HomeMy WebLinkAboutC-8597-2 - Agreement for Temporary Assignment of a Vehicular EquipmentGAVIN NEWSOM
GOVERNOR Cal CNES
GOVERNOR'S OFFICE
OF EMERGENCY SERVICES
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�O NEWPORT BEACH
August 1, 2023 FIRE ADMINISTRATION
Jeff Boyles, Fire Chief AUG U 23
City of Newport Beach
100 Civic Center Drive RECEIVED BY:_
Newport, CA 92660
Dear Chief Jeff Boyles,
NANCY WARD
DIRECTOR
You will find enclosed two copies of Assignment of Equipment Form, and Agreement for
Temporary Transfer of Vehicular Equipment covering the assignment of Cal OES Fire Engine
No. 1105 to the City of Newport Beach. The Agreement is effective August 22, 2023.
Please have the authorized official sign both copies of the above -mentioned documents and
return one original set to our office.
NOTE 1: Cal OES cannot assign the apparatus to your agency until this signed Agreement is
returned.
It is required that this office be furnished with a Certificate of Insurance, or a letter certifying
self-insurance in accordance with Paragraph 16 and 17 of the Agreement for Temporary Transfer
of Vehicular Equipment.
If you have any questions regarding this assignment, please feel free to contact our office.
Sincerely,
Brian S Marshall
State Fire and Rescue Chief
Cc: Anthony Marrone, Chief, Region I Fire and Rescue Coordinator
Brian Fennessy, Chief, Operational Area Coordinator, Region I
Art Torrez, Cal OES Deputy Chief of Operations South
Dave Stone, Cal OES Assistant Chief Region I
3650 SCHRIEVER AVENUE • MATHER, CA 95655
FIRE AND RESCUE DIVISION
PHONE: (916) 845-8711 • FAx: (916) 845-8396
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
AGREEMENT FOR
TEMPORARY ASSIGNMENT OF VEHICULAR EQUIPMENT
THIS AGREEMENT, entered into this 22nd day of August 2023, by and between the
Governor's Office of Emergency Services, hereinafter "CAL OES" acting by and between its
duly appointed and qualified Director of the Governor's Office of Emergency Services and the
City of Newport Beach, acting by and through its duly appointed, qualified and acting officers,
hereinafter called "ASSIGNEE."
WITNESSETH:
WHEREAS, the State of California has purchased fire apparatus and equipment for the purpose
of responding to incidents in furtherance of the California Fire Service and Rescue Emergency
Mutual Aid Plan; and
WHEREAS, Cal OES is authorized to assign these fire apparatus and equipment to local
jurisdictions throughout the State under written agreements to be staged for Cal OES purposes
and for use by local jurisdictions for the purposes described below; now, therefore,
IT IS HEREBY MUTUALLY AGREED between the parties hereto as follows:
1. ASSIGNMENT. CAL OES hereby transfers possession to ASSIGNEE and ASSIGNEE
hereby accepts possession from CAL OES of the fire apparatus and equipment listed on the
attached Exhibit "A" which is by this reference made a part hereof, for the period commencing
August 22d, 2023, for the following all-risk events, emergency incidents, civil defense, and
disaster purposes, namely:
Mutual aid, multiple alarm events and emergency incidents, emergency incidents
threatening properties vital to national defense or important military installations,
parades and displays, training of regular, volunteer, and auxiliary firefighters and
temporary standby for ASSIGNEE's regular apparatus and the regular apparatus
of other departments while out of service for repairs.
a. Vehicle Description: 2022 HME Type 1 Engine
Vehicle Designation: 1105
Vehicle License Number: 1656487
Vehicle Identification Number: 44KFT428ONWZ23721
Value of Vehicle: $437,851.50
Value of Hose and Appliances: $101,511.71
b. Equipment inventories (Exhibit "A") may by mutual concurrence of the CAL
OES and ASSIGNEE be changed during the term of this Agreement, utilizing property
accountability procedures established or approved by the State.
2. TERM. The term of this Agreement shall be for ten (10) years unless terminated pursuant
to the terms of this Agreement.
