20-007 David Wellhouse & Associates, Inc., State Mandated Cost Reimbursement Claims (Copy of February 2021) ODavid Wellhouse
...and Associates,Inc.
February 19, 2021
Ms. Kristen Squarcia
City Clerk
City of Cupertino
10300 Torre Avenue
Cupertino, California 95014
RE: COPIES OF FEBRUARY 2021 STATE MANDATED COST REIMBURSEMENT CLAIMS
Dear Ms. Squarcia:
Enclosed are the copies of the February 2021 state mandated cost reimbursement claims prepared on behalf
of the City of Cupertino by David Wellhouse&Associates, Inc..
I would like to especially thank you and the City staff for the support, experience, and professionalism
extended to me throughout this process. In this field,the optimization of the state mandated cost
reimbursement process is directly influenced by a good working relationship and the support extended by
City staff.
Thank you again for selecting David Wellhouse &Associates to fulfill your state mandated cost claiming
needs. As always, I have very much enjoyed working with you and hope to assist the City of Cupertino
for many years to come.
In the next few days, you should receive an invoice for our services for the preparation and filing of the
February 2021 state mandated cost reimbursement claims. Should you have any questions,please contact
me at(916) 797-4883.
Sincerely,
*enee M. Wellhouse
Enclosures
3609 Bradshaw Road, Suite H-382• Sacramento,California 95827
(916)797-4883 • FAX (916) 797-4887
David Welffiouse
...and Associates,Inc.
STATE MANDATED COST CLAIMS RECEIPT
FEBRUARY 2021 STATE MANDATED COST CLAIMS
AGENCY: CITY OF CUPERTINO
DATE: FEBRUARY 15, 2021
The State Controller's Office, Division of Accounting, Local Reimbursement Bureau hereby
acknowledges receipt of the following State Mandated Cost Claims (SB 90) prepared and
submitted on behalf of the above-noted agency by David Wellhouse &Associates, Inc.
CHAPTER CLAIM PERIOD AMOUNT
Chapter 256,Statutes of 1995 FY.2015/2016 $6,317
Domestic Violence Arrest Standards Amended
Chapter 698&702,Statutes of 1998 FY.2019/2020 $4,387
Domestic Violence Arrest&Victim Assistance
Chapter 1460,Statutes of 1989 FY.2019/2020 $2,248
Administrative License Suspension
Chapter 465,Statutes of 1976 FY.2019/2020 $1,710
Peace Officers Procedural Bill of Rights
Chapter 630,Statutes of 1978 FY.2019/2020
Peace Officer's Personnel Records
Chapter 999,Statutes of 1991 FY.2019/2020
Rape Victim Counseling Center Notices
Chapter 483,Statutes of 2001 FY.2019/2020
Crime Victims Domestic Violence Incident Reports II
Chapter 1120,Statutes of 1996 FY.2019/2020
Health Benefits for Survivors of Police&Fire
Chapter 721,Statutes of 2015
U Visa 918 Form,Victims of Crime: FY.2019/2020
Nonimmigrant Status
State of California
State Controller's Office Mandated Cost Manual for Local Agencies
DOMESTIC VIOLENCE ARREST For State Controller Use Only
POLICIES AND STANDARDS (19) Program Number00167 Program
CLAIM FOR PAYMENT FORM (20) Date Filed
(01)Claimant Identification Number 9843 (21) LRS Input 167
Reimbursement Claim ®eta
(02) Claimant Name City of Cupertino (22) FORM 1, (04) (a)
County of Location Santa Clara (23) FORM 1, (04) (b) 60
Street Address or P.O. Sox and Suite 10300 Torre Avenue (24) FORM 1, (06) 219-33
City, State, and Zip Code Cupertino,CA 95014
(03) Type of Claim (2b) FORM 1, (07)A. (g)
(04) (09) Reimbursement (26) FORM 1, (07) I3. (g)
(05) (10) Combined � (27) FORM 1, (07) C. (g)
(06) (11)Amended (28) FORM 1, (09)
(07) (12) Fiscal Year of Cost (29) FORM 1, (10)
20'19/2020 (30) FORM 1, (12)
(08) (13) Total Claimed Amount 6 317 (31) FORM 1, (13)
04) Less: 10% Late Penalty (32)
(15) Less: Prior Claim Payment Received (33)
(16) Net Claimed Amount 6 317 (34)
(17) Due from State 6 317 (35)
(18) Due to State (36)
(37) CERTIFICATION OF CLAIM
In accordance with the provisions of Government Code sections 17560 and 17561, 1 certify that I am the officer
authorized by the local agency to file mandated cost claims with the State of California for this program, and certify
under penalty of perjury that I have not violated any of the provisions of Article 4, Chapter 1 of Division 4 of Title 1 of
the Government Code.
