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Agenda 02/26/2019 Item #16C1
02/26/2019 EXECUTIVE SUMMARY Recommendation to award Solicitation # 18-7487, “Collection and Recycling of Latex Paint,” to Clark Environmental, Inc. OBJECTIVE: To obtain services relating to the collection and recycling of latex paint collected at the County’s Hazardous Material Collection and Recycling Drop-off Centers. CONSIDERATIONS: The Solid and Hazardous Waste Management Division (“SHWMD”) is responsible for the collection and processing of recyclable material throughout Collier County. The Integrated Solid Waste Management Strategy includes the goals of preserving landfill airspace and protecting the environment. Both of those goals are furthered by the collection and recycling of waste latex paint and containers. On October 16, 2018, the Procurement Division issued notices of Solicitation # 18-7487 to 7,481 firms, which resulted in 29 vendors downloading the bid package. By the November 16, 2018 bid closing date, only the incumbent vendor, Clark Environmental, Inc. (“Clark”), submitted a bid. Staff reviewed Clark’s bid, found it to be responsive and reasonable, and recommends that the Board award this solicitation to Clark. The bid was found reasonable by virtue of the fact that Clark proposed to hold their current and last several years' price of $0.18/pound into a new three-year contract. Clark is a Florida company that recycles latex paint and paint containers. The SHWMD has been satisfied with the service provided by Clark, including its pickup service at the County’s recycling drop-off centers and following hurricane events. In FY 2018, Clark recycled approximately 560,500 pounds of combined latex paint and containers brought to the County's recycling drop-off and hazardous materials collection centers. The services procured from Clark will be obtained through the issuance of standard Collier County purchase orders. This award will be for an initial period of three years from the date of the Board of County Commissioners approval, with two one-year renewal options. This award will promote and ensure that the SHWMD and Collier County remain on target to meet the State's 2020 recycling and waste reduction goal of 75 percent as well as properly recycling and disposing of latex paint for the citizens of Collier County. FISCAL IMPACT: Funding is available in, and consistent with, the FY2019 SHWMD operating budget (Fund 470) approved by the Board of County Commissioners. Annual operating expenses are estimated to be less than $100,000 for the collection and disposal of 560,500 pounds of latex paint under this contract. LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires majority vote for Board approval. -SRT GROWTH MANAGEMENT IMPACT: This action is consistent with the Growth Management Plan requiring collection and proper disposal of hazardous waste generated in Collier County. RECOMMENDATION: That the Board of County Commissioners award Solicitation # 18-7487, Collection and Recycling of Latex Paint, to Clark Environmental, Inc., and authorize staff to issue Collier County Purchase Orders to procure these services. Prepared By: Alister Burnett, Manager Environmental Compliance, Solid and Hazardous Waste Management Division 16.C.1 Packet Pg. 736 02/26/2019 ATTACHMENT(S) 1. 18-7487 NORA_Signed (PDF) 2. 18-7487 Bid Tabulation (PDF) 3. 18-7487 Solicitation (PDF) 4. 18-7487 Clark_Submittal (PDF) 5. 18-7487 Clark_E-Verify (PDF) 6. 18-7487 Clark_Sunbiz (PDF) 7. 18-7487 Clark_Insurance (PDF) 8. 18-7487 Clark_State of Florida Corporation Certificate 2018 (PDF) 16.C.1 Packet Pg. 737 02/26/2019 COLLIER COUNTY Board of County Commissioners Item Number: 16.C.1 Doc ID: 7750 Item Summary: Recommendation to award Solicitation # 18-7487, “Collection and Recycling of Latex Paint,” to Clark Environmental, Inc. Meeting Date: 02/26/2019 Prepared by: Title: Manager - Environmental Compliance – Solid and Hazardous Waste Name: Alister Burnett 01/10/2019 12:21 PM Submitted by: Title: Manager - Waste Reduction & Recycling – Solid and Hazardous Waste Name: Dilia Camacho 01/10/2019 12:21 PM Approved By: Review: Procurement Services Opal Vann Level 1 Purchasing Gatekeeper Completed 01/10/2019 12:36 PM Public Utilities Operations Support Joseph Bellone Additional Reviewer Completed 01/10/2019 12:42 PM Procurement Services Sandra Herrera Additional Reviewer Completed 01/16/2019 9:18 AM Procurement Services Swainson Hall Additional Reviewer Completed 01/22/2019 9:03 AM Solid and Hazardous Waste Dilia Camacho Additional Reviewer Completed 01/23/2019 11:28 AM Public Utilities Department Dan Rodriguez Additional Reviewer Completed 01/23/2019 11:33 AM Procurement Services Ted Coyman Additional Reviewer Completed 02/05/2019 5:38 PM Public Utilities Department Sarah Hamilton Level 1 Division Reviewer Completed 02/06/2019 4:41 PM Public Utilities Department George Yilmaz Level 2 Division Administrator Review Completed 02/08/2019 4:59 PM County Attorney's Office Scott Teach Level 2 Attorney Review Completed 02/13/2019 3:09 PM County Attorney's Office Scott Teach Additional Reviewer Completed 02/11/2019 9:27 AM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 02/11/2019 9:38 AM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 02/13/2019 8:20 AM Budget and Management Office Ed Finn Additional Reviewer Completed 02/14/2019 11:07 AM County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 02/18/2019 8:08 PM Board of County Commissioners MaryJo Brock Meeting Pending 02/26/2019 9:00 AM 16.C.1 Packet Pg. 738 16.C.1.aPacket Pg. 739Attachment: 18-7487 NORA_Signed (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Notices Sent: 7,481 Downloads: 29 Submittals: 1 No.Description Unit *Qty Unit Price Total 1 Collection & Recycling of Latex Paint per pound LB 444,482 $0.18 80,006.76$ 2 Sell back recycled paint 1 to 5 gallons GAL 1 $0.00 -$ TOTAL 80,006.76$ *Quantity based on average of last four years. E-Verify 18-7487 Collection and Recycling of Latex Paint Bid Tabulation Clark Environmental, Inc. Form 1: Vendor’s Non-Response Statement Form 2: Vendor Check List Yes Not Applicable Yes Yes Yes Yes Yes Not Local Form 3: Conflict of Interest Affidavit Form 4: Vendor Declaration Statement Yes/No Yes Form 5: Immigration Affidavit Certification Form 6: Vendor Substitute W – 9 Form 7: Vendor Submittal – Local Vendor Preference Affidavit Insurance and Bonding Requirements 16.C.1.b Packet Pg. 740 Attachment: 18-7487 Bid Tabulation (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS INVITATION TO BID (ITB) FOR COLLECTION AND RECYCLING OF LATEX PAINT SOLICITATION NO.: 18-7487 EVELYN COLON, PROCUREMENT STRATEGIST PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FLORIDA 34112 TELEPHONE: (239) 252-2667 evelyn.colon@colliercountyfl.gov (Email) This solicitation document is prepared in a Microsoft Word format. Any alterations to this document made by the Consultant may be grounds for rejection of proposal, cancellation of any subsequent award, or any other legal remedies available to the Collier County Government. 16.C.1.c Packet Pg. 741 Attachment: 18-7487 Solicitation (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) SOLICITATION PUBLIC NOTICE INVITATION TO BID (ITB) NUMBER: 18-7487 PROJECT TITLE: COLLECTION AND RECYCLING OF LATEX PAINT DUE DATE: November 16, 2018 at 3:00PM PLACE OF BID OPENING: PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FL 34112 All proposals shall be submitted online via the Collier County Procurement Services Division Online Bidding System: https://www.bidsync.com/bidsync-cas/ INTRODUCTION As requested by the Collier County Solid and Hazardous Waste Department (hereinafter, the “Department”), the Collier County Board of County Commissioners Procurement Services Division (hereinafter, “County”) has issued this Invitation to Bid (hereinafter, “ITB”) with the intent of obtaining bid submittals from interested and qualified vendors in accordance with the terms, conditions and specifications stated or attached. The vendor, at a minimum, must achieve the requirements of the Specifications or Scope of Work stated. The results of this solicitation may be used by other County departments once awarded according to the Board of County Commission ers Procurement Ordinance. Historically, County departments have spent approximately $78,000 annually on these services which have involved over 400,000 pounds of used/waste paint. BACKGROUND The County is interested in receiving bids from suppliers to provide for the recycling of latex paint. TERM OF CONTRACT The contract term, if an award(s) is/are made is intended to be for three (3) years with two (2) one (1) year renewal option. Prices shall remain firm for the initial term of this contract. Surcharges will not be accepted in conjunction with this contract, and such charges should be incorporated into the pricing s tructure. The County Manager, or designee, may, at his discretion, extend the Agreement under all of the terms and conditions contained in this Agreement for up to one hundred eighty (180) days. The County Manager, or designee, shall give the Contractor written notice of the County's intention to extend the Agreement term not less than ten (10) days prior to the end of the Agreement term then in effect. All goods are FOB destination and must be suitably packed and prepared to secure the lowest transportation rates and to compl y with all carrier regulations. Risk of loss of any goods sold hereunder shall transfer to the COUNTY at the time and