File #: 11-569    Name:
Type: Minutes Status: Passed
File created: 5/24/2011 In control: Board of Supervisors
On agenda: 5/24/2011 Final action: 5/24/2011
Title: Authorize the Purchasing Manager for Natividad Medical Center (NMC) to execute Amendment No. 2 to the Authorize the Purchasing Manager for Natividad Medical Center (NMC) to execute Amendment No. 2 to the
Attachments: 1. Completed Board Order and Amendment, 2. Signed Board Report and Supporting Docs

 

 

 

 

 

 

COMPLETED BOARD ORDER AND AME�L�23

Before the Board of Supervisors in and for the

County of Monterey, State of California

Agreement No. A-11997

Authorize the Purchasing Manager for Natividad

Medical Center NMC) to execute Amendment #2 to the

Agreement with Quinn Power Systems for Maintenance

for Caterpillar Diesel Electric Sets and Emergency 6

Power Generator Services at NMC in an amount not to

exceed $140,000 in the aggregate and $40,000 for the

period July 1, 2011 to June 30, 2012 

Upon motion of Supervisor Potter, seconded by Supervisor Armenta, and carried by those

members present, the Board hereby;

Authorized the Purchasing Manager for Natividad Medical Center NMC) to

execute Amendment #2 to the Agreement with Quinn Power Systems for

Maintenance for Caterpillar Diesel Electric Sets and Emergency 6 Power

Generator Services at NMC in an amount not to exceed $140,000 in the aggregate

and $40,000 for the period July 1, 2011 to June 30, 2012.

PASSED AND ADOPTED on this 24`" day of May, 2011, by the following vote, to wit:

AYES: Supervisors Armenta, Calcagno, Salinas, Parker, and Potter

NOES: None

ABSENT: None

I, Gail T. Borkowski, Clerk of the Board of Supervisors of the County of Monterey, State of California, hereby

certify that the foregoing is a true copy of an original order of said Board of Supervisors duly made and entered in the

minutes thereof of Minute Book 75 for the meeting on May 24, 2011.

Dated: May 25, 2011 Gail T. Borkowski, Clerk of the Board of Supervisors

County of Monterey, State of California

By

Deputy

 

 

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COMPLETED BOARD ORDER AND AME�L�Original Agreement No or POX SC0958)

RENEWAL AMENDMENT NO.2

FOR PROFESSIONAL SERVICE AGREEMENT

BETWEEN Quinn Power Systems AND

THE NATIVIDAD MEDICAL CENTER

FOR

Provide Maintenance for the Caterpillar Diesel Electric Sets and Emergency 6 Power Generators for NMC

The parties to Professional Service Agreement, dated March 01, 2006between the County of Monterey, on behalf

of Natividad Medical Center NMC"), and Quinn Power Systems Contractor), hereby agree to renew their

Agreement No. SC0958) on the following terms and conditions:

1. Contractor will continue to provide NMC with the salve scope of service as stated in the original Agreement

No. SC0958).

2. This Amendment shall become effective on July 1, 2011 and shall continue in full force until June 30, 2012.

3. The total amount payable by County to Contractor under Agreement No. SC0958) shall not exceed the

total sum of $140,000 for the full term of the Agreement and $40,000 for fiscal year 2011-2012.

4. All other terms and conditions of the Agreement shall continue in full force and effect.

5. A copy of this Amendment shall be attached to the original Agreement No. SC0958).

IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and Professional

Service Agreement on the basis set forth in this document and have executed this amendment on the day and year

set forth herein.

CONTRACTOR

Printed Name ROBERT J ALLEN

Signature 2.__A---

Printed Name LINO MARTIN

Dated April 12, 2011

Title V.P. & General Manager

Dated April 12, 2011

Title Secretary

*"INSTRUCTIONS: If CONTRACTOR is a corporation, including limited liability and non-profit corporations, the full legal name of the

corporation shall be set forth above together with the signatures of two specified officers. If CONTRACTOR is a partnership, the name of

the partnership shall be set forth above together with the signature of a partner who has authority to execute this Agreement on behalf of

the partnership. If CONTRACTOR is contracting in and individual capacity, the individual shall set forth the name of the business, if any

and shall personally sign the Agreement.

NATIVIDAD MEDICAL CENTER

Signature Dated

Purchasing Manager

Signature

NMC  CEO

Dated

OVISIOlIS

Approved as to Legal Form:

Charles J. McKee, County Counsel

Stacy Saetta, Deputy

Attorneys for County and NMC

Z i a

County f Monterey

Dated:     201 1

 

 

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SIGNED BOARD REPORT AND SUPPO�O�r4

MONTEREY COUNTY BOARD OF SUPERVISORS

MEETING: May 24, 2011

AGENDA NO.:

SUBJECT: Authorize the Purchasing Manager for Natividad Medical Center NMC)

to execute Amendment #2 to the Agreement with Quinn Power Systems

for Maintenance for Caterpillar Diesel Electric Sets and Emergency 6

Power Generator Services at NMC in an amount not to exceed $140,000

in the aggregate and $40,000 for the period July 1, 2011 to June 30, 2012.

DEPARTMENT: Natividad Medical Center

RECOMMENDATION:

It is recommended that the Board of Supervisors Authorize the Purchasing Manager for Natividad

Medical Center NMC) to execute Amendment #2 to the Agreement with Quinn Power Systems for

Maintenance for Caterpillar Diesel Electric Sets and Emergency 6 Power Generator Services at

NMC in an amount not to exceed $140,000 in the aggregate and $40,000 for the period July 1, 2011

to June 30, 2012.

SUMMARY/DISCUSSION:

Quinn Power Systems has provided emergency generator and automatic transfer switch preventive

maintenance and testing services for Natividad Medical Center since March of 2006.

The Life Safety Code requires the hospital to provide reliable emergency electrical power to alarm

systems, exit route and exit sign illumination, emergency communication systems, elevators,

equipment that could cause patient harm when it fails, including life support systems, blood, bone,

and tissue storage systems, medical air compressors, medical and surgical vacuum systems, and

areas in which loss of power could result in patient harm, including operating rooms, recovery

rooms, obstetrical delivery rooms, nurseries, and urgent care areas. Maintaining the reliability of the

emergency electrical system requires periodic preventive maintenance to be performed.

In addition, the Joint Commission requires that monthly emergency generator tests are conducted

with a dynamic load that is at least 30% of the nameplate rating of the generator or meets the

manufacturer's recommended prime movers' exhaust gas temperature. If the hospital does not meet

either the 30% of nameplate rating or the recommended exhaust gas temperature during any of the

monthly tests then they must test each emergency generator once every 12 months using

supplemental dynamic or static) loads of. 25% of nameplate rating for 30 minutes, followed by 50%

of nameplate rating for 30 minutes, followed by 75% of nameplate rating for 60 minutes, for a total

of 2 continuous hours.

At least once every 36 months, hospitals must test each emergency generator under dynamic or static

load that is at least 30% of the nameplate rating of the generator or meets the manufacturer's

recommended prime movers' exhaust gas temperature for a minimum of 4 continuous hours.

In addition to the generator maintenance and testing, the automatic transfer switches are required to

be maintained in operating condition to provide automatic restoration of power for emergency

circuits within ten seconds after normal power failure.

A written record of inspection, performance, exercising period and repairs shall be maintained and

available.

 

 

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SIGNED BOARD REPORT AND SUPPO�O�r

OTHER AGENCY INVOLVEMENT:

The Amendment has been reviewed and approved by County Counsel, the Auditor/Controller's

office and the Natividad Medical Center Board of Trustees.

