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HomeMy WebLinkAboutBID - 9859 MAGNESIUM HYDROXIDEcity of � • ort o � ns Purchasing Financial Services Purchasing Division 215 N. Mason St. 2"tl Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 fcgov. com/purchasing INVITATION TO BID 9859 MAGNESIUM HYDROXIDE BIDS DUE: OCTOBER 11, 2023 3:00 PM MT (our clock) The City of Fort Collins is requesting bids from qualified Vendors to supply Magnesium Hydroxide to the Drake Water Reclamation Facility (DWRF) in accordance with the specifications with this document. Rocky Mountain E-Purchasing System hosted by BidNet: As part of the City's commitment to Sustainable Purchasing, electronic bid submission is required. Bids shall be submitted online through the Rocky Mountain E-Purchasing System (RMEPS) at http://www.bidnetdirect.com/colorado/city-of-fort-collins. Please note: submitting bids through RMEPS may need additional time for completion. Bids not submitted by the designated Opening Date and Time will not be accepted by the system. The City encourages all disadvantaged business enterprises to submit bid in response to all invitations to bid. No individual or business will be discriminated against on the grounds of race, color, sex, or national origin. It is the City's policy to create a level playing field on which DBEs can compete fairly and to ensure nondiscrimination in the award and administration of all contracts. A copy of the Bid may be obtained at http://www.bidnetdirect.com/colorado/citv-of-fort-collins. Questions should be submitted at any time, in writing via email, to JD McCune, Buyer II at Imccune(c�fcqov.com. Final questions shall be submitted no later than 3:00 p.m. MT (our clock) on ,September 29, 2023. Please format your email to include: 9859 Magnesium Hydroxide in the subject line. Questions after this deadline may not be answered. Responses to all questions submitted before the deadline will be addressed in an addendum and posted on the Rocky Mountain E-Purchasing System webpage. Prohibition of Unlawful Discrimination: The City of Fort Collins, in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (78 Stat. 252, 42 US.C. §§ 2000d to 2000d- 4) and the Regulations, hereby notifies all bidders that it will affirmatively ensure that any contract entered into pursuant to this advertisement, disadvantaged business enterprises will be afforded full and fair opportunity to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, or national origin in consideration for an award. The City strictly prohibits unlawful discrimination based on an individual's gender (regardless of gender identity or gender expression), race, color, religion, creed, national origin, ancestry, age 40 years or older, marital status, disability, sexual orientation, genetic information, or other characteristics protected by law. For the purpose of this policy "sexual orientation" means a person's actual or perceived orientation toward heterosexuality, homosexuality, and bisexuality. The City also strictly prohibits unlawful harassment in the workplace, including sexual harassment. Further, the City strictly prohibits unlawful retaliation against a person who engages in protected activity. Protected activity includes an employee complaining that he or she has been ITB 9859 Magnesium Hydroxide Page 1 of 14 discriminated against in violation of the above policy or participating in an employment discrimination proceeding. The City requires its Vendor to comply with the City's policy for equal employment opportunity and to prohibit unlawful discrimination, harassment and retaliation. This requirement applies to all third-party Vendor and their subcontractors/subconsultants at every tier. Colorado Open Records Act: The City is a governmental entity subject to the Colorado Open Records Act, C.R.S. §§ 24-72-200.1 et seq. ("CORA"). Any bid submitted hereunder is subject to public disclosure by the City pursuant to CORA and City ordinances. All submitted bids, Bid Forms, and the awarded contract will be considered public records subject to disclosure under CORA. By responding to this Bid, Vendor hereby waives any and all claims for damages against the City for the City's good faith compliance with CORA. Special I nstructions: All bids must be properly signed by an authorized representative of the company with the legal capacity to bind the company to the agreement. Bids may be withdrawn up to the date and hour set for closing. Once bids have been accepted by the City and closing has occurred, failure to enter into contract or honor the purchase order will be cause for removal of supplier's name from the City of Fort Collins' bidders list for a period of twelve months from the date of the opening. The City may also pursue any remedies available at law or in equity. Bid prices must be held firm for a period of ninety (90) days after bid openings. Submission of a bid is deemed as acceptance of all terms, conditions and specifications contained in the City's specifications initially provided to the Vendor. Any proposed modification must be accepted in writing by the City prior to award of the bid. Only bids properly received by the Purchasing Office will be accepted. All bids should be clearly identified by the bid number and bid name contained in the bid proposal. No bid will be accepted from, or any purchase order awarded, to any person, firm or corporation in default on any obligation to the City. Bids must be furnished exclusive of any federal excise tax, wherever applicable. Vendors must be properly licensed and secure necessary permits wherever applicable. The City may elect where applicable, to award bids on an individual item/group basis or on a total bid basis, whichever is most beneficial to the City. The City reserves the right to accept or reject any and all bids, and to waive any irregularities or informalities. Sales Prohibited/ Conflict of Interest: No officer, employee, or member of City Council, shall have a financial interest in the sale to the City of any real or personal property, equipment, material, supplies or services where such officer or employee exercises directly or indirectly any decision-making authority concerning such sale or any supervisory authority over the services to be rendered. This rule also applies to subcontracts with the City. Soliciting or accepting any gift, gratuity, favor, entertainment, kickback or any items of monetary value from any person who has or is seeking to do business with the City of Fort Collins is prohibited. Freight Terms: Unless otherwise noted, all freight is F.O.B. Destination, Freight Prepaid. All freight charges must be included in prices submitted on proposal. Collusive or Sham Bids: Any bid deemed to be collusive or a sham bid will be rejected and ITB 9859 Magnesium Hydroxide Page 2 of 14 reported to authorities as such. Your authorized signature of this bid assures that such bid is genuine and is not a collusive or sham bid. Utilization of Award by Other Agencies: The City of Fort Collins reserves the right to allow other state and local governmental agencies, political subdivisions, and/or school districts to utilize the resulting award under all terms and conditions specified and upon agreement by all parties. Usage by any other entity shall not have a negative impact on the City of Fort Collins in the current term or in any future terms. Vendor Registration: The City requires a new Vendor receiving awards from the City to submit IRS form W-9 and requires all Vendors to accept Direct Deposit (Electronic) payment. If needed, the W-9 form and the Vendor Direct Deposit Authorization Form can be found on the City's Purchasing website at www.fcqov.com/purchasinq under Vendor Reference Documents. Please do not submit these documents with your proposal, however, if you take exception to participating in Direct Deposit (Electronic) payments please clearly note such in your proposal as an exception. The City may waive the requirement to participate in Direct Deposit (Electronic) payments at its sole discretion. Bid results are posted online at http://www.bidnetdirect.com/colorado/city-of-fort-collins. � , � C'"1 � �_:�� � Gerry Paul Purchasing Director (Remainder of Page Left Intentionally Blank) ITB 9859 Magnesium Hydroxide Page 3 of 14 I. GENERAL INFORMATION 1. Schedule The following represents the City's target schedule for the bid. The City reserves the right to amend the target schedule at any time. • Bid issuance: • Question deadline: • Final Addendum: • Bid Due Date: September 20, 2023 3:00 PM MT on September 29, 2023 October 4, 2023 3:00 MT (our clock) on October 11 , 2023 2. Method of Award The City reserves the right to split the bid award in whatever percentages are most advantageous to the City. This project will be awarded based on price, proposed means and methods for completing services, and Vendor availability to provide the services and materials. Future orders may be authorized, at the option of the City, from this bid for a period of three years after bid closing date. Satisfactory pricing and delivery are required for future orders based on this bid. 3. Aqreement The awarded Vendor will receive a Purchase Order from the City authorizing delivery. Vendor should not begin any work prior to receipt of the Purchase Order. At the option of the City, the Agreement may be extended for up to two (2) additional one (1) year periods. Renewals and pricing changes shall only be negotiated at time of renewal and agreed to by both parties at least thirty (30) days prior to Agreement expiration. Written notice of renewal shall be provided to the Vendor and mailed no later than thirty (30) days prior to the Agreement expiration date. Rates shall be escalated no more than three percent (3%) per year. Overhead, profit, insurance, general & administrative expenses shall be included in the line item pricing stated in the Bid Schedule. 4. Invoices & Payments Invoices should be emailed monthly or after a shipment to invoices@fcgov.com with a copy to the Project Manager. The cost of the item(s) delivered shall be paid to the Vendor each month following the submittal of a correct invoice. Vendor should include Purchase Order Number and a detailed description of item(s) on each invoice submitted. The City pays invoices on Net 30 terms. 5. Fees, Licenses, Permits The successful Vendor shall be responsible for obtaining any necessary licenses, fees or permits without additional expense to the City. All equipment shall be properly licensed and insured, carry the appropriate permits and be placarded as required by law. ITB 9859 Magnesium Hydroxide Page 4 of 14 6. Laws and Requlations All work and/or materials must meet current standards in force by recognized technical and professional societies, trade and materials supply associations, institutes and organizations, bureaus and testing laboratories. The Vendor agrees to comply fully with all applicable local, State of Colorado and Federal laws and regulations and municipal ordinances to include American Disabilities Act (ADA). The Vendor further agrees to comply fully with the Occupational Safety and Health Act, all regulations issued there under, and all state laws and regulations enacted and adopted pursuant thereto. 7. Current Standards All Work and/or materials must meet current standards in force by recognized technical and professional societies, trade and material supply associations, institutes and organizations, bureaus and testing laboratories, and national, federal, state, county, and local laws, codes and ordinances. All work shall be performed in accordance with applicable ANSI, OSHA, or AWWA standards. In addition, Vendor(s) must adhere to the following: Drake Water Reclamation Facility EMS Guide for Vendors and Contractors, attached hereto as Exhibit A and incorporated by this reference. 8. Insurance Requirements Vendor(s) will provide, from insurance companies acceptable to the City, the insurance coverage designated in Exhibit B Insurance Requirements, attached hereto and incorporated by this reference. 9. Delivery and Freiqht The awarded Vendor(s) shall deliver the product FOB destination to the below facility: Drake Water Reclamation Facility 3036 Environmental Drive Fort Collins, CO 80525 Prices quoted shall include freight, FOB DWRF. The quoted price is to include all hazmat charges, delivery charges, regulatory compliance charges, fuel/surcharge fees, deposits, and transportation charges, etc. The City will not pay demurrage or other charges unless the City requests the Vendor leave the container past the delivery date. The Vendor will deliver the product between the hours of 7:00 am and 3:00 pm on weekdays only, unless alternate times are approved in writing prior to delivery. Tanker loads shall be delivered within five calendar days, including weekends and holidays, of order placement. Vendor will notify DWRF Staff 24 hours before delivery. DWRF has a 16,000-gallon storage tank located in the north process tunnel; delivery conveyance to this tank is located at the north loading dock. The north loading dock is equipped with quick connect fill couplings. The Vendor shall be responsible to provide all pumping equipment, hose, valves, and fittings necessary to transfer the ITB 9859 Magnesium Hydroxide Page 5 of 14 product from the delivery tanker into the DWRF north loading dock. The City shall review the product certification upon each delivery. Product certification shall meet the requirements listed within this document. The certificate of analysis shall be performed by a NELAC certified laboratory. The City shall have the right to reject the product which does not meet the specified requirements. The City shall have the right to reject product which is not accompanied by a written certification. The Vendor shall be responsible for accurately metering product as it is being delivered such that an accurate delivery volume (in gallons) of product may be documented. Following delivery and prior to leaving the DWRF site, the Vendor shall provide, in writing, the volume delivered product to DWRF staff. Vendor shall be required to provide calibration certification for all instruments used to determine the volume of delivered product. 