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HomeMy WebLinkAbout2017 ContractFORM OF AGREEMENT DEBRIS REMOVAL AND DISPOSAL THIS AGREEMENT made and entered into on the 4th day of April , 2017 by and between Ceres Environmental Services, Inc., 6968 Professional Parkway East, Sarasota, FL 34240, the Contractor, and the CITY OF SEBASTIAN, a municipal corporation organized and existing under the laws of the State of Florida and located in Indian River County, Florida, hereinafter called the City. WITNESSETH: That the Contractor and the City, for the consideration hereinafter named, agree as follows: Article 1. SCOPE OF WORK - The Contractor shall perform all the work as described for the City of Sebastian, Florida, and shall do everything required by this Agreement and any other Contract Documents, including without limitation, the Request for Qualifications and Exhibit "A" Scope Exhibit "B" Addendum and Exhibit "C" Price forms and Equipment Hourly Rate form. Article 2. COMMENCEMENT AND COMPLETION - The Contractor shall commence work as soon as practical after the City has issued a notice to proceed before or after a storm event, as described in the Notice to Proceed, and shall continuously pursue the work seven (7) days per week during daylight hours until debris work has been completed and closed. Article 3. The City shall pay the Contractor for all work included and completed in accordance with this Agreement, based on the items of work set forth in the Contractor's Proposal Price Form and the Contractor's hourly rate schedule for any force account. The Contractor's price at the time of delivery of services will be a) the price set forth on the Proposal Price Form; and b) when not delineated on the Proposal Price Form, the latest price based on the FEMA price rate structure applicable to the date of Notice to Proceed. Article 4. PROGRESS PAYMENTS - The City will make progress payments, calculated based on the number of units of work, as described in the Proposal Price Form, which the Contractor has submitted with the payment invoice, all supporting documents such as summary of load and tree trimming tickets. The City shall make such progress payments on or about the 10th of each month for the previous month's work. Progress Payments: OWNER shall make progress payments on account of the Contract Price on the basis of CONTRACTOR's Applications for Payment at intervals not less than once each month during performance of the Work as provided below. Ninety percent (90%) of Work completed (with the balance being retainage); and Eighty percent (80%) of cost of materials and equipment not incorporated in the Work but stored on the Project site (with the balance being retainage). Final Payment: Upon final completion and acceptance of the Work, City shall pay the remainder of the Contract Price including any retainage as recommended by City Contract Administrator. ly_6i1 Ten percent (10%) of the amount due and payable to the Contractor will be retained from each progress payment, to ensure that the Contractor completes all work under this Agreement and complies with all obligations hereunder. The Project Manager will certify all requests for progress payments before presenting them to the City Engineer for review and then submitting an original progress payment to the City's Administrative Services Department for payment. If the contractor is authorized to assist the City in the initial 70 hours of "Push" operation, the contractor will bill based on the unit cost of equipment which includes all operator and labor and any incidentals. Article 5. CONTRACT PERIOD — This Agreement shall be binding on the parties for a period of two years from the executed date of the contract by both parties unless terminated earlier in accordance with its term. The City by written notice, may extend the terms of this Agreement for up to two (2) additional terms of twenty four (24) months each on the same terms and conditions. Article 6. ACCEPTANCE AND FINAL PAYMENT — Upon receipt of written notice that the Work is ready for final close-out and acceptance, the Project Manager will promptly make such inspection to determine the project is closed. When the Project Manager finds the work acceptable under the terms of the Work Order and Agreement, the Project Manager will promptly issue a final certificate, over Project Manager's signature, stating that the Work provided for in the Work Order has been completed, acceptance is recommended and the amount due to the Contractor will be paid by the City. Before issuance of the final certificate, the Contractor shall submit evidence satisfactory to the City that all payrolls, material bills and other expenses and indebtedness connected with the Work have been paid. A Waiver of Lien form signed by a duly authorized officer of any subcontractor is required and must accompany the request for final payment. The making and acceptance of the final payment shall constitute a waiver of all claims by the Contractor and the City, other than any claims the City may have arising from unsettled liens or from faulty work appearing after final payment. The City may withhold from final payment such amounts as may be described elsewhere herein. Article 7. INDEMNIFICATION AND INSURANCE - The Contractor shall indemnify and hold the City and its officials and employees harmless, and procure and maintain the insurance specified in the General Instructions accompanying this Agreement contained herein; and to the extent required in said paragraphs, require any and all subcontractors to do the same. GENERAL INDEMNIFICATION - For other and additional good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Contractor shall and does hereby indemnify, hold harmless and defend the City of Sebastian, its officers, agents, officials, representatives and employees against any and all liability, loss, cost, damages, expenses, claim or actions, or whatever type, including but not limited to attorney's fees and suit costs, for trial and appeal which the City of Sebastian, its officers, officials, agents, official representatives or employees or any other person(s) or business entity(ies) who may hereafter sustain, incur or be required to pay, arising wholly or in part due to any act or omission of Contractor, its agent(s), vendors, sub-Contractor(s), FA -2 representatives, servants, or employees in the execution, performance or nonperformance or failure to adequately perform Contractor's obligations pursuant to this contract. Article 8. GUARANTEES - The Contractor shall guarantee work completed as described herein, the equipment, articles, devices and materials furnished or installed, against any and all failure in proper use and operation for a period of one (1) year from the date of final acceptance of the Work completed under this Agreement. The Contractor shall also guarantee as described herein, warranties from manufacturers for each article and piece of equipment furnished or installed, so that the manufacturer's warranty fully covers the equipment from date of shipment to Contractor through the period of one (1) year after date of final acceptance of the work completed under this Agreement. Article 9. LIQUIDATED DAMAGES - The parties, recognizing that time is of the essence and that it would be impossible to determine the City's damages in the event that Contractor fails to complete the work required under a Work Order by the completion date described herein, hereby agree that the Contractor shall pay as liquidated damages, and not as a penalty, the sum of $300 for each calendar day beyond the Completion Date that Contractor fails to complete the work. The parties further agree that the City may withhold such liquidated damages from any payment due the Contractor. Article 9. TERMINATION OF CONTRACT— A. The occurrence of any of the following shall constitute a default by Contractor and shall provide the City with a right to terminate this Agreement in accordance with this Article, in addition to pursing any other remedies which the City may have under this Agreement or under law: 1. If Contractor improperly performs work or violates any provisions of the Contract Documents; 2. If Contractor neglects or refuses to correct defective work or replace defective parts or equipment, as directed by the City Engineer; 3. If Contractor's work is being unnecessarily delayed and is not finished within the prescribed time; 4. If Contractor assigns this Agreement or any monies accruing hereon; 5. If Contractor abandons the work, files for bankruptcy, makes a general assignment for the benefit of creditors, or if a trustee or receiver is appointed for Contractor. B. The City shall notify Contractor in writing of the grounds for default and provide Contractor with ten (10) calendar days to cure the default; C. If the Contractor fails to correct or cure the default within the time provided, City may terminate this Agreement by notifying Contractor in writing. Upon receiving such notification, Contactor shall immediately cease all Work and shall vacate any site occupied by it; provided, however, that the City may authorize Contractor to restore any work site. D. The Contractor shall be liable for any new cost incurred by the City in soliciting bids or proposals for letting a new contract, and the difference FA -3 between the cost of completing the new contract and cost of completing this Agreement together with any court costs and attorney's fees associated with any lawsuit undertaken by the City to enforce its rights herein, E. TERMINATION FOR CONVENIENCE — The City may at any time and for any reason terminate Contractor's services and work for City's convenience. Upon receipt of written notice of such termination Contractor shall, unless the notice directs otherwise, immediately discontinue the Work and immediately cease ordering of any materials, labor, equipment, facilities, or supplies in connection with performance under this Agreement. Upon such termination Contractor shall be entitled to payment only as follows: a. The actual cost of the work completed in conformity with this Agreement. b. Such other costs actually incurred by Contractor as are permitted under this Agreement. Article 11. PUBLIC RECORDS COMPLIANCE - A. The City of Sebastian is a public agency subject to Chapter 119 Florida Statutes. The Contractor shall comply with Florida's Public Records Law. Specifically, the Contractor shall: i. Keep and maintain public records that ordinarily and necessarily would be required by the City to order to perform the service. ii. Provide the public with access to public records on the same terms and conditions that the City would provide the records and at a cost that does not exceed the cost provided in Chapter 119 or as otherwise provided by law. iii. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law. iv. Meeting all requirements for retaining public record and transfer, at no cost to the city all public record in possession of the Contractor upon termination of the Agreement and destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the City in a format that is compatible with the Information Technology System of the City. B. Failure of the Contractor to comply with these requirements shall be a breach of this Agreement. Article 12. CONTRACTOR'S REPRESENTATIONS - In order to induce the City to enter into this Contract, Contractor makes the following representations: A. Contractor has familiarized himself with the nature and extent of the obligations under this Agreement. Contractor has familiarized himself with the work site, locality, approved DMS locations and all local conditions and laws and regulations that in any manner may affect its costs, progress, or performance. B. Contractor has carefully studied, or will carefully study, all reports of explorations and tests of subsurface conditions of the approved DMS FA -4 locations which are identified or provided in this Agreement and accepts the accuracy of any technical data contained in such reports and drawings, upon which Contractor is entitled to rely. C. Contractor has obtained and carefully studied (or assumes responsibility for obtaining and carefully studying) all such examinations, investigations, explorations, tests, reports, and studies (in addition to those referred to in Sub -Paragraph B. above) pertaining to the subsurface or physical conditions at or contiguous to the site or otherwise affecting performance, as Contractor considers necessary for the performance at the Contract Price and in accordance with the other terms and conditions of this Agreement. D. Contractor has correlated the results of all such observations, examinations, investigations, explorations, tests, reports, and studies with the terms and conditions of the Contract Documents. E. At the time of entering into this Agreement, Contractor has given the City written notice of any conflicts, errors, and discrepancies that Contractor has discovered in the Contract Documents and the resolution thereof by the City is acceptable to the Contractor. Contractor warrants that it is satisfied with the information presented which enabled its to prepare its bid. Article 13. CONTRACT UNIT PRICES - The unit prices contained in the Proposal Price Form are incorporated herein, and made a part of this Agreement as the Contract Unit Price Schedule, as follows in Exhibit C — Pricing Form and Equipment Hourly Rate Form. Article 14. PUBLIC RECORDS FORM Contract Name: Professional Services For Disaster Debris Removal and Disposal In accordance with the requirements of Chapter 119 Florida statutes, as amended, the contract between the City of Sebastian and the Contractor shall require the contractor to: a) Comply with the public records law of the State of Florida, as the same may be amended from time to time. b) Keep and maintain public records that ordinarily and necessarily would be required by the City in order to perform services, and C) Provide the public with access to public records on the same terms and conditions that the City would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law, and e) Meet all requirements of retaining public records and transfer, at no cost, to the City all public records in possession of the contractor upon termination of the contact and destroy any duplicate public records that are exempt or confidential and exempt from public ydd.9 records disclosure requirements. All records stored electronically must be provided to the City in a format that is compatible with the information technology systems of the City. f) IF CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT 1-772-388-8212 / E-MAIL JWILLIAMS@CITYOFSEBASTIAN.ORG CITY OF SEBASTIAN, 1225 MAIN STREET SEBASTIAN, FLORIDA. AUTHORIZED SIGNATURE: ❑q.1kV1 TITLE: TE: IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed, the day and year first above written. IN WITNESS WHEREOF, the parties hereto have executed this agreement the date and year first written above. TEST: pp�� !J� J anette-Williarns, MMC ity 0erk (SEAL)- Appr9ved-as to Form and Content for Relia e by -the -City of Sebastian Only Robert A. Ginsburg, City Attorney THE CITY OF EBASTIAN By: u--, Name: Joseph Cofffin title: City Manager Signed, sealed and delivered in the presence of: NAME: Contractor Signature bP A.euS Print Name WITNESS: . 09 G -/t; / M. wf+nscom W^w,, al M. Hanscom ° Notary Public 17 Minnesota }.31ryCanmssmUpn Unuatt31.2822 records disclosure requirements. All records stored electronically must be provided to the City in a format that is compatible with the information technology systems of the City. 0 IF CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT 1-772-388-8212 / E-MAIL JWILLIAMS@CITYOFSEBASTIAN.ORG CITY OF SEBASTIAN, 1225 MIN STREET SEBASTIAN, FLORIDA. AUTHORIZED SIGNATURE: szDATE: PRINT F � TITLE: t Q J IN WITNESS WHEREOF, the parties hereto have caused these presents to -be executed, the day and year first above written. IN WITNESS WHEREOF, the parties hereto have executed this agreement the date and year first written above. ATTEST: Jeanette Wiiliams, MMC City Clerk (SEAL) Approved as to Form and Content for Reliance by the City of Sebastian Only Robert A. Ginsburg, City Attorney THE CITY OF SEBASTIAN By: Name: Joseph Griffin title: City Manager --------------------------------------- CONTRACTOR --_---------------- ------- Signed, sealed and delivered in the presence of. WITNESS: NAME: By: Contractor Signature Print Name Print Name Exhibit A Scope of Services Disaster Recovery Contractors are sought to support the City of Sebastian in the management of debris resulting from but not limited to catastrophic storm events such as tornadoes and hurricanes. The Contractor shall provide all required services to clear and remove any and all "eligible" debris (See Exhibit B for definition of "eligible" debris) primarily from public right-of-way on City streets. Work will include the following: ♦ Examine debris to determine whether or not debris is eligible ♦ Load the debris onto certified dump trucks ♦ Haul the debris to approved staging area, dumpsite or landfill Process debris including sorting, grinding, mulching, or burning • Establish and operate temporary debris staging and processing sites ♦ Provide for a temporary tower to view debris within trucks ♦ Provide project management services ♦ Haul and dispose of reduced debris to permitted disposal site • Respond and repair damages resulting from Contractor's work ♦ Keep accurate records and provide copies to County if requested. ♦ Assist the City in FEMA or FWHA reporting and reimbursement efforts The Contractor shall comply with all provisions contained in Appendix A Page FA -15 The City intends to award a contract to one Primary Contractor and one Secondary Contractor. City does prefer a local contractor (Indian River County) to provide this debris hauling and removal service to due experience learned in 2016 Hurricane Matthew debris removal operation. City does not require haul trucks to have self-contained grabbing claw to pick-up debris. EXPENSESINCURRED This solicitation does not commit the City to pay any costs incurred in the preparation and submission of an offer in any form or to produce or contract for said services. CITY PROJECT ADMINISTRATION All firms are hereby placed on notice that the City has designated the City of Sebastian City Engineer, as the liaison for this project. RESPONDENT'S RESPONSIBILITY Before submitting a proposal, each firm shall make all investigations and examinations necessary to learn the conditions and requirements that may influence the performance of the services requested and the contract. Failure to make such investigations and examinations shall not relieve successful Contractor(s) from the obligations to comply, in every detail, with all the provisions and requirements of the awarded contract nor shall it be a basis for any claim whatsoever for alteration in any condition of the awarded contract. Scope of Work COOPERATION/COORDINATION The OWNER and its authorized representatives shall be permitted access at every facility or property for the inspection of all work. Work by OWNER: The City hereby reserves the right to perform activities in the area where work is being done under this contract with its own forces. FA -7 Work by Other CONTRACTORS: The City hereby reserves the right to permit other CONTRACTORS to work within the area, which is the site of the work under this contract. Coordination: CONTRACTOR shall afford OWNER and other CONTRACTORS reasonable opportunity for the introduction and storage of their equipment, materials and the execution of their work concurrently, and shall properly coordinate its work with theirs in the best interest of the City. COMMENCEMENT OF WORK The work shall commence immediately upon receipt of a Notice to Proceed. A mandatory kick- off meeting will be held with the contractor to review hauling and logistic and to issue the NTP. The Contractor shall mobilize within 72 hours of receiving Notice to Proceed. PAYMENT AND PERFORMANCE BONDS Contractor shall provide the City with a Payment and Performance Bonds in the amount of $1,000,000 or 100% of the contract value, whichever is greater, within three (3) calendar days of a written Notice to Proceed (NTP) by City. Once activated, the Payment and Performance Bond shall be in force for a period of not less than one (1) year from the date of original execution by the Bond Surety. Bonds shall be executed by the Contractor and surety company authorized to do business in the State of Florida with an A.M. Best rating of "A-" (Excellent) or better, which bond shall be conditioned upon the successful completion of all work, labor, services, materials to be provided and furnished, and the payment of all subcontractors, materials and laborers. If the value of the contracted work increases, the Contractor shall be required to provide an updated Public Construction Bond in an amount equal to the new value. DEFECTIVE EQUIPMENT All equipment furnished or work performed, when not in accordance with the intent of these Specifications, shall be rejected and shall be removed immediately and replaced by suitable and satisfactory equipment. Failure to reject any defective work or equipment will not prevent later rejection when such a defect is discovered and shall not relieve the CONTRACTOR of his obligation to fulfill his contract even though such work and equipment have been previously inspected by the OWNER and accepted; it shall not obligate the OWNER to final acceptance nor shall it prevent the OWNER in any time subsequent from recovering damages from work actually shown to be defective within a one (1) year period after the final acceptance. If the CONTRACTOR fails to remove any defective work or equipment, the OWNER shall have the right to stop work and remedy the cause at the expense of the CONTRACTOR. If the OWNER deems it expedient to accept minor imperfect work, the OWNER shall have the right to retain such work and an equitable deduction shall be made in the Contract price. DAMAGE TO ROADWAYS, RIGHTS-OF-WAY AND PRIVATE PROPERTY Until final acceptance of the work by the OWNER, it shall be under the charge and care of the CONTRACTOR and he shall take every necessary precaution against injury or damage to property by the action of the elements, or from any other cause whatsoever. The CONTRACTOR shall rebuild, repair, restore and make good, at his own expense, damages to any portion of properties before its completion and acceptance. Final Cleanup, before the contract is considered complete, all rubbish and unused material due to, or connected with, the work must be removed and all premises, rights -of -ways, and lands left ME in a condition satisfactory to the OWNER. All property, public or private, disturbed or damaged, during the execution of the work shall be restored to its former condition. Final payment will be withheld until such work is accomplished. SAFETY AND PROTECTION The CONTRACTOR shall furnish and install all necessary equipment and facilities for the protection of the workers and the safety of the public and shall carry on this work in a manner best calculated to avoid injury to the public or to the workers. Protection of Adjacent Property and Utilities: The CONTRACTOR shall conduct his work in such a manner as to avoid damage to adjacent private or public property and shall immediately repair or pay for any damage incurred through his operations. The CONTRACTOR shall take cognizance of all existing utilities and he shall operate with due care in the vicinity of such utilities and shall immediately repair or have repaired at no additional costs to the OWNER any breakage or damage caused by his operation. Should the OWNER be required to make such repairs, the cost of such repairs shall be deducted from the contract price. CONTRACT PERIOD This Contract shall be binding on the parties for a period of twenty four (24) consecutive months from the date of this Contract by both parties unless terminated earlier in accordance with its terms. The City may extend the term of this Contract for up to three (3) additional terms of twenty four (24) months each on the same terms and conditions. REQUIRED NOTIFICATIONS The Contractor shall notify the City immediately upon any change in ownership or financial condition of the company. The City reserves the right to terminate any contract entered into between the City and an awarded Contractor if in the City's sole and absolute judgment changes to the company's ownership or financial condition renders the Contractor unable to perform the scope of services sought under this contract. The Contractor shall disclose future contractual obligation within the State of Florida or other Counties or Municipalities throughout the term of the contract and provide reasonable assurance that such obligations will not preclude the Contractor from meeting its obligations under this Contract. ADJUSTMENTS TO RATES Price adjustments will be made on an annual basis after the first 12 -month term based on the consumer price index (CPI). Unit prices shall be adjusted upward or downward annually to reflect changes in the CPI for all urban consumers for the South. Should the CPI be discontinued or substantially modified, an alternate index shall be chosen by mutual agreement of the Contractor and the City. Prior to each 12 -month contract renewal, the unit contract prices shall be adjusted to reflect the increase or decrease in the CPI for the immediately preceding twelve (12) month period of December to December. The Contractor shall notify the City in writing of increases that are based on the CPI, as provided in this section, no less than thirty (30) days prior to their implementation. PAYMENT PROCEDURES Progress Payments: OWNER shall make progress payments on account of the Contract Price on the basis of CONTRACTOR's Applications for Payment at intervals not less than once each month during performance of the Work as provided below. 1. Ninety percent (90%) of Work completed (with the balance being retainage); and FA -9 2. Eighty percent (80%) of cost of materials and equipment not incorporated in the Work but stored on the Project site (with the balance being retainage). Final Payment: Upon final completion and acceptance of the Work, OWNER shall pay the remainder of the Contract Price including any retainage as recommended by City Contract Administrator. ITIuIf H&W—M_1106 ;l The City shall appoint a contract administrator for this contract with the authority to issue Notices to Proceed for Federal and State Public Assistance categories of work. All Notices to Proceed shall include a complete and comprehensive Scope of Work. The Contractor shall not initiate work if there is not a Scope of Work provided with the Notice to Proceed. AVAILABILITY OF FUNDS This Contract is for goods and services related to disaster response and recovery operations. Activation of this Contract will occur in anticipation of Federal and State Public Assistance funding. Specific Work Tasks The qualified firm(s) will develop and present the scope of services, meeting the City needs. The work to be undertaken includes, but is not limited to the following: DEBRIS REMOVAL Emergency Roadway Clearance – Removal of debris from the primary transportation routes as directed by the City. In this role the contractor will perform an emergency "PUSH" within the initial 70 hours after the storm event to allow emergency vehicles to traverse the roadways. The City will determine route priorities for this push operation. Additionally, in preparation for an imminent hurricane strike, contractor crews may be asked to stage outside the strike area. In this case, contractors are to provide the emergency push into the City. The City will designate roadway priorities for this push. The contractor will also provide the required equipment and manpower to handle the "first pass" of all City Street as part of this contract after a storm event. The Pass operation will require the load tickets. Debris Removal from Public Property – Removal of debris from public rightsEofEway will be the responsibility of the contractor. The contractor shall remove debris beyond public rightsEofr-way as necessary to abate imminent and/or significant threats to the public health and safety of the community. These areas may include vacant public lands, operational facilities, utility facilities and other land owned by the City. It may be necessary to make several trips through a neighborhood as debris is moved to the ROW. In this case the loads will need to be documented separately, per the instructions of the City. Debris Removal from Private Property – Removal of debris beyond public rightsEofEway as necessary to abate imminent and/or significant threats to the public health and safety of the community Should an imminent threat to life, safety, and health to the general public be present on private property, the Contractor, as directed by the City, will accomplish the removal of debris from private property, to include private roadways. Eligible ROW Construction and Demolition (C&D) or Municipal Solid Waste (MSW) Debris Removal E Work consists of the collection and transportation of Eligible C&D or MSW debris on FA -10 the Public ROW or private property to a City approved TDSR site or City designated final disposal site. Eligible Demolition, Removal and Transportation of Structures E Work consists of the demolition of structures on public property or private property, as directed by the City, obtaining necessary permits and hauling the resulting debris to a City designated final disposal site. Removal of Eligible Hazardous Trees and Limbs E Work consists of removing Eligible hazardous trees and limbs and placing them on the safest possible location on the City ROW for collection under the terms and conditions of Element 1, Eligible ROW Vegetative Debris Removal. Eligible Household Hazardous Waste (HHW) Removal, Transport and Disposal - Work will consists of removal, transportation and disposal of Eligible household hazardous waste. Eligible Abandoned Vehicle/Vessel Removal G Work consists of removal of Eligible Abandoned Vehicles in areas identified and approved by the City and subsequently transported to a City approved staging area. White Goods — The Contractor may expect to encounter white goods available for disposal. White goods will constitute household appliances as defined in the Florida Administrative Code. The Contractor will dispose of all white goods encountered in accordance with applicable Federal, State and local laws. Eligible EEwaste Item Removal — Work consists of the recovery and disposal (or recycling) of televisions, computers, computer monitors, etc. unless otherwise specified in writing by the City. Eligible Dead