HomeMy WebLinkAboutContract 40870-Between
CITY OF FORT WORTH
and
INTERCON ENVIRONMENTAL, INC.
For
Structural Demolition and Removal,
Transportation, and Disposal of Asbestos
Contaminated Materials
DEM 10-08: GHA
Environmental Management Department
September 2010
OFFICIAL RECOR
CITY SECRETAR
FORT WORTH,
09-29-1 0 A08: 22 IN
P age I of2
City Of Fort Worth, Texas
Mayor and Council Communication
COUNCIL ACTION: Approved on 8/24/2010 -Ord. No. 19291-08-2010 & 19292-08-2010
DATE: Tuesday , August 24 , 201 o
LOG NAME: 52GRANBURY HILLS REFERENCE NO.: C-24419
SUBJECT;
Authorize Execution of Contract with Int E . .
Demolition and Asbestos Abatement Se~fi;s i nvironmental, Inc.: in the Amount of $598 ,076 .85 for
Appropriation Ordinances (COUNCIL D1STR1Cr6\he Granbury Hills Apartment Complex and Adopt
RECOMMENDATION:
It is recommended that the City Council :
1. Authorize the City Manager to execute a contract with lntercon Environmental , Inc. for Demolition and
Asbestos Abatement Services for the Former Granbury Hills Apartment Complex in the Amount of
$598 ,076 .85 .
2. ~dopt the attached appropriation ordinance increasing estimated receipts and appropriations in the
Environmental Protection Project Fund in the amount of $393 ,798 .95 from available funds ;
3. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations in the
Fort Worth Housing Finance Corporation Fund in the amount of $204 ,277 .90 from available funds ; and
DISCUSSION:
In March 2010, the Fort Worth Housing Finance Corporation adopted a resolution authorizing the
acquisition and demolition of the Granbury Hills Apartments located at 5250 Wonder Drive from Blue
Valley Apartments , Inc ..
The apartment buildings contain asbestos-containing materials that are required to be removed prior to
bu ilding demolition. The Environmental Management Department is contract ing for the demolition
including removal of the asbestos-containing materials including : sheetrock with wall texture and joint
compound , popcorn ceiling texture , linoleum floor covering, and floor tile with mastic. Following the
asbestos removal activit ies , all buildings will be demolished and all improvements includ ing parking areas,
sidewalks , bu ilding slabs, and pools will be removed.
Bids for the demolition were advertised in the Fort Worth Star-Telegram on June 2 , 2010 and June 9,
2010 . The following firms subm itted bids on July 1, 2010 :
• ARC Abatement
• Garrett Demolition
• lntercon Enviro nmental , Inc
• Lloyd Nabors Demol it ion
• Midwest Wrecking Company
• Precision Demolition , LLC
• ocs
• Sisk-Robb , Inc.
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
experience , qualifications of personnel , contractor capabilities , cost , and subcontractors. Based on the
total po int distribution of the pre -determined measures , lntercon Environmental , Inc . met all the
htt p ://app s.cfwnet.org/ec ounci l/printmc.asp?id =l 399 7&print=true&D ocTy pe=Print 9/15/20 10
;
Page 2 of 2
requirements and with a bid of $598 ,0 76 .85 .
lntercon Environmental, Inc ., is in compliance with the City's M/WBE Program by committing to 16 percent
M/WBE participation on this project. The City's goal on this project is 16 percent.
The Environmental Management Department will oversee this asbestos removal and demolition project for
the Housing and Economic Development Department.
Work on the asbestos removal and demolition project is expected to begin in September 201 O.
The project is physically located in COUNCIL DISTRICT 6 but will serve Fort Worth residents in ALL
COUNCIL DISTRICTS.
FISCAL INFORMATION/ CERTIFICATION:
The Financial Management Services Director certifies that upon approval of the above recommendations
and adoption of the attached appropriation ordinances, funds will be available in the current operating
budgets , as appropriated, of the Environmental Protection Project Fund and the Fort Worth Housing
Finance Corporation Fund .
------------------··---·-··---··---·---------·--------·-"----------·---------··----·----·---·-··· ·-----·----------------------------·-------
FUND CENTERS:
TO Fund/Account/Centers
1) R101 441042 052011000000
1) R101 539120 052011000000
2) R109 444105 005109005101
2) R109 539120 005109005101
FROM Fund/Account/Centers
$393 ,798.95 1) R101 539120 052201007000
$393,798 .95 2) R109 539120 005109005101
$204,277.90
$204 ,277 .90
CERTIFICATIONS:
Submitted for City Manager's Office by:
Originating Department Head:
Additional Information Contact:
ATTACHMENTS
1. 52GRANBURY HILL Rec1 .doc (Public)
2 . 52GRAN .BURY HILL Rec2.doc (Public)
Fernando Costa (6122)
Brian Boerner (6647)
Michael Gange (6569)
3. Bond Fund Trfr and Report 09 .Q.df (CFW Internal)
4 . Compliance Memo-Granbury Hills Apt Complex.QQ.f (CFW Internal)
5. R101 5zzzzz052201007000 .doc (CFW Internal)
6 . R109 5zzzzz 005109005101 .doc (CFW Internal)
7 . Site Map...,Qd f (Public)
http:// apps. cfwnet. org / ecouncil/printmc .as p ?id = 13 997 & print=true&Doc Type= Print
$393,798 .95
$204,277.90
9/15 /2010
STATE OF TEXAS
COUNTY OF TARRANT
§
§
§
KNOWN ALL BY THESE PRESENTS
CONTRACT FOR STRUCTURAL DEMOLITION
AND REMOVAL, TRANSPORTATION , AND DISPOSAL OF
ASBESTOS CONTAMINATED MATERIALS
GRANBURY HILLS APARTMENTS
DEM PROJECT: DEM 10-08: GHA
This Contract is entered into by and between the City of Fort Worth, Texas , a home-rule
municipality located within Tarrant County Texas , ("City") acting through Fernando
Costa, its duly authorized Assistant City Manager, and lntercon Environmental , Inc. a
Texas corporation , acting through Karen Andrews its duly authorized President
("Contractor").
WHEREAS , the City desi res to conduct a project for removal of asbestos containing
material and the demolition of certain structures located at the Granbury Hills
Apartments , 5250 Wonder Drive , Fort Worth , Texas; and
WHEREAS , the City desires to hire a professional firm knowledgeable and experienced
in conducting such asbestos removal , transportation , disposal 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 consideration of the mutual promises and benefits of this
Contract, the City and the Contractor agree as follows:
1.
DEFINITIONS
In this contract , the following words and phrases shall be defined as follows :
Asbestos shall mean the asbestiform varieties of chrysotlle, amosite, crocidolite,
tremolite, anthophyllite, and actinolite and all materials containing one percent or more
of any of those substances .
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -Page 1 of 26
GRANBURY HILLS APARTMENTS -DEM 10-08 GHA -INTERCON ENVIRONMENTAL, INC.FFICIAL RECORD
CITY SECRETARY
FORT 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 containing 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 limited 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, DEM 10-08: Granbury Hills Apartments,
proposa l, 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 PROJECT: DEM 10-
08 : GHA 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
non-friable ACM that will be or has been subjected to sanding, grinding, cutting, or
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
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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 to complete the work specified in Attachment A. Work shall be conducted
in accordance with the most recent edition of the document entitled "Specifications
for Asbestos Abatement , May 11, 2010" prepared by Industrial Hygiene and Safety
Technology, Inc.
B. Contractor shall perform, in a good and professional manner, the services contained
in this Contract.
3.
SCOPE OF CITY SERVICES
The City 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 will be responsible for coordinating with the Environmental Management
Department, within five (5) days after receipt of notice to proceed, the start date of
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
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asbestos abatement to allow for notification to the Texas Department of State Health
Services (DSHS).
Contractor shall achieve substantial completion of work under this contract within forty
five (45) days from the beginning of initial asbestos abatement activities 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.
A working day shall be defined as each day beginning with the day of initial asbestos
abatement until the work is completed and accepted by the City. If a stop work order is
issued by the City, the tolling of working days shall be suspended until a new Notice to
Proceed is issued.
Should the Contractor fail to begin the work herein provided for within the time herein
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 price or prices set forth in the Contract Documents, the Contractor and/or its
surety shall pay Owner upon its demand in a writing, setting forth and specifying an
itemized statement of the total cost thereof, said excess cost.
5.
INDEPENDENT CONTRACTOR
The City agrees to hire Contractor as an independent contractor, and not as an officer,
servant, or employee of the City. Contractor shall have the exclusive right to control the
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.
6.
COMPENSATION
Compensation by City to Contractor for work performed in accordance with the terms of
the contract shall be as specified in Attachment 8.
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7.
LIQUIDATED DAMAGES
If Contractor fails to commence and complete work under this Contract within 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 the date the project was to be completed, until the project is substantially
completed. Such sum shall be treated as liquidated damages and not as a penalty, and
City may withhold from Contractor's compensation such sums as liquidated damages.
The amount of damage to City for delay in completion of the work is difficult to ascertain
and the amount of the liquidated damages per day as stated above is reasonably
anticipated pecuniary damages for such delay, and is not a penalty.
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 faith
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 federal,
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
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
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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 connection with the
items referenced in subparagraph (b) herein.
2. Environmental requirements shall mean all applicable present and future
statutes, regulations, rules, plans, authorizations, concessions, franchises,
and similar items, of all governmental agencies, departments,
commissions, boards, bureaus, or instrumentalities of the United States,
states, and political subdivisions thereof and all applicable judicial,
administrative, and regulatory decrees, judgments, and orders relating to
the protection of human health or the environment, 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.
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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 all claims, suits and
administrative proceedings (with counsel reasonably approved by the City), even
if such claims, suits or proceedings are groundless, 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 against such indemnified persons.
E. Upon learning of a claim, lawsuit, or other liability which Contractor is required
hereunder to indemnify, City 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 City 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 termination 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 Liability Insurance
$1 ,000,000 each occurrence; $2,000,000 aggregate
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2. Professional Liability Insurance
Not applicable.
3. Automobile Liability Insurance
Coverage on vehicles involved in the work performed under this contract:
$1,000,000 per accident on a combined single limit basis or:
$500,000 bodily injury each person; $1,000,000 bodily 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.
4. Worker's Compensation
Coverage A: statutory limits
Coverage 8: $100,000 each accident
$500,000 disease -policy limit
$100,000 disease -each employee
5. Environmental Impairment Liability (Ell) and/or Pollution Liability $4,000,000 per
occurrence. Ell coverage(s) must be included in 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).
6. 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.
8. 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.
1. 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 services ..
2. Certificate(s) of Insurance shall document that insurance coverage specified
herein are provided under applicable policies documented thereon.
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3. Any failure on part of the City to request required insurance documentation shall
not constitute a waiver of the insurance requirements.
4. 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 policies . Notice shall be sent to Department of Risk
Management, City of Fort Worth, 1000 Throckmorton Street, Fort Worth, Texas
76102.
5. Insurers for all policies must be authorized to do business in the state of Texas or
be otherwise approved by the City; and , such insurers shall be acceptable to the
City 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 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 insurance
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 coverage as required 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
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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. Payment and Performance Bonds . Before beginning the work, the Contractor
shall be required to execute to the City 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 conditions required, within 14
calendar days after Notice of Award.
B. Requ irements 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 satisfaction 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
reinsurer 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 surety satisfactory to the City.
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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 services under this Contract in a safe,
efficient and lawful manner using industry accepted practices, and in full compliance
with all applicable state and federal laws governing its activities and is under no restraint
or order which would prohibit performance of services under this Contract.
12.
DEFAULT AND TERMINATION
A. Contractor shall not be deemed to be in default because of any failure to perform
under this contract if the failure arises from acts of God, acts of the public enemy,
fires, flood, epidemics, quarantine restrictions, strikes, freight embargoes, and
extreme meteorological events. Contractor affirms a duty to mitigate any delays
or damages arising from such causes.
B. If Contractor fails to begin work herein provided for within the time specified
herein, or to complete such work within the time specified herein, 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.
C. 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 at the
discretion of the City. All costs and attorneys fees incurred by City in the
enforcement of any provision of this contract shall be paid by Contractor.
D. City may terminate this Contract at its sole discretion and without cause upon
thirty (30) days prior written notice to Contractor, and such termination shall be
without prejudice to any other remedy the City may have. In the event of
termination, any work in progress will continue to completion unless specified
otherwise in the notice of termination. The City shall pay for any such work that is
completed by Contractor and accepted by the City.
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E. 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 with all federal, state, and local laws and
regulations and with all City ordinances and regulations which in any way affect this
Agreement and the work hereunder, and shall observe and comply with all orders, laws
ordinances and regulations which may exist or may be enacted later by governing bodies
having jurisdiction 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 claims or
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. No modification shall be
binding upon the City unless signed by the City Manager or an Assistant City Manager
of the City of Fort Worth. 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 authorization changing the scope of work or verbal agreements
for additional 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, contractor, 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, contractors, 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 expiration 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 the Contractor involving
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
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
GRANBURY HILLS APARTMENTS -DEM 10-08 GHA -INTERCON ENVIRONMENTAL, INC.
Page 12 of 26
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.
MINORITY AND WOMAN BUSINESS ENTERPRISE
(M/WBE) PARTICIPATION
In accordance with City Ordinance No. 15530, the City has goals for the participation of
minority business enterprises and woman business enterprises ("M/WBE") in City
contracts. Contractor agrees to a minimum M/WBE participation of at least 16% in
accordance with its proposal and the aforementioned ordinance or to the M/WBE
participation rate as specified in its proposal, whichever is higher. Contractor
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.
17.
PREVIALING WAGE RATES
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
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 prohibit the contractor or subcontractor from paying an
employee an amount greater than the prevailing wage rate.
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18.
NON-DISCRI Ml NATION
During the performance of this contract, Contractor shall not discriminate in its
employment practices and shall comply with all applicable provisions of Chapter 17,
Article Ill of the Code of the City of Fort Worth.
Contractor agrees not to discriminate against any employee or applicant 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 applicants for employment,
advertising, hiring, layoff, recall, termination of employment, promotion, demotion,
transfer, compensation, employment classification, training and selection for training or
any other terms, conditions or privileges 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.
19.
GOVERNING LAW
The City and Contractor agree that the validity and construction of this contract shall be
governed by the laws of the State of Texas, except where preempted by federal law.
20.
SEVERABILITY
The provisions of this contract are severable; and if for any reason any one or more of
the provisions contained herein are held to be invalid, illegal or unenforceable in any
respect, the invalidity, illegality or unenforceability shall not affect any other provision of
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.
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21.
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 provision 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.
22.
VENUE
Venue of any suit or cause of action under this Contract shall lie in Tarrant County,
Texas.
23 .
NOTICES
Any notices, bills, invoices or reports required by this contract shall be sufficient if sent
by 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, President
lntercon Environmental, Inc.
210 South Walnut Avenue
Mansfield , TX 76063
24.
ASSIGNMENT
The City and Contractor bind 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. Nothing 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 giving any rights or benefits hereunder to anyone other than the City and Contractor.
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
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25.
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.
26.
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
effect that any ambiguities are to be resolved against the drafting party must not be
employed in the interpretation of this Agreement or any amendments or exhibits hereto.
The headings contained herein are for the convenience in reference and are not
intended to define or limit the scope of any provision of this Agreement.
27.
ENTIRETY
This contract, the contract documents, and any other documents incorporated by
reference herein are binding upon the parties and contain all the terms and conditions
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
bind any of the parties hereto. In the event of any conflict between the specific terms of
this contract and any other contract documents, then the terms of this contract shall
govern.
28.
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 examine and explain 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.
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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 AND ASBESTOS ABATEMENT -
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A TTI ACHMENT A.
SCOPE OF WORK
Contractor will furnish all labor, materials and equipment necessary to perform the
removal of all asbestos-containing materials (ACM) and the demolition of all structures
located at 5250 Wonder Drive , Wedgewood Addition, Block 20, Lot D, and Block 21, Lot
C1A, Fort Worth , Texas (the Granbury Hills Apartment Complex).
THE FOLLOWING TABLES ARE FOR ILLUSTRATIVE PURPOSES ONLY TO
DEMONSTRATE THE POTENTIAL AMOUNTS AND TYPES OF ACM LIKELY TO
ENCOUNTERED ON THE PROJECT AND ARE NOT TO BE CONSTRUED AS A
LIMITATION OR MAXIMUM ON THE AMOUNTS OF ACM TO BE ABATED BY
CONTRACTOR.
IN ADDITION THE ESTIMATES OF DEMOLITION QUANTITIES ARE FOR ILLUSTRATIVE
PURPOSES ONLY TO DEMONSTRATE THE AMOUNT OF DEMOLITION TO BE
PERFORMED ON THE PROJECT AND ARE NOT TO BE CONSTRUED AS A LIMITATION
OR MAXIMUM ON THE AMOUNTS OF DEMOLITION REQUIRED TO BE PERFORMED BY
CONTRACTOR.
QUANTITIES IDENTIFIED IN CONTRACT ARE ESTIMATED BY THE CITY AND/OR THE
CITY'S CONSUL TANT, AGENT, OR DESIGNEE. THE CONTRACTOR IS RESPONSIBLE
FOR VERIFYING ALL QUANTITIES. CLAIMS FOR ADDITIONAL COMPENSATION DUE TO
VARIATIONS BETWEEN CONDITIONS ACTUALLY ENCOUNTERED IN THE PROJECT
AND AS INDICATED IN THE CONTRACT DOCUMENTS WILL NOT BE ALLOWED.
Item Description
1. 12" x 12" Floor Tile & Associated Mastic
2. Black Mastic on Concrete Floor
3. Sheetrock & Joint Compound,
Wall & Ceiling Texture
4. TSI -Black Tar Wrap
5. Texture on Brick
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABA TEMENT -
GRANBURY HILLS APARTMENTS -DEM 10-08 GHA -INTERCON ENVIRONMENTAL, INC.
Estimated
Quantity*
-23,475 SF
-525 SF
-368,400 SF
-114 SF
-8,734 SF
Page 18 of 26
6. Popcorn Ceiling Spray -On Texture -87,560 SF
7. Mobilization Each
8. Demobilization Each
*Quantities identified in this table are estimated by the City and/or the city's consultant, agent, or designee; the
Contractor is responsible for verifying all quantities. Claims for additional compensation due to variations
between conditions actually encountered in the project and as indicated in the Contract Documents will not be
allowed.
Item Description Estimated
Quantity*
Demo of improvements including clean-up and disposal of
1. single and up to three-level structures, including footers,
beams , piers, and slabs -59,000 SF
2. Removal of concrete and asphalt -patio, parking lot,
interior sidewalks, and grading of site ( perimeter drives,
curbs, and streets will remain) -87,555 SF
4. Removal of misc. items, wood, metal fencing,
playground, misc. debris -1,000 CY
Prepare and implement a Storm Water Pollution Prevention
5. Plan, installing and maintaining all BMPs, establishing
vegetation, and removal of BMPs upon completion. 1
9. Mobilization/demobilization (includes disconnect,
equipment, generators, traffic control, etc.) 1
*Quantities identified in this table are estimated by the City and/or the city's consultant, agent, or designee ;; the
Contractor is responsible for verifying all quantities. Claims for additional compensation due to variations
between conditions actually encountered in the project and as indicated in the Contract Documents will not be
allowed.
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
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Page 19 of 26
PROJECT SPECIFICATIONS
Consultant Specifications
All work shall be performed in accordance with the consultant specification documents
entitled "Specifications for Asbestos Abatement, May 11, 201 O" and those specification
documents are incorporated into the terms of this contract by reference in their entirety.
It is foreseeable that the specifications may be amended by the consultant in response
to site specific information which may be obtained in the future. Any future
modifications of the consultant specifications shall be binding on the contractor.
Site Preparation
Prior to any abatement or demolition activities, the contractor will remove all universal
waste items including light bulbs, mercury-containing devices, paints, pesticides, etc.
These items will be properly packaged and disposed by the contractor. The contractor
will provide documentation (waste manifest, bill of lading, etc.) that the waste was
properly disposed.
Contractor will disconnect all associated air conditioning units and properly evacuate
any remaining refrigerant contained within the units prior to being disconnected.
Utilities will have been terminated to the sites. Prior to demolition, the contractor will be
responsible for verifying that all utilities (i.e. natural gas, telephone, water, etc.) have
been disconnected. Contractor will cut and cap all site utilities at point of connection to
the site.
Contractor will be responsible for contacting applicable utility services in order to decide
whether or not main lines or routes effectively traverse the project site. It will be
determined with the consultation of City staff the best method to address any utility
concerns involving the aforementioned utility service issues.
Site Work
All structures will be abated of all ACM and will 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 demolition of any structure, each structure shall be
inspected to ensure the safety of the crew.
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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 building
owner and/or his designee ; the Contractor is responsible for verifying all quantities.
Claims for additional compensation due to variations between conditions actually
encountered in the project and as indicated in the Contract Documents will not be
allowed. The only exception is if the Contractor can clearly show why the variation was
not identifiable prior to job commencement.
Prior to any site disturbance , the contractor will have implemented the Best
Management Practices (BMPs) detailed in the approved SWPPP. This shall include,
but not be limited to, the use of silt fencing, rock check dams , mulching , erosion control
blankets, curb and inlet protection devices , sediment traps, sediment basins , and/or
stabilized construction entrances and exits.
Demolition activities will include the demolition of all site structures, concrete/asphalt
parking, slabs/foundations , and retaining walls. Streets, drives, and curbs within the
perimeter of the complex will be removed; however streets, drives and curbs
constituting the perimeter will remain. All demolition debris will be removed from the
site and recycled or disposed in a landfill accepting such waste. All foundations will be
removed down to a minimum of 2 feet below grade . If foundations/piers extend beyond
2 feet below grade , they may be severed at that point and left in place.
A filled in swimming pool and hot tub will be decommissioned by removing at least the
top of pool curbing from the surface to at least two feet below ground surface or even
greater in areas where sloping must be performed. Additionally, the base of the former
swimming pool and hot tub, if needed, will be perforated so as not to allow groundwater
to pool. Excavation of the swimming pool may be required to perforate the base.
Contractor shall clean and remove all remaining furniture, household furnishings,
building materials, tires , debris , trash, rubbish and any other solid waste from the
premises. These materials shall be recycled , reclaimed or disposed at a facility or
landfill that is approved to accept such waste.
Contractor shall maintain proper safety fencing, as needed, and also provide for
adequate signage , barricades, traffic cones, and "flagmen" during the course of the
project when heavy traffic will be leaving or entering the site .
Associated fencing existing entirely on the project site that does not exist as a single
barrier between the project site and the neighboring properties will be removed and
properly disposed of.
Demolition activities will be performed in accordance with Federal, State and local
visible emission requirements (i.e . no visible emissions will leave the demolition area).
Water is available in the vicinity of the construction area. The Contractor is responsible
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
GRANBURY HILLS APARTMENTS -DEM 10-08 GHA -INTERCON ENVIRONMENTAL, INC.
Page 2 1 of 26
for obtaining a City of Fort Worth -Water Department water meter if usage of water
from nearby fire hydrants is anticipated.
The work area will be maintained in a manner that will control all demolition debris from
becoming windblown and/or migrating from the work area during and after working
hours.
The contractor shall use site material, if available, or clean fill from an approved source
to fill any holes in the terrain resulting from any of the above work, and grade the entire
lot, ensuring that low areas are filled to prevent the pooling of water.
For the duration of the entire project, contractor shall sweep dirt and debris from the
haul routes used to ensure any sediment tracked from the site is collected and does not
migrate onto City streets .
A specific grass type indigenous to the area will be selected and agreed to depending
upon the time of year when the planting will occur. The soil will be analyzed by the
contractor in order to determine current nitrogen , phosphoric acid , and potash contents
in order to determine the concentration and fertilization rate that should be applied to
maximize growth . Soil samples and analytical results must be provided to the City for
the determination of addition of soil amendments will be necessary. This must be done
prior to the dissemination of the applicable indigenous grass seed. The seeded area
will be watered by the contractor, as needed, to allow proper establishment of
vegetation.
The Contractor will maintain the BMPs and the vegetative area for at least six months,
or until a uniform vegetative cover with a minimum of 70 percent coverage has been
established and has been accepted by the City for maintenance by others , whichever is
earlier.
Once sufficient vegetation has been established, all BMPs will be removed by the
contractor and the project will be closed out.
Project Coordination
Contractor will be responsible for coordinating with the Environmental Management
Department, within five (5) days after receipt of notice to proceed, the start date for
asbestos abatement, to allow for notification to the Texas Department of State Health
Services (DSHS). The City of Fort Worth will prepare and submit the DSHS notification
and pay all DSHS notification fees.
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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 the
apartment complex located at 5250 Wonder Drive.
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 required 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 interfere with construction is permissible while still retaining 50% of
existing canopy. A copy of the ordinance has been included in section 3.4. 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" for this project. This will include the performance of a
tree survey identifying the current canopy cover on site. This will allow the removal of
up to 50 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 prog ress. 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
designated to be removed and for following the requirements of the ordinance during
the performance of this project.
Prior to site mobilization , the contractor must prepare and submit a Storm Water
Pollution Prevention Plan (SWPPP) in accordance with the requirements detailed in the
TPDES General Permit No. TXR150000 and received approval from the City . In
addition, the contractor must also submit a Notice of Intent (NOi) to the Texas
Commission on Environmental Quality (TCEQ) for storm water discharges associated
with construction activities. The contractor must maintain this plan until sufficient
vegetation has been established. The contractor must also post the SWPPP in such a
manner so that the information can readily be obtained by the general public .
The remainder of this page is left blank intentionally.
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
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ATIACHMENT 8.
COMPENSATION SCHEDULE
THIS IS A FIXED-PRICE CONTRACT.
ALL QUANTITIES HEREIN OTHER THAN THE GRAND TOTAL PRICE (NOT-TO-EXCEED
AMOUNT} ARE FOR ILLUSTRATIVE PURPOSES ONLY TO DEMONSTRATE THE
POTENTIAL AMOUNTS AND TYPES OF ACM LIKELY TO ENCOUNTERED ON THE
PROJECT AND ARE NOT TO BE CONSTRUED AS A LIMITATION OR MAXIMUM ON THE
AMOUNTS OF ACM TO BE ABATED, REMOVED, TRANSPORTED, OR LAWFULLY
DISPOSED OF BY THE CONTRACTOR FOR THE FIXED PRICE AS AGREED HEREIN.
IN ADDITION THE ESTIMATES OF DEMOLITION QUANTITIES ARE FOR ILLUSTRATIVE
PURPOSES ONLY TO DEMONSTRATE THE AMOUNT OF DEMOLITION TO BE
PERFORMED ON THE PROJECT AND ARE NOT TO BE CONSTRUED AS A LIMITATION
OR MAXIMUM ON THE AMOUNTS OF DEMOLITION REQUIRED TO BE PERFORMED BY
CONTRACTOR.
QUANTITIES IDENTIFIED IN CONTRACT ARE ESTIMATED BY THE CITY AND/OR THE
CITY'S CONSULTANT, AGENT, OR DESIGNEE. THE CONTRACTOR IS RESPONSIBLE
FOR VERIFYING ALL QUANTITIES. CLAIMS FOR ADDITIONAL COMPENSATION DUE TO
VARIATIONS BETWEEN CONDITIONS ACTUALLY ENCOUNTERED IN THE PROJECT
AND AS INDICATED IN THE CONTRACT DOCUMENTS WILL NOT BE ALLOWED.
A. In consideration for the work performed by Contractor under this Contract,
City shall pay Contractor a grand total price (a sum not to exceed) of five
hundred ninety eight thousand, seventy six dollars and eighty five cents
($598,076.85) for the completion of all work specified in this contract.
8. 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 signed by the City Manager or an Assistant City
Manager of the City of Fort Worth. It is expressly agreed between the parties
that there shall be no oral modifications to this contract.
C. 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 five
hundred ninety eight thousand, seventy six dollars ($598,076.85) shall be the
whole of compensation for all of the services specified in this contract. In the
event of a discrepancy between any unit price and the contract grand total or
not-to-exceed price, the grand total or not-to-exceed price shall prevail. In no
event will compensation be greater than the not-to-exceed amount described
herein.
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
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Page 24 of 26
D. 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 responsible for verifying all quantities upon which the
Contractor's bid was based. The Contractor was to rely exclusively upon its
own estimates, investigation, research, tests, and other data necessary to
supply the full and complete information upon which the Contractor's bid was
based. It is mutually agreed that submission of a bid is prima-facie evidence
that the Contractor has made all of the investigations, examinations, and tests
required to make a fully informed offer.
E. By executing this contract, the Contractor affirms and agrees that the
Contractor has had the opportunity and duty to confirm all quantities prior to
submitting a bid, and Contractor expressly waives any and all right to
additional compensation 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.
F. 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
conditions actually encountered in this project and conditions as indicated in
the Contract Documents will not be allowed. Any claims for additional
compensation proposed by Contractor will be examined by the City in
consideration of the terms described herein and the Contractors request for
additional compensation must clearly show why the variation was not
identifiable prior to the Contractor submitting its bid. As used in this contract,
"not identifiable" means that the Contractor a) performed all investigation,
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. The final
determination as to additional compensation will be made at the sole
judgment and discretion of the City.
The remainder of this page is left blank intentionally.
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -
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Page 25 of 26
SIGNATURE PAGE FOR
CONTRACT FOR STRUCTURAL DEMOLITION
AND REMOVAL, TRANSPORTATION, AND DISPOSAL OF
ASBESTOS CONTAMINATED MATERIALS
GRANBURY HILLS APARTMENTS
DEM PROJECT: DEM 10-08: GHA
IN WITNESS THEREOF, the parties have executed this contract in triplicate in Fort
Worth, Texas, on the dates written below.
CITY OF FORT WORTH
BY:5-~a__
Fernando Costa
Assistant City Manager
APPROVED AS TO FORM
AND LEGALITY:
~/IL,/}~
Arthur N. Bashor
Assistant City Attorney
Marty Hendrix
City Secretary
CONTRACTOR
lntercon Environmental, Inc.
BY:~~
Karen Andrews
President
CORPORATE SEAL:
CONTRACT FOR STRUCTURAL DEMOLITION AND ASBESTOS ABATEMENT -Page 26of 26 0 :A B · 'ti' HI ~ -DEM 10-08 GHA -INTERCON ENVIRONMENTAL, INC.
CITY SECRETARY
FORT WORTH, TX
Industrial Hygiene and
Safety Technology, Inc.
2235 Keller Way
Carrollton, TX 75006
Phone: (972) 4 78-7 415
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:
Granbury Hills Apartments
5250 Wonder Drive
Fort Worth, Texas
DATE: May 11, 2010
Specifications Prepared by:
)(~I( ~/;tr'
Tracy K. Bramlett, CIH, CSP
TDSHS LICENSE #10-5040
Expiration: 12/31/09
Prepared by:
Industrial Hygiene & Safety Technology, Inc.
2235 l!(eller Way
Carrollton, Texas 75006
972-478-7415
OFFICIAL RECORD
CITY SECRETARY
FORT WORTH, TX
TABLE OF CONTENTS
Asbestos Abatement Specifications
Granbury Hills Apartments
5250 Wonder Drive
Fort Worth, Texas
1.1 . SUMMARY OF THE 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: .................................................................................................. 3
1.2. DIFFERING SITE CON DITIONS: ...................................................................................................................... .4
1.3. STOP AS BESTOS REMOVAL : .......................................................................................................................... .4
1.4 . CODES AND REG ULAT IONS : .......................................................................................................................... .4
1.4.1. GENERAL APPLICABILITY OF CODES, REGULATIONS AND STANDARDS : ............................ .4
1.4.2. CONTRACTOR RESPONSIBILITY: ....................................................................................................... .4
1.4.3 . STATE REQUIREMENTS : ........................................................................................................................ 5
1 .4 .4. LOCAL REQUIREMENTS: ........................................................................................................................ 5
1 .4 .5 . NOTICES : .................................................................................................................................................... 5
1 .4 .6 . PERMITS: .................................................................................................................................................... 6
1.4.8. POSTING AND FILING OF REGULATIONS : ........................................................................................ 6
1.5 . PROJECT COORDINATION: .............................................................................................................................. 6
1 .5 .1. PERSONNEL: ............................................................................................................................................. 6
1.6 . RESPIRATORY PROTECTION: ......................................................................................................................... 6
1 .6 .1 . GENERAL : ................................................................................................................................................... 6
1 .6 .2 . RESPIRATORS FOR ABATEMENT OPERATIONS: ........................................................................... 6
1.7. WORKER PROTECTION : ................................................................................................................................... 7
1 .7 .1. TRAINING PRIOR TO ENGAGING IN ABATEMENT WORK: ............................................................ 7
1.7.2 . MEDICAL EXAMINATIONS: ..................................................................................................................... ?
1.7.3. PROTECTIVE CLOTHING : ....................................................................................................................... ?
1 .7.4. ENTERING AND EXITING PROCEDURES: .......................................................................................... ?
1.7.5 . DECONTAMINATION PROCEDURES : .................................................................................................. 8
1.7.6. LIMITATIONS WITHIN WORK AREA : .................................................................................................... 9
1.8. DECONTAMINATION FACILITIES: ................................................................................................................. 9
1 .8 .1 . DESCRIPTION: ........................................................................................................................................... 9
1 .8 .2 . GENERAL REQUIREMENTS : .................................................................................................................. 9
1.8.3. TEMPORARY UTILITIES TO PDF AND EDF: ....................................................................................... 9
1 .8.4. DECONTAMINATION FACILITIES (DF): .............................................................................................. 10
1.9 . NEGATIVE PRESSURE FILTRATION SYSTEMS: ........................................................................................ 10
1.9.2. PRESSURE DIFFERENTIAL: ................................................................................................................. 10
1.9.3. MONITORING: .......................................................................................................................................... 10
1.9.4. TESTING THE SYSTEM : ........................................................................................................................ 10
1 .9 .5 . DEMONSTRATION OF NEGATIVE AIR SYSTEM OPERATION : ................................................... 10
1 .9 .6. USE OF SYSTEM DURING ABATEMENT OPERATIONS : .............................................................. 11
1 .9 .7. DISMANTLING THE SYSTEM: .............................................................................................................. 11
1.10 . CONTAINMENT BARRIERS AN D COVERINGS OF WORK AREA: ........................................................ 11
1 .10.1. GENERAL: ............................................................................................................................................... 11
1 .10 .2. PREPARATION PRIOR TO SEALING OFF: ..................................................................................... 11
1 .10.3. CONTROL ACCESS TO WORK AREA: ............................................................................................. 12
1 .10.4 . CRITICAL BARRIERS : .......................................................................................................................... 12
1 .1 0 .5 . PRIMARY BARRIERS: .......................................................................................................................... 12
1 .10.6. EXTENSION OF WORK AREA: ........................................................................................................... 12
1.10.7 . SECONDARY BARRIERS : ................................................................................................................... 13
1.11. MONITORING , INSPECTION AND TESTING : ............................................................................................ 13
1.11 .1. GENERAL: ............................................................................................................................................... 13
1.11 .2. OUTLINE SCOPE OF SERVICES OF THE OWNER'S CONSULTANT: ...................................... 13
1.11.3. MONITORING, INSPECTION AND TESTING BY ABATEMENT CONTRACTOR: ..................... 14
1.11 .4 . ANALYSIS : .............................................................................................................................................. 15
2.1. PREABATEMENT ACTIVITIES: ..................................................................................................................... 15
2 .1.1. PREABATEMENT MEETING : ................................................................................................................ 15
2.1 .2 . PREABATEMENT INSPECTION AND PREPARATIONS : ................................................................ 15
2.1 .3. PREABATEMENT CONSTRUCTION AND OPERATIONS : .............................................................. 16
2.2. REMOVAL OF ACM AN D ACE: ...................................................................................................................... 16
2 .2 .1 . WETTING MATERIALS : .......................................................................................................................... 16
2.2.2. SITE PREPARATION : ............................................................................................................................. 17
2.2 .3. PERSONAL PROTECTION: ................................................................................................................... 17
2 .2.4. THERMAL SYSTEM INSULATION : ...................................................................................................... 17
2 .2.6 WALL AND CEILING TEXTURE ............................................................................................................. 21
2.3. DISPOSAL OF ACM AND ACE WASTE MATERIAL: .................................................................................. 22
2 .3.1. GENERAL: ................................................................................................................................................. 22
2 .3 .2 . PROCEDURES : ........................................................................................................................................ 22
2.4 . PROJECT DECONTAMINATION : ................................................................................................................... 23
2 .4.1. GENERAL : ................................................................................................................................................. 23
2 .4.2 . WORK AREA CLEARANCE: .................................................................................................................. 23
2 .4 .3. WORK DESCRIPTION : ........................................................................................................................... 23
2.4.4. PRE-DECONTAMINATION CONDITIONS: ......................................................................................... 23
2 .4.5. FIRST CLEANING : ................................................................................................................................... 23
2 .4.6 . SECOND CLEANING : ............................................................................................................................. 24
2.4.7. PRE-CLEARANCE INSPECTION AND TESTING: ............................................................................. 24
2 .4.8. LOCK-BACK ENCAPSULATION: .......................................................................................................... 24
2 .5 . FINAL AIR CLEARANCE TESTING ............................................................................................................... 24
2 .5.1. GENERAL: ................................................................................................................................................. 24
2.5 .2 . FINAL TESTING: ...................................................................................................................................... 24
2 .5.3 . FINAL TESTING PROCEDURES: ......................................................................................................... 25
2 .5.4 . SCHEDULE OF AIR SAMPLES WITH PCM: ....................................................................................... 25
2 .5.5. LABORATORY TESTING FOR PCM: ................................................................................................... 25
2 .5.7. FINAL AIR TESTING REQUIREMENTS : ............................................................................................. 26
2.6 . ABATEMENT CLOSEOUT AND CERTIFICATE OF COMPLIANCE: ......................................................... 26
2.6 .1. COMPLETION OF ABATEMENT WORK: ............................................................................................ 26
2 .6.2. CERTIFICATE OF COMPLETION BY CONTRACTORS: .................................................................. 27
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 partial owner occupancy during work, coordination 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) utilizing 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.
Granbury Hills Apartments
Floor tile and mastic All units and clubhouse 23,475 SF
Sheetrock joint com-All units, laundry room , 368,400 SF
pound on walls and clubhouse , mechanical
ceilings room, and maintenance
shop
Black tar wrap on valve All units 114 each
Texture on brick See narrative below 8 ,734 SF*
* Contractor is responsible to verify which units have texture on brick walls . Contractor will be required to
remove all texture on brick walls in the apartment complex . It is estimated that no more than 8,734 SF of
texture is on the brick walls.
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IHST Project #18620 Page 1
ASBESTOS REMOVAL
Th f II e o owmq ta bl d 'I th t f e eta, s e types o apa rt ments an d b tth G b A rt num er a e ran ury ,pa t mens:
Type of Apartment Number of Units
A-1 12 units
A-2 8 units
A-3 32 units
8-1 10 units
8-2 12 units
8-3 24 units
8-4 12 units
C-1 4 units
The Work Area will be inclusive of the locations and the quantities noted above, in the attached
drawings, and as directed 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
additional time to perform the work on the basis of having multiple Work Areas and associated
Cleaning Sequences .
The Contractor will be responsible for the removal and disposal 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 Emission Standards for Hazardous Air Pollut-
ants (NESHAP) Regulations 40 CFR Part 61.
The CONTRACTOR shall be responsible for verifying existing site conditions and determining
the quantity of ACM delineated for removal prior to abatement described in these specifications
and associated drawings .
1.1.3. TASKS:
The work, located at the facility, 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 specifications and procedures as out-
lined.
Power and Water Connections: The Contractor on this project will be required to furnish
power generators for electricity or to get power from the utility company. The Contractor will
also be required to furnish water for the project.
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IHST Project #18620 Page 2
ASBESTOS REMOVAL
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 containers. The Contractor will conduct a wet
decontamination of equipment and tools before final clearance sampling in the work area .
The Contractor will use the existing interior walls and ceilings in the buildings to provide struc-
tural support for an asbestos containment work area provided the containment remains sound
and is not in danger of collapse . The Contractor should make every effort not to damage the in-
terior walls of the building during the project.
The Contractor will establish critical barriers over all openings into the work area. ACM debris
should be adequately wetted prior 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.
Respiratory 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.
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IHST Project #18620 Page 3
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 constra ints 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 with in 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 , v isitors 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 #18620 Page4
ASBESTOS REMOVAL
local regulations . Contractor will hold the Owner and Consultants harmless for failure to comply
with any appl icable work, hauling , disposal , safety , health or other on the part of himself, his
employees , or his subcontractors. Contractor incurs all costs to comply with OSHA regulations.
The Abatement Contractor will determine the applicability of any process patents he/she may be
employing and be responsible 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 with all applicable local requirements regarding asbes-
tos abatement activities.
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 Civil 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 notifications must be comp letely 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 State Health Services and other notifications will be submit-
ted to the Owner for the facility 's records in the same time frame 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 agenc ies in accordance with the Texas Department of State Health Services
(Texas Civil Statutes, Article 4477-3a , Section 12) asbestos regulations.
IHST Project #18620 Page 5
ASBESTOS REMOVAL
1.4.6. PERMITS:
The Contractor will be responsible for any permits.
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 appl icable 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 .1 34 and 29 CFR 1926.1101, EPA regulations 40 CFR 763.120 ,
121 , ANSI standards 288.2-1980 , 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-
IHST Project #18620 Page 6
ASBESTOS REMOVAL
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
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 respiratory 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 protection may be used.
1.7. WORKER PROTECTION:
1. 7.1. TRAINING PRIOR TO ENGAGING IN ABATEMENT WORK:
Train workers in accordance with OSHA 29 CFR 1926 .1101 and the Texas Asbestos Health
Protection Rules and this section . Workers 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 , decontamina-
tion procedures, emergency procedures and waste transportation and disposal ; review OSHA
29 CFR 1910 .134 for respirators ; medical surveillance program ; review OSHA 29 CFR
1926.1101 , and for air monitoring , personnel and area; review this section of the project specifi-
cations.
1.7.2. MEDICAL EXAMINATIONS:
Provide medical examinations 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.
IHST Project #18620 Page 7
ASBESTOS REMOVAL
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:
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 require-
ment whenever leaving the work area with a full face cartridge type respirator:
1. When exiting 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
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 without wetting the respirator filter if using an air
purifying type respirator.
IHST Project #18620 Page 8
ASBESTOS REMOVAL
b. Take a deep breath, hold it and/or exhale slowly , complete wetting of hair, thoroughly
wetting face, respirator and filter (air purifying respirator). While 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.
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 lighting to reach 50 foot candles throughout PDF and EDF.
IHST Project #18620 Page 9
ASBESTOS REMOVAL
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 OF to accommodate the number of employees scheduled for
the project. The center chamber of the three chamber OF 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 OF of opaque or colored polyethyl-
ene for privacy . Construct OF 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 differential 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:
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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-
tion of the work area is complete. Do not turn off units at the end of the work shift or when
abatement operations temporarily stop.
Do not shut down negative air system during abatement operations procedures, unless author-
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 units are operating again.
At completion of abatement work, allow exhaust units to run as specified under this section, to
remove airborne fibers that may have been generated during abatement work and cleanup and
to purge the work area with clean makeup air. 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-mil
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 contamination created by abatement work. Cover all surfaces of the work area
to protect them from cross contamination, to facilitate more efficient cleanup, and to protect the
finishes from the asbestos abatement work. Should the area beyond the seal off limits 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 erection 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 restarting of equipment, i.e., disconnecting wires, removing circuit breakers,
lockable switch, etc.
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1.10.3. CONTROL ACCESS TO WORK AREA:
Permit access to the work area only through the OF . 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 barrier 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 to the work area is accessible to the
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 . Visib le 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 th is 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.
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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.
1.11. MONITORING, INSPECTION AND TESTING:
1.11.1. GENERAL:
Perform throughout abatement work monitoring, inspection and testing inside the work area in
accordance with 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 paid 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.
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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 work 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
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 final 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
P.A.T. 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.
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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 samples.
Air samples will be analyzed by an individual participating in the American Industrial Hygiene
Association's (AIHA) Proficiency Analytical Testing Program .
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. SUBMITTALS 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. PREABATEMENT 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-
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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 t hreat to life in a work area where
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 CONSTRUCT/ON 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 w ith 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 Specifica t ions. The Owner's Representa-
t ive 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 Contra ctor 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 regulations .
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 .
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2.2.2. SITE PREPARATION:
Erect critical barriers at all doors and windows entering the regulated areas. This project will be
conducted by establishing critical 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 maintain a pressure differential of
-0.02 inches of water column pressure differential.
2.2.3. PERSONAL PROTECTION:
One (1) layer of disposable clothing air-purifying respirators (PAPR) with 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.
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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.
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 twisted 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.
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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 .
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 fac ility 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 foo t 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" d imension, 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.
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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
scraper as it is moved under the tile until the tile released from the floor. Again, dispose of the
tile, and succeeding tiles, by placing in the heavy-duty bag or closed container without additional
breaking.
Some tiles will release quite easily while others require 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 biodegradable 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.
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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.
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 third worker collects and contains 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.
Establish 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.
IHST Project #18620 Page 21
ASBESTOS REMOVAL
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.
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 in 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
IHST Project #18620 Page 22
ASBESTOS REMOVAL
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.
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-DECONTAMINATION 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.
IHST Project #18620 Page 23
ASBESTOS REMOVAL
2.4.6. SECOND CLEANING:
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 inside 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 Specifica t ion. 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 #18620 Page 24
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.
Each Work Area
Outside Each Work
Outside Entrance to De-
ntamination Facil it
Outside Bag-out Area
Output Negative
Press ure S stem
DAILY SCHEDULE OF AIR SAMPLES .
3 PCM 0 .02 2-15
2-3 PCM 0 .01 1,000 2-15
PCM 0 .01 1,000 2-15
PCM 0 .01 1,000 2-15
PCM 0 .01 1,000 2-15
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 #18620 Page 25
ASBESTOS REMOVAL
testing laboratory, of all a ir 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 PAT. 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 l'I:< Analysis Analytical Sensi-Recommended Rate
Sampled Samples ,Method tivify ·~ ··volume LPM
'~ s/mrrf . {L iters)
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 section .
IHST Project #18620 Page 26
ASBESTOS REMOVAL
2.6.2. CERT/FICA TE 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 #18620 Page 27
Appendix A
Attachments
CERT/FICA TE OF COMPLETION
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 maintaining
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
Kite n
Living Room Bedroom
Note: Sheetrock ceilings and 1..va!!s a!! co!"lt~in Ar.M
00 Sample Location
~ Floor Tile with black mastic
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth , Texas
Asbestos Inspection
Project# 18620 Drawing #1
Not To Scale
Drawn by: AHG Date : 03/15/10
Lie : 10-5040 Exp : 12/31/2011
A-2 Apt 73
1111
OCCUPATIONAL HEAL TH
CONSULT ANTS
2235 Keller Way
Carrollton , Texas 75006
.,..r-, ,,.....,.,..\ .. ..,.n ..,.,. .. r:
I ~L \ .::7 I ~) "t Io-I .... 1 '-'
FAX (972) 478-7615
11 12 1
Dining Room
Be Bedroom
Living Room
1
Note: Sheetrock ceilings and walls all contain ACM
00 Sample Location
~ Floor Tile with black mastic
---· Texture on Brick
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth , Texas
Asbestos Inspection
Project# 18620 Drawin #2
Not To Scale
Drawn by : AHG Date : 03/15/10
Lie : 10-5040 Exp : 12/31/2011
A-3 Apt 1 and 3
1111
OCCUPATIONAL HEAL TH
CONSULTANTS
223 5 Kell er Way
Carroll ton , Texas 75006
TEL (972) 478-7415
FAX (972) 478-7615
Apt 97 Apt 105
Bedroom
Living Room Living Room
!'Jote: Sheetrock cei!!ngs and wa!!s a!! contain ACM
00 Sample Location
V/77J 12x12 Floor Tile with ~ black mastic
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth , Texas
Asbestos Inspection
Pro·ect # 18620 Drawin #3
NotTo Scale
Drawn by: AHG Date: 03/15/1 O
Lie : 10-5040 Exp: 12/31/2011
A-1 Apt 105 and 9
1111
OCCUPATIONAL HEAL TH
CONSULTANTS
2235 Keller Way
Carrollton , Texas 75006
TCI (07'l \ A7Q 7,11i::;
I ._L.. \"' r &../ ""T, v *• "'T ,""'
FAX (972) 478-7615
Bedroom Living Room
en ,....
Q) .,
CJ) en ,....
Dining
Q) .,
CJ)
Bedroom
Note: Sheetrock ceilings and walls all contain ACM
~ Floor Tile with
~ black mastic
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth, Texas
Asbestos Inspection
B-4 Apt 110
1111
Pro·ect # 18620 Drawin #4 OCCUPATIONAL HEALTH
t-N-ot.;;T.;;.o;..;S_ca.;.;le;.;.;;.;._~;.:;.:.:.::.:.;i.::.;;.. __ -J I CONSULT ANTS
2235 Keller Way
Drawn by: AHG Date: 03/15/1 O Carrollton , Texas 75006
Lie : 10-5040 Exp: 12/31/2011
TEL (972) 478-7415
FAX (972) 478-7615
Bedroom Bedroom Bedroom
Dining Dining
Living Living
Note: Sheetrock ceilings and 'Na!!s a!! conta,n .A.CM
00 Sample Location
~ Floor Tile with
~ black mastic
---· Texture on brick wall
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth , Texas
Asbestos Inspection
B-1 Apt 67
1111
Project# 18620 Drawin #5 OCCUPATIONAL HEALTH
t-No_.t_T_o -Sc-a-le.;......-+~=.;i.;;.;;;..._ __ -1 I CONSULTANTS
2235 Keller Way
Drawn by : AHG Date : 03/15/10 Carrollton , Texas 75006
Lie : 10-5040 Exp : 12/31/2011
Tr-I l f"\"7r,\ A"7 0 "7A AC:
1 1::L\OIL/-..tO-t~l,J
FAX (972) 478-7615
Bedroom Bedroom
Dining
Bedroom
Living
Note: Sheetrock ceilings and walls all contain ACM
00 Sample Location
~ Floor Tile with
~ black mastic
---· Texture on brick wall
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth, Texas
Asbestos Inspection
C-1 Apt 51
1111
t-Pr_o""·e..;.ct..;.#_1;,,;;;8.;.;62;;.;;0-t-=D;,;.:ra;,.:;w:.::,in..::.#6.:::...... ___ U OCCUPATIONAL HEAL TH
Not To Scale CONSULTANTS
22 35 Keller Way
Drawn by : AHG Date : 03/15/10 Carrollton , Te xas 75006
Lie: 10-5040 Exp: 12/31/2011
TEL (972) 478-7415
FAX (972) 478-7615
Laundry Mech Room
Maintenance Shop
!'Jote: Sheetrock ce!!!ngs and w~11~ ~11 f'nnt~in Ar.M
00 Sample Location
Maintenance Sho
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth , Texas
Asbestos Inspection
Project# 18620 Drawin #7
Not To Scale
Drawn by : AHG Date : 03/15/10
Lie: 10-5040 Exp: 12/31/2011
1111
OCCUPATIONAL HEAL TH
CONSULTANTS
2235 Keller Way
Carrollton , Texas 75006
I CL \ ~ / L.} 't I 0-1 't I;:,
FAX (972) 478-7615
Laundrv under club house
I
I
Note: Sheetrock ceilings and walls all contain ACM
00 Sample Location
~ Floor Tile with
~ black mastic
---· Texture on brick wall
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth , Texas
Asbestos Inspection
Club House
1111
Project# 18620 Drawin #8 OCCUPATIONAL HEALTH
t-N-ot._T_o_S-ca-le....;;.;......,i1-=,;;,,;,,;,;,;,,;,;i.;::.::;_ __ --I I CONSULTANTS
2235 Keller Way
Drawn by : AHG Date: 03/15/10 Carrollton, Texas 75006
Lie: 10-5040 Exp: 12/31 /2011
TEL (972) 478-7415
FAX (972) 478-7615
Bedroom
Bedroom
Dining
Living
Note: Sheeirock ceiiings and walis aii contain ACM
00 Sample Location
~ Floor Tile with
~ black mastic
A t 57 B-3 Downstairs
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth , Texas
Asbestos Inspection
Pro ·ect # 18620 Drawin #9
Not To Scale
Drawn by: AHG Date: 03/15/10
Lie : 10-5040 Exp: 12/31/2011
1111
OCCUPATIONAL HEAL TH
CONSULTANTS
2235 Keller Way
Carrollton , Texas 75006
TEL (972) 478-7415
FAX (972) 478-7615
Bedroom
Bedroom
Dining
Living
Note: Sheetrock ceilings and walls all contain ACM
00 Sample Location
~ Floor Tile with
uLa black mastic
A t 60 B-3 U stairs
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth , Texas
Asbestos Inspection
Pro ·ect # 18620 Drawin #10
Not To Scale
Drawn by: AHG Date : 03/15/10
Lie : 1 0-5040 Exp: 12/31/2011
1111
OCCUPATIONAL HEAL TH
CONSULTANTS
2235 Keller Way
Carrollton , Texas 75006
TEL (972) 478-7415
FAX(972)478-7615
00 Sample Location
v777:l Floor Tile with
~ black mastic
A t 85 B-2 U stairs
Granbury Hills Apts -City of Fort Worth
5250 Wonder Drive
Fort Worth, Texas
Asbestos Inspection 1111
Project# 18620 Drawin #11 OCCUPATIONAL HEAL TH
t-N-ot.._T_o.;,,,S.;,,,c.;,,,a,,,;;,le=;.....i~;,,:;,,;,,;,;,;,,;,,!,,,;;,,,,;..;_ ___ u CONSULTANTS
2235 Keller Way
Drawn by: AHG Date: 03/15/10 Carrollton , Texas 75006
I C:L \ ::11 £) '+I 0-1 'f I:::,
Lie : 10-5040 Exp: 12/31/2011 FAX (972) 478-7615
INSURANCE
AND
BONDS
_
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' compensation insurance coverage for all of its employees employed on
City of Environmental Management Department , Project DEM 10-08: Structural Demolit ion
and Removal , Transportation , and Disposal of Asbestos Contaminated Materials .
CONTRACTOR
INTERCON ENVIRONMENTAL, INC.
By : _..,..~~-=~~--=-.;;_JJ¥=-----
Karen Andrews
Title President
Date Se p temb er 21 , 2010
STA TE OF TEXAS
COUNTY OF TARRANT
§
§
§
Before me , the undersigned authority , on this day personally appeared
Karen An d r ews , known to me to be the person whose name is subscribed to the
foregoing instrument , and acknowledged to me that he executed the same as the act and
deed of President for the purposes and
consideration therein expressed and in the capacity there in stated .
Given Under My Hand and Seal of Office this2ls t day of September , 2010.
/
~NGELICA PETRUZZELLI
Notary Public, State of Texas
My Commission Expires
~bruary 28, 2012
09/16/2018 11:28 8174779996 INTERCON ENVIRO PAGE 05/06
SU 110 8136 B
TIIB STATE OF TEXAS
COUNTY OF TARRANT
PERFORMANCE BOND
KNOW AJ.,L MEN BY THESE PRESENTS: That we (1) I11ttrcon Envlro:nmentA l,
l~., a (2) corponition of T ~xas herein.after caJled Principed and ARCH INSURANCE CQMPANY
a corporation organized and ~x.istit'li, under the laws of the State and fully authorli.ed to transact
. busioess in the State ~Texas, as Surety, are held and firmly bound unto the City of Port WOffl'l, a
municipal corpontion organized and ex.isting under the laws of the Stat e of Texas he~inafter
90/t:>0 39\;;l d
cal led Owner, in the p:!!nal sum of
Five hundred nin6fy•eight thous111Jd and ~venty•stt dollars 1md 85/1.00's ($598,076.85)
rn lawful money of the Uni~ States, to be paid in Fo rt Worth, Tarrant County, Texas, for the
payment of which su m well attd truly be made, we hereby bind ourselves, our h eirs, e1'ecutors,
admlnletratot'i, and sucoossors, jointly and severally, firmly by t beae ~rtts. ·
THE CONOIDON OF THIS OB~IGA TION i& such that Whereas, the Principal eatered
into a oort.a,n eomraet with the Clty of:Fort Worth, the Owner, dated th.e _day of , 2010,
a eopy otwhlch !s herem attached and made a part hereof, for the conmuction of:
Stroi:tural Demolition and
litcmm<2l, T1ransporta.tim,, :and Dhipo$$-1 of' .i\$bestos Contaminated ~1aterl11l:s
designated as Proj~ct Number DEM 1.0-0Si GB.A, a copy of whieh eontraet is hereto attac hed,
refemd to, and ma.de a pa.rt hereof as nilly and to the same extent as if copies at length herein ,
such project and construction being he:rclnafter .ret'erred to as the ''work".
NOW THERE'F'ORE, If~ I>rtncJpal sITTll l well, truly and faithfully perlom, tM work in
accord:wc:e with the plans, ipeoifioatfon, !U'td eon~t doeument during the origim.l tenn thereof,
ll.nd ruiy extension$ themof which may be granted by the Owner, with or without notice to th e
Su~, and if he shall satisfy all c laims and dcimmds in<.urred under such c<:mtraot, ~nd sludl fl.llly
indemnify and save harmless the Owner from all costs and damages wh!ch i t may suffer by
reason of failure to do so, and shall r~imburse and repay the owner all outla.y and expense which
thci ~ may in cur m m:a.k it1 1;; good any defeu[t, then thi!! obligtlti¢m ohci11 be void; o1hcr.vise to
remain in full force and effect. ·
PROVIDED Fl..iRTHBR,. thA:t if any !&gal /i\Otion be filed YJ)On this bond, venue sh all lie
lit Tarrant County, State ofTexas_
AND PROVIDED FURTHER. that the said Surety. for value roc.c ived, herehy !rtirml::tte.,;
and agrees that no choiillge, extension of time, alteration or ad dit io n to the terms of the contract or
to the work to be performed thereunder or the specifications accompanying tlle same shall in any
wise affect its ob li gatio n on this bond. and it does hereby waive notice of at1:Y such change,
extension of t!mc a lteration or addition to th~ tem,s of the contract or to 'tile work or to the
specifications .
09/16/2010 11:28 IMTERCON ENVIRO PAGE 05/06
90/90 39\:ld
IN WITNES S WHEREOF. this inst'ri.unent is t;'(ecuJ:ecl in. .3 Counterparts each one of
which :,h a.II ~ deemed 1m original, this the l §TI{jay of SEPTEMBER · 20,0. ·
.Intt)"tOn Environmental, Inc..
Principal (4) .
By:k~ A~
(Principal) Secrewy
3100 BROADWAY
(Address)
(Printed Name/fitle)
210 South Wa!nutAvenus;
ADD.RESS
M;m;rf}eld. TX 76063
CITY /ST A TBJZn>
ARCH INSURANCE COMPAN Y
(Surety)
KANSAS CITY , MO 64111
By:
Note: Date of'Bu11u ,nu,;111v1.b .. prior lO dav: ufCOntrllO!
(}) Corre:ct nante QfConooctor
(Z) A Corportst./Q/1," Pattncihip or and lndivfdi.lDI, as (Y::Si! mQJI bt
(3) C(>lffd .~ of Siuw1y
(4) lfC_,.,,,,_ i., p<ll"f,tctshlp all ArHnsn, :,ltr:n,/d.,;z,,",P.t; /;QII((
(S) A tr<1t1 ~ ~/ /'ewer of Aiwr,iey INlfl l,11. Oft~;//() l,"'11i by I. /:'1r1tey•llt"F~1
A::)N391;;1 11 'itAM LTZH5C.:9£5
09/15/2010 11:29 8174779996
SU 110 8136 B
THE STATE OF TEXAS
COUNTY OF TARRANT
INTERCON ENVIRO PAGE 03/135
PAYMENTB~
KNOW ALL MEN BY TH.ESE PRESENTS; That we, lnte~ou EIJVironm2n•al, Inc., hereinafter called
Principal and ARCH INSURANCE COMPANY · a <:orporation organized and existing
·under the laws of the State and fu lly authorized to transact business in the State ofTe,ws. as Surety, are
held .md finnly bound unto the C ity of Fort Worth, a munfoipe.l corporation otgani:Ged and existing under
tnf laws ofth~ ~ta.te of Texas hereinaft.crca.ll cd Owner , !n ti\c pe,,al SU!'1 of:
. .
Fi'1e hu1tdred ninety-eight thouand and seventy-six dollars 1!,Dd 85/lOO's ($~8,076.SS}
dollars In lawful money of the United States, to be paid in Fort Worth, Tarrant County, Texas, for the
payment of wh ich sum well and truly be made, we hereby bind ourselves, our he ir9, execut ors,
administrators, and .succasso~jointly and severally, firmly by these presents.
THE CONDITrON OF nns OBLIGA TfON ls such th at Wnereas, the Principal entered into a
certain contract with the City of Fort Worth, the Owner, dated the __ rr.zy of 201 0, a copy
of which is hereto ettAched and ntade a part h crc:of, for the promion of:
Structural Demo!iticn and
R e m ovru, Transportation, sud Disposal of Asbestos Cont asninated Materlat'i
des ignated as ProjootNumbcr :DEM 10-03: GEA a eopy of wh ich contract is hereto attached, referred to,
a nd made a part her~f as fu lly a11d to the same ex.tent as if copies at length her~in , such project and
coTistruction being hereinafter referred to a:i the "work"_
NOW THEREFORE, i f the 'P rincipal shall well. tru ly and faithfully perfmm the work in
accordance with the plans, specifi cation , and contract document during the origL'1&1 term th ereof, and any
extensions thereof which may be granted by the Owner, with o t without notice to the Surety, s.nd if he
shall sati&fy a ll claims and d~ands incurred under such contnu;t. 2nd shall fu lly indem nify and save
harmless the Owner from all costs and damages which it may suffer by reason or ranure to do so, and
shall reimburse and repay the owner all outlay and expense which the Owner n;,a.y h:icur in tnaking good
any default, then this obl igation shall be \loid; otherwise to remain in full f<>rce and et'kct.
PROVIDED FURTHER, that if any legt\l a.ction bo fi led upon this bond, venue sh all He in Tam mt
County, State of Texas .
AND PROVIDED FUR.TIIER, t hat the said Sun:ty. for value received, hereby stipulatea and
agrees that no change, extension of time, alteration or addition to the tctms of the contract o r to the work
to ~ pc.rfurma& the,..,,:mdm-of' th= ;p .. dfiaation~ ~coomp.m;ving the :.amc ::;hQll in cny wise 11.ffeet it.:,
ohligatfon on thls bond, and it does hereby waive notlee of any such change, e~i.ion oftime alteration
or addition to the, terms of the contract or to the work ot to the specifications.
5z :01 0 t 0Z/9l/5 0
..
09/16/2010 11:28 8174779996 INTERC[1sl EMIIRO PAGE '04/06
IN WITNESS WHEl\E.OF, this instn1mem is executed in _3_ Counterpens ea.ch ones of Which
shaU be deen_,ed ;i:n orlsinat, this the day of . 2010~
AITEST:
·~
(Pnncipal) Secretary
3100 BROADWAY
{Addr~)
KANSAS CITY, MO 64111
(Surety) Secretary
-~
Note:
(!)
(2)
(3)
(4)
(SJ
!uten:on. Environm~rllal, Im.:.
· Principal (4)
(Printi:d N'an:ictritle)
2i () F;m sth Wa.lnnt Av.el'!JJ.O,.,___..;_ _____ _
ADDRESS
Mansfield, TX 75063
Cl'O.'/STATFJUP
ARCH INSURANCE COMPAN Y
(Surety)
By:
(Printed Attorney-in .f act)
Date of Bond must not be prior to date of Cootrai:t
Can'flcf,,,,,,,. afCm1fl'act,;,-
A Cllf1)GPtllll»I. a l'01'mU3lflP Dr llfflf Jl!di..,ldua/. t:s cast MOJ> be
C~ct Nam~ (![SIJN1j,
U C~lrtl<!!c.r Jz pc.rm,u,J.dp a/11>"1'"1Jtr.t fhcuk! <l(>Ce,1r., holfll
Al l7lls C0'1J' ef PIJYl//1' Qf t,11<;'1M}l .vtall I,(' tnla.1P1«i u,JJOfflJ hvAru,,ney.,tn-l'acr
S0/E0 39'\i'd A:JN 3 9'\i' l.l'v'AM
• / I i POWER OF ATTORNEY . . . . .
SU 110 8136 B
Know All Men By These Presents:
Thath Arch lniUr8nC8 eon,pa,y, a corporation organimd and 8Xlsting under the laws or the State dMisaourl, having Its
principal office in ~ City. M~ (heralRder 1af'ened to II tht "Compeny")does hereby app<*rt
William A. Bailey, Maria A. Gonzalez, Anne M. Barber, Michael J . Friedrich and Dana M. Kuber of Bridgeview, IL (EACH)
,11a true and i.wru1 ·~-~ to make, execute, seal, and deliver from the date of la8uilhce cl this power for and
on lis behalf as iUrfity, and • 11s act and deed:
Any and an bonds and undertaki,g8
=--~~~~=·:=k:lver·bonda~~thfltgua••the
111111 atdbcdy does not permit 1he ..,,. d#lgl4m to. ·be spit i1ID two or men bonds wa ·order to _ bdrlg -.ch IUCh bond
............ ~of~---fathhliwli1,
The Campany rnay -revoke .. appoillbnent at ,any time.
The ·~ d -tuGh _,. 111d -~ fn ~a,.,.._:~htdlt~.,_ be• blncllnf upon the said ,... __ -:a..._ _ __. ........,,IIOal ·~ and . ·GIii : lfltJe-...iahild beet,,••--..-and acknowledtllid byfll ~WY•·~ .. ,..,.. .. ,... ---_ . .., ..... '9 _ --~ ••• -,,, '!'!'!I'll'---,,. --~'~"""' -- -~tr --
..-~ dlbnatll_~offtce lnf<ai'IWCitl, ~·-',. ::'.: .. ' .·. ; . ::·:-:-.
~ Pow d AtfDrMy la_., by -~ of r1N1D1ut1Dnelldapled·1r,-~:canaant <lttl8Board "Dlreciora ef
1he -~.on Mllrd'l-3, 2003.,..,. .... 8CCIQllt capfila of Wblati : .... barliinaftlt aet witl and .. hnby cartlfted lo by
-~ Seci-y ... Wig lnfultforce and alfect:
'VQTED, lba1t1h8 Chalf.maQd ....... the~-Qr..,,-. ~-1halr ........ ,..........,In ·wrllnfil
and fled wflh h Seaa181y, or ....... , .... t.-the _power and -IUlbadly ID appoint ... and~
ar)d, 1D. authorize them fD 4i>Oiclde an behalf of 8* Company. and alllidl the ...., d 119 'Campany thanllo, ·bonds tlld
IRlllf1llktlgt, recagHIZIII~ oanll----~ .., ........ ~NY .......... ....., • .,.,_, . ...,.
-cifflo,rs.ofthe Company~ IPPOlnhigardafor -........ fl#,.._ 11
' lbiii.-,Power d A1IDmey ii ~ ..... --certified by 1'amiinle ·ooder and by aatharlty cl 'the following reaolutlQn
adopted t,ythe tNnltnous camintdlMt Board of'Dnctors d a. ~pany on Mardi 3, 2003.:
VOTEDt n.t u. ...,__ d tbe a.man d 1tJe Board, 1118 PNilidalll. o.r erwy Vice -~ or their IPiJOlntl'es
deitj'l•tt In Wl9lg anci illcl will the Secteay, lli'ld the .-.. -fl .ae Sea•.Y~ the tNI d the eemp.ay~ and
01111btians-by lie Seca•r.-,w a-. afflxad by rac.n .. on....,,_.."..,.., er~ .. ...,_,.... to -the
......, -adDpted by the Baard fl 'Dlrac:tiorl on Man:tJ S, 200$, and any -=ti powlt· IO tlllCUlld; 11811d and Clltlled
wft.h ,_. to -.u bond ot ................ to which it ii attliichad ..-. --""'be-._.Id--_.; ~ ...... ,._ · -, -•1 ---'Iii . t --""'91UHUV U ... . mN ...,,,...,'W upon U -• ""'1'1P8DY•
00ML0013 00 03 03
Page1 of2 Printed In U.S.A.
In Taatimony Whereof, the Company haa caused this lnstn.R'nent to,be ,ignec:t and its corporate ..., to be affixed by tt1e ~1r
authorized C)ffleets. this 1st . day of May , 20..QL. ' · ' ..
STATE OF PENNSYt,.VANIA SS
COUNTY OF PHILAOELPHtA 8S
Arch Insurance Company
J •..
.. , ..
CERTIFICATION
LMldnJ.:....,,SeqnatyOft.AJah ·........_Company~do....,.a,yfhatlleattached~·af-.-.d
M!J 1, 2008 on ·behalf d. the peraon(1) • lllllld abovellJ.a.,. a.ricJ conect copy and hltlbe --• •n n M ror. and. effect.llil1G8 a.• e.-and 11 1n 1u1 ,.,._. _. Qf) the dale d 1111a a11--.1P1 1 • idNN' .
~'thlll '-latd J. MlctJll8t ,._ who 8IIICUl9d 118 'Pew.ar fl,.,,._,,,• vtc. Pt11lr:lent, wa o,rh, ._.of IDIIIICUtkln
fla.attattal Powllr"·-...,·1"clulytiteclld Vice PNlldlnt4f.bJ .Antl•·""'"'1ce·~.IY; · · ·.
IN TS$1lMONY WHER.EOF, l ._..fttlrllU.nlo IUblal)ed .fff'I l"lllrtW q . .._. ._ r.1 .. _ _..
Con,pany on thla 16th ~ Qt SEPT, 2010 , 20_.
Tua. ·Power" Atbney ·--'lleaala -thole .naned ,theniln to •·bands and~ . ......., named therein
andblybawno aulharlly to blnd .h 'Companyemeptln .. milnnW.and to·IMt mant.hnln·tlllflllCL ·
.Pl ·U8E8eND ALL CLAIM .... RELATING TO 1Hl81iONDT01llE -FOLL.OWING MDREIIS:
M:118uNly
3 Pallway, .... 1500
PNladelphla, PA 19102
OOML0013 00 03 03
Page2of2 Print.cl In U.SJl
INVITATION
TO BID·
RESPONSE
210 South Walnut Creek Drive • Mansfield , Te xas 76063 • Phone : (817 ) 477-9995 • Fa x: (817) 477-9996
COPY
SEALED PROPOSAL
Project:
PROJECT: DEM l 0-08: GHA
GRANBURY HILLS APARTMENTS
ENVIRONMENTAL, INC.
www.intercon-environmental .com
REMOVAL OF ASBESTOS-CONTAINING MATERIALS AND
DEMOLITION OF STRUCTURES
5250 WONDER DRIVE, FORT WORTH, TEXAS
Submitted by:
lntercon Environmental, Inc.
Proposal No. 0 7-l 0-00 l / D-0 7-l 0-00 l
Prepared for:
City of Fort Worth
Purchasing Division
l 000 Throckmorton Street
Fort Worth, Texas 76102-6311
Bid Due: July l, 2010@ l :30 P.M.
ENVIRONMENTAL , IN C.
Table of Contents
a) INVITATION TO BID COVER SHEET (signed)
b) BIDDER'S NOTICE OF INTENT TO BID DOCUMENTATION
1. Proposal Documents ............................................................. 2.0
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
Health & Safety Plan ........................................................... 2.6.5
Storm Water Pollution Prevention Plan (SWPPP) .......................... 2.6.6
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. (M/WBE) Utilization Requirements ............................................ 2. 9
8. Statement of Residency ........................................................ 2.10
Nondiscrimination ............................................................... 2.11
Prevailing Wage Rates & Davis Bacon Requirements ....................... 2 .12
9. Insurance Certificate ........................................................... 2.13
Workers Compensation Insurance Coverage ................................. 2.14
10. Contractor's Responsibilities .................................................. 2.15
Contractor's Legal & Compliance History ................................... 2.16
INVITATION TO BID
FORT WORTH
CITY OF FORT WORTH
ENVIRONMENTAL MANAGEMENT DEPARTMENT
1000 THROCKMORTON
FORT WORTH, TEXAS 76102
PROJECT: DEM 10-08: GHA
GRANBURY HILLS APARTMENTS
REMOVAL OF ASBESTOS-CONTAINING MATERIALS AND
DEMOLITION OF STRUCTURES
Submitted by :
lntercon Environmental, Inc.
Company Name
210 S. Walnut Creek Drive
Address
Mansfield, Texas 76063
Telephone
5250 WONDER DRIVE
FORT WORTH, TEXAS
May 27, 2010
Karen Andrews, President
Pr~
PresidenWice-President -Signature
July 1, 2010
Date
Ph: (817) 477-9995 Fax: (817) 477-9996
Fax
Angelica Petruzzelli
From: Angelica Petruzzelli
Sent:
To:
Tuesday, June 01 , 2010 4:27 PM
'Grantham , Roger'
Subject: NOTICE OF INTENT -Project: DEM 10-08: GHA
Importance: High
Mr. Grantham,
As per section 1.3 of the proposal documents for Project: DEM 10-08: GHA, lntercon Environmental, Inc. is hereby
submitting our Notice of Intent.
Thank you for the opportunity.
Respectfully,
A~Pett--~
Executive Vice President
lntercon Environmental Inc.
210 S. Walnut Creek Drive
Mansfield, Texas 76063
Phone: 817-477-9995
Fax: 817-477-9996
Cellular: 817-507-8546 ·
www .intercon-environmental.com
1
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 Checklist
All Bid Documents, including this checklist , must be completed in full and submitted in a
sealed envelope, in the requested order, to be considered a responsive submittal.
Bid Documents Initial if Included
1. Bid Document Checkl ist
2. Acknowledgement of Receipt of Addenda
3. Scope of Work
4. Cost
5. Contractor Information and Qualifications
6. Contractor Submittals
7. Subcontractor Information and Qualifications
8. Bonds
9. Disadvantaged Business Enterprise Utilization Requirements
10. Statement of Residency
11. Nondiscrimination
12. Prevailing Wage Rates
13. Insurance Certificates
14 . Contractor's Responsibilities
15. Contractor's Legal and Compliance History
I understand that all of these items will be reviewed, and any items not included may
result in my bid being considered non-responsive.
Signature
Name Karen Andrews ---------------------
Title President ----------------------
Company
Date
lntercon Environmental , Inc.
July 1, 2010
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 Invitation to
Bid, and has attached all addenda following this page. Failure to submit applicable
addenda may result in the bid document being considered non-responsive.
(Add lines if necessary).
Addendum Number 1 June 16, 2010
Addendum Number 2
Addendum Number 3
(Date received)
June 23, 2010
(Date received)
June 29, 2010
(Date received)
2.2.2. Check if applicable __
The undersigned acknowledges the receipt of no addenda to the Invitation to Bid.
CONTRACTOR:
~
Signature
Karen Andrews
Name
President
Title
lntercon Environmental, Inc.
Company
July 1, 2010
Date
2-3
FORT WORTH
ENVIRON :VI ENTAL l\rlANAGEVIENT
AD ENDUM
TO: Interested Parties
FROM: Roger Grantham, Environmental Supervisor
Department of Environmental Management
June 16, 2010 DATE:
RE: Addendum #1
DEM 10-08: GHA
As of Wednesday, June 16, 2010, the following apply;
1. Q: Is the Pre-Bid Meeting mandatory? .
A: No
2. Q: Does the retaining wall along the eastern side of the southern
portion of the complex remai n?
A: Yes. The retaining wall and "legs" will remain intact.
3. Q: When is the anticipated start date for the project?
A: It is anticipated to begin near September 1, 2010.
4. Q: Has the roof been assessed for asbestos?
A: No. The City will sample the roofing materials and pub lish the
results in Addenda #2.
5. Q: Will the project site be av ail ab le at a later date for bid di ng
purposes?
A: No.
"
6. Q: Is a Stormwater Pollution Prevention Plan required?
A: Yes.
7. Q: Can fill material from the northern portion of the site be used on
the southern portion of the site?
A: Yes.
8. Q: Do you anticipate interviewing the highest scoring vendors to
determine each ones strategic approach to working on th is project
given the demanding and dynamic site conditions?
A: It is being strongly considered given the overall complexity of the
site terrain and conditions.
9. Q: Will Wooten Drive be closed to through traffic?
A: No. Traffic control plans and signage and flagmen are necessary as
outlined in the 1TB.
10. Q: Are there any recycling requirements for the demolition?
A: No. Although it is desirable to recycle as much as possible, there
are no requirements for recycling for this project.
11. Q: Does the contractor need to apply for the Urban Foresby Permit?
A: No. The City will handle the Urban Forestry Permit.
12. Q: Will the City supply electricity and water?
A: No. You may obtain a meter from the Water Department and no
temporary power poles will be set on City property.
FORT WORTH
ENV I RO N ;VI El\T AL MANAGE\'I ENT
ADDENDU
TO: Interested Parties
FROM: Roger Grantham, Environmental Supervisor
Department of Environmental Management
June 23, 2010 DATE:
RE: Ad dend um #2
DEM 10-08: GHA
As of Wednesday, June 23, 2010, the following apply;
1. Q: Does the roofing materials contain asbestos? The survey does not
include roofing materials.
A: No. The roofing components throughout the complex are non-
detect for asbestos.
2. Q: Are Sections 2.5.4 and 2.5.6 the same?
A: Yes. On Page 2-13, please disregard Section 2.5.6. This section is
redundant to Section 2.5.4.
3. Q: Does the Health and Safety Plan need to be submitted in paper
format? Can it be submitted on a CD?
A: No. It may be submitted on a CD.
4. Q: Will the City be conducting interviews for the top-scoring
submittals?
A: It has not been decided at this time, but is highly likely to ensure
the vendor is capable of accomplishing all tasks as outlined in the bid
package.
5. Q: What are the main areas of concern the City has i n regards to the
complexity of this project?
A: The City requi res that all phases of the project be accomplished
while strictly ad hering to app li cable State and Federal laws t hat app ly
to this project. Additiona ll y, traffic control during incr eased t ruck
activity is a concern and t he final acceptance of the project site in
relation to applicable stormwater regulations is a top priori ty. T he
awarded vendor will be required to ma intain the site in acco rdance to
stormwater regulations until such a time that it can be re leased.
6. Q: Does the city require any type of strategic plan for t his project to
address the stormwater issues?
A: As stated in the 1TB , Section 2.6.1, a timetable, schedule, and/or
chart detailing the organization of activities is required.
However, with the publication of th is addendum, the City is requ i ring
additional information in detail regarding the type of sto rmwater BMPs
to be implemented and the course of activities that will be r equired to
address substantial stormwater related issues at the site. Th ese issues
include the type of erosion control devices to be utilized in the City
streets, the scope of BMPs to be utilized on the project site, and the
long term plan to monitor the site and BMPs to ensure co mpli ance until
the site has achieved substantial vegetative coverage.
All submitters should include this strategic summary addr essing the
issues, as Section 2.6.6 . The summary should be we ll -organized and
comprehensive in addressing the stormwater issues t hat will exist at
the site. Post-demolition care for the site, in regards to stor mwater, is
equally important as is the removal of the ACM and de molition of the
structures .
7. Q: Will the site be available for another site visit prior t o the bid
opening?
A: Yes. The site will be open from 9A to lP on Tuesda y, Ju ne 29 for
final site visits.
8. Q: Will the City extend the Bid Due Date past July 1, 2010?
A: No. July 1, 2010 at 1:30 PM is the due date. Sub mittals must be
received in Purchas ing by th is date and time to be val id.
TO:
FROM:
DATE:
RE:
FORT WORTH
ENV IRON :VI EN T A L JVl ANAGE:VIENT
ADDENDUM
Interested Parties
Roger Grantham, Environmental Supervisor
Department of Environmental Management
June 29, 2010
Addendum #3
DEM 10-08: GHA
As of Tuesday, June 29, 2010, the following apply;
· 1. Q: What does the City mean as "substantially complete"?
A: The City expects asbestos abatement, demo lition of all
improvements located at the site, and the SWPPP bei ng actively
followed to ensure all BMPs are in place to prevent stormwater erosion
from significantly impacting City streets and nearby stormwater
features at the end of 45 working days after the vendor receives the
Notice to Proceed. There is expected a certain length of t ime that will
be required to ma intain the SWPPP until the NOT is able to be filed.
Weather conditions and the type of vegetative coverage one stipulates
in the strategic summary will dictate the length of ma i ntenance
required prior to filing the NOT. All references to Liquidated Damages
refer to after 45 "working days", not 45 "calendar days".
2. Q: What is the timeframe to complete the project?
A: The vendor will be substantially complete with the wo rk at the si t e
within 45 working days. Continued maintenance of the SWPPP will
continue until the site has reached a level of accep t ab le vegetative
cover for release and filing of the NOT. ·
3. Q: Will the contractor be required to have a SWPPP for this project?
A: Yes. Please see ITB and previous addenda.
4. Q: Will the City remove the fenc i ng currently surrounding the
property?
A: The City will have the chain-linked fencing removed from the
perimeter of the property prior to the demolition of the structures .
The fencing will remain in place during the asbestos abatement portion
of the project.
This is t he FI NAL Addendum t o be issued.
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 located within the Granbury Hills
Apartment Complex located at 5250 Wonder Drive, Wedgewood Addition, Block 20, Lot
D, and Block 21, Lot C1A, Fort Worth, Texas. The apartment complex was constructed
in 1965 and is situated on approximately 2.009 acres.
2.3.1 . Site Information
*Quantities identified in this Bid Package are estimated by the building owner and/or his designee; the
Contractor is responsible for verifying all quantities. Claims for additional compensation due to variations
between conditions actually encountered in the project and as indicated in the Contract Documents will not be
allowed. The only exception is if the Contractor can clearly show why the variation was not identifiable prior to
job commencement.
Location ACM for Abatement Square Feet for
Demolition
All Units and Clubhouse 12" x 12" Floor Tile and Black Mastic (-23,475 SF)* -59,000 SF
Clubhouse over Laundry Black Mastic on Concrete Floor (-525 SF)* -59,000 SF Room
All Units, Laundry Room, Sheetrock and Joint Compound, Wall and Ceiling Clubhouse, Mechanical -59,000 SF
Room, Maintenance Shop Texture (-368,400 SF)*
Valves in all Units TSI -Black Tar Wrap (-114 LF)* -59,000 SF
All 114 Units Popcorn Ceiling Spray -On Texture -87,560 SF
All A-3 Units Texture on Brick (-8,734 SF)* -full extent of texture -59,000 SF not identified
2-4
2.3 .2 . Project Coordination
Contractor will be responsible for coordinating with the Environmental
Management Department, within five (5) 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 notification 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 the
apartment complex located at 5250 Wonder Drive.
Upon receipt of a notice to proceed and prior to demolition, contractor must
obta in 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
Ordin ance." 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 interfere with construction is
permissible while still retaining 50% of existing canopy. A copy of the ordinance
has been included in section 3.4. 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" for this project. This will include the
performance of a tree survey identifying the current canopy cover on site. This will
allow the removal of up to 50 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 designated to be removed and for following the
requirements of the ordinance during the performance of this project.
Prior to site mobilization, the contractor must prepare and submit a Storm Water
Pollution Prevention Plan (SWPPP) in accordance with the requirements detailed
in the TPDES General Permit No. TXR150000 and received approval from the
City. In addition, the contractor must also submit a Notice of Intent (NOi) to the
Texas Commission on Environmental Quality (TCEQ) for stonn water discharges
associated with construction activities. The contractor must maintain this plan
until sufficient vegetation has been established. The contractor must also post
the SWPPP in such a manner so that the information can readily be obtained by
the general public.
2-5
2.3 .3. Site Preparation
Prior to a ny abatement or demolition activities , the contractor will remove all
universal w aste items including light bulbs, mercury-conta ining devices , paints,
pesticides, etc. These items will be properly packaged and disposed by the
contractor. The contractor will provide documentation (waste manifest , bill of
lading , etc.) that the waste was properly disposed .
Contractor will disconnect all associated air conditioning units and properly
evacuate any remaining refrigerant contained within the units prior to being
disconnected.
Utilities will have been terminated to the sites. Prior to demolition, the contractor
will be responsible for verifying that all utilities (i.e. natural gas, telephone,
water, etc.) have been disconnected. Contractor will cut and cap all site utilities
at point of connection to the site.
Contractor will be responsible for contacting applicable utility services in order to
decide whether or not main lines or routes effectively traverse the project site . It
will be determined with the consultation of City staff the best method to address
any utility concerns involving the aforementioned utility service issues.
2.3.4. Site Work
All structures will be abated of all ACM and will 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 demolition of any structure, each structure
shall be inspected to ensure the safety of the crew.
Abatement activities will include the removal of approximately 368,400 square
feet of sheetrock wall texture and joint compound, approximately 23,475 square
feet of 12"x 12" floor tile and associated mastic, approximately 525 square feet of
black floor mastic, approximately 114 linear feet of black tar wrap located on
valves within each unit, 87,560 square feet of spray-on ceiling texture located in
all 114 units, and approximately 8 ,734 square feet of surfacing texture located on
brick.
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
building owner and/or his designee; the Contractor is responsible for verifying all
quantities. Claims for additional compensation due to variations between
conditions actually encountered in the project and as indicated in the Contract
Documents will not be allowed. The only exception is if the Contractor can clearly
show why the variation was not identifiable prior to job commencement.
Prior t o any site disturbance, the contractor will have implemented the Best
Management Practices (BMPs) detailed in the approved SWPPP. This shall
. '
2-6
include, but not be limited to, the use of silt fencing , rock check dams, mulching,
erosion control blankets, curb and inlet protection devices, sediment traps,
sediment basins, and/or stabilized construction entrances and exits .
Demolition activities will include the demolition of all site structures,
conc rete/a sphalt park in g , slabs/foundations , and retaining walls. Streets , drives ,
and curbs within the perimeter of the complex will be removed; however streets,
drives and curbs constituting the perimeter will remain. All demolition debris will
be removed from the site and recycled or disposed in a landfill accepting such
waste. All foundations will be removed down to a minimum of 2 feet below
grade. If foundations/piers extend beyond 2 feet below grade, they may be
severed at that point and left in place.
A filled in swimming pool and hot tub will be decommissioned by removing at
least the top of pool curbing from the surface to at least two feet below ground
surface or even greater in areas where sloping must be performed . The base of
the swimming pool and hot tub will be fractured or broken to prevent water from
artificially pooling in the area of concern .
Contractor shall clean and remove all remaining furniture, household furnishings,
building materials, tires, debris, trash, rubbish and any other solid waste from the
premises. These materials shall be recycled, reclaimed or disposed at a facility or
landfill that is approved to accept such waste.
Contractor shall maintain proper safety fencing, as needed , and also provide for
adequate signage, barricades, traffic cones, and "flagmen" during the course of the
project when heavy traffic will be leaving or entering the site. Temporary safety
fencing to be used shall be a heavy-duty, diamond-link mesh, orange, high density
polyethylene safety or security fencing that will withstand substantial weather-
related stresses.
Demolition activities will be performed in accordance with Federal, State and local
visible emission requirements (i.e. no visible emissions will leave the demolition
area). Water is available in the vicinity of the construction area. The Contractor is
responsible for obtaining a City of Fort Worth -Water Department water meter if
usage of water from nearby fire hydrants is anticipated.
The work area will be maintained in a manner that will control all demolition debris
from becoming windblown and/or migrating from the work area during and after
working hours.
The contractor shall use site material, if available , or clean fill from an approved
source to fill any holes in the terrain resulting from any of the above work, and
grade the entire lot, ensuring that low areas are filled to prevent the pooling of
water.
For the duration of the entire project, contractor shall sweep dirt and debris from
the haul routes used to ensure any sediment tracked from the site is collected
and does not migrate onto City streets.
A specific grass type indigenous to the area will be selected and agreed to
depending upon the time of year when vie planting will occur. The soil will be
2-7
analyzed by the contractor in order to determine current nitrogen, phosphoric
acid, and potash contents in order to determine the concentration and fertilization
rate that should be applied to maxim ize growth . Soil samples and analytical
results must be provided to the City for the determination of add ition of soil
amendments will be necessary. This must be done prior to the dissemination of
the applicable indigenous grass seed . The seeded area will be watered by the
contractor, as needed, to allow proper establishment of vegetation .
The Contractor will maintain the BMPs and the vegetative area for at least six
months, or until a uniform vegetative cover with a minimum of 70 percent
coverage has been established and has been accepted by the City for
maintenance by others, whichever is earlier.
Once sufficient vegetation has been established, all BMPs will be removed by the
contractor and the project will be closed out.
2-8
2.4. Cost
1.
2.
3.
4.
5.
6.
7.
8.
The undersigned hereby proposes to furnish t he equipme nt, labor materials,
superintendence , and any other items or services necessary to co mplete the scope of
services detailed in this Solicitation.
Bids shall be firm priced offers unless otherwise specified. In the ev e nt of a discrepancy
between unit price and extended price , the unit price shall govern .
Asbestos Abatement and Removal
:t Qes~ription
:'}j;;:,c .. , · -,~1{'//;::i 3
';;j Estimated '
' rn, [;db Quanta" •; ..
12" x 12" Floor Tile & Associated Mastic -23,475 SF
Black Mastic on Concrete Floor
Sheetrock & Joint Compound,
Wall & Ceiling Texture
TSI -Black Tar Wrap
Texture on Brick
Popcorn CeiDng Spray -On Texture
Mobifization Charge
Demobilization Charge
Abate~ent \
-525SF
-368,400 SF
-114SF
-8,734SF
-87,560 SF
Each
Each
. '· SubtotaF ,( " .
Price
$16,175.19
$577.50
$271,122.43
$26,448.00
$15,557.03 .
$63,918.80
0.00
0
$. 393. 798-95
2-9
Demolition
Item
Description Unit Price Estimated Price
Quantity*
Demo of improvements including clean-up and
1. disposal of single and up to three-level structures, $1.95 -59,000SF $115,050.00
including footers, beams, piers, and slabs
2. Removal of concrete and asphalt -patio, parking lot,
interior sidewalks, and grading of site ( perimeter $0.70 -87,555SF $61 ,288.50 drives, curbs, and streets will remain)
4. Removal of misc. items, wood, metal fencing, -1 ,000CY
playground, misc. debris $10.00 $10,000.00
Prepare and implement a Storm Water Pollution
5. Prevention Plan, installing and maintaining all BMPs, 1
establishing vegetation, and removal of BMPs upon
completion. $17,056.15 $17,056.15
Mobilization/demobilization fee (includes 1
9. disconnect, equipment, generators, traffic control,
etc.) $883.25 $883.25
DEMOLITION SUBTOTAL $ 204,277.90
ABATEMENT & DEMOLITION GRAND TOTAL $ 598,076.85
Contractor shall complete all phases of work to achieve substantial completion within 45
calendar days of receipt of notice to proceed per project ·
2-10
CONTRACTOR:
~~D,li,)¥
Signature
Karen Andrews
Name
President
Title
lntercon Environmental, I nc .
Company
July 1, 2010
Date
2-11
2.5. Contractor Information and Qualifications
Bidder shall submit the following items proving they are duly qualified and capab le to fulfill
and abide by the requirements listed herein . The documents listed below shall be included
in this bid sub mittal , in the same order as listed , following this page , bound within the
response .
Failure to subm it any of the following information may result in th e bid document being
considered non-responsive.
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 ContacUProject
• Email , Phone, and Address of Contact
• ContracUProject Value
• Brief Description of Service Provided
2.5 .5. Bidder shall complete a staff matrix including the following information 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 t his contract, (President, Vice
President, Project Managers, Technical Managers, Field SupeNisors, etc.)
• Name
• Tasks to be performed in association with this contract
• Certifications/Licenses
• Total Years Experience
• Length of employment with your company
2-12
See Tab 3,
Section 2.5.4
2.5.6 . Bidder shall provide at least four (4) project references similar in scope and size to
that of this Solicitation . Each project reference shall include the following i nformation :
• Company 's Name
• Name and Title of Contact/Project
for this information. • Email, Phone, and Address of Contact
• Contract/Project Value
• Brief Description of Service Provided
2.6. Contractor Submittals See Tab 4 for this information.
Bidder shall subm it the following items included in this bid submittal , in th e same order as
listed , following this page , bound within the response.
2.6.1 . Project Schedule : Contractors shall provide a project schedule that includes all
major tasks pursuant to the Scope of Work and Specifications . The project
schedule shall show all tasks in the left most column and their duration shall be
plotted horizontally versus time. A time scale shall be selected so that the
complete duration of the project can be shown on paper w ith a maximum
dimension of 11" high by 17" wide . The project schedule m ust be submitted with
the bid. During the term of the contract the Contractor shall submit monthly project
schedules showing planned work and actual work accomplished.
2.6.2 . Schedule of Values : Progress Payments will only be made after completion of those
tasks and/or subtasks identified on the Project Schedule and Schedule of Payments.
Progress 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 fur each task and/or
subtask, and the amount that would be remaining in the contract account. Upon
receipt of final project completion documentation , final proj ect payments will be
approved . Final payments will not be approved until p roject completion
documentation has been submitted to and approved by the C ity of Fort Worth.
2 .6.3. Provide a sample invoice and sample project closeout documentation.
2 .6.4. Provide an organization chart that details the communication channels betwe_en the
Contractor and City of Fort Worth personnel for th is contract.
2.6 .5. Provide an o rganizational health and safety plan. A site-specific h ealth and safety
p lan (HASP) will be required and daily safety briefings will be mandated and recorded
in the HASP, which is subject to City inspection .
2-13
ENV I RONMENTA L, IN C.
2 10 S W a lnu t Creek D rive . Ma n sfie l d, T ex a s 76063. T eleph on e (8 17 ) 477 -9995 . F a cs i mi le (817) 477 -999 6
'
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
www. i n t e rco n -e n vi ron ment a I .c om
'* Texas DSHS Asbestos Contractor License No. 80-0805 "* Texas DSHS Asbestos Transporter License No. 40-0336 "* Texas DSHS Lead Firm License No. 2110368 "* Texas DSHS Mold Remediation Contractor License No . RC00136 "* NCTRCA Cert ificate No. WFDB42229Y0910 "* SCTRCA Certificate No. 2090218 19
,;qj. HUB Cert ificate No. 152243777 4500
,,.
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
INTERCON ENVIRONMENTAL INC
is certifiea to peifonn as a
Asbestos Abatement Contractor
in. the State of Texas within the purview ofTe"Cas Occupations Code, chapter 1954, so long as this license is not
suspended or revoked and is renewed according to the rules adopted by the Texas Board of Health.
DA YID LAKEY; M.D.
COMMISSIONER OF HEAL TH
License Number: 800805 Expiration Date: 2/5/2011
Control Nun1ber: 95442 (Void After Expiration Date)
VOID IF AL TE RED NON-TRANSFERABLE
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
INTERCON ENVIRONMENTAL INC
is certifiea to peiform as a
Asbestos Transporter
in the State of Texas within the purview of Texas Occupations Code, chapter 1954, so long as this license is not
suspended or revoked and is renewed according to the rules adopted by the Texas Board of Health .
. Y~/49'£7
DAVID LAKEY, M .D .
COMMISSIONER OF HEALTH
License Number: 400336 Expiration Date: 2/5/2011
Control Number: 95484 (Void After Expiration Date)
VOID IF ALTERED NON-TRANSFERABLE
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
<Be it k,nown tfiat
INTERCON ENVIRONMENTAL INC
is certifiecl to peifonn as a
Lead Firm
in tfie State of 'Te~as ancl is fiere6y govemecl 6y tfie rigfits, privifeges ancl responsi6iuties
set fortfi in 'Te~as Occupations Cocle, Cfiapter 1955 ancl<Titfe 25, 'Te)Cas }Iclministrative Code, Cfiapter 295
re fating to 'TeJ;,as P,nvironmenta{ Leacl <Rgcluction, as Cong as tfiis {icense is not suspenclecl or revok§cl.
<Davia£. Lafigy, :M.. <D.
Commissioner ojJ{ea{tli
License :Num6er: 2110368 P.xpiration <Date: 9/2/2011
Contro[:Num6er 6151 (Vouf }Ijter<Expiration (])ate)
VOID IF ALTERED NON-TRANSFERABLE
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
Be it known that
INTERCON ENVIRONMENTAL, INC
is licensed to perform as a
Mold Remediation Company
in the State of Texas and is hereby governed by the rights, privileges, and responsibilities set forth in Title 25, Texas Administrative
Code, Chapter 295, relating to Texas Mold Assessment and Remediation Rules, as long as this license is not suspended or revoked.
License Number: RC00136
Expiration Date: 1/25/2012
David Lakey, M.D.
Commissioner of Health
VOID IF ALTERED NON-TRANSFERABLE
Control Number: 6619
(Void After Expiration Date)
. ' '1.
NCTRCA
Disadvantaged Busine$s
Enterprise Certificati~n
I
lntercon environmental, Inc
I
j
l . Di.sadvautaa:.e.d Bus.i.o.ess Enterorise . . has filed with the Agency an Affidavit as det.int!q by4Y Cl''K part 2<> ~nd 1s hereby certified to provide
i
service(s) in t:he following areas:
sJ2910; 238910;
Asbestos Contractor and Removal: Rbmediation Services; Site Preparation Contractors I (pt);
;
!
This Certification is valid beginning Sep~ember 2009 and superseded any registration or listing
previously issued. This certification must be updated ahnually by submission of an Annual Update Affidavit. At any
time there is a charge in ownership or control of the \r.rm, notification must be made immediately to the North
Central Texas Regional Certification Agency or an TU<CP certifying entity.
I
September 2J
'1 Certificate expiration 10
Issued date Septembe~ 21--09
CERTIFICATION NO. WFD842229Y0910 !
SCTRCA
Small, Minority, Woman, African-American , Ve teran , Disabled
Individual Business Enterprise
(S/M/W/AAN/DIBE) Program
lntercon Environmental, Inc.
: has f!l~d the' appropriate affidavit with the South Central Texas Regional Certification Agency (SCTRCA)
an9 is'he[.1by. cer'.tifi~d /in ~ccord~nbe with SCTRCA Policies and Procedures, as a:
:K.:t:: · -~·\ ,, -~ -. ~ ·•j "'C-~,:".,;_ \ _.,
., ._.e ..... _-.,.,<, ; _\ ?}: ' , I. '
• ,T -f,' • • )
1-',•
SBEWBE
•. _;t: _,/ .·: ,. __ j • ·~ :.. .\..··. • -• j ••• •
This'.Certifit:aliol"l Certificate must be updated by submission of a Compliance Affidavit You are required . . .} ' ,. .',;(..,.: ~ ·, .• ~ ' ., . . . -. '
., · to notify.the .SCTRf~_witbi.n 30 .days of any ~hange in circumstances affecting your ability to meet size,
1
,, ,·; disadyantage status, qw_nership; q_r control. requirements and any material changes in the information =~ . " ~prpvided in th ~ submissihn of the business application for certification.
' I. ~\ .,:__! ·. _,,"'. ·\'. -. ,:.,•;. --~•·, .. •
.... ·:. t ·. : ' _: t• ·. ··Jc."' -·. ·' :i. '
: ·. :· 'CERTii=1cl ii' EXPIRES: February 28, 2011 CERTIFICATE NO . 209021819 ·
•. ! ,\ • i.,.,:":lf,' ,-' ·~· • •
, . Certified in the following work categories:
N~rthAmerican Industry Classification System (NAICS) codes (s):
, .· . NAICS-562910: ASBESTOS ABATEMENT SERVICES
.. N·AfcS-:562910: ASBESTOS REMOVAL CONTRACTORS
NAICS-,562910: ENVIRONMENTAL REMEDIATION SERVICES
· ·NAICS-562910:°LEAD PAINT.ABATEMENT SERVICES
NAICS:,.56291-0 .: LEAD PAINT REMOVAL CONTRACTORS
.. NA1c·S-5629fo: MINE·RECLAMATION SERVICES, INTEGRATED (E.G., DEMOLITION, HAZARDOUS
:MATERIAt RE;M,OVAL; SOIL REMEDIATION) ,
. NA1cs.:552910: OIL:" SPILL CLEANUP SERVICES
~~ ,_,. NAICS-562910::REMEDIATION AND CLEAN UP OF CONTAMINATED BUILDINGS, MINE SITES,
SOIL, OR _GROUND WATER
NAICS-562910: REMEQIATION SERVICES, ENVIRONMENTAL
NAICS-562910: SITE .REMEDIATION SERVICES
NAICS-562910: SOIL REMEDIATION SERVICES
NAICS-562910: TOXIC MATERIAL ABATEMENT SERVICES
NAICS-562910: TOXIC MATERIAL REMOVAL CONTRACTORS
~faf r nf '<!rrxas
Historically Underutilized Business
Certification and Compliance Program
The Texas Comptroller of Public Accounts (CPA),
hereby certifies that
INTERCON ENVIRONMENT AL, 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, printed 19-JAN-2008, supersedes any registration and 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 authorized signatures) provided in the
submission of the business' application for registration/certification as a HUB, you must immediately (within 30
days of such changes) notify the HUB Program in writing. The CPA reserves the right to conduct a compliance
review at any time to confirm HUB eligibility. HUB certification may be suspended or revoked upon findings of
ineligibility.
CertificateNID Number: 1522437774500 Paul A. Gibson
FileNendor Number: 36251 HUB Compliance Supervisor
Approval Date: 15-JAN-2008
Expiration Date: 15-JAN-2012
Note: In order for State agencies and institutions of higher education (universities) to be credited for utilizing this
business as a HUB, they must award payment under the CertificateNID Numb€r identified above. Agencies and
universities are encouraged to validate HUB certification prior to issuing a notice of award by accessing the
Internet (http://www2.cpa .state.tx.us/cmbl/hubonly.htrnl) or by contacting the HUB Program at (888) 863-5881 or
(512) 463-5872.
ENVIRONMENTAL, INC.
210 S W a lnut Cr eek Driv e . Man sf i e ld Te xas 76063 . Tel ephone (817) 4 77-9995 . Fac simile (817) 477-9996
Prepared for City of Fort Worth
PROJECT: DEM10~08: GHA
Response to Section 2.5.2
Bidder's Statement of Qualifications
www . i ntercon-e nvi ron menta l. com
lntercon Environmental, Inc. possesses contractor licenses for asbestos abatement, lead and lead-based paint
abatement, mold remediation and demolition projects. We are also qualified to demolish, rebuild or construct
buildings, respond to emergencies and perform general construction 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 unique, effective 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 ability 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.
Our team members have been in the Dallas/Fort Worth market for over l 8 years, specializing in all 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
mobilize 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 effective i n meeting the needs of our clients. By utilizing in -
house resources, we have a much greater control on meeting deadlines and maintaining a consistency of high
quality work and customer satisfaction. We cover every aspect of the abatement and demolition process.
lntercon Environmental, Inc. will never disregard a request for service, even in 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 never requested a change order for work we contracted to complete. We take pride i n every project we
are awarded.
Bid Documents /Specific /SQQ
ENVIRONMENTAL , INC.
2 10 S Wal n ut C r eek D rive . M ansfield T exas 76063 . T elephone (817 ) 477 .9995 . Facsimile (817) 477-9996
www . i ntercon -env i ron menta I . com
Bidder's Statement of Qualifications
lntercon Environmental, Inc. possesses contractor licenses for asbestos abatement, lead and lead-based paint
abatement, mold remediation and demolition projects. We are also qualified to demol i sh, rebuild or construct
buildings, respond to emergencies and perform general construction 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, fle_et and equipment provide us with unique, effective capabilities. Our fleet of late-
model vehicles, state -of-the -art abatement, demolition, and transportat i on 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 ability 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 ev ery project.
Our team members have been in the Dallas /Fort Worth market for over 18 years, specializing in all 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
mobilize 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 effective in meeting the needs of our clients. By utilizing in-
house resources, we have a much greater control on meeting deadlines and maintain in g a consistency of high
quality work and customer satisfaction. We cover every aspect of the abatement and demolition process.
lntercon Environmental, Inc. will never disregard a request for service, even in an em ergency. 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 never requested a change order for work we contracted to complete. We take pride in every project we
are awarded.
Bid Documents /Sp ecific /SQQ
Statement of Qu alifications
Page 2 of 7
Firm:
Corporate / Main Office:
Telephone :
Officer:
Email address:
Karen Andrews, President
COMPANY / PERSONNEL INFORMATION
lntercon Environmental, Inc.
21 0 South Walnut Creek Drive, Mansfield, Texas 76063
(817) 477-9995, Facsimile : (817) 477-9996
Karen Andrews, President
karen@i nte rcon-e nvi ran mental .com
ENV I RO NMEN TAL , INC.
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 administrative duties in various
disciplines of the environmental industry. Presently she conducts all of lntercon's financial, operational, and
regulatory responsibilities. She is currently licensed by Texas Department of State Health Services as a Lead
Abatement Supervisor and maintains an expertise 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
required in the environmentaj industry.
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 interactive with clients 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 Supervisor and a Mold
Remediation Supervisor .
Fernando Avila, Vice President Operations
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 clients.
Byron Davis, Vice President Field Operations
Mr. Davis began working in 1979 in the construction industry building Hi-Rise Buildings in the Dallas-Fort
Worth area. In 1989, he entered the environmental industry as an asbestos abatement worker. His ability to
learn this trade qu ickly and take charge aided him in his promotion to an asbestos abatement supervisor
position. Mr. Davis has a vast knowledge of asbestos remediation in industrial, commercial, and residential.
He has performed projects for various municipalities and educational facilities. He is a Texas Department of
State Health Services as an Asbestos Abatement Supervisor.
Bob McFadin, Demolition Manager
Mr. Mcfadin started in the transportation industry in 1 972 and progressed to the Environmental and
Demolition Industries in 2000. He is licensed by the Texas Department of State Health Services as an Asbestos
Abatement Superv i sor and is educated in all transportation regulations and procedures and the Demolition and
Abatement Industries. With this knowledge, he i s able to procure both demolition and asbestos projects.
Bid Documents /Specific /SOQ -Asb&D emo
Statement of Qualifications
Page 3 of 7
Jose Contreras, Project Manager
ENVIRONM ENTAL , 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 his position to Project
Manager over lntercon's Supervisors for Asbestos Abatement, Mold Remediation, Lead Removal, and
Demolition projects.
David Dunham, Demolition Project Manager
Mr. Dunham began in 1970 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, Demolition Sales
In 1978, Mr . Flowers began in construction sales and progressed to various management pos1t1ons. In 2001
he was certified by the US Army Corp of Engineers in Construction Quality 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 and Demolition projects.
Based on his experience and his proven compliance record, he was promoted to Senior Supervisor to oversee
lntercon's Supervisors .
Eulogio 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 in 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. Ramos began his career in 1 999 as an asbestos abatement worker, licensed by the Texas Department of
State Health Services. In 2003, he was promoted to a licensed Asbestos Abatement Supervisor heading over
crews performing Asbestos Abatement and Mold Remediation projects.
Jorge Hernandez, Asbestos Abatement Supervisor
Mr. Hernandez began his career in 1998 as an asbestos abatement worker, licensed by the Texas Department
of State Health Services. In 2001, he was promoted to a licensed Asbestos Abatement Supervisor heading over
crews performing Asbestos Abatement, Mold Remediation, Lead Removal, and Demolition projects.
Bid Documents /Specific /SOQ -Asb&Demo
Statement of Qualifications
Page 4 of 7
Dave D i.riiliam
Demolition .
Project Manager
Drivers
Bob McFaclin
Demolition
Manager
Keith Flowers
Demolition Sales
ORGANIZATION CHART
Karen Anchews
President
Jer rold Andrews
,Vice President
,Jesse .Andrews .
Managing
Directot·
. Fe:r·uando Avila
·, 'VP Operations'
Angelica
. Petruzzelli . :;; ' 1· ·~
~xecutive Vice
• · r, Pre~!d~nt
ff'\
~ltitercon
ENVI RONMENTAL , INC.
Byron Davis
VP Field
O~rat,i?ns
Jose C-0nt:reras '··. .·;'Hect~/IVI&1inh·
.. S~nior Stlpe~visor
Operntors
Ground Crew l• . Eulogio Torres·
Supe1Yiso ,r . .
Crew
Bid Documents /Specific /SOQ -Asb&Demo
Pr:oject lYfanttger
i----~ ? ' ,, -----------
Moises R11mos ·
Su~e1-visor
Crew ;,, t ."
; J~rge EfernI1:£1clez
. Supenis'or
C,':rew
Hugo V alderram11
• Wa.:rehot1se ·
Supervisor
Statem e nt of Qu alifi cations
Page5of7
ENVIRONMENTAL , INC.
lntercon Environmental, Inc. has successfully completed projects for the following governmental and
educational institutions :
Federal Government
Abilene National Guard
Citv Government
City of Arlington
City of Carrollton
City of Fort Worth
City of Duncanville
City of Garland
City of Dallas Love Field Aviation Dept.
City of Haltom City
Colleges and Universities
Austin College
Dallas Baptist University
Dallas County Community College
Dallas Theological Seminary
School Districts
Amarillo ISD
Birdville ISD
Eagle Mountain-Saginaw ISD
Everman ISD
Fort Worth ISD
Hudson ISD
Graford ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Irving ISD
Housing Authorities
Balmorhea Housing Authority
Grapevine Housing Authority
Groesbeck Housing Authority
Linden Housing Authority
Mabank Housing Author ity
Bi d Docum ents l Specific l SOQ -Asb&D e mo
State Government
Texas Department of
Transportation
Countv Government
Dallas County
Tarrant County
City of Irving
City of Mansfield
City of Nacogdoches
City of Plano
City of Richardson
City of River Oaks
Grayson County Community Coll ege
Tarrant County Community College
Texas State Technical College
University of North Texas Denton
Kilgore ISD
Mansfield ISD
Neches ISD
Prairiland ISD
Richardson ISD
Spearman ISD
Tidehaven ISD
Trenton ISD
Valley Mills ISD
Meridian Housing Authority
Poteet Housing Authority
Teague Hous i ng Authority
Temple Housing Authority
St atement of Qualifications
Page 6 of 7
Current License and Certifications
Program Name Certification Number
NCTRCA -DBE WFD42229Y0910
SCTRCA -SBE, WBE 20702202
State of Texas -HUB 1522437774500
WBE National Council -WBE 234367
Texas Department of State Health Services License Number
Contractor Asbestos Abatement License 80-0805
Asbestos Transporter License 40-0336
Contractor Lead Abatement License 2110368
Mold Remediation License RCOOl 36
Insurance
General Liability
Arch Specialty Insurance Company
$5,000,000.00
Includes Pollution Liability
Worker's Compensation
Texas Mutual Insurance Company
$5,000,000.00
Automobile Liability
Hired Autos & Non-Owned Autos
Arch Insurance Company
$5,000,000.00
Policy Number
12 EMP43513 00
Policy Number
1142280
Policy Number
11CAB58237 -00
ENV IRONMENTAL, INC.
Expires
09 /30/10
02 /28 /1 1
01 /15/12
01 /31 /11
Expires
02 /05 /11
02 /05/11
09 /02 /1 1
01 /25/12
Expires
02 /03 /1 1
Expires
02 /25 /1 1
Expires
02 /06 /1 1
Excess General Liability, Additional Insured and Waiver of Subrogation insurance is
available upon request.
Bid Docume nt s/Sp ec ific /SOQ -Asb &Demo
St ate m ent of Qu al ifi cation s
Page 7 of 7
Additional References :
Bank References:
Mansfield Community Bank
l 700 East Broad Street
Mansfield, Texas 76063
Mr. Chuck Wilson -(817) 453-7053
Credit Rating Information:
Dun & Bradstreet
Rating: 3A 1
Credit Score Percentile : 90%
Paydex: 80
Duns# l 43048119
Client References :
Mr. Roger Grantham, City of Fort Wo r th
Mr . Larry Gilbert, Texas Dept of Transportation ; R.O.W.
Mr. John Flippen, University of North Texas Housing
Ms. Lynda Hutson, University of North Texas Facilities
Mr. Sam Peacock, City of Dallas Love Field Aviation
Ms . Melanie Rhea, Richardson ISO
Mr. Dave Casey, Richardson ISO
Mr. Mark Smith, Lockheed Martin Fire & Missile
Mr. George Reid, Fort Worth ISO
Bid Documen t s /Specific /SOQ -Asb&Demo
( 81 7) 3 9 2 -8 5 9 2
(214) 320-6255
(940) 565 -4837
(940) 369 -7345
(214) 670-6654
(4 69) 593 -0044
(469) 628-1 770
(972) 603 -7288
( 81 7) 8 71 - 3 2 9 3
ENVIRO NM ENTA L . INC.
j~~~~:0
~-01117) TEXAS SALES AND USE TAX PERMIT
This permit is not transferable, and this side must be prominently displayed in your place of business.
YOU MAY NEED TO COLLECT SALES AND,OR USE TAX FOR OTHER LOCAL TAXING /VJTHORIT/ES DEPENDING ON YOUR TYPE OF BUSINESS.
If you have any questions regarding sales tax, you may contact the Texas State Comptroller 's field office
in your area or call 1-800-2 52-5555, toll free, nationwide. The Austin number is 512/463-4600.
Response to Section 2 .5 .3
*Texas Sales / Use Tax Certificate
*Certificate of Good Standing
, ... ~<;& i~' ~.~ •u.•
TEXAS COMPTROLLER OF PUBL IC ACCOUNTS
S USAN CO MBS •C O M PT ROLL ER• AUSTIN. Tl:.XA S 78774
June 8 , 20 10
CERTIFICATE OF ACCOUNT STATUS
THE STATE OF TEXAS
COUNTY OF TRAVIS
I , Susan Combs , Comptroller of Public Accounts of the State of Texas , DO
HEREBY CERTIFY that according to the records o f this office
INTERCON ENVIRONMENTAL, INC.
is , as of this date , in good s tanding with this office having n o franchise
tax reports or payments du e at this time. This certificate is v a l id thr o ugh
the da t e tha t the next franc h ise tax report will be due May 1 6, 2011.
This certificate d o es not make a representation as to the status of the
entity 's registrati o n , if any , with the Texas Secretary of State.
This certificate is valid for the purpo se o f conversion when the conv erted
entit y is subject to franchise tax as required by law . This certificate is
not v alid for any o ther filing with the Te x as Secretary of S t a t e.
GIVEN UND ER MY HAND AND
SEAL OF OFFICE i n the City of
Aust i n , this 8th day of
June 2010 A .O.
Susan Co mbs
Texas Comptroller
Ta x pa y er number : 15 22 4377745
File number: 0800 2 8 83 6 1
Form 05 -304 (Rev . 12-07 /1 7)
,-
Respon s e to Section 2 .5 .3
*Texas Sa le s I Use Tax Certifi c ate
*Ce r tificate of Good Standing
ENVIRONMENTAL, INC.
2 10 S W a lnut C r eek Dr iv e. Ma nsfi e l d Te x a s 7 6 06 3. T e le p h o ne (8 17 ) 477-9995 . Fa csi m i le (8 17 ) 477 -9996
m ai l @i nte r c on-e n v i ro n me nta I. c o m ww w . i n t e r con -e n v i ron m e nt a I . co m
l . Project Information :
Client / Owner:
Contact Information:
RESPONSE TO SECTION 2.5.4
PROJECT REFERENCES
Various Facilities, Fort Worth, Texas
City of Fort Worth
l 000 Throckmorton Street
Fort Worth, Texas 76102
Roger Grantham, Env i ronmental Program Manager ; (81 7) 392-8592
roger_grantham@fortworthgov .org
Completion date : On Going
Contract Information: 6 -yr Annual Asbestos Price Agreement, Cowtown Inn, Var i ous Contracts
Contract Information: Billed to Date : $1,645,740.26
Consultant Information : IHST Environmental, Inc.; (972) 478-7415
Scope of work: Removal of asbestos-containing sheetrock , fireproofing, floor tile & mastic, t hermal pipe
i nsulation and thermal pipe fittings.
2. Project Information :
Cl i ent / Owner:
Asbestos & Demolition of Vickery Corridor for Right-of-Way (SH 121 ), Fort Worth, Texas
City of Fort Worth
l 000 Throckmorton Street
Fort Worth , Texas 761 02
Contact Information: Roger Grantham, Environmental Program Manager; (817) 392-8592
roger_grantham @fortworthgov.org
Completion date : 06 /09
Contract Information: Con tract Amount: $1,844,554 .78
Consultant Information : IHST Environmental, Inc.; (972) 478 -741 5
Scope of work: Removal of asbestos -contai n i ng materials and demoliti on of 39 parcels.
3. Project Information:
Client / Owner:
Oak Hollow & Villa Del Rio Apartments, Fort Worth , Texas
City of Fort Worth
l 000 Throckmorton Street
Fort Worth, Texas 76102
Contact Informati on : Roger Grantham, Environmental Program Manage r; (8 1 7) 392-8592
roger.grantham @fortworthgov.org
Comple t ion date : 05 /08
Con t ract Infor mati on : Co ntract Amount: $1, 534 ,772 .39
Consultant Informat i on : IH5T Env i ronmental , Inc.; (972) 478-7415
Scope of w ork: Apartments: Removal of asbestos-contain i ng sheetrock, floor t ile & m as t i c, ce ili ng t exture,
and l i noleum ; demolition of 35 two-story apartm ent build i n g s.
Asbestos A b ate m e nt & Dem o li tion Proj ects
Asbestos Abatement & Demolition Projects
Page 2 of 2
4. Project Information :
Client / Owner:
Contact Information :
Completion date :
Contract Amount:
Scope of work:
5. Project Information :
Client / Owner:
Contact Information :
Contact Information:
Completion date :
Contract Information:
Consultant Information :
6-County Abatement / Demolition Pr ice Agreement, Dallas Di str ict
Texas Department of Transportation
P.O. Box l 33067
Dallas, Texas 75313-3067
Attn : Right-of-Way Section
Mr. La r ry Gilbert, Right-of-Way Agent ; (214) 320-62 5 5
lgilbe l@dot.state.tx.us
On Going
$7,175,000.00 / Billed to Date : $6,074 ,557.08
Asbestos abatement & demolition for the Dallas District.
Various Facilities, Denton, Texas
University of North Texas
P.O. Box 31 l 040
Denton, Texas 76203-1040
Lynda Hutson, Scheduling Coordinator -Facilities ; (940) 369-7345
hutsonl@unt.edu
John Flippen , Project Coordinator -Housing ; (940) 565 -4837
jkf@hsl.admin.unt.edu
On Going
On-going 6-yr Annual Price Agreement / Billed to Date : $1,608,082.59
SW GeoScience; (214) 350-5469 Ext 206 ; REC, Inc.; (972) 385-4535
E N V I RO N M E N T A L , I N C.
Scope of work: Removal of asbestos-containing sheetrock, fireproofing, floor t i le & mastic, thermal pipe
insulation and thermal pipe fittings .
6. Project Information:
Client / Owner:
Contact Information:
Completion date:
Contract Information:
Consultant Information:
Scope of work:
7. Project Informati on :
Client / Owner:
Various Facilit ies, Tarrant County, Texas
Tarrant County
l 00 East Weatherford, Suite 303
Fort Worth, Texas 76196
Danny Roberson, Senior Contracts Administrator; (817) 884-1141
dwroberson@tarrantcounty.com
On Going
Asbestos & Demolition Projects / Billed to Date : $542,814.99
ERi Consulting, Inc.; (81 7) 5 60-1 61 3
Removal of asbestos-containing sheetrock, floor tile & masti c, thermal pipe insulation and
thermal pipe fittings.
Lockheed Martin Fire & Missile Control, Grand Prairie, Texas
Lockheed Martin Fire & Missile Control
P.O. Box 650003, M /S: LOl -11
Dallas, Texas 75265-0003
Contact Informati on : Devan Miller, Field Engineer; (972) 603 -9504 ; De n nis Stephens ; (972 ) 603-9503
devan .miller@lmco.com
Contract Information : On-going Annual Price Agreement / Billed to date : $262 ,064.34
Consul t an t Information : ERi Consulting , Inc. / (817) 560-1613
Scope of wo r k : Removal of asbestos-containing sheetrock, roofing , f i r eproofin g, ce ili ng t i le, floor tile &
mastic, thermal pipe insulati on and the r mal pipe fittin<1s.
Asbes t os Abatement & Demolition Projects
ENVIRONMENTAL, INC.
210 S. Walnut Creek Dr i ve. M a nsf ie ld T exa s 76063. Telep h o n e (8 1 7 ) 4 77 -9995. Facs i mil e (817) 477-9996
Position Title Name
&Job
Function
President Karen Andrews
Vice President Jerrold Andrews
VP Operations Fernando Avila
VP Field Byron Davis
Operations
Demolition Sales Bob Mcfadin
Manager
Asbestos Project Jose Contreras
Manager
Demolition David Dunham
Project Manager
Asbestos Hector Medina
Supervisor
Asbestos Eulogio Torres
Supervisor
RESPONSE TO SECTION 2.5.5
CONTRACTORS STAFF MATRIX
Tasks Certifications / Licenses
www . i nte rco n-e nv i ron me nta I . com
Total Years Length of
Experience Employment
Operations Bachelor of Science in Biology 18 years 6 years
with a minor in Chemistry;
DSHS Lead Abatement
Supervisor
Operations & DSHS Asbestos Abatement 19 years 6 years
Safety Supervisor and Mold
Remediation Supervisor
Operations, Safety, DSHS Asbestos Abatement 23 years 6 years
& Project Supervisor
Management
Operations, Safety, DSHS Asbestos Abatement 19 years 3 year
& Project Supervisor
Management
Operations, Safety DSHS Asbestos Abatement 36 years 6 years
& Project Supervisor, Class A CDL
Management License
Project DSHS Asbestos Abatement 23 years 6 years
Management Supervisor
Project Class A CDL License 23 years 4.5 years
Management
Project Supervision DSHS Asbestos Abatement 23 years 6 years
Supervisor
Project Supervision DSHS Asbestos Abatement 26 years 4.5 years
Supervisor
i
See Tab 3,
Section 2 .5.4
2.5.6. Bidder sha ll provide at least four (4) project references similar in scope and size to
that of this Solicitation . Each project reference shall include t he following information:
• Company's Name
• Name and Title of Contact/Project
for this information. • Email, Phone, and Address of Contact
• Contract/Project Value
• Brief Description of Service Provided
2.6. Contractor Submittals
Bidder shall submit the following items included in this bid submittal, in the same order as
listed, following this page, bound within the response .
2.6 .1. Project Schedule: Contractors shall provide a project schedule that includes all
major tasks pursuant to the Scope of Work and Specifications. The project
schedule shall show all tasks in the left most column and their duration shall be
plotted horizontally versus time . A time scale shall be selected so that the
complete duration of the project can be shown on paper with a maximum
dimension of 11" high by 17" wide. The project schedule must be submitted with
the bid. During the term of the contract the Contractor shall submit monthly project
schedules showing planned work and actual work accomplished.
2.6.2. Schedule of Values: Progress Payments will only be made after completion of those
tasks and/or subtasks identified on the Project Schedule and Schedule of Payments .
Progress 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
receipt of final project completion documentation, final project payments will be
approved. Final payments will not be approved until project completion
documentation has been submitted to and approved by the City of Fort Worth.
2.6 .3. Provide a sample invoice and sample project closeout documentation.
2.6.4 . Provide an organization chart that details the communication channels between the
Contractor and City of Fort Worth personnel for this contract.
2.6.5 . Provide an organizational health and safety plan. A site-specific health and safety
plan (HASP) will be required and daily safety briefings will be mandated and recorded
in the HASP, which is subject to City inspection.
2-13
�
r
ID Task Name
1 ABATEMENT - -
2 DEMOLITION
3 South End Bidg 1
4 Demo Mobilizes to Site
5 Install Erosion Control
6 Install Security Fence —
7 South End Bldg 1
8 South End Bldg 2
9 South End Bldg 2
10 South End Bldg 3
11 South End Bldg 3
12 South End Bldg 4
13 South End Bldg 4
14 South End Bldg 5
15 South End Bldg 5
16 South End Bldg 6
17 South End Bldg 6
18 North End Bldg 1
19 North End Bldg 1
20 North End Bldg 2
21 North End Bldg 2
22 North End Bldg 3
23 North End Bldg 3
24 North End Bldg 4
25 North End Bldg 4
26 North End Bldg 5
27 North End Bldg 5
28 North End Bldg 6
29 North End Bldg 6
30 North End Bldg 7
31 North End Bldg 7
32 South End Ret. Walls &
Sidewalks
33 North End Ret. Walls &
Sidewalks
34 South End Parking
35 North End Parking
--- -- _ _
36 Dirt Work
37 Rough Grade North End
38 Rough Grade South End
39 Install Hydro-mulch &
Irrigation
City of Fort Worth
Granbury Hilis Apts DEM 10-08 GHA
5250 Wonder Drive, Ft. Worth, Texas
Intercon Envioronmental, Inc.
210 S. Walnut Creek Drive
Mansfield, Texas 76063
Duration 5, '10 Sep 12, '10 Sep 19, '10 Sep 26, '10 Oct 3, '10 � Oct 10, '10 Oct 17, '10 Oct 24, '10
M T W T F S S M T_ ) W_ T__F S S M T W T F S S M T W T LF S S M I T 1 W) T I F S I S I M I T I W_I T I F I S S I M I T I W I T I F I S S I M I T I W I T I F
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� Deadline �j
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Date:
Project:
EN VIRONMENTAL, INC.
A B
Item Description
Number Item
Asbestos Abatement
1 12" x 12" Floor Tile & Associated Mastic
2 Black Mastic on Concrete Floor
3 Sheetrock & Joint Compound, Wall & Ceiling Texture
4 TSI -Black Tar Wrap
5 Texture on Brick
6 Popcorn Ceiling Spray -On Texture
7 Mobilization Charge
8 Demobilization Charge
Demolition
Demo of improvements including clean -up and
disposal of single and up to three-level structures,
9 Including footers, beams, piers, and slabs
Removal of concrete and asphalt -patio, parking lot,lnterior
sidewalks, and grading of site (perimeter drives, curbs, and
10 streets will remain)
Removal of misc. items, wood, metal fencing, p la yground,
11 misc. debris
Prepare and implement a Storm Water Pollution
Prevention Plan, installing and maintaining all BMPs,
establishing vegetation, and removal of BMPs upon
12 completion.
Mobilization/demobilization fee (Includes
disconnect, equipment, generators, traffic control,
13 etc.)
...... Page Total
Schedule of Values
07/01/10
PROJECT: DEM 10-08: GHA
Granbury Hills Apartments
Removal of Asbestos-Containing Materials and
Demolition of Structures
5250 Wonder Drive, Fort Worth Texas
C D E F G
Quantity Type Rate Schd Value Previous
Total Application
1 Lump $16,175 .19 $16,175.19 $0.00
1 Lump $577 .50 $577.50 $0.00
1 Lump $271,122.43 $271,122.43 $0.00
1 Lump $26,448.00 $26,448.00 $0.00
1 Lump $15,557.03 $15,557.03 $0.00
1 Lump $63,918.80 $63,918.80 $0.00
1 Lump $0.00 $0.00 $0.00
1 Lump $0.00 $0.00 $0.00
59,000 SF $1 .95 $115,050.00 $0 .00
87,555 SF $0.85 $74,421 .75 $0.00
1,000 CY $10.00 $10,000.00 $0.00
1 Lump $4,056.15 $4,056.15 $0.00
1 Lump $750.00 $750.00 $0 .00
........ ...... . ..... $125,050.00 $0.00
H
This Application
Work in place
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
page
Application Number:
Period to:
I J K
This Application Total Completed
Stored Materials and stored to date %
$0 .00 $0.00 0.00%
$0.00 $0.00 0.00%
$0.00 $0.00 0.00%
$0.00 $0.00 0.00%
$0.00 $0.00 0.00%
$0.00 $0.00 0.00%
$0.00 $0.00 0.00%
$0.00 $0.00 0.00%
$0 .00 $0.00 0.00%
$0.00 $0.00 0.00%
$0 .00 $0.00 0.00%
$0.00 $0.00 0.00%
$0.00 $0.00 0.00%
$0.00 $0 .00 0.00%
1 of 1
One
07/01/10
L
Balance to
Finish
$16,175.19
$577.50
$271,122.43
$26,448.00
$15,557.03
$63,918.80
$0.00
$0.00
$115,050.00
$74,421 .75
$10,000.00
$4,056.15
$750.00
$125,050.00
M
Retainage
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
ENVIRONMENTAL, INC.
210 S. Walnut Creek Drive. Mansfield Texas 76063. Telephone (817 ) 477-9995. Facsim i le (817) 477-9996
www . i ntercon-environmental . com
2.6.3
SAMPLE CLOSEOUT AND INVOICE
dntercon
210 South Walnut Creek Drive • Mansfield , Texas 76063 • Phone : (817) 477-9995 • Fax: (817) 477-9996 ENVIRONMENTA L, INC.
www.intercon-environmental.com
PROJECT CLOSEOU
Consultant:
Prepared for:
CLIENT /OWNER NAME
CLIENT /OWNER ADDRESS
DATE OF CLOSEOUT
ENVIRONMENTAL, INC.
Table of Contents
1. Invoice
2. Notification
3.
4. Project Record
5.
i. Daily Logs
ii.
iii.
Me ical Surveillance of Asbestos Exposure
Or RFCI certificates
exas DSHS Contractors License
7. Texas DSHS Transporter License
8. Waste Manifest (if applicable)
j
.;•'
tercon
ENVIRONMENTAL, INC.
210 S. WaJnut. Crr,ek Drive, Mansfield, Texas 7606a
Tel ephone (817) 477-99 95 -Fw.,-simile (817) 4-77-9996
R ill 'ro
P.O.No.
Description
Invoice
Date lmoicc #
Amount
Total $0.00
-tc* 4
I*~~~. • TEXAS ...... Ti Department of
Ill( ' State Health Services
ASBESTOS/DEMOLITION NOTIFICATION FORM =======
TYPE OF NOTIFICATION: (Select one and fill in the requested i1iformati01i)
!ZI ORIGINAL D AMENDMENT No. __ N"""'/_A __
0 EMERGENCY
0 CANCELLATION
•Was emergency request made to the Regional Office or Environmental Health Notifications
0Yes0No
•If yes, the DSHS reference #:_N_/_A ____ _
N/A
D ORDERED: (For structurally unsound facilities, attach copy of demolition order and identify Gov":ni
Name: N/ A Registration No . ..:.N"""' 7},:.,;14.'--"',::'=:":r"------...,;:,,.-
(I)
Below it
Amended
Title: _N..:.../A __________________ --='"""",,-----'-,-'=,....,,,----~'-='-
Date of order (MM/DD/YY):_i!_/ .. A../_
TYPE OF WORK
~ Asbestos Abatement D Demolition D Annua
Is this a phased project? D Y es !ZI No
FACILITY INFORMATION
1. Facility Location
D ....... Description or Facility Name:---~-~-=---,.,...,,,-~---------------------
D ....... Physical Address: -------=-"'"'t:--.----'-'~:-::.------=c-:-----------------0 ....... County:__________ ----'-~--------Zip: ______________ _
0 ....... Facility Contact:---,.----,",...,,..------~-.# ) ----------------
3. Facility Details
D ...... Descriptio,f<fr-Xrea£R_oom Num r: -----------------------------0 ...... Age of Building: ___ Size: Number of Floors: ___ _
D...... Is this building occupied?-{] Yes ,
0.:"!!f.: PriotUse:•.;;,·~~~~=·"~.+.......!~----------------------------
0 ...... Future Use=-----~-------------------------------0 ...... Date of Asbestos SurveyfNESHAP Inspection :_/_/_
0 ...... DSHS Inspector Eicense-o.:~--~~-
0...... Analytical Method : @ PLM D TEM D Assumed Asbestos D No Suspect Material
0 ...... DSHS Laboratory License#: _____ _
WORK SCHEDULE/ ASBESTOS AMOUNTS (Note: if the start date(s) entered below cannot be met, the DSHS Regional or Local
Program offiu nmst be notified prior to the scheduled start date. Failure to do so is a violatio11 of T AHP A Section 2fJ5.6L)
1. Asbestos Abatement Work Schedule:
D ...... Start date: / / and End date: / /
0 ...... Workdays: 0Mon~0Tues. 0Wed. 0Thurs~0Fri. 0Sat: Osun.
O ...... Working hours: D a.m . D p.m. to _________ Oa.m. Op.m.
2. Demolition Work Schedule:
O ...... Start date: N / A / and End date : N / A /
O ...... Workdays: 0Mon~0Tues. Owed. 0Thurs~0Fri. 0Sat. 0Sun.
O ...... Working hours: N/A Dam. D p.m. to _N_/A ________ Oam. Op.m.
FORM APB #5, REV 5/07
(.1.)
Below if
Amended
C. ASBESTOS AMOUNTS
D ...... ls Asbestos Present? !8[ Yes D No (Complete t/ie 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
o ......
o ....... 3.
PROJECT INFORMATION
0 ...... A.FACILITYOWNER
demolitioa
demolition
Approximate amount of
Asbestos
Pipes Surface Area
Ln La SQ
Ft M Ft
0 ...... C. ASBESTOS ABATEMENT CONTRACTOR #2 (Only if there is more than one Contractor)
DSHS Asbestos Coq _ ctor License#: _N_/_A _____ _
Contractor Name: N/ A -----------------------------------Address : N/ A :---------------,--------------------------City: _N_/_A ___________ State: _N_/A ____ Zip: _N_/_A _____________ _
Office Phone #: ( ) N/ A Job-Site Phone #: ( ) N/ A
D.ASBESTOSSUPERVISOR
D ...... DSHS Supervisor License #: _____ _
D ...... DSHS Supervisor License#: _____ _
FORM APB #5, REV 5/0 7
Site Supervisor:-------------------
Site Supervisor:-------------------
(x)
Below if
Amended E. NESHAP TRAINED INDIVIDUAL
O ...... NESHAP Trained Individual:------------------------------
Certification Date: _!iJ _A}_
0 ...... F. DEMOLffiON CONTRACTOR
Demolition Contractor: __ N_/_A ____________________________ _
Address: _N_/A __________________________________ _
City : N/A State: N/A Zip: _N~/A~ ___ Phone #: ( ) N/A
0 ...... G. PROJECT CONSULTANT OR OPERATOR
DSHS License No.: _________ _
Project Consultant or Operator:-----------------------------
Address: ___ -'----------------------,----------,-s-=~------City: __________ State: Zip : ____ Phone #: (
D ...... H. Waste Transporter
DSHS Waste Transporter License#: 40-0336
Waste Transporter: lntercon Environmental Inc.
Address: 210 S. Walnut Creek Drive
City: Mansfield State: TX Zip:-"--':...::...::-=------A--------~-=:;,::....----
Contact Person: Jerrold Andrews
O ...... I. Waste Disposal Site
TCEQ Pennit #: _1_0_25_8 _______ _
Waste Disposal Site: -=D...:..FW.:...:...._L::...:a_n...:..d-'-fi...:...11 ________ .,..c...;!'-----'r-'!-------''=""'~:;,::...---------
Address: 1600 Railroad Street
City: Lewisville State: ]2L_
Phone #: ( 972) 315-5421
Date: __ ! __ ! __
(Printed Name & Title)
Phone #:
IMPORTANT INFORMATION
NOTIFICA . ON TIMELINESS REQUIREMENT:
Your Asbestos1De -&hion Notification form must be postmarked no less than ten working days (not
calendar days) prior to the start of any asbestos abatement or demolition.
FILJNG FEE: An invoice w ill be mailed to the faci li ty owner upon completion of the project.
CALL FOR ASSISTANCE: (512) 834-6747 or (888) 778-9440 (toll free in Tex as)
MAIL FORM TO: ENVIRONMENTAL HEAL TH NOTIFTCA TIONS GROUP
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
PO BOX 143538
AUSTrN, TX 78714-3538
FORM APB #5, REV 5/07
.;r.
Project Name!.__ _____________ __.
te rco n ProjectNumberL...-...-----------'
ENVI RON MENTAL, I NC. Shift Supervisor '---------------~ DAILY PROJECT LOG.
Activity
.. ,.
Date C.__ _________ __,
Shift
Today's Work Areas
Consulting Firm
On Site Representatives
Site Inspections
Yes No
INTERCON
TDH
D
D
D
D
D
D
Received Removed
Dumpsters Today! I
Dumpsters To-Date 1-.... -_ -----------+-.... =======
Daily Project Log Shift Supervisor Signature ====================
·~i Project Name
~'n ercon Project Number
ENVIRONMENTAL, INC.
Shift Supervisor
DAILY TIME SHEET
C:r\imeln Employee
~. A .\ )'
\\ f)
1
2
3
4
~ ~
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
-~
'vY
'
.
-i
I~ f 1:,
¥~l
~'
Time Out Time In Time Out
(f
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' l~l -= ~~tX
.~ 'Y ' ..
f,;P -· //' )\ ,?v 7fl" ~---/:-t:Y\_~
'< ~
y:;
~
Daily Time Sheet Shift Supervisor Signature
Date
Shift I
Day
Total Safety Meeting Topic
Accidents or Incidents Today
New Hires Today
)\
C} "' ·7 ,Ay \. .
AV
/
~ ' ' "' .... ~ 'P ~
~. ll.<
Percent Complete
1'-Total Hours Today
~
Total Hours To· Date
Project Budget Hours
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2 0
ENVIRONMENTAL, INC.
CONTAINMEN T LOG
Employee
Containment Log
Project Name ,__ ______________ _
Project Number ,._ ______________ ___,
Shift Sup_ervisor
Socia(<':\~. Time In Timeout Time In Time Out
/f ~~\ //
"''\ l ; ~ -"" ~ i~/ ~~ ... . ~ ,t./ ,r '-... )l ~,)
" If/ 1#'£1
'<\'-_,Jr 1:1 -'""' "'. ll~ ~...tJ.-"'.1.':' ' ~r'Y +-
~ /7 A A •
~ V ~ V,\
"' /:.? .... _./"1
'"r ~
' A
.._A/
"" '
Shift Supervisor Signature
Pers
D
D
D
D
D
D
'
D
D
D
~D
Cl
D
D
Date ,__ _____________ __.
Shift
Day ______________ __.
Containment Area
onaf Protection Equipment Used
Steel Toe Rubber Boots
Single Tyvek Type Sult
Double Tyvek Type Sult
Cotton Gloves
Rubber Gloves
1/2 Face Respirator I HEPA FIiters
Full Face Respirator !HEPA FIiters
PAPR Respirator I HEPA Filters
Ea r Plugs
O~er ________ _
.. · · J"exas Department of
:-State Health Services
license No. 804201 -·
Control No. 95798
Expir tion Date:
GEBCO ASSOCIATES
in cooperation with
HE UNIVERSITY OF NORTH TEXAS
certifies that
Asbestos
• President
Date of issue : 01/04/10
Certificate Number: 10013 4839
i
_!
i
I
1
I
J •
:
! ...
' '.
FEB/05/2010 /FRI 10:50 AM
..;:*~
~~TEXAS IL.... I : nepartmenr ct ,.._ l , State Health Seiivic:es
l!!"Y{,tdh.state.tt.ps/bebfasbestos
Physician'-s Written Statement
Medical Smveillance for Asbest~ .Exposure
Envmmmcntal &. Sanitation Lirensing Group
800/572-5548 or:512/834-6600
· F11Ct: 512-~6614
C-tty . . Sm:tt:
. . .
P. 002 /004
· lNl>lCATE WBlCR ITEMS WERE PERFORMED ·wrra.PHYSICIAN'S-0 ;ASSISTANT'S lNITIALS:
(Anytbat _are not-appll~ nmst still be :initialed offin.addition:t.othe N/·
Tue above-named individual was s~ on o Z "d .0 Zall)
rr__
S7
5,J_
>) The employee~ :i:nfonned by the ph~ of the reJUJ.ts of the ~ and of any medical amditibIJS 1hat may UJSUlt from
asbestos exposure incl!iding the inr;reased iisk oflnng cancer attn~le to the combined effect of smo~ and asbestos
exposure.
Unless otherwise noted below, · aialoatiok · · that no medical conditions were detected 1imt ~ould place the employee at an
:increased risk of material ~ imp_p:mcnt~ from exposure· to asbe~s, and no limitrlions are :reeo~dcd on the employee
concemmg the me-of personal prqte /.• e equip~ or ~r. By~ this form, l aclmowledge that flri.s .e::nrrrination has been
performedw~~ with eithei.29 (?R.1926.1101 or40 CFR 763.122(a), as required. IDl!!IOOgaope)epa!U
Jose G. Trevfio, M.D.
3141 Irving B1vd,Suite220 DaUas TX .. -City
OZ8£°1£9'1'17::xeJ
ttIF8&9.HZ:1111
DZ5L n 'S2!Ji0 ezz ~ 'JIA!B Juin q ttlt
Jell~ .nm~psw
~14 630-1144
75247
Zip
l PRIVACY NOTIFICA.TION; NOTIFICACION soaRE PRtVACJDAD I
With tsw exceptions, you have n-ie tight to ·request aru, De lnfonned about information ttiat the State of. Texas i:;oBecto l;lbOtJt you. You am antltled to
~eelve and review 1he informetion upon raguel;IL YOll a!l;o hav& the right to ask the s!ma agency to correc:t any infonnation 1hat ls detannlned to bl!!
!nc:orrac:t. See http://www.dr,hs.$fe.bt:,u5(for more infoilnallon on Privacy Nolffic81ion.. {Refetenca: Govemar Coda, Section 552.021, 552.023, 559,003
· and 559.004) ·
Tan solo por unas cuantas GXCapclones, usted tlene 81 derecho de solicitor y de ·ael' lnfonnado sobre ~_infomliician que bl &iarlo de Ta~ l'8Un8 sobre
usted. A u~ se le ~~ conceder el derecho de recibit y reviser la lnfonnaci6n _al reqUerlrla. Ustl!ld 1ambl8n tiime el ~ de pedlr que la agencia
8l;1;atal comJa cualquier informaclo que se ha determinado sea irn;:orrecta. Dlrijme a htip:Jlwww.dt1h$.slaft.tx,us( para mes informecion sobrn la
Notfficacion sol)re pnvacicad. (Refen;incia: Sovemment Coae.._seccion 552-021, 552.023, 559.003 y 555.D04.)
Revised May 2008 Publlcation # F1S.11669
t
ENVIR ONMENTAL, INC.
210 S Wa l nu t Creek D ri ve. M a n s fiel d , Texas 76063 . Telep hone (817) 477-9995. Facs i m i l e (8 1 7) 477-9996
Employee Name:
DSHS License Number:
Respirator Type:
Respirator Brand:
Respirator Size:
1.
2.
3.
4.
5.
6.
7.
Respirato r Fit Te st
_/ ;;sc. C{.?/l fY crc .. ~
?{{) ·-'-/<LO (
Half-face
www.in1erco n -environ me ntal .co m
Yes ,.
i P(
~
L
_/
./ _7 ,,......
7
No
These items are my l?-~a::sonal responsioility;. If I lose any of t his equipm e n t or negligently
damage any, I will ref"-qrse..Intercon E vironmental, Inc. the full list p rice for each article
lost or damaged. · ·
·-OSHA Regulations (Standards -29 CFR)
1910.134(f}(2) The employer shall ensure that an employee using a ti ght-fitting facepiece r e sp i rator is fit
tested prior to i nit ial u se of the resp i rator, whenever a different respira t or faceple c e (s ize, sty le, model or
make) is used, a n d at least annual ly thereafter. .
1910.134(f}(3) The employer shall conduct an add it iona l fit test whenever t he employ ee ref)orts, or the employer,
PLHCP, supervisor, or program administrator makes vi sual observations of, chang es i n the employee's ph y sical
cond it ion that co uld affect respirator fit. Such conditions i nclu de , but a r e not limited to, f ac ial scarri ng, denta l
changes, cosmetic surgery, or an obvious c hange i n body w e i g ht.
:
.I_
t
r
r
r
r
r
Inter-con Environine:ntal, Inc.
Project N ame ____ _ Date ·---------------------·-·--
Projec.t Address
'\VORKING \VITH ASBESTOS CAN BE Dr~'l'GEROUS. INHALING AS ESTOS FIBERS HAS
BEEN LINKED 'W1TH VARIOUS T YPES OF CANCER. IF YOU SivIO ,.. ~ AND IN HALE
ASBESTOS FIBERS THE CHANCE THAT YOU \VILL DE"VECOP LU1·G CANCER IS
GREATER Tfllu'\T THAT OF THE NON-Siv!OKING I'lTBLIC.
Respiratory protection
Use of protective eq1..1ipment
Pressu r e D iffer Mal ysterns
JvfEDICAL EXAMINATIOl.,: 1 have h~d a medical examination \V!thin the past 12 months a t no co.s1 to
,ne. This cxaminanon-m 1t.1ded: health history, pulmonary function tests and may have i ncluded an
evaluation of a chest x-ray.
13 v s ignb1g this document I am ackncn:vlede:in~ onlv that rh.:: Ov.:r:er o f the builc.Enf! I .am about to vrnrk in
,.; ._.. -...... .... ., -
has advised me of mv r ights to training 2.nd orotcclion r elative co rnv cmDl.ove r , fotercon Environmental -....... ...,.. . ... --· ~
l:1c .
' ,,.
tr
HECTOR MEDINA
Lecense No. 804027
Control No. 95799
Expiration Date: 07/27/2010
GEBCO ASSOCIATES J in cooperation with
HE UNIVERSITY. OF NORTH TEXAS
President
Date of issue: 08/31/09
Certificate Number: 09238 1341
certifies that
JUN /27 /2009/SAT 12:38 PM
· · Depilrtment o:
¥ \ Sare Heaith Servi-ce.~
1
v"Jw•,;;•_ttlh.~to t;1:_!.!5/banfa~b2sto,
Physidan 1 s Written Stateme~f
Medical Su:rveillarrce for Asbestos Exposure
· En vironmental ~ S:miration-Lic=nsirrl! G,oup
S00/572-5548 or 511/834-6600
Fax: 512-834-6614
63:S 03 f 3 c/ I
Social Security¢; DateofBirm
INDICATE ~iBJCH l'i'EMS WERE PERFORMED WIT'H.PEYSICLA,_~'S
P. 002
9J /o;} v
ill
ymess ofa~{ise n"oi:e_d ~ei~~'= ~\~ aJ.1:12-uon · _ "ciicates fu2.! no medical conditions w~~e _det~cted tbE! would pl~e :the employe:;: ~ an
mvr~a.sed ns·,~ macerntl neal.tn mipaii-m~m Irom e1.1)osure to asbestos, and no um1rc.nons are recommended O):: fue ~ployee
concern.in~ tl:!.e us~ of u=;;omtl nmi:eccive eaummem o:r resDii-ai:oL B,, simrin~ this fortn.. I .acknowleri!';e ibB.t fuis e~ation has b~n
p~-io:mied accor;ianee-wfti'r'ert..he! i"-6R 19:Zo.llOl o,40 CFR 763.El(a), a; ,equireci.
Jos~ G . "Trevmo. MD
Prim Pilysi::ian's N~
314J lrvin2:Bi vd
City
PR.IVACY NO'ilFICATJOf'1 ! NOTIPICACION S0!5~= ?R.IVACIDAO t .
Vv-fth. fucw excep~or.s '. yo_u _r.2.vc _!h;, right to raqu:st and b2 inronn3d .,bout irrform;;tion "t hat the State of Texes c:ol!S!~ 'fi!(Manl~ .. i-e enmled t o
:5ce1vs 2nd rsv12w •"= m,ormauon upon request. You a!so hi;ive tns right to ask ths stat= l!!g2ncy to -:::orr2d ~y il'lfor.nation·"l:~lf~inar::! to b2
1m::;orr=~:.. See /;lttzi:Jiwww.dshs.sta• ... tx.us/for more iniorrr.a,ion on !='rivacy Notfficatlon. (Reference : Governor CDde, Sec:tlon e:52 .021 .'~52.023, i;:59,0 03
an~ 5;i::l.004)
T~n solo .por unas cuan~s a~ap::::ion;:;;, usad fi~n= 21 d;;racho da soficii:or y da s:er in fol'l7!ado sobre la informaicion-cus s ! ;;.stado c!e Texas reCme sob;;;
usted. A usted se· le de::ie ccma:iEr sl dare=ho d.; r;c;ioir y f:!vi;;;:r la inforrn3cion al requ!:rlrla. l.!sted tambi~n ti!;!~-~ ds~cho de pedir que la agencia
ss.:a::al corrU;;; cual.;iula, lnforrn.;cio qus se h<i d<,ierininacic seca incorF-c;;ta Dirij3sa a nfi'DY!www.dshs .stem;.p..µsl o;::r: mas inforrnaci6n soore :2
t\l:,~,...::.f">iAn ~""h:-c. nrl\.-~,...;~~~ /~='=~,.,:-~=-· t:n1r.:;1t'T'ITTT.:::::anf-r.,.,..f= c::c::u-r:iAn F;Fi? n?1 .F:~7 n,~ ~:=iA nn.1 y .!::5fLOD4..l ,,_.
f,•
t
ENV IR ONMENTAL, INC.
210 S Wa l nut C ree k Dr ive Mansfield, Texas 76063. Telepho n e (817) 477-9995, Facsimile (817) 477-9996
www. in tercon-envi ro n menta I . com
Employee Name:
DSHS License Number:
Respirator Type:
Respirator Brand:
Respirator Size:
1.
2.
3.
4.
5.
6.
7.
Question
Respirator Fit Test
bl EC .TOE?,, .. fV\ ED l N A
Half-face
North
Medium~r9
, (circle
No
t/
These items are my P . r~onal respons1}?Jl ~ If I lose any of this equipment or negligently
damage any, I will rei' · urse.,lntercon E \ii ronmental, Inc. the full list price for each article
lost or damaged. ·
Test administe· e)Pby k sc Ct,/1 tt'c.«r. s Title Supervisor
I am experienced in the administration of proper fit tests.
If /zL/ /b9 Date of fit test ____ ....,.. _____ _
OSHA Regulations (Standards -29 CFR)
1910.134(f}(2) The employer shall ensure th at an employee using a tight-fitting facepiece resp ira tor is fit
tested prior to initial use of the respirator, whenever a different resp irator facepiece (size, sty le , model or
make) is used, and at least annually thereafter.
1910.134(f)(3) The employer shall conduct an add it iona l fit te st whenever the employee reports, or the employer,
PLHCP, supervisor, or program adm inistrator makes visual obse rva t ions of, changes in the employee's physical
co ndition that could affect resp irator fit. Such conditions include, but are not lim ited to, facia l scarring, dental
ch ang es, cosmetic surgery, or an obvious cha nge in body weight.
Certificate of Worker's Acknowledgement
and Worker Release
Intercon Environmental, Inc.
ProjectName ________________ Date __________ _
Project Address---------------------------
WORKING WITH ASBESTOS CAN BE DANGEROUS. Il\11IALING ~STOS FIBERS HA.S
BEEN LINKED WITH VARIOUS TYPES OF CANCER. IF YO , SMOKE AND INHALE
ASBESTOS FIBERS THE CHANCE THAT YOU 'WILL DE ,, · ".LOP L 1G CANCER IS
GREATER THAN THAT OF THE NON-SMOKING PUBLIC.
Respiratory protection
Use of prot_ea~ve ~quipm~n
Pressure Jtr ere{:tial Systems
Work :gtictices including h ds-on or on-job training
Personal _eco~tamJna ·:on p)-oeedures
MEDICAL EXAMINN , ION: I have had a medical examination within the past 12 months at no cost to
me. T~is ex~ip~t~included: health history, pulmonary function tests and may have included an
evaluation of a ch st x-ray.
By signing this document I am acknowledging only that the Owner of the building I am about to work in
has advised me of my rights to training and protection relative to my employer, Intercon Environmental,
Inc.
Texa s Department
State He alth Service
EULOGIO TORRES
License No. 80441 --
._. .....
-I
-... <... __
---------.
'
I '
d· .'
I
J ' i
GEBCO ASSOCIATES J in cooperation with
E UNIVERSITY OF NORTH TEXAS
certifies that
This is an EPA fully approved c rse
TSCA, Title 11. It covers topics liste
Part 61, subpart M.
~~-·~
President
Date of issue : 03/30/09
Cert ificate Number: 09090 1077
Torres
JAN /04 /20 10/MON 05: 17 PM
Applicant Name: (Fint, )',1..l., Last)
Strcct Address:
Physician's Written Statement
Medical Surveillance for Asbestos Exposure
Enviro=e.i.tlll &. Saniw.tion Licensmg Group
800/571M554& or 512/834-6600
Fax: 512-834-6614
Social Secuxiry ¢1' ~t:eofBinh
Ci~ State
P. 003
Teleph(llle Nun>ber f111eluding a:rea code)
INDICATE WHICH ITEMS WERE !'ERFORM'.El> WITH PHYSICIAN'S OR ASSIST. S lNXUALS:
· (Any that are not applicable, mnst still be initial~d off in additio 'to the NI.A!
The above-named individual was seen on o! C) i -IZ>
S7
Completion and review of the standardized modica.J. que61:ioDIJaire and work' history with special"~b.asis.,diroeted to the
pulmonary, cardiovascular, and gastt"ointestinal. systems pei-pa.rt 1 and 2 f pp6I1dix Din 1926.1101 . .
Tho i=ployee was informed by the physici~n of tne ts of the exam and of any medical conditions that may result from
asbestos exposure including the increased rf~of lung cancer· attn"butable to the combined effect of smolpng and asbestos
exposure.
Unless otherwise· noted below, this evalrnmo~µidicares that: o medical conditions . were dete~od that would place ~ employee at an
increased risk of matorial health impairm · frofP~= to asbest~s, and no lirnil:atioua aro recommended on the employee
<,oncerning _ the use o{f ersofIB1 ~rotel;ti,ve e_gui.pment ? respirator. By signing this fo~ I acknowled&_e_ tbztihis exru;mn;tj.on. bas been.
performed m. accordance with either z 9\ R 1926 .1101 or40 CFR. 763.12.2(a), as requrred.. . . -r-: ·-· ·--~·""Y··· . '-'•' : , •
. 3141 ir'Ving Blvd, Suite 220
Street .Ad&ass ....... _
. . .
· ~Oa:,ipanoaat> · · .
3J41~-=
!Was, 11 75247 .
tel·2l! 630 1144
a214.637..382iJ
~-: JoseG. Trevno, M.D. · 214 630-1144:
:Print Physi~'s Name
Dallas
City .State
. Telcpbmlc ~ (including area code)
75247
L . PRJVACY NOTIFICATION I NQTIFICACJ6N SOB RE P~IVACIDAD .'"'· '· ·., · \;· ,:. • _ /
With few exceptions, you have the right to raquest and be informed about information that the Stat& of Texas colladi;::filitrut4'gu. You are entitled -to
recalve ano review the iriformatlon upon request. · Yov also have the right to ask the stats agency to cor:rect any mfur;m~j:m Ula ·;s d~ermined to be
Incorrect. See /]/tp:llwww.dshs.state.tx.us/foc-mols! infoimation on Privacy Notification. (Reference: Govamor Cl!lde,1~dian.552:P21, 552.023, 559,003
and 559.004) • · ·o · ._,..., '---•-• • . · . · : ~ _ f -... ~1 · ...... -_ .. · -
Tan solo por unas cuantas axcepcjones, usted tiene el derecho de soliciior y de sar informado sobre la lnfotmaci6rt:qu~:e1 ;;;:$g2.-de Texas reiine sobre
uS1ed. A usted se -le ~e~ ~onced_~r el deritcho de reciblr y revlsar la irJformaci6n .al requerirla. Usted tambien tie~ el d eredlo '.Je pedlt qua I;;:; agencr.i
est ~!al con1Ja. cua)qu1er mrormac10 que s!l;ha detennlnado saa. rncorrecta . · D!:ljase a lrttp:l~dshs.st§w.tx.usl para •mas infonnaci6n sobra !a
. ~otificacl6n ·sobre privacidad. (Referen~a:.· GovemmMt Coda~seccion 552-021, ~52.023, 559.003 y 559.004.) · ·
RevisGd May 2008 ?ubli~tl on # F'18-J 1669
n
ENVIR ONMENTA L, INC.
210 S Walnut Creek Drive Mansfield, Texas 76063. T elephone {817) 477-9995, Facs imile (817) 477-9996
www .intercon-env i r on men ta I . com
Employee Name:
DSHS License Number:
Respirator Type:
Respirator Brand:
Respirator Size:
1.
2.
3.
4.
5.
6.
7.
Respirator Fit Test
-----I::. u Lo;,1 .: o ID rre_~
Half-face
North
Medium
(circle one
No
These items are my p~r,~onal responsil>iUt ,. If I lose any of this equipment or negligently
damage any, I will rei urs"-~...Intercon E vironmental, Inc. the full list price for each article
lost or damaged. ·
Test administer ed.:;:'.!Jy lase Ccn -!vr re; s Title Supervisor , ,,,. .. r. l,.
I am experienced in the administration of proper fit tests.
5 · ~ 1/oq Date of fit test ___ _,/ __ '--'-/ __
OSHA Regulations (Standards -29 CFR}
1910.134(f}(2) The employer shall ensure that an employee using a tight-fitting· facepiece respirator is fit
tested prior to in iti al use of the respirator, whenever a different resp i rator facepiece (size, sty le, model or
make) is used, and at least annuallY.'. thereafter.
1910.134{f}(3} The employer sha l~cond uct an add it ional fit test whenever the employ ee reports, or the employer,
PLHCP, supervisor, or program administrator makes visual observations of, changes in the employee's phys ical
condition that could affect respirator fit. Such cond itions in clude, but are not limited to, facia l scarring, dental
changes, cosmetic surgery, or an obv ious change in body weight.
Certificate of ·\:~i orker'.s Acknowledgement
and Worker Release
Intercon Environmen tal, Inc.
Proi ect Name ... Date
J ---------------------------
Project Address-----------------------------
WORKING WITH ASBESTOS CAN BE DANGEROUS. INHALING ASBESTOS FIBERS HAS
BEEN LINKED WITH VARIOUS TYPES OF CANCER. IF YOU ~K10KE AND Il\'HALE
ASBESTOS FIBERS THE CHANCE THAT YOU WILL DEVE /{)p L G CANCER IS
GREATER THAN THAT OF THE NON-SMOKING PUBLIC.
Your employer's contract with the Owner for the above project requires that ·· 6 be sup hed with the
proper respirator and be trained in its use, you be trained in safe work practice and in the use of the
equipment found on the_jo~, and _YOU r~c_eiv~ a medial ex~ . These thin s are o have been done
at no cost to you. By s1gmng this cert1f1cat10n you are assunng e;;,Owner tha your employer has met
these obligations to you and are agreeing to hold the . ', his cf arsultant · esting Laboratory, and
representative harmless in any and all claims arising fr.om or rel~ed to .-. ·s'.RWJect.
Respiratory protecti n
Use of protec~ive _eg:u}P,ment
Pressure Differ~ tial Systems
Work practices ·. clu~g:-}Iat)ds-on 6r on-job training
Personal decontaminatf<5YJ. procoo iles
MEDICAL EXAMINATION: I have had a medical examination within the past 12 months at no cost to
me. This examination~t~.ded: health history, pulmonary function tests and may have included 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
has advised me of my rights to training and protection relative to·my employer, Intercon Environmental,
Inc.
Social Security No. l...f.53 9 9 { CJ 7<
Printed Name: ~ G, r:·
.. ij ... \il1 ~·ni\ ' ;k T~J Department of .. , St,ate Health Services ( MOISES RAMOS license No. 804432 Control No. 95747 Expiration Date: 04/06/201 O
President
Date of issue : 03/15/1 O
Certificate Number: 10087 8761
Ramos
Ull/ Ub/LUU~/TU h 11 : 14 AM P. UUl
..;: * .)f
l*~TEXAS liill: . Stare Health SeNices
Physician•s Written Statement
Medical Surveillance for Asbestos Exposu:re
· Department' of
www.tdb.state.n:.us/beh/asbestos
Environmental & Sanitation Liceusing Group
800/572-5548 or 512/834-6600
Fax: 512-834-6614
Applicant Name: {Fii:st, M.L, Last) Social Securtty# Date ofBirtll
Street Addr=:
Telephone NuJDbcr (including'areacode)
INDICATE WHICH ITEMS WERE PERFORMED WIIB PHYSICIAN'S OR SISTANT'S lNITIALS:
(Any that are not applicabl~ must still be initialed off in additi~n: to the N/ .N..
The above -named individual was seen on /0 4lJ {p -t) f
zL
57
rr The employee was informed by the phys cian ofth e$Ufis of the exam and of any medical conditions that may result from
asbestos exposure including the increasednllk of lung cancer attnbutable to the combined effect of smoking and asbestos
exposure.
Unless otherwise noted below, tlii~'afua~~n indicates ~o medical conditions were detected that would placo the employeo at an.
increased risk of material health impamnent fr-opi ~J>Osure to asbestos, and no limitations are· recoIIIIllCildcd on the c;mployee
concerning tho use of personal protectiv~pm\t ,., respirator. By signing t~i~ ~DJ.ID,}. aclmowlcdge that this examination has been
performed in accordance with eitheii 29~ R 1926. 101 or 4-0 CFR 763.122(a), as required. ·. , . ffll!dAtERr Occupafionaf
. ' .. ~.
Print Physici='s Name
P;;illas
City
3141 lrvlng B11rd. Ste 220
Balm, TX 7'fii.47
tel:214.630.1144
~:214.637.3826
llledalertonline.Clllll
214 630-1144
TX
Stnte
Telephone Numbl:C (inclu<lin.i ur~" ~ode)
75247
Zip
With few exceptions, you have the right to request and be Informed about Information that thG state of Texas .collects about you . You are entitled to
receiVe and review the information upon request You also have the right to ask the stata agency to corroct any infonnatlon 1hat is determined to be
incorrecl See http://yyww.dshs.state.tx.us/for more information on Privacy Notification. (Reference: Governor Code, S6ction 552.021, 552.023, 559,003
and 559.004) · · · ·· ··' · · ·
PRIVACY NOTIFICATION I NOTIFICACl6N SOBRE PRIVACIDAD J
Tan solo por unas euantas sxcE;Jpcioties, 1,1sted tiene el derecho d1a1 solicitor y de e.er informado e.obre la infonnacion QUe el &taclo ds Texas reune e.obre
usted. A usted se I& debe concedet el derecho de rscibir y reviser la informaci6n al requsriria. Uatscl tambifurtiene al darec:ho de psdir qua la agsncia
estauil corrija cualqu ier informaci6 que se ha determinado sea ·!ncorrecta. Dlrljase a http ://www,dshs.state .tx,usl para mas lnformacl6n sobro la
Notificacion sobre privacidad. (Referencia: Government Code.._seccl6n 552.021 , 552.023, 559.003 y 559_004.)
Revised May 2008 Publication# F18-11669
ENVIRONMENTAL, INC.
210 S Wa l nut Cre e k Dr ive. Man s field, Texas 76063 . Te l ep ho ne (817) 477 -9995 • Facs i m il e (817) 477 -9996
------------------------------·---··· ......
www .i nte rcon-envi ronmental .com
Employee Name:
DSHS License Number:
Respirator Type:
Respirator Brand:
Respirator Size:
1.
2.
3 .
4.
5.
6.
7.
Question
Respirator Fit Test
fi1oi&·e~ RAnllo.s
Half-face
North
Medium
(circle on
No
These items are my p_e,;~onal respons1 il}P."· If I lose any of this equipment or negligently
damage any, I will re'im Ul;SE;;Jntercon }"vironmental, Inc. the full list price for each article
lost or damaged. · .
-Test administe"rff ,""DY /;;sc C,7p ·fvc.>Z c:, Title Supervisor
I am experienced in the administration of proper fit tests.
6~1 /oc:;7 Date of fit test ___ ..,!./_ 1
____ _
OSHA Regulations (Standards -29 CFR)
1910.134(f)(2} The employer shall ensure that an employee using a tight-fitting facepiece resp i rator is fit
tested prior to i nitial use of the respirator, whenever a different respirator facepiece (size, style, model or
make) is used, and at least annually thereafter. .
1910.134(f}(3) The employer shall conduct an additional fit test whenever the employ ee reports, or th€ employer,
PLHCP, supervisor, or program administrator makes visual observations of, changes in the employee 's physical
condit ion that could affect resp irator fit. Such conditions include, but are not limited to1 facial scarring, dental
changes, cosmetic surgery, or an obv i ous change in body weight.
Certificate -of Worker's A.ckno-wledgernent
and Worker Release
Intercqn Environmental ~ Ine,
Project ___________________ Date ___________ _
Project Address ------------------------------
'\VORKING ·wrrn ASBESTOS CAN BE DANGER OUS. INHALING ASBESTOS FIBERS HAS
BEEN LINKED W"ITH VA..PJOUS TYPES OF CANCER IF YOU ST\ OKE A...7\TD INliA.LE
AS BESTOS FIBERS THE CR-'\...NCE THA.T YOU WILL DE'VELO,, I;tJN G CANCER IS
GREATER THA.N TEAT OF THE NON-SMOKIN G PUBLIC.
Your employer's contract v.ith the Ov-ner for the above project requires that o
proper respirator and be trained in its use , you be trained in safe work pract1..........,'>Q.li
equipment found on the job, and you recei v e a medial examinati.0-n. These things,..are to nave been done
at no cost to you . By signing this certification you are assuring , e Owner that your mployer has met
these obligations to you and are agreeing to bold the Own~nis· &:onsultant, 'Festlllg Laboratory , and
representative harmless in any and all claims arising from<9~eJated ~o ~his projec.
MEDICAL E'~Aue>N: I ave had a medical examination within the past 12 months at no cost to
me . This examination i.i.1clu,aed: health history, pulmonary function te sts and may have included an
evaluation of a ches~~-:a,,,.O
By signing this document I am acknov;.-ledging only that the Owner of the building I am about to ·work in
has advised me of my rights to training and protectio n relative to my employer, Intercon E nvironmental,
Inc.
Employee No. ~~~0~4_4_3_d\~-
. '1.
"'·
....
'.; .,,
ii .
ii' ~~:;(-;
JORGE M HERNANDEZ
license No . 804409
Control Noa 96221
Expiration !Date: 08 /07/2011
\.:>c:BcoCM::;::;vciate <,t:f ur les u!,
Jorge M. Hernandez
604-25-4376
has successrully compleled Iha Te xas Deparlmenl of
S/ale Heallh Services approved course enlllled:
ASBESTOS CONTRACTOR/SUP ERVISOR REFRESHER
Certificate No.: 10057
www .gebco.org
GEBCOAssociates,LP A r GEBCO ASSOC/A TES
;::1°;:~~;;~6~~~e
120 • Ph;::: :~;::::~~~: \ ; )~ in cooperation with " ).f HI! UNIVER~1-:::...~~ NORTH TEXAS
· .,Jcer,le M. Hernandez
Asbestos
• President
Date of issue : 02/15/10
Certificate Number : 10057 4376
-.}I; 'IC',.
I*,~.~ TEXAS ~ ,ii{" Oep:rl~;1t or IIIK_ 1r, f \ St ate Health Services
www.tdh.state.tx.us/beh/asbestos
Physician's Written Statement
M edical Surveillance for Asbestos Exposure
Environmental & Sanitation Licensing Group
800/572-5548 or 512/834-6600
Fax: 512-834-6614
ll '27 /7~
Date of Birth
·-r City..._.. State
? } . ) Ll?-L\ -I ,~
Telephom!Number (including area code)
-; ;:=!., /i-,.,\ ' ' ./ .,.
Zip
INDICATE WHICH ITEMS WERE PERFORMED WITH PHYSICIAN'S OR ASSISI:'.~'S INITIALS:
(Any that are not applicable, must still be initialed off in addition t o"the N/ )
The above-named individual was seen on /) /' / c;-~ / ! )
("_: 7 ,
exposure .
1) in
Unless otherwise noted below, this ev.alua ·on indicates that no medical conditions were detected that would place the employee at an
4"
increase~ risk of material health im~~rme~ · mt ~X:I?.~~e to asbe~to~, and_ no limitations are recomme_n!1ed o~ ~e employee
concemmg the use of personal protective eqJJ.tpment or espirator. By signmg this form, I acknowledge that this ex.ammatxon has been
performed in accordance with either 29 OF::R'. 1926.11 d1 or40 CFR 763.122(a), as required. medAI.ERT Occupational
3141 lmng Blvd, Ste 220
Print Physician's Name
3141 Irving Blvd, Su ite 220 Dallas TX
Street Address Ci ry Staie
PRIVACY NOTIFICATION / NOTlFICACIQN SOBRE PRIVACIDAD
Dallas, TX 75247
fiJ:214.630.1144
fa::214.637 .382D
De.COIi
214 ) 630-1144
Telephone NllIIlber (including area code)
75247
Zip
With few exceptions , you have the right to request and be informed about information that U,e State of Texas collects about you. You are entitled to
receive and review the information upon request. You also have the right to ask the state agency to correct any infonnation that is detennined to be
incorrect. See http://www.dshs.state.tx.us/for more information on Privacy Notification. (Reference : Governor Code, Section 552.021 , 552.023 , 559,003
and 559.004)
Tan solo por unas cuantas excepciones , usted tiene el derecho de solicitor y de ser informado sabre la informaci6n que el Estado de T exas reune sabre
usted. -A usted se le debe conceder el derecho de reci bir y reviser la infonnaci6n al requerirla. Usted ta mbien tiene el derncho de pedir que la agen ci a
estataf corrija cualquier informaci6 que se ha determinado sea incorrecta. Dirijase a htto:/lwww.dshs .state.tx.us/ para mas infonnacion sabre la
Not ificaci6n sabre privacidad. (Referen ci a: Government Code,_secc i6n 552.021 , 552.02 3, 559.003 y 559.004.)
Re vi sed May 2008 Publication# F"lB-11669
tercon
E N V I RONM E N T A L , IN C.
2214 FM 1187 , 8ui l d i r,g 6, Ma nsfi e ld Texas 7 6 063. Te l e phon e (817 ) 477-9995. Facs i mile (8i 7 ) 477-9996
Emp l o y ee N ame:
DSHS License N u mber:
Resp i rator T yp e :
Respirator Brand :
Resp i rator Size :
Questio n
Respirator Fit Test
3, O \r q \f! \.;\ • \l~ YV0A./~ lJ '-"
Ha lf-face
1. Was resp i rator reasonab ly comfortable?
2. Was pos itive and negati v e pressure test~·el ' in i:stere
3. Does the i nd i v i dual understand fu lly tr<" protecf1o n
factor of this type respirator? ·
4. Was the i ndivi dua l i nstructed on
5.
6.
7.
Test ad mi n_i st ered b7., lo 5~" .... A-. Can fr:e t'O... S
I am e x perie n ce a rn t h e admin1stra t1 on of pro p er fit tests.
Da te o f fi t t es t -~&:, ___ -_,_7 _3_._/D_· --K:'~-
OSHA Regu l ati ons (Sta n dard s -2 9 CF R )
www .i nt ercon-env i ronmenta I. com
No
T itl e Supe rvi s o r
1 910.1 34(f)(2} The emp loyer shall ensure that an employee using a tight-fitting facep1ece respirator is fit
tested prior to in itial use of the respirator, whenever a different respirator facep i ece {5i ze , styl e , model or
make) is used , and at least annua ll y thereafter.
1 910 .134(f)(3) T he employ er shall conduct an add ition al fit test whenever the employ ee r eports , or the emp loy er,
PL HCP, supervisor, o r program adm ini strator makes vi sual observations of, changes i, the emplo y ee's phys ical
co nd ition that cou l d affect resp i rator fit. Such cond ition s in clude, but aretnot limite d 0 0 -facia l scarri ng, dental
changes, co smeti c surgery, or an obvious change i n body weight.
Certificate of Worker's Acknowl edgement
and Worker Rel eas e
Intercqn Environmental, Inc.
Project ___________________ Date __________ _
Project Address-----------------------------
W ORKING WITH ASBESTOS CAN BE DANGEROUS. INHALING ASBESTOS FIBERS HAS
BEEN LINKED WITH VARIOUS TYPES OF CANCER. IF YOU SM OKE AND INHALE
ASBESTOS FIBERS THE CHANCE THAT YOU WILL DEVELO P CtJN G CANCER IS
GREATER THAN THAT OF THE NON-SMOKING PUBLIC.
Your employer's contract with the Owner for the above proj ect requires at-o , oe supplied with the
proper respirator and be trained in its use, you be trained in safe work practrce . i;tnd in t . use of th e
equipment found on the job , and you receive a medial examinati ,n. These things,are to nav e been done
at no cost to you. By signing this certification you are assuring the Owner tha your fu ployer has m et
these obligations to you and are agreeing to bold the Owner, ·s . Consultant, 'fesHb g Laboratory , and
representative harmless in any and all claims arising fro:m,.-o l"'rel ate cf 'a. this proje t
Physical characteristics of asbestos
Health hazards associated with asbestos
Respiratory protection
Use of protectiv e equipmen
Pressure Differential Systems
Work practicesfme u_g ing hands-on or on-job training
Personal dee0ntamination proceaur s
'
MEDICAL EXAMIN¥(4."10N: f'have had a medical examination within the past 12 months at no cost to
me. This examination included: health history , pulmonary func tion te sts and may hav e included an
evalu ation of a chest.x ~rn ;,Y
By signing this document I am ackno wledging only th at the Own er of the building I am about to w ork in
h as ad vi sed me of my rights to tr aining and protection relativ e t o my emplo yer, Intercon Env ironm ental,
Inc .
~ ft ., ft .·I
S · + ~ ,<', ,F''J V i i.,(_, I.A.;. ,JI~ E I N 1gn aL ure: ---'-'---''"-· ---------------mp oyee o.
Firme
Pri nte d Name: -:S:o v-.;1 r }vl ·
.-
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
INTERCON ENVIRONMENTAL INC
is ccrtifiea to peifonn· as a
Asbestos Abatement Contractor
i11 the State of Texas within the purview of Texas Occupations Code, chapter 1954. so long as this license is not
suspe11ded or revoked and is renewed according to the rules adopted by the Te x.as Board of Health_
License Number: 800805
Control Number: 95442
r.:..J") -_/ >""".~·j
/,,/ r'-t,.#'f . ;,/7
/ / -/'/./
DAVID LAKEY, M.D.
COMMlSSJONER .OF HEALTH
VOID IF ALTERED
rr/:~
T ~~DEPA\KTMENT OF STATE HEALTH SERVICES
INJ R.CON ENVIRONMENTAL INC
is certifotl to pmfimn a.r a
Asbestos Transporter ..
in the Sr ate of'~-.:a · ithi11 the purview of Texas Occnpations Code , chapter 1954. so long as this license is not
suspended 01; revoked and is renewed according to the n,/es adopted by the Texas Board of Health.
DAVID LAKEY, M.D.
COMMISSIONER OF HEALTH
License Number: 400336 Expiration Date: 2/5/2011
Control Number: 95484 (Void After Expiration Date)
VOID IF ALTERED N ON-1f'.ANSFERABLE
Please p;int or type . {Form designed for use on elite (12-pitch) typewriter.) Qi-X)(X Form Approved . 0MB No . 2050-0039
~;:::U:.:N!:;.IF;;.;O:..:RM;;...:::.:;.H~PJ.A_,_R;..O_O_U_S..:,-:-1.-:::G:-en_e_ra'.'"'to-:r l;::-D-::N-um-:-b.:..er"'"'""-'-'-:.......--'-----i-:::2:--;. Pa=ge:-:1:-:of:7rf'3_'::Eme::::rg:::e::'nc="y:;:R;:-espo:':":'.n::s:-e Plln:::one--·--4. i'tlaniiast Traclting Number -
1
WAS TE MANIFEST NiA 1 17-477-9995 0 0 5 3 7 8 918 JJK
5. Generator's Name and Mailing Address
name
a d dress
Generatlii'i c:Stat e Z i P
6. Transporter 1 Company Name
l ntercon Envi ronmenta l Inc.
7. Transporter 2 Company Name
8. Designated Facil ity Name and Site Address
DFW La nd fi ll
1 600 Rairoad S tre et
Lewisvill e, TX 75067
Facility's Phone: ·
hone#
9 72-315-5421
9a. 9b . U.S. DOT Description Dnciud ing Proper Shipping Name, Hazard aass. ID Number,
HM and Pecidng Group (if any))
1.
Hazardo us substan ce, so lid , N.O.S. (asbestos)
ORM-E, NA 9 188, RQ=1 Pound
2.
Waste wh i ch conta i ns non -f riable asbestos or
w ast e contai ni ng non-friable asbestos
3.
Hazardous substance, solid, N.O.S . (asbestos)
ORM-E , NA 9188, RQ=1 Pound
Generator's Stte Address (if differentlha; mall ing adctess)
job site
address
Ci
No.
U.S. EPA ID Number
U.S. EPA ID Nt.mber
U.S. EPA ID Nmlber
13. Waste Codes
n/a +-·-
n/a
15. GENERATOR'S/OFFE ROR'S CERTIFICATIO N: I hereby declare that the C!l!llenls oftfiis,~nient are fully and accurately described above by the propers1lipJjng name , and are classifi ed , packaged,
marked and labeled/placarded, and are in all respects in proper condition for trans~ acconl ing lo applicable international and national governmental regu!alims. If export shipmen t and I am the Primary
Exporter, I certify 1hat the contents of this consignment conform to the terms of the attached EPA Acknowledg ment of Consent.
I certify that the waste minimization statement idenp 1eo in 40 CFR 262.27(a) (if I am .rla,rg'1_ qg~ttty generator) or (b) [If I am a small quantity generator) is true..
Port of entry/exit: ------------------
Date leaving U.S.:
18a . Discrepancy Ind ication Space
1
18 . Discrepancy
1=: 18b . Alternate Faciltty ( or Generator)
:i u
~ Facil ity's Phone :
53 18c. Signature of AJlemate Facil ity (or Generator)
~
Signature
Signature
Month Day Year
Month Day Year
0Residue D Full Rejection
Manifest Reference Number :
U.S. EPAIDNumber
Mon1h Day Year
z t------------------------------------------------'---'---........ --1 fj§ ,.19 . Ha zardous Was1e Report Management Me!hod Codes (i.e., codes for hazardous waste treatmenl disposal, and recycling systems)
~ 1. 2. 3.
j 20 . Designated Facility Owner or Operator: Certification of receipt of hazardous materials covered by the manifest except as ncted in Item 18a
Printed/Typed Name Signature Month Day Year
EPA Form 8700-22 (Rev. 3-05) Previous editions are obsolele . DESIGNATED FACILITY TO DESTINATION STATE {IF REQUIRED)
tercon
EN VIR ONM E NTAL , INC.
210 S . W a lnut Creek Dr i ve. Mansf i e l d , T exas 76063. Telephone (817) 477 -9995. Facs i mile (817) 477-999 6
www . i nte rcon-e nv i ron menta I . com
2.6.4
ORGANIZATION COMMUNICATION CHART
Ci ty of _Fort Worth '
Personnel ..
. ~
I
Jerrold Andrews '
'• .
Vice President
.,
I ·····-···-·--·--~--
Fernando Avila Bob Mcfadin
Project Manager Project Manager
.)
I I .. -.. . ·--~
lritercon Asbestos ' ' lntercon Demolition
Operations o ·peratio'ns
'-.)
I I
---. --"*""
lntercon Asbestos lntercon Demolition
Supervisors _ Supervisors
'-,/ .)
EN VI RONMENTAL, INC.
210 S . Walnut Creek Drive. Mansf i eld , Te x as 76063. Teleph o ne (817 ) 477-9995. Fac s i m i le (817 ) 477-9996
www. intercon-env i r on mental . com
RESPONSE TO 2.6.5
HEALTH AND SAFETY PLAN
Reviewed and Approved:
Karen Andrews
President ;;;t::ental, Inc ~
Jerrold Andrews
Health and Safety Officer
Intercon Environmental, Inc.
07 /01/10
Date
07/01/10
Date
Table of Contents
Health & Safety Plan
1. Introduction ......................................................................................................................... 5
2. Health and Safety Responsibility ........................................................................................ 5
3. Medical Monitoring Program .............................................................................................. 5
4. Health and Safety Training .................................................................................................. 6
5. Exposure/Injury Reports ...................................................................................................... 6
5 .1 Accident/Injury Reporting ............................................................................................. 7
5.2 First Aid Response ......................................................................................................... 7
5.3 Procedure if an Accident Occurs ................................................................................... 7
5.3 .1 FirstAid ................................................................................................................... 7
5.3.2 Serious Injury .......................................................................................................... 7
6. Chemical Substances of Concern ........................................................................................ 8
7. Physical Hazards of Concem ............................................................................................... 8
7.1 . Trip, Slip, Fall Hazards .................................................................................................. 8
7.2. Noise .............................................................................................................................. 8
7.3. Confined Space .............................................................................................................. 9
7.4. Hand and Power Tools .................................................................................................. 9
7.5. Fixed Ladders ............................................................................................... .-................ 9
7. 6. Portable Ladders ............................................................................................................ 9
7. 7. Manual Lifting ............................................................................................................... 9
7.8. Illumination ................................................................................................................. 10
7. 9. Hot Processes -Steam ................................................................................................. 10
7.10. Inclement Weather ....................................................................................................... 10
7 .11. Electrical Safety ........................................................................................................... 10
7.12. Heat Stress ........................................................................... , ........................................ 10
7.12.1. Symptoms .............................................................................................................. 11
7 .12.2 . Treatment. .............................................................................................................. 11
7 .13. Heat exhaustion ........................................................................................................... 11
7 .13 .1. Symptoms .............................................................................................................. 11
7.13.2. Treatment ............................................................................................................... 11
7.14 . HeatCramps ................................................................................................................ 11
7.14.1. Symptoms .............................................................................................................. 11
7.14.2. Treatment ............................................................................................................... 11
7.15. Heat Rash ..................................................................................................................... 12
7.15.1. Symptoms .............................................................................................................. 12
7.15.2. Treatment ............................................................................................................... 12
7.16. Heat stroke ................................................................................................................... 12
7.16.1. Symptoms .............................................................................................................. 12
7.16.2. Treatment ............................................................................................................... 12
7 .1 7. Measure Heart Rate ..................................................................................................... 12
7.18. Measure Body Temperature ........................................................................................ 13
7.19. Physiological Monitoring Schedule ............................................................................. 13
7.20. Working at Elevation ................................................................................................... 13
7 .21 . Utilities ........................................................................................................................ 14
Health & Safety Plan 3
7.22. Heavy Equipment ......................................................................................................... 14
8. Biological Hazards of Concern .......................................................................................... 14
8 .1. Bloodborne Pathogens ................................................................................................. 14
8.2. Animal Bites and Stings .............................................................................................. 14
8.3. Contact with Plants ...................................................................................................... 15
8.4. Animal and Bird Refuse .............................................................................................. 15
9. Basic Safety Work Rules ................................................................................................... 15
10. Emergency Response Plan ................................................................................................. 17
10.1. Evacuation Routes and Procedures .............................................................................. 17
10.2. Emergency Security and Control.. ............................................................................... 18
10.3. Emergency Decontamination Procedures .................................................................... 18
10.4. Fire or Explosion ......................................................................................................... 18
10.5. Spills and Leaks ........................................................................................................... 18
10.6. Medical Emergencies .................................................................................................. 19
11. Plan Approvals .................................................................................................................. 19
Health & Safety Plan 4
Intercon Environmental, Inc.
Health and Safety Plan
1. Introduction
The purpose of this Health and Safety Plan (Plan) is to define requirements and designate
protocols to be followed by employees during any and all project activities. This Plan is
designed to provide guidance to protect the health and safety of individuals working on-·
site and assist in compliance with all relevant health and safety regulati ons during the
completion of any site activity. Specifically, the Plan has been prepared in strict
accordance with OSHA 29 CFR 1910-Subpart 7. The Plan addresses standard operating
and emergency procedures for anticipated site hazards related to asbesto s abatement and
other environmental activities
A copy of this plan will be reviewed by all employees with the corporate health and
safety officer. At which time any questions will be addressed. Upon completion of the
plan review all employees will sign an authorization sheet acknowledging their
understanding of the contents of this Plan. The original Plan will be maintained at
Intercon Environmental, Inc. 's principal office and copies of the plan on every project
site.
Modifications to this Plan may be required to adjust for changing laws and project
conditions. The Corporate Health & Safety Officer will make all changes. Permanent
revisions will be attached as addenda to the Plan.
2. Health and Safety Responsibility
Each Project Manager will be responsible for assuring that all site activities are
performed in accordance with the protocols defined in this document. The Project
Manager will have a direct line of communication with the Corporate Health and Safety
Officer.
All work performed by personnel shall be conducted in conformance with the Plan and
appropriate regulations. Intercon will take appropriate steps to protect employees from
unsafe acts or actions over which Intercon has no control and will be obliged,
professionally, to bring any such actions, as well as any actions on any work location
where there are work assignments, which constitute obvious or imminent h azard violation
of regulations to the attention of the appropriate client contact. Employees are
encouraged to report unsafe work place situations to the Corporate Health and Safety
Officer without fear of recrimination.
3. Medical Monitoring Program
In compliance with OSHA regulations, all employees who particip ate in asbestos related
activities will be enrolled in a medical monitoring program. Medical surveillance shall
be provided to employees prior to employment, annually thereafter (m inimum) and ~ a
Health & Safety Plan 5
follow-up to injuries or over-exposures. All employees shall be required to maintain
current medical fitness status with an annual physical examination.
4. Health and Safety Training
All supervisory personnel are required to have the 40-hour health and safety training
requirements, as specified in OSHA regulations (29 CFR 19I0.120(e)/8 CCR 5192).
Employees and subcontractors successfully completing this course are certified to
perform field activities in hazardous locations in EPA designated levels of protection B,
C and D. Copies of training certificates shall be maintained on-site. This training must be
renewed annually with an 8-hour refresher course. Each employee must also undergo an
annual respirator fit test and be medically certified to perform fieldwork on an annual
basis (all employees working with asbestos must be trained in accordance with 29 CFR
1926.1101).
Intercon will conduct health and safety meetings at the beginning of every project and
periodically as needed maintaining a minimum of one per week. During these health and
safety training seminars, any questions regarding the Plan will be answered. The purpose
of these orientations is to ensure compliance with the Plan as well as fulfilling applicable
right-to-know regulations. The issues to be addressed at this orientation will include:
1. Chemical hazards on-site;
2. Physical hazards on-site;
3. Biological hazards on-site;
4. Potential for exposure to hazardous materials on-site;
5. Monitoring procedures and protocols;
6. Levels of personal protection to be utilized and personal protective equipment
required to mitigate potential exposure;
7. Decontamination procedures;
8. Emergency and evacuation procedures; and
9. Site documentation procedures.
10. Any incident investigations
11. Modifications if any to the Health and Safety plan
5. Exposure/Injury Reports
In the case of an injury or exposure, effective corrective actions must be taken, an
incident investigation must be completed and an incident report filed.
Health & Safety Plan 6
5.1 Accident/Injury Reporting
If an injury or exposure occurs, the specific incident will be immediately reported to the
Environmental Health and Safety Officer verbally as soon as possible. Intercon shall
notify a representative of the client in the event of an accident or injury while on the site.
Intercon will ensure that a written exposure or injury report is completed and reviewed
with the employee(s), Contractors involved and supervisors. After review of an exposure
or injury report is complete, Intercon will investigate and ensure that corrective measures
were appropriate and are complete.
5.2 First Aid Response
1. First aid should be administered only by trained, certified personnel.
2. Do not move an injured or seriously ill person unless necessary to prevent further
Injury.
3. If off-site medical treatment is obtained (without reporting to the appropriate
supervisor) for a work-related injury or illness, notify the appropriate supervisor
at the start of the next scheduled work date.
4. Prior to returning to work after a disabling injury or illness, present a completed
medical release from the attending physician to the appropriate supervisor.
5.3 Procedure if an Accident Occurs
In the event of an accident, the following steps should be taken in the sequence listed:
5 .3 .1 First Aid
Contact qualified first aid personnel.
5.3.2 Serious Injury
1. Call an ambulance, hospital, at 911, or physician.
2. Have qualified first aid personnel administer first aid as soon as possible.
3. Assist first aid and ambulance personnel as directed.
4. Notify the supervisor or designated alternate .
5. Assist in completion of appropriate accident information report and
witness statements.
Health & Safety Plan 7
6. Chemical Substances of Concern
The Health and Safety Officer will maintain all Material Safety Data Sheets (MSDS) for
all chemicals used and stored on-site. These will include all those substances necessary
for equipment decontamination and samples analysis preparation. Copies of these MSDS
are maintained in our office and at the project site . See Intercon's Standard Operating
Procedure manual for full instruction on MSDS.
7. Physical Hazards of Concern
The nature and extent of the field activities creates a number of potential physical hazards
on-site. Although engineering and administrative controls will be implemented to
mitigate some hazards, the primary prevention will be based on a communication
program. The program will start with the initial site briefing, which will be presented to
all field personnel and reinforced at the weekly project safety meetings. The field
activities to be conducted during asbestos related activities will potentially require site
personnel to be in close proximity to various physical hazards. The specific hazards
encountered will be dependent upon the task and the operation conducted.
Below is a partial list of physical hazards that may be encountered during the oversight
activities at the site.
Drilling
Noise
Hoists
Portable Ladders, Scaffolds ·
Heavy Equipment
Confined Space
Drum Handling
Hot Processes Steam
Weather
Ropes, Slings, Chains and Hooks
Manual Lifting
Electrical Safety
7.1. Trip, Slip, Fall Hazards
Use of Compressed Air Tools
Power Tools/Hand Tools/Air Tools
Utilities
Excavations, Trenches
Illumination
Hot Work
Heat/Cold Stress
Pressure Washers
Materials Handling
Power Transmission, Mechanical
Hazardous Material Use/Storage
Personnel shall be reminded to maintain a workplace free of scattered tools and supplies.
"Housekeeping" procedures will be discussed at the daily safety briefings. The
importance of maintaining safe footing will be reinforced in daily safety briefings.
7.2. Noise
Noise levels in excess of the 85 decibels, or dBA, the action level specified in 29 CFR
1910.95 and 8 CCR 5095, are not anticipated during completion of the work at the site.
However, should you be exposed to elevated noise levels be encountered (adjacent to
operational compressors, etc.), personnel shall utilize earplugs or hearing protection to
attenuate noise levels. Noise dosimeters may be employed periodically to quantify
personnel noise exposures.
Health & Safety Plan 8
7.3 . Confined Space
Personnel will only enter a confined space if procedures defined in Intercon 's Confined
Space Manual are followed. A confined space may be defined as any area having a
limited means of egress where ventilation is not adequate to remove a toxic or flammable
atmosphere or oxygen deficiency that may exist. Examples of confined spaces may
include storage tanks, process vessels, bins, boilers, ventilation or exhaust ducts , sewers ,
underground utility vaults, tunnels, pipelines and open-top spaces more than four feet in
depth such as pits, tubs, vaults and vessels.
7.4. Hand and Power Tools
Personnel shall be reminded at daily safety meetings of the importance of using the
correct tool to accomplish the various work tasks. Utilizing the wrong tool for the job
can often lead to injuries. Throwing of tools or materials from one location to another
will be prohibited. All power tools shall be inspected prior to use. Any defective tools
shall be tagged out by the on-site project manager and prohibited from being used.
7.5. . Fixed Ladders
Fixed ladders must be inspected prior to use. Moorings, hardware and rungs should be
visually inspected to ensure that they are structurally sound. Efforts should be made to
ensure that no more than one person at a time be present on a fixed ladder. Materials,
tools and/or supplies should be passed up to elevated work areas or placed in a bucket or
other vessel attached to a rope and hauled up rather than being hand-carried.
7.6. Portable Ladders
Portable ladders should be inspected prior to use. Attention should be paid to the rungs
and side rails of the ladder to ensure that they are not degraded or bent in any manner.
Damaged ladders should be tagged out if they are repairable. If they are not, they shall
be destroyed. All ladders should be equipped with safety feet that are placed on a firm,
flat surface. Straight extension ladders should extend at least three feet above the landing
area. A spotter should be used at all times during ladder work. This individual should
steady the base of the ladder and be prepared to pass supplies or tools to the individual
working on the ladder.
7. 7. Manual Lifting
Improper lifting can result in cuts, pinches, crushing and serious muscle strains and tears.
Daily safety meetings shall communicate the importance of proper lifting techniques to
site personnel. Prior to lifting bulky or heavy objects, the object should be inspected for
sharp edges, splinters and any signs of chemical or biological hazards (i.e. staining or
insects/arthropods). The area should also be inspected prior to the lifting and moving of
the object. The area should be checked to ensure that wet or slippery conditions are not
present and that the route to be traveled is free of trip hazards. Where at all possible,
assistance should be obtained in performing a lift. It will be stressed in the daily safety
meeting that moving an object is not worth incurring an injury. If an object is not readily
moved, mechanical means should be sought out and employed.
Health & Safety Plan 9
7.8 . Illumination
It is anticipated that elect rical po wer and li ghting systems shall be fully operationa l at the
project site. Inadequate lighting can result in trips , falls and other inadvertent injuries
incurred during work activities. If poor or inadequate lighting conditions are disco vered,
work shall be stopped in that specific area and the conditions shal l be reported
immediately.
7.9. Hot Processes .Steam
Steam may be present in varying locations throughout the site. Steam represents a severe
thermal burn hazard. It may condense and leave wet work surfaces and will displace
oxygen in enclosed areas. The heat and high moisture content associat ed w ith steam may
affect instrument and PPE function. Personnel shall be reminded to be cognizant of areas
or structures that may contain steam (i.e. boiler rooms , steam lines). Caution should be
taken when working around such structures.
7.10. Inclement Weather
Potential hazards associated with inclement weather as they relate to this project may
include heat, rain, wind and electrical storms. Should any of these conditions present a
threat of injury of site personnel , work activities potentially exposed to these hazards
shall be terminated.
Heat may increase the likelihood of personnel experiencing heat stress and other heat
related disorders. Extreme heat may also lead to increased rates of v olatilization and
increase the pressure on sealed containers, potentially increasing th e risk of toxic
exposure or flammable/explosive atmospheres .
Rain may increase slipping and tripping hazards and the braking distances of vehicles.
Rain may also fill in depressions and obscure trip and fall hazards. Rain may also
increase the potential of electrical shock when working in proximity to electrical
equipment.
Lightning represents a real hazard of electrical shock when working in flat, open spaces ,
elevated work places, or near tall structures such as stacks.
7.11. Electrical Safety
Personnel shall remain cognizant of electrical lines and equipment witrnn the work area.
Personnel and shall be prohibited from contacting electrical power circuits unless they
are protected from electrical shock by de-energizing the circuit and grounding it or by
guarding it effectively by insulation or other means.
7.12. Heat Stress
Heat stress is an acute and dangerous reaction to heat caused by a failure of heat
regulating mechanisms of the body, the individual's temperature c ontrol system that
causes sweating stops working correctly. Body temperature rises so high that brain
damage and death will result if the person is not cooled quickly.
Health & Safety Plan 10
7.12 .1. Symptoms
Red, hot, dry skin, although person may have been sw eating earlier; nausea;
dizziness; confusion; extremely high body temperature ; rapid respiratory and
pulse rates ; unconsciousness or coma.
7.12.2. Treatment
Cool the victim quickly. If the body temperature is not brought down fast ,
permanent brain damage or death will result. Soak the victim in cool , but not
cold water; sponge the body with cool water or pour water on the body to reduce
the temperature to a safe level (102°F). Observe the v ictim and obtain medical
help. Do not give coffee , tea, or alcoholic beverages.
7.13. Heat exhaustion
Heat exhaustion is a state of very definite weakness or exhaustion caused by the loss of
fluids from the body. The condition is much less dangerous than heat stroke , but it
nonetheless must be treated .
7.13 .1. Symptoms
Symptoms are pale, clammy, moist skin, profuse perspiration and extreme
weakness. Body temperature is normal , pulse is weak and rapid and breathing is
shallow. The person may have a headache, may vomit and may be dizzy.
7.13.2. Treatment
Remove the person to a cool , air conditioned place, loosen clothing, place in a
head-low position and ensure the individual remains immobile. Consult
physician, especially in severe cases. The normal thirst mechanism is not
sensitive enough to ensure body fluid replacement. Have patient drink 1 to 2 cups
of water in-immediately and every 20 minutes thereafter until symptoms subside.
Total water consumption should be about 1 to 2 gallons per day.
7.14. Heat Cramps
Heat cramps are caused by perspiration that is not balanced by adequate fluid intake.
Heat cramps are often the first sign of a condition that can lead to heat stroke.
7.14.1. Symptoms
Symptoms of heat cramps are acute painful spasms of voluntary muscles, e.g.,
abdomen and extremities.
7.14.2. Treatment
Remove victim to a cool area and loosen clothing. Have patient drink 1 to 2 cups
of water immediately and ev ery 20 minutes thereafter until symptoms subside.
Total water consumption should be 1 to 2 gallons per day.
Health & Safety Plan 11
7.15. Heat Rash
Heat Rash is caused by continuous ex posure to heat and h umi d air and aggravat ed
chafing clothes. The condition decreases ability to tolerate heat.
7.15.1. Symptoms
A mild red rash occurs, especially in areas of the body that come into contact with
protective gear.
7.15.2. Treatment
Decrease amount of time in protective gear and provide powder to help absorb
moisture and decrease chafing.
7.16. Heat stroke
Heat stroke is an acute and dangerous reaction to heat stress caused by a failure of heat
regulating mechanisms of the body; the individual's temperature control system that
causes sweating stops working correctly. Body temperature rises so high that brain
damage and death will result if the person is not cooled quickly.
7.16.1. Symptoms
Red, hot, dry skin, although the person may have been sweating earlier; nausea;
dizziness; confusion; extremely high body temperature; rapi d respiratory and
pulse rate ; unconsciousness or coma.
7.16.2. Treatment
Cool the victim quickly. If the body temperature is not brought down quickly ,
permanent brain damage or death will result. Soak the victim in cool, but not
cold, water; sponge the body with cool water or pour water on the body to reduce
the temperature to a safe level (102°F). Observe the victim and obtain medical
help. Do not give coffee~ tea, or alcoholic beverages.
For strenuous field activities that are part of on-going site work activities in hot
weather, the following procedures shall be used when appropriate to monitor the
body's physiological response to heat and to manage the work cycle, even if
workers are not wearing impervious clothing. Awareness and limited monitoring
procedures are to be instituted when the temperature exceeds 70°F. ,
7 .1 7 . Measure Heart Rate
Heart rate should be measured by the radial or carotid pulse for 30 seconds as early as
possible in the resting period. The heart rate at the beginning of the rest period should
not exceed 110 beats per minute. If the heart rate is higher, the next work period should
be shortened by 33 %, while the length of the rest period stays the same. If the pulse rate
still exceeds 110 beats per minute at the beginning of the next rest period, the following
work cycle should be further shortened by 33%. The procedure is continued until the rate
is maintained below 11 0 beats per minute.
Health & Safety Plan 12
7.18. Measure Body Temperature
With ambient temperatures over 90 °, body temperatures should be measured with a
clinical thermometer as early as possible in the resting period. Oral temperature should
be taken at the beginning of the rest period before the employee drinks anything . Oral
temperature (TO) at the beginning of the rest period should be shorten ed by 33 %, while
the length of the rest period stays the same. If the TO ex ceeds 99.6°F at the beginning of
the next rest period, the following work cycle should be further shorten ed by 33%. The
procedure is continued until the body temperature is maintained below 99.6 °F.
7 .19 . Physiological Monitoring Schedule
The following suggested frequency of physiological monitoring sch edule for fit and
acclimat ed workers shall be used as a guideline.
Temperature
90°F or above
87.5°F
82.5°-87.5°F
77.5°-82.5°F
72 .5°-77.5°F
Level D
After each 45 minutes of work
After each 60 minutes of work
After each 90 minutes of work
After each 120 minutes of work
After each 150 minutes of work
Level C
After each 15 minutes of work
After each 30 minutes of work
After each 6 0 minutes of work
After each 90 minutes of work
After each 120 minutes of work
Measure the air temperature with a standard thermometer. The thermometer bulb used
will be shielded from radiant heat. Estimate fraction of sunshine by judging what percent
the sun is out.
100% sunshine = no cloud cover = 1.0
sunshine = 50% cloud cover 0.5
sunshine = full cloud cover = 0.0
adjusted temp . = actual temp. + 13 X (%sunshine factor)
Frequency of physiological monitoring governs the length of work peri od . The length of
the rest period is governed by physiological parameters (heart rate and oral temperature).
For example, if an individual 's heart rate exceeds 110 beats per minute at the beginning
of the rest period, that individual will remain on rest-time until his/her heart rate drops
well below 110 beats per minute and their next work period (=duration of time before
suggested physiological monitoring) is decreased by 33 %.
7.20. Working at Elevation
Climbing stairs, working at elevation (more than four (4) feet above grade), on platforms,
roofs or scaffolding; working on ladders , or performing activities w here falls could result
in injury or contact with chemicals requires provisions for preventing fall ing. Ideally fall
prevention can be addressed through appropriate engineering controls including safety
railings etc. Fall protection PPE including harnesses and lanyards, may be required
during the course of this project. The requirement for such PPE will b e evaluated on a
case-by-case basis.
He alth & Safety Plan 13
7.21. Utilities
Injury and death as a result of shock, electrocution, thermal burns and other utility related
hazards can be avoided by remaining alert to the presence of utilities in the work area.
Such utilities may include; electrical lines, gas lines, pipelines, steam lines , water lines,
sewer lines and pressurized air lines. All utilities should be considered active unless a
reliable source has documented them to be otherwise . Personnel will be instructed to
avoid stepping or holding onto any such utility line.
7 .22 . Heavy Equipment
It is anticipated that a variety of heavy equipment will be present on the site during the
completion of this project. All personnel shall be required to wear high-visibility safety
vests at all times during site work. Site personnel and subcontractors shall be instructed
to maintain eye contact with equipment operators when entering their w ork area(s). In
addition, no personnel will be allowed to walk beneath elevated booms or buckets.
8. Biological Hazards of Concern
This section identifies biological hazards that may be transmitted via human blood or
blood products or through other modes of transmission including poisonous plants, insect
and/or animal bites or stings.
8.1. Bloodborne Pathogens
Bloodborne pathogens are pathogenic microorganisms that may be present in human
blood and can cause disease in humans. These pathogens include, but are not limited to
hepatitis B virus (HBV) and human immunodeficiency virus (HIV).
OSHA requires compliance with 29 CFR 1910.1030/8 CCR 5193 , Occupational
Exposure to Bloodbome Pathogens Standard, where as a condition of employment, there
is known or potential exposure to bloodborne pathogens. A source of occupational
exposure may occur when an employee gives first aid and CPR to an individual who has
infectious blood. The occupational exposure occurs when potentially infectious materials
come in contact with the employee's eyes, mucous membranes, non-intact skin through
cuts and abrasions while administering first aid and CPR. Additional sources of exposure
are contact with infectious waste found at hazardous waste sites, glassware, needles other
sharp objects which have been involved in injuries to personnel resulting in
contamination with blood or related bodily fluids and laboratory personnel who may
analyze samples containing infectious waste.
Outlined below is a more detailed description of potential biological hazards that may be
present on-site.
8.2. Animal Bites and Stings
Animal bites or stings are usually nuisances (localized swelling, itching and minor pain)
that can be handled by first-aid treatments. The bites of certain snakes, lizards, spiders
and scorpions contain sufficient poison to warrant medical attention. There are diseases
that can be transmitted by insect and animal bites. Examples are Rocky Mountain spotted
fever, Lyme disease (tick), rabies (mainly dogs, skunks and foxes), malaria and equine ~
~
Health & Safety Plan 14
encephalitis (mosquitoes). The greatest hazard and most common cause of fatalities from
animal bites -particularly bees , wasps and spiders is a sensitivity reaction. Anaphylactic
shock due to stings can lead to severe reactions in the circulatory, respiratory and central
nervous systems, which can also result in death.
8.3. Contact with Plants
Personnel are prohibited from eating any plant material that may grow on the site.
Certain plants, including poison oak, produce adverse effects from direct dermal contact.
The usual effect is dermatitis inflammation of the skin. The protective clothing and
decontamination procedures used for chemicals also reduce the exposure risk from plant
toxins. Cleaning the skin thoroughly with soap and water after contact will reduce risk.
8.4. Animal and Bird Refuse
Buildings that have been inactive or have normally inaccessible areas such as high
ceilings, crawlspaces, etc., may become refuges or nesting places for animals or roosting
places, particularly for birds. Refuse in the form of nesting materials and droppings often
accumulate around those nests or roosting places. This refuse often contains mold,
fungus or bacteria, which represent respiratory system hazards, including lung diseases
and allergies.
It is expected that site personnel will have a minimum potential for exposure to these
biological agents. Those individuals who are involved in obtaining additional
environmental samples may incur a greater risk of exposure to these materials during
sampling. However, risks associated with exposure to these hazards can be greatly
reduced through proper training, recognition and application of control mechanisms.
9. Basic Safety Work Rules
Intercon is committed to the safety and health of all its employees. In our effort to make
our project hazard free and provide the safest working conditions possible, we expect all
site personnel to learn and practice the following basic safe work rules. In addition to the
rules listed below, there are additional site-specific work rules that must be observed on
this project.
1. Prior to beginning field activities, all site personnel will receive a Health and
Safety briefing and sign a master sheet indicating they have read and understood
this plan.
2. Prior to beginning field activities, the Project Manager will review site-specific
Health and Safety items with all workers to be involved.
3. There will be no eating, drinking or tobacco use during the performance of
drilling activities on the site.
4. As minimum, emergency eyewash will be located at Intercon's trailer located on-
site.
Health & Safety Plan 15
5. Fire extinguishers will be maintained on-site and in each project v ehicle for use
on equipment or small fires .
6. An adequately stocked first aid kit will be on scene and maintained by each
supervisor in each work area at all times during operations.
7. A daily safety meeting will be conducted for all site personnel. Records of these
meetings will be kept at the project field office by Intercon.
8. All personnel will wash hands thoroughly after completing any activity prior to
taking breaks and at the conclusion of each work shift. The project trailers shall
have a restroom equipped with a washbasin.
9. Approved and unaltered hard hats and sturdy work boots are required at all times
in the work areas.
10. Sleeveless shirts and short pants will not be permitted.
11. Approved (Z.87.1) safety glasses/goggles/eye protection shall be worn as
required.
12. Hearing protection shall be worn in all high noise areas or while performing high
noise tasks.
13 . Approved respiratory protection shall be worn as required.
14. Proper gloves are required when handling material that cuts, bums, or
contaminates the skin.
15. Safety belts or harnesses and lanyards shall be worn by employees working on
unguarded or unprotected work platforms six feet or more above the ground
16 . Do not climb on or work from any handrail , mid-rail or brace. Use the ladder to
get on a scaffold.
1 7. Secure or cleat scaffold boards to prevent movement.
18. Inspect all ladders for damage or defects before use. Stepladders will only be
used in the fully opened position.
19. Extension ladders are not to be separated . They must have ladder feet set on a
secure surface and tied off at the top.
20. Good housekeeping shall be practiced at all times.
21. Projecting nai ls shall be bent over or removed from lumber.
Health & S afety Plan 16
22 . Clean up spills immediately and remove oily, flammable , or combustible
waste/rags.
23. Compressed air shall not be used for blowing dust or dirt from clothing.
24. Access to safety and fire fighting equipment shall be kept clear at all times. Learn
how to use an extinguisher before you need it.
25 . Gasoline equipment shall not be refueled when running .
26. Secure all cylinders in the upright position with caps on when not in use.
27. Never enter a confined space/excavation until you check with your supervisor.
Supplied air may be required.
28. Never enter an un-shored excavation over four feet deep unless the slopes are laid
back or secured.
29. Excavations will be provided with an accessible ladder.
30. Horseplay, fighting gambling and stealing will not be tolerated.
31. All electrical cords shall be of the three-wire type.
32 . Tagout and lockout rules are to be strictly enforced.
33. Wire rope chokers, slings, chainfall and come-a-longs are to be inspected by
workers before use.
34. No employee, other than the operator, shall ride on trucks , loaders , shovels or
moving equipment unless authorized.
35. Immediately report all near injuries, accidents and injuries to your supervisor.
36. Report unsafe conditions or practices to your supervisor.
10. Emergency Response Plan
The emergency response plan is an integral part of the Plan and will be reinforced to site
personnel during the daily safety meetings. Ideally , appropriate planning and control will
preclude the need for a response action. However, it is imperative that all personnel are
prepared to respond to an emergency to prevent further harm or injury.
10.1. Evacuation Routes and Procedures
In the event of a site emergency requiring evacuation, the followin g alarm procedures
will be implemented:
6-
Health & Safety Plan 17
1. In the event of an emergency situation, site personnel shall immediately notify the
supervisor of the location and nature of the emergency. The supervisor on the site
shall then contact the appropriate authorities.
2. Normal traffic flow patterns will be in effect unless a local detour is required.
3. Security will also contact the local police to assist with the traffic control of
intersections outside of the site.
10.2. Emergency Security and Control
Following the broadcast of an emergency alarm signal via radio, access to the site and
immediate vicinity of the incident will be restricted. Depending upon the severity and
location of the incident, physical barriers or banner guard will be used to delineate
restricted areas.
10.3. Emergency Decontamination Procedures
Normal decontamination procedures will be modified to suit the specifics of an incident.
The orderly sequence of clothing removal may be adapted to facilitate quick exit of
personnel from hazardous conditions. In the event of a medical emergency, a decision
will be made concerning the priority of decontaminating the patient relative to the
potential for life threatening injuries. If a patient is contaminated, outer clothing can be
cut off and removed and/or the individual can be wrapped in plastic or a blanket.
10.4. Fire or Explosion
In the event of an explosion, personnel will notify the base Fire Department immediately.
This will occur concurrently with evacuation of appropriate personnel and accounting for
personnel. Upon arrival of the fire department, Intercon will advise the fire commander
of the location, nature and identification of the hazardous materials onsite. Providing it
can be done safely, site personnel may:
1. Use fire extinguishers available on-site to control or extinguish a small, localized
fire.
2. Remove or isolate flammable or other hazardous materials that may contribute to
the fire.
3. Begin containment and recovery of the spilled materials.
10.5. Spills and Leaks
In the event of a spill from a fuel storage tank, personnel will:
1. Inform their supervisor immediate I y.
2. Locate the source of the spillage and stop the flow if it can be done safely.
Health & Safety Plan 18
3. Take corrective actions to prevent similar occurrence.
The location of emergency spill response equipment will be indicated on-site drawings
and discussed with site personnel during site indoctrination training and periodically in
safety meetings.
10.6. Medical Emergencies
In the event of a medical emergency, the follo wing procedures shall be implemented :
1. Call 911 (for outside emergency services)
2. Request assistance from emergency medical service and/or additional assistance.
3. Identify location, request medical assistance, provide name and telephone
number.
4. The supervisor will contact the Environmental Health & Safety Officer.
Any person who becomes ill or injured in the work area must be decontaminated to the
maximum extent possible. If the injury or illness is minor, full decontamination should
be completed and first aid administered prior to transport. If the patient's condition is
serious, at least partial decontamination should be completed (i.e., complete disrobing of
the victim and redressing in clean coveralls or wrapping in a blanket). First aid should be
administered while awaiting an ambulance or paramedics. All injuries and illnesses must
be reported immediately to the Corporate Health & Safety Officer. The first aid kit
location will be specially marked and provided with adequate water and other supplies
necessary to clean and decontaminate bums, wounds, or lesions.
11. Plan Approvals
This Plan and all modifications thereto, must be approved by the Corporate Health &
Safety Officer or by individuals specifically designated by the Corporate Health & Safety
Officer to approve.
Health & Safety Plan 19
Section 2.6.6
STORM WATER POLLUTION PREVENTION PLAN
PART1 GENERAL
1.01 SCOPE
A. PURPOSE OF SWPPP: This SWPPP covers the storm water management practices that the
Contractor shall employ in accordance with the TPDES permit governing storm water discharges during
construction , and in accordance with erosion control practices specified in other sections .
B. GENERAL PERMITS FOR STORM WATER DISCHARGE FROM CONSTRUCTION SITES:
Regulations promulgated by the Texas Commission on Environmental Quality (TCE Q) regulate the
discharge of storm water from construction activities on sites where more than 1 acre of soil is disturbed.
One of the ways to comply with these regulations for affected sites is to request coverage under the
Texas General Permit for Construction Activities, Permit Number TXR150000. In o rder to use the
General Permit, for sites which disturb 5 or more acres, a Notice of Intent (N.OJ.) form must be
completed and mailed to the TCEQ (at least 48 hours prior to any earth-disturbing activities) and a copy
of the N.0.1. posted at the construction site; and a Storm Water Pollution Preventio n Plan (SWPPP) for
the site must be prepared and followed during the construction activities. In order to u se the General
Permit, for sites which disturb 1 or more acres but less than 5 acres, a Construction Site Notice be
completed, signed by an official of the Operator, and posted at the construction site; and a Storm Water
Pollution Prevention Plan (SWPPP) for the site must be prepared and followed during the construction
activities.
C. NOTICE OF INTENT: The Owner has agreed to comply with the requirements of the TCEQ for
the storm water discharges during construction at this site to be covered by the TCEO General Permit for
Construction Activity TXR150000. A Notice of Intent (N .OJ .) to be covered under this permit has been
filed by the Owner. The Contractor is required to follow the same procedures as the Owner regarding the
filing of a N.0.1. or the posting of a Construction Site Notice. The signatory on the N..O J. for the Owner
must sign all documents (i.e. N.0.1., N.O.T., NOC, inspection reports) associated wilh 1he SWPPP. If the
signatory chooses not to sign all documents, he/she must designate a duly authorized r epresentative to
sign all relevant documents. This designation must be made in writing and be included in the SWPPP.
The duly authorized representative may be either a named individual or any in<fJVidual occupying a
named position . Additionally, the written designation must be subm itted to the TCEQ. A sample form for
designating a duly authorized representative is included in Appendix A.
D. TERMINATION OF PERMIT COVERAGE: If an N.0.1. was filed for the site, a Notice of
Termination (N.O.T.) form is required to be filed with the TCEQ by each Operafol" wilhin 30 days after
construction has been completed, the site has undergone final stabilization, and the faCITJty no longer
discharges storm water associated with construction activities. This filing terminates coverage under the
General Permit and terminates the Owner's responsibility to implement the SWPPP. but 1he requirements
of the SWPPP, including required inspections, must be continued until the N.O.T. is fied.. Jf a N .0.1. was
not required to be filed for the site, a N.O.T. is not required to be filed .
E. INSPECTION REQUIREMENTS: The SWPPP is meant to be a working doaJment and a
guideline to be used on the construction site. It includes a schedule of regular inspedion of the controls
specified for use at the site, and written documentation of these inspections m ust be kept on file along
w ith the SWPPP and made available to the TCEQ or any other agency w ith regulatDiy authority over
storm water issues. The requirement for written documentation of inspections is most easily met by using
the inspection forms which have been prepared a nd included in the SWPPP manual Jnspections are
required at least bi-weekly (at least once every 14 days) and w ithin 24 hours following a rainfall event of
more than 0.5 inches. However, the permit provides that if inspections are performed on a weekly basis
(at least once every 7 days), that inspections within 24 hours following a rainfall event of more than 0.5
inches are not required. If the inspection forms are signed by someone other t han a axporate officer of
the Contractor, then a corporate officer must designate a duly authorized re presemafive to s ign all
relevant documents. Owner will perform weekly inspections on every Monday.
1
~
F. SWPPP MODIFICATIONS: The SWPPP is also meant to be a dynamic working guide that is to be
kept current and amended whenever the design, construction , operation , or maintenance of the site
changes in a way which significantly affects the potential for the discharge of pollutants or when the plan
proves to be ineffective in eliminating or significantly minimizing pollutant discharges. The SWPPP must
also be amended to identify any new contractor and/or subcontractor that will implement a measure of the
SWPPP. Notification of any modifications to or amendments of the SWPPP must be made in writing to
both the Owner and the Contractor within 7 days of the date such modification or amendment is made.
G. RESPONSIBILITIES OF CONTRACTOR REGARDING THE GENERAL PERMIT:
The Contractor shall manage the discharge of storm water from the site in accordance with the TPDES
permit and the following provisions of this section of the specifications. The Contractor shall be
responsible for conducting the storm water management practices in accordance with the permit The
Contractor shall be responsible for any enforcement action taken or imposed by Federal or State
agencies , including the cost of fines, construction delays, and remedial actions resulting from the
Contractor's failure to comply with the permit provisions.
H. RESPONSIBILITIES OF CONTRACTOR TO OWNER: The Contractor shall monitor the Suitability
of the designated management practices to achieve the storm water quality provisions of the permit, and
shall notify the Owner of the need to change management practices. The Contractor's failure to monitor
or report deficiencies to the Owner will result in the Contractor being liable for fines and construction
delays resulting from any Federal or State agency enforcement action.
I. REQUIRED SITE NOTICES: The Owner shall ensure that the construction site complies with
all notification requirements of the TCEQ General Permit, which are as follows:
For sites which disturb 1 or more acres but less than 5 acres, a Construction Site Notice,
prepared by the Operator who has day to day control over the implementation of the SWPPP,
must be completed (Which gives the name and telephone number of a representative of the
Operator, a brief description of the construction project, and the location of the Storm Water
Pollution Prevention Plan), signed by an official of the Operator, and posted at the construction
site; a copy of this Construction Site Notice(s) must be provided to the operator of any Municipal
Separate Storm Sewer System (MS4) which receives any discharge from the construction site.
For sites which disturb 5 or more acres, a copy of the N .0.1. prepared by each Operator must be
posted near the main entrance of the construction site in a publicly accessible location for viewing
by the general public; and a Construction Site Notice, which gives the name and telephone
number of a representative of the Operator who has day to day control over the implementation of
the SWPPP, a brief description of the construction project, and the location of the Storm Water
Pollution Prevention Plan, must also be posted . A signed copy of the N.OJ_ form must also be
provided, at least 48 hours prior to commencement of construction activities, to the operator of
any MS4 operator which receives any discharge from the construction site.
PART 2 SITE DESCRIPTION
2.01 PROJECT NAME AND LOCATION
2.009 acres located at 5250 Wonder Drive, Fort Worth , Texas 76112
2.02 OWNERS NAME AND ADDRESS
City of Fort Worth
1 ODO Throckmorton Street
Fort Worth, Texas 76102
2.03 DESCRIPTION
This project will consist of removing all structures and improvements from the former Granbury Hills
Apartments (includ ing foundations), excavating and removing buried piping , removal of miscellaneous debris,
and the removal of small brush and/or trees as may be necessary to complete the demolition activities. The
estimated time for completion of the construction project is 45 working days . Soil disturbing act ivities will
include:
A. See Section IV.
2.04 RUNOFF COEFFICIENT, SOILS, AND RAINFALL INFORMATION
The initial coefficient of runoff for the pre-construction site is "c" = 0.3. The post-construction
coefficient of runoff for the site will be "c" = 0.3. The site is 2 .009 acres of which 2 .009 acres will be
disturbed by construction activities .
The site is in Tarrant County which receives an average of 31.4" rainfall annuaDy with the highest
amounts of rainfall received in the months of May and October.
2 .05 NAME OF RECEIVING WATERS
The site will drain into an unnamed tributary to the West Fork of the Trinity River.
2 .06 INDIAN COUNTRY LANDS
The site is not located on Indian lands.
PART3 CONTROLS
3,01 EROSION AND SEDIMENT CONTROLS
3.01 .1 Stabifization Practices
Stabif!Zation practices for this site include:
A. Land clearing activities shall be done only in areas where earthwork wil be performed and
shall progress as earthwork is needed.
B. Frequent watering of excavation and fill areas to minimize wind erosion during construdion,
C. Pennanent seeding and planting of all unpaved areas using the hydro-mulching g rass
seeding technique.
3.01 .2 Structural Practices
Structural practices for this site include:
A Perimeter protection using silt fences
8-Stabilized construction exit points
C. Jnlet protection of ex isti ng storm water drains on the streets a djacent to the site .. A
temporary sediment basin will not be used at this site. Howev er, equivalen t controts
with perimeter silt fencing will be implemented.
.,-
3.01.3 Sequence of Major Activities
The Owner will be respons ible for implementing the following erosion c:onlrol and storm water
management control structures. The Owner may designate t hese tasks to certain
subcontractors as he sees fit, but the ultimate responsibility for implementing these controls
and ensuring their proper functioning remains with the contractor an d owner. The order of
activities will be as listed on the Sequence Sheet fo rm contained in t his SWPPP plan .
3.01 .4 Storm Water Management
The site will drain into an unnamed tributary to the West Fork of the Trinity River. Owner will
notify the City of Fort Worth and send a copy of the N.0 .1. and NOT.
3.02 OTHER CONTROLS
3.02.1 Waste Disposal
All asbestos containing waste materials will be collected and stored in a securely lidded metal
dumpster rented from a local waste management company which m ust be a solid waste
management company licensed to do business in the State of Texas. The dumpster will comply
with all local and state solid waste management regulations.
All trash and construction debris from the site will be loaded into dump truckslbaJlers. The trash
and construction debris will be hauled to a landfill approved by the Staie of Texas. No
construction waste materials will be buried on site. All personnel will be instrucled regarding the
correct procedures for waste disposal. Notices stating these practices w ill be posted on the job
site and the job site superintendent will be responsible for seeing that these p rocedures are
followed.
3 .02.2 Sanitary Waste
All sanitary waste will be collected from the portable units on a regu lar bas'is by a licensed
portable facility provider in complete compliance with local and state regulations..
3 .02.3 Off-Site Vehicle Tracking
Contractor shall provide a mechanical road sweeper, which shall be pre-approved by the Owner.
Contractor shall sweep adjacent streets on an as needed basis along the entire tength of ·the
property. Contractor shall also sweep adjacent streets beyond the limits of 1he property should
the contractor's operations affect that portion of the road. Contractor shall pe,form said sweeping
on an as needed basis from the day he mobilizes until the Owner accepts 1he project.
A stabilized construction exit will be provided to help reduce vehicle tracking of sediments. The
paved streets adjacent to the site entrance will be inspected daily and swept as necessary to
remove any excess mud , dirt, or rock tracked from the site. Dump trucks hauling m aterial from
the construction site will be covered with a tarpaulin . The job site s upefimendent will be
responsible for seeing that these procedures are followed .
3 .02.4 Concrete Waste from Concrete Trucks
A. Not Applicable
3.02.5 Hazardous Substances and Hazardous Waste
PART4
A. All hazardous waste materials will be disposed of in the manner specified by local ,
state, and/or federal regulations and by the manufacturer of such products. Site
personnel wi ll be instructed in these pract ices by the job site superintendent, who will
also be responsible for seeing that these practi ces are followed .
B. The contractor shall devise and implement a Spill Plan . Contractor shall train all
personnel in the proper cleanup and handling of spilled materials. No spilled hazardous
materials or hazardous wastes will be allowed to come in contact w ith storm water
discharges. If such contact occurs, the storm water discharge will be contained on site
until appropriate measures in compliance w ith state and federal reg u lations are taken to
dispose of such contaminated storm water.
C. Any spills of hazardous materials which are in quantities in excess of Reportable
Quantities as defined by TCEQ regulations shall be immediately reported to the TCEQ
National Response Center 1-512-239-2507.
D. In order to minimize the potential for a spill of hazardous materials to come into contact
with storm water, the following steps will be implemented:
1. All materials with hazardous properties (such as pesticides, petroleum products,
fertilizers, detergents, construction chemicals, acids, paints, paint solvents,
cleaning solvents, additives for soil stabilization, concrete curing compounds and
additives, etc.) will be stored in a secure location when not in use.
2. The minimum practical quantity of all such materials will be kept on the job site.
3. A spill control and containment kit {containing, for example, absorbent such as
kitty litter or sawdust, acid neutralizing powder, brooms,. dust pans, mops, rags ,
gloves, goggles, plastic and metal trash containers, etc.) wiD be provided at the
storage site.
4. All products will be stored in and used from the original container with the original
product label.
5. All products will be used in strict compliance with instructions on the product
label.
3.02 .6 Contaminated Soils
A. Any contaminated soils (resulting from spills of materials with hazardous properties)
which may result from construction activities will be contained · and deaned up
immediately in accordance with the spill plan and in accordance with applicable state and
federal regulations,
B. The job site superintendent will be responsible for seeing that these procedures are
followed.
COMPLIAN CE WITH FEDERAL, STATE, AND LOCAL REGULATIONS
The Owner will obtain copies of any and all local and state r egulations which are applicable to storm
water management and pollution minimization at this job site and will comply fu lly with such regulations.
The contractor and Owner will comply with all conditions of the TPDES General Permit for Construction
Activities, including the conditions related to maintaining the SWPPP and evidence of compliance with. the
SWPPP at the job site and allowing regulatory personnel access t o the job site and 1D r ecords in order to
determine compliance.
,i
PART 5 MAINTENANCE/INSPECTION PROCEDURES
5.01 Erosion and Sed iment Co nt rol Maintenance and Inspecti on Practi ces
A. The following is a list of erosion an d sediment controls to be used on th is site during construction
practice .
1. Stabilization practices for t his site inclu de :
Land clearin g activ ities shall be done only in areas wh ere e a rthwork will be
performed and shall progress as earthwork is needed .
Perform frequent watering of excavation and fill areas to minimize wind erosion
during construction .
Perform permanent seeding and planting of all unpaved a reas u sing the hydro-
mulching grass seeding technique.
2. Structural practices for this site include:
Silt fence installation at perimeter.
Stabilized construction exit points
B. The following inspection and maintenance practices will be used to maintain erosion and
sediment controls.
1. All control measures will be inspected every Monday. If inspections are conducted
on a schedule of at least every 7 days , then inspections after rainfall events are not
required .
2. All measures will be maintained in good working order; if repairs are found to be
necessary, they w ill be initiated as soon as possible.
3. Built up sediment will be removed from silt fence when it has reached one-half the
height of the fence.
4. Silt fences will be inspected for depth of sediment, tears, to see if the fabric is
securely attached to the fence posts, and to see that the fence posts are securely in
the ground.
5. Temporary and permanent seeding will be inspected for bare spots, washouts, and
healthy growth.
6. A maintenance inspection report will be made after each inspection.. Copies of the
report forms to be completed by the inspector are included in this SWPPP.
7. Personnel selected for the inspection and maintenance responsiblTrties will receive·
training from the O wner. They w iU be trained in all the inspection and maintenance
practices necessary for keeping the erosion and sediment controJs that are used
· onsite in good working order. They will also be trained in the cornp1etion of, in itiation
of actions required by, and the fi ling of the inspection forms. Doc:urnentation of the
qualifications of in spection personnel must be kept in the SWPPP_
5.02 Inspection and Maintenance Report Forms
Once installation of any required or optional erosion control d~vice or measure has been
implemented, weekly inspections of each measure shall be performed by the Owner's inspection
personnel. The Inspection and Maintenance Reports found in this SWPPP shall be used by the
inspectors to inventory and report the condition of each measure to assist in maintaining the
erosion and sediment control measures in good working order.
Based on the results of the periodic inspections, necessary control modifications shall be
implemented within 7 calendar days. These inspection reports shall be kept on file as part of the
Storm Water Pollution Prevention Plan for at least three years from the date of completion and
submission of the Notice of Termination .
These report forms shall become an integral part of the SWPPP and shall be made readily
accessible to TCEQ inspection officials, the City Inspection Officials, and the Owner for review
upon request during visits to the project site. In addition, copies of the reports shall be provided
to any of these persons, upon request, via mail or facsimile transmission .
PART 6 SPILL PLAN
6.01 MATERIALS COVERED
The following materials or substances with known hazardous properties are expected to be
present onsite during construction:
Concrete
Petroleum based products
6.02 MATERIAL MANAGEMENT PRACTICES
The following are the material management practices that will be used to reduce the risk of spills
or other accidental exposure of materials and substances to storm water runoff_
6.02 .1 Good Housekeeping
The following good housekeeping practices will be followed onsite during the construction project.
A An effort will be made to store only enough of each product required to do the job.
B. All materials stored onsite will be stored in a neat orderly manner and, if possible, under a
roof or other enclosure.
C. Products will be kept in their original containers with the original manufacturer's label in
legible condition.
D. Substances will not be mixed with one another unless recommended by the manufacturer.
E. Whenever possible, all of a product will be used up before disposing of the container.
F. Manufacturer's recommendations for proper use and disposal will be followed.
G. The job site superintendent will be responsible for daily inspections to ensure proper use and
disposal of materials.
6.02 .2 Hazardous Products
These practices will be used to reduce the risks associated with hazardous materials.
A Products will be kept in original containers with the orjginal labels in leg ible condition .
8. Original labels and material safety data sheets (MSDS's) will be procured and used for each
material.
C. If surplus product must be disposed of, the manufacturer's or local/state/federal
recommended methods for proper disposal will be followed .
D. A spill control and containment kit (containing , for example, absorbent such as kitty litter or
sawdust, acid neutralizing powder, brooms, dust pans, mops, rags, gloves, goggles, plastic
and metal trash containers, etc.) will be provided at the storage site .
E. All of the product in a container will be used before the container is disposed of. All such
containers will be triple-rinsed with water prior to disposal. The rinse water used in these
containers will be disposed of in a manner in compliance with state and federal regulations
and will not be allowed to mix with storm water discharges,
6 .02 .3 Product Specific Practices
The following product specific practices will be followed on the job site.
A Petroleum Products
All onsite vehicles will be monitored for leaks and receive regular preventative maintenance to
reduce the chance of leakage. Petroleum products will be stored in tightly sealed containers
which are clearly labeled. Any petroleum storage tanks used onsite will have a dike or burm
containment structure constructed around it to contain any spills which may occur. Any asphalt
substances used onsite will be applied according to the manufacturer's recommendations.
6.02.4 Spill Prevention Practices
In addition to the good housekeeping and material management practices discussed in the
previous sections of this plan, the following practices will be followed for spill prevention and
cleanup.
A Manufacturer's recommended methods for spill cleanup will be clearly posted and site
personnel will be trained regarding these procedures and the location of 1he information and
cleanup supplies.
8. Materials and equipment necessary for spill cleanup will be kept in the material storage area
onsite in spill control and containment kit (containing, for example, absorbent such as kitty
litter or sawdust, acid ·neutralizing powder, brooms, dust pans, mops. rags. gloves, goggles,
plastic and metal trash containers, etc,),
C. All spills will be cleaned up immediately after discovery.
D. The spill area will be kept well ventilated and personnel will wear appropriate protective
clothing to prevent injury from contact with the hazardous substances.
E. Spills of toxic or hazardous materials will be reported t o the appropria te federal, state, and/or
local government agency, regardless of the size of the spill . Spills of a m ounts that exceed
Reportable Quantities of certain substances specifically mentioned in fe d eral regulations (40
CFR 302 list and oi l) will b e immed iately reported to the TCEQ Nati o nal R esponse Center,
telepho ne 1-512-239-2507 . Reportable Quantit ies of some substances whic h m ay be used
at th e j ob site are as foll ow s :
Petroleum based products-appearance of a film or sheen on w ater
F. The SPCC plan will be adjusted to include m easu res to prevent this type of spill from
rec urring and how to clean u p the spill if there is anot her one. A description o f th e spill , what
caused it, and the cleanup measures will also be included . If the spill ex ceeds a Reportable
Quantity, all federal reg ulations regarding reports of t he incident will be com p lied w ith.
PART7 CONTROL OF ALLOWABLE NON-STORMWATER DISCHARGES
Certain types of discharges are allowable under the TPDES General Permit for Construction Activity, and
it is the intent of this SWPPP to allow such discharges. These types of discharges will be allowed under
the conditions that no pollutants will be allowed to come in contact w ith the wate r p rior to or after its
discharge. The control measures which have been outlined previously in this SWPPP will be strictly
followed to ensure that no contamination of these non-storm water discharges takes place, The following
allowable non-storm water discharges which may occur from the job site include:
A Discharges from firefighting activities
B. Flushing Fire Hydrants {See Note below)
C. Waters used to wash vehicles or control dust in orde·r to minimize offsite sediment tracking.
D. Potable water sources such as flushing of waterlines, routine exterior butlding wash downs
(without detergents present). (See Note below)
E. Pavement wash waters where spills or leaks of hazardous materials have not occurred or
detergents have not been used.
F. Springs and other uncontaminated groundwater, including dewatering ground water
infiltration.
G. Foundation or footing drains where no contamination with process materials such as solvents
is present
NOTE: Contractor shall neutralize any super-chlorinated water from water distribution pipes before
releasing it into the environment Neutralization techniques a re available from the En.9ineer.
PARTS CERTIFICATION AND NOTIFICATION
The TCEQ permit does not require certification of the SWPPP. The on ly certifications required are those
on the Construction Site Notice form (for sites t hat disturb more than 1 acre but less than 5 acres) or the
Notice of Intent form (for s ites that disturb more than 5 acres). Notification of ihe oper ator of any
Municipal Separ ate Storm Sewer Syst em (MS4) into which storm w ater d ischarg es from the construction
site are conveyed is required . This notification must be provided in the form of a copy of either the Notice
of Intent form , which must be provided at least 48 hours prior to commencement of -construction, or the
Construction Site Notice form required by the Permit.
Section 2.6.6
STORM WATER POLLUTION PREVENTION PLAN
PART1 GENERAL
1.01 SCOPE
A. PURPOSE OF SWPPP: This SWPPP covers the storm water management practices that the
Contractor shall employ in accordance with the TPDES permit governing storm water d ischarges during
construction , and in accordance with erosion control practices specified in other sections.
B. GENERAL PERMITS FOR STORM WATER DISCHARGE FROM CONSTRUCTION SITES:
Regulations promulgated by the Texas Commission on Environmental Quality (TCEQ) regulate the
discharge of storm water from construction activities on sites where more than 1 acre of soil is d isturbed .
One of the ways to comply w ith these regulations for affected sites is to request coverage under the
Texas General Permit for Construction Activities, Permit Number TXR150000 . In order to use the
General Permit, for sites which disturb 5 or more acres, a Notice of Intent (N .0.1 .) fonn must be
completed and mailed to the TCEQ (at least 48 hours prior to any earth-disturbing activities) and a copy
of the N.0.1 . posted at the construction site; and a Storm Water Pollution Prevention Plan {SWPPP) for
the site must be prepared and followed during the construction activit ies. In order to use the General
Permit, for sites which disturb 1 or more acres but less than 5 acres, a Construction Site Notice be
completed, signed by an official of the Operator, and posted at the construction site; and a Storm Water
Pollution Prevention Plan (SWPPP) for the site must be prepared and followed dun,g the construction
activities.
C. NOTICE OF INTENT: The Owner has agreed to comply w ith the requirements of the TCEQ for
the storm water discharges during construction at this site to be covered by the TCEQ General Permit for
Construction Activity TXR150000. A Notice of Intent (N.0.1.) to be covered under this permit has been
filed by the Owner. The Contractor is required to follow the same procedures as the Owner regarding the
filing of a N.0.1 . or the posting of a Construction Site Notice. The signatory on the N.O.t for the Owner
must sign all documents (i.e. N.0.1 ., N.O.T ., NOC, inspection reports) associated with 1he SWPPP. If the
signatory chooses not to sign all documents, he/she must designate a duly authorized representative to
sign all relevant documents. This designation must be made in writing and be included in the SWPPP.
The duly authorized representative may be either a named individual or any individual occupying a
named position . Additionally, the written designation must be submitted to the TCEO. A sample form for
designating a duly authorized representative is included in Appendix A.
D. TERMINATION OF PERMIT COVERAGE: If an N.0 .1. was filed for the site. a Notice of
Termination (N .O.T.) form is required to be filed with the TCEQ by each Operator within 30 days after
construction has been completed, the site has undergone final stabilization , and the facility no longer
discharges storm water associated with construction activities. This filing terminates coverage under the
Generat Permit and term inates the Owner's responsibility to implement the SWPPP. but 1he requirements
of the SWPPP, including required inspections, must be continued until the N.O.T. is fied... .If a N.0 .1. was
not required to be filed for the site, a N.O.T. is not required to be filed .
E. INSPECTION REQUIREMENTS: Th e SWPPP is meant to be a wooong doaJme nt an d a
guideline to be used on th e con struction site. It includes a schedul e of regula r inspedion of the control s
specified for use at th e site, and written documentation of the se inspections must be kept on fi le along
with the SWPPP an d mad e available t o th e TCEQ o r any other agency with reguJairny autho rity over
storm w ater issues. Th e requirem ent for written docu mentation of ins pection s is most -easily met by using
th e inspectio n f orms which have been prepared and in cluded in th e SWPPP manual l nspections are
requ ired at least bi-weekly (at least once every 14 days) and with in 24 hours following a rainfall event of
more than 0.5 inches. However, the permit provides that if inspections are performed 011 a weekly bas is
(at least once every 7 days), t hat inspections w ithin 24 hours fo ll owing a rai nfall evm d more than 0.5
inches are not required. If the inspection forms are signed by someone other th an a axporate officer of
the Contractor, then a corporate officer must designate a duly authorized representative fo sign all
relevant documents. Owner will perform weekly inspections on every Monday.
r
F. SWPPP MODIFICATIONS: The SWPPP is also meant to be a dynamic working guide that is to be
kept current and amended whenever the design , construction , operation , or maintenance of the site
changes in a way wh ich significantly affects the potential for the discharge of pollutants or when the plan
proves to be ineffective in eliminating or s ignificantly m inimizing pollutant discharges. The SWPPP must
also be amended to identify any new contractor and/or subcontractor that will implement a measure of the
SWPPP. Notification of any modifications to or amendments of the SWPPP must be made in writing to
both the Owner and the Contractor within 7 days of the date such modificati on or amendment is m ade.
G . RESPONSIBILITIES OF CONTRACTOR REGARDING THE GENERAL PERMIT:
The Contractor shall manage the discharge of storm water from the site in accordance w ith the TPDES
permit and the following provisions of this section of the specifications. The Contractor shall be
responsible for conducting the storm water management practices in accordance with the permit The
Contractor shall be responsible for any enforcement action taken or imposed by Federal or State
agencies, including the cost of fines, construction delays, and remedial actions resulting from the
Contractor's failure to comply with the permit provisions.
H. RESPONSIBILITIES OF CONTRACTOR TO OWNER: The Contractor shall monitor the Suitability
of the designated management practices to achieve the storm water quality provisions of the permit, and
shall notify the Owner of the need to change management practices. The Contractor's failure to monitor
or report deficiencies to the Owner will result in the Contractor being liable for fines and construction
delays resulting from any Federal or State agency enforcement action.
I. REQUIRED SITE NOTICES: The Owner shall ensure that the construction site complies with
all notification requirements of the TCEQ General Permit, which are as follows:
For sites which disturb 1 or more acres but less than 5 acres, a Construction Site Notice,
prepared by the Operator who has day to day control over the implementation of the SWPPP,
must be completed (Which gives the name and telephone number of a representative of the
Operator, a brief description of the construction project, and the location of the Storm Water
Pollution Prevention Plan), signed by an official of the Operator, and posted at the construction
site; a copy of this Construction Site Notice(s) must be provided to the operator of any Municipal
Separate Storm Sewer System (MS4) which receives any discharge from the construction site.
For sites which disturb 5 or more acres, a copy of the N.0.1 . prepared by each Operator must be
posted near the main entrance of the construction site in a publicly accessible location for viewing
by the general public; and a Construction Site Notice, which gives the name and telephone
number of a representative of the Operator who has day to day control over the implementation of
the SWPPP, a brief description of the construction project, and the location of the Storm Water
Pollution Prevention Plan, must also be posted. A signed copy of the N.0.1. form must also be
provided, at least 48 hours prior to commencement of construction activities, to the operator of
any MS4 operator which receives any discharge from the construction site.
PART 2 SITE DESCRIPTION
2 .01 PROJECT NAM E AN D LOCA TION
2 .009 acres located at 5250 Wonder Drive, Fort Worth , Texas 7 6112
2 .02 OWNERS NAME AND AD DRESS
C ity of Fort Worth
1000 Throckmorto n Street
Fort Worth, Te xas 76 102
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2 .03 DESCRIPTION
This project will consist of removing all structures and improvements f rom the former Granbury Hills
Apartments (including foundations), excavating and removing buried piping, removal of miscellaneous debris,
and the removal of small brush and/or trees as may be necessary to complete the demolition activities. The
estimated time for completion of the construction project is 45 working days . Soil disturbing activities wil
include:
A. See Section IV .
2.04 RUNOFF COEFFICIENT, SOILS, AND RAINFALL INFORMATION
The initial coefficient of runoff for the pre-construction site is "c" = 0.3. The post-construction
coefficient of runoff for the site will be "c" = 0.3. The site is 2.009 acres of which 2 .009 acres wil be
disturbed by construction activities .
The site is in Tarrant County which receives an average of 31 .4" rainfall annuaffy with the highest
amounts of rainfall received in the months of May and October.
2.05 NAME OF RECEMNG WATERS
The site will dran into an unnamed tributary to the West Fork of the Trinity River.
2 .06 INDIAN COUNTRY LANDS
The site is not located on Indian lands.
PART 3 CONTROLS
3,01 EROSION AND SEDIMENT CONTROLS
3.01. 1 Stabifization Practices
Stabilization practices for this site include:
A. Land clearing activities shall be done only in areas where earthwork wil be perfonned and
shall progress as earthwork is needed.
B. Frequent watering of excavation and fill areas to minimize wind erosion during construction,
C. Pemianent seeding and planting of all unpaved areas using the hydro-mulching grass
seeding technique.
3.01 .2 Structural Practices
Structural practices for this site include:
A Perimeter protection us in g silt fe nc es
B. Stabilized constructi on e xit poi nts
C . lnlet protection of existing storm water drains on t he street s adjacent to the site . A
temporary sediment basin will not be used at this site. However, equivalent controls
with perimeter silt fencing will be implemented.
3.01.3 Sequence of Major Activities
The Owner will be responsible for implementing the follow ing erosion control and storm water
management control structures. The Owner may designate these tasks to certain
subcontractors as he sees fit, but the ultimate responsibility for implementing these controls
and ensuring their proper functioning remains with the contractor and owner. The order of
activities will be as listed on the Sequence Sheet form contained in this SWPPP plan .
3.01.4 Storm Water Management
The site will drain into an unnamed tributary to the West Fork of the Trinity River. Owner will
notify the City of Fort Worth and send a copy of the N.0 .1. and NOT.
3 .02 OTHER CONTROLS
3.02.1 Waste Disposal
All asbestos containing waste materials will be collected and stored in a securely lidded metal
dumpster rented from a local waste management company which must be a solid waste
management company licensed to do business in the State of Texas. The dumpster will comply
with all local and state solid waste management regulations.
All trash and construction debris from the site will be loaded into dump trucksltrallers. The trash
and construction debris will be hauled to a landfill approved by the Stale of Texas. No
construction waste materials will be buried on site. All personnel will be instructed regarding the
correct procedures for waste disposal. Notices stating these practices will be posted on the job
site and the job site superintendent will be responsible for seeing that these procedures are
followed.
3 .02.2 Sanitary Waste
All sanitary waste will be collected from the portable units on a regular basis by a licensed
portable facility provider in complete compliance with local and state regulations.
3 .02.3 Off-Site Vehicle Tracking
Contractor shall provide a mechanical road sweeper, which shall be pre-approved by the Owner.
Contractor shall sweep adjacent streets on an as needed basis along the entire length of the
property. Contractor shall also sweep adjacent streets beyond the limits of 1he poperty should
the contractor's operations affect that portion of the road . Contractor shall perlonn said sweeping
on an as needed basis from the day he mobilizes until the Owner accepts the project
A stabilized construction exit will be provided t o help redu c e vehicle tracking of sediments. The
paved streets adjacent t o the site entrance will be inspected da il y and swept as necessary t o
remove an y excess m ud , dirt, o r rock tracked from th e s ite. Dum p trucks ha~g mate ri al from
the con structi on site w ill be covered w ith a ta rp aulin. The j o b site superintendent w ill be
resp onsible for seeing that these proce dures are followed.
3 .02.4 Co ncrete Waste from Concrete Trucks
A. Not Applicable
r
I
3 .02.5 Hazardous Substances and Hazardous Waste
PART4
A. All hazardous waste materials will be disposed of in the manner specified by local,
state, and/or federal regulations and by the manufacturer of such products. Site
personnel will be instructed in these practices by the job site superintendent, who will
also be responsible for seeing that these practices are followed .
B. The contractor shall devise and implement a Spill Plan . Contractor shall train all
personnel in the proper cleanup and handling of spilled materials. No spilled hazardous
materials or hazardous wastes will be allowed to come in contact with storm water
discharges. If such contact occurs, the storm water discharge will be contained on site
until appropriate measures in compliance with state and federal regulations are taken to
dispose of such contaminated storm water.
C. Any spills of hazardous materials which are in quantities in excess of Reportable
Quantities as defined by TCEQ regulations shall be immediately reported to the TCEQ
National Response Center 1-512-239-2507 .
D. In order to minimize the potential for a spill of hazardous materials to come into contact
with storm water, the following steps will be implemented:
1. Al materials with hazardous properties (such as pesticides, petroleum products,
fertilizers, detergents, construction chemicals, acids, paints, paint solvents,
deaning solvents, additives for soil stabilization, concrete curing compounds and
additives, etc.) will be stored in a secure location when not in use.
2. The minimum practical quantity of all such materials will be kept on the job site.
3. A spin control and containment kit (containing, for example. absorbent such as
kitty litter or sawdust, acid neutralizing powder, brooms, dust pans, mops, rags,
gloves, goggles, plastic and metal trash containers, etc.) wil be provided at the
storage site.
4. Al products will be stored in and used from the original container with the original
product label.
5. Al products will be used in strict compliance with instructions on the product
label.
3.02 .6 Contaminated Soils
A. Any contaminated soils (resulting from spills of materials with hazardous properties)
which may result from construction activities will be contained and deaned up
immediately in accordance with the spill plan and in accordance with applicable state and
federal regulations,
B . The job site superintendent will be responsible for seeing that these procedures are
followed.
COMPLIANCE WITH FEDERAL, STATE, AND LOCAL REGULATIONS
The Owner w ill obtain copies of any and all local and state regulations which are applicable t o storm
water management and pollution minimization at this job site and will comply fully wtlh such regulations.
The contractor and Owner will comply with all conditions of the TPDES General Penni for Construction
Activities , including the conditions related to maintaining the SWPPP and evidence of compliance with_ the
SWPPP at the job site and alJowing regulatory personnel access to the job site and 1o records in order to
determine compliance.
,i
PART 5 MAINTENANCE/INSPECTION PROCEDURES
5.01 Erosion and Sediment Control Maintenance and Inspection Practices
A. The following is a list of erosion and sediment controls to be used on this site during construction
practice .
1. Stabilization practices for this site include:
Land clearing activities shall be done only in areas where earthwork will be
perfonned and shall progress as earthwork is needed.
Perfonn frequent watering of excavation and fill areas to minimize wind erosion
during construction .
Perfonn pennanent seeding and planting of all unpaved areas using the hydro-
mulching grass seeding technique. ·
2. Structural practices for this site include:
Silt fence installation at perimeter.
Stabilized construction exit points
B. The following inspection and maintenance practices will be used to maimajn erosion and
sediment controls.
i
1. All control measures will be inspected every Monday. If inspections are conducted
on a schedule of at least every 7 days, then inspections after rainfall events are not
required.
2. All measures will be maintained in good working order; if repairs are found to be
necessary, they will be initiated as soon as possible.
3. Built up sediment will be removed from silt fence when it has reached one-half the
height of the fence.
4. Silt fences will be inspected for depth of sediment, tears, to see if the fabric is
securely attached to the fence posts, and to see that the fence posts are securely in
the ground.
5. Temporary and pennanent seeding will be inspected for bare spo1s. washouts, and
healthy growth.
6. A maintenance inspection report will be made after each in spection. Copies of the
report forms to be completed by the inspector are included in this SWPPP.
7. Personnel selected for the inspection and maintenance responsibilities will receive
training from the Owner. They will be trained in all th e inspection and maintenance
practices necessary for keeping the erosion and sediment oontrols that are used
· onsite in good working order. They will also be trained in the completion of, initiation
of actions required by, and the filin g of the inspection forms. Oocmnentation of the
qualifications of inspection personnel must be kept in the SWPPP.
5.02 Inspection and Maintenance Report Forms
Once installation of any required or optional erosion control device or measure has been
implemented , weekly inspections of each measure shall be performed by the Owner's inspection
personnel. The Inspection and Maintenance Reports found in this SWPPP shall be used by the
inspectors to inventory and report the cond ition of each measure to assist in maintain ing the
erosion and sediment control measures in good working order.
Based on the results of the periodic inspections, necessary control modifications shall be
implemented within 7 calendar days. These inspection reports shall be kept on file as part of the
Storm Water Pollution Prevention Plan for at least three years from the date of completion and
submission of the Notice of Termination .
These report forms shall become an integ ral part of the SWPPP and shall be made readily
accessible to TCEQ inspection officials, the City Inspection Officials, and the Owner for review
upon request during visits to the project site. In addition, copies of the reports shall be provided
to any of these persons, upon request, via mail or facsimile transmission .
PART 6 SPILL PLAN
6.01 MATERIALS COVERED
The following materials or substances with known hazardous properties are expected to be
present onsite during construction :
Concrete
Petroleum based products
6.02 MATERIAL MANAGEMENT PRACTICES
The following are the material management practices that will be used to reduce the risk of spills
or other accidental exposure of materials and substances to storm water runoff.
6 .02 .1 Good Housekeeping
The following good housekeeping practices will be followed onsite during the construction project.
A An effort will be made to store only enough of each product required to do the job.
B. All materials stored onsite will be stored in a neat, orderly manner and, if possible , under a
roof or other enclosure.
C. Products will be kept in their orig inal containers with the original manufacturer's label i n
leg ible condition.
D. Su bstances wi ll not be mixed with one another unless recommen ded b y t he manufacturer.
E. Whenever possible, a ll of a product will be used up before disposin g of the contain er.
F. Man ufacturer's recommendations for pro pe r use an d disp osal wi ll be followed.
G. The job site superintend ent will be respo ns ible for daily inspections to ensure proper use and
d isposal of materi als.
6 .02 .2 Hazardous Products
These practices will be used to reduce the risks associated with hazardous materials .
A Products will be kept in original containers with the original labels in legible cond ition .
B. Original labels and material safety data sheets (MSDS's) will be procured and used for each
material.
C. If surplus product must be disposed of, the manufacturer's or local/state/federal
recommended methods for proper disposal will be followed .
D. A spill control and containment kit (containing, for example, absorbent such as k itty litter or
sawdust, acid neutralizing powder, brooms, dust pans, mops, rags, gloves, goggles, plastic
and metal trash containers, etc.) will be provided at the storage site .
E. All of the product in a container will be used before the container is disposed of. All such
containers will be triple-rinsed with water prior to disposal. The rinse water used in these
containers will be disposed of in a manner in compliance with state and federal regulations
and will not be allowed to mix with storm water discharges,
6 .02 .3 Product Specific Practices
The following product specific practices will be followed on the job site.
A Petroleum Products
All onsite vehicles will be monitored for leaks and receive regular preventative maintenance to
reduce the chance of leakage. Petroleum products will be stored in tightly sealed containers
which are clearly labeled. Any petroleum storage tanks used onsite will have a dike or burm
containment structure constructed around it to contain any spills which may occur. Any asphalt
substances used onsite will be applied according to the manufacturer's reconvnendations.
6 .02.4 Spill Prevention Practices
In addition to the good housekeeping and material management practices discussed in the
previous sections of this plan , the following practices will be followed for spill prevention and
cleanup.
A Manufacturer's recommended methods for spill cleanup will be clearty posted and site
personnel will be trained regarding these procedures and the location of the infom,ation and
cleanup supplies.
B. Materials and equipment necessary for spill cleanup will be kept in the material storage area
onsite in spill control and containment kit (conta ini ng, for exa m ple, a bsorbent su c h as kitty
litter or sawdu st, aci d ne utraliz in g powder, brooms , dust pans , mops. ra gs. gloves , gogg les ,
plastic an d metal trash contain ers, etc,),
C. Al l spill s will be cleane d up immediately after discovery .
D. The spill area will be kept well ven til at ed and personnel wi ll we-aT appropriate protective
cl oth ing to prevent i njury from contact wi th the hazardous substances.
'
E. Spills of toxic or hazardous materials will be reported to the appropriate federal, state, and/or
local government agency, regardless of the size of the spill. Spills of amounts that exceed
Reportable Quantities of certain substances specifically mentioned in federal regulations (40
CFR 302 list and oil) will be immediately reported to the TCEQ National Response Center,
telephone 1-512-239-2507. Reportable Quantities of some substances which may be used
at the j ob site are as follows:
Petroleum based products--appearance of a film or sheen on water
F. The SPCC plan will be adjusted to include measures to prevent this type of spill from
recurring and how to clean up the spill if there is another one. A description of the spill , what
caused it, and the cleanup measures will also be included . If the spill exceeds a Reportable
Quantity, all federal regulations regarding reports of the incident will be complied with .
PART7 CONTROL OF ALLOWABLE NON-STORMWATER DISCHARGES
Certain types of discharges are allowable under the TPDES General Permit for Construction Activity, and
it is the intent of this SWPPP to allow such discharges. These types of discharges wil be allowed under
the conditions that no pollutants will be allowed to come in contact with the water prior to or after its
discharge. The control measures which have been outlined previously in this SWPPP will be strictly
followed to ensure that no contamination of these non-storm water discharges takes place, The following
allowable non-stonn water discharges which may occur from the job site include:
A Discharges from firefighting activities
B. Flushing Fire Hydrants (See Note below)
C . Waters used to wash vehicles or control dust in order to minimize offsite sediment tracking.
D. Potable water sources such as flushing of waterlines, routine exterior-building wash downs
(without detergents present). (See Note below)
E. Pavement wash waters where spills or leaks of hazardous materials have not occurred or
detergents have not been used.
F. Springs and other uncontaminated groundwater, including dewatering ground water
infiltration.
G . Foundation or footing drains where no contamination with process malaials such as solvents
is present
NOTE: Contractor shall neutralize any super-chlorinated water from water distribution pipes before
releasing it into the environment Neutralization techniques are available from the Engineer.
PARTS CERTIFICATION AND NOTIFICA TJON
The TCEQ permit doe s not require certification of the SWP PP . The only certifications required are th os e
on th e C o nstructio n Site Notice form (for si tes that disturb more tha n 1 acre bu t less than 5 acres) or th e
Notice of Intent form (for sites th at distu r b more t han 5 acres). Notificati o n at the operator of any
Municipal Separate Storm Sewer Syst em (MS4) into w h ich storm w ater d ischarges from the construction
site are conveyed is required . This not ification must be provided in the form of a copy of either the Notice
of In tent form , which must be provided at least 48 hours prior to c ommencement of construction, or the
C onstruction Site Notice form required by th e Permit.
2.7.Subcontractors In formation and Qualifications
Complete the following table li sting each subcontractor and th e ir proposed task associated
with this contract.
1,Silbcontractor's Nani_e 'rt Rror ..:"~ T~t ~~;1:.:t.J1,zr ,,, p 'i~" , * ~~ " ~--i--. \ t~, __ ,0tff
CBA Services , Inc. Asbestos Waste Hauling
Tomas Reyes Trucking , Inc. Demo Waste Hauling
MRL Hydromulching Hydromulching
MMG Building & Constructio ~ Portable Toilets
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 MWBE
documentation in Section 2.9.)
2.7.1. Subcontractor's company name, address, email address, telephone number(s),
and FAX number(s) for the local office as well as the headquarters.
2. 7.2. Subcontractors current Statements of Qualifications.
2.7.3. Matrix including the following information detailing the subcontractor's personnel,
their qualifications, and years of experience.
• Position title and job function as associated with this cont ract. (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
2-14
2.7.Subcontractors lnfonnation and Qualifications
Complete the following table listing each subcontractor and their proposed task associated
with this contract.
CSA Services , Inc. Asbestos Waste Hauling
Tomas Reyes Trucking, Inc. Demo Waste Hauling
MRL Hydromulching Hydromulching
MMG Building & Constructio Portable Toilets
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 MWBE
documentation in Section 2.9.)
2.7.1. Subcontractor's company name, address, email address , telephone number(s),
and FAX number(s) for the local office as well as the headquarters.
2 .7.2. Subcontractors current Statements of Qualifications.
2 .7.3. Matrix including the following information detailing the subcontractor's personnel,
their qualifications , and years of experience.
• Position title and job function as associated with this contract. (President, Vice
President, Project Managers, T echnica/ Managers, Field Supe,visors, etc . .)
• Name
• Tasks to be performed in association with th is contract
• Certifications/Licenses
• Total Years Experience
'
2-14
ENVIRONMENTAL, INC.
210 S . Walnut Creek Drive. Mansfield, Texas 76063. Te l ephone (817) 477 -9995. Facs i m i le (817) 477-9996
www .intercon-envi ron mental .com
Prepared for City of Fort Worth
PROJECT:DEM1~08:GHA
Response to Section 2. 7.3 -Subcontractor Staff Matrix
(!8A Services, Inc.
5877 Barnett Road, Suite A
Krum, Texas 76249
Phone: (940) 482-9900
FAX: (940) 482-3457
June 29, 2010
Name
Jana Osborn
Kelsey Mccaughan
Ned Daniels
Adrian Hill
Michael Hill
Job Title
President
Ops. Mgr.
Driver
Driver
Driver
Tasks Certificates
Performed /Licenses
Operations & Safety
TX Class A CDL #15022647
Driving, Operations & w/HazEnd.
Safety Asbestos Awareness
TX Class A CDL #09859793
w/HazEnd.
Driving Asbestos Awareness
TX Class A CDL #16640558
w/ Haz End.
Driving Asbestos Awareness
TX Class A CDL
#01589471 w/HazEnd.
Driving Asbestos Awareness
If you have any questions or need any additional information., please call me at (940) 482-9900.
Sincerely,
Jana Osborn.,
President
Years
Em.
19years
11 years
24years
14 years
14 years
tercon
ENVIRONMENTAL, INC.
210 S . Walnut Creek Drive. Mansfield , Texas 76063 . Tel ephone {817) 477 -9995. Facsimile (817) 477-9996
Prepared for City of Fort Worth
PROJECT: DEM10-08: GHA
www .intercon-envi ron men ta I .com
Response to Section 2. 7.3 -Subcontractor Staff Matrix
Tomas Reyes Trucking, Inc.
3529 Peoria Street
Dallas, Texas 7 5 212
Tel. (214) 631-2711
Fax (214) 905-7565
Ms. Karen Andrews
Intercon Environmental, Inc.
210 S. Walnut Creek Drive
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 listed
the employees that will be involved and their areas of responsibility as well as their years of
experience in the industry.
Name
Tomas Reyes
Antonio Reyes
Manuela Cavazos
Job Title
Owner
Co-Owner
Estimator
Tasks Performed
Project Management
Project Management
Rate Quotes
Experience
36 years
20 years
lo+years
If you have any questions or need any additional informatio~ please call me at (214) 631-2711.
Sincerely,
Manuela Cavazos
1517 Birchmont Lane
Keller, Texas 76248
Phone: (817) 247 0719 _,
Email: mrlhydromulching@sbcglobal.net
June 30, 2 010
Mr. Bob Mcfadin
Intercon Environmental, Inc.
210 S. Walnut Creek Drive
Mansfield, Texas 76063
Response to Section 2. 7.3 -Subcontractor Staff Matrix
Employee Matrix
Dear Mr. Mcfadin :
The following are the employees that will work on this project.· I hav e outlined each employ ee
that will be involved and their respective responsibilities, licenses, certificat es and experience.
Name Job Title Tasks Certificates Years
Performed /Licenses Exp.
MarkR Loika Sole Hydromulching Tx DL: 07405221 5 y ears
Proprietor
If y ou have any questions or need any additional information, please call m e at (817) 247-0719.
Sincerely,
Mark (Randy) Loika,
Owner/Operator
MMG
Bui ldin g & Co nstructi o n Se rvices LLC
PO Box 1298 I Hurst, Texas 76053 I P (817J 510.0490 I F (817) 510.0495
Cally Monson
Owner
5 years experience
A brief overview of MMGBCS, LLC .
General Overseer of all projects
Mike O 'Bar
Operations Manager
12 years experience
Coordinates between field and office personnel
Wendy Simmons
Sales & Field Consultant
1 7 years experience
Point of contact for clients , Organize the client's needs and assemble strategy for
Operations Manager
Licenses:
NCTRA Certified -Certification# WFWB44480N03 l l
TCEQ -Registration # 2364 7
LWH Permit-City of Fort Worth-ID# 409037
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED , the pol icy (i es) must be endorsed . A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED , subject to the terms and conditions of the policy , ce rtain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon .
CORD 25 (2009/01)
ENVIRONMENTAL, INC.
210 S. Walnut Creek Drive . Mansfield , T exas 76063. Te lephone (817) 477-9995 . Facsimile (817) 477-9996
Prepared for City of Fort Worth
PROJECT: DEMl0-08: GHA
Response to Section 2. 7 .1
Subcontractors Company Information
ASBESTOS HAULING
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
www Jntercon-environ men ta I. com
,,-
ENVIRONMENTAL, INC.
2 1 0 S . Walnut Creek Drive. Mansf i eld, Texas 76063. Telephone (8 1 7) 477 -9995. Facsim i le (817) 477-9996
Prepared for City of Fort Worth
PROJECT: DEMI0-08: GBA
Response to Section 2.7.1
Subcontractors Company Information
DEMOLITION DEBRIS HAULING
Tomas Reyes Trucking
3529 Peoria Street
Dallas, Texas 75212
Person of Contact: Ms. Manuela Cavazos
(214) 631-2711 Telephone
(214) 905-7565 Facsimile
manuela@reyestrucking.com
www. intercon-envi ronmenta I . com
tercon
ENV I RONMENTAL, INC.
210 S . Wal nut Cr ee k Dr i ve . Mansfie ld , T ex a s 7 6 063 . Te l e p ho n e (817) 47 7-9995 . Fa csimi l e (817) 4 77 -9 996
Prepared for City of Fort Worth
PROJECT: DEM1~8: GHA
Response to Section 2. 7 .1
Subcontractors CoIBpany Information
H YDROMUL CHING
1517 Birchmont Ln
Keller, TX 76248
Person of Contact: Mark Randy Loika
817-247-0719 Telephone
mrlhydromulching@ sbcglobaLnet
www .intercon-e nvi r on mental . com
ENVIRONMENTAL, INC.
210 S . Walnut Creek Drive. Mans fi eld , Texas 76063. Telephone (817 ) 477 -9995. Facs i m il e (817) 477-9996
Prepared for City of F_ort Worth
PROJECT: DEMl0-08: GHA
Response to Section 2. 7 .1
Subcontractors Company Information
PORTABLE TOILETS
MMG
1115 NE 23rd St.
Fort Worth, TX 76164
(817) 510-0490 Telephone
(817) 510-0495 Facsimile
Person of Contact: Ms. Wendy Simmons
wendys@mmgbcs.com
www .i ntercon-envi ron mental .com
Prepared for City of Fort W orth
PROJECT: DEM10-08: GHA
Response to Section 2 .7.2
Subcontractor St atement of Qualifications
Statement of Qualifications
CBA Servic.es, Inc.
April 1, 2010
,
Introduction CBA Services, Inc. was fqunded in 2001. entered the environmental arena with a driving force providing an array of services in various areas of the State of Texas. CBA Services, being 100o/o woman owned small business. CBA Services' primary focus is rolk>ff and end dump transportation and disposat of waste materials, such as asbestOs waste, industrial waste, comaminated soils, construction and demolition debris. CBA has been successful at offering cost ·etrecfive environmentally friendly solutions for transportation and disposal, 24 hour emergency response dispatch and ~rirrled <f1Sposal documents. The company's permanent staff includes highly motivated professionals with experience in various fields bringing multiple areas of expertise to the company. Location CBA Semces' primary base of operation is kx3ed in Krum, Texas, a suburb surrouncfmg the Dallas/ Fort Worth, Texas Metmplex which provides easy access to the thriving rnetropofis, as wel as, the entire state. Representative Proiects The following aie a list of representative projects demonstrating experience on similar projects. Arington, Texas (University of Texas) CBA ~40 cubic yaid ~ vau11s for transportation and dilij)()Sal of approximately 50 loads of asbestos. Proper docllnenlation is provided back to the client through fully executed EPA Uniform Hazardous Waste Manifests. These projects have been on-going for seven years. OaDas, Texas (ACE-PSC) CSA provides 20 cubic yard open-top roll-off containers for transportation of waste materials from a facility for PSC. We provme transportation of two to three loads per day. Proper documentation is provided back to the client through . nrinlM fullu executed ·. of Waste Man~ Inc. Waste Manifests for trackin of the shipment of their pre,..,......... . •1 . copes . . . ""'l:f"""'"" . . g waste. This is an on-going contract for six years. Cresson, Texas (Sally's) CBA ~ 25 cubic yard open-top ml-off containers with tarps and gasket; for transportation of DI field waste from their facility. We provided dedicated trucks to continuously empty boxes white they cieaned 1he pit We provided the client with fully executed waste manifest for trucking of the shipment of their waste. This ls a quarterly contract We have performed service for one yea,. Fort Worth. Texas (American Commodities) CBA provides 25 cubic yard open-top ml-off containers with tarps and gaskets for transportation of industrial waste materials from a facility of American Commodities. We provided the client wttb fully executed Waste Management, Inc. was1e Manifests for tracmg of 1he shipment of their waste. This is an on-going contract for seven yea,s. Fort Worth, Texas (Protect) CSA received a response call at 2:00 am. raquesting services for an emergency response. A truck had opened a valve on 1-30 and dumped materials into a nearby creek. CBA responded with cont:iners on-site within one hour. CBA pa:ed one 30 cubic yard open-top roll-off container for 1he contaminated sait and plat:ed two 30 cubic yard watertight vacuum containers to hokl the water being removed from the creek. Within four hours .of the origwi response call CBA had removed 1he containers from the site and properly cfisposed of the waste materials. CBA provided fully executed Texas Commission of Environmental Quafity Uniform Hazardous Waste Manifests to the client for fuB and complete closure of the incident Project completed in a timely manner during a 1hree week period. 4
Fam,ers Branch, Texas (City of Farmers Branch)
CBA was cal1ed in response to an emergency response. CBA immediately pulled into action and responded within 1
hour to provide twenty 30 cubic yard open-top roll-off containers for the transportation and disposal d diesel
contaminated soil . The highway was closed due to an accident and within one hour CBA was on-sie wilh roll-off
containers. CSA was loaded and off-site. which allowed the highway to re-open, within two and one-haJf hoUJS from
the original response cal CSA provided pre-printed, fully executed Texas Commission of Enviroomenlal Quality
Uniform Hazardous Waste Manifests to the client The material was disposed of as Class I Non-hazadous
contaminated soil in a Class I permitted landfil Project completed in a timely manner during a four monlh period. ·
Haslet. Texas (Devon Energy)
CSA provided 25 cubic yard ~m boxes for the transportation and disposal of approximately 125 loads of sludge
from their job site in Haslet, Texas. Proper .documentation was provided back to the client through pre,printed, fully
executed Environmental Protection Agew:;y Uniform Hazardous Waste Manifests. This project lasted b'a period of
two months.
Fort Worth, Texas (lntercon)
CSA provided equipment .and personnel for the cleanup of sewage and garbage disposal spills. Pqa'
docUmentation is provided for the client as documentation of complete cleanup. This is an OD-gOing contract CSA
has peJformed the services for five years.
Rockwall, Texas (Texas Commission of Environmental Quality)
CBA provided three 30 cubic yard open-top rol-off containers for the transportation and disposald contmnated
materials from a Texas Commission of Enwonmental Quality funded clean-up. CBA provided pmi]linted disposal
fonns and managed the transportation a,d disposal of al waste materials being removed from lhesile. CBA
provided fuRy executed Texas Commission of Environment.al Quality Uniform Haz.ardousWaste Manii:sts to the
clientu complete closu!eof the clean-up. This Project was completed in a timely mannerduringaone year period .
San Antonio, Texas {Department of Defense)
CBA provides a permanent 40 cubic yard asbestos vault for the transportation and disposal of asbes1xJs waste
materials from a facity of the Department of Defense. We provided the client with fuBy executed Texas Commission
of Environmental Quality and Environmemal Protection Agency Uniform Hazardous Waste Manifes1s. in addition to
certified payroH Md special reports required by the Depanment of Defense. This was an on-goingmoba:t for five
years.
Texas Department of Criminal Justice {Statewide)
CBA provides 40 cubic yard asbestos vault for 1he 1ransponation and cfrsposal of asbestos waste malelials irom the
various facilities across the State of Texas. We provided the Texas Department of Criminal Justice d fully
executed copies of the Environmental Proteclion Agency Uniform Hazardous Waste Manifests. lmss an on-going
contract for seven years.
Wichita Falls, Texas (Innovative)
CBA provided ten 25 cubic yard open-top roll-off containers with traps and gaskets for transportation of waste
materials from a facility for Texas Department of Transportation. We provlded the cJient with fully executed Texas
Commission of Environmental Quality Unifonn Hazardous Waste Manifests. The project was completed in a timely
manner over two months.
Personnel
CSA maintains nine ful-time employees to manage environmental transpor1ation and disposal of waste materials.
Their combined ptofessional staff included 40 hour Hazardous Materials Trained and Certified personnel and
Asbestos Awareness personnel Al employees have been fit tested and certified with their % face respirator with
HEPA fillrafion cartridge systems.
Equipment Profile
CBA has proven to be ·a, association of some of the most highly skilled and experienced personnel from the
management level to the field operations personnel. CBA currently owns and/or opecates roll-off trucks and provides
oversight management of end dump trucks. CBA currently provided 20 cubic yard opeo-top contanms. 40 cubic
yard open-top containers, 40 cubic yard a;beslos vaults, and vacuum containers.
Certifications
• State of Texas Historically Under UtiUzed Business
• North Central Texas Council of Government Minority Certification
• South Central Texas Council of Government Minority Certification
Permits and Licenses
CBA currently holds permits and licenses from 1he bllowing agencies
• Texas Department of Health Asbestos Transporter License
• US Oepal1rnent of Transportation Hazardous Materials Certification of Registration
• Texas Department of Transportation License
• Texas Commission of Environmental Ouar,ty Permit
Insurance
CBA cunentty holds insurance limits on 1he following types
• General Liability
• Automobile Liabiity
• Workers Compensation and Employers' liabiiity
• Professional/ Pollution Liabifrty
/
$1,000,000
$1,000.000
$500,000
$1,000,000
Programs
CBA's safety policy is to establish, actively promote, and continuously improve the safety, heaJlh, and accident
prevention program; to provide a safe and healthful Mlrk environment for all employees; to preveit human and
material loss; and to meet or exceed Occupational Safety and Health Administration (OSHA) regulations , and
FederaJ, State and Local laws for safety and heaHh.
We believe that injuries can be prevented, management is responsible for preventing injuries, safety requires
invoMng al 8111lfoyees, baning employees to work safety is essential, and that accident prevention ls good
business.
OUr practice is that al of the employees actively participate in the Safety and Health program.
Our health cl1d safely program establishes the poicies and procedures, which protect workers and 1he public from
potential tszads posed by wont We consider safely the hipst priority during work at a siie containing polentially
hazardous condilons. In all instances, all project activities will be cenducted in a manner hit mnnizes the
probability of qury, accident or incident occunence.
Medical Monitoring
AH personnel participate in a company supported. medical surveillance progran under the direction of a physician.
Our medica surveillance program requires 40 hours 1rained personnel to be medically scieened upon employment
and subsequent examinations annually while under the employment of CBA. We have in-place a substance abuse
program, whi:h requires initial pre-employment and random screening.
Policy Statement on Drµgs and Alcohol
The company has a vital interest in maintaining safe. heallhful and efficient wooong conditions b Is employees.
Being under the influence of a drug or alcohol on the pb poses serious safety and health risks. not only lo the user,
but to those who worfc with or come in contact with the user. The use oc sale of an i1lega drug m-alrohol in the wor1c
place or on IJe \\Olk time also poses unacceptable risks for safety, heahhfuj and efficient operalions. Accordirigly, it
is the right axl intent of the oornpany to maintain a working environment that is free of subslana: abuse.
Alcohol
• It is prohibited for any employee to be under the influence of alcohol while periomdng company business,
while in a company facility, or while operating vehicles or equipment owned by or leased by the company.
• Possession of alcohol while in or on a company 1nJdc or~ is prohlbiled.
• Use of alcohol or possession of any open container of afcohol wtnle in a comp;my faci1J a project site is
prohibited.
Legal Drugs
Presaibed and/or over·the-counter drugs may affect behavior and pelformance. Employees are encouraged 1D
advise their supervisor that they are taking such drugs for medical reaso.'lS, and medical eva1oation may be required.
During 'afl'/ period that such use of drugs adversely affect job perfonnance, the employee wil be relieved of his/her
job duties a-reassigned by the company.
Illegal Drugs
The use. saie, 1nl1sfer on possession of any illegal drug by any employee while in a company facllly or whiJe
performing company business is striclty protubited. VIOiation of this policy wiH result in disciplinary action, up to and
inclucfll'IQ, tennilatioo of employment, even for the first offense.
Experience
CBA is a fioensed transporter of asbestos in the State of Texas. In all instances when asbestos or asbestos
containing material are being transported and/or disposed of, drivers are required to be donned in Level C PPE.
Being an in demand transporter for multiple asbestos contractors thlooghout the state requires UM!I C PPE to be
required constantly.
References .
ACE Environmental (Remediation Contnnor)
P.O. Box541436
Grand~. Texas 75054
Conta:t Nclne: Ms;. LaDonna Leshuk
Phone#(214) 734-4000
Fax#{972) 641-1208
Saty's (Oi field Con1ractor)
701 N. First St, Suite 100
Lufkin. Texas 75901
Contact Name: fk. Kris Mowery
Phone# (940) 577-9231
CST Environmental {Asbestos Contractor)
14010 lnterdrive West
Housmn, Texas 77032
Contact Nana: Mr. PJ Parish
Phone# (972) 579-8939
Fax# {972) 579-9009
Devon Energy Corporation (Oil and Gas Company)
1209CR 1304
Bridgeport. Texas 76426
Contm Name: Mr. Darrel Mosby
Phone# (940) 394-2000
Fax# {940) 394-2105
Bridgepolt Tank Trucks (Oil Field Conlra:tor)
P.O. Box6
Bridgeport. Texas 76246
Contact Name: lot". PaJI Glbbons
Phone#(817)475-7171
Fax# (940) 683-2725
GEO Exploraioll SeMc:es {Emergency Respoiise Contractor)
12775 Business 2.87 ~
Fort Wor1h. Texas 76179
Contact Name: Mr. Sl!Mt Cohn
Phone# (817) 439-4610
Fax# (817) 439-4612
HP EnviR>vision (Asbesm Contractor)
460 S. Bellne, Suite 430
Irving. Texas 75060
Comict.Hame: Mr. TCIIIPalet
. Phone#(972) 399-0068
Fax# (972) 986-6013
Fast~Envi~
2603 Glenfield Ava.
Dallas. Texas 75233
ConlactName: ~ Maio Lopez
Phone I (214) 333-2192
Fax# (214) 453-7054
lnleltm Envi'onmenlal, Inc. (Asbestos Con1ra:;tor)
210 S. waJnut Creek Dr.
Mansliekl. Texas 76063
Contact Name: lot". Jeny Aoorews
Phanel{817) 477--9995
Fat # (817). 477-9996
l.Jl,erty Services (Remediation Contrador)
103 N. Oatlawn
Easlland. Texas 76448
Cootd Name: tk. Brian Rogers
Phone I (254) 629-8801
Fax I (254) 629-8803
Merciay Sefvices {Asbestos Conlndor) 1731 Wal Sireet Garland, Texas 75P41 Contact~: Mr. Devin Droemer Phone #(972} 926-5900 Fax# (972) 926-5903 Protect~ (Emergency Response Compaty) 6504 r.tway Road, Suite 200 Haltom Cly, Texas 76117-5363 CoritactNane: Mr. Rchard Qlmeron Phone#{817)~ Fax# (817) 838-9898 Additional Documentation Included • Resume of President • Copy of Cer1iJicate d tnsurance· • cap, of Texas Depali,iellt of Health Asbestos Transporter License . . • Ccpy of Texas Commission of Environmenta Quaity Transporter Permit _ • Copy of US Depal1ment of T ranspol1ation Hazardous Materials Certificate of Regis1ralion • Copy of Texas Oepaftment of Transportation license • Copy of State of Texas HUB Certification • Copy of North Central Texas Counci of Governments Minority Certiocation • Copy of South ·Central Texas Council of Governments Minority Certification • Copy of Letter of Good stancfmg with the State of Texas Comptroler & ,-
[
Objective~
Jana Osborn
;g77 Bametl Road
Krum. Texas 76249
(940} 482-9900
{940) 465-2314 Cell
My objective is co build and grow a financially strong company through a com m itment to our
customers1 satisfaction and employee's wel being.
Overview:
• Excelenoe in customer satisfaction
• Reviewing Fanancial Statements and overview of company
• Commitment to honesty and integrity in an business dealings
Professional Experience; 21 years bo.siness e~
I CSA. Servicn, Inc..
PrMldegl f Cgpparalll I!! p April 2002 lo ,,,.....
• Responsible tor clailf msagement of ope,ation$·
• Serve on Board of Direc:tors
• ~ F...:tat S1at1:1111e1:ts and mate decisions for imprO¥ed ~ility
• u.wge~isManager
• Review and approwe ·lagal-ax-,bt...acts-
• Revlliw and approve bid 'dOCUmen1S
• Review and approve biling
• Rmiew..t appmwe npenses and inlloices
• Renew and Sign payml
• llainlain Id licenses. pennis and oeMICalions
• Trackirlg and ~-of sales taxes. and federal taxes
• >fe9aiate conirads wiQI aistomers and vendors
• Oevalopment of accounting systems and legal structure
• Ensuring that company compies with all applicable federal. ~ and local regulations
• Ensuring lhat a,111paoy complies Wil all applicable safety gutdelmes
• O,vaseei11g 1he maintenance and repair of equioment
• ~ and make deci$,QI,$ regarding -~ profitability.
·j Eagle Comatruclioa-& Environmental Services, LP.
Stat,widt Diailliog ....,_-fnclustriat s,me., January 1191-Apr;t 2882
• Responsible b' managing daily operations.
• lniliall oe, eq,n~ d dMsiOn
• ~ of Financial Stalemen1s IO make dectsms for imp!Olled profitability
• Daily Gp91atiof1S d transportation dh.tision throughout thi? State of Texas
• Revenue generatea dS5.000,000.00 annually
• AppconA of lime shee!s. sales reports; utilization d equipment reports. weekly sesw:e reports.
dalJ wart schedu1es. e,ipense reports. ,ob profitability repod$. wstomer invoices and -..endor
ii'M:JiCeS.
• ~cf al Estimalu
• Deu eloping dallabase sys1e1n
• Man&ge,,.a4 of Sales Represen:atives, Oisp:atchers al'\d Drivers statewl(le
• Ensuring that equipnent is maintained and repaired
• Nagaliatitig coolRic1B wilb customers and vendors
• Managing and owirsee9'lJ woftc on various job siteS
• Ensollng that al ~n and disposal regulabons a,e fallowed.
• Ensuring 1tlat al emplo}ees c:om;>!ied with safety guidelines .
,
! WNta Ma........,.., Inc •
.......,,.. ..... .... ...., 1992 -Ja!!V•!Y 11N
• ~Sible for managing daily ope,atious and program ,mplemen\ation:
• lnitialy iffildlled in the de-.eqmieiit ol a pilot program 1 ndustnal Se!'Vices · and assisted with
irripiementatio throughout a 7 slate araa
• Developed $8.000,000.00 in revenue
• Deulaped ctaiabaw ltaCking system
• Cle. 1laped new programs for mass marketing of services
• Managed CUSlamef Serviee R~ntam,es and $a!eS Represenatlve$
• Negutialed pncing and comrw with CUstomers and Vend0f$
• Managing and OY«SeM'lg Mlf'IC on various jOo sles
• Consulled will customers regarding ~ions lor oisposal of waste
• RC!View Financial Slatements and determine oppc,rtunities for improved profitability
• I 1'31'18d new em~ on disposal regulations. dalabaSe and prac11Ce$ and procedures.
National Accounla '"'""' • Responsible Jar Soulhi.estern program .
• lnlialf inlfOMd in ~topment of pilol program "National Aeeounts • and asS1Sted with nationwide
in1J]lemel liation
• Obtained and maintai1ed naticnMde aceounls
• Estimlled wen and coo.dinO..d nationwide far eSlimateS
• Ar wJ in developing nalic11wicle pricing database system
• Oei a'.IC,-:1 avet account lists fl)( 5 state reglOfl
• ~ for marketing and de1ermining most effeclM program for dients
_fs,..._pring--=_C_lean __________________ _
Owner Mfn:h 191f:: lby 1ffl
• Respo,,stie for managing daily opera!ions:
• Deweloped:$200,000. oo in annual revenue
• Managed crews on job s!les
• Prepare and review payroll. laxes and bookkeeping
• RevieWed F,nancial Ref)Ofts
l Hulcher Senfces. Inc. '-==---==-~--...;_ __________ ----·--·---------------omc, Mama,, .June 1tff:Mardl 1111
• Responsl,le tor managing dally adml"lislrallve wor1( load and equipment:
• Managed Administrative Assistants
• Maiaged pq,es1ies and utilities nationwide
• Purchased equipment. WJhides and trucks
• Oe:wetaped dalabase for tradm9 equipment repairs ams life expectancy of major ro,,.......,aents
• Em.uted ta equipment w.n; maintained and repaired
• As6is1ed wiffi developinenl d the maintenar,ce program
PQOlltJaill MY~OI> F. ST3VBS & COMP.Ali!' :.2°901 ll~::l.':'F. CBN':'F.AL ?:XP:U:£SWAY tlsn:-E ::;,2s DALLAS TX 15243 IH8IJlilJ . cs~ s~~V!CES, INC. NJJC• 5877 3.AR]ETT RCAD, STE. A KF.UM, ':'X i62{S 1.l'.P .. ltr~:ITY ·-:n:·P.li_ x»s ll'ISURIR~ COVERAGaS camecATE NUii BER EYJaQJf __tfUMSER ntS IS TO cem:-Y iW>.T THE RUB CF .ltSJRANCE LISTB) B8,.()N HO.VE BIBI ISSUED TO lHE tlSJltil NAMED Nn/E K..tC llE lUJCV fmCO INOI0\1BJ. fOT'MTI-ISrNDNO AHY ~. nfH ~ CONDmON OF NfY CDIJRl'Cf ~ on9 DCQJMallT WITH im:EJ' TO lMilCH THIS ~TE MAY IE 1SS1.m OR MAY ~ JHE ~ .AfrolaD BY TIE RlJCl!JjDt:fUU:D HBaN lS SUBJa:::J' TO ALL 'THE TERMS, EXQJ,J9CNS.ANO caoncws OF SlJQ,J Rl.lC&I. LNITS SHOl'IIH MAY HI\.VEBB:N IHIIJCSl Bi ~QAIMS. 'liR' TYN:a~ ...... ,.., ....... = m~ UJlrT'I GBISW..UAet.m' -Bl.Of~ $ ]. OJO. OCO L Dt.1$;:!AL G~.U."81UTY ~,;.~~ S 50.000 -UANSMAC,f 0 Oo:uR M3>EXf' (A. ............. $ s. -000 J. y !' ll.?RG£002ll3-01 )J.iJS.llJ'!.3 Gl:!!3!!~ll X ~OTOP. VEKI=i.£ i'B!SONAL£ A!H IN.LP.Y • 1, o:,o. oco --G~ AOOP.B;AT,;: S 2, 0:)0. oco ~ AGGRSATe u'MIT Af'!'ll:5 P5! !'P.OtlUCTS-COWffllF AeG S EltCLUDEO !>'X:CY n ~-· n LOC $ A1JT31arn.E UAIIIIJTY COVBND~ .s 1, o:io, oco -Sa~) -JJUAVTO !IOOII.Y IN..IJIN f'et pa"$"") s -AU.~-'UTOS 90DII. y llol.lJR'l'f'lr a:dao-11 l • X ~8).JI.B .O.lllCS .:U/U:l?":;.'l· ~nci"'.2012 ti -lt l:i C'?OO!.l2l.l0 PRl>F!RT'Y ::lo".K-' X ~AIJ'fOS ~=:iclril -X NOJr,,1-0-JVrSS)AUTCS ' -s IJME!FlB.U. U4B Hoc~ er.CH~ f -EXC!:SSLl.U a.At.ls.MAO! .M.:;;;s;,.. Te • OIDUCTllll.E s ,__ P.EIENTION t t w.JAtelSCOIIIPINSA'TlON ,.,.~~~• l°I:'" A,Nll ENPUYfiRS' W.lillUTY y t H ~r'~o NIA EL 3'01 ACCEBfl s <lf!'ICl:RIMtMB!R exa....c=-, ~~~ El.. t:JS5',SE • 311. fMl'I..O'l'a ' l';ltS.---....... ,......-i,,c,i-lON r-F "'"•"•·t.T~JhS lJel.,.. El.. ~-P.11.JC'fl.-""'IT I ? 3711.3013031 1t.,.:1e::c:• n::;a::,.:: C:::!il'-lllti:: $2,!>0D C CCJMKERCUu 7,UTO lf 13 ~!'.Al rl&U.t.r.,: C::~l.i-DEL $2,500 cecAIFTIONOF~TION5/!.0CATIONS/VfHICl.!5{1't!adll'.CON>101,A--Schidl*,·=--lll~ 'l'IU\.',/SJ?O:F.n .. noH p:;1,1 U'J'!Olil LH.Bit.I':'Y cov:::P..\G-S: A::CGREGJI.TE $2. oco. OODi:.:r:MlT $2, 000.,000jU "J'RAJISPOE.T.t.'!'ION p::,J.I.UTION 'CONDITION LIHIT $1, :lOC, COO/POLICY AG::UG.P-T:C l;:uil:' ;2, 000, 000/SZ, 500 D:::D .PDI. ~CUP..F.Ef\Cli. CELTTFICATE 30LD:Elt IS !.!STI::) AS AN 1'.DDITIOllJ...L. IlI£Ul':?D WIT:I A 1>'.7.:I'JER OF s:I:!lROGA,.!OJI' 3UT Cl'I!.!' WZTll RESP, .. ,S TO TRE NAl'ctD u:: ·?.E:D' S BIJS:!NE.SS OPE!';. ,:~RS. &FF: :t«:liP'I ~ -_·-;: -· .. . -· I CErnAc. I L ·~ '-------r• :c,CEUATION ~"·-·c..::i Alff GfllffAfm'f ~ -""" PQIJQ!II «~ -~ I "TH;;. -~"tlml DA.TI: ~. :,.-:;...QE nl. 1£ ~ -;!i ACORD 25 (2009/0S} ·_.._:;,.·._-· Acet,..-.,;.,"""'C:'tilw. T.-IE l'OUCY ~1,:;.,-.,;:s., l .u.lTKIRJ£)~1l'71YE ~ J> ~. :'."':::::,.~ ----9188W008 ACO.-~::: COiFORATIOIC. Alri#Jk ,'·~etVed. .. Tha AC'-;'-· :-,~rtHl end loge ant ,agir.t, · ~ =>rlcs d A.CORD 6 (
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tlit'!' ifJ{; :1} .'.XAS DEPARTMENT OF ST ATE HEAL TH SER. VICES
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,. CBA SERVICES INC
is certifaa to perform as a
.. Asbestos Transporter
· · .;,ln i'ths iStattJ ,:q/TexQ4 within the purview a/Texas Occupations Code, chapter 1954, so .long as this lic ,.·nse is not
:/·,.~·iuspendtid or revoked and is renewed according to . the rules adopted by the Texas Board of Ih· .. :lth.
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\·', ' C.()fitrol Number: 2SS9 l
DAVID LAKEY, M.D.
COMMISSIONER OF HEALTH
VOID IF ALTERED NON"TRANSFERABLE
Expiration Date:.~ //2012
(Void After Exr .ration Date)
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~1/'\''iB~\ '20 '· · •n TEXAS COMMISSION ON ENVIRONMENTAL QUA U TY ... 'J}\i · · · · · Not 1ce of Reg1 st rat 10n
Page .:
Oate: Ff> Industrtal and Hazardous wast!?
~:k, T,h·l,s.,,.reg1str :ei '· I on ,doe s no const 1 tute ' autilor1 l ai1on -of a nywasfii "managemen~cffv1t-1esor' ra c1 i'ffis If st9d"i>eiow.""""'fri, r'eii 'itrat·1oK::r et!1ect 8"' ...
,'.!:f:r · · -~.ue a r ,or 1ndust r f waste generat1on and nanagement acttvttles for which the reg11trant has provided not1f'lcatton. R,1MJJ11rtii~.t.a ,for i)Jiti1 ·~,~.st• .1,111 agement J) .•• orovltled by Texas Administrative code sect ton 335 of the rulee or the Texas Conmteeton on !nvtronmtnl•l .,1(.11Jtti v
;-<'~ie'-. ;/.1~ ... ,.111i;Jes o r a,•.; 1 ,ons to waste management methods referred to In this not1ce reQU1re written not1flcat1on to the TC!Q,.· '"
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. , " ¢l 1d ··n st e Reg1st n . '.o n Nurnoer: 87418 EPA Id: TXR000057489 -~ 'it:~~: .
\So :U ,d ;waste Re.g ·s tra tion Number provides access to computer1 z ed and filed Information pertat u 1ng to your operat1on. Please ref'~f
. •ir..;t:t11;.,-.nY . corre sp ondence .
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'.0~1Pa l'iY.1/!'.Hame : CBA Serv1 ce r ; nc . < s \~\ti/Name l CBA Ser VI ('. %
· 'Cl t1on : 5 877 Ba rm t \ Rd, Ste A, ltrum , TX ·. ntac t · Osborn, J : :1a
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,: :f~g r ., .·,ms: 587 7 t!ar ne tt Rd ., .. ,. Sl ·; 11. ;r;::. \ /'>· Kn ,m, TX 76249
tstrA'(fon Status: Ac t 1 ve . )H~11\a.t 1 on Type : Transpo r t er
• 1 ransporter Typ e : For h I r ;;
· . ·i 1·,rns pb,t.'.t ·Wst Clas s : 1 2 J H Jji.t. "I ··'. :.-.• ·-,,-.,r -1 !
Region:
Count')':
4
61 Denton
Title: Pres i dent
Si te Street Address : !,877 Barnett Rd
:;te A Krum, TX 76249
ft~t~,~-~} ry e·~,s .'Descr 1 Pt 1 on :
';tlfti;-,p::~.~r~:·:);H :~t. Nl, .. i\S Code !
~-''.";(ta)(• :t6ent I ', 1~a t ion II :
Tr :• ,~iportatlon of waste material -Indu6tr1al & ha:zarctous
4r 11 General Freight Tru:::klng, Local
r', i:.23 415 .... ,::Hr·1;1i~r status1 Ji~}·,,' ~ ..
.at ·.w Informat.l on
air,,.::~ CtlA Serv1 c ,1s Inc
on e ,f.·~t 940·482-9 1:oo r ct ,l?_~f -'(5877 Barn e tt Rd , .·•· · . •, ... Ste A :?f> ,·: ·. >/· · Krum, TX, 76249
Owner Information
Name: CBA services. Inc
Phone: 940-482-9900
Address: 5877 Barnett Rd
Ste A Krum, TX, 76249
~'l"~~'., ·.~.1 . . 't:~r,i~s of ·oa/12/20 04 -the n· t unass1gned sequence ,umber for WASTES Is 0001 and {1r/;r< :· the n 1t unassigned seauence .,um be r ror UNITS 1 s 001 .
't itor,;,,a~··, Chapter a, .;11' t he 'Texas Adm1nstrat1va Code specifies the nottt1catlon, record keep1ng, man1festlng and reporting ·requ1 ~~"''
t ha:rn. '"...;s and 1n c:':.:,.~:'1a l solid wastes. <ff' ;, ·
-~
TION
·'uRIALs SAFETY ·ADMINISTRATION
HAZARDOUS MATERIALS
CERTIFICATE OF REGI~TRATION /
FORREGISTRATIONYEAR(S) 2009-2012
R~t: CHA SERVICES, INC.
Attn: JANA OSBORN
5877 BURNETI RD. STE A
KRUM, TX 76249
This certifies that the registrant is registered with the U.S. Department of Transportation as required by
49 CFRPart 107, Subpart G.
This certificate is issued under the authority of 49 U.S.C. 5108. It is unlawful to alter or falsify this
document..
Reg. No: 050109 550 046RT Issued: 05/04/2009 Expires: 06/30/2012
Record Keeping ~uirements for the Registration Progra~
The following must be maintained at the principal place of business for a period of three years from the
date of issuance of this Certificate of Registration:
(1) A copy of the registration statement filed with PHMSA; and
(2) This Certificate ofRegistration
Each person .subject to the registration requirement must furnish that person's Certificale of .Registration
{or a copy) and all other records and information pertaining to the information contained in me registration
statement to an authorized representative or special agent of the U. S. Department of Transportation upon
request.
Each motor carrier {private or for-hire) and each vessel operator subject to the registration requirement
must keep a copy of the current Certificate of Registration or another document hearing the ~stration
number identified as the "U.S. DOT Hazmat Reg. No." in each truck and truck tr"dctor or vessel (trailers
and semi-trailers not included) used to transport hazardous materials subject to the registration
requirement. 1ne Certrficate of Registration or document bearing the registration number must be made
available, upon request, t o enforcement personnel.
For info . -:,,i n n. r-rm!act the Haz,,-• ·,;; M 11icr ia !s Regis tra ,;'.·n Man ~g er, PHH--62, h , -:'in t and Hazardous
Materials _ ..... 0 i•u1 n istration, u .... · .·r 1men t of Tr.:m:,j: . . ·:,_ 120 0 N ew .;,_ ~u e, SE,
Washington. DC 2 \, ·0. t elephone {2 02) 36{, -~' :)9 . L _______ _
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~ SERVICES, INC.
STEA
5817 SARNETT RO
KRUM. ,x 762-49
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Having fulfilled the application requirements of the Department of Transportation {TxOOT) relating to the
registration of commercial motor carriers, this Certificate of Registration is hereby granted to:·
CBA SERVICES, INC.
STEA
5177 BARNETI RO
KRUM, TX 76249
This Certificate of Registration authorized TxOOrs issuance of an insurance cab card identifying each
Commercial motor vehicle registered with TxDOT.
'
This Certificate of Registration is not transferable.
VOID IF ALTERED
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The Texas Build in g & Procurement Commission (TBPC),
hereby certifies that
CBA SERVICES, INC.
has successfully met the established requirements of the
· State of Texas Historically Underutilized Business (HUB)
Certification and Compliance Program to be recognized as a HUB.
Th is certificate, printed 19-AUG-2006. s upersedes any registration and cert ificate p reviously issued by the
TBPC 's HUB Cert ification and Com p!1ance Program. If there are any changes regarding the inbrmat10n (i.e .•
business structure, ownership. day-to-day management, operational control , addresses. phone and iax numbers
or au thori zed signatures) provi ded in the submission of the business' appl ication for registration!certificafion as a
HUB, you must i mmediately {within 30 days of such changes) notify the TBPC's HUB program in writing . The
Com mi ssion reserv~s the right to conduct a compli ance review at any time 1o confirm HUB elig ibility . HUB
certif ication may be suspended or revoked upon find ings of ineligibility.
Certificate/VlD Number: 1020623415400
FileNendor Numbe r: 20396
,\:,proval Date: 18-AUG-2006
-• ; 'C -2010
Paul A. Gibson
HUB Certification & Compliance Ma."lager
Texa~ 0 ui!din g & P rocure,::2.nt Comm ission
{512) 3 ~-... ,--'
Note : In or,>. !0r State agencies , , J'Sl itutions of h i ghL ·.,.i:.i~tion (universifa, ·.~· be crem!eo for u::·? ,'.J t his
bus iness as a :-:~:a. th ey must awar:__ ,.-.;-r..e nt under the Cc~::~:::2 leNID Number k . .,-::,;;i~d ahove. A genc,"·"'· c mJ
universities are encouraged i o valid ate HUB certification prior to issuing a notice of award by accessin g the
Internet (http://www .tbpc.state.tx.us) or by contacting the T B PC·s HUB Cen ,f;cati on and Compliance Program at
(888) r,-~-c;s s 1 or (512) 463-~ · ,2 .
,/
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NCTRCA
Disadvantaged Business
Enterprise Certification
CBA Services, Inc.
Disadvan,aged Business Enterprise
laas fUed wltb the Agency an Affidavit as defined by 49 CFR part 26 and ls hereby certlfled to provide
scrvicc(s) In the foUo~ing areas:
484220;562211; 562219;
Specialized Freight (except Used Goods) Trucking, Local; Hazardous Waste Treatment and
Disposal; Other Nonhazardous Waste Treatment and Disposal;
1)lti1 Certlflcatlon la vaUd bealnning March 2010 and superseded any regtstratlon or listhl·
prevloutly b.ued. Thb certification must be updaCed annually by submission or an Annµal Update Affidavit, At ~"ii
tlnae then I.I a charge ht ownership or control or tht tlrm, notification muu be mnde Immediately to the North
Ceotr,1 Te1u Regional Certlf'lc.':atlon Agency or an TUCPccrtlfylng tn.tlty,
Ccu1lflcate expiration _____ M_a_rc_h __
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Certtncatlon Admlnlstra t m
Issued date ________ _.M ... a .... c .... ~ ..... b---' 20-1.Q_
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SBEWB~-: .---. -: .•. -. . . 1 • • ·:..~: .. ~-~ ' -= .• --·_ .,.--.. ~~ ••·•• ~'. : This Certi~~t?~ -?~~e must b~ uP<;f~e~, ~il~~i~J<?~ ~?.!'~ .¢~~~pg-:.',.·. Y~u are· requir~-~o-ne>fjfy tp~ SCTR~~.,~@11:1 ~~-:of.{uiy; _q,~nge')ri:.~if-c 2;}/affectin . '"oufabiUty' tcf ~·eetsize disadvarita ')=i~s./own""'rshr '1&r'.toif··· ,~.,·.· .. .. . . _g Y .. ,, .. ~ . -,~ ...... , ... , ,.. -... •. -....... , .... -. !;l..,~~r-"=·:;, ,•."'··-~"" .. ,P• .. ·, .... , , ,, ""'::c"r-Ef uiremeiits aricf •· :--·-maleiiat cfo{"'. ·es'irttht:d13101fnatio1f·:·:rovided f··.tfi>suo · n C ..••. Cl .. ,.,. ,.,. ·. ·,c.'-::,-·,.-::·~h~."'-' ..... _,_. ... .J~ -"·!'-~.;;-· .. ·t"%"'"'._,,,. -.P_ ··.·. ·-.. ·' ~; ,.'\ _J;ft°":"'~/"'~: ·~. ofthebusmessapph~1Yitf~rce:rt1fiqatiQn. :~,~-~-\-· -·· .·---, .(·:-: -~ -:/::~~',:;;,:: ~,~~J -. _·· · .. ·-· ... -·:-:J'ilZi~;;c ·, · ·:.---· · · . -:"~~-~:-.~:-./ ~:~· ... _. ~::~Jr,.'.:.~rrtt:-=):(· ;~/-;;_·cE~IFiCATE EXPtRES:Jurie~30, 2011 . · ~¢anFtcATEN~:>:209'06116l\,;· .c ·!-'~, _., .. ~.(.:: .. ·: . . . t·: :::_~ .. :. :W• ~-. • ._ • .,.._..,, ,-·: : ... _":.,,.-. •• ·_ . Certified i~ the following .vi<>rk categories: · -.. '_ .,: . North American Industry Ciassificatioif~em-(NAICS)_codes{s): NAICS-484220: SPECIAL~ FREIGHT {EXCEPT usEtf ci;6~;-~RDtKiNG, LOCAL . . ~-. •A<""\ ·: NAIC&.562211: HAzARDOUS WASTE TREATMENT F~ES COMBINED WITH col.l£CTION ' AND/OR LOCAL HAULING OF HAZARDOUS WAsTE .. _z/: ... ~-.,· ·-~~-·-: .. .: . '· . . . . . NAle&-562219: QTHEf(NON}:iAZARDOUS WASTE TF$TMENT A~O. D\SPOSAL . 1f-t?· 15~ '~~~
April 22, 2010
_/
CERTIFICATE OF ACCOUNT STATUS
THE STATE OF TEXAS
COUNTY OF TRAVIS
I, Susan Combs, Comptroller of Public Accounts of the State o .f Texas, bO
HEREBY CERTIFY that according to the records of this office
CBA SERVICES, 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 va1id 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 or the
entity's registration, if any, with the Texas Secretary of State.
This certificate is valid for the purpose of conversion when the <::0nverted
entity is subject to franchise tax as required by law. This certificate is
not valid for any other filing with the Texas Secretary of State.
GIVEN UNDER MY HAND AND
SEAL OF OFFICE in the City of
Austin, this 22nd day of
April 2010 A.D.
Susan Combs
Texas Comptroiler
Taxpayer number: 10206234154
r;le number: 0BOOOQ2937
.-;_. •, .. --
.:tJi<·f~?~f P'{'i'.:~~i\:.~~-,-
Prepared for City of Fort Worth
PROJECT: DEM10-08: GHA
Response to Section 2. 7 .2
Subcontractor Statement of Qualifications
Tomas Reyes Trucking, Inc.
3529 Peoria Street
Dallas, Texas 75212
Office: (214) 631-2711; Fax: (214) 905-7565
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 industr ies. 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 o n 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 a n a ffordable price
with minimal service failures.
'
June 30th, 2010
MRL Hydromulching has been registered with the Tarrant County
Courthouse since April 26th 2005.
Mark (Randy} Loika has been sole owner and operator during that time.
A few of the local contractors I have served are; Linbeck, Ark Const.
TexRoots, Mcspadden, PATCO, Eagle Crest, City of Arlington Parks Dept.,
8-C Co., Dallas Baptist University and many small home builders.
Past projects have included City owned parks, baseball fields, golf
courses, river/creek bank retention projects, churches and personal
properties.
MRL Hydromulching has had a water meter contract with the City of Fort
Worth since July 2005, acct. 959935-366122.
MRL Hydromulching carries General Liability Insurance through Farmers.
Mark Randy Loika -817 247 0719
mrlhydromulching@sbcglobal.net
Con1n1ercial Certificate of Insurance
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2 0U Rufo Sn O\\ Drin~ \l orth
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This rPnifiratP i•; is\urcl :\s ~ m,1tter of inf,mna rion on ly and crn ;_k r, 11 ,, ri .~hl'>
upon rtw ce rtifi cate holder. Tt1J.s_ n'rtificali" <lu,'s 11 0 1 ;mwn r!. c.\l 1·1 1d ur ;ji lt': 1'1,
co vr·ragc: dlTonlt'd·by tlw pnlirits ~hm\n hrl mr.
Compan ies Pro vidin g Cunrage:
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VIR L. Hydrnmulch ing
! 5 l 7 B in:hmont Lane
Keller . Tnas 7624X
Company C J'vtid -Ccntury I nc.ur,rncT C 0 1 n µ;m y
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:111, ri ·quirenwnr . CPrm o r ro ndicion of an y co ntrart or other docurnenl with respect to whi r h this certificate may bt• issurd or rrny pn1;1 in. 1h1· imuran :·f'
.iih 1rd (•ci lw I lw pr,l i,ie, dPsnilwd here in is subjrrt to all LhP rerm~. Pxclu sions and conditions o f surh polirii''i. 1.imils shm\-n may h,1vc· IH'cn n•dun•d h1
p.i iil cla i1 11,
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Gene ral Liabil it y
C 011 11 rwrci;i l CP nrral
' Li;ihil ir-,
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Cu nrrartual · Incidental
Policy Nu mht'r
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Auto mobile· Liability
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IJVorke r :, · Co rnpensatior,
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-----· -·· --·-· ··-·-·-·· :_ --·-·· -----·-~"--:""'/ I
Copy Distribution: SP rvicr. Center Copy and Agent's Copy
MM G
Building & Construction Servi ces LLC
Yea r Es ta blis h ed
Current Owne rs h ip
Ca lly Mon s on
Mike O 'Bar
N ick Macki e
J eff Ma cki e
COMPANY RESUM E
BOARD OF DIRECTORS
Major Construction Customers
K. Hovnanian Homes-DFW Metroplex
Drees Homes
Bloomfield Homes
Manhattan Construction
· Rogers O'Brien Construction
Austin Commercial Construction
Mcclendon Construction
JLB Contracting
Sedalco
Hunt Construction
Special Events
May 2005
January 1, 2009
Manag ing Me mb er
Op eratio ns Manager
Me mb er
Mem b er
January 2007-Present City of McKinney-City Contract
Contract with Parks and Recreation department to place and service all portable
sanitation needs at Day Labor Center, Parks, and Athletic Fields
June 2008-August 2008 FEMA-Cedar Rapids Flood Relief
200 portable restrooms , 25 hand wash stations on daily service
3 x 26 private stall showe rs operating 24 hours a day, 7 days a week
MM G
Building & Construction Serv ices LLC
Septemeber 2008-April 2009 FEMA-Hurrican Ike (Houston-Galveston)
40 Portable restrooms on daily service
2 x 26 private stall showers operating 24 hours a day , 7 days a w eek
Turnkey Base Relief Camp
Modular Kitchen with catering service for 3 meals a day for 2000 people
Portable Restrooms , 26 stall shower, trash removal
October 2008, 2009, 2010 Pirate Days-The Colony
Portable Restrooms and Hand Wash Stations for city event
January 2009-Present City of Lewisville
Farmers Market in the Summer and Fall , Cinco de Mayo Celebration , Firefighters
Symposium, and Sounds of Lewisville
June 2009, June 2010 Denton Air Show
15 Portable Restrooms and Sanitizer Stands
July 4, 2009 City of McKinney 4th of July Event
50 Portable Restrooms
Fall 2009 UNT-Home Football Games
20 Restrooms delivered on Friday and placed for every home game
Fall 2009 LLS-Light the Night Walks
Three different weekends at various DFW Metroplex locations
. ,
September 2009, 2010 Cowtown Cruisin ' for a Cure
Classic Car Show
Quarterly DFW Car Collector Swap Meet
40 Restrooms and 2 dumpsters de livered and serviced daily
October 30-31 , 2009 RanchBash and LegendsFest
VIP comfort station and 45 restrooms serviced daily along with3 fu ll-ti me on site
att endents to clean the restroom trailer and restock portable un its
December 5, 2009 Jingle Bell Run-Arthrit is Foundatio n
24 Restrooms with sanit izer service delivered and removed on race day
MM G
Building & Constructio n Serv ices LLC
March 27 , 2010 Joe 's Run-The Samaritan House
Portable Restrooms with sanitizer service delivered and removed on race day
March 27, 2010 Fort Worth Sings for Haiti Concert
Coordinate and manage delivery and service of portable restrooms , hand
washing stations, trash removal , and fence installation/maintenance
May 1-3, 2010-02-08 Warrior Dash -Cousins Paintba ll
100 Portable Restrooms , and on-site service for the entire event. Over 10 ,000
attendees.
Cally Monson
General Manager
Sales
Office
Emily
MMG CUSTOMER
I
--------~---------~-
---------------~ -------------------------------------------· ----------------
Bu il d i n g & Con stru c t i on Servi ces LLC
Cally
Monson Nick Mackie
--------------------------
Wendy Sarah
Sales Accounting
Jeff Mackie
-
Mike O'Bar
Mike O'Bar
Operations Manager
Operations
Vehicle Maintanence
Dispatch
Routing
Supplies
-~\~ -~ ------
Intern Representative Payroll
Drivers Office Support Sales
Activations
Deactivations
AP/AR
Office Support
Collections
Jim
Operations Assista
Swing Driver
QA/QC
Dispatch
Office Support
Safety
nt Colorado
Franco
Leon
Omar
Rios
Ruben
Steve
Cheyenne
EC Operations
Erosion Control
Office Support
PortoSan Support
Blue
Nathan
Travis
Wayne
Coco
Facilities
Trucks
Yard
Prep Trucks
Operations
tercon
ENV I RONMENTAL, INC.
210 S . W a lnut Creek D rive . M a nsfiel d , Tex a s 7 6 0 63. T eleph o n e (81 7) 477-99 95. Fac si m ile (8 17) 477 -9 996
Prepared for City of Fort Worth
PROJECT: DEM1~08: GHA
Response to Section 2.7.1
Subcontractors Company Information
ASBESTOS HA ULIN G
CBA Services, Inc.
5877 Barnett Road, Suite A
Krum, Te xas 76249
Person of Contact: Ms. Jana Osborn
(940) 482-9900 Telephone
(940) 48 2-3457 Facsimile
ianaosbom@hotmail .com
,-
www .i ntercon -env i ronme n t a I. com
tercon
ENVIRONMENTAL, INC.
210 S. Walnut Creek Driv e . Mansfiel d , Tex as 76063 . Tele ph one (81 7 ) 4 77 -9 99 5. Facs i m i l e (817) 477 -9996
'
Prepared for City of Fort Worth
PROJECT: DEMl0-08: GHA
Response to Section 2.7.1
Subcontractors Company Information
D EMOLJTION D EBRIS HA ULING
Tomas Reyes Trucking
3529 Peoria Street
Dallas, Texas 75212
Person of Contact: Ms. Manuela Cavazos
(2 14) 631-2711 Telephone
(2 14) 905-7565 Facsimile
manuela@reyestrucking.com
www .i nterco n-en v i r on men ta I . com
ENVIRONMENTAL, INC.
210 S . W a lnut Creek D r ive . Man sfie ld , Tex a s 760 63. Te l eph o n e (8 17) 4 77 -9995 . F ac si m ile (817) 4 7 7 -9996
Prepared for City of Fort Worth
PROJECT: DEM1~8: GHA
Response to Section 2. 7 .1
Subcontractors Company Information
H YDRO MULCHING
1517 Birchmont Ln
Keller, TX 76248
Person of Contact: Mark Randy Loika
817-247-0719 Telephone
mrlhydromulching@ sbcglobal.net
www . i n te r con -e nvi ron me n tal . c om
tercon
ENVIRONMENTAL, INC.
210 S . Walnut Cree k Drive . Mansfield , T exa s 7 6063. Telephone (817 ) 477-9 9 95 . Fa cs i mile (81 7) 477 -999 6
~
Prepared for City of Fort Worth
PROJECT: DEMl0-08: GHA
Response to Section 2.7.1
Subcontractors Company Information
PORTABLE TOILETS
MMG
1115 NE 23rd St.
Fort Worth, TX 76164
(817) 510-0490 Telephone
(817) 510-0495 Facsimile
Person of Contact: Ms. Wendy Simmons
wendys@mmgbcs.com
www . i ntercon -envi ron menta I .com
'
Prepared for City of Fort Worth
PROJECT:DEM10-08:GHA
Response to Section 2.7.2
Subcontractor Statement of Qualifications
Statement of Qualifications
CBA Services, Inc.
April 1, 2010
'
Introduction
CBA Services, Inc. was bll'lded in 2001, entered the environmental arena with a driving force providilg an atray of
services in vaious areas of the Stale of Texas. CBA Services. beiV 100% woman owned small business. CBA
Services' prinary bcus is rol-df and end dump transportation and clsposa of waste materials, such as asbestos
waste, irQJSbial waA9, contanlnal9d soil$, construction and demolition debris. CSA has been SI iccessU at offering
cost etfeclve enviroi·lfflel ~ friendly solulions for tnmportat1on am disposal, 2.c hour emergerq response
dispa:h il1d pre-pmted ~ ~ The coo,panys pemmert staff inckJdes highly rnotivcEd
pmfessiollals with experience 11 vaicus fields bringing mu""'9 areas of expertise m the company.
Location
C8A SeMcal' primay base of oparalD1 is localed in Krum, Texas. a stmUrb Sl.ll'IOUJl(fing the Oa1as / Fort Worth,
Texas Melluplex which provides easy access 1o the thriving metropolis, as wel as, the entire stale.
Representative Proiects
The t>lbwitg ant a 1st d repras8 atalw. pmjects demol istraing experience oo sin& projects.
Allnglor., TeiaS(lWvtnilyofTexas)
CSA provides 40 cubic yard __. valls for transportation and dsposa d approximately 50 loads of asbes1os.
Props dcmnenlalion is provided back ID ht client through July executed EPA Unibm Hazardous Waste
Mriasls. These pmjec:l!s have been m.going for sewn years.
Da1as. Texas (ACE·PSC)
CBA pnMdes 20 cubic yard open-mp IOI-off containers for transportation of wasla materials from a facioty for PSC.
We pn,vm tralSpOl1atioo d two b three loads per day. Proper doa.unenlation is provided back m the client through
pre-priJted. fuly ~ Q:lJl9S of waste Management, Inc. Was1e Mcllifes1s b' trackilg of the shipment of lheir
waste. This is an~ conirac:t b' six years.
C1'991G11. Tun (Sally's)
CBA provided i5 cubic yard open-tip rokl COi dai 1915 wilh tarps and gaskets tor transportation of Di field waslB
from bi' faalty. We proviSed dedi:ated 1rucks 1D cootinuously enw boxes whle they cleaned l1e pit. We provided
the ciert will fully execuled waste maiifest for trucking of the sh1pmert of thei'waste. This Is a quar1effy contract
We hawe perbmed service bone yes.
Fort Wonh, Texas (American Commodffles)
CBA provi1es 25 cubic yard open-tJp ml-off contailers with tarps and gaskets for transportation of industrial waste
materas m a facilty of American Canmodifies. We provided the c1ert Wilb fully executed wasse Management,
Inc. Waste Mcnfests b' lracmg of 1he shipmeri of their waste. This is an en-going oontract iJr seven years.
Fort Wedi, Texas (Protect)
CSA received a response cal at 2:00 am. requesting services for an emergency response. A truck had opened a
valft on 1-30 and dmlped mae ials into a nearby creel CBA responded With contail lel'S on-sill wilhin one hotl'.
CBA pa;sd one 30 cubic yard open-top rol-off contair ier fer" 1he contaninaled soi and pla:ed two 30 a.di: yard
wateftigtt vacm.m containers 1D hold the water being removed from the aeek. Within four hours of the origina
respoi ise cal CBA had removed 1he containers from the site and property disposed of the waste materia!s. CBA
provided fully executed Texas Commission of Environmental Quality Uniform Hazardous Waste Manifests 1D the
crm bful and complete closure of the incident Project completed in a timely manner during a lwe week period.
Farmers Branch, Texas (City of Farmers Branch)
CBA was called in response 1D an emergency response. CBA immediately pulled into action ~ responded within 1
hotl" to provide twenty 30 cubic yard open-top roll-off containers for the transportation and disposal d diesel
contaminated soil . The highway was closed due to an accident and within one hour CBA was on-sle wilh roll-off
containers. CSA was loaded and off-site. which allowed lhe highway to llHlp81l, within two and one-half hours from
the original response cal. CSA provided pre-printed, fufty executed Texas Commission of Environmental Quality
Uniform Halardous Waste Ma1itests k> lhe client The material was disposed of as Class I Non-haladous
coi1timnaled soil in a Class I permitted landfil Project OOf1l)leted in a timely manner durilg a f<u mcnlh period. ·
Haslet, Texas (Devon Energy)
CBA provided 25 cubic yard vacuum boxes for the transportation cnl disposal of approximately 125 bads of sludge
from lhair jd> site in Haslet. Texas. Proper documentation was provided back to the clent through pe-prinled, fulty
execuled Elivirolimenlal Protection AgreroJ Unlform Haznous Waste Ma1ifests.. This project lasled tr a period of
two months.
Fort Worth, Texas (lntarcon)
CSA provided equipmert and personnel b' Ile cleanup of sewage and garbage disposal spills. Pqa
documentallon Is provided for the crtent as doctDlentation of complete cleanup. This is an OD-going mlbact. CSA
has perbmed the services for five years.
Rockwall, Texas (Texas Commission of Environmental Quality)
CSA provided three 30 cubic yard open-lop rol-off containers for the transportation and disposal d cananinated
materials from a Texas Commission of Environmental Quality funded clean-up. CBA provided JmiD1(ed disposal
fonns aid managed ht transportation aid disposal of al waste materials being removed from 1hesila. CBA
provided fuly exeaJled Texas Commission of Envirormental Quality Uniform Hazardous Was1e Manfests *> the
clent b' oomple1e closure of 1he clean-up. This Project was completed in a timely namer dumg a one yea-period.
San Antonio, Texas (Department of Defense)
CBA provides a permanent 40 cumc yard aslles1os vault for the transportation and disposal of asll e 51 s waste
materials from a facity of the Department of Defense. We promed the client with fully executed Texas Commission
of Environmental Quality and Environmental Protection Agerq Unifonn Hazardous Waste Ma1ri 2s, jn add'di:ln to
certified payrol aid special reports required by the Oepmlment of Defense. This was an on--going .CQDba:t for he
years.
Texa Department cl Criminal Justice {Statewide)
CBA provides 40 cubic yard asbestos vau1 u the 1ralsportation cm cf!SpOSal of asbes1os waste ma a from the
vm.as facilities across the State of Texas. We provided the Texas Departmert d Criminal Justice wilh fljly
executed copies of lhe Enviroomenta Protecbl Agency Uniform Hazardous Waste Manifests. This ls an on-going
contraa for seven years.
Wichita FaHs. T ex11 (Innovative)
CBA prowled ten 25 cooic yard open-top roll-Off containers with traps and gaskets for trcmportaoon of waste
materials from a facility for Texas Department of Transportation. We provided the clieri with fully executed Texas
Commission of Environmental Quality Unibm Hazardo~ Waste Manifests. The project was completed in a timely
manner over two months.
Personnel
CBA maintai • nine fut.tine empbyees '> mimge enviroomenta tra11sportation int disposal of waste malesials.
Thar COlilbiled ptofessiola stBI included 40 how Hazardous Materials Trailed and Certified petDI iel and
Asbeslos Awnness personnel. Al employees have been flt tested cm certffied with 1heir % face respirator with
HEPA filraflon cartridge sys1erns.
Equipment Profile
CBA has proven to be an associalion of some of the most highly skiled and experienced personnel from the
managemert 1evel k> the field operations persoi 11,el CBA CllTel'l1ly owns ancUor operates roll-off tnm and provides
oversigtt management of end dump tn.cks. CBA currantJy provided 20 cubic yad open-tDp contaneis. 40 cubic
yard open-mp contaners, 40 cubic yard asbestos vaults, and vacuum containers.
Certifications
• Stale of Texas ffistorEaDy Under Ublzed Business
• North Centra Texas Council of Government Minority Certification
• South Central Texas Couocil ex Government Minority Certikation
Pennits and Licenses
CBA currently holds pennils and licenses from lhe blowing agencies
• Texas Department d Health Asbestos Transporter License
• US Oeparmri of Transportation Hazardous Materials Certfficatlon of RegistJafioo
• Texas Department cl Tr.mportation license
• Texas ColMlission of Environmental Ouarrty Pennit
Insurance
CBA Cl.V18ntty holds insurance limits on the following types
• General Liability
• AulDmobie Uabiity
• Worters Canpensalion and Employers' Liabifity
• Professiona / Polluti:ln Liability
$1 ,000,000
$1,000,000
$500,000
$1.000,000
Programs CBA's safety policy is to establish, actively promote, ald continuously improve the safety, healttl, and accident prevention pmgiam; to provide a safe and healthful won environment for al employees; to prewn human and material loss; n to meet or exceed Occupational Safety and Health Administration (OSHA) reggations, and Federal, Stale and local laws for safety and heaHh. We berieve that i1jlJies cao be prevented, management is respoi lsible u preventing injt.Wies, safety requires involvlng al~ mining empt,yees to wortc safety is essential, and that accident prevenion is good business. Our practice is ta al of lhe employees actively part:ipate in the Safety and Heal1h progr.m. OUr heallh am safety prog1311 eslabishes the polcies and procedures, which protect workers and 1he public from potential t.azads posed by wm. We consiter safety Ile hirJ,est pri>rity dumg wort at a slle co11taini11g polentialy hazardous codions. In al ilistaices, all project activities wil be conducted in a mamer ta mnnizes the probability d qmy, accident or Incident occurrence. Medical lbilDltng All per9tml!I pa1iq>ale in a company supported. meclcal surwilance progian under the diedDn of a physician. Our me<ical uveilance program requires 40 hours trained personnel to be medically saeened upon employment and s•absequent examinations annually while under 1he employment of CM. We haven-place a substance abuse program, wl*:h requires initial pr&-empk>yment and random screening. Polley Slatement on Drugs and Alcohol The company has a vital interest in maintaining safe. heanhful and efficieq working ccndi1i>ns b Is employees. Being under the influence cl a drug or alcoha on the pl> poses serious safety and heallh fists. not only ID the user, but to those who wortc with or come in contact with the user. The use er sale of an illegal drug ar alcohol in the wont place or oo l1e work time also poses unacceptable risks for safety, healtt1U and e~ ope1aiol& Accordingly, it is the rVJ1 cnl nent of the CXJmJ>mlY to maintain a working envircnnent that is free cl subslante a>use. Alcohol • l is prooibited for any employee to be under the inlluence of alc(jg while peooi ming company business, while in a company facility, or while operating vehicles or equipmert owned by or leased by the company. • Possession of alcotd while in or on a company truck or equipmert is prohlbiled. • Use of aloohol or possessi>n of any open container of alrohol wtu1e in a COfflpaly facilJ c, project site is prohi)i1ed. Legal Drugs Prescribed and/or over-the-counter drugs may affect behavior Md perbmance. Employees are encouraged 1D advise Ha supervisor that they are taking such drugs for medical reasons. and mecfical ewmaiul1 may be required. During any period that such use of drugs adversely affect job performance, the employee d be refieved of his/her job duties or reassigned by the company. #-
Illegal Drugs
The use. sale, tr.efer on possession d any illegal drug by any employee while in a company facllly or whiJe
performing company busiless is strictly prohibited. VIOiation cl this policy wil result in disciplinary adion, ~ to and
including, termilation of employment, eveo for the first offense.
Experience
CBA is a lioensed transporter d asbestos in the Stats cl Texas. In all i isbYlces when asbes1os or asbestos
containirv malerial are being transported and/or disposed d. drivers are requed to be donned in UMII C PPE.
Being M in demand transporlar for muJtiple asbesa comactors throughcM the state requires l.8'181 C PPE 1D be
required constanlly.
References
ACE Envirol met ita (Remediation Cot ,lnEIDr)
P.O. Box5'1436
Grand Praiie, Texas 75054
Contact NaTl9: Ms-. LaOonna l..eshtJt
Phone# (214) 734-4000
Fax I (972) 641-1208
Salty's (Oi field Con1rcdor)
701 N. Fist St, Stile 100
Lufki1. Texas 75901
Contact Nane: t.t. Kris Mowery
Phone I (940) 517-9231
CST Envitnnenlal (Asbestos Con1ractol)
14010 lnterdrive West
Houston. Texas 77032
Contact Name: l.t'. PJ Parish
Phone' (972) 579-8939
Fax# (972) 57S-9009
Devon Energy Q,rporafion (Oi and Gas Company)
1209CR 1304
Bridgeport. Texas 76426
Conla:t Name: ~-Darrel Mlsby
Phone# (940) 394--~
Fax # {940) 394-2105
Bridgeport Tank Trucks {al F191d ConlractDr)
P.O. Box6
Bridgeport, Texas 76246
Conbd Name: tk. Paul Gibbons
Phcn,#(817)475-7171 ·
F81l # (940) 683.2725
GEO &pbaioo Ser.ices (Emergeiicy Respolise ConlractDr)
12ns Busi1eSI 'l87 Noott
Falt Worth, Texas 76179
Contact Hane: ... Slave Com
Phone I (817) 439-4610
Fax I (817) 439-4612
HP EnmMian (Asbesm Coldraca)
460 S. Bellh. Sulllt U,
Irving. Texas 75()(1)
C'4ldld Hana: ..... TCIII Palet
. Phone' {972) 399-0069
Fax I (972) 986-6013
Fast Soll6>tls Envirolunenlal
2603 Glenfield Ave.
Dallas. Texas 75233
Conlact Name: ..... Maio Lopez
Ptme t (214) 333-2192
Fax I (214) 453-7054
lnat:on Enviolfflfllai, Inc. (Asbesk>s Contractor)
210 S. Walru Creek Dr.
Marldeld. Texas 76Cm
ContEt Name: ~-Jeny Aoorews
Phone I (817) 477-9995
Fa t (817) 477~
Liberty Services (Remecialion Contracb')
103 N. Oaktawn
Easlland, Texas 76448
Contact N.:wne: M'. Brian Rogers
Phone I (254) 629--8801
Fax I (254) 629-8803
Merci.y Services {Asbestos Ca1lrador)
1731 Wal S1reet
Gartinl, Texas 75041
Contact Nana: Mr. Dem Droemer
Phone' (972) 926-5900
Fax# (972) 926-5903
Protect Effllionmental (EmergBl'Cf Response CoqaJy)
6504 Mclwar Road. Sute 200
HallDm Cly, Texas 76117-5363
Contact Nana: Mr. Ri:hanf camemn
Phone t (817) 589-9005
Fax# (817) 838-9898
Additional Documentation Included
• Resume cl Presidm
• Copy cl Catifa:aBd Insurance
• Copp d Texas Depall11dt d Healh Asbesm Trcmporter License
• Copy cl Texas Coi1•,aissicwl of Envionrnental Quaity Transporter Permit
• Copy of US 0epanent of Transportation Hazardous Materials Certificate of Registralion
• Copy cl Texas Oepartmn of Transportab, license
• CopJ d State of Texas HUB Cenificafion
• Copy c:I North Cemal Texas Councl ri Govenvnents Minority CertifK;afion
• COpy cl South Cenlral Texas Courd of Governments Minority Certification
• Copy of Leier of Good staldilig with the Slated Texas Coq)lroler
"
Jana Osborn
Objective~
~177 Basu lload
Krum Tan 76249
(9'0) 432-9900
{9'0) 465-2314 Cell
My objective iS ID build and grow a financially strong company through a commitment to our
customers' 581isfadio" al'ld employee's well being.
Oven,lew:
• Excelei ICe in cuslDfner satisfaction
• Rew,wing Financial Statements and ove1"iew of company
• Commilment to honesty and integrity in al business dealings
21 years business experience
• Responsible b d8ilJ !'\al agement of operatiana-
• S.-on Board d Dncb's
• FlftlN r...:rat S-.,•:ts and mau declSions tar~ profllab~ily
• u.wge ap.-. .. Manager
• ~and appowe lllgal-ca-,...,bacts-
• Rawww ..s approwe bid dOCumenlS
• Alves and appo,e ... • ,__ ..s appDll8 mpenaes aid inllOic:es
• Ref-. and Sign P8Jl'DI
• ......, al llcenses. ,-mb and certifications
• Tl'lldlng ~ ..,..._.-or sale5 taxes. and federal taxes
• NeiJ a· n c:o,•.dl will cuslomerS and wendotS
• Oewelcpmenl of aocounling systemS and legal structore
• E1ISUfing lhal a,mpa If cornptes llliltl all appllcable federal. state and local ~lations
• Ensuring 11111 a.e..-'J complies wil all applicab1I! safety guldeltnes
• ova 1 • ig 1he mainlel 1S1C1t and repair o1 equioment
• Rewiew and make dbosoiS regarding ,prgj«t profitability.
·j Eagle CoMlllidkM-& &nironmental Services. LP.
Stft»-Mt IJlrl •• ....,._......,.. lt!tiC!I
• Respm ...... lar ffllN5ISIII dailJ upaalicJi•.
• ..,... Ol!'I. :elopn•• d clhrilion
• Re'lleW d F....cial Sta:ements to make declSioM for i!'npnM!d profitability
• Dair qeaioos d lransportatiOI' dMsion throughout the Stale of Texas
• ~ gerlelalBO d $5,000,000.00 annually
• Appnwal of lime sheels. sales reports, lMlizat.on d equ.,.nent res,orts . weekly serw:e repo,1S.
dalJ -,rt schedules. ~ reports. JOb profitability .,epcxt&. eusfomer inl/Oices and vendor
li'lloces.
• ~d al Eslinaes
• Oeu :eloping Mafeee syslern
• Man•g••d d S.. R~. Dispatctiers and OnveB siatewlde
• ~ 1hal eq.ipmmt Is ma!lttai1,ed and repaired
• Niig1Atatirf,J CU**=1a will custom4m a,-, vendors
• 1&11119.g and overseeing wortc on vanous job sttes
• Emunng !NI al nnspoctation and dispcAI regula'°"5 are followed.
• Ensuring ttia al IWDpic,Jees com plied wilh safety guidelines
,
..., 1m -Ja..,..., 1m
,_[s,,...prtng __ c_ ..... ____________ .. _____ ·-· -=--:-~:c=-=---,..=,=---
o.n,r Mardi 111f: lltr 1112
• Re9p01,sllll far managing dailf ~
• Del ·~S200.000 .00 ill annual~
• Mmlaged eras on job 111N
• ~ and rvvleW paytOI. lads and bookkeeping
• Reva,ed Fw,a,cial Repo,15
I Hulcher s.mc... Inc.
Qffla... H Junt 1Mlf:Mmb 1m
• Responsllla lor fflallOing dally lldmelilnltlle wen IOad and equipment
• Man9ged AdnwliSbab¥e Anisiants
• Mal aged pioper1ies and Ulilifies naitialMJde
• Purdlaed equipment ll9hides and tr!Jcits
• Dei. I +e,I daabaM for traciting equipment R!plliB and life e1epeda11cy of tnator ro.14011!11ts
• Ensured 111111 ~ w;is maintained and ~ed
• Aa -led will! ctewlopmenl d ht maintenance program
-.
In Testimony Whereof. the Company has caused this instrument to -be signed and its corporate seal to be affbced by their
aµthorized officers. this 1st day ef May 20 _08 .
Attested aod Certified
STATE OF PENNSYLVANIA SS
COUNTY OF PHILADELPHIA $S
Arch Insurance Company
I, Brian c. Kuhn, a Notary PUblic, do hereby cer:tify that -Madn J. Nlsefi and J. Mtehael Pete pe,sonaliy knowo to.me to be
the same persons whose ~ are respecllvely as Secretar a,d Vice President of the ArCh lnSl.nnce Company, a ~:~~:~8tt~~G1ese::~ofa:-==:t:'1~~~~:~
seaied with the corp.orate seal aJ.ld 'del!vered 1he said instrument as ffie be and voluntary act of said . ca:poratlon and as
their own free and voluntary acts-for ·the uses and purposes themiuset forth.
~-:;...;;.:.=··· ....... ~'""'ll~i!!!!====-. ,~. -s;:~
· 8riarl C. Kuhn, tfc,tary~
My commission eocpies.12-86-2011
CERTIFICATION
,. t,1artin J. ~. Seqre1ary d1he Aral Insurance Compaf1y; dob.ereby -~ that ihe attached~ ofAltomey11ated
May 1, 2008 on behalf of the person(s) as ll$ted above -a~ 8!l"id correct copy am 9-'the ·8':lffle has be'en
in ful force and effect since the. ~ theraof and is in full ~ a,d ~ Qt') the date df this ~ _.d I oo further
certify that the said J. Micbael .,._ who executed the Power., ~yes Vc.e Pntsident. was on tf18 dafe·.of execution
of~ attadled Power of AttQrney 0. duty elected Vice President d the An::h ·"1sl,nnce Company.
IN TESTIMONY WHEF\EPF. J flave. ~ sub$Cribed my l'llilM-and .affb-.1 the tt_ ll'nnll'RIII
Company on this 29th _,of . JUNE, 2010 · • 20_· _.
Thi. ·Power of Attorney limit$ 'th$ acts rA those named 1hereln ID IN, bonds and ~ apeeifically named ·therein
-andflfeYbave no authorityto·bhdtne COfnplnyexcept:in ffie .mtn\er andto·lheextent hereirrSfal!ad.--·
. PLEASE SEND ALL CLAIM JNQWRIES R_ELATING TO nus BOND TO THE FOLLOWING ADDRESS:
An:hSurety
3 Paikway, Ste.1500
Plilladelphla, PA 19102
OOML0013 00 03 03
Page2of2 Printed In U.S.A.
POW'ER 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 ·Company") does hereby appoint
William A Bailey, Maria A Gonzalez, Anne M. Barber, Michael J. Friedrich and Dana M. Kuber of Bridgeview, IL (EACH)
its 1tue and 1awru1· AttonieY(s~-t() make, execute, seat. and deliver from the date of is(uarice of this power for and
on its behalf as surety, and as tts act and deed:
Any and au bonds and undertakings
sccePTlON: . NO AUTHORITY js. granted to make, ~ $881 and deliver bonds .or ~ngs that ~ the pa~e,r-eotrection of any pr.omlssocy nole. Check. draft« letter· of credit ··
ThiS aulbodly does not permit 1he same Obligation to ·be spit mo two or more bonds n GR1er to brirlg each such bond
Wittlin tt,e 4olb;lr ~It d aulhorlly as set forth htiein,
TheCompany may revoke 1his appointment at ,..., time.
The ~ -Of auc:h bonds end u~ in ~-of ·---:·~ie,lls~$hall be B$ binding· upon the ~kl :e:t¥::.sk):k:r:C:=~~~~,~-~:~8*1-,and~byits
Thi,$ Power of Attorney is~ by aU1hority of resolutioris adoptitd by-~-~ dthe Board of Decio,s. of
the Company on Marcb -3, 2003. true and~ copies of Which ·are tiers.inailar set fd and are hereby certified lo by
tt)e mdar8igned Seaetay as being lnfui force and eliact:
"VOTED. That the~ of Ile Board. the President.or q~ ~IJ.« 1hefr ~ (teslgnated in writing
and m.J with the Secaelaiy, or the Secrela-y shal hava lhe power and authorly to appon agents and attomeys-n-fact
and ' to autboriZe them to execute on behalf of the Company. and attach the seal of the Company theretQ, bonc;ls aod
undertakilp, recognlza1C8S, contract& of Indemnity ..,g ott. ·~ ~· in If.le --thend. • "1J ·sueh
offk:ers of the Company may appoint ,agents fQf' acceptance of process.•
This Power of Attorney is sigh~. seal.ed and eertifled by facSmle under ald by authorly of the following resolution
adopted by the unanimous consentd'the Board of 'Oil ectors of the Company Qn March 3, 2003:
VO'ra)~ '1hlt the signature of ··the Chatrtnan of the Board, the President. or any Vice Aelidem. or 1hei' appointees
designated in writing and flied wtth 1he Secrelay, and the signature of the. Seaetay, lie teal of the Company~ and
cerUficatioos by the Sec:.retary, m~y be affixed by fac$inle on any power' of attorney ar ~ executed ~ to the
resootion adopted by the Board ·of Directors on March 3, 2003, and any such power sc, aecuted. sealed and certified
with respect to any bond or undertaking to which it is attached. shaft continue lo be valld and binding upon tbe Conipany.
OOML0013 00 03 03
Page1 of2 Printed In U.S.A.
THE AMERICAN INSTITUTE OF ARCHITECTS
I
AIA Document .i\.310
Bid Bond# ZA34840
KNOW ALL MEN BY THESE PRESENTS, thatwe
INTERCON ENVIRONMENT AL INC CHere insert full name and address or lepl title ol Qmtractor)
TEXAS
as Principal, hereinafter called the Principal, and
ARCH INSURANCE COMPANY (Here Insert lull name and address or lepl ti tle of Surety)
3 Parkway, Suite 1500-Ph iladelphia, PA 19102
a corporation duly organized under the laws of the State of MISSOURI
as Surety, hereinafter called the Surety, are held and firmly bound unto
CITY OF FORT WORTH (Here insert full name and add,as or lepl lltle of Owner!
TEXAS
as Obligee, hereinafter called the Obligee, in the sum of FIVE PERCENT OF THE BID AMOUNT
Dollars ($ TBD ),
for the payment of which sum well and truly to be made, the said Principal and the said Surety, bind
ourselves, our heirs,. executors, administrators, successors and assigns, jointly and severally, firmly by
these presents.
WHEREAS, the Principal has submitted a bid for
A SBESTOS ABATEMENT & DEMOLITION
{Here insert full name, .acldreu and description of project) ..
DEM 10-08: GHA
NOW, THEREFORE, if the Obllgee shall accept the bid of the Principal and the Principal shall enter into a Contract
with the Obllgee in accordance with the terms of such bid, and give such bond or bonds as may be specified in the bidding
or Contr.1ct Documents with good and sufficient surety for the faithful performance of such Contract and for the prompt
payment of labor and material furnished in the prosecution thereof, or in the event of the failure 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 said bid and such larger amount for which the Obligee may in good faith contnct
with another party to perform the Work covered by said bid, then this obligation shall be null and void, otherwise to rermin
in full force and effect.
Signed and sealed this 29TH day of JUNE 2010
-{) INTERCON ENVIRONMENT AL INC
--=~=-=--~-=-11':...,,,,.,::ffi""'--AM~m_.,.....&.._....L...__ .... _, i)~
~Witness) QD ~~
Angelica Petruzzelli . (Title)
Karen Andrews, President
~:-!\-~---=Q('--. -_L----_____ -_··----IARCH INSURANCE COMPANY ~ (Witness)
AIA DOCUMENT A310 • 810 BOND • AIA e • fEBRUARY 1970 ED • THE AMERICAN
INSTITUTE Of ARCHITECTS, 1735 N.Y. AVE., N.W., WASHINGTON, D. C. 20006
(Seal)
· (Seal}
1
ATTACH CASHIER'S CHECK OR BIDDER'S BOND HERE
2-16
2.8.Bonds
2 .8.1. Bidder's Bond
Proposals must be accompan ied by a bidder's bond in the amount of five percent
(5%) of the largest possible total of the cost estimate . A lternatively, the City will
accept a cashier's check , in said amount , with the City named as payee, to be held
in escrow until the successful Contractor signs the project co ntract. This bond will
serve as a guarantee that the successful Contractor will e nte r into an ag reement
with the City to perform the project. The bond is subject to forfeiture in the event the
successful Contractor fails to execute the contract documents within 10 calendar
days after the con tract has been awarded .
2 .8.2. Payment and Performance Bonds
Before beginning the work, the Contractor shall be required to execute to the City 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
sole ly 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 performan ce bond is solely
for the protection of the City of Fort Worth ; in 100% the amou nt of the Contract; and
cond itioned on the faithful performance by Contractor of the work in accordance
w ith the plans, specifications, and contract documents. Contractor must provide the
payment and performance bonds, in the amounts and on the conditions 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 business in the State of Texas that is of sufficient financi al strength and
solvency to the satisfaction of the City. The surety must meet all requirements of
Article 7 .19-1 of the Texas Insurance Code. All bonds furn is hed hereunder shall
meet the requirements of Chapter 2253 of the Texas Gove rn ment Code, as
amended.
In addition, the surety must (1) hold a certificate of authority from t he 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 reinsurer 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 pennitted 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 detennine the adequacy
of the proof required here in.
No sureties will be accepted by the City that are at the time in d efault 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 th e Contractor to that effect and the Contractor shall imm ediately
provide a new surety satisfactory to the City.
2-15
2.9. Minority/Women Business Enterprise (MWBE) Utilization Requirements
A MWBE goal of 16% percent has been established for this 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 i n the award and
administration of DOT assisted contracts. Failure by the contractor to carry out these
requirements is a material breach of this contract, which may result in the term i nation 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
MWBE 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.
MWBE 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 MWBE 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 MWBE participation, they must submit the Subcontractor Utilization
Form and the Good Faith Effort Form and documentation.
All MWBE 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 (TX.DOT), 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 Faith Effort
Form or the Prime Contractor Waiver Form, or the Joint Venture Form ("and
documentation") as appropriate.
The Environmental Management Department must receive the documentation no later
than 5:00 p.m., five City business days after the bid opening date, exclusive of the bid
opening date. Contractor shall obtain a receipt from an employee of the Environmental
Management Department. Such receipt shall be evidence that the City received the
documentation. The submission of the applicable completed form(s) within the allotted
time will be considered "when determining the responsiveness of the bid. Failure to
I
2-17
comply with the bid specifications, inclusive of the MWBE requirements and
documentation, shall render the bid non-responsive.
The Good Faith Effort documentation shall demonstrate the Contracto r's commitment
and honest efforts to utilize MWBE(s). The burden of preparing and s ubmitting the Good
Faith Effort information is on the Contractor and will be evaluated as part of the
responsiveness to the bid/proposal. A Contractor who intentionally a nd/or knowingly
misrepresents facts on the documentation submitted will constitute a basis for
classification as non-responsive and possible debarment.
Questions about MWBE requirements may be directed to the City's MWBE Business
Office at 817 .392.6104.
Check the appropriate box/boxes:
!XI The following MWBE documents are included in this bid su bmittal, following this
page, bound within the response :
X Subcontractor Utilization Form
N/A Joint Venture Form
N/A Prime Contractor Waiver Form
N/A Good Faith Effort Form
D MWBE documents will be delivered to the Environmental Management
Department* no later than 5:00 p.m., five City business days aftel" the bid opening
date, exclusive 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
receipt 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 frame may occur only for good cause following written
approval of the Recipient. This clause applies to both DBE and non-DBE subcontractors.
CONTRACTOR:
~~
Signature
Karen Andrews
Name
President
Title
lntercon Environmental, I nc.
Company
July 1, 2010
Date
NOTE: 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
ATTACHMENT 1A
Page 1 of 4
FORT WORTH
~ City of Fort Worth
Subcontractors/Suppliers Utilization Form
PRIME COMPANY NAME : Check applicable block to describe prime
lntercon Environmental, Inc. xi MtwmeE I I NON -M/W/DBE PROJECT NAME:
Granbury Hills Apartments Removal of Asbestos-Containing BID DATE
Materials and Demolition of Structures July 1. 2010
City's M/WBE Project Goal: I Prime's M/WBE Project Utilization: PROJECT NUMBER
16 % 16 % DEM 10-08: GHA
Identify all subcontractors/suppliers you will use on this project
Failure to complete this form , in its entirety with requested documentation, and received by the Managing
Department on or before 5:00 p.m. five (5) City business days after bid opening, exdusive of bid opening date,
will result in the bid being considered non-responsive to bid specifications .
The undersigned Offerer agrees to enter into a formal agreement with the MJWBE firm(s) listed in this
utilization schedule, conditioned upon execution of a contract with the City of Fort Worth. The intentional
and/or knowing misrepresentation of facts is grounds for consideration of disqualification and will result in the
bid being considered non-responsive to bid specifications
M/WBEs listed toward meeting the project goal must be located in the nine (9) county marketplace or
currently doing business in the marketplace at the time of bid. Marketplace is the geographic area of Tarrant,
Parker, Johnson, Collin, Dallas , Denton , Ellis , Kaufman and Rockwall counties .
Identify each Tier level. Tier is the level of subcontracting below the prime cornractor, i.e., a direct
payment from the prime contractor to a subcontractor is considered 1st tier, a pay ment by a subcontractor to
its supplier is considered 2"d tier
ALL M/WBEs MUST BE CERTIFIED BEFORE CONTRACT AWARD.
Certification means those firms, located or doing business at the time of bid opening wi thin the !M arketplace , that have
been determined to be bonafide minority or women businesses by the North Centra t Texas Regional Certification
Agency (NCTRCA), or the Texas Department of Transportation (TX DOT), highway division. Disadvantaged Business
Enterprise (DBE) is synonymous with Minority/Women Business Enterprise (M/WBE).
If hauling services are utilized, the prime will be given credit as long as the MJWBE listed owns and
operates atleast one fully licensed and operational truck to be used on the contract The M/WBE may lease
trucks from another M/WBE firm, including M/WBE owner-operators, and rece ive full M/WBE credit. The
M/WBE may lease trucks from non-M/WBEs, including owner-operators , but will onJy :receive credit for the
fees and commissions earned by the M/WBE as outlined in the lease agreement.
Rev . 5/30/03
Fo RTWORTH
~
ATIACHMENT 1A
Page 2 of 4
Primes are required to identify ALL subcontractors/suppl iers , regardless of status ; i.e ., Minority , Women and non -M/WBEs .
Please list M/WBE firms first , use add itional sheets if necessary .
Certification N
(check one) 0
SUBCONTRACTOR/SUPPLIER n T Detail Detail
Company Name i N T
Address e M w C X M Subcontracting Work Supplies Purchased Dollar Amount
T D w Telephone/Fax r B B R 0 B E E C T E
A
CBA Services , Inc.
5877 Barnett, Suite A
Krum , Texas 76249 1 X Asbestos Waste N/A $24 ,850 .00
Phone : (940) 482-9900 Hauling
Fax: (940) 482-3457
Tomas Reyes Trucking , Inc.
3529 Peoria Street Demolition Waste N/A $70 ,366 .00
Dallas, Texas 75212 1 X Hauling
Phone : (214) 631-2711
Fax: (214) 905-7565
MMG Building & Construction
1115 NE 23rd Street X Portable Toilets N/A $510 .00
Fort Worth, Texas 76164 1
Phone : (817) 510-0490
Fax : (817 ) 510-0495
MRL Hydromulching
1517 Birchmont Lane $13 ,750 .00
Keller, Texas 76248 1 X Hydromulch ing N/A
Phone : (817) 247-0719
Fax : n/a
I -
Rev . 5/30/03
FORTWORTH ---..,..--
ATTACHMENT 1A
Page 3 of 4
Primes are required to identify ALL subcontractors/suppliers, regardless of status ; i.e., Minority , Women and no n-MNVBEs.
Please list M/WBE finns first , use additional sheets if necessary .
Certification N
(check one) 0
SUBCONTRACTOR/SUPPLIER n T Detail Detail Company Name i N T
C X M Subcontracting Work Supplies Purchased Dollar Amount
Address e M w T D VII Telephone/Fax r B B R 0 B E E C T E
A
'
Rev . 5/30/03
FORT WORTH
~
Total Dollar Amount of M/WBE Subcontractors/Suppliers
Total Dollar Amount of Non-M/WBE Subcontractors/Suppliers
$
$
95,726.00
13,750.00
ATTACHMENT 1A
Page 4 of 4
TOTAL DOLLAR AMOUNT OF ALL SUBCONTRACTORS/SUPPLIERS $ 109,476.00
The Contractor will not rnake additions, deletions, or substitutions to this certified list without the prior approval
of the Minority and Women Business Enterprise Office Manager or designee through the submittal of a
Request for Approval of Change/Addition . Any unjustified change or deletion shal be a material breach of
contract and may result in debarment in accord with the procedures outlined in the ordinance. The contractor
shall submit a detailed explanation of how the requested change/addition or deletion will affect the committed
M/WBE goal. If the detail explanation is not submitted, it will affect the final compliance determination .
By affixing a signature to this form, the Offeror further agrees to provide , directly to th e City upon request,
complete and accurate information regarding actual work performed by all subcontractors, including
M/W/DBE(s) arrangements submitted with the bid. The Offeror also agrees to a l ow an audit and/or
examination of any books, records and files held by their company . The bidder agrees to allow the
transmission of interviews with owners , principals, officers, emp loyees and applicable
subcontractors/suppliers/contractors participating on the contract that will substantiate the actual work
performed by the M/W/DBE(s) on this contract , by an authorized officer or employee of the City. Any
intentional and/or knowing m isrepresentation 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 ordina nce and create 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
lntercon Environmental , Inc.
Company Name
210 S. Walnut Creek Drive
Address
Mansfield Texas 76063
City/State/Zip
Karen Andrews
Printed Signature
Karen Andrews, President
Contact Name/Title (if different)
(817) 4 77-9995 / (.817) 4 77-9996
Telephone and/or Fax
karen@intercon--enviro nmental.com
E-mail Address
July 1, 2010
Date
Rev . 5/30/03
NCTRCA
Disadvantaged Business
Enterprise Certification
CBA Services, Inc.
Disadvantaged Business Enterprise
has filed with the Agency an Affidavit as defined by 49 CFR part 26 and is hereby certified to provid e
service(s) in the following areas:
484220;562211;562219;
Specialized Freight (except Used Goods) Trucking, Local i Hazardous Waste Treatment and
Disposal; Other Nonhazardous Waste Treatment and . Disposal ;
This Cllrtlflcatlon ls valid be,ilnning March 2010 and superseded any re gistratio n or li sti ng
previously issued. This certltlcatlon must be updated annually by submission of an Annual Updat" A111davlt. At any
time the re ls a charge bt ownership or control of the firm, notlflcatlon must be made immediately to th e North
Central Texas Regional CertUlcatlon Agency or au TUCP certifying entity.
Certifica te expiration _____ M_a_rc_h ____ , 20.J.L.
I ssued date --------.uiM.wau.1rc .... b'-----'' 20.J.Q_
CERTIFICATION NO.
Certification Adminis t r ator
,;1 GOES 346
NCTRCA
Disadvantaged Business
Enterprise Certification
Tomas Reyes Trucking, Inc
Disadvantaged Business Enterprise
has tiled with th~ Agency an Affidavit as defined by 49 CFR part 26 and is hereby certified to provide
service(s) in the following areas:
484220;
Specialized Freight (except Used Goods) Trucking, Local ;
This Certlflcntion is valid beginning June 2009 nnd superseded any registration or listing
pt·eviously issued. This certlficntion must be Ulldated annu11lly by submission of 1111 Annual Update Affidav it. At any
time there is n charge in ownership or control of the firm, notification must be made Immediately to the North
Central Texas Regional Certification Agency or an TUCP certifying entity.
Certificate expiration ______ Ju_n_e ____ , 20_1Q_
Issued date June 20 09 --------------' --
CERTIFICATION NO.
HMDB41411Y0610
Lll ho. In U.S.A.
'··
'(.'
NCTRCA
WoIDen-Owned Business Enterprise Certification
MMG Building Services & Construction Services, LLC
Woman-Owned Business Enterprise
has flied wlth the Agency 1u1 Affidavit as defined by the NCTRCA M/WBE policies & procedures and Is hereby certified to
provide servke(s) In lhe Collowing areas:
562991;
Septic Tank and Related Services; Renting and Servicing of Portable Toilets;
This Certil1catlon Is valid beginning__ March 201 O and superseded any registration or listing
p1·cvlously J111mid, Thls certlfleRtJou must be updated nnnunlly by submission of an Annual Update Affidavit. At any tim e
thetc ls a ch,rngt, ht ownership or control or the fil'm, notlfleatlun niust be made lmmedlotely . to the North Centnl 'l'e:u11~
Regional Certification Agency.
March 11 CertU1cute expiration,_. _____________ ,20. __
10 Issued date _______________ .,20 __ _ March CertlOcutlon Administrator
CERTIFICA'l'ION NO.
2.10. Statement of Residency
The following information is required by the City of Fort Worth in order to
comply with provisions of state law, TEXAS GOVERNMENT CODE § 2252 .001,
State or Political Subdivision Contracts for Construction, Suppl ies, Services; Bids
by Nonresident.
Every bidder shall affirmatively state its principal place of business in its
response to a bid invitation. Failure to provide the requ i red information shall
result in your bid being declared non-responsive. Bidders' cooperation in this
regard will avoid costly time delays in the award of bids by the City of Fort
Worth. For this reason, each Bidder shall complete and return, with its bid, the
Statement of Residency Form. Failure to provide all required information shall
result in the bid being considered non-responsive.
TEXAS GOVERNMENT CODE § 2252.001 defines a Texas "Resident Bidder"
as a bidder whose principal place of business* is in the state of Texas, including
a contractor whose ultimate parent company or majority owner has its principal
place of business in the state of Texas. TEXAS GOVERNMENT CODE §
2252.001 defines a "Nonresident Bidder" as a bidder whose parent company
or majority owner does not have its principal place of business* in the state of
Texas.
Bidder's complete company name lntercon Environmental, Inc. ---------------'---------
State your business address in the
adjacent space provided if you are
a Texas Resident Bidder:
State your business address in the
adjacent space provided if you are
a Nonresident Bidder:
210 S. Walnut Creek Drive
Mansfield, Texas 76063
*The State Purchasing and General Services Commission defines Principal
Place of Business as follows:
Principal Place of Business in Texas means, for any type of business entity
recognized in the State of Texas, that the business entity
o has at least one permanent office located within the State of Texas, from
which business activities other than submitting bids to governmental
agencies are conducted and from which the bid is submitted, and
o has at least one employee who works in the Texas office
Form (Section 2.10) prepared by:
Name
Title
Karen Andrews
President
Date __ J_u~ly~1 ~· 2_0_1_0 ____________ _
2.11. Nondiscrimination
All City contractors are required to comply with Chapter 17 , "Human Relations,"
Article Ill, "Discrimination," Division 3, "Employment Practices," of the Code of the
City of Fort Worth, prohibiting discrimination in employment practices. Contractor
agrees that Contractor, its employees, officers, agents , or subcontractors, have
fully complied with all provisions of such Ordinance, and that no employee,
participant, applicant, contractor or subcontractor has been discriminated against
according to the terms of such Ordinance by Contractor, its employees, officers,
agents, or subcontractors herein .
CONTRACTOR:
~~
Signature
Karen Andrews
Name
President
Title
lntercon Environmental, Inc.
Company
July 1, 2010
Date
2-13
2.12. P revaili ng W age Rates
A Contract o r selected for this proj ect wi ll be req u ired t o comply w it h TEXAS
GOVERNMENT CODE, Chapter 2258, w ith respect to pa ym e nt of P rev ailing Wage
Rates for pub li c wo rks contracts. T he cu rr en t w age sca le for m e m bers of t he
Bu i lding and Constru ctio n t rade ma y be found at:
http ://www.texoassociati on .org/Chapte r/wagerates .asp.
A worker employed on a public work by or on beha lf of t he C ity 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 n ot less t han the
general prevailing rate of per diem wages for legal holiday a nd 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 su bcontractor of the
contractor, shall pay not less than t he prevailing wage rates t o a w orker employed
by it in the execution of the contract. A contractor or subcontractor w ho 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 pai d less than the wage
rates stipulated in the contract.
This requirement does not proh ib it t he contractor or subcontractor from paying an
employee an amount greater than the prevailing wage rate .
The undersigned acknowledges the requirements of Chapte r 2258 of the Texas
Government Code, and intends to comply with same in the execution of this proj ect.
CONTRACTOR:
lntercon Environmental , Inc.
Company Name
210 S. Walnut Creek Drive
Address
Mansfield , Texas 76063
C ity, State, Z ip
BY: Karen Andrews
(P.rint or type name of signatory)
(Signature)
Pres ide nt
T itle (prin t or type )
2-14
2.13. Insurance Certificates
A successful Contractor will be required by the contract to have insurance
coverage as detailed below. Contractor must provide Certificates of Insurance in
the amounts and for the coverages required to the Environmental Management
Department , Administrative Offices , within 14 calendar days after Notice of Award .
(a) Insurance coverage and limits:
1. Commercial General Liability Insurance
o $1 ,000,000 each occurrence
o $2,000,000 aggregate
2. Professional Liability Insurance -NOT APPLICABLE.
3. Automobile Liability Insurance
Coverage on vehicles involved in the work performed under this
contract:
o $1,000 ,000 per accident on a combined single limit basis or:
o $500,000 bodily injury each person; $1 ,000,000 bodily 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.
4 . Worker's Compensation
o Coverage A: statutory limits
o Coverage B: $100 ,000 each accident
$500,000 disease -policy limit
$100 ,000 disease -each employee
5. Environmental Impairment Liability (Ell) and/or Pollution Liability
$2,000 ,000 per occurrence. Ell coverage(s) must be included in
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
in surance or other policy(s).
6. Asbestos Abatement Insurance -$2,000,000 each occurrence with
no Sunset Clause.
2-15
(b)
1.
2 .
3.
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 services.
Certificate(s) of Insurance shall document that in surance coverage
specified according to items in section 2 .13(a) 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 .
4. 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 policies.
Notice shall be sent to Brian Boerner, Director, Environmental
Management Department, City of Fort Worth , 1000 Throckmorton
St., Fort Worth, Texas 76102.
5. Insurers for all policies must be authorized to do business in the
state of Texas or be otherwise approved by the City ; and, such
insurers shall be acceptable to the City 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
maintained through insurance pools or risk rete ntion 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 insurance premiu m payments.
9. The Commercial General Liability insurance po licy shall have no
exclusions by endorsements unless the City approves such
exclusions.
I
2-16
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 in Section 2.13(a) above, except for the
Professional Liability insurance policy , 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 coverage as
required 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.
The undersigned acknowledges the insurance requirements of this section and
intends to comply with same in the execution of this project.
CONTRACTOR:
lntercon Environmental, Inc. BY: Karen Andrews
Company Name
210 S . Walnut Creek Drive
(print or type name of signatory)
~~
Address (Signature)
Mansfield, Texas 76063 President
City, State, Zip Title (print or type)
2-17
'
=
FOR PURPOSES OF EVALUATING THIS BID, PLEASE ATTACH A COPY OF
YOUR CURRENT INSURANCE CERTIFICATE(S) HERE AND BOUND WITHIN
THE BID PACKAGE .
2-18
2.14. Workers Compensation In surance Coverage
A. Defi nition s :
Certificate of coverage ("certificate"). A copy of a certificate of insurance , a
certificate of authority to self-insure issued by t he commiss io n , or a coverage
agreement (TWCC-81, TWCC-82, TWCC-83, or TWCC-84), showing statutory
workers' compensation insurance coverage for the person or entity 's employees
providing services on a project, for the duration of th e project.
Duration of the project-includes the time from the beginning of th e work on the
project until the Contractor's/person 's work on the project has been completed
and accepted by the governmental entity .
Persons providing services on the project ("subcontractor" in Texas Labor Code,
406.096) -includes all persons or entities performing all or part of the services
the Contractor has undertaken to perform on the project, regardless of whether
that person contracted directly with the Contractor and regardless of whether that
person has employees. This includes, without limitation , independent
Contractors, subcontractors, leasing companies, motor carriers, owner-operators,
emp loyees of any such entity, or employees of any entity, which furnishes
persons to provide services on the project. "Services" include, without limitation ,
providing, hauling, or delivering equipment or materials, or providing labor,
transportation, or 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 ,
which meets the statutory requirements of Texas Labor Code, Section 401 .011
(44) for all employees of the Contractor providing services on the project, for the
duration of the project.
C. The Contractor must provide a certificate of coverage to the City prior to
being awarded the contract.
D. If the coverage period shown on the Contractor's current certificate of
coverage ends during the duration of the project, the Contractor must, prior to the
end of the coverage period , file a new certificate of coverage with the City
showing that coverage has been extended.
E. The Contractor shall obtain from each person providing services on a project,
and provide to the City:
(1) a certificate of coverage, prior to th at person beginning work on the
project, so the City will have on file certificates of coverage showing coverage
for all persons providing services on the project; and
(2) no later than seven (7) days after receipt by the Contractor, a new
2-19
certificate of coverage showing extension of coverage , if the coverage period
shown on t he current certificate of coverage ends during the duration of the
project.
B. The Co nt ract or shall retain all required certificates of coverage for the
duration of t he project and for one year thereafter.
C. The Contractor shall notify the City in writing by certified mail or personal
delivery, within ten (10) days after the Contractor knew or should have known, of
any change that materially affects the provision of coverage of any person
providing services on the project.
D. The Contractor shall post on each site a notice, in the text, form and manner
prescribed by t he Texas Workers' Compensation Commission, informing all
persons providing services on the project that they are required to be covered,
and stating how a person may verify coverage and report lack of coverage. (see
paragraph II)
E. The Contractor shall contractually require each person with whom it contracts
to provide services on a project, to:
(1) provide coverage, based on proper reporting on classification codes and
payroll amount and filing of any coverage agreements, which meets the
statutory requirements of Texas Labor Code, Section 401.011 (44) for all of its
employees providing services on the project, for the duration of the project;
(2) provide to the Contractor, prior to that person beginning work on the
project, a certificate of coverage showing that coverage is being provided for
all employees of the person providing services on the project, for the duration
of the project;
(3) provide the Contractor, prior to the end of the coverage period, a new
certificate of coverage showing extension of coverage, if the coverage period
shown on the current certificate of coverage ends during the duration of the
project;
(4) obtain from each other person with whom it contracts, and provide to the
Contractor:
(a) a certificate of coverage , prior to the other person beginning work on
the project; and
(b) a new certificate of coverage showing extension of coverage, prior to
the end of the coverage period , if the coverage period shown on the
current certificate of coverage ends during the duration of the project;
(5) retain all required certificates of coverage on file for the duration of the
project and for one year thereafter;
2-20
(6) notify the City in writing by certified mail or personal delivery, within ten
(10) days after the person knew or should have known , of any change that
materially affects the provision of coverage of any person providing services
on the project; and
(7) contractually require each person with whom it contracts, to perform as
required by paragraphs (1) -(7), with the certificates of coverage to be
provided to the person for whom they are providing services.
J. By signing this contract or providing or causing to be provided a certificate of
coverage, the Contractor is representing to the 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 project, that the coverage will be
based on proper reporting of classification codes and payroll amounts, and that
all coverage agreements will be filed with the appropriate insurance carrier or, in
case of a self-insured, with the commission's Division of Self-Insurance
Regulation. Providing false or misleading information may subject the Contractor
to administrative penalties, criminal penalties, civil penalties or other civil actions.
K. The Contractor's failure to comply with any of these provisions is a breach of
contract by the Contractor which 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'
Compensation commission rules. This notice must be printed with a title in at
least 30 point bold type and text in at least 19 point normal type, and shall be
in both English and Spanish and any other language common to the worker
population. The text for the notices shall be the following text, without any
additional words or changes:
"REQUIRED WORKERS' COMPENSATION COVERAGE"
'The law requires that each person working on this site or providing services
related to this construction project must be covered by workers'
compensation insurance. This includes persons providing, hauling, or
delivering equipment or materials, or providing labor or transportation or other
service related to the project, regardless of the identity of their employer or
status as an employee."
"Call the Texas Worker's Compensation Commission at 512/440-3789 to
receive information on the legal requirement for coverage, to verify whether
,,
2-21
your employer has provided the required coverage, or to report an employer's
failure to provide coverage ."
2-22
CONTRACTOR COMPLIANCE WITH WORKERS' COMPENSATION LAW
Pursuant to V .T.C.A. Labor Code , Section 406.096 Contractor cert ifies t hat it provi des
Workers' Compensation insurance coverage for all of its employees employed on the
public project to abate asbestos/demolition in the uni t identified in th is contract.
STA TE OF TEXAS}
COUNTY OF TARRANT}
lntercon Environme ntal , Inc .
Contractor
By :
Contractor's Signat ure
Karen Andrews
President
Title
July 1, 2010
Date
BEFORE ME , the undersigned authority , on this day personally appeared __ _
Karen Andrews , known to me to be the person whose name is
subscribed to the foregoing instrument, and acknowledged 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 .
GIVEN UNDER MY HAND AND SEAL OF OFFICE this~ day of
July , ~-2010.
ANGELICA PETRUZZELLI
Notary Public, State ofTexas
My Comm iss ion Exp ires
February 28, 2012
My Comm iss ion Expires 02/28/12
'
~~~,t~f
Angel ica Petruzzelli
2-23
2.15. Contractor's Responsibilities
Contractor is responsible for becoming familiar with the cha racter, quality , quantity
of work to be performed, materials and equipment 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.
CONTRACTOR:
\J~ lntercon Environmental, Inc.
Company Signature
Karen Andrews July 1, 2010
Name Date
President
Title
2-24
2.16. Contractor's Legal and Compliance History
Contractor's legal and compliance history is a critical compone nt of this Invitation
to Bid. Read this section with care and respond accord ing ly. Failure of the
Contractor to provide all the information requested and to certify the report, will
result in the Contractor's submittal being declared non-respons ive .
Contractor shall attach a written report of legal action broug ht against Contractor ,
Contractor's officers, Contractor's employees , AND Co ntractor's proposed
subcontractors relating to the protection of the environment. The terms "legal
action" and "relating to the protection of the environment" are defined below.
The report shall include all legal action brought within fwe (5) years of the
closing date of this Invitation to Bid. The report shall detail the substance,
status, and outcome of such legal action. This includes without limitation the
names of the agency and/or persons bringing the action, all re levant dates, 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 ACTION" means: ANY enforcement action by the United States
Environmental Protection Agency, the Occupational Safety and Health
Administration, any other federal agency, the Texas Commission on
Environmental Quality (including its predecessor agency the Texas Natural
Resource Conservation Commission}, the Texas Department of State Health
Services (including its predecessor agency the Texas Deparbnent of Health), and
any other state agency, commission or department, whether in Texas or
elsewhere , when such enforcement action is a result of violations, real or alleged ,
of any laws, licenses, permits, judicial orders, or administrative orders, relating to
the protection of the environment. In this context, enforcement action shall
include without limitation, written warnings, notices of violation, consent orders or
agreements , compliance orders, administrative hearings, civil litigation and
criminal prosecution. Legal action also means any civil litigation brought by any
person relating to the protection of the environment.
"RELATING TO THE PROTECTION OF THE ENVIRONMENT" means:
requirements pertaining to the manufacture, processing. distribution , use,
handling, storage, transportation, reporting , records keeping , permitting,
licensing, treatment, disposal, emission, discharge, spill, release, or threatened
release of hazardous materials, hazardous substances, h azardous wastes,
toxic substances, petroleum , industrial waste, solid w aste, pollutants or
contaminants into or onto the air, surface water, drinking w ater, groundwater,
storm water, publicly owned treatment works, or land.
THE REPORT SHALL BE SIGNED AND CERTIFIED by an authorized
representative of the Contractor, using the following form. The top portion of the
2-25
form is to be completed if a report of legal action is attached . The bottom portion
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
2-26
Certi fication of Contractor's Legal and Complian ce History
Co m plete ONE of t he Follow ing Cert ificatio ns
Certifica'lion of Legal A ction Report
I certify under penalty of law that the attached Legal Action Repo rt detailing Contractor's,
Contractor's officers , Contractor's employees, and Contractor's pro po sed subco ntractors
lega l and compliance history relating to the protection of the environment was pre pared
unde r my direction or supervision in accordance w ith a system desig ned to assure t hat
qua lified personnel properly gather and evaluate the information sub mitted. Based on my
inqu iry of the person or persons who manage the system , or th ose persons directly
respo nsible for gathering the information , the information subm itted is , to the best of my
knowledge and belief, true , accurate, and complete. I am aware that there are significant
pena lties for submitting false information , including t he possibility of fine and imp risonment
fo r kno wi ng violations .
C~RACT~
AQ)A.; lntercon E nvironmental, Inc
Signatu re Company
Karen Andrews July 1, 2010
Name Date
President
Title
Certifica'lion of NO Legal Action
I certify under penalty of law that the lega l and compliance history of Contractor,
Contractor's officers, Contractor's employees, and Contractor's proposed subcontractors
was researched under my direction or supervis ion in accordance w ith a system designed to
assu re that qualified personnel prope rly gather and evaluate the information su bmitted .
Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering the information , I hereby cert ify that no lega l action
relating to the protection of the environment was brought against Contractor, Contractor's
officers, Contractor's employees, or Contractor's proposed subcontractors w ithin the
preceding five years. To the best of my knowledge and belief, thi s statement is true ,
accurate, and complete. I am aware that there are significant pena lties for subm itti ng false
informati on , including the possibility of fine and imp risonment for kn owing violations.
CONTRACTOR:
Signatu re Compan y
Name Date
Title
2-27
ENVIRONMENTAL, INC.
2 1 0 S Walnut Creek Drive. Mans f ield , Texas 76063. Telephone (817) 477 -9995. Facs i m il e (817) 477-9996
Prepared for City of Fort Worth
PROJECT: DEM10-08: GHA
Response to Section 2.16
Contractor's Legal & Compliance History
www .intercon-envi ron men ta I .com
• lntercon Environmental, Inc. has the following citations from Texas Department of State
Health Services (DSHS):
4 Project Name/ Address: Bear Creek Elementary; 401 Bear Creek Drive, Euless, Texas
4. Case No. 1412080038
'4. Violation: Failure to have Consultant's Mold Remediation Protocol on-site; (Report not
provided to lntercon).
4 Date of Violation: June 1 3, 2007
4 Settlement: Penalty paid $750.00 to DSHS
4 Project Name/Address: Liberty Elementary; 7976 Whitney Drive ·White Settlement,
Texas
4 Case No. 1410080438
4 Violation: Fail1.1re to fill out notification form correctly; (Address number was
transposed, typographical error).
4 Date of Violation: June 28, 2007
,l,. Settlement: Penalty paid $100.00 to DSHS
. , ~ .... _"'
DOCKET NO. All564-600-2008
CASE N0.1412080038
IN THE MATTER OF
INTERCON ENVIRONMENT AL.
INCORPORATED
MANSFIELD, TEXAS
§
§
§
§
§
§
AGREED ORDER
L JURISDICTION
BEFORE THE TEXAS
DEPARTMENT OF STATE
HEALm 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.
R 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.
IR FACTS
On June 13, 2007, a representative from the department conducted a compliance inspection of the mold
remediation project at Bear Creek Elementary 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
"I. 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 violations were alleged:
• Failure to have the mold remediation protocol on-site in violation of 25 TAC §295.326(b XI XA)-penalty
amount of$1,500.00.
IV.NOTICE
By the Notice Letter, Ms. Alyson 0. Herny, Division for Regulatory Services. informed Respondent of the
department 's intent to assess an aggregat.e administrative penalty of $1,500.00. The letter was received by
Respondent.
V.RESPONSE
Respondent responded to the department's Notice Letter by requesting an informal conference.
'
VI. SETTLEMENT
On February 27, 2007, an informal conference was held between representatives 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, based on various factors including the desire to avoid litigation.
Respondent agrees to terms of this Order as evidenced by signing this Order. The following terms were agreed
upon:
• Failure to have the mold remediation protocol on-site in violation of25 TAC §295.326(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.
VIL 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 terms.
D. NO RIGHT TO APPEAL
Respondent waives the right to judicial review of this Order.
NOW THEREFORE, IT IS ORDERED that:
1. Respondent pay an administrative penalty, in the amount of $750.00, in full settlement for the
violation(s) that is/are the subject of this Order. Payment must be made by cashier's check or money order
and mailed to: Department of State Health Services, MC 2003, P .O. Box 149347, Austin, Texas 78714-
9347. Each cashier's check or money order must be made payable to the Department of State Health
Services and must also include the notation: ··Deposit in Budget No. ZZl 56, Fund No. 092, Case No.
1412080038."
2. Payment is due in one lump sum payment, thirty (30) days from the date this Order is signed by the
department.
' . ':;
3. Respondent shall henceforth comply with this Order and with all applicable la w s, rules and regula tion s .
Failure to comply w ill result in additional penalties.
i -;Tai ///1 /
Signed and ordered this // day of g,iz-c.c~-L-, 2008 .
//
I 7 "<-/')~ .· ~'7';,. . -~77,.L C-,, -v:-. t::~--=
/
thryn C ."'Perkins, RN, MBA
Assistant Commissioner
Division for Regulatory Services
SPONDENT:
Signature of Authorized Agent
Jerrold Andrews
Printed Name Vice President
3/4/08
Signature Date
'
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, L/JURISDICTION ; .' .... -. ' : .. •:.:.;~=;."·:, · ... ' . ·.: ... \ .'·:'. .. . . ' ·: ; '.': ' .. : : ..
.. ···. -_.·::::.-:\~ .. .:·-: .. ·, ·._·; .<: .:--·: _::_,·:·:_--_::_: .. <:.-:.·,_.·_..::-: .. '([f.~SJ>QM>l;NI (,.·:r· -. -:, _·: .. c,-.
····.t~~~~::~~£~!~hti~~-~~f>.
: ·:·-.' : . ~ ;_ ; ; . ·. ~.--:.; : · .. ::·-.·:_ :·,. ? .... ·.\\/:-~: ·-.:,
----,,liiJ?A.Cl~f .. /\,.
. ~~;i~~i:;)ii~tii~~~~tf:l::"'~~~ .
--; inspection was -tQ , detern:iine .the projt:et's COJDPli~e witJi. th~ Rul~; Act or :NESHAP 'as -
-> ·ferere~ced m "I. i1ll1S(lictioi,.~" :: -· · -, · -· · --· ----· · ·· ··_ -· -
:.·.:::·:·::
. ~~~;i~!ii~!~I?}~~~~
-The following ~iol~tion was ~leged:
' -: . ·: .·· .. · ··.: . . .... ·.
• -_ Failure to properly ~~i:n,plet~ n~tification fonn in violatio~ of 2:5 TAC §2~61 ( a) -pemtlty -_
aniollllt of$100.00. > ··-· · · · · ·-·· · ---· ---· -· ·
1 · _,
--.l
:·_ ·. ··: ... ··.: ... ·: ... ·. '· ' . ~ .... ' . ···. ··-··--··-· .. _:· __ ··-· ---·---·-----··. ->---··-··--·· .. · ___ , ..... -----~·-·--:.:
IV.NOTICE
,·.:]3)'.,th~_-N?rt.~~-r¥ii /Mr;• -~-JS -·§~i•Bi~~i~R{)f~~~~9ry§~c~,:wf<?~tX!.te~114~l .Bf.•:
: th~ qepanpi~nf-~ tµ~<;rtt to ll5,Se~~ ~ ~l.Ill~tiye p~ilalty of $1:00.00. 'I1)e .letter Was received by _:~~sptjnq~pt · :::. \ · · · · · ·· · · · · ·· · · · ·· · · · · ·
:.:···,
. v.,REsroN~E · .
. · .\ .·. : ==~;~:l~Ji~i;;n~~~;: r; r1~1 ~FiS!A() §~s:;l(a) .~ ;;f :?
..... • .. \··.··-.·~J·.~ .· :~:~
.-.··'.111~:p~~~~~l$J:i~ii){ipqs.'\:C':
:::~:.\·;:-:.·-: . . ..... ·. . . ·. :.: : ... :.·• .
. ,;~~i!~lttlfiriit ·.·.~ .. ~.1~1·r ~t't'issi~<>f~~o~!th ·· .. ; .
. ;:_._•yil.-;9MP~JJJ:~;iJ~1:~.•-•,_-_:.
Th~ fa~ts contaiti~: h~~ ·;~;~-~~Pi~~ -s~~€!Ilt .of .i1/~:~~ .regarding the yiolation(s)
described in "IV. Notice" of this Ord~. . '. '· -"
:-'.•:t(~W~~fH~#/
.. _·· In~xchari~~. fo~ ~e e~ecuti<?11 .f r¥s ~d~: R~n~~11t7aif f::th~ ~glit f() :hearin~: · ..
· .. B. NO .WAIVEJl WITH REGARD TO FUTURE: VIOLATIONS .
. . 'Th.e department does uo( waive the right,to enforce future vi~lations committed by Respondent.
• •; :-.· :·: \. :: • .. ·> ,:, ·;' -:, : .. -: ., ::' . ;, .. "•." ·.·.. . :· · .. • ;_. . ; . ~·:; . '..·-• ' ... • :· I, .···. ... . . : ._. •
. C. COMPLETE UNDERSTANDING
.. · .. · .• ~;;~~t:.:~ .. ~~±1~i~:tl:~~~t~~~oftllis~ettl~~~··
' 2 ·.·
:··.•, ... · .. ··· .:. : -•. ··:--· ... :.-.. -·-.-. _. .. ·c-:.:. ' -. -.. _ .•. G . ·--·-....• '•-----------· .-.--. ·-.·-.· --. ----..
:p~·.· NO .RIGlf( J.c;>;Af PEAL
,l~~~ij#ci7rit~ijv~fr :ri$lfO J,u~ic;i#t_eX1ewof¥.t~ei .
. ·.: ..
,~~~/t,E~f?~.~.Jr!~,:9'1?~.~~.~ft,:,·
. ·. :'::~€s1'?ti§~.t,~,q,aj1 :99itip:Iywit11t1µsQrtler ian4 w.i~#J .~JJIJlical>l~l~\v:s,'rul~sclDd~la~ons. ·•
~{~~Y.?f •...
·~~
~~~~<#\/·.•·
3
2.15. Contractor's Responsibilities
Contractor is responsible for becoming familiar with the character , quality , quantity
of work to be performed , materials and equipment 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.
CONTRACTOR:
\J~ lntercon Environmental , Inc.
Signature Company
Karen Andrews July 1, 2010
Name Date
President
Title
2-24
2.16. Contractor's Legal and Compliance History
Contractor's legal and compliance history is a critical component of th is Inv itat ion
to Bid . Read this section with care and respond accord ingly . Failure of the
Contractor to provide all the information requested and to certify the report , will
result in the Con tracto r's submittal being declared non-respo nsive.
Contractor shall attach a written report of legal action brought against Contractor,
Contractor's officers, Contractor's employees, AND Contractor's proposed
subcontractors relating to the protection of the environment. The terms "legal
action " and "re lating to the protection of the environment" are defined below.
The report shall include all legal action brought with in five (5) years of the
closing date of this Invitation to Bid . The report shall detail the substance ,
status , and outcome of such legal action . This includes without limitation the
names of the agency and/or persons bringing the action , all relevant dates, 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 ACTION" means: ANY enforcement action by the United States
Environmental Protection Agency, the Occupational Safety and Health
Adm inistration , any other federal agency , the Texas Commission on
Environmental Quality (including its predecessor agency the Texas Natural
Resource Conservation Commission}, the Texas Department of State Health
Services (including its predecessor agency the Texas Deparbnent of Health), and
any other state agency, commission or department, whether in Texas or
elsewhere, when such enforcement action is a result of violations, real or alleged ,
of any laws, licenses , permits, judicial orders , or administrative orders , relating to
the protection of the environment. In this context, enforcement action shall
include without limitation , written warnings , notices of violation, consent orders or
agreements, compliance orders, administrative hearings, civil litigation and
criminal prosecution. Legal action also means any civil litigation brought by any
person relating to the protection of the environment.
"R ELATING TO TH E PROT ECTION OF T HE ENVIRO NM ENT" mea ns :
requirem ents pertaining to th e man ufacture , processing, dist ributio n , use ,
handling, storage, trans portat ion, reportin g , re cords keeping, permitting ,
licensing, treatment, disp osal, emiss ion, di scharge, sp ill, release, or threatened
rel ea s e of haza rdou s mate ri als , hazardou s substan ces, h az ardou s wastes ,
toxi c s ubst ances , p etroleum , in dustria l wa st e, soli d w aste, pollutan t s or
conta mi nants into or onto the air, surface water, drink ing w ater, gro undwat e r,
storm water, publicly owned treatment works , or land.
THE REPORT SHALL BE SIGNED AND CERTIFIED by an autho ri zed
representative of the Contractor, using the following form. The top port ion of the
2-25
,-
form is to be completed if a report of legal action is attached. The bottom portion
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
2-26
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 Legal Action Report detailing 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 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
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.
Signature
Karen Andrews
Name
President
Title
Certification of NO Legal Action
lntercon Environmental. Inc
Company
July 1, 2010
Date
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 responsible for gathering the information, I hereby certify that no legal action
relating to the protection of the environment was brought against Contractor, Contractor's
officers, Contractor's employees, or Contractor's proposed subcontractors within the
preceding five years. To the best of my knowledge and belief, this statement is true ,
accurate, and complete . I am aware that there are significant penalties for submitting false
information , includ ing the poss ibility of fine and imp ri sonment for knowing violations.
CONT RA CTO R:
Signature Company
Name Date
Titl e
2-27
ENVIRONMENTAL, INC.
210 S Walnut Creek Drive. Mansfield, Texas 76063. Telephone (817) 477 -9995. Facs i m i le (817) 477 -9996
Prepared for City of Fort Worth
PROJECT: DEM10-08: GHA
Response to Section 2.16
Contractor's Legal & Compliance History
www . intercon -environ mental . com
'8 lntercon Environmental, Inc. has the following citations from Texas Department of State
Health Services (DSHS):
... Project Name/Address: Bear Creek Elementary; 401 Bear Creek Drive, Euless, Texas
~ Case No. 1412080038
-. Violation: Failure to have Consultant's Mold Remediation Protocol on-site; (Report not
provided to lntercon).
'* Date of Violation: June 13, 2007
-. Settlement: Penalty paid $750.00 to DSHS
* Project Name/ Address: Liberty Elementary; 7976 Whitney Drive White Settlement,
Texas
·• Case No. 1410080438
• Violation: Failure to fill out notification form correctly; (Address number w as
transposed, typograp h i cal er ro r).
• Date of Violation : Ju ne 28, 2007
-. Settl ement: Penalty p aid $1 0 0 .00 to DSHS
DOCKET NO. Al 1564-600-2008
CASE NO. 1412080038
IN THE MATTER OF
INTERCON ENVIRONMENT AL,
INCORPORATED
MANSFIELD, TEXAS
§
§
§
§
§
§
AGREED ORDER
L JURISDICTION
BEFORE THE TEXAS
DEPARTMENT OF STATE
HEALm SERVICES
AUSTIN, TEXAS
The Department of State Health Services ("departmentj, Division for Regulatory Services, is authorized to
enforce the Texas Mold Assessment and Remediation Rules ("Rules'), Title 25 of the Texas Administrative
Code (TAC), Chapta 295 .301 et seq.
IL 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
remediation project at Bear Creek Elementary 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
"I. 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 violations were alleged:
• Faihrre to have the mold remediation protocol on-site in violation of 25 TAC §295.326{b )(1 )(A)-penalty
amount of $1 ,500 .00.
IV.NOTICE
By the N otice Letter, Ms. A ly son 0 . Herny, Division for Regulatory Services.. informed Respondent of the
department's intent to assess an aggregate administrative penalty of $1,500.00. Toe letter was received by
Respondent.
V.RESPONSE
Respondent responded to the department's Notice L etter by requesting an informal conference.
VI. SETTLEMENT
On February 2 7, 2007, an informal conference was held between representatives of the department and
RespondenL The parties reached a proposed settlement, the terms of which are contained in the "It is Ordered"
section of this Order, based on various factors including the desire to avoid litigation .
Respondent agrees to terms of this Order as evidenced by signing this Order. The following terms were agreed
upon:
• Failure to have the mold remediation protocol on-site in violation of 25 TAC §295.326(b )( 1 )(A)-penalty
amount of $750.00.
Respondent bas 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 terms.
D. NO RIGHT TO APPEAL
Respondent waives the right to judicial review of this Order.
NOW THEREFORE, IT IS ORDERED that:
1. Respondent pay an administrative penalty, in the amount of $750.00, in full settlement for the
vio lation(s) that is/are the subject of this Order. Payment must be made by cashier's check or money OTder
and mailed to: Department of State Health Services, MC 2003, P .O. Box 149347, Austin.. Texas 787 14-
9347 . Each cashier's check or money order must be made payable t o the Department o f State Health
Services and must also include the notation: '·Deposit in Budget No. ZZ156, Fund No_ 092, C ase No.
1412080038 ...
2 . Payment is due in one lump sum payment, thirty (30) days from the date this Order i s 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.
i -;-al ,,j/1 /
Signed and ordered this V day of ,!{,:,i ~-c c--tf{_,_
/
, 2008 .
I • /)d-i __,/_ -::.?7 --;_ ~ --rt:~~y?{_, C:-,,-~ 'CL-?
thryn c :Perkins , RN, MBA
/
Assistant C ornmissioner
Division for Regulatory Services
Jerrold Andrews
Printed Name Vice President
3/4/08
Signature Date
,-
TEXAS DEPARTMENT OF STATE HEAL TH SERVICES
DAVID L LAKEY, M.O.
COMMISSIONER
August 6, 2008
Ms. Karen Andrew~. Agent
Intercon Environmen4tl, Incorporated
2214 FM 1187, Building #6
Mansfield, Texas 760(;3 ·
. . .
RE: Agreed Ord,r -Intercon Environmental, Incorporated
: . ·:·-.:·' . ·. ·-:: \ ,_ . . . :;· ·'· . . .. ·.:-. ·:._.::"_;_·,-· · ..
Dear Ms. Andrews · ··.• ... :
P.O. Box 149347
Austin. Texas 7871:4-9347
I -88&-963-7 I I I
rn: 1-s00.:735-2989
www.dshs.slate.tx.us
Case No. 1410080438
En,clo~ed is a copy for. yolll" re<:<>rds of an Ord~ r~lapv~ :to the Departme~t (?f Stare,. flealtli ·
Services, Division for Regulatory Services, Enforcement lJnii and the above referenced entity •. If you have questions, please 0CQntact .Mr. Dustin Em~ :at (512) 83~6665, Ext 3460. • . . .. ·
' ':· .. ' . ·. . ... · ·• · .. '. ·, ·.·._·,.. ',. . ' .
Sincerely,
.~.el~
Roni S. Thompson, Enforcement Specialist
Enforcement Unit . .
D_ivision of Regulatory Services
Enclosure
I
An Equal Employment Opportunity Employer and Provider
J
DOCKET NO. A12440-S60-2008
CASE NO. 1410080438
IN THE" MATIER OF
INTE.RCON . ENVIRONMENT AL, .. · .. -·'····-:··-.::\':' .. -\ . ·. _,
INCORPORATED ·
MANS~ELD., TEXAS
§
§
§,
§
§
§
AGREED ORDER
,,
I~ JURISDICTION
BEFORE THE TEXAS
D~PART~NT ~f STATE
HEAL TH SERVICES
AUSTIN, TEXAS
Th~ .Department of Sqite 'Health Servi~; Pivision. fqr Regulatory Service$ (·departmentj is
aµthpiµ¢ t9 eJlfo~ th.~J ~~ ~~ll ~th Prot~Q~ Act. :oc#ipm.ions Code.~ j 954
(''A~"); tile Texas N;besio~ Heaitlt fn>t.~o4 Rules (Rules),Title 25T AC~ Pan l, ~295; the
=~~~t~zi!~~~t:r~tt~~i~~~~f~~~"t'1M;
IL RESPONDENT ·
. ·. \
hitercon Environmenta1, Incorporated <"R~ndent") is a Ii~ asbestos abatement contract~or a renov ation/demolitionproject, andas such is subje<:t to the aforementioned Act and .Rules. . .. _,··
DI.FA,CTs.··.
On June 28, 2007, a representative froID the depaitmerit conducted an asbestos inspection at the
Liberty Elementary located at 7976 Whitney i;>rive, White Settlement, Texas. The puipose of the .
impeciion was to determine the project's compliance with the Rules, Act or NFSHAP . as
referenced in "I. Jurisdictiot;1." . . .
As a result of the inspection and during a subsequent review of department files, it was determined
that Respondent failed to comply with various provi sions of the Rules, Act or NESHAP as
referenced in "I. J urisdiction." The v io lation i s d escnbed in Certified Letter No. 7 000 0 520 002 4
1426 235 5, dated May 26, 2008 (hereinafter, "Notice Letter"), referenced in "IV. Notice."
The following violation was alleged:
• Failure to properly comp lete n otificati on form in violation of 25 T AC §295.61 (a)-penalty
amount of$100.00.
,-
IV.NOTICE
_ By the Notice Letter, Mr. Dustin~ Exner, Division ofRegulatory Services, informed Respondent of
the department's intent to as,ses~ ap. apministrative penalty of$100.00. The letter was received by
• Respondent
' .
V. RESPONSE
Respondent responded to . the 'depmtIIlf?n.t's Notice Letter by paying the administrative penalty of
$100.00. . . .. .. . . ·. .
VI. SETTLEMENT
The parties ~~h~ a prop<>.~ sen.}CQi~t,Jhe terms of whic:li ~ COJ;\f~ed in the "Jt ~S Ordered" .
se(;tion 'of tbis 'Ordef, b~~(6n ,&~~#s/act.ors including the 4~t<> avoi~ liti~ · -. ----
:::~~lfoli~~~~~da,f4 by ~ihe WJ'inimative ~ty of •.
. • . Fa.ilµre J o proJ)Cl"ly ~lllpi #~· notifi~o~ foilll in vi<?I~ pf 25TA~ §295.6 .1 (a) ~ ~iy · .• amount ors100.oo.< ,, :,·<· ' ,· •. · ·_-· _--· · ' · < · · __ . · ·, , ·--. · · --. ·-·
', . \ '· . ; . ~ ·.:
Respondent .has no objectioJJ. to this Order being _ signed by the Commissioner of State Health .
Services ·or his d~ignee. . . . . . . . . . ' .
VIL COMPLETE SETTLEMENT
The facts contained h~ are the complete sett:l~ent of all issues regarding the yiolation(s).
described in "N. Notice" of this Ord~. ·. ' · · · ·
A.. WAIVEROF HEARING
In exchange for the execution of this Order~ Respondent waives the right to a hearing.
B. NO WAIVER WITH REGARD TO FUTURE VIOLATION S
The department does not waive the right to enforce future violations committed by Respondent.
C. COMPLETE UNDERSTANDING
The department and R esp o ndent acknowl edge that they undemand the temis of this s ettlement, enter
in to the settlement freely, and agree to the t erms.
i
2
D~ NO RIGHT TO APPEAL
Respondent waives the right to judicial review of this Order.
. . .
NOW THEREFORE, IT IS ORDERED that:
Respohdent ~ CO!Dply .with this Ord~ and with all applicable laws, rules and regulations.
Ass.is~ ~ommissioner signed and ordered this &?~day Of~ • 2008.
~~~
Assistant Commissioner : .
•,'
Di~bn for Regu}atmy Services .,
·. . : ' . ~ : . . : . . : ' . . . . -..
I'.,:
'
3