3. CONSIDERATION. Consideration for this Agreement is the mutual benefit the parties will
enjoy by having a fire apparatus locally available for use as provided in this Agreement.
1 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
4. HOUSING, MAINTENANCE, REPAIR, AND REPLACEMENT. During the term of this transfer,
ASSIGNEE agrees to adequately house in an enclosed secure structure, staff, operate, maintain
and repair (consistent with section 4b) said fire apparatus and equipment (hereinafter collectively
referred to as "the Apparatus" except where it is desired to refer to equipment alone, in which
case the term "Equipment" is used) at its sole cost and expense, except as otherwise expressly
provided in this Agreement. ASSIGNEE also agrees to complete all reports and maintain
records consistent with Section 14. Apparatus shall be housed on property of the ASSIGNEE in
a manner to provide reasonable protection against inclement weather, sabotage, theft, or
malicious damage. Apparatus shall be maintained in such condition that it is available for
immediate emergency use, and at the same standard as other emergency apparatus operated by
ASSIGNEE. Maintenance shall include care of hose, batteries, tires, appliances, lubrication and
fuel, general cleaning and polishing, minor body repairs and periodic testing. Repairs shall
include, without being limited to, motor tune-ups, pump repairs, transmission, differential and all
running gear, brake and exhaust systems, cooling devices including radiator, pump packing, and
equipment assigned to Apparatus.
a. Repairs to the extent of $100.00 for each individual item of repair shall be the
responsibility of ASSIGNEE.
b. Repairs to the extent that they exceed $100.00 for each individual item of repair
shall be the responsibility of CAL OES on a $100.00 deductible basis, unless in the judgment of
the CAL OES the need for repair results from misuse or negligence on the part of ASSIGNEE
in the maintenance or use of the Apparatus, in which event the cost of each such item of repair
above $100.00 shall also be the responsibility of ASSIGNEE. In no event shall ASSIGNEE
arrange for repairs costing over $100.00 for any item of repair, whether it is the responsibility of
CAL OES or ASSIGNEE, without first obtaining written authorization from the Cal OES Fire
and Rescue Division.
C. Notwithstanding the foregoing, replacement of hose, batteries and tires shall be
the responsibility of CAL OES, except to the extent CAL OES determines that the damage
thereto is the result of negligence or misuse on the part of ASSIGNEE, in which event
ASSIGNEE will bear such portion of the replacement cost thereof as the CAL OES deems
equitable. Procurement of tires, hose and batteries is subject to State fiscal policies and
procedures, and written approval must be obtained from the Cal OES Fire and Rescue Division
prior to procurement.
d. Maintenance and repairs must be requested and authorized pursuant to the most
recent version of the Cal OES Fire and Rescue Division Operations Bulletin #18, which is
hereby incorporated into this Agreement by reference.
e. Repair or replacement of the Apparatus transferred hereunder which is consumed,
lost, stolen, damaged or destroyed during mutual aid operations when CAL OES has dispatched
or directed the dispatch of said Apparatus through Regional or Operational Area Fire and Rescue
Coordinators, or when CAL OES has reassigned said Apparatus pursuant to the provisions of
paragraph 11 of this Agreement, shall be the responsibility of CAL OES, providing that any
such loss or damage shall be the responsibility of ASSIGNEE, if due to the negligence of
ASSIGNEE. ASSIGNEE agrees that it will assume responsibility in full for the repair or
replacement of Apparatus that has been consumed, lost, stolen, damaged or destroyed in
2 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
operations ASSIGNEE has directed or controlled.
f. ASSIGNEE must request from CAL OES, in writing, permission to make any
and all changes to assigned fire apparatus and equipment. Furthermore, ASSIGNEE will not
make modifications, changes, adjustments, or additions, including decals or stickers, to
Apparatus without prior written approval from CAL OES.
5. INSPECTION OF APPARATUS. ASSIGNEE agrees that representatives of the Cal OES Fire
and Rescue Division and other authorized State personnel may inspect the Apparatus at any time.
