CITY OF
El
PROFESSIONAL/CONSULTING SERVICES AGREE1\1ENT
CUPERTINO
1. PARTIES
This Agreement is made by and between the City of Cupertino, a municipal corporation ("City"), and 4Leaf, Inc ("Contractor"), a Corporation for Construction Management Jollyman Park Project, and is effective on the last date signed below ("Effective Date").
2. SERVICES
2.1 Contractor agrees to provide the services and perform the tasks ("Services") set forth in detail in Scope of Services, attached here and incorporated as Exhibit A. Contractor further agrees to carry out its work in compliance with any applicable local, State, or Federal order regarding COVID-19.
2.2 Contractor's duties and services under this agreement shall not include preparing or assisting the City with any portion of the City's preparation of a request for proposals, request for qualifications, or any other solicitation regarding a subsequent or additional contract with the City.
The City shall at all times retain responsibility for public contracting, including with respect to any subsequent phase of this project. Contractor's participation in the planning, discussions, or drawing of project plans or specifications shall be limited to conceptual, preliminary, or initial plans or specifications. Contractor shall cooperate with the City to ensure that all bidders for a subsequent contract on any subsequent phase of this project have access to the same information, including all conceptual, preliminary, or initial plans or specifications prepared by contractor pursuant to this agreement.
3. TI1\1E OF PERFORMANCE
3.1 This Agreement begins on the Effective Date and ends on June 30, 2026 ("Contract Time"), unless terminated earlier as provided herein. Contractor's Services shall begin on the effective date and shall be completed by June 30, 2026. The City's appropriate department head or the City Manager may extend the Contract Time through a written amendment to this Agreement, provided such extension does not include additional contract funds. Extensions requiring additional contract funds are subject to the City's purchasing policy.
3.2 Schedule of Performance. Contractor must deliver the Services in accordance with the Schedule of Performance, attached and incorporated here Exhibit B.
3.3 Time is of the essence for the performance of all the Services. Contractor must have sufficient time, resources, and qualified staff to deliver the Services on time. 4Leaf, Inc. for Construction Management Jollyman Park Project
4. COMPENSATION
4.1 Maximum Compensation. City will pay Contractor for satisfactory performance of the Services an amount that will based on actual costs but that will be capped so as not to exceed $393,081.00 ("Contract Price"), based upon the scope of services in Exhibit A and the budget and rates included in Exhibit C, Compensation attached and incorporated here. The maximum compensation includes all expenses and reimbursements and will remain in place even if Contractor's actual costs exceed the capped amount. No extra work or payment is permitted without prior written approval of City.
4.2 Invoices and Payments. Monthly invoices must state a description of the deliverable completed and the amount due for the preceding month. Within thirty (30) days of completion of Services, Contractor must submit a requisition for final and complete payment of costs and pending claims for City approval. Failure to timely submit a complete and accurate payment requisition relieves City of any further payment or other obligations under the Agreement.
5. INDEPENDENT CONTRACTOR
5.1 Status. Contractor is an independent contractor and not an employee, partner, or joint venture of City. Contractor is solely responsible for the means and methods of performing the Services and for the persons hired to work under this Agreement. Contractor is not entitled to health benefits, worker's compensation, or other benefits from the City. 52 Contractor's Qualifications. Contractor warrants on behalf of itself and its subcontractors that they have the qualifications and skills to perform the Services in a competent and professional manner and according to the highest standards and best practices in the industry. 53 Permits aitd Licenses. Contractor warrants on behalf of itself and its subcontractors that they are properly licensed, registered, and/or certified to perform the Services as required by law and have procured a City Business License, if required by the Cupertino Municipal Code. 5A Subcontractors. Only Contractor's employees are authorized to work under this Agreement. Prior written approval from City is required for any subcontractor, and the terms and conditions of this Agreement will apply to any approved subcontractor.
5.5 Tools, Materials, and Equipment. Contractor will supply all tools, materials and equipment required to perform the Services under this Agreement.
5.6 Payment of Benefits and Taxes. Contractor is solely responsible for the payment of employment taxes incurred under this Agreement and any similar federal or state taxes. Contractor and any of its employees, agents, and subcontractors shall not have any claim under this Agreement or otherwise against City for seniority, vacation time, vacation pay, sick leave, personal time off, overtime, health insurance, medical care, hospital care, insurance benefits, social security, disability, unemployment, workers compensation or employee benefits of any kind. Contractor shall be solely liable for and obligated to pay directly all applicable taxes, fees, contributions, or charges applicable to Contractor's business including, but not limited to, federal and state income taxes. City shall have no obligation whatsoever to pay or withhold any taxes or benefits on behalf of Contractor. In the event that Contractor or any employee, agent, or subcontractor of Contractor providing services under this 4Leaf, Inc. for ConstructionManagement Jollyman Parkl'roject
Agreement is determined by a court of competent jurisdiction, arbitrator, or administrative authority, including but not limited to the California Public Employees Retirement System (PERS) to be eligible for enrollment in PERS as an employee of City, Contractor shall indemnify, defend, and hold harmless City for the payment of any employee and/or employer contributions for PERS benefits on behalf of Contractor or its employees, agents, or subcontractors, as well as for the payment of any penalties and interest on such contributions, which would otherwise be the responsibility of City, and actual attorney's fees incurred by City in connection with the above.
6. PROPRIETARY /CONFIDENTIAL INFORMATION
In performing this Agreement, Contractor may have access to private or confidential information owned or controlled by the City, which may contain proprietary or confidential details the disclosure of which to third parties may be damaging to City. Contractor shall hold in confidence all City information provided by City to Contractor and use it only to perform this Agreement.
Contractor shall exercise the same standard of care to protect City information as a reasonably prudent contractor would use to protect its own proprietary data.
7. OWNERSHIP OF MATERIALS
7.1 Property Rights. Any interest (including copyright interests) of Contractor in any product, memoranda, study, report, map, plan, drawing, specification, data, record, document, or other information or work, in any medium (collectively, "Work Product"), prepared by Contractor in connection with this Agreement will be the exclusive property of the City upon completion of the work to be performed hereunder or upon termination of this Agreement, to the extent requested by City. In any case, no Work Product shall be shown to any third-party without prior written approval of City.
72 Copyright. To the extent permitted by Title 17 of the U.S. Code, all Work Product arising out of this Agreement is considered "works for hire" and all copyrights to the Work Product will be the property of City. Alternatively, Contractor assigns to City all Work Product copyrights .
Contractor may use copies of the Work Product for promotion only with City's written approval. 73 Patents and Licenses. Contractor must pay royalties or license fees required for authorized use of any third party intellectual property, including but not limited to patented, trademarked, or copyrighted intellectual property if incorporated into the Services or Work Product of this Agreement.
7.4 Re-Use of Work Product. Unless prohibited by law and without waiving any rights, City may use or modify the Work Product of Contractor or its sub-contractors prepared or created under this Agreement, to execute or implement any of the following :
(a) The original Services for which Contractor was hired; (b) Completion of the original Services by others;
(c) Subsequent additions to the original Services; and/or (d) Other City projects .
7.5 Deliverables and Format. Contractor must provide electronic and hard copies of the Work Product, on recycled paper and copied on both sides, except for one single-sided original. 4Leaf, Inc. for Construction Manageme nt Jollyman Park Project
8. RECORDS
Contractor must maintain complete and accurate accounting records relating to its performance in accordance with generally accepted accounting principles. The records must include detailed information of Contractor's performance, benchmarks and deliverables, which must be available to City for review and audit. The records and supporting documents must be kept separate from other records and must be maintained for four ( 4) years from the date of City's final payment.
Contractor acknowledges that certain documents generated or received by Contractor in connection with the performance of this Agreement, including but not limited to correspondence between Contractor and any third party, are public records under the California Public Records Act, California Government Code section 6250 et seq. Contractor shall comply with all laws regarding the retention of public records and shall make such records available to the City upon request by the City, or in such manner as the City reasonably directs that such records be provided.
9. ASSIGNMENT
Contractor shall not assign, sublease, hypothecate, or transfer this Agreement, or any interest therein, directly or indirectly, by operation of law or otherwise, without prior written consent of City. Any attempt to do so will be null and void. Any changes related to the financial control or business nature of Contractor as a legal entity is considered an assignment of the Agreement and subject to City approval, which shall not be unreasonably withheld. Control means fifty percent (50%) or more of the voting power of the business entity.
10. PUBLICITY / SIGNS
Any publicity generated by Contractor for the project under this Agreement, during the term of this Agreement and for one year thereafter, will reference the City's contributions in making the project possible. The words "City of Cupertino" will be displayed in all pieces of publicity, including flyers, press releases, posters, brochures, public service announcements, interviews and newspaper articles. No signs may be posted, exhibited or displayed on or about City property, except signage required by law or this Contract, without prior written approval from the City.
11. INDEMNIFICATION
11.1 To the fullest extent allowed by law, and except for losses caused by the sole and active negligence or willful misconduct of City personnel, Contractor shall indemnify, defend and hold harmless City, its City Council, boards and commissions, officers, officials, employees, agents, servants, volunteers, and consultants ("Indemnitees"), through legal counsel acceptable to City, from and against any and all liability, damages, claims, actions, causes of action, demands, charges, losses, costs, and expenses (including attorney fees, legal costs, and expenses related to litigation and dispute resolution proceedings) of every nature, arising directly or indirectly from this Agreement or in any manner relating to any of the following:
(a) Breach of contract, obligations, representations, or warranties; (b) Negligent or willful acts or omissions committed during performance of the Services; (c) Personal injury, property damage, or economic loss resulting from the work or performance 4Leaf,Jnc..for Construction Management Joll.xman Park PJ:Qject
of Contractor or its subcontractors or sub-subcontractors; (cl) Unauthorized use or disclosure of City's confidential and proprietary Information; (e) Claim of infringement or violation of a U.S. patent or copyright, trade secret, trademark, or service mark or other proprietary or intellectual property rights of any third party.
11.2 Contractor must pay the costs City incurs in enforcing this provision. Contractor must accept a tender of defense upon receiving notice from City of a third-party claim. At City's request, Contractor will assist City in the defense of a claim, dispute, or lawsuit arising out of this Agreement.
11.3 Contractor's duties under this section are not limited to the Contract Price, workers' compensation payments, or the insurance or bond amounts required in the Agreement. Nothing in the Agreement shall be construed to give rise to an implied right of indemnity in favor of Contractor against City or any Indemnitee.
11.4 Contractor's payments may be deducted or offset to cover any money the City lost due to a claim or counterclaim arising out of this Agreement, or a purchase order, or other transaction.
11.5 Contractor agrees to obtain executed indemnity agreements with provisions identical to those set forth here in this Section 11 from each and every subcontractor, or any other person or entity involved by, for, with, or on behalf of Contractor in the performance of this Agreement.
Failure of City to monitor compliance with these requirements imposes no additional obligations on City and will in no way act as a waiver of any rights hereunder.
11.6 This Section 11 shall survive termination of the Agreement.
12. INSURANCE
Contractor shall comply with the Insurance Requirements, attached and incorporated here as Exhibit D, and must maintain the insurance for the duration of the Agreement, or longer as required by City. City will not execute the Agreement until City approves receipt of satisfactory certificates of insurance and endorsements evidencing the type, amount, class of operations covered, and the effective and expiration dates of coverage. Failure to comply with this provision may result in City, at its sole discretion and without notice, purchasing insurance for Contractor and deducting the costs from Contractor's compensation or terminating the Agreement.
13. COMPLIANCE WITH LAWS
13.1 General Laws. Contractor shall comply with all local, state, and federal laws and regulations applicable to this Agreement. Contractor will promptly notify City of changes in the law or other conditions that may affect the Project or Contractor's ability to perform. Contractor is responsible for verifying the employment authorization of employees performing the Services, as required by the Immigration Reform and Control Act.
13.2 Labor Laws. Contractor shall comply with all labor laws applicable to this Agreement. If the Scope of Services includes a "public works" component, Contractor is required to comply with prevailing wage laws under Labor Code Section 1720 and other labor laws. 4Leaf, Inc. for Construc tion Management Jollyman Park Project
13.3 Discrimination Laws. Contractor shall not discriminate on the basis of race, r eligious creed, color, ancestry, national origin, ethnicity, handicap, disability, marital status, pregnancy, age, sex, gender, sexual orientation, gender identity, Acquired-Immune Deficiency Syndrome (AIDS), or any other protected classification. Contractor shall comply with all anti-discrimination laws, including Government Code Sections 12900 and 11135, and Labor Code Sections 1735, 1777, and 3077.5. Consistent with City policy prohibiting harassment and discrimination, Contractor understands that harassment and discrimination directed toward a job applicant, an employee, a City employee, or any other person, by Contractor or its employees or sub-contractors will not be tolerated. Contractor agrees to provide records and documentation to the City on request necessary to monitor compliance with this provision.
13.4 Conflicts of Interest. Contractor shall comply with all conflict of interest laws applicable to this Agreement and must avoid any conflict of interest. Contractor warrants that no public official, employee, or member of a City board or commission who might have been involved in the making of this Agreement, has or will receive a direct or indirect financial interest in this Agreement, in violation of California Government Code Section 1090 et seq. Contractor may be required to file a conflict of interest form if Contractor makes certain governmental decisions or serves in a staff capacity, as defined in Section 18700 of Title 2 of the California Code of Regulations. Contractor agrees to abide by the City's rules governing gifts to public officials and employees.
13.5 Remedies. Any violation of Section 13 constitutes a material breach and may result in City suspending payments, requiring reimbursements or terminating this Agreement. City reserves all other rights and remedies available under the law and this Agreement, including the right to seek indemnification under Section 11 of this Agreement.
14. PROJECT COORDINATION
City Project Manager. The City assigns Susan Michael as the City's representative for all purposes under this Agreement, with authority to oversee the progress and performance of the Scope of Services. City reserves the right to substitute another Project manager at any time, and without prior notice to Contractor.
Contractor Project Manager. Subject to City approval, Contractor assigns Gene Barry as its single Representative for all purposes under this Agreement, with authority to oversee the progress and performance of the Scope of Services. Contractor's Project manager is responsible for coordinating and scheduling the Services in accordance with the Scope of Services and the Schedule of Performance. Contractor must regularly update the City's Project Manager about the progress with the work or any delays, as required under the Scope of Services. City written approval is required prior to substituting a new Representative.
15. ABANDONMENT OF PROJECT
City may abandon or postpone the Project or parts therefor at any time. Contractor will be compensated for satisfactory Services performed through the date of abandonment, and will be given reasonable time to assemble the work and close out the Services. With City's pre-approval in writing, the time spent in closing out the Services will be compensated up to a maximum often percent (10%) of the total time expended to date in the performance of the Services. 4Leaf, Inc. for Construction Management Jollyman Parle Project
16. TERMINATION
City may terminate this Agreement for cause or without cause at any time. Contractor will be paid for satisfactory Services rendered through the date of termination, but final payment will not be made until Contractor closes out the Services and delivers the Work Product.
17. GOVERNING LAW, VENUE, AND DISPUTE RESOLUTION
This Agreement is governed by the laws of the State of California. Any lawsuits filed related to this Agreement must be filed with the Superior Court for the County of Santa Clara, State of California. Contractor must comply with the claims filing requirements under the Government Code prior to filing a civil action in court. If a dispute arises, Contractor must continue to provide the Services pending resolution of the dispute. If the Parties elect arbitration, the arbitrator's award must be supported by law and substantial evidence and include detailed written findings of law and fact.
18. ATTORNEY FEES
If City initiates legal action, files a complaint or cross-complaint, or pursues arbitration, appeal, or other proceedings to enforce its rights or a judgment in connection with this Agreement, the prevailing party will be entitled to reasonable attorney fees and costs.
19. THIRD PARTY BENEFICIARIES
There are no intended third party beneficiaries of this Agreement.
20. WAIVER
Neither acceptance of the Services nor payment thereof shall constitute a waiver of any contract provision. City's waiver of a breach shall not constitute waiver of another provision or breach.
21. ENTIRE AGREEMENT
This Agreement represents the full and complete understanding of every kind or nature between the Parties, and supersedes any other agreement(s) and understanding(s), either oral or written, between the Parties. Any modification of this Agreement will be effective only if in writing and signed by each Party's authorized representative. No verbal agreement or implied covenant will be valid to amend or abridge this Agreement. If there is any inconsistency between any term, clause, or provision of the main Agreement and any term, clause, or provision of the attachments or exhibits thereto, the terms of the main Agreement shall prevail and be controlling.
22. INSERTED PROVISIONS
Each provision and clause required by law for this Agreement is deemed to be included and will be inferred herein. Either party may request an amendment to cure mistaken insertions or omissions of r equired provisions. The Parties will collaborate to implement this Section, as appropriate.
4Leaf, Inc. for Construction Managemen t Jollyman Parle Project
23. HEADINGS
The headings in this Agreement are for convenience only, are not a part of the Agreement and in no way affect, limit, or amplify the terms or provisions of this Agreement.
24. SEVERABILITY/PARTIAL INVALIDITY
If any term or provision of this Agreement, or their application to a particular situation, is found by the court to be void, invalid, illegal, or unenforceable, such term or provision shall remain in force and effect to the extent allowed by such ruling. All other terms and provisions of this Agreement or their application to specific situations shall remain in full force and effect. The Parties agree to work in good faith to amend this Agreement to carry out its intent.
25. SURVIVAL
All provisions which by their nature must continue after the Agreement expires or is terminated, including the Indemnification, Ownership of Materials/Work Product, Records, Governing Law, and Attorney Fees, shall survive the Agreement and remain in full force and effect.
26. NOTICES
All notices, requests and approvals must be sent in writing to the persons below, which will be considered effective on the date of personal delivery or the date confirmed by a reputable overnight delivery service, on the fifth calendar day after deposit in the United States Mail, postage prepaid, registered or certified, or the next business day following electronic submission:
To City of Cupertino
Office of the City Manager
10300 Torre Ave.
Cupertino, CA 95014
Attention: Susan Michael
Email: [email protected]
27. EXECUTION
To Contractor:
4Leaf, Inc.
2126 Rheem Dr.
Pleasanton, CA 94588
Attention : Gene Barry
Email: [email protected]
The person executing this Agreement on behalf of Contractor represents and warrants that Contractor has full right, power, and authority to enter into and carry out all actions contemplated by this Agreement and that he or she is authorized to execute this Agreement , which constitutes a legally binding obligation of Contractor. This Agreement may be executed in counterparts, each one of which is deemed an original and all of which, taken together, constitute a single binding instrument.
SIGNATURES CONTINUE ON THE FOLLOWING PAGE
_______ 4.;.;;;L~eaf, Inc. for Construction Management Jollyman Park Project
IN WITNESS WHEREOF, the parties have caused the Agreement to be executed.
CITY OF CUPERTINO
A Municipal Corporation
By _________ _
Name ________ _
Title _________ _
Date _________ _
APPROVED AS TO FORM:
CHRISTOPHER D. JENSEN
Cupertino City Attorney
ATTEST:
KIRSTEN SQUARCIA
City Clerk
Date _________ _
CONTRACTOR
By F 8 7
Name Gene Barry
----------
Title Vice President
Date May 23, 2024
4Leaf, Inc. for Construction Management Jollyman Park Project
EXHIBIT A, BAND C
- 4LEAF, INC. CONSTRUCTION MANAGEMENT • INSPECTION • PLAN CHECK • PLANNING V)
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City of Cupertino
Susan Michael
Capital Improvement Project Manager
Public Works
10300 Torre Ave.
Cupertino, CA 95014
Submitted via E-mail as Acrobat PDF Document to [email protected] May 20, 2024
RE: Updated Cost Estimate to Provide Construction Management and Inspection Services for the City of Cupertino All-Inclusive Playground at Jollyman Park.
Dear Ms. Michael:
4LEAF, Inc. ("4LEAF") appreciates the opportunity to submit our updated Cost Estimate to provide Construction Management (CM) and Inspection services for the City of Cupertino ("City") Public Works All-Inclusive Playground at Jollyman Park Project ("Project") . This proposal supersedes 4LEAF's Cost Estimate submitted to Evelyn Moran with the City on December 1, 2023, and updated Cost Estimate submitted to you on April 24, 2024.
The attached updated Cost Estimate provides a detailed breakdown of our estimated level of effort and includes the following general assumptions:
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One part-time Construction Manager at an average of 20 hours per week during the construction phase for a duration of 7.5 months.
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One, Construction Inspector at 8 hours per day at regular time rate for 100 working days. Based on our recent conversation, this assumes that the Construction Inspector will not be required to be on site full-time for portions of the project (e.g. when above-ground items are being constructed and can be inspected periodically). We have also included a budgetary estimate for inspection hours at the overtime rate for an assumed 20 hours when the contractor works more than 8 hours /day.
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Per your request, our estimate includes a cost proposal tram our subconsultant, Construction Testing Services ("CTS") to perform material testing and special inspections. It assumes that CTS will not assume the role of Geotechnical Engineer of Record for the project and will provide the special inspections identified on the Statement of Special Inspections form that was completed by the Design Engineer and provided to 4LEAF by the City. A copy of the Statement of Special Inspections form is provided as Attachment B of this proposal.
Per the City's original request, our cost proposal does not include budget for performing detailed or in-depth labor compliance monitoring services that are typically provided by our subconsultant, Contractor Compliance & Monitoring, Inc. (CCMI). Our cost estimate does include budget for 4LEAF staff to provide intermittent and cursory reviews of contractor and subcontractor certified payroll information that is provided with the contractor pay applications .
No construction schedule or defined construction start date was available at the time of submittal of this cost estimate so we are unable to identify specific staff that may be assigned to the Project at this time. 2 1 26 RHEEM DRIVE • PLEASANTON, CA 94588 •
8896 NORTH WINDING WAY • FAIR OAKS, CA 95628 •
PHONE (925) 462-5959 •
PHONE (916) 965-001 0 •
FAX (925) 462-5958
FAX (91 6) 965-00 1 3
Updated Cost Estimate to Provide CM and Inspection Services for the City of Cupertino All-Inclusive Playground at Jollyman Park Project 4LEAF appreciates the opportunity to provide this proposal to the City. If you have any questions, please do not hesitate to contact me by phone at (925) 462-5959 or by e-mail at [email protected] .
Respectfully Submitted,
4LEAF, Inc.
Gene Barry, P.E.
Vice President
2126 RHEEM DRIVE • PLEASANTON, CA 94588 •
8896 NORTH WINDING WAY • FAIR OAKS, CA 95628 •
PHONE (925) 462-5959 • FAX (925) 462-5958
PHONE (916) 965-00 1 0 • FAX (916) 965-00 1 3
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Updated Cost Estimate to Perform Part-Time Construction Management and Full-Time Construction Inspection Services for the City of Cupertino All-Inclusive Playground at Jollyman Park May 20, 2024
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0. Task Task Task Description 0 oo ::, 0. 0 Notes a: u u!=. u- Q. Q. < u Hourly Rate $207 $175 $156.67 $211.50 $105.00 $97.85 See Notes (a), (b), & (c). l Preconstrudion Phase Hours Hours Hours Hours Hours Hours Hours la Attend Teleconferen ce Kickoff Meetin• w/ Client. 1 1 1 0 0 3 $539 lb Perform Visual Pre-Construction Project Site Condition 0 2 16 0 0 18 $2,857 Documentation. .. le Review Conformed Set of Project Plans and Specifications. 1 16 8 0 0 2S $4 260 See Note Id\ ld Prepare for and Chair Pre-Construction Conference Meeting. 1 16 4 0 0 21 $3,634 le Receive and Process Early Contractor Submittals. 0 20 4 0 0 24 $4,127 See Note (e). 1f Miscellaneous Pre-Construction Tasks. 0 20 16 0 0 36 $6,007 lg Proiect Mana~ement. 2 0 0 0 0 2 $414
Task 1 Subtotal: 5 75 49 0 0 119 ~21837
2 Construction Phase Hours Hours Hours Hours Hours Hours Hours See Notes (e) & (f) 2a Perform Construction Manaeement. 0 600 0 0 0 600 $10S,OOO See Note (g) 2b Perform Construction Inspections. 0 0 800 20 0 820 $129,566 See Note (g) 2c Receive and Process Subconsultant Invoices. 0 0 0 0 lS lS $1,57S 2c Proiect Management. 30 0 0 0 30 $6,210
2d Materials Testine: and Soecial Inspectio ns (CTS). $70,688 See Note (h) Task 2 Subtatal : 30 600 800 20 15 .. 1,465 $313,039
3 I Post Construction Phase Hours Hours Hours Hours Hours Hours Hours 3a Final Inspections and Provide Red-lined Set of Plans to Client. 0 4 16 0 20 $3,207 3b Construction Management - Project Closeout. 0 24 0 0 24 $4,200 3c Proiect Management. 4 0 0 0 4 $828
Task 3 Subtotal: 4 28 16 0 0
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48 $8,235
TOTAL 14LEAF + CTS}: 39 703 865 20 15 1642 5343111
4 Public Warks lnsaection Aoorenticeshio /if Reauired} Hours I Hours Hours Hours Hours Hours Hours 4a Provide Public Works lnsoection Aoorentice 0 0 0 0 0 160 160 $15 656 See Notes (a) and (b).
Task 4 Subtotal /Aoorentice Onlv! 0 0 0 0 0 160 160 515.656 I
TOTAL [4LEAF + CTS + Apprentice (if required)] 39 703 865 20 15 160 1,802 $358,767 Notes:
(a) Assumes project will require compliance with California Prevailing Wage rate requirements under SB 854, and the Client will be required to file a PWC-100 Form to the California Department of Industrial Relations for the project. (b) Per the new requirements being enforced under SB 854 and because it Is assumed that a PWC-100 Form will be filed by the City to the CA DIR, 4LEAF is required to notify an authorized Apprenticeship Committee th rough submittal of a DAS-140 form. We are then required to make an official request to an authorized Apprenticeship Committee for an apprentice by submitting a OAS-142 form. We are not assured the apprenticeship committee will be able to provide a suitable/ qualified apprentice for the project. Per the apprenticeship requirements , the hours worl<ed by the apprentice must be in a ratio of 1:5 for apprentice to journeyman hours. Hours are included as a placeholder in the event that an apprenticeship for a public works inspector is required and dispatched by the apprenticeship committee. We have assumed the public works apprentice assigned to the project wiH be classified as a Period l Apprentice as defined by the DI R's Wage Determination dated 8/22.
In the event that a higherdassification apprentice is assigned to the project, we will contact the City to request a change order for this line item. (c) 4LEAF staff will be supplied with typical tools of the trade to perform their daily tasks (e.g. cell phone, laptop computer, and PPE). (d) Not intended as a Constructlbility Review but for 4LEAF staff to come up to speed on the project. (e) Assumes the City will provide budget for the Project Design Team to remain engaged and available during the pre-construction and construction phase to provide responses to design darificatons, RFls, Submittals, etc. {f) No construction schedule was available at the time of preparation for this estimate. (g) Per additional information provided by Susan Michael with the City on 5/17/24 and a phone conversation between Susan and Gene Barry with 4LEAF on 5/20/24, the City requested that the estimate assume that full-time inspections won't be required throughout the project (for instance when the contractor is installing above-ground equipment). The City has not yet contracted with QLM (contractor who is apparent low bidder) and no construction schedule was available. For purposes of this revised estimate, we assumed the construction phase wnl have a duration of 150 working days (7 .5 months) . For estimating purposes, we have assumed one, part.time Construction Manager at 20 hrs/wk at 4 wks/mo at 7.5 months during the Construction Phase. We also assume a Construction Inspector at 8 hrs/day for 100 worlting days at regular•time rate and an assumed budgetary estimate of 20 hours at the overtime rate for instances when the contractor wokrs longer than 8 hours per day. This assumes that inspections will not be needed continuously during the construction phase. Does not include any allowance for addltional OT or any nighttime, weekend, or holiday work. If additiona l nighttime, weekend, or holiday worlt Is required , the require ments for these hours will be billed in accordance with California Prevailing Wage law requirements. If construction inspection frequencies exceed the assumed quantities, if the duration extends past 150 working days, or the contractor works more than 8 hours per day during the project, 4LEAF will submit a budget amendment request.
SUBCONSULTANT SCOPE OF SERVICES AND COMENSATION
~ CONSTRUCTION
~ TESTING SERVICES PRELIMINARY ESTIMATE: QUALITY ASSURANCE INSPECTIONS & TESTING DATE:
PROPOSAL No.:
CLIENT:
05/20/2024
P24820
1248 - 4LEAF, Inc
PROJECT: City of Cupertino, All-Inclusive Playground atJollyman Park (4LEAF)
1000 S Stelling Rd
LOCATION: Cupertino
ITEM: I
ONSITE TESTING & INSPECTIONS
REINFORCING STEEL & CONCRETE
FOOTINGS/GRADE BEAMS
WALLS & COLUMNS
SLAB ON GRADE
OTHER - MISC CONCRETE
MISC FIELD TESTING SERVICES
EPOXY REBAR/BOLTS - INSTALL OBSERVATION
EPOXY REBAR/ BOLTS - PROOF LOADING/PULL TESTING (PORTAL TO PORTAL)
EXPANSION/SCREW ANCHOR - INSTALL OBSERVATION
EXPANSION ANCHOR - TORQUE TESTING (PORTAL TO PORTAL)
PORTAL TO PORTAL TRAVEL TIME· TEST EQUIPMENT TRANSPORT
PORTAL TO PORTAL MILEAGE • TEST EQUIPMENT TRANSPORT
SOILS & ASPHALT
GRADING OBSERVATION
ITEM: Ill
SOILS COMPACTION TESTING - SUBGRADE PREPARATION
SOILS COMPACTION TESTING - BUILDING PAD
SOILS COMPACTION TESTING - SITEWORK
SOILS COMPACTION TESTING - TRENCH BACKFILL
PORTAL TO PORTAL TRAVEL TIME - NUCLEAR GAUGE TRANSPORT
PORTAL TO PORTAL MILEAGE - NUCLEAR GAUGE TRANSPORT
LABORATORY TESTING & ENGINEERING
ITEM: IV
CONCRETE COMPRESSION TESTS ( SET OF 5-4X8 CYLINDERS )
SOIL GRADATION
SOIL PLASCIITY INDEX
SOIL MODIFIED PROCTOR
SAMPLE PICK-UPS
MIX DESIGN REVIEW
STAFF ENGINEER
FIELD SUPERVISION
PROJECT MANAGER
PRINCIPAL ENGINEER IN CHARGE
FINAL LETTER - ENGINEER REVIEW
FINAL LETTER
CERTIFIED PAYROLL
ADD ALTERNATE ITEMS
REINFORCING STEEL & CONCRETE
PIERS - CONCRETE PLACEMENT (SUN SHADE)
PIER DRILLING OBSERVATION (SUN SHADE)
ESTIMATED ESTIMATED UNIT
DAYS HOURS PRICE
4 4 $160.00
4 8 $160.00
4 4 $160.00
4 4 $160.00
4 4 $160.00
4 4 $160.00
4 2 $160.00
4 2 $160.00
8 2 $160.00
8 80 $0.670
2 8 $160.00
2 8 $160.00
1 8 $160.00
6 4 $160.00
5 4 $160.00
14 2 $160.00
14 80 $0.670
Preliminary Sub-Total of Onsite Testing & Inspection (approx.)
ESTIMATED UNIT
UNIT/HOURS PRICE
75 $50.00
2 $275.00
2 $400.00
4 $350.00
83 $30.00
3 $310.00
8 $200.00
4 $230.00
3 $200.00
1 $365.00
2 $260.00
1 $310.00
ESTIMATED
TOTAL
$2,560.00
$5,120.00
$2,560.00
$2,560.00
$2,560.00
$2,560.00
$1,280.00
$1,280.00
$2,560.00
$428.80
$2,560.00
$2,560.00
$1,280.00
$3,840.00
$3,200.00
$4,480.00
$750.40
$42,139.20
ESTIMATED
TOTAL
$3,750.00
$550.00
$800.00
$1,400.00
$2,490.00
$930.00
$1,600.00
$920.00
$600.00
$365.00
$520.00
$310.00
9 $180.00 $1,620.00
Preliminary Subtotal of Laboratory Testing & Engineering (a,._p._pr_o_x_.1 __ $_1 __ s_,s_s_s_.o_o-t $57,994.20 Preliminary Estimated Fees
Project Administration (12%)
Total Preliminary Estimated Fees
ESTIMATED
DAYS
ESTIMATED
UNIT/HOURS
UNIT
PRICE
$6,959.30
$64,953.50
ESTIMATED
TOTAL
$2,560.00
$2,560.00
Preliminary Sub-Total of Geotechnical Testing & Inspection (approx,) __ $._5""",_12_0_.0_0-I 4 4
4 4
$160.00
$160.00
Preliminary Estimated Fees
Project Administration (12%)
Total Preliminary Estimated Fees
$5,120.00
$614.40
$5,734.40
*Steel shop price based on work being done in Northern California in one shop and one shift. If work is performed at night a 12.5% differential will be charged. **Estimate assumes that CTS will not be acting as the geotechnical engineer of record .
Depending location of facility, travel time and mileage may apply.
A 12% project administration fee will be charged monthly per invoice.
No contingency is budgeted by CTS for uncontrollable overtime, union or prevailing wage incre ases and unfores een requirements that may arise in the specifications, as well as for work over the estimated hours . Owner should budget appropriate amount for budgetary purposes .
Estimate based on plans by KPFF Structural Engineers dated , 03/22/24.
No construction schedule was available at the time this estimate was prepared . See attached fee schedule for basis of charge s.
The liability of Construction Testing Services (CTS) is limited to CTS's contra ct value. ~ -··, CONSTRUCTION • i-~-- TESTING SERVICES I I www.cts - 1.com 2024 FEE SCHEDULE - P24820 05/20/2024
PERSONNEL FEES AND BASIS OF CHARGES
INSPECTIO NS, ENGINEERING & SPECIA L SERVICES
• FIELD INSPECTION AND LABORATORY SERVICE
Steel Visual
Nondestructive - UT, MT, PT
Steel Visual/UT Combination
Steel Shop Inspections - Outside Northern California
Concrete ACI
Concrete ICC
Masonry
Fireproofing
Firestopping
Shear Wall Nailing/Framing/Hold Downs
Soil Technician w/Nuclear Gauge and/or Sand Cone (portal-to-portal) Asphalt Technician (portal-to-portal)
Shoring/Soldier Piers
Roofing & Waterproofing
NACE Coating Inspection - Level II
NACE Coating Inspection - Level Ill
Med-Gas 6020
Multi-DiscipHned Inspector
Inspector Requiring G1 Pay Grade
Specialty Inspector or Where Formal Certification is Required Field Inspector with Special Enhancement
DSA Masonry Inspector
Safety Manager/Safety lnspector/Jobsite Safety Accountabi6ty Supervisor (JSAS) Laboratory Technician
Additional Sample Preparation nme
Technician Typist
.. PROFESSIONAL ENGINEERING SERVICES
Principal Engineer (CivlVStructuraO
Geotechnical Engineer
Professional Geologist
Consulting Engineer (CivlVStructuraO
Associate Engineer, Licensed
Project Manager/Project Executive
Staff Engineer
Field Supervision
ASNTLevel 111
Drafting
Quality Control Manager
SPECIAL SERVICES
Portable and Mobile Laboratories, NOT and Soils
Epoxy Bolt/Expansion Anchor - Installation Observation
• Epoxy Bolt/Expansion Anchor Proof Load Testing (portaf-to-portaf) • Coring, 1 Person Oncluding equipment) (portal-to-portal) • Coring, 2 Persons Oncluding equipment) (portal-to-portal) • Asphalt Coring (portal-to-portal)
Project Research
Ultrasonic Testing for Non-Metallic Materials
Pavement Rehabilitation Analysis Using Deflections
Roof Moisture Survey
Soil Drilling Equipment
Geotechnica/ Site Investigations/Foundation Reports
Estimating Concrete Strength by the Maturity Method - Equipment Fee $125/kit CSLJCrosshole Sonic Logging
Vector Mapping
Roof Uplift Testing
Inclinometer Testing
Vibration Moniroring/Accelerometer
TIit Monitoring
External Windows And Doors Dynamic Water Penetration Testing Curtain Wall Testing
Ground Penetrating Radar
OCP - Dynamic Cone Penetrometer
Gamma-Gamma Logging of CIDH Piles (Daily Rate)
FGIA/AAMA Window and Skylight Testing (Daily Rate)
Pachometer, Schmidt Hammer, Windsor Probe, Skidmore - Equipment Fee $115/0ay (portal-to-portal) Ultrasonic Pulse Velocity Testing - Equipment Fee $250/0ay (portaf-to-portal) Impact Echo Testing - Equipment Fee $250/Day (portal-to-portal) Floor Flatness Testing FF/FL- Equipment Fee $115/Day (portal-to-portal) Surface Frictional Properties Using Pendulum Tester- Equipment Fee $115/0ay (porta~to-portal) Measuring Moisture Vapor Emission Rate (Calcium Chloride) - $55/Kit (portal-to-portal) Relative Humidity Testing -$75/Kit (portal-to-portal)
Ferroscan - Equipment Fee $115/day (portal-to-portal)
GPR - Equipment Fee $115/day (portal-lo-portal)
Dynamic Cone Penetrometer- Equipment Fee $155/day
Administration, Secretarial, Special Projects, Notary, Certified Payroll Concrete/Grout/Mortar Mix Design Review (less than 48 hours notice - $500) Welding Procedure Review (less than 48 hours notice - $500) Procedure Qualification Record (PQR) - Standard Procedure (document fee) Welding Procedure Specification (WPS} - Standard Procedure (document fee) Welder Quafification Test Record (WQTR) - Standard Procedure (document fee) DSA Interim Reports
Geotechnical Pad Letter (less than 48 hours notice - $550) Final Letter (less than 48 hours notice - $550)
EXPERT WITNESS TESTIMONY
Court appearance, per day
Court appearance, per half day
• Field inspection and laboratory technician services will be billed in accordance with minimums shown on Basis of Charges **Prot&ssional anginesring services will ba bi/lad in two hour increments.
ASTM C1074
AAMA501.1
AAMA501.2
CT233
ASTM E1105, AAMA 501.2, 502 503
ASTM C597
ASTM C1383
ASTM E1155
ASTM E303
ASTM F1 869
ASTM F2170
All fees subject to Basis of ChllTgts
Standard
Rate/Hour
$245.00
$250.00
$250.00
$245.00
--
$245.00
$245.00
$245.00
$245.00
-
$245.00
$245.00
$245.00
$295.00
$355.00
$245.00
$245.00
$295.00
$245.00
$245.00
$250.00
$515.00
$245.00
$245.00
$245.00
-
$335.00
$320.00
$315.00
----
$295.00
$180.00
OOR
OOR
--
$320.00
$475.00
$345.00
OOR
OOR
OOR
OCR
OCR
OOR
OCR
OCR
OCR
OCR
OCR
OCR
OOR
OCR
OCR
OOR
OCR
$3,605.00
$3,605.00
$355.00
$705.00
$355.00
$355.00
$355.00
$355.00
$355.00
$355.00
$405.00
$405.00
---
$555.00
$555.00
$555.00
$230.00
$405.00
-
$3,005.00
$2,005.00
Inspecting
testing
engineering
Discounted
Rate/Hour
$160.00
$160.00
$160.00
$365.00
$260.00
$200.00
$200.00
$230.00
$160.00
$160.00
$180.00
$310.00
$310.00
$310.00
- CONSTRUCTION • !""t'A TESTING SERVICES I I www.cts-1.com
BASIS OF CHARGES
GENERAL
Fees for tests and inspection include cost of technician, normal equipment and regular reports. Engineering services will be charged at applicable rates and will require travel and mileage charges for equipment transport and storage per code (portal to portal) from the nearest CTS laboratory. Soils testing with nuclear gauge and/or sand cone equipment and inspections requiring equipment will require applicable travel and mileage charges for equipment transport and storage per code (portaJ..to-portal) from the nearest CTS laboratory .
Fees for special projects, services overseas, or elsewhere in the United States, will be quoted on request. VVith prior notification to Client; charges are subject to change at any time.
Construction Testing Services reserves the right to adjust the rates quoted in this contract based upon any Union or prevailing wage increases and/or changes in any industry requirements.
MINIMUM HOURLY CHARGES-INSPECTION
Technician personnel and the following minimum charges are contractual commitment:
One-half day or less
Over one-half day
Show-up time (less than 2 hours notice= 4 hour charge)
WORKING HOURS AND PREMIUM TIME
4 Hours
8 Hours
2 Hours
Regular workday is the first 8 hours between 6:00 am and 6:00 pm Monday through Friday. Premium time is as follows:
Overtime, Weekdays and Saturdays (first 8 hours) 1.5 x quoted hourty rate Overtime Saturdays (over 8 hours) and Sundays (first 8 hours) 2 x quoted hour1y rate Overtime Sundays (over 8 hours) and Holidays 3 x quoted hour1y rate Shift differential , swing and graveyard -
(Work performed between 2:00 pm and 4:00 am)
MISCELLANEOUS CHARGES - Only Where Applicable
Notary Seivices Fee
Facsimile Charges. Plus $1.00/page (n/c for cover page) Wireless Router/Data Card for Jobsite Internet
iPad Monthly Rental Fee
Electronic Reporting Fees/Subscriptions (PlanGrid, BIM, etc.) Parking Fees
Air Travel
Outside Services
Subsistence (per Union contract)
Subsistence Premium: Meal Allowance (over 100 miles one way) (per Union contract) Subsistence Premium: Meal Allowance (over 150 miles one way) (per Union contract) Mileage
Sample Pickup
Sample Pickup Trip Charge
Weekend Sample Pickup
Project Administration
Samples Made by Others: Concrete Cylinders
Samples Made by Others: All Other Tests
Laboratory Sample Witness Fee
Laboratory Sample Storage Fee (per sample)
EZ Cure Boxes (Thermostatically Controlled Curing Boxes) Returned Check Fee
Additional Sample Retention
TESTS
12.5%/hour additional to base or quoted rate.
$45.00/each
$12.00/minimum
$140.00/day
$105.00/month
At Cost
At Cost
Cost Plus 20%
Cost Plus 30%
$135.00/day
$35.00/day
$90.00/day
Standard Federal Rate
-
QOR
$155.00/each
29% ef P4entA~ lfheiee
$135 + Test
$80.00 + Test
$135.00
$125.00
QOR
$155.00
QOR
$30.00/each
12% of Monthly Invoice
Testing fees shown include normal time for performing test. Samples requiring special preparation will be charged at the laboratory technician rate. Fees for tests not listed will be quoted upon request. There will be a minimum charge of $100.00 for any engineering report. Please note some tests may be tested by subconsultants. Samples delivered to the laboratory after 3:00pm or samples needing results within 24 hours will incur a 50% mark-up.
INSURANCE
The liabiHty of Construction Testing Services (CTS) is limited to CTS's contract value.
PAYMENT
Invoices will be submitted monthly or bimonthly for services performed during the preceding month and are payable on receipt. Interest of 1.5% per month (but not exceeding the maximum rate allowable by law) will be payable on any amounts not paid within 30 days, payment thereafter to be applied first to accrued interest and then to the principle unpaid amount. Attorney's fees or other costs incurred in collecting any delinquent amount shall be paid by client. Visa, MasterCard and American Express payments are accepted however fees will apply. Visa and MasterCard payments require an additional 3% on top of the amount of the invoice being paid. American Express payments require an additional 4% on top of the amount of the invoice being paid.
All /us .1ubj~el to Brull o/Chargn
inspec ttng
testi ng
en gineeri ng
-- CONSTRUCTION .. ~ TESTING SERVICES
I l www.cts-l.com
CONCRETE ANO MASONRY TESTS
CONCRETE
Compressive Strength of Cylindrical Concrete Specimens (6x12) Compressive Strength of Cy~ndrical Concrete Specimens (4x8) Compressive Strength of Cyindrical Concrete Specimens (Over 8000 PSI) Cylinder molds. 6" x 12" and 4" x 8"
Compressive Strength of Lightweight Insulating Concrete Compressive Strength of Cytindrical Concrete Core and Sawed Beam Specimens Flexural Toughness of Fiber Reinforced Concrete (Round Panel) Flexural Strength of Concrete (Using Simple Beam with Third-Point Loading) Flexural Strength of Concrete (Using Simple Beam with Third-Point Loading) Length Change of Hardened Hydraulic-Cement Mortar and Concrete (Shrinkage, 1 Sample) Shotcrete Nozzleman Qualification Letter (Per Nozzleman , Per Position) Shotcrete Pre-Quaification Cores (Compression and Visual) Shotcrete Production Cores
Coefficient of Thermal Expansion
Determining Density of Structural Lightweight Concrete (Cylinders) Standard Specification for Concrete Made by Volumetric Batching and Mixing Cement Quality Sampling
Physical Testing of Gypsum, Gypsum Plasters and Gypsum Concrete Splitting Tensile Strength of Cylindrical Concrete Specimens Static Modulus of Elasticity and Poisson's Ratio of Concrete in Compression Grab Sample, Sealing and Storing in a Humidity and Temperature Controlled Room Density of Hydraulic Cement
Testing of Controlled Low Strength Material (CLSM) Test Cylinders GFRC Pull Test
GFRC Flexural Test
Foaming Agents for Use in Producing Cellular Concrete Using Preformed Foam (Cell-Crete)
MASONRY
Compressive Testing of Grout (Masonry)
Compressive Strength of Hydraulic Cement Mortars Using 2· Cube Specimens Compressive Strength of Masonry Prisms
Testing Concrete Masonry Units and Related Units (Core Compression) Compressive Strength of Mokled Masonry Mortar Cylinders and Cubes (2" Sample) Testing Concrete Masonry Units {CMU) and Related Units (Full Unit) Linear Drying Shrinkage of Concrete Masonry Units (Per Unit) Masonry Core Shear Testing
Testing Concrete Masonry Units (Absorption, Moisture Content, Unit Weight) Brick and Clay Tlle (modulus of rupture, compression, saturation coefficient, suction rate, efflorescence)* Mortar Molds. 2" x 4". Single Use
Mortar or Grout , Stored and Cured, Not Tested (Including Mold) Veneer Bond Testing, does not include sample fabrication (Set of 5)
AGGREGATES (CONCRETE AND SOILS)
Sieve Analysis of Coarse Aggregates {Coarse Only 2~ - No.4)(sample size over 2" QOR) Sieve Analysis of Fine Aggregates (Fine Only, Wash Included No.4- No.200) Sieve Analysis of Combined Fine and Coarse Aggregates (Wash Included 2" - No.200) (sample size over 2" QOR)
Materials Finer Than 75-µm (No. 200) Sieve in Mineral Aggregates by Washing (200 Wash) Evaluating Cleanness of Coarse Aggregate
Soundness of Aggregates by Use of Sodium Sulfate or Magnesium Sulfate Bulk Density/Unit Weight of Aggregate
Clay Lumps and Friable Particles in Aggregates
Flat Particles, Elongated Particles or Flat and Elongated Particles in Coarse Aggregate Organic Impurities in Fine Aggregates for Concrete
Density, Relative Density(Specific Gravity), and Absorption of Coarse Aggregate Density, Relative Density(Specific Gravity), and Absorption of Fine Aggregate Resistance to Degradation of Small Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine
Resistance to Degradation of Large Size Coarse Aggregate by Abrasion and Impact in the Los Angeles Machine
Percentage of Crushed Particles/Standard Test Method for Determining the Percentage of Fractured Particles in Coarse Aggregate
Uncompacted Void Content of Fine Aggregate (as Influenced by Particle Shape, Surface Texture, and Grading)
Sand Equivalent Value of Soils and Fine Aggregate
Durability Index (Fine)
Durabifity Index (Coarse)
Durabrnty Index (Fine and Coarse)
Lightweight Particles in Aggregate
Resistance of Rock to Wetting and Drying
Aggregate Moisture Content
*Unusual sample preparation tor brick specimen will be charged at the established hour/',' rata.
ASTM C39 and CT521
ASTM C39 and CT521
ASTM C39 and CT521
ASTM C470
ASTM C495
ASTM C42
ASTM C1550
ASTM C78
CT523 and CT524
ASTM C157
ACI 506, ASTM C42 and C1140
AC! 506, ASTM C42 and C1140
ASTM C1140
AASHTOT336
ASTM C567
ASTM C685
CBC 2010
ASTM C472
ASTM C496
ASTM C469
CBC
ASTM C188
ASTM D4832
PCI
PCI
ASTM C796
ASTM C1019
ASTM C109
ASTM C1314
CBC 2105A.4
ASTM C780 A7.6
ASTM C140
ASTM C426
CBC 2105A.4
ASTM C140
ASTM C67
ASTM C482
ASTM C136, CT202, and AASHTO T-27
ASTM C136/C117, CT202, and AASHTO
27/AASHTO T-11
ASTM C136/C117, CT202, and AASHTO
27/AASHTO T-11
ASTM C117, CT202, and AASHTO T-11
CT227
ASTM C88, CT214, and AASHTO T-104
ASTM C29, CT212, and AASHTO T-19
ASTM C 142 and AASHTO T-19
ASTM D4791 and CT235
ASTM C40 and CT213
ASTM C127, CT206, and AASHTO T-85
ASTM C128, CT207, and AASHTO T-84
ASTM C131, C211, and AASHTOT-96
ASTM C535
ASTM D5821, CT205, and AASHTO T-335
ASTM C1252, CT234, and AASHTO T304A
ASTM D2419, CT217, and AASHTO T-176
ASTM D3744, CT229, AASHTO T-210
ASTM D3744, CT229. AASHTO T-210
ASTM D3744, CT229. AASHTO T-210
ASTM C123 and AASHTO T113
CRD-C169
ASTM C566
All fees subjt!ct to Basis of Chargts
Standard
Rate/Each
$100.00
-
$175.00
$95.00
$115.00
$150.00
$560.00
$360.00
$360.00
$185.00
$510.00
$135.00
$135.00
$585.00
$460.00
$3,000.00
$710.00
$75.00
$280.00
$260.00
$170.00
$230.00
$185.00
$450.00
$450.00
$610.00
$145.00
$145.00
$220.00
$220.00
$145.00
$220.00
$325.00
$325.00
$400.00
$1,060.
