HomeMy WebLinkAboutContracts & Agreements_37-2016 AGREEMENT TO PERFORM PROFESSIONAL SERVICES
This agreement for the preparation of a comprehensive user fee study ("Agreement") is
made and entered in this 18th day of February, 2016 ("Effective Date"), by and between the City
of Redlands, a municipal corporation ("City)" and Matrix Consulting Group ("Consultant"). City
and Consultant are sometimes individually referred to herein as a "Party" and, together, as the
"Parties." In consideration of the mutual promises contained herein, City and Consultant agree as
follows:
ARTICLE 1 —ENGAGEMENT OF CONSULTANT
1.1. City hereby engages Consultant to prepare a comprehensive user fee study for City's
Development Services Department(the"Services").
1.2 The Services shall be performed by Consultant in a professional manner, and Consultant
represents that it has the skill and the professional expertise necessary to provide the
Services to the City at a level of competency presently maintained by other practicing
professional consultants in the industry providing like and similar types of Services.
ARTICLE 2—SERVICES OF CONSULTANT
2.1 The Services that Consultant shall perform are more particularly described in Exhibit
"A," entitled "Scope of Services and Project Schedule," which is attached hereto and
incorporated herein by reference.
2.2 Consultant shall comply with applicable federal, state and local laws and regulations in
the performance of this Agreement including, but not limited to, State prevailing wage
laws.
ARTICLE 3—RESPONSI131LITIES OF CITY
3.1 City shall make available to Consultant information in its possession that may assist
Consultant in performing the Services.
3.2 City designates Mr. Oscar W. Orci, Development Services Director, as City's
representative with respect to performance of the Services, and such person shall have the
authority to transmit instructions, receive information, interpret and define City's policies
and decisions with respect to performance of the Services.
ARTICLE 4—PERFORMANCE OF SERVICES
4.1 Consultant shall perform and complete the Services in a prompt and diligent manner in
accordance with the schedule set forth in Exhibit "A." The Services shall commence
within ten (10) days of the Effective Date of this Agreement.
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4.2 If Consultant's Services include deliverable electronic visual presentation materials, such
materials shall be delivered in a form, and made available to the City, consistent with
City Council adopted policy for the same. It shall be the obligation of Consultant to
obtain a copy of such policy from City Staff.
ARTICLE 5 —PAYMENTS TO CONSULTANT
5.1 The total compensation for Consultant's performance of the Services shall be the fixed
amount of Twenty Three Thousand Dollars ($23,000.00).
5.2 Consultant shall submit monthly invoices to City describing the Services performed
during the preceding month. Consultant's invoices shall include a brief description of the
Services performed, the dates the Services were performed, the number of hours spent
and by whom, and a description of reimbursable expenses related to the services. City
shall pay Consultant no later than thirty (30) days after receipt and approval by City of
Consultant's invoice.
5.3 Any notice or other communication required, or which may be given, pursuant to this
Agreement, shall be in writing. Any such notice shall be deemed delivered (i) on the date
of delivery in person; (ii) five (5) days after deposit in first class registered mail, with
return receipt requested; (iii) on the actual delivery date if deposited with an overnight
courier; or (iv) on the date sent by facsimile, if confirmed with a copy sent
contemporaneously by first class, certified, registered or express mail; in each case
properly posted and frilly prepaid to the appropriate address set forth below, or such other
address as a Party may provide notice in accordance with this section:
CLty Consultant
Oscar Orci, Director Richard Brady, President
Development Services Department Matrix Consulting Group,Ltd.
City of Redlands 201 San Antonio Circle, Ste. 148
35 Cajon Street, Suite 20 Mountain View, CA 94040
PO Box 3005 (mailing)
Redlands, CA 92373
ARTICLE 6—INSURANCE AND INDEMNIFICATION
6.1 Insurance required by this Agreement shall be maintained by Consultant for the duration
of its performance of the Services. Consultant shall not perform any Services unless and
until the required insurance listed below is obtained by Consultant. Consultant shall
provide City with certificates of insurance and endorsements evidencing such insurance
prior to commencement of the Services. Insurance policies shall include a provision
prohibiting cancellation or modification of the policy except upon thirty (30) days prior
written notice to City.
6.2 Consultant shall secure and maintain Workers' Compensation and Employer's Liability
insurance in the amount that meets statutory requirements with an insurance carrier
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acceptable to City, or certify to City that Consultant is self-insured or exempt from the
workers' compensation laws of the State of California. Consultant shall provide City with
Exhibit "C," entitled "Workers' Compensation Insurance Certification," which is
attached hereto and incorporated herein.
6.3 Consultant shall secure and maintain comprehensive general liability insurance with
carriers acceptable to City. Minimum coverage of One Million Dollars ($1,000,000) per
occurrence and Two Million Dollars ($2,000,000) aggregate for public liability, property
damage and personal injury is required. City shall be named as an additional insured and
such insurance shall be primary and non-contributing to any insurance or self-insurance
maintained by City.
6.4 Consultant shall secure and maintain professional liability insurance throughout the term
of this Agreement in the amount of One Million Dollars ($1,000,000) per claim made.
6.5 Consultant shall secure and maintain business auto liability coverage, with minimum
limits of One Million Dollars ($1,000,000) per occurrence, combined single limit bodily
injury liability and property damage liability. This coverage shall include all Consultant
owned vehicles used in connection with ConsuItant's provision of the Services, hired and
non-owned vehicles, and employee non-ownership vehicles. City shall be named as an
additional insured and such insurance shall be primary and non-contributing to any
insurance or self insurance maintained by City.
6.6 Consultant shall defend, indemnify and hold harmless City and its elected officials,
employees and agents from and against any and all claims, losses or liability, including
attorneys' fees, arising from injury or death to persons or damage to property occasioned
by any negligent act or omission by, or the willful misconduct of, Consultant, or its
officers, employees and agents in performing the Services.
ARTICLE 7—CONFLICTS OF INTEREST
7.1 Consultant covenants and represents that it does not have any investment or interest in
any real property that may be the subject of this Agreement or any other source of
income, interest in real property or investment that would be affected in any manner or
degree by the performance of Consultant's Services. Consultant further covenants and
represents that in the performance of its duties hereunder, no person having any such
interest shall perform any Services under this Agreement.
7.2 Consultant agrees it is not a designated employee within the meaning of the Political
Reform Act because Consultant:
A. Does not make a governmental decision whether to:
(i) approve a rate, rule or regulation, or adopt or enforce a City law;
(ii) issue, deny, suspend or revoke any City permit, license, application,
certification, approval, order or similar authorization or entitlement;
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(iii) authorize the City to enter into, modify or renew a contract;
(iv) grant City approval to a contract that requires City approval and to which
City is a party, or to the specifications for such a contract;
(v) grant City approval to a plan, design, report, study or similar item;
(vi) adopt or grant City approval of, policies, standards or guidelines for City
or for any subdivision thereof.
B. Does not serve in a staff capacity with City and in that capacity, participate in
making a governmental decision or otherwise perform the same or substantially
the same duties for City that would otherwise be performed by an individual
holding a position specified in City's Conflict of Interest Code under Government
Code section 87302.
7.3 In the event City determines that Consultant must disclose its financial interests,
Consultant shall complete and file a Fair Political Practices Commission Form 700,
Statement of Economic Interests, with the City Cleric's office pursuant to the written
instructions provided by the City Clerk.
ARTICLE 8--GENERAL CONSIDERATIONS
8.1 In the event any action is commenced to enforce or interpret any of the terms or
conditions of this Agreement the prevailing Party shall, in addition to any costs and other
relief, be entitled to the recovery of its reasonable attorneys' fees, including fees for the
use of in-house counsel by a Party.
8.2 Consultant shall not assign any of the Services, except with the prior written approval of
City and in strict compliance with the terms and conditions of this Agreement.
8.3 Records, drawings, designs, cost estimates, electronic data files, databases and any other
documents developed by Consultant in connection with its performance of the Services,
and any copyright interest in such documents, shall become the property of City and shall
be delivered to City upon completion of the Services, or upon the request of City. Any
reuse of such documents, and any use of incomplete documents, shall be at City's sole
risk.
8.4 Consultant is for all purposes under this Agreement an independent contractor and shall
perform the Services as an independent contractor. Neither City nor its agents shall have
control over the conduct of Consultant or Consultant's employees, except as herein set
forth. Consultant shall supply all necessary tools and instrumentalities required to
perform the Services. Assigned personnel employed by Consultant are for its account
only, and in no event shall Consultant or personnel retained by it be deemed to have been
employed by City or engaged by City for the account of, or on behalf of City. Consultant
shall have no authority, express or implied, to act on behalf of City in any capacity
whatsoever as an agent, nor shall Consultant have any authority, express or implied, to
bind City to any obligation.
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8.5 Unless earlier terminated as provided for below, this Agreement shall terminate upon
completion and acceptance of the Services by City. This Agreement may be terminated
by City, in its sole discretion, by providing not less than five (5) days prior written notice
to Consultant of City's intent to terminate. If this Agreement is terminated by City, an
adjustment to ConsuItant's compensation shall be made, but (1) no amount shall be
allowed for anticipated profit or unperformed Services, and (2) any payment due
Consultant at the time of termination may be adjusted to the extent of any additional costs
to City occasioned by any default by Consultant. Upon receipt of a termination notice,
Consultant shall immediately discontinue its provision of the Services and, within five(5)
days of the date of the termination notice, deliver or otherwise make available to City,
copies (in both hard copy and electronic form, where applicable) of related data, design,
reports, estimates, summaries and such other information and materials as may have been
accumulated by Consultant in performing the Services. Consultant shall be compensated
on a pro-rata basis for Services completed up to the date of termination.
8.6 Consultant shall maintain books, ledgers, invoices, accounts and other records and
documents evidencing costs and expenses related to the Services for a period of three (3)
years, or for any longer period required by law, from the date of final payment to
Consultant pursuant to this Agreement. Such books shall be available at reasonable times
for examination by City at the office of Consultant.
8.7 This Agreement, including the Exhibits incorporated herein by reference, represents the
entire agreement and understanding between the Parties as to the matters contained
herein, and any prior negotiations, written proposals or verbal agreements telating to such
matters are superseded by this Agreement. Except as otherwise provided for herein, any
amendment to this Agreement shall be in writing, approved by City and signed by City
and Consultant.
8.8 This Agreement shall be governed by and construed in accordance with the laws of the
State of California.
8.9 If one or more of the sentences, clauses, paragraphs or sections contained in this
Agreement is declared invalid, void or unenforceable by a court of competent
jurisdiction, the same shall be deemed severable from the remainder of this Agreement
and shall not affect, impair or invalidate the remaining sentences, clauses, paragraphs or
sections contained herein, unless to do so would deprive a Party of a material benefit of
its bargain under this Agreement.
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IN WITNESS WI,IERI'-,'.OF, dUly authorized representatives of City and Consultant have signed
in confil'Illation ofthis Agreement.
CITY OF .REDL.ANDS MATRIX flllN4,S-tJ4,TING GROUP
By:
itl i
I tl,2 It �y gBrady, Isresident
N. i iqu� Mart Manag r Ricll6rd Bi
Attest:
Sarn It-win, -"it lerk
6
Cm is olting Giroup 2 2016,doc
" IT "A"
Mope of Services
CITY OF REDL4NDS, CALIFORNIA
Proposal to Conduct a Compmhensive User Fee Study for the Building and Safety Division
Task 1 Determine and Review Initial Documentation
The project team will provide the City of Redlands' Division of Building and
Safety with a written "Data Collection List" outlining documents and information needed
prior to our first onsite visit. This data request typically includes the following items:
• Current f=iscal Year adopted budget for all Departments and Divisions involved in
the study.
+ Revenue reports for all Departments and Divisions involved in the study.
List of all budgeted personnel by Department/ Division.
List of all current fees being charged by Redlands to be included in the analysis.
Before our first on-site visit, we will review this information to familiarize
ourselves with strengths, weaknesses and opportunities for improvement related to the
City's existing fee structure. In addition, we will familiarize ourselves with the budgetary
and staffing structures relevant to fees for service.
Em
• List of basic data requirements for the Study Basic data requirements for the Study as
listed by the Matrix Consulting Group
(staffing,salary,budget,etc.)
itstimated Hours: 1 -2 hours for Finance
Task 2 Project Initiation—Establish the City & Division's Goals and
Objectives for the Study, and Identify Trends and Plans Which
Impact Cost Recovery Analysis and Policy.
To effectively analyze and present the full cost of providing the Division's
services, it is important that the project team develops an understanding of key issues
which impact and shape the Division's service delivery and cost recovery policies. To
develop this perspective and customize the structure of the project, we plan to do the
following:
• Conduct an initial meeting with City and Division management staff to solidify the
exact parameters of the study.
• Develop a detailed project management plan, including timelines and associated
deliverables.
• Conduct discussions regarding current fee structures and potential changes.
• Identify current cost recovery policies or established subsidies.
Matrix Consulting Group Page 3
CITY OF REDLANDS, CALIFORNIA
Proposal to Conduct a Comprehensive User Fee Study for the Building and Safety Dlvlslon
As a "user fee" study, the Matrix Consulting Group does not propose to evaluate
any fines, taxes, utility rates, or impact fees. Services and activities included in the study
are those that are defined specifically by an estimate of staff time.
1=♦ A lfflllmlmln��. s
• On-site meeting with City and Division Designated project management
management involved In or impacted by the representative
Study Approval of work pian as provided by the
• Project Management Plan Matrix Consulting Group
Estimated Hours: 0.5 hours per executive staff member attending the meeting.
Task 3 Develop a Schedule of Current and Potential Fees for Service
Current, as well as potential fees and charges will be identified and documented.
Meetings with the Building and Safety Division will identify the areas of greatest
potential cost recovery, and structure and expand existing fee schedules for both
optimum cost recovery and fairness and equitability to the applicant for services.
Potential areas for discussion would include streamlining or expanding the fee schedule
for ease of use by the end user or adding any additional or new fees for service.
At this time, the project team will request volume statistics to be used for staff
utilization and cost/revenue comparisons later in the analysis.
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• On-site meeting to discuss and revise fee Participation in discussion of existing and
structures for the Division proposed fee Items for the analysis
• Thorough review of existing documentation Review,comment, and approval of fee
and analyses that support the Division's structure report prepared by the Matrix
current fee structure and operations Consulting Group.
Estimated Hours:3 hours per Building and Division Safety staff
Task 4 Conduct Time and Activity Data Gathering Workshops
The project team will conduct a total of two workshops to gather time and activity
estimates for each service included in the study, interviewing key personnel from each
department and analyzing the various activities being performed within it that are both
revenue and non-revenue generating. The following flowchart shows an example of the
steps involved in processing a permit and the staff and time associated with each step.
Matrix Consulting Group Page 4
CITY OF REDLANDS, CALIFORNIA
Proposal to Conduct a Comprehensive User Fee Study for the Building and Safety Division
Permit Tech •Perm t Tech •EngineeF "engineer •Permit Tech
•15 min •1 D min •1 hr •30 min •15 min
As the flowchart above shows, basic process steps in application 1 permit
processing will be documented and provided in the Departmental detail for each
department represented in the study.
e
• Facilltatioq of two-days of meetings related to Attendance at workshop meetings
available rjet hour calculations,documentation Provision of follow up data or discussion as
of service levels. needed
1 -2 Iterations of review to achieve a
defensible and reasonable allocation of staff
time to fee and non-fee activities
Estimated Hours:3-7 hours per Building and Safety staff
Task 5 Perform a Total Cost Analysis
The Matrix Consulting Group's costing model is built based on Redlands'
operations, budget detail and intended uses for the results. This method is a customized
approach, specific to each jurisdiction, for cost analysis of user fee services. This
costing method uses time and annual activity level data to establish the cost of
providing services on both a unit and annual level. Once the time spent for a fee activity
is determined for each individual or position, the team uses its fee and rate software to
apply applicable City costs to the calculation of the full cost of providing each service.
The following chart describes the typical costs considered as applicable to fees.
e
Resulting costs are presented on a unit and annual level, and are compared to
the existing fee schedule and revenue reports. Redlands will obtain information about
cost recovery surpluses and deficits on both a detailed (per unit) and global
(annualized) level, as well as an understanding of cost components for each service (i.e.
direct cost, indirect cost, technology cost, etc.)
Matrix Consulting Group Page 5
CITY OF REDLANDS, CALIFORNIA
Proposal to Conduct a Comprehensive User Fee Study for the Building and Safety Division
• Detailed documentation of current charges Provision of follow up data or discussion as
versus the actual cost of providing services needed
from both a cost per unit and annual cost
perspective
Estimated Hours: 1 -3 hours per Building and Safety Division staff
Task 6 Analysis of Recoverable Revenue
Utilizing the Division's volume and workload data, the project team will analyze
potential and actual recoverable revenue. This will help the City and the Division
understand how workload volume impacts revenue and cost subsidies. While potential
revenue can be identified, recoverable revenue is dependent upon the following factors:
• Current policies and legal restrictions, which limit the Division's ability to increase
fees and thereby revenue recovery.
• Economic and revenue impacts of proposed and recommended fee levels and
methodologies, including compliance with policies and fee affordability for
recreation classes or small projects and applications,
These factors influence the actual recoverable revenue of a department and
directly influence the self-sustainability of a department 1 division. City staff can use this
information to shape or alter current or future City policies on cost recovery.
NEEMr10 111
-
• Discussion of internal and external policies • Provide documentation regarding current City
limiting fee increases policies
• Analysis of potential and actual recoverable • Attendance at meetings related to discussion
revenjoe of revenue results
Estimated Hours: 2-4 hours per Building and Safety Division staff
Task 7 Conduct a Market Rate Survey to Similar Jurisdictions
The project team will work with the Department to identify at least 5 comparable
jurisdictions in San Bernardino and Riverside counties or elsewhere in Southern
California targeted for the fee comparison survey. We will also develop the survey tools
and select the most appropriate fee items in the Division for benchmarks. Then, we will
administer the survey, collect comparative data, conduct the comparison, and document
the results. The following graph provides an example of how comparative survey results
for Building Fees would be presented:
Matrix Consulting Group Page 6
CITY OF REDL4NDS, CALIFORNIA
Proposal to Conduct a Comprehensive User Fee Study for the Building and Safety Division
Single Family Home-New
Permit and Plan Check Fees
$8,000
$7,000
w $6,000
$5,000
$4,000 0 Plan Check
$3,000 Perms
CL $2,000 '
$1,000
04 In
CL CL CL CL
a o o U U U U U
n o 0 0 0
U U U CJ U
Market surveys do not provide adequate or objective information about the
relationship of a jurisdiction's costs to its fees, therefore, it is recommended that
information contained in the market comparison of fees be used as a secondary
decision-making tool, rather than as a tool for establishing price points for services.
EMr -
• Survey of fees in similar jurisdictions Review of proposed jurisdictions and list of
• Written comparative summary of the results comparable fees to be included In the survey
Estimated Hours: i hour per Building and Safety staff
Task 8 Review I Revise the Fee Study Results
Because the analysis of fees for service is based on estimates and information
provided by Division staff, it is extremely important that all participants are comfortable
with our methodology and with the data they have provided. Once the Division agrees
that the analysis reflects the reasonable costs of providing services, the project team
will present the results to City management. Management will have an opportunity to
review the results.
The project team will address implementation strategies that consider both policy
issues and goals for optimum cost recovery. While it is generally desirable to eliminate
any subsidies, discussions regarding the feasibility of raising fees based on political
climate, legal restrictions, and social and economic consequences must occur.
Matrix Consulting Group Page 7
CITY OF REDLANDS, CALIFORNIA
Proposal to Conduct a Comprehensive User Fee Study for the Building and Safety Division
• Approval of analytical results at the Review of final analytical documentation
Department and City management levels • Attendance at meetings related to discussion
• Formulation of cost recovery of results and economic policy implications
recommendations and revenue Impacts Follow up data or discussion as needed
Estimated Hours: 1 -3 hours per Building and Safety Division Staff
Task 9 Prepare a Final User Fee Study Report
Upon conclusion of the fee study, we will prepare a detailed report that
summarizes the results of each of the previous work tasks described above. This report
will include the following:
• A succinct executive summary discussing the study, the methodology, and the
results.
• A narrative describing the services included in the study, as well as any revenue
enhancement and operational recommendations specific to your organization
and based on our extensive experience with hundreds of jurisdictions, as well as
key decision making points to be considered.
• Appendices that compare existing and potential cost recovery on a unit and
annual basis by department.
The report will be reviewed, revised and finalized with Division and City
management.
• Preparation and approval of the Final User Fee Review and approval of Final Report drafts.
Study report
• Bound and electronic copies of the final report.
•
Detailed back-up documentation for the
Division.
Estimated Hours:2 hours per Building and Safety Division staff
Task 10 Present the Final Report to the City Council
The presentation of results to City officials and/or stakeholders is critical to the
success of the overall engagement. Because the product from the study is often
controversial, the objective of this final step is to present a succinct summary that
provides decision makers with key information. The Matrix Consulting Group will attend
and present the Study at up to City Council workshops or meetings. Additional
meetings can be arranged at cost.
Matrix Consulting Group Page 8
CITY OF REDLANDS, CALIFORNIA
Proposal to Conduct a Comprehensive User Fee Study for the Building and Safety Dhvlslon
Rim® •
• Presentation of Study results to City Council • Preparation discussion with the consultant
meetings or workshops and review of any presentation materials
required for Board meetings
Preparation of City Staff Report
Estimated Hours:4 hours per Building and Division Safety Staff
Task 11 User Fee Software Model and Training
The City and the Division wishes to have the ability to update the final version of
the service cost analysis, including the ability to add, revise or remove direct and
indirect costs, or apply an annual cost factor to calculate fee increases in future years.
Our technical fee model, produced in Microsoft Excel, provides the ability for the
City to adapt and continuously update user fees from year to year as the organization
changes. The model allows for the City to conduct simple annual updates such as CPI
or COLA increases, or allows for more in-depth and comprehensive updates such as
budget levels, staffing, and time estimates.
While the model is structured in Excel, the technical model is proprietary and for
internal use by City staff only. By having our model based in Excel, the requirements for
software training, cost of new software products, updates, licensing or other additional
support, would be minimized.
After the final draft of the fee study is approved, at the discretion of staff, the
project team will meet with and train designated City employees on use of the Excel
model. Staff will be provided with initial training that includes: a step-by-step PowerPoint
presentation; a User's Manual which explains key concepts and defines basic terms;
and a customized update checklist of data and information that needs to be entered.
While staff training typically takes about four hours, the Matrix Consulting Group is
committed to supporting City staff well after project completion, including answering
questions and providing model support, for no additional costs.
111MIM.
•.
• Technical User Fee Mode[ Attend training session with Matrix Consulting
• Four(4)hours of on-site training for Group
appropriate Finance Department staff.
Estimated Hours,Training attendance-4 hours
Matrix Consulting Group Page 9
Project Costs & Hourly Rate-
CITY OF REDLANDS, CALIFORNIA
Proposal to Conduct a Comprehensive User Fee Study for the Building and Safety Division
6. FEE 1 COST PROPOSAL
The Matrix Consuiting Group is prepared to conduct a Comprehensive User Fee
Study for the Building and Safety Division at the level of detail described in this proposal
for$23,000, for professional time within our hourly rates. The following table provides a
breakdown of team member hours and project costs by task for each of the City's
requested scopes of work.
1. Initial Documentation 2 4 4 $1,060
2. Project Kick-off 4 4 0 $1,080
3. Current&Potential Fees 4 4 6 $1,530
4. Data Workshops 4 8 2 $1,670
5.Total Cost Analysis 8 12 16 $3,800
6.Analysis of Recoverable Revenue 4 0 10 $1,390
7. Rate Comparison 0 0 12 $900
8. Review 1 Revise Results 8 12 12 $3,500
9. Prepare Final Report 4 8 6 $1,970
10. Present Final Report 8 4 0 $1,_720
Subtotal Fee Study 46 56 68 $18,620
USER FEE AND CAP MODEL&TRAINING 2;500.'.
--- --
RATE PER HOUR $160 $110 $75
TRAVEL $1,880
TOTAL.PROJECT COST $23,000
We are prepared to enter into a fixed price contract for any I all scopes of work
included above. This fixed price includes all reimbursable expenses, including travel
and report production. The Matrix Consulting Group is committed to providing the
services requested in this proposal at the level of detail and for the cost proposed above,
regardless of extenuating circumstances. All measures have been taken to ensure that
projects costs were minimized, while ensuring work is completed in a timely manner.
Matrix Consulting Group Page 19
ExHIBI ICt,
WORKERS' COMPENSATION INSURANCE CERTIFICATION
Every employer, except the State, shall secure the payment of compensation in one or more of
the following ways:
(a) By being insured against liability to pay compensation by one or more insurers
duly authorized to write compensation insurance in this State.
(b) By securing from the Director of Industrial Relations, a certificate of consent to
self-insure, either as an individual employer, or as one employer in a group of
employers, which may be given upon furnishing proof satisfactory to the Director
of Industrial Relations of ability to self-insure and to pay any compensation that
may become due to his or her employees.
CHECK ONE
✓ I am aware of the provisions of Section 3700 of the Labor Code which requires every
employer to be insured against liability for Workers' Compensation or to undertake self-
insurance in accordance with the provisions of that Code, and I will comply with such provisions
before commencing the performance of the work and activities required or permitted under this
Agreement. (Labor Code §1861).
I affirm that at all times, in performing the work and activities required or permitted under
this Agreement, I shall not employ any person in any manner such that I become subject to the
workers' compensation laws of California. However, at any time, if I employ any person such
that I become subject to the workers' compensation laws of California, immediately I shall
provide the City with a certificate of consent to self-insure, or a certification of workers'
compensation insurance.
I certify under penalty of perjury under the laws of the State of California that the information
and representations made in this certificate are true and correct.
Matrix Cons ti oup Date: 02/18/2016
By:
Richard Brady, Presi ent
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