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Contract - Polydyne, Inc. - 7/11/2019 CITY OF ROUND ROCK AGREEMENT FOR PURCHASE OF WATER TREATMENT CHEMICALS FROM POLYDYNE,INC. THE STATE OF TEXAS § CITY OF ROUND ROCK § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § COUNTY OF TRAVIS That this Agreement for purchase of Bulk Flocculant Polymer, referred to herein as the "Agreement," is made and entered into on this the day of the month of 11 1AA , 2019, by and between the CITY OF ROUND ROCK, TEXAS, a home-rule municipality whose offices are located at 221 East Main Street, Round Rock, Texas 78664, referred to herein as the "City," and POLYDYNE, INC., whose offices are located at 1 Chemical Plant Road, Riceboro, Georgia 31323, referred to herein as the "Vendor." This Agreement supersedes and replaces any previous agreements between the named parties, whether oral or written, and whether or not established by custom and practice. RECITALS: WHEREAS, City desires to purchase Bulk Flocculant Polymer, and City desires to purchase same from Vendor; and WHEREAS, City has issued its "Invitation for Bid" for the provision of said goods, and City has selected the bid submitted by Vendor; and WHEREAS, the parties desire to enter into this Agreement to set forth in writing their respective rights, duties, and obligations; NOW, THEREFORE, WITNESSETH: That for and in consideration of the mutual promises contained herein and other good and valuable consideration,the receipt and sufficiency of which are hereby acknowledged,the parties mutually agree as follows: 1.01 DEFINITIONS A. Agreement means the binding legal contract between City and Vendor whereby City is obligated to buy specified goods and Vendor is obligated to sell same. The Agreement includes the following: (a) City's Invitation for Bid designated IFB 19-021 dated April 2019; (b) Vendor's Response to IFB; (c) contract award; and (d) any exhibits, addenda, and/or amendments thereto. Any inconsistencies or conflicts in the contract documents shall be resolved by giving preference in the following order: 00425462/ss2 ?...-L-Cl(I-ozq (1) This Agreement; (2) Vendor's Response to IFB; (3) City's Invitation for Bids, exhibits, and attachments. B. City means the City of Round Rock, Williamson and Travis Counties, Texas. C. Effective Date means the date upon which the binding signatures of both parties to this Agreement are affixed. D. Force Majeure means acts of God, strikes, lockouts, or other industrial disturbances, acts of the public enemy, orders of any kind from the government of the United States or the State of Texas or any civil or military authority, insurrections, riots, epidemics, landslides, lightning, earthquakes, fires, hurricanes, storms, floods, restraint of the government and the people, civil disturbances, explosions, or other causes not reasonably within the control of the party claiming such inability. E. Goods mean the specified supplies, materials, commodities, or equipment. F. Vendor means Polydyne, Inc., or any of its successors or assigns. 2.01 EFFECTIVE DATE AND TERM A. This Agreement shall be effective on the date it has been signed by both parties hereto, and shall remain in full force and effect unless and until it expires by operation of the term stated herein, or until terminated or extended as provided herein. B. The term of this Agreement shall be for sixty (60) months from the effective date hereof. C. City reserves the right to review the relationship at any time, and may elect to terminate this Agreement with or without cause or may elect to continue. 3.01 CONTRACT DOCUMENTS AND EXHIBITS City selected Vendor to supply certain goods as outlined in IFB 19-021 dated April 2019. The goods which are the subject matter of this Agreement are described in Exhibit "A" and, together with this Agreement, comprise the total Agreement and they are fully a part of this Agreement as if repeated herein in full. 4.01 ITEMS AWARDED A. The goods which are the subject matter of this Agreement are described generally in the attached Exhibit"A," incorporated herein by reference for all purposes. B. This Agreement shall evidence the entire understanding and agreement between the parties and shall supersede any prior proposals, correspondence or discussions. 2 C. Vendor shall satisfactorily provide all deliverables described in Exhibit "A" within the contract term specified. A change in the Scope of Services or any term of this Agreement, including bonding requirements, must be negotiated and agreed to in all relevant details, and must be embodied in a valid Supplemental Agreement as described herein. 5.01 COSTS A. City agrees to pay for supplies during the term of this Agreement at the pricing set forth in"Attachment A—Bid Sheet"Exhibit"A." B. The City shall be authorized to pay the Services Provider an amount not-to- exceed Two Hundred Seventeen Thousand Eight Hundred and No/100 Dollars ($217,800.00) per year for a total not-to-exceed amount of One Million Eighty-Nine Thousand and No/100 Dollars ($1,089,000.00) for the term of this Agreement. 6.01 INVOICES All invoices shall include, at a minimum,the following information: A. Name and address of Vendor; B. Purchase Order Number; C. Description and quantity of items received; and D. Delivery dates. 7.01 INTERLOCAL COOPERATIVE CONTRACTING/PURCHASING Authority for local governments to contract with one another to perform certain governmental functions and services, including but not limited to purchasing functions, is granted under Government Code, Title 7, Chapter 791, Interlocal Cooperation Contracts, Subchapter B and Subchapter C, and Local Government Code, Title 8, Chapter 271, Subchapter F, Section 271.101 and Section 271.102. Other governmental entities within the State of Texas may be extended the opportunity to purchase off of the City of Round Rock's bid, with the consent and agreement of the successful vendor(s) and Round Rock. Such agreement shall be conclusively inferred for the vendor from lack of exception to this clause in the vendor's response. However, all parties hereby expressly agree that the City of Round Rock is not an agent of,partner to, or representative of those outside agencies or entities and that the City of Round Rock is not obligated or liable for any action or debts that may arise out of such independently-negotiated"piggyback"procurements. 3 8.01 NON-APPROPRIATION AND FISCAL FUNDING This Agreement is a commitment of City's current revenues only. It is understood and agreed that City shall have the right to terminate this Agreement at the end of any City fiscal year if the governing body of City does not appropriate funds sufficient to purchase the services as determined by City's budget for the fiscal year in question. City may effect such termination by giving Vendor a written notice of termination at the end of its then-current fiscal year. 9.01 PROMPT PAYMENT POLICY In accordance with Chapter 2251, V.T.C.A., Texas Government Code, any payment to be made by City to Vendor will be made within thirty (30) days of the date City receives goods under this Agreement, the date the performance of the services under this Agreement are completed, or the date City receives a correct invoice for the goods or services, whichever is later. Vendor may charge interest on an overdue payment at the "rate in effect" on September 1 of the fiscal year in which the payment becomes overdue, in accordance with V.T.C.A., Texas Government Code, Section 2251.025(b). This Prompt Payment Policy does not apply to payments made by City in the event: A. There is a bona fide dispute between City and Vendor, a contractor, subcontractor, or supplier about the goods delivered or the service performed that causes the payment to be late; or B. There is a bona fide dispute between Vendor and a subcontractor or between a subcontractor and its supplier about the goods delivered or the service performed that causes the payment to be late; or C. The terms of a federal contract, grant, regulation, or statute prevent City from making a timely payment with federal funds; or D. The invoice is not mailed to City in strict accordance with any instruction on the purchase order relating to the payment. 10.01 GRATUITIES AND BRIBES City may, by written notice to Vendor, cancel this Agreement without incurring any liability to Vendor if it is determined by City that gratuities or bribes in the form of entertainment, gifts, or otherwise were offered or given by Vendor or its agents or representatives to any City officer, employee or elected representative with respect to the performance of this Agreement. In addition, Vendor may be subject to penalties stated in Title 8 of the Texas Penal Code. 11.01 TAXES City is exempt from Federal Excise and State Sales Tax; therefore, tax shall not be included in Vendor's charges. 4 12.01 ORDERS PLACED WITH ALTERNATE VENDORS If Vendor cannot provide the goods as specified, City reserves the right and option to obtain the products from another supplier or suppliers. 13.01 INSURANCE Vendor shall meet all requirements as stated in the attached Invitation for Bid No. IFB 19-021 and as set forth at: https://www.roundrocktexas.gov/wp-content/uploads/2014/12/corr insurance 07.20112.pdf 14.01 CITY'S REPRESENTATIVE City hereby designates the following representative(s) authorized to act in its behalf with regard to this Agreement: Michael Thane Director of Utilities and Environmental Services 2008 Enterprise Drive Round Rock, Texas, 78664 Telephone: (512) 218-3236 mthanegroundrocktexas.gov 15.01 RIGHT TO ASSURANCE Whenever either party to this Agreement, in good faith, has reason to question the other party's intent to perform hereunder, then demand may be made to the other party for written assurance of the intent to perform. In the event that no written assurance is given within the reasonable time specified when demand is made, then and in that event the demanding party may treat such failure as an anticipatory repudiation of this Agreement. 16.01 DEFAULT If Vendor abandons or defaults hereunder and is a cause of City purchasing the specified goods elsewhere, Vendor agrees that it may be charged the difference in cost, if any, and that it will not be considered in the re-advertisement of the service and that it may not be considered in future bids for the same type of work unless the scope of work is significantly changed. Vendor shall be declared in default of this Agreement if it does any of the following: A. Fails to make any payment in full when due; B. Fails to fully, timely and faithfully perform any of its material obligations hereunder; C. Fails to provide adequate assurance of performance under the "Right to Assurance" section herein; or 5 D. Becomes insolvent or seeks relief under the bankruptcy laws of the United States. 17.01 TERIVIINATION AND SUSPENSION A. City has the right to terminate this Agreement, in whole or in part, for convenience and without cause, at any time upon thirty(3 0) days' written notice to Vendor. B. In the event of any default by Vendor, City has the right to terminate this Agreement for cause, upon ten(10) days' written notice to Vendor. C. Vendor has the right to terminate this Agreement only for cause, in the event of material and substantial breach by City, or by written mutual agreement to terminate. D. In the event City terminates under subsections (A) or (B) of this section, the following shall apply: Upon City's delivery of the referenced notice to Vendor, Vendor shall discontinue all services in connection with the performance of this Agreement and shall proceed to cancel promptly all existing orders and contracts insofar as such orders and contracts are chargeable to this Agreement. Within thirty (30) days after such notice of termination, Vendor shall submit a statement showing in detail the goods and/or services satisfactorily performed under this Agreement to the date of termination. City shall then pay Vendor that portion of the charges, if undisputed. The parties agree that Vendor is not entitled to compensation for services it would have performed under the remaining term of the Agreement except as provided herein. 18.01 INDEMNIFICATION Vendor shall defend (at the option of City), indemnify, and hold City, its successors, assigns, officers, employees and elected officials harmless from and against all suits, actions, legal proceedings, claims, demands, damages, costs, expenses, attorney's fees, and any and all other costs or fees arising out of, or incident to, concerning or resulting from the fault of Vendor, or Vendor's agents, employees or subcontractors, in the performance of Vendor's obligations under this Agreement, no matter how, or to whom, such loss may occur. Nothing herein shall be deemed to limit the rights of City or Vendor (including, but not limited to the right to seek contribution) against any third party who may be liable for an indemnified claim. 19.01 COMPLIANCE WITH LAWS, CHARTER AND ORDINANCES A. Vendor, its agents, employees and subcontractors shall use best efforts to comply with all federal and state laws, City's Charter and Ordinances, as amended, and with all applicable rules and regulations promulgated by local, state and national boards, bureaus and agencies. B. In accordance with Chapter 2270, Texas Government Code, a governmental entity may not enter into a contract with a company for goods or services unless the contract contains written verification from the company that it: (1) does not boycott Israel; and (2)will not boycott Israel and will not boycott Israel during the term of this contract. The signatory executing this Agreement on behalf of Vendor verifies Vendor does not boycott Israel and will not boycott Israel during the term of this Agreement. 6 20.01 ASSIGNMENT AND DELEGATION The parties hereby bind themselves, their successors, assigns and legal representatives to each other with respect to the terms of this Agreement. Neither party shall assign, sublet or transfer any interest in this Agreement without prior written authorization of the other party. 21.01 NOTICES All notices and other communications in connection with this Agreement shall be in writing and shall be considered given as follows: 1. When delivered personally to recipient's address as stated in this Agreement; or 2. Three (3) days after being deposited in the United States mail, with postage prepaid to the recipient's address as stated in this Agreement. Notice to Vendor: Polydyne, Inc. 1 Chemical Plant Road Riceboro, GA 31323 Notice to City: City Manager Stephen L. Sheets, City Attorney 221 East Main Street AND TO: 309 East Main Street Round Rock, TX 78664 Round Rock, TX 78664 Nothing contained herein shall be construed to restrict the transmission of routine communications between representatives of City and Vendor. 22.01 APPLICABLE LAW; ENFORCEMENT AND VENUE This Agreement shall be enforceable in Round Rock, Texas, and if legal action is necessary by either party with respect to the enforcement of any or all of the terms or conditions herein, exclusive venue for same shall lie in Williamson County, Texas. This Agreement shall be governed by and construed in accordance with the laws and court decisions of the State of Texas. 23.01 EXCLUSIVE AGREEMENT This document, and all appended documents, constitutes the entire Agreement between Vendor and City. This Agreement may only be amended or supplemented by mutual agreement of the parties hereto in writing, duly authorized by action of the City Manager or City Council. 7 24.01 DISPUTE RESOLUTION If a dispute or claim arises under this Agreement, the parties agree to first try to resolve the dispute or claim by appropriate internal means, including referral to each party's senior management. If the parties cannot reach a mutually satisfactory resolution, then and in that event any such dispute or claim will be sought to be resolved with the help of a mutually selected mediator. If the parties cannot agree on a mediator, City and Vendor shall each select a mediator and the two mediators shall agree upon a third mediator. Any costs and fees, other than attorney fees, associated with the mediation shall be shared equally by the parties. City and Vendor hereby expressly agree that no claims or disputes between the parties arising out of or relating to this Agreement or a breach thereof shall be decided by any arbitration proceeding, including without limitation, any proceeding under the Federal Arbitration Act (9 USC Section 1-14) or any applicable state arbitration statute. 25.01 SEVERABILITY The invalidity, illegality, or unenforceability of any provision of this Agreement or the occurrence of any event rendering any portion or provision of this Agreement void shall in no way affect the validity or enforceability of any other portion or provision of this Agreement. Any such void provision shall be deemed severed from this Agreement, and the balance of this Agreement shall be construed and enforced as if this Agreement did not contain the particular portion or provision held to be void. The parties further agree to amend this Agreement to replace any stricken provision with a valid provision that comes as close as possible to the intent of the stricken provision. The provisions of this section shall not prevent this entire Agreement from being void should a provision which is of the essence of this Agreement be determined to be void. 26.01 MISCELLANEOUS PROVISIONS Standard of Care. Vendor represents that it employs trained, experienced and competent persons to perform all of the services, responsibilities and duties specified herein and that such services, responsibilities and duties shall be performed in a manner according to generally accepted industry practices. Time is of the Essence. Vendor understands and agrees that time is of the essence and that any failure of Vendor to fulfill obligations for each portion of this Agreement within the agreed timeframes will constitute a material breach of this Agreement. Vendor shall be fully responsible for its delays or for failures to use best efforts in accordance with the terms of this Agreement. Where damage is caused to City due to Vendor's failure to perform in these circumstances, City may pursue any remedy available without waiver of any of City's additional legal rights or remedies. Force Majeure. Neither City nor Vendor shall be deemed in violation of this Agreement if it is prevented from performing any of its obligations hereunder by reasons for which it is not 8 responsible as defined herein. However, notice of such impediment or delay in performance must be timely given, and all reasonable efforts undertaken to mitigate its effects. Multiple Counterparts. This Agreement may be executed in multiple counterparts, any one of which shall be considered an original of this document; and all of which, when taken together, shall constitute one and the same instrument. IN WITNESS WHEREOF, City and Vendor have executed this Agreement on the dates indicated. City of Round ock,Texas Polydyne, Inc. ,�/ o,s' M By: By: Printed Name: U N,r Printed Name: Mark Schlag Title: W406yTitle: Vice-President Date Signed: Date Signed: 6/11/19 Attest: By: Sara L. White, City Clerk For City,Approved as to Form: By: < IV L5� '111 Step]Ta4 L. Sheets, City Attorney 9 Exhibit "A" ROUND ROCK TEXAS PURCHASING DWISION City of Round Rock, Texas Purchasing Division 221 East Main Street Round Rock, Texas 78664-5299 www.roundrocktexas.gov INVITATION FOR BID (IFB) BULK FLOCCULENT POLYMER SOLICITATION NUMBER 19-021 APRIL 2019 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item:885-77 APRIL 2019 BULK FLOCCULANT POLYMER PART I GENERAL REQUIREMENTS 1. PURPOSE: The City of Round Rock, herein after"the City"seeks a bid from firms experienced in providing bulk (truckload) quantities of flocculant polymer for wastewater treatment purposes. 2. BACKGROUND: The City of Round Rock operates a 52 million gallons per day surface water treatment plant, a five million gallons per day ground water plant and a six million gallons per day waste water effluent reuse plant. The East Waste Water Treatment Plant facility uses bulk flocculant polymer in their treatment processes. 3. SOLICITATION PACKET: This solicitation packet is comprised of the following: Description Index Part I—General Requirements Page(s)2-5 Part II—Definitions, Standard Terms and Conditions Page 6 and Insurance Requirements Part III —Supplemental Terms and Conditions Page(s) 7-10 Part IV—Specifications Page(s) 11-12 Attachment A—Bid Sheet&Additional Requirements Page 13 Attachment B—Reference Sheet Page 14 4. AUTHORIZED PURCHASING CONTACT: For questions or clarification of specifications, you may contact: Cheryl Kaufman Purchasing Supervisor I Purchasing Division City of Round Rock Phone: 512-218-5417 E-mail: ckaufman(Q7roundrocktexas.gov The individual listed above may be contacted by e-mail for clarification of the specifications only. No authority is intended or implied that specifications may be amended or alterations accepted prior to solicitation opening without written approval of the City of Round Rock through the Purchasing Department. I Page 2 of 14 5 r5 f I 4 S City of Round Rock Exhibit "A" Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 5. SCHEDULE OF EVENTS: It is the City's intention to follow the solicitation timeline below. EVENT DATE Solicitation released April 3, 2019 Pre-Bid meeting/site visit April 16,2019 @ 1:00 PM, CST Deadline for submission of questions April 18, 2019 @ 5:00 PM, CST City responses to questions or addendums Approximately April 19, 2019 @ 5:00 PM, CST Deadline for submission of responses May 2, 2019 @ 3:00 PM, CST All questions regarding the solicitation shall be submitted in writing by 5:00 PM, CST on the due date noted above.A copy of all questions submitted and the City's response to the questions shall be posted on the City's webpage in the form of an addendum at: .hftps://www.roundrocktexas._qov/businesses/solicitations/. Questions shall be submitted in writing to the"Authorized Purchasing Contact". The City reserves the right to modify these dates. Notice of date change will be posted to the City's website: hftp://www.roundrocktexas.-gov/bids. 6. SOLICITATION UPDATES: Respondents shall be responsible for monitoring the City's website at http://www,roundrocktexas.-gov/bids for any updates pertaining to the solicitation described herein.Various updates may include addendums, cancellations, notifications, and any other pertinent information necessary for the submission of a correct and accurate response. The City will not be held responsible for any further communication beyond updating the website. 7. PRE-BID MEETING/SITE VISIT AND INSPECTION:A pre-bid meeting/site visit, and inspection will be conducted to fully acquaint Respondents with the facilities, difficulties and/or restrictions inherent in the services specified. The pre-bid meeting/site visit will be conducted on the date specified in PART I Section 5-Schedule of Events. A. Attendance at the pre-bid meeting/site visit is optional. Respondents shall sign-in at the pre-bid meeting to document their attendance. Immediately following the pre-bid meeting a site visit will be conducted to enable Respondents to determine labor, equipment, supplies and materials necessary to perform the services specified herein. Collection of a water sample is permitted at this time. The pre-bid meeting and site visit shall occur at: East Waste Water Treatment Plant 3939 East Palm Valley Blvd. Round Rock,Texas 78665 B. Respondents are strongly encouraged to bring a copy of the solicitation document with them to the pre- bid meeting/site visit. C. It is the responsibility of the Respondent to examine each facility and determine quantity, amounts,take precise measurements,determine material requirements, equipment requirements, labor requirements and other solicitation related details during said inspections. 8. RESPONSE DUE DATE: Signed and sealed responses are due at or before 3:00 PM, on the due date noted in PART I, Section 5—Schedule of Events. Mail or hand deliver sealed responses to: City of Round Rock Attn:Cheryl Kaufman Purchasing Department 221 E.Main Street Round Rock,Texas 78664-5299 Page 3 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 A. Sealed responses shall be clearly marked on the outside of packaging with the Solicitation title, number, due date and"DO NOT OPEN". B. Facsimile or electronically transmitted responses are not acceptable. C. Responses cannot be altered or amended after opening. D. No response can be withdrawn after opening without written approval from the City for an acceptable reason. E. The City will not be bound by any oral statement or offer made contrary to the written specifications. F. Samples and/or copies shall be provided at the Respondent's expense,and shall become the property of the City. 9. RESPONDENT REQUIREMENTS:The City of Round Rock makes no warranty that this checklist is a full . ................................ comprehensive listing of every requirement specified in the solicitation.This list is only a tool to assist participating Respondents in compiling their final responses. Respondents are encouraged to carefully read the entire solicitation. Respondent shall submit one(1)evident signed "Original" and one identical electronic copy of the IFB response on a flash drive. The submittal is required to include all addendums and requested attachments. The bid response along with samples and/or copies shall be provided at the Respondent's expense, and shall become the property of the City. This invitation for bid (IFB) does not commit the City to contract for any supply or service. Respondents are advised that the City will not pay for any administrative costs incurred in response preparation to this IFB; all costs associated with responding to this IFB will be solely at the interested parties' expense. Not responding to this IFB does not preclude participation in any future RFP/RFQ/IFB. For your bid to be responsive,addendums and the attachments identified below shall be submitted with your proposal. ❑ Addendums: Addendums may be posted to this solicitation. Bidders are required to submit signed addendums with their sealed response. The Bidder shall be responsible for monitoring the City's website at http://www.roundrocktexas.gov/bids for any updates pertaining to the solicitation. ❑ Attachment A: BID SHEET AND ADDITIONAL REQUIREMENTS: The bid response shall be submitted on itemized, signed Bid Sheet provided in the solicitation packet. Failure to complete and sign the bid sheet will result in disqualification. If there is a conflict between the unit price and extended price,the unit price will take precedence. Submission of responses on forms other that the City's Solicitation Document may result in disqualification of the response. The additional information requested shall be submitted with your response. ❑ Attachment B: REFERENCE SHEET: Provide the name, address, telephone number and E-MAIL of at least three(3) valid Municipal, Government agencies or firms of comparable size that have utilized services that are similar in type and capacity within the last two(2)years. City of Round Rock references are not applicable. References may be checked prior to award. If references cannot be confirmed or if any negative responses are received it may result in the disqualification of submittal. 10. BEST VALUE EVALUATION AND CRITERIA: The City reserves the right to reject any or all responses, or to accept any response deemed most advantageous, or to waive any irregularities or informalities in the response received that best serves the interest and at the sole discretion of the City.All solicitations received may be evaluated based on the best value for the City. In determining best value, the City may consider: A. Purchase price; B. Reputation of Respondent and of Respondent's goods and services; C. Quality of the Respondent's goods and services; D. The extent to which the goods and services meet the City's needs; E. Respondent's past performance with the City; F. The total long-term cost to the City to acquire the Respondent's goods or services; G. Any relevant criteria specifically listed in the solicitation. Page 4 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 Respondents may be contacted for clarification of bid and/or to discuss details of the services they are proposing.This may include a presentation and/or the request for additional material/information. 11. CONFIDENTIALITY OF CONTENT:As stated in Section 16 of City of Round Rock Purchasing Definitions, Standard Terms and Conditions, all documents submitted in response to a solicitation shall be subject to the Texas Public Information Act. Following an award, responses are subject to release as public information unless the response or specific parts of the response can be shown to be exempt from the Texas Public Information Act. Pricing is not considered to be confidential under any circumstances A. Information in a submittal that is legally protected as a trade secret or otherwise confidential must be clearly indicated with stamped, bold red letters stating"CONFIDENTIAL"on that section of the document. The City will not be responsible for any public disclosure of confidential information if it is not clearly marked as such. B. If a request is made under the Texas Public Information Act to inspect information designated as confidential, the Respondent shall, upon request from the City, furnish sufficient written reasons and information as to why the information should be protected from disclosure.The matter will then be presented to the Attorney General of Texas for final determination. 12. SUSPENSION OR DEBARMENT CERTIFICATION:The provisions of the Code of Federal Regulations 2 CFR part 180 suspension and debarment may apply to this agreement. The City of Round Rock is prohibited from contracting with or making prime or sub-awards to parties that are suspended or debarred or whose principals are suspended or debarred from doing business with the Federal Government, State of Texas, or the City of Round Rock. 13. CERTIFICATE OF INTERESTED PARTIES: Section 2252.908 of the Texas Government Code requires the successful offeror to complete a Form 1295"Certificate of Interested Parties"that is signed for a contract award requiring council authorization. The"Certificate of Interested Parties"form must be completed on the Texas Ethics Commission website, printed, signed and submitted to the City by the authorized agent of the Business Entity with acknowledgment that disclosure is made under oath and under penalty of perjury prior to final contract execution. Link to Texas Ethics Commission Webpage: https://www.ethics.state.tx.us/whatsnew/elf info form1295.htm Page 5 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 PART II DEFINITIONS, STANDARD TERMS AND CONDITONS AND INSURANCE REQUIREMENTS 1. DEFINITIONS,STANDARD TERMS AND CONDITIONS: By submitting a response to this solicitation, the Respondent agrees that the City's Definitions, Standard Terms and Conditions, in effect at the time of release of the solicitation, shall govern unless specifically provided otherwise in a separate agreement or on the face of a purchase order. Said Definitions, Terms and Conditions are subject to change without notice. It is the sole responsibility of Respondents to stay apprised of changes. The City's Definitions, Standard Terms and Conditions can be viewed and downloaded from the City's website at: https://www.roundrocktexas.gov/departments/purchasing/ 2. INSURANCE: Insurance does not apply to this solicitation. Page 6 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 PART III SUPPLEMENTAL TERMS AND CONDITIONS 1. AGREEMENT TERM: The terms of the awarded agreement shall include but not be limited to the following: A. The term of the Agreement shall begin from date of award and shall remain in full force for sixty(60) months. B. Upon expiration of the contract term, the Contractor agrees to hold over under the terms and conditions of this agreement for such a period as is reasonably necessary to re-solicit and/or complete the project up to 90 days. 2. RESPONDENT QUALIFICATIONS:The City has established the following minimum qualifications. Respondents who do not meet the minimum qualifications will not be considered for award.The Respondent shall: A. Be firms, corporations, individuals or partnerships normally engaged in providing truckload quantities of flocculant polymers as specified herein and have adequate organization,facilities, equipment,financial capability,and personnel to ensure prompt and efficient service to the City; B. Provide all labor, supplies and materials required to satisfactorily perform the services as specified herein and own or acquire at no cost to the City all construction aids, appliances, and equipment Respondent deems necessary and maintain sole responsibility for the maintenance and repair of Respondent's vehicles,equipment,tools and all associated costs.The City shall not be responsible for any Respondent's tools,equipment or materials lost or damaged during the performance of the services specified herein; C. Be domiciled in or have a home office inside the United States. Respondents domiciled outside the United States, or not having a home office inside the United States will not be included for consideration in this procurement process. 3. SUBCONTRACTORS: Respondent shall not subcontract or otherwise engage subcontractors to perform required services. The City seeks to do business directly with a company experienced in providing flocculant polymer in bulk quantities. 4. SAFETY: The City reserves the right to remove any employee from City property for violation of federal, state, and local health, safety and environmental laws, ordinances, rules and regulations. The Respondent shall: A. Ensure that all employees comply with all Occupational Safety and Health Administration (OSHA), State and City safety and occupational health standards and other applicable federal, state, and local health, safety, and environmental laws ordinances, rules and regulations in the performance of these services; B. Be held responsible for the safety of their employees and unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site. In case of conflict,the most stringent safety requirement shall govern; C. Indemnify and hold the City harmless from and against all claims,demands,suits, actions,judgments, fines penalties and liability of every kind arising from the breach of the Successful Respondents' obligations under this paragraph. 5. WORKFORCE: Successful Respondent shall: A. Ensure Respondent's employees perform the services in a timely, professional and efficient manner; B. Ensure Respondent's employees,while working on City property,wear a company uniform that clearly identifies them as the Respondent's employee; C. Employ all personnel for work in accordance with the requirements set forth by the United States Department of Labor. The City reserves the right to verify citizenship or right to work in the United States. Page 7 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 6. PRICING: The Respondent shall determine and submit a fixed cost for the work and shall include all incidental costs, labor, overhead charges, travel, payroll expenses, freight, equipment acquisition and maintenance, demurrage,fuel surcharges, delivery charges, costs associated with obtaining permits, insurance, bonds and risk management. No separate line item charges shall be permitted for either response or invoice purposes. 7. PRICE INCREASE: Contract prices for bulk flocculant polymer shall remain firm throughout the initial twelve (12) month term of the contract. A price increase to the agreement may be considered on the anniversary date of the Contract each year and shall be equal to the consumer price index for that year, but at no time can the increase be greater than 10%for any single line item unless agreed upon by the City. A. Consumer Price Index(CPI): Price adjustments will be made in accordance with the percentage change in the U.S. Department of Labor Consumer Price Index(CPI-U)for all Urban Consumers. The price adjustment rate will be determined by comparing the percentage difference between the CPI in effect for the base year six-month average(January through June OR July through December); and each (January through June OR July through December six month average)thereafter. The percentage difference between those two CPI issues will be the price adjustment rate. No retroactive contract price adjustments will be allowed. The Consumer Price Index(CPI) is found at the Bureau of Labor Statistics, Consumer Price Index website: http:lAvww.bls.aov/cpi/ B. Procedure to Request Increase: i. Mail the written price increase request with the rate detail comparison and comprehensive calculation and any supporting documentation to the designated City Contract Specialist a minimum of 45 days prior to the annual Contract anniversary date. The detailed written calculation will be verified and confirmed. All written requests for increases must include the City of Round Rock contract number,solicitation reference information and contact information for the authorized representative requesting the increase. Price increase requests shall be sent by mail to: City of Round Rock Purchasing Department Attn: Contract Specialist 221 East Main Street Round Rock,TX 79664-5299 ii. Upon receipt of the request,the City reserves the right to either, accept the escalation and make change to the purchase order within 30 days of the request, negotiate with the Vendor or cancel the agreement or purchase order if an agreement cannot be reached on the value of the increase. 8. PERFORMANCE REVIEW: The City reserves the right to review the awarded respondents' performance anytime during the contract term. S. ACCEPTANCE/INSPECTION: Acceptance inspection should not take more than five(5)working days. The awarded respondent will be notified within the time frame if the materials delivered are not in full compliance with the specifications. In the event the materials are not to the satisfaction of the City; the vendor shall agree to provide materials to specification at no additional cost to the City. If any agreement or purchase order is cancelled for non-acceptance,the needed materials may be purchased elsewhere. 10. SAMPLES: A. The City may require the Respondent to submit a no-charge sample of the goods to be provided per the specification contained herein. This sample shall be provided within five working days after request by the City. B. If required, send samples to the City at the following address: East Waste Water Treatment Plant 3939 East Palm Valley Blvd. Round Rock,TX 78665 C. Products provided to the City under this solicitation may be evaluated or tested and must meet all requirements of the specification. Page 8 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer I FB No. 19-021 Class/Item: 885-77 APRIL 2019 D. Samples will be provided at no cost to the City, will be retained by the City, and may be used for use in assuring compliance with materials specifications after award.Failure to supply samples when requested shall subject the Offer to disqualification from consideration for award. 11. MATERIALS SPECIFICATIONS/DESCRIPTIVE LITERATURE: A. If a solicitation refers to a Qualified Products List(QPL), Standard Products List(SPL), or a manufacturer's name and product, any Offeror offering products not referenced in the solicitation must submit as part of their Offer materials specifications/descriptive literature for the non-referenced product. Materials specifications/descriptive literature must be identified to show the item(s) in the Offer to which it applies. B. Materials specifications/descriptive literature are defined as product manufacturer's catalog pages,"cut sheets"applicable tests results, or related detailed documents that specify material construction, performance parameters,and any industrial standards that are applicable such as ANSI,ASTM,ASME, SAE, NFPA, NBS, EIA, ESL, and NSA. The submitted materials specifications/descriptive literature must include the manufacturer's name and product number of the product being offered. C. The failure of the materials specifications/descriptive literature to show that the product offered conforms to the requirements of the Solicitation shall result in rejection of the Offer. D. Failure to submit the materials specifications/descriptive literature as part of the Offer may subject the Offer to disqualification from consideration for award. 12. ORDER QUANTITY: The quantities shown on the solicitation are estimates only. No guarantee of any minimum or maximum purchase is made or implied. The City will only order the services/goods needed to satisfy requirements within budgetary constraints,which may be more or less than indicated. 13. PERMITS: The Successful Respondent shall verify and obtain all necessary permits, licenses, and/or certificates required by federal, state and local laws, ordinances, rules or regulations for the completion of the services as specified if required for the project. 14. AWARD: The City reserves the right to enter into an Agreement or a Purchase Order with a single award, split award, primary and secondary award, non-award, or use any combination that best serves the interest and at the sole discretion of the City. Respondents to the solicitation will be notified when City staff recommendation of award has been made. The award announcement will be posted to the City's website at https://www.roundrocktexas.cov/businesses/solicitations/once City Council has approved the recommendation of award and the agreement has been executed. 15. POST AWARD MEETING: The City and Successful Respondent(s) may have a post award meeting to discuss, but not be limited to the following: A. The method to provide a smooth and orderly transition of services performed from the current contractor; B. Provide City contact(s)information for implementation of agreement. C. Identify specific milestones, goals and strategies to meet objectives. 16. POINT OF CONTACT/DESIGNATED REPRESENTATIVE: A. Contractor's point of contact: In order to maintain consistent standards of quality work performed across the City,the City shall be provided with a designated and identified point of contact upon award of the contract to include contact information. The City's designated representative shall be notified by the Respondent immediately should the point of contact change. B. The City's designated representative: Buddy Franklin Wastewater Treatment Plant Superintendent Utilities and Environmental Services Phone: (512)218-5578 E-mail: bfranklin(aDroundrocktexas.gov Page 9 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 17. INTERLOCAL PURCHASING AGREEMENTS A. The City has entered into Interlocal Agreements with other Governmental agencies pursuant to the Interlocal Cooperation Act, Chapter 791 of the Texas Government Code. The Contractor agrees to offer the same price and terms and conditions to other eligible agencies that have an interlocal agreement with the City. B. The City does not accept any responsibility or liability for the purchases by other government agencies through an interlocal cooperative agreement i i Page 10 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 PART IV SPECIFICATIONS 1. PURPOSE:The City of Round Rock requires the delivery of truckload amounts of flocculant polymer needed to make'floc'for the daily intake of solids at Brushy Creek Waste Water Treatment Plant(WWTP), also known as East WWTP. 2. BACKGROUND: The City of Round Rock operates a 52 million gallons per day surface water treatment plant, a five million gallons per day ground water plant and a six million gallons per day waste water effluent reuse plant. The East Waste Water Treatment Plant facility uses bulk flocculant polymer in their treatment processes. 3. TANK AND DELIVERY INFORMATION AND REQUIREMENTS: A. The WWTP currently owns one bulk tank.The tank has the capacity to hold 60,000 lbs. of polymer. Deliveries will need to be at least 30,000 lbs. of polymer for each shipment. B. The bulk tank is equipped with a 3-inch female Camloc fitting for offloading product. The Vendor or transporter shall supply a 3-inch discharge hose equipped with a 3-inch male Camloc fitting for the transfer of bulk material. C. The Vendor's transport shall ensure that all hoses,valves, and connections are non-leaking and all offloading of flocculant polymer will be made by the Vendor. 4. CHEMICAL REQUIREMENTS A. The flocculant shall be an uncontaminated polymer product free of organic materials and particulate matter. B. The flocculant polymer is to perform equal to or better than 18%solids overall as determined by the City's daily cake test. C. Polymer dosage will be modified by City personnel on a daily basis to reach the 18% solids. 5. CONTRACTOR RESPONSIBILITIES:The Contractor shall A. Provide the City with a single point of contact(SPDC)to ensure appropriate communication needs are met; B. Communicate with the City's POC by phone when a shipment is estimated to arrive. The contact phone number is 512-218-3234; C. Check in with the Administration Building upon arrival to ensure plant personnel are aware of the bulk shipment and await direction to the appropriate location on site. The WWTP speed limit of 5mph shall be observed by the transport driver at all times. No smoking on site is permitted; D. Ensure that all shipments are made during normal plant hours: Monday through Friday from 7:00 am to 6:00 pm CST Shipments will not, under any circumstances, be received afterhours, on weekends, or holidays; E. Provide all volumes of flocculant delivered to WWTP be delivered in clean tanker trucks; F. Deliver and offload bulk tank truck volumes to the specified location within the Waste Water Plant; G. Warrant that the product delivered complies with the minimum requirements of this specified product (Goal of 18%solids). H. Supply with each delivery a chemical analysis of the flocculant polymer. The analysis must be performed by an accredited laboratory and must be representative of the material being delivered and shall include the specific gravity of the flocculant polymer and the Vendor's name for the product or the numeric designation/ID for the product; I. Ensure the Vendor's transport driver shall have in their possession and must have read the current Safety Data Sheet(SDS)for the flocculant polymer; Page 11 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer (FB No. 19-021 Class/Item: 885-77 APRIL 2019 J. Ensure that the Contractor's transport driver uses appropriate Personal Protective Equipment for the unloading of the flocculant polymer.The PPE shall be donned prior to beginning unloading; K. Comply with all Department of Transportation rules and regulations at all times for safe transport of this product. Vendors transport shall display the proper placarding as required by the D.O.T. The transport vessel shall be closed during transport and free of leaks; 6. CITY RESPONSIBILITIES: The City will A. Order in bulk tank volumes of approximately 30,000 lbs; B. Will order a volume of flocculant polymer in advance; C. Reserve the right to sample and analyze the material, at the time of delivery,to ensure the delivery meets requirements specified.The sample will be conducted by the Waste Water Plant's laboratory; D. Reserve the right to refuse any shipment, at no cost to The City of Round Rock, that does not meet these specifications; E. Reserve the right to request a sample to perform a field test to ensure the vendors product works for the specific application (See Part IV, Item 13). I Page 12 of 14 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 ATTACHMENT A BID SHEET 1. ATTACHMENT A—BID SHEET is posted in Solicitation Documents for IFB 19-021 Bulk Flocculant Polymer in an Excel format on the City of Round Rock website at: https://www.roundrocktexas.gov/departments/purchasing/pu rchasing-active-solicitations/ A. In order to be considered responsive Attachment A-Bid Sheet must be completed,signed by an authorized representative and returned by the deadline for submission of response indicated in Part I Section 5—Schedule of Events. B. The Respondent, by submitting and signing Attachment A—Bid Sheet, acknowledges that he/she has received and read the entire document packet sections defined above including all documents incorporated by reference, and agrees to be bound by the terms therein. C. In order to do business with the City of Round Rock you must be registered with the City's Vendor Database. To register, go to: https://roundrock.munisselfservice.com/Vendors/default.aspx. D. By the signature affixed on Attachment A-Bid Sheet, the Respondent hereby certifies that neither the Respondent nor the entity represented by the Respondent, or anyone acting for such entity has violated the antitrust laws of this State, codified in Section 15.01 et seq., Texas Business and Commerce Code, or the Federal antitrust laws, nor communicated directly or indirectly, the response made to any competitor or any other person engaged in such line of business." E. The Respondent agrees, if this Offer is accepted within 120 calendar days after the Due Date,to fully comply in strict accordance with the Solicitation,specifications and the amounts shown on bid sheet. 2. ADDITIONAL REQUIREMENTS A. All bids shall be submitted quoting the price per pound for the flocculant polymer. B. Each bidder shall submit with their bid a current copy of the chemical analysis of their product. C. Each bidder shall provide with their bid the most recent SDS sheet of the product being offered. Page 13 of 14 Exhibit "A" Attachment A- Bid Sheet Bulk Flocculant Polymer IFB 19-021 The Respondent represents by their signature below that he/she is submitting a binding offer and is authorized to bind the respondent to fully comply with the solicitation documents contained in I FB 19-021 Bulk Flocculant Polymers. The Respondent acknowledges that he/she has received and read the entire solicitation packet, attachments, and all documents incorporated by reference, and agrees to be bound by the terms therein. Special Instructions: All prices must be quoted in order to be considered responsive, be advised that exceptions taken to any portion of the solicitation will jeopardize acceptance of the bid. Alternative bids other than flocculant polymer will not be considered, modification to the bid sheet format will result in the rejection of the bid. The City reserves the right to purchase more or less than the quantities indicated below. No. Description Estimated Unit Unit Cast Extended Total Annual Quantity Clarifloc CE-1309 1 Bulk Flocculant Polymer 165,000 LB $1.32/Lb. $217,800.00 Annual Total: $217,800.00 COMPANY NAME: Polydyne Inc. SIGNATURE OF AUTHORIZED REPRESENTATIVE: PRINTED NAME: Mark Schlag,Vice-President 912-880-2035 PHONE NUMBER: EMAIL ADDRESS: PolyBidDpt@snfhc.com Page 1 of 1 Exhibit "A" City of Round Rock Bulk Flocculant Polymer IFB No. 19-021 Class/Item: 885-77 APRIL 2019 ATTACHMENT B: REFERENCE SHEET PLEASE COMPLETE AND RETURN THIS FORM WITH THE SOLICITATION RESPONSE SOLICITATION NUMBER: IFB 19-021 RESPONDENT'S NAME: Polydyne Inc. DATE: 4/29/19 Provide the name, address, telephone number and E-MAIL of at least three(3)valid Municipal, Government agencies or firms of comparable size that have utilized services that are similar in type and capacity within the last two(2)years.City of Round Rock references are not applicable. References may be checked prior to award. If references cannot be confirmed or if any negative responses are received it may result in the disqualification of submittal. 1. Company's Name City of Atlanta Name of Contact Daniel Sabou Title of Contact WRC Manager-RM Clayton E-Mail Address dsabou@AtlantaGa.Gov Present Address RM Clayton-2440 Bolton Road City, State,Zip Code Atlanta,GA 30318 Telephone Number ( 404 )546-0683 Fax Number: ( ) 2. Company's Name Metropolitan Council Name of Contact David Quast Title of Contact Prinicipal Engineer-Technical Services E-Mail Address david.quast@metc.state.mn.us Present Address 2400 Childs Road City, State,Zip Code St. Paul,MN 55101 Telephone Number (651 ) 602-1164 Fax Number: ( ) 3. Company's Name Louisville M.S.D. Name of Contact Robin Burch Title of Contact Process Support Supervisor E-Mail Address robin.burch@louisvillemsd.org Present Address 4522 Algonquin Parkway City, State,Zip Code Louisville,KY 40203 Telephone Number ( 502 )377-7646 Fax Number: ( ) FAILURE TO PROVIDE THE REQUIRED INFORMATION WITH THE SOLICITATION RESPONSE MAY AUTOMATICALLY DISQUALIFY THE RESPONSE FROM CONSIDERATION FOR AWARD. Page 14 of 14 Exhibit "A" 0"q- ROUND ROCK TEXAS PUNCO MNG am mold ADDENDUM CITY OF ROUND ROCK,TEXAS Solicitation: IFB 19-021 Addendum No: 1 Date of Addendum: 4118/19 This addendum is to incorporate the following changes to the above referenced solicitation: I. Clarifications: A. The Solicitation document has been updated to reflect that the City of Round Rock operates a 2.2 million gallons per day waste water effluent reuse plant. B. References to truckload quantities have been amended to reflect less-than-truckload quantities. H. Questions: Q1. For Bulk Flocculant Polymer who is the current supplier and the price per pound? Al. The City does not currently have a contracted supplier for bulk flocculant polymer. Q2. Given that procuring the raw material and their relative availability fluctuates on a regular basis how will the City account for those price changes? What happens if these price increases exceed the contract value? A2. Per Part III,Item 7 of the solicitation the City states"Contract prices for bulk flocculant polymer shall remain firm throughout the initial twelve(12)month term of the contract. A price increase to the agreement may be considered on the anniversary date of the Contract each year and shall be equal to the consumer price index for that year,but at no time can the increase be greater than 10%for any single line item unless agreed upon by the City." The section goes on to explain that the Contractor will provide"the written price increase request with the rate detail comparison and comprehensive calculation and any supporting documentation to the designated City Contract Specialist a minimum of 45 days prior to the annual Contract anniversary date." If the price increase is deemed reasonable per the City and the Contract Specialist the 10% allotment can fluctuate. Once the contract runs out of money the City will bid the requirements again. Q3. Is there a delivery expectation from the day the order is placed? A3. Yes,we have added Part IV, Item 5.1-to set the expectation that"The Contractor shall deliver product with 7-10 business days of the City's request for material." We also modified Part IV,item 63 to reflect that the City will"order a volume of flocculant polymer 7- 10 business days in advance of the required delivery date." Q4. Will the contract award be a split award? A4. No,we do not intend to have multiple awards for the resulting contract. Q5. What specific test method and protocol is the City using to determine the%solids? A5. The City uses Standard Methods 2540 B for%solids. III. Add Contact: The Authorized Contact for contractual and technical issues has been added as follows: Authorized Contact: Amanda Crowell Purchasing Technician 512-218-5458 acrowell(�2),roundrocktexas.gov Exhibit "A" IV. ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME. APPROVED BY: April 18,2019 Che Kauf an, Pur9fi6sing Supervisor Purchasing Office, 51"18-5458 By the signature affixed below this addendum is hereby incorporated into and made a part of the above referenced solicitation. ACKNOWLEDGED BY: Polydyne Inc. Mark Schlag,Vice-President 4/29/19 Name Authod-Zed Signature Date RETURN ONE SIGNED COPY OF THIS ADDENDUM TO THE PURCHASING OFFICE WITH YOUR SEALED PROPOSAL. FAILURE TO DO SO MAY AUTOMATICALLY DISQUALIFY YOUR RESPONSE FROM CONSIDERATION FOR AWARD. Exhibit "A" CERTIFICATE Polydyne Inc. SNFOF ONE CHEMICAL PLANT ROAD POLYDYNE ANALYSIS RICEBORO GA 31323 CUSTOMER NAME: CITY OF ROUND ROCK,TX-BRUSHY CREEK CITY OF ROUND ROCKJX OA#: 1276121-1-1 221 EAST MAIN ROUND ROCK E 001 ROUND ROCK TX 78664 UNITED STATES jheaps@roundrocktexas.gov JOHN POLYDYNE PRODUCT NAME: CLARIFLOC CE-1309 PURCHASE ORDER NR: 20190807 DATE: 03/13/2019 AMOUNT: 32000 LB QUALITY CONTROL QC BATCH NUMBER UNIT SPECIFICATION RC24/2783M TEST BULK VISCOSITY cps 300-2000 599 1010 A NON VOLATILE SOLIDS % 43.5-50.5 46.8 1050 A UL BROOKFIELD VISCOSITY cps 2.50-3.30 2.83 1019 A RESIDUAL ACRYLAMIDE ppm 0-999 205 1001 A Date: 03/13/2019 Signature Kiet Tran If the#symbol appears in the QC-TEST column,then the data on that line is given for information only,and does not constitute a specification. If ND appears in the result column,that means under the limit of detection. For Personal Care ingredients,the generic name is corresponding to the INCI name. SUP NR:OG-0098 REVISION:04 Exhibit "A" SNF POLYDYNE CLARIFLOC CE-1309 POLYMER PRINCIPAL USES MANUFACTURING SPECIFICATIONS CLARIFLOC CE-1309 is a high charge cationic polyacrylamide Total Solids 43.5-50.5% in emulsion form that is used as a flocculant in a wide variety of Residual AcAm < 1000 ppm municipal wastewater treatment applications. It has been successfully Neat Viscosity 300-2000 cPs CZ applied in all liquid/solids separation systems including clarification, UL Viscosity 2.5-3.3 cPs raft thickening,and dewatering. HANDLING AND STORAGE TYPICAL PROPERTIES Suggested in-plant storage life is 6 months in unopened drums.For best results,store at 50-80 F. Bulk tanks should be mixed by periodically Physical Form Clear to Milky White Liquid Cationicity 60% recirculating the contents bottom to top.Bulk tanks can also be fitted , Active Polyacrylamide Min. 41% with an agitator type mixer that reaches the bottom 2 feet of the tank. I Freezing Point 7 F.(-14 C.) Drums and bins should be mixed very well before first use and weekly l after that. Do not allow emulsion polymers to freeze. Should freezing Density 8 t Specific Gravity 8.55 -_8,7.7 occur,allow the product to thaw thoroughly in a heated area and mix well before attempting to use it. For spills of CLARIFLOC CE-1309, I PREPARATION AND FEEDING sprinkle vermiculite or equivalent absorbant over the spill area and sweep the material into approved chemical disposal containers. Do not spray water onto a spill because the resulting gel is very i CLARIFLOC CE-1309 is a single component emulsion polymer difficult to clean up. 3 that must be pre-diluted in water before use. In most cases, this product should not be applied neat. One method for dilution is adding SAFETY INFORMATION the neat polymer into the vortex of a mixed tank at a concentration CLARIFLOC CE-1309 is a mildly acidic product that can irritate between 0.25-1.0% polymer (0.5% is optimum) by weight. The the skin and eyes and should be handled accordingly. Gloves,goggles polymer can also be injected through a number of commercially available systems thatprovide in-line mechanical mixing.The bestfeed and apron are highly recommended. Anyone responsible for the systems use initial high energy mixing(>1000 rpm)for a short time Procure-ment, use or disposal of this product should familiarize (<30 sec)to achieve good dispersion followed by low energy mixing themselves with the appropriate safety and handling precautions (<400 rpm)for a longer time(10-30 min). Polymer solutions should be involved. Such information is outlined in the POLYDYNE Material aged for 15-60 minutes for best results. Solution shelf life is 8-16 Safety Data Sheet.In the event of an emergency with this product, hours. contact Chemtrec anytime day or night at(800)424-9300. MATERIALS OF CONSTRUCTION SHIPPING CLARIFLOC CE-1309 Polymer is shipped in 55 gallon drums Cross-linked polyethylene,fiberglass,stainless steel or lined steel are containing 450 pounds net or in 275 gallon totes containing 2300 the preferred materials of construction for bulk tanks. Avoid natural pounds. Bulk quantities are also available. rubber and Buna-N gaskets as these materials swell when placed in contact with neat polymer. Unlined mild steel,black iron,galvanized ADDITIONAL INFORMATION steel,copper or brass are not recommended in any part of the feed To place an order or obtain technical information from anywhere in the system. Stainless steel,Viton or Teflon are the best choices for pump continental United States call toll free: Y , heads. For feed lines,use PVC or reinforced Tygon tubing. [8001848-7659 For additional information, please refer to the Safety Data Sheet (SDS) All statements,information and data given herein are believed to be accurate,but are presented without warranty,expressed or implied. Statements concerning possible use are made without representation or warranty that any such use is free of patent infringement,and is not a recommendation to infringe on any patent. The user should not assume that all safety measures are indicated or that other measures may not be required. Any determination of the suitability of a particular product for any use contemplated by the user is the sole responsibility of the user. ©2016 SNF Holding Company PolyJyne Inc. I Ckemical Plant Roacl Rice6oro,GA 31323 Tel 800.348.7659 Exhibit "A" SAFETY DATA SHEET According to U.S.Code of Federal Regulations 29 CFR 1910.1200,Hazard Communication. SECTION 1: Identification of the substancelmixture and of the company/undertaking- 1.1. ompany/undertaking1.1.Product identifier Product name: CLARIFLOCTM CE-1309 Type of product: Mixture. 1.2.Relevant identified uses of the substance or mixture and uses advised against Identified uses: Processing aid for industrial applications. Uses advised against.' None. 1.3.Details of the supplier of the safety data sheet Polydyne Inc. Company: 1 Chemical Plant Road PO BOX 279,Riceboro, GA 31323 United States Telephone: 1-800-848-7659 Telefax: (912)-884-8770 E-mail address: 1.4.Emergency telephone number 24-hour emergency number. 1-800-424-9300 SECTION 2: Hazards identification 2.1. Classification of the substance or mixture Classification according to paragraph(d)of 29 CFR 1910.1200: Not classified. 2.2. Label elements Labelling according to paragraph(t)of 29 CFR 1910.1200: Print Date: 2910412019 Revision date:10/12/2018 Page: 1 114 Exhibit "A" SAFETY DATA SHEET CLARIFLOCTM CE-1309 Hazard symbol(s): None. Signal word: None. Hazard statement(s): None. Precautionary statement(s): None. 2.3. Other hazards Spills produce extremely slippery surfaces. For explanation of abbreviations see Section 16. SECTION 3: Compositiontnformation on ingredients 3.1.Substances Not applicable,this product is a mixture. 3.2.Mixtures This product is a mixture. Hazardous components Distillates (petroleum), hydrotreated light Concentrationl-range: 20-30% CAS Number: 64742-47-8 Classification according to paragraph(d) Asp. Tox. 1;H304 of 29 CFR 1910.1200: Notes Does not result in classification of the mixture if the kinematic viscosity is greater than 20.5 mm2ls measured at 40°C. Pol (oxy-l,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Concentrationl-range: <5% CAS Number: 69011-36-5 Classification according to paragraph(d) Acute Tox.4;H302, Eye Dam. 1;H318 of 29 CFR 1910.1200: For explanation of abbreviations see section 16 SECTION 4: First aid measures Print Date: 2910412019 Revision date:10/1212018 Page: 2114 Exhibit "A" SAFETY DATA SHEET CLARIFLOCT" CE-1309 SECTION 4: First aid measures 4.1.Description of first aid measures Inhalation: Move to fresh air.No hazards which require special first aid measures. Skin contact.' Wash off immediately with soap and plenty of water while removing all contaminated clothes and shoes.In case of persistent skin irritation, consult a physician. Eye contact.' Rinse immediately with plenty of water, also under the eyelids, for at least 15 minutes. Get medical attention immediately. Ingestion: Rinse mouth with water.Do NOT induce vomiting. Call a physician or poison control centre immediately. 4.2.Most important symptoms and effects,both acute and delayed None under normal use. 4.3.Indication of any immediate medical attention and special treatment needed. None reasonably foreseeable. Other information: None. SECTION 5: Fire-fighting measures 5.1.Extinguishing media Suitable extinguishing media: Water. Water spray. Foam. Carbon dioxide(CO2).Dry powder. Warning! Spills produce extremely slippery surfaces. Unsuitable extinguishing media: None. 5.2.Special hazards arising from the substance or mixture Hazardous decomposition products: Ammonia. Carbon oxides(COx).Nitrogen oxides(NOx).Hydrogen chloride.Hydrogen cyanide(hydrocyanic acid)may be produced in the event of combustion in an oxygen deficient atmosphere. 5.3.Advice for fire-fighters Protective measures: Wear self-contained breathing apparatus and protective suit. Other information: Spills produce extremely slippery surfaces. Print Date: 2910412019 Revision date:10/1212018 Page: 3114 Exhibit "A" SAFETY DATA SHEET CLARIFLOCTm CE-1309 SECTION 6:Accidental release measures 6.1.Personal precautions,protective equipment and emergency procedures Personal precautions: Do not touch or walk through spilled material. Spills produce extremely slippery surfaces. Protective equipment.' Wear adequate personal protective equipment(see Section 8 Exposure Controls/Personal Protection). Emergency procedures: Keep people away from spill/leak. Prevent further leakage or spillage if safe to do so. 6.2.Environmental precautions As with all chemical products, do not flush into surface water. 6.3.Methods and material for containment and cleaning up Small spills: Do not flush with water.Soak up with inert absorbent material. Sweep up and shovel into suitable containers for disposal. Large spills: Do not flush with water.Dam up. Soak up with inert absorbent material. Clean up promptly by scoop or vacuum. Residues: After cleaning, flush away traces with water. 6.4.Reference to other sections SECTION 7:Handling and storage; SECTION 8:Exposure controls/personal protection; SECTION 13:Disposal considerations; SECTION 7: Handling and storage 7.1.Precautions for safe handling Avoid contact with skin and eyes. Renders surfaces extremely slippery when spilled. When using, do not eat, drink or smoke. 7.2. Conditions for safe storage,including any incompatibilities Keep away from heat and sources of ignition.Freezing will affect the physical condition and may damage the material. Incompatible with oxidizing agents. 7.3.Specific end use(s) This information is not available. SECTION 8: Exposure controls/personal protection 8.1.Control parameters Occupational exposure limits: Print Date: 2910412019 Revision date:10/12/2018 Page: 4114 Exhibit "A" SAFETY DATA SHEET CLARIFLOC'm CE-1309 Distillates (petroleum), hydrotreated light ACGIH:200 mg/m3(8 hours) 8.2.Exposure controls Appropriate enaineering controls: Ensure adequate ventilation, especially in confined areas.Use local exhaust if misting occurs.Natural ventilation is adequate in absence of mists. Individual protection measures,such as personal protective equipment a)Eyefface protection: Safety glasses with side-shields. b)Skin protection: i)Hand protection:PVC or other plastic material gloves. it)Other'Wear coveralls and/or chemical apron and rubber footwear where physical contact can occur. c)Respiratory protection: No personal respiratory protective equipment normally required. d)Additional advice: Wash hands before breaks and immediately after handling the product.Wash hands before breaks and at the end of workday.Handle in accordance with good industrial hygiene and safety practice. Environmental exposure controls: Do not allow uncontrolled discharge of product into the environment. SECTION 9; Physical and chemical properties 9.1.Information on basic physical and chemical properties a)Appearance: Viscous liquid,Milky. b) Odour: Aliphatic. c)Odour Threshold: No data available. d)pH: 3.5 -6.5@5g/L e)Melting pointffreezing point: <5°C t)Initial boiling point and boiling range: > 100°C g)Flash point: Does not flash. h)Evaporation rate: No data available. Print Date: 2910412019 Revision date:10/1212018 Page: 5114 Exhibit "A" SAFETY DATA SHEET CLARIFLOCTm CE-1309 i)Flammability(solid,gas): Not applicable. j)Upper/lower flammability or explosive limits: Not expected to create explosive atmospheres. k) Vapour pressure: 2.3 kPa @ 20°C 1) Vapour density: 0.804 g/litre @ 20°C m)Relative density: 1.0- 1.2 n)Solubility(ies): Completely miscible. o)Partition coefficient Not applicable. p)Autoignition temperature: Not applicable. q)Decomposition temperature: > 150°C r) Viscosity: >20.5 mm2/s @ 40°C s)Explosive properties: Not expected to be explosive based on the chemical structure. t)Oxidizing properties: Not expected to be oxidising based on the chemical structure. 9.2.Other information None. SECTION 10: Stability and reactivity 10.1.Reactivity Stable under recommended storage conditions. 10.2.Chemical stability Stable under recommended storage conditions. 10.3.Possibility of hazardous reactions Oxidizing agents may cause exothermic reactions. 10.4.Conditions to avoid Protect from frost,heat and sunlight. 10.5.Incompatible materials Oxidizing agents. 10.6.Hazardous decomposition products Thermal decomposition may produce: hydrogen chloride gas, nitrogen oxides (NOx), carbon oxides (COx). Ammonia. Hydrogen cyanide(hydrocyanic acid). Print Date: 2910412019 Revision date:10/12/2018 Page: 6114 Exhibit "A" SAFETY DATA SHEET CLARIFLOCTM CE-1309 SECTION 11:Toxicoloalcal information 11.1.Information on toxicological effects Information on the product as supplied. Acute oral toxicity: LD50/oral/rat>5000 mg/kg(Estimated) Acute dermal toxicity: LD50/dermal/rat>5000 mg/kg. (Estimated) Acute inhalation toxicity. The product is not expected to be toxic by inhalation. Skin corrosion/irritation: Non-irritating to skin. Serious eye damage%ye irritation: Not irritating.(OECD 437) Respiratory/skin sensitisation: Not sensitizing. Mutagenicity: Not mutagenic. Carcinogenicity: Not carcinogenic. Reproductive toxicity: Not toxic for reproduction. STOT-Single exposure: No known effects. STOT-Repeated exposure: No known effect. Aspiration hazard: Due to the viscosity,this product does not present an aspiration hazard. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Acute oral toxicity: LD50/oral/rat>5000 mg/kg(OECD 401) Acute dermal toxicity: LD50/dermal/rabbit> 5000 mg/kg. (OECD 402) Acute inhalation toxicity. LCO/inhalation/4 hours/rat>=4951 mg/m3(OECD 403) (Based on results obtained from tests on analogous products) Skin corrosion/irritation: Not irritating. (OECD 404) Repeated exposure may cause skin dryness or cracking. Serious eye damage%ye irritation: Not irritating. (OECD 405) Respiratory/skin sensitisation: By analogy with similar products,this product is not expected to be sensitizing. (OECD 406) Mutagenicity: Not mutagenic. (OECD 471,473,474,476,478,479) Print Date: 2910412019 Revision date:10/1212018 Page: 7/14 Exhibit "A" SAFETY DATA SHEET CLARIFLOCTM CE-1309 Carcinogenicity: Carcinogenicity study in rats (OECD 451):Negative. Reproductive toxicity: By analogy with similar substances,this substance is not expected to be toxic for reproduction.NOAEL/rat=300 ppm. (OECD 421) STOT-Single exposure: No known effects. STOT-Repeated exposure: NOAEL/oral/rat/90 days>=3000 mg/kg/day(OECD 408)(Based on results obtained from tests on analogous products) Aspiration hazard: May be fatal if swallowed and enters airways. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Acute oral toxicity: LD50/oral/rat=500-2000 mg/kg Acute dermal toxicity: LD50/dermal/rabbit>2000 mg/kg. Acute inhalation toxicity: No data available. Skin corrosion/irritation: Not irritating. (OECD 404) Serious eye damage%ye irritation: Causes serious eye irritation. (OECD 405) The results of testing pigs showed this material to be non-sensitizing. Respiratory/skin sensitisation: g on guinea p g g• Mutagenicity: In vitro tests did not show mutagenic effects. In vivo tests did not show mutagenic effects. Carcinogenicity: Based on the absence of mutagenicity,it is unlikely that the substance is carcinogenic. Reproductive toxicity: Two-Generation Reproduction Toxicity(OECD 416) -NOAEL/rat>250 mg/kg/day Prenatal Development Toxicity Study(OECD 414) -NOAEL/Maternal toxicity/rat>50 mg/kg/day -NOAEL/Developmental toxicity/rat>50 mg/kg/day STOT-Single exposure: No known effects. STOT-Repeated exposure: NOAEL/oral/rat/600 days=50 mg/kg/day Aspiration hazard: No known effects. SECTION 12: Ecological information 12.1. Toxicity Information on the product as supplied: Print Date: 2910412019 Revision date:10/12/2018 Page: 8/14 Exhibit "A" SAFETY DATA SHEET CLARIFLOCn" CE-1309 Acute toxicity to fish: LC50/Fish/96 hours= 10- 100 mg/L(Estimated) Acute toxicity to invertebrates: EC50/Daphnia magna/48 hours= 10- 100 mg/L. (Estimated) Acute toxicity to algae: Algal inhibition tests are not appropriate. The flocculation characteristics of the product interfere directly in the test medium preventing homogenous distribution which invalidates the test. Chronic toxicity to fish: No data available. Chronic toxicity to invertebrates: No data available. Toxicity to microorganisms: No data available. Effects on terrestrial organisms: No data available. Sediment toxicity: No data available. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Acute toxicity to fish: LCO/Oncorhynchus mykiss/96 hours> 1000 mg/L. (OECD 203) Acute toxicity to invertebrates: ECO/Daphnia magna/48 hours> 1000 mg/L. (OECD 202) Acute toxicity to algae: ICO/Pseudokirchneriella subcapitata/72 hours> 1000 mg/L. (OECD 201) Chronic toxicity to fish: NOEC/Oncorhynchus mykiss/28 days> 1000 mg/L Chronic toxicity to invertebrates: NOEC/Daphnia magna/21 days> 1000 mg/L Toxicity to microorganisms: EC50/Tetrahymena pyriformis/48h> 1000 mg/L. Effects on terrestrial organisms: No data available. Sediment toxicity: No data available.Readily biodegradable, exposure to sediment is unlikely. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Acute toxicity to fish: LC50/Cyprinus carpio/96 hours= 1 - 10 mg/L(OECD 203) Acute toxicity to invertebrates: EC50/Daphnia/48 hours= 1 - 10 mg/L(OECD 202) Acute toxicity to algae: IC50/Desmodesmus subspicatus/72 hours= 1 - 10 mg/L(OECD 201) Chronic toxicity to fish: No data available. Print Date: 2910412019 Revision date:10112/2018 Page: 9/14 Exhibit "A" SAFETY DATA SHEET CLARIFLOC'm CE-1309 Chronic toxicity to invertebrates: NOEC/Daphnia magna/21 days> 1 mg/L(OECD 202) Toxicity to microorganisms: EC 10/activated sludge/17 hours> 10000 mg/L(DIN 38412-8) Effects on terrestrial organisms: No data available. Sediment toxicity: No data available. 12.2.Persistence and degradability Information on the product as sup Ip ied: Degradation: Readily biodegradable. Hydrolysis: At natural pHs(>6)the polymer degrades due to hydrolysis to more than 70%in 28 days. The hydrolysis products are not harmful to aquatic organisms. Photolysis: No data available. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Degradation: Readily biodegradable. 67.6%/28 days (OECD 301 F); 68.8%/28 days(OECD 306) ; 61.2%/61 days(OECD 304 A) Hydrolysis: Does not hydrolyse. Photolysis: No data available. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Degradation: Readily biodegradable.>60%/28 days(OECD 301 B) Hydrolysis: Does not hydrolyse. Photolysis: No data available. 12.3.Bioaccumulative potential Information on the product as supplied: The product is not expected to bioaccumulate. Partition co-efficient(Log Pow): Not applicable. Bioconcentration factor(BCF): No data available. Relevant information on the hazardous components: Print Date: 2910412019 Revision date:10/12/2018 Page:10114 Exhibit "A" SAFETY DATA SHEET CLARIFLOCTm CE-1309 Distillates (petroleum), hydrotreated light Partition co-efficient(Log Pow): 3 -6 Bioconcentration factor(BCF): No data available. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Partition co-efficient(Log Pow): >3 Bioconcentration factor(BCF): No data available. 12.4.Mobility in soil Information on the product as supplied: No data available. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Koc: No data available. Poly(oxy-1,2-ethanediyl), a-tridecyl--w-hydroxy-, branched Koc: >5000 12.5.Other adverse effects None known. SECTION 13: Disposal considerations 13.1. Waste treatment methods Waste from residues/unused products: Dispose in accordance with local and national regulations. Contaminated packaging: Rinse empty containers with water and use the rinse-water to prepare the working solution. If recycling is not practicable, dispose of in compliance with local regulations. Can be landfilled or incinerated,when in compliance with local regulations. Rec cly ina: Store containers and offer for recycling of material when in accordance with the local regulations. Print Date: 2910412019 Revision date:10/12/2018 Page:11/14 Exhibit "A" SAFETY DATA SHEET CLARIFLOCTM CE-1309 SECTION 14:Transport information Land transport(DOT) Not classified. Sea transport(1MDG) Not classified. Air transport(IATA) Not classified. SECTION 15: Regulatory information 15.1.Safety,health and environmental regulations/legislation specific for the substance or mixture Information on the product as supplied: TSCA Chemical Substances Inventory: All components of this product are either listed on the inventory or are exempt from listing. US SARA Reporting Requirements: SARA(Section 311/312)hazard class: Not concerned. SARA Title Ill Sections: Section 302(TPQ)-Reportable Quantify: Not concerned. Section 304-Reportable Quantity: Not concerned. Section 313(De minimis concentration): Not concerned. Clean WaterAct Section 311 Hazardous Substances(40 CFR 117.3)-Reportable Quantify: Not concerned. Clean AirAct Section 112(r) Accidental release prevention requirements(40 CFR 68)-Reportable Quantify: Not concerned. CERCLA Print Date: 2910412019 Revision date:10/12/2018 Page:12114 Exhibit "A" SAFETY DATA SHEET CLARIFLOCTM CE-1309 Hazardous Substances List(40 CFR 302.4)-Reportable Quantity: Not concerned. RCRA status: Not RCRA hazardous. California Proposition 65 Information: WARNING! This product contains a chemical known to the State of California to cause cancer and birth defects or other reproductive harm,Acrylamide SECTION 16: Other information NFPA and HMIS Ratings: NFPA: Health: 0 Flammability: 1 Instability: 0 HMIS: Health: 0 Flammability: 1 Physical Hazard: 0 PPE Code: B This data sheet contains changes from the previous version in section(s): SECTION 8. Exposure controls/personal protection, SECTION 15. Regulatory information, SECTION 16. Other Information. Key or legend to abbreviations and acronyms used in the safety data sheet: Acronyms STOT= Specific target organ toxicity Print Date: 2910412019 Revision date:10/12/2018 Page:13/14 Exhibit "A" SAFETY DATA SHEET CLARIFLOC'm CE-1309 Abbreviations Acute Tox. 4=Acute toxicity Category Code 4 Asp. Tox. 1 =Aspiration hazard Category Code 1 Eye Dam 1 =Serious eye damage/eye irritation Category Code 1 Hazard statements H302-Harmful if swallowed H304-May be fatal if swallowed and enters airways H318-Causes serious eye damage Training advice: Do not handle until all safety precautions have been read and understood. This SDS was prepared in accordance with the following: U.S. Code of Federal Regulations 29 CFR 1910.1200 Version: 17.01.a ENCC046 The information provided in this Safety Data Sheet is correct to the best of our knowledge, information and belief at the date of its publication. The information given is designed only as a guidance for safe handling, use, processing, storage, transportation, disposal and release and is not to be considered a warranty or quality specification. The information relates only to the specific material designated and may not be valid for such material used in combination with any other materials or in any process,unless specified in the text. Print Date: 2910412019 Revision date:10/12/2018 Page:14/14 7 �y DATE(MM/DD/YYYY) ,AICUR[3 CERTIFICATE OF LIABILITY INSURANCE 12/27/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone No.: (212)488-0200 CONTACT NAME: Fax No.: (212)488-0220 PHONE FAX Frenkel&Company, an EPIC company E-MAIL A/C Ext: A1C No L 350 Hudson Street—4th Floor ADDRESS: New York, NY 10014 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: AIG SPECIALTY INSURANCE COMPANY 26883 INSURED INSURER B: COMMERCE&INDUSTRY INSURANCE COMPANY 19410 Polydyne Inc. INSURER C: TRUMBULL INSURANCE COMPANY 27120 One Chemical Plant Road INSURER D: PO Box 250 INSURER E: Riceboro GA 31323 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OFINSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICYNUMBER A X COMMERCIAL GENERAL LIABILITY EG14362834 12/31/2018 12/31/2019 EACH OCCURRENCE $1,000,000 n DAMAGE TO RENTED $500,000 CLAIMS-MADE L X I OCCUR PREMISES Ea occurrence MED EXP(Any one person) $25,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ❑PRO- F1PRODUCTS-COMP/OP AGG $2,000,000 JECT LOC OTHER' $ B AUTOMOBILE LIABILITY CA4691818 12/31/2018 12/31/2019 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ ALL OWNEDSCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE X HIRED AUTOS X NON-OWNED Per accident $ AUTOS $ A UMBRELLA LIABX OCCUR EGU18403155 12/31/2018 12/31/2019 EACH OCCURRENCE $5,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 $ DED RETENTION$ C WORKERS COMPENSATION 1OWNR30600 12/31/2018 12/31/2019 X PSTATUTEEl AND EMPLOYERS'LIABILITY Y/N1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? $1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 30 DAY CANCELLATION CLAUSE INCLUDED CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Round Rock ACCORDANCE WITH THE POLICY PROVISION 211 East Main Street AUTHORIZED REPRESENTATIVE Round Rock,TX 78664 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF INTERESTED PARTIES FORM 3.295 1 of 1 Complete Nos. 1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2019-502871 Polydyne Inc. Riceboro, GA United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/11/2019 being filed. City of Round Rock Date Acknowledged: g Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. 000000 Supply and Delivery Bulk Flocculant Polymer 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 UNSWORN DECLARATION My name is Mark Schlag and my date of birth is My address is One Chemical Plant Road Riceboro GA 31323 USA (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Lily County, State of Georgia on the l Ithday of June 20 19 (month) (year) Signature of authorized ant of contracting business entity (Decca ant) Mark Schla ,Vice-President Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.39f8039c CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f1 Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1,2, 3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2019-502871 Polydyne Inc. Riceboro, GA United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/11/2019 being filed. City of Round Rock Date Acknowledged: 06/27/2019 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. 000000 Supply and Delivery Bulk Flocculant Polymer 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION My name is and my date of birth is My address is (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of on the day of 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.39f8039c