INTRODUCTION TO GOSS ENGINEERING

INTRODUCTION TO GOSS ENGINEERING STATEMENT OF QUALIFICATIONSRFP No. 19-016CAOn-Call Engineering & Professional Consulting Services

255 E. Rincon St., Suite 301 Corona, CA 92879www.gossengineering.com(951) 340-1977

Mr. Carol Appelt,

Subject: Request for Qualifications – Electrical Engineering

Dear Mr. Carol Appelt,

Thank you for the opportunity to submit the enclosed Statement of Qualifications (SOQ) to (The City of Corona Department of Water and Power) in regards to providing Electrical Engineering services.

Goss is a corporation founded in 1994. We strive for enduring excellence on all projects to provide solutions that will serve our clients for decades. Our clients benefit from the extensive participation of our experienced engineers on every project. Consistently going beyond our clients’ expectations, we take pride in providing outstanding services. In addition, our work is carefully coordinated to be on time and in budget. The seasoned team is made up of engineers, designers, AutoCAD operators, administrative staff, and subcontractors ready to take any project from initial concept to successful completion.

Goss Identification

Firm Name: Business Address:

: Phone Number Fax Number: Email: Federal Tax ID:California Corp. No.:

Goss Engineering, Inc. 255 E. Rincon St., Suite 301 Corona, CA 92879(951) 340-1977(951) [email protected]

We acknowledge that we received the RFQ for this addenda and our Statement of Qualifications shall remain valid for a period of no less than ninety (90) days from the due date of proposal. All information contained in this RFQ is not confidential and does not need to be withheld from disclosure to others.

PROPOSER’S AUTHORIZED SIGNATURE:I have read, understood, and agreed to all statements in this request for proposal and acknowledge receipt of all addendums/amendments as well as to the terms, conditions, and attachments referenced.

SIGNED:_____________________________________________ DATE:_______________________________________________ NAME:_________________________________________ TITLE:_______________________________________________

Principal: Address:

Email:

Nick Ubrun255 E. Rincon St., Suite 301 Corona, CA 92879 [email protected]

Phone Number: (951) 340-1977

12-18-18

PrincipalNick Ubrun

meet their project requirements, but also create opportunities to maximize energy savings, increase system reliability and reduce costs. Our experienced staff of mechanical, electrical, and plumbing engineers specialize in successfully analyzing complex problems to provide innovative solutions while meeting the clients’ specific budgetary needs and reducing their carbon footprint and operating costs.

Founded in 1994, Goss Engineering is a corporation that specializes in planning, design, management, and the commissioning of HVAC systems for public and private organizations. Our firm is located in Corona CA. and consists of 26 employees. We have successfully implemented projects at major universities, hospitals, schools, governmental agencies, private firms and large theme parks. Our focus has always been to deliver high-quality engineering services that provide our clients with solutions that not only

What we doGoss Engineering’s area of expertise includes the planning, study, design, and commissioning of:• Heating, Ventilation, and Air Conditioning (HVAC)• Chiller and Boiler Replacements and Central Plant Upgrade• Thermal and Electrical Distribution Systems• Facility and Utility Infrastructure• Control Systems• Thermal Energy Storage Feasibility and Design

Who we are We are Mechanical, Electrical, and Plumbing (MEP) Engineers with expertise with a variety of projects. We adhere to proven engineering processes to deliver accurate analysis, project designs, high-quality design services and well-coordinated documentation. We have the capacity to provide full-service engineering as required as we have close professional relationships with structural sub-consultants with whom we work seamlessly.

Firms financial condition is in good standings and has no bankruptcy, pending litigation, planned office closures, and or impending merges.

Goss Engineering’s experience in electrical engineering has encompassed a variety of Planning, Management, Design/Build and Commissioning of Projects involving low voltage power systems, utility infrastructure upgrade projects, programming, indoor & outdoor lighting systems, backup generation systems, UPS systems and fire life safety systems, as well as medium voltage power distribution systems. Project experience has included K-12 Schools, Colleges, Universities, Municipal Buildings, Data Processing Centers, Retail Centers, and Healthcare Facilities. Such mentioned experience comprises GEI’s experience and knowledge of safety regulations and practices required by authorized agencies and/or governments. Goss Engineering has encouraged every member to undergo all safety programs, seminars and trainings outlining policies and procedures regarding health and safety in every project as required. Each member has become familiar with the program, following and enforcing the procedures, and become an active participant in every Electrical Safety Program and Training.

George LwinSustainability Manager3801 W Temple Ave, Pomona, CA 91768(909) 869-3034

Ken KolegraffProject ManagerSan Luis Obispo, CA 93407(805) 756-6543

Drew HechtPrincipal Architect900 University Ave, Riverside, CA 92521(951) 827-7358

Sub-consultantsVCA Engineers Inc.Discipline: Structural EngineerAddress: 1041 S. Garfield Ave., Suite 210, Alhambra, CA 91801 Phone: 323-729-6098Contact: Mr. Young Nam

References

Lundstrom & Associates Architects Discipline: ArchitectsAddress: 5, Corporate Park #200, Irvine, CA 92606 Phone: 949-250-1772Contact: Jon Lundstrom

NICK UBRUN, PEAs Principal, Nick Ubrun utilizes his extensive project experience to lead a driven engineering team to develop solutions to a variety of projects and problems. Nick is a licensed professional mechanical engineer with over nine years of mechanical and plumbing design and planning experience in the industry. Nick’s clients include major universities, government agencies, schools, major theme parks and private firms.

Additionally, Nick’s experience has included the planning and design of central heating and cooling plants, cogeneration systems, laboratory retrofits, and building HVAC systems, including several LEED certified projects.

Nick has also successfully assisted clients with preparing project programming requirements in order to maximize energy savings and system reliability while minimizing the cost to the client.

EducationBS Mechanical Engineering, University of California, Riverside

Professional LicenseMechanical Engineer, CA M35378

Contact Information255 E. Rincon St., Suite 301 Corona, CA 92879

[email protected]

(951) 340-1977

FACILITY ASSESSMENTS

• Lothian MEP Infrastructure Assessment;University of California, Riverside

• Building 19 Facility Assessment andProgramming; San Luis Obispo,CA

• North County Regional Center ThermalEnergy Storage Assessment; County ofSan Diego

• Building 13, 15, 17 BMS ControlAssessment; California Polytechnic StateUniversity, CA

• Campbell Hall Facility ConditionAssessment; University of California, Santa Barbara

• Campus wide Boiler Assessment andCompliance Planning; University ofCalifornia, Santa Barbara

• Reed Neurological Center EnergyReduction Study;University of California, Los Angeles

• Chilled Water Master Plan;University of California, Irvine MedicalCenter

• Bourns Hall Lab Mechanical SystemAssessment; University of California,Riverside

• Kinesiology Rooftop EquipmentAssessment; San Luis Obispo,CA

• Campus wide Heating Hot WaterSystem Assessment; San Luis Obispo,CA

• Graphic Arts Building MEP Assessment;California Polytechnic State University,CA

• Buena Park Fire Station 63;Buena Park, CA

• Santa Lucia Fire Alarm;San Luis Obispo, CA

• Sessions Woodbridge;Irvine, CA

• Chilled Water Coil Replacement;University of California, Riverside

• Chapman Hall Roof Replacement;University of California, Riverside

• Moreto Mathison & AssociatesBrotman Hall; Long Beach, CA

• University Union Surfboard Shop;San Luis Obispo, CA

• Rubidoux Greenhouse WaterBooster; University of California,Riverside

• Boyce 5478 Hall Grow Room;University of California, Riverside

• Library Room 209 BuildOut;California Polytechnic StateUniversity, CA

• Mott Gym Room TI;California Polytechnic StateUniversity, CA

• CPMS 3133 Chemical Science 0164;University of California, Riverside

• OCPW 2301 Glassell Package UnitReplacement; Santa Ana, CA

• Pomona College Seeley Mudd TI – MEP;Pomona, CA

• Bldg. 19 Infrastructure Analysis;San Luis Obispo, CA

• Bldg. 33 Office Remodel;California Polytechnic State University,CA

• 5030 Campus TI and BuildingImprovements; Santa Ana, CA

• Kinesiology Rooftop UnitReplacement; California Polytechnic State University, CA

• Building 52-E5 Office Convector;California Polytechnic State University,CA

BUILDING MEP EXPERIENCE

ED BURTCH, PE, LEED, AP BD+CEd Burtch is an electrical engineer with over 30 years of project engineering and electrical design experience.

His experience in electrical engineering encompasses a variety of design projects involving low and medium voltage power distribution systems, lighting and electrical vehicle charging stations.

Ed’s project experience included K-12 schools, university, municipal buildings, data processing centers, retail centers and health care facilities etc.

Ed’s design experience included power systems, utility infrastructure upgrade projects, indoor and outdoor lighting systems, backup generation systems, Fault Current Reports and Arc Flash Studies using SKM Software, UPS systems and fire life safety systems.

EducationBS Electrical Engineering, Lawrence Technological University, Southfield, Michigan

Professional LicenseElectrical Engineer, CA E17083LEED AP BD+C

Contact Information255 E. Rincon St., Suite 301 Corona, CA 92879

[email protected]

(951) 340-1977

• Utility Infrastructure Master Plan;San Bernardino Valley College,San Bernardino

• Utility Infrastructure Master Plan;LA Valley College, CA

• City of Hope Fox Lab North BuildingRenovation Assessment;Duarte, CA

• Sierra Madre Co-Generation Study; San Luis Obispo, CA

• Utility Infrastructure Master Plan;Norco College, Norco

• Utility Infrastructure Master Plan;Moreno Valley College, Moreno Valley

• Utility Infrastructure Master Plan;Riverside Community College,Riverside

• Performing Art Center Remodel andHVAC Assessment; Laguna Woods, CA

• San Rafael Building 2nd Floor Pre-Programming Assessment; GlendaleCommunity College, Glendale

• Admin Building Pre-ProgrammingAssessment; Glendale CommunityCollege, Glendale

FACILITY ASSESSMENTS


• Buena Park Fire Station 63;Buena Park,CA

• Santa Lucia Fire Alarm;California Polytechnic StateUniversity, CA

• Sessions Woodbridge; Irvine,CA

• Beckman Laser EFReplacement; University of California, Irvine

• Chapman Roof HallReplacement; University of California, Riverside

• Bren Hall 2nd Floor TI;University of California, Irvine

• Performing Arts Center;Laguna Woods,CA

• Mott Gym Room 205 Ventilation SystemUpgrade; San Luis Obispo,CA

• Social Ecology II 1342, 1342A, 1392, 1392AElectrical TI; University of California Irvine

• Pomona College Seeley Mudd TI; Pomona,CA

• Enginering Gateway Building UCI EG 2105& 3108; University of California, Irvine

• ET Breezeway Infill MEFA;University of California, Irvine

• Social Sciences Lab 3rd and 4thFloor TI; University of California,Irvine

• Bldg. 33 Office Remodel;California Polytechnic State University, CA

• 5030 Campus TI & Build. Improvements;Newport Beach,CA

• University Union Surfboard Shop;California Polytechnic State University, CA

• Irvine Hall Dean’s Office TI;University of California, Irvine

• Café Med TI;University of California, Irvine

• Moreto Mathison & Associates BrotmanHall 2; Long Beach,CA

• Demolition of Computer RoomEquipment; Cal State University LongBeach,CA

• Rubidoux Greenhouse WaterBooster; University of California, Riverside

Contact Information255 E. Rincon St., Suite 301 Corona, CA [email protected]

(951) 340-1977

Chrisly LatagChrisly Latag has 9 years of experience in Electrical Design and Project Engineering. His experience in Electrical Engineering has encompassed a variety of Design and Build Projects involving Low and Medium Voltage Power Distribution Systems, Indoor and Outdoor Lighting Systems, Back-up Generation Systems, UPS Systems and Fire Life Safety Systems from previousconstruction companies not just here in the United States but in Asia and in the Middle East as well.

Mr. Latag assists in Electrical Design, Field visits, Short Circuit Calculations and Load Summaries. He oversees and handles Site Development Plans for projects and has worked in various Residential, Commercial, Industrial,Institutional Projects, in which includes Airports, Hotels, Resorts, Horizontal/Vertical Buildings, Waste Water Treatment Facilities, Utility Infrastructure Upgrades, and Manufacturing Facilities Projects and additionally a Projectin the Oil & Gas Industry. Chrisly also has experience in Sustainability and Renewable Energy, Electrical System Protection and Safety Analysis.


EducationBS Electrical Engineering Polytechnic University of thePhilippines, Philippines

• Buena Park Fire Station 63; BuenaPark, CA

• Santa Lucia Fire Alarm; CaliforniaPolytechnic State University, CA

• Sessions Woodbridge;Irvine, CA

• Beckman Laser EF Replacement;University of California, Irvine

• Chapman Roof Hall Replacement;University of California, Riverside

• Bren Hall 2nd Floor TI;University of California, Irvine

• Winston Chung Hall 3rd Floor OfficeRenovations; Riverside, CA

• Olmstead Hall Renovations;Riverside, CA

• University Union Surfboard Shop;Cal Poly San Luis Obispo, CA

• Engineering Gateway Building EG 2105& 3108; University of California, Irvine

• ET Breezeway Infill MEFA;University of California, Irvine

• Social Sciences Lab 3rd and 4th Floor TI;University of California, Irvine

• Bldg. 33 Office Remodel;Cal Poly San Luis Obispo, CA

• Middle Earth Restroom S;University of California, Irvine

• Ingram Micro TI;Eastvale, CA

• Irvine Hall Roof EquipmentReplacement; University of California, Irvine

• Bookstore Rooftop Package UnitReplacement; Long Beach, CA

• 5030 Campus TI & Build. Improvements;Newport Beach, CA

PROPOSED PERSONNEL

Nick Ubrun, PE Lic No. M 35378 Lic Date 1-7-2011As a Principal at Goss, Nick directly oversees half of our work, coordinating with clients and project staff on all his projects. Nick Ubrun is a licensed professional mechanical engineer with extensive design and planning experience in the industry. He has planned and designed mechanical system improvements for major universities, government agencies, schools, major theme parks and private firms. Nick’s experience has included the planning and design of central heating and cooling plants, cogeneration systems, laboratory retrofits, as well as building HVAC systems, including several LEED certified projects. Nick has successfully assisted clients with getting projects LEED and CHPS accredited.

Ed Burtch, PE, LEED AP BD+C Lic No. E 17083 Lic Date 6-27-2003Ed Burtch is a licensed professional electrical engineer with over twenty-five years of project engineering and electrical design experience. His experience in electrical engineering has encompassed a variety of design projects, including K-12 schools, universities, municipal buildings, data processing centers, and healthcare facilities. His design experience includes power systems, utility infrastructure upgrade projects, indoor and outdoor lighting systems, backup generation systems, UPS systems, and fire life safety systems. As Senior Electrical Engineer, Ed oversees all electrical design and coordinates with other disciplines.

Chrisly LatagChrisly Latag has 9 years of experience in Electrical Design and Project Engineering. His experience in Electrical Engineering has encompassed a variety of Design and Build Projects involving Low and Medium Voltage Power Distribution Systems, Indoor and Outdoor Lighting Systems, Back-up Generation Systems, UPS Systems and Fire Life Safety Systems from previous construction companies not just here in the United States but in Asia and in the Middle East as well.

ORGANIZATIONAL CHART

Key personnel that are assigned to this project will be available to the extent proposed for the duration of the project and no person designated as “key” to the project shall be removed or replaced without the prior written concurrence of the City.

Exceptions/DeviationsGoss has no exceptions or deviations from the requirements, terms or conditions of the form agreement.

Ed Burtch, PE(Senior Electrical)

Chrisly Latag(Electrical Engineer)

Steven Piepenhagen(Electrical Design)

Tyler Rodriguez(Electrical Design)

RFP No. 19-016CA Section VI. “Price Form” - Pg 1 of 4

On-Call Engineering and Professional Services Contracts

SECTION VI.

PRICE FORM

REQUEST FOR PROPOSALS: RFP No. 19-016CA

DESCRIPTION OF WORK: On-Call Engineering and Professional Services Contracts

CONSULTANT’S NAME/ADDRESS:

NAME/TELEPHONE NO. OF

AUTHORIZED REPRESENTATIVE

Place an “x” in the spaces provided for each discipline being proposed:

______ A. Potable Water and Reclaimed Water Pipelines

______ B. Potable Water and Reclaimed Water Pump Stations, Well Equipping,

Storage Facilities and Pressure Regulating Facilities

______ C. Water Reclamation (Sewage) Collection Piping

______ D. Water Reclamation (Sewage) Collection Lift Stations

______ E. Water Treatment Systems Design

______ F. Water Reclamation Systems Design

______ G. Structural Engineering

______ H. Landscape Architectural and Irrigation Design

______ I. Electrical Engineering

_____ J. Geotechnical Engineering, Inspection and Materials Testing

X

Goss Engineering Inc.

