HomeMy WebLinkAboutMINUTES - 02042003 - C14 .....................................I....1.1.11,111,111,.......
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TO: BOARD OF SUPERVISORS AS THE BOARD OF DIRECTORS, BLACKHAWK GEOLOGIC
HAZARD ABATEMENT DISTRICT 4r-11#
FROM: MAL-RICE M. SHIU, PUBLIC WORKS DIRECTOR
DATE: February 4, 2003
SUBJECT: APPROVE and AUTHORIZE Kleinfelder, hic., as General Manager of the Blackhawk Geologic
Hazard Abatement District(GHAD)to execute a contract with Siteworks Construction, Inc. in the
amount of $100,000 to provide maintenance services for the Blackhawk GHAD for the period
December 15, 2002 through June 30, 2003, Danville area. (District III)Project No. 7760-6X5147
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
I. Recommended Action:
APPROVE and AUTHORIZE Kleinfelder, Inc., as General Manager of the Blackhawk Geologic Hazard
Abatement District (GHAD) to execute a contract with Siteworks Construction, Inc. in the amount of
$100,000 to provide maintenance services for the Blackhawk GHAD for the period December 15, 2002
through June 30, 2003,Danville area.
11. Financial) :
There is no impact on the County General Fund. The Blackhawk GHAD is funded through revenues
generated by County Service Area M-23.The proposed contract is consistent with the proposed Fiscal Year
2002/03 Program Budget.
Z",
Continued on Attachment: X SIGNATURE:
HORN-
COMMENDATION OF COUNTY ADMINISTRATOR
—RECOMMENDATION OF BOARD COMMITTEE
,,AI�PROVE OTHER
SIGNATURE(s)° ,
ACTION OF B01 ON FE-BRIUARY 04, 2003 APPROVED AS RECOMMENDED XXOTHER
VOTE OF SUPERVISORS
XX UNAN- IMOUS(ABSENT DIST. III Ihereby certify that this is a true and correct copy of an action
taken and entered on the minutes ofthe Board of Supervisors
AYES: NOES: acting as the G-HAD Board on the date shown.
ABSENT: III ABSTAIN:
ATTESTED: FF3RUkRY04, 2QQ3
RNI,:sr JOHN SWEETEN,Clerk of the Blac'Kh-awk GRAD Board
G:\GrpData\SpD, ;st\Bw-d 4rders\2003\02-04-03 BO-(B)Siteworks.doc of Directors and Board Adm;nist-.ator
Orig.My- Public-Works(Special Distacts)
Contact: Skip Epperly,1313-2253) 21,
cc: County Counsel By_
Auditor-Control-er Deputy,,'
Accoi.inting-L.Holden
M,Morton,Eng.Svc,
Clerical Binder
R.Shoat,Kleinfelder,Inc.
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SUBJECT: APPROVE and AUTHORIZE Kleinfelder,Inc.,as General Manager of the Blackhawk Geologic
Hazard Abatement District(CHAD)to execute a contract with Siteworks Construction,Inc. in
the amount of$100,000 to provide maintenance services for the Blackhawk CHAD for the
period December 15,2002 through June 30,2003,Danville area.(District III)Project No.7760-
6X5147
DATE: February 4, 2003
PAGE: 2
111. Reasons for Recommendation and Bac1 ground:
Siteworks Construction, Inc. will provide on call maintenance service to Blackhawk GHAD, these
services are part of the emergency response program put in place for the 2003 rain season. Richard D.
Short, Kleinfelder, Inc., General Manager of the Blackhawk Geologic Hazard Abatement District.,
recommends approval of Siteworks Construction's contract with the Blackhawk GHAD.
IV, ConIggpences of Negative Action:
Without Board approval,reimbursements for costs incurred to coordinate repair of the landslides will not
occur. A negative action will jeopardize the safety of those citizens whose residences are in the path of
these landslides.
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C(3NTR.ACT
(Standard Forni Maintenance Services Agreement)
1, SA� t,TF MS. nese special teres are ineorpdrated"below by reference.
(See Secs.2,3) Marries. Public agency–Blackhawk Geologic hazard Abatement District
Contractor–Siteworks Construction,Inc.
Effective gate: December 15,2002
(Sce Sec.3)Project blame, Number and Location: General Maintenance Activities located in the Blackhawk cosxttrunity,
Danville,California area.
The work consists of on-call maintenance services as described its Appendix A.
(See Sec.4)Duration'. June 30,2003
(See Sec.4)Public Agency's agent: Richard D. Shot,Kleinfelder,Inc.
(See Sec.S)Contract Limit: 5100,000
(See Sec.6)Federal Taxpayer's E.D. or Social Security No.68-0235377
2. SECNA'"Ut�E S_�_�,C�CNOWL�!!�
Pu`slic Ageny �.-
Richard D.Short,Kleinfe der,Inc,
General.Massager
Contactor, hereby also certifying awareness of and contpliancc with Labor Code Sections 1,861 and 3700
concerning Workers'Compensation Law,
( esignate oftici l cap<c` s th ess)
Z11
:
By:
( esTV,are+sfruciare apacity in the business)
Note to Contractor For corpo;atio;as,the contract must be signed by two officers. The;srst signature crust be that of the chairman of the
board,president or vice presieent the second signature must be that of the secretary,assistant secretary,chief financial officer or assistant
treasurer. (Civ'Cade Section 1140 and Cor orations Code,Section,313. The acknowleA ant below must be si ned b a Not Public.
CERTIFICATE OF ACKNOWLEDGMElmT
Stale of Cal ifarni a )
) ss.
Counry of )
On the date written below,before rete,the undersigned Notary Public,personally appeared the person s signing above for Contracto*,
personally known to me or to me ants the basis of satisfactory evidence)to be the person use nameW*e subscribed to the
w,#;-t n instrument and � gov�,edge to+ oaf they executed the same in air authormetr rapacat test and 6,at by
their sigrs^ttsre sl an the stsstrstsz ant the per or the entity opens bet slfof which the p szOrt sacied,execute:rs°sat tint.
WITNESS S stay hand and off'.cial scat.
Dated: .. , 2-0��
g°
7—
(N Otiry S 561) sa (Notary Pub ab)
jig" CMUM C.d ly
(Paige t of'7)
3. W iC Com" CC,C �'N s (a) By their sigtaatures in Section,2,effective on the above date,these partlzs prorr4se amid agree at
set forth in this contract,incorporating by these references the riterial it Section 1,SPECIAL TERMS.
(b) Contractor shall,at his own cost and expense,and in a work nanlike manner,fully and faithfully perform and cornplrse the work;
and wvili furnish all rnaterials,labor,services and transportation necessary,convenient and,proper in order fairly to perfort the requirements
of this cont act,all strictly in accordance with the scope of work as described in Appendix A.,
(c) "Tile work can be changed only with Public Agency's prior written order speeif�ing such change and its cost agreed to by the parties;
and the Public Agetncy shall never have to pay more than specified in Section 5,PAYMENT,without such an order.
4. Contractor shall start this work as directed by tate General Manager of his Agent or the Notice to
Proceed;aid shall complete it as specified in Section t,SPECIAL TERMS.
5. EAYM �'. Public agency small pay Contractor for services performed at the ra,es shown in Appendix B'actached hereto,,which
include all overhead and incidental expenses,for which no addi'donal compensation shall be allowed, Notwithstanding the foregoing,those
incidental expenses specifically Iternized in Appendix B shall be reimbursable by Public Agency to Contractor,provided that Contractor
submits copies of receipts and,i€applicable,a detailed mileage log to Public Agency. In;not event shall the total amount paid to Contractor
exceed the payment lirnit(s) specified in the Contract imits without prior written approval of the Public Agency, Coantractces billing
statements shall be submitted at convenient intervals approved by Public Agency and shall list,for each item of services,the employee
categories, hours and rates, Public Agency will pay Contractor in accordance with the requirernents of Civil Code Section 3320 as
applicable,
r PAYM I I" WIn I t T I l3 (a) The Public Agency or its Agent may withhold any payment,or because of aterdiscovertd evidersce
nutlify all or any certificate for 5psymenr,to such extent and period of time only as may be necessary to protect the?abut Agency from loss
because of:
(I) Defective work not rcmedied,or uncompleted work,or
(2) Claims tiled or reasonable evidence indicating probable filing,or
(3) Failure to properly pay subcontractors or for material or labor,or
(4) Reasonable doubt that the work can be completed for the balance then unpaid,or
(5) barrage to another contractor,or
(6) Damage to the Public Agency,other than damage due to delays.
(b) The Public Agency shall use reasonable diligen.,ce to discover and report to the Contractor,as the work progresses,the materialsand
labor which are not satisfactory, to it,so as to avoid unnecessary trouble or cost to the Contractor in making good any defective work or
gtart�.
A Contractor performing services under this contract shall provide at all times the following insurance las amounts
not less than.those specified: (a)Workers` Compensation Insurance complying with the laws of the state of California;(b)
Prcfessiotnal Liability Insurance with a smimmum coverage of$1,000,000 and a maxinnum deductible of 50,000;and(c)
Comprehensive General—liability Insurance,including blanket corirmctual(or contractual liability)coverage,broad forret property
damage coverage,and coverage for owned and Pori-owned vehicles,with a minimums combined single limit coverage of S1,000,000 for
:sit damages due to bodilly injury,sickness or disease,or death to any person,and damage to property,including the lost of use thereof,
arising out of each accident or occurrernce,and naming Public Agency,Richard D.Short,Kleitnfelder,Irv.,their hoards,officers and
employees as additional insured. Contractor is aware of and complies with:Labor wile Section 3700 and the Workers`Cornpensati sc
Law.
g. =DS. Contractor shall provide,if the contract exceeds$25,000,at the time of the execution of the agreement or contract for the
worts,and at no additional expense to the Public Agency,a surety bond executed by an admitted surety insurer in are amount equal to at least
enc:-hundred percent(100%)of the contract price as security for the faithful performance of said agreement. Contractor shall also provide,
at the time of the execution of the agreement or contract for the work,and at no additional expense to the Public Agency,a separate surety
bond executed by ars admitted surety insurer in an amount equal to at least fifty percent(50%)of the cc:ntrsct price as security for the
Payment of a l persons performing labor and furnishing materials in connection with said agreement, Sureties on each of said bonds shall be
satisfactory to the state.
9. vl I£7 , I If the Contractor at any time refuses or neglects,without fault of the Public.Agency or its.agent(s),W
supply sufficient materials ar workmen to complete this agreement and work as provided herein,fora period of l0 days or more after written
notice thereof by the Public Agency,the Public Agency may furnish same and deduct the reasonable expenses thereof ftom the contract
price.
(Page 2 of 7)
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l4. i,,&WS_APPLY. General. Both parties recognize the applicability of various federal,state and local laws and regulations,especially
Chapter 1 of Part 7 of the California Labor Code(beginning with Section 1720,and including Sections 4'135,1777.5,and 1777.6 forbidding
discrirfsirat ori) and intend that this agreenatnt complies therewith. The parties specifically stipulate that the relevant penalties and
forfeitures provided in the Labor Code,especially in Sections 1775 and IS 13,concerning prevailing wages and fours,shall apply to this
agreement as though fully stipulated herein.
11. Eiac4NMAMI—S, Contractor shall not subcontract any work without approval of the General Manager.
a ]MAts"E RATS (a) Pursuant to labor Code Section 1773,the Director ofthe Department of Industrial Relations has ascertained the
general prevasl;ng rates of wages per diens,and for holiday and overtime work,in the local ity in,which this work is to be perfbrmed,for each
craft,classification,or type of workman needed to execute this contract,and said rates are as specified in the call for bids for this work and
are on file with the Public Agency,and are hereby incorporated herein.
(b) This schedule of wages is based on a working day of 8 hours unless otherwise specified,and the daily rate is the hourly rate
multiplied by the number of hours constituting the working drip, When less than that number of hours are worked,the daily wage rate is
proportionately reduced,but the hourly rate remains as stated.
(c) The Contractor,and all his subcontractors,must pay at least these rates to alt persons of this work,including all travel,subsistence,
and fringe benefit payments provided for by applicable collective bargaining agreements. All skilled labor not listed above trust be paid at
least the wage seat',-established by collective bargaining agreement for such labor in the locality where such work is being performed. If it
becomes necessary for the Contractor or any subcontractor to employ any person.in a craft,classification or type ofwork(except executive,
supervisory,admin strative,clerical or other non-manual workers as steels)for which no rninunutr,wage rate is spactftod,the Contractor shall
immediately notify the Public Agency which shall apply from the time of the initial employment of the person affected and during the
continuance of such employment.
13. HCUABO,. Eight hours of labor in one calendar day constitutes a legal day's work,and no workman employed atahy time or
this wort(by the Contractor or by any subcontractor shall be required or permitted to work longer thereon except as provided in Labor Code
Sections 1510-1815.
l 4. N f-__TC E5. Properly indentured apprentices may be employed on this work In accordance with.Labor Cade Sections 1777.5 and
t 777,6,forbidding discrimination,
15. D_E51&E TO PROMf3jZ_E_QO'�OMY OF CC3lvTAAL_Q STA. ahe Public Agency desires to promote the industries and econorrny of
Contra Costa county,and the Contractor therefore is encouraged to use the products,workmen,laborers and mechanics of this County in
every case where the price,fitness and quality are equal,
16. ASSIGNMENT. f @se agreement binds the heirs,successors,assigns,and representatives of the Contractor,but he cannot assign it in
whole or in past,nor any rnonies due or to become due tinder a,without the prior written consent of the Public Alercy and the Contractor's
surety or sureties,unless they have waived:notice of assignment.
17. NP)MA'5/ BY PUSUC� E1 _'m lnspe€tion of the work and/or materials,or approval of work and/or materials inspected or
statement by any officer agent or employee of the Public Agency indicating the wont or any part thereof complies with the requirements of
payments therefor,or any cornbina,ion of these acts,shall not relieve the ConLractor of tris obligations to fulfill this contract as prescribed;
nor shall the public Agency be thereby estapped from bringing any lesion for damages or enforcement arising from the failure to comply
with any of the terms and conditions hereof,
18. i,QLD HARMLESS 21NPLML41 TY (a) Contractor promises to and shall hold harmless and inde,nnify from tete liabilities as
defined ire this section.
(b) The indemnitces benefited and protected by this promise are tate Public Agency,Richard D. Short,Kicignfelder,Inc. and their
elective and appointive boards,commissions,officers,agents and employees.
(e) The liabilities protected against are any liability or claim for damage of any kind allegedly su;`fered,incurred or threatened because
of actions defined below,including but not limited to personal injury,dead;;property darn,age.trespass,nuisance,inverse condemnation,
patent infringernent,or any combination of these,regardless of whether or not such liability,claire:or damage was unforeseeable at any
time before the Public Agency approved the-!mprovcm.en:'�lsrrs or accepted the improvements as completed,and including the defense of
any suit(s)or action(s)at law or equity concerning these.
(d) The actions causing liability are any actor omission(negligent or noes-noglige;it)in connection with the matters covered by this
contract and attributable to the contractor,subcon rtictor(s),or any officer(s),agent(s)or employee(s)of one or more of them.
(Pugs 3 of 7)
(e), Non-Conditioriv The promise and agreerraent in this section is not conditioned or deperidertt on whether or not any i demrns tee has
pr sarec#,supplied,or approved any glen(s),drawingks),slseciflel"On(s)or special provision.($)in connection wit this work,has insurance
or other:indemnification covering arsy ortbese matters,or that the allegeddamage resulted partly from any negligent or willful tnisoonduct
of any indemnitec
19,B CAYALt- Contractor shall comply with the provisions of Labor Code Section 6705, if applicable,by submitting to Pul�li.
Agency detailed plan showing the design of shoring, bracing;sloping,or other provisions to be made for worker protection frontthin
hazard of caving ground during trench excavation.
20. - CJRTQ TNTrt}N Except for records delivered to Public Agency,Contractor shall retain.,for a period ofat least five years after
Contractor's receipt of tite n nal payment under this contract,all records prepared in the performance of this cop>tract or otherwise pertaining
to he worts, including without limitation bidding,financial and payroll records. Upon request by Public Agency,Contractor shall mak
such records available to Public Agency,or to authorized representatives of the state and federal governments,at no additional chime and
without restrictions or limiuit on on their use.
21.'U��V Contractor shall not use private property for any purpose in connection wiTS the work absent a prior,
written agreement with the affected property owner(s).
c2, P Til A? `�YACr RA a i he statement of prevailing wages appearing in the Equipment Rental Rates and General
Prevailing gage Rates is hereby specifically referred to and by this reference is made a part of this contract:
23.C S. Resolutior,of corfgniction claims shall be handled as outlined in Article 20I04 of the Public Contract Code,attached to
this contract as Appcndix C.
U\Sluckhzwk 02.03 contrict
(Pne A of 7)
lackh wk Geologic Hazard Abatement District ( HAD)
Siteworks Construction, Inc
Maintenance Services Contract
Appendix "All Scope of Work
Up-der this contract, t s y"ir .1 , (CCT TRACTO ), agrees to provide
4' 1k S'h t.}. IT F" 'uf �' 7' hA... hF" b;AM ( •ii�k171f
pr xr ` � s d f e Czeaoi� ardr�� nrtistrit
(CHAD)on an "on call", this is a time and inaterials contract. Work shall be authorized by Task
Order and are approved and issued by the General Manager.
Under the direction of the General Manager or his designee, CONTRACTOR,agrees to perform the
following;
Provide the necessary workforce, material and equipment in accordance with the General Conditions
and at the agreed Labored operated hourly Equipment Rates in Appendix B of this Contract for the
following Response Levels.
The .esMonse Level will he established.by the General Manager or his Designee. Response levels
will be instituted progressively, Level 1, Level 2, then to Level 3,
Remo ase Level l -Mobilize within 24 hours
Respond to a Level 1 call within 4 tars. Prepare and mobilize to any District location within 24 hours.
Provide the necessary workforce, material and equipment.
Compensation is at the agreed Labor and operated hourly Equipment Rates in Appendix B.
lonse Level 2 a 1Vlobilize within 4 hours
Despond to a Level 2 callimmediately, Prepare and mobilize to any District location within 4 hours.
Provide the necessary workforce,material and equipment.
Compensation is at the agreed Labor and operated hourly Equipment Rates irk Appendix B,with a 4
hour minimum for labor.
response Level 3 - Mobilize onsite within 2 hrs
Workforce and equipment are or standby. Be prepared to mobilize to multiple District locations
wienin 2 hours. Provide the necessary work—force, material and equipment, and mountain a sufficient
workforce in the District until released by General Manager or lois Designee.
(Compensation is at the agreed Labor and operated hourly Equipment Dates in Appendix 13,with a 8
hoar nairrixnum for standby labor. Equipment will be compensated for standby and active time at the
agreed Rates in Appendix B.
(Par 5 of 7)
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.. .'., Geologic Hazard Abatement District (GHAD)
Sitewor•ks Construction, Inc.
Maintenance Services Contract
Appendix"B" Fee Schedule
Labor rates are in conformance with Labor Cade Sections 1773, tab e attached.'
Rates for Equipment,not listed in the attached Equipment Rental Rates. will be at the most current
published CA.LTRAINS Labor Surcharge&Equipment Rental.Rates bade..
