Common use of TYPE OF SUBMISSION Clause in Contracts

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'

Appears in 1 contract

Sources: Child Care Benefit Service Management Agreement

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇_7/29/2021___________________ 05/03/2022 ▇▇▇▇▇▇ ▇▇▇▇▇, CEO 10/25/2024 Qualified Manager Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇07/29/2021 05/03/2022 ▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'08/24/2022

Appears in 1 contract

Sources: Security Services Agreement

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'. I. City’s Equal Opportunity Contracting Commitment.

Appears in 1 contract

Sources: Contract for Education and Community Outreach Services

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇ . ▇▇▇▇▇▇, CEO 10/25/2024 Chief Administrative Officer Name and Title Signature Date 12/16/2022 Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇ ▇. ▇▇▇▇▇▇, Chief Administrative Officer Print Name, Title DocuSign Envelope ID: 2199EA8D-5DD3-4590-9751-B4D7931794D7 The objective of the Equal Employment Opportunity Outreach Program, San Diego Municipal Code Sections 22.3501 through 22.3517, is to ensure that contractors doing business with the City, or receiving funds from the City, do not engage in unlawful discriminatory employment practices prohibited by State and Federal law. Such employment practices include, but are not limited to unlawful discrimination in the following: employment, promotion or upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rate of pay or other forms of compensation, and selection for training, including apprenticeship. Contractors are required to provide a completed Work Force Report (WFR). Type of Contractor: 🞎 Construction 🞎 Vendor/Supplier 🞎 Financial Institution 🞎 Lessee/Lessor 🞎 Consultant 🞎 Grant Recipient 🞎 Insurance Company 🞎 Other Name of Company: OpenGov, Inc. ADA/DBA: Address (Corporate Headquarters, where applicable): ▇▇▇▇ ▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇. #▇▇▇▇▇ Digitally signed by City: San ▇▇▇▇ County: Santa ▇▇▇▇▇ State: CA Zip: 95160 Telephone Number: (▇▇) ▇▇▇-▇▇▇▇ Fax Number: Name of Company CEO: Address(es), phone and fax number(s) of company facilities located in San Diego County (if different from above): Address: City: County: State: Zip: Telephone Number: Fax Number: Email: Type of Business: Type of License: The Company has appointed: ▇▇▇▇▇ ▇▇▇▇▇ As its Equal Employment Opportunity Officer (EEOO). The EEOO has been given authority to establish, disseminate and enforce equal employment and affirmative action policies of this company. The EEOO may be contacted at: Address: ▇▇▇▇ 10/25/2024 _Lezama Date▇▇▇▇▇ ▇▇▇▇. #▇▇▇▇▇ ( ) (▇▇▇) ▇▇▇-▇▇▇▇ Telephone Number: 2024.10.25 17:01:10 -07'00'Fax Number: Email: ▇▇@▇▇▇▇▇▇▇.▇▇▇ 🞏 One San Diego County (or Most Local County) Work Force - Mandatory 🞏 Branch Work Force * 🞏 Managing Office Work Force I, the undersigned representative of OpenGov, Inc. San Mateo , California hereby certify that information provided herein is true and correct. This document was executed on this 16 day of December , 20 . 22 (Authorized Signature) ▇▇▇▇▇ ▇▇▇▇▇ NAME OF FIRM: DATE: OFFICE(S) or BRANCH(ES): N/A COUNTY: INSTRUCTIONS: For each occupational category, indicate number of males and females in every ethnic group. Total columns in row provided. Sum of all totals should be equal to your total work force. Include all those employed by your company on either a full or part- time basis. The following groups are to be included in ethnic categories listed in columns below: (1) Black or African-American (5) Native Hawaiian or Pacific Islander (2) Hispanic or Latino (6) White (3) Asian (7) Other race/ethnicity; not falling into other groups (4) American Indian or Alaska Native Definitions of the race and ethnicity categories can be found on Page 4 ADMINISTRATION OCCUPATIONAL CATEGORY (1) Black or African American (2) Hispanic or Latino (3) Asian (4) American Indian/ Nat. Alaskan (5) Pacific Islander (6) White (7) Other Race/ Ethnicity (M) (F) (M) (F) (M) (F) (M) (F) (M) (F) (M) (F) (M) (F) A&E, Science, Computer Administrative Support 1 3 0 1 Services Crafts Operative Workers Transportation Laborers* *Construction laborers and other field employees are not to be included on this page Totals Each Column 6 6 26 8 29 29 2 1 1 178 105 136 38 565 Indicate by Gender and Ethnicity the Number of Above Employees Who Are Disabled: Non-Profit Organizations Only: Volunteers Artists NAME OF FIRM: DATE: OFFICE(S) or BRANCH(ES): COUNTY: INSTRUCTIONS: For each occupational category, indicate number of males and females in every ethnic group. Total columns in row provided. Sum of all totals should be equal to your total work force. Include all those employed by your company on either a full or part- (1) Black or African-American (5) Native Hawaiian or Pacific Islander (2) Hispanic or Latino (6) White (3) Asian (7) Other race/ethnicity; not falling into other groups (4) American Indian or Alaska Native Definitions of the race and ethnicity categories can be found on Page 4 TRADE OCCUPATIONAL CATEGORY (1) Black or African American (2) Hispanic or Latino (3) Asian (4) American Indian/ Nat. Alaskan (5) Pacific Islander (6) White (7) Other Race/ Ethnicity (M) (F) (M) (F) (M) (F) (M) (F) (M) (F) (M) (F) (M) (F) Brick, Block or Stone Masons Carpenters Carpet, Floor & Tile Installers Finishers Cement Masons, Concrete Finishers Construction Laborers Drywall Installers, Ceiling Tile Inst Electricians Elevator Installers First-Line Supervisors/Managers Glaziers Helpers; Construction Trade Millwrights Misc. Const. Equipment Operators Painters, Const. & Maintenance Pipelayers, Plumbers, Pipe & Steam Fitters Plasterers & Stucco Masons Roofers Security Guards & Surveillance Officers Sheet Metal Workers Structural Metal Fabricators & Fitters Welding, Soldering & Brazing Workers Workers, Extractive Crafts, Miners Iindicate By Gender and Ethnicity the Number of Above Employees Who Are Disabled: DocuSign Envelope ID: 2199EA8D-5DD3-4590-9751-B4D7931794D7 The Work Force Report (WFR) is the document that allows the City of San Diego to analyze the work forces of all firms wishing to do business with the City. We are able to compare the firm’s work force data to County Labor Force Availability (CLFA) data derived from the United States Census. CLFA data is a compilation of lists of occupations and includes the percentage of each ethnicity we track (American Indian or Alaska Native, Asian, Black or African-American, Native Hawaiian or Pacific Islander, White, and Other) for each occupation. Currently, our CLFA data is taken from the 2010 Census. In order to compare one firm to another, it is important that the data we receive from the consultant firm is accurate and organized in the manner that allows for this fair comparison.

Appears in 1 contract

Sources: Software Services Agreement

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and signed.and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, CEO 10/25/2024 Principal/ Managing Partner Name and Title Signature 10.20.2022 �I a Date Contractor Standards Form Revised: April 5. 20 I 8 Document No. 841283_4 Pagcllofl2 Provide additional information in space below. Use additional Attachment "A" pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing t · oregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Principal / Managing Partner 10.20.2022 Print Name, Title Contractor Standards Form Revised: April 5. 2018 Document o. 841283_4 ------.,L-,,£..---'.!: ..::::::.. Signature Date: 2024.10.25 17:01:10 -07'00'

Appears in 1 contract

Sources: Consultant Services Agreement

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Signature Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 President 07/31/2023 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank Signature I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇, President 07/31/2023 Office of Labor Standards Enforcement Company Name: Field Data Services of Arizona, Inc. Company Address: ▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇., CEO ▇▇▇▇▇▇▇▇, ▇▇ Digitally signed by ▇▇▇▇▇ Company Contact Name: ▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Contact Phone: (▇▇▇) ▇▇▇-▇▇▇▇ Contract Number (if no number, state location): 10090058-24-C Start Date: 2024.10.25 17:01:10 -07'00'08/01/2023 Contract Title (or description: Traffic Data Gathering Services End Date: 08/01/2028 Purpose/Service Provided: Traffic data gathering counts for turning mo vement counts, speed/classification/volume counts, pedestrian counts A contractor or subcontractor working on or under the authority of an agreement subject to the Living Wage Ordinance [LWO] must comply with all applicable provisions unless specifically approved for an exemption. Basic requirements of the LWO are: (a) Pay covered employees the current fiscal year hourly wage rate; (b) If any lesser amount is applied toward the health benefits rate, add this difference to the hourly wage rate as cash; (c) Provide minimum of 80 compensated leave hours per year for illness, vacation, or personal need at the employee’s request and permit 80 additional unpaid leave hours for personal or family illness when accrued compensated leave hours have been used; (d) Annually distribute a notice with the first paycheck after July 1 to inform all covered employees of LWO requirements, their possible right to Federal Earned Income Tax Credit, and possible availability of health insurance coverage under the Affordable Care Act; (e) Prohibit retaliation against any covered employee who alleges noncompliance with the requirements of the LWO; (f) Permit access for authorized City representatives to work sites and records to review compliance with the LWO; and (g) Maintain wage and benefit records for covered employees for 3 years after final payment. If a subcontractor fails to submit this completed form, the prime contractor may be found in violation of the LWO for failure to ensure its subcontractor’s compliance. This may result in a withholding of payments or termination of the agreement. By signing, the contractor certifies under penalty of perjury under laws of the State of California to the following: (a) comply with the requirements of the Living Wage Ordinance; and (b) will perform at least fifty percent (50%) of the work with its own employees. ▇▇▇▇▇ ▇▇▇▇▇▇ President 07/31/2023 Contract Number: LWO Analyst: Date of Receipt: LWP-002 (rev. 04/12/2022)

Appears in 1 contract

Sources: Contract Resulting From Invitation to Bid

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 ▇ Chief Revenue Officer Name and Title Signature Date Contractor Standards Form Revised: April 5, 2018 Document No. 841283_4 Concord - DoPcuagmee1n1t IoDf: 1Z2GJmMzU2ZWQtNj 52-60 Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank CalAmp has been subject to litigation typical of the course of doing business. These matters are detailed in our SEC filings. I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama DateChief Revenue Officer Contractor Standards Form Revised: 2024.10.25 17:01:10 -07'00'April 5, 2018 Concord - Document ID: ZGJmMzU2ZWQtNj 54-60 Concord - Document ID: ZGJmMzU2ZWQtNj 55-60

Appears in 1 contract

Sources: Cooperative Procurement Contract

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 Account Executive 10/28/22 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank Prior name: ▇▇▇▇▇▇, Inc New name: ▇▇▇▇▇▇ ▇▇▇▇▇▇, Inc address is still the same. I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'Account Executive 10/28/22

Appears in 1 contract

Sources: Contract Resulting From Invitation to Bid

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and agree to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 PE Vice President 09/10/2024 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank If not using this Attachment “A”, please check here Not Applicable. Company Name: Allied Geotechnical Engineers, Inc. Contact Name and Phone Number: ▇▇▇▇ ▇▇▇▇▇▇▇ | ▇▇▇-▇▇▇-▇▇▇▇ Contact Email: ▇_▇▇▇▇▇▇▇@▇▇▇▇▇▇▇▇▇.▇▇▇ Address: ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇▇▇ ▇▇▇, ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ Contract Date: TBD Contract Amount: TBD Requirements of the Contract: Geology & Geotechnical Engineering What Portion of the work will be assigned to this subcontractor: 6% Is the Subcontractor a certified SLBE, ELBE, MBE, DBE, DVBE, or OBE? (Check One) YES ☒ NO☐ Company Name: Balk Biological, Inc. Contact Name and Phone Number: ▇▇▇▇▇▇▇▇ ▇▇▇▇ | ▇▇▇-▇▇▇-▇▇▇▇ Contact Email: ▇▇▇▇▇@▇▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇ Address: ▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇, Suite 223, Carlsbad, CA 92008 Contract Date: TBD Contract Amount: TBD Requirements of the Contract: Biological Consulting What Portion of the work will be assigned to this subcontractor: 5% Is the Subcontractor a certified SLBE, ELBE, MBE, DBE, DVBE, or OBE? (Check One) YES ☒ NO☐ Company Name: Dudek Contact Name and Phone Number: ▇▇▇▇▇▇ ▇▇▇▇▇▇ | ▇▇▇-▇▇▇-▇▇▇▇ Contact Email: ▇▇▇▇▇▇▇@▇▇▇▇▇.▇▇▇ Address: ▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇, ▇▇▇▇▇ ▇▇▇, ▇▇▇ ▇▇▇▇▇, ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇ Contract Date: TBD Contract Amount: TBD Requirements of the Contract: Environmental What Portion of the work will be assigned to this subcontractor: 25% Is the Subcontractor a certified SLBE, ELBE, MBE, DBE, DVBE, or OBE? (Check One) YES ☒ NO☐ I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto Attachment “A”(s) there to and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed PE Vice President 9/10/2024 Signature Date Except for public works projects of one thousand dollars ($1,000) or less, not less than the general prevailing rate of per diem wages for work of a similar character in the locality in which the public work is performed, and not less than the general prevailing rate of per diem wages for holiday and overtime work fixed as provided in this chapter, shall be paid to all workers employed on public works. This section is applicable only to work performed under contract, and is not applicable to work carried out by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'a public agency with its own forces. This section is applicable to contracts let for maintenance work. As used in this chapter, “public works” means:

Appears in 1 contract

Sources: Design Agreement

TYPE OF SUBMISSION. This document is submitted as: Pledge of Compliance Initial submission. OR Update to prior Pledge of Compliance dated / / Complete all questions and sign below.. Under penalty of perjury under the laws of the State of California, I certify that I have read and understand the questions contained in this Pledge of Compliance, that I am responsible for completeness and accuracy of the responses contained herein, and that all information provided is true, full and complete to the best of my knowledge and belief. I agree to provide written notice to the Purchasing Agent within five (5) business days if, at any time, I learn that any portion of this Pledge of Compliance requires an updated response. Failure to timely provide the Purchasing Agent with written notice is grounds for Contract termination. I, on behalf of the firm, further certify that I and my firm will comply with the following provisions of SDMC section 22.3004: (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and agree to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-non- responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank If not using this Attachment “A”, please check here Not Applicable. I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto Attachment “A”(s) there to and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇correct Print Name, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'Title Signature Date Public Works Contracts – Contractor Standards Pledge of Compliance 10 of 10 Revised 02-01-18 Use the "Disclosure Determination for Consultantn form (CC-1671) to report the disclosure requirement for any consultant hired to provide services to the City of San Diego or the boards, commissions and agencies that fall under the City of San Diego's jurisdiction.

Appears in 1 contract

Sources: Sole Source Agreements

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'. I. City’s Equal Opportunity Contracting Commitment.

Appears in 1 contract

Sources: Consultant Services Agreement

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will firmwill cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with formwith the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇ . ▇▇▇▇▇▇, CEO 10/25/2024 President September 7, 2021 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'.

Appears in 1 contract

Sources: Contract for Legal Services

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 Signature Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00' I. City’s Equal Opportunity Contracting Commitment.

Appears in 1 contract

Sources: Contract Resulting From Request for Proposal

TYPE OF SUBMISSION. This document is submitted as: Pledge of Compliance Initial submission. OR mm/dd/yyyy Complete all questions and sign below.. Under penalty of perjury under the laws of the State of California, I certify that I have read and understand the questions contained in this Pledge of Compliance, that I am responsible for completeness and accuracy of the responses contained herein, and that all information provided is true, full and complete to the best of my knowledge and belief. I agree to provide written notice to the Purchasing Agent within five (5) business days if, at any time, I learn that any portion of this Pledge of Compliance requires an updated response. Failure to timely provide the Purchasing Agent with written notice is grounds for Contract termination. I, on behalf of the firm, further certify that I and my firm will comply with the following provisions of SDMC section 22.3004: (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and agree to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'.