FINANCING:

The cost for this Amendment is $40,000 and is included in the 2011/2012 Fiscal Year

Recommended Budget. This action will not require any additional General Fund subsidy.

n

Prepared by: l�

James Kari, Engineering Director 755-4280 Harry Weis

April 4, 2011 Chief Executive Officer

Attachments; Amendments #1, 2, Original Agreement, Board Order

 

 

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SIGNED BOARD REPORT AND SUPPO�O�Original Agreement No or PO#. SC0958)

RENEWAL AMENDMENT NO.2

FOR PROFESSIONAL SERVICE AGREEMENT

BETWEEN Quinn Power Systems AND

THE NATIVIDAD MEDICAL CENTER

FOR

Provide Maintenance for the Caterpillar Diesel Electric Sets and Emergency 6 Power Generators for NMC

The parties to Professional Service Agreement, dated March 01, 2006between the County of Monterey, on behalf

of Natividad Medical Center NMC"), and Quinn Power Systems Contractor), hereby agree to renew their

Agreement No. SC0958) on the following terms and conditions:

1. Contractor will continue to provide NMC with the same scope of service as stated in the original Agreement

No. SC0958).

2. This Amendment shall become effective on July 1, 2011 and shall continue in full force until June 30, 2012.

3. The total amount payable by County to Contractor under Agreement No. 5C0958) shall not exceed the

total sum of $140,000 for the full term of the Agreement and $40,000 for fiscal year 2011-2012.

4. All other terms and conditions of the Agreement shall continue in full force and effect.

5. A copy of this Amendment shall be attached to the original Agreement No. SC0958).

IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and Professional

Service Agreement on the basis set forth in this document and have executed this amendment on the day and year

set forth herein.

CONTRACTOR

Signature 1 Dated April 12, 2011

Printed Name ROB T J ALLEN Title V.P. & General Manager

Signature 2 r Dated April 12, 2011

Printed Name LINO MARTIN Title Secretary

** *INSTRUCTIONS: If CONTRACTOR is a corporation, including limited liability and non-profit corporations, the full legal name of the

corporation shall be set forth above together with the signatures of two specified officers., If CONTRACTOR is a partnership, the name of

the partnership shall be set forth above together with the signature of a partner who has authority to execute this Agreement on behalf of

the partnership. If CONTRACTOR is contracting in and individual capacity, the individual shall set forth the name of the business, if any

and shall personally sign the Agreement.

NATIVIDAD MEDICAL CENTER

Signature

Signature

Purchasing Manager

NMC  CEO

Approved as to Legal Form:

Charles J. McKee, County Counsel

By

acy Saetta, Deputy

Attorneys for County and NMC

Dated

Dated

editor/Olontroller

rlnt~~ f Monterey

Dated:

2011

 

 

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SIGNED BOARD REPORT AND SUPPO�O�Original Agreement No or PO#. SC0958)

RENEWAL AMENDMENT NO.2

FOR PROFESSIONAL SERVICE AGREEMENT

BETWEEN Quinn Power Systems AND

THE NATIVIDAD MEDICAL CENTER

FOR

Provide Maintenance for the Caterpillar Diesel Electric Sets and Emergency 6 Power Generators for NMC

The parties to Professional Service Agreement, dated March 01, 2006between the County of Monterey, on behalf

of Natividad Medical Center NMC"), and Quinn Power Systems Contractor), hereby agree to renew their

Agreement No. SC0958) on the following terms and conditions:

1. Contractor will continue to provide NMC with the same scope of service as stated in the original Agreement

No. SC0958).

2. This Amendment shall become effective on July 1, 2011 and shall continue in full force until June 30, 2012.

3. The total amount payable by County to Contractor under Agreement No. SC0958) shall not exceed the

total sum of $140,000 for the full term of the Agreement and $40,000 for fiscal year 2011-2012.

4. All other terms and conditions of the. Agreement shall continue in full force and effect.

5. A copy of this Amendment shall be attached to the original Agreement No. SC0958).

IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and Professional

Service Agreement on the basis set forth in this document and have executed this amendment on the day and year

set forth herein.

CONTRACTOR

Signature

Printed Name ROBERT J ALLEN

Signature 2

Printed Name LINO MARTIN

Dated April 12, 2011

Title V.P. & General Manager

Dated April 12, 2011

Title Secretary

***INSTRUCTIONS: If CONTRACTOR is a corporation, including limited liability and non-profit corporations, the full legal name of the

corporation shall be set forth above together with the signatures of two specified officers. If CONTRACTOR is a partnership, the name of

the partnership shall be set forth above together with the signature of a partner who has authority to execute this Agreement on behalf of

the partnership. If CONTRACTOR is contracting in and individual capacity, the individual shall set forth the name of the business, if any

and shall personally sign the Agreement.

NATIVIDAD MEDICAL CENTER

Signature

Signature

Purchasing Manager

NMC  CEO

Approved as to Legal Form:

Charles J. McKee, County Counsel

By

Stacy Saetta, De rty

Attorneys for County and NMC

Dated

Dated

 

ount,t f Monterey

Dated:

  C 2011

 

 

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SIGNED BOARD REPORT AND SUPPO�O�Original Agreement No or PO#. S C 0958)

RENEWAL AMENDMENT NO.2

FOR PROFESSIONAL SERVICE AGREEMENT

BETWEEN Quinn Power Sytems AND

THE NATIVIDAD MEDICAL CENTER

FOR

Provide Maintenance for the caterpillar Diesel Electric Sets and Emergency 6 Power Generators for NMC

The parties to Professional Service Agreement, dated March 01, 2006 between the County of Monterey,

on behalf of Natividad Medical Center NMC"), and Quinn Power Systems Contractor), hereby agree

to renew their Agreement No. SC 0958) on the following terms and conditions:

1. Contractor will continue to provide NMC with the same scope of service as stated in the original

Agreement No. SC 0958).

2. This Amendment shall become effective on July 01, 2011 and shall continue-in full force until

June 30, 2012.

3. The total amount payable by County to Contractor under Agreement No. SC 0958) shall not

exceed the total sum of $140,000 for the full term of the Agreement and $40,000 for fiscal year

2011-2012.

4. All other terms and conditions of the Agreement shall continue in full force and effect.

5. A copy of this Amendment shall be attached to the original Agreement No. SC 0958).

IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and

Professional Service Agreement on the basis set forth in this document and have executed this

amendment on the day and year set forth herein.

CONTRACTOR

 

Signature

Dated

Printed Name David A. Covell Title Manager EPC&SS

NATIVIDAD MEDICAL CENTER

Signature

Purchasing Manager

Signature f-

Dated

Dated U 1-4h,

NMC  CEO

Approved as to Legal Form:

Charles J. McKee, County Counsel

By JU1 1.

Stacy 3aCtt~, Deputy

Attorneys for County and NMC

 

 

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SIGNED BOARD REPORT AND SUPPO�O�Original Agreement No or POX SC 095 8)

RENEWAL AMENDMENT NO. 2

FOR PROFESSIONAL SERVICE AGREEMENT

BETWEEN Quinn Power Sytems AND

THE NATIVIDAD MEDICAL CENTER

FOR

Provide Maintenance for the caterpillar Diesel Electric Sets and Emergency 6 Power Generators for NMC

The parties to Professional Service Agreement, dated March 01, 2006 between the County of Monterey,

on behalf of Natividad Medical Center NMC"), and Quinn Power Systems Contractor), hereby agree

to renew their Agreement No. SC 0958) on the following terms and conditions:

1. Contractor will continue to provide NMC with the same scope of service as stated in the original

Agreement No. SC 0958).

2. This Amendment shall become effective on July 01, 2011 and shall continue in full force until

June 30, 2012.