I further certify that there was no application other than from the claimant, nor any grant(s) or Payment(s)
received for reimbursement of costs claimed herein and claimed costs are for a new program or increased level of
services of an existing program.All offsetting revenues and reimbursements set forth in the parameters and
guidelines are identified,and all costs claimed are supported by source documentation currently maintained by the
claimant.
The amount for this reimbursement is hereby claimed from the State for payment of actual costs set forth on the
attached statements.
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature of Authorized Officer Date Signed
h
Telepone Number
(408) 777-3225
Type or Print Name and Title of Authorized Signatory Email Address _
kirstensiSs:upertino ora
Kirsten Squarcia, City Claris
(38)Name of Agency Contact Person for Claim Telephone Number
Email Address
Name of Consulting Firm/Claim Preparer Telephone Number
®avid Wellhoaase&Associates, Inc (916)797�4883
Email Address dwanreneeC�surewest.net
Kevised 9/2020
DOMESPIC VIOLENCE
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EXHIBIT A
PROPOSED COSTS
FISCAL YEAR 2019-2020
LOS ALTOS UNINCORP.
RATES CUPERTINO HILLS SARATOGA CITIES
GENERAL LAW ENFORCEMENT
Proposed Hours-Activity
Proposed Hours-Patrol
Total Hours 41,881.0 5,421.0 20,060.0
14,696.0
Capped Rates/Costs FY 2019-2020 @ $219.33 , $9,185,760 $1,188,988 $4,399,760
$3,223,274
TRAFFIC ENFORCEMENT-DAYS:
Proposed Hours 9,015.0 1,859.5 4,195.4
0.0
Capped Rates/Costs FY 2019-2020 @ $214.82 $9,237 $901,245 $0
Motor @ $213.72
$1,926,686 $388,222
TRAFFIC ENFORCEMENT-NIGHTS:
Proposed Hours 0.0 0.0
0.0 0.0
Capped Rates/Costs FY 2019-2020 @ $221.67 $0 $0
Motor @ $220.57 $p $0
INVESTIGATIVE HOURS:
Proposed Hours 7,200.0 600.0 2,400.0
0.0
Capped Rates/Costs FY 2019-2020 @ $216.65 $1,559,880 $129,990 $519,960 $p
FY20 Contract Cities Proposed Costs 3-21-2019 A-36
DSA=3%
State of California
State Controller's Office Mandated Cost Manual for Local agencies
DOMESTIC VIOLENCE ARRESTS AND VICTIM For State Controller use Only
ASSISTANCE CLAIM FOR PAYMENT FORM (19) Program Number 00274 Program
(20) Date Filed 274
21) LRS Input
(01)Claimant Identification Number 9843239 Reimbursement Claim Data
(02)Claimant Name City of Cupertino (22) IFORM 1,(04)A. 1.(f)
County of Location Santa Clara) (23) FORM 1,(04)A.2.(f)
Street Address or P.O. Box and Suite 10300 Torre Avenue (24) FORM 1,(04)A.3.(f)
City,State, and Zip Code Cupertino,CA 95014 (25) FORM 1,(04)B. 1 (fj
4.387
(03) Type of Claim (26) FORM 1,(06)
(04) (09)Reimbursement o (27) FORM 1,(07)
(05) (10)Combined (28) FORM 1,(09)
(06) (11)Amended (29) FORM 1,(10)
(07) (12)Fiscal Year of Cost 201912020 (30)
(08) (13)Total Claimed Amount 4 387 (31)
(14)Less: 10%Late Penalty (32)
(15) Less:Prior Claim Payment Received (33)
(16)Net Claimed Amount 4 387 (34)
(17)Due from State 4 387 (35)
(18)Due to State (36)
(37)CERTIFICATION OF CLAIM
In accordance with the provisions of Government Code sections 17560 and 17561, 1 certify that I am the officer
authorized by the local agency to file mandated cost claims with the State of California for this program,and certify
under penalty of perjury that I have not violated any of the provisions of Article 4,Chapter 1 of Division 4 of Title 1
of the Government Code.
I further certify that there was no application other than from the claimant, nor any grant(s) or payment(s)
received for reimbursement of costs claimed herein and claimed costs are for a new program or increased level of
services of an existing program.All offsetting revenues and reimbursements set forth in the parameters and
guidelines are identified,and all costs claimed are supported by source documentation currently maintained by the
claimant.
The amount for this reimbursement is hereby claimed from the State for payment of actual costs set forth on the
attached statements.
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature of Authorized Officer Date Signed
Telephon®Number (408)777-3225
Type or Print Name and Title of Authorized Signatory Email Address ldrstens aC�cur�ertino or
Kirsten Sguarcia,City Clerk
(38)Name of Agency Contact Person for Claim Telephone Number
Email Address
Name of Consulting Firm/Claim Preparer Telephone Number (916)797-4883
David Wellhouse&Associates,Inc Email Address dwa-reneegsureweat._net
Revised 9/2020
State of California
State Controller's Office Mandated Cost Manual for Local Agencies
PROGRAM
F®��
274 DOMESTIC VIOLENCE ARRESTS AND VICTIM ASSISTANCE
CLAIM SUMMARY
(01) Claimant (02)
Fiscal Year
City of Cupertino 2019/2020
(03) Department
Direct Costs Object Accounts
(a) (b) (°) (d) (a) (fl
Salaries Benefits Materials Contract Fixed Total
(04) Reimbursable Activities and Services Assets
Supplies
A. One-Time Activity
1. Print Victim Cards
2.Add Two New Crimes to Response Policy
3.Add Information to Response Policy
B. Ongoing Activities
1. Provide Cards to Victims $4,387 $0
$4,387
(05) Total Direct Costs $4,387 $0
$4,387
Indirect Costs
(06) Indirect Cost Rate
[From ICRP or 10%]
(07) Total Indirect Costs [Refer to Claim Summary Instructions]
(08) Total Direct and Indirect Costs [Line(05)(fl+line(07)j
$4,387
Cost Reduction
(09) Less: Offsetting Revenues
0
(10) Less: Other Reimbursements
0
(11) Total Claimed Amount [Line(08)-(line(09)+line(10))j
$4,387
Revised 9/2020
State of California
State Controller's Office Mandated Cost Manual for Local Agencies
PROjAM DOMESTIC VIOLENCE ARRESTS AND VICTIM ASSISTANCE ®R�
2 ACTIVITY COST DETAIL
2
(01) Claimant (02) Fiscal Year
City of Cupertino 2019/2020
(03) Reimbursable Activities: Check only one box per form to identify the activity being claimed.
A. One-Time Activities B. Ongoing Activity
❑ 1. Print Victim Cards 1. Provide Cards to Victims
❑ 2. Add Two New Crimes to Response Policy
❑ 3.Add Information to Response Policy
(04) Description of Expenses Object Accounts
(a) (b) (c) (d) (e) (f) (g) (h)
Employee Names,Job Hourly Rate Hours Salaries Benefits Materials Contract Fixed Assets
Classifications,Functions Performed or Unit Cost Worked or And Services
and Descri tion of Expenses Quantity
Su lies
Police Officer/Sergeant $219.33 20 $4,387
Time spent providing victim cards
to victims, explaining what the
card is and how the victim can
use the card, addressing all
questions about the card and
shelters and providing an
interpreter, if necessary.
Police Officer/Sergeant spent 20
minutes per case. There were 60
cases during the fiscal year.
(05)Total Subtotal Page:_ of $4,387 $0
Revised 9/2020
EXHIBIT A
PROPOSED COSTS
FISCAL YEAR 2019-2020
LOS ALTOS UNINCORP.
