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HomeMy WebLinkAbout10-0061 h t' t New Hanover County Contract #10-0061 NORTH CAROLINA AGREEMENT NEW HANOVER COUNTY THIS CONTRACT made and entered into this )03. day of U~~ ~i y Sk , 2009, by and between NEW HANOVER COUNTY, a political subdivision of the State of North Carolina, hereinafter referred to as "County"; and JETCLEAN AMERICA, a Florida entity, hereinafter referred to as "Contractor". WITNESSETH: WHEREAS, County secured informal bids for Leachate line jetting/cleaning for the Landfill Facility of the Environmental Department, and bids were received required by law; and WHEREAS, after careful consideration of the bid proposal submitted by Contractor, the County has authorized the acceptance of such bid proposal and the execution of a contract with Contractor covering leachate line jetting/cleaning. NOW, THEREFORE, in consideration of the mutual benefits inuring to the parties hereto, said parties covenant and agree as follows: 1. Performance. Contractor shall perform all work for the project generally described as: the jetting/cleaning and explosion proof pipeline video inspection of the leachate force main from the 3B/4A pump station to Cell 5 pump station. The Bid Package, which includes County's Technical Specifications, Invitation to Bid and Instructions to Bidders, marked ; and Contractor's Bid Proposal, marked Page 1 of 40 dm 70070200 700000 ORIGINAL New Hanover County Contract #10-0061 Exhibit A; are attached hereto and made a part of this contract as though fully written herein. Contractor shall also provide all labor, tools, and safety equipment to perform the work required. Daily progress reports will be given to the Project Manager, Andrew Mulvey. Safety briefings will be required between the employed contractors and the Project Manager and the Safety Officer regarding any and all work prior to commencing said project. 2. Term. This contract shall begin upon Notice to Proceed and shall end within five (5) days the Notice to Proceed or when all funds have been depleted. 3. Payment . The total contract amount shall not exceed the sum of Twenty Thousand ($20,000) Dollars. Payment shall be made within thirty (30) days after completion of service, acceptance of work by County and receipt of invoice. 4. Indemnity. Contractor shall indemnify and hold New Hanover County, its agents and employees, harmless against any and all claims, demands, causes of action, or other liability, including attorney fees, on account of personal injuries or death or on account of property damages arising out of or relating to the work to be performed by Contractor hereunder, resulting from the negligence of or the willful act or omission of Contractor, his agents, employees and subcontractors. 5. Insurance. Contractor shall maintain insurance from companies licensed to write business in North Carolina, with an A.M. Best rating of "A" or higher, and acceptable to New Hanover County, of the kinds and minimum amounts specified below. Page 2 of 40 dm 1 New Hanover County Contract #10-0061 6. Certificates and Notice of Cancellation. Before commencing work under this contract, Contractor shall furnish County with certificates of all insurance required below. Certificates shall indicate the type, amount, class of operations covered, effective date and expiration date of all policies, applicable deductions and self-insured retentions and shall contain the following statement: The insurance covered by this certificate will not be canceled or materially altered, except after thirty (30) days written notice has been received by County. The Certificate of Insurance, naming New Hanover County as an additional insured, shall be further evidenced by an actual endorsement furnished to the County from the insurer within thirty (30) days of the signing of the contract between the Contractor and the County. 7. Workers Compensation and Employers Liability Insurance. Covering all of the Contractor's employees to be engaged in the work under this contract, providing the required statutory benefits under North Carolina Workers Compensation Law, and employer's liability insurance providing limits at least in the amount of $500,000/500,000/500,000 applicable to claims due to bodily injury by accident or disease. 8. Commercial General Liability. Including coverage for independent contractor operations, contractual liability assumed under the provisions of this contract, products/completed operations liability and broad form property damage liability insurance coverage. Exclusions applicable to explosion, collapse and underground hazards are to be deleted when the work involves these exposures. The policy shall provide liability limits at least in the amount of $1,000,000 per occurrence, Page 3 of 40 dm e New Hanover County Contract # 10-0061 $2,000,000 aggregate, combined single limits, applicable to claims due to bodily injury and/or property damage. New Hanover County shall be named as an additional insured under this policy. 9. Automobile Liability Insurance. Covering all owned, non-owned and hired vehicles, providing liability limits at least in the amount of $1,000,000 per occurrence combined single limits applicable to claims due to bodily injury and/or property damage. 10. Umbrella Liability Insurance. Providing coverage as excess above the underlying Commercial General Liability Insurance, Automobile Liability Insurance, Employers Liability Insurance and policies required by this Contract. This coverage shall provide excess liability limits at least in the amount of $1,000,000 per occurrence, combined single limits, applicable to claims arising from bodily injury, personal injury and/or property damage. The parties named as additional insureds under the primary underlying policies are to be included as additional insureds under the Umbrella Liability Insurance coverage. 11. Contractor's Warranties. Contractor makes the following warranties concerning the materials, equipment and work furnished pursuant to this contract. 11.1. Warranty of Title. Contractor warrants that title to all work, materials and equipment covered by a request for payment, whether incorporated in the project or not, will have passed to County prior to the submission of the request for payment, free and clear of all liens, claims, security interests and encumbrances. Page 4 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 11.2 Warranty of Work. Contractor warrants that the work and services to be performed under this contract shall be free from defects in workmanship and material. Should any failure to conform to this warranty arise within one (1) year from date of County acceptance of work and services, Contractor shall, correct such nonconformity by repair or, at its options, by replacement of such defective item at no cost to the customer. Contractor shall not be responsible for the cost of removing and replacing defective items which can be isolated and replacing using normal troubleshooting and maintenance procedures. Contractor shall not be responsible for the costs or removal or installation of any item not supplied by Contractor. The effects of corrosion, erosion, aging and normal wear are specifically excluded from this warranty. 