Agenda 11/10/2009 Item #16F 2
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Agenda Item No. 16F2
November 10, 2009
Page 1 of 18
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Recommendation that the Board of County Commissioners approves an Agreement
between the State of Florida, Division of Emergency Management and Collier County
accepting $7,086 for the preparation of Hazards Analysis Reports for facilities storing
extremely hazardous substances within Collier County and authorize all necessary
budget amendments.
OBJECTIVE: To obtain Board of County Commissioners approval of an Agreement between
the State of Florida, Department of Community Affairs (DCA), Division of Emergency
Management (OEM) and Collier County accepting $7,086 for the preparation of hazards
analysis reports on twenty-nine (29) Extremely Hazardous Substances (EHS) sites within
Collier County.
CONSIDERATIONS: The State of Florida, DCA, OEM requires that 50% of the Extremely
Hazardous Substances (EHS) sites within Collier County be visited and reported on each year.
The Conservation and CoastallVlanagement Element of the County Growth Management Plan
requires that hazards analysis site visits be made to all sites biennially, Acceptance of the
Agreement will allow Collier County to comply with both the DCA, OEM and Collier Growth
Management Plan requirements. Under the terms of the Agreement, 100% of the EHS sites in
the County will be visited and reported on by March 1,2010.
- Agreement A 12659 was received by the Emergency Management Department on October 1,
2009 and assigned county contract # 10-5363. Emergency Management staff does not
anticipate problems meeting the first deliverable date of December 1, 2009, and is
recommending that the County accept the Agreement as written.
FISCAL IMPACT: An increase by budget amendment of $7,086 to Fund 118 (Emergency
Management Grants) for FY 10. No matching funds are required.
LEGAL CONSIDERATIONS: This Executive Summary and underlying agreement have been
reviewed for legal sufficiency and are legally sufficient for Board action. (STW)
GROWTH MANAGEMENT IMPACT: The review and updating of hazards analysis reports is
required by the Conservation and Coastal Management Element of the County Growth
Management Plan, Objective #9.1, Policy 9.1.7.
RECOMMENDATION: That the Board of County Commissioners approve and authorize its
Chairman to sign an Agreement between the Florida Department of Community Affairs
(DCA), Division of Emergency Management (OEM) and Collier County accepting $7,086 for
the preparation of hazards analysis reports for twenty-nine (29) facilities within Collier County,
and authorize all necessary budget amendments.
- Prepared by: Christine Chase, Sr. Admin. Assistant, Emergency Management Department
.a- 1,,4.0"'" ..L V..L ..L
Agenda item No. 16F2
November 10, 2009
Page 2 of 18
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
,.,,_.
Item Number:
Item Summary:
16F2
Recommendation that tne Boara of County Commissioners approves an Agreement between
the State of Florida, Division of Emergency Management and Collier County accepting
$7,086 for the preparation of Hazards Analysis Reports for facilities storing extremely
hazardous substances within Collier County and authorize all necessary budget
amendments.
Meeting Date:
11/10/2009 9:00:00 AM
Prepared By
Christine Chase
Senior Administrative Assistant
Date
County Manager's Office
Emergency Management
10/22/200910:10:59 AM
A pproved By
Marlene J. Foord
Grants Coordinator
Date
Administrative Services
Administrative Services Admin.