Animal Carcasses — Work consists of the recovery and disposal of dead animal carcasses. Hazardous Tree Stumps — The Contractor shall remove all stumps that are determined to be hazardous to public access and as directed by the City. Stumps shall be hauled to DMS where they shall be inspected and categorized by size. GPS X and Y coordinates are required for reimbursement by FEMA. Fill Dirt — The Contractor shall place compacted fill dirt in ruts created by equipment, holes created by removal of hazardous stumps and other areas that pose a hazard to public access upon direction of the City. Canals, Streams and Conservation Areas — The Contractor shall coordinate with the appropriate local, state, or federal agencies with jurisdictional authority to remove debris in natural or manmade waterways. DEBRIS PROCESSING: Temporary Debris Staging and Reduction Site (TDSRS) — The Debris Monitoring Team, as assigned by the City, will determine the minimum number of sites required for each storm event. The City will designate the TDSRS to be activated. The City has two pre -approved DMS locations at the Sebastian Municipal Airport These two sites will be activated in event of an approach storm and the City will obtained the approval letters from the DEP to open these Debris Management Site (DMS) at the Sebastian Airport. FA -11 Preparation, maintenance and operation of the DMS facilities are entirely the Contractor's responsibility. Preparation and maintenance of facilities shall include maintenance of the DMS approach and interior road(s) for the entire period of debris hauling, including provision of rock for any roads that require stabilization for ingress and egress. Each facility shall include a roofed inspection tower sufficient for a minimum of three (3) inspectors for the inspection of all incoming and exiting loads. The contractor will be responsible for obtaining any required permits, which shall be paid at cost by the City. At the City's discretion, owned rights of way or other entity owned property could be provided for temporary storage of debris. DMS Debris Removal Operations Plan and Environmental Protection Plan — This plan is to address site setup, preEuse activities, postEuse activities and operational activities. The plans will also include pre and post video and other checklists to assure proper management of the site. Once the debris management site is selected for use, the CONTRACTOR will provide a Site Management Plan. Three (3) copies of the plan are required. The plan shall be drawn to a scale of 1" = 50' and address following functions: ♦ Access to the DMS site ♦ Site preparation Eclearing, erosion control, grading and pushing piles to maintain access ♦ Traffic control procedures, if needed ♦ Safety • Segregation of debris ♦ Location of ash disposal area, hazardous material containment area, contractor work area, and inspection tower ♦ Location of incineration operations, grinding operation. Burning operations will not be permitted ♦ Location of existing structures or sensitive areas requiring protection ♦ Restoration of site All debris operation shall be processed in accordance with local, State and Federal law, standards and regulations and will comply with FEMA Public Assistance program for Federal Funding. Processing shall include, but is not limited to, reduction by grinding and/or incineration when approved by the City. Prior to reduction, all debris shall be segregated between vegetative debris, construction and demolition debris, recyclable debris, white goods and hazardous waste. Generated Hazardous Waste Abatement — Abatement of hazardous waste identified by the City is to be disposed of in accordance with all applicable Federal, State, and local laws, standards and regulations. Debris Disposal — Disposal of all eligible debris, reduced debris, ash residue and other products of the debris management process is to be in accordance with all applicable Federal, State, and local laws, standards and regulations. The Contractor shall be responsible for paying all landfill tipping fees and provide all required documentation to the City needed to receive eligible reimbursement through FEMA Public Assistance Program and any State requirements for matching fund for such fees. Assist the City and Debris Monitoring Staff in the following: ♦ Monitoring multiple contractors and multiple trucks delivering materials to the DMS. FA -12 ♦ Verify that each truck that delivers to the DMS matches its manifest load ticket — truck and maximum capacity will be measured, certified and then labels placed on each truck showing capacity. ♦ Make sure load is properly secured for transport. ♦ Photograph of each loaded truck bed and attach photograph to truck's manifest ticket or link with digital photographic records, as applicable. ♦ Review trucks manifest and observe the truck bed to confirm that the truck was loaded to capacity or as described on manifest ticket, and completely empty on departure. ♦ Maintain manifest tickets in an organized manner for proper record review and storage. ♦ Initial load tickets before permitting truck to leave the DMS checkEin area to empty its load. ♦ Document location of origin of debris. ♦ Troubleshoot questions and problems at the DMS and identify issues that could impact eligibility for cost reimbursements. ♦ Remain in contact with the central office/staging operation command center. ♦ Perform other duties as directed by City personnel, e.g. conduct final inspections and issue closeout reports. DOCUMENTATION AND RECORDS: Storm debris shall be subject to inspection by the City. Inspections will be to insure compliance with the contract and applicable local, State and Federal laws and any requirements per FEMA Public Assistance Program for Federal Funds. The Contractor will, at all times, provide the City access to all work sites and disposal areas. The Contractor and Debris Monitoring Personnel will have in place at the DMS personnel to verify and maintain records regarding the contents and cubic yards of the vehicles entering and leaving the DMS. The Debris Monitoring Personnel will coordinate data collection and information management systems, including but not limited to: ♦ Truck certification and labels for all certified trucks ♦ Prepare detailed estimates and submit to FDEM, FHWA and FEMA for use in Project Worksheet preparation. ♦ Implement and maintain a disaster debris management system linking load ticket and DMS information, including reconciliation and photographic documentation processes. ♦ Provide daily, weekly or other periodic reports for City managers and the Debris Monitoring Consultant, noting work progress and efficiency, current/revised estimates, project completion and other schedule forecasts/updates. ♦ The Contractor shall provide all requested information to the Debris Monitoring Personnel that is necessary for proper documentation. City staff shall review all documentation prior to submittal. The Contractor will work closely with the FDEM, FEMA and other applicable State and Federal agencies to ensure that eligible debris collection and data documenting appropriately address concerns of the likely reimbursement agencies. The Debris Monitoring Consultant will coordinate this work. ♦ Discrepancies in what is required of the Contractor must immediately be brought to the attention of the Debris Management Team. Documentation and Recovery Process — The Contractor will provide the following assistance in addition to debris removal: ♦ Recovery process documentation — create recovery process documentation plan ♦ Maintain documentation of recovery process ♦ Provide written and oral status reports as requested to City Debris Monitoring Personnel ♦ Review documentation for accuracy and quantity ♦ Assist in preparation of claim documentation. FA -13 DMS Site Reclamation — Site reclamation shall be accomplished in accordance with all Federal, State and local laws, standards and regulations. Site reclamations shall be accomplished in accordance with the Contractor's Debris Removal Operations Plan and Environmental Protection Plan, as approved by the City. Work Areas — The City will establish and approve all areas that the Contractor will be allowed to work. These include Right of Way, public land, private properties/accesses and DMS. The Contractor will remove all eligible debris and leave the site from which the debris was removed in a clean and neat condition. Fill dirt, reEvegetation and grading may be required to achieve the desired condition. Working Hours— All activity associated with gathering and loading of eligible debris shall be performed during visible daylight hours only unless otherwise authorized by the City. Hauling of eligible debris to the DMS will be allowed during visible daylight hours only between dawn and dusk unless otherwise authorized by the City. The Contractor may work during these hours seven (7) days per week including holidays. It is understood between the parties that at the DMS, debris reduction may take place twentyCfour (24) hours, seven (7) days per week if the Contractor deems it necessary to meet the work demand, subject to City approval. The City approval shall consider safety and impacts to surrounding land uses such as occupied residential areas. The Contractor shall be responsible for obtaining sites to stage equipment, such as trucks, while not in use. The Contractor shall comply with Sections 103 and 107 of the Contract Work Hours and Safety Standards Act (40 U.S.C. 327-330) as supplemented by Department of Labor regulations (29 CFR Part 5). Priority of Work Areas — The City will establish and approve all areas that the Contractor will be allowed to work. Daily and/or weekly scheduled meetings will be held to determine approved work areas. The Contractor shall remove all eligible debris and leave the site from which the debris was removed in a clean and neat condition. Determination of when a site is in a clean and neat condition will be at the reasonable judgment of the City. Such determination will not be unreasonably withheld. Safety — The Contractor shall have at least one Safety Officer on duty at all times during the active operation of the hauling and grinding. The safety officer shall be familiar with and properly trained