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HomeMy WebLinkAboutVeronica Tam & Associates - 2007-09-28 r + ykq CONTRACTS SUBMITTAL NOUN v3 AM 19: 02 CITY CLERIC'S OFFICE r J To: JOAN FLYNN, City Clerk Name of Contractor: Veronica Tam & Associates Purpose of Contract: For Example:Audit Services or Water Quality Testing Huntington Lake—Huntington Central Park CDBG and Home Programs Consulting Amount of Contract: $40,000.00 Copy of contract distributed to: The original insurance certificate/waiver distributed ❑ Initiating Dept. ❑ to Risk Management Finance Dept. ❑ ORIGINAL bonds sent to Treasurer ❑ Date: // -7/0 Y Nam /Extens n City Attorney's Office G:AttyMisc/Contract Forms/City Clerk Transmittal fnd'j PROFESSIONAL SERVICES CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND VERONICA TAM &ASSOCIATES, LLC FOR CDBG AND HOME PROGRAMS CONSULTING Table of Contents 1 Scope of Services.....................................................................................................1 2 City Staff Assistance................................................................................................2 3 Term; Time of Performance.....................................................................................2 4 Compensation..........................................................................................................2 5 . Extra Work...............................................................................................................2 6 Method of Payment..................................................................................................3 7 Disposition of Plans, Estimates and Other Documents ...........................................3 8 Hold Harmless .........................................................................................................3 9 Professional Liability Insurance.............................................................................4 10 Certificate of Insurance............................................................................................5 11 Independent Contractor............................................................................................6 12 Termination of Agreement.......................................................................................6 13 Assignment and Delegation......................................................................................6 14 Copyrights/Patents...................................................................................................7 15 City Employees and Officials..................................................................................7 16 Notices.........................................................................................7. 17 Consent....................................................................................................................8 18 Modification.............................................................................................................8 19 Section Headings .....................................................................................................8 20 Interpretation of this,Agreement...............................................................................8 21 Duplicate Original....................................................................................................9 22 Immigration...............................................................................................................9 23 Legal Services Subcontracting Prohibited................................................................9 24 Attorney's Fees..........................................................................................................10 25 Survival.....................................................................................................................10 26 Governing Law.........................................................................................................10 27 Entirety......................................................................................................................10 PROFESSIONAL SERVICES CONTRACT BETWEEN THE CITY OF HUNTINGTON BEACH AND VERONICA TAM AND ASSOCIATES, LLC FOR CDBG AND HOME PROGRAMS CONSULTING THIS AGREEMENT ("Agreement") is made and entered into this 28TH day of SEPTEMBER 20 07 , by and between the City of Huntington Beach, a municipal corporation of the State of California, hereinafter referred to as "CITY, and VERONICA TAM &ASSOCIATES a CALIFORNIA LIMITED LIABILITY COMPANY hereinafter referred to as "CONSULTANT." WHEREAS, CITY desires to engage the services of a consultant to ADVISE ON HUD CDBG AND HOME PROGRAMS ; and Pursuant to documentation on file in the office of the City Clerk, the provisions of the Huntington Beach Municipal Code, Chapter 3.03, relating to procurement of professional service contracts have been complied with; and CONSULTANT has been selected to perform these services, NOW, THEREFORE, it is agreed by CITY and CONSULTANT as follows: 1. SCOPE OF SERVICES CONSULTANT shall provide all services as described in Exhibit "A," which is attached hereto and incorporated into this Agreement by this reference. These services shall sometimes hereinafter be referred to as the "PROJECT." CONSULTANT hereby designates VERONICA TAM who shall represent it and be its sole contact and agent in all consultations with CITY during the performance of this Agreement. agree/forms/profsery 10/15101-A 1 2. CITY STAFF ASSISTANCE CITY shall assign a staff coordinator to work directly with CONSULTANT in the performance of this Agreement. 3. TERM; TIME OF PERFORMANCE Time is of the essence of this Agreement. The services of CONSULTANT are to commence as soon as practicable after the execution of this Agreement by CITY(the "Commencement Date"). This Agreement shall expire on SEPTEMBER 30, 2008 , unless sooner terminated as provided herein. All tasks specified in Exhibit "A" shall be completed no later than IONE YEAR from the Commencement Date of this Agreement. These times may be extended with the written permission of CITY. The time for performance of the tasks identified in Exhibit "A" are generally to be shown in Exhibit "A." This schedule may be amended to benefit the PROJECT if mutually agreed to in writing by CITY and CONSULTANT. 4. COMPENSATION In consideration of the performance of the services described herein, CITY agrees to pay CONSULTANT on a time and materials basis at the rates specified in Exhibit "B," which is attached hereto and incorporated by reference into this Agreement, a fee, including all costs and expenses, not to exceed FORTY THOUSAND Dollars($ 40,000 J. 5. EXTRA WORK In the event CITY requires additional services not included in Exhibit "A" or changes in the scope of services described in Exhibit "A," CONSULTANT will undertake such work only after receiving written authorization from CITY. Additional agree/forms/profsery 1 0/1 510 1-A 2 compensation for such extra work shall be allowed only if the prior written approval of CITY is obtained. 6. METHOD OF PAYMENT CONSULTANT shall be paid pursuant to the terms of Exhibit "B." 7. DISPOSITION OF PLANS, ESTIMATES AND OTHER DOCUMENTS CONSULTANT agrees that title to all materials prepared hereunder, including, without limitation, all original drawings, designs, reports, both field and office notices, calculations, computer code, language, data or programs, maps, memoranda, letters and other documents, shall belong to CITY, and CONSULTANT shall turn these materials over to CITY upon expiration or termination of this Agreement or upon PROJECT completion, whichever shall occur first. These materials may be used by CITY as it sees fit. 8. HOLD HARMLESS CONSULTANT hereby agrees to protect, defend, indemnify and hold harmless CITY, its officers, elected or appointed officials, employees, agents and volunteers from and against any and all claims, damages, losses, expenses, judgments, demands and defense costs (including, without limitation, costs and fees of litigation of every nature or liability of any kind or nature) arising out of or in connection with CONSULTANT's (or CONSULTANT's subcontractors, if any) negligent performance of this Agreement or its failure to comply with any of its obligations contained in this Agreement by CONSULTANT, its officers, agents or employees except such loss or damage which was caused by the sole negligence or willful misconduct of CITY. CONSULTANT will conduct all defense at its sole cost and expense and CITY shall agree/forms/profsery 10/15/01-A 3 approve selection of CONSULTANT's counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance policies are applicable. The policy limits do not act as limitation upon the amount of indemnification to be provided by CONSULTANT. 9. PROFESSIONAL LIABILITY INSURANCE CONSULTANT shall obtain and furnish to CITY a professional liability insurance policy covering the work performed by it hereunder. This policy shall provide coverage for CONSULTANT's professional liability in an amount not less than One Million Dollars ($1,000,000.00) per occurrence and in the aggregate. The above- mentioned insurance shall not contain a self-insured retention, "deductible" or any other similar form of limitation on the required coverage except with the express written consent of CITY. A claims-made policy shall be acceptable if the policy further provides that: A. The policy retroactive date coincides with or precedes the initiation of the scope of work (including subsequent policies purchased as renewals or replacements). B. CONSULTANT shall