11.3. Correction of Defects. County shall give Contractor reasonably prompt written notice of all observable defects. If Contractor fails to perform corrective work within three (3) days after receipt of notice, County may perform such work and charge Contractor for the costs thereby incurred. 12. Termination. 12.1 Default. If Contractor fails to prosecute the work with such diligence as will ensure its completion within the contract time, or if Contractor materially breaches any one of the terms or conditions contained in this contract and fails to cure said breach within three (3) days of County's mailing of Notice of Default or otherwise fails to perform the work hereunder to the County's reasonable satisfaction, County may terminate this contract forthwith. Upon termination, County may, without prejudice to an Page 5 of 40 New Hanover County Contract # 10-0061 action for damages or any other remedy, enter into another contract for the completion of this contract. County may deduct all costs of completing the contract from any monies due or which may become due to Contractor. 12.2 Termination for Convenience. County may terminate this Contract for convenience at any time and without cause. Upon receipt of notice, Contractor shall immediately discontinue the work and placing of orders for materials, facilities and supplies in connection with the performance of this Contract. 12.3 Non-appropriation. All funds for payment by the County under this contract are subject to the availability of any annual appropriation for this purpose by the Board of Commissioners. In the event of non-appropriation of funds by the Board of Commissioners for the services provided under the contract, the County will terminate the contract, without termination charge or liability, on the last day of the then- current fiscal year or when the appropriation made for then-current year for the services/items covered by this contract is spent, whichever occurs first. If at any time funds are not appropriated for the continuance of this contract, cancellation shall be accepted by the Contractor on thirty (30) days' prior written notice, but failure to give such notice shall be of no effect and the County shall not be obligated under this contract beyond the date of termination. 12.4. This agreement may be terminated without cause by either party with thirty (30) days written notice to the other party. 13. Non-Waiver of Rights. It is agreed that County's failure to insist upon the strict performance of any provision of this contract or to exercise any right Page 6 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 based upon a breach thereof, or the acceptance of any performance during such breach, shall not constitute a waiver of any rights under this contract. 14. Subcontractors. Contractor shall be fully responsible for all negligent acts and omissions of his or her subcontractors and of persons and organizations employed by them to the same extent that Contractor would be responsible for these acts and omissions. Nothing in the contract documents shall create any contractual relationship between County and any subcontractor or other person or organization having a direct contract with Contractor, nor shall it create any obligation on the part of County to pay any money due any such subcontractor or other person or organization, except as may otherwise be required by law. 15. Assignment. The parties mutually agree that this contract is not assignable and shall not be assigned by either party without the written consent of the other party and the surety to this contract. 16. Non-Discrimination. Contractor will take affirmative action not to discriminate against any employee or applicant for employment or otherwise illegally deny any person participation in or the benefits of the project which is the subject of this contract because of age, race, creed, color, sex, age, disability or national origin. To the extent applicable, Contractor will comply with all provisions of Executive Order No. 11246, the Civil Rights Acts of 1964 (P.L. 88-352) and 1968 (P.L. 90-284), and all applicable Federal, State and local laws, ordinances, rules, regulations, orders, instructions, designations and other directives promulgated to prohibit discriminations. Violation of this provision, after notice, shall be a material breach of this agreement and Page 7 of 40 New Hanover County Contract # 10-0061 may result, at County's option, in a termination or suspension of this agreement in whole or in part. 17. Familiarity with Laws. The Contractor specifically acknowledges that he has made himself familiar with all Federal, State and local laws, ordinances, rules and regulations, including all Federal and State Occupational Safety and Health Act (OSHA) requirements, which may in any manner affect those engaged or employed in the work of the project, or the materials or equipment in or about such work, or in any way affect the conduct of such work and agrees that he, his employees, subcontractors and suppliers will, at all times, comply with same. If the Contractor shall discover any provisions in the Contract Documents which are contrary to or inconsistent with any such law ordinance, rule or regulation, he shall immediately give notice thereof to the County in writing, identifying any items of work affected, and he shall not proceed until he has received written direction from the County with respect to these items. If the Contractor performs contrary to or inconsistently with any such law ordinance rule or regulation without giving such notice, he shall bear all costs which area consequence of such performance. 18. Notices. All notices required hereunder to be sent to either party shall be sent to the following designated addresses, or to such other address or addresses as may hereafter be designated by either party by mailing of written notice of such change of address, by Certified Mail, Return Receipt Requested: Page 8 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 To County: New Hanover County Environmental Management Attention: Andrew Mulvey, Project Manager 3002 Highway 421 North Wilmington, NC 28401 To Contractor: Jetclean America Attn: Ralph Calistri 19019 Fern Meadows Loop Lutz, FL 33558 19. Independent Contractor. It is mutually understood and agreed that Contractor is an independent contractor and not an agent of County, and as such, Contractor, his or her agents and employees shall not be entitled to any County employment benefits, such as, but not limited to, vacation, sick leave, insurance, worker's compensation, or pension or retirement benefits. 20. Interpretation. All of the terms and conditions contained in the contract documents shall be interpreted in accordance with the laws of the State of North Carolina. 21. Entire Understanding. This contract constitutes the entire understanding of the parties and contains all of the terms agreed upon with respect to the subject matter hereof. No modification or rescission of this contract shall be effective unless evidenced by a signed writing. IN WITNESS WHEREOF, the parties have caused the execution of this instrument, by authority duly given on the day and year first above written. Page 9 of 40 New Hanover County Contract # 10-0061 NEW HANOVER COLIN [SEAL]N,tio o~ Py - 4 County Manager ATT S 3 n 2 Clerk to th ' JetClean America [SEAL] c~SHED By: ATTEST: Secretary This instrument has been pre- audited in the manner required by the Local Government Budget an Fiscal Control Act. pproved as to form: , 4o3un&-tyyFF~irn an Director County Attorney NORTH CAROLINA NEW HANOVER COUNTY I, 6qo"q~6. OYDWell, a Notary Public of the State and County aforesaid, ce ify that eila L. Schult personally came before me this day and acknowledged that she is Clerk to the Board of County Commissioners of New Hanover County, and that by authority duly given and as the act of the Board, the foregoing instrument was signed in its name by its Manager, sealed with its official seal and attested by herself as its Clerk. WITNESS my hand and official seal, this day of~ 2009. 0 met ogh G. C, 0"'d v'RY N Mary Public My commission eipire§Qmm. Expires y~ VUBLiC;ic,`` ' Page 10 of 40 Hanovejdm 70080200 700000 "t, New Hanover County Contract # 10-0061 STATE OF / COUNTY OF I, J a Notary Public of the State and County aforesaid, ce ify that personally came before me this da and acknowledged that (s)he is -8erre4erry Mb'S pi~~ J2~-c \e n me-r i , a Florida entity, and that by authority duly given and as the act of the the foregoing instrument was signed in its name by its President, , sealed with its official seal and attested by himself/herself as its Seery "13 ,-Tcc4'a f' WITNESS my hand and official seal, this day of , 2009. lie MYCHELL R. ROBINSO My commission expires: : p,iyc %iISSIONODD72C760 lw ~ ~ E ,Pri Feh,•ary t EU`~ ; ~+`al a r7f, to S rare WUt;; u egrw r< . Page 11 of 40 New Hanover County Contract # 10-0061 Exhibit A Leachate line high pressure jetting/cleaning and explosion-proof pipeline video- inspection at the New Hanover County Secure Landfill Division I 1.1 Project Description: The project generally consists of the jetting/cleaning and explosion-proof pipeline video-inspection of the leachate force main from the 3B/4A pump station to Cell 5 pump station. 1.2 Existinq Conditions: It is the responsibility of the contractor, to thoroughly investigate the site, inspect the existing conditions of the leachate lines, and clearly understand all the equipment necessary to perform the above mentioned work. The contractor is fully prepared to sustain all losses and damages incurred; is fully prepared to provide all necessary tools, equipment, labor and materials to successfully complete the work. 1.3 Project Closeout: The contractor shall at all times keep the site clean of excess debris caused by the contractor during the project. After completion of the work, the contractor shall remove all debris and rubbish from the site and have it disposed of in a safe and proper manner. Division II 2.1 Leachate line Jetting/cleaning and explosion-proof pipeline video-inspection: The contractor shall, upon notification to proceed, provide the following: 2.2 Leachate jetting/cleaning of the leachate forcemain from the 3B/4A pump station to Cell 5 pump station. 2.3 Leachate jetting/cleaning of the leachate forcemain from the 3B/4A pump station to Cell 5 pump station. 2.4 Leachate cleanouts and leachate forcemain will be video inspected after jetting/cleaning is complete. A report and DVD of the leachate line inspection will be provided to the New Hanover County landfill within two weeks of project completion. Page 12 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 2.5 Leachate cleanouts and leachate forcemain will be jetted/cleaned first via the use of 10,000 psi water-jetting equipment with the water and dislodged solids removed from 3B/4A manhole using a vacuum truck. 2.6 Leachate cleanouts and leachate forcemain will be inspected using either a tractor driven camera system or a rigid push-rod system. 2.7 Contractor shall follow all rules and regulations set forth in the New Hanover County Department of Environmental Management Contractor Compliance Requirements. Contractor must sign and date page 30 of this contract before project start up. Division III 2.8 Rates for Time and Material as of July 13, 2009 • 10,000 PSI pipe jetting equipment, explosion-proof pipeline video-inspection equipment, and operator(s) - $4440.00/day. • One-time mobilization/demobilization of the above equipment- $1,250.00. • Vacuum truck- $1950.00/day if/when needed. • Day-rate covers up to 8 hours. • Total cost of the project not to exceed $20,000.00. • No charges of any kind will be allowable beyond the stated price limitation. C o prov; e. ~a ~ 4 -F(0LJ 447 AO Pr fy) e F cct 01 'boQ- w 4, t ILL Fe'Q Md Page 13 of 40 New Hanover County Contract # 10-0061 COUNTY NEw HANOVER CONTRACTOR COMPLIANCE REQUIREMENTS Page 14 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 TABLE OF CONTENTS DE$C Introduction Statement of Purpose 3 1.0 General Contractor Guidelines 4 2.0 Safety Training Options 6 3.0 Standards of Conduct 7 4.0 Hot Work Supplement for Contractors 8 5.0 Personal Protective Equipment 9 6.0 Hazard Communications (HAZCOM) 12 7.0 Lockout/Ta out 13 8.0 Electrical Safety Supplement for Contractors 14 9.0 Contractor Agreement Form 18 APPENDIX A DEM Inspection Forms and Non-Routine Work Permits 18-27 Page 15 of 40 New Hanover County Contract # 10-0061 INTRODUCTION The personal safety and health of each employee of the New Hanover County, Department of Environmental Management is of primary importance. The prevention of occupationally induced injuries and illnesses is of such consequence that it will be given precedence over operating productivity whenever necessary. Our goal is to maintain a safety and health program conforming to all applicable OSHA standards and to be a leader in safety program management within our industry. To be successful, it will require cooperation to all safety and health matters. Only through such cooperation can a safety program be established and preserved. The following contractor safety and health rules, when applied properly and used with good common sense will assure smooth workflow, high quality results, and aid in the safety effort. In turn, this will result in reduced possibilities of injury to you, other employees, or the public and, furthermore, will reduce the possibility of avoidable damage to any equipment or property. It is not possible to detail all of the situations or to provide precise guidance for every contingency employee can encounter in the course of their work or off-the-job activities. However, close adherence to the rules and the desire to apply good sense to all actions will yield the best possible safety results. It is your responsibility to act so as to provide: a. Safety to yourself b. Safety to your co-workers c. Protection to the public; and d. Protection to property You are expected as part of your job, to take an active part in the DEM Safety Program and apply it in your everyday work. 1.0 GUIDELINES A. All contractors and sub-contractors shall furnish the New Hanover County, Department of Environmental Management with a copy of the following certificates: ♦ WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE: Covering all of the Contractor's employees to be engaged in the work under this contract, providing the required statutory benefits under NC Workers' Compensation Law and Employers' Liability Insurance providing limits in the amount of $500,000/500,000/500,000. Page 16 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 ♦ COMMERICIAL GENERAL LIABILITY: Including coverage for independent contractor operations, contractual liability assumed under the provisions of this contract, products/completed operations liability and broad from property damage liability insurance coverage. Exclusions applicable to explosion, collapse and underground hazards are to be deleted when the work involves these exposures. The policy shall provide liability limits at least in the amount of $1,000,000/occurrence, $2,000,000 aggregate combined single limits, applicable to claims due to bodily injury and/or property damage. New Hanover County shall be named as an additional insured under this policy. ♦ AUTOMOBILE LIABILITY INSURANCE: Covering all owned, non-owned and hired vehicles, providing liability limits at least in the amount of $1,000,000/occurrence combined single limits applicable to claims due to bodily injury and/or property damage. B. The contractor agrees to hold DEM harmless in the event of an accident or injury to one of his employees or damage to his property regardless of which party may be at fault. C. The contractor must have a competent individual in charge at the job site to supervise the job and conduct an adequate accident prevention program. D. At all times when non-routine work is being performed, the contractor must obtain a non-routine work permit. The non-routine permit can be obtained from the shift supervisor, maintenance foremen, maintenance manager, or safety manager. E. All contractor employees must abide by DEM General Safety Rules and Regulations at all times. F. All accidents must be reported immediately to the Project Manager or Safety Manager. G. Contractor employees are not to enter other areas of the plant unless it is required for the performance of their job. H. It is the responsibility of the contractor to inform management of any known hazardous condition that may exist due to the contract work being done in the areas where departmental employees may be exposed to the known hazards. 1. It is the responsibility of DEM to hold a pre-construction operation and safety briefing with the contractor before any work is to begin. Page 17 of 40 New Hanover County Contract # 10-0061 J. Periodic job site inspections are to be done by a departmental representative to see that the job is proceeding safely and according to the agreement. K. Contract personnel are to check in and out of the department's premises on a daily basis. L. It is the responsibility of the contractor to review the confined space information supplied by DEM before entering confined spaces to perform work on DEM property and comply with 29 CFR 1910.146. M. It is the responsibility of the contractor to review the lockout/tagout information supplied by DEM before performing work that requires the locking or tagging out of any type of energy source and comply with 29 CFR 1910.147. N. It is the responsibility of the contractor to review the hazard communication program supplied by DEM before performing any work on DEM property and comply with 29 CFR 1910.1200. 0. It is the responsibility of the contractor to provide Material Safety Data Sheets for all containers of hazardous substances brought on DEM property. P. It is the responsibility of the contractor to make sure all his employees comply with the DEM Personal Protective Equipment (PPE) policy at all times. Q. It is the responsibility of the contractor to make sure all his employees comply with the DEM Hot Work policy at all times. R. The contractor understands that violating these rules will lead to his/her immediate dismissal. S. The contractor understands that a waiver form must be signed to use any New Hanover County equipment. 2.0 CONTRACTOR SAF I s Y TRAi ; iJ:tG OPTIONS Option A The job site and construction procedures used by the contractor and/or contractor employees shall meet OSHA compliance found at 29 CFR 1910 and 1926 at all times. It Page 18 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 is the duty of the contractor to submit training records for the following programs that are marked with a (X). Lockout/Tagout Confined Space Entry Respiratory Protection Hazard Communication MSDS Submittal (if applicable) Fire Prevention and Protection (i.e. Fire Extinguishers) Fall Protection Scaffolding Powered Industrial Trucks Ladders Personal Protective Equipment Welding, Cutting & Brazing Electrical Trenching/Excavation X Other(s): Complete Safety Manual Option B In lieu of submitting valid training records the contractor may present a valid Wilmington Area Contractors Safety Council (WACSC) Card. The WACSC Contractors class covers job safety and health guidelines that are necessary to be familiar with before working at DEM. Option C (Department of Corrections Only) Before any inmate or DOC Supervisor may begin work at the Department of Environmental management, they must attend the DEM Safety Orientation. The DEM safety orientation provides valuable information concerning the hazards that may be present at the New Hanover County Landfill and WASTEC. 3.0 STANDARDS OF CONDUCT The Department of Environmental Management has established these Standards of Conduct to ensure the smooth and efficient operations of the Department and your job. Violation of these standards is serious and will subject the employee to disciplinary action including the possibility of immediate discharge. Page 19 of 40 New Hanover County Contract # 10-0061 A. Willful damage of any departmental property or the property of other employees. B. Possession, use or distribution of alcohol, narcotics, or illegal drugs on department property. C. The possession of firearms, ammunition, concealed weapons, or explosives, unless properly authorized. D. Abusive or threatening language, fighting, or interfering with fellow employee(s), supervisor's or manager's job. E. Stealing or attempting to steal from fellow DEM employee(s) or the department. F. Refusal to perform assigned duties or to obey instructions. G. Sleeping on the job is forbidden. H. Negligence or conduct which could result in injury to themselves or another person or damage to department property. 1. Use of profane language. J. Falsifying any documents. 4.0 HOT WORK All contractors must obtain a hot work permit before beginning any welding, cutting, or brazing work. The hot work permit may be obtained by contacting the Maintenance Manager, Safety Manager, Maintenance Supervisor, or Shift Supervisor. The following checklist must be completed before a hot work permit is issued. 1. The location, where the work is to be done, has been personally examined by the Maintenance Manager, Safety Manager, Maintenance Supervisor, or Shift Supervisor. 2. Overhead sprinklers, where provided, are in service and will not be taken out of service until work has been completed. 