Common use of CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION Clause in Contracts

CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract") with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Contractor. Contractor has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract (check all that apply): The Contractor has complied with the fingerprinting requirements of Education Code section 45125.1 with respect to all Contractor's employees and all of its subcontractors’ employees who may have contact with District pupils in the course of providing services pursuant to the Contract, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of Contractor's employees and of all of its subcontractors' employees who may come in contact with District pupils during the course and scope of the Contract is attached hereto; and/or Pursuant to Education Code section 45125.2, Contractor has installed or will install, prior to commencement of Work, a physical barrier at the Work Site, that will limit contact between Contractor's employees and District pupils at all times; and/or Pursuant to Education Code section 45125.2, Contractor certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising Contractor's employees and its subcontractors' employees is Name: Title: The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. Contractor’s responsibility for background clearance extends to all of its employees, Subcontractors, and employees of Subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the Contractor. Date: Proper Name of Bidder/Contractor: Signature: Print Name: Title:

Appears in 2 contracts

Samples: cdn.cocodoc.com, www.gusd.net

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CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract") with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Contractor. Contractor has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract (check all that apply): The Contractor has complied with the fingerprinting requirements of Education Code section 45125.1 with respect to all Contractor's employees and all of its subcontractors’ employees who may have contact with District pupils in the course of providing services pursuant to the Contract, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of Contractor's employees and of all of its subcontractors' employees who may come in contact with District pupils during the course and scope of the Contract is attached hereto; and/or Pursuant to Education Code section 45125.2, Contractor has installed or will install, prior to commencement of Work, a physical barrier at the Work Site, that will limit contact between Contractor's employees and District pupils at all times; and/or Pursuant to Education Code section 45125.2, Contractor certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising Contractor's employees and its subcontractors' employees is Name: Title: The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. Contractor’s responsibility for background clearance extends to all of its employees, Subcontractors, and employees of Subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the Contractor. Date: Proper Name of Bidder/Contractor: Signature: Print Name: Title:: ASBESTOS & OTHER HAZARDOUS MATERIALS CERTIFICATION Contractor hereby certifies that no Asbestos, or Asbestos-Containing Materials, polychlorinated biphenyl (PCB), or any material listed by the federal or state Environmental Protection Agency or federal or state health agencies as a hazardous material, or any other material defined as being hazardous under federal or state laws, rules, or regulations “New Material Hazardous”, shall be furnished, installed, or incorporated in any way into the Project or in any tools, devices, clothing, or equipment used to affect any portion of Contractor's work on the Project for District. Contractor further certifies that it has instructed its employees with respect to the above-mentioned standards, hazards, risks, and liabilities. Asbestos and/or asbestos-containing material shall be defined as all items containing but not limited to chrysotile, crocidolite, amosite, anthophyllite, tremolite, and actinolite. Any or all material containing greater than one-tenth of one percent (.1%) asbestos shall be defined as asbestos-containing material. Any disputes involving the question of whether or not material is New Hazardous Material shall be settled by electron microscopy or other appropriate and recognized testing procedure, at the District’s determination. The costs of any such tests shall be paid by Contractor if the material is found to be New Hazardous Material. All Work or materials found to be New Hazardous Material or Work or material installed with “New Hazardous Material” containing equipment will be immediately rejected and this Work will be removed at Contractor's expense at no additional cost to the District. Contractor has read and understood the document Hazardous Materials Procedures & Requirements, and shall comply with all the provisions outlined therein. Date: Proper Name of Bidder: Signature: Print Name: Title: LEAD-PRODUCT(S) CERTIFICATION California Occupational Safety and Health Administration (CalOSHA), Environmental Protection Agency (EPA), California Department of Health Services (DHS), California Department of Education (CDE), and the Consumer Product Safety Commission (CPSC) regulate lead-containing paint and lead products. Because the Contractor and its employees will be providing services for the District, and because the Contractor’s work may disturb lead-containing building materials, CONTRACTOR IS HEREBY NOTIFIED of the potential presence of lead-containing materials located within certain buildings utilized by the District. All school buildings built prior to 1993 are presumed to contain some lead-based paint until sampling proves otherwise. The CDE mandates that school districts utilize DHS lead-certified personnel when a lead-based hazard is identified. Examples of lead-certified personnel include: project designers, inspectors, and abatement workers. Furthermore, since it is assumed by the district that all painted surfaces (interior as well as exterior) within the District contain some level of lead, it is imperative that the Contractor, its workers and subcontractors fully and adequately comply with all applicable laws, rules and regulations governing lead-based materials (Including Title 8, California Code of Regulations, Section 1532.1). Any and all Work which may result in the disturbance of lead-containing building materials must be coordinated through the District. The California Education Code also prohibits the use or import of lead-containing paint, lead plumbing and solders, or other potential sources of lead contamination in the construction of any new school facility or in the modernization or renovation of any existing school facility. The Contractor shall provide the District with any sample results prior to beginning Work, during the Work, and after the completion of the Work. The District may request to examine, prior to the commencement of the Work, the lead training records of each employee of the Contractor. If failure to comply with these laws, rules, and regulations results in a site or worker contamination, the Contractor will be held solely responsible for all costs involved in any required corrective actions, and shall defend, indemnify and hold harmless the District, pursuant to the indemnification provisions of the Contract, for all damages and other claims arising therefrom. If lead disturbance is anticipated in the Work, only persons with appropriate accreditation, registrations, licenses and training shall conduct this Work. It shall be the responsibility of the Contractor to properly dispose of any and all waste products, including but not limited to, paint chips, any collected residue, or any other visual material that may occur from the prepping of any painted surface. It will be the responsibility of the Contractor to provide the proper disposal of any hazardous waste by a certified hazardous waste hauler. This company shall be registered with the Department of Transportation (DOT) and shall be able to issue a current manifest number upon transporting any hazardous material from any school site within the District. THE UNDERSIGNED HEREBY ACKNOWLEDGES, UNDER PENALTY OF PERJURY, THAT HE OR SHE HAS RECEIVED NOTIFICATION OF POTENTIAL LEAD-BASED MATERIALS ON THE OWNER’S PROPERTY, AS WELL AS THE EXISTENCE OF APPLICABLE LAWS, RULES AND REGULATIONS GOVERNING WORK WITH, AND DISPOSAL OF, SUCH MATERIALS WITH WHICH IT MUST COMPLY. THE UNDERSIGNED ALSO WARRANTS THAT HE OR SHE HAS THE AUTHORITY TO SIGN ON BEHALF OF AND BIND THE CONTRACTOR. Date: Proper Name of Bidder: Signature: Print Name: Title: EXHIBIT “A” (“SCOPE OF WORK”) PLANS [ATTACH ALL PLANS DISTRICT POSSESSES THAT CONTRACTOR CAN USE TO PERFORM ITS WORK.] WORK SPECIFICATIONS

