fully informed of all existing and proposed federal, state and local laws,

ordinances, regulations, orders and decrees which may affect those engaged or employed under this

Agreement;

4.3.3. At all times observe and comply with, and cause all of its employees to observe

and comply with all of said laws, ordinances, regulations, orders and decrees mentioned above; and

4.3.4. Immediately report to COUNTY’s Contract Manager in writing any discrepancy

or inconsistency it discovers in said laws, ordinances, regulations, orders and decrees mentioned above

in relation to any plans, drawings, specifications or provisions of this Agreement.

///

///


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5. REPRESENTATIONS BY CONSULTANT.

5.1. CONSULTANT understands and agrees that COUNTY has limited knowledge in the

multiple areas specified in the Proposal. CONSULTANT has represented itself to be an expert in these

fields and understands that COUNTY is relying upon such representation.

5.2. CONSULTANT represents and warrants that it is a lawful entity possessing all required

licenses and authorities to do business in the State of California and perform all aspects of this

Agreement.

5.3. CONSULTANT shall not commence any work under this Agreement or provide any

other services, or materials, in connection therewith until CONSULTANT has received written

authorization from COUNTY’s Contract manager to do so.

5.4. CONSULTANT represents and warrants that the people executing this Agreement on

behalf of CONSULTANT have the authority of CONSULTANT to sign this Agreement and bind

CONSULTANT to the performance of all duties and obligations assumed by CONSULTANT herein.

5.5. CONSULTANT represents and warrants that any employee, contractor and/or agent who

will be performing any of the duties and obligations of CONSULTANT herein possess all required

licenses and authorities, as well as the experience and training, to perform such tasks.

5.6. CONSULTANT represents and warrants that the allegations contained in the Proposal are

true and correct.

5.7. CONSULTANT understands that COUNTY considers the representations made herein

to be material and would not enter into this Agreement with CONSULTANT if such representations

were not made.

5.8. CONSULTANT understands and agrees not to discuss this Agreement or work

performed pursuant to this Agreement with anyone not a party to this Agreement without the prior

permission of COUNTY. CONSULTANT further agrees to immediately advise COUNTY of any

contacts or inquiries made by anyone not a party to this Agreement with respect to work performed

pursuant to this Agreement.

///

///


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5.9. Prior to accepting any work under this Agreement, CONSULTANT shall perform a due

diligence review of its files and advise COUNTY of any conflict or potential conflict CONSULTANT

may have with respect to the work requested.

5.10. CONSULTANT understands and agrees that in the course of performance of this

Agreement CONSULTANT may be provided with information or data considered by the owner or the

COUNTY to be confidential. COUNTY shall clearly identify such information and/or data as

confidential. CONSULTANT shall take all necessary steps necessary to maintain such confidentiality

including but not limited to restricting the dissemination of all material received to those required to

have such data in order for CONSULTANT to perform under this Agreement.

5.11. CONSULTANT represents that the personnel dedicated to this project as identified in

CONSULTANT’s Proposal, will be the people to perform the tasks identified therein. CONSULTANT

will not substitute other personnel or engage any contractors to work on any tasks identified herein

without prior written notice to COUNTY.

6. TERM OF AGREEMENT.

This Agreement shall commence on the date first written above and shall remain in effect until

the services provided as outlined in paragraph 3, (“DESCRIPTION OF WORK”), have been

completed, unless otherwise terminated as provided for in this Agreement.

7. COMPENSATION.

7.1. The total compensation payable under this Agreement shall not exceed [dollar amount]

[(numerical amount)] unless otherwise previously agreed to in writing by COUNTY.

7.2. The fee for any additional services required by COUNTY will be computed either on a

negotiated lump sum basis or upon actual hours and expenses incurred by CONSULTANT [and based

on CONSULTANT’s current standard rates as set forth in []]. Additional services or costs will not be

paid without a prior written agreement between the Parties.

7.3. Except as provided under paragraph 7.1 and 7.2, COUNTY shall not be responsible to

pay CONSULTANT any compensation, out of pocket expenses, fees, reimbursement of expenses or

other remuneration.

///


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8. PAYMENT.

8.1. CONSULTANT shall bill COUNTY on a time and material basis as set forth in Exhibit

“[].” COUNTY shall pay CONSULTANT for completed and approved services upon presentation of its

itemized billing.

8.2. COUNTY shall retain five percent (5%) of the total of amount of each invoice, not to

exceed five percent (5%) of the total compensation amount of the completed project. “Completion of the

Project” is when the work to be performed has been completed in accordance with this Agreement, as

determined by COUNTY, and all subcontractors, if any, have been paid in full by CONSULTANT. Upon

completion of the Project CONSULTANT shall bill COUNTY the retention for payment by COUNTY.

9. METHOD OF PAYMENT.

CONSULTANT shall at any time prior to the fifteenth (15th) day of any month, submit to

COUNTY a written claim for compensation for services performed. The claim shall be in a format

approved by COUNTY. No payment shall be made by COUNTY prior to the claims being approved in

writing by COUNTY’s Contract Manager or his/her designee. CONSULTANT may expect to receive

payment within a reasonable time thereafter and in any event in the normal course of business within

thirty (30) days after the claim is submitted.

10. TIME FOR COMPLETION OF THE WORK.

The Parties agree that time is of the essence in the performance of this Agreement. Program

scheduling shall be as described in Exhibit “[]” unless revisions to Exhibit “[]” are approved by both

COUNTY’s Contract Manager and CONSULTANT’s Contract Manager. Time extensions may be

allowed for delays caused by COUNTY, other governmental agencies or factors not directly brought

about by the negligence or lack of due care on the part of CONSULTANT.

11. MAINTENANCE AND ACCESS OF BOOKS AND RECORDS.

CONSULTANT shall maintain books, records, documents, reports and other materials

developed under this Agreement as follows:

11.1. CONSULTANT shall maintain all ledgers, books of accounts, invoices, vouchers,

canceled checks, and other records relating to CONSULTANT’s charges for services or expenditures


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and disbursements charged to COUNTY for a minimum period of three (3) years, or for any longer

period required by law, from the date of final payment to CONSULTANT pursuant to this Agreement.

11.2. CONSULTANT shall maintain all reports, documents, and records, which demonstrate

performance under this Agreement for a minimum period of five (5) years, or for any longer period

required by law, from the date of termination or completion of this Agreement.

11.3. Any records or documents required to be maintained by CONSULTANT pursuant to

this Agreement shall be made available to COUNTY for inspection or audit at any time during

CONSULTANT’s regular business hours provided that COUNTY provides CONSULTANT with

seven (7) days advanced written or e-mail notice. Copies of such documents shall, at no cost to

COUNTY, be provided to COUNTY for inspection at CONSULTANT’s address indicated for receipt

of notices under this Agreement.

12. SUSPENSION OF AGREEMENT.

COUNTY’s Contract Manager shall have the authority to suspend this Agreement, in whole or

in part, for such period as deemed necessary due to unfavorable conditions or to the failure on the part

of CONSULTANT to perform any provision of this Agreement. CONSULTANT will be paid the

compensation due and payable to the date of suspension.

13. TERMINATION.

COUNTY retains the right to terminate this Agreement for any reason by notifying

CONSULTANT in writing seven (7) days prior to termination and by paying the compensation due

and payable to the date of termination; provided, however, if this Agreement is terminated for fault of

CONSULTANT, COUNTY shall be obligated to compensate CONSULTANT only for that portion of

CONSULTANT’s services which are of benefit to COUNTY. Said compensation is to be arrived at by

mutual agreement between COUNTY and CONSULTANT; should the parties fail to agree on said

compensation, an independent arbitrator shall be appointed and the decision of the arbitrator shall be

binding upon the parties.

14. INSPECTION.

CONSULTANT shall furnish COUNTY with every reasonable opportunity for COUNTY to

ascertain that the services of CONSULTANT are being performed in accordance with the requirements


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and intentions of this Agreement. All work done and materials furnished, if any, shall be subject to

COUNTY’s Contract Manager’s inspection and approval. The inspection of such work shall not

relieve CONSULTANT of any of its obligations to fulfill its Agreement as prescribed.

15. OWNERSHIP OF MATERIALS.

All original drawings, videotapes, studies, sketches, computations, reports, information, data

and other materials given to or prepared or assembled by or in the possession of CONSULTANT

pursuant to this Agreement shall become the permanent property of COUNTY and shall be delivered

to COUNTY upon demand, whether or not completed, and shall not be made available to any

individual or organization without the prior written approval of COUNTY.

16. INTEREST OF CONSULTANT.

16.1. CONSULTANT covenants that it presently has no interest, and shall not acquire any

interest, direct or indirect, financial or otherwise, which would conflict in any manner or degree with

the performance of the services hereunder.

16.2. CONSULTANT covenants that, in the performance of this Agreement, no sub-

contractor or person having such an interest shall be employed.

16.3. CONSULTANT certifies that no one who has or will have any financial interest under

this Agreement is an officer or employee of COUNTY.

17. INDEMNIFICATION.

17.1. CONSULTANT agrees to the fullest extent permitted by law to indemnify, defend,

protect and hold COUNTY and its representatives, officers, directors, designees, employees,

successors and assigns harmless from any and all claims, expenses, liabilities, losses, causes of actions,

demands, losses, penalties, attorneys’ fees and costs, in law or equity, of every kind and nature

whatsoever arising out of or in connection with CONSULTANT’s negligent acts and omissions or

willful misconduct under this Agreement (“Claims”), whether or not arising from the passive

negligence of COUNTY, but does not include Claims that are the result of the negligence or willful

misconduct of COUNTY.

17.2. CONSULTANT agrees to defend with counsel acceptable to COUNTY, indemnify and

hold COUNTY harmless from all Claims, including but not limited to:


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17.2.1. Personal injury, including but not limited to bodily injury, emotional injury,

sickness or disease or death to persons including but not limited to COUNTY’s representatives,

officers, directors, designees, employees, agents, successors and assigns, subcontractors and other third

parties and/or damage to property of anyone (including loss of use thereof) arising out of

CONSULTANT’s negligent performance of, or willful misconduct surrounding, any of the terms

contained in this Agreement, or anyone directly or indirectly employed by CONSULTANT or anyone

for whose acts CONSULTANT may be liable;

17.2.2. Liability arising from injuries to CONSULTANT and/or any of

CONSULTANT’s employees or agents arising out of CONSULTANT’s negligent performance of, or

willful misconduct surrounding, any of the terms contained in this Agreement, or anyone directly or

indirectly employed by CONSULTANT or anyone for whose acts CONSULTANT may be liable;

17.2.3. Penalties imposed upon account of the violation of any law, order, citation, rule,

regulation, standard, ordinance or statute caused by the negligent action or inaction, or willful

misconduct of CONSULTANT or anyone directly or indirectly employed by CONSULTANT or

anyone for whose acts CONSULTANT may be liable;

17.2.4. Infringement of any patent rights which may be brought against COUNTY

arising out of CONSULTANT’s work;

17.2.5. Any violation or infraction by CONSULTANT of any law, order, citation, rule,

regulation, standard, ordinance or statute in any way relating to the occupational health or safety of

employees; and

17.2.6. Any breach by CONSULTANT of the terms, requirements or covenants of this

Agreement.

17.3. These indemnification provisions shall extend to Claims occurring after this Agreement

is terminated, as well as while it is in force.

18. INDEPENDENT CONTRACTOR.

In all situations and circumstances arising out of the terms and conditions of this Agreement,

CONSULTANT is an independent contractor, and as an independent contractor, the following shall

apply:


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18.1. CONSULTANT is not an employee or agent of COUNTY and is only responsible for

the requirements and results specified by this Agreement or any other agreement.

18.2. CONSULTANT shall be responsible to COUNTY only for the requirements and results

specified by this Agreement and except as specifically provided in this Agreement, shall not be subject

to COUNTY’s control with respect to the physical actions or activities of CONSULTANT in

fulfillment of the requirements of this Agreement.

18.3. CONSULTANT is not, and shall not be, entitled to receive from, or through, COUNTY,

and COUNTY shall not provide, or be obligated to provide, CONSULTANT with Workers’

Compensation coverage or any other type of employment or worker insurance or benefit coverage

required or provided by any Federal, State or local law or regulation for, or normally afforded to, an

employee of COUNTY.

18.4. CONSULTANT shall not be entitled to have COUNTY withhold or pay, and COUNTY

shall not withhold or pay, on behalf of CONSULTANT, any tax or money relating to the Social

Security Old Age Pension Program, Social Security Disability Program, or any other type of pension,

annuity, or disability program required or provided by any Federal, State or local law or regulation.

18.5. CONSULTANT shall not be entitled to participate in, nor receive any benefit from, or

make any claim against any COUNTY fringe program, including, but not limited to, COUNTY’s

pension plan, medical and health care plan, dental plan, life insurance plan, or any other type of benefit

program, plan, or coverage designated for, provided to, or offered to COUNTY’s employees.

18.6. COUNTY shall not withhold or pay, on behalf of CONSULTANT, any Federal, State,

or local tax, including, but not limited to, any personal income tax, owed by CONSULTANT.

