The URL can be used to link to this page

Home My WebLink AboutContract 40099CITY SECRETARY Lr l"\r--9 a CONTRACT NO. ___ -n.AJ.....;;._,;;;,-.1._--1,_J_ CONTRACT Between CITY OF FORT WORTH and INTERCON ENVIRONMENTAL, INC. For Structural Demolition and Removal, Transportation and Disposal of Asbestos Contaminated Materials in the Fort Worth Alliance Airport Vicinity DEM 09-08: Alliance NMP Environmental Management Department March 2010 OFFICIAL RE CORD CITY SECRI .TARY FT. WORTI I, TX • .. -. City of Fort Worth, Texas Mayor and Council Communication COUNCIL ACTION: Approved on 10/27/2009 -Ord. No. 18887-10-2009 & 18888-10-2009 DATE: Tuesday, October 27, 2009 LOG NAME: 55AFWNOISEPROPDEMO SUBJECT: REFERENCE NO.: C-23880 Authorize Execution of a Contract with lntercon Environmental, Inc., in the Amount of $281 ,471 .00 for Demolition and Asbestos Abatement Services for 18 Structures Adjacent to Fort Worth Alliance Airport and Adopt Supplemental Appropriation Ordinances RECOMMENDATION: 1. Authorize the use of revenue derived from gas well drilling on City-owned airports in the amount of $281 ,471 .00 for the demolition and asbestos abatement of 18 properties adjacent to Fort Worth Alliance Airport ; 2. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations in the Airports Gas Lease Project Fund in the amount of $281,471 .00 , from available funds ; 3. Authorize the transfer of $281 ,471 .00 from the Airports Gas Lease Project Funds to the Municipal Airports Fund ; 4. Adopt the attached supplemental appropriation ordinance increasing estimated receipts and appropriations in the Municipal Airports Fund in the amount of $281,471.00 from available funds ; and 5. Authorize the City Manager to execute an agreement with lntercon Environmental , Inc ., in the amount of $281,471 .00 for demolition and asbestos abatement services for 18 properties adjacent to Fort Worth Alliance Airport . DISCUSSION: On March 23 , 1993 the City Council adopted the Federal Aviation Regulation Part 150 Noise Study for Fort Worth Alliance Airport. The Noise Study program consisted of fee simple acquisition of 11 tracts of land within the 65 LON . To date , the City of Fort Worth has purchased ten properties with grant funds and the remaining properties were purchased from non-federal sources . To eliminate any future incompatible use , the 18 properties are being cleared of the improvements and incorporated into the airport boundary for future possible development. Bids for the demolition were advertised in the Fort Worth Star-Telegram on May 17 and May 24, 2009 . The following firms submitted bids on June 11, 2009 : • Nationwide Demolition • A & R Demolition , Inc. • Midwest Wrecking Company • Eagle Remediation Services , Inc . • Atlas Equipment • Cactus Environmental • lntercon Environmental The proposals were evaluated based on a pre-determined combination of qualitative and quantitative (bid point) measures . These measures included, but were not limited to , the evaluation of previous work ~xperience , qualifications of personnel , contractor capabilities, cost and subcontractors . Based on the total J:.'. int d!stribution of the pre-determined measures , lntercon Environmental met all the requirements with a id ot $281 ,471 .00 . lntercon Environmental , Inc . is in compliance wi t h the City's M/WBE Program by committing to 1 O percent M/WBE participation on this project. The City's goal on this project is 1 O percent. The Environmental Management Department and will oversee this asbestos removal and demolition project for the Aviation Department. Work on the asbestos removal and demolition project is expected to begin in November 2009 . The project is physically located in COUNCIL DISTRICT 2 . FISCAL INFORMATION/ CERTIFICATION: The F inancial Management Services Director certifies that upon adoption of the attached supplemental appropriation ordinance , funds will be available in the current operating budget , as appropriated , of the Municipal Airports Fund . FUND CENTERS: TO Fund/Account/Centers PE40 539120 0551301 PE40 476240 0551301 P240 538040 551929990100 P240 446100 551929990100 CERTIFICATIONS: FROM Fund/Account/Centers $281 ,4 71 .00 P240 538040 551929990100 $281 ,4 71 .00 PE40 539120 0551301 $281 ,4 71 .00 $281 ,4 71 .00 Submitted for City Manager's Office by: Fernando Costa (6122) Originating Department Head: Kent Penney (5403) Additional Information Contact: Aya Ealy (5406) ATTACHMENTS 1. 55AFWNOISEPROPDEMO REC 2 .doc (Public) 2. 55AFWNOISEPROPDEMO REC 4 .doc (Public) 3. Accounting lnfo .pdf (CFW Internal) 4. M&C Fund Allocat ion . df (CFW Internal) 5. MWBE comp l iance .gdf (CFW Internal) $281 ,4 71.00 281 471 .00 ST ATE OF TEXAS COUNTY OF TARRANT § § § KNOWN ALL BY THESE PRESENTS CONTRACT FOR STRUCTURAL DEMOLITION AND REMOVAL , TRANSPORTATION AND DISPOSAL OF ASBESTOS CONTAMINATED MATERIALS FORT WORTH ALLIANCE AIRPORT VICINI T Y DEM 09-08 :ALLIANCE NMP This Contract is entered into by and between the City of Fort Worth , Texas , a home-rule municipality located w ithin Tarrant County Texas , ("City") acting through Fernando Costa , its duly authorized Ass istant City Manager, and lntercon Environmental , Inc . a Texas corporation , act ing through Karen Andrews its duly authorized President ("Contractor"). WHEREAS , the C ity desires to conduct a project for removal of asbestos containing material and the demolition of certain structures located within the Alliance Airport Noise Mitigation Area , Fort Worth , Texas ; and WHEREAS , the City desires to h i re a professional firm knowledgeable and experienced in conducting such asbestos removal , transportation , d isposal and demolition ; and WHEREAS , the Contractor has represented that it is knowledgeable and experienced in conducting such an asbestos removal , transportation , and disposal and demolition project. WITNESSETH : NOW, THEREFORE , in considerat ion of the mutua l promises and benefits of this Contract , the City and the Contractor agree as follows : 1. DEFI NIT IONS In th is con tract , the following word s and phrase s shall be define d as follows : Asbestos shall mean the asbest iform varieties of chrysotlle , amosite , crocidol ite , tremolite , anthophyllite , and act inol ite and all materia ls conta in ing one percent o r more of a ny of tho se sub st ances . CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL , INC . Page 1 of 28 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Asbestos-Containing Material (ACM) shall mean materials or products that contain more than one percent (1.0%) of any kind or combination of asbestos , as determined by Environmental Protection Agency (EPA) recommended methods as listed in Section 40 of the Code of Federal Regulations , (CFR) Part 763 , Subpart F and 40 CFR 763 Subpart E, Appendix A. This means anyone material component of a structure. Asbestos Removal shall mean any action that dislodges, strips, or otherwise takes away asbestos co nta ining material (ACM). City's Representative means the Director of Environmental Management, or the Director's designee . Contract Documents shall consist of the written , printed , typed and drawn instruments which comprise and govern the performance of the work including this contract. Said Contract Documents include, but are not lim ited to, the notice to bidders, instructions to bidders , special instructions to bidders, addenda to the notice to bidders, the Contractor's Response to the Invitation to Bid DEM09-08: ALLIANCE NMP , proposal , plans , specifications , maps, blueprints, notice of award , general conditions , special conditions, supplementary conditions, general provisions, special provisions , work order(s), this Contract and the payment, performance , and maintenance bonds . The Contract Documents shall also include any and all supplemental agreements approved by the Owner which may be necessary to complete the work in accordance with the intent of the plans and specifications in an acceptable manner, and shall also include the additional instruments bound herewith. Contractor shall mean lntercon Environmental, Inc. Director shall mean the Director of the City of Fort Worth's Environmental Management Department. Invitation to Bid (1TB) shall mean the City's Invitation to Bid DEM 09-08 : ALLIANCE NMP incorporated as part of the Contractor's Response to the 1TB . NESHAP shall mean the United States Environmental Protection Agency National Emissions Standards for Hazardous Air Pollutants, as described in Title 40 CFR Part 61. Notice to Proceed means the letter issued by the City that authorizes Contractor to begin work. It also authorizes future invoices to be paid. Regulated Asbestos-Containing Material (RACM) shall mean (a) friable asbestos material, (b) Category I non-friable ACM that has become friable, (c) Category I CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT- DEM 09-08 -INTERCON ENVIRONMENTA L, INC. OFFICIJ L RECORD CITY SECRETARY FT. WORTH, TX non-friable ACM that will be or has been subjected to sanding, grinding, cutting, or abrading, or (d) Category II non-friable ACM that has a high probability of becoming or has become crumbled, pulverized, or reduced to powder by forces expected to act on the material in the course of demolition or renovation operations. Subcontract means a contract between the Contractor for this project and another person or company for any task defined in the scope of work. A purchase order is also considered a subcontract. 2. SCOPE OF CONTRACTOR'S SERVICES A. The scope of work shall include the furnishing of all labor, materials and equipment necessary for the removal of all asbestos-containing materials ("ACM)" according to specifications outlined by the City (or its agent) and to perform the demolition of all structures on each lot specified by address in Table 1. Work shall be conducted in accordance with the most recently amended version of the document entitled "Specifications for Asbestos Abatement" prepared by Industrial Hygiene and Safety Technology, Inc. B. Seventeen (17) residential structures plus outlying structures at eighteen (18) addresses will be demolished. Asbestos containing material will be removed from each structure with ACM ( estimated to be 13 of the structures) prior to demolition. C. The scope of work includes the removal, transportation and disposal of the asbestos-containing materials and asbestos contaminated materials in accordance with all Federal, State, and local statutes, rules, ordinances and regulations . Upon completion of the asbestos removal each identified structure shall be demolished by the Contractor. D. The water wells on some lots shall be plugged and abandoned in accordance with good work practices and all applicable federal, state, and local statutes, rules, ordinances and regulations. The lots containing wells to be plugged and abandoned are as specified in Table 1 with the term "Well P&A". E. The septic tanks on certain lots as identified in Table 1 shall be decommissioned by removing all concrete to at least 2' bgs, cracked or holes punched into the base so as not to allow pooling of water, and backfilled with native soils found within the project site. F. Any and all trash located on the project sites shall be considered debris and should be disposed of appropriately. This includes fences that are not in good repair, CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT- DEM 09-08-INTERCON ENVIRONMENTAL, INC. Page 3 of 28 OFFICIAL RECORD CITY SECRETARY FT. WORTH , TX wood, sheet iron, metal, tires , and concrete that have been randomly scattered across the sites. G. Bee colonies are present on some of the lots and shall be either be relocated to another site by the professional beekeeper or professionally exterminated at the project location at the expense of the Contractor . H. Prior to commencement of work , Contractor shall verify utilities have been disconnected. I. Prior to commencement of any work under this Contract, the Contractor shall obtain a written notice to proceed from the Environmental Management Department. J. Upon completion of the work, Contractor shall obtain a final inspection Environmental Management Department. K. Contractor shall protect the work site as necessary with barriers , lights, safeguards or warnings. L. Contractor agrees to protect from damage and to leave in good condition all of the sidewalks, curbs, and other public infrastructure in or near its work areas. Before any demolition work is commenced and before heavy equipment is moved to the work site , the Contractor agrees to take photographic evidence of any preexisting damage to the sidewalks, curbs, or infrastructure. Failure to so document preexisting damage shall constitute prima-facie evidence that such damage was the result of the Contractor's activities and Contractor will be responsible for repairing or reimbursing the City for the damage. M. Contractor shall demolish and remove any signs at the site as well as demolish improved surface parking areas. N. Contractor shall remove all demolition debris , junk , trash, and salvageable materials from the site. 0. Contractor shall fill any holes in the terrain resulting from any of the above work with native soils found within the project site and grade the entire lot, ensuring that low areas are filled to prevent the pooling of water. P. Contractor shall sweep dirt and debris from the sidewalk and street that accumulate during loading and removal. CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT- DEM 09-08-INTERCON ENVIRONMENTAL, INC. OFFICIAL RECORD CITY SECRETARY FT. WORTH. TX Q. Contractor shall clean and remove all debris, trash , rubbish and any other solid waste from the demolition premises to a state licensed disposal site or to a properly permitted landfill site at Contractor's expense. R. Prior to site mobilization, the Contractor shall prepare and submit a Storm Water Pollution Prevention Plan (SWPPP) in accordance with the requirements detailed in the TPDES General Permit No . TXR150000 and receive approval from the City. In addition, the Contractor must also submit a Notice of Intent (NOi) to the Texas Commission on Environmenta l Quality (TCEQ) for storm water discharges associated with construction activities. The Contractor must maintain this plan until sufficient vegetation has been established. S. Contractor shall perform , in a good and professional manner, the services contained in this Contract. Remainder of this page is left intentionally blank. CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT- DEM 09-08 -INTERCON ENVIRONMENTAL, INC. Page 5 of 28 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Table 1. Addresses and specifications of structures to be asbestos-abated and demolished (Note : All quantities are estimates only; actual quantities to be verified by Contractor prior to bidding and executing contract). Address/Location Asbestos/Water Well /Septic/Beehive Information • Texture on walls and ceiling -throughout (-4 ,320 SF) 1304 Westport Pkwy • Linoleum flooring -Kitchen and Hall (-180 SF) Abst. 991 , Tr. 1 • 9"x 9" floor tile -Entry and Bath (-120 SF) • Well Depth : -450 ' Well P&A Well Diameter: - 4" OD Cased • • Septic --800 gallon • At least 1 confirmed beehive 1404 Westport Pkwy Abst. 737 , Tr . 2A • Linoleum flooring -Living Room (-48 SF) • Septic --800 gallon No Well • Linoleum flooring -throughout (-600 SF) 1504 Westport Pkwy • Well Depth : -420 ' Abst. 737 , Tr . 2A03 • Well Diameter: -4" OD Cased • Septic - -800 gallon Well P&A >- 301 Harmon Rd . • Linoleum flooring -Kitchen , Utility Room , Bathroom Abst. 737 , Tr. 2A04 (-350 SF) • Septic - - 2 x 800 gallon No Well 305 Harmon Rd . • No ACM Abst. 737 , Tr. 2A04 • Septic - -800 gal lon No We ll CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL. INC . Square Feet of Structures for Demolition -1 ,680 SF (6 outlying structures of -10,000 SF) -1 ,144 SF (4 outly ing structures of -7,500 SF) -1 ,800 SF (2 outlying structure of -1 ,000 SF) f--· -1 ,840 SF (1 outlying structure of -1 ,500 SF) -1 ,100 SF (4 outlying structures of -2 ,000 SF ) OFFICI L RECORD CITY SECRETARY FT. WORTH, TX Page 6 of 28 • Linoleum floor ing -throughout (-1 ,095 SF ) 410 Harmon Rd . • Texture /Joint compound walls & ce iling -throughout Abst. 991 , Tr. 2 (-4,700 SF ) • Well Depth : -430 ' We ll P&A • Well Diameter: -4" OD Cased • Septic --800 gallon • Vinyl floor -Kitchen , Nook , Hall , Master Bath (-395 491 Harmon Rd . SF ) Abst. 1825 , Tr. 1 A • Well Depth : -410 ' Well P&A • Well Diameter: - 4 " OD Cased • Septic --1,000 gallon 525 Harmon Rd . Abst. 1957 , Tr. 1A01 • Linoleum flooring - k itchen , ut ility , bathroom , dining (-624 SF ) Well Remains • Septic - - 1,200 gallon 605 Harmon Rd. Abst. 1957 , Tr. 1 A02 • No ACM • Well Depth : -425 ' Well P&A • Well Diameter: -4 " OD Cased • Sept ic - - 1,000 gallon 650 Harmon Rd . Abst. 646 , Tr . 2 • Septic.= -800--galiG A--------- Well Remains 680 Harmon Rd . Abst. 646 , Tr . 2F01 • No res ident ial structure , No ACM 740 Ha r mo n Rd . • No ACM A bs t. 646 , T r. 2 0 • Well De pth : -400 ' • Well Diameter: -4 " OD Cased Well P&A • Septic --800 gallon CONTRACT FOR STRUCTURAL DEMOLITION ANO ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL. INC. -1 ,464 SF (4 outly ing st ructures of -3,000 SF ) -2 ,2 14 SF (4 outly ing structures of -5 ,000 SF ) -2 .650 SF (2 outlying structures of -3,000 SF) -3,000 SF (t hree-story) (5 outlying structures of -3 ,000 SF ) -2 ,000 SF (_5__Q.u!J')dng_ ~ structures = -5,000 SF) 1,000 yards debris (1 outly ing structure of -1 ,000 SF ) -1 ,200 SF (1 outlyin g st ructure of -1 ,000 SF) OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 7 of 28 745 Harmon Rd . • No ACM -1 ,900 SF Abst. 646 , Tr . 2A • Well Depth: -405 ' (2 outlying structures of • Well Diameter: -4" OD Cased -2 ,000 SF) Well P&A • Septic --1,200 gallon 815 Harmon Rd. • No ACM Abst. 1776 , Tr. 2F • Septic -- 1,000 gallon -2 ,000 SF 845 Harmon Rd . No ACM • Abst. 1776 , Tr. 2J • Well Depth : -41 O' -950 SF Well P&A • Well Diameter: -4 " OD Cased • Septic --1,000 gallon 865 Harmon Rd. • 12 "x 12 " Floor tile -Bathrooms (-1 ,000SF) Abst. 1776 , Tr. 2E • Well Depth : -405 ' -3,390 SF • Well Diameter: - 4 " OD Cased (1 outlying Well P&A Septic --800 gallon structure= • -500 SF) • At least 1 confirmed beehive • No ACM 895 Harmon Rd . Well Depth : -415 ' -1 ,857 SF • Abst. 1776 , Tr. 2M • Well Diameter: -4 " OD Cased (2 outlying structures of Well P&A • Septic --1,200 gallon -2 ,000 SF) • At least 1 confirmed beehive 959 Harmon Rd . • Texture on ceiling and walls -throughout (-3 ,284 SF) -2 ,308 SF Abst. 1776 , Tr. 2G • Linoleum flooring -Kitchen and Entry (-168 SF) • Well Depth : -400 ' Well P&A • Well Diameter: -4 " OD Cased • Septic --1,200 gallon Well P&A means well plugged and abandoned in accordance w ith applicable law T il de (-) means approximately SF means squ are fee t CO NTRACT FOR STRUCTURAL D EMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL , INC. (5 outlying structures of -2 ,000 SF) OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 8 of 28 3 . SCOPE OF CITY SERVICES The C ity agrees to perform the following services : A. City shall coordinate with facilities , City departments , and any tenants for access to the site . B. City shall prepare and revise all notifications necessary to the Texas Department of State Health Services Health (TDSHS) for the work provided herein . C . City shall make payment of all applicable TDSHS fees . D . City shall give timely direction to the Contractor. E . City shall render decisions regarding modifications to the Contract and any other issue . 4. TIME TO COMPLETE THE PROJECT Contractor shall achieve substantial completion of work under this contract within ninety (90) days from receipt of the Notice to Proceed unless an extension of time is granted (in writing) due to inclement weather, any such determination being made in the sole judgment and discretion of the City of Fort Worth. -S-huotcrthe-euntractorfait-tcrbeglrrthe-work--hereir, pr ovictecrforwithirrthe-time-her eir r fixed or to carry on and complete the same according to the true meaning of the intent and terms of the plans , specifications and other Contract Documents , then the Owner shall have the right to either (1) demand that the Contractor's surety take over the work and complete same in accordance with the plans , specifications and other Contract Documents or (2) to take charge of and complete the work in such a manner as it may deem proper , and if in the completion thereof, the cost to Owner shall exceed the contract pr ice or prices set forth in the Contract Documents , the Contractor and/or its surety shall pay Owner upon its demand in a writ ing , setting forth and specifying an item ized state m ent of t he tota l cost thereof, sa id excess cost. 5 . IND EPENDEN T CON T RA CTOR The C ity agrees to hire Contractor as an independent contractor, and not as an officer , servant , or employee of the C ity . Contractor shall have the exclusive r i . t...to-c:OAtro. t,b CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09 -08 -INTERCON ENVIRONMENTAL. INC. OFFICIAL RECORD ~5'.~~ETARY FT. WORTH, TX details of the work performed hereunder, and all persons performing same , and shall be solely responsible for the acts and omissions of its officers , agents , employees , and subcontractors . Nothing herewith shall be construed as creating a partnership or joint venture between the City and Contractor, its officers , agents , employees , and subcontractors ; and the doctrine of respondent superior has no application as between the City and Contractor. A. B. C . D . E . F . 6 . COMPENSATION In consideration for the work performed by Contractor under this Contract, City shall pay Contractor a sum not to exceed two hundred eighty one thousand , four hundred seventy one do l lars ($281 ,471 .00) for the completion of all work specified in this contract. The City shall not compensate Contractor in excess of the Not-to-Exceed Amount unless the City has executed a written , authorized , and formal Modification to the Contract. It is expressly agreed between the parties that there shall be no oral modifications to this contract. The unit prices , subtotals , and grand totals for the work to be performed under this contract are shown in Tables 2 through 6 be low . The unit prices will only be used to calculate payment for additional work authorized by a change order. The parties agree that the abatement and demolition grand total as specified in the Contractor's bid (and the Not-to-Exceed amount in this contract) of two hundred eighty one thousand , four hundred seventy one dollars ($281,471 .00) shall be the whole of compensation for all of the services sp ecifi ed itLth-is __ contract. In the event of a discrepancy between the unit price and the contract grand total price , the grand total shall prevail. In no event will compensation be greater than the not-to-exceed amount described herein. Quantities identified in the Invitation to Bid and bid package were estimated quantities only . Prior to submitting a bid , as noted in the Invitation to Bid , the Contractor was respons ible for verifying all quantities upon which the Contractor's bid was based . The Contractor was to rely exclusively upon its own est imates , invest igation , research , tests , and other data necessary to supply the f ull a nd c om p lete in fo rm at io n u pon wh ic h th e Contracto r's b id was ba sed . It is mutually agreed that submission of a b id is pr ima -faci e evidence that the Contracto r has made a ll of the investigat ions , exam inat ions , and tests required to make a fully informed offer . By executing th is contract , the Contractor affirms and agrees that the Contractor has had the opportunity and duty to confirm all quantities prior to submitting a bid , a nd Contracto r expressly wa ives any and all right to additiona l compensation CONTRACT FOR STRUCTURAL DEMOLITION ANO ASBESTOS ABATEMENT - OEM 09-0 8 -INTERCON ENVIRONMENTAL. INC . Pa ij I AL RECORD CITY SECRETARY FT. \1\IOt<'fH1 TX other than the contract grand total as a result of any discrepancy between the quantities encountered and the estimated quantities in the Invitation to Bid and bid documents . G . The parties intend and agree that any change order or modification to this contract will be in the case of only the most extraordinary of circumstances . Any claims for additional compensation based upon variations between cond itions actually encountered in this project and cond it ions as indicated in the Contract Documents will not be allowed . Any proposed exception will be examined by the City in consideration of the terms described herein and the Contractors request for additional compensat ion must clearly show why the var iation was not identifiable prior to the Contractor submitting its bid . As used in this contract , "not identifiable " means that the Contractor a) performed all invest igation , research , tests , and other data collection necessary to accurately determine quantities , and b) no reasonably possible investigation , research , tests , or other data collection could have identified the variation . T bl 2 A a e ,gree d p . f A b t Ab t t nces or s es os a emen . Item Description Unit Price 1 Wall & Ceiling Drywall Material/Joint $1 .50 Compound texture 2 Popcorn Ceiling Texture $1 .50 3 9"x 9" Floor T il e & Associated Mastic $1.40 4 12 " by 12 " Floor T ile & Associated Mastic $1 .40 5 Lino leum Floorinq & Associated Mastic $1 .50 f--e---Mattr-:ta y c, v i, , y ,Ftoor i n g $1.50 7 Transite Shinqles $1 .7 5 8 Contaminated Carpet Removal $1 .00 9 Debris p ile w ith asbestos-contain ing $30 .00 materials 10 Transite flues -6" $10 .00 11 Mobilization Charge per Parcel $100 .00 Abatement Subtotal CO NTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL . INC Estimated Quantity -38 ,000 SF -2 ,500 SF -1 ,300 SF -2 ,000 SF -11 ,000 SF <10 SF -100 SF -5 ,000 SF -100 SF 8 11 Extended Price 57 ,000 .00 3,750 .00 1,820 .00 2 ,800 .00 16,500 .00 15 .00 175.00 5 ,000.00 3,000 .00 80 .00 1 ,100.00 $91 ,240 .00 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX T bl 3 A a e ,gree d p . f D rices or IT emo 110n an dA ·11 nc1 ary s erv,ces . Item Description Unit Pr ice Estimated Extended Pr ice Quantity Demo of improvements including 1 clean-up and d isposal of s ingle and $1.40 -40 ,000 SF $56 ,000 .00 up to three-level structures , including footers , beams , piers , and slabs Removal of concrete and asphalt - 2 patio , parking lot , interior sidewalks , $0 .60 -5 ,000 SF $3 ,000 .00 and grading of site (drives , curbs , and streets will rema in) 3 Removal of metal o r wood storage $0.80 -50 ,000 SF $40 ,000.00 sheds and other outlying structures 4 Removal of misc . items , wood , metal , $12 .50 -1 ,000 CY $12 ,500 .00 m isc . debris 5 Removal of fence $0 .75 -5 ,000 LF $3 ,750.00 6 Septic system removal and fill $328 .00 17 sites $5 ,576 .00 7 Abandon and pluq water wells $2,493 .00 11 wells $27,423 .00 Prepare and implement a Storm Water Pollution Prevention Plan , 8 installing and maintaining all BMPs , $5 ,000.00 1 $5 ,000 .00 establishing vegetation , and removal of BMPs upon completion Mobilization/demobilization fee 9 (includes disconnect , equipment, $1 ,000.00 1 $1 ,000.00 qenerators , traffic control , etc. 10 Concrete Debris $6 .00 -6 ,000 CY $36 ,000 .00 11 . Credit for salvaqe value $(1 .00) Each Parcel ($18 .00) Demolition Subtotal $190,231.00 J Abatement & Demolition Grand Total (ENTIRE PROJECT) $2s1,411.oo 1 Table 4. Asbestos-Related Unit Costs ACM Type *COST Carpet (ONLY) $1 .00/SF Floor applied Mastic (ONLY): $1 .10 / SF Floor T il e and Mastic $1.40 I SF Note : Above listed prices may be used ALONE or in conjunction with each other. P laster or stucco mate ri a l: Ro of Fl ashin g : Roofin g Fe lt: Sheetrock Jo int Compound : Spray-on Fireproofing (from Yi inch to 2 Yi inch th ickness ): Surfacing Material Boiler Insulation : Ro ll ed -on Texture : CONTRACT F OR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTER CON ENVIRONMENTAL , INC. $3 .50 I SF $3 .50 I SF $3 .50 I SF $1.50 I SF $7 .00 I SF $1 .50/SF $2 .00 I SF $1 .50 I SF Pa e 12 oL ; OFFI IAL K _CORD CITY SECRETARY FT. WORTH , TX Sprayed-on Texture (e .g . popcorn ce ili ng): $1 .50 /SF Trawled-on Texture : $1.50/SF Thermal System Insulation (TSI) 0-6 inch OD $7 .00 I LF 6 .1 -12 inch OD $7 .00 I LF >12 inch OD $7 .00 I LF FittinQ O -6 inch OD each $15 .00 I fitt ing Fitt ing 6 .1 -12 inch OD $15 .00 I fittinQ Fitting > 12 inch OD $15 .00 I fitting Mastic on duct insulation $1 .75/LF Transite Material : $1 .75/SF Wall , floor, or ceiling fibrous ACM board : $1 .75/SF Asbestos contaminated carpeting $1 .00/SF Table 5. List of Services NOT included in Standard List above : SERVICE COST Site Mobilization .... (once per job site) $100 .00 I site Construction of additional containments for abatement $100 .00 / conta inment Transportation and Disposal of Contaminated Debris not $65 .00 I cubic yard associated with abatement work Table 6 . Hourly Rates for workers if UNIT PRICE table above does not apply: POSITION HOURLY RATE Licensed Worker $42 50 L bo11r Licensed Supervisor $42 .50 I hour 7. LIQUIDATED DAMAGES If Contractor fails to commence and complete work under this Contract w ithin the stipulated time , there shall be deducted from any moneys due or owing Contractor, or which may become due , the sum of $1 ,000 .00 (one thousand dollars) per day for each day after t he date the proj ect was to be comp leted , un t il t he proj e ct is substa nt ial ly completed . Such sum sh a ll be treated as liq uidated damages and not as a pe na lty , a nd City may withho ld from Contractor's c ompensation such sums as li qu idated damag e s . The am o unt of d a mage to City fo r de lay in com p letion of t he work is diffi c ul t to as ce rt a in and t he amo unt of t he liqu idat ed damages per day as stated above is reasonably ant icipated pecun iary damages for such delay , and is not a penalty . CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - OEM 09-08 -INTERCON ENVIRONMENTAL. INC. .----A=~---. OFFICIAL RECORD CITY SECRETARY FT. WORTH 1 TX 8. INDEMNIFICATION A . Definitions . In this paragraph , the following words and phrases shall be defined as follows : 1 . Environmental Damages shall mean all claims , judgments , damages , losses , penalties, fines , liabilities (including strict liability), encumbrances , liens costs , and expenses of investigation and defense of any claim , whether or not such claim is ultimately defeated , and of any good fa ith settlement of judgment, of whatever kind or nature , contingent or otherwise , matured or unmatured , foreseeable or unforeseeable , including without limitation reasonable attorney's fees and disbursements and consultant's fees , any of which are incurred as a result of the existence of a violation of environmental requirements pertaining to the wells , and including without limitation : a. Damages for personal injury and death , or injury to property or natural resources ; b . Fees incurred for the services of attorneys , consultants , contractors , experts , laboratories and investigation or remediation of the monitoring wells or any violation of environmental requirements including, but not limited to , the preparation of any feasibility studies or reports of the performance of any cleanup , remediation, removal, response , abatement, containment, closure, restoration or monitoring work required by any fede ral , state or local governmental agency or political subdivision , or otherwise expended in connection with the existence of such monitoring wells or violations or environmental requirements , and including without limitation any attorney's fees , costs and expenses incurred in enforcing this contract or collecting any sums due hereunder; and c . Liability to any third person or governmental agency to indemnify such person or agency for costs expended in connect ion w ith the it ems refere nced in subparag raph (b) here in . 2 . Environmenta l requ irements shall mean all applicable present and future st atutes , re g ul ations , rul es , pl a ns , a uthorization s , concess ion s , fra nc h ises , and s im ilar items , of a ll g overnme nta l agencies , department s , commissions , boards , bureaus , or inst rumental it ies of the Un ited States , states , and pol itical subdivisions thereof and all applicable judicial , admin istrative , and regulatory dec rees , j udgments , and orders re lat ing to CONTRACT F OR STRUCTURA L DEMOLITION ANO A SBESTOS ABA TEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL , INC. Page 14 o f 28 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX the protection of human health or the env ironment , including without limitation : a . All requirements , including , but not limited to , those pertaining to reporting , licensing , em1ss1ons , discharges , releases , or threatened releases of hazardous materials , pollutants , contaminants or hazardous or toxic substances , materials , or wastes whether solid , liquid , or gaseous in nature , into the air, surfacewater, groundwater, stormwater, or land , or relating to the manufacture , processing , distribution , use , treatment, storage , disposal, transport, or handling of pollutants , contaminants , or hazardous or toxic substances , materials , or wastes , whether solid , liquid , or gaseous in nature ; and b. All requirements pertaining to the protection of the health and safety of employees or the public . B. General Indemnification. CONTRACTOR DOES HEREBY RELEASE, INDEMNIFY, REIMBURSE, DEFEND, AND HOLD HARMLESS THE CITY, ITS OFFICERS, AGENTS, AND EMPLOYEES, FROM AND AGAINST ANY AND ALL LIABILITY, CLAIMS, SUITS, DEMANDS, OR CAUSES OF ACTIONS WHICH MAY ARISE DUE TO ANY LOSS OR DAMAGE TO PERSONAL PROPERTY, OR PERSONAL INJURY, AND/OR DEATH, OCCURRING AS A CONSEQUENCE OF THE CONTRACTOR'S OPERATIONS UNDER THIS AGREEMENT, WHEN SUCH INJURIES, DEATH, OR DAMAGES ARE CAUSED BY THE SOLE NEGLIGENCE OF CONTRACTOR, ITS OFFICERS, AGENTS, EMPLOYEES, OR CONTRACTORS, OR THE JOINT NEGLIGENCE OF CONTRACTOR, ITS OFFICERS, AGENTS, EMPLOYEES, OR CONTRACTORS AND ANY OTHER PERSON OR ENTITY. C. Environmental Indemnification. CONTRACTOR DOES HEREBY RELEASE, INDEMNIFY, DEFEND, REIMBURSE, AND HOLD HARMLESS THE CITY, ITS OFFICERS, AGENTS, AND EMPLOYEES, AGAINST ANY AND ALL ENVIRONMENTAL DAMAGES AND THE VIOLATION OF ANY AND ALL ENVIRONMENTAL REQUIREMENTS RESULTING FROM CONTRACTOR'S OPERATIONS UNDER THIS AGREEMENT WHEN SUCH ENVIRONMENTAL DAMAGES OR VIOLATION OF ENVIRONMENTAL REQUIREMENTS ARE CAUSED BY THE ACT OR OMISSION OF CONTRACTOR , ITS OFFICERS , AGENTS , EMPLOYEES , OR CONTRACTORS , OR THE JOINT ACT OR OMISSION OF CONTRACTOR , ITS OFFICERS , AGENTS , EMPLOYEES , OR CONTRACTORS AND ANY OTHER PERSON OR ENTITY. D. The obligations of the Contractor under this paragraph shall include , but not be limited to , the burden and expense of defending al l cla ims , su its and CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09 -08 -INTERCO N ENVIRONMENTAL . INC Page 15of 28 OFFICIAL RECORD CITY SECRETARY FT. WORTH , TX administrative proceedings (with counsel reasonably approved by the City), even if such claims , suits or proceedings are ground less , false , or fraudulent , and conducting all negotiations of any description , and paying and discharging , when and as the same become due , any and all judgments , penalties or other sums due aga inst such indemnified persons . E. Upon learning of a claim , lawsuit , or other liability which Contractor is required hereunder to indemnify , C ity shall provide Contractor with reasonable timely notice of same . F . All Contractors under this contract agree that they assume joint and several liability for any claim by the C ity or for a third party claim against the City for general or environmental damages caused by any of the Contractors herein . G . The obligations of the Contractor under this paragraph shall survive the expiration or term ination of this Agreement and the discharge of all other obligations owed by the parties to each other hereunder. 9 . INSURANCE The Contractor certifies it has, at a minimum , current insurance coverage as detailed below and will maintain it throughout the term of this Contract. Prior to commencing work , the Contractor shall deliver to City , certificates documenting this coverage . The City may elect to have the Contractor submit its entire policy for inspection . A . Insurance coverage and limits : 1. Commercial General Liabil ity Insurance $1 ,000 ,000 each occurrence ; $2 ,000 ,000 aggregate 2 . Professional Liability Insurance Not applicable . 3. Automob ile Liability Insurance Coverage on veh icles involved in the work performed under th is contract: $1,000 ,000 pe r acc ident on a co m b in ed s in g le li m it bas is or : $500 ,000 bodily i njury each person ; $1 ,000 ,000 bod i ly inj ury each accident ; and $250 ,000 property d amage . Th e na med ins ured and em p loyees of Co ntracto r s ha ll be c ove red u nde r t his policy . The City of Fort Worth shall be named an Add it ional Insured , as its interests may appear . Liability for damage occurring while loading , unloading and CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-0 8 -INTERCO N ENVIRONME N TAL. INC . OFFICIAL RECORD 'f'age f6 of 28 CITY SECRETARY FT. WORTH, TX 4 . 5 . 6. 8 . 1. 2 . 3. 4 . 5 . transporting materials collected under the Contract shall be included under this policy . Worker's Compensation Coverage A : statutory limits Coverage 8 : $100 ,000 each accident $500,000 disease -policy limit $100 ,000 disease -each employee Environmental Impairment Liability (Ell) and/or Pollution Liability $4 ,000 ,000 per occurrence . Ell coverage(s) must be included i n policies listed in subsections 1 and 2 above ; or, such insurance shall be provided under separate policy(s). Liability for damage occurring while loading , unloading and transporting materials collected under the contract shall be included under the Automobile Liability insurance or other policy(s). Asbestos Abatement Insurance $2,000 ,000 each occurrence with no Sunset Clause , if any abatement is to be performed and prior to commencement of such work . Certificates of Insurance evidencing that the Contractor has obtained all required insurance shall be delivered to the City prior to Contractor proceeding with the Contract. Applicable policies shall be endorsed to name the City an Additional Insured thereon, as its interests may appear. The-term City shall include its employees, officers , officials , agents , and volunteers as respects the Contracted servic.e-s __ Certificate(s) of Insurance shall document that insurance coverage specified herein are provided under applicable policies documented thereon. Any failure on part of the City to request required insurance documentation shall not constitute a waiver of the insurance requirements . A minimum of thirty (30) days notice of cancellation or material change in coverage shall be provided to the City . A ten (10) days notice shall be acceptable in the event of non -payment of premium . Such terms shall be endorsed onto Contractor's insurance pol icies . Notice shall be sent to Department of Risk Management , C ity of Fort Worth , 1000 Throckmorton Street, Fort Worth , Texas 76102 . Insurers for all polic ies m ust be authorized to do business in the state of Texas or be otherwise approved by the C ity ; and , such insurers shall be acceptable to the City in terms of the ir financial strength and solvency . CONTRACT FOR STRUC TU RAL D EMO LI TION AND ASBESTOS ABATEMENT - DEM 09-08 -IN TE RCON ENVIRONMENTAL , INC . OFFI ~ 1 RO CITY SECRETARY FT. WORTH, TX 6. Deductible limits , or self-insured retentions , affecting insu rance required herein shall be acceptable to the City in its sole discretion ; and , in lieu of traditional insurance , any alternative coverage maintained through insurance pools or risk retention groups must be also approved . Dedicated financial resources or Letters of Credit may also be acceptable to the City . 7 . Applicable policies shall each be endorsed with a waiver of subrogation in favor of the City as respects the Contract. 8 . The City shall be entitled , upon its request and without incurring expense , to review the Contractor's insurance policies including endorsements thereto and , at the City's discretion ; the Contractor may be required to provide proof of insu rance premium payments . 9. The Commercial General Liability insurance policy shall have no exclusions by endorsements unless the City approves such exclusions . 10 . The City shall not be responsible for the direct payment of any insurance premiums required by the contract. It is understood that insurance cost is an allowable component of Contractor's overhead . 11 . All insurance required above shall be written on an occurrence basis in order to be approved by the City . 12 . Subcontractors to the Contractor shall be required by the Contractor to maintain the same or reasonably equivalent insurance covera e as re uired for the Contractor. When subcontractors maintain insurance coverage , Contractor shall provide City with documentation thereof on a certificate of insurance . Notwithstanding anything to the contrary contained herein , in the event a subcontractor's insurance coverage is canceled or terminated , such cancellation or termination shall not constitute a breach by Contractor of the contract. 10 . BONDING A . Paymen t and Performan ce Bonds . Before beg innin g t he work , th e Co ntractor shall be require d to execute to the City of Fort Worth a payment bond if th e contract is in excess of $25 ,000 and a performance bond if the co nt ract is in excess of $100 ,000 . Th e p ayment bo nd is solely for th e protection and us e of pay me nt bo nd be nefi c ia ri es who have a direct co ntractua l re lati o nsh ip w ith t he Contractor or subcontracto r to supply labor or materia l ; and in 100 % the amount of the Contract. The performance bond is solely for the protect ion of the City of Fort Worth , in 100% the amount of the Contract , and conditioned on the faithful CONTRACT FOR STRUCTURAL DEMOLITION ANO ASBESTOS A BATEMENT - DEM 09-0 8 -/NTERCON ENVIR ONME N TA L, INC . OFFI RD CITY SECRETARY FT. WORTH, TX performance by Contractor of the work in acco rdance with the plans , specifications , and contract documents. Contractor must provide the payment and performance bonds , in the amounts and on the conditions required , with in 14 calendar days after Notice of Award. B. Requirements for Sureties . The bonds shall be issued by a corporate surety duly authorized and permitted to do business in the State of Texas that is of sufficient financial strength and solvency to the sat isfact ion of the City . The surety must meet all requirements of Article 7 .19-1 of the Texas Insurance Code . All bonds furnished hereunder shall meet the requirements of Chapter 2253 of the Texas Government Code , as amended . In addition , the surety must (1) hold a certificate of authority from the United States Secretary of the Treasury to qualify as a surety on obligations permitted or required under federal law ; or (2) have obtained reinsurance for any liability in excess of $100 ,000 from a reinsurer that is authorized and admitted as a re insurer in the state of Texas and is the holder of a certificate of authority from the Untied States Secretary of the Treasury to qualify as a surety on obligations permitted or required under federal law . Satisfactory proof of any such reinsurance shall be provided to the City upon request. The City , in its sole discretion , will determine the adequacy of the proof required herein . No sureties will be accepted by the City that 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 suret satisfactory to theC =_,.,_it ~.'------------ 11. WARRANTY Contractor warrants that it understands the currently known hazards and the suspected hazards which are presented to persons , property and the environment by the work specified in this contract. Contractor further warrants that it will perform all serv ices under this Contract in a safe , effic ie nt and lawful ma nn e r us in g in dustry acce pted pra ctic es , a nd in f ull com p li a nce w ith all appl icable state and federal laws govern ing its act ivit ies and is under no restra int or o rder which would proh ibi t performance of serv ices u nd er th is Contract. 12 . DEFAULT AND TERMINAT ION CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL . INC . OFFICIAL RECORD Pae 19of28 Cl SECRETARY FT. WORTH, TX ---· ___ , ___ A. B . C . D. E. Contractor shall not be deemed to be in default because of any failure to perform under this contract , if the failure arises from causes beyond the control and w ithout the fault or negligence of Contractor. Such causes shall include acts of God , acts of the public enemy , acts of Government , in either its sovereign or contractual capacity , fires , flood , epidem ics , quaranti ne restrictions , str ikes , freight embargoes , and unusually severe weather. Contractor affirms a duty to mitigate any delays or damages arising from such causes . If Contractor fails to begin work herein provided for within the time specified above , or to complete such work within the time specified above , within the true meaning of this contract , City shall have the right to take charge of and complete the work in such a manner as it may deem appropriate . If City 's total costs exceeds the costs as agreed in the contract documents , the City may deliver to Contractor a written itemized statement of the total excess costs , and Contractor shall reimburse City for such excess costs without delay. Alternatively , if at any time during the term of this contract the work of Contractor fails to meet the specifications of the contract documents , City may notify Contractor of the deficiency in writing. Failure of Contractor to correct such deficiency and complete the work required under this contract to the satisfaction of City within ten days after written notification shall result in termination of this contract. All costs and attorneys fees incurred by City in the enforcement of any provision of this contract shall be paid by Contractor. City may terminate this Contract with or w ithout cause upon thirty (30) days prior written notice to Contractor, and such termination shall be without prejudice to any other remedy the Ci ty may have. In the event of terminatio n,_a ny_wmk in progress will continue to completion unless specified otherwise in the notice of termination. The C ity shall pay for any such work in progress that is completed by Contractor and accepted by the City . The remedies provided for herein are in addition to any other remedies available to City elsewhere in this contract. 13. OBSERVE AND COMPLY Contractor shall at all times observe and comply w ith all federal , state , and local laws and regulations and w ith all City ordinance s and regulations wh ich in any way affect this Agreement and th e work hereund e r, and shall obs e rv e a nd comp ly w it h all orde rs , laws ord inances and reg ul at io ns w hi ch may ex ist or may be enacted later by govern in g bodies having jurisdict ion or authority for such enactment. No plea of misunderstanding or ignorance thereof shall be considered . Contractor agrees to defend , indemnify and hold harmless City and all of its officers , agents and employees from and against all cla ims or CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTE RCON ENVIRONMENTAL . INC. OFFi . ag @ fl. ..,ORD CITY SECRETARY FT. WORTH, TX .__ ____ --· -- liability arising out of the violation of any such order, law , ordinance , or regulation , whether it be by itself or its employees . 14 . MODIFICATION No modification of this Contract shall be binding on the Contractor or the City unless set out in writing and signed by both parties. Any changes to the scope of work or compensation must be in the form of a written , formal , authorized modification of this contract that is in accordance with all applicable state and city laws , regulations , and ordinances . In no event shall any verbal authorizat ion changing the scope of work or verbal agreements for add itional compensation be binding upon the City . Contractor expressly agrees a) not to make changes to its legal , financial , or logistical position on any matter based on any oral representation by an employee or agent of the City prior to obtaining a written modification to this contract ; b) that it waives any claim based upon reliance or estoppel as a result of acting or not acting due to an alleged oral change to a material term of this contract from the City , its employees , or agents ; and c) that it waives any claim for compensation for work performed based upon an alleged oral change to a material term of this contract from the City , its employees , or agents . 15 . RIGHT TO AUDIT City and Contractor agree that , until the expirat ion of three (3) years after the final payment under this Contract, the City shall have access to and the right to examine any directly pertinent books , documents , papers and records of th e C ontraciOLlrnt.o.lY.ing transactions relating to this Contract. Contractor further agrees to include in all its subcontracts hereunder a provision to the effect that the subcontractor agrees that the City shall, until the expiration of three (3) years after final payment under the subcontract , have access to papers and records of such subcontractor involving transactions relating to the subcontract. The term "subcontract" as used herein includes purchase orders . 16 . MINOR ITY AND WOMAN BUS INESS E NTE RPR ISE (M/WB E) PARTICIPATION In accord a nce w ith C ity Ord inance No . 15530 , th e City ha s go a ls fo r the particip ation of mi nority bu s iness ente rp r ises and wo m a n bu s in ess enterp ri ses ("M/WBE") i n C ity contracts . Contractor agrees to a m in imum M/WBE participation of at least 10 % in accordance with its proposal and the aforementioned ordinance or to the M/WBE participation rate as specified in its proposa l, wh ichever 1s h ighe r . Contractor CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09 -08 -INTERCON ENVIRONMEN TAL , INC . 0 a-C . et~s CORD CITY SECRETARY FT. WORTH, TX acknowledges the M/WBE goal established for this Agreement and its commitment to meet that goal. Any misrepresentation of facts (other than a negligent misrepresentation) and/or the commission of fraud by the Contractor may result in the termination of this Agreement and debarment from participating in City contracts for a period of time of not less than three (3) years. Additionally Contractor agrees to abide by the federal Disadvantaged Business Enterprise requirements of 49 CFR Part 23. 17 . PREVIALING WAGE RA TES Contractor shall comply with TEXAS GOVERNMENT CODE, Chapter 2258 , with respect to payment of Prevailing Wage Rates for public works contracts and Contractor shall comply with the Davis -Bacon Act for building and construction trades , and shall comply with the prevailing wage requirements as specified in the RFP for the project. A worker employed on a public work by or on behalf of the City of Fort Worth shall be paid not less than the general prevailing rate of per diem wages for work of a similar character in the locality in which the work is performed ; and not less than the general prevailing rate of per diem wages for legal holiday and overtime work. A worker is employed on a public work if the worker is employed by a contractor or subcontractor in the execution of a contract for the public work with the City of Fort Worth. The contractor who is awarded a public work contract , or a subcontractor of the contractor, shall pay not less than the prevailing wage rates to a worker employed by it in the execution of the contract. A contractor or subcontractor who violates this requirement shall pay to the City of Fort Worth , $60 for each worker employed for each ------...-ca,..-jl""e""'naarday or part of lhe day fhanhe worker is paid less than the wage rates stipulated in the contract. This requirement does not prohibit the contractor or subcontractor from paying an employee an amount greater than the prevailing wage rate. 18. NON-DISCRIMINATION During the performance of this contract , Contractor shall not discriminate in its employment practices and shall com ply with a ll app lic ab le provisions of Chapter 17 , Art icle Ill of the Code of the City of Fort Worth . Contractor agrees not to discriminate aga inst any employee or appl icant for employment because of because of age , race , color, religion , sex , disability , national origin , sexual orientation , transgender, gender identity or gender expression in any manner involving employment, including the recruitment of applican lo ment, CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL. INC. advertising , hiring , layoff, recall , terminat ion of employment, promotion , demotion , transfer, compensation , employment classification , tra i ning and selection for training or any other terms , cond itions or priv ileges of employment. Contractor agrees to post in conspicuous places , available to employees and applicants for employment , notices setting forth the provisions of the non -discrimination clause. Contractor also agrees that in all solicitations or advertisements for employees placed by or on behalf of this contract , that Contractor is an equal opportunity employer. Notices , advertisements , and solicitations placed in accordance with federal law , rule or regulation shall be deemed sufficient for the purpose of meeting the requirements of this section . Additionally the Contractor agrees to abide by the provisions of 41 CFR Part 60-1.4(b). 19 . CONTRACTOR AFFIRMATIONS Some or all of the funding for this project are provided by the federal government. As such , certain federal requirements are imposed upon the Contractor including but not limited to equal opportunity , civil rights, lobbying of government officials , energy conservation , worker safety, and record-keeping . The Contractor shall heed and observe these requirements . These requirements and/or the citations to the statutes and regulations have been provided to the Contractor in the Invitation to Bid and are hereby incorporated by reference into this contract. Contractor acknowledges receipt and affirms its commitment to abide by all of the federal requirements disclosed in the ~~~~--1~nv-,~ta~t-,o~n~t-o~s~,~d·~t ~ha~t~a~r=e-a~p~p~1r·~c~a~b ~le~t=h~e-w~o~r~k~t~o ~b~e~p~e~rt=o~r~m~e~d~u-n~a~e~r~t~h-,s-c~o-n~tr-a-c~t.~~~~-- 20 . GOVERNING LAW The City and Contractor agree that the validity and constructi on of this contract shall be governed by the laws of the State of Texas , except where preempted by federal law . 21 . SEVERABILITY The prov is ion s of thi s contract are severab le ; a nd if for a ny reas on any one or more of the prov isions conta in ed here in are held to be in val id , illegal or unenfo rceable in any respect , the invalidity , i llegal ity or unenforceabil ity shal l not affect any other prov ision of CONTRACT FOR STRUCTURAL DEMOLITION AND A SBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL . INC OFFICIAL RECORD CITY srckif A8RY FT. WORTH, TX this contract , and this contract shall remain in effect and be construed as if the invalid , illegal or unenforceable provision had never been contained in the contract. 22 . RIGHTS AND REMEDIES NOT WAIVED In no event shall the making by the City of any payment to Contractor constitute or be construed as a waiver by the City of any breach of covenant , or any default which may then exist , on the part of Contractor, and the making of any such payment by the City while any such breach or default exists shall in no way impair or prejudice any right or remedy available to the City with respect to such breach or default. Any waiver by either party of any prov ision or condition of the contract shall not be construed or decreed to be a waiver of any other provision or condition of this Contract, nor a waiver of a subsequent breach of the same provision or condition , unless such waiver be expressed in writing by the party to be bound. 23 . VENUE Venue of any suit or cause of action under this Contract shall lie in Tarrant County , Texas . 24. NOTICES Any notices , bills , invoices or re12orts required by this contract shall be s.uffLcienLilsent y the parties in the United States mail , postage paid , to the address noted below: If to the City : If to the Contractor: Brian Boerner, Director Department of Environmental Management 1000 Throckmorton St. Fort Worth , TX 76102 Karen Andrews , Preside nt lnte rcon En v i ro n me nta l , Inc . 210 So uth W a lnut A ven ue Mansfield , TX 76063 CONTRACT FOR STRUCTURAL DEMOLITION ANO ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL . INC . OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 24 of 28 25 . ASSIGNMENT The City and Contractor b ind themselves and any successors and assigns to this contract. Contractor shall not assign , sublet, or transfer its interest in this contract without written consent of the City . Noth ing herein shall be construed as creating any personal liability on the part of any officer or agent of the City , nor shall it be construed as g iving any rights or benefits hereunder to anyone other than the City and Contractor. 26 . NO THIRD-PARTY BENEFICIARIES This Agreement shall inure only to the benefit of the parties hereto and third persons not privy hereto shall not, in any form or manner, be considered a third party beneficiary of this Agreement. Each party hereto shall be solely responsible for the fulfillment of its own contracts or commitments. 27 . CONTRACT CONSTRUCTION The parties acknowledge that each party and , if it so chooses , its counsel have reviewed and revised this Agreement and that the normal rule of construction to the -e tfecf t fiafany amb1guTties arelo be reso ve againsn he drafting pa y mus no -~- employed in the interpretation of this Agreement or any amendments or exhibits hereto. The paragraph headings contained herein are for the convenience in reference and are not intended to define or limit the scope of any provis ion of this Contract. The headings contained herein are for the convenience in reference and are not intended to define or limit the scope of any provis ion of th is Agreement. 2 8 . ENTIRETY This contra ct , the contract documents , an d any other docum e nts incorporated by reference he re in a re b i nd ing u po n t he part ies a n d c on t a in all the terms and co nd it ions agreed to by the City and Contractor, and no other contracts , oral or otherwise , regarding the subject matter of this contract or any part thereof shall have any validity or b ind any of t he part ies he reto . In the event of any c on f lict between the spe cific te rm s of CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-0 8 -INTERCON ENVIRONMENTAL , INC. -51!'1 ~. 'f ECORD CITY SECRETARY FT. WORTH, TX this contract and any other contract documents , then the terms of th is contract shall govern . 29 . AUTHORITY AND EXECUTION By signing this contract Contractor warrants that it has had the opportunity 1) to examine this contract in its entirety , 2) to have its legal counsel exam i ne and expla in the content , terms , requirements , and benefits of this contract if Contractor so chooses , and 3) to negotiate the terms of this contract within the bounds of applicable law. Having had the opportunity to submit its bid and also to specifically negotiate the terms of this contract, Contractor agrees to be bound by this contract and expressly agrees to the terms of this contract, including terms that may vary from those of the Invitation to Bid or the Contractor's proposal. The signatory to this contract represents that he or she is legally authorized by the Contractor to enter into a binding agreement on behalf of the Contractor. The remainder of this page is left blank intentionally . CONTRACT FOR STRUCTURAL DEMOLITION ANO ASBESTOS ABATEMENT · OEM 09-08 -INTERCON ENVIRONMENTAL. INC. OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 26 of 28 SIGNATURE PAGE FOR CONTRACT FOR STRUCTURAL DEMOLITION AND REMOVAL , TRANSPORTATION AND DISPOSAL OF ASBESTOS CONTAMINATED MATERIALS PROJECT DEM 09-08 :ALLIANCE NMP IN WITNESS THEREOF , the parties have executed this contract in triplicate in Fort Worth , Texas , on the dates written below . CITY OF FORT WORTH CONTRACTOR lntercon Environmental , Inc . BY ~a_. Fernando Costa Assistant City Manager APPROVED AS TO FORM AND LEGALITY : ~£>~ Arthur N . Bashor Assistant City Attorney BY : Karen Andrews President WITNESS: CORPORATE SEAL : CONTRACT FOR STRUCTURAL DEMOLITION ANO ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL , INC. OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 27 of 28 CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT - DEM 09-08 -INTERCON ENVIRONMENTAL. INC . Page 28 o f 28 CONTRACTOR COMPLIANCE WITH WORKERS' COMPENSATION LAW Pursuant to V.T.C .A. Labor Code §406 .96 (2000), as amended , Contractor certifies that it provides workers' compensat ion insurance coverage for all of its employees employed on City of Environmental Management Department , Project DEM 09-08 : All iance for structural demolition and removal , transportation and disposal of asbestos contaminated materials in the Fort Worth Alliance A irport Vicinity . CONTRACTOR INT~INC. By :----......-~-~~~~-------- STA TE OF TEXAS COUNTY OF TARRANT Karen An d rews Title President Date 4/6/10 § § § Before me , the undersigned authority , on this day personally appeared ~~ known to me to be the person whose name is subscribed to the forego i ng instrument , and .acknowle ged to me that he executed the same as the act and deed of for the purposes and consideration therein expressed and in the capacity therein stated . . ' G iven Under My Hand and Seal of Office this Jd!aay of Q p&-0 , 20 J O . ANGELICA PETRUZZELLI Notary Publ ic, State of :raxas My Comm ission Expi res February 28, 2012 THE STATE OF TEXAS COUNTY OFT ARRANT PAYMENT BOND SU 110 6306 B KNOW ALL MEN BY THESE PRESENTS: That we, Intercon Environmental, Inc., hereinafter called Principal and ARCH INSURANCE COMPANY , a corporation organized and existing under the laws of the State and fully authorized to transact business in the State of Texas , as Surety, are held and firmly bound unto the City of Fort Worth, a municipal corporation organized and existing under the laws of the State of Texas hereinafter called Owner, in the penal sum of: Two-hundred eight-one thousallld, four hundred seventy-one ($281,471.00) dollars in lawful money of the United States, to be paid in Fort W01ih, Tarrant County, Texas, for the payment of which sum well and truly be made, we hereby bind ourse lves, our heirs , executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that Whereas, the Principal entered into a ce1iain contract with the City ofF01i Worth, the Owner, dated the ___ day of , 2010, a copy of which is hereto attached and made a pa1i hereof, for the provision of: structural demolition and removal, transportation and disposal of asbestos contaminated materials in the Fort Worth Allian ce Airport Vicinity designated as Project Number DEM 09-08: Alliance Nl.VIP a copy of which contract is hereto attached, referred to , and made a paii hereof as fu lly and to the same extent as if copies at length herein, such project and construction being hereinafter referred to as the "work". NOW THEREFORE, if the Principal shall well, truly and faithfully perform the work in accordance with the plans , s pe c ifi cati o n, and contract document durin g the original term thereof, and any extensions th e reo f which may be granted by the Owner, with or without notice to the Surety, and if he shall sat isfy a ll claims and demands incurred und er such contract, and shal l fully indemnify and save harmless the Owner from a ll co sts and dam ages which it may suffer by reaso n of failure to do so, and shall reimburs e and repay the owner all outlay and expense which the Owner may incur in making good any default, then thi s obligat ion shall be void; otherwise to remain in full force and effect. PROVIDED FURTHER, that if any legal action be filed up on this bond , venue shall lie in Ta1i-ant County, State of Texas. AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, a lt eration or addit ion to the terms of the contract or to the work to be performed thereunder or the specifications accompanying the same shall in any wise affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time alteration or addition to the terms of the contract or t o the work or to the specifications . IN WITNESS WHEREOF, thi s instrument is executed in _3_ Counterparts each one of which shall be deemed an original, this the 5TH day of APRIL , 2010! (Principal) Secretary fotercon Environmental, Inc. Principal (4) Q ~~~lli (SEA-~ed By: Karen Andrews President (Printed Name/Title) vp210 South Walnut Avenue ADDRESS Angelica Petruzzelli, Exec. 3100 BROADWAY (Address) KANSAS CITY, MO 64111 ATTEST: ~ (urety) Secretary (SEAL) Q~M\Lk Witness as ;;· Surety Note : (I) (2) (3) (4) (5) Mansfield TX 76063 CITY /ST ATE/ZIP ARCH INSURANCE COMPANY (Smety) By: (Printed Attorney-in-Fact) Date of Bond must not be prior to date of Contract Correct name of Contractor A Corporation, a Partnership or and Individual, as case may be Correct Mame a/Surety If Contractor is partnership all Partners should execute bond A tn1e copy of Power of Attorney shall be al/ached to bond by Attorney-in-Fact THE ST ATE OF TEXAS COUNTY OFT ARRANT PERJFORMANCJE BOND SU 110 6306 B KNOW ALL MEN BY THESE PRESENTS: That we (1) Intercon lEnvirornmental, Inc., a (2) corporation of Texas hereinafter called Principal and Arch Insurance Company a corporation organized and existing under the Jaws of the State and fully authorized to transact business in the State of Texas, as Surety, are held and firmly bound unto the City ofFmi Wo1th , a municipal corporation organized and existing under the laws of the State of Texas hereinafter called Owner, in the penal sum of Two-hundred eight-one thousand, four hundred seve nty -o ne dollars ($281,471.00) in lawful money of the United States, to be paid in Fort Wmth, Tarrant County, Texas, for the payment of which sum well and truly be made, we hereby bind ourselves, our heirs, executors, administrators, and successors, jointly and severally, firmly by these presents. THE CONDITION OF THIS OBLIGATION is such that Whereas, the Principal entered into a ce1iain contract with the City ofFmt Wmth, the Owner, dated the _day of , 2010, a copy of which is hereto attached and made a pa1t hereof, for the construction of: structural demolition and removal, transportation and disposal of asbestos contaminated materials in the Fort Worth Alliance Airport Vicinity designated as Project Number DEM 09-08: Alliance NMP, a copy of which contract is hereto attached, referred to , and made a pa1t hereof as fully and to the same extent as if copies at length herein, such project and construction being hereinafter refen-ed to as the "work". NOW THEREFORE, if the Principal shall well , truly and faithfully perform the work in accordance with the plans , specification, and contract document during the original term thereof, and any extensions thereof which may be granted by the Owner, with or without notice to the Surety, and if he shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the Owner from a ll costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the owner all outlay and expense which the Owner may incur in making good any default, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED FURTHER, that if any legal action be filed upon this bond , venue shall lie in Tarrant County, State of Texas. AND PROVIDED FURTHER, that the said Surety, for value received, hereby stipulates and agrees that no change, extension of time, alteration or addition to the terms of the conirnct or to the work to be perfonned thereunder or the specifications accompanying the same shall in any wise affect its obligation on this bond, and it does hereby · waive notice of any such change, extension of time alteration or addition to the terms of the contract or to the work or to th e specifications. IN WITNESS WHEREOF, t hi s instru ment is execut ed in _3_ Cou nterpaits each one of wh ic h shall be d ee m ed a n ori g in a l, thi s th e 5th d ay of APRIL 2010 . (Prmc ipal) Sec ret ary .... ~ ~ ~~ ($.E:A~By: =Angelica Petruzzelli, Ex ec. VP 3100 BROADWAY (A ddress) KANSAS CITY, MO 64111 ATTEST: ~~"'~ (S EAL ) 0 ~'-If\/\ llL. itness as to Surety IntercoH1 EIIlvironmental, Inc . Prin c ipal (4) Kare n A n drews P res ident (Printed Nam e/Tit le) 21 0 So uth W al n ut Avenue ADDRESS Mans fi e ld T X 76 0 63 CITY /STATE/ZIP ARCH INSURANCE COMPANY (Surety) By : (Printed Attorn ey-i n-Fact ) No te: Dat e of Bo nd must not be pri or t o date of Co ntract (I) Carree/ name afCanlrac/ar (2) A Corpora/ion, a Parlnership or and Individual, as case may be (3) Carree/ Name of Surely (4) lfContrac/or is partnership all Partners shou ld execute bond (5) A true copy of Power of Attorney shall be al/ached to bond by Attomey-in-Fact • POWER OF ATTORNEY SU 110 6306 B Know All Men By These Presents: That the An:h lnauance Company, a corporation Olg8f1lmd and existing under the laws of the State Of Missouri, having Its principal afflce il Kansas City, MlssQuri (ht1 alnaflar ,.,._ to as the "Com~ does her8by eppolnt WIiiiam A. Bailey, Maria A. Gonzalez, Anne M. Barber, Michael J . Friedrich and Dana M. Kuber of Bridgeview, IL (EACH) Its true and -...· ~-~ to make, execute, seal, and deliver from 1he dale d iauance of 1h18 J)OMil' fOr Sid on 11s behalf 1a sarity, illnd as Its act arid dead: Any and al bonds and undlrtakings EXCEPTION; NO AUTHORITY 11 .Ql'M.led to rn.ke, exec:utit, ,-, -.od dellver ._ c. uodertakJngl thatguei•• the .___. er· . ·. • i.ctlon. ;J *"" ftl'ftffl.__, _.. .......... chlft·ot ieltar' or ---it. ' . ,....,n,-,,.~~ . COi. . . . llil'I --·1. r ·--·~--1 ,_, ,.._, 11,lS'll'U • 1h11 aulhatly doea . no1 pwml 1he .... -d._m to ·beaplt kllD two or _mcn bolKls tn order to brtnO 8'lch • ..., band wflttlnthedolllf ~Clf ~ --farth .... The Company nmyNIWJke Ilia appollMmllnt llter.ytrne. The -~ d _... • _ _. • under:tafcl:P ·tn ~-af ;i-.•f P.t;•iffllt:.,.. be • ~ upc,n 1he 181d ~.-,.. .. .,... ... ._. .• J.Q'PC!,1•.•r•--•tt:, ..... ....., ... ~1;y-11s ~., ........... ~ifflDelni<anla°".~-~--~ '• ·::-. ~-', ·':'."' ·,. ,. •a.t :•. ' •. ~ • -·~ •·• I ,. • nw..Powerd~lsmcaaudbyauthorityd,....._.~-tw -~CQnlentoftheBoarddDhdorld the Company:oa . Man:lti..2003. llve and .._.capllaof-whlah .............. tarth and 819 hllnlbymrtlll!d ·ID by tb,e undlfillgned Sea ••1 • being lnU b'ce ilnif 1!llaat: · "VOTED. ·Thll a.~ fl 118 8-11. thll~or..., vtc. J'rlllldenl.,°-f ._ ..,,_ ... ........,.In ·wrllnD and tied wllh ..... y. at ... a.ca .... y ....... power ... ....., tD:lllppOfitt 11911* _....,_. ln-facl, and to aullOria .fhlli'n to t-=ade an bltllllf fl _the 'Company, and allach the NIii d 118 'Company taelQ,, ·bands p ul1dlrtlllck'lp, .....--. ••• af lndtl,.1"1 .,.. ... wt.,_P. ~ frt "8 nature ""8af. •--,'weh offlcera afthe ~-appolntagenll.for_.,.. __ ,,,__. . ' Thii.-:Powli' ol AIIOi'ney II~ NIiied -.C8i11ffed• by faclll,lle ...... anl by aulhorlly of lhe followlng reeouton adopted ·t,r .. tlW1lmoul cm.-.t oflle BoMhf Dlndcn of the Oornpaa, on l4a'Gh 3. 2003: ,ll"'ffi:ft ...__ -..., _......._._ of-Chllnnlln d Ill .a-_ ... · PNilldilnl. a,·· · anv ,..._ ~ -....._ IIPPC*wl · wv,s;.w, 1-111!111 ~· ..--· ·-.. · , -uu,au, -•_1. Y... U1 V... n 1111 dUlgi' li1d In wrlllnO *'4 tllNI wllh lie Slia111Kiy~ and 118 ....... db Sea•y~ 119 N81 of 119 ~'Y• ·.-I cerllli:atioi• by lie a.a•,. ,....y be llllbGld by,_.. .. QR_ q ""' of,..,., ar bofld .-.:.lll!d ,.,.... tp ttle ,....., ._,..11y lie BoanJ of Dilactn on Man:113, 200I, and ,..,._ pcM9r' • amculed, llli1ect and Cllftllecl wtlh -.,act to *'Y bond ar ~ ID Which It II~ 1111111 c:on11rmetDbewiild and binding upon the CCrripiny. 00ML0013 00 03 03 Page 1 of2 PrtntN In U.S.A. l N s. N I 5' ~ ~ 8 -w 8 0 w 8 1.\/ • I ,'1 ( Ii' 1 ..... 11 r1 'ti:! 1 111.1n t ! F·~' •. f!L ~. lr1~, ~ ,,.1~1~ ~ ~ '."G,-a ii .-ll . i . 11· 1 I' :z: z ii ~.1 ~1 :~ti ·· l if Ii i I i 1! ,-1l,1i. i ,1?1!!;: .I ISL 11•r' '1'! . .ni.111.· ! f 11111 : J lfJ:r I ! 11 I ''ii JI! 1· !•I i 1! ra 1!1 ti d1 11 _;J! ! h · 1 ifhl :n,~n i u f . I ,. f !1J f!I .. 1 .. 1JIJ; ! I • ft ~ a. ! £ • • __ I f !f ·~. . _ . I l -t •~ 1rlil 'I I ~J! ~ r Ip • f ii. r i .. " 0. ~ [ ii • --~i o.J ~'< al 1; g .. • ~1 Ji . . 8" i f m !-I ~ ; ! I i I ] ; a ' ~ . ! C: ... •' C ii I I INVITATION TO BID FORT WORTH CITY OF FORT WORTH ENVIRONMENTAL MANAGEMENT DEPARTMENT 1000 THROCKMORTON FORT WORTH, TEXAS 76102 PROJECT: DEM 09-08: ALLIANCE NMP ALLIANCE NOISE MITIGATION PROJECT REMOVAL OF ASBESTOS-CONTAINING MATERIALS AND DEMOLITION OF STR UCTU RE S-------- . ----AT ALLIANCE Al RPO RT FORT WORTH , TEXAS April 17 , 2009 INTERCON ENVIRONMENTAL. INC . Compan y Nam e 210 S . Walnut Creek Drive Ad dress Mansfield Texas 76063 City , State , Zip J u n e 11 2009 Date ENVIRONMENTAL, INC. Table of Contents 2.0 Proposal Documents 1. Proposal Document Checklist ................................................... 2.1 Acknowledgement of Receipt of Addenda .................................... 2.2 Scope of Work ..................................................................... 2.3 2. Cost Sheet ......................................................................... 2.4 3. Contractor Information & Qualifications ...................................... 2. 5 Company Information ......................................................... 2.5 .1 Statement of Qualifications .................................................. 2. 5.2 Texas Sales/Use Tax Certificate & Certificate of Good Standing ....... 2.5.3 Project References ............................................................ 2.5.4 Staff Matrix ..................................................................... 2.5.5 4. Contractor Submittals Project Schedule .............................................................. 2.6.1 Schedule of Values ............................................................ 2.6.2 Sample Invoice and Project Closeout documentation .................... 2.6.3 Communication Channels Organization Chart. ............................ 2.6.4 ------------- 5.-Subcontractors Information & Qualifications ................................. 2.7 Subcontractor Company Information ....................................... 2. 7.1 Subcontractor Statement of Qualifications ................................ 2. 7.2 Subcontractor Staff Matrix ................................................... 2. 7. 3 6. Bonds ............................................................................... 2.8 7. Disadvantage Business Enterprise (DBE) Utilization Requirements ........ 2. 9 8 . Statement of Residency ....................................................... 2. 1 O Nondiscrimination .............................................................. 2.11 Prevailing Wage Rates & Davis Bacon Requirements ...................... 2.12 9 . In su r ance Ce rtif i cate ........................................................... 2. 13 Workers Compensation Insurance Coverage ................................ 2.14 10 . Co ntracto r's Re sp onsibili t ies ................................................. 2 .1 5 Contracto r's Legal & Compliance History ................................... 2.16 Federal Supplemental Information .......................................... 2.17 ' ii 2.0 BID DOCUMENTS Note: ALL BID DOCUMENTS MUST BE SUBMITTED IN THE SAME ORDER AS RECEIVED FROM THE CITY AND WITHIN A BOUND PACKAGE. FAILURE TO SUBMIT ALL OF THE ITEMS LISTED ON THE FOLLOWING PAGES, IN A SEALED ENVELOPE, MAY RESULT IN THE BID BEING CONSIDERED NON-RESPONSIVE. 2-1 2.1.Bid Document Check list All Bid Documents , including this checklist, must be completed in full and subm itted in a sealed envelope, in the requested order, to be considered a responsive submittal. Bid D ocuments Initial if Included 1. Bid Document Checklist 2. Acknowledgement of Receipt of Addenda 3. Scope of Work 4. Cost 5 . Contractor Information and Qualifications 6. Contractor Subm ittal s 7. Subcontractor Information and Qualifications 8 . Bonds 9. Dis advantaged Business Enterprise Util ization Requ irements 10 . Statement of Res idency 11. Nondiscrimination 12. Prevailing Wage Rates 13. In surance Certificates 14 . Contractor's Responsibil itie s 15 . Contractor's Legal and Compliance History understand that all of these items will be reviewed, and any items not included may resultin my bid..being-con-siderea-nen-res·ponsive:------ Signature Name Karen Andrews T itle President Company D ate lntercon Env ir onmental Inc . June 11 , 2009 2-2 2.2.Acknowledgement of Receipt of Addenda 2.2.1. Check if applicable X The undersigned acknowledges the receipt of the following addenda to the Inv itatio n to Bid , and has attached all addenda following th is page . (Add lines if necessary). Addendum Number 1 Addendum Number 2 Addendum Number 3 2 .2 .2. Check if applicable __ May 5, 2009 (Date received) May 12 , 2009 (Date rece ived) June 1, 2009 (Date rec eived) The undersigned acknowledges the receipt of no addenda to the Inv itation to Bid . lntercon Environmental, Inc. Company Karen Andrews June 11 , 2009 Name Date President Titl e 2-3 FORT WORTH E N VIRO N !\'IENTAL MANA GEYIE N T A DDENDUM TO: Interested Parties FROM: Roger Grantham, Environmental Program Manager Department of Environmental Management DATE: May 5, 2009 RE: Addendum #1 DEM 09-08: ALLIANCE ~ / ; , • ' \ ~ ,' • t ": ,-- • ,..·· • " ~ .... ~,;·: ~ ••• ' ..... ~ ' ,.. • ~ ~~ As of Tuesday, May 5, 2009, the following apply; L IndudecLwitb this addendum are-the-fellowing-attachments. a. Bid Specifications b. Aerial Photograph of properties c. Pre-bid meeting attendees list 2. A Professional Beekeeper will be required to remove the ex isting beehives located within several of the project structures. Information should be submitted on the Subcontractor Utilization Forms and the DBE documentation forms. 3. The project area is not located wi t hi n t he lim its of th e Ci ty of Fo rt Wo rth. Therefore, the port io ns of Section 2.3 .2 w hich des cri be adherence t o the City of Fo rt Wo rth perm itti ng proce ss an d th e Ci ty of Fo rt Worth "Tree Prese rv ation Or dinance" are not require d . 4. The requirements of preparin g and submittin g a SWPPP and NOI are stil l required . 5. Wate r an d Electricity are not ava ilable at the project sites. ' 6. Concerning debris: any materials located on the project sites shall be considered debris and should be disposed of appropriately. This includes fences that are not in good repair, wood, sheet iron, metal , tires, and concrete that have been randomly scattered across the sites. 7. Water wells have been identified at eleven (11) properties. The estimated depth of these water wells is in the range of 600bgs to 1,200'bgs. At least two of the existing water wells will remain intact w ith electricity connected in order to supply water for the cattle . These water wells will be specifically marked pr ior to demolition activities . 8. Existing utilities across the sites will be term inated and disconnected by the City of Fort Worth. 9. The project sites will be accessible with the exception of 650 Harmon Road and 1504 Westport Parkway. 10. Existing OSSF or septic tanks shall be permanently abandoned and filled in place with an inert material such as sand or existing topsoil from around the area. Please be aware additional addenda may follow as additional details with event planning and work area scheduling are finalized . FORT WORTH ENVIRONMENTAL MANAGE:VIE NT ADDENDUM #2 TO: Interested Parties FROM: Roger Grantham, Environmental Program Manager Department of Environmental Management DATE: May12, 2009 RE: Addendum #2 DEM 09-08: ALLIANCE .. :r .. ,, ~·: ..... ~ .. .;;~. ':.,.. ~ r '"'~,.·-... •, ~ ·~:·: ·"'~-..... ~!;,~·~: -.,~ ·:. _>.·. ~ ---,-:-- As of Tuesday, May12, 2009, the following questions have been received; ' 1. Can you please define limits of clearing or clean up in reference to properties like 1304 WestpOft Pkwy,410-H-armon-Rd;815Ha-rmonRa~S-45 Ra r mon R~865 ___ -- Harmon Rd.? Answer: Please refer to Addendum #1. Basically debris associated with each site will be removed and either disposed of properly or recycled in an appropriate manner. 2. There is one house with a basement. Will you clarify the scope of work with th is house? Does the basement walls and floor totally come out or just 2 ~ below grade and punch holes in the floor? Answer: The struc t ure loca t ed at 605 Harmon should have the basement walls removed to at least 2' bgs and the basement floor sh o uld be rendered to preve nt pooling of water (i.e. ho les punched through floor, broken o r cracked , etc ... ) 3. Wi ll the re be a road provided to w he re w e can lea ve t he gates open to get into 8 15,845, & 865 Harmo n Rd? An sw er : Access wi ll be ava ila ble fro m Harm on Ro ad . 4. In reference to the properties located @ 845 Harmon & 865 Harmon could you please clarify the scope of work on the east end of the property. Answer: The con cr ete and co nst r uction debris will be re move d from th is portion of t he project site vi a acce ss from the l -3 5W Se rv ice Road. 5. Could you clarify the amount of fencing being removed from each property? Answer: Fenc ing associated with each property wi ll be evaluated on it s future usage for conducting cattle gra zi ng operations. Exterior fenc ing surrou nd i ng the properties w ill remain in place . Interior fenc i ng on each property that is considered in good repair w i ll be allowed to rema i n intact. Fences deemed as i n poor quality and of no strategic use for the gra zing operations w i ll be removed (i.e. fences surrounding the individual houses, fences i n poor repair ) 6. On 1304 Westport Pkwy there are several large dead trees on the property. Are these to be removed? Answer: Yes. 7. In the specs it calls for a 500 SF outlying structure to be removed @ 865 Harmon. There are two other outlying structures on the other 2 properties in that area. Are these to be removed & added to the specs? Answer: Yes. 8. There are several properties with bee hiv~. Will th.e5-e b.e remo.ved-befor:e weF k---- is tn startT ----~ - Answer: Please refer to Addendum # 1. Proposals are due at 1 :30PM on May 28 , 2009 . Please de li ve r t o the Purc hasing Department, Low er Leve l, Ci ty Hall, 1000 T hroc km orton, Fo rt Wo rth , Te xas 76 10 2. • FORT WORTH ENV IRO N;\I EN T A L l\'IANAGE:\I ENT ADDENDUM TO: Interested Parties FROM: Roger Grantham, Environmental Program Manager Department of Environmental Management DATE: June 1, 2009 RE: Addendum #3 DEM 09-08: ALLIANCE As of Thursday, May 28, 2009, the following apply; 1. The Invitation to Bid due date _b_as been re_s_cbeduleciJ~To-ur-Stlay, June--1-1, --- 2009" ror delfvery at 1 :30 pm to the Purchasing Division, Lower Level of City Hall, Fort Worth, Texas 76102. 2. The estimated bid quantities found in the cost estimate table are only to be used to tabulate the bid and determ ine best value of the City; The contract will be based on unit pricing found in the Cost Estimate Tables and the field ver ified amounts agreed upon between the City and the successful bidder prior to beginning actual work on the site or sites. 3. Ad d iti onal detailed information involving the following areas can be found in the revised Information Table, Section 2.3 Scope of Work: • Water Well Information: • Septic System (OSSF) Information: • Beehive Information: 4. Concerning the SWPPP: .. • Vegetation should be utilized that would provide the best stand for the time of the year. With the schedule to begin in the early fall, ryegrass would be sufficient. • Concerning construction entrances, Harmon Road may be utilized for the construction entrance rather than establishing one for each individual parcel. 5. Bee colonies may either be relocated to another site by the professional beekeeper or professionally exterminated at the project location . 6. Septic Systems are to be decommissioned by removing all concrete to at least 2' bgs, cracked or holes punched into the base so as not to allow pooling of water, and backfilled with native soils found within the project site. 7. Please substitute the following pages (replacements) within the bid document: 2.3 Scope of Work Bids are being accepted by the City of Fort Worth for the furnishing of all labor, materials and equipment necessary to perform the removal of all asbestos- containing materials (ACM) and the demolition of all structures identified below located within the Noise Mitigation Area at Alliance Airport . 1.1.1. Site Information Addresses for structures located within the Alliance Airport Noise Mitigation Area in Fort Worth , Texas , are provided in the tables below. A total of 17 residential structures plus outlying structures at 18 addresses will be demolished . ACM will be removed from approximately 11 of these structures prior to demolition . *Quantities identified in this Bid Package are estimated by the building owner and/or his designee and will utilized for tabulating this bid only in order to determine the best value award; the Contractor is responsible for verifying all quantities with the City prior to initiation of work on a site for establishing the actual agreed upon value of the Contract Address/location Asbestos/Water Well /Septic/Beehive Information Square Feet for Demolition 1304 Westport Pkwy Texture on walls and ceiling -throughout (-4,320 SF) -1,680 SF Abst. 991, Tr. 1 Linoleum flooring -Kitchen and Hall (-180 SF) (6 outlying structures= 9"x 9" floor tile -Entry and Bath (-120 SF) -10,000SF) Well P&A Well Depth: -450' Well Diameter: -4" OD Cased -Sl!pttc'"~ -800 gallon ----------------- At least 1 confirmed beehive 1404 Westport Pkwy Linoleum flooring -Living Room (-48 SF) -1,144 SF Abst. 737, Tr. 2A Septic - -800 gallon (4 outlying structures = -7,500SF) No Well 1504 Westport Pkwy Linoleum flooring -throughout (-1,000 SF) -1,800 SF Abst. 737, Tr. 2A03 Texture/Joint compound walls & ceiling -throughout (2 outlying structure = (-4,000 SF) -1,000SF) Well P&A Well Depth: -420' Well Diameter: -4" OD Case d Septi c --800 aallo n 301 Harmon Rd. Linoleum flooring -Kitchen, Utility Room, Bathroom -1 ,840 SF Abst. 737, Tr. 2A04 (-350 SF) (1 outlying structure= -1,500SF) No Well Septic --2 x 800 gallon 305 Harmon Rd. Abst. 737, Tr. 2A04 No Well 410 Harmon Rd. Abst. 991, Tr. 2 Well P&A 491 Harmon Rd. Abst. 1825, Tr. 1A Well P&A 525 Harmon Rd. Abst. 1957, Tr. 1A01 'Well Remains" -605J:tarmon Rd. __ Abst. 1957, Tr. 1A02 Well P&A 650 Harmon Rd. Abst. 646, Tr. 2 'Well Remains" 68 0 Harmon Rd. Abst. 64 6, Tr. 2F01 740 Harmon Rd. Abst. 646, Tr. 2D Well P&A No ACM Septic - -800 gallon Linoleum flooring -throughout (-1,095 SF) Texture/Joint compound walls & ceiling -throughout (-4,700 SF) Well Depth: -430' Well Diameter: -4" OD Cased Septic --800 aallon Vinyl floor -Kitchen, Nook, Hall, Master Bath (-395 SF) Well Depth: -410' Well Diameter: -4" OD Cased Septic - -1,000 gallon Linoleum flooring -kitchen, utility, bathroom, dining (-624 SF) Septic - -1,200 gallon NoAC~--- Well Depth: -425' Well Diameter: -4" OD Cased Septic - -1,000 gallon Linoleum flooring -throughout (-1,000 SF) Texture/Joint compound walls & ceiling -throughout (-4,000 SF) Septic - -800 gallon No residential structure, No ACM No ACM Well Depth: -400' Well Diameter: -4" OD Cased Septic --80 0 gallon -1,100 SF (4 outlying structures = -2,000SF) -1,464 SF (4 outlying structures = -3,000SF) -2,214 SF (4 outlying structures = -5,000SF) -2.650 SF (2 outlying structures = -3,000SF) -3,000 SF (three-story) (5 outlying structures= -3,000SF) -2,000 SF (5 outlying structures= -5,000SF) 1,000 ya r ds debris (1 outlying structure = -1,000SF) -1 ,200 SF (1 outlying structure= -1 ,000SF) 7 45 Harmon Rd. No ACM Abst. 646, Tr. 2A Well Depth: -405' -1,900 SF Well P&A Well Diameter: -4" OD Cased (2 outlying structures = Septic --1,200 aallon -2,000SF) 815 Harmon Rd. No ACM -2,000 SF Abst. 1776, Tr. 2F Septic --1,000 gallon 845 Harmon Rd. No ACM Abst. 1776, Tr. 2J Well P&A Well Depth: -410' -950 SF Well Diameter: -4" OD Cased Septic - -1,000 gallon 865 Harmon Rd. 12"x 12" Floor tile -Bathrooms (-65 SF) Absl 1776, Tr. 2E Well Depth: -405' -3,390 SF Well P&A Well Diameter: -4" OD Cased (1 outlying structure = Septic --800 gallon -500SF) At least 1 confirmed beehive 895 Harmon Rd. No ACM Absl 1776, Tr. 2M Well Depth: -415' -1,857 SF (2 outlying structures = Well P&A Well Diameter: -4" OD Cased -2,000SF) Septic --1,200 gallon At least 1 confirmed beehive - ----959-Hanmm Rtt:""-T~xtul'8-on c:eil!ng-and-walts~ through-oat(-3",28°'SF)------------ Abst. 1776, Tr. 2G Linoleum flooring -Kitchen and Entry (-168 SF) -2,308 SF Well P&A Well Depth: -400' (5 outlying structures = Well Diameter: -4" OD Cased -2,000SF) Septic --1,200 gallon 2.3 .2 . Project Coordination Contractor will be responsible for coordinating with the Env iro nmental Management Department , within twelve (12) days after receipt of notice to proceed , the start date of demolition to allow for notification to the Texas Department of State Health Services (DSHS). The City of Fort Worth will prepare and submit the DSHS notificat ion and pay all DSHS notification fees . Upon award , contractor shall provide to the City of Fort Worth an updated schedule detailing the phased approach to performing the abatement and demolition of structures identified within the Noise Mitigation Area at Alliance Airport. Upon receipt of a notice to proceed and prior to demolition , contractor must obtain a wrecking permit to demolish the subject structure from the Development Department , telephone (817) 392-2222 . In obtaining the wrecking permit, the contractor will be requ ired to abide by City of Fort Worth ordinance number 17228 , also known as the "Tree Preservation Ordinance." Under the preservation ordinance, no tree 6 " diameter or greater will be removed and all trees within 50 feet of a structure will be protected as per Tree Ordinance #17228. Removing trees that interferes with construction is permissible while still retaining 25% of existing canopy. A copy of the ordinance has been included as Appendix B . It is the City's intent to leave all trees in place and only remove trees that are dead or will jeopardize the health and safety of the workers performing demolition activities . It may be necessary to remove a number of the trees to facilitate demolition of the site structures . In addition, many may become severely damaged during the demolition process . The City of Fort Worth will prepare Phase One documents as detailed in the "Tree Preservation Ordinance " ~r this_p_i:o~ct. This will include the performan ce Of a free survey identifying the current canopy cover on site . This will allow the removal of up to 25 percent of the existing tree canopy . The City of Fort Worth believes this will allow for the proper protection of the existing resource and will also facilitate the completion of the scope of work without impeding progress . In addition , this will alleviate the contractor from paying any fees associated with the "Tree Preservation Ordinance " and from being held liable for the preservation of trees designated to be removed. The contractor will still be responsible for protecting the trees that are not des ignated to be removed and for following the requ irements of th e ordinance during the performance of this project. Pr ior to sit e mobilization , the contrac tor m ust prepare and submit a Storm Wa ter Pollution Pr evention Plan (SW PPP ) in accordance wit h the requ irements detailed in the TPDES General Permit No. TXR150000 and receive d approval from the C ity . In addition, the contractor must also submi t a Notice of Intent (NOi ) to the Texas Commission on Env ironmental Quality (T CEQ ) for storm water discharges assoc iated wit h construction activities . T he contractor must ma intain thi s plan u nti l sufficient vegetation ha s been establ ished . 4 2-6 2.3 .3 . 2 .3.4 . S ite Prepara t ion Prior to any abate me nt or demol ition act ivit ies , the contra ct o r wi ll remo ve a ll un iversal w aste it ems in clud ing light bulbs , me rcury-conta in ing de vic es , pa in ts , pesticides , etc . Th e se items wi ll be p roperly packaged and disposed by th e contractor . The co nt ra ct or will prov id e documen tation (was t e man ifest , bi ll of lading , etc .) that t he w aste was prope rly d isposed . Contractor w ill d isconnect all associated air condition ing units and properly evacuate any rema ining refrigerant contained within the un its pr io r to be i ng disconnected . Utilities have been term inated to the sites . Prior to demolit ion , the cont ractor will be respons ible for verifying t hat all utilities (i .e . natural gas , telephone , water , etc .) have been disconnected . Contractor w ill cut and cap all s ite utilit ies at po int of connection to the site . Site Work All structures w ill be abated of all ACM and w ill be demolished removing all slabs /foundations , utility infrastructure and grading of the parcel to properly manage storm water . Prior to the start of abatement and demol ition of any structure , each structure shall be inspected to ensure the safety of the crew . Abatement activit ies w ill include the removal of approximately 45 ,000 square feet of sheetrock wall texture and joint compound , approx imately 2 ,500 square feet of popcorn ceiling texture , approximately 13 ,000 square feet of linoleum and associated mastic , approx imately 2 ,000 square feet of 12 "x 12 " floo r_J Ue and ___ _ assoc ia ted mast rc ~ a pprox iniaTefy-1 ,300-s quare feet of 9"x -9,, fl o or tile and associated mast ic , approximately 5 ,000 square feet of carpet and asso ci ated mast ic and <100 square feet of t ransite shingles. All debris generated from the removal of ACM is to be disposed of as asbestos-containing waste . Quantities identified in this Bid Package are estimated by the bu ilding owner and /or his designee ; the Contractor is respons ible for verify in g all quantit ies . Cla ims for additio nal compensat ion due to va ri at ions between conditions actually e ncountered in th e proj e ct and as ind ica ted in the Contract Docume nts w ill not be allo wed . The only excep tio n is if t he Con tract o r can cl early sho w w hy the vari at ion wa s no t ident ifiable prior to job commen cement. Prior to any site disturbance, the contractor w ill have implemented the Best Management Pra ctices (BMPs) detailed in the approved SWPP P . Th is shall include , but not be limited to , the use of silt fencing, rock check dams , mulching , eros ion control blankets , c urb and inlet protection de v ices , sed iment traps , sediment basins , and /o r stabilized construction entrance s and exits . Demol itio n act ivi ties wi ll inclu de t he demol iti on of al l sit e st ru ct u res , concrete /asphalt pa rk ing , slabs /foundat ion s, and re ta inin g walls . St reets , driv es , and curb s will remain in place . A ll demo lition debris will be remo v ed from the site and recycled or disposed in a landfill accepting such w aste . All foundat ions w ill 2-7 be removed down to a m ini mum of 2 fee t belo w grade . If founda tions /piers extend beyond 2 fe et below grade , t hey may be se v ered at tha t po in t and left in pla ce . Contractor shall clean a nd remove all rema inin g fu rn iture , house ho ld fu rn ishin gs , building materials , tires , debris , tr ash , rubb ish and any oth e r sol id w aste fr om th e prem ises . These ma te ri als shall be recycled , reclaimed or d is posed at a fa ci lity o r landfill that is approved to accept su ch waste . Demolition activ ities w ill be performed in accordance with Federal , State and lo cal visible emission requirements (i.e. no visible emissions will leave the demol itio n area). Water is available in the vicin ity of the construct ion area . The work area will be main tained in a manner that will control all demol ition deb ris from becoming windblown and /or migrati ng from the work area during and afte r work ing hours . Upon completion of the demolition work , the Contractor will obtain a final inspection on the wrecking permit from the Build ing Inspection Division in the Development Department. (call 2222 to verify) Ex ist ing domestic water wells shall be properly plugged and abando ned by a licensed water well driller in accordance w ith State of Texas regulat ions . Ex isting On-site Sewage Fac ilities (OSSF) or septic tanks shall be properly decomm issioned w it h contents of septic tanks removed and properly d isposed of by a licensed person . The contractor shall use s ite material , if ava ilable , or clean fill from an appro ved source to fill a ny holes in the terra in resulti ng from any of the above work , inc luding any OSSF or sept ic tanks and grade the entire lo t, ensuring t hat low ar eas are filled to prevenrthepoollng of wate r. ------------ Upon completion of t he entire project , contractor shall sweep d irt and debr is from t he haul routes used to ensure any sed iment tracked from the s ite is collected . A spec ific g rass type in d igen o us to t he area w ill be selected and agree d to depend ing upon t he tim e of year when the pl anti ng w ill occur . The so il wi ll be analyzed by t he contracto r in or de r to dete rmi ne cu rren t nitro g en , phosphoric aci d , and pota sh con te nts in order to determine th e conc e ntrat ion a nd fe rt il ization rate that s houl d be app lied to max im ize growt h . T he seeded area w ill be watered by the con t ra ctor , as nee ded, to allow prop er establishm ent of ve ge tation. The Contractor will maintain the vegetative area for six months, or unti l a un iform vegetative cover w ith a m inimum of 70 percent coverage has been establ ished and has been accepted by the City for maintenance by others , whichever is earlier. Once sufficient vegetation ha s been established , all BM Ps will be removed by the con t racto r an d t he proj e ct will be closed out. ' 2-8 2.4 C ost Item 1. 2. 3. 4. 5. 6. The undersig ned he re by pro po ses to furnis h the equipment , labor materials , superintendence , and any other items or services necessary to complete the scope of servic es detailed in thi s So licitat ion. Quantitie s identified in this Bid Package are estimate d by the building owner an d/o r his desi gnee an d will utili zed for tabulatin g this bid only in order to determine th e best value awa rd ; th e Contracto r is respo nsi b le fo r verifyin g all q uantitie s with th e City pri or to initia t ion of work for establishing the actual agree d upon value of the Co ntract. Asbestos Aba teme nt and Remo va l De s c ripti on Un it P r ice Estimated Quantity* Wall & Ceiling Drywall Material/Jo int 1 .5 0 -38 ,000 SF CompoundfTexture Popcorn Ceiling Te xt ure 1.5 0 -2 ,500 SF 9 "x 9" Floor Tile & Associated Mastic -1 ,300 SF 1.4 0 12"x 12 " Floor Til e & Associated Mastic -2 ,000 SF 1.4 0 Linoleum Flooring & Associa ted Mastic 1 .5 0 -11 ,000 SF Multi-Layer Vinyl Flooring 1 .5 0 <10 SF Extended Price 57,000 .00 3 ,75 0 .0 0 1,820.0 0 2 ,8 00 .00 16 ,500 .00 15 .0 0 Tran ~i~ Sb..i ng Jes.. __ 1------------------· 1-------1 -; -----100 SF -1 .7 5 17 5.00 8. Co ntamina ted Ca rpet Removal -5,000 SF 1.0 0 5 ,00 0 .00 Debris pile w it h asbe stos -c on tain ing 9 . materials 30 .00 -100 SF 3 ,00 0 .0 0 10. Trans it e flu es -6" 10.00 80.0 0 8 1 1. Mobilization Charge per Parcel 100 .0 0 11 1,100 .00 Abatement Subtotal ** $ 91 ,240 .00 *Quantities id entified in this Bid Package are estimated by the building owner and/or his designee and will be utilized fo r tabulating this bid only in order to determine th e best valu e award; t he Contractor is responsible for verifying all quantities with th e City prior to initiation of work for establi s hin g the actual agreed upon value of the Contract. Demolition Item 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. D escri ption Unit Price Estimated Extended Price Quantity* Demo of improvement including clean-up and -40,000 SF disposal of single and up to three-level structures, 1.40 56 ,000.00 including footers, beams, piers, and slabs Removal of concrete and asphalt -patio, parking lot, -5,000 SF interior sidewalks, and grading of s ite (drives, curbs , and streets will remain) 0 .60 3 ,000 .00 Removal of metal or wood storage sheds and other 0 .8 0 -50,000 SF 40 ,000.00 outlying structures Removal of misc. items, wood, metal, misc. debris 12 .50 -1,000 CY 12 500 .00 Removal of fence -5,000 LF n 7,; , 7,;n nn Septic system removal and fill ".l'JA nn 17 sites r; r:.7 R nn Abandon and plug water wells ? AQ1 nn 11 wells 27 <1?1 nn Prepare and implement a Stonn Water Pollution Prevention Plan, installing and maintaining all BMPs, establishing vegetation, and removal of BMPs upon 5 ,000 .00 1 5 ,000 .00 completion. Mobilization/demobilization fee (includes disconnect, equipment, generators, traffic control, etc.) 1,000.00 1 1 ,000.00 Concrete Debris 6 .00 -6,000 CY 36 ,000 .00 Credit for salvage value (Bids must be at least $1 for Each parcel salvage) (1 .00) (18.00) DEMOLITION SUBTOTAL $ 190 ,231 .00 .. *Quantities identified in this Bid Package are estimated by the building owner and/or his designee and will-be utilized for tabulating--this-bid-only-in order-to determine the-best vatue-awa-m;-tne Contractor =,s--- responsible for verifying all quantities with the City prior to initiation of work for establishing the actual agreed upon value of the Contract. ABATEMENT & DEMOLITION GRAND TOTAL $281,471 .00 A s bes tos-Related Unit Costs ACM Type *COST Carpet (ONLY) $ 1.0 0 /SF Floor applied Mastic (O NLY): $ 1.10 ,1 SF Floor Tile and Mastic $ 1.40 / I SF Note: Above listed prices mav be used AL ONE or in conjunction with eaclf o th er. Plaster or stucco mater ia l: $ :Y.50 /SF Roof Flashing: $ /3.5 0 /SF Roofing Felt: $ I 3.5 0 /SF Sheetrock Joint Compound: $1 1.50 /SF Spray-on Fireproofing (from % i nch to 2 % inch t hicknes s): I;$ 7.00 /SF Surfacing Material I $ 1.50 /SF Boiler Insulation: I $ 2 .0 0 /SF Rolled-on Texture: I $ 1.50 / SF Sprayed-on Texture (e.g. popcorn ceiling): I $ 1.50 /SF Trawled-on Texture: I $ 1.50 /SF Thermal System Insulation (TSI) I 0-6 inch OD I $ 7 .00 / LF 6.1 -12 inch OD I $ 7 .00 / LF >12 inch OD I $ 7 .00 / LF Fitting O -6 inch OD ,'ach $ 1 5 .00 / fitting Fitting 6.1 -12 inch,CD $ 1 5 .00 / fitting Fitting > 12 inch 00 $ 15 .00 / fitting Mastic on duct insulation I $ 2 .00 / LF Transite Material: I $ 1.75 / SF Wall, floor, or ceiling fibrous ACM board: $ 1 .75 /SF Asbestos contaminated carpeting I $ 1 .00 /SF ~ist :f Servic~: NOT ~nclu ;e~/standa:d u:t ab:ve • ------------ SER,VI CE COST Site Mobilization .... (once p~ job site) $ 100.00 I site Construction of additi on alj onta i nments for a bate ment $ 100 .00 / contain m ent Transportation an d D'.~s a l of Co ntaminated Debris not $ 65 .0 0 / cubic ya r d associated with abate nt work Hou~y Rates for/.ers if UNIT PRICE table above does not apply • I POSITI O N HOURLY RATE Licensed Wo,ker $ 42 .50 / hour Licensed S\,lpervisor $ 4? ,:;n / hour Contractor shall complete all phases of work to achieve substantial completion within 120 calendar days of receipt of notice to proceed per project. - CONTRACTOR : A<~ Signature lntercon Environmental. Inc. Company Karen Andrews June 11 2009 Name Date President Title ---·------ 2-11 2.5. Contractor Information and Qualifications Bidder shall submit the following items proving they are duly qualified and capable to fulfill o~d abide by the requirements listed herein . The documents listed below shall be included in this bid submittal, in the same order as listed , following th is page , bound within the response . 2.5.1 . Bidder shall provide company information including its company name , address , telephone number(s), email address and FAX number(s ) for the local office as well as the headquarters . 2.5 .2. Bidder shall attach an up -to-date and concise copy of its current Statement of Qualifications. Licenses and Certifications: Provide copies of necessary company licenses and certifications required to complete project. • Bidder shall provide applicable asbestos-related licenses. 2.5.3. Bidder shall provide necessary company licenses and certifications required to complete the project: • current Texas Sales/Use Tax Certificate • current Certificate of Good Standing (Texas Secretary of States' office) 2 .5.4 . Bidder shall provide at least four project references similar in scope and size to that of this Solicitation . Each project references shall include the following information : • Company's Name • Name and Title of Contact/Project • Email, Phone , and Address of Contact • Contract/Project Value • Brief Description of Service Provided _ _ __ 2 .5~5. -Bidder shalr-coo,ptete a-staffmafrixincluamgtne folfowlng1ntormation detailing the provider's personnel, their qualifications, and years of experience for staff that will be providing services associated with this Solicitation. • Position title and job function as associated with this contract, (President, Vice President, Project Managers, Technical Managers, Field Supervisors, etc.) • Name • Tasks to be performed in association with this contract • Certifications/Licenses • Total Years Experience • Length of employment with your company 2-12 • ENVIRONMENTAL, INC. 2 1 0 S Walnut Creek Drive . M ans f ield Texas 76063 . Telephone (817) 477 -9995 . F acsimile (817) 477 -9996 ----·------- www . i ntercon -e nvi r o nment a l .co m RESPONSE TO SECTION 2.5.1 CONTRACTORS COMP ANY INFORMATION lntercon Environmental, Inc. 210 S. Walnut Creek Drive Mansfield , Texas 76063 (817) 477-9995 Telephone (817) 477-9996 Facsimile Person of Contact: Ms . Karen Andrews karen@intercon-environmental .com ..,1.. Texas DSHS Asbestos Contractor License No . 80-0805 ..,1.. Texas DSHS Asbestos Transporter License No. 40-0336 ..,I.. Texas DSHS Lead Firm License No . 2110368 ..,1.. Texas DSHS Mold Remediation Contractor License No . RC00136 ..,I.. NCTRCA Certificate No. WFDB38281Y0809 ..,I.. SCTRCA Certificate No . 209021819 ..,1.. HUB Certificate No . 1522437774500 ------------------- ' TEXAS DEPARTMENT OF STATE HEALTH SERVICES INTERCON ENVIRONMENTAL INC 'is certified to peifonn as a Asbes~os Abatement Contractor in th e State of Texas wit hin the purview of T,eYas Occupations Code, chapter 19 54, so long as this licens e is not suspended or revo k ed and is renewed 1 according to the rules adopted by the Texas Board of Health. License Numb er: 800805 Control Number: 95442 DA YID LAKEY, M.D. c9MMrSSIONER OF HEALTH VOID IF l TERED NON-TRANSFERABLE Expiration Date: 2/5/2011 (Void After Expiration Date) --·------·------------------------ TE XAS DEPARTMENT OF STATE HEALTH SERVICES INTERCON ENVIRONMENTAL INC is certifiea to peiform as a ,.\sbestos Transporter I in th e State of Texas w ith in the purview of T,exas Occupations Code, chapter 19 54, so long as this licens e is not suspended or re voked and is renewed pccording to the rules adopted by the Texas Board of Health. I DA YID LAKEY, M .D . COMMISSION ER OF HEALTH I Lice ns e N umber: 400336 Expiration Date: 2/5/2011 Co ntrol N umber: 95484 (Void After Expiratjon Date) VOID IF ,4LTERED NON -T RANSFERABLE TEXAS DEPARTMErT OF STATE HEALTH SERVICES Be it known that INTERCO~ ENVIRONMENTAL, INC i~ licensed to perfonn as a I Mold 1 Remediation Company in th e Stat e of Te.xas an d is hereby governed by the fi ghts, privileges, and responsibilities set forth in Title 25, Texas Administrative Co de, Chapter 295, rela ting to Texas Mold Assess~ent and Remediation Rules, as long as this licen se is not suspended or revoked. Lice nse Number: RC00136 Ex piration Date: l /25/20 l 0 David Lackey, M.D. ~ommissioner of Health VOID IF ALTERED NON-TRANSFERABLE Control Number: 6426 (Void After Expiration Date) N CTRCA Disadvantaged B,siness E nterprise Certification I lntercon Environmental, Inc. I Dis1dvantaged Business Enterprise ha s 111cd with the Agency an Affidavi ~ as defined by 49 CFR part 26 and is hereby certified lo provide ser~ice(s) in the following areas: I 562910; 238910; Asbes to s Contractor and Remov~I : Remediation Services; Site Preparation Contractors (pt); T11is C ertificatio n is valid beginning August 2008 and superseded any registration or listing previou s ly issue d. This certification must be ~pdated annually by submission of an Annual Update Affidavit. Al any lime there is a change in ownership or control of the firm, notification must be made immediately to the North Central Texas Reg ional Certification Agency pr an TUCP certifying entity. Gertificate expiration _____ A_u....;;g_u_s_t _____ , 20_0_9_ ~u . C t'fi ti Ad ' • t t er 1 &ca on mm1s ra or I ssued date _________ A_u_,,g'-u_s_t --..---' 20~ CERTIFI C ATION NO. WFDB38281Y0809 : • SCTRCA Sma ll, Minority, Woman , African-American, Veteran , Disab led Ind ivi dual Business Enterprise (S/M/W/AA/\//DIBE) Program lntercon Environmental, Inc. has filed the appropriate affidavit with the South Central Texas Regional Certification Agency (SCTRCA) 1-and is hereby certified, in accordance with SCTRCA Policies and Procedures , as a : _.4.. -~ SBEWBE This ¢ertification Certificate must be updated by submiss ion of a Compl iance Affidavit. You are requ ired to notify the SCTRCA within 30 days of any change in circumstances affecting your ability to meet size , ... ~· disadyantage status, owr,ership, or control requirements and any material changes in the information . '< 'provided i_n the ;ubmission of the business application for certification . CERTIFICATE EXPIRES : February 28, 2011 CERTIFICATE NO. 209021819 ' ' Certified in the following work categories: No~h American Industry Classification System (NAICS) codes(s): ·~ ~ NAICS-562910: ASBESTOS ABATEMENT SERVICES N-A'IC~562ITTO:ASBESTOS REMOVAL CONTRACTORS NAICS-562910: ENVIRONMENTAL REMEDIATION SERVICES NAICS-562910: LEAD PAINT ABATEMENT SERVICES NAiCS-562910 : LEAD PAINT REMOVAL CONTRACTORS NAICS-562910 : MINE RECLAMATION SERVICES , INTEGRATED (E.G., DEMOLITION , HAZARDOUS MATERIAL REMOVAL , SOIL REMEDIATION) NAICS-56291 O: OIL SPILL CLEANUP SERVICES NAICS-562910: REMEDIATION AND CLEAN UP OF CONTAMINATED BUILDINGS , MINE SITES , SOIL;. OR GROUND WATER NAICS-562910 : REMEDIATION SERVICES, ENVIRONMENTAL NAICS-562910 : SITE REMEDIATION SERVICES NAICS-562910 : SOIL REMEDIATION SERVICES NAICS-562910 : TOXIC MATERIAL ABATEMENT SERVICES NAICS-562910 : TOXIC MATERIAL REMOVAL CONTRACTORS I ~f af r nf '<!trxas Historically Underutilized Business Certification and Compliance Program ~'~~, ('~ ~~ ')_'-1_ -~ I ~~y,·~ II ( ; ~\ ,__.;..·, r~ . ·, ~· \\..'' \ /:I: \, ; . * ; '1 ):S:l \~\'~ 0 '~ . 'CrJ J ~, \~~.m J -~ ~ ~ /,; The Texas Comptroller of Public Accounts (CPA), hereby certifies that INTERCON ENVIRONMENTAL, INC. has successfully met the established requirements of the State of Texas Historically Underutilized Business (HUB) Program to be recognized as a HUB. This certificate, priAteEl-19-JAN-2008-, st1persedes any registration ana certificate previously issued by the HUB Program. If there are any changes regarding the information (i .e ., business structure, ownership, day-to-day management, operational control, addresses, phone and fax numbers or au thorized signatures) provided in the submiss ion of the business' application for registration/certificat ion as a HUB , you must immediately (w ithin 30 days of such changes) not ify the HUB Program in writing . The CPA reserves the right to conduct a compliance review at any time to confirm HUB el igibility. HUB certific ation may be suspended or revoked upon fi ndings of ineligibility. CertiticateNID Numbe r : 1522437774500 Paul A. Gibson FileNendor Number: 36251 HUB Complian ce Supervisor Approval Date: 15 -JAN -2 008 Expiration Date : 15-JAN-2012 Note: In orde r for State agencies and instituti ons of higher education (universities) to be credited fo r util izing this business as a HUB , they must awa rd payment unde r the CertificateNI D Nu mber identified above . Agencies and un iversities are encouraged to val id ate HUB ·certificatio n p rior to issuing a notice of awa rd by accessing th e In tern et (htt p://www2 .cpa .state.tx .us/cmb l/hubonly.html) or by co ntacting the HUB Program at (888) 863-588 1 or (5 12) 46 3-5872. ' -·· I ENVIRONMENTAL, INC. 210 S Wa lnu t Cre e k Dr iv e . Mansf i eld Texas 76 0 63 . Tele p h on e (8 17 ) 4 7 7 -9995 . Fa c s i m i le (8 1 7 ) 477-99 96 Response to Section 2.5.2 Bidder's Statement of Qualifications www . i ntercon-environ mental . co m lntercon Environmental, Inc. possesses contractor licenses for asbestos abatement, lead and lead -based paint abatement, mold remediation and demolition projects. We also have the qualifications to demolish, rebuild or construct buildings , respond to emergencies and perform general construct ion improvements. lntercon Environmental, Inc. has completed numerous projects such as floor tile installation, demolition, lead and mold decontamination, wall and ceiling installation and painting projects. Our abilities are only limited by your needs, as we require no minimum contract amount. lntercon's team members, fleet and equipment provide us with excellent capabilities. Our fleet of late-model vehicles, state-of-the-art abatement, demolition, and transportation equipment allows us to get in and out of project sites quickly. Our demolition team is capable of performing multiple "full scale" demolition projects simultaneously. We have the abil ity to staff and perform six large abatement projects concurrently. During peak abatement season, we have the resources to obtain additional supervisors and laborers from a group that is licensed by the Texas Department of State Health Services to perform up to ten abatement projects simultaneously. Our Project Managers are available at all times during every project. _q_ur_ tea_111 _ me_mbe_rs_ ha',/e been iruhe Dallas-/Foct We-Fth ma-f ket-for-over 1 S--years-;-s-pec 1at1zing -fnaT aspects of the asbestos and lead abatement, mold remediation and demolition industries. lntercon maintains 24 full time employees to handle the needs of our clients and ensure that we can meet or exceed any project's demand. Our telephones are answered 24 hours a day by knowledgeable company representatives with the ability to mobil i ze personnel and equipment to a project site at a moments notice. lntercon Environmental, Inc. has in-house resources for work normally sub-contracted to other firms. We have found this to be more reliable, efficient , and effect iv e i n meeting the needs of our clients. By utili z ing in - house resources , we have a much greater control on meeting deadlines and maintaining a consistency of high quality work and customer sat i sfact ion. We cover every aspect of the abatement and demolition process. lntercon Environmental , I nc. w i ll never disregard a request for service , even i n an emergency. lntercon's team members are averaging less than two hours response time for emergency clean -ups. All projects are completed on time or ahead of schedule. Each project was completed to the owners' total satisfaction. We have n ever requeste d a chang e o rder for work we contracted to complete. We take pr i de i n every project we are awarded. i Bid Documents /Spec ific /SQQ I ::,ratement ot Qual ifications Page 2 of 6 Firm: Corporate / Main Office: Telephone: Officer: Email address: Karen Andrews, President COMPANY / PERSONNEL INFORMATION lntercon Env i ronmental, Inc. 210 S. Walnut Creek Drive, Mansfie l d , Texas 76063 (817) 477-9995, Facs i mile : (817) 477-9996 Karen Andrews, President karen @i ntercon -environmental.com f1f\ &ihtercon ENV I RONMENTAL , I NC. Ms . Andrews possesses a Bachelor of Science in Biology with a minor in Chemistry and with her degree began in the environmental field in 1992 encompassing both operational and administrat ive duties in vari ous disciplines of the environmental industry. Presently she conducts all of lntercon 's financial, operat i onal, and regulatory responsibilities. She is currently licensed by Texas Department of State Health Services as a Lead Abatement Supervisor and ma i ntains an expert i se in all facets of the Asbestos, Lead , and Mold Industries utilizing her many years of experience in field operations, lab analysis, and all regulatory documentation requ i red in the environmental i ndustry. Jerrold Andrews, Vice President Mr. Andrews began his Business Management experience in 1984. He transitioned to the Demolition and Environmental Industries in 1991. He has extensive experience and knowledge in all phases of Commercial and Residential Demolition and Construction, General Contracting and Project Management, Asbestos, Lead and Mold Abatement, Hazardous Chemical and PCB Disposal. He is i nteractive with cl i ents and suppliers on a daily basis and maintains a constant oversight of all of lntercon's financial and operational activities. He is licensed by the Texas Department of State Health Services as an Asbestos Abatement Superv i sor and a Mold Remediation Supervisor ; and by the State of Louisiana as an Asbestos Abatement Supervisor. -Fernando-Avita; Vtce-Pre~taenlOperat ons Mr. Avila established his Business Management career in 1984 and went on to successfully pursue a profession in the Environmental Industry in 1986. He is licensed by Texas Department of State Health Services as an Asbestos Abatement Supervisor, handling a multitude of projects including Asbestos Abatement, Mold Remediation, Lead Removal , and Demolition. With his vast knowledge of the abatement and demolition industries, he is able to competitively bid projects and secure opportunities with cl i ents. Byron Davis, Vice President Field Operations Mr. Davis began working in 1979 in the construction i ndu stry bui l ding Hi-Rise Bu i ld i ngs i n the Da l las -Fo r t Worth area. In 1989 , he entered the environmental industry as an asbestos abatemen t worker. His ability to learn this trade qu i ckly an d take charge aided him in his promotion to an asbestos abatement supervisor position . Mr. Davis has a vast knowledg e of asbestos remediation in industrial, commercial, and residential. He has performed projects for vari o us muni c ipali t i es and edu cati o nal facilities. Bob McFadin, Demolition Sales Manager Mr. McFad i n started i n the t ransportat i on i ndustry i n 197 2 and p ro gressed to t h e Environmental and Demolition Industries in 2000. He is licensed by the Texas Departmen t of State Health Services as an Asbestos Abatement Supervisor and i s educated in all transportation regulations and procedures and the Demolit i on and ' Abatement Industri es. With this knowledge, he is able to procu r e both demoli t ion and asbestos projects. Bi d Do c umen t s/Spe c ific /SO Q-A sb&De mo • :::,tatement of Qualifications Page 3 of 6 Jose Contreras, Project Manager ENVIRONMENTAL, INC. Mr. Contreras began his career as an asbestos abatement worker in 1987 and within two years was promoted to a Texas Department of State Health Services Licensed Asbestos Abatement Supervisor. His ability to manage large crews effectively, expediently and profitably, has enabled him to further h i s position to Project Manager over lntercon's Supervisors for Asbestos Abatement, Mold Remediation , Lead Removal , and Demolition projects. David Dunham, Demolltlon Project Manager Mr. Dunham began in 1 970 in the transportation industry and in 1998 moved over to the Construction and Demolition industries. His experience as a heavy equipment operator along with his Class A CDL License enables him to manage all facets of lntercon's Demolition Team. Keith Flowers, Demolltlon Sales In 1978, Mr. Flowers began in construction sales and progressed to various management positions. In 2001 he was certified by the US Army Corp of Engineers in Construction Qua l ity Management. Additionally he was Superintendent of military construction projects for the US Navy and the US Air Force with a major local construction firm . In 2002, Mr. Flowers entered the Environmental Industry as an Operations Manager and Estimator and obtained his Asbestos Abatement Supervisor's license through the Texas Department of State Health Services. Hector Medina, Senior Asbestos Abatement Supervisor Mr. Medina began his environmental career in 1987 as an asbestos abatement worker, licensed by the Texas Department of State Health Services, and in 1995 became licensed as an Asbestos Abatement Supervisor directing crews over Asbestos Abatement, Mold Remediation and Lead Removal an_g _DemoJitio_[l_p.roj.eGts. -Based---g n---hi-s e-x-pe-r+en-ce--a-nd his-prov en compffance recor d, hewas -p-rom~t ed t~ Senior Supervisor to oversee lntercon 's Supervisors. ' Euloglo Torres, Asbestos Abatement Supervisor Mr. Torres has been in the environmental industry since 1984, working as an asbestos abatement worker licensed by the Texas Department of State Health Services and i n 2002 advanced to a successful licensed Asbestos Abatement Supervisor over crews performing Asbestos Abatement, Mold Remediation, Lead Removal and Demolition projects. Moises Ramos, Asbestos Abatement Supervisor Mr. Ramo s began hi s caree r i n 199 9 as an asb esto s abatement worker, license d by the Texas Department of State He alth Services. In 2003, he wa s promot ed to a licensed Asbes t os Abatement Superviso r headin g over crews performin g Asbesto s Abatemen t an d Mol d Reme d iat i o n projects. Jorge Hernandez, Supervisor Mr. Hernande z began his career i n 1998 as an asbestos abatement worker, licensed by the Texas Department of State Health Services . In 2001 , he was promoted to a licens ed Asbe st o s A b at em en t Su p ervis or headin g o ve r crews p e rfo r m in g A sbes t o s Abatement, Mo l d Remediation, Lead Removal, an d Demol ition projects . Bi d Docume n ts /Sp ec i fic /SOQ -A sb &Dem o I Statement of Qual ifi cations Page 4 of 6 ' Dave Dunham ' Demolition PI'Oj ect :\iaJJager '- r- Drivers / Bob l\foFadin Demolition SaJes Manager / Keith Flowers " Demolition Sales '- ORGANIZATION CHART ,r K111-en Anchews Presi d en t J errold Andrews Vice President J esse And1-ews ' i\lru1aging Dfrector ,) /' ' Fer111u1do Avila VP Operations '-,) ,r Angelica ' P etmzzelli Executive Vice President '- 1"1;i: &{ffl,tercon ENVIRONMENTAL, INC. ,r Byron DaYis 'I VP Field Operations '-,) ' Jose Contreras / H ector l\ledina ' r-1 Operators GI'Ound Crew I Eulogio Torres Supe1"isor I [ Crew ] '- Bid Do cu ments /Specifi c/SOQ -Asb&Demo Project Manager Senior Supenisor 1----1 1----------.. I l\loises Ra mos Supenisor I C1-e w ] \. ---~· I Jorge Hernandez Supenisor I [ Ci-ew ] ,) I Hugo V alderra.ma Warehouse Supe1Tisor • ::itatement of Qualifications Page 5 of 6 ... ;1~~.\ \(. ~· .Y'. ~ntercon ENVIRONMENTAL, INC. lntercon Environmental, Inc has successfully completed projects for the following governmental and educational institutions : Federal Government Abilene National Guard State Government Texas Department of Transportation Countv Government Dallas County Tarrant County Citv Government City of Arlington City of Carrollton City of Dallas City of Duncanville City of Fort Worth City of Dallas Love Field Aviation Dept. Colleges and Universities Austin College Grayson County Community College Texas State Technical College -Un·iversity-uf Norrl'f Tex·as Denton-- School Districts Birdville ISD Eagle Mountain-Saginaw ISD Fort Worth ISD Hudson ISD Graford ISD Ki lgore ISD Housing Authorit ies Balmorhea Housing Authority Gr a p evine Housin g Auth o rity Groesbeck Hous i ng Author ity Linden Hous i ng Author ity Mab an k Ho using Authority Teague Housing Authority Temple Hous i ng Authority Bi d Document s/Specific /SOQ-Asb&Demo City of Garland City of Jacksboro City of Lancaster City of Mansfield City of River Oaks EDC City of University Park Mansfield ISD Prairiland ISD Richardson ISD Tidehaven ISD Trenton ISD Valle y M ills ISD Statement of Qual ifications Page 6 of 6 Current License and Certifications Program Name Certification Number NCTRCA -DBE WFDB38281Y0809 SCTRCA -SBE, WBE 20702202 State of Texas -HUB 1522437774500 WBE National Council -WBE 234367 City of Austin -DBE INT8315158 City of Austin -WBE INT8315158 Bi d Documents /Spec i fic /SOQ -Asb&Demo if9.!Y. ~ntercon ENVIRONMENTAL, INC. Expires 08 /31 /09 02 /28 /1 1 01 /1 5 /1 2 01 /31 /1 0 12 /05 /09 12 /05 /09 ' I @'§'~~~-07 /1 7) TEXAS SALES AND USE TAX PERMIT This permit is not transferable, and this side must be prominently displayed in your place of business. ype of permit SALES AND USE TAX ;j .,. ~ .1, I NTERCQN, ENV I RONHtNTAI.:,. I t:f C. 210 5-i-WA-h-NU: CREEK DR , . axpayer number 1-52-2437774-5 location number MANSFIELD \'OU MAY NEED TO COLLECT S/llES AND,OR USE TAX FOR OTHER LOCAL T A»NO //UrHORIT/ES DEPENDING ON YOUR TYPE OF BUSINESS. If you haw any questions rega,cing sales tax. you may contact lhe Texas State Comp1roller 'a ield ofice in your •ea or cal 1-800-252-5555 , tol free. nationwide. The Austin number is 512 /403 -4600. Response to Section 2 .5.3 * Texas Sales / Use Tax Certificate * Certificate of Good Stan.d ing • Certificate of Account Status -Letter of Good Standing THE STATE OF TEXAS COUNTY OF TRAVIS ,~('~ ~ TEXAS CoMPTROLLER Of' PuBLJC ACCOUNTS SUSAN COMBS • COMPTROLLER • AUSTIN, TEXAS 78774 April 28, 2009 CERTIFICATE OF ACCOUNT STATUS Page 1 of 1 I, Susan Combs, Comptroller of Public Accounts of the State of Texas, DO HEREBY CERTIFY that according to the records of this office INTERCON ENVIRONMENTAL, INC. is, as of this date, in good standing with this office having no franchise tax reports or payments due at this time. This certificate is valid through the date that the next franchise tax report will be due May 17, 2010. This certificate does not make a representation as to the status of the entity's registration, if any, with the Texas Secretary of State. This certificate is valid for the purpose of conversion when the converted entity is subject to franchise tax as required by la~:_ T_his certi.f.i __ e_ate_ iS-no.t--va--Lid--for----any-otl'nrr"" --fi:l:±ng-wi"-1:li Elie-Texas -Secretary ~f State. GIVEN UNDER MY HAND AND SEAL OF OFFICE in the City of Austin, this 28th day of April 2009 A.D. Su san Comb s Texas Comptroller Taxpayer number: 15224377745 File number: 0800288361 Form 05-304 (Rev . 12-07117) ' http ://ecpa.cpa .state .tx .us /coa/servlet/c pa.app .co a.CoaLetter Response to Section 2.5.3 * Texas Sales / Use Tax Certificate * Certificate of G ood St an din g 4/28 /2 009 I ~tercon ENVIRONMENTAL, INC. 210 S . Walnut Creek Dr iv e . Mansfield Te x as 7 6 063 . Te lephone (817 ) ~77 -9995 . Fa c sim ile (817} 47 7-9996 m a i l@intercon-envi ronmental .c om www . i ntercon-en vi ron mental . com l . Project Informati on : Client / Owner: Contact Informati on : Contract Information : Response to Section 2.5.4 Project References Va r ious Fac i lities , Fo r t Worth, Texas Ci ty of Fort Worth Completi on dat e : Roger Grantham, Environmental Program Manager ; (81 7) 3 92 -8592 6-yr Annual Asbestos Price Agreement , Cowtown Inn Asbestos & Demolition of Vickery Corridor for Right -of-Way (SH 121) Contract Amount: $1,579,126 .05 Oak Hollow & Villa Del Rio Apartments Contract Amount: $1 , 518,472 .39 Completion date : On -Going On -Go i ng 05 /08 Consultant Information : IHST Environmental , Inc.; (972) 478-7415 Scope of work : Removal of asbestos -containing sheetrock , fi r eproofing, floor t i le & masti c, thermal pipe 2 . Project Informati on : Clie.ot / Owner:-- Contact Informati on : Scope of work : 3. Project Informati on : Client / Owner: Contact Informatio n : Contr act Informati o n : Consu ltant Information: Scope of work : 4 . Pr oject Informati on : Cli ent / Owner : Contact Information: Scope of work: i nsulation and thermal pipe fittings. SH 121 : Removal of asbestos-containing materials and demolition of 39 parcels. Apartments : Removal of asbestos-contai ning sheetrock , floor t i le & mastic , ceiling texture , and linoleum ; demol ition of 35 two-story apartment buildings. 6 -County Demoliti on Price Agreement -Te*as--Department-uf-Tr a:m port at, on Mr . Larry Gi lbert; (214) 320-6255 Completi on date : Project Cost : Asbestos abatement & demolition for the Dallas Distri ct . __ __Q n-Gping $3,295,385 .00 (Plus Change Order) Various Facil it ies , Tarrant County, Texas Completion date : On -Going Tarrant County Asb e stos : Cla r ence Pressley ; (81 7) 8 8 4 -3 708 ; De m o li t ion : Jean ne Gr ee ne ; (8 1 7) 8 84 -11 77 A sbe st o s & Demo l iti on Projects ER i Consulting , Inc.; (817) 560 -1613 Removal of asbestos -containing sheetrock, floor tile & mastic, thermal pipe insulatio n and thermal pipe fitt i ngs. Th omas Center, Carrollton, Texas City of Carrol lto n Ms. Cindy Ar i as ; (972) 466 -3059 Asbestos abat emen t & demo li t i on o f structure. Completion date : Project Cost : 09 /07 $75,500 .00 1tercon /BidD0cs /Bid Spec ific City of Fort Worth DEM 09-08 ALLI ANCE NMP II < I ' ~tercon ENVIR O NMENTAL, INC. 2 1 0 S . Walnut C r eek o ,;,e . Mansf i eld Te xa s 76063 . Teleph on e (8 17 ) 477-9995 . Fa csimil e (817 ) 477-9996 P os ition Title Nam e &Job Function President Karen Andrews Vice President Jerrold Andrews VP Operations Fernando Avila VP Fie ld Byron Davis Operations Demolition Sales Bob Mcfadin --Manager - Asbestos Project Jose Contreras Manager Demolition Dav id Dunham Project Manager As be sto s Hector Medina Supervisor Asbestos Eulogio Torres Supervisor www . i n ter co n-env i ronmen t a I .co m RESPONSE T O SECTION 2 .5 .5 CONTRACTORS S TAFFlVIATRIX Tas ks Certifica ti on s / Licen ses Operations Bachelor of Science in Biology with a minor in Chemistry ; D SHS Lead Abatement Supervisor Operations & DSHS Asbestos Abatement Safety Supervisor and Mold Remed iation Supervisor Operation s, Safety, DSHS Asbestos Abatement & Project Supervisor Management Operations, Safety, DSHS Asbestos Abatement & Project Supervisor Management ~ _Ogesation__S ,__Safe.ty __ >-DSHS-Asbestes--Ae atement---· & Project Supervisor, Class A CDL Management L ice n se Project DSHS Asbestos Abatement Management Supervisor Project Class A CDL License Management Project Supervi s ion D S HS A s be sto s Abatement Supervi sor Project Supervision DSHS Asbestos Abatement Supervi sor Total Years Lengt h of Experience E mploym ent 17 years 5 years 18 years 5 ye ars 22 y ears 5 years 18 years 2 year --3s-y~---S years 22 years 5 years 22 years 3.5 years 22 y ea rs 5 ye ars 25 years 3 .5 years I I 2.6. Contractor Submittals Bidder shall submi t the following items included in th is bi d su bmitt al , in t he sa me o rde r as listed , follow ing th is page , bound wi thin the respo nse. 2.6 .1. Project Schedu le : Contractors shall provide a pro ject sc hedu le th at includes all major tasks pursuant to the Scope of W ork and Spec ifi cat io ns . T he project schedule shall show all tasks in the left most colu mn and their duration s hall be plotted horizontally versus time . A t ime scale s hall be selected so t hat the complete duration of the project can be shown o n pa per w it h a maxi mum d imension of 11" high by 17" wide. The project schedule must be su bmitted with the bid. During the term of the contract the Contractor shall subm it mon t hl y proj ect schedules show ing planned work and actual work accomplished . 2.6 .2 . Schedule of Values : Progress Payments w ill only be made after complet ion of those tasks and/or subtasks identified on the Project Schedule and Schedule of Payments . Prog ress Payments will be made during the project no more frequently than once per month . A payment schedule must be submitted with the Bid showing the name of each task and/or subtask , the name of the deliverable document for each task and/or subtask, total task and/or subtask cost , planned payment dates for each task and /or subtask , and the amount that would be remaining in the contract account. Upon rece ipt of final project completion documentation , final project payme nts will be approved. Final payments will not be approved until project complet ion documentation has been submitted to and approved by the City of Fort Worth . 2.6.3 . Prov ide a sample invoice and sample project closeout documentation . 2.6.4 . Provide an organ ization chart that details the communication channels between the Contractor and City of Fort Worth personnel for this contract. 2 -13 10 _o Task.Name 2 -895 Harmon Abatemeni 959 Harmon Aoatement 650 Harmon Anatemen1 5 -740 Harmon ADatemen1 6 525 Harmon Abatement 491 Harmon Abatemer.~ 41 0 Harmoo Abatement 305 Hmmon Abatemen1 301 Harmon Abatemen1 -11--1504 Westport Parkway Aba1ement 1404 Westport Parkway Aba1ement 1 3 -1304 Westport Park.way Abatement 8 15 Harmon Demolition 845 Harmon Demolition 865 Hl!1"mon Demolition 17 895 Harmon Demolition 959 Harmon Demolition 650 Harmon Demol1t1on 680 Harmon Demolition 740 Harmon Oemol1tion 745 Harmon Oemol1hon 605 Harmon Demolil1on ,, 525 Harmon Demoh!lon 491 HarmonDemolilioo 4 10 Harmon Demolition 27 -305 Harmon OemoMion 301 Harmon Oemoli11on 1504 Westport Parkway Demolition JO 1404 W estport Parkway Demoht1on 31 1304 Westport Parkway Demolition ln tercon En vi ronmental. Inc. City o f Fo rt Worth Task Split Proiec1 Schedule Dur at ion Start 1day wci:15127/09 3days Thu5.'28!09 3days Tue 612109 3days ~n 615/09 3days We<16/10/09 2days Mon 6115/09 lday Wed 6/17109 4 days Thu6/18109 3days Wei:16/24/09 lday Mon6/29/09 3days Tue6/30/09 1day Fn 713/09 3days Mon 716109 Mon6/1/09 Thu6/4/09 Tue61'9!09 1 Fn6/12/09 I Tue 6/16/09 Wed6117/09 Tue 6123109 Fri 6/26/09 Mon 6/29109 Thu 712/09 I F11 7/31091 I Wed 718109 Allia nce Noise M1d1 gation Project Removal 01 asbeslos conta1nin9 ma1,~na!s and demoh11on ol structures !: hfl65 Harmon Abatem•nt r'-·----j....895 Harmo n Abatement i"'--, · -,-,959 Harmon Abatement I L:.• · _ · _ . ~-_j-,650 Harmon Abatement I ~--·-· L1,or;_ rm o, Ab,to m,"' L_ ' 525 Harmo n Abatement ... j-491 Harmon Abatement ~~ ~-2_:,.: ::}410 Harmon Abatement b }-l-as-armon Abatement b,01 Honno, •••"m'"t * f:.c::J:JJ '_-50-'. Westport Parkway Abatement L}·"i:::pon P,n.w,y Abotom,"' ~IJ 1304 Westport Parkway Abatement 2days Wed 5127109 Thu 5/28/09 ' 1!115 Hamion OemollUon lday Fn 5129109 3days Mon 611109 1 day? Thu6/4/09 3 days Fri6J5!09 3 days Wed 6/1 0/09 4 days Moo6/15109 3 days Fri6/19/09 3 days Wed6/24/09 ' Fri5/29/09 Wed 613/09 Thu6J4/09 Tue6/9/09 Fn6J12109 I Thu6/18/09 I Tue6/23109 Fri6126/09 3 days Mon 6129109 Wed 711109 I day? Thu 7/V09 Thu 712/09 3 days Fri 713/09 3 days Wed 7/8/09 Moo 7113/09 3 days Thu 7116/09 3days Tue 7121 /09 4 days Fn 7124109 4 days Thu 7130109 I Tue 717/09 Fri 7/10/09 Wed7/15/09 i Mon 7120/09 1 I Thu 7123/09 Wed 7/29109 Tue 814/09 740 Harmon Demolition 745 H1 n Demolitlon L ~armon Demolltlon 605 Heon Deh o lltion :::,/:> 605 Harmon Demolition 525 Harm1 De5;;'~~~on Demolition ____ _J__ ~v--~-==''='''=·':='''' Progress Summary @ @ External Task.s ~ Deadline Mi lestone • Project Summary , ... --.... , EKlemal Milestone + Page 1 301 rmon Demo lition 11~ ~;;:~f ~;;:;;:: Pon.w,, o.molluo, 1404 We~rt P1r1lw1 Demolition L · · · · · · ·,,;:;:,:.~1404 Westport Parkway Demolition 1304 Wet~ P~~W:a_y_ ~molillon .. ::,:,:::.:.'_~"'.2';::::'l_ 13~Westport Parkway Oemollt,o n l .-*4 ~~~:, 'TEXAS f i Department of ~ State Health Services ASBESTOS/DEMOLITION NOTIFICATION FORM TYPE OF NOTIFICATION: (Select one and.fill in the requested information) ~ ORIGINAL O AMENDMENT No. __ N-'-/A __ D EMERGENCY 0 CANCELLATION •, .. \ •Was emergency request made to the Regional Office or En vironmental Health Notifications Group (EHNG ) by phone ? 0Yes 0No ' ,. •If yes, the DSHS reference#: N/A and name of the Regional or EHNG representative with w hom you spoke? N/ A Date : Ji_! _A_!_ Time: . , 'N/ A Da.m. [Jp .m. ' ~, D ORDERED: (Fo r structurally unsound facilities, attach copy of demollJion order andulelifify Governmental Official) Name : N/A Registration No . _N_/_A ___ ~----- Title : N/ A · ; Date of order (:t-.1M/DD/YY):__!i_/ _A_/_ Date.,order to begin (MM/DDNY): _Ji/~- (x) Below if Amended AMENDMENTS: You must complett tht tntirt form and !!!!ll!_tlti 11pproprlatt checlc box( ts} along tht left-hand sidt of this form to indicalt amauled information. · TYPE OF WORK D Abatement/Demolition FACILITY INFORMATION 1. Facility Location ; ., 0 ....... Description or Facility N ame:_. -~------t;-"-:;,I'_· ---------------------- 0 ....... Ph y sical Address :=-----:=-::;---:::-~~:;:;::::;:::;::::-/'-=-:::-=--=:::----~:;::-----==-----=--=:--------0 ~ ... ~ .. County:-_...,.,..________ _ __________ Zip:--------------- 0 ....... Facilityf o~: -------------Phone #: ( 2. ~ of Facility (Select on ~). ~ Public O f J der.al -Qlndustrial/Manufacturing O NESHAP-Only O Public School K-12 : : >--t • ; ~~'.;;.. 3. Facility. Details · ~ O ...... Description of Area/Room Number:----------------------------- 0 ...... Ag e ofBuilding: __ ,Si ze : _______ _ 0 ...... ls this building occupied ? 0 Yes O No Number of floors: ---- 0 -~--: Pr ior Use: ---~--------------------------------- 0 ...... Futur e Us e:------------------------------------- D ...... Date of As be stos Survey /NESH AP Inspection :_/_/_ O ...... DSHS Inspector License No .:-=---=,--- 0 ...... Analytical Me th od: 0 PLM D TEM O Assu med As bestos 0 No Suspec t Material O ...... DSH S Lab oratory Licens e #: _____ _ WORK SCHEDULE /AS BESTOS AMO UJll'TS (Note: if the start date(s) entered below cannot be met. the DSHS R egional or Local Program office must bt notified prior to the s ch eduled start dale. Failure to do so is a viola.ion of TAHPA Section 295.61 .) 1. Asbestos A batement Wo rk Schedule: 0 ...... Start date : / / and End date : / / O ...... Wo rk da ys: 0 Mo n~Tues . O w ed . 0 Thurs-:--0Fri . 0Sat. Osun. O ..... Wo rking hours : 0 a.m . 0 p.m. to _________ Oa.m. Op.m. 2. Demolition Work Schedule : D ...... Start dat e: N / A / an d End date : N / A I D ..... Work days~M on~Tues . Owed. 0 Thurs-:--0Fri. 0Sat.. []Sun . 0 .... Wor king hours : NI A' 0 a.m. 0 p.m. to _N_/A_' ______ ~_ Oa.m Opm . FO RM f .P3 t:5. RE \' 5107 (1:) Belo"' if Amended C. ASBESTOS AMOUNTS D ...... Is Asbestos Present? '81 Yes D No (Complete the table below if asbestos is present) Asbestos-Containing Building Material Type *Only mark the boxes below on this chart if they are being amended RACM to be removed RACM left in place durin2 demolition Interior Category I non-friable removed Exterior Cate2:orv I non-friable removed Cate2:ory I non-friable left in place durin2 demolition Interior Cate2ory II non-friable removed Exterior Cateeory Il non-friable removed Cate2:orv Il non-friable left in olace during demolition RACM Off-Facilitv Comoooent Approximate amount of Asbestos Pipes Surface Area / DESCRIPTION OF WORK PRACTICES AND PROCEDURES ,. Lo Lo Ft M 1,, ' I it SQ SQ Cu Cu Ft M Ft M . D ...... 1. Description of procedures to be followed in the event that unexpected asbestos is found or previousl y non-friable asbestos material becomes crumbled, pulverized, or reduced to powder: Stop work, notify owner, consultant and Texas Department of State Health Services D ...... 2. Description of planned demolition or abatement ~ork, type of material.:an,d rnethod (s) to be used: _______ _ ,. prevent emissions of asbestos at the demolition site: PROJECT INFORMATION 0 ...... A. FACILITY OWNER' Facility Owner N ame :----::=----=,....,,,====-/------------------------- Pnon e 1F: l .:J ------------,---------------------------- Attention;;.'-"'-"'-"-'-------------------------------------Mailigg' Address': ... ____________________________________ _ City : ·-'.t State: Zi p : --,,,----.,.,..,,,-_ ---.-,.--~.-.. -,_---------------------------- 0 ...... B. ASBESTOS ABATEMENT CONTRACTOR #1 DSHS Asl>es os ContractorLicense #: 80-0805 -------Contractor N ame : lnte rcon Enviro nmental Inc . Address: 210 S. Walnut Creek Dr iv e City : Mansfield ~ Stat e: Te xas Zip:_7_6_0_6_3 ______________ _ Office Ph one #: ( 817) _4_77_-_99_9_5 ___ _ Job-Site Phone #: ( 817 ) _28_7_-_88_9_9 _____________ _ 0 ...... C. ASBESTOS ABATEMENT CONTRACTOR #2 (Only if th ere is more than on e Contractor) DSHS Asbestos Co ntra cto r License#: _N~/_A _____ _ Contractor Name : _N_/_A __________________________________ _ Ad dress : N/ A ---------------------------------------City : _N_I _A ___________ State: _N_/A ___ _ Zi p: _N_/A _____________ _ Office Ph one #: ( ) N/ A Job-Si te Phone#: ( ) N/A D. ASBESTOS SUPER"1SOR 0 ..... DSHS Superv isor License#: _____ _ D ..... DSHS Superviso r Li cen se #: _____ _ ' FOFUv1 AP B F5 . REV 5/C•i Site Supervis or :-------------------- Site Supervisor:-------------------- (x) Below If Amended E. NESHAP TRAINED INDIVIDUAL O ...... NESHAP Trained Individual :------------------------------- Certification Date : Ji_/..£_/_ 0 ...... F. DEMOLITION CONTRACTOR Demoliti on Contractor : __ N_/_A ______________________________ _ Address : _N_/_A ___________________________________ _ City : N/A State: N/A Z ip : _N_/A ____ Phone #: ( ) N/A ,:4',, 0 ...... G. PROJECT CONSULTANT OR OPERATOR DSHS Licen se No.: ---------- Project Consultant or Operator : -------------------"+-""------,-:;;;c..----,----- Address : -----------------------------'-.,,-------,=---- City :__________ State: Zip: _____ Phone #: ( D ...... H. Waste Transporter DSHS Waste Transporter Li cense #: 40-0336 Waste Transporter: lntercon Environmental Inc. Address: 210 S. Walnut Creek Drive City: Mansfield State:~ Zip:.-'-===-----"-----"=:...,--..:..:....; ________ _ Contact Person: Jerrold Andrews O ...... I. Waste Disposal Site TCEQ Permit#: -'1--"0=2=5B:;.._ ______ _ Waste Disposal Site : _D_F_W_La_n_d_fi_ll _____ ___. Address: 1600 Railroad Street City : Lewisville Phone #: ( 972 ) 315-5421 CERTIFICATION STATEMENT I hereby declare that I have examined this CL c on ian 'to the best of my knowledge and belief, all information provided is complete, true , and corrrct. I affirm that I am th,e owner, operator, or delegated agent and that I am responsible for the fee associated with this notification. I also understa'il~ that the owner, operator, or delegated agent is responsible for notification to the department. ,. ',<ct:::,,.,,... ~i~· ' \ ' : ,' •l,.,,,,, "'·,,~' /'' -~ -Date:-/---I ~ ~-· (Signature of Owner, Operatoror Delegated Ag~nt) r,, -... "'~-;, .,ti • ..,.,<;, .; ' ' (Printed N ame &.Tjtl~~ -.'."!'~~ .:.?.·:~ )."':., } •:.-, . E-mail Adclress:.... Phone # : IMPORT ANT INFORMATION N OTIFICATION TIMELINESS REQUIREMENT: Your Asbestos/Demolition Notification form must be p ostmarked no less than ten working days (not calendar days ) prior to the start of any asbestos abatement or demolition . FILING FEE: An invoice will be mailed to the facility owner upon completion of the project. CALL FOR ASSISTANCE: MAIL FORM TO : ' :'ORM APB ~5. RE V 5107 (512) 834 -6747 or (8 88 ) 778-9440 (toll free in T exas) ENVIRONMENT AL HEAL TH NOTIF ICATI ONS GROU P TEXAS DEPARTMENT OF STATE HEALTH SERVICES PO BOX 143538 A U STIN , TX 78 71 4-3538 u •. / ,f5' ·;,,:.• ' , Project Name I f@!]hie ,con Project Number'---+-----------' ~NVI R ON M E N T A L, I N C. Shift Supervisor &.,,---.---------------' DAILY PROJECT LOG n 111 e A c tivi ty I .. Shift Day '------------~ Today's Work Areas Consulting Firm On Site Representatives Site Inspections Yes No INTERCON TDH 0 D D D D D OSHA Received Removed Dumpsters Today I Dumpsters To-Date:=======:======= Daily Project Log Shift ~upervisor Signature ======================== ~---~-Y----~ ProjectName~I _______________ __. Project Number .__ _______________ _, DAILY TIME SHEET Employee '~ Timefn Timeout Time In Time Out Total !., ' 2 t-------------------.-,.:.~--,,.-<-+---------------t-----; 3 • I .. 4 5 ~·/ t----------------------+---+---+-----"'--+-------- 6 ,1,,''' .i .1 t------------------+-----+---+---+-----"=--·· ----+----~ 7 " "'"'.<.'4 .J' .r' -' 8 i-----------------1r-----l---,-,--t~:---..,._ .--\,'t'l'-t---::::~,-?i+,r-=-'---l ! t .-~~ ~-_' 9 t------------------t-----+---..---+------+--_-_, ..... , ,-.---t---- t------------------+-----+---..----+----,,:---+,_...,.._ -,,y\"'"!"'-.-----lf--.-,,,·"'"",,-, --I 10 ~~:,. 11 .,.. 12 13 14 I ' ' · .. ,_. 15 t------------------t-----+-----+------+------t-----11• ~.p,.- 16 1 7 18 19 20 Daily Tim e Sh eet I I I Shift Supervisor Signature Date Shift Day ...__ __________ ~ Safety Meeting Topic Accidents or Incidents Today New Hires Today Percent Complete _______ __, Total Hours Today -------~ Total Hours To-Date Project Budget Hours .__ ______ ___, f .. ..-_; ~\ .. ~~tercon 2 3 4 5 6 7 8 9 10 11 1 2 1 3 14 1 5 16 17 18 1 9 20 ENVIRON M E N T A L, IN C. CONTAINMENT LOG Employee .. - ... C Qntai nme nt Log Project Name .__ ________________ ... Project Number '------r------------~ Shift Supervisor .. !~--...--------------- f '() Social Secur((y ~'.i_nmeln nmeOut Time In Time Out ' "'\ ,r ' ! ,., ,,,J I I ' ' I : _, ... .. ,1 .. n ~l ... (_.<'.,,_\,,, .. ,:-, ?"' i :,1 ,;.., " .-:'t I • _.,...,Ji.JC j _y,,;,. ' /Ir,, .. •'"Y . "1,11 .~ . ~ . . , .... . I·;/ I I ~,,, . ·:fl '"'r .. ..... I t I < I ' I I Shift Supervisqr Signature Date .... ! _______________ ... Shift Day .__ ______________ __. Containment Area Personal Protection Equipment Used 0 Steel Toe Rubber Boots i' 0 Single Tyvek Type Sult 0 Double Tyvek Type Sult 0 Cotton Gloves " 0 Rubber Gloves .0 112 Fee! Respirator I HEPA Filters 0 Full Face Respirator /HEPA FIiters 0 f' PAPR Respirator I HEPA FIiters -~ .· ·E1 Type C Respirator I Supplied Air Q Safety Glassu • · .. 0 , 0 0 EarPluiJa 0 Other 0 Other TEXAS D EPARTJ\1ENT OF STATE H EALTH SERVICES DA VJD L. LAK EY, M.D . COMMJSSI ONER MAY 13, 2008 JOSE CONTRERAS INTERCON ENVIRONMENT AL INC 2214 FM 1187 BLDG 6 MANSFIELD , TX 76063 1100 West 49th Street • A ustin , Te xas 78756 P .O . B ox 14934 7 • A ustin, Te x as 787 14-9347 1-88 8-963-71 1 I • www .dshs .s1 a1c .1 u,s . .._ TIY : 1'--800-735 -2989 .,,/ " This is to verify that the individual shown below holds a va lid credential to. ractice as an ASBESTOS ABATEMENT SUPERVISOR in the State of Te; s. ;- ~ ~ ; NAME : JOSE CONTRERAS LICENSE TYPE: ASBESTOS ABATEMENT S{JPER V1SOR LICENSE NUMBER : 80420 I ' CONTROL NUMBER: 95798 • EXPIRATION DA TE : 7/22 /29Hl '-~:·' 5.~. ~- If you hav e any questions, please contaqt:us b y phone at 512-3 4-6600 , by fax at 512 /834-66 14 . We encourage yo u to vis it our website at http ://W\vw .dshs.state .tx .us ·ror. frequentl y updated inforn1ation, including rules , Jaws, publications and fonil s : You ma y also v erify a credential through this w ebsite . . ~. -:-;~ En.v ironmental & Sanita.d:otlic~ing_Gro~ ' ' A n Equal .c mpl oym em O;:mon u n:ry Empl oy~r and Pro\·d'.:r ,1 G1!EIIGO ASSOCIATES i } ,\ in cooperation with ,, t THE:()N/VEf $LTjY OF NORTH TEXAS ' •.. "' " . 'J 'fi b t .,, .. } ,.,. . ( c~rtt 1es t a JoS 1 ;,A. c · ntreras _l'"l ti "-.'., .. .,"J' .''fl h as s uccessfully completed and . assed Jhe exaui given on th,e final day for the Environmental .{, ,, '/ . "~ning r,ogram e ti qf~'"' Asbestos Contra'c \o·j,Sfi.]!j rviso.r Refresher Conducf d at Fort Worth, Tex,clS ~ January 5, 2009 . Th is is an EPA fully apprtj ved course for p~ps/"o faccreditation under Section 206 of TSC A, Title II. It covers ,opics listed in the'~SHAP ~ini9t,requiremenV>f 40 ~FR, Part 6 1, subpart M. . " ",~tr' '· · . "Hi' . I r ., .. -' • I ~~-~ P re s ident Da te o f iss ue : 01/05/09 Certificate Number: 09003 48 39 I I I ' ' I " , .. GEBCO's Training Programs are provided in cooperation j ith federal and state regulatory agcncics, and fulfill all applicable requi r~nts fo r-.accreditation . GE BCO is li censed fo1 Asbestos Training under the Texas Asbestos Health Protection Ru!~~··," _,. ,;' · ~, GE BCO Ass oc iates , LP • 469f Diplomacy Road, Suite 120 • Fort Worth, TX 76 15 5 • (817) 26!!,4006 ! ---------·-·--·--------------------------------------------- -I FEB /27 /2009 /FR l !2:29 PM -!c:*"' 'I*{--.~ TEXAS .......... ~ D~artment oi lllllti.. V, F \ State Health Servic es -www .tdh.rtare.p;.us/behhsbestos JoSe. A . Ca:n frevo., s. Applicant Name: (First, M.I., l..ast) Physician's Written Statement Medical Surveillance for Asbestos Exposure Environmental & Sanitatio~ Licensing Group 800/572-5548 or 512/83~600 Fax: 5 11 -834-661 4 G3S-a'1-9i3 G\ 01-og-y 1 Social Security 11 . Date of Birth P. 002 r 0J 1 ) ~o~ -Joq9 T elcphqnc Number (includin: area code) SD'eet Adores~: City srm' Zip · Il'IDICATE WRICH ITEMS WERE PERFOR.l\>IED. WITH PHYSICL~·s OR ASSIST.~·s INITV\L~: (Any that are .not applicable, mu.st still be initialed off iu addition to the N/A.) The above-named individual was seen on 02-c) ~ -:-cft (Must be fille d:in by Physician or clinic.) S :S.co~pleti~n and ~evi~ of the standardized medical ·questionnaire and worl< histocy. witli :pecial emph~ .directed to rhe 5 ~ Pll;lmonary, cardiovascular, and gastrointestin1 systems pe[ part l and 2. of Appendix D in 1926.110 L ,) If employed, the employer provided, end review was made o~ the employer's description of this employee 's duties as they relate to the employ~·s ex.posure, the employee's reprf;sentative or anticipated exposure leve~ the personal prorei;tive !!Dd respinttory equipmenr to be utilized by the employee, and in:fo.rmalion from previous medical examinations of the affected e.nployee that is nor otherwise available to the physician. · · A physics! examination with e;nphasis upon the pulrnonmy~ cucliowscular, and gastrointestinal syst~s .. The pulmonary function ·tt:sts ·J>f.f~ ,:ital ca:P,&crty (FV~Jf'd forced expiratory voium~cond (FEV 1) in accorcwice with NlOSH IIIld A TS srandmds. . , ;, " ~ .- Indicate whether or not the physicW:-decided ttiat Bn \-ray was required acd was performedl, S or NO __ A chest roenrgenogtam. posterior-anterior,·,1,r x 17" or c um:nt film oo file with interprettcion I.Q a ce with 29 CFR 1926.1101, Appendi:x: E., *NOTE: Accordm: to,..29 CFR 19:2.6.1101(M)(2)(il)(C), the requirernenr for a chest :May is S. 7at the physician 's discretl~n. . ·-... i7 . . ___ The ~ployee w__a.s. informed.by th~~ian-of the-results-of me exam-and ef !Ii'!)' meclfo~l-eonditions thatmay-resukfrom · ast1est05 e,cposure including the incr~ed risk of lung cancer artnbutable· to the comb_ined effect of smokiog and asbestos' exposure , Unless othervrise nqted..below, this .ev!!.luation indicates that no medical conditions were detected that would place the employee at an inc:reased.,.__risk.of ~aterial 'health impairment from exposure to asbestos , and no limitations are recom.-nended on tlle employee coocemi:ng the !!Se of personal protective equipment or respirator . By signing this form., I acknowle dge that this ey...z..TIJ..inarion has beeo performed in accordance with either 29 CTR 1926.1101 or40 CFR 763 .1 22(~), as required. ' ... .. Comments or iim.itatiom, if any------------------------------------- " 3 . ne N wnber (mcludin~ ~a :ode) . 1(1 Irvi ng Blvd , stt 22a . Dallas, lX 75241 · City t!!H&630.ll4t . . m ,214.637.3820 Zip PRIVA CY NOT1 F1CAT10N / NOT[FICACION SOBR E ~-COIII With few ei:captions , you have the right t o re qu est and be informed about iniormatton that tne S:ate of I e ):aS colle= a:>out y ou . You are entitled 10 r;~ive and ,eview the information upo n requesi. Y ou also h av e the right to ask the stati agency to. ::o rrQct :a'.l y information i hai is determined to be in co rrect. SE!;! h(tq:lhr.vw.dshs.stats .bu1sl f or more iniormation on Pri vacy Notification. (Reference: Governo r Cod e, Section 552.021, 552..C 23 . 559 .00 3 an d 55 9 .DD4) ~an solo por :.mas CU 3ntaS ex~pciones , us.e;J iie ne el oer;cho de so[icltor y de ser inform.;do sot,re I;; inform:.::icin que eJ E~:i::lo de:= reune so!:i'~ ~:stc d . ;.. usteti :SE 1e 0 19 be concede r c l ocrecho :ie recfbir )' revise I;; 1nformaoon al raq:.ierirla. Usted tar.,oien tien e el osr;ecno oe pe:fr que la ;;gen=1E :s~c l =:ir.ij z =:.12 lou i s r inf orm~~ ~u e se he de t:mi1n ado s ea 1nCO rrecta. £)1 :ija s!: = ,.,;:;D :/lw1,vw .~s'1s .state .:x :.1st :,a;a !T,Es i:iio:-i:1c1011 s:,:)re la ~Otlri Cc!oO r. so :,~~ ;::,riv aci:iad. (qeferenoE.. Govemment Code_sec:::lcin 55Z.C2 1. 552 .'.:2 3. 559 .003 y 55S o=,.:;.) ENVIRONME N TAL, INC. 210 S W a ln ut C r eek Drive . M a n s fi e l d Te x as 7 6063 , T e l e p h on e (8 17) 47 7-9995 . Facs i m i l e (8 1 7) 4 77-9996 Employee Name: Respirator Fit Test J;;.sc. c<,1 (1 j Y (,rv ... .;::. DSHS License Number: Respirator Type: Half-face Respirator Brand: North /_ .. ----- Respirator Size: Medium~),,· (circle ne) l_... ;... . . Question ,1 · 1. Was respirator reasonably comfortable? 2. Was pos itive and negative pressure test administered? 3. Does the individual understand fully the protection · factor of this type respirator? , 4. Was the individual instructed on t'fl e proper.: use and care of this type r'e spinitor'.'l~\:'• ~? JI _,.,. 5. Was a smoke type test a:dm111 1sterei:1? 6. During the actual test was ·t -h e indivi'dual required to converse and m o'~e his or her head around .. ... to insure correct fit? ;, 7. Did recipient ·pass fit test? / --+:. - www .in t ercon-environmen t al .com ·_L ~ ./ ./ / _7 '/ :z I' No Thes& items are my personal responsibility. If I lose any of this equipment or negligent ly da.f!'age any, I will reim_burse Intercon Environmental, Inc. the full list price for each article lost or damaged. '• · .. ~:- I agree that this information above is true and correct. -.~P,; ; -OSHA Regulations (Standards -29 CFR) 1910.134{f)(2) The emp loyer shall ens ure that an em ployee using a t i ght-fitting face p i ece resp i ra t or is f it t ested p r ior to initial use of the resp irator, whenever a d ifferent resp i rator face p i ece (s ize , sty le , mode l o r make) i s used , and at least annually t h ereafter. 1910.134(f)(3) The em ploye r shall conduct an add ition a l fi t tes t wheneve r ·he employee reports, or th e er.ploy er, PL H(P, supe rvi so r , or p ro gram ad m1n ;strator makes v isual ob servati o;;s o', change s i1 the e:np icy ee 's ph y si cal cond ition tha t cou ld affect r esp irato r fi t. Suc h cond iti on s in clude, but a·e no t l1m 1ted rn, faci al sca mn,i, den ~al ch ange s, cosm et ic surgery , or an obvious change i n bo dy w e ight. Certificate of ,vorker's Ackno-~'Fledger.nent and vVodier Release Intercon Environmental, Inc. Proj ect N a me ____ _ Projec.t Add ress----------------------------,.----- \VORKING \\TfH ASBESTOS CA.~~ BE DA:."GEROUS. INHALING ASBESTOS FIBERS HAS BE-EN LI~"RED \VITH VARIOUS TYPES OF CA.NCE.If IF YOU SJ\'10KE A.ND INHALE ASBESTOS FIBERS THE CHANCE THAT YOU WILL DEVELOP Lu:\!G~ CANCER rs GREATER THAN THAT OF THE NON-SJ\,f0.KL"1G PCRLIC. ~ .. Your emp loyer's contract with the Q ,.vner for the above project requires that )'.OU be supp lied with the proper respirator and be trained in i ts use, you be 'trained in ~afe work1 p.ract1ces and in 1.he use of the equipment found on Lhe job, and you receive a,medial examination. Thesy tl1ings are to have been done at no cost to you. By si gning this ccrtificat,iOn you are assi iring t.he Own er t hat your employer has met L'l-iese obligations to you and c:.re agreeing to ~old the O\vner, his Consultant. Testing Labornwry, a.rid representative harmless in any and all claims arising:from or relat~to this project. " . RESPIRATORY PROTECTION: 1 have been ·trnincd in the proper use of respirators. and informed of the type respirator to be uscqf on ~~ above ref~rencod· p,r~ject. I 'Nas given a copy of the v:ritten respiratory protection manual issued by my .~~plo}'er. I ·h""ave been equipped at no cost w1fr1 a respirator to be used on the above prnject '~ \ -"<,,,!J. TRAL'\'ING COURSE: 1. have been trai11e-elin e clangers i.nhcrenl in handling asbestos and breatJ1ing asbestos dust and in proper-"vork proce.dures '.":f nd pe.n;ona! and area protective mez.surcs. The topics covere.d in Lhe course included th.e follo\1\-"iP.g:/ Physi cal c,hjrr'acteristics of asbestos Hca!Lh hazards associated \x,'ith asbestos Rcspirat~r;_y protecii.on . U se of protective ~quipment. Pre~sure D iffer e';;_tial Systems \Vo rk practices incJudingJ iancls-on or or >j oh train ing Per sonal d cconLaminaticn1 proceduri;s \ j\.-f EDICAL EXAMIN ATIO:\': I ;ia v e h ~.d a m e d ical exam ina t ion \V)thin th e pa~t 12 mon ths at no cost !o m e. This ex ami n ation included: health hi:-:Lory . pu lm onary funcrion tesLs and may ha\'e inc lu dt.d at evalu ation o f a chest x-ray. Bv sign ing th is document I am ackno"·kcl!li rig on !v that th e O\v1,er of rhc: b:.1iluin g I ,un about to \VOrk in ~ .... '-'-.... .,, ~- h as ad\·ised me of my rights to trainin g md protc~--~ion rel3ii\'C ,o r:1y ~-m:-iloy,;:r. ~ritcrc on E rwiror:.r:1enr;,l. he. ----.S:gn:tLLr e: / ,~ S ,-:._ j.L\ · r · I ( ,,-"') n ~ re ~(~C-·~· ~(, ------ r-I ~ , ,.., ,,·~ j ,. ... ~_r__' ..,..,'-'·-~·"-... --- TEXAS DEPARTMENT OF STATE HEALTH SERVICES DAVID L LAKEY , M .D COMM ISSJONER MAY 13 , 2008 HECTOR MEDINA INTERCON ENVIRONMENTAL INC 2214 FM 11 87 BLDG 6 MANSFIELD , TX 76063 1100 West 49tl\ Street • A us tin , Texas 78756 P 0 . Box 14934 7 • ,A, ustin; Texas 7871 4-934 7 l-888-963-7 111 • ~.dshs.s1atc,g .us TTY 1-800-735 -2 989 This is to veri fy that the indi vidual shown below boliils a valid credent ial to)practice as an ASBESTOS ABATEMENT SUPERVISOR in the State of Te 1 NAME: HECTOR MEDINA LICENSE TYPE : ASBESTOS ABATEMENT SBPER:· LICENSE NUMBER: 804027 CONTROL NUMBER: 95799 EXPIRATION DA TE : 7 /27/20{0 \ If you have an y qnestions , please contact us by phone-at 512-34-6600, by fax at 512/83 4-66 14 . W e encourage you to visit our website at http ://www .dshs'..state .tx.us ·ro ~ frequently updated infomiation. including rules, laws, publications and fom15 :•Ypu ma y also verif)"'"a ..,credenrial through this website . . ~ ~~:~~.; -~ ;r· En vu:o~nt.al& SanitatsimLL.i c,.,rnsing_Qro14L _ 1 qE~~.~.!!w~CIATES THE ·UNIVBRSITY OF NORTH TEXAS ~. '. certifies that I . Heptor edina ' f . has s uccessfully completed and P,asse d t,lie exa~ given on the final day for the Environmental • Trnining Program entitled· t ' ' ·. :\ \. Asbestos Coq.tractoi;/Su·P.ervisor Refresher Conduc ~ed at Fort Worth, Texa~. fll'September 8, 2008 Thi s is an EPA fu ll y appro ved course for pu\"P_~S&ofaccreditati(!n under Section 206 o f T SCA , Title IL It coverf topics li sted in the · ~SHAP trainip g requirement of 40 CFR, Part 6 1, subpart M. i ~ President Dale of Issue : 09/08/08 Instructor: Dana Brown .Certificate expires : 09/08/2009 Cerli fi c ale Number. 08233 1341 •, OEBC O's Tra111i 11g Progra111s are provided in cooperation with federal and stale regulatory agencies, and fulfill all appliCllble requirements foraccreditalio n. GEOCO is liccnscdifor Asbestos Training under the Texas Asbestos Health Protection Rules .• · GE BCO Associ ates , LP • r 90 Diplomacy Road, Suite 120 • Fort Worth , TX 76155 • (817J° 68 -400 6 ---=--,-========= JUN /27 /2008 /FRl 09: 16 AM P. 005 0 • • (':"' -1(*'1- I*~~-.. ~· TEXAS L...-f · Depan:mant ol .... 1 . Slale Health Services Pllysician's Written Statement Medical Surveillance for Asbestos Exposure Envi ronml!ll!W & Sa.nitatiOD Licensini: Group S00/5i2-5548 ar 512/83+6600 "''ww .tdh.i:tate.. tx. uslbeh/asbesros Pax: 512 -834-66 14 . T t.lephoot Ndmber (includ!".i; area code) str= A.ddn:Js: Ciry swe . Zip INDICATE WHICH ITEMS WERE PERFORMED WITH rlnffucIAN'S OR ASSISTANT'S INITIALS: (Any that are not applicable, must still be initialet! off in addition to ~e N/ A~) The above-named individual was seen on __ (p~. _J..,~J_'_fP_S" __ (Mu:st be filled-in by Physician or clinic.) y Completioc 2II1d review of the staDdardized medical qncstionnaire and work histoi:y with special emphasis di=;ted to the pulmonary, carmovascular, 11nd gastroi.ctestinal systems per part 1 ao.~1 of Appendix D .in 1926.1101. H employed, the employer proviped, and revj=( was m.ade o( the employer', des:cription of this employee's duties as they relate to the employee's exposure, the employen~entative or anticipated exposure lovcl., the personal proteetive and respiratory c,quipment to be utilized by the emp~. and information from previous medical examinations of the affected (J, employee that io not otherwise available to the p~ ~. ' · A physical e:rarnin•tion with emphasis upon the pµhnOtJ8%1. cardiovascular, and gastrointestinal systeim. The puhnonary function te~tf9("'~ .. d VJ. ·ta1 ca~ty (FVC)'~"fo~ expiratory volume at one second (FEY I) in accordance with l\ilOSH and ATS l:tandaias . ;,+. : W" 1n ~~Cate whether or not .the phy~:n ~a that an l .ay wa1~uired and was perfor:m.:d: YES ~o __ A ~st·foe:ntgenogrmn, posterior-anterior, 14" x 17 " dr'cuaent film on file with interpretation in accordance >with 29 CFR 1926.1101 , Appendix E . "~: According to 29 CFR 1.92'.110l(M)(1)(11)(C), the requtremeat for a chest x:-r2y is at the physician's ~creti~~·. , .~ F Thc =ployee was ~formed by the b.)'.eiciB.ll i[~e results of ~e exam and of aDX medica.1 _£:on.diti~ ~ mav e~t_ ~m __ iioestos ~= including the increased risk oflung cancer allributable to the combined effect of rmolcing and asbestos ... ..c. .. ~ ~-~~ .. Unless oth.er,,.'i11c noted below, this evaluation indicates tho.t no medical conditions were detected that would place the =Ployee at an io~c! risk of ml\terial health imp~ent from e,:posure to asbestos, and no limitations are recommended on the employee concemmg the b5e of~ protectfve equipment or respirator. By signing this form, I acknowledge that this examination bas been performed in accordance witn'.eitb.er 29 CFR 1926 .1101 or 40 CFR 763.122 (a), as r equired. Comments or limitations, if an; _ _,;Pi'-'---'r;;'-'-"_-f-----------------------------~ ~~ Telephone Number (i ncluding ,u:er. code) City Zip PRIVACY NOTIFICATION / NOTIFICACION SOBRE PRNACI DAD W ith few exceptions, you hev s the right to request an d be inform&d a!>out Information lh21 I the State of Texa s collects abovl yo u . You are entitl ed to rece ive and re vi ew me Inform ation upon r11quest You also heve the ri ght to a11 k the state sgenc)• to o-:irrect eny information that IG determined to be lncorrecl S ee http://www .dshs.state.rx u.,Jfor more Information on Priv acy NotificaHon . (Referen ce : Govemor code. Sectlon 552.021 , 552.023 , 559,003 end 559.004) · Ta n solo por unas cuantas exc epdonas , usted tlene el derecho de sol icitor y de ser info rm sdo sob re Is iniorm sci6n oue al Estado de Texas reune w bre u sted . A usted so Iii debG concGd9r el dorecho de reclblr y reviser la inforrmici6n al requerirla . U sted tambien ti@n ~ al dere::ho de pedlr cue la agen~is e statal ::orrqa cua lquier lnformacl6 que SQ h a determlna do sea incorrec:ta . D1rij1l!5 e e ntt;,:ff\r:""11'.· ij/§hs .stale.tx.usl pars mtl~ lntormaci6n sobre la Notlficac:l::in so bre priv acidad (R sferenci e· Go11ernmanr CodG~seccl6n 552 321. 552 ,023. 559 .003 y 559 .004.) ' =l.evised A;,·il 2 00 5 ?c.Jblication # F1 B-116 69 ENVIRONMENTAL , INC. 210 S Wa l nut C r eek Drive . Mansf i e l d Texas 760 6 3. Tel ephone (8 17) 477-9995 , Fa c s imi l e (81 7) 477 -999 6 www .1nte r co n-envi ronme nta I . com Employee Name: Respirator Fit Test ~EC.TOR. /0.SDtNA DSHS License Number: Respirator Type: Half-face ,. Respirator Brand: North .~ Respirator Size: 1. 2. 3. 4. 5. 6. 7. , (circle n , --- Question ./ ·:"'. Was respirator reasonably comfortable? Was positive and negative pressure, test admfnistered? Does the individual understanci''{u lly~the protecti9n factor of this type respirator? , Was the individuaJ...J.~s~cted on .,e pro !?., r: use and care of this type respirator?, . . ~-) Was a smoke type test administered? During the actual test wa!f tl)e indi\ildual required to converse and move his or her head around to insure corrertfjt? ~-,I" Did recipient pass fit test? .~ -------' - - ,, Yes No These items are my personal responsibility. If I lose any of this equipment or negligently da6'1a ge an~ I will reimburse Intercon Environmental, Inc. the full list price for each article lost or damaged. ~ ' -.::---,~., . I agr'e gJ:hat this information above i s true and correct . .;r Emp loye e Sig.nature: #$~' -. I T est administered by / a~c C,,11 1t'c ,z ,., Tit le Supervisor I am expe ri enced in the adm i nis t ratio n of proper fit tests . L.f-l zlf /09 Date of fit te st ________ _ OSHA Regulations (Standards -29 CFR) 1910 .134(f)(2) The em.P.loy er shall en sure tha t an employee using a tight-fitting Fa c ep iece r es pi rator is it t ested p ri or to in itiaFuse of the resp i rator, w h en ev er a d iffere n t r esp ira tor f ace p 1e ce (s i ze , st y le , model o r ma ke ) is used, a n d at least annu a ll y t h er eafter. 1910 .134(f)(3 ) The em plo y er sh al l con duct an add it ion al fi t t es t w h e never th e emplo y ee report s, or t he emplo y e r, ?LHCP, superv is·x, o r p ro gra m administ ~at o r m ak es vi sual obs erv ation s 9°, ch ang es n th ~ en plcy ee 's p 'l y s ica l c o nd it ion :hat could affect resp i ra to r fit . Such condit io ns in clude , b ut are no t limited to , f acial sc arrin g, d e nta l c h anges, co smetic surgery, or a ob vi ou s ch2nge i n bod y we i ght. Certificate of Worker's Acknowledgement and ,v orker Release Intercon Environmental, Inc. Proj ect Address -----------------------r-'------- WORKING WITH ASBESTOS CA..N BE DA..NGEROUS .. INHALING ASBESTOS FIBERS HAS BEEN LINKED WITH VARIO US TYPES OF CANCER. IF YOU SMOKE Al\'"D INHALE ASBESTOS FIBERS THE CH..\NCE THAT YOlf WILL DEVELOP LUNG CANCER IS GREATER THAN THAT OF THE NON-SMOKING PUBLIC. ' • , Your employer 's contract wi th the Own er for th;e abo ve project requires thai you be supplied wi th the proper respirator and be trained in its use , you be trained in safe wor:it .practices and in the use of th e equipment found on the job, and you receive a medial examination. These things are to have been done at no cost to you. By signing this certification you are assuring the Owner that your employer has met these obligations to you and are agree ir\g· to hold the Owner, his Consultant, Testin g Labor atory, and representative harmless in any and all claims arisi?g from or related to this project. ' • ,t' RESPIRATORY PROTECTJON: I have oeen trained in the proper use of respirators , and informed of the type respirator to be.,.u ~.;,gn the above ref~reticec(project. I was given a copy of the written respiratory protection manual issued b.y my e};'ilplo yep I have been equipped at no cost with a respirator to be used on the abov e project ... .. .._ '\,,. :. TRAINING COURSE; I have been i:rained in the dangers inherent in handling asbes tos and breathing asbestos dust and m 'proper work procedures and personal and area protective measures. The topics _ ___ covered in the co~se .included the folJ.o w'm~ _ _ _ _ _ _ f; . Physicalcharacteristics of asbestos · Health hazards associated with asbestos Respirato!)' protec · on _ U se ofpro~ti.ve· equipment Pressure Differenti al Systems Work practices including hands-on or on-j ob training Person al decon~ati on procedure s MED ICAL EXAMIN ATION : I have had a medical examination within the past 12 months at no cost to m e. This examination included: health history, pulmonary function tests and may hav e included an evaluation of a chest x-ray. By signing this document I am acknowledgin g only that the Ovmer of th e building I am abo ut to work in has advised me of my rights to training and protection relative to my employer, lntercon Environmenta l , Inc. Signature: ~ ec+or Med ; t".O- ~ted N]e ft:;,fk ,?;{Y,0/z -==-= ~· --~ .. C(lO.tt·()I N (): /553tf .. .. ',c .Q~1>,t1,.tmcn.t <lf Sta.te '·,:'.~~l , .. · ,· ',,:_"'~1ices .···.ce1·tifies that: )~~-i~\-~ ~~t . . T· 0< .. ::,:;·:.:·. . ·/;:. . - ;B .. _ t · \,;;~ • . .. -· - ·''i~t , ·. . .... '. ' . ,,. i / .: \,4, Asbesto s Ah,!t ement S11uelf\'iM>);·· ',,. • . I /?"t;;,:: '-, t ~;~r· ~:· ·' .. ' ' ::"ili~tt.. t,~.w·':;w '· . Li~~11se N~.'f~·e{;r .18044l~ ,'}t Expiration l.)a\e: I ~16/1009 ... \! . ) ' , . -i I , 1GEfHJ:·~.!r!!w~CIA TES Tk;i~ UNIVERi~l!Y/OF NORTH TEXAS · · · · certifies that , I ' has s uccessfully compl'.tcd ~~ l~~:.~t~:~:~ay for the Environmental Tril ining Pr~gram cnt'tled • I '-' Asbestos Cont,ractor/Sup:~Fvisor Refresher Conducted at Fort Worth, Texas on t-,1arch 30, 2009 This is an EPA fully approved course for pu1-µQse Jfaccreditation un .der Section 206 of TSCA, Title II. IL covers to ~ics listed in the N ES AP lrai1 }ing, requirement of 40 CF:R, Part 61, s ubpart M. · · 4...... Preside nt D<1te or issue: 03/30/09 Instructor: Dana Brown Certificate expires : 03/30/2010 Cer tifica te Nu mber: 09090 1077 GEl:ICO's T1amin g l'wgrams we provided in cooperation will t le<leral and stale regulatory agencies. aml lirllill all applicabfe requiremcl!IS for accn:dit alion . GE BCO is licensed for Af bestos Training under lhc Texas Asbestos Health Prot~tion Ru~. •. ' ' GEDCO Associales, LP • 4690 9 iptomacy Road. Suite 120 I ' - MAR /16 /2009/MO N 2:53 PM P. 00 4 .•. :'.-ii:*"'" l*~;iTEXAS Physician's \iVritten Sta t ement Medical Surveillance for A sbestos Expo swe IIL....... 1 ~ Departmen t oi -~,, f \ State Heatth Se rv ices Environmental &: Sanitation Licensing Group g00{572 .554g or S 12/8.34-6600 ww'N.tdh..stirt:t.tx.us/beh/0tsbestos Fax: 51 2-&3~6]4 Applicait Name; (First, Mi~ Last) So:ial Security ft Dau ofBirth Tclephon: Number (tncludin g area code) .... S=t A,cicir=: iry St= Z ip / Il'H)!CATE WHICH ITEMS WERE PERFORMED WITH BHYSICI.A.N'S OR ASSISTANT'S ThTTIALS: (Any that a.re not applic:able, ·must still be iiµtisled, off in addition to the NIA-) . ~ . The above-named individual was seen on f) / ~ 0 h -.() f , ·. ·(N.(~ be filled:~ b~ Physician or clinic .) u Completion at1d n:Yicw · of the 'Standardized medical questionnaire ·and work histoty with special emphasis directed to the pulmoo~J, cl!Tdiovascular, and pstrointesrinal _ stems per part l and2 of AppendixD in 1926.11 01. . . . 1,,v If employed, the employer provided, and review was made of, tli e employer's description .of this ~ployee's duties as they relm to the employe:'s expo~. the employee's representative or anticipated exposure level. the personal protective and rcspimory equipment to be utilized by the eu;iploy~ and informmon from previous medical examinatio!!S of the affected employee tlllt is not otherwis.e 21.vaiiAblc to the'pjl~ · " A physical examination with ~basis upon the J!llm~. cardiovascular, and gastrointestinal sysrems. The pulmonary function ~ o1 f~. vital ca city ~e,/ ,d forced expiratory volume at one second (FEV i) in accordance wrtb l'HOSH and A TS .stmc:imds. "' 7 a Indicate wbeth:r or not the physici~ dec:i~d th.11! 0 an x-ray :as required and~ pe..•form~d: . or NO __ A chest roenrgenogrem,, posterior-anterior, 14" x 17" or cum:nt film on fiie with ilnerpretation · dance with .29 CFR 1926 . l l O 1, Appendbc E. •.!iQii: Accord~ to "9 CTR 1926.l 10l(M)(2Xii)(C), the requirement for a chest :c-ray is at the physician's disc:retion:; -~ -,,. The emp loy~ was ii:!Iorm~'oyffi~ pliysi c'ianof t?ieres!Il t! ~f me· exannmd-ofmy medr..at cotrdiriorrnhannay resultilonr- ~'&estos exposure _inciud.ing the increased risk of lung ca,;cer attributable to tbe combined effect of smoking an d asbestos e..xposure . U nless otherwise noted,-below, t.riis ev aluation ~dicates that no ined icai conditions were detected that would place the employee at .m increased ns • of'mao::rial1iealth impairment from exposure to asbestos , and no limitations are recommended on the employ ee concerning the lis e of persond protecti ve eq ui pment or respirator . By signing this form, I ackn owledge that this examination has be~n performed in accordance with e imer 29 CFR 1926 .1101 or 4 0 CFR 763 .122(.a), as ·re quired · Co.IT'~ents or limitanim', ~~81!Y------------------------------------- -I i,.;.c/ Tcl cphon~ N"moer (induding ~ cod e) .{/r'J'. State PRIVAC Y NOTIFICATION I NOTIFICACl61~ S03 PE PRIVA CIDACi With fe w e xceptions, y ou h2ve th e ri ght to request and be informed <!b out information t hat the State of TexFS collaC'.s about you . Y ou :are entitled 10 re~ive :and reviaw the iniormation upon rQqu est Yo u also have the right to es~ the state age ncy t o correct any inforrruation that is d etermined t.o be in:::irrac::.. See hltD://www,dshs .sta',e .!:x . us/for more information on Pr iv a::;y Not'iicati o n. (R efe ren ce : Governor Coci e, Section 552.021 , :55 2..023 , 559 .003 :c.nd 55e .O OL ) ·a~, solo :mr ur.1:5 ;;uantn excao::io :;es . •;sted iis:ie el derecho jf s:ilicitor" ::l e ser 1nforma dc sobre le informa::iOn oue e l Estaoo d ~ T2:::.i s re'Jne score ..Jsis~ .. !.. \.!stad ~• ls oobe conceds; ei oerecho de recibi.r y rev~ar ~-info~adon a! r~quenrl-.. L:sted tam~ien tiene el osn:!:;ho ci e .pedir q ue !a agcnci~ "-S~o,iii co171i;; cu elquier in brmac,6 que s a r.a o aet-.rm i-.adc seo i:lc::,rre::tc. '.)irij2se a !J ffp :IJ.,.,.,r.1 ,.c!s~s .sta~.t;.uEI c ar a m2s i ni::>rr.s aci::,n sobre 1a Notifice C:6n ~obre ;:>rtv a ci:;cd. (R6 pe ;ici~: Gov e mfTl ent Cvo'l»_$eco~~ ;5~-~.2,, 552...0.23 . 5.5;.002 ; 55g _QJ4 .) 1 ?u:>Gcat ion ~ ~, S-p. ", 5~? ENVIRONMENTAL , INC. 210 S Walnut C r eek D r iv e. M a n s fie l d, T exas 7 606 3. Te l epho n e (8 1 7 ) 477-9995 . Facsim i l e (817 ) 477-9996 w_ww .lntercon -environ mental .corn Respirator Fit Test Employee Name: [ u LoB i o /0 rreS!" DSHS License Number: f'O-Lfy1q Respirator Type: Half-face Respirator Brand: North Respirator Size: Medium 1. 2. 3. ( ci rc;Je· one Question . Was respirator reasonably comf9rtablei·' ~( Was positive and negative preS$ura test administered? Does the individual understand rul1ithe protectign .... factor of this type respirator? · ,. ~ 4. Was the individual ·n structed on the proper. l;;ISe and care of this type respira,tor:?:-',. }' 5. Was a smoke type test ad_f11iriist~ree.? 6. During the actual test was tj:)e indivldual ?' ~ ~ required to conv_erse and move his or her head around to insure correct fit? ~ :V ;,/ No 7. Did recipient''Rass ''fit test? , . )' ~ > -----: :;,;---. , ' ------------ The ~items are my personal responsibility. If I lose any of this equipment or negligently da h'l age any, I will reimburse Intercon Environmental, Inc. the full list price for each article lo'l or damaged. ·. . · ...... ™' ~ I agr:ee ~that-~tHls information above is true and correct. ,N Em ployee"sTgna (ure: --~C-.......LL.-C_·_. _J _, ~--~ __ o_/_t:P_,·_r_f'.~'.>_· _______ _ Test adm i nistered by Tc sc C,,,o 1cc r?< c:.., Title Sup e rvi so r I am ex perienced i n the adm i n i stration of proper fit tests. c:;/1 r/c q Date of fit test ___ _,__'------'-'-- OSHA Regulations (Standards -29 CFR) 1910.134(0(2) The err,f'l(1yer shall en sure th a t an empl oyee u sin g a tight-fitting facepiece r espi rato r i s f it t ested p rio r t o in it ia l u se of the r es p ir ato r , wh e n ev er a d iffere nt r esp irator f a ce p ie ce (s ize, sty l e, m o de l o r make) is used , and at l ea st a n nu a l ly ::here after. 1910 .1 34(0(3) Th e emp loy er sh all cond u ct a n add ition al f it t es t wh en ever t h e emp loye e repo rts, or t he em p loy er, PLHCP, supe rv isor, o r<f pr og ram ad :-n i n 1st ra tor m a ke s vi su al o bse r v ation s o~ ch ang es in t h e em:,lc y ee 's p'i y sica l co n d ition that .could affect resp irato r fi t. Such con d iti ons incl ude, bu t are no t li m it ed to , faci al scarrin g, dental ch a nges, co sme t ic surg ery , or an obviou s cha n ge i n bo dy we ig ht . Certificate of ,v orker's Acknowledgement and Worker Release Intercon Environmental, Inc. .,. Project Name _________________ Date------------ Project Address----------------------'---,--~--=----- ·woRKING WITH ASBESTOS CAN BE DANGEROUS. INHALING ASBESTOS FIBERS HAS BEEN LINKED \VITH VARIO US TYPES OF CANCER!' IF YOU S1\10KE AND INHALE ASBESTOS FIBERS THE CHANCE THAT YOU )VIL.L DEVELOP LUNG CANCER IS GREATER THAN THAT OF THE NON-SMOKING PUBLi€.: \ i' Your employer's contract with the Owner for the above proJect requires that yoti be suppl ied with the proper respirator and be trained in its use, you be trained in safe worlc practices and in the use of the equipment found on the job, and you receive a medial examination. These things are to have been done at no cost to you. By signing this certificatio,n _you are a.sstjring the Owrter that your employer has met these obligations to you and are agreeing to' hb1d. the Owner, his Consultant, Testing Laboratory, and representative harmless in any and all claims arising from or related to this project. "".. '" RESPIRATORY PROTECTION: I have been trained . the proper use of respirators, and informed of the type respirator to be used ,d n -tbe':.abov:e referenced .project. I was given a copy of the written respiratory protection manual issued 'B,:\?ny employer. · I -h"ave been equipped at no cost with a respirator to be used on the above project , ~. -~\ TRAINING COURSE: I haY..e q~en trained in. the dangers inherent in handling asbestos and breathing asbestos. dust and in proper work~pr0£~Ure~/and personal and area protective measures . The topics -----coverecHn the-~urse-indudeEi thc-foUgw.mg:-_ _ _ ___ _ __ Physical chai~cteiistics of asb~tos Health hazards associated with asbestos y • ,,,,,,,.,...,.,~ .J Respiratory protection . · , ' Use of protective equipment, Pressure Differential Systems Work practices including h .. ands -on or on-job tra in ing Personal decontamination procedures MEDICA L E XAMINATI ON : I hav e h ad a medical examinat io n w ith in th e p ast 12 m onths at no c os t to m e . This e x amination included : health history , pulmonary functi on tests an d may have inclu ded an evaluation of a chest x-ray. By signing this document I am acknowledging only that the Owner of the building I am about to work in h as ad vised m e of my rights to training and protection relative to ·rny employer, Intercon Environm ental, Inc. Signature:~~; t?· ~e ~ ' . ' Social Security No . '-f.S3 9 9 ( 0 '7< TEXAS D EPARTMENT OF STATE HEALTH SERVICES DAVID L LAK EY, M.D COMMJSSJONER MARCH 27, 2008 MOIS E S RAMOS 421 6 CULMER L N MESQUITE , TX 7 5180 ' ' I JOO We st 49th;Street • .A ustin , Texas 78756 P.O. Box 149 4 7 • Austill Texas 787Ja.9347 I -8 88-9 63-71 I I • W\\-:.>-'.dfil1lYf:!.e .1::. ,1-, 1TY 1 -s00-13:-1989 • ~ . . ·· ) This is to v erify that the individual shown below bolds a v alid credential ·. o practice as an ASB ESTOS A BATEMENT SUPERVISOR in th e State of Tex as ., N AME : MOISES RAMOS •: LICENSE TYPE : ASBESTOS A BA TEMEN T SUPERVISOR LICENSE NUMBER: 80 44 32 · t:l: CON TROL l'-Tl.JMBER: 95747 EXPIRATI ON DA TE : 4 /6/20 10 l\ ,, ' \ ' . .,I' lf you ha v e an y questions , pleafe\on1att us 'by.phone .at 5 12-834-6600, by fax at 5 l 2 /834-661 4 . W e encoura ge you to v isit our website a• http ://www .a's~.state:~,.lis . fo[ frequ f ntly updated informa tion, including rules, law s, publications and forms . You may also verify a cred ential through th is website . En vironmental & San it ation Licensing Group i I GfiJG~.:!r!!w~CIA TES .. :THE UNIVE=RSIJ?( OF NORTH TEXAS · ... .: · , I · certifies that MOfses has s uccessfully completed and ~~ssed !he ·:;.~ given on the final day for the Environmental T ·aining J rogram eµtitle~ . Asbestos Contracto ~iSn;R rvisor Refresher • Dale of issue: 03/16/09 Conducted at Fort Worth, Texas o·pMarch 16,.2009 I ,. This is an EPA fully appr9ved co urse for purpps of accredit,atjon W1der Section 206 of TSCA, Tille II. It covers topics listed in the Nl;iSHAP trainingi:equirement of 40,rFR, I '\ • '( 't'. Part 6 1, subpart M. ~. 1 • ~~.~ President ' ' , V ''\: Instructor: Paul Laman " c:;ertificate expires : OJ/16/2010 Certific ate Number: 09067 8761 ~ GE BCO's Trai ning Program s are provided in coo peration ')'iU1 federal and state regulal o ry agencies, and fulfill all app li dil ble requirements for accredila~ion .. , GEBCO is licensed fo , Asbestos Training under the Texas Asbestos Health Protect ion Rules! • G El:ICO Assoc iates, LP • 469r Diplomacy Road, Suite 120 • Fo rt Worth, TX 76155 • {817) 268-4006 OCT /08 /2008/WED 05:30 PM Phy1:ician's Writteii. Statement Medical Surveillance for Asbest.os Exp~sure EDviroiimental & Smi.tation Ll=s;ing Group ' 800/572-5548 or 51.2.183+6500 · Fax: SU-834-6614 P. 00 4 Appt\it~~~~ ~ o>5 5~fil,~1o</,2?/ 1 ,~ ~ ~~2-~~'1( Y LL;}/6 ctzl[vr~Y · /LA fsc,Jc,b Srf)r· h$: f} ~ 1 rt:> !ree( Addre&c I Clty 'SJm i; . ~ ;,- IND I CATE wroc:a: ITEMS WERE PERFORMED WITB PRYSICIAN'S OR ASSISTANT'S lNITlALS: (Any that are not applicable, must still be initial~ oft,Qil~tion to the 'NJ A.),.. ... P· The above-named individual was seen Oll 17), o& 'O 8 ~ . · . (Mtkoe,filled-i:nbyPhysicia:n or clinic.) 5-2.. Completion and revil!W of the ~ medical ~ mid vvorlc ~ ~ sp~ emphasis directed to ~ pulmonmy, c:mliovasc:clar, !!Ild gastrointestinal spbns p:r part 1 anf2 of Appc:ndtt D ,m 1926 .1101. s .J' If employed. the employer provided, and :review 1ftS made of. the ~loye:rslhes~an of this employee'& dutie; ,u they relate to the ei:xiplayee's e:xposure, the empl~s~tive or~ exposim ltve~ the p=onal pro~ and respnaiwy eqtiipmem to be utilized by the cmpl~ mid.illformati~ m,m _rL 'ons medical examinations of the affected employ~ that is not otherwise availahl~ to the~ ~ · A pbyiical ~on with ergplilSis upon the pulil;a;nmy, c=diov~a:Jar, aria ~ .yst= . . . . "·· . ~.,.. .)/ 11 ----~ The :pulmona.-y function tes!s of forced vital cap~ (FVC) and forced ~ voh.ime at one sec:and (E:.l!W-::~in accordancewithNIOSHandATS ~ · ... _}'. ) ·ll · ·Indicate~ or not the phy;ician decided that m X·:r&"Yi, was requied and was pcrfm:m=d: YES __ or __ c:bcst ro=ntgcoo~ postmor-ant:rior, 14•: 1r or c:mrmt film on file with i%itetpxetation in IICCOI"dance · · 1926.l l O 1, Appendix E., "'~: · According :bl 290CFR 19Ui.ll OJi(M)(l)(~")(C), tbe requirement for a cltest 1-ray is · at the pbysician's discretion.·.· , ~ 'f 1 .> 7 T!!e mJRloyee wu mf~tmed ~~·~~ffie ~md~o;aey~c:ah:anditions~ - a&b•~sure mcJudixl& the 'incxeas!:11 risk of Inn& cancer attn~blc to the combined effect of smokini and asbestos '~ j! . Unless otherwise n~ below, ftris ·~on indicares 'tbat'no medical condi!ioos w~ detected th:n'wtrulc1 pl.ace the ~loyee llt m · increased iisk OfiDatl!rial health iinpajn:nmt from e.xpo= to a.i:besto£, aDd DO limitations are recommended Oil the employee conceming .i'!:m me« pc:rscmal protective c::quipment or respi.-inor. By signmg[ttris f~ I acknowledge that flm =nnination bas been pettOimed in accordance with c:ffl:ier 29 CTR 1926.1101 or 40 CTR 763.122(2.).. as requ,'rrcd.. Co=c:nts orlimimtiODS; ~~' . . · I; < Ii 1· ,· ' /; Stre:t Addr-...u Ciry i'. Stn1e ?r<JVACY NOTI FICATION / NOTIRCACION s;OB.R E ?~VACIDAD inclndi~ = code) lel:214 .630J l 44 far·21' 632 3820 W ith li¥W s xc:sptl ons . you have the right to request and be informed aboui lrrformation 1hst !hB State of Tex as colle.;:tS .about you. Yo are entitled .o receive end ~iew the inft>rmsticn upon na quast: You a~ have th~ right to ssl< 1hfl srate agetjoy to c:irrad ar,y information lhst is d;,tarmined t o b!!I in corre::t. S911 hful:li www.ct.hs,s rats.!X.usJfor more information on Prtv acy N otifi cation. (Referem:, .. : Governor Code, .Section 552.021 , 552.023, 559,003 and 559.004) · · I, . . l T an solo por ·unes ~antas excep;:ionaii, usled ~ane l!ll ei.rec.>10 de ·sor.citor y de ~sr ln!on:nado sotlre la inf:>rmacion que el !::siado de Ts= .r eu:1e sobre usled. A ustad !!!! le oabe conceder al deracho de racibir y ~iser le infunnacion al .;,qi,crirla, ~st!!d tambien ti&ns ~ deree:10 de pc>dir quQ r.a ag;,ncia m l corrija ::ualouie, informacio que se ha :1 91s nnln::,clo Sell lncofT9::ta Dirijase 'll h µp.'l.lw,,..,.1.::/ims .st<m,.tx.vsl paci, me1< iniorr:iai::l6n sobre la Nomic::acl6n sobre priva::,dad. (!:teisrencia: Go vemment Code~s2=6n 552.021. 552 .0 23, 559.003 y 55a.004 _) ... · , . I Revised !o.prll 2::JOS ' I ]: 1: ENVIRON M ENTAL, I NC. 210 S Wa l nut Cre e k Drive, Mansf i e l d Texas 760 63 . Te l eph on e (8 1 7) 4 77-999 5 . Facs i m i le (817) 477-9996 www. i n t e rcon -e nv i ron men t a l. co m Respirator Fit Test Employee Name: /\-1oi&·e~ RemoS DSHS License Number : Resp irator Type: Half-face Respirator Brand: North Respirator Size: Medium 1. 2. 3. 4. 5. 6. 7. (circl e on Question Was respirator reasonably co r:rq .>ctable? .. ··,.,, Was positive and negative pressure test admin i stered? Does the individual understand ,fiJ lly tb~ protecti.on factor of this type respirator? , ; · Was the individua).,.:.iQstructed on fb e propei: use and care of this type respi rator.?;':; ' >> Was a smoke type test 'adm i nistered-? During the actual test was the individual required to cony erse and mo\,~ hts or her head around t~ insu~e. co rrect fit?-~ ~ ? :, D1d rec,~t ~ss fit test .. , ,., _ <l . , -- Yes No v J,/ ~ / v / ~ Th~e items are my p~rsonal responsibility. If I lose any of this equipment or negligently damage any, I will reimburse Intercon Environmental, Inc. the full list price for each article lost or damaged .• -~~~ I agree thatthis IAformation above is true and correct. Employee Sig na"tu r e : _:2--"'-·_...---0...=-=..:. .... i.;.i.1.,_,/\..,., o""'--S"--"'-/\---><-/\4 ,..:::<::=--· '-=--1 S:...__12_S _____ _ T est administered by Tc -s,., C,,p jt'.'.c.« c... T itle Superviso r I am experienced in the administrat ion of proper fit tests. si1 /oa7 Date of At te st ___ .,_L_ _____ _ OSHA Regulations (Standards -29 CF R) 1910 .134(f}(2) The employer shall ensure that an employee using a t ight-fittin g facep i ece resp i rator is f it tested prior to init ial use of the respirator, whenever a d ifferent re spirator facepiece (size, sty le, model o r make) is u sed, an d at l east annually thereafter. 1910.134(f }(3l The emp loy er shall conduct an additional f it test wh enever the em;:,loyee reports, or th e emp loy er, PLHCP, superv"5o r, or program admin 1st,ator make s vi sual ob serva tion s of, :hanges i1 t he er;,p loy ee 's phy sic al cond iti on that cou ld affect r esp irator fi t. Such co nditions i nclude, but are no t limi ted to, fac ial sca r r in g, d e:ita l ch anges, co sm etic su rg e ry , or an obviou s change i n body w eig ht. Certificate of \Vorker's Ac kno:w l e dgement and Worker Release Intercon En vironmen tal! I nr , Project ____________________ Date _____ ,:__-"------ P ro ject Address -------------------------~---- . ,. . ~ "' ,VORKING WTTH ASBESTOS CAN BE DA_NGERO US. Th:tIALL~G ASBESTO S FIBERS HAS ' ' ! BEEN LINKED WITH VARIO US TY-PES OF CAN CER IF YOU SMOKE A..~'fl)' IBA.LE A.SBESTOS FIBERS THE Cii~NCE Til~T YOU MLL DE 'VELOP LUNG Cl~CER LS GR.EA. TER THA..N THA.T OF THE NON-S MOKrnG PJJB Ll~. -. , } ,,, Your empl oyer's contract ,;..'itb tbe Ov.ner for tbe abov€-project r~es that y~t be supplied with the proper respirator and be trained in its use, you be ~nea fu ,safe wo rk ,practicesyand in the use of the equipment found on tbe job , and you recei v e a mediaj examin~tion. These, things are to ha v e been done at no co st to you. By signing this certification you· are. assu,r:ing the Ov.·rr(1{tbat your employer has met th ese obli gations to you and are agreeing t~.,oold the Qwper, his Consuftanl Testing Laboratory , and representative harmles s in any and all claims g from" or~r elated to thi s project RESPIRATORY PROTECTION: I have bee\ u-a gie,d in the proper use of respirators , and informed of the type r espiratoi to be u sed l ~ the above '~f fe.i'b~ project. I was given a copy of the written respiratory protecti on manual :ssu. :_ emp!py er. ' '\i been eq uipped at no cost with a respirator t,J be u sed on th e above project ~' --~ . TR.AlNThG COURSE: I have been tramed in th:... dangers i.i.'l.berent i::i handling asbes to s and breathing asbestos dust and in proper . '.Ji'Ork procedt }es a.Dd personal and are.a protective measures . The topics co v ered in the course inoludhlfllie folJowino::V,' -;,.,, ~~ .i ''"' :::, / -P nv sicalcliafacterisli cs of;-B.SD.f:S ,OS . ------ H;al th h aiafa.t associated witb . asbes tos Respirat'brv prot;ction · Use of ~f0.~F~.tiv 7-:e:g;tp-~I;? en t Pressure Diffe1:entiaJSvsiems W ork practi~s incl utfuli:h ands-on or o n -J·ob trainiD£ '-?if - Personal decontaminati0:E Drocedures -·· .JI' .. .;; .. :.;., . " -----·~--------- MEDICAL EXA.MINATI ON : I ha v e had a medical exam.im.tio!l ·v.·ith in tbe pas t 12 m on ths at no co st to me . This examination iDc lu ded: be altb his tory, pu lm onary funct ion te sts and m a y h2ve includ ed an ev aluati o n o f a ches t x -ray. By si gnin g thi s docurnent I 2.m ack .. 11 0·,;.·Jedgin g onJy iliat Lh e Ov.·::ier of th e bui l di.:i g I 2.m about :o ·,,;o rk in bas ad vised me of m y r:gh1s w 1r aining 2.n d protection re l aiv: i.O :::i ~; em?loyer. :.ILerco:1 E rr,;i.ro::ioen:2.L Inc F i r me ' TEXAS DEPART:t\1ENT OF STATE HEALTH SERVICES INTERCON ENVIRONMENTAL INC i.s cmifietl to pc ,jo m r aJ t1 Asbestos Abatement Contractor i11 the S ta te of Te.xas within the pwview of Texas Occupatio11s Code, chapter I 954, so lo ng as this lice11s~ is 11 0/ s uspend ed or re voked and is renewed ac cording to the 111 les adop ted by the Tex as B o ard of Healt h . License Number: 800805 Control Number : 95442 ..;..7.) _ J ·'" i} /y· ,--'""",,,q,..,..--~4-92? / DAVID LAKEY . M.D. COMMlSSJONER OF HEALTH . Expiration Date: V5 120 I I (Void After Expiration Date) TEXAS DEPARTMENT OF STATE HEALTH SERVICES ,..; .";fr INTERCON E NVIR0 N1\1ENTAL IN C i.s certified to pc,jomr ru a Asb es t os Transpor t er i11 the Stale of Texas within the purview ofTe.,as Occupations Code . chapter /954. so /011g as this license is 1101 suspended or revok ed and is renewed according to the ru les adop 1ed /Jy the Tex.as Board of Heal th . License Nu111ber : 40 033 6 Con,rol Nu111ber 95 4 84 DAV ID LAHY. M.D . COMMISSION ER OF HEALTH Expiration Da te : 2/5/20 I I !",·0 1d _t,f1er hpirn tion Dare) ' T EX A S D EP A RTMENT OF STATE HEALTH SERVICES I • ,., , I . ', ' CBASEitVJCES I~C ! . ' /.eJ ·~ is certifiedl_,to pe~fon~i a.'s ~( ~, k' ,} & ' Asbestos ~,Jl~~nspo.11'ter I ... . , r!' -- Il l !lw S tuf c. r~{[cxas w ithin th e p 1.u ·11i e w of Texas Occ~tpqtionsff;Coa/., cl!al!,l~r 1954, so long as this li c ens e is nut s uspende d or r e voked a nd is rene1 ,ved accordinE; to the ;-ules _,~~(J_pied bY, tf~~ Te.tas Board of Health . [ ,1~;c 11 .sc N umbe r: 400 ] 12 ( 'u 1Ll 1u l I\J uJll lJ l,;L 9 54 2 l DAV1D LAKEY, M .D. COMTvnssrqNER OF HEALTH I I V O ID IF AL TEREO NON -TRANSFERABLE Expiration Date: ~17/20.l 0 (Void Aftei· Expiration Date) Ple ase print or type . (Form des igned fo r use on elite (1 2-pitch ) typewriter.) Job# Form Ap pro ved 0MB No 2050-0 039 UNI FOR M HAZA RDOUS ,1. Generator ID Numb er WA STE MA NI FES T NI.ti. 1 2. Page 1 of I 3. Emergency Response Phone 1 ~17 -4 77 -9995 i.,,,9, ,5. General.ors Narrie ~d Mail[n.g Address c..;ffy OT t"O it \'i!Orth r--... 1000 Th r ockmorton Street Fo rt Worth , TX 7S10 2 Generator s Phone : 6. Trans~orter 1 Compan~Nam e inte rcon t:n vironme nta l, In c . 7. Transporter 2 Company Name CSA Se rvi ces , Inc. 8. Des igB Wn'..1a~m=rrf Stte Ad dress 1600 Railroa d Street Lewis v ille, Te xas 75067 Facility's Phone : 817 -392 -85 9 2 972-3 15-54 21 9a. 9b. U.S . DOT Descri ption 0nclu ding Prope r Shipping Name , Hazard Class , ID Number, HM an d Packing Grou p (n any)) Generator's Stte Address (i f different than mailing add ress ) Proj ect r-iame P roject Str eet Address 1 P roj ect C ity Stat e Zip I U .S EPA ID Number .,. U.li . EPA ID Number ,r 1b. Containers Type U.S. EPA ID ~umbe r 11 . Total Quanttty -. e::: 1Haza rdo us substan ce , sol id , N.O.S. (asbestos) . . ,/,~ JJK 13 . Waste Code s n/a ~ OR M-E, NA 9 188, RQ=1 Pound .X · · .,,.__ . !~1~ w1--1------------------------------1--,----+""""""'"''---+--.,....---,---1---+---+----i ~ 2 Waste w hich contai ns non-fria ble asbestos o r {o; 1 · ' "'.:,;:Y-· I 3 waste contain i ng non-f r i able asbestos ~· -,,'·'":~ / n/a j Hazardous s ubstance, sol id , N.O .S. (asbesto . ''\\;;,. I ORM-E , NA 9188, RQ=1 Pound • n/a I . : .. :' \vaste which contai ns non-friable.as~_ . os or l\ "·!;\. .'f' ~ -~ ta ' . f . bl b "'!';"<.:":..Hh,4., ~ '; I wa::...e co n mi ng non -ria e a e~f~-.J!.t,,~ ;,\ n/a 14 . Specia l.Handling Instructions and Addition al lnfonmation "'~. "< \. ~tt~\ . CBA Services, Inc. Di sposal must be i n accordance with TDSt;S MSWMR 25 TAC 5877 Barnett Rd ., Ste A 3 25 .13S(b )(6) or other ha~dl!ng p l an appro.J\ci,. in .w r it i ng BY T DS HS Krum , Texas 7 624 9 'e,~-<li._. ~' ·,.., ~,t OAt\ _.,..,. "'"IM 15 . GENERATOR 'S/OFF ERO R'S CE RTIFIC ATIO N: I hereby declare :thai the gintents of triis consignment are full y an d accurately described above by the prope r shipping name . ard are classified , packaged . --1-+-1--, -u .. -1.At!U""-" .. andJabeledJplacarde.d,.and.are..in a!Lr.espec!sjn.prnp;iµ:ondl!ionJotJiim pciLac.cordiogJo applicable...intematlon al and natio.naLg~m..!!l enta l r~!!@tion ~Jf e;i:io rt shipment and I am the PJi!ni!ry_ Exporte r, I certify that the contents of this consignme nt conforri\' to the terms of tt,e" attached EPA Acknowledgment of Co nsent I certify that the wast~ffeiza1kih statement identified,i\4'0 CFR 262.27(a)·frf I am a large qu an tity generator) or (b) (ifl am a smal l quantity generator) is true . - Generator's/Offerer s Prigt!id!T yped Name ~~-... ..-·~~~ .. '.), .f ..J 16 International Shipments,,>;( . O·;··; :, 4' ;, -'\ ;,r ~ ~"·"'· .Import o u.~.1 ~ Tran sporter signatu re (fo r exports only): .'t e::: 17 . Transporter Acknowledgment of Receipt of Materi als ,:J w I-iransport er 1 Printed/Typed Name ,;, .-·-r,;; e::: 0 ll.. Cl') z Transporte r 2 Printedtryped Name < e::: I- l 18 . Discrep ancy 18a . Discrepan cy Indi cation Space D Ouanttty 0Type ~ 18b . Alt ernate Fadlity 1or Generato r) ;;;1 u ~ Fa cility's Phone ffi 18c . Si gnature o; Alt ernate r=a cility tor Ge nerator) !;j: Signature I D Export from U.S . Sig nature I Sig nature I Month Day Ye ar I I I Port of ent ry/exit ------------------- Date leaving U.S._. Mon tr, Day Ye ar I I I Month Day Yea r I I I D Resid ue D Partial Rejection D Full Re1ecbon Manife st Reference Number U.S. EPA IC l~umbe r I i ea~ ...---~~-------------------------------------------------"----'--'\ 19 . -lazardous Was te Recor: Manage men : Metnoc ::od es (1.: .. co de s io· haza rdous wa ste trea tmen t. disposa l an d rec ycl1n9 systems ) I Month 1 . Day J 14 " Mon tn Jay 'sa· I I I _.J 1 12 J3 j 20 )es1;ma1ec Fa ciht) Jwn e1 o· )pe·a to· :enif1:at1or o' rece1p: of nc:a rdous maienals coveieC b) tile ma 1ife s: exceo: as nctec 1r. h~rr ·,B e 1 r'nmed, yp ec Nam e J Sign ature I I i I ENVIRONMENTAL , INC. 2 1 0 S . Wa lnut Cr e e k D r i ve . Ma nsfield T ex a s 76063 . T e l ephone (817) 4 77 -9995 . F acsim i le (817 ) 4 77-9996 ww w . i ntercon-e n vi r o nmenta I .com 2.6.4 ORGANIZATION COMMUNICATION CHART City of Fort Worth "I Personnel I 1m1111mnmmn1 inmi,1m1111mnr1m111wnnm~, Jerrold Andrews "I Vice President .) I ,Uii14l ...... ~~l#ol111 ,!~l»!"!·l•U,, .. 111!•!· I~ 11,..1.'i; ' , .• , ... , .. ,,,,. , . .i1mlllll!!~'lllltll~ill!:~11mm~11~l!lm:mr.r.tn111i!t.. "I Fernando Avila Bob Mcfadin Project Manager Project Manager nnm11!1!imm~n~ni11111'h111!1ilffillllm!llf~llll;llllllrn, +------ iill!llll!lmtmmnninml!lllilllllll1ll!lln1111ntt1111111,. "I I ntercon Asbestos lntercon Demolition ! Operations Operations .) · I 11•1111~1m:11tt1LfJlltm11111n1mnn11a:m11~11·m111m1;,i.. I ,.:nr11:11n~1wllll111111rnr11'111:111fi<lll!11lr,!1'1"11111to. lntercon Asbestos lntercon Demolition .r\ ·1 Supervisors Supervisors i 2.7.Subcontractors Information and Qualifications Complete the following table list ing each subco nt ractor and the ir pro po se d task as so ci ated with th is contract. ~-------........ -~,r -------~--.-~~-----~,__...,,...,_......,..,--__..,.__,., Subcontractor's Name , Proposed Task -- CBA Services , Inc . Asbestos Waste Hauling -----------+--------------------- Tomas Reyes Trucking Demoltion Debris Hauling ~-----·----·--·---------·--------------- If subcontractors are to be utilized , the following information should be submitted for EACH subcontractor. (This section must be completed in addition to the required DBE documentation in Section 2 .9 .) 2 .7.1 . 2 .7 .2 . 2.7 .3 . Subcontractor's company name , address , ema il address , telephone number(s), and FAX number(s) for the local office as well as the headquarters . Subcontractors current Statements of Qualifications . Matrix includ ing the following information detailing the subcontractor's personnel , their qualifications, and years of experience. --------- ---Positior.titte-·an-ct Jotnunct,on as associated with this contract, (President, Vice President, Project Managers, Technical Managers, Field Supervisors, etc . .) • Name • Tasks to be performed in association w ith this contract • Certifications/Licenses • Total Years Experience 2-14 ENVIRONMENTAL , INC. 210 S. Walnut Creek Drive . Mansfield, Texas 76063 . Telephone (817) 477-9995 . Facs imile (8 1 7) 477-9996 www . i ntercon-envi ronmen tal. co m 2.7.1 Subcontractors Company Information ASBESTOS H AULING CBA Services , Inc. 5877 Barnett Road , Suite A Krum , Texas 76249 Person of Contact: Ms. Jana Osborn (940) 482-9900 Telephone (940) 482-3457 Facsimile janaosbo m @ hotm ai l.co m .,.. Texas DSHS Asbestos Transporter License No. 40-0312 DEMOLITION D EBRIS H A UL/NG Tomas Reyes Trucking 3529 Peoria Street Dallas, Texas 7 5212 Person of Contact: Mr. Jesse Valasquez (214) 631-2711 Telephone (2 14) 905-7565 Facsimile j ve lasq uez (a)reve s truc kin g.co m ..J.. NCTRCA M inor ity Bu s in ess Certification No. HMMB38406Y0909 ENVIRONMENTAL, INC. 210 S . Wa l nut Creek Dr iv e . Ma ns f i e l d Te x as 7 6 0 6 3 . Telep ho ne {81 7 } 4 77 -99 9 5 . Fa c s i m il e (81 7) 477 -9996 www . in ter con-enviro n mental .co m Response to Section 2.7.2 Subcontractor Statement of Qualifications CBA Services, Inc., a 1 00% woman -owned small business i s located at 5877 Barnett Road , Suite A , Krum , Texas 76249 . The company was founded in 2001 providing services from hazardous waste t r eatment , asbestos transportat i on and project management. CBA currently owns and /or operates roll -off trucks and end dump trucks . CBA provides 20 , 25 , and 30 Cubic Yard (CY) open -top containers and 40 CY asbestos vaults. Below is a l i st of representative projects demonstrating CBA Services , lnc.'s past experience with performing remed i ation of Superfund Sites , hazardous waste remediat i on , transportat ion and disposal : Sweetwater. Texas : Provided 40 CY asbestos vaults for transportati on and disposal of approx i mately 1 0 loads of asbestos ; the demolition phase of the project r equired transportation of 35 loads of demolition debris uti lizing 35 CY end dump trucks . San Antonio. Texas: Provided a permanent 40 CY asbestos vau lt for the transportation and d i sposal of asbestos waste materi als from a facility for the Department of Defense. --9aHas.-Texas-:----Provi cte d-semt=p-e rma nen c 3U-CYo pen -t<5p-roH -off cont ai ners for transportat i on and disposal of construction debris from large Dallas facility for long term construction /renovation projects. Waxahachie, Texas: Responded to an emergency call within one hour time frame to provi de four 30 CY open -top roll-off containers for the transportation and disposal of diese l -contaminated soil which caused highway closure. Job complete within 2 Yi hours. Fort Worth. Texas: Responded to an emergency call rece ived at 2 :00 am ; wi t hin one hour ti me frame t o prov i de one 3 0 CY op e n -t op ro ll -off co ntai ner an d two 30 CY w at ert i ght v acuu m contai n er s fr om t ruck opening a valve on 1-30 and dumped materials into a nearby creek. Job complete within four hours. Denton, Texa s: Prov i ded four 40 CY asbestos vaults fo r the transportation and disposal of asbestos waste mater i als from a Un ivers ity . Transported 52 loads . Rockwa ll , Texas: Prov i ded thr ee 30 CY ope n -top roll -off containers for the transportat i on and disposal of co ntaminated m aterials fr o m a T exa s Commissi on of Environmental Quality funded cl ean-up . ' Bi d Documents /Soecific /Citv of FW DEM 09 -0 8 -Subcontractor Statem e nt of Qualificat i ons STATEMENT OF QUALIFICATIONS Tomas Reyes Trucking, Inc. 3529 Peoria Street Dallas, Texas 75212 Tomas Reyes Trucking, Inc. is a local family owned and operated company based in Dallas, Texas. We have been in business for over 36 years and operate a fleet of 86 trucks and trailers. We specialize in providing transportation services geared toward the construction and demolition industries. We are a safety oriented carrier with a full time engineering safety consultant under cent-rae-t-and-in-the-fi-elc:rorra-ctatty"oas .. ls. We pride ourselves on-our safet_y __ rating along with our maintence facility and maintence program to keep our state of the art fleet in top notch operating condition. Our number one goal is to give our clients quality transportation service at an affordable price with minimal service failures. ~A Services, Inc. 5877 Barnett Road , Ste. A Krum , Texas 76249 Phone : (940) 482 -9900 FAX : (940) 482-3457 February 19 , 2009 Ms . Karen Andrews Intercon Environmental , Inc. 210 S. Walnut Creek Drive Mansfield , Texas 76063 Response to Section 2.7 .3 -Subcontractor Staff M atrix CBA S enrice #: Employ ee M atrix Dear Ms. Andrews: The following are the employees that will work on the project we discussed earlier today . I have outlined each emp loyee that will be involved and their respective respon sibilities , licenses , certificates and experience. N ame Job Tasks Certificates Y ears T itle Performed / Licens es E xp. Jana Osborn President Operations & Safety 18 years TX Class A C D L 02._s. _Qrivif!g.,_ Op~~tionL #1_5_Q2264J__i¥L Haz End _ ---------Kelsey Mccaughan Mgr. & Safety Asbestos Awaren ess 10 years TX Class A CD L #09859793 w/ Haz End. Ned Daniels Driver Driving Asbestos Awareness 23 years TX Class A CDL #16640558 w/ Haz End. Adrian Hill Dri v er Dri ving Asbestos Awareness 13 years TX Class A CDL #01589471 w/Haz End. Michae l Hi ll Drive r Driving As b estos Awareness 13 years If you have any questions or need any additional information, please call me at (940) 482-9900. Sincerely , Jana Os born , Presiden t - ----- Tomas Reyes Trucking, Inc. 3529 Peoria Street Dallas , Texas 75212 Tel. (214) 631-2711 Fax (214) 905-7565 Ms. Karen Andrews Intercon Environmental , Inc . 210 S. Walnut Creek Dri ve Mansfield, Texas 76063 Tomas Reyes Trucking, Inc. Employee Matrix Dear Ms. Andrews: The following are the employees that will work on the project we discussed. I have li sted the employees that will be involved and their areas of responsibility as we ll as their years of experience in the industry. Name Job Title Tasks Performed Experience Tomas Reyes Owner Project Management 36 years Antonio Reyes Co-Owner Project Management 20 years Jesse Valasquez Fleet Mgr. _!)i~p_atch Coor:9il}?to L 15 years_ __ - ----- If you have any questions or need any additional information , please call me at (214) 631-271 l. Sincerely, Jesse Valasquez 2.8.Bonds 2.8 .1. Bidder's Bond Proposals must be accompanied by a bidder's bond in the amou nt of five percent (5%) of the largest possible total of t he cost estimate . Al terna tively , the City will accept a cashier's check , in said amount , with the City named as pa yee , to be held in escrow until the successful Cont ractor signs the project contract. Th is bond w ill serve as a guarantee that the successful Contractor will enter into an agreement with the C ity to perform the project. The bo nd is subject to forfe iture in the event t he successful Contractor fails to execute the contract documents w ithin 10 calendar days after the contract has been awarded . 2.8.2 . Payment and Performance Bonds Before beginning the work , the Contractor shall be required to execute to the C ity of Fort Worth, a payment bond if the contract is in excess of $25 ,000 , and a performance bond if the contract is in excess of $100,000 . The payment bond is solely for the protection and use of payment bond beneficiaries who have a direct contractual relationship with the Contractor or subcontractor to supply labor or material ; and in 100% the amount of the Contract. The performance bond is solely for the protection of the City of Fort Worth ; in 100% the amount of the Contract ; and conditioned on the faithful performance by Contractor of the work in accordance with the plans, specifications , and contract documents . Contractor must provide the payment and performance bonds , in the amounts and on the cond itions required , within 14 calendar days after Notice of Award . 2 .8 .3 . Requirements for Sureties The bonds shall be issued by a corporate surety duly authorized and permitted to do bus i ness in the State of Texas that is of sufficient financial strength and solve-ncy to the satisfaction of t he C ity. Th e surety mustmeet all requiremen t s of Article 7 .19-1 of the Texas Insurance Code . All bonds furnished hereunder shall meet the requirements of Chapter 2253 of the Texas Government Code , as amended . In addition , the surety must (1) hold a certificate of authority from the Un ited States Secretary of the Treasury to qualify as a surety on obligations permitted or required under federal law ; or (2 ) have obta i ned reinsurance for any liability in ex cess of $100 ,000 from a re insurer that is authorized and adm itt ed as a re insurer in t he state of T ex as and is the holder of a certific ate of authority from the U ntie d States Secretary of the Treasury to qual ify as a surety on obligations permitted or required under federal law . Sat is factory proof of any such reinsura nce shall be prov ided to the City upon request. The City , in its sole discretion , w ill determine th e adequ acy of the proof required herein . No suret ies will be accepted by the City that are at the time in default or delinquent on any bonds or which are interested in any litigation aga in st the City . Should any surety on th e Contract be determined unsatisfactory at any time by th e City , notice wil l be given to th e Contractor to that effect and the Contractor shall immed iatel y provid e a new surety satisfactory to the City . 2-15 ATTACH CASHIER'S CHECK OR BIDDER 'S BOND HERE 2-1 6 THE AMERICAN INSTITUTE OF ARCHITECTS I A/A Document l'.310 Bid Bond # ZA32576 KNOW ALL MEN BY THESE PRESENTS, that we !NTERCON ENVIRONMENT AL INC (H ere insert full name and address o r Cepl ti tle o f Contractor) TEXAS as Principal, hereinafter called the Principal , and A RCH INSURANCE COMPANY (He re insert full name and address or legal titl e o f Surely! 3 Parkway, Suite 1500 -Philad e lph ia , PA 19 102 a corporation duly organized under the laws of the State of MISSOURI as Surety, hereinafter called the Surety, are held and firmly bound unto C IYT OF FORT WOR TH IHue in~,, fu ll name and addrns o r lepl lltl e o f Owner) T EXAS as Obligee, hereinafter called the Obligee, in the sum of FIVE PE R CENT OF THE B ID AMOUNT Dollars ($ T BD ), for the payment of which sum well and truly to be made, the sa id Principal and the said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, fi rmly by these presents. WHEREAS, the Principal has submitted a bid for DEMOLI TI ON (Here inse r t full name, address and descri pti on o f pro jecU DEM 09-0 8 : ALLIANCE NMP NOW, THEREFORE, if the Obllgee shall accept the bid of the Principal and the Principal shall enter into a Contract w ith the Obligee in accordance w ith the terms of such bid, and give such bond or bonds as may be specified in the bidding or Contract Documents with good and suffic ient surety for the faithful performance of such Contract 11nd for the prompt payment of labor and material furnished in the prosecution thereof, or in the event of the fa ilure of the Principal to enter such Contract and give such bond or bonds, if the Principal shall pay to the Obllgee the difference not to exceed the penalty hereof between the amount specified in sa id bid and such larger amount for wh ich the Obligee may in good faith contract with another party to perform the Work covered by said bid, then this ob li gat ion shall be null 11nd vo id, otherwise to remain in full force and effect. Signed and sealed this 26TH day of MAY 2009 ,.... JNTER CON ENVI RONME NT AL JNC ~~la<:,l· ~ ..... LA~C....::;A ...... @_.........1ZJ:....1:.itn~~..;,.-Oi""",e...__ ___ , ~~ Angelica Petruzzelli Karen Andrews, Pr~~e n t _,(,-....,..! .... =:;C'>.....-.:-..1.-0,_Y--_____ . _______ 1 ARCr~ !.t4 SU RA NCE C~:}-JY P (Witn ess) ~ --\ Maria A . Gonzakz AIA DOCUMEN T A310 • BIO BONO • AIA ® • FEBR UARY 1970 ED • THE AMERICAN INSTITUT E O F ARCHITECT S, 1735 N.Y. AV E., N.W., WASHI NGTO N, D. C. 20006 (T i t/<?) ~- / (Seal) (Sea l) 1 POWER OF ATTORNEY Know All Men By These Presents : That the Arch Insurance Company, a corporation organized and existing under the laws of the State of Missouri, having Its principal office in Kansas City, M issouri (hereinafter referred to as the "Companyj does hereby appoint William A. Bailey, Maria A. Gonzalez , Anne M. Barber, Michael J. Friedrich and Dana M. Kuber of Bridgeview, IL (EACH) Its true and la*ful ·Attomey{,J-ln-F41Ct, to make, execute, seal, and deliver from the date of issuance d this power for and on its behalf as suriity, and as Its act and deed: Any and al bonds and undertakings EXCEPTION: NO AUTHORllY is granted to make, execute, seal and deliver bonds or undertakings that guarantee the payment or a>llection of any promisscry note, check. draft or letter of aedil . This authority does not permit the same obligation to be spit into two or more bonds in order to bring each such bond wllhln the dolar llrrilt d aulhorify as set forth herein. The Company may nwoke this appointment at any time. The execution cl such bonds and undertakings in pursuance . d · lheee .. preseti1s : shall be as binding upon the said Company as ·fully and amply to au intents and JUPOSN, as r ~ .-had ~ duty executed and acknowledged by Its reguarty elecled offlcerl at II pmcipa1 office In i<ansas City, i'A~ ·· · :,. · .. · ·· · . •• • • '• ·,· ... l This Power d Attorney Is executed by authority of resolutions .adopted by unanimous consent d the Board d Dlredcn d the Company on March 3, 2003, true and ~ c:aplN of which are heralnallar set forth and are hereby certified to by the undawigned Secndaly as being In ful force and effect "VOTED, That the ChannarJ d 118 Boad, the Prasidant. or Bl1Y Vice PrMldent. or their appointees designated In wrtllng and flied with the Sec.eta y, or the Secia y ltllll have the P-QM[_and authar.ily to. appoint agents an6 ~ and·un 1utfio nze thim to eX8alle on behalf d the Company, and attach the seal of the Company thereto, bonds Sid undartaki'lgl, racognlzancel, caib acts of Indemnity and other wrflqs, obQgatory In the nature thereof, and any euch offlcars of the Company may appoint agents for acceptance d process.• · This Power d Attorney ts ~. sealed and c:ertffled by facsinle under and by authority of the following reaolutlon adopted by the unaninous consent of the Board cl Directors of the Company on March 3, 2003: VOTED, That the slgnalLn of the Channar'I of the Botvd, the President, or any Vice President, or thei' appointees designated In writing and fled wllh the Seaetay, and the signature d the Sec:retay, the seal of the Compm,y, and certificatiol11 by the Seaetay, may be affixed by facsinle on any power d attorney or bond executed pursuant to lhe resolution adopted by the Board cl Directors on March 3 , 2003, and a,y such power so exea.rted , sealed and cer1lled with respect to any bond or undertakilg to which it Is attached, sha R continue to be valid and binding upon the Company. OO ML0013 00 03 03 Page 1 of 2 Prtnte& In U.S .A. In Testimony Whereof, the Company has caused this instrument to be signed and its corporate seal to be affixed by their authorized officers, this 1st day of May 20 08 . Attested and Certified STA TE OF PENNSYLVANIA SS COUNTY OF PHILADELPHIA SS Arch Insurance Company I, Brian C. Kuhn, a Notary Public, do hereby certify that Ma1in J. NUsen and J. Michael Pete perionally known 1o me to be the same persons whose names are respecllvely as Secntary and Vice President of the Arch lnstnmC& Compa,y, a Corporation organized a.nd ulsting under the laws al ~ state al M.Jssouri, subscribed to the foregQing Instrument. appearild befCJre me thil day In person and severaQy atknowledged that they being thereunto duly authortzad signed, sealed with the corpoi ale seal and delivered the said Instrument as the free and voluntary act al said corpoi"ation and as their own free and voluntary acts for the uses and purposes therein set forth. c:::::::=::., Brian C. Kutwl. Noisy Public My comm1u1on eocpns 12-0&-2011 CERTIFICATION l, Matin J. Nlsen. Secrebl y al the Arch Insurance Compa.y, do hereby certify that 1he altachec:I .Power al AJtiJnwJy dated May 1, 2008 on behalf of the person(s) • 1118d lllboYe 1a a true and carrect copy and that the same has bean in ful force and effect since the date thereof and Is in full force and effact on the date of this certfflcata; and I do b1her certify that the said J. Michael Pete. who 8X8CUted 1he Poww al Attanw,y as Vice PnNlidaat, WIii on the date -of execution cl the attached Power cl Attorney 1he duly elected Vice Pnllldant ~ the Arch ·lnaurance ~--- . -. ---- IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affix8d the r.1._ vnnnata of the Arch · Insurance Company on this 26th day of MAY, 2009 , 20_. This Power of AIIDmey linlls the acts of those named therein to the bonds and oodertalm,ga speclfically named therein and they have no authority to bild the Company except in the manner and to the extent herein stated. PLEASE SEND ALL CLAIM INQUIRIES RELATING TO THIS BOND TO THE FOLLOWING ADDRESS: Arch Surety 3 Parkway, Ste. 1500 Phlladelphla. PA 19102 OO ML0013 00 03 03 Page 2 of 2 Printed In U.S.A. 2.9. Disadvantage Business Enterprise (DBE) Utilization Requirements A DBE goal of 10% percent has been establ ished for th is contract. Contract Assurance -The contractor or subcontractor shall not discriminate on the basis of race, color , national origin , or sex in the performance of this contract. The contractor shall carry out applicable requirements of 49 CFR Part 26 in the award and administration of DOT assisted contracts . Failure by the contractor to ca r ry out these requirements is a material breach of this contract , which may result in the termination of this contract or such other remedy, as the recipient deems appropriate . Contractors shall make a good faith effort to subcontract with or purchase supplies from DBE firms . Contractors shall meet or exceed the stated goal or submit documentation of good faith effort for all applicable contracts to permit a determination of compliance with the specifications . DBE documentation consists of the Special Instructions to Bidders, the Subcontractor Utilization Form, the Prime Contractor Waiver Form , the Good Faith Effort Form , and the Joint Venture Form. Copies can be obtained from the City 's MWBE Office. 2.9.1. If Contractor equals or exceeds the project goal, they must submit the Subcontractor Utilization Form or the Joint Venture Form. 2.9.2 . If Contractor does not have subcontracting and/or supplier opportunities, they must submit the Prime Contractor Waiver Form. 2.9.3 . If Contractor has subcontracting and/or supplier opportunities but does not include DBE participation in an amount which equals or exceeds the project goal, they must submit the Subcontractor Utilization Form and the Good Faith Effort Form and documentation. 2.9.4 . If Contractor has subcontracting and/or supplier opportunities but does not include any DBE participation, they must submit the Subcontractor Utilization _FormandJbe_ Gooclfaith Effuct Eorm ancLdocumeA.tatioA~ - All DBE firms must be currently certified or in the process of being certified by the North Central Texas Regional Certification Agency (NCTRCA), or Texas Department of Transportation (TXDOT), Highway Division. For the purpose of determining contract compliance under the DBE program , businesses listed as DBE within the Utilization Plan must be certified as such prior to a recommendation for award being made to the City Council. Contractor shall submit the Subcontractor Utilization Form and /or the Good Fa ith Effort Form or the Pr ime Contractor Wai ver Form , o r the Joint Venture For m ("a nd doc um e nt at ion") as a ppro pri at e . The E nvi ron mental Ma nag e men t De partmen t must rec e iv e the documentation no later than 5:00 p.m ., five City busines s days afte r the bid op ening date, exclusive of the bid opening date . Contractor shall obtain a rece ipt from an employee of t he Env ironmental Management Department. Such receipt shall be evidence that the C it y receive d the documentation . The submission of the appl ic able comp leted fo rm (s) within th e all otted tim e will be consid e re d when determinin g the respons iv eness of the bi d . Fa ilure to comply with t he bi d spec ifica ti o ns , in clus iv e of the DBE requ ireme nts and documentation , shall render th e bid no n-respons iv e . The Good Fa ith Effort documentation sha ll demonstrate the Contractor 's commitmen t and honest efforts to utilize DBE (s). The burden of preparing and subm itt ing the Good ' 2 -17 Fai th Effo rt informati o n is on t he C o ntractor an d wi ll be eva lua ted as part of t he res pons iven es s to th e bid /prop osa l. A Co ntractor who inte nt io n al ly a nd/o r k now in gl y mis re pr ese nt s fact s on th e docu men t ati o n subm itt ed will co nst itute a bas is fo r cl ass ifi cat ion as non -res pon siv e a nd poss ible debarme nt. Qu es tio ns about D BE requireme nt s ma y be d irect ed to th e Ci ty 's DBE Bus iness Office at 817.392 .6 104 . C heck th e ap pro pr iate box/box es : lZl Th e follo win g DBE documents a re included in t his b id subm itta l , foll owin g th is page , bo u nd wi t hin th e response : _x_ Subcont racto r Ut ilization Form ~ Jo int V e nture Form x Pr ime Contractor Wa iver Form NIA Good Faith Effort Form D DBE documen ts will be delivered to the Environmental Management Department* no later than 5 :00 p .m ., five City business days after the bid open i ng date , exclusive of t he bid opening date . Prompt Payment -The prime contractor agrees to pay each subcontractor under th is prime con t ract for satisfactory perfo rmance of its contract no later than 30 days from the rece ipt of each payment the prime contractor rece ives. The p ri me contractor agrees further to return reta inage payments to each subcontractor w ithin 30 days after the subcontractor's work is satisfactorily completed . Any delay or postponement of payment from the above referenced time frame may occur onlyj or__good_gause__iollawin g_ written.-- approva lo f tneRec1p1en f. T hi s cl ause appl iesto both DBE and non-DBE subcon t ractors . c~ Signatu re Karen Andrews Name Pres ident Title lntercon Environmental , Inc . Company June 11 , 2009 Dat e NOTE: The Environmental Management Department's Administrative Offices are located in the City Hall Annex, 908 Monroe Street, t h Floor, Fort Worth , Texas 76102 . The Department's mailing address is 1000 Throckmorton . Fo rt Worth, Texas 76102 . 2-18 FOR T W"O RTH CITY OF FORT WORTH ENT1A Page 1 of 3 ----w· ~ I Disadvantaged Business Enterpri,e I Schedule of Subcontractors/Suppliers PRIME COMPANY NAME: lntercon Environmental, Inc. IXI DBE IHJ MWBE CNON-M/W/DBE PROJECT NAME : Noise Miti ation Pro·ect Removal of Asbestos-Co Materials & Demolition of Structures at Alliance Air ort BID DATE : May 28 , 2009 PROJECT NUMBER : DEM 09-08 : Alliance NMP I CITY 'S DBE PROJECT GOAL : 10% I Prime's DBE GOAL COMMITMENT: 10% Please read the following statements prior to executin' this form. Bidders/Offerors must provide i nfonnati on on all prospective subcontracttr(s)/suppliers who submit bids/quotations in support of this solicitation. Failure to complete this form , in its entirety with supporti ng d oc umentation, and received by the M naging Department on or before 5:00 p.m. five (5) City business days after bit opening, exclusive of bid open ing d ate , will result i n the bid bei ng considered non-responsive to the bid specifications. The bidder further agrees to provide, directly to the City upon request, co~plete and accurate infonnation regarding actual work perfonned by all subcontractors, including DBE(s) arrangements submitted w ith this bid. The bidder also agrees to tow an audit and/or examination of any books, records and files held by their company that will substantiate the actual work performed by the DBE(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 tenn i nating the contract or debannent 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 ~is ordinance and creates a material breach of contract may result in a detennination of an irresponsible offeror and barred from participating in City work for a perio~ of time not less than one (1) year. Prime contractors must identify by tier level of all subcontractors/suppli11 rs. Tier: means the level of subcontracting below the prime contractor/consultant i.e. a direct payment from the prime contractor to a subcontractor is considered 1•t ~er, a payment by a subcontractor to its supplier is considered 2nd.tier. The prime contractor is responsible to provide proof of payment of all tiered subcontractors identified as a DBE and counting those dollars towards meeting the contract committed goal. I Prime contractors must also provide the previous year's annual gross ~ceipts of all subcontractors/suppliers listed on the utilization fonn. This infonnation may be expressed i n the dollar ranges provided that column. I I Counting DBE Participation: If materials or supplies are obtained from a qBE manufacturer, count 100 percent of the cost of the materials or supplies towards the goal. If the materials or supplies are purchased f rom a DBE regular dealer, cou~, 60 percent of the cost of the materials and supplies toward the DBE goal. When materials or supplies are purchased from a DBE ne ither a manufacture nor a regular dealer, count the entire amount of fees or commissions charged for assistance in the procurement of the materials and supplies or fees or transportation charges for the deli~ry of the materials or supplies delivered to the job site. In all cases, the prime contractor is responsible to identify the amounts to be used toward the committeid DBE goal. If hauling services is utilized, separation of dollars for haul-in and haul out \is required. In addition, the prime will be given credit for utilizing a DBE hauling finn as long as the DBE owns and operates a least one fully licensed and operational true~ used on the contract The DBE may lease trucks from another DBE finn, including DBE owner- operated and receive full DBE credit The DBE may lease trucks from nqn-DBEs, including owner-operators, but will only receive credit for the fees and commissions earned by the DBE as outlined in the lease agreement Note: Be mindful of "1e 60% rule. I Rev . 5-30-03 FORT WORTH ..___ w ~ a a CITY) OF FORT WORTH SCHEDULE OF SUBCONTRACTORS/SUPPLIERS ATTAC ~ENT 1A Pa ge 2 of 3 Chec k this box D if any subcontractor/su pplier is a Sole Source andl identify by writing sole source by the subcontractor/supplier name. NAMES AN D ADD RESSES OF TYPE OF WO i K TO BE PERFORMED Specify CERTIFIED DBE PREVIOUS YEAR 'S SUBCONTRACTOR S/SUPPLIERS Tier FIRM ANNUAL GROSS I RECEIPTS ( check one) N a me : CBA S ervices , Inc. Type of Work: i Yes ..L No_ _ less than $500K Add ress: 5877 Ba rnett Road , Suite A Asbestos Waste Hauling Krum, Texas 76249 I Certified By: _ $500K to $2M ! P hon e : 940-482-9900 Tier I NCTRCA _x_ Fax: 940-482-3457 $AMOUNT: $2,ssp .oo TXDOT _x_ $2M to $5M -- Ema il : janao@cba-corp.com Other please more than $5M attach DBE certification - Contact Person : Jana Os bo rn Name: Tomas Reyes T rucking Type of Work: I I Yes ..L No _ less than $500K -Ad d ress: 3529 Pe oria Street Demo Waste 1auling Dallas , T exas 7 5 2 12 Certified By : _ $500K to $2M Ph o n e: (214) 63 1-2711 Tier I NCTRCA _x_ _x_ $2M to $5M Fax: (214) 9 0 5 -7565 $AMOUNT: $19 ,0f 3.10 TXDOT -- E m ail: maricela @reyestrucking.com Other __ please more than $5M I attach DBE certification - C o ntact Person : J esse Velasquez I I Name: Type of Work: I Yes -No - - less than $5 00K A dd ress: Certified By : -$500K to $2M P hon e: I NCTRCA -- Fax: $AMOUNT: I TXDOT -$2M to $5M -- I Othe r __ please Ema i l: more t han $SM I attach DBE certification - C o ntact Person : Nam e: Type of Wo r k : I Yes -No_ _ less than $500K A d dress: I Certified By : -$500K to $2M Ph o ne: I NCTRCA -- Fax: $AMOUNT: I TXDOT _ $2M to $5M -- Ema i l: Other pl eas e _ more than $5M attach DBE ce rtification Contact Person: I Rev. 5-30-03 FO R T WORTH "--, •. ~ NAM ES AND ADD RES SES OF SU BCONTRA CTOR S/SUPP LIERS Name: Ad d ress : Phone : Fax : E m ai l : C o n t act Person : Na m e: Ad d r ess: Phone : Fax : Email: Cont act Person: I I I CIT~ OF FORT WORTH SCHEDULE OF SUBCONTRACTOR/SUPPLIERS TYPE OF WO f K TO BE PERFORMED Specify CERTIFIED DBE Tie r FIRM Type of Work: I Yes No_ - I I Certifi ed By : NCTRCA --TXDOT --$AMOUNT : Oth er __ please attach DB E certification Ty pe of Wo r k: I Yes No -- Certi fi ed By: I NCTRCA -- $AMOUNT : I TXDOT --Other please I attach DB E certification AITA . ENT 1A Page 3 o f 3 PREVIOUS YEAR'S ANNUAL GROSS RECE IPTS I c heck o ne) _ le ss than $SOO K _ $SOOK to $2M _ $2M to $SM _ mo re t han $SM _ les s than $S OO K -$SOO K to $2M -$2M t o $SM _ mo re than $SM T h e u nd ers i gned b idder ag rees to enter i nto a formal agreement ,ith the DBE firms for work listed in this schedule, conditioned upon execution of a contract with the C ity of Fo rt Worth. The intentional and/or knowi~g misrepresentation of facts is grounds for consideration of disqualification and will result in the b id be i n g considered non-res ponsive to bid specificatior s . I ALL D BES M US T B E C ERTIFIE D BY T HE CITY OF FORT w q RT H PRIOR TO A RECOMMENDATION FOR AWARD TO THE CITY COUNCI L. A uthorized Signature Pre sid en t Title l ntercon Env iron menta l, Inc. Compa n y Name 210 S . Wa l nut C reek Drive Add r ess Mansfield, Te xas 76 063 Ci t y/Stat e/Z i p Code I Karen Andrews Pri nted Signature Contact Name and Title (if different) (817) 477-9995 Phone Number karen@intercon-envi ronmental.com Email Address June 11 2009 Date (817) 477 -999 6 Fax Number Rev. 5-30-03 ATTACHMENT 18 Page 1 of 1 City of Fort Worth Disadvantage Business Enterprise Specifications Intercon Env iron mental, Inc . Prime Company Name June 11. 2009 Prime Contractor Waiver Al li ance Noise Mitigation Project Re m ova l o f As b estos-Co ntaining Ma te rials and De molition o f Stru ctures Project Name DEM 09-08: Alliance NMP 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. 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 perfonn this entire contract without subcontractors? __ Yes _lL_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 perfonn 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 nonnal 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 DBE(s) on this contract, the payment therefore and any proposed changes to the original DBE(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 b the DBE~)_QO..lhis....c.o.ntcact.---- -by-an-authorized-officerorempto--yee of ffieC1fy.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 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 President Title Int e rc o n Environmental, Inc . Company Name 2 10 S Walnut Cr ee k Drive Address Mansfield. Te xas 76063 City/State/Zip Kar e n Andrews Printed Signature Kar e n Andr ews Contact Name (i f different) 81 7 -4 77 -9995 Phone Number 8 17 -4 77 -9996 Fax Number kare n@inte rco n -e nvi ronmental .co m Email Address June 11 . 2009 Date Rev . 5/30/03 Faith Effort information is on the Contractor and w ill be evaluated as part of the responsiveness to the b id/proposal. A Contractor who intentionally and /or knowingly misrepresen ts facts on the documentation subm itted will constitute a bas is for c lass ificat ion as non-respons ive and poss ible debarme nt. Ques ti ons about DBE requ ire ments may be d ire c ted to the C ity 's DBE Bus in ess Office at 817 .392 .6104 . Check the appropriate bo x/boxes : ~ The follow ing DBE documents are in cl uded in th is b id subm ittal , follow ing th is page , bound w ith in the response : _x __ Subcontractor Utilization Form _lli6_ Jo int Venture Form X Prime Contractor Waiver Form NIA Good Faith Effort Form 0 DBE documents will be delivered to the Env ironmental Management Department* no later than 5 :00 p .m., five City business days after the bid opening date , exclus ive of the bid opening date . Prompt Payment -The prime contractor agrees to pay each subcontractor under this prime contract for satisfactory performance of'its contract no later than 30 days from the rece ipt of each payment the prime contractor receives. The prime contractor agrees further to return retainage payments to each subcontractor within 30 days after the subcontractor's work is satisfactorily completed . Any delay or postponement of payment from the above referenced time _fr_§lme _!!l ay oc~u__r:_o_D ly fQI good ca !JfilLfallowin-9--wJitte n- -approvalo f tne~ecTpl en tTfiTsclause applies to both DBE and non-DBE subcontractors. CONTRACTOR: Signature Karen Andrews Name President Title lntercon Environmental , Inc . Company June 11 , 2009 Date N O TE : The Environmental Management Department's Administrative Offices are located in the City Hall Annex, 908 Monroe Street, 1h Floor, Fort Worth , Texas 76102. The Department 's mailing address is 1000 Throckmorton , Fort Worth , Texas 76102 . 2-18 2 10 South Waln ut Cre ek Drive • M ansfic '~. Tex as 76063 • Phone : (817 j 477 -9995 • Fax : (817 j 47i-9996 PROJECT CLOSEOUT Consultant: y S~MPLE CLOS ~ UT DOCUMENTATION ... · '• ~·.:,' \~"} .,. PREP.ARE FOR DEM 09-08 -,. -;,- ' Response to Section 2.6.3 lntercon Environmental, Inc. Project No. 09-XXX Prepared for: Mr. Roger Grantham C ity of Fort Worth 1000 Throckmorton Stre et Fort Worth, Texas 76102 May 28, 2009 E NVI RO NM ENT/>,L , IN( www.intercon-environme nta l.cor ENVIRONMENTAL, INC. Table of Contents 1. Invoice 2. Notification 3. ,t. 4. Proje'C:fJ{e<::ords: ,~~~" '.! ·'*-:f,. i. Daily l:pgs ii. Daily T ~~. Sheets iii~ ·contai nm~t~·v(ogs (if applicable) ' ' .·~~-*• )' --~ ------. ,. Workers' P'aperwork: i. DSHS Asbestos Abatement License ·· ii . Asbestos Training Certificate ~ W. Medical Surveillance of Asbestos Exposure ~':k. ... ,.,;,· iv. Or RFCI cert i ficates 6. Texas DSHS Contractors License 7. Texas DSHS Transporter License 8 . Waste Man i fest (i f appl i cab l e) ------- ' tercon ENVIRONMENTAL, INC. 210 S . Walnut Creek Drive, Mansfield, T a-...:as 76063 Telephone (81 7) 477-9995 -Facsimile (81 7) 4 77-9996 Bill To P .O.No. Description 1--.-.,-- Terms Invoice Date Invo ice # 5/1 1/2 009 09 -034 .506N Proj ect I Rate Amount To t & $0.00 ' 2.12. Prevailing Wage Rates and Davis Bacon Requirements The Contractor selected for this project will be required to comply w ith TEXAS GOVERNMENT CODE , Chapter 2258 , with respect to payment of Prevailing Wage Rates for public works contracts and the Davis-Bacon Act , whichever is higher for building and construction trades . Cop ies of these rates are located below and made a part thereof the same as if it were copied verbatim herein . Contractor(s ) agree(s) to forfeit as a penalty to the City ten dollars ($10 .00) for each laborer, workman, or mechanic employed , for each calendar day, or portion thereof for such laborer , workman , or mechanic who is paid less that the required rates for any work done under this contract , by it, or by any subcontractor under him/her. The cur rent wage scale for members of the Building and Construction trade immediately follows this section . A worker employed on a public work by or on behalf of the City of Fort Worth shall be paid not less than the general prevailing rate of per diem wages for work of a similar character in the locality in which the work is performed ; and not less than the general prevailing rate of per diem wages for legal holiday and overtime work. A worker is employed on a public work if the worker is employed by a contractor or subcontractor in the execution of a contract for the public work with the City of Fort Worth . The contractor who is awarded a public work contract. or a subcontractor of the contractor, shall pay not less than the prevailing wage rates to a worker employed by it in the execution of the contract. A contractor or subcontractor who violates this requirement shall pay to the City of Fort Worth, $60 for each worker employed for each calendar day or part of the day that the worker is paid less than the wage rates stipulated in the contract. This requirement does_ not pwbibit tbe-contracto~ or sYbwrnr-aster fmrn paying-aA- employee an amount greater than the prevailing wage rate . DAVIS BACON REQUIREMENTS (29 CFR Part 5) 1. Minimum Wages (i) All laborers and mechanics employed or working upon the site of the work will be paid unconditionally and not less often than once a week , and w ithout subsequent deduction or rebate on any account (except such payroll deductions as are permitted by th e Secretary of Labor under the Copeland Act (29 CFR Part 3)), the fu ll amount of wages and bona fide fringe benefits (o r cash equiva len t thereof) due at tim e of paymen t computed at rates not less than those contained in the wage determination of the Secretary of Labor wh ich is attached hereto and made a part hereof, reg ardless of any contractual rel ationsh ip which may be alleged to exist between the contractor and such laborers and mechanics. Contributions made or cost s reasonably ant ici pated for bona fide fr inge be nefits under section 1 (b )(2) of the Da vi s-Ba con Act on behalf of laborers o r mechanic s are considered wages paid to such laborers or mechanics , subject 2-14 ' to the provisions of paragraph (1 )(iv ) of this section ; also , regular contr ibutions made or costs incurred for more than a weekly period (but not less often than quarterly) under plans , funds , or programs which cover the particular weekly period , are deemed to be constructively made or incurred during such weekly period . Such laborers and mechanics shall be paid the appropriate wage rate and fr inge benefits on the wage determination for the classification of work actually performed , without regard to skill , except as provided in 29 CFR Part 5 .5(a)(4). Laborers or mechanics performing work in more than one classification may be compensated at the rate specified for each class ificat ion for the time actually worked there in: Provided, That the emp loyer's payroll records accurately set forth the time spent in each classification in wh ic h work is performed . The wage determination (including any additional classificat ion and wage rates conformed under (1 )(ii) of th is section) and the Dav is-Bacon poster (WH-1321) shall be posted at all times by the contractor and its subcontractors at the site of the work in a prominent and access ible place where it can easily be seen by the workers . (ii)(A) The contracting officer shall require that any class of laborers or mechanics, including helpers, which is not listed in the wage determination and wh ich is to be employed under the contract shall be classified in conformance w ith the wage determination. The contracting officer shall approve an add itional classification and wage rate and fringe benefits therefore only when the following criteria have been met: (1) The work to be performed by the classificat ion requested is not performed by a classification in the wage determ ination ; and (2) The classification is utilized in the area by the construction industry ; and (3) The proposed wage rate , in cludmgany bona trae·lnnge oe ne fits, -- bears a reasonable relationship to the wage rates contained in the wage determination . (8) If the contractor and the laborers and mechanics to be employed in the classification (if known), or their representatives , and the contracting officer ag ree on the classification and wage rate (i ncluding the amount des ignated for fringe benefits where appropriate), a report of the act ion taken shall be sent by the contract ing officer to the Adm inistrator of t he Wage and Hour D ivi sion , Emp loym ent Standards Adm ini stra ti o n, U .S . Departm ent of Lab o r , Washin gton, D.C . 20210 . The Adminis trato r , o r an authorized repres entativ e , will approve , modify , or disapprove every add itional classifica t ion action w ithin 30 days of receipt and so adv ise the cont ract in g officer or will notify the contracting officer within th e 30-day period that additional time is necessary . (C) In the event the contractor, the laborers or mechan ics to be employed in th e cl assification or their representatives , and the contracting officer do not ag ree o n the p ropos ed class ification and wage rate (in clud in g the amount design ated for fring e benefi ts where appropriate), the contracting officer shall refer the questions , includin g the views of all interested parties and the 2-15 recommendation of the contracting officer, to the Admin istrator for determination . The Administrator , or an authorized representative , will issue a determination within 30 days of receipt and so adv ise the contracting officer or will notify the contracting officer within the 30-day period that additional time is necessary . (D) The wage rate (including fringe benefits where appropr iate ) determined pursuant to subparagraphs (1 )(ii) (B) or (C) of this paragraph , shall be pa id to all workers performing work in the classification under this contract from the first day on which work is performed in the classification . (i ii) Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly cash equivalent thereof. (iv) If the contractor does not make payments to a trustee or other third person , the contractor may consider as part of the wages of any laborer or mechanic the amount of any costs reasonably anticipated in providing bona fide fringe benefits under a plan or program, Provided, That the Secretary of Labor has found , upon the written request of the contractor, that the applicable standards of the Davis-Bacon Act have been met. The Secretary of Labor may require the contractor to set aside in a separate account assets for the meeting of obligations under the plan or program . 2 Withholding. The Federal Aviation Administration or the Sponsor shall upon its own action or u130n-written--request-of an autborize.d repmseritativEL.oLth ~De~ment of Labor withhold or cause to be withheld from the contractor under this con tract-or any - other Federal contract with the same prime contractor, or any other Federally- ass isted contract subject to David-Bacon prevailing wage requirements , which is held by the same prime contractor , so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics , including apprentices, trainees, and helpers , employed by the contractor or any subcontractor the full amount of wages required by the contract. In the event of failure to pay any laborer or mechanic , including any apprentice , tr ainee , or helper, employed or working on the site of work , all or part of the wages requi re d by th e contract, th e Federal Aviation Administration may , after writt en notice to the contractor , sponsor, appl icant, or owner, take such action as may be necessary to cause the su s pen sion of any furt her payme nt , adv a nc e , or gua ra ntee of fund s unti l suc h violation s ha ve ce ased . 3 . Pa y rolls a nd bas ic record s . (i) Pa yrolls and basic records relating thereto shall be ma int a in ed by th e co ntractor during the cours e of the work and preserved for a period of three years thereafter fo r all laborers and mechani c s working at the site of t he w o rk . S uc h rec ords sh all co nt ain the na me , addre ss, an d social se c urity numb e r of 2-16 each such wo rker , his or her correct classification , hourly rates of wages paid (including rates of contributions or costs ant icipated for bona fide fr inge benefits or cash equivalents thereof of the types described in 1(b)(2 )(B) of the Davis- Bacon Act), daily and weekly number of hours worked , deductions made and actual wages paid . Whenever the Secretary of Labor has found under 29 CFR 5 .5(a)(1 )(iv) that the wages of any laborer or mechanic include the amount of any costs reasonably anticipated in prov iding benefits under a plan or program described in section 1 (b)(2)(B) of the Davis-Bacon Act , the contractor shall maintain records which show that the commitment to prov ide such benefits is enforceable , that the plan or program is financially responsible , and that the plan or program has been communicated in writing to the laborers or mechan ics affected , and records which show the costs anticipated or the actual costs incurred in providing such benefits . Contractors employing apprentices or tra inees under approved programs shall maintain written evidence of the registration of apprenticeship programs and certification of trainee programs , the registration of the apprentices and trainees , and the ratios and wage rates prescribed in the applicable programs. (ii)(A) The contractor shall submit weekly, for each week in which any contract work is performed, a copy of all payrolls to the applicant , sponsor, or owner, as the case may be, for transmission to the Federal Aviation Administration . The payrolls submitted shall set out accurately and completely all of the information required to be maintained under paragraph 5.5(a)(3)(i) above . This information may be submitted in any form desired. Optional Form WH-347 is ava ilable for this purpose and may be purchased from the Superintendent of Documents (Federal Stock Number 029-005-00014-1 ), U.S. Government Printing Office , Washington, D.C. 20402. The prime contractor is respons ible for the submission of copies of payrolls by all subcontractors. (B )-Eaeh-~ayr-el l-su emitte4---shall be-aGGOmpanied-b-¥--a ~S1ate.m.en.L af __ Compliance ," signed by the contractor or subcontractor or his or her agent who pays or supervises the payment of the persons employed under the contract and shall certify the following: (1) That the payroll for the payroll period contains the information required to be maintained under paragraph (3)(i) above and that such information is correct and complete ; (2 ) That each laborer and mechanic (i ncl uding ea ch helpe r , appre ntic e a nd tra inee ) employed on the co ntract d u ring th e payro ll perio d has been pa id the full weekly w ages earned , without rebate , ei ther d ire ctly or indi rectly , and th at no de ductio ns hav e been m ad e e it her directly or indirectly from th e full wages e arned , other than permiss ible deductions as set forth in Regulations 29 CFR Pa rt 3 ; (3 ) Th at eac h labo rer or me c ha nic has bee n pa id not less t han th e applica ble w age rate s an d frin ge benefits or cash equi valen ts for t he class ifi cation of work performed , as sp eci f ied in t he a p pl ic ab le wage determ inat ion inco r po rat e d into t he contract. 2 -1 7 (C) The weekly submiss ion of a prope r ly executed certification set forth on the reverse s ide of Optional Form WH-347 shall satisfy the requi rement for subm ission of the "Statement of Compliance" requ i red by paragraph (3 )(ii)(B ) of this sect ion . (D) The falsification of any of the above cert ifi cations may subject the contractor or subcontractor to civil or criminal prosecut ion under Section 1001 of T itle 18 and Section 231 of T itle 31 of the United States Code . (ii i) The contractor or subcontractor shall make the records required under paragraph (3)(i) of this section ava ilable for inspection , copying or transcription by authorized representatives of the Sponsor, the Federal Avia ti on Administration or the Department of Labor , and shall permit such representatives to interview employees during working hours on the j ob . If the contractor or subcontractor fails to submit the required records or to make t hem available , the Federal agency may , after written notice to the contractor, sponsor, applicant or owner, take such action as may be necessary to cause the suspension of any further payment, advance, or guarantee of funds . Furthermore , failure to submit the required records upon request or to make such records available may be grounds for debarment action pursuant to 29 CFR 5 .12 . 4 . Apprentices and Trainees. (i) Apprentices . Apprentices will be permitted to work at less than the predetermined rate for the work they performed when they are employed pursuant to and individually registered in a bona fide apprenticeship program reg istered w ith the U .S . Department of Labor, Employment and Training Administration , Bureau of Apprenticeship and Training , or w it h a State App refltieesh4J;r-A§eAG-Y-F0GGgnized-by -the--Bur:eau,_oLlt a pers.o.n_Js_employ ed i o__ his or her first 90 days of probationary employment as an apprentice in such an apprenticeship program , who is not ind ividually reg istered in the program , but who has been certified by the Bureau of Apprenticeship and Training or a State Apprent icesh ip Agency (where appropriate) to be eligible for probationary employment as an apprentice . The allowable ratio of apprent ices to journeymen on the job site in any craft classification shall not be greater than the ratio perm itted to t he contractor as to the ent ire work force under the reg istered program . Any worker listed on a payroll at an apprentice wag e rate , who is not reg istered or otherwise employed as stated above , shall be paid no t less than the applicable wage rate on the wage determination for the classification of work actually performed . In addit ion , any apprentic e perform in g work on the job site in excess of the ratio permitted under the re gistered program shall be paid not less than the applicable wage rate on the wage det erm ination for the work actually performed . Where a contractor is perform in g cons truct ion on a project in a lo cali ty other than that in which it s program is reg istered , the rat ios and wage rates (expressed in percentages of the journeyman 's hourly rat e ) specified in the contractor's or subcontractor's registere d program sha ll be observed . Every apprentice must be pa id at not le ss than the rate specified in the regis tered pro gra m for the apprenti c e 's lev el of progress , expressed as a percentage of the journeymen hourly rate specified 2-18 in the applicable wage determination . Apprentices shall be paid fr in ge benefits in accordance with the prov isions of the apprenticeship program . If the apprent iceship program does not specify fringe be nefits , apprentices must be paid the full amount of fringe benefits listed on t he wage determination for the applicable classification . If the Admin istrator determines that a different practice prevails for the applicable apprentice classification , fringes shall be paid in accordance with that determination . In the event the Bureau of App rent ic esh ip and Training , or a State App renticeship Agency recognized by the Bureau , withdraws approval of an apprenticeship program, the contractor will no longer be permitted to utilize apprentices at less than the applicable predeterm ined rate for the work performed until an acceptable program is approved. (ii) Trainees . Except as provided in 29 CFR 5.16 , trainees will not be perm itted to work at less than the predetermined rate for the work performed unless they are employed pursuant to and individually registered in a program which has received prior approval , evidenced by formal certification by the U.S. Department of Labor, Employment and Training Administration . The ratio of trainees to journeymen on the job site shall not be greater than permitted under the plan approved by the Employment and Training Administration . Every trainee must be paid at not less than the rate specified in the approved program for the trainee's level of progress, expressed as a percentage of the journeyman hourly rate specified in the applicable wage determination . Trainees shall be paid fringe benefits in accordance w ith the provisions of the trainee program . If the trainee program does not mention fringe benefits , trainees shall be paid the full amount of fringe benefits listed on the wage determination unless the Administrator of the Wage and Hour D ivi sion determines that there is an apprenticeship program associated with the corresponding journeyman wage rate on the wage determination which provides for less than full fringe benefits for apprentices . Any employee listed u n-ttre-payrolt-at-a-trainee-rate-who-is-not-registered-and-l}aftiei13atiA9-iA--a-- training plan approved by the Employment and Train ing Administration shall be paid not less than the applicable wage rate on the wage determination for the classification of work actually performed . In addition , any trainee perform ing work on the job site in excess of the ratio permitted under the reg istered program shall be paid not less than the applicable wage rate on the wage determ in ation for the work actually performed . In th e event t he Employment and Training Adm inistration withdraws approval of a training program , the contractor will no longer be permitted to utilize trainees at less th an the applicable pre dete rmined rate for the work performed until an ac ceptable program is approved . (iii) Equa l E mployment Opportunity. The ut iliza tion of apprentices , trainees and journeymen under th is part shall be in conform ity w ith the equal emp loyment opportunity requirements of Executive Order 11246 , as amended , an d 2 9 CF R Pa rt 30 . 5. Compliance w it h Co pe land A ct Req uire ments . The con t ractor shall co mply w ith the req uire men ts of 29 C FR Pa rt 3, which are inc orporated by re fere nce in this contract. ' 2 -19 I 6 . Subcontracts . The contractor or subcontractor shall in sert in any subco ntrac ts the clauses contained in 29 CFR Part 5.5(a )(1) through (10 ) and such othe r clauses as the Federal Aviation Administration may by appropriate instructions require , and also a clause requiring the subcontractors to include these clauses in any lo we r tier subcontracts . The pr ime contractor shall be respons ible for the compliance by any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR Part 5.5. 7. Contract Termination: Debarment. A breach of the contract clauses in paragraph 1 through 10 of this section may be grounds for termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29 CFR 5.12. 8 . Compliance with Davis-Bacon and Related Act Requirements. All rul ings and interpretations of the Davis-Bacon and Related Acts contained in 29 CFR Parts 1, 3, and 5 are herein incorporated by reference in this contract. 9. Disputes Concerning Labor Standards. D isputes aris ing out of the labor standards provisions of this contract shall not be subject to the general disputes clause of this contract. Such disputes shall be resolved in accordance with the procedures of the Department of Labor set forth in 29 CFR Parts 5, 6 and 7. Disputes within the meaning of this clause include disputes between the contractor (or any of its subcontractors) and the contract ing agency; the U. S:--Department-of Labo r;-or-the-employees Of their rel:)resentattves:---- 10. Certification of Eligibility . (i) By entering into this contract , the contractor certifies that neither it (nor he or she) nor any person or firm who has an interest in the contracto r's firm is a person or firm ineligible to be awarded Government contracts by virtue of section 3(a) of the Dav is-Bacon Act or 29 CFR 5 .12 (a)(1 ). (ii) No part of this contract shall be subcontracted to any perso n or firm ine ligible for awa rd of a Go vernmen t contract by virtue of sect ion 3(a) of th e Davis-Bacon Act or 29 CFR 5.12(a)(1). (iii) The penalty for making false statements is prescribed in the U.S. Crim inal Code , 18 U.S .C . 100 1. The undersigned acknowledges the requirements of Chapter 2258 of the Texas Government Code and the Davis Ba con Act , and in tends to comp ly with same in the execution of this project. ' 2-20 c~ lntercon Environmental Inc . S ignature Company Karen Andrews June 11 , 2009 Name Date President T it le 2-21 i Davis Bacon Wage Rate General Deci sion Number: TX20080044 07 /25/2008 TX 44 Superseded General Dec ision Number: TX20070046 State : Texas Construction Type : Heavy Count ies : Johnson , Parker and Tarrant Counties in Texas . Heavy Construction Projects (Including Water and Sewer Lines ) Modification Number Publ ica tion Date 0 02/08/2008 1 05/09/2008 2 07/25/2008 * PLUM0146-002 05/01 /2008 Plumber/Pipefitter Carpenter Concrete Finisher Electrician Form Setter Laborers: Common Utility Painter Pipelayer Power equipment operators : Rates $ 25 .06 $ 10.40 $ 9 .81 $ 13.26 $ 7 .86 $ 6.55 $ 8 .09 $10 .89 $ 8.43 Backhoe $ 11 .89 Bulldozer $ 10 .76 Fringes $6 .76 $3 .64 $3 .30 crane-$ tS-;1 6-$3.30-- Front End Loader $ 10.54 Mechanic. $ 10 .93 Scraper $ 10.00 Reinforcing Steel Setter $ 10.64 Truck Driver $ 7 .34 Welders -Receive rate prescribed for craft performing operation to which welding is incidental. Unlisted classi fications ne ede d for work not included wit hin the scope of th e classifications li st ed may be added after aw ard on ly as provid ed in the labor standard s contract cl auses (29CFR 5 .5 (a) (1) (ii)). In the listing above , the "SU" desi gnat io n means that rates listed under the identifi er do not reflect collectiv ely bargained wage and fringe benefit rates . Other designations indicate unions whose rates have been determined to be pre vailing . 2-22 City of Fort Worth Building & Construction Trades Prevailing Waqe Rates For 2008 Classifications Hourly Rates Classifications Hourly Rates Air Cond itioninq Mechanic $23 .95 Shee trock Hanq e r $13 .37 Ai r Co nd iti o ni nq Mecha nic Helper $15.00 Sheetrock Hanqer He lp er $9 .4 8 Acoust ic Ce ilinq Installer $16 .25 Sprin kle r System Installer $20 .50 !Acoust ic Ceilina Installer Helper $10 .53 Sprinkler System In staller Hel per $1 1 .00 Bricklayer/Stone Mason $19 .88 Steel Worker Structural $19 .72 Bricklayer/Stone Mason Helper $10 .54 Steel Worker Structu ral Helper $11 .71 Carpenter $19 .03 Welder $18 .82 Carpenter Helper $14 .69 Welder Helper $13 .95 Concrete Finisher $14.95 Concrete Finisher Helper $10.09 Concrete Form Builder $15.40 Concrete Form Builder Helper $8 .81 Drvwall Taper $13 .00 Drvwall Taper Helper $11 .70 Electrician Journevman $23.00 Heavv Eaui pment Op erato rs Ho urly Rates Crane , Clamshell , Backhoe , Electrician Helper $16 .51 Derrick, Draqline , Shovel $20 .17 Electronic Technician $23.18 Forklift Operator $13 .33 Electronic Technician Helper $13.36 Foundation Drill Operator $17 .55 Floor Laver (Carpet) $15 .17 Front End Loader Operator $13 .16 Floor Laver (Resilient) $20 .72 Truck Driver $17 .17 Floor Layer Helper $13 .72 Gtazie r--------$-2--1-.9-2 ------ Glazier Helper $15.82 Insulator (Pipe) $17 .95 Insulator Helper (Pipe) $13.40 Laborer Common $11.93 Laborer Skilled $14 .98 Lather $18 .60 Lather Helper $11 .12 Me tal Bu il d ing Assemb ler $14 .29 Metal Buil d in q As se m bler He lper $9 .3 3 Pa inter $17.42 Pa in ter Helper $8 .00 Pipefitter $20 .82 Pi pefitter Helper $14 .77 Plasterer $19 .93 Plasterer Helper $14 .16 Reinforcinq Steel Setter $12 .50 Roofer $1 4 .0 0 Roofer Helpe r $10 .00 Source is Fort Worth Chapter Sheet Metal Worke r $19.45 Associated Gene ral Contractors (www .Quoin .o rg ) 2 -23 Ishee! Metal Worker Helper $14 .52 01 /30 /2008 2-24 2.13. Insurance Certificates A successful Con t ractor will be required by th e contract to have insurance coverage as deta iled below. Contractor must provide Certificates of Insurance in the amounts and for the coverages required to th e Env ironmental Management Department, Adm ini strative Offices , w ithi n 14 calendar days after Notice of Award . (a) Insurance coverage and limits : (b ) 1. Commercial General Liability Insurance o $1 ,000 ,000 each occurrence o $2 ,000 ,000 aggregate 2 . Professional Liabil ity Insurance -NOT APPLICABLE . 3. Automobile Liability Insurance 5 . 6 . Coverage on vehicles involved in the work performed under thi s contract: o $1 ,000,000 per accident on a combined single limit bas is 2r: o $500,000 bodily injury each person ; $1 ,000 ,000 bod ily injury each accident ; and $250 ,000 property damage The named insured and employees of Contractor shall be covered under this policy. The City of Fort Worth shall be named an Additional Insured , as its · interests may appear. Liability for damage occurring while loading , unloading and transporting materials collected under the Contract shall be included under this policy . Workets-comp-ensation-------- o Coverage A: statutory lim its o Coverage B : $100 ,000 each accident $500 ,000 disease -pol icy limit $100 ,000 disease -each employee Environmental Impairment Liabil ity (Ell) and /or Pollution Liability $2 ,000 ,000 per occurrence . Ell cove rage(s ) must be included in policies listed in subsections 1 and 2 above ; or, su ch in s urance shall be pro v id ed under sepa rate pol icy(s). Liabi lity for damage occu rri ng w h il e lo ad ing , unloadi ng and t ransport ing materials collected under the contract shall be included under the Automobile Liability insurance or other policy(s). Asbestos Abatement Insurance -$2 ,000,000 each occurrence with no Sunset Clause . Certificates of Insura nce evidencing that the Contractor has obta ined all req uired insurance shall be delivered to the C ity prior to Contractor proceed ing with the contract. ' 2-25 1. Applicable pol ici es shall be endo rsed to na me t he City a n Additional Insured thereon , as its interests may appear. Th e term City shall include it s employees , officers, officials , agents , and vo lu nteers as respects the contracted se rvic es . 2 . Certificate(s) of Insurance shall document that insurance cove rage specified according to it ems in secti on 2.13 (a) a re provid ed under appl icable policies documented th ereon . 3. Any failure on part of the City to request required in surance documentation shall not const it ute a waiver of th e in surance requirements. 4. A minimum of thirty (30) days not ice of cancellat ion or material change in coverage shall be provided to the City . A ten (1 0) days notice shall be acceptable in the event of non-payment of premium . Such terms shall be endorsed onto Contractor's insurance policies. Notice shall be sent to Brian Boerner, Director, Env iro nmental Management Department, City of Fort Worth , 1000 Throckmorton St., Fort Worth , Texas 76102. 5. Insurers for all policies must be authorized to do bus iness in the state of Texas or be otherwise approved by the C ity ; and , such insurers shall be acceptable to the C ity in terms of their financial strength and solvency . 6 . Deductible limits , or self-insured retentions , affecting insurance required herein shall be acceptable to the City in its sole discretion ; and , in lieu of traditional insurance, any alternative coverage maintamealnroug ninsurancep ools onisl< rel'ention -groups mosroe also approved . Dedicated financ ial resources or Letters of Cred it may also be acceptable to the City . 7. Applicable policies shall each be endorsed w ith a waiver of subrogation in favor of the City as respects the cont ract. 8. The City shall be entitled , upon its request and w ithout incurrin g expense , to review the Co ntractor's insurance policies in clud in g endorsements thereto and , at the City's discretion , the Contractor may be require d to provide proof of insurance premium payments . 9. The Commerci al General Liability insurance policy shall have no exclusions by endorsements unless the City approves such exclusions. 10 . Th e City shall not be responsible for th e direct payment of any insurance premiums requ ired by the contract. It is understood th at insurance cost is an allowable component of Contractor's overhead . ' 2-26 i 11 . All insurance required in Sectio n 2 .13 (a ) above , exc ept for t he Professional Liabil ity insuran c e policy , shall be w ritten on an occurrence basis in ord er to be ap proved by the C ity . 12 . Subcontractors to the Contractor shall be required by t he Contractor to maintain the same or reasonably equivalent insurance coverage as requ ired for the Cont ractor. When subcontractors ma intain insurance coverage , Contractor shall provide City w ith documentation thereof on a certificate of insurance . Notw ithstanding anything to the contrary conta ined here in, in the event a subcontractor's insurance coverage is canceled or term inated , such cancellation or termination shall not constitute a breach by Contractor of the contract. FOR PURPOSES OF EVALUATING THIS BID, PLEASE ATTACH A COPY OF YOUR CURRENT INSURANCE CERTIFICATE(S) HERE AND BOUND WITHIN THE BID PACKAGE . 2-27 2.14. Workers Compensation Insurance Coverage A. Definitions : Certificate of coverage ("c ert ificate "). A copy of a cert ificate of insurance , a cert ificate of authori ty to self-insure issued by the commiss ion , o r a coverage agreement (TWCC-81 , TWCC-82 , TWCC-83 , or TWCC-84 ), show in g statutory workers ' compensation insurance cove rage for the person or ent ity 's employees prov iding serv ices on a project , for the durat ion of the proj ect. Duration of the project-includes the t ime from the beginning of the work on the project until the Contractor's/person 's work on the project has been comple t ed and accepted by the governmental entity. Persons providing services on the project ("subcontractor" in Texas Labor Code , 406 .096) -includes all persons or entities performing all or part of the serv ices 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-ope rators , employees of any such entity , or employees of any entity , which furnishes persons to provide services on the project. "Services " include , w ithout limitation , providing , hauling, or delivering equipment or materials, or providing labor, transportation , or other service 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 provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements , whic n meels tfie s fatu ory requirements ofTexasCab or Cocfe, Section 40T:tr1 'r (44) for all emp loyees 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 City prio r to being awarded the contract. D . If the coverage period shown on the Contractor's current cert ificate of coverage ends during the duration of the project , the Contractor must , prior to t he en d of the co verage period , file a new ce rti fica te of cov e rage wit h the C ity showing th at coverage ha s been ex tended . E. The Contractor shall obtain from each person providing serv ices on a project , and prov ide to the City : (1) a cert ificate of cov erage , prior to that person beginning work on the proj ect, so th e City wi ll have on file certific ates of coverage show in g coverage for all pers on s providin g serv ice s on the project ; and (2) no later th an seven (7) days after receip t by the Contractor , a new 2 -2 8 certificate of coverage show ing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project. 2-29 B. The Contractor shall retain all required certificates of coverage for the duration of the project and for one year th ereafter . C . The Contractor shall notify the City in writin g by certified mail or personal delivery , within ten (10) days after the Contractor knew o r should have kn own , of any change that materially affects the provision of coverage of any person prov iding services on the proj ect. D . The Contractor shall post on each site a notice , in the text , form and manner prescribed by the Texas Workers ' Compensation Commission , informing all persons provid ing services on the project that they are required to be covered , and stating how a person may verify coverage and report lack of coverage . (see paragraph II) E . The Contractor shall contractually require each person w ith whom it contracts to provide services on a project , to : (1) provide coverage , based on proper reporting on classification codes and payroll amount and filing of any coverage agreements, wh ich 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 beginn in g work on the project , a certificate of coverage showing that coverage is being provided for all employees of the person providing serv ices on the project, for the duration of the project; (1.)_ piill!ida tlla Contractos ,_pJ LOL!QJba end Qf the c_overa 9.§_ periodJ new cert ificate of coverage showing extens ion of coverage , if the coverage period shown on the current certificate of coverage ends during the du ration of th e project ; (4) obtain from each other person with whom it contracts, and prov ide to the Contractor: (a) a certi fic ate of coverage , prior to the othe r person beginning work on the project; and (b) a ne w ce rt ificate of coverage showing extension of coverage, prior to the end of the coverage period, if the coverag e period shown on the current certificate of covera ge ends du rin g the duration of t he project; (5) retain all required cert ificates of coverag e o n fil e for the duration of the project and for on e ye ar th e reafter ; (6) notify the C ity in writin g by certified ma il or personal del iv e ry , wi thin ten ( 10 ) days after the per son knew or should have known , of any change that materi ally affects the prov ision of coverage of any person provi d in g servic es 2-30 on the proj ect; and (7) contractually require each person w ith whom it contracts , to perfo rm as requ ired by paragraphs (1) -(7), with the cert ificates of cov erage 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 certific ate of coverage , the Contractor is representing to the City that all employees of the Contractor who will provide services on the project will be covered by workers' compensation coverage for the duration of the proj ect , that the coverage will be based on proper reporting of classification codes and payroll amounts , and t hat all coverage agreements will be filed w it h the appropriate insurance carrier or , in case of a self-insured , with the comm ission 's Division of Self-Insurance Regulation. Providing false or mislead ing information may subject the Contractor to administrative penalties, criminal penalties , civil penalties or othe r civil actions . K. The Contractor's failure to comply with any of these provisions is a breach of contract by the Contractor wh ich entitles the governmental entity to declare the contract void if the Contractor does not remedy the breach within ten (10) days after receipt of notice of breach from the governmental entity . L. Contractor posting required . 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 Workers ' Compensation Act or other Texas Workers' _Comgensation commission rules. Th is notice mus~inted w ith 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 wo rk er population. The text for the notices shall be the follow i ng text, w ithout any additional words or changes : "REQUIRED WORKERS ' COMPENSATION COVERAGE " 'The law requires that each person work ing on this site or providing services related to this construction project must be covered by workers ' com pe nsation 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 Comm ission at 512 /440-3789 to rece iv e information on the legal requirement for coverage , to verify wheth er your employer has provid ed the re quired coverage , or to report an employer 's fa ilure to provide coverage ." ' 2-3 1 CONTRACTOR COMPLIANCE WITH WORKERS' CO M PENSATION LAW Pursuant to V .T .C .A . La bor Code , Section 4 06 .096 Contractor c ert ifi es that it pro vi des Workers' Compensation insurance coverage for all of it s employees emplo yed on the public project to abate asbestos /demolit ion in the un it ident if ied in th is contract. ST A TE OF TEXAS} COUNTY OF TARRANT} lntercon Environmental, Inc. Contractor By : Contractor's Signature Karen Andrews President T itle June 11 , 2009 Date BEFORE ME , the undersigned authority , on this day personally appeared __ _ ---Karen: Andrews:;: President-known-· to-me-to-be-t he-person-whus e-rrame-is- subscribed to the foregoing instrument , and acknowledged to me that he executed the same as the act and deed of lntercon Environmental, Inc . for the purposes and consideration therein expressed and in the capacity therein stated . GIVEN UNDER MY HAND AND SEAL OF OFFICE th is 11th day of June , 2009 , ~- My Commiss io n Expires 02 /28 /12 ANG fllC A PET RU ZZELL I Notary Publ:c. St ~te of Texa s My Cornmis s,on Ex pire s Februar y 2t :1 012 Angelica Pet ruzzelli 2-3 3 2.15. Contractor's Responsibilities Contractor is responsible for becoming familiar with the character , quality, quantity of work to be performed, materials and equ ipmen t required . Contractor shall procure all permits and licenses , pay all charges, costs , and fees , and give all notices necessary and incident to the due and lawful prosecution of the work, unless otherwise specified in this Invitation to Bid . All costs associated with preparing a Bid in response to the Solicitation shall be borne by the Bidder. The undersigned acknowledges the requirements of this section , and intends to comply with same in the execution of this project. Karen Andrews Name President Title lntercon Environmental. Inc. Company June 11 2009 Date ------------------------ 2-34 2.16. Contractor 's Legal and Compliance History Contractor's legal and co m pl iance histo ry is a criti cal com po ne nt of th is In v it ati o n to Bid . Read this section w ith care and res pond ac co rdingl y . Fa ilure of the Cont ractor to prov ide all the informati on req ueste d a nd to cert ify the repo rt , wi ll result in the Co ntractor's subm ittal being decl ared non-re spons ive . Contractor shall attach a writte n report of legal action brough t aga inst Co ntrac tor, Contractor's officers , Contracto r's e m ployees , AND Co nt racto r's pro posed subcontractors relating to the protection of the environment. The terms "legal action " and "relat ing to the protect io n of the env ironment " are defi ned below . The report shall include all legal acti on brought w it hin five (5) years of the closing date of this Invitation to Bid . The report shall deta il the substan ce , status , and outcome of such legal action. Th is includes w ithout li mitat ion the names of the agency and/or persons bringing the action , all relevant da tes , and all fines , judgments, and/or settlements . Include the following information for each case at a minimum : • Style of Case ( X vs . Y ) • Settlement Information (as appropriate) • Cause Number • Names/ Addresses of all parties named • Court • Counsel List and phone numbers • Date of Disposition • Judgment and Order of Judgment "LEGAL ACT ION " means : ANY enforcement action by the United States Environmental Protection Agency , t he Occupational Safety and Health Administration, any other federal agency , the Texas Comm iss ion on Environmental Quality (including its predecessor agency the Texas Natural Resource Conservation Commission ), t he Texas Department of Sta te Health _ ~erv ~es {includ ing its predecessor agency the Texas Department of Hea lth ), and any other state agency , commission or department , whether m Texas or elsewhere , when such enforcement act ion is a result of v iolat ions , real or alleged , of any laws , licenses , perm its , judicial orders , or admin istrat ive orders , relating to the protection of the environment. In th is context , enforcement action shall inc lude without limitation , written warn ings , notices of violation , consent orders or agreements , compliance orders , admin istrat ive hea ri ngs , ci v il lit igat ion and cri minal prosecution. Legal act ion also means any civ il lit igation brought by any person relat ing to the protection of the en vi ronme nt. "R ELAT IN G T O T H E P ROTECTION OF TH E ENV IRONM ENT" mea ns: requ ireme nt s pertain ing to the ma nufa ct ure, pro cess in g , d istri buti on , us e , handlin g , storage, transportation, reporting , records keeping, permitting, licensing, treatment, disposal, emission , discharge , sp ill , release , or threatened release of hazardous materials , hazardous substances, hazardous wastes , toxic substances , petroleum , industrial waste , solid waste , pollutants or contaminants into or on to the air , surface water , drinking water , groundwater, stor m w ater, publ icl y ow ned trea tment work s , or land . THE REP OR T SHALL B E SIGNED AND CERTI F IED by a n au thoriz ed representat ive of the Contractor, using the following form . T he top portion of the form is to be completed if a report of legal action is attached . The bottom port ion 2-35 of the form is to be completed if Contractor has no legal action to report . Make certain that the appropriate portion of the form is filled out and signed. AN AUTHORIZED REPRESENTATIVE OF THE CONTRACTOR shall mean : (1) if the Contractor is a corporation : the president , secretary , or treasurer, or a vice president of the corporation in charge of a principal business function , or any other person who performs similar policy or decision-making functions for the corporation ; (2) if the Contractor is a partnership , a general partner ; and (3) if the Contractor is a sole proprietorship, the sole proprietor. INCLUDE A COPY OF THE REPORT OF LEGAL ACTION FOLLOWING THE CERTIFICATION OF CONTRACTOR'S LEGAL AND COMPLIANCE HISTORY BOUND WITHIN THE BID 2-36 Certification of Contractor's Legal and Compliance History Complete ONE of the Following Certifications Certification of Legal Action Report I certify under penalty of law that the attached Le gal Action Report deta iling Contractor's , Contractor's officers, Contractor 's employees , and Contractor's proposed subcontractors legal and compliance history relating to the protection of the environment was prepared under my direction or superv ision in accordance with a system des igned to assure that qualified personnel properly gather and evaluate the information subm itted . Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is , to the best of my knowledge and belief, 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 . CONTRACTOR: lntercon Environmental , Inc . Signature Company Karen Andrews June 11 , 2009 Name Date President Title Certification of NO Legal Action I certify under penalty of law that the legal and compliance history of Contractor , Contractor's officers, Contractor's employees, and Contractor's proposed subcontractors was researched 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 the system , or those persons directly respons ible for gathering the informat ion, I hereby certify that no legal action relat ing to t he prot ection of the env ironment was brought aga inst Contractor, Contractor's office rs, Co ntractor's emp lo yee s , o r Contractor's pr opose d subcon tr actors wit h in th e prece ding fiv e years . To the best of my knowledge an d bel ie f , this statemen t is true , accurate, and comple te. I am aware that there are significant penalties for submitting false information, incl uding the possibility of fine and imprisonment for knowing violations. CON TRACTO R: Signature Compan y Name Date 2-3 7 , 91l!l DOCKET NO. Al1564-600-2008 CASE NO. 1412080038 IN THE MATTER OF INTERCON ENVIRONMENT AL, IN CORPORA TED MANSFIELD, TEXAS § § § § § § AGREED ORDER I. JURISDICTION BEFORE THE TEXAS DEPARTMENT OF ST ATE HEAL TH SERVICES AUSTIN, TEXAS The Department of State Health Services ("department"), Division for Regulatory Services, is authorized to enforce the Texas Mold Assessment and Remediation Rules ("Rules"), Title 25 of the Texas Administrative Code (TAC), Chapter 295.301 et seq. 0. RESPONDENT Intercon Environmental, Incorporated ("Respondent") is a licensed mold remediation company, performing regulated mold-related activities, and as such is subject to the aforementioned Rules. III. FACTS On June 13, 2007, a representative from the department conducted a compliance inspection of the mold remediatio~ proJecl at B.ear. Creek Ele111entm School ._ 401 Bear Creek Drive, Euless , Texas. The __ purpose of the inspection was to determine the Respondent's compliance with the Rules as referenced in "1. Jurisdiction." As a result of a subsequent review of department files, it is determined that Respondent failed to comply with various provisions of the Texas Administrative Code or statute referenced in "I. Jurisdiction." The alleged violation is described in Certified Letter No. 7000 0520 0024 1486 1855 , dated January 23 , 2008 (hereinafter, "Notice Letter"), referenced in "IV. Notice." The following vio lations were alle ged: • Failure to have the mold remediation protoco l on-s ite in violation o f 25 TAC §295 .326(b )(l )(A ) -penalty amount of $1,500 .00. IV. NOTICE By the Notice Letter, Ms . Al yso n 0 . Henry, Di vision fo r Regu latory Services, informed Respondent of the dep artm ent 's intent to assess an ag gregate adminis tra tiv e penalty of $1,500.00 . The letter wa s received by Res pondent. V . RESPONSE Respondent responded to the department's Notice Letter by reque sting an informal confe rence . ' VI. SETTLEMEN T On February 27, 2007 , an infonnal co nference was held between representative s of the department and Respondent. The parties reached a proposed settlement, the terms of which are contained in the "It is Ordered" section of this Order, ba sed on various factors including the desire to avo id litigation . Re spondent agrees to terms of this Order as evidenced by signing this Order. The follo w ing te rms were agreed upon: • Failure to have the mold remediation protocol on-site in violation of25 T AC §2 95 .326(b )( 1 )(A) -penalty amount of $750 .00. Respondent has no objection to this Order being signed by the Commissioner of State Health Services or his designee. VII. COMPLETE SETTLEMENT The facts contained herein are the complete settlement of all issues regarding the alleged violation(s) described in "IV. Notice" of this Order. A. WAIVER OF HEARING In exchange for the execution of this Order, Respondent waives the right to a hearing. B. NO WAIVER WITH REGARD TO FUTURE VIOLATIONS The department does not waive the right to enforce future violations committed by Respondent. C. COMPLETE UNDERSTANDING The department and Respondent acknowledge that they understand the terms of this settlement, enter into the settlement freely, and agree to the tenns. D. NO RIGHT TO APPEAL Respondent wa ives the right to j udicial review of this Order. N OW THEREFORE, IT IS ORDERED th at: 1. Respondent pay an administrative penalty, in the amount of $750 .00, in full settlement for the violation(s) that is/are th e subject of this Order. Payment must be made by cashier's chec k or money order and mailed to: Department of State Health Services, MC 2003, P .O. Box 149347, Austin, Texas 78 714- 9347. Eac h cashier 's check or money order must be made payable to the Department of State Heal th Services and must also include the notation: ''De posit in Budget No. ZZ156, Fund No . 092, Case No. 1412 080038.'' 2. Paymen t is due in one lum p su m payment, thirty (30) da ys from the date th is Order is signed by the department. -- ' . ':; . 3. Respondent shall henceforth comply with this Order and with all applicable laws, rules and regulations. Failure to comply will result in additional penalties. ,. 7-al ,.;J /1 / Signed and ordered this U day of~/(_'./;_i£_·£_.c._c_-P_·Lc--______ , 2008 . SPONDENT: Signature of Authorized Agent Jerrold Andrews Printed Name Vice President 3/4/08 Signature Date // ~,, ~ ~· ' ' -::77;_ ~ -~-<;p,L , C°,,-/'. 'C •-= ; thryn c :'Perkins, RN, MBA Assistant Commissioner Division for Regulatory Services ::,;_ <..· TEXAS DEPARTMENT OF STATE HEALTH SERVICES DAVID L LAKE';Y, M.D . COMMISSIONJ;::R ·. . August 6,2008 . . . . Ms. Karen .Andrews, Ag~nt . . . . Intercon Envifoajnental, 1n·c9rporated . . . 22.14 FM 1187; Bw,lding#6 . · ·,. . ' Mansfield, Texas :76063 : ··.' . \ . :: . ~ . : :;_ : '. ·• . ·. ' RE: Agr:eed Qrd~r -~ Iiitercon :Envi,ronµien~a~, lncorpo,rate<I · Dear Ms. Andrews P.O. Box 149347 Austin, Texas 7871 _4s9J47 1-888-963.-7111 . TIY: 1-800-735-2989 w'ww .ds~s .state.tx .us Case No . 1410080438 · ',I •' _Enclosed is a c;opy .for y()\ll':re~9rgs .of Jm Qfdei: rel11tive , t9 / th~ Departmen.t 9LStaie . Health ·. Services, Divisi()n f~r Regul_atory S¢n,ices, Enforc~ent Unit and the ab9ve referenced entity .. If you haye que~tions, please coritact ,Mr1 Dustin Exner at (512) 83~-?665, Ext. 3460. . ',:_,, • ',. I ' . • •, • . . \ "·.'. -·C~., .. :, .. ~~J.~~. ·.· ... _:, 'Ro~i:tThompso~, E~{~;~~~ntS~eciali~t ' . .. · .. ··.;·:_,··.· -;_ ·' ,.. ; _·, :. ; ,. . . ' . . . . . . '--~~_.::0_· -··' .-~ .• :_.~...-~-· . ' . --~-. ~ . ·,·· · ..... ; _:. •,. ;·.' '.. ' . Enforcement Unjt ' . . .· . ' ' . · Diy1sion of Regqlat~ry Services . -. . ' -. Enclosure An Equal Employment Opportunity Employer and Provide r ·'\' .,·, ··' .: '· .· DOCKET NO. A12440-560-21)08 CASE NO. 1410080438 .IN.lllJMATTE:R OF . INTERCON ENVIRONMENT AL, IN CORPORA TED :'. . . MANSFIE:LD, TEXAS § § § §. .§ § · BEFORE THE TEXAS . · . ' ., ·, ..... I. JURISD~CT.lQN D~PARTMENT OF STATE HEAL TH SERVICES '. ' AUSTIN, TEXAS . The Dep~,ent of State Health . Services,. Di~ision for 1:legul{ltory Services . ("depa~~nn . is authorizedJ~ ~riforce ~heTexas Aspest9s, Health . Prot~tipri Act, Q.qcupations Code, Chapter .1954 (''.Act''.); th~ T~~.~s As.~~t9-~ H~alth Prot~cti,onRy,les .. (R~les), Title2{TAC; Pcµt .,l, Chaptef295; tlle ' National Erni~si9ri Stan~~ds'for. Hazardous Ai{Pollµ!~~tfiliASIµP), 40 CFR)1 az16 i; ~ubpclrt M; ·· and the'Asbest9sJiaz.µ:d Eill~rg~ncy Response Act(AHI;RAf40 GFR ~art 763, S~bpartE ... . ·· ,·,.• .· ·>.<\,,.> .. ··':.il~ESPO~;i;(//.···. < .. ::·· .\ .. ·· ,,: . Interco~ Enviromn~ntal, In6'6rpbr~t~·cl ('~R~~p~~dent'') is aE2e~ed ;besto~·abat~ment contra~tor of a reno~~tion/demolitiqn project, and a:S-such)s subject fo 'the aforerri.enti~ned Act llll<l Rules .. ··· . · ' ·, ~ . . '. ' '· '.; \ ·, ' : '' .. : .... : ' .. ,;, '. ·· ..... ::.; ; . •' . '.. i" '·. · .. '' . : . . '' ·~. .· > : ' ·: ·, ·,. . ' . . . ''· . . -·:.-·+_-· .. ·-·-·-~-··---:·.;:..--~.· ..... ·-.:·;:-:·: • • .. : .. · .. ~ '' ,' .·.,-..... I.,-,,;., .. ,,.' ' ,· •· . · .. ' ,. • • ·---:--=-:-~r-'-.• :.1 .• ~~~-..+~~.~~~., .... ~-;-.~--'~~~~""-:'--.:~.-·-:-. -· -. ,.'-.'-:~~ ~-f-~'"7'~~. · '· . · ·. . III. FACTS . · . On June 28, 2CXh, ·ar~p.resentativ~fr6.m~e, 4.~parf~~Iitc~~~ucte4 ~11 ·a~be~tps i~pectioq~t the .. · Liberty Elementary loi;ated at7~76. Whitney Ori ye, ,White Settlemen~, Texas.:· Tliepurpose of the .. inspection was to determine the projecfs compfomc 'e with the . Rules, Act or NESHAP ·as refere~ced in "I. Jurisdiction." .. . . ·. . . . . As a result of the inspection and during a subs~quent review of department files, it was dete~ined that Respondent fail~d to comply with various pro visions of the Rules, Act or NESHAP as refere ncy d in "I. Jurisdicti on." The vio latio n is des.cribe.d in Certified Lette ~ No : 7000 0520 002 4 1426 2355, dated May 26, 2008 (hereinafter, "Notice Letter"), referenced in "IV. Notice." The following violation was alleged: • Failure to properly comp lete notification form in violation of 2 5 TAC §29 5.6 1 (a) -penalty amount of $100.00. · - -.... ~.,:~ IV. NOTICE By the Notice L ~tter, Mr. Dustin K . Exner, Division ofRegµlatory Sei:vi ~es, informed Respondent of the d epartment's int ~~t to assess an administrative penalty of $1 ~.00. The l~tter .was . re ceiv ed by Respondent.' . . . .. . . . . . . . . V.RESfON~E: Respondent responded to the department's Notice Letter by paying the administrativ e penalty of $100.00. . . . . , ·: . . .' . :,. ', . · VI. SETTLEMENT: . , ·;:-·. ne p~i~s r~~~~~ ~·proJ~sed s~ttl~tnent, the.tercii{ of ~hi ch 'iµ-e c~rii ained in the "I tis Ordered'' · secti~n of this 'Order, b#ed 'on v¥i9us .. f!lc~ors incl~dirig the ~esfr~ to avoid Jitigation. · · ~espo:~d~n: ;agr~~i\9 t~i ~· ~f thi8 ori ~r a~. evi~e~·ced. by p~yi ng the a~rnini s·i;:iive p~al~y of . $100.00 . The following terms .were agreed upon; . ' ' . . . . ; \ ) ; : \ -. I • \ ,\. ' ' • \ • :. I,', ~ '. ' / /. ·.' Fa,il~e to 0 pr<;>perly CQ~;lete notificati_on roan: in yiolation' 9f 25 TAC §2.95 .6,1 (a).~ p~nalty · ariiouiitof$ioo .oo.:. · ... · ·· ·. · · ·. ·. ·. · .• · · .· · ·. . . · ... : · . , · >· -. . . . . ·, :~' . . •... . . . ' · . . , -,. · . Tpe penilty was paici on:iuly ·11,2008. . .·:·.·\ . '. ·. ::'.;.'·:' . : _,; .·_·,·c": '· ·'', .·-·--. . '• . .', . '·' . ., · 'ilesppn~~qt'iias ll() obj~ctio11 to this hrd~r .b~i ng si~ed by ·th~ Co~issi~ner of State Heal ~h ··Sei:vicei'or_hi~.d.esignee~/~~·/ ;._';(-~~~:.::T~'"-,-.~.~'..~~~~~'-~~~ >··: .. :.~~~~·.· .... · .. ,. ~~·~. ---· .. VIL C:Ol\'.lrLETE SE"t;TLEMENT \.. : ·, \ .. : . '· . . ,;=:·: .. ·: ·::·' :. '. · .• ·: .. '. ::. : _1 •. ,· ,: :. :'.. '_<> .-\ . .-.. ,.· ·.·.·: ' : ;.•-: . . . ' . · Jhe . facts contained herein are . the complete settlement of all issues regarding the violation( s) described in "IV .. Notice" of this Order .. : . . . . A. w AIYER OF HE A RfN G In exchan ge fo r t~e execution o f this Order, Respond ent waives the right to a hear ing .. B. NO ,v AIYER WITH REGARD T O FUTURE VIOLATIONS The department does not waive the right to enforce future violations committed by Respondent. C. CO M PL ET E UN DER STANDING The de partment .an d Res ponden t acknow ledge that they understand the terms of this settlem en t, enter into the settlement freely, and agree to the terms. 2 D. NO RIGHT TO APPEAL . Respond~nt waives the right to jud.icialre~i:ew of thi~·Order. NOW THE}IB.fO~, IT IS ORJ;>EREQ. that: .· Respondent shall tomply with this Ord~r and with all applicable laws, rules and regulations. • • ' . '· . : .. '. ; • : ; . ' ; ' . . ~ • l ' . ' . . . . '. ~ -......-.. ..:.. --._._._ ....... : ..... : ',· . . ' . ' -~--~ ····.·· ,. ~~-----~- i 3 2.17. Federal Supplemental Information Requirements Fund ing for this Co ntra ct is Federally ass is ted . Co nt ractor m ust comply w it h th e Dav is-Bacon A ct , t he Ant i-K ickback Act , th e Co ntract W o rk Ho urs Standa rd Act , Executi ve Order 11246 t he Equal Op po rt u ni ty Clause , a nd the Buy Ame ri ca n Requirements . REQUIRED LANGUAGE IN PUBLISHED ADVERTISEMENT FOR BIDS FOR AIP CONSTRUCTION CONTRACTS Requ ired Language In Publ ished Adve rti sements For Bids For All AIP Con t rac ts : (1) Policy . It is the policy of the Department of Transportation (DOT ) that d isadvantaged bus iness enterprises as defined in 49 CFR Part 23 shall have the max imum opportunity to participate in the performance of contracts financed in whole or in part with Federal funds . (2) Buy American Provision. The proposed contract is subject to the Buy American provision under Section 9129 of the Aviation Safety and Capacity Expansion Act of 1990. Details of such requ irement are contained in the Specifications. Additional Language Required In Published Advert isement For Bids For AIP Contracts Where The Sponsor Has A DBE Program In Effect Or Is Requ ired By 49 CFR Part 23 To Have An Approved DBE Program : All bidders and proposers shall make good faith efforts , as defined in Appendix A of 49 CFR Part 23 , Regulations of the Office of the Secretary of Transportation , to subcontract 1Q% of the dollar value of the prime contract to small bus iness concerns owned and controlled by socially and economically aisadvantagea-in div1auars (DBET,-1n tn e evenr tnar l ne 5ic@er ror tnis solicitation qual ifies as a DBE , the contract goal shall be deemed to have been met. Individuals who are reputably presumed to be socially and econom ically d isadvantaged include women , Blacks , Hispanics , Native Americans , Asian-Pacific Americans and Asian-Indian Americans . The apparent successful bidder (proposer) will be requ ired to submit information concerning the DBE's that will part icipate in this con tract. The informat ion w ill include the name and add ress for each DBE , a description of the wo rk to be performed by each named firm , and the dollar value of th e cont ra ct (sub co ntra ct). If th e bi dde r fa ils to achi eve the contract goal as st ated he re in, it w ill be requ ired to pro vi de docu mentation demonst rat ing that it made good fai th efforts in attempting to do so . A bi d that fails to meet these requirements wi ll be consid ered non-responsive . Required Notices For Contracts Over $10 ,000 : Th e regu lations an d orders of the Secretary of Labo r , OFCC P and FAR 152 .61 require that the sponsor or the spon sor's co nt ra ctor(s) incl ude , in invit ations for bi ds or negoti atio ns for con tracts over $10 ,000 , the foll ow ing notices : (1) T he proposed con tra ct is under and subject to Exe cutiv e O rd er 1 1246 of 2 -3 9 September 24 , 1965 , and to the Equal Opportunity Clause. The Bidder's (Proposer's) attention is called to the "Equal Opportunity Clause" and the "Standard Federal Equal Employment Opportunity Construction Contract Specifications" set forth in the Specifications . (2) The Bidder (Proposer) must supply all the information required by the bid or proposal form. (3) The successful bidder will be required to submit a Certification of Nonsegregated Facilities prior to award of the contract , and to notify prospective subcontractors of the requirement for such a Certification where the amount of the subcontract exceeds $10 ,000 . Samples of the Certification and Notice to Subcontractors appear in the Specifications. (4) Women will be afforded equal opportunity in all areas of employment. However, the employment of women shall not diminish the standards or requirements for the employment of minorities . Contracts In Excess Of $50,000 : In the invitation for bids relating to contracts of $50 ,000 or more, the sponsor shall include the following notice : For contracts of $50,000 or more, a contractor having 50 or more employees , and the contractor's subcontractors having 50 or more employees and who may be awarded a subcontract of $50,000 or more , will be required to maintain an affirmative action program within 120 days of the commencement of the contract. Additional Notices For $1 Million Contracts: For each contract, which may result in a bid of $1 million or more, the invitation for bids shall also include the following notices: (1) Preaward Equal Opportunity Compliance Reviews. Where the bid of the apparenllow_responsibla bidder. is in _Jba amount o.f $..Lmillio.n _o.r. more, the __ bidder and the bidder's known all-tier subcontractors which will be awarded subcontracts of $1 million or more will be subject to full on-site , preaward equal opportunity compliance reviews before the award of the contract for the purpose of determining whether the bidder and the bidder's subcontractors are able to comply with the provisions of the equal opportunity clause . (2) Compliance Reports . Within 30 days after award of this contract, the contractor shall file a compliance report (Standard Form 100) if: (a) The contractor has not submitted a complete compliance report w ithin 12 months preceding the date of award ; and (b) T he cont ra ct or is wi th in the defin ition of "emp loye r" in Paragraphs 2e(3) of the instructions included in Standard Form 100 . (3) The contractor shal l require the subcontractor on all-tier subcontracts , irrespective of dolla r amount , to file Standard Form 100 within 30 days after aw ard of th e su bco ntract if the abov e two conditions apply . St andard Form 100 wi ll be fu rni shed upon request. 2-40 BUY AMERICAN PREFERENCES (a) The Aviation Safety and Capacity Expansion Act of 1990 provides that preference be given to steel and manufactured products produced in the Un ited States when funds are expended pursuant to a grant issued under the Airport Improvement Program . The following terms apply : 1. Steel and manufactured products. As used in this clause, steel and manufactured products include (1) steel produced in the United States or (2) a manufactured product produced in the United States , if the cost of its components mined , produced or manufactured in the United States exceeds 60 percent of the cost of all its components and final assembly has taken place in the United States . Components of foreign origin of the same class or kind as the products referred to in subparagraphs b. (1) or (2) shall be treated as domestic . 2 . Components. As used in this clause, components means those articles, materials, and supplies incorporated directly into steel and manufactured products. 3 . Cost of Components . This means the costs for production of the components , exclusive of final assembly labor costs. (b) The successful bidder will be required to assure that only domestic steel and manufactured products will be used by the Contractor, subcontractors, materialmen and suppliers in the performance of this contract, except those : 1. that the US Department of Transportation has determined , under the Aviation Safety and Capacity Expansion Act of 1990, are not produced in the United States in sufficient and reasonably available quantities and of a satisfactory quality ; 2. that the US Department of Transportation has determined, under the A-vlatlon Safety arrd-Cop-acity cXparrsion Acrof 19M-;-th-at dumestic--preference - would be inconsistent with the public interest; or 3. that inclusion of domestic material will increase the cost of the overall project contract by more than 25 percent. BUY AMERICAN CERTIFICATE By subm itting a bid /proposal under this solicitat ion , except for those items listed by the offerer below or on a separate and clea rly ide ntified attachment to this bid /proposal , the offeror certifies that steel and each manufactured produ ct , are produ ced in the Uni ted States, as defined in th e cl au se Buy Ame rican -Steel and Manufactured Products for Construction Contracts) and that components of unknown origin are considered to have been produced or manufactured outside the United States . Offerors may obtain from the owner a listing of articles, materials and supplies excepted from this provision . 2-41 Product Country of Oriqin N/A NIA CIVIL RIGHTS ACT OF 1964, TITLE VI -CONTRACTOR CONTRACTUAL REQUIREMENTS During the performance of this contract, the contractor, for itself, its assignees and successors in interest (hereinafter referred to as the "contractor") agrees as follows : 1. Compliance with Regulations. The contractor shall comply with the Regulations relative to nondiscrimination in federally assisted programs of the Department of Transportation (hereinafter, "DOT") Title 49 , Code of Federal Regulations, Part 21, as they may be amended from time to time (hereinafter referred to as the Regulations), which are herein incorporated by reference and made a part of this contract. 2. Nondiscrimination. The contractor, with regard to the work performed by it during the contract, shall not discriminate on the grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials and leases of equipment. The contractor shall not participate either directly or indirectly in the discrimination prohibited by section 21 .5 of the Regulations, including employment practices when the contract covers a program set forth in Appendix B of the Regulations . 3. Solic1tations for S--ubcotttraas, Including-Procurements-of Materials ana Equipment. In all solicitations either by competitive bidding or negotiation made by the contractor for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the contractor of the contractor's obligations under this contract and the Regulations relative to nondiscrimination on the grounds of race , color , or national orig in. 4. Information and Reports. The contractor shall provide all information and reports requ i red by the Reg ulations or d irect ives issued pursuant the reto and sha ll pe rmi t a cc ess t o it s bo o ks , record s , accounts, oth er so u rces of informa t ion , and its fac il iti es as may be determined by the Sponsor or th e Federal Av iat ion Admin is trat ion (FAA) to be pertinent to ascertain compliance with such Regulations, orders, and instruction s. Where any inform ation required of a contractor is in the exclusive possession of another who fails or refuses to furn ish this in formation , the contractor shall so certify to th e sponsor or the FAA, as appropriate , and sh all set forth wh at effort s it has mad e to obtain the information . 5. Sanctions for Noncompliance. In th e eve nt of th e contractor's noncompli a nce with the nondiscrim inat io n prov isions of thi s contract , the sponso r 2 -42 shall impose such cont ract sanctions as it or the FAA ma y dete rm ine to be appropriate , in clud ing , but not limited to : a. Withhold ing of payments to t he contractor unde r the con tract until th e contractor complies , and /or b. Cancellation , termination , or suspens ion of the contract, in whole or in part . 6. Incorporation of Provisions. The contractor shall include the provisions of paragraphs 1 through 5 in every subcontract , includ ing procurements of materials and leases of equipment, unless exempt by the Regulations or directives issued pursuant thereto. The contractor shall take such action w ith respect to any subcontract or procurement as the sponsor or the FAA may direct as a means of enforcing such prov isions including sanctions for noncompliance. Provided , however, that in the event a contractor becomes involved in, or is threatened w ith , litigation w ith a subcontractor or supplier as a result of such direction , the contractor may request the Sponsor to enter into such litigation to protect the interests of the sponsor and , in addition , the contractor may request the Un ited States to enter i nto such litigation to protect the interests of the United States . DISADVANTAGED BUSINESS ENTERPRISE CONTRACT PROVISIONS (49 CFR PART 23) PART A Policy . It is the policy of the Department of Transportation (DOT) that disadvantaged business enterprises as defined in 49 CFR Part 23 shall have the maximum opportunity to parttclp-ate 111 tlTe p-erformar1c-e-of contracts fin-an--cem In whoteor trT p-a1twtth reoe-ralftJrTd-s- under this agreement. Consequently , the DBE requ irements of 49 CFR Part 23 apply to this agreement. DBE Obl igation. The contractor agrees to ensure that disadvantaged business enterprises as defined in 49 CFR Part 23 have the ma xi mum opportun ity to part icipate in the performance of contracts and subcontracts financed in whole or in part with Federal funds provided under th is agreement. In this regard all cont ractors shall take all necessary and reasonable steps in accordance w ith 49 CFR Part 23 to ensure that d isad v an taged busin ess ent erprises have the ma xi mum opportunity to compe te fo r and perfo rm contra ct s. Co ntracto rs s hall not discriminate on th e basis of race, colo r, nation al orig in o r sex in the award and performance of DOT-ass isted contracts . Compliance . All bidders , potential contractors or subcontractors for this DOT-ass isted contract are he reby not ified that fa ilu re to carry out the DOT policy and the DBE obl igat ion , as se t forth above, sha ll constitute a breach of contract which may result in term ination of the contract or such other remedy as deemed appropriate by t he owner . Subcontract Clauses . All bidders and potenti al contractors hereby assure th at they will includ e the abov e cl auses in all subcontracts , whic h offers furt her subcontracting opportunitie s . ' 2-4 3 PARTB It is furt he r u nde rstood an d agreed : T he award pro ced u re for t his so l icita t ion w ill incl ud e the select io n cr ite ria of 4 9 CFR Part 23 .45(i) to ensu re that pri me co ntracts a re aw arded to co mpet itors tha t meet Disad vantaged Bus in ess Ente r prise (DBE) goa ls . Not ifi cat ion is hereby given th at DBE go als are es tab lish ed for thi s prim e co nt ract. The goal for fir ms owned an d co ntro ll ed by socia lly an d econom ically disa dvan ta ge d in d ividua ls is ten pe rcent (10%) of the do ll ar v alue of th is co ntract. After open ing b ids , the a pp arent suc c essfu l bidder w ill be requi red to subm it the nam es and addres ses of the DBE firms t hat wi ll partic ipate in the co ntract along with a descript ion of the work to be performed by each named firm and the dollar value for each contract (subcontract). If the respon ses do not clearly show DBE part ici pat ion w ill meet t he goals above , the apparent successful b idder must prov ide do cumentation clearly demonstrating , to the satisfaction of the a irport sponsor, that it made good faith efforts in attempting to do so and that meeting sa id goals is not reasonably pos si ble . A bid that fails to meet these requ irements wi ll be cons idered non-respo nsive. Agreements between bidder/proposer and a D BE in wh ich the DBE promises not to prov ide sub-contracting quotation s to other bidders /propose rs are proh ib ited . All bidders an d p rop ose rs shall ma ke a good fait h effort to replace a DBE subcontractor that is unable to perform successfully with anothe r DBE su bco ntractor. Th e b idder shall establish an d mainta in records and subm it regular reports , as requ ire d , wh ich will identify an d asse ss progress in achiev ing DB E subcontract goals an d other DBE affirmat iv e action efforts. SPECIAL INSTRUCTION TO BIDDERS REG A RD ING EEO Notice of Requi rement for Affi rmat ive Ac ti on to Ensu re Equal Employment Oppo rt uni ty (Execut iv e Order 11246, as amen ded ) 1. The Offerer's or Bidder's atte ntion is called to the "Equ al Opportu n ity Clau se" and th e "Standard Fe dera l Equal Emp lo ymen t O ppo rt un ity C onstruction Con tract Specifi cat io ns" set fort h he rei n . 2. The goa ls an d timetabl es for min ority an d femal e pa rt icipatio n , expressed in percen tag e terms for the contractor's aggregate work forc e in each trade on all construction work in the covered area, are as follows : Goal s for minority participation in eac h trade 1Q_% Goa ls for female partici pation in eac h trad e __l._% 2-44 These goals are applicable to all the co ntractor's construct ion wo rk (w het her or not it is Federal or federally assisted) performed in the co vered area . If the contractor performs construct ion work in a geograph ical area located outs ide of the co vered area , it shall apply the goals established for such geograp hi cal a rea whe re the work is actually performed . With regard to this second area , t he contracto r also is subject to the goals for both its federally involved and non federally in vol ved construction . The contractor's compliance with the executive order and the regulat ions in 41 CFR Part 60-4 shall be based on its implementat ion of the Equal Opportunity Clause , specific affirmative action obligations required by the specifications set forth in 41 CFR Part 60-4 .3(a), and its efforts to meet the goals established for the geographical area where the contract resulting from this solicitation is to be performed . The hours of minority and female employment and tra ining must be substantially uniform throughout the length of the contract , and in each trade, and the contractor shall make a good faith effort to employ minorities and women evenly on each of its projects . The transfer of minority or female employees or trainees from contractor to contractor or from project to project , for the sole purpose of meeting the contractor's goals , shall be a violation of the contract , the executive order, and the regulations in 41 CFR Part 60-4 . Compliance w ith the goals will be measured against the total work hours performed . 3 . The contractor shall prov ide written notification to the Director, OFCCP , w ithin 10 working days of award of any construction subcontract in excess of $10 ,000 at any tier for construction work under the contract resulting from this solicitation . The notification shall list the name , address , and telephone number of the subcontractor; employee identification number; estimated dollar amount of the subcontract; estimated starting and completion dates of the subcontract ; and the geographical area in which the contract is to be performed . 4. As used in th is notice and in the contract resulting from this solicitation , the "covered area " is Fort Worth , Tarrant County ,Texas. EQUAL EMPLOYMENT OPPORTUNITY (41 CFR PART 60-1 .4(b)) Durin g th e perfo r man ce of thi s co ntract , th e co ntra ctor agrees as fo ll ows: 1. Th e contractor wi ll not discriminate agains t a ny employee or applicant for employment because of race , colo r , religion , sex , or national origin. T he contractor wi ll take affirmative act ion to ensure that applicants are employed , and that emplo yees are treated du ri ng employment without reg ard to their race, color, religion , sex , or nation al origin . Such act ion sh all include , but not be lim ited to the following : Employme nt, upgradi ng , de motion , or transfer; rec ruitment or recru itme nt adv ert is ing ; layoff o r te rmination ; rate s of pay o r oth er fo rm s of compen sa ti o n ; and se lecti on for tra ini ng , in cl udin g appren tic esh ip . The co ntra ctor agrees to post in cons pic uo us pl aces , 2-4 5 available to employees and applicants for employment , notices to be provided setting forth the provisions of th is nondiscrimination clause . 2. The contractor will , in all solic itations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive considerations for employment without regard to race , color , religion , sex , or national origin . 3 . The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4 . The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, as amended , and of the rules , regulations , and relevant orders of the Secretary of Labor. 5 . The contractor will furnish all information and reports required by Executive Order 11246 of September 24 , 1965, and by rules , regulations , and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books , records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules , regulations , and orders. 6 . In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled , terminated or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedure authorized in Executive Order 11246 of September 24 , 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Omer 11240· of Septemoer 24, i9o5-;-or !Sy rule, -regulafio~ or order ofthe Secretary oT - Labor, or as otherwise provided by law. 7 . The contractor will include the portion of the sentence immediately preceding paragraph D-1 and the provisions of paragraphs D-1 through D-7 in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24 , 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such prov ision , including sanctions for no nco mpl ian ce : Prov ided , ho we ver , that in the eve nt a contracto r be co mes invol ve d in, or is threatened w it h, litiga tion wi t h a subcontractor or ve ndor as a resul t of such di rection by the administering agency the contractor may request the United States to enter into such litigation to protect the interests of the United States . ' 2-46 INSTRUCTIONS REGARDING CONTRACTOR'S INSURANCE The following provision or a sim ilar provision shall be included in the Special Prov isions and in the Instructions to Bidders for all proposed AIP project bidding documents : Contractor's Liability Insurance Requirements . The bidder shall provide with the Proposal a listing of both automobile and personal liability insurance coverage currently in force , along with a copy of a Certificate of Insurance as verification of that coverage . In addition , the bidder shall provide a statement of premium cost issued by the agent or insurance carrier for that coverage . In the event the Owner determines that the low bidder's coverage in force is inadequate, the Owner may require the low bidder to procure additional coverage in amounts specified by the Owner. The cost of premiums for such additional coverage shall be paid by the Owner in the form of a re imbursement under the contract. In the event the low bidder is unable, after diligent effort, to procure such additional coverage as may be required by the Owner, the Owner shall provide such additional coverage, naming the contractor as insured or, at the option of the Owner, reduce the amount of additional coverage required or waive any requirement for additional coverage. Third Party Coverage . In the event the bidding documents require the contractor to name the consultant and/or the Owner as additional insured, the bidder shall show the premium cost for the additional insured in the Proposal in the item for additional coverage . The amount shown in the bid item for additional premium cost shall be that amount of additional premium above the premium for the coverage shown in the Certificate of Insurance subm itted with the bid. In the event additional coverage is required by the Owner, the additional premium cost for third party coverage above the amounts shown in -the-Certificate uf lnsuranc-e-strall Ire p~icl oy tne owner in tne form of a reiml5ursemem under the contract. 2-47 REQUIRED LANGUAGE IN PROPOSALS FOR AIP CONTRACTS Section 60-1 .?(b) of the Regulations of the Secretary of Labor requires each bidder or prospective prime contractor and proposed subcontractor, where appropriate , to state in the bid or at the outset of negotiations for the contract whether it has participated in any previous contract or subcontract subject to the equal opportunity clause ; and if so , whether it has filed with the Joint Report ing Committee , the Director, an agency , or the former President's Committee on Equal Employment Opportunity all reports due under the applicable filing requirements. In any case in which a bidder or prospective prime contractor or proposed subcontractor which participated in a previous contract subject to Executive Order 10925, 11114 . or 11246 has not filed a report due under the applicable filing documents, no contract or subcontract shall be awarded unless such contractor submits a report covering the delinquent period or such other period specified by the FAA or the Director , OFCCP . The bidder shall complete the following statement by checking the appropriate space . The bidder has _x_ has not __ participated in a previous contract subject to the equal opportunity clause prescribed by Executive Order 10925, or Executive Order 11114, or Executive Order 11246. The bidder has ....x_ has not __ submitted all compliance reports in connection with any such contract due under the applicable filing requirements; and that representations indicating submission of required compliance reports signed by proposed subcontractors will be obtained prior to award of subcontracts. If the bidder has participated in a previous contract subject to the equal opportunity -dause-and has -not sul:)mittect compliance repoffs aue under appl1ca6le filing requirements, the Bidder shall submit a compliance report on Standard Form 100, "Employee Information Report EE0-1" prior to the award of contract. Standard Form 100 is normally furnished contractors annually, based on a mailing list currently maintained by the Joint Reporting Committee . In the event a contractor has not received the form , he may obtain it by writing to the following address: Joint Report ing Comm ittee 1800 G Street Wash ington , DC 20506 2-48 AIRPORT AND AIRWAY IMPROVEMENT ACT OF 1982, SECTION 520 - GENERAL CIVIL RIGHTS PROVISIONS The contractor assures that it w ill comply with pertinent statutes , Executive orders and such rules as are promulgated to assure that no person shall , on the grounds of race , creed , color, national origin , sex , age, or handicap be excluded from participating in any activity conducted with or benefit ing from Federal assistance . This prov ision obligates the tenant/concessionaire/lessee or its transferee for the period during wh ich Federal assistance is extended to the airport a program , except where Federal assistance is to provide , or is in the form of personal property or real property or interest therein or structures or improvements thereon . In these cases the provision obligates the party or any transferee for the longer of the following periods : (a) the period during which the property is used by the airport sponsor or any transferee for a purpose for which Federal ass istance is extended , or for another purpose involving the provision of similar services or benefits or (b) the period during which the airport sponsor or any transferee retains ownership or possession of the property . In the case of contractors , this provision binds the contractors from the bid solicitation period through the completion of the contract. This provision is in addition to that required of Title VI of the Civil Rights Act of 1964. LOBBYING AND INFLUENCING FEDERAL EMPLOYEES (1) No Federal appropriated funds shall be paid, by or on behalf of the contractor, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress , an officer or employee of Congress, or an employee of a Member of Congress in connection with the making of any Federal grant and the amendment or modification of any Federal grant. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting fo influence-an officer or empfoyee orany agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with any Federal grant, the contractor shall complete and submit Standard Form-LLL, "Disclosure of Lobby Activities ," in accordance with its instructions. ACCESS TO RECORDS AND REPORTS The Contractor shall maintain an acceptable cost accounting system . The Contractor agrees to prov ide the Sponsor , the Federal Av iation Adm inistrat ion and t he Compt ro ller Ge neral of th e U nited States or an y of th e ir du ly autho r iz ed rep res entative s acces s to any books , do cuments , papers, and record s of the contractor which are directly pertin ent to the specific contract for the purpose of making audit , examination, excerpts and transcript ions . The Contractor agrees to maintain all books, records and reports required und er this contract for a period of not less than three years after final paymen t is made a nd all pendin g matters are closed . ENERGY CONSERVATION REQUIREMENTS The contractor agrees to comply with mandatory standards and policies relating to energy 2-49 efficiency that are conta ined in the state ene rgy conserva tion plan issued in compl iance w ith the Energy Policy and Conservation Act (Publ ic Law 94-163 ) BREACH OF CONTRACT TERMS Any violation or breach of terms of this contra ct on the part of the con t rac tor o r their subcontractors may result in the suspension or termination of this contract or such other action that may be necessary to enforce the ri ghts of the parties of th is agreemen t. The du ti es and obligations imposed by t he Con t ract Documents and t he righ ts and remed ies available thereunder shall be in add ition to and not a lim it ation of any duties , obligations, rights and remedies otherwise imposed or ava ilable by law . TRADE RESTRICTION CLAUSE The contractor or subcontractor, by submission of an offer and/or execution of a contract, certifies that it: a. is not owned or controlled by one or more cit izens of a fore ign country included in the list of countries that d iscrim ina te against U .S . firms publ ished by the Office of the Un ited States Trade Representative (USTR); b. has not knowingly entered into any contract or subcontract for this project with a person that is a c it izen or national of a fore ign country on said list , or is owned or controlled directly or ind i rectly by one or more ci t izens or na ti onals of a fore ign country on said list; c. has not procured any product nor subcontracted for the supply of any produ cf for us e on -ffi e -proje cl f ha fls produced in a fore ign co un f ry -on s a icl list. Unless the restrictions of this clause are wa ived by t he Secretary of T ransportation in accordance w ith 49 CFR 30 .17 , no contract shall be awarded to a contractor or subcontractor who is unable to certify to the above . If th e contractor know in gly procu res or subcontract s for t he supply of any product or serv ice of a fore ign country on said list for use on t he project , the Fede ral Av iat ion Adm in ist ra ti on may direct t hrough th e Sponsor canc e llation of th e contra ct at no co st to t he Gove rn ment. Further , the contractor ag rees that , if awarded a contract result ing from this solicitation , it will incorporate this provision for certification without mod ification in each contract and in all lower t ier subcontracts . The contractor may rely on the cert ification of a pro spect ive subcontractor unless it has knowledge that the cert ificat ion is erroneous. The contractor shall provide immediate written not ice to the sponsor if the contracto r le a rn s that it s certificat ion or tha t of a subcontractor w as erroneous when submitted or has become erroneou s by reason of change d circumstances. The subcontractor agree s to provid e written notice to the contractor if at any time it learns that it s cert ification was erroneou s by re as on of changed circumstances . 2-50 Th is certification is a material representation of fact upon which rel iance was placed when making the award . If it is later determined that the contractor or subcontractor knowingly rendered an erroneous cert ification , the Federal Aviation Administration may d irect through t he Sponsor cancellation of the contract or subcontract for default at no cost to the Government. Noth ing contained in the foregoing shall be construed to require establ ishment of a system of records in orde r to render , in good faith, the certificat ion required by this provision. The knowledge and information of a contractor is not requ ired to exceed that which is normally possessed by a prudent person in the ordinary course of business deal ings . This certification concerns a matter within the jurisdiction of an agency of the Un it ed States of America and the making of a false , fictitious , or fraudulent certification may render the maker subject to prosecution under T it le 18 , United States Code , Section 1001. RIGHTS TO INVENTIONS All r ights to inventions and materials generated under this contract are subject to regulations issued by the FAA and the Sponsor of the Federal grant under wh ich this contract is executed. VETERAN 'S PREFERENCE In the employment of labor (except in executive, administrative , and supervisory positions), preference shall be g iven to Veterans of the Vietnam era and disabled ~ veterans as definea in Section 5f5(c)T1T and-(2 r offne ,ll;irpo ftand--ATrvvay Improvement - Act of 1982 . However, this preference shall apply only where the individuals are ava ilable and qualified to perform the work to which the employment relates . EQUAL EMPLOYMENT OPPORTUNITY -41 CFR PART 60-1.4(b) Dur ing th e performance of this con t ract , t he contractor agrees as follows : 1. The contractor will not discriminate against any employee or applicant for employment because of race , co lor, religion , sex , or national origin . The contractor will take affirmative act ion to ensure that applicants are employed , and that employees are t reated du ri ng employment w ithout regard to the ir race , color , religion , sex, or national ongin . Such act ion shall include , but not be limited to the following : Employment , upgrad ing , demotion , o r transfer; recru itment or recruitment advert ising ; layoff or termin at ion ; rates of pay or other forms of compensation ; and selection for training , in cluding apprenticeship . The contractor ag ree s to post in conspicuous places , available to employees and applica nts for emplo ymen t , notices to be prov ided sett ing forth the provisions of this nondiscrimination clause . ' 2-51 2. The contractor w ill , in all solicitations or advert iseme nts for employees placed by or on behalf of the contractor , state that all qualified applicants will receive conside rat ions for employment without regard to race, color , religion , se x , or national origin . 3. The contractor will send to each labor union or representative of workers w it h which s/he has a collective barga ining agreement or other contract or understanding , a notice to be provided advis in g the said labor un ion or workers' representatives of the contractor's comm itments under th is section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4 . The contractor will comply with all provisions of Executive Order 11246 of September 24 , 1965 , as amended , and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. The contractor will furnish all information and reports required by Executive Order 11246 of September 24 , 1965 , and by rules , regulations, and orders of the Secretary of Labor, or pursuant thereto , and will permit access to his books, records , and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations , and orders. 6 . In the event of the contractor's noncompliance w ith the nondiscrimination clauses of this contract or with any of the said rules, regulations , or orders , this contract may be canceled , terminated or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedure authorized in Executive Order 11246 of September 24 , 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965 , or by rule , regulation, or order of the Secretary of Labor, or as otherwise provided by law. 7 . The contractor w ill include the portion of the sentence immediately preced~ paragraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to sect ion 204 of Executive Order 11246 of September 24 , 1965, so that such prov isions w ill be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase o rder as the administering agency may direct as a means of enforcing such provision , including sanctions for noncompliance : Provided, however, t hat in the event a cont ractor becomes inv olved in , or is threatened with , lit ig ation w ith a subcontractor or v endor as a resul t of such direction by the administe rin g agency the contracto r may request the United States to enter into such litigation to protect the interests of the Uni ted States . ' 2-52 CERTIFICATION OF NONSEGREGATED FACILITIES -41 CFR PART 60-1.8 Notice to Prospective Federally Assisted Construction Contractors 1. A Certificat ion of Non-segregated Facil ities shall be submitted prior to the award of a federally-ass isted construction contract exceeding $10 ,000 which is not exempt from the provisions of the Equal Opportunity Clause . 2. Contractors receiving federally-assisted construct ion contract awards exceeding $10 ,000 which are not exempt from the provisions of the Equal Opportun ity Clause will be required to provide for the forwarding of the following notice to prospective subcontractors for supplies and construction contracts where the subcontracts exceed $10,000 and are not exempt from the provisions of the Equal Opportunity Clause . NOTE : The penalty for making false statements in offers is prescribed in 18 U.S .C . 1001 . Notice to Prospective Subcontractors of Requirements for Certification of Non-Segregated Facilities 1. A Certification of Non-segregated Facilities shall be submitted prior to the award of a subcontract exceeding $10 ,000, which is not exempt from the provisions of the Equal Opportunity Clause . 2 . Contractors receiving subcontract awards exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause will be required to provide for the forwarding of this notice to prospective subcontractors for supplies and construction contracts where the subcontracts exceed $10 ,000 and are not exempt from the provisions of the Equal Opportunity Clause. NOTE : The penalty for making false statements in offers is prescribed in 18 U .S .C . 1001 . The federally-assisted construction contractor certifies that she or he does not maintain or provide, for his employees , any segregated facilities at any of his establishments and that she or he does not permit his employees to perform their services at any location , under his control , where segregated facilities are maintained . The federally-assisted construction contractor certifies that she or he will not maintain or provide , for his employees , segregated facilities at any of his establishments and that she or he will not perm it his employees to perform their services at any location under his control where segregated facil ities are maintained . The federally-assisted construction contractor ag rees t hat a brea c h of this ce rt ificat ion is a vi ola tion of the Eq ual Opp o rtu nity Cla use in this contract. As used in this certification , the term "segregated facilities" means any wait ing rooms, work areas , restrooms, and washrooms, restaurants and other eating areas , timeclocks , locker rooms and other storage or dressing areas, parking lots, drinking fountains , recre ati on or en te rt a inment areas , t ra nspo rt at ion, and housin g faci lities provided for emp loy ees w hic h a re segrega ted by ex plicit d ire ctive s o r are , in fa ct , seg rega ted o n th e bas is of ra ce , co lor, re lig ion , or national orig in be cause of habit , lo cal custom , or any other rea son . The federally-assisted cons t ruction contract o r ag rees that (except where she or he has obtained identical certificat ions from proposed subcontra ctors for s pec ific ' 2-53 time periods) she or he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000 which are not exempt from the provisions of the Equal Opportunity Clause and that she or he will retain such certifications in his files. NOTICE OF REQUIREMENT FOR AFFIRMATIVE ACTION -41 CFR PART 60-2 1. The Offeror's or Bidder's attention is called to the "Equal Opportunity Clause" and the "Standard Federal Equal Employment Opportunity Construction Contract Specifications" set forth herein. 2 . The goals and timetables for minority and female participation , expressed in percentage terms for the contractor's aggregate workforce in each trade on all construction work in the covered area, are as follows: Timetables Goals for minority participation for each trade (Vol. 45 Federal Register pg . 65984 10/3/80) Goals for female participation in each trade (6 .9%) These goals are applicable to all the contractor's construction work (whether or not it is Federal or federally-assisted) performed in the covered area. If the contractor performs construction work in a geographical area located outside of the covered area , it shall apply the goals established for such geographical area where the work is actually performed. With regard to this second area, the contractor also is subject to the goals for both its Federally involved and non-federally involved construction . The contractor's compliance with the Executive Order and the regulations in 41 CFR Part 60-4 shall be based on its implementation of the Equal Opportunity Clause , specific affirmative action obligations required by the specifications set forth in 41 CFR 60-4.3(a), and its efforts to meet the goals . The hours -of minority and female employmen t and training shall be substantially uniform throughout the length of the contract , and in each trade, and the contractor shall make a good faith effort to employ minorities and women evenly on each of its projects. The transfer of minority or female employees or trainees from contractor to contractor or from project to project, for the sole purpose of meeting the contractor's goals, shall be a violation of the contract, the Executive Order, and the regulations in 41 CFR Part 60-4 . Compliance with the goals will be measured against the total work hours performed . 3. The contractor shall prov ide written notificat ion to the D irector , OFCCP , w it hin 1 O wo rkin g days of aw ard of a ny const ruct ion subco ntract in exc ess of $10 ,000 at a ny tier for construction work under th e contract resulting from this solicitation . T he not ification shall lis t th e na me , address , and telephone number of the subcontractor; employer identificati on number of the subcontractor; estimated doll ar amount of the subcontract ; estimated starting and comp letion dates of subcontract ; an d th e geographical area in which the subcontract is to be performed . 4 . As used in t hi s notic e an d in th e contract re su ltin g fro m th is so licit a tion , th e "cov ered area" is the No ise Mit igation Areas . ' 2 -54 ST AN OARD FEDERAL EQUAL EMPLOYMENT OPPORTUNITY CONSTRUCTION CONTRACT SPECIFICATIONS· 41 CFR Part 60.4 .3 1. As used in these specifications : a . "Covered area" means the geographical area described in th e solic it ation from which t his contract resulted ; b. "Director" means D irector , Office of Federal Con tract Compliance Programs (OFCCP), U .S . Department of Labor , or any person to whom the Director delegates authority ; c. "Employer identification number" means the Federal social security number used on the Employer's Quarterly Federal Tax Return , U .S. Treasury Department Form 941 ; d . "Minority" includes: (1) Black (all) persons hav ing origins in any of the Black African rac ial groups not of Hispanic origin); (2) Hispanic (all persons of Mexican, Puerto Rican, Cuban, Central or South American , or other Spanish culture or origin regardless of race ); (3 ) Asian and Pacific Islander (all persons having origins in any of the original peoples of the Far East, Southeast Asia , the Indian Subcontinent, or the Pacific Islands); and (4) American Indian or Alaskan native (all persons having origins in any ofThe original peoples of North America and ma intaining identifiable tribal affiliations through membership and participation or community identification). 2. Whenever the contractor, or any subcontractor at any tier, subcontracts a portion of the work involving any construction trade, it shall phys ically include in each subcontract in excess of $10 ,000 the provisions of these specifications and th e Notice which contains t he applicable goals for minority and female participation and which is set forth in the solic itations from which this contract resulted. 3 . If the contra ctor is participating (pursuant to 41 CFR 60-4 .5 ) in a Hometown Plan approved by the U.S. Department of Labor in the covered area either in d ividu ally or through an association, its affirmative action obligations on all work in the Plan area (inclu d ing goals and timetables) shall be in accordance with that Plan for those trades which have unions participating in the Plan. Contractors shall be able to demonstrate their participation in and compliance with the provisions of any such Hometown Plan. Each contractor or subcontractor particip at ing in an approved plan is in d ivi dually required to comply with it s obligations under the EEO clause and to make a good faith effort to achieve each goa l under the Plan in ea ch trade in wh ich it has employees . The overall good faith performance by other co ntractors or subcontractors toward a goal in 2-5 5 an approved Plan does not excuse any covered contractor's or subcontractor's failure to take good faith efforts to achieve the Plan goals and timetables . 4. The cont ractor shall implement the specific affirmative action standards provided in paragraphs 18 . 7a through 18. 7p of these specifications . The goals set forth in the solicitation from which this contract resulted are expressed as percentages of the total hours of employment and training of minority and female utilization the contractor should reasonably be able to achieve in each construction trade in which it has employees in the covered area . Covered construction contractors performing construction work in a geographical area where they do not have a Federal or federally assisted construction contract shall apply the minority and female goals establ ished for the geograph ical area where the work is being performed . Goals are published periodically in the Federal Register in notice form , and such notices may be obtained from any Office of Federal Contract Compliance Programs office or from Federal procurement contracting officers . The contractor is expected to make substantially uniform progress in meeting its goals in each craft during the period specified. 5 . Neither the provisions of any collective bargaining agreement nor the failure by a union with whom the contractor has a collective bargaining agreement to refer either minorities or women shall excuse the contractor's obligations under these specifications , Executive Order 11246 or the regulations promulgated pursuant thereto . 6. In order for the non-working training hours of apprentices and trainees to be counted in meeting the goals , such apprentices and trainees shall be employed by the contractor during the training period and the contractor shall have made a commitment to employ the apprentices and trainees at the completion of their training, subject to the availability of employment opportunities . Trainees shall be trained pursuant to training programs approved by the U.S . Department of Labor. 1. The contractor shall take sPecific affirmat ive actions to ensure eQual employment opportunity. The evaluation of the contractor's compliance with these specifications shall be based upon its effort to achieve maximum results from its actions . The contractor shall document these efforts fully and shall implement affirmative action steps at least as extensive as the following : a. Ensure and maintain a working environment free of harassment , intim idation , and coercion at all sites , and in all facilit ies at which the contractor's employees are assigned to work . The contractor , where poss ible , will ass ign two or more women to ea c h construc t ion project. The contractor s hall spe ci fically ensu re that all forem e n, superint e nde nts, an d other o ns ite su pe rvisory pe rsonne l a re aware of and ca r ry out the contractor's obligation to maintain such a working environment, with spec ific attention to m ino ri ty or female in d ividuals working at su ch sites o r in such fa ci lities . b. Establish and ma in tain a current list of minority and female recru it ment sources, prov id e written not ification to minority and female recruitment sources and to co mm uni ty orga ni za ti o ns whe n th e contractor or its union s have employm e nt o pportun iti es ava ilable , a nd mainta in a record of t he organ iza tio ns' res po ns es . c. Maintain a current file of the names , addresses , and telephone numbers of each m inority and female off-the-st reet appl icant and m inority or fe male referral from a 2-56 union . a recruitment source , or community organization and of what action was taken with respect to each such individual. If such individual was sent to the union hiring hall for referral and was not referred back to the contractor by the union or , if referred, not employed by the contractor, this shall be documented in the file with the reason therefore along with whatever additional actions the contractor may have taken . d. Provide immediate written notification to the Director when the union or unions with which the contractor has a collective bargaining agreement has not referred to the contractor a minority person or female sent by the contractor , or when the contractor has other information that the union referral process has impeded the contractor's efforts to meet its obligations . e. Develop on-the-job training opportunities and/or participate in training programs for the area which expressly include minorities and women , including upgrading programs and apprenticeship and trainee programs relevant to the contractor's employment needs, especially those programs funded or approved by the Department of Labor. The contractor shall provide notice of these programs to the sources compiled under 7b above . f. Disseminate the contractor's EEO policy by providing notice of the policy to unions and training programs and requesting their cooperation in assisting the contractor in meeting its EEO obligations; by including it in any policy manual and collective bargaining agreement; by publicizing it in the company newspaper, annual report, etc .; by specific review of the policy with all management personnel and with all minority and female employees at least once a year; and by posting the company EEO policy on bulletin boards accessible to all employees at each location where construction work is performed . g . Review, at least annualry,-fne company's EEO policy ana affifmru1ve acf1on obligations under these specifications with all employees having any responsibility for hiring, assignment, layoff, termination, or other employment decisions including specific review of these items with onsite supervisory personnel such a superintendents, general foremen, etc., prior to the initiation of construction work at any job site. A written record shall be made and maintained identifying the time and place of these meetings , persons attending, subject matter discussed , and disposition of the subject matter. h. Disseminate the contractor's EEO policy externally by including it in any advertising in the news media , specifically in cluding minority and female news med ia , and providing written notification to and discussing the contractor's EEO policy with other con tra ctors and subcontractors with whom the contractor does or a nt ici pates doin g business . i. D ir ect its recru itment efforts , both oral and written , to minority, female , and co mmu nity organ iz ations , to sc hool s with minority and female students ; a nd to minority a nd female recru itment and tra inin g organ izations serving the contractor's recruitment area and employment needs . Not later than one month prio r to the date for the ac ceptanc e of application s for apprenticeship or othe r training by any recru itment source, the contractor shall send wri tt e n notification to org an izations , 2-57 such as the above , describing the openings , screen i ng procedures , and te sts to be used in the selection process . j . Encourage present minorit y and female employees to recruit other minority persons and women and, where reasonable provide after school , summer, and vacation employment to minority and female youth both on the site and in other areas of a contractor's workforce . k . Validate all tests and other selection requirements where there is an obligation to do so under 41 CFR Part 60-3 . I. Conduct, at least annually , an inventory and evaluation at least of all minority and female personnel , for promotional opportunities and encourage these employees to seek or to prepare for , through appropriate train ing , etc ., such opportunities . m . Ensure that seniority practices , job classifications , work assignments , and other personnel practices do not have a discriminatory effect by continually monitoring all personnel and employment related activities to ensure that the EEO pol icy and the contractor's obligations under these specifications are being carried out. n. Ensure that all facilities and company act ivities are non-segregated except that separate or single user toilet and necessary changing facilities shall be prov ided to assure privacy between the sexes. o . Document and maintain a record of all solicitations of offers for subcontracts from minority and female construction contractors and suppliers, including circulation of solicitations to minority and female contractor associations and other business associations . p. -conaucta review , at least annually , or air s upervfsor's adnerence fo an-a-- performance under the contractor's EEO policies and affirmative action obligations. 8 . Contractors are encouraged to participate in voluntary associations , which assist in fulfilling one or more of their affirmative action obligations (18 . 7a through 18. 7p ). The efforts of a contractor association, joint contractor union , contractor community , or other similar groups of which the contractor is a member and participant, may be asserted as fulfilling any one or more of its obligations under 18 .7a through 18 .7p of these spe c ificat ions provided t hat the contractor activel y participates in t he g roup , makes every effo rt to assure that the group has a positive imp act on the employment of minorities and women in the industry, ensures that the concrete benefits of the prog ram are reflected in the contractor's minority and female workforce participat ion , makes a good fa ith effort to meet its ind ividua l goals an d timetables , and can provide access to documentation which demonstrates the effectiveness of actions taken on behal f of the contr actor . The obligation to comply, however, is th e co ntractor's and fa il ure of such a group to fulfill an oblig at ion sha ll not be a defense for the contractor's noncompliance . 9. A single goal for minorities and a separate s ingle goal for women have be en establ ished . T he co ntractor, how ever , is requ ired to prov id e equal employment opportunity and to tak e affi rmat ive action for all minority groups , bot h male and femal e, and all women , 2-58 both minority and non-minority. Consequently , if the particular group is employed in a substantially disparate manner (for example , even though the contractor has ach ieved its goals for women generally ,) the contractor may be in violation of th e Executive Order if a specific minority group of women is underutiliz ed . 10 . The contractor shall not use the goals and timetables or affirmat ive act ion standards to discriminate against any person because of race , color , religion , sex , or national origin . 11 . The contractor shall not enter into any subcontract with any person or firm debarred from Government contracts pursuant to Executive Order 11246 . 12 . The contractor shall carry out such sanctions and penalties for v iolation of these specifications and of the Equal Opportunity Clause, including suspens ion , term ination , and cancellation of existing subcontracts as may be imposed or ordered pursuant to Executive Order 11246 , as amended, and its implementing regulations , by the Office of Federal Contract Compliance Programs. Any contractor who fails to carry out such sanctions and penalties shall be in violation of these specifications and Executive Order 11246 , as amended . 13. The contractor, in fulfilling its obligations under these specifications, shall im plement specific affirmative action steps, at least as extensive as those standards prescribed in paragraph 18. 7 of these specifications, so as to achieve maximum results from its efforts to ensure equal employment opportunity . If the contractor fails to comply with the requirements of the Executive Order, the implementing regulations , or these specifications , the Director shall proceed in accordance with 41 CFR 60-4 .8 . 14. The contractor shall designate a responsible official to monitor all employment related activity to ensure that the company EEO policy is being carried out, to submit · -reports relating to the provisions hereof as may be required by the Government, and to keep records. Records shall at least include for each employee, the name, address, telephone number, construction trade , union affiliation if any, employee identification number when assigned, social security number , race , sex, status (e.g., mechanic, apprentice, trainee , helper , or laborer), dates of changes in status , hours worked per week in the indicated trade, rate of pay, and locations at which the work was performed. Records shall be ma intained in an easily understandable and retrievable form ; however , to the degree that ex isting records sat isfy t his requirement, contractors shall not be required to maintain separate records . 15 . Nothing herein provided shall be construed as a limitatio n upon the application of other laws which es tab lish differen t standards of compliance or upon the application of requirements for the hiring of local or other area res idents (e .g ., t hose under the Publ ic Works Employment Act of 1977 and the Commun ity Development Block G rant Program). TERMINATION OF CONTRACT 1. The Spon sor may , by written notice , terminate this contract in whole or in part at any ti me , e ither for the Sponsor's con venie nce o r bec ause of fa ilure to fulf ill th e contra ct ' 2-5 9 obligations . Upon receipt of such notice services shall be immediately discontinued (unless the notice d irects otherwise) and all materials as may have been accumulated in performing this contract , whether completed or in progress , delivered to the Sponsor. 2 . If the termination is for the convenience of the Sponsor, an equitable adjustment in the contract price shall be made , but no amount shall be allowed for anticipated profit on unperformed services. 3. If the termination is due to failure to fulfill the contractor's obligations , the Sponsor may take over the work and prosecute the same to completion by contract or otherwise. In such case , the contractor shall be liable to the Sponsor for any add ition al cost occasioned to the Sponsor thereby . 4. If, after notice of termination for failure to fulfill contract obligations, it is determined that the contractor had not so failed, the termination shall be deemed to have been effected for the convenience of the Sponsor. In such event, adjustment in the contract price shall be made as provided in paragraph 2 of this clause . 5. The rights and remedies of the sponsor provided in this clause are in add ition to any other rights and remedies provided by law or under this contract. CERTIFICATION REGARDING DEBAREMENT, SUSPENSION , INELIGIBILITY AND VOLUNTARY EXCLUSION The bidder/offeror certifies, by submission of this proposal or acceptance of this contract, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by_ any __ _ --FederaTdepartment or agency. It further agrees by submitting this proposal that it will include this clause without modification in all lower tier transactions, solicitations, proposals, contracts, and subcontracts. Where the bidder/offeror/contractor or any lower tier participant is unable to certify to this statement, it shall attach an explanation to this solicitation/proposal . CONTRACT WORKHOURS AND SAFETY STANDARDS ACT REQUIREMENTS (29 CFR PART 5) 1. Overt ime Requ irements . No contractor or subcontractor contracting for any part of the contract work which may require or in volve the employment of laborers or mechan ic s shall requi re or perm it any such laborer or mechan ic , includ ing watchmen and gua rds , in any w o rkw ee k in wh ich he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic rece ives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek . 2. Viol ation ; Liability for Unpaid Wages; Liquidated Da mages . In the event of any violation of the clause set forth in paragraph (1) above , the co ntractor and an y sub contra cto r respo nsi ble there fo r shall be li a bl e fo r th e u npa id w ages . In i 2-60 addition , such contractor and subcontractor shall be liable to the Un ited States (in the case of work done under contract for the District of Columbia or a territory , to such District or to such territory), for liquidated damages . Such liquidated damages shall be computed w ith respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph 1 above , in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph 1 above . 3. Withholding for Unpaid Wages and Liquidated Damages. The Federal Aviation Administration or the Sponsor shall upon it s own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any monies payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor , or any other Federally-assisted contract subject to the Contract Work Hours and Safety Standards Act , which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph 2 above. 4 . Subcontractors. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraphs 1 through 4 and also a clause requiring the subcontractor to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs 1 through 4 of this section. 5. Working Conditions. No contractor or subcontractor may require any laborer or mechanic employed in the performance of any contract to work in surroundings or under working conditions that are unsanitary, hazardous or dangerous to his health or safety as determined under construction safety and health standards (29 CFR Part 1926) issued by the Department of Labor. 2-61 ' WAGE, LABOR, EEO, SAFETY AND GENERAL REQUIREMENTS (Federal Aviation Administration (FAA) Requirements) 1. Airport and Airway Improvement Program Project. The work in this contract is included in Airport Improvement Project No .«GRANT No. 3-48- 0085-1202 wh ich is being undertaken and accomplished by the City of Fort Worth (Alliance A irport) in accordance with the terms and conditions of a grant agreement between the Sponsor and the United States , under the Airport and Airway Improvement Act of 1982 (P.L. 97-248) as amended by the Airport and Airway Safety and Capacity Expansion Act of 1987 (P .L. 100-223) and Part 152 of the Federal Aviation Regulations (14 CFR Part 152), pursuant to which the United States has agreed to pay a certain percentage of the costs under those Acts . The Un it ed States is not a party to th is contract and no reference in this contract to the FAA or any representative thereof, or th e United States, by the contract, makes the United States a party to this contract. 2. Consent to Assignment. The contractor shall obtain the pr ior written consent of the Sponsor to any proposed assignment of any interest in or part of th is contract. 3. Convict Labor. No convict labor may be employed under this contract. 4. Veterans Preference. In the employment of labor (except in executive , administrative , and supervisory positions), preference shall be given to veterans of the V ietnam era and d isabled veterans as defined-in-Section 515(c)(1) and -(2)of the Act. -However , T his-preferenceshall a pply -- only where the individuals are available and qualified to perform the work to which the employment relates . 5. Withholding: Sponsor from Contractor. Whether or not payments or advances to the City of Fort Worth withheld or suspended by th e FAA , the Sponsor may withhold or cause to be withheld from the contractor so much of the accrued payments or advances as may be considered necessary to pay laborers and mechanics employed by the con tracto r or any sub contracto r on the work , the full amount of wages required by this contract. 6. Nonpayment of Wages . If the contractor or subcontractor fails to pay any laborer or mechanic employed or working on the site of the work any of the wages required by th is contract, the City of Fort Worth may , after written notice to the contractor , take such action as may be necessary to cause th e suspension of any further payment or advance of funds until the violations ce ase . 7. FAA inspection an d review. 2-62 The contractor shall allow any authorized representative of the FAA to inspect and review any work or materials used in the performance of this contract. 8. Subcontracts . The contractor shall insert in each of his subcontracts the prov1s1ons contained in paragraphs A-1 , A-3 , A-4 , A-5 , A-6, and A-7 requiring the subcontractors to include these provis ions in any lower tier subcontracts which they may enter into, together with a clause requiring this in sertion in any further subcontracts that may in turn be made . 9. Contract Termination. Any violation or breach of the terms of this contract on the part of the contractor or subcontractor may result in the suspension or termination of this contract or such other action that may be necessary to enforce the rights of the parties of this agreement. (49 CFR Part 18). 10. Inspection of Records. The contractor shall maintain an acceptable cost accounting system . The Sponsor, the FAA, and the Comptroller General of the United States shall have access to any books , documents, paper, and records of the contractor which are directly pertinent to the spec ific contract for the purposes of making an audit, examination, excerpts , and transcriptions. The contractor shall maintain all required records for three years after the Sponsor makes final payment and all other pending matters are closed . (49 CFR Part 18). 11. Rights to Inventions. All rights to inventions and materials generated under this contract are subject to --regulations issued oytne--FAAanafne Sponsor mme Federal grant una erwnicn t.-h--,~s -- contract is executed . Information regarding these rights is available from the FAA and the Sponsor. (49 CFR Part 18). 12. General Civil Rights Provisions. The contractor assures that it w ill comply with pertinent statutes , Executive orders and such rules as are promulgated to assure that no person shall , on the grounds of race, creed , color , national origin , sex , age , or handicap be excluded from part ic ipating in any activ it y conducted with or benefiting from Federal assistance . Th is provi sion binds the contractor from the bi d solicitation period through the completion of the contract. (Section 520, Airport and Airway Improvement Act of 1982). 2 -63 CONTRACT WORKHOURS AND SAFETY STANDARDS ACT REQUIREMENTS (29 CFR PART 5) 1. Overtime Requirements. No contractor or subcontractor cont racting for any part of the contract work wh ich may requ ire or involve the employment of laborers or mechan ics shall require or permit any such laborer or mechanic , including watchmen and guards , in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek . 2. Violation; Liability for Unpaid Wages; Liquidated Damages. In the event of any violation of the clause set forth in paragraph C-1 above , the contractor or any subcontractor responsible therefor shall be liable for the unpa id wages . In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory , to such District or to such territory), for liquidated damages . Such liquidated damages shall be computed with respect to each individual laborer or mechanic , including watchmen and guards, employed in violation of the clause set forth in paragraph C-1 above, in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages requ ired by the clause set forth in paragraph C-1 above . 3. Withholding for Unpaid Wages and Liquidated Damages. TFi e Federal Aviat ion -Aamin istraffon or the Sponsor shaff upon its own a ct ion or upon--- written request of an authorized representative of the Department of Labor withhold or cause to be withheld , from any monies payable on account of work performed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor , or any other Federally-assisted contract subject to the Contract Work Hours and Safety Standards Act , which is held by the same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as prov ided in the clause set forth in paragraph C-2 above . 4. Subcontractors. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraphs C-1 through C-4 and also a clause requiring th e subcontractor to in clude these cl auses in any lower tier subcon tracts . The pri me contractor shall be respons ib le for complianc e by any subcontractor or lower tier subcontractor w ith the clauses set forth in pa rag ra ph s C-1 throu g h C-4 . 5. Working Conditions. 2 -6 4 No contractor or subcontractor may require any laborer or mechanic employed in the performance of any contract to work in surroundings or under working conditions that are unsanitary, hazardous or dangerous to his health or safety as determined under construction safety and health standards (29 CFR Part 1926) issued by the Department of Labor. CLEAN AIR AND WATER POLLUTION CONTROL Any other provision herein to the contrary notwithstanding , the contractor in carrying out work under this contract , shall at all times comply with all applicable state and federal air and water quality standards ; with all pollution control laws; and with such rules, regulations , and directives as may be lawfully issued by a local , state , or federal agency having within its jurisdiction the protection of the environment in the area surrounding where work under this contract will be performed . In addition, the contractor shall comply with directives given by the Project Engineer in implementation of the letter and intent of FAA Advisory Circular 150/5370-10, Item P-156 , Temporary Air and Water Pollution , Soil Erosion and Siltation Control. Copies of this Advisory Circular can be obtained from Department of Transportation , Distribution Unit , TAD-484 .3, Washington , D.C. 20590 . Contractors and subcontractors agree : a. That any facility to be used in the performance of the contract or subcontract or to benefit from the contract is not listed on the Environmental Protection Agency (EPA) List of Violating Facilities; b. To comply with all the requirements of Section 114 of the Clean Air Act , as amended, 42 U.S.C. 1857 et seq. and Section 308 of the Federal Water Pollution Control Act , as amended, 33 U.S .C. 1251 et seq. relating to inspection, monitoring, entry , reports , and information, as well as all other requirements specified in Section 114 and Section 308 0Uhe_Ac.ts_,_r_especthtel¥,-aAd--aU--0tl=leF-Fef/Ulatiens-a-nd-g11idelines-jssmrd ereu n er; c. That, as a condition for the award of this contract, the contractor or subcontractor will notify the awarding official of the receipt of any communication from the EPA indicating that a facility to be used for the performance of or benefit from the contract is under consideration to be listed on the EPA List of Violating Facilities ; d. To include or cause to be included in any construction contract or subcontract which exceeds $100,000 the aforementioned criteria and requirements . 2-65 FORT WORTH -----,,.----CITY OF FORT WORTH Disadvantaged Business Enterprise l chedule of Subcontractors/Suppliers I IBJ DBE [RI MWBE ONON -M /W/DBE ATIACHME NT 1A Page 1 of 3 PRIME COMPANY NAME : lntercon Environmental Inc. PROJECT NAME : Noise Mitigation Project Removal of Asbestos-Containing Materials J Demolition of Structures at A lliance Airport BID DATE June 11, 2009 PROJECT NUMBER : DEM 09-08: Alliance NMP I CITY 'S DBE PROJECT GOAL : 10% I p rime 's DBE GOAL COMMITMEN T : 10% Please read the following statements prior to executing this form. Bidders/Offerors must provide information on all prospective subcontractor(s)/suppliers who su pmit bids/quotations in support of this solicitation . Failure to com plete this form , in its entirety with supporting documentation , and received by the Managing Department o 1 or before 5 :00 p .m . five (5) City business da ys after bit opening , exclusive of bid opening date , will result in the bid being considered non-responsive to the bid specificatio lS . The bidder further agrees to provide, directly to the City upon request, complete and accurate infkrmation regarding actual work performed by all subcontractors , i ncluding DBE(s) arrangements submitted with this bid. The bidder also agrees to allow an audit and/ore amination of any books , records and files held by their company that will substantiate the actual work performed by the DBE(s) on this contract, by an authorized officer t employee of the City . Any intentional and/or knowing m is rep re sentation of facts will be grounds for terminating the contract or debarment from City work for a period of ot 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 d ete rmina t ion of an irresponsible offerer and barred from participating in City work for a period of time not less than tj ne (1) year. Prime contractors must identify by tier level of all subcontractors/suppliers. Tier: means the IE vel of subcontracting below the prime contractor/consulta nt i.e . a di rect payment from the prime contractor to a subcontractor is considered 151 tier, a payment by a su )contractor to its supplier is considered 2"d.t ier. The prime cont ractor is responsible to provide proof of payment of all tiered subcontractors identified as a DBE and coun ing those dollars towards meeting the contract committed goal. Prime contractors must also provide the previous year's annual gross receipts of all subcont ctors/suppliers listed on the utilization form . This i nfo rmation may be expressed in the dollar ranges provided that column . Counting DBE Participation : If materials or supplies are obtained from a DBE manufacturer, cour t 100 percent of the cost of the materials or supplies towa rds the goal. If the materials or supplies are purchased from a DBE regular dealer, count 60 percent of the cos of the materials and supplies toward the DBE goal. Wh en mate r ia ls or supplies are purchased from a DBE neither a manufacture nor a regular dealer, count the entire a1 nount of fees or commissions charged for assistance in the procurement of the materials and supplies or fees or transportation charges for the delivery of the materials or supplies delivered to the job site . In all cases , the prime contractor is responsible to identify the amounts to be used toward the committed DBE goal. If hauling services is utilized , separation of dollars for haul-i n and haul out is required . In additio1 , the prime will be given credit for utilizing a DBE hau ling firm as long as the DBE owns and operates a least one fully licensed and operational truck used on the contract. The DBE may lease trucks from another DBE firm, including DBE owner- operated and receive full DBE credit. The DBE may lease trucks from non-DBEs , including owr r-operators , but will only re ceive credit for the fees and commi ss ions earned by the DBE as outlined in the lease agreement. Note: Be mindful of the 60% rule . I Rev . )-30-03 FORT WORTH .._,_ w· ~ CITY OF FORT WO ~TH SCHEDULE OF SUBCONTRAC ORS/SUPPLIERS ATIACHMENT 1A Page 2 of 3 Check this box ~ if any subcontractor/supplier is a Sole Source and identify by writing s le source by the subcontractor/supplier name. I NAMES AND ADDRESSES OF TYPE OF WORK TO BE PERFORMEO Specify CERTIFIED DBE PREVIOUS YEAR 'S SUBCONTRACTORS/SUPPLIERS I Tier FIRM ANNUAL GROSS RECEIPTS ( chec k one) Name: CBA Services, Inc. Type of Work: Yes ....!... No --less tha n $500K Address : 5877 Barnett Road, Suite A Asbestos Waste Hauling Krum, Texas 76249 Sole Source Certified By: -$SOOK to $2M Phone: (940) 482-9900 Tier I NCTRCA _x_ Fax: (940) 482-3457 $AMOUNT: $2,990.00 TXDOT ....!... $2M to $SM -- Email: janao@cba-corp.com I Other __ please more than $SM I atta ch DBE certification - Contact Person: Jana Osborn Name: Tomas Reyes Trucking Type of Work: I Yes ....!... No --less tha n $500K Address: 3529 Peoria Street Demo Waste Hauling Dallas, Texas 75212 Sole Source Certified By: -$SOOK to S2M Phone : (214) 631-2711 Tier I NCTRCA _x _ Fax: (214) 905-7565 $ AMOUNT: $19,023.10 TXDOT ....!... $2M to $SM -- Email : maricela@reyestrucking.com Other please more than $SM I attac h DB E certification - Contact Person: Jesse Velasquez Name: Geyer Drilling Company, Inc. Type of Work: I Yes -No ....!... -less than $SOOK Address: 108 W Broad St Water Well Plugging Mansfield, TX 76063-1659 Sole Source Tier I Certified By: ....!... $SOOK t o $2M Phone: (817) 477-2215 NCTRCA --$2M to $SM Fax: (817) 473-7455 $AMOUNT: $22 ,8SO .OO TXDOT --- Email: geyerd rill@aol.com Other please more than $SM attach DB E certification - Contact Person: Bob Geyer Name: Jackey Lackey Septic Cleaning Type of Work: Yes -No ....!... -less than $SOOK Address : 802 Meadowview Septic Tank Services Cleburne, Texas 76033 Sole Source I Tier I Certified B y : _!_ $SOOK to S2M Phone: (817) 645-7586 NCTRCA --$2M (817) 556-2552 $AMOUNT: $4 ,8SO .OO TXDOT -to $SM Fax: -- Email: jackeylackeyseptic@yahoo.com Other please more than $SM attac h DBE certification - Contact Person: Dwain Lackey Rev . 5-3 0-03 I CITY OF FORT w d RTH FORT WORTH ....., •. .-- SCHEDULE OF SUBCONTRAGTOR/SUPPLIERS NAMES AND ADDRESSES OF TYPE OF WORK TO BE PERFORMED Specify CERTIFIED DBE SUBCONTRACTORS/SUPPLIERS Tier FIRM Name: Best Bee Keepers Type of Work: Yes -No X Address: 3817 Piedmont Road Profession Beekeeping and/or Extermination Certified By : Fort Worth, Texas 76116 Tier I NCTR CA -- Phone: (817) 377-0233 TXDO T -- Fax: (817) 377-0233 $ AMOUNT : $1 ,020 .00 Other please Based on $8S.OO/hr x 4 hrs )< 3 Hives attach DB E certification Email : None Contact Person : Chaim Saadon Name: Type of Work : Yes No --Address: Certified By : Phone: NCTRC A -- Fax: $ AMOUNT: TXDOT -- Email: Other please atta ch DBE certifi c ation Contact Person : ATT ACHMENT 1A Page 3 of 3 PREVIO US YE A R'S ANNUA L GR OSS RECEIPTS ( c heck one) X less tha n $S OOK - $SOOK t o $2M - $2M t o $SM - more t han $S M - less than $SO OK - $SOOK t o $2 M - $2M to $S M - more th an $S M - The undersigned bidder agrees to enter into a formal agreement with the DBE firms for work listed in this schedule , c o nd itioned upon execution of a contract with the City of Fort Worth. The intentional and/or knowing misrepresentatio~ of facts is grounds for consid e ra ti on of disqualification and will result in the bid being considered non-responsive to bid specifications. \ ALL DBES MUST BE CERTIFIED BY THE CITY OF FORT WORTH PRIOR TO A R~COMMENDATION FOR AWAR D TO THE CITY COUNC IL. ~ ---'K-"a=r....;;e..;.;n....;;ll\-"n;.;..d=r....;;e'"'"w;;.,;;s'--------------------- Authori~ Printed Sighature President Title lntercon Environmental Inc. Company Name 210 S. Walnut Creek Drive Address Mansfield Texas 76063 City/State/Zip Code Contact Na~e and Title (if different) (817) 47 7 -9995 Phone Numlber karen@intercon-environmental .com Email Address I June 11 2009 Date (817) 477-9996 Fax Numbe r C OO ES346 NCTRCA Disadvantaged Business Enterprise Certification \ lntercon Environmeni al, Inc. I I Disadvantaged Business E rl terprise has filed with the A~ency an Affidavit as defined by 49 CFR p•rt 26 and is hereby certified to provide sen•ice(s) in the following a ~eas: I 56291 O; 23891 O; I Asbestos Contractor and Removal : Remediation Services ; Site Preparation Contractors (pt); This Certification is valid beginning August 2008 and superseded any registration or listin~ previously issued. This certification must be updated annually by sutimission of an Annual Update Affidavit. At any time there is a change in ownership or control of the firm, notificahon must be made immediately to the North Central Texas Regional Certification Agency or an TUCP certifying ehtity. I Certificate expiration August 20 09 _____ ...;;._ _____ , --~~0 ertification Administlt!: Issued date ________ A_ug.._u_s_t _____ , 20.Q§__ CERTIFICATION NO. WFDB38281Y0809 Lithe In US A CTRCA Di advantaged Business Enterpri e Certification CBA Services , Inc. r .. ad aa 0 i4 8'..l f "'SS ~nt0 ~"'ri ·e has filed with the A~ency an Affichfvi a c e nH!d"f,y" , •t< Jllirf'2o • no i , hereby certifi("d to proYide crvice(s) in fh e following a r ell : 48 4220; -52211 : 56 221 9: Spec:ali ::ed Frei;;h (exce;::>t Used Good s) Trucking . Lo al : Haza dous Waste 7'rea men· a-1·::'. Disposal : ther onhazardous Waste Treatm en~ nr1 Di-po s 1· Thi Certification i vaHd beginning Fe bruary 2009 and s u perseded any regi tration or li stin~ previou . ly i · Ul'd. Thi certification mu t be updated annuall y by sub mis io o f an Annual Update Affida it. t any time the r e i a charge in owner hip or contr ol of the firm , notificatio n mu ·t be made immediately to the North Central Texa · R egional Certification Agency or an T UC P certifying entity. Certificate expiration _____ _.F....,e ..... b ..... r..._1..._1a .... o.,...,1 ___ , 20 __ 10 Certification dmini trator T ued date ----------"r""e;:.,,b~r .... " .... ~~f)r' ___ , 20 __ 09 CERTIFICATION NO. WF0B40188Y0210 ci tJl ~ 0 I- ~ 0 co 0 a. Q) <J) NCTRCA Minority Business Enterpri e Certification Tomas Reyes Truckin ~, Inc Minority Business Enterp L e has filed with the Agency the appropriate Affidavit and is hereby certified l ~ provide service(s) in the follo w in g areas: 484220 ; I Spe cia li zed Freight (ex t:ept Used Goods) i ruc king , Loc al ; --·-·--· ------··· ----------. l . . . . Se !ember 2008 . . . . l'hts Certification is valid beginning p an superseded any regi stratio n or hstmg previously Issued. This certlflcatlon must be updated annually by submlssl ~n of an Annual Update Affida vit. At any time there is a charge in ownership or control of the firm , notification m~st be made Immediately to the North Central Texas Regional Certification Agency. \ September 09 Certificate expiration-----------' 20 __ l11sued elute September 20 08 ---------------· -- CERTIFICATION NO. HMMB38406Y0909 I I )/~ Certification Administrator ENVIRONM ENTAL , INC. 210 S. Walnut Creek Drive , Ma n s fie l d T e x a s 76063 , T e lephone (817 ) 4 77-999 5 , Facs i m il e (8 17) 477-9996 www . i ntercon-environmental . com 2 .7.1 Subcontra ctors Compan y Information ASBESTOS H A UL!NG CBA Services , Inc . 5877 Barnett Road, Suite A Krum , Texas 76249 Person of Contact: Ms. Jana Osborn (940) 482-9900 Telephone (940) 482-3457 Facsimile janaosborn@ hotmail .com -----·~epa:n-m_e_n~t -o_,.f ....... S-.ta-:-te----rH,....-e_a,..lt'h "S;-e-rv--si:--c-es- " Asbestos Transporter License No. 40-0312 DEMOLITION DEBRIS H A ULJN G Tomas Reyes Trucking 3529 Peoria Street Dallas , Texas 75212 Person of Contact: Mr. Jesse Valasquez (214) 631-2711 Telephone (214) 905-7565 Facsimile j velasquez@ reyestrucking.com WA TER W ELL PL UGG ING Gey er Drilling Company, Inc . 108 West Broad Street Mansfield, Texas 76063 Person of Contact: Mr. Bob Gey er (817 ) 477-2215 Telephone (817 ) 473-7455 Facsimile ge y erdrill@ ao I. com Tex as Department of Licensing & Regulation (TDLR) Water Well Driller and Pump Inst all er License N o. 15 0 5 City of Fort Worth Noise Mitigation Project Removal of A sh e tos-Containing Materials & Dem o liti o n of Structures at Alliance Airport 2 .7.1 Subcontractor Compan y Informati o n SEPTIC TA NK SER VI CES Jackey Lackey Septic Cleaning 802 M e ad owview Cleburne , Texas 76033 (817) 645-7586 Telephone (817) 556-2552 Facsimile Person of Contact: Mr. Dwain Lackey j ackey lackeysepti c (a),yahoo . com ~ Texas Commission on Environmental Quality (TECQ) Sludge Transporter License No. 23271 PROFESSIONAL BEEKEEPING ANDI OR EXTERMINATION Best Bee Keepers 3817 Piedmont Road Fort Worth, Texas 76116 (81 7) 3 77-0233 Telephone (817) 377-0233 Facsimile Person of Contact: Mr. Chaim Saadon No email ENVIRONMENTAL, I NC. ~ Office of the State Entomologist at Texas A&M University Department of Entomology Interstate Permit to Move Bees and/or Equipment License No . I-09-019 2.7.Sub con tracto rs Info rm at io n and Qu ali fic at ion s Comp lete the following table list ing each subcontractor and their proposed task associated w ith this contract. · C BA Se rvic es , Inc . A s be sto s Was te Hauling I j Tomas Reyes Truck ing ; Demoltion Debris Hauling ! I . ·+··-· ·-··-----·····-· --------·--·---· -·-·--···· ·--· ·-· -··· ------···-·-···--····· --·---------I Geyer Drilling Co . Inc . Water Well Plugging I -----------' Jackey Lackey Septic 1 1 Cleaning I Septic Tank Services . ------------r----- : Best Bee Keep~ Professional Beekeeping and/or Extermination ---------tf-Slfec-ootfiieto rs-are-to--be otiiize&,-tht:fottowtn~nformat1on shourao e su mitted for EACH subcontractor. (This section must be completed in addition to the requ ired DBE documentation in Section 2.9 .) 2 .7 .1. Subcontractor's company name, address, emai l address , telephone number(s), and FAX numbe r(s ) for the local office as well as the headquarters . 2 .7 .2 . Subcontractors current Statements of Qual ifications . 2 .7 .3 . Matrix including the following information detail ing the subcontractor's pe rsonne l, thei r qualifications , and years of experience . • Pos it ion t itle and job function as associated with this contract , (President, Vice President, Project Managers, Techn ical Managers, Field Supervisors, etc . .) • Name • Tasks to be performed in association with th is contract • Cert ificat ions/Licenses • Total Years Experience 2-14 ~·· ...... ~tercon EN V IRONMENTAL , INC. 210 S . Wa ln ut Creek Drive . Mans fi eld Texas 76063 . Telephone (817) 477-9995 . F a csim i le (8 17) 477-9996 R es p on se to Sectio n 2.7.2 Subcon t ra ctor Stat e m e nt of Qualification s www .i nt e rcon-env iron me nt a I . com CBA Services , Inc., a 100% woman-owned small business is located at 5877 Barnett Road , Su ite A , Krum , Texas 76249 . The company was founded in 2001 provi d i ng serv ices from hazardous waste treatment, asbestos transportation and project management. CBA currently owns and /or operates roll -off trucks and end dump trucks . CBA provi des 20 , 25, and 30 Cubic Yard (CY) open -top containers and 40 CY asbestos vaults. Below i s a list of representative proj ects demonstrating CB I\ Serv ices lnc.i pa.s.Ux.p.e d..e.ru:e...w itb _pe.rfo Lmin.g remed iation of Superfund Sites , hazardous waste remediation, t r ansportat i on and disposal : Sweetwater. Texas : Prov i ded 40 CY asbestos vaults for transportat i on and d i sposal of approximately 1 0 loads of asbestos ; the demoliti on phase of the project required transportation of 3 S loads of demolition debris utilizing 35 CY end dump trucks. San Antonio, Texas : Provided a permanent 40 CY asbestos vault for the transportation and d i sposal of asbestos waste materials from a facil ity for the Department of Defense . Dallas, Texas: Prov ided sem i-permanent 30 CY open-top roll-off containe r s for transportation and disposal of construct ion debris from large Dallas facility for long term construction /renovat i on projects. Waxahachie. Texas: Responded to an emergency call within one hou r t i me frame to provi de four 30 CY open-top roll-off conta i ners for the transportation and disposal of d i esel -contam i nated soil which caused highway closure . Job complete w ith i n 2 V2 hours . Fort Worth. Texas : Responded to an emergency call rece ived at 2 :00 am ; w ithin one hour time frame to provide one 30 CY open -top roll -off con t a i ner and two 30 CY wa t erti ght vacuum containe r s from truck open i ng a valve on 1-3 0 and dumped materials i nto a nearby c r eek. Job complete w ithin four hours . Denton. Texas : Prov i ded four 40 CY asbestos vaults for the tran sportat i on and d i sposal of asbestos was t e materials from a Un iversity. Transported 52 loads. Rockwall. Texas : Prov ided t hree 30 CY open -top ro l l -off conta i ne r s for t he transportat i on a nd d i sposal of contam i nated mate ri als from a Texas Com mi ss i on of Env i ronmen ta l Qu al ity funded cl ean -up . Bid Docu m e nts /Soecific /S u hrontr;irt nr ,t;itPmPnt nf n 11::difir::iti f"\nc ~rl Services, Inc. 5877 Barnett Road, Ste . A Krum, Texas 76249 Phone : (940) 482-9900 FAX : (940) 482-3457 Ms . Karen Andrews Intercon En vi ronm ent al, In c. 210 S . W alnut Creek D rive M ansfie ld , Texas 76063 Dear Ms . Andrews : CBA Service#: Employee Matrix The following are the employees that will work on the project we discussed earlier today. I have outlined each employee that will be involved and their respecti ve responsibilities , licenses , certificates and experience . Name Job Tasks Certificates Years _ ----------------e---Tme-Performed / Licenses Exp. Jana Osborn President Operations & Safety 18 years TX Class A CD L Ops . Dri v ing, Operations #15022647 w/ Haz End . Kelsey Mccaughan Mgr . & Safety Asbestos Awareness 10 years TX Class A CDL #098 59793 w / Haz End . Ned Daniels Driver Dri ving Asbestos Awareness 23 years TX Class A CDL #16640558 w/ Haz End . Adrian Hill Dri ver Dri ving Asbestos Awareness 13 years TX Class A CDL # 01589471 w / Haz End. Michael Hill Dri ver Dri vi ng Asbestos Awareness 13 years If yo u ha ve any questions or need any additional information, please call me at (940) 482-9900 . Sincerel y, Jana Osborn, President ' .. , Lic~se Number : 4003.Ii Control Numb~r: 95421, ', 't ' ~ ' • • --h. ' .., ··· . CBA .SER~lCES :IN ·· .. , . : ·.:, 1'4 , . .. Expiration Date: 517/2010 (Void After Expiration Date) VOID I~ AL TE~ED STATEMENT OF QUALIFICATIONS Tomas Reyes Trucking, Inc. 3529 Peoria Street Dallas, Texas 75212 ----------------- ------- Tomas Reyes Trucking, Inc. is a local family owned and operated company based in Dallas, Texas. We have been in business for over 36 years and operate a fleet of 86 trucks and trailers. We specialize in providing transportation services geared toward the construction and demolition industries. We are a safety oriented carrier with a full time engineering safety consultant under contract and in the field on a daily basis. We pride ourselves on our safety rating along with our maintence facility and maintence program to keep our state of the art fleet in top notch operating condition. Our number one goal is to give our clients quality transportation service at an affordable price with minimal service failures. ' Tomas Reyes Trucking , Inc. 3529 Peoria Street Dal las, Texa s 752 12 Tel. {214) 631 -2711 Fax (214) 905 -7565 Ms . Karen Andrews Intercon Environmental, Inc . 210 S. Walnut Creek Dri ve Mansfie ld , Tex as 76063 Tomas Reyes Trucking, Inc. Employee Matrix Dear Ms . Andrews : The following are the emplo yees that will work on the project we discussed. I ha v e listed the employees that w ill be invol ved and their areas of responsibility as well as their years of experience in the industry . Name Tomas Re yes Antonio Re yes Jesse V alasquez Job Title Owner Co-Owner Fleet Mgr . Tasks Performed Project Management Project Management D ispatch Coordinator Experience 36 years 20 years 15 years If you ha v e an y questions or need an y additional information, please call me at (2 14 ) 631-2 711 . Sincerel y, Jess e Valasque z ' ENVIRONMENTAL , INC. 210 S Walnut Creek Drive , Mansfield Texas 76063 , Telephone (817 ) 477-9995 , Facs i mi l e (817 ) 477-9996 www . int ercon-environ me nta I . com R es p o nse to Se c t io n 2.7.2 S u bco n tractor Statement o f Q ualificatio ns Geyer Drilling Company, Inc . 108 W Broad St Mansfield, TX 76063-1659 Geyer Drilling, Inc . is a local family owned and operated company based in Mansfield , Texas . The company was founded in 1952 and has been in business for over 50 years. They operate 2 types of drilling rigs and have ------------------------- -mu tiple service units . Drill Rigs: • Mud/air combination drill rig -Speedstar 30K • Straight air drill rig -Ingersoll-Rand T3W Geyer Dr i lling is licensed with the Texas Department of Licensing and Regulation (TDLR) as a "Water Well Driller and Pump Installer". The TDLR is the umbrella licensing agency of the State of Texas . Their license number is 1505 and it expires on 05/30/2010 . They are licensed for the following types of work . Driller Designation : (W) -water well ; (M) -monitoring well; (C) -closed loop geothermal well ; Pump Installer Des ignations : (L) -windmill s, hand pumps, and pump jacks ; (P) -single phase pumps ; (K) -three phase pump s; (T) -line -shaft turbine pump s; Bi d Documents /Spec i fic /Subcontract or Statement of Q u al i fications Respon e to Section 2.7.3 -Subcontractor Staff Matrix Geyer Drilling Company , Inc . 108 W Broad St Mansfi eld , TX 76063 -1659 Te l. (817) 477-2215 Fax (817) 473 -7 455 M s. Kare n Andrews lntercon Environmental , Inc . 210 S Walnut Creek Drive Mansfield, Texas 76063 Dear Ms . Andrews : Geye r Drill ing Co m pany Employee Matrix ------ine1o11owmg are t e emp oyees that w1 work on the project we discussed . I have listed the employees that will be involved and their areas of responsibility as well as their years of experience in the industry. Na m e Job Title Tasks Performed Experience Robert Geyer President/Owner Project Manager 35 years Darla Ra y Office Manager Administrative 15 year s Scott Harrison Driller Plugs Wells 25 y ears Art Martinez Laborer General Labor 1.5 y ears If yo u ha v e any questions or n eed any additional informati o n , pl e ase call m e at (8 17 ) 477-2 2 15 . Sincerel y, Robert Geyer 05 /25 /2009 08:44 817473 7 455 GE YER DRl STATa: OF TEXAS -----ROBEIU"-B-GEXER----- MASTcR Wfil DRILLER AND llCENSE NUMBER 1.SOS A. I EXJ>IRES 05/'J0/2010 PAGE 02 0 5 /25 /2 0 09 08:44 8174737455 GE YER DRl Tbe person named on this card m•y perform the duties "'1tbh, the 11eope of work authorized by •pplic•ble Jaw tbrongh the explr1tion d•t~ 1holl'D on the front or the card. G~J~ WUJiam H. Ku/a..' Jr. Executive Director Teu1 Department of Licensing and Regulation PAGE 03 ' ENVIRONMENTAL, INC. 2 1 0 S . Walnut Creek Drive . Mansfield Texas 76063 . T eleph o ne (817 ) 477-9995 . Fa cs i mi l e (817 ) 4 77-9 9 96 www .i ntercon-en vi r on me ntal .co m Res pons e to Section 2. 7.2 Subco n tracto r Statement of Qualifi catio ns Jackey Lackey Septic Clean i ng 802 Meadowview Cleburne, Texas 76033 Jackey Lackey Septic Cleaning is a local family owned and operated company based i n Cleburne, Texas. They have been in business for over 10 years and operate a fleet of 4 septic trucks. They spec ialize in providing septic tank cleaning services . They are registered with the Texas Commission on Environmental Quality (TCEQ) as a Sludge Transporter (ID# 23271) and have permits to dispose of waste in the cities of Fort Worth , Grand View, and Cleburne. We have used Jackey Lackey Septic Cleaning on numerous occasions including several City of Fort Worth projects and have always been pleased with their punctual i ty and professional performance . Attached are Texas Commission on Environmental Quality (TCEQ) Transpo r ter and Disposal facil ity information . ' Bid Dnrnmpnt, /Snecific /Subcontractor Statement of Qual i fications Response to Section 2. 7 .3 -Subcontractor Staff Matrix Jac key Lackey Septic Cleaning 802 Meadowview Cleburne , Tex as 76033 Tel. (817) 645 -7586 Fa x (81 7 ) 556 -2552 Ms . Kar e n Andrews lntercon Environmental , Inc . 2 IO S Walnut Creek Dri ve Mansfield , Texas 76063 Dear Ms . Andrews: Jackey Lackey Septic Cleaning Employee Matrix ---YheTollowmg are the employees that will work on the project we discussed . I ha ve listed the employees that will be involved and their areas ofresponsibility as well as their years of experience in the industry . Name Job Title Tasks Performed Experience Dwain Lackey Owner Project Management 20 years James Ellis Septic Technician Septic Waste Services 5 year s Chris Kaeven y Septic Technician Septic Waste Services 15 years Ben Waddell Septic T eclm ician Septic Waste S erv ice s 5 year s If yo u have an y questions or need an y additional information , please call me at (817 ) 645 -75 86. Sincerel y, Dwain Lacke y ' ....... c /'"\("'I /'"\f"'l ,'"'17 - '-'-' ..)...I '.J>./·-' c,. r-\., ,_;_ i,....,.,..:..,11 , 0 17C:IIC:.7C:.O C: I .... .-.1 , ..... , -' _.,._. . ...,_ .... ._ ...... ...,. ,.._) TEXAS COMMISSION ON ENVIRONMENTAL Q UALITY 'l' .. ~-, " ..... .,... ••. ............ .-:,,,._ ..... ~·· §'Siiil Registration Number 23271 TCEQ CN602293102 1/15/2009 Company: JACKEY DWAIN LACKEY RN102670072 Regulat ed Entity: JACKEY LACKEY SEPTIC SERVICE Last Update: 1/14/2009 Expiration Date: 8/31/20 10 Status: ACTlVE Registered Since: 6/1/2002 Business Type: County: Haul waste from TX to another state?: Physical Address: INDIVIDUAL OWNER TYPE Johnson N 504 N GRANBURY ST CLEBURNE, TX 76033-9233 ------ Mailing Address: 802 MEADOW VIEW DR CLEBURl\1E, TX 76033-5964 Region: 4 Haul waste from another state to TX?: N Contact Information: Contact: Phone: Fax: E-Mail: MR. JACKEY DWAIN LACKEY 817-645-7586 Ext ------- 817-556-2552 jackeylackeyseptic@yahoo.com Sticker Nwmers issued: The stickers listed below will expire on 8/31nOtO . 1021 1022 2113 2458 2511 ... . ---------------------------;-;,i:, i;. your reg istration wilich reflects lhe infonnalion submitted on your application to the Register or Renew as a Transporter of Municipal Sluc:lge(s) and Similar Wastes . Requirements for transportation are ~ded in accordance with 30 TAC Cnapt:er 312. Issuance of this registration is not acknowledgement by the TCEQ that }'Du r operation is in fun comp liance with the rules and regulations of the TCEQ. Changes or additions referred lo th is notice require written notification to the TCEQ. Please !<eep a copy of this registration in every vehicle transporting sludge and a ll locations where business is bein g transacied under th i s registration . ' Jun 25 09 09 :28 a Dwain Lackey 8176457586 p.2 ,, • T(EQ TEXAS COW\-IISSIO!\ ON ENVIRONMENTAL QUALITY SLUDGE TRANSPORTER U£:o- Transporter ID: 23271 MJ ' 1/1 5 /2009 · Fo r the Commission DISPOSAL FACILITY INFORMA TION Disposal Waste Type Disposal Facility's Name Disposal Facility's Facility Phone Permit ID WQ0010494013 DS C JTY OF FT W ORTH VILLAGE CREEK WWTP 8173924960 1225C GS COLD SPRINGS PROCESS ING AND 8173324939 DISPOSAL INC FACILITY WQOD10494013 pp CITY OF FT WORTH VILLAGE CREEK WWTP 8173924960 TX0024503 TX0024503 TX0047155 TX0047155 --::.··· WW: 1WT : DS: DS CITY OF GRANDVIEW WWTP 8178662699 PP CITY OF GRANDVIEW WWTP 8178662699 DS CITY OF CLEBURNE WWTP 1-7....64...1.97 39 PP CITY OF CLEBURNE WWTP 8176419739 Wastewater T reatment P l ant Sl udgeGT : Water Treatment Plant Sludge Se pt ic Taruc \Vaste PP: GT: Chemical Toilet WasteGrit Trap Waste Grit Trap Waste GS : Grease Trap Waste Amy: Best Bee Keepers 3817 Piedmont Road Fort Worth , Texas 76116 817-377-0 233 817-205-6 757 Fax: 81 7-377-023 3 Dallas Fort Worth Airport You requested some information: We have been in the business -otremovingi,-e-es-forihe--past-4-years:-We-have-a -9BA-name-e A- record as the Best Bee Keepers. We have a sales tax permit through Comtroller. We also have a License through the State of Texas. We are a minority company of Spanish origin. We have performed work for the City of Fort Worth, and the City of Arlington . It is a small company with two employees. Our rate is $85.00 an hour, plus material. Our job is to remove the hive, scraped off the remaining part of the hive , and treat the area so that the bees do not come back. Our guarantee is for 60 days. Our Federal ID is 94-346-6098. D.U .N .S . # 6J5X29 . If you need any additional information, please cont act us. 1d WdST : rn s00c: c:c: ·n e t.i [[C:0-ll[-lTB : 'O N X~~ + s ::i q : WOc:L::J Response to Section 2.7.3 -Subcontractor Staff Matrix Best Bee Keepers 3817 Piedmont Ro ad Fort Wort h, TX 7 6 11 6 Tel. (817) 377 -0233 Fax (817) 377 -023 3 M s . Karen A ndrews Intercon Environmental , Inc . 210 S Walnut Creek Dri ve Mansfield , Texas 76063 Dear Ms . Andrews : Best Bee Keepers Employee Matrix The following are the employees that will work on the project-we discussed . I ha ve listed the employees that will be involved and their areas ofresponsibility as well as their years of experience in the industry . Name Job Title Tasks Performed Experience Chaim Saadon Owner Bee Keeper 4 y ears If you have any questions or need any additional information, please call me at (817 ) 377-0233 . Sincerel y , Chaim Saadon Office of the State Entomologist .... APIARY INSPECTIC* SERna TEXAS A&M UNIVERSITY DEPARTMENT OF ENTOMOLOGY COLLEGE STATION, TEXAS 77843-2 475 INTRASTATE PERMIT TO MOVE BEES ANO/OR EQUIPMEN T INTRASTATE PERMIT '--t-4I ~-o~1a.-i--- NAME _____ C;.;.h:a;;;.im;.:..:.._=S:a::::.:;;i=d""'o;.:.:.n ___________ DATE ISSUED _______ __...s~"P.....,2 ..... 2i.:..'i::..i:Q!8iL_ ADDRESS --~33"""'--'1.,_7...1..F..uie::.,.dwro ..... r...,,n11-t .a.R ..... d _________ DATE VOID ___ . _A_u_..g_us_t_3_1...;.,_2JJ~u'""'gu=s::..:;t,c3::..e·l ...... =09~- Fort Woctb IX ZS" 1 S at the end of the fiscal year NUMBER OF COLONIES/EQUIPMENT ~----=-:.. ......... ----------------- PERMIT GRANTED TO SHIP HONEYBEES AND/OR USED APIARY EQUIPMENT TO AND FROM THE FOLLOWING COUNTIES IN TEXAS ___ .....r..T.Alacra...:..LI.P.U..t _..:;;.Psa.:.'l':J:o.' 1=,.11?(+-, ... 1 .... n .... hp .... :;..:.."a..:P,-..Oi..::2.u.DiL;..~*"n.,--..:....n'-"3""'-l I 3=""-'''-'0 .... l.u.lP-:.;'":_..,.·, .... n.::."'~--------- THE OFFICIAL STATEMENT DATED Affi"'.< i --....:....:..a.'-'-""-' ......... ---------------------- having been received showing THE APIARY OF ~~___.,~.;:;h"«"u:~~-,,_1 ...;,~ ..... ~~.iz;!o.;e~F,-. ~~-----~~~~~~ to be apparently free of American Foulbrood and other infectious diseases of the brood of · bees, PERMISSION IS HEREBY GRANTED to him and his agents to ship or move bees on combs, honey, or second-hand apiary equipment covered by said statement. SEAL: [[20-ll[-LTS : ·oN x ~~ FROM :be st FAX NO. :8 17-377-02 33 Ma~. 22 2009 0 1 :15 PM P3 a TEXAS AGR!CULB:JRAL EXPERIMENT STATION 109362 Recei~: ~ ' fooc ~ ...a/~ . ___ (Name) ~ 3Y7 __f!~ 12,,_:__ (Address) u in payment of account as follows · l:i . ---_,.. ... ·-··-. -.. rl.l r_ -09'-019' . rail -·-· ~ ·--. ·-VJ ~ ..... -··-·-- 0 --···· -·. .. ... t: w~ .. -0 ·-· ----... -. .. -,~~~j ____ _ ORIGINAL -··· ··-.. ·-· (\J, ~ ~,;J.3 7? and -..g,-/100 Dollars ---· $ Texas (Date) ------- .~S-Oc) ??o Oc) (Title)~~~------· ' Industrial Hygiene and Safety Technology, Inc. 2235 Keller Way Carrollton, TX 75006 Phone: (972) 478-7415 Fax: (972) 478-7615 http://www.ihst.com Leaders in Quality, Service and Innovation SPECIFICATIONS FOR ASBESTOS ABATEMENT Prepared for: City of Fort Worth Texas Department of Environmental Management 1000 Throckmorton Street Fort Worth, Texas Project: Multiple Vacant Structures Westport Avenue, Harmon Avenue Fort Worth, Texas DATE: March 12, 2010 Specifications Prepared by: )(~ I( fj/X,m/.;tr' Tracy K. Bramlett, CIH, CSP TDSHS LICENSE #10-5040 Expiration: 12/31/11 Prepared by: Industrial Hygiene & Safety Technology, Inc. 2235 Keller Way Carrollton, Texas 75006 972-478-7415 TABLE OF CONTENTS Asbestos Abatement Specifications Multiple Vacant Structures Westport Avenue, Harmon Avenue Fort Worth, Texas 1.1. SUMMARY OF TJ--ffi WORK ............................................................................................................................... 1 1.1 .1. CONTRACT DOCUMENTS AND RELATED REQUIREMENTS: ....................................................... 1 1.1.2 . EXTENT OF WORK : .................................................................................................................................. 1 1.1.4 . CONTRACTORS USE OF PREMISES: ................................................................................................. .4 1.2. DIFFERING SITE CO DITIONS : ....................................................................................................................... 5 1.3. STOP AS BESTOS REMOVAL: ........................................................................................................................... 5 1.4 . COD ES AND REG ULA TIONS : ........................................................................................................................... 5 1.4.1. GENERAL APPLICABILITY OF CODES , REGULATIONS AND STANDARDS : ............................. 5 1.4.2. CONTRACTOR RESPONSIBILITY : ........................................................................................................ 5 1.4 .3. STATE REQUIREMENTS : ........................................................................................................................ 6 1.4.4. LOCAL REQUIREMENTS : ........................................................................................................................ 6 1.4 .5. NOTICES : .................................................................................................................................................... 6 1.4 .6 . PERMITS : .................................................................................................................................................... 6 1.4 .8. POSTING AND FILING OF REGULATIONS : ........................................................................................ 7 1.5. PROJECT COORD INATION: .............................................................................................................................. 7 1.5.1. PERSONNEL: ............................................................................................................................................. 7 1.6 . RESPIRATORY PROTECTION : ......................................................................................................................... 7 1.6.1. GENERAL: ................................................................................................................................................... 7 1.6 .2. RESPIRATORS FOR ABATEMENT OPERATIONS : ........................................................................... 7 1.7 . WORKER PROTECTION: ................................................................................................................................... 8 1.7.1. TRAINING PRIOR TO ENGAGING IN ABATEMENT WORK : ............................................................ 8 1.7 .2. MEDICAL EXAMINATIONS: ..................................................................................................................... 8 1.7.3. PROTECTIVE CLOTHING : ....................................................................................................................... 8 1.7.4 . ENTERING AND EXITING PROCEDURES : .......................................................................................... 8 1.7.5. DECONTAMINATION PROCEDURES: .................................................................................................. 8 1.7.6 . LIMITATIONS WITHIN WORK AREA : .................................................................................................. 10 1.8. DECONTAMINATION FACfLITIES: ............................................................................................................... 10 1.8.1. DESCRIPTION : ......................................................................................................................................... 10 1.8.2. GENERAL REQUIREMENTS: ................................................................................................................ 10 1.8.3. TEMPORARY UTILITIES TO PDF AND EDF : ..................................................................................... 10 1.8.4. DECONTAMINATION FACILITIES (DF): .............................................................................................. 10 1.9 . NEGATIVE PRESSURE FILTRATION SYSTEMS : ........................................................................................ 11 1.9.2. PRESSURE DIFFERENTIAL: ................................................................................................................. 11 1.9.3. MONITORING : .......................................................................................................................................... 11 1.9.4 . TESTING THE SYSTEM : ........................................................................................................................ 11 1.9.5. DEMONSTRATION OF NEGATIVE AIR SYSTEM OPERATION : ................................................... 11 1.9.6 . USE OF SYSTEM DURING ABATEMENT OPERATIONS : .............................................................. 11 1.9.7. DISMANTLING THE SYSTEM : .............................................................................................................. 12 1.10. CONTAINMENT BARRIERS AND COVERINGS OF WORK AREA: ........................................................ 12 1.10 .1. GENERAL: ............................................................................................................................................... 12 1.10 .2 . PREPARATION PRIOR TO SEALING OFF : ..................................................................................... 12 1.10 .3. CONTROL ACCESS TO WORK AREA: ............................................................................................. 12 1.10.4. CRITICAL BARRIERS : .......................................................................................................................... 13 1.10 .5. PRIMARY BARRIERS : .......................................................................................................................... 13 1.10 .6. EXTENSION OF WORK AREA: ........................................................................................................... 13 1.10.7. SECONDARY BARRIERS : ................................................................................................................... 13 1.11. MONITORING , INSPECT ION AND TESTING: ............................................................................................ 14 1.11 .1. GENERAL: ............................................................................................................................................... 14 1.11.2 . OUTLINE SCOPE OF SERVICES OF THE OWNER'S CONSUL TANT: ...................................... 14 1.11.3 . MONITORING , INSPECTION AND TESTING BY ABATEMENT CONTRACTOR: ..................... 15 1.11.4 . ANALYSIS : .............................................................................................................................................. 15 2.1 . PREABATEMENT ACTIVITIES: ..................................................................................................................... 16 2 .1.1. PREABATEMENT MEETING : ................................................................................................................ 16 2.1.2 . PREABATEMENT INSPECTION AND PREPARATIONS : ................................................................ 16 2 .1.3. PREABATEMENT CONSTRUCTION AND OPERATIONS : .............................................................. 17 2.2. REMOVAL OF ACM AND ACE: ...................................................................................................................... 17 2 .2 .1 . WEITING MATERIALS : .......................................................................................................................... 17 2 .2 .2 . SITE PREPARATION : ............................................................................................................................. 17 2 .2 .3 . PERSONAL PROTECTION : ................................................................................................................... 18 2 .2.4 . THERMAL SYSTEM INSULATION : ...................................................................................................... 18 2 .2 .6 WALL AND CEILING TEXTURE ............................................................................................................. 21 2.3 . DISPOSAL OF ACM AND ACE WASTE MATERIAL: .................................................................................. 23 2 .3 .1. GENERAL: ................................................................................................................................................. 23 2 .3.2 . PROCEDURES : ........................................................................................................................................ 23 2.4. P ROJEC T DECONTAMINATION: ................................................................................................................... 24 2.4.1. GENERAL: ................................................................................................................................................. 24 2.4.2 . WORK AREA CLEARANCE : .................................................................................................................. 24 2.4 .3 . WORK DESCRIPTION : ........................................................................................................................... 24 2.4.4. PRE-DECONTAMINATION CONDITIONS : ......................................................................................... 24 2.4 .5 . FIRST CLEANING: ................................................................................................................................... 24 2 .4 .6 . SECOND CLEANING : ............................................................................................................................. 24 2.4 .7 . PRE-CLEARANCE INSPECTION AND TESTING : ............................................................................. 25 2 .4 .8 . LOCK-BACK ENCAPSULATION : .......................................................................................................... 25 2.5. FINAL AI R CLEARANCE TESTING ............................................................................................................... 25 2 .5.1 . GENERAL: ................................................................................................................................................. 25 2 .5 .2 . FINAL TESTING : ...................................................................................................................................... 25 2 .5 .3 . FINAL TESTING PROCEDURES : ......................................................................................................... 26 2 .5.4 . SCHEDULE OF AIR SAMPLES WITH PCM: ....................................................................................... 26 2.5 .5 . LABORATORY TESTING FOR PCM : ................................................................................................... 26 2 .5 .7 . FINAL AIR TESTING REQUIREMENTS : ............................................................................................. 27 2.6. ABATEMENT CLOSEOUT AND CE RTIFICATE OF COMPLIA CE: ......................................................... 27 2.6 .1. COMPLETION OF ABATEMENT WORK: ............................................................................................ 27 2.6.2 . CERTIFICATE OF COMPLETION BY CONTRACTORS : .................................................................. 28 Appendix A: Attachments Appendix B: Specification Drawings ASBESTOS REMOVAL PART 1 -GENERAL SECTION , ASBESTOS REMOVAL SPECIFICATIONS 1.1. SUMMARY OF THE WORK 1.1.1. CONTRACT DOCUMENTS AND RELATED REQUIREMENTS: General provisions of the contract , including general and supplementary conditions , apply to the work of this section . The contract documents show the work of the contract and related re- quirements and conditions impacting the project. Related requirements and conditions include applicable codes and regulations , notices and permits , existing site conditions and restrictions on use of the site , requirements for part ial owner occupancy during work, coordinat ion with other work and phasing of work . Whenever there is a conflict or overlap of the above refer- ences , the more stringent provisions apply . 1.1.2. EXTENT OF WORK: A brief summary of the extent of the work and non-binding to the contract documents is as fol- lows : BASE BID: Removal and disposal of asbestos-containing materials (ACM) and asbestos-contaminated elements (ACE) utiliz ing wet methods within full , negative-pressure containments equipped with HEPA ventilation from specified areas of the buildings . The following asbestos-containing ma- terials (ACM) will be removed at the property where applicable. 1304 Westport, Fort Worth Texas Location Asbestos Materials Estimated Quantity Walls and ceilings Sheetrock joint com-4 ,320 SF pound and texture Kitchen and hallway Linoleum flooring 180 SF Entry and bathroom 9' x 9" floor tile and 120 SF mast ic 1404 Westport, Fort Worth Texas Location Asbestos Materials Estimated Quantity Living room Linoleum flooring 48 SF 1504 Westport, Fort Worth Texas Location Asbestos Materials Estimated Quantity )/~I( &-,/;tr Uti lity , kitchen , break-Linoleum flooring -600 SF DSHS I 0-5040 fast and bathrooms Expires 12-31 -11 IHST Project #17849 Page 1 ASBESTOS REMOVAL 301 Harmon, Fort Worth Texas Location Asbestos Materials Estimated Quantity Kitchen , utility room Linoleum flooring 350 SF and bathroom 305 Harmon, Fort Worth Texas Location Asbestos Materials Estimated Quantity Throughout Linoleum flooring -1 ,000 SF Walls and ceilings Sheetrock joint com--4,000 SF pound and texture 410 Harmon, Fort Worth Texas Location Asbestos Materials Estimated Quantity Throughout structure Linoleum flooring 1 ,095 SF Cei lings and walls Sheetrock joint com-4 ,700 SF pound and texture 491 Harmon, Fort Worth Texas Location Asbestos Materials Estimated Quantity Kitchen , nook , hall , Vinyl f looring 395 SF master bathroom 650 Harmon, Fort Worth Texas Location Asbestos Materials Estimated Quantity No Asbestos in building 845 Harmon, Fort Worth Texas Location Asbestos Materials Estimated Quantity )(~/(. ~1r Throughout Linoleum flooring -1 ,000 SF DSHS 10 -5040 Walls and ceilings Sheetrock joint com--4,000 SF Expire s 12 -31 -1 1 pound and texture 865 Harmon, Fort Worth Texas Location Asbestos Materials Estimated Quantity Bathrooms Floor tile 65 SF IHST Project #17849 Page 2 ASBESTOS REMOVAL 959 Harmon, Fort Worth Texas Location Asbestos Materials Estimated Quantity Ceilings and walls Textu re on ce ilings and 3 ,284 SF walls Kitchen and entry Linoleum flooring 168 SF The Work Area will be inclusive of the locations and the quantities noted above , in the attached drawings , and as d irected by a representative of IHST. The Work may be broken down into multiple Work Areas at the discretion of the Contractor. However, the Contractor will receive no add itional time to perform the work on the basis of having mu ltip le Work Areas and associated Cleaning Sequences . The Contractor will be responsible for the removal and disposa l of the asbestos-containing ma- terial and asbestos-contaminated materials in accordance with Texas Department of State Health Services (TDSHS), OSHA 29 CFR 1926 .1101 , Asbestos Hazard Emergency Response Act (AHERA) 40 CFR Part 763 , and the National Emiss ion Standards for Hazardous Air Pollut- ants (NESHAP) Regulations 40 CFR Part 61 . The CONTRACTOR shall be responsible for verifying existing site conditions and determin i ng the quantity of ACM delineated for removal prior to abatement described in these spec ifications and associated drawings . 1.1.3. TASKS: The work , located at the facil ity , is summarized briefly as follows: The PROJECT requires the removal of the materials outlined in Section 1.1.2 . The asbestos abatement will be performed in accordance with these spec ifications and procedures as out- lined . Power and Water Connections: The Contractor on th is project will be required to furn ish power generators for electricity . The Contractor will also be required to furnish water for the project. Asbestos Removal within full Containment: The Contractor will use wet methods for all re- moval operations . The Contractor is responsible for prompt clean-up and disposal of waste and debris contaminated with asbestos in leak tight containe rs. The Contracto r will conduct a wet decontamination of equipment and tools before final clearance sampl ing in the work area. The Contractor will use the ex isting interior walls and ceilings in the buildings to provide struc- tural support for an asbestos containment work area prov ided the conta inment remains sound and is not in danger of collapse . The Contractor should make every effort not to damage the in - terior walls of the bu ilding during the project. )/~ I(_ &-,If DSHS Lice nse 10-5040 Expires 12-31-11 IHST Project #17849 Page 3 ASBESTOS REMOVAL The Contractor will establish critical barriers over all openings into the work area . ACM debris should be adequately wetted pr ior to establishing perimeter critical barriers. Contractor will fur- nish all water and electricity for the project. The Contractor will remove the asbestos-containing material from the work area . The full containment design must be structurally sound so that it will not collapse under negative pressure and work conditions . A structurally unsound containment design will not be ac- cepted. The full containment design will consist of one (1) layer of 6-mil polyethylene sheeting for all critical barriers , floors and walls . Two layers of polyethylene sheeting will be required on walls and floors not affected by the abatement Polyethylene sheeting shall meet the requirements in accordance with current TDSHS rules . The Contractor must establish negative air into the containment and maintain a pressure differential of -0 .02 inches of water as indicated by a working manometer. After the ACM has been removed and the work area cleaned , a detailed visual clearance in- spection will be conducted to determine if ACM or asbestos-contaminated elements (ACE) re- main prior to final clearance and work completion. OSHA personnel and area monitoring will be conducted with analysis by (PCM). Final air clearance sampling will be conducted utilizing PCM . Resp i ratory protection will require half-face , air-purifying respirators (APR) with NIOSH- approved P-100 (HEPA) cartridges during removal. The CONTRACTOR is responsible to verify site conditions and estimated quantities of ACM to be removed. 1.1.4. CONTRACTORS USE OF PREMISES: Cooperate fully with the Owner's Representative to minimize conflicts and to facilitate Owner's safe and smooth usage of buildings . Perform the work in accordance with specifications , draw- ings , and phasing plan . Use existing facilities in building strictly within the limits shown in contract documents and the approved pre-abatement plan of action . Several of the structures have asbestos containing ma- terials in the flashing around roof penetrations . The Contractor will not be required to remove the flashing on the structures . )/~I( ~/.Jr" DSHS License 10-5040 Ex pires 12-31-11 IHST Project #17849 Page 4 ASBESTOS REMOVAL 1.2 . DIFFERING SITE CONDITIONS: The quantities and location of ACM indicated on the drawings and the extent of work included in this section are only best estimates which can be limited by the physical constraints imposed by structural enclosures or by occupancy of the building. The CONTRACTOR is responsible to verify site conditions and estimated quantities of ACM to be removed and determining the quantity of ACM delineated for removal prior to abatement described in these specifi- cations and associated drawings. The Contractor by placing a bid for this project agrees with all quantity estimates and there bid reflects there price to remove all of the material at all of the structures as identified in these specifications. 1.3. STOP ASBESTOS REMOVAL: If the Owner's Representative presents a written Stop Asbestos Removal Order, immediately stop all asbestos removal and initiate fiber reduction activities . Do not resume asbestos removal until authorized in writing by Owner's Representative . A Stop Asbestos Removal Order will be issued at any time the Owner or Owner's Representative determines abatement conditions are not within specifications requirements . Stoppage will continue until conditions have been corrected. Standby time and cost required for corrective action is at Contractor's expense . The occurrence of the following events will be re- ported in writing to the Owner's Representative and will require the Contractor to automatically stop asbestos removal and initiate fiber reduction activities : A. Excessive airborne fibers outside containment area (0 .01 flee or greater). B. Break in containment barriers. C. Loss of negative air pressure (at or above 0.01 inches of water) D. Serious injury within the containment area. E . Fire and safety emergency F. Respiratory system failure. G . Power failure. H. Excessive airborne fibers inside containment area (0 .1 flee or greater when wet methods are employed). 1.4. CODES AND REGULATIONS: 1.4.1. GENERAL APPLICABILITY OF CODES, REGULATIONS AND STANDARDS: Except to the extent that more explicit or more stringent requirements are written directly into the contract documents , all applicable codes , regulations , and standards have the same force and effect (and are made a part of the contract documents by reference) as if copied directly into the contract documents , or as if published copies are bound herewith . 1.4.2. CONTRACTOR RESPONSIBILITY: The Asbestos Abatement Contractor will assume full responsibility and liability for the compli- ance with all applicable federal , state , and local regulations pertaining to work practices , hauling and disposal of ACM and ACE, and protection of workers, visitors to the site , and persons oc- cupying areas adjacent to the site . Contractor is responsible for providing medical examinations and maintaining medical records of personnel as required by the applicable federal , state , and IHST Project #17849 Page 5 ASBESTOS REMOVAL local regulations. Contractor will hold the Owner and Consultants harmless for failure to comply with any appl icable work , haul ing , disposal , safety , health or other on the part of hi mself, his employees , or his subcontractors . Contractor incurs all costs to comply with OSHA regulations . The Abatement Contractor will determ ine the applicabil ity of any process patents he/she may be employing and be respons ible for paying any fees , royalties or licenses that may be required for the use of patented processes . 1.4.3. STATE REQUIREMENTS: State requirements which govern asbestos abatement work or hauling and disposal of asbestos waste materials include but are not limited to the following : Texas Department of State Health Services , Texas Asbestos Health Protection Act , as amended , Chapter 1954 , Texas Occupations Code , effective June 1, 2003 , formerly Texas Civil Statutes , Article 4477-3a. 1.4.4. LOCAL REQUIREMENTS: The Contractor is responsible to comply w ith all applicable local requirements regarding asbes- tos abatement activit ies . 1.4.5. NOTICES: STATE OF TEXAS, TEXAS DEPARTMENT OF STATE HEALTH SERVICES Send Written Notification as required by the State of Texas .Texas Asbestos Health Protection Act , as amended , Chapter 1954 , Texas Occupations Code , effective June 1, 2003 , formerly Texas Civ il Statutes , Article 4477-3a . Send at least 10 working days prior to asbestos abate- ment activities to the following address : Texas Department of State Health Services Toxic Substances Control Division Asbestos Programs Branch P.O . Box 143538 Austin , Texas 78714-3538 512-834-6600 or 1-800-572 -5548 The not ifications must be completely filled out. In the event that a section is not applicable to the project , the section must be marked as not applicable . Copies of the Texas Department of Stat e Health Services and other notifications will be submit- ted to the Owner for the facility's records in the same time f rame that notification is given to EPA , state , and local authorities . In the event of a change in the starting date the Contractor will notify regulatory agencies in accordance with the Texas Department of State Health Services (Texas Civil Statutes , Article 4477-3a , Section 12) asbestos regulations . 1.4. 6. PERMITS: The Contractor w ill be responsible for any permits . IHST Project #17849 Page 6 ASBESTOS REMOVAL 1.4. 7. LICENSES: Maintain current licenses as required by the Texas Department of State Health Services Rules as adopted under Texas Civil Statutes , Article 4477-3a , Section 12 for the removal , transporting , disposal or other regulated activity relative to the work of this contract. 1.4.8. POSTING AND FILING OF REGULATIONS: Maintain two (2) copies of applicable federal , state and location regulations . Post one copy of each at the job site where workers will have ready, easy and daily exposure to the text. Keep on file in Contractor's office one copy of each . 1.5. PROJECT COORDINATION: Minimum administrative and supervisory requirements necessary for coordination of work on the project are personnel , contingency arrangements and security. 1.5.1. PERSONNEL: Administrative and Supervisory Personnel : will consist of a qualified general superintendent, and appropriate number of qualified or competent foremen to complete abatement within con- tract time. Non-Supervisory Personnel : An adequate number of qualified personnel will be able to meet the schedule requirements of the project. 1.6. RESPIRATORY PROTECTION: 1.6.1. GENERAL: Provide respiratory protection in accordance with these specifications , the OSHA regulations 29 CFR 1910.1001 , 29 CFR 1910.134 and 29 CFR 1926.1101, EPA regulations 40 CFR 763 .120 , 121 , ANSI standards Z88 .2-1980, CGS Pamphlet G-7 and specification G-7 .1, the NIOSH and MSHA standards and the Texas Department of State Health Services Protection Rules . In case of conflict , the most stringent requirements are applicable for this project. 1.6.2. RESPIRATORS FOR ABATEMENT OPERATIONS: Where a person is or could reasonably be expected to be exposed during abatement operations to airborne asbestos above 0.1 flee or where ACM debris is visible , the following maximum level of respiratory protection is required : If it is reasonably anticipated that fiber counts generated during abatement will not exceed the protection factor of a half-face respirator, and this can be verified by on-site fiber counts , a half-face respirator may be used. If verification cannot be made , a full face PAPR must be used . PAPR must be used for friable surfac- ing or thermal system insulation removal until fiber counts are confirmed consis- tently below the PEL and STEL. Head coverings : PAPR respirators will be equipped with full facepieces. Full facepieces will be worn with either a bonnet-type disposable head cover/hood or with a full head cover/hood which IHST Project #17849 Page 7 ASBESTOS REMOVAL is part of a fully encapsulating protective garment. Respirator straps will be located under the hoods . This allows removal of the head covering prior to showering without disturbing the respi - rator (which is worn into the shower). Exemptions from maximum respi ratory protection during abatement operations : When the abatement contractor has demonstrated to the Owner's satisfaction that levels of airborne as- bestos fibers in the work area are consistently below 0.1 flee , a full facepiece or half face respi- rator with HEPA cartridges may be used. The Certified Industrial Hygienist will determine if a lesser form of respiratory protect ion may be used. 1.7. WORKER PROTECTION: 1. 7.1. TRAINING PRIOR TO ENGAGING IN ASA TEMENT WORK: Train workers in accordance with OSHA 29 CFR 1926 .1101 and the Texas Asbestos Health Protection Rules and this section . Wo rkers will be trained and be knowledgeable on the follow- ing topics: Methods of recognizing ACM; health effects of asbestos exposure ; effects of smok- ing and asbestos exposure ; activities that could result in hazardous exposures ; protective con- trols, practices and procedures to minimize exposure including engineering controls , work prac- tices , respirators , housekeeping procedures , hygiene facilities , protective clothing , decontam ina- tion procedures , emergency procedures and waste transportation and disposal ; review OSHA 29 CFR 1910.134 for respirators ; medical surve illance program ; review OSHA 29 CFR 1926 .1101 , and for air monitoring , personnel and area; review t his section of the project specifi- cations . 1. 7.2. MEDICAL EXAMINATIONS: Provide medical examinat ions for all workers and any other employee entering the work area per OSHA 29 CFR 1926 .1101 regardless of exposure levels. 1.7.3. PROTECTIVE CLOTHING: Provide boots , safety glasses and gloves for all workers. Equipment will meet OSHA require- ments for personal protection. Provide all persons entering the work area with disposable full body coveralls , disposable head covers and rubber boots . 1. 7.4. ENTERING AND EXITING PROCEDURES: Provide worker protection per most stringent applicable requirements . Provide as a minimum the following : Ensure that each time workers enter the work area , they remove all street clothes in the chang- ing room of the personnel decontamination unit and put on new disposable coveralls , new head covers , and clean respirators , then proceed through shower room to equipment room , and put on work boots . 1.7.5. DECONTAMINATION PROCEDURES: Require all workers to adhere to the following personal decontamination procedures whenever they leave the work area of a full decontamination unit: IHST Project #17849 Page 8 ASBESTOS REMOVAL Three-stage Wet Decontamination: Require that all workers use the following decontamination procedure as a minimum require- ment whenever leaving the work area : 1. When exiting work area , remove disposable coveralls , and all other clothes disposable head covers , and disposable footwear covers or boots in the equipment room. 2. Still wearing respirators , and completely naked proceed to showers. Showering is man- datory . Care must be taken to follow reasonable procedures in removing the respirator to avoid asbestos fibers while showering. The following procedure is required as a minimum: a. Thoroughly wet body including hair and face . If using a Powered Air-Purifying Respi- rator (PAPR) hold blower unit above head to keep canisters dry . b. With respirator still in place thoroughly wash body , hair , respirator face piece , and all parts of the respirator except the blower unit and battery pack on a PAPR. Pay par- ticular attention to clean seal between face and respirator and under straps . c . Take a deep breath , hold it and/or exhale slowly , completely wet hair, face , and respi - rator. While still holding breath , remove respirator and hold it away from face before starting to breath . 3 . Carefully wash facepiece of respirator inside and out. If using PAPR , shut down in the following sequence , first cap inlets to filter cartridges , then turn off blower unit (this se- quence will help keep debris which has collected on the inlet side of filter from dislodging and contaminating the outside of the unit). Thoroughly wash blower unit and hoses . Carefully wash battery pack with wet rag . Be extremely cautions of getting water in bat- tery pack as this will short out and destroy battery . 4 . Shower completely with soap and water. Rinse thoroughly . 5. Rinse shower room walls and floor prior to exit. 6. Proceed from shower to Changing Room and change into street clothes or into new dis- posable work items . Air Purifying-Negative Pressure Respirators: Require that all workers use the following decontamination procedure as a minimum requ ire- ment whenever leaving the work area with a full face cartridge type respirato r: 1. When exiting area , remove disposable coveralls, and all other clothes disposable head- covers , and d isposable footwear covers or boots in the equipment room . 2. Still wearing respirators and completely naked , proceed to showers . Showering is man- datory. Care must be taken to follow reasonable procedures in removing the respirator and filters to avoid asbestos filters while showering . The following procedure is required as a minimum: a . Thoroughly wet body from neck down . Wet hair as thoroughly as possible w ithout wetting the respirator filter if using an air purifying type respirator . b. Take a deep breath , hold it and/or exhale slowly , complete wetting of hair , thoroughly wetting face , respirator and filter (air purifying respirator). Wh ile still holding breath , remove respirator and hold it away from face before starting to breath . 3. Dispose of wet filters from air purifying respirator . 4 . Carefully wash facepiece of respirator inside and out. 5 . Shower completely with soap and water . Rinse thoroughly . 6 . Rinse shower room walls and floor prior to exit. IHST Project #17849 Page 9 ASBESTOS REMOVAL 7. Proceed from shower to Changing Room and change into street clothes or into new disposable work items. 1.7.6. LIMITATIONS WITHIN WORK AREA: Ensure that workers do not eat , drink , smoke , chew gum or tobacco , or in any way break the protection of the respiratory protection system in the work area . 1.8. DECONTAMINATION FACILITIES: 1.8.1. DESCRIPTION: Provide each work area with separate personnel decontamination facility (PDF) and equipment decontamination facility (EDF). Ensure that the PDF is the only means of ingress and egress for the work area and that all equipment, bagged waste material and other material exit the work area only through the EDF or the PDF . 1.8.2. GENERAL REQUIREMENTS: All persons entering and exiting the work area will follow the entry and exit procedures required by the applicable regulations and these specifications . Process all equipment and material exit- ing the work area through the EDF or PDF and decontaminate as required by the specifications . Construct walls and ceilings of PDF and EDF airtight with at least 6 mil polyethylene sheeting and attach to existing building components or to a temporary framework. The EDF and PDF may be combined if the size of the work area will not permit both . Use a minimum of two layers of 6-mil opaque polyethylene to cover floor under PDF . Construct doors from overlapping polyethylene sheets so that they overlap adjacent surfaces . Weight sheets at bottom so that they quickly close after release . Put arrows on sheets showing direc- tion of overlap and travel. 1.8.3. TEMPORARY UTILITIES TO PDF AND EDF: Provide temporary water service connection to the PDF and the EDF. Provide backflow protec- tion at the point of connection to the Owner's system. Water supply must be properly pressured and temperature balanced at shower discharge . Pro- vide adequate temporary electric power with ground fault protection and overhead wiring throughout the PDF and the EDF. Provide a sub-panel for all temporary power in changing room . Provide adequate light ing to reach 50 foot candles throughout PDF and EDF. Provide temporary heat to maintain 70°F throughout the PDF and EDF except that the shower of the PDF will be maintained at 75°F . 1.8.4. DECONTAMINATION FACILITIES (DF): Provide a PDF consisting of serial arrangement of clean room , showers room and equipment room. Provide adequately sized DF to accommodate the number of employees scheduled for IHST Project #17849 Page 10 ASBESTOS REMOVAL the project. The center chamber of the three chamber DF will be fitted with as many portable walk through shower stalls as necessary so that all employees will be able to go through the en- tire decontamination procedure within 15 minutes . Construct DF of opaque or colored polyethyl- ene for privacy . Construct DF so that it will not allow for parallel routes of exit without shower- ing . 1.9. NEGATIVE PRESSURE FILTRATION SYSTEMS: The Asbestos Abatement Contractor will provide enough HEPA-filtered negative air units to completely exchange the work air four (4) times per hour. Contractor will demonstrate the num- ber of units needed per work area for 4 room air changes by calculating the volume flow rate (cfm) delivered by each unit under 2" pressure drop across filters . Provide at least one standby unit in the event of a machine failure or emergency such as contamination in surrounding non- work area . When a pressure differential system is selected provide enough HEPA filtration units to filter and recirculate the air in the work area at a rate of four (4) room air changes per hour. 1.9.2. PRESSURE DIFFERENTIAL: Provide a fully operational negative air system within the work area continuously maintaining a pressure differential across work area enclosures of -0 .02 inches of water. Demonstrate to the Owner's Representative the pressure differential by use of a pressure differential meter or a manometer, before disturbance of any asbestos containing materials. This pressure differential will be used for either negative air system or pressure differential system . 1.9.3. MONITORING: Continuously monitor and record the pressure d ifferential between the work area and the build- ing outside of the work area with a monitoring device incorporating a strip chart recorder. Make the strip chart record part of the project log . 1.9.4. TESTING THE SYSTEM: Test negative-pressure system before any ACM is wetted or removed. After the work area has been prepared , the decontamination facility set up , and the exhaust unit(s) installed, start the unit(s) (one at a time). Demonstrate operation and testing of negative-pressure system to the Owner's Representative . 1.9.5. DEMONSTRATION OF NEGATIVE AIR SYSTEM OPERATION: Demonstrate the operation of the negative-pressure system to the Owner's Representative to include, but not be limited to , the following : 1. Demonstrate pressure differential system will maintain -0 .02" of water. 2 . Emergency shutoff will operate in case of fire. 1.9.6. USE OF SYSTEM DURING ABATEMENT OPERATIONS: Start exhaust units before beginning work (before any ACM is disturbed). After abatement work has begun , run units continuously to maintain a constant negative-pressure until decontamina- IHST Project #17849 Page 11 ASBESTOS REMOVAL tion of the work area is complete . Do not turn off units at t he end of the work shift or when abatement operations temporarily stop . Do not shut down negative air system during abatement operations procedures , unless autho r- ized by the Owner's Representative in writing . The systems may be shut down daily if air moni- toring in the containment shows airborne levels of less than 0.01 fibers/cc . Start abatement work at a location farthest from the exhaust units and proceed toward them . If an electric power failure occurs , immediately stop all removal work and do not resume until power is restored and all exhaust un its are operating again . At completion of abatement work , allow exhaust un its to run as specified under this section , to remove airborne fibe rs that may have been generated during abatement work and cleanup and to purge the work area with clean makeup ai r. Units may be required to run after decontamina- tion , if dry or only partially wetted asbestos material was encountered during any abatement work . 1.9.7. DISMANTLING THE SYSTEM: When a final inspection and the results of the final air tests indicate that the area has been de- contaminated , exhaust units may be removed from the work area . Before removal from the work area , remove and properly dispose of pre-filters , and seal intake to the machine with 6-m il polyethylene to prevent environmental contamination from the pre-filters . 1.10. CONTAINMENT BARRIERS AND COVERINGS OF WORK AREA: 1. 10. 1. GENERAL: Seal off perimeter of work area to completely isolate abatement areas and to contain all air- borne asbestos contaminat ion created by abatement work . Cover all surfaces of the work area to protect them from cross contaminat ion , to facilitate more efficient cleanup , and to protect the f inishes from the asbestos abatement work . Should the area beyond the seal off li mits become contaminated as a consequence of the work , clean those areas in accordance with procedures described in this section at no additional cost. 1.10.2. PREPARATION PRIOR TO SEALING OFF: Place all tools , staging , etc . necessary for the work in the area to be isolated prior to erect ion of temporary plastic sheeting enclosure. Disable ventilating systems or any other system bringing air into or out of the work area. Disable system utilizing positive means that will prevent acci- dental premature restart ing of equipment, i.e., disconnect ing wires , remov ing c ircu it breakers , lockable switch , etc. 1.10.3. CONTROL ACCESS TO WORK AREA: Permit access to the work area only through the DF . All other means of access will be closed off and sealed and warning signs displayed on the clean side of the sealed access . Where the work area is immediately adjacent to or within view of occupied areas , provide a visual barr ier of opaque polyethylene sheeting at least 6-mil in thickness so that the work procedures are not visible to building occupants . Where the area adjacent t o the work area is accessible to the IHST Project #17849 Page 12 ASBESTOS REMOVAL public , construct a barrier of plywood or other suitable material at least eight feet (8') in height that is able to withstand the negative pressure as specified. Post warning signs at each visual and physical barrier per OSHA requirements . Alternate method of containing the work area or different definition of the limits of seal -off from the one shown on the drawings may be submitted to the Owner's Representative for approval in accor- dance with this section . Do not proceed with any such alternatives without prior written approval by the Owner's . 1.10.4. CRITICAL BARRIERS: Completely separate the work area from other portions of the building , and the outside by sheet polyethylene barriers at least 6 mil in thickness and sealing with duct tape . Individually seal all ventilation openings (supply and exhaust), lighting fixtures , doorways , windows , and other open- ings into the work area with duct tape alone and with polyethylene sheeting at least 6-mil in thickness , taped securely in place with duct tape . Maintain seal until all work including project decontamination is completed . Take care in sealing off lighting fixtures to avoid melting or burn- ing of sheeting . Provide sheet plastic barriers at least 6-mil in thickness as required to com- pletely seal openings from the work area into adjacent areas . Seal the perimeter of all sheet plastic barriers with duct tape or spray cement. 1.10.5. PRIMARY BARRIERS: The primary barrier of the full containment walls will consist of a minimum of Primary barriers for full containment shall consist of two (2) layers of minimum 4-mil polyethylene sheeting for the walls securely anchored from the floors to the ceiling . The containment for the removal of the li- noleum flooring will require a minimum 4-mil polyethylene sheeting for the ceiling . Polyethylene sheeting shall meet ASTM requirements in accordance with TDSHS regulations . Visible open- ings observed along the perimeter walls and the ceiling shall be completely sealed polyethylene sheeting and the wall corners of the containment should be attached with an overlap of at least twelve inches . The primary barrier construction should form an airtight, impermeable , perma- nent barrier around the ACM and ACM debris to contain the release of asbestos fibers into the air. 1.10.6. EXTENSION OF WORK AREA: If the enclosure barrier is breached in any manner that could allow the passage of asbestos de- bris or airborne fibers , then where possible, add affected area to the work area . Enclose it as required by this Section of the specification and decontaminate it as described elsewhere in this section . If contaminated area cannot be added to work area , decontamination measures will start immediately after contamination is discovered and work will stop in work area . Decontami- nation procedures will continue until exposure returns to background levels . 1.10. 7. SECONDARY BARRIERS: Secondary barriers should be established in areas to separate any non-related work activity from the abatement containment to prevent dust or debris from potentially contaminating fresh air (make-up air) into the containment or regulated asbestos removal area . IHST Project #17849 Page 13 ASBESTOS REMOVAL 1.11. MONITORING, INSPECTION AND TESTING: 1.11.1. GENERAL: Perform throughout abatement work monitoring , inspection and testing ins ide the work area in accordance w ith OSHA requirements and these specifications . I.H . Technician will continuously inspect and monitor conditions inside the work area to ensure compliance with these specifica- tions . In addition , the I.H . will personally manage air sample collection , analysis and evaluation for personnel and work area samples to satisfy OSHA requirements . Additional inspection and testing requirements are specified in other parts of this section . The Owner will employ a Certified Industrial Hygienist (C .I.H .) representative to perform various services on behalf of the Owner. The C. I. H. representative or representative under the direction of a C .I.H . will perform the necessary monitoring , inspection , testing and other support services to ensure that the Owner, employees and visitors will not be adversely impacted by the abate- ment worked , and that the abatement work proceeds in accordance with these specifications , that the abated areas or abated buildings have been successfully decontaminated. The work of the C .I.H . representative in no way relieves the abatement Contractor from his responsibility to perform his work in accordance with contract documents, to perform continuous inspection , monitoring and testing for the safety of his employees , and to perform other such services as specified in this section . The cost of the CIH representative and his services will be born by the Owner except for repeated final inspection and testing that may be required due to unsatisfac- tory initial results . These repeated final inspections and testing , if required , will be pa id for by the Contractor. The Asbestos Abatement Contractor may request confirmation of above results . This request must be in writing and submitted to the Owner's Representative . Cost for the confirmation of re- sults will be born by the Contractor for both the collection and analysis of samples and for the time delay that may result for this confirmation . Confirmation sampling and analysis will be the responsibility of the Contractor with review and approval by the C .I.H. 1.11.2. OUTLINE SCOPE OF SERVICES OF THE OWNER'S CONSULTANT: The purpose of the work of the Owner's Representative is to: assure quality , resolve problems , and prevent the spread of contamination beyond the work area . In addition, the consultants work include performance of final inspection and testing to determine whether a space or a building has been adequately decontaminated. All air monitoring is to be done utilizing PCM sampling procedures with final clearance to be performed by TEM . The Owner's Representa- tive will perform the following tasks: TASK 1: Establish background levels before abatement work will start. This will in- clude taking background samples (at least 3) and retaining samples for pos- sible TEM analysis . TASK 2: Perform continuous air monitoring , inspection and testing outside the work area during actual abatement work area . In addition, the Owner's Represen- tative will be required to detect any faults in the wo rk area isolation and any adverse impact of surroundings from work area activities . TASK 3 : Perform unannounced site visits to spot check overall compliance of work with contract documents . These visits may include any inspection , monitoring IHST Project #17849 Page 14 ASBESTOS REMOVAL and testing inside and outside the work area and all aspects of operation ex- cept personnel monitoring . TASK 4: Provide support to the Owner such as evaluation of submittals from the abatement contractor , resolution of unforeseen developments in abatement work , etc . TASK 5: Perform fina l inspection and testing of a decontaminated area or building at the conclusion of the abatement and cleanup work to certify compliance with Owner's decontamination standards . TASK 6 : Issue certificate of decontamination for each area or building and a final project report . TASK 7 : The Owner's Representative will have authority to require building materials to be removed and disposed of as ACM waste where visible ACM debris is pre- sent. All data , inspection results and testing results generated by the Owner's Representative will be available to the Contractor for information and consideration. Contractor will provide coopera- tion and support to the Owner's Representative for efficient and smooth performance of their work. Monitoring and inspection results of the Owner's Representative will be used by the Owner to issue any Stop Asbestos Removal Orders to the contractor during abatement work and to ac- cept or reject an area or a building as decontaminated . The Owner's Representative will make available to the Contractor the plan for sample collection and analysis for continuous monitoring outside the work areas and the plan of final inspection and testing for each space or building prior to executing each plan. Plan will include location for samples , name and qualification of person taking samples , whether on site analysis and/or lab analysis will be utilized , methodol- ogy of analysis , lab information and qualifications of on-site analyst. 1.11.3. MONITORING, INSPECTION AND TESTING BY ABATEMENT CONTRACTOR: The Contractor is responsible for managing all monitoring , inspection and testing required by these specifications and the OSHA requirements . The analytical laboratory that will be used by the Contractor to analyze the samples will be AIHA PAT. Accredited and Texas Department of State Health Services Licensed. Keep a daily log of personnel samples taken and analyzed and make log available to the Owner's Representa- tive . Log will contain information on the persons sampled , the date of sample collection the time of sample start and finish , flow rate, sample volume and fibers/cc. Take and analyze personnel samples for at least 25% of the workers in each shift , but not less than two where active abate- ment takes place . 1.11.4. ANALYSIS: Bulk samples (if required) will be analyzed at a laboratory that is Accredited by the National Vol- untary Laboratory Accreditation Program (NVLAP). Proof of accreditation must be submitted prior to the project start date . Polarized light microscopy will be used to analyze bulk samp les . Air samples will be analyzed by an individual participating in the American Industrial Hygiene Association's (AIHA) Proficiency Analytical Testing Program. IHST Project #17849 Page 15 ASBESTOS REMOVAL In addition to the continuous monitoring required, the Owner's Representative will perform in- spection and testing at the final stages of abatement for each work area or building as specified elsewhere in this section . 1.12.5. SUBMITTAL$ AT COMPLETION OF ABATEMENT: The Contractor will submit a final project report consisting of the daily log book and the docu- mentation of events during abatement including the original disposal manifests signed by the operator of licensed landfill . The project report will include a certificate of completion , dated and signed by the Contractor. All certificates and original disposal manifests are due to the Owner's Representative office within 30 (thirty) days after completion of abatement work . PART 2 -EXECUTION 2.1. PREABATEMENT ACTIVITIES: 2.1.1. PREABA TEMENT MEETING: The Owner's Representative, upon receipt , review and substantial approval of all preabatement submittals and upon verification that all material and equipment required for the project are on site , will arrange for a preabatement meeting between the Asbestos Abatement Contractor, su- perintendent and foremen and the Owner's Representatives . The purpose of the meeting is discuss any aspects of the submittals needing clarification or amplification and to discuss any aspects of the project execution and the sequence of operations . The Asbestos Abatement Contractor and his employees will be prepared to provide any sup- plemental evidence and information to the Owner's Representative pertaining to any aspects of the submittals or the materials and equipment. No abatement work of any kind described in the following provisions of these specifications will be initiated prior to the preabatement meeting . 2.1.2. PREABA TEMENT INSPECTION AND PREPARATIONS: Before any work begins on the containment barriers , the contractor will: 1. Conduct a space-by-space inspection with an authorized Owner's Representative , and prepare a written inventory of all existing damage in those spaces where asbestos re- moval work will occur. Still or video photography may be used to supplement this written damage inventory . Documents will be signed and certified as accurate by both parties . 2 . Ensure that all furniture , machinery, equipment, curtains drapes , blinds and other mov- able objects which the contractor is bound to remove from the work area have been re- moved or protected. 3. Notify the Owner's Representative of systems that need to be shut down as soon as practical in advance . The Owner's Representative will coordinate shutdown with Con- tractor and Owner's Facility Representative . The Owner's Facility Representative will perform and monitor shutdown as required by Contractor. a . Shutdown and seal off all heating , cooling , ventilating or other air handling systems serving the work area . The environment of the work area will be completely isolated from all other air flows in the building . Owner's Representative will monitor shut- down . b. Shut down all electrical circuits which pose a potential hazard on the job. Exact elec- trical arrangements will be tailored to the particular space and systems involved. All electrical circuits will be turned off at the box outside the removal area , not just the wall switch. Potential for electrical shock is a major threat to life in a work area where IHST Project #17849 Page 16 ASBESTOS REMOVAL large amounts of water will be sprayed on ceilings , conduits , lighting fixtures and other electrical items . Electrical lines which are used to power work lights and equipment will conform to all electrical safety standards and will be protected by a ground fault interrupter. The Asbestos Abatement Contractor will be responsible for all OSHA lockout/tagout requirements . A copy of the Asbestos Abatement Contrac- tor's lockout/tagout program must be submitted for review prior to asbestos abate- ment operations. 2.1.3. PREABA TEMENT CONSTRUCTION AND OPERATIONS: Perform all preparatory work for the first work area in accordance with the approved detailed work schedule . Execute the preparatory work in accordance with this specification . Upon completion of all preparatory work , the Owner's Representative will inspect the work and systems to assure work is in accordance with these Specifications . The Owner's Representa- tive may require that , upon satisfactory inspection , the Contractor's employees perform all major aspects of the approved SOP especially on worker protection , respiratory protection , contin- gency plans , decontamination procedures and monitoring to demonstrate satisfactory operation . The operating systems for respiratory protection and negative pressure air systems will be demonstrated for performance. Upon satisfactory inspection of the installation and systems and satisfactory demonstration of operations the Owner's Representative will notify the Contractor to proceed with abatement work . 2.2. REMOVAL OF ACM AND ACE: 2.2.1 . WETTING MATERIALS: The Asbestos Abatement Contractor will adequately wet and remove all ACM as follows : 1. Spray wetting agent on the asbestos containing materials . 2. After wetting and removal , seal all ACM waste in leaktight two layers of 6-mil polyethyl- ene while wet. For waste material not fitting into containers without additional breaking , put material into leaktight wrapping . 3. Label containers and wrapped material using warning labels as specified by OSHA 29 CFR 1910.1001 or 1926 .1101 and the NESHAPS regulat ions . 4 . For ACM being transported off the facility site , label ACM waste containers and wrapped material with the name of the waste generator and the location where the waste was generated . 2.2.2. SITE PREPARATION: Erect critical barriers at all doors and windows entering the regulated areas . This project will be conducted by establishing crit ical barriers over all openings into the work area . A three stage wet decontamination unit will be erected for worker entrance and exit into the work area . The Contractor must establish negative air in the containment and ma intain a pressure differential of -0.02 inches of water column pressure differential. IHST Project #17849 Page 17 ASBESTOS REMOVAL 2.2.3. PERSONAL PROTECTION: One (1) layer of disposable clothing air-purifying respirators (PAPR) w ith NIOSH-approved HEPA cartridges shall be worn by all personnel during removal of the asbestos-containing ther- mal system insulation. Provide boots , safety glasses and gloves for all workers. Equipment will meet OSHA require- ments for personal protection . Provide all persons entering the work area with disposable full body coveralls , disposable head covers and rubber boots . 2.2.4. THERMAL SYSTEM INSULATION: The Contractor may remove the pipe insulation and elbows in a full containment or use a glove bag . If a glovebag is usued the procedures listed below will be used : The minimum crew size for a glovebag operation is two : one member performs the actual re- moval with "hands in the gloves" and the second directs the spray wand at the work. It is rec- ommended that three people be used . The third helps support the bag , makes sure tools and supplies are readily available , and is on hand in case of emergency . All crew members should be trained in the use of the glovebag . The Contractor will erect critical barriers and establish negative air filtration . Rope off work area and place warning signs . Bring the necessary materials into the work area. Have a HEPA vac- uum system available at all times. The HEPA vacuum will be used to establish negative air fil- tration inside of the glove bag . Make sure that possible contaminants in the area have been cleaned with the proper methods before beginning the glovebag procedure to avoid confusion concerning the source of the mate- rial. Wrap the adjacent pipe not to be enclosed in the glovebag with 6-mil plastic . Cover surfaces , such as the floor and walls, near the glovebag removal site with 6-mil plastic . Disposable clothing and full-face PAPR respirators will be worn be any person performing glovebag removal. If fiber counts generated during abatement do not exceed the protection fac- tor of a half-face respirator during glovebag removal of TSI , and this can be verified by on-site PCM fiber counts , a half-face respirator may be used. Wrap duct tape around the insulation where the shoulders of the glovebag will be attached . Put the necessary tools in the pouch of the glovebag. Slit the glovebag as necessary to fit it over the pipe from which insulation is to be removed . Attach the glovebag to the previously applied duct tape at the shoulders . Fold the top edge of the bag between shoulders over on itself about an inch , then staple it about every two inches. Fold it again and tape the folded edge to the bag . Seal all joints with duct tape. IHST Project #17849 Page 18 ASBESTOS REMOVAL Prepare the opening for the spray wand . If the manufactured location is not accessible , be sure to reinforce the bag with duct tape where the slit is to be made . Slit must be covered with rub- ber septum-like material that will seal after the wand is removed . Be sure the sprayer and bag are properly supported . The glovebag will have to have a smoke test to assure that the bag is sealed . Assemble the tube and bulb . Insert the tube into the slit prepared for the spray wand . Fill the bag with smoke and gently squeeze . Watch for leaks particularly at seams , joints , corners , and arms. Seal leaks with duct tape . Establish negative air filtration of the glovebag before any removal operations take place . Wet the covering of the insulation, keeping it wet through the entire operation . Remove any metal covering with the tin snips . Remove the outer covering of the insulation . This may expose wire that needs to be cut before proceeding. Be sure that sharp edges of metal and wire are folded inward to avoid puncturing the bag . It may be possible to further pro- tect the bag by packing insulation , which has already been removed from the pipe and placed at the bottom of the bag , around sharp edged material. Remove the insulation . If possible , remove sections as they were installed . Otherwise use the utility knife and/or the flex saw to cut out the section which is then pried off. Keep the insulation (especially newly exposed surfaces) wet during the procedure . As pieces of insulation are removed , lower them carefully to the bottom of the bag. Using the putty knife and the screwdriver , scrape any remaining residue from the pipe . Rinse the pipe while scraping . Clean the pipe with the scrub brush . Wipe all cleaned surfaces with a wet rag and put the rag in the bottom of the bag . Rinse and wipe the inside of the glovebag . Rinse and wipe the tools , then put them in the pouch . Develop a check list to inventory tools in the glovebag. Pull one arm out of the glovebag , inverting the glove in the process. With the other hand , place tools in the inverted glove . Grasp the remaining tools and place them in the other glove as the second arm is withdrawn . After the bag has been collapsed and the bottom tw isted off, twist the gloves between the tool and the glovebag and wrap with tape for about four inches starting at the bag . Leave a tab and cut through the tape . Either transfer the glove to a new bag (if work is to continue) or open the bag under water and remove the tools , making sure they are free from debris . Remove the spray wand and insert the nozzle of the HEPA vacuum in the slit. Turn the vacuum on and run it long enough to collapse the bag . IHST Project #17849 Page 19 ASBESTOS REMOVAL Twist the bag and wrap it with duct tape just below the gloves and remove the HEPA vacuum nozzle. Glovebags may only be used once and may not be moved . When the bag is finally to be removed from the pipe , fold the dirty side inward and put it in a 6- mil disposal bag. Seal the disposal bag. Inspect the sections of the pipe where the insulation has been removed. Remove any remain- ing material with a wet rag or the HEPA vacuum . Apply a coat of sealant to the pipe . Clean up any debris or water on the floor with wet rags and/or the HEPA vacuum . As in any asbestos related project, the work area should be kept free of debris . Any contamina- tion should be cleaned up immediately. When the work day is complete , (or as soon as the pro- ject is complete) the work area should be cleaned using wet methods and/or a HEPA vacuum . All glovebags should be removed from the pipes at the end of the work day (or as soon as the procedures are completed) and placed in double layer 6-mil asbestos disposal bags. Dispose of waste in accordance with regulations for asbestos waste found in these specifications . Workers should pass through a complete decontamination facility when exiting the work area . If the bag develops a leak , stop work inside the bag . Catch the water in a plastic disposal bag. Lift and move the bag so that water stops running out. Do not "pump" the bag in a way that would force air out. Twist the bag in the area of the puncture to form a stem , dry the surface and tape it securely closed . Clean up the contaminated water and debris from the floor immedi- ately using wet methods and/or the HEPA vacuum. Dispose of the waste properly. Alternate removal techniques may be used if approved by the CIH . 2.2.5. FLOOR TILE AND MASTIC: Those areas normally exposed to heavy foot traffic patterns usually have tiles adhered the tight- est. As a matter of good practice in starting the tile removal , those sections which receive the least traffic should be the locations selected for starting the removal of the tile. Since tiles are normally in a 9" x 9" or 12" x 12" dimension , it should be the goal to remove individual tiles as a complete unit to the best extent possible . Start the removal by carefully wedging the wall scraper in the seam of two adjoining tiles and gradually forcing the edge of one of the tiles up and away from the floor . Do not break off pieces of the tile but continue to force the balance of the tile up by working the scraper beneath the tile and exerting both a forward pressure and a twisting action on the blade to promote re- lease of the tile from the adhesive and the floor. When the first tile is removed, place it , without breaking into smaller pieces, in the heavy-duty impermeable waste bag or closed impermeable container which will be used for disposal. With the removal of the first tile accessibility of the other tiles is improved . Force the wall scraper under the exposed edge of another tile and continue to exert a prying twisting force to the IHST Project #17849 Page 20 ASBESTOS REMOVAL scraper as it is moved under the tile until the tile released from the floor . Again , dispose of the tile , and succeed ing tiles , by placing in the heavy-duty bag or closed container without additional breaking . Some tiles will release quite easily while others requ ire varying degrees of force . Where the adhesive is spread heavily or is quite hard , it may prove easier to force the scraper through the tightly adhered areas by striking the scraper handle with a hammer using blows of moderate force while maintaining the scraper at a 25° to 30° angle to the floor . Caution: Use safety gog- gles. If some areas are encountered where even the technique detailed in the previous paragraph proves to be inadequate , the removal procedure can be simplified by thoroughly heating the tile(s) with a hot air blower until the heat penetrates through the tile and softens the adhesive . Note 1: Handle the hot air blower, tiles , and adhesive carefully to avoid personal burns . Note 2: Do not handle the heated tiles and adhesive without suitable glove protection for the hands . As small areas of subfloor are cleared of tile , the adhesive remaining on the floor must be scraped up with the 4" hand scraper until only a thin, smooth film remains . In those area where deposits are heavy or difficult to scrape , the removal can be expedited by heating with the hot air blower prior to scraping . Deposit scrapings in a heavy-duty impermeable trash bag or closed impermeable container. Thoroughly spread approved mastic biodegradab le cleaner/solvent onto all mastic with a garden sprayer (Note The solvent used to remove the mastic must have a flash point of >140 degrees F. Submittals for the solvent must include a Material Safety Data Sheet. Let the solution stand for at least 15 minutes . Use an industrial buffer with coarse pads to dislodge the material or a squeegee . Squeegee , or use scrapers to push material into a cen- tral location for final mopping and cleanup. Hand-scraping may be done at the Contractor's op- tion , or as required to completely remove all material. As indicated in previous paragraphs , tiles should be placed immediately in a waste disposal bags or closed impermeable container . Do not attempt to break tiles after they are in the bag . When all tiles , mastic and sorbent material have been removed from the floor and placed in polyethylene waste bags at least 6-mil thick or closed containers , seal the bags securely for dis- posal. "Shot blaster" or "bead blaster" machines will not be allowed to remove the floor tile and mastic. Alternate removal techniques may be used if approved by the CIH. 2.2.6 WALL AND CEILING TEXTURE The asbestos texture will be kept wet and removed by wet scraping or as intact sheetrock and ceiling tile sections utilizing hand tools and a low water volume , short distance power diffusing "Airless" sprayer . The asbestos plaster texture and texture on CMU block will be kept wet and removed utilizing hand tools and a low water volume , short distance power diffusing "Airless" sprayer. IHST Project #17849 Page 21 ASBESTOS REMOVAL The minimum crew size for the operation is three: one member performs the actual removal , the second directs the spray wand at the work and the th ird worker collects and conta ins the wet ACM debris generated during the work . It is recommended that four workers be utilized in the procedure . The fourth person provides support during the work , making sure tools and supplies are readily available , and is on hand in case of emergency . All crew members should be trained in the use of the wet scraping procedure . The Contractor will erect critical barriers and establish negative air filtration . Rope off work area and place warning signs . Bring the necessary materials into the work area . Have a HEPA vac- uum system available at all times. The HEPA vacuum will be used to remove debris which may settle in remote areas such as corners , cracks or crevices in the work area . Make sure visible ACM debris and dust in the area have been wetted with amended water and cleaned with the proper methods before beginning the procedure to avoid confusion concerning the source of the material. Cover floor with a minimum of two layers of 6 mil plastic sheeting if flooring is not being re- moved , and cover wall surfaces with a minimum of two layers of 4 mil plastic sheeting . The top polyethylene sheeting layer may be removed as part of the detail cleaning process after gross removal. Hard hats , disposable clothing and full-face PAPR respirators will be worn by all persons per- forming the ACM removal. Establ ish negative air filtration in the containment before any removal operations take place . The containment may be smoke tested to assure the negative pressure inside the containment is adequately sealed . Assemble the smoke tube and bulb. Generate short bursts of smoke in the containment particularly at seams , joints and corners and critical barriers . Observe the direc- tion of the smoke trail. Watch for leaks , and seal any leaks with duct tape. Wet the plaster and surfacing material adequately to suppress any generation of airborne dust or debris , keeping it wet throughout the entire operation . As sections of ACM are removed , keep the material wet and shovel debris carefully into the bot- tom of a disposal bag . Wipe all cleaned surfaces with a wet rag and put the rag in the bottom of a 6 mil disposal bag . Rinse and wipe the inside of the disposal bag. Clean up any debris or water on the floor with wet rags and/or the HEPA vacuum . As in any asbestos related project, the work area should be kept free of debris . Any contamina- tion should be cleaned up immediately . When the work day is complete , (or as soon as the pro- ject is complete) the work area should be cleaned using wet methods and a HEPA vacuum . IHST Project #17849 Page 22 ASBESTOS REMOVAL All asbestos material and associated debris should be removed and placed in double layer 6 mil asbestos disposal bags before the end of the work day . Dispose of waste in accordance with regulations for asbestos waste found i n these specifications . Workers should pass through a complete three-stage wet decontamination facility prior to exit- ing the building . If a disposal bag develops a leak , stop work inside the containment. Catch the water in a plastic disposal bag . Lift and move the bag so that water stops running out. Do not "pump" the bag in a way that would force air out. Twist the bag in the area of the puncture to form a stem , dry the surface and tape it securely closed . Clean up the contaminated water and debris from the floor immediately using wet methods and the HEPA vacuum . Dispose of the waste properly. 2.3. DISPOSAL OF ACM AND ACE WASTE MATERIAL: 2.3.1. GENERAL: The Asbestos Abatement Contractor will dispose of friable ACM and debris which is packaged in accordance with these specifications at the approved landfill. Dispose of non-friable ACM in accordance with the applicable regulations for friable asbestos . The transporter must be li- censed in accordance with the Texas Department of State Health Services Asbestos Rules and Regulations . The truck transporting the waste must have the following noted on the shipping papers , manifests and trucks : Hazardous Material Proper Shipping Name: hazardous substance solid , N.O .S. DOT Hazard Class: Class 9 PG . Ill Identification Number: NA 2212 (friable waste) Reportable Quantity: RQ Name and Address of Generator 2.3.2. PROCEDURES: Carefully load containerized waste on sealed trucks for transport. Ensure that unauthorized persons do not have access to the material outside of the work area . Take bags from the work area directly through the EDF process to a sealed truck. Double bagged material may be trans- ported in open trucks only if they are first loaded in sealed drums . Label drums with same warn- ing labels as bags . Dispose drums as contaminated , do not attempt to empty them for reuse . Advise the sanitary landfill operator, at least twenty-four hours in advance of transport, of the quantity of material to be delivered . At the burial site , sealed plastic bags may be carefully dumped from the truck. If bags are broken or damaged , leave in the truck and decontaminate entire truck and contents using procedures set forth elsewhere in this section . IHST Project #17849 Page 23 ASBESTOS REMOVAL 2.4. PROJECT DECONTAMINATION: 2.4.1. GENERAL: The entire work of project decontamination will be performed under the close supervision and monitoring of the Owner's Representative . 2.4.2. WORK AREA CLEARANCE: Air testing and other requirements which must be met before release of Contractor and reoccu- pancy of the work area are specified elsewhere in this Section . Air Clearance will be performed utilizing Phase Contrast Microscopy with an airborne level of <0 .01 Flee. 2.4.3. WORK DESCRIPTION: The work of decontamination includes the decontamination floor and air within the work area and the decontamination and removal of temporary facilities installed prior to abatement work including Primary and Critical Barrier , Decontamination Facilities (PDF and EDF) and Negative Pressure Systems . The work of decontamination includes the cleaning , and decontamination of all surfaces (ceiling , walls , floor) of the Work Area , or equipment in the Work Area . 2.4.4. PRE-DECONTAMINA T/ON CONDITIONS: Before decontamination work starts , all ACM and ACE will be removed from the work area and disposed of along with any gross debris generated by the work. At the start of work for decontamination , the following will be in place : 1 Critical barrier which forms the sole barrier between the work area and other portions of the building or the outside . 2 . Critical barrier sheeting over lighting fixtures , ventilation openings , doorways , convectors , speakers and other openings . 3. Decontamination facilities for personnel and equipment in operating condition and nega- tive pressure system in operation . 2.4.5. FIRST CLEANING: The Asbestos Abatement Contractor will carry out a first cleaning of all surfaces of the work area including items of remaining sheeting , tools , scaffolding and/or staging by use of damp- cleaning and mopping , and a HEPA filtered vacuum. Do not perform dry dusting or dry sweep- ing . Use each surface of a cleaning cloth one time only and then dispose of as contaminated waste . Continue this cleaning until there is no visible debris from removed materials or residue on plastic sheeting or other surfaces . Remove all filters in air handling system(s) and dispose of as asbestos containing waste in accordance with requirements of these specifications . 2.4.6. SECOND CLEANING: IHST Project #17849 Page 24 ASBESTOS REMOVAL If the Asbestos Project Manager is not satisfied with the first cleaning , the Contractor will per- form a second cleaning inside containment. If the containment fails to pass final air clearance criteria , the Contractor will perform additional wet cleaning ins ide containment. 2.4. 7. PRE-CLEARANCE INSPECTION AND TESTING: The Owner's Representative will perform a thorough and detailed visual inspection at the end of the second cleaning to determine whether there are any signs of visible ACM or dust in the work area . If the visual inspection is satisfactory , the Contractor will then encapsulate all surfaces in- side the containment. Final air clearance will be performed in accordance with these Specifica- tions . 2.4.8. LOCK-BACK ENCAPSULATION: With the express permission of the Owner's Representative , the Asbestos Abatement Contrac- tor will perform a lock-back encapsulation of all surfaces from which ACM was removed . Exe- cute in accordance with provisions specified elsewhere and performance requirements as speci- fied in Paragraph 2.2.2 of this Specification . Maintain negative pressure in work area during en- capsulation work . 2.5. FINAL AIR CLEARANCE TESTING 2.5.1. GENERAL: The Asbestos Abatement Contractor will notify the Owner's Representative in advance for the performance of the final visual inspection and testing . The final air clearance will be performed by the Owner's Representative starting after completion of the encapsulation of the containment and the material is dry . 2.5.2. FINAL TESTING: After a satisfactory final visual inspection and encapsulation , The Owner's Representative , will undertake the final testing. Air samples will be taken and analyzed in accordance with the pro- cedures for PCM specified elsewhere in this section . If release criteria are not met , the con- tractor will repeat final cleaning and continue decontamination procedure from that point. Addi- tional inspection and testing will be at the expense of the Contractor. If results of PCM air samples are satisfactory , remove the critical barriers and shut down and remove HEPA units as specified under Abatement Closeout. Any small quantities of residue material found upon removal of the plastic sheeting will be removed with a HEPA filtered vac- uum cleaner and localized isolation . If significant quantities , as determined by the Owner's Consultant, are found then the entire area affected will be decontaminated as specified herein for the Final Cleaning. If release criteria are met the Contractor will perform the abatement closeout and issue the cer- tificate of compliance in accordance with these specifications . IHST Project #17849 Page 25 ASBESTOS REMOVAL 2.5.3. FINAL TESTING PROCEDURES: CONTRACTORS RELEASE CRITERIA: Work in an area is complete when the work area is visually clean and airborne fiber levels have been reduced to less than 0.01 fibers/cc by PCM analysis. AIR MONITORING AND FINAL CLEARANCE SAMPLING: To determine if the elevated air- borne fiber counts encountered during abatement operations have been reduced to the speci- fied level , the Owner's representative will secure samples and analyze them according to the following procedures : 1. Fibers Counted : "Fibers" referred to in this section will be either all fibers regardless of composition as counted in the NIOSH 7400 method , or asbestos fibers of any size as counted using PCM ; and 2.5.4. SCHEDULE OF AIR SAMPLES WITH PCM: The Owner's Consultant will perform background , perimeter and work area samples during con- struction and abatement. These samples will be analyzed by PCM . At least three (3) background samples will be taken before work begins for a baseline meas- urement. The Owner's Representative will sample at a rate of one sample per 1,000 sq . ft . of work area with a minimum of two area samples for small containment areas . A minimum of 1,250 liters of air will be collected for all baseline and clearance samples . From start of actual removal of asbestos-containing materials the Owner will take the following samples on a daily basis . The number of samples may vary according to site plan and approval from the CIH . DAILY SCHEDULE OF AIR SAMPLES Location Sampled Number of Sam-Analytical Method Detection Limit Minimum Vol-Rate LPM pies Fibers/cc. ume (Liters) Each Work Area 3 PCM 0 .02 750 2-15 Outside Each Work 2-3 PCM 0 .01 1,000 2-15 Outside Entrance to De-1 PCM 0 .01 1,000 2-15 contamination Facility Outs ide Bag-out Area 1 PCM 0 .01 1,000 2-15 Output Negative 1 PCM 0 .01 1,000 2-15 Pressure System If airborne fiber counts exceed allowed limits , additional samples will be taken as necessary to monitor fiber levels . *At a minimum , five (5) samples will be collected per containment area over the duration of work in that area each day. 2.5.5. LABORATORY TESTING FOR PCM: The services of a AIHA P.A.T. accredited testing laboratory will be employed by the Owner to perform PCM analysis of the air samples collected prior to final clearance testing. A technician will be at the job site , and samples will be analyzed on-site . A complete record , certified by the IHST Project #17849 Page 26 ASBESTOS REMOVAL testing laboratory , of all air monitoring tests and results will be furnished to the Owner and the Abatement Contractor . The analytical laboratory must be licensed in accordance with State of Texas Civil Statutes Article 4477-3a pg. 295 .54 in addition to being AIHA P.A.T. Accredited . 2.5. 7. FINAL AIR TESTING REQUIREMENTS: Final air testing will be performed by Phase Contrast Microscopy (PCM). Final air testing re- quirements are outlined below : In each homogeneous work area after completion of all cleaning work , a minimum of three (3) samples will be taken and analyzed as follows : PHASE CONTRAST MICROSCOPY CLEARANCE CRITERIA Location Number of Analysis Analytical Sensi-Recommended Rate Sampled Samples Method tivity Volume LPM s/mm2. (Liters) Each Work Area 3 PCM <0.005 1,250 < 15 Work Area Blank 1 PCM <0 .005 0 Open for 30 Seconds Outside Blank 1 PCM <0 .005 0 Open for 30 Seconds Laboratory Blank 1 PCM <0 .005 0 Do Not Open Release Criteria: Decontamination of the work site is complete when every work area sample is at or below 0.01 FIBERS/CC. 2.6. ABATEMENT CLOSEOUT AND CERTIFICATE OF COMPLIANCE: 2.6.1. COMPLETION OF ABATEMENT WORK: The asbestos abatement contractor will seal negative air machines with 6 mil polyethylene sheet and duct tape to form a tight seal at intake end before being moved from work area . Complete asbestos abatement work upon meeting the work area clearance criteria and fulfilling the following : Remove all equipment , materials , debris from the work site . Dispose of all asbestos containing waste material as specified elsewhere in this section . Repair or replace all interior finishes damaged during the course of asbestos abatement work . Replace all asbestos containing insulation and other ACM with suitable non-asbestos material so that facility is fully functional and safe as prior to abatement if required by these specifications . Fulfill other project closeout requirements as specified elsewhere in this sect ion. IHST Project #17849 Page 27 ASBESTOS REMOVAL 2.6.2. CERTIFICATE OF COMPLETION BY CONTRACTORS: The Contractor will complete and sign a "Certificate of Completion" in accordance with attach- ment #1 at the completion of the abatement and decontamination of a work area . IHST Project #17849 Page 28 Appendix A Attachments CERT/FICA TE OF COMPLETION PROJECT: ________________ DATE ______ _ LOCATION: _______________________ _ 1. I certify that I have personally inspected, monitored and supervised the abatement work of (Specify Work Area or Building) which took place from _________ to __________ _ (Beginning of Work) (End of Work) 2 . That throughout the work all applicable regulations and the specifications were ob- served . 3 . That any person who entered this area was protected with the appropriate clothing and respirators systems and that they followed the proper entry and exit procedures and the proper operation procedures throughout the work. 4 . That all employees of the contractor engaged in this work were trained in respiratory pro- tection , experienced with abatement work , had proper medical records and were not ex- posed at any time during the work to asbestos without the benefit of adequate respira- tory protection . 5 . That I performed and supervised all inspection and testing specified and required by ap- plicable regulations and the specifications . 6 . That the condition inside the work area were always safe and the maximum asbestos fi- ber count never exceeded 0 .5 flee . Except as describe here : 7 . That the negative pressure air systems were installed and operated properly ma intain ing the specified negative pressure in the work area throughout the work. CONTRACTOR/SUPERVISOR COMPANY NAME CONTRACTOR ADDRESS ATTACHMENT#1 Asbestos Abatement Page 1 AppendixB Specification Drawings ACM in Light Brown 9 x 9 Floor Tile ACM in Brown Linoleum Flooring ----·--·-· --------·--------·--- Family Room Bath Bedroom Bedroom Living Room Porch to (I) 0.. ~ 0 0 s City of Fort Worth 1304 Westport Fort Worth , Texas Asbestos Specification 1111 Project# 17850 Drawing #1 Industrial Hygiene and -No-t-To_S_cal_e ________ , SafelyTechnology, INC. 2235 Keler Way Drawn by: AHG Dale: 01/18/08 Cam>llon, Texas 75006 Revised by: Date : TEL (972) 478-7415 FAX(972)478-7615 ami ly oom C ("-1--· -,-... . q B ath ;1 Kitchen B e droom Living_ oom orch edroom to (D Q.. 1-t 0 0 s LE GEND ACM in Tex ture and Joint Compound associated with drywa ll )/~ ~w,-- /0-5040 ri/31/11 City of Fort Worth 1304 Westport Fort Worth, Texas Asbestos Specification G 1111 Industrial Hygiene and Project # 17850 Drawing #2 l,N~o=t :To~Sca~le~:-1f------Jl Safety Technology, INC. Drawn by: AHG Date: 01118 ,08 2235 Keffer Way '' Carromon, Texas 75006 Revised by: Date: TEL(972)478-7415 FAX(972)478-7615 ACM in Texture and Joint Compound associated with drywall orch )(~~Id! I 0 --'":}Ot(O ('J,/311 ,, City of Fort Worth 1304 Westport Fort Worth, Texas Asbestos Specification 1111 Project# 17850 Drawing #3 Industrial Hygiene and Not To Scale Safety Technology, INC. t":"-----+------JI 2235 KenerWay Drawn by: AHG Date: 01/18/08 Carrnmon, Texas 75006 Revised by: Date: TEL(972)478-7415 FAX(972)478-7615 jo 0 o 0 o 0 o 0 o ) 0 0 0 0 )000000000 )000000000 , 01""\0r'\ 01""\0f""\ 0 Living Kitchen I I Bath I Uti l. Office L I -Storage Master Bedroom! Covered Porch House Jf/UlfJ. ~w I 0-so Cf. o ti/111,1 City of Fort Worth 1404 Westport Fort Worth, Texas Asbestos Specification Project# 17850 Drawing #4 Not To Scale Drawn by: AHG Date: 01/18/08 Revised by: Date: ------------------------------------------------ 1111 Industrial Hygiene and Safety Technology, INC. 2235 Keller Way Carromon, Texas 75006 TEL (972) 478-7415 FAX (972) 478-7615 Ca ort ove e orch ACM Texture on Drywall ( aprox. 4700 SF) r~ ~/dj- ,0 --5 ()'-{0 t2./!.J/f1 City of Fort Worth I 11 T 410 Harmon Avenue Fort Worth, TX i-,:..::.;..Asbe=:.stos S...;..._pecifica-tion ----i Project# 17850 Drawing #1 Not To Scale Drawn by: AHG Date: 01/18/08 Revised by: Date: lnduslrial Hygiene and Safety Technology, INC. 2235 Keffer Way canoaton, Texas 75006 TEL (972) 478-7415 FAX(972)478-7615 Ca ort overed -ACM F looring (1 025 SF) --·---------- ch )f~ ~&JJ- tD-So'{O t~f 31/,, City of Fort Worth I H S I .____410HannonAv-enue -----4I ~ Asbestos Specificat ion Project# 17850 Drawing #2 Industrial Hygiene and i--N...;...ot T-o Sca-le-i---....;.._--11 Safety Technology, INC . 2235 Kener Way Drawn by: AHG Date: 01/18/08 Revised by: Date: Garrolton. Texas 75006 TEL (972) 478-7415 FAX(972)478-7615 ·------------·--- torage a age M s~ . e 0 ~ ACM Brown Viny l Flooring (35 SF) fDI ACM Red Vinyl Flooring (36 0 SF ) NOT DRAWN TO SCALE 1v1ng 0 01n 1n1ng ed Rm C C Bath2 C Bed C Rm r~~{Jl;{ JO-St>C/0 12-/ 31/ft City of Fort Worth I H S T 491 Harmon Avenue Fort Worth , TX i.,:..:;.:..:.:Asbestos Specifi-. cation ------1I Industrial Hygiene and i_:Pro.:,::1~·ect:..:.:#...;,1,;..;.785;..;.0~D..;..rawi_·ng;;;...#3 __ 11 Safety Technology, INC. Not To Scale Drawn by: AHG Date : 01/18/08 Revised by: Date: 2235 Kenor Way Carmmon, Texas 75006 TEL (972) 478-7415 FAX (972) 478-7615 =====---------------- 959 Harmon Bedroom Z J ACM C ·lin e1 gTexture r~~w 10-so'-lo l2/31/1, CityofFortW 959 Harm orth Fort W on Avenue orth,TX Asbestos Specification Project# 17850 Not To Scale Drawing #4 Drawn by: AHG Date: 01/18/08 Revised by: Date : ~-Il l SafetyT:i:yg,ene and 2235 nology' INC Ca Ke lle rWay · rrolllon, Te,.,s 75006 ;;-L (972) 478-7415 AX(972)478-7615 Bedroo m ~ ACM Texture I Joint associated with ceilings & walls Jf~ ~{8J-,o -~t:>t.t,O I °?/s1/t/<J City of Fort Worth 959 Hannon Avenue Fort Worth, TX Asbestos Specification Project # 17850 Drawing #5 Not To Scale Drawn by: AHG Date: 01/18/08 Revised by: Date: 1111 Industrial Hygiene and Safety Technology, INC. 2235 KeDer Way Carmlton, Texas 75006 TEL (9n) 478-7415 FAX(972)478-7615 -------- r---r------------,r;u7 --:J-;------;07--;c-:--,-r ---------,,-------.--------------_j.(-~ o 0 o 0 o 0 o ' = 0 C) 0 0 C O O ' Bedroom ool@&e~ 0 0 ( Bedroom ·o'JnOoOo · o'-'o n , 0 Q O ( 0 r., 0 r C If-----'--- Bath Dining Room -- Bedroom ; O ~ O : ACM Brown Flower Linoleum Flooring -------------~ -- Li ving --Garage C ._ -Bath )f /kUfJ-~ lJ15t 10 ,70'-l:'D ,z /31/fti City of Fort Worth 959 Harmon Avenue Fort Worth, 1X Asbestos Specification 1111 Project # 17850 Drawing #6 Industrial Hygiene and I--No...;t-To_S_ca_l_e_-+----=~-----11 Safety Technology, INC . 2235 Keller Way Drawn by: AHG Dale: 01/18/08 Carrolton, Texas 75006 Revised by: Date: TEL (972) 478-7415 FAX(972)478-7615 Garage Mud Roo Nook Bdrm Bdrm Living 1st Floor 2nd Floor ~ ACM Floor Tile f~~wt /0 -501.[D ( ?../311,, City of Fort Worth 865 Hannon Avenue Fort Worth, Texas Asbestos Specification Project# 17850 Drawing #7 Not To Scale Drawn by: AHG Date: 01/18/08 Revised by: Date: 1111 Industrial Hygiene and Safety Technology, INC. 2235 Kener Way Carrolton. Texas 75006 TEL (972) 478-7415 FAX (972) 478-7615 I 19 Garage v:~ _L/' ACM in vinyl flooring ~ ACM in vinyl flooring 1 Sample locations I LR l 1 18 8 1p BR 5 I ~14-15 ~~ljJ( IO -SO'f'D t ~/ 31/11 City of Fort Worth 301 Hannon Fort Worth, Texas Asbestos specification Project # 17850 Drawina #1 NotToScale Drawn by: AHG Date: 01/18/08 Revised by: Date: - 1111 Industrial Hygiene and Safety Technology, INC . 2235 Keler Wiry Carrolllon, Texas 75006 TEL (972) 478-7415 FAX (972) 478-7615 --- BR Garage 11 03 02 /:,~ ACM in vinyl flooring ~ ACM in vinyl flooring 1 Sample locations 14 1 16-17 ""'07 DR BR 10 15 Mstr.BR >~~/jj ,~R ; >::: / /, /' / ./ / / ,~/ _/_ 04-06 City of Fort Worth 525 Harmon Fort Worth, Texas Asbestos Specification Project # 17850 Not To Scale 12 BR Drawn by: AHG Date: 01/18/08 Revised by: Date: 09 RR 1111 Industrial Hygiene and Safety Technology, INC. 2235 KelerWay carrolllon, Texas 75006 TEL (972) 478-7415 FAX (972) 478-7615 Dining room Garage Living room t Scale: 1' = 10' N ENVIRONMENTAL MANAGEMENT Brown, rock-patterned vinyl flooring Bedroom I Restroom Hall Bedroom 3 Identified ACM Vacant Residence 1504 Westport Parkway Sampled: 12/31 /2009 By: Stewart Brown Bedroom 2 Closet Restroom- I-- Closet t(~ Jt! IIAl(}J;( JO, S()'-fO l z, 'JI' II Yellow, square-patterned vinyl flooring Brown, square-patterned vinyl flooring