RATES CUPERTINO HILLS SARATOGA CITIES
GENERAL LAW ENFORCEMENT
Proposed Hours-Activity
Proposed Hours-Patrol
Total Hours 41,881.0 5,421.0 20,060.0 14,696.0
Capped Rates/Costs FY 2019-2020 @(�$219.33 $9,185,760 $1,188,988 $4,399,760
$3,223,274
TRAFFIC ENFORCEMENT-DAYS:
Proposed Hours 9,015.0 1,859.5 4,195.4
0.0
Capped Rates/Costs FY 2019-2020 @ $214,82 $9,237 $901,245 $0
Motor @ $213.72 $1,926,686
$388,222
TRAFFIC ENFORCEMENT-NIGHTS:
Proposed Hours 0.0 0.0 0.0 0.0
Capped Rates/Costs FY 2019-2020 @ $221.67 $0 $0 $0
Motor @ $220.57 $0
INVESTIGATIVE HOURS:
Proposed Hours 7,200.0 600.0 2,400.0 0.0
Capped Rates/Costs FY 2019-2020 @ $216.65 $1,559,880 $129,990 $5191960 $0
FY20 Contract Cities.-Proposed Costs 3-21-2019 A-36
DSA=3
3
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State of California
State Controller's Office Mandated Cost Manual for Local Agencies
ADMINISTRATIVE LICENSE For State Controller Use Only
SUSPENSION — PER SE (19) Program Number 00246 Program
CLAIM FOR PAYMENT FORM (20) Date Filed 246
(21) LRS Input
(01) Claimant Identification Number 9843231 Reimbursement Claim Data
(02) Claimant Name City of Cupertino (22) FORM 1, (04)A. 1. (h)
County of Location Santa Clara (23) FORM 1, (04)A. 2. (h)
Street Address or P.O. Sox and Suite 10300 Torre Avenue (24) FORM 1, (04) S. 1. (h) 2 24
City, State, and Zip Code Cupertino, CA 95014 (25) FORM 1, (06)
(03) Type of Claim (26) IFORIM 1, (07)
(04) (09) Reimbursement o (27) FORM 1, (09)
(05) (10) Combined (28) FORM 1, (10)
(06) (11)Amended (29)
(07) (12) Fiscal Year of Cost 201912020 (30)
(08) (13)Total Claimed Amount $2,248 (31)
(14) Less: 10% Late Penalty (32)
(15) Less: Prior Claim Payment Received (33)
(16) Net Claimed Amount 12,248 (34)
(17) Due from State $2,248 (35)
(18) Due to State (36)
(37) CERTIFICATION OF CLAIM
In accordance with the provisions of Government Code sections 17560 and 17561, 1 certify that I am the officer
authorized by the local agency to file mandated cost claims with the State of California for this program, and certify
under penalty of perjury that I have not violated any of the provisions of Article 4, Chapter 1 of Division 4 of Title 1 of
the Government Code.
I further certify that there was no application other than from the claimant, nor any grant(s) or payment(s)
received for reimbursement of costs claimed herein and claimed costs are for a new program or increased level of
services of an existing program.All offsetting revenues and reimbursements set forth in the parameters and
guidelines are identified, and all costs claimed are supported by source documentation currently maintained by the
claimant.
The amount for this reimbursement is hereby claimed from the State for payment of actual costs set forth on the
attached statements.
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature of Authorized Officer Date Signed
Telephone Number (408)777-3225
Type or Print Name and Title of Authorized Signatory Email Address kirstens@cuoertino.ore
Kirsten Scquarcia,City Glens
(38)Name of Agency Contact Person for Claim Telephone Number
Email Address
Name of Consulting Firm/Claim Preparer Telephone Number (916)797-4883
David Welihouse&Associates, Inc Email Address dwa-renee&.sur@�g t.ne
Revised 9/2020
State of California
State Controller's Office Mandated Cost Manual for Local Agencies
PROGRAM Administrative License Suspension- Per Se F01 M
246 CLAIM SUMMARY
(01) Claimant: (02) Fiscal Year
City of Cupertino 2019/2020
(03) Department
Direct Costs Object Accounts
(a) (b) (c) (d) (e) (fl (g) (h)
Number Uniform Salary Subtotal Total
Benefit Subtotal Materials&
(04) Reimbursable Activities of Time Hourly Rate Salaries Benefits Supplies (e)+ (fl+
Cases Allowance Rate (d)times (9)
(hours) (a)times(b) (e)
times c
A. Minors Detained But Not Arrested
1.Admonish Drivers/Screen Tests on
Minors(IV.A.1. &2.) 0.2667 0
2. Seize Licenses&Serve Notices/Completing
Sworn Reports/Submit Reports to DMV(IV.A.
3.to A.5.) 0.2500 1 J 1 1 $0
B.Arrested Drivers for Violation of DUI Statute
1. Seize Licenses&Serving Notices/
Completing Sworn Reports/Submitting Reports
to DMV(IV. B.1.to B. 3.)
41 0.2500 $219.33 $2,248 1 $2,248
(05)Total Direct Costs $2,248 $2,248
Indirect Costs
(06) Indirect Cost Rate [From ICRP or 10%]
(07)Total Indirect Costs [Line(06)times line (05)(e)]
$2,248
(08)Total Direct and Indirect Costs [Line(05)(h)+line(07)]
Cost Reduction
$0
(09) Less: Offsetting Revenues
$0
(10) Less: Other Reimbursements
$2,248
(11) Total Claimed Amount [Line(08)-{line(09)+line(10)}]
Revised 912020
EXHIBIT A
PROPOSE®COSTS
FISCAL YEAR 2019-2020
LOS ALTOS UNINCORP.