255 E. Rincon St., Suite 3301 Corona, CA 92879

Nick Ubrun 951-340-1977



_____ K. Traffic Engineering

_____ L. Land Surveying

_____ M. Construction Management and Support

_____ N. Project Management

_____ O. Construction Inspection Services

_____ P. Hydrogeology (Groundwater Well) Design and Construction Services

_____ Q. Water Management Programs and Engineering

_____ R. Environmental Consulting

_____ S. Hazardous Materials Testing

_____ T. Ground Penetrating Radar Utility Locating

_____ U. Grant Writing and Management Consultant

_____ V. Accounting and Financial Consulting Services

_____ W. Radio Tower Engineering Services

_____ X. Public Relations Consulting

_____ Y. Dry Utility Design and Plan Checking Services

Provide hourly rate schedule on company letterhead for each discipline being proposed. All rates

and costs shall be effective through June 30, 2022. Hourly rate schedule should include the typical

following categories of labor classifications modified as appropriate for the category of labor

required to perform the work:

• Principal-in-Charge, QA/QC Manager

• Senior Project Manager

• Project Manager

• Construction Manager, Resident Engineer

• Senior Project Engineer, Senior Project Architect/Landscape Architect, Senior Land

Surveyor

• Project Engineer, Project Architect/Landscape Architect, Project Land Surveyor

• Professional Engineer, Land Surveyor, Architect/Landscape Architect



• Inspector

• Engineer-in-Training, Civil Engineering Designer

• CAD Designer/Technician

• Engineering Assistant

• Administrative Assistant, Project Administrator

• Two-Man Survey Crew (per hour/day)

• Ground Penetrating Radar Utility Locating Crew (per hour/day)

Provide list of reimbursable charges and rates to include:

• Mileage

• Prints, plots, messenger service and other direct expenses markup

• Outside consultant services markup

• Traffic control

• Other

Are there any other additional or incidental costs which will be required by your firm in order to

meet the requirements of the Scope of Work? Yes / No (circle one). If you answered

“Yes”, please provide detail of said additional costs:

Please indicate any elements of the Scope of Work which cannot be met by your firm.

Have you included in your proposal all requested informational items and forms? Yes / No

(circle one). If you answered “No”, please explain:

All elements of the scope can be met by our firm.



Have you been on any federal list of debarred or suspended consultants? Yes / No (circle one).

This offer shall remain firm for 90 days from RFP close date.

Terms and conditions as set forth in this RFP apply to this proposal.

Unless otherwise stated, payment terms are: Net thirty (30) days.

In signing this proposal, Consultant warrants that all certifications and documents requested herein

are attached and properly completed and signed.

From time to time, the City may issue one or more addenda to this RFP. Below, please indicate all

Addenda to this RFP received by your firm, and the date said Addenda was/were received. It is

Consultant’s responsibility to ensure that all addenda are received. Failure to acknowledge receipt

of addenda may cause the City to reject the proposal as non-responsive.

Verification of Addenda Received

Addenda No: __________ Received on: _____________________

Addenda No: __2______ Received on: _____________________

Addenda No: __________ Received on: _____________________

AUTHORIZED SIGNATURE:

PRINT SIGNER’S NAME AND TITLE:

DATE SIGNED:

COMPANY NAME & ADDRESS:

PHONE: EMAIL: _____________________________

Nick Ubrun: Principal

255 E. Rincon St., Suite 301 Corona, CA 92879

(951) 340-1977 [email protected]

1

2

November 30

December 6

December 11

DIR REGISTRATION NO.: _1000054328________________________________________________

3

12-18-18

DESIGN PROFESSIONAL RATE SCHEDULE

2018 Rate Table

Position Hourly Rates

Administration $70Auto Cad Drafter $90Energy Analyst $90Engineering Aide $90Project Engineer $115Engineer $150Commissioning Project Manager $160Senior Engineer $175Principal Engineer $200Executive Engineer $215Reimbursable Expenses (Transportation, lodging, long distance communications, etc.) per contract

FEE SCHEDULE/ COST PROPOSAL

This requested engineering service fee also includes other direct costs associated withtelephone, computers, travel, etc., which are necessary to complete the engineering effort.

SELECTED ELECTRICAL EXPERIENCE

Goss has extensive experience providing engineered designs complying with the California Building Codes, as well as all other relevant codes including Title-24 and the Energy Code. Additionally Goss has completed numerous projects for the Division of the State Architect (DSA) as well as maintained design compliance with the State Fire Marshal.

Firm Project Name: 4th, 5th and 6th Floor Library Lighting Retrofit Project Address: California State Polytechnic University, Pomona Work Done: Library Lighting and EM lighting, wireless LV lighting controls, lighting control panel, occupancy sensors, Integration with HVAC system, photometrics. Contact Person: “George Lwin Manager, Energy Services Facilities Planning & Management California State Polytechnic University, Pomona (909) 869-3034 “

Firm Project Name: Aldrich Hall Phase 2 Tenant ImprovementProject Address: University of California, Irvine Work Done: Retrofit lighting to restrooms, offices, and corridor. EM lighting, LV lighting controls, switches, occupancy sensors. Contact Person: “Kyka Adachi Project Manager , University of California, Irvine (949) 824-9520”

Firm Project Name: 5030 Campus Specialty LightingProject Address: Newport Beach, California Work Done: Complete remodel indoor lighting to offices , package units, lighting, exterior lighting, entrance lighting, and power telecoms Contact Person: “William Itzen Project Manager (714) 716-5042 ”

Firm Project Name: Lynwood City Hall North Building Tenant Lighting ImprovementsProject Address: Lynwood, California Work Done: Retrofit lighting to offices and EM lighting, wireless LV lighting controls, lighting control panel, occupancy sensors.Contact Person: “Sami Pakbaz Architect (714) 940-0100 ”

Firm Project Name: Humanities Room Classroom Renovation Project Address: University of California, Irvine Work Done: Classroom Lighting and EM lighting, LV lighting controls, switches, occupancy sensors. Contact Person: “Jordan Terrones Project Manager Facilities Management, UCI (949) 824-5792”

Firm Project Name: School of Medicine Trailer Expansion Project Address: University of California, Riverside Work Done: Exterior Building Lighting and Parking Lighting, Ingress path lighting, photometrics. Contact Person: “Tamesha Hayes Project Manager Architects and Engineers, UCR (951) 827-2455”

LICENSES

RFP No. 19-016CA Section V. “Proposal Content and Forms” - Pg 5 of 15


PARTY SUBMITTING PROPOSAL: ______________________

NON-COLLUSION DECLARATION

(TO BE EXECUTED BY CONSULTANT AND SUBMITTED WITH PROPOSAL)

The undersigned declares:

I am the _________________________________________________ [title] of

___________________________________ [proposer], the party making the foregoing proposal.

The proposal is not made in the interest of, or on behalf of, any undisclosed person,

partnership, company, association, organization, or corporation. The proposal is genuine and not

collusive or a sham. The proposer has not directly or indirectly induced or solicited any other

proposer to put in a false or sham proposal. The proposer has not directly or indirectly colluded,

conspired, plotted, or agreed with any proposer or anyone else to put in a sham proposal, or to

refrain from submitting a proposal. The proposer has not in any manner, directly or indirectly,

sought by agreement, communication, or conference with anyone to fix the proposal price of the

proposer or any other proposer, or to fix any overhead, profit, or cost element of the proposal price,

or of that of any other proposer. All statements contained in the proposal are true. The proposer

has not, directly or indirectly, submitted his or her proposal price, or any breakdown thereof, or

the contents thereof, or divulged information or data relative thereto, to any corporation,

partnership, company, association, organization, proposal depository, or to any member or agent

thereof to effectuate a collusive or sham proposal, and has not paid, and will not pay, any person

or entity for such purpose.

Any person executing this declaration on behalf of a proposer that is a corporation,

partnership, joint venture, limited liability company, limited liability partnership, or any other

entity, hereby represents that he or she has full power to execute, and does execute, this declaration

on behalf of the proposer.

I declare under penalty of perjury under the laws of the State of California that the

foregoing is true and correct and that this declaration is executed on ____________________

[date], at ________________________________ [city], _________________________[state].

____________________________________

Signature

____________________________________

Typed or Printed Name

____________________________________

____________________________________


PrincipalGoss Engineering Inc.

12-18-18Corona California

Nick Ubrun

PrincipalTitle

Goss Engineering Inc.Party Submitting Proposal



ACKNOWLEDGMENT OF THE TERMS AND CONDITIONS OF THE CITY OF

CORONA PROFESSIONAL SERVICES AGREEMENT

(To be Completed and Submitted with Consultant’s Proposal)

This is to acknowledge that we have read the City of Corona Professional Services Agreement and

will sign the Agreement, as presented, without exception, for the City’s RFP No. 19-016CA.

______________________________________________________________________________

(Firm name)

______________________________________________________________________________

(Print name and title of person signing for firm)

______________________________________________________________________________

(Signature/date)

Goss Engineering Inc

Nick Ubrun Principal



ACKNOWLEDGMENT OF THE INSURANCE REQUIREMENTS CHECK SHEET


This is to acknowledge that we have reviewed the City of Corona Insurance Requirements Check

Sheet and understand that we will be able to provide the insurance coverage required. A sample

certificate of insurance is enclosed for the City’s preliminary review. Any deductibles or self-

insured retention amounts have been specified below for City’s review and approval.

Deductible Amounts/Self-insured Retentions:

_____________________________________________ ___________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

______________________________________________________________________________

(Firm name)

______________________________________________________________________________


______________________________________________________________________________

(Signature/date)



General Liability Package -0-, Property ded $500, Worker's Compensation -0-,

Umbrella -0-, Business Auto COMP & COLL ded $1,000



City of Corona

RFP Insurance Requirements Check List

Circle One Applicable

Can your company provide General Liability - $1M occurrence/$2M aggregate? Yes No YES

Can your company provide Automobile Liability - $1M? Yes No YES

Can your company provide Workers Compensation and Employer's Liability - $1M? Yes No YES

Can your company provide Errors and Omissions (Professional) Liability Insurance - $1M occurrence or claim/$2M aggregate?

Yes No YES

Can your company provide Technology Professional Errors and Omissions Liability Insurance - $2M occurrence or $2M aggregate?

N/A NO

Can your company provide Builders'/All Risk for the completed value of the project naming the City as the loss payee?

N/A NO

Can your company provide Contractor’s Pollution Liability and Transportation Pollution Liability with minimum limits of $1 million/$2 million with a primary Additional Insured endorsement?

N/A NO

Can your company provide coverage with an insurer with a current A.M. Best’s rating no less than (A-):VII and licensed as an admitted insurance carrier in California ?

Yes No YES

Can your company provide coverage with an insurer with a current A.M. Best’s rating no less than (A-):X and authorized to issue the required policies in California?

Yes No YES

Insurance Endorsements

General Liability

(Occurrence form CG 0001) Circle One Applicable

Will your company provide an insurance policy that states the City, its directors, officials, officers, employees, agents, and volunteers shall be covered as additional insured with respect to liability arising out of work or operations performed by or on behalf of the Contractor, including materials, parts or equipment furnished in connection therewith?

Yes No YES

Will your company provide an insurance policy that states any person or organization whom you have agreed to include as an additional insured under a written contract provided such contract was executed prior to the date of loss?

Yes No YES

Can your company provide Completed Operations as evidenced with the following endorsements?

YES

Endorsement form CG 20 10 11 85 -OR- Yes No YES

CG 20 37 and one of the following Yes No YES

CG 20 10 Yes No YES

CG 20 26 Yes No YES

CG 20 33 Yes No YES

CG 20 38 Yes No YES



Will your company provide a General Liability endorsement stating that the insurance coverage shall be primary and any City insurance will be in excess of the consultant's insurance and will not be called upon to contribute? Endorsement Form shall be as broad as CG 20 01 04 13.

Yes No YES

Automobile Liability

Circle One Applicable

Does your insurance cover owned automobiles with Form number CA 0001 code 1 (any auto)?

Yes No YES

If your company does not have owned automobiles, does your insurance cover No Owned Autos Code 8 (hired) and 9 (non-owned)?

Yes No

Workers' Compensation

Will your company provide a waiver for all rights of subrogation against the City, its directors, officials, officers, employees, agents, and volunteers for losses paid under the terms of the insurance policy which arise from work or Services performed by the Consultant?

Yes No YES

Will your company provide a Waiver of Subrogation – All Other Policies. Consultant hereby waives all rights of subrogation any insurer of Consultant’s may acquire against the City, its directors, officials, officers, employees, agents, and volunteers for losses paid under the terms of any insurance policy which arise from work or Services performed by the Consultant?

Yes No YES

Will your insurance policies have a (30) days' notice of cancellation endorsement? Yes No YES

If your firm is unable to provide a (30) day notice of cancellation will your firm sign a City provided statement that the Vendor shall notify the City within two business days any notice of cancellation?

Yes No YES

Does your insurance have any deductibles and/or self-insurance retentions? Yes No YES

Professional Liability

Can your company provide errors and omissions liability insurance appropriate to its profession with minimum limits of $1,000,000 per occurrence or claim/$2,000,000 aggregate?

Yes No YES

Is the coverage on a claims-made basis? Yes No YES

If the coverage is on a claims-made basis, can you maintain and provide evidence of insurance for a period of five (5) years or purchase extended reporting coverage if coverage is not renewed?

Yes No YES

Use the space below to explain any "No" responses.

