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Home My WebLink AboutContract 47842-R5 CSC No. 47842-R5 CITY OF FORT WORTH REQUEST TO EXERCISE RENEWAL OPTION March 23, 2021 NSF International Strategic Registration 7890N Dixboro Road Ann Arbor, MI 48105 Attn: Janette Halliday Re: Contract Renewal Notice Contract No, CSC No. 47842-R5 Renewal Term No, R5. June 2, 2021 to June 1,2022 The above referenced Contract with the City of Fort Worth expires on June 1, 2021, Pursuant to the Contract, contract renewals are at the mutual agreement of the parties. This letter is to inform you that the City is requesting to renew the Contract for an additional one (1) year period, which will begin immediately after the Expiration Date.All other terms and conditions of the Contract remain unchanged, To agree to renew the Contract for an additional one (1)year period, please sign and return this request to exercise renewal option, along with a copy of your current insurance certificate, to the address set forth below. Please log onto PeopleSoft Purchasing at http:/fiortworthtexas,gov/purchasing to insure that your company information is correct and up-to-date. If you have any questions concerning this Contract Renewal Notice, please contact me at the telephone number listed below. Sin e y, Darla Morales Parts Material Supervisor 817-392-4932 Contract Renewal Page 1-of 2 ACCEPTED AND AGREED: CITY OF FORT WORTH CONTRACT COMPLIANCE MANAGER: By signing I acknowledge that I am the person responsible for the monitoring and bay guaA&JcE administration of this contract, including By: Dana Burghdoff(M6,202 :09CDT) ensuring all performance and reporting Name: Dana Burghdoff requirements. Title: Assistant City Manager By: APPROVAL RECOMMENDED: Name:Darla Morales Title: Parts Material Supervisor C %JtOf�LL APPROVED AS TO FORM AND By: ChOstopherH rder(Jun30,202107:58CDT) LEGALITY: Name: Chris Harder Title: Water Director ATTEST: By: DB lack(Ju 12,202111:20 CDT) Name: Doug Black BY: Title: Assistant City Attorney Name: Mary J Kayser Title: City Secretary CONTRACT AUTHORIZATION: M&C: NA Date Approved: Form 1295 CeilificationNo.: NSF International Strategic Registrations,Ltd. $ Y.- Name: Thomas Chestnut Title: Vice President Contract Renewal Page 2 of 2 NSF International Strategic Registrations Management Systems Registration Attachment A NSF-ISR Cost Estimate Far the Village Creek Wastewater Treatment Facility Fort worth,Texas Biosolids Management System Re-verification Audit October 2021 Activity Audit Time Other Costs Initial Pre rattan and Review BM5 manual review,scheduling,preparation,and coordination(1 $ 550 auditor for 0.5 days) On-site Re-Verification Audit Office Audit—review corrective actions (1 auditor for 0.5 days) $ 650 Treatment/biosolids/application site evaluation(1'auditor for 1.5 $ 1.,950 days) Comprehensive manual element reviews(1 auditor for 1.5 days) $ 1,950 Evaluation of Goals/Objectives/Outcomes(1 auditor for0.5 days) $ 650 Auditor Travel Time $ 6W Auditor's travel expenses will be billed at cost(estimate) $ 1,950 Report Preparation Report Preparation and Coordination (1 auditor for 1 day) $ 1,300 Total $ 7,150 $ 2,550 Note: Review of corrective plans,it needed,will be charged at$162.50/hour Scope of work will include a review of the organizations progress towards goals and objectives; BMP outcomes (environmental performance regulatory compliance, interested party relations, and quality practices.); actions taken to correct minor nonconformances(and opportunities for improvement, as appropriate); corrective action requests and responses and preventive actions.The scope will also specifically include a comprehensive review and verification of all BMP Elements.Work will involve document review, interviews and field observations. Jeanette Halliday•Business Development Manager-Ileadquarters 789 N.Dixboro Rd.,Ann Arbor,MI 48105 USA• 1-888-NSF-9000•halliday@nsrorg-www.nsf-isr.org ACaR CERTIFICATE OF LIABILITY INSURANCE °ATEIMMIODIYYYYi `� 6/26/2020 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 policy(ies)must have ADDITIONAL INSURED provisions or 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). Marsh PRODUCE&McLennan Agency LLC PNAMV HONE Amy L.Micallef,CIC,CISR,A1S,LIC,AAF 15415 Mlddlebelt Road •734-525-2445 Alc No:734-525-1841 Livonia MI 48154-3805 EAMALE DREs : a mica llef mma-mi.com INSURER S AFFORDING COVERAGE RAIC N INSURER A!Federal Insurance Company 2028'1 INSURED NSFINTER INSURER B:ACE American Insurance Com an 22667 NSF International; NSF International Strategic Registrations, Ltd DBA NSF-ISR Ltd. INSURER C: 789 N. Dixboro Road INSURER D: Ann Arbor M 148105 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:964970794 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 AFFORDFD 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. ILTSRR TYPE OF INSURANCE AOOL BR POLICY NUMBER MMIODYfYYYY E-11PM..,YYY LIMITS A x COMMERCIAL GENERAL LIABILITY Y 35854061 7/1/2020 7/1/2021 EACHOCCURRENCE $1,000,000 DAMAGE TO RENTED_ CLAIMS-MADE �OCCUR PREMISES Ea occurrence) $1.000.000 MED EXP(Anyone person) $10,000 PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO GENERAL AGGREGATE $2,000,000 POLICY JECT LOC PRODUCTS-COMPIOPAGG $2,000,000 'OTHER: $ A AUTOMOBILE LIABILITY Y 73538064 7/1/2020 7/1/2021 Ea IBIN DtSINGLE LIMIT g T 000,000 IX ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) S HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ A X UMBRELLA LIAB }( OCCUR 79853485 7/1/2020 7/1/2021 EACHOCCURRENCE $10.000.000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED RETENTIONS S A WORKERS COMPENSATION Y 71722632 7/1/2020 7/1/2021 H PER OTH. AND EMPLOYERS*LIA$ILITY YIN STATUTE ER ANYPROPRIETORIPARTNER)EXECUTIVE E.L.EACH ACCIDENT 1, OFFICERIMEMaEREXCLUDED7 ❑ NIA $ 000,000 U(Mandatory In and E.L.DISEASE-EA EMPLOYEE $1.000.000 If yes,describe under PESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1.000.000 B Professional uahR((yy G27882067003 7/1/2019 8/1/2020 Limit $15,000,000 Relm Date 0110 AW14 Retention.Non Mess $250,000 MassfClassAclion $500,000 DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES(ACORD 10f,Additional Remarks Schedule,may be attached If more space is requked) The City of Fort Worth is Included as an additional insured for commercial general liability coverage to the extent provided in the attached Farm#80-02-2387 and for au(o liability cave rage to the extent provided in the attached form#16-92-0292. Where permitted by state law,the workers'compensation Insurer waives its right to subrogation against certificate holder to the extent provided in the attached form#WC420304B The insurance Gamer will provide the Certificate Holder with direct notice of cancellation to the extent provided in the attached form#80-02-9779 for commercial general liability coverage,form#16-02-0303 for auto liability,and form#WC990644 for workers'compensation coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Worth ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Risk Manager 1000 Throckmorton AUTHORIZED REP RESENTATIVE Fort Worth TX 76102 az� �] �� J{ 01988.2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD