Common use of COMPLIANCE WITH GOVERNMENT CODE SECTION 7550 Clause in Contracts

COMPLIANCE WITH GOVERNMENT CODE SECTION 7550. As required by Government Code section 7550, each document or report prepared by CONTRACTOR for or under the direction of COUNTY pursuant to this Agreement shall contain the numbers and dollar amounts of the Agreement and all subcontracts under the Agreement relating to the preparation of the document or written report. The Agreement and subcontract dollar amounts shall be contained in a separate section of the document or written report. If multiple documents or written reports are the subject of the Agreement or subcontracts, the disclosure section may also contain a statement indicating that the total contract amount represents compensation for multiple documents or written reports. EXHIBIT “B” SCHEDULE OF FEES [Company Name] [Street Address] [City, ST ZIP Code] Phone [phone] Fax [fax] Taxpayer ID # TO: EXHIBIT “C” FOR: SAMPLE INVOICE INVOICE #_________ DATE:____________ [Customer Name] [Street Address] [City, ST ZIP Code] [Project or service description] Contract No. Date DESCRIPTION Employee & Title HOURS RATE AMOUNT 1/1/15 Xxxxx, 1/1/15 1/1/15 Site visit/investigation 000 Xxxx Xx, Xxxx. Conf w/Owner AutoCad, Bldg X, 3rd Floor Engineer Xxxxx, Engineer Xxxxx, 1.5 1 4 $165.00 $165.00 $165,00 247.50 165.00 660.00 Engineer 1/2/15 Rev plans, phone conf w/Owner Xxxxx, XX 1.75 $195.00 341.25 1/2/15 0/0/00 XxxxXxx Xxxx X, 0xx Xxxxx Xxxxx, Engineer 4 $165.00 660.00 Conf w/Owner re 2nd Floor Xxxxx, .5 $165.00 82.50 Engineer 1/3/15 1/3/15 Mtg w/Xxxxx re 2nd Floor; conf w/Owner Xxxxx, Engineer 1.5 $165.00 247.50 Mtg w/Xxxxx; conf w/Owner re 2nd Xxxxx, XX 1.5 $195.00 292.50 Floor TOTAL Exhibit B, DBE Subcontractor Utilization Form This form is intended to capture the prime contractor’s actual and/or anticipated use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. Prime Contractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Issuing/Funding Entity: I have identified potential DBE certified subcontractors  YES  NO Subcontractor Name/ Company Name Company Address/Phone/Email Est. Dollar Amt Currently DBE Certified? 1 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205. 2 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. In the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CRF Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date DBE Subcontractor Performance This form is intended to capture the DBE3 subcontractors’4 description of work to be performed and the price of the work submitted to the prime contractor. Prime contractor is required to have its DBE subcontractors complete this form and include all completed forms in the prime contractors bid or proposal package unless subcontractors will not be used. Subcontractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Prime Contractor Name Issuing/Funding Entity: Contract Item Number Description of Work Submitted to the Prime Contractor Involving construction, Services, Equipment or Supplies Price of Work Submitted to the Prime Contractor BDE Certified by  DOT  SBA  Other: Meets/ exceeds EPA certification standards:  YES  NO  Unknown 3 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205 4 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date Subcontractor Signature Print Name Title Date MBE/WBE/SBE FORMS Exhibit "C" FEDERAL PROVISIONS

COMPLIANCE WITH GOVERNMENT CODE SECTION 7550. As required by Government Code section 7550, each document or report prepared by CONTRACTOR for or under the direction of COUNTY pursuant to this Agreement shall contain the numbers and dollar amounts of the Agreement and all subcontracts under the Agreement relating to the preparation of the document or written report. The Agreement and subcontract dollar amounts shall be contained in a separate section of the document or written report. If multiple documents or written reports are the subject of the Agreement or subcontracts, the disclosure section may also contain a statement indicating that the total contract amount represents compensation for multiple documents or written reports. EXHIBIT “B” SCHEDULE OF FEES COMPENSATION AND EXPENSE REIMBURSEMENT [DELETE “AND EXPENSE REIMBURSEMENT” IF EXPENSES ARE NOT BEING REIMBURSED. THIS EXHBIT MUST DESCRIBE WHETHER PAYMENT IS FIXED PRICE OR BASED ON AN HOURLY NOT TO EXCEED AMOUNT. IF TRAVEL EXPENSES ARE INCLUDED, THE MAXIMUM PER DIEM AND MAXIMUM LODGING MUST BE SPECIFICALLY SET FORTH.] [Company Name] [Street Address] [City, ST ZIP Code] Phone [phone] Fax [fax] Taxpayer ID # TO: EXHIBIT “C” FOR: SAMPLE INVOICE INVOICE‌ INVOICE #_________ DATE:____________ [Customer Name] [Street Address] [City, ST ZIP Code] [Project or service description] Contract No. Date DESCRIPTION Employee & Title HOURS RATE AMOUNT 1/1/15 Xxxxx, 1/1/15 1/1/15 Site visit/investigation 000 Xxxx Xx, Xxxx. Conf w/Owner AutoCad, Bldg X, 3rd Floor Xxxxx, Engineer Xxxxx, Engineer Xxxxx, Engineer 1.5 1 4 $165.00 $165.00 $165,00 247.50 165.00 660.00 Engineer 1/2/15 Rev plans, phone conf w/Owner Xxxxx, XX 1.75 $195.00 341.25 1/2/15 0/0/00 XxxxXxx Xxxx X, 0xx Xxxxx Xxxxx, Engineer 4 $165.00 660.00 Conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, Engineer 4 .5 $165.00 $165.00 660.00 82.50 Engineer 1/3/15 1/3/15 Mtg w/Xxxxx re 2nd Floor; conf w/Owner Xxxxx, Engineer 1.5 $165.00 247.50 Mtg w/Xxxxx; conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, XX 1.5 1.5 $165.00 $195.00 292.50 Floor TOTAL Exhibit B, DBE Subcontractor Utilization Form This form is intended to capture the prime contractor’s actual and/or anticipated use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. Prime Contractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Issuing/Funding Entity: I have identified potential DBE certified subcontractors  YES  NO Subcontractor Name/ Company Name Company Address/Phone/Email Est. Dollar Amt Currently DBE Certified? 1 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205. 2 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. In the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CRF Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date DBE Subcontractor Performance This form is intended to capture the DBE3 subcontractors’4 description of work to be performed and the price of the work submitted to the prime contractor. Prime contractor is required to have its DBE subcontractors complete this form and include all completed forms in the prime contractors bid or proposal package unless subcontractors will not be used. Subcontractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Prime Contractor Name Issuing/Funding Entity: Contract Item Number Description of Work Submitted to the Prime Contractor Involving construction, Services, Equipment or Supplies Price of Work Submitted to the Prime Contractor BDE Certified by  DOT  SBA  Other: Meets/ exceeds EPA certification standards:  YES  NO  Unknown 3 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205 4 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date Subcontractor Signature Print Name Title Date MBE/WBE/SBE FORMS Exhibit "C" FEDERAL PROVISIONS247.50 292.50

COMPLIANCE WITH GOVERNMENT CODE SECTION 7550. As required by Government Code section 7550, each document or report prepared by CONTRACTOR for or under the direction of COUNTY pursuant to this Agreement shall contain the numbers and dollar amounts of the Agreement and all subcontracts under the Agreement relating to the preparation of the document or written report. The Agreement and subcontract dollar amounts shall be contained in a separate section of the document or written report. If multiple documents or written reports are the subject of the Agreement or subcontracts, the disclosure section may also contain a statement indicating that the total contract amount represents compensation for multiple documents or written reports. EXHIBIT “B” SCHEDULE OF FEES COMPENSATION ACTIVITY Hours $100.00/HR Task 1 Update Property Database 16 $1,600.00 Task 2 Calculate Assessments 12 $1,200.00 Task 3 Prepare Engineer's Report 16 $1,600.00 Task 4 Submit Assessment Roll 10 $1,000.00 Task 5 Attend Meetings 4 $400.00 PROJECT TOTALS: Hours 58.0 Project cost $5,800.00 [Company Name] [Street Address] [City, ST ZIP Code] Phone [phone] Fax [fax] Taxpayer ID # TO: EXHIBIT “C” FOR: SAMPLE INVOICE INVOICE #_________ DATE:____________ [Customer Name] [Street Address] [City, ST ZIP Code] [Project or service description] Contract No. Date DESCRIPTION Employee & Title HOURS RATE AMOUNT 1/1/15 Xxxxx, 1/1/15 1/1/15 Site visit/investigation 000 Xxxx Xx, Xxxx. Conf w/Owner AutoCad, Bldg X, 3rd Floor Xxxxx, Engineer Xxxxx, Engineer Xxxxx, Engineer 1.5 1 4 $165.00 $165.00 $165,00 247.50 165.00 660.00 Engineer 1/2/15 Rev plans, phone conf w/Owner Xxxxx, XX 1.75 $195.00 341.25 1/2/15 0/0/00 XxxxXxx Xxxx X, 0xx Xxxxx Xxxxx, Engineer 4 $165.00 660.00 Conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, Engineer 4 .5 $165.00 $165.00 660.00 82.50 Engineer 1/3/15 1/3/15 Mtg w/Xxxxx re 2nd Floor; conf w/Owner Xxxxx, Engineer 1.5 $165.00 247.50 Mtg w/Xxxxx; conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, XX 1.5 1.5 $165.00 $195.00 292.50 Floor TOTAL Exhibit B, DBE Subcontractor Utilization Form This form is intended to capture the prime contractor’s actual and/or anticipated use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. Prime Contractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Issuing/Funding Entity: I have identified potential DBE certified subcontractors  YES  NO Subcontractor Name/ Company Name Company Address/Phone/Email Est. Dollar Amt Currently DBE Certified? 1 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205. 2 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. In the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CRF Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date DBE Subcontractor Performance This form is intended to capture the DBE3 subcontractors’4 description of work to be performed and the price of the work submitted to the prime contractor. Prime contractor is required to have its DBE subcontractors complete this form and include all completed forms in the prime contractors bid or proposal package unless subcontractors will not be used. Subcontractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Prime Contractor Name Issuing/Funding Entity: Contract Item Number Description of Work Submitted to the Prime Contractor Involving construction, Services, Equipment or Supplies Price of Work Submitted to the Prime Contractor BDE Certified by  DOT  SBA  Other: Meets/ exceeds EPA certification standards:  YES  NO  Unknown 3 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205 4 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date Subcontractor Signature Print Name Title Date MBE/WBE/SBE FORMS Exhibit "C" FEDERAL PROVISIONS247.50 292.50

COMPLIANCE WITH GOVERNMENT CODE SECTION 7550. As required by Government Code section 7550, each document or report prepared by CONTRACTOR for or under the direction of COUNTY pursuant to this Agreement shall contain the numbers and dollar amounts of the Agreement and all subcontracts under the Agreement relating to the preparation of the document or written report. The Agreement and subcontract dollar amounts shall be contained in a separate section of the document or written report. If multiple documents or written reports are the subject of the Agreement or subcontracts, the disclosure section may also contain a statement indicating that the total contract amount represents compensation for multiple documents or written reports. EXHIBIT “B” SCHEDULE OF FEES [Company Name] [Street Address] [City, ST ZIP Code] Phone [phone] Fax [fax] Taxpayer ID # TO: EXHIBIT “C” FOR: SAMPLE INVOICE INVOICE #_________ DATE:____________ [Customer Name] [Street Address] [City, ST ZIP Code] [Project or service description] Contract No. Date DESCRIPTION Employee & Title HOURS RATE AMOUNT 1/1/15 Xxxxx, 1/1/15 1/1/15 Site visit/investigation 000 Xxxx Xx, Xxxx. Conf w/Owner AutoCad, Bldg X, 3rd Floor Engineer Xxxxx, Engineer Xxxxx, 1.5 1 4 $165.00 $165.00 $165,00 247.50 165.00 660.00 Engineer 1/2/15 Rev plans, phone conf w/Owner Xxxxx, XX 1.75 $195.00 341.25 1/2/15 0/0/00 XxxxXxx Xxxx X, 0xx Xxxxx Xxxxx, Engineer 4 $165.00 660.00 Conf w/Owner re 2nd Floor Xxxxx, .5 $165.00 82.50 Engineer 1/3/15 1/3/15 Mtg w/Xxxxx re 2nd Floor; conf w/Owner Xxxxx, Engineer 1.5 $165.00 247.50 Mtg w/Xxxxx; conf w/Owner re 2nd Xxxxx, XX 1.5 $195.00 292.50 Floor TOTAL Exhibit B, DBE Subcontractor Utilization Form This form is intended to capture the prime contractor’s actual and/or anticipated use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. Prime Contractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Issuing/Funding Entity: I have identified potential DBE certified subcontractors  ⭘ YES  ⭘ NO Subcontractor Name/ Company Name Company Address/Phone/Email Est. Dollar Amt Currently DBE Certified? 1 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205. 2 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. In the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CRF Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date DBE Subcontractor Performance This form is intended to capture the DBE3 subcontractors’4 description of work to be performed and the price of the work submitted to the prime contractor. Prime contractor is required to have its DBE subcontractors complete this form and include all completed forms in the prime contractors bid or proposal package unless subcontractors will not be used. Subcontractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Prime Contractor Name Issuing/Funding Entity: Contract Item Number Description of Work Submitted to the Prime Contractor Involving construction, Services, Equipment or Supplies Price of Work Submitted to the Prime Contractor BDE Certified by  ⭘ DOT  ⭘ SBA  ⭘ Other: Meets/ exceeds EPA certification standards:  ⭘ YES  ⭘ NO  ⭘ Unknown 3 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205 4 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date Subcontractor Signature Print Name Title Date MBE/WBE/SBE FORMS Exhibit "C" FEDERAL PROVISIONS

