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# R4260 SStatus Approved Page 1 of 5
1 resource(s) 332 booking(s) SSubtotal: $6,413.00
System User Randii Gallegos
Primary Phone Number (714) 994-9573
Email Address [email protected]
Agent Name Ben Berkley
Organization Phone 1
Number
(714) 994-9573
Organization Phone 2
Number
(714) 394-7144
Organization Name Placentia Community Chorus - 62
TypeCustomer Non-profit Non-resident
Organization Address 679 Brunswick Avenue
Placentia, CA 92870
Permit #R4260
Status Approved
Date Jul 7, 2025 1:33 PM
CITY OF PLACENTIA
401 East Chapman Ave
PLACENTIA, CA 92870
PHONE:(714) 993-8232
FAX:(714) 961-0283
EMAIL:[email protected]
Permit
Rental Fee $6,233.00
Discounts $0.00
Subtotal $6,233.00
Deposits $180.00
Deposit Discounts $0.00
Total Permit Fee $6,413.00
Total Payment $0.00
Refunds $0.00
Balance $6,413.00
Placentia Community Chorus
Booking Summary
Backs Community Building Main Room (Meeting)Center: Kraemer Memorial Park
START DATE/TIME END DATE/TIME ATTENDEE AMT W/O TAX
Thu, Sep 18, 2025 7:00 PM Thu, Sep 18, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Sep 25, 2025 7:00 PM Thu, Sep 25, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Oct 2, 2025 7:00 PM Thu, Oct 2, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Oct 16, 2025 7:00 PM Thu, Oct 16, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Oct 23, 2025 7:00 PM Thu, Oct 23, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Oct 30, 2025 7:00 PM Thu, Oct 30, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Nov 6, 2025 7:00 PM Thu, Nov 6, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Nov 13, 2025 7:00 PM Thu, Nov 13, 2025 9:00 PM 1 $194.00 278
# R4260 SStatus Approved Page 2 of 5
Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Nov 20, 2025 7:00 PM Thu, Nov 20, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Dec 18, 2025 7:00 PM Thu, Dec 18, 2025 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Jan 8, 2026 7:00 PM Thu, Jan 8, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Jan 15, 2026 7:00 PM Thu, Jan 15, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Jan 22, 2026 7:00 PM Thu, Jan 22, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Jan 29, 2026 7:00 PM Thu, Jan 29, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Feb 5, 2026 7:00 PM Thu, Feb 5, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Feb 12, 2026 7:00 PM Thu, Feb 12, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Feb 19, 2026 7:00 PM Thu, Feb 19, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Feb 26, 2026 7:00 PM Thu, Feb 26, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Mar 5, 2026 7:00 PM Thu, Mar 5, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Mar 12, 2026 7:00 PM Thu, Mar 12, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Mar 19, 2026 7:00 PM Thu, Mar 19, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Mar 26, 2026 7:00 PM Thu, Mar 26, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Apr 2, 2026 7:00 PM Thu, Apr 2, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Apr 9, 2026 7:00 PM Thu, Apr 9, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Apr 16, 2026 7:00 PM Thu, Apr 16, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Apr 23, 2026 7:00 PM Thu, Apr 23, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Apr 30, 2026 7:00 PM Thu, Apr 30, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, May 7, 2026 7:00 PM Thu, May 7, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 279
# R4260 SStatus Approved Page 3 of 5
Mon, Jun 8, 2026 7:00 PM Mon, Jun 8, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Tue, Jun 9, 2026 7:00 PM Tue, Jun 9, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Wed, Jun 10, 2026 7:00 PM Wed, Jun 10, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Thu, Jun 11, 2026 7:00 PM Thu, Jun 11, 2026 9:00 PM 1 $194.00 Backs/Whitten Main Weekday Non-Resident Non-Profit $97.00 / Hour x 2 $194.00 Resource level fees $205.00
Damage Deposit $180.00 / Each x 1 $180.00
Permit Processing Fee Non-refundable $25.00 / Each x 1 $25.00 Custom Questions
QUESTION ANSWER
Do you have any special needs or medical concerns/limitations that we need to be aware of?