place of delivery; provided that risk of loss prior to actual receipt of the goods by the COUNTY nonetheless remain with VENDOR. AWARD CRITERIA ITB award criteria are as follows: ➢ The County’s Procurement Services Division reserves the right to clarify a vendor’s submittal prior to the award of the solicitation. ➢ It is the intent of Collier County to award to the lowest, responsive and responsible vendor(s) that represents the best value to the County. ➢ For the purposes of determining the winning bidder, the County will select the vendor with the lowest base bid as outlined below: • The lowest base bid ➢ Collier County reserves the right to select one, or more than one suppliers, award on a line item basis, establish a pool for quoting, or other options that represents the best value to the County; however, it is the intent to: 16.C.1.c Packet Pg. 742 Attachment: 18-7487 Solicitation (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) • Primary / Secondary /Tertiary ➢ The County reserves the right to issue a formal contract, standard County Purchase Order, or utilize the County Purchasing Card for the award of this solicitation. DETAILED SCOPE OF WORK These specifications are intended to provide the information by which prospective bidders may understand the requirements of Collier County relative to the recycling of latex paint collected at our facilities. Existing County sites are located at the following addresses: Naples Recycling Drop-off Center Marco Island Recycling Drop-off Center 2640 W . Enterprise Ave., FL 34104 990 Chalmers Drive, FL 34145 Immokalee Transfer Station North Collier Recycling Drop-off Center 700 Stockade Road, FL 34142 9950 Goodlette Frank Road N., FL 34109 Hazardous Materials Collection Center North East Recycling Drop-off Center 3728 White Lake Blvd., FL 34117 825 39th Ave. N.E., FL 34120 Additional sites may be added in the future. The awarded contractor shall: 1. Provide each of the County sites with an adequate number of storage and/or transport bin(s)/dumpsters to hold used latex and water-based paint in one-gallon cans and five gallon pails. 2. Provide pick up and exchange of these bin(s)/dumpsters from each of the sites at least once per week or on an as need basis for emergencies and transport the bins to their paint recycling location. Emergencies shall be determined by the Solid and Hazardous Waste Management Department, e.g. following declaration of a hurricane warning. 3. Provide a paint buy back service when and as requested by the Collier County Solid and Hazardous W aste Management Division. Bid must include sell back price per five-gallon containers of paint. 4. Provide a recycling plant in Florida to ensure that all of Florida’s recycling rules and regulations are met. 5. Provide and supply the Solid and Hazardous W aste Management Department with the following items: Shipping Papers Registration Applicable Permits OSHA Training Certification Fire Department Facility Approval Annual Documentation of Paint Container Recycling 6. Recycle the paint collected at each site. The recycled paint must meet the following specifications: Product content shall include: 75% Post –Consumer Paint 25% Raw materials to include but not be limited to: o Resin Acrylic o Dispersant o In-Can Preservative o Mildewcide o Defoamer o Thickener o Colorant or W hitener One or T wo Coat Coverage 300 Square Feet Spread Rate per Gallon Viscosity = 100 KU 16.C.1.c Packet Pg. 743 Attachment: 18-7487 Solicitation (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Sheen: o Low Luster o Eggshell o Matte/Flat Testing: Metal Check o Lead o Mercury Filling: Filtering Can T ypes: o One Gallon Cans o Five Gallon Pails Colors: Off W hite Beige Brown Yellow Light Grey Dark Grey Blue T urquoise Custom Colors 7. Provide for invoicing that includes: Date Invoice number PO number T ax ID number Quantity in Pounds Description of Commodity Unit Price Total Price Include Delivery/Pickup Receipt with following information: o Number of Empty Bins delivered o Number of Full Bins Picked up o Total Gross W eight o Total Tare W eight o Total Net W eight o Name and Signature of Scalemaster 8. Provide quarterly reports of all recycled materials that include: Date Site Name Invoice number Account number T ax ID number Quantity in Pounds Description of Latex Paint Collection Fee Unit Price Total Price VENDOR CHECKLIST 16.C.1.c Packet Pg. 744 Attachment: 18-7487 Solicitation (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) ***Vendor should check off each of the following items as the necessary action is completed (please see, Form 2: Vendor Check List): The Solicitation Submittal has been signed. The Solicitation Pricing Document (Bid Schedule/Quote Schedule/Proposal Pricing/etc.) has been completed and attached. All applicable forms have been signed and included, along with licenses to complete the requirements of the project. Any addenda have been signed and included. Affidavit for Claiming Status as a Local Business, if applicable. Division of Corporations - Florida Department of State – http://dos.myflorida.com/sunbiz/ (If work performed in the State). E-Verify/Immigration Affidavit (Memorandum of Understanding). 16.C.1.c Packet Pg. 745 Attachment: 18-7487 Solicitation (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) PM: Alister Burnett Bid No. 18-7487 Collection and Recycling of Latex Paint No. Description Unit *Qty Unit Price Total 1 Collection & Recycling of Latex Paint per pound LB 444,482 $0.18 $ 80,006.76 2 Sell back recycled paint 1 to 5 gallons GAL 1 $ -TOTAL $ 80,006.76 *Quantity based on average of last four years. Yes/No Form 1: Vendor's Non-Response Statement Form 2: Vendor Check List ✓ Form 3: Conflict of Interest Affidavit ✓ Form 4: Vendor Declaration Statement ✓ Form 5: Immigration Affidavit Certification ✓ Form 6: Vendor Substitute W -9 ✓ Form 7: Vendor Submittal -Local Vendor Preference Affidavit Insurance and Bonding Requirements E-Verify Q:\Bethx\CONTRACTS-PO's 1 & Qualifications 2 & 3\CITY & COUNTY Certifications\Collier County 1\18-7487\Copy of 18-7487 Bid Schedule 16.C.1.dPacket Pg. 746Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 11/27/2018 WorkComp Solutions, Inc. P.O. Box 24987 Lakeland, FL 33802 863-646-4642 863-646-3521 www.workcompsolutionsfl.com Bridgefield Employers Insurance Company 10701 A 830-35594 1/1/2018 1/1/2019 3 3 1,000,000N 1,000,000 1,000,000 Darrell J. Mills Eglis Vinson eglis@workcompsolutionsfl.com Clark Environmental, Inc. 755 North Prairie Industrial Parkway Mulberry FL 33860 45530375 3 For any and all work performed on behalf of Collier County. Collier County Board of Commissioners 3295 Tamiami Trail East Naples FL 34112 Project No. 18-7487 - Collection and Recycling of Latex Paint Waiver of Subrogation in favor of Collier County Board of Commissioners, it officers and employees, with respect to Workers' Compensation. 30 Day Notice of Cancellation Applies. 45530375 | 18/19 WC | Eglis Vinson | 11/27/2018 11:32:19 AM (EST) | Page 1 of 2 This certificate cancels and supersedes ALL previously issued certificates. 16.C.1.d Packet Pg. 747 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Clark Environmental, Inc. 830-35594 1/1/2018 Bridgefield Employers Insurance Company 11/27/2018 45530375 | 18/19 WC | Eglis Vinson | 11/27/2018 11:32:19 AM (EST) | Page 2 of 2 This certificate cancels and supersedes ALL previously issued certificates. 16.C.1.d Packet Pg. 748 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECT PRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS PER STATUTE OTH- ER E.L.EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes,describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S)AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) 11/27/2018 Lassiter-Ware Insurance of Tampa Bay 1300 N. Westshore Blvd. Suite 110 Tampa FL 33607 Wendy Tyree (800)845-8437 (888)883-8680 wendyt@lassiter-ware.com Clark Environmental, Inc. 755 Prairie Industrial Parkway Mulberry FL 33860 Westchester Surplus Lines Ins 10172 ACE American Ins Co 22667 18-19 cert A X X X Contractors Pollution X X G27450234005 5/6/2018 5/6/2019 1,000,000 50,000 5,000 1,000,000 2,000,000 2,000,000 B X X CALH08457098005 5/6/2018 5/6/2019 1,000,000 PIP-Basic 10,000 A X X G27450246005 5/6/2018 5/6/2019 5,000,000 5,000,000 A Professional Liability G27450234005 5/6/2018 5/6/2019 Each Claim $1,000,000 Claims-Made Aggregate $2,000,000 Re: Bid #18-7487 - Collection and Recycling of Latex Paint Collier County Board of County Commissioners are an additional insured under the terms and conditions of the General Liability and Automobile Liability policies with respect to work performed by the named insured as required by written contract. This insurance shall be primary and non-contributory. Cancellation: Thirty (30) days’ notice except for Ten (10) days’ notice for non-payment of premium. P Schmaltz/WENDTY Collier County Board of Commissioners 3295 Tamiami Trail East Naples, FL 34112 Swainson.Hall@colliercount 16.C.1.d Packet Pg. 749 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Co~e-r Cou.11.ty ~ Admin istrative Services Department Procurement Serv\ces Division Form 2: Vendor Check List IMPORT ANT: THIS SHEET MUST BE SIGNED. Please read carefully, sign in the spaces indicated and return with your Proposal. Vendor should check off each of the following items as the necessary ac tion is completed: vEf The Solicitation Submittal has been signed. done o vi (i" l'JC:. vO The Solicitation Pricing Document (Bid Schedule/Quote Schedule/etc.) has been completed and attached. dovi-e_ O f'1 I 1'.