(Page 6 of 7) /417
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GENEE AL PREVAILING WAG!:DETERMINATION MADE BY THE DIMC'i OR OP INDUSTRIAL i' LATdF?NS
PURSUANT'i0 CALIPORNIA LABOR-J;3P PAR7f 7,CHAPTER t,ARTICLE 2,SECTIONS 1770,1773 AND 1773.1
FOR"NDSCAPS CONSTRUCT 10N PROJECrS t a
CRAFT: #OPERA.TING ENGDMER �}, 3
Dr TEMINATION� NC-63-3-75-2002-1 I
ISSU .#3AT. i Augw,22,2 02
iy1£JIMMON DA'l°E€F DETERMINA`X'3ON- Jwtc 15,2003'*'rhe nm to Ise paid&,r work potImmed after IW6 darts has be a dctermincd. if evoA will
cxienal vast this dats<t1le,tea rats must se oaid and 0014d be inco:rpogated in coftaels ertcred Lino mow. Contact the Div'ssiuti of Labor Stntistim and i:esearcta
(Cs1'sptel'ic rn?us at j415)773.477+1.
LOCALITY; AU/oealities wiet;n.Alwwda,AtpLge,AmAdor,Butte,Calayszas,Coluta,Cortin Costo,Del Naas,E7 Dorado,Pressmo,Qicasrs, Hamsnbotd4 xlnpg
Lake,Lasseas,Madcra°Mvinm aMnripean,Madobitta.Mtsatad,Wodoc,Mont y,NApa,Nevada,p,ecer,Plaaacas:Sacraraacr"A'San bmilo,Saris Fraaausco,Sari
icmqubr,Sarin Motco,sitnm Ctaca,Santa Cruz,Shuts,Skm,Ssskiyctt,SOaz,o,Soioama,Swmislovs;Suites,Tehorna,Trinity.'I'�arc,suotumnc,5t01a,end Yuba
Counties.
g#9vsEarn sat� Sixaiz L1'ircis tYvr rtirne i3trit'mate
C1asa ftcsbti 1st
Basic Hm h Pension Javertion Training 3tlser Haws 7atal Owly Saradsy` Stinday and
I,k;tt ae)pz:lacmnt
Hourly and and Payntoilta I•taurly Holiday
£Lvat€ Welfare Holiday trate I1i2x 1 2X
Group,
Ata a 1t AaCR 21 Area I$ Area 2` Ansa is Asci V Circa 0 Afea 2' Area 1� Area?C
izvwl
F2"+.3i ?9,3i 3,45 3:RS 3,20 0.6..1 df1.40 R 41.02 43.02 54.673 57.675 54.€"sS 57.675 0.33 72.33
. 23,71 25.71 5.65 3.85 310 0.61 x0.40 8 37.62 39,42 49.775 52.275 49.273 52?75 61.1365.13l 19.10 21,10 5.55 3.95 3.20 0,61 °0.40 8 32.81 34.8.€ 42.35 45.36 42.36 45.36 St.91 55.99
C3rasup iV 17,72 19.72 5165 3.35 3.20 0,61 '13.40 8 31.43 33.43 40.29 43.29 4.0.29 43.29 49.15 53.15
k bidie tas an appreniircable c-aft l4tes far apprrmdecs avaitablc in the.Cicnrzal Prevailing Wage Appi caUc c Schedarlc.
For elacsit€cations within each,;ottp,seas WOW,
a AREA.€-As'ambda,Smtc,Contra Casira,Made,ta:esr;+d,Napa.Sammanw,-"'an 9cnite, San Fmciar:o,San 3oaquirn,Smit i,Utro,Santz Clans,Santa OW,
so?W,U,Scie islx>as,Suite+,Yale and.Yuba Courties:and poatiow of At**,Alwdor,Calaveras,Cuhmi,EI Domdo,Fresno Clem,Iii,arnbsldt,Kings; Lake,
Lattser., Mttdcm, Mpripussi, Mmtdottino, Mont=Y, N-lida, Placer, Pitarrtas, Shasta, Sierxx, Siskayou, Sonoma, Teham Tuiage, Cbcalumams atld [ti»ity
Coum.wl.
° 2- Dcl Naxste mad:Moduc;,road pwi:ans a Alpi m,Artmodcu,Calaveras, Cola:sa, fl 13 srada Emno,Gl inn,kiumbol4 Kints,We,L asm. ivl.adetz,
3~aFipm' enduc:inu,Monwcy,Nevada,Plocar,e)uttmas,3laasm,Sie.re,ShWyssct,Sonoma, aanA Trisziry Cxt mtias. IPoiiians of
cesyati:gs fiulssa�;its caa :3.333 detai#a:a1 c;n gnlic d().
hnrurty r':tmst Fa,xad,
c Svtxtrdtsys iz thr flame sv ak cvcck stray be warksd rt stmighi-tismc if 6 job is shutdown during the normo#work wasek due to incl:tact wcathcr,
t lncluda:s an amnu,it fbi Svpplcc ectal lace.
RECOGNIZED 1°It3LMAYS.Holidays spas which the gc=ral irrvailing houty wagc rats for Hulit.my waric shall bin quid, ghat#Cas all hatsdsys k&i s eattet zive haryruning
UVry scnc sppi rattEc t<t the pardeulur txa£t,alrrssl£ta;:stion'or typc or wurkrtr talpldycd®a cEte p^jt t,wtmsclt is sxa Vic with dic Wmc;Asr of Fsdt s?riaF Reis#ivus. £4r a prx rttiiirag xs>e
#s sox baxrrs off«aultcwWvuly r 4L-g.%bcd race.%8c bulfdays upon vAicls Ilse rcvaliing rssae 4kuA he pasd slsatl bcxs rrovic kd in Suction 67 1 aC slay Gevrrasmsnt Code You rtlny obuia
•>e°te "')U:y r4avisi6rui Cor Chc oatmml dsu=tsinatsnns on dw Bonet at hBiM:lfw.yat,Cy r,g„ �v I..` Holviay pmvirivas Car sasrrr,.at oz ruMsnded d%ftrr+arg6cn$may!c
obEsrned by wuaa.tutg floe Pt siiing Mp Uait xt(415)703-4774.
T RAV1EL AMWOP HUMSESTENCE S°Ai`{biENT:In st:essrdanec mv1Eh tstmor Cade Sections 1"73.1 and 17 3.9, otraoatars sleet#n oke amass!esdisz se3sis c s c pa}srcnts so each:
avorkcr to t`xnmt tl a ws,;.;t,Ytsu ta,,y ehimu;4 r brx*J Alwor sut"iNUmc s pxayssiass for ileo catrrart de zsmiCatiosu azt the laatea^eY a:r.m>t+uuuw+lsr -=rswJ,I tiff bStf3. g>cvel
any w celtsivnlctt m auipearmilu fur cu=at or superrsdcd dcLcros au aarus may tae ebtadatsd by umcdtting tilt:prcvt;Llp WaSc Unit ss(d 15)703-4774,
MOIL WC14cl•LAadsczpt Otsmrn Wg enciucears Equipmaeat
Hyd$il,rr3p,hit Sucdrr ti+lachinC
1 Ito at-
ItuEsbc Timd soil T.-ack Esrtlrooviny!zp1powtt
Lardaaalse Fsamislt Grade OPc.raof. Aji t&aafs#s endA work regar+deas of the eyuipmeua owd, &1k ploader
nud&I:equleaaseum wick o hcrmpawa retia;ol'xrmou gingn 65. $raa l3iewers
E u+ j `feenefaer-:a r E3oeaepaava uy mu GS Horsepower
Lnn:is. j1'r Opoxa>at tilt an 65 112, All epipram with a r=vdoohiurs horsapowt-%utxag
03 63 w less Hca:}i czutpnmasas cmcecd by runup I or Croup W. Thx twltom:ug Lmd$"pts Utility 0, rawC
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MVERAL,rPREVAMING WALE I;E"1`E2tM NATION I ADP BY T�M DMICTOR O3'INDUSTIUAL RBLATIONS
PCIRbSLAN i"TC3 CAI<1T'43€1, A LABOR COG s AAT 7.C°I APTER 1,ARY ICL2 2,SECP£ONS Mi:I,1773 AND 1773,1
FOR:,t3KMERCIAL BUILM04G,MCIMAY,MA Y CONSTkg7CT 014 AND 33MOV0 MITICTS
3
CRAFT: W C1.PERATtNO ENGMtV R(M:.t?PT'G CONS'3IXUCTION) �' ¢
JETERMI'iEA"3'EON. NC.23-63-1-200-1A
ISSUDATE: Auguss22,2002
I9YATIf3N 9ATtw OP$TS a I1ib1IPoATt43tVt:3une i5,NO$"Theme to be paid for waek porfornmd a'+tar tbi3 date leas ucoa dettmiatosl lf4rork wi0 extend past 11147
class,tho zew rm must be gaid tmd ihoold b:s mtorpamtod in zilatmcts ra'ttased into now. Cunuct rke Division of Labor Stalwucs tad kzscmmvt Eio•spxztirc 14144 ai{4 15)703.
47,14.
LOCALITY: witlsia Atp4ttw Aituulssr.9'1111 CsEn4'caos,Ca lett.Dx#ldorte�1 act sdo,Frosnc.Gtr seat I�urta0u dt ��x.Lalc4, asxsozs,k(sssiCrt.9 6atipvS0.
l o rtazixter.?�ttud ?r+s E c,Monterey.Ntlm Nevada,Plass.Plutons.Sacrm=lo,SU 8anito,Sat Jat4ula,Sams Cmt.Sb4s(4,Sierra.$E3ieay=,S*ro=,Sib kk S.Sus^».
`1'elta;xa,`ftvraity,Tnaa�,Ttss itrtrste,Yaks. Yuha ctaeatatiea.
tay��yrrr_nia :tprsa'ht-i?°ne Prverti«ee ltntarty Rasa
Clsssi iuzdon Posit: Beal, t'cosioa Vttuatioc Tithirg Odvzr &Tonne Tow Baily sxtw&y° Saodq nrad
(Jatsss0>Tza•xnul Hourly Paan =6 payments Howly Holiday
!ruse W8fam aolidayr Poco 11/2X 11/210 2X
Clex%!5'za idnGroup'
Aral`Arsa2' Area t i Atna 2s tact 1' Acca 2° ✓*Vu 9° Acca 2` Arca 1" Arca 2'
Grad! 32.54 34.54 5,74 4,00 ;6,25 0.62 `GAO 8 46.56 40.56 6181 55.81 62.91. 65.51 '79,06 81.06
Crew,1 31.05 33.115 5.79 A 0 0 3,25 0.62 10.40 8 45.11 47.11 60.535 64.635 64,635 63.635 7.4.16 90.16
Group 3 29.43 31,65 519 6.50 3.23 31.62 °4.40 8 43.76 AS,% WS35 615.335 59.535 61.535 73.3tt 77.36
Croup d 28132 30,32 5.79 4:00 3125 5.62 "°5.40 It 12.33 44.36 56.54 59.54 56.54 57.54 70.70 74.10
Gr9 3 27.11 29.11 5.79 4.00 3.25 0.62 10.40 6 41.17 4.3.17 $4.72$ 57.725 61.725 57.725 69.29 72.28
sotp6 25,94 27.84 3.74 4.05 ).2.5 0.62 10640 z 34.90 41.9) 52.93 $5.92 52.82 55.82 65.0 64.14
Frssg7 26,73 2'1.74 4.79 4.05 3.25 0,62 ''0,40 9 38.81 40.8#. 51.195 54.99{ 5:.185 54.1ic5 Q-% 67.$6
s 13.67 25.67 5,79 4,00 2.25 0.62 °0.10 S 37.73 39.9; 49.5'55 52563 0.565 52.50 61.40 0AU
Crcvp st.A 11:53 23.55 .5.79 4.00 3.21 0.62 1d.4C a 35,61 37:43 46.U 41ons 4x.3315 411,3135 57,16 fit 14
Gioup I•A 33.33 15.33 5.79 4150 3.15 0.62 "0.40 8 47.41 49.41 14.043 67.085 IrAM5 67:085 90.71 8.1.'6
:mcl.s asnaG11'. 26.60 28.64 5.19 4.50 3.25 0.62 "4.50 8 H0.75 42.75 54.095 57.095 X095 57.095 67,44 71.44
Oiler 24,52 M52 51" 4.00 3.25 0.62 10.40 8 31'SS 40,58 50AA 5.1.1t4 50;84 5.3.8.4 61.10 67,10
Group 2-A 31.66 33.64 5.79 4.00 3,25 11.52 15.40 b 45,72 47,72 61,55 64,55 61.55 54.55 77.38 81.38
Tm%,.b C'r'eate Ciier 26.45 2sA5 5.79 4.00 3.15 O.fs2 10.453 S 44,51 42,5! 53.;35 51:.735 $3.735 56.735 66,96 713,96
Giles 24.40 26.35 5.79 4,00 3.25 0,62 '10,44 8 AM 46.36 50,41 53,51 Sa.57 53.51 62.66 66,66
Gmup'3-A 34,02 32.02 5.79 4.00 3.25 0.62 °0.40 8 4x.09 46.08 59.09 62.69 $909 62,09 74.19 %.10
T'rucltC7x-a.0tler 26.21 29.21 3,79 4.0,11 1.25 C.62 40.44 8 40,27 42.27 53.373 15.375 53175 55:375 66AS 7U,4S
i yGsttulic 15484 27A4 5.74 4.04 3.23 4.42 10.46 8 39.90 41.90 52.82 55.82 $2,n 55;82 65.74 69.74
00cr 24.05 26.05 5,79 4.00 3,25 6.52 eOAO 8 38.11 40.11 50.135 5105 SUM 53.135 62.16 6616
e Is 6xisaax xt aP;ucetsuzer:i;z zi ffl. [Cates fur app;erltisas ore awsilaWc is uo Cencrul prevAiliag WW Apgtauidv S%:hodulc.
'Fe,cLmifia.itlmi witttm attar Voup.sea pages.398 and 40.
a Alt' A 1-SuitsSa,sMmawo,,Sara 8aaiso,Scat isugo-In.Sriata Cruz.smwsiaus,SWcr.Yole a"Yutas+wucties;and portions of Atyin.A maJor.COW-term,
coiun3 El Domdt' }•ncsw,CScara.tdur4gIdt.lziags,Lake,Wm,madal•4.mwipuss,Mmdnoiuo,Momemj,,'iavads.Placer,dumas,Skol,ta,Skrm,Siisktyt:s.S9aomu.
Tom=-, Telve,b imirtm to ud Triaiiy i:tuities.
Aft$%2-no,`Tut*asxd M--dO,:,14d pori b$$O(Alpise,Awarder,Cu14v,4as,C'aittsu.&L3=do.T",o,Glenn,Humboldt,Kings.Lzim,Lmc%cb Aden, Mas lipuw6
Mcodoeirto,Mosemmy,Vevada,4"Nuer,Plumas.Stttsvt.S(tr.'a,Siokiybo.SanomA.T'r4mra,7ularc.Tuofatmze and Trioity cosy iii ;' o uo ls,ofoour leg znitg is Trach z mc.
dowtod on page s IL
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kac'ledts au at<1loWat forsupp4ttar=Tal detas.
NOTE;Par Sy"iAJ Single vltd See.and Shift,woes;plow see gage 40C,
3CECOV-Ns1ZRYs 1101-MAYS,flulWAYS upas0 wvh'eslt tho getaesal prevailing hourlyw&gv rate for Holiday work.W be lapid.shalt be reit holEeayz is the vstleolive bra 0ping
ttg;aetmmt,t pyli✓sisic td 9;e pr..rticulat 11411,classill atiost.or type cf orker cmiltuyed cxz ilte ptoz j i,w12iuh is oss file with the Director of kidustrlalfLeladtav, if the pma Ailiaalr
rate k tris huszd Oki s volleWivety burguisttd rate,the F,atidrys up"Whid)tilt Peovailirb mte t1toll be paid shall be as prvvidcs9 in soc-d it 6100 diths Ciovemt!'+rrtt Coir. `s°tw
trayobtainehtlwli43yprovitiorsfor thtcurrentdete. atioasso0tha1rt,etnmtxs�{kr;(/ flssLs#uyp7svisiansfesaila�tttofsu3sxrszded
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each v vr5t so exeeitit tht worL You til ly chmin',he tt W atsd,or sllbsistemx$aYs Woxu for ncc rurteot dmterntivatisme on Use irtamet at fittn•LeWvut7 d,r Hf,vlF CFWD.
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INC.SITEWORKS CONSTRUCTION,
GENERAL ENGINEERING CCN"RACTOR FSC Box 1324 Lafayette, CA 94549
;JCEN5B#610597 aAX(925)256-83-57 Phone(925)2849437
EQUIPMENT RENTAL RATES
January 1, 2003
LOADERS Banc
'Ces:relsttor Da geek Month
SCAT 966=D Loader 587,50 2,350.00 7,000.00 935.00
}5 yd Bkt,235 hp
45,000 tb.class
Pard 545 Loader 225,00 1 650.00 2,500.00 65.00 ;
Gammon Box,7/8 d:bkt
Cat 226 Skidsteer Loader 195.00 ! 70.00 810.00
5.60011b,Cass,54 tip
DOZERS/CO PAC i OPS Bare
�escri tier
Day Week 1 Month:]® jratgd
'CAT D8-K Dozer/Ripper 975.00 3,500.00 1 10,500.0'3 155.00
80,000 lb.Class
#CAT D6XL-R. Dozer/Ripper 1300.00 3,200.00 9,600= 1 140.00
4S,000 lb:Cass 6 wA ;PAT Power/dors IeJNE Blade !
Dresser TD-7E Dozer/Ripper j 300.00 900.00 2,600.00 ! 95.00
114,0001b 'VaSs 6 wa4:PAT�PcwerfArtcle/T!E Blade E
ICAT CP-4330 Pad Compactor 365.001 1.450,00 4,300.00 110.00
$5 fi�tl�lb.Cly&S, 1 it3 htp.,66" Orurn
EXCAVATORS ,dare
JescrsptEa l3a 51`sleek r Month Operated
Hitachi EX4'6OLC-5 Excavator 985,00 ; 3,700.00 � 11,100.0€1 195.00
101,000 ib :;ass 301 he,66114 e, Buvket f
Hitachi EX33OLC Exc. w/thumb 775,00 3,000.00 6,900.00 170.00
72,0001b.Class.240 hp,38"ar:d 54"Buckets
Cat 315L Excavator wlthumb ; 525.00 2,900.00 ' 6,200.00130.00
36,000 tb.Class, 105 hp.24"&36"and 48"Buckets i E
rGat 4160 4WD Backhoe/Loader 250.00 90€3,00 2,700.00 # 100.00
17 000 ids:Class,30 hp, S2',24°',&36"Buckets I
Bobcat 331 Excavator 225.00 1 654,00 2,500.00 85.00
7,126 lb,Gass 40 hp,12" 16",25"Suckets
ON!Auger Attachment w112" ,8"briiis&Exte,aslcrs 80.00 320.00 960.00 105.00
Breaker s,111# Attac?anent 225.00 900.010 2,700.00 120.00
TRICKS Bare
IDescription Day Week ' Month 12 +er ect
!International Water Truck 300.00 1,'100.00 3,300.00 70.00
2000 Gal. Ca
• All rates based on 40 hrs. per week& 168 hrs, per month.
• Operated rentals are based on prevailing wage rates.
Certificates of insurance are required on all bare rentals.
All rates are based on normal working conditions. Highly abrasive
or hard rock conditions will be billed at a premium.
For bare rentals, renter is responsible for fuel, oil &minor maintenance.
® All transportation and taxes will be paid to and from job site by Renter.
Renter is responsible for Lire damage and repair costs,
...................................................................................
14 6l Geologic Hazard Abatement District
S tewor s Construction, Ince
Maintenance Services Contract
Appendix "C" Resolution of Construction Claims
See attached the Public Contract Code, article 20104
(£',gs 7 of 7)
CA Code eca20104e20104.6)
PLTLICC04NTRACT CODE
SECTION 20104-20104.6
2*104. (a) (1) This article applies to all public works claims of
three hundred seventy-five thousand dollars (075,oao) or lase which
arise between a contractor and a local agency,
(2) This article shall not apply to any claims resulting from as
contract between a contractor and a public agency when the public
agency has, elected: to resolve any disputes pursuant to Article 7.1
(commencing with Section 10240) of Charter Z of Part 2.
(b) (3) "Public work" has the same meaning as in Sections 3100 and
3106 of the Civil :wale, except that Op€;blic work" does not include
any work or improvement contracted for by the stats or the Regents of
the University of California.
(2) "ClaimO meant a separate demand by the contractor for (A) a
time extension, (p) payment of moneys or damages &rising from work
done by, or on behalf of, the contractor pursuant to the contract for
a public work armed payment of which is not otherwise expzessly
provided for or the claimant Is not otherwise entitled to, or (C) an
amount the payment, of which is disputed by the local agency.
{d) The pro-Isions of this article or a summary thereof shall be
set €ort: in them plans or specifications for any work whicb may give
rice to a chaise :ander this article.
(d) This article applies only to contracts entered into on or
after January 1, 1991.
201x:4.2. for any claim subject to this article, the following
requirements apply.-
(a)
pply.(a) The clams shall be in writing and include the documents
necessary to substantiate the claim. claims must be filed on or
before the date of final payment. Nothing in thin subdivision is
intondtd to extend the time limit or supersede notice requirements
otherwise provided by contract for the filiag of claims,
(b) f1P For claims of le-sa thasn fifty thousand dollars t55o,€oo)
the ,local agency shall respond in writing to any written claim within
45 days of receipt of the claim, or may request, in writing, within
30 slays of receipt of the claim, any additional documentation
supporting the claim or relating to defenses to the claim the local
agency may have against the claimant..
(2) Xf additional information is thereafter required, it shrill be
requested and provided pursuant to this subdivision, upon ?trs..sttuasl
agreement of the local agency and than claimant.
(3) The local agency's written response to the claim, as further
documented, shall be submitted to the claimant within 15 days after
receipt of the further docu nta:tson or within a par° od of time no
greater than that taken by the claimant in producing the additional
informAtion, whichever in greater.
(c) (1) for clauses of over fifty thousand dollars (tSO,3sv) and
less than or Equal to three hundred seventy-five thousand dollars
M75,000), the local agency shall respond in writing to all written
claims within 60 days of receipt of the claim, or maty recr4est, in
writing, within 30 days of receipt of the claim, any additional
documentation supporting the claim or relating to direhnes to than
claim the local agency maty have 49aizaaat the claimant.
(2) If additional information is thereafter required, it shall be
requested and provided pursuant to this subdivision, upon mutual
agreement of the local agency and the claimant.
(l) The l0c9l ax9tney4s written response to the claire, as further
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CA Codes(pec-20104-20144 6)
documented, shall be submitted to the claimant within 30 days after
receipt of the further documentation, or within a period of time no
greater than that; ta%en by the claimant in producing the additional
information or requested documentation, whichever is greater.
(d) if the claimant disputes the local agency's Written- rosponse,
or the local agency fails to respond within the time prescribed, the
clairmut may so notify the local agency, arra writing, either within 15
days of receipt of the local a tncy,a response or within 1.5 days of
the Local agency's failure to respond within he time prescribed.,
respectively, and demand an informal conference to meet and confer
for settl nt of the issues in dispute, VPOA a demand, the local
agent shall schedule as meet and confer conference within 30 days for
settlement of the dispute.
(a) Following the most and confer conference, it the claim or any
portlon remains in dispute, the claimant may file a claim ss provided
in Chapter i (comencing with Section 9001 and Chapter 2 (commencing
with Section 910) of mart 3 of Division 3.6 of Title 1 of the
Government Codes For purposes of those provisions, the running of
the period of time within which a claim must be filed shall be tolled
from the time the claimant submits his or her written claim pursuant
to subdivision (a) until the time that claim is denied as a result
of the meet and confer process, including any period of time utilized
by the meet and confer process.
(f) This article aces not apply to tort claims and nothing in this
article ,is intended nor shall be construed to chaat e ,the time
periods for filing text claims or actions specified by Chapter i
(commencing with Section 900) and Chapter 2 (commencing with 9action
910) of Part 3 of Division 3.6 of Title 1 of the Government Code.
20104.4. The following procedures are established for all civil
actions filed to resolve claims sub4ect to this aarticl.e z
(a) within 60 days, but no earlier than 30 days, following the
filing or responsive pleadings, the court shall submit the matter to
nonbindibg mediation unless waived by mutual stipulation of both
parties. The mediation process shall provide for the selection
within 15 days by .both partiea of as disinterested: third person as
madiator, shall be commenced within 30 days of the submittal., and
shall ,bt concluded within is days from the connencement, of the
mediation unless a time requirement is extended upon a good cause
showing to the court or by stipulation of bogs parties. if the
partiva fail to Select a Mediator within the IS-day period, any partly
may petition the court to appoint the mediator.
(b) (1) if the matter remain# in dispute, the cave shall be
submitted to judicial a xbi.trat.ion pursuant to Chapter 2.5 (commencing
with Section 1141.10) of Title 3 of part 3 of the Coda of Civil
Procedure, a aatvithatanding section 5141,21 of that code, The Civil
Discovery hot of 1086 (article 3 (commencing with Section 2016) of
Chapter 3 of Title 3 of part 4 of the Code of Civil Procedure) shall
apply to any proceeding brought under this subdivision consistent
with the rules pertaining to judicial arbitration.
( ) Notwithstanding any other provision of law, upon stipulation
of the parties, arbitrators appointed for purposes of this article
shall be experienced in' construction law,.and, upon Stipulation of
the. parties, mediat °e and arbitrators shall be paid necessary and
reasonable hourly rates of pay not to exceed their customary rate,
and such fees and estpences Shall be paid equally by the parties,
except in the VAR* of Arbitration where the arbitrator, for good
cause, determines a different division. In no event aalaaall these fuss
or expenses be paid by state or county funds.
(3) Sit addition to Chapter 2.5 (commencing with section 1141.1e)
of Title 3 of part 3 of the wade of Civil Procedure, any party who
after receiving an arbitration award requests a trial day novo but
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.1.111._. ......... ......... .......111.1. 11.11
...... ........ ............... ...._...._. ......... ... ..... ... ......... .............1111
......... ......... ......... ......... ...................
......................................
CA Codes co:20104-20104.61
does not obtain a more favorable judgement shall, in addition to
payment of costs and fees under that chapter, pay the attorney's fees
of the other party arising out of the trial de novo.
(c) The court may, upon request by any party,. order &ny witnesses
to participate in the madiation or arbitration process.
20104.6. (a) Rd local agency shall fail to pay money as to any
portion of a claim which is undisputed except as otherwise provided
in tke oontr'act.
(b) in amy suit filed under Section 20104.4, the local agency
shall pay interest at the legal rata on any arbitration award or
judgment. The interest shall begin to accrue on the date the suit is
filed in a court of law.
hftp:I/www.Iegjnf*.ca...idpl:yeode?s tions gyoup-2 1-2I00fl& & 20104-20104. 12126100
Form W-9 Request for `taxpayer Give form to the
(Rev.January 2002) requester. Do not
Identification Number and Certification
00annunt of the Tress:ny send to the IRS,
3ntemat Revems Service
Name
cL Business name,If different from above
C
a
M ladividuall t �i Exempt from backup
C#seck at propriate box: LJ So?e<Pro pdeter Corporation Partnership Other �* w;ftliYoiden
a
Ad&eSSJnumber,strew' and apt.or suite no. Requester`s name and address(optional)
ate•
City,state,apd ZIP code
yList account num. bars)here(Optional)
t3T
LfS
Tei a er Identifica t Numb (TIN)
Enter your T#iV In the appropriate box..Forindividuals:this is your social security number(SSN). Social.security number
pp
However,for a resident alien;sole propriator,or disregarded entity,see the Part#ins6ructions on
page 2.For other antides it is your employer Identification number(E#N).If you do not have a number,
spa Flow to get a TIN on pace 2. or - -
Note. if tie account is in more than one name, see the chart or,page 2 for guidelines on whose number entif}cadon number
to eater.
Certification
Under penalties of perjury, #certify that:
Ia The nurmber shown ars this form is my correct taxpayer identification number(or#ars waiting for a number to be issued to tree),and
2. #acrd not subject to backup withholding because:(a)#ars exempt from backup with olding,'or(b)l have not beer,notif*d by the Internal
Revenue Service(IRS)that#am subject to backup withholding as a result of.a failure to report all interest or dividends,or(c)the IRS has
notified true that i am no longer subject to backup withholding,and
3. #am a U.S.person(Including a U.S.resident alters).
Certification instnsctiorfso You must Cross out item 2,above if you have been notified by the IRS that you are curreritly subject to backup
withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions,item 2 does not apply.
For mortgage interest' said,acquisition or abandonment of seed property, cancellation of debt,contributions to an individual retirement
arrangement(IRA), and get Fera0y, payments tether than nterest and dividends,you are not required to sign the Certificatilon, but you must
provide your correct TIM (See # tions on page 2;)
Signature of
Mere U.S, rson Date
Purpose of dorm What is backup withholding?Persons making 5.You do not certify to the requester that you
certain Payments to you must under certain, are not subject to backup withholding under 4
A person wt,o is required to file an information conditions idtio#d and pay to tifa IRS 30%of above qor reportable Interest and dividend
return relit,the IRS must get Your correct such payments after December 31,2CO1 (29 accounts opened`after 1883 only).
taxpayer ideritillcation number(TIN)to report,for after December 31,2003).This is caged'backup Cf train payees and payments are exempt
transactions,
In Mo paid LI yin,raa#, statepaid, w€thholding.'Payments that maybe sutject to trot t backu Wi t€fd#n See the#.^wtr actions ort
acqab,gage fnteresc you e d. backup withholding Include interest,dividends, page 2 andtheseparate Instr tfo for the
acquisition on staat�xfos tent a secured property, broker and barter exchange transactions,refits,
Requester of Farrk-9.
oafroyalties,rorerp#oyer pad;and certain
€ tt €
to an IRA. payments from ksNng Heat operators. Real Penalties ;
Use Farrar W-9 only if you are a U.S.person estate trarfsactlons are not sutlect to backup
(including a resident alien),to give your correct withholding. Failure to furnish TIM if you fail to fumish your.
€#N to tate person,requesting#t(the requester) You will not be subject to backup withholding Correct TIN to a requester,you are subject to a
and,when applicable,to, on paysrasnLs you receive#€ytstr eve the penalty Of$50 for each suet Whim e unless your
1..Certify the TIN you are #vIr is correct(or requester your correct TIN,make the proper failure#s dere Les reasonable cause and not to
� y g '9 ry##fu#neglect.
you are waiting for a ru tuber to be issued), certifications,and report at your taxable interest
and dividends on your tax return. Civil penalty for,false Information with respect ,
2>Cenify.you are not subject to backup to withholding.If you make a false statement
withholding,or Payments you receive wit be subject to with no reasonable basis.hat results i1 no
3.Claim exemption from backup withholding if backup withholding if: backup withholding,you are subject to a$505
you ata a U.S.exempt payee. 1,You do not fu;nish your TIN to tie penalty,
If you are a;foreign person,use the requester,or Criminal penalty for falsifying information,
appropriate Form ilrt-3.See Pub.515, 2.You do not certify your TIN wirer;required viii#lfully falslfying osryifications or affix satlons
Withholding of Tax on Nonresident Aliens and (see the Part ti Instuniction,s or,page 2 for may subject you to criminal penalties including
Foreign Entities_, details),or lines and/or Imprisonment,
Note:if a requester gives you a torn other than 3.The IRS tei€s the requester that you Misuse of?'ibis.If the requester discloses or
Form'�1 g 20 hast your 3114,you must use the furdshed an Irscaa of Federal law,the
rect TIN,or uses TWs In violation.
fe[ LE5Ler may be subject to Cit##and criminal
requester's ibrm if it is substanda;AysimPar to this �e The IRS Les you that you are subject to
penalties.
Form#Rt-9. backup withholding because you did not report
all your interest and dividends on your tax return
(for reportab;e interest and dividends only),or
Cat.No.10231X Form Vit"-$ (Rev. 1-2002)