10/25/20091 :03 PM
Approved By
Dan E. Summers
Bureau of Emergency Services Director
Date
County Manager's Office
Bureau of Emergency Services
"10/26/2009 1 :09 PM
Approved By
OMS Coordinator
OMB Coordinator
Date
County Manager's Office
Office of Management & Budget
10/29/2009 1 :46 PM
Approved By
Sherry Pryor
Management & Budget Analyst
Date
County Manager's Office
Office of Management & Budget
10/3Q12009 12: 16 PM
Approved By
Jeff Klatzkow
County Attorney
Date
County Attorney
County Attorney Office
10130/20092:26 PM
Approved By
John A. Yonkosky
Director of the Office of Management
Date
County Manager's Office
Office of Management & Budget
10/30/20093:42 PM
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Agenda Item i\Jo 16F2
November 10. 2009
Page 3 of '!8
D 1/16
Order No. A 12659
Issued on Tue. 06 Oct. 2009
Creeted on Too. 06 Oet. 2009 by Ar1ba System
Supplier:
COL.L.IER COUNTY EMERGENCY MANAGEMENT
SUITE 44518075 tEL Y CUL TU~.AL l)!<\NV
NAPL.ES, Fl. 34113
Phone: 239-252-3617
Fax: 239-252-6769
Conlacl; CHRISTINE CHASE
Ship To:
DCA - DivisIon of emergency Manilgtlm,nt
2555 Shumard oak Blvd
Tallahsssee, Fl. 32399-2100
United Stlltes
Bill To:
DCA. Divl810n of Emergency Management
OepeMment of CommLnlty Affe1rs
2555 ShI.rnIlrd Oak BtYd
Tallahassee. f"L 323t19-2100
UIlted States
Entity o.scrlptlQl1; Department of CommLllily Affairs
Organization COde: 52600502001
Object Cod,; ??oo00-730000
~anslon Option: 04
Exemption Status: y"
Exemption Reason?: 1 E
Deliver To:
Nlelde Ryster
Version Number: 1
Requester. Nlelde Ryster
Ship To Code: U0A03q2ft.t1,q
Distributors?: N
State Contract 10:
PR No.: PR4159760
Requester Phone: 8504139943
Mast~ Agreement 10:
MyGreenFlorlda Content: N
Method of Procurement: L - governmental agency per 287.057(5)(f)13, defined In 163.31e4(10).
Shipping Method; Best Way
FOB Code: INC-Dest
FOB Code Description; De5tlnation freIght pald by vendor and inclUded In price. Tl1le passes upon receipt. Vendor files any d!lims.
Encumber Funds: Yes
PO Start Date: Mon, 28 Sep, 2009
PO End Date; Wed. 30 Jun, 2010
Fiscal Year Indicator: 2010
PUIIt; 5260
Site Code: 520000-00
Additional Item Info:
Terms and CondJ1lons: hffp:/lmarkelplace.myflonda.conwendor/pcUou.pdf
P Card Order?: No
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Agenda Item r\!o. 16F2
November 10, 2009
Page 4 of 18
D 2/16
Item Oncr/ptlon Part Unit Qty N.ed By Unit Price Extended Amount
N U!llber
1 50% of all hlZard analysl. complced by ... each 1 None $3,188.7oo00USD $3,188.700DDUSD
I 50',4 of 81 hlllard analysis eompleted by December 1, 2009 and aPPl'O\led tJy the Project Maneger as specJ1led In the attached Scope of Work.
IWm O..crlptlon Part Unit Qty N..d ~y Unit Prlc. extended Amount
Number
2 50% of the remaining hazard anal)'Bill .N each 1 None $3,188.70000USD $3,188.70000USD
I 50% 01 the rematntng hazard analysis completed by March 1. 2010 and apprOlled by the Project Mllne.ger as specl1led In the llttached Scope of
Work.
Item Dellcriptlon Part Unit Qty Need By Unit Price Extended Amount
Number
3 Haurd Analyele approval, cll.trlbutlon ancl... 8ach 1 None $70e.aOOOOUSD $70S.60000USD
Hazard Analysis approval. distribution and notification.
Total S7,066.00000USD
.. ..---,- ---
Status: Ordering
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Comments
· SUBMITTED by Davia Shufflebo1ham on MQOdlY, Sepwmber 28,2009 at 10:54 AM wi1h comment (2 docurnentll attached)
See attached Scope of Work and supporting documentallon. CSFA No. 52.023.
F'lease sign and reiLm the Scope 01 Work Aecaplanee Form.
Contact F'erson: TIm Date, Tel, No. 1150...410.1272 (David SlUfIebotham, Mon, 28 Sep, 2009)
· APPROVED by Nickle Ryster on Frtday, October 2. 2009 at 5:08 PM wi1h comment
Coding Ipproved. (Nickle Ryster, Fri, 02 Oct, 2009)
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Aaenda item ~~o. 16F2
~ November 10, 2009
Page 5 of 18
D 3/16
Attachment A
PURPOSE, REQUIREMENTS, SCOPE AND SCHEDULE OF DELIVERABLES AND
SCHEDULE OF PAYMENTS
PurDos.e
To update the hazards analysis for all facilities listed in Attachment B, whioh have reported to the State
Emerg&ncy Response Commission the pr.sence of those specific Extremely Hazardous Substances
designated by the U.S. Environmental Protection Agency in quantities at or above the Threshold Planning
Quantity. The data collec1ed under this Agreement wlll be used to oomply with the requirements of the
Emergency Planning and Community Rlght-To-Know Act's planning requirements.
Reaulrements
A. The County shall submit a list of faollities within the County's geographical boundaries that are
suspected cf not reporting to 1he State Emergency Response Commission the presenoe of
Extremely Hazardous Substances in quantities at or above the Threshold Planning Quantity, as
designated by the U. S. Environmental Proteotion Agency.
B. The completed hazards analyels shall comply with the site-specific hazards analysis criteria
outlined in this Attaohment for eaoh iaollfty listed in Attaohment B. The primary guidance
doouments are Attaohment D (Hazards Analysis Contract Checklist and CAMEO Guide) to this
Agreement and the U.S. Environmental Protection Agency's "Technical Guidance for Hazards
Analysis". All hazards analyses shall be consistent with the provisions of these documents, Any
variation from the procedures outlined in these documents must be requested in writing and
approved by the Division.
C. Provide an on-site visit to each Attachment B facility to ensure accuracy of the hazards analysie.
Eaeh applicable facility's hazards analysis information shall be entered into the U.S.
Environmental Protection Agenoy's CAMEOfm software program. Each facility hazards analysis
shall Include, but Is not Jimlted to, the following i1ems:
(1) Faaility Information
(a) Provide the Facility name (per Attaohment B)
(b) Facility addreS$
Provide the physioal address (no Post Offioe Box) of the facility,
(c) Faolllty Identification
Provide the State Emergency Response Commission Code
identification number (per Attachment B) and the geographic
coordinates (latitude and longitude in decimal degrees).
(d) Faoility Emergency Coordinator
Provide the nam., titl, and 1elephone number (daytime and 24-hour) of the
designated facility emergency coordinator.
(e). Transportation Routes
List the main routes used (from the County line 10 1he facility) to
transport ohemicals to and/or from the facility.
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Agenda Item No. 16F2
November 10, 2009
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(I) Evacuation Routes
Based on wind dlrec1ion from the North, South, East and W.s~, identify the
route(a) from the facility to exit the Vulnerable Zone(s).
(g) Historical Accident Record
Desoribe any past releases or Inoidents that have oocurred at the
facility. Include date, ~im., ch.mical nam., quantity and number of
perlons injured or killed (this Informa~ion Is available from ~h. fe.oilny).
If It Is determined that a facility does not have a historical accident
record, the.~ shall be noted.
(2) Hazard Identifioallon
(a) Chemloallclentltles
Provide proper chemical name, Chemical Aba~ract Service (CAS)
number and natural physical state (according to exhibit G of the
Teohnical Guidance for Hazards Analysis) for each Extremely
Hazardous Substance pre.ent at the facility at any time up to one year
prior to the site visit.
(b) Maximum quantity on-site
Expreu In exac1 pounds (not range codes) the maximum quantity of
iNch Extremely Hazardous Substance the facility has on-site at any
time up to one year prior to the site visit.
(0) Amount in largest container or interconnected contain.rs
5xpr... In pound. the amount of eacn Extremely Hazardous
Substanoe stored in the largest container or interconnected containers
(this Is the release amount used to determine the Vulnerable Zone).
(d) Type and design of storage oontainer or vessel
Indloa~. the storage method of each Extreme!y Hazardous Substance,
I.e., drum, oyllnder, tank, and their respective capacities (It is helpful to
Indicate system types suoh as manifold versus vaouum as well).
(9) Nature of the hazard
Describe 'the type of hazard (i.e" fire, explosion) and hee.l~h .ffects
(acute and chronic) most likely to acoompany a spill or release of each
Extremely Hazardous Substance.