6. STAFFING. Reasonable and continual training shall be carried on so that trained personnel
shall at all times be available to staff and operate said Apparatus. The ASSIGNEE shall provide
personnel to staff the assigned apparatus per FIRESCOPE ICS standards. The Cal OES engine
may be assigned to out of area assignments for up to 14 days, plus travel time. When local
government personnel, staffing Cal OES Apparatus, are committed to extended assignments
there may be a need to replace or rotate personnel. Personnel rotation will follow the direction
outlined in the California Fire Assistance Agreement when assigned to an incident within
California. Crew rotation for incidents outside of California shall be consistent with the
appropriate forest's agencies policy and coordinated by Cal OES.
7. PERSONAL PROTECTIVE EQUIPMENT (PPE) AND SPECIALIZED EQUIPMENT. In addition to
providing the standard complement of firefighting PPE, it shall be the ASSIGNEE'S
responsibility to provide its personnel with all other PPE that may be required by NFPA 1901,
other NFPA Standards, and California Title 8. This shall include, but not be limited to, one
Traffic Vest (ANSI / ISEA 207) for each seating position. In addition, we recommend chainsaw
chaps be provided. In addition, an automatic external defibrillator (AED) has been added to
"Miscellaneous_ Equipment" in NFPA 1901. To provide consistency with the ASSIGNEE'S
equipment, it shall be the ASSIGNEE'S responsibility to provide this device for use on the
assigned engine.
8. TRAINING. Personnel assigned shall meet wildland fire and ICS standards established in
the California Incident Command Certification System (CICCS) or NWCG 310-1, Wildlife
Qualification System Guide (current edition). Personnel assigned to Cal OES Engine's shall
meet Rescue System I standards as certified by the California State Fire Marshal or have
completed an equivalent course that meets or exceeds Rescue System I curriculum.
9. DISPATCHING. All movement of the Apparatus shall be handled through the official
dispatching channels of ASSIGNEE. ASSIGNEE dispatchers will recognize and act on all
official requests for movement of the Apparatus in conformance with the Fire and Rescue Annex
(California Fire and Rescue Mutual Aid System) to the State Emergency Plan and its subsequent
revisions. CAL OES reserves the right to dispatch, direct the dispatch of, or temporarily
reassign the Apparatus whenever, in the opinion of the Director of Cal OES, his representatives
or Operational Area and Regional Fire and Rescue Coordinators, such Apparatus is essential to
the protection of life and property in another jurisdiction or in the best interest of the State.
10. MUTUAL AID RESPONSE. Procedures for mutual aid response shall be in accordance with
California Fire Service and Rescue Emergency Mutual Aid Plan.
11. REIMBURSABLE RESPONSE. Reimbursement for mutual aid may be provided pursuant to a
3 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
governor's disaster proclamation or when conditions warrant invoking the California Fire
Assistance Agreement, the State of Nevada Cooperative Agreement, or the Interstate Compact as
appropriate. There is no other existing provision for mutual aid reimbursement.
12. TEMPORARY USE. ASSIGNEE shall be permitted to use the Apparatus for temporary
cover of fire stations when emergency conditions warrant, or when regular apparatus is out of
service for repairs and a closer engine cannot cover the gap. In either case, the ASSIGNEE shall
immediately notify the Operational Area Dispatch Center and the Cal OES Fire Duty Chief. The
ASSIGNEE further agrees that Cover -in or Standby of said Apparatus exceeding 30 days is at
the discretion of the CAL OES.
13. TEMPORARY TRANSFER.
a. A sub -assignment of the Apparatus or any portion thereof by ASSIGNEE for any
period not exceeding seven consecutive days within a given Operational Area may be made with
the consent of the Operational Area Fire and Rescue Coordinator and the CAL OES, providing
that at the time such Apparatus is received, such Sub -Assignee furnish ASSIGNEE and CAL
OES a letter to the effect that he assumes all obligations of ASSIGNEE with respect to such
Apparatus under this Agreement during the period of assignment, including insurance coverage
in accordance with Section 16 or 17, as appropriate. Any sub -assignment by ASSIGNEE for a
period of more than seven consecutive days shall be subject to authorization by the CAL OES
and execution of an "Agreement for the Temporary Transfer of Vehicular Equipment," with the
agency requesting the transfer.
b. Whenever Apparatus is assigned in accordance with the provisions of this
paragraph, regular ASSIGNEE shall be relieved of its obligations under this Agreement during
such period of sub -assignment.