00 $145.00
$145.00
$535.00
$255.00
T-
-
T-
$410.00
$255.00
$410.00
$900.00
$235.00
$260.00
$425.00
$425.00
$425.00
$425.00
$575.00
$575.00
$460.00
$460.00
$325.00
$460.00
$460.00
$600.00
QOR
$635.00
$635.00
inspecting
testing
engineering
Discounted
Rate/Each
$50.00
$275.00
- CONSTRUCTION
• ~-- TESTING SERVICES I I www.cts-1 . com
SOILS AND AGGREGAT E SERVICES AND TESTS
SOILS
Moisture Content of Soil by Oven
Moisture Content of Soil by Microwave Oven
Density of Soil in Place by the Drive-Cyfinder Method including Moisture Content of Soil by Oven Remold of Soil Samples
Hydraulic Conductivity of Saturated Porous Materials Using a Flexible Wall Permeameter (Permeability) Permeability Additional Cell Time
Direct Shear Test of Soils Under Consolidated Drained Conditions (per point) Consolidated Undrained Triaxial Compression Test for Cohesive Soils (three points) Consolidated Undrained Triaxial Compression Test for Cohesive Soils (added points) Consolidated Undrained Triaxial Compression Test for Cohesive Soils (single point) Consolidated Undrained Triaxial Compression Test for Cohesive Soils Oncludes 3 points)Oncludes Pore Pressures)
Consolidated Undrained Triaxial Compression Test for Cohesive Soils (added points)Oncludes Pore Pressures)
Consolidated Undrained Triaxial Compression Test for Cohesive Soils (single point)Oncludes Pore Pressures)
Unconsolidated Undrained Triaxial Compression Test for Cohesive Soils (per point) Unconsolidated Undrained Triaxial Compression Test for Cohesive Soils with added backpressure saturation (per point)
One-Dimensional Consolidation Properties of Soils Using Incremental Loading Unconfined Compressive Strength of Cohesive Soil
Compressive Strength of Molded Soil-Cement Cylinders
Particle-Size Analysis of Soils (with Hydrometer)
Particle-Size Analysis of Soils (without Hydrometer)
Particle-Size Distribution of Fine Grained Soils using Sedimentation Analysis Particle-Size Distribution (Gradation) of Soils Using Sieve Analysis (2• - No.200) (sample size over 2" QOR)
Material Finer than No.200 by Washing (200 Wash)
Liquid Limit, Plastic Limit, and Plasticity Index of Soils Determination of Organic Soils Classification using Liquid Limit of Soils Organic Content of Soils and Peat
Unified Soil Classification System (USC$) Test
Moisture-Density Relations of Soil Using Modified Effort (Modified Proctor) Moisture-Density Relations of Soil Using Standard Effort (Standard Proctor) Moisture-Density Relations of Soil Using Modified DWR Method Moisture-Density Relations of Soil Using Rapid Compaction Method Moisture-Density Relations of Soil-Cement Mixtures
Moisture-Density Relations of Soil, 1 Point Check Point Moisture-Density Relations of Soil, 2 Point Check Point Moisture-Density Relations of Soil, 3 Point Check Point Moisture-Density Relations of Soil, 1 Point Check Point Moisture-Density Relations of Soil, 2 Point Check Point Moisture-Density Relations of Soil, 3 Point Check Point Maximum Index Density and Unit Weight of Soils Using a Vibratory Table Minimum Index Density and Unit Weight of Soils and Calculation of Relative Density Maximum Ory Unit Weight of Granular Soils Using a Vibrating Hammer Relative Compaction of Untreated and Treated Soils and Aggregates Determining the Resistance ~ R ~ Value of Treated and Untreated Bases, Subbases , and Basement Soils by the Stabiliometer
Expansion Index of Soils
Standard Test Methods for Specific Gravity of Soil Solids by Water Pycnometer pH of Soils
Density of Hydraulic Cement
Volatile Organic Content
Semi Volatile Organics by GC/Ms (Basic Target List)
Total Organic Carbon
ICP Metals Concentration
Total Extractable Petroleum Hydrocarbons : TPH, MTBE, Benzene ,Toluene , Ethylbenzene , Zylenes , ¾SS ICP Metals Concentration
pH
Sequential Batch Extraction of Waste with Acidic Extraction Fluid Chromium Soluble
Ca/trans Corrosivity Package
Determining Fiek:I and Laboratory Resistivity and pH Measurements for Soil and Water Soils and Waters for Sulfate Content
Soils and Waters for Chloride Content
Pore Water Extraction and Determination of the Soluble Salt Content of Soils by Refractometer California Bearing Ratio Test (does not include moisture density relations) Bentonite Slurry Testing
Unconfined Compressive Strength of Lime Treated Soils and Aggregate s Unconfined Compressive Strength of Lime Treated Soils and Aggrega tes ASTM D2216, CT226 , and AASHTO T-265
ASTM D4643
ASTM D2937
Varies
ASTM D5084
ASTM D3080
ASTM D4767
ASTM D4767
ASTM D4767
ASTM D4767
ASTM D4767
ASTM D4767
ASTM D2850
ASTM D2850
ASTM D2435
ASTM 02166 and CT221
ASTM D1633
ASTM D422
ASTM D422
ASTM 07928 and ASTM 0422
ASTM D6913
ASTM D1140
ASTM D4318 and CT204
ASTM D4318/02487
ASTM D2974
ASTM D2467
ASTM D1557
ASTM D698
OWRModified
ASTM D5080
ASTM D558
ASTM D698
ASTM D698
ASTM D698
ASTM D1557
ASTM D1557
ASTM D1557
ASTM D4253
ASTM D4254
ASTM D7382
CT216
ASTM D2844 and CT301
ASTM D4829
ASTM D854
ASTM D4972
ASTM C188
EPA82608
EPA 8270C
ASTM 2974/EPA 53108m
EPA 6020 - CAM/CCR 17
EPA 80158
EPA 6020
EPA 9045D
ASTM D5284
EPA 7196A
CT643
CT417
CT422
ASTM D4542
ASTM D1883
CT 373 (4 pts)
CT 373 (3 pts)
Standard
Rate/Each
$180,00
$235.00
$265.00
$160.00
$610.00
$610.00
$610.00
$1 ,110.00
$385.00
$385.00
$1 ,960.00
$660.00
$660.00
$195,00
$325.00
$585.00
$500,00
$500.00
$670.00
$610.00
$610,00
$395.00
$245.00
-
$785,00
$340.00
$360.00
-
$535.00
$535.00
$535.00
$535,00
$410.00
$460.00
$535,00
$410.00
$460.00
$535.00
$560,00
$340.00
$510.00
$610.00
$750.00
$510.00
$410.00
$560.00
$385.00
OOR
OCR
OOR
OCR
OCR
OCR
$610.00
OCR
OOR
$650.00
OCR
OCR
OCR
$710.00
$750,00
OCR
$1 ,505.00
$1 ,130.00
• Unusual sample preparation (dried clays, saturated clays, etc.) and all other tests for treated or untreated soils. aggregate subbase and aggregate base will be charged at established rates for laboratory technician .
0 Doss not include sample preparation or sieve analysis All/tes subjul to Basis of Chargf's
inspecting
testing
engi neeri ng
Discounted
Rate/Each
$400.0 0
$310.00
CONSTRUCTION
TESTING SERVICES
I l www . cts - l . com
AS PHAL TIC CONCRETE SERVICES AND TESTS
ASPHALT
Thicknessfl-!eight of Compacted Bituminous Paving Mixture Specimens Field Cores Bulk Specific Gravity of Compacted Bituminous Mixture {Individual field cores or lab compacted) Lab Compaction Only of Bituminous Mixture by Marshall Apparatus (MarshalQ (Per Specimen) Lab Compaction Only of Bituminous Mixture by CA Kneading Compactor (HVEEM) (Per Specimen) Lab Compaction Only of Bituminous Mixture by Superpave Gyratory (Superpave) (Per Specimen) Laboratory Test Max Density (LTMD) (5 Specimen, includes compaction of specimen and bulk specific Superpave Bulk specific gravity Oncludes gyratory compaction of 3 specimen and bulk specific gravity) Marshal Lab Compacted Max Density (3 Specimen, includes compaction of specimen and bulk specific Theoretical Maximum Specific Gravity and Density (Rice} Marshall Stability and Flow of Bituminous Mixtures (average Set of 3, includes sample compaction) Measuring the Permeability of Bituminous Pavements and Seal Coats Swell of Bituminous Mixtures
Moisture Vapor Susceptibility of Bituminous Mixtures/lv1oisture or Volatile Distillates in Asphalt Stabilometer Value of field compacted cores (Per Specimen) Stabilometer Value of Lab compacted samples (Average of 3 Specimen, Includes Sample Compaction) Determination of Asphalt Content of Bituminous Paving Mixtures by the Ignition Method Determination of Correction Factor of Bituminous Paving Mixtures by the Ignition Method Quantitative Extraction of Bitumen from Bituminous Paving Mixtures (Solvent) Mechanical Size Analysis (Coarse and Fine) of Extracted Aggregate (Afterbum Gradation) Moisture Content of Bituminous Mixture
Effect of Water on Compressive Strength of Compacted Bituminous Mixtures {Set of 6) Compressive Strength of Bituminous Mixtures
Hamburg Wheel Track Qncludes compaction by gyratory)(includes 2 runs) Tensile Strength Ratio (TSR) Moisture Susceptibility (includes compaction of 6 Specimen Tensile Strength Ratio (TSR) Moisture Susceptibility Qncludes compaction of 12 Specimen) Indirect Tensile (IDT) Strength of Bituminous Mixtures
Air Voids Calculatlon of Compacted Bituminous Mixture
PG Verification (Determining Low Temperature Performance Grade (PG) of Asphalt Binders) Standard
Rate/Each
ASTM D3549 and CT308 $210.00
ASTM D1188, ASTM D2726, CT308, AASHTO $325.00
ASTM D6926 $325.00
ASTM D1561, CT304, and AASHTO T-247 $325.00
ASTM D6925, and AASHTO T-312 $325.00
ASTM D1561/(D1188 and D2726) and $1 ,160.00
AASHTO T-312/T-275/T-166 $1 ,160.00
ASTM D6926/(D1188 and D2726) $1 ,160.00
ASTM D2041, CT309, and AASHTO T-209 $510.00
ASTM D6926/ASTM D6927 $1 ,160.00
CT341 QOR
CT305 $450.00
ASTM D1461 and CT307 $1 ,010.00
ASTM D1560, CT366, and AASHTO T-246 $455.00
ASTM D1561/01560 , CT304/CT366, and $1 ,160.00
ASTM D6307, CT382, and AASHTO T-308 $460.00
ASTM D6307, CT382, and AASHTO T-308 $1,500.00
ASTM D2172 and CT310 $810.00
ASTM D5444, CT202, and AASHTO T-30 $460.00
CT370 and AASHTO T-329 $485.00
ASTM D1075 $3,710.00
ASTM D1074 $360.00
AASHTO T324 $4,010.00
ASTM D4867 and AASHTO T-283 $4,010.00
CT371 $6,010.00
ASTM D6931 $3,760.00
ASTM 03203 , CT367, and AASHTO T-269 $225.00
ASTM 6816 QOR
MECHANICAL TESTS AND FIREPROOFING
MATERIALS MECHANICAL TESTS
Mechanical Testing of Steel Products (General Tensile)
Fillet Weld Break Test for Qualification (Welding)
Tension Testing of Metallic Materials, Tension Testing Wrought and Cast Aluminum and Magnesium-Alloy Mechanical Testing of Steel Products (Couplers); #3-#11 Mechanical Testing of Steel Products (Couplers); #14+
Impact Testing of Miniaturized Charpy V-Notch Specimens, Notched Bar Impact Testing of Metallic Testing, Practices, and Terminology for Chemical Analysis of Steel Products Mechanical Testing of Steel Products & Bend Testing of Material for Ductility; #3-#8 Mechanical Testing of Steel Products & Bend Testing of Material for Ouctitity; #9-#11 Mechanical Testing of Steel Products & Bend Testing of Material for Ductility; #14+ Mechanical Testing of Steel Products, Standard Specification for Steel Wire, Plain, for Concrete Guided Bend Test for Ductility of Welds, Mechanical Testing of Welds Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Anchor Bolts Only Rockwell Hardness of Metallic Materials
Proof Test for Carbon and Alloy Steel (Nuts Only)
Radiographic Examination of Metallic Castings/Weldments Macroetching Metals and Alloys
Determining the Mechanical Properties of Externally and Internally Threaded Fasteners, Washers, Direct Mechanical Testing of Steel Products (Terminators Tensile) Strength for Sewn or Bonded Seams of Geotextiles
Tearing Strength of Fabrics by the Tongue (Single Rip) Procedure Breaking Strength and Elongation of Textile Fabrics (Grab Test) Tensile Properties of Fiber Reinforced Polymer Matrix Composite Bars Steel Strand, Uncoated Seven-Wire for Prestressed Concrete (Set of 2)
FIREPROOFING
Thickness and Density of Sprayed Fire-Resistive Material (SFRM) Cohesion/Adhesion of Sprayed Fire-Resistive Materials (Test Kit Only)
CONTACT INFORMATION
Headquarters : 2118 Rheem Drive • Pleasanton, CA 94588 • P 925.462.5151 • F 925.462.5183 Peninsula : 44 Tehama, Suite 305 • San Francisco, CA 94105 • P 415.334.4747 • F 415.438.2357 Oakland: 246 3oth Street, Suite 101 • Oakland, CA 94601 • P 510.444.4747 • F 510.835.1825 San Jose: 2033 Gateway Place, #500 • San Jose, CA 95110 • P 408.573.6992 • F 408.437.1201 Stockton: 343 East Main Street, #711 • Stockton, CA 95202 • P 209.507.7555 • F 209.507.7554 Rocklin: 4400Yankee Hill Road • Rocklin, CA 95677 • P 916.419.4747 • F 916.419.4774 Las Vegas : 3842 E. Post Road• Las Vegas, NV 89120 • P 702.257.4747 • F 702.257.4718 ASTM A370
AWS B4.0
ASTM EB, 8557 and AWS B4.0
ASTM A370
ASTM A370
ASTM E2248 and ASTM E23
ASTM A751
ASTM A370 and E290
ASTM A370 and E290
ASTM A370 and E290
ASTM A370, A82 and A185
ASTM E190 and AWS B4.0
ASTM F307, F1554 and F606
ASTM E18
ASTM A 194 or A563
ASTM E94, E1030 and E1032
ASTM E340, E381 and AWS
ASTM F606
ASTM A370
ASTM D4884
ASTM D2261
ASTM D5034
ASTM D3039
ASTM A416 and A1061
ASTM E605
ASTM E736
. .tfl/us .1ubj l!ct to Ba.sis of Charga
$560.00
$260.00
$560.00
$750.00
$1,500.00
QOR
$385.00
$450.00
$510.00
$1,500.00
$510.00
$360.00
$610.00
$195.00
$385.00
QOR
$385.00
$435.00
$435.00
$385.00
$385.00
$335.00
$1,060.00
$1,610.00
$305.00
$95.00
Insp e c ting
testing
engin e eri ng
El
SUBCONSULTANT SCOPE OF SERVICES AND COMENSATION
STATEMENT OF SPECIAL INSPECTIONS, 2022 CBC
C UPERTIN O
COMMUNITY DEVELOPM ENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO , CA 95014-3255
(408) 777-3228 • building@cupertino .org
!~~RESS 1000 South Stelling Road, Cupertino, CA 95014 APN APN# 359-25-049 I BP# BLD-2024-0186 Owner.~l1t?.1.~.~~.~.~i~.?....................................................................................... Contractor ...................................................................................................... .
Address.!.?~~?. ~?'.1:~. ~.~~~.~~.............................................................................. Address .......................................................................................................... .
City/St...~~~:.~!~.~:.~~················ ....... Zip .. ?.~.?.1.~ ............... Phone..................... City/St.. ............................................... Zip ................... Phone ....................... .
Applicant......................................................................................................... Engineer/Architect. 8.1~~~.~!(~~o.rth_..~,~~~r~l·E·~?.i~.:~.r_. .~~.I'.':. .................... ... .
Address........................................................................................................... Address.~?.".'~~~?.~!?:'.~.~!·. ~~:~.:.1~?~ ....................................................... .
City/St... .......................................... Zip ........................... Phone..................... City/St.~~.~.'..r~~~i.~<:? ........................ Zip .. ~~).?~ ..... Phone .~.1.5:-~~~:!??~ ..
PROJECT DESCRIPTION:
THE PROJECT INVOLVES DEMOLITION OF THE EXISTING AGE 5-12 PLAY AREA AT JOLLYMAN PARK AND INSTALLATION OF A NEWALL-INCLUSIVE PLAY AREA AND PRE-FABRICATED RESTROOM .
This "STATEMENT OF SPECIAL INSPECT IONS" is submitted in fulfillment of the requirements of CBC Sections 1704 and 1705. This form is structured after and used by permission from the Structural Engineer Association of Northern California 's (SEAONC) mode statement of Special Inspections . Also, included with this form is the following :
Ii] "LIST OF SPECIAL INSPECTION AG ENCi ES (page 2). A list of testing agencies and other special inspectors that will be retained to conduct the tests and inspections for this project Ii] "SCHEDULE OF SPECIAL INSPECTION" (page 3). The Schedule of Special Inspections summarizes the Special Inspections and tests required . Special Inspectors will refer to the approved plans and specifications for detailed special inspection requirements. Any additional tests and inspections required by the approved plans and specifications shall also be performed.
Special Inspections and Testing will be performed in accordance with the approved plans and specifications , this statement and CBC Sections 1704, 1705, 1706, 1707, and 1708. Interim reports will be submitted to the Building Official and the Registered Design Professional in Responsible Charge in accordance with CBC Section 1704.1.2.
A Final Report of Special Inspections documenting required Special Inspections , testing and correction of any discrepancies noted in the inspections shall be submitted prior to issuance of a Certificate of Use and Occupancy (Section 1704.1.2). The Final Report will document:
• Required special inspections.
• Correction of discrepancies noted in inspections.
The Owner recognizes his or her obligation to ensure that the construction complies with the approved permit documents and to implement this program of special inspections . In partial fulfillment of these obligations , the Owner will retain and directly pay for the Special Inspections as required in CBC Section 1704.1.
This plan has been developed with the understanding that the Building Official will:
• Review and approve the qualifications of the Special Inspectors who will perform the inspections. • Monitor special inspection activities on the job site to assure that the Special Inspectors are qualified and are performing their duties as called for in this Statement of Special Inspection . • Review submitted inspection reports.
• Perform inspections as required by the local building code.
I have read and aqree to comply with the terms and conditions of this statement Prepared By:
Project IZI Engineer □ Architect
Reqistered Desicm Professional in Charqe Sicinature ... ~~ ... Lie.# .~~2? ............................... Date: .~1.1~'.~.0~: ........... .
Owner Name:
Owner's Authorization Siqnature .................................................................................................................... Date: .. ...................... ..
Inspection Agency / Inspector Name:
Construction Testing Services Siqnature ... ~ ... ~ .................... Lie.#.~.~.~.?.~~ ......................... Date: .?1~~(~~?~ ........ .
Building Official or designee:
Signature .................................................................................................................... Date: ......................... .
SpecialnspectionF orm _ 20 I 2.doc revised O 1110/2023
SUBCONSULTANT SCOPE OF SERVICES AND COMENSATION
LIST OF SPECIAL INSPECTION AGENCIES
APPROVAL OF SPECIALINSPECTORS :
Each special inspection agency , testing facility, and special inspector shall be recognized by the Building Official prior to performing any duties. Special Inspection agency 's listed on this form must be pre-approved and listed on Cupert ino's approved Special Inspector 's list.
Special inspectors shall carry approved identification when performing the functions of a special inspector. Identification cards shall follow the criteria set by the California Council of Testing and Inspect ion Agencies . No personnel changes shall be made without first obtaining the approval of the Building Official. Any unauthorized personnel changes may result in a "Stop Work Order" and possible permit revocation . To be pre- approved by the City of Cupertino , refer to the SPECIAL INSPECTION CRITERIA handout. Please allow two weeks to complete the application process .
The followinq are the testing and special inspection agencies that will be retained to conduct tests and inspection on this project:
EXPERTISE
1. Special Inspection (except for
geotechnical)
2. Material Testing
3. Geotechnical Inspections
4. Other:
FIRM/ INSPECTOR INFORMATION*
Firm .. ~?~'!1!~cl_i?.~.~~.•.t!~9. ~~f'!!,~~ ................................... Addr .. ~! 1.~ .Rh.•:~. □.nv~ ................................................................. .
City.~1~~~.~~.1?.~ ............................................................................................ State .~!': ................... Zip .. ~~~~.~ ............. .
Telephone .. ~.2.~.~~~:~!~.1 ....................... Fax ......................................... ... Email .d.~~~1~'.~.~.<:t.~:) ,~.~ ~ .............................. .
Firm. c:r.~.: ~.~~:. ~.•. ~.~?~.• ............................................ Addr ........................................................................................ .
City .......................................................................................................... State ....................... Zip .................... ..
Telephone ....................................... Fax ............................................ Email ........................................................ .
Firm.~.1•~0 .~"0:':':'?~; . .. ............................................ Addr ........................................................................................ .
City .......................................................................................................... State ...................... .Zip .................... ..
Telephone ...................................... Fax ............................................ Email ........................................................ .
Firm ..................................................................... Addr ......................................... ............................................... .
City .......................................................................................................... State ....................... Zip ..................... .
Telephone ...................................... Fax ............................................ Email ........................................................ . *All agencies specified on this form must be pre-approved and listed on the City of Cupertino 's Approved Special Inspector 's List.
SEISMIC REQUIREMENTS (Section 1704.3.2)
Description of seismic-force-resisting system and designated seismic systems subject to special inspections as per Section 1705.13 or 1705.1 4:
The extent of the seismic-force-resisting system is defined in more detail in the construction documents.
WIND REQUIREMENTS (Section 1704.3.3)
Description of main wind-force-resisting system and designated wind resisting components subject to special inspections in accordance with Section 1704.12:
The extent of the main wind-force-resisting system and wind resisting components is defined in more detail in the construction documents.
SpecialnspectionF arm_ 2012. doc revised 0 II I 0/20 2 3
SUBCONSULTANT SCOPE OF SERVICES AND COMENSATION
SCHEDULE OF SPECIAL INSPECTION
!~~RESS 1000 South Stelling Road, Cupertino, CA 95014 I APN APN# 359-25-049 I BP# BLD-2024-0186 PROJECT DESCRIPTION :
THE PROJECT INVOLVES DEMOLITION OF THE EXIST ING AGE 5-12 PLAY AREA AT JOLLYMAN PARK AND INSTALLATION OF A NEW ALL-INCLUSIVE PLAY AREA ANO PRE-FABRICAT ED RESTROOM .
I hereby certify that the Special Inspection & Testing Agency named above has been engaged to perform structural tests and inspection during construction , as checked below, to satisfy all applicable portions of the Building Code.
Prior to issuance of an occupancy permit , the special inspection agency shall submit a statement that all items of designated work performed were reported . Any item s checked but not tested or inspected will be noted and explained .
Whenever any designated items on th is list are ready for sampling, testing or inspection , it shall be the responsibility of the Contractor to give timely notice to the Special Inspection Agency so that the required services may be performed .
REINFORCING STEEL STRUCTURAL STEEL
Tensile & Bond Sample & Test
X Inspection of Placement Shop Indent . & Welding Inspection Inspection of Welding Shop Ultrasonic Inspection
Shop Radiography
MASONRY Field Welding Inspection
Preliminary Acceptance Test (Masonry Units, Wall Prism) Field Bolting Subsequent Tests (Mortar, Grout, Field Wall Prisms) Field Ultrasonic Inspection Inspection of Grouting Field Radiography
Inspection of Placement and Grouting Metal Deck Welding Inspection
CONCRETE, GUNITE/SHOTCRETE, GROUT & MORTAR STRUCTURAL HARDWARE Cone. Shotcrete Grout Mortar Holdown Installation
Agg. Tests for Designs Tiedown System Installation
Suitability of Agg. X Epoxied Anchors & Bolts
X Mix Designs
Batch Plant lnsp. INSULATING CONCRETE
X Compression Tests
X Cast Specimens
I Sample & Test
Unit Weights
X Pick-Up Samples
Shrinkage Bars FIREPROOFING
Yield Check Inspection of Placement
Air Check Density Tests
Dry Unit Weight Thickness Tests
Inspection Batching
PRECAST CONCRETE
Reinforcing Tests GEOTECHNICAL (Inspections & Testing by Geotechnical Engineer) Inspection of Reinforcing Placement X Fill Material Acceptance Tests Tendon Tests Moisture-Density Determination
Inspection of Tendon Placement X Field Density/Compaction Inspection of Concrete Placement Pier Drilling
Inspection of Concrete Batching X Observation & Testing by Geotechnical Engineer Inspection of Panel Attach & Inserts
Inspection of Panel Installation ROOFING & WATERPROOFING Compression Tests Inspection of Placement
Inspection of Stressing/Transfer Sample & Tests
Basement Waterproofing
PILING, CAISSONS, CAPS, TIES
Inspection of Reinforcing Placement STRUCTURAL WOOD
Inspection of Concrete Placement Inspection of Fabrication Inspection of Concrete Batching Inspection of Truss Joist Fabrication Sample & Test Components
UNDERPINNING Inspection of Glulam Fabrication
Inspection of Steel Fabrication Shearwall Construction & Nailing Inspection of Reinfor cing & Forms
Inspection of Concrete Placement OTHER TESTS OR INSPECTIONS:
Inspectio n ofTiebacks
SpecialnspectionF orm _ 20 I 2. doc revised O I/ I 0/20 2 3 4LEAF, INC.
CONSTRUCTION MANAGEMENT • PLAN CHECK
INSPECTION • PLANNING • CooE ENF O RC EMENT
4LEAF, INC.
a
CUP'l!ltTIHO
RATE SCHEDULE TO PROVIDE CONSTRUCTION MANAGEMENT
AND INSPECTION SERVICES FOR THE CITY OF CUPERTINO
JOLLYMAN AurlNCLUSIVE PLAYGROUND PROJECT
Program Management Services*
Staff Designation Rate
Principal-in-Charge/ Project Manager $207/hr
Construction Management/ Inspection Services*
Staff Designation Rate
Construction Manager $175/hr
Assistant Engineer/ Office Engineer $160/hr
Public Works Inspector (Regular Time) (see Note E for Overtime and Premium times) $156.67/hr Public Works Inspector Apprentice $97.85
Project Assistant $105/hr
*All Fees Subject to Basis of Charges. Rates shown are subject to an Annual Escalation of 3% starting on January 1 of each calendar year (CY).
BASIS OF CHARGES
A. Rates shown assume projects under this on-call contract will require compliance with California Prevailing Wage rate requirements and assumes the City will be filing a PWC-100 Form to the California Department of Industrial Relations (DIR) for the project.
B. Rates for prevailing wage categories are subject to annual escalations in accordance with the bi-annual wage determinations from the California DIR. Rates based on California DI R's wage determinations dated August 2023.
C. Per the new requirements being enforced under SB 854 and because it is assumed that a PWC-100 Form will be filed by the City to the CA DIR for each project, 4LEAF is required to notify an authorized Apprenticeship Committee through submittal of a DAS-140 form. We are then required to make an official request to an authorized Apprenticeship Committee for an apprentice by submitting a DAS-142 form . We are not assured the apprenticeship committee will be able to provide a suitable/ qualified apprentice for the project. Per the apprenticeship requirements, the hours worked by the apprentice must be in a ratio of 1:5 for apprentice to journeyman hours. 4LEAF will not know the labor classification of the Public Works Apprentice until an Apprentice is dispatched to the site; therefore, the rates for the five Periods listed under the California DIR's Wage determination for Building Construction Inspector issued August 2023 were used to determine the range of Calendar Year 2024 hourly rates for Public Works Inspector Apprentice.
D. All invoicing will be submitted monthly .
E. Overtime and Premium time will be charged as follows :
Night Time (work begun after 4PM or before 5AM) 1.125 x hourly rate Overtime (over 8 hour M-F or Saturdays) 1.35 x hourly rate Overtime (over 8 hours Sat or 1st 8 hour Sun) 1.85 x hourly rate Overtime (over 8 hours Sun or Holidays) 2.35 x hourly rate F. All work with less than 8 hours rest between shifts will be charged the appropriate overtime rate.
G. Subconsultant invoices will be assessed a 10% Administrative Processing Fee.
H. Project-related mileage for inspections will be billed at the allowable IRS Rate.
I. Payment due on receipt . All payments over 30 days will be assessed a 1.5% interest charge.
J. Client shall pay attorneys' fees, or other costs incurred in collecting delinquent amounts.
K. Client agrees that 4LEAF's liability will be limited to the value of services provided .
L. In accordance with California's Meal Break and Rest Break Law requirements, Client will be billed one (1) additional hour per day at the regular rate for each missed meal or rest break due to Client-directed tasks or requirements. Client should allow 4LEAF's non-exempt , hourly employees the opportunity to take their entitled rest and meal breaks during each work shift.
M. If 4LEAF is requested or otherwise required to conform to Client's alternative work week schedule ("AWW"), Client hereby agrees to compensate or reimburse 4LEAF for all overtime paid to its employees who work an AWW. - If 4LEAF's affected employment group approves an AWW election and the same is registered, the overtime compensation/reimbursement shall not be required/ MAY21,2024
EXHIBITD
Insurance Requirements
Design Professionals & Consultants Contracts
Consultant shall procure prior to commencement of Services and maintain for the duration of the contract, at its own cost and expense, the following insurance policies and coverage with companies doing business in California and acceptable to City.
INSURANCE POLICIES AND MINIMUMS REQUIRED
1. Commercial General Liability (CGL) for bodily injury, property damage, personal injury liability for premises operations, products and completed operations, contractual liability, and personal and advertising injury with limits no less than $2,000,000 per occurrence (ISO Form CG 00 01 ). If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location (ISO Form CG 25 03 or 25 04) or it shall be twice the required occurrence limit. a It shall be a requirement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits shall be made available to the Additional Insured and shall be (i) the minimum coverage/limits specified in this agreement; or (ii) the broader coverage and maximum limits of coverage of any insurance policy, whichever is greater. b. Additional Insured coverage under Consultant's policy shall be "primary and non-contributory," will not seek contribution from City's insurance/self-insurance, and shall be at least as broad as ISO Form CG 20 10 (04/13).
c. The limits of insurance required may be satisfied by a combination of primary and umbrella or excess insurance, provided each policy complies with the requirements set forth in this Contract. Any umbrella or excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary basis for the benefit of City before the City's own insurance or self insurance shall be called upon to protect City as a named insured.
2. Automobile Liability: ISO CA 00 01 covering any auto (including owned, hired, and non-owned autos) with limits no less than $1,000,000 per accident for bodily injury and property damage.
3. Workers' Compensation: As required by the State of California, with Statutory Limits and Employer's Liability Insurance of no less than $1,000,000 per occurrence for bodily injury or disease.
D Not required. Consultant has provided written verification of no employees.
4. Professional Liability for professional acts, errors and omissions, as appropriate to Consultant's profession, with limits no less than $2,000,000 per occurrence or claim, $2,000,000 aggregate. If written on a claims made form:
a The Retroactive Date must be shown and must be before the Effective Date of the Contract. b. Insurance must be maintained for at least five (5) years after completion of the Services. c. If coverage is canceled or non-renewed, and not replaced with another claims-made policy form with a Retroactive Date prior to the Contract Effective Date, the Consultant must purchase "extended reporting" coverage for a minimum of five (5) years after completion of the Services.
OTHER INSURANCE PROVISIONS
The aforementioned insurance shall be endorsed and have all the following conditions and provisions:
Exh. D-lnsurance Requirements for Design Professionals & Consultants Contracts Form Updated Jan. 2022 1 II
II
It
Additional Insured Status
The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers ("Additional Insureds") are to be covered as additional insureds on Consultant's CGL and automobile liability policies. General Liability coverage can be provided in the form of an endorsement to Consultant's insurance (at least as broad as ISO Form CG 20 10 (11/ 85) or both CG 20 10 and CG 20 37 forms, if later editions are used).
Primary Coverage
Coverage afforded to City/Additional Insureds shall be primary insurance. Any insurance or self-insurance maintained by City, its officers, officials, employees, or volunteers shall be excess of Consultant's insurance and shall not contribute to it.
Notice of Cancellation
Each insurance policy shall state that coverage shall not be canceled or allowed to expire, except with written notice to City 30 days in advance or 10 days in advance if due to non-payment of premiums.
Waiver of Subrogation
Consultant waives any right to subrogation against City/ Additional Insureds for recovery of damages to the extent said losses are covered by the insurance policies required herein. Specifically, the Workers' Compensation policy shall be endorsed with a waiver of subrogation in favor of City for all work performed by Consultant, its employees, agents and subconsultants. This provision applies regardless of whether or not the City has received a waiver of subrogation endorsement from the insurer.
Deductibles and Self-Insured Retentions
Any deductible or self-insured retention must be declared to and approved by the City. At City's option, either:
the insurer must reduce or eliminate the deductible or self-insured retentions as respects the City/Additional Insureds; or Consultant must show proof of ability to pay losses and costs related investigations, claim administration and defense expenses. The policy shall provide, or be endorsed to provide, that the self-insured retention may be satisfied by either the insured or the City.
Acceptability of Insurers
Insurers must be licensed to do business in California with an A.M. Best Rating of A-VII, or better.
Verification of Coverage
Consultant must furnish acceptable insurance certificates and mandatory endorsements ( or copies of the policies effecting the coverage required by this Contract), and a copy of the Declarations and Endorsement Page of the CGL policy listing all policy endorsements prior to commencement of the Contract. City retains the right to demand verification of compliance at any time during the Contract term.
Subconsultants
Consultant shall require and verify that all subconsultants maintain insurance that meet the requirements of this Contract, including naming the City as an additional insured on subconsultant's insurance policies.
Higher Insurance Limits
If Consultant maintains broader coverage and/or higher limits than the minimums shown above, City shall be entitled to coverage for the higher insurance limits maintained by Consultant.
Adequacy of Coverage
City reserves the right to modify these insurance requirements/coverage based on the nature of the risk, prior experience, insurer or other special circumstances, with not less than ninety (90) days prior written notice.
Exh. D-Jnsurance Requirements for Design Professionals & Consultants Contracts Form Updated Jan. 2022 2 4LEAINC-01 BUAKl1
ACORD · CERTIFICATE OF LIABILITY INSURANCE I
DATE (MM/DDNYYY)
~ 4/3/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
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).
PRODUCER License# OC41366 s2m;~cT
Granite Professional Insurance Brokerage, Inc. FlJ8,NJo, Ext): (925) 462-8400 I FAX 360 Lindbe~h Avenue IA/C, No):(925) 462-8888
Livermore, A 94551 11~.fil~cc. [email protected] INSURERISl AFFORDING COVERAGE NAIC#
INSURER A: Travelers Property Casualty Company of America 25674 INSURED INSURER s: Berkshire Hathawav Homestate
4LEAF, Inc. INSURER c: Houston Casualtv Comoanv 42374
2126 Rheem Dr INSURERD:
Pleasanton, CA 94588 INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER· REVISION NUMBER·
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. l~f~ TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS ,.,~n ,.n,n TT A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - ~ CLAIMS-MADE [K] OCCUR ~~~b~~J9F~ENTED 1,000,000 X X 6806X631656 3/15/2024 3/15/2025 $ -
MED EXP IAnv one oerson\ $ 5,000
-
PERSONAL & ADV INJURY $ 1,000,000
-
2,000,000
R
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY [K] ~m □ LOC PRODUCTS - COMP/OP AGG $ 2,000,000
OTHER: $
A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 ,~ -"""'"""" $ ......_ X ANY AUTO 8106X632782 3/15/2024 3/15/2025 BODILY INJURY /Per oerson\ $ ......_ O'l'INED ~ SCHEDULED
......_ AUTOS ONLY ......_ AUTOS BODILY INJURY /Per accident\ $ X HIRED X NON-OWNED lp~9~tc~le~t?AMAGE $ ......_ AUTOS ONLY ......_ AUTOS ONLY $
A X UMBRELLA LIAS
~
OCCUR EACH OCCURRENCE $ 6,000,000 ......_
CUP6X635599 3/15/2024 3/15/2025 EXCESS LIAS CLAIMS-MADE AGGREGATE $ 6,000,000 OED I I RETENTION $ $
B WORKERS COMPENSATION x I nrTIITF 1 I 2lH-AND EMPLOYERS' LIABILITY Y/N FOWC521971 3/15/2024 ANY PROPRIETOR/PARTNER/EXECUTIVE □
X 3/15/2025 E.L. EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N/A 1,000,000 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes. describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Professional Liab HCC2425616 4/9/2024 3/15/2025 Each Claim 2,000,000 C HCC2425616 4/9/2024 3/15/2025 Aggregate 2,000,000
DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) The attached forms apply as required per written contract or written agreements between the listed parties and the insured, which are subject to the policy provisions. In the absence of such written contract or written agreement the attached form may not be applicable.
The City of Cupertino, its City Council, officers, officials, employees, agents, servants and volunteers are named as additional insured on General Liability Policy per attached endorsement CG D3 81 09 15. Primary and non-contributory applies to General Liability policy per attached endorsement CG D3 81 09 15.
Waivers of subrogation apply to General Liability and Workers Compensation Policies per attached endorsements CG D3 81 09 15 and WC 99 03 76.
Professional Liability Retro Date 4/1/07
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Cupertino THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
10300 Torre Ave.
Cupertino, CA 95014
AUTHORIZED REPRESENTATIVE
I
e;:;:.~
ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
Policy Number 6806X631656
COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BLANKET ADDITIONAL INSURED
(ARCHITECTS, ENGINEERS AND SURVEYORS)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
1. The following is added to SECTION II - WHO IS
AN INSURED:
Any person or organization that you agree in a
"written contract requiring insurance" to include as
an additional insured on this Coverage Part, but:
a. Only with respect to liability for "bodily injury",
"property damage" or "personal injury"; and
b. If, and only to the extent that, the injury or
damage is caused by acts or omissions of
you or your subcontractor in the performance
of "your work" to which the "written contract
requiring insurance" applies, or in connection
with premises owned by or rented to you.
The person or organization does not qualify as an
additional insured:
c. With respect to the independent acts or
omissions of such person or organization; or
d. For "bodily injury", "property damage" or
"personal injury" for which such person or
organization has assumed liability in a
contract or agreement.
The insurance provided to such additional insured
is limited as follows:
e. This insurance does not apply on any basis to
any person or organization for which
coverage as an additional insured specifically
is added by another endorsement to this
Coverage Part.
f. This insurance does not apply to the
rendering of or failure to render any
"professional services".
g. In the event that the Limits of Insurance of the
Coverage Part shown in the Declarations
exceed the limits of liability required by the
"written contract requiring insurance", the
insurance provided to the additional insured
shall be limited to the limits of liability required
by that "written contract requiring insurance".
This endorsement does not increase the
limits of insurance described in Section Ill -
Limits Of Insurance.
h. This insurance does not apply to "bodily
Injury" or "property damage" caused by "your
work" and included in the "products
completed operations hazard" unless the
"written contract requiring insurance"
specifically requires you to provide such
coverage for that additional insured, and then
the insurance provided to the additional
insured applies only to such "bodily injury" or
"property damage" that occurs before the end
of the period of time for which the "written
contract requiring insurance" requires you to
provide such coverage or the end of the
policy period, whichever is earlier.
2. The following is added to Paragraph 4.a. of
SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS:
The insurance provided to the additional insured
is excess over any valid and collectible other
insurance, whether primary, excess, contingent or
on any other basis, that is available to the
additional insured for a loss we cover. However, if
you specifically agree in the "written contract
requiring insurance" that this insurance provided
to the additional insured under this Coverage Part
must apply on a primary basis or a primary and
non-contributory basis, this insurance is primary
to other insurance available to the additional
insured which covers that person or organizations
as a named insured for such loss, and we will not
share with the other insurance, provided that:
(1) The "bodily injury" or "property damage" for
which coverage is sought occurs; and
(2) The "personal injury" for which coverage is
sought arises out of an offense committed;
after you have signed that "written contract
requiring insurance". But this insurance provided
to the additional insured still is excess over valid
and collectible other insurance, whether primary,
excess, contingent or on any other basis, that is
available to the additional insured when that
person or organization is an additional insured
under any other insurance.
© 2015 The ave e s lndemnl!Y Com an . AlL!Jghts reserved. Page 1 of 2 Includes the copyrighted material of Insurance Services Office, Inc., with Its permission
COMMERCIAL GENERAL LIABILITY
3. The following is added to Paragraph 8., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV - COMMERCIAL GENERAL
LIABILITY CONDITIONS:
We waive any right of recovery we may have
against any person or organization because of
payments we make for "bodily injury", "property
damage" or "personal injury" arising out of "your
work" performed by you, or on your behalf, done
under a "written contract requiring insurance" with
that person or organization. We waive this right
only where you have agreed to do so as part of
the "written contract requiring insurance" with
such person or organization signed by you
before, and in effect when, the "bodily injury" or
"property damage" occurs, or the "personal injury"
offense is committed.
4. The following definition is added to the
DEFINITIONS Section:
"Written contract requiring insurance" means that
part of any written contract under which you are
required to include a person or organization as an
additional insured on this Coverage Part,
provided that the "bodily injury" and "property
damage" occurs and the "personal injury" is
caused by an offense committed:
a. After you have signed that written contract;
b. While that part of the written contract is in
effect; and
c. Before the end of the policy period.
Includes the copyrighted material of Insurance Services Office, Inc., with Its permission POLICY# 8106X632782
COMMERCIAL AUTO
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
BUSINESS AUTO EXTENSION ENDORSEMENT
This endorsement modifies insurance provided under the following:
BUSINESS AUTO COVERAGE FORM
GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cove age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered.
A. BROAD FORM NAMED INSURED
B. BLANKET ADDITIONAL INSURED
C. EMPLOYEE HIRED AUTO
D. EMPLOYEES AS INSURED
E. SUPPLEMENTARY PAYMENTS - INCREASED
LIMITS
F. HIRED AUTO - LIMITED WORLDWIDE COV-
ERAGE - INDEMNITY BASIS
G. WAIVER OF DEDUCTIBLE - GLASS
PROVISIONS
A. BROAD FORM NAMED INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II - COVERED AUTOS
LIABILITY COVERAGE:
Any organization you newly acquire or form dur
ing the policy period over which you maintain
50% or more ownership interest and that is not
separately insured for Business Auto Coverage.
Coverage under this provision is afforded only un
til the 180th day after you acquire or form the or
ganization or the end of the policy period, which
ever is earlier.
B. BLANKET ADDITIONAL INSURED
The following is added to Paragraph c. in A.1.,
Who Is An Insured, of SECTION II - COVERED
AUTOS LIABILITY COVERAGE:
Any person or organization who is required under
a written contract or agreement between you and
that person or organization, that is signed and
executed by you before the "bodily injury" or
"property damage" occurs and that is in effect
during the policy period, to be named as an addi
tional insured is an "insured" for Covered Autos
Liability Coverage, but only for damages to which
H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF
USE - INCREASED LIMIT
I. PHYSICAL DAMAGE - TRANSPORTATION
EXPENSES - INCREASED LIMIT
J. PERSONAL PROPERTY
K. AIRBAGS
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
M. BLANKET WAIVER OF SUBROGATION
N. UNINTENTIONAL ERRORS OR OMISSIONS
this insurance applies and only to the extent that
person or organization qualifies as an "insured"
under the Who Is An Insured provision contained
in Section II.
C. EMPLOYEE HIRED AUTO
1. The following is added to Paragraph A.1.,
Who Is An Insured, of SECTION II - COV
ERED AUTOS LIABILITY COVERAGE:
An "employee" of yours is an "insured" while
operating an "auto" hired or rented und
contract or agreement in an "employee's"
name, with your permission, while performing
duties related to the conduct of your busi
ness.
2. The following replaces Paragraph b. in B.5.,
Other Insurance, of SECTION IV - BUSI
NESS AUTO CONDITIONS:
b. For Hired Auto Physical Damage Cover
age, the following are deemed to be cov
ered "autos" you own:
(1) Any covered "auto" you lease, hire,
rent or borrow; and
(2) Any covered "auto" hired or rented by
your "employee" under a contract i
an "employee's" name, with your
CA T3 53 0215 © 2015 The Travelers Indemnity Company. All rights reseNed. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
COMMERCIAL AUTO
perm1ss1on, while performing duties
related to the conduct of your busi
ness.
However, any "auto" that is leased, hired,
rented or borrowed with a driver is not
covered "auto".
D. EMPLOYEES AS INSURED
The following is added to Paragraph A.1., Who Is
An Insured, of SECTION II - COVERED AUTOS
LIABILITY COVERAGE:
Any "employee" of yours is an "insured" while us
ing a covered "auto" you don't own, hire or borrow
in your business or your personal affairs.
E. SUPPLEMENTARY PAYMENTS - INCREASED
LIMITS
1. The following replaces Paragraph A.2.a.(2),
of SECTION II - COVERED AUTOS LIABIL
ITY COVERAGE:
(2) Up to $3,000 for cost of bail bonds (in
cluding bonds for related traffic law viola
tions) required because of an "accident"
we cover. We do not have to furnish
these bonds.
2. The following replaces Paragraph A.2.a.(4),
of SECTION II - COVERED AUTOS LIABIL
ITY COVERAGE:
(4) All reasonable expenses incurred by the
"insured" at our request, including actual
loss of earnings up to $500 a day be
cause of time off from work.
F. HIRED AUTO - LIMITED WORLDWIDE COV
ERAGE - INDEMNITY BASIS
The following replaces Subparagraph (5) in Para
graph B.7., Policy Period, Coverage Territory,
of SECTION IV - BUSINESS AUTO CONDI
TIONS:
(5) Anywhere in the world, except any country or
jurisdiction while any trade sanction, em
bargo, or similar regulation imposed by the
United States of America applies to and pro
hibits the transaction of business with or
within such country or jurisdiction, for Cov
ered Autos Liability Coverage for any covered
"auto" that you lease, hire, rent or borrow
without a driver for a period of 30 days or less
and that is not an "auto" you lease, hire, rent
or borrow from any of your "employees",
partners (if you are a partnership), members
(if you are a limited liability company
members of their households.
(a) With respect to any claim made or "suit"
brought outside the United States of
America, the territories and possessions
of the United States of America, Puerto
Rico and Canada:
(i) You must arrange to defend the "in
sured" against, and investigate or set
tle any such claim or "suit" and keep
us advised of all proceedings and ac
tions.
(ii) Neither you nor any other involved
"insured" will make any settlement
without our consent.
(iii) We may, at our discretion, participate
in defending the "insured" against, or
in the settlement of, any claim or
"suit".
(iv) We will reimburse the "insured" for
sums that the "insured" legally must
pay as damages because of "bodily
injury" or "property damage" to which
this insurance applies, that the "in
sured" pays with our consent, but
only up to the limit described in Para
graph C., Limits Of Insurance, o
SECTION II - COVERED AUTOS
LIABILITY COVERAGE.
(v) We will reimburse the "insured" for
the reasonable expenses incurred
with our consent for your investiga
tion of such claims and your defense
of the "insured" against any such
"suit", but only up to and included
within the limit described in Para
graph C., Limits Of Insurance, of
SECTION II - COVERED AUTOS
LIABILITY COVERAGE, and not in
addition to such limit. Our duty to
make such payments ends when we
have used up the applicable limit of
insurance in payments for damages,
settlements or defense expenses.
(b) This insurance is excess over any valid
and collectible other insurance available
to the "insured" whether primary, excess,
contingent or on any other basis.
(c) This insurance is not a substitute for r
quired or compulsory insurance in any
country outside the United States, its ter
ritories and possessions, Puerto Rico and
Canada.
Includes copyrighted material of Insurance Services Office , Inc. with its permission.
You agree to maintain all required or
compulsory insurance in any such coun
try up to the minimum limits required by
local law. Your failure to comply with
compulsory insurance requirements will
not invalidate the coverage afforded by
this policy, but we will only be liable to the
same extent we would have been liable
had you complied with the compulsory in
surance requirements.
(d) It is understood that we are not an admit
ted or authorized insurer outside the
United States of America, its territories
and possessions, Puerto Rico and Can
ada. We assume no responsibility for the
furnishing of certificates of insurance, or
for compliance in any way with the laws
of other countries relating to insurance.
G. WAIVER OF DEDUCTIBLE - GLASS
The following is added to Paragraph D., Deducti
ble, of SECTION Ill - PHYSICAL DAMAGE
COVERAGE:
No deductible for a covered "auto" will apply
glass damage if the glass is repaired rather than
replaced.
H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF
USE - INCREASED LIMIT
The following replaces the last sentence of Para
graph A.4.b., Loss Of Use Expenses, of SEC
TION Ill - PHYSICAL DAMAGE COVERAGE:
However, the most we will pay for any expenses
for loss of use is $65 per day, to a maximu
$750 for any one "accident".
I. PHYSICAL DAMAGE - TRANSPORTATION
EXPENSES - INCREASED LIMIT
The following replaces the first sentence in Para
graph A.4.a., Transportation Expenses, of
SECTION Ill - PHYSICAL DAMAGE COVER
AGE:
We will pay up to $50 per day to a maximum of
$1,500 for temporary transportation expense in
curred by you because of the total theft of a cov
ered "auto" of the private passenger type.
J. PERSONAL PROPERTY
The following is added to Paragraph A.4., Cover
age Extensions, of SECTION Ill - PHYSICAL
DAMAGE COVERAGE:
Personal Property
We will pay up to $400 for "loss" to wearing ap
parel and other personal property which is:
(1) Owned by an "insured"; and
COMMERCIAL AUTO
(2) In or on your covered "auto".
This coverage applies only in the event of a total
theft of your covered "auto".
No deductibles apply to this Personal Property
coverage.
K. AIRBAGS
The following is added to Paragraph 8.3., Exclu
sions, of SECTION Ill - PHYSICAL DAMAGE
COVERAGE:
Exclusion 3.a. does not apply to "loss" to one or
more airbags in a covered "auto" you own that in
flate due to a cause other than a cause of "loss"
set forth in Paragraphs A.1.b. and A.1.c., bu
only:
a. If that "auto" is a covered "auto" for Compre
hensive Coverage under this policy;
b. The airbags are not covered under any war-
ranty; and
c. The airbags were not intentionally inflated.
We will pay up to a maximum of $1,000 for any
one "loss".
L. NOTICE AND KNOWLEDGE OF ACCIDENT OR
LOSS
The following is added to Paragraph A.2.a., of
SECTION IV - BUSINESS AUTO CONDITIONS:
Your duty to give us or our authorized representa
tive prompt notice of the "accident" or "loss" ap
plies only when the "accident" or "loss" is known
to:
(a) You (if you are an individual);
(b) A partner (if you are a partnership);
(c) A member (if you are a limited liabilit
pany);
(d) An executive officer, director or insurance
manager (if you are a corporation or other o
ganization); or
(e) Any "employee" authorized by you to give no
tice of the "accident" or "loss".
M. BLANKET WAIVER OF SUBROGATION
The following replaces Paragraph A.5., Transfer
Of Rights Of Recovery Against Others To Us,
of SECTION IV - BUSINESS AUTO CONDI
TIONS:
5. Transfer Of Rights Of Recovery Against
Others To Us
We waive any right of recovery we may have
against any person or organization to the ex
tent required of you by a written contrac
signed and executed prior to any "accident"
or "loss", provided that the "accident" or "loss"
arises out of operations contemplated by
© 2015 ,he :rravelers lndemAity Comp ny.-All rights resen,_ed. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc. with its permission.
COMMERCIAL AUTO
such contract. The waiver applies only to the
person or organization designated in such
contract.
N. UNINTENTIONAL ERRORS OR OMISSIONS
The following is added to Paragraph 8.2., Con
cealment, Misrepresentation, Or Fraud, of
SECTION IV - BUSINESS AUTO CONDITIONS:
The unintentional om1ss1on of, or unintentional
error in, any information given by you shall not
prejudice your rights under this insurance. How
ever this provision does not affect our right to col
lect additional premium or exercise our right of
cancellation or non-renewal.
Includes copyrighted material of Insurance Services Office , Inc. with its permission . ~
TRAVELERSJ •
ONE TOWER SQUARE
HARTFORD CT 06183
WORKERS COMPENSATION
AND
EMPLOYERS LIABILITY POLICY
ENDORSEMENT WC 99 03 76 ( A) - 001
POLICY NUMBER: UB2T357728
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS
ENDORSEMENT - CALIFORNIA
(BLANKET WAIVER)
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule.
The additional premium for this endorsement shall be 2 . o o % of the California workers' compensation pre- mium.
Person or Organization
ANY PERSON OR ORGANIZATION FOR
WHICH THE INSURED HAS AGREED
BY WRITTEN CONTRACT EXECUTED
PRIOR TO LOSS TO FURNISH THIS
WAIVER.
Schedule
Job Description
ENGINEERS
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective
Insured
Insurance Company
DATE OF ISSUE: 04-03-23
Policy No. Endorsement No.
Premium
Countersigned by ____________ _
ST ASSIGN: Page 1 of 1