3. The total amount payable by County to Contractor under Agreement No. SC 0958) shall not

exceed the total sum of $140,000 for the full term of the Agreement and $40,000 for fiscal year

2011-2012.

4. All other terms and conditions of the Agreement shall continue in full force and effect.

5. A copy of this Amendment shall be attached to the original Agreement No. SC 0958).

IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and

Professional Service Agreement on the basis set forth in this document and have executed this

amendment on the day and year set forth herein.

CONTRACTOR

Signature

Printed Name David A. Covell Title Manager EPC&SS

Dated 3   I  r

NATIVIDAD MEDICAL CENTER

Signature

Purchasing Manager

Dated

Signature

NMC  CEO

Approved as to Legal Form:

Charles J. McKee, County Counsel

By

$aeg-Saetta, Deputy

Attorneys for County and NMC

Dated I Y I t

Dated: l   2011

 

 

BIB]

 

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SIGNED BOARD REPORT AND SUPPO�O�Original Agreement No orPO#. S C 0958)

RENEWAL AMENDMENT NO.2

FOR PROFESSIONAL SERVICE AGREEMENT

BETWEEN Quinn Power Sytems AND

THE NATIVIDAD MEDICAL CENTER

FOR

Provide Maintenance for the caterpillar Diesel Electric Sets and Emergency 6 Power Generators for NMC

The parties to Professional Service Agreement, dated March 01, 2006 between the County of Monterey,

on behalf of Natividad Medical Center NMC"), and Quinn Power Systems Contractor), hereby agree

to renew their Agreement No. SC 0958) on the following terms and conditions:

1. Contractor will continue to provide NMC with the same scope of service as stated in the original

Agreement No. SC 0958).

2. This Amendment shall become effective on July 01, 2011 and shall continue in full force until

June 30, 2012.

3. The total amount payable by County to Contractor under Agreement No. SC 0958) shall not

exceed the total sum of $140,000 for the full term of the Agreement and $40,000 for fiscal year

2011-2012.

4. All other terms and conditions of the Agreement shall continue in full force and effect.

5. A copy of this Amendment shall be attached to the original Agreement No. SC 0958).

IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and

Professional Service Agreement on the basis set forth in this document and have executed this

amendment on the day and year set forth herein.

CONTRACTOR

 

Signature

Dated 3[911)

Printed Name David A. Covell Title Manager EPC&SS

NATIVIDAD MEDICAL CENTER

Signature

Signature

Purchasing Manager

NMC  CEO

Approved as to Legal Form:

Charles J. McKee, County Counsel

Dated

Dated  1)-'~ I,I

By

r~~ C

tacy-Saetta, Deputy

Attorneys for County and NMC Dated: 2  2011

1 151011")

 

Monterey

 

 

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SIGNED BOARD REPORT AND SUPPO�O�COUNTY OF MONTEREY

PURCHASE ORDER

50000.00

 

V QUINN POWER SYSTEMS S NATIVIDAD MEDICAL CENTER B NATIVIDAD MEDICAL CENTER

E  H 1441 CONSTITUTION BLVD I P 0 BOX 81611

N DEPT 9665  L

D  P  L

0   SALINAS CA 93906  SALINAS CA 93912-1611

R  T  T

 LOS ANGELES CA 90084-9665 0  0

VENDOR NUMBER: CV000001834

ITEM I QUANTITY

UNIT COMMODITY CODE

DELIVERY DATE:

ITEM DESCRIPTION

F.O.B.:

PURCH DESC: CC: 8462 THIS PURCHASE ORDER IS ISSUED TO QUINN POWER SYSTEMS PER AMENDMENT #1 TO AGREEMENT

#BPO2128 TO PROVIDE MAINTENANCE FOR CATERPILLAR DIESEL ELECTRIC SETS AND EMERGENDY 6 POWER GENERATORS

SERVICES AT NMC.

ALL SERVICES SHALL BE PROVIDED IN ACCORDANCE WITH TERMS, CONDITIONS, AND EXHIBITS OF THE APPROVED COUNTY OF

MONTEREY AGREEMENT.

TERM OF THE AGREEMENT MARCH 1, 2009 THROUGH JUNE 30, 2011 UNLESS SOONER TERMINATED PURSUANT TO THE TERM OF

THE AGREEMENT.

THIS PURCHASE ORDER IS VALID 7-1-2010 THROUGH 6-30-2011. A NEW PURCHASE ORDER WILL BE ISSUED AFTER THAT TIME TO

THE CURRENT AGREEMENT.

THE TOTAL OF THIS PURCHASE ORDER IS NOT TO EXCEED $50,000

1 0.0 94899

COMM LINE DESC: NMC Non Physicians Services

451  9600  8142  NM0001  6321  

THE SHADED ROWS ARE FOR MONTEREY COUNTY DEPARTMENT USE ONLY

EXTENDED PRICE

00 00 50,000.00

ORDER TOTAL

50,000.00

All Vendors are required to review the Monterey County general terms and conditions which apply to all contracts, purchase orders, and other electronic procurements made with the County unless otherwise

noted. Said terms and conditions can be found on the County website at http://www.co.nionterey.ca.us/admin/terms conditions.htrn

TAX EXEMPTION INFORMATION:

FEDERAL EXCISE TAX EXEMPTION NUMBER 94-6000524

PRINT DATE: 08/06/10

AUTHORIZED BY COUNTY OF MONTEREY

DEPUTIZED PURCHASING AGENT

COUNTY BUYER INFORMATION

Sidney Cato

EMAIL: catosl@natividad.com

ORDER DATE 07-15-2010

SC 9600 0000000958

IMPORTANT

THE ABOVE NUMBER AND SHIP TO DEPARTMENT MUST

APPEAR ON ALL SHIPPINGLABELS, PACKING SLIPS,

TRANSPORT DOCUMENTS, INVOICES AND CORRESPONDENCE.

UNIT PRICE SALES TAX

TELEPHONE: 831)755-4223 x71-4223

CONTRACTS/PURCHASING DIVISION

168 W.Alisal St. 3rd Floor, Salinas, CA 93901

PAGE NUMBER: 1 OF 1

 

 

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SIGNED BOARD REPORT AND SUPPO�O                     �OriginalAgreementNo. BPO 561)

RENEWAL AMENDMENT NO.

FOR PROFESSIONAL SERVICE AGREEMENT

BETWEEN O inn Po- er_Svstems AND

THE COUNTY OF MONTEREY

FOR

Provide-Mainte nce for the caterpillar Diesel Electric. Sets and Emergency ower Generators for NMC

The parties to Professional Service Agreement, dated March 01,.200 ietween the County of Monterey,

on behalf of Natividad Medical Center NMC"), and Quinn Power Systems Contractor), hereby agree

to renew their Agreement No. BPO 561) on the following amended terms and conditions:

1. Contractor will continue to provide NMC with the same scope of service as stated in the original

Agreement No. BPO 561).

2. This Renewal Amendment shall become effective on July 01, 2010 and shall continue in full force

and extending the term date until. June 30,2011.

3. The total amount payable by County to Contractor under Agreement No. BPO 561) shall not

exceed the total sum of $100,000.00 for the full term of the Agreement and $50,000.00 for fiscal

year 2010-2011.

4. All other terms and conditions of the Agreement shall continue in full force and effect.

5. A copy of this Amendment shall-be attached to the original Agreement No. BPO 561).

IN WITNESS WHEREOF, the parties hereto are in agreement with this Amendment and

Professional Service Agreement on the basis set forth in this document and have executed this

amendment on the day and year set forth herein.