Appears in 1 contract

Sources: Agreement for Design of San Carlos Interconnect and Transmission Pipeline

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and agree to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by . ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date, P.E, Vice President September 9, 2024 Name and Title Signature Date B. Bidder Proposer Information - (key persons of interest continued) Name: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 Name P.E. Title/Position: Civil Engineer City and Title Signature Date Provide additional information State of Residence: San Diego, CA Employer (if different than Bidder/Proposer): n/a Interest in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank the transaction: 0% I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto Attachment “A”(s) there to and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'.

Appears in 1 contract

Sources: Design Agreement

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇▇▇▇▇, CEO 10/25/2024 April 11, 2023 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'April 11, 2023

Appears in 1 contract

Sources: Community Survey Agreement

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will firmwill cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with formwith the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇ . ▇▇▇▇▇▇, CEO 10/25/2024 President September 7, 2021 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'. I. City’s Equal Opportunity Contracting Commitment.

Appears in 1 contract

Sources: Contract for Legal Services

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below.: (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 ▇ 3/8/23 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 3/8/23 Complete this form and return via Email to: ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇@▇▇▇▇▇▇▇▇▇▇ ▇▇▇.▇▇▇ 10/25/2024 _Lezama Company Name: Company Address: Company Contact Name: Contact Phone: Contract Number (if none, purchase order number): Start Date: 2024.10.25 17:01:10 -07'00'Contract Title (or description): End Date:

Appears in 1 contract

Sources: Services Agreement

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Signature Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 3/10/23 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank N/A I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'3/10/23

Appears in 1 contract

Sources: Contract Resulting From Invitation to Bid

TYPE OF SUBMISSION. This document is submitted as: Complete all questions and sign below. (a) I and my firm will comply with all applicable local, State and Federal laws, including health and safety, labor and employment, and licensing laws that affect the employees, worksite or performance of the contract. (b) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of receiving notice that a government agency has begun an investigation of me or my firm that may result in a finding that I or my firm is or was not in compliance with laws stated in paragraph (a). (c) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of a finding by a government agency or court of competent jurisdiction of a violation by the Contractor of laws stated in paragraph (a). (d) I and my firm will notify the Purchasing Agent in writing within fifteen (15) calendar days of becoming aware of an investigation or finding by a government agency or court of competent jurisdiction of a violation by a subcontractor of laws stated in paragraph (a). (e) I and my firm will cooperate fully with the City during any investigation and to respond to a request for information within ten (10) working days. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ Date: 2024.10.25 17:00:30 -07'00' Signature Failure to sign and submit this form with the bid/proposal shall make the bid/proposal non-responsive. In the case of an informal solicitation, the contract will not be awarded unless a signed and completed Pledge of Compliance is submitted. ▇▇▇▇▇ ▇ ▇▇▇▇▇ ▇▇▇▇▇▇, CEO 10/25/2024 2/3/2022 Name and Title Signature Date Provide additional information in space below. Use additional Attachment “A” pages as needed. Each page must be signed. Print in ink or type responses and indicate question being answered. Purposefully left blank ▇▇▇▇▇ ▇ ▇▇▇▇▇▇▇, CEO of Kosmont & Associates, Inc. dba Kosmont Companies, is also 100% owner of Kosmont & Assocites, Inc., and is also 100% owner of: Kosmont Real Estate Services, dba Kosmont Realty, a full servie and licensed real estate brokerage firm Kosmont Transactions Services, Inc., a public finance firm providing financial advisory services, and is registered with the SEC I have read the matters and statements made in this Contractor Standards Pledge of Compliance and attachments thereto and I know the same to be true of my own knowledge, except as to those matters stated upon information or belief and as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇- CEO Print Name, CEO ▇▇▇▇▇▇▇▇▇▇ Digitally signed by ▇▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ 10/25/2024 _Lezama Date: 2024.10.25 17:01:10 -07'00'Title 2/3/2022

Appears in 1 contract

Sources: Consultant Services Agreement