Appears in 2 contracts

Samples: cdn.cocodoc.com, www.gusd.net

CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract"“Agreement”) with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Contractor. Contractor certifies that it has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract Agreement (check all that apply): The Contractor has complied with the fingerprinting requirements of Education Code section 45125.1 with respect to all Contractor's ’s employees and all of its subcontractors’ employees who may have contact with District pupils in the course of providing services pursuant to the ContractAgreement, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in Education Code section 45122.145122. 1. A complete and accurate list of Contractor's ’s employees and of all of its subcontractors' employees who may come in contact with District pupils during the course and scope of the Contract Agreement is attached hereto; and/or Pursuant to Education Code section 45125.2, Contractor has installed or will install, prior to commencement of Workbeginning to provide Services, a physical barrier at the Work Sitework site, that will limit contact between Contractor's ’s employees and District pupils at all times; and/or Pursuant to Education Code section 45125.2, Contractor certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising Contractor's ’s employees and its subcontractors' employees is Name: Title: The Work on Services to be provided under the Contract is Agreement will be at an unoccupied school site and/or will not be done on any District property and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. Contractor’s responsibility for background clearance extends to all of its employees, Subcontractorssubcontractors, and employees of Subcontractors subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the Contractor. Date: Proper Name of Bidder/Contractor: Signature: Print Name: Title:

Appears in 1 contract

Samples: District Independent Contractor Agreement for Special Services

CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract") with the District; Consultant certifies that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Contractor. Contractor it has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract Agreement (check all that apply): 🞎 The Contractor fingerprinting and criminal background investigation requirements of Education Code section 45125.1 apply to Consultant’s Services under this Agreement and Consultant certifies its compliance with these provisions as follows: Consultant certifies that the Consultant has complied with the fingerprinting and criminal background investigation requirements of Education Code section 45125.1 with respect to all Contractor's employees Consultant’s employees, subcontractors, agents, and all of its subcontractors’ employees or agents (“Employees”) regardless of whether those Employees are paid or unpaid, concurrently employed by the District, or acting as independent contractors of the Consultant, who may have contact with District pupils in the course of providing services Services pursuant to the ContractAgreement, and the California Department of Justice has determined that none of those employees Employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of Contractor's employees and of all of its subcontractors' employees Employees who may come in contact with District pupils during the course and scope of the Contract Agreement is attached hereto; and/or . 🞎 Pursuant to Education Code section 45125.2, Contractor Consultant has installed or will install, prior to commencement of WorkServices, a physical barrier at the Work Sitework site, that will limit contact between ContractorConsultant's employees and District pupils at all times; and/or 🞎 Pursuant to Education Code section 45125.2, Contractor Consultant certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor Consultant who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising ContractorConsultant's employees and its subcontractors' employees is Name: The Center for Leadership, Equity, and Research (CLEAR) Title: The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. ContractorConsultant’s responsibility for background clearance extends to all of its employees, Subcontractorssubcontractors, and employees of Subcontractors subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the ContractorConsultant. The undersigned does hereby certify that I am a representative of the Consultant currently under contract with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this Certificate on behalf of Consultant. Date: Proper January 25, 2021 Name of BidderConsultant or Company: The Center for Leadership, Equity, and Research (CLEAR) Representative’s Name and Title: Xxxxxxx Xxxxxxxxx, Ed.D., Founder/Contractor: CEO Signature: Print Name: Title:Services cannot be rendered until all documentation is submitted and final approval is received.

Appears in 1 contract

Samples: District Independent Contractor Agreement for Special Services

CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract") with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Contractor. Contractor has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract (check all that applyapplies): The Contractor has complied with the fingerprinting requirements of Education Code section 45125.1 with respect to all Contractor's employees and all of its subcontractors’ employees who may have contact with District pupils in the course of providing services pursuant to the Contract, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of Contractor's employees and of all of its subcontractors' employees who may come in contact with District pupils during the course and scope of the Contract is attached hereto; and/or Pursuant to Education Code section 45125.2, Contractor has installed or will install, prior to commencement of Work, a physical barrier at the Work Site, that will limit contact between Contractor's employees and District pupils at all times; and/or Pursuant to Education Code section 45125.2, Contractor certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising Contractor's employees and its subcontractors' employees is Name: Title: The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. Contractor’s responsibility for background clearance extends to all of its employees, Subcontractors, and employees of Subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the Contractor. Date: Proper Name of Bidder/Contractor: Signature: Print Name: Title:

Appears in 1 contract

Samples: s3.amazonaws.com

CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract") with the District; Design-Builder certifies that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Contractor. Contractor it has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract Agreement (check all that apply): The Contractor Design-Builder has complied with the fingerprinting requirements of Education Code section 45125.1 with respect to all Contractor's Design-Builder’s employees and all of its subcontractors’ employees who may have contact with District pupils in the course of providing services pursuant to the Contract, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of ContractorDesign-Builder 's employees and of all of its subcontractors' employees who may come in contact with District pupils during the course and scope of the Contract Agreement is attached hereto; and/or Pursuant to Education Code section 45125.2, Contractor Design-Builder has installed or will install, prior to commencement of Work, a physical barrier at the Work Site, that will limit contact between ContractorDesign-Builder 's employees and District pupils at all times; and/or Pursuant to Education Code section 45125.2, Contractor certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor Design-Builder who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising ContractorDesign-Builder's employees and its subcontractors' employees is is: Name: Title: The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. ContractorDesign-Builder’s responsibility for background clearance extends to all of its employees, Subcontractorsits subcontractors, and employees of Subcontractors subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the ContractorDesign-Builder. The undersigned does hereby certify that I am a representative of the Design-Builder currently under contract with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Design-Builder. Date: Proper Name of Bidder/ContractorDesign-Builder: Signature: Print Name: Title:: ASBESTOS & OTHER HAZARDOUS MATERIALS CERTIFICATION Design-Builder hereby certifies that no Asbestos, or Asbestos-Containing Materials, polychlorinated biphenyl (PCB), or any material listed by the federal or state Environmental Protection Agency or federal or state health agencies as a hazardous material, or any other material defined as being hazardous under federal or state laws, rules, or regulations “New Material Hazardous”, shall be furnished, installed, or incorporated in any way into the Project or in any tools, devices, clothing, or equipment used to affect any portion of Design- Builder's work on the Project for District. Design-Builder further certifies that it has instructed its employees with respect to the above-mentioned standards, hazards, risks, and liabilities. Asbestos and/or asbestos-containing material shall be defined as all items containing but not limited to chrysotile, crocidolite, amosite, anthophyllite, tremolite, and actinolite. Any or all material containing greater than one-tenth of one percent (.1%) asbestos shall be defined as asbestos-containing material. Any disputes involving the question of whether or not material is New Hazardous Material shall be settled by electron microscopy or other appropriate and recognized testing procedure, at the District’s determination. The costs of any such tests shall be paid by Design-Builder if the material is found to be New Hazardous Material. All Work or materials found to be New Hazardous Material or Work or material installed with “New Hazardous Material” containing equipment will be immediately rejected and this Work will be removed at Design-Builder's expense at no additional cost to the District. Design-Builder has read and understood the document Hazardous Materials Procedures & Requirements, and shall comply with all the provisions outlined therein. Date: Name of Design-Builder: _ Signature: Print Name: Title: LEAD-PRODUCT(S) CERTIFICATION California Occupational Safety and Health Administration (CalOSHA), Environmental Protection Agency (EPA), California Department of Health Services (DHS), California Department of Education (CDE), and the Consumer Product Safety Commission (CPSC) regulate lead- containing paint and lead products. Because the Design-Builder and its employees will be providing services for the District, and because the Design-Builder’s work may disturb lead-containing building materials, DESIGN- BUILDER IS HEREBY NOTIFIED of the potential presence of lead-containing materials located within certain buildings utilized by the District. All school buildings built prior to 1993 are presumed to contain some lead-based paint until sampling proves otherwise. The CDE mandates that school districts utilize DHS lead-certified personnel when a lead-based hazard is identified. Examples of lead-certified personnel include: project designers, inspectors, and abatement workers. Furthermore, since it is assumed by the district that all painted surfaces (interior as well as exterior) within the District contain some level of lead, it is imperative that the Design-Builder, its workers and subcontractors fully and adequately comply with all applicable laws, rules and regulations governing lead-based materials (Including Title 8, California Code of Regulations, Section 1532.1). Any and all Work which may result in the disturbance of lead-containing building materials must be coordinated through the District. The California Education Code also prohibits the use or import of lead-containing paint, lead plumbing and solders, or other potential sources of lead contamination in the construction of any new school facility or in the modernization or renovation of any existing school facility. Design-Builder shall provide the District with any sample results prior to beginning Work, during the Work, and after the completion of the Work. The District may request to examine, prior to the commencement of the Work, the lead training records of each employee of the Design- Builder. All contractors who disturb lead-based paint in a six-square-foot area or greater indoors or a 20-square-foot area outdoors shall comply with the Renovation, Repair and Painting Rule, shall receive training from a U.S. EPA-accredited training provider, and shall be certified by the U.S. EPA. Design-Builder, its workers and subcontractors must fully and adequately comply with all applicable laws, rules and regulations governing lead-based materials, including those rules and regulations appearing within title 40 of the Code of Federal Regulations as part 745 (40 CFR 745). If failure to comply with these laws, rules, and regulations results in a site or worker contamination, Design-Builder will be held solely responsible for all costs involved in any required corrective actions, and shall defend, indemnify and hold harmless the District, pursuant to the indemnification provisions of the Contract, for all damages and other claims arising therefrom. If lead disturbance is anticipated in the Work, only persons with appropriate accreditation, registrations, licenses and training shall conduct this Work. It shall be the responsibility of the Design-Builder to properly dispose of any and all waste products, including but not limited to, paint chips, any collected residue, or any other visual material that may occur from the prepping of any painted surface. It will be the responsibility of Design-Builder to provide the proper disposal of any hazardous waste by a certified hazardous waste hauler. This company shall be registered with the Department of Transportation (DOT) and shall be able to issue a current manifest number upon transporting any hazardous material from any school site within the District. The undersigned hereby acknowledges, under penalty of perjury, that he or she has received notification of potential lead-based materials on the owner’s property, as well as the existence of applicable laws, rules and regulations governing work with, and disposal of, such materials with which it must comply. The undersigned also warrants that he or she has the authority to sign on behalf of and bind the design-builder. Date: Name of Design-Builder: Signature: Print Name: Title: 49 Agreement For Design, Installation and Commissioning of Solar/Photovoltaic System between Napa Valley Unified School District and SunPower Corporation, Systems ROOFING PROJECT CERTIFICATION This form shall be executed by (1) all architects, engineers, or roofing consultants who provide professional services related to a roof repair or replacement project (“roofing project”) and shall be submitted to the District prior to the time professional services are engaged and (2) all contractors, materials manufacturers, or vendors involved in a bid or proposal for a roof repair or replacement project (“roofing project”) and submitted to the District when the award is made.

Appears in 1 contract

Samples: nvusd.granicus.com

CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board Governing Board of the District as follows: That I am a representative of the Contractor OpTerra Energy Services currently under contract ("Contract") with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of ContractorOpTerra Energy Services. Contractor OpTerra Energy Services (hereinafter “Designer/Builder”) certifies that it has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract (check all that apply): The Contractor Designer/Builder has complied with the fingerprinting requirements of Education Code section 45125.1 with respect to all ContractorDesigner/Builder's employees and all of its subcontractors' employees who may have contact with District pupils in the course of providing services Services pursuant to the Contract, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of ContractorDesigner/Builder's employees and of all of its subcontractors' employees who may come in contact with District pupils during the course and scope of the Contract is attached hereto; and/or Pursuant to Education Code section 45125.2, Contractor Designer/Builder has installed or will install, prior to commencement of Work, a physical barrier at the Work Site, that will limit contact between ContractorDesigner/Builder's employees and District pupils at all times; and/or Pursuant to Education Code section 45125.2, Contractor Designer/Builder certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor Designer/Builder who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising ContractorDesigner/Builder's employees and its subcontractors' employees is Name: Title: The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. Contractor’s Designer/Builder's responsibility for background clearance extends to all of its employees, Subcontractors, and employees of Subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the ContractorDesigner/Builder. Date: Proper Name of BidderDesigner/ContractorBuilder: Signature: Print Name: Title:: ASBESTOS & OTHER HAZARDOUS MATERIALS CERTIFICATION OpTerra Energy Services (“Designer/Builder”) hereby certifies that no Asbestos, or Asbestos-Containing Materials, polychlorinated biphenyl(PCB), or any material listed by the federal or state Environmental Protection Agency or federal or state health agencies as a hazardous material, or other material defined as being hazardous under federal or state laws, rules, or regulations “New Material Hazardous”, shall be furnished, installed, or incorporated in any way into the Project or in any tools, devices, clothing, or equipment used to affect any portion of Designer/Builder’s work on the Project for District. Designer/Builder further certifies that it has instructed its employees with respect to the above-mentioned standards, hazards, risks, and liabilities. Asbestos and/or asbestos-containing material shall be defined as all items containing but not limited to chrysotile, crocidolite, amosite, anthophyllite, tremolite, and actinolite. Any or all material containing greater than one-tenth of one percent (.l%) asbestos shall be defined as asbestos-containing material. Any disputes involving the question of whether or not material is New Hazardous Material shall be settled by electron microscopy or other appropriate and recognized testing procedure, at the District's determination. The costs of any such tests shall be paid by Designer/Builder if the material is found to be New Hazardous Material. All Work or materials found to be New Hazardous Material or Work or material installed with "New Hazardous Material" containing equipment will be immediately rejected and this Work will be removed and replaced at Designer/Builder's expense at no additional cost to the District. Designer/Builder has read and understood the document Hazardous Materials Procedures & Requirements, and shall comply with all the provisions outlined therein. Date: Proper Name of Designer/Builder: Signature: Print Name: Title: LEAD-PRODUCT(S) CERTIFICATION California Occupational Safety and Health Administration (CaIOSHA), Environmental Protection Agency (EPA), California Department of Health Services (DHS), California Department of Education (CDE), and the Consumer Product Safety Commission (CPSC) regulate lead-containing paint and lead products. Because the OpTerra Energy Services (“Designer/Builder”) and its employees will be providing services for the District, and because the Designer/Builder's work may disturb lead-containing building materials, DESIGNER/BUILDER IS HEREBY NOTIFIED of the potential presence of lead-containing materials located within certain buildings utilized by the District. All school buildings built prior to 1993 are presumed to contain some lead-based paint until sampling proves otherwise. The CDE mandates that school districts utilize DHS lead-certified personnel when a lead-based hazard is identified. Examples of lead-certified personnel include: project designers, inspectors, and abatement workers. Furthermore, since it is assumed by the District that all painted surfaces (interior as well as exterior) within the District contain some level of lead, it is imperative that the Designer/Builder, its workers and subcontractors fully and adequately comply with all applicable laws, rules and regulations governing lead-based materials (Including Title 8, California Code of Regulations, Section 1532.1). Any and all Work which may result in the disturbance of lead-containing building materials must be coordinated through the District. The California Education Code also prohibits the use or import of lead-containing paint, lead plumbing and solders, or other potential sources of lead contamination in the construction of any new school facility or in the modernization or renovation of any existing school facility. The Designer/Builder shall provide the District with any sample results prior to beginning Work, during the Work, and after the completion of the Work. The District may request to examine, prior to the commencement of the Work, the lead training records of each employee of the Designer/Builder. If failure to comply with these laws, rules, and regulations results in a site or worker contamination, the Designer/Builder will be held solely responsible for all costs involved in any required corrective actions, and shall defend, indemnify and hold harmless the District, pursuant to the indemnification provisions of the Contract, for all damages and other claims arising therefrom. If lead disturbance is anticipated in the Work, only persons with appropriate accreditation, registrations, licenses and training shall conduct this Work. It shall be the responsibility of the Designer/Builder to properly dispose of any and all waste products, including but not limited to, paint chips, any collected residue, or any other visual material that m.ay occur from the prepping of any painted surface. It will be the responsibility of the Designer/Builder to provide the proper disposal of any hazardous waste by a certified hazardous waste hauler. This company shall be registered with the Department of Transportation (DOT) and shall be able to issue a current manifest number upon transporting any hazardous material from any school site within the District. THE UNDERSIGNED XXXXXX ACKNOWLEDGES, UNDER PENALTY OF PERJURY, THAT HE OR SHE HAS RECEIVED NOTIFICATION OF POTENTIAL LEAD-BASED MATERIALS ON THE OWNER'S PROPERTY, AS WELL AS THE EXISTENCE OF APPLICABLE LAWS, RULES AND REGULATIONS GOVERNING WORK WITH, AND DISPOSAL OF, SUCH MATERIALS WITH WHICH IT MUST COMPLY. THE UNDERSIGNED ALSO WARRANTS THAT HE OR SHE HAS THE AUTHORITY TO SIGN ON BEHALF OF AND BIND THE DESIGNER/BUILDER. Date: Proper Name of Designer/Builder: Signature: Print Name: Title: ATTACHMENT N Anticipated Energy Savings for Proposition 39 Funded Projects ECM #1 – Interior & Exterior Lighting Retrofits The table below provides the anticipated energy savings for the lighting scope that will utilize Proposition 39 funds. Site Anticipated Annual Electric Savings (kWh) Anticipated Savings ($) Xxxxxx Xxxx High School 159,709 $33,543 Evergreen Valley High School 468,274 $102,163 Independence High School 79,972 $17,960 Mount Pleasant High School 138,888 $22,946 Oak Grove High School 77,610 $15,799 Xxxxxxx X. Xxxxxxxx High School 63,944 $11,079 Yerba Buena High School 56,697 $21,981 Foothill High School 50,939 $8,703 Total 1,096,033 $234,174 Solar Generating Facilities. The table below provides the anticipated energy savings for the solar generating facilities that will utilize Proposition 39 funds. ECM # Location Anticipated First Year Electric Savings (kWh) Anticipated First Year Savings ($) SG-1 Xxxxxx High School 184,303 $42,491 SG-2 Xxxxxxxx Adult Center 134,894 $41,186 52 ATTACHMENT E Project Schedule ID Task Mode 1 Task Name ESC Approval Duration 0 days Start Thu 8/20/15 Finish Thu 8/20/15 Predecessors August September October November December January February March April May June July August 8/20 2 Notice to Proceed 0 days Wed 9/2/15 Wed 9/2/15 1FS+10 days 9/2 3 Solar PV 155 days Thu 9/3/15 Wed 4/6/16 4 Final Design 40 days Thu 9/3/15 Wed 10/28/15 2 5 DSA Approval 45 days Thu 10/29/15 Wed 12/30/15 4 6 Product Procurement 45 days Thu 10/29/15 Wed 12/30/15 4 7 Construction 50 days Thu 12/31/15 Wed 3/9/16 5 8 Closeout 20 days Thu 3/10/16 Wed 4/6/16 7 9 Lighting 237 days Thu 9/3/15 Fri 7/29/16 10 Final Design 50 days Thu 9/3/15 Wed 11/11/15 2 11 District Review of Product Submittals 12 Equipment Procurement 20 days 42 days Thu 11/12/15 Thu 12/10/15 Wed 12/9/15 10 Fri 2/5/16 11 13 Construction 105 days Mon 2/8/16 Fri 7/1/16 12 14 Closeout 20 days Mon 7/4/16 Fri 7/29/16 13 15 Project Final Completion 0 days Fri 7/29/16 Fri 7/29/16 7/29 Date: Tue 7/21/15 Task Split Milestone Summary Project Summary Inactive Task Inactive Milestone Inactive Summary Manual Task Duration-only Manual Summary Rollup Manual Summary Start-only Finish-only External Tasks External Milestone Deadline Progress Manual Progress INTERIOR FIXTURE RETROFIT LEGEND Retrofit Code Retrofit Description BR30 GE BR 30, 15W. CR14(B) Surface mount CREE CR 1'x4' troffer, 22W, dimmable. CR14(B)E Surface mount CREE CR 1'x4' troffer, 22W, dimmable. Emergency driver. CR24(B) CREE CR 2'x4' troffer, 40W, dimmable. CR24(B)E CREE CR 2'x4' troffer, 40W, dimmable. Emergency driver. CS14-22E CREE CS 4' linear luminaire, 22 W, dimmable. Emergency driver. CS14-38 CREE CS 4' linear luminaire, 38 W, dimmable. CS18-44 CREE CS 8' linear luminaire, 44 W, dimmable. CS18-44E CREE CS 8' linear luminaire, 44 W, dimmable. Emergency driver. EVOKIT36D Xxxxxxxx EVOKIT 2'x4' troffer LED retrofit kit, 36W, dimmable. EVOKIT36DE Xxxxxxxx EVOKIT 2'x4' troffer LED retrofit kit, 36W, dimmable. Emergency driver. LED Kit LED kit to be specified by contractor. LUSIO2M LUSIO 2M 88W fixture with integrated motion sensor. LUSIO2MS LUSIO 2MS 44W fixture with integrated motion sensor and wire guard. P8(3) (3) Xxxxxxxx 8W R20 Dimmable LED lamps. RB(Combo) One Red Bird LED 18W tube facing down, and two Red Bird LED 9W tubes facing up, powered by one 36W LED driver. Maintain existing IO switching. RB(Combo)E One Red Bird LED 18W tube facing down, and two Red Bird LED 9W tubes facing up, powered by one 36W LED driver. Maintain existing IO switching. Emergency driver. RB10(2)2' Two Red Bird 2' LED 10W tubes, powered by one 20W LED driver.

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CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract") with the District; Consultant certifies that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Contractor. Contractor it has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract Agreement (check all that apply): 🞎 The Contractor fingerprinting and criminal background investigation requirements of Education Code section 45125.1 apply to Consultant’s Services under this Agreement and Consultant certifies its compliance with these provisions as follows: Consultant certifies that the Consultant has complied with the fingerprinting and criminal background investigation requirements of Education Code section 45125.1 with respect to all Contractor's employees Consultant’s employees, subcontractors, agents, and all of its subcontractors’ employees or agents (“Employees”) regardless of whether those Employees are paid or unpaid, concurrently employed by the District, or acting as independent contractors of the Consultant, who may have contact with District pupils in the course of providing services Services pursuant to the ContractAgreement, and the California Department of Justice has determined that none of those employees Employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of Contractor's employees and of all of its subcontractors' employees Employees who may come in contact with District pupils during the course and scope of the Contract Agreement is attached hereto; and/or . 🞎 Pursuant to Education Code section 45125.2, Contractor Consultant has installed or will install, prior to commencement of WorkServices, a physical barrier at the Work Sitework site, that will limit contact between ContractorConsultant's employees and District pupils at all times; and/or 🞎 Pursuant to Education Code section 45125.2, Contractor Consultant certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor Consultant who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising ContractorConsultant's employees and its subcontractors' employees is Name: Title: The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. ContractorConsultant’s responsibility for background clearance extends to all of its employees, Subcontractorssubcontractors, and employees of Subcontractors subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the ContractorConsultant. The undersigned does hereby certify that I am a representative of the Consultant currently under contract with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this Certificate on behalf of Consultant. Date: Proper Name of Bidder/Contractor: Signature: Print Name: Title:

Appears in 1 contract

Samples: Independent Contractor Agreement for Special Services

CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract") with the District; that • That I am familiar with the facts herein certified, ; and • That I am authorized and qualified to execute this certificate on behalf of Contractor. Contractor certifies that it has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract (check all that applyapplies): # The Contractor has complied with the fingerprinting requirements of Education Code section 45125.1 with respect to all Contractor's ’s employees and all of its subcontractorsSubcontractors’ employees who may have contact with District pupils in the course of providing services pursuant to the Contract, and the California Department of Justice has determined that none of those employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of Contractor's employees and of all of its subcontractors' employees who may come in contact with District pupils during the course and scope of the Contract is attached hereto; and/or # Pursuant to Education Code section 45125.2, Contractor has installed or will install, prior to commencement of Work, a physical barrier at the Work Site, that will limit contact between Contractor's employees and District pupils at all times; and/or # Pursuant to Education Code section 45125.2, Contractor certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising Contractor's employees and its subcontractors' employees is Name: Title: # The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. Contractor’s responsibility for background clearance extends to all of its employees, Subcontractors, and employees of Subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the Contractor. Date: Proper Name of Bidder/Contractor: Signature: Print Name: Title:: ASBESTOS & OTHER HAZARDOUS MATERIALS CERTIFICATION Contractor hereby certifies that no Asbestos, or Asbestos-Containing Materials, polychlorinated biphenyl (PCB), or any material listed by the federal or state Environmental Protection Agency or federal or state health agencies as a hazardous material, or any other material defined as being hazardous under federal or state laws, rules, or regulations “New Material Hazardous”, shall be furnished, installed, or incorporated in any way into the Project or in any tools, devices, clothing, or equipment used to affect any portion of Contractor's work on the Project for District. Contractor further certifies that it has instructed its employees with respect to the above- mentioned standards, hazards, risks, and liabilities. Asbestos and/or asbestos-containing material shall be defined as all items containing but not limited to chrysotile, crocidolite, amosite, anthophyllite, tremolite, and actinolite. Any or all material containing greater than one-tenth of one percent (.1%) asbestos shall be defined as asbestos-containing material. Any disputes involving the question of whether or not material is New Hazardous Material shall be settled by electron microscopy or other appropriate and recognized testing procedure, at the District’s determination. The costs of any such tests shall be paid by Contractor if the material is found to be New Hazardous Material. All Work or materials found to be New Hazardous Material or Work or material installed with “New Hazardous Material” containing equipment will be immediately rejected and this Work will be removed at Contractor's expense at no additional cost to the District. Contractor has read and understood the document Hazardous Materials Procedures & Requirements, and shall comply with all the provisions outlined therein. Date: Name of Contractor: Signature: Print Name: Title: Exhibit A – Scope of Work

Appears in 1 contract

Samples: Agreement for Construction Services

CRIMINAL BACKGROUND INVESTIGATION CERTIFICATION. The undersigned does hereby certify to the governing board of the District as follows: That I am a representative of the Contractor currently under contract ("Contract") with the District; Consultant certifies that I am familiar with the facts herein certified, and am authorized and qualified to execute this certificate on behalf of Contractor. Contractor it has taken at least one of the following actions with respect to the construction Project that is the subject of the Contract Agreement (check all that apply): The Contractor fingerprinting and criminal background investigation requirements of Education Code section 45125.1 apply to Consultant’s Services under this Agreement and Consultant certifies its compliance with these provisions as follows: Consultant certifies that the Consultant has complied with the fingerprinting and criminal background investigation requirements of Education Code section 45125.1 with respect to all Contractor's employees Consultant’s employees, subcontractors, agents, and all of its subcontractors’ employees or agents (“Employees”) regardless of whether those Employees are paid or unpaid, concurrently employed by the District, or acting as independent contractors of the Consultant, who may have contact with District pupils in the course of providing services Services pursuant to the ContractAgreement, and the California Department of Justice has determined that none of those employees Employees has been convicted of a felony, as that term is defined in Education Code section 45122.1. A complete and accurate list of Contractor's employees and of all of its subcontractors' employees Employees who may come in contact with District pupils during the course and scope of the Contract Agreement is attached hereto; and/or .  Pursuant to Education Code section 45125.2, Contractor Consultant has installed or will install, prior to commencement of WorkServices, a physical barrier at the Work Sitework site, that will limit contact between ContractorConsultant's employees and District pupils at all times; and/or Pursuant to Education Code section 45125.2, Contractor Consultant certifies that all employees will be under the continual supervision of, and monitored by, an employee of the Contractor Consultant who the California Department of Justice has ascertained has not been convicted of a violent or serious felony. The name and title of the employee who will be supervising ContractorConsultant's employees and its subcontractors' employees is Name: Title: The Work on the Contract is at an unoccupied school site and no employee and/or subcontractor or supplier of any tier of Contract shall come in contact with the District pupils. ContractorConsultant’s responsibility for background clearance extends to all of its employees, Subcontractorssubcontractors, and employees of Subcontractors subcontractors coming into contact with District pupils regardless of whether they are designated as employees or acting as independent contractors of the ContractorConsultant. The undersigned does hereby certify that I am a representative of the Consultant currently under contract with the District; that I am familiar with the facts herein certified, and am authorized and qualified to execute this Certificate on behalf of Consultant. Date: Proper Name of Bidder/Contractor: Signature: Print Name: Title:

Appears in 1 contract

Samples: Independent Contractor Agreement for Special Services

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