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Backup Documents 10/09/2018 Item #16E 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING n WCt f' TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO nrT 9 2018 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the Co 4 Ment Office no later than Monday preceding the Board meeting. **NEW** ROUTING SLIP Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Risk Risk Management '44 IS 2. County Attorney Office County Attorney Office '447,4 I�� ciJ 4. BCC Office Board of County Commissioners °Ss-114 (l 1-K 4. Minutes and Records Clerk of Court's Office )1\1°) toI I I l L 5. Procurement Services Procurement Services PRIMARY CONTACT INFORMATION Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above,ma need to contact staff for additional or missing information. Name of Primary Staff Ana Reynoso/PURCHASING Contact Information 239-252-8950 Contact/ Department Agenda Date Item was October 9,2018 Agenda Item Number 16.E.4 Approved by the BCC Type of Document CONTRACT Number of Original 2 Attached Documents Attached PO number or account N/A 18-7321 Palmdale Oil Palmdale Oil Co. number if document is Co to be recorded INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. 1) Appli,(�ble) 1. Does the document require the chairman's original signature STAMP OK �n`'� `` IK� 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be AR signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A Office and all other parties except the BCC Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BCC approval of the AR document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's AR signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip N/A should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on /25/2018 and all changes made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made,and the document is ready for the Chairman's signature. 16E 4 MEMORANDUM Date: October 11, 2018 To: Ana Reynoso, Procurement Services From: Martha Vergara, Sr. Deputy Clerk Minutes & Records Department Re: Contract #18-7281 "Gas & Diesel Fuel Multi-Agency Cooperative Purchase" Contractor: Palmdale Oil Company, Inc. Attached for your records is an original of each referenced document above, (Item #16E4) adopted by the Board of County Commissioners on Tuesday, October 9, 2018. The Board's Minutes & Records Department has kept an original as part of the Board's Official Records. If you have any questions, please feel free to contact me at 252-7240. Thank you. Attachment 16E4 FIXED TERM SERVICE AGREEMENT # 18-7321 for Gas and Diesel Fuel Multi-Agency Cooperative Purchase THIS AGREEMENT, made and entered into on this day of ()C20 I , by and between Palmdale Oil Company, Inc. , authorized to do business in the State of Florida, whose business address is 911 N. 2nd Street Fort Pierce, Florida 34950 , (the "Contractor") and Collier County, a political subdivision of the State of Florida, (the "County"): WITNESSETH: 1. AGREEMENT TERM. The Agreement shall be for a three (3 ) year period, commencing 1.1 upon the date of Board approval or❑ on and terminating on three (3 ) year(s) from that date or until all outstanding Purchase Order(s) issued prior to the expiration of the Agreement period have been completed or terminated. The County may, at its discretion and with the consent of the Contractor, renew the Agreement under all of the terms and conditions contained in this Agreement for two (2 ) additional one ( 1 ) year(s) periods. The County shall give the Contractor written notice of the County's intention to renew the Agreement term prior to the end of the Agreement term then in effect. The County Manager, or his designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred and eighty (180) days. The County Manager, or his designee, shall give the Contractor written notice of the County's intention to extend the Agreement term prior to the end of the Agreement term then in effect. 2. COMMENCEMENT OF SERVICES. The Contractor shall commence the work upon issuance of a ® Purchase Order ❑Notice to Proceed. 3. STATEMENT OF WORK. The Contractor shall provide services in accordance with the terms and conditions of n 'Request for Proposal (RFP) Invitation to Bid (ITB) • Other Invitation to Negotiate ( ITN ) # 18-7321, including all Attachment(s), Exhibit(s) and Addenda and the Contractor's proposal referred to herein and made an integral part of this Agreement. • The Contractor shall also provide services in accordance with Exhibit A — Scope of Services attached hereto. Page 1 of 17 Fixed Term Service Agreement 112017-002(Ver.1) 16E4 E 4 3.1 This Agreement contains the entire understanding between the parties and any modifications to this Agreement shall be mutually agreed upon in writing by the Parties, in compliance with the County's Procurement Ordinance, as amended, and Procurement Procedures in effect at the time such services are authorized. 4. THE AGREEMENT SUM. The County shall pay the Contractor for the performance of this Agreement based on Exhibit B- Fee Schedule, attached hereto and the price methodology as defined in Section 4.1. Payment will be made upon receipt of a proper invoice and upon approval by the County's Contract Administrative Agent/Project Manager, and in compliance with Chapter 218, Fla. Stats., otherwise known as the "Local Government Prompt Payment Act". 4.1 Price Methodology (as selected below): transferred from the County to the contractor; and, as a business practice thcrc arc no hourly or material invoices presented, rather, the contractor must perform to the is authorized. . . . - documentation for the project. • Unit Price: The County agrees to pay a firm total fixed price (inclusive of all costs, including labor, materials, equipment, overhead, etc.) for a repetitive product or service delivered (i.e. installation price per ton, delivery price per package or carton, etc.). The invoice must identify the unit price and the number of units received (no contractor inventory or cost verification). 4.2 Any County agency may obtain services under this Agreement, provided sufficient funds are included in their budget(s). 4.3 Payments will be made for services furnished, delivered, and accepted, upon receipt and approval of invoices submitted on the date of services or within six (6) months after completion of the Agreement. Any untimely submission of invoices beyond the specified deadline period is subject to non-payment under the legal doctrine of "laches" as untimely submitted. Time shall be deemed of the essence with respect to the timely submission of invoices under this Agreement. Page 2 of 17 Fixed Term Service Agreement#2017-002(Ver.I) IÔE 4 4.4 n • _ Reimbursable Expenses must be approved in advance in writing by the County. Travel expenses shall be reimbursed as per Section 112.061 Fla. Stats. Reimbursements shall be at the following rates: Mileage $0.44.5 per mile Brea # et Lunch -13044er $4-19708 vehieles -. .. - _ ,. !.0: -'e Actual cost of parking Taxi or Airport Limousine Actual cost of either taxi or airport limousine Reimbursable items other than travel expenses shall be limited to the following: telephone items will be paid only after Contractor has provided all receipts. Contractor shall be 5. SALES TAX. Contractor shall pay all sales, consumer, use and other similar taxes associated with the Work or portions thereof, which are applicable during the performance of the Work. Collier County, Florida as a political subdivision of the State of Florida, is exempt from the payment of Florida sales tax to its vendors under Chapter 212, Florida Statutes, Certificate of Exemption # 85-8015966531C. 6. NOTICES. All notices from the County to the Contractor shall be deemed duly served if mailed or emailed to the Contractor at the following: Company Name: Palmdale Oil Company, Inc. Address: 911 N. 2nd Street Fort Pierce, Florida 34950 Authorized Agent: Lachlan Chestham, President Attention Name & Title: Robert Talley, Operations Manager Telephone: 863-763-3617 E-Mail(s): transport@palmdaleoil.com All Notices from the Contractor to the County shall be deemed duly served if mailed or emailed to the County to: Page 3 of 17 Fixed Term Service Agreement#2017-002(Ver.1) 16E4 Board of County Commissioners for Collier County, Florida Division Name: Fleet Management Division Director: Dan Croft Address: 2901 County Barn Road Naples, Florida 34112 Administrative Agent/PM: Mario Menendez, Senior Operations Analyst Telephone: 239-252-4170 E-Mail(s): Mario.Menendez@colliercountyfl.gov The Contractor and the County may change the above mailing address at any time upon giving the other party written notification. All notices under this Agreement must be in writing. 7. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating a partnership between the County and the Contractor or to constitute the Contractor as an agent of the County. 8. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits necessary for the prosecution of the Work shall be obtained by the Contractor. The County will not be obligated to pay for any permits obtained by Subcontractors. Payment for all such permits issued by the County shall be processed internally by the County. All non-County permits necessary for the prosecution of the Work shall be procured and paid for by the Contractor. The Contractor shall also be solely responsible for payment of any and all taxes levied on the Contractor. In addition, the Contractor shall comply with all rules, regulations and laws of Collier County, the State of Florida, or the U. S. Government now in force or hereafter adopted. The Contractor agrees to comply with all laws governing the responsibility of an employer with respect to persons employed by the Contractor. 9. NO IMPROPER USE. The Contractor will not use, nor suffer or permit any person to use in any manner whatsoever, County facilities for any improper, immoral or offensive purpose, or for any purpose in violation of any federal, state, county or municipal ordinance, rule, order or regulation, or of any governmental rule or regulation now in effect or hereafter enacted or adopted. In the event of such violation by the Contractor or if the County or its authorized representative shall deem any conduct on the part of the Contractor to be objectionable or improper, the County shall have the right to suspend the Agreement of the Contractor. Should the Contractor fail to correct any such violation, conduct, or practice to the satisfaction of the County within twenty-four (24) hours after receiving notice of such violation, conduct, or practice, such suspension to continue until the violation is cured. The Contractor further agrees not to commence operation during the suspension period until the violation has been corrected to the satisfaction of the County. Page 4 of 17 Fixed Term Service Agreement#2017-002(Ver.1) 16E4 10. TERMINATION. Should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said Agreement for cause; further the County may terminate this Agreement for convenience with a thirty (30) day written notice. The County shall be sole judge of the non-performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. 11. NO DISCRIMINATION. The Contractor agrees that there shall be no discrimination as to race, sex, color, creed or national origin. 12. INSURANCE. The Contractor shall provide insurance as follows: A. ■ Commercial General Liability: Coverage shall have minimum limits of $ 1,000,000 Per Occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. B. I■I Business Auto Liability: Coverage shall have minimum limits of $ 1,000,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include: Owned Vehicles, Hired and Non-Owned Vehicles and Employee Non-Ownership. C. Workers' Compensation: Insurance covering all employees meeting Statutory Limits in compliance with the applicable state and federal laws. The coverage must include Employers' Liability with a minimum limit of $ 1,000,000 for each accident. Be- ••_.• : e . e• e e liability for claims arising out of the performance of professional services under this this insurance. Such insurance shall have limits of not less than $ each E. I I Cyber Liability: Coverage shall have minimum limits of$ per claim. F. IN Pollution : Coverage shall have minimum limits of $ 1,000,000 per claim. Page 5 of 17 Fixed Term Service Agreement#2017-002(Ver.1) 16E4 Special Requirements: Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR, Collier County Government shall be listed as the Certificate Holder and included as an "Additional Insured" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Contractor's policy shall be endorsed accordingly. Current, valid insurance policies meeting the requirement herein identified shall be maintained by Contractor during the duration of this Agreement. The Contractor shall provide County with certificates of insurance meeting the required insurance provisions. Renewal certificates shall be sent to the County thirty (30) days prior to any expiration date. Coverage afforded under the policies will not be canceled or allowed to expire until the greater of: thirty (30) days prior written notice, or in accordance with policy provisions. Contractor shall also notify County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Contractor from its insurer, and nothing contained herein shall relieve Contractor of this requirement to provide notice. Contractor shall ensure that all subcontractors comply with the same insurance requirements that the Contractor is required to meet. 13. INDEMNIFICATION. To the maximum extent permitted by Florida law, the Contractor shall defend, indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, whether resulting from any claimed breach of this Agreement by Contractor, any statutory or regulatory violations, or from personal injury, property damage, direct or consequential damages, or economic loss, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor or anyone employed or utilized by the Contractor in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. 13.1 The duty to defend under this Article 13 is independent and separate from the duty to indemnify, and the duty to defend exists regardless of any ultimate liability of the Contractor, County and any indemnified party. The duty to defend arises immediately upon presentation of a claim by any party and written notice of such claim being provided to Contractor. Contractor's obligation to indemnify and defend under this Article 13 will survive the expiration or earlier termination of this Agreement until it is determined by final judgment that an action against the County or an indemnified party for the matter indemnified hereunder is fully and finally barred by the applicable statute of limitations. Page 6 of 17 Fixed Term Service Agreement#2017-002(Ver.l) 16E 14. AGREEMENT ADMINISTRATION. This Agreement shall be administered on behalf of the County by the Fleet Management Division 15. CONFLICT OF INTEREST. Contractor represents that it presently has no interest and shall acquire no interest, either direct or indirect, which would conflict in any manner with the performance of services required hereunder. Contractor further represents that no persons having any such interest shall be employed to perform those services. 16. COMPONENT PARTS OF THIS AGREEMENT. This Agreement consists of the following component parts, all of which are as fully a part of the Agreement as if herein set out verbatim: Contractor's Proposal, Insurance Certificate(s), 511 Exhibit A Scope of Services, Exhibit B Fee Schedule, n RFP/ ❑ 443/51 Other Invitation to Negotiate #18-7321 , including Exhibits, Attachments and Addenda/Addendum, ❑ subsequent quotes, and ■ Other Exhibit/Attachment: Federal Grant Provisions 17. APPLICABILITY. Sections corresponding to any checked box ( ■ ) expressly apply to the terms of this Agreement. 18. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between the parties herein that this Agreement is subject to appropriation by the Board of County Commissioners. 19. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311. Violation of this provision may result in one or more of the following consequences: a. Prohibition by the individual, firm, and/or any employee of the firm from contact with County staff for a specified period of time; b. Prohibition by the individual and/or firm from doing business with the County for a specified period of time, including but not limited to: submitting bids, RFP, and/or quotes; and, c. immediate termination of any Agreement held by the individual and/or firm for cause. 20. COMPLIANCE WITH LAWS. By executing and entering into this Agreement, the Contractor is formally acknowledging without exception or stipulation that it agrees to comply, at its own expense, with all federal, state and local laws, codes, statutes, ordinances, rules, regulations and requirements applicable to this Agreement, including but not limited to those dealing with the Immigration Reform and Control Act of 1986 as located at 8 U.S.C. 1324, et seq. and regulations relating thereto, as either may be amended; taxation, workers' compensation, equal employment and safety including, but not limited to, the Trench Safety Act, Chapter 553, Florida Statutes, and the Florida Public Records Law Chapter 119, including specifically those contractual requirements at F.S. § 119.0701(2)(a)-(b) as stated as follows: Page 7 of 17 Fixed Term Service Agreement#2017-002(Ver.l) 1 6 E 4 IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE CONTRACTOR'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT: Communication and Customer Relations Division 3299 Tamiami Trail East, Suite 102 Naples, FL 34112-5746 Telephone: (239) 252-8383 The Contractor must specifically comply with the Florida Public Records Law to: 1. Keep and maintain public records required by the public agency to perform the service. 2. Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law. 3. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the Contractor does not transfer the records to the public agency. 4. Upon completion of the contract, transfer, at no cost, to the public agency all public records in possession of the Contractor or keep and maintain public records required by the public agency to perform the service. If the Contractor transfers all public records to the public agency upon completion of the contract, the Contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the Contractor keeps and maintains public records upon completion of the contract, the Contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. If Contractor observes that the Contract Documents are at variance therewith, it shall promptly notify the County in writing. Failure by the Contractor to comply with the laws referenced herein shall constitute a breach of this Agreement and the County shall have the discretion to unilaterally terminate this Agreement immediately. 21. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County encourages and agrees to the successful Contractor extending the pricing, terms and conditions of this solicitation or resultant Agreement to other governmental entities at the discretion of the successful Contractor. Page 8 of 17 Fixed Term Service Agreement 42017-002(Ver.1) IÔF 6 F 22. PAYMENTS WITHHELD. The County may decline to approve any application for payment, or portions thereof, because of defective or incomplete work, subsequently discovered evidence or subsequent inspections. The County may nullify the whole or any part of any approval for payment previously issued and the County may withhold any payments otherwise due Contractor under this Agreement or any other Agreement between the County and Contractor, to such extent as may be necessary in the County's opinion to protect it from loss because of: (a) defective Work not remedied; (b) third party claims failed or reasonable evidence indicating probable fling of such claims; (c) failure of Contractor to make payment properly to subcontractors or for labor, materials or equipment; (d) reasonable doubt that the Work can be completed for the unpaid balance of the Contract Amount; (e) reasonable indication that the Work will not be completed within the Contract Time; (f) unsatisfactory prosecution of the Work by the Contractor; or (g) any other material breach of the Contract Documents. If any conditions described above are not remedied or removed, the County may, after three (3) days written notice, rectify the same at Contractor's expense. The County also may offset against any sums due Contractor the amount of any liquidated or unliquidated obligations of Contractor to the County, whether relating to or arising out of this Agreement or any other Agreement between Contractor and the County. 23. n _ A - e-_ a --_- a .- - - .. e e rubbish and waste materials arising out of the Work. At the completion of the Work, materials, and shall leave the Project site clean. 24. STANDARDS OF CONDUCT: PROJECT MANAGER, SUPERVISOR, EMPLOYEES. The Contractor shall employ people to work on County projects who are neat, clean, well-groomed and courteous. Subject to the American with Disabilities Act, Contractor shall supply competent employees who are physically capable of performing their employment duties. The County may require the Contractor to remove an employee it deems careless, incompetent, insubordinate or otherwise objectionable and whose continued employment on Collier County projects is not in the best interest of the County. 25. WARRANTY, Contractor expressly warrants that the goods, materials and/or Page 9 of 17 Fixed Term Service Agreement#2017-002(Ver.1) 16E4 fabricators, suppliers or processors-except as otherwise provided for in the Contract Documents. If, within one (1) year after final completion, any Work is found to be defective or not in conformance with the Contract Documents, Contractor shall correct it promptly after receipt of written notice from the County. Contractor shall also be responsible for and pay for replacement or repair of adjacent materials or Work which may be damaged as a result of such replacement or repair. These warranties arc in addition to those implied 26. I I TESTS AND INSPECTIONS. If the Contract Documents or any codes, laws, Contractor shall assume full responsibility therefore, pay all costs in connection therewith 27. n A. Contractor shall fully protect the Work from loaf or damage and shall bear the cost of any such lose or damage until final payment has been made. If Contractor or to replace such loss or damage shall be deducted from any amounts due Contractor. B. Contractor shall not load nor permit any part of any structure to be loaded in any Work or adjacent property to stresses or pressures that will endanger it. C. Contractor shall not disturb any benchmark established by the County with respect to the Project. If Contractor, or its subcontractors, agents or anyone, for whom 28. SUBMITTALS AND SUBSTITUTIONS. Any substitution of products/materials form specifications shall be approved in writing by the County in advance. 29. CHANGES IN THE WORK. The County shall have the right at any time during the progress of the Work to increase or decrease the Work. Promptly after being notified of a change, Contractor shall submit an estimate of any cost or time increases or savings it foresees as a result of the change. Except in an emergency endangering life or property, or as expressly set forth herein, no addition or changes to the Work shall be made except upon modification of the Purchase Order by the County, and the County shall not be liable to the Contractor for any increased compensation without such modification. No officer, employee or agent of the County is authorized to direct any extra or changed work orally. Any modifications to this Agreement shall be in compliance with the County Procurement Ordinance and Procedures in effect at the time such modifications are authorized. Page 10 of 17 Fixed Term Service Agreement#2017-002(Ver.1) • z3, 9 16E4 30. AGREEMENT TERMS. If any portion of this Agreement is held to be void, invalid, or otherwise unenforceable, in whole or in part, the remaining portion of this Agreement shall remain in effect. 31. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to this Agreement in compliance with the Procurement Ordinance, as amended, and Procurement Procedures. 32. DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. The negotiation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached during negotiations to County for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation shall be attended by representatives of Contractor with full decision-making authority and by County's staff person who would make the presentation of any settlement reached at mediation to County's board for approval. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under section 44.102, Fla. Stat. 33. VENUE. Any suit or action brought by either party to this Agreement against the other party relating to or arising out of this Agreement must be brought in the appropriate federal or state courts in Collier County, Florida, which courts have sole and exclusive jurisdiction on all such matters. 34. - . , ., �., ----.----_- s : - e r . . - e as many people as necessary to complete the services on a timely basis, and each person The Contractor shall make commercially reasonable efforts to notify Collier County within seven (7) days of the change. The County retains final approval of proposed replacement personnel. AGREEMENT STAFFING. The Contractor's personnel and management to be utilized for this Agreement shall be knowledgeable in their areas of expertise. The County reserves the right to perform investigations as may be deemed necessary to ensure that competent persons will be utilized in the performance of the Agreement. The Contractor shall assign as many people as necessary to complete required services on a timely basis, and each person assigned shall be available for an amount of time adequate to meet required services. Page 11 of 17 Fixed Term Service Agreement#2017-002(Ver.l) 16E4 35. n . - . • - .. .- - -• - .. ._ --- _ - - e ._ - .. and/or thc County's Beard approved Executive Summary, thc Contract Documents shall take preccdcncc. • ORDER OF PRECEDENCE (Grant Funded). In the event of any conflict between or among the terms of any of the Contract Documents and/or the County's Board approved Executive Summary, the terms of the Agreement shall take precedence over the terms of all other Contract Documents, except the terms of any Supplemental Conditions shall take precedence over the Agreement. To the extent any conflict in the terms of the Contract Documents cannot be resolved by application of the Supplemental Conditions, if any, or the Agreement, the conflict shall be resolved by imposing the more strict or costly obligation under the Contract Documents upon the Contractor at County's discretion. 36. ASSIGNMENT. Contractor shall not assign this Agreement or any part thereof, without the prior consent in writing of the County. Any attempt to assign or otherwise transfer this Agreement, or any part herein, without the County's consent, shall be void. If Contractor does, with approval, assign this Agreement or any part thereof, it shall require that its assignee be bound to it and to assume toward Contractor all of the obligations and responsibilities that Contractor has assumed toward the County. 37. SECURITY. The Contractor is required to comply with County Ordinance 2004-52, as amended. Background checks are valid for five (5) years and the Contractor shall be responsible for all associated costs. If required, Contractor shall be responsible for the costs of providing background checks by the Collier County Facilities Management Division for all employees that shall provide services to the County under this Agreement. This may include, but not be limited to, checking federal, state and local law enforcement records, including a state and FBI fingerprint check, credit reports, education, residence and employment verifications and other related records. Contractor shall be required to maintain records on each employee and make them available to the County for at least four(4)years. All of Contractor's employees and subcontractors must wear Collier County Government Identification badges at all times while performing services on County facilities and properties. Contractor ID badges are valid for one (1) year from the date of issuance and can be renewed each year at no cost to the Contractor during the time period in which their background check is valid, as discussed below. All technicians shall have on their shirts the name of the contractor's business. The Contractor shall immediately notify the Collier County Facilities Management Division via e-mail (DL-FMOPS@colliergov.net) whenever an employee assigned to Collier County separates from their employment. This notification is critical to ensure the continued security of Collier County facilities and systems. Failure to notify within four (4) hours of separation may result in a deduction of$500 per incident. Page 12 of 17 Fixed Term Service Agreement#2017-002(Ver.1) 16E4 38. n SAFETY. All Contractors and subcontractors performing service for Collier County are required and shall comply with all Occupational Safety and Health Administration (OSHA), State and County Safety and Occupational Health Standards and any other applicable rules and regulations. Also, all Contractors and subcontractors shall be responsible for the safety of their employees and any unsafe acts or conditions that may cause injury or damage to any persons or property within and around the work site. Collier County Government