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Agenda Item No. 16F2
November 10, 2009
P[j%716of 18
(3) Vulnerability AnalYoi~
(a) Extent of the Vulnerable Zone
For eaoh Extremely Hazardous Substance present at a facilltYI provide
the estimated geographical area (vulnerable zone) that may be subject
tl;J conC*rTtralion$ 01 an airborne Ex:il'.m.iy Hazardous Substance at
levels that could cause irreversible acute health effects or death to
human populations following an accidental release,
(b) Estimate Faoility Population
Provide an estimate 01 the maximum number of employees present at
the facility at any given time, i.e, if the facility is unmanned except for
rou1fne maintenance by only one person then, the number of
employees present at any given time shall be noted as one.
(c) Critical FacUlties
Identify each oritical facility by name and eaoh cmlcal faollity's
maximum expected occupancy, within each vulnerable zone, which are
essential to emergency response or house special needs populations
(schools, day cares, public safety faollitles, hospitals. eto,). If there are
no critical facilities within the vulnerable zone, that shall be noted.
(d) Estimate Total Exposed Population
Provide an es1imate of the total exposed population (faoillty employees oj.
general population + critical facilities), within each vulnerable zone, that would
be affected in a worit case release scenario.
(4) Risk Analysis (the three ratings {Risk Assessment} at the bottom of the CAMEOfm
Scenario Page will meet the four requirements below)
(a) Probability of release
Rate the probability of release as Low, Moderate, or High based on
observations at the facility. Considerations should Include history of
previous Inoldents and ourrent conditions and oontrols at the facility.
(b) Severity of consequences of human Injury
Rate the severity of oonsequences If an actual release were 10 occur
(c) Severity of consequences of damage to property
Rate the potential damage to the facility, nearby buildings and
Infrastructure If an actual release were to occur,
(d) Severity of consequences of environmental exposure
Rate the potential damage to the surrounding environmentally
sensitive areas, natural habitat and wildlife if an actual release were to
occur.
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Agenda Item No. 16F2
November 10. 2009
1f%EJP6of 18
D. Identify those faollities in Attachment B for which a hazards analysis was not submitted.
Supporting documentation must be provided with a Hat to account for the facilitiea for which
a hazards analysis was not oompleted, In addltlon to the facility name and the State
Emergency Response Commission Code identification number, supporting doeumentation
should Indicate:
(1) Facility has closed or Is no longer in business,
(2) Facillty is not physloally located in the County (indicate appropriate County location, if
known).
(3) Facility does not have Extremely Hazardous Substance(s) on-site or Extremely
Hazardou$ Substance(s) are below the Threshold Planning Quantity. TheM faclll1ies
require:
(a) A Statement of Determination from 1Me facility representatIve for the previous
reporting yearj or
(b) A letter ~rom the facility representative fully explaining why the Extremely
Hazardous Substanoe(s) Islara not now present at or above the Threshold
Planning Quantity and a date when the Extremely Hazardous Substanoe(s)
wat/were removed from the facility.
E. On-Site Visits
(1) Conduct a detailed on-site visit, within the period of this Agreement, of all the laellities
listed In Attaehment 8. to confirm the accuracy and completeness of Information in
the hazards analysis.
(2) SubrrJl1 a completed Huards Analysis Site VIsit Certification Form (Attachment E) to
the Division for each facility site visit conduc1ed,
(3) $l,lbmlt (eleetronicallv) a site plan map wi1h the State emergency Response
Commission Code Identification number and in suffioient detail to identify:
(a> location of major building(s)
(b) Looation and Identification of EHS oontainer(s)
(0) Looatlon of major street(s) and amranoe(s)
(d) North arrow
F, Ensure that the Hazards Analysis Information is reflected In the County Looal Mitigation
Strategy,
Scope and Schedule of Dellverables
Deliverable 1:
On of belore Deoember 1, 2009, the County shall submit lifty (50) peroent of the completed
hazards analyses of the Attaohment B faollltles to the Division for review and approval.
Deliv8l'8bl82:
On or before March 1, 2010, the County shall submit the final fifty (50) parcent of the completed
hazards analysea of tM Attachment B facilities to the Division for review and approval.
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Aaenda Item ~~o. 16F2
- November 10, 2009
Paqe 9 of 18
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Deliverable 3:
A. On or before June 30,2010, the County shall provide the Division one (1) copy (electronic
format) of each approved hazards analysis, A oomplete copy of each approved hazards
analysis shall be submitted to the applicable Local Emergency Planning Committee and a
copy of the transmittal document shall be submitted to the Division,
B. The County shall notify all Attachment 8 facilities and applicable first responder agencies of
the availability of the hazards analyses information, and make that Information avallable upon
request and submit proof of said notifioations to the Division,
C. As appropriate, participate In a teohnlcal assistance training session provided by the Division.
Schedule of Payments
Payment
Deliverable #1 . 45% of the Agreement Amount
$3,1 aa .70
Oellverable #2 - 45% of the Agreement Amount
$3,188.70
Oeliverablel3 - 10% of the Agreement Amount
$708.60
Each payment shall be made upon satisfactory completion of the dellverable a.bove and upon receipt of
an aooeptable Flnanclallnvoloe (Attaohment C).
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Agenda Item No. 16F2
November 10, 2009
Pa~sr(!~f 18
I
I
ATTACHMENT B. COLLIER COUNTY SECTION 302 FACILITIES
LEPCISERC pl-ri-I Addl'ell
Code ..".--...
EVERGLADES CITY PUBLIC WORKS - BOOSTER WTP
9 NORTH COPBLAND A VBNtJB
11018 EVBRGLADES CITY FL 34139
Mdint Add_
CITY OP BVERGI...ADES CI1Y
POST Ol'P.lCBBOX 110
BVBRGLADES CITY PL 34139.
9 EMBMQ - NAPLES (GOLDEN GATE CE.N1'R.AL OFFICE
%61 StlNSET ROAD
22SS1 GOLDEN GATS FL 34116-512
EMEMQ
555 LAICa :BORDER DliUYB PLAPKAOZ06
APOPICA FL 32703
9 AG MART PRODUCB - PARM 12
!3SS COtlNTY R.OAD ass
33549 lMMOKALEB PL 34142-650
AG - MART PRODUCE
4006 NORTH AIRPORT ROAD
PLANTcnY PL 33563
AG MAR. T PRODUCB - IMMOXAI..:SB l'AlitM
9 C:OlJNTY ROAD 846
33621 lMMOKALBB PL 34142
AG-MARTPRODuca
4006 NOR.TI! AIRPORT ROAD
PLANT CI1Y PL 33563
BARNBTT l'ARMS
9 HlOHWA Y 858/ EAST COUN'Ii'LlNB RO:\D
18743 IMMOKALBB PL 34143
SARNErT l'ARMS
POST OFFICE BOX 1144
IMMOKALBB PL 34143.
PARMERS StJPFLY
9 710BROWARD STREBT
2517 IMMOKAUlB FL 34142
PARJ.!:E!JlS SUPPLY
710BROWARDSTMET
IMMOICAI..BB PI.. 34142-
9 OAROIULO - IlHN RBSMRCH
25672 IMMOICALEaROAD
20BO IMMOKAUm FL 34142
GARGIULO
15000 OLD US HIGHWAY 41 NORTH
NAPLES FL 34110..
HOWARD PBRTlLIZER - IMMOKALBB
9 218 WESTNBWMA.S.KBTROAD
29431 IMMOKALBB PI., 34142-
9 C1TV OP .MARCO ISLAND - LIMB SOFItlNlNG PLANT
9151 WlNDWARD DIilI'V:B
2318 MARCOISLAND PI., 3414.5-
HOWARD P.BR.TILIZBR
POST OPPICB BOX 6211202
O.RI..ANDo PI., 32862
C1TV OPMAR(:O ISLAND
50 BALD RAGLB DRIVE.
Mi\.RCO ISLAND FL 34145-3528
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Agenda Item No 16F2
November 10, 2009
Paae 11 of 13
D 9/16
LEPClSERC Pb)1dcal Address
Code
MaIling Addrea:
9 CITY OF M:ARCO ISI.AlIa'D . REVERSE OSMOSIS FAC'lLITY
415 LIILYCOtlRT
15121 MARCO ISLAND PL 