notify CITY of circumstances or incidents that might give rise to future claims. CONSULTANT will make every effort to maintain similar insurance during the required extended period of coverage following PROJECT completion. If insurance is terminated for any reason, CONSULTANT agrees to purchase an extended reporting provision of at least two (2) years to report claims arising from work performed in connection with this Agreement. agree/forms/profsery 10/15/01-A 4 10. CERTIFICATE OF INSURANCE Prior to commencing performance of the work hereunder, CONSULTANT shall furnish to CITY a certificate of insurance subject to approval of the City Attorney evidencing the foregoing insurance coverage as required by this Agreement; the certificate shall: A. provide the name and policy number of each carrier and policy; B. shall state that the policy is currently in force; and C. shall promise that such policy shall not be suspended, voided or canceled by either party, reduced in coverage or in limits.except after thirty (30) days' prior written notice; however, ten (10) days' prior written notice in the event of cancellation for nonpayment of premium. CONSULTANT shall maintain the foregoing insurance coverage in force until the work under this Agreement is fully completed and accepted by CITY. The requirement for carrying the foregoing insurance coverage shall not derogate from CONSULTANT's defense, hold harmless and indemnification obligations as set forth in this Agreement. CITY or its representative shall at all times have the right to demand the original or a copy of the policy of insurance. CONSULTANT shall pay, in a prompt and timely manner, the premiums on the insurance hereinabove required. 11. INDEPENDENT CONTRACTOR CONSULTANT is, and shall be, acting at all times in the performance of this Agreement as an independent contractor herein and not as an employee of CITY. CONSULTANT shall secure at its own cost and expense, and be responsible for any and agree/forms/profsery 10/15101-A 5 all payment of all taxes, social security, state disability insurance compensation, unemployment compensation and other payroll deductions for CONSULTANT and its officers, agents and employees and all business licenses, if any, in connection with the PROJECT and/or the services to be performed hereunder. 12. TERMINATION OF AGREEMENT All work required hereunder shall be performed in a good and workmanlike manner. CITY may terminate CONSULTANT's services hereunder at any time with or without cause, and whether or not the PROJECT is fully complete. Any termination of this Agreement by CITY shall be made in writing, notice of which shall be delivered to CONSULTANT as provided herein. In the event of termination, all finished and unfinished documents, exhibits, report, and evidence shall, at the option of CITY, become its property and shall be promptly delivered to it by CONSULTANT. 13. ASSIGNMENT AND DELEGATION This Agreement is a personal service contract and the work hereunder shall not be assigned, delegated or subcontracted by CONSULTANT to any other person or entity without the prior express written consent of CITY. If an assignment, delegation or subcontract is approved, all approved assignees, delegates and subconsultants must satisfy the insurance requirements as set forth in Sections 9 and 10 hereinabove. 14. COPYRIGHTS/PATENTS CITY shall own all rights to any patent or copyright on any work, item or material produced as a result of this Agreement. agree/forms/profservl0/15101-A 6 15. CITY EMPLOYEES AND OFFICIALS CONSULTANT shall employ no CITY official nor any regular CITY employee in the work performed pursuant to this Agreement. No officer or employee of CITY shall have any financial interest in this Agreement in violation of the applicable provisions of the California Government Code. 16. NOTICES Any notices, certificates, or other communications hereunder shall be given either by personal delivery to CONSULTANT's agent (as designated in Section 1 hereinabove) or to CITY as the situation shall warrant, or by enclosing the same in a sealed envelope, postage prepaid, and depositing the same in the United States Postal Service, to the addresses specified below. CITY and CONSULTANT may designate different addresses to which subsequent notices, certificates or other communications will be sent by notifying the other parry via personal delivery, a reputable overnight carrier or U. S. certified mail-return receipt requested: TO CITY: TO CONSULTANT: City of Huntington Beach VERONICA TAM ATTN: CAROL RUNZEL 107 S.,Fair Oaks Avenue, Suite 213 2000 Main Street Huntington Beach, CA 92648 Pasadena, CA 91105 (626) 304-0440 17. CONSENT When CITY's consent/approval is required under this Agreement, its consent/approval for one transaction or event shall not be deemed to be a consent/approval to any subsequent occurrence of the same or any other transaction or event. agree/forms/profsery 10/15/01-A 7 18. MODIFICATION No waiver or modification of any language in this Agreement shall be valid unless in writing and duly executed by both parties. 