DSA_Approval,_D._Grant_04_124684_0.pdf

Application #: APPROVAL LETTER File #: ACS ONLY PROJECT

A set of drawings and specifications for the subject project has been examined, stamped, and signed for identification. A set of said drawings and specifications has been filed.

Therefore, this letter constitutes the written approval certifying that drawings and specifications are in compliance with State regulations for accommodations of the disabled, which you are required to have before letting a contract for construction (see Section 4454, Government Code). Approval is limited to the particular location, and is only for work shown on the drawings and specifications for the project.

Upon completion of this project, please fill out form DSA-168 – Statement of Final Actual Project Cost and return to this office. The form is also available on line in fillable format on the DSA web site, forms page, at

Please refer to the above file and application numbers in all correspondence, reports, etc., in connection with this project.

Sincerely, for Ida Antoniolli Clair, AIA State Architect cc:

Increment #:

Total Scope of Project:

http://www.dgs.ca.gov/dsa/Forms.aspx www.dsa.dgs.ca.gov

STATEMENT OF FINAL ACTUAL PROJECT COST

To be filed by the owner upon completion of construction, as required by the California Code of Regulation (CCR),Title 24, Part 1, Section 4-339, or CCR Sections 5-105 and 5-107 for access compliance projects.

Owner/School District: DSA File #: -

Project Name/School: DSA App. #: - Scope of Work:

Was any scope or any element from the original approved construction documents not constructed? Yes No Did the construction documents include any alternate designs that were not constructed? Yes No

FOR LINES 1, 2, 3, 4 AND 6 ......................................... ENTER COST AMOUNTS AS A POSITIVE NUMBER OR ZERO.

FOR LINE 5 ..................................................................... ENTER COST AMOUNT AS A NEGATIVE NUMBER OR ZERO.

If spaces below are left blank, this form will be considered incomplete.

1. Total original construction contract amount (exclude allowances/contingencies) $

2. Total increases to contract amount (change orders & used allowances/contingencies) $

3. Total construction management amount $

4. Project cost for DSA fee reconciliation (Sum of lines 1, 2, and 3) $

5. Total decreases to contract amount (deductive change orders) - $

6. Final actual project cost (Sum of lines 4 and 5) $

DISTRICT/OWNER CERTIFICATION:

The person signing this form must be one of the following or hold a district / owner equivalent position:

School District Superintendent; College Chancellor; Chief Business Officer or Chief Financial Officer.

I certify, under penalty of perjury, under the laws of the State of California, that the information reported on this form is true and correct.

I certify that the documentation supporting the information reported on this form is available at the district’s/owner’s office for review upon request by the Division of the State Architect (DSA).

Signature of Owner:

(see note above) Date:

Print Name: Title:

Email: Phone #:

Mailing Address:

City: State: ZIP:

Submit completed form to the DSA Regional Office with construction oversight authority for the project.

DSA OAKLAND

1515 Clay Street, Suite 1201 Oakland, CA 94612

DSA SACRAMENTO

1102 Q Street, Suite 5200 Sacramento, CA 95811

DSA LOS ANGELES

700 N. Alameda Street, Suite 5-500 Los Angeles, CA 90012

DSA SAN DIEGO

10920 Via Frontera Rd., Suite 300 San Diego, CA 92127

DSA 168 (Revised 07-22-15) Page 1 of 1 DIVISION OF THE STATE ARCHITECT DEPARTMENT OF GENERAL SERVICES STATE OF CALIFORNIA

Headquarters Office 1102 Q Street, Suite 5100 | T 916.445.8100 Sacramento, CA 95811 | F 916.445.3521 www.dsa.dgs.ca.gov

FORM DSA-104 CALIFORNIA DEPARTMENT OF GENERAL SERVICES Page 2 of 2 (rev 07-27-11)

CALIFORNIA CODE OF REGULATIONS

Title 24, Part 1 Chapter 5 – Access to Public Buildings by Persons with Disabilities

Article 1 – Compliance Procedures 5-105. Project cost. For purposes of determining the fees, both the estimated and actual project cost shall be the cost for the total outlay contemplated for all work included in the certified plans and specifications.

The term “project” shall be defined as all buildings and other structures, together with the development of the site, but in the event the plans and specifications submitted with the application do not provide for the construction of, addition or alteration to a building or structure, then it shall be for the site development proposed in the application.

The actual project cost shall include all items, which are normally considered to be contractors operation costs. Addenda or change order items which increase the contract amount shall be included in the final actual project cost computation.

All fees and/or reimbursable charges paid the construction managers shall be included in the actual project cost. When the contract for the work includes items not otherwise subject to the approval of the office and not included in the approved plans and specifications the actual cost shall include this work unless such costs are segregated by separate bid items or by separately priced items of change orders, or by a certified copy of the subcontractor’s bid. Such segregation shall not be made by contract price breakdown or estimates.

Authority: Government Code Section 4454.

Reference: Government Code Section 4454.

HISTORY: New section filed 8-30-84; effective upon filing pursuant to Government Code Section 11346.2 (d) (Register 84, No. 35).

5-107. Billing for further fees. For public school projects the DSA shall determine whether or not further fees are due and shall bill the district for such further fees.

For projects other than public schools, the applicant or owner shall submit to the office a report verifying the actual project cost within 90 days after the completion of the project. This actual project cost shall be the basis for the further fee computation. The accuracy and timely submission of this actual project cost report shall be the responsibility of the owner or his designated agent. The owner shall be billed for further fees upon completion of the project or portion thereof if fee is due.

Authority: Government Code Section 4454.

Reference: Government Code Section 4454.

HISTORY: New section filed 8-30-84; effective upon filing pursuant to Government Code Section 11346.2 (d) (Register 84, No. 35).

Samer Alzubaidi - District Facilities Contact

10920 Via Frontera, Suite 300 San Diego, CA 92127

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