HomeMy WebLinkAboutAlliance Consulting International; 2012-01-06; PEM567PUBLIC WORKS
LETTER OF AGREEMENT
PEM567
This letter will serve as an agreement between Alliance Consulting international, a
Environmental testing company (Contractor) and the City of Carlsbad (City). The Contractor will
provide all equipment, material and labor necessary to conduct an indoor air quality assessment
at Harding Community Center's front office, per the Contractor's proposal dated November 7,
2011 and City specifications, for a sum not to exceed Two-Thousand, Two-hundred and Eighty
dollars ($)2,280.00. This work is to be completed within two (2) working days after issuance of a
Purchase Order.
ADDITIONAL REQUIREMENTS
1. City of Carlsbad Business License
2. The Contractor shall assume the defense of, pay all expenses of defense, and indemnify and
hold harmless the City, and its agents, officers and employees, from all claims, loss, damage,
injury and liability of every kind, nature and description, directly or indirectly arising from or in
connection with the performance of this Contract or work; or from any failure or alleged failure
of the contractor to comply with any applicable law, rules or regulations including those
relating to safety and health; except for loss or damage which was caused solely by the active
negligence of the City; and from any and all claims, loss, damage, injury and liability,
howsoever the same may be caused, resulting directly or indirectly from the nature of the
work covered by this Contract, unless the loss or damage was caused solely by the active
negligence of the City. The expenses of defense include all costs and expenses, including
attorney's fees for litigation, arbitration, or other dispute resolution method.
3. Contractor shall furnish policies of general liability insurance, automobile liability insurance
and a combined policy of workers compensation and employers liability in an insurable
amount of not less than five hundred thousand dollars ($500,000) each, unless a lower
amount is approved by the City Attorney or the City Manager. Said policies shall name the
City of Carlsbad as a co-insured or additional insured. Insurance is to be placed with insurers
that have (1) a rating in the most recent Best's Key Rating guide of at least A-:V, and (2) are
admitted and authorized to transact the business of insurance in the State of California by the
Insurance Commissioner. Proof of all such insurance shall be given by filing certificates of
insurance with contracting department prior to the signing of the contract by the City.
4. The Contractor shall be aware of and comply with all Federal, State, County and City Statues,
Ordinances and Regulations, including Workers Compensation laws (Division 4, California
Labor Code) and the "Immigration Reform and Control Act of 1986" (8USC, Sections 1101
through 1525), to include but not limited to, verifying the eligibility for employment of all
agents, employees, subcontractors and consultants that are included in this Contract.
5. The Contractor may be subject to civil penalties for the filing of false claims as set forth in the
California False Claims Act, Government Code sections 12650^et seq., and Carlsbad
Municipal Code Sections 3.32.025, etseq. init ^init
6. The Contractor hereby acknowledges that debarment by another jurisdiction is grounds for
the City of Carlsbad to disqualify the Contractor from participating in contract bidding. ,
init _^_jDit
- 1 - Revised 9/28/00
7. The Contractor agrees and hereby stipulates that the proper venue and jurisdiction for
resolution of any disputes between the parties arising out of this agreement is San Diego
County, California.
8. The City of Carlsbad is a Charter City. Carlsbad Municipal Code Section 3.28.130
supersedes the provisions of the California Labor Code when the public work is not a
statewide concern. Payment of prevailing wages is at contractor's discretion.
TO INDICATE ACCEPTANCE OF THIS AGREEMENT, PLEASE SIGN IN THE SPACE
BELOW AND RETURN TO:
Joe Garuba
(Project Mgr)
PEM. Facilities
(Department)
405 Oak Ave
(Address)
Carlsbad. CA 92008
Alliance Consultinq International
(Name of Contractor)
By:
(Sign Here)
(Contractor's License Number)
(Print Name and Title)
PLEASE SEE ATTACHED
NOTARIZED FORM
(Print Name and Title)
(E-mail Address)
Departrnent^ead Date
(Proper notarial acknowledgment of execution by Contractor must be attached.
Chairman, president or vice-president and secretary, assistant secretary, CFO or assistant
treasurer must sign for corporations. Otherwise, the corporation must attach a resolution
certified by the secretary or assistant secretary under corporate seal empowering the officer(s)
signing to bind the corporation.)
APPROVED AS TO FORM:
RONALD-RT^^L, City Attorney
_Deptrty-City Attorney
Revised 9/28/00
California All-Purpose Acknowledgment
State of Califomia
County of San Diego
Qnogc Qo^,2Q\ j , before me, Elyce Marie Martinez, Notary
Public, personally appeared Hv^^... ^ t-^^ a.^c-^ <...>^._ .
