Contract - Fort Bend Services, Inc. - 2/9/2017 CITY OF ROUND ROCK AGREEMENT
FOR PURCHASE OF WATER TREATMENT CHEMICALS
FROM
FORT BEND SERVICES,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 belt press polymer, and for related goods and
services, referred to herein as the "Agreement," is made and entered into on this the day
of the month of _�, by and between the CITY OF ROUND ROCK,
TEXAS, a home-rule municip ity whose offices are located at 221 East Main Street, Round
Rock, Texas 78664, referred to herein as the"City,"and FORT BEND SERVICES, INC.,whose
offices are located at P.O. Box 1688, Stafford, Texas 77497, 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 belt press polymer, and associated goods and
services, 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 11-024; Specification
Number 16-013 dated August 2016; and Addendum No. 1 dated August 29, 2016; (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:
00369346/ss2
(1) This Agreement;
(2) Purchaser'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 Fort Bend Services, Inc., or any of its successors or assigns.
2.01 EFFECTIVE DATE,INITIAL TERM,AND ALLOWABLE RENEWALS
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 16-013, Specification
Number 885-16, dated August 2016, and Addendum No. 1 dated August 29, 2016. 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
Only the following IFB line item on Exhibit "A" are awarded to the Vendor: item 49,
belt press polymer.
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5.01 COSTS
The City shall pay to Vendor the bid costs listed on page twenty-five (25) of Exhibit"A,"
which are specifically relevant to the referenced bid item #9.
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.
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
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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.
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
16-2013 and as set forth at:
https•//www roundrocktexas ovg_/wp-content/uploads/2014/12/corr insurance 07.20112.pdf
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14.01 CITY'S REPRESENTATIVE
City hereby designates the following representative(s) authorized to act in its behalf with
regard to this Agreement:
Kim Lutz, Senior Utility Services Manager
2008 Enterprise Drive
Round Rock, Texas, 78664
Telephone: (512) 341-333
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
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(30) 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
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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. Vendor acknowledges and understands that City has adopted a Storm Water
Management Program (SWMP) and an Illicit Discharge Ordinance, Sections 14-139 through 14-
152 of the City's Code of Ordinances, to manage the quality of the discharges from its Municipal
Separate Storm Sewer System (MS4) and to be in compliance with the requirements of the Texas
Commission on Environmental Quality (TCEQ) and the Texas Pollutant Discharge Elimination
System (TPDES). The Services Provider agrees to perform all operations on City-owned
facilities in compliance with the City's Illicit Discharge Ordinance to minimize the release of
pollutants into the MS4. The Services Provider agrees to comply with of the City's stormwater
control measures, good housekeeping practices and any facility specific stormwater management
operating procedures specific to a certain City facility. In addition, the Services Provider agrees
to comply with any applicable TCEQ Total Maximum Daily Load (TMDL) Requirements and/or
I-Plan requirements.
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.
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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:
Fort Bend Services, Inc.
P.O. Box 1688
Stafford, TX 77497
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.
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
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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
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.
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01/11/2017 11:38 FAX 5122187097 1a010/034
IN WITNESS WHEREOF, City and Vendor have executed this Agreement on the dates
indicated.
City of Round Rock,Texas Fort Bend Services,Inc.
By: By: O1.
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Printed NamiQ: AUA W Printed Name: td ,TA yW 6-s
Title: WVATitle: y;Cc Ps_Es;oCjT OF SAt.C–c
Date Signed: - Date Signed:jr4 ni4e,v-,, 1'7
Attest:
By: - 14y�
Sara L. White, City Clerk
For CityA roved as to Fa—
*Stephan
By: k, L
eets, City Attorney
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n
UND ROCK TEXAS
ASING DIVISION
City of Round Rock, Texas
Purchasing Division
221 East Main Street
Round Rock, Texas 78664-5299
www.roundrocktexas.gov
INVITATION FOR BID
Water Treatment Chemicals
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SOLICITATION — IFB No. 16-013
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AUGUST 2016
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Exhibit "A"
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City of Round Rock
Water Treatment Chemicals
I IFB No. 16-013
Class/Item:885-16
August 2016
TABLE OF CONTENTS
Part I General
1. Purpose
2. Background
3. Attachments
4. Clarification
5. Respondent Qualifications
6. Subcontractors
7. Damage
8. Safety
9. Pricing
10.Price Increase
11.Agreement Term
12.Acceptance/Inspection
Part II Specifications
1. Service Requirements
2. Raw Water Characteristics
3. Chemical Specifications
4. Chemical Testing
5. Freight
6. Point-of-Contact/Designated Representative
7. Workforce
8. Order Quantity
9. Permits
Part III Schedule and Response Instructions
1. Schedule of Events
2. Solicitation Updates
3. Response Due Date
4. Best Value Evaluation and Criteria
5. Award
6. Post Award Meeting
Page 2 of 27
Exhibit "A"
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City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/item: 885-16
August 2016
I 7. Non-Appropriation
8. Interlocal Cooperative Contracting (Piggyback)
Part IV Response
1. Response Requirements
Part V Content
1. Confidentiality of Content
Part VI General Terms and Conditions
1. Insurance
2. Definitions, Terms, and Conditions
3. Prompt Payment Policy
Part VII Water Treatment Chemicals — Itemized List
(Refer to pages 13—20)
Part VIII Solicitation Instructions
(Refer to pages 21 -23)
Attachments
Attachment A— Bid Form
Attachment B— Reference Sheet
Attachment C—Addendum Acknowledgement Form
Page 3 of 27
Exhibit "A"
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City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
i CITY OF ROUND ROCK
INVITATION FOR BID
Water Treatment Chemicals
PART
GENERAL
1. PURPOSE: The City of Round Rock, herein after"the City"seeks formal bids to establish a multiple
year agreement with a qualified person,firm or corporation, herein after"Respondent",to provide all
equipment, material and labor necessary to supply and deliver various water supply treatment
chemicals for treating potable water supplies located at various locations throughout the City of
Round Rock,Texas.
2. BACKGROUND: The City of Round Rock operates a fifty-two (52) million per day surface water
treatment plant, a five (5) million gallons per day ground water plant and a six(6) million gallons per
day waste water effluent reuse plant, each facility uses bulk treatment chemicals in their treatment
processes.
3. ATTACHMENTS: Attachment A through C, are herein made part of this invitation for bid:
3.1 Attachment A: Bid Form
3.2 Attachment B: Respondent's Reference Sheet
3.3 Attachment C: Addendum Acknowledgment Form
4. CLARIFICATION: For questions or clarification of specifications, you may contact:
Mike Schurwon, CPPB, CTPM
Purchaser
Purchasing Division
City of Round Rock
E-mail: mschurwon a)roundrocktexas.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.
5. 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:
5.1. Be firms,corporations, individuals or partnerships normally engaged in providing and delivering
various water supply treatment chemicals for treating potable water supplies as specified
herein and have adequate organization, facilities, equipment, financial capability, and
personnel to ensure prompt and efficient service to the City;
5.2. Provide all labor, supplies and materials required to satisfactorily perform the services as
specified herein. 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;
5.3. 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.
Page 4 of 27
Exhibit "A"
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City of Round Rock
Water Treatment Chemicals
i IFB No. 16-013
Class/Item:885-16
August 2016
6. 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 the
3 supply and deliver of various water supply treatment chemicals for treating potable water supplies.
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7. DAMAGE: The Respondent shall be responsible for damage to the City's equipment and / or
property,the workplace and its contents by its work,negligence in work,its personnel and equipment
usage.
8. 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:
8.1. 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;
8.2. 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;
8.3. 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.
9. 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.
10. PRICE INCREASE: Contract prices for the various water supply treatment chemicals shall remain
firm throughout the initial twelve(12) month term of the contract. A price increase to the agreement
may be considered at renewal time each year and shall be equal to the consumer price index for that
year, but at no time can the increase be greater than 25%of the contract price.
10.1. 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
II 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://www.bls.govlcpi/
10.2. Procedure to Request Increase:
10.2.1. Mail the written price increase request with the rate detail comparison and
comprehensive calculation to the designated City Contract Specialist a minimum of 45
days prior to each renewal period. 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:
Page 5 of 27
Exhibit "A"
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City of Round Rock
Water Treatment Chemicals
I IFB No. 16-013
j Class/Item: 885-16
August 2016
City of Round Rock
Purchasing Department
Attn: Contract Specialist
221 East Main Street
Round Rock, TX 79664-5299
10.2.2. 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.
11. AGREEMENT TERM: The terms of the awarded agreement shall include but not be limited to the
following:
11.1 The term of the Agreement shall begin from date of award and shall remain in full force for six
(60) months.
11.2 The City reserves the right to review the awarded respondents' performance anytime during
the contract term.
11.3 If the awarded respondent fails to perform its duties in a reasonable and competent manner,
the City shall give written notice to the respondent of the deficiencies and the respondent shall
have thirty (30) days to correct such deficiencies. If the respondent fails to correct the
deficiencies with the thirty (30) days, the City may terminate the agreement by giving the
respondent written notice of termination and the reason for the termination.
12. 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 services delivered are
not in full compliance with the specifications. In the event the services are not performed to the
satisfaction of the City, the product will be rejected. Returned and/or rejected product shall be
transported off-site at no cost to the City.City facilities that require cleaning or decontamination due
to contractor negligence shall be remediated at no cost to the City. If any agreement or purchase
order is cancelled for non-acceptance,the needed services may be purchased elsewhere and the
vendor may be charged liquidated damages.
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Page 6 of 27
Exhibit "A"
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
PART II
SPECIFICATIONS
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I SCOPE: The City of Round Rock requests various water supply treatment chemicals for treating potable
water supplies located at various locations throughout the City of Round Rock,Texas.
1. SERVICE REQUIREMENTS: Services shall be performed and products deliver to the following
locations at:
Water Plant
5494 N.IH 35
Round Rock,Texas 78681
Lake Creek Well Site
j 310 S. Burnet Street
Round Rock,TX 78664
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Brushy Creek Regional Waste Water Facility
3939 Palm Valley Blvd
Round Rock, TX 78664
2. RAW WATER CHARACTERISTICS
Constituent Average Concentration or Range
j Hardness 160 to 180 mg/L
II Turbidity 1.5 to 4.0 NTU
Alkalinity 165 to 185 mg/L
Temperature 10 to 30 degrees Celsius
pH 7.2 to 7.8
3. CHEMICAL SPECIFICATIONS: All chemicals specified herein shall meet with the intended use,
critical requirements and delivery specifications outlined on itemized chemical list on pages 13-20
of this solicitation.
4. CHEMICAL TESTING: Sample testing shall be required for Liquid Aluminum Sulfate, Liquid
Aluminum Sulfate with 2% Copper Sulfate, Liquid Cationic Polymer, Aluminum Chlorohydrate and
Belt Press Polymer.
4.1 Testing instructions are specified on itemized chemical list, pages 13-20 of this solicitation.
4.2 The prospective low bidder(s) shall be required to submit the chemical product samples for
testing no later than(7)days from the date the chemical samples are requested by the City.
4.3 Failure to submit the required chemical samples for testing may disqualify a response for
consideration for award.
5. FREIGHT: Price shall include FOB Destination, pre-paid and allowed unless otherwise specified in
writing. Price shall be inclusive of demurrage charges. No fuel surcharges shall be allowed.
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Page 7 of 27
Exhibit "A"
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City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
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6. POINT OF CONTACT/DESIGNATED REPRESENTATIVE:
6.1 Respondent'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.
6.2 The City's designated representative: Upon contract award, the City's designated
representative shall be:
Kim Lutz
Senior Utility Service Manager
Water Treatment Plant
E-mail:kiml@roundrocktexas.gov
7 WORKFORCE: Successful Respondent shall:
7.1 Ensure Respondent's employees perform the services in a timely, professional and efficient
manner;
7.2 Ensure Respondent's employees, while working on City property, wear a company uniform
that clearly identifies them as the Respondent's employee;
7.3 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.
8 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 goods/services
needed to satisfy requirements within budgetary constraints, which may be more or less than
indicated.
9 PERMITS: The Successful Respondent shall obtain all necessary permits, licenses, and/or
certificates required by federal, state and local laws, ordinances, rules or regulations for the
completion and delivery of goods/services as specified herein.
Page 8 of 27
Exhibit "A"
i
i
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
i
PART III
SCHEDULE AND RESPONSE INSTRUCTIONS
1. SCHEDULE OF EVENTS: It is the City's intention to comply with the following solicitation timeline:
EVENT DATE
Solicitation released August 18, 2016
Deadline for submission of questions August 25, 2016 @ 5:00 PM,CST
City responses to questions or addendums August 30, 2016 @ 5:00 PM, CST
Deadline for submission of responses September 8 , 2016 @ 3:00 PM, CST
All questions regarding the solicitation shall be submitted in writing by August 25,2016 @ 5:00 p.m.,
CST on the due date noted above. A copy of all the 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:
http://www.roundrocktexas.gov/departments/purchasing/purchasing-active-
solicitations/ http:/Iesbd.cpa.state.tx.us/
} Questions shall be submitted to the City contact named herein. The City reserves the right to modify
these dates. Notice of date change will be posted to the City's website.
2. SOLICITATION UPDATES: Respondents shall be responsible for monitoring the City's website
at http://www.roundrocktexas.gov/departments/purchasinq/purchasing-active-solicitations/
http://esbd.cpa.state.tx.us/for any updates pertaining to the solicitation described herein. Various
updates may include addendums, cancelations, 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.
i
3. RESPONSE DUE DATE: Signed and sealed responses are due at or before September 8, 2016,
@ 3:00 p.m.,CST on the due date noted in Part 111, Section 1. Mail or hand deliver sealed responses
to:
City of Round Rock—15t Floor Receptionist Desk
j Attn: Mike Schurwon, CPPB, CTPM
Purchasing Department
221 E. Main Street
Round Rock,Texas 78664-5299
3.1 Sealed responses shall be clearly marked on the outside of packaging with the company name,
solicitation name(Water Treatment Chemicals), bid number(IFB-16-013), due date and"DO
NOT OPEN".
3.2 Facsimile or electronically transmitted responses are not acceptable.
E 3.3 Responses cannot be altered or amended after opening.
3.4 No response can be withdrawn after opening without written approval from the City for an
acceptable reason.
3.5 The City will not be bound by any oral statement or offer made contrary to the written
specifications.
3.6 Samples and/or copies shall be provided at the Respondent's expense, and shall become the
property of the City.
Page 9 of 27
Exhibit "A"
I
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
I Class/Item: 885-16
August 2016
4. 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:
i
4.1 Purchase price;
4.2 Reputation of Respondent and of Respondent's goods and services;
4.3 Quality of the Respondent's goods and services;
4.4 The extent to which the goods and services meet the City's needs;
4.5 Respondent's past performance with the City;
4.6 The total long-term cost to the City to acquire the Respondent's goods or services;
4.7 Any relevant criteria specifically listed in the solicitation.
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
to clarify.
5. 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. Award announcement will be made upon
City Council approval of staff recommendation and executed agreement. Award announcement will
appear on the City's website at http://www.roundrocktexas.gov/departments/purchasing/purchasing-
active-solicitations/
6. POST AWARD MEETING: The City and Successful Respondent(s)may have a post award meeting
to discuss, but not be limited to the following:
6.1 The method to provide a smooth and orderly transition of services performed from the current
contractor;
j 6.2 Provide City contact(s)information for implementation of agreement.
6.3 Identify specific milestones, goals and strategies to meet objectives.
I
7. NON-APPROPRIATION: The resulting Agreement is a commitment of the City's current revenues
only. It is understood and agreed the City shall have the right to terminate the Agreement at the end
of any City fiscal year if the governing body of the City does not appropriate funds sufficient to
purchase the estimated yearly quantities, as determined by the City's budget for the fiscal year in
question. The City may affect such termination by giving Vendor a written notice of termination at the
end of its then current fiscal year.
8. INTERLOCAL COOPERATIVE CONTRACTING (PIGGYBACK): Other governmental entities may
be extended the opportunity to purchase off of the City's agreements,with the consent and agreement
of the awarded Vendor(s)and the City. Such consent and agreement shall be conclusively inferred from
lack of exception to this clause in a Respondent's submittal. However, all parties indicate their
understanding and hereby expressly agree that the City is not an agent of, partner to,or representative
j of those outside agencies or entities and that the City is not obligated or liable for any action or debts
that may arise out of such independently-negotiated"piggyback"procurements.
f
t
Page 10 of 27
Exhibit "A"
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item:885-16
August 2016
i
PART IV
RESPONSE
1. RESPONSE 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.
i
Respondents shall submit one (1) evident signed "Original" and two (2) copies of the response
requirements including any required attachments.The samples and/or copies shall be provided at the
Respondent's expense, and shall become the property of the City.
j 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
j this IFB;all costs associated with responding to this IFB will be solely at the interested parties'expense.
I
Not responding to this IFB does not preclude participation in any future RFP/RFQ/IFB.
I For your bid to be responsive, all required Items identified below shall be submitted with your
3
3
proposal.
Attachment A: Responses shall be submitted on itemized, signed Bid Sheet provided herein. Failure
to itemize or sign solicitation may result in disqualification. Submission of responses on forms other
that the City's Solicitation Document may result in disqualification of the response.
Attachment B: Provide the name, address, telephone number and E-MAIL of at least three (3)
Municipal, Government agencies or firms of comparable size that have utilized similar service within
the last two(2)years. City of Round Rock references are not applicable. References may be checked
prior to award. Any negative responses received may result in disqualification of submittal.
Attachment C: Provide signed copy of the Addendum Acknowledgement Form or a signed copy of
each issued addendum with bid upon submission.
Additional Information Requested:
Contract Information: Respondent shall provide information of any current established contract
with a local City, County, Municipality, Cooperative Agreement, Comptroller of Public Accounts (CPA)
Texas Smart Buy Contract,Texas Multiple Award Schedule(TXMAS), General Services
Administration(GSA), Inter-local Agreement,or any other contractual resource.
PART V
CONFIDENTIALITY OF CONTENT
1. CONFIDENTIALITY OF CONTENT: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.
1.1 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.
1.2 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
S
1
I
Page I I of 27
Exhibit "A"
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
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.
PART VI
GENERAL TERMS AND CONDITIONS/INSURANCE REQUIREMENTS
(ITEMS BELOW APPLY TO AND BECOME A PART OF THE CONTRACT)
1. INSURANCE: The Respondent shall meet or exceed all insurance requirements set forth by the
Insurance Requirements as identified on the City's website at: http://www.roundrocktexas.gov/wp-
content/uploads/2014/12/corr insurance 07.20112.pdf
2. DEFINITIONS, TERMS AND CONDITIONS: By submitting a response to this solicitation, the
Respondent agrees that the City's standard Definitions, 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, Terms and Conditions can be obtained from the City's website
at: http://www.roundrocktexas.gov/wp-contenUuploads/2014/12/corr t c revised 07.2011.pdf
3. PROMPT PAYMENT POLICY: Payments will be made in accordance with the Texas Prompt
Payment Law, Texas Government Code, Subtitle F, Chapter 2251. The City will pay Vendor within
thirty days after the acceptance of the supplies, materials, equipment, or the day on which the
performance of services was completed or the day, on which the City receives a correct invoice for
the supplies, materials, equipment or services,whichever is later. The Vendor may charge a late fee
(fee shall not be greater than that which is permitted by Texas law) for payments not made in
accordance with this prompt payment policy; however, this policy does not apply to payments made
by the City in the event:
3.1 There is a bona fide dispute between the City and Vendor concerning the supplies, materials,
services or equipment delivered or the services performed that causes the payment to be late;
or
3.2 The terms of a federal agreement, grant, regulation, or statute prevent the City from making a
timely payment with Federal Funds;or
3.3 The is a bona fide dispute between the Vendor and a subcontractor or between a subcontractor
and its suppliers concerning supplies, material, or equipment delivered or the services
performed which caused the payment to be late; or
3.4 The invoice is not mailed to the City in strict accordance with instructions, if any, on the
purchase order or agreement or other such contractual agreement.
I
i
Page 12 of 27
Exhibit "A"
f
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
PART VII
Water Treatment Chemicals
WATER TREATMENT CHEMICAL LIST ITEMIZED AS FOLLOWS:
CHLORINE OR EQUIVALENT
1. All chlorine delivered shall:
1.1. Be approved as a drinking water additive in accordance with National Sanitation
Foundation (NSF)/American National Standards Institute(ANSI)Standard 60.
1.2. Be filtered with a media removing eighteen to twenty microns prior to filling any container
for delivery to the City of Round Rock.
1.3. Be 99.5 percent pure by volume.
( 1.4. Contain no soluble mineral or organic substances in quantities producing deleterious or
j injurious effects on the health of persons consuming water that has been treated properly
(� with liquid chlorine.
1.6. Not to exceed 150 parts per million (ppm)moisture by weight.
1.6. Not to exceed 10 ppm lead, 1 ppm mercury, 3 ppm arsenic or 30 ppm of the sum of all
3 heavy metals.
1.7. Be in conformance with all applicable federal, state and local laws.
1.8. Have a certified weight ticket.
1.9. Be in clean, properly identified and labeled vehicles used only for the transport and
delivery of chlorine.
1.10. Use City owned equipment(e.g.;hoist apparatus, hand truck, etc.)
1.11. Be delivered to:
Water Plant
5494 N.IH 35
Round Rock, Texas 78681
And
Lake Creek Well Site
f
310 S. Burnet St.
( Round Rock,Texas 78664
And
i
i
Brushy Creek Regional Wastewater Plant
3939 Palm Valley Blvd.
Round Rock,Texas 78664
2. All containers shall:
2.1. Meet all applicable Department of Transportation and Chlorine Institute, Inc.standards.
2.2. Open with reasonable ease, using a wrench not greater than six inches in length.
I 2.3. Have a new or rebuilt valve installed prior to delivery.
i
I 2.4. Be visually inspected, vacuumed, exterior repainted, and leak tested prior to delivery.
i
Page 13 of 27
j Exhibit "A"
l
a
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
2.5. Successfully pass hydrostatic testing at least every five years.
2.6. Have container number and tare weight clearly visible and legible.
3. The successful Respondent shall maintain a twenty-four (24) hour emergency service for liquid
chlorine emergencies that includes,at a minimum, the following:
3.1. Trained and certified personnel in hazardous materials response that shall be on-site within
two(2) hours of emergency notification from the City.
3.2. All necessary equipment and apparatus for managing and remediating any emergency
I leak or release of chlorine from Respondent supplied cylinders or containers.
j 3.3. Procedures for the removal and disposal of defective or leaking cylinders or containers.
1
j 4. THE SUCCESSFUL RESPONDENT SHALL,AT NO ADDITIONAL COST, PROVIDE ANNUAL
TRAINING TO CITY EMPLOYEES ON THE CHARACTERISTICS AND SAFE HANDLING
PRACTICES OF CHLORINE GAS.
LIQUID ALUMINUM SULFATE OR EQUIVALENT
1. All Liquid Aluminum Sulfate delivered shall:
1.1. Be approved as a drinking water additive in accordance with NSF/ANSI Standard 60.
1.2. Contain no less than 8 percent water-soluble aluminum oxide.
1.3. Contain no less than .35 percent water soluble iron.
1.4. Be free of insoluble and suspended matter, including but not limited to: chips, dirt, grit and
all other foreign matter.
1.5. Possess adequate clarity for the easy reading of measuring devices.
1.6. Be in conformance with all applicable federal, state and local laws.
11 1.7. Have a certified weight ticket.
1.8. Be in clean, properly identified and labeled trucks used only for the transport and delivery
of liquid aluminum sulfate.
1.9. Be delivered into four 10,000-gallon bulk storage tanks through a standard 2-inch female
quick connect.
1.10. Be delivered to:
i
Water Plant
5494 N. IH 35
Round Rock,Texas 78681
2. Special Requirements
2.1. The City shall request chemical samples for Liquid Aluminum Sulfate for testing from any
1 prospective low bidder(s)after the bid opening date.
i
2.2. Respondents shall ship,at their own expense,a sample of the product to be bid to:
i
Kim Lutz
j 2008 Enterprise Dr.
! Round Rock, TX 78664
2.3. The quantity of chemical sample product requested by the City shall be at least five(5)
gallons and must be received at the above address.
Page 14 of 27
Exhibit "A"
I
City of Round Rock
Water Treatment Chemicals
j IFB No. 16-013
Class/Item:885-16
August2016
LIQUID ALUMINUM SULFATE with 2%Copper Sulfate OR EQUIVALENT
1. All Liquid Aluminum Sulfate delivered shall:
1.1. Be approved as a drinking water additive in accordance with NSF/ANSI Standard 60.
1.2. Contain no less than 8 percent water-soluble aluminum oxide.
1.3. Contain no less than.35 percent water soluble iron.
1.4. Be free of insoluble and suspended matter, including but not limited to:chips, dirt, grit and
all other foreign matter.
1.5. Possess adequate clarity for the easy reading of measuring devices.
1.6. Be delivered in conformance with all applicable federal, state and local laws.
1.7. Have a certified weight ticket.
1.8. Be in a clean, properly identified and labeled trucks used only for the transport and
delivery of liquid aluminum sulfate.
1.9. Be delivered into four 10,000-gallon bulk storage tanks through a standard 2-inch female
quick connect.
1.10. Be delivered to:
Water Plant
5494 N.IH 35
Round Rock,Texas 78681
2. Special Requirements
2.1 The City shall request chemical samples for Liquid Aluminum Sulfate with 2%copper
sulfate for testing from any prospective low bidder(s)after the bid opening date.
2.2 Respondents shall ship, at their own expense,a sample of the product to be bid to:
Kim Lutz
2008 Enterprise Dr.
Round Rock,TX 78664
2.3 The quantity of chemical sample product requested by the City shall be at least five(5)
gallons and must be received at the above address.
ALUMINUM CHLOROHYDRATE OR EQUIVALENT
1. All Aluminum Chlorohydrate delivered shall:
1.1. Be approved as a drinking water additive in accordance with NSF/ANSI Standard 60.
1.2. Contain approximately 50% aluminum chlorohydrate by weight.
1.3. Contain no more than 100 ppm Fe2O3.
1.4. Contain a relative basicity of 83%.
1.5. Be free of insoluble and suspended matter, including but not limited to: chips, dirt, grit and
all other foreign matter.
1.6. Possess adequate clarity for the easy reading of measuring devices.
1.7. Be delivered in conformance with all applicable federal, state and local laws.
1.8. Have a certified weight ticket.
1.9. Be in a clean, properly identified and labeled trucks used only for the transport and
delivery of aluminum chlorohydrate.
Page 15 of 27
Exhibit "A"
I
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
1.10. Be delivered into four 10,000-gallon bulk storage tanks through a standard 2-inch female
quick connect.
1.11. Be delivered to:
Water Plant
5494 N. IH 35
Round Rock,Texas 78681
2. Special Requirements
2.1. The City may request chemical samples for testing from any prospective low bidder(s)after
the bid opening date.
2.2. Respondents shall ship, at their own expense, a sample of the product to be bid to:
Kim Lutz
2008 Enterprise Dr.
Round Rock,TX 78664
2.3. The quantity of the chemical sample product the City may request shall be at least five(5)
gallons and must be received at the above address.
i
i
HYDROFLUOSILICIC ACID 23%OR EQUIVALENT
1. All Hydrofluosilicic Acid delivered shall:
1.1. Be approved as a drinking water additive in accordance with NSF/ANSI Standard 60.
1.2. Be free of insoluble and suspended matter, including but not limited to: chips, dirt, grit and
all other foreign matter.
1.3. Contain between 20% and 30% Hydrofluosilicic Acid.
1.4. Maximum dosage of 1.2 mg/L fluoride ion.
1.5. Be delivered in conformance with all applicable federal, state and local laws.
1.6. Have a certified weight ticket.
1.7. Be in a clean, properly identified and labeled trucks used only for the transport and
delivery of hydrofluosilicic acid.
1.8. Be delivered into a bulk storage tank through a standard 2-inch female quick connect.
1.9. Be delivered to:
Water Plant
5494 N. IH 35
Round Rock,Texas 78681
And
Lake Creek Well Site
310 S.Burnet St.
Round Rock,Texas 78664
Page 16 of 27
Exhibit "A"
i
s
I
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item:885-16
August 2016
2. The successful Respondent shall maintain a twenty-four (24) hour emergency service for
hydrofluosilicic acid emergencies that includes, at a minimum,the following:
2.1. Trained and certified personnel in hazardous materials response that shall be on-site within
two(2) hours of emergency notification from the City.
2.2. All necessary equipment and apparatus for managing and remediating an emergency leak
or release of hydrofluosilicic acid.
COAGULANT AID(Liquid Cationic Polymer)OR EQUIVALENT
NOTE: Because the quality of the City's raw water changes periodically,the City is interested in receiving
bids for various weights of polymer. Data characterizing the raw water quality is included in Part III, Para.
No.8 for use in product selection. Respondents may also submit polymer blends. The following
specifications apply to all coagulant aids:
1. All Liquid Cationic Polymer shall:
1.1. Be approved as a drinking water additive in accordance with NSF/ANSI Standard 60.
1.2. Have a high molecular weight.
1.3. Be cationic.
1.4. Be a liquid that is readily soluble in water at all concentrations.
1.5. Be effective over a pH range of 5.0 to 7.0 Standard Units.
1.6. Be effective over a temperature range from five degrees Celsius to 30 degrees Celsius.
1.7. Be resistant to chlorine.
1.8. Contain no less than .35 percent water soluble iron.
1.9. Be free of insoluble and suspended matter, including but not limited to: chips, dirt, grit and
all other foreign matter.
1.10. Possess adequate clarity for the easy reading of measuring devices.
j 1.11. Be delivered in conformance with all applicable federal, state and local laws.
E
1 1.12. Have a certified weight ticket.
{ 1.13. Be in clean, properly identified and labeled fifty-five gallon drums.
i
1 1.14. Delivered to:
3
I Water Plant
5494 N.IH 35
Round Rock,Texas 78681
2. Special Requirements
2.1. The City shall request chemical samples for Liquid Cationic Polymer coagulant aid for
testing from any prospective low bidder(s)after the bid opening date.
2.2. Respondents shall ship, at their own expense,a sample of the product to be bid to:
Kim Lutz
2008 Enterprise Dr.
Round Rock,TX 78664
2.3. The quantity of chemical sample product requested by the City shall be at least five(5)
gallons and must be received at the above address
SODIUM PERMANGANATE 20%OR EQUIVALENT
1. All Sodium Permanganate delivered shall:
Page 17 of 27
Exhibit "A"
i
City of Round Rock
Water Treatment Chemicals
i IFB No. 16-013
Class/Item:885-16
August 2016
I
1.1 Be approved as a drinking water additive in accordance with NSF/ANSI Standard 60.
1.2 Contain 19 to 21.5% sodium permanganate.
1.3 Have a pH between 5 and 8 standard units.
1.4 Have a specific gravity of 1.15 to 1.17.
1.5 Be delivered in conformance with all applicable federal, state and local laws.
1.6 Have a certified weight ticket.
1.7 Be in clean, properly identified and labeled totes.
1.8 Be delivered to:
Water Plant
5494 N.IH 35
Round Rock,Texas 78681
2. The successful Respondent shall maintain a twenty-four(24) hour emergency service for
Potassium Permanganate emergencies that includes, at a minimum,the following:
2.1. Trained and certified personnel in hazardous materials response that shall be on-site within
two(2)hours of emergency notification from the City.
2.2. All necessary equipment and apparatus for managing and remediating an emergency leak
or release of sodium permanganate.
2.3. Procedures for the removal and disposal of defective or leaking drums or containers.
BELT PRESS POLYMER OR EQUIVALENT
1. All Belt Press Polymer delivered shall:
1.1. Have a high molecular weight.
1.2. Have a broad cationic charge.
1.3. Be a liquid that is readily soluble in water at all concentrations.
1.4. Be effective over a pH range of 5.0 to 7,0 Standard Units.
1.5. Be effective over a temperature range from five degrees Celsius to 30 degrees Celsius.
1.6. Contain no less than.35 percent water soluble iron.
1.7. Be free of insoluble and suspended matter, including but not limited to: chips, dirt, grit and
all other foreign matter.
1.8. Possess adequate clarity for the easy reading of measuring devices.
1.9. Achieve a belt filter cake that is at least 93%solids at optimum dosing rates.
1.10. Be delivered in conformance with all applicable federal, state and local laws.
1.11. Have a certified weight ticket.
1.12. Be in clean, properly identified and labeled fifty-five gallon drums.
1.13. Be delivered to:
Water Plant
5494 N.IH 35
Round Rock,Texas 78681
Page 18 of 27
Exhibit "A"
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
2. Special Requirements
2.1. The City shall request chemical samples for Belt Press Polymer for testing purposes from
any prospective low bidder(s)after the bid opening date.
f 2.2. Respondents shall ship, at their own expense,a sample of the chemical product to be bid
I to:
Kim Lutz
2008 Enterprise Dr.
Round Rock, TX 78664
2.3. The quantity of chemical sample product requested by the City shall be at least five(5)
gallons and must be received at the above address.
LIQUID AMMONIUM SULFATE(LAS) OR EQUIVALENT
1. All Liquid Ammonium Sulfate delivered shall:
1.1 Be approved as a drinking water additive in accordance with NSF/ANSI Standard 60.
1.2 Contain no soluble mineral or organic substances in quantities producing deleterious or
injurious effects on the health of persons consuming water that has been treated properly
with chlorine.
1.3 Contain 10%ammonia(NH3).
1.4 Be completely soluble in water.
1.5 Be delivered in conformance with all applicable federal, state and local laws.
1.6 Have a certified weight ticket.
1.7 Be in clean, properly identified and labeled vehicles used only for the transport and
delivery of liquid ammonium sulfate.
1.8 Be delivered into a bulk storage tank through a standard 2-inch female quick connect.
1.9 Be delivered to the
Water Plant
5494 N.IH 35
Round Rock,Texas 78681
And
Lake Creek Well Site
310 S. Burnet Street
Round Rock,TX 78664
2. The successful Respondent shall maintain a local twenty-four(24)hour emergency service for
liquid ammonium sulfate emergencies that includes, at a minimum, the following:
2.1 Trained and certified personnel in hazardous materials response that shall be on-site
within two(2) hours of emergency notification from the City.
2.2 All necessary equipment and apparatus for managing and remediating an emergency
leak or release of liquid ammonium sulfate.
Page 19 of 27
Exhibit "A"
t
I
City of Round Rock
I Water Treatment Chemicals
IFB No. 16-013
Class/Item:885-16
August 2016
SODIUM HYDROXIDE(17%)OR EQUIVALENT
1. All Sodium Hydroxide delivered shall:
1.1 Contain 17—20%sodium hydroxide.
1.2 Be completely soluble in water.
1.3 Be delivered in conformance with all applicable federal, state and local laws.
1.4 Have a certified weight ticket.
1.5 Be in clean, properly identified and labeled totes used only for the transport and delivery
of sodium hydroxide.
1.6 Be delivered to the
Water Plant
5494 N.IH 35
Round Rock,Texas 78681
2. The successful Respondent shall maintain a local twenty-four(24) hour emergency service for
liquid ammonium sulfate emergencies that includes, at a minimum,the following:
2.1 Trained and certified personnel in hazardous materials response that shall be on-site
within two (2) hours of emergency notification from the City.
2.2 All necessary equipment and apparatus for managing and remediating an emergency
leak or release of sodium hydroxide.
NOTE: The City of Round Rock reserves the right to request chemical product
samples of all other chemicals in addition to the required samples for liquid
aluminum sulfate, liquid aluminum sulfate with 2% copper sulfate, liquid cationic
polymer coagulant aid, and belt press polymer chemicals.
Page 20 of 27
i
Exhibit "A"
City of Round Rock
Water Treatment Chemicals
f IFB No. 16-013
( Class/Item:885-16
August 2016
PART VIII
SOLICITATION INSTRUCTIONS
ITEMS BELOW APPLY TO AND BECOME A PART OF TERMS AND CONDITIONS OF
SOLICITATION
ANY EXCEPTIONS THERETO MUST BE IN WRITING
1. SOLICITATION REQUIREMENTS:
1.1 Responding requires pricing per unit shown and extensions. If trade discount is shown on
solicitation, it should be deducted and net line extensions shown. Respondents guarantees
product offered will meet or exceed specifications identified in this Invitation for Bid(IFB).
1.2 Solicitations shall be submitted on Solicitation Sheet. Each response shall be placed in a separate
envelope completely and properly identified. Responses must be in the Purchasing Department
before the hour and date specified on the solicitation.
1.3 Late responses properly identified will be returned to respondent unopened. Late responses will not
be considered.
1.4 Respond F.O.B.destination,freight,prepaid,&allowed unless otherwise specified on the solicitation.
If otherwise, show exact cost to deliver.
1.5 Response shall show unit price on quantity and unit of measure specified,extension and show total.
In case of errors in extension,unit prices shall govern.Responses subject to unlimited price increase
will not be considered.
1.6 Submitted prices shall be firm for acceptance 30 days from solicitation opening date."Discount from
List" responses are not acceptance unless requested. Cash discount will not be considered in
determining the low response.All cash discounts offered will be taken if earned.
1.7 Responses shall give Tax Identification Number, full name and address of respondent. Failure to
sign will disqualify response. Person signing response shall show title and authority to bind
signatories firm in an agreement. Firm name should appear on each page in the block provided in
the upper right corner. Business Entity shall be one(1)of the following:Individual, Partnership,Sole
Proprietorship, Estate/Trust, Corporation, Government, or Non-profit, all others shall be specified.
INDIVIDUAL:List name and number as shown on Social Security Card.SOLE PROPRIETORSHIP:
List legal name followed by legal business name and Social Security Number. ALL OTHERS: List
legal name of entity and Tax Identification Number(TIN).
i 1.8 Responses cannot be altered or amended after opening time.Any Alterations made before opening
time shall be initialed by respondent or an authorized agent. No response can be withdrawn after
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opening time without approval of the CITY based on a written acceptable reason.
1.9 The City is exempt from State Sales Tax and Federal Excise Tax. Do not include tax in response.
1.10 The City reserves the right to accept or reject all or any part of response,waive minor technicalities
and award the response to best serve the interests of the City. Split awards may be made at the
sole discretion of the City.
1.11 Consistent and continued tie responses could cause rejection of responses by the City and/or
investigation for antitrust violations.
1.12 Telephone, facsimile, and electronically transmitted responses are not acceptable in response to
the solicitation.
1.13 CAUTION: Solicitation invitation allows sufficient time for receipt of the preferred mail response.
The City shall not be responsible for responses received late, illegible, incomplete, or otherwise
non-responsive.
Page 21 of 27
a
Exhibit "A"
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1
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item:885-16
August 2016
2. SPECIFICATION:
2.1 Any catalog, brand name or manufacturer's reference used in the solicitation is descriptive only
(not restrictive), and is used to indicate type and quality desired. Responses on brands of like
i nature and quality will be considered unless advertised under the provisions of Section 252.022
of the Texas Local Government Code. If other than brand(s)specified is offered,illustrations and
complete descriptions of product offered are requested to be made a part of the response. If
respondent takes no exceptions to specifications or reference data in response, respondent will
be required to furnish brand names, numbers, etc., as specified in the solicitation.
2.2 All items on the solicitation shall be new, in first class condition,including containers suitable for
shipment and storage, unless otherwise indicated in the solicitation.Verbal agreements to the
contrary will not be recognized.
I 2.3 Samples, when requested, must be furnished free of expense to the City. If not destroyed in
examination,they will be returned to the respondent, on request, at respondent expense. Each
example should be marked with respondents' name and address, City solicitation number and
j code.Do not enclose in or attach to response.
I 2.4 The City will not be bound by any oral statement or representation contrary to the written
a
specifications of the solicitation.
2.5 Manufacturer's standard warranty shall apply unless otherwise stated in the solicitation.
3. TIE RESPONSES: In case of tie responses,the award will be made in accordance with Section 271.901
of the Texas Local Government Code.
4. DELIVERY:
4.1 Response shall show number of days required to place material in City's designated location under
normal conditions.Failure to state deliver time obligates respondent to complete delivery in fourteen
(14) calendar days. Unrealistically short or long delivery promises may cause response to be
disregarded. Consistent failure to meet delivery promises without valid reason may cause removal
from Vendor list. (See 4.2 following.)
4.2 If delay is foreseen, Vendor shall give written notice to the City. The City has the right to extend
delivery date if reasons appear valid. Vendor shall keep the City advised at all times of status of
order. Default in promised delivery (without acceptable reasons) or failure to meet specifications,
authorizes the City to purchase supplies elsewhere and charge full increase, if any, in cost and
I handling to defaulting Vendor.
4.3 No substitutions or cancellations permitted without written approval of the City.
4.4 Delivery shall be made during normal working hours only, unless prior approval for late delivery
has been obtained from the City, unless otherwise specified in the solicitation.
6. INSPECTION AND TESTS:All goods will be subject to inspection and test by the City to the extent
practicable at all times and places.Authorized City personnel shall have access to any supplier's
place of business for the purpose of inspecting merchandise.Tests may be performed on samples
submitted with the response or on samples taken from regular shipments. If the products tested fail
to meet or exceed all conditions and requirements of the specifications,the cost of the sample used
and the cost of the testing shall be borne by the supplier. Goods,which have been delivered and
rejected in whole or in part, may, at the City's option, be returned to the Vendor or held for
i disposition at Vendor's risk and expense. Latent defects may result in revocation of
acceptance.
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Page 22 of 27
i.
Exhibit "A"
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
6.AWARD OF AGREEMENT:A response to a solicitation is an offer to contract with the City based upon
the terms, conditions, and specifications contained in the solicitation. Responses do not become
agreements or purchase orders unless and until they are accepted by the City through its designees
and an agreement or a purchase order is issued.The agreement or purchase order shall be governed,
construed,and interpreted under the Charter of the City and the laws of State of Texas.All agreements
or purchase orders are subject to the approval of the City Council or Manager.
7.PAYMENT:Vendor shall submit three(3)copies of an invoice showing the agreement or purchase order
number on all copies.
i
8. PATENTS AND COPYRIGHTS: The Respondent agrees to protect the City from claims involving
i infringements of patents or copyrights.
I
9. RESPONDENT ASSIGNMENTS: Respondent hereby assigns to the purchaser any and all claims for
j overcharges associated with this agreement,which arise under the antitrust laws of the State of Texas.
TX, Bus.And Comm. Code Ann. Sec. 15.01, et seq. (1967).
10. RESPONDENT AFFIRMATION:
10.1 Signing the response with a false statement is a material breach of agreement and shall void the
submitted response or any resulting agreements, and the Respondent shall be removed from all
Vendor lists. By signature hereon affixed,the respondent hereby certifies that:
j 10.2 The respondent has not given,offered to give,nor intends to give any time hereafter any economic
i opportunity,future employment,gift,loan,gratuity,special discount,tip,favor,or service to a public
! servant in connection with the submitted response.
10.3 The respondent is not currently delinquent in the payment of any debt owed the City.
10.4 Neither the respondent nor the firm, corporation, partnership, or any entity represented by the
respondent, or anyone acting for such firm,corporation,or entity has violated the antitrust laws of
this State codified in Section 15.01 et.Seq.Texas Business and Commercial 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.
10.5 The respondent has not received compensation for participation in the preparation of the
specification for the solicitation.
11. NOTE TO RESPONDENTS: Any terms and conditions attached to response will not be considered
unless the respondent specifically references them on the front of the response form. WARNING:
Such terms and conditions may result in disqualification of the response (e.g. responses with the
..__........__._—___.._.....laws.._nf_.a._state-other....than_Texas...requirements for prepayment, Limitations on remedies, etc.) The
City of Round Rock can only accept responses which contain all the terms and conditions of its formal
solicitation;in particular,all respondents'affirmations and certifications must be included.Submission
of responses on forms other than City's form may result in disqualification of your response.
12. INQUIRIES: Inquiries pertaining to Solicitation invitations must give Solicitation number, codes, and
opening date.
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Page 23 of 27
Exhibit "A"
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f
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City of Round Rock
Water Treatment Chemicals
3 IFB No. 16-013
Class/Item: 885-16
s August 2016
4
ATTACHMENT A: BID FORM
c PURCHASING DEPARTMENT
221 E. Main Street•Round Rock,Texas 78664-5299
I
Solicitation Number: 16-013 Tax ID Number:
] Solicitation Name: Water Treatment 74-7144642
II Chemicals
Opening Date: September 8, 2016 Business Name:
Fort Bend Services, Tnr_
p Opening Time: 3:00 p.m., CST o i Address:
'" Opening Location: City of Round Rock E
P.O. Box 1688
p Attn: City Hall 1sT Floor z Address: Stafford Texas 774()7
F, Receptionist Desk w I
{ " 221 E. Main Street A David James
U Round Rock,TX a Contact:
0 78664 Telephone: 281-261-5199
Email: djames@fortbendservices.con
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:/Iroundrock.munisselfservice.com/Vendors/default.aspx
Item# Description Quantity Unit of Unit Price Extended Price
Measure
1 Chlorine(Ton Cylinders) or equivalent 150 Ton "Ivo Bid"
2 Chlorine(150 Ib.Cylinders)or equivalent 250 Each "No Bid"
3 Liquid Aluminum Sulfate (Sample testing 50 DT "No Bid"
required)orequivalent
E
4 Liquid Aluminum Sulfate with 2% Copper Sulfate 500 DT "No Bid"
(Sample testing required) orequivalent
5 Aluminum Chlorohydrate or equivalent 69 DT "No Bid"
6 Hydrofluosilicic Acid 23% or equivalent 40 Ton "No Bid"
7 Liquid Cationic Polymer, 55 Gallon Drums,
Sam le esting required) orequivalent 108,000 Lbs. $.60 64,800.00
8 Sodium Permanganate 20%,tote or equivalent 25,550 Lbs. "No Bid"
Belt Press Polymer,55 Gallon Drums (Sample
9 1 testing required)or equivalent 8,59# Gallon 1 550 Gallon Please se attached
Page 24 of 27
Exhibit "A"
E
E
�j
)rt Bend Services, Inc.
later&Waste Treatment Specialists
CITY OF ROUND ROCK
IFB NO.16-013
WATER TREATMENT CHEMICALS
ITEM#9 BELT PRESS POLYMER
OPTION#1(FACTORY DIRECT----10-15 DAY DELIVERY)
FBS C1286 OR FBS C1085 8.59 LBS/GALLON
550 GALLONS $9.277/GALLON $4,638.50(EXTENDED PRICE)
OPTION#2(STAFFORD,TX WAREHOUSE----3-5 DAY DELIVERY)
FBS C1286 OR FBS C1085 8.59 LBS/GALLON
550 GALLONS $9.88/GALLON $5,434.00(EXTENDED PRICE)
TERMS:NET 30 DAYS
FOB: DELIVERED PRICING
office:281.261.5199 toll free:800.933.3678 1 fax:31
■ .�kh2�b1t 11 1
office: 13303 Redfish, Stafford,TX 77477 4 mailing:•PO Box 1688, Stafford,TX 77497
www . fortbendservices . com
i
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item:885-16
August 2016
ATTACHMENT A: BID FORM
(CONTINUED)
10 Liquid Ammonium Sulfate(LAS)or equivalent 46,400 Gallon "No Bid"
11 Sodium Hydroxide(17%),tote or equivalent 3,025 Gallon "No Bid"
By the signature hereon affixed,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 at 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. Further,by signing and submitting this response the Respondent acknowledges:
• That they have read and fully understand the solicitation and accept all terms and conditions set forth herein.
• The respondent is not currently delinquent in the payment of any debt owed to the City.
Sealed response envelope shall be clearly marked with solicitation name,solicitation number and name of responding entity.
The agreement or purchase order resulting from this solicitation may qualify for Inter-local or Cooperative Contracting(Piggybacking)per the terms
outlined in Part III#8 of this solicitation. If applicable,do you agree to"piggyback"purchasing from other governmental agencies?
,{ Yes No Response�Includeone(1)signed original and two(2)copies of bid response.
David James September 2, 2016
Printed Name Authorized Sign#e Date
Failure to sign response will disqualify response.
*0r.]-y if other agencies use the same product
Page 25 of 27
Exhibit "A"
i
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
ATTACHMENT B:
iRESPONDENT'S REFERENCE SHEET
PLEASE COMPLETE AND RETURN THIS FORM WITH THE SOLICITATION RESPONSE
SOLICITATION NUMBER: IFB No. 16-013
RESPONDENT'S NAME: Davi d .TamPg DATE: Se tainhar 9, 9016
Provide the name,address,telephone number and e-mail of at least three(3)Municipal and/or
Government agencies or firms of comparable size that have utilized similar service within the last two(2)
years. City of Round Rock references are not applicable. References may be checked prior to award.
Any negative responses received may result in disqualification of submittal.
1. Company's Name City of Pearland
Name of Contact nark Wahlstrom
Title of Contact Director—Superintendent
E-Mail Address mwahlstrom@pearlandtx.gov
Present Address 3501 East Orange St.
City, State,Zip Code PearlRnd, TX 77581
Telephone Number ( 281—P52-1778 Fax Number:( )
2. Company's Name City of College Station
Name of Contact Kerry Maxwell
Title of Contact Superintendent
E-Mail Address kmaxwell@cstx.gov
Present Address
2200 North Forest Pkwy
City,State,Zip Code Cn11PgP StAti Ani TPXac 77849
Telephone Number ( 979 )764-6275 Fax Number: ( )
3. Company's Name City of Bryan
Name of Contact
-Victor Harris
Title of Contact
RnnPrinfiendPnt-
E-MailAddress vharris@bryantx.gov
Present Address P.O. Box 1000
City, State,Zip Code Bryan, .Texas 77805
Telephone Number ( 979 )225-7259 Fax Number: ( )
FAILURE TO PROVIDE THE REQUIRED INFORMATION WITH THE SOLICITATION RESPONSE MAY
AUTOMATICALLY DISQUALIFY THE RESPONSE FROM CONSIDERATION FOR AWARD.
Page 26 of 27
Exhibit "A"
i
City of Round Rock
Water Treatment Chemicals
IFB No. 16-013
Class/Item: 885-16
August 2016
ATTACHMENT C:
ADDENDUM ACKNOWLEDGMENT FORM
NOTE: If multiple addendums have been issued, respondents may complete and return this attachment
with their proposal in place of the individual addendums to be submitted. Failure to provide either this form
j or the individual addendums with signatures may result in disqualification of the proposal.
Addenda Acknowledgment: The undersigned acknowledges the receipt of the following Addenda:
Addendum #: 1 Dated: 8/29/16
Addendum #: Dated:
Addendum #: Dated:
Addendum #: Dated:
Addendum #: Dated:
Respondent(Company): Fort Rend Service-, T_nc.
r
Signature(in ink):
Name(Typed/printed): David James
Title: •Vice Predisent of Sales Date: September 2, ' 2016
Page 27 of 27
Exhibit "A"
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ROUND ROCK TEXAS
PuRc"Asma ONISIUN
f
CITY OF ROUND ROCK
IFB NO. 16-013
WATER TREATMENT CHEMICALS
Solicitation: 16-013 Addendum No. 1 Date: 08/29/2016
The following response is in reference to all questions submitted for IFB No. 16-013 for Water
Treatment Chemicals by the deadline on Thursday, August 25, 2016, @ 5:00 p.m.
Question No. 1: Do we have to be HUB ZONE Company to quote this?
Answer: No.
Question No. 2: Follow up question to HUB Zone Company. Will you consider us for an award if I
quote this requisition?
Answer: The award will be based on the best value to the City as stipulated in the IFB No. 16-013
Water Treatment Chemicals, Part III, Schedule and Response Instructions, 4. Best Value Evaluation
Criteria, on page 10 of 27.
Question No. 3: Can you please tell me what product is being used for the coagulant aid and belt
press polymer? Also, who is supplying the products?
Answer: The water treatment plant coagulant aid currently in use is WC 9923 supplied by Brenntag
Southwest, Inc. The belt press polymer has not been in regular use since 2010. The product typically
used is FBS 5800 supplied by Fort Bend Services, Inc.
Question No. 4: Will you please provide a copy of the previous bid tabulation, pricing, and chemical
list from five (5) years ago?
Answer: For a copy of the previous bid tabulation, please submit an open records request at:
http://www roundrocktexas gov/departments/administration/city-clerk/open-records-center/
Question No. 5: In reference to the request for products and pricing, may I have the following as it
pertains to items#7 and #9. What are the specific names of the products in use today?
Answer: The water treatment plant coagulant aid currently in use is WC 9923 supplied by Brenntag
Southwest, Inc. The belt press polymer has not been in regular use since 2010. The product typically
used is FBS 5800 supplied by Fort Bend Services, Inc.
Exhibit "A"
i
ROUND ROCK TEXAS
PURCHASING DIVISION
CITY OF ROUND ROCK
IFB NO. 16-013
WATER TREATMENT CHEMICALS
Solicitation: 16-013 Addendum No. 1 Date: 08/29/2016
Question No. 6: Normally, how many drums of each are delivered per shipment?
Answer: Water treatment plant polymer is typically delivered in lots of 20 drums. Belt press polymer
is typically delivered in lots of 4 drums.
Summit Chemicals
Question No. 7: For Item 5 (Aluminum Chlorhydrate), does the item of measure DT stand for dry ton?
Answer: Yes
Question No. 8: Would it be possible to obtain the bid tab and date of bid for the last time the
Aluminum Chlorohydrate was bid?
Answer: The City has never bid Aluminum Chlorohydrate. Therefore, no bid tab exits.
Question No. 9: In reference to liquid aluminum sulfate on page 14, Liquid Aluminum Sulfate,
Section 1.8, we can say that our tanks are dedicated to water treatment chemicals. We can provide
wash out tickets to certify the cleanliness if possible. Does the City of Round Rock require dedicated
tankers for all of their chemical requirements?
Answer: The city requires that the delivery of liquid aluminum sulfate be in a clean, properly
identified and labeled truck used only for the transport and delivery of liquid aluminum sulfate. The
city will accept a certification of cleanliness in lieu of dedicated tanker trucks as long as other
elements of the chemical specification are met.
Question No. 10: The bid states no subcontractors-Would this statement apply to transportation of
the chemical?
Answer: No subcontractors applies to all chemical products, however, not transportation of the
chemicals.
Question No. 11: Does the manufacturer have to be the owner of the tank trucks or can a common
carrier be used?
Answer: No. Common carrier may be used.
Exhibit "A"
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ROUND ROCK TEXAS
PURCRASIHG OMSIGH
CITY OF ROUND ROCK
1176 NO. 16-013
WATER TREATMENT CHEMICALS
Solicitation: 16-013 Addendum No. 1 Date: 08/29/2016
Question No. 12: Is the agreement term as outlined on page 6 of 27, in Part I, General, 11.
Agreement Term, 11.1 for six (6) or sixty(60) months?
Answer: Please change Part I, General, 11. Agreement Term, 11.1 to read as follows:
11.1 The term of the Agreement shall begin from dated of award and shall remain in full force for a
total of six (60) months.
Question No. 13: Would you advise regarding the current pricing for chemical products and current
suppliers listed in IFB No. 16-013 for Water Treatment Chemicals?
Answer: For a copy of the current pricing and supplier for chemical products, please submit an open
records request at: http://www roundrocktexas gov/departments/administration/city-c.lerk/open-
records-center/
Approved by: Date:
Mike Schurwon, CPPB, CTPM
Purchaser
By the signatures affixed below this addendum is hereby incorporated into and made a part of the
above referenced solicitation.
ACKNOWLEDGED:
FOQT 6 C—I'io CC-S,I
Vendor Authorizedi nature Date
RETURN ONE COPY 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"
3
? PAGE Page 1 of 4
REV. DATE: 06/8/2016
I PRODUCT: FBS C1085
'
FBS4
SAFETY DATA SHEET
FBS C108S
rots sena 5-00".Inc.
Wa—&W—e T-1-1-1 Sr—Wl-
1.PRODUCT AND COMPANY IDENTIFICATION
PRODUCT NAME: FBS C 1085
CHEMICAL NAME:Cationic water-soluble polymer in emulsion
PRODUCT USE: Flocculation/Dewatering agent
SUPPLIER: Fort Bend Services Inc. Tel:281-261-5199
13303 Redfish Lane Tel:800-933-3678
Stafford,TX 77477 USA
j EMERGENCY TELEPHONE:
CHEMTREC: 1-800-424-9300
IDENTIFICATION NO:
i
If.HAZARDS IDENTIFICATION
Emergency oven iew
Caution—Slippery when wet!
Eye wash fountains and safety showers must be readily accessible.
Potential health effects
Primary routes of exposure:
Routes of entry for solids and liquids include eye and skin contact,ingestion and inhalation.Routes of entry for gases include inhalation and eye
contact.Skin contact may be a route of entry for liquefied gases.
Chronic toxicity:
Sensitization:
Not sensitizing.
Carcinogenicity:
Not carcinogenic.
Reproductive toxicity:
Not toxic for reproduction
Mutagenicity:
Not nwtagenic
Ill.COtMPOSITION/INFORMATiON ON INGREDIENTS
Hazardous Component I CAS Number Concentration Hazard Classification
Distillates,petroleum,hydrotreated li tt 6474247-8 20-30% Asp.Tox 1;H304
Pol (ox y-1 2-ethanedi I),a-tridec I-w-h drox -,branched 1 69011-36-5 <5.0% Acute Tox.4;H302,Eye Dam.1;11318
W.FIRST AID MEASURES
ItNHALATION:
Remove to fresh air.No hazards which require special first aid treasures.
INGESTION:
Rinse mouth with water.Do NOT induce vomiting.Call a physician or poison control centre immediately.
SKIN CONTACT:
Wash affected areas thoroughly with soap and water.Seek medical attention if irritation persists.
EYE CONTACT:
immediately wash affected eyes for at least 15 minutes under running water with eyelids held open.Seek medical attention immediately.
V.FIRE-FIGHTING MEASURES
Flash point does not flash
Self-ignition temperature not self-igniting
SUITABLE EXTINGUISHING MEDIA:
Dry powder,foam,carbon dioxide,water,water spray
ADDITIONAL INFORMATION—
Avoid use of water jet.If water is used,restrict pedestrian and vehicular traffic in areas where slip hazard may exist.
Contaminated extinguishing water must be disposed of in accordance with official regulations.
I-AZARDS DURING FIRE-FIGHTING:
Thermal decomposition may produce: hydrogen chloride gas,nitrogen oxides,carbon oxides.
Hydrogen cyanide may be produced in the event of combustion in an oxygen deficient atmosphere.
Exhibit "A"
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PAGEPage 2 of 4
REV. DATE: 06/8/2016
j PRODUCT: FBS C1085
I
Spilled product is slippery underfoot.Extremely slippery when wet.
PROTECTIVE EQUIPMENT FOR FIRE-FIGHTING:
Wear a self-contained breathing apparatus and protective suit.
Vt.ACCIDENTAL RELEASE MEASURES
PERSONAL PRECAUTIONS:
Use personal protective clothing.
ENVIRONNIENTAL PRECAUTIONS:
Do not discharge into drains/surface waters/groundwater.
SPILL CLEAN UP METHODS:
Do not flush with water.Dike spill. Large spills clean up promptly by scoop or vacuum. Soak up residual material with an inert absorbent
material.Keep in suitable,closed and labeled container(s)for disposal in accordance with local,state and federal regulations.
VII.HANDLING AND STORAGE
HANDLING:
Avoid contact with skin and eyes.Ensure there is adequate local/mechanical exhaust.Do not smoke.
Handle in accordance with good industrial hygiene and safety practices.
STORAGE:
Keep container tightly closed and dry;store in a cool and dry place(0-30°C).Avoid wet,damp or humid conditions,temperature extremes and
ignition sources.Freezing will affect the physical condition and may damage the product.Incompatible with oxidizing agents.
VIII.EXPOSURE CONTROLS/PERSONAL PROTECTION
COMPONENTS WITH OCCUPATIONAL EXPOSURE LIMITS:
Distillates(petroleum),hydrotreated light ACGIH TWA value 200 mg/m3 8 hour
ENGINEERING CONTROLS:
Ensure adequate ventilation,especially in confined areas.Use local exhaust if misting occurs;natural ventilation is adequate in absence of mists.
PROTECTIVE EQUIPMENT:
�y.
`'X
RESPIRATORY EQUIPMENT: Not required except in case of aerosol formation or inadequate ventilation.
HAND PROTECTION: PVE or other plastic material gloves
EYE PROTECTION: Safety glasses with side-shields;do not wear contact lenses where product is used.
SHIN PROTECION: Protective clothing
HYGIENE MEASURES: Handle in accordance with good industrial hygiene and safety practice
LY.PHYSICAL AND CHEMICAL PROPERTIES
FORM: Viscous liquid
ODOR: Aliphatic
COLOR: Milky white
PH: 4—6 (5 g/1)
RELATIVE DENSITY: 1.0-1.1
MELTING/FREEZING POINT: <50C
BOILING POINT: >100°C
AUTOIGNITION TEMPERATURE: Does not ignite
FLASH POINT: Does not flash
DECOMPOSITION TEMPERATURE: >150°C
VAPOR DENSITY: 0.804 g/litre @ 20°C
VAPOR PRESSURE: 2.3 kPa @ 20°C
VISCOSITY: >20.5 MM2/s @ 40°C
SOLUBILITY IN WATER: Soluble,solubility limited by viscosity
X.STABILITY AND REACTIVITY
CONDITIONS TO AVOID:
Avoid extreme temperatures;protect from frost,heat and sunlight.
SUBSTANCES TO AVOID:
Oxidizing agents may cause exothermic reactions.
HAZARDOUS REACTIONS:
Stable under normal conditions.Hazardous polymerization does not occur.
HAZARDOUS DECOMPOSITION PRODUCTS:
EXhlblt A
PAGE Page 3 of 4
REV. DATE: 06/8/2016
PRODUCT: FBS C1085
3
Thermal decomposition may produce: hydrogen chloride gas,nitrogen oxides,carbon oxides.
j Hydrogen cyanide may be produced in the event of combustion in an oxygen deficient atmosphere.
XI.TOXICOLOGICAL INFORADtTION
ACUTE TOXICITY
ORAL:
Type of value: LD50
Species: rat
Value: >5,000 mg/kg
DERMAL:
Type of value: LD50
Species: rat
Value: >5,000 mg/kg
INHALATION: This product is not expected to be toxic by inhalation.
IRRITATION/CORROSION
SKIN: Not irritating
EYE: Not irritating
SENSITIZATION: Not sensitizing
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/dermaUrabbit >5000 mg/kg OECD 402
Acute inhalation toxicity: LC50/inhalation/4 hr/rat 4951 mg/m3 OECD 403
Skin corrosion/irritation; Not irritating OECD 404
Eye corrosion/irritation: Not irritating OECD 405
( Sensitization: Not expected to be sensitizing
? Poly(oxy-1,2-etlranediyl),a-tiidecyl-iv-hydroxy-,branched
Acute oral toxicity: LD501oral/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
Eye corrosion/irritation: Causes serious eye irritation
Sensitization: Not expected to be sensitizing
X11.ECOLOGICAL INFORMATION
Fish
Acute:
LC50(96): 10-100 mg/L (Estimated)
Aquatic invertebrates
Acute:
Daphnia m./EC50(48 h): 10-100 mg/L(Estimated)
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.
Environmental Fate
Hydrolysis: At natural pHs(>6)the polymer degrades due to hydrolysis to more than 70%in 28 days.The hydrolysis products arc
not harmful to aquatic organisms.
Degradation: Readily biodegradable
Bioaccumulation: Does not bioaccumulate.
Relevant information on the hazardous components:
Distillates,petroleum,hydrotreated light
Acute toxicity to fish: LC50/Oncorhynchus mykiss/96 hr >I 000 mg/L
Acute toxicity to invertebrates: EC50/Daphnia magna/48 lir >I000 mg/L
Acute toxicity to algae: ICO/Pseudok.irchneriella subcapitata/72 hr >I 000 mg/L
Chronic toxicity to fish: NOEC/Oncorhynchus mykiss/28 day >I000 mg/L
j Chronic toxicity to invertebrates: NOEC/Daphnia magna/21 day >1000 mg/L
( Toxicity to microorganisms: FC.50/Tetrah}mena pyriformis/48 hr >1000 mg/L
i
E
j Poly(oxy-1,2-ethanediyl),a-trid cey1-w-hydroxy-,branched
! Acute toxicity to fish: LC50/Cyprinus carpio/96 hr l- 10 mg/L(Estimated)
Acute toxicity to invertebrates: EC50/Daphnia/43exhibit „A i-10 mg/L(Estimated)
I
1
I
PAGE Page 4 of 4
REV. DATE: 06/8/2016
PRODUCT: FBS C1085
Acute toxicity to algae: IC50/Algae/72 hr I- 10 mg/L(Estima(ed)
Chronic toxicity to fish: No data available.
Chronic toxicity to invertebrates: No data available.
Toxicity to microorganisms: EC10/activated sludge/17 hr >10000 mg/L
X111.DISPOSAL CONSIDERATIONS
WASTE MANAGEMENT:
Dispose of in accordance with national,state and local regulations.
CONTAINER DISPOSAL:
Dispose of in a licensed facility.Recommend crushing,puncturing or other means to prevent unauthorized use of used containers.
Product as supplied is not considered RCRA hazardous.
XIV.TRANSPORT INFORMATION
LAND TRANSPORT:
US DOT Not classified as a dangerous good under transport regulations
SEA TRANSPORT:
IMDG Not classified as a dangerous good under transport regulations
AIR TRANSPORT:
IATA/ICAO Not classified as a dangerous good under transport regulations
XV.REGULATORY INFORMATION
US SARA Reporting Requirements:
SARA 311/312: Not concerned
CALIFORNIA PROP.65: Theproduct contains the following substance(s)known to the State of California
to cause cancer: Acrylamide
INTEMNATIONAL INVENTORIES:
I TSCA: All components are listed or exempt from listing
XVI.OTHER INFORMATION
HAZARDOUS MATERIAL INFORMATION SYSTEM(FIM IS) NATIONAL FIRE PROTECTION ASSN(NFPA)
HEALTH 0
FLAMMABtLITY 1 (0) ?
PHYSICAL 0
PERSONAL B
PROTECTION '
GENERAL INFORMATION:
IMPORTANT:WHILE THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION CONTAINED HEREIN ARE PRESENTED IN GOOD FAIT14 AND
BELIEVED TO BE ACCURATE, IT IS PROVIDED FOR YOUR GUIDANCE ONLY.BECAUSE MANY FACTORS MAY AFFECT PROCESSING OR
APPLICATIONIUSE,WE RECOMMEND THAT YOU MAKE TESTS TO DETERMINE THE SUITABILITY OF A PRODUCT FOR YOUR PARTICULAR
PURPOSE PRIOR TO USE. NO WARRANTIES OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE ARE MADE REGARDING PRODUCTS DESCRIBED OR DESIGNS,DATA OR
INFORMATION SET FORTH,OR THAT THE PRODUCTS, DESIGNS, DATA OR INFORMATION MAY BE USED WITHOUT INFRINGING THE
INTELLECTUAL PROPERTY RIGHTS OF OTHERS.IN NO CASE SIUILL THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION PROVIDED
BE CONSIDERED A PART OF OUR TERMS AND CONDITIONS OF SALE. FURTHER YOU EXPRESSLY UNDERSTAND AND AGREE THE
DESCRIPTIONS,DESIGNS,DATA AND INFORMATION FURNISHED BY OUR COMPANY HEREUNDER ARE GIVEN GRATIS AND WE ASSUME
NO OBLIGATION OR LIABILITY FOR THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION GIVEN OR RESULTS OBTAINED,ALL SUCH
BEING GIVEN AND ACCEPTED AT YOUR RISK
i
i
Exhibit "A"
i
PAGE Page 1 of 4
I REV. DATE: 06/8/2016
PRODUCT: FBS C1286
FBS
SAFETY DATA SHEET
� FBS C1286
Fon Bend scrNccs,Inc.
Water MY-e Peat-1 SMcWisn
I.PRODUCT AND COMPANY IDENTIFICATION
PRODUCTNAME: FBS C1286
CHEMICAL NAME:Cationic water-soluble polymer in emulsion
PRODUCT USE: Flocculation/Dewatering agent
SUPPLIER: Fort Bend Services Inc. Tel:281-261-5199
13303 Redfish Lane Tei:800-933-3678
Stafford,TX 77477 USA
EMERGENCY TELEPHONE:
CHEMTREC: 1-800424-9300
IDENTIFICATION NO:
H.HAZARDS IDENTIFICATION
Emergency overview
Caution—Slippery when wet!
Eye wash fountains and safety showers must be readily accessible.
Potential health effects
Primary routes of exposure:
Routes of entry for solids and liquids include eye and skin contact,ingestion and inhalation.Routes of entry for gases include inhalation and eye
contact.Skin contact may be a route of entry for liquefied gases.
Chronic toxicity:
Sensitization:
Not sensitizing.
Carcinogenicity:
Not carcinogenic.
Reproductive toxicity:
Not toxic for reproduction
Mutagenicity:
Not mutagenic
III.COMPOSITIONANFORMATION ON INGREDIENTS
Hazardous Component CAS Number Concentration Hazard Classification
Distillates petroleum,hydrotreated light 64742-47-8 1 20-30% Asp.Tox 1;H304
Pol (ox -1,2-etlianedi 1),a-tridec 1-%v-li drox -,branched 69011-36-5 1 <5.0% Acute Tox.4•H302 Eye Dam.1;ID 18
IV.FIRST AID MEASURES
INHALATION:
Remove to fresh air.No hazards which require special first aid measures.
INGESTION:
Rinse mouth with water.Do NOT induce vomiting.Call a physician or poison control centre immediately.
SIGN CONTACT:
Wash affected areas thoroughly with soap and water.Seek medical attention if irritation persists.
EYE CONTACT:
Immediately wash affected eyes for at least 15 minutes under running water with eyelids held open.Seek medical attention immediately.
V.FIRE-FIGHTING MEASURES
Flash point does not flash
Self-ignition temperature not self-igniting
SUITABLE EXTINGUISHING MEDIA:
Dry powder,foam,carbon dioxide,water,water spray
ADDITIONAL INFORMATION:
Avoid use of water jet.If water is used,restrict pedestrian and vehicular traffic in areas where slip hazard may exist.
Contaminated extinguishing water must be disposed of in accordance with official regulations.
HAZARDS DURING FIRE-FIGHTING:
Thermal decomposition may produce: hydrogen chloride gas,nitrogen oxides,carbon oxides.
Hydrogen cyanide may be produced in the event of combustion in an oxygen deficient atmosphere.
Exhibit "A"
i
i
PAGE Page 2 of4
REV. DATE: 06/8/2016
PRODUCT: FBS C1286
I Spilled product is slippery underfoot.Extremely slippery when wet.
PROTECTIVE EQUIPMENT FOR FIRE-FIGHTING:
Wear a self-contained breathing apparatus and protective suit.
VI.ACCIDENTAL RELEASE MEASURES
PERSONAL PRECAUTIONS:
Use personal protective clothing.
ENVIRONMENTAL PRECAUTIONS:
Do not discharge into drains/surface waters/groundwater.
SPILL CLEAN UP METHODS:
Do not flush with water.Dike spill. Large spills clean up promptly by scoop or vacuum.Soak up residual material with an inert absorbent
material.Keep in suitable,closed and labeled container(s)for disposal in accordance with local,state and federal regulations.
VII.HANDLING AND STORAGE
HANDLING:
Avoid contact with skin and eyes.Ensure there is adequate local/mechanical exhaust.Do not smoke.
Handle in accordance with good industrial hygiene and safety practices.
STORAGE:
Keep container tightly closed and dry;store in a cool and dry place(0-301C).Avoid wet,damp or humid conditions,temperature extremes and
ignition sources.Freezing will affect the physical condition and may damage the product.Incompatible with oxidizing agents.
VIII.EXPOSURE CONTROLS/PERSONAL PROTECTION
COMPONENT'S WITH OCCUPATIONAL EXPOSURE LIMITS:
Distillates(petroleum),hydrotreated light ACGIH 200 mg/m3 8 hour
ENGINEERING CONTROLS:
Ensure adequate ventilation,especially in confined areas.Use local exhaust if misting occurs;natural ventilation is adequate in absence of mists.
PROTECTIVE EQUIPMENT:
a
lam_ _.� '3
RESPIRATORY EQUIPMENT: Not required except in case of aerosol formation or inadequate ventilation.
HAND PROTECTION: PVE or other plastic material gloves
EYE PROTECTION: Safety glasses with side-shields;do not wear contact lenses where product is used.
SKIN PROTECION: Protective clothing
HYGIENE MEASURES: Handle in accordance with good industrial hygiene and safety practice
IX.PHYSICAL AND CHEMICAL PROPERTIES
FORM: Viscous liquid
ODOR: Aliphatic
COLOR: Milky white
pH: 4-6 (5g/1)
RELATIVE DENSITY: 1.0-1.1
MELTING/FREEZING POINT: <5°C
BOILING POINT: >100°C
AUTOIGNITION"TEMPERATURE: Does not ignite
FLASH POINT: Does not flash
DECOMPOSITION TEMPERATURE: >1500 C
VAPOR DENSITY: 0.804 g/litre @ 20°C
VAPOR PRESSURE: 2.3 kPa @ 20°C
VISCOSITY: >20.5 MM2/s @ 40°C
SOLUBILITY IN WATER: Soluble,solubility limited by viscosity
Y.STABILITY AND REAC'T'IVITY
CONDITIONS TO AVOID:
Avoid extreme temperatures;protect from frost,heat and sunlight.
SUBSTANCES TO AVOID:
Oxidizing agents may cause exothermic reactions.
i HAZARDOUS REACTIONS:
Stable under normal conditions.Hazardous polymerization does not occur.
HAZARDOUS DECOMPOSITION PRODUCTS:Exhibit "A"
PAGE Page 3 of 4
REV. DATE: 06/8/2016
PRODUCT: FBS C1286
1
Thermal decomposition may produce: hydrogen chloride gas,nitrogen oxides,carbon oxides.
j Hydrogen cyanide may be produced in the event of combustion in an oxygen deficient atmosphere.
I XI.TOXICOLOGICAL INFORMATION
ACUTE TOXICITY
ORAL:
Type of value: LD50
Species: rat
Value: >5,000 mg/kg
DERMAL:
Type of value: LD50
Species: rat
Value: >5,000 mg/kg
INHALATION: This product is not expected to be toxic by inhalation.
IRRITATION/CORROSION
SKIN: Not irritating
EYE: Not irritating
SENSITIZATION: Not sensitizing
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: LC50/inhalation/4 hr/rat 4951 mg/m3 OECD 403
Skin corrosion/irritation: Not irritating OECD 404
Eye corrosion/irritation: Not irritating OECD 405
Sensitization: Not expected to be sensitizing
d
Poly(oxy-1,2-ethanediyl),a-tridecyl-3v-hydroxy-,branched
Acute oral toxicity: LD50/oral/rat 500- 2000 rng/kg
Acute dermal toxicity: LD50/dermal/rabbit >2000 mg/kg
Acute inhalation toxicity: No data available
Skin corrosion/irritation: Not irritating
Eye corrosion/irritation: Causes serious eye irritation
i Sensitization: Not expected to be sensitizing
XII.ECOLOGICAL INFORMATION
1 Fish
Acute:
LC50(96): 10-100 mg/L (Estimated)
Aquatic invertebrates
Acute:
Daphnia rn./EC50(48 h): 10-100 mg/L(Estimated)
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.
Environmental Fate
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.
Degradation: Readily biodegradable
Bioaccumulation: Does not bioaccumulate.
Relevant information on the hazardous components:
Distillates,petroleum,hydrotreated light
Acute toxicity to fish: LC50/Oncorhyncltus mykiss/96 hr >1000 mg/L
Acute toxicity to invertebrates: EC50/Daplinia magna/48 hr >I000 mg/L
Acute toxicity to algae: ICO/Pseudokirchneriella subcapitata/72 hr >1000 mg/L
Chronic toxicity to fish: NOEC/Oncorhynchus mykiss/28 day >I 000 mg/L
Chronic toxicity to invertebrates: NOEC/Daphnia magna/21 day >I 000 mg/L
Toxicity to microorganisms: EC50/I'etrabyntenapyriformis/48 hr >1000 mg/L
1 Poly(oxy-1,2-ethanediyl),a-tiidecyl-w-hydroxy-,branched
Acute toxicity to fish: LC50/Cyprinus carpio/96 hr 1-10mg/L(Estimated)
Acute toxicity to invertebrates: EC50/Daphnia/48Exhibit „A"-10 mg/L(Estimated)
i
I
PAGE Page 4 of 4
REV. DATE: 06/8/2016
PRODUCT: FBS C1286
Acute toxicity to algae: IC50/Algae/72 hr 1 -10 mg/L(Estimated)
Chronic toxicity to fish: No data available.
Chronic toxicity to invertebrates: No data available.
Toxicity to microorganisms: EC I0/activated sludge/17 hr >10000 mg/L
XIII.DISPOSAL CONSIDERATIONS
WASTE MANAGEMENT:
Dispose of in accordance with national,state and local regulations.
CONTAINER DISPOSAL:
Dispose of in a licensed facility.Recommend crushing,puncturing or other means to prevent unauthorized use of used containers.
Product as supplied is not considered RCRA hazardous.
XIV.TRANSPORT INFORMATION
LAND TRANSPORT:
US DOT Not classified as a dangerous good under transport regulations
SEA TRANSPORT:
IMDG Not classified as a dangerous good under transport regulations
AIR TRANSPORT:
IATA/ICAO Not classified as a dangerous good under transport regulations
XV.REGULATORY INFORMATION
US SARA Reporting Requirements:
SARA 311/312: Not concerned
CALIFORNIA PROP.65: The product contains the following substance(s)known to the State of California
to cause cancer: Acrylamide
INTERNATIONAL INVENTORIES:
TSCA: All components are listed or exempt from listing
XVI.OTHER INFORMATION
HAZARDOUS MATERIAL INFORMATION SYSTEM(HMIS) NATIONAL FIRE PROTECTION ASSN(NFPA)
HEALTH 0
FLAMMABILITY I
PHYSICAL 0
PERSONAL B
PROTECTION
GENERAL INFORMATION:
IMPORTANT:WHILE THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION CONTAINED HEREIN ARE PRESENTED IN GOOD FAITH AND
BELIEVED TO BE ACCURATE,IT IS PROVIDED FOR YOUR GUIDANCE ONLY. BECAUSE MANY FACTORS MAY AFFECT PROCESSING OR
APPLICATION/USE,WE RECOMMEND THAT YOU MAKE TESTS TO DETERMINE THE SUITABILITY OF A PRODUCT FOR YOUR PARTICULAR
PURPOSE PRIOR TO USE. NO WARRANTIES OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE ARE MADE REGARDING PRODUCTS DESCRIBED OR DESIGNS,DATA OR
INFORMATION SET FORTH, OR THAT THE PRODUCTS, DESIGNS, DATA OR INFORMATION MAY BE USED WITHOUT INFRINGING THE
INTELLECTUAL PROPERTY RIGHTS OF OTHERS.IN NO CASE SHALL THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION PROVIDED
BE CONSIDERED A PART OF OUR TERMS AND CONDITIONS OF SALE. FURTHER YOU EXPRESSLY UNDERSTAND AND AGREE THE
DESCRIPTIONS,DESIGNS,DATA AND INFORMATION FURNISHED BY OUR COMPANY HEREUNDER ARE GIVEN GRATIS AND WE ASSUME
NO OBLIGATION OR LIABILITY FOR THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION GIVEN OR RESULTS OBTAINED,ALL SUCH
BEING GIVEN AND ACCEPTED AT YOUR RISK.
Exhibit "A"
i
i
PAGE Page 1 of 4
REV. DATE: 03/22/2016
PRODUCT: FBS 521N
FBS SAFETY DATA SHEET
FBS S21N
fort Sena SerNees.Inc.
Wakv R Wane TrtMmMf S�a"us
I.PRODUCT AND COMPANY IDENTIFICATION
PRODUCTNAME: FBS 521N
CHEMICAL NAME:Cationic polymer
PRODUCT USE: Coagulant aid
SUPPLIER: Fort Bend Services Inc. Tel:281-261-5199
13303 Redfish Lane Tel:800-933-3678
Stafford,TX 77477 USA
EMERGENCY TELEPHONE:
CHEMTREC: 1-800-424-9300
IDENTIFICATION NO:
It.HAZARDS IDENTIFICATION
State of Matter: Amber liquid with slight odor
Emereency overview
Caution—Slippery when wet!
Use with local exhaust ventilation.Wear protective clothing.
Eye wash fountains and safety showers must be readily accessible.
Potential health effects
Primary routes of exposure:
Routes of entry for solids and liquids include eye and skin contact,ingestion and inhalation.Routes of entry for gases include inhalation and eye
contact.Skin contact may be a route of entry for liquefied gases.
Sensitization:Non-sensitizing
Chronic toxicity:
Carcinogenicity:
Based on the absence of mutagenicity,it is unlikely the substance is carcinogenic.
Reproductive toxicity:
By analogy with similar substances,this material is not expected to be toxic for reproduction.
Mutagenicity:
Not mutagenic.
IH.COMPOSITION/INFORMATION ON INGREDIENTS
Cationic polymer in solution. Regulated components:None
IV.FIRST AID MEASURES
Note to physician:
Treatment: Treat according to symptoms.
INHALATION:
Remove to fresh air.No hazards which require special first aid measures.
INGESTION:
Rinse mouth with water.Do not induce vomiting.Get medical attention immediately if symptoms present.
SKIN CONTACT:
Wash affected areas thoroughly with soap and water.Seek medical attention if irritation persists.
EYE CONTACT:
Immediately wash affected eyes for at least 15 minutes under running water with eyelids held open.Get prompt medical attention.
V.FIRE-FIGHTING MEASURES
Flash point Does not flash
Auto-ignition temperature Does not ignite
SUITABLE EXTINGUISHING MEDIA:
Dry powder,foam,carbon dioxide,water,water spray
ADDITIONAL INFORMATION:
Avoid use of water jet.If water is used,restrict pedestrian and vehicular traffic in areas where slip hazard may exist.
Contaminated extinguishing water must be disposed o�aacccprdggFe yijh cigl riviations.
HAZARDS DURING FIRE-FIGHTING: �] p t
i
PAGE Page 2 of 4
REV. DATE: 03/22/2016
PRODUCT: FBS 521N
Evolution of fumes/fog.
Thermal decomposition may produce: hydrogen chloride gas,nitrogen oxides,carbon oxides.
Hydrogen cyanide may be produced in the event of combustion in an oxygen deficient atmosphere.
Spilled product is slippery underfoot.Extremely slippery when wet.
PROTECTIVE EQUIPMENT FOR FIRE-FIGHTING:
Wear a self-contained breathing apparatus and protective suit.
VI.ACCIDENTAL RELEASE MEASURES
PERSONAL PRECAUTIONS:
Use personal protective clothing.
ENVIRONMENTAL PRECAUTIONS:
Do not discharge into drains/surface waters/groundwater.
SPILL CLEAN UP METHODS:
Do not flush with water.Dike spill.Large spills clean up promptly by scoop or vacuum. Soak up residual material with an inert absorbent
material. Keep in suitable,closed and labeled container(s)for disposal in accordance with local,state and federal regulations.After cleaning,
flush away traces with water.
VII.HANDLING AND STORAGE
HANDLING:
Avoid contact with skin and eyes.Ensure there is adequate local/mechanical exhaust.Do not smoke.
Handle in accordance with good industrial hygiene and safety practices.
STORAGE:
Keep container tightly closed and dry;store in a cool and dry place(0-30°C).Avoid wet,damp or humid conditions,temperature extremes and
ignition sources.Freezing will affect the physical condition and may damage the product.
VIII.EXPOSURE CONTROLSIPERSONAL PROTECTION
ENGINEERING CONTROLS: Use local exhaust if misting occurs.Natural ventilation is adequate in absence of mists.
PROTECTIVE EQUIPMENT:
. ._.r: a
RESPIRATORY EQUIPMENT: Not required except in case of aerosol formation or inadequate ventilation.
HAND PROTECTION: PVC or other plastic material gloves
EYE PROTECTION: Safety glasses with side-shields;do not wear contact lenses where product is used.
SKIN PROTECION: Protective clothing
HYGIENE MEASURES: Handle in accordance with good industrial hygiene and safety practice
IX.PHYSICAL AND CHEMICAL PROPERTIES
FORM: Liquid
ODOR: Slight
COLOR: Clear to pale yellow
PH: 3-7
RELATIVE DENSITY: 1.0-1.2
VAPOR PRESSURE: 2.3 kPa @ 20°C
VAPOR DENSITY: 0.804 g/litre @ 20°C
FLASH POINT: Does not flash
FREEZING POINT: <0°C
DECOMPOSITION POINT: >150°C
SOLUBILITY IN WATER: Completely miscible
LogPow: 0
X.STABILITY AND REACTIVITY
CONDITIONS TO AVOID:
Avoid extreme temperatures.Protect from frost,heat and sunlight.
SUBSTANCES TO AVOID:
Oxidizing agents may cause exothermic reactions.
HAZARDOUS REACTIONS:
Stable under normal conditions.No hazardous reactions known.
HAZARDOUS DECOMPOSITION PRODUCTS:
Thermal decomposition may produce: hydrog �ngcFlel lcarbon oxides.
H dro rodu the event of combustion in an oxygen deficient atmosphere.
i
PAGE Page 3 of 4
REV. DATE: 03/22/2016
PRODUCT: FBS 521N
XI.TOXICOLOGICAL INFORMATION
ACUTE TOXICITY
ORAL:
Type of value: LD50
Species: rat
Value: >5,000 mg/kg
SICIN:
Type of value: LD50
Species: rabbit
Value: >5,000 mg/kg
INHALATION: Testing by the inhalation route is inappropriate because exposure to humans via inhalation is unlikely:the
substance has no vapor pressure and there is practically no exposure to inhalable solids.
IRRITATION/CORROSION
SICIN: Not irritating.
EYE: May cause slight eye irritation.
SENSITI7ATION: Not sensitizing
X11.ECOLOGICAL INFORMA'T'ION
i Fish:
Acute:
LC50/Danio rerio/96 hr: >I 00 mg/L
Aquatic invertebrates:
Acute:
EC50/Daphnia ntagna/48 hr: >I00 mg/[,
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.
Toxicity to microorganisms:
ECO/activated sludge/0.5 hr 1000 nng/L
Persistence and degradability: Not readily biodegradable.
Hydrolysis: Does not hydrolyse.
Bioaccumulation: Does not bioaccumulate
LogPonv: <0
Other information: The effects of this product in aquatic organisms are rapidly and significantly mitigated by the presence of
dissolved organic carbon the in aquatic environment.
XIII.DISPOSAL CONSIDERATIONS
WASTE iMANAGENIENT:
Dispose of in accordance with national,state and local regulations.
CONTAINER DISPOSAL:
Dispose of in a licensed facility.Recommend crushing,puncturing or other means to prevent unauthorized use of used containers.
i RCRA:
Not a hazardous waste under RCRA(40 CFR 26 1)
XIV.TRANSPORT INFORMATION
LAND TRANSPORT:
US DOT Not classified as a dangerous good under transport regulations
SEA TRANSPORT:
IMDG Not classified as a dangerous good under transport regulations
AIR TRANSPORT:
IATA/ICAO Not classified as a dangerous good under transport regulations
XV.ftEGIJLA'I'GIZY 1NFORMATION
US SARA REPORTING RE,QUIRE,RE, ME NTS:
SARA TITLE III SECTIONS: Fhlb It /t A„
SARA 311/312: Not con
PAGE Page 4 of 4
REV. DATE: 03/22/2016
PRODUCT: FBS 521N
I
STATE REGULATIONS:
California Prop.65: This product does not contain any substances known to the State of California to cause
cancer,birth defects or other reproductive harm.
INTERNATIONAL INVENTORIES:
USA(TSCA): All components are listed or exempt from listing
CANADA(DSL): All components are listed or exempt from listing
AUSTRALIA(AICS): All components are listed or exempt from listing
JAPAN(ENCS): All components are listed or exempt from listing
CHINA(IECSC): All components are listed or exempt from listing
KOREA(ECL): All components are listed or exempt from listing
XVI.OTIIER Vir,ORMATION
HAZARDOUS MATERIAL INFORMATION SYSTEM(HMIS) NATIONAL FIRE PROTECTION ASSN(NFPA)
HEALTH 0
FLAtiTMABIIITY 0
PHYSICAL 0
PERSONAL
PROTECTION
GENERAL INFORMATION:
IMPORTANT:WHILE THE DESCRIPTIONS,DESIGNS,DATA AND CONTAINED HEREIN ARE PRESENTED IN GOOD FAITH AND
BELIEVED TO BE ACCURATE, IT IS PROVIDED FOR YOUR GUIDANCE ONLY. BECAUSE MANY FACTORS MAY AFFECT PROCESSING OR
APPLICATIONIUSE,WE RECOMMEND THAT YOU MAKE TESTS TO DETERMINE THE SUITABILITY OF A PRODUCT FOR YOUR PARTICULAR
PURPOSE PRIOR TO USE. NO WARRANTIES OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE ARE MADE REGARDING PRODUCTS DESCRIBED OR DESIGNS,DATA OR
INFORMATION SET FORTH, OR THAT THE PRODUCTS, DESIGNS,DATA OR INFORMATION MAY BE USED WITHOUT INFRINGING THE
INTELLECTUAL PROPERTY RIGHTS OF OTHERS.IN NO CASE SHALL THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION PROVIDED
BE CONSIDERED A PART OF OUR TERMS AND CONDITIONS OF SALE. FURTHER YOU EXPRESSLY UNDERSTAND AND AGREE THE
DESCRIPTIONS,DESIGNS,DATA AND INFORMATION FURNISHED BY OUR COMPANY HEREUNDER ARE GIVEN GRATIS AND WE ASSUME
NO OBLIGATION OR LIABILITY FOR THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION GIVEN OR RESULTS OBTAINED,ALL SUCH
BEING GIVEN AND ACCEPTED AT YOUR RISK
Exhibit "A"
PAGEPage 1 of 4
REV. DATE: 03/22/2016
PRODUCT: FBS 591C
FBS
SAFETY DATA SHEET
� FBS 591C
Fort Lend Services.Inc.
Wnw&%Vaste Twtmcnr Sr' Wtats
I.PRODUCT AND COMPANY IDENTIFICATION
PRODUCTNAME: FBS 591C
CHEMICAL NAME:Cationic polymer
PRODUCT USE: Coagulant aid
SUPPLIER: Fort Bend Services Inc. Tel:281-261-5199
13303 Redfish Lane Tel:800-933-3678
Stafford,TX 77477 USA
EMERGENCY TELEPHONE:
CI IEMTREC: 1-800-424-9300
IDENTIFICATION NO:
It.HAZARDS IDENTIFICATION
State of Matter: Amber liquid with slight odor
Emereency overview
Caution—Slippery when wet!
Use with local exhaust ventilation.Wear protective clothing.
Eye wash fountains and safety showers must be readily accessible.
Potential health effects
Primary routes of exposure:
Routes of entry for solids and liquids include eye and skin contact,ingestion and inhalation.Routes of entry for gases include inhalation and eye
contact.Skin contact may be a route of entry for liquefied gases.
Sensitization:Non-sensitizing
Chronic toxicity:
Carcinogenicity:
Based on the absence of mutagenicity,it is unlikely the substance is carcinogenic.
Reproductive toxicity:
By analogy with similar substances,this material is not expected to be toxic for reproduction.
Mutagenicity:
Not mutagenic.
111.COMPOSITION/INFORMATION ON INGREDIENTS
Cationic polymer in solution. Regulated components:None
IV.FIRST AID MEASURES
Note to physician:
Treatment: Treat according to symptoms.
INHALATION:
Remove to fresh air.No hazards which require special first aid measures.
INGESTION:
Rinse mouth with water.Do not induce vomiting.Get medical attention immediately if symptoms present.
SKIN CONTACT:
Wash affected areas thoroughly with soap and water.Seek medical attention if irritation persists.
EYE CONTACT:
Immediately wash affected eyes for at least 15 minutes under running water with eyelids held open.Get prompt medical attention.
V.FIRE-FIGHTING MEASURES
Flash point Does not flash
Auto-ignition temperature Does not ignite
SUITABLE EXTINGUISHING MEDIA:
Dry powder,foam,carbon dioxide,water,water spray
ADDITIONAL INFORMATION:
Avoid use of water jet.If water is used,restrict pedestrian and vehicular traffic in areas where slip hazard may exist.
Contaminated extinguishing water must be disposedo ccs w-h o ici�l rg4ulations.
HAZARDS DURING FIRE-FIGHTING: nl A
i
PAGEPage 2 of 4
REV. DATE: 03/22/2016
PRODUCT: FBS 591C
Evolution of fumes/fog.
Thermal decomposition may produce: hydrogen chloride gas,nitrogen oxides,carbon oxides.
Hydrogen cyanide may be produced in the event of combustion in an oxygen deficient atmosphere.
Spilled product is slippery underfoot.Extremely slippery when wet.
PROTECTIVE EQUIPMENT FOR FIRE-FIGHTING:
Wear a self-contained breathing apparatus and protective suit.
VI.ACCIDENTAL RELEASE MEASURES
PERSONAL PRECAUTIONS:
Use personal protective clothing.
ENVIRONMENTAL PRECAUTIONS:
Do not discharge into drains/surface waters/groundwater.
SPILL CLEAN UP METHODS:
Do not flush with water.Dike spill. Large spills clean up promptly by scoop or vacuum. Soak up residual material with an inert absorbent
material. Keep in suitable,closed and labeled container(s)for disposal in accordance with local,state and federal regulations.After cleaning,
flush away traces with water.
V1I.HANDLING AND STORAGE
HANDLING:
Avoid contact with skin and eyes.Ensure there is adequate local/mechanical exhaust.Do not smoke.
Handle in accordance with good industrial hygiene and safety practices.
STORAGE:
Keep container tightly closed and dry;store in a cool and dry place(0-30°C).Avoid vet,damp or humid conditions,temperature extremes and
ignition sources.Freezing will affect the physical condition and may damage the product.
VIII.EXPOSURE CONTROLS/PERSONAL PROTECTION
ENGINEERING CONTROLS: Use local exhaust if misting occurs.Natural ventilation is adequate in absence of mists.
PROTECTIVE EQUIPMENT:
� ]
s 'sl
t 2
i
RESPIRATORY EQUIPMENT: Not required except in case of aerosol formation or inadequate ventilation.
HAND PROTECTION: PVC or other plastic material gloves
EYE PROTECTION: Safety glasses with side-shields;do not wear contact lenses where product is used.
SKIN PROTECION: Protective clothing
HYGIENE MEASURES: Handle in accordance with good industrial hygiene and safety practice
IX.PHYSICAL AND CHEMICAL PROPERTIES
FORM: Liquid
ODOR: Slight
COLOR: Clear to pale yellow
PR: 3-7
RELATIVE DENSITY: 1.0-1.2
VAPOR PRESSURE: 2.3 kPa @ 20°C
VAPOR DENSITY: 0.804 g/litre rr 20°C
FLASH POINT: Does not flash
FREEZING POINT: <00 C (26.6°F)
DECOMPOSITION POINT: >150°C
SOLUBILITY IN WATER: Completely miscible
LogPow: 0
X.STABILITY AND REACTIVITY
CONDITIONS TO AVOID:
Avoid extreme temperatures.Protect from frost,heat and sunlight.
SUBSTANCES TO AVOID:
Oxidizing agents may cause exothermic reactions.
HAZARDOUS REACTIONS:
Stable under normal conditions.No hazardous reactions known.
HAZARDOUS DECOMPOSITION PRODUCTS:
Thermal decomposition may produce: hydroge��irWt�g�lo, Alcarbon oxides.
Hydrog -� . odu the event of combustion in an oxygen deficient atmosphere.
i
I
PAGEPage 3 of 4
REV. DATE: 03/22/2016
PRODUCT: FBS 591C
XI.TOXICOLOGICAL INFORMATION
ACUTE TOXICITY
ORAL:
Type of value: LD50
Species: rat
Value: >5,000 mg/kg
SKIN:
Type of value: LD50
Species: rabbit
Value: >5,000 mg/kg
INHALATION: Testing by the inhalation route is inappropriate because exposure to humans via inhalation is unlikely:the
substance has no vapor pressure and there is practically no exposure to inhalable solids.
i
IRRITATION/CORROSION
SKIN: Not irritating.
EYE: May cause slight eye irritation.
SENSITIZATION: Not sensitizing
XII.ECOLOGICAL INFORMATION
Fish:
Acute:
LC50/Dario rerio/96 hr: >100 mg/L
Aquatic invertebrates:
Acute:
EC50/Daphnia magna/48 hr: >I 00 mg/I.
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.
Toxicity to microorganisms:
ECO/activated sludge/0.5 hr 1000 mg/l,
Persistence and degradability: Not readily biodegradable.
Hydrolysis: Does not hydrolyse.
13ionecumulation: Does not bioaccunmlate
LogPow: <0
Other Information: The effects of this product in aquatic organisms are rapidly and significantly mitigated by the presence of
dissolved organic carbon the in aquatic environment.
XIII.DISPOSAL CONSIDERATIONS
WASTE MANAGEMENT:
Dispose of in accordance with national,state and local regulations.
COIN"I'AINER DISPOSAL:
Dispose ofin a licensed facility.Recommend crushing,puncturing or other means to prevent unauthorized use of used containers.
RCRA:
Not a hazardous waste under RCRA(40 CFR 26 1)
XIV.TRANSPORT INFORMATION
LAND TRANSPORT:
US DOT Not classified as a dangerous good under transport regulations
SEA TRANSPORT:
IMDG Not classified as a dangerous good under transport regulations
AIR TRANSPORT:
hA'I A/ICAO Not classified as a dangerous good under transport regulations
XV.REGULATORY INFORMATION
US SARA REPORTING REQUIREMENTS:
SARA TITLE IH SECTIONS: �hibit A
SARA 31 t/312: Not con
PAGE Page 4 of 4
REV. DATE: 03/22/2016
PRODUCT: FBS 591C
STATE REGULATIONS:
i California Prop.65: This product does not contain any substances known to the State of California to cause
cancer,birth defects or other reproductive harm.
INTERNATIONAL INVENTORIES:
USA(TSCA): All components are listed or exempt from listing
CANADA(DSL): All components are listed or exempt from listing
AUSTRALIA(AICS): All components are listed or exempt from listing
JAPAN(ENCS): All components are listed or exempt from listing
CHINA(IECSC): All components are listed or exempt from listing
KOREA(ECL): All components are listed or exempt from listing
XVI.OTHER INFORMATION
HAZARDOUS MATERIAL INFORMATION SYSTEM(HMIS) NATIONAL FIRE PROTECTION ASSN(NFPA)
HEALTH 0
FLAMMABILITY 0
PHYSICAL 0
PERSONAL
PROTECTION
GENERAL INFORMATION:
IMPORTANT:WHILE THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION CONTAINED HEREIN ARE PRESENTED IN GOOD FAITH AND
BELIEVED TO BE ACCURATE, IT IS PROVIDED FOR YOUR GUIDANCE ONLY. BECAUSE MANY FACTORS MAY AFFECT PROCESSING OR
APPLICATIONIUSE,WE RECOMMEND THAT YOU MAKE TESTS TO DETERMINE THE SUITABILITY OF A PRODUCT FOR YOUR PARTICULAR
PURPOSE PRIOR TO USE. NO WARRANTIES OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE ARE MADE REGARDING PRODUCTS DESCRIBED OR DESIGNS,DATA OR
INFORMATION SET FORTH, OR THAT THE PRODUCTS, DESIGNS, DATA OR INFORMATION MAY BE USED WITHOUT INFRINGING THE
INTELLECTUAL PROPERTY RIGHTS OF OTHERS.IN NO CASE SHALL THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION PROVIDED
BE CONSIDERED A PART OF OUR TERMS AND CONDITIONS OF SALE. FURTHER YOU EXPRESSLY UNDERSTAND AND AGREE THE
DESCRIPTIONS,DESIGNS,DATA AND INFORMATION FURNISHED BY OUR COMPANY HEREUNDER ARE GIVEN GRATIS AND WE ASSUME
NO OBLIGATION OR LIABILITY FOR THE DESCRIPTIONS,DESIGNS,DATA AND INFORMATION GIVEN OR RESULTS OBTAINED,ALL SUCH
BEING GIVEN AND ACCEPTED AT YOUR RISK
Exhibit "A"
i
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
loft
Complete Nos.i-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.1,2,3,5,and 6 if there are no interested partes. 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. 2016-147053
Fort Bend Services, Inc.
Stafford,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 12/15/2016
being filed.
City of Round Rock,TX Date Acknowledged:
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 contracL
Purchase of Belt Press Polymer
Polymer
Nature of interest
4 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 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
,rtw w RENITA THOMPSON
*Notary Public State of Texas
• My Commission#128913773
My Comm.FItp.April 8,2020 Signa ure f authorized agent of contracting business entity
AFFIX NOTARY STAMP!SEAL ABOVE
Sworn to and subscribed before me,by the said YY\LJ ✓— this the 15 day of b eC.e Yy &
20JL,to certify which,witness my hand and seal of office.
r 't Wv\ So 1V D �c 1�L
Signature of officer administering oath Printed name of officer administering oath Title of officer admi 6
tering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277
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. 2016-147053
Fort Bend Services, Inc.
Stafford,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 12/15/2016
being filed.
City of Round Rock,TX Date Acknowledged:
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
Purchase of Belt Press Polymer
Polymer
Nature of interest
4 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 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
rtPAN,'•••+�. RENITA THOMPSON
` 4E4f Notary Public State of Texas
i y• `. My Commission#128813773
My Comm.Exp.April 8,2020 Signa ure f authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE I_
Sworn to and subscribed before me,by the said f iq rvN rr\q t a be�— ,this the � 5 day of b ICCe-ryl.�P
20_L_to certify which,witness my hand and seal of office.
-f:Ro M��n 2 11,11 o►.,\ So t�1 i� c�12L
Signature of officer administering oath Printed name of officer administering oath Title of officer admirt.1kering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
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. 2016-147053
Fort Bend Services, Inc.
Stafford,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 12/15/2016
being filed.
City of Round Rock,TX Date Acknowledged:
01/10/2017
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.
Purchase of Belt Press Polymer
Polymer
Nature of interest
4
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 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said this the day of
20 ,to certify which,witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277