Common use of COMPENSATION CERTIFICATION Clause in Contracts

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement. The scope of services for this project includes providing project inspector (PI) services including inspection, observation, reporting, and coordinating of other third party inspections/special tests required to meet applicable codes, regulations, and DSA requirements for all newly installed work. These services shall be provided as required by the project documents and DSA requirements. Documents required by this contract include, but are not limited to, daily site visit reports and semi-monthly progress reports. Related meetings may include, but are not limited to, pre- installation meetings, weekly construction meetings, and meetings to resolve specific issues which arise during the course of construction. On time completion of construction is of critical importance to mitigate any impact to college operations, and construction duration is limited due to the availability of the facilities. Competent qualified staff, available resources and testing facilities are required for a successful outcome of the project objectives in regards to scope and schedule. EXHIBIT “B” HOURLY RATES AND/OR UNIT PRICES Refer to Fee Proposal. Fee Proposal Project Inspector Services Project 0000 Xxxxxxx, Xxxxxxxx and Parking The lump sum fee for the Construction Phase of the project beginning 12/19/2016 and finishing 01/20/2017: Class 1 DSA Inspector $6,150.00 If the project exceeds the specified duration and lump sum total, additional fees will be charged as time and materials at our hourly rate as follows: Class 1 DSA Inspector $82.00 Hr.* The following is standard hourly rates: Class 1 DSA Inspector $ 82.00 Hr.* Class 2 DSA Inspector $ 77.00 Hr.* There will be no additional charges for office related expenses or travel time. United Inspection, Inc. will submit monthly xxxxxxxx for services rendered. All regular hourly rates, Monday through Friday, will have a two (2) hour minimum. Overtime: Rate will be charged at time and one-half for any hours worked over forty (40) hours per week (Monday through Friday) and Saturday. Overtime / Sundays and Holidays: Rate to be charged at double time. *Hourly rate for the entire timeframe for that particular project.

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement. The scope of services for this project includes providing project inspector (PI) services including inspection, observation, reporting, and coordinating of other third party inspections/special tests required to meet applicable codes, regulations, and DSA requirements for all newly installed work. These services shall be provided as required by the project documents and DSA requirements. Documents required by this contract include, but are not limited to, daily site visit reports and semi-monthly progress reports. Related meetings may include, but are not limited to, pre- installation meetings, weekly construction meetings, and meetings to resolve specific issues which arise during the course of construction. On time completion of construction is of critical importance to mitigate any impact to college operations, and construction duration is limited due to the availability of the facilities. Competent qualified staff, available resources and testing facilities are required for a successful outcome of the project objectives in regards to scope and schedule. EXHIBIT “B” HOURLY RATES AND/OR UNIT PRICES Refer to Fee Proposal. Fee Proposal Project Inspector Services Project 0000 Xxxxxxx, Xxxxxxxx and Parking 9101C Geothermal Ground Loop The lump sum fee for the Construction Phase of the project beginning 12/19/2016 and finishing 01/20/201711/17/2017: Class 1 DSA Inspector $6,150.00 59,040.00 If the project exceeds the specified duration and lump sum total, additional fees will be charged as time and materials at our hourly rate as follows: Class 1 DSA Inspector $82.00 Hr.* The following is standard hourly rates: Class 1 DSA Inspector $ 82.00 Hr.* Class 2 DSA Inspector $ 77.00 Hr.* There will be no additional charges for office related expenses or travel time. United Inspection, Inc. will submit monthly xxxxxxxx for services rendered. All regular hourly rates, Monday through Friday, will have a two (2) hour minimum. Overtime: Rate will be charged at time and one-half for any hours worked over forty (40) hours per week (Monday through Friday) and Saturday. Overtime / Sundays and Holidays: Rate to be charged at double time. *Hourly rate for the entire timeframe for that particular project.

