HomeMy WebLinkAboutItem No. 5CITY OE
LAKE LLSIl`IOI�E
DREAM EXTREME-
REPORT TO CITY COUNCIL
TO: HONORABLE MAYOR
AND MEMBERS OF THE CITY COUNCIL
FROM: TOM EVANS
INTERIM CITY MANAGER
DATE: AUGUST 28, 2012
SUBJECT: AGREEMENT FOR PROFESSIONAL SERVICES
STK ARCHITECTURE, INC., ARCHITECTURAL DESIGN SERVICES
SEISMIC RETROFIT OF THE CULTURAL CENTER AND
CITY HALL PROJECT NUMBER 4327
Recommendations
1. Award the Seismic Retrofit Architectural Finishes Design of the Cultural
Center and City Hall to STK Architectural in the not to exceed amount of
$22,000.00.
2. Authorize the Interim City Manager to execute the contract with STK
Architectural.
Background
The Cultural Center was constructed in 1923 and the City Hall was constructed in 1934
both facilities are unreinforced masonry. On August 29, 2008, CCS Group Inc.,
completed the Seismic Vulnerability Assessment on both facilities. The report
examined construction methods and building conditions, building structural
vulnerabilities and associated hazards and risks, with recommendations and a cost
estimate for the retrofit. The City contracted with Risha Engineering to provide the City
with current floor plans and the existing structural details for both the Cultural Center
and City Hall.
AGENDA ITEM NO. 5
Page I of 16
Discussion
The Request for Proposal for design and project construction support was placed on the
City website in February 2011. The proposal requested fees based upon the seismic
retrofit design of both the Cultural Center and City Hall. The scope of work for this
phase of the project included professional engineering consultant services related to the
seismic assessment and upgrade of the facilities; providing existing architectural floor
and structural plans. The seismic design is complete and the location and number of
shear walls have been established for both facilities. The City requires the services of
an architectural firm to specify the finishes and architectural construction details to
complete the bid documents. In the seismic selection process a committee reviewed
the submitted proposals and listed the three top firms. Risha Engineering, who was
number one in the selection process, did not include an architectural design consultant;
therefore STK Architectural is being proposed to complete the architectural design
details.
The top three firms are as follows:
Anticipated Proiect Schedule
Award
Notice to Proceed
Submit Construction Documents
Start Bid
Open Bids
Award Construction Contract
Start Construction
Fiscal Impact
Risha Engineering (Burbank, CA)
STK Architecture, Inc. (Temecula, CA)
IDS Group (Irvine, CA)
August 28, 2012
September 4, 2012
September 26, 2012
October 1, 2012
October 30, 2012
November 13, 2012
December 3, 2012
The City of Lake Elsinore will fund the design and construction with Fund 108 DR -1731
HMGP, Fund 105 Miscellaneous, and Fund 116 City Hall /Public Works DIF. The project
budget is $1,663,202.
108 DR -1731 HMGP
105 Miscellaneous
116 City Hall /Public Works DIF
Total Project Budget
Expenditures to Date:
Design /Seismic reports
Administration
Miscellaneous
$ 825,735.75
$ 275,245.25
$ 562,222.00
$1,663,202.00
$ 133,234.00
$ 22,991.00
$ 1,050.00
$ 157,275.00
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Remaining Project Budget $1,505,927.00
Architectural Design
$ 22,000.00
Engineers Estimate City Hall /Cultural Center
$1,035,833.00
Fire Sprinkler System City Hall
$ 125,000.00
Fire Sprinkler System Cultural Center
$ 200,000.00
Engineers Required Structural Inspection
$ 20,000.00
Contract Administration /Inspection
$ 30,000.00
Miscellaneous (Rental Meeting Room Moving /Storage
$ 73 094.00
$1,505,927.00
The engineers estimate includes allowances for architectural finishes ADA restroom
upgrades and other ancillary improvements.
Prepared by: Peter Ramey
i'
Project Engineer
Approved by: Ken Seumalo 05
Director of Public Works
Approved by: James Riley
Director of Administrative Services
Approved by: Tom Evans
Interim City Muir
Attachments: Agreement for Professional Services
Exhibit A Consultant Proposal
Exhibit B Consultant Compensation
Exhibit C Exemption from Workers Compensation
Page 3 of 16
AGREEMENT FOR PROFESSIONAL SERVICES
This Agreement for Professional Services (the "Agreement ") is made and entered into as
of the 28 day of August , 2012, by and between the City of Lake Elsinore, a
municipal corporation ( "City ") and STK Architecture, Inc. ( "Consultant ").
RECITALS
A. Consultant is specially trained, experienced and competent to perform the special
services which will be required by this Agreement.
B. Consultant possesses the skill, experience, ability, background, certification and
knowledge to provide the services described in this Agreement on the terms and conditions
described herein.
C. City desires to retain Consultant to render professional consulting services and related
work as set forth in this Agreement.
AGREEMENT
1. Scope of Services. Consultant shall perform the services described on Exhibit A which
is attached hereto and incorporated herein by reference. Consultant shall provide said services
at the time, place, and in the manner specified in Exhibit A, subject to the direction of the City
through its staff that it may provide from time to time.
2. Time of Performance. The services of Consultant are to commence upon execution of
this Agreement and shall continue for a period of one (1) year or as specified in the Consultants
proposal.
3. Compensation. Compensation to be paid to Consultant shall be in accordance with the
Schedule of Charges set forth in Exhibit A, which is attached hereto and incorporated herein by
reference. In no event shall Consultant's compensation exceed $22,000 without additional
authorization from the City. Payment by City under this Agreement shall not be deemed a
waiver of defects, even if such defects were known to the City at the time of payment.
4. Method of Payment. Consultant shall submit monthly billings to City describing the work
performed during the preceding month. Consultant's bills shall include a brief description of the
services performed, the date the services were performed, the number of hours spent and by
whom, and a description of any reimbursable expenditures. City shall pay Consultant no later
than 30 days after approval of the monthly invoice by City staff. When payments made by City
equal 90% of the maximum fee provided for in this Agreement, no further payments shall be
made until the final work under this Agreement has been accepted by City.
5. Extra Work. At any time during the term of this Agreement, City may request that
Consultant perform Extra Work. As used herein, "Extra Work" means any work which is
determined by City to be necessary for the proper completion of the Project, but which the
parties did not reasonably anticipate would be necessary at the execution of this Agreement.
Consultant shall not perform, nor be compensated for, Extra Work without written authorization
from City. Extra work will be invoiced separately from services performed in accordance with
the Scope of Services
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6. Termination. This Agreement may be terminated by the City immediately for cause or by
either party without cause upon thirty (30) days' written notice of termination. Upon termination,
Consultant shall be entitled to compensation for services performed up to the effective date of
termination.
7. Ownership of Documents. All plans, studies, documents and other writings prepared by
and for Consultant, its officers, employees and agents and subcontractors in the course of
implementing this Agreement, except working notepad internal documents, shall become the
property of the City upon payment to Consultant for such work, and the City shall have the sole
right to use such materials in its discretion without further compensation to Consultant or to any
other party. Consultant shall, at Consultant's expense, provide such reports, plans, studies,
documents and other writings to City upon written request. City acknowledges that any use of
such materials in a manner beyond the intended purpose as set forth herein shall be at the sole
risk of the City. City further agrees to defend, indemnify and hold harmless Consultant, its
officers, officials, agents, employees and volunteers from any claims, demands, actions, losses,
damages, injuries, and liability, direct or indirect (including any and all costs and expenses in
connection therein), arising out of the City's use of such materials in a manner beyond the
intended purpose as set forth herein.
a. Licensing of Intellectual Propert y. This Agreement creates a nonexclusive and
perpetual license for City to copy, use, modify, reuse, or sublicense any and all copyrights,
designs, and other intellectual property embodied in plans, specifications, studies, drawings,
estimates, and other documents or works of authorship fixed in any tangible medium of
expression, including but not limited to, physical drawings or data magnetically or otherwise
recorded on computer diskettes, which are prepared or caused to be prepared by Consultant
under this Agreement ( "Documents & Data "). Consultant shall require that all subcontractors
agree in writing that City is granted a nonexclusive and perpetual license for any Documents &
Data the subcontractor prepares under this Agreement. Consultant represents and warrants that
Consultant has the legal right to license any and all Documents & Data. Consultant makes no
such representation and warranty in regard to Documents & Data which were prepared by
design professionals other than Consultant or provided to Consultant by the City. City shall not
be limited in any way in its use of the Documents & Data at any time, provided that any such
use not within the purposes intended by this Agreement shall be at City's sole risk.
b. Confidentiality. All ideas, memoranda, specifications, plans, procedures,
drawings, descriptions, computer program data, input record data, written information, and other
Documents & Data either created by or provided to Consultant in connection with the
performance of this Agreement shall be held confidential by Consultant. Such materials shall
not, without the prior written consent of City, be used by Consultant for any purposes other than
the performance of the services under this Agreement. Nor shall such materials be disclosed to
any person or entity not connected with the performance of the services under this Agreement.
Nothing furnished to Consultant which is otherwise known to Consultant or is generally known,
or has become known, to the related industry shall be deemed confidential. Consultant shall not
use City's name or insignia, photographs relating to project for which Consultant's services are
rendered, or any publicity pertaining to the Consultant's services under this Agreement in any
magazine, trade paper, newspaper, television or radio production or other similar medium
without the prior written consent of City.
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8. Consultant's Books and Records
a. Consultant shall maintain any and all ledgers, books of account, invoices,
vouchers, canceled checks, and other records or documents evidencing or relating to charges
for services, or expenditures and disbursements charged to City for a minimum period of three
(3) years, or for any longer period required by law, from the date of final payment to Consultant
to this Agreement.
b. Consultant shall maintain all documents and records which demonstrate
performance under this Agreement for a minimum period of three (3) years, or for any longer
period required by law, from the date of termination or completion of this Agreement.
C. Any records or documents required to be maintained pursuant to this Agreement
shall be made available for inspection or audit, at any time during regular business hours, upon
written request by the City Manager, City Attorney, City Auditor or a designated representative
of these officers. Copies of such documents shall be provided to the City for inspection at City
Hall when it is practical to do so. Otherwise, unless an alternative is mutually agreed upon, the
records shall be available at Consultant's address indicated for receipt of notices in this
Agreement.
d. Where City has reason to believe that such records or documents may be lost or
discarded due to dissolution, disbandment or termination of Consultant's business, City may, by
written request by any of the above -named officers, require that custody of the records be given
to the City and that the records and documents be maintained in City Hall. Access to such
records and documents shall be granted to any party authorized by Consultant, Consultant's
representatives, or Consultant's successor -in- interest.
9. Independent Contractor. It is understood that Consultant, in the performance of the work
and services agreed to be performed, shall act as and be an independent contractor and shall
not act as an agent or employee of the City. Consultant shall obtain no rights to retirement
benefits or other benefits which accrue to City's employees, and Consultant hereby expressly
waives any claim it may have to any such rights.
10. Interests of Consultant. Consultant (including principals, associates and professional
employees) covenants and represents that it does not now have any investment or interest in
real property and shall not acquire any interest, direct or indirect, in the area covered by this
Agreement or any other source of income, interest in real property or investment which would
be affected in any manner or degree by the performance of Consultant's services hereunder.
Consultant further covenants and represents that in the performance of its duties hereunder no
person having any such interest shall perform any services under this Agreement.
Consultant is not a designated employee within the meaning of the Political Reform Act
because Consultant:
a. will conduct research and arrive at conclusions with respect to his /her rendition of
information, advice, recommendation or counsel independent of the control and direction of the
City or of any City official, other than normal agreement monitoring; and
b. possesses no authority with respect to any City decision beyond rendition of
information, advice, recommendation or counsel. (FPPC Reg. 18700(a) (2).)
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11. Professional Ability of Consultant. City has relied upon the professional training and
ability of Consultant to perform the services hereunder as a material inducement to enter into
this Agreement. Consultant shall therefore provide properly skilled professional and technical
personnel to perform all services under this Agreement. All work performed by Consultant under
this Agreement shall be in accordance with applicable legal requirements and shall meet the
standard of quality ordinarily to be expected of competent professionals in Consultant's field of
expertise.
12. Compliance with Laws. Consultant shall use the standard of care in its profession to
comply with all applicable federal, state and local laws, codes, ordinances and regulations.
13. Licenses. Consultant represents and warrants to City that it has the licenses, permits,
qualifications, insurance and approvals of whatsoever nature which are legally required of
Consultant to practice its profession. Consultant represents and warrants to City that Consultant
shall, at its sole cost and expense, keep in effect or obtain at all times during the term of this
Agreement, any licenses, permits, insurance and approvals which are legally required of
Consultant to practice its profession.
14. Indemnity. Consultant agrees to defend, indemnify and hold harmless the City, its
officers, officials, agents, employees and volunteers from and against any and all claims,
demands, actions, losses, damages, injuries, and liability, direct or indirect (including any and all
costs and expenses in connection therein), arising out of the performance of this Agreement or
its failure to comply with any of its obligations contained in this Agreement, except for any such
claim arising out of the sole negligence or willful misconduct of the City, its officers, agents,
employees or volunteers.
15. Insurance Requirements.
a. Insurance. Consultant, at Consultant's own cost and expense, shall procure and
maintain, for the duration of the contract, the following insurance policies.
I. Workers' Compensation Coverage. Consultant shall maintain Workers'
Compensation Insurance and Employer's Liability Insurance for his /her
employees in accordance with the laws of the State of California. In addition,
Consultant shall require each subcontractor to similarly maintain Workers'
Compensation Insurance and Employer's Liability Insurance in accordance with
the laws of the State of California for all of the subcontractor's employees. Any
notice of cancellation or non - renewal of all Workers' Compensation policies must
be received by the City at least thirty (30) days prior to such change. The insurer
shall agree to waive all rights of subrogation against City, its officers, agents,
employees and volunteers for losses arising from work performed by Consultant
for City. In the event that Consultant is exempt from Workers' Compensation
Insurance and Employer's Liability Insurance for his /her employees in
accordance with the laws of the State of California, Consultant shall complete
and submit to the City a Certificate of Exemption from Workers Compensation
Insurance in the form attached hereto as Exhibit "B ".
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II. General Liability Coverage. Consultant shall maintain commercial
general liability insurance in an amount not less than one million dollars
($1,000,000) per occurrence for bodily injury, personal injury and property
damage. If a commercial general liability insurance form or other form with a
general aggregate limit is used, either the general aggregate limit shall apply
separately to the work to be performed under this Agreement or the general
aggregate limit shall be at least twice the required occurrence limit.
III. Automobile Liability Coverage. Consultant shall maintain automobile
liability insurance covering bodily injury and property damage for all activities of
the Consultant arising out of or in connection with the work to be performed
under this Agreement, including coverage for owned, hired and non -owned
vehicles, in an amount of not less than one million dollars ($1,000,000) combined
single limit for each occurrence.
IV. Professional Liability Coverage. Consultant shall maintain professional
errors and omissions liability insurance for protection against claims alleging
negligent acts, errors or omissions which may arise from Consultant's operations
under this Agreement, whether such operations by the Consultant or by its
employees, subcontractors, or subconsultants. The amount of this insurance
shall not be less than one million dollars ($1,000,000) on a claims -made annual
aggregate basis, or a combined single limit per occurrence basis.
b. Endorsements. Each general liability and automobile liability insurance policy
shall be with insurers possessing A.M. Best's rating of no less than A: VII and shall be endorsed
with the following specific language:
I The City, its elected or appointed officers, officials, employees, agents
and volunteers are to be covered as additional insured's with respect to liability
arising out of work performed by or on behalf of the Consultant, including
materials, parts or equipment furnished in connection with such work or
operations.
II. This policy shall be considered primary insurance as respects the City, its
elected or appointed officers, officials, employees, agents and volunteers. Any
insurance maintained by the City, including any self- insured retention the City
may have shall be considered excess insurance only and shall not contribute
with it.
111. This insurance shall act for each insured and additional insured as though
a separate policy had been written for each, except with respect to the limits of
liability of the insuring company.
IV. The insurer waives all rights of subrogation against the City, its elected or
appointed officers, officials, employees or agents.
V. Any failure to comply with reporting provisions of the policies shall not
affect coverage provided to the City, its elected or appointed officers, officials,
employees, agents, or volunteers.
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VI. The insurance provided by this Policy shall not be suspended, voided,
canceled, or reduced in coverage or in limits except after thirty (30) days written
notice has been received by the City.
C. Deductibles and Self- Insured Retentions. Any deductibles or self- insured
retentions must be declared to and approved by the City. At the City's option, Consultant shall
demonstrate financial capability for payment of such deductibles or self- insured retentions.
d. Certificates of Insurance. Consultant shall provide certificates of insurance with
original endorsements to City as evidence of the insurance coverage required herein.
Certificates of such insurance shall be filed with the City on or before commencement of
performance of this Agreement. Current certification of insurance shall be kept on file with the
City at all times during the term of this Agreement.
16. Notices. Any notice required to be given under this Agreement shall be in writing and
either served personally or sent prepaid, first class mail. Any such notice shall be addressed to
the other party at the address set forth below. Notice shall be deemed communicated within 48
hours from the time of mailing if mailed as provided in this section.
If to City: City of Lake Elsinore
Attn: City Manager
130 South Main Street
Lake Elsinore, CA 92530
If to Consultant: STK Architecture, Inc.
Attn: G.V. Salts
42095 Zevo Drive, Suite A15
Temecula, CA 92590 -3780
17. Entire Aqreement. This Agreement constitutes the complete and exclusive statement of
Agreement between the City and Consultant. All prior written and oral communications,
including correspondence, drafts, memoranda, and representations, are superseded in total by
this Agreement.
18. Amendments. This Agreement may be modified or amended only by a written document
executed by both Consultant and City and approved as to form by the City Attorney.
19. Assignment and Subcontracting. The parties recognize that a substantial inducement to
City for entering into this Agreement is the professional reputation, experience and competence
of Consultant and the subcontractors listed in Exhibit "A" Consultant shall be fully responsible to
City for all acts or omissions of any subcontractors. Assignments of any or all rights, duties or
obligations of the Consultant under this Agreement will be permitted only with the express
consent of the City. Consultant shall not subcontract any portion of the work to be performed
under this Agreement except as provided in Exhibit "A" without the written authorization of the
City. If City consents to such subcontract, Consultant shall be fully responsible to City for all
acts or omissions of those subcontractors. Nothing in this Agreement shall create any
contractual relationship between City and any subcontractor nor shall it create any obligation on
the part of the City to pay or to see to the payment of any monies due to any such subcontractor
other than as otherwise is required by law.
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20. Waiver. Waiver of a breach or default under this Agreement shall not constitute a
continuing waiver of a subsequent breach of the same or any other provision under this
Agreement.
21. Severabilitv. If any term or portion of this Agreement is held to be invalid, illegal, or
otherwise unenforceable by a court of competent jurisdiction, the remaining provisions of this
Agreement shall continue in full force and effect.
22. Controlling Law Venue. This Agreement and all matters relating to it shall be governed
by the laws of the State of California and any action brought relating to this Agreement shall be
held exclusively in a state court in the County of Riverside.
23. Litigation Expenses and Attorneys' Fees. If either party to this Agreement commences
any legal action against the other party arising out of this Agreement, the prevailing party shall
be entitled to recover its reasonable litigation expenses, including court costs, expert witness
fees, discovery expenses, and attorneys' fees.
24. Mediation. The parties agree to make a good faith attempt to resolve any disputes
arising out of this Agreement through mediation prior to commencing litigation. The parties shall
mutually agree upon the mediator and share the costs of mediation equally. If the parties are
unable to agree upon a mediator, the dispute shall be submitted to JAMS /ENDISPUTE
( "JAMS ") or its successor in interest. JAMS shall provide the parties with the names of five
qualified mediators. Each party shall have the option to strike two of the five mediators selected
by JAMS and thereafter the mediator remaining shall hear the dispute. If the dispute remains
unresolved after mediation, either party may commence litigation.
25. Execution. This Agreement may be executed in several counterparts, each of which
shall constitute one and the same instrument and shall become binding upon the parties when
at least one copy hereof shall have been signed by both parties hereto. In approving this
Agreement, it shall not be necessary to produce or account for more than one such counterpart.
26. Authority to Enter Agreement. Consultant has all requisite power and authority to
conduct its business and to execute, deliver, and perform the Agreement. Each party warrants
that the individuals who have signed this Agreement have the legal power, right, and authority to
make this Agreement and to bind each respective party.
27. Prohibited Interests. Consultant maintains and warrants that it has not employed nor
retained any company or person, other than a bona fide employee working solely for
Consultant, to solicit or secure this Agreement. Further, Consultant warrants that it has not paid
nor has it agreed to pay any company or person, other than a bona fide employee working
solely for Consultant, any fee, commission, percentage, brokerage fee, gift or other
consideration contingent upon or resulting from the award or making of this Agreement. For
breach or violation of this warranty, City shall have the right to rescind this Agreement without
liability. For the term of this Agreement, no member, officer or employee of City, during the term
of his or her service with City, shall have any direct interest in this Agreement, or obtain any
present or anticipated material benefit arising there from.
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28. Equal Opportunity Employment. Consultant represents that it is an equal opportunity
employer and it shall not discriminate against any subcontractor, employee or applicant for
employment because of race, religion, color, national origin, handicap, ancestry, sex or age.
Such non - discrimination shall include, but not be limited to, all activities related to initial
employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff or
termination. Consultant shall also comply with all relevant provisions of City's Minority Business
Enterprise program, Affirmative Action Plan or other related programs or guidelines currently in
effect or hereinafter enacted.
IN WITNESS WHEREOF the parties have caused this Agreement to be executed on the
date first written above.
CITY OF LAKE ELSINORE:
ATTEST:
City Clerk
APPROVED AS TO FORM:
City Attorney
CONSULTANT:
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EXHIBIT A
CONSULTANTS PROPOSAL/
SCHEDULE OF CHARGES
Page 12 of 16
August 20, 2012
Peter Ramey, Project Manager
City of Lake Elsinore
130 S. Main Street
Lake Elsinore, CA 92530
RE: City of Lake Elsinore — City Hall and Cultural Center
Architectural Finishes Design for Seismic Upgrade
Dear Mr. Ramey,
STK Architecture, Inc. is pleased to provide a proposal for services for the above
mentioned project. This proposal is based upon our discussion at the project site on
August 16, 2012. My understanding of the scope of work is as follows:
Provide drawings and specifications for the replacement / repair of architectural finishes
that will most likely need to be removed to retrofit concrete shear walls at the interior of
both buildings. The City also wishes to install a fire sprinkler system in both buildings.
This can be done as a contractor design build system.
For the above scope of work, STK Architecture, Inc. proposes an hourly not to exceed
fee of $22,000. The fee will be billed per the hourly rate schedule below.
The above Proposal is based upon the following assumptions:
A. Owner will provide CAD base plans.
B. Work shall be limited to the areas impacted by shear walls only.
C. No consultants will be required.
This fee does not include any of the following:
a. Permit, Development, Utility or Processing Fees
b. Soil Reports or Geotechnical Engineering
c. Material testing (i.e. concrete, welding, etc.)
d. Specialty consultants (i.e. Hazardous Waste, Traffic, Archeological, etc.)
e. Security Engineering.
f. Asbestos Engineering /abatement engineering and or testing.
g. Fire sprinkler Design and Engineering, fire sprinkler water service upgrade or fire
hydrant upgrade engineering
ARCHITECTURE INTERIOR DESIGN PLANNING
42095 Zevo Drive, Suite At 5, Temecula, California 92590 -3780 Phone: 951/296 -9110 Paz: 951/296 -6079 E -Mail: stk@stkinacom
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City of Lake Elsinore
Page 2 of 2
h. Interior Design / M &P Engineering / Structural Engineering.
i. Deliverables beyond one set at each phase.
The fee will be invoiced monthly, based on the percentage of work completed, plus any
reimbursable expenses. Any invoices unpaid 45 days after the invoice date will bear
interest at the rate of 1.5% per month, or 18% per year. STK Architecture, Inc. assumes
the contract will be executed on a standard AIA B141 Contract, edited to suit the project
specifics. Please also note that STK Architecture, Inc. carries $1,000,000 of Professional
Liability coverage and can provide all the required insurance coverage requested. If
extra services are required, and approved by the Owner, the following hourly rates would
apply:
Principal
$185
Associate
$135
Project Manager
$115
Senior Draftsman
$85
Junior Draftsman
$70
Clerical
$48
Consultants
Cost x 1.15
Reimbursable Expenses
Cost x 1.05
Reimbursable Agency Fee
Cost x 1.15
Thank you for the opportunity to propose on this project. We look forward to once again
working with the City of Lake Elsinore. Should you have any questions, or wish to
discuss this Proposal, please give me a call.
Sincerely,
Tohy Finaldi, Architect, LEED® AP
Senior Associate
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EXHIBIT B
EXEMPTION FROM WORKERS COMPENSATION
Page 15 of 16
CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
I hereby certify that in the performance of the work for which this Agreement is entered
into, I shall not employ any person in any manner so as to become subject to the Workers'
Compensation Laws of the State of California
Executed on this day of , 201_ at
California.
Consultant
Not Applicable
}
Consultant
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