COMPLIANCE WITH GOVERNMENT CODE SECTION 7550. As required by Government Code section 7550, each document or report prepared by CONTRACTOR for or under the direction of COUNTY pursuant to this Agreement shall contain the numbers and dollar amounts of the Agreement and all subcontracts under the Agreement relating to the preparation of the document or written report. The Agreement and subcontract dollar amounts shall be contained in a separate section of the document or written report. If multiple documents or written reports are the subject of the Agreement or subcontracts, the disclosure section may also contain a statement indicating that the total contract amount represents compensation for multiple documents or written reports. EXHIBIT “B” SCHEDULE OF FEES COMPENSATION AND EXPENSE REIMBURSEMENT [Company Name] [Street Address] [City, ST ZIP Code] Phone [phone] Fax [fax] Taxpayer ID # TO: EXHIBIT “C” SAMPLE INVOICE AND TASK ORDER FOR: SAMPLE INVOICE INVOICE #_________ DATE:____________ [Customer Name] [Street Address] [City, ST ZIP Code] [Project or service description] Contract No. Date DESCRIPTION Employee & Title HOURS RATE AMOUNT 1/1/15 Xxxxx, 1/1/15 1/1/15 Site visit/investigation 000 Xxxx Xx, Xxxx. Conf w/Owner AutoCad, Bldg X, 3rd Floor Xxxxx, Engineer Xxxxx, Engineer Xxxxx, Engineer 1.5 1 4 $165.00 $165.00 $165,00 247.50 165.00 660.00 Engineer 1/2/15 Rev plans, phone conf w/Owner Xxxxx, XX 1.75 $195.00 341.25 1/2/15 0/0/00 XxxxXxx Xxxx X, 0xx Xxxxx Xxxxx, Engineer 4 $165.00 660.00 Conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, Engineer 4 .5 $165.00 $165.00 660.00 82.50 Engineer 1/3/15 1/3/15 Mtg w/Xxxxx re 2nd Floor; conf w/Owner Xxxxx, Engineer 1.5 $165.00 247.50 Mtg w/Xxxxx; conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, XX 1.5 1.5 $165.00 $195.00 247.50 292.50 Floor TOTAL Exhibit BEXHIBIT “D” CALIFORNIA PREVAILING WAGE REQUIREMENTS Pursuant to California Labor Code sections 1720 and 1771, DBE Subcontractor Utilization Form This form is intended to capture the prime contractor’s actual and/or anticipated use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. Prime Contractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Issuing/Funding Entity: I have identified potential DBE certified subcontractors  YES  NO Subcontractor Name/ Company Name Company Address/Phone/Email Est. Dollar Amt Currently DBE Certified? 1 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205. 2 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. In the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CRF Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date DBE Subcontractor Performance This form is intended to capture the DBE3 subcontractors’4 description of work to be performed and the price of the work submitted to the prime contractor. Prime contractor is required to have its DBE subcontractors complete this form and include all completed forms in the prime contractors bid or proposal package unless subcontractors will not be used. Subcontractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Prime Contractor Name Issuing/Funding Entity: Contract Item Number Description of Work Submitted to the Prime Contractor Involving construction, Servicesalteration, Equipment or Supplies Price of Work Submitted demolition, installation, repair and maintenance work performed under this Agreement is subject to State prevailing wage laws. State prevailing wage laws require certain provisions be included in all contracts for public works. The Contractor and any subcontractors shall comply with State prevailing wage laws including, but not limited to, the Prime Contractor BDE Certified by  DOT  SBA  Other: Meets/ exceeds EPA certification standards:  YES  NO  Unknown 3 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205 4 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date Subcontractor Signature Print Name Title Date MBE/WBE/SBE FORMS Exhibit "C" FEDERAL PROVISIONSlisted below.

