Staff ReportMEETING DATE: 10/06/15
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COUNCIL AGENDA REPORT ITEM NO:
DATE: SEPTEMBER 23, 2015
TO: MAYOR AND TOWN COUNCIL
FROM: LAUREL PREVETTI, TOWN MANAGER(
SUBJECT: AUTHORIZE THE TOWN MANAGER TO EXECUTE A SECOND
AMENDMENT TO THE CONSULTING SERVICE AGREEMENT WITH
ENVIRONMENTAL AND OCCUPATIONAL RISK MANAGEMENT, INC. TO
INCREASE THE CONTRACT AMOUNT BY $21,000 AND EXTEND THE TERM
THROUGH JUNE 30, 2016
RECOMMENDATION:
Authorize the Town Manager to execute a second amendment to the consulting service agreement
with Environmental and Occupational Risk Management, Inc. (FORM) to increase the contract
amount by $21,000 and extend the term through June 30, 2016.
BACKGROUND:
Since February 2013, the Town has used EORM to provide a variety of Health and Safety services
related to program development, training, and Occupational Safety and Health Administration
(OSHA) compliance. Services in prior years were performed to the satisfaction of the Town as
agreed. A new scope of work is identified at the beginning of each term based on priorities
determined by the Health and Safety Committee. The original Agreement, executed on February 20,
2013, was for an amount not to exceed $28,000. The First Amendment, executed on September 29,
2014 was for an amount not to exceed $21,000. A Second Amendment, extending the contract
through June 30, 2016 and adding an additional $21,000, is necessary to continue service for the
remainder of the fiscal year without interrupting Health and Safety services. The second amendment
results in a total contracted amount of $70,000 for FY 2013/14, FY 2014/15 and FY 2015/16.
Reviewed by: { 11 / Assistant Town Manager
Ur own Attorney Finance
Vendors \Agi eements\2015\EORM\HR Stan' Report EORM 10615.doc
PAGE 2
MAYOR AND TOWN COUNCIL
SUBJECT: AUTHORIZE THE TOWN MANAGER TO EXECUTE AN AMENDMENT TO
THE CONSULTING SERVICE AGREEMENT WITH ENVIRONMENTAL AND
OCCUPATIONAL RISK MANAGEMENT, INC.
SEPTEMBER 23, 2015
CONCLUSION:
Staff recommends that the Town Council authorize the Town Manager to execute an Second
Amendment to the Consulting Service Agreement with EORM to extend the services through June
30, 2016 with an additional amount not to exceed $21,000, for a total amended contract amount of
$70,000 for ongoing Health and Safety program services.
FISCAL IMPACT:
Funding to support this amendment to the agreement is included in the adopted budget for FY
2015/16 from Program 2202 (Workers' Compensation/Safety Operating Budget).
Attachments:
1. Agreement
2. First Amendment
3. Proposed Second Amendment to the Agreement
CLERK DEPARTMENT
11114
AGREEMENT FOR CONSULTANT SERVICESoRD_ ___ _-
THIS AGREEMENT is dated for identification on February 20, 2013 by and kid een DWN nF
LOS GATOS, a California municipal corporation, ( "Town") and EORM, ("Consultant" ), whose
address is 4 North 2nd Street, San Jose, CA 95113. This Agreement is made with reference to the
following facts.
I. RECITALS
1.1 The Town desires to engage Consultant to provide ongoing Health & Safety program
development and training and support.
1.2 The Consultant represents and affirms that it is willing to perform the desired work pursuant
to this Agreement.
11. AGREEMENTS
2.1 Scone of Services. Consultant shall provide services as described in that certain written
proposal sent to the Town on February 04, 2013, which is hereby incorporated by reference
and attached as Exhibit A.
2.2 Term and Time of Perfor ance. This contract will remain in effect from February 28, 2013
to June 30, 2015. Consultant shall develop customized comprehensive Safety Programs
that meet all Cal -OSHA requirements for the following programs as described in this
agreement:
2.2.1. Develop a written permit - required confined space program,
2.2.2. Develop a comprehensive Electrical Safety Program using National Fire Protection
Agency (NFPA) 70E, and Cal -OSHA regulations guidelines as documents.
2.2.3. Develop a Written Respiratory Protection Program in accordance with the California
Code of Regulations, Title 8, and Section 5144.
2.2.4. Provide respirator fit testing for Community Development, Parks and Public Works,
and Police Department employees at a rate of $105.00/hour.
2.2.5. Create a written lockout/tag out (LOTO) program conforming to the requirements in
California Code of Regulations (CCR) Title 8, Section 3314(g).
2.2.6. Develop a written fall protection program based on the requirements in 8 CCR
Section 3200 and 3400.
2.2.7. Consultant will provide ergonomic evaluator to perform detailed ergonomics
assessment for individuals at their office workstations utilizing the Cartevia
Ergonomics Tool to identify risk factors associated with office workstations. Each
site visit shall be a fixed rate of $400.00 per evaluation. A discount of
$25.00 /evaluation will be applied when two or more evaluations are scheduled back
to back in the same location.
2.2.8. Consultant will provide on -call as needed EH &S and Risk management support for
the Town of Los Gatos. All additional work will be provided according to the rate
schedule noted in Exhibit A.
C90SRRStMUUI LOSOATOSCAIAPPDATA ILOCAL"CROSOFTWMDOwSITEMPORAR H FRNhTFILEM00 T W.OUTTAOK%N56TBDGM0RM HEALTH AND SAFELY
PROGRAM DEVELOPMENT AND TRAROM SUPPORT 2012 D.RTF
ATTACHMENT 1.
2.8 Availability of Records. Consultant shall maintain the records supporting this billing for
not less than three years following completion of the work under this Agreement.
Consultant shall make these records available to authorized personnel of the Town at the
Consultant's offices during business hours upon written request of the Town.
2.9 Assignability and Subcontracting. The services to be performed under this Agreement are
unique and personal to the Consultant. No portion of these services shall be assigned or
subcontracted without the written consent of the Town.
2.10 Independent Contractor. It is understood that the Consultant, in the performance of the
work and services agreed to be performed, shall act as and be an independent contractor and
not an agent or employee of the Town. As an independent contractor he /she shall not obtain
any rights to retirement benefits or other benefits which accrue to Town employee(s). With
prior written consent, the Consultant may perform some obligations under this Agreement
by subcontracting, but may not delegate ultimate responsibility for performance or assign or
transfer interests under this Agreement. Consultant agrees to testify in any litigation brought
regarding the subject of the work to be performed under this Agreement. Consultant shall
be compensated for its costs and expenses in preparing for, traveling to, and testifying in
such matters at its then current hourly rates of compensation, unless such litigation is
brought by Consultant or is based on allegations of Consultant's negligent performance or
wrongdoing.
2.11 Conflict of Interest. Consultant understands that its professional responsibilities are solely
to the Town. The Consultant has and shall not obtain any holding or interest within the
Town of Los Gatos. Consultant has no business holdings or agreements with any individual
member of the Staff or management of the Town or its representatives nor shall it enter into
any such holdings or agreements. In addition, Consultant warrants that it does not presently
and shall not acquire any direct or indirect interest adverse to those of the Town in the
subject of this Agreement, and it shall immediately disassociate itself from such an interest,
should it discover it has done so and shall, at the Town's sole discretion, divest itself of such
interest. Consultant shall not knowingly and shall take reasonable steps to ensure that it
does not employ a person having such an interest in this performance of this Agreement. If
after employment of a person, Consultant discovers it has employed a person with a direct
or indirect interest that would conflict with its performance of this Agreement, Consultant
shall promptly notify Town of this employment relationship, and shall, at the Town's sole
discretion, sever any such employment relationship.
2.12 Equal Employment Op ortunity. Consultant warrants that it is an equal opportunity
employer and shall comply with applicable regulations governing equal employment
opportunity. Neither Consultant nor its subcontractors do and neither shall discriminate
against persons employed or seeking employment with them on the basis of age, sex, color,
race, marital status, sexual orientation, ancestry, physical or mental disability, national
origin, religion, or medical condition, unless based upon a bona fide occupational
qualification pursuant to the California Fair Employment & Housing Act.
11I. INSURANCE AND INDEMNIFICATION
C�USERS{SN iM' PDATAILOCAIAMICROSOF1 \WWDOWSgE.WORARY MI' ERNE. TER. ESiCON I'CNT.OUTLOOK\UUKEPW3DIEORMHHA l'lJ ANUSA Iy PROGRAM
DEVELOPMENT AND TRAINING SUPPORT 2012 13.RTF
3.2 All Coverages. Each insurance policy required in this item shall be endorsed to state that
coverage shall not be suspended, voided, cancelled, reduced in coverage or in limits except
after thirty (30) days' prior written notice by certified mail, return receipt requested, has
been given to the Town. Current certification of such insurance shall be kept on file at all
tines during the term of this agreement with the Town Clerk.
3.3 Workers' Compensation. In addition to these policies, Consultant shall have and maintain
Workers' Compensation insurance as required by California law and shall provide evidence
of such policy to the Town before beginning services under this Agreement. Further,
Consultant shall ensure that all subcontractors employed by Consultant provide the required
Workers' Compensation insurance for their respective employees.
3.4 Indemnification. The Consultant shall save, keep, hold harmless and indemnify and defend
the Town its officers, agent, employees and volunteers from all damages, liabilities,
penalties, costs, or expenses in law or equity that may at any time arise or be set up because
of damages to property or personal injury received by reason of, or in the course of
performing work which may be occasioned by a willful or negligent act or omissions of the
Consultant, or any of the Consultant's officers, employees, or agents or any subconsultant.
IV. GENERAL TERMS
4.1 Waiver. No failure on the part of either party to exercise any right or remedy hereunder
shall operate as a waiver of any other right or remedy that party may have hereunder, nor
does waiver of a breach or default under this Agreement constitute a continuing waiver of a
subsequent breach of the same or any other provision of this Agreement.
4.2 Governing Law. This Agreement, regardless of where executed, shall be governed by and
construed to the laws of the State of California. Venue for any action regarding this
Agreement shall be in the Superior Court of the County of Santa Clara.
4.3 Termination of Agreement. The Town and the Consultant shall have the right to terminate
this agreement with or without cause by giving not less than fifteen days (15) written notice
of termnation. In the event of termination, the Consultant shall deliver to the Town all
plans, files, documents, reports, performed to date by the Consultant. In the event of such
termination, Town shall pay Consultant an amount that bears the same ratio to the
maximum contract price as the work delivered to the Town bears to completed services
contemplated under this Agreement, unless such termination is made for cause, in which
event, compensation, if any, shall be adjusted in light of the particular facts and
circumstances involved in such termination.
4.4 Amendment. No modification, waiver, mutual termination, or amendment of this
Agreement is effective unless made in writing and signed by the Town and the Consultant.
4.5 Disputes. In any dispute over any aspect of this Agreement, the prevailing party shall be
entitled to reasonable attorney's fees, including costs of appeal.
C:\ USERS \WOLTERCWPDATA\LOCA MCROSOP1 IYMOWS\TEMPORARY INTERNET FMEMCONTENT.OUCL00R\VQJMDZ03 \FORM STEALTH AND SAFETY VIOORAM
DEVELOPMENT AND TRATNWO SUPPORT 2012_13 (2).RTP
IN WITNESS WHEREOF, the Town and Consultant have executed this Agreement.
Town of Los Gatos by:
Greg Larso own Manager
Recommended by:
Todd Capurso, Parks and Public Works
Director
Approved as to Form:
` / _
Judith J. Yr' pp, Town omey
Consultant, by:
t�an��.l�e. t2et U.�, Cep
�} 1ay1Gf Ilil ihCi atL
Title
C\ USERS \WOLTGRCWPPDATAiLOCA MICROSOFAWtMKWS \S'EAIPDRARY Wi[RNECFILES \CONTEMI. OUTLOOK \VQJAtHZO3\EORM HEALTH AND SAT &TYPROGRAM
DEVELOPMENT AND TRAMllNO SUPPORT 2012_13 (2) RTP
EXHIBIT A
4 North 2nd Street
Suite
L[rn EORM" San Jose,
CA 95773
.Environmental, Health, Safety 800.648.1506
and Sustainability Ooneutting vrxw.eorm.com
Project Authorization Order (PAO)
Order Number: 12.0986 ❑X New Authorization FI Change Orderto Previous Auth. No.
Date: 2/412013 Expiration Date: 3/31/2013
Company Name: Town of Los Gatos Address: 41 Miles Ave, Los Gatos, CA 95030
Phone: (408) 761 -4547
Contact Name: Steve Regan Title: PPW Superintendent email: sregan@losgatosca.gov
Project Title: Safety and Health Program Development Support
Purpose /Scope /Deliverables
Environmental and Occupational Risk Management, Inc. (EORM) is pleased to present this proposal to the Town
of Los Gatos for ongoing Health & Safety program development and training support. Additional support maybe
provided on a time and materials basis following authorization and an approved change -order request.
Task One: Confined Space Program Development
EORM will develop a written permit - required confined space program, customized to Los Gatos operations,
spaces, and employees. The development of this written program will begin with an inventory of potential
confined spaces at the facility and an evaluation of current operations. EORM will determine which of these
spaces might be considered "Permit Required Confined Spaces ", and which may require entry by staff or
contractors. A single draft of the written program will be provided in editable format (MS Word), Training
requirements will then be determined based upon the confined space inventory and operations review. The
time and materials estimate for Task One is $5,000.
Task Two: Electrical Safety Program Development
EORM will resource a Senior Consultant experienced in electrical safety to develop a customized, comprehensive
Electrical Safety Program using National Fire Protection Agency (NFPA) 70E, and Cal -OSHA regulations as
guideline documents. The program will include requirements such as employee /employer responsibilities,
energized vs. de- energized work, training, designation of authorized electrical workers (qualified persons),
requirements for hazard analysis procedures, personal protective equipment, energized electrical hot work
permit requirements, preventive maintenance of electrical equipment, etc. Note: the written program will NOT
include task or equipment specific procedures for energized work, but will provide policy for development of
such procedures. One editable, draft version of the written program will be provided. EORM expects up to one
onsite meeting with Town of Los Gatos stakeholders to confirm electrical work tasks, existing, and proposed
controls. Project management and quality review of the program will be provided by a Senior Consultant. The
time and materials cost estimate for Task Two is $4,500.
EORM Proposal No. 112.098161112 0986 Los Gatos Safety and Health Program Development Support
This proposal is considered Confidential & Proprietary information to Environmental and Occupational Risk Management, inc (EORM}. It shall be used only
for consideration of this proposal. Disclosure to other parties outside of client company is prohibited without express written consent by EORM_
Steve Regan, Town of Los Gatos Page 2
Task Three: Respiratory Protection Program Development and Training
EORM will develop a Written Respiratory Protection Program in accordance with the California Code of
Regulations, Title 8, and Section 5144: "Respiratory Protection ". in order to properly determine the respiratory
protection needed for PPW employees, EORM will conduct a review of PPW herbicide MSDS sheets, and will
conduct industrial hygiene monitoring for dust exposure for up to three representative employees. Following the
monitoring and program development, EORM will develop and deliver a customized respiratory protection
training class. The training class will be conducted in accordance with the requirements contained in Title 8,
California Code of Regulation (CCR), Section 5144(k), and will last approximately 45 -60 minutes. The time and
materials estimate for Task Three is $6,000.
Task Four: Respirator Fit Testing
EORM will provide respirator fit testing for PPW, CDD, and PD department employees at a rate of $105 /hour. It
is estimated that 2 PD employees can be completed in one hour, and 3 PPW /CDD employees can be completed in
one hour. Based on the estimated number of employees provided by the police department, EORM estimates
between 20 and 22 hours to complete fit testing. An additional three to four hours would be needed to complete
fit testing for PPW staff. The time and materials estimate for Task Four Is $3,500.
Task Five: Control of Hazardous Energy (Lockout/Tagout) and Training
EORM will create a written lockout /tagout (LOTO) program that conforms to the requirements in California Code
of Regulation (CCR) Title 8, Section 3314(g), as well as a generic equipment specific lockout /tagout procedure.
This will require one site visit to examine the equipment subject to lockout /tagout and interview representative
employees to determine current policy and procedure. This does not include the development of equipment
specific procedures for each piece of equipment that requires maintenance. EORM will also develop and conduct
one training class to cover both general awareness and the specific requirements of California Code of Regulation
(CCR) Title 8, Section 3314(8). The time and materials estimate for Task Five is $5,000.
Task Six: Fall Protection Program Development and Training
EORM will develop a written fall protection program based on the requirements in 8 CCR Sections 3200 and 3400
for the Town of Los Gatos PPW group. This program will include specific information related to the use of the
aerial lift truck. Following the program development, EORM will develop and deliver one 2.5 hourtraining session
that will include the requirements of the written program as well as hands on practice using the Town's fall
protection equipment. The time and materials estimate for Task Six is $4,000.
Task Seven: Ergonomic Evaluations with individual Reports
EORM will provide an ergonomic evaluator to perform detailed ergonomic assessments for individuals at their
office workstations. EORM will utilize the Cartevia Ergonomics Tool to identify risk factors associated with office
workstations. The deliverable will be a report that identifies ergonomic concern by body part, pictures of
Individual workstation, and recommendations to reduce or mitigate the concerns. Recommendations may
include simple workstation adjustments or specific equipment recommendations. The report will be quality
reviewed by a Certified Professional Ergonomist (CPE) prior to submittal to the Town of Los Gatos,
Professional Fee Option 7A: Principal Consultant
A Principal Consultant level CPE (7+ years of experience) will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $400 /evaluation. A discount of
$25 1evaluation will be applied when two or more evaluations are scheduled back to back in the same
location.
EGRM Proposal No. 12.0986112 0966 Los Gatos Safety and Health Program Development Support
This proposal is considered Confidential & Proprietary information to Environmental and Occupational Risk Management, Inc (FORM). It shall be used only
for consideration of this proposal. Disclosure to other parties outside of client company 15 prohlblted without express written consent by EORM.
Steve Regan, Town of Los Gatos
Professional Fee Option 7B: Associate Consultant
An Associate Consultant level (3+ years of experience) consultant will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $300 /evaluation. A discount of
$25 /evaluation will be applied when two or more evaluations are scheduled back to back in the same
location.
Professional Fee Option 7C: Consulting Specialist
A Consulting Specialist level Consultant (1 -2 years of experience) will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $250 /evaluation. A discount of
$25 /evaluation will be applied when two or more evaluations are scheduled back to back in the same
location.
EORM will provide additional ergonomics consulting support as requested. The number of hours and scope of
work will be confirmed via email prior to commencement of any projector support. This support may include
developing a standard product list and order form /process for equipment, identifying and setting up an
alternative vendorfor ordering products In addition to using the current vendor for office supplies, reviewing and
updating or creating any process documents or ergonomic program documents, reviewing any planned designed
for new buildings or build outs for ergonomic considerations, general guidance and assistance to run the
ergonomics program. Additional tasks maybe completed as requested and will be completed according to the
rate schedule below.
Task Eight: Miscellaneous EHS Consulting
EORM will provide on -call, as needed EH &S and Risk Management support for the Town of Los Gatos. This
support may include, but is not limited to Workers Compensation data analysis and recommendations, safety
committee meeting facilitation, ergonomics, safety training, and industrial hygiene monitoring. All support will
be authorized by Steve Regan, PPW Superintendent, Rumi Portillo, HR Director, or another authorized Town of
Los Gatos employee, and a Not to Exceed estimate will be provided before initiating any project work. All work
will be provided accordingto the rate schedule noted below.
EORM Proposal No. 12-09B6/12 0966 Los Gatos Safety and Health Program Development Support
This propoW is considered Confidential & Proprietary information to Environmental and Occupational Risk Management, Inc. (FORM). it shall be used only
for consideration of this proposal. Disclosure to other parties outside of client company is prohibited without express written consent by EORM.
Steve Regan, Town of Los Gatos
Support will be provided on a time and materials basis according to the rate schedule summarized below. The
rates provided reflect up to a 5 -10% discount over our standard fee schedule rates.
Labor
Cost /Hr
Principal Consultant
$225
Senior EHS Consultant
$200
EHS Consultant
$180
Associate EHS Consultant
$155
EHS Specialist
$120
Technician
$100
Mileage
Federal Rate +20%
Assumptions
❑X One draft version of each deliverable
F1Other:
Project Budget
X�Time & Materials Estimate
FI Fixed Price
❑ Normal sample turnaround (no rush fees)
Not -to- Exceed $28,000 plus actual expenses
Not -to- Exceed plus actual travel expenses
❑X A rescheduling/cancellation fee of ❑X 25 %/ [—]actual expenses incurred will be applied
unless notice of at least 5 business days is provided.
Budget Conditions
• After -hours (before 7AM and after 7PM) and Sat /Sun /Holiday work is billed at 150% of hourly rate; Expert witness/
deposition/ public hearing representation is billed at 200% of hourly rate; Travel time is billed at 100% of hourly rate.
• Travel Expenses (e.g., lodging, airfare, auto rental, meals) are billed at cost plus 5 %.
• Authorized Subcontracts, Equipment Rental, Project Supplies /Outside Vendor Services are billed as proposed.
• Automobile Mileage is billed at the federal rate plus 20 %.
Estimated completion date: 4/30/2013
Christine Wolter
Prepared by: N. California Regional Manager
Signature: ePrawsewoo"
Jessica Ellison
Reviewed by: N. California Operations Manager
Signature: 7±26iM MOIL
EORM Proposal No. 12.0986112 0386 Los Gatos Safely and Health Program Development Support
This proposal is considered Confidential & Proprietary information to Environmental and Occupational Risk Management, Inc, (EORM). It shall be used only
for consideration of this proposal. Disclosure to other parties outside of client company is prohibited without express written consent by EORM.
Steve Regan, Town of Los Gatos Page 5
FORM Proposal No. 12.0986 / 12 0986 Los Gatos Safety and Health Program Development Support
This proposal is considered Confidential & Proprietary information to Environmental and Occupational Risk Management, Inc. (FORM). R shall be used only
for consideration of this proposal. Disclosure to other parties outside of client company is prohibited without express written consent by EORM.
FIRST AMENDMENT TO AGREEMENT
This I" AMENDMENT TO AGREEMENT is dated for identtfi'cation this-291' .day of _
September 2014 and amends that certain AGREEMENT FOR CONSULTANT SERVICES dated
February 20, 2013, made by and between the Town of Los Gatos, ( "Town, ") and EORM,
( "Consultant. ")
RECITALS
A. Town and Consultant entered into an Agreement on February 20, 2013, a copy of which is
attached hereto and incorporated by reference as Attachment 1 to this Amendment.
B. Town desires to add ergonomic evaluation services to the Agreement.
AMENDMENT
2.1 Scope of Services. Consultant shall provide services as described in that certain written
proposal sent to the Town on February 4, 2013, in addition per the Project Authorization
Order (Attachment 2) thus increasing the Project Budget by $21,000.
All other terms and conditions of the Agreement remain in full force and effect.
IN WITNESS WHEREOF, the Town and Consultant have executed this Amendment.
Town of Los Gatos CONSULTANT
"!
Greg Larson Signature
Town Manager
ommended B �_J
R mi Portillo
IIn ' an Resourcetele to r
Department Approval:
r i "-
Malt orley
Parks & Public Works Dire
r
%_
:;tor
Approved as to Fgr1f1 ,\
Robert Schultz, Town orney
i
Printed Name and Title
ATTACHMENT
Environmental, Health, Safety
and Sustarnability Consulting
4 North 2nd Street
Suite 1270
San Jose, CA 95113
800.648.1506
wtmw.eor o.com
Prinject Authorization Order (PAO)
Order Number: 14 -0832 X❑New Authorization FI Change Order to Previous Auth. No.
Date: 9/26/2014 Expiration Date: 12/31/2014
Company Name: Town of Los Gatos
Contact Name: Rumi Portillo
Address: 41 Miles Ave, Los Gatos, CA 95030
Human Resources
Title: Director
Phone: (408) 354 -6829
email: rportillo @losgatosca.gov
Project Title: Safety and Health Program Development Support — 2014 -2015
Environmental and Occupational Risk Management, Inc. (EORMO) is pleased to present this proposal to the Town
of Los Gatos for ongoing Health & Safety program development and training support. Additional support may be
provided on a time and materials basis following authorization and an approved change -order request.
Tank Onc: Eloctrluaf Safety Prcr�raT Dievelopirricitt
EORM will resource a Senior Consultant experienced in electrical safety to finalize a customized, comprehensive
Electrical Safety Program using National Fire Protection Agency (NFPA) 70E, and Cal -OSHA regulations as
guideline documents. The development of this program was started during FY2014 -2015, but was not finalized
due to other safety program priorities. The program will include requirements such as employee /employer
responsibilities, energized vs. de- energized work, training, designation of authorized electrical workers (qualified
persons), requirements for hazard analysis procedures, personal protective equipment, energized electrical hot
work permit requirements, preventive maintenance of electrical equipment, etc. Note: the written program will
NOT include task or equipment specific procedures for energized work, but will provide policy for development
of such procedures. One editable, draft version of the written program will be provided. EORM expects up to one
onsite meeting with Town of Los Gatos stakeholders to confirm electrical work tasks, existing, and proposed
controls. Project management and quality review of the program will be provided by a Senior Consultant.
The time and materials cost estimate for Task Two is $2,000.
Task T%afo Re:s`plratm F`[F-- to €,fion Program €`SeMelCapnient and =ra €nfrtg
EORM will develop a Written Respiratory Protection Program in accordance with the California Code of
Regulations, Title 8, and Section 5144: "Respiratory Protection ". In order to properly determine the respiratory
protection needed for PPW employees, EORM will conduct a review of PPW herbicide MSDS sheets, and will
conduct industrial hygiene monitoring for dust exposure for up to three representative employees. Following the
monitoring and program development, EORM will develop and deliver a customized respiratory protection
training class. The training class will be conducted in accordance with the requirements contained in Title 8,
California Code of Regulation (CCR), Section 5144(k), and will last approximately 45 -60 minutes.
The time and materials estimate for Task Three is $4,000.
a °, tftee PH} & iCFdni3 o'- Lquir menu Mg at'fir
EORM will compete the development of a training matrix for the Town of Los Gatos, to document the EH &S
training requirements within each Town Department. This project was started in early 2014 as part of an action
LORIM Proposal No. 14 -0832 114-0832 Town of Los Gatos Support FY14 -15 071414
This proposal is considered Confidential & Proprietary urfot mation to Environmental and Occupational Risk Management, Inc. (EORM). It shall be used only
for consideration of this proposal. Disclosure to other parties outside of client company is prohibned without express writ *.en consent by EORM_
Rumi Portillo, Town of Los Gatos
item from the Town Safety Committee. EORM will complete this matrix and work with Town staff to integrate
this information into the training management system.
The time and materials estimate for Task Five is $2,000.
`Erik Foabr. Evacuation Ull air Training
EORM will provide a customized training for Town of Los Gatos staff on the use of evacuation chairs installed in
Town buildings. Each training will be up to 1 hour in length and will include some hands -on practice for
employees who may use the chairs. EORM assumes a total of 3 training sessions will be provided.
The time and materials estimate for Task Six is $1,400.
Tasks Severs: Ergonomic Evaluations; with I€ divideuai Report;
EORM will provide an ergonomic evaluator to perform detailed ergonomic assessments for individuals at their
office workstations. EORM will utilize the Cartevia Ergonomics Tool to identify risk factors associated with office
workstations. The deliverable will be a report that identifies ergonomic concern by body part, pictures of
individual workstation, and recommendations to reduce or mitigate the concerns. Recommendations may
include simple workstation adjustments or specific equipment recommendations. The report will be quality
reviewed by a Certified Professional Ergonomist (CPE) prior to submittal to the Town of Los Gatos.
Prole ssionak Fee Option A Principal Consbiltart
A Principal Consultant level CPE (7+ years of experience) will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $400 /evaluation. A discount of $25 /evaluation
will be applied when two or more evaluations are scheduled back to back in the same location.
Pfcrfcss?dnzl Fate caption 7131 Aesocisate Gransuitaruf,
An Associate Consultant level (3+ years of experience) consultant will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $300 /evaluation. A discount of $25 /evaluation
will be applied when two or more evaluations are scheduled back to back in the same location.
Pirofcss =c nak Fee Opticyn 7 C: Consulli s, g Specialist
A Consulting Specialist level Consultant (1 -2 years of experience) will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $250 /evaluation. A discount of $25 /evaluation
will be applied when two or more evaluations are scheduled back to back in the same location.
EORM will provide additional ergonomics consulting support as requested. The number of hours and scope of
work will be confirmed via email prior to commencement of any project or support. This support may include
developing a standard product list and order form /process for equipment, identifying and setting up an
alternative vendor for ordering products in addition to using the current vendor for office supplies, reviewing and
updating or creating any process documents or ergonomic program documents, reviewing any planned designed
for new buildings or build outs for ergonomic considerations, general guidance and assistance to run the
ergonomics program. Additional tasks may be completed as requested and will be completed according to the
rate schedule below.
The time and materials estimate for Task Seven is $8,000.
Task E4ght, Kgfict c.oilarhecui EHS -...E p 4 lturrig
EORM will provide on -call, as needed EH &S and Risk Management support for the Town of Los Gatos.
This support may include, but is not limited to Workers Compensation data analysis and recommendations,
safety committee meeting facilitation, ergonomics, safety training, and industrial hygiene monitoring. All support
will be authorized by Steve Regan, PPW Superintendent, Rumi Portillo, HR Director, or another authorized Town
-- --- ------- - -- ------ - - - - -- .. — -
EORM Proposal No 14 -08x2 l 14-(8 Too rn of Los Cato' Support FY14 -15 071414
This proposal is considered Cosildential & Proprietary information to Eirmonmentar and Occupational Risk Management, Inc iEORMJ. it shall be used only
for mnsidention of this proposal- Disclosure to other parties outside of client company Is prohibited without express written consent by FORM.
Rum Portillo, Town of Los Gatos _...- -- _ --- Page
of Los Gatos employee, and a Not to Exceed estimate will be provided before initiating any project work. All work
will be provided according to the rate schedule noted below.
The time and materials estimate for Task Eight is $3,600.
EORM Proposal No '140832 / 14-0832 iovvn of Los Gatos Support FY14 -15 071414
Th6 proposal is considered Confidential S Proprietary n?fonnaticon to Environmentai and Occupational R %k Management, I¢C (EORM). iI rha11 be used only
for wnederafion of this proposal Dlsdosare to other parties outside of dlent company 15 prohibited without express wroten consent oy FORM,
Rurni Porbilo, Town of Los Gatos
Support will be provided on a time and materials basis according to the rate schedule summarized below.
The rates provided reflect up to a 5 -10% discount over our standard fee schedule rates.
Assumptions
One draft version of each deliverable
Other:
Pro jeCt Budget
LX_1 Time & Materials Estimate Not -to- Exceed $21,000 F-1 plus actual expenses
Fixed Price Not -to- Exceed plus actual travel expenses
A rescheduling /cancellation fee of [X] 25 % / 0 actual expenses incurred will be applied
1XINormal sample turnaround (no rush fees)
unless notice of at least 5 business days is provided.
Budget Conditions
a After -hours (before 7AM and after 7PM) and Sat /Sun /Holiday work is billed at 150% of hourly rate; Expert witness/
deposition/ public hearing representation is billed at 200% of hourly rate; Travel time is billed at 100% of hourly rate.
Travel Expenses (e.g., lodging, airfare, auto rental, meals) are billed at cost plus 5 %.
Authorized Subcontracts, Equipment Rental, Project Supplies /Outside Vendor Services are billed as proposed.
Automobile Mileage is billed at the federal rate plus 20 %.
Estimated completion date: 6/30/2015
Christine Foster
Prepared by: N. California Regional Manager
Signature: e.,Rnbtine `3aotex
Jessica Ellison
Reviewed by: N. California Operations Manager
Signature: k±oica £PPioau
FORM Proposal No. 14 -0832 / 14 -0832 Town of Los Gatos Support FYI 4-115 071414
This propma a mnodered Con(dentia =. & Proprietary information to Environmental and Occup t onal Risk Management, Inc (EDfi It shall be need only
for considera tion of Phis praposaI. Dlsdosure D o t 1 ther parties outside of deent company is prohibited avnhout express written consent by EORM-
SECOND AMENDMENT TO AGREEMENT
This 2nd AMENDMENT TO AGREEMENT is entered into this 23`d day of September, 2015
by and between the Town of Los Gatos, ( "Town, ") and EORM, ( "Consultant. ")
RECITALS
A. Town and Consultant entered into an Agreement on February 20, 2013, a copy of the
proposed is attached hereto and incorporated by reference as Exhibit A.
B. The Town and Consultant entered into a First Amendment to Agreement dated September
29, 2014, a copy of which is attached hereto and incorporated by reference as Exhibit B.
C. The Town desires to extend the term of the agreement to June 30, 2016.
AMENDMENT
2.1 Scope of Services. Consultant shall provide services as described in that certain written
proposal sent to the Town on September 2, 2015, in addition per the Project Authorization
Order (Attachment 1) thus increasing the Agreement by $21,000.
All other terms and conditions of the Agreement dated February 20, 2013 remain in full force
and effect.
IN WITNESS WHEREOF, the Town and Consultant have executed this Amendment.
Town of Los Gatos
an
Laurel Prevetti
Town Manager
CONSULTANT
By:
Signature
Printed Name and Title
ATTACHMENT
Recommended By:
RumiPortillo
Human Resources Director
Department Approval:
Matt Morley
Parks & Public Works Director
Approved as to Fonn:
Robert Schultz, Town Attorney
2
EORM'
*i 1 Sorvaces co ?perry
4 North 2nd Street
Suite 1270
San Jose, CA 95113
600.645.1506
mAc,, eorm.com
Order Number: 15 -1191 ❑X New Authorization FI Change Order to Previous Auth. No.
Date: 9/2/15 Expiration Date: 6/30/16
Company Name: Town of Los Gatos Address: 41 Miles Ave, Los Gatos, CA 95030
Contact Name: Rumi Portillo
Human Resources
Title: Director
Phone: (408) 354 -6829
email: rportillo @losgatosca.gov
Project Title: Safety and Health Program Development Support — 2015 -2016
Purpose /Scope /Deliverables
Environmental and Occupational Risk Management, Inc. (EORM ®) is pleased to present this proposal to the Town
of Los Gatos for ongoing Health & Safety program development and training support. Additional support may be
provided on a time and materials basis following authorization and an approved change -order request.
r ask Orle ErMirorornerApd Health and Safety F "or
gram Support
EORM will provide EH &S program support for various technical areas such as Injury and Illness Prevention
Program, Confined Space Entry, Electrical Safety, Machine and Equipment Safety, Respiratory Protection, Fire
Prevention, and Heat Illness Prevention. This support will include provision of monthly safety training "lunch and
learn" topics for PPW, and other EMS training requests as needed. Work under this task will be prioritized and
scheduled in conjunction with Town of Los Gatos personnel. The time and materials estimate for Task One is
$9,400.
lack "e vf,, Safety Gornririif ee R-upport
Christine Foster, Principal Consultant will provide guidance and support for Quarterly Safety Committee
meetings. This support will include review of agendas and minutes, attendance at quarterly meetings, and
additional follow up action items in support of these meetings. The time and materials estimate for Task Two is
$3,600.
7 fl: T hree:. ErgE"Efcrn�r; Ev dttafionF, vvfth indivi dEuai Fi'oports
EORM will provide an ergonomic evaluator to perform detailed ergonomic assessments for individuals at their
office workstations. EORM will utilize the Cartevia Ergonomics Tool to identify risk factors associated with office
workstations. The deliverable will be a report that identifies ergonomic concern by body part, pictures of
individual workstation, and recommendations to reduce or mitigate the concerns. Recommendations may
include simple workstation adjustments or specific equipment recommendations. The report will be quality
reviewed by a Certified Professional Ergonomist (CPE) prior to submittal to the Town of Los Gatos.
-1 U V '7e r'; nP r[ of N n( [I) _E C,-,risi o
A Senior or Principal Consultant level (7+ years of experience) will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $400 /evaluation. A discount of $25 /evaluation
will be applied when two or more evaluations are scheduled back to back in the same location.
EORK4 Proposal No 15 -1591 / Town of Los Gatos Support FYI 5 -16,
This pro pescl is consldere_ Ccn i.- ential o. F clp'etary I nfor mat, on to T muoil .cnt,, I a, er o<( u , ", nJ kirk Maa�u I lent, Inc (FnRanI I =,n,ai Is,
rirarsitic_ti. cthe ,'s,J.,�rtoofl)D itiedo.,v eode ntcompriys ,xonl6itcemIIroutexpessmr.iene EXHIBIT
Rum Porlillo, Tovvn of Los Gags
Profe u orIM Fee Option 7B Astsce tare ConsuR rit'.
An Associate Consultant level (3+ years of experience) consultant will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $300 /evaluation. A discount of $25 /evaluation
will be applied when two or more evaluations are scheduled back to back in the same location.
Pr,i„ssic, rtpl Fee Option, 7C: Curtsufting S tees €aHsl
A Consulting Specialist level Consultant (1 -2 years of experience) will perform detailed office ergonomics
assessments. EORM will provide this task as a Fixed Fee of $250 /evaluation. A discount of $25 /evaluation
will be applied when two or more evaluations are scheduled back to back in the same location.
EORM will provide additional ergonomics consulting support as requested. The number of hours and scope of
work will be confirmed via email prior to commencement of any project or support. This support may include
developing a standard product list and order form /process for equipment, identifying and setting up an
alternative vendor for ordering products in addition to using the current vendor for office supplies, reviewing and
updating or creating any process documents or ergonomic program documents, reviewing any planned designed
for new buildings or build outs for ergonomic considerations, general guidance and assistance to run the
ergonomics program. Additional tasks may be completed as requested and will be completed according to the
rate schedule below.
The time and materials estimate for Task Seven is $8,000.
Support will be provided on a time and materials basis according to the rate schedule summarized below.
The rates provided reflect up to a 5 -10% discount over our standard fee schedule rates.
Principal Consultant
$ 225
Senior EHS Consultant
$ 200
EHS Consultant
$ 180
Associate EHS Consultant
$ 155
EHS Specialist _
$120
Technician
$ 100
Federal Rate +20%
Assumptions
One draft version of each deliverable Normal sample turnaround (no rush fees)
Other:
Project Budget
YTime & Materials Estimate Not -to- Exceed $21,000 plus actual expenses
Fixed Price Not -to- Exceed plus actual travel expenses
A rescheduling /cancellation fee of I—XI 25 %/ El actual expenses incurred will be applied
unless notice of at least 5 business days is provided.
EORM Proposal No 15 -1191 /
h,spmposa s tai n eldereo wnndeot la hPro p i eta ry iornr_ioe is P rvlrenmental n I(I..(,r m to sI< M a, t a bei sent,: it c- (LOf,f sieif be used only
le, co of tbds rrepos... Disclosure to other 13811 1-1 ouisPde..i c ient mmparf ii prertteied without expre s vvritiec co sent by FORM.
Rumi Portlllo. Town cr£ Los Oates Page 3
Budget Conditions
r After -hours (before 7AM and after 7PM) and Sat /Sun /Holiday work is billed at 150% of hourly rate; Expert witness/
deposition/ public hearing representation is billed at 200% of hourly rate; Travel time is billed at 100% of hourly rate.
.. Travel Expenses (e.g., lodging, airfare, auto rental, meals) are billed at cost plus 5 %.
Authorized Subcontracts, Equipment Rental, Project Supplies /Outside Vendor Services are billed as proposed.
g Automobile Mileage is billed at the federal rate plus 20 %.
Estimated completion date: 6/30/2016
Christine Foster Jessica Ellison
Prepared by: N. California Regional Manager Reviewed by: N. California Operations Manager
Signature: C'hwtuw rewtet Signature: )eooica £QPGsaz
FORIM P,aoosal No 15 -119? /
11, Is propose I aarsiae,od co aerrfFa F npaetary foii natfwl toJwlron menta 1_111Oca.I So0(nG RLJ, "4a If agciz ylnc(L OAISS) a sha 11 re iSt'donly
Rv con Side a.ic ci. 1 his proposal. 3611nsure to Whet pa: iws ouis,de of (I e ?t co"I is ), "hi bV(o w t =1011 ez,r, ss mrit?en (onssint by EORos