18.7. CONSULTANT is, and at all times during the term of this Agreement, shall represent

and conduct itself as an independent contractor, not as an employee of COUNTY.

18.8. CONSULTANT shall not have the authority, express or implied, to act on behalf of,

bind or obligate COUNTY in any way without the written consent of COUNTY.

19. INSURANCE.

19.1. CONSULTANT agrees at its own cost and expense to procure and maintain during the

entire term of this Agreement, and any extended term, commercial general liability insurance (bodily


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injury and property damage), employer’s liability insurance, commercial automobile liability insurance

(bodily injury and property damage) and professional liability insurance in a sum acceptable to

COUNTY and adequate to cover potential liabilities arising in connection with the performance of this

Agreement and in any event not less than the minimum limit set forth as follows:

Insurance Minimum Limit

Errors & Omissions Coverage

(professional liability – malpractice)

[*] million dollars ($[*])

Per person, per occurrence.

Workers’ Compensation, Coverage A Statutory

Employer’s Liability, Coverage B [*] million dollars ($[*])

Commercial General Liability

(Including Contractual Liability)

Bodily Injury

Property Damage

[*] million dollars ($[*])

combined single limit to any one

person (“CSL”) and [*] million

dollars ($[*]) aggregate for any one

accident, including personal injury,

death and property damage.

Commercial Automobile Liability

(owned, hired & non-owned vehicles)

Bodily Injury

Property Damage

[*] million dollars ($[*]) combined

single limit and [*] million dollars

($[*]) aggregate, including owned,

non-owned and hired vehicles.

19.2. Special Insurance Requirements. All insurance required shall:

19.2.1. Be procured from California admitted insurers (licensed to do business in

California) with a current rating by Best’s Key Rating Guide, acceptable to COUNTY. A rating of at

least A-VII shall be acceptable to COUNTY; lesser ratings must be approved in writing by COUNTY.

19.2.2. Be primary coverage as respects COUNTY and any insurance or self-insurance

maintained by COUNTY shall be in excess of CONSULTANT’s insurance coverage and shall not

contribute to it.


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19.2.3. Name The Imperial County Department of Public Works and the County of

Imperial and their officers, employees, and volunteers as additional insured on all policies, except

Workers’ Compensation insurance and Errors & Omissions insurance, and provide that COUNTY may

recover for any loss suffered by COUNTY due to CONSULTANT’s negligence.

19.2.4. State that it is primary insurance and regards COUNTY as an additional insured

and contains a cross-liability or severability of interest clause.

19.2.5. Not be canceled, non-renewed or reduced in scope of coverage until after thirty

(30) days written notice has been given to COUNTY. CONSULTANT may not terminate such

coverage until it provides COUNTY with proof that equal or better insurance has been secured and is

in place. Cancellation or change without prior written consent of COUNTY shall, at the option of

COUNTY, be grounds for termination of this Agreement.

19.2.6. If this Agreement remains in effect more than one (1) year from the date of its

original execution, COUNTY may, at its sole discretion, require an increase to liability insurance to the

level then customary in similar COUNTY Agreements by giving sixty (60) days notice to

CONSULTANT.

19.3. Additional Insurance Requirements.

19.3.1. COUNTY is to be notified immediately of all insurance claims. COUNTY is

also to be notified if any aggregate insurance limit is exceeded.

19.3.2. The comprehensive or commercial general liability shall contain a provision of

endorsements stating that such insurance:

a. Includes contractual liability;

b. Does not contain any exclusions as to loss or damage to property caused by

explosion or resulting from collapse of buildings or structures or damage to property underground,

commonly referred to by insurers as the “XCU Hazards;”

c. Does not contain a “pro rata” provision which looks to limit the insurer’s

liability to the total proportion that its policy limits bear to the total coverage available to the insured;

///


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d. Does not contain an “excess only” clause which require the exhaustion of other

insurance prior to providing coverage;

e. Does not contain an “escape clause” which extinguishes the insurer’s liability if

the loss is covered by other insurance;

f. Includes COUNTY as an additional insured.

g. States that it is primary insurance and regards COUNTY as an additional insured

and contains a cross-liability or severability of interest clause.

19.4. Deposit of Insurance Policy. Promptly on issuance, reissuance, or renewal of any

insurance policy required by this Agreement, CONSULTANT shall, if requested by COUNTY,

provide COUNTY satisfactory evidence that insurance policy premiums have been paid together with

a duplicate copy of the policy or a certificate evidencing the policy and executed by the insurance

company issuing the policy or its authorized agent.

19.5. Certificates of Insurance.

CONSULTANT agrees to provide COUNTY with the following insurance documents on or

before the effective date of this Agreement:

19.5.1. Complete copies of certificates of insurance for all required coverages including

additional insured endorsements shall be attached hereto as Exhibit “C” and incorporated herein.

19.5.2. The documents enumerated in this Paragraph shall be sent to the following: County of Imperial Risk Management Department 940 Main Street, Suite 101 El Centro, CA 92243

County of Imperial Department of Public Works 155 South 11th Street El Centro, CA 92243

19.6. Additional Insurance. Nothing in this, or any other provision of this Agreement, shall

be construed to preclude CONSULTANT from obtaining and maintaining any additional insurance

policies in addition to those required pursuant to this Agreement.


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20. PREVAILING WAGE.

20.1. CONSULTANT acknowledges that any work that qualifies as a “public work” within

the meaning of California Labor Code section 1720 shall cause CONSULTANT, and its sub-

consultants, to comply with the provisions of California Labor Code sections 1775 et seq.

20.2. When applicable, copies of the prevailing rate of per diem wages shall be on file at

COUNTY’s Department of Public Works and available to CONSULTANT and any other interested

party upon request. CONSULTANT shall post copies of the prevailing wage rate of per diem wages at

the Project site.

20.3. CONSULTANT hereby acknowledges and stipulates to the following:

20.3.1. CONSULTANT has reviewed and agrees to comply with the provisions of

Labor Code section 1776 regarding retention and inspection of payroll records and noncompliance

penalties; and


Labor Code section 1777.5 regarding employment of registered apprentices; and


Labor Code section 1810 regarding the legal day’s work; and


Labor Code section 1813 regarding forfeiture for violations of the maximum hours per day and per

week provisions contained in the same chapter.

20.3.5 CONSULTANT has reviewed and agrees to comply with any applicable

provisions for those Projects subject to Department of Industrial Relations (DIR) Monitoring and

Enforcement of prevailing wages. COUNTY hereby notifies CONSULTANT that CONSULTANT is

responsible for submitting certified payroll records directly to the State Compliance Monitoring Unit

(CMU) The Compliance Monitoring Unit or “CMU” is a new component within the State Division of

Labor Standards Enforcement (DLSE) that was created to monitor and enforce prevailing wage

requirements on public works projects that receive state bond funding and on other projects that are

legally required to use the CMU. The CMU began operations on January 1, 2012, following the

recent adoption of AB 436 and approval of revisions to program regulations. By actively monitoring


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compliance on an ongoing basis while work is being performed, the CMU will play a special role in

ensuring that public works construction workers are promptly paid the proper prevailing wage rates

and in helping maintain a level playing field for employers who comply with the law.

Effective Date and Applicability: The laws and regulations that govern the new program are

effective January 1, 2012. Only projects for which the public works contract is awarded on or after

January 1, 2012 are subject to the CMU requirements. For further information concerning compliance

monitoring please visit the website located at: http://www.dir.ca.gov/dlse/cmu/cmu.html

21. WORKERS’ COMPENSATION CERTIFICATION.

21.1. Prior to the commencement of work, CONTRACTOR shall sign and file with

COUNTY the following certification: “I am aware of the provisions of California Labor Code §§3700

et seq. which require every employer to be insured against liability for workers’ compensation or to

undertake self-insurance in accordance with the provisions of that code, and I will comply with such

provisions before commencing the performance of the work of this contract.”

21.2. This certification is included in this Agreement and signature of the Agreement shall

constitute signing and filing of the certificate.

20.3. CONSULTANT understands and agrees that any and all employees, regardless of hire

date, shall be covered by Workers’ Compensation pursuant to statutory requirements prior to beginning

work on the Project.

20.4. If CONSULTANT has no employees, initial here: __________.

22. ASSIGNMENT.

Neither this Agreement nor any duties or obligations hereunder shall be assignable by

CONSULTANT without the prior written consent of COUNTY. CONSULTANT may employ other

specialists to perform services as required with prior approval by COUNTY.

23. NON-DISCRIMINATION.

During the performance of this Agreement, CONSULTANT and its subcontractors shall not

unlawfully discriminate, harass or allow harassment against any employee or applicant for

employment because of sex, race, color, ancestry, religious creed, national origin, physical disability

(including HIV and AIDS), mental disability, medical condition (cancer), age (over forty (40)), marital


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status and denial of family care leave. CONSULTANT and its subcontractors shall insure that the

evaluation and treatment of their employees and applicants for employment are free from such

discrimination and harassment. CONSULTANT and its subcontractors shall comply with the

provisions of the Fair Employment and Housing Act (Gov. Code §12990 (a-f) et seq.) and the

applicable regulations promulgated thereunder (California Code of Regulations, Title 2, §7285 et seq.).

The applicable regulations of the Fair Employment and Housing Commission implementing

Government Code §12990 (a-f), set forth in Chapter 5 of Division 4 of Title 2 of the California Code

of Regulations, are incorporated into this Agreement by reference and made a part hereof as if set forth

in full. The applicable regulations of §504 of the Rehabilitation Act of 1973 (29 U.S.C. §794 (a)) are

incorporated into this Agreement by reference and made a part hereof as if set forth in full.

CONSULTANT and its subcontractors shall give written notice of their obligations under this clause to

labor organizations with which they have a collective bargaining or other agreement. CONSULTANT

shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to

perform work under this Agreement.

///

24. NOTICES AND REPORTS.

24.1. Any notice and reports under this Agreement shall be in writing and may be given by

personal delivery or by mailing by certified mail, addressed as follows:

COUNTY CONSULTANT Director of Public Works [name of consultant] 155 South 11th Street [address of consultant] El Centro, CA 92243

County of Imperial Clerk of the Board of Supervisors 940 W. Main Street, Suite 209 El Centro, CA 92243

24.2. Notice shall be deemed to have been delivered only upon receipt by the Party, seventy-

two (72) hours after deposit in the United States mail or twenty-four (24) hours after deposit with an

overnight carrier.


020212.doc ##-####-XXX – BPL HWH– 1-27-12

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24.3. The addressees and addresses for purposes of this paragraph may be changed to any

other addressee and address by giving written notice of such change. Unless and until written notice of

change of addressee and/or address is delivered in the manner provided in this paragraph, the addressee

and address set forth in this Agreement shall continue in effect for all purposes hereunder.

25. ENTIRE AGREEMENT.

This Agreement contains the entire Agreement between COUNTY and CONSULTANT

relating to the transactions contemplated hereby and supersedes all prior or contemporaneous

agreements, understandings, provisions, negotiations, representations, or statements, either written or

oral.

26. MODIFICATION.

No modification, waiver, amendment, discharge, or change of this Agreement shall be valid

unless the same is in writing and signed by both Parties.

27. CAPTIONS.

Captions in this Agreement are inserted for convenience of reference only and do not define,

describe or limit the scope or the intent of this Agreement or any of the terms thereof.

///

28. PARTIAL INVALIDITY.

If any provision in this Agreement is held by a court of competent jurisdiction to be invalid,

void, or unenforceable, the remaining provisions will nevertheless continue in full force without being

impaired or invalidated in any way.

29. GENDER AND INTERPRETATION OF TERMS AND PROVISIONS.

As used in this Agreement and whenever required by the context thereof, each number, both

singular and plural, shall include all numbers, and each gender shall include a gender.

CONSULTANT as used in this Agreement or in any other document referred to in or made a part of

this Agreement shall likewise include the singular and the plural, a corporation, a partnership,

individual, firm or person acting in any fiduciary capacity as executor, administrator, trustee or in any

other representative capacity or any other entity. All covenants herein contained on the part of


020212.doc ##-####-XXX – BPL HWH– 1-27-12

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CONSULTANT shall be joint and several if more than one person, firm or entity executes the

Agreement.

30. WAIVER.

No Waiver of any breach or of any of the covenants or conditions of this Agreement shall be

construed to be a waiver of any other breach or to be a consent to any further or succeeding breach of

the same or any other covenant or condition.

31. CHOICE OF LAW.

This Agreement shall be governed by the laws of the State of California. This Agreement is

made and entered into in Imperial County, California. Any action brought by either party with respect

to this agreement shall be brought in a court of competent jurisdiction within said County.

32. ATTORNEYS’ FEES.

If either party herein brings an action to enforce the terms thereof or declare rights hereunder,

the prevailing party in any such action, on trial or appeal, shall be entitled to his reasonable attorneys’

fees and actual costs to be paid by the losing party as fixed by the court.