RATES CUPERTINO HILLS SARATOGA CITIES
GENERAL LAW ENFORCEMENT
Proposed Hours-Activity
Proposed Hours-Patrol
Total Hours 41,881.0 5,421.0 20,060.0 14,696.0
Capped Rates/Costs FY 2019-2020 @ $219.3 $9,185,760 $1,188,988 $4,399,760 $3,223,274
TRAFFIC ENFORCEMENT-DAYS:
Proposed Hours 9,015.0 1,859.5 4,195.4 0.0
Capped Rates/Costs FY 2019-2020 @ $214.82 $9,237 $901,245 $0
Motor @ $213.72 $1,926,686 $388,222
TRAFFIC ENFORCEMENT-NIGHTS:
Proposed Hours 0.0 0.0 0.0 0.0
Capped Rates/Costs FY 2019-2020 @ $221.67 $0 $0 $0
Motor @ $220.57 $0
INVESTIGATIVE HOURS:
Proposed Hours 7,200.0 600.0 2,400.0 0.0
Capped Rates/Costs FY 2019-2020 @ $216.65 $1,559,880 $129,990 $519,960 $0
FY20 Contract Cities_Proposed Costs 3-21-2019 A-36 DSA=3%
DUE
Case Date/rime Charges
19-197-0021C 7/16/2019 CVC 23152(b)
19-204-0511C 7/23/2019 VC 23152(a)/(b)
19-237-0061C 8/25/2019 VC 23152(a)
19-243-0316C 8/31/2019 CVC 23152(a)
19-249-0025C 9/6/2019 VC 23152(a)/(b)
19-251-OD15C 9/8/2019 VC 23152(f),H&S 11364(a),H8S 11375(b)(2)
19-252-0449C 9/9/2019 CVC 23152(a)(b)-23550.5(a)
19-259-0398C 9/16/2019 CVC 23152(a)-DUI,CVC 20002(a)
19-260-0026C 9/17/2019 CVC 23152(b)
19-267-0019C 9/24/2019 CVC 23152(a)(b),CVC 14601.2(a)
19-276-0500C 10/3/2019 CVC 23152(a)/(b)
19-279-0014C 10/6/2019 VC 23152(f),HS 11377(a),HS 11364(a)
19-279-0089C 10/6/2019 VC 23152(a),VC 23152(b)
19-285-0408C 10/12/2019 CVC 23152(b)
19-285-0449C 10/12/2019 VC 20001/VC 23153(f)/PC148.9/HS 11359(b)
19-292-0235C 10/19/2019 CVC 23152(f)
19-293-OO15C 10/20/2019 CVC 23152(g),HS 11362.3(a)(4)
19-293-0288C 10/20/2019 CVC 23152(a)
19-295-0369C 10/22/2019 CVC 23152(a),CVC 23152(b)
19-309-0004C 11/5/2019 CVC 23152(b),CVC 20002(a),PC 148.3(a)
19-309-0446C 11/5/2019 23152(a)/(b)&23550.5 VC;14601.2(a)VC;1203.2(a)PC
19-309-0509C 11/5/2019 VC 23152(a)/(b)
19-314-0032C 11/10/2019 CVC 23152(a)
19-320-0002C 11/16/2019 VC 23152(a)/(b)
19-321-0006C 11/17/2019 CVC 23152(a)
19-325-0445C 11/21/2019 VC 23152(b)
19-327-0357C 11/23/2019 VC 23152(a)
20-006-0357C 1/6/2020 CVC 23152(a)
20-019-OOIOC 1/19/2020 VC 23152(a)/(b)
20-027-0308C 1/27/2020 CVC 23152(a),CVC 23152(b),HS 11362.3(a)(4)
20-031-0004C 1/31/2020 CVC 23152(a),CVC 23152(b)
20-038-0004C 2/7/2020 VC 23152(a);VC 23152(b)
20-052-0009C 2/21/2020 VC 23152(a),VC 23152(b)
20-058-0013C 2/27/2020 CVC 23152(a),CVC 23152(b)
20-064-0532C 3/5/2020 VC 23152(a),VC 23152(b)and VC 20002
20-097-0304C 4/6/2020 CVC 23152(f),HS 11362.3(a)(4)
20-107-0309C 4/17/2020 CVC 23152(a),23152(b),23152(g)PC 148(a)(1) _
20-130-0146C 5/9/2020 VC 23152(a)/(b),VC 14601.2,HS 120295(a),PC 466
20-136-0410C 5/15/2020 CVC 23152(b)&CVC 20002(a)
20-141-0331C 5/20/2020 VC 23152(a),VC 23152(b)
20-154-0388C 6/2/2020 CVC 23 15 2 OWN
State of California
State Controller's Office Mandated Cost Manual for Local Agencies
PEACE OFFICERS For State Controller Use Only
PROCEDURAL BILL OF RIGHTS (19) Program Number 00187 Program
CLAIM FOR PAYMENT FORM (20) Date Filed I F37
(21) LRS Input
(01)Claimant Identification Number 9843231 Reimbursement Claim Data
(02) Claimant Name City of Cupertino (22) FORM 1, (04)
County of Location Santa Clam (23) FORM 1, (05)
Street Address or P.O. Box and Suite 10300 Torre Avenue (24) FORM 1, (06)(A)(g)
City, State, and Zip Code Cupertino,CA 96014 (25) FORM 1, (06)(B)(g)
(03) Type of Claim (26) FORM 1, (06)(C)(g)
(04) (09) Reimbursement o (27) FORM 1, (06)(D)(g)
(05) (10)Combined (28) FORM 1, (08)
(06) (11)Amended (29) FORM 1, (09)
(07) (12) Fiscal Year of Cost 2019/2020 (30) FORM 1, (11)
(08) (13)Total Claimed Amount 1 (31) IFORM 1, (12)
(14) Less: 10% Late Penalty (32)
(15) Less: Prior Claim Payment Received (33)
(16) Net Claimed Amount 1 10 (34)
(17) Due from State 1 71 (35)
(18) Due to State 1 (36)
(37) CERTIFICATION OF CLAIM
In accordance with the provisions of Government Code sections 17560 and 17561, 1 certify that I am the officer
authorized by the local agency to file mandated cost claims with the State of California for this program, and certify
under penalty of perjury that I have not violated any of the provisions of Article 4, Chapter 1 of Division 4 of Title 1
of the Government Code.
I further certify that there was no application other than from the claimant, nor any grant(s) or payment(s)
received for reimbursement of costs claimed herein and claimed costs are for a new program or increased level of
services of an existing program.All offsetting revenues and reimbursements set forth in the parameters and
guidelines are identified, and all costs claimed are supported by source documentation currently maintained by the
claimant.
The amount for this reimbursement is hereby claimed from the State for payment of actual costs set forth on the
attached statements.
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Signature of Authorized Officer Date Signed
— Telephone Number (408)777-3225
Type or Print Name and Title of Authorized Signatory Email Address 4zirstens@cupertino ores
Karsten Squarcia, City Clerk
(38)Name of Agency Contact Person for Claim Telephone Number
Email Address
Name of Consulting Firm/Claim Preparer Telephone Number (916)797-4883
David Wellhouse&Associates,Inc Email Address dwa-renee _surewest net
Revised 912020
State of California
State Controller's Office Mandated Cost Manual for Local Agencies
F187
F®��
PEACE OFFICERS PROCEDURAL BILL OF RIGHTS
CLAIM SUMMARY 1
i
(01) Claimant (2)
Fiscal Year
City of Cupertino 2019/2020
(03) Department
Claim Statistics
(04) Number of full-time sworn peace officers employed by the agency during this fiscal year 34
Flat Rate Method
(05)Total Cost [Line(04)times unit cost rate][Skip lines(06)through(09)and carry forward total to line(10)] $1710
Actual Cost Method
Direct Costs Object Accounts
(a) (b) t
(d) (e) (fl (g)
Salaries Benefits M Contract Fixed Travel Total
(06) Reimbursable Activities Services Assets And
S Training
A. Administrative Activities
B. Administrative Appeal
C. Interrogations
D. Adverse Comment
(07)Total Direct Costs
Indirect Costs
(08) Indirect Cost Rate [From ICRP or 10%]
(09)Total Indirect Costs [Refer to Claim Summary Instructions]
(10)Total Direct and Indirect Costs [Refer to Claim Summary Instructions]
$1,710
Cost Reduction
(11) Less: Offsetting Revenues
(12) Less: Other Reimbursements
(13)Total Claimed Amount [Line(10)minus{line(11)+line(12))]
$1,710
Revised 9/2020