REQUEST FOR PROPOSALS - City of Norwalk

REQUEST FOR QUALIFICATIONSPROFESSIONAL ENGINEERING DESIGN SERVICESSTREET PROJECTSCITY OF NORWALKEngineering Division12700 Norwalk Boulevard, Room 12Norwalk, CA 90650(562) 929-5723Key RFQ DatesIssued: April 1, 2013Written Questions: April 16, 2013Offers Due: April 24, 2013Page 1

TABLE OF CONTENTSPAGESECTION I - INSTRUCTIONS TO OFFERORS 3SECTION II - OFFER CONTENT 8SECTION III - SCOPE OF WORK 13SECTION IV – PROJECT SCHEDULE 18SECTION V - EVALUATION 20SECTION VI - PROPOSED AGREEMENT 22SECTION VII - CONFLICT OF INTEREST DISCLAIMER 42SECTION VIII - ACKNOWLEDGEMENT OF INSURANCE REQUIREMENTS 45SECTION IX – DBE REQUIREMENTS 47SECTION X – NON-LOBBYING CERTIFICATION ON FEDERAL-AIDCONTRACTS AND DISCLOSURE OF LOBBYING ACTIVITIES 54Page 2

SECTION IINSTRUCTIONS TO OFFERORSPage 3

SECTION I - INSTRUCTIONS TO OFFERORSA. EXAMINATION OF PROPOSAL DOCUMENTSThe City of Norwalk is requesting offers of qualifications for engineering design services forupcoming street rehabilitation projects. Only prequalified offerors will have an opportunity torespond to a future Request for Proposals for these design services.By submitting an offer, Offeror represents that it has thoroughly examined and become familiarwith the work required in this RFQ and that it is capable of performing quality work to achievethe objectives of the City of Norwalk Engineering Division.B. ADDENDAAny City of Norwalk changes to the requirements will be made by written addendum to thisRFQ. Any written addenda issued pertaining to this RFQ shall be incorporated into the termsand conditions of any resulting Agreement. The City of Norwalk will not be bound to anymodifications or deviations from the requirements set forth in this RFQ as the result of oralinstructions. Offerors shall acknowledge receipt of addenda in their offers. Failure toacknowledge receipt of all addenda may cause an offer to be deemed non-responsive.C. CITY CONTACTAll questions and/or inquiries regarding this RFQ shall be submitted in writing and directed to:D. CLARIFICATIONS1. Examination of DocumentsDaniel R. Garcia, PE, REA, CPPCity EngineerCity of Norwalk12700 Norwalk BoulevardNorwalk, California 90650Phone: (562) 929-5723Fax: (562) 929-5584E-mail: dgarcia@ci.norwalk.ca.usShould an Offeror require clarifications regarding the RFQ, the Offeror shall notify Daniel R.Garcia of the City of Norwalk Engineering Division in writing in accordance with Section I.D.2.Should it be found that the point in question is not clearly and fully set forth in the RFQ, the Cityof Norwalk will issue a written addendum clarifying the matter(s). The written addendum willbe sent to all listed Offerors via e-mail.2. Submitting RequestsPage 4

a. All questions must be submitted in writing to the City of Norwalk no later than 5:00 p.m. onApril 16, 2013.b. Requests for clarifications, questions and comments must be clearly labeled, "WrittenQuestions Re: “RFQ for Professional Engineering Design Services – Street Projects." TheCity of Norwalk is not responsible for failure to respond to a request that has not beenlabeled as such.c. Any of the following methods of delivering written questions are acceptable as long as thequestions are received no later than the date and time specified above:(1) U.S. Mail or Personal Courier: Attention: Daniel R. Garcia, PE, REA, CPP, CityEngineer, City of Norwalk, 12700 Norwalk Boulevard, Norwalk, CA 90650.(2) Facsimile: The City of Norwalk’s fax number is (562) 929-5584, attention: Daniel R.Garcia.(3) E-mail: dgarcia@ci.norwalk.ca.us3. City of Norwalk ResponsesResponses from the City of Norwalk will be e-mailed to all listed Offerors no later than 5:00P.M. on April 18, 2013.E. SUBMISSION OF OFFERS1. Date and TimeOffers must be submitted on or before 11:00 A.M. on April 24, 2013. Proposals receivedafter the above-specified date and time will be returned to Offerors unopened.2. AddressSubmittals delivered in person or by the U.S. Postal Service shall be submitted to the followingaddress:3. Identification of SubmittalsDaniel R. Garcia, PE, REA, CPPCity EngineerCity of Norwalk12700 Norwalk BoulevardNorwalk, California 90650Offeror shall submit 1 original and 1 copy of its offer in a sealed package, addressed as shownPage 5

above, bearing the Offeror’s name and address and clearly marked as follows:"OFFER OF QUALIFICATIONS FOR PROFESSIONAL ENGINEERING DESIGNSERVICES – STREET PROJECTS ”4. Acceptance of Offersa. The City reserves the right to accept or reject any or all offers, waive any informalities orirregularities in the offers, request additional information or revisions to the proposals, and tonegotiate with any or all Offerors.b. The City of Norwalk reserves the right to withdraw this RFQ at any time without prior noticeand the City of Norwalk makes no representations that any contract will be awarded to anyOfferor responding to this RFQ.c. The City of Norwalk reserves the right to postpone the offer submittal deadline for its ownconvenience.d. The City of Norwalk reserves the right to issue a new RFQ for the work.e. Offers received by the City of Norwalk are subject to public inspection under the CaliforniaPublic Records Act (Government Code Section 6250 et seq.), unless exempt and will be madeavailable upon request after evaluation.f. Offers submitted are not to be copyrighted.g. The City of Norwalk reserves the right to require confirmation of information furnished byany Offeror and/or request any Offeror to provide additional evidence of qualifications tosuccessfully perform the work.F. PRE-CONTRACTUAL EXPENSESThe City of Norwalk shall not, in any event, be liable for any pre-contractual expense incurredby Offeror in the preparation of its offer. Pre-contractual expenses are defined as expensesincurred by Offeror in:1. Preparing its offer in response to this RFQ2. Submitting its offer to the City of Norwalk3. Any other expenses incurred by Offeror.G. JOINT OFFERSWhere two or more Offerors desire to submit a single offer in response to this RFQ, they shall doso on a prime-sub-consultant basis rather than as a joint venture. The City of Norwalk intends tocontract with a single firm and not with multiple firms doing business as a joint venture.Page 6

H. CONTRACT TYPEIt is anticipated that the Agreement resulting from this solicitation, if awarded, will be on a notto-exceedprice contract.I. PREVAILING WAGESCertain labor categories under this project may be subject to prevailing wages as identified in theState of California Labor Code commencing in Section 1770 et. seq. These labor categorieswhen employed for any work on or in the execution of a “Public Works” project require paymentof prevailing wages.Wage guidelines entitled, Consultant Guidelines for Prevailing Wage and Labor Compliance onArchitectural and Engineering (A&E) Contracts is used to administer Caltrans Consultantcontracts and is available at:http://www.dot.ca.gov/hq/construc/A&E_Guidelines/A&EGuidelines.pdfWage information is available through the Caltrans Division of Local Assistance web site at:http://www.dir.ca.gov/dlsr/statistics_research.htmlPage 7

SECTION IIOFFER CONTENTPage 8

A. OFFER FORMAT AND CONTENT1. PresentationSECTION II - PROPOSAL CONTENTOfferors must submit 1 original and 1 copy of their offer on or before 11:00 A.M. on April 24,2013 to be considered.Offers shall be typed and submitted on 8 1/2” x 11” size paper, using a single method offastening. Offerors should not include any unnecessarily elaborate promotional material.Lengthy narrative is discouraged and offers should be brief, clear and concise.2. Letter of TransmittalA Letter of Transmittal shall be addressed to Daniel R. Garcia, PE, REA, CPP, City Engineerand must, at a minimum, contain the following information:a. Identification of Offeror who will have contractual responsibility with the City of Norwalk.Identification shall include legal name of company, corporate address, telephone number and e-mail address of the contact person identified during the period of proposal evaluation.b. Proposed working relationship between Offeror and sub-consultants, if applicable.c. Acknowledgment of receipt of all addenda, if any.d. A statement to the effect that the offer shall remain valid for a period of not less than 120 daysfrom the date of submittal.e. Signature of the official authorized to bind Offeror to the terms of the proposal.f. Signed statement attesting that all information submitted with the proposal is true and correct.3. Technical Submittala. Qualifications, Relevant Experience and ReferencesThis section of the offer shall establish the ability of the Offeror to satisfactorily perform therequired work by reasons of: experience in performing work of a similar nature to the Scope ofWork shown in Section III; proven competence in the services to be provided; strength andstability of the firm; staffing capability; current work load; track record of meeting schedules onsimilar projects and supportive client references.The Offeror shall:(1) Provide a brief profile of the firm, including the types of services offered; the year founded;Page 9

form of the organization (corporation, partnership, or sole proprietorship); number, size andlocation of offices; and total number of employees.(2) Provide a general description of the firm’s financial condition and identify any conditions(e.g. bankruptcy, pending litigation, planned office closures, impending merger, etc.) that mayimpede the Offeror’s ability to provide these services.(3) Describe the firm’s experience in performing work of a similar nature to that solicited in thisRFQ, and highlight the participation in such work by the key personnel proposed for assignmentto the City.(4) Describe specialized training, experience and professional competence in the area directlyrelated to this RFQ.(5) Identify sub-consultants by company name, address, contact person, telephone number andproject function, if applicable. The list should include a summary of the roles andresponsibilities of each sub-consultant.(6) Provide a minimum of three (3) references for completed work similar to that in scope ofwork contained in this RFQ. Furnish the contact name, title, address and telephone number ofthe person at each client agency/organization who is most knowledgeable about the workperformed. Similar work is defined as design for public highway improvements with valuesbetween $300,000 and $3 million.b. Proposed TeamThis section of the proposal shall establish the method that will be used by the Offeror to providerequested services as well as identify key personnel assigned.The Offeror shall:(1) Provide the education, training, experience and applicable professional credentials of theproposed Project Manager.(2) Furnish brief resumes (two pages maximum per resume) for the proposed Project Managerand key personnel (including sub-consultants).(3) Identify key personnel proposed to perform the specified tasks and include major areas ofsub-consultant work.(4) Include a statement that key personnel will be available to the extent proposed for theduration of the required services acknowledging that no person designated as “key” shall beremoved or replaced without the prior written concurrence of the City of Norwalk.c. Detailed Work PlanPage 10