() ,c All applicable forms have been signed and included, along with licenses to complete the r equirements of the project. WM 3 fivvv, 4 tV(V\I\ ,;--fvtfV\ 1_p Any addenda have been signed and included. , , , 1 Affidavit for Claiming Status as a Local Business, if applicable. Division of Corporations -Florida Department of State -http://dos.myflorida.c om/s unbiz/ (If work performed in the State). wwi 4 E-Verify/Immigration Affidavit (Memorandum of Understanding). tDMtl 5 ALL SUBMITTALS MUST HAVE THE SOLICITATION NUMBER AND TITLE Name of Firm: Address: City, State, Zip: Telephone: Email: Representative Signature: Representative Name: Clark Environmental, Inc. 755 Prairie Industrial Parkway Mulberry, FL 33860 863-425-4884 j clark@clarkenv.com L w , coJlJJL ~es W. Clark, III Date: 11-14-2018 16.C.1.d Packet Pg. 750 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) ~unt z_ Administrative Services Department Procurement Services Di vision Form 3: Conflict oflnterest Affidavit The Vendor certifies that, to the best of its knowledge and belief, the past and current work on any Collier County project affiliated with this solicitation does not pose an organizational conflict as described by one of the three categories below: Biased ground rules -The firm has not set the "ground rules" for affiliated past or current Collier County project identified above (e.g., writing a procurement's statement of work, specifications, or performing systems engineering and technical direction for the procurement) which appears to skew the competition in favor of my firm. Impaired objectivity -The firm has not performed work on an affiliated past or current Collier County project identified above to evaluate proposals / past performance of itself or a competitor, which calls into question the contractor's ability to render impartial advice to the government. Unequal access to information -The firm has not had access to nonpublic information as part of its performance of a Collier County project identified above which may have provided the contractor (or an affiliate) with an unfair competitive advantage in current or future solicitations and contracts. In addition to this signed affidavit, the contractor I vendor must provide the following: 1. All documents produced as a result of the work completed in the past or currently being worked on for the above-mentioned project; and, 2. Indicate if the information produced was obtained as a matter of public record (in the "sunshine") or through non-public (not in the "sunshine") conversation (s), meeting(s), document(s) and/or other means. Failure to disclose all material or having an organizational conflict in one or more of the three categories above be identified, may result in the disqualification for future solicitations affiliated with the above referenced project(s). By the signature below, the firm ( employees, officers and/or agents) certifies, and hereby discloses, that, to the best of their knowledge and belief, all relevant facts concerning past, present, or currently planned interest or activity (financial, contractual, organizational, or otherwise) which relates to the project identified above has been fully disclosed and does not pose an organizational conflict. Firm: Clark Environmental, Inc. Signature and Date: ~ Print Name: JamW:lark, III Title of Signatory: Vice President 16.C.1.d Packet Pg. 751 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) BOARD OF COUNTY COMMISSIONERS Collier County Government Complex Naples, Florida 34112 Dear Commissioners: Co~er County ~ Admi nistrative Services Department Procuremen t Services Division Form 4: Vendor Declaration Statement The undersigned, as Vendor declares that this response is made without connection or arrangement with any other person and this proposal is in every respect fair and made in good faith , without collusion or fraud. The Vendor agrees, if this solicitation submittal is accepted, to execute a Collier County document for the purpose of establishing a formal contractual relationship between the firm and Collier County, for the performance of all requirements to which the solicitation pertains. The Vendor states that the submitted is based upon the documents listed by the above referenced Solicitation. Further, the vendor agrees that if awarded a contract for these goods and/or services, the vendor will not be eligible to compete, submit a proposal, be awarded, or perform as a sub-vendor for any future associated with work that is a result of this awarded contract. IN WITNESS WHEREOF, WE have hereunto subscribed our names on this~ day of November Polk , in the State of Florida Firm's Legal Name: Address: City, State, Zip Code: Florida