Automobile Insurance covers hHired autos only and non-owned autos only

YES

The CG endorsements are out of date. I have attached what our policy covers in place of these endorsements.

PPA 300 03 11 Page 2 of 5

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

A. Broad Form Named InsuredThe following is added to the SECTION II –LIABILITY Coverage, Paragraph A.1. Who Is AnInsured Provision:

Any business entity newly acquired or formed by youduring the policy period, provided you own fiftypercent (50%) or more of the business entity and thebusiness entity is not separately insured forBusiness Auto Coverage. Coverage is extended upto a maximum of one hundred eighty (180) daysfollowing the acquisition or formation of the businessentity.

This provision does not apply to any person ororganization for which coverage is excluded byendorsement.

B. Employees As InsuredsThe following is added to the SECTION II –LIABILITY COVERAGE, Paragraph A.1. Who Is AnInsured Provision:

Any "employee" of yours is an "insured" while usinga covered "auto" you don't own, hire or borrow inyour business or your personal affairs.

C. Blanket Additional InsuredThe following is added to the SECTION II –LIABILITY COVERAGE, Paragraph A.1. Who Is AnInsured Provision:

Any person or organization that you are required toinclude as an additional insured on this coverageform in a contract or agreement that is executed byyou before the “bodily injury” or “property damage”occurs is an “insured” for liability coverage, but onlyfor damages to which this insurance applies andonly to the extent that person or organizationqualifies as an “insured” under the Who Is AnInsured provision contained in SECTION II –LIABILITY COVERAGE.

The insurance provided to the additional insured willbe on a primary and non-contributory basis to theadditional insured’s own business auto coverage ifyou are required to do so in a contract or agreementthat is executed by you before the “bodily injury” or“property damage” occurs.

D. Blanket Waiver Of SubrogationThe following is added to the SECTION IV –BUSINESS AUTO CONDITIONS, A. LossConditions, 5. Transfer Of Rights Of RecoveryAgainst Others To Us:

We waive any right of recovery we may have against any person or organization to the extent required of you by a contract executed prior to any “accident” or “loss”, provided that the “accident” or “loss” arises out of the operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract.

E. Employee Hired Autos1. The following is added to the SECTION II –

LIABILITY COVERAGE, Paragraph A.1. WhoIs An Insured Provision:

An "employee" of yours is an "insured" whileoperating an "auto" hired or rented under acontract or agreement in that "employee's"name, with your permission, while performingduties related to the conduct of your business.

2. Changes In General Conditions:

Paragraph 5.b. of the Other InsuranceCondition in the BUSINESS AUTOCONDITIONS is deleted and replaced with thefollowing:

b. For Hired Auto Physical Damage Coverage,the following are deemed to be covered"autos" you own:

(1) Any covered "auto" you lease, hire, rentor borrow; and

(2) Any covered "auto" hired or rented byyour "employee" under a contract in thatindividual "employee's" name, with yourpermission, while performing dutiesrelated to the conduct of your business.However, any "auto" that is leased,hired, rented or borrowed with a driver isnot a covered "auto".

F. Fellow Employee CoverageSECTION II – LIABILITY COVERAGE, ExclusionB.5. does not apply if you have workerscompensation insurance in-force covering all of youremployees.

G. Auto Loan Lease Gap Coverage

SECTION III – PHYSICAL DAMAGE COVERAGE,C. Limit Of Insurance, is amended by the additionof the following:

In the event of a total "loss" to a covered "auto" shown in the Schedule of Declarations, we will pay any unpaid amount due on the lease or loan for a covered "auto", less:

Ashley Gherasim

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Ashley Gherasim

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ACKNOWLEDGMENT OF THE VENDOR PERFORMANCE EVALUATION FORM

This is to acknowledge that we have read the City of Corona Vendor Performance Evaluation

Form and understand a version of this type of form will be used to provide the basis for periodic

assessments by the City to establish contract performance metrics.

______________________________________________________________________________

(Firm name)

______________________________________________________________________________


______________________________________________________________________________

(Signature/date)





INDUSTRIAL SAFETY RECORD


Number of OSHA Violations within the last 5 years (must state zero if none):

___ Serious ___ Willful ___ Repeat ___ Other ___ Unclass _____ Total

Firm Name (Print)

Signature

Name and Title (Print)

Date

0



0 0 0 0 0

12-18-18

INTRODUCTION TO GOSS ENGINEERING

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Transcript of INTRODUCTION TO GOSS ENGINEERING