The Offeror shall provide a narrative addressing the Scope of Work and demonstrating theOfferor’s understanding of the City of Norwalk's needs and requirements.The Offeror shall:(1) Describe the proposed approach and work plan for completing the services specified in theScope of Work. The description of the proposed approach shall discuss the services in sufficientdetail to demonstrate the Offeror’s ability to accomplish the City’s objectives.(2) Describe approach to managing resources, including a description of the role(s) of any subconsultants,if applicable, their specific responsibilities, and how their work will be supervised.Identify methods that Offeror will use to ensure quality, budget, and schedule control.d. Exceptions/DeviationsState any exceptions or deviations from the requirements of this RFQ, segregating "technical"exceptions from "contractual" exceptions. Where the Offeror wishes to propose alternativeapproaches to meeting the City of Norwalk's technical or contractual requirements, these shall bethoroughly explained. If no contractual exceptions are noted, Offeror will be deemed to have noobjection to the contract requirements as set forth in Section VI, “Proposed Agreement.”e. Fee ProposalNo indication of hourly rates or potential fees is to be included in the offer of qualifications.f. Conflict of Interest DisclaimerComplete and submit Section VII, “Conflict of Interest Disclaimer” Form with the offer.g. Acknowledgement of Insurance RequirementsComplete and submit Section VIII, “Acknowledgement of Insurance Requirements” Form withthe offer.h. Disadvantaged Business Enterprise (DBE) RequirementsThe City of Norwalk has determined that Disadvantaged Business Enterprises (DBEs) canreasonably be expected to compete for subcontracting opportunities on this project. Offerorsshall comply with the California Department of Transportation’s (Caltrans) DBE Programguidelines as outlined in the Local Assistance Procedures Manual (LAPM).Section IX, “DBE Requirements,” includes the following forms for reference. These formsrepresent requirements that can be anticipated in the future RFP to be issued for this work.:• Notice to Proposers DBE Information (Exhibit 10-I)• Local Agency Proposer UDBE Commitment (Consultant Contracts) (Exhibit 10-O1)Page 11

• Local Agency Proposer DBE Information (Consultant Contracts) (Exhibit 10-O2)The City of Norwalk has established an Underutilized goal for this Agreement of 4.6%.i. Federal Lobbying Restrictions, Title 31 U.S.C. Section 1352Complete and submit Section X, “Non-Lobbying Certification for Federal-aid Contracts (Exhibit10-P) and Disclosure of Lobbying Activities (Exhibit 10-Q)” with the proposal.j. AppendicesInformation considered by Offeror to be pertinent to this RFQ and which has not beenspecifically solicited in any of the aforementioned sections may be placed in a separate appendixsection. Offerors are cautioned, however, that this does not constitute an invitation to submitlarge amounts of extraneous materials. Appendices shall be relevant and brief.Page 12

SECTION IIISCOPE OF WORKPage 13

A. PROJECT DESCRIPTIONSECTION III – SCOPE OF WORKThe City of Norwalk has budgeted four projects in Fiscal Year 2012/2013 for design. Proposedprojects for this RFQ include but are not limited to:1. 7182 Alondra Boulevard Rehabilitation from Gridley Road to Studebaker Avenue,Divided highway, half mile long.2. 7183 Pioneer Boulevard Rehabilitation from Rosecrans Avenue to Imperial HighwayDivided highway one mile long.3. 7184 Carmenita Road Rehabilitation from Rosecrans Avenue to Interstate 5,Undivided highway, half mile long.4. 7185 Shoemaker Avenue Rehabilitation from Rosecrans Avenue to Firestone FrontageRoad, collector street, less than quarter mile long.The proposed projects will rehabilitate the existing streets and may include efficiency upgradesto traffic signalization. The street rehabilitation is anticipated to employ grind and overlay withrubberized asphalt and spot full depth repairs.B. SCOPE OF SERVICESThe following scope of services is intended as a guide only, and additional services may berequired which may not listed below, but will need to be completed as part of APWArequirements.1. Project AdministrationThe consultant shall designate a Project Manager to oversee all aspects of the project, includingensuring the scope of services are completed in a timely and professional manner; preparing andimplementing a project schedule; design; oversee progress meetings; present conceptual andfinal plans to the City Council; ensure the project meets all federal, state, and local designrequirements; report directly to the City Engineer; ensure all appropriate communications,correspondence, and reports are completed in a timely manner; arrange and participate in adetailed review of the 65%, 90% and 100% PS&E package; coordinate and ensure allstakeholders complete plan check of all appropriate project documents; and prepare and processall paperwork that may be required to advertise and award the project.2. Research and DevelopmentThe Consultant shall research and obtain copies of available as-built drawings and otheravailable database/information pertaining to the project.Page 14

The consultant shall review the preliminary utility information and prepare and send utilitynotifications to all utility companies known to operate within the project area to clear utilities forthe project. The consultant shall prepare a digital master file in AutoCAD format (latest version)depicting location of all known underground and above ground utilities within the project limits.The consultant shall conduct field review. The field review of the project site shall identifydesign constraints, verify as-built information, and observe general site conditions. Undergroundand overhead utilities shall be identified and potential conflicts shall be noted and resolvedduring final design.The consultant shall review preliminary concept plans/geometrics and coordinate with the City toestablish the approved alternatives for construction. If necessary, the consultant shall prepare ageometric plan at a scale of 1”=40’ in AutoCAD digital format for approval.3. Final Engineering/DesignUpon approval of final geometrics by the City, the consultant shall proceed with final design.The PS&E shall be prepared under the direct supervision of a registered engineer licensed in theState of California. The plans shall be stamped and signed by the responsible engineer. Thefollowing plans shall be prepared in AutoCAD digital format in English units at a scale of1”=40’ horizontal unless noted otherwise. The PS&E shall be in conformance with thecorresponding latest editions of Standard Specifications for Public Works Construction(Greenbook); APWA Standard Plans for Public Works Construction; and Caltrans StandardSpecifications and Standard Plans; and applicable design standards.The following is, at a minimum, a listing of drawings, data and calculations that may be includedas part of the Street Project construction contract:a) Title sheet and location mapb) Plans and profilesc) Signing and pavement delineationd) Stage construction and traffic control planse) Detour layout for interim conditionsf) Typical sectionsg) Construction details and notesh) Drainage layout, profiles, and detailsi) Erosion control plan/SWPPP requirementsj) Utility locations/relocations4.1 Roadway DesignAPWA and Caltrans Highway Design Standards shall be used as the basis for roadway design.Each roadway plan shall include a plan view, centerline survey control, construction notes,general notes, and details necessary to construct the improvements. Match lines shall beprovided for continuity between individual plan sheets. Drafting shall be AutoCad based andadhere to the City of Norwalk and industry drafting standards.Page 15

4.2 Roadway DrainageThe roadway drainage design shall consist mainly of surface flow within the curb and gutter,directed to existing catch basins. If existing curb drainage impairments are encountered withinthe proposed street limits, those facilities shall be reconstructed.4.3 UtilitiesThe consultant shall work closely with utility companies and municipalities to resolve conflictswith the proposed improvements. Utilities that are to be relocated/adjusted by agencies otherthan the City shall be notified in writing.4.6 Water QualityDepending on regulatory permits, the consultant shall determine the appropriate structural bestmanagement practices (BMP’s) to be included in the project. A conceptual Storm WaterPollution Prevention Plan (SWPPP) shall be prepared to depict the minimum constructionBMP’s to be incorporated into the contractor’s SWPPP.4.7 Traffic and Staging DesignThe Consultant shall develop staging and detour plans for intersection reconstruction work. Atraffic control plan for construction shall be prepared and incorporated into the bid package.The Consultant shall prepare signing and striping plans for the project.4.9 Construction DocumentsPreliminary PS&E – 65% stage. Preliminary PS&E shall be prepared in conformance with theapproved design development plan. These documents shall include all roadway and structuralplans in the required format and shall be submitted to the City and other responsibleparties/governing agencies for review and comments.Preliminary PS&E – 90% stage. Following incorporation of City (and other pertinent agencies’)comments and approval of the 65% PS&E, the construction PS&E shall be completed in detailand submitted to the City and responsible parties/governing agencies for review and approval.Final PS&E – 100% stage. Following incorporation of City (and other pertinent agencies’)comments and approval of the 90% PS&E, submit final (100% PS&E) for final approval. TheConsultant shall make sure that the final PS&E package includes all mitigation measures as maybe required by the approved environmental documents and regulatory permits.Page 16

