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Contract 25840
CITY SECRETARY oJrd CIT'" SECKTA�RY CONTRACT NO. SPECIFICATIONS �_�.E. FILE AND CONST'RUC 300 S C C)PY CONTRACT DOCUMENTS CLIENT UEPARi,^ . RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAN' PROJECT NO. DOE. NO. 2921 IN THE CITY OF FORT WORTH,TEXAS FILE No. K-1612 2000 KENNETH L. BARR BOB TERRELL MAYOR CITY MANAGER HUGO A. MALANGA, PE -DIRECTOR DEPARTMENT OF TRANSPORTATION AND PUBLIC WORKS A. DOUGLAS RADEMAKER, PE - DIRECTOR DEPARTMENT OF ENGINEERING BY: ` Cl"p Carter-Burgess CARTER& BURGESS, INC. 3880 Hulen Street Fort Worth, Texas 76107 46 (817) 735-6000 C&B NO. 991258010 ea City of Fort Worth, Texas "avow and Council Communication DATE REFERENCE NUMBER I LOG NAME PAGE 5/9/00 C-18001 30SHIVR 1 of 3 SUBJECT REJECTION OF ORIGINAL BIDS FOR RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY AND AWARD OF CONTRACT WITH STABILE & 4 N, INC. FOR RE-BID OF RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY RECOMMENDATION: It is recommended that the City Council: 1. Reject all original bids received for Reconstruction of Shiver Road from North Beach Street to Trace Ridge Parkway; and 2. Authorize the City Manager to execute a contract with Stabile & Wf nn, Inc. in the amount of $394,473.66 and 45 working days for re-bid of Reconstruction of Shiver Road from North Beach Street to Trace Ridge Parkway. DISCUSSION: On February 15, 2000 (M&C C-17862), the City Council approved a Community Facilities Agreement with Hillwood Development Corporation for the installation of community facilities for improvements to Shiver Road from North Beach Street to Trace Ridge Parkway. Hillwood Development Corporation has executed a proposed contract for community facilities to serve a proposed Keller Independent School District (KISD) elementary school that is currently under construction. The elementary school is located immediately north off Shiver Road and west of Trace Ridge Parkway (see attachment). The improvements to Shiver Road need to be completed before the new elementary school is opened on August 1, 2000. These improvements will provide 40 feet of pavement within a 60-foot right-of-way from Trace Ridge Parkway to North Beach Street. In addition, a right turn lane will be provided on Shiver Road at the south entrance to the Keller Elementary School. Trace Ridge Parkway will be constructed to 20 feet of pavement on the west half of the right-of-way from Shiver Road north to the east entrance of the Keller Elementary School. F F City of Fort Worth, Texas 4vayor And Council Communication DATE REFERENCE NUMBER LOG NAME __ PAGE 5/9/00 C-18001 30SHIVR 2 of 3 SUBJECT REJECTION OF ORIGINAL BIDS FOR RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY AND AWARD OF CONTRACT WITH STABILE & WYNN, INC. FOR RE-BID OF RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY This project was originally advertised for bid on February 3 and 10, 2000. On March 9, 2000, the following bids were received: BIDDERS AMOUNT TIME OF COMPLETION Stabile & Wynn, Inc. $395,123.66 45 Working Days Walt Williams Construction, Inc. $398,987.21 McClendon Construction Company, Inc. $425,141.00 Gilco Contracting, Inc. $438,405.05 J. L. Bertram Construction & Engineering, Inc. $448,682.13 Texas-Sterling, Inc. $455,203.70 Jackson Construction, Inc. $471,465.35 S. J. Louis Construction of Texas, Inc. $474,324.77 Ed A. Wilson, Inc. $499,585.45 McMahon Contracting, Inc. $506,352.60 APAC-Texas, Inc. $527,414.85 M. A. Vinson Construction Company, Inc. $573,482.10 Intrepid Contractors, Inc. $675,809.40 The apparent low bidder, Stabile & Wynn, Inc., was ruled in non-compliance of the City's M/WBE Ordinance and was unable to meet the established goal of 17%. Therefore, Stabile & Wynn, Inc. was non-responsive to the bid. No other bidders submitted M/WBE documentation and therefore were also non-responsive. KISD anticipated that the project would be completed prior to the start of the new school year on August 1, 2000. In order to accommodate KISD's expectations and complete this project as soon as possible, staff re-advertised this project on April 11 and 18, 2000, prior to this action coming before the City Council for consideration. On April 26, 2000, the following bids were received: BIDDERS AMOUNT TIME OF COMPLETION Stabile & Wynn, Inc. $394,473.66 45 Working Days Richard Carr Construction, Inc. $399,500.00 Gilco Contracting, Inc. $420,371.45 J. L. Bertram Construction and Engineering, Inc. $421,984.65 McClendon Construction Company, Inc. $430,323.00 Jackson Construction, Inc. $450,978.25 The contingency for possible change orders is $19,724.00. City of Fort Worth, Texas *V61yor And Council communication DATE REFERENCE NUMBER LOG NAME PAGE 5/9/00 C-18001 30SHIVR 3 of 3 SUBJECT REJECTION OF ORIGINAL BIDS FOR RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TOXTRACE RIDGE PARKWAY AND AWARD OF CONTRACT WITH STABILE & WYNN, INC. FOR RE-BID OF RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY Stabile & Wj hn, Inc. is in compliance with the City's M/WBE,Ordinance by committing to 2% M/WBE participation and documenting good faith effort. Stabile & Winn, Inc. identified several subcontracting and supplier opportunities. However, the M/WBEs contacted in the identified areas did not respond or did not submit the lowest bid. The City's goal on this project is 19%. This project is located in COUNCIL DISTRICT 4. FISCAL INFORMATION/CERTIFICATION: The Finance Director certifies that funds are available in the current capital budget, as appropriated, of the Street Improvements Fund. MG:k Submitted for City Manager's FUND ACCOUNT CENTER AMOUNT CITY SECRETARY Office by: (to) Mike Groomer 6140 APPROVED Originating Department Head: CITY COUNCIL "ANF"Ei) A.Douglas Rademaker 6157 (from) MAY 9 2000 C115 541200 020115136292 $225,086.86 Additional Information Contact: C115 541200 020115136295 $ 99,384.80 Aw� yy��liGu� C181 541200 080181046120 $ 70,652.00 City Secretary o/the A.Douglas Rademaker 6157 City of Fort Worth,Taw AlK-'ll-UU ext 1L.-4-I rM r. Y1. urrL. cnUinccaiAU rAA nu. uii oil ruiY ADDENDUM NO. 1 SPECIFICATIONS AND CONTRACT DOCUMENTS FOR RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY D.O.E.NO. 2921 FILE NO. K-1612 IN THE CITY OF FORT WORTH,TEXAS RELEASE DATE: April 21,2000 The purpose of this addendum is to clarify the following points and make the following corrections: 1. In the Proposal section, add the following bid item: PAY APPROX. DESCRIPTION OF ITEMS WITH BID UNIT TOTAL ITEM QUANTITY PRICES WRITTEN IN WORDS PRICE AMOUNT BID 20. 1 EA. 4' SQ.STORM DRAIN MANHOLE nr e9 JW&5*,r^►rv.G Dollars& ep ey& Cents Per Each $ ?~ $ 2d+lcto.aD 2. This project,for timing purposes, has been divided into 2 phases. Phase I consists of Trace Ridge Parkway, the intersection of Trace Ridge Parkway and Shiver Road,and the portion of the storm drain located in this area. Phase II consists of the box culvert, additional channel grading, Shiver Road, and the remaining storm drainage system. Construction may occur in the 2 phases concurrently, but Phase I construction shall be completed to allow traffic access to Shiver Road Elementary School by July 1,2000. SPECIADDENDI.DOC C&B No.991258.010.1.0001 21 April,2000 Page l oft AYK-LI-UU rxl 1L 41 ra r. rr, urri, zavjiirccniiry rnn iw, UL U; 1 1u17 , 3. Tree removal and disposal within the right-of-way shall be completed by the contractor and is subsidiary to this contract. CARTER&BURGESS,INC. iR' RECEIPT ACKNOWLEDGED: ,oF r k°s�tt •- '� ............... DON E ALLEY. i i� zoo Il. .......................6D505 .� Date l%5�0711+1�A�%,`a1N� A. DOUGLAS RADEMAKER,P.E. DIRECTOR,DEPARTMENT OF ENGINEERING Air 4ct Trice, P.E. Nftager, Consultant Services SPECIADDENDI.DOC C&B No.991258.010.1.0001 21 April,2000 Page 2 of 2 SPECIFICATIONS AND CONTRACT DOCUMENTS RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY PROJECT NO. DOE NO. 2921 IN THE CITY OF FORT WORTH, TEXAS FILE No. K-1612 2000 KENNETH L. BARR BOB TERRELL MAYOR CITY MANAGER HUGO A. MALANGA, PE - DIRECTOR DEPARTMENT OF TRANSPORTATION AND PUBLIC WORKS A. DOUGLAS RADEMAKER, PE - DIRECTOR - DEPARTMENT OF ENGINEERING BY: «Z Carter n Burgess CARTER& BURGESS, INC. 3880 Hulen Street Fort Worth, Texas 76107 (817) 735-6000 C&B NO. 991258010 SPECIFIC TO THIS CONTRACT: All references in these bid documents, including attachment A. related to the time to submit M/WBE documentation is amended to: ALL M/WBE FORMS MUST BE SUBMITTED WITH THE SEALED BID. FAILURE TO SUBMIT M/WBE FORMS WITH THE SEALED BID MAY RENDER THE BIDDER NON- REPONSIVE. TABLE OF CONTENTS TABLE OF CONTENTS 1. Notice to Bidders 2. Special Notice to Bidders 3. Special Instructions to Bidders 4. Proposal 5. Vendor Compliance to State Law 6. Minority and Women Business Enterprises Specifications 7. Storm Water Pollution Prevention Plan 8. Special Provisions 9. Permits/Easements 10. Certificate of Insurance 11. Contractor Compliance With Worker's Compensation Law 12. Equipment Schedule 13. Experience Record 14. Performance Bond 15. Payment Bond 16. Contract NOTICE TO BIDDERS Sealed proposals for the following: FOR: RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY FILE NO.K-1621 DOE#:2921 Addressed to Mr.Bob Terrell,City Manager of the City of Fort Worth,Texas will be received at the Plans Desk in the Department of Engineering until 1:30 PM,Wednesday,April 26,2000 and then publicly opened and read aloud at 2:00 PM in the Department of Engineering Conference Room 255A. Plans,Specifications and Contract Documents for this project may be obtained at the Office of the Department of Engineering,Municipal Office Building, 1000 Throckmorton Street,Fort Worth,Texas. One set of documents will be provided to prospective bidders for a deposit of$20.00;such deposit will be refunded if the document is returned in good condition within(10)days after bids are opened. Additional sets may be purchased on a nonrefundable basis for twenty dollars($20.00)per set. These documents contain additional information for prospective bidders. Bid security is required in accordance with the Special Instruction to Bidders. The City reserves the right to reject any and/or all bids and waive any and/or all irregularities. No bid may be withdrawn until the expiration of forty-nine(49)days from the date the M/WBE UTILIZATION FORM, PRIME CONTRACTOR WAIVER FORM and/or the GOOD FAITH EFFORT FORM("Documentation")as appropriate is received by the City. The award of contract,if made,will be within forty-nine(49)days after this documentation is received,but in no case will the award be made until the responsibility of the bidder to whom it is proposed to award the contract has been verified. Bidders are responsible for obtaining all Addenda to the contract documents and acknowledging receipt of the Addenda by initialing the appropriate spaces on the PROPOSAL form. Bids that do not acknowledge receipt of all Addenda may be rejected as being nonresponsive. Information regarding the status of Addenda may be obtained by contacting the Department of Engineering at 817-871-7910. In accord with City of Fort Worth Ordinance No. 11923,as amended,the City of Fort Worth has goals for the participation of minority business enterprises and women business enterprises in City contract. A copy of the Ordinance can be obtained from the Office of the City Secretary. In addition,the bidder shall submit the MBE/WBE UTILIZATION FORM,PRIME CONTRACTOR WAIVER FORM and/or the GOOD FAITH EFFORT FORM("Documentation')as appropriate. SPECIFIC TO THIS CONTRACT: All references in these bid documents, including Attachment A. related to the time to submit M/WBE documentation is amended to: ALL M/WBE FORMS MUST BE SUBMITTED WITH THE SEALED BID. FAILURE TO SUBMIT M/WBE FORMS WITH THE _ SEALED BID MAY RENDER THE BIDDER NON-RESPONSIVE. For additional information,contact Jill Rankin with Carter&Burgess at 735-7025 or Bryan Beck,P.E.with the City of Fort Worth at 871-7909. BOB TERRELL GLORIA PEARSON f CITY MANAGER CITY SECRETARY A.Dougla dem' 6 P.E. Direct Dep tm By Rick Trice,P.E. Manager,Engineering Services Advertising Dates: April 11,2000 April 18,2000 SPECIAL NOTICE TO BIDDERS FOR: RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY FILE NO.K-1621 D.O.E.#: 2921 The construction of this project shall be phased to allow access to Shiver Road Elementary School in a timely manner. The proposed length of Trace Ridge Parkway and the intersection with Shiver Road, including storm drainage and paving,shall be completed first. Once access to the school is provided from Trace Ridge parkway,then Shiver Road west of the intersection with Trace Ridge Parkway may be closed temporarily for the reconstruction so that no traffic phasing plan is required. SPECIAL INSTRUCTION TO BIDDERS 1. BID SECURITY: Cashier's check or an acceptable bidder's bond payable to the City of Fort Worth, in an amount of not less than five(5%)per cent of the total of the bid submitted must accompany the bid,and is subject to forfeit in the event the successful bidder fails to execute the contract documents within ten(10)days after the contract has been awarded. To be an acceptable surety on the bond,(1)the name of the surety shall be included on the current U.S. Treasury,or(2)the surety must have capital and surplus equal to ten times the limit of the bond. The surety must be licensed to do business in the state of Texas. The amount of the bond shall not exceed the amount shown on the treasury list or one-tenth(1/10)the total capital and surplus. 2. PAYMENT BOND AND PERFORMANCE BOND: The successful bidder entering into a contract for the work will be required to give the City surety in a sum equal to the amount of the contract awarded. In this connection,the successful bidder shall be required to furnish a performance bond as well as payment bond,both in a sum equal to the amount of the contract awarded. The form of the bond shall be as herein provided and the surety shall be acceptable to the City. All bonds furnished hereunder shall meet the requirements of Article 5160 of the Revised Civil Statutes of Texas,as amended. In order for a surety to be acceptable to the City,(1)the name of the surety shall be included on the current U.S.Treasury List of Acceptable Sureties(Circular 870),or(2)the surety must have capital and surplus equal to ten times the amount of the bond. The surety must be licensed to do business in the State of Texas. The amount of the bond shall not exceed the amount shown on the Treasury list or one-tenth(1/10)of the total capital and surplus. If reinsurance is required,the company writing the reinsurance must be authorized,accredited or trusteed to do business in Texas. No sureties will be accepted by the City which are at the time in default or delinquent on any bonds or which are interested in any litigation against the City. Should any surety on the contract be determined unsatisfactory at any time by the City,notice will be given to the contractor to that effect and the contractor shall immediately provide a new surety satisfactory to the City. If the contract amount is in excess of$25,000 a Payment Bond shall be executed, in the amount of the contract,solely for the protection of all claimants supplying labor and materials in the prosecution of the work. If the contract amount is in excess of$100,000,a Performance Bond shall be executed, in the amount of the contract conditioned on the faithful performance of the work in accordance with the plans, specifications,and contract documents. Said bond shall solely be for the protection of the City of fort Worth. 3. LIQUIDATED DAMAGES:The Contractor's attention is called to Part 1,Item 8,paragraph 8.6,of the"General Provisions"of the Standard Specifications for Construction of the City of Fort Worth, Texas,concerning liquidated damages for late completion of projects. 4. AMBIGUITY: In case of ambiguity or lack of clearness in stating prices in the proposal,the City reserves the right to adopt the most advantageous construction thereof to the City or to reject the proposal. 5. EMPLOYMENT:All bidders will be required to comply with City Ordinance No.7278 as amended by City Ordinance No. 7400(Fort Worth City Code Section 13-A-21 through 13-a-29)prohibiting discrimination in employment practices. 6. WAGE RATES: All bidders will be required to comply with provision 5159a of"Vernons Annotated Civil Statutes"of the State of Texas with respect to the payment of prevailing wage rates as established by the City of Fort Worth,Texas and set forth in Contract Documents for this project. 7. FINANCIAL STATEMENT:A current certified financial statement may be required by the Department of Engineering if required for use by the CITY OF FORT WORTH in determining the successful bidder. This statement,if required,is to be prepared by an independent Public Accountant holding a valid permit issued by an appropriate State Licensing Agency. 8. INSURANCE: Within ten(10)days of receipt of notice of award of contract,the Contractor must provide,along with executed contract documents and appropriate bonds,proof of insurance for Worker's Compensation and Comprehensive General Liability(Bodily Injury-$250,000 each person, $500,000 each occurrence;Property Damage-$300,000 each occurrence). The City reserves the right to request any other insurance coverages as may be required by each individual project. NONRESIDENT BIDDERS: Pursuant to Article 601g,Texas Revised Civil Statutes,the City of Fort Worth will not award this contract to a non resident bidder unless the nonresident's bid is lower than the lowest bid submitted by a responsible Texas resident bidder by the same amount that a Texas resident bidder would be required to underbid a nonresident bidder to obtain a comparable contract in the state in which the nonresident's principal place of business is located. "Nonresident bidder"means a bidder whose principal place of business is not in this state,but excludes a contractor whose ultimate parent company or majority owner has its principal place of business in this state. "Texas resident bidder"means a bidder whose principal place of business is in this state,and includes a contractor whose ultimate parent company or majority owner has its principal place of business in this state. This provision does not apply if this contract involves federal funds. The appropriate blanks of the Proposal must be filled out by all non resident bidders in order for its bid to meet specifications. The failure of a nonresident contractor to do so will automatically disqualify that bidder. 10. MINORITY AND WOMEN BUSINESS ENTERPRISES: In accord with City of Fort Worth Ordinance No. 11923,as amended,the City of Fort Worth has goals for the participation of minority business enterprises and women business enterprises in City contracts. A copy of the Ordinance can be obtained from the office of the City Secretary. In addition,the bidder shall submit the MBE/WBE UTILIZATION FORM,PRIME CONTRACTOR WAIVER FORM and/or the GOOD FAITH EFFORT FORM("Documentation")as appropriate. The Documentation must be received no later than 5:00 p.m.,five(5)City business days after the bid opening date. The bidder shall obtain a receipt from the appropriate employee of the managing department to whom delivery was made. Such receipt shall be evidence that the Documentation was received by the City. Failure to comply shall render the bid non-responsive. Upon request,Contractor agrees to provide to owner complete and accurate information regarding actual work performed by Minority Business Enterprise(WBE)on the contract and payment therefore. Contractor further agrees to permit an audit and/or examination of any books,records or files in its possession that will substantiate the actual work performed by an MBE and/or WBE. The misrepresentation of facts(other than a negligent misrepresentation)and/or the commission of fraud by the Contractor will be grounds for termination of the contract and/or initiation action under appropriate federal,state or local laws or ordinances relating to false statement;further,any such misrepresentation(other than a negligent misrepresentation)and/or commission of fraud will result in the Contractor being determined to be irresponsible and barred from participation in City work for a period of time of not less than three(3)years. 11. AWARD OF CONTRACT:Contract will be awarded to the lowest responsive bidder.The City reserves the right to reject any and/or all bids and waive any and/or all irregularities. No bid may be withdrawn until the expiration of forty-nine(49)days from the date the M/WBE UTILIZATION FORM,PRIME CONTRACTOR WAIVER FORM and/or the GOOD FAITH EFFORT FORM ("Documentation")as appropriate is received by the City. The award of contract,if made,will be within forty-nine(49)days after this documentation is received,but in no case will the award be made until the responsibility of the bidder to whom it is proposed to award the contract has been verified. 12. PAYMENT:The Contractor will receive full payment(minus 5%retainage)from the City for all work for each pay period. Payment of the remaining amount shall be made with the final payment, and upon acceptance of the project. 13. ADDENDA:Bidders are responsible for obtaining all addenda to the contract documents prior to the bid receipt time and acknowledging them at the time of bid receipt. Information regarding the status of addenda may be obtained by contacting the Department of Engineering Construction Division at (817)871-7910.Bids that so not acknowledge all applicable addenda may be rejected as non- responsive. 14. CONTRACTOR COMPLIANCE WITH WORKER'S COMPENSATION LAW: A.Workers Compensation Insurance Coverage a.Definitions: Certain of coverage("certificate").A copy of a certificate of insurance,a certificate of authority to self-insure issued by the commission,or a coverage agreement(TWCC-81, TWCC-82,TWCC-83,or TWCC-84),showing statutory worker's compensation insurance coverage for the person's or entity's employees providing services on a project,for the duration of the project. Duration of the project-includes the time from the beginning of the work on the project until the contractor's/person's work on the project has been completed and accepted by the governmental entity. Persons providing services on the project("subcontractor"in§406.096)-includes all persons or entities performing all or part of the services the contractor has undertaken to perform on the project,regardless of whether that person contracted directly with the contractor and regardless of whether that person has employees. This includes,without limitation, independent contractors,subcontractors,leasing companies,motor carriers,owner-operators, employees of any such entity,or employees of any entity which furnishes persons to provide services on the project. "Services"include,without limitation,providing,hauling,or delivering equipment or materials,or providing labor,transportation,or toner services related to a project."Services"does not include activities unrelated to the project,such as food/beverage vendors,office supply deliveries,and delivery of portable toilets. b. The contractor shall provided coverage,based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements,which meets the statutory requirements of Texas Labor Code,Section 401.011 (44)or all employees of the contractor providing services on the project,for the duration of the project. c. The Contractor must provide a certificate of coverage to the governmental entity prior to being awarded the contract. d. If the coverage period shown on the contractor's current certificate of coverage ends during the duration of the project,the contractor must,prior to the end of the coverage period,file a new certificate of coverage with the governmental entity showing that coverage has been extended. e. The contractor shall obtain from each person providing services on a project,and provide to the governmental entity: (1) a certificate of coverage,prior to that person beginning work on the project,so the governmental entity will have on file certificates of coverage showing coverage for all persons providing services on the project;and (2) no later than seven days after receipt by the contractor,a new certificate of coverage showing extension of coverage,if the coverage period shown on the current certificate of coverage ends during the duration of the project. f. The contractor shall retain all required certificates of coverage for the duration of the project and for one year thereafter g. The contractor shall notify the governmental entity in writing by certified mail or personal delivery,within ten(10)days after the contractor knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project. h. The contractor shall post on each project site a notice,in the text,form and manner prescribed by the Texas Worker's Compensation Commission,informing all persons providing services on the project that they are required to be covered,and stating how a person may verify coverage and report lack of coverage. I. The contractor shall contractually require each person with whom it contracts to provide services on a project,to: (1) provide coverage,based on proper reporting on classification codes and payroll amounts and filing of any coverage agreements,which meets the statutory requirements of Texas labor Code,Section 401.011 (44)for all of its employees providing services on the project,for the duration of the project; (2) provide to the contractor,prior to that person beginning work on the project,a certificate of coverage showing that coverage is being provided for all employees of the person providing services on the project,for the duration of the project; (3) provide the contractor,prior to the end of the coverage period,a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (4) obtain from each other person with whom it contracts,and provide to the contractor: (a) a certificate of coverage,prior to the other person beginning work on the project;and (b) a new certificate of coverage showing extension of coverage,prior to the end of the coverage period,if the coverage period shown on the current certificate of coverage ends during the duration of the project; (5) retain all required certificates of coverage on file for the duration of the project and for one year thereafter. (6) notify the governmental entity in wiring by certified mail or personal delivery, within ten(10)days after the person knew or should have known,of any change that materially affects the provision of coverage of any person providing services on the project;and (7) contractually require each person with whom it contracts,to perform as required by paragraphs(1)-(7),with the certificates of coverage to be provided to the person for whom they are providing services. j. By signing this contract or providing or causing to be provided a certificate of coverage, the contractor is representing to the governmental entity that all employees of the contractor who will provide services on the project will be covered by worker's compensation coverage for the duration of the project,that the coverage will be based on proper reporting of classification codes and payroll amounts,and that all coverage agreements will be filed with the appropriate insurance carrier or, in the case of a self insured,with the commission's Division of Self-Insurance Regulation. Providing false or misleading information may subject the contractor to administrative,criminal,civil penalties or other civil actions. k. The contractor's failure to comply with any of these provisions is a breach of contract by the contractor does not remedy the breach within ten days after receipt of notice of breach from the governmental entity. B. The contractor shall post a notice on each project site informing all persons providing services on the project that they are required to be covered,and stating how a person may verify current coverage and report failure to provide coverage. This notice does not satisfy other posting requirements imposed by the Texas Worker's Compensation Act or other Texas Worker's Compensation Commission rules. This notice must be printed with a title in at least 30 point bold type and text in at least 19 point normal type,and shall be in both English and Spanish and any other language common to the worker population. The text for the notices shall be the following text,without any additional words or changes: "REQUIRED WORKER'S COMPENSATION COVERAGE" The law requires that each person working on this site or providing services related to this construction project must be covered by worker"compensation insurance.This includes persons providing,hauling or delivering equipment or materials,or providing labor or transportation or other service related to the project,regardless of the identity of their employer or status as an employee". Call the Texas Worker's Compensation Commission at 512-440-3789 to receive information on the legal requirement for coverage,to verify whether your employer has provided the required coverage, or to report an employer's failure to provide coverage". 15. NON DISCRINIINATION:The contractor shall not discriminate against any person or persons because of sex,race,religion,color,or national origin and shall comply with the provisions of City Ordinance 7278,as amended by City Ordinance 7400(Fort Worth City Code Sections 13A-21 through 13A-29),prohibiting discrimination in employment practices. 16. AGE DISCRIMINATION: In accordance with the policy("Policy")of the Executive Branch of the federal government,contractor covenants that neither it nor any of its officers,members,agents,or employees,will engage in performing this contract,shall, in connection with the employment, advancement or discharge of employees or in connection with the terms,conditions or privileges of their employment,discriminate against person because of their age except on the basis of a bona fide occupational qualification,retirement plan or statutory requirement. Contractor further covenants that neither it nor its officers,members,agents,or employees,or person acting on their behalf,shall specify,in solicitations or advertisements for employees to work on this Contract,a maximum age limit for such employment unless the specified maximum age limit is based upon a bona fide occupational qualification,retirement plan or statutory requirement. Contractor warrants it will fully comply with the Policy and will defend,indemnify and hold City harmless against any and all claims or allegations asserted by third parties against City arising out of Contractor's alleged failure to comply with the above referenced Policy concerning age discrimination in the performance of this Contract. 17. DISCRIMINATION DUE TO DISABILITY: In accordance with the provisions of the Americans with Disabilities Act of 1990("ADA"),Contractor warrants that it will not unlawfully discriminate on the basis of disability in the provision of services to the general public,nor in the availability,terms and/or conditions of employment for applicants for employment with,or current employees of Contractor. Contractor warrants it will fully comply with ADA's provisions and any other applicable federal state and local laws concerning disability and will defend indemnify and hold City harmless against any claims or allegations asserted by third parties against City arising out of Contractor's alleged failure to comply with the above-referenced laws concerning disability discrimination in the performance of this Contract. Revised March 15, 1996 CITY OF FORT WORTH HIGHWAY CONSTRUCTION PREVAILING WAGE RATES FOR 1999 AIR TOOL OPERATOR $9.00 ASPHALT RAKER 9.55 ASPHALT SHOVELER 8.80 BATCHING PLANT WEIGHER 11.51 CARPENTER 10.30 CONCRETE FINISHER-PAVING 10.50 CONCRETE FINISHER-STRUCTURES 9.83 CONCRETE RUBBER 8.84 ELECTRICIAN 15.37 FLAGGER 7.55 FORM BUILDER-STRUCTURES 9.83 FORM LINER-PAVING&CURB 9.00 FORM SETTER-PAVING&CURB 9.24 FORM SETTER-STRUCTURES 9.09 LABORER-COMMON 7.32 LABORER-UTILITY 8.94 MECHANIC 12.68 OILER 10.17 w SERVICER 9.41 PAINTER-STRUCTURES 11.00 PIPE LAYER 8.98 BLASTER 11.50 ASPHALT DISTRIBUTOR OPERATOR 10.29 ASPHALT PAVING MACHINE 10.30 BROOM OR SWEEPER OPERATOR 8.72 BULLDOZER 10.74 CONCRETE CURING MACHINE 9.25 CONCRETE FINISHING MACHINE 11.13 CONCRETE PAVING JOINT MACHINE 10.42 CONCRETE PAVING JOINT SEALER 9.00 CONCRETE PAVING SAW 10.39 CONCRETE PAVING SPREADER 10.50 SLIPFORM MACHINE OPERATOR 9.92 CRANE,CLAMSHELL,BACKHOE,DERRICK,DRAGLINE,SHOVEL 11.04 FOUNDATION DRILL OPERATOR CRAWLER MOUNTED 10.00 FOUNDATION DRILL OPERATOR TRUCK MOUNTED 11.83 FRONT END LOADER 9.96 MILLING MACHINE OPERATOR 8.62 MIXER 10.30 MOTOR GRADER OPERATOR FINE GRADE 11.97 MOTOR GRADER OPERATOR 10.96 PAVEMENT MARKING MACHINE 7.32 ROLLER,STEEL WHEEL PLANT-MIX PAVEMENTS 9.06 ROLLER,STEEL WHEEL OTHER FLATWHEEL OR TAMPING 8.59 ROLLER,PNEUMATIC,SELF-PROPELLED SCRAPER 8.48 SCRAPER 9.63 TRACTOR-CRAWLER TYPE 10.58 TRACTOR-PNEUMATIC 9.15 TRAVELING MIXER 8.83 WAGON-DRILL,BORING MACHINE 12.00 REINFORCING STEEL SETTER-PAVING 13.21 REINFORCING STEEL SETTER-STRUCTURES 13.31 STEEL WORKER-STRUCTURAL 14.80 SPREADER BOX OPERATOR 10.00 _ WORK ZONE BARRICADE 7.32 TRUCK DRIVER-SINGLE AXLE LIGHT 8.965 TRUCK DRIVER-SINGLE AXLE HEAVY 9.02 TRUCK DRIVER-TANDEM AXLE SEMI TRAILER 8.77 TRUCK DRIVER-LOWBOY/FLOAT 10.44 TRUCK DRIVER-TRANSIT MIX 9.47 TRUCK DRIVER-WINCH 9.00 VIBRATOR OPERATOR-HAND TYPE 7.32 WELDER 11.57 ' 11 PROPOSAL TO: Mr. Bob Terrell City Manager Fort Worth, Texas FOR: RECONSTRUCTION OF SHIVER ROAD FROM NORTH BEACH STREET TO TRACE RIDGE PARKWAY PROJECT No. r., FILE No. K-1612 DOE #: 2921 Pursuant to the foregoing"Notice to Bidders",the undersigned has thoroughly examined the plans, specifications and the site,understands the amount of work to be done,and hereby proposes to do all the work and furnish all labor,equipment,and materials necessary to complete all the work as provided in the plans and specifications,and subject to the inspection and approval of the Department of Engineering Director of the City of Fort Worth. Upon acceptance of this proposal by the City Council,the bidder is bound to execute a contract and furnish Performance and Payment Bond approved by the City of Fort Worth for performing and completing said work within the time stated and for the following sums,to-wit: SPEC PAY APPROX. DESCRIPTION OF ITEMS WITH BID UNIT TOTAL ITEM ITEM QUANTITY PRICES WRITTEN IN WORDS PRICE AMOUNT BID S.P. 1. 1 LS. UTILITY ADJUSTMENT OAA r pow"rov" Dollars& 040y Cents Per LS. $1,000.00 $1,000.00 S.P. 2. 2 EA. PROJECT DESIGNATION SIGNS Tta'.ytivOe�'o Dollars& .rte Cents Per EA. $300.00 $600.00 S.P. 3. 6500 CY. UNCLASSIFIED STREET EXCAVATION 106 "Wo-If- Dollars& ZW,y-*y o1*V Cents Per CY. $ ZS $ °O 112 4. 5100 CY. BORROW TAHe Dollars& 7107-✓ Cents Per CY. $ 2 $ 210 5. 138 Ton LIME .0C--0VW!X Dollars& mw Cents Per Ton $_9,0'. $_e4y vap. 210 6. 9201 SY. 6"LIME STABILIZED SUBGRADE O�vF Dollars& Fiery Cents Per SY. $ / $ b -� S.P. 7. 8858 SY. 6"REINFORCED CONCRETE PAVEMENT 314 _1~,,_ w Dollars& r�t,�:yrYtE i�Cents Per SY. $ /7. — $ /�97?1.4 S.P. 8. 12850 LF. SILICONE JOINT SEALANT 6rit4l 1 Dollars& 1G�r Cents Per LF. S.P. 9. 3578 LF. 7"CONCRETE CURB 71"^o Dollars& Cents Per LF. $ 1 $ 0.eo 504 10. 4266 SF. STD.4"REINFORCED CONCRETE SIDEWALK,LEADWALK AND/OR WHEELCHAIR RAMPS K o0 Jymear't Dollars& $ $ ,79 - /Vb Cents Per SF. S.P. 11. 171 Ton H.M.A.C.TRANSITION(6"THICK, 312 SUBBASE ONLY) -gr6 Ample Fi✓B Dollars& $ /Z��ZS. .W Cents Per Ton 12. 20 L.F END-OF-ROAD BARRICADES PER STANDARD S-M 12 '.0ery 00040e Dollars& $ .q¢, $ *.VV Cents Per'seri 4r, S.P. 13. 100 LF. 6"PIPE SUBDRAIN r~4460d Dollars& tiv Cents Per LF. $ /I, $ /�Z�,=w 440 14. 80 LF. 12"CL.III R.C.P. nyAtovsy oiv€ Dollars& it/o Cents Per LF. $ 2s=' $ 440 15. 90 LF. 21"CL. III R.C.P. rWiRrf oawovo-0- Dollars& Cents Per LF. $ —MV $ she o0 440 16. 126 LF. 24"CL.III R.C.P. *svery riM9 Dollars& Ow Cents Per LF. $ -ov. w. $ S29Z, 440 17. 218 LF. 30"CL.III R.C.P. ,-*A P P V 070V,Wr Dollars& .o -,Cb Cents Per LF. $ 9fw - $ 440 18. 303 LF. 33"CL.III R.C.P. Si)e!Ze Dollars& _/e% Cents Per LF. $ „on '" $ 19. 1 EA. 33"SLOPING HEADWALL .lE vOAU - Dollars& iLr� Cents Per bg eV 444 21. 3 EA. STD. 1�5' INLE 'i .vydtEd Dollars& µ Cents Per EA. $ ,.foe. $ 7=fcw.'b 444 22. 2 EA. STD.4' SQ.DROP INLET rsae r vvriao%oy Dollars& O.b Cents Per EA. $�,00w. a $ -oram v S.P. 23. 737 LF. TRENCH SAFETY 525 avow- Dollars& 09Ar Cents Per LF. $ /,�� $ 402 24. 620 CY TRENCH EXCAVATION&BACKFILL sic Dollars& iw Cents Per CY. $ i!oo $ me7to. 25. 151.3 CY 2-10'X8' MULTIPLE BOX CULVERT WITH WALL14ND APOS qc�0 �yr~y .vd Dollars& $ 3ZS.'s $ giro Cents Per CY. 26. 220 SY. ROCK RIPRAP(12"— 15" DIA.TYPE `A' DRY,THD ITEM 432.4) ?wywrYi060w_ Dollars& I $ �S,'s' $ f..4Y Cents Per @*s. "p'N4 27. 2600 CY UNCLASSIFIED CHANNEL EXCAVATION r*940 Dollars& ow-Fry Cents Per CY. $ ?. $ S.P. 28. 280 CY TOP SOIL 116 NINE Dollars& NO Cents Per CY. $ 9.00 $ 2,520.00 29. 1 LS REMOVE AND DISPOSE OF EXISTING 8' X 4' BOX,INCLUDING WINGWALLS, APRONS AND RIJRAP S0 en Dollars& $ Z-1bo $_jrwxdp,?' _g0Vd0 Cents Per LS. 30. 33,500 SF SEEDING .w Dollars& $ m,es $ /r7s Fir1f' Cents Per SF. 31. 116 LF STD.HAND RAIL,TXDOT TYPE PR2 fiirf Dollars& $ .w Cents Per LF. TOTAL BID $ This contract is issued by an organization which qualifies for exemption pursuant to the provision of Article 20.04(F)of the Texas Limited Sales,Excise and Use Tax Act, Taxes. All equipment and materials not consumed by or incorporated into the project construction,are subject to State sales taxes under House Bill 11,enacted August 15, 1991. The successful Bidder shall be required to complete the attached Statement of Materials and Other Charges at the time of executing the contract. The Contractor shall comply with City Ordinance 7278,as amended by City Ordinance 7400(Fort Worth City Code Sections 13-A-21 through 13-A-29),prohibiting discrimination in employment practices. The undersigned agrees to complete all work covered by these contract documents within Forty-five (45) Working Days from and after the date for commencing work as set forth in the written Work Order to be issued by the Owner and to pay not less than the"Prevailing Wage Rates for Street, Drainage and Utility Construction'as established by the City of Fort Worth,Texas. Within ten(10)days of receipt of notice of acceptance of this bid,the undersigned will execute the formal contract and will deliver an approved Surety Bond for the faithful performance of this contract. The attached deposit check in the sum of ,s% ./ Dollars ($ )is to be forfeited in the event the contract and bond are not executed within the time set forth,as liquidated damages for delay and additional work caused thereby. (Uwe), acknowledge receipt of the following addenda to the plans and specifications,all of the provisions and requirements of which have been taken into consideration in preparation of the foregoing bid: / Addendum No. 1 (Initials) A.X Addendum No.3(Initials) Addendum No.2(Initials) Addendum No.4(Initials) Respectfully submitted: BY fir.+L✓. fa►C 79S Address f „www Ts,., Oj -*11c) Telephone (2!;P)-8'147- P066 (SEAL) Date 20 2 VENDOR COMPLIANCE TO STATE LAW The 1985 Session of the Texas Legislature passed House Bill 620 relative to the award of contracts to nonresident bidders. This law provides that,in order to be awarded a contract as low bidder,nonresident bidders (out-of-State contractors whose corporate offices or principal place of business are outside of the State of Texas) bid projects for construction,improvements,supplies or services in Texas at an amount lower than the lowest Texas resident bidder by the same amount that a Texas resident bidder would be required too underbid a nonresident bidder in order to obtain a comparable contract in the State in which the nonresident's principal place of business is located. The appropriate blanks in Section A must be filled out by all out-of-State or nonresident bidders in order for your bid to meet specifications. The failure of out-of-State or nonresident contractors to do so will automatically disqualify that bidder. Resident bidders must check the box in Section B. A. Nonresident vendors in (give State),our principal place of business,are required to be percent lower than resident bidders by State law. A copy of the Statute is attached. Nonresident vendors in (give State),our principal place of business,are not required to underbid resident bidders. B. Our principal place of business or corporate offices are in the State of Texas. BIDDER: .o By: ✓rr`..d✓. Sr4L.-I& (Please print) ,oP;:,46y- -79 3d o Signatu00�� Title: Age..ds.,g City State Zip (Please print) THIS FORM MUST BE RETURNED WITH YOUR QUOTATION City of Fort Worth Minority and Women business Enterprise Specifications SPECIAL INSTRUCTIONS FOR BIDDERS APPLICATION OF POLICY If the total dollar value of the contract is $25,000 or more, the M/WBE goal is applicable. If the total dollar value of the contract is less than $25,000,the M/WBE goal is not applicable. POLICY STATEMENT It is the policy of the City of Fort Worth to ensure the full and equitable participation by Minority/Women Business Enterprises (M/WBE) in the procurement of all goods and services to the City on a contractual basis. The objective of the Policy is to increase the use of M/WBE firms to a level comparable to the availability of M/WBEs that provide goods and services directly or indirectly to the City. MNVBE PROJECT GOALS The City's MBE/WBE goal on this project is 19%of the base bid value of the contract. COMPLIANCE TO BID SPECIFICATIONS On City contracts of$25,000 or more, bidders are required to comply with the intent of the City's M/WBE Ordinance by either of the following: 1. Meet or exceed the above stated MfWBE goal, or; { 2. Good Faith Effort documentation, or; 3. Waiver documentation. SUBMITTAL OF REQUIRED DOCUMENTATION The applicable documents must be received by the Managing Department, within the following times allocated, in order for the entire bid to be considered responsive to the specifications. 1. M/WBE Utilization Form: received by 5:00 p.m.,five(5)City business days after the bid opening date,exclusive of the bid opening date. 2. Prime Contractor Waiver Form: received by 5:00 p.m.,five(5)City business days after the bid opening date,exclusive of the bid opening date. 3. Good Faith Effort Form: received by 5:00 p.m.,five (5)City business days after the bid opening date,exclusive of the bid opening date. FAILURE TO COMPLY WITH THE CITY'S M/WBE ORDINANCE,WILL RESULT IN THE BID BEING CONSIDERED NON-RESPONSIVE TO SPECIFICATIONS. a Any questions, please contact the MfWBE Office at(817)871-6104. Rev.6/2/98 ATTACHMENT 1A City of Fort Worth Page 1 of 2 Minority and Women Business Enterprise Specifications MBE/WBE UTILIZATION ".,PRIME COMPANY NAMES ' BID DATE Apawhe 9 PROJECT NAME PROJECT NUMBER CITY'S M/WBE PROJECT GOAL: /C?n/ EI E PERCENTAGE ACHIEVED: 31Y. Failure to complete this form, in its entirety with supporting documentation, and received by the Managing „Department on or before 5:00 p.m. five (5) City business days after bid opening, exclusive of bid opening date, will result in the bid being considered non-responsive to bid specifications. The undersigned bidder agrees to enter into a formal agreement with the MBE and/or WBE firms for work listed in this schedule, conditioned upon execution of a contract with the City of Fort Worth. The intentional and/or knowing misrepresentation of facts is grounds for consideration of disqualification and will result in the bid being considered non-responsive to specifications. Company Name, Contact Name, Certified Specify All Contracting Specify All Items to be Dollar Amount Address,and Telephone No. _ Scope of Work(*) Supplied(*) �.-- � � �a H X y f V 2 AIT, "f/jro., .rw�isrt l Z So �, e�...�j kit ys.s' ✓s.:.d.Gr.l.�y 1 L,SS3,s� s MMMmust be located In the 8(nine)county marketplace or currently doing business In the marketplace at the time of bid. (*) Specify all areas In which MWBE's are to be utllbwd and/or hems to be supplied: i (') A complete listing of Items to be supplied Is required In order to receive credit toward the MNVBE goal. identify each Tier level. Tier.Means the level of subcontracting below the prime contractoriconsultant,Le.,a direct payment from the prime contractor to a subcontractor is considered 15`tier,a payment by a subcontractor to its supplier Is considered a tier. THIS FORM MUST BE RECEIVED BY THE MANAGING DEPARTMENT BY 5:00 p.m., FIVE(5)CITY BUSINESS DAYS AFTER BID OPENING, EXCLUSIVE OF THE BID OPENING DATE Rev.612198 ATTACHMENT 1A Page 2 of City of Fort Worth Minority and Women Business Enterprise Specifications MBE/WBE UTILIZATION .� Company Name,Contact Name, Certified Specify All Contracting Specify All Items to be Dollar Amount Address,and Telephone No. uScope of Work(•) Supplied(*) ,P: �- - 00 V 2 m U x3F Z ~_ The bidder further agrees to provide, directly to the City upon request, complete and accurate information regarding actual work performed by all subcontractors, including MBE(s) and/or WBE(s) arrangements submitted with this bid. The bidder also agrees to allow an audit and/or examination of any books, records and files held by their company that will substantiate the actual work performed by the MBE(s) and/or WBE(s) on this contract, by an authorized officer or employee of the City. Any intentional and/or knowing misrepresentation of facts will be grounds for terminating the contract or debarment from City work for a period of not less than three (3) years and for initiating action under Federal, State or Local laws concerning false statements. Any failure to comply with this ordinance and creates a material breach of contract may result in a determination of an irresponsible offeror and barred from participating in City work for a period of time not less than one (1)year. ALL MBEs and WBEs MUST BE CERTIFIED BY THE CITY BEFORE CONTRACT AWARD Gv. fe�.W �► mow. uthorized Signature Printed Signature Title Contact �. ,yam Conitaact Name and Title (if different) A tar "AiwNR Company Name Telephone Number(s) —AO-Ayn 79A30 45;w'7-2G►'S�B' Address ...�. Fax Number City/Sta-te/Zip Code Date THIS FORM MUST BE RECEIVED BY THE MANAGING DEPARTMENT BY 5:00 p.m., FIVE (5)CITY BUSINESS DAYS AFTER BID OPENING, EXCLUSIVE OF THE BID OPENING DATE Rev.6/2/98 ,.. ATTACHMENT 1B City of Fort Worth Page 1 of 1 Minority and Women Business Enterprise Specifications Prime Contractor Waiver Prime Company Name Project Name Bid Opening Date Project Number If both answers to this form are YES, do not complete ATTACHMENT 1C(Good Faith Effort Form). All questions on this form must be completed and a detailed explanation provided, if applicable. If the answer to either question is NO, then you must complete ATTACHMENT 1C. This form is only applicable if both answers are yes. i Failure to complete this form in its entirety and be received by the Managing Department on or before 5:00 p.m., five (5) City business days after bid opening, exclusive of the bid opening date, will result in the bid being considered non-responsive to bid specifications. - Will you perform this entire contract without subcontractors? Yes No If yes, please provide a detailed explanation that proves based on the size and scope of this project, this is your normal business practice and provide an operational profile of your business. Will you perform this entire contract without suppliers? Yes No If yes, please provide a detailed explanation that proves based on the size and scope of this project, this is your normal business practice and provide an inventory profile of your business. The bidder further agrees to provide, directly to the City upon request, complete and accurate information regarding actual work performed by all subcontractors, including MBE(s) and/or WBE(s)on this contract,the payment therefore and any proposed changes to the original MBE(s) and/or WBE (s) arrangements submitted with this bid. The bidder also agrees to allow an audit and/or examination of any books, records and files held by their company that will substantiate the actual work performed by the MBE(s) and/or WBE(s)on this contract, by an authorized officer or employee of the City. Any intentional and/or knowing misrepresentation of facts will be grounds for terminating the contract or debarment from City work for a period of not less than three (3) years and for initiating action under Federal, State or Local laws concerning false statements. Any failure to comply with this ordinance and creates a material breach of contract may result in a determination of an irresponsible offeror and barred from participating in City work for a period of time not less than one(1)year. ® Authorized Signature Printed Signature Title Contact Name (if different) Company Name Contact Telephone Number(s) Address Fax Number Rev.6/2/98 PW ATTACHMENT 1C Page 1 of 3 City of Fort Worth Minority and Women Business Enterprise GOOD FAITH EFFORT Prime Company Name Bid Date . .ww .F'•.�O Dobe z9Z� Project Name Project Number If you have failed to secure M/WBE participation and you have subcontracting and/or supplier opportunities or if your M/WBE participation is less than the City's project goal,you must complete this form. If the bidder's method of compliance with the M/WSE goal is based upon demonstration of a "good faith effort", the bidder will have the burden of correctly and accurately preparing and submitting the documentation required by the City. Compliance with each item, 1 thru 6 below, shall satisfy the Good Faith Effort requirement absent proof of fraud, intentional and/or knowing misrepresentation the facts or intentional discrimination by the bidder. Failure to complete this form, in its entirety with supporting documentation, and received by the Managing Department on or before 5:00 p.m. five (5) City business days after bid opening, exclusive of bid opening date, will result in the bid being considered non-responsive to bid specifications. 1.) Please list each and every subcontracting and/or supplier opportunity (DO NOT LIST NAMES OF FIRMS)which will be used in the completion of this project, regardless of whether it is to be provided by a M/WBE or non-M/WBE. (Use additional sheets, if necessary) List of: Subcontracting Opportunities List of: Supplier Opportunities ,Aewvw7dW-V,,WOWV".,4 .At T� r L•SA1�L �.��s+A�a- i�"iM•'Cr�r.Y(<r�l`J�ll �o�c�c .P� �y� �L�i•cv.to.. C•.�7�s1, ATTACHMENT 1C Page 2 of 3 2.) Did you obtain a current list of M/WBE firms from the City's M/WBE Office? The list is considered in compliance, if it is not more than 3 months old from the date of bid opening. Yes Date of Listing d-4 / .3 1 / oc> No 3.) Did you solicit bids from M/WBE firms,within the subcontracting and/or supplier areas previously �- listed, at least ten calendar days prior to bid opening by mail, exclusive of the day the bids are opened? -/Yes If yes, attach M/WBE mail listing to include name of firm and address and a dated No copy of letter mailed. 4.) Did you solicit bids from M/WBE firms,within the subcontracting and/or supplier areas previously listed, at least ten calendar days prior to bid opening by telephone, exclusive of the day the bids are opened? /Yes If yes, attach list to include name of M/WBE firm, person contacted, No phone number and date and time of contact. el.//•d -W11rA10 NOTE: A facsimile may be used to comply with either 3 or 4, but may not be used for both. If a facsimile is used, attach the fax confirmation, which is to provide M/WBE name, date, time, fax number and documentation faxed. NOTE: If a SIC list of M/WBE is ten or less, the bidder must contact the entire list to be in compliance with questions 3 and 4. If a sic list of M/WBE is more than ten, the bidder must contact at least two- thirds of the list but not less than ten to be in compliance with questions 3 and 4. 5.) Did you provide plans and specifications to potential M/WBEs or information regarding the location of plans and specifications in order to assist the M/WBEs? Yes No 6.) If M/WBE bids were received and rejected,you must: (1) List the M/WBE firms and the reason(s)for rejection (i.e.,quotation not commercially reasonable, qualifications, etc.)and (2) Attach affidavit and/or documentation to support the reason(s) listed below(i.e.. letters, memos, bids,telephone calls, meetings,etc.) Please use additional sheets,it necessary,and attach. Company Name Telephone Contact Person Scope of Work Reason for Rejection ATTACHMENT 1C Page 3 of 3 ADDITIONAL INFORMATION: Please provide additional information you feel will further explain your good and honest efforts to obtain MIWBE participation on this project. The bidder further agrees to provide, directly to the City upon request, complete and accurate information regarding actual work performed on this contract, the payment thereof and any proposed changes to the original arrangements submitted with this bid. The bidder also agrees to allow an audit and/or examination of any books, records and files held by their company that will substantiate the actual work performed on this contract, by an authorized officer or employee of the City. Any intentional and/or knowing misrepresentation of facts will be grounds for terminating the contract or debarment from City work for a period of not less than three (3) years and for initiating action under Federal, State or Local laws concerning false statements. Any failure to comply with this ordinance and creates a material breach of contract may result in a determination of an irresponsible offeror and barred from participating in City work for a period of time not less than one (1) year. The undersigned certifies that the information provided and the M/WBE(s) listed was/were contacted in good faith. It is understood that any M/WBE(s) listed in Attachment 1C will be contacted and the reasons for not using them will be verified by the 's M/WBE Office. thorized Signature Printed Signature Title Contact Name and Title(if different) Company Name Telephone Number(s) Address Fax Number City/StatelZip Date STORM WATER POLLUTION PREVENTION PLAN for CONSTRUCTION ACTIVITIES at Shiver Road Reconstruction Fort Worth, Texas Prepared for: CITY OF FORT WORTH Department of Engineering 1000 Throckmorton Street Fort Worth,Texas 76102 Y Prepared b : P Carter . Burgess Consultants in Planning,Engineering,Architecture, Construction Management,and Related Services 3880 Hulen Street Fort Worth, Texas 76107 (817) 735-6000 February 2000 C&B NO.991258010 EXECUTIVE SUMMARY PROJECT: Shiver Road Reconstruction The United States Environmental Protection Agency (USEPA) promulgated storm water regulations pursuant to the National Pollutant Discharge Elimination System (NPDES) Program. This Storm Water Pollution Prevention Plan (SWPPP) has been developed in accordance with the conditions of the General Permit for Storm Water Discharges from Construction Activity authorized pursuant to the USEPA NPDES Program. The purpose of the SWPPP is to minimize the potential release of pollutants directly or indirectly I� into the storm water collection system or waters of the United States. To achieve this objective, the permittee(s)will be required to implement the USEPA NPDES policies and procedures presented in this SWPPP including, but not limited to, the following: • File a Notice of Intent (NOI)with the USEPA at least 48 hours prior to beginning the construction activities (a copy of the NOI is located in Appendix A). Upon receipt, place a copy of the Permit Coverage Notice from USEPA in Appendix B. Contractors and Construction Managers must refer to Part IX.V of the NPDES, Page 26509 (Appendix.!) to determine if they will be required to submit an NOI. If considered an 'Operator', then an NOI will need to be submitted. • Prior to filling in the box regarding endangered species of the NOI, it is recommended that the 'Operator' consult with the U.S. Fish and Wildlife or a biologist (Carter& Burgess, Inc.'s environmental department has personnel in staff who can perform the field investigation and research) to insure that the construction activities are not likely to jeopardize the continued existence of any listed species or result in the destruction or adverse modification of critical habitat. Refer to Section IV, "Endangered Species Protection" of the attached NPDES (Appendix J), Pages 36492-36495. • Prominently post in a place for public viewing at the construction site (such as along side a building permit) a copy of the following: The NPDES permit number for the project or a copy of the NOI if a permit number has not yet been assigned; the name and telephone number of a local contact person; a brief Project description; the location of the SWPPP if the site is inactive or does not have an on-site location to store the plan. • Implement and properly maintain all erosion and sediment controls presented in this " SWPPP. • Maintain a record of the dates when major grading activities occur, when construction activities temporarily or permanently cease on a portion of the Project site, and when final stabilization measures are implemented (a copy of the Record of Temporary/Permanent Ceasing of Construction Activities sheet is provided in Appendix C). • Conduct regular inspections of the erosion and sediment controls. These inspections must occur at least once every fourteen (14) calendar days and within 24 hours of the end of a storm that is 0.5 inches or greater(a copy of the Inspection Report sheet is provided in Appendix D). • Based on the outcome of the inspections, implement any needed repairs or modifications to the control(s)within seven calendar days following the inspection. Modifications specific to construction projects must be approved by the Client prior to implementation by the Contractor and/or subcontractors. • This SWPPP must be updated within seven calendar days each time a significant modification to the construction activities or pollutant control practices occur. These modifications shall be recorded on the Storm Water Pollution Prevention Plan Revision sheet located in Appendix E and in additional appendix material if required. • Keep a record of construction materials which are stored on site and may be a source of pollutants, i.e., sand, gravel, cement, etc. Indicate dates of storage and measures taken to minimize the potential release of such pollutants directly or indirectly into the storm water collection system. Note that offsite material storage areas (also including overburden and stockpile areas of dirt, borrow areas, etc.) Used solely by the permitted project are considered a part of the project and shall also be included on the record. A form for recording materials is found in Appendix F. • Maintain a copy of this SWPPP and the Erosion Control Plans on the Project site throughout a the duration of construction activities. • Upon completion of the construction activities and final stabilization, submit a Notice of Termination (NOT) to the USEPA (a copy of the NOT is located in Appendix G). • This SWPPP along with the supporting documentation must be retained for a period of three (3) years after the completion of the Project. It is recommended that each of the operator(s) maintain a copy of the SWPPP for the three-year period. The SWPPP has been developed for the construction activities to occur at the above-referenced Project. The SWPPP allows for flexibility in complying with the provisions of the USEPA NPDES General Permit for Storm Water Discharges Associated With Construction Activity. TABLE OF CONTENTS Page No. I. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 II. SITE DESCRIPTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 A. Location and Nature of Construction Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 B. Sequence of Major Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 C. Estimate of Total Site Area and Disturbed Area . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 D. Estimate of Runoff Coefficient 4 E. Storm Water Discharge Quality Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 F. Information on Soil Types : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : 4 G. Receiving Waters 4 H. Standard Industrial Classification Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 III. MEASURES AND CONTROLS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 A. Erosion and Sediment Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 1. Structural Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 �I 2. Soil Stabilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 B. Storm Water Management Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 C. Other Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 1. Dust Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2. Waste Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 3. Sanitary/Septic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 4. Water Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 5. Construction Phase 'Best Management Practices" . . . . . . . . . . . . . . . . . . . 9 IV. STATE AND LOCAL PROGRAMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 V. INSPECTION AND MAINTENANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 VI. PROCEDURAL REQUIREMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 VII. APPENDIX A. Notice of Intent B. Permit Coverage Notice from EPA C. Record of Temporary/Permanent Ceasing of Construction Activities D. Inspection Report E. Storm Water Pollution Prevention Plan F. Record of Construction Materials G. Notice of Termination H. Project Description (To Be Posted at Construction Site) I. Project Location Map J. Reissuance of NPDES General Permits for Storm Water Discharges ■ From Construction Activities in Region 6 STORM WATER POLLUTION PREVENTION PLAN for CONSTRUCTION ACTIVITIES at Shiver Road Reconstruction I. INTRODUCTION This Storm Water Pollution Prevention Plan(Plan)has been prepared for major construction activities associated with mass grading, underground utilities, storm drain and street construction at Shiver Road Reconstruction, in the City of Fort Worth, Texas. It includes the elements necessary for compliance with the Texas general permit for construction activities (Permit No. T X R100000) administered by the U.S. Environmental Protection Agency(EPA)under the National Pollutant Discharge Elimination System(NPDES)program. This Plan must be implemented prior to the start of each major construction activity which could disturb site soil. The purpose of this Plan is to provide guidelines and techniques for preventing soil and pollutants that originate on the site during construction from flowing off the site with storm water. It addresses the major activities known to present significant pollution potential during construction of subdivision improvements. Also, the necessary forms are included for implementing the Plan, including Notice of Intent, Inspection Reports, and Notice of Termination. IP This project consists of constructing public improvements and graded lots for detached single-family homes. This Plan has been prepared for mass grading, underground utilities, storm drain and street `- paving only, and not for home construction. This Plan terminates when areas disturbed reach final stabilization. (Final stabilization is achieved once all unpaved areas have at least 70% grass coverage.) The Texas general permit for construction activities provides for the following types of non-storm water discharges (which could originate at the site): A. Fire hydrant flushings, B. Water used to wash vehicles or control dust, C. Potable water sources, such as flushing new water distribution pipes, D. Springs, E. Uncontaminated groundwater, F. Irrigation drainage, and G. Pavement washwaters where spills or leaks of toxic or hazardous materials have not occurred(unless all spilled material has been removed). The storm water management controls included in this Plan focus on providing control of pollutant discharges with practical approaches that utilize readily available techniques, expertise, material and equipment. i NAJ0B\991258\RP n99125801.R01 Page 1 The Owner referred to in this Plan is _ The City of Fort Worth, II. SITE DESCRIPTION A. Location and Nature of Construction Activity The project is located in Fort Worth, Tarrant County, Texas (latitude 32°54' 06" north and longitude 97'16' 50" west). The sequence of construction will be as follows: mass grading, followed by construction of underground utilities(storm drain) and street pavement. B. Sequence of Major Activities Major activities included that are expected to disturb significant areas of soil are listed below in the anticipated sequence. 1. Construction of underground utilities (storm drain); 2. Grading including fine grading of street to prepare the area for paving; and 3. Construction of street pavement. Based on the anticipated construction sequence, specific tasks for each contractor are listed below. Utility Contractor: 1. Provide stabilized construction entrances, sediment barriers and silt traps. 2. Proceed with underground utility construction subject to the pollutant control requirements of this plan. 3. Install Stage I Inlet Protection devices following inlet construction. 4. Upon completion of utilities, make sure the construction entrance, sediment barriers, sediment traps, and Stage I Inlet Protection devices are clean and functional. Grading Contractor 1. Repair the construction entrance. Clean the existing rock and/or add rock as necessary to prevent mud and dirt from being tracked onto adjacent streets. N:VOB\991258\RPT199125801.R01 Page 2 2. Repair, maintain, and install sediment barriers, silt traps, and inlet protection devices throughout the project. Replace if required. Remove silt and mud, if required to restore sediment containment volume. 3. Proceed with grading subject to the pollutant control requirements of this plan. 4. Make sure the construction entrances, sediment barriers, sediment traps, and inlet protection devices are clean and functional before leaving the site. Paving Contractor 1. Repair the construction entrances. Clean the existing rock and/or add rock as necessary to prevent mud and dirt from being tracked onto adjacent streets. 2. Proceed with construction subject to the pollutant control requirements of this Plan. 3. Install stage 2 curb inlet protection devices after the streets are paved. (The Contractor may select from the techniques shown on the Detail Sheet or propose another technique for Owner consideration.) 4. Remove and dispose of the construction entrance and earth containment berms once their use is no longer needed. The pavement contractor must dispose of the material off the project site at no additional expense to the Owner. The paving contractor will also remove the sediment barriers, sediment traps, and stage 2 inlet protection devices. C. Estimate of Total Site Area and Disturbed Area The total project area is approximately 5 acres. The entire area will be disturbed as a result of the mass grading. D. Estimate of Runoff Coefficient During construction,the site will have a runoff coefficient of approximately 0.35. After site improvements are complete, it will have a runoff coefficient of approximately 0.90. E. Storm Water Discharge Quality Data Data is not available describing quality of storm water discharges from the site. N:\JOB\991258\RPTW9125801.R01 Page 3 F. Information on Soil Types According to the "Soil Survey of Tarrant County Texas" (U.S. Department of Agriculture, Soil Conservation Service), there are 3 predominant soil types at the site. All the soils have a value of 0.32 for Erosion Factor W of the Universal Soil Loss Equation. The soil types are: 1. Branyon Clay, 0 to 1 percent slopes 2. Sanger clay, 1 to 3 percent slopes 3. Slidell clay, 1 to 3 percent slopes G. Receiving Waters The receiving water body is Whites Branch. �r H. Standard Industrial Classification Codes The major construction activities associated with development of this subdivision have the Standard Industrial Classification codes listed below. 1629 Heavy Construction(Earth moving and drainage construction) 1623 Water, Sewer and Miscellaneous Underground Utility Construction 1611 Street Construction IV. MEASURES AND CONTROLS A. Erosion and Sediment Controls 1. Structural Controls The first step in implementing this Plan is for the mass grading contractor to build the Construction Entrances. The Sediment Barriers must be constructed before grading begins in order to contain sediment on-site. The barriers must be functional before upslope land is disturbed. Subject to inspection and repair, underground utility and pavement contractor should continue to use the Construction Entrances and other erosion and sediment measures which were installed by the mass grading contractor. Structural controls must be supplemented by each contractor as on-site Ir experience proves necessary in order to control sediment and pollutant discharge. (As an example,weather and construction conditions could make it N:U0B\991258\RPT199125801.R01 Page 4 necessary to install temporary sediment traps.) Each contractor is responsible for controlling erosion, sedimentation and chemical pollution that could result from his particular activity. Curb inlet protection will occur in two stages. While the surrounding area is disturbed(prior to paving),Stage 1 will be installed to prevent soil from entering the outlet pipe. As streets are paved, Stage 1 curb inlet protection can be removed. The second stage involves placing protection around the inlet entrance. Stage 2 inlet protection will be removed by the Owners once the site has reached final stabilization. Silt fence with stakes attached to the filter fabric is available commercially. Subject to approval by the Owners, contractors may utilize that product or the silt fence details,whichever proves adequate for each particular application. 2. Soil Stabilization The Contractor is responsible for establishing grass on all disturbed soil as grading is completed, and will also be responsible for watering and maintaining the grass. Thereafter, the Owners will maintain the grass. a. Temporary Vegetation ■' Within 14 days after construction activity ceases on any particular area, all disturbed ground that will remain dormant for longer than 21 days must be seeded with fast-germinating temporary seed. If needed, the seed should be protected with mulch. b. Permanent Vegetation All areas at final grade shall be seeded within 14 days after completion of grading activities. Except for small, level spots, seeded areas might need to be protected with mulch. (1) Mulching: For this Plan, the term mulching means the application of plant residues or synthetic materials to the soil surface. The purpose of applying mulch is to prevent erosion from raindrop impact, shallow overland flow and wind. This is generally necessary during the period when grass is sprouting in order to protect the seeds and sprouts,and to provide a moist environment conducive to germination. op N:\J0B\991258\RP'n99125801.R01 Page 5 Mulch can be either organic material that has been specifically processed to function as mulch or synthetic material 4 manufactured for that use. Mulch should be applied according to manufacturer or supplier instructions. Asphalt binders are not permitted on this project. (2) Seedins�: The term "seeding" means the establishment of grass cover on disturbed areas by planting seed. The purpose is to protect the soil surface from erosion. Seed can be applied by broadcast, drilling, or hydraulic means, as approved by the Owner. The surface should be prepared and the seed applied according to seed supplier recommendations. Suggested seed compositions are intended as guidelines only, and can be modified with Owner approval based on specific site conditions. far `in> U, bet* . en:arch 1 and.S a pember:: ...._ ._. _..............I....._........... .. ............_. . ......_.. .: bs.{X CIoMmon l a>a�e.. P W e1r ui t�©u 25 unhulled Bermuda 90% 90% 75 hulled Bermuda 90% 90% NOTE: As an alternative, Millet can be planted at 75 lbs/ac between March I and September 10. .. ..... _ .... . .... _ ._ _ . . ....................................... ........................................................... ............ ............................. 1. ............ ......................... ............ ............................................................ .............. ............... For I2: iti .between Se tember 1 U and<Marcli I: , Lbs.lAc. omrna>Q 11€ae Fnr>irm>inat�on 220 Rye Crass 90% 90% 75 hulled Bermuda 90% 90% Hydraulic seeding and turf sod are alternative methods which can be used for establishing grass on bare soil (subject to Owner approval). N:V0B\991258\RP'n99125801.R01 Page 6 B. Storm Water Management Controls Storm water management during construction of subdivision improvements will consist of containing pollutants on the site. Soil is the most significant potential pollutant. It will be contained by utilizing the Construction Entrances, Sediment Barriers, Sediment Traps. These controls must be properly installed and maintained by the contractors in order to contain soil on the site. Chemicals, fuels and similar potential pollutants will be contained by careful handling and storage and by utilizing Earth Containment Berms as needed. Sediment Control will be accomplished by interception before it enters storm drainage swales and by trapping it before it leaves the site. C. Other Controls 1. Dust Control During construction,water trucks will be used by each contractor to reduce dust as needed. After construction, the site will be stabilized with grass cover in order to reduce dust. Construction traffic must enter and exit the site at a Construction Entrance. The purpose of the rock pad is to contain nearly all soil and mud so that a minimum amount is tracked onto existing streets. i 2. Waste Disposal a. No solid materials,including building materials, can be discharged into either of the receiving waters, either directly or indirectly. All solid waste materials, including disposable materials incidental to the major construction activities, must be collected in containers. The containers must be emptied periodically and hauled to a landfill. Each contractor is responsible for proper collection and disposal of his own trash. b. Substances that have the potential for polluting surface and/or groundwater must be controlled by whatever means is necessary in order to ensure that they do not discharge from the site. (It is the responsibility of each contractor to make sure pollutant discharge is avoided.) As an example, special care must be exercised during equipment fueling and servicing operations. If a spill occurs, it must be contained and disposed of so that it will not flow from the site or soak into the soil. In this regard, potentially polluting substances must be handled in a manner consistent with the impact they represent. N:\.10B\991258\RPT\99125801.R01 Page 7 3. Sanitary/Septic Contractors must comply with all state and local sanitary sewer or septic system regulations. Temporary portable sanitary facilities must be provided at the site by each contractor throughout construction activities. They are to be utilized by construction personnel and serviced regularly by a commercial operator. All expenses associated with providing sanitary facilities are the responsibility of the contractors. 4. Water Source Water used to establish and maintain grass, to control dust, and for other construction purposes must originate from an approved public water supply. Otherwise, the water must not be allowed to discharge from the site. 5. Construction Phase "Best Management Practices" During construction the contractors will employ the following practices: a. Equipment fueling, maintenance and cleaning will only be done in protected areas. The areas will be surrounded by a temporary 15" high perimeter Earth Containment Berm, as shown on the Detail Sheet. b. Equipment washdown(except for wheel washes)must take place within an area surrounded by an Earth Containment Berm. Use of detergents is prohibited. C. Chemicals, paints, solvents, fertilizers and other toxic or hazardous materials must be stored in waterproof containers. Except during application, the containers must be kept in trucks or within covered storage facilities. Runoff containing such materials must be collected, removed from the site and disposed of at an approved solid waste or chemical disposal facility. V. STATE AND LOCAL PROGRAMS For this project,no state or local programs are currently in effect that would require erosion and sediment control, detention/retention of storm water runoff, or pollutant removal from storm water runoff beyond the scope of this Plan. N:U0B\991258\RPn99125801.R01 Page 8 VI. INSPECTION AND MAINTENANCE A. All disturbed areas and sediment control devices must be inspected every fourteen calendar days and within 24 hours after a rainfall of 0.5 inches or greater. Inspections must be conducted, and a written report prepared, by qualified personnel familiar with e the NPDES nationwide general permit, this Plan and the project. The Owners will conduct the inspections, keep a current copy of the Plan on the project site, post the Project Description (Appendix I), and insert inspection report forms (and all other h documents relating to storm water pollution prevention) in the Plan. B. Locations where vehicles exit the site must be inspected for evidence of off-site sediment tracking. Each contractor is responsible for inspecting and maintaining the Construction Entrances (as described previously), and other structural controls that remain in service while he is working. C. Inspections must evaluate areas used for storage of materials that are exposed to precipitation. The purpose is to ensure that materials are protected and/or impounded so that pollutants cannot discharge from the storage area. D. If sediment escapes the construction site, off-site accumulations of sediment must be removed at a frequency sufficient to minimize offsite impacts. E. Sediment must be removed from sediment traps or sedimentation ponds when design capacity has been reduced by 50%. F. Seeded areas will be inspected to confirm that a healthy stand of grass is maintained. The site has achieved final stabilization when all areas not covered with pavement have a stand of grass with at least 70%density. G. Based on inspection results,any necessary modification to the Plan and pollutant control devices must be implemented within seven(7)calendar days. The Owners will update the Plan and the contractor(s) active at the time must modify the pollutant control devices. A modification is necessary if a control measure or operational procedure does not provide adequate pollutant control. Inspection reports must be completed including scope of the inspection,name(s)and qualifications of personnel making the inspection, date of the inspection, observed major construction activities, and actions taken as a result of the inspection. The inspection report should state whether the site was in compliance with this Plan or identify incidents of non-compliance. The report must be signed in accordance with Part VI.G of the NPDES nationwide general permit and inserted into the Plan. A sample Inspection Report is included in Appendix D. (Inspection reports must be kept,along with the Storm Water Pollution Prevention Plan, for at least three years from the date that the site achieves final stabilization.) NAV0B\991258\RPn99125801.R01 Page 9 H. It is the responsibility of each contractor to maintain effective pollutant controls. Physical site conditions or construction practices could make it necessary for the contractors to install more controls than are shown on the plan sheet. For example, localized concentrations of surface runoff or unusually steep areas could require additional Sediment Barrier or other structural controls. Assessing the need and installing additional controls will be a contractor responsibility until final stabilization is achieved. VII. PROCEDURAL REQUIREMENTS During construction,the following requirements of the NPDES nationwide general permit must be implemented: A. A Storm Water Pollution Prevention Plan(this Plan)must be completed for the project prior to submission of the Notices of Intent. B. Notices of Intent(EPA Form 3510-9)must be completed, signed and mailed at least 48 hours prior to beginning each major construction activity. The Owner will submit a signed Notice of Intent (NOI). The contractor(s), if required to submit by Owner or City,will submit a separate signed NOI. A copy of the NOI is included in Appendix A. The NOI should be mailed either registered or certified with return receipt requested. To the extent possible, mail all NOIs in the same envelope. The Owners and/or the reviewing municipality will decide whether each particular contractor will be required to sign the NOI. That decision is based on the level of responsibility for pollutant control that the Owners assign to each individual contractor. C. A copy of the current NOI and a brief description of the project (see Appendix H) must be posted in a prominent place for public viewing at the construction site until final stabilization has been achieved (and Notices of Termination have been mailed). The Owners will post the project description. Each contractor, in turn, will be responsible for maintaining the posted Notices of Intent and project description. D. A signed copy of the SWPPP must be retained at the project site at all times. E. The Owners will conduct inspections of the project as described previously to assure compliance with the Plan. Based on inspection results, the Plan and pollution prevention control techniques must be modified, if necessary, to assure that storm water or the identified non-storm water discharges are the only discharges leaving the site. (Refer to Part IV.D.4. of the NPDES nationwide general permit for specific requirements). NAJ0B\991258\RM99125801.R01 Page 10 Each contractor is responsible for: 1. Installing pollutant control devices indicated on the plan sheet; 2. Maintaining, repairing and replacing pollutant control devices during the time he is working on the project; and 3. Installing additional devices as directed by the Owner in order to control pollutants associated with his construction activities. F. This Plan must be updated each time there is a significant modification to major construction activities, contractors, or pollutant control practices. G. Discharge of hazardous substances or oil into storm water is subject to reporting requirements. The Operator is responsible for complying with these reporting requirements. H. If he submitted an NOI, the last task for each contractor who finishes his work is to complete a Notice of Termination(NOT) and give it to the Owners. Once each phase is completed and fully stabilized, the Owners will complete his NOT and submit all of them to the EPA. A sample NOT(EPA Form 3510-7)is included in Appendix G. I. Questions about the NPDES program can be directed to the EPA Region 6 Storm Water hotline at 800/245-6510. Information is also available through the EPA Region 6's Storm Water website at"http://www.epa.gov/region6/sw/." NAU0B\991258\RPTx99125801.R01 Page 11 VIII. APPENDIX A. Notice of Intent B. Permit Coverage Notice from EPA C. Record of Temporary/Permanent Ceasing of Construction Activities D. Inspection Report E. Storm Water Pollution Prevention Plan F. Record of Construction Materials G. Notice of Termination H. Project Description (To Be Posted at Construction Site) I. Project Location Map J. Reissuance of NPDES General Permits for Storm Water Discharges from Construction Activities in Region 6 N:VOBV91258\RPT199125801.R01 Page 12 r f s r APPENDIX A NOTICE OF INTENT 1 i 1 THIS FORM REPLACES PREVIOUS FORM 35113.6(8-98) Form Approved. OMB No.2040-m8 See Reverse for Instructions A United States Environmental Protection Agency NPDES Washington,OC 20460 FORM \��E PANotice of Intent(N01)for Storm Water Discharges Associated with CONSTRUCTION ACTIVITY Under a NPDES General Permit Submission of this Notice of Intent constitutes notice that the party Identified In Section I of this form intends to be authorized by a NPDES permit issued for storm water discharges associated with construction activity in the StateAndlan Country Land identified in Section II of this form. Submission d this Notice of Intent also constitutes notice that the party Identified in Section I of this form meets the eligibility requirements in Part I.B.of the general permit(including those related to protection of endangered species determined through the procedures In Addendum A of the general permit),understands that continued authorization to discharge Is contingent on maintaining permit etigibi ft and that Implementation of the Storm Water Pollution Prevention Plan required under Part iV of the general permit will begin at the time the permittee commences work on the construction project identified in Sedon 11 below. IN ORDER TO OBTAIN AUTHORIZATION,ALL INFORMATION REQUESTED MUST BE INCLUDED ON THiS FORM. SEE INSTRUCTIONS ON BACK OF FORM. L Owner/Operator(Applicant)Information Name: ! I I I I l t t l l I 1 1 1 1 1 1 1 i t l l l l l 1 1 I I I Phone: Status of Address;! t 1 1 1 1 i 1 1 1 1 1 1 1 i L 1 I l i t l t l l l l l l l l l l Owner/Opemtor. ❑ Ctf. I t 1 t 1 t i t I 1 1 1 I 1 I I i I I I I J State: I Zip Code: 1 1 1 1 1 1-1 1 1 1 ! h. Project/Site information Is the tadlity located on Indian Country Lands? Project Name: I t I I i I L t I I I 1 1 I I I I I 1 I 1 1 I 1 I I I I I t ! Yes ❑ No ❑ Project Address/Location:I I I I 1 1 1 1 1 1 1 .I 1 1 I 1 I i 1 I t I I I I I i t I 1 I I 1 1 State: L-J Zip code: 1 Latitude: 1 1 1 1 11 Longitude: 1 1 1 1 1 1 1 1 County- Has ounty Has the Storm Water Pollution Prevention Plan(SWPPP)been prepared? Yes❑ No❑ Optional: Address of location of SWPPP for viewing ❑ Address In Section 1 above ❑Address in Section II above ❑ Other address(N known)below: SWPPP Phone: Address: ) I I 1 1 1 1 1 1 1 1 j 1 I I t I I 1 1 I 1 I 1 1 1 II I I I 1 I I 1 I I 1 1 1 1 1 1 1 1 1 City I I I I I I I j 1 1 I I i t t I I 1 I 1 I IJ State: L t Zip Code: Name of Receiving Water: J l l l l l l l 11 1 1 I I I I I Based on Instruction provided in Addendum A of the permit,are Month gory Y"r Monte Day Year there any listed endangered or threatened species,or designated Estimated Construction Start Date Estimated Completion Date critical habitat in the project area? Estimate of area to be disturbed(to nearest acre): I I I I I I J Yes ❑ No ❑ Estimate of Likelihood of Discharge(choose only one): I have satisfied permit eligibility with regard to protection of endangered species through time indicated section of Part 1.B.3.e.(2) 1. ❑ Unlikely 3. ❑ Once per week 5. ❑ Continual of the permit(check one or more boxes): 2. ❑ One per month 4. ❑ Once per day (a) ❑ (b) ❑ (c) ❑ (d)❑ 111. Certification I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my Inquiry of the person or persons who manage this system,or those persons directly responsible for gathering the Information,the information submitted Is,to the best of my knowledge and bellef,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,including the possibility of fine and imprisonment for knowing violations. Print Name:I I I i l I l i l l l j l l l j l l l l l t l l l l t f l i l Date: ( 1 1 1 1 1 1 Signature: - EPA Form 3510-9 replaced 3510-6(8-98) Instructions—EPA Form 3510-9 Form Approved. OMB No.2040.0188 �-�EPA Notice of Intent(NOI)for Storm Water Discharges Associated with Construction Activity to be Covered Under a NPDES Permit Who Must File a Notice of Intent Form Convert decimal latitude 45.1234567 to degrees,minutes,and seconds. Under the provisions of the Clean Water Act,as amended,(33 U.S.C.1251 1) The numbers to the left of the decimal point are degrees. st.seq.;the Act),except as provided by Part I.B.3 the permit,Federal law 2) To obtain minutes, multiply the first four numbers to the right of the prohibits disclutrges of without a National PollutantDischargeDischarge Amination from Pte,ce Operator(s) Thenal point by 0.006. 1234 fthe x decimal =7.404. Sys Ope tox(s) 3) The numbers to the left of the Thenal point in the result obtained in of construction sites where 5 or more acres are disturbed,smaller sites that step 2 are the minutes: 7'. are part of a larger common plan of development or sale where there is a 4) To obtain seconds,multiply the remaining three numbers to the right of cumulative disturbance of at least 5 acres,or any site designated by the the decimal from the result in step 2 by 0.06: 404 x 0.06=24.24. Since Director,must submit an NOI to obtain coverage under an NPDES Storm the numbers to the right of the decimal point are not used,the result is Water Construction General Permit. If you have questions about whether 24'. you need a permit under the NPDES Storm Water program,or If you need 5) The conversion for 45.1234=450 T 24'. information as to whether a particular program is administered by EPA or Indicate whether the project is on Indian Country lends. a State agency,write to or telephone the Notice of Intent Processing Center at(703)931-3230. Indicate if the Storm Water Pollution Prevention Plan(SWPPP)has been developed. Refer to Part N of the general pemmft for information on SWPPPs. Whom to File NOI Form To be eligible for coverage,a SWPPP must have been prepared. NOls must be sent to the following address: Optional: Provide the address and phone number where the SWPPP can Storm Water Notice of Intent(4203) be viewed if different from addresses previously given. Check appropriate USEPA box 401 M.Street,SW Enter the name of the closest water body which receives the project`s Washington.D.C. 20460 construction'storm water discharge. Do not send Storm Water Pollution Prevention Plans(SWPPPs)to the Enter the estimated construction start and completion dates using four dgb above address. For overnight/express delivery of NOls,please include the for the year(I.e.05127/1998). room number 2104 Northeast Mall and phone number(202)260-9541 in Enter the estimated area to be disturtred including but not limited to: the address. grubbing,excavation,grading,and utilities and infrastructure installation. When to File Indicate to the nearest acre;If less than 1 acre,enter*1.* Note: 1 acre= This form must be filed at least 48 hours before construction begins. 43,560 sq.n. Indicate your best estimate of the likelihood of storm water discharges from Completing the Form the project. EPA recognizes that actual discharges may differ from this OBTAIN AND READ A COPY OF THE APPROPRIATE EPA STORM WATER estimate due to unforeseen or chance,circumstances. CONSTRUCTION GENERAL PERMIT FOR YOUR AREA, To complete Indicate if there are any listed endangered or threatened species, or designated critical habitat in the project area. this form,type or print,using uppercase letters,In the appropriate areas only. Please place each character between the marks (abbreviate if Indicate which Pari of the permit that the applicant is eligible with regard necessary to stay within the number of characters allowed for each item). to protection of endangered or threatened species,or designated critical Use one space for breaks between words,but not for punctuation marks habitat unless they are needed to clarify your response. If you have any questions on this form,call the Notice of intent Processing Center at(703)931-3230. Section III. Certification Section I. Facility Owner/Operator(Applicant)Information Federal Statutes provide for severe penalties for submitting false Information Provide the legal name, mailing address,and telephone number of the on this application form. Federal regulations require this application to be person,firm,public organization,or any other entity that meet either of the signed as follows: following two criteria: (1)they have operational control over construction For a corporation: by a responsible corporate officer, which means: plans and specifications,including the ability to make modifications to those (I)president,secretary,treasurer,or vice president of the corporation In plans and specifications;or(2)they have the day-to-day operational control charge of a principal business function,or any other person who perforans of arose activities at the project necessary to ensure compliance with SWPPP similar policy or decision making functions,or(II)the manager of one or requirements or other permit conditions. Each person that meets either of more manufacturing,production,or operating facilities employing more than these criteria must file this form: Do not use a colloquial name. Correspon- 250 persons or having gross annual sales or expenditures exceeding$25 dente for the permit will be sent to this address. million(in second-quarter 1980 dollars),if authority to sign documents has Enter the appropriate letter to indicate the legal status of the owner/operator been assigned or delegated to the manager In accordance with corporate of the project: F a Federal;S=State;M=Public(other than federal or procedures; state);P•Private. For a partnership or sale proprietorship: by a general partner of the proprietor, or Section I1. Project/Site Information For a municipality.state,federal,or other public facility. by either a principal Enter the official or legal name and complete street address,including city, executive or ranking elected official. An unsigned or undated NOI form will county,state,zip code,and phone number of the project or sne, If tt lacks not be granted permit coverage. a street address,Indicate with a general statement the location of the site (e.g.,intersection of State Highways 61 and 34). Complete site information Paperwork Reduction Act Notice must be provided for permit Coverage to be granted. Public reporting burden for this application is estimated to average 3.7 I The applicant must also provide the latitude and longitude of the facility in hours. This estimate includes time for reviewing instructions,searching 1 degrees,minutes,and seconds to the nearest 15 seconds. The latitude existing data sources,gathering and maintaining the data needed.and and longitude of your facility can be located on USGS quadrangle maps. completing and reviewing the collection of information. An agency may not Ouadrangie maps can be obtained by calling 1-800 USA MAPS. Longitude conduct or sponsor,and a person Is not required to respond to,a collection and latitude may also be obtained at the Census Bureau Internet site: of information unless it displays a currently valid OMB control number. http:/Avww.census.gov/cgi-biNgazatteer. Send comments regarding ft burden estimate,any other aspect of the Latitude and longitude for a facility In decimal form must be converted to collection of information,or suggestions for improving this form,Including degrees,minutes and seconds for proper entry on the NOI form. To convert any suggestions which may increase or reduce this burden to. Director, decimal latitude or longitude to degrees,minutes,and seconds,follow the OPPE Regulatory Information Division(2137),U.S.Envimn mental Protection steps In the following example. Agency,401 M Street, SW,Washington, D.C.20460. include the OMB I control number on any correspondence. Do not send the completed form 1 to this address. THIS FORM REPLACES PREVIOUS FORM 3510-6(8-98) Form Approved. OMB No.2040.0188 See Reverse for Instiuctions A United States Environmental Protection Agency NPDES Washington,DC 20480 FORM E PANotice of Intent(NQI)for Storm Water Discharges Associated with CONSTRUCTION ACTIVITY Under a NPDES General Permit Submission of this Notice of Intent constitutes notice that the party Identified in Section I of this form Intends to be authorized by a NPDES permit issued for storm water discharges associated with construction activity in the StateAndlan Country Land identified in Section 11 of this form. Submission of this Notice of Intent also constitutes notice that the party Identified In Section I of this form meets the eligibility requirements in Part I.B.of the general permit(Including those related to protection of endangered species determined through the procedures In Addendum A of the general permit),understands that continued authorization to discharge Is contingent on maintaining perrNt eligibility,and that Implementation of the Storm Water Pollution Prevention Plan required under Part IV of the general permit will begin at the time the permittee commences work on the construction project identified in Sedon II below. IN ORDER TO OBTAIN AUTHORIZATION,ALL INFORMATION REQUESTED MUST BE INCLUDED ON THIS FORM. SEE INSTRUCTIONS ON BACK OF FORM. L Owner/Operator(Applicant)Information Name: l l l l l { 1 1 { I I i l f 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Phone: I i I I I I I i I I I Status of Address:l I L I { 1 1 I I { I l t l l l i l l l i l l l l l l l l l l l l Owner/Operator; ❑ qty: I l l l t l l t l l l l l l l t l l i l l i l State: l_.LJ Zip Code: 1 1 1 11 1-1 1 1 1 1 P. Project/Site Information Is the facility located on Indian Country Lands? Project Name: 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t ! 1 1 1 1 1 1 1 t I Yes ❑ No❑ Project AddresslLocation:I I I 1 1 1 1 1 J I I I j i j 1 1 ► 1 1 1 I' '1 I I 11 I I I I I I I CRY I l l l 1 t_ 1 ► 1 ► I 1 { t 1 ► I I I 1 t I I state: w Zip Code: Latitude: 11 i I I IJ Longitude: I I I I I I I I qty. L I 1 I 1 I 1 1 I t t I { I 1 I 1 1 1 I Has the Storm Water Pollution Prevention Plan(SWPPP)been prepared? Yes ❑ No❑ Optional: Address of location of SWPPP for viewing ❑ Address in Section I above ❑Address in Section II above ❑ Other address(if known)below: SWPPP Phone: Address:I { I I I { i { I l t l i l t I _I l i 1 a 1 1 1 t { t l l l l l l Lt City. I I 1 1 1 1 I I 1 I 1 I I t 1 i t i I I I IJ State: t Zip Code: Name of Receiving Water. I I I 1 I I _1 1 1 I I I I I I 1 1 Based on instruction provided in Addendum A of the pemdt,are Moritb Dar }bar Month Day Y"r there any listed endangered or threatened species,or designated Estimated Construction Start Date Estimated Completion Date critical habitat in the project area? Estimate of area to be disturbed(to nearest acre): I 1) 1 I 1 J `les ❑ No ❑ Estimate of Likelihood of Discharge(choose only one): 1 have satisfied permit eligibility with regard to protection of endangered species through the indicated section of Part I.B.3.e.(2) 1. ❑ Unlikely 3. ❑ Once per week S. ❑ Continual of the permit(check one or more boxes): 2 ❑ Once per month 4. ❑ Once per day (a) ❑ (b) ❑ (c) ❑ (d)❑ In. Certification I certify under penalty of taw that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel property gather and evaluate the information submitted. Based on my Inquiry of the person or persons who manage this system,or those persons directly responsible for gathering the Information,the Information submitted I%to the best of my knowledge and belief,true,accurate,and complete. 1 am aware that there are significant penalties for submitting false information,Including the possibility of fine and imprisonment for knowing violallo ma Print Name: l i l l l l ) I i t l l 1 1 1 1 1 ! 1 1 1 1 1 1 1_1 1 1 { Date: Signature: EPA Form 3510-9 replaced 3510-8(8.98) Instructions—EPA Form 3510-9 Form Approved. OMB No.2040-0188 "0 EPA Notice of Intent(NOI)for Storm Water Discharges Associated with Construction Activity to be Covered Under a NPDES Permit Who Must File a Notice of Intent Form Convert decimal latitude 45.1234567 to degrees,minutes,and seconds. Under the provisions of the Clean Water Act,as amended,(33 U.S.C.1251 1) The numbers to the left of the decimal point are degrees. st.seq.;the Act),except as provided by Part I.B.3 the permit,Federal law 2) To obtain minutes, multiply the first four numbers to the right of the prohibits discharges of pollutants in storm water from constriction activities decimal point by 0.006. 1234 x.006 at 7.404. without a National Pollutant Discharge Elimination System Permit. Operator(s) 3) The numbers to the left of the decimal point in the result obtained in of construction sites where 5 or more aces are disturbed,smaller sites that step 2 are the minutes: 7. are part of a larger common plan of development or sale where there is a 4) To obtain seconds,multiply the remaining three numbers to the right of cumulative disturbance of at least 5 acres,or any site designated by the the decimal from the result In step 2 by 0.06: 404 x 0.06-24.24. Since Director,must submit an NOI to obtain coverage under an NPDES Storm the numbers to the right of the decimal point are not used,the result Is Water Construction General Permit. If you have questions about whether 24'. you need a permit under the NPDES Storm Water program,or If you need 5) The conversion for 45.1234 as 45' 7 24'. Information as to whether a particular program is administered by EPA or Indicate whether the project is on Indian Country Lands. a State agency,write to or telephone the Notice of Intent Processing Center at(703)931-3230. Indicate if the Storm Water Pollution Prevention Plan(SWPPP)has been developed. Refer to Part IV of the general permit for Information on SWPPPs. Where to File NOI Form To be eligible for coverage,a SWPPP must have been prepared. NOls must be sent to the following address: Optional: Provide the address and phone number where the SWPPP can Storm Water Notice of Intent(4203) be viewed 9 different from addresses previously given. Check appropriate USEPA box 401 M.Street,SW Enter the name of the closest water body which receives the project's Washington.D.C. 20460 construction storm water discharge. Do not send Storm Water Pollution Prevention Plans(SWPPPs)to the Enter the estimated constriction start and completion dates using four dgfts above address. For overnight/express delivery of NOls,please include the for the year(I.e.05/27/1998). room number 2104 Northeast Mall and phone number(202)260-9541 in the adEnter the estimated area to be disturbed Including but not limited to: grubbing,excavation,grading,and utilities and infrastructure installation. When to File Indicate to the nearest acre;if less than 1 acre,enteral' Note: 1 acre- This form must be filed at least 48 hours before construction begins 43,560 sq.ft.Indicate your best estimate of the likelihood of storm water discharges from Completing the Forth the project. EPA recognizes that actual discharges may differ from this OBTAIestimate due to unforeseen or chance,circumstances. CONS AND READ A COPY OF THE IT FOR OURRIATE EPA STORM WATER indicate If there are any listed endangered or threatened species, or CONSTRUCTION GENERAL PERMIT FOR YOUR AREA. To complete this form,type or print,using uppercase letters,in the appropriate areas designated critical habitat in the project area only. Please place each character between the marks (abbreviate if Indicate which Part of the permit that the applicant is eligible with regard necessary to stay within the number of characters allowed for each item). to protection of endangered or threatened species,or designated critical Use one space for breaks between words,but not for punctuation marks habitat unless they are needed to clarity your response. if you have any questions on ft form,call the Notice of Intent Processing Center at(703)931-3230. Section IN. Cartiflcatlon Section I. Facility Owner/Operator(Applicant)Information Federal Statutes provide for severe penalties for submitting false information Provide the legal name, mailing address,and telephone number of the on this application form. Federal regulations require this application to be person,firm,public organization,or any other entity that meet either of the signed as follows: following two criteria: (1)they have operational control over constriction For a corporation: by a responsible corporate officer, which means: plans and specifications,Including the ability to make moditicatlons to those (1)president,secretary,treasurer,or vice president of the corporation in plans and specifications:or(2)they have the day-today operational control charge of a principal business function,or any other person who performs of those activities at the Project necessary to ensure compliance with SWPPP similar policy or decision making functions,or pi)the manager of one or requirements or other permit conditions. Each person that meets either of more manufacturing,production,or operating facilities employing more than these criteria must file this torn: Do rot use a colloquial name. Correspon- 250 persons or having gross annual sales or expenditures exceeding$25 dence for the permit will be sent to this address. million pn second-quarter 1980 dollars),if authority to sign documents has Enter the appropriate letter to Indicate the legal status of the owner/operator been assigned or delegated to the manager in accordance with corporate of the project: F a Federal;S-State; M at Public(other than federal or procedures; slate);P-Private. For a partnership or sole proprietorship: by a general partner of the pmpdetor, or Section 11. Project/Slte Information For a municipality, facility: by federal,or other public faciby either a principal Enter the official or legal name and complete street address,including city, executive or ranking elected official. An unsigned or undated NOI form will county,state,zip code,and phone number of the project or site. ff ft lacks not be granted permit coverage. a street address,Indicate with a general statement the location of the site (e.g.,Intersection of State Highways 61 and 34). Complete site information Paperwork Reduction Act Notice must be provided for permit coverage to be granted. Public reporting burden for this application Is estimated to average 3.7 The applicant must also provide the latitude and longitude of the facility in hours. This estimate includes time for reviewing instructions,searching degrees,minutes,and seconds to the nearest 15 seconds. The latitude existing data sources,gathering and maintaining the data needed,and and longitude of your facility can be located on USGS quadrangle maps, completing and reviewing the collection of Information. An agency may rat Ouadrangle maps can be obtained by calling 1-800 USA MAPS. Longitude conduct or sponsor,and a person Is not required to respond to,a collection and latitude may also be obtained at the Census Bureau Internet site: of information unless it displays a currently valid OMB control number. http://www•census•goy/cgi'Wr/gazeftew. Send comments regarding the burden estimate,any other aspect of the Latitude and longitude for a facility in decimal form must be converted to collection of Information,or suggestions for improving this form,including degrees,minutes and seconds for proper entry on the NOI form. To convert any suggestions which may Increase or reduce this burden to: Director, decimal latitude or longitude to degrees,minutes,and seconds,follow the OPPE Regulatory Informmation Division(2137),U.S.Environmental Protection steps In the following example. Agency,401 M Street,SW,Washington, D.C.20460. Include the OMB control number on any correspondence. Do not send the completed form to this address. t 1 r i r r t r r APPENDIX B 1 PERMIT COVERAGE NOTICE FROM EPA r r r r r r r APPENDIX C RECORD OF TEMPORARY / PERMANENT CEASING OF CONSTRUCTION ACTIVITIES RECORD OF TEMPORARY / PERMANENT CEASING OF CONSTRUCTION ACTIVITIES Storm Water Pollution Prevention Plan For Storm Water Discharges Associated with Construction Activity PROJECT: Shiver Road Reconstruction Project Activity Area Date Activities Temporary or Date Soil Stabilization Date Activities Ceased Permanent Implemented Resumed r i I r r r r APPENDIX D INSPECTION REPORT i t f f f EROSION CONTROL INSPECTION REr T PROJECT NAME: Shiver Road Reconstruction PROJECT FILE NO. DATE: INSPECTOR REASON FOR INSPECTION: Weekly / 1/2"rain(circle one) SITE CONDITIONS: -E E&S CONTROL IN CONFORMANCE EFFECTIVE Construction Entrances YES/NO/N.A. YES/NO/N.A. Sediment Traps YES/NO/N.A. YES/NO/N.A. Inlet Protection YES/NO/N.A. YES/NO/N.A. Stabilization YES/NO/N.A. YES/NO/N.A. Silt Fence YES/NO/N.A. YES!NO/N.A. Straw/Hay Bales YES/NO/N.A. YES/NO/N.A. Ve etative Buffer Strips YES/NO/N.A. YES/NO/N.A. Other YES/NO/N.A. YES/NO/N.A. VIOLA T IONS NOTED RECOMMENDED REMEDIAL ACTIONS: CONSTRUCTION ACTIVITY IN PROGRESS: f COMMENTS: INSPECTOR: DATE: (Signature) COPY: F f F APPENDIX E STORM WATER POLLUTION PREVENTION PLAN r r Q r r r APPENDIX F RECORD OF CONSTRUCTION MATERIALS ON f- J Q W YLU H � W Z 3 Q US ~ J WO �• Q � V LU Q B' C G OLL ,r V N� ILL r Z O c W W ,^ 0 O N O O U. N O LL moo/ O ce W O U Q W WlO w LL 0 J W F- ~ Z r r f i APPENDIX G 1 NOTICE OF TERMINATION 1 1 r r THIS FORM REPLACES PREVIOUS FORM 3510-7(8-91) Form Approved, ase Ns,»4oeoa Piersse See Instructions Before Compledrig This Form 4Prwolerg 4a1-1 NPDt:a A United Sta We Environmental Protection Agency Washington.DC 204M FORM ��itv EPANotice of Termination(NOT)of Coverage Under a NPDES General Permit for Stone Water Discharges Associated with Industrial Activity Submission of this Notice of Terminaflon coneg uses notice that the wly kW#Ned in Section If of tills form is no loncier authorized to dlsdtaVe storm water associated with IrduatrW activity under lite NPDES proWann. ALL NECESSARY INFOF1FMTiON MUST BE PROVIDED ON THIS FORM. I.PerrNt hNamatbn NPDES Stone Water Check Here I You are No Longer I I Check Hen If the Storm Water General Pemtt Number: L ' r 1 e r r ( the Operator d the fadM r: �,J DFxhame Is Baktp Termktated: I.Facft Opernfor Wotmailon Name: i r i eo r e t L til r r t r r ! t n t r r t r i Phone: qty; ( ! t r t t t t t r t t r t 1 1 r s _L..1_LJ State: t t t ZIP Code• t i t e- 1-1._1 III.FadBylSite location Informalon Narrm i l t , 1 r r t i I . j t r t r t t 6 • r r r i Addra3S Stetir W ZIP Code: Latitude: I Lonylbde:l t 1 I l I 1 Utter LI J Section: L--L-J Township: Range: N. C nfficaWn: I certify under penalty of law that all storm water dlsdlargas associated with industrial activity from the Wantlfled fadrdy that are audxxUad by a NPDES gperwral penult have been elkntnated or that I am no k)rW the operator of the facility or conSln,ctlan Site. I understand that by stlbenttfing this Notice d Termite ,1 anti n0 lornger eulttoriztsd to discharge storm water associated with Indtrstrtal activtty under lifts general peetrdt,and that ay ging polkrtarYsthee fa not authorliebilty for nviolations of this panrq or the L'iean water Acx I ' ' Print Nartw: L�L1 e,6 � ���r..Js t r 1_J._.L._L..1�LL � r ! .J..�.l�L�....J � r J_i.J Date: � ! � t tI Instructions for Completing Notice of Termination(NOT)Form Who May FU a Notkv of TernBtatton(NOT)Form Where to Fie NOT Forra Penmttiees who are presently caroted under an EPA-(saved National PciW W Sand this form to the the following address: Dwdwge EI-ination System (NPDES) General Para* Oncluding the 1995 MASecior Permit)br Storm Water fthiarges Associated wkh kwdusMal Activity Stone Water Notice d Torniration(4203) may stbrntt a Notice of Teminatbn(NOT)tor-when their ledltlee no longer 401 M Street.S.W. haus any storm water darlwgas associated wMh kdustriat activity as daunted in Waahingtr^OC 20460 ore storm water regulations at 40 CFR 122.2e(b)(14),or wrlwrthey are no longer the opntw of the facilities. Comple"the Fomf For owatiuction acivRbs,efndrution of sit atone water discharges associated with Industrial activity 000urs when dcstrbed cols at the construction sit have Type or print,using upper-rase letters. In the appropriate areas o*. Pam been finally stabilized and temporary erosion and asdrnent eorriol measures place each OMuacter between the marks. Abbreviate I necessary to Bury within have been removed or wdi be ramovad at an appropriate erns,or that N porn the number of charscters allowed for each kern. Use only one space for brwks water discharges associated with Industrial acttvitp from the construdlon sib stat between words,but not for punctuation madka unless dw are needed to clarify are outhodzed by a NPDES gaunt pynNt have othuwrise boon elrttwtd.Final your response. If you have any queatlww about oris brm,ideprrons or wits tits stabilization means chat aft sol-disWrbing swavides at tfu site haw been Native of Intent Pmco"ft Cantor at MM 931�23a completed,and thst a uniform perennial vegetative ower m1h a density of 70%of on cover for unpaved areas and areas not covered by porawnsru sMmures has been eatabilshed,or egtiveletx permanent atabRzation measures(such as the use of rlprap,gattlons,or geottodfes)have been employed. FPA Finn M&7(8-48) Instructions-EPA Form 3510.7 Notice of Termination(NOT)of Coverage Under The NPDES General Permit for Storm Water Discharges Associated With Industrial Activity Section I Permit Information Section IV Certification Enter the existing NPDES Storm Water General Permit number assigned to the Federal statutes provide for severe penalties for submitting false information on this facility or site identified in Section III. If you do not know the permit number, application form Federal regulations require this application to be signed as y telephone or write your EPA Regional storm water contact person. folbws: Indicate your reason for subrrutting this Notice of Termination by checking the. For a corporation:by a responsible corporate officer.which means:M president, appropriate box: secretary,treasurer,or vice-president of the corporation in charge of a prc►cipal business function,or any other person who performs similar policy or decision 9 there has been a change of operator and you are no"or the operator of making functions,or(Ii)the manager of one or more manufacturing,production,or the facility or site identified in Section 111,check the corresponding box. operating facilities employing more than 250 parsons or having gross annual sales or expenditures exceeding$25 million(un second-quarter 1980 dollars),ff Authority If all storm water discharges at the facility or site identified in Section III have to sign documents has been assigned or delegated to the manager in accordance been terminated,check the corresponding box. with corporate procedures; Section 11 Facility Operator Information Fora partnership or sole proprietorship:by a general partner or the proprietor or Give the legal name of the person,firm,public organization,or any other entity that For a municipality, State, Federal, or other pubfie facility:by either a principal operates the facility or site described in this application. The name of the operator executive officer or ranking elected official. may or may not be the same name as the facility. The operator of the facility is the legal entity which controls the facility's operation, rather than the plant or site Paperwork Reduction Act Notice manager. Do not use a colloquial name. Enter the complete address and telephone number of the operator. Public reporting burden for this application is estimated to average 0.5 hours per application, including time for reviewing instructions, searching existing data Section III Facility/Site Location Information soma,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate,any Enter the facility's or site's official or legal name and complete address,including cher aspect of the collection of information,or suggestions for improving this form, city,state and LP code. If the facility lacks a street address,Indicate the state,the including any suggestions which may increase or reduce this burden to:Chief, latitude and longitude of the facility to the nearest 15 seconds,or the quarter, information Policy Branch,2138,U.S.Environmental Protection Agency,401 M section,township,and range(to the nearest quarter section)of the approximate Street, SW, Washington, DC 20480, or Director, Office of Information and center of the she. Regulatory Affairs,Office of Management and Budget,Washington,DC 20503. THIS FORM REPLACES PREVIOUS FORM 36107(8-92) Foes Approved. ow Na,zwo4m Please See instractlons Before Compteing This Form aw'ovoil expirtim s a1 NPDBS United Sta wFn` t`o nnen� �ligancy Fowl+ ��r0E Notloe of Termination((NOT)of Coverage Under a NPDES General Permit for Storm Water Dlecharges Associated with Industrial Activity Submission of this Notice of Termination oonetltutes poke titer the part'IdenrAed In Section 11 of this form Is no longer authorized to disoharge storm water associated will Ir dutili lal activity ober to NPDES program ALL NECESSARY INFORMATION MUST BE PROVIDED ON THIS FORM. I.PorrNt 1flfofr moors NPDE8 Storm Water Check Here r You we No Longer Check Here N the Storm Water ❑ General Pemdt Number �..� r t r r i the Operabr d the Facility: ing Discharge is BeTerminaU>ad: a.Fadlty Operator Information Name i n i r a , — t- , , I r a r r r r r r r r , „) r , r r , Photo: r I ► r r I r v r Address i r lir r , Itot t t r r r r r r , , r , r r r 1 i r c r Gt)C L�i t L I n t r e t n t r r i r s 1 i State: L r 1 ZIP Code: III.FadttylSke Location lniormatbn Name: L r . I , r r e I i I , a , , , , , , . , e , , , Address j r r r r r r r L r r r r 1 n 1 s r t r t r r r r r I I qty: i 1 e r r t t u u r t r r r r 1 h.1 r L J State: L-L—J ZIP Code' t t ll I • t I l t l.attude: I I l L I l l ongttude;l t i I I T O=W.. LLJ Section: i 1 I Township: RJOP: IV. Certification: I certify under penalty of taw that al storm water d1sct►arges associated with industrial activity from the Identified facility that are authorized by a NPDES gerwral permit have been eliminated or that I am no briger the operator of the tadtty or construction site. I understand that by strbrNtUtp iNe Notice utd Termination 111i;rt rtq lodger autttoriztad to tischargs storm water ssscnciated with lrndustrlal activity under tttia general pemdt,and that citx#targrng polkrtants in storm water associated with industrial to waters d the United States is uNawfui under the pear Water Ad where the discharge fa not aharLted by a NPDES permit f afzo trrtderstarlti�the submittal Of hila Notice of TemTtinatltm does not release en opetBfOr lnarrt itablity for any vblatlaru d tris PerNt«the t�esn water Act print Name: Date: i _tel instructions for Cornpieting Notice of Termination(NOT)Form Who May Fee a Haft*of TWINnetilm(NOT)Fore WNsn to Fie NOT Forra Pemtitle s who aro presenly oovered under an EPAassued Natbnd Pdk t M Send this form to the the tobwirg address DWd+age Eliminadon System INPDE9) Genera! Porn* (Itduding the 19% Mur 14%clor Permlo br Storm Water Dkharges Associated wkh 44ustrhl Activity Storm Water Notice of Ternration(42031 may$L&nt a Notice of Temination(NOT)farm when their ladlaes no longer 401 M Sliest.S.W. have any aim.. water dsr Ann associated with k"triat activity u defined In Washington.DC 20460 me stem water rogrletions at 40 Ci-R 122.26(b)(14),or when they are no longer the operator of tha taclitles. GomplWng the Fore Far owntructlon aetivMbs, ekninatlon of sit storm water discharges associated wlar Industrial soft 000um whin dettnbed sob at the Construction silo have Typa or print,using uppercase lepers. In the appropriate areas onh. Pbax Iran tYuapy steblized and temporary erosion and sediment control measures place each a+aracter between the marks. Abbreviate l necessary to slay within have been removed or wit be removed d an appmpriois tine,or hat al storm the number of characters allowed for each Rem. Use only one apace for bm" wider dlsdt "associated with Industrial aclvity from the construction 9M that between words,but not for punctuation marks unless they are needed to Clarify are authorized by a NPDES general permit have otherwise been elmirteted Rnsf your response. a you have any questions about @rh form,telephone or write the stabilnion means hat all soi•dsturbin0 advitlas at the site haus been Nolioe of Intent Proo*sen g Gaiter At(703)9314lM aomrplsted,end that a uniform perennial vegetative cover with a density of 70%of ane ower fpr unpaved areas end areae not covered by penmariont structures his been velitbhhed.or W$AVAW IiNmanerR stabilization memme(such as ens use of rrxap,gabions,or geatmdies)have been employed FPAA- slit 7 ra tr81 Instructions•EPA Form 3810.7 Notice of Termination(NOT)of Coverage Under The NPDES General Permit for Storm Water Discharges Associated With Industrial Activity Section I Permit Information Section IV Certification Enter the existing NPDES Storm Water General Permit number assigned to the Federal statutes provide for severe penalties for submitting false information on this facility or site identified in Section III. If you do not know the perrrdt number, application form. Federal regulations require this application to be signed as telephone or write your EPA Regional storm water contact person. follows: Indicate your reason for submitting this Notice of Termination by checking the. For a corporation:by a responsible corporate officer,which means:(1)president appropriate bcoc secretary,treasurer,or vice-president of the corporation in charge of a principal business function,or any other person who performs similar policy or decision if two has been a change of operator and you are no longer the operator of malting functions,or(i)the manager of one or more manufacturing,production,or the facility or site identified in Section III,check the corresponding box. operating facilities employing more than 250 persons or having gross annual sales or expenditures exceeding$25 million(in second-quarter 1980 dollars),if authority If all akx,, water discharges at the facility or site identified in Section III have to sign documents has been assigned or delegated to the manager in accordance been terminated,check the corresponding box. with corporate procedures; Section II Facility Operator Information Fora partnership or sob proprietorship:by a general partner or the proprietor;or Give the legal name of the person,Am%public organization,or any other entity that For a municipality, State,Federal,or other public facW. by ei0er a principal operates the facility or site described in this application. The name of the operator executive officer or ranking elected official. may or may not be the same name as the facility. The operator of the facility is the legal entity which controls the facilitys operation, rather than the plant or site Paperwork Reduction Act Notice manager. Do not use a colloquial name. Enter the complete address and telephone number of the operator. Public reporting burden for this application is estimated to average 0.5 hours per application, including time for reviewing instructions, searching existing data Section III FacilitylSite Location Information sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send comments regarding the burden estimate.any Enter the facility's or site's official or legal name and complete address,including other aspect of the collection of information,or suggestions for improving this form, city,state and ZIP code. If the facility lacks a street address,indicate the state,the including any suggestions which may increase or reduce this burden to:Chief, latitude and longitude of the facility to the nearest 15 seconds,or the quarter, Information Policy Branch,2138,U.S.Environmental Protection Agency,401 M section,township,and range(to the nearest quarter section)of the approximate Street SW, Washington, DC 20480, or Director, Office of Information and center of the site. Regulatory Affairs,Office of Management and Budget Washington,DC 20503. l APPENDIX H PROJECT DESCRIPTION (TO BE POSTED AT CONSTRUCTION SITE) I Paving, Drainage and Utility Improvements for Shiver Road Reconstruction in Fort Worth, Texas The City of Fort Worth of Fort Worth, Texas, is undertaking paving, drainage and utility improvement activities for the reconstruction of Shiver Road from North Beach Street to Trace Ridge Parkway. The development includes construction of the following improvements: 1. Construction of underground utilities (storm drain) 2. Grading, including fine grading of street to prepare the area for paving 3. Street Paving Construction of these improvements is subject to storm water pollution controls required by the Clean Water Act. This construction is permitted under the Texas general permit for construction activities administered by the U.S. Environmental Protection Agency under the National Pollutant Discharge Elimination System program. APPENDIX I PROJECT LOCATION MAP f i A e CONTINUED ON MAP TT 36 W a h 3 a j SHRIVER D I 5 r y A IRA CT AJL CAROU TRACER ,,.N E = RUNG TRACE W- CAVE a Ciu YMPIA CE b on BRI LTRACE Nj KWY GEil TRACE RSH 1�� 52 0 54 m 0 57 5 f EMERALD TRACE_ y NO¢ 'y,,LAKE CHELE E + 3 ! Fossil Ridge >> -'41 W 9 ST CR0IX - � ESERT W CRAM j EVERG 9 o�+ y �G♦ o Y3 s,� R THOMPSON �+ S v r m L o x s MATANZAS ERITAGE W ER HIE r�y�i �Hi \ SME _ BANDELAI UER O 1 wu C C, mTRAIL A (O n ND N pA-rSMAS ( I C(R o O J W 9 < OMapaeo.Inc. 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BIRCHBEND .� ��� " ¢ gA55 OD BL 56IGHTOWE 0 - t BRACKEN ESA VERGE CT 1 CONSTI v T ow P I 0 13 —43 mss O o ,�FAWAY BUC LOS PA S mJ nn 0�S +CHESAPEA'< C I ! m RI E Ivyck U RK �BA�iYTREE J NESERRY V��r dpG el. F- RARTOE kz >.>m., < k BLUE FLAG o CREf WINEBE CIR i^ � N E�nu rEe z,.p,P r o BUNKER i DOGWOOD C H TH g qRY C R O v cNp > c BLVI S z MINE J ARM �' ROCKY f COW �` I �THO R SiHrns Perk ,�,� S FIA HI T o 9 SPRINGS TRA -MOUN PH IA i K EAT 45 AZE'( i- US CAgL c DALE +b '- r i LONG RAW =tib TS BRIAR 9 RIDGE .__._ a t m Parkhava� oo OSS R G 29 Mq J Parkview N C, ROE m ! I ROSE OF SHARON _ a e < m o GLENSCAPE TR 1 5 A'. CHINA ROSE & BEA fl rn Perk-' S A N LOOGEPO y j SP(IOpE EE PoPPYE 47 z ISTLEDO H =CAALBOU I �, - HEMLOCKS S _ oo SU BU FIRE HILL ODSTOCK OR ID m ELK CT1 b� 57 CHESTNUT SUN K DA IDEUON HALTOM TUup m m �� LINDA r LONGLEAF g H U m oy 3 5 $r 56 Y ve r 0 Z .TER W AIJG RQ FAIR C 4S W 39 42 - O c 49 BLVD ti - CREEK LAKE A a e AZALEA JUDI W SPRUCE v C r" - 57 I IRI$Cf WAYGO I 9Ze o "� TERN z` ` 1 m a• S CRIPPLE CREEK CR pp , ARIGO( r VINCENT r AE'p F®Ytt I c 3 LAR SPUR �� F ®S cert 9� ESTE P I` w y., m ��W WIS ERIA m =9q5 W yp413 a r _ Al m 4 56 G The Golf.Ckrb atW 9l ASH Fossil Creek i ne - „ r t SCALE IN MILES SCALE IN FEET 0 ,/. '1 V2 CONTINUED ON MAP 50 0 1000 2000 3000 BOOK PAGE 1036 I COPYRIGHT 1971,2000 by MAPSCO,INC.-ALL RIGHTS RESERVED