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part Scope of Consultant services includes preparation of all documentation necessary to initiate, process, review, and ultimately obtain appropriate certification of a Project Environmental Impact Report or other appropriate environmental documentation (i.e. “Negative Declaration”) that will environmentally clear approval and implementation of the Vacaville Campus Site, noted as “Project” in compliance with CEQA requirements, with the intent to utilize this Agreementinformation to form a campus-wide EIR. The Specifically for Vacaville Campus site, the Consultant scope of services for this project work includes providing project inspector (PI) services including inspection, observation, reporting, preparation and coordinating of other third party inspections/special tests required to meet applicable codes, regulations, and DSA requirements for all newly installed work. These services shall be provided as required by the project documents and DSA requirements. Documents required by this contract include, but are not limited to, daily site visit reports and semi-monthly progress reports. Related meetings may include, but are not limited to, pre- installation meetings, weekly construction meetings, and meetings to resolve specific issues which arise during the course of construction. On time completion of construction is of critical importance to mitigate any impact to college operationsan Initial Study/Mitigated Negative Declaration, and construction duration is limited due to including:  Project Initiation  Prepare Administrative Draft CEQA Document including the availability of the facilities. Competent qualified staff, available resources and testing facilities are required for a successful outcome of the project objectives in regards to scope and schedule. EXHIBIT “B” HOURLY RATES AND/OR UNIT PRICES Refer to Fee Proposal. Fee Proposal Project Inspector Services Project 0000 Xxxxxxx, Xxxxxxxx and Parking The lump sum fee for the Construction Phase of the project beginning 12/19/2016 and finishing 01/20/2017following considerations: Class 1 DSA Inspector $6,150.00 If the project exceeds the specified duration and lump sum total, additional fees will be charged as time and materials at our hourly rate as follows: Class 1 DSA Inspector $82.00 Hr.* The following is standard hourly rates: Class 1 DSA Inspector $ 82.00 Hr.* Class 2 DSA Inspector $ 77.00 Hr.* There will be no additional charges for office related expenses or travel time. United Inspection, Inc. will submit monthly xxxxxxxx for services rendered. All regular hourly rates, Monday through Friday, will have a two (2) hour minimum. Overtime: Rate will be charged at time and one-half for any hours worked over forty (40) hours per week (Monday through Friday) and Saturday. Overtime / Sundays and Holidays: Rate to be charged at double time. *Hourly rate for the entire timeframe for that particular project.o Aesthetics o Agricultural Resources o Air Quality o Biological Resources

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT ConsultantThe consultant’s entire Proposal is not made part scope of this Agreementwork includes specifying, procurement and coordination of all equipment and furniture, fixtures and equipment for the new Autotechnology Building in Vallejo. The consultant will also validate that the specified technical equipment is inclusive and that furniture and equipment is aligned with Program Level Furniture, Fixtures and Equipment Standards. The consultant’s scope of services work includes meetings with faculty and other user group participants, detailed specifications for this project includes providing project inspector (PI) services including inspectionbidding, observation, reporting, and coordinating of other third party inspections/special tests required to meet applicable codes, regulations, and DSA requirements for all newly installed work. These services shall be provided as required by the project documents and DSA requirements. Documents required by this contract include, but are not limited to, daily site visit reports and semi-monthly progress reports. Related meetings may include, but are not limited to, pre- installation meetings, weekly construction meetings, and meetings to resolve specific issues which arise during the course of construction. On time completion of construction is of critical importance to mitigate any impact to college operations, and construction duration is limited due to the availability coordination of the facilitiesbidding process as needed with the Design Build Entity, tracking of orders in coordination with the Design Build team and support to District as related to delivery and installation