3. There is no flammable dust, vapors, liquids, or unpurged tanks or equipment previously containing such materials in the area. 4. The work will be confined to the area or equipment specified in the permit. Page 20 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 5. The contractor has provided ample portable extinguisher(s). 6. All combustibles will be moved 35 feet from the cutting or welding area that can be moved and the remainder will be protected with welding curtains, flame proof blankets, or metal guards (provided by the contractor). 7. Responsible personnel have been assigned to watch for dangerous sparks in the area, as well as the floors above and below. 8. The contractor will provide a flash curtain where work is being performed in an area where other employees will be working or passing by. 5.0 PERSONAL P,,:.; LCTIVE EOI..~` -E} Personal Protective Equipment (PPE) will be required and must be used in all areas where the job or operation performed or the location is a hazard to the health and safety of the employee. The department has conducted a personal protective equipment assessment which is available for review. The following are examples where personal protective equipment may be required. NOTE: Any employee that reports to work without his or her personal protective equipment will not be allowed to perform work without first obtaining the proper protective equipment. Head Protection 1. Head Protection shall be worn: ♦ In the plant ♦ Outside the plant 2. Department issued hard hats are not to be drilled or cut. This may result in weakening the mechanical strength and dielectric strength of a hard hat. 3. Hard hats shall be worn with the brim positioned to the front. The wearing of baseball caps under the hard hat invalidates the integrity of the suspension and shall not be worn. (Note: Maintenance personnel who use a grinding or cutting/welding shield may wear their hat backwards if the suspension is adjusted accordingly). 4. It is the individual's responsibility to inspect the hat and the suspension prior to each use. If either is found defective, it shall be replaced without delay. Page 21 of 40 r New Hanover County Contract # 10-0061 5. Only approved Department decals and the employee's name will be permitted on a hard hat. When an employee's name is on the hard hat, it shall be produced on a non-conducting material. No other method is allowed or acceptable. 6. All head protection shall meet ANSI Z89.1 approval. Eye Protection 1. Departmental eye protection consists of safety glasses, goggles, and face shields. 2. All protective eyewear will meet ANSI Z87.1 - 1994. 3. Eye protection will be worn in the following areas: ♦ All WASTEC facilities, except for the control room, restrooms, and offices. ♦ When working on the NHC Landfill. 4. A pair of goggles with a faceshield or a combination goggle-faceshield shall be worn when doing the following jobs: ♦ Handling chemicals ♦ Servicing storage batteries ♦ Grinding ♦ Chipping ♦ Drilling ♦ Chiseling ♦ Soldering ♦ Breaking concrete 5. Any employee whose eyes may be exposed to electric arc while assisting a welder shall wear eye protection equivalent to that of the welder. Foot Protection 1. No open toed shoes are allowed in the plant area. 2. All employees performing work at WASTEC will be required to wear ANSI Z41 - 1991 approved steel-toed work boots or shoes. Page 22 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 Respiratory Protection 1. Disposable Dust/Mist masks are available for voluntary use. 2. No employee shall don a negative or positive pressure respirator without being properly trained, fit tested, and have a current medical evaluation on file (by assignment only). 3. All assigned respirators shall be clean and maintained monthly. 4. Refer to the following respiratory protection assesment for information concerning where contractor's may be required to wear respiratory protection. Hand Protection 1. Appropriate hand protection shall be worn when employee's hands are exposed to hazards such as skin absorption of harmful substances, severe cuts or lacerations, punctures, chemical burns, thermal burns, and harmful temperature extremes. Ear Protection 1. Hearing protection will be required and used by any employee who is performing work in any hearing protection required area of the plant. These areas have been identified and a mark as such, HEARING PROTECTION REQUIRED. Fall Protection 1. Fall protection is required for work performed at heights six (6) feet of greater. At no time will an employee be exposed to the potential of a fall exceeding six feet without required fall protection. 2. Full body harnesses and shock absorbent lanyards meeting OSHA standards shall be used by employees. Safety belts and regular lanyards are not acceptable. 3. Appropriate work platforms with standard guardrails or the use of an interior and exterior safety nets which remove such fall exposures shall be considered adequate substitutes. 4. Full body harnesses and shock absorbent lanyards are to be inspected by a DEM representative prior to any work beginning. A sample copy of this inspection form can be found in Appendix A. Page 23 of 40 New Hanover County Contract # 10-0061 6.0 HAZARD COMMUNICATION F~:::~ ARV, ,Tl~t ~rd ) Like many industries, the Department of Environmental Management is subject to the Hazard Commination Standard, found at 29 CFR 1910.1200; therefore, all contractors and contract employees must comply with this standard when working on DEM property. The department has a written HAZCOM program, maintains a current chemical inventory, and material safety data sheets (MSDS), and trains our employees according to the requirements of the standard. DEM will make available to all contractors our written program, chemical inventory list, and material safety data sheets. Contractors must train their employees concerning the standard and inform these employees of the following when they are performing work on DEM property. ♦ How to read and understand a MSDS. ♦ Where the DEM MSDS book is kept. ♦ Where chemicals are stored. ♦ What chemicals are located in the area they are working? ♦ Apprise them of any dangers to them or other employees. NOTE. If a contractor is bringing any chemicals on-site they must supply the DEM Safety Director with the applicable MSDS. 7.0 LOCKOUT/TA`s e .JT DEM has a written lockout/tagout program that establishes the minimum requirements for the lockout or tagout of all energy isolating devices. It shall be used to ensure that the machines or equipment are isolated for all potentially hazardous energy, and locked out or tagged out before employees perform any servicing or maintenance activities where the unexpected energization, start-up or release of stored energy could cause injury. We require that all work being performed on any hazardous energy source be in compliance with 1910.147 and the DEM written lockout/tagout program. Before performing any work on DEM property, contractors and contract employees must: Page 24 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 ♦ Provide the DEM Safety Manager with valid training records (within the last 12 months) or a valid WACSC card. ♦ Have all trained contract employees who will be involved in the job familiarize