CONTRACTOR

Signature e` la. Dated 3IdQ1io

PrfntedNanre_ 1o94 A  cove 1

COUNTY OF MONTEREY

 

Title Mahar I d Y

Signature Dated jz  SP:

Purchasi

Manager

r

AtureV-  V=

NMC  CEO

Approved as to Legal Fonn:

Charles J. McKee, County Counsel

 

William Litt, Dep(J y

Attorneys for County and NMC

0

 

 

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SIGNED BOARD REPORT AND SUPPO�O

�Print Form

A.t4 NatividadMMICALCEf trER

COUNTY OF MONTEREY AGREEME FOR PROFESSIONAL SERVICES

NOT TO EXCEED $100.000)

This Professional Services Agreement hereinafter Agreement") is made by and between Natividad Medical

Center NMC"), a general acute care teaching hospital wholly owned and operated by the County of

Monterey, which is apolitical subdivision of the State of California and QUINN COMPANY dba QUINN

POWER SYSTEMS hereinafter CONTRACTOR").

In consideration of the mutual, covenants and conditions set forth h This Agreement; the parties agree as

follows:

SERVICES TO BE PROVIDED. NMC' hereby engages  CONTRACTOR to perform, and

CONTRACTOR hereby agrees to perform, the services described in Exhibit A in conformity with the

terms ofthe Agreement. The services are generally described as follows: provide maintenance services

for caterpillar diesel electric arts, emergency 6 power generators

1. PAYMENTS BYNMC, NMC shall pay the CONTRACTOR in accordance with the payment provisions

set forth in Exhibit A, subject to the limitations set forth in this Agreement. The total amount payable by

NMC to CONTRACTOR under this Agreement shall not exceed the sum of $50,000.00

2. TERM OF AGREEMENT. The term of this Agreement is from Mar 1, 2009 J to

unless  sooner termingted pursuant to the  terms of this Agreement This

Agreement is of no force or effect until signed by both CONTRACTOR and NMC.and with NMC signing-

last and CONTRACTOR may not comnaenbe work before NMC signs this Agreement.

3. AbDITIONAL PROVISIONS/EX) I]BITS. The following attached exhibits ar' incorporated herein by

reference and constitute a part of this Agreement:

Exhibit AWSohedule A: Scope of Services/Payment Provisions

4. PERFORMANCE STANDARDS.

4.1. CONTRACTOR warrants that CONTRACTOR and Contractor's agents, employees, and-

subcontractors performing services under this Agreement are specially trained, experienced,

competent, and appropriately licensed to perform the work and deliver the services required under

this Agreement and are not employeea.of NMC, or immediate family of an employee of NMC.

4,2. CONTRACTOR, its agents, employees, and subcontractors shah perform all work in a safe and

skillful manner and in compli4nce with all applicable laws and regulations, All wo;k performed under

this Agreement that Is required by law to be performed or supervised by licensed personnel shall be

performed in accordance with such licensing requirements.

Rovmeed 12/ISOOSNMCPSAS'mm $100,000 orLe  1

 

 

 

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SIGNED BOARD REPORT AND SUPPO�O
�4.3. CONTRACTOR shall furnish, at its own etpensa, all materials, equipment, and personnel necessary

to carry out the terms of this Agreement, except as other wise specified in this Agreement.

CONTRACTOR shall not use NMC premises, property including equipment, instruments, or

supplies) or personnel for any purpose other than in the performance of its obligations under this

Agreement.

5. PAYMRNT CONDITIONS.

5.1. CONTRACTOR shall submit to the Contract Administrator an invoice on a form acceptable to NMC.

If not otherwise specified, the CONTRACTOR may submit such invoice periodically or' at the

completion of services, but in any event, not later than 30 days after completion of services. Tho

invoice shall set forth the amounts claimed by CONTRACTOR for the previous period, together with

an itemized basis for Administrator or his or her designee shall certify the invoice, either in the

requested amount or in such other amount as NMC approves in conformity with this Agreement, and

shall promptly submit such invoice to the County Auditor-Controller for payment. The County

Auditor-Controller shall pay the amount certified within 30 days of receiving the certified invoice.

5.2. CONTRACTOR shall not receive reimbursement for travel expenses unless set forth in this

Agreement

6. TERMINATION.

6.1. During the term ofthis Agreement, NMC may terminate the Agreement for any reason by giving

written notice of termination to the CONTRACTOR at least thirty 30) days prior to the effective date

of termination. Such notice shall set forth the affective date of termination. In the event of such

termination, the amount payable under this Agreement shall be reduced in proportigri to the services

provided prior to the date of termination.

6.2, NMC may cancel and terminate this Agreement for good cause effective immediately upon written

notice to Contractor. Good cause" includes the failure of CONTRACTOR to perform the required

services at the tiino and in the-manner provided under this Agreement. If NMC terminates this

Agreement for good cAhse; NMC may be relieved of the payment of airy consideration to Contractor,

and NMC may proceed with the work in any manner, which NMC deems proper. The cost to NMC

shall be deducted from any sum due the CONTRACTOR under this Agreement.

7. INDEMNIFICATION: CONTRACTOR shall indemnify, defend and hold'harrnless. NMC and the

County of Monterey hereinafter County"), it o.cers, agents and employees from any claim, liability,

loss, injury or damage 4rising out of, or in connection with, performance of this Agreement by

CONTRACTOR and/or its agbnt, employees or sub-contractors, excepting only low, injury or damage

caused by the negligence or willful misconduct of personnel employed by NMC. It is the intent of the

parties to this Agreement to provide the broadest possible coverage for NMC, The CONTRACTOR shall

reimburse NMC for all costs, attorneys' fees, expenses and liabilities incurred with respect to any

litigation in which the CONTRACTOR is obligated to indenvziiy, defend and hold harmless NMC and the

County under this Agreement.

8. INSURANCE,

8,1, Evidence of Coverage:

Prior to commencement of this Agreement, the CONTRACTOR shall provide a Certifioate of

Insurance" certifying that coverage p required herein has been obtained, Individual endorsements

Bovines 12/1 006 M40PSAP"rm $100,000 arLe

 

 

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SIGNED BOARD REPORT AND SUPPO�O

�executed by the insurance carrier shall accompany the certificate. In addition, the CONTRACTOR

upon request shall provide a certified copy of the policy or policies.

Executed by the insurance carrier shall accompany the certificate. In addition, the CONTRACTOR

upon request shall provide a certified copy of the policy or policies.

This verification of coverage shall be sent to NMC's Contracts/Purchasing Department, unless

otherwise directed. The CONTRACTOR shall not receive a Notice to Proceed" with the work under

this Agreement until it has obtained all insurance required and NMC has approved such insurance.

This approval of insurance shall neither relieve nor decrease the liability of the Contractor,

8.2. Quali iug Insurers: All coverage's except surety, shall be issued by companies which hold a current

policy o er s alphabetic and financial size category rating of not less that A-VII, according to the

current Best's Key Rating Guide or a company of equal financial stability that is approved by NMC's

Contracts/Purcbasing Dirqctor.

8.3. Insurance Cover Re uirements: Without limiting Contractor's duty to indemnify, CONTRACTOR

shalt maintain in effect throughout the term of this Agreement a policy or policies of insurance with

the following ru nimum limits of liability:

Commercial general liability insurance, including but not limited to premises and operations, including

coverage for Bodily Injury and Property Damage, Personal Injury, Contractual Liability, Broad form

Property Damage, Independent Contractors, Products and Completed Operations, with a combined

single limit for Bodily Injury and Property Damage of not less than $1,000,000 per occurrence.

 Exemption/Modification Justification attached; subject to approval),

Business automobile liability insurance  covering all motorvahioles, including owned, leased, non-

owned, and red v cles, used in providing services under this Agreement, with a combined single

limit for Bodily Injury and Property D.alnage of blot less than $500,000 per occurrence.

 Exempt$on/Mddifi.cation Justjf.cation attached; subjpt�to approval).

Workers' Compensation. Insurance  If CONTRACTOR e;nploys other in the performance of this

Agreemen% in accordance with alifornia Labor Code section 3700 and with Employer's Liability

limits not less than $1,000,000 each person, $1,000,000 each accident and $1,000,000 e4ch disease.

 Exemption/Modification Justification attached; subject to approval).

Professional llabllity insurance, if required for the professional services being provided, e.g., those

persons authorized by a cane to engage in a business or profession regulated by the California

Business and Professions Code), in the amount of not less than $1,000,000 per claim and $2,000,000

in the aggregate, to cover liability for malpractice or errors or omissions made in the course of

rendering professional services. If professional liability insurance is written on a. claims made" basis.

rather than an occurrence basis, the CONTRACTOR shall, upon the expiration or earlier termination

of this Agreement, obtain extended reporting coverage tail coverage") with the same liability limits.

Any such tail coverage shall continue for at least three years following the expiration or earlier

termination of this Agreement,

 Exemption/Modification. Justification attached; subject to approval).

RevLed 11/1/1008 NMCPSAFonn 5100,000 orLou 3

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O

�8.4, Other Insurance Requirements:

All insurance required by this Agreement shall be with a company acceptable to NMC and issued and

executed by an admitted insurer authorized to transact insurance business in the State of California.

Unless otherwise specified by this Agreement, all such insurance shall be written on an occurrence

basis, or, if the policy is not written on an occurrence basis, such policy with the coverage required

herein shall continue in effect for a period of three years following the, date CONTRACTOR

completes its performance of services under this Agreement,

Each liability policy shall provide that NMC shall ba given notice in writing at least thirty days in

advance of any endorsed reduction in coverage or limit, cancellatiop, or intended non-renewal thereof

Each policy shall provide coverage for CONTRACTOR and additional insured with respect to claims'

arising from each subcontractor, if any, performing work under this Agreement, or be accompanied by

a certificate of insurance from each subcontractor showing each subcontractor has identical insurance

coverage to the above requirements,

Commercial general liability and automobile liabt t 7ol1cles shallproylde an endorsement nmning the

County QfMontVey its o cers agents. and employees,as Additional insureds' with respect to liability

arising o t of the Contractor's work including ongoing and completed 91J re ations, and c all  tr her

vide that such insurance 1sprimarkinsurance to an insurance or set insurgysce m fined i the

County and that the Insurance pf the Additional Insureds shall not be called upon to contribute to a loss

covered by the Contractor'{nsurance The required endorsements for Commercial General

LtabilityAddltionallnszired is LM Form CG 20 I0 11 45 or CG 201010 01 to tandem with CG 20 3710

01(1000) The required endorsement from forAuto. obile ddinonal lnsuredEndorsement is 90 Form

C420480,?99.

Prior to the execution of this Agreement by NMC, CONTRACTOR shall file certificates of insurance

with NMC's Contracts/Purchasing Department, showing that the CONTRACTOR. has in effect the

insurance required by this Agreement, The CONTRACTOR. shall file a new or amended certificate of

insurance within Ave oslendar:days after any change is made in any insurance policy, which would

alter the information on- the certificate then on file. Acceptance or' approval of insurance shall in no,

way modify or change the indemnifloation clause in this Agreement, which shall continue in full force

and effect.

CONTRACTOR shall at all tines during the term of this Agreement maintain in force the insurance

coverage required under this Agreement and shall send, without demand by NMC, annual certificates

to NMC's Contracts/Purchasing Department, If the certificate is not received by the expiration date,

NMC shall notify CONTRACTOR and CONTRACTOR shall have five calendar days to send in the

certificate, evidencing no lapse in coverage during the interim. Failure by CONTRACTOR to maintain

such insurance is a default of this Agreement, which entitles NMC, at its sole discretion, to terminate

the Agreement immediately.

9. RECORDS AND CONFIDENTIALITY.

9,1. Confidentiality, CONTRACTOR and its officers, eipployees, agents and subcontractors shall comply

with any and all federal, state, and local laws, which provide for the confidentiality of records and

other information. CONTRACTOR shall not disclose any confidential records or other confidential

information received from NMC or prepared in connection with the performance of this Agreement,

unless NMC specifically permits CONTRACTOR to disclose such records or information.

CONTRACTOR shall promptly transmit to NMC any and all roquests for disclosure of any such

Revised 121112008 NMCPSA Port $100,000 orL 31 4

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�confidential records or information, CONTRACTOR shall not use any confidential information

gained by CONTRACTOR in the performance of this Agreement except for the sole purpose of

carrying out Contractor's obligations under this Agreement.

9.2. NMC Records. When this Agreement expires or terminates, CONTRACTOR shall return to NMC

and NMC records which CONTRACTOR used or received from NMC to perform services under

this Agreement

9.3. Maintenance of Records  CONTRACTOR shall prepare, maintain, and preserve all reports and

records that may be required by federal state, and County rules and regulations related to services-

performed under this Agreement, CONTRACTOR shall maintain such records for a period of at

least three years after receipt of final. payment under this Agreement. If any litigation, claim,'

negotiation, audit exception, or other action relating to this Agreement is pending at the end of the

three year period, then CONTRACTOR shall retain said records until such action is resolved.

9.4. Access to and Audit of Records. NMC shall have the right to examine, monitor and audit all records,

documents, conditions, an activities of the CONTRACTOR and its subcontractors related to

services provided under this Agreement. Pursuant to Government Code section 8546.7, if this

Agreement involves the expenditure of public funds in excess or $10,000, the parties to this

Agreement may be subject, at the request of NMC or as part of any audit of NMC, to the

examination and audit of the State Auditor pertaining to matters connected with the performance of

this Agreement for a period of three years after final payrnent under the Agreement.

9.5, Royalties and Inventions  NMC shall have a royalty-free, exclusive and irrevocable license to

reproduce, publish, and use, and authorize other to do so, all original computer programs, writings,

sound recordings, pictorial reproductions, drawings, and other works of similar nature produced in the

course of or under this Agreement. CONTRACTOR shall not publish any such material without the

prior written approval of NMC.

10, NON 71SCRIM[NATlON. During the performance of this Agreement, Contractor, and its

subcontractors, shall not unlawfully discriminate against any person because of lace, religious creed,

color,, sex, national origin, ancestry, physical disability, mental disability, medical conditidn, marital

status, age over 40), or sexual orientation, either in Contractor's employment practices or in the

furnishing of services to recipients. CONTRACTOR shah ensure that the evaluation and treatment of its

employees and applicants for employment and all persons' receiving and requesting services are free of

such discrimination, CONTRACTOR and any subcontractor shall, in the performance of this Agreement,

full comply with all federal, sate, and local laws and regulations which prohibit discrimination, The

provision of services primarily or exclusively to such target population as may be designated in this

Agreement shall not be deemed to be prohibited discrimination.

11. COMPLIANCE W'TTH TERMS OF STATE OR FEDERAL GRANT. If this Agreement has been or

will be funded with monies received by NMC pursuant to a contract,with the state or federal government

in which NMC is the grantee, CONTRACTOR will comply with all the provisions of said contract, and

said provisions shall be deericed a part of this Agreement, as though fully set forth herein: Upon request,

NMC will deliver a copy of said contract to Contractor, at no cost to Contractor.