No
How did you hear about us? Previous Customer
Will you be having Amplified Sound? No
Will you be needing the use of the kitchen? No
Disclaimers
DESCRIPTION TEXT
Facility Rules & Regulations I have received a copy of the City of Placentia's Facility Rules & Regulations and agree to abide by them. Please initial below.
________
Waivers and Information
WAIVER NAME DUE DATE FOR SIGNING STATUS
Facility Waiver
Attachment
Sep 18, 2025 Ben Berkley Waiver Signed by: Ben
Berkley on Jul 7, 2025
280
# R4260 SStatus Approved Page 4 of 5
Current Balance: $6,413.00Original Balance: $6,413.00Payment Schedules
CITY OF PLACENTIA FACILITY RENTAL WAIVER
AND
RELEASE OF LIABILITY
I, _________________, (Full legal name)(“Applicant”) desire to rent__________ facility (“Facility”) on__________ (Date). I understand that any false statements are grounds for denial or revocation of this Application.
In consideration for rental of the Facility, I agree as follows:
1. The City of Placentia (the "City") reserves the right to cancel this Agreement at any time. In the event of an EMERGENCY OR AFTER OFFICE HOURS, please call 714-993-8111.
2. I specifically accept responsibility for any damage to the Facility, furniture or equipment caused by the occupancy and/or use of said premises.
I further acknowledge and understand that the City is not responsible for lost or stolen property.
3. I agree to obey all policies, procedures and all other applicable laws that pertain to the rental of the Facility provided by the Community Services Department and/or by City staff and volunteers during my use of the Facility.
4. I agree to follow the current State and County health guidelines for events and gatherings and will be solely responsible to ensure the safety and health of event participants. Guidance is meant to supplement, not replace any State and County safety laws, rules and/or regulations. I acknowledge that these orders and guidelines may change at any time with no prior notice. Changes in any orders may result in additional requirements to permittees and issued permits. If the State determines that the County must return to a more restrictive tier, the City reserves the right to cancel facility rentals in public areas to protect the health and well-being of the community.
5. I, on my own behalf and/or on behalf of the named organization, hereby, voluntarily release, discharge, waive and relinquish any and all actions or causes of action for personal injury, property damage or wrongful death that occurs as a result of my and/or said organization's use of the Facility.
6. I and/or said organization agree to defend, indemnify and hold harmless, the City and/or its officers, officials, agents, employees and volunteers from and against any claims, cause of actions, loss, liability or wrongful death arising out of the use of the Facility.
7. I am solely responsible for implementing any cleaning measures required or suggested to ensure the Facility is safe for use prior to any of my volunteers, agents, personnel or invitees entering the Facility and agree to adequately clean the Facility after any such use.
8. I understand and agree that there are dangers, inherent and otherwise, in accessing and/or utilizing the Facility during the COVID-19 pandemic, and that by entering and/or utilizing the Facility, anyone who uses the Facility may be exposed to COVID-19, which may cause myself and/or anyone that attends an event that I hold at the Facility to acquire and/or transmit the virus to others. I acknowledge that accessing and/or utilizing the Facility is voluntary and agree to assume the full risk of any injuries, illnesses, viruses, communicable diseases, damages, and/or losses of any kind, regardless of severity and including death that may occur in connection with accessing and/or utilizing the Facility.
9. I, intending to be legally bound for myself and my heirs, personal representatives, next of kin, and anyone who might make a claim on my behalf, hereby waive, release, and discharge the Community Services Department, the City, and their elected officials, officers, agents, employees, and volunteers from any and all claims for damages and/or liability, whether caused by any active or passive negligent act or omission of the Community Services Department or the City, or their elected officials, officers, agents, employees, and/or volunteers, or otherwise related to my use of the Facility and promise not to sue the Community Services Department, the City, or their elected officials, officers, agents, employees, and/or volunteers for any damages I incur in connection with the rental of the Facility. This release and waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown.
10. I acknowledge and agree that this Agreement is binding upon my heirs, assigns and legal representatives. I agree that this Agreement is intended to be as broad and inclusive as is permitted by California law. I further agree that this Agreement is severable and that if any clause is found invalid, the balance of the Agreement will remain in effect, valid, and enforceable.
I HAVE READ THIS AGREEMENT AND WAIVER AND RELEASE OF LIABILITY, KNOW, UNDERSTAND AND AGREE TO BE BOUND BY ITS CONTENTS, AND SIGN IT OF MY OWN FREE WILL.
Applicant’s Full Legal Name:________ ______
Signature:__ _______________Date:___ ___
Signature
Deposit
EVENT RESOURCE DEPOSIT FEE CHARGE TAX AMOUNT PAID REFUNDS BALANCE Placentia
Community
Chorus
Backs
Community
Building
Main Room
Damage
Deposit
$180.00 $0.00 $0.00 $0.00 $180.00
281
# R4260 SStatus Approved Page 5 of 5
X:
Date:
Placentia Community Chorus
Customer Type: Non-profit Non-resident
Customer ID: 23235
Mailing Address: 679 Brunswick Avenue, Placentia, CA
92870
Organization Phone 1 Number: (714) 994-9573
Organization Phone 2 Number: (714) 394-7144
Authorized Agent Name: Ben Berkley
Primary Phone Number: (714) 994-9573
Email Address: [email protected]
X:
Date:
CITY OF PLACENTIA
Mailing Address: 401 East Chapman Ave, PLACENTIA, CA
92870
Phone Number: (714) 993-8232
Fax Number: (714) 961-0283
Email Address: [email protected]
DUE DATE AMOUNT DUE AMOUNT PAID WITHDRAWAL ADJUSTMENT BALANCE Sep 4, 2025 $6,413.00 $0.00 $0.00 $6,413.00
282
283
ATTACHMENT 3
AMENDMENT NO. 16 TO
AMENDED, REVISED AND RESTATED AGREEMENT FOR SOLID WASTE
SERVICES BETWEEN
THE CITY OF PLACENTIA AND
REPUBLIC WASTE SERVICES OF SOUTHERN CALIFORNIA, LLC
This Amendment No. 16 (the “Amendment”) is made and entered into effective the 1st day of July 2025, by and between the City of Placentia, a Charter City and Municipal Corporation (“City”), and Republic Waste Services of Southern California, LLC, a wholly owned subsidiary of Republic Services, Inc., a Delaware Limited Liability Company, dba Placentia Disposal for Solid Waste Handling Services (hereinafter “Contractor”). City and Contractor are sometimes hereinafter individually referred to as “Party” and or collectively referred to as the “Parties.”
A. Recitals.
(i) Effective July 20, 2010, City and Contractor entered into the “Amended, Revised and Restated Agreement” (the “Agreement”).
(ii) The Agreement has been revised thirteen times previously, the most recent revision being the Amendment No. 15, which became effective July 1, 2024.
(iii). City and Contractor have determined that this Amendment is required to adjust the solid waste collection rates per the terms of the Agreement in connection with solid waste handling services for City’s residents and commercial, industrial and municipal entities and agencies within the City.
(iv.) All legal prerequisites to the making of this Amendment have occurred.
NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, the Parties Agree as follows:
B. Agreement Amendment
1. Recitals Incorporated. In all respects as set forth in the Recitals, Part A., above, the Recitals are incorporated into the Agreement.
2. Contractor shall continue to provide solid waste handling services for City’s residents and commercial, industrial and municipal entities and agencies within the City in accordance with the Agreement.
3. Exhibit A Rates Revised. Exhibit “A” of the Agreement hereby is amended to reflect the rates and charges permitted to be charged by Contractor during Fiscal Year 2025-26 as set forth in Exhibit “A” hereto captioned “City of Placentia Rate Summary – Effective July 1, 2025.”
4. Terms Remain in Effect. Except as specifically modified herein, all of the remaining terms, conditions and provisions of the Agreement shall remain in full force and effect. 216284
ATTACHMENT 3
5. Merger. The Agreement, all amendments together with this Amendment No.16 and all Exhibits attached thereto, constitutes the entire Agreement between the Parties and supersedes all prior negotiations, arrangements, representations, and understandings, if any, made by or between the Parties with respect to the subject matter hereof. No amendment or other modification of the Agreement, as modified by this Amendment No. 16 shall be binding unless executed in writing by both Parties hereto, or their respective successors, assigns, or grantees.
6. Authority to Sign. Each of the undersigned represents and warrants that he or she is duly authorized to execute and deliver this Amendment No. 16 and that such execution is binding upon the entity for which he or she is executing this document.
IN WITNESS WHEREOF, the Parties have caused Amendment No. 16 to the Agreement are to be executed as of the day and year first above written.
CONTRACTOR: CITY OF PLACENTIA
By: ______________________________
Peter Besada, General Manager
By: _________________________________
Jennifer Lampman, City Administrator
ATTEST:
By: _________________________________
Robert S. McKinnell, City Clerk
APPROVED AS TO FORM:
By: _________________________________
Christian L. Bettenhausen, City Attorney
217285
AMENDMENT NO. 3 TO
PROFESSIONAL SERVICES AGREEMENT
PROVISION OF MAINTENANCE SERVICES WITH TEAM ONE MANAGEMENT INC.
This Amendment No. 3 (“Amendment”) to Professional Services Agreement is made and entered into effective the 1ST day of August 2025, by and between the CITY OF PLACENTIA, a Charter City and Municipal Corporation (“CITY”), and TEAM ONE MANAGEMENT INC., a California corporation (hereinafter “CONTRACTOR”). CITY and CONTRACTOR are sometimes hereinafter individually referred to as “Party” and or collectively referred to as the “Parties.”
A. Recitals.
(i) CITY and CONTRACTOR entered into a Professional Services Agreement (“Agreement”) effective July 1st, 2021, through which CONTRACTOR has been providing professional services as more fully explained in the Scope of Services attached to the Agreement as Exhibit “A”.
(ii) The Parties now seek to amend the Agreement to add additional services to the scope of work of porter services and janitorial services for the Civic Center under the Public works Department.
(iii) All legal prerequisites to the making of this Amendment have occurred.
NOW, THEREFORE, in consideration of the mutual covenants and conditions set forth herein, the Parties agree as follows:
B. Amendment to Agreement.
1. Section 2, Paragraph 1 of the Agreement is hereby amended to read as follows:
2.1. Contract Sum. Consultant’s total compensation shall not exceed One Hundred Thirty-Seven Thousand, Five Hundred Sixty-Two Dollars and Seventy Cents ($137,562.70).
2. Section 4.1, Paragraph 1 of the Agreement is hereby amended to read as follows:
4. 1. Term. This Agreement shall commence on the Effective Date and continue for a period of 12 months, ending on July 31, 2026, unless previously terminated as provided herein or as otherwise agreed to in writing by the parties.
3. Except as specifically modified herein, all of the terms, conditions and provisions of the Agreement shall remain in full force and effect.
4. The Agreement, all amendments together with this Amendment No. 3 and all Exhibits attached thereto, constitutes the entire Agreement between the Parties and supersedes all prior negotiations, arrangements, representations, and understandings, if any, made by or between the Parties with respect to the subject matter hereof. No amendment or other modification of the Agreement, as modified by this Amendment No. 3 shall be binding unless executed in writing by both Parties hereto, or their respective successors, assigns, or grantees.
163286
5. Each of the undersigned represents and warrants that he or she is duly authorized to execute and deliver this Amendment No. 3 and that such execution is binding upon the entity for which he or she is executing this document.
IN WITNESS WHEREOF, the Parties have caused Amendment No. 3 to the Consulting Services Agreement are to be executed as of the day and year first above written.
CONSULTANT CITY OF PLACENTIA
By: ______________________________
Mike Akhavan
President
By: _____________________________
Jennifer Lampman
City Administrator
ATTEST:
_____________________________
Robert S. McKinnell
City Clerk
APPROVED AS TO FORM:
By:_____________________________
Christian L. Bettenhausen
City Attorney
164287