C. Complete a written Temporary Cal OES Apparatus Assignment Record, Exhibit
"B". The ASSIGNEE will retain one copy, the Sub -Assignee will retain one copy, and one copy
will be forwarded to the Cal OES Fire and Rescue Division.
14. REPORTS AND RECORDS. ASSIGNEE shall maintain daily and monthly reports on the
details of Apparatus use on Cal OES F-101 Form. A Smoke Opacity Test, Pump Test, Hose
Test, and Ladder Test shall be the responsibility of ASSIGNEE and completed annually.
Written results of all tests and reports shall be forwarded to the Cal OES Fire and Rescue
Division by the end of the calendar year. A recent copy of the tests and reports shall be
maintained in the vehicle logbook.
15. REPORT OF ACCIDENTS. ASSIGNEE shall immediately notify the Cal OES Fire and
Rescue Division following any and all accidents involving the Apparatus. It shall be the
responsibility of ASSIGNEE to fill out State Form 270, "Report of Automobile Accident," and
file the report with the Governor's Office of Emergency Services. A copy of this report shall be
retained by the ASSIGNEE and the original and four copies forwarded to Cal OES.
16. INSURANCE PROTECTION. (Non- State Agencies)
a. ASSIGNEE agrees forthwith to fixrnish evidence of insurance protecting the legal
liability of the ASSIGNEE and CAL OES for liability and/or property damage with a combined
4 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
single limit of $1,000,000.00 per occurrence, by means of a Certificate of Insurance naming the
State of California as Additional Insured. Said certificate shall contain an Agreement by the
insurance company that it will not cancel said policy without 15 days prior written notice to the
CAL OES and that the CAL OES is not liable for the payment of any premiums or assessments
thereon. Said certificate must include the description of the apparatus including VIN, state
license number, and Cal OES unit number.
b. In the event the ASSIGNEE is self -insured, ASSIGNEE in lieu of a certificate of
insurance shall furnish CAL OES a written statement of such fact. In such event, ASSIGNEE
agrees to hold the CAL OES harmless from any personal injury or property damage claims
arising out of its maintenance, use or operation of the Apparatus under the terms of this
Agreement.
C. Physical damage insurance, including collision coverage and comprehensive
coverage, shall be obtained. The State of California will be named as a loss payee. In the event
of a non -total loss, ASSIGNEE is responsible for returning Apparatus to original standard. The
description of the vehicle and the necessary amount of insurance required is outlined in attached
Exhibit "C" which is by this reference made a part hereof.
17. INSURANCE PROTECTION. (State Agencies) Any insurance necessary for coverage of the
apparatus shall be the sole responsibility of the department having custody of the vehicle,
including when it directs, dispatches, and controls the use of the Apparatus. ASSIGNEE agrees
to report Apparatus as being under its control to the Insurance Officer, Department of General
Services.
18. TERMINATION OF AGREEMENT
a. Either party may terminate this Agreement upon 14 days written notice to other
party, or ASSIGNEE may relinquish, or CAL OES may repossess any portion of the Apparatus
upon like notice to the other party, except that CAL OES may repossess any portion thereof
without written notice whenever it deems the same is not being maintained in accordance with
this Agreement.
b. Upon the termination of this Agreement, ASSIGNEE agrees to return said
Apparatus in the same condition as received, reasonable wear and tear, acts of God, and
conditions over which it has no control excepted.
C. As inventory changes occur, or items of equipment are replaced, deleted or added
by the CAL OES or replaced by ASSIGNEE, it is mutually agreed that no amendment to this
Agreement need be made at the time of the change; provided however, at the termination of this
Agreement a complete reconciliation of all equipment will be made. ASSIGNEE further agrees
that all replacements for equipment or apparatus will be made with identical or substantially like
items as approved by the CAL OES.
d. Nothing in this Agreement shall be construed to create a new property interest or
right of action for the ASSIGNEE.