33. AUTHORITY.

33.1. Each individual executing this Agreement on behalf of CONSULTANT represents and

warrants that:

33.1.1. He/She is duly authorized to execute and deliver this Agreement on behalf of

CONSULTANT;

33.1.2. Such execution and delivery is in accordance with the terms of the Articles of

Incorporation or Partnership, any by-laws or Resolutions of CONSULTANT and;

33.1.3. This Agreement is binding upon CONSULTANT accordance with its terms.

33.2. CONSULTANT shall deliver to COUNTY evidence acceptable to COUNTY of the

foregoing within thirty (30) days of execution of this Agreement.

34. COUNTERPARTS.

This Agreement (as well as any amendments hereto) may be executed in any number of

counterparts, each of which when executed shall be an original, and all of which together shall


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constitute one and the same Agreement. No counterparts shall be effective until all Parties have

executed a counterpart hereof.

35. REVIEW OF AGREEMENT TERMS.

35.1. Each Party has received independent legal advice from its attorneys with respect to the

advisability of making the representations, warranties, covenants and agreements provided for herein,

and with respect to the advisability of executing this Agreement.

35.2. Each Party represents and warrants to and covenants with the other Party that:

35.2.1. This Agreement in its reduction to final written form is a result of extensive

good faith negotiations between the Parties and/or their respective legal counsel;

35.2.2. The Parties and their legal counsel have carefully reviewed and examined this

Agreement for execution by said Parties; and

35.3. Any statute or rule of construction that ambiguities are to be resolved against the

drafting party shall not be employed in the interpretation of this Agreement.

36. NON-APPROPRIATION.

This Agreement is based upon the availability of public funding. In the even that public funds

are unavailable and not appropriated for the performance of the services set forth in this Agreement,

the Agreement shall be terminated without penalty after written notice to CONSULTANT of the

unavailability and/or non-appropriation of funds.

IN WITNESS WHEREOF, the Parties have executed this Agreement on the day and year first

above written.

COUNTY OF IMPERIAL CONSULTANT [CONSULTANT NAME] By:_________________________________ By:_________________________________ [chairman name], Chairman [Designee] Imperial County Board of Supervisors ATTEST:


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[clerk name] Clerk of the Board, County of Imperial, State of California APPROVED AS TO FORM: MICHAEL L. ROOD County Counsel By: [ATTORNEY NAME] [Title]

INSURANCE REQUIREMENTS

Insurance Requirements are set forth by the Imperial County Department of Risk Management. Minimum requirements may vary per project and are subject to additional review after Consultant is selected. The insurance requirements for this project are as follows:

MINIMUM INSURANCE AMOUNTS

Consultant Contract (Agreement for Services) form and content is included.

Insurance Minimum Limit * Errors & Omissions/ Professional Liability $1 million per occurrence Workers Compensation, Coverage A Statutory Employers Liability, Coverage B $1 million Comprehensive General Liability (Including Contractual Liability): Bodily Injury $1 million per occurrence $2 million aggregate Property Damage $1 million per occurrence $2 million aggregate Comprehensive Automobile Liability (Owned, hired & non-owned vehicles) Bodily Injury $1 million per occurrence Property Damage $1 million per occurrence

An endorsement covering any explosion, collapse and underground exposures, “XCU”, in the Commercial General Liability policy is also required.

Insurance Certificates should name both: -Imperial County Department of Public Works -County of Imperial

*Minimums subject to additional review after bid open.

D

EXHIBIT


LOCATION MAPS

EL CENTRO

IMPERIAL

BRAWLEY

SEELEY

IMPERIAL COUNTYPUBLIC WORKS DEPARTMENT

EL CENTRO, CALIFORNIA

DRAWN:

L. LEALDRAWING No.:

L-825DATE:

06/07/10

Forrester Road Bridge over Westside Main CanalBridge No. 58C-0014

LOCATION MAP

NTS

LEGEND Bridge No. 58C-0014

Bridge No. 58C-0014

E

EXHIBIT


BIDDER/PROPOSER DISADVANTAGED BUSINESS ENTERPRISE (DBE) PROGRAM REQUIREMENTS

Local Assistance Procedures Manual EXHBIT 10-I Notice to Proposers DBE Information

Page 1 of 3 LPP 13-01 May 8, 2013

EXHIBIT 10-I NOTICE TO PROPOSERS DBE INFORMATION

The Agency has established a DBE goal for this Contract of ____________%

OR

The Agency has not established a goal for this Contract. However, proposers are encouraged to obtain DBE participation for this contract.

1. TERMS AS USED IN THIS DOCUMENT

• The term “Disadvantaged Business Enterprise” or “DBE” means a for-profit small business concern owned and controlled by a socially and economically disadvantaged person(s) as defined in Title 49, Code of Federal Regulations (CFR), Part 26.5.

• The term “Agreement” also means “Contract.”

• Agency also means the local entity entering into this contract with the Contractor or Consultant.

• The term “Small Business” or “SB” is as defined in 49 CFR 26.65.

2. AUTHORITY AND RESPONSIBILITY

A. DBEs and other small businesses are strongly encouraged to participate in the performance of Contracts financed in whole or in part with federal funds (See 49 CFR 26, “Participation by Disadvantaged Business Enterprises in Department of Transportation Financial Assistance Programs”). The Consultant must ensure that DBEs and other small businesses have the opportunity to participate in the performance of the work that is the subject of this solicitation and should take all necessary and reasonable steps for this assurance. The proposer must not discriminate on the basis of race, color, national origin, or sex in the award and performance of subcontracts.

B. Proposers are encouraged to use services offered by financial institutions owned and controlled by DBEs.

3. SUBMISSION OF DBE INFORMATION

If there is a DBE goal on the contract, Exhibit 10-O1 Consultant Proposal DBE Commitment must be included in the Request for Proposal. In order for a proposer to be considered responsible and responsive, the proposer must make good faith efforts to meet the goal established for the contract. If the goal is not met, the proposer must document adequate good faith efforts. All DBE participation will be counted towards the contract goal; therefore, all DBE participation shall be collected and reported.

Exhibit 10-O2 Consultant Contract DBE Information must be included with the Request for Proposal. Even if no DBE participation will be reported, the successful proposer must execute and return the form.

4. DBE PARTICIPATION GENERAL INFORMATION

It is the proposer’s responsibility to be fully informed regarding the requirements of 49 CFR, Part 26, and the Department’s DBE program developed pursuant to the regulations. Particular attention is directed to the following:

A. A DBE must be a small business firm defined pursuant to 13 CFR 121 and be certified through the California Unified Certification Program (CUCP).

7


Page 2 of 3 LPP 13-01 May 8, 2013

B. A certified DBE may participate as a prime consultant, subconsultant, joint venture partner, as a vendor of material or supplies, or as a trucking company.

C. A DBE proposer not proposing as a joint venture with a non-DBE, will be required to document one or a combination of the following:

1. The proposer is a DBE and will meet the goal by performing work with its own forces.

2. The proposer will meet the goal through work performed by DBE subconsultants, suppliers or trucking companies.

3. The proposer, prior to proposing, made adequate good faith efforts to meet the goal.

D. A DBE joint venture partner must be responsible for specific contract items of work or clearly defined portions thereof. Responsibility means actually performing, managing, and supervising the work with its own forces. The DBE joint venture partner must share in the capital contribution, control, management, risks and profits of the joint venture commensurate with its ownership interest.

E. A DBE must perform a commercially useful function pursuant to 49 CFR 26.55, that is, a DBE firm must be responsible for the execution of a distinct element of the work and must carry out its responsibility by actually performing, managing and supervising the work.

F. The proposer shall list only one subconsultant for each portion of work as defined in their proposal and all DBE subconsultants should be listed in the bid/cost proposal list of subconsultants.

G. A prime consultant who is a certified DBE is eligible to claim all of the work in the Contract toward the DBE participation except that portion of the work to be performed by non-DBE subconsultants.

5. RESOURCES

A. The CUCP database includes the certified DBEs from all certifying agencies participating in the CUCP. If you believe a firm is certified that cannot be located on the database, please contact the Caltrans Office of Certification toll free number 1-866-810-6346 for assistance.

B. Access the CUCP database from the Department of Transportation, Office of Business and Economic Opportunity Web site at: http://www.dot.ca.gov/hq/bep/.

1. Click on the link in the left menu titled Disadvantaged Business Enterprise;

2. Click on Search for a DBE Firm link;

3. Click on Access to the DBE Query Form located on the first line in the center of the page.

Searches can be performed by one or more criteria. Follow instructions on the screen.

6. MATERIALS OR SUPPLIES PURCHASED FROM DBES COUNT TOWARDS THE DBE GOAL UNDER THE FOLLOWING CONDITIONS:

A. If the materials or supplies are obtained from a DBE manufacturer, count 100 percent of the cost of the materials or supplies. A DBE manufacturer is a firm that operates or maintains a factory, or establishment that produces on the premises the materials, supplies, articles, or equipment required under the Contract and of the general character described by the specifications.

B. If the materials or supplies purchased from a DBE regular dealer, count 60 percent of the cost of the materials or supplies. A DBE regular dealer is a firm that owns, operates or maintains a store, warehouse, or other establishment in which the materials, supplies, articles or equipment of the general character described by the specifications and required under the Contract are bought, kept in stock, and regularly sold or leased to the public in the usual course of business. To be a DBE regular dealer, the firm must be an established, regular business that engages, as its principal business and under its own name, in the


Page 3 of 3 LPP 13-01 May 8, 2013

purchase and sale or lease of the products in question. A person may be a DBE regular dealer in such bulk items as petroleum products, steel, cement, gravel, stone or asphalt without owning, operating or maintaining a place of business provided in this section.

C. If the person both owns and operates distribution equipment for the products, any supplementing of regular dealers’ own distribution equipment shall be, by a long-term lease agreement and not an ad hoc or Agreement-by-Agreement basis. Packagers, brokers, manufacturers’ representatives, or other persons who arrange or expedite transactions are not DBE regular dealers within the meaning of this section.

D. Materials or supplies purchased from a DBE, which is neither a manufacturer nor a regular dealer, will be limited to the entire amount of fees or commissions charged for assistance in the procurement of the materials and supplies, or fees or transportation charges for the delivery of materials or supplies required on the job site, provided the fees are reasonable and not excessive as compared with fees charged for similar services.

Local Assistance Procedures Manual EXHBIT 10-J Standard Contract Provisions for Subconsultant/DBE Participation

Page 1 of 3 LPP 13-01 May 8, 2013

EXHIBIT 10-J STANDARD CONTRACT PROVISIONS FOR SUBCONSULTANT/DBE PARTICIPATION

1. Subconsultants

A. Nothing contained in this Contract or otherwise, shall create any contractual relation between the Agency and any subconsultants, and no subcontract shall relieve the Consultant of his/her responsibilities and obligations hereunder. The Consultant agrees to be as fully responsible to the Agency for the acts and omissions of its subconsultants and of persons either directly or indirectly employed by any of them as it is for the acts and omissions of persons directly employed by the Consultant. The Consultant's obligation to pay its subconsultants is an independent obligation from the Agency's obligation to make payments to the Consultant.

B. Any subcontract in excess of $25,000, entered into as a result of this Contract, shall contain all the provisions stipulated in this Contract to be applicable to subconsultants.

C. Consultant shall pay its subconsultants within ten (10) calendar days from receipt of each payment made to the Consultant by the Agency.

D. Any substitution of subconsultants must be approved in writing by the Agency’s Contract Administrator in advance of assigning work to a substitute subconsultant.

2. Disadvantaged Business Enterprise (DBE) Participation

A. This Contract is subject to 49 CFR, Part 26 entitled “Participation by Disadvantaged Business Enterprises in Department of Transportation Financial Assistance Programs”. Proposers who obtain DBE participation on this contract will assist Caltrans in meeting its federally mandated statewide overall DBE goal.

B. If the contract has a DBE goal, the Consultant must meet the goal by committing DBE participation or document a good faith effort to meet the goal. If a DBE subconsultant is unable to perform, the Consultant must make a good faith effort to replace him/her with another DBE subconsultant, if the goal is not otherwise met. A DBE is a firm meeting the definition of a DBE as specified in 49 CFR.

C. DBEs and other small businesses, as defined in 49 CFR, Part 26 are encouraged to participate in the performance of contracts financed in whole or in part with federal funds. The Consultant or subconsultant shall not discriminate on the basis of race, color, national origin, or sex in the performance of this Contract. The Consultant shall carry out applicable requirements of 49 CFR, Part 26 in the award and administration of US DOT- assisted agreements. Failure by the Consultant to carry out these requirements is a material breach of this Contract, which may result in the termination of this Contract or such other remedy as the local agency deems appropriate.

D. Any subcontract entered into as a result of this Contract shall contain all of the provisions of this section.

E. A DBE may be terminated only with prior written approval from the local agency and only for the reasons specified in 49 CFR 26.53(f). Prior to requesting local agency consent for the termination, the prime consultant must meet the procedural requirements specified in 49 CFR 26.53(f).


