2018 CVMC - Shumway Ranch Caretakers Cabinta Q"fra
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TO: Chris Escobedo, Acting City Manager
FROM: Teresa Thompson
DATE: July 12, 2018
RE: Coachella Valley Mountains Conservancy Service Agreement
Shumway Ranch - Phase 1
Attached for your signature is an agreement for services for the City to provide preliminary
services for due diligence, restoration assessment and evaluation for the caretakers cabin at
Shumway Ranch.
Please sign the attached agreement(s) and return to the City Clerk for processing and
distribution.
Reauestino department shall check and attach the items below as anarooriate:
Contract payments will be charged to account number:
Amount of Agreement, Amendment, Change Order, etc.:
A444 A Conflict of Interest Form 700 Statement of Economic Interests from Consultant(s) is attached with
no reportable interests in LQ or _ reportable interests
N A Conflict of Interest Form 700 Statement of Economic Interests is not required because this Consultant
does not meet the definition in FPPC regulation 18701(2).
Authoritv to execute this aareement is based uoon:
Approved by the City Council on
City Manager's signature authority provided under Resolution No. 2015-045 for budgeted expenditures
of $50,000 or less. This expenditure is $ and authorized by contract approved by
Initial to certify that 3 written informal bids or proposals were received and considered in selection
The followina required documents are attached to the aareement: CAV\� 1"5. CQ A!b �0
prc,VigVrt1
7� Insurance certificates as required by the agreement 6eppfovadby Risk Manager on 711V19' date)
Performance bonds as required by the agreement (originals)
City of Lo Quinta Business License number
A requisition for a Purchase Order has been prepared (amounts over $5,000)
A copy of this Cover Memo has been emailed to Finance (Sandra)
Revised May 2017
State of California -- Natural Resources Agency ❑ HQ. ❑ OHV ❑ NO. ❑ SO. No. A CVM 1802
DEPARTMENT OF PARKS AND RECREATION
CONTRACT TYPE DATE:PREPARED
AGREEMENT FOR SERVICES ❑A&E ❑ Consultant 0 Service (Onetlmeonly) 7/6/2018
This document is not valid if the Total Amount DISTRICT/DIVISION •PARK WORK LOCATION
exceeds $9,999.99 including all applicable taxes. Coachella Valley Mountains Conservancy Palm Desert, CA
FISCAL PURCHASE ORDER NO BU/GL/PC BUS DPR COI` TACT PERSON (Print or type) CONTACT PHONE NO.
UNIT 3850 Diana Rosas ( 760 ) 776-5026
CONTRACTOR'S NAME (Print or type) PHONE NO. LICENSE NO. (Professional Services)
City of La Quinta ( 760 ) 777-7100
MAILING ADDRESS REMITTANCE ADDRESS
78495 Calle Tampico, La Quinta CA 92253 78495 Calle Tampico, La Quinta CA 92253
SMALL BUSINESS TYPE SB L� MB or ❑ No JDVBE Yes or ❑_ No SUPPLIER NO. or STD. 204
Cerlificafion Nw Exp. Date: Cert. No.: Exp. Date,_ attached
Based on the Estimated amount of: $ 4,900.00 the contractor agrees to furnish all labor, equipment, and materials necessary to
accomplish the following:
Provide preliminary services for due diligence, restoration assessment and evaluation services required to
prepare a work program for the caretakers cabin at Shumway Ranch.
Anticipated date of completion: 10/15/2018
INSURANCE REQUIREMENTS: ❑✓ Workers' Compensation ❑✓ Automobile Liability ❑✓ General Liability ❑ N/A
EXHIBITS: Items checked below are hereby incorporated by reference and made a part of this Agreement by reference as if attached hereto:
❑✓ GTr 04-2017 ❑ CCC04/2017 . The GTC and CCC can be viewed at www.ols.dns.ca.aov/Standard+Lanouaae.
State's
The Total Amount of this agreement including all applicable taxes is: $
COTOR' IGNA _� -' PRINTED NAME TITLE CONTRACTOR JOB REF. NO, DATE
�NTRACChris Escobedo Acting City Mgr�(Optimao 7 /G
EXPENDITURE CODING
Appr.Ref Fund ENY Account Alt Account Prog
(Departmental Use Only)
Project Activity I eporting Structure CAL-Card'Amount
AWARD METHOD USED (Check one)
❑ Informal Quotes/Bids (List contractor names and prices for at least 2 quotes/bids below):
0 Fair & Reasonable Determination (Sign the following certification statement): I certify that the cost of the acquisition is fair and reasonable and that the listed cost is low.
I further certify that I possess the State of California procurement experience and knowledge to make this cost analysis determination. The acquisition cost is so low that the cost to the
Stateto verify the pricing fairness most likely is more than any potential benefitthat could be reasonably gained from searching out the marketplace for lower priced comparable acquisition
Certifier Signature Printed Name Diana Rosas
❑ Exempt from Bidding (Oita FxPmntionl-
DPR APPROVAL SIGNATURE PRINTED NAME TITLE DATE
CERTIFICATION OF COMPLETION
.I hereby certify that the above services were received by and necessary for use of the State of California and that the quantity and quality are as indicated.
SIGNATURE (Must be different from DPR Approval Signature) PRINTED NAME TITLE DATE WORK COMPLETED
0.
Jim R. Karpiak
Executive Director
STANDARD DISTRIBUTION: Division/District keep original, attach scanned copy of the original to the FI$Cal Purchase Order (PO), copy to the Contractor
DISTRIBUTION WHEN PAID BY CAL -CARD: Same as Standard Distribution - plus: FI$Cal PO must be assigned to the PCard Cardholder
DPR 285 (Rev. 2/2018)(Excel 5/1012018)
State of California - Natural Resources Agency
DEPARTMENT OF PARKS AND RECREATION
DPR 285, AGREEMENT FOR SERVICES
CHECKLIST/TRANSMITTAL
Maximum $9,999.99 (Used for Services, Consulting Services and A&E Contracts")
TO DPR CONTRACT ADMINISTRATOR 0.4 1
Contract Services Unit Diana Rosas 7/6/2018
DISTRICT/ DIVISION CONTACT PHONE NO
Coachella Valley Mountains Conservancy ( 760) 776-5026
CONTRACTOR CONTRACT NO.
City of La Quinta ACVM1802
L1 Verify that contractor/vendor is NOT on FTB/BOE Delinquent Tax Listings prior to contract award.
DOCUMENT NO. OF COPIES INCLUDED?
O DPR 285, AGREEMENT FOR SERVICES 1 Original & 2 Copies Yes
License No. for Services (If Applicable)
Examples:
Pesticide Application (Dept. of Pesticide Reg.), www.odor.ca.aovidocs/licenselcurrlfc.htm
CA Board of Professional Engineers (Dept. of Consumer Affairs), www.Dels.ca.aov
CA Architects Board (Dept. of Consumer Affairs), wvvvv.cab.ca.clov
Small Business and/or DVBE Certification No. and Expiration Date
www.bidsvnc.com/DPXBisCASB (Note: URL is case sensitive) (Include Printout)
GTC & CCC boxes checked and current version numbers entered
(NOTE: Copy of signed CCC to be kept in the originating unit's file.)
Award Method (Check only one):
Informal Quote, Fair and Reasonable Determination or Exemption
SCOPE: Any changes to the scope (including differences between Estimate and Total
Amount) must be noted in the scope description & invoice attached if amount changed.
NOTE: Increases to the "Total Amount "once written on the form are prohibited. A new DPR
285 must be created that reflects the changes and new "Total Amount. "
O EXHIBIT A, SPECIFICATIONS & OTHER ATTACHMENTS (If Applicable)
(Do not include printed copy of GTC/CCC.)
O STD. 204 - PAYEE DATA RECORD/DPR 88 - SUPPLEMENT (If Applicable)
(Only when there is no vendor number/vendor information or number is not current)
p DPR 74, DARFUR CONTRACTING ACT CERTIFICATION (If Applicable)
O CONTRACTOR BUSINESS STATUS (Choose appropriate one) (Include Printout)
❑ CORPORATION STATUS PRINT OUT: httoJlkeoler.sos.ca.aov/
DL
❑ DE 542 - REPORT OF INDEPENDENT CONTRACTOR: www.edd.ca,ocv
Refer to Contracts User's Guide, Miscellaneous Information chapter for instruction.
Use only for amounts over $600.00. Must be sent to EDD within 20 days.
Please include Federal ID No: 68-030-3606 and CA Employer Act No: 936054971.
ID CERTIFICATES OF INSURANCE (If Applicable)
General Liability, Auto Liability and Workers' Compensation, ORIM Approval,
Endorsements: Additional Insured and Waiver of Subrogation
NOTE: General Liability Insurance of $1,000,000 per occurrence - $2,000,000 general
aggregate & ORIM approval prior to work is required if the work is 'hazardous."
The seven applicable categories of hazardous are: 1- Pest control, fumigation, crop or
agriculture spraying or application of chemicals of any kind, 2- Handling of hazardous
substances; 3- Transporting persons; 4- Elevator Maintenance; 5- Use of aircraft or
watercraft; 6- Exhibitions; 7- Excavation, drilling or demolition.
LABOR RELATIONS (All Service Agreements)
Employee Bargaining Unit Notification is required for all service agreements.
Requires separate document signed by Labor Relations prior to award of contract to certify
compliance with Government Code 19132(b)(1).
Labor. Relationsftarks.ca.aov
DPR 285 DISTRIBUTION
Yes NIA
Yes N/A
1 Yes I N/A
Yes
Yes
Yes
STANDARD DISTRIBUTION: Division/District keep original, attach scanned copy of the original to the FI$Cal Purchase Order (PO), copy to the Contractor
DISTRIBUTION WHEN PAID BY CAL -CARD: Same as Standard Distribution - plus: FI$Cal PO must be assigned to the PCard Cardholder
N/A
(Under
$600)
NIA
*When using a DPR 285 for a professional service (A&E) contract, contact the Contract Analyst for details.
DPR 285C (Rev 2/2018)(Excel 2/23/2018)
CALIFORNIA JOINT POWERS INSURANCE AUTHORITY
CERTIFirATF �V- LIA�11 0tY PROTECTION
In accordance with the provisions of Article 11(a) of the Joint Powers Agreement creating the
CALIFORNIA JOINT POWERS INSURANCE AUTHORITY,
the Executive Committee has designated a Joint Liability Protection Program for the Members.
City of La Quinta
including its governing body, along with all its commisions, agencies and employees thereof, is
protected in accordance with the terms and provisions of the CALIFORNIA JPIA Liability Protection Program.
This Certificate is evidence of the Member's participation in the Primary Liability Protection Program
during the period of July 1, 2018 to July 1, 2019.
The CALIFORNIA JOINT POWERS INSURANCE AUTHORITY will investigate, defend and/or pay
all claims, settlements and final judgements which come within the provisions of the
CALIFORNIA JPIA Memorandum of Coverage of the Primary Liability Protection Program as defined therein.
CALIFORNIA JOINT POWERS INSURANCE AUTHORITY
CALIFORNIE
J , P , 1 • A Jonathan R. Shull, Chief Executive Officer
CALIFORNIA JOINT POWERS INSURANCE AUTHORITY
CERTIFICATE OF
WORKERS' COMPENSATION PROTECTION
CALIFORNIA JOINT POWERS INSURANCE AUTHORITY has complied with
the requirements. of the Director of Industrial Relations under the provisions of Section 3700
of the Labor Code of the State of California. The employees, governing body, and other
legally authorized or appointed committees or commissions of
City of La Quinta
are covered in accordance with California Labor Law and the provisions of the California JPIA
Memorandum of Coverage of the Primary Workers' Compensation Program for the period of
July 1, 2018 to July 1, 2019.
CALIFORNIA JOINT POWERS INSURANCE AUTHORITY
Jonathan R. Shull, Chief Executive Officer