19. UNAUTHORIZED USE OF CAL OES APPARATUS AND EQUIPMENT. Use of this Apparatus
other than as specified in Paragraph 1 will be considered a breach of this Agreement.
5 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
20. USE OF RADIO EQUIPMENT
a. CAL OES will furnish at CAL OES'S sole cost, radio equipment installed in the
Apparatus to be operated on the following frequencies: 151.145-170.925 .
b. CAL OES agrees to maintain said equipment without cost to ASSIGNEE.
C. The ASSIGNEE agrees to operate said radio equipment in accordance with the
Rules and Regulations of the Federal Communications Commission.
d. Ownership of said equipment is in the CAL OES, and all applications to the
Federal Communications Commission seeking authority to add, modify, or replace radio
equipment covered by this Agreement shall be made by and in the name of the State of
California. To activate this Agreement and in compliance with the control requirements of the
Communications Act of 1934, as amended, the CAL OES hereby deputizes the Chief of the
agency of said ASSIGNEE, and such volunteers, regularly employed and salaried assistants as
shall be designated by the Chief of the agency as his agents to operate said radio equipment as
specified in Paragraph "c" above.
e. CAL OES assumes no liability hereunder for claims or losses accruing or
resulting to any person, firm or corporation furnishing or supplying work, services or material or
services in connection with the performance of this Agreement or for any claims and losses
accruing or resulting to any person, firm or corporation injured or damaged by performance of
either party hereunder.
21. NOTICES. All correspondence and notices required or contemplated, or which may be
given by either party to the other shall be deemed to have been fully given when made in writing
and deposited in the U.S. mail, registered and postage prepaid and addressed as follows: To the
ASSIGNEE at City of Newport Beach, 100 Civic Center Drive, Newport, CA 92660, and to the
CAL OES at Governor's Office of Emergency Services, Fire and Rescue Division, 3650
Schriever Ave., Mather, CA, 95655. The address to which notices shall or may be mailed as
aforesaid to either party shall or may be changed by written notice given by such party to the
other, as hereinabove provided; but nothing herein contained shall preclude the giving of any
such notice by personal service.
22. ALTERATION. It is mutually understood and agreed that no alteration or variation of the
terms of this Agreement shall be valid unless made in writing and signed by the parties hereto,
and that no oral understanding or agreements not incorporated herein, and no alterations or
variations of the terms hereof unless made in writing between the parties hereto shall be binding
on any of the parties hereto.
23. WAIVER. The CAL OES may in its sole discretion and for such good cause as it
determines waive in writing in whole or in part any requirement of this Agreement that apparatus
and/or equipment shall be maintained in operating condition, or repaired, or replaced, providing
that any such waiver shall be applicable only to the specific apparatus or equipment to which it
refers.
6 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
24. JURISDICTION AND VENUE. This Agreement, and any dispute arising from the relationship
between the parties to this Agreement, will be governed by the laws of the State of California.
25. WHOLE AGREEMENT. This Agreement constitutes the entire agreement between the
parties hereto, with respect to the subject matter hereof. No party has been induced to enter into
this Agreement by, nor is any party relying on, any representation or warranty outside those
expressly set forth in this Agreement.
IN WITNESS WHEREOF the parties hereto have executed this Agreement upon the date first
above written.
ASSIGNEE:
City o Newport Beach
By
Grac . Leung, ity Manage
By 4✓
Aaron C. Harp, City Attorney g l4 t l 3 Dv
Date: ;5�z ?/;?- d 2 3
A TTEST.• &
Date: .
By"JI'l- JZIA-.,.A
Leilani 1. Brown, City Clerk
CAL OES:
Nancy Ward
Director,
Governor's Office of Emergency Services
By.