10. Spillaqe Should a chemical spill or leak result due to negligence, faulty equipment, or inferior packaging on the part of the Vendor or their agents, the Vendor or their agents must be responsible for cleaning the spill or leakage and for bearing any cost incurred due to spill or leakage cleanup. The Vendor shall be responsible to effect immediate containment, cleanup, disposal and restoration activities in accordance with DWRF's requirements and all applicable laws and regulations. All material associated with such cleanup operations must be hauled away and lawfully disposed of at no charge to the City. 11. Quality Standards The product supplied must meet or exceed the requirements stated. The Vendor shall have practices and procedures in place to ensure cross contamination of the product does not occur from the point of manufacture to the point of delivery. The City shall have the right to inspect the manufacturing facility upon request. 12. Consistency of Supply Vendors shall provide a consistent and uninterrupted supply of product. The Vendor shall provide the City with advanced notice whenever the Vendor is unable to meet its delivery obligations, and in such case the City may obtain product from another qualified Vendor. Should the Vendor, in the sole determination of the City, fail to consistently provide adequate supply of product, the City may terminate the agreement. II. BACKGROUND AND OBJECTIVE The City of Fort Collins is requesting bids for Magnesium Hydroxide to be used at Drake Water Reclamation Facility (DWRF). Wastewater at DWRF is treated through biological and chemical processes to meet effluent discharge limitations established in its regulatory permit. One of the effluent limitations is that pH must be between 6.5 — 9.0 S.U. to protect receiving stream health including fish, stream ecosystems, and downstream users. The biological process that reduces ammonia from wastewater, known as the nitrification process, consumes alkalinity and causes low pH. ITB 9859 Magnesium Hydroxide Page 6 of 14 The product will be used in the wastewater treatment process to provide alkalinity and facilitate nitrification and denitrification to achieve effluent nutrient removal. The volume of product is anticipated to fluctuate dependent upon process performance. To reach targets, it is anticipated product volumes needed may range between 15,000 and 100,000 gallons annually. This estimate is for evaluation purposes only and not considered a purchase commitment. III. SPECIFICATIONS Below you will find the related requirements and specifications for Magnesium Hydroxide. Requirements: 1. The product must be highly reactive magnesium hydroxide produced to a 55-59% solids slurry. 2. The product must be stable and have a minimum shelf life of 12 months. 3. Vendors must provide a minimum of three references. References must be municipal wastewater treatment facilities which currently use the product for pH. 4. No additives shall be included in the product without prior approval by or at the City's request. 5. The Vendor shall provide the locations of at least three of their manufacturing facilities to provide supply redundancy. Identify the manufacturing location closest to the DWRF site. If any future manufacturing facilities are planned, the Vendor shall identify future locations closest to the DWRF site and anticipated openings. 6. The Vendor shall provide documentation showing its manufacturing facilities can meet the upper demand volume listed above and without interruption of operations. 7. A Product sample will be taken from randomly selected deliveries to verify the delivered product meets specifications. These samples will be tested by a certified laboratory. Any deviations from the specified parameters will result in rejection of the product. �a nesium H droxide Specifications and Chemical Composition: M OH z Ca0 Si02 Fe20s M O Lbs./Gal H 94-98% <3.0% <0.5% <0.75% 68+% �'12.50 --10.5 Other Physical and Chemical Properties: • Physical State: Liquid • Appearance: white slurry • Odor: No odor • pH: �10.5 • Freezing point: <32°F • Decomposition Temperature: 350°C • Specific Gravity: 1.42 g/cm3 • Solubility: Water ITB 9859 Magnesium Hydroxide Page 7 of 14 IV. BID SUBMITTAL The bid shall be considered technical offers of what Vendor propose to provide and shall be incorporated in the contract award as deemed appropriate by the City. A bid that does not include all of the information required may be deemed incomplete and may be subject to rejection. The following items must be provided in the bid submittal packaqe: 1. Completed Bid Submittal Form including: • Bid Schedule • Product Specification Sheet • Product MSDS • Experience & References List, providing documentation of at least three (3) reference projects. • List of Subcontractors to be used on project (if applicable). • Vendor Acknowledgement Form Failure to submit any of the above may result in your bid being considered non-responsive. ITB 9859 Magnesium Hydroxide Page 8 of 14 9859 MAGNESIUM HYDROXIDE BID SUBMITTAL VENDOR NAME: SUBMITTAL DATE: A. BID SCHEDULE 1. Product name and manufacturer's part number 2. Product cost per gallon (includes freight and any other applicable costs) 3. What is the truckload quantity? 4. What is the expected lead time? 5. How long with you hold firm the price submitted? ITB 9859 Magnesium Hydroxide Page 9 of 14 B. EXPERIENCE 8� REFERENCES LIST PROJECT #1 Project Name: Project Type: Location: Contract Amount: Client: Contact Name: Phone: Start Date: Title: Email: Completion Date: Was the Project completed on time? ❑ Yes ❑ No If no, please describe: Was the Project completed within the original budget? ❑ Yes ❑ No If no, please describe: Additional information: ITB 9859 Magnesium Hydroxide Page 10 of 14 PROJECT #2 Project Name: Project Type: Location: Contract Amount: $ Client: Contact Name: Phone: Start Date: Was the Project completed on time? If no, please describe: ❑ Yes Was the Project completed within the original budget? If no, please describe: Additional information: Title: Email: Completion Date: ❑ No ❑ Yes ❑ No ITB 9859 Magnesium Hydroxide Page 11 of 14 PROJECT #3 Project Name: Project Type: Location: Contract Amount: $ Client: Contact Name: Phone: Start Date: Was the Project completed on time? If no, please describe: ❑ Yes Was the Project completed within the original budget? If no, please describe: Additional information: Title: Email: Completion Date: ❑ No ❑ Yes ❑ No PLEASE NOTE: THE CITY RESERVES THE RIGHT TO REQUEST AND CONTACT ADDITIONAL REFERENCES. ITB 9859 Magnesium Hydroxide Page 12 of 14 C. SCHEDULE OF SUBCONTRACTORS Please list all subcontractors and their corresponding Work items in the space below. If not applicable, please note "N/A". ITEM SUBCONTRACTOR D. MANUFACTURING FACILITIES (minimum of three) (include volume of product produced annually at each facility as well as location) ITB 9859 Magnesium Hydroxide Page 13 of 14 E. ACKNOWLEDGEMENT Vendor hereby acknowledges receipt of the City of Fort Collins Bid and acknowledges that it has read and agrees to be fully bound by all of the terms, conditions and other provisions set forth in 9859 Magnesium Hydroxide except as otherwise noted. Additionally, Vendor hereby makes the following representations to City: a. All of the statements and representations made in this proposal are true to the best of the Vendor's knowledge and belief. b. Vendor commits that it is able to meet the terms provided in this proposal. c. This proposal is a firm and binding offer, for a period of 90 days from the date hereof. d. Vendor further agrees that the method of award is acceptable. e. Vendor also agrees to complete the proposed Notice of Award (NOA) with the City of Fort Collins within ten (10) days of notice of award. If NOA is not completed and signed within ten (10) days, City reserves the right to cancel and award to the next highest rated firm. f. Vendor acknowledges receipt of _ addenda. g. Vendor acknowledges no conflict of interest. h. Failure to provide a public viewing copy will be considered a waiver of any claim of confidentiality under Colorado Open Records Act (CORA). Vendor hereby waives any and all claims for damages against the City for the City's good faith compliance with CORA. Legal Firm Name: Physical Address: Remit to Address: Phone: Email Address: Name of Authorized Agent of Firm: Signature of Authorized Agent: Primary Contact for Project: Title: Phone: Email Address: Cell Phone: NOTE: ALL BID SUBMITTAL FORM PAGES MUST BE COMPLETED, SIGNED WHERE REQUIRED & RETURNED WITH YOUR BID PROPOSAL PACKAGE. ITB 9859 Magnesium Hydroxide Page 14 of 14 ��a���� ��:�� ..a�'c.