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person^ whose n^e(s)
is/a^e^bscribed to the within instrument and acknowledged to me that he/she/they
executed the same in his/her/their authorized capacity (iep) and that by his/heiv&eit—.
signature^) on the instrument the persons) or the entityupon behalf of which the
person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws ofthe State of Califomia that
the foregoing paragraph is true and correct
WITNESS my hand and official seal.
Signature of Notary Public
OFFICIAL SEAL , ELYCE MARIE MARTINEZ •
^^^^^
OPTIONAL
Description of Attached Document
Title or Type of Document Pi^^v.c Ujo>^vc-<^ L^eV^^ A><g^£.^v<^
Additional Information
Document Date: \n.-qa- M Number of Pages (including this one) '7
Capacity(ies) Claimed by Signer
• Individual
• Corporate Officer- Title(s)
• Partner: Limited General
• Attomey-in-Fact
• Tmstee
• Guardian or Conservator
• Other
Signer is Representing:
Right Thumbprint of
Signer 1
Right Thumbprint of
Signer 2
Time
Date
9:04:51AM
1/6/2012
City of Carlsbad
Account Details Read-Only Report
Page 1
Account Nunnber Business Name
1233934 ALLIANCE CONSULTING INTERNATIONAL
Business Address Mailing Address
3361 28TH ST
SAN DIEGO, CA 92104-4524
Business Phone
(619)297-1469
SIC
8999
Services, Not Elsewhere Classi
status
LICENSED
Current Balance
License Frequency
A
3361 28TH ST
SAN DIEGO, CA 92104-4524
Business Type
Professional License
Business Subtype
OS
Contractor Number
Location Code
0
PARCEL
EMPLOYEES
0
Extra 1
0
Extra 2
0
Expiration Date
11/30/2012
License Issued Da
12/22/2011
Start Date
12/20/2011
Cease Date
Contact Code
Owner
01 Contact Name
MEDINA, ENRIQUE
Contact Address
3361 28TH ST
SAN DIEGO, CA 92104-4524
Contact Code EC
Emergency Contact
Contact Code SG
Signature from Web A
Contact Name
CLEGHORN, ELSPETH
Contact Address
Contact Name
MEDINA, ENRIQUE
Contact Address
Cont Field#1
CORPORATIO
PHONE
Business (619)297-1469
Cont Field#1
PHONE
Business (619)347-0051
Cont Field#1
PRESIDENT
PHONE
Business (619)297-1469
Email emedina@pulse-poir
PAYTYPE
7
Payment History
POSTDATE AMOUNT CHECKS NOTES
12/21/2011 $50.00 na na
NOTES
CODE Entered Entered Bv
CC SIC's code has been changed from 8711 to 8999. 12/21/11 3:57 pm DRUBS
ADDR Old mailing address: 12/21/11 3:57 pm DRUBS
3361 28TH ST.
SAN DIEGO, CA 92104-
ADDR Old account address: 12/21/11 3:57 pmDRUSS
3361 28TH ST.
SAN DIEGO, CA 92104-
BDESC Environmental Health and Safety Consulting Services 12/21/11 3:55 pm DRUBS
\\fdfps02\Apps\cityapps\LicenseTrack\LT2000\reports\acdetailsro4.rpt Modified-05/11/2009
CERTIFICATE OF LIABILITY INSURANCE
GRID: IQ
DATE (MM/DD/YYYY)
01/04/12
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Hays Affinity Solutions
1133 20th St. N.W., Suite 450
Washington, DC 20036
Barry F. Peters
202-263-4000
202-263-4001
Alliance Consulting
International
IVIr. Enrique Medina
3361 28th Street
San Diego, CA 92104
CONTACT
N.A.ME: PHONE
(A/C, No, Est): E-NlAIL ADDRESS;
pRobucik Al 1 IA o
FFAX
I (A/C. No):
INSURER(SI AFFORDINQ COVERAGE
INSURER A: Lloyds of London
INSURER B: Hartford Casualty Cornpany
INSURER C ;
INSURER D :
INSURER E ;
INSURER F :
\ NAIC #
it C'&O
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR LTR TYPE OF INSURANCE ADDL'^UBR
.iwsR:..wva. POUCY NUMSeR POLICY EFF I POUCY EXP ' iMWDD/YYYY) I WM/DPffYYY) I
GENERAL UABILITY
I COMMERCIAL GENERAL LIABILITY
I OCCUR CLAIMS-MADE
X Business Liab.
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO-i POLICY i LOC
AUTOMOBILE LIABILITY
; ANY AUTO
ALL OWNED AUTOS
i SCHEDULED AUTOS
X HIRED AUTOS
X I NON-OWNED AUTOS
42SBABX9960 12/10/11
42SBABX99eO 1 a/10/11
i EACH OCCURRENCE
i OAliSASE TO RENTEO
i PREMISES (Ea occurrences
i MED tXP (Any OM ptxsooi
12/10/12 I PERSONALS. ADV INJURY
; GENERAL AGGREGA1E
i PRODUCTS • CON'P'OP AGG
2,000,000
300,000
10.000
2,000,000
4,000.000
4,000.000
12/10/12
coMBWD siNGi.fe" umr
rodent) i
I BODILY INJURY (Per person)
I BODILY INJURY (Per acoidenl)
i PROPERTY DAMAGE
2,000,000
UMBRELLA LIAS
EXCESS LIAB
: OEOUCTIBLE
RKTENTION $
J OCCUR
I CLAIMS-MADE
i WORKERS COMPENSATION
AND EMPLOYERS' UABILITY y / N
i ANY PROPRIETOR/PARTNEREXECUTIVE
I OFFICER/MEMBER EXCLUDED?
I (Mandatory in NH) If M asscfibe ufiaw
I DESCRIPTION OF OPERATIONS Wg«
• N/A
A Professional (E&O)
ItiaWII^
EACH OCCURHENCr
AGGREGATE
i WC STATU- 1 I imY UM T S 1 'OTH-
. ER .
EL EACH ACCIDENT i S
ELJJISEASE ^ EA EMPLOYEE; S
£ L OlSEASe • POLICY LIMIT i S
A1HA00110S1 02/10/11 ! 02/10/12 Per Claim
Aggregate
1,000.000
1.000.000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more space Is required)
Re:PEM567 .......
The City of Carlsbad is hereby listed as Additional Insured with respect to
the General Liability coverage.
CITYOCA
City of Carlsbad
Attn: Mr. Joe Gauba, Manager
405 Oak Avenue
Carlsbad, CA 92008-3009
1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POUCY PROVISIONS.
CITYOCA
City of Carlsbad
Attn: Mr. Joe Gauba, Manager
405 Oak Avenue
Carlsbad, CA 92008-3009
1
AUTHORIZEO REPRESENTATWE
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
MINTED An ALLIA-8 PAGE 2
NUlcrAU (NsuRED-SNAME Alliance Consulting OP ID: IQ OATE 01/04/12
A.) Prbfesislonal •(Ea.O) MoldT Sub-Omit: $100,000
WAIVER REQUEST FOEM
FACTORS m SUPPORT OF REQUEST TO MODIFY INSURANCE REQUmEMENT(S)
Generally, a modification to the coverage requirement will be accepting a lower limit of coverage or waiving the
requirement(s).
Requested by:_
I (Nameand Department) (Date)
Proposed modification(s) to the ALL^ requirement(s) for I M CM'^jtl^ inii^'
(Type of insurance) (Name of contract)
[j Reduce coverage to the amount of: $
®. Waive coverage , . . ,^ A-I -^I . • J_
• other: "T^ kmcH 6^^pM^% :Afe:4^e0:.J^
FACTOR(S) IN SUPPORT OF MODIFICATION(S)
(check those that apply)
riSignificance of Contractor: Contractor has previous experience with the City that is important to the
efficiency of completing the scope of work and the quality of the work-product, [explain J ,„_,_ „„
^Significance of Contractor: Contractor has unique skills and there are few if any alternatives, [explain:
inchide number of candidates RFP .ten/ to and number responded if applicable]
K;Contract AmouniTerm of Contract: S 7..^tE0- OO. Work will be completed over a period of CQ^k ft^;
Qprofessional Liability coverage is not available to this contractor or would increase the cost ofthe contract by
$ [explain]. . _— ~—-— -
[pother (e.g. explain why exposures are minimal how exposures are covered in another policv:>.exB..osiM:s
control mechanisms, and anv other infonnation gertincnt.to VQU SJMl—Cm^'^&^ ^^X-^
mm^j^ m mvtw<h4.r 2^1U —— ___ .—
Approved bv Risk Manager for tMsconjractCTUyi (Signature) (Date)
H:' WORD'lnsunmce.Admm Onkr «S8 doc
06/15/2006 27
CERTIFICATE OF EXEMPTION
WORKERS' COMPENSATION/EMPLOYERS' LIABILITY INSURANCE
1, l%tdlk0i am the ffm^^iX^
[insert name] [lillc]
QfAWmCA. \^mkd^ hereby certify that AWmUi CmS/litW^ f^lixU^W^f
[naraeofcomp&y] ' [name of company]
has no employees and is not required by law to maintain workers' compensation or employers' liability
insurance. Should ^lIl^HCi. (j^Syl'h^^ fM.iy»W"Wa/ employ any person during the term
[name of company]
ofthe Agreement with the Cit>^ of Carlsbad for fM /|lMllfef k6^m 4+ fi^^^dm
[description of project or work that is being ciJntracted]
then workers' compensation and employers' liability insurance will be obtained.
[Name]
[Title and name of company or corporation]
06/15/2006 25