COMPLIANCE WITH GOVERNMENT CODE SECTION 7550. As required by Government Code section 7550, each document or report prepared by CONTRACTOR for or under the direction of COUNTY pursuant to this Agreement shall contain the numbers and dollar amounts of the Agreement and all subcontracts under the Agreement relating to the preparation of the document or written report. The Agreement and subcontract dollar amounts shall be contained in a separate section of the document or written report. If multiple documents or written reports are the subject of the Agreement or subcontracts, the disclosure section may also contain a statement indicating that the total contract amount represents compensation for multiple documents or written reports. EXHIBIT “B” SCHEDULE OF FEES [Company Name] [Street Address] [City, ST ZIP Code] Phone [phone] Fax [fax] Taxpayer ID # TO: EXHIBIT “C” FOR: SAMPLE INVOICE INVOICE #_________ DATE:____________ [Customer Name] [Street Address] [City, ST ZIP Code] [Project or service description] Contract No. Date DESCRIPTION Employee & Title HOURS RATE AMOUNT 1/1/15 Xxxxx, 1/1/15 1/1/15 Site visit/investigation 000 Xxxx Xx, Xxxx. Conf w/Owner AutoCad, Bldg X, 3rd Floor Xxxxx, Engineer Xxxxx, Engineer Xxxxx, Engineer 1.5 1 4 $165.00 $165.00 $165,00 247.50 165.00 660.00 Engineer 1/2/15 Rev plans, phone conf w/Owner Xxxxx, XX 1.75 $195.00 341.25 1/2/15 0/0/00 XxxxXxx Xxxx X, 0xx Xxxxx Xxxxx, Engineer 4 $165.00 660.00 Conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, Engineer 4 .5 $165.00 $165.00 660.00 82.50 Engineer 1/3/15 1/3/15 Mtg w/Xxxxx re 2nd Floor; conf w/Owner Xxxxx, Engineer 1.5 $165.00 247.50 Mtg w/Xxxxx; conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, XX 1.5 1.5 $165.00 $195.00 292.50 Floor TOTAL Exhibit B, DBE Subcontractor Utilization Form This form is intended to capture the prime contractor’s actual and/or anticipated use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. Prime Contractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Issuing/Funding Entity: I have identified potential DBE certified subcontractors  YES  NO Subcontractor Name/ Company Name Company Address/Phone/Email Est. Dollar Amt Currently DBE Certified? 1 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205. 2 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. In the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CRF Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date DBE Subcontractor Performance This form is intended to capture the DBE3 subcontractors’4 description of work to be performed and the price of the work submitted to the prime contractor. Prime contractor is required to have its DBE subcontractors complete this form and include all completed forms in the prime contractors bid or proposal package unless subcontractors will not be used. Subcontractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Prime Contractor Name Issuing/Funding Entity: Contract Item Number Description of Work Submitted to the Prime Contractor Involving construction, Services, Equipment or Supplies Price of Work Submitted to the Prime Contractor BDE Certified by  DOT  SBA  Other: Meets/ exceeds EPA certification standards:  YES  NO  Unknown 3 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205 4 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date Subcontractor Signature Print Name Title Date MBE/WBE/SBE FORMS Exhibit "C" FEDERAL PROVISIONS247.50 292.50

COMPLIANCE WITH GOVERNMENT CODE SECTION 7550. As required by Government Code section 7550, each document or report prepared by CONTRACTOR for or under the direction of COUNTY pursuant to this Agreement shall contain the numbers and dollar amounts of the Agreement and all subcontracts under the Agreement relating to the preparation of the document or written report. The Agreement and subcontract dollar amounts shall be contained in a separate section of the document or written report. If multiple documents or written reports are the subject of the Agreement or subcontracts, the disclosure section may also contain a statement indicating that the total contract amount represents compensation for multiple documents or written reports. EXHIBIT “B” SCHEDULE OF FEES COMPENSATION AND EXPENSE REIMBURSEMENT “Insert Caltrans 10-H2 for FHWA and consultants hourly rates for non-FHWA projects placed here” [Company Name] [Street Address] [City, ST ZIP Code] Phone [phone] Fax [fax] Taxpayer ID # TO: EXHIBIT “C” SAMPLE INVOICE AND TASK ORDER FOR: SAMPLE INVOICE INVOICE #_________ DATE:____________ [Customer Name] [Street Address] [City, ST ZIP Code] [Project or service description] Contract No. Date DESCRIPTION Employee & Title HOURS RATE AMOUNT 1/1/15 Xxxxx, 1/1/15 1/1/15 Site visit/investigation 000 Xxxx Xx, Xxxx. Conf w/Owner AutoCad, Bldg X, 3rd Floor Xxxxx Xxxxx, Engineer Xxxxx, Engineer Xxxxx, Engineer 1.5 1 4 $165.00 $165.00 $165,00 247.50 165.00 660.00 Engineer 1/2/15 Rev plans, phone conf w/Owner Xxxxx, XX 1.75 $195.00 341.25 1/2/15 0/0/00 XxxxXxx Xxxx X, 0xx Xxxxx Xxxxx, Engineer 4 $165.00 660.00 Conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, Engineer 4 .5 $165.00 $165.00 660.00 82.50 Engineer 1/3/15 1/3/15 Mtg w/Xxxxx re 2nd Floor; conf w/Owner Xxxxx, Engineer 1.5 $165.00 247.50 Mtg w/Xxxxx; conf w/Owner re 2nd Floor Xxxxx, Engineer Xxxxx, XX 1.5 1.5 $165.00 $195.00 247.50 292.50 Floor TOTAL Exhibit BEXHIBIT “D” CALIFORNIA PREVAILING WAGE REQUIREMENTS Pursuant to California Labor Code sections 1720 and 1771, DBE Subcontractor Utilization Form This form is intended to capture the prime contractor’s actual and/or anticipated use of identified certified DBE1 subcontractors2 and the estimated dollar amount of each subcontract. Prime Contractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Issuing/Funding Entity: I have identified potential DBE certified subcontractors  YES  NO Subcontractor Name/ Company Name Company Address/Phone/Email Est. Dollar Amt Currently DBE Certified? 1 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205. 2 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. In the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CRF Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date DBE Subcontractor Performance This form is intended to capture the DBE3 subcontractors’4 description of work to be performed and the price of the work submitted to the prime contractor. Prime contractor is required to have its DBE subcontractors complete this form and include all completed forms in the prime contractors bid or proposal package unless subcontractors will not be used. Subcontractor Name Project Name Bid/Proposal No. Assistance Agreement ID No. ( If known) Point of Contact Address Telephone No. Email Address Prime Contractor Name Issuing/Funding Entity: Contract Item Number Description of Work Submitted to the Prime Contractor Involving construction, Servicesalteration, Equipment or Supplies Price of Work Submitted demolition, installation, repair and maintenance work performed under this Agreement is subject to State prevailing wage laws. State prevailing wage laws require certain provisions be included in all contracts for public works. The Contractor and any subcontractors shall comply with State prevailing wage laws including, but not limited to, the Prime Contractor BDE Certified by  DOT  SBA  Other: Meets/ exceeds EPA certification standards:  YES  NO  Unknown 3 A DBE is a Disadvantaged, Minority, Small or Woman Business Enterprise that has been certified as described in 40 CFR 33.204-33.205 4 Subcontractor is defined as a company, firm, joint venture or individual who enters into an agreement with a contractor to provide services pursuant to an EPA award of financial assistance. DBE Subcontractor Performance I certify under penalty of perjury that the foregoing statements are true and correct. Signing this form does not signify a commitment to utilize the subcontractors above. I am aware of that in the event of a replacement of a subcontractor, I will adhere to the replacement requirements set forth in 40 CFR Part 33 Section 33.302(c). Prime Contractor Signature Print Name Title Date Subcontractor Signature Print Name Title Date MBE/WBE/SBE FORMS Exhibit "C" FEDERAL PROVISIONSlisted below.