No technical specifications are required provided that the design project abides by the StandardSpecifications for Public Works Construction (Greenbook) regarding all aspects pertaining to theconstruction of all items depicted in the construction documents.The Consultant shall determine construction quantities and prepare a project cost estimate. Thecost estimate shall be prepared electronically in a spreadsheet format using Microsoft Excel(latest version). The quantities and cost estimate shall be updated with each submittal.5. Construction Support Services (Optional Task)The Consultant shall provide support services during bidding and construction phases of theproject. These services may include:a) Attending a Pre-Bid Meetingb) Responding to bidders’ questionsc) Preparing addenda as necessaryd) Reviewing and evaluating bidse) Attending Pre-construction meetingf) Reviewing shop drawings and submittalsg) Responding to contractor’s requests for information (RFI’s)h) Providing structural verification/inspections during constructioni) Preparing as-built drawingsPage 17

SECTION IVPROJECT SCHEDULEPage 18

SECTION IV - PROJECT SCHEDULEThe following proposed project schedule is provided for reference only:Receive RFQ for design April 24, 2013Send out RFP for design May 9, 2013Proposals due June 4, 2013Start Design June 2013Complete 100% PS&E August/September 2013Page 19

SECTION VEVALUATIONPage 20

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A. EVALUATION CRITERIA:SECTION V - EVALUATIONThe City of Norwalk will review and evaluate the offers based on the following criteria:1. Qualifications of the FirmTechnical experience in performing work of a similar nature; experience working with publicagencies; strength and stability of the firm; and assessment by client references.2. Proposed Team and OrganizationQualifications of proposed Design Engineer and key personnel; logic of organization; andadequacy of labor commitment and resources to satisfactorily perform the requested services andmeet the City’s needs.3. Detailed Work PlanThorough understanding of the City's requirements and objectives; logic, clarity, specificity, andoverall quality of work plan.B. EVALUATION PROCEDURE:An Evaluation Committee will be appointed to review all offers. The committee will becomprised of City staff and may include outside personnel. The committee members will reviewand evaluate the offers. The committee will recommend to the Director of CommunityDevelopment the firms whose offers qualify them to submit proposals on the proposed scope ofwork.D. NOTIFICATION OF QUALIFICATION:Offerors who submit a proposal in response to this RFQ shall be notified by mail regarding thefirms who were selected to be on this RFQ list. Such notification shall be made within fourteendays of the date closing.Page 22

SECTION VIPROPOSED AGREEMENTPage 23

PROPOSED AGREEMENTAGREEMENT FORPROFESSIONAL SERVICES(City of Norwalk)THIS AGREEMENT is made and entered into this _____ day of _____, 2010,by and between the City of Norwalk, a municipal corporation (“City”) and_________________, (“Consultant”).R E C I T A L SA. City desires to utilize the services of Consultant as an independent contractor toprovide final design services for the Firestone Boulevard Bridge over San Gabriel River Project.B. Consultant represents that it is fully qualified to perform such services by virtueof its experience and the training, education and expertise of its principals and employees.C. City desires to retain Consultant and Consultant desires to serve City to performthese services subject to the terms contained herein and all applicable.NOW, THEREFORE, in consideration of performance by the parties of themutual promises, covenants, and conditions herein contained, the parties hereto agree asfollows:1. Consultant’s Services.1.1 Scope of Services. CONSULTANT shall provide City final design andrelated services, and shall perform the specific services more particularly described in Exhibit E,attached hereto and incorporated herein by this reference as though set forth in full.1.2 Personnel. Consultant represents that it has, or will secure at its ownexpense, all personnel required to perform the services under this Agreement. All of the servicesrequired under this Agreement will be performed by Consultant or under its supervision, and allpersonnel engaged in the work shall be qualified to perform such services.1.3 Party Representatives. For the purposes of this Agreement, the CityRepresentative shall be the Director of Community Development or such other person designatedin writing by the Director (the “City Representative”). For the purposes of this Agreement, theConsultant Representative shall be _________________ (the “Consultant Representative”).1.4 Time of Performance. Consultant shall commence the servicescontemplated under this Agreement immediately upon receipt of a request for such services fromPage 24

the City Representative and shall perform and complete each task listed during and by the timesindicated in Exhibit E.2. Term of Agreement. The term of this Agreement shall be from _________through _________-, unless sooner terminated as provided in Section 13 herein.3. Compensation. Subject to the maximum sums hereafter provided, City shall payConsultant an hourly fee based on the hourly rate schedule set forth in Exhibit E. The maximumamount of compensation which Consultant shall be entitled to receive pursuant to thisAgreement is _____________ for the term set forth in Section 2 or any extension thereof. Cityshall not withhold applicable federal or state payroll and other required taxes, or other authorizeddeductions from each payment made to the Consultant. No claims for additional servicesperformed by Consultant will be allowed unless such additional work is authorized by the CityCouncil in writing prior to the performance of such services or the incurrence of such expenses.Any additional services authorized by the City Council shall be compensated at the hourly ratesset forth in the hourly rate schedule included in Exhibit E.4. Method of Payment.4.1 Invoices. Not later than the fifteenth (15 th ) day of each month, Consultantshall submit to City invoices for all services performed and the expenses incurred pursuant tothis Agreement during the preceding month. The invoices shall describe in detail the servicesrendered during the period and shall show the days worked, number of hours worked, the hourlyrates charged, milestone achievements, and the services performed for each day in the period.City shall review such invoices and notify Consultant in writing within ten (10) business days ofany disputed amounts.4.2 Payment. City shall pay all undisputed portions of the invoice withinthirty (30) calendar days after receipt of the invoice up to the maximum amount set forth inSection 3.4.3 Audit of Records. Upon City providing 24-hour prior notice, Consultantshall make all records, invoices, time cards, cost control sheets and other records maintained byConsultant in connection with this Agreement available to City for review and audit by the City.City may conduct such review and audit at any time during Consultant’s regular working hours.5. Standard of Performance. Consultant shall perform all services under thisAgreement in accordance with the standard of care generally exercised by like professionalsunder similar circumstances and in a manner reasonably satisfactory to City.6. Ownership of Work Product. All reports, documents or other written materialdeveloped by Consultant in the performance of this Agreement shall be and remain the propertyof City without restriction or limitation upon its use or dissemination by City. Such materialshall not be the subject of a copyright application by Consultant. Any alteration or reuse by Cityof any such materials on any project other than the project for which they were prepared shall beat the sole risk of City unless City compensates Consultant for such reuse.Page 25

7. Status as Independent Contractor. Consultant is, and shall at all times remainas to City, a wholly independent contractor. Consultant shall have no power to incur any debt,obligation, or liability on behalf of City. Neither City nor any of its agents shall have controlover the conduct of Consultant or any of Consultant’s employees, except as set forth in thisAgreement. Consultant shall not, at any time, or in any manner, represent that it or any of itsofficers, agents or employees are in any manner employees of City, provided, however, thatnothing contained in this provision shall be construed or interpreted so as to deprive Consultantof any and all defenses or immunities available to public officials acting in their officialcapacities. Consultant agrees to pay all required taxes on amounts paid to Consultant under thisAgreement, and to indemnify and hold City harmless from any and all taxes, assessments,penalties, and interest asserted against City by reason of the independent contractor relationshipcreated by this Agreement. Consultant shall fully comply with the workers’ compensation lawregarding Consultant and Consultant’s employees. Consultant further agrees to indemnify andhold City harmless from any failure of Consultant to comply with applicable workers’compensation laws. City shall have the right to offset against the amount of any fees due toConsultant under this Agreement any amount due to City from Consultant as a result ofConsultant’s failure to promptly pay to City any reimbursement or indemnification arising underthis Section 7.8. Confidentiality. Consultant covenants that all data, documents, discussion, orother information developed or received by Consultant or provided for performance of thisAgreement are deemed confidential and shall not be disclosed by Consultant to any person orentity without prior written authorization by City. City shall grant such authorization ifdisclosure is required by law. All City data shall be returned to City upon the termination of thisAgreement. Consultant’s covenant under this section shall survive the termination of thisAgreement.9. Conflict of Interest. Consultant and its officers, employees, associates andsubconsultants, if any, will comply with all conflict of interest statutes of the State of Californiaapplicable to Consultant’s services under this agreement, including, but not limited to, thePolitical Reform Act (Government Code Sections 81000, et seq.) and Government Code Section1090. During the term of this Agreement, Consultant shall retain the right to perform similarservices for other clients, but Consultant and its officers, employees, associates andsubconsultants shall not, without the prior written approval of the City Manager, perform workfor another person or entity for whom Consultant is not currently performing work that wouldrequire Consultant or one of its officers, employees, associates or subconsultants to abstain froma decision under this Agreement pursuant to a conflict of interest statute.10. Indemnification. Consultant agrees to indemnify, defend and hold harmlessCity, and its elected officials, officers, attorneys, agents, employees, designated volunteers,successors and assigns in accordance with the Indemnification and Hold Harmless Agreementand Waiver of Subrogation and Contribution attached hereto as Exhibit A and incorporatedherein by this reference. Consultant agrees that Consultant’s covenant under this Section 10 shallsurvive the termination of this Agreement.11. Insurance.Page 26

11.1. Consultant shall at all times during the term of this Agreement carry,maintain, and keep in full force and effect, with an insurance company admitted to do business inCalifornia, rated “A” or better in the most recent Best’s Key Insurance Rating Guide, andapproved by City, (1) a policy or policies of broad-form commercial general liability insurancewith minimum limits of $1,000,000 combined single limit coverage against any injury, death,loss or damage as a result of wrongful or negligent acts by Consultant, its officers, employees,agents, and independent contractors in performance of services under this Agreement;(2) automobile liability insurance, with minimum combined single limits coverage of$1,000,000; (3) professional liability (errors and omissions) insurance, with minimum combinedsingle limits coverage of $1,000,000, on a form approved by the City Attorney; and (4) workers’compensation insurance with a minimum limit of $1,000,000 or the amount required by law,whichever is greater. City, its officers, employees, attorneys, and designated volunteers shall benamed as additional insureds on the policy(ies) as to commercial general liability bodily injuryand property damage coverages and automobile coverages with respect to liabilities arising outof Consultant’s work under this Agreement.11.2 Each insurance policy required by this Section 11 shall be endorsed asfollows: (1) the insurer waives the right of subrogation against City and its officers, employees,agents and representatives; (2) the policies are primary and non-contributing with any insurancethat may be carried by CITY; and (3) the policies may not be canceled or materially changedexcept after thirty (30) days prior written notice by insurer to CITY. The endorsementrequirements set forth in this subsection shall not apply to the professional liability policyrequired by this Section 11.11.3 All insurance coverages shall be confirmed by execution of endorsementson the forms attached hereto and incorporated herein as Exhibits B, C and D. Consultant isrequired to file the completed policy endorsements with City on or before the Effective Date ofthis Agreement, and to thereafter maintain current endorsements on file with City. Thecompleted endorsements are subject to the approval of City. If for any reason it shall not bepossible to obtain endorsements on City’s forms, the underlying insurance policies arenonetheless required to include the terms and conditions set forth on City’s forms unlessotherwise agreed to in writing by the City Manager.12. Cooperation. In the event any claim or action is brought against City relating toConsultant’s performance or services rendered under this Agreement, Consultant shall renderany reasonable assistance and cooperation which City might require.13. Termination. Either party may terminate this Agreement for any reason withoutpenalty or obligation on thirty (30) calendar days written notice to the other party. Consultantshall be paid for services satisfactorily rendered to the last working day the Agreement is ineffect, and Consultant shall deliver all materials, reports, documents, notes, or other writtenmaterials compiled through the last working day the Agreement is in effect. Neither party shallhave any other claim against the other party by reason of such termination.14. Notices. Any notices, bills, invoices, or reports required by this Agreement shallbe given by first class U.S. mail or by personal service. Notices shall be deemed received on (a)the day of delivery if delivered by hand or overnight courier service during Consultant’s andPage 27

City’s regular business hours or by facsimile before or during Consultant’s regular businesshours; or (b) on the third business day following deposit in the United States mail, postageprepaid, to the addresses heretofore set forth in the Agreement, or to such other addresses as theparties may, from time to time, designate in writing pursuant to the provisions of this section.All notices shall be delivered to the parties are the following addresses:If to City:City ClerkCity of Norwalk12700 Norwalk BoulevardNorwalk, California 90650Fax: (562) 929-5773With a copy to:Director of Community DevelopmentCity of Norwalk12700 Norwalk BoulevardNorwalk, California 90650Fax: (562) 929-5773If to Consultant:________________________________________________________________________15. Non-Discrimination and Equal Employment Opportunity. In the performanceof this Agreement, Consultant shall not discriminate against any employee, subcontractor, orapplicant for employment because of race, color, creed, religion, sex, marital status, nationalorigin, ancestry, age, physical or mental handicap, medical condition, or sexual orientation.Consultant will take affirmative action to ensure that subcontractors and applicants areemployed, and that employees are treated during employment, without regard to their race, color,creed, religion, sex, marital status, national origin, ancestry, age, physical or mental handicap,medical condition, or sexual orientation.16. Non-Assignability; Subcontracting. Consultant shall not assign or subcontractall or any portion of this Agreement. Any attempted or purported assignment or sub-contractingby Consultant shall be null, void and of no effect.17. Compliance with Laws. Consultant shall comply with all applicable federal,state and local laws, ordinances, codes and regulations in the performance of this Agreement.18. Non-Waiver of Terms, Rights and Remedies. Waiver by either party of anyone or more of the conditions of performance under this Agreement shall not be a waiver of anyother condition of performance under this Agreement. In no event shall the making by City ofPage 28

any payment to Consultant constitute or be construed as a waiver by City of any breach ofcovenant, or any default which may then exist on the part of Consultant, and the making of anysuch payment by City shall in no way impair or prejudice any right or remedy available to Citywith regard to such breach or default.19. Attorney’s Fees. In the event that either party to this Agreement shall commenceany legal action or proceeding to enforce or interpret the provisions of this Agreement, theprevailing party in such action or proceeding shall be entitled to recover its costs of suit,including reasonable attorney’s fees.20. Exhibits; Precedence. All documents referenced as exhibits in this Agreementare hereby incorporated in this Agreement. In the event of any material discrepancy between theexpress provisions of this Agreement and the provisions of any document incorporated herein byreference, the provisions of this Agreement shall prevail.21. Entire Agreement. This Agreement, and any other documents incorporatedherein by specific reference, represent the entire and integrated agreement between Consultantand City. This Agreement supersedes all prior oral or written negotiations, representations oragreements. This Agreement may not be amended, nor any provision or breach hereof waived,except in a writing signed by the parties which expressly refers to this Agreement.[Signatures begin on next page]Page 29

IN WITNESS WHEREOF, the parties, through their respective authorizedrepresentatives, have executed this Agreement as of the date first written above.CITYCITY OF NORWALKBy:Michael Egan, City ManagerATTEST:By:City ClerkAPPROVED AS TO FORM:By:_________________________________City Attorney__________________________________By:Name:Title:By:Name:Title:(Please note, two signatures required forcorporations pursuant to CaliforniaCorporations Code Section 313.)Page 30

EXHIBIT AINDEMNIFICATION AND HOLD HARMLESS AGREEMENTAND WAIVER OF SUBROGATION AND CONTRIBUTIONContract/Agreement/License/Permit No. or description:______________________________________________________________-----Indemnitor(s) (list all names): ___________________________A. Indemnity for Design Professional Services. To the fullest extent permitted bylaw, Indemnitor hereby agrees, at its sole cost and expense, to indemnify and holdharmless the City of Norwalk (“City”), its elected officials, officers, attorneys, agents,employees, designated volunteers, successors, assigns and those City agents servingas independent contractors in the role of City officials (collectively “Indemnitees”), fromand against any and all damages, costs, expenses, liabilities, claims, demands, causesof action, proceedings, expenses, judgments, penalties, liens, and losses of any naturewhatsoever, including fees of accountants and other professionals, and all costsassociated therewith, and reimbursement of attorneys’ fees and costs of defense(collectively “Liabilities”), whether actual, alleged or threatened, which arise out of,pertain to, or relate to, in whole or in part, the negligence, recklessness or willfulmisconduct of Indemnitor, its officers, agents, servants, employees, subcontractors,materialmen, contractors or their officers, agents, servants or employees (or any entityor individual that Indemnitor shall bear the legal liability thereof) in the performance ofdesign professional services under the above-referenced contract, agreement, license,or permit (the “Agreement”) by a “design professional,” as the term is defined underCalifornia Civil Code § 2782.8(c)(2).B. Other Indemnities. Other than in the performance of design professionalservices, and to the fullest extent permitted by law, Indemnitor hereby agrees, at its solecost and expense, to defend, hold harmless and indemnify the Indemnitees from andagainst any and all damages, costs, expenses, liabilities, claims, demands, causes ofaction, proceedings, expenses, judgments, penalties, liens, and losses of any naturewhatsoever, including fees of accountants, attorneys, or other professionals and allcosts associated therewith and the payment of all consequential damages (collectively“Claims”), in law or equity, whether actual, alleged or threatened, which arise out of,pertain to, or relate to the acts or omissions of Indemnitor, its officers, agents, servants,employees, subcontractors, materialmen, contractors or their officers, agents, servantsor employees (or any entity or individual that Indemnitor shall bear the legal liabilitythereof) in the performance of the Agreement, including the Indemnitees’ active orpassive negligence, except for Claims arising from the sole negligence or willfulmisconduct of Indemnitees, as determined by final arbitration or court decision or by theagreement of the parties. Indemnitor shall defend Indemnitees in any action or actionsfiled in connection with any Claim with counsel of Indemnitees’ choice, and shall pay allcosts and expenses, including all attorneys’ fees and experts’ costs actually incurred inconnection with such defense. Indemnitor shall reimburse Indemnitees for any and alllegal expenses and costs incurred by Indemnitees in connection therewith.Page 31

C. This indemnification is effective regardless of any prior, concurrent, orsubsequent misconduct, negligent acts, errors or omissions of Indemnitees. Thisindemnification shall survive the termination of the Agreement and is in addition to anyother rights or remedies which Indemnitees may have under the law. Payment is notrequired as a condition precedent to Indemnitees’ right to recover under this indemnityprovision, and an entry of judgment against the Indemnitor shall be conclusive in favorof the Indemnitees’ right to recover under this indemnity provision. Indemnitor shall payIndemnitees for any attorneys’ fees and costs incurred in enforcing this indemnification.D. Notwithstanding the foregoing, nothing in this instrument shall be construed toencompass (a) Indemnitees’ sole negligence or willful misconduct, to the limited extentthat the Agreement is subject to California Civil Code § 2782(a), or (b) the Indemnitees’active negligence, to the limited extent that the Agreement is subject to California CivilCode § 2782(b).E. This indemnification is effective without reference to the existence or applicabilityof any insurance coverages that may have been required under the Agreement or anyadditional insured endorsements that may extend to the Indemnitees. The City agreesto promptly inform Indemnitor in writing of any claim that the City believes to be subjectto this Indemnification and Hold Harmless Agreement and Waiver of Subrogation andContribution.F. Waiver of Subrogation. Indemnitor, on behalf of itself and all parties claimingunder or through it, hereby waives all rights of subrogation and contribution against theIndemnitees, while acting within the scope of their duties, from all claims, losses andliabilities arising out of or incident to activities or operations performed by or on behalf ofthe Indemnitor regardless of any prior, concurrent, or subsequent non-active negligenceby the Indemnitees.G. In the event there is more than one person or entity named in the Agreement asan Indemnitor, then all obligations, liabilities, covenants and conditions under thisinstrument shall be joint and several.H. Inasmuch as the remodeling and/or rehabilitation of an existing facility requiresthat certain assumptions be made regarding existing conditions, and because some ofthese assumptions may not be verifiable without expending additional sums of money,or destroying otherwise adequate or serviceable portions of the facility, the City agreesthat, except for negligence on the part of the Consultant acting in its capacity as adesign professional in perceiving inadequate existing conditions or assumptions, theConsultant will not be responsible for claims arising out of work previously designed andconstructed by others.“Indemnitor”NameNameBy:ItsBy:ItsPage 32

EXHIBIT BADDITIONAL INSURED ENDORSEMENTCOMMERCIAL GENERAL LIABILITYName and address of named insured (“Named Insured”):Name and address of Insurance Company (“Company”):General description of agreement(s), permit(s), license(s), and/or activity(ies) insured:Notwithstanding any inconsistent statement in the policy to which thisendorsement is attached (the “Policy”) or in any endorsement now or hereafter attachedthereto, it is agreed as follows:1. The City of Norwalk (“Public Agency”), its elected officials, officers,attorneys, agents, employees, and volunteers are additional insureds (“Above-NamedAdditional Insureds”) under the Policy in relation to those activities described generallyabove with regard to operations performed by or on behalf of the Named Insured. TheAbove-Named Additional Insureds have no liability for the payment of any premiums orassessments under the Policy.2. The insurance coverages afforded the Above-Named Additional Insuredsunder the Policy shall be primary insurance, and no other insurance maintained by theAbove-Named Additional Insureds shall be called upon to contribute with the insurancecoverages provided by the Policy.3. Each insurance coverage under the Policy shall apply separately to eachAbove-Named Additional Insured against whom claim is made or suit is brought exceptwith respect to the limits of the Company’s liability.4. Nothing in this contract of insurance shall be construed to precludecoverage of a claim by one insured under the policy against another insured under thepolicy. All such claims shall be covered as third-party claims, i.e., in the same manneras if separate policies had been issued to each insured. Nothing contained in thisprovision shall operate to increase or replicate the Company’s limits of liability asprovided under the policy.5. The insurance afforded by the Policy for contractual liability insurance(subject to the terms, conditions and exclusions applicable to such insurance) includesPage 1 of 3 ADDITIONAL INSURED ENDORSEMENTCOMMERCIAL GENERAL LIABILITYEXHIBIT B

liability assumed by the Named Insured under the indemnification and/or hold harmlessprovision(s) contained in or executed in conjunction with the written agreement(s) orpermit(s) designated above, between the Named Insured and the Above-NamedAdditional Insureds.6. The policy to which this endorsement is attached shall not be subject tocancellation, material change in coverage, or reduction of limits (except as the result ofthe payment of claims) below $1,000,000 combined single limit, except after writtennotice to Public Agency, by first class mail not less than thirty (30) days prior to theeffective date thereof. In the event of Company’s failure to comply with this noticeprovision, the policy as initially drafted will continue in full force and effect untilcompliance with this notice requirement.7. Company hereby waives all rights of subrogation and contribution againstthe Above-Named Additional Insureds, while acting within the scope of their duties, fromall claims, losses and liabilities arising out of or incident to the perils insured against inrelation to those activities described generally above with regard to operationsperformed by or on behalf of the Named Insured regardless of any prior, concurrent, orsubsequent non-active negligence by the Above-Named Additional Insureds.8. It is hereby agreed that the laws of the State of California shall apply toand govern the validity, construction, interpretation, and enforcement of this contract ofinsurance.9. This endorsement and all notices given hereunder shall be sent to PublicAgency at:City ClerkCity of Norwalk12700 Norwalk Blvd.P.O. Box 1030Norwalk, CA 90651-103010. Except as stated above and not in conflict with this endorsement, nothingcontained herein shall be held to waive, alter or extend any of the limits, agreements, orexclusions of the policy to which this endorsement is attached.TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OFTHIS ENDORSEMENT ATTACHES FROM/TO LIABILITYPage 2 of 3 ADDITIONAL INSURED ENDORSEMENTCOMMERCIAL GENERAL LIABILITYEXHIBIT B

11. Scheduled items or locations are to be identified on an attached sheet.The following inclusions relate to the above coverages. Includes:□ Contractual Liability □ Explosion Hazard□ Owners/Landlords/Tenants □ Collapse Hazard□ Manufacturers/Contractors □ Underground Property Damage□ Products/Completed Operations □ Pollution Liability□ Broad Form Property Damage □ Liquor Liability□ Extended Bodily Injury □□ Broad Form Comprehensive □General Liability Endorsement□12. A □ deductible or □ self-insured retention (check one) of $applies to all coverage(s) except:(if none, so state).The deductible is applicable □ per claim or □ per occurrence (check one).13. This is an □ occurrence or □ claims made policy (check one).14. This endorsement is effective on at 12:01 A.M. and forms apart of Policy Number .I, (print name), hereby declare under penalty ofperjury under the laws of the State of California, that I have the authority to bind theCompany to this endorsement and that by my execution hereof, I do so bind theCompany.Executed, 20___Signature of Authorized Representative(Original signature only; no facsimile signature or initialedsignature accepted)Phone No.: ( )Page 3 of 3 ADDITIONAL INSURED ENDORSEMENTCOMMERCIAL GENERAL LIABILITYEXHIBIT B

EXHIBIT CADDITIONAL INSURED ENDORSEMENTAUTOMOBILE LIABILITYName and address of named insured (“Named Insured”):Name and address of Insurance Company (“Company”):General description of agreement(s), permit(s), license(s), and/or activity(ies) insured:Notwithstanding any inconsistent statement in the policy to which thisendorsement is attached (the “Policy”) or in any endorsement now or hereafter attachedthereto, it is agreed as follows:1. The City of Norwalk (“Public Agency”), its elected officials, officers,attorneys, agents, employees, and volunteers are additional insureds (“Above-NamedAdditional Insureds”) under the Policy in relation to those activities described generallyabove with regard to operations performed by or on behalf of the Named Insured. TheAbove-Named Additional Insureds have no liability for the payment of any premiums orassessments under the Policy.2. The insurance coverages afforded the Above-Named Additional Insuredsunder the Policy shall be primary insurance, and no other insurance maintained by theAbove-Named Additional Insureds shall be called upon to contribute with the insurancecoverages provided by the Policy.3. Each insurance coverage under the Policy shall apply separately to eachAbove-Named Additional Insured against whom claim is made or suit is brought exceptwith respect to the limits of the Company’s liability.4. Nothing in this contract of insurance shall be construed to precludecoverage of a claim by one insured under the policy against another insured under thepolicy. All such claims shall be covered as third-party claims, i.e., in the same manneras if separate policies had been issued to each insured. Nothing contained in thisprovision shall operate to increase or replicate the Company’s limits of liability asprovided under the policy.5. The insurance afforded by the Policy for contractual liability insurance(subject to the terms, conditions and exclusions applicable to such insurance) includesPage 1 of 3 ADDITIONAL INSURED ENDORSEMENTAUTOMOBILE LIABILITYEXHIBIT C

liability assumed by the Named Insured under the indemnification and/or hold harmlessprovision(s) contained or executed in conjunction with the written agreement(s) orpermit(s) designated above, between the Named Insured and the Above-NamedAdditional Insureds.6. The policy to which this endorsement is attached shall not be subject tocancellation, material change in coverage, reduction of limits (except as the result of thepayment of claims) below $1,000,000 combined single limit, or non-renewal except afterwritten notice to Public Agency, by first class mail, not less than thirty (30) days prior tothe effective date thereof. In the event of Company’s failure to comply with this noticeprovision, the policy as initially drafted will continue in full force and effect untilcompliance with this notice requirement.7. Company hereby waives all rights of subrogation and contribution againstthe Above-Named Additional Insureds, while acting within the scope of their duties, fromall claims, losses and liabilities arising out of or incident to the perils insured against inrelation to those activities described generally above with regard to operationsperformed by or on behalf of the Named Insured regardless of any prior, concurrent, orsubsequent non-active negligence by the Above-Named Additional Insureds.8. It is hereby agreed that the laws of the State of California shall apply toand govern the validity, construction, interpretation, and enforcement of this contract ofinsurance.9. This endorsement and all notices given hereunder shall be sent to PublicAgency at:City ClerkCity of Norwalk12700 Norwalk Blvd.P.O. Box 1030Norwalk, CA 90651-103010. Except as stated above and not in conflict with this endorsement, nothingcontained herein shall be held to waive, alter or extend any of the limits, agreements, orexclusions of the policy to which this endorsement is attached.TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OFTHIS ENDORSEMENT ATTACHES FROM/TO LIABILITYPage 2 of 3 ADDITIONAL INSURED ENDORSEMENTAUTOMOBILE LIABILITYEXHIBIT C

11. Scheduled items or locations are to be identified on an attached sheet.The following inclusions relate to the above coverages. Includes:□ Any Automobiles □ Truckers Coverage□ All Owned Automobiles □ Motor Carrier Act□ Non-owned Automobiles □ Bus Regulatory Reform Act□ Hired Automobiles □ Public Livery Coverage□ Scheduled Automobiles □□ Garage Coverage □12. A □ deductible or □ self-insured retention (check one) of $applies to all coverage(s) except:(if none, so state).The deductible is applicable □ per claim or □ per occurrence (check one).13. This is an □ occurrence or □ claims made policy (check one).14. This endorsement is effective on at 12:01 A.M. and forms apart of Policy Number .I, (print name), hereby declare under penalty ofperjury under the laws of the State of California, that I have the authority to bind theCompany to this endorsement and that by my execution hereof, I do so bind theCompany.Executed, 20___Signature of Authorized Representative(Original signature only; no facsimile signature or initialedsignature accepted)Phone No.: ( )Page 3 of 3 ADDITIONAL INSURED ENDORSEMENTAUTOMOBILE LIABILITYEXHIBIT C

EXHIBIT DADDITIONAL INSURED ENDORSEMENTEXCESS LIABILITYName and address of named insured (“Named Insured”):Name and address of Insurance Company (“Company”):General description of agreement(s), permit(s), license(s), and/or activity(ies) insured:Notwithstanding any inconsistent statement in the policy to which thisendorsement is attached (the “Policy”) or in any endorsement now or hereafter attachedthereto, it is agreed as follows:1. The City of Norwalk (“Public Agency”), its elected officials, officers,attorneys, agents, employees, and volunteers are additional insureds (“Above-NamedAdditional Insureds”) under the Policy in relation to those activities described generallyabove with regard to operations performed by or on behalf of the Named Insured. TheAbove-Named Additional Insureds have no liability for the payment of any premiums orassessments under the Policy.2. The insurance coverages afforded the Above-Named Additional Insuredsunder the Policy shall be primary insurance, and no other insurance maintained by theAbove-Named Additional Insureds shall be called upon to contribute with the insurancecoverages provided by the Policy.3. Each insurance coverage under the Policy shall apply separately to eachAbove-Named Additional Insured against whom claim is made or suit is brought exceptwith respect to the limits of the Company’s liability.4. Nothing in this contract of insurance shall be construed to precludecoverage of a claim by one insured under the policy against another insured under thepolicy. All such claims shall be covered as third-party claims, i.e., in the same manneras if separate policies had been issued to each insured. Nothing contained in thisprovision shall operate to increase or replicate the Company’s limits of liability asprovided under the policy.Page 1

5. The insurance afforded by the Policy for contractual liability insurance(subject to the terms, conditions and exclusions applicable to such insurance) includesliability assumed by the Named Insured under the indemnification and/or hold harmlessprovision(s) contained in or executed in conjunction with the written agreement(s) orpermit(s) designated above, between the Named Insured and the Above-NamedAdditional Insureds.6. The policy to which this endorsement is attached shall not be subject tocancellation, material change in coverage, reduction of limits (except as the result of thepayment of claims) below $1,000,000 combined single limit, when added to the primarycoverage to which the excess policy applies, or non-renewal except after written noticeto Public Agency, by certified mail, return receipt requested, not less than thirty (30)days prior to the effective date thereof. In the event of Company’s failure to comply withthis notice provision, the policy as initially drafted will continue in full force and effectuntil compliance with this notice requirement.7. Company hereby waives all rights of subrogation and contribution againstthe Above-Named Additional Insureds, while acting within the scope of their duties, fromall claims, losses and liabilities arising out of or incident to the perils insured against inrelation to those activities described generally above with regard to operationsperformed by or on behalf of the Named Insured regardless of any prior, concurrent, orsubsequent non-active negligence by the Above-Named Additional Insureds.8. It is hereby agreed that the laws of the State of California shall apply toand govern the validity, construction, interpretation, and enforcement of this contract ofinsurance.9. This endorsement and all notices given hereunder shall be sent to PublicAgency at:City ClerkCity of Norwalk12700 Norwalk Blvd.P.O. Box 1030Norwalk, CA 90651-103010. Except as stated above and not in conflict with this endorsement, nothingcontained herein shall be held to waive, alter or extend any of the limits, agreements, orexclusions of the policy to which this endorsement is attached.TYPE OF COVERAGES TO WHICH POLICY PERIOD LIMITS OFTHIS ENDORSEMENT ATTACHES FROM/TO LIABILITY□□□Following FormUmbrella LiabilityPage 2

11. Applicable underlying coverages:INSURANCE COMPANY POLICY NO. AMOUNT12. The following inclusions, exclusions, extensions or specific provisionsrelate to the above coverages:13. A □ deductible or □ self-insured retention (check one) of $applies to all coverage(s) except:(if none, so state).The deductible is applicable □ per claim or □ per occurrence (check one).14. This is an □ occurrence or □ claims made policy (check one).15. This endorsement is effective on at 12:01 A.M. and forms apart of Policy Number .I, (print name), hereby declare under penalty ofperjury under the laws of the State of California, that I have the authority to bind theCompany to this endorsement and that by my execution hereof, I do so bind theCompany.Executed , 20Phone No.: ( )Signature of Authorized Representative(Original signature only; no facsimile signature or initialedsignature accepted)Page 3

SECTION VIICONFLICT OF INTERESTAND OTHER DISCLAIMERSLPP 09-02Page 10-50July 31, 2009

PUBLIC CONTRACT CODEPublic Contract Code Section 10285.1 StatementIn accordance with Public Contract Code Section 10285.1 (Chapter 376, State. 1985), the bidder herebydeclares under penalty of perjury under the laws of the State of California that the bidder has, has not been convicted within the preceding three years of any offensesreferred to in that section, including any charge of fraud, bribery, collusion conspiracy, or any other actin violation of any state or Federal antitrust law in connection with the bidding upon, award of, orperformance of, any public works contract, as defined in Public Contract Code Section 1101, with anypublic entity, as defined in Public Contract Code Section 1100, including the Regents of the Universityof California or the Trustees of the California State University. The term “bidder” is understood toinclude any partner, member, officer, director, responsible managing officer, or responsible managingemployee thereof, as referred to in Section 10285.1.Note:The bidder must place a check mark after “has” or “has not” in one of the blank spaces provided. Theabove Statement is part of the Proposal. Signing this Proposal on the signature portion thereof shall alsoconstitute signature of this Statement. Bidders are cautioned that making a false certification may subjectthe certifier to criminal prosecution.Public Contract Code Section 10162 QuestionnaireIn accordance with Public Contract Code Section 10162, the Bidder shall complete, under penalty ofperjury, the following questionnaire:Has the bidder, any officer of the bidder, or any employee of the bidder who has a proprietary interest inthe bidder, ever been disqualified, removed, or otherwise prevented from bidding on, or completing afederal, state, or local government project because of a violation of law or a safety regulation:YesNoIf the answer is yes, explain the circumstances in the following space.Public Contract Code 10232 StatementIn accordance with Public Contract Code Section 10232, the Contractor, hereby states under penalty ofperjury, that no more than one final unappealable finding of contempt of court by a federal court hasbeen issued against the Contractor within the immediate preceding two year period because of theContractor’s failure to comply with an order of federal court which orders the Contractor to comply withan order of the National Labor Relations Board.Note: The above Statement and Questionnaire are part of the Proposal. Signing this Proposal on the signatureportion thereof shall also constitute signature of this Statement and Questionnaire. Bidders are cautioned that makinga false certification may subject the certifier to criminal prosecution.LPP 09-02Page 10-51July 31, 2009

Noncollusion Affidavit(Title 23 United States Code Section 112 andPublic Contract Code Section 7106)To the CITY of Norwalk.In accordance with Title 23 United States Code Section 112 and Public Contract Code 7106 the bidderdeclares that the bid is not made in the interest of, or on behalf of, any undisclosed person, partnership,company, association, organization, or corporation; that the bid is genuine and not collusive or sham; thatthe 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 toput in a sham bid, or that anyone shall refrain from bidding; that the bidder has not in any manner, directlyor indirectly, sought by agreement, communication, or conference with anyone to fix the bid price of thebidder or any other bidder, or to fix any overhead, profit, or cost element of the bid price, or of that of anyother bidder, or to secure any advantage against the public body awarding the contract of anyone interestedin the proposed contract; that all statements contained in the bid are true; and, further, that the bidder hasnot, 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, any fee to any corporation,partnership, company association, organization, bid depository, or to any member or agent thereof toeffectuate a collusive or sham bid.Note:The above Noncollusion Affidavit is part of the Proposal. Signing this Proposal on the signatureportion thereof shall also constitute signature of this Noncollusion Affidavit.Bidders are cautioned that making a false certification may subject the certifier to criminalprosecution.LPP 09-02Page 10-52July 31, 2009

SECTION VIIIACKNOWLEDGEMENT OF INSURANCE REQUIREMENTSLPP 09-02Page 10-53July 31, 2009

ACKNOWLEDGMENT OF INSURANCE REQUIREMENTSAND CERTIFICATION OF ABILITY TOPROVIDE COVERAGES SPECIFIEDI, ____________________________________, the ________________________(President; Secretary; Owner or Representative)of _______________________________________________________, certify that the(Company Name or Corporation, or Owner)Insurance Requirements set forth in Article IV of the Proposed Agreement have been read andunderstood that our insurance company(ies) ____________________________________________________________________________________________________________(Name(s) of insurance company(ies)is/are able to provide the coverages specified.____________________________________Signature of President, Secretary, Partner,Owner or Representative____________________________________DateLPP 09-02Page 10-54July 31, 2009

SECTION IXDISADVANTAGED BUSINESS ENTERPRISE(DBE) REFERENCE REQUIREMENTSLPP 09-02Page 10-55July 31, 2009

Exhibit 10-I Notice to Proposers DBE InformationLOCAL AGENCY LETTERHEAD(DATE)NOTICE TO PROPOSERSDISADVANTAGED BUSINESS ENTERPRISEINFORMATIONThe Agency has established an Underutilized DBE goal for this Agreement of % ORThe Agency has not established an Underutilized goal for this Agreement. However, proposers are encouraged toobtain DBE participation for this Agreement.1. TERMS AS USED IN THIS DOCUMENT• The term “Disadvantaged Business Enterprise” or “DBE” means a for-profit small business concernowned and controlled by a socially and economically disadvantaged person(s) as defined in Title 49, Part26.5, Code of Federal Regulations (CFR).• The term “Underutilized Disadvantaged Business Enterprise” or “UDBE.” DBE classes that have beendetermined in the 2007 Caltrans Disparity Study to have a statistically significant disparity in theirutilization in previously awarded transportation contracts. UDBEs include: African Americans, NativeAmericans, Asian-Pacific Americans, and Women.• The term “Agreement” also means “Contract.”• Agency also means the local entity entering into this contract with the Contractor or Consultant.• The term “Small Business” or “SB” is as defined in 49 CFR 26.65.2. AUTHORITY AND RESPONSIBILITYA. DBEs and other small businesses are strongly encouraged to participate in the performance ofAgreements financed in whole or in part with federal funds (See 49 CFR 26, “Participation byDisadvantaged Business Enterprises in Department of Transportation Financial Assistance Programs”).The Contractor should ensure that DBEs and other small businesses have the opportunity to participatein the performance of the work that is the subject of this solicitation and should take all necessary andreasonable steps for this assurance. The proposer shall not discriminate on the basis of race, color,national origin, or sex in the award and performance of subcontracts.B. Proposers are encouraged to use services offered by financial institutions owned and controlled by DBEs.LPP 09-02Page 10-56July 31, 2009

3. SUBMISSION OF UDBE AND DBE INFORMATIONIf there is a UDBE goal on the contract, a “Local Agency Proposer UDBE Commitment (ConsultantContract)” (Exhibit 10-O1) form shall be included in the Request for Proposal. In order for a proposer to beconsidered responsible and responsive, the proposer must make good faith efforts to meet the goalestablished for the contract. If the goal is not met, the proposer must document adequate good faith efforts.Only UDBE participation will be counted towards the contract goal; however, all DBE participation shall becollected and reported.A “Local Agency Proposer DBE Information (Consultant Contract)” (Exhibit 10-O2) form shall be includedwith the Request for Proposal. The purpose of the form is to collect data required under 49 CFR 26. Forcontracts with UDBE goals, this form collects DBE participation by DBEs owned by Hispanic American andSubcontinent Asian Americans males (persons whose origin are from India, Pakistan, Bangladesh, Bhutan,Maldives Islands, Nepal or Sri Lanka). For contracts with no goals, this form collects information on allDBEs, including UDBEs. Even if no DBE participation will be reported, the successful proposer must executeand return the form.4. DBE PARTICIPATION GENERAL INFORMATIONIt is the proposer’s responsibility to be fully informed regarding the requirements of 49 CFR, Part 26, and theDepartment’s DBE program developed pursuant to the regulations. Particular attention is directed to thefollowing:A. A DBE must be a small business firm defined pursuant to 13 CFR 121 and be certified through theCalifornia Unified Certification Program (CUCP).B. A certified DBE may participate as a prime contractor, subcontractor, joint venture partner, as a vendorof material or supplies, or as a trucking company.C. A UDBE proposer not proposing as a joint venture with a non-DBE, will be required to document one ora combination of the following:1. The proposer is a UDBE and will meet the goal by performing work with its own forces.2. The proposer will meet the goal through work performed by UDBE subcontractors, suppliers ortrucking companies.3. The proposer, prior to proposing, made adequate good faith efforts to meet the goal.D. A DBE joint venture partner must be responsible for specific contract items of work or clearly definedportions thereof. Responsibility means actually performing, managing, and supervising the work with itsown forces. The DBE joint venture partner must share in the capital contribution, control, management,risks and profits of the joint venture commensurate with its ownership interest.E. A DBE must perform a commercially useful function pursuant to 49 CFR 26.55, that is, a DBE firmmust be responsible for the execution of a distinct element of the work and must carry out itsresponsibility by actually performing, managing and supervising the work.F. The proposer shall list only one subcontractor for each portion of work as defined in their proposal and allDBE subcontractors should be listed in the bid/cost proposal list of subcontractors.G. A prime contractor who is a certified DBE is eligible to claim all of the work in the Agreement towardthe DBE participation except that portion of the work to be performed by non-DBE subcontractors.LPP 09-02Page 10-57July 31, 2009

5. RESOURCESA. The CUCP database includes the certified DBEs from all certifying agencies participating in the CUCP.If you believe a firm is certified that cannot be located on the database, please contact the Caltrans Officeof Certification toll free number 1-866-810-6346 for assistance. Proposer may call (916) 440-0539 forweb or download assistance.B. Access the CUCP database from the Department of Transportation, Civil Rights, Business EnterpriseProgram web site at: http://www.dot.ca.gov/hq/bep/.• Click on the link in the left menu titled Disadvantaged Business Enterprise• Click on Search for a DBE Firm link• Click on Access to the DBE Query Form located on the first line in the center of the page• Searches can be performed by one or more criteria• Follow instructions on the screenC. How to Obtain a List of Certified DBEs without Internet AccessD. DBE Directory: If you do not have Internet access, Caltrans also publishes a directory of certified DBEfirms extracted from the online database. A copy of the directory of certified DBEs may be ordered at:http://caltrans-opac.ca.gov/publicat.htm6. MATERIALS OR SUPPLIES PURCHASED FROM DBES COUNT TOWARDS DBE CREDIT, AND IF A DBE IS ALSO AUDBE, PURCHASES WILL COUNT TOWARDS THE UDBE GOAL UNDER THE FOLLOWING CONDITIONS:A. If the materials or supplies are obtained from a DBE manufacturer, count 100 percent of the cost of thematerials or supplies. A DBE manufacturer is a firm that operates or maintains a factory, orestablishment that produces on the premises the materials, supplies, articles, or equipment required underthe Agreement and of the general character described by the specifications.B. If the materials or supplies purchased from a DBE regular dealer, count 60 percent of the cost of thematerials or supplies. A DBE regular dealer is a firm that owns, operates or maintains a store,warehouse, or other establishment in which the materials, supplies, articles or equipment of the generalcharacter described by the specifications and required under the Agreement are bought, kept in stock,and regularly sold or leased to the public in the usual course of business. To be a DBE regular dealer, thefirm must be an established, regular business that engages, as its principal business and under its ownname, in the purchase and sale or lease of the products in question. A person may be a DBE regular dealerin such bulk items as petroleum products, steel, cement, gravel, stone or asphalt without owning,operating or maintaining a place of business provided in this section.C. If the person both owns and operates distribution equipment for the products, any supplementingof regular dealers’ own distribution equipment shall be, by a long-term lease agreement and notan ad hoc or Agreement-by-Agreement basis. Packagers, brokers, manufacturers’representatives, or other persons who arrange or expedite transactions are not UDBE regulardealers within the meaning of this section.LPP 09-02D. Materials or supplies purchased from a DBE, which is neither a manufacturer nor a regularPage 10-58July 31, 2009

dealer, will be limited to the entire amount of fees or commissions charged for assistance in theprocurement of the materials and supplies, or fees or transportation charges for the delivery ofmaterials or supplies required on the job site, provided the fees are reasonable and not excessiveas compared with fees charged for similar services.7. FOR DBE TRUCKING COMPANIES: CREDIT FOR DBES WILL COUNT TOWARDS DBE CREDIT,AND IF A DBE IS A UDBE, CREDIT WILL COUNT TOWARDS THE UDBE GOAL UNDER THEFOLLOWING CONDITIONS:A. The DBE must be responsible for the management and supervision of the entire truckingoperation for which it is responsible on a particular Agreement, and there cannot be a contrivedarrangement for the purpose of meeting the UDBE goal.B. The DBE must itself own and operate at least one fully licensed, insured, and operational truckused on the Agreement.C. The DBE receives credit for the total value of the transportation services it provides on theAgreement using trucks it owns, insures, and operates using drivers it employs.D. The DBE may lease trucks from another DBE firm including an owner-operator who is certifiedas a DBE. A DBE who leases trucks from another DBE receives credit for the total value of thetransportation services the lessee DBE provides on the Agreement.E. The DBE may also lease trucks from a non-DBE firm, including an owner-operator. A DBE wholeases trucks from a non-DBE is entitled to credit only for the fee or commission it receives as aresult of the lease arrangement. A DBE does not receive credit for the total value of thetransportation services provided by the lessee, since these services are not provided by the DBE.F. For the purposes of this Section D, a lease must indicate that the DBE has exclusive use andcontrol over the truck. This does not preclude the leased truck from working for others duringthe term of the lease with the consent of the DBE, as long as the lease gives the DBE absolutepriority for use of the leased truck. Leased trucks must display the name and identificationnumber of the DBE.LPP 09-02Page 10-59July 31, 2009