has authorized the Occupational Safety and Health Administration (OSHA) to enter any Collier County Facility, property and/or right-of-way for the purpose of inspection of any Contractor's work operations. This provision is non- negotiable by any division/department and/or Contractor. All applicable OSHA inspection criteria apply as well as all Contractor rights, with one exception. Contractors do not have the right to refuse to allow OSHA onto a project that is being performed on Collier County Property. Collier County, as the owner of the property where the project is taking place shall be the only entity allowed to refuse access to the project. However, this decision shall only be made by Collier County's Risk Management Division Safety Manager and/or Safety Engineer. (Intentionally left blank-signature page to follow) Page 13 of 17 Fixed Term Service Agreement#2017-002(Ver.1) 16E4 IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person or agent, have executed this Agreement on the date and year first written above. ATTEST: BOARD OF OU TY COM • ERS COLLIE' COU fY FLO- r / Crystal K. Kinzel,'Clerk of Courts & r , Co • .l -r i\ B 0 = Andy Solis, Esq. , Chairman Dated: & A IA A 20 (SEAL) Attes as to airman's signature only. Contractor's Witnesses: Palmdale Oil Company, Inc. Contractor By: Contractor's First Witness ignatur L l�� Cha/% I VL 1\C L&"`( TType/print signature and title TType/print wi�lness nameT Contractor's Second V1,itness TType/print witness nameT A••rov-d as to F. • ant Legality: Ag ' ,.� ount Attorney em. _ / ,IP Print Name Page 14of17 Fixed Term Service Agreement#2017-002(Ver.I) 16E4 Exhibit A Scope of Services �U following this page (containing 4 pages) _ this exhibit is not applicable Page 15 of 17 Fixed Term Service Agreement#2017-002(Ver.l) 16E4 18-7321 Gas and Diesel Fuel`Multi-Agency Cooperative Purchase SCOPE OF SERVICES These services are intended for the furnishing and delivering of unleaded gasoline and diesel fuel on an as-needed basis to government agencies and locations throughout Collier County, Lee County, and Charlotte County. Projected Annual Requirements Collier County The quantities listed below are approximate and are for the purpose of proposal evaluation. The County reserves the right to order such quantities as may be required during the contract period, but no guarantee is made as to any minimum or maximum amounts. Product Specifications Estimated Annual Usage(Gallons) Unleaded Gasoline Regular 87 AKI 650,000 All gasoline shall be volatile hydrocarbon fuel, free from water and suspended matter, and suitable for use as a fuel in internal combustion engines, must meet or exceed State of Florida specifications. Gasohol or alcohol additives, must not exceed 10% by volume. All unleaded gasoline must have a minimum of a "maintenance"detergent dose of injector cleaning additive. Product Estimated Annual Usage (Gallons) #2 Off-Road Diesel Fuel 670,000 #2 On-Road Ultra Low Sulfur Diesel 70,000 The No. 2 diesel fuel must be suitable for use in diesel engines and free from water, foreign matter and must meet or exceed State and Federal specifications. Ultra-Low Sulfur Diesel must have a sulfur content of 15PPM or less and meet all Federal standards for use in mandated diesel engine low emission systems. No. 2 diesel shall have a cetane rating of 42 or higher based on standard industrial testing. Collier County reserves the right to modify the product specifications in order to comply with future mandates. Product, Locations and Storage Capacities: The following is a list of current and anticipated primary delivery locations within the boundaries of Collier County. The County reserves the right to add or delete delivery locations, through an Amendment, during the term of the contract. Location Storage Capacity Product (Gallons) Chiller Building Generator 4,000 Diesel Fuel 3301 Tamiami Trail East Health & Community Services Bldg. Generator 4,000 Diesel Fuel 3301 Tamiami Trail East Administration Bldg. Generator 6,000 Diesel Fuel 3301 Tamiami Trail East Naples County Barn 20,000 Unleaded Gasoline* 2901 County Barn Road 10,000 Diesel Fuel* 10,000 Diesel Fuel* Davis Boulevard Maintenance Facilities 10,000 Unleaded Gasoline* 4800 Davis Boulevard 10,000 Diesel Fuel* CAT Bus Terminal 14,000 Diesel Fuel* Radio Rd./Davis Blvd. North County Wastewater Treatment Facility 24,000 Diesel Fuel* 10500 Goodlette Road Page 1 of 4 16E4 South County Wastewater 10,000 Diesel Fuel* Treatment Facility 5600 Warren Street South County Regional Water Plant 10,000 Diesel Fuel* 3851 Utilities Drive North County Regional Water Plant 40,000 Diesel Fuel* 8005 Vanderbilt Road Ext. Carica Repump Station 15,000 Diesel Fuel* Carica Road lmmokalee County Barn 10,000 Unleaded Gasoline* 402 Stockade Road 10,000 Diesel* *Above Ground Tank Each location listed above shall be considered one stop. There shall be no additional cost to deliver fuel to separate tanks within the same location,to deliver a transport with two types of fuel to the same location,to deliver a transport of one or two types of fuel to two (2) different locations, or to deliver a tank wagon of one or two types of fuel to multiple locations. The School District of Lee County The quantities listed below are approximate and are for the purpose of proposal evaluation. The School District reserves the right to order such quantities as may be required during the contract period, but no guarantee is made as to any minimum or maximum amounts. Product Specifications Estimated Annual Usage(Gallons) Unleaded Gasoline Standard 90 AKI 220,000 Product Estimated Annual Usage(Gallons) #2 On Road Diesel Fuel 2,800,000 Product, Locations and Storage Capacities: The following is a list of current and anticipated primary delivery locations within the boundaries of Lee County. The School District reserves the right to add or delete delivery locations during the term of the contract. Location Storage Capacity Product Transportation South 10,000 Diesel Fuel* 9251 Williams Road Estero, Florida 33928 Transportation Central 12,000 Diesel Fuel* 3234 Canal Street 12,000 Unleaded Gasoline* Fort Myers, FL 33916 Transportation East 10,000 Diesel Fuel* 3291 Buckingham Road Fort Myers, FL 33905 Transportation Leonard 20,000 Diesel Fuel* 301 Leonard Blvd 12,000 Unleaded Gasoline* Lehigh Acres, FL 33971 Six Mile Cypress 20,000 Diesel Fuel* 14701 Ben C. Pratt 18,000 Unleaded Gasoline* Six Mile Cypress Parkway Fort Myers, FL 33912 Transportation West 10,000 Diesel Fuel* 450 N.W. 14th Avenue 2,000 Unleaded Gasoline* Cape Coral, FL 33909 *Above Ground Tank Page 2 of 4 1 6 E 4 City of Naples The quantities listed below are approximate and are for the purpose of proposal evaluation. The City of Naples reserves the right to order such quantities as may be required during the contract period, but no guarantee is made as to any minimum or maximum amounts. Product Specifications Estimated Annual Usage (Gallons) Unleaded Gasoline Regular 87 AKI 145,000 Unleaded Gasoline Ethanol Free 90 200,000 Product Estimated Annual Usage (Gallons) #2 Off-Road Diesel Fuel 100,000 #2 On-Road Ultra Low Sulfur Diesel 12,000 Product, Locations and Storage Capacities: The following is a list of current and anticipated primary delivery locations within the boundaries of the City of Naples. Location Storage Capacity Product (Gallons) City of Naples 12,000 Unleaded Gasoline* Equipment Services 12,000 Diesel Fuel* 370 Riverside Circle City of Naples 12,000 Diesel Fuel* Water Plant 1000 Fleishmann Blvd City of Naples 12,000 Diesel Fuel* Wastewater Plant 1400 3rd Avenue North City Dock 4,000 Ethanol Free 90 880 12th Avenue South Octane Gasoline 4,000 Diesel Fuel Police Department 550 Diesel Fuel* 355 Riverside Circle City Hall 500 Diesel Fuel* 735 8th Street South Development Services 500 Diesel Fuel* 295 Riverside Circle East Naples Tank Site 2,700 Diesel Fuel* 2270 Pineland Avenue Port Royal Tank Site 500 Diesel Fuel* 2680 Lantern Lane Solana Tank Site 2,700 Diesel Fuel* 1601 Burning Tree Drive Pine Ridge Genset(Services wells 323-328) 330 Diesel Fuel* 7300 Goodlette Road Golden Gate Well 420 Genset(Services wells 419-421) 500 Diesel Fuel* 3871 20th Ave NE Golden Gate Well 423 Genset 500 Diesel Fuel* 210 Everglades Blvd North Golden Gate Well 425 Genset 3870 500 Diesel Fuel* 24th Avenue NE Utilities Operations 510 Diesel Fuel* 380 Riverside Circle 6th Street& Central Bypass Pump 150 Diesel Fuel* Lift Station 34 Page 3 of 4 16E4 Port Royal— Half Moon Bypass 150 Diesel Fuel* Sewer Lift Station 38 Master Lift Bypass Pump 150 Diesel Fuel* 10th Street South, & Broad Avenue South (Sewer Lift Station 49) Royal Harbour- Marlin Drive Lift Bypass Pump 150 Diesel Fuel* (Sewer Lift Station 56) Cove Storm Pump Station 1,000 Diesel Fuel* (Storm Water) 4000 Gulfshore Boulevard North 150 Diesel Fuel* Genset(Sewer Lift Station 24) Public Works Storm Pump Station 1,000 Diesel Fuel* Cove Storm Pump (Storm Water) 225 Diesel Fuel* *Above Ground Tank Charlotte County School Board The quantities listed below are approximate and are for the purpose of proposal evaluation. The School Board reserves the right to order such quantities as may be required during the contract period, but no guarantee is made as to any minimum or maximum amounts. Product Specifications Estimated Annual Usage (Gallons) Unleaded Gasoline Regular 87 AKI 44,300 Product Estimated Annual Usage (Gallons) #2 Off-Road Diesel Fuel 6,000 #2 On-Road Ultra Low Sulfur Diesel 242,400 The No. 2 diesel fuel must be suitable for use in diesel engines and free from water, foreign matter and must meet or exceed State and Federal specifications. Ultra-Low Sulfur Diesel must have a sulfur content of 15PPM or less and meet all Federal standards for use in mandated diesel engine low emission systems. No. 2 diesel shall have a cetane rating of 42 or higher based on standard industrial testing. Collier County reserves the right to modify the product specifications in order to comply with future mandates. Product, Locations and Storage Capacities: The following is a list of current and anticipated primary delivery locations within the boundaries of Charlotte County. The Charlotte County reserves the right to add or delete delivery locations during the term of the contract. Location Storage Capacity Product Punta Gorda 5,000 Unleaded Gasoline* Transportation, 1025 10,000 Diesel Fuel* Carmalita St, Punta Gorda, FL Murdock Transportation 10,000 Unleaded Gasoline* 17490 Abbott Ave, Port Charlotte, FL 33954 10,000 Diesel Fuel* Englewood Transportation 4,000 Unleaded Gasoline 255 Cougar Way, Rotonda West, 33947 10,000 Diesel Fuel Various Schools Standby Generators 150-850 Diesel Fuel* (See Attachment A for Locations) *Above Ground Tank Each location listed above shall be considered one stop. There shall be no additional cost to deliver fuel to separate tanks within the same location,to deliver a transport with two types of fuel to the same location, to deliver a transport of one or two types of fuel to two (2) different locations, or to deliver a tank wagon of one or two types of fuel to multiple locations. Page 4 of 4 16E4 Exhibit B Fee Schedule following this page (containing 1 pages) Page 16 of 17 Fixed Term Service Agreement#2017-002(Ver.l) 16E4 ITN# 18-7321 Gas and Diesel Fuel Multi-Agency Cooperative Purchase Palmdale Negotiated Rates Negotiated Mark Up Charlotte County Schools (Per Gallon) Regular Unleaded 87 Transport Loads 0.0189 #2 Off Road Diesel Transp Loads N/A On Road Diesel Transport Loads 0.0347 All Products Normal Tank Wagon Deliveries 0.11 Negotiated Mark Up Collier County (Per Gallon) Regular Unleaded 87 Transport Loads 0.0273 #2 Off Road Diesel Transport Loads 0.035 On Road Diesel Transport Loads 0.035 All Products Normal Tank Wagon Deliveries 0.11 Negotiated Mark Up Lee County Schools (Per Gallon) Regular Unleaded 87 Transport Loads 0.0275 #2 Off Road Diesel Transport Loads N/A On Road Diesel Transport Loads 0.0382 All Products Normal Tank Wagon Deliveries 0.11 Negotiated Mark Up City of Naples (Per Gallon) Regular Unleaded 87 Transport Loads 0.0273 #2 Off Road Diesel Transport Loads 0.035 On Road Diesel Transport Loads 0.035 All Products Normal Tank Wagon Deliveries 0.0273 Additional Information: 1.Palmdale will eliminate all emergency delivery fees. Caveat:Agencies identified in the solicitation agree to work with Palmdale Oil Company,Inc if the vendor is required pay abnormally high prices to obtain fuel during the event of an emergency i.e. Hurricane. Palmdale Oil Company,Inc.will provide supporting documentation to justify any increase. 2. $35.00 split load fee,if govt agency requests. No fee,if Palmdale coordinates a split load 3.Government agencies will pay no fee for monitoring 4.Pricing shall remain firm for the initial term 16E4 4 Other Exhibit/Attachment Description: Federal Grant Provisions • following this page (containing 10 pages) n this exhibit is not applicable Page 17 of 17 Fixed Term Service Agreement#2017-002(Ver.1) 16E 4 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES FEDERAL PROVISIONS This project activity is funded in whole or in part by the Federal Government, or an Agency thereof. Federal Law requires that the Applicant's contracts relating to the project include certain provisions. Per uniform requirements of federal awards (2 CFR Part 200.23) the definition of CONTRACTOR is an entity that receives a contract(including a purchase order). Reporting: The contractor will provide any information required to comply with the grantor agency requirements and regulations pertaining to reporting. It is important that the contractor is aware of the reporting requirements of the County, as the Federal or State granting agency may require the contractor to provide certain information, documentation, and other reporting in order to satisfy reporting requirements to the granting agency. Access to Records: (1) The contractor agrees to provide the County, the FEMA/FTA Administrator, the Comptroller General of the United States, or any of their authorized representative's access to any books, documents, papers, and records of the Contractor which are directly pertinent to this contract for the purposes of making audits, examinations, excerpts, and transcriptions. (2)The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed. (3)The contractor agrees to provide the FEMA/FTA Administrator or his authorized representatives' access to construction or other work sites pertaining to the work being completed under the contract. DHS Seal, Logo, and Flags: The contractor shall not use the Department of Homeland Security seal(s), logos, crests, or reproductions of flags or likenesses of DHS agency officials without specific FEMA pre- approval. No Obligation by Federal Government: The Federal Government is not a party to this contract and is not subject to any obligations or liabilities to the non-Federal entity, contractor, or any other party pertaining to any matter resulting from the contract. Program Fraud and False or Fraudulent Statements or Related Acts: The contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements) applies to the contractor's actions pertaining to this contract. Energy Efficiency Standards: The contractor agrees to comply with mandatory standards and policies relating to energy efficiency which are contained in the state energy conservation plan issued in compliance with the Energy Policy and Conservation Act. Termination: Unless otherwise provided in this contract, should the Contractor be found to have failed to perform his services in a manner satisfactory to the County as per this Agreement, the County may terminate said Agreement for cause;further the County may terminate this Agreement for convenience with a thirty(30) day written notice. The County shall be sole judge of non-performance. In the event that the County terminates this Agreement, Contractor's recovery against the County shall be limited to that portion of the Agreement Amount earned through the date of termination. The Contractor shall not be entitled to any other or further recovery against the County, including, but not limited to, any damages or any anticipated profit on portions of the services not performed. Federal Changes Contractor shall at all times comply with all applicable FTA regulations, policies, procedures and directives, including without limitation those listed directly or by reference in the Master Agreement between Purchaser and FTA, as they may be amended or promulgated from time to time during the term of this contract. Contractor's failure to so comply shall constitute a material breach of this contract. EXHIBIT I- 1 �;J 16E4 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES_ Suspension and Debarment: The Contractor shah comply and facilitate compliance with U.S. DOT regulations, "Nonprocurement Suspension and Debarment," 2 C.F.R. part 1200, which adopts and supplements the U.S. Office of Management and Budget (U.S. OMB) "Guidelines to Agencies on Governmentwide Debarment and Suspension (Nonprocurement)," 2 C.F.R. part 180. These provisions apply to each contract at any tier of$25,000 or more,and to each contract at any tier for a federally required audit (irrespective of the contract amount), and to each contract at any tier that must be approved by an FTA official irrespective of the contract amount. As such, the Contractor shall verify that its principals, affiliates,and subcontractors are eligible to participate in this federally funded contract and are not presently declared by any Federal department or agency to be: a) Debarred from participation in any federally assisted Award; b) Suspended from participation in any federally assisted Award; c) Proposed for debarment from participation in any federally assisted Award; d) Declared ineligible to participate in any federally assisted Award; e) Voluntarily excluded from participation in any federally assisted Award; or f) Disqualified from participation in ay federally assisted Award. By signing and submitting its bid or proposal, the bidder or proposer certifies as follows: The certification in this clause is a material representation of fact relied upon by the AGENCY. If it is later determined by the AGENCY that the bidder or proposer knowingly rendered an erroneous certification, in addition to remedies available to the AGENCY, the Federal Government may pursue available remedies, including but not limited to suspension and/or debarment. The bidder or proposer agrees to comply with the requirements of 2 C.F.R. part 180, subpart C, as supplemented by 2 C.F.R. part 1200, while this offer is valid and throughout the period of any contract that may arise from this offer. The bidder or proposer further agrees to include a provision requiring such compliance in its lower tier covered transactions. Contracting with small and minority businesses,women's business enterprises, and labor surplus area firms §200,321 (a) The Solicitor must take all necessary affirmative steps to assure that minority businesses, women's business enterprises, and labor surplus area firms are used whenever possible. (b) Affirmative steps must include: (1) Placing qualified small and minority businesses and women's business enterprises on solicitation lists; (2)Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; (3) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; (4) Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; (5) Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce; and (6) Requiring the prime contractor,if subcontracts are to be let, to take the affirmative steps listed in paragraphs (1) through (5)of this section. EXHIBIT I-2 -- 1 6 E EXHIBIT .FEDERAL CONTRACT PROVISIONS AND AS8URANCEG DBE Participatio For the purpose of this Contr act, the COUNTY will accept only DBE's who are: 1. C ertifiedbytha Florida". fied Certification Program;or 2.An out-of-state firm who has been certified byeu»era|»oa|Q»«ernmeni 'ebateQovernmentorFedura|gnvemmententityauthorizedhnoerbfyD8Eutsuaoranage»«y« ho«eOBEcertification process has received FTA approval; or 3. Certified by another agency approved by thaCOUNTY. DBE Participation Goal: Collier Area ransit's goal for DBE participation is 1.6%. A separate contracgoal has not been established for this procurementrrmpom*dSubmission: Each Bidder/Offeror, as part of its submission, shall complete an Anticipated DBE Statement that indicates the percentage and dollar value of the total bid/contract amount to be supplied by Disadvantaged Business Enterprises with whom the Bidder/Offeror intends to contract with for the performance of portions of the work under the Prompt Payment: The prime contractor agrees to pay each subcontractor under this prime contract for satisfactory performance of its contract no later than 30 days from the receipt of each payment the prime contract reci«enfr»mihe8CC. BeteimmQe/ If retainage from DBE subcontractors is allowed per the contract, theprimecontraotormgreeafurther1onyturnna1a/nagepaymenhotaeauhsubcontractor within 30 days after the subcontractors work is satisfactorily completed ubnontre brwbh)n3OdayaaMerihoyubountnonhonawmrkiouoUsfaohoh|yuomp/ehed Any delay or postponement of payment frothe above referenced time frame may occur only for good cause following written approval of the COUNTY. Civil Rights The following requirements apply to the underlying contract: The COUNTY is an Equal Opportunity Employer, As such, the COUNTY agrees to comply with all applicable Federal civil rights laws and implementing regulations, Apart from inconsistent requirements imposed by Federal laws or regulations, Qum�«h the COUNTY agrees b)comply v�ththe requirements of40UGC §5323(h) (3) bynot using any Federal assistance awarded byFTA huauppo�procurements using e�c|'m�oneryurdiscriminatory specifications. Under this Agreement, the Contractor shall at all times comply with the following requirements and shall include these requirements in each subcontract entered into as part thereof. 1. Nundimchminatio« |maouordanoevithFodexs/tranait|awat4QU.S.C. § 5332. the Cun(nm�oragrees that itwU| notdioormmao discriminate against employee orapp|�entfor empbyment because of race, color, religion, national origin, sex,'disability, gender identity or age. In addition, the Contractor agrees to comply with applicable Feoeno//mpkamenUngnygu|aUnnuando�arimphamenUnUrequirem*ntsFTAmay��«e 2. Race, Color, Religion, National Sex. |naccordance with T�eVII ofthe C�i| Rights Act, as amended, 42 U.S.C. §2000e et and Federal transit laws at 49 U.S.C. § 5332, the Contractor agrees to comply with all applicable employment opportunity requirements onU S Department of Labor (U.S. DOL) regulations, "Officeof Federal Contract Compliance Programs, Equal EmploymentOpportunity, Department of Labor," 41 chapter 60, and Executive Order No. 11246' "Equal Employment Opportunity in Fedena|E .p|"ymont.' September24. 1965. 42 U.G.C. § 2000e note, as amen ded by any later Exect�e Order d e rthat amends or supersedes it, referenced in 42 U.S.C. § 2000e note. The Contractoragrees to take action to ensure that applicants are employed, and that employees are treated duringamp|oymnnLvi0houtraQurd(otheirnaoa' nn/o� religion, nationalohQin' or sex(includingorientationandQenderkjenhb) Such acdonshaUinq/ude' but »toe»m�sdto, �ehd�wing: emp�ynen� pnomobon`demotion orban�er,neczoibnent /o�mhmentade�uing. �yo�or�rminebun; ��yofpayoro�er�nn—of �mpenmoUon; andselection for training, including apprenticeship. In addition, the Contractor agrees tocnmp|y with any implementing requirements FTA may issue. 3. Age. In accordance with the AgeDimchminationinEmployment Act,29 U.S.C.§§821-G34` U.S. Equal Employment Qppo�unityCommi Commission EEOC) regulations, "Age Discrimination in Employment Act," 29 C.F.R. part 1625, theDiscrimination Act of 1975, as amended, 42 U.S.C. § 6101 et seqU.S. Health and Human ServicesreQu/adona. "Nond�chmine¢ionontheBaa� ofAgeinnoQ—muor' ~~v~~s ' '^eivingFedea| FinancialAom��nce."45CFR QO'-- Feder��ano��=`49 U.S.C. §5332,the Contractor agrees to refrain from discrimination against present and prospective employees for reason of age. In addition, the Contractor to comply with any implementing requirements FTA may issue. 4. Disabilities. In accordance with section 504 of the Rehabilitation Act of 1973,as amended,29 U.S.C.§794,the Americans with Disabilities Act of 1990, as amended,42U'8.U.S.C. § 121O1etmyq'.the Architectural Barriers Act nf1y8].eoamended,42 U.S.C. @4/51otseq., and Federal transit law a14QU.S C05332. the Contractor agrees Age EXHIBIT|'] 16E4 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES that it will not discriminate against individuals on the basis of disability. In addition, the Contractor agrees to comply with any implementing requirements FTA may issue. Administrative, Contractual, or Legal Remedies (over $150,000): Unless otherwise provided in this contract, all claims, counter-claims, disputes and other matters in question between the local government and the contractor, arising out of or relating to this contract, or the breach of it,will be decided by arbitration, if the parties mutually agree, or in a Florida court of competent jurisdiction. Clean Air Act and Federal Water Pollution Control Act: (over$150,000) (1) The contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act, as amended, 42 U.S.C. § 7401 et seq. (2) The contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251 et seq. (3)The contractor agrees to report each violation to the County and understands and agrees that the County will, in turn, report each violation as required to assure notification to the Federal Emergency Management Agency, and the appropriate Environmental Protection Agency Regional Office. (4) The contractor agrees to include these requirements in each subcontract exceeding$150,000 financed in whole or in part with Federal assistance provided by FEMA. Byrd Anti-Lobbying Amendment (31 U.S.C. § 1352 (as amended) (over$100,000): Contractors who apply or bid for an award of$100,000 or more shall file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant, or any other award covered by 31 U.S.C. § 1352. Each tier shall also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient." Privacy Act The following requirements apply to the Contractor and its employees that administer any system of records on behalf of the Federal Government under any contract: (1) The Contractor agrees to comply with, and assures the compliance of its employees with, the information restrictions and other applicable requirements of the Privacy Act of 1974, 5 U.S.C. § 552a. Among other things, the Contractor agrees to obtain the express consent of the Federal Government before the Contractor or its employees operate a system of records on behalf of the Federal Government. The Contractor understands that the requirements of the Privacy Act, including the civil and criminal penalties for violation of that Act, apply to those individuals involved, and that failure to comply with the terms of the Privacy Act may result in termination of the underlying contract. (2) The Contractor also agrees to include these requirements in each subcontract to administer any system of records on behalf of the Federal Government financed in whole or in part with Federal assistance. Incorporation of Federal Transit Administration Terms The preceding provisions include, in part, certain Standard Terms and Conditions required by DOT,whether or not expressly set forth in the preceding contract provisions. All contractual provisions required by DOT, as set forth in FTA Circular 4220.1 F, are hereby incorporated by reference. Anything to the contrary herein notwithstanding, all FTA mandated terms shall be deemed to control in the event of a conflict with other provisions contained in this Agreement. The Contractor shall not perform any act, fail to perform any act,or refuse to comply with any COUNTY requests which would cause the COUNTY to be in violation of the FTA terms and conditions. State Provisions Convicted Vendor and Discriminatory Vendors List Those who have been placed on the convicted vendor list following a conviction for a public entity crime or on the discriminatory vendor list may not submit a bid on a contract to provide any goods or services to a public entity, may not submit a bid on a contract with a public entity for the construction or repair of a public building or public work, may not submit bids on leases of real property to a public entity, may not be awarded or perform work as a contractor, supplier, subcontractor, or consultant under a contract with a public entity, and may not transact business with any EXHIBIT I-4 1 6 E EXHIBIT FEDERAL CONTRACT PROVISIONS AND ASSURANCES -_--_-___' -- public entity in excess of $25,000.00 for a period of 36 months from the date of being placed on the convicted vendor Ustoron the discriminatory vendor list. Lobbying: No funds received pursuant to this Agreement may be expended for lobbi theL i ! the judicial branch or any state agency. y»g eg a��um. Inspector General Cooperation: The Parties agree to comply with Section 20055(5) F|orida 8tatu�en for the inspector general to have access to any recordsdata and other information deemed' necessaryt ' carry out his or incorporateher duties and into all subcontracts the obligation oo to | o 20.055(5), Florida Statutes. mPy with Section Record Retention - The contractor shall maintain and retain sufficient records demonstrating its compliance with the terms of the Agreement for a period of at least five (5) years after final payment is made and shall allow the County. FOEyN, or its designee's access to such records upon request. EXHIBIT/ 5 1 6 E 4 EXHIBIT FEDERAL CONTRACT PROVISIONS AND ASSURANCES FEDERAL ASSURANCES 7. Acknowledgement of Grant Terms and Conditions 2. Certification Regarding Debarment, Suspension, and Other Responsibility Matters Primary Covered Transactions - 3. Anticipated DBE, MNVBE or VETERAN Participation Statement 4. Certification regarding Lobbying EXHIBIT I s 16E 4 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES Acknowledgement of Terms, Conditions, and Grant Clauses Certification If the vendor subcontracts any of the work required under this Agreement,a copy of the signed subcontract must be available to the Department for review and approval. The vendor agrees to include in the subcontract that (1) the subcontractor is bound by the terms of this Agreement, (ii) the subcontractor is bound by all applicable state and federal laws and regulations, and (iii) the subcontractor shall hold the Department and Recipient harmless against all claims of whatever nature arising out of the subcontractor's performance of work under this Agreement, to the extent allowed and required by law. The recipient shall document in the quarterly report the subcontractor's progress in performing its work under this agreement. For each subcontract, the Recipient shall provide a written statement to the Department as to whether the subcontractor is a minority vendor as defined in Section 288.703, Fla. Stat. On behalf of my firm, I acknowledge, the grant requirements identified in this document. Vendor/Contractor Name 4 e/ , 17,16 Date 6 / Authorized Sin ' Signature EXHIBITI-7 16E4 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY and VOLUNTARY EXCLUSION (1) The prospective primary participant certifies to the best of its knowledge and belief,that it and its principals: (a) Are not presently debarred, suspended, proposed for debarment, declared ineligible,or voluntarily excluded from covered transactions by any Federal department or agency; (b) Have not within a three-year period preceding this proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public(Federal, State or local)transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements,or receiving stolen property; (c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity(Federal,State or local)with commission of any of the offenses enumerated in paragraph(l)(b)of this certification;and (d) Have not within a three-year period preceding this application/proposal had one or more public transactions (Federal, State or local)terminated for cause or default. (2) Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. f °i v9 Name DUNS Number 1'9/(5/cleat- _2-3-s-66, Title Tax ID Number y'tl dot ' r i`�{ Oilidelypc, Firm u fat , 2'1641 ,/, ,-- fe 1 , "6 -- Street Addre ,City, State,Zip x r Si ature EXHIBIT I 1 6 E 4 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES COLLIER cC)UNTY I ANTICIPATED DISADVANTA43ED,MINoRiTY,WOMEN OR VETERAN PARTRAPATION STATEMENT i'Itatps MI 1,..5...verihed. Vt.veadatge statuses'rad requite tna PR ALE tp gNtker ohsr4de a reetsap statemern dr pahvida soucce Oocum.emaTion That va!idatas a i ausiNEss CONI-EIIN OK-SERVICE BISABLEOVE TERAN PRIME IS TO CONIPLETE•TiliS NEXT SECTION : 1 ____r ___ _____ ________ ._______ ...____. _____ ...._..___________ ._____________ .. . ___________ ..,_______. ni , _____ .. ..________ _____ ...._____________, ,_______________ _ EMAIL ADO REAS OF PRIME Et USNIfFTEP) TELEPHONE NUMBER M BE arr,Otlill 4 veuntztry and',,,,lit not be:pine part ci the tontrattot;'arms, "'his iorm alw:Ise adtmdted E.'arft.1 a Nt*-4:ils,*to zi / r-L------- HgNptirac A rrwicari NP 11 . / /71' 7.13,C1 /1::„,„ 2----....,,, - -- --~ �- . ' - /-- _ ___ _________________ -------~, ~�r 1 6 E EXHIBIT FEDERAL CONTRACT PROVISIONS AND ASSURANCES ----' ~ ' 0[o be ER - ''~'~ bid mrofhe, ' ' ~=_-" The undersigned certifies, to the besof his or her knowledge, that: 1. No Federal appropriated funds have been paid or will be paid, for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influenci oraoemp,/nQk/inMuenoeonofUoero/employee cfany agency, a&4ambe/ofCongneua anof5cmroremp|o »Q Congress, or an employee of a Member of Congress in connection with this Federal' contract, t | yeev/ cooperative agreement, the undersigned shashallcomplete and submit Standard Form- grantman' or Report Lobbying,"in accordance with its instructions. �LL' ''�i oc»au»e Form ho 3. Theundernk]nedmhaUrequ|ny1hatthe |anguogeofthiooertificahonbe )ncluded in the award documents for a UsuoowanJo at all tiers (including suboontnsoto, subgrants, and contracts under grants, loans, and «ooPenati«eegnaemenhe)andthetoUaubrecipientnehaUcarbfyanddis |oseacnooding|y. This certification is a material representation of fact upon which reliance was placed when this transaction made orentered into. Submission ofthis ce�i�oaUnnivaprerequisite for making orenbahnginto&h� m»moo � *ma imposed byJ1. U.S.C, § 1352 (as amended bythe Lobbying Disclosure Act of1QS6) Any person who m» merequired oe�K/oa�onshaUbosubject $10,000toao�i| penalty ofnot less than *'ndnotmunathan/�»»u�n* mreach such failure. olUU^0OO The Contractor certifies or affirms the truthfulness and accuracy of each statement of its certification and m oc(ooupe. ifony. |naddkion. theContmcto/ undamhyndoandegnaeoLhat the provisions of 31 U.S.C. § 3801 et seq. apply to this certification and disclosure, if any. &^/ J �} / /� ��/ym��/{' L/' / L0v.°a� � 7-~«�. Contractor(Firm Name) / 41 • • uoureoruonUacN(uAuthnhzedOffinia| , / - � ��/rS ek Nmn »andTNacfConhaohr�nAuMh - - ~'- ' orized Official - 1/5 Date EXHIBIT I-10 ``~ � 16E4 4 Client#: 67371 PALO! ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE ) 10/01/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Karla Castro Gulfshore Insurance, Inc-SFL PHONE (A/C,No,Ext):239 263-4527 FAX (A/C,No): 239 213-2803 4100 Goodlette Rd N E-MDRAIL SS: kcastro@gulfshoreinsurance.com ulfshoreinsurance.com AD Naples, FL 34103 INSURER(S)AFFORDING COVERAGE NAIC# 239 261-3646 INSURER A:Houston Specialty Insurance Company 12936 INSURED INSURER B:Amerisure Mutual Insurance Company 23396 Palmdale Oil Company, Inc. Certain Underwriters at Lloyds 23396 INSURER C: 911 N 2nd St INSURER D Imperiurn Insurance Company 35408 Fort Pierce, FL 34950 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRLTYPE OF INSURANCE NSR WVD POLICY NUMBER (MM/DD YYYY) (MM/DCY EFF D�YY) LIMITS A GENERAL LIABILITY X X ECAPI HSGL00000400 09/30/2018 09/30/2019 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY ?a occu ante) $100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $0 PERSONAL&ADV INJURY $1,000,000 _ GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 PRO- X POLICY ECT LOC $ D AUTOMOBILE LIABILITY X X ECAPI IICCA00000400 09/30/2018 09/30/2019 COMBIaccidNEent)D SINGLE LIMIT $1,000,000 (Ea X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS (Per accident) XMCS-90 X Pollution Lia _ $ A UMBRELLA LIAB X OCCUR ECAPI HSCX00000400 09/30/2018 09/30/2019 EACH OCCURRENCE $4,000,000 x EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION X WC207405308 06/30/2018 06/30/2019 X rig-NW C STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) 1 E.L.DISEASE-EA EMPLOYEE $1,000,000 IfEON under DE.L.DISEASE-POLICY LIMIT $1 000,000 DESCRIPTION OF OPERATIONS below s C Excess Liability 18RENMA18000557042 09/30/2018 09/30/201 $5,000,000 Occ&Aggreg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate Holder is included as Additional Insured on a primary and noncontributory basis with respects to General Liability per form CG HIIG2019 0614; completed operations per form CG2037 0413 and ongoing operations per form CG2010 0413 only as required by written contract,Waiver of Subrogation per form CG2404 0509.Additional Insured in regards to the Auto Liability on a primary and noncontributory basis per form IICCA3301 0413 and Waiver of Subrogation per FLCA0444 0312 only as required by written contract.Waiver of (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Board of CountySHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. 3327 Tamiami Trail East Naples, FL 34112 AUTHORIZED REPRESENTATIVE Cj 4412'°' _ ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S1333133/M1328266 KPA 16E4 4 DESCRIPTIONS (Continued from Page 1) subrogation in regards to the Workers Compensation only as required by written contract per form WC000313 0484.Auto Liability includes MCS90 and Pollution Liability Broadened Coverage for Covered Autos CA9948 0306. SAGITTA 25.3(2010/05) 2 of 2 #S1333133/M1328266 16E4 COMMERCIAL AUTO CA 99 48 03 06 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. POLLUTION LIABILITY - BROADENED COVERAGE FOR COVERED AUTOS - BUSINESS AUTO, MOTOR CARRIER AND TRUCKERS COVERAGE FORMS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. A. Liability Coverage is changed as follows: "Covered pollution cost or expense" does not 1. Paragraph a. of the Pollution Exclusion ap- include any cost or expense arising out of the plies only to liability assumed under a contract actual, alleged or threatened discharge, disper or agreement. sal, seepage, migration, release or escape of "pollutants": 2. With respect to the coverage afforded by Para- graph A.1. above, Exclusion B.6. Care, Cus- a. Before the "pollutants" or any property in tody Or Control does not apply. which the "pollutants" are contained are moved from the place where they are B. Changes In Definitions accepted by the "insured" for movement For the purposes of this endorsement, Paragraph into or onto the covered "auto"; or D. of the Definitions Section is replaced by the b. After the "pollutants" or any property in following: which the "pollutants" are contained are D. "Covered pollution cost or expense" means any moved from the covered "auto" to the cost or expense arising out of: place where they are finally delivered, 1. Any request, demand, order or statutory or disposed of or abandoned by the "in- regulatory requirement that any "insured" or sured". others test for, monitor, clean up, remove, Paragraphs a. and b. above do not apply to contain, treat, detoxify or neutralize, or in "accidents" that occur away from premises any way respond to, or assess the effects of owned by or rented to an "insured" with re- "pollutants"; or spect to "pollutants" not in or upon a cov- 2. Any claim or"suit" by or on behalf of a gov- ered "auto" if: ernmental authority for damages because of (1) The "pollutants" or any property in testing for, monitoring, cleaning up, remov- which the "pollutants" are contained ing, containing, treating, detoxifying or neu- are upset, overturned or damaged as tralizing, or in any way responding to or as- a result of the maintenance or use of sessing the effects of"pollutants". a covered "auto"; and (2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage. CA 99 48 03 06 ©ISO Properties, Inc., 2005 Page 1 of 1 0 16E E 4 FORM MCS-90 Revised 01/05/2017 OMB No.:21.26-0008 Expiration:01/31/2020 USDOT Number: 688675 Date Received: A Federal Agency may not conduct or sponsor,and a person is not required to respond to,nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number.The OMB Control Number for this information collection is 2126-0008.Public reporting for this collection of information is estimated to be approximately 2 minutes per response,including the time for reviewing instructions,gathering the data needed,and completing and reviewing the collection of information.All responses to this collection of information are mandatory.Send comments regarding this burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden to:Information Collection Clearance Officer,Federal Motor Carrier Safety Administration,MC-RRA,Washington,D.C.20590. United States Department of Transportation Age' Federal Motor Carrier Safety Administration Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCS-90 Issued to Palmdale Oil Company Inc. of Florida (Motor Carrier name) (Motor Carrier state or province) Dated at 8:45 am on this 27th day of September 2018 Amending Policy Number: ECAPIIICCA00000400 Effective Date: 9/30/2018 Name of Insurance Company: Imperium Insurance Company Countersigned by: (authorized c The policy to which this endorsement is attached provides primary or excess insurance,as indicated for the limits shown(check only one): C) This insurance is primary and the company shall not be liable far amounts in excess of$ 1,000,000.00 for each accident. 0 This insurance is excess and the company shall not be liable for amounts in excess of$ for each accident in excess of the underlying limit of$ for each accident. Whenever required by the Federal Motor Carrier Safety Administration(FMCSA),the company agrees to furnish the FMCSA a duplicate of said policy and all its endorsements.The company also agrees,upon telephone request by an authorized representative of the FMCSA, to verify that the policy is in force as of a particular date.The telephone number to call is: (312)456-6779 Cancellation of this endorsement may be effected by the company of the insured by giving(1)thirty-five(35)days notice in writing to the other party(said 35 days notice to commence from the date the notice is mailed,proof of mailing shall be sufficient proof of notice), and(2)if the insured is subject to the FMCSA's registration requirements under 49 U.S.0 13901,by providing thirty(30)days notice to the FMCSA(said 30 days notice to commence from the date the notice is received by the FMCSA at its office in Washington,DC). Filings must be transmitted online via the Internet at http:l/www.fmcsa.dot.gov/urs. (continued on next page) FORM MCS-90 Page 1 of 3 16E4 FORM MCS-90 Revised 01/05/2017 OMB No.:2126-0008 Expiration:01/31/2020 SCHEDULE OF LIMITS - PUBLIC LIABILITY Type of carriage Commodity transported January 1,1985 (1)For-hire(in interstate or foreign commerce,with a Property(nonhazardous) $750,000 gross vehicle weight rating of 10,000 or more pounds). (2)For-hire and Private(in interstate,foreign,or Hazardous substances,as defined in 40 CFR 171 8, $5,000,000 intrastate commerce,with a gross vehicle weight rating transported in cargo tanks,portable tanks,or hopper- of 10,000 or more pounds). type vehicles with capacities in excess of 3,500 water gallons;or in bulk Division 1.1,1.2,and 1.3 materials, Division 2.3,Hazard Zone A,or Division 6.1,Packing Group I,Hazard Zone A material;in bulk Division 2.1 or 2.2;or highway route controlled quantities of a Class 7 material,as defined in 49 CFR 173.40;. (3)For-hire and Private(in interstate or foreign Oil listed in 49 CPR 172.101;hazardous waste, $1,000,000 commerce,in any quantity;or in intrastate commerce, hazardous materials,and hazardous substances in bulk only;with a gross vehicle weight rating of defined in 49 CFR 171.8 and listed in 49 CFR 172.101, 10,000 or more pounds). but not mentioned in(2)above or(4)below. (4)For-hire and Private(In interstate or foreign Any quantity of Division 1.1,1.2,or 1.3 material;any $5,000,000 commerce,with a gross vehicle weight rating of less quantity of a Division 2.3,Hazard Zone A,or Division than 10,000 pounds). 6.1,Packing Group I,Hazard Zone A material;or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173.403. *The schedule of limits shown does not provide coverage.The limits shown in the schedule are for information purposes only. FORM MCS-90 Page 3 of 3 16E4 FORM MCS-90 Revised 01/05/2017 OMB No.:2126-0008 Expiration:01/31/2020 USDOT Number: 688675 Date Received: A Federal Agency may not conduct or sponsor,and a person is not required to respond to,nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number.The OMB Control Number for this information collection is 2126-0008.Public reporting for this collection of information is estimated to be approximately 2 minutes per response,including the time for reviewing instructions,gathering the data needed,and completing and reviewing the collection of information.All responses to this collection of information are mandatory.Send comments regarding this burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden to:Information Collection Clearance Officer,Federal Motor Carrier Safety Administration,MC-RRA,Washington,D.C.20590. (it United States Department of Transportation \711,7i Federal Motor Carrier Safety Administration Endorsement for Motor Carrier Policies of Insurance for Public Liability under Sections 29 and 30 of the Motor Carrier Act of 1980 FORM MCS-90 Issued to Palmdale Oil Company Inc. of Florida (Motor Carrier name) (Motor Carrier state or province) Dated at 8:45 am on this 27th day of September , 2018 Amending Policy Number: ECAP1HSCX00000400- Effective Date: 9/30/2018 Name of Insurance Company: Houston Specialty Insurance Company Countersigned by: (authorized c The policy to which this endorsement is attached provides primary or excess insurance,as indicated for the limits shown(check only one): 0 This insurance is primary and the company shall not be liable for amounts in excess of$ far each accident. Q This insurance is excess and the company shall not be liable for amounts in excess of$ 4.000,000.00 for each accident in excess of the underlying limit of$ 1,000,000.00 for each accident. Whenever required by the Federal Motor Carrier Safety Administration(FMCSA),the company agrees to furnish the FMCSA a duplicate of said policy and all its endorsements.The company also agrees,upon telephone request by an authorized representative of the FMCSA, to verify that the policy is in force as of a particular date.The telephone number to call is: (312)456-6779 Cancellation of this endorsement may be effected by the company of the insured by giving(1)thirty-five(35)days notice in writing to the other party(said 35 days notice to commence from the date the notice is mailed,proof of mailing shall be sufficient proof of notice), and(2)if the insured is subject to the FMCSA's registration requirements under 49 U.S.C. 13901,by providing thirty(30)days notice to the FMCSA(said 30 days notice to commence from the date the notice is received by the FMCSA at its office in Washington,DC). Filings must be transmitted online via the Internet at http://www.fmcsa.dot.gov/urs. (continued on next page) FORM MCS-90 Page 1 of 3 16E4 FORM MCS-90 Revised 01/05/2017 OMB No.:23.26-0008 Expiration:01/31/2020 SCHEDULE OF LIMITS- PUBLIC LIABILITY Type of carriage Commodity transported January 1,1985 (1)For-hire(in interstate or foreign commerce,with a Property(nonhazardous) $750,000 gross vehicle weight rating of 10,000 or more pounds). (2)For-hire and Private(in interstate,foreign,or Hazardous substances,as defined in 49 CFR 171 8, $5,000,000 intrastate commerce,with a gross vehicle weight rating transported in cargo tanks,portable tanks,or hopper- of 10,000 or more pounds). type vehicles with capacities in excess of 3,500 water gallons;or in bulk Division 1.1,1.2,and 1.3 materials, Division 2.3,Hazard Zone A,or Division 6.1,Packing Group I,Hazard Zone A material;in bulk Division 2.1 or 2.2;or highway route controlled quantities of a Class 7 material,as defined in 49 CFR 173.403. (3)For-hire and Private(in interstate or foreign Oil listed in 49 CFR 172.101;hazardous waste, $1,000,000 commerce,in any quantity;or in intrastate commerce, hazardous materials,and hazardous substances in bulk only;with a gross vehicle weight rating of defined in 49 CFR 171.8 and listed in 49 CFR 1 12.1 Q1, 10,000 or more pounds). but not mentioned in(2)above or(4)below. (4)For-hire and Private(In interstate or foreign Any quantity of Division 1.1,1.2,or 1.3 material;any $5,000,000 commerce,with a gross vehicle weight rating of less quantity of a Division 2.3,Hazard Zone A,or Division than 10,000 pounds). 6.1,Packing Group I,Hazard Zone A material;or highway route controlled quantities of a Class 7 material as defined in 49 CFR 173 403. "The schedule of limits shown does not provide coverage.The limits shown in the schedule are for information purposes only. FORM MCS-90 Page 3 of 3