Page 2 of 3 LPP 13-01 May 8, 2013

3. Performance of DBE Consultant and other DBE Subconsultants/Suppliers

A. A DBE performs a commercially useful function when it is responsible for execution of the work of the Contract and is carrying out its responsibilities by actually performing, managing, and supervising the work involved. To perform a commercially useful function, the DBE must also be responsible with respect to materials and supplies used on the Contract, for negotiating price, determining quality and quantity, ordering the material, and installing (where applicable) and paying for the material itself. To determine whether a DBE is performing a commercially useful function, evaluate the amount of work subcontracted, industry practices; whether the amount the firm is to be paid under the Contract is commensurate with the work it is actually performing; and other relevant factors.

B. A DBE does not perform a commercially useful function if its role is limited to that of an extra participant in a transaction, Contract, or project through which funds are passed in order to obtain the appearance of DBE participation. In determining whether a DBE is such an extra participant, examine similar transactions, particularly those in which DBEs do not participate.

C. If a DBE does not perform or exercise responsibility for at least 30 percent of the total cost of its Contract with its own work force, or the DBE subcontracts a greater portion of the work of the Contract than would be expected on the basis of normal industry practice for the type of work involved, it will be presumed that it is not performing a commercially useful function.

4. Prompt Payment of Funds Withheld to Subconsultants

A. Any subcontract entered into as a result of this Contract shall contain all of the provisions of this section.

(Local agency to include either B, C, or D below; delete the other two.)

B. No retainage will be withheld by the Agency from progress payments due the prime Consultant. Retainage by the prime Consultant or subconsultants is prohibited, and no retainage will be held by the prime Consultant from progress due subconsultants. Any violation of this provision shall subject the violating prime Consultant or subconsultants to the penalties, sanctions, and other remedies specified in Section 7108.5 of the California Business and Professions Code. This requirement shall not be construed to limit or impair any contractual, administrative, or judicial remedies, otherwise available to the prime Consultant or subconsultant in the event of a dispute involving late payment or nonpayment by the prime Consultant or deficient subconsultant performance, or noncompliance by a subconsultant. This provision applies to both DBE and non-DBE prime Consultants and subconsultants.

C. No retainage will be held by the Agency from progress payments due the prime Consultant. Any retainage held by the prime Consultant or subconsultants from progress payments due subconsultants shall be promptly paid in full to subconsultants within 30 days after the subconsultant’s work is satisfactorily completed. Federal law (49 CFR26.29) requires that any delay or postponement of payment over the 30 days may take place only for good cause and with the Agency’s prior written approval. Any violation of this provision shall subject the violating prime Consultant or subconsultant to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedies, otherwise available to the prime Consultant or subconsultant in the event of a dispute involving late payment or nonpayment by the prime consultant, deficient subconsultant performance, or noncompliance by a subconsultant. This provision applies to both DBE and non-DBE prime consultant and subconsultants.


Page 3 of 3 LPP 13-01 May 8, 2013

D. The Agency shall hold retainage from the prime consultant and shall make prompt and regular incremental acceptances of portions, as determined by the Agency, of the contract work, and pay retainage to the prime consultant based on these acceptances. The prime consultant, or subconsultant, shall return all monies withheld in retention from a subconsultant within 30 days after receiving payment for work satisfactorily completed and accepted including incremental acceptances of portions of the contract work by the agency. Federal law (49 CFR26.29) requires that any delay or postponement of payment over 30 days may take place only for good cause and with the agency’s prior written approval. Any violation of this provision shall subject the violating prime consultant or subconsultant to the penalties, sanctions and other remedies specified in Section 7108.5 of the Business and Professions Code. These requirements shall not be construed to limit or impair any contractual, administrative, or judicial remedies, otherwise available to the prime consultant or subconsultant in the event of a dispute involving late payment or nonpayment by the prime Consultant, deficient subconsultant performance, or noncompliance by a subconsultant. This provision applies to both DBE and non-DBE prime consultant and subconsultants.

5. DBE Records

A. The Consultant shall maintain records of materials purchased or supplied from all subcontracts entered into with certified DBEs. The records shall show the name and business address of each DBE or vendor and the total dollar amount actually paid each DBE or vendor, regardless of tier. The records shall show the date of payment and the total dollar figure paid to all firms. DBE prime consultants shall also show the date of work performed by their own forces along with the corresponding dollar value of the work.

B. Upon completion of the Contract, a summary of these records shall be prepared and submitted on the form entitled, “Final Report-Utilization of Disadvantaged Business Enterprise (DBE), First-Tier Subconsultants,” CEM-2402F (Exhibit 17-F, Chapter 17, of the LAPM), certified correct by the Consultant or the Consultant’s authorized representative and shall be furnished to the Contract Administrator with the final invoice. Failure to provide the summary of DBE payments with the final invoice will result in 25 percent of the dollar value of the invoice being withheld from payment until the form is submitted. The amount will be returned to the Consultant when a satisfactory “Final Report-Utilization of Disadvantaged Business Enterprises (DBE), First-Tier Subconsultants” is submitted to the Contract Administrator.

6. DBE Certification and Decertification Status

If a DBE subconsultant is decertified during the life of the Contract, the decertified subconsultant shall notify the Consultant in writing with the date of decertification. If a subconsultant becomes a certified DBE during the life of the Contract, the subconsultant shall notify the Consultant in writing with the date of certification. Any changes should be reported to the Agency’s Contract Administrator within 30 days.

F

EXHIBIT


REQUIRED CERTIFICATION BY CONSULTANT WITH PROPOSAL

Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort

Page 15-1 OB 12-04 June 29, 2012

EXHIBIT 15-H DBE INFORMATION —GOOD FAITH EFFORTS

DBE INFORMATION - GOOD FAITH EFFORTS Federal-aid Project No. ______________________________ Bid Opening Date ___________________ The County of Imperial established a Disadvantaged Business Enterprise (DBE) goal of _____% for this project. The information provided herein shows that a good faith effort was made. Lowest, second lowest and third lowest bidders shall submit the following information to document adequate good faith efforts. Bidders should submit the following information even if the “Local Agency Bidder DBE Commitment” form indicates that the bidder has met the DBE goal. This will protect the bidder’s eligibility for award of the contract if the administering agency determines that the bidder failed to meet the goal for various reasons, e.g., a DBE firm was not certified at bid opening, or the bidder made a mathematical error. Submittal of only the “Local Agency Bidder DBE Commitment” form may not provide sufficient documentation to demonstrate that adequate good faith efforts were made. The following items are listed in the Section entitled “Submission of DBE Commitment” of the Special Provisions:

A. The names and dates of each publication in which a request for DBE participation for this project was placed by the bidder (please attach copies of advertisements or proofs of publication):

Publications Dates of Advertisement

_________________________________________________________________ _________________________________________________________________ _________________________________________________________________

B. The names and dates of written notices sent to certified DBEs soliciting bids for this project and

the dates and methods used for following up initial solicitations to determine with certainty whether the DBEs were interested (please attach copies of solicitations, telephone records, fax confirmations, etc.):

Names of DBEs Solicited Date of Initial

Solicitation Follow Up Methods and Dates

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________

josecastaneda

Text Box

6

jenellguerrero

Typewritten Text

jenellguerrero

Typewritten Text

Exhibit 15-H Local Assistance Procedures Manual DBE Information -Good Faith Effort

Page 15-2 June 29, 2012 OB 12-04

C. The items of work which the bidder made available to DBE firms including, where appropriate,

any breaking down of the contract work items (including those items normally performed by the bidder with its own forces) into economically feasible units to facilitate DBE participation. It is the bidder's responsibility to demonstrate that sufficient work to facilitate DBE participation was made available to DBE firms.

Items of Work Bidder Normally

Performs Item (Y/N)

Breakdown of Items

Amount ($)

Percentage Of

Contract

______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

D. The names, addresses and phone numbers of rejected DBE firms, the reasons for the bidder's

rejection of the DBEs, the firms selected for that work (please attach copies of quotes from the firms involved), and the price difference for each DBE if the selected firm is not a DBE:

Names, addresses and phone numbers of rejected DBEs and the reasons for the bidder's rejection

of the DBEs: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Names, addresses and phone numbers of firms selected for the work above: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

E. Efforts made to assist interested DBEs in obtaining bonding, lines of credit or insurance, and any

technical assistance or information related to the plans, specifications and requirements for the work which was provided to DBEs:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

jenellguerrero

Typewritten Text

Local Assistance Procedures Manual Exhibit 15-H DBE Information - Good Faith Effort

Page 15-3 OB 12-04 June 29, 2012

F. Efforts made to assist interested DBEs in obtaining necessary equipment, supplies, materials or

related assistance or services, excluding supplies and equipment the DBE subcontractor purchases or leases from the prime contractor or its affiliate: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

G. The names of agencies, organizations or groups contacted to provide assistance in contacting,

recruiting and using DBE firms (please attach copies of requests to agencies and any responses received, i.e., lists, Internet page download, etc.):

Name of Agency/Organization Method/Date of Contact Results

____________________________________________________________________________________ ____________________________________________________________________________________

H. Any additional data to support a demonstration of good faith efforts (use additional sheets if

necessary): ______________________________________________________________________________ ______________________________________________________________________________

NOTE: USE ADDITIONAL SHEETS OF PAPER IF NECESSARY.

Local Assistance Procedures Manual EXHIBIT 10-O1 Consultant Proposal DBE Commitment

Page 1 of 2 LPP 13-01 May 8, 2013

EXHIBIT 10-O1 CONSULTANT PROPOSAL DBE COMMITMENT (Inclusive of all DBEs listed at bid proposal. Refer to instructions on the reverse side of this form)

Consultant to Complete this Section

1. Local Agency Name: ________________________________________________________________________________________ 2. Project Location: ___________________________________________________________________________________________ 3. Project Description: _________________________________________________________________________________________ 4. Consultant Name: __________________________________________________________________________________________ 5. Contract DBE Goal %: ________________

DBE Commitment Information 6. Description of Services to be Provided 7. DBE Firm

Contact Information 8. DBE Cert.

Number 9. DBE %

Local Agency to Complete this Section 16. Local Agency Contract Number: ________________________________________________

17. Federal-aid Project Number: ___________________________________________________

18. Proposed Contract Execution Date: ________________________

Local Agency certifies that all DBE certifications are valid and the information on this form is complete and accurate: _____________________________________________________________________________ 19. Local Agency Representative Name (Print)

___________________________________________________ ________________________

20. Local Agency Representative Signature 21. Date

___________________________________________________ ________________________ 22. Local Agency Representative Title 23. (Area Code) Tel. No.

10. Total % Claimed

___________ %

________________________________

11. Preparer’s Signature

________________________________ 12. Preparer’s Name (Print)

________________________________ 13. Preparer’s Title

____________ ___________________ 14. Date 15. (Area Code) Tel. No.

Distribution: (1) Original – Consultant submits to local agency with proposal (2) Copy – Local Agency files

Local Assistance Procedures Manual EXHIBIT 10-O1 Consultant Proposal DBE Commitment

Page 2 of 2 LPP 13-01 May 8, 2013

INSTRUCTIONS - CONSULTANT PROPOSAL DBE COMMITMENT

Consultant Section

The Consultant shall: 1. Local Agency Name – Enter the name of the local or regional agency that is funding the contract. 2. Project Location - Enter the project location as it appears on the project advertisement. 3. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab,

Overlay, Widening, etc.). 4. Consultant Name - Enter the consultant’s firm name. 5. Contract DBE Goal % - Enter the contract DBE goal percentage, as it was reported on the Exhibit 10-I Notice to Proposers

DBE Information form. See LAPM Chapter 10. 6. Description of Services to be Provided - Enter item of work description of services to be provided. Indicate all work to be

performed by DBEs including work performed by the prime consultant’s own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms.

7. DBE Firm Contact Information - Enter the name and telephone number of all DBE subcontracted consultants. Also, enter the prime consultant’s name and telephone number, if the prime is a DBE.

8. DBE Cert. Number - Enter the DBEs Certification Identification Number. All DBEs must be certified on the date bids are opened. (DBE subcontracted consultants should notify the prime consultant in writing with the date of the decertification if their status should change during the course of the contract.)

9. DBE % - Percent participation of work to be performed or service provided by a DBE. Include the prime consultant if the prime is a DBE. See LAPM Chapter 9 for how to count full/partial participation.

10. Total % Claimed – Enter the total DBE participation claimed. If the Total % Claimed is less than item “6. Contract DBE Goal”, an adequately documented Good Faith Effort (GFE) is required (see Exhibit 15-H DBE Information - Good Faith Efforts of the LAPM).

11. Preparer’s Signature – The person completing this section of the form for the consultant’s firm must sign their name. 12. Preparer’s Name (Print) – Clearly enter the name of the person signing this section of the form for the consultant. 13. Preparer’s Title - Enter the position/title of the person signing this section of the form for the consultant. 14. Date - Enter the date this section of the form is signed by the preparer. 15. (Area Code) Tel. No. - Enter the area code and telephone number of the person signing this section of the form for the

consultant.

Local Agency Section:

The Local Agency representative shall: 16. Local Agency Contract Number - Enter the Local Agency Contract Number. 17. Federal-Aid Project Number - Enter the Federal-Aid Project Number. 18. Contract Execution Date - Enter date the contract was executed and Notice to Proceed issued. See LAPM Chapter 10, page 23. 19. Local Agency Representative Name (Print) - Clearly enter the name of the person completing this section. 20. Local Agency Representative Signature - The person completing this section of the form for the Local Agency must sign their

name to certify that the information in this and the Consultant Section of this form is complete and accurate. 21. Date - Enter the date the Local Agency Representative signs the form. 22. Local Agency Representative Title - Enter the position/title of the person signing this section of the form. 23. (Area Code) Tel. No. - Enter the area code and telephone number of the Local Agency representative signing this section of the

form.

Local Assistance Procedures Manual EXHIBIT 10-H Sample Cost Proposal

Page 1 of 5 LPP 15-01 January 14, 2015

EXHIBIT 10-H SAMPLE COST PROPOSAL (EXAMPLE #1) Page 1 of 2

ACTUAL COST-PLUS-FIXED FEE OR LUMP SUM (FIRM FIXED PRICE) CONTRACTS (DESIGN, ENGINEERING AND ENVIRONMENTAL STUDIES)

Note: Mark-ups are Not Allowed

Consultant ____________________________________ Contract No. ______________ Date _______________ DIRECT LABOR

Classification/Title Name Hours Actual Hourly Rate Total

_______________ ____________________________ ________ $ _____________ $ _____________ _______________ ____________________________ ________ $ _____________ $ _____________ _______________ ____________________________ ________ $ _____________ $ _____________ _______________ ____________________________ ________ $ _____________ $ _____________ _______________ ____________________________ ________ $ _____________ $ _____________

LABOR COSTS a) Subtotal Direct Labor Costs $ _______________ b) Anticipated Salary Increases (see page 2 for sample) $ _______________ c) TOTAL DIRECT LABOR COSTS [(a) + (b)] $ _______________ FRINGE BENEFITS d) Fringe Benefits (Rate: ______) e) TOTAL FRINGE BENEFITS [(c) x (d)] $ _______________ INDIRECT COSTS f) Overhead (Rate: ______) g) Overhead [(c) x (f)] $ _______________ h) General and Administrative (Rate: ______) i) Gen & Admin [(c) x (h)] $ _______________ j) TOTAL INDIRECT COSTS [(e) + (g) + (i)] $ _______________ FEE (Profit) q) (Rate: ______) k) TOTAL FIXED PROFIT [(c) + (j)] x (q)]$ _______________ OTHER DIRECT COSTS (ODC)

Description Unit(s) Unit Cost Total l) Travel/Mileage Costs (supported by consultant actual costs) _____ $______ $______________ m) Equipment Rental and Supplies (itemize) _____ $______ $______________ n) Permit Fees (itemize), Plan sheets (each), Test Holes (each), etc. _____ $______ $______________ o) Subconsultant Costs (attach detailed cost proposal in same format as prime consultant estimate for each subconsultant) _____ $______ $______________ p) TOTAL OTHER DIRECT COSTS [(l) + (m) + (n) + (o)] $ _______________ TOTAL COST [(c) + (j) + (k) + (p)] $ _______________ NOTES: � Employees subject to prevailing wage requirements to be marked with an *. � ODC items should be based on actual costs and supported by historical data and other documentation. � ODC items that would be considered “tools of the trade” are not reimbursable. � ODC items should be consistently billed directly to all clients, not just when client will pay for them as a direct cost. � ODC items when incurred for the same purpose, in like circumstances, should not be included in any indirect cost pool or in

overhead rate.

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EXHIBIT 10-H SAMPLE COST PROPOSAL (EXAMPLE #1) Page 2 of 2

ACTUAL COST-PLUS-FIXED FEE OR LUMP SUM (FIRM FIXED PRICE) CONTRACTS

(SAMPLE CALCULATIONS FOR ANTICIPATED SALARY INCREASES)

Consultant ____________________________________ Contract No.______________ Date _______________

1. Calculate Average Hourly Rate for 1st year of the contract (Direct Labor Subtotal divided by total hours)

Direct Labor Subtotal per Cost

Proposal

Total Hours per Cost Proposal

Avg Hourly

Rate

5 Year Contract Duration

_______________ _______________ = Year 1 Avg Hourly Rate

2. Calculate hourly rate for all years (Increase the Average Hourly Rate for a year by proposed escalation %)

Avg Hourly Rate Proposed Escalation Year 1 _______________ + _______________ = _______________ ____________________ Year 2 _______________ + _______________ = _______________ ____________________ Year 3 _______________ + _______________ = _______________ ____________________ Year 4 _______________ + _______________ = _______________ ____________________

3. Calculate estimated hours per year (Multiply estimate % each year by total hours)

Estimated % Completed Each Year

Total Hours per Cost Proposal

Total Hours per Year

Year 1 _______________ * _______________ = ____________________ Year 2 _______________ * _______________ = ____________________ Year 3 _______________ * _______________ = ____________________ Year 4 _______________ * _______________ = ____________________ Year 5 _______________ * _______________ = ____________________

Total _______________ _______________ =

4. Calculate Total Costs including Escalation (Multiply Average Hourly Rate by the number of hours)

Avg Hourly Rate (calculated above)

Estimated hours (calculated above)

Cost per Year

Year 1 _______________ * _______________ = ____________________ Year 2 _______________ * _______________ = ____________________ Year 3 _______________ * _______________ = ____________________ Year 4 _______________ * _______________ = ____________________ Year 5 _______________ * _______________ = ____________________

Total Direct Labor Cost with Escalation = Direct Labor Subtotal before Escalation =

Estimated total of Direct Labor Salary Increase

=

Transfer to Page 1

NOTES: � This is not the only way to estimate salary increases. Other methods will be accepted if they clearly indicate the % increase, the #

of years of the contract, and a breakdown of the labor to be performed each year. � An estimation that is based on direct labor multiplied by salary increase % multiplied by the # of years is not acceptable.

(i.e. $250,000 x 2% x 5 yrs = $25,000 is not an acceptable methodology) � This assumes that one year will be worked at the rate on the cost proposal before salary increases are granted.

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EXHIBIT 10-H SAMPLE COST PROPOSAL (EXAMPLE #3) COST PER UNIT OF WORK CONTRACTS

(GEOTECHNICAL AND MATERIAL TESTING)Note: Mark-ups are Not Allowed

Consultant ____________________________________ Contract No.______________ Date ______________

Page ___ of ___

Unit/Item of Work: (Example: Log of Test Boring for Soils Report, or ADL Testing for Hazardous Waste Material Study) Include as many Items as necessary.

DIRECT LABOR Hours Hourly Total ($) Billing Rate ($)

Professional (Classification) _________ _________ _________

Sub-professional/Technical* _________ _________ _________

EQUIPMENT (with Operator) _________ _________ _________

OTHER DIRECT COST

Description Unit(s) Unit Cost

Mobilization/De-mobilization _____ $________ _________

Supplies/Consumables (Itemize) ______ $_________ _________

Travel/Mileage ______ $_________ _________

Report (if applicable) ______ $_________ _________

TOTAL COST PER UNIT OF WORK _________

NOTES: � Denote labor subject to prevailing wage with asterisk (*). � Hourly billing rates should include prevailing wage rates and be consistent with publicly advertised rates charged to all clients

(Commercial, Private or Public). � Hourly billing rates include hourly wage rate, net fee/profit, indirect cost rate, and actual direct equipment rate. � Mobilization/De-mobilization is based on site location and number and frequency of tests/items. � ODC items should be based on actual costs and supported by historical data and other documentation.� ODC items that would be considered “tools of the trade” are not reimbursable.

$ 0.00

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$ 0.00

$ 0.00

$ 0.00

$ 0.00

$ 0.00

$ 0.00

Local Assistance Procedures Manual EXHIBIT 10-P Nonlobbying Certification for Federal-aid Contracts

Page1 of 1

LPP 13-01 May 8, 2013

EXHIBIT 10-P NONLOBBYING CERTIFICATION FOR FEDERAL-AID CONTRACTS

The prospective participant certifies by signing and submitting this proposal/bid to the best of his or her knowledge and belief that:

(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than federal appropriated funds have been paid or will be paid to any person

for influencing or attempting to influence an officer or employee of any federal agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. The prospective participant also agrees by submitting his/her proposal/bid that he/she shall require that the language of this certification be included in all lower-tier subcontracts which exceed $100,000 and that all such sub-recipients shall certify and disclose accordingly.

Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities

Page 1 LPP 13-01 May 8, 2013

EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES COMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 1352

1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:

a. contract

a. bid/offer/application

a. initial

b. grant b. initial award b. material change c. cooperative agreement c. post-award d. loan For Material Change Only: e. loan guarantee year ____ quarter _________ f. loan insurance date of last report ___________

4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee, Enter Name and Address of Prime: Prime Subawardee Tier _______ , if known Congressional District, if known Congressional District, if known

6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number, if applicable ____________________

8. Federal Action Number, if known: 9. Award Amount, if known:

10. Name and Address of Lobby Entity 11. Individuals Performing Services (including (If individual, last name, first name, MI) address if different from No. 10a) (last name, first name, MI) (attach Continuation Sheet(s) if necessary)

12. Amount of Payment (check all that apply) 14. Type of Payment (check all that apply)

$ _____________ actual planned a. retainer b. one-time fee 13. Form of Payment (check all that apply): c. commission a. cash d. contingent fee b. in-kind; specify: nature ______________ e deferred Value _____________ f. other, specify __________________________

15. Brief Description of Services Performed or to be performed and Date(s) of Service, including officer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11: (attach Continuation Sheet(s) if necessary)

16. Continuation Sheet(s) attached: Yes No

17. Information requested through this form is authorized by Title 31 U.S.C. Section 1352. This disclosure of lobbying reliance was placed by the tier above when his transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be reported to Congress semiannually and will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

Signature: _________________________________________ Print Name: _______________________________________ Title: ____________________________________________ Telephone No.: ____________________ Date: ___________

Authorized for Local Reproduction

Federal Use Only: Standard Form - LLL

Standard Form LLL Rev. 04-28-06

Distribution: Orig- Local Agency Project Files

Local Assistance Procedures Manual EXHBIT 10-Q Disclosure of Lobbying Activities

Page 2 LPP 13-01 May 8, 2013

INSTRUCTIONS FOR COMPLETING EXHIBIT 10-Q DISCLOSURE OF LOBBYING ACTIVITIES

This disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient at the initiation or receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filing of a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee of a Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information if the space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of Management and Budget for additional information.

1. Identify the type of covered federal action for which lobbying activity is or has been secured to influence, the outcome of a covered federal action.

2. Identify the status of the covered federal action.

3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to the information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last, previously submitted report by this reporting entity for this covered federal action.

4. Enter the full name, address, city, state, and zip code of the reporting entity. Include Congressional District if known. Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime or subaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier. Subawards include but are not limited to: subcontracts, subgrants, and contract awards under grants.

5. If the organization filing the report in Item 4 checks "Subawardee" then enter the full name, address, city, state, and zip code of the prime federal recipient. Include Congressional District, if known.

6. Enter the name of the federal agency making the award or loan commitment. Include at least one organization level below agency name, if known. For example, Department of Transportation, United States Coast Guard.

7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.

8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g., Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant. or loan award number, the application/proposal control number assigned by the federal agency). Include prefixes, e.g., "RFP-DE-90-001."

9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter the federal amount of the award/loan commitments for the prime entity identified in item 4 or 5.

10. Enter the full name, address, city, state, and zip code of the lobbying entity engaged by the reporting entity identified in Item 4 to influence the covered federal action.

11. Enter the full names of the individual(s) performing services and include full address if different from 10 (a). Enter Last Name, First Name and Middle Initial (Ml).

12. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned to be made.

13. Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment.

14. Check all boxes that apply. If other, specify nature.

15. Provide a specific and detailed description of the services that the lobbyist has performed or will be expected to perform and the date(s) of any services rendered. Include all preparatory and related activity not just time spent in actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s) employee(s) or Member(s) of Congress that were contacted.

16. Check whether or not a continuation sheet(s) is attached.

17. The certifying official shall sign and date the form, and print his/her name title and telephone number.

Public reporting burden for this collection of information is estimated to average 30-minutes per response, including time for reviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0046), Washington, D.C. 20503. SF-LLL-Instructions Rev. 06-04

Local Assistance Procedures Manual EXHIBIT 10-V Non-Discrimination Clause

Page 1 of 1 LPP 13-01 May 8, 2013

EXHIBIT 10-V NON-DISCRIMINATION CLAUSE (To be included in Consultant Contract)

NON-DISCRIMINATION CLAUSE

During the performance of this Contract, Consultant and its subconsultant shall not unlawfully discriminate, harass, or allow harassment against any employee or applicant for employment because of sex, race, color, ancestry, religious creed, national origin, physical disability (including HIV and AIDS), mental disability, medical condition (e.g., cancer), age (over 40), marital status, and denial of family care leave. Consultant and subconsultants shall insure that the evaluation and treatment of their employees and applicants for employment are free from such discrimination and harassment. Consultant and subconsultants shall comply with the provisions of the Fair Employment and Housing Act (Gov. Code §12990 (a-f) et seq.) and the applicable regulations promulgated thereunder (California Code of Regulations, Title 2, Section 7285 et seq.). The applicable regulations of the Fair Employment and Housing Commission implementing Government Code Section 12990 (a-f), set forth in Chapter 5 of Division 4 of Title 2 of the California Code of Regulations, are incorporated into this Contract by reference and made a part hereof as if set forth in full. Consultant and its subconsultants shall give written notice of their obligations under this clause to labor organizations with which they have a collective bargaining or other Agreement.

Consultant shall include the nondiscrimination and compliance provisions of this clause in all subcontracts to perform work under the Contract.

Local Assistance Procedures Manual EXHIBIT 12-E PS&E Checklist Instructions

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EXHIBIT 12-E PS&E CHECKLIST INSTRUCTIONS The PS&E Checklist is to be completed by the local agency in accordance with the following instructions and attached to the PS&E Certification. I. HIGHWAY SYSTEM AND FUNCTIONAL CLASSIFICATION

A. National Highway System

Some PS&E requirements depend on the whether the project is on or off the National Highway System (NHS). For FHWA approved NHS maps, see http://www.fhwa.dot.gov/planning/national_highway_system/nhs_maps/

B. Functional Classification

Federal-aid eligibility, design standards as well as some PS&E requirements depend on the functional classification of the route the project is on. For more guidance see FHWA’s Guidance for the Functional Classification of Highways Website at: http://www.fhwa.dot.gov/policy/ohpi/hpms/fchguidance.cfm.

II. PROJECT SCOPE OF WORK

Scope of work in the PS&E must be consistent with that identified in the original scoping document or application. Otherwise, appropriate approvals must have been obtained.

III. TYPE OF CONSTRUCTION

Design standards as well as some oversight responsibilities depend on the type of construction. See Section 11.1 of the LAPM for definitions.

IV. METHOD OF CONSTRUCTION

A. Contracting Method

Unless justified by a Public Interest Finding (Exhibit 12-F Request for Approval of Cost- Effectiveness/Public Interest Finding), all Federal-aid construction contracts must be awarded to the lowest responsible bidder of a competitive bid process. See Section 12.4 Method of Construction of the LAPM for additional information.

B. Force Account (Day Labor)

A PIF (See Section 12.4 Method of Construction in the LAPM and Exhibit 12-F Request for Approval of Cost-Effectiveness/Public Interest Finding) must justify any force account construction work performed by the local agency. Check the appropriate boxes and process the PIF as required.

V. ENVIRONMENTAL ANALYSIS

The preparation of PS&E must reflect findings of the environmental analysis performed for the project. By checking the box, the agency certifies that the necessary actions called for by the environmental documents have been responded to in the PS&E. Failure to check the box will result in denial of the Request for Authorization. (See Section 12.3 Environmental Procedures of the LAPM for additional guidance).

VI. VALUE ENGINEERING ANALYSIS (VA)

A value engineering analysis is required for: (1) all Federal-aid highway projects on the NHS with a total estimated project cost of $50 million or more, and (2) all bridge projects on the NHS with a total estimated project cost of $40 million or more. (See Section 12.5 Value Engineering Analysis of the LAPM for additional guidance).

http://www.fhwa.dot.gov/planning/national_highway_system/nhs_maps/

http://www.fhwa.dot.gov/policy/ohpi/hpms/fchguidance.cfm


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OB 13-06 August 12, 2013

VII. GEOMETRIC DESIGN STANDARDS

If the project does not change existing geometrics, Section A and B do not apply and the local agency is not required to check any boxes in these sections. See Chapter 11 of the LAPM for additional guidance on geometric design standards.

A. Geometric Design Standards Used

New and reconstruction projects on the NHS shall be designed in accordance with Standards as defined in the current edition of A Policy on Geometric Design of Highways and Streets, published by the American Association of State Highway and Transportation Officials (AASHTO). The minimum standards for geometric design of local Federal-aid resurfacing, restoration and rehabilitation (3R) projects on the NHS are shown in Exhibit 11-A. Local geometric design standards that have been developed for use on locally funded new and reconstruction, or 3R projects off the NHS, may be used subject to the conditions listed in Chapter 11, “Design Standards.” Check appropriate box only if this section applies.

B. Deviations from Controlling Criteria

The controlling criteria listed are considered to be of primary importance for highway safety, and deviations require design exception approval procedures as described in Chapter 11, “Design Standards,” and Section 12.7 “Plans” of the LAPM. Check whether the criteria have been met on this project. If a design exception has been approved, indicate the approval date. Documentation shall be retained in the project files.

VIII. BRIDGE DESIGN PROCEDURES

All bridges shall be designed in accordance with the current edition of the Caltrans Bridge Design Specifications Manual and the latest California Amendments to the AASHTO LRFD Bridge Design Specifications. Check if requirement met, or if the project does not include any bridge construction indicate requirement does not apply.

IX. STANDARD PLANS

For projects off the State Highway System, the local agency may use Caltrans Standard Plans, Standard Plans for Public Works Construction, or subject to the conditions described in Section 11.3 Locally Developed Design Standards and Section 12.7 Plans of the LAPM.

X. PROJECT PLANS AND SPECIFICATIONS

Project plans and specifications shall be signed and stamped on behalf of the local agency by the person in responsible charge and who is a registered professional engineer licensed to practice in the State of California. (See Section 12.7 Plans of the LAPM).

A traffic control plan shall be included in the PS&E for all Federal-aid highway construction projects. Check boxes to indicate requirements are met. Failure to check both boxes will result in denial of the Request for Authorization.

Erosion control plans may be required, see Section 12.7 Plans, in the LAPM. If required, check box.

Whenever applicable, project plans and specifications will need to comply with the federal Americans with Disabilities Act (ADA) requirements 28 CFR, Part 35 or Part 36, and the California and Local Building Codes within the project limits. In accordance with 28 CFR Sec. 35.151, curbs ramps must meet current ADA standards if the project includes streets that are to be newly constructed or altered (includes repaving). For ADA requirements, see Chapter 11 “Design Standards,” and Section 12.7 of this chapter. If ADA requirements apply and will be complied with, check box.


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OB 13-06 August 12, 2013

XI. STANDARD SPECIFICATIONS

For projects off the State Highway System, the local agency may use Caltrans Standard Specifications, the Standard Specifications for Public Works Construction, or subject to the conditions described in Section 11.3 Locally Developed Design Standards of the LAPM.

XII. FEDERAL REQUIREMENTS

A. Required Federal Contract Provisions - Ensure Exhibit 12-G Required Federal-aid Contract Language or equivalent provisions are in the contract. Provide page numbers if not using Caltrans 2010 Standard Specifications and Revised Standard Specifications (RSS). RSS must be included in your contract special provisions.

Provisions for liquidated damages shall be included in all Federal-aid contracts on the NHS (see Chapter 12 Plans, Specifications & Estimate of the LAPM for requirements.

Current Buy America regulations are discussed in Section 12.8 Federal Contract Requirements of the LAPM. Buy America requirements do not apply to minimal use of the material such that the cost, delivered to the project site, is less than $2,500 or one-tenth-of-one-percent of the contract amount, whichever is greater. Buy America applies if federal dollars are used on any phase of the project.

Chapter 12 Plans, Specifications & Estimate of the LAPM includes information for On-the-Job Training.

B. DBE Goal

Individual DBE contract goals will be established. Complete evaluation documentation is required and shall be retained for each contract (see DBE references in the LAPM).

In some cases, the contract DBE goal may be zero due to the extremely limited subcontracting opportunities for DBEs, the lack of certified DBEs willing to work in the geographic area in which work is to be performed, or other reasons. Documentation is required verifying that the local agency has determined that a zero percent DBE goal is appropriate. Documentation must be based on the DBE contract goal methodology with the specific project-related work codes and DBEs highlighted. In some cases there may be no contract goal (which is different than zero percent goal) if, for example, the contract is sole-source or non-profit.

C. Certification/Disclosures

The certification and disclosure forms listed in Exhibit H Sample Bid shall be included in all Federal-aid projects. Except for the Disclosure of Lobbying form and instructions, equivalent provisions may be used. See Section 12.8 Federal Contract Requirements of the LAPM for more information.

D. Other Required Forms

Two forms, or their equivalents, relating to subcontractors must be included as part of the bid package. - Exhibits 15-G Local Agency Bidder DBE Commitment (Construction Contracts, and 12-B Bidder’s List of Subcontractors (DBE and Non-DBE). Exhibit 15-H DBE Information - Good Faith Efforts must also be part of the bid package if the DBE goal was not met.

E. Federal Wage Rates

If payment of federal predetermined wages are required per instructions in Subparagraph B.2.a “Section IV. Payment of Predetermined Wages,” they shall be physically incorporated into the final contract documents and in all related subcontracts signed by the local agency and the contractor.

Check appropriate box (i.e., Federal Wage Rates are included in the contract advertising package, referenced by the Internet Web site address, or not required) and indicate page number if applicable.

It must be emphasized that if the Internet Web site address is used in the advertising package, the final contract package upon signed by the local agency and the contractor, must physically contain the Federal Wage Rates or the Federal Wage rates as revised by addendums, if any addendums were issued.


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OB 13-06 August 12, 2013

By checking the box the local agency is indicating that they are aware of the Federal-aid “10-day rule” for federal wage rates. See Section 12.9 Required Federal Contract Provisions – Federal Wage Rates for local agency requirements under the “10-day rule.”

F. Relations with Railroad

Where construction of a Federal-aid project requires use of railroad properties or adjustments to railroad facilities, there shall be an agreement in writing between the local agency and the railroad company. The pertinent portions of the agreement applicable to any protective services required during performance of the work shall be included in the project specifications and special provisions.

Check appropriate box (i.e., provisions are included or not required). If provisions are included, indicate page number.

XIII. RESTRICTED CONTRACT PROVISIONS

Unless otherwise noted, see Section 12.10 of Chapter 12 for detailed guidance.

A. INDIAN PREFERENCES

Generally, local agencies may not use local hiring practices. However, SAFETEA-LU permits an Indian employment preference provision for projects on or near Indian reservations or Indian lands. Check the appropriate box.

B. BONDING AND PREQUALIFICATION

Bonding and prequalification procedures are not required for Federal-aid projects. However, any procedures or requirements for bonding, insurance, prequalification, qualification, or licensing of contractors shall not be used which may operate to restrict competition, prevent submission of a bid by or prohibit consideration of a bid submitted by any responsible contractor, whether a resident or nonresident of California. Check appropriate boxes, and if bonding and/or prequalification are used, check the last box to indicate the requirement will be met.

C. PRICE ADJUSTMENT CLAUSES

Price adjustment clauses may be implemented if certain conditions are met. If these clauses are used, the local agency must provide documentation of the required conditions in the project files. Check the appropriate box.

D. WARRANTY CLAUSES

Warranty clauses may be implemented if the conditions described in Section 12.12 of Chapter 12 are met. The local agency must provide documentation of the required conditions in the project files. Check the appropriate box.

E. PROPRIETARY ITEMS

The use of proprietary items is restricted as described in Section 12.12 in Chapter 12. If the use does not meet these restrictions, a Public Interest Finding justifying the use must be approved by the local agency and documented in the project files. Check the appropriate box.

XIV. MATERIALS AND EQUIPMENT

Unless otherwise noted, see Section 12.12 of Chapter 12 for details.

A. Publicly Owned Equipment (for use by Contractor)

The use of publicly owned equipment on a project going to bid must be justified with a Public Interest Finding. The local agency may approve the use provided it meets conditions described in Chapter 12. Check the appropriate box.


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OB 13-06 August 12, 2013

B. Equipment Purchases for Local Ownership

The cost of equipment purchased by the local agency or by the contractor with ownership transferred to the local agency for construction engineering is limited. Check the appropriate box.

C. Convict Produced Materials

Materials produced by convict labor may be used on any Federal-aid project if they meet certain conditions.

Check appropriate box.

D. Local Agency Furnished Materials

The use of local agency furnished materials not acquired on the basis of competitive bidding must be supported by a Public Interest Finding justifying the use (see Section 12.13 of Chapter 12). The justification must be approved by the local agency and documented in the project files. If these materials are included, check the appropriate box indicating the method of acquisition.

XV. PRELIMINARY ESTIMATE

An estimate of the contract items of work must be prepared in a format which describes the items of work, unit amount, quantity, unit price, amount, a subtotal, contingencies and a total (Exhibit 12-A Preliminary Estimate of Cost or equivalent). The estimate must be broken down into items sufficient in detail to meet the stated requirements. Check boxes if these requirements are met.

If the project is funded with more than one type of Federal-aid it must be segregated by fund types (see Chapter 3, “Project Authorization,” of the LAPM). Check box if this requirement is met.

XVI. MAJOR PROJECTS WITH TOTAL COSTS EXPECTED TO EXCEED $100 MILLION OR $500 MILLION

The federal SAFETEA-LU requires that a local agency receiving an amount of federal financial assistance for “major” projects with an estimated total cost exceeding $100 million must have a financial plan and projects exceeding $500 million must also have a project management plan. For details of the required submittal and approval of these two plans, which are required for all “major” projects exceeding the two estimated total costs, refer to Chapter 2 “Roles and Responsibilities” of the LAPM .

XVII. LOCAL AGENCY SIGNATURE

The Federal Contract Provisions Checklist shall be signed by the person preparing the contract specifications. The checklist shall be signed even if prepared by the same person who will sign the PS&E Certification.

XVIII. CALTRANS ACCEPTANCE

Caltrans will indicate the appropriate acceptance statement based on the type of review, as described in Chapter 12, “Plans, Specifications & Estimate,” of the LAPM and sign the bottom o

G

EXHIBIT


REQUIRED CERTIFICATION BY CONSULTANT AFTER CONTRACT EXECUTION

Local Assistance Procedures Manual EXHBIT 10-F Certification of Consultant, Commissions & Fees

Page 1 of 1 LPP 13-01 May 8, 2013

EXHIBIT 10-F CERTIFICATION OF CONSULTANT, COMMISSIONS & FEES

I HEREBY CERTIFY that I am the , and duly authorized representative of the firm of , whose address is , and that, except as hereby expressly stated, neither I nor the above firm that I represent have: (a) employed or retained for a commission, percentage, brokerage, contingent fee, or other consideration,

any firm or person (other than a bona fide employee working solely for me or the above consultant) to solicit or secure this contract; nor (b) agreed, as an express or implied condition for obtaining this contract, to employ or retain the services of any firm or person in connection with carrying out the contract; nor (c) paid, or agreed to pay, to any firm, organization or person (other than a bona fide employee working solely for me or the above consultant) any fee, contribution, donation, or consideration of any kind, for or in connection with, procuring or carrying out this contract.

I acknowledge that this Certificate is to be made available to the California Department of Transportation (Caltrans) in connection with this contract involving participation of federal-aid highway funds, and is subject to applicable state and federal laws, both criminal and civil.

(Date) (Signature) Distribution: 1) Local Agency Project File (Original & Contract)

2) DLAE (with contract copy)

Local Assistance Procedures Manual EXHIBIT 10-O2 Consultant Contract DBE Information

Page 1 of 2

LPP 13-01 May 8, 2013

EXHIBIT 10-O2 CONSULTANT CONTRACT DBE INFORMATION (Inclusive of all DBEs listed at contract award. Refer to instructions on the reverse side of this form)

Consultant to Complete this Section

1. Local Agency Name: ________________________________________________________________________________________ 2. Project Location: ___________________________________________________________________________________________ 3. Project Description: _________________________________________________________________________________________ 4. Total Contract Award Amount: $ ______________________ 5. Consultant Name: __________________________________________________________________________________________ 6. Contract DBE Goal %: ________________ 7. Total Dollar Amount for all Subconsultants: $ ______________________ 8. Total Number of all Subconsultants: _______________

Award DBE/DBE Information 9. Description of Services to be Provided 10. DBE/DBE Firm

Contact Information 11. DBE Cert.

Number 12. DBE Dollar Amount

Local Agency to Complete this Section 20. Local Agency Contract Number: ________________________________________________ 21. Federal-aid Project Number: ___________________________________________________ 22. Contract Execution Date: ________________________

Local Agency certifies that all DBE certifications are valid and the information on this form is complete and accurate:

_____________________________________________________________________________ 23. Local Agency Representative Name (Print)

___________________________________________________ ________________________ 24. Local Agency Representative Signature 25. Date ___________________________________________________ ________________________ 26. Local Agency Representative Title 27. (Area Code) Tel. No.

13. Total Dollars Claimed

$ ___________

14. Total % Claimed

__________ %

________________________________

15. Preparer’s Signature

________________________________ 16. Preparer’s Name (Print)

________________________________ 17. Preparer’s Title

____________ ___________________ 18. Date 19. (Area Code) Tel. No.

Caltrans to Complete this Section Caltrans District Local Assistance Engineer (DLAE) certifies that this form has been reviewed for completeness:

___________________________ _______________________________ ______________ 28. DLAE Name (Print) 29. DLAE Signature 30. Date

Distribution: (1) Copy – Email a copy to the Caltrans District Local Assistance Engineer (DLAE) within 30 days of contract award. Failure to send a copy to the DLAE within 30 days of contract award may result in delay of payment.

(2) Copy – Include in award package sent to Caltrans DLAE (3) Original – Local agency files

Local Assistance Procedures Manual EXHIBIT 10-O2 Consultant Contract DBE Information

Page 2 of 2

LPP 13-01 May 8, 2013

INSTRUCTIONS - CONSULTANT CONTRACT AWARD DBE INFORMATION

Consultant Section

The Consultant shall: 1. Local Agency Name – Enter the name of the local or regional agency that is funding the contract. 2. Project Location - Enter the project location as it appears on the project advertisement. 3. Project Description - Enter the project description as it appears on the project advertisement (Bridge Rehab, Seismic Rehab,

Overlay, Widening, etc). 4. Total Contract Award Amount - Enter the total contract award dollar amount for the prime consultant. 5. Consultant Name - Enter the consultant’s firm name. 6. Contract DBE Goal % - Enter the contract DBE goal percentage, as it was reported on the Exhibit 10-I Notice to Proposers

DBE Information form. See LAPM Chapter 10. 7. Total Dollar Amount for all Subconsultants – Enter the total dollar amount for all subcontracted consultants. SUM = (DBE’s +

all Non-DBE’s). Do not include the prime consultant information in this count. 8. Total number of all subconsultants – Enter the total number of all subcontracted consultants. SUM = (DBE’s + all Non-

DBE’s). Do not include the prime consultant information in this count. 9. Description of Services to be Provided - Enter item of work description of services to be provided. Indicate all work to be

performed by DBEs including work performed by the prime consultant’s own forces, if the prime is a DBE. If 100% of the item is not to be performed or furnished by the DBE, describe the exact portion to be performed or furnished by the DBE. See LAPM Chapter 9 to determine how to count the participation of DBE firms.

10. DBE Firm Contact Information - Enter the name and telephone number of all DBE subcontracted consultants. Also, enter the prime consultant’s name and telephone number, if the prime is a DBE.

11. DBE Cert. Number - Enter the DBE’s Certification Identification Number. All DBEs must be certified on the date bids are opened. (DBE subcontracted consultants should notify the prime consultant in writing with the date of the decertification if their status should change during the course of the contract.)

12. DBE Dollar Amount - Enter the subcontracted dollar amount of the work to be performed or service to be provided. Include the prime consultant if the prime is a DBE, and include DBEs that are not identified as subconsultants on the Exhibit 10-O1 Consultant Proposal DBE Commitment form. See LAPM Chapter 9 for how to count full/partial participation.

13. Total Dollars Claimed – Enter the total dollar amounts for column 13. 14. Total % Claimed – Enter the total DBE participation claimed for column 13. SUM = (item “14. Total Participation Dollars

Claimed” divided by item “4. Total Contract Award Amount”). If the Total % Claimed is less than item “6. Contract DBE Goal”, an adequately documented Good Faith Effort (GFE) is required (see Exhibit 15-H DBE Information - Good Faith Efforts of the LAPM).

15. Preparer’s Signature – The person completing this section of the form for the consultant’s firm must sign their name. 16. Preparer’s Name (Print) – Clearly enter the name of the person signing this section of the form for the consultant. 17. Preparer’s Title - Enter the position/title of the person signing this section of the form for the consultant. 18. Date - Enter the date this section of the form is signed by the preparer. 19. (Area Code) Tel. No. - Enter the area code and telephone number of the person signing this section of the form for the

consultant.

Local Agency Section:

The Local Agency representative shall: 20. Local Agency Contract Number - Enter the Local Agency Contract Number. 21. Federal-Aid Project Number - Enter the Federal-Aid Project Number. 22. Contract Execution Date - Enter the date the contract was executed and Notice to Proceed issued. See LAPM Chapter 10, page

23. 23. Local Agency Representative Name (Print) - Clearly enter the name of the person completing this section. 24. Local Agency Representative Signature - The person completing this section of the form for the Local Agency must sign their

name to certify that the information in this and the Consultant Section of this form is complete and accurate. 25. Date - Enter the date the Local Agency Representative signs the form. 26. Local Agency Representative Title - Enter the position/title of the person signing this section of the form. 27. (Area Code) Tel. No. - Enter the area code and telephone number of the Local Agency representative signing this section of the

form.

Caltrans Section:

Caltrans District Local Assistance Engineer (DLAE) shall: 28. DLAE Name (Print) – Clearly enter the name of the DLAE. 29. DLAE Signature – DLAE must sign this section of the form to certify that it has been reviewed for completeness. 30. Date - Enter the date that the DLAE signs this section the form.

(DBE), FIRST-TIER SUBCONTRACTORS

Local Assistance Procedures Manual EXHIBIT 17-F Final Report-Utilization of Disadvantaged Business Enterprises (DBE), First-Tier Subcontractors

STATE OF CALIFORNIA - DEPARTMENT OF TRANSPORTATION FINAL REPORT-UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES ADA Notice

For individuals with sensory disabilities, this document is available in alternate formats. For information call (916) 654-6410 or TDD (916) 654-3880 or write Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814

CEM-2402F (REV 02/2008)

CONTRACT NUMBER COUNTY ROUTE POST MILES FEDERAL AID PROJECT NO. ADMINISTERING AGENCY CONTRACT COMPLETION DATE

PRIME CONTRACTOR BUSINESS ADDRESS ESTIMATED CONTRACT AMOUNT $

ITE M

NO.

DESCRIPTION OF WORK PERFORMED

AND MATERIAL PROVIDED

COMPANY NAME AND BUSINESS ADDRESS

DBE CERT. NUMBER

CONTRACT PAYMENTS

NON-DBE DBE DATE WORK COMPLETE

DATE OF FINAL PAYMENT

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

ORIGINAL COMMITMENT

$

TOTAL $ $

DBE

List all First-Tier Subcontractors, Disad

of work) was different than that approve

vantaged Business Enterprises (DBEs) regardless of tier, whether or not the firms were originally listed for goal credit. If actual DBE utilization (or item d at time of award, provide comments on back of form. List actual amount paid to each entity.

I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT CONTRACTOR REPRESENTATIVE'S SIGNATURE BUSINESS PHONE NUMBER DATE

TO THE BEST OF MY INFORMATION AND BELIEF, THE ABOVE INFORMATION IS COMPLETE AND CORRECT

RESIDENT ENGINEER'S SIGNATURE BUSINESS PHONE NUMBER DATE

Copy Distribution-Caltrans contracts: Original - District Construction Copy- Business Enterprise Program Copy- Contractor Copy Resident Engineer

Copy Distribution-Local Agency contracts: Original - District Local Assistance Engineer (submitted with the Report of Expenditure

Copy- District Local Assistance Engineer Copy- Local Agency file

Page 17-21 LPP 09-02 July 1, 2012

jenellguerrero

Typewritten Text

EXHIBIT 17-F Local Assistance Procedures Manual Final Report-Utilization of Disadvantaged Business Enterprises (DBE), First-Tier Subcontractors

FINAL REPORT – UTILIZATION OF DISADVANTAGED BUSINESS ENTERPRISES (DBE), FIRST-TIER SUBCONTRACTORS CEM 2402(F) (Rev. 02/2008)

The form requires specific information regarding the construction project: Contract Number, County, Route, Post Miles, Federal-aid Project No., the Administering Agency, the Contract Completion Date and the Estimated Contract Amount. It requires the prime contractor name and business address. The focus of the form is to describe who did what by contract item number and descriptions, asking for specific dollar values of item work completed broken down by subcontractors who performed the work both DBE and non-DBE work forces. DBE prime contractors are required to show the date of work performed by their own forces along with the corresponding dollar value of work.

The form has a column to enter the Contract Item No. (or Item No's) and description of work performed or materials provided, as well as a column for the subcontractor name and business address. For those firms who are DBE, there is a column to enter their DBE Certification Number. The DBE should provide their certification number to the contractor and notify the contractor in writing with the date of the decertification if their status should change during the course of the project. The form has six columns for the dollar value to be entered for the item work performed by the subcontractor.

The Non-DBE column is used to enter the dollar value of work performed for firms who are not certified DBE.

The decision of which column to be used for entering the DBE dollar value is based on what program(s) status the firm is certified. This program status is determined by the California Unified Certification Program by ethnicity, gender, ownership, and control issues at time of certification. To confirm the certification status and program status, access the Department of Transportation Civil Rights web site at: http://www.dot.ca.gov/hq/bep or by calling (916) 324-1700 or the toll free number at (888) 810-6346.

Based on this DBE Program status, the following table depicts which column to be used:

DBE Program Status Column to be used

If program status shows DBE only with no other programs listed DBE

If a contractor performing work as a DBE on the project becomes decertified and still performs work after their decertification date, enter the total dollar value performed by this contractor under the appropriate DBE identification column.