12, INDBPI3NDRNT CONTRACTOR. In the performance of work, duties, and obligations under this

Agreement, CONTRACTOR is at all times acting and performing as an independent CONTRACTOR and

not as an employee of NMC. No offer or obligation of permanent employment with NMC or particular

County department or agency is intended in any manner, and CONTRACTOR shall not become entitled

R,v1,cd171112008NWPsArom 5100,050orLm4 5

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�by virtue of this Agreement to receive from NMC any form of employee benefits including but not limited

to sick leave, vacation, retirement benefits, workers' compensation coverage, insurance or disability

benefits. CONTRACTOR shall be solely liable for an obligated to pay directly all applicable taxes,

including federal and state income taxes and social security, arising out of Contractor's performance of

this Agreement, In connection therewith, CONTRACTOR shall defend, indemnify, and hold NMC and

the County of Monterey harmless from any and all liability, which NMC may incur because of

Contractor's failure to pay such taxes.

13. NOTICES. Notices required under this Agreement shall be delivered personally or by first-class, postage

per-paid mail to NMC and Contractor's contract administrators at the addresses listed below,

FORNAT.TVIDAD MEDICAL CENTER:

Contracts/Purchasing Manager

Name

FOR CONTRACTOR:

David A. Covell

B P. Commissioning & Support Svc. Mgr.

Name and Title

1441 Const(tutionElvd. Salinas, CA. 93906

Addmgs

831.755.4111

Phone

14. MISCELLANEOUS PROVISIONS.

3500 Shepherd Street

City of Industry CA 90601

Address

562.463.6082

Phoper

14. 1, Conflict of Interest, CONTRACTOR represents that it presently has no interest and agrees not to

acquire any interest during the term of this Agreement, which would directly, or indirectly conflict

in any manner or to any degree with the flail and complete performance of the professional services

required to be rendered under this Agreement

14,2, Amendment This Agreement maybe amended or modified only by an instrument in writing signed

by NMC and the Contractor.

14.3, Waiver. Any waiver of any terms and conditions of this Agreement must be in writing and signed by

NMC and the Contractor. A waiver of any of the terms and conditions of this Agreement shall not be

construed as a waiver of any other terms or conditions in this Agreement,

14.4. Contractor. The term Contractor" as used in this Agreement includes Contractor's officers, agents,

arid employees acting on Contractor's behalf in the performance of this Agreement.

14.5. Disputes  CONTRACTOR shall continue to perform under this Agreement during any dispute.

14,6. Assignment and Subcontracting. The CQNTRACTOR shall not assign, sell, or otherwise transfer its

interest or obligations in this Agreement without. the prior written consent of NMC, None of the

services covered by this Agreement shall be subcontracted without the prior written approval of

Rev[eed 17/]12008 NMC P8A Fotm 5100,000 or Leas 6

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�NMC, Notwithstanding any Such subcontract, CONTRACTOR shall continue to be liable for the

performance of all requirements of this Agreement.

14,7. Successors and Assi s. This Agreement and the rights, privileges, duties, and obligations ofNMC

an CON CTOR under this Agreement, to the extent assignable or delegable, shall be binding

upon and inure to the benefit of the parties and their. respective successgrs, permitted assigns, and

heirs.

14,8, Compliance with A licable Law  fhe parties shall comply with all applicable federal, state, and

local laws and re ationA in performing this Agreement.

14,9. Headings. The headings are for convenience only and shall not be used to interpret the terms of this

Agreement

14,10. Time is of the FEssence. Time is of the essence in, each and all of the provisions of this Agreement

14,11, Gove Law. Tf1is Agreement shall be governed by and interpreted under the laws of the State

of Ca i ornia.

14.12. Non-exclusive Agra  mentThis Agreement is non-exclusive and both NMC and CONTRACTOR

expressly reserve the right to contract with other entities for the same or similar services.

14.13. Construction of Agreement NMC and CONTRACTOR agree that each party has fully participated

in the review and revision of this Agreement and that any rule of construction to the effect that

ambiguities are to be resolved against the drafting party shall not apply in the interpretation of this

Agreement or any amendment to this Agreement.

14,14, Coun arts  prix Agreement may be executed in two or more counterparts, each of which shall

ba eemed an original, but all of which together shallconstitute one and the same Agreement.

14.15, Inte ation. This Agreement; including the exhibits, represents the entice Agreement between

the CONTRACTOR with fespect to the subject niatter'of*this Agreement and shall

supersede all prior negotiations. Representations, or agreements, either written or oral, between

NMC and CONTRACTOR as of the effective data of this Agreement, which is the date that NMC

signs the Agreement.

14,16. Interpretation of Conflicting Provisions  In the event of any conflict or inconsistency between the

provisions of this Agreement and the Provisions of aRy exhibit or other attachment to this

Agreement, the provisions of this Agreement shall prevail and control.

i

&mLad r2)L O58 NA.1C PSA Yom $100,000 orLess 7

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�NATAMAD MEDICAL CENTER

NMC Contracts/Pur6basing Agent

Date:

 

Signaturep ChairP President, or Vice-President

Department Tead if applicable)

I~~-^l~

CONTRACTOR

Quinn Company

dba Quinn Power Systems

Contractor's Business Name***

Robert J Allen

V.P. & General Svc. Mgr-

 Name and Title

Date: 7~o

Date:

By:

Signature ofSeomtary, Asst Secretary, CFO, Treasurer

orAest Treasurer)

Lino Martin

Controller & Corp. Secretary

Name and Title

Auditcip9Contr UJ'or

Date:

**INSTRUCTIONS: If CONTRACTORie a corporation,

including limited tiebiLity and non-profit corporations,

the fall legal name of the. corporation shall be set forth

above together with the signatures of two specified

o5cers. If CONTRACTOR is a partnership, the name of

the partnership shall be set forth above together with the

signature of a partner who has authority to execute this

Agreement on behalf of the parlaarehip. If

CONTRACTOR is contracting in and individual

ca aci~y file indivl'deal shall sat fgrtllthe fan a ofthe

bvSlna a, if any and shall personally sign the Agreement,

RrnL,edNMC Pa Farm 9100,000 or1ese

12,148

8

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�1 I-- I I E3 I r

SALINAS

QUINN POWER SYSTEMS

EMERGENCY NUMBERS AND LABOR CHARGES

Quinn Company will provide On Call" emergency service 24 hours per

day, 7 days a week with a response of 4 hours or less.

Normal working hours 8:00arn to 4:30pm / Monday  Friday) call:

CSA Customer Service non-emergency) 800) 789-9774

Keith Krebs  Service Manager 83"1) 775.3408

Joanna Gonzales  Service Coordinator...................... 831) 775.3413

For regular or emergency service, call the following numbers:

831) 758.8461

Exhibit C"

 

ADDITIONAL CSA LABORRATES AREAS FOLLOWS

Standard rate: 8:00am to 4:30pm

Monday through Friday excluding

Holidays)

Overtime rate: after 4:30pm and

Saturdays/holidays)

Premium time: over 12 hours per

day and Sunday)

Travel truck charges)

EFFECTIVE NOVEMBER 2, 2007

$1d8.00 per hour- Shop

$108.00 per hour  Field

$159,00 per hour  Shop

$159.00 per hour- Field

$212.00 per hour  Shop

$212.00 per hour  Field

$2,00 per mile

 

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�

ACORDTM

CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ Y)

 03/08/22011

011

PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND

Zurich, Account Service Center CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE

7045 College Blvd. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE

 POLICIES BELOW.

Overland Park, KS 66211 

Fax: 888-734-6776 Ph: 877-225-5276 opt. 1 INSURERS AFFORDING COVERAGE NAIC #

INSURED 012906100 INSURER A: Universal Underwriters Insurance Company 41181

QUINN GROUP, INC.; QUINN COMPANY

QUINN POWER SYSTEMS; QUINN USED INSURER B: Universal Underwriters of Texas Ins. Co. 40843

PARTS  QUINN SHEPHERD MACHINERY INSURER C:

QUINN POWER SYSTEMS ASSOCIATES

ALTA LIFT

I

UI INSURER D

 

NC.; Q

NN RENTAL 

SERVICES; QUINN COMMERCIAL, INC. 

Q4G PROPERTIES LP; QUINN SHEPHERD 

RENTAL SERVICES; QUINN SHEPHERD 

POWER SYSTEMS INSURER E:

10006 ROSE HILLS RD. 

CITY OF INDUSTRY, CA 90601 

COVERAGES

THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING

ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY

PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.

AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

INSR

LTR ADD'L

INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE

DATE MM/DD/YY POLICY EXPIRATION

DATE MMIDDIYV

LIMITS

A X GENERAL LIABILITY    EACH OCCURRENCE s 500

000

      

  X COMMERCIAL GENERAL LIABILITY  I I DAMAGE TO RENTED $

       PREMISES Ea occurence

   CLAIMS MADE F OCCUR    MED EXP Any one person) $

       PERSONAL & ADV INJURY $

    279004B 07-01-2010 07-01-2011 

       GENERAL AGGREGATE $

  GEN'L AGGREGATE LIMIT APPLIES PER:    PRODUCTS  COMP/OP AGG $

A X AU TOMOBILE LIABILITY    

  X     COMBINED SINGLE LIMIT $ 500 000

   ANY AUTO    Ea accident)

   ALL OWNED AUTOS    

  

SCHEDULED AUTOS

279004B

07-01-2010

07-01-2011 BODILY INJURY

Per person) $

   HIRED AUTOS    

  X

NON-OWNED AUTOS    BODILY INJURY

 

Per accident) $

       

       PROPERTY DAMAGE $

A X GARAGE LIABILITY    AUTO ONLY  EA ACCIDENT $

   ANY AUTO 279004B 07-01-2010 07-01-2011 OTHER THAN EA ACC S 500,000*

       AUTO ONLY: AGG $

A  EXCESSIUMBRELLA LIABILITY    Each Occurrence

$ 15,000,000

  X OCCUR  CLAIMS MADE    

      

   279004B 07-01-2010 07-01-2011 PRODUCTSCOMP/OPAGG $ 45,000,000

   DEDUCTIBLE    

$

  X RETENTION $ 0     $

WORKERS COMPENSATION AND    WC STATUTORY

EMPLOYERS' LIABILITY    LIMITS OTHER

ANY PROPRIETOR/PARTNER/EXECUTIVE

OFFICER/MEMBER EXCLUDED'?    E.L. EACH ACCIDENT $

If yes, describe under SPECIAL PROVISIONS below    E.L. DISEASE  EA EMPLOYEE $

OTHER   

Customer's Goods  Direct   

 

Primary 279004B 07-01-2010 07-01-2011 $ 5,000,000 Limit

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS

End. 395, 396 & 763 Applies: The County of Monterey, Its Officers, Agents and Employees, are named as Additional Insured. Quinn, Unicover Policy

carries liability limits of $500,000 underlying along with a $15,000,000 Commercial Umbrella for a total liability limit of $15,000,000 per

*

occurrence.

Garage Liability with a Product Completed Operation Aggregate Limit of $1,500,000. End. 089-Umbrella Limit Inclusive applies Reason

for Certificate: General Liability. 30 day notice of cancellation applies, except for cancellation due to non payment of premium.

CERTIFICATE HOLDER CANCELLATION

COUNTY OF MONTEREY

 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

NATIVIDAD MEDICAL CENTER THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO

 MAIL 15 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE

1441 CONSTITUTION BLVD. BLDG 900 LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY

SALINAS, CA 93906 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.

Attn: ROXANNE SEGOBIA AUTHORIZED REPRESENTATIVE

Fax: 831-755-4268

 

ACORD 25 2001/08)  ACORD C ORATION 1988

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�UNIVERSAL UNDERWRITERS INSURANCE COMPANY

7045 College Boulevard, Overland Park, KS 66211

Name and Address

of Insured:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

QUINN GROUP, INC.; QUINN COMPANY

QUINN POWER SYSTEMS; QUINN USED

PARTS; QUINN SHEPHERD MACHINERY

QUINN POWER SYSTEMS ASSOCIATES

ALTA LIFT, INC.; QUINN RENTAL

SERVICES; QUINN COMMERCIAL, INC.

Q4G PROPERTIES LP; QUINN SHEPHERD

RENTAL SERVICES; QUINN SHEPHERD

POWER SYSTEMS

10006 ROSE HILLS RD.

CITY OF INDUSTRY, CA 90601

ASM Account # 012906100

ENDORSEMENT NUMBER 395

OTHER INSURED  OTHER THAN AUTOS)

The WHO IS AN INSURED condition in this Coverage Part is changed by adding the following to With respect to GARAGE

OPERATIONS other than the AUTO HAZARD, CUSTOMER COMPLAINT DEFENSE or STATUTE AND TITLE E&O)":

4) The person or organization shown in the declarations as applicable to this endorsement, its directors, officers and employees but only

with respect to your negligent acts.

If the injury arises out of your maintenance operation or use of equipment leased to you by such persons or organization, this endorsement

does not apply to any occurrence which takes place after the lease expires.

This endorsement modifies insurance provided under the following: POLICY NUMBER POLICY PERIOD

COMMERCIAL GENERAL LIABILITY COVERAGE PART 500) 279004B 07/01/2010-07/01/2011

a otlserson or organization:

The County of Monterey, Its Officers, Agents and Employees

COUNTY OF MONTEREY

NATIVIDAD MEDICAL CENTER

1441 CONSTITUTION BLVD. BLDG 900

SALINAS, CA 93906

Date March 8, 2011 Countersigned by:

Authorized Representative

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�UNIVERSAL UNDERWRITERS INSURANCE COMPANY

7045 College Boulevard, Overland Park, KS 66211

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ASM Account #012906100

Name and Address

of Insured:

QUINN GROUP, INC.; QUINN COMPANY

QUINN POWER SYSTEMS; QUINN USED

PARTS; QUINN SHEPHERD MACHINERY

QUINN POWER SYSTEMS ASSOCIATES

ALTA LIFT, INC.; QUINN RENTAL

SERVICES; QUINN COMMERCIAL, INC.

Q4G PROPERTIES LP; QUINN SHEPHERD

RENTAL SERVICES; QUINN SHEPHERD

POWER SYSTEMS

10006 ROSE HILLS RD.

CITY OF INDUSTRY, CA 90601

ENDORSEMENT NUMBER 396

OTHER INSURED  AUTO)

The WHO IS AN INSURED condition in this Coverage Part is changed by adding the following to With respect to AUTO HAZARD":

4) The person or organization shown in the declarations as applicable to this endorsement, its directors, officers and employees but only

with respect to your negligent acts.

The who is not an insured condition in this coverage part does not apply to this endorsement.

This endorsement modifies insurance provided under the following:

POLICY NUMBER POLICY PERIOD

COMMERCIAL GENERAL LIABILITY COVERAGE PART 500) 279004B 07/01/2010-07/01/2011

Name of Person or Organization:

The County of Monterey, Its Officers, Agents and Employees

COUNTY OF MONTEREY

NATIVIDAD MEDICAL CENTER

1441 CONSTITUTION BLVD. BLDG 900

SALINAS, CA 93906

Date March 8, 2011 Countersigned by:

Authorized Representative

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�UNIVERSAL UNDERWRITERS INSURANCE COMPANY

7045 College Boulevard, Overland Park, KS 66211

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ASM Account # 012906100

Name and Address

of Insured:

QUINN GROUP, INC.; QUINN COMPANY

QUINN POWER SYSTEMS; QUINN USED

PARTS; QUINN SHEPHERD MACHINERY

QUINN POWER SYSTEMS ASSOCIATES

ALTA LIFT, INC.; QUINN RENTAL

SERVICES; QUINN COMMERCIAL, INC.