timeframes. Competent qualified staffConsulting services include: • Stage 1 – Project Development o June 2015 to February 2015: Develop scope of FF&E procurement, available resources coordination and testing facilities are required for a successful outcome of the project objectives in regards to scope and schedule. EXHIBIT “B” HOURLY RATES AND/OR UNIT PRICES Refer to Fee Proposal. Fee Proposal Project Inspector Services Project 0000 Xxxxxxx, Xxxxxxxx and Parking The lump sum fee for the Construction Phase of the project beginning 12/19/2016 and finishing 01/20/2017: Class 1 DSA Inspector $6,150.00 If the project exceeds the specified duration and lump sum total, additional fees will be charged as time and materials at our hourly rate as follows: Class 1 DSA Inspector $82.00 Hr.* The following is standard hourly rates: Class 1 DSA Inspector $ 82.00 Hr.* Class 2 DSA Inspector $ 77.00 Hr.* There will be no additional charges for office related expenses or travel time. United Inspection, Inc. will submit monthly xxxxxxxx for implementation management services rendered. All regular hourly rates, Monday through Friday, will have a two (2) hour minimum. Overtime: Rate will be charged at time and one-half for any hours worked over forty (40) hours per week (Monday through Friday) and Saturday. Overtime / Sundays and Holidays: Rate to be charged at double timeperformed by design building entity, with performance criteria for such services. *Hourly rate o May 2017 to January 2018: Provide the full range of FF&E services designated for the entire timeframe for that particular project.Measure Q Team as defined • Stage 2 – Product Evaluation • Stage 3 - Final Specifications • Stage 4 – Order Documentation

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part of this Agreement. The scope of services for this project includes providing project inspector (PI) services including inspection, observation, reporting, and coordinating of other third party inspections/special tests required to meet applicable codes, regulations, and DSA requirements for all newly installed work. These services shall be provided as required by the project documents and DSA requirements. Documents required by this contract include, but are not limited to, daily site visit reports and semi-monthly progress reports. Related meetings may include, but are not limited to, pre- installation meetings, weekly construction meetings, and meetings to resolve specific issues which arise during the course of construction. On time completion of construction is of critical importance to mitigate any impact to college operations, and construction duration is limited due to the availability of the facilities. Competent qualified staff, available resources and testing facilities are required for a successful outcome of the project objectives in regards to scope and schedule. EXHIBIT “B” HOURLY RATES AND/OR UNIT PRICES Refer to Fee Proposal. Fee Proposal Project Inspector Services Project 0000 March 7, 2017 Ohlone Community College District 00000 Xxxxxxx Xxxx. Xxxxxxx, Xxxxxxxx and XX 00000 Attn: Xxxxx Xxxx Gilbane Construction Management Re: Ohlone Community College Parking Lot K Improvement Project Xx. Xxxx: United Inspection Inc. would like to thank the Ohlone Community College District for the opportunity to Quote Inspection Services on the projects stated above. The lump sum inspection fee for the Construction Phase projects would be based on the hourly rates shown below with a “Not to Exceed” amount of $6,396.00 $82.00 per hour Monday - Friday (Up to 40hrs/week) $102.00 per hour (After 40hrs/week and Saturdays) The “Not to Exceed” amount was determined by the seven-week duration of the project beginning 12/19/2016 and finishing 01/20/2017the information that we have been provided regarding the project. Our proposal does not include materials and special testing as may be required and any overtime that might be related to this project. If overtime is required, prior district approval would be required and all overtime billing would be separate. If our quote is acceptable, please issue a purchase order at your earliest convenience. Sincerely, Xxxx Xxxxxx Xxxx Xxxxxx Main Office: Class 1 DSA Inspector $6,150.00 If the project exceeds the specified duration and lump sum total0000 Xxxxxxx Xxxx, additional fees will be charged as time and materials at our hourly rate as follows: Class 1 DSA Inspector $82.00 Hr.* The following is standard hourly rates: Class 1 DSA Inspector $ 82.00 Hr.* Class 2 DSA Inspector $ 77.00 Hr.* There will be no additional charges for office related expenses or travel time. United InspectionHughson, Inc. will submit monthly xxxxxxxx for services rendered. All regular hourly rates, Monday through Friday, will have a two CA 95326 – PH (2209) hour minimum. Overtime: Rate will be charged at time and one634-half for any hours worked over forty (40) hours per week (Monday through Friday) and Saturday. Overtime / Sundays and Holidays: Rate to be charged at double time. *Hourly rate for the entire timeframe for that particular project.1052