to perform the assigned Safety Officer duties. Training shall include, but not limited to certification in the Florida Department of Transportation Maintenance of Traffic (FDOT MOT) standards. All work zones shall conform to FDOT MOT Standards and all work sites/conditions shall conform to all applicable Federal, State and local safety standards. In addition, Contractor shall ensure that all subcontractors have received appropriate safety training. FA -14 Appendix A - Additional Provisions A. The Contractor shall collect, remove, transport, and process disaster debris to the Indian River County Solid Waste Landfill at 1325 74th Avenue S.W., Vero Beach, Florida 32968 or other Facilities or properties as specified by Indian River County, as APPROVED OR directed by the City to the two local approved DMS locations. B. Collection of debris shall include identification, assessment and removal of hazardous materials, hazardous wastes, bio -hazardous wastes, dead animals, and hazardous stumps. C. Collection and removal of debris shall include clearing limits of right-of-way. Trees located on private property that have fallen into the right-of-way shall be cut off at the right-of- way line and removed. D. Eligibility of stumps and hanging limbs must be determined on a case-by-case basis by a FEMA inspector. E. Trees and limbs in contact or close proximity to Utility lines shall not be removed until the Utility Company has removed or relocated their facilities. F. Processing of debris shall include the establishment and operation of multiple temporary debris -staging areas/processing-sites throughout the City where collected debris may be sorted, recycled, ground, mulched, burned, or otherwise segregated for transport and disposal to the Indian River County Solid Waste Landfill or other approved disposal facilities. G. Eligibility of debris is determined by FEMA. Contractors do not have the authority to make eligibility determinations. Generally, disaster -related debris located on public property and in public rights-of-way is eligible for FEMA reimbursement. Eligible disaster debris may include downed trees, vegetation and other woody debris; sand, silt, mud and gravel; building wreckage; and vehicles in the right-of-way. H. Debris on private property generally is not eligible for FEMA funding, but disaster - damaged personal property may be moved to the curbside to be picked up by an eligible Applicant. Debris from a commercial business or resulting from work performed by a private contractor is not eligible. I Disposal of debris shall include any reduction, separation, or other processing of material needed for the further removal and disposal of debris. Contractor will recycle the resulting mulch at a City approved disposal site. J The maintenance of traffic for this contract shall be in accordance with the applicable FDOT Standard Index numbers (600 Series) and the U.S. Department of Transportation, Federal Highway Administration, Manual on Uniform Traffic Control Devices and shall be followed in application, installation, maintenance and removal of all traffic control devices, warning signs, devices, and barriers necessary to protect the public and workmen on roads, and rights-of-way in the City of Sebastian. Pedestrian and vehicular traffic shall be maintained and protected at all times. K The Contractor shall ensure that all vehicles, trucks, equipment, and trailers operating on City roadways and rights-of-way are in compliance with all Federal, State, and local rules, laws, and regulations. All vehicles, equipment, trucks, and trailers shall be properly licensed, insured, FA -15 and equipped with lights, back-up alarms, horns, and any other safety equipment mandated by Federal, State, and local rules, laws, and regulations. Vehicles without proper safety equipment shall not be utilized. L The Contractor shall supply pre -numbered 5 part Debris Load Tickets to the City for the entire project. Each ticket will contain the following information: • Ticket Number • Contractor Name • Truck Number • Loading Location • Field Inspector/Monitor Name • Measured Truck Capacity • Date • Site Departure Time • Dump Site Location • Dump Site Arrival Time • Debris Classification (Vegetative, C&D, Mixed) • Estimated % Full and Debris Quantity M The Contractor shall notify the City at least 3 days in advance of any unusual "ramping up" of work forces needed to provide the debris hauling operation. M No homemade trailers with plywood extensions will be permitted. Trailers towed behind trucks must be able to mechanically dump on their own with no assistance from equipment at the dumping site. O The Contractor shall utilize mechanical loading equipment, such as: frontend loaders and/or skid -steer for loading debris. A truck mounted grabbing device is an option. Hand loading will be prohibited. P All transport hauling equipment shall be single axle, tandem wheel, or semi -trailer trucks that are designed by the manufacturer for the intended purpose. No plywood extended sides will be permitted. Steel side extensions that have steel reinforced vertical supports are allowed. Q All transport hauling equipment shall be equipped with tailgates that extend upward minimally to the height of the sides of the box. All trucks will have the company name and phone number on both sides of the vehicle doors. R All loaded trucks and trailers shall be tarped or covered during transport, in accordance with Florida law and local codes. S The Contractor shall meet minimum production demands established by the City and begin debris removal phasing (C & D removal and mulch reduction and hauling) within three days of the City request. T All collection activities shall be directed in a logical, sequential manner, approved by the City, with no materials skipped over or left behind. U The Contractor shall assure that all subcontractors have English speaking supervisors or representatives available in the field at all times during the contract period. FA -16 V The Contractor shall repair immediately upon request any damage caused by the debris removal operation that is deemed a public safety issue, including, but not limited to, asphalt, sidewalks, culvert pipes, swales, driveways, and/or any public or private property. W If it is determined to be in the best interest of the City to use City owned properties for the debris -staging areas/processing-sites, the Contractor shall credit the City $1.00 per cubic yard (Tipping Fee) for the total cubic yards collected for the use of the property. X The Contractor shall provide the following facilities at each debris management site (DMS)/processing-site, regardless of who provides the site (Contractor or City): 1. Each processing site shall have a roofed inspection tower erected upon it sufficient to support a minimum of three inspectors, and built to a height to allow a clear view down into a loaded truck. Mechanical lifts are discouraged. 2. Each processing site shall have a temporary roofed shelter or canopy erected for the comfort of support staff and personnel from weather conditions. 3. Each processing site shall have at least two portable sanitary units (porta-potties) that are clean and regularly maintained throughout the contract period. The Contractor shall keep an adequate supply of toilet paper in each unit. 4. The Contractor shall provide stabilized ingress and egress to each debris - processing site and shall maintain such access throughout the contract period. Y All loads brought to a temporary debris -processing site shall be inspected and recorded by the Contractor and the City. Z The Contractor shall reclaim the site upon completion of the processing activities to include at a minimum removal of all equipment and debris, grading of the site to historical condition, and seeding and mulching of the exposed areas. Compliance of Federal, State, and Local Laws, Rules, and Regulations All processing activities shall be conducted in compliance with all federal, state, and local laws, rules, and regulations. i) The Contractor shall be responsible for obtaining and paying for all permits needed to construct, operate, maintain, close, and reclaim the debris processing sites. ii) The Contractor shall be responsible for any environmental sampling required at the debris staging area. Normally areas used to stage vegetative debris do not require any environmental sampling. Areas used to stage mixed debris, or ash from burning mixed debris, will normally require environmental sampling to close the site after the debris or ash is removed. It would also be advisable to sample the area prior to staging any mixed debris to identify any existing contamination at the site. iii) The Contractor shall maintain the site in accordance with all local, state, and federal laws, rules, and regulations including at a minimum erosion control, storm water management, and fire control. iv) The Contractor shall not be responsible for C&D disposal fees at the County landfill. V) The Contractor shall provide and pay for all the necessary labor, tools, and equipment to execute the work described in this Scope of Services. FA -17 vi) The Contractor shall obtain burn authorizations when using the burning option as a reducing technique. A permit from the Florida Forest Service (FFS) is required for temporary incinerators such as portable air curtain incinerators and a permit from Florida Department of Environmental Protection (FDEP) is required for permanent incinerators such as an air curtain incinerator. Contractor Assistance and Cooperation 1. The Contractor shall provide the City any assistance, in its capacity, to the FEMA reimbursement efforts. i) The Contractor shall provide all records, including, but not limited to, truck and trailer registrations, disposal tickets, debris -dumping site logs, area maps, and other data sufficient to provide substantiation for FEMA and State reimbursement applications. ii) The Contractor shall assist the City in responding to federal and state agencies request for additional information and/or auditing as directed by the City. 2. The Contractor shall conduct the Debris Removal and Disposal Contract in strict accordance with guidelines set forth in this contract document. FA -18 ono EXHIBIT "B" A C� City of Sebastian VAS SEp Main Street e—. - Sebastian, FL 32958 Seb - (772)388-8228 HOME OF PELICAN ISLAND fax: (772) 388-8248 February 22, 2017 ADDENDUM NO.1 City of Sebastian Bid 17-03 Disaster Debris Removal and Disposal The following will be considered as Addendum No.1 to the bid documents and specifications for the Bid 17-03: 1. Attached is the Sworn Disclosure of Relationships form to be completed and returned 2. Attached is Hourly Rate Sheet for Equipment and Vehicles to be completed and returned 3. On page 5, the RFP discusses the pre -staging of equipment for the emergency road clearance. However, there is no pricing element for this phase. Secondly, if the event changes direction and there is no impact to the City, will the contractor be paid for pre -staging and at what rate? What equipment is the City requesting to be pre -staged? Response: Mobilization and pre -staging of equipment prior to a storm event will not be a bid item since it is not covered by FEMA to be reimbursed. 