HomeMy WebLinkAboutTransportation Development Services Authorizat (34)D Public Works
919 Palm Stree[, San Luis Obispo, CA 93401-321 B
805.781 7200
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Transportation Development Services Authorization
PROJECT TITLE: French Hospital Medical Center
APPLICANT: Dignity Health
APPLICANT ADDRESS: 1911 Johnson Ave, San Luis Obispo, CA
PROJECT DESCRIPTION: Focused Transportation Analysis French Hospital Medical Center
PROCESSING FEES:
1. Consultant Fee (Firm: Michael Baker International)...... ............... $21,230.00
Revenue Account 701-0000-21012)
2. Administration Fee (30% of Consultant Fee) .............. ......... .$6,369.00
Revenue Account 101-5010-46008) 3. Report
Reproduction Fee/Advertising Fee......... ..... . ........................... $ 0 4. Other
Fees (Specify )............................... ... $ 0 5. Total
Fees ................... ......... ................ $27,599.00 Authorization and
Assurances The cost
to the applicant for consultant services (as stated in line 1 above) is based on the total
cost included in the consultant's proposal for preparation of the Focused Transportation Analysis
French Hospital Medical Center, as detailed in the attached TIS Scope dated
May 6, 2020. 1J1 JJ1_
4 Date Luke
Schwartz, Transportation Manager As applicant
for this project, I hereby accept the fees for the preparation of a Transportation Impact
Study (TIS) and agree to deposit with the City of San Luis Obispo Public Works
Department, the amount shown on line 5 above. Upon receipt of this sum, the Public
Works Director or their designee is authorized to employ a qualified consultant to
complete the TIS. I acknowledge that any schedules represented in the Consultants scope
of services will be adjusted to reflect a start date that coincides with receipt of
the deposit. I acknowledge that any changes to the project description after the start
date will result in impacts to the project schedule and will require additional funds to
complete. 06/10/
20 Date Dignity
Health
Dignity h eafthV
3033 North Third Ave.
Phoenix. AZ 85013
916)851-2150
CITY OF
SAN LUIS OBISPO
COM. DEV. DEPT.
DATE 06/15/2020 MON TIME 09:42
M]:SC 39 21230 , 00
MI'SC 40 6369.00
TOTAL 27599.00
CHECK 27599.00
THANK YOU
CORI No.096446 00001
Bank of America
Gommercial Disbursement Account
Northbrook, IL
PAY Twenty Seven Thousand Five Hundred Ninety Nine and 00/100 Dollars
TO THE PUBLIC WORKSORDEROF
919 PALM STREET
SAN LUIS OBISPO CA 93401-3218
0-2328
0719 3371077
PAYMENT DATE PAY THIS AMOUNT
06/01/2020 ***$27,599.00
111
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