If a contractor performing work as a non-DBE on the project becomes certified as a DBE, enter the dollar value of all work performed after certification as a DBE under the appropriate identification column.

Enter the total of each of the six columns in Form CEM-2402(F).

Any changes to DBE certification must also be submitted on Form-CEM 2403(F).

Enter the Date Work Completed as well as the Date of Final Payment (the date when the prime contractor made the “final payment” to the subcontractor for the portion of work listed as being completed).

The contractor and the resident engineer sign and date the form indicating that the information provided is complete and correct.

Page 17-22 July 1, 2012 LPP 09-02

CONTRACT ITEM NO.

SUBCONTRACT NAME AND

BUSINESS ADDRESS BUSINESS

PHONE

CERTIFICATION NUMBER AMOUNT PAID WHILE

CERTIFIED

CERTIFICATION/ DECERTIFICATION

DATE Letter attached

$

$

$

$

$

$

$

$

$

Comments:

I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND CORRECT CONTRACTOR REPRESENTATIVE SIGNATURE TITLE BUSINESS PHONE NUMBER DATE

TO THE BEST OF MY KNOWLEDGE, THE ABOVE INFORMATION IS COMPLETE AND CORRECT

RESIDENT ENGINEER BUSINESS PHONE NUMBER

Local Assistance Procedures Manual EXHIBIT 17-O Disadvantaged Business Enterprises (DBE) Certification Status Change

EXHIBIT 17-O DISADVANTAGED BUSINESS ENTERPRISES (DBE) CERTIFICATION STATUS CHANGE STATE OF CALIFORNIA – DEPARTMENT OF TRANSPORTATION CP-CEM-2403(F) (New. 10/99)

CONTRACT NUMBER COUNTY ROUTE POST MILES ADMINISTERING AGENCY CONTRACT COMPLETION DATE

PRIME CONTRACTOR BUSINESS ADDRESS ESTIMATED CONTRACT AMOUNT

Prime Contractor: List all DBEs with changes in certification status (certified/decertified) while in your employ, whether or not firms were originally listed for good credit. Attach DBE certification/Decertification letter in accordance with the Special Provisions

DATE

Distribution Original copy -DLAE Copy -1) Business Enterprise Program 2) Prime Contactor 3) Local Agency 4) Resident Engineer

Page 17-43 LPP 11-05 December 12, 2011

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EXHIBIT 17-O Local Assistance Procedures Manual Disadvantaged Business Enterprises (DBE) Certification Status Change

Form CP-CEM 2403(F) (New 10/99) DISADVANTAGED BUSINESS ENTERPRISES (DBE) CHANGE IN CERTIFICATION STATUS REPORT The top of the form requires specific information regarding the construction project: Contract Number, County, Route, Post Miles, the Administering Agency, the Contract Completion Date, and the Estimated Contract Amount. It requires the Prime Contractor’s name and Business Address. The focus of the form is to substantiate and verify the actual DBE dollar amount paid to contractors on federally funded projects that had a changed in Certification status during the course of the completion of the contract. The two situations that are being addressed by CP-CEM 2403(F) are, if a firm certified as a DBE and doing work on the contract during the course of the project becomes Decertified, and if a non-DBE firm doing work on the contract during the course of the project becomes Certified as a DBE. The form has a column to enter the Contract Item No (or Item Nos.) as well as a column for the Subcontractor’s Name, Business Address, Business Phone, and contractor's Certification Number. The column entitled Amount Paid While Certified will be used to enter the actual dollar value of the work performed by those contractors who meet the conditions as outlined above during the time period they are Certified as a DBE. This column on the CP-CEM-2403(F) should only reflect the dollar value of work performed while the firm was Certified as a DBE. The column called Certification/Decertification Date (Letter attached) will reflect either the date of the Decertification Letter sent out by the Civil Rights Program or the date of the Certification Certificate mailed out by the Civil Rights Program. There is a box to check that support documentation is attached to the CP-CEM-2403 (F) form. There is a Comments section for any additional information that may need to be provided regarding any of the above transactions. The CEM-2403(F) has an area at the bottom where the Contractor and the Resident Engineer sign and date that the information provided is complete and correct.

There is a Comments section for any additional information that may need to be provided regarding any of the above transactions. The CEM-2403(F) has an area at the bottom where the Contractor and the Resident Engineer sign and date that the information provided is complete and correct.

Page 17-44 July 21, 2006 LPP 06-03

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EXHIBIT


REQUIRED CERTIFICATION FOR AGREEMENTS WITH A VALUE GREATER THAN $150,000 (BEFORE CONTRACT EXECUTION)

Local Assistance Procedures Manual EXHIBIT 10-A A&E Consultant Audit Request Letter and Checklist

Page 1 of 2 LPP 13-01 (Technical Change) September 16, 2013

EXHIBIT 10-A A&E CONSULTANT AUDIT REQUEST LETTER AND CHECKLIST (For Proposed A&E Consultant Contracts of $1 Million or More)

[Attach this form to local agency cover letter for transmittal]

Department of Transportation Date: _________________________________ Audits and Investigations, MS 2 Federal Project Number: __________________ Attention: External Audit Manager Project Description: ______________________ P.O. Box 942874 _______________________________________ Sacramento, CA 94274-0001 Dear External Audit Manager: The following information is attached for proposed A&E consultant contract number _______________ at a proposed cost of $ ___________________ with [Consultant’s Name, Address, Contact Name, Phone Number] :

1. Proposed contract between the local agency and the consultant.

2. Cost proposal(s) for prime consultant and all subconsultant contracts of $150,000 or more.

3. Names, mailing addresses, phone numbers, and email addresses for all subconsultants.

4. Name of local agency contact person, phone number, and e-mail address.

5. All that apply: Consultant generated Indirect Cost Rate(s) schedule prepared in accordance with applicable Code of Federal Regulations (CFRs) and/or Safe Harbor Indirect Cost Rate certification and supplemental questionnaire, see: DLA-OB 13-07 - Safe Harbor Indirect Cost Rate for Consultant Contracts.

6. A completed Internal Control Questionnaire (AASHTO Uniform Audit and Accounting Guide, Appendix B).

7. Exhibit 10-K Consultant Certification of Contract Costs and Financial Management System

completed for the prime and all subconsultants when total contract is $150,000 or more. If requesting to use the Safe Harbor Indirect Cost Rate see: DLA-OB 13-07 - Safe Harbor Indirect Cost Rate for Consultant Contracts.

8. Include one of the following; if applicable:

a. A copy of the prior fiscal year and most recently completed fiscal year Cognizant approved indirect cost rate(s) and approved State Department of Transportation letters for the consultant, (must be provided if issued);

b. A copy of the prior fiscal year and most recently completed fiscal year Indirect Cost Rate(s) Schedule and audited report by an independent Certified Public Accountant (CPA). If a CPA-audited indirect cost rate is available for the appropriate fiscal year (applicable one-year accounting period), then the consultant must use the indirect cost rate(s), or lower (see 23 CFR 172.7(b) for guidelines), in the cost proposal.

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Local Assistance Procedures Manual EXHIBIT 10-A A&E Consultant Audit Request Letter and Checklist


c. A copy of the prior and most recently completed fiscal year Indirect Cost Rate(s) Evaluation or audit report on a prior Caltrans or local agency contract; and any other governmental agency report, review or attestation.

9. Check this box if the proposed cost (including amendments) is $3.5M or more, in which case the indirect cost rate provided by the prime consultant has been audited by a CPA. Forward the following documents to Caltrans Audits & Investigations: a. A copy of the consultant’s approved State DOT Cognizant Indirect Cost Rate(s) Schedule

and Report (must be provided if issued), and the Cognizant Approved State DOT Cognizant Concurrent Letter (if issued); OR

b. A CPA Audited Indirect Cost Rate Audit Report (if there is not an approved State DOT Cognizant Indirect Cost Rate); AND

c. A copy of the CPA audited financial statements, if any.

[Local Agency Name] understands that any work with costs incurred prior to the approval of the “Authorization to Proceed (E-76)” is not eligible for federal fund reimbursement. [Local Agency Name] further understands that a Conformance Letter will be issued to us within 30 business days of your receipt of complete documentation. If you need further information, please contact _____[Local Agency Contact Name] at _____[Phone # and email address] . Sincerely, Signed ________________________________________________________ Title _______________________________________________________ Agency ________________________________________________________ Attachments: Proposed Contract, Cost Proposal(s), Certifications, Indirect Cost Rate Schedules and Reports and other supporting documentation cc: Caltrans District Local Assistance Engineer Distribution: 1) Original – Caltrans Audits & Investigations 2) Copy – DLAE 3) Local Agency Project files

Local Assistance Procedures Manual EXHBIT 10-K Consultant Certification of Costs and Financial Management System


EXHIBIT 10-K CONSULTANT CERTIFICATION OF CONTRACT COSTS AND FINANCIAL

MANAGEMENT SYSTEM

(Note: If requesting to utilize the Safe Harbor Indirect Cost Rate submit Attachment 1 of DLA-OB 13-07 - Safe Harbor Indirect Cost Rate for Consultant Contracts found at

http://www.dot.ca.gov/hq/LocalPrograms/DLA_OB/DLA_OB.htm in lieu of this form.) Certification of Final Indirect Costs: Consultant Firm Name: _____________________________________________________ Indirect Cost Rate: ________________________________________ Fiscal Period Covered for Indirect Cost Rate Developed (mm/dd/yyyy to mm/dd/yyyy): __________________ Date of Proposal Preparation (mm/dd/yyyy): ___________________________ I, the undersigned, certify that I have reviewed the proposal to establish final indirect cost rates for the fiscal period as specified above and to the best of my knowledge and belief:

1. All costs included in this proposal to establish final indirect cost rates are allowable in accordance with the cost principles of the Federal Acquisition Regulations (FAR) of Title 48, Code of Federal Regulations (CFR), Part 31.

2. This proposal does not include any costs which are expressly unallowable under the cost principles of the FAR of 48 CFR, Part 31.

All known material transactions or events that have occurred affecting the firm’s ownership, organization, and indirect cost rates have been disclosed as of the date of proposal preparation noted above.

Certification of Financial Management System: I, the undersigned, certify to the best of my knowledge and belief that our financial management system meets the standards for financial reporting, accounting records, internal and budget control as set forth in the FAR of Title 49, CFR, Part 18.20 to the extent applicable to Consultant. Certification of Dollar Amount for all A&E contracts: I, the undersigned, certify that the approximate dollar amount of all A&E contracts awarded by Caltrans or a California local agency to this firm within the last three (3) calendar years for all State DOT and Local Agencies is $________________________ and the number of States in which the firm does business is ________. Certification of Direct Costs: I, the undersigned, certify to the best of my knowledge and belief that all direct costs identified on the cost proposal(s) in this contract are reasonable, allowable and allocable to the contract in accordance with the cost principles of the FAR of Title 48, CFR, Part 31. Allowable direct costs to a Government contract shall be:

1. Compliant with Generally Accepted Accounting Principles (GAAP) and standards promulgated by the Cost Accounting Standards Board (when applicable).

Local Assistance Procedures Manual EXHBIT 10-K Consultant Certification of Costs and Financial Management System


2. Compliant with the terms of the contract and is incurred specifically for the contract. 3. Not prohibited by 23 CFR, Chapter 1, Part 172 –Administration of Engineering and Design

Related Service Contracts to the extent requirements are applicable to Consultant.

All costs must be applied consistently and fairly to all contracts. All documentation of compliance must be retained in the project files. Subconsultants (if applicable) Proposed Contract Amount (or amount not to exceed if on-call contract): $____________________ Prime Consultants (if applicable) Proposed Total Contract Amount (or amount not to exceed if on-call contract): $ ________________ Prime, list all subconsultants and proposed subcontract dollar amounts (attach additional page if necessary):

_______________________________________ $_____________________ _______________________________________ $_____________________ _______________________________________ $_____________________ _______________________________________ $_____________________ _______________________________________ $_____________________

* Consultant Certification Signature: ______________________________________________________ Consultant Certifying (Print Name and Title):

Name: ________________________________________________________________________ Title: _________________________________________________________________________

Consultant Contact Information:

Email: _______________________________________________________________________ Phone number: ______________________________________________

Date of Certification (mm/dd/yyyy): __________________________________ *An individual executive or financial officer of the consultant’s organization at a level no lower than a Vice President or Chief Financial Officer, or equivalent, who has authority to represent the financial information utilized to establish the indirect cost rate proposal submitted in conjunction with the contract. Note: Per 23 U.S.C. 112(b)(2)(B), Subconsultants must comply with the FAR Cost Principles contained in 48 CFR, Part 31. 23 CFR Part 172.3 Definitions state: Consultant means the individual or firm providing engineering and design related services as a party to the contract. Therefore, subconsultants as parties of a contract must complete a certification and send originals to A&I and keep copies in Local Agency Project Files. Distribution: 1) Original to Caltrans Audits and Investigations 2) Retained in Local Agency Project Files