COMPENSATION CERTIFICATION. Labor Code Section 3700 in relevant part provides: Every employer except the State shall secure the payment of compensation in one or more of the following ways:  • By being insured against liability to pay compensation by one or more insurers duly authorized to write compensation insurance in this State.  • By securing from the Director of Industrial Relations a certificate of consent to self-insure, which may be given upon furnishing satisfactory proof to the Director of Industrial Relations of ability to self-insure and to pay any compensation that may become due to its employees. I am aware of the provisions of Section 3700 of the Labor Code which require every employer to be insured against liability for workers’ compensation or to undertake self-insurance in accordance with the provisions of that code, and I will comply with such provisions before commencing the performance of the Work of this Contract. Date: Name of Consultant: Signature: Print Name and Title: (In accordance with Article 5 – commencing at Section 1860, Chapter 1, part 7, Division 2 of the Labor Code, the above certificate must be signed and filed with the District prior to performing any Work under this Contract.) EXHIBIT “A” DESCRIPTION OF SERVICES TO BE PERFORMED BY CONSULTANT Consultant’s entire Proposal is not made part Scope of this AgreementConsultant services includes preparation of all documentation necessary to initiate, process, review, and ultimately obtain appropriate approvals and certification of a Program Environmental Impact Report that will environmentally clear approval and implementation of the Vallejo Campus Sites, noted as “Project” in compliance with CEQA. The Specifically for Vallejo Campus site, the Consultant scope of services for this project includes providing project inspector (PI) services including inspection, observation, reporting, work included preparation and coordinating of other third party inspections/special tests required to meet applicable codes, regulations, and DSA requirements for all newly installed work. These services shall be provided as required by the project documents and DSA requirements. Documents required by this contract include, but are not limited to, daily site visit reports and semi-monthly progress reports. Related meetings may include, but are not limited to, pre- installation meetings, weekly construction meetings, and meetings to resolve specific issues which arise during the course of construction. On time completion of construction is the following: • Project Initiation and Notice of critical importance to mitigate any impact to college operationsPreparation • Technical Study: Air Quality/Greenhouse Gas Emissions • Technical Study: Biological Assessments • Technical Study: Phase I Cultural Resources Assessment • Noise Analysis • Traffic Impact Analysis • Administrative Draft EIR • Draft EIR • Administrative Final EIR • Review, revise and construction duration is limited due to the availability produce final EIR • Mitigation Monitoring and Reporting Program • Notice of the facilities. Competent qualified staff, available resources and testing facilities are required for a successful outcome of the project objectives in regards to scope and schedule. EXHIBIT “B” HOURLY RATES AND/OR UNIT PRICES Refer to Fee Proposal. Fee Proposal Project Inspector Services Project 0000 Xxxxxxx, Xxxxxxxx and Parking The lump sum fee for the Construction Phase of the project beginning 12/19/2016 and finishing 01/20/2017: Class 1 DSA Inspector $6,150.00 If the project exceeds the specified duration and lump sum total, additional fees will be charged as time and materials at our hourly rate as follows: Class 1 DSA Inspector $82.00 Hr.* The following is standard hourly rates: Class 1 DSA Inspector $ 82.00 Hr.* Class 2 DSA Inspector $ 77.00 Hr.* There will be no additional charges for office related expenses or travel time. United Inspection, Inc. will submit monthly xxxxxxxx for services rendered. All regular hourly rates, Monday through Friday, will have a two (2) hour minimum. Overtime: Rate will be charged at time and one-half for any hours worked over forty (40) hours per week (Monday through Friday) and Saturday. Overtime / Sundays and Holidays: Rate to be charged at double time. *Hourly rate for the entire timeframe for that particular project.Determination • Meetings