themselves with the DEM lockout/tagout procedures (DEM pre-construction meeting). ♦ Ensure that all trained contract employees have the necessary approved lockout/tagout devices. Each of the contractor's employees must have their own lockout locks. These locks must be clearly marked with the employee's name. 8.0 ELECTRICAL SAFETY-BELATED WORK PRACTICES Safety-related work practices covered by the electrical safety program include persons working on, near or with the following installations: ♦ Premises wiring: Installations of electric conductors and equipment within or on building or other structures, and on other premises such as yards, parking, and other lots, and industrial substations. ♦ Wiring for connection to supply: Installation of conductors on the premises. ♦ Other wiring: Installations of other outside conductors on the premises. Contractors must provide minimum training to qualified contract employees who are permitted to work on or near exposed parts and be familiar with the following: ♦ The skills and techniques necessary to distinguish exposed live parts from other parts of the electric equipment. ♦ The skills and techniques necessary to determine the nominal voltage of exposed live parts. ♦ The clearance distance specified for working on or near energized parts and the corresponding voltages to which the qualified contractor employee will be exposed. Qualified contract employees whose work on energized equipment involves either direct contact or contact by means of tools or material also must be trained concerning: ♦ The capability of working safely on energized circuits. ♦ Be familiar with the proper use of special precautionary techniques. Page 25 of 40 New Hanover County Contract # 10-0061 ♦ Required personal protective equipment. ♦ Insulating and shielding materials, and insulated tools. Unqualified contract employee whose work may place them in an area where electrical work is being performed must be advised of the following: ♦ Where the work is being performed. ♦ The type of work being performed. ♦ How to distinguish lockout/tagout devices. ♦ What the hazards are and how to avoid them. ♦ Any personal protective equipment they may be required to wear. DEM will require a copy of the contractor's electrical safety-related work practices program before we will allow a contractor to perform any work on our property. The contractor must do the following: ♦ Follow the lockout/tagout standard while performing any electrical work on DEM property. ♦ Provide training records or valid WACSC card for qualified and unqualified contract employees if requested. ♦ Provide contract employees with the proper insulated equipment to perform the assigned task. ♦ Provide the contract employees with the proper personal protective equipment. ♦ Perform work in such a manner so as to not expose DEM employees to any hazard. ♦ If the contractor and DEM employees are working on the same project coordinate with the activities to be performed so neither are endangered by the other group's work. ♦ Have a valid CPR card from an established training agency (i.e. American Red Cross). SECTION 9.0 F k~_~ jROTECTION/E~r .-k%;1ENCY EVACUATION Page 26 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 1. The emergency alarm/announcement method shall be: ♦ Fire Alarm ♦ Sprinkler System ♦ Paging System ♦ Voice Command 2. Upon discovery of a minor fire (incipient stage or a fire which can be contained by a portable fire extinguisher): ♦ Pull the fire alarm. ♦ Report the fire to your supervisor. ♦ Alert others in the immediate area. ♦ Use the nearest portable fire extinguisher, if safe to do so and you have been trained. 3. Upon discovery of a major fire: ♦ Pull the fire alarm. ♦ Report the fire to your supervisor (supervisor call 911) ♦ Evacuate the area immediately. In the event of an evacuation: ♦ Do not panic. ♦ Shutdown equipment, if possible. ♦ Proceed to the nearest EXIT. ♦ Report to the DEM front gate. 4. Flammable and combustible liquids shall be dispensed by a pump or self-closing valve. 5. Never leave open containers of flammable or combustible liquids, oily and/or greasy rags in the Plant. 6. Flammable or combustible liquids shall be stored in appropriate closed containers or tanks. All containers of flammable or combustible liquids are to be properly labeled to indicate their contents. 7. As soon as fire extinguishers have been used, they shall be returned to the Materials Building for recharging and temporary replacement extinguishers put back in place Page 27 of 40 New Hanover County Contract # 10-0061 8. No material, equipment, or tools are to be stored in any location which blocks or obstructs free access to any fire-fighting equipment and its use. 9. No material, equipment, or tools are to be stored in any location which blocks or obstructs any escape route. 10.All fire extinguishers are to be inspected at least on a monthly basis, records kept, and faulty or missing equipment replaced as soon as possible. CONTRACTOR AGREEMENT TO COMPLY a representative of do hereby acknowledge that my company has received a copy of the guidelines governing contract work being performed on New Hanover County, Department of Environmental management property. It is agreed that as part of the contract my company and its employees will comply with these guidelines and all the written programs with apply to the work being performed. Page 28 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 Signed: Contractor Date: APPENL~iX A CONTRACTOR INSPECTION FORMS AND NON-ROUTINE WORK PERMIT'S AND WAIVER FORMS BODY HARNESS INSPECTION CHECKLIST Inspected By: Date: Page 29 of 40 New Hanover County Contract # 10-0061 Instructions: H z 1. All parts of safety belt and attachments m CU cc are to be inspected for wear and damage. J N W m y N J 0.0 U m U O C Na c c 2. This ~ symbol is for YES or OK. _ U) CU M (n .2 This x symbol is for NO or REPLACE. Q J Y o > o 3. To be inspected prior to any work m a beginning and returned in to DEM Safety Office. Employee Badge Mfg.'s Serial Name Number Number SCAFFOLD PERMIT Project Name: Floor: Building Number: Room Number: Contractor: Scaffold Type: Date of Procedure: Time of Procedure: Page 30 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 .Safety Belts Needed? Yes No Names of Scaffold Erector s Name Company Name Company If Scissors or Hi-Lift, Name of Operator Comments: Ins ected B Competent Person: LOCATION: CONTRACTOR: DATE OF PROCEDURE: TIME OF PROCEDURE: NAME OF COMPETENT PERSON: DATE REMOVED: EXCAVATION/TRENCHING PERMIT Project Name: Inspected By: Trenching Area: Title: Date of Procedure: Time of Procedure: Contractor Supervisor: Company Name: Page 31 of 40 New Hanover County Contract # 10-0061 Purpose of Excavation/Trenching Operation (Drainage, etc.): Classification of soil (Solid Rock, Type A, Type B, Type C Protective System (Trench Box, Wood Shoring, Sloping, Hydraulic Shoring, Other Trenching Excavation Depth Width Measurements: Not Yes N Requir o ed Is a ladder provided inside the trench/excavation? Is excavate material stored 2 ft or more from edge of trench/excavation? Are employees exposed to vehicular traffic? (If YES reflective tests are required) Are underground utilities and other structures protected? Water, Gas, Sewer, Telephone, Electric, etc. Is there a potential for hazardous atmosphere to exist? Oxygen deficiency - 19.5 or less / Flammable Limit - 20% of L.E. L (If YES, Refer to DEM Safety Manual - Confined Space Entry) Are employees trained in the recognition and avoidance of unsafe conditions associated with trenching/excavating activities? Comments/Precautions: Approved By: DEM Signature Date Page 32 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 * The approval must be given by a competent person. SAFETY SURVEY AREA OF PROCEDURE: DATE OF PROCEDURE: Unsafe Acts/Conditions Observed During Survey Action Taken/Dat e Corrected Page 33 of 40 New Hanover County Contract # 10-0061 Comments: SAFETY TRAINING LOG DATE OF TRAINING: SUBJECT TRAINED: Name Date Name Date 1 26 2 27 3 28 4 29 Page 34 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 5 30 6 31 7 32 8 33 9 34 10 35 11 36 12 37 13 38 14 39 15 40 16 41 17 42 18 43 19 44 20 45 21 46 22 47 23 48 24 49 25 50 Contractor Trained: Comments: HOT WORK PERMIT INSTRUCTIONS 1. Manager/Supervisor: A. Verify precautions listed below. B. Complete and Retain PART 1. C. Issue PART 2 to the person doing the work. PART 1 SECT A Location: WASTEC /LANDFILL/ Permit RECYCLING Page 35 of 40 New Hanover County Contract # 10-0061 Date: Gas Welder, Arc Welder, or Cutting Torch Building Location: Floor: Nature of Job: Welder's Name: The above location has been examined. The precautions checked on bottom of this page have been taken to prevent fire. Permission has been granted for this work. PERMIT EXPIRES: Date: Time: AM/PM Signed (Supervisor): Precautions within 35 feet of work ❑ Floors swept clean of all combustibles ❑ Flammable liquids removed; other combustibles, if not removed, protected with fire- resistive tarpaulins or metal shields ❑ Explosive atmosphere in area eliminated ❑ All wall and floor openings covered ❑ Combustibles moved away ❑ Enclosed equipment cleaned of all combustibles ❑ Containers purged of flammable liquids ❑ Fire watch will be provided during hot work activities ❑ Fire watch is supplied with suitable extinguishers, or small charged hose ❑ Fire watch is trained in the use of this equipment and in sounding alarm ❑ If welding in the crane bay area: • Has it been wet down? • Has the atmosphere been tested for oxygen and flammability levels? ❑ If welding in the basket of the JLG, or 6 feet off the ground, is fall protection used? ❑ Has the area been barricaded off? ❑ Is proper PPE being worn by the person(s) performing hot work? DEPARTMENT OF ENVIRONMENTAL MANAGEMENT CONFINED SPACE ENRTY PERMIT SYSTEM Entry Date: Time: Person Completing Permit: Page 36 of 40 dm 70080200 700000 New Hanover County Contract # 10-0061 Location of work to be performed: Reason for entering confined space: Mark the appropriate column with an X Y N N/ Is a "Danger Confined Space" sin posted? ❑ ❑ ❑ Have all valves, switches, operating mechanisms and energy ❑ o ❑ sources been locked/tagged out? Have all ENTRANTS, ATTENDANTS, and ENTRY SUPERVISORS ❑ ❑ ❑ been trained? Is ventilating equipment necessary to obtain acceptable entry? ❑ ❑ ❑ Is communication equipment necessary and available for use ❑ ❑ ❑ between attendant and entrant? Has adequate lighting been supplied to allow a safe work area and ❑ ❑ ❑ allow a quick exit in an emergency? Has the area been barricaded? ❑ ❑ ❑ Is the confined space provided with equipment, such as handrails, ❑ ❑ ❑ needed for safe ingress and egress b authorized entrants? Is PPE being used? If so what type? ❑ ❑ ❑ ❑ Coveralls ❑ Hard Hat ❑ Gloves ❑ Safety Eye Protection ❑ Hearing ❑ Safety ❑ Lifelin ❑ Rescue/Retrieval Protection Harness a Equipment ❑ Special Rescue Gear: ❑ Fire Extinguishers L3 Respirator What are the potential atmospheric hazards? ❑ Lack of 02 ❑ Dust ❑ Carbon Monoxide ❑ Hydrogen Sulfide ❑ Combustible/Flamma ❑ Other: ble Gases What are the potential physical hazards? ❑ Entrapment ❑ Engulfment ❑ Heat Hazards ❑ Cold Hazards ❑ Burn ❑ Noise Hazards ❑ Mechanical ❑ Steam Hazards Hazards ❑ Congestion ❑ Uncontrolled ❑ Walking Hazards ❑ Other: Energy EMERGENCY NUMBERS X-4343 (Control) X-4504 (Safety) X-(Shop) X- (Maintenance) X-(Operations) X- (Plant Mgr.) X-4340 (Main) 9-911 (Emergency) Confined Space Rescue Team on Shift ❑ Maintenance ❑ A-Shift ❑ B-Shift ❑ C-Shift ❑ D-Shift ❑ Landfill Page 37 of 40 New Hanover County Contract # 10-0061 EQUIPMENT CALIBRATION Type & S/N Date Calibrated B ATMOSPHERIC TESTING Date %Oxygen %LEL CO (PEL = 50 H2S (PEL = PPM 10 PPM) 1. 2. 3. 4. 5. 6. Note: Test: 1. At the top of the space 2. At the center of the space. 3. At the bottom of the space. Permit required confined spaces are to be tested eve two hours. PRE-ENTRY BRIEFING To be completed for all Confined Spaces) Has the attendant been designated? o YE n N/ S A Have all employees been trained? n YES Have the hazards of the work been explained? YES Has the means of communication been established and o YES explained? Has the means of emergency response/rescue been o YES established and explained? Page 38 of 40 dm 70080200 700000 a Y New Hanover County Contract # 10-0061 AGREEMENT FOR USE OF NEW HANOVER COUNTY EQUIPMENT This Agreement must be read carefully and signed by the undersigned prior to entering, and in consideration of being permitted to use any equipment owned by New Hanover County (hereinafter "County Equipment") in and around the WASTEC facility. EACH OF THE UNDERSIGNED, for himself/herself and any entity or person he/she represents, whether as an employee, agent, contractor, owner or otherwise, and his/her/its personal representatives, heirs, and successors in interest, expressly acknowledges, agrees, warrants and represents that: I. He/she will, prior to the use of any County equipment, inspect such equipment. His/her use of said equipment, if any, constitutes an acknowledgment that he/she has so inspected such equipment and that he/she finds and accepts the same as being safe and reasonably suited for the purposes of his/her use and the use of the equipment, including vehicles. If, at any time, he/she is using county equipment and he/she feels anything to be unsafe, he/she will immediate cease using the equipment and will immediately advise the applicable employee/personnel of such perceived unsafe situation and will not use the equipment until the cause for concern has been addressed. 2. He/she HEREBY RELEASES, WAIVES AND DISCHARGES ANY CLAIMS AGAINST, AND COVENANTS NOT TO SUE, (a) New Hanover County and each its directors, officers, agents, employees, and affiliated entities and persons (collectively referred to herein as the "Releasees"), from and for any and all liability, loss or damage, and any claim or demands therefor on account of injury to the undersigned, any entity or person he/she represents and his/her/its personal representatives, heirs, and successors in interest or to any property or person or living thing brought by or on behalf of the undersigned, or any entity or person he/she represents, in conjunction with the use of County equipment, whether such liability, loss or damage is caused by the action, omission, negligence, or gross negligence of the Releasees or otherwise. 