Agenda packet — Placentia City Council, May 16, 2023 (part 1 of 3)

Mayor Ward L. Smith
District 5
Mayor Pro Tem Jeremy B. Yamaguchi
Councilmember
District 3
Kevin Kirwin
Councilmember
District 2
Rhonda Shader
Councilmember
District 1
Chad P. Wanke
Councilmember
District 4
Robert S. McKinnell
City Clerk
Kevin A. Larson
City Treasurer
Damien R. Arrula
City Administrator
Christian L. Bettenhausen
City Attorney
City of Placentia
401 E. Chapman Avenue
Placentia, CA 92870
Phone: (714) 993-8117
Fax: (714) 961-0283
Email:
[email protected]
Website: www.placentia.org
Regular Meeting Agenda
May 16, 2023
Placentia City Council
Placentia City Council Acting as Successor Agency to the Placentia Redevelopment Agency
Placentia Industrial Commercial Development Authority
Placentia Public Financing Authority
MC. iQ 'St t ment
Thee City Co-wnei l' 14- committed/ to- keep Inv, Placentia/ a/ plea sc n t place by provCd.Gng•a scl fe fa.wnily atww4phere, superiorpul>i+cbevvLceka.n.d/po-L+.cGes- that promote the hCg-heft atanula rd *- of comes kuuty lid VCsCovvStatement
The/ City of Placentiawill ntiainta.Lw an/ opew, h.an.e,st responsive, a.n.d/ inmovatwe government that d e iverk quality services- in/ cv fair owl& equitable was nn.er while optuni/k/ng, ava ita.b-le resources:

Copies of all agenda materials are available for public review in the Office of the City Clerk, online at www.placentia.org , and at the Placentia Library Reference Desk.

Persons who have questions concerning any agenda item may call the City Clerk's Office, (714) 993-8231, to make inquiry concerning the nature of the item described on the agenda.

Procedures for Addressing the Council/Board Members
Any person who wishes to speak regarding an item on the agenda or on a subject within the City's jurisdiction during the "Oral Communications" portion of the agenda should fill out a "Speaker Request Form" and give it to the City Clerk BEFORE that portion of the agenda is called. Testimony for Public Hearings will only be taken at the time of the hearing. Any person who wishes to speak on a Public Hearing item should fill out a "Speaker Request Form" and give it to the City Clerk BEFORE the item is called.

The Council and Board members encourage free expression of all points of view. To allow all persons the opportunity to speak, please keep your remarks brief. If others have already expressed your position, you may simply indicate that you agree with a previous speaker. If appropriate, a spokesperson may present the views of an entire group. To encourage all views, the Council and Board discourage clapping, booing or shouts of approval or disagreement from the audience.

PLEASE SILENCE ALL PAGERS, CELL PHONES, AND OTHER ELECTRONIC EQUIPMENT WHILE COUNCIL AND BOARD MEMBERS ARE IN SESSION.

Special Accommodations
In compliance with the Americans with Disabilities Act, if you need special assistance to participate in this meeting, please contact the City Clerk's Office at (714) 993-8231.

Notification 48 hours prior to the meeting will generally enable City Staff to make reasonable arrangements to ensure accessibility.
(28 CFR 35.102.35.104 ADA Title II)
In compliance with California Government Code § 54957.5, any writings or documents provided to a majority of the City Council regarding any item on this agenda that are not exempt from disclosure under the Public Records Act will be made available for public inspection at the City Clerk's Office at City Hall, 401 East Chapman Avenue, Placentia, during normal business hours.

Study Sessions are open to the public and held in the City Council Chambers or City Hall Community Room. Executive Sessions are held in the Council Caucus Room. While the public may be in attendance during oral announcements preceding Executive Sessions, Executive Sessions are not open to the public.

Placentia City Council/Successor Agency/ICDA/PPFA Agenda, May 16, 2023

Page 1 of 7 ends

PLACENTIA CITY COUNCIL

PLACENTIA CITY COUNCIL ACTING AS SUCCESSOR AGENCY TO THE

PLACENTIA REDEVELOPMENT AGENCY

PLACENTIA INDUSTRIAL COMMERCIAL DEVELOPMENT AUTHORITY

PLACENTIA PUBLIC FINANCING AUTHORITY

REGULAR MEETING AGENDA - CLOSED SESSION
May 16, 2023
5:30 p.m. - City Council Chambers
401 E. Chapman Avenue, Placentia, CA
CALL TO ORDER:

ROLL CALL:

Councilmember/Board Member Kirwin
Councilmember/Board Member Shader
Councilmember/Board Member Wanke
Mayor Pro Tem/Board Vice Chair Yamaguchi
Mayor/Board Chair Smith
ORAL COMMUNICATIONS:

At this time, the public may address the City Council and Boards of Directors concerning any items on the Closed Session Agenda only. There is a five (5) minute time limit for each individual addressing the City Council and Boards of Directors.

The City Council and Boards of Directors will recess to the City Council Caucus Room for the purpose of conducting their Closed Session proceedings.

1. Pursuant to Government Code Section 54957.6

CONFERENCE WITH LABOR NEGOTIATOR
Agency Designated Representatives: Damien Arrula, City Administrator Alice Burnett, Director of Human Resources
Employee Organizations: Placentia City Employees Association (PCEA) Placentia Firefighters Association (PFA)
Placentia Police and Fire Management Association (PPFMA) Placentia Police Officers Association (PPOA)
Unrepresented Employees

2. Pursuant to Government Code Section 54956.8

CONFERENCE WITH REAL PROPERTY NEGOTIATOR
Property: 323, 307, 312 and 314 Baker Street
Agency Negotiator: Damien R. Arrula, City Administrator Negotiating Party: Damien R. Arrula, City Administrator Under Negotiations: Price and Terms of Payment

3. Pursuant to Government Code Section 54956.8

CONFERENCE WITH REAL PROPERTY NEGOTIATOR
Property: 207 -209 W. Crowther Avenue
Agency Negotiator: Damien R. Arrula, City Administrator Negotiating Party: Damien R. Arrula, City Administrator Under Negotiations: Price and Terms of Payment
RECESS: The City Council and Boards of Directors will recess to their 7:00 p.m. Regular Meeting.

Placentia City Council/Successor Agency/ICDA/PPFA Agenda, May 16, 2023 Page 2 of 7

PLACENTIA CITY COUNCIL

PLACENTIA CITY COUNCIL ACTING AS SUCCESSOR AGENCY TO THE

PLACENTIA REDEVELOPMENT AGENCY

PLACENTIA INDUSTRIAL COMMERCIAL DEVELOPMENT AUTHORITY

PLACENTIA PUBLIC FINANCING AUTHORITY

REGULAR MEETING AGENDA
May 16, 2023
7:00 p.m. - City Council Chambers
401 E. Chapman Avenue, Placentia, CA
CALL TO ORDER:

ROLL CALL:

Councilmember/Board Member Kirwin
Councilmember/Board Member Shader
Councilmember/Board Member Wanke
Mayor Pro Tem/Board Vice Chair Yamaguchi
Mayor/Board Chair Smith
INVOCATION: Chaplain Kenneth Milhander
PLEDGE OF ALLEGIANCE: Officer John Martinez
PRESENTATIONS:
a. Proclamation of May 15 - 21, 2023 as National Police Week Presenter: Mayor Smith
Recipient: Chief of Police Brad Butts
b. Proclamation of May 21 — 27, 2023 as National Public Works Week Presenter: Mayor Smith
Recipient: Deputy City Administrator Luis Estevez
c. Proclamation of May 20, 2023 as Red Sneakers Day for Food Allergy Awareness Presenter: Mayor Smith
Recipient: Emma Melin
d. Proclamation of May 26, 2023 as Poppy Day
Presenter: Mayor Smith
Recipients: Loretta Jimenez and Members of American Legion Auxiliary Unit 277 CLOSED SESSION REPORT:

CITY ADMINISTRATOR REPORT:

ORAL COMMUNICATIONS:

At this time, the public may address the City Council and Boards of Directors concerning any agenda item, which is not a public hearing item, or on matters within the jurisdiction of the City Council and Boards of Directors. There is a five (5) minute time limit for each individual addressing the City Council and Boards of Directors.

CITY COUNCIL/BOARD MEMBER COMMENTS:

Placentia City Council/Successor Agency/ICDA/PPFA Agenda, May 16, 2023 Page 3 of 7

1. CONSENT CALENDAR (Items 1.a. through 1.i.):

All items on the Consent Calendar are considered routine and are enacted by one motion approving the recommended action listed on the Agenda. Any Member of the City Council and Boards of Directors or City Administrator may request an item be removed from the Consent Calendar for discussion. All items removed shall be considered immediately following action on the remaining items.

1.a.

1.b.

1.c.

1.d.

Consideration to Waive Reading in Full of all Ordinances and Resolutions Fiscal Impact: None
Recommended Action: Approve
City Fiscal Year 2022-23 Registers for May 16, 2023
Check Register
Fiscal Impact: $1,443,913.43
Electronic Disbursement Register
Fiscal Impact: $1,264,594.46
Recommended Action: It is recommended that the City Council:
1) Receive and file
Setting of the Annual Special Tax Rate for Fiscal Year 2023-24 for Community Facilities District No. 2014-01 (Public Services CFD) and Declaring the Intention to Allow for the Annexation of Property to Community Facilities District No. 2014-01
Fiscal Impact: Revenue: $64,139.16 Recouped through Assessments (550000-4505) Recommended Action: It is recommended that the City Council:
1) Adopt Resolution No. R-2023-32, a Resolution of the City Council of the City of Placentia, California, setting the levy of an Annual Special Tax for Community Facilities District No. 2014-01 (Public Services); and
2) Authorize inclusion of the Annual Special Tax for Community Facilities District No. 2014-01 (Public Services) for Fiscal Year 2023-24 on the Orange County Secured Property Tax Roll; and
3) Adopt Resolution No. R-2023-33, a Resolution of the City Council of the City of Placentia, California, declaring its intention to annex certain territory to Community Facilities District No. 2014-01 (Public Services).

Setting of the Annual Special Tax Rate for Fiscal Year 2023-24 for Community Facilities District No. 2018-01 (TOD CFD) and Declaring the Intention to Allow for Future Annexations to Community Facilities District No. 2018-01 Fiscal Impact: Revenue: $31,448.05 (800000-4505)
Recommended Action: It is recommended that the City Council:
1) Adopt Resolution No. R-2023-30, a Resolution of the City Council of the City of Placentia, California, setting the levy of an annual special tax for Community Facilities District No. 2018-01 (TOD Maintenance Services); and
2) Adopt Resolution No. R-2023-31, a Resolution of the City Council of the City of Placentia, California, declaring its intention to allow for future annexations of territory to Community Facilities District No. 2018-01 (TOD Maintenance Services); and 3) Authorize inclusion of the Annual Special Tax for Community Facilities District No. 2018-01 (TOD Maintenance Services) for Fiscal Year 2023-24 on the Orange County Secured Property Tax Roll.

1.e. Public Works Agreement with Asad Holdings LLC DBA Orangeblue General Contractors for the Installation of Tile Walls at the Placentia Navigation Center Fiscal Impact:

Expense: $144,500.00 Contract Amount (Navigation Center Fund) Budgeted: $150,000.00 (Navigation Center Tile Project Fund) $ 8,950.00 (Navigation Center Maintenance Fund)
Recommended Action: It is recommended that the City Council:
1) Approve a Public Works Agreement with Asad Holdings LLC DBA Orangeblue General Contractors for the installation of tile walls at the Placentia Navigation Center for a not -to -exceed amount of $144,500; and
Placentia City Council/Successor Agency/ICDA/PPFA Agenda, May 16, 2023 Page 4 of 7

2) Authorize the City Administrator to approve contract change orders up to 10% of the contract amount, or $14,450; and
3) Authorize the City Administrator and/or his designee to execute all necessary documents, in a form approved by the City Attorney.

1.f.

1.g.

1.h.

Award of Contract to Mariposa Landscapes, Inc., for Median and Parkway Landscape Maintenance Services
Fiscal Impact:

Expense: $279,575.91 Annual Contract Amount
Proposed Budget: $279,575.91 Fiscal Year 2023-34 Operating Budget (103655-6115, 173555-6115, 296561-6115)
Recommended Action: It is recommended that the City Council:
1) Approve a Professional Services Agreement with Mariposa Landscapes, Inc., for Median and Parkway Landscape Maintenance Services in an amount not -to -exceed $279,575.91 per year for an initial three (3) year contract term with the option to extend for an additional two-year term; and
2) Authorize the City Administrator to approve contract change orders up to 10% of the annual contract not -to -exceed amount; and
3) Authorize the City Administrator and/or his designee to execute all necessary documents, in a form approved by the City Attorney; and 4) Authorize the City Administrator to approve the eligible contract term extension an additional two-year term based upon contractor performance and at the discretion of the City.

Award of Maintenance Services Agreement to Hasa Inc., for Swimming Pool and Fountain Maintenance Services
Fiscal Imoact:

Expense: $53,250 Annual Contract Amount
Proposed Budget: $53,250 Fiscal Year 2023-34 Operating Budget (104076-6130)
Recommended Action: It is recommended that the City Council:
1) Approve a Maintenance Services Agreement with Hasa Inc. for Public Swimming Pool and Fountain Maintenance Services for an amount not -to -exceed $159,750 for an initial three-year contract term with the option to extend for one (1) additional two- year term for an amount not -to -exceed $53,250 per year; and 2) Authorize the City Administrator to approve contract change orders up to 10% of the annual contract average of $53,250; and
3) Authorize the City Administrator and/or his designee to execute all necessary documents, in a form approved by the City Attorney; and 4) Authorize the City Administrator to approve the eligible contract term extension for one (1) additional two-year term based upon contractor performance and at the discretion of the City.

Approve the Metropolitan Urban County Cooperation Agreement Amendment No. 3 Between the County of Orange and the City of Placentia for Community Development Block Grant Funds
Fiscal Imoact:

Potential Revenue of up to $323,000 per Fiscal Year for 2024-25, 2025-26 and 2026-27
Recommended Action: It is recommended that the City Council:
1) Approve a Metropolitan Urban County Cooperation Agreement Amendment No. 3 between the County of Orange and the City of Placentia for Community Development Block Grant Funds; and
2) Authorize the City Administrator to execute the agreement in a form approved by the City Attorney.

Placentia City Council/Successor Agency/ICDA/PPFA Agenda, May 16, 2023 Page 5 of 7

1.i. Approval Of Plans & Specifications and Award of Construction Contract to Grigolla & Sons Construction Co. Inc., For the 2022-2023 Concrete Repair Project, City Project No. 1302
Fiscal Impact:

Expense: $107,250.00 Total Construction Contract Amount $ 97,500.00 Construction Contract Amount
$ 9,750.00 Construction Contingency Amount
Available Budget: $108,273.56 Fiscal Year 2022-23 CIP Budget (791302-6740)
Recommended Action: It is recommended that the City Council:
1) Approve Plans & Specifications prepared by the City Engineer and approve a Public Works Agreement with Grigolla & Sons Construction Co. Inc., for the 2022-2023 Concrete Repair Project in the amount of $97,500; and
2) Reject the bid proposal submitted by National Pools Inc., as non -responsive; and 3) Reject all other bids received and authorize return of the bid bonds; and 4) Authorize the City Administrator to approve contract change orders up to ten percent (10%) of the contract amount, or $9,750, for a total construction contract not -to - exceed amount of $107,250; and
5) Authorize the City Administrator to execute all necessary documents, in a form approved by the City Attorney.

2. PUBLIC HEARINGS: None

3. REGULAR AGENDA:

3.a. Appointments to Fill Vacancies on One City Commission and Various Committees Fiscal Impact: None
Recommended Action: It is recommended that the City Council:
1) Make the necessary appointments to fill the vacancies listed below:
a. One (1) vacancy on the Planning Commission
b. One (1) alternate vacancy on the Heritage Committee
c. Three (3) vacancies on the Historical Committee
2) Direct Staff to update the City's master Commission and Committee vacancy list; and 3) Continue the Commission and Committee Application/Recruitment process for any remaining vacancies for future consideration of appointments.

3.b. Study Session: Presentation of the Proposed Fiscal Year 2023-24 Operating Budget and Capital Improvement Program (CIP)
Fiscal Impact: FY 2023-24 Expenditures: $ 85,583,391
Revenue: $ 84,855,133
Recommended Action: It is recommended that the City Council:
1) Review and discuss the Proposed Fiscal Year 2023-24 Annual Operating Budget Capital Improvement Program (CIP) and provide input and direction for final budget adoption; and
2) Set the date of the public hearing for budget adoption as June 6, 2023, at 7:00 p.m.

CITY COUNCIL/BOARD MEMBERS REQUESTS:

Council/Board Members may make requests or ask questions of Staff. If a Council/Board Member would like to have formal action taken on a requested matter, it will be placed on a future Council or Board Agenda.

ADJOURNMENT:

The City Council/Successor Agency/ICDA/PPFA Board of Directors will adjourn to a regular City Council meeting on Tuesday, June 6, 2023 at 5:30 p.m.

Placentia City Council/Successor Agency/ICDA/PPFA Agenda, May 16, 2023 Page 6 of 7

TENTATIVE AGENDA FORECAST
The Tentative Agenda Forecast is subject to change up until the posting of the Agenda for the Council Meeting listed below:
• Amendment to CNG Station Lease Agreement
• Amendment to Street Sweeping Contract
• Maintenance Services Agreement for Traffic Signal Maintenance Services • Public Works Agreement with Great Western Installations for Park Amenities Install • Public Hearing: Landscape Maintenance District Annual Assessment:
• Public Hearing: Street Lighting District Annual Assessment • Public Hearing: Review and Adoption of Annual General Fund Operating Budget, CIP, & Position Allocation Plan for FY 2023-24
• Public Hearing: SPA 2022-01, DPR 2022-04, and TTM 19250 (Toll Brothers) Development of an Approximately 17.02 -Gross Acre Site With 100 Single -Family, Detached Two - Story Dwelling Units Located Along Alta Vista Street, Between Rose Drive and Jefferson Street • First Reading of Ordinance requiring electronic and paperless filing of FPPC Campaign Disclosure Statements and Statement of Economic Interest
• Fiscal Recap of 2022 Heritage Festival and Approval of 2023 Event

CERTIFICATION OF POSTING
I, Carole M. Wayman, Deputy City Clerk of the City of Placentia and Assistant Secretary of the Industrial Commercial Development Authority, the Successor Agency, and the Placentia Public Financing Authority hereby certify that the Agenda for the May 16, 2023 meetings of the City Council, Successor Agency, Industrial Commercial Development Authority, and the Placentia Public Financing Authority was posted on May 11, 2023.

Carole M. Wayman
Deputy City Clerk
Placentia City Council/Successor Agency/ICDA/PPFA Agenda, May 16, 2023 Page 7 of 7

Type Vendor Name/ID Description
City of Placentia
Check Register
For 05/16/2023
Account/Description
Batch ID Amount Invoice#
PO # Checic # Check Date
Check Totals by ID
AP 1,443,913.43
EP
IP
OP

0.00 0.00

0.00 Fund Name
101 -General Fund (0010)
117 -Measure U Fund (0079)
208-Sccssr Agncy Ret Oblg (0054)
225 -Asset Seizure (0021)
227 -Explorer Grant NOC (0076)
228-NOC-Public Safety Grant(0061)
231 -Placentia Reg Nay Cent(0078)
233 -Gen Plan Update Fees (0074)
234 -Technology Impact Fees (0075)
242 -City Pub Sfty Impct Fee (0067)
244-CW Aford House ImpactFee(0068)
246-TOD Traffic Impact Fees (0070)
247-TOD Sewer Impact Fees (0071)
248-TOD Strscape Impel Fee (0072)
265 -Landscape Maintenance (0029)
270-CDBG Fund (0030)
275 -Sewer Maintenance (0048)
280 -Mist Grants Fund (0050)
282-CalRecycle Grant (0083)
401 -City Capital Projects (0033)
405 -Afford Housing In -Lieu (0034)
501 -Refuse Administration (0037)
601 -Employee Health & Wlfre (0039)
605 -Risk Management (0040)
701 -Special Deposits (0044)
Check Totals by Fund
558,651.95
576,207.22
479.91
7,360.83

8.65 88.00
5,250.00
963.11

1.75 23,000.00
3,661.44
1,125.00
89,109.11
920.00
4,035.26
37,556.16
169.53
97,283.52
7,035.42
10,175.85
868.56
740.24
4,297.80
7,020.12
7,904.00
Check Total: 1,443,913.43
Grand Total: 1,443,913.43
Void Total: 0.00
Check Total: 1,443,913.43
Funds will be transferred from the Cash Basis Fund as needed to fund the warrants included on this wan -ant register

1.b.

May 16, 2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
05/10/2023 :Date
12:04:31 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice#
PO /4 Check # Check Date
MW OH ADMINSURE MAR WORKERS COMP CLAIM ADMI11D4580-6025 V004980 Third Party Administration
MW OH ALL CITY MANAGEMENT 3/19-4/1 CROSSING GUARD SVS 103047-6290 V000005 Dept. Contract Services

MW OH AMAZON CAPITAL SERVICEDFFICE SUPPLIES
V012336

MW OH AMAZON CAPITAL SERVICE)UAL TRASH CONTAINERS
101512-6315
Office Supplies
101513-6315
Office Supplies
102020-6315
Office Supplies
103065-6315
Office Supplies
833593-6301
V012336 Special Department Expenses
MW OH AT &T 4/15-5/14 LMD INTERNET SVS
V008736

MW OH AT&T
V008736
109595-6215
Telephone/Internet
4/13-5/12 KOCH PARK INTERNET 109595-6215
Telephone/Internet
MW OH AT & T MOBILITY 5/8-6/7 IPAD INTERNET CHARGES 109595-6215 V008709 Telephone/Internet
MW OH AT&T CH DEDICATED INT/VOICE BUNDLE 109595-6215
V011041 Telephone/Internet
AP042423 4,860.00 15971 00126881 04/27/2023
Check Total: 4,860.00
AP042423 4,431.60 84557 P12461 00126882 04/27/2023
Check Total: 4,431.60
AP042423 88.41 14LX-4HQN- 00126883 04/27/2023
AP042423 215.26 16N7-LFW3- 00126883 04/27/2023
AP042423 137.00 1PGY-4XXV- 00126883 04/27/2023
AP042423 19.47 1 V VR-4XD7- 00126883 04/27/2023
AP042423 3,948.45 17CY-GC7Y- P12822 00126883 04/27/2023 Check Total: 4,408.59
AP042423 52.79 APRIL LMD 23 00126884 04/27/2023
AP042423 0.71 KP APRIL 23 00126884 04/27/2023
Check Total: 53.50
AP042423 594.58 X04152023 00126885 04/27/2023
Check Total: 594.58
AP042423 3,612.86 8558296709 00126886 04/27/2023
Check Total: 3,612.86
User: Gabriela Cahn
Report: AP 1400M : AP: Warrant List - Machine
Page: 1
05/10/2023 :Date
12:04:31 :Time

City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date

MW OH AT&T MOBILITY
V011025

MW OH BEE MAN, THE
V000117
3/14-4/13 PD FIRSTNET SVS
3/14-4/13 FD FIRSTNET SVS
3/14-4/13 CS FIRSTNET SVS
11/2 BEE REMOVAL SERVICE
MW OH CANON FINANCIAL SERVICB81-30 COPIER LEASE
V008979

MW OH CANON FINANCIAL SERVIC
V008979
4Y�
1-30 COPIER USAGE
MW OH CHARTER COMMUNICATION814-5/13 PD FIBER INTERNET
V004450
MW OH CHARTER COMMUNICATION814-5/13 NEIGHBORHOOD SVS INT V004450
MW OH CHARTER COMMUNICATION812-5/11 BACKS BLDG INTERNET V004450

MW OH COAST EMS LLC
V011441

MW OH COSTAR REALTY
V012340
109595-6215
Telephone/Internet
109595-6215
Telephone/Internet
109595-6215
Telephone/Internet
103655-6130
Repair & Maint/Facilities
109595-6175
Office Equipment Rental
109595-6175
Office Equipment Rental
109595-6215
Telephone/Internet
109595-6215
Telephone/Internet
109595-6215
Telephone/Internet
EMERGENCY MEDICAL SUPPLIES 103066-6362
Emergency Medical Supples
APR REAL ESTATE & PROP DATA 109595-6999
Other Expenditure
AP042423
AP042423
AP042423
Check Total:

AP042423
Check Total:

AP042423
AP042423
Check Total:

AP042423
AP042423
AP042423
Check Total:

AP042423
Check Total:

AP042423
Check Total:
2,883.86 2116991
316.36 2116991

84.84 2116991
3,285.06
195.00 120526
195.00
254.09 30331440
1,598.65 30331441
1,852.74
619.00 0528002041423
129.99 0619546041423
299.98 0629685041223
1,048.97
335.91 12742
335.91
00126887 04/27/2023
00126887 04/27/2023
00126887 04/27/2023
00126888 04/27/2023
00126889 04/27/2023
00126889 04/27/2023
00126890 04/27/2023
00126890 04/27/2023
00126890 04/27/2023
00126891 04/27/2023
540.00 117478035-1 P12608 00126892 04/27/2023
540.00
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
Page: 2
05/10/2023 :Date
12:04:31 :Time

City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date

MW OH COUNTY OF ORANGE
V008881

MW OH COUNTY OF ORANGE
V000715

MW OH CSG CONSULTANTS INC
V011609

MW OH CSMFO
V012274

MW OH DENNIS GRUBB &
V012137

MW OH DURATECH USA INC
V009370

MW OH ENTERPRISE FLEET
V003312

APR OCATES CIRCUIT SUPPORT

APR AFIS SERVICES
APR -JUN 800MHZ COSTS - FD
APR -JUN 800MHZ COSTS - PD

MAR FD INSPECT SVS

MAR BLDG INSPECTION SVS

CSMFO MEETING REG - GRIGGS
103043-6099
Professional Services
103040-6290
Dept. Contract Services
103066-6137
Repair Maint/Equipment
103043-6137
Repair Maint/Equipment
102532-6050
Fire Plan Check Services
102532-6290
Dept. Contract Services
102020-6250
Staff Training
PLAN CHECKS/FIRE REVIEW ITEMS 102532-6050
Fire Plan Check Services
NETMOTION VPN SOFTWARE 103043-6099
Professional Services
APR PD VEHICLE LEASE PMT 103041-6165
Vehicle Lease
APR PD VEHICLE LEASE PMT 103042-6165
Vehicle Lease
AP042423
AP042423
Check Total:

AP042423
AP042423
Check Total: 24,948.00
AP042423 1,610.00 50230
AP042423 26,963.50 50231
Check Total:
28,573.50
AP042423 45.00 200016695
Check Total:

AP042423
Check Total:

AP042423
AP042423

45.00 5,670.00 3098
5,670.00
9,975.00 5908
1,104.51 SH 65132 P12478 00126893 04/27/2023
1,956.00 SH 64992 P12530 00126893 04/27/2023
3,060.51
5,331.00 SC13811 P12573 00126894 04/27/2023
19,617.00 SC13811 P12573 00126894 04/27/2023
P12547 00126895 04/27/2023
P12547 00126895 04/27/2023
00126896 04/27/2023
P12843 00126897 04/27/2023
00126898 04/27/2023
9,975.00
3,916.33 FBN4711763 P12531 00126899 04/27/2023
7,273.20 FBN4711763 P12531 00126899 04/27/2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
Page: 3
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12:04:31 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
MW OH EXPLORER POST 680
V012523

MW OH FAIRWAY FORD
V000376
8/4-6 EXPLORER COMPETITION REG 213041-6250
Staff Training
MAR VEHICLE REBATE PROGRAM 102534-6363
Resident Vehicle Rebate Prog

MW OH FERGUSON ENTERPRISES LLTAIL CELL LAVATORY
V012415

MW OH GLOBAL BUILDERS INC
V012514

MW OH GOLDEN STATE WATER
V000928

MW OH HDL COREN & CONE
V001564
103654-6130
Repair & Maint/Facilities
103654-6130
Repair & Maint/Facilities
OUTDOOR DINING PLATFORM 302534-6401
Community Programs

MAR -APR WATER CHARGES

MAR -APR WATER CHARGES
296561-6335
Water
109595-6335
Water
APR -JUN PROPERTY TAX MGMT SVS102020-6099
Professional Services
MW OH HEALTHPOINTE MEDICAL APR DOT PHYSICAL, PRE-EMPL SCR 101512-6099 V010713 Professional Services
MW OH HINDERLITER DE LLAMAS 8Q2- SALES TAX AUDIT SVS
102020-6099
Check Total:

AP042423
Check Total:

AP042423
11,189.53
500.00 EXPLORER0418
500.00
3,000.00 MARCH, 2023
Check Total: 3,000.00
AP042423 4,333.01 041223
AP042423 228.05 041223
Check Total: 4,561.06
AP042423 37,556.16 2023-2-1
Check Total: 37,556.16
AP042423 1,008.59 041823
AP042423 2,848.77 041823
Check Total: 3,857.36
AP042423 3,728.34 51N027441
Check Total:

AP042423
3,728.34
754.00 30601-4015770
Check Total: 754.00
AP042423 3,377.87 SIN022988
00126900 04/27/2023
00126901 04/27/2023
P12698 00126902 04/27/2023
P12698 00126902 04/27/2023
P12831 00126903 04/27/2023
00126904 04/27/2023
00126904 04/27/2023
P12542 00126905 04/27/2023
00126906 04/27/2023
P12593 00126907 04/27/2023
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05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice4
PO 4 Check 4 Check Date
V000465

MW OH HOYT ROOFS INC
V003476

MW OH IMPERIAL SPRINKLER
V006506

ROOFING BOND REFUND

IRRIGATION SUPPLIES

IRRIGATION SUPPLIES
MW OH INTERNATIONAL INSTITUTEMEMBERSHIP FEE - C. WAYMAN V000506

MW OH JOHN HANCOCK USA -PARS
V010625

MW OH JOHN HANCOCK USA -PARS
V010625
MW OH
PARS -FT PE 4/15 PD 4/21
PARS -FT PE 4/15 PD 4/21
PARS -FT PE 4/15 PD 4/21
PARS -FT PE 4/15 PD 4/21
PARS -FT PE 4/15 PD 4/21
JOHN HANCOCK USA -PARS PARS -FT PE 4/15 PD 4/21
Professional Services
0044-2033
Construction & Demo Deposit
104071-6130
Repair & Maint/Facilities
103655-6130
Repair & Maint/Facilities
103655-6130
Repair & Maint/Facilities
103655-6130
Repair & Maint/Facilities
101002-6255
Dues & Memberships
0010-2131
Employer PARS/ARS Payable
0010-2131
Employer PARS/ARS Payable
0010-2131
Employer PARS/ARS Payable
0029-2131
Employer PARS/ARS Payable
0037-2131
Employer PARS/ARS Payable
0037-2131
Check Total:

AP042423
Check Total:

AP042423
AP042423
AP042423
AP042423
Check Total:

AP042423
Check Total:

AP042423
AP042423
AP042423
AP042423
AP042423
AP042423
3,377.87
100.00 30-22-183
100.00
116.77 0010291037-001 P12509

31.75 0010167252-001 P12634
457.15 0010185896-001 P12634

53.95 0010203377-002P12634
659.62
125.00 041123
125.00
773.22 PR2301008
872.02 PR2301008
638.87 PR2301008

17.77 PR2301008
215.64 PR2301008

73.54 PR2301008
00126908 04/27/2023
00126909 04/27/2023
00126909 04/27/2023
00126909 04/27/2023
00126909 04/27/2023
00126910 04/27/2023
00126911 04/27/2023
00126911 04/27/2023
00126911 04/27/2023
00126911 04/27/2023
00126911 04/27/2023
00126911 04/27/2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
V010625

MW OH JOHN HANCOCK USA -PARS
V010625

MW OH KAPPE TERRACINA LLC
V012436

MW OH KEYSER MARSTON
V010468

MW OH KOSMONT COMPANIES
V006131

MW OH LAE ASSOCIATES INC
V011942

MW OH LEHR AUTO
V009930
PARS -FT PE 4/15 PD 4/21
PARS -FT PE 4/15 PD 4/21
PARS -FT PE 4/15 PD 4/21
PARS -FT PE 4/15 PD 4/21

APRIL -JUNE LEASE PAYMENT
Employer PARS/ARS Payable
0048-2131
Employer PARS/ARS Payable
0048-2131
Employer PARS/ARS Payable
0054-2131
Employer PARS/ARS Payable
0054-2131
Employer PARS/ARS Payable
103043-6160
Facility Rental
MAR REAL ESTATE ADV FOR BAKER582534-6099
Professional Services
MAR REAL ESTATE ADV FOR BAKER342534-6099
Professional Services
MAR EIFD & IFP CONSULTING SVS 109595-6999
Other Expenditure
MAR SUCCESOR AGENCY SUPPORT 547525-6099
Professional Services
REFUND OVER PMT BL# 930001487 100000-4101
Business License Fees
OUTFIT CHIEF'S FORD F150 213041-6840
Machinery & Equipment
AP042423
AP042423
AP042423
AP042423
Check Total:
102.57 PR2301008

52.53 PR2301008

4.50 PR2301008
2,803.19
AP042423 39,128.07 032023
Check Total: 39,128.07
AP042423 3,661.44 0037725
AP042423 868.56 0037725
Check Total: 4,530.00
AP042423 2,197.00 2207.10-007
AP042423 422.50 1502.9-075
Check Total: 2,619.50
AP042423 513.92 041923
Check Total:
513.92
AP042423 5,302.96 SI86426
00126911 04/27/2023
00126911 04/27/2023
00126911 04/27/2023
00126911 04/27/2023
P12849 00126912 04/27/2023
P12732 00126913 04/27/2023
P12732 00126913 04/27/2023
P12609 00126914 04/27/2023
P12711 00126914 04/27/2023
00126915 04/27/2023
P12838 00126916 04/27/2023
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Report: AP 1400M : AP: Warrant List - Machine
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice# PO # Check # Check Date