4. 1 understand that the City has identified two (2) DMS locations that could be activated for an event as the primary and secondary locations. However, on page 11 paragraph "w" indicates that if additional City property is opened due to need, that the contractor is expected to provide a one dollar ($1.00) offset per cubic yard. There is no indication of when or under what circumstances the third DMS will be opened. As written, the City can choose to open the facility on a whim simply to save a dollar. The end result is that any contractor must take into account this possibility and increase the primary fee to accommodate such a contingency. The end result would be an increased cost to the City. The document also is silent as to whether the credit will begin upon opening the DMS; whether it applies only to the debris taken to that DMS; if it applies ato all debris collected, and; if it is retroactive or prospective of the debris removal efforts. This is extremely problematic for a host of other reasons: a. Subcontractors are employed with express written contracts by volume is by the cubic yard; b. If the City opens a third DMS, the contractor will have to go back and re -negotiate contracts with the subcontractors which they may or may not accept; c. The opening of a third DMS will require the contractor to mobilize additional personnel and equipment to man the facility and process/manage the debris is the costs to the contractor increase while the reimbursement/payment to the contractor decrease. Response: The fee for $1.00 is a tipping fee at the temporary DMS. 5. One part of the RFP states that the City will reimburse the contractor for permits while another part states that they won't; Response: All permits will be obtained by the City. 6. The pricing sheet for T & M (Hourly) is not there. Attached is a sample typically used. Response: Attached is the hourly equipment pricing for time and material. 7. There is an issue of tipping fees. One part says there will be no tipping fees for C&D leaving it open as to vegetation and other types of debris. Can you please verify that all debris will have disposal fees paid by the City directly or that the contractor must initially pay the fees to be reimbursed at actual cost? Response: Any tipping fees will be submitted to the City for reimbursement. /l%� Pagel of 2 1r 8. The RFP requests pricing for demolition but does not distinguish between standard demolition and those with Regulated Asbestos Containing Material (RACM). Secondly, the RFP does not mention who will be responsible for structure decommissioning, utility disconnects and sewer, gas, water capping. Response: Attached bid sheet has been revised 9. Is the $1.00 being classified as a tipping fee? This is the first time this request has been made and if it's not a tipping fee, by adding a $1.00 into our price to cover this may jeopardize FEMA eligibility as to reasonableness of cost. Response: The $1.00 is a tipping fee. Please sign and return this Addendum No. 1 with the bid package due on February 28, 2017. Signature ate Page 2 of 2 SWORN STATEMENT UNDER CITY CODE, ON DISCLOSURE OF RELATIONSHIPS THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement MUST be submitted with Bid, Proposal or Contract No. 17-03 for Disaster Debris Removal and Disposal 2. This sworn statement is submitted by: Ceres Environmental Services Inc. (Name of entity submitting Statement) whose business address is: 6968 Professional Parkway East, Sarasota, FL 34240 and its Federal Employer Identification Number (FEIN) is 3. My name is Ron Nutting (Please print name of individual signing) and my relationship to the entity named above is Chief Financial Officer 4. 1 understand that an "affiliate" as defined in City Code, means: The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of the entity. 5. 1 understand that the relationship with a City Council or City employee that must be disclosed as follows: Father, mother, son, daughter, brother, sister, uncle, aunt, first cousin, nephew, niece, husband, wife, father-in-law, mother-in-law, daughter-in-law, son-in-law, brother-in-law, sister- in-law, stepfather, stepmother, stepson, stepdaughter, stepbrother, stepsister, half brother, half sister, grandparent, or grandchild. 6. Based on information and belief, the statement, which I have marked below, is true in relation to the entity submitting this sworn statement. [Please indicate which statement applies.] X Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, have any relationships as defined in City Code, with any City Council or City employee. Page 1 of 2 ,The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents, who are active in management of the entity have the following relationships with a City Council or City employee: Name of Affiliate or entity none AlftA STATE OF /MN Minnesota CITY OF 11&4 i I'll Name of City Council or employee Relationship 2 (Signat ) February 27, 2017 (Date) The foregoing instrument was acknowledged before me this 27th day of February 2017 , by_ Ron Nutting , who is personally known to me or who has produced as identification. 14� TARY PUBLIC SIGN: a P Ahkx k'/Lm" i" Notary Public, State at large My Commission Expires: Page 2 of 2 (Seal) Ann M Kemp Notary Public STATE OF MINNESOTA MY Commission Fires 1/31/2020 Qualifications Questionnaire Firm Name: Ceres Environmental Services, Inc. 1. 2. 3. Firm Address: 6968 Professional Parkway East Sarasota FL 34240 Telephone: (800) 218-4424 Fax: Contact Name: Gail Hanscom Email: Contract Administrator Licensing and Corporate Status: a. Is Contractor License Current? Yes (866) 228 - 5636 gail.hanscom@ceresenv.com b. Contractor's License No: CGC1508764 (see Attachment 1) C. Attach documentation from State of Florida Division of Corporations that indicates the business entity's status is active and that lists the names and titles of all officers. See Attachment 2 d. If Bidder is not a licensed Contractor, attach documentation on the qualifications of all key staff by position. Describe education, experience and training. Describe experience with Maintenance of Traffic, damage repairs, job site safety, protection of public, working with heavy equipment and removal of hazardous and bio -hazardous waste. Also, identify staff experience working with governmental entities and list those projects. Not applicable, as Ceres is a licensed contractor 4. Number of years the firm has performed business as a Contractor in work of the type involved in this contract: 41 5. What is firm's bonding capacity? $ 200,000,000.00 + (attach a letter from your bonding company stating its rating and the maximum amount in which your firm can be bonded) See Attachment 3 6. Attach a detailed description of the Contractor's organizational structure, "chain of command" of Contractor's response team and project management methods. Provide the name and address of Subcontractors and detail the intended scope of their work. See Attachment 4 and 5 7. Attach a list of types and quantities of recovery equipment, availability of equipment, estimate of workload, and future commitments to other emergency response contracts. The Contractor must provide reasonable assurance that all equipment identified for disaster recovery will be available and are not contractually obligated to other projects. See Attachments 6 and 7 16 8. Attach a list of all contractual obligations within Florida for similar disaster recovery services and provide reasonable assurance that such contracts will not interfere with or preclude the Contractor from responding to the County with Contractor's full force of manpower and equipment. The Contractor shall disclose future contractual obligation within the State of Florida throughout the term of the contract and provide reasonable assurance that such obligations will not preclude the Contractor from meeting its obligations under this Contract. See attachments 8 and 9 9. Attach a mobilization plan that outlines the Contractor's mobilization procedures following a disaster event. This outline should include a breakdown of the time required to perform each mobilization task including the time required to mobilize the Contractor's forces, time to mobilize equipment, time required to mobilize subcontractors, and time to set up debris staging areas. See Attachment 10 17 "Idla. EXHIBIT "C" Proposal Pricing Form The undersigned, as PROPOSER, declares that he/she has reviewed the RFP specifications for the scope of the project, visited the premises to review existing conditions and has reviewed the contractual documents thereto; and has read all special provisions furnished prior to the opening of responses; that he/she has satisfied himself/herself relative to the work to be performed. The following addenda have been received and are hereby acknowledged: Addendum Number Date Addendum Number Date 1 02/22/2017 The PROPOSER proposes and agrees, if this Bid is accepted, to enter into an agreement for the work as follows: Category Description Unit Cost Per Unit 5 0-15 Miles Veg from Right of Way (ROW) to Debris Management Site (DMS) CY $ 7.42 M = Y C 16-30 Miles Veg from ROW to DMS CY $ 7.94 C 31-60 Miles Veg from ROW to DMS CY $ 8.97 QJm j w >60 Miles Veg from ROW to DMS CY $ 10.44 0 Single Price Veg from ROW to DMS CY $ 8.97 Grinding/chipping vegetative debris cY $ 2.24 C c o m G Air Curtain Burning vegetative debris CY $ 1.05 E � ba R Open Burning vegetative debris CY $ 0.48 v Compacting vegetative debris CY $ 0.48 c M Debris Preparation, management, and segregation at debris management site CY $ 1.94 0-15 Miles C&D from Right of Way (ROW) to Debris Management Site (DMS) CY $ 7.42 16-30 Miles C&D from ROW to DMS CY $ 7,94 c = 31-60 Miles C&D from ROW to DMS CY $ 8.97 o >60 Miles C&D from ROW to DMS Cy $ 10.44 071 U Single Price C&D from ROW to DMS CY $ 8.97 0-15 Miles from DMS to Final Disposal CY $ 3,44 16-30 Miles from DMS to Final Disposal CY $ 4.12 31-60 Miles from DMS to Final Disposal CY $ 4.98 N C >60 Miles from DMS to Final Disposal CY $ 5.98 m Single Price from DMS to Final Disposal CY $ 4.98 Tipping Fees (Vegetative) Pass through amount [Line Item Deleted by LL Addendum it4] Tipping Fees (Mix) Pass through amount [Line Item Deleted by Addendum #4] Tipping Fees (C&D) Pass through amount [Line Item Deleted by Addendum a41 25 Firm: Ceres Environmental Services, Inc. Category Description Unit Cost Per Unit Remove Hazardous Trees 6"-12" trunk Tree $ 58.00 Remove Hazardous Trees 13"-24" trunk Tree $ 127.00 Remove Hazardous Trees 25"-36" trunk Tree $ 188.00 cRemove Hazardous Trees 37"-48" trunk Tree $ 239.00 Remove Hazardous Trees > 48" trunk Tree $ 298.00 m O Remove Trees with Hazardous Limbs >2" from tree Tree $ 84.84 Remove Hazardous Sumps 24"-36" diameter Stump $ 118.00 Remove Hazardous Sumps 37"-48" diameter Stump $ 168.00 Remove Hazardous Sumps >49" diameter Stump $ 218.00 Fill dirt for stump holes after removal Cy $ 26.71 Debris Removal from canals, rivers, creeks, streams, and ditches Cy $ 39.97 Pick up, screen, and return debris laden sand/mud/dirt/rock CY $ 16.83 Removal of eligible vehicles EA $ 145.00 Removal of eligible vessel from land LF $ 41.56 Removal of eligible vessel from waterway LF $ 99.89 0 E Carcass and Putrescent Removal (animals and organic fleshy matter) LB $ 0.76 00 White Goods from Row to Disposal EA $ 36.00 Freon Management and Recycling EA $ 31.00 d ,CL Demolition of Private Structure Price for Non-RACM, see note below Cy $ 18.16 Ewaste containing hazardous materials (CRT, computers, monitors and TVs) EA $ 34.95 Silt Removal Cy $ 9.87 Biowaste LB $ 19.67 HHW LB $ 8.90 o Beach/Lake Restoration (Berm/Beach Construction) Cy $ 29.80 0 V Canal Shoreline Restoration Cy $ 32.42 Demolition of Private Structure, RACM 25 CY $27.84 The undersigned hereby certifies that they have read and understand the contents of this solicitation and agree to furnish at the prices shown above all of the services specified in the RFP document, subject to all instructions, conditions, specifications and attachments hereto. Failure to have read all the provisions of this solicitation shall not be cause to alter any resulting contract or request additional compensation. Ceres Environmental Services, Inc. Name of Firm Authorized Signature Chief Financial Officer Title February 27, 2017 Date Signed 26 6968 Professional Parkway East Address Sarasota, FL 34240 City, State, Zip Code ( 800 ) 218 - 4424 Phone gail.hanscom@ceresenv.com E-mail HOURLY COST PROPOSAL TO INCLUDE OPERATOR, FUEL AND MAINTENANCE City of Sebastian Bid 17-03 EQUIPMENT HOURLY RATE WHEEL LOADER WITH DEBRIS GRAPPLE or BUCKET (Bucket capacity 2 CY) $125.00 WHEEL LOADER WITH DEBRIS GRAPPLE or BUCKET (Bucket capacity 3 CY) $135.00 WHEEL LOADER WITH DEBRIS GRAPPLE or BUCKET (Bucket capacity 4 CY) $145.00 WHEEL LOADER WITH DEBRIS GRAPPLE or BUCKET (Bucket capacity 5 CY) 158.00 WHEEL LOADER WITH DEBRIS GRAPPLE or BUCKET (Bucket capacity 6 CY) $170.00 WHEEL LOADER WITH DEBRIS GRAPPLE or BUCKET (Bucket capacity 7 CY) $188.00 EXTENDABOOM FORKLIFT WITH DEBRIS GRAPPLE $78.00 SKID STEER LOADER WITH STREET SWEEPER $82.00 SKID STEER LOADER WITH BUCKET or GRAPPLE (Capacity 1000 CY) $77.00 SKID STEER LOADER WITH BUCKET or GRAPPLE (Capacity 2000 CY) 2- 21/2 CY ARTICULATED LOADER WITH BUCKET 30-50 HP FARM TRACTOR WITH BOX BLADE OR RAKE DOZER (75 HP) T.198 no DOZER (105 HP) DOZER (160 HP) 11.95 nn DOZER (250 HP) DOZER (360 HP) MOTOR GRADER (110-150 HP) $168.00 TRACK HOE WITH DEBRIS GRAPPLE $188.00 TRACK HOE WITH BUCKET AND THUMB $184.00 RUBBER TIRED EXCAVATOR WITH DEBRIS GRAPPLE (184 HP) $188.00 RUBBER TIRED EXCAVATOR WITH DEBRIS GRAPPLE (230 HP) $198.00 RUBBER TIRED EXCAVATOR WITH DEBRIS GRAPPLE (238 HP $218.00 SELF LOADER SCRAPER $165.00 HAND FED DEBRIS CHIPPER $105.00 300-400 HP GRINDER $375.00 800-1000 HP GRINDER $455.00 50 TON CRANE $260.00 75 TON CRANE 100 TON CRANE (EIGHT HOURS MINIMUM) 40'-60' BUCKET TRUCK 60' OR GREATER BUCKET TRUCK tigg on FUEL/SERVICE TRUCK WATER TRUCK 2000 GALLON PORTABLE LIGHT PLANT LOWBOY TRAILER WITH TRACTOR $q7 nn FLATBED TRUCK SELF LOADING TRUCK with DEBRIS GRAPPLE & TRAILER $185.00 SELF LOADING DUMP TRUCK & WITH DEBRIS GRAPPLE $168.00 SINGLE AXLE DUMP TRUCK 5-12 CY $77.00 TANDEM AXLE DUMP TRUCK 16-20 CY $79.00 TANDEM AXLE DUMP TRUCK 21-30 CY $82.00 TANDEM AXLE DUMP TRUCK 31-50 CY $85.00 TANDEM AXLE DUMP TRUCK 51-80 CY $89.00 TANDEM AXLE DUMP TRUCK/TRACTOR TRAILER OVER 80 CY $92.00 GENERATOR (25-125 HP) 60 kW $183.44 GENERATOR (240-500 HP) 200 kW $410.45 GENERATOR (500-1000 HP) 400 kW CHAINSAW TEMPORARY ONCE TRAILER (8 ft. x 32 ft. minimum) RESPONSE TRAILER 20' 94s nn RESPONSE TRAILER 36' %5a no PORTABLE TOWER WITH CANOPY (DMS) $19.00 LABORER WITH HAND TOOLS $36.00 FLAGGER/MOT $36.00 SKILLED SAW MAN (TREE TRIMMING) $41.00 CREW FOREMAN WITH TRUCK AND COMMUNICATIONS $56.00 OPERATIONS MANAGER WITH TRUCK AND COMMUNICATIONS $85.00 CLIMBER WITH GEAR 0 * ALL EQUIPMENT DESCRIPTIONS WILL BE IN ACOORDANCE WITH THE FEMA Cost Code for Equipment and Vehicles ** ALL EQUIPMENT RATES INCLUDE THE COST OF THE OPERATOR, FUEL, AND MAINTENANCE UNLESS OTHERWISE NOTED. *** ALL LABOR RATES INCLUDE THE APPLICABLE PERSONAL PROTECTIVE EQUIPMENT SUCH AS HARD HATS, SAFETY SHOES, GLOVES, SAFETY GLASSES/SHIELD, HEARING PROTECTION AND TRAFFIC SAFETY VESTS. DRUG-FREE WORKPLACE FORM The undersigned Contractor, in accordance with Florida Statute 287.087 hereby certifies that Ceres Environmental Services, Inc. does: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance Is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business' policy of maintaining a drug free workplace, any available drug counseling, rehabilitation, employee assistance programs and the penalties that may be Imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under bid a copy of the statement specified in Paragraph 1. 4. In the statement specified in Paragraph 1, notify the employees that, as a condition of working on the commodities or contractual services that the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to any violation of Chapter 1893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. S. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee's community, by any employee who Is so convicted. 5. make a good faith effort to continue to maintain a drug free workplace through implementation of Paragraph 1 through 5. As the person authorized to sign this statement, l certify that this firm complies fully with the above requirements. Date: February 27, 2017 Signature: Ron Nutting, Chief Financial Officer 27 PUBLIC ENTITY CRIMES FORM Any person submitting a quote, bid, or proposal in response to this invitation or Agreement, must execute the enclosed form sworn statement under section 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES, including proper check(s), in the space(s) provided, and enclose it with his quote, bid, or proposal. If you are submitting a quote, bid or proposal on behalf of dealers or suppliers who will ship commodities and receive payment from the resulting Agreement, it is your responsibility to see that copy(ies) of the form are executed by them and are included with your quote, bid, or proposal. Corrections to the form will not be allowed after the quote, bid, or proposal opening time and date. Failure to complete this form in every detail and submit it with your quote, bid, or proposal may result in immediate disqualification of your bid or proposal. The 1989 Florida Legislature passed Senate Bill 458 creating Sections 287.132 - 133, Florida Statutes, effective JUIy 1, 1989. Section 287.132(3)(d), Florida Statutes, requires the Florida Department of General Services to maintain and make available to other political entities a "convicted vendor" list consisting of persons and affiliates who are disqualified from public and purchasing process because they have been found guilty of a public entity crime. A public entity crime is described by Section 287.133, Florida Statutes, as a violation of any State or Federal law by a person with respect to and directly related to the transaction of business with any public entity in Florida or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or Agreement for goods or services to be provided to any public entity or with an agency or political subdivision and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. By law no public entity shall accept any bid from, award any Agreement to, or transact any business in excess of the threshold amount provided in Section 287.017, Florida Statutes, for category two (currently $10,000) with any person or affiliate on the convicted vendor list for a period of 36 months from the date that person or affiliate was placed on the convicted vendor list unless that person or affiliate has been removed from the list pursuant to Section 287.133(3)(f), Florida Statutes. Therefore, effective October 1, 1990, prior to entering into an Agreement (formal Agreement or purchase order) in excess of the threshold amount of $10,000 to provide goods or services to THE CITY OF SEBASTIAN, a person shall file a sworn statement with the Contract/Agreement officer or Purchasing Director, as applicable. The attached statement or affidavit will be the form to be utilized and must be properly signed in the presence of a notary public or other officer authorized to administer oaths and properly executed. THE INCLUSION OF THE SWORN STATEMENT OR AFFIDAVIT SHALL BE SUBMITTED CONCURRENTLY WITH YOUR QUOTE OR BID DOCUMENTS NON-INCLUSION OF THIS DOCUMENT MAY NECESSITATE REJECTION OF YOUR QUOTE OR BID. SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 28 1. This sworn statement is submitted with Bid, Proposal or Agreement No. 17-03 for THE CITY OF SEBASTIAN. 2. This sworn statement is submitted by Ceres Environmental Services, Inc. (name of entity submitting sworn statement) whose business address is 6968 Professional Parkway East, Sarasota, FL 34240 and (if applicable) its Federal Employer Identification (FEIN) is (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: N/A ) 3. My name is Ron Nutting (please print name of individual signing) and my relationship to the entity named above is Chief Financial Officer 4. 1 understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or Agreement for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and Involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 5. 1 understand that "convicted" or "conviction" as defined in Paragraph 287.133(i)(b), Florida Statutes. means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, In any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere. 6. 1 understand that an "affiliate" as defined in Paragraph 287.133(1)(a), Florida Statutes. means: (1) A predecessor or successor of a person convicted of a public entity crime; or (2) An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active In the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 7. 1 understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding Agreement and which bids or applies to bid on Agreements for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, Aolftk employees, members, and agents who are active in management of an entity. 29 8. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. (Please indicate which statement applies.) X Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, nor any affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members or agents who are active in management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989, AND (Please indicate which additional statement applies.) _ There has been a proceeding concerning the conviction before a hearing officer of the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer did not place the person or affiliate on the convicted vendor list. (Please attach a copy of the final order.) _ The person or affiliate was placed on the convicted vendor list. There has been a subsequent proceeding before a hearing officer of the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer determined that it was in the public interest to remove the person or affiliate from the convicted vendor list. (Please attach a copy of the final order.) The person or affiliate has not been placed on the convicted vendor list. (Please describe any action taken by or pending with the Department of General Services.) � ^ Ron Nutting, CFO (Signature) Date:=>l�r?'"1 � r'7 / ✓I I r1r1 i i C4 -1' - STATE OF A COUNTY OF vN The foregoing instrument was acknowledged before me this 27th day of February , 2017 by Chief Financial Officer(title) on behalf of Ceres Environmental Services, Inc. (name of - --S"'-`, ---wneFshi' He/she is personally known to me or has produced corporation as identification and did ( ) did not ( ) take an oath. Name: �41`t't- 4 yyr P . My Commission Expires: t 1-311 a0 Commission Number: Atm M Kemp Notary Public STATE OF NNNESOTA 30 My commission Explres 1/3112620 ``i h® CERTIFICATE OF LIABILITY INSURANCE DA E(MNVDD 8/5/2016 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Christensen Group Insurance 11100 Bran Road West Minnetonka MN 55343 CONTACT Nelly Preston PHONE (952) 653-1000 FAXMIC. Noll (9 52) 653-1101 E-MAILAppgsn-kpreston@christensengroup.com INSURER(S) AFFORDING COVERAGE NAIC0 INSURERA:Old Republic General Insurance 24139 INSURED CERES ENVIRONMENTAL SERVICES, INC. 6968 Professional Pkwy Sarasota FL 34240 INSURER B: INSURER C: INSURER O: NSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER:16-17 - LLAB - FL - REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Iexp LTR TYPE OF INSURANCE L U BR POLICY NUMBER MM/DDr MEFF MIIDDNYYY UNITS A GENERA -LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx—] OCCUR lk5CGI1261600 /18/2016 /18/2017 EACHOCCURRENCE $ 1,000,000 PRM(Ea oaurrence S 300,000 MED EXP (Any one son $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE POLICY UNIT APPLIES PER: RO- Loc X PIFQT PRODUCTS - COMP/OPAGG $ 2,000,000 $ A AUTOMOBILE LIABILITYEa X ANY AUTO ALL OWNED SCHEDULED AlfT05 AUTOS NON -OWNED HIREDAUTOS HAUTOS CA11261600 /18/2016 /18/2017 UMIT 2,000,000 (Ea BODI LY INJURY (Per Person) $ BODILY INJURY IF" aaidmt) S PROPERTY DAMAGE S Pwacadent S UMBRELLA LIAR EXCESS LIAB O�DR CLAIMS -MADE EACHOCCURRENCE $ AGGREGATE $ DED I I RETENTIONS Is A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOIVPARTNERIEXECUTIVE Y� OFFICERAIEMSER EXCLUDED? (Mandatoryin NH) If Yes, describe under DESCRIPTION OF OPERATIONS Del o.Y MIA CW11261600 /18/2016 /18/2017 y WC STATU- OTH- E.L EACH ACCIDENT S 1,000,000 E.L DISEASE - EA EMPLOYE S 1,000,00 E.L DISEASE - POLICY UMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AMach ACORD 101, AddRional Remarks Schedule, If mora apace Is mquimd) City of Sebastian is included as an Additional Insured under the Cosuaercial General Liability 6 Auto Liability when required by written contract. City of Sebastian City Hall 1225 Main Street Sebastian, FL 32958 ACORD 25 (2010105) INS025 (zotol5)c1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. EulrmlrTgrra�sixad, Valr�� Tyler Simmons/KP The ACORD name and logo are registered marks of ACORD CORPORATION. All rights reserved. FormW'9 Social secudty number Request for Taxpayer Give Form to the (Rev. Dagember 2o,4) Identification Number and Certification entities, it is your employer identification number (EIN). If you do not have a number, see How to get a requester. Do not ry send to the IRS. Nl��d Revenwsenze 1 Name in shown on your Income tax return). Name Is required on this line; do not leave this line blank. Ceres Environmental Services, Inc. a 2 Business name/dieregerded entity name. If different from above m res m a 3 Check appropriate hoz for letlerei lax classification; check only one of the following seven boxes: 4 Exemptions (catles apply only to m ❑ Indwiduagsols proprietor or ❑ C Corporation ❑! S Corporation ❑ Pad..hip ❑ Tmegedffie certain entities, not individuals; see m c single -member LLC Instructions on page 3): i❑ Limited liability compairy. Enter the lax classification (C•C corporation, S=3 corporation, P=pertnershlp) 10Exempt Payee code Of any) p Note. Fora single -member ULC that Is disregarded, do not check LLC; check the appropriate box in the licca above for Exemption from FATCA reporting the taz claseUicetion of the single -member owner. code Of any) 0 ❑ otter One Instructions) ► fAwro m.m•memvt.eax.e. s. usJ � 6 Address (number, street, and apt. or wile no.) Requester's name and address (optbnag u n 3625 85th Avenue North a e Cay, state, and ZIP code m Brooklyn Park, MN 55443 7 Lid account numbegs) here(optional) JEM Tax ayer Identification Number IN Enter your TIN In the appropriate box. The TIN provided must match the name given on line 1 to avoid Social secudty number backup withholding. For Individuals, this Is generally your social security number (SSN). However, fora resident alien, sole proprietor, or disregarded entity, see the Part I Instructions on page 3. For other - m - entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TW on page 3. Or Note. If the account is In more than one name, see the Instructions for line 1 and the chart on page 4 for I Employer Identification number guidelines on whose number to enter. 1. The number shown on this form Is my correct taxpayer identfcation number (or I am waiting for a number to be Issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, m (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (If any) Indicating that 1 am exempt from FATCA reporting is correct. Ceriification Instructions. You must cross out hem 2 above if you have been notified by the IRS that you are curren0y subject to backup withholding because you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid, acquisition or abandonment of secured property, cancellation of debt, cordributions to an Individual retirement arrangement (IRA), and generally, payments other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the Here I LJ.S ppwzon►G� Y`/` Darts / /14 -Il y General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release It) Is at www.tis.gov1W. Purpose of Form An Individual or an* (Form W-9 requester) who is required to file an Information return with the IRS must obtain your correct taxpayer Identifikation number (RN) which may be your social security number (SSN), Individual taxpayer Identification number (mM, selection taxpayer Identification number (ATIr), or employer Identification number (EIM, to report on an Information return the amount paid to you, or other amount reportable on an Marmation return. Examples of Information returns Include, but are nrt limited to, the following: • Form 1099 -INT (interest earned or paid) • Farm 1099 -ON (dividends, intruding those from stocks or mutual funds) • Farm 1099-MISC (sad Ws types of imoome, prizes, awards, or gross proceeds) • Form 1099-5 (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1099 (lame mortgage Interest), 1096-E (student ban Interest). 1098-T (tultlon) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form WA only If you are a US. person (ncludlog a resident alien), to provide your certactTIN. ¢you do not return Fomr W-9 W the requester with a 7IN, you migm be subject to baeary witMaMing. See What Is backup wdhhofO g? on papa 2. By signing the 9sed-out forth, you: 1. Certify that the TIN you we giving is correct (fir you are waiting for a number to be Issuar0, 2. Certify that you we not subject W backup withholding. or 3. Claim exemption from backup withholding If you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business Is net subject to the withholding hex on foreign partners'share of effectively connected Income, and 4. Certify that FATCA ccde(s) entered on this form (it any) Indicating that you are exempt from the FATCA reporting, h correct. See What Is FATC4 reportkfg? on page 2 for further Information. Cal, No. 10231X Form W-bl Rev. 12-2014)