3. He/she HEREBY AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS, AND REIMBURSE, THE RELEASEES and each of them from and for any loss, liability, damage, or cost (including reasonable attorneys' fees) that the Releasees may incur due to use by the undersigned, or any person, property, or living thing brought by or on behalf of the undersigned, or any entity or person he/she represents, of County equipment, including, for example, damage to the equipment or facilities of the Releasees and the cost of cleanup for any lubricant spills, whether caused by the actions or inactions, including negligence and gross negligence, of any of the Releasees or otherwise. 4. He/she represents by his or her use of said equipment that he or she has obtained the necessary and appropriate training and is capable of using said equipment in a safe manner. I New Hanover County Contract # 10-0061 5. He/she HEREBY ASSUMES FULL RESPONSIBILITY FOR, AND RISK OF BODILY INJURY, DEATH, PROPERTY DAMAGE, INCLUDING VEHICLE DAMAGE OR FAILURE, TO, himself/herself and any entities or persons he/she represents resulting from the actions or inactions, including negligence and gross negligence, of any of the Releasees or otherwise, in conjunction with his/her use of County equipment. In stating the above, each of the undersigned hereby expressly acknowledges that bodily injuries received or damage to property or vehicles may be compounded or increased by negligent rescue operations or procedures of the Releasees. 6. He/she expressly acknowledges and agrees that the foregoing release, waiver and indemnity provisions are intended to be as broad and inclusive as is permitted by law of the state in which the activities, including tests, classes and demonstrations, are conducted, and that if any portion of this Agreement is held invalid, it is agreed that the balance of the Agreement shall, notwithstanding, continue in full legal force and effect. THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THIS CONSENT, RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, AND FURTHER AGREES THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENTS APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. This Agreement shall continue in perpetuity. (If any of the undersigned is under the age of eighteen (IS), a parent or legal guardian of such undersigned must also sign this Agreement, and in so signing executes this Agreement for himself and such minor.) SIGNATURE PRINTED NAME Date: 2 Page 40 of 40 dm 70080200 700000 1 M MIDD/YYYY) co CERTIFICATE OF LIABILITY INSURANCE OP ID DI DATE [__(_3 FLOR-28 08 109 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bouchard-Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 101 Starcrest Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O Box 6090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Clearwater FL 33758-6090 Phone:727-447-6481 Fax:727-449-1267 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Auto-0-ra Insurance Company 18988 INSURER B: Jetclean America LLC dba Florida Jetclean INSURER C: 19019 Fern Meadow Loop INSURER D: Lutz FL 33558 INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ]Nb TIVE POLICY /DDNTI N LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY DATE MM/DD DDlYYYY DATE MM/DDMlYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ CLAIMS MADE D OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ POLICY 71 PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 A X ANY AUTO 9542538000 07/12/09 07/12/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION JOTH - AND EMPLOYERS' LIABILITY Y I N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVq E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yas, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION NE, wHANO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR NEW HANOVER COUNTY REPRESENTATIVES. 230 GOVERNMENT CENTER DR WILMINGTON NC 28403 Au NTATIVE ACORD 25 (2009101) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) . w CERTIFICATE OF LIABILITY INSURANCE FLOR-28 FOATOE 09) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bouchard-Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 101 Starcrest Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P 0 Box 6090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Clearwater FL 33758-6090 Phone:727-447-6481 Pax:727-449-1267 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Rockhill Insurance Company 28053 INSURER B: Jetclean America dba Florida Jetclean INSURERC: 19019 Fern Meadow LOOP INSURERD: Lutz FL 33558 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NALOED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W ITH 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR FGENE-RAL YPE OF INSURANCE POLICY NUMBER DATE MID DATE M OMITS LIABILITY EACH OCCURRENCE $1,000,000 A X MERCIAL GENER AL LIABILITY 090311002 03/11/09 03/11/10 PREMISESEaoccurence $50,000 CLAIMS MADE ❑ OCCUR MED EXP (Any one person) $ 5 , 000 PERSONAL EADV INJURY $ 1, 000, 000 lution GENERAL AGGREGATE $1,000,000 7 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOPAGG $1,000,000 POLICY J'RO' LOC r~ AUTOMOBILE LIABILITY D COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED ALTOS (Par person) HIREDAUTOS MAR 13 2009 BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per aoddent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE s2,000,000 A X OCCUR EICLAIMSMADE 090311001 03/11/09 03/11/10 AGGREGATE $2,000,000 S DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN TORY LIMITS ER 11 1 ANY PROPRIETORIPARTNERlEXECUTNE--I E.L. EACH ACCIDENT $ OFFICERMIEMBER EXCLUDED? u (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ Ifs, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT I SPECLAL PROVISIONS CERTIFICATE HOLDER IS ADDITIONAL INSURED WITH RESPECTS TO GENERAL LIABLITY SUBJECT TO ALL TERMS, CONDITIONS AND EXCLUSIONS OF THE POLICY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION NEWHANO DATE THEREOF, THE ISSIANG INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR NEW HANOVER COUNTY 230 GOVERNMENT CENTER DR #125 REPRESENTATIVES WILMINGTON NC 28403 AUTHORIZED REPRESEN ACORD 25 (2009101) 01988- RD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of A~ VNIY. ~ O F p~ G 3y - - ~'nfit unto NEW HANOVER COUNTY WANDA M. COPLEY County Attorney KEMP P. BURPEAU SHARON J. HUFFMAN Deputy County Attorney Assistant County Attorney August 24, 2009 Jetclean America Attn: Ralph Calistri 19019 Fern Meadows Loop Lutz, FL 33558 RE: New Hanover Contract # 10-0061 Dear Mr. Calistri: Enclosed please find your copy of the above referenced contract. Thank you for your assistance in this matter. If you have any questions please give us a call. Sincerely, , HaW wtet 2.Owdap Margaret R. Dunlap Administrative Support Specialist Office of the County Attorney Enclosure 230 Government Center Drive - Suite # 125 - Wilmington, NC 28403 Phone: 910-798-7153 - Fax: 910-798-7157 www.nhcgov.com New Hanover County Routing Slip Contract # DepartiWnt Acct. # Initials Date To: Risk Manager Grants Coordinator Finance Director r County Manager r'~ ? 6 Commission Chairman Clerk to the Board County Attorney Z } ` h rom: Legal Dept. Date Re: Contract for/Dept.