Attachments_B_through_D.pdf

State of California Request for Qualifications No. C15E0055 Department of Parks and Recreation MALAKOFF DIGGINS STATE HISTORIC PARK Acquisition and Development Division Site Characterization and Remediation Services for Hazardous Materials throughout the Park Site Project

March 2016 Attachments

ATTACHMENT B

Darfur Contracting Act

Acquisition and Development Division Site Characterization and Remediation Services for Hazardous Materials throughout the Park Site Project

February 2014 Attachments

DPR 74 (Rev. 9/2010)(Excel 9/2/2010)

FOR DEPARTM ENT USE ONLYState of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

DARFUR CONTRACTING ACT CERTIFICATION

Public Contract Code Sections 10475 -10481 applies to any company that currently or within the previous three years has had business activities or other operations outside of the United States. For such a company to bid on or submit a proposal for a State of California contract, the company must certify that it is either a) not a scrutinized company; or b) a scrutinized company that has been granted permission by the Department of General Services to submit a proposal.

If your company has not, within the previous three years, had any business activities or other operations outside of the United States, you do not need to complete this form.

AGREEMENT/PAPO NO.

OPTION #1 - CERTIFICATION

If your company, within the previous three years, has had business activities or other operations outside of the United States, in order to be eligible to submit a bid or proposal, please insert your company name and Federal ID Number and complete the certification below.

I, the official named below, CERTIFY UNDER PENALTY OF PERJURY that a) the prospective proposer/bidder named below is not a scrutinized company per Public Contract Code 10476;

and b) I am duly authorized to legally bind the prospective proposer/bidder named below. This certification is made under the laws of the State of California.

COMPANY/VENDOR NAME (Printed)

BY (Authorized Signature)

PRINTED NAME AND TITLE OF PERSON SIGNING

DATE EXECUTED EXECUTED IN THE COUNTY AND STATE OF

FEDERAL ID NUMBER

OPTION #2 - WRITTEN PERMISSION FROM DGS

Pursuant to Public Contract Code section 10477(b), the Director of the Department of General Services may permit a scrutinized company, on a case-by-case basis, to bid on or submit a proposal for a contract with a state agency for goods or services, if it is in the best interests of the state. If you are a scrutinized company that has obtained written permission from the DGS to submit a bid or proposal, complete the information below.

We are a scrutinized company as defined in Public Contract Code section 10476, but we have received written permission from the Department of General Services to submit a bid or proposal pursuant to Public Contract Code section 10477(b). A copy of the written permission from DGS is included with our bid or proposal.

COMPANY/VENDOR NAME (Printed)

INITIALS OF SUBMITTER

PRINTED NAME AND TITLE OF PERSON INITIALING

FEDERAL ID NUMBER

Acquisition and Development Division Site Characterization and Remediation Services for

ATTACHMENT C

SAMPLE FORMS

1. Standard Agreement (STD 213) including Note: This sample Agreement (10 pages) is a representation of the agreement that will be awarded, if any, from this RFQ. Please review carefully and present any questions in writing per 1.3 RFQ Issuing Office, Paragraph 1.3.2 of this RFQ.

i. Exhibit A, Scope of Work (DPR 603AE)

ii. Exhibit B, Budget Detail and Payment Provisions (DPR 604AE)

iii. Exhibit B, Attachment I, Sample Work Order

iv. Exhibit C, General Terms and Conditions (GTC 610), incorporated by reference

View/download at:

http://www.dgs.ca.gov/ols/Resources/StandardContractLanguage.aspx

v. Exhibit D, Special Terms and Conditions, 5 pages (DPR 605AE)

2. Payee Data Record (STD 204) and Payee Data Record Supplement (DPR 88) http://www.dgs.ca.gov/ols/Resources/StandardContractLanguage.aspx

State of California Request for Qualifications Bid No. R15AD023 Department of Parks and Recreation Resource Specialist Professional Services Acquisition and Development Division for Projects within California State Parks

ATTACHMENT C.1

Standard Agreement (STD 213) including

a. Exhibit A, Scope of Work (DPR 603AE)

b. Exhibit B, Budget Detail and Payment Provisions (DPR 604AE)

c. Exhibit B, Attachment I, Sample Work Order

d. Exhibit C, General Terms and Conditions (GTC 610) Incorporated by reference. View/downloaded at:

www.ols.dgs.ca.gov/Standard+Language/default.htm

e. Exhibit D, Special Terms and Conditions (DPR 605AE)

This sample Agreement (10 pages) is a representation of the agreement that will be awarded, if any, from this RFQ.

Please review carefully and present any questions in writing per 1.3 RFQ Issuing Office, Paragraph 1.3.2 of this

RFQ.

http://www.ols.dgs.ca.gov/Standard+Language/default.htm through

Exhibit A - Scope of Work 1 page(s) Exhibit B - Budget Detail and Payment Provisions 2 page(s)

1 page(s) Exhibit C* - General Terms and Conditions - GTC 610 4 page(s) Exhibit D - Special Terms and Conditions 5 page(s)

IN WITNESS WHEREOF, this Agreement has been executed by the parties hereto.

TBD

CONTRACTOR

Exhibit B, Attachment I - Master Agreement Work Order

* (incorporated by reference and made part of this agreement as if attached hereto; document can be viewed at www.ols.dgs.ca.gov/Standard+Language

Department of Parks and Recreation

TBD

Stephen R. Lehman, Deputy Direcor, Acquisition and Development

One Capitol Mall, Suite 410, Sacramento, California 95814

STATE OF CALIFORNIA

Department of Parks and Recreation

STATE OF CALIFORNIA

STANDARD AGREEMENT

STD 213 (Rev 06/03)(CA ST PKS, EXCEL 10/20/2004)

AGREEMENT NUMBER

REGISTRATION NUMBER

STATE AGENCY'S NAME

CONTRACTOR'S NAME

CONTRACTOR'S NAME (if other than an individual, state whether a corporation, partnership, etc.)

BY (Authorized Signature) DATE SIGNED(Do not type)

PRINTED NAME AND TITLE OF PERSON SIGNING

ADDRESS

AGENCY NAME

DATE SIGNED(Do not type)

PRINTED NAME AND TITLE OF PERSON SIGNING

The term of this Agreement is:

The maximum amount of this Agreement is:

The parties agree to comply with the terms and conditions of the following exhibits which are by this reference made a part of the Agreement.

This Agreement is entered into between the State Agency and Contractor named below: 1.

2.

3.

4.

California Department of General Services Use Only

Exempt per:

BY (Authorized Signature)

ADDRESS

CONTRACTOR STATE AGENCY DEPT. OF GEN.SER. CONTROLLER ACCOUNTING SVS.

Contractor's Name:

Agreement Number:

Page: 1 1

SCOPE OF WORK

1.

2.

3. The services shall be conducted during Contractor's normal work hours.

4. The Agreement representatives during the term of this Agreement will be:

State Agency: Contractor:

Section/Unit: Section/Unit:

Attention: Attention:

Address: Address:

City/State/Zip Code: City/State/Zip Code:

Phone: Phone:

Fax: Fax:

Email: Email:

There shall be no change in the Contractor's Project Representative or members of the Project team, without written approval by the State.

DPR 603AE (New 10/2004)(Excel 10/20/2004)

Department of Parks and Recreation Northern Service Center

One Capitol Mall, Suite 410

TBD

TBD, Contract Manager

Sacramento, CA 95814

EXHIBIT A — A & E SERVICES

(Standard Agreement) of

Pursuant to Government Code Sections 4525-4529 and California Code of Regulations, Title 14, Sections 4725- 4736, the State does hereby engage Contractor to furnish all materials, labor and incidentals to provide Architectural Professional Services for the State.

The services shall be provided for various statewide projects located within California State Parks.

Page: 1 of 2

BUDGET DETAIL AND PAYMENT PROVISIONS

1. Invoicing and Payment A. For services satisfactorily rendered, and upon receipt and approval of the invoices, the State agrees to compensate the Contractor in accordance with the payment terms indicated in Paragraph C, below.

B. Invoices shall include the Agreement Number and shall be submitted in triplicate not more frequently than monthly in arrears to: Department of Parks and Recreation

C.

DPR makes no guarantee, either written or implied, as to the actual number of projects prosecuted under this agreement nor the actual total amount of funds paid to Contractor.

2. Budget Contingency Clause

A. It is mutually agreed that if the Budget Act of the current year and/or any subsequent years covered under this Agreement does not appropriate sufficient funds for the program, this Agreement shall be of no further force and effect. In this event, the State shall have no liability to pay any funds whatsoever to Contractor or to furnish any other considerations under this Agreement and Contractor shall not be obligated to perform any provisions of this Agreement.

B. If funding for any fiscal year is reduced or deleted by the Budget Act for purposes of this program, the State shall have the option to either cancel this Agreement with no liability occurring to the State, or offer an agreement amendment to Contractor to reflect the reduced amount.

3. Prompt Payment Clause

Payment will be made in accordance with, and within the time specified in, Government Code Chapter 4.5, commencing with Section 927.

DPR 604AE (New 10/2004)(Excel 10/20/2004)

TBD

EXHIBIT B — A & E SERVICES

(Standard Agreement)

EXHIBIT B — A & E SERVICES

(Standard Agreement)

Prior to assignment of each Project, the State will provide a project-specific scope of services Work Order (see sample Exhibit B, Attachment I). The Contractor shall submit a cost proposal indicating the number of hours and travel costs necessary to provide Architectural Professional Services for the specific project. The cost proposal shall be subject to State approval. For services satisfactorily performed, and in accordance with the terms of this Agreement, the State agrees to pay Contractor based on a Fixed Fee as negotiated and agreed upon by Contractor and State which fixed amounts shall be listed in the Work Order. Total compensation shall be listed in the Work Order. Total compensation shall be based upon the fixed amounts which shall include full compensation for all Contractor's services and expenses including travel and per diem or any other direct or indirect expenses incident to providing the services.

Contractor shall be paid monthly in arrears upon receipt and approval by the Project Manager of an itemized invoice. Payment shall be based on the percentages of work accomplished for the individual Work Orders. From amount earned for each Work Order there shall be retained from each progress payment an amount equal to ten percent (10%). One hundred percent (100%) of the payment shall be made upon acceptance and approval by DPR of successfully completed services for each individual Work Order.

EXHIBIT B — A & E SERVICES

(Standard Agreement)

Page: 2 2

4. Timely Submission of Final Invoice

A. A final undisputed invoice shall be submitted for payment no more than ninety (90) calendar days following expiration or termination date of this Agreement, unless a later or alternate deadline is agreed to in writing by the project representative. Said invoice should be clearly marked "Final Invoice," thus indicating that all payment obligations of the State under this Agreement have ceased and that no further payments are due or outstanding.

B. The State may, at its discretion, choose not to honor any delinquent final invoice if the Contractor fails to obtain prior written State approval of an alternate final invoice submission deadline. Written State approval shall be sought from the project representative prior to the expiration or termination date of this Agreement.

DPR 605AE

TBD

of

EXHIBIT B — A&E SERVICES

of

EXHIBIT B — A&E SERVICES

CM V8-06 Page 5

Contractor's Name: TBD Agreement Number:

Project: Work Order Date:

Park Unit: Work Order Amt:

District: Start Date:

Project No.: Finish Date:

PCA Number: Work Order #:

DEPARTMENT OF PARKS AND RECREATION CONTRACTOR NAME OF FIRM

Name: Name:

Title: Title:

Service Center:

Address: Address:

Telephone: Telephone:

Cell Phone Cell Phone Fax: Fax:

E-Mail: E-Mail:

Scope of Work

Deliverables

DEPARTMENT OF PARKS AND RECREATION CONTRACTOR FIRM NAME

By: By:

Name, State's Representative Date Project Representative, Title

By: Date:

Name, Contract Manager Date

By:

Date

CONTACTS:

All items shown on this Work Order shall be delivered in accordance with the attached schedule. This work order is agreed to and accepted by:

TOTAL THIS WORK ORDER -------->

This work order implements and is hereby made a part of Agreement Number

Kathy Amann. Assistant Deputy Director

EXHIBIT B, ATTACHMENT I

WORK ORDER

PROJECT SPECIFIC SCOPE OF SERVICES

Page: 1 5

SPECIAL TERMS AND CONDITIONS

1. Insurance Requirements

A. Policy

B. Coverage (Additional coverage beyond the following, when required, shall be identified through an attachment to this exhibit.)

C. Endorsements (The following endorsements must appear on the Certificate of Insurance.)

D. Contractor’s Additional Responsibilities

DPR 605AE (New 10/2004)(Excel 10/20/2004)

TBD

EXHIBIT D — A & E Services (Standard Agreement) of

When Contractor submits a signed agreement to State, Contractor shall furnish to State a Certificate of Insurance in compliance with the following requirements:

Cancellation: That the insurer will not cancel the insured’s coverage without 30 days prior written notice to State, except in the case of cancellation for nonpayment of premiums, in which instance insurer shall give State ten (10) days written notice prior to the effective date of the cancellation.

Additional Insured: That the State of California, its officers, agents, employees and servants are included as additional insured, but only insofar as the operations under this agreement are concerned.

Premiums: That the State will not be responsible for any premiums or assessment on the policy.

The Certificate of Insurance shall: (a) be in a form acceptable to State; (b) be written by an insurer acceptable to State; (c) be maintained at Contractor’s sole expense; (d) be in full force for the complete term of the agreement; (e) be primary, and not in excess to any insurance carried by State; (f) be furnished to State within fifteen (15) days, upon request.

General Liability Insurance: Contractor shall procure commercial general liability insurance covering bodily injury, property damage, and personal injury with limits not less than $1,000,000 per occurrence and $2,000,000 general aggregate. Said policy shall apply separately to each insured against whom any claim is made or suit is brought subject to Contractor’s limits of liability.

Motor Vehicle Liability Insurance: Contractor shall maintain motor vehicle liability insurance with limits not less than $1,000,000 per accident. Such insurance shall cover liability arising out of an accident involving a motor vehicle in use by Contractor, including, but not limited to, Contractor owned, hired, and non-owned motor vehicles.

Worker’s Compensation and Employer’s Liability Insurance: Contractor shall maintain statutory worker’s compensation and employer’s liability insurance for all of Contractor’s employees who will be engaged in the performance of work on the property, including special coverage extensions where applicable.

Professional Liability: Contractor shall maintain Professional Liability covering any damages caused by an error, omission or any negligent acts. Limits of not less than $1,000,000 Bodily Injury and Property Damage combined Single Limit per Claim shall be provided.

Contractor is responsible for any deductible or self-insured retention contained within the insurance program.

Page: 2 5

E. Insurance Companies

F. State Remedies

2. Licenses and Permits

DPR 605AE

TBD

of

Contractor shall be an individual or firm licensed to do business in California and shall obtain at its expense all license(s) and permit(s) required by law for accomplishing any work required in connection with this agreement.

If Contractor is located within the State of California, a business license from the city/county in which it is headquartered is necessary; however, if Contractor is a corporation, a copy of the incorporation documents/letter from the Secretary of State’s Office can be submitted. If Contractor is located outside the State of California, Contractor shall submit to State a copy of the business license or incorporation papers for the respective state showing that the company is in good standing within that state.

In the event, any license(s) and/or permit(s) expire at any time during the term of this agreement, Contractor agrees to provide State with a copy of the renewed license(s) and/or permit(s) within 30 days following the expiration date. In the event Contractor fails to keep in effect at all times all required license(s) and permit(s), State may, in addition to any other remedies it may have, terminate this agreement upon occurrence of such event.

EXHIBIT D — A&E SERVICES

(Standard Agreement)

Contractor shall ensure that all subcontractors procure insurance meeting the requirements of these provisions.

Upon State’s request, Contractor shall provide copies of its Worker’s Compensation and Employer’s Liability Insurance.

Concurrent with the execution of this agreement, Contractor shall provide to State evidence that the insurance required to be carried by these provisions, including any endorsement affecting the additional insured status, is in full force and effect and that premiums therefore have been paid. At State’s discretion, such evidence shall be the appropriate ACORD Form (Certificate of Insurance) or a certified copy of the original policy, including all endorsements.

Upon notification by State of receipt of a notice of cancellation, expiration, or any reduction in coverage, or if the insurer commences proceeding or has proceeding commenced against it, indicating the insurer is insolvent, Contractor shall provide to State evidence of replacement policy at least ten (10) working days prior to the effective date of such cancellation, expiration, or reduction in coverage.

Insurance companies issuing any of the policies required by these provisions shall have a rating classification of “B” or better and a financial size category rating of “VII” or better according to the latest edition of the A.M. Best Key Rating Guide. Any other rating classification requires State approval.

All insurance companies issuing any of the policies required by these provisions shall be licensed to do business in the State of California.

Should Contractor fail to keep the insurance required to be carried by these provisions in full force and effect at all times, State may in addition to any other remedies State has, terminate this agreement immediately and all payments due or that become due will be withheld until notice is received by State that such insurance has been restored or replaced to full force and effect and that the premiums therefore have been paid to cover a period of time satisfactory to State.

Page: 3 5

3. Disputes

4. Termination for Convenience

5. Force Majeure

6. Potential Subcontractors

7. Priority Hiring Considerations for Contracts of $200,000 or More

DPR 605AE

TBDEXHIBIT D — A&E SERVICES

(Standard Agreement) of

Unless otherwise provided in this agreement, any dispute concerning a question of fact arising under this agreement which cannot be resolved informally shall be decided by the following two-step procedures.

Contractor must provide written notice of the particulars of such disputes to the Project Manager or his/her duly appointed representative. The Project Manager must respond in writing within ten (10) working days of receipt of the written notice of dispute. Should Contractor disagree with the Project Manager’s decision, Contractor may appeal to the second level. Pending the decision on appeal, Contractor shall proceed diligently with the performance of this agreement in accordance with the Project Manager’s decision. The second level appeal must indicate why the Project Manager’s decision is unacceptable, attaching to it Contractor’s original statement of the dispute with supporting documents, along with a copy of the Project Manager’s response. The second level appeal shall be sent to the Deputy Director of Administrative Services or his/her duly appointed representative.

The second level appeal must be filed within fifteen (15) working days of receipt of the Project Manager’s decision. Failure to submit an appeal within the period specified shall constitute a waiver of all such right to an adjustment of this agreement. The Deputy Director or designee shall meet with Contractor to review the issues raised. A written decision signed by the Deputy Director or designee shall be returned to Contractor within fifteen

(15) working days of the receipt of the appeal.

State reserves the right to terminate this agreement subject to 30 days written notice to Contractor. Contractor may submit a written request to terminate this agreement only if State should substantially fail to perform its responsibilities as provided herein.

Except for defaults of subcontractors, neither party shall be responsible for delays or failures in performance resulting from acts beyond the control of the offending party. Such acts shall include but shall not be limited to acts of God, fire, flood, earthquake, other natural disaster, nuclear accident, strike, lockout, riot, freight embargo, public regulated utility, or governmental statutes or regulations superimposed after the fact. If a delay or failure in performance by Contractor arises out of a default of its subcontractor, and if such default of its subcontractor, arises out of causes beyond the control of both Contractor and subcontractor, and without the fault or negligence of either of them, Contractor shall not be liable for damages of such delay or failure, unless the supplies or services to be furnished by subcontractor were obtainable from other sources in sufficient time to permit Contractor to meet the required performance schedule.

Nothing contained in this agreement or otherwise, shall create any contractual relation between State and any subcontractors, and no subcontract shall relieve Contractor of its responsibilities and obligations hereunder.

Contractor agrees to be as fully responsible to State for the acts and omissions of its subcontractors and of persons either directly or indirectly employed by any of them as it is for the acts and omissions of persons directly or indirectly employed by any of them as it is for the acts and omissions of persons directly employed by Contractor. Contractor's obligation to pay its subcontractors is an independent obligation from State's obligation to make payments to Contractor. As a result, State shall have no obligation to pay or to enforce the payment of any moneys to any subcontractor.

If the resulting agreement will have a total value of $200,000 or more, Contractor is hereby advised that it will be obligated to give priority consideration in filling vacancies in positions funded by the resulting agreement to

Page: 4 5

8. Intellectual Property

9. Conflict of Interest (FPPC Form 700)

10. Indemnification (Paragraph Number 5, of the General Terms and Conditions (GTC 610) is hereby replaced with the following indemnification provision)

11. Errors and Omissions

DPR 605AE

TBD

of qualified recipients of aid under Welfare and Institutions Code Section 11200. This requirement shall not interfere with or require a violation of a collective bargaining agreement, a federal affirmative action obligation for hiring disabled veterans of the Vietnam era, or nondiscrimination compliance laws of California and does not require the employment of unqualified recipients of aid.

Any works developed during and/or pursuant to this agreement by Contractor, including all related copyrights and other proprietary rights therein, as may now exist and/or which hereafter come into existence, shall belong to State upon creation, and shall continue in State’s exclusive ownership upon termination of this agreement.

Contractor further intends and agrees to assign to State all right, title and interest in and to such materials as well as all related copyrights and other proprietary rights therein.

Contractor agrees to cooperate with State and to execute any document or documents that may be found to be necessary to give the foregoing provisions full force and effect, including but not limited to, an assignment of copyright.

Contractor agrees not to incorporate into or make the works developed, dependent upon any original works of authorship or Intellectual Property Rights of third parties without first (a) obtaining State’s prior written permission, and (b) granting to or obtaining for State a nonexclusive, royalty-free, paid-up, irrevocable, perpetual, world-wide license, to use, reproduce, sell, modify, publicly and privately display and distribute, for any purpose whatsoever, any such prior works.

EXHIBIT D — A&E SERVICES

(Standard Agreement)

Contractor hereby acknowledges that it has obtained the Fair Political Practices Commission Form 700, “State of Economic Interests” via www.fppc.ca.gov and reviewed a copy of the Department’s Conflict of Interest Code and, specifically, has reviewed the categories and disclosures required of consultants to the Department.

Contractor shall indemnify, protect, defend, and hold State, its affiliates, agents and employees harmless from all liability and loss due to or arising out of or in connection with injury (including death) to any person, including Contractor's employees, agents, consultants and representatives, or damage to any property at any time during or after the performance of the work as a result of the willful misconduct, acts, errors, omissions or negligent acts of Contractor, its consultants, agents, servants or employees. Contractor shall defend all suits or claims alleging such injury or damages and shall pay all charges of attorneys, court costs and all other costs and expenses of defense. The provisions of this Section shall survive Final Acceptance of the Work.

In the event of the commission of any negligent act, error or omission or the default by Contractor in the performance of any of its duties or obligations under this agreement, Contractor shall, without cost or expense to State, make such corrections or revisions to the documents prepared by Contractor hereunder as may be necessary to rectify such error or omission or the effects of such default, and State shall withhold any premium costs and expenses which State incurs on account of Contractor's failure to perform its services according to the professional standard. Contractor shall promptly reimburse State for such premium costs and expenses which are not withheld by State as provided above. Contractor and State agree that if a dispute arises over whether an act of Contractor constitutes negligence, both will promptly meet and confer with each other regarding the existence or nonexistence or allocation of such negligence. In the event State makes a claim hereunder for

Page: 5 5

12. Confidentiality of Data:

13. Death or Incapacity:

14. Limitation of Service:

15. Notices:

16. Reports and/or Meetings:

17. Unlawful Considerations:

DPR 605AE

TBD

of

EXHIBIT D — A&E SERVICES

(Standard Agreement) premium costs and expenses, the parties shall, as soon as possible thereafter, meet and confer, consult and advise in good faith with a view towards reaching agreement with respect to the amounts (if any) of the premium costs and expenses for which Contractor shall be responsible hereunder. As used herein, "premium costs and expenses" shall mean those costs and expenses incurred by State on account of an error or omission or default by Contractor as herein specified which would not have been incurred but for such error or omission or default.

Specifically by way of example but not limitation, premium costs and expenses include uncovering, demolition and reworking of work previously completed, overtime work necessary to make corrections to the work and restocking charges levied by material suppliers or subcontractors for return of materials and supplies. As used herein, "error and omission" and "default" by Contractor includes negligent acts, errors and omissions of Contractor which are caused by the negligent act of Contractor, non-conformance of the contract documents with applicable laws, negligent ambiguities, errors or inconsistencies in the contract documents resulting from the negligence of Contractor, or in any work not sufficiently detailed or explained therein, or the negligent failure of Contractor to properly coordinate or conform its documents with those of other persons as specified in this agreement.

Contractor shall not issue any news releases or public relations item of any nature whatsoever regarding work performed under this contract without prior review of the contents thereof by State and receipt of State's written permission.

If Contractor transacts business as an individual, and not as a corporation, Contractor's death or incapacity shall automatically terminate this contract as of the date of such event. Neither Contractor nor Contractor's estate shall have any further right to perform hereunder, and State shall pay Contractor or Contractor's estate the compensation payable for any services rendered prior to such termination not heretofore paid reduced by the amount of additional costs incurred by State because of such termination.

The State does not assume any obligation to employ the Contractor's services or pay Contractor royalties of any type as to future programs which may result from the work performed under this contract.

Any notice may be served effectually upon the State or Contractor by certified mail addressed as set forth on page one of Exhibit A, or such other address as State or Contractor may designate by written notice served upon the other.

Contractor shall submit progress reports or otherwise contact State's Project Manager on a routine basis during the course of the work. These reports will determine if the project is on schedule and will also officially document any difficulties or special problems encountered in the fulfillment of the contract obligations, so that remedies may be found.

Contractor warrants that the contract was not obtained or secured through rebates, kickbacks or other unlawful considerations either promised or paid to any state employee. Contractor agrees that failure to adhere to this warranty may be cause for contract termination and recovery of damages due State.

State of California Request for Qualifications Bid No. R15AD023 Department of Parks and Recreation Resource Specialist Professional Services Acquisition and Development Division for Projects within California State Parks

ATTACHMENT C.2

DISABLED VETERAN BUSINESS ENTERPRISE (DVBE) NOTICE

DVBE Notice and Documentation: Disabled Veteran Business Enterprise Program Requirements and Forms DPR 486, STD 843 and DPR 489 (8 pages)

DVBE Participation will be required if you are selected as a Contractor from this RFQ.

DVBE Compliance Certification and Documentation is not required at the time of SOQ submittal.

916 Fax:

Department of Parks and Recreation

Sacramento, CA 95814

One Capitol Mall, Suite 410

Acquisition and Development

STATE OF CALIFORNIA-DEPARTMENT OF FINANCE

PAYEE DATA RECORD

(Required when receiving payment from the State of California in lieu of IRS W-9) STD. 204 (Rev. 6-2003)(CA ST PKS, EXCEL 6/11/2009)

INSTRUCTIONS: Complete all information on this form. Sign, date, and return to the State agency (department/office) address shown at the bottom of this page. Prompt return of this fully completed form will prevent delays when procesing payments. Information provided in this form will be used by State agencies to prepare Information Returns (1099). See reverse side for more information and Privacy Statement.

NOTE: Governmental entities, federal, State, and local (including school districts), are not required to submit this form.

PAYEE'S LEGAL BUSINESS NAME (Type or Print)

SOLE PROPRIETOR — ENTER NAME AS SHOWN ON SSN (Last, First, M.I.)

MAILING ADDRESS

CITY, STATE, ZIP CODE

EMAIL ADDRESS

BUSINESS ADDRESS

CITY, STATE, ZIP CODE

ENTER FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN):

PARTNERSHIP

ESTATE OR TRUST

CORPORATION:

MEDICAL (e.g., dentistry, psychotherapy, chiropractic, etc.)

LEGAL (e.g., attorney services)

EXEMPT (nonprofit)

ALL OTHERS

INDIVIDUAL OR SOLE PROPRIETOR

ENTER SOCIAL SECURITY NUMBER:

(SSN required by authority of California Revenue and Tax Code Section 18646)

PAYEE

ENTITY

TYPE

CHECK

ONE BOX

ONLY

NOTE:

Payment will not be processed without an accompanying taxpayer I.D.

number.

PAYEE

RESIDENCY

STATUS

California resident - Qualified to do business in California or maintains a permanent place of business in California.

California nonresident (see reverse side) - Payments to nonresidents for services may be subject to State income tax witholding.

No services performed in California.

Copy of Franchise Tax Board waiver of State withholding attached.

I hereby certify under penalty of perjury that the information provided on this document is true and correct.

Should my residency status change, I will promptly notify the State agency below.

AUTHORIZED PAYEE REPRESENTATIVE'S NAME (Type or Print)

SIGNATURE DATE

TITLE

TELEPHONE

Please return completed form to:

Department/Office:

Unit/Section:

Mailing Address:

City/State/Zip:

Telephone:

E-mail Address:

All suppliers doing business with the Department of Parks and Recreation must complete this form.

Upon completion, submit the following as instructed in box/section 6 of the attached STD. 204:

STD. 204, Payee Data Record DPR 88, Payee Data Record Supplement

DPR 88 (Rev. 9/2010)(Excel 9/9/2010)

Vendor Information

Authorized Representative - complete and sign (REQUIRED)

FOR DEPARTMENT USE ONLY

Certificate of Acceptance

Submission Checklist

State of California - Natural Resources Agency

DEPARTMENT OF PARKS AND RECREATION

PAYEE DATA RECORD SUPPLEMENT

PAYEE'S LEGAL BUSINESS NAME (Type or Print)

DATE

PRINTED NAME

Seller's Permit (No.

Certificate of Registration (No.

FEDERAL ID NO.

When doing business with the Department of Parks and Recreation I accept and will abide by the State's IT General Provisions or General Provisions Non-IT Commodities, as applicable, located on the internet at www.pd.dgs.ca.gov/modellang/GeneralProvisions.htm.

E-MAIL TO VENDINFO@PARKS.CA.GOV

OR FAX TO FISC. SYS. UNIT

VENDOR NO. (If Known )

EXECUTED IN THE COUNTY AND STATE OF

No

NO ATTACHMENT NEEDED

- No inventory or sales staff in CA.

Will tangible goods be provided?

Attach:

Yes

No additional attachments needed.

AUTHORIZED REPRESENTATIVE'S SIGNATURE

Requirement to Complete Payee Data Record, STD. 204

A completed Payee Data Record, STD. 204, is required for payments to all non-governmental entities and will be kept on file at each State agency. Since each State agency with which you do business must have a separate STD. 204 on file, it is possible for a payee to receive this form from various State agencies.

Payees who do not wish to complete the STD. 204 may elect to not do business with the State. If the payee does not complete the STD. 204 and the required payee data is not otherwise provided, payment may be reduced for federal backup withholding and nonresident State income tax withholding. Amounts reported on Information Returns (1099) are in accordance with the Internal Revenue Code and the California Revenue and Taxation Code.

2 Enter the payee’s legal business name. Sole proprietorships must also include the owner’s full name. An individual must list his/her full name. The mailing address should be the address at which the payee chooses to receive correspondence. Do not enter payment address or lock box information here.

3 Check the box that corresponds to the payee business type. Check only one box. Corporations must check the box that identifies the type of corporation. The State of California requires that all parties entering into business transactions that may lead to payment(s) from the State provide their Taxpayer Identification Number (TIN). The TIN is required by the California Revenue and Taxation Code Section 18646 to facilitate tax compliance enforcement activities and the preparation of Form 1099 and other information returns as required by the Internal Revenue Code Section 6109(a).

The TIN for individuals and sole proprietorships is the Social Security Number (SSN). Only partnerships, estates, trusts, and corporations will enter their Federal Employer Identification Number (FEIN).

Are you a California resident or nonresident?

A corporation will be defined as a "resident" if it has a permanent place of business in California or is qualified through the Secretary of State to do business in California.

A partnership is considered a resident partnership if it has a permanent place of business in California. An estate is a resident if the decedent was a California resident at time of death. A trust is a resident if at least one trustee is a California resident.

For individuals and sole proprietors, the term "resident" includes every individual who is in California for other than a temporary or transitory purpose and any individual domiciled in California who is absent for a temporary or transitory purpose. Generally, an individual who comes to California for a purpose that will extend over a long or indefinite period will be considered a resident.

However, an individual who comes to perform a particular contract of short duration will be considered a nonresident.

Payments to all nonresidents may be subject to withholding. Nonresident payees performing services in California or receiving rent, lease, or royalty payments from property (real or personal) located in California will have 7% of their total payments withheld for State income taxes. However, no withholding is required if total payments to the payee are $1,500 or less for the calendar year.

For information on Nonresident Withholding, contact the Franchise Tax Board at the numbers listed below:

Withholding Services and Compliance Section: 1-888-792-4900 E-mail address: wscs.gen@ftb.ca.gov For hearing impaired with TDD, call: 1-800-822-6268 Website: www.ftb.ca.gov

5 Provide the name, title, signature, and telephone number of the individual completing this form. Provide the date the form was completed.

6 This section must be completed by the State agency requesting the STD. 204.

Privacy Statement

Section 7(b) of the Privacy Act of 1974 (Public Law 93-579) requires that any federal, State, or local governmental agency, which requests an individual to disclose their social security account number, shall inform that individual whether that disclosure is mandatory or voluntary, by which statutory or other authority such number is solicited, and what uses will be made of it.

It is mandatory to furnish the information requested. Federal law requires that payment for which the requested information is not provided is subject to federal backup withholding and State law imposes noncompliance penalties of up to $20,000.

You have the right to access records containing your personal information, such as your SSN. To exercise that right, please contact the business services unit or the accounts payable unit of the State agency(ies) with which you transact that business.

All questions should be referred to the requesting State agency listed on the bottom front of this form.

STATE OF CALIFORNIA-DEPARTMENT OF FINANCE

PAYEE DATA RECORD

STD. 204 (Rev. 6-2003)(REVERSE)(CA ST PKS, EXCEL 9/22/2004)

Complete all required information and return form as instructed on Section 6 of the STD. 204.

DPR 88 (Instructions)

DPR 88, PAYEE DATA RECORD SUPPLEMENT INSTRUCTIONS

All current and potential vendors/suppliers must have completed both the STD. 204 and DPR 88 in its entirety prior to commencing business with the Department of Parks and Recreation (DPR).

Attach DPR 88 to STD. 204 (with section 6 pre-filled on the STD. 204) and send to vendor/supplier for completion.

Fill in Vendor No. if known in appropriate box in the top, right corner of the DPR 88. Once forms are returned, check for completeness. Resend to vendor/suppler if necessary until all information, signatures and attachments are included.

Once complete, scan and e-mail both forms and any attachments to the Fiscal Systems Unit in Acccounting Services at: vendinfo@parks.ca.gov (Vendinfo).

If scanner is not available, fax both forms and any attachments to Fiscal Systems at: (916) 653-7358.

Original DPR 88 (and STD. 204) forms must be retained in the procurement file at the District/Section level.

DPR 88 COMPLETION INSTRUCTIONS FOR VENDOR/SUPPLIER

DEPARTMENT INSTRUCTIONS

check when finished with each form

If no tangible goods provided, skip to Authorized Representative Section. If yes, complete the appropriate checkbox below

If you do NOT have inventory or sales staff in CA, check here and no additional attachments are needed.

This section must be signed with all boxes/fields completed.

If you have inventory or sales staff in CA, choose appropriate checkbox, enter permit or certificate no.

in space provided, & attach copy of permit/cert.

Acquisition and Development Division Site Characterization and Remediation Services for

ATTACHMENT D

DISABLED VETERAN BUSINESS ENTERPRISE

(DVBE) REQUIREMENTS

i. DVBE Notice (DPR 479RFQ)

ii. Bidder’s DVBE Participation (DPR 486)

iii. DVBE Declarations (STD 843)

iv. Contractor’s Actual SB/MB & DVBE Participation (489)

DVBE Participation will be required if you are selected as a Contractor from this RFQ.

DVBE Compliance Certification and Documentation is not required at the time of SOQ submittal.

DPR 479RFQ (Page 2 of 8)

What is a Disabled Veteran Business Enterprise (DVBE)?

For a business to be considered a Disabled Veteran Business Enterprise (DVBE), they must be certified with the State of California - Department of General Services in accordance with California Code of Regulations, Title 2, Section 1896.94. Please see the following website for more information about DVBE certification benefits and eligibility requirements: http://www.pd.dgs.ca.gov/smbus/dvbecert.com.

Only DVBEs who perform a commercially useful function relevant to this solicitation, may be used to satisfy the DVBE participation and/or incentive program requirements.

Commercially Useful Function Definition California Code of Regulations, Title 2, § 1896.61(l): The term "DVBE contractor, subcontractor or supplier" means any person or entity that satisfies the ownership (or management) and control requirements of §1896.61(f); is certified in accordance with §1896.70; and provides services or goods that contribute to the fulfillment of the contract requirements by performing a commercially useful function.

As defined in MVC §999, a person or an entity is deemed to perform a "commercially useful function" if a person or entity does all of the following:

• Is responsible for the execution of a distinct element of the work of the contract.

• Carries out the obligation by actually performing, managing, or supervising the work involved.

• Performs work that is normal for its business services and functions.

• Is not further subcontracting a portion of the work that is greater than is expected by normal industry practices.

A contractor, subcontractor, or supplier will not be considered to perform a commercially useful function if the contractor's, subcontractor's, or supplier's role is limited to that of an extra participant in a transaction, contract, or project through which funds are passed in order to obtain the appearance of disabled veteran business enterprise participation.

What is the DVBE participation requirement?

6% DVBE participation is required for this solicitation. The Selected Contractor must meet the full participation requirement based on the total bid amount in order to be considered a responsive bidder.