19. SECTION HEADINGS The titles, captions, section, paragraph and subject headings, and descriptive phrases at the beginning of the various sections in this Agreement are merely descriptive and are included solely for convenience of reference only and are not representative of matters included or excluded from such provisions, and do not interpret, define, limit or describe, or construe the intent of the parties or affect the construction or interpretation of any provision of this Agreement. 20. INTERPRETATION OF THIS AGREEMENT The language of all parts of this Agreement shall in all cases be construed as a whole, according to its fair meaning, and not strictly for or against any of the parties. If any provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be unenforceable, void, illegal or invalid, such holding shall not invalidate or affect the remaining covenants and provisions of this Agreement. No covenant or provision shall be deemed dependent upon any other unless so expressly provided here. As used in this Agreement, the masculine or neuter gender and singular or plural number shall be deemed to include the other whenever the context so indicates or requires. Nothing contained herein shall be construed so as to require the commission of any act contrary to law, and wherever there is any conflict between any provision contained herein and any present or future statute, law, ordinance or regulation contrary to which the parties have no right to contract, then the latter shall prevail, and the_provision of this Agreement agree/forms/profsery 10/1 510 1-A 8 which is hereby affected shall be curtailed and limited only to the extent necessary to bring it within the requirements of the law. 21. DUPLICATE ORIGINAL The original of this Agreement and one or more copies hereto have been prepared and signed in counterparts as duplicate originals, each of which so executed shall, irrespective of the date of its execution and delivery, be deemed an original. Each duplicate original shall be deemed an original instrument as against any parry who has signed it. 22. IMMIGRATION CONSULTANT shall be responsible for ,full compliance with the immigration and naturalization laws of the United States and shall, in particular, comply with the provisions of the United States Code regarding employment verification. 23. LEGAL SERVICES SUBCONTRACTING PROHIBITED CONSULTANT and CITY agree that CITY is not liable for payment of any subcontractor work involving legal services, and that such legal services are expressly outside the scope of services contemplated hereunder. CONSULTANT understands that pursuant to Huntington Beach City Charter Section 309, the City Attorney is the exclusive legal counsel for CITY; and CITY shall not be liable for payment of any legal services expenses incurred by CONSULTANT. 24. ATTORNEY'S FEES In the event suit is brought by either party to construe, interpret and/or enforce the terms and/or provisions of this Agreement or to secure the performance hereof, agree/forms/profsery 10/15101-A 9 each party shall bear its own attorney's fees, such that the prevailing party shall not be entitled to recover its attorney's fees from the non-prevailing party. 25. SURVIVAL Terms and conditions of this Agreement, which by their sense and context survive the expiration or termination of this Agreement, shall so survive. 26. GOVERNING LAW This Agreement shall be governed and construed in accordance with the laws of the State of California. 27. ENTIRETY - The parties acknowledge and agree that they are entering into this Agreement freely and voluntarily following extensive arm's length negotiation, and that each has had the opportunity to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and agree that no representations, inducements, promises, agreements or warranties, oral or otherwise, have been made by that party or anyone acting on that party's behalf, which are not embodied in this Agreement, and that that party has not executed this Agreement in reliance on any representation, inducement, promise, agreement, warranty, fact or circumstance not expressly set forth in this Agreement. This Agreement, and the attached exhibits, contain the entire agreement between the parties respecting the subject matter of this Agreement, and supercede all prior understandings and agreements whether oral or in writing between the parties respecting the subject matter hereof. agree/forms/profsery 10/15/0 1-A 10 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by and through their authorized offices the day, month and year first above written. CONSULTANT, CITY OF HUNTINGTON BEACH, VERONICA TAM &ASSOCIATES, LLC a municipal corporation of the State of California r „' Eal. e'LL Director of ' By; (Pursuant To HBMC§3.03.100) VC U6Jt e-A 7ij`t-4 print name ITS: (circle one)Chairma Press e fNice President APPROVED AS TO FORM: AND City Attorney &AA r ye REVIEWED AN�, APPROVED: print name ITS: (circle one<Secre hief Financial Officer/Asst. / Secretary—Treasurer Ctntracts administrator (only for c $50,000.00 and over) agree/forms/profservl0/15/01-A 1 1 �S iu Exhibit A Scope of Work Scope of work covered under this contract includes the following tasks, to be billed on a time- and-materials basis: • General grants assistance including: program strategy; determination of eligibility;staff training (e.g. IDIS); environmental clearance; research; and coordination with HUD, as well as other tasks as directed by City staff. j. • Preparation of the Annual Action Plan to describe the planned uses of annual program allocations and the relationship between proposed activities and goals and objectives of the five-year Consolidated Plan. The Action Plan is due 45 days before the beginning of the program year. } • Preparation of the Consolidated Annual Performance Evaluation Report (CAPER) to describe accomplishments under the CDBG and HOME programs during the previous program year and progress in implementing the goals and objectives of the five-year Consolidated Plan. The CAPER is due 90 days after the close of the program year. • Subrecipient file management. • IDIS setup,maintenance,and close-out functions and IRIS report preparation. i a SOUTH GATE GRANTS ADMINISTRATION SERVICES PAGE 1 Exhibit B Budget Tam Planners Other $ 100 $ 85 Costs Total General Grants Assistance 40 $ 200 4,200 Report Writing CAPER(FY 05-06) 24 64 $ 750 $ 8,590 Action Plan(FY 07-08) 24 64 $ 750 $ 8,590 Consolidated Plan(FY 2010-2015) To be determined Subrecipient File Management 20 $ 2,000 MIS Input Assistance 122 40 $ 1,020 $ 16,620 Total 230 168 $ 2,720 $ 40,000 HUNTINGTON BEACH GRANTS ADMINISTRATION SERVICES wient : a oaae V GKU I AIVI V t ACGRD� CERTIFICATE OF LIABILITY INSURANCE �2/07107D'YYYY) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HRH Professional Practice ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insurance Brokers, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 2030 Main Street,Suite 350 Irvine, CA 92614-7248 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: American Casualty Co of Reading, PA 20443 Veronica Tam and Associates, LLC INSURER B: Continental Casualty Company 107 S. Fair Oaks Avenue, Suite 212 INSURER C: Pasadena, CA 91105 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DA TE MM/DD/YY DATE MM/DD/YY LIMITS A GENERAL LIABILITY B2084529924 11/16/07 11/16/08 EACH OCCURRENCE $1,000,000 )( MERCIAL GENERAL LIABILITY DAMAGE TO RENTED COM P I E n $100 000 CLAIMS MADE ®OCCUR MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY M PROJECT M LOC A AUTOMOBILE LIABILITY 82084529924 11/16/07 11/16/08 COMBINED SINGLE LIMIT $� 000,000 ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS PP VED S TO I RIB (Per accident) [/ PROPERTY DAMAGE $�� (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ B OTHER Professional MCA276199824 11/16/07 11/16/08 $1,000,000 Per Claim Liability $1,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ALL OPERATIONS. GENERAL LIABILITY: CITY OF HUNTINGTON BEACH, ITS AGENTS, OFFICERS AND EMPLOYEES ARE NAMED AS ADDTN INSRD PER ENDT ATTACHED. CERTIFICATE HOLDER CANCELLATION Ten Day Notice for Non-Payment of Premium SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF HUNTINGTON BEACH DATE THEREOF,THE ISSUING INSURER WILL x RKj(§t MAIL 'Ifl DAYS WRITTEN 2000 MAIN STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, R Huntington Beach, CA 92648 > �tt� �ar�xx�axxxxaaxttxetatoc �ncea�tx�cxx xl �ux AUTHORIZED REPRESENTATIVE ACORD 25(2001108)1 of 2 #397176 CCL © ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 4CORD 25-S(2001/08) 2 of 2 #397176 i 1 SB-146932-B (Ed. 03/06) This insurance does not apply to or organization. A person's or structural.alterations,-ne-w-Dnstr_�cii4n of or anization's status as an insured under demolition operations performed by or for this endorsement ends when their written such additional insured. contract or agreement with you for such f. Owners/Other Interests — Land Is leased equipment ends. Leased With respect to the insurance afforded An .owner or other interest from whom these additional insureds, Abe following land has been leased by you but only additional exclusions apply: with respect to liability arising out of the This insurance does not apply: ownership, maintenance or use of that specific part of the land leased to you and (1) To any °occurrence° which takes subject to the following additional place after the equipment lease exclusions: expires; or This insurance does not apply to: . (2) To 'bodily injury,° °property damage" or "personal and advertising injury" (1) Any "occurrence' which takes place arising out of the sole negligence of after you cease to lease that land; or such additional insured. (2) Structural alterations, new Any insurance provided to an additional insured construction or demolition operations designated under paragraphs a. through h. above performed by or on behalf of such does not apply to °bodily injury" or "property additional insured. damage' included within the 'products-completed g. Co-owner of Insured Premises operations hazard.' A co-owner of a premises co-owned by 3. The following is added to Paragraph H. of the you and covered under this insurance but BUSINESSOWNERS COMMON POLICY only with respect to the co-owners liability CONDITIONS: as co-owner of such premises. H. Other Insurance h. Lessor of.Equipment 4. This insurance is excess over any other Any person or organization from whom insurance naming the additional insured as an you lease equipment. Such person or insured whether primary, excess, contingent or organization are insureds only with on any other basis unless a written contract or respect to their liability arising out of the written agreement specifically requires that this maintenance, operation or use by you of insurance be either primary or primary and equipment leased to you by such person noncontributing. ADDITIONAL INSURED: CITY OF I3UNTINGTON BEACH, ITS AGENTS, OFFICERS AND EMPLOYEES SB-146932-B Page 3 of 3 (Ed. 03/06) S ity }it CITY OF HUNTINGTON BEACH 2000 Main Street, Huntington Beach, CA 92648 Hun Declaration of Non-Employer Status In order to comply with the City Council Resolution No. 6277, you are required to provide proof of Workers' Compensation Insurance. If you have no employees, this form must be signed and returned to: City of Huntington Beach Risk Management Division 2000 Main Street Huntington Beach, CA 92648 1 certify that in the performance of the activity or work for which this permit is issued, I shall not employ any person in any manner so as to become subject to California Workers' Compensation Insurance requirements. I authorize the City of Huntington Beach to immediately and retroactively revoke the license or permit issued under this declaration if I hire any employee(s) or become subject to the provision of the laws requiring Workers' Compensation Insurance. Applicant/Company Name: ViEkotj (C4i A m tvN D A Ssoc i,�T E-s Address: fo �J I FA1aZ 0M-­5 A VE 2 z PAsAPC_N^ CA 91101:1- Applicant's Signature: Title: ?g irvcf cAL_ Date Signed: z/1 :- /0 Telephone Number: 626 ) 309 - 0-T46 CITY����~�� 6���� ��� ��������4��~��"��� ��D������� u n�rw m u�wm� u um'mp�� N *�'m� ��m�����n m Professional �� ^ �~ � *m� �����0��� ~��������� Purchasing~ Certification �^ o �����xo����0���� ����" uUuuK���uKon 1. Date: 10/15/2007 2. Department Economic Development 3. Requested by: CandRunze| 4. Name of consultant: Veronica Tam &Associates, LbC 5' Attach the written statement of the spenifioadon, oonditionm, and other requirements for the requested services provided to solicited consultants. See Attached RFP G. Amount ofthe contract: $40.000 7. Are sufficient funds available to fund this contract?' Yes F� No 8. Is this contract generally described on the list of professional service contracts approved by the City Council?' EYao El No S. Company number and object code where funds are budgeted: 85880302.89365 10. |s this contract less than $5O.00O? Yes El No 11. Does this contract fall within $5O.00O and $1UO.00O? El Yes ENo 12. |s this contract over$1OO.0DO? El Yes ENo (Note: Contracts requiring City Council Approval need to be signed by the Mayor and City Clerk. Make sure the appropriate signature page io attached t000ntraot.) 13. Were formal written proposals requested from at least three available qualified consultants? M-Yes f~ ^� 14. Attach list of consultants from whom proposals were requested (including a contact telephone number). See attached. 15. Attach proposed scope ofwork. See attached. 16. Attach proposed payment schedule. See attached. Purchasing and Central Services Manager 1, |ftheunswertothiequeahonin^No.^ thecontnactvviUrcquireapprovo|fromthmCityCounoii RFP Solicitations IUD Entitlement Grant Programs CDBG and HOME June 2006 Mr. Mike Linares P.O. Box 3913 San Clemente, CA mike@mlinaresinc.com (714) 608-72-63 MDG Associates Inc. 10722 Arrow Route, Ste 822 Rancho Cucamonga, CA 91730 (909) 476-9696 Wildan 13191 Crossroads Parkway North, Ste 405 Industry, CA 91746-3497 (562) 908-6200 Veronica Tam & Associates/ EDAW 46 Alta Street, Unit A Arcadia, CA 91006