�r�t �C�llln� �;�. .�'"�.���„�.� � Dear Contractor or Vendor, Water Reclamation Division 3036 Environmental Dr. Fort Coilins, CO 80525 970.221.6900 970221.6970 - fax fcgov.com The City of Fort Collins has adopted an environmental policy that focuses on its environmental responsibility and reflects the community's strong desire to protect the environment. This policy specifies the need to comply with legal requirements and includes a commitment to continually improve environmental performance. With the implementation of this policy, a number of policies and procedures have been adopted at the Drake Water Reclamation Facility (DWRF). The purpose of this EMS Guide for Contractors and Vendors is to familiarize you with these policies and procedures and to address how you will be affected. An Environmental Management System (EMS) is being implemented at DWRF to achieve the City's goal of high environmental performance. In addition to addressing in-house activities, the EMS requires that any party doing work within the DWRF fence line adhere to the relevant portions of the EMS. To fulfill this requirement, a list of procedures has been developed for all DWRF contractors or vendors to follow while working on site. This guide provides an introduction to the EMS, communicates the environmental policy, and describes how you can help DWRF achieve its environmental goals. If you have any concerns or questions regarding the information contained in this guide, please feel free to contact DWRF any time at (970) 221-6900. DocuSign Envelope ID: 86045885-5DA6-4666-6666-BA3EAD9A05E4 Section 3 - Environmental Stewardship 3, � Environmenta/ Commitment The City of Fort Collins is committed to conducting its operations in a manner that is environmentally responsible and reflective of the community's strong commitment to the environment, optimizing decisions that are inclusive of the economy and social equity. The City will provide community leadership by reducing its environmental impact while benefiting citizens, the economy, and society. In order to meet or exceed these objectives, the City of Fort Collins wi1L• • Meet or exceed all legal compliance obligations and voluntary commitments • Develop and implement programs for pollution prevention, energy conservation and natural resource protection. • Foster a culture through strong management commitment, education and investment where all employees are empowered and expected to proactively perform work in an environmentally responsible manner • Commit to continuous improvement through establishing measureable objectives for evaluating environmental performance This environmental policy will be communicated to employees and contractors and will be available to the public via the City's website. �DocuSigned by: �w a�� �,3�zo�� OF393F2B13454CC... City Manager Date ������ _s����'t �C)��I�I� � �`��`� i- Drake Water Reclamation Facility Emergency Response Policy for Visitors Water Reclamation Division 3D36 Environmental Dr. Fort Collins, CO 80525 970.221.6900 970.221.6970 - fax fcgov. com IN THF, EV�:NT YOLJ HEAR THF. AtJllIB1.E WARN[NG ALARM: You must start evacuating immediately. If you are making a chemical delivery, safely halt all transfers and unloading without delay. 2. Evacuate through the south gate, go west up the hill towards Timberline. Turn left on Illinois Drive (near King Soopers), and head south to Timberline Church. The meeting point is the northern side of the church parking lot. If you cannot readily evacuate with your own vehicle, start walking to the south gate and any remaining exiting staff will provide you a ride off-site. 3. You should check in with either your accompanying staff inember or the Incident Commander (who will be wearing an Incident Commander vest and have a hand-held radio). 4. You will remain at this gathering point until otherwise informed in person by the Incident Commander. � ��4 � �� �;%, �,,. ��r �' � � :,,�C��'t ����I�1� ,� . + ��, �.