MW OH LUPERCIO, EMILY
V012527

MW OH MCKESSON MEDICAL -
V012321

MW OH MIDAMERICA
V008972

MW OH MOLONEY, TRACEY
V011052

PD TRAINING MEALS, MILEAGE
213041-6250
Staff Training
EMERGENCY MEDICAL SUPPLIES 103066-6362
Emergency Medical Supples
Q4 2022 401A FEES

MURAL AT NAVIGATION CTR
395083-6025
Third Party Administration
784070-6999
Other Expenditure
MW OH MV CHENG & ASSOCIATES MAR HR CONSULTING SERVICES 101512-6099 V010389 Professional Services

MW OH OFFICE INDUSTRIES
V007477

MW OH ORANGE COUNTY
V000699

MW OH ORANGE COUNTY

OFFICE SUPPLIES

OFFICE SUPPLIES
OCEA PE 4/15 PD 4/21
OCEA PE 4/15 PD 4/21
OCEA PE 4/15 PD 4/21
OCEA PE 4/15 PD 4/21
103040-6315
Office Supplies
103040-6315
Office Supplies
0037-2176
PCEA/OCEA Assoc Dues
0054-2176
PCEA/OCEA Assoc Dues
0048-2176
PCEA/OCEA Assoc Dues
0079-2176
Check Total:

AP042423
Check Total:

AP042423
AP042423
Check Total:

AP042423
AP042423
AP042423
AP042423
5,302.96
738.40 LUPERCIO0424
738.40
290.72 20543096
290.72
110.00 0205547
110.00
5,250.00 004
5,250.00
5,760.00 3/31/2023
5,760.00

67.26 69969

34.55 B69912-1
101.81

14.09 PR2301008

0.35 PR2301008

13.28 PR2301008

3.34 PR2301008
00126917 04/27/2023
00126918 04/27/2023
00126919 04/27/2023
P12845 00126920 04/27/2023
P12846 00126921 04/27/2023
00126922 04/27/2023
00126922 04/27/2023
00126923 04/27/2023
00126923 04/27/2023
00126923 04/27/2023
00126923 04/27/2023
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05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
V000699 PCEA/OCEA Assoc Dues

MW OH ORANGE COUNTY
V000699

MW OH ORTEGA, JEANETTE
V007724

MW OH PARS
V006999

MW OH PARS
OCEA PE 4/15 PD 4/21 0010-2176
PCEA/OCEA Assoc Dues
OCEA PE 4/15 PD 4/21 0029-2176
PCEA/OCEA Assoc Dues
ENVIR WELLNESS WS SUPPLIES 101511-6301
Special Department Expenses
FEB REP -PARS FEES 395083-6025
Third Party Administration
FEB ARS-FARES FEES 395083-6025
V006999 Third Party Administration
MW OH PCEA C/O NORTH ORANGE C UEA PE 4/15 PD 4/21
V000679
MW OH PCEA C/O NORTH ORANGE CRICEA PE 4/15 PD 4/21
V000679
MW OH PCEA C/O NORTH ORANGE GUEEA PE 4/15 PD 4/21
V000679
MW OH PCEA C/O NORTH ORANGE CUEA PE 4/15 PD 4/21
V000679
MW OH PCEA C/O NORTH ORANGE Ct₹10EA PE 4/15 PD 4/21
V000679
MW OH PCEA C/O NORTH ORANGE CECEA PE 4/15 PD 4/21
V000679
0029-2176
PCEA/OCEA Assoc Dues
0037-2176
PCEA/OCEA Assoc Dues
0079-2176
PCEA/OCEA Assoc Dues
0010-2176
PCEA/OCEA Assoc Dues
0048-2176
PCEA/OCEA Assoc Dues
0054-2176
PCEA/OCEA Assoc Dues
MW OH PSCASN 2023 ANNUAL MEMBERSHIP DUES 101515-6255
AP042423 446.53 PR2301008
AP042423 7.51 PR2301008
Check Total: 485.10
AP042423 74.57 041923
Check Total: 74.57
AP042423 400.00 52826
AP042423 799.70 52879
Check Total: 1,199.70
AP042423 0.65 PR2301008
AP042423 1.22 PR2301008
AP042423 0.29 PR2301008
AP042423 38.66 PR2301008
AP042423 1.15 PR2301008
AP042423 0.03 PR2301008
Check Total: 42.00
AP042423 50.00 1759
00126923 04/27/2023
00126923 04/27/2023
00126924 04/27/2023
00126925 04/27/2023
00126925 04/27/2023
00126926 04/27/2023
00126926 04/27/2023
00126926 04/27/2023
00126926 04/27/2023
00126926 04/27/2023
00126926 04/27/2023
00126927 04/27/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 8
05/10/2023 :Date
12:04:31 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
V012526 Dues & Memberships
MW OH QUENCH USA FEB PD WATER/ICE MACHINE RENT 103041-6301 V012472 Special Department Expenses

MW OH ROGERS, TODD
V004640

MW OH SAMAKLIS, LYNN
V012525

MW OH SERNA, MARIO
V004667

MW OH SERNA, MARIO
V004667
CAR RENTAL REIMBURSEMENT 104070-6245
Meetings & Conferences
CLAIM SETTLEMENT 404582-6210
Liability Claims
TOOLS REIMBURSEMENT 103658-6350
Small Tools/Equipment
TOOLS REIMBURSEMENT 103658-6350
Small Tools/Equipment
TOOLS REIMBURSEMENT 103658-6350
Small Tools/Equipment
MW OH SMITH, DONNA SPRING 2023 - DANCE INSTRUCTOR 104071-6060 V001269 Instructional Services
MW OH SO CAL LAND MAINTENANOEXTRA WORK - PARKS LANDSCAPE 104071-6130 V011102 Repair & Maint/Facilities
MW OH SPARKLETTS APR DIPATCH FILTRATION SYSTEM 109595-6301 V000967 Special Department Expenses
Check Total: 50.00
AP042423 170.80 INV05540988 00126928 04/27/2023
Check Total: 170.80
AP042423 456.28 03222023 00126929 04/27/2023
Check Total: 456.28
AP042423 2,160.12 040323 00126930 04/27/2023
Check Total: 2,160.12
AP042423 272.43 041623A 00126931 04/27/2023
AP042423 211.14 041623B 00126931 04/27/2023
AP042423 16.43 041623C 00126931 04/27/2023
Check Total: 500.00
AP042423 624.00 SPRING 2023 00126932 04/27/2023
Check Total: 624.00
AP042423 8,103.53 10598 P12842 00126933 04/27/2023
Check Total: 8,103.53
AP042423 66.48 20765979 041523 00126934 04/27/2023
Check Total: 66.48
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 9
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date

MW OH STARLITE RECLAMATION INTAZARDOUS WASTE REMOVAL
V008845

MW OH T -MOBILE USA
V009215

MW OH TANGO TANGO INC
V011054
MW OH THINKSUPPLIES.COM
V007047
PHONE GPS SERVICES DR#22-04498
PHONE GPS SERVICES DR#22-04498
103658-6285
Hazardous Materials Disposal
103042-6290
Dept. Contract Services
103042-6290
Dept. Contract Services
Q2 DETECTIVE RADIO INTEGRATION 03042-6290
Dept. Contract Services
PAPER

MW OH TIAA COMMERCIAL FINANCRPR PRINTER MGMT SERVICES
V010867

MW OH TOTUM CORP
V010229

MW OH UNIQUE PRINTING
V0I0259

MW OH UNIQUE PRINTING
V010259

MW OH UNIQUE PRINTING
V010259
109595-6315
Office Supplies
109595-6137
Repair Maint/Equipment
MAR PSC - CONST INSPECTION SVS 105213-6850 / 229999-6850 Building & Facilities

BUSINESS CARDS - CHUNG

BUSINESS CARDS - NAVARRO

EMBROIDERY SERVICES

BUSINESS CARDS - KRAHLING
103040-6315
Office Supplies
103040-6315
Office Supplies
103041-6360
Uniforms
103040-6315
Office Supplies
AP042423
Check Total:

AP042423
AP042423
Check Total:

AP042423
Check Total:

AP042423
1,034.26 121795
1,034.26

25.00 9529972502

25.00 9529972503

50.00 645.00 1898
645.00
260.96 69967
260.96
2,226.75 9459225
2,226.75
20,541.25 206075
Check Total: 20,541.25
AP042423 34.53 44912
AP042423 34.53 44934
AP042423 76.12 44934
AP042423 34.53 44956
00126935 04/27/2023
00126936 04/27/2023
00126936 04/27/2023
00126937 04/27/2023
00126938 04/27/2023
P12702 00126939 04/27/2023
P12762 00126940 04/27/2023
00126941 04/27/2023
00126941 04/27/2023
00126941 04/27/2023
00126941 04/27/2023
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
MW OH US BANK PARS #6746022400 PARS PE 4/15 PD 4/21
V008781
MW OH US BANK PARS #6746022400 PARS PE 4/15 PD 4/21
V008781

MW OH VALDEZ, FABIAN PD TRAINING MEALS, MILEAGE
V012210

MW OH WELLS FARGO
V010076

MW OH WELLS FARGO
V010076
MW OH

WELLS FARGO
V010076
VENDOR FIN4/23-5/22 COPIER/PRINTER SVS
VENDOR FIN4/23-5/22 PRINTER SERVICE
VENDOR FIN4/23-5/22 KONICA PRINTER SVS
VENDOR FIN5/1-31 KYOCERA COPIER LEASE
0010-2126
Employee PARS/ARS W/H
0010-2131
Employer PARS/ARS Payable
213041-6250
Staff Training
109595-6175
Office Equipment Rental
109595-6175
Office Equipment Rental
109595-6175
Office Equipment Rental
109595-6175
Office Equipment Rental
MW OH AFTERMATH SERVICES LLC4/10 BIO-HAZARD CLEANING SVS 103043-6099 V009949 Professional Services

MW OH AGA ENGINEERS INC
V012178

MW OH AGUILERA, CHRISTIAN
V012531

FEB TOD TS UPDATE

BUILDING PERMIT REFUND

BUILDING PERMIT REFUND
702001-6741
Infrastructure - Traffic
750000-4303
Technology Fee
0044-2049
Health & Safety Collection
Check Total: 179.71
AP042423 1,482.20 PR2301008
AP042423 1,482.20 PR2301008
Check Total: 2,964.40
AP042423
Check Total:

AP042423
AP042423
AP042423
AP042423
Check Total:

AP050123
Check Total:

AP050123
AP050123

51.49 VALDEZ041923

51.49 255.57 5024674126

70.69 5024674127

79.39 5024674I28
219.89 5024747209
625.54
200.00 JC2023-6185
200.00
205.00 23038-1N
205.00

1.75 042723

5.00 042723
00126942 04/27/2023
00126942 04/27/2023
00126943 04/27/2023
00126944 04/27/2023
00126944 04/27/2023
00126944 04/27/2023
00126944 04/27/2023
00126945 05/04/2023
00126946 05/04/2023
00126947 05/04/2023
00126947 05/04/2023
User: Gabriela Calm
Report: AP 1400M : Al': Warrant List - Machine
Page: 11
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date

MW OH AGUILERA, CHRISTIAN
V012531

MW OH AIR EXCHANGE INC
V011544

MW OH ALL AMERICAN ASPHALT
V000067

BUILDING PERMIT REFUND

EXHAUST MAINTENANCE
102532-4164
Electrical Permits
740000-4302
General Plan Update Fee
103066-6301
Special Department Expenses
MAR ARTERIAL ROADWAY REHAB 791201-6740
Infrastructure - Streets
MAR ARTERIAL ROADWAY REHAB 331201-6740
Infrastructure - Streets
MW OH ALL CITY MANAGEMENT 4/2-15 CROSSING GUARD SVS
V000005

MW OH ALTERNATIVE HOSE INC AIR COMPRESSOR HOSE
V005320

MW OH AMAZON CAPITAL SERVICEEMERGENCY MEDICAL SUPPLIES
V012336
MW OH AMAZON CAPITAL SERVICEfilFFICE CHAIR
V012336

MW OH AMAZON CAPITAL SERVICEDFFICE CHAIRS
V012336

MW OH AMAZON CAPITAL SERVICED SUPPLIES, OFFICE CHAIRS
V012336

MW OH AMAZON CAPITAL SERVICEED KITCHEN SUPPLIES
103047-6290
Dept. Contract Services
103658-6301
Special Department Expenses
103066-6362
Emergency Medical Supples
103065-6301
Special Department Expenses
103066-6301
Special Department Expenses
103066-6301
Special Department Expenses
103066-6301
AP050123
AP050123
Check Total:

AP050123
161.00 042723

3.00 042723
170.75
1,938.67 91609494
Check Total: 1,938.67
AP050123 200,392.82 1201-6
AP050123 10,175.85 1201-6
00126947 05/04/2023
00126947 05/04/2023
00126948 05/04/2023
P12550 00126949 05/04/2023
P12550 00126949 05/04/2023
Check Total: 210,568.67
AP050123 2,215.80 84901 P12461 00126950 05/04/2023
Check Total: 2,215.80
AP050123 11.86 6048225 00126951 05/04/2023
Check Total: 11.86
AP050123 1,771.66 1791-FW49-96.13 00126952 05/04/2023
AP050123 218.40 17XC-7X1P- 00126952 05/04/2023
AP050123 2,184.00 IMJY-HWHV- 00126952 05/04/2023
AP050123 1,979.10 1P3Q-7KQ4- 00126952 05/04/2023
AP050123 109.38 1PFD-KYJK- 00126952 05/04/2023
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Page: 12
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
V012336

MW OH AMAZON CAPITAL SERVICETOOL KIT
V012336
MW OH AMAZON CAPITAL SERVICESyD MEDICAL SUPPLIES
V012336

MW OH AMAZON CAPITAL SERVICEDFFICE SUPPLIES
V012336
MW OH AMAZON CAPITAL SERVICE®FFICE SUPPLIES
V012336

MW OH AMAZON CAPITAL SERVICED SUPPLIES
V012336

MW OH AMAZON CAPITAL SERVICEEMERGENCY MEDICAL SUPPLIES
V012336
MW OH

MW OH AMAZON CAPITAL SERVICESUAL TRASH CONTAINERS

AMAZON CAPITAL SERVICESIUAL TRASH CONTAINERS
V012336
V012336

MW OH AMERICAN OFFICE
V009212

MW OH AT&T
V004144

MW OH AUDI NORTH OC
V012263

FD OFFICE FURNITURE

MAR -APR PHONE SERVICE

MAR -APR PHONE SERVICE
Special Department Expenses
103065-6301
Special Department Expenses
103066-6362
Emergency Medical Supples
103065-6315
Office Supplies
103066-6315
Office Supplies
103066-6301
Special Department Expenses
103066-6362
Emergency Medical Supples
833593-6301
Special Department Expenses
833593-6301
Special Department Expenses
103065-6301
Special Department Expenses
109595-6215
Telephone/Intemet
296561-6215
Telephone/Intemet
APR VEHICLE REBATE PROGRAM 102534-6363
Resident Vehicle Rebate Prog
AP050123
AP050123
AP050123
AP050123
AP050123
AP050123
AP050123
AP050123
Check Total:

56.16 1 PFD-KYJK-
753.83 1 PFD-KYJK-
315.41 1PFD-KYJK-
263.29 1PFD-KYJK-

55.97 1 QRF-TYVD-
321.54 1RMM-D3Q-
1,435.80 17LT-6KHN- P12822
1,651.17 1MGY-MIC6- P12822
11,115.71
AP050123 429.56 14269
Check Total:

AP050123
AP050123
Check Total:

AP050123
429.56
6,103.22 042423
1,288.55 042423
7,391.77
1,000.00 APRIL, 2023
00126952 05/04/2023
00126952 05/04/2023
00126952 05/04/2023
00126952 05/04/2023
00126952 05/04/2023
00126952 05/04/2023
00126952 05/04/2023
00126952 05/04/2023
00126953 05/04/2023
00126954 05/04/2023
00126954 05/04/2023
00126955 05/04/2023
User: Gabriela Calin
Report: AP 1400M : Al': Warrant List - Machine
Page: 13
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice#
PO # Check # Check Date
Check Total: 1,000.00
MW OH BANISTER, JAMES FD COMPANY OFFICER CERT APPL 103066-6250 AP050123 100.00 2004-1784 00126956 05/04/2023 V011869 Staff Training
Check Total: 100.00
MW OH BOA ARCHITECTURE EOC ARCHITECTURAL DESIGN SVS 795307-6850 AP050123 2,000.00 23-3001-2 P12823 00126957 05/04/2023 V010118 Building & Facilities
Check Total: 2,000.00
MW OH BUENA PARK PLAQUE & CITIZENS ACADEMY PLAQUES 503040-6301 / 233001-6301 AP050123 307.57 25567 00126958 05/04/2023 V011364 Special Department Expenses
Check Total: 307.57
MW OH CAVENAUGH & ASSOCIATES'D DUI COURSE REGISTRATION 213041-6250 AP050123 620.00 MENDOZA0426 00126959 05/04/2023 V012231 Staff Training
Check Total: 620.00
MW OH CBE CANON WASTE TONER CASE 109595-6175 AP050123 29.58 IN2608608 00126960 05/04/2023 V008124 Office Equipment Rental
Check Total: 29.58
MW OH CHARTER COMMUNICATIONIS'23-5/22 NAV CTR INTERNET 109595-6215 AP050123 226.91 0570178042323 00126961 05/04/2023 V004450 Telephone/Intetnet
Check Total: 226.91
MW OH CHARTER COMMUNICATIONS21-5/20 BWC INTERNET SVS 109595-6215 AP050123 1,584.13 11980240104212 00126962 05/04/2023 V012060 Telephone/Intemet
Check Total: 1,584.13
MW OH CITY CLERKS ASSOCIATIONMEMBERSHIP - C. WAYMAN 101002-6255 AP050123 200.00 300001841 00126963 05/04/2023 V010474 Dues & Memberships
Check Total: 200.00
MW OH CITY OF ANAHEIM 3/16-4/17 SHARED TS ELECTRICAL 109595-6330 AP050123 72.29 042423 00126964 05/04/2023 V010186 Electricity
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Report: AP 1400M : AP: Warrant List - Machine
Page: 14
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date

MW OH CITY OF PLACENTIA PD TRAINING
V000773

MW OH CITY OF PLACENTIA PD TRAINING
V000773
MW OH CLEAR CHOICE LIEN SALES 3/1 LIEN SERVICES
V005847
MW OH CLEAR CHOICE LIEN SALES 3/2 LIEN SERVICES
V005847
MW OH CLEAR CHOICE LIEN SALES 3/9 LIEN SERVICES
V005847
MW OH CLEAR CHOICE LIEN SALES 3/9 LIEN SERVICES
V005847
MW OH CLEAR CHOICE LIEN SALES 3/23 LIEN SERVICES
V005847
MW OH CLEAR CHOICE LIEN SALES 3/3 LIEN SERVICES
V005847
MW OH CLEAR CHOICE LIEN SALES 3/22 LIEN SERVICES
V005847
MW OH CLEAR CHOICE LIEN SALES 3/30 LIEN SERVICES
V005847

MW OH COUNTY OF ORANGE CAM REPAIRS
V007152
Check Total: 72.29
213041-6250 AP050123 147.98 V000773
Staff Training
103041-6250 AP050123 24.39 V000773
Staff Training
103042-6250 AP050123 78.77 V000773
Staff Training
Check Total: 251.14
103047-6182 AP050123 25.00 220-030123
Lien Services
103047-6182 AP050123 50.00 223-030223
Lien Services
103047-6182 AP050123 50.00 229-030923
Lien Services
103047-6182 AP050123 25.00 229-030923B
Lien Services
103047-6182 AP050123 25.00 241-032323
Lien Services
103047-6182 AP050123 90.00 3899-030323
Lien Services
103047-6182 AP050123 15.00 6796-032223
Lien Services
103047-6182 AP050123 15.00 6803-033023
Lien Services
Check Total: 295.00
103043-6137 AP050123 208.50 STTM000974
Repair Maint/Equipment
Check Total: 208.50
00126965 05/04/2023
00126965 05/04/2023
00126965 05/04/2023
00126966 05/04/2023
00126966 05/04/2023
00126966 05/04/2023
00126966 05/04/2023
00126966 05/04/2023
00126966 05/04/2023
00126966 05/04/2023
00126966 05/04/2023
00126967 05/04/2023
User: Gabriela Galin
Report: AP 1400M : AP: Warrant List - Machine
Page: 15
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
MW OH CREATIVE SERVICES OF NE\W OFFICER BADGE STICKERS 503040-6301 / 233001-6301 V009004

MW OH CRON & ASSOC
V001603

MW OH DAVID TAUSSIG AND
V001040

MW OH DENNIS GRUBB &
V012137

TRANSCRIPTION SERVICES

MAR CONSULTANT FEES
4/18-27 FD INSPECTIONS
Special Department Expenses
103042-6290
Dept. Contract Services
109595-6999
Other Expenditure
103066-6290
Dept. Contract Services
MW OH DEPARTMENT OF JUSTICE MAR LIVESCAN PROCESSING 0044-2053 V000213 DOJ Livescan
MW OH DEPARTMENT OF JUSTICE MAR LIVESCAN PROCESSING 0044-2054 V000213 FBI Livescan
MW OH DEPARTMENT OF JUSTICE MAR LIVESCAN PROCESSING 101512-6099 V000213 Professional Services

MW OH DIVISION OF THE STATE
V008904
SB 1186/SB 1379-2023 Q1 TAXES
100000-4101
Business License Fees
MW OH DIVISION OF THE STATE SB 1186/SB 1379 -2023 Q1 TAXES 0044-2032 V008904 SB 1186 BL State Fee
MW OH DUDEK & ASSOCIATES INC ENGINEERING & CONST SUPPORT 713101-6750 V004114 Infrastructure - Sewer
MW OH EPOWER NETWORK INC FD 1 GENERATOR MAINT
103654-6137
AP050123
Check Total:

AP050123
Check Total:
460.95 C23-27145
460.95
388.50 6657
388.50
AP050123 7,632.30 2303143
Check Total:
7,632.30
AP050123 3,600.00 3126
Check Total:

AP050123
AP050123
AP050123
Check Total:
3,600.00
111.00 647485

68.00 647485

32.00 647485
211.00
AP050123 -5,184.00 04272023
AP050123 5,760.00 04272023
Check Total:

AP050123
Check Total:

AP050123
00126968 05/04/2023
00126969 05/04/2023
P12855 00126970 05/04/2023
P12571 00126971 05/04/2023
00126972 05/04/2023
00126972 05/04/2023
00126972 05/04/2023
00126973 05/04/2023
00126973 05/04/2023
576.00
687.50 202302418 P12818 00126974 05/04/2023
687.50
330.00 31475
P12474 00126975 05/04/2023
User: Gabriela Calin
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Page: 16
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
V011953 Repair Maint/Equiprnent
Check Total: 330.00
MW OH FORENSIC NURSE SART EXAM DR# 23-01433 103040-6099 AP050123 1,200.00 5452 00126976 05/04/2023 V009316 Professional Services
Check Total: 1,200.00
MW OH FRANCO, CYNTHIA PLAN CHECK FEES REFUND 740000-4302 AP050123 960.11 11282022 00126977 05/04/2023 V003116 General Plan Update Fee
Check Total: 960.11
MW OH GEOCON WEST INC PSC - GEOTHECHNICAL INSP 105213-6850 / 229999-6850 AP050123 13,400.00 723030050 P12771 00126978 05/04/2023 V011765 Building & Facilities
Check Total: 13,400.00
MW OH GOLDEN STATE WATER MAR -APR WATER CHARGES 109595-6335 AP050123 803.00 042523 00126979 05/04/2023 V000928 Water
MW OH GOLDEN STATE WATER MAR -APR WATER CHARGES 296561-6335 AP050123 250.12 042523 00126979 05/04/2023 V000928 Water
Check Total: 1,053.12
MW OH GONZALEZ, SANDRA LANDSCAPE PLAN CHECK 0044-2040 AP050123 1,760.00 042523 00126980 05/04/2023 V010618 Special Deposits
Check Total: 1,760.00
MW OH GRAFIX SYSTEMS FD VEHICLE DECAL, GRAPHICS 103066-6134 AP050123 1,586.86 31109 00126981 05/04/2023 V011370 Vehicle Repair & Maintenance
Check Total: 1,586.86
MW OH HALO CONFIDENTIAL APR PD TRAINING MGMT SVS 103040-6290 AP050123 1,700.00 0211T P12503 00126982 05/04/2023 V011712 Dept. Contract Services
Check Total: 1,700.00
MW OH HF&H CONSULTANTS LLC MAR SB 1383 CONSULTING SVS 374386-6099 AP050123 435.75 9720108 P12686 00126983 05/04/2023 V010575 Professional Services
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Page: 17
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
MW OH HF&H CONSULTANTS LLC SOLID WASTE BENCHMARK STUDY 103550-6099 V010575 Professional Services
MW OH HI -WAY SAFETY RENTALS 3/21-4/18 K -RAIL RENTAL
V000459
103652-6099
Professional Services
MW OH HR GREEN PACIFIC INC FEB CONSTRUCTION MGMT & INSP 791201-6740 V010735
Infrastructure - Streets
MW OH HR GREEN PACIFIC INC MAR CONST MGMT & INSPECTION 791201-6740 V010735

MW OH JV PLUMBING
V011345

MW OH KNOX COMPANY
V003420

MW OH LEHR AUTO
V009930

MW OH MANAGED HEALTH
V008122

MW OH MCMURRAY STERN
V006352

HYDRO JET MAINLINE

GATE KET SWITCHES
Infrastructure - Streets
103655-6130
Repair & Maint/Facilities
103065-6301
Special Department Expenses
CODE ENF VEHICLE SAFETY LIGHTS103658-6137
Repair Maint/Equipment
MAY - EMPLOYEE ASSISTANT PROGR95083-5161
Health Insurance Premiums
SPACESAVER STORAGE SYSTEM 105213-6850
Building & Facilities

8.75% SALES TAX
105213-6850
Building & Facilities
AP050123
Check Total:

AP050123
Check Total:
7,498.75 9720115
7,934.50
1,300.00 119082
1,300.00
AP050123 26,470.00 162103
AP050123 17, 856.00 162104
Check Total:

AP050123
Check Total:

AP050123
Check Total:
44,326.00
650.00 3662
650.00
1,718.25 IN V-ICA-183008
1,718.25
1,551.56 SI86187
1,551.56
518.70 PRM-080323
518.70
AP050123 125,776.00 002855
AP050123 9,747.64 002855
P12802 00126983 05/04/2023
P12484 00126984 05/04/2023
P12548 00126985 05/04/2023
P12548 00126985 05/04/2023
00126986 05/04/2023
00126987 05/04/2023
P12835 00126988 05/04/2023
00126989 05/04/2023
P12848 00126990 05/04/2023
P12848 00126990 05/04/2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
Page: 18
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date

MW OH MICHAEL BAKER
V010699
1/30-4/2 SDMP CONSULTING SVS

MW OH MUNICIPAL EMERGENCY FLAME GENERATOR FOR CERT
V011423

MW OH NORTH NET TRAINING
V012187
MW OH NV5 INC
V011256
MW OH NV5 INC
V011256

MW OH OFFICE INDUSTRIES
V007477

MW OH ORANGE COUNTY
V000698

MW OH ORANGE COUNTY
V007306

MW OH PACIFIC COMPLIANCE

FD HAZMAT TRAINING
1/1-3/31 CM/CI SERVICES
1/1-3/31 INSPECTION SVS
PAPER
Q4 2021-22 OCHA FOG/BMP INSP
QI 2022-23 OCHA FOG/BMP INSP
11/08 GENERAL ELECTION COST

VAPOR RECOVERY TEST
794201-6751
Infrastructure - Storm Drain
101514-6301
Special Department Expenses
103066-6250
Staff Training
103101-6750
Infrastructure - Sewer
713101-6750
Infrastructure - Sewer
103550-6315
Office Supplies
103593-6257
Licenses & Permits
103593-6257
Licenses & Permits
101002-6299
Other Purchased Services
103658-6301
Check Total:

AP050123
Check Total:

AP050123
Check Total:
850.00
AP050123 14,802.50 326366
AP050123 88,421.61 326366
Check Total: 103,224.11

27.67 69948
AP050123
Check Total:

AP050123
AP050123
Check Total:

27.67 376.17 61455
112.14 61464
488.31
AP050123 70,371.98 R1214
Check Total:
70,371.98
AP050123 1,324.98 6877
Check Total:
135,523.64
AP050123 22,544.77 1177164 P12538 00126991 05/04/2023
22,544.77
4,435.16 IN185948 P12850 00126992 05/04/2023
4,435.16
850.00 2304 00126993 05/04/2023
P12650 00126994 05/04/2023
P12650 00126994 05/04/2023
00126995 05/04/2023
00126996 05/04/2023
00126996 05/04/2023
00126997 05/04/2023
00126998 05/04/2023
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Warrant List - Machine
Page: 19
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
V009292
MW OH PACIFIC PLAY SYSTEMS 1NCPLAYGROUND- SANTA FE PARK V012326

MW OH PACIFIC PLAY SYSTEMS INCPLAYGROUND - SANTA FE PARK V012326
MW OH PLACENTIA YORBA LINDA 4/18 FACILITY RENTAL
V000794

MW OH PRINCIPAL FINANCIAL
V000844

MW OH PRINCIPAL LIFE
V008141

MW OH PRUDENTIAL OVERALL
V000836

MW OH RBI TRAFFIC INC
V010707

MAY LIFE INSURANCE

MAY DENTAL PREMIUM

MAY DENTAL PREMIUM
Special Department Expenses
797203-6760
Infrastructure - Parks
507203-6760
Infrastructure - Parks
104070-6245
Meetings & Conferences
109595-5110
Life Ins Allocation
395083-5163
Life Insurance Premiums
395083-5162
Dental Insurance Premiums
395000-4720
ISF Dental Ins Reimbursement
4/19 PW UNIFORM CLEANING SVS 103650-6360
Uniforms
JAN -MAR TRAFFIC PLAN CHECK SVS103590-6290
Dept. Contract Services

MW OH REXEL ENERGY SOLUTIONSCH - EV STATIONS
798206-6842
Check Total:
1,324.98
AP050123 300,000.00 INV2022-926 P12851 00126999 05/04/2023 AP050123 73,000.00 INV2022-926 P12851 00126999 05/04/2023 Check Total: 373,000.00
AP050123 286.00 7055 00127000 05/04/2023
Check Total:

AP050123
AP050123
Check Total:

AP050123
Check Total:
286.00
1,156.54 124123378000-
390.40 124123378000-
1,546.94
782.10 05012023
1,296.90 05012023
2,079.00
163.29 62801797
163.29
AP050123 4,762.50 3243
Check Total:

AP050123
4,762.50
3,470.00 S2863689.002 P12776
00127001 05/04/2023
00127001 05/04/2023
00127002 05/04/2023
00127002 05/04/2023
P12480 00127003 05/04/2023
P 12467 00127004 05/04/2023
00127005 05/04/2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
Page: 20
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
V012465

MW OH REXEL ENERGY SOLUTIONSOLD CH - EV STATIONS
V012465

MW OH RHA LANDSCAPE
V011993
Vehicles
795106-6850
Building & Facilities
12/26-1/25 LA PLACITA PARKETTE 507911-6760
Infrastructure - Parks

MW OH RP LAURAIN & ASSOCIATESAPPRAISAL SERVICES
V010868

MW OH SELBERT PERKINS DESIGN
V012172

MW OH SO CAL GAS
V000909
103551-6099
Professional Services
MAR WAYFINDING DESIGN SVS 729201-6770
Infrastructure - Major Studies
MAR WAYFINDING DESIGN SVS 709201-6770
Infrastructure - Major Studies

MAR -APR GAS CHARGES
109595-6340
Natural Gas
MW OH SOCAL DATA DESTRUCTIONPD HARD DRIVE DESTRUCTION SVS 103040-6299 V012513 Other Purchased Services

MW OH SOUTHERN CALIFORNIA
V000910

MW OH SOUTHERN CALIFORNIA

MAR -APR ELECTRIC CHARGES
MAR -APR ELECTRIC CHARGES 109595-6330 / 21009-6330
MAR -APR ELECTRIC CHARGES 109595-6330 / 21011-6330
MAR -APR ELECTRIC CHARGES 296561-6330
109595-6330
Electricity
Electricity
Electricity
AP050123 3,470.00 S2863691-002 P12776 00127005 05/04/2023 Check Total: 6,940.00
AP050123 23,515.00 1022122 P12847 00127006 05/04/2023
Check Total: 23,515.00
AP050123 5,400.00 10005 P12675 00127007 05/04/2023
Check Total: 5,400.00
AP050123 920.00 20230287 P12539 00127008 05/04/2023
AP050123 920.00 20230287 P12539 00127008 05/04/2023
Check Total: 1,840.00
AP050123 1,217.24 042423
Check Total:

AP050123
Check Total:
1,217.24
387.00 10025
387.00
AP050123 13,893.53 042523
AP050123 12.39 042523
AP050123 153.57 042523
AP050123 1,462.07 042523
00127009 05/04/2023
00127010 05/04/2023
00127011 05/04/2023
00127011 05/04/2023
00127011 05/04/2023
00127011 05/04/2023
User: Gabriela Calin
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Page: 21
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
V000910

MW OH SOUTHERN CALIFORNIA
V012325

MW OH TAN, DANILO
V012530
E2 SERVICE, BRAKES

ROOFING BOND REFUND

MW OH TEAM ONE MANAGEMENT APR PARK JANITORIAL SVS
V010070

MW OH TIAA COMMERCIAL FINANCRIAY PRINTER MGMT SERVICES
V010867

MW OH TRANSUNION RISK &
V009317

MW OH UNIQUE PRINTING
V010259

MW OH UNITED STATES POSTAL
V001085

MW OH VERIZON WIRELESS
V008735
Electricity
103066-6134
Vehicle Repair & Maintenance
0044-2033
Construction & Demo Deposit
103655-6290
Dept. Contract Services
109595-6137
Repair Maint/Equipment
FEB-MAR PD DATABASE TRANSACT103042-6290
Dept. Contract Services

PD BUSINESS CARDS

POSTAL PERMIT BULK MAILING

PALM QUARTERLY MAILING
3/21-4/20 PD DEVICES INTERNET
103040-6315
Office Supplies
104071-6325
Postage
104070-6325
Postage
109595-6215
Telephone/Internet
Check Total:

AP050123
Check Total:

AP050123
AP050123
Check Total:

AP050123
15,521.56
5,653.20 OC22827 P12844 00127012 05/04/2023
5,653.20
100.00 30-22-265 00127013 05/04/2023
100.00
7,231.25 84 P12516 00127014 05/04/2023
7,231.25
2,226.75 9503235 P12702 00127015 05/04/2023
2,226.75
538.60 49451-202304-1 00127016 05/04/2023
538.60

69.06 44971 00127017 05/04/2023

69.06 290.00 26 00127018 05/04/2023
5,000.00 041823 P12852 00127018 05/04/2023
5,290.00
3,925.70 9932986416
00127019 05/04/2023
User: Gabriela Calin
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Page: 22
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date

MW OH VERIZON WIRELESS
V008735

MW OH XCS DOCUMENT
V006561

MW OH YORBA LINDA WATER
V001148
3/21-4/20 CA IPAD INTERNET
3/21-4/20 CS CELL PHONE SVS
3/21-4/20 COUNCIL I -PADS INTER

PLOTTER PAPER

FEB-MAR WATER CHARGES
109595-6215
Telephone/Internet
109595-6215
Telephone/Internet
109595-6215
Telephone/Internet
103550-6315
Office Supplies
109595-6335
Water
MW OH DON CHURROS GOMEZ LLC EMPLOYEE APPRECIATION WEEK 109595-6301 / 231501-6301 V012538 Special Department Expenses

MW OH ESTHER'S TACO HOUSE
V010241

MW OH ILARIA HERNANDEZ
V012536

MW OH ORANGE COUNTY
V012478
EMPLOYEE APPRECIATION WEEK 109595-6301 / 231501-6301
Special Department Expenses
EMPLOYEE APPRECIATION WEEK 109595-6301 / 231501-6301
Special Department Expenses
PD PARKING LOT GATES - DEPOSIT 675310-6850
Building & Facilities

MW OH WESTERN STATES AUTO OC ATAC AWARD CEREMONY
V012537
109595-6301/231501-6301
Special Department Expenses
AP050123
AP050123
AP050123
Check Total:

38.01 9932986417
121.84 9932986418
220.95 9932986419
4,306.50
AP050123 170.25 130823 1
Check Total:

AP050123
Check Total:

AP050823A
Check Total:

AP050823A
Check Total:
170.25
251.91 041123A
251.91
1,377.00 000026
00127019 05/04/2023
00127019 05/04/2023
00127019 05/04/2023
00127020 05/04/2023
00127021 05/04/2023
00127022 05/09/2023
1,377.00
2,525.17 ESTHERS05032P12873 00127023 05/09/2023
2,525.17
AP050823A 570.00 191
Check Total:
570.00
AP050823A 23,000.00 1610
Check Total:
23,000.00
AP050823A 70.00 ATAC050323
00127024 05/09/2023
P12862 00127025 05/09/2023
00127026 05/09/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 23
05/10/2023 :Date
12:04:31 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
Check Total: 70.00
Type Total: 1,440,077.37
Check Total: 1,440,077.37
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 24
05/10/2023 :Date
12:04:31 :Time

City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date

MW OH PLACENTIA POLICE
V000839

MW OH PLACENTIA POLICE
V003519

MW OH PLACENTIA POLICE
V003519
PPMA PE 4/15 PD 4/21
PPOA PE 4/15 PD 4/21
PPOA PE 4/15 PD 4/21
PPOA PE 4/15 PD 4/21
0010-2180
Police Mgmt Assn Dues
0010-2178
Placentia Police Assoc Dues
0061-2178
Placentia Police Assoc Dues
0076-2178
Placentia Police Assoc Dues
PY23008
Check Total:

PY23008
PY23008
PY23008
Check Total:

Type Total:

Check Total:
665.76 PR2301008
665.76
3,073.65 PR2301008

88.00 PR2301008

8.65 PR2301008
3,170.30
3,836.06
3,836.06
00017340 04/27/2023
00017341 04/27/2023
00017341 04/27/2023
00017341 04/27/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 25
05/10/2023 :Date
12:04:31 :Time

Type Vendor Name/ID Description
City of Placentia
ACH Check Register
For 05/16/2023
Account/Description
Batch ID Amount Invoice#
PO # Check # Check Date
Check Totals by ID
AP 715,997.13
EP 0.00
IP 0.00
OP 0.00
Fund Name
101 -General Fund (0010)
117 -Measure U Fund (0079)
208-Sccssr Agncy Ret Oblg (0054)
227 -Explorer Grant NOC (0076)
228-NOC-Public Safety Grant(0061)
231 -Placentia Reg Nav Cent(0078)
240 -Sewer Construction (0024)
265 -Landscape Maintenance (0029)
275 -Sewer Maintenance (0048)
501 -Refuse Administration (0037)
601 -Employee Health & Wlfre (0039)
Check Totals by Fund
387,711.07
604.84
1,555.09
174.34
4,671.59
763.50
2,306.38
1,441.09
7,142.18
4,631.07
304,995.98
Check Total: 715,997.13
ACH Payroll Direct Deposit for 02/17/2023: 548,597,33
Electronic Disbursement Total: 1,264,594.46
Grand Total: 715,997.13
Void Total:

Check Total:

Funds will be transferred from the Cash Basis Fund as needed to fund the warrants included on this warrant register

0.00 715,997.13
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH ALDWIR, MAMOUN MAY MEDICAL REIMBURSEMENT 395083-5161 E000113 Health Insurance Premiums
MW OH ANDERSON, MARLA MAY MEDICAL REIMBURSEMENT 395083-5161 E000071 Health Insurance Premiums
MW OH ARMSTRONG, JOHN T MAY MEDICAL REIMBURSEMENT 395083-5161 E000046 Health Insurance Premiums
MW OH AUDISS, JAY SCOTT MAY MEDICAL REIMBURSEMENT 395083-5161 E000125 Health Insurance Premiums
MW OH BABCOCK, CHARLES A MAY MEDICAL REIMBURSEMENT 395083-5161 E000015 Health Insurance Premiums
MW OH BEALS, SHARLENE MAY MEDICAL REIMBURSEMENT 395083-5161 E000076 Health Insurance Premiums
MW OH BERMUDEZ, ALBERT MAY MEDICAL REIMBURSEMENT 395083-5161 E000124 Health Insurance Premiums
MW OH BUNNELL, DONALD MAY MEDICAL REIMBURSEMENT 395083-5161 E000062 Health Insurance Premiums
MW OH BURGNER, ARTHUR MAY MEDICAL REIMBURSEMENT 395083-5161 E000074 Health Insurance Premiums
RETAPR23 1,293.00 MAY -2023
Check Total: 1,293.00
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 1,143.00 MAY -2023
Check Total: 1,143.00
RETAPR23 1,821.00 MAY -2023
Check Total: 1,821.00
RETAPR23 314.00 MAY -2023
Check Total: 314.00
RETAPR23 191.39 MAY -2023
Check Total: 191.39
RETAPR23 571.00 MAY -2023
Check Total: 571.00
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 533.78 MAY -2023
Check Total: 533.78
00017258 04/28/2023
00017259 04/28/2023
00017260 04/28/2023
00017261 04/28/2023
00017262 04/28/2023
00017263 04/28/2023
00017264 04/28/2023
00017265 04/28/2023
00017266 04/28/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 1
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH BUSSE, MICHAEL MAY MEDICAL REIMBURSEMENT 395083-5161 E000131 Health Insurance Premiums
MW OH CHANDLER, JOHN P MAY MEDICAL REIMBURSEMENT 395083-5161 E000109 Health Insurance Premiums
MW OH CHANG, ROBERT MAY MEDICAL REIMBURSEMENT 395083-5161 E000107 Health Insurance Premiums
MW OH COBBETT, GEOFFREY MAY MEDICAL REIMBURSEMENT 395083-5161 E000007 Health Insurance Premiums
MW OH COOK, ARLENE M MAY MEDICAL REIMBURSEMENT 395083-5161 E000018 Health Insurance Premiums
MW OH D'AMATO, ROBERT MAY MEDICAL REIMBURSEMENT 395083-5161 E000056 Health Insurance Premiums
MW OH DAVID, PRESTON MAY MEDICAL REIMBURSEMENT 395083-5161 E000112 Health Insurance Premiums
MW OH DAVIS, CAROLYN JUN MEDICAL REIMBURSEMENT 395083-5161 E000005 Health Insurance Premiums
MW OH DEAN, ANDREW MAY MEDICAL REIMBURSEMENT 395083-5161 E000135 Health Insurance Premiums
RETAPR23 1,391.00 MAY -2023
Check Total: 1,391.00
RETAPR23 1,391.00 MAY -2023
Check Total: 1,391.00
RETAPR23 1,288.00 MAY -2023
Check Total: 1,288.00
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 191.39 MAY -2023
Check Total: 191.39
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 533.78 JUN -2023
Check Total: 533.78
RETAPR23 1,821.00 MAY -2023
Check Total: 1,821.00
00017267 04/28/2023
00017268 04/28/2023
00017269 04/28/2023
00017270 04/28/2023
00017271 04/28/2023
00017272 04/28/2023
00017273 04/28/2023
00017274 04/28/2023
00017275 04/28/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 2
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice#
PO # Check # Check Date
MW OH DELOS SANTOS, JAMIE MAY MEDICAL REIMBURSEMENT 395083-5161 E000045 Health Insurance Premiums
MW OH DICKSON, ROBERTA JO MAY MEDICAL REIMBURSEMENT 395083-5161 E000011 Health Insurance Premiums
MW OH DOWNEY, CAROL JUN MEDICAL REIMBURSEMENT 395083-5161 E000082 Health Insurance Premiums
MW OH ECKENRODE, NORMAN JUN MEDICAL REIMBURSEMENT 395083-5161 E000029 Health Insurance Premiums
MW OH ESCOBOSA, LILLIAN MAY MEDICAL REIMBURSEMENT 395083-5161 E000055 Health Insurance Premiums
MW OH ESPINOZA, ROSALINDA MAY MEDICAL REIMBURSEMENT 395083-5161 E000016 Health Insurance Premiums
MW OH FRICKE, JUERGEN MAY MEDICAL REIMBURSEMENT 395083-5161 E000075 Health Insurance Premiums
MW OH FULLER, GLENN H MAY MEDICAL REIMBURSEMENT 395083-5161 E000081 Health Insurance Premiums
MW OH GALLANT, KAREN MAY MEDICAL REIMBURSEMENT 395083-5161 E000008 Health Insurance Premiums
RETAPR23 185.29 MAY -2023
Check Total: 185.29
RETAPR23 191.39 MAY -2023
Check Total: 191.39
RETAPR23 533.78 JUN -2023
Check Total: 533.78
RETAPR23 533.78 JUN -2023
Check Total: 533.78
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 571.00 MAY -2023
Check Total: 571.00
RETAPR23 879.00 MAY -2023
Check Total: 879.00
RETAPR23 879.00 MAY -2023
Check Total: 879.00
RETAPR23 533.78 MAY -2023
Check Total: 533.78
00017276 04/28/2023
00017277 04/28/2023
00017278 04/28/2023
00017279 04/28/2023
00017280 04/28/2023
00017281 04/28/2023
00017282 04/28/2023
00017283 04/28/2023
00017284 04/28/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 3
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Natne/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH GARNER, JO ANN MAY MEDICAL REIMBURSEMENT 395083-5161 E000047 Health Insurance Premiums
MW OH GARNER, KITTY MAY MEDICAL REIMBURSEMENT 395083-5161 E000080 Health Insurance Premiums
MW OH GRIMM, DENNIS L MAY MEDICAL REIMBURSEMENT 395083-5161 E000042 Health Insurance Premiums
MW OH HOLTSCLAW, KATHERINE MAY MEDICAL REIMBURSEMENT 395083-5161 E000121 Health Insurance Premiums
MW OH IRVINE, SUZETTE MAY MEDICAL REIMBURSEMENT 395083-5161 E000019 Health Insurance Premiums
MW OH JENKINS, ROBERT MAY MEDICAL REIMBURSEMENT 395083-5161 E000084 Health Insurance Premiums
MW OH JOHNSON, SHARON MAY MEDICAL REIMBURSEMENT 395083-5161 E000099 Health Insurance Premiums
MW OH JONES, ROBERT MAY MEDICAL REIMBURSEMENT 395083-5161 E000053 Health Insurance Premiums
MW OH JUAREZ, JANET MAY MEDICAL REIMBURSEMENT 395083-5161 E000134 Health Insurance Premiums
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 876.44 MAY -2023
Check Total: 876.44
RETAPR23 314.00 MAY -2023
Check Total: 314.00
RETAPR23 571.00 MAY -2023
Check Total: 571.00
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 689.04 MAY -2023
Check Total: 689.04
RETAPR23 191.39 MAY -2023
Check Total: 191.39
RETAPR23 148.68 MAY -2023
Check Total: 148.68
RETAPR23 148.68 MAY -2023
Check Total: 148.68
00017285 04/28/2023
00017286 04/28/2023
00017287 04/28/2023
00017288 04/28/2023
00017289 04/28/2023
00017290 04/28/2023
00017291 04/28/2023
00017292 04/28/2023
00017293 04/28/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 4
05/10/2023 :Date
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City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH JUDD, TERRELL JUN MEDICAL REIMBURSEMENT 395083-5161 E000115 Health Insurance Premiums
RETAPR23 1,000.50 JUN -2023
Check Total:

MW OH KIRKLAND, RICHARD L MAY MEDICAL REIMBURSEMENT 395083-5161 RETAPR23 E000110 Health Insurance Premiums
MW OH LITTLE, DIANE M MAY MEDICAL REIMBURSEMENT 395083-5161 E000098 Health Insurance Premiums
MW OH LOOMIS, CORINNE MAY MEDICAL REIMBURSEMENT 395083-5161 E000122 Health Insurance Premiums
MW OH LOWREY, B J MAY MEDICAL REIMBURSEMENT 395083-5161 E000041 Health Insurance Premiums
MW OH MAERTZWEILER, MICHAEL ILUN MEDICAL REIMBURSEMENT 395083-5161 E000032 Health Insurance Premiums
MW OH MILANO, JAMES MAY MEDICAL REIMBURSEMENT 395083-5161 E000054 Health Insurance Premiums
MW OH MILLER, RICHARD MAY MEDICAL REIMBURSEMENT 395083-5161 E000106 Health Insurance Premiums
MW OH NAJERA, JOSEPH D. MAY MEDICAL REIMBURSEMENT 395083-5161 E000136 Health Insurance Premiums
1,000.50
148.68 MAY -2023
Check Total: 148.68
RETAPR23 269.02 MAY -2023
Check Total: 269.02
RETAPR23 571.00 MAY -2023
Check Total: 571.00
RETAPR23 314.00 MAY -2023
Check Total: 314.00
RETAPR23 533.78 JUN -2023
Check Total: 533.78
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 1,143.00 MAY -2023
Check Total: 1,143.00
RETAPR23 571.00 MAY -2023
Check Total: 571.00
00017294 04/28/2023
00017295 04/28/2023
00017296 04/28/2023
00017297 04/28/2023
00017298 04/28/2023
00017299 04/28/2023
00017300 04/28/2023
00017301 04/28/2023
00017302 04/28/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 5
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH OLEA, ARLENE J MAY MEDICAL REIMBURSEMENT 395083-5161 E000014 Health Insurance Premiums
MW OH PALMER, GEORGE MAY MEDICAL REIMBURSEMENT 395083-5161 E000094 Health Insurance Premiums
MW OH PASCARELLA, RICHARD MAY MEDICAL REIMBURSEMENT 395083-5161 E000129 Health Insurance Premiums
MW OH PASCUA, RAYNALD MAY MEDICAL REIMBURSEMENT 395083-5161 E000114 Health Insurance Premiums
MW OH PASPALL, MIHAJLO MAY MEDICAL REIMBURSEMENT 395083-5161 E000085 Health Insurance Premiums
MW OH PEREZ, ROBERT MAY MEDICAL REIMBURSEMENT 395083-5161 E000111 Health Insurance Premiums
MW OH PICHON, WALTER MAY MEDICAL REIMBURSEMENT 395083-5161 E000103 Health Insurance Premiums
MW OH PINEDA, MATEO MAY MEDICAL REIMBURSEMENT 395083-5161 E000127 Health Insurance Premiums
MW OH PISCHEL, STEPHEN MAY MEDICAL REIMBURSEMENT 395083-5161 E000130 Health Insurance Premiums
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 1,143.00 MAY -2023
Check Total: 1,143.00
RETAPR23 1,821.00 MAY -2023
Check Total: 1,821.00
RETAPR23 1,726.00 MAY -2023
Check Total: 1,726.00
RETAPR23 448.36 MAY -2023
Check Total: 448.36
RETAPR23 148.68 MAY -2023
Check Total: 148.68
RETAPR23 269.02 MAY -2023
Check Total: 269.02
RETAPR23 415.50 MAY -2023
Check Total: 415.50
RETAPR23 876.17 MAY -2023
Check Total: 876.17
00017303 04/28/2023
00017304 04/28/2023
00017305 04/28/2023
00017306 04/28/2023
00017307 04/28/2023
00017308 04/28/2023
00017309 04/28/2023
00017310 04/28/2023
00017311 04/28/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 6
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH POINT, ERIC MAY MEDICAL REIMBURSEMENT 395083-5161 E000133 Health Insurance Premiums
MW OH REDIFER, KIM R MAY MEDICAL REIMBURSEMENT 395083-5161 E000022 Health Insurance Premiums
MW OH RENDEN, BRIAN MAY MEDICAL REIMBURSEMENT 395083-5161 E000083 Health Insurance Premiums
MW OH REYES, ROGER T MAY MEDICAL REIMBURSEMENT 395083-5161 E000024 Health Insurance Premiums
MW OH REYNOLDS, MATTHEW MAY MEDICAL REIMBURSEMENT 395083-5161 E000132 Health Insurance Premiums
MW OH RICE, RUSSELL J MAY MEDICAL REIMBURSEMENT 395083-5161 E000059 Health Insurance Premiums
MW OH RIVERA, AIDA MAY MEDICAL REIMBURSEMENT 395083-5161 E000026 Health Insurance Premiums
MW OH ROACH, MICHAEL MAY MEDICAL REIMBURSEMENT 395083-5161 E000105 Health Insurance Premiums
MW OH ROBB, SANDRA MAY MEDICAL REIMBURSEMENT 395083-5161 E000043 Health Insurance Premiums
RETAPR23 1,821.00 MAY -2023
Check Total: 1,821.00
RETAPR23 879.00 MAY -2023
Check Total: 879.00
RETAPR23 448.36 MAY -2023
Check Total: 448.36
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 571.00 MAY -2023
Check Total: 571.00
RETAPR23 1,391.00 MAY -2023
Check Total: 1,391.00
RETAPR23 191.39 MAY -2023
Check Total: 191.39
RETAPR23 1,391.00 MAY -2023
Check Total: 1,391.00
RETAPR23 191.39 MAY -2023
Check Total: 191.39
00017312 04/28/2023
00017313 04/28/2023
00017314 04/28/2023
00017315 04/28/2023
00017316 04/28/2023
00017317 04/28/2023
00017318 04/28/2023
00017319 04/28/2023
00017320 04/28/2023
User: Gabriela Calin
Report: AP 1400M : Al': Warrant List - Machine
Page: 7
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Dcscription
Batch ID Amount Invoice#
PO # Check # Check Date
MW OH ROSE, RICHARD D MAY MEDICAL REIMBURSEMENT 395083-5161 E000050 Health Insurance Premiums
MW OH SALE, LEER MAY MEDICAL REIMBURSEMENT 395083-5161
E000031 Health Insurance Premiums
MW OH SANCHEZ, LAURA MAY MEDICAL REIMBURSEMENT 395083-5161 E000058 Health Insurance Premiums
MW OH SCHLIEDER, BEVERLY MAY MEDICAL REIMBURSEMENT 395083-5161 E000120 Health Insurance Premiums
MW OH SMITH, WARD MAY MEDICAL REIMBURSEMENT 395083-5161 E000128 Health Insurance Premiums
MW OH SOTO, PHILIP J MAY MEDICAL REIMBURSEMENT 395083-5161 E000052 Health Insurance Premiums
MW OH SPRAGUE, GARY A MAY MEDICAL REIMBURSEMENT 395083-5161 E000064 Health Insurance Premiums
MW OH STEPHEN, JEFFREY MAY MEDICAL REIMBURSEMENT 395083-5161 E000119 Health Insurance Premiums
MW OH TAYLOR, DAVID M MAY MEDICAL REIMBURSEMENT 395083-5161 E000088 Health Insurance Premiums
RETAPR23 1,288.00 MAY -2023
Check Total: 1,288.00
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 191.39 MAY -2023
Check Total: 191.39
RETAPR23 876.44 MAY -2023
Check Total: 876.44
RETAPR23 584.00 MAY -2023
Check Total: 584.00
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 1,685.00 MAY -2023
Check Total: 1,685.00
RETAPR23 1,288.00 MAY -2023
Check Total: 1,288.00
RETAPR23 584.00 MAY -2023
Check Total: 584.00
00017321 04/28/2023
00017322 04/28/2023
00017323 04/28/2023
00017324 04/28/2023
00017325 04/28/2023
00017326 04/28/2023
00017327 04/28/2023
00017328 04/28/2023
00017329 04/28/2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
Page: 8
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH TAYLOR, LINDA MAY MEDICAL REIMBURSEMENT 395083-5161 E000126 Health Insurance Premiums
MW OH THOMANN, DARYLL L MAY MEDICAL REIMBURSEMENT 395083-5161 E000101 Health Insurance Premiums
MW OH TRIFOS, WILLIAM MAY MEDICAL REIMBURSEMENT 395083-5161 E000104 Health Insurance Premiums
MW OH VALENTINE, THOMAS MAY MEDICAL REIMBURSEMENT 395083-5161 E000118 Health Insurance Premiums
MW OH VERSTYNEN, WILLIAM MAY MEDICAL REIMBURSEMENT 395083-5161 E000092 Health Insurance Premiums
MW OH WAHL, KATHLEEN A MAY MEDICAL REIMBURSEMENT 395083-5161 E000030 Health Insurance Premiums
MW OH WIEST, STEPHEN MAY MEDICAL REIMBURSEMENT 395083-5161 E000079 Health Insurance Premiums
MW OH WORDEN, LARRY M MAY MEDICAL REIMBURSEMENT 395083-5161 E000116 Health Insurance Premiums
MW OH YAMAGUCHI, BRIAN MAY MEDICAL REIMBURSEMENT 395083-5161 E000123 Health Insurance Premiums
RETAPR23 529.37 MAY -2023
Check Total: 529.37
RETAPR23 533.78 MAY -2023
Check Total: 533.78
RETAPR23 879.00 MAY -2023
Check Total: 879.00
RETAPR23 584.00 MAY -2023
Check Total: 584.00
RETAPR23 148.68 MAY -2023
Check Total: 148.68
RETAPR23 191.00 MAY -2023
Check Total: 191.00
RETAPR23 534.00 MAY -2023
Check Total: 534.00
RETAPR23 584.00 MAY -2023
Check Total: 584.00
RETAPR23 1,391.00 MAY -2023
Check Total: 1,391.00
00017330 04/28/2023
00017331 04/28/2023
00017332 04/28/2023
00017333 04/28/2023
00017334 04/28/2023
00017335 04/28/2023
00017336 04/28/2023
00017337 04/28/2023
00017338 04/28/2023
User: Gabriela Cahn
Report: AP 1400M : AP: Warrant List - Machine
Page: 9
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH ZINN, JOHN MAY MEDICAL REIMBURSEMENT 395083-5161
E000009 Health Insurance Premiums
MW OH AMERICAN FIDELITY FSA P/E 4/15 PD 4/21
Volooll
MW OH AMERICAN FIDELITY FSA P/E 4/15 PD 4/21
V010011
MW OH AMERICAN FIDELITY FSA P/E 4/15 PD 4/21
V010011
MW OH AMERICAN FIDELITY FSA P/E 4/15 PD 4/21
V010011
MW OH AMERICAN FIDELITY FSA P/E 4/15 PD 4/21
V010011
MW OH AMERICAN FIDELITY Pitt/ 007, PR# 008
V010011
MW OH AMERICAN FIDELITY PR# 007, PR# 008
V010011
MW OH AMERICAN FIDELITY PR# 007, PR# 008
V010011
MW OH AMERICAN FIDELITY PR# 007, PR# 008
V010011
MW OH AMERICAN FIDELITY PR# 007, PR# 008
V01o011
MW OH AMERICAN FIDELITY PR# 007, PR# 008
V010011
MW OH AMERICAN FIDELITY PR# 007, PR# 008
V010011
MW OH AMERICAN FIDELITY PR# 007, PR# 008
V010011
0010-2188
Health Care SSA
0037-2188
Health Care SSA
0048-2188
Health Care SSA
0054-2188
Health Care SSA
0010-2190
Dependent Care SSA
0010-2155
Per Sec Plan - Opt. Life
0079-2155
Per Sec Plan - Opt. Life
0029-2155
Per Sec Plan - Opt. Life
0037-2155
Per Sec Plan - Opt. Life
0048-2155
Per Sec Plan - Opt. Life
0050-2155
Per Sec Plan - Opt. Life
0054-2155
Per Sec Plan - Opt. Life
0076-2155
Per Sec Plan - Opt. Life
RETAPR23 1,293.00 MAY -2023 00017339 04/28/2023
Check Total: 1,293.00
ACH042423 1,297.70 2178136G 00017342 04/27/2023
ACH042423 10.57 2178136G 00017342 04/27/2023
ACH042423 36.35 2178136G 00017342 04/27/2023
ACH042423 8.35 2178136G 00017342 04/27/2023
ACH042423 233.33 2178136G 00017342 04/27/2023
ACH042423 2,560.80 D579149 00017342 04/27/2023
ACH042423 38.99 D579149 00017342 04/27/2023
ACH042423 49.35 D579149 00017342 04/27/2023
ACH042423 18.00 D579149 00017342 04/27/2023
ACH042423 107.32 D579149 00017342 04/27/2023
ACH042423 0.00 D579149 00017342 04/27/2023
ACH042423 10.26 D579149 00017342 04/27/2023
ACH042423 4.82 D579149 00017342 04/27/2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
Page: 10
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice# PO # Check # Check Date
MW OH AMERICAN FIDELITY PR# 007, PR# 008
V010011
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/I PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
395000-2187
Voluntary Plan Life
0078-2140
Employee PERS W/H
0079-2140
Employee PERS W/H
0029-2195
PERS Uniform
0048-2195
PERS Uniform
0050-2195
PERS Uniform
0079-2195
PERS Uniform
0061-2195
PERS Uniform
0010-2195
PERS Uniform
0021-2195
PERS Uniform
0061-2150
Survivor Benefit Package
0054-2150
Survivor Benefit Package
0079-2150
Survivor Benefit Package
0078-2150
Survivor Benefit Package
ACH042423 2,117.34 D579149 00017342 04/27/2023
Check Total: 6,493.18
ACH042423 214.29 PR2301007
ACH042423 78.16 PR2301007
ACH042423 0.02 PR2301007
ACH042423 0.56 PR2301007
ACH042423 0.00 PR2301007
ACH042423 0.18 PR2301007
ACH042423 1.04 PR2301007
ACH042423 24.21 PR2301007
ACH042423 0.00 PR2301007
ACH042423 0.93 PR2301007
ACH042423 0.48 PR2301007
ACH042423 0.44 PR2301007
ACH042423 0.47 PR2301007
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
User: Gabriela Cahn
Report: AP 1400M : AP: Warrant List - Machine
Page: 11
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
MW OH CALIFORNIA PUBLIC PERS P/E 4/I PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
0037-2150
Survivor Benefit Package
0050-2150
Survivor Benefit Package
0076-2150
Survivor Benefit Package
0029-2150
Survivor Benefit Package
0048-2140
Employee PERS W/H
0010-2140
Employee PERS W/H
0024-2140
Employee PERS W/H
0061-2140
Employee PERS W/H
0076-2140
Employee PERS W/H
0050-2140
Employee PERS W/H
0054-2140
Employee PERS W/H
0037-2140
Employee PERS W/H
0029-2140
Employee PERS W/H
0029-2140
Employee PERS W/H
0029-2145
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423

2.09 PR2301007

0.00 PR2301007

0.11 PR2301007

1.11 PR2301007
1,845.88 PR2301007
ACH042423 108,417.81 PR2301007
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
792.67 PR2301007
1,736.59 PR2301007

68.91 PR2301007

0.00 PR2301007
421.50 PR2301007
1,275.45 PR2301007
446.56 PR2301007

0.00 PR2301007

2.59 PR2301007
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
Page: 12
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/1 PD 4/07
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
Employee PERS Payback W/H
0037-2145
Employee PERS Payback W/H
0054-2145
Employee PERS Payback W/H
0010-2145
Employee PERS Payback W/H
0048-2145
Employee PERS Payback W/H
0048-2150
Survivor Benefit Package
0024-2150
Survivor Benefit Package
0010-2150
Survivor Benefit Package
0076-2150
Survivor Benefit Package
0054-2150
Survivor Benefit Package
0061-2150
Survivor Benefit Package
0079-2150
Survivor Benefit Package
0078-2150
Survivor Benefit Package
0048-2150
Survivor Benefit Package
0029-2150
Survivor Benefit Package
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423

18.11 PR2301007

12.94 PR2301007
220.71 PR2301007

4.40 PR2301007

3.03 PR2301007

0.93 PR2301007
143.49 PR2301007

0.06 PR2301008

0.48 PR2301008

0.93 PR2301008

0.41 PR2301008

0.47 PR2301008

3.08 PR2301008

1.09 PR2301008
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 13
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS PIE 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
V010053
MW OH CALIFORNIA PUBLIC PERS P/E 4/15 PD 4/21
0010-2150
Survivor Benefit Package
0024-2150
Survivor Benefit Package
0037-2150
Survivor Benefit Package
0037-2145
Employee PERS Payback W/H
0010-2145
Employee PERS Payback W/H
0029-2145
Employee PERS Payback W/H
0048-2145
Employee PERS Payback W/H
0054-2145
Employee PERS Payback W/H
0078-2140
Employee PERS W/H
0079-2140
Employee PERS W/H
0061-2140
Employee PERS W/H
0048-2140
Employee PERS W/H
0054-2140
Employee PERS W/H
0029-2140
Employee PERS W/H
0029-2140
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
131.82 PR2301008
0,93 PR2301008

2.09 PR2301008

18.11 PR2301008
220.71 PR2301008

2.59 PR2301008

4.40 PR2301008

12.94 PR2301008
214.29 PR2301008

63.44 PR2301008
1,552.14 PR2301008
2,012.17 PR2301008
424.12 PR2301008
443.27 PR2301008

0.00 PR2301008
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 14
05/10/2023 :Date
12:06:13 :Time

MW OH EMPLOYMENT
Employee PERS W/H
0037-2140
Employee PERS W/H
0076-2140
Employee PERS W/H
0024-2140
Employee PERS W/H
0048-2195
PERS Uniform
0061-2195
PERS Uniform
0010-2195
PERS Uniform
0021-2195
PERS Uniform
0010-2140
Employee PERS W/H
0010-2196
Garnishments W/H
0029-2196
Garnishments W/H
0037-2196
Garnishments W/H
0048-2196
Garnishments W/H
P/E 4/15 PD 4/21 0010-2135
ACH042423 1,279.13 PR2301008
ACH042423 32.44 PR2301008
ACH042423 792.67 PR2301008
ACH042423 0.60 PR2301008
ACH042423 1.04 PR2301008
ACH042423 24.37 PR2301008
ACH042423 0.00 PR2301008
ACH042423 107,026.74 PR2301008
Check Total: 230,002.19
ACH042423 2,196.90 PR2301008
ACH042423 9.23 PR2301008
ACH042423 69.23 PR2301008
ACH042423 46.15 PR2301008
Check Total: 2,321.51
ACH042423 32,114.82 PR2301008
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017343 04/27/2023
00017344 04/27/2023
00017344 04/27/2023
00017344 04/27/2023
00017344 04/27/2023
00017345 04/27/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 15
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
V010052

MW OH EMPLOYMENT
V010052

MW OH EMPLOYMENT
V010052
P/E 4/15 PD 4/21
P/E 4/15 PD 4/21
P/E 4/15 PD 4/21
P/E 4/15 PD 4/21
P/E 4/15 PD 4/21
P/E 4/15 PD 4/21
P/E 4/15 PD 4/21
P/E 4/15 PD 4/21
P/E 4/15 PD 4/21
MW OH INTERNAL REVENUE P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED PIE 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
Calif Income Tax W/H
0024-2135
Calif Income Tax W/H
0029-2135
Calif Income Tax W/H
0037-2135
Calif Income Tax W/H
0048-2135
Calif Income Tax W/H
0054-2135
Calif Income Tax W/H
0061-2135
Calif Income Tax W/H
0076-2135
Calif Income Tax W/H
0078-2135
Calif Income Tax W/H
0079-2135
Calif Income Tax W/H
0010-2110
Federal Income Tax W/H
0024-2110
Federal Income Tax W/H
0078-2110
Federal Income Tax W/H
0079-2110
Federal Income Tax W/H
0061-2110
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
Check Total:
191.42 PR2301008
106.37 PR2301008
429.08 PR2301008
542.44 PR2301008
124.91 PR2301008
281.33 PR2301008

16.57 PR2301008

70.91 PR2301008
98,39 PR2301008
33,976.24
ACH042423 75,165.19 PR2301008
ACH042423 384.06 PR2301008
ACH042423 143.85 PR2301008
ACH042423 235.70 PR2301008
ACH042423 960.39 PR2301008
00017345 04/27/2023
00017345 04/27/2023
00017345 04/27/2023
00017345 04/27/2023
00017345 04/27/2023
00017345 04/27/2023
00017345 04/27/2023
00017345 04/27/2023
00017345 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 16
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID
Description
Account/Description
Batch ID Amount Invoice#
PO # Check # Check Date
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
Federal Income Tax W/H
0076-2110
Federal Income Tax W/H
0048-2110
Federal Income Tax W/H
0054-2110
Federal Income Tax W/H
0037-2110
Federal Income Tax W/H
0029-2110
Federal Income Tax W/H
0029-2115
Employee Medicare W/H
0024-2115
Employee Medicare W/H
0048-2115
Employee Medicare W/H
0037-2115
Employee Medicare W/H
0061-2115
Employee Medicare W/H
0054-2115
Employee Medicare W/H
0078-2115
Employee Medicare W/H
0079-2115
Employee Medicare W/H
0076-2115
Employee Medicare W/H
ACH042423 40.88 PR2301008
ACH042423 1,501.91 PR2301008
ACH042423 332.33 PR2301008
ACH042423 1,013.23 PR2301008
ACH042423 244.98 PR2301008
ACH042423 50.27 PR2301008
ACH042423 71.85 PR2301008
ACH042423 198.74 PR2301008
ACH042423 127.31 PR2301008
ACH042423 68.60 PR2301008
ACH042423 40.49 PR2301008
ACH042423 22.11 PR2301008
ACH042423 24.02 PR2301008
ACH042423 4.15 PR2301008
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
User: Gabriela Galin
Report: AP1400M : AP: Warrant List - Machine
Page: 17
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH INTERNAL REVENUE FED P/E 4/15 PD 4/21
V010054
MW OH MISSION SQUARE 100091 P/E 4/15 PD 4/21
V012393
0010-2115
Employee Medicare W/H
0010-2120
Employer Medicare Payable
0076-2120
Employer Medicare Payable
0079-2120
Employer Medicare Payable
0078-2120
Employer Medicare Payable
0054-2120
Employer Medicare Payable
0061-2120
Employer Medicare Payable
0037-2120
Employer Medicare Payable
0048-2120
Employer Medicare Payable
0024-2120
Employer Medicare Payable
0029-2120
Employer Medicare Payable
0010-2125
Employee Social Sec W/H
0010-2130
Employer Soc Sec Payable
0010-2170
Deferred Comp Payable - ICMA
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
10,286.39 PR2301008
10,286.39 PR2301008

4.15 PR2301008

24.02 PR2301008

22.11 PR2301008

40.49 PR2301008

68.60 PR2301008
127.31 PR2301008
198.74 PR2301008

71.85 PR2301008

50.27 PR2301008

0.00 PR2301008

0.00 PR2301008
Check Total: 101,810.38
ACH042423 7,344.94 PR2301008
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017346 04/27/2023
00017347 04/27/2023
User: Gabriela Calm
Report: AP1400M : AP: Warrant List - Machine
Page: 18
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type
Vendor Name/ID
Description
Account/Description
Batch ID
Amount Invoice#
PO # Check # Check Date
MW OH
MW OH
MW OH
MW OH
MW OH
MW OH
MW OH
MW OH
MISSION SQUARE 301387 P/E 4/15 PD 4/21
V012394
MISSION SQUARE 301387 P/E 4/15 PD 4/21
V012394
MISSION SQUARE 301387 P/E 4/15 PD 4/21
V012394
MISSION SQUARE 301387 P/E 4/15 PD 4/21
V012394
MISSION SQUARE 301387 P/E 4/15 PD 4/21
V012394
MISSION SQUARE 301387 P/E 4/15 PD 4/21
V012394
MISSION SQUARE 301387 P/E 4/15 PD 4/21
V012394
MISSION SQUARE 301387 P/E 4/15 PD 4/21
V012394

MW OH CALIFORNIA PUBLIC
V006234

MW OH CALIFORNIA PUBLIC
V006234
P/E 4/15 PD 4/21

MAY MED INSURANCE PREMIUM
MAY MED INSURANCE PREMIUM 395083-5161
Health Insurance Premiums

MAY MED INPREMIUM NON-PERS
0010-2170
Deferred Comp Payable - ICMA
0029-2170
Deferred Comp Payable - ICMA
0037-2170
Deferred Comp Payable - ICMA
0048-2170
Deferred Comp Payable - ICMA
0054-2170
Deferred Comp Payable - ICMA
0076-2170
Deferred Comp Payable - ICMA
0078-2170
Deferred Comp Payable - ICMA
0079-2170
Deferred Comp Payable - ICMA
MW OH WASHINGTON STATE P/E 4/15 PD 4/21
395000-4715
ISF Health Ins Reimbursement
395000-4715
ISF Health Ins Reimbursement
395000-4715
ISF Health Ins Reimbursement
0010-2196
Check Total:

ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
ACH042423
Check Total:
7,344.94
29,774.75 301387-PY008

33.39 301387-PY008
241.36 301387-PY008
636.41 301387-PY008
125.80 301387-PY008

2.25 301387-PY008

75.00 301387-PY008

41.09 301387-PY008
30,930.05
ACH042423 371.97 10000001713116
ACH042423 197, 815.93 10000001714607
ACH042423 15,407.31 10000001714607
ACH042423 31,167.19 10000001714608
Check Total: 244,762.40
ACI-I042423 240.00 PR2301008
00017348 04/27/2023
00017348 04/27/2023
00017348 04/27/2023
00017348 04/27/2023
00017348 04/27/2023
00017348 04/27/2023
00017348 04/27/2023
00017348 04/27/2023
00017349 04/27/2023
00017349 04/27/2023
00017349 04/27/2023
00017349 04/27/2023
00017350 04/27/2023
User: Gabriela Calin
Report: AP 1400M : AP: Warrant List - Machine
Page: 19
05/10/2023 :Date
12:06:13 :Time

City of Placentia
Check Register
For 05/10/2023
Type Vendor Name/ID Description
Account/Description
Batch ID Amount Invoice#
PO # Check # Check Date
V011597 Garnishments W/H
Check Total: 240.00
Type Total: 715,997.13
Check Total: 715,997.13
User: Gabriela Calin
Report: AP1400M : AP: Warrant List - Machine
Page: 20
05/10/2023 :Date
12:06:13 :Time

TO:

VIA:

FROM:

DATE:

SUBJECT:

Placentia City Council

AGENDA REPORT

CITY COUNCIL

CITY ADMINISTRATOR

DEPUTY CITY ADMINISTRATOR/ PUBLIC SERVICES & INFRASTRUCTURE MAY 16, 2023
SETTING OF THE ANNUAL SPECIAL TAX RATE FOR FISCAL YEAR 2023-24 FOR COMMUNITY FACILITIES DISTRICT NO. 2014-01 (PUBLIC SERVICES

CFD) AND DECLARING THE INTENTION TO ALLOW FOR THE ANNEXATION OF PROPERTY TO COMMUNITY FACILITIES DISTRICT NO. 2014-01 FISCAL
IMPACT: REVENUE: $64,139.16 RECOUPED THROUGH ASSESSMENTS (550000-4505) SUMMARY:

On February 18, 2014, the City Council adopted Resolution No. R-2014-10, establishing Community Facilities District No. ("CFD") 2014-01 ("Public Services CFD") to provide an ongoing sustainable funding source paid for by new developments to help fund the cost of public safety services. On March 4, 2014, the City Council adopted Ordinance No. 2014-03, authorizing the City Council to determine, by resolution, on or before August 1 of each year, the specific special tax to be levied on each parcel of land within the CFD. At that time, the City Council also, in the adoption of the territory map, approved the area designated as future annexation to the CFD.

Staff recommends that the City Council adopt a resolution to levy a special tax to pay for public safety services for Fiscal Year (FY) 2023-24 (Attachment 1), adopt a resolution declaring its intention to annex territory to the CFD and set a public hearing on June 20, 2023 (Attachment 2).

RECOMMENDATION:

It is recommended that the City Council take the following actions:

1. Adopt Resolution No. R-2023-32, a Resolution of the City Council of the City of Placentia, California, setting the levy of an Annual Special Tax for Community Facilities District No. 2014-01 (Public Services); and

2. Authorize inclusion of the Annual Special Tax for Community Facilities District No. 2014-01 (Public Services) for Fiscal Year 2023-24 on the Orange County Secured Property Tax Roll; and

3. Adopt Resolution No. R-2023-33, a Resolution of the City Council of the City of Placentia, California, declaring its intention to annex certain territory to Community Facilities District No. 2014-01 (Public Services).

1.c.

May 16, 2023

City Council Agenda
May 16, 2023

Page 2 of 3 ends

STRATEGIC PLAN STATEMENT:

There is no specific Strategic Plan Goal or Objective associated with this Council action.

DISCUSSION:

In 2014, the City Council created CFD 2014-01 to provide a new revenue stream paid for by new residential developments to be used to help fund the cost of public safety services. This type of financing program, which is authorized under the Mello -Roos Community Facilities Act of 1982, envisioned the participation of all future additional new development projects, either by formation of new districts or annexation into the existing CFD.

The special tax that is currently being assessed on properties within the CFD is based upon a Fiscal Impact Analysis ("FIA") that was prepared for the intital formation of the CFD in 2014. Based on the FIA, the tax rate needed to support public safety services for new residential developments was established at $225.00 for each single-family residential unit per year. Therefore, the special tax rates for 2014-15 were $225.00 per residential unit for single-family residential property and $170.00 per residential unit for multi -family residential property.

The CFD is subject to an Annual Escalation Factor beginning on July 1, 2015, which shall be the greater of five percent (5%) or the annual percentage increase, if any, of the Consumer Price index for the twelve (12) months ending the preceding December 31. The index identified in the Rate and Method of Apportionment from 2014 was the All -Urban Consumers (CPI_U) for Los Angeles -Riverside -Orange County area. However, in January 2018, the Bureau of Labor and Statistics split the index geographically into a Los Angeles -Long Beach -Anaheim area and a Riverside -San Bernardino -Ontario area. The City has determined that the Los Angeles -Long Beach -Anaheim index is the most appropriate index as it includes both Los Angeles and Orange Counties. The CPI for the 12 months ending the preceding December 31 was 4.9%. Therefore, the special tax rates are being increased by 5% as allowed. The adjusted special tax rates for FY 2023-24 are $354.36 per residential unit for single-family residential property and $267.74 per residential unit for multi -family residential property.

As a condition of approval, the JPI transit -oriented development at 505 W. Crowther Avenue, was required to annex itself to the CFD. This project is currently under the final phase of construction and will need to be annexed to the CFD prior to receiving a Certificate of Occupancy. To commence the annexation process, the City Council must adopt a Resolution of Intention (Attachment 2). This Resolution sets forth terms and conditions for annexing territory into the CFD and includes the rate and apportionment for the special tax to be levied. The Resolution of Intention also establishes a date for a public hearing on the annexation action, and for an election among the authorized electors. The hearing date, which by statute must be within 30-60 days following the adoption of the Resolution of Intention, is scheduled for June 20, 2023. Since there are less than twelve (12) registered voters in the territory proposed to be annexed, the election will be a landowner vote which is a vote of JPI annexing its property to the CFD.

City Council Agenda
May 16, 2023

Page 3 of 3 ends

FISCAL IMPACT:

For the tax to be applied to a parcel, either construction must be completed or a building permit for the home needs to be issued by the City by June 1 of the preceding fiscal year. Currently, a total of 181 single-family properties have been annexed into CFD 2014-01 since its creation. For FY 2023-24, 181 parcels will be assessed at the adjusted special tax rate of $354.36. The 54 detached single-family homes by Shea Homes located on the southeast corner of Alta Vista Street and Rose Drive were annexed into CFD 2014-01 and will be levied for the first time in FY 2023-

24. The anticipated revenue from these assessments in FY 2023-24 is $64,139.16. The addition of the new annexation into the special tax district will generate future new revenue as summarized in the following.

Development
Number of Units
Annual Unit Rate
Total Annual
Revenue
JPI Luxury
Apartments
418
$267.74
$111,915.32
Prepared by:
,SA, Fbl,itn,SDun,
Elsa Y. Robinson
Reviewed and approved:

Y ..4 e
Jennifer Lampman
Senior Management Analyst Director of Finance
Reviewed and approved: Reviewed and approved:
(p.is f s{t»
Luis Estevez Damien R. Arrula
Deputy City Administrator City Administrator
Attachments:

1. Resolution No. R-2023-32 — Annual Levy for CFD 2014-01

2. Resolution No. R-2023-33 — Intention to Annex Territory to CFD 2014-01

3. Rate and Method of Apportionment of Special Tax

RESOLUTION NO. R-2023-32

A RESOLUTION OF CITY COUNCIL OF THE CITY OF

PLACENTIA, CALIFORNIA, SETTING THE LEVY OF AN

ANNUAL SPECIAL TAX FOR COMMUNITY FACILITIES
DISTRICT NO. 2014-01 (PUBLIC SERVICES) FOR FY 2023-24.

A. Recitals.
(i). The City Council of the City of Placentia ("City Council"), has initiated proceedings, held a public hearing, conducted an election and received a favorable vote from the qualified electors to authorize the levy of a special tax in a community facilities district, all as authorized pursuant to the terms and provisions of the "{Mello -Roos Community Facilities Act of 1982", being Chapter 2.5, Part 1, Division 2, Title 5 of the California Government Code ("Act") denominated COMMUNITY FACILITIES DISTRICT NO. 2014-01 (Public Servicers) ("District").
(ii). The City Council, by adoption of Ordinance No. 2014-03 ("Ordinance") as authorized by § 53340 of the California Government Code, has authorized the levy of special taxes within the District to finance the authorized service in accordance with the Rate and Method of Apportionment of the Special Tax ("RMA") set forth in Exhibit "B" to the Resolution of Formation, which is on file in the office of the City Clerk and incorporated by reference herein.
(iii). California Government Code § 53340 provides that the City Council may provide, by resolution, for the levy of the special tax in the current tax year or future tax years at the same rate or at a lower rate than the rate provided by the Ordinance, if the resolution is adopted and a certified list of all parcels subject to the special tax levy including the amount of the tax to be levied on each parcel for the applicable tax year, is filed by the Clerk or other official designated by the legislative body with the county auditor on or before the 10th day of August of that tax year.
(iv). The RMA provides for an annual escalation factor of the greater of five percent (5%) or the annual percentage increase, if any, of the All Urban Consumers Consumer Price Index ("CPI") for the Los Angeles — Riverside — Orange County, CA area as determined by the Bureau of Labor Statistics for the twelve (12) months ending the preceding December 31.
(v). The All Urban Consumers Consumer Price Index ("CPI") for the Los Angeles — Long Beach -Anaheim, CA area (part of the former Los Angeles -Riverside -Orange County, CA area) as determined by the Bureau of Labor Statistics for the twelve (12) months ending the preceding December 31 was 4.9%.

B. Resolution.

NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF PLACENTIA DOES HEREBY FIND, DETERMINE AND RESOLVE AS FOLLOWS:

Resolution R-2023-32 ATTACHMENT 1

Page 1 of 3 ends

1. The facts set forth in the Recitals, Part A of this Resolution, are true and correct.

2. This City Council does hereby find and determine as follows:

A. The annual escalation for FY 2023-24 shall be 5%.

B. The City Council hereby levies a special tax within the District for Fiscal Year 2022-23 at the rate of $354.36 per residential unit for single-family residential property and $267.74 per residential unit for multi -family residential property.

C. The CFD Administrator herby is authorized and directed to file with the County Auditor on or before the 10th day of August a certified copy of this Resolution accompanied by a list of all parcels subject to the special tax levy with the taxes to be levied on each parcel based on the 2023-24 special tax rates set forth in Part B of this Resolution.

D. The special tax shall be collected in the same manner as ordinary ad valorem property taxes are collected and shall be subject to the same penalties and same procedure and sale in cases of any delinquency for ad valorem taxes, and the Tax Collector is hereby authorized to deduct reasonable administrative costs incurred in collecting any said special tax.

E. The County Auditor is hereby directed to enter in the next County assessment roll on which taxes will become due, opposite each lot or parcel of land affected, in a space marked "Public Services Special Tax" or by any other suitable designation, the installment of the special tax.

F. The County Auditor shall, at the close of the tax collection period, promptly render to the District a detailed report showing the amount and/or amounts of such special tax installments, interest, penalties, and percentages so collected and from what property collected, and also provide a statement of any percentages retained for the expense of making any such collection.

G. This Resolution shall become effective upon its adoption.

APPROVED and ADOPTED this 16th day of May 2023.

Ward L. Smith, Mayor
ATTEST:

Robert S. McKinnell, City Clerk
Resolution R-2023-32 ATTACHMENT 1

Page 2 of 3 ends

STATE OF CALIFORNIA

COUNTY OF ORANGE
I, Robert S. McKinnell, City Clerk of the City of Placentia do hereby certify that the foregoing Resolution was adopted at a regular meeting of the City Council held on the 16th day of May 2023 by the following vote:

AYES:

NOES:

ABSENT:

ABSTAIN:

Councilmembers:

Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:

Christian L. Bettenhausen, City Attorney
Resolution R-2023-32 ATTACHMENT 1

Page 3 of 3 ends

RESOLUTION NO. R- 2023-33

RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PLACENTIA

ACTING AS THE LEGISLATIVE BODY OF COMMUNITY FACILITIES
DISTRICT NO. 2014-01 DECLARING ITS INTENTION TO ANNEX

CERTAIN TERRITORY INTO SAID DISTRICT
A. Recitals
(i) The City Council of the City of Placentia ("City Council"), initiated proceedings, held a public hearing, conducted an election and received a favorable vote from the qualified electors to authorize the levy of a special tax in a community facilities district, all as authorized pursuant to the terms and provisions of the "Mello -Roos Community Facilities Act of 1982", being Chapter 2.5, Part 1, Division 2, Title 5 of the California Government Code ("Act") denominated COMMUNITY FACILITIES DISTRICT NO. 2014-01 (Public Services) ("District"), Resolution No. 2014-10. (ii) The City Council heretofore adopted Ordinance No. O-2014-03 which provided for the levying and collection of special taxes ("Special Taxes") within the District, as provided in the Act in accordance with the Rate and Method of Apportionment ("RMA") set forth in Resolution No. 2014-10.
(iii) The City Council has received a petition ("Petition") requesting the institution of proceedings for annexation to the District signed by the landowner(s) within the territory proposed to be annexed ("Property") pursuant to the Act. (iv) The City Council has determined that the Petition complies with the requirements of California Government Code § 53318 and now intends to annex the Property to the District.
(v) The City Council desires to adopt this Resolution of Intention to annex said Property to the District as provided in § 53339 of the Act consisting of the territory described in Exhibit "A" attached hereto and incorporated herein by reference, which the City Council hereby determines shall be known as "City of Placentia Community Facilities District No. 2014-01 (Public Services) JPI Annexation" ("JPI Annexation" or the "Annexation") pursuant to the Act to finance (1) the public services described in Exhibit "B" attached hereto and incorporated herein by reference ("Services"); and (2) the incidental expenses to be incurred in connection with financing the Services and forming and administering the District ("Incidental Expenses") . (vi) It is the intention of the City Council to consider financing the Services and the Incidental Expenses through the annexation of the Property to the District and the levy of a special tax therein to pay for the Services and the Incidental Expenses, provided that the special tax levies are approved at an election to be held within the District.

Resolution R-2023-33 ATTACHMENT 2

Page 1 of 7 ends

B. Resolution.

NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF PLACENTIA DOES HEREBY FIND, DETERMINE AND RESOLVE AS FOLLOWS:

1. The facts set forth in the Recitals, Part A of this Resolution, are true and correct and incorporated herein by reference.

2. The Property is proposed to be annexed to the District pursuant to the terms of the Act. It is further proposed that the boundaries of the annexation shall be as described in Exhibit "A" hereto, which boundaries shall, upon recordation of the boundary map for the Annexation, include the entirety of all parcels subject to taxation by the District. The proposed boundaries of the Annexation are depicted on the map of the proposed Community Facilities District No. 2014- 01 JPI Annexation which is on file in the office of the City Clerk entitled "Map of Proposed Boundaries of City of Placentia Community Facilities District No. 2014-01 ( Public Services) JPI Annexation" which map indicates by a boundary line the extent of the territory included in the District and shall govern for all details as to the extent of the Annexation. On the original and one (1) copy of the map of said Annexation on file in the City Clerk's office, the City Clerk shall endorse the certificate evidencing the date and adoption of this Resolution. The City Clerk shall file the original of such map in the City Clerk's Office and, within fifteen (15) days after the adoption of this Resolution, shall file a copy of such map so endorsed in the records of the County Recorder, County of Orange, State of California, all as required by § 3111 of the California Streets and Highways Code.

3. The name of the proposed Annexation shall be "City of Placentia Community Facilities District No. 2014-01 (Public Services) JPI Annexation".

4. The Services proposed to be provided and financed by District are described on Exhibit "B" attached hereto. The cost of providing the Services includes Incidental Expenses, which include expenses to be incurred in connection with the determination of the amount of the levy of the special tax, the collection of the special tax including the expenses of collecting delinquencies, the payment of salaries and benefits of any City employee whose duties are directly related to the administration of the District, and costs otherwise incurred in order to carry out the authorized purposes of the District.

The City Council hereby finds and determines that the description of the Services herein is sufficiently informative to allow taxpayers within the proposed Annexation to understand what the funds may be used to finance. The City Council hereby finds that the proposed Services are necessary to meet increased demands placed upon the City as a result of development occurring in the District, including the JPI Annexation thereto.

5. Except where funds are otherwise available, it is the intention of the City Council to levy annually in accordance with procedures contained in the Act a special tax within the District, including the Annexation area, secured by recordation of a continuing lien against all nonexempt real property in the District, including the Annexation area, sufficient to pay for the Services and Incidental Expenses. The rate and method of Resolution R-2023-33 ATTACHMENT 2

Page 2 of 7 ends

apportionment and manner of collection of the special tax within the District is described in detail in the RMA attached hereto as Exhibit "C" and incorporated herein by reference.

Exhibit "C" allows each landowner within the District to estimate the maximum amount that may be levied against each parcel. In the first year in which such special tax is levied, the levy shall include an amount sufficient to repay the District all amounts, if any, transferred to the District pursuant to § 53314 of the Act and interest thereon.

6. If special taxes of the District are levied against any parcel used for private residential purposes, (i) the maximum special tax rate shall not be increased over time except that it may be increased by an amount not to exceed the greater of five percent (5%) or the annual percentage increase, if any, of the All Urban Consumers Consumer Price Index ("CPI"). The annual CPI used shall be for the area of Los Angeles - Riverside - Orange County, CA as determined by the Bureau of Labor Statistics for the twelve (12) months ending the preceding December 31 to the extent permitted in the rate and method of apportionment; (ii) such tax shall be levied for a period not to exceed fifty (50) years commencing with Fiscal Year 2014-15, as further described in Exhibit "C" hereto; and (iii) under no circumstances will such special tax be increased as a consequence of delinquency or default by the owner of any other parcels within the District by more than ten percent (10%).

7. The special tax within the proposed Annexation is based on the expected demand that each parcel of real property within the proposed Annexation will place on the Services and on the benefit that each parcel derives from the Services . The City Council hereby determines that the proposed Services are necessary to meet the increased demand placed upon the City as a result of the development of land proposed for inclusion in the District. The City Council hereby determines the rate and method of apportionment of the special tax set forth in Exhibit "C" for the District to be reasonable. The special tax is apportioned to each parcel on the foregoing basis pursuant to § 53325.3 of the Act and such special tax is not based upon the value or ownership of real property. In the event that a portion of the property within the Annexation shall become for any reason exempt, wholly or partially, from the levy of the special tax specified on Exhibit "C," the City Council shall, on behalf of the District No., cause the levy to be increased, subject to the limitation of the maximum special tax for a parcel as set forth in Exhibit "C," to the extent necessary upon the remaining property within the District which is not delinquent or exempt in order to yield the special tax revenues required for the purposes described in § 5, above. The obligation to pay special taxes may be prepaid as set forth in Exhibit "C."

8. A public hearing ("Hearing") on the annexation of the Property to District, the proposed rate and method of apportionment of the special tax and Incidental Expenses shall be held on June 20, 2023, at 7 :00 O' clock p.m., or as soon thereafter as the matter may be heard, at the chambers of the City Council of the City of Placentia, 401 E. Chapman Avenue, Placentia, California 92870. Should the City Council determine to annex the Property to the District, immediately thereafter, a special election will be held within the District to authorize the levy of the special tax in accordance with the procedures contained in California Government Code § 53326. If held, the proposed voting procedure at the elections will be a landowner vote with each landowner who is the Resolution R-2023-33 ATTACHMENT 2

Page 3 of 7 ends

owner of record of land subject to annexation to the District at the close of the Hearing, or the authorized representative thereof, having one vote for each acre or portion thereof owned within the Annexation. Ballots for the special elections may be distributed by mail or by personal service prior to the Hearing.

9. At the time and place set forth above for the Hearing, any interested person, including all persons owning lands or registered to vote within the proposed Annexation may appear and be heard.

10. The City Clerk is hereby directed to publish a notice ("Notice") of the Hearing pursuant to California Government Code § 6061 in a newspaper of general circulation published in the area of the proposed District. Such Notice shall contain the text of this Resolution, state the time and place of the Hearing, a statement that the testimony of all interested persons or taxpayers will be heard, a description of the protest rights of the registered voters and landowners in the proposed Annexation as provided in § 53324 of the Act and a description of the proposed voting procedure for the election required by the Act. Such publication shall be completed at least seven (7) days prior to the date of the Hearing.

ADOPTED AND APPROVED this 16th day of May 2023.

Ward L. Smith, Mayor
ATTEST:

Robert S. McKinnell, City Clerk
I, Robert S. McKinnell, City Clerk of the City of Placentia do hereby certify that the foregoing Resolution was adopted at a regular meeting of the City Council held on the 16th day of May 2023 by the following vote:

AYES:

NOES:

ABSENT:

ABSTAIN:

Councilmembers:

Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:

Christian L. Bettenhausen, City Attorney
Resolution R-2023-33 ATTACHMENT 2

Page 4 of 7 ends

EXHIBIT "A"

ANNEXATION BOUNDARIES
Resolution R-2023-33 ATTACHMENT 2

Page 5 of 7 ends

EXHIBIT "B"

SERVICES
Police protection services and fire protection and suppression services, including but not limited to (i) the costs of contracting services, (ii) equipment, vehicles, ambulances and paramedics, fire apparatus, supplies, (iii) the salaries and benefits of City staff that directly provide police protection services and fire protection and suppression services and other services as defined herein, respectively, and (iv) City overhead costs associated with providing such services within the District. On each July 1 following the Base Year the increases attributed to salaries and benefits shall be calculated and limited to the increase based on the Annual Escalation Factor as provided in the Rate and Method of Apportionment of the Special Taxes. The Special Tax will finance Services that are in addition to those provided in or required for the territory within the District and will not be replacing services already available. The Special Tax provides only partial funding for police and fire services.

Resolution R-2023-33 ATTACHMENT 2

Page 6 of 7 ends

EXHIBIT "C"

RATE AND METHOD OF APPORTIONMENT OF SPECIAL TAX
Resolution R-2023-33 ATTACHMENT 2

Page 7 of 7 ends

RATE AND METHOD OF APPORTIONMENT OF

SPECIAL TAX

CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT NO. 2014-01
(PUBLIC SERVICES)
A Special Tax as hereinafter defined shall be levied on all Assessor's Parcels within the City of Placentia Community Facilities District No. 2014-01 (Public Services), ("CFD No. 2014-01"), other than Assessor's Parcels classified as Exempt Property as defined herein, and collected each Fiscal Year commencing in Fiscal Year 2014-2015, in an amount determined by the CFD Administrator through the application of the procedures described below. All of the real property within CFD No. 2014-01, unless exempted by law or by the provisions hereof, shall be taxed for the purposes, to the extent, and in the manner herein provided, including property subsequently annexed to CFD No. 2014-01, unless a separate Rate and Method of Apportionment of Special Tax is adopted for the annexation area.

A. DEFINITIONS
The terms hereinafter set forth have the following meanings:
"Acre or Acreage" means the land area of an Assessor's Parcel, expressed in acres, as shown on an Assessor's Parcel Map, or if the land area is not shown on an Assessor's Parcel Map, the land area shown on the applicable Final Subdivision Map, other final map, other parcel map, other condominium plan, or functionally equivalent map or instrument recorded in the Office of the Country Recorder. The square footage of an Assessor's Parcel is equal to the Acreage multiplied by 43,560.
"Act" means the Mello -Roos Communities Facilities Act of 1982 as amended, being Chapter

2.5, Part 1, Division 2 of Title 5 of the Government Code of the State of California. "Administrative Expenses" means the following actual or reasonably estimated expenses related to the administration of FD No. 2014-01: the costs of determining the amount of the levy of Special Taxes, the collection of Special Taxes, including the expenses of collecting delinquencies and pursuing foreclosures, the payment of a proportional share of salaries and benefits of any City employee and City overhead whose duties are directly related to the administration of CFD No. 2014-01, fees and expenses for counsel, audits, costs associated with responding to public inquiries regarding CFD No. 2014-01, and any and all other costs incurred in connection with the administration of CFD No. 2014-01. "Annual Escalation Factor" means the greater of five percent (5%) or the annual percentage increase, if any, of the All Urban Consumers Consumer Price Index ("CPI").

The annual CPI used shall be for the area of Los Angeles — Riverside — Orange County, CA as determined by the Bureau of Labor Statistics for the twelve (12) months ending the preceding December 31.
"Assessor's Parcel" means a Condominium lot, Lot, or parcel shown in an Assessor's Parcel Map with an assigned assessor's parcel number.
"Assessor's Parcel Map" means an official map of the Assessor of the County designating parcels by assessor's parcel number.
"Base Year" means Fiscal Year beginning July 1, 2014 and ending June 30, 2015.

WI LLDAN
Financial Services
1 CFD No. 2014-01
ATTACHMENT 2

EXHIBIT B

"Boundary Map" means the map of the boundaries of CFD No. 2014-01 recorded on January 21, 2014 in the Orange County Recorder's Office in Book 94, Pages 46, of Maps of Assessments and Community Facilities Districts (instrument number 2014-24969), as the same may be amended by annexation from time to time hereafter. "Building Permit" means a permit issued for new construction of a residential dwelling. For purposes of this definition, "Building Permit" shall not include permits for construction or installation of retaining walls, grading, utility improvements, or other such improvements not intended for human habitation.
"CFD Administrator" means an official of the City, or designee thereof, responsible for determining the Special Tax Requirement for Services and providing for the levy and collection of the Special Taxes for CFD No. 2014-01.
"CFD No. 2014-01" means City of Placentia Community Facilities District No. 2014-01 (Public Services) established by the City Council under the Act. "City" means the City of Placentia.
"City Council" means the Council of the city of Placentia, acting as the legislative body of CFD No. 2014-01.
"Condominium" means an estate in real property consisting of an undivided interest in common in a portion of a parcel of real property together with a separate interest in space in a residential, industrial or commercial building on such real property, such as an apartment, office or store. A condominium may include in addition a separate interest in other portions of such real property. Such estate may, with respect to the duration of its enjoyment, be either:
(1) An estate of inheritance or perpetual estate;
(2) An estate for life; or
(3) An estate for years, such as a leasehold or a sublease hold. "County" means the County of Orange.
"Developed Property" means an Assessor's Parcel of Taxable Property for which a Building Permit was issued on or before June 1 preceding the Fiscal Year for which Special Taxes are being levied.
"Developed Residential Property" means an Assessor's Parcel of Taxable Property for which a Building Permit was issued on or before June 1 preceding the Fiscal Year for which Special Taxes are being levied and which Building Permit was issued for purposes of constructing one or more Residential Unit(s).
"Exempt Property" means all Assessor's Parcels within CFD No. 2014-01 that are exempt from the Special Taxes pursuant to law or Section F herein. "Final Map" means an Assessor's Parcel Map, a Final Subdivision Map, condominium plan, lot line adjustment, or any other map functionally considered to be an equivalent development map that has been recorded in the Office of the County Recorder. "Final Subdivision Map" means a subdivision of property creating single family residential buildable Lots by recordation of a final subdivision map or parcel map pursuant to the Subdivision Map Act (California Government Code § 66410, et seq.), or recordation of a condominium plan pursuant to California Civil Code § 1352, that creates individual Lots or condominium lots for which building permits may be issued without further subdivision and is recorded prior to June 1 preceding the Fiscal Year in which the Special Tax is being levied. "Fiscal Year" means the period commencing on July 1 of any year and ending the following June 30.

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"Future Annexation Area" means the areas designated for potential future annexation to CFD No. 2014-01 as shown in the "Map of Proposed Boundaries of City of Placentia Future Annexation Area of Community Facilities District No. 2014-01 (Public Services)" recorded and on file with the Orange County Recorder's Office.
"Land Use Type" means any of the land use types listed in Table 1 below. "Lot" means property within a Final Map identified by a lot number or condominium number for which a Building Permit has been issued or may be issued. "Maximum Special Tax" means the maximum Special Tax determined in accordance with Section C, which may be levied in any Fiscal Year on an Assessor's Parcel of Taxable Property. "Multi -Family Residential Property" or "MFR Property" means all Assessor's Parcels of Developed Property for which a Building Permit has been issued for purposes of constructing a residential structure consisting of five (5) or more residential units that share common walls, including, but not limited to, condominiums, and apartment units. "Property Owner Association Property" means for each Fiscal Year any property within the boundaries of CFD 2014-01 that was owned by, or irrevocably dedicated as indicated in an instrument recorded with the County Recorder to, a property owner association, including any master or sub -association, as of June 1.
"Proportionately" means in a manner such that the ratio of the actual Special Tax levy to the Maximum Special Tax is equal for all Assessor's Parcels within each Land Use Type. "Public Property" means any property that is owned by, dedicated or irrevocably dedicated to a city, the federal government, the State of California, the County, or any other public agency (each, a "Public Entity"); provided, however, that if any such property is leased by such a Public Entity to a private entity and is thereby subject to taxation pursuant to § 53340.1 of the Act, such leasehold estate shall be classified and taxed according to the use thereof. "Residential Property" means all Assessor's Parcels of Developed Property within CFD No. 2014-01 for which a Building Permit has been issued for purposes of constructing one or more Residential Unit(s).
"Residential Unit" means any residence in which a person or persons may live, which is not considered to be used for non-residential purposes.
"Services" means those authorized services that may be funded by CFD No. 2014-01 pursuant to the Act, as amended, including, without limitation, those services authorized to be funded by CFD No. 2014-01 as set forth in the documents adopted by the City Council at the time CFD No. 2014-01 was formed.
"Single -Family Residential Property" or "SFR Property" means an Assessor's Parcel classified as Developed Property for which a Building Permit(s) has been issued for purposes of constructing one or more single-family residential dwelling units including residential structures or Condominium structures that consist of 4 or fewer units which share common walls. "Special Tax" means the special tax authorized to be levied within CFD No. 2014-01 pursuant to the Act to fund the Special Tax Requirement.
"Special Tax Requirement" means the amount, as determined by the CFD Administrator, for any Fiscal Year to: (i) pay the costs of providing the Services during such Fiscal Year, (ii) pay Administrative Expenses associated with the Special Tax, (iii) establish or replenish any operational reserve fund established for Services, (iv) pay incidental expenses related to the Services as authorized pursuant to the Act, (v) fund an amount equal to a reasonable estimate Ww1 LLDAN !
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of delinquencies expected to occur in the Fiscal Year in which the Special Tax will be levied ("Estimated Special Tax Delinquency Amount") and (vi) fund the shortfall, if any, in the Special Tax revenues collected in the preceding Fiscal Year necessary to fund the Special Tax Requirement for Services for such Fiscal Year where such shortfall resulted from delinquencies in the payment of Special Taxes in such Fiscal Year that exceeded the Estimated Special Tax Delinquency Amount included in the Special Tax Requirement for Services for such Fiscal Year.
"Taxable Property" means all Assessor's Parcels that are not exempt from the Special Tax pursuant to law or Section F.
"Undeveloped Property" means an Assessor's Parcel of Taxable Property for which a Building Permit has not been issued on or before June 1 preceding the Fiscal Year for which Special Taxes are being levied.

B. CLASSIFICATION OF ASSESSOR'S PARCELS
Each Fiscal Year, beginning with Fiscal Year 2014-2015, using the definitions above, each Assessor's Parcel within CFD 2014-01 shall be classified by the CFD Administrator as Taxable Property or Exempt Property. In addition, each such Fiscal Year, each Assessor's Parcel of Taxable Property shall be further classified by the CFD Administrator as Developed Property or Undeveloped Property. Developed Property shall be further classified as Single -Family Residential Property or Multi -Family Residential Property. Commencing with Fiscal Year 2014-2015 and for each subsequent Fiscal Year, Developed Residential Property shall be subject to the levy of Special Taxes pursuant to Section C below.

C. MAXIMUM ANNUAL SPECIAL TAXES

1. Developed Residential Property
Each Fiscal Year commencing in Fiscal Year 2014-2015, each Assessor's Parcel of Developed Residential Property shall be subject to the Special Tax. The Maximum Special Tax for Developed Residential Property for Fiscal Year 2014-2015 is shown below in Table

1. TABLE 1

DEVELOPED RESIDENTIAL PROPERTY

MAXIMUM SPECIAL TAX RATES
Land Use Type
Maximum
Special Tax
Residential
SFR Property
$225 per Residential Unit
MFR Property
$170 per Residential Unit
For each subsequent Fiscal Year following the Base Year, the Maximum Special Tax rate shall be increased from the Maximum Special Tax rate in effect for the prior Fiscal Year by the Annual Escalation Factor.

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2. Annexed Property
Each Fiscal Year commencing in Fiscal Year 2014-2015, each Assessor's Parcel of Developed Residential Property that has been annexed into CFD 2014-01 shall be subject to the prevailing Special Tax in effect during the then current Fiscal Year and as determined by Section C.1 above.

3. Undeveloped Property
Each Fiscal Year commencing in Fiscal Year 2014-2015, each Assessor's Parcel classified as Undeveloped Property shall be exempt from the levy of the Special Tax

4. Exempt Property
No Special Tax shall be levied on Exempt Property as defined in Section F.

For each Fiscal Year, if the use or ownership of an Assessor's Parcel or Exempt Property changes so that such Assessor's Parcel is no longer classified as one of the uses set forth in Section F, therefore making such Assessor's Parcel no longer eligible to be classified as Exempt Property, such Assessor's Parcel shall be deemed to be Taxable Property and shall be taxed pursuant to the provisions of Section C.

D. METHOD OF APPORTIONMENT OF SPECIAL TAX
Commencing in Fiscal Year 2014-2015 and for each subsequent Fiscal Year, the CFD Administrator shall levy the Special Tax on all Taxable Property of CFD No. 2014-01 until the total amount of Special Tax levied equals the Special Tax Requirement. The Special Tax shall be levied Proportionately on each Assessor's Parcel of Developed Property within CFD No. 2014-01 up to 100% of the applicable Maximum Special Tax to satisfy the Special Tax Requirement.

Notwithstanding any provision of this Section D to the contrary, under no circumstances will the Special Tax levied against any Assessor's Parcel of Developed Property that is classified as Residential Property be increased by more than ten percent (10%) per Fiscal Year as a consequence of delinquency or default in the payment of Special Taxes by the owner of any other Assessor's Parcel, excluding therefrom the increased amount levied pursuant to the Annual Escalation Factor.

E. PREPAYMENT OF SPECIAL TAX
The Special Tax shall be levied in perpetuity for the purpose of financing ongoing authorized services and therefore may not be prepaid.

F. EXEMPTIONS
The City Council shall classify as Exempt Property: (i) Public Property, (ii) Property Owner Association Property, (iii)Assessor's Parcels with public or utility easements making impractical their utilization for other than the purposes set forth in the easement, including but not limited to property designated for open space, trails, pathways, parks or park and recreation related facilities, (iv) property reasonably designated by the City or CFD Administrator as Exempt Property due to deed restrictions, conservation easement, or similar factors.

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G. APPEALS
Any property owner claiming that the amount or application of the Special Tax is not correct may file a written notice of appeal with the CFD Administrator not later than twelve months after having paid the first installment of the Special Tax that is disputed. The CFD Administrator shall promptly review the appeal, and if necessary, meet with the property owner, consider written and oral evidence regarding the amount of the Special Tax, and rule on the appeal. If the decision of the CFD Administrator requires that the Special Tax for an Assessor's Parcel be modified or changed in favor of the property owner, a cash refund shall not be made but an adjustment shall be made to the Special Tax on that Assessor's Parcel in the subsequent Fiscal Year(s) to compensate for the overpayment of the Special Tax.

H. MANNER OF COLLECTION
The annual Special Taxes shall be collected in the same manner and at the same time as ordinary ad valorem property taxes, provided, however, that the Special Taxes may be billed and collected at a different time or in a different manner if necessary to meet the financial obligations of CFD No. 2014-01.
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•
6 CFD No. 2014-01
ATTACHMENT 2

RATE AND METHOD OF APPORTIONMENT OF

SPECIAL TAX

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EXHIBIT B

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C. MAXIMUM ANNUAL SPECIAL TAXES

1. TABLE 1

DEVELOPED RESIDENTIAL PROPERTY

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3. Undeveloped Property
Each Fiscal Year commencing in Fiscal Year 2014-2015, each Assessor's Parcel classified as Undeveloped Property shall be exempt from the levy of the Special Tax

4. Exempt Property
No Special Tax shall be levied on Exempt Property as defined in Section F.

E. PREPAYMENT OF SPECIAL TAX
The Special Tax shall be levied in perpetuity for the purpose of financing ongoing authorized services and therefore may not be prepaid.

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ATTACHMENT 2

TO:

VIA:

FROM:

DATE:

SUBJECT:

Placentia City Council

AGENDA REPORT

CITY COUNCIL

CITY ADMINISTRATOR

DEPUTY CITY ADMINISTRATOR / PUBLIC SERVICES & INFRASTRUCTURE MAY 16, 2023
SETTING OF THE ANNUAL SPECIAL TAX RATE FOR FISCAL YEAR 2023-24 FOR COMMUNITY FACILITIES DISTRICT NO. 2018-01 (TOD CFD) AND

DECLARING THE INTENTION TO ALLOW FOR FUTURE ANNEXATIONS TO COMMUNITY FACILITIES DISTRICT NO. 2018-01
FISCAL
IMPACT: REVENUE: $31,448.05 (800000-4505)
SUMMARY:

On April 20, 2018, the City Council adopted Resolution No. R-2018-08, establishing Community Facilities District ("CFD") 2018-01 within the City's Transit Oriented District ("TOD") to provide a non -General Fund and sustainable funding source to pay for the ongoing maintenance and repairs of the public streetscape improvements constructed within the TOD. At that time, the City Council also, in the adoption of the territory map, approved the area designated as future annexation to the CFD. Staff recommends that the City Council adopt a resolution to levy a special tax to pay for maintenance services in the TOD for Fiscal Year (FY) 2023-24 (Attachment 1), adopt a resolution declaring its intention to annex territory to the CFD and set a public hearing on June 20, 2023 (Attachment 2).

RECOMMENDATION
It is recommended that the City Council take the following action:

1. Adopt Resolution No. R-2023-30, a Resolution of the City Council of the City of Placentia, California, setting the levy of an annual special tax for Community Facilities District No. 2018-01 (TOD Maintenance Services); and

2. Adopt Resolution No. R-2023-31, a Resolution of the City Council of the City of Placentia, California, declaring its intention to allow for future annexations of territory to Community Facilities District No. 2018-01 (TOD Maintenance Services); and

3. Authorize inclusion of the Annual Special Tax for Community Facilities District No. 2018-01 (TOD Maintenance Services) for Fiscal Year 2023-24 on the Orange County Secured Property Tax Roll.

1.d.

May 16, 2023

City Council Agenda
May 16, 2023

Page 2 of 4 ends

STRATEGIC PLAN STATEMENT:

There is no specific Strategic Plan Goal or Objective associated with this Council action.

DISCUSSION:

In 1978, California voters enacted Proposition 13, which limited the ability of local public agencies to increase property taxes based upon a property's assessed value. In 1982, the Mello -Roos Community Facilities Act of 1982 ("Act") was created to provide an alternate method of financing public infrastructure and services. Under the Act, a Community Facilities District ("CFD") may fund public improvements with a useful life of five (5) years or more, such as park and recreational facilities, streets, sewer systems, schools, libraries, childcare facilities, and other public infrastructure. CFDs may also fund the maintenance and servicing of public landscape areas, parks, streetlights, storm drain systems, and public safety services.

In 2018, the City Council created a new CFD to assist in the financing of maintenance and repairs of the new public amenities constructed within the TOD which includes street and pedestrian lighting, landscaping, storm water basins, and pedestrian amenities. All TOD developers are required to annex their properties into the District as a condition of approval for receiving their entitlements. Each fiscal year, the City determines the special tax requirement and associated annual special tax rates for the CFD based upon maintenance and servicing costs within the Project. The special tax is levied and collected in perpetuity, unless and until such time the City determines that the revenue is no longer needed.

The special taxes within the CFD will be levied according to formulas and provisions of the Rate and Method of Apportionment of Special Tax (the "RMA") cointained within the Special Tax Report ("Report") prepared for the formation of the TOD CFD. The Report describes the services to be funded by the CFD; and provides an estimate of the fair and reasonable cost of the Services and incidental expenses for the CFD. In addition, the Report specificed the tax rate needed to support services in the TOD by land use classificiaton. The RMA Report for CFD 2018-01 only allows for taxing developed property and developed property is defined as property that has received a Certificate of Occupancy issued prior to May 1 of the preceding fiscal year. The tax rate needed to support maintenance services within the TOD was established at the base rates summarized in the table below:

Table 1: Base Tax Rate for CFD 2018-01 TOD
Land Use Classification
Base Year Maximum Rate
Developed Single Family Detached Property
$138 per residential unit
Developed Single Family Attached Property
$112 per residential unit
Developed Multi -Family Property
$127 Der residential unit
Developed Retail/Other Property
$0.09 per scuare foot of building area
Developed Office Property
$0.13 per square foot of building area
Developed Industrial Property
$0.06 per scuare foot of building area
Undeveloped Property
$0.00
Tax -Exempt Property
$0.00

City Council Agenda
May 16, 2023

Page 3 of 4 ends

The CFD is subject to an Annual Escalation Factor beginning on July 1, 2019, which shall be the greater of three percent (3%) or the annual percentage increase, if any, of the CPI for the 12 months ending the preceding December 31. The index identified in the RMA was the All -Urban Consumers ("CPI -U") for the Los Angeles -Long Beach -Anaheim area. The CPI for the 12 months ending the preceding December 31, 2022, was 4.9%. Therefore, the special tax rates are being increased by 4.9% as allowed and summarize in the table below:

Table 3: FY 23-24 Tax Rate for CFD 2018-01(TOD)
Land Use Classification
FY 23-24 Assessment Tax Rate
Developed Single Family Detached ProDerty
$158.94 per residential unit
Developed Single Family Attached ProDerty
$129.00 per residential unit
Developed Multi -Family Property
$146.27 per residential unit
Developed Retail/Other Property
$0.103 Der sc uare foot of building area
Developed Office Property
$0.149 per square foot of building area
Developed Industrial Property
$0.069 per scuare foot of building area
Undeveloped Property
$0.00
Tax -Exempt Property
$0.00
Currently, the CFD has one annexation to date. In 2017, the City Council approved the land entitlements for the Integral/Lyon Living Project, also known as "The Herald," along with a Development Agreement. The Agreement required Integral/Lyon Living to be the first project to create and annex itself into the new District. This project has been completed and received its Certificate of Occupancy in Fall 2021 and accordingly, this property was levied for the first time in Fiscal Year ("FY") 2022-23 at the rate for a Developed Multi -Family Property. The second property proposed for annexation to the CFD is the JPI development at 505 W. Crowther Avenue. This project is currently under construction. The JPI development will need to be annexed to the CFD prior to receiving a Certificate of Occupancy.

However, to allow for a more streamlined procedure in the annexation to the CFD, the City Council will need to declare its intention to allow for future annexation of territory to the CFD and establish those procedures. In the adoption of the CFD, the City Council approved the boundaries of the CFD, which included and specifically designated area for future annexation. Since the future annexation to the CFD was contemplated and approved by the City Council with the formation of the CFD, the attached Resolution establishes the annexation procedures (Attachment 2). This Resolution also establishes a date for a public hearing on the annexation action, and for an election among the authorized electors. The public hearing date by statute must be within 30-60 days following the adoption of the Resolution of Intention. Upon City Council approval, a public hearing on the annexation will be scheduled for June 20, 2023. Since there are less than twelve (12) registered voters in the territory proposed to be annexed, the election will be a landowner vote. Pursuant to waiver of election time limits from the landowner, a ballot will be mailed in advance of the public hearing. At the close of the public hearing, an election of the qualified electors (landowners in the District) will be held to determine if the electors approve the annexation to the District and the levy of the special tax.

City Council Agenda
May 16, 2023

Page 4 of 4 ends

FISCAL IMPACT:

The anticipated revenue from these assessments in FY 2023-24 is $31,448,05. The addition of the new annexation into the special tax district will generate future new revenue as summarized in the following table.

Development
Number of Units
Annual Unit Rate
Total Annual
Revenue
JPI/Cenza
418
$146.27
$61,140.86
Prepared by:
,sa IbtiitA,sotA,
Elsa Y. Robinson
Reviewed and approved:

Jennifer Lampman
Senior Management Analyst Director of Finance
Reviewed and approved: Reviewed and approved:
(,uas `Lsf
Luis Estevez Damien R. Arrula
Deputy City Administrator City Administrator
Attachments:

1. Resolution No. R-2023-30 — Annual Levy of for CFD 2018-01

2. Resolution No. R-2023-31 — Intention to Annex Territory to CFD 2018-01

3. Rate and Method of Apportionment for CFD 2018-01

RESOLUTION NO. R-2023-30

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF

PLACENTIA, CALIFORNIA, SETTING THE LEVY OF AN

ANNUAL SPECIAL TAX FOR COMMUNITY FACILITIES
DISTRICT NO. 2018-01 (TOD MAINTENANCE SERVICES) FOR
FY 2023-24.

A. Recitals.
(i) The City Council of the City of Placentia ("City Council"), has initiated proceedings, held a public hearing, conducted an election and received a favorable vote from the qualified electors to authorize the levy of a special tax in a community facilities district, all as authorized pursuant to the terms and provisions of the "Mello -Roos Community Facilities Act of 1982", being Chapter 2.5, Part 1, Division 2, Title 5 of the California Government Code ("Act") denominated COMMUNITY FACILITIES DISTRICT NO. 2018-01 (TOD Maintenance Services) ("District").
(ii) The City Council, by adoption of Ordinance No. 2018-01 ("Ordinance") as authorized by § 53340 of the California Government Code, has authorized the levy of special taxes within the District to finance the authorized service in accordance with the Rate and Method of Apportionment of the Special Tax ("RMA") set forth in Exhibit "B" to the Resolution of Formation, which is on file in the office of the City Clerk and incorporated by reference herein.
(iii) California Government Code § 53340 provides that the City Council may provide, by resolution, for the levy of the special tax in the current tax year or future tax years at the same rate or at a lower rate than the rate provided by the Ordinance, if the resolution is adopted and a certified list of all parcels subject to the special tax levy including the amount of the tax to be levied on each parcel for the applicable tax year, is filed by the Clerk or other official designated by the legislative body with the county auditor on or before the 10th day of August of that tax year.
(iv) The RMA provides for an annual escalation factor of the greater of three percent (3%) or the annual percentage increase, if any, of the All Urban Consumers Consumer Price Index ("CPI") for the Los Angeles — Riverside — Orange County, CA area as determined by the Bureau of Labor Statistics for the twelve (12) months ending the preceding December 31.
(v) The All Urban Consumers Consumer Price Index ("CPI") for the Los Angeles — Long Beach -Anaheim, CA area (part of the former Los Angeles -Riverside -Orange County, CA area) as determined by the Bureau of Labor Statistics for the twelve (12) months ending the preceding December 31 was 4.9%.

Resolution R-2023-30 ATTACHMENT 1

Page 1 of 3 ends

B. Resolution.

NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF PLACENTIA DOES HEREBY FIND, DETERMINE AND RESOLVE AS FOLLOWS:

1. The facts set forth in the Recitals, Part A of this Resolution, are true and correct.

2. This City Council does hereby find and determine as follows:

A. The annual escalation for FY 2023-24 shall be 4.9%.

B. The City Council hereby levies a special tax within the District for Fiscal Year 2023-24 at the rate of $158.95 per residential unit for single-family residential detached property, $129.00 per residential unit for single-family residential attached property, $146.28 per residential unit for multi -family residential property, $0.104 per square foot of retail building area, $0.149 per square foot of office building area and $0.069 per square foot of industrial building area.

E. The County Auditor is hereby directed to enter in the next County assessment roll on which taxes will become due, opposite each lot or parcel of land affected, in a space marked "TOD Maintenance Services Special Tax" or by any other suitable designation, the installment of the special tax.

G. This Resolution shall become effective upon its adoption.

Resolution R-2023-30 ATTACHMENT 1

Page 2 of 3 ends

ADOPTED AND APPROVED this 16th day of May 2023.

Ward L. Smith, Mayor
ATTEST:

AYES:

NOES:

ABSENT:

ABSTAIN:

Councilmembers:

Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:

Christian L. Bettenhausen, City Attorney
Resolution R-2023-30 ATTACHMENT 1

Page 3 of 3 ends

RESOLUTION NO. R-2023-31

A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF

PLACENTIA, CALIFORNIA, DECLARING ITS INTENTION TO

ALLOW FOR FUTURE ANNEXATIONS OF TERRITORY TO
COMMUNITY FACILITIES DISTRICT 2018-01 (TOD
MAINTENANCE SERVICES).

A. Recitals.
(i) The City Council of the City of Placentia ("City Council"), initiated proceedings, held a public hearing, conducted an election and received a favorable vote from the qualified electors to authorize the levy of a special tax in a community facilities district, all as authorized pursuant to the terms and provisions of the "Mello -Roos Community Facilities Act of 1982", being Chapter 2.5, Part 1, Division 2, Title 5 of the California Government Code ("Act") denominated COMMUNITY FACILITIES DISTRICT NO. 2018- 01 (TOD Maintenance Services) ("District"), Resolution No. 2018-18. (ii) The City Council desires to provide for the authorization to annex territory in the future to the District.
(iii) The City Council has determined it to be within the public interest and convenience to establish a procedure to allow and provide for future annexations to the District. That in the formation of the District, the City Council had designated the territory subject to future annexation area on the Map of Proposed Boundaries of the Community Facilities District No. 2018-01 ("Map"), which Map and future annexation areas, was approved at a public hearing as part of the proceedings for the formation of the District. (iv) The territory proposed to be annexed in the future shall be known as "City of Placentia Community Facilities District No. 2018-01 (TOD Maintenance Services) (Future Annexation Area)" (the "Future Annexation Area"), and the Map showing the territory proposed to be annexed in the future will be submitted and approved as part of these proceedings and a copy thereof shall be kept on file with the transcript of these proceedings.
(v) In connection with the development of property in the District, and which property is within the Future Annexation Area, the City Council has received a petition ("Petition") signed by the landowners requesting the institution of proceedings for annexation to the District.
(vi) The City Council has determined that the Petition complies with the requirements of California Government Code § 53318 and now intends to annex the property to the District.

Resolution R-2023-31 ATTACHMENT 2

Page 1 of 5 ends

B. Resolution.

NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF PLACENTIA DOES HEREBY FIND, DETERMINE AND RESOLVE AS FOLLOWS:

1. The facts set forth in the Recitals, Part A of this Resolution, are true and correct and incorporated herein by reference.

2. These proceedings for future annexation of territory to the District are authorized and initiated by the legislative body pursuant to the authorization of California Government Code § 53339.2.

3. The City Council hereby determines that the public convenience and necessity requires and this City Council further declares its intention to provide for the establishment of a procedure to allow and authorize territory to be annexed in the future to the District in in order to finance the costs and expenses for the authorized public services.

4. The name of the District is the "Community Facilities District No. 2018-01 (TOD Maintenance Services)," and the designation for the Future Annexation Area shall be "City of Placentia Community Facilities District No. 2018-01 (TOD Maintenance Services) (Future Annexation Area)."

5. The Future Annexation Area is delineated on the Map, which Map was adopted by the City Council with the formation of the District. A copy of said Map is on file in the Office of the City Clerk and shall remain open for public inspection. The boundaries of the property within the Future Annexation Area proposed to be annexed to the District are described in Exhibit "A" attached hereto ("Property") and upon the annexation to the District said Property shall be subject to taxation by the District and subject to all the terms and requirements set out in this resolution.

6. The services proposed to be provided and financed by the District for the Future Annexation Area and Property are the same types of services described in Exhibit "A" attached to the formation of the District Resolution No. 2018-18. The services are in addition to those provided in or required for the territory within the District and will not be replacing services already available. The same type of services which are authorized to be financed by the District are the types of services to be provided to the Future Annexation Area and Property. If, and to the extent possible, such services shall be provided in common with the District.

7. Except where funds are otherwise available, it is the intention of the City Council to levy annually in accordance with procedures contained in the Act, a special tax within the boundaries of the Future Annexation Area and the Property, secured by recordation of a continuing lien against all nonexempt real property in such Future Annexation Area and Property, sufficient to pay for the services and incidental expenses.

The rate and method of apportionment and manner of collection of the special tax within the boundaries of the Future Annexation Area is described in detail in Exhibit "B," Rate Resolution R-2023-31 ATTACHMENT 2

Page 2 of 5 ends

and Method of Apportionment ("RMA"), in the District formation Resolution No. 2018-18.

The RMA allows each landowner within the proposed Future Annexation Area to estimate the maximum amount that may be levied against each parcel. In the first year in which such special tax is levied, the levy shall include an amount sufficient to repay the District all amounts if any, transferred to the District pursuant to § 53314 of the Act and interest thereon.

The special tax proposed to be levied within the Future Annexation Area for services to be supplied within the Future Annexation Area shall be equal to the special tax levied to pay for the same services in the District, except that a higher or lower special tax may be levied within the Future Annexation Area to the extent that the actual cost of providing the services in the Future Annexation Area is higher or lower than the cost of providing those services in the District. Notwithstanding the foregoing, the special tax may not be levied at a rate which is higher than the maximum special tax authorized to be levied pursuant to the RMA.

The special taxes herein authorized, to the extent possible, shall be collected in the same manner as ad valorem property taxes and shall be subject to the same penalties, procedure, sale and lien priority in any case of delinquency as applicable for ad valorem taxes. Any special taxes that may not be collected on the County tax roll shall be collected through a direct billing procedure by the Treasurer.

The maximum special tax rate in the District shall not be increased as a result of the annexation of the Future Annexation Area and Property to the District.

8. Annexation of territory in the future shall be effective upon the unanimous approval of such annexation by the owner or owners of any such parcel at the time the parcel is annexed and the vote by the qualified electors of such territory to authorize the levy of special taxes within such territory pursuant to the applicable RMA, and no further public hearings or additional proceedings will be required to accomplish such annexation.

9. A public hearing ("Hearing") on the annexation of the Property to District, the proposed rate and method of apportionment of the special tax and Incidental Expenses shall be held on June 20, 2023, at 7 :00 o' clock p. m., or as soon thereafter as the matter may be heard, at the chambers of the City Council of the City of Placentia, 401 E. Chapman Avenue, Placentia, California 92870. Should the City Council determine to annex the Property to the District, immediately thereafter, a special election will be held within the District to authorize the levy of the special tax in accordance with the procedures contained in California Government Code § 53326. If held, the proposed voting procedure at the elections will be a landowner vote with each landowner who is the owner of record of land subject to annexation to the District at the close of the Hearing, or the authorized representative thereof, having one vote for each acre or portion thereof owned within the Annexation. Ballots for the special elections may be distributed by mail or by personal service prior to the Hearing.

Resolution R-2023-31 ATTACHMENT 2

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10. At the time and place set forth above for the Hearing, any interested person, including all persons owning lands or registered to vote within the proposed Future Annexation Area, may appear and be heard.

11. The City Clerk is hereby directed to publish a notice ("Notice") of the Hearing pursuant to California Government Code § 6061 in a newspaper of general circulation published in the area of the proposed District. Such Notice shall contain the text of this Resolution, state the time and place of the Hearing, a statement that the testimony of all interested persons or taxpayers will be heard, a description of the protest rights of the registered voters and landowners in the proposed Annexation as provided in § 53324 of the Act and a description of the proposed voting procedure for the election required by the Act. Such publication shall be completed at least seven (7) days prior to the date of the Hearing.

ADOPTED AND APPROVED this 16th day of May 2023.

Ward L. Smith, Mayor
ATTEST:

AYES:

NOES:

ABSENT:

ABSTAIN:

Councilmembers:

Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:

Christian L. Bettenhausen, City Attorney
Resolution R-2023-31 ATTACHMENT 2

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EXHIBIT "A"

ANNEXATION PROPERTY BOUNDARIES
Resolution R-2023-31 ATTACHMENT 2

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EXHIBIT D - RATE AND METHOD OF APPORTIONMENT OF SPECIAL TAX

CITY OF PLACENTIA
Community Facilities District No. 2018-01
(TOD Area Maintenance)
A Special Tax authorized under the Mello -Roos Community Facilities Act of 1982 applicable to the land in the Community Facilities District No. 2018-01 (the "CFD") of the City of Placentia (the "City") shall be levied and collected according to the tax liability determined by the City through the application of the appropriate amount or rate described herein.

A. DEFINITIONS
"Acre" means each acre of the land area making up an Assessor's Parcel as shown on an Assessor's Parcel Map, or if the land area is not shown on an Assessor's Parcel Map, the land area shown on the applicable Final Map or other recorded County parcel map.
"Act" means the Mello -Roos Community Facilities Act of 1982, as amended, being Chapter 2.5, Division 2 of Title 5 of the Government Code of the State of California. "Administrative Expenses" means the actual or estimated costs incurred by the City to determine, levy and collect the Special Taxes, including the proportionate amount of the salaries and benefits of City employees whose duties are directly related to administration of the CFD and the fees of Special Tax levy administrator, other consultants, legal counsel, the costs of collecting installments of the Special Taxes upon the County tax rolls and any other incidental costs authorized by the Act. "Annexation Parcel" means any Parcel that is annexed to the CFD after it is formed. "Annual Escalation Factor" means an amount equal to the percentage increase during the preceding year in the Consumer Price Index for All Urban Consumers in the Los Angeles -Riverside -Orange County metropolitan area (CPI -U), as published by the U.S. Department of Labor, Bureau of Labor Statistics, (or if this index ceases publication, an equivalent index ), or 3 percent, whichever is greater. "Assessor's Parcel" or "Parcel" means a lot or parcel shown on an Assessor's Parcel Map with an assigned Assessor's Parcel number.
"Assessor's Parcel Number" means, with respect to an Assessor's Parcel, that number assigned to such Assessor's Parcel by the County for purposes of identification.

CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT No. 2018-01 (TOD AREA MAINTENANCE)

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"Annual Special Tax" means the annual Special Tax, determined in accordance with Section D below to be levied in the CFD in any Fiscal Year on any Assessor's Parcel. "Base Year" means the Fiscal Year ending June 30, 2019. "Certificate of Occupancy" means a permit issued by the City authorizing the occupancy of a new Residential Unit or new Nonresidential Building Area. "CFD Administrator" means an official of the City, or designee thereof, responsible for determining and providing for the levy and collection of the Special Tax. "CFD" or "CFD No. 2018-01" means Community Facilities District No. 2018-01 (TOD Area Maintenance) of the City of Placentia.
"City" means the City of Placentia.
"Council" means the City Council of the City of Placentia, acting as the legislative body of the City and the CFD.
"County" means the County of Orange, California.
"County Assessor" means the Orange County Assessor.
"Developed Property" means, in any Fiscal Year, all Taxable Property for which a Certificate of Occupancy has been issued after December 31, 2017 and prior to May 1 of the preceding Fiscal Year. These Assessor's Parcels can be classified into one of following groups: Single Family Detached, Single Family Attached, Multi -Family Residential, Retail/Other, Office, and Industrial.
"Existing Developed Property" means Residential Units and Nonresidential Building Area for which a building permit has been issued prior to January 1, 2018. "Fiscal Year" means the period starting July 1 and ending the following June 30. "Future Annexation Area" means the territory designated for potential future annexation to the CFD as shown in the "Map of Proposed Boundaries of the Community Facilities District No. 2018-01."
"Industrial Property" means all Assessor Parcels of Developed Property for which a Certificate of Occupancy has been issued after December 31, 2017 and prior to May 1 of the preceding Fiscal Year for manufacturing construction. "Land Use Classification" means any of the classes listed in Section B(1).

CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT No. 2018-01 (TOD AREA MAINTENANCE)

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"Maximum Special Tax" means the greatest amount of Special Tax, determined in accordance with Sections B and C below that can be levied in the CFD in any Fiscal Year on any Assessor's Parcel.
"Multi -Family Residential Property" means all Assessor Parcels of Developed Property for which a Certificate of Occupancy has been issued for construction of a structure with more than one Residential Unit after December 31, 2017 and prior to May 1 of the preceding Fiscal Year. This category includes but is not limited to apartment buildings, duplexes, triplexes, fourplexes, and condominiums. "Nonresidential Building Area" means the "chargeable covered and enclosed space" as defined by California Government Code section 65995(b)(2) to be constructed on Retail/Other Property, Office Property and Industrial Property. "Office Property" means all Assessor Parcels of Developed Property for which a Certificate of Occupancy has been issued after December 31, 2017 and prior to May 1 of the preceding Fiscal Year for general, professional and medical office construction. "Public Property" means any property within the boundaries of the CFD that is either (i) owned by the federal government, the State of California, the County, another public agency, or a private nonprofit organization that owns and is responsible for conservation of open space areas or (ii) encumbered by an easement owned by any such public agency or private organization which easement makes the development of such property impractical. Notwithstanding the foregoing, a leasehold or other possessory interest in any such property which is subject to taxation pursuant to Section 53340.1 of the Act shall not constitute "Public Property." "Residential Unit" means each separate residential dwelling unit on an Assessor's Parcel that comprises an independent facility capable of conveyance or rental as distinct from adjacent residential dwelling units. An accessory residential dwelling unit that shares a Parcel with a Single Family Detached Residential Unit shall not be considered as a Residential Unit for the purposes of this RMA. "Retail/Other Property" means all Assessor Parcels of Developed Property for which a Certificate of Occupancy has been issued for the retail, commercial, or other nonresidential construction after December 31, 2017 and prior to May 1 of the preceding Fiscal Year and is not Industrial Property or Office Property. "RMA" means this Rate and Method of Apportionment of Special Tax. "Services" means the services authorized to be funded by the CFD as described in the Resolution of Intention for the CFD.
"Single -Family Attached Property" means all Assessor Parcels of Developed Property for which a Certificate of Occupancy has been issued after December 31,

CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT No. 2018-01 (TOD AREA MAINTENANCE)

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2017 and prior to May 1 of the preceding Fiscal Year for construction of a residential structure consisting of two or more Residential Units that share common walls, have separate Assessor's Parcel Numbers assigned to them (except for a duplex Residential Unit which may share an Assessor's Parcel Number with another duplex Residential Unit).
"Single -Family Detached Property" means all Assessor Parcels of Developed Property for which a Certificate of Occupancy has been issued after December 31, 2017 and prior to May 1 of the preceding Fiscal Year for construction of a single-family Residential Unit that does not share a common wall with another Residential Unit. "Special Tax" means a Special Tax levied in any Fiscal Year to pay the Special Tax Requirement.
"Special Tax Requirement" means the amount required in any Fiscal Year for the CFD to 1) provide the Services; 2) pay for reasonable Administrative Expenses; 3) pay any amounts required to establish or replenish any reserve funds, and 4) cure any delinquencies in the payment of Special Taxes which have occurred in the prior Fiscal Year or pay for reasonably anticipated delinquent Special Taxes based on the delinquency rate for Special Taxes levied in the previous Fiscal Year. "State" means the State of California.
"Taxable Property" means any Assessor's Parcel that is not Tax -Exempt Property. "Tax -Exempt Property" means any Parcel within the CFD which is not Developed Property or Undeveloped Property, and includes Public Property and Existing Developed Property.
"Undeveloped Property" means any Assessor's Parcel which is not Tax -Exempt Property, and for which no Certificate of Occupancy has been approved and issued by June 30 of the previous Fiscal Year.

CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT No. 2018-01 (TOD AREA MAINTENANCE)

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B. DETERMINATION OF MAXIMUM SPECIAL TAX
The Maximum Special Tax shall be calculated as follows:

1. Classification of Parcels. Each Fiscal Year, using the Definitions above and the Parcel records of the County Assessor's Secured Tax Roll of July 1, the City shall cause each Parcel of land in the CFD to be classified as Developed Property, Undeveloped Property, or Tax -Exempt Property. The City shall cause all Developed Property to be further classified as Single Family Detached Property, Single Family Attached Property, Multi -Family Property, Retail/Other Property, Office Property and Industrial Property.

2. Assignment of Maximum Special Tax. Each Fiscal Year, the Base Year Maximum Tax shown below shall be escalated as specified in Section C, Annual Adjustment of Maximum Special Tax, to determine the Maximum Special Tax for the upcoming Fiscal Year for each Land Use Classification.

Land Use Classification
Base Year Maximum Tax
Developed Single Family Detached Property
$138 per Residential Unit
Developed Single Family Attached Property
$112 per Residential Unit
Developed Multi -Family Property
$127 per Residential Unit
Developed Retail/Other Property
$0.09 per square foot of
Nonresidential Buildinc Area
Developed Office Property
$0.13 per square foot of
Nonresidential Buildinc Area
Developed Industrial Property
$0.06 per square foot of
Nonresidential Buildinc Area
Undeveloped Property
$0
Tax -Exempt Property
$0

3. Conversion of a Tax -Exempt Property to a Taxable Property. If a Tax -Exempt Property is not needed for public use and is converted to private use, it shall become subject to the Special Tax.

4. Multiple Land Use Classifications. In some instances, an Assessor's Parcel may contain more than one Land Use Classification. The Maximum Special Tax that can be levied on an Assessor's Parcel shall be the sum of the Maximum Special Taxes that can be levied for all Land Use Classes located on that Assessor's Parcel. The CFD Administrator shall determine the allocation to each Land Use Classification.

5. Existing Developed Property. Residential Units and Nonresidential Building Area for which a building permit has been issued prior to January 1, 2018 is exempt from the Special Tax.

CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT No. 2018-01 (TOD AREA MAINTENANCE)

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6. Annexed Property. Each Assessor's Parcel of Developed Property that is annexed into the CFD shall be subject to the Special Tax in effect during the current Fiscal Year.

C. ANNUAL ADJUSTMENT OF MAXIMUM SPECIAL TAX
Beginning in January 2019 and each January thereafter, the Maximum Special Tax shall be adjusted each fiscal year in an amount equal to the percentage increase during the preceding year in the Consumer Price Index for All Urban Consumers in the Los Angeles -Riverside -Orange County metropolitan area (CPI -U), as published by the U.S. Department of Labor, Bureau of Labor Statistics, (or if this index ceases publication, an equivalent index), or three (3) percent, whichever is greater. Each annual adjustment of the Maximum Special Tax shall become effective for the following Fiscal Year.

D. DETERMINATION OF THE ANNUAL SPECIAL TAX
Commencing with the Base Year, and for each subsequent Fiscal Year, the Council shall determine the Special Tax Requirement and shall levy the Annual Special Tax on each Assessor's Parcel of Developed Property at up to one hundred percent of the applicable Maximum Special Tax to fund the Special Tax Requirement.

Under no circumstances will the Annual Special tax levied against any Assessor's Parcel of Developed Property increase by more than ten (10) percent as a consequence of delinquency or default by the owner of any other Assessor's Parcel within the CFD.

Subject to the preceding, the amount of Annual Special Tax levied upon any Developed Property and Undeveloped Property in any Fiscal Year shall not exceed the Maximum Special Tax for such Fiscal Year as computed herein.

E. DURATION OF THE SPECIAL TAX
Assessor's Parcels in the CFD shall remain subject to the Special Tax in perpetuity. If the Special Tax ceases to be levied, the City or its designee shall direct the County Recorder to record a Notice of Cessation of Special Tax. Such notice will state that the obligation to pay the Special Tax has ceased and that the lien imposed by the Notice of Special Tax Lien is extinguished.

CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT No. 2018-01 (TOD AREA MAINTENANCE)

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F. PREPAYMENT OF SPECIAL TAX
Prepayment of the Special Tax is not authorized.

G. APPEALS AND INTERPRETATION PROCEDURE
Any property owner who feels that the portion of the Special Tax levied on the subject property is in error, may file a written appeal no later than April 10 of the Fiscal Year in which the levy occurred, with the Public Works Director or his or her designee, appealing the levy of the Special Tax on the subject property. Public Works Director or his or her designee will promptly review the appeal, and, if necessary, meet with the applicant, and decide the merits of the appeal. If the findings of the Public Works Director or his or her designee verify that the Special Tax levied should be modified, the Special Tax levy for future Fiscal Years shall be corrected, and a credit against future Special Taxes shall be arranged, if applicable. Any overcharges shall be corrected solely by means of adjustments to future Special Tax levies; no cash refunds shall be made. Any dispute over the decision of the Public Works Director or his or her designee shall be referred to the Public Works Director, and the Council and the decision of the Council shall be final and binding on all parties.

Interpretation may be made by resolution of the Council for purposes of clarifying any vagueness or uncertainty as it relates to the application of the Special Tax rate, or application of the method of apportionment, or classification of properties or any definition applicable to the CFD.

H. COLLECTION OF THE SPECIAL TAX
The Special Tax shall be collected each year in the same manner and at the same time as ad valorem property taxes are collected and shall be subject to the same penalties and lien priorities in the case of delinquency as is provided for ad valorem taxes. The City shall cause the actions required above to be done for each Fiscal Year in a timely manner to assure that the schedule of the Special Taxes to be collected are received by the County Auditor for inclusion with billings for such ad valorem taxes for the applicable Fiscal Year. However, the CFD Administrator may directly bill the Special Tax, may collect Special Taxes at a different time or in a different manner if necessary to meet the financial obligations of the City or as otherwise determined appropriate by the CFD Administrator.

CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT No. 2018-01 (TOD AREA MAINTENANCE)

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CITY OF PLACENTIA
COMMUNITY FACILITIES DISTRICT No. 2018-01 (TOD AREA MAINTENANCE)

PUBLIC HEARING REPORT
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ATTACHMENT 3

TO:

VIA:

FROM:

DATE:

SUBJECT:

Placentia City Council

AGENDA REPORT

CITY COUNCIL

CITY ADMINISTRATOR

DIRECTOR OF COMMUNITY SERVICES
MAY 16, 2023

PUBLIC WORKS AGREEMENT WITH ASAD HOLDINGS LLC DBA

ORANGEBLUE GENERAL CONTRACTORS FOR THE INSTALLATION OF TILE

WALLS AT THE PLACENTIA NAVIGATION CENTER
FISCAL
IMPACT: EXPENSE: $144,500.00 CONTRACT AMOUNT (NAVIGATION CENTER FUND) BUDGETED: $150,000.00 (NAVIGATION CENTER TILE PROJECT FUND) $ 8,950.00 (NAVIGATION CENTER MAINTENANCE FUND)
SUMMARY:

The North Orange County Service Planning Area ("North SPA") received Homeless Emergency Aid Program (HEAP) funding to open Navigation Centers in the Cities of Placentia and Buena Park. The North SPA is comprised of the Cities of Brea, Buena Park, Cypress, Fullerton, La Habra, La Palma, Los Alamitos, Orange, Placentia, Villa Park, Stanton, and Yorba Linda. The Placentia Navigation Center ("Center") is one of two (2) facilities serving the North SPA. The Center, along with the other North SPA site in Buena Park, is part of a comprehensive regional solution in North Orange County that provides supportive services to individuals experiencing homelessness.

The North SPA has approved the usage of funds for the installation of tile walls at the Center. In order to improve the health and safety of the residents, the City of Placentia ("City"), released a Request for Proposal ("RFP") for the installation of the over the current wooden partition walls.

The tile project will enhance the durability and the aesthetics of the interior of the building. In addition, utilizing tile on the wooden partition walls will improve the longevity of the heavily used facility and provide for easier maintenance and cleanliness of the building.

This proposed Public Works Agreement with Asad Holdings LLC DBA Orangeblue General Contractors is to install tile walls. The scope of work includes the installation of tile walls, removal, protection, and reinstalling of the epoxy glass barriers on top of the walls. The proposed action will award a Public Works Agreement with Asad Holdings LLC DBA Orangeblue General Contractors for a not -to -exceed amount of $144,500 to complete this work.

1.e.

May 16, 2023

City Council Agenda
May 16, 2023

Page 2 of 3 ends

RECOMMENDATION:

It is recommended that the City Council take the following actions:

1. Approve a Public Works Agreement with Asad Holdings LLC DBA Orangeblue General Contractors for the installation of tile walls at the Placentia Navigation Center for a not -to - exceed amount of $144,500; and

2. Authorize the City Administrator to approve contract change orders up to 10% of the contract amount, or $14,450; and

3. Authorize the City Administrator and/or his designee to execute all necessary documents, in a form approved by the City Attorney.

DISCUSSION:

The Placentia Navigation Center (Center) has been in operation since March 2020. Since its opening, the Center has operated to near capacity every month. The Center primarily serves single men and females experiencing homelessness. As part of the operation of the Center and in alignment with Orange County's Continuum of Care (CoC), it is necessary to install additional health and safety measures within the facility to provide improved quality of living quarters.

It was determined that adding hardy backboard and tile would improve the longevity and preservation of the interior space within the building. The wooden partition walls currently serve as dividers to separate the men's and women's sleeping areas. Each individual sleeping quarter is highly utilized by residents of the Placentia Navigation Center. Due to the high use of these areas, the current wooden walls are difficult to maintain and clean based on the type of material.

The project will consist of furnishing all materials, equipment, tools, labor, and incidentals as required by the RFP. The general items of work include the installation of ceramic tiles per the instruction and the specifications outlined in the RFP. In addition to tile work, the project will include demolition work: moving/demolition, cement board work/taping: drywall, and framing work for cement board joints (adding studs): framing and rough carpentry. Due to the complexity of the project, which includes multiple trades of work; Staff has determined that the most appropriate Contractors State License should be Class B - General Building Contractor for this project.

CONTRACTOR
Proposal
Asad Holdings LLC DBA Orangeblue General Contractors
$144,500.00
At Your Service Construction & Energy Inc.
$144,960.80
Construction Masters
$147,195.88
Garza Construction Inc.
$148,039.70
Based upon the proposal provided and qualifications and experience with similar projects, Staff recommends the City Council award the Public Works Agreement to contract Asad Holdings LLC DBA Orangeblue General Contractors. In addition, Asad Holdings LLC DBA Orangeblue General Contractors has the ability to coordinate and complete the work quickly.

City Council Agenda
May 16, 2023

Page 3 of 3 ends

FISCAL IMPACT:

A total of $158,950 has been budgeted in the FY 2022-23 Navigation Center Program Budget for the installation of tile walls. As such, sufficient funds exist for the recommended actions. The following table summarizes the costs associated with the award of this contract:

Construction Contract Amount
$144,500
Construction Contingency @ 10%
$ 14,450
Total Project Cost
$158,950
Prepared by:
7G
M delinne Villapando
Management Analyst
Reviewed and approved
Jennifer Lampman
Director of Finance
Reviewed and approved:
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Karen Crocker
Director of Community Services
Reviewed and approved:

Damien R. Arrula
City Administrator
Attachment:

Public Works Agreement with Asad Holdings LLC DBA Orangeblue General Contractors

NAVIGATION CENTER TILE WALL PROJECT

CITY OF PLACENTIA

PUBLIC WORKS AGREEMENT FOR

INSTALLATION OF TILE WALL AT NAVIGATION CENTER
THIS AGREEMENT (herein "Agreement'), is made and entered into this 16 day of May, 2023 by and between the CITY OF PLACENTIA, a municipal corporation and charter city, (herein "City") and Asad Holdings LLC DBA Orangeblue General Contractors (herein "Contractor"). The parties hereto agree as follows:

WITNESSETH:

A. WHEREAS, City requires the installation of tile walls as set forth more fully in this Agreement.

B. WHEREAS, Contractor represents to City that Contractor is qualified to perform said work and has submitted a proposal to City for the same.

C. WHEREAS, City desires to have Contractor perform said services on the terms and conditions set forth herein.

D. WHEREAS, no official or employee of City has a financial interest, within the provisions of Sections 1090-1092 of the California Government Code, in the subject matter of this Agreement.

NOW, THEREFORE, for and in consideration of the mutual covenants and conditions contained herein and for good and valuable consideration, the receipt and sufficiency of which is acknowledged by both parties, City and Contractor hereby agree as follows:

1.0 DEFINITIONS

1.1 Definitions. As used in this Agreement, the following definitions shall be applicable:
(a) Contractor. Contractor shall mean Asad Holdings LLC DBA Orangeblue General Contractors a (California corporation, partnership, individual) located at 27071 Cabot Rd, Ste 108, Laguna Hills, CA 92653. (b) City. City shall mean the City of Placentia, a Municipal Corporation and Charter City, located at 401 E. Chapman, Placentia, California 92870.
(c) City Council. City Council shall mean the City Council of the City of Placentia.
(d) Contract Officer shall mean the person designated by the City Administrator or City Engineer of City and shall have the duties set forth in Section 5.2.
1 NAVIGATION CENTER TILE WALL PROJECT
(e)
(f)
Services. Services shall mean the services to be performed by the Contractor pursuant to this Agreement.

Satisfactory. Satisfactory shall mean satisfactory to the City Administrator or his/her designee.

2.0 SERVICES OF CONTRACTOR

2.1 Scope of Services. In compliance with all terms and conditions of this Agreement, the Contractor shall provide those services specified in the "Scope of Services" attached hereto as Exhibit "A" and incorporated herein by this reference, which services may be referred to herein as the "services" or "work" hereunder. As a material inducement to the City entering into this Agreement, Contractor represents and warrants that Contractor is a provider of first class work and services and Contractor is experienced in performing the work and services contemplated herein and, in light of such status and experience, Contractor covenants that it shall follow the highest professional standards in performing the work and services required hereunder and that all materials will be of good quality, fit for the purpose intended.

2.2 Documents Included in Contract. This contract consists of this Agreement and any Exhibits, which are incorporated herein by this reference. In the event of an inconsistency, the terms of this Agreement shall govern.

2.3 Compliance with Law. All services rendered hereunder shall be provided in accordance with all ordinances, resolutions, statutes, rules, and regulations of the City and any Federal, State or local governmental agency having jurisdiction in effect at the time service is rendered, including but not limited to, the claims procedure set forth in Public Contract Code Section 9204, a summary of which is attached to this agreement as Exhibit "E."

2.4 Licenses, Permits, Fees and Assessments. Contractor shall obtain at its sole cost and expense such licenses, permits and approvals as may be required by law for the performance of the services required by this Agreement, including registration with the Department of Industrial Relations of the State of California as required by Labor Code Section 1725.5 before commencing performance under this Agreement. Contractor shall have the sole obligation to pay for any fees, assessments and taxes, plus applicable penalties and interest, which may be imposed by law and arise from or are necessary for the Contractor's performance of the services required by this Agreement, and shall indemnify, defend and hold harmless City against any such fees, assessments, taxes penalties or interest levied, assessed or imposed against City hereunder.

Contractor shall be responsible for all subcontractors' compliance with this Section 2.4.

2.5 Familiarity with Work. By executing this Contract, Contractor warrants that Contractor (a) has thoroughly investigated and considered the scope of services to be performed, (b) has carefully considered how the services should be performed, and (c) fully understands the facilities, difficulties and restrictions attending performance of the services under this Agreement. If the services involve work upon any site, Contractor warrants that Contractor has or will investigate the site and is or will be fully acquainted with the conditions there existing, prior to commencement of services hereunder. Should Contractor discover any latent or unknown conditions, which will materially affect the performance of the services hereunder, Contractor shall immediately inform 2 NAVIGATION CENTER TILE WALL PROJECT
the City of such fact and shall not proceed except at Contractor's risk until written instructions are received from the Contract Officer.

2.6 Standard of Performance. Contractor, its subcontractors and their employees, in the performance of Contractor's work under this Agreement shall be responsible for exercising the degree of skill and care required by customarily accepted good professional practices and procedures used in the Contractor's field.

Any costs for failure to meet the foregoing standard or to correct otherwise defective work that requires re -performance of the work, shall be borne in total by the Contractor and not by the City. The failure of a project to achieve the performance goals and objectives stated in this Agreement is not a basis for requesting re -performance unless the work conducted by Contractor and/or its subcontractors is deemed by the City to have failed the foregoing standard of performance.

In the event Contractor fails to perform in accordance with the above standard:

1. Contractor will re -perform, at its own expense, any task which was not performed to the reasonable satisfaction of City. Any work re -performed pursuant to this paragraph shall be completed within the time limitations originally set forth for the specific task involved.

Contractor shall work any overtime required to meet the deadline for the task at no additional cost to the City;

2. The City shall provide a new schedule for the re -performance of any task pursuant to this paragraph in the event that re -performance of a task within the original time limitations is not feasible; and

3. The City shall have the option to direct Contractor not to re -perform any task which was not performed to the reasonable satisfaction of the City Project Manager pursuant to application of (1) and (2) above. In the event the City directs Contractor not to re - perform a task, the City shall negotiate a reasonable settlement for satisfactory work performed. No previous payment shall be considered a waiver of the City's right to reimbursement.

Nothing contained in this section is intended to limit any of the rights or remedies which the City may have under law.

2.7 Care of Work. The Contractor shall adopt reasonable methods during the life of the Agreement to furnish continuous protection to the work, and the equipment, materials, papers, documents, plans, studies and/or other components thereof to prevent losses or damages, and shall be responsible for all such damages, to persons or property, until acceptance of the work by City, except such losses or damages as may be caused by City's own negligence.

2.8 Further Responsibilities of Parties. Both parties agree to use reasonable care and diligence to perform their respective obligations under this Agreement. Both parties agree to act in good faith to execute all instruments, prepare all documents and take all actions as may be reasonably necessary to carry out the purposes of this Agreement. Unless hereafter specified, neither party shall be responsible for the service of the other. Contractor shall require all subcontractors to comply with the provisions of this agreement. 3 NAVIGATION CENTER TILE WALL PROJECT

2.9 Additional Services. City shall have the right at any time during the performance of the services, without invalidating this Agreement, to order extra work beyond that specified in the Scope of Services or make changes by altering, adding to or deducting from said work. No such extra work may be undertaken unless a written change order is first given by the Contract Officer to the Contractor, incorporating therein any adjustment in (i) the Contract Sum as set forth in Section

3.1, and/or (ii) the time to perform this Agreement, which said adjustments are subject to the written approval of the Contractor. Any increase in compensation of twenty five percent (25%) or less of the Contract Sum, or in the time to perform of one hundred eighty (180) days or less may be approved by the Contract Officer. Any increases, taken either separately or cumulatively, that result in the Contract Sum exceeding $25,000 must be approved by the City Council. It is expressly understood by Contractor that the provisions of this Section shall not apply to services specifically set forth in the Scope of Services or reasonably contemplated therein. Contractor hereby acknowledges that it accepts the risk that the services to be provided pursuant to the Scope of Services may be more costly or time consuming than Contractor anticipates and that Contractor shall not be entitled to additional compensation therefore.

2.10 Prevailing Wace Laws. Contractor represents and warrants that it is registered with the Department of Industrial Relations pursuant to SB 854 and Labor Code 1725.5.

Contractor shall ensure that its subcontractors comply with said requirements. In accordance with Labor Code Section 1770 et seq., the Director of the Department of Industrial Relations of the State of California has ascertained a general prevailing rate of wages, which is the minimum amount, which shall be paid to all workers employed to perform the work pursuant to this Agreement. A copy of the general prevailing wage rate determination is on file in the Office of the City Clerk and is hereby incorporated by reference into this Agreement. In accordance with the provisions of Labor Code Section 1810 et seq., eight (8) hours is the legal working day. Contractor must forfeit to the City Twenty Five Dollars ($25.00) a day for each worker who works in excess of the minimum working hours when Contractor does not pay overtime. Contractor is required to post a copy of such wage rates at all times at the contract site. The statutory penalties for failure to pay prevailing wage or to comply with State wage and hour laws will be enforced. Contractor also shall comply with State law requirements to maintain payroll records and shall provide for certified records and inspection of records as required by California Labor Code Section 1770 et. seq., including Section 1776. Contractor shall comply with all statutory requirements relating to the employment of apprentices.

3.0 COMPENSATION

3.1 Contract Sum. For the services rendered pursuant to this Agreement, the Contractor shall be compensated as specified herein, but not exceeding the maximum contract amount of One Hundred Forty Four Thousand and Five Hundred Dollars ($144,500) (herein "Contract Sum"), except as provided in Section 2.9. The Contract Sum shall include the attendance of Contractor at all project meetings reasonably deemed necessary by the City; Contractor shall not be entitled to any additional compensation for attending said meetings.

3.2 Procress Payments. Prior to the first day of the month, during the progress of the work, commencing on the day and month specified in the Agreement, Contractor shall submit to the Contract Officer a complete itemized statement of all labor and materials incorporated into the work during the preceding month and the portion of the contract sum applicable thereto. Upon approval in writing by the Contract Officer, payment shall be made in thirty (30) days. City shall pay Contractor a sum based upon ninety-five percent (95%) of the 4 NAVIGATION CENTER TILE WALL PROJECT
contract price apportionment of the labor and materials incorporated into the work under the contract during the month covered by said statement. The remaining five percent (5%) thereof shall be retained as performance security. Refer to Section 8.4 of this Agreement for retention of funds.
4M PERFORMANCE SCHEDULE

4.1 Time of Essence. Time is of the essence in the performance of this Agreement.

4.2 Schedule of Performance. Contractor shall commence the services pursuant to this Agreement upon receipt of a written notice to proceed and shall perform all services within the time period(s) established in the "Schedule of Performance" attached hereto as Exhibit "B", and incorporated herein by this reference. When requested by the Contractor, extensions to the time period(s) specified in the Scope of Services may be approved in writing by the Contract Officer.

4.3 Force Majeure. The time period(s) specified in the Scope of Services for performance of the services rendered pursuant to this Agreement shall be extended because of any delays due to unforeseeable causes beyond the control and without the fault or negligence of the Contractor, including, but not restricted to, acts of God or of the public enemy, unusually severe weather, fires, earthquakes, floods, epidemics, quarantine restrictions, riots, strikes, freight embargoes, wars, litigation, and/or acts of any governmental agency, including the City, if the Contractor shall within ten (10) days of the commencement of such delay notify the Contract Officer in writing of the causes for the delay. The Contract Officer shall ascertain the facts and the extent of delay, and extend the time for performing the services for the period of the enforced delay when and if in the judgment of the Contract Officer such delay is justified. The Contract Officer's determination shall be final and conclusive upon the parties to this Agreement.

4.4 Term. Unless earlier terminated in accordance with Section 8.9 of this Agreement, this Agreement shall continue in full force and effect until final approval and acceptance of the project by the Contract Officer. Notwithstanding the foregoing, this Agreement shall terminate no later than July 26, 2023, unless the parties mutually agree in writing to extend the term.

5.0 COORDINATION OF WORK

5.1 Representative of Contractor. The following principals of Contractor are hereby designated as being the principals and representatives of Contractor authorized to act in its behalf with respect to the work specified herein and make all decisions in connection therewith:

Arman Tehran
Managing Member
It is expressly understood that the experience, knowledge, capability and reputation of the foregoing principals were a substantial inducement for City to enter into this Agreement. Therefore, the foregoing principals shall be responsible during the term of this Agreement for directing all activities of Contractor and devoting sufficient time to personally supervise the services hereunder. 5 NAVIGATION CENTER TILE WALL PROJECT
For purposes of this Agreement, the foregoing principals may not be replaced nor may their responsibilities be substantially reduced by Contractor without the express written approval of City.

5.2 Contract Officer. The Contract Officer shall be such person as may be designated by the City Administrator or City Engineer of City. It shall be the Contractor's responsibility to assure that the Contract Officer is kept informed of the progress of the performance of the services and the Contractor shall refer any decisions that must be made by City to the Contract Officer.

Unless otherwise specified herein, any approval of City required hereunder shall mean the approval of the Contract Officer. The Contract Officer shall have authority to sign all documents on behalf of the City required hereunder to carry out the terms of this Agreement.

5.3 Prohibition Acainst Assignment. The experience, knowledge, capability and reputation of Contractor, its principals and employees were a substantial inducement for the City to enter into this Agreement. Neither this Agreement nor any interest herein may be transferred, assigned, conveyed, hypothecated or encumbered voluntarily or by operation of law, whether for the benefit of creditors or otherwise, without the prior written approval of City. Transfers restricted hereunder shall include the transfer to any person or group of persons acting in concert of more than twenty five percent (25%) of the present ownership and/or control of Contractor, taking all transfers into account on a cumulative basis. In the event of any such unapproved transfer, including any bankruptcy proceeding, this Agreement shall be void. No approved transfer shall release the Contractor or any surety of Contractor of any liability hereunder without the express consent of City.

5.4 Independent Contractor. Neither the City nor any of its employees shall have any control over the manner, mode or means by which Contractor, its subcontractors, agents or employees, performs the services required herein, except as otherwise set forth herein. City shall have no voice in the selection, discharge, supervision or control of Contractor's employees, subcontractors, servants, representatives or agents, or in fixing their number, compensation or hours of service. Contractor shall perform all services required herein as an independent contractor of City and shall remain at all times as to City a wholly independent contractor with only such obligations as are consistent with that role. Contractor shall not at any time or in any manner represent that it or any of its subcontractors, agents or employees are agents or employees of City.

City shall not in any way or for any purpose become or be deemed to be a partner of Contractor in its business or otherwise or a joint venture or a member of any joint enterprise with Contractor.

5.5 Identity of Persons Performing Work. Contractor represents that it employs or will employ at its own expense all personnel required for the satisfactory performance of any and all tasks and services set forth herein. Contractor represents that the tasks and services required herein will be performed by Contractor or under its direct supervision, and that all personnel engaged in such work shall be fully qualified and shall be authorized and permitted under applicable State and local law to perform such tasks and services.

5.6 Utility Relocation. City is responsible for removal, relocation, or protection of existing main or trunkline utilities to the extent such utilities were not identified in the invitation for bids or specifications. City shall reimburse contractor for any costs incurred in locating, repairing damage not caused by contractor and removing or relocating such unidentified utility facilities, including equipment idled during such work. Contractor shall not be assessed liquidated damages for delay arising from the removal or relocation of such unidentified utility facilities. 6 NAVIGATION CENTER TILE WALL PROJECT

5.7 Trenches or Excavations. Pursuant to California Public Contract Code Section 7104, in the event the work included in this Agreement requires excavations more than four (4) feet in depth, the following shall apply.
(a) Contractor shall promptly, and before the following conditions are disturbed, notify City, in writing, of any: (1) material that Contractor believes may be material that is hazardous waste, as defined in Section 25117 of the Health and Safety Code, that is required to be removed to a Class I, Class I I, or Class III disposal site in accordance with provisions of existing law; (2) Subsurface or latent physical conditions at the site different from those indicated; or (3) Unknown physical conditions at the site of any unusual nature, different materially from those ordinarily encountered and generally recognized as inherent in work of the character provided for in the contract.
(b) City shall promptly investigate the conditions, and if it finds that the conditions do materially so differ, or do involve hazardous waste, and cause a decrease or increase in Contractor's cost of, or the time required for, performance of any part of the work shall issue a change order per Section 2.9 of this Agreement.
(c) That, in the event that a dispute arises between City and Contractor whether the conditions materially differ, or involve hazardous waste, or cause a decrease or increase in Contractor's cost of, or time required for, performance of any part of the work, Contractor shall not be excused form any scheduled completion date provided for by the contract, but shall proceed with all work to be performed under the contract. Contractor shall retain any and all rights provided either by contract or by law, which pertain to the resolution of disputes and protests between the contracting parties.

6.0 INSURANCE, INDEMNIFICATION AND BONDS

6.1 Insurance. The Contractor and all subcontractors, if any, shall procure and maintain, at its sole cost and expense, in a form and content satisfactory to City, during the entire term of this Agreement including any extension thereof, insurance as set forth in Exhibit "C" attached hereto and incorporated herein by this reference.

Conditions:

In accordance with Public Contract Code Section 20170, the insurance of surety companies who provide or issue the policy shall have been admitted to do business in the State of California with a credit rating of A- or better.

This insurance shall not be canceled, limited in scope or coverage or non -renewed until after thirty (30) days prior written notice has been given to the Community Development Director, City of Placentia, 401 E. Chapman Ave., Placentia, California 92870. 7 NAVIGATION CENTER TILE WALL PROJECT
Any insurance maintained by the City of Placentia shall apply in excess of and not combined with insurance provided by this policy.

The City of Placentia, its officers, employees, representatives, attorneys, and volunteers shall be named as additional named insureds.

Prior to commencement of any work under this contract, Contractor shall deliver to the City insurance endorsements confirming the existence of the insurance required by this contract, and including the applicable clauses referenced above.

Such endorsements shall be signed by an authorized representative of the insurance company and shall include the signator's company affiliation and title. Should it be deemed necessary by the City, it shall be Contractor's responsibility to see that the City receives documentation, acceptable to the City, which sustains that the individual signing said endorsements is indeed authorized to do so by the insurance company.

If the Contractor fails to maintain the aforementioned insurance, or secure and maintain the aforementioned endorsement, the City may obtain such insurance, and deduct and retain the amount of the premiums for such insurance from any sums due under the agreement. However, procuring of said insurance by the City is an alternative to other remedies the City may have, and is not the exclusive remedy for failure of Contractor to maintain said insurance or secure said endorsement. In addition to any other remedies the City may have upon Contractor's failure to provide and maintain any insurance or policy endorsements to the extent and within the time herein required, the City shall have the right to order Contractor to stop work hereunder, and/or withhold any payment(s) which became due to Contractor hereunder until Contractor demonstrates compliance with the requirements hereof.

Nothing herein contained shall be construed as limiting in any way the extent to which Contractor may be held responsible for payments of damages to persons or property resulting from Contractor's or its subcontractor's performance of the work covered under this agreement.

Each contract between the Contractor and any subcontractor shall require the subcontractor to maintain the same policies of insurance that the Contractor is required to maintain pursuant to this Section 6.1.

6.2 Certificates of Insurance. Contractor shall provide to City certificates of insurance showing the insurance coverages and required endorsements described above, in a form and content approved by City, prior to performing any services under this Agreement. The certificates of insurance and endorsements shall be attached to this Agreement as Exhibit "D", and are incorporated herein by this reference.

6.3 Indemnification. Contractor shall defend, indemnify, hold free and harmless the City of Placentia, its elected and appointed officials, officers, agents and employees, at Contractor's sole expense, from and against any and all actions, suits, claims, damages to persons or property, losses, costs, penalties, obligations, errors, omissions or liabilities, (herein "claims or liabilities") that may be asserted or claimed by any person, firm or entity arising or alleged to arise out of or in connection with the performance of the work, operations or activities of Contractor, its agents, employees, subcontractors, or invitees, provided for herein, or arising or alleged to arise from the negligent acts or omissions of Contractor hereunder, or arising or alleged to arise from 8 NAVIGATION CENTER TILE WALL PROJECT
Contractor's performance of or failure to perform any term, provision, covenant or condition of this Agreement.
(a) Contractor will defend any action or actions filed in connection with any of said claims or liabilities and will pay all costs and expenses, including legal costs and attorneys' fees incurred in connection therewith. (b) Contractor will promptly pay any judgment rendered against the City, its officers, agents or employees for any such claims or liabilities arising or alleged to arise out of or in connection with Contractor's (or its agents', employees', subcontractors' or invitees') negligent performance of or failure to perform such work, operations or activities hereunder; and Contractor agrees to save and hold the City, its officers, agents, and employees harmless therefrom.
(c) In the event the City, its officers, agents or employees is made a party to any action or proceeding filed or prosecuted against Contractor for such damages or other claims arising or alleged to arise out of or in connection with the performance of or failure to perform the work, operation or activities of Contractor hereunder, Contractor shall pay to the City, its officers, agents or employees, any and all costs and expenses incurred by the City, its officers, agents or employees in such action or proceeding, including but not limited to, legal costs and attorneys' fees for counsel selected by City. (d) Contractor's duty to defend and indemnify as set out in this Section 6.3 shall include any claims, liabilities, obligations, losses, demands, actions, penalties, suits, costs, expenses or damages or injury to persons or property arising or alleged to arise from, in connection with, as a consequence of or pursuant to any state or federal law or regulation regarding hazardous substances, including but not limited to the Federal Insecticide, Fungicide and Rodenticide Act ("FIFRA"), Comprehensive Environmental Response, Compensation and Liability Act of 1980 ("CERCLA"), Resource Conservation and Recovery Act of 1976 ("RCRA"), the Hazardous and Solid Waste Amendments of 1984, the Hazardous Material Transportation Act, the Toxic Substances control Act, the Clean Air Act, the Clean Water Act, the California Hazardous Substance Account Act, the California Hazardous Waste Control Law or the Porter -Cologne Water Quality Control Act, as any of those statutes may be amended from time to time.

Notwithstanding the foregoing, Contractor shall not be liable for the defense or indemnification of the City for claims, actions, complaints or suits arising out of the sole active negligence or willful misconduct of the City.

The Contractor's indemnification obligations pursuant to this Section 6.3 shall survive the termination of this Agreement. Contractor shall require the same indemnification from all subcontractors.

6.4 Labor and Materials and Performance Bonds. Concurrently with execution of this Agreement, Contractor shall deliver to City a labor and materials bond and a performance 9 NAVIGATION CENTER TILE WALL PROJECT
bond each in the sum of the amount of this Agreement, in the forms provided by the City Clerk, which secures the faithful performance of this Agreement. The bonds shall contain the original notarized signature of an authorized officer of the surety and affixed thereto shall be a certified and current copy of his power of attorney. The bonds shall be unconditional and remain in force during the entire term of the Agreement and shall be null and void only if the Contractor promptly and faithfully performs all terms and conditions of this Agreement.

6.5 Sufficiency of Insurer or Surety. Insurance required by this Agreement shall be satisfactory only if issued by companies qualified to do business in California, rated "A" or better in the most recent edition of Best Rating Guide, The Key Rating Guide or in the Federal Register, and only if they are of a financial category Class VII or better, unless such requirements are waived by the Risk Manager of the City due to unique circumstances. In the event the Senior Management Analyst of City ("Senior Management Analyst") determines that the work or services to be performed under this Agreement creates an increased risk of loss to the City, the Contractor agrees that the minimum limits of the insurance policies required by this Section 6 may be changed accordingly upon receipt of written notice from the Senior Management Analyst; provided that the Contractor shall have the right to appeal a determination of increased coverage by the Senior Management Analyst to the City Council of City within ten (10) days of receipt of notice from the Senior Management Analyst.

6.6 Substitution of Securities. Pursuant to California Public Contract Code Section 22300, substitution of eligible equivalent securities for any monies withheld to ensure performance under the contract for the work to be performed will be permitted at the request and expense of the successful bidder.

7.0 RECORDS AND REPORTS

7.1 Reports. Contractor shall periodically prepare and submit to the Contract Officer such reports concerning the performance of the services required by this Agreement as the Contract Officer shall require. Contractor hereby acknowledges that the City is greatly concerned about the cost of work and services to be performed pursuant to this Agreement.

For this reason, Contractor agrees that if Contractor becomes aware of any facts, circumstances, techniques, or events that may or will materially increase or decrease the cost of the work or services contemplated herein or, if Contractor is providing design services, the cost of the project being designed, Contractor shall promptly notify the Contract Officer of said fact, circumstance, technique or event and the estimated increased or decreased cost related thereto and, if Contractor is providing design services, the estimated increased or decreased cost estimate for the project being designed.

7.2 Records. Contractor shall keep, and require subcontractors to keep, such books and records (including but not limited to payroll records as required herein) as shall be necessary to perform the services required by this Agreement and enable the Contract Officer to evaluate the performance of such services. The Contract Officer shall have full and free access to such books and records at all times during normal business hours of City, including the right to inspect, copy, audit and make records and transcripts from such records. Such records shall be maintained for a period of three (3) years following completion of the services hereunder, and the City shall have access to such records in the event any audit is required. 10 NAVIGATION CENTER TILE WALL PROJECT

7.3 Ownership of Documents. All drawings, specifications, reports, records, documents and other materials prepared by Contractor, its employees, subcontractors and agents in the performance of this Agreement shall be the property of City and shall be delivered to City upon request of the Contract Officer or upon the termination of this Agreement, and Contractor shall have no claim for further employment or additional compensation as a result of the exercise by City of its full rights of ownership of the documents and materials hereunder. Contractor may retain copies of such documents for its own use. Contractor shall have an unrestricted right to use the concepts embodied therein. All subcontractors shall provide for assignment to City of any documents or materials prepared by them, and in the event Contractor fails to secure such assignment, Contractor shall indemnify City for all damages resulting therefrom.

7.4 Public Records Act Disclosure. Contractor has been advised and is aware that this Agreement and all reports, documents, information and data, including, but not limited to, computer tapes, discs or files furnished or prepared by Contractor, or any of its subcontractors, pursuant to this Agreement and provided to City may be subject to public disclosure as required by the California Public Records Act (California Government Code Section 6250 et seq.).

Exceptions to public disclosure may be those documents or information that qualify as trade secrets, as that term is defined in the California Government Code Section 6254.7, and of which Contractor informs City of such trade secret. The City will endeavor to maintain as confidential all information obtained by it that is designated as a trade secret. The City shall not, in any way, be liable or responsible for the disclosure of any trade secret including, without limitation, those records so marked if disclosure is deemed to be required by law or by order of the Court.

8.0 GENERAL PROVISIONS

8.1 Governing Law. This Agreement shall be construed and interpreted both as to validity and to performance of the parties in accordance with the laws of the State of California.

Legal actions concerning any dispute, claim or matter arising out of or in relation to this Agreement shall be instituted in the Superior Court of the County of Orange, State of California, or any other appropriate court in such county, and Contractor covenants and agrees to submit to the personal jurisdiction of such court in the event of such action.

8.2 Representatives. The City Administrator or his or her designee shall be the representative of City for purposes of this Agreement and may issue all consents, approvals, directives and agreements on behalf of the City, called for by this Agreement, except as otherwise expressly provided in this Agreement.

The Principal set forth in Section 5.1 above shall be the representative for Contractor for purposes of this Agreement, and shall be authorized to issue all consents, approvals, directives and agreements on behalf of Contractor called for by this Agreement, except as otherwise expressly provided in this Agreement.

8.3 Disputes. In the event either party fails to perform its obligations hereunder, the nondefaulting party shall provide the defaulting party written notice of such default. The defaulting party shall have ten (10) days to cure the default; provided that, if the default is not reasonably susceptible to being cured within said ten (10) day period, the defaulting party shall have a reasonable time to cure the default, not to exceed a maximum of thirty (30) days, so long as the defaulting party commences to cure such default within ten (10) days of service of such notice and diligently prosecutes the cure to completion; provided further that if the default is an immediate 11 NAVIGATION CENTER TILE WALL PROJECT
danger to the health, safety and general welfare, the defaulting party shall take such immediate action as may be necessary. Notwithstanding the foregoing, the nondefaulting party may, in its sole and absolute discretion, grant a longer cure period. Should the defaulting party fail to cure the default within the time period provided in this Section, the nondefaulting party shall have the right, in addition to any other rights the nondefaulting party may have at law or in equity, to terminate this Agreement. Compliance with the provisions of this Section 8.3 shall be a condition precedent to bringing any legal action, and such compliance shall not be a waiver of any party's right to take legal action in the event that the dispute is not cured.

8.4 Retention of Funds. Progress payments shall be made in accordance with the provisions of Section 3.2 of this Agreement. In accordance with said section, City shall pay Contractor a sum based upon ninety-five percent (95%) of the contract price apportionment of the labor and materials incorporated into the work under the contract during the month covered by said statement. The remaining five percent (5%) thereof shall be retained as performance security to be paid to the Contractor within sixty (60) days after final acceptance of the work by the City Council, after Contractor shall have furnished City with a release of all undisputed contract amounts if required by City. In the event there are any claims specifically excluded by Contractor from the operation of the release, the City may retain proceeds (per Public Contract Code 7107) of up to 150% of the amount in dispute. City's failure to deduct or withhold shall not affect Contractor's obligations hereunder.

8.5 Waiver. No delay or omission in the exercise of any right or remedy by a nondefaulting party on any default shall impair such right or remedy or be construed as a waiver. A party's consent to or approval of any act by the other party requiring the party's consent or approval shall not be deemed to waive or render unnecessary the other party's consent to or approval of any subsequent act. Any waiver by either party of any default must be in writing and shall not be a waiver of any other default concerning the same or any other provision of this Agreement.

8.6 Rights and Remedies. Rights and Remedies are cumulative except with respect to rights and remedies expressly declared to be exclusive in this Agreement, the rights and remedies of the parties are cumulative and the exercise by either party of one or more of such rights or remedies shall not preclude the exercise by it, at the same or different times, of any other rights or remedies for the same default or any other default by the other party.

8.7 Legal Action. In addition to any other rights or remedies, either party may take legal action, in law or in equity, to cure, correct or remedy any default, to recover damages for any default, to compel specific performance of this Agreement, to obtain declaratory or injunctive relief, or to obtain any other remedy consistent with the purposes of this Agreement.

8.8 Liquidated Damaces. Since the determination of actual damages for any delay in performance of this Agreement would be extremely difficult or impractical to determine in the event of a breach of this Agreement, the Contractor and its sureties shall be liable for and shall pay to the City Five Hundred Dollars ($500) as liquidated damages for each working day of delay in the performance of any service required hereunder, as specified in the Scope of Services (Exhibit A) or Schedule of Performance (Exhibit B). The City may withhold from any monies payable on account of services performed by the Contractor any accrued liquidated damages.

8.9 Termination for Default of Contractor. If termination is due to the failure of the Contractor to fulfill its obligations under this Agreement, Contractor shall vacate any City owned property which Contractor is permitted to occupy hereunder and City may, after compliance with 12 NAVIGATION CENTER TILE WALL PROJECT
the provisions of Section 8.3, take over the work and prosecute the same to completion by contract or otherwise, and the Contractor shall be liable to the extent that the total cost for completion of the services required hereunder exceeds the compensation herein stipulated (provided that the City shall use reasonable efforts to mitigate such damages), and City may withhold any payments to the Contractor for the purpose of setoff or partial payment of the amounts owed the City as previously stated.

8.10 Notice. Any notice, demand, request, document, consent, approval, or communication either party desires or is required to give to the other party or any other person shall be in writing and shall be deemed to be given when served personally or deposited in the US Mail, prepaid, first-class mail, return receipt requested, addressed as follows:

To City:

To Contractor:

City of Placentia
401 E. Chapman Ave
Placentia, California 92870
Attn.: Maddie Villapando
Asad Holdings LLC DBA Orangeblue General Contractor
27071 Cabot Rd, Ste 108,
Laguna Hills, CA 92653
Attn: Arman Tehrani

8.11 Non -liability of City Officers and Employees. No officer or employee of the City shall be personally liable to the Contractor, or any successor in interest, in the event of any default or breach by the City or for any amount which may become due to the Contractor or to its successor, or for breach of any obligation of the terms of this Agreement.

8.12 Conflict of Interest. The Contractor warrants that it has not paid or given and will not pay or give any third party any money or other consideration for obtaining this Agreement.

Contractor and its officers, employees, associates and subcontractors, if any, will comply with all conflict of interest statutes of the State of California applicable to Contractor's services under this agreement, including, but not limited to, the Political Reform Act (Government Code Sections 81000, et seq.) and Government Code Section 1090. During the term of this Agreement, Contractor and its officers, employees, associates and subcontractor shall not, without the prior written approval of the City Representative, perform work for another person or entity for whom Contractor is not currently performing work that would require Contractor or one of its officers, employees, associates or subcontractors to abstain from a decision under this Agreement pursuant to a conflict of interest statute.

8.13 Covenant Against Discrimination. Contractor covenants that, by and for itself, its heirs, executors, assigns, and all persons claiming under or through them, that there shall be no discrimination against or segregation of, any person or group of persons on account of race, color, creed, religion, sex, marital status, national origin, or ancestry in the performance of this Agreement. To the extent required by law, contractor shall take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, color, creed, religion, sex, marital status, national origin, or ancestry. 13 NAVIGATION CENTER TILE WALL PROJECT

8.14 Interpretation. The terms of this Agreement shall be construed in accordance with the meaning of the language used and shall not be construed for or against either party by reason of the authorship of this Agreement or any other rule of construction which might otherwise apply.

8.15 Severability. In the event that any one or more of the phrases, sentences, clauses, paragraphs, or sections contained in this Agreement shall be declared invalid or unenforceable by a valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining phrases, sentences, clauses, paragraphs, or sections of this Agreement which are hereby declared as severable and shall be interpreted to carry out the intent of the parties hereunder unless the invalid provision is so material that its invalidity deprives either party of the basic benefit of their bargain or renders this Agreement meaningless.

8.16 Hiring of Illegal Aliens Prohibited. Contractor shall not hire or employ any person to perform work within the City of Placentia or allow any person to perform work required under this Agreement unless such person is properly documented and legally entitled to be employed within the United States. Further, Contractor shall comply with the following:
(a) Unauthorized Aliens. Contractor hereby represents and warrants that it will comply with all of the provisions of the Federal Immigration and Nationality Act, 8 U.S.C.A. §§ 1101, et seq., as amended, and in connection therewith, shall not employ unauthorized aliens as defined therein. Should Contractor so employ such unauthorized aliens for the performance of any work and/or services under this Agreement, and should any liability or sanctions be imposed against City for such use of unauthorized aliens, Contractor hereby agrees to reimburse City for any and all liabilities, actions, suits, claims, demands, losses, costs, judgments, arbitration awards, settlements, damages, demands, orders, or penalties which arise out of or are related to such employment, together with any and all costs, including attorneys' fees, incurred by City.
(b) E -Verify. If Contractor is not already enrolled in the U.S. Department of Homeland Security's E -Verify program, Contractor shall enroll in the E - Verify program within fifteen (15) days of the effective date of this Agreement to verify the employment authorization of employees assigned to perform work hereunder. Contractor shall verify employment authorization within three (3) days of hiring a new employee to perform work under this Agreement. Information pertaining to the E -Verify program can be found at http://www.uscis.gov , or access the registration page at https://e- verify.uscis.gov/enroll. Contractor shall certify its registration with E -Verify and provide City its registration number within sixteen days of the effective date of this Agreement. Failure to provide certification will result in withholding payment until full compliance is demonstrated.

8.17 Unfair Business Practices Claims. In entering into a public works contract or a subcontract to supply goods, services or materials pursuant to a public works contract, the contractor or subcontractor offers and agrees to assign to the awarding body all rights, title, and interest in and to all causes of action it may have under Section 4 of the Clayton Act (15 U.S.C. 14 NAVIGATION CENTER TILE WALL PROJECT
Sec. 15) or under the Cartwright Act (Chapter 2, (commencing with Section 16700) of Part 2 of Division 7 of the Business and Professions Code), arising from purchases of goods, services or materials pursuant to the public works contract or the subcontract. This assignment shall be made and become effective at the time the awarding body renders final payment to the contractor without further acknowledgment by the parties. (Sec. 7103.5, California Public Contract Code).

8.18 Corporate Authority. The persons executing this Agreement on behalf of the parties hereto warrant that (i) such party is duly organized and existing, (ii) they are duly authorized to execute and deliver this Agreement on behalf of said party, (iii) by so executing this Agreement, such party is formally bound to the provisions of this Agreement, and (iv) the entering into this Agreement does not violate any provision of any other Agreement to which said party is bound.

8.19 PERS Eligibility Indemnification. In the event that Contractor or any employee, agent, or subcontractor of Contractor providing services under this Agreement claims or is determined by a court of competent jurisdiction or the California Public Employees Retirement System (PERS) to be eligible for enrollment in PERS as an employee of the 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.

Notwithstanding any other agency, state or federal policy, rule, regulation, law or ordinance to the contrary, Contractor and any of its employees, agents, and subcontractors providing service under this Agreement shall not qualify for or become entitled to, and hereby agree to waive any claims to, any compensation, benefit, or any incident of employment by City, including but not limited to eligibility to enroll in PERS as an employee of City and entitlement to any contribution to be paid by City for employer contribution and/or employee contributions for PERS benefits.

8.20 Cooperation. In the event any claim or action is brought against City relating to Contractor's performance or services rendered under this Agreement, Contractor shall render any reasonable assistance and cooperation which City might require.

8.21 Lecal Responsibilities. The Contractor shall keep itself informed of City, State, and Federal laws, ordinances and regulations, which may in any manner affect the performance of its services pursuant to this Agreement. The Contractor shall at all times observe and comply with all such laws, ordinances and regulations. Neither the City, nor its officers, agents, or employees shall be liable at law or in equity as a result of the Contractor's failure to comply with this section.

8.22 Termination for Convenience. The City may terminate this Agreement without cause for convenience of the City upon giving contractor 30 days prior written notice of termination of the Agreement. Upon receipt of the notice of termination the Contractor shall cease all further work pursuant to the Agreement. Upon such termination by the City the Contractor shall not be entitled to any other remedies, claims, actions, profits, or damages except as provided in this paragraph. Upon the receipt of such notice of termination Contractor shall be entitled to the following compensation:
15 NAVIGATION CENTER TILE WALL PROJECT

1. The contract value of the work completed to and including the date of receipt of the notice of termination, less the amount of progress payments received by contractor.

2. Actual move -off costs including labor, rental fees, equipment transportation costs, the costs of maintaining on -site construction office for supervising the mover -off.

3. The cost of materials custom made for this Agreement which cannot be used by the Contractor in the normal course of his business, and which have not been paid for by City in progress payments.

4. All costs shall not include any markups as might otherwise be allowed by any plans or specifications which were a part of the Agreement.

The provisions of this paragraph shall supersede any other provision of the Agreement or any provision of any plans, specification, addendums or other documents which are or may become a part of this Agreement. City and Contractor agree that the provisions of this paragraph are a substantive part of the consideration for this Agreement.

8.23 Responsibility for Errors. Contractor shall be responsible for its work and results under this Agreement. Contractor, when requested, shall furnish clarification and/or explanation as may be required by the City's representative, regarding any services rendered under this Agreement at no additional cost to City. In the event that an error or omission attributable to Contractor occurs, then Contractor shall, at no cost to City, provide all necessary design drawings, estimates and other Contractor professional services necessary to rectify and correct the matter to the sole satisfaction of City and to participate in any meeting required with regard to the correction.

8.24 Order of Precedence. In the event of an inconsistency in this Agreement and any of the attached Exhibits, the terms set forth in this Agreement shall prevail. If, and to the extent this Agreement incorporates by reference any provision of any document, such provision shall be deemed a part of this Agreement. Nevertheless, if there is any conflict among the terms and conditions of this Agreement and those of any such provision or provisions so incorporated by reference, this Agreement shall govern over the document referenced.

8.25 Costs. Each party shall bear its own costs and fees incurred in the preparation and negotiation of this Agreement and in the performance of its obligations hereunder except as expressly provided herein.

8.26 No Third Party Beneficiary Richts. This Agreement is entered into for the sole benefit of City and Contractor and no other parties are intended to be direct or incidental beneficiaries of this Agreement and no third party shall have any right in, under or to this Agreement.

8.27 Headings. Paragraphs and subparagraph headings contained in this Agreement are included solely for convenience and are not intended to modify, explain or to be a full or accurate description of the content thereof and shall not in any way affect the meaning or interpretation of this Agreement.

8.28 Construction. The parties have participated jointly in the negotiation and drafting of this Agreement. In the event an ambiguity or question of intent or interpretation arises with 16 NAVIGATION CENTER TILE WALL PROJECT
respect to this Agreement, this Agreement shall be construed as if drafted jointly by the parties and in accordance with its fair meaning. There shall be no presumption or burden of proof favoring or disfavoring any party by virtue of the authorship of any of the provisions of this Agreement.

8.29 Counterparts. This Agreement may be executed in one or more counterparts, each of which shall be deemed an original. All counterparts shall be construed together and shall constitute one agreement.

8.30 Funding Source Conditions — Contractor's Oblication. Contractor acknowledges that the City may be paying for the Project by using funds it receives or will receive from various funding sources in the form of grants and/or subsidies, and the like under certain terms and conditions. Contractor acknowledges and agrees that any failure of the Contractor and/or its subcontractors to perform its obligations under the Contract, including, but not limited to, timely submitting accurate reports and records, that in any way results in the City not meeting the terms and conditions placed on the funds by the funding source, or forfeiting its entitlement to or, otherwise, not receiving, the funds, then the Contractor shall be liable to pay the City for the funds not granted to the City on the Project.

8.31 Entire Acreement. This Agreement constitutes the entire agreement between the parties with respect to any matter referenced herein and supersedes any and all other prior writings and oral negotiations. This Agreement may be modified only in writing, and signed by the parties in interest at the time of such modification. The terms of this Agreement shall prevail over any inconsistent provision in any other contract document appurtenant hereto, including exhibits to this Agreement.

IN WITNESS WHEREOF, the parties have executed and entered into this Agreement as of the date first written above.

ATTEST:

CITY OF PLACENTIA,
A municipal corporation and Charter City
Date:

City Administrator
ATTEST:

Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:

CONTRACTOR
17 NAVIGATION CENTER TILE WALL PROJECT
antuitA, ttlufwAi 5/4/2023
Date:

Signature
arman tehrani
Arman Tehani, Managing Member
85-4198812
Social Security or Taxpayer ID Number
Date:

Christian L. Bettenhausen, City Attorney
APPROVED AS TO INSURANCE:

Date:

Rosanna Ramirez, Director of
Administrative Services
APPROVED AS TO CONTENT:

Date:

Madelinne Villapando, Project Manager

DEPARTMENTAL APPROVAL
Date:

Karen Crocker,
Director of Community Services
18 NAVIGATION CENTER TILE WALL PROJECT

Page 1 of 2 ends

(Use of City Bond Form is Required)

LABOR AND MATERIAL PAYMENT BOND

PUBLIC WORK (CALIFORNIA)
KNOW ALL MEN BY THESE PRESENT:

WHEREAS, , as Principal, has
entered into a contract dated , with the City of Placentia (Obligee) referred to and made a part hereof to perform the following work, to wit:
and all appurtenant work in accordance with PROJECT NO. , which requires Principal to file this bond to secure claims made in relation to the project.

NOW THEREFORE, we, , as Principal,
and , a corporation organized under the
laws of and duly authorized to transact business in the State of California, as Surety, are held firmly bound unto the City of Placentia, as Obligee, and all sub- contractors, laborers, material persons and other persons employed in the performance of the referenced agreement, in the sum of
Dollars (S .00), lawful money of the United States of America, for the payment whereof well and truly to be made the Principal and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents.

If the above bounden PRINCIPAL, his or its heirs, executors, administrators, successors, assigns, or any of his or its sub -contractors, fails to pay for any materials, provisions, provender, or other supplies, or teams, implements or machinery, used in, upon, for or about the performance of the work contracted to be done, or for any work or labor to persons named in Section 9100 or the Civil Code, thereon of any kind, or for amounts due under the Unemployment Insurance Code with respect to such work or labor deducted, withheld and paid over to the Employment Development Department from the wages of employees of the contractor and sub -contractors pursuant to Section 13020 of the Unemployment Insurance Code, that the SURETY on this bond will pay the same, in an amount not exceeding the sum specified in this bond, AND ALSO, in case suit is brought upon this bond, a reasonable attorney's fee, which shall be awarded by the court to the prevailing party in said suit, said attorney's fee to be taxed as costs in said suit and to be included in the judgment herein rendered.

As part of the obligation secured hereby, the SURETY shall not be exonerated or released from the obligation of the bond by any change, alteration, or modification in or of any contract, plans, specifications, or agreement pertaining or relating to any scheme or work of improvement or pertaining or relating to the furnishing of labor, materials, or equipment therefor, nor by any change or modification of any terms of payment or extension of the time for any payment pertaining or relating to any scheme of work of improvement, nor by any rescission or attempted rescission of the contract, agreement or bond, nor by any conditions precedent or subsequent in the bond attempting to limit the right of recovery of claimants otherwise entitled to recover under

NAVIGATION CENTER TILE WALL PROJECT

Page 2 of 2 ends

any such contract or agreement, or under the bond, nor, where the bond is given for the benefit of claimants, by any fraud practiced by any person other than the claimant seeking to recover on the bond.

This bond shall inure to the benefit of any and all persons, companies and corporations entitled to file claims under the Civil Code so as to give them a right of action in a suit on this bond.

This bond is executed for the purpose of complying with the laws of the State of California and shall inure to the benefit of any of the persons named in Section 9100 of the Civil Code of the State of California.

IN WITNESS THEREOF, we have hereunto set our hands and seals this day of , 20_
(Corporate Seal)
Principal
By
Title
(Corporate Seal)
Principal
By
Title
APPROVED AS TO FORM:
/s/ Christian L. Bettenhausen
City Attorney

NAVIGATION CENTER TILE WALL PROJECT

Page 1 of 1 ends

(Use of City form is required)

SUPPLEMENTAL INFORMATION TO BE COMPLETED BY PRINCIPAL
If an individual, so state. If a firm or co -partnership, state the firm and give the names of all individual co-partners composing the partnership. If a Corporation, state legal name of corporation; state also the names of the president, secretary, treasurer and manager thereof.

Business Address:

Telephone Number:

Date:

Print Name:

Principal
Signature:

Title

NAVIGATION CENTER TILE WALL PROJECT

Page 1 of 1 ends

(Use of City form
is required)

TAX IDENTIFICATION NUMBER
The Tax Equity and Fiscal Responsibility Act of 1982 requires the payer (City of Placentia) to report to the Internal Revenue Service taxable payments to payees.

You (as a payee) are required by law to provide us with your Taxpayer Identification Number (if an individual or partnership, your Social Security Number). If you do not provide us with your correct identification number, you may be subject to a penalty imposed by the Internal Revenue Service. The payments subject to withholdings may include, but are not limited to, interest, dividends, or other payments the City of Placentia and/or the Placentia Redevelopment Agency made to you. Other payments may include rents, royalties, commissions and fees for service of non -employees.

If you are exempt from income tax, we are still required, by law, to maintain a Tax Identification Number on file. PLEASE PROVIDE YOUR TAX IDENTIFICATION NUMBER next to the appropriate listing below, sign, date and return to:

CITY OF PLACENTIA FINANCE DEPARTMENT
401 E. Chapman
Placentia, CA 92870
Exempt: Yes No Telephone ( )
CORPORATION:

U.S.A. OR ANY AGENCIES THEREOF:

IRS CODE #501 TAX-EXEMPT ORGANIZATION:

A NON-COMMISSIONED CITY OF PLACENTIA EMPLOYEE:

SOLE PROPRIETOR:

A PARTNERSHIP:

OTHER: (Explain)
Signature/Title: Date:

NAVIGATION CENTER TILE WALL PROJECT

BID GUARANTEE

TO THE CITY OF PLACENTIA
PROJECT NO.

As a material inducement to the City to award the contract for Project No. to , the undersigned ("Guarantor") has agreed to enter into this guarantee. The Guarantor hereby unconditionally guarantees to the fullest extent allowed by law the following work included in this project: ("the work").

Guarantor guarantees that the materials and equipment used by itself and its subcontractors will be free from defects and that the work will conform to the plans and specifications. Should any of the materials or equipment prove defective or should the work as a whole, or any part thereof, prove defective for any reason whatsoever (except due to intentional torts by the City), or should the work as a whole or any part thereof fail to operate properly or fail to comply with the plans and specifications, Guarantor will, at the City's sole election: 1) reimburse the City, upon written demand, for all of the City's expenses incurred replacing or restoring any such equipment or materials, including the cost of any work necessary to make such replacement or repairs; or 2) replace any such defective material or equipment and repair said work completely, all without any cost to the City. Guarantor further guarantees that any such repair work will conform to the plans and specifications for the project. This guarantee will remain in effect for five years from the date on which the contracted for work is accepted for use by the City.

Guarantor understands and agrees that the City shall have the unqualified option to make any replacements or repairs itself or to have such replacement, repair, performed by the undersigned. The City shall have no obligation to consult with Guarantor before the City proceeds to perform any repair, replacement, or work itself. If the City elects to have Guarantor perform said repair, replacement, or work, Guarantor agrees that the repair, replacement, or work shall be performed within 15 days after receipt of a written demand from the City.

If the City elects to perform the replacement, repairs itself, Guarantor agrees to make reimbursement payment within 15 days after receipt of a written demand for payment from the City.

If the Guarantor fails or refuses to comply with this guarantee, the City shall be entitled to all costs and expenses, including attorneys and expert fees, reasonably incurred by reason of Guarantor's failure or refusal.

Guarantor
Contractor:

Title:

Date:

By:

NAVIGATION CENTER TILE WALL PROJECT

STATEMENT OF NON COLLUSION BY CONTRACTOR
The undersigned who submits herewith to the City of Placentia a bid or proposal does hereby certify:
a. That all statements of fact in such bid or proposal are true; b. That such bid or proposal was not made in the interest of or on behalf of any undisclosed person, partnership, company, association, organization or corporation; c. That such bid or proposal is genuine and not collusive or sham; d. That said bidder has not, directly or indirectly by agreement, communication or conference with anyone, attempted to induce action prejudicial to the interest of the City of Placentia or of any other bidder or anyone else interested in the proposed procurement; e. Did not, directly or indirectly, collude, conspire, connive or agree with anyone else that said bidder or anyone else would submit a false or sham bid or proposal, or that anyone should refrain from bidding or withdraw his bid or proposal;
f. Did not in any manner, directly or indirectly seek by agreement, communication or conference with anyone to raise or fix the bid or proposal price of said bidder or of anyone else, or to raise or fix any overhead, profit or cost element of his bid or proposal price, or that of anyone else; Did not, directly or indirectly, submit his bid or proposal price or any breakdown thereof, or the contents thereof, or divulge information or data relative thereto, to any corporation, partnership, company, association, organization, bid depository, or to any member agent thereof, or to any individual or group of individuals, except to the City of Placentia, or to any person or persons who have a partnership or their financial interest with said bidder in his business. h. Did not provide, directly or indirectly to any officer or employee of the City of Placentia any gratuity, entertainment, meals, or anything of value, whatsoever, which could be objectively construed as intending to invoke any form of reciprocation or favorable treatment.

That no officer or principal of the undersigned firm is related to any officer or employee of the city by blood or marriage within the third degree or is employed, either full or part time, by the City of Placentia either currently or within the last two (2) years.

That no officer or principal of the undersigned firm nor any subcontractor to be engaged by the principal has been convicted by a court of competent jurisdiction of any charge of fraud, bribery, collusion, conspiracy or any other act in violation of any state or federal antitrust law in connection with the bidding upon award of, or performance of, any public work contract, with any public entity, within the last three years.
g.

I certify, under penalty of perjury under the laws of the State of California, that the foregoing is true and correct and that this certification was executed:

On at California.

Firm
Street
City State Zip
(Signature)
(Print Name & Title)

NAVIGATION CENTER TILE WALL PROJECT

EXHIBIT A

SCOPE OF SERVICES
The work to be performed consists of furnishing all materials, equipment, tools, labor, and incidentals as required by the Plans, Specifications and Contract Documents for Navigation Center Tile Wall Project.

The general items of work include the installation of ceramic tiles per the instruction and the specifications depicted on the attached drawings Nos. 1 and 2, in addition to specifications listed as Tile, Section 09-3000.

In addition to the installation of Hardie backer and tile work of the walls and the removal, protection, and reinstallation of the Epoxy Glass barriers on top of the walls, contractors will be responsible for the removal of beds and cabinetry after all personal items have been removed from the bed and cabinetry and push them 5 feet away to perform the work on the walls. The contractor will also be responsible for returning the beds and cabinetry back to their original location. Each section must be completed with the original items moved back into their proper place at the end of each workday as clients of the Navigation Centers will be sleeping in their areas each night during the construction project.

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GENER AL NOTES:
1) Work shall co nform to the City of Pl acentia standard and codes.
2) All specification shall be consider ed a part of th e impr ov eme nt plans.
3) contractors and subcontractors shall obtain appropriate permits and licenses from the City of Plac entia a nd oth er g overni ng j urisdictions pri or to a ny c onstructio n.
4) The contractor shall notify the City Engineer's office at least 48 to ur s prior to start of any construction.
5) Tile installati on shall be performed by dividing th e project int o Eight(8) separate phases scheduled and c ontractor c an work on one -phase al a lime.
6) Work hours shall be between the hours of 8 AM to 5 PM. 7) C ontractors to provide a schedule for the city's review and appr oval pri or to start of the work.
8) Contractor to provide all required submittals for the ply's r eview and approval per the project the specifications. 9) All file edges and corner shall be finished using the trims, type and color of the tile trim shall be submitted for the city's for r evi ew a nd approval.
10) All works must be completed within 60 calendar days 11) Contr act or must remove and reinstall all EXISTING partition glasses 170'.

CONSTRUCTION NOTES:
2-1- TILE SPECIFICATIONS (SEE ATTACHED). STALL WALL TILE 4,500 SOFT . 3• TILE TO BE FLOOR DECOR MANSFIELD AMBER III .

P ORCELAIN W OOD PLA NK TILE.( OR E QUAL)
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NAVIGATION CENTER SITE PLAN
DRAWIN G NO.
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WALL TILE INSTILLATION

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1-100-2 27-X100

CITY OF PLACENTIA
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TYPICAL DETAIL! N OT IN SCALE

NAVIGATION CENTER SITE PLAN

W ALL TILE INSTILLATION

CITY OF PLACENTIA
DRAWING N O.
2 SECTION C

PROPOSAL
for the

INSTALLATION OF TILE WALLS AT PLACENTIA NAVIGATION CENTER in the

CITY OF PLACENTIA
TO THE HONORABLE MAYOR AND MEMBERS OF THE COUNCIL OF PLACENTIA:

In compliance with the Notice Inviting Sealed Bids, the undersigned hereby proposes and agrees to perform all the work therein described, and to furnish all labor, material, equipment and incident insurance necessary therefor, in accordance with the plans and specifications on file in the office of the City Engineer of the City of PLACENTIA. The undersigned agrees to perform the work therein to the satisfaction of and under the supervision of the City Engineer of the City of PLACENTIA, and to enter into a contract at the following prices. The undersigned agrees to complete the work within 60 working days, from the date of the Notice to Proceed.

BIDDER declares that this proposal is based upon careful examination of the work site, plans, specifications, Instructions to Bidders and all other contract documents. If this proposal is accepted for award, BIDDER agrees to enter into a contract with AGENCY at the unit and/or lump sum prices set forth in the following Bid Schedule. BIDDER understands that failure to enter into a contract in the manner and time prescribed will result in forfeiture to AGENCY of the guaranty accompanying this proposal.

BIDDER understands that a bid is required for the entire work and that the estimated quantities set forth in the Bid Schedule are solely for the purpose of comparing bids, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. THE AGENCY RESERVES THE RIGHT TO DELETE ANY ITEM FROM THE CONTRACT. It is agreed that the unit and/or lump sum prices bid include all appurtenant expenses, taxes, royalties, fees, etc., and will be guaranteed for a period of sixty days from the bid opening date. If at such time the contract is not awarded, the AGENCY will reject all bids and will re -advertise the project. In the case of discrepancies in the amounts bid, unit prices shall govern over extended amounts, and words shall govern over figures.

C-1

If awarded the Contract, the undersigned agrees that in the event of the BIDDER'S default in executing the required contract and filing the necessary bonds and insurance certificates within 10 working days after the date of the AGENCY'S notice of award of contract to the BIDDER, the proceeds of the security accompanying this bid shall become the property of the AGENCY and this bid and the acceptance hereof may, at the AGENCY'S option, be considered null and void.

Accompanying this proposal of bid, find Bidder's Bond in the amount of $ 15,000 which said amount is not less than 10% of the aggregate of the total bid price, as required by the Notice Inviting Sealed Bids, payable to the AGENCY. (Please insert the words "Cash", "Certified Check", or "Bidder's Bond", as the case may be).

Bidder shall signify receipt of all Addenda here, if any: N/A Addenda
No.

Date Received
Bidder's Signature
C-2

BID SCHEDULE FOR

ON -CALL CONCRETE REPAIR SERVICES

BID ITEMS
ITEM
NO.

ITEMS DESCRIPTION

QUANTITY
UNIT

UNIT PRICE
TOTAL

1. Mobilization — Mobilization includes all
activities required to start the project and to
de -mobilize, including, preparation of
material submittals, project schedules and
phasing. Work under this item shall also
include the cost to secure bonds and
insurance, movement of personnel,
equipment, materials, and incidentals to
and from the project sites, staging,
maintaining the project in a safe, clean
and orderly manner during construction
and final cleanup of the work.
1 LS
$ i .,�r;r,
$ 15,000

2. Install tiles on all the walls per the
instructions and specifications shown on
the Drawing Nos. 1 & 2, attached to the
Notice Inviting Bids, listed as Appendix I
and per the attached Tile Installation
Specification Section No. 09-3000, listed as
Appendix III.
4,500
SF
$25
$ 112,500

3. Removal, protection, and reinstalling of the
Epoxy Glass barriers on top of the walls.
170
LF
$100
$ 17,000
BID SCHEDULE -TOTAL PRICE: $ 144,500
BID SCHEDULE TOTAL PRICE WRITTEN IN WORDS:

One Hundred Forty Four Thousand and Five Hundred Dollars NOTE: The City reserves the right to award a contract to the lowest responsible bidder in parts or in its entirety and reserves the right to reject all bids and re -advertises, as appears to be in the best interests of the City. A bid is required for this entire work, the estimated quantities set forth in this Bid Sheet being solely for the purpose of comparing bids, and final compensation under the Contract will be based upon the actual quantities of work satisfactorily completed. The unit and/or lump sum prices bid shall include all appurtenant expenses, taxes, royalties, and fees. In the case of discrepancies in the amount bid, unit prices shall govern over extended amounts, and words shall govern over figures.

The City reserves the right to increase or decrease the amount of any quantity shown and to delete any item from the Contract. Through submission on PlanetBids, the bidder certifies that he/she has followed the bidder instructions, acknowledges the requirements set forth in this proposal form for bid submission, and has thoroughly checked the figures set forth in the proposal and inputted into PlanetBids, that they are correct to the best of his/her knowledge and constitute his/her proposal to perform all the work called out and implied throughout these contract documents. ***BID ITEMS TO BE INPUTED ON-LINE VIA PLANETBIDS***
C-3

LIST OF SUBCONTRACTORS
In accordance with Government Code Section 4104, the Bidder shall set forth the name and business address of each subcontractor who will perform work or render service to the bidder on said contract in an amount in excess of one-half of one percent of the total bid and the portion of the work to be done by such subcontractor.

Portion
of Work
Name and Address of Subcontractor
State License
Number
Class
Prep and Tile
Instation
Exclusive Construction : 402 N. Weslridge Ave, Glendora, CA91741 DIR#1000032253
765699
B
By submission of this proposal, the Bidder certifies:

1. That he is able to and will perform the balance of all work, which is not covered in the above subcontractors listing.

2. That the AGENCY will be furnished copies of all subcontracts entered into and bonds furnished by subcontractor for this project.

C-4

NONCOLLUSION AFFIDAVIT

TO BE EXECUTED BY BIDDER AND SUBMITTED WITH BID
State of California
ss.

County of Orange
Arnran 't'ch rani
, being first duly sworn, deposes and says that he or she is of D1:\ Ova.geDlue<:e:,e:':,ic„„er:,c,,,t, the party making the foregoing bid that the bid is not made in the interest of, or on the behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the bid is genuine and not collusive or sham; that the bidder has not directly or indirectly induced or solicited any other bidder to put in a false or sham bid, and has not directly or indirectly colluded, conspired, connived, or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the bid price, or that of any other bidder, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the bid are true; and, further, that the bidder has not, directly or indirectly, submitted his or her bid price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham bid.

Arman Tehrani o/b/o Asad Holdings LLC
Name of Bidd: r
Srgn- t r- Bidder
27071 Cabot Rd. Ste 108. Laguna Hills. CA 92653
Address of Bidder
Subscribed and sworn to before me this / day of /fp- . 1 , 20 ��

NOTARY PUBLIC

NOTARY SEAL
Notary Ce .,
rt�ficate
Attached
C-5

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California Jurat Certificate
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached and not the truthfulness accuracy or validity of that document State of California
County of ��
s.s.

Subscribed and sworn to (or affirmed) before me on this \ day of i\ 20 fP3 , by ' Cl i tP ,eirvM-i-N
proved to me on the basis of
satisfactory evidence to be the person(s) who appeared before me.

OPTIONAL INFORMATION
Description of Attached Document
The certificate is attached to a document titled/for the purpose of ,l'!'/V b/ IIU Si Gr -ft, be
netik QJk ( �►l
LA -in (b:
containing pages, and dated
Tlr ++"-T-
rZ ",T
Jrw rr ; -11 ;
., ,
and
Method of Affiant Identification
Proved to me on the basis of satisfactory evidence
form(s) of identification credible witness(es)
Notarial event is detailed in notary journal on
Page # Entry #
Notary contact
Other
Affiant(s) Thumbprint(s) Describe
rr, .r,, 4.11 •;r r. rr.;•-f

DISQUALIFICATION QUESTIONNAIRE
In accordance with Government Code Section 14310.5, the Bidder shall complete, under penalty of perjury, the following questionnaire.

QUESTIONNAIRE
Has the Bidder, any officer of the Bidder or any employee of the Bidder who has a proprietary interest in the Bidder ever been disqualified, removed or otherwise prevented from bidding on or completing a Federal, State or local government project because of a violation of law or a safety regulation?
❑ Yes l No
If the answer is yes, explain the circumstances in the space provided.

Note: This questionnaire constitutes a part of the Proposal, and a signature portion of the Proposal shall constitute signature of this questionnaire.

C-6

COMPENSATION INSURANCE CERTIFICATE
Pursuant to Section 1861 of the State Labor Code, each contractor to whom a public works contract has been awarded shall sign the following certificate.

I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for worker's compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the work of this contract.

ASAD HOLDINGS LLC DBA Orangeblue General Contractors
Contractor
Arman Tehrani
By
Managing Member
Title
Date: 03/30/2023
C-7

BIDDER'S INFORMATION
BIDDER certifies that the following information is true and correct:

Arman Tehrani
Bidder Name
27071 Cabot Rd, Ste 108, Laguna Hills, CA 92653
Business Address
Laguna Hills
CA 92653
City,
949 ) 317-5700
Telephone Number
State Zip
ASAD HOLDINGS LLC DBA Orangeblue General Contractors
Contractor Name
1000994213
Contractor's DIR Public Works Registration Number
B1074946
State Contractor's License No. and Class
04/20/2021
Original Date Issued
04/30/2022
Expiration Date
The work site was inspected by Aaron Anderson
of our office on December 14th , 20 22
The following are persons, firms, and corporations having a principal interest in this proposal:

Arman Tehrani
Mehran kaDanpour
C-9

Signatur$ of Bidder
The undersigned is prepared to satisfy the Council of the City of PLACENTIA of its ability, financially or otherwise, to perform the contract for the proposed work and improvements in accordance with the plans and specifications set forth.

ASAD HOLDINGS LLC DBA Orangeblue General Contractors
d T-ehrani
Printed or Typed Signature
Subscribed and sworn to before me this I day of A -1z / , 20 ,93.

NOTARY PUBLIC
titcate
�ec
ota�y Attached

NOTARY SEAL
Listed below are the names, address and telephone numbers for three public agencies for which the bidder has performed similar work within the past two years:

1. NOCC: Saddleback College
Name and Address of Public Agency
Name and Telephone No. of Project Manager:
0200,00 f
Max T DSA Project Inspector -
[email protected]
2011?
Contract Amount Type of Work

2. Orange Coast College 2701 Fairview Rd, Costa Mesa, CA 92626 Date Completed
Name and Address of Public Agency
Name and Telephone No. of Project Manager: James Farrow 310 704-2776 087000 Gymnasium Bathroom Remodel
2021
Contract Amount
Type of Work Date Completed

3. Orange Coast College 2701 Fairview Rd, Costa Mesa, CA 92626 Name and Address of Public Agency
Name and Telephone No. of Project Manager:
65,000
ames Farrow 310-704-2776
Healthcare Center Lab Remodeling 2021
Contract Amount
Type of Work Date Completed
C-10

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A notary pubic or other officer completing this certificate vertfies only the Identity of the individual who signed the document to which this certificate is attached and not the truthfulness accuracy or validity of that document State of California
1 s.s
County of «4z6
Subscribed and sworn to (or affirmed) before me on this `�, day of 20 ,73, by
1 (,C\.,v) t and
, proved to me on the basis of
satisfactory evidence to be the person(s) who appeared before me.

OPTIONAL INFORMATION
Description of Attached Document
The certificate is attached to a document titled/for the purpose of Corr�o`�ia�
containing pages and dated
�7i!.tt.n!.•1Jam..+1r�. Cr lP'I:TF-rr i::i'ii't,�7.ii r—ir. r'T•1 jr-W. -17'r T,•i .LEi ft' -7711" R. STU LZ
COMM. #2399807 c
Notary Public . California
Orange County
Comm.Ex.ires Aril 5,2026
Method of Affiant Identification
Proved to me on the basis of satisfactory evidence
form(s) of identification credible witness(es)
Notarial event is detailed in notary journal on
Page # _ Entry #
Notary contact
Other
Affiant(s) Thumbprint(s) Describe
F-1 .: itrri.-7r
! I i:;1.r-1 1•• 171
, T.
t

RESPONSIBLE BIDDER - SUPPLEMENTAL QUESTIONNAIRE

1. How many years has your organization been in business in California as a contractor under your present business name and license number?

2.5 Years

2. What is your firm's Average Gross Revenue for the last three years? $ 2,500,000.00

3. Is your firm currently the debtor in a bankruptcy case? ❑ Yes EfNo
If " yes," indicate the case number, bankruptcy court, and the date on which the petition was filed.

Case Number
Bankruptcy Court Date Filed

4. Was your firm in bankruptcy any time during the last five years? (This question refers only to a bankruptcy action that was not described in answer to question 2, above.) ❑ Yes No
If " yes," indicate the case number, bankruptcy court, and the date on which the petition was filed.

Case Number
Bankruptcy Court Date Filed

5. Has any CSLB license held by your firm or its Responsible Managing Employee (RME) or Responsible Managing Officer (RMO) been suspended within the last five years? CI Yes ES No

6. At any time in the last five years, has your firm been assessed and paid liquidated damages after completion of a project, under a construction contract with either a public or private owner?
❑ Yes ® No

7. Has your firm ever defaulted on a construction contract? ❑ Yes ® No
If "yes," explain on a separate page.

8. In the last five years has your firm, or any firm with which any of your company's owners, officers or partners was associated, been debarred, disqualified, removed or otherwise prevented from bidding on, or completing, any government agency or public works project for any reason?
C-11

❑ Yes @ No
If "yes," explain on a separate page. State the name of the organization debarred, the year of the event, the owner of the project, and the basis for the action.

9. In the last five years, has your firm been denied an award of a public works contract based on a finding by a public agency that your company was not a responsible bidder? LI Yes @ No
If "yes," on a separate page identify the year of the event, the entity denied the award, the owner, the project, and the basis for the finding by the public agency.

10. In the past five years, has any claim against your firm concerning your firm's work on a construction project, been filed in court or arbitration? ❑ Yes @ No
If "yes," on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution).

11. In the past five years, has your firm made any claim against a project owner concerning work on a project or payment for a contract, and filed that claim in court or arbitration? ❑ Yes ® No
If "yes," on a separate page identify the claim be providing the name of claimant, the project name, date of the claim, name of the entity (or entities) against whom the claim was filed, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending, or if resolved, a brief description of the resolution.

12. At any time during the past five years, has any surety company made any payments on your firm's behalf as a result of a default, to satisfy any claims made against a performance or payment bond issued on your firm's behalf in connection with a construction project, either public or private?
CI Yes ®No

13. In the last five years, has any insurance carrier, for any form of insurance, refused to renew the insurance policy for your firm?
❑ Yes @ No

14. Has your firm or any of its owners, officers, or partners ever been liable in a civil suit, or found guilty in a criminal action, for making any false claim or material misrepresentation to any public agency or entity?
❑ Yes© No
C-12

15. Has your firm or any of its owners, officers or partners ever been convicted of a crime involving any federal, state, or local law related to construction? ❑ Yes No
If "yes," explain on a separate page, including identifying who was convicted, the name of the victim, the date of the conviction, the court and case number, the crimes, and the grounds for the conviction.

16. Has your firm or any of its owners, officers or partners ever been convicted of a federal or state crime of fraud, theft, or any other act of dishonesty? ❑ Yes 0 No
If "yes," identify on a separate page, the person or persons convicted, the court and case number, the crimes, and the year convicted.

17. If your firm was required to pay a premium of more than one per cent for a performance and payment bond on any project(s) on which your firm worked at any time during the last three years, state the percentage that your firm was required to pay. You may provide an explanation for a percentage rate higher than one per cent, if you wish to do so.

18. During the last five years, has your firm ever been denied bond credit by a surety company, or has there ever been a period of time when your firm has no surety bond in place during a public construction project when on was required?
❑ Yes IA No

19. Has CAL OSHA cited and assessed penalties against the General Contractor or its associates for any "serious," "willful" or "repeat" violations of its safety or health regulations in the past five years?
(Note: If you have filed an appeal of a citation, and the Occupational Safety and Health Appeals Board has not yet ruled on your appeal, you need not include information about it.)
❑ Yes 21 No
If "yes," on separate page describe the citations, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of project, and the amount of penalty paid, if any. State the case number and date of any OSHAB decision.

20. Has the Federal Occupational Safety and Health Administration cited and assessed penalties against the General Contractor or its associates in the past five years? (Note: If an appeal of the citation has been filed and the Appeals Board has not yet ruled, or there is a court appeal pending, you need not include information about the citation.) ❑ Yes 0 No
C-13

If "yes," on separate page describe the citation, the party against whom the citation was made, date of citation, nature of the violation, project on which the citation was issued, owner of project, and the amount of penalty paid, if any. State the case number and date of any decision.

21. Has there been more than one occasion during the last five years in which the General Contractor or its associates was required to pay either back wages or penalties for failure to comply with the state's prevailing wage laws?
❑ Yes ❑ No
If "yes," on separate page, describe the violator, nature of each violation, name of the project, date of its completion, the public agency for which it was constructed, the number of employees who were initially underpaid an the amount of back wages and penalties that were assessed.

22. During the last five years, has there been more than one occasion in which the General Contractor or its associates have been penalized or required to pay back wages for failure to comply with the Federal Davis -Bacon prevailing wage requirements? ❑ Yes 21 No
If "yes," on separate page, describe the violator, nature of each violation, name of the project, date of its completion, the public agency for which it was constructed, the number of employees who were initially underpaid an the amount of back wages and penalties that were assessed.

C-14

DESIGN ENGINEER MAY NOT BID ON

CONSTRUCTION CONTRACT
No engineering or architectural firm which has provided design services for a project shall be eligible to bid on the contract to construct the project. The firms ineligible to bid include the prime contractor for design, subcontractors of portions of the design, and affiliates of either. An affiliate is a firm which is subject to the control of the same persons(s), through joint ownership or otherwise.

ACKNOWLEDGED this 30th day of March 2023
Laguna Hills
Authorized Signature
Managing Member
Position
ASAD HOLDINGS LLC DBA Orangeblue General Contractors
Company
at
C-15

NOTICE OF AFFIRMATIVE ACTION
"NOTICE"
By submitting a proposal on any job or entering into any contractual agreement with the City of Placentia, the undersigned agrees not to discriminate in employment decisions against any person on account of race, creed, national origin, ethnic background, color, sex, age, or handicap in performing the work required under this proposal.

ACKNOWLEDGED this 30th day of March
Laguna Hills
Authorized Signature
Managing Member
Position
ASAD HOLDINGS LLC DBA Orangeblue General Contractors
Company
, 20 23 , at
C-16

BID BOND
(Percentage)
Bond Number: 66501726
KNOW ALL PERSONS BY THESE PRESENTS, That we
Contractors
Asad Holdings LLC dba Orangeblue General
of
27071 Cabot Rd Ste 108, Laguna Hi11s, CA 92653 , hereinafter referred to as the Principal, and Western surety Company as Surety, are held and firmly bound unto CITY of PLACENTIA Of 401 E. CHAPMAN, PLACENTIA CA 92670 Ten Percent of the hereinafter referred to as the Obligee, in the sum of Amount Bid ( to %) percent of the greatest amount bid, for the payment of which we bind ourselves, our legal representatives, successors and assigns, jointly and severally, firmly by these presents.

WHEREAS, Principal has submitted or is about to submit a proposal to Obligee on a contract for Installation of Tile Wall(S) at Placentia Navigation Center NOW, THEREFORE, if the said contract be awarded to Principal and Principal shall, within such time as may be specified, enter into the contract in writing and give such bond or bonds as may be specified in the bidding or contract documents with surety acceptable to Obligee; or if Principal shall fail to do so, pay to Obligee the damages which Obligee may suffer by reason of such failure not exceeding the penalty of this bond, then this obligation shall be void; otherwise to remain in full force and effect.

SIGNED, SEALED AND DATED this 19th day of January 2023
Asad Holdings LLC dba Orangeblue General
Contractors
(Principal)
By (Seal)
Western Surety Company
(Surety)
By ®
C eimk '' flea; (Seal)
Form F5876-8-2022

Western Surety Company

POWER OF ATTORNEY - CERTIFIED COPY
Bond No.6 65 017 2 6
Know All Men By These Presents, that WESTERN SURETY COMPANY, a corporation duly organized and existing under the laws of the State of South Dakota, and having its principal office in Sioux Falls, South Dakota (the "Company"), does by these presents make, constitute and appoint C . Bendt
its true and lawful attorney(s)-in-fact, with full power and authority hereby conferred, to execute, acknowledge and deliver for and on its behalf as Surety, bonds for:

Principal:Asad Holdings LLC dba Orangeblue General Contractors Obligee: CITY OF PLACENTIA
Amount: $1, 000, 000.00
and to bind the Company thereby as fully and to the same extent as if such bonds were signed by the Vice President, sealed with the corporate seal of the Company and duly attested by its Secretary, hereby ratifying and confirming all that the said attorney(s)-in- fact may do within the above stated limitations. Said appointment is made under and by authority of the following bylaw of Western Surety Company which remains in full force and effect.
"Section 7. All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." If Bond No. 66501726 is not issued on or before midnight of Ajr i 1 19th, 2023 , all authority conferred in this Power of Attorney shall expire and terminate.

In Witness Whereof, Western Surety Company has caused these presents to be signed by its Vice President, Paul T. Bruflat, and its corporate_seal to be affixed this 19th day of January 2023 WES 7 SURE.I,Y COMPANY
S t�E O U AI O' A l
jss
c66E D.F itIIlVi\ A JJJ(
Onitbis - ^ 3t$ day of January , in the year 2 023 , before me, a notary public, personally appeared Paul T. Bruflat, who being to me duly sworn, acknowledged that he signed the above Power of Attorney as the aforesaid officer of WESTERN SURETY COMPANY and acknowledged said instrument to be the voluntary act and deed of said corporation. 555555545544444445455544
M. BENT
r S AE L NOTARY PUBLIC gL s

SOUTH DAKOTA
+44444445444454444444444 +
My Commission Expires March 2, 2026
I the undersigned officer of Western Surety Company, a stock corporation of the State of South Dakota, do hereby certify that the attached Power of Attorney is in full force and effect and is irrevocable, and furthermore, that Section 7 of the bylaws of the Company as set forth in the Power of Attorney is now in force.

In testimony whereof, I have hereunto set my hand and seal of Western Surety Company this 19th day of January , 2023
Paul T. Bruflat,
Vice President
Notary Public - South Dakota
WES' ; SURFI.`fiY COMPANY
G.2/•
Paul Tl ruflat, Vice President
To validate bond authenticity, go to www.cnasurety.coin > Owner/Obligee Services > Validate Bond Coverage.

Form F5306-11-2020

NAVIGATION CENTER TILE WALL PROJECT

EXHIBIT B

SCHEDULE OF PERFORMANCE
All work must be complete within sixty (60) workdays from the issuance of the Notice to Proceed.

NAVIGATION CENTER TILE WALL PROJECT

EXHIBIT C

INSURANCE REQUIREMENTS
Contractor shall maintain and shall require all of its subcontractors, consultants, and other agents to maintain the insurance listed below. Any requirement for insurance to be maintained after completion of the work shall survive this agreement.

CITY reserves the right to review any and all of the required insurance policies and/or endorsements, but has no obligation to do so. Failure to demand evidence of full compliance with the insurance requirements set forth in this agreement or failure to identify any insurance deficiency shall not relieve Contractor from, nor be construed or deemed a waiver of, its obligation to maintain the required insurance at all times during the performance of this agreement.

A. Workers Compensation & Employers Liability Insurance • Workers Compensation insurance with statutory limits as required by the Labor Code of the State of California.
• Employers Liability with limits of $1,000,000 per Accident; $1,000,000 Disease per employee; $1,000,000 Disease per policy.
• The policy shall include a written waiver of the insurer's right to subrogate against CITY.
• Required Evidence Of Coverage:

1. Subrogation waiver endorsement; and

2. Properly completed Certificate of Insurance.

B. General Liability Insurance
• Commercial General Liability Insurance no less broad than Insurance Services Office (ISO) form CG 00 01.
• Coverage shall be on a standard occurrence form. Claims -Made forms are not acceptable without prior written consent. Modified, limited or restricted Occurrence forms are not acceptable without prior written consent. • Minimum Limits: $1,000,000 per Occurrence; $2,000,000 General Aggregate; $2,000,000 Products/Completed Operations Aggregate. The General Aggregate shall apply separately to each project. The required

NAVIGATION CENTER TILE WALL PROJECT
limits may be provided by a combination of General Liability Insurance and Commercial Excess or Umbrella Liability Insurance. If contractor maintains higher limits than the specified minimum limits, CITY requires and shall be entitled to coverage for the higher limits maintained by contractor. • Any deductible or self -insured retention shall be shown on the Certificate of Insurance. If the deductible or self -insured retention exceeds $25,000 it must be approved in advance by CITY. Contractor is responsible for any deductible or self -insured retention and shall fund it upon CITY'S written request, regardless of whether Contractor has a claim against the insurance or is named as a party in any action involving CITY. • Coverage shall be continued for one (1) year after completion of the work. • CITY shall be endorsed as an additional insured for liability arising out of ongoing and completed operations by or on behalf of the contractor. CITY shall continue to be an additional insured for completed operations for (1) year after completion of the work.
• The policy definition of "insured contract" shall include assumptions of liability arising out of both ongoing operations and the products -completed operations hazard ("f' definition of insured contract in ISO form CG 00 01, or equivalent).
• The insurance provided to the additional insureds shall be primary to, and non-contributory with, any insurance or self-insurance program maintained by them.
• The policy shall cover inter -insured suits and include a "Separation of Insureds" or "severability" clause which treats each insured separately. • The policy shall be endorsed to include a written waiver of the insurer's right to subrogate against all persons or entities that are, or are required to be, additional insureds.
• The policy shall not contain a Contractors' Warranty or other similar language which eliminates or restricts insurance because of a subcontractor's failure to carry specific insurance or to supply evidence of such insurance.

NAVIGATION CENTER TILE WALL PROJECT
• Required Evidence of Coverage:

1. Copy of the additional insured endorsement or policy language granting additional insured status;

2. Copy of the endorsement or policy language indicating that coverage applicable to the additional insureds is primary and non-contributory;

3. Properly completed Certificate of Insurance; and

4. Completed and signed Agent/Broker Questionnaire with supporting documentation as required.

C. Automobile Liability Insurance
Minimum Limit: $1,000,000 combined single limit per accident.

Coverage shall apply to all owned, hired and non -owned vehicles. • CITY shall qualify as an insured.
• Required Evidence of Coverage:

1. Copy of the endorsement or policy language indicating that CITY is an insured; and

2. Properly completed Certificate of Insurance.

D. Contractors Pollution Liability Insurance
• Minimum Limits: $1,000,000 per Pollution Incident; $1,000,000 Aggregate; • Coverage shall apply to pollution incidents at or from any location at which Contractor is performing work under this agreement.
• Any deductible or self -insured retention shall be shown on the Certificate of Insurance. If the deductible or self -insured retention exceeds $25,000 it shall be approved in advance by CITY. Contractor is responsible for any deductible or self -insured retention and shall fund it upon CITY written request, regardless of whether Contractor has a claim against the insurance or is named as a party in any action involving CITY. • CITY shall be endorsed as an additional insured for liability arising out of ongoing and completed operations by or on behalf of the Contractor.

Additional insured status shall continue for one (1) year after completion of

NAVIGATION CENTER TILE WALL PROJECT
the work.
• The insurance provided to the additional insureds shall apply on a primary and non-contributory basis with respect to any insurance or self-insurance program maintained by them.
• If the insurance is on a Claims -Made basis, the retroactive date shall be no later than the commencement of work.
• The insurance shall be continued for one (1) year after completion of the work. If the insurance is on a Claims -Made basis, the continuation coverage may be provided by: (a) renewal of the existing policy; (b) an extended reporting period endorsement; or (c) replacement insurance with a retroactive date no later than the commencement of the work. • Required Evidence of Coverage:

1. Copy of the additional insured endorsement or policy language granting additional insured status;

2. Copy of the endorsement or policy language indicating that coverage for the additional insureds is primary and non- contributory;

3. Properly completed Certificate of Insurance.

E. Surety Bonds
• Bid bond.
• Performance and payment bonds for the entire contract price. • The surety must be authorized to issue these bonds in the State of California.

F. Standards for Insurance Companies
• Insurers, other than the California State Compensation Insurance Fund, shall have an A.M. Best's rating of at least A:VII.

G. Documentation

NAVIGATION CENTER TILE WALL PROJECT
• The Certificate of Insurance shall include the following reference:

NAVIGATION CENTER TILE WALL PROJECT
• The name and address for Additional Insured endorsements and Certificates of Insurance is: City of Placentia
• Contractor shall provide immediate written notice if: (1) any of the required insurance policies is terminated; (2) the limits of any of the required policies are reduced; or (3) the deductible or self -insured retention is increased.
• Current Evidence of Coverage shall be provided for the entire required period of insurance.
• Upon written request, certified copies of required insurance policies shall be provided within thirty (30) days.

NAVIGATION CENTER TILE WALL PROJECT

EXHIBIT D

CERTIFICATES OF INSURANCE AND ENDORSEMENTS

NAVIGATION CENTER TILE WALL PROJECT

EXHIBIT E

CLAIMS PROCEDURE
SUMMARY OF PUBLIC CONTRACT CODE § 9204
The following procedure will apply to any claims by the Contractor on the City:

A "claim" is a separate demand on the City by a contractor on a public works project and sent by registered mail or certified mail with return receipt requested, for one or more of the following:
• A time extension, including relief from penalties for delay • Payment by the City of money damages under the terms of the contract • Payment of an amount that is disputed by the City
Initial Review
The claim must be supported by appropriate documentation. The City has 45 days within which to review the claim and provide the contractor with a written statement identifying the disputed and undisputed portions of the claim. If the City does not issue a written statement, the claim is deemed rejected in its entirety. The City will pay any undisputed portion of the claim within 60 days of issuing the statement.

Meet & Confer
If the contractor disputes the City's written response, or if the City does not issue one, the contractor may request in writing an informal conference to meet and confer for possible settlement of the claim. The City will schedule the meet and confer conference within 30 days of this request and provide a written statement identifying the remaining disputed and undisputed portions of the claim within 10 business days of the meet and confer. The City will pay the undisputed portion within 60 days of issuing this statement.

Mediation
With respect to any disputed portion remaining after the meet and confer, the City and contractor will submit the matter to nonbinding mediation, agree to a mediator within 10 business days after issuing the written statement, and share mediation costs equally. If mediation is unsuccessful, then the terms of the public works agreement and applicable law will govern resolution of the dispute.

Miscellaneous Provisions
Amounts not paid by the City in a timely manner bear interest at 7% per annum. Subcontractors may submit claims via this procedure through the general contractor. The City and contractor may waive the requirement to mediate, but cannot otherwise waive these claim procedures.

A`oR0® CERTIFICATE OF LIABILITY INSURANCE
/Y

DATE(MM/DDYYY)
04/28/2023
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(S), 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 po icy, 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
AP Tutton Insurance Services
2913 S Pullman St
License #0B89376
Santa Ana CA 92705
CONTACT Certificate Department
NAME:
(PAHONNE Ext) (949) 261-5335 FAX plc, No): (949) 261-1911 E-MAIL
ADDRESS:

INSURER(S) AFFORDING COVERAGE
NAIC H
INSURERA: Associated Industries Ins Co
23140

INSURED
ASAD Holdings LLC
DBA: Orangeblue General Contractors
27071 Cabot Road Unit 108
Laguna Niguel CA 92653
INSURER B : California Auto Insurance Comp
38342
INSURER C : Clear Spring Property & Casualty
15563
INSURER D :

INSURER E :

INSURER F:

COVERAGES
CERTIFICATE NUMBER: 22-23 Auto, WC, 23-24 GL
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 POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSR
LTR

TYPE OF INSURANCE
ADDL
INSD
SUHR
WVD

POLICY NUMBER

POLICY EFF
(MM/DD/YYYY)

POLICY EXP
(MM/DD/YYYY)
LIMITS
A
X

COMMERCIAL GENERAL LIABILITY
AES123223800
04/06/2023
04/06/2024

EACH OCCURRENCE
g 1,000,DAMAGE

CLAIMS -MADE
X
OCCUR
T 000
D
PREMISESO(Ea occRE urrence)
S 100,000
MED EXP (Any one person)
$ 5,000
X
Deductible: $2,500 per occurrence

PERSONAL BADV INJURY
$ 1,000,000
GEN'L

AGGREGATE
X

LIMIT APPLIES
PRO
JECT
PER:

LOC

GENERAL AGGREGATE
$ 2000,000

PRODUCTS - COMP/OP AGG
2,000,000
$
Total Policy Aggregate
s 5,000,000
B

AUTOMOBILE
X

LIABILITY

ANY AUTO
OWNED

AUTOS ONLY
HIRED

AUTOS ONLY
X
�./
_

SCHEDULED
AUTOS

NON -OWNED

AUTOS ONLY
BA040000076087
09/19/2022
09/19/2023

COMBINED SINGLE LIMIT
(Ea accident)
s 1,000,000
BODILY INJURY (Per person)
$
BODILYINJURY(Peraccident)

PROPERTY DAMAGE
Per accident
$
Uninsured motorist
s 1,000,000
_

UMBRELLA LIAB

EXCESS LIAB
OCCUR

CLAIMS -MADE

EACH OCCURRENCE
$

AGGREGATE
$
DED
RETENTION $
$
C

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY

ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
Y I N
Y
NIA
CWC00250301
10/19/2022
10/19/2023
X

STATUTE
EOTH
EL. EACH ACCIDENT
.
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Installation of Tile Walls @ Placentia Navigation Center The City of Placentia, its officers, employees, representatives, attorneys, and volunteers are named as additional insured per attached CG2010 07/04 and CG2037 07/04. General Liability Primary and Non -Contributory applies per NXGL009 08/09 attached. General Liability Waiver of Subrogation applies per CG2404 05/09. Auto Additional Insured per MCA85100817-CA attached. WC Blanket WOS Endt. - WC040306 04/84.

CERTIFICATE HOLDER

CANCELLATION
City of Placentia
401 E. Chapman Ave.

Placentia
CA 92870

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

The ACORD name and logo are registered marks of ACORD

POLICY NUMBER: AES1232238 00 COMMERCIAL GENERAL LIABILITY CG 20 10 07 04
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED - OWNERS, LESSEES OR

CONTRACTORS - SCHEDULED PERSON OR

ORGANIZATION
This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s):

Location(s) Of Covered Operations
All persons or organizations where required by
written contract with the Named Insured
Any location where you perform work for such
additional insured
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II — Who Is An Insured is amended to
include as an additional insured the person(s) or
organization(s) shown in the Schedule, but only
with respect to liability for "bodily injury", "property damage" or "personal and advertising injury"
caused, in whole or in part, by:

1. Your acts or omissions; or

2. The acts or omissions of those acting on your
behalf;
in the performance of your ongoing operations for
the additional insured(s) at the location(s) desig-
nated above.

B. With respect to the insurance afforded to these
additional insureds, the following additional exclu-
CG 20 10 07 04
sions apply:

This insurance does not apply to "bodily injury" or
"property damage" occurring after:

1. All work, including materials, parts or equip-
ment furnished in connection with such work, on
the project (other than service, maintenance or
repairs) to be performed by or on behalf of the
additional insured(s) at the location of the
covered operations has been completed; or

2. That portion of "your work" out of which the
injury or damage arises has been put to its in-
tended use by any person or organization other
than another contractor or subcontractor en-
gaged in performing operations for a principal
as a part of the same project.
© ISO Properties, Inc., 2004

Page 1 of 1 ends

Placentia City CouncilMay 16, 2023

Placentia City Council
May 16, 2023