Brian S. Marshall, State Fire and R scue
Chief
7 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of Califomia
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
EXHIBIT "A"
EQUIPMENT INVENTORY: TYPE I, 2022 / NEWER
ACCOUNTABLE PROPERTY & EQUIPMW I MSSUEDI #RCVD I #SHORT
ACCOUNTABLE PROPERTY & EQUIPMENT
#ISSUED
#RCVD
#SHORT
ACCOUNTABLE PROPERTY & EQUIPMENT
# ISSUED
#RCVD
#SHORT
Apparatus Cab
43. Couple, 2 W Double Male
2
95. Chemical Light Kit (see fact into sheet)
2
1. Radio, Mobile APX
Serial #
OES #
1
44. Crank, Hose Reel
1
96. Hacksaw
2
45. Clamp, Wildland Hose
2
97. Hacksaw, Crosscut, 26'
2
46. Increaser,)" NPSH F x 1 X" NH M
1
98. Hammer, 24oz. Framing
3
47. Gated Wye, (1) 2 X" NH F x (2)1 %' NH M
2
99. Hammer, 3-41b. Sledge, Short
2
2. Radio, Mobile BK-KNG-M-150
Serial #
OES #
1
48. Mallet, Rubber
1
100. Knife, Utility
1
49. Nozzle, i" NPSH Comb Wildland
4
101. Level, 6" Torpedo
3
50. Nozzle, ) %" Comb Structural
1
102. Marking Kit, building (see 'Tool info sheer)
1
51, Nozzle, I %" NH Combo Wildland
2
103. Nails @ 251b. ea., 8d
1
3. Radio, Handheld BK-P-150 w/Mic, 4 - Clamshell
Serial #
DES #
Serial #
DES #
Serial #
DES #
Serial #
DES #
4
52. Nozzle,1 %" NH x 71e straight nP w/Pistd lt
1
104. Nails @ 251b. ea.,16d
1
53. Nozzle,1 %" Foam, Air Aspirating (MAD DOG)
1
105. Square, Tri or Speed
3
54. Nozzle, 2 X" Shutoff w/Fog tip
1
106. Square, Framing, 24"
1
55. Nozzle, 2 %" Shutoff w/3tips
1
107. Tape Measure, n
3
56. Reducer,1 %" NH F x 1" NPSH M
1
108, Tape, Barrier
2
ST Reducer, 2 X" F x i %" M
1
109. Tape, Duct
2
58. Reducer, 6" NH F x 4' NH M
1
110. Tool Kit (See "Tool Info Sheet")
1
59. Reducer, 4" NH F x 2 X" NH M
1
111. Hurst Battery Powered Spreader
Serial #
DES #
1
60. Siamese, (2) 2 %" NH F x (1) 2 %" NH M
1
4. BOX light's (4) (Whelen poneer life seder) LF35)
4
61. Strap, Hose & Ladder
4
5. Intercom Headset's
4
62.Tee, Wildland Hose 1WNHFx1&'NHMxVNPSH
3
112, Hurst Battery Powered Cutter
Serial #
DES #
1
6. First Aid Kit (DOT)
1
63. Thermo, Foam Pick -Up Tube
1
7. Logbook, W/Credit Card
1
64. Wrench, Wildland Spanner (1• to 2 Y Faesoy(
2
8. Spotlight
1
65. Wrench, Suction Hose Spanner
1
113. Hurst Battery Powered RAM
Serial #
DES #
1
Compartment Cross-Thru W/Slide Tool Tray
66. San Francisco Hydrant Adapter (r F x 2 V 0
1
9. Axe, Pick Head
Driver's Side, Rear Compartment
10. Axe, Flat Head
67. Carabiner, Locking "D",11 mm
27
114. Hurst Batteries for Extric Tools
6
11. Bar, Pinch Point, 6("
El
68. Edge Protection
1
Passenger Side, Rear Compartment
12. Chain, 25' Tow W/Grab Hods
69. Rescue edge pad
1
115. Backboard Head Immobilizer
13. Clamp, Herbert Hose
70. Emergency Signaling Device, Whistle
1
116. Blanket, Disposable
14. Cutter, Bolt, 30
71. Frication Device
1
117. Can, Fuel
1
15. Extinguisher, 5# A: B:C
1
72. Fig. 8 & Breaker Bar
lea.
118. Haul Bag
2
16, Hammer, 3.41b. Sledge, Short
2' '
73. Hamess, Body, NFPA
2
119. Hose,1 %" x 10', Hard Suction
1
17. Hammer, 8-101b. Sledge, %at
2
74. Litter Pre -Rig
1
120. Litter Cover Co nor in ere)
18 HalliganTool
1
75. Load Release
2
121. Portable Pump
Serial #
DES #
1
19. Hose, 4" x 16 Soft Suction
1
76. Multi -paint Collection Plate
2
20. lack, 8-ton Hydraulic w/Handle
2
77. Prusik loop
6pr
21. McLeod/Thau Claw
2
78. Pulley, Rescue, Prusik Minding
3
122. Rope, X" X 150', Utility in bag
2
22. Picket, Steel, )" x 4'
6
79. Rope, Logbook
2
123. Strainer, Self -Leveling Floating 1 %"
1
23. Pulaski
1
80. Rope, Kernmantle, %" x W
2
124. Strainer, Suction,1 %"
1
24. Triangle Reflector Set
1
81. Webbing Kit (see &Tool info sW
1
25. Shovel, Round Point, Long Handle
1
Driver's Side, Rear Compartment
Passenger Side, Compartment Above Rear Tires
26. Shovel, Square Point, Long Handle
1
82. Can, Fuel (forgenerator)
1
125. Chainsaw Kit (see fool info wee)
1
27. Strainer, 6" Suction
1
83. Generator
Serial#
DES#
1
126. Chainsaw CHAPS 36"
1
28. Wrench, Hose Spanner (1 %" to 2 W)
4
127. Chainsaw w/24" Bar
Serial#
DES#
1
29. Wrench, Adjustable Hydrant
2
30. Shovel, Scoopw/(D)Handle
1
84. Hose Roller
1
Engineer's Compartment
Rear Compartment Upper Top Left Side
128. 1 Gallon Dain 01
1
31. Adapter, 6" x 2 %", DF, Hydrant
1
85. Hose, Hard Suction, 6' x 111 1 2
Passenger Side, Compartment Ahead Rear Tires
32. Adapter, 6" x V, DF, Hydrant
1
Rear Compartment, Upper
129. Fire Extinguisher (Class A Ware)
1
33. Adapter, 6" x 4 X", DF, Hydrant
1
86. Ladder,10' Attic
1
130, Collapsible, Traffic Canes
5
34. Adapter, 4 %" NH F (Rocker Lug)x 4" NH
1
87, Ladder, 14' Roof
1
131. Light flashing Cones (Amber)
5
35, Adapter, 4" NH F (Rotkeaq)x 4" NH DF w/swivel
1
88. Ladder, 24' Extension
1
132. Mount, Ground Deluge
1
36. Adapter, DM, V NH M x 4" NH M
1
89. Pike Pole, 6
1
133. Salvage Covers, Canvas
2
8 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
37. 4"NH(l ydwCapw/able)
1
90. Pike Pole, 8
1
Note any equipment damage below:
38. 4" NH F (Rocker Lug Cap w/ No Chain)
1
91. Interface Hose Bars
2
39. Adapter,)" NPSH F x 1" NH M
1
Rear Compartment, Lower
40. Adapter,)" NH F x 1" NPSH M
1
92. Belt, Carpenter3,.,
41. Air Hose w/nozzle
1
93. Blade, Hacksaw, Carbide
12
NOTE: CELL SHADING INDICATES US&R;INVENTOA
"Tool Info Sheet" can be found in 0ES Yellow Binder
42. Couple, 2 %" Double Female
2
94. Chisel, l"x77/8'
2
ACCOUNTABLE PROPERTY &EQUIPMENT MSSUEDI #RCVD I #SHORT
ACCOUNTABLE PROPERTY &EQUIPMENT 14ISSUEDI #RCVD #SHORT
ACCOUNTABLE PROPERTY & EQUIPMENT I #ISSUED I#RCVDI SHORT
Hosebed & Reel Line Area
Recap all Cal OES Owned Special Equipment Carried
Note any equipment damage below:
134. Cribbing & Wedge Kit (see *Tool into
135. Hose,1" NPSH x 100' Wildland
8
136. Hose,1 W NH x 10Y Wildland
10
137. Hose, i %" x 50' Structural
12
138. Hose, 3" NH x 50' Structural
12
139, Hose, 4x 100' Structural
SO
140. Hose, Booster,)' x 100'
2
141, Litter, Stokes Basket
1
142. Backboard
1
143. Stream Straightener
1
144, Nozzles, Deluge (1 Lx —Lx -z1
1
145. Nozzle, Deluge, Combo, 500-1250GPM
1
Apparatus Exterior
146. Cap, 2 %" Discharge
4
147. Cap, 4" Discharge