---- �—� .y Environmental Management Procedures Water Reclamation Division 3036 Environmental Dr. Fort Collins, CO 80525 970.221.6900 970.221.6970-fax fcgov.com The following information is supplied to contractors and vendors who perform work on site for the Drake Water Reclamation Facility (DWRF). The information presented below has been developed as part of the facility's Environmental Management System (EMS). The intent of this information is to make contractors and vendors aware of the EMS and to ensure conformance to applicable EMS procedures and work instructions. ■ Minimize idling of vehicles during any work operations. ■ Control fugitive dust emissions during any work operations and activities. ■ Do not excavate without the prior approval of appropriate DWRF staff. ■ Label, store, and dispose of any waste materials according to local, state, and federal regulations. NO UNLABELED CONTAINERS ARE PERMITTED ON SITE. ■ Notify appropriate DWRF staff if there are any hazardous wastes on site. Recycle or dispose of all wastes in an appropriate manner according to all local, state, and federal regulations. ■ Notify appropriate DWRF staff when a regulated material is being used on site (asbestos, PCBs, etc. ). ■ Provide Material Safety Data Sheets (MSDS) for all materials upon request. ■ Do not discharge ANY material to storm water drains or sanitary sewer without approval of appropriate DWRF staff. Notify appropriate DWRF staff if a state-permitted discharge will occur. ■ Keep roadways and outside areas clean and free of debris. ■ Obtain approval for outside storage of materials from appropriate DWRF staff. ■ Equip storage areas with adequate secondary containment of all regulated materials. ■ Label and store all materials according to Hazard Communication standard [29CFR1910.1200]. ■ Close all chemical containers except when in use. ■ Have appropriate spill kits available. ■ REPORT ALL SPIL.LS OR RELEASES OF MATERIALS IMMEDIATELY to DWRF staff (970) 221-6900 and the Special Projects Manager. Contractors will follow up by submitting a completed Spill Reporting Form. Water Reclamation Division ������ �� 3036 Environmental Dr. � � Fort Collins, CO 80525 - ��� ����' � � 970.221.6900 970.221.6970 - fax ,a`� � ���' �� fcgov.com ` � �`` �``-�.��w� EMS Gacide for Cofitractors and Vendors Checklist This form must be completed, signed, and returned to the City of Fort Collins Drake Water Reclamation Facility (DWRF). NOTE: Please review the enclosed materials prior to completing this form. Contractor/Company Name: Contact Phone Number: E-mail address: Date: ✓ Read and understand the signed Environmental Policy for the City of Fort Collins ✓ Read and understand the Emergency Response Policy for Visitors ✓ Read and understand the Environmental Management Procedures Environmental Agreement My company will abide by all environmental regulations and policies when performing work at the DWRF. My company will ensure that the requirements of the EMS are adequately communicated to all personnel that may visit DWRF. For questioris or additional information cot2tctct the City of Fort Collins Drake Water Reclamation Fncilit�� c�t (970) 221-6900. Signature: Date: EXHIBIT D INSURANCE REQUIREMENTS The Service Provider will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs. Before commencing work under this bid, the Service Provider shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies. In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement. Insurance certificates should show the certificate holder as follows: City of Fort Collins Purchasing Division PO Box 580 Fort Collins, CO 80522 The City, its officers, agents and employees shall be named as additional insureds on the Service Provider's general liability and automobile liability insurance policies by marking the appropriate box or adding a statement to this effect on the certificate, for any claims arising out of work performed under this Agreement. Insurance coverages shall be as follows: A. Workers' Compensation & Employer's Liability. The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement. Workers' Compensation & Employer's Liability insurance shall conform with statutory limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee, or as required by Colorado law. B. General Liabilitv. The Service Provider shall maintain during the life of this Agreement such General Liability as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a"broad form" basis. The amount of insurance for General Liability, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. C. Automobile Liabilitv. The Service Provider shall maintain during the life of thisAgreement such Automobile Liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement. Coverage for property damage shall be on a"broad form" basis. The amount of insurance for Automobile Liability, shall not be less than $1,000,000 combined single limits for bodily injury and property damage. In the event any work is perFormed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance.