Common use of ROOFING PROJECT CERTIFICATION Clause in Contracts

ROOFING PROJECT CERTIFICATION. This form shall be executed by all architects, engineers, or roofing consultants who provide professional services related to a roof repair or replacement project (“roofing project”) and submitted to the District prior to the time professional services are engaged. Certification of: □ Architect □ Engineer □ Roofing Consultant □ Other I, [Name], [Name of Employer], certify that I have not offered, given, or agreed to give, received, accepted, or agreed to accept, any gift, contribution, or any financial incentive whatsoever to or from any person in connection with the roofing project contract. As used in this certification, “person” means any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group of individuals. Furthermore, I, [Name], [Name of Employer], certify that I do not have, and throughout the duration of the contract, I will not have, any financial relationship in connection with the performance of this contract with any architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor that is not disclosed below. I, [Name], [Name of Employer], have the following financial relationships with an architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor, or other person in connection with the following roofing project contract(s) [provide Name and Address of Building, and Contract Date and Number]: By my signature below, I hereby certify that, to the best of my knowledge, the contents of this disclosure are true, or are believed to be true. I further certify on behalf of the Firm that I am aware of section 3000 et seq. of the California Public Contract Code, and the sections referenced therein regarding the penalties for providing false information or failing to disclose a financial relationship in this disclosure. I further certify that I am authorized to make this certification on behalf of the Firm. Date:

ROOFING PROJECT CERTIFICATION. This form shall be executed by all architects, engineers, or roofing consultants who provide professional services related to a roof repair or replacement project (“roofing project”) and submitted to the District prior to the time professional services are engaged. Certification of: □ Architect □ Engineer □ Roofing Consultant □ Other I, [Name], [Name of Employer], certify that I have not offered, given, or agreed to give, received, accepted, or agreed to accept, any gift, contribution, or any financial incentive whatsoever to or from any person in connection with the roofing project contract. As used in this certification, “person” means any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group of individuals. Furthermore, I, [Name], [Name of Employer], certify that I do not have, and throughout the duration of the contract, I will not have, any financial relationship in connection with the performance of this contract with any architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor that is not disclosed below. I, [Name], [Name of Employer], have the following financial relationships with an architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor, or other person in connection with the following roofing project contract(s) [provide Name and Address of Building, and Contract Date and Number]: By my signature below, I hereby certify that, to the best of my knowledge, the contents of this disclosure are true, or are believed to be true. I further certify on behalf of the Firm that I am aware of section 3000 et seq. of the California Public Contract Code, and the sections referenced therein regarding the penalties for providing false information or failing to disclose a financial relationship in this disclosure. I further certify that I am authorized to make this certification on behalf of the Firm. Date:: Proper Name of Firm: Signature: Print Name: Title: Project: Ohlone College: Academic Core - Buildings 1, 2 & 8 Prepared by: MILLENNIUM CONSULTING ASSOCIATES Contact: Xxxx XxXxxxxx/Xxxxxx Xxxxxx Email Address: j xxxxxxxx@xxxxxxxxxx.xxx xxxxxxx@xxxxxxxxxx.xxx Scope of Work: Provide pre-demolition hazmat site characterization and abatement design services in conformance with scope presented in Proposal P14-2003A Task 1: Project coordination, sample llection and analysis Labor Labor Category Description of Work Estimated No. of Not-To-Exceed Hrs Hourly Rate per SOQ Total Principal Program Mgmt/Quality Assurance 6 $175.00 $1,050.00 Registered Professional Project Lead 40 $150.00 $6,000.00 Senior Project Professional: Engineer/IH Survey and sample collection 0 $125.00 $0.00 Project Professional Survey and sample collection 72 $105.00 $7,560.00 Staff Professional Survey and sample collection 144 $90.00 $12,960.00 Drafter CAD, Drafting 0 $65.00 $0.00 Administrative Support Clerical, Data Entry, etc. 0 $50.00 $0.00 Total Labor Costs $27,570.00 Other Costs Item Estimated No. of Item Fixed Unit Rate Total Bulk Asbestos - PLM - TAT 24 hour 0 $20.00 $0.00 Bulk Asbestos - PLM - TAT >24 hour 363 $15.00 $5,445.00 Point Count (1000 pts) - TAT 3 to 5 days 54 $55.00 $2,970.00 Lead - Total (TTLC) - TAT 48 hr [paint chip] 36 $20.00 $720.00 STLC Extraction + Lead (waste Characterization - 5 Day TAT) 36 $95.00 $3,420.00 TCLP Extraction + Lead (waste Characterization - 5 Day TAT) 36 $95.00 $3,420.00 PCB Characterization (EPA method 8082) 24 $65.00 $1,560.00 Other Specialized Laboratory Analysis, as required (i.e Hg, Chemical Hazards) 1 $1,500.00 $1,500.00 Equipment (All Rates are per day except where noted) XRF 5 $195.00 $975.00 Hi-Reach Boom Lift (if required) 2 $300.00 $600.00 Office Consumables 0 $50.00 $0.00 Total Other Costs $20,610.00 TOTAL TASK 1 $48,180.00 Task 2: Hazmat Assessment Report & Hazmat Design Documents Labor Labor Category Description of Work Estimated No. of Not-To-Exceed Hrs Hourly Rate per SOQ Total Principal Program Mgmt/Quality Assurance 6 $175.00 $1,050.00 Registered Professional Project Lead 40 $150.00 $6,000.00 Project Professional Spec Preparation, Data Analysis & Reporting 40 $105.00 $4,200.00 Drafter CAD, Drafting (figures and HM drawing) 24 $65.00 $1,560.00 Administrative Support Clerical, Data Entry, etc. 8 $50.00 $400.00 Total Labor Costs $6,160.00 Other Costs Item No. of Item Fixed Unit Rate Total Office Consumeables (Reproduction) 1 $50.00 $50.00 Shipping (Fed Exp, UPS) $40.00 $0.00 Total Other Costs $50.00 TOTAL TASK 2 $6,210.00 Task 3: Bidding Services - NOT INCLUDED IN THIS FEE PROPOSAL Task 4: Inspection & Monitoring - NOT INCLUDED IN THIS FEE PROPOSAL Task 5: Project Closeout - NOT INCLUDED IN THIS FEE PROPPOSAL TOTAL: Tasks 1-2 $54,390 Attachment 1 - Fee Schedule Project: Ohlone College: Academic Core - Buildings 3 & 4 Prepared by: MILLENNIUM CONSULTING ASSOCIATES Contact: Xxxx XxXxxxxx/Xxxxxx Xxxxxx Email Address: xxxxxxxxx@xxxxxxxxxx.xxx xxxxxxx@xxxxxxxxxx.xxx Scope of Work: Provide pre-demolition hazmat site characterization and abatement design services in conformance with scope presented in Proposal P14-2003B Task 1: Project coordination, sample c ollection and analysis Labor Labor Category Description of Work Estimated No. of Not-To-Exceed Hrs Hourly Rate per SOQ Total Principal Program Mgmt/Quality Assurance 4 $175.00 $700.00 Registered Professional Project Lead 24 $150.00 $3,600.00 Senior Project Professional: Engineer/IH Survey and sample collection 0 $125.00 $0.00 Project Professional Survey and sample collection 40 $105.00 $4,200.00 Staff Professional Survey and sample collection 40 $90.00 $3,600.00 Drafter CAD, Drafting 0 $65.00 $0.00 Administrative Support Clerical, Data Entry, etc. 0 $50.00 $0.00 Total Labor Costs $12,100.00 Other Costs Item Estimated No. of Item Fixed Unit Rate Total Bulk Asbestos - PLM - TAT 24 hour 0 $20.00 $0.00 Bulk Asbestos - PLM - TAT >24 hour 168 $15.00 $2,520.00 Point Count (1000 pts) - TAT 3 to 5 days 16 $55.00 $880.00 Lead - Total (TTLC) - TAT 48 hr [paint chip] 9 $20.00 $180.00 STLC Extraction + Lead (waste Characterization - 5 Day TAT) 8 $95.00 $760.00 TCLP Extraction + Lead (waste Characterization - 5 Day TAT) 8 $95.00 $760.00 PCB Characterization (EPA method 8082) 12 $65.00 $780.00 Other Specialized Laboratory Analysis, as required (i.e Hg, Chemical Hazards) 1 $1,500.00 $1,500.00 Equipment (All Rates are per day except where noted) XRF 2 $195.00 $390.00 Hi-Reach Boom Lift (if required) 1 $300.00 $300.00 Office Consumables 0 $50.00 $0.00 Total Other Costs $8,070.00 TOTAL TASK 1 $20,170.00 Task 2: Hazmat Assessment Report & Hazmat Design Documents Labor Labor Category Description of Work Estimated No. of Not-To-Exceed Hrs Hourly Rate per SOQ Total Principal Program Mgmt/Quality Assurance 2 $175.00 $350.00 Registered Professional Project Lead 24 $150.00 $3,600.00 Project Professional Spec Preparation, Data Analysis & Reporting 24 $105.00 $2,520.00 Drafter CAD, Drafting (figures and HM drawing) 24 $65.00 $1,560.00 Administrative Support Clerical, Data Entry, etc. 8 $50.00 $400.00 Total Labor Costs $4,480.00 Other Costs Item No. of Item Fixed Unit Rate Total Office Consumeables (Reproduction) 1 $50.00 $50.00 Shipping (Fed Exp, UPS) $40.00 $0.00 Total Other Costs $50.00 TOTAL TASK 2 $4,530.00 Task 3: Bidding Services - NOT INCLUDED IN THIS FEE PROPOSAL Task 4: Inspection & Monitoring - NOT INCLUDED IN THIS FEE PROPOSAL Task 5: Project Closeout - NOT INCLUDED IN THIS FEE PROPPOSAL

ROOFING PROJECT CERTIFICATION. This form shall be executed by all architects, engineers, or roofing consultants who provide professional services related to a roof the repair or replacement of a roof of a public school where the project is for repair of more than 25% of the roof or that has a total cost more than $21,000 (“roofing project”) and submitted to the District prior to the time professional services are engaged. Certification of: □ Architect □ Engineer □ Roofing Consultant □ Other I, [Name], [Name of EmployerFirm], certify that I have not offered, given, or agreed to give, received, accepted, or agreed to accept, any gift, contribution, or any financial incentive whatsoever to or from any person in connection with the roofing project contract. As used in this certification, “person” means any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group of individuals. Furthermore, I, [Name], [Name of EmployerFirm], certify that I do not have, and throughout the duration of the contract, I will not have, any financial relationship in connection with the performance of this contract with any architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor that is not disclosed below. I, [Name], [Name of EmployerFirm], have the following financial relationships with an architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor, or other person in connection with the following roofing project contract(s) [provide Name and Address of Building, and Contract Date and Number]: By my signature below, I hereby certify that, to the best of my knowledge, the contents of this disclosure are true, or are believed to be true. I further certify on behalf of the Firm that I am aware of section 3000 et seq. of the California Public Contract Code, and the sections referenced therein regarding the penalties for providing false information or failing to disclose a financial relationship in this disclosure. I further certify that I am authorized to make this certification on behalf of the Firm. Date: Proper Name of Firm: Signature: Print Name: Title: EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement. General:

ROOFING PROJECT CERTIFICATION. This form shall be executed by all architects, engineers, or roofing consultants who provide professional services related to a roof the repair or replacement of a roof of a public school where the project is for repair of more than 25% of the roof or that has a total cost more than $21,000 (“roofing project”) and submitted to the District prior to the time professional services are engaged. Certification of: □ Architect □ Engineer □ Roofing Consultant □ Other I, [Name], [Name of EmployerFirm], certify that I have not offered, given, or agreed to give, received, accepted, or agreed to accept, any gift, contribution, or any financial incentive whatsoever to or from any person in connection with the roofing project contract. As used in this certification, “person” means any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group of individuals. Furthermore, I, [Name], [Name of EmployerFirm], certify that I do not have, and throughout the duration of the contract, I will not have, any financial relationship in connection with the performance of this contract with any architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor that is not disclosed below. I, [Name], [Name of EmployerFirm], have the following financial relationships with an architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor, or other person in connection with the following roofing project contract(s) [provide Name and Address of Building, and Contract Date and Number]: By my signature below, I hereby certify that, to the best of my knowledge, the contents of this disclosure are true, or are believed to be true. I further certify on behalf of the Firm that I am aware of section 3000 et seq. of the California Public Contract Code, and the sections referenced therein regarding the penalties for providing false information or failing to disclose a financial relationship in this disclosure. I further certify that I am authorized to make this certification on behalf of the Firm. Date:: Proper Name of Firm: Signature: Print Name: Title: EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT PROGRAM/PROJECT LEVEL FIXTURES, FURNISHES, AND EQUIPMENT (FF&E) CONSULTANT

ROOFING PROJECT CERTIFICATION. This form shall be executed by all architects, engineers, or roofing consultants who provide professional services related to a roof repair or replacement project (“roofing project”) and submitted to the District prior to the time professional services are engaged. Certification of: □ Architect □ Engineer □ Roofing Consultant □ Other I, [Name], [Name of Employer], certify that I have not offered, given, or agreed to give, received, accepted, or agreed to accept, any gift, contribution, or any financial incentive whatsoever to or from any person in connection with the roofing project contract. As used in this certification, “person” means any natural person, business, partnership, corporation, union, committee, club, or other organization, entity, or group of individuals. Furthermore, I, [Name], [Name of Employer], certify that I do not have, and throughout the duration of the contract, I will not have, any financial relationship in connection with the performance of this contract with any architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor that is not disclosed below. I, [Name], [Name of Employer], have the following financial relationships with an architect, engineer, roofing consultant, materials manufacturer, distributor, or vendor, or other person in connection with the following roofing project contract(s) [provide Name and Address of Building, and Contract Date and Number]: By my signature below, I hereby certify that, to the best of my knowledge, the contents of this disclosure are true, or are believed to be true. I further certify on behalf of the Firm that I am aware of section 3000 et seq. of the California Public Contract Code, and the sections referenced therein regarding the penalties for providing false information or failing to disclose a financial relationship in this disclosure. I further certify that I am authorized to make this certification on behalf of the Firm. Date:: Proper Name of Firm: Signature: Print Name: Title: September 5, 2013 Xxxxxx Xxxxx Director, Facilities and Modernization Ohlone College 00000 Xxxxxxx Xxxxxxxxx Xxxxxxx, XX 00000-0000 Re: Feasibility/Needs Assessment for Renovation of Buildings 5, 9 and 12 Dear Xxx: It was a pleasure to meet with you and Xxxx Xxxxx of Gilbane on 8/13/13 to discuss our proposal to Ohlone College for Needs Assessment/Feasibility for Renovations to Building 5 Hochler Commons, Building 9 Xxxxx Gymnasium/Pool, and Building 12 Xxxxx Xxxx. Based on our discussions that day and follow-up with Xxxxx Xxxxxx of Xxxxxxx on 9/5/13, we revised our fee and scope to accommodate the changes requested. SCOPE Our scope for the Needs Assessment/Feasibility would include: • Building 5 Hochler o Convert portion of second floor Bookstore for a potential Student Lounge area o Explore possibility of opening up a part of the third floor to allow for events on the patio (maybe via Nanowall). o Re-program the Kitchen/Servery area o Consider ways to bring more light into the building o Evaluate potential skylights and structural impact of wall removal; evaluate ME impact to ventilate remodeled and new covered spaces. x Xxxxxxxxx fee: $13,756 • Building 9 Xxxxx Gymnasium/Pool o Enclose the breezeway to convert to a lobby o Refurbish gym bleachers, scoreboard, lighting, and flooring o Consider ways to bring more light into the building o Re-program spaces on the ground floor o Evaluate potential skylights and structural impact of wall removal; evaluate ME impact to ventilate remodeled and new covered spaces. o Coordinate the Pool Consultant study x Xxxxxxxxx fee: $13,756 • Building 12 Xxxxx Xxxx o Renovate two-story building, including conversion of six (6) large classrooms into twelve (12) smaller ones o Re-do the entry o Program for Police, Administration and Academic Classrooms o Evaluate potential skylights and structural impact of wall removal; evaluate MEP impact to ventilate remodeled and new covered spaces. 00 Xxxxxx Xxxxxx San José, California 95110 xxx.xxxxxxxxx.xx.com 415.683.2000 San Francisco 408.295.5446 San Xxxx 213.629.0500 Los Angeles +00.00.0000.0000 Shanghai x Xxxxxxxxx fee: $15,340 MEETINGS Xxxxxxxxx Architects envisions a series of strategic meetings over the next few months to clarify the scope and understand both the programmatic and the functional needs of these buildings: • Two (2) meetings with Dining/Kitchen group • Two (2) meetings with PE department • One (1) meeting regarding the Pool • Three to four (3-4) meetings with representatives from the Academic sector DELIVERABLE The deliverables would be in the form of a Needs Assessment/Feasibility document with scaled block diagrams to indicate placement, size, and purpose of program spaces for each building. It would be accompanied with a Feasibility Cost estimate, through TBD Consulting. We will work with Xxxxx Xxxxxxx for Structural input and Alfa Tech for ME input. FEE Xxxxxxxxx Fee: $42,852 Consultant Fees • Structural (Xxxxx Xxxxxxx) $7,300 • ME (Alfa Tech) $6,620 • Cost Consultant (TBD) $4,700 Consultant Sub-total: $18,620 Reimbursable Allowance: $3,074 Total A/E Fees: $64,546 TIMELINE The timeline of our proposal is to conduct the meetings during September and October 2013, with facilities and high level academic representatives. We would provide a Program Document by early October, followed by Block Diagrams in early November, from which a Feasibility Cost would be determined by mid-November. It is exciting to potentially share in the next steps for Ohlone College and contribute further to student success and campus vitality. We are truly excited to submit this proposal to you, and to have the opportunity to continue working with Ohlone College and the District. We embrace this project with great enthusiasm. Sincerely, Xxxxx Xxxxxx, AIA, LEED AP Principal Attachments: Fee Spreadsheet S T E I N B E R G A R C H I T E C T S‌ Ohlone College - Needs Assessment/Feasibility 9/5/2013 Professional Fees Summary - RENOVATIONS TO 5, 9 & 12 Item Building / Function Title / Position Hrs/Wk Rate Total Hrs Extended Cost