1
148. Chock Block
2
149. Hose, 3' x 12' Soft x Suction
2
150. Plug, 2 W' Suction
2
151 Intake Ball Valve 6" NH F x 6" NH M
2
Front Bumper
152. Hose,1 %" x 35' Truck Protection
1
153. Nozzle,) %", Combo (widland)
1
Note any equipment damage below:
9 01/2023
Agreement for Temporary Assignment of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
"Tool Info Sheet" can be found in OES Yellow Binder
A-1 4/2012
Agreement for Temporary Transfer of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
EXHIBIT "B"
TEMPORARY CAL OES APPARATUS ASSIGNMENT RECORD
NO.
ARTICLE
CAL OES
DECAL
QUANTITY
1.
1,500 gpm Triple Combination Fire Engine, complete
with equipment per attached Exhibit "A" of Agreement for
Temporary Transfer of Vehicular Equipment.
Cal OES
1
2.
License No: 1656487
3.
VIN No: 44KFT428ONWZ23721
4.
Engine No: 1105
5.
Proof of Insurance:
6.
Inventory Completed:
7.
8.
9.
10.
11.
REASON FOR TEMPORARY TRANSFER: New Assignee
SIGNATURES:
Date
PERMANENT ASSIGNEE
Date
TEMPORARY ASSIGNEE
B-1 4/2012
Agreement for Temporary Transfer of Vehicular Equipment
State of California
GOVERNOR'S OFFICE OF EMERGENCY SERVICES
Fire and Rescue Division
EXHIBIT "C"
INSURANCE REQUIREMENTS
Part of the Agreement through which the State makes a temporary transfer of vehicular equipment is the
Agreement on the part of the ASSIGNEE to furnish certain evidence of insurance. Your organization, as
an ASSIGNEE of equipment, will want to be mindful of these requirements and assure they are complied
with. If self -insured, in lieu of a certificate of insurance, a written statement of self-insurance shall be
furnished on official letterhead and agreeing to hold Cal OES harmless from any personal injury or
property damage claims arising out of the maintenance, use or operation of the Apparatus.
Liability Insurance
A certificate of insurance shall be furnished to the State providing minimum limits of insurance as
follows:
BODILY INJURY and PROPERTY DAMAGE LIABILITY $1,000,000.00 PER OCCURENCE
A certificate of insurance will have the following provisions included:
1. The State of California shall be named Additional Insured.
2. The insurance company shall agree that in the event of cancellation, 15 days prior written
notice will be given to the State.
3. The State shall not be responsible for premium or assessments.
4. Certificate of Insurance must include the description of the Apparatus including identification
number, State license number and Cal OES unit number.
Physical Damage Insurance
The transfer agreements place certain responsibilities upon your organization for the safekeeping of the
vehicle and equipment. The State will look to your organization for reimbursement for repair or
replacement cost in the event the vehicle or equipment is damaged by misuse or negligence or by other
causes, except normal wear and tear, acts of God and conditions over which your organization has no
control.
VEHICLE
2022 ID4E Type 1 Engine
License Number:
VIN Number:
Engine Number:
EQUIPMENT
Hose and Appliances
Description of Apparatus
1656487
44KFT428ONWZ23721
1105
VALUE
$437,851.50
$101,511.71
C-1 4/2012
Agreement for Temporary Transfer of Vehicular Equipment