Q4G PROPERTIES LP; QUINN SHEPHERD

RENTAL SERVICES; QUINN SHEPHERD

POWER SYSTEMS

10006 ROSE HILLS RD.

CITY OF INDUSTRY, CA 90601

ENDORSEMENT NUMBER 763

ADDITIONAL INSUREDS: PRIMARY AND NON-CONTRIBUTORY CONDITIONS

OTHER INSURANCE

THE FOLLOWING IS ADDED:

IF:

1. *YOU SPECIFICALLY AGREE IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT TO PROVIDE INJURY

COVERAGE FOR AN OTHER INSURED ON A PRIMARY AND NON-CONTRIBUTORY BASIS; AND

2. THE WRITTEN CONTRACT OR WRITTEN AGREEMENT WAS SIGNED AND EXECUTED PRIOR TO AN

OCCURRENCE, CLAIM OR SUIT;

THE INSURANCE THAT THIS COVERAGE PART PROVIDES FOR INJURY WILL BE PRIMARY TO THE OTHER INSURED'S

POLICY, AND WE WILL NOT SEEK CONTRIBUTION FROM THAT POLICY.

This endorsement modifies insurance provided under the following: POLICY NUMBER POLICY PERIOD

COMMERCIAL GENERAL LIABILITY COVERAGE PART 500, 950 AND 980) 279004B 07/01/2010-07/01/2011

Name ot Person or Organization:

The County of Monterey, Its Officers, Agents and Employees

COUNTY OF MONTEREY

NATIVIDAD MEDICAL CENTER

1441 CONSTITUTION BLVD. BLDG 900

SALINAS, CA 93906

Date March 8, 2011

Countersigned by:

Authorized Representative

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012

 

 

SIGNED BOARD REPORT AND SUPPO�O�YEAR Withholding Exemption Certificate CALIFORNIA FORM

2011

This form can only be used to certify exemption from nonresident withholding under California Revenue

and Taxation Code R&TC) Section 18662. Do not use this form for exemption from wage withholding.)

File this form with your withholding agent. Please type or print)

Withholding agent's name

Payee's name

QUINN COMPANY, DBA QUINN POWER SYSTEMS

Address number and street, PO Box, or PMB no.)

DEPT 9665

City

LOS ANGELES

590

Payee's  SSN or ITIN

 SOS file no.  CA corp. no. Gd FEIN

7 7- 0 5 5 5 8 7 5

State

CA

Apt. nod Ste. no.

ZIP Code

9 0 0 8 4 9 6 6 5

Read the following carefully and check the box that applies to the payee.

I certify that for the reasons checked below, the payee named on this form is exempt from the California income tax withholding

requirement on payment(s) made to the entity or individual.

 Individuals  Certification of Residency:

I am a resident of California and I reside at the address shown above. If I become a nonresident at any time, I will promptly

notify the withholding agent. See instructions for General Information D, Who Is a Resident, for the definition of a resident.

W Corporations:

The above-named corporation has a permanent place of business in California at the address shown above or is qualified

through the California Secretary of State SOS) to do business in California. The corporation will file a California tax return

and withhold on payments of California source income to nonresidents when required. If this corporation ceases to have

a permanent place of business in California or ceases to do any of the above, I will promptly notify the withholding agent.

See Instructions for General Information F, What is a Permanent Place of Business, for the definition of permanent place of

business.

 Partnerships or limited liability companies LLC):

The above-named partnership or LLC has a permanent place of business in California at the address shown above or is

registered with the California SOS, and is subject to the laws of California. The partnership or LLC will file a California tax

return and will withhold on foreign and domestic nonresident partners or members when required. If the partnership or

LLC ceases to do any of the above, I will promptly inform the withholding agent. For withholding purposes, a limited liability

partnership LLP) is treated like any other partnership.

 Tax-Exempt Entitles:

The above-named entity is exempt from tax under California Revenue and Taxation Code R&TC) Section 23701

insert letter) or Internal Revenue Code Section 501(c) insert number). The tax-exempt entity will withhold on payments

of California source income to nonresidents when required. If this entity ceases to be exempt from tax, I will promptly notify the

withholding agent. Individuals cannot be tax-exempt entities.

 Insurance Companies, Individual Retirement Arrangements IRAs), or Qualified Pension/Profit Sharing Plans:

The above-named entity is an insurance company, IRA, or a federally qualified pension or profit-sharing plan.

 California Trusts:

At least one trustee and one noncontingent beneficiary of the above-named trust is a California resident. The trust will file a

California fiduciary tax return and will withhold on foreign and domestic nonresident beneficiaries when required. If the trustee

becomes a nonresident at any time, I will promptly notify the withholding agent.

 Estates  Certification of Residency of Deceased Person:

I am the executor of the above-named person's estate. The decedent was a California resident at the time of death. The estate

will file a California fiduciary tax return and will withhold on foreign and domestic nonresident beneficiaries when required.

 Nonmilitary Spouse of a Military Servicemember:

I am a nonmilitary spouse of a military servicemember and I meet the Military Spouse Residency Relief Act MSRRA)

requirements. See instructions for General Information E, MSRRA.

CERTIFICATE: Please complete and sign below.

Under penalties of perjury, I hereby certify that the information provided in this document is, to the best of my knowledge, true and

correct. If conditions change, I will promptly notify the withholding agent.

 

Payee's name and title type or print) DALE ILB RT, AX

G E T MANAGER Daytime telephone no. 562 463-4717

Payee's signature is  Date 2-9-11

  

For Privacy Notice, get form F rB 1131. 7 0 61113 Form 590 02 201 0

 

 

BIB]

 

40718-U01

SIGNED-U02

BOARD-U02

REPORT-U02

SUPPORTING-U02

DOCS-U02

LI21329-U03

FO96183-U03

FO96184-U03

FO99716-U03

MG99791-U03

AS99817-U03

AS99818-U03

AI102088-U03

DO103403-U03

C10-U03

BOARD-U03

REPORTS-U03

6/24/2011-U04

MARCELLAC-U04

16534-U05

5-U06

AUTHORIZE-U07

THE-U07

PURCHASING-U07

MANAGER-U07

NATIVIDAD-U07

MEDICAL-U07

CENTER-U07

NMC)-U07

TO-U07

EXECUTE-U07

AMENDMENT-U07

NO.-U07

2-U07

TO-U07

THE-U07

960-NMC-U08

RUIZ-IGNACIO-U09

MAEGAN-U09

RUIZ-IGNACIOM-U10

5/13/2011-U011

AGREEMENT-U012

QUINN-U012

POWER-U012

SYSTEMS-U012

MAINTENANCE-U012

CATERPILLAR-U012

DIESEL-U012

ELECTRIC-U012

SETS-U012

EMERGENCY-U012

6-U012

POWER-U012

GENERATOR-U012

SERVICES-U012

AT-U012

NMC-U012

IN-U012

AN-U012

AMOUNT-U012

TO-U012

EXCEED-U012

$140,000-U012

IN-U012

THE-U012

AGGREGATE-U012

$40,000-U012

THE-U012

PERIOD-U012

JULY-U012

1,-U012

2011-U012

TO-U012

JUNE-U012

30,-U012

2012.-U012