PLEASE NOTE: If, for this agreement, a contractor made a commitment to achieve disabled veteran business enterprise (DVBE) participation, within 60 days of receiving final payment under this agreement (or within such other time period as may be specified elsewhere in this agreement) the contractor must certify in a report to the awarding department:

• the total amount the prime contractor received under the contract

• the name and address of the DVBE(s) that participated in the performance of the contract

• the amount each DVBE received from the prime contractor

• that all payments under the contract have been made to the DVBE(s)

• the actual percentage of DVBE participation that was achieved http://www.pd.dgs.ca.gov/smbus/dvbecert.com

DPR 479RFQ (Page 3 of 8)

You will be required to report to DPR the actual dollars spent with each DVBE subcontractor on DPR

489. If awarded the contract you will receive this form at the completion of the contract. A person or entity that knowingly provides false information shall be subject to a civil penalty for each violation.

(Military & Veterans Code (M&VC) § 999.5(d))

Documentation

To be considered a responsive bidder, the selected contractor must document at least 6% DVBE participation commitment by completing and submitting the following forms at the time the Standard Agreement is signed:

• DPR 486, Bidder’s DVBE Participation

• STD. 843, DVBE Declarations

DPR 486, Bidder’s DVBE Participation: The DPR 486 is used to document the proposed prime contractor and subcontractors, including their roles and responsibilities. The form must be submitted by the selected contractor at the time the Standard Agreement is signed.

STD. 843, DVBE Declarations: All disabled veteran owners and disabled veteran managers of the DVBE must complete the form and submit it with the bid package. A STD. 843 needs to be submitted by every DVBE supplier who is part of a bid whether they are the prime or a sub.

Bids that fail to submit the completed required forms to confirm the level of DVBE participation may be declared unresponsive due to DVBE participation requirements. Clerical and typographical errors on these forms may be corrected at the State’s sole discretion.

Information submitted by the bidders to claim the DVBE incentive(s) will be verified by the State. If evidence of an alleged violation is found during the verification process, the State shall initiate an investigation, in accordance with the requirements of the PCC §10115, et seq., and MVC §999 et seq., and follow the investigatory procedures required by the 2 CCR §1896.80. Contractors found to be in violation of certain provisions may be subject to loss of certification, penalties and/or contract termination.

Substitution of Proposed DVBE

• If awarded the contract, the DVBE subcontractors and/or contractors proposed by bidder must be used unless prior written notice of substitution is provided to the state and the state approves such substitution.

• The notice must include a minimum of: (1) a written explanation of the reason for the substitution;

and (2) an updated DPR 486 must be submitted to the award office of Department of Parks and Recreation. The substitution request must before approved before the substitution can take place.

• Failure to adhere to at least the DVBE participation proposed by the successful bidder may be cause for contract termination and recovery of damages under the rights and remedies due the state under the default section of the contract.

Contractor understands and agrees that should award of this contract be based in part on their commitment to use the Disabled Veteran Business Enterprise (DVBE) subcontractor(s) identified in their bid or offer, per Military and Veterans Code 999.5 (e), a DVBE subcontractor may only be replaced by another DVBE subcontractor and must be approved). Changes to the scope of work that impact the DVBE subcontractor(s) identified in the bid or offer and approved DVBE substitutions will be documented by contract amendment.

Failure of Contractor to seek substitution and adhere to the DVBE participation level identified in the bid or offer may be cause for contract termination, recovery of damages under rights and remedies due to the State, and penalties as outlined in M&VC § 999.9; Public Contract Code (PCC) § 10115.10, or PCC § 4110 (applies to public works only).

To locate DVBE contractors:

Contact the department’s contracting official named in this solicitation for any DVBE contractors who may have identified themselves as potential subcontractors, and to obtain suggestions for search criteria to possibly identify DVBE contractors for the solicitation. You may also contact the department’s SB/DVBE Advocate for assistance – www.parks.ca.gov/advocate.

Access the list of all certified DVBEs by using the Department of General Services, Procurement Division (DGS-PD) online certified firm database at http://www.Caleprocure.ca.gov

Search by “Keywords” or United Nations Standard Products and Services Codes (UNSPSC), that apply to the elements of work you want to subcontract to a DVBE.

Check for subcontractor ads that may be placed on the California State Contracts Register (CSCR) for this solicitation prior to the closing date. You may access the CSCR at: http://www.Caleprocure.ca.gov

The State of California, Department of General Services, Procurement Division, Office of Small Business and DVBE Services (OSDS) offers many services that assist contractor/business owners with a variety of information designed to streamline the State contracting process. OSDS also certifies DVBE contractors.

For more information, please contact OSDS to find out more:

The State of California www.pd.dgs.ca.gov/smbus Department of General Services Receptionist: (916) 375-4940 Office of Small Business and DVBE Services 24-hour recording: (916) 322-5060 707 Third Street, First Floor – Room 400 FAX: (916) 375-4950 West Sacramento, CA 95605 OSDCHelp@dgs.ca.gov

DPR 479RFQ (Page 4 of 8) http://www.parks.ca.gov/advocate http://www.caleprocure.ca.gov/ http://www.caleprocure.ca.gov/ http://www.pd.dgs.ca.gov/smbus mailto:OSDCHelp@dgs.ca.gov

DISABLED VETERAN BUSINESS ENTERPRISE (DVBE)

DVBE Documentation Checklist

The State of California acknowledges the service and sacrifice of its disabled veterans, in part, through the “Disabled Veteran Business Enterprise (DVBE) Participation Program.” As mandated by law,…