EXHIBIT 10-O1 Local Agency Proposer UDBE Commitment (Consultant Contracts)NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORMLOCAL AGENCY:LOCATION:PROJECT DESCRIPTION:PROPOSAL DATE:PROPOSER’S NAME:CONTRACT UDBE GOAL (%):WORKITEM NO.DESCRIPTION OR SERVICES TO BESUBCONTRACTED (or contracted ifthe proposer is a UDBE)UDBE CERT NO.AND EXPIRATIONDATENAME OF EACH UDBE (Must becertified at the time proposals aredue - include UDBE address andphone number)PERCENTPARTICIPATIONOF EACH UDBEFor Local Agency to Complete:Local Agency Proposal Number:Federal-Aid Project Number:Federal Share:Proposal Date:Total Claimed UDBECommitment %Signature of ProposerLocal Agency certifies that the UDBE certifications have been verified and allinformation is complete and accurate/unless noted otherwise.Date(Area Code) Tel. No.Print Name Signature DateLocal Agenc RepresentativePerson to Contact(Please Type or Print)(Area Code) Telephone Number:Local Agency Proposer UDBE Commitment (Consultant Contracts)(Rev 6/27/09)LPP 09-02Page 10-60July 31, 2009

EXHIBIT 10-O2 Local Agency Proposer DBE Information (Consultant Contracts)NOTE: PLEASE REFER TO INSTRUCTIONS ON THE REVERSE SIDE OF THIS FORMLOCAL AGENCY:LOCATION:PROJECT DESCRIPTION:TOTAL CONTRACT AMOUNT ($):PROPOSER’S NAME:WORKITEM NO.DESCRIPTION OR SERVICES TO BESUBCONTRACTED (or contracted ifthe proposer is a DBE)DBE CERT NO.AND EXPIRATIONDATENAME OF EACH DBE (Mustbe certified at the time proposalsare due - include DBE addressand phone number)DOLLAR AMOUN T OFEACH DBEFor Local Agency to Complete:Local Agency Contract Number:Total Claimed DBEParticipation$Federal-Aid Project Number:Federal Share:_%Contarct Award:Local Agency certifies that the DBE certifications have been verified and allinformations is complete and accurate.Signature of ProposerPrint Name Signature DateLocal Agency RepresentativeDate(Area Code) Tel. No.(Area Code) Telephone Number:For Caltrans Review:Person to Contact(Please Type or Print)Print Name Signature DateCaltrans District Local Assistance EngineerLocal Agency Proposer DBE Information (Consultant Conttarcts)(Rev 6/27/09)LPP 09-02Page 10-61July 31, 2009

SECTION XNON-LOBBYING CERTIFICATIONFOR FEDERAL-AID CONTRACTSANDDISCLOSURE OF LOBBYING ACTIVITIESLPP 09-02Page 10-62July 31, 2009

LPP 09-02Page 10-63July 31, 2009

Exhibit 10-Q Disclosure of LobbyingActivitiesDISCLOSURE OF LOBBYINGACTIVITIESCOMPLETE THIS FORM TO DISCLOSE LOBBYING ACTIVITIES PURSUANT TO 31 U.S.C. 13521. Type of Federal Action: 2. Status of Federal Action: 3. Report Type:a. contract a. bid/offer/application a. initialb. grantb. initial awardb. material changec. cooperative agreementc. post-awardd. loan For Material Change Only:e. loan guarantee year quarterf. loan insurance date of last report4. Name and Address of Reporting Entity 5. If Reporting Entity in No. 4 is Subawardee,Enter Name and Address of Prime:PrimeSubawardeeTier , if knownCongressional District, if knownCongressional District, if known6. Federal Department/Agency: 7. Federal Program Name/Description:CFDA Number, if applicable8. Federal Action Number, if known: 9. Award Amount, if known:10. a. Name and Address of Lobby Entity b. Individuals Performing Services (including(If individual, last name, first name, MI) address if different from No. 10a)(last name, first name, MI)(attach Continuation Sheet(s) if necessary)11. Amount of Payment (check all that apply) 13. Type of Payment (check all that apply)$ actual planned a. retainerb. one-time fee12. Form of Payment (check all that apply): c. commissiona. cash d. contingent feeb. in-kind; specify: natureValuee deferredf. other, specify14. Brief Description of Services Performed or to be performed and Date(s) of Service, includingofficer(s), employee(s), or member(s) contacted, for Payment Indicated in Item 11:(attach Continuation Sheet(s) if necessary)15. Continuation Sheet(s) attached: Yes No16. Information requested through this form is authorized by Title31 U.S.C. Section 1352. This disclosure of lobbying reliancewas placed by the tier above when his transaction was made orentered into. This disclosure is required pursuant to 31 U.S.C.1352. This information will be reported to Congresssemiannually and will be available for public inspection. Anyperson who fails to file the required disclosure shall be subjectto a civil penalty of not less than $10,000 and not more than$100,000 for each such failure.Signature:PrintTitle:Telephone No.:Name:Date:Authorized for Local ReproductionStandard Form - LLLStandard FormLLL Rev. 04-28-06LPP 09-02Page 10-64July 31, 2009

INSTRUCTIONS FOR COMPLETIONOF SF-LLL, DISCLOSURE OFLOBBYING ACTIVITIESThis disclosure form shall be completed by the reporting entity, whether subawardee or prime federal recipient at the initiationor receipt of covered federal action or a material change to previous filing pursuant to title 31 U.S.C. Section 1352. The filingof a form is required for such payment or agreement to make payment to lobbying entity for influencing or attempting toinfluence an officer or employee of any agency, a Member of Congress an officer or employee of Congress or an employee ofa Member of Congress in connection with a covered federal action. Attach a continuation sheet for additional information ifthe space on the form is inadequate. Complete all items that apply for both the initial filing and material change report. Referto the implementing guidance published by the Office of Management and Budget for additional information.1. Identify the type of covered federal action for which lobbying activity is and/or has been secured to influence, theoutcome of a covered federal action.2. Identify the status of the covered federal action.3. Identify the appropriate classification of this report. If this is a follow-up report caused by a material change to theinformation previously reported, enter the year and quarter in which the change occurred. Enter the date of thelast, previously submitted report by this reporting entity for this covered federal action.4. Enter the full name, address, city, state and zip code of the reporting entity. Include Congressional District if known.Check the appropriate classification of the reporting entity that designates if it is or expects to be a prime orsubaward recipient. Identify the tier of the subawardee, e.g., the first subawardee of the prime is the first tier.Subawards include but are not limited to subcontracts, subgrants and contract awards under grants.5. If the organization filing the report in Item 4. checks "Subawardee" then enter the full name, address, city, Stateand zip code of the prime federal recipient. Include Congressional District, if known.6. Enter the name of the federal agency making the award or loan commitment. Include at least oneorganization level below agency name, if known. For example, Department of Transportation, United StatesCoast Guard.7. Enter the federal program name or description for the covered federal action (item 1). If known, enter the full Catalogof FederalDomestic Assistance (CFDA) number for grants, cooperative agreements, loans and loan commitments.8. Enter the most appropriate federal identifying number available for the federal action identification in item 1 (e.g.,Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contractgrant. or loan award number, the application/proposal control number assigned by the federal agency). Includeprefixes, e.g., "RFP-DE-90-001."9. For a covered federal action where there has been an award or loan commitment by the Federal agency, enter thefederal amount of the award/loan commitments for the prime entity identified in item 4 or 5.10. (a) Enter the full name, address, city, state and zip code of the lobbying entity engaged by the reporting entityidentified in Item4. to influenced the covered federal action.(b) Enter the full names of the individual(s) performing services and include full address if different from 10 (a).Enter LastName, First Name and Middle Initial (Ml).11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to thelobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Checkall boxes that apply. If this is a material change report, enter the cumulative amount of payment made or planned tobe made.12. Check the appropriate box(es). Check all boxes that apply. If payment is made through an in-kindcontribution, specify the nature and value of the in-kind payment.13. Check the appropriate box(es). Check all boxes that apply. If other, specify nature.14.Provide a specific and detailed description of the services that the lobbyist has performed or will be expected toperform and the date(s) of any services rendered. Include all preparatory and related activity not just time spentin actual contact with federal officials. Identify the federal officer(s) or employee(s) contacted or the officer(s)65

employee(s) or Member(s) of Congress that were contacted.15. Check whether or not a continuation sheet(s) is attached.16. The certifying official shall sign and date the form, print his/her name title and telephone number.Public reporting burden for this collection of information is estimated to average 30-minutes per response, including time forreviewing instruction, searching existing data sources, gathering and maintaining the data needed, and completing andreviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collectionof information, including suggestions for reducing this burden, to the Office of Management and Budget, PaperworkReduction Project (0348-0046), Washington, D.C. 20503.SF-LLL-InstructionsRev. 06-04-90«ENDIF»66