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Attach 2 - Agreement including Scope and Fee

Hercules City Council
August 9, 2022

Document
Attach 2 - Agreement including Scope and Fee
Meeting
August 9, 2022
Body
Hercules City Council
Pages
8
Original file
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Text extracted from the city's file for reading and search. Open the original on hercules.legistar1.com. That file is the official record.

Professional Services Agreement Agreement No. 22-036
City Attorney Approved, 082321 Code Enforcement Services FY 2022-23

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CITY OF HERCULES

PROFESSIONAL SERVICES AGREEMENT
Thi
s Agreement (“Agreement”) for professional services is made on July 21, 2022, between the City of Hercules, a California municipality (“City”), and CSG Consultants , Inc., a California Corporation (“Consultant”) (individually, a “Party,” and collectively, the “Parties”).

1. S
cope of Services. Consultant will provide to City the professional services described in the Scope of Services, attached as Attachment A and incorporated in this Agreement (the “Services”). Only the City Council or the City Manager may authorize any change or addition to the Scope of Services specified in Attachment A.

2. T
erm. This Agreement will become effective on July 1, 2022 (“Effective Date”), and will terminate upon the full and satisfact ory completion of the Services or as otherwise specified in Attachment A, unless terminated sooner in accordance with Section 10 of this Agreement. Time is of the essence with respect to all provisions of this Agreement that specify a time for performance.

3. C
ompensation. For the full and satisfactory completion of the Services, City will pay Consultant in an amount not to exceed $130 ,000, without prior written authorization by City , pursuant to the terms set forth in Attachment B on Payment, which is attached to and incorporated in this Agreement. Consultant’s compensation is intended to encompass all costs required for performing the Services, including overhead and indirect costs. Except as expressly provided in Attachment B, Consultant will not be entitled to reimbursement for expenses it incurs to provide the Services.

3. 1 Payment. City will pay Consultant for Services satisfactorily provided during each calendar month within 30 days following City receipt and approval of a detailed invoice. The invoice must include, at a minimum: a description of the specific Services provided; the name of the individual providing the Services; the date(s) upon which the Services were provided; the time spent providing the Services; the amount due for the Services ; and the basis for calculating the amount due.

3. 2 Additional Services. If the City requests related services beyond the Scope of Services described in Attachment A, the Consultant will provide City a written estimate for the additional services (“Additional Services”). Consultant will not provide Additional Services until Consultant has received written authorization from the City to perform the Additional Services .

Consultant will not be entitled to payment for Additional Services performed without City’s prior written authorization or for costs to correct Consultant’s errors or omissions.

4. I
ndependent Contractor. The Parties agree that Consultant will act as an independent contractor under this Agreement and will have control of its work and the manner in which the Services are performed. Consultant is not an employee of City and is not entitled to participate in any health, retirement, or similar employee benefits from the City.

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

Professional Services Agreement Agreement No. 22-036
City Attorney Approved, 082321 Code Enforcement Services FY 2022-23

Page 2 ends

5. Consultant’s Warranties.

5.1 Consultant warrants that all Services provided under this Agreement will be performed in accordance with generally accepted professional practic es and standards for Consultant’s profession in the Bay Area.

5.2 Consultant warrants that all Services provided under this Agreement will be performed in accordance with applicable federal, state, and local laws and regulations, including, but not limited to, conflict of interest laws and City ordinances and policies.

5.3 Consultant warrants that Consultant has no present interest which would conflict in any manner with the performance of Services on the City’s behalf.

5.4 Consultant warrants that it will comply with the City’s Nepotism and Cronyism Policy.

6. Notice. Any notice, billing, or payment required by this Agreement must be made in writing, and sent to the other P arty by personal delivery, U.S. Mail, a reliable overnight deliv ery service, or by e mail as a PDF (or comparable) file. Notice is effective upon deli very unless otherwise specified. Notice for each Party will be given as follows:

City: Consultant:

City of Hercules CSG Consultants, Inc.
111 Civic Drive 550 Pilgrim Dr
Hercules, CA 94547 Foster City, CA 94404
(510) 799-8200 (650) 522-2500
Attn: Tim Rood [email protected]
Email: [email protected] Copy to: [email protected]

7. Indemnity. Subsection 7.1 is not applicable to this Agreement if Consultant’s Services are “design professional” services as that term is used and defined in Civil Code section 2782.8.

Subsection 7.2 is applicable to this Agreement if Consultant’s Services are “design professional” services as used and defined in Civil Code section 2782.8.

7.1 To the full extent permitted by law, Consultant will indemnify, defend with counsel acceptable to City, and hold harmless City, its governing body, officers, agents, employees, and volunteers (collectively, “City Indemnitees”) from and against any and all liability, demands, loss, damage, claims, settlements, expenses, and costs (including, without limitation, attorney fees, expert witness fees, and costs and fees of litigation) (collectively, “ Liability”) of every nature arising out of or in connection with Consultant’s acts or omissions with respect to this Agreement, except such Liability caused by the active negligence, sole negligence, or willful misconduct of any of the City Indemnitees. This indemnification obligation is not limited by any limitation on the amount or type of damages or compensation payable under Workers’ Compensation or other employee benefit acts, or by insurance coverage limits, and will survive the expiration or early termination of this Agreement. This Subsection 7.1 does not apply if the Services to be provided under this Agreement are design professional services provided by a licensed architect, landscape architect, professional engineer, or professional land surveyor.

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

Professional Services Agreement Agreement No. 22-036
City Attorney Approved, 082321 Code Enforcement Services FY 2022-23

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7.2 To the full extent permitted by law, Consultant will indemnify, defend, and hold harmless City, its City Council, officials, officers, agents, employees, and volunteers from and against any and all liability, loss, damage, claims, expenses and costs (includi ng, without limitation, attorney fees and costs and fees of litigation) (collectively, “Liability”) of every nature which arises out of, pertains to, or relates to the negligence, recklessness, or willful misconduct of Consultant in the performance of this Agreement, except such Liability caused by the active negligence, sole negligence or willful misconduct of City. This indemnification obligation is not limited by any limitation on the amount or type of damages or compensation payable under Workers’ Compensation or other employee benefit acts, or by insurance coverage limits, and will survive the expiration or early termination of this Agreement. This Subsection 7.2 is applicable if the Services to be provided under this Agreement are design professional services provided by a licensed architect, landscape architect, professional engineer, or professional land surveyor.

8. Insurance. Before providing any Services under this Agreement, Consultant is required to procure and provide proof of the insur ance coverage required by this S ection in the form of certificates and endorsements. Each certificate of insurance must state that the coverage afforded by the policy or policies will not be reduced, cancelled or allowed to expire without at least 30 days written notice to City, unless due to nonpayment of premiums, in which case at least 10 days written notice will be made to City. The required insurance must cover the activities of Consultant and its employees or subcontractors relating to or arising from the performance of the Services, and must remain in full force and effect at all times during the term of the Agreement. All required insurance must be issued by an insurer licensed to do business in the State of California, and each such insurer must have an A.M. Best financial strength rating of “A” or better and a financial size rating of “VIII” or better. If Consultant fails to provide any of the required coverage, City may, at its sole discretion, purchase such coverage at Consultant’s expense and deduct the cost from payments due to Consultant.

8.1 The following insurance policies and limits are required for this Agreement:

8.1.1 Commercial General Liability Insurance (“CGL”) . CGL insurance issued on an occurrence basis, including coverage of liability arising from Consultant’s acts or omissions in the performance of S ervices under this Agreement, with limits of at least $1,000,000.00 per occurrence.

8.1.2 Automotive. Commercial automotive liability coverage for owned, nonowned and hired vehicles must provide coverage of at least $1,000,000.00 combined single limit per accident for bodily injury, death, or property damage.

8.1.3 Workers’ Compensation Insurance and Em ployer’s Liability. The policy must comply with the requirements of the California Workers’ Compensation Insurance and Safety Act, with limits of at least $1,000,000.00. If Consultant is self- insured, Consultant must provide its duly authorized Certificate of Permission to Self-Insure.

8.1.4 Professional Liability. This in surance must insure against Consultant ’s errors and omissions in the provision of S ervices under this Agreement , in an amount no less than $1,000,000.00 combined single limit.

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

Professional Services Agreement Agreement No. 22-036
City Attorney Approved, 082321 Code Enforcement Services FY 2022-23

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8.2 Subrogation Waiver. Each required policy must include an endorsement that the insurer agrees to waive any right of subrogation it may have against City or the City’s insurers.

8.3 The CGL policy and the automotiv e liability policy must include the following endorsements:

(1) The City, including its Council, officials, officers, employees, agents, volunteers and consultants (collectively, “ Additional Insured”) must be named as an additional insured for all liability arising out of the operations by or on behalf of the named insured, and the policy must protect the Additional Insured against any and all liability for personal injury, death or property damage or destruction arising directly or indirectly in the performance of the Agreement.

(2) The inclusion of more than one insured will not operate to impair the rights of one insured against another, and the coverages afforded will apply as though separate policies have been issued to each insured.

(3) The insurance provided is primary and no insurance held or owned by City will be called upon to contribute to a loss.

(4) Any umbrella or excess insurance must contain or be endorsed to contain a provision that such coverage will also apply on a primary or non-contributory basis for the benefit of City before the City’s own insurance or self -insurance will be called upon to protect it as a named insured.

9. Dispute Resolution. In the event that any dispute arises between the Parties in relation to this Agreement, the Parties agree to meet face to face as soon as possible to engage in a good faith effort to resolve the matter informally. In the event that any dispute arises between the Parties in relation to this Agreement, and the dispute is not resolved by informal discussions, the Parties agree to submit the dispute to mediation.

9.1 Either Party may give written notice to the other Party of a request to submit a dispute to mediation, and a mediation session must take place within 60 days after the date that such notice is given, or sooner if reasonably practicable. The Parties will jointly appoint a mutually acceptable mediator. The Parties further agree to share equally the costs of the mediation, except costs incurred by each Party for representation by legal counsel.

9.2 Good faith participation in mediation pursuant to this S ection is a condition precedent to either Party commencing litigation in relation to the dispute.

10. Early Termination.

10.1 Termination for Convenience. City may terminate this Agreement for convenience by giving 10 calendar days written notice to Consultant. In the event City elects to terminate the Agreement without cause, it will pay Consultant for Services satisfactorily provided up to that date.

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

Professional Services Agreement Agreement No. 22-036
City Attorney Approved, 082321 Code Enforcement Services FY 2022-23

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10.2 Termination for Cause. If either Party breaches this Agreement by failing to timely or satisfactorily perform any of its obligations or otherwise violates the terms of this Agreement, the other Party may terminate this Agreement by giving written notice five calendar days prior to the effective date of termination, specifying the reason a nd the effective date of the termination.

Consultant will be entitled to payment for all Services satisfactorily provided up to the effective date of termination, except that the City may deduct from that p ayment the amount of costs the City incurred, if any, because of Consultant’s breach of the Agreement.

11. Work Product. City will be the sole owner of all rights to any work product in any form which has been prepared by Consultant on City ’s behalf pursuant to this Agreement, unless otherwise specified in writing by the Parties.

12. Records. Unless otherwise specified in Attachment A, C onsultant will maintain records related to this Agreement for a period of four years from expiration or termination of this Agreement, including records of the Services performed, on a daily basis if necessary .

Consultant’s accounting systems will conform to generally accepted accounting principles, and all records will provide a breakdown of total costs charged under this Agreement, including properly executed payrolls, time records, invoices, and vouchers. Consultant will permit City to inspect and examine Consultant’s books, records, accounts, and any and all data relevant to this Agreement at any reasonable time.

13. General Provisions.

13.1 Assignment and Successors. Consultant may not assign its rights or obligations under this Agreement, in part or in whole, without City’s written consent. This Agreement is binding on Consultant’s and City’s lawful heirs, successors, and permitted assigns.

13.2 Third Party Beneficiaries. There are no intended third-party beneficiaries to this Agreement.

13.3 Nondiscrimination. Consultant will not discriminate in the employment of persons under this Agreement because of race, color, ancestry, national origin, religion, sex, marital status, age, medical condition, disability, or other prohibited basis. All nondiscrimination rules or regulations required by law to be included in this Agreement are incorporated by this reference.

13.3.1 Avoidance of Cronyism and Nepotism. Consultant shall comply with regulations adopted by the City of Hercules to avoid favoritism in the award of contracts. Consultant shall submit a fully executed copy of the “Contractor Acknowledgment of City of Hercules Nepotism and Cronyism Policy” as Attachment C to this Agreement.

13.3.2 Compliance with the California Equal Pay Act . Consultant shall comply with regulations adopted by the City of Hercules to allow for verification of Consultant compliance with the requirements of the California Equal Pay Act. Consultant shall submit a fully executed copy of the “Contractor Acknowledgment of Compliance with the California Equal Pay Act” as Attachment D to this Agreement.

13.4 Choice of Law and Venue. This Agreement will be governed by California law, and venue will be in the Superior Court of Contra Costa County, and no other place.

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

Professional Services Agreement Agreement No. 22-036
City Attorney Approved, 082321 Code Enforcement Services FY 2022-23

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13.5 Integration. This Agreement and the documents incorporated in this Agreement constitute the final, complete, and exclusive terms of the agreement between the City and the Consultant.

13.6 Severability. If any provision of this Agreement is determined to be illegal, invalid, or unenforceable, in part or in whole, the remaining provisions of the Agreement will remain in full force and effect.

13.7 Amendment. No amendment or modification of this Agreement will be binding unless it is in a writing duly authorized and signed by the Parties to this Agreement.

13.8 Provisions Deemed Inserted. Every provision of law required to be inserted in this Agreement will be deemed to be inserted, and this Agreement will be construed and enforced as though included. If it is discovered that through mistake or otherwise that any required provision is not inserted, or not correctly inserted, this Agreement will be amended to make the insertion or correction.

13.9 Precedence. If any provision in any document attached to or incorporated in this Agreement conflicts with or is inconsistent with the provisions set forth in the body of this Agreement, the provisions set forth in the body of this Agreement will control over any s uch conflicting or inconsistent provisions.

13.10 Waiver. No waiver of a breach, failure of any condition, or any right or remedy contained in or granted by the provisions of this Agreement will be effective unless it is in writing and signed by the P arty waiving the breach, failure, right, or remedy. No waiver o f any breach, failure, right, or remedy will be deemed a waiver of any other breach, failure, right, or remedy, whether or not similar, nor will any waiver constitute a continuing waiver unless the writing so specifies.

13.11 Force Majeure. If either Party is delayed or hindered in or prevented from the performance of any act required under this Agreement because of strikes, lockouts, inability to procure labor or materials, failure of power, riots, insurrection, war, fire or other casualty, or other reason beyond the reasonable control of the P arty delayed, excluding financial inability (“Force Majeure Event”), performance of that act will be excused for the period during which the Force Majeure Event prevents such performance, and the period for that performance will be extended for an equivalent period. Delays or failures to perform resulting from lack of funds will not be Force Majeure Events.

13.12 Headings. The headings in this Agreement are included for convenience only and will not affect the construction or interpretation of any provision in this Agreement or any of the rights or obligations of the Parties to this Agreement.

13.13 Execution in Counterparts. This Agreement may be executed in any number of counterparts, each of which will be an original, but all of which together will constitute one instrument.

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

Professional Services Agreement Agreement No. 22-036
City Attorney Approved, 082321 Code Enforcement Services FY 2022-23

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13.14 Authorization. Each individual signing below warrants that he or she is authorized to do so by the Party that he or she represents, and that this Agreement is legally binding on that Party. If Consultant is a corporation, signatures from two officers of the corporation are required pursuant to California Corporation Code section 313.

[Signature page follows.]
The Parties agree to this Agreement as witnessed by the signatures below:

CITY: Approved as to form:

s/_______________________________ s/__________________________________

________________________________ ___________________________________ Dante Hall, City Manager Patrick Tang, City Attorney

Date: ___________________________ Date: ______________________________

Attest:

s/_______________________________

_________________________________
Lauren Berges, City Clerk

Date: ___________________________

CONSULTANT: CSG Consultants, Inc. ________________________________ Business Name

s/_______________________________

_________________________________
Name/Title

Date: ____________________________

s/_______________________________

_________________________________
Name/Title

Date: ____________________________

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279 PresidentCyrus Kianpour
7/27/2022

Professional Services Agreement Agreement No. 22-036
City Attorney Approved, 082321 Code Enforcement Services FY 2022-23

Page 8 ends

Attachments:

Attachment A: Scope of Services
Attachment B: Payment
Attachment C: Contractor Acknowledgment of City of Hercules Nepotism and Cronyism Policy Attachment D: Contractor Acknowledgment of Compliance with the California Equal Pay Act DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

Professional Services Agreement Agreement No. 22-027-CM City Attorney Approved, 082321 Scope of Services

Attachment A

SCOPE OF SERVICES

Consultant shall provide municipal code & zoning enforcement services within the City, including identifying violations and responding to municipal & zoning code violation complaints, which may involve but are not limited to: weeds and overgrown landscaping; blighted and/or vacant properties; illegal structures and signs; unauthorized uses; graffiti and vandalism; public nuisance conditions; inoperable vehicles; and other municipal, zoning, and other code-related violations. Services will be provided on a regular part-time basis, with additional on-call or work orders as needed. The proposed scope of services allows flexibility for the contract service provider to work independently and to serve as an extension of City staff and may include training of volunteers assigned to code compliance tasks.

Consultant shall engage residents, stakeholders, and responsible parties to correct code violations. Beyond promoting voluntary compliance, services to be provided include a full range of code enforcement activities, including but not limited to:

• Drafting and disseminating information for the general public; • Drafting notices of violation and monitoring compliance with abatement timelines; • Enforcing abatement notices;
• Testifying in public hearings and court proceedings on behalf of the City; • Facilitating settlement agreements;
• Recommending changes to the code(s) and procedures;
• Appearing as an expert witness;
• Assisting in recording notices of violation, liens, and collections; and • Other services as outlined herein.

Code enforcement consultant shall work with City staff to maintain a comprehensive log of contacts/communications, follow-up actions, and status/results.

Sub-Contractor
The use of any sub-contractor must be approved in advance in writing by the City and must meet the requirements of this Agreement. Use of sub-contractors must be clearly explained in the proposal, and major sub-consultants must be identified by name. Prime consultants shall be wholly responsible for the entire performance whether or not sub-consultants are used.

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279 Professional Services Agreement Agreement No. 22-027-CM City Attorney Approved, 082321 Payment
Attachment B
PA
YMENT
P
rice Changes
All prices shall be firm and not subject to increase during the period of the Contract.

Compensation
City will compensate Consultant for the following expenses (“Allowable Reimbursable Expenses”) at the following rate(s), not to exceed a total of $130,000, without prior written authorization:

DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

FOSTER CITY | PLEASANTON | SAN JOSE | SACRAMENTO | NEWMAN | ORANGE | REDLANDS

EXHIBIT A
City of Hercules
Code Enforcement Services - Fee Schedule
Effective July 1, 2022

CSG's fee schedule which includes fees for personnel providing the proposed scope of work is provided in the table below. We will coordinate the pickup and return of all plans via CSG staff or licensed courier service. This service is provided at no additional cost. CSG will mail an invoice at the beginning of every month for services rendered during the previous month.

All hourly rates include overhead costs including, but not limited to, salaries, benefits, Workers Compensation Insurance, and office expenses. Overtime work will be billed at 1.5 X the hourly rates indicated in the table above. Should the scope of work change or circumstances develop which necessitate special handling, CSG will notify the City prior to proceeding. .

On July 1 of each year following the contract year, CSG will initiate a rate increase based on the change in CPI for the applicable region. CSG will invoice on a monthly basis for services rendered during the prior month. Unless otherwise agreed, payment terms are 30-days from receipt of invoice.

Review Type / Role Current Hourly Rate FY 22-23 Hourly Rate Code Enforcement Officer I $115 $121
Code Enforcement Officer II $120 $126
Senior Code Enforcement Officer $130 $137
Code Enforcement Officer Manager $150 $158
Overtime 1.5 X Hourly Rate 1.5 X Hourly Rate
DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279 Professional Services Agreement Agreement No. 22-027-CM City Attorney Approved, 082321 Nepotism and Cronyism Policy Attachment C
C

ONTRACTOR ACKNOWLEDGMENT OF

CITY OF HERCULES NEPOTISM AND CRONYISM POLICY
DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279 Pag e 1

CONTRACTOR ACKNOWLEDGMENT OF CITY OF HERCULES NEPOTISM AND CRONYISM POLICY SECT
ION A:

To be completed by City Representative Prior to Distribution to Contractor:

City Representative Phone Project Spec No.

Department Contract/Proposal Name
SE
CTION B:

This is an Original Revised form (check one). If Original, complete all that applies. If revised, complete Contractor Name and include any changed data.

Contractor/Consultant Name Phone
Street Address City State Zip
Type of Submission (Check One) Bid Proposal Qualification Contract/Agreement/Amendment SE
CTION C:

The undersigned Contractor’s Representative acknowledges by his or her signature the following:

It is the policy of the City of Hercules to avoid favoritism or discrimination in making decisions to award contracts for supplies, construction, maintenance, professional or other services. The awarding of a contract or the approval of payments or expenses under a contract by a City Official, to a person with whom she or he has a family relationship or a consensual romantic and/or sexual relationship, is regarded as a violation of t his Section. Nepotism and cronyism as defined in Section 2-3.402 are hereby prohibited from City contracting decisions to the full extent permitted by law.

I
have read Hercules Ordinance Number 486 and certify that I/we have not knowingly, nor will I/we in the future, enter into a contract with the City of Hercules or accept payment from the City of Hercules when to do so is in violation of Ordinance Number 486.

If
circumstances require changing the information on this form while I/we have a bid, proposal, or qualifications under review, or while we are under contract with the City, we will amend this form within five business days.

Signature Date
Print Name of Signer Position
SE
CTION D:

To Be Completed by Administrative Services Departmen t with the City of Hercules after Submission of the Completed Form by Contractor
Date Received by City By
✔
CSG Consultants
650-522-2500
550 Pilgrim Dr
Foster City
CA
94404
✔
Tim Rood
510-799-8251
22-036
Community Development
Code Enf Svcs FY 22-23
DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279 7/27/2022
PresidentCyrus Kianpour
Professional Services Agreement Agreement No. 22-027-CM City Attorney Approved, 082321 California Equal Pay Act Attachment D
C

ONTRACTOR ACKNOWLEDGMENT OF COMPLIANCE

WITH THE CALIFORNIA EQUAL PAY ACT
DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279

CONTRACTOR ACKNOWLEDGMENT OF COMPLIANCE WITH CALIFORNIA EQUAL PAY ACT SECTION A:

To be completed by City Representative Prior to Distribution to Contractor:

City Representative Phone Project Spec No.

Department Contract/Proposal Name __
SECTION B:

This is an Original Revised form (check one). If Original, complete all that applies. If revised, complete Contractor Name and include any changed data.

Contractor/Consultant Name____________________ Phone
Street Address City State Zip
Type of Submission (Check One) Bid Proposal Qualification Contract/Agreement/Amendment SECTION C:

The undersigned Contractor’s Representative acknowledges by his or her signature the following:

It is the policy of the City of Hercules to avoid awarding contracts for supplies, construction, maintenance, professional or other services to contractors who are not in compliance with the equal pay requirements of the California Equal Pay Act.. The awarding of a contract or the approval of payments or expenses under a contract by a City Official, to a person or contractor not in compliance with the California Equal Pay Act, is regarded as a violation of this Section.

I have read Hercules Ordinance Number 534 and certify that I/we have not in the past 5 years been found to be in violation of the California Equal pay Act, and I/we have not knowingly, nor will I/we in the future, enter into a contract with the City of Hercules or accept payment from the City of Hercules when to do so is in violation of Ordinance Number 534 .

If circumstances require changing the information on this form while I/we have a bid, proposal, or qualifications under review, or while we are under contract with the City, we will amend this form within five business days.

Signature Date
Print Name of Signer Position
SECTION D:

To Be Completed by Administrative Services Department with the City of Hercules after Submission of the Compl eted Form by Contractor
Date Received by City By
Tim Rood
510-799-8251
22-036
Community Development
650-522-2500
550 Pilgrm Dr
Foster City
CA
94404
Tim Rood
CSG Consultants
DocuSign Envelope ID: 94E13252-27FB-4892-9E5B-EEE5334D1279 7/27/2022
PresidentCyrus Kianpour

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