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<br />RFP No. 57818 – Design Services for a Treatment Wetland Page 43 of 43 <br /> <br /> <br />SECTION II <br /> <br />Please read, complete, and sign the following: <br /> <br />THIS CONTRACT IS SUBJECT TO THE LIVING WAGE ORDINANCE.  <br />THIS CONTRACT IS NOT SUBJECT TO THE LIVING WAGE ORDINANCE.  <br /> <br />The undersigned, on behalf of himself or herself individually and on behalf of his or her business or <br />organization, hereby certifies that he or she is fully aware of San Leandro's Living Wage Ordinance, and the <br />applicability of the Living Wage Ordinance, and the applicability of the subject contract, as determined <br />herein. The undersigned further agrees to be bound by all of the terms of the Living Wage Ordinance, as <br />mandated in the San Leandro Municipal Code, Title 1, Chapter 6. <br />If, at any time during the term of the contract, the answers to the questions posed herein change so that <br />Contractor would be subject to the LWO, Contractor will promptly notify the City Manager in writing. <br />Contractor further understands and agrees that the failure to comply with the LWO, this verification, or the <br />terms of the Contract as it applies to the LWO, shall constitute a default of the Contract and the City <br />Manager may terminate the contract and pursue any other legal remedies available to the city, including <br />debarment. If the contractor is a for-profit business and the LWO is applicable to this contract, the <br />contractor must pay a living wage to all employees engaged in work directly related to the contract with the <br />City. If the contractor is a non-profit business and the LWO is applicable to this contract, the contractor <br />must pay a living wage to all employees who spend 25% or more or their compensated time engaged in <br />work directly related to the contract with the City. <br /> <br />These statements are made under penalty of perjury under the laws of the state of California. <br /> <br />Printed Name: <br />___________________________________Title:________________________________________ <br /> <br />Signature: ___________________________________Date:_______________________________________ <br /> <br />Business Entity: <br />______________________________________________________________________________ <br /> <br />Contract Description/Specification No: <br />____________________________________________________________ <br /> <br />SECTION III <br />.. <br />* * FOR ADMINISTRATIVE USE ONLY -- PLEASE PRINT CLEARLY * * * <br />I have reviewed this Living Wage Ordinance Self Verification form, in addition to verifying Contractor's total <br />dollar amount contract commitments with the City in the past twelve (12) months, and determined that <br />this Contract IS / IS NOT (circle one) subject to San Leandro's Living Wage Ordinance. <br /> <br />Department Name _____________________ Department Representative ___________________ <br />229