Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
D. DISCLOSURE - CAMPAIGN FINANCE ORDINANCE - CONTRACTORS AND
SUBCONTRACTORS
The City Council adopted Ordinance No. 5744, "Campaign Finance Ordinance," which became effective on September 9, 2011, and amended it with Ordinance No. 5768, which became effective on March 15, 2012 ("the Ordinance"). The Ordinance prohibits: (1) A contractor* (including a subcontractor**) who has a contract with the City of Glendale (City ), Glendale Successor Agency or Glendale Redevelopment Agency (GSA), or the Housing Authority of the City of Glendale ("HA") and that contract is subject to approval by the City Council, GSA, or HA— from making a contribution to a City Council member, GSA member, HA member, City Clerk, or City Treasurer; and (2) Council members, GSA members, and HA members from voting on matters concerning a contract affecting a contractor or subcontractor who has provided a campaign contribution.
The provisions of the Ordinance restricting Council members from voting on matters affecting campaign contributors applies to a contractor whose contract requires the City Council's, GSA's, or HA's approval, and specified subcontractors. A contract with the City, GSA, or HA is known as a "City Contract." The Ordinance excludes a competitively bid contract awarded to the lowest responsible bidder.
To assist members of the City Council, GSA, and HA before they vote on a matter regarding a City Contract, the Ordinance requires City staff to prepare this report which discloses certain information about: the contractor receiving the City Contract, and specified subcontractors) working under the City Contract.
Information that must be disclosed: • Name of the person, entity, or organization (i.e., the Contractor or Subcontractor) • Name of the Chief Executive Officer/President
• Chief Operating Officer
• Chairperson
• All members of the Board of Directors
• All persons who own more than 10% of the person, entity, or organization • Name of any campaign committee owned or controlled by the person, entity, or organization Please complete the following disclosure form:
Contractors)*:
Name Address
David Evans and Associates, Inc. 201 S. Figueroa St., Suite 240, Los Angeles, CA 90012 Full Name | Title Business Address _City State Zip
Al Barkouli, PhD, PE Chairperson 2100 S. River Parkway, Suite 100 Portland OR 97201 Al Barkouli, PhD, PE Chief Executive Officer / President 2100 S. River Parkway, Suite 100 Portland OR 97201 Cindi Polychronis, JD Chief Operating Officer 2100 S. River Parkway, Suite 100 Portland OR 97201 Aaron Fetzer, CPA, CGMA Chief Financial Officer 2100 S. River Parkway, Suite 100 Portland OR 97201 Board of Directors 2100 S. River Parkway, Suite 100 Portland OR 97201 More than 10% interest owner
Executive Officer, Chief Financial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, 104
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project xxiv
Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Please disclose these persons' name and business address.
Subcontractors)**: Please see attached pages
Name Address
Full Name Title Business Address City State Zip
Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
** "Subcontractor" is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or general or prime contract, usually by a general or prime contractor. You must also disclose the names of the Subcontractor's Board of Directors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization.
Above please disclose these persons name and business address.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
CERTIFICATION
On behalf of the above-named M Contractor I Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute— or if I select additional— architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and • I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is 9 pages.
Executed on: July 25 _ 20_24 , at: Los Angeles California.
Signature: con ain Print Full Name: Sean Haeri, PE, TE, CPM Address: 201 S. Figueroa St., Suite 240, Los Angeles, CA 90012 Phone Number: 714.665.4553 E-mail Address: _ [email protected] 105
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project XXV
Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Please disclose these persons' name and business address.
Subcontractor(s)**: The listed names below have 0% ownership interest Name Address
Verdantas Inc. 2600 Michelson Drive, Suite 400, Irvine, CA 92612 Full Name Title Business Address City State Zip
Jesse Kropelnicki Chief Executive Officer / President 6397 Emerald Parkway, Suite 200 Dublin OH. 43016 Rebecca Ashton Chief Operating Officer 6397 Emerald Parkway, Suite 200 Dublin OH. 43016 Pat Sheridan Chief Financial Officer 6397 Emerald Parkway, Suite 200 Dublin OH. 43016 Kristen Williams Vice President 2600 Michelson Drive, Suite 400 Irvine CA 92612 Sean Colorado Vice President 2600 Michelson Drive, Suite 400 Irvine CA 92612 Nikhila Srirangpatna Vice President 2600 Michelson Drive, Suite 400 Irvine CA 92612 ** "Subcontractor" is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or general or prime contract, usually by a general or prime contractor. You must also disclose the names of the Subcontractor's Board of Directors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization.
Above please disclose these persons' name and business address.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
CERTIFICATION
On behalf of the above-named • Contractor X Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute— or if I select additional— architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and • I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is _ pages.
Executed on: July 2 , 2024 Irvine , California.
Signature: isten (silliams Print Full Name: Kristen Williams, PG Address: 2600 Michelson Drive, Suite 400, Irvine, CA 92612 Phone Number: 949.681.4273 E-mail Address: [email protected] 105
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project xxvi
Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Please disclose these persons' name and business address.
Subcontractor(s)**:
Name Address
CL Surveying and Mapping, Inc. 400 East Rincon Street, Suite 202, Corona, CA 92879 Full Name Title Business Address City State Zip
Chairperson
Lam Le Chief Executive Officer / President Same as above Chief Operating Officer
Daniel Calvillo Chief Financial Officer Same as above
Board of Directors
More than 10% interest owner
** "Subcontractor" is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or general or prime contract, usually by a general or prime contractor. You must also disclose the names of the Subcontractor's Board of Directors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization.
Above please disclose these persons' name and business address.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
None
CERTIFICATION
On behalf of the above-named • Contractor Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute— or if I select additional— architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and • I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is O pages.
Executed on: July 10 ., 2024 , at: Corona , California.
Jan I Print Full Name: Lam Le
Signature:
Address: 400 East Rincon Street, Suite 202, Corona, CA 92879 Phone Number: (909) 484-4200 E-mail Address: [email protected] 105
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project xxvii
Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Please disclose these persons' name and business address.
Subcontractor(s)**:
Name Address
Design West Engineering 412 E Vanderbilt Way, San Bernardino, CA 92408 Full Name Title Business Address City State Zip
N/A Chairperson
Leonard Maya Chief Executive Officer / President 110 James St. Suite 106 Edmonds WA 98020 Chief Operating Officer
Mark Galle Chief Financial Officer 412 E Vanderbilt Way San Bernardino CA 92408 Board of Directors
Steven Johnson & Jeremy Richard | More than 10% interest owner 412 E Vanderbilt Way San Bernardino CA 92408 ** "Subcontractor" is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or general or prime contract, usually by a general or prime contractor. You must also disclose the names of the Subcontractor's Board of Directors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization.
Above please disclose these persons' name and business address.
Campaign Committee owned or controlled by: N/A
Title Business Address City State Zip
CERTIFICATION
On behalf of the above-named • Contractor X Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute— or if I select additional— architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and • I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is two pages.
Executed on: July 1st : 2024 , at: San Bernardino _ California.
Signature: _ Steven Johnson Print Full Name: Steven Johnson Address: 412 E Vanderbilt Way, San Bernardino, CA 92408 Phone Number: (909) 763-4223 E-mail Address: [email protected] 105
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project xxviii
Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Please disclose these persons' name and business address.
Subcontractors)**:
Name Address
ADVANTEC Consulting Engineers, Inc. 1200 Roosevelt, Irvine, CA, 92620 Full Name Title Business Address City State Zip
Leo Lee Chairperson 1200 Roosevelt Irvine CA 92620
Carlos A. Ortiz Chief Executive Officer / President 1200 Roosevelt Irvine CA 92620 N/A Chief Operating Officer
Pauline Yip Chief Financial Officer 1200 Roosevelt Irvine CA 92620 Leo Lee, Pauline Yip, Carlos Ortiz, Joe Harake, Kieth Rang Board of Directors 1200 Roosevelt Irvine CA 92620 More than 10% interest owner
** "Subcontractor" is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or general or prime contract, usually by a general or prime contractor. You must also disclose the names of the Above please disclose these persons' name and business address.
Campaign Committee owned or controlled by: Not Applicable Title Business Address City State Zip
N/A
CERTIFICATION
On behalf of the above-named • Contractor / Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute — or if I select additional— architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • hereby certify that:
• I have identified all persons for which the Ordinance requires disclosure; • The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and • I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is 2 pages.
Executed on: July 12 - 2024 , at: Irvine , California.
Signature: Print Full Name: Carlos A. Ortiz
Address: 1200 Roosevelt, Irvine, CA, 92620
Phone Number: 949-861-4999
105
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project xxiX
Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Please disclose these persons' name and business address. (
Subcontractors)**:
Name Address
TDG Engineering, Inc. 742 South Hill Street, Suite 600, Los Angeles, CA 90014 Full Name Title Business Address City State
No campaign contributions to report Chairperson
Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
** "Subcontractor" is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or general or prime contract, usually by a general or prime contractor. You must also disclose the names of the Subcontractor's Board of Directors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization.
Above please disclose these persons' name and business address.
Campaign Committee owned or controlled by: No campaign contributions to report Title Business Address City State Zip
No campaign contributions to report
CERTIFICATION
On behalf of the above-named • Contractor X Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute — or if I select additional— architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
• I have identified all persons for which the Ordinance requires disclosure; • The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and • I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is pages.
Executed on: July 3r° , 20_24 _, at: Los Angeles , California.
Signature: Print Full Name: Jessica Fields, PE, AICP, Director of Operations. Western U.S.
Address: 742 South Hill Street, Suite 600, Los Angeles, CA 90014 Phone Number: 720.204.7061 x145 E-mail Address: [email protected] 105
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project XXX
Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Please disclose these persons' name and business address.
Subcontractors)**:
Name Address
Arellano Associates 5851 Pine Ave., Suite A. Chino Hills, CA 91709 Full Name Title Business Address City State Zip
Chairperson
Genoveva Arellano Chief Executive Officer / President 5851 Pine Ave., Suite A Chino Hills CA 91709 Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
** Subcontractor" is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or general or prime contract, usually by a general or prime contractor. You must also disclose the names of the Subcontractor's Board of Directors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization.
Above please disclose these persons' name and business address.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
Not Applicable
CERTIFICATION
On behalf of the above-named • Contractor [ Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute— or if I select additional— architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and • I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is pages.
Executed on: July : 2024 - at: Chino Hills , California.
Signature: Print Full Name: Genoveva L. Arellano
Address: 5851 Pine Ave., Suite A. Chino Hills, CA 91709 Phone Number: 909) 627-2974 E-mail Address: [email protected] 105
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project
Exhibit 4
North Verdugo Road Multimodal Improvements Project
RFP No. PWA 2024-018
or organization, and any campaign committee that is owned or controlled by that person, entity, or organization. Please disclose these persons' name and business address.
Subcontractor(s)**:
Name Address
Inland Urban Forest Group 10650 Deerfield Drive, Cherry Valley, CA 92223 Full Name Title Business Address City State Zip
Chairperson
Nancy Sappington Chief Executive Officer / President
Chief Operating Officer
Chief Financial Officer
Board of Directors
More than 10% interest owner
** "Subcontractor" is the person, entity, or organization that has entered into a contract for the performance of all or a portion of the work undertaken under an agreement with an architect, design professional, engineer, or general or prime contract, usually by a general or prime contractor. You must also disclose the names of the Subcontractor's Board of Directors, its Chairperson, Chief Executive Officer, Chief Financial Officer, Chief Operating Officer, any person with an ownership interest of more than ten percent (10%) in that person, entity, or organization, and any campaign committee that is owned or controlled by that person, entity, or organization.
Campaign Committee owned or controlled by:
Title Business Address City State Zip
CERTIFICATION
On behalf of the above-named • Contractor X Subcontractor:
• I acknowledge that I have a continuing obligation to update this disclosure form if I substitute— or if I select additional— architects, design professionals, contractors, or subcontractors within ten (10) days of the selection or change; and • I hereby certify that:
• I have identified all persons for which the Ordinance requires disclosure; The information in this disclosure form (and any attachment to this form) is true, accurate, correct, and complete; and • I have been legally authorized to submit this disclosure form.
In total, this disclosure form (including attachments) is pages.
Executed on: July 25 : 20_24 → at: Cherry Valley , California.
Signature: - Nancy Sappington Print Full Name: Nancy Sappington Address:_10650 Deerfield Drive, Cherry Valley. CA 92223 Phone Number:310.562.4904 E-mail Address:[email protected] 105
David Evans and Associates, Inc. | North Verdugo Road Multimodal Improvements Project xxxii