Certificate of Authority Document Number Federal Tax Identification Number *CCR # or CAGE Code *Only if Grant Funded Telephone: Signature by: (Typed and written) Title: Clark Environmental, Inc. 755 Prairie Industrial Parkway Mulberry, FL 33860 S46584 59-3061371 863-425-4884 James W. Clark, III , 2018 in the County of 16.C.1.d Packet Pg. 752 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Send payments to: (required if different from above) Contact name: Title: Address: City, State, ZIP Telephone: Email: Office servicing Collier County to place orders (required if different from above) Contact name: Title: Address: City, State, ZIP Telephone: Email: Additional Contact Information Company name used as payee James W. Clark, III Vice President Same as above 863-425-4884 ext: 416 jclark@clarkenv.com Same as above 16.C.1.d Packet Pg. 753 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Co~er County ~ Administrative Services Department Procurement Services Division Form 5: Immigration Affidavit Certification This A ffidavit is requi red and should be signed, notarized by an authorized principal of the firm and submitted with formal solicitation submittals. Further, Vendors are required to enroll in the E-Verify program, and provide acceptable evidence of their enrollment, at the time of the submission of the Vendor's proposal. Acceptable evidence consists of a copy of the properly completed E-Verify Company Profile page or a copy of the fully executed E-Verify Memorandum ofUnderstanding for the company. Failure to include this Affidavit and acceptable evidence of enrollment in the E-Verify program may deem the Vendor's proposal as non- responsive. Collier County will not intentionally award County contracts to any Vendor who knowingly employs unauthorized alien workers , con stituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e) Section 274A(e) of the Immigration and Nationality Act ("INA"). Collier County may consider the employment by any Vendor ofunauthorized aliens a violation of Section 274A (e) of the INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A (e) of the INA shall be grounds for unilateral termination of the contract by Collier County. Vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Irnrnigration Act and su bsequent Amendment(s)) and agrees to comply with the provisions of the Memorandum of Understanding with E-Verify and to provide proof of enrollment in The Employment E ligibility Verification System (E-Verify), operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the Vendor's propo sal. Company Name Print Name Signature State of Florida Clark Environmental Inc. James W. Clark, III County of ---'P'"'"o .... l=k ____ _ Titl e Vice President Date 11-14-2018 The signee of these Affidavit guarantees, as evidenced by the sworn affidavit required herein, the truth and accuracy of this affidavit to interrogatories hereinafter made. 16.C.1.d Packet Pg. 754 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Co~er County ~ Administrative Services Department Procurement Services Division Form 6: Vendor Substitute W - 9 Request for Taxpayer Identification Number and Certification In accordance with the Internal Revenue Service regulations, Collier County is required to collect the following information for tax reporting purposes from individuals and companies who do business with the County (including social security numbers if used by the individual or company for tax reporting purposes). Florida Statute 119.071(5) requires that the county notify you in writing of the reason for collecting this information, which will be used for no other purpose than herein stated. Please complete all information that applies to your business and return with your quote or proposal. I. General Information (provide all information) Taxpayer Name Clark Environmental Inc. (as shown on income tax return) Business Name (if different from taxpayer name) Address 755 Prairie Industrial Parkway City Mulbeny State Florida Zip 33860 Telephone 863-425-4884 Email j clark(@,clarkenv.com Order Information (Must be filled out) Address 755 Prairie Industrial Parkway City Mulberry State FL Email jclark@clarkenv.com 2. Company Status (check only one) __ Individual / Sole Proprietor Zip 33860 X Corporation __ Tax Exempt (Federal income tax-exempt entity under Internal Revenue Service guidelines IRC 501 (c) 3) Remit I Payment Information (Must be filled out) Address 755 Prairie Industrial Parkway City Mulbeny State FL Zip 33860 Email j clark(@,clarkenv.com __ Partnership __ Limited Liability Company ____ Enter the tax classification 3. Taxpayer Identification Number (for tax reporting pwposes only) Federal Tax Identification Number (TIN) ----=59'--=3-=-06""'1""'3~7~1 ____________________ _ (Vendors who do not have a TIN, will be required to provide a social security number prior to an award). 4. Sign and Date Form: Certification: that the information shown on this form is correct to m knowled e. Date 11-14-2018 Phone Number 863-425-4884 16.C.1.d Packet Pg. 755 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 756 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 757 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 758 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 759 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 760 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 761 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 762 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 763 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 764 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 765 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.d Packet Pg. 766 Attachment: 18-7487 Clark_Submittal (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 16.C.1.e Packet Pg. 767 Attachment: 18-7487 Clark_E-Verify (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Department of State /Division of Corporations /Search Records /Detail By Document Number / Document Number FEI/EIN Number Date Filed State Status Last Event Event Date Filed Event Effective Date Detail by FEI/EIN Number Florida Profit Corporation CLARK ENVIRONMENTAL, INC. Filing Information S46584 59-3061371 04/17/1991 FL ACTIVE AMENDMENT 12/07/1999 NONE Principal Address 755 PRAIRIE INDUSTRIAL PKWY MULBERRY, FL 33860 Changed: 03/27/1992 Mailing Address 755 PRAIRIE INDUSTRIAL PKWY MULBERRY, FL 33860 Changed: 03/27/1992 Registered Agent Name & Address CLARK, ELIZABETH G 755 PRAIRIE INDUSTRIAL PKWY MULBERRY, FL 33860 Name Changed: 01/14/2008 Address Changed: 03/27/1992 Officer/Director Detail Name & Address Title PTD CLARK, ELIZABETH G 755 PRAIRIE INDUSTRIAL PKWY MULBERRY, FL 33860 DIVISION OF CORPORATIONS Page 1 of 3Detail by FEI/EIN Number 1/3/2019http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=FeiNu... 16.C.1.f Packet Pg. 768 Attachment: 18-7487 Clark_Sunbiz (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Title VSD CLARK III, JAMES W 755 PRAIRIE INDUSTRIAL PKWY MULBERRY, FL 33860 Title D GORHAM, GWEN S 755 PRAIRIE INDUSTRIAL PKWY MULBERRY, FL 33860 Title D GRIMBERG, MARY ELIZABETH 755 PRAIRIE INDUSTRIAL PKWY MULBERRY, FL 33860 Annual Reports Report Year Filed Date 2016 03/08/2016 2017 04/05/2017 2018 01/24/2018 Document Images 01/24/2018 -- ANNUAL REPORT View image in PDF format 04/05/2017 -- ANNUAL REPORT View image in PDF format 03/08/2016 -- ANNUAL REPORT View image in PDF format 01/11/2015 -- ANNUAL REPORT View image in PDF format 04/04/2014 -- ANNUAL REPORT View image in PDF format 02/13/2013 -- ANNUAL REPORT View image in PDF format 02/16/2012 -- ANNUAL REPORT View image in PDF format 02/05/2011 -- ANNUAL REPORT View image in PDF format 02/19/2010 -- ANNUAL REPORT View image in PDF format 03/04/2009 -- ANNUAL REPORT View image in PDF format 01/14/2008 -- ANNUAL REPORT View image in PDF format 03/28/2007 -- ANNUAL REPORT View image in PDF format 03/07/2007 -- ANNUAL REPORT View image in PDF format 04/17/2006 -- ANNUAL REPORT View image in PDF format 03/20/2005 -- ANNUAL REPORT View image in PDF format 03/19/2004 -- ANNUAL REPORT View image in PDF format 04/07/2003 -- ANNUAL REPORT View image in PDF format 05/08/2002 -- ANNUAL REPORT View image in PDF format 05/02/2001 -- ANNUAL REPORT View image in PDF format 05/02/2000 -- ANNUAL REPORT View image in PDF format 12/07/1999 -- Amendment View image in PDF format 04/20/1999 -- ANNUAL REPORT View image in PDF format 05/14/1998 -- ANNUAL REPORT View image in PDF format Page 2 of 3Detail by FEI/EIN Number 1/3/2019http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=FeiNu... 16.C.1.f Packet Pg. 769 Attachment: 18-7487 Clark_Sunbiz (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) 04/14/1997 -- ANNUAL REPORT View image in PDF format 05/01/1996 -- ANNUAL REPORT View image in PDF format 05/01/1995 -- ANNUAL REPORT View image in PDF format Florida Department of State, Division of Corporations Page 3 of 3Detail by FEI/EIN Number 1/3/2019http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=FeiNu... 16.C.1.f Packet Pg. 770 Attachment: 18-7487 Clark_Sunbiz (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) The ACORD name and logo are registered marks of ACORD CERTIFICATE HOLDER ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25 (2014/01) AUTHORIZED REPRESENTATIVE CANCELLATION DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE LOCJECT PRO-POLICY GEN'L AGGREGATE LIMIT APPLIES PER: OCCURCLAIMS-MADE COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence)$DAMAGE TO RENTED EACH OCCURRENCE $ MED EXP (Any one person)$ PERSONAL &ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $RETENTIONDED CLAIMS-MADE OCCUR $ AGGREGATE $ EACH OCCURRENCE $UMBRELLA LIAB EXCESS LIAB DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY)LIMITS PER STATUTE OTH- ER E.L.EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ ANY PROPRIETOR/PARTNER/EXECUTIVE If yes,describe under DESCRIPTION OF OPERATIONS below (Mandatory in NH) OFFICER/MEMBER EXCLUDED? WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON-OWNED AUTOS AUTOS AUTOS COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ $ $ $ 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. INSD ADDL WVD SUBR N / A $ $ (Ea accident) (Per accident) OTHER: 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: INSURED PHONE (A/C, No, Ext): PRODUCER ADDRESS: E-MAIL FAX (A/C, No): CONTACT NAME: NAIC # INSURER A : INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : INSURER(S)AFFORDING COVERAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INS025 (201401) 11/27/2018 Lassiter-Ware Insurance of Tampa Bay 1300 N. Westshore Blvd. Suite 110 Tampa FL 33607 Wendy Tyree (800)845-8437 (888)883-8680 wendyt@lassiter-ware.com Clark Environmental, Inc. 755 Prairie Industrial Parkway Mulberry FL 33860 Westchester Surplus Lines Ins 10172 ACE American Ins Co 22667 18-19 cert A X X X Contractors Pollution X X G27450234005 5/6/2018 5/6/2019 1,000,000 50,000 5,000 1,000,000 2,000,000 2,000,000 B X X CALH08457098005 5/6/2018 5/6/2019 1,000,000 PIP-Basic 10,000 A X X G27450246005 5/6/2018 5/6/2019 5,000,000 5,000,000 A Professional Liability G27450234005 5/6/2018 5/6/2019 Each Claim $1,000,000 Claims-Made Aggregate $2,000,000 Re: Bid #18-7487 - Collection and Recycling of Latex Paint Collier County Board of County Commissioners are an additional insured under the terms and conditions of the General Liability and Automobile Liability policies with respect to work performed by the named insured as required by written contract. This insurance shall be primary and non-contributory. Cancellation: Thirty (30) days’ notice except for Ten (10) days’ notice for non-payment of premium. P Schmaltz/WENDTY Collier County Board of Commissioners 3295 Tamiami Trail East Naples, FL 34112 Swainson.Hall@colliercount 16.C.1.g Packet Pg. 771 Attachment: 18-7487 Clark_Insurance (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 11/27/2018 WorkComp Solutions, Inc. P.O. Box 24987 Lakeland, FL 33802 863-646-4642 863-646-3521 www.workcompsolutionsfl.com Bridgefield Employers Insurance Company 10701 A 830-35594 1/1/2018 1/1/2019 3 3 1,000,000N 1,000,000 1,000,000 Darrell J. Mills Eglis Vinson eglis@workcompsolutionsfl.com Clark Environmental, Inc. 755 North Prairie Industrial Parkway Mulberry FL 33860 45530375 3 For any and all work performed on behalf of Collier County. Collier County Board of Commissioners 3295 Tamiami Trail East Naples FL 34112 Project No. 18-7487 - Collection and Recycling of Latex Paint Waiver of Subrogation in favor of Collier County Board of Commissioners, it officers and employees, with respect to Workers' Compensation. 30 Day Notice of Cancellation Applies. 45530375 | 18/19 WC | Eglis Vinson | 11/27/2018 11:32:19 AM (EST) | Page 1 of 2 This certificate cancels and supersedes ALL previously issued certificates. 16.C.1.g Packet Pg. 772 Attachment: 18-7487 Clark_Insurance (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) Clark Environmental, Inc. 830-35594 1/1/2018 Bridgefield Employers Insurance Company 11/27/2018 45530375 | 18/19 WC | Eglis Vinson | 11/27/2018 11:32:19 AM (EST) | Page 2 of 2 This certificate cancels and supersedes ALL previously issued certificates. 16.C.1.g Packet Pg. 773 Attachment: 18-7487 Clark_Insurance (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to Clark Environmental) State of Florida Department of State I certify from the records of this office that CLARK ENVIRONMENTAL,INC. is a corporation organized under the laws of the State of Florida,filed on April 17,1991. The document number of this corporation is S46584. I further certify that said corporation has paid all fees due this office through December 31,2018,that its most recent annual report/uniform business report was filed on January 24,2018,and that its status is active. I further certify that said corporation has not filed Articles of Dissolution. Given under my hand and the Great Seal of the State of Florida at Tallahassee,the Capital,this the Twenty-fourth day of January, 2018 Tracking Number:CC2790688683 To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateOfStatus/CertificateAuthentication 16.C.1.h Packet Pg. 774 Attachment: 18-7487 Clark_State of Florida Corporation Certificate 2018 (7750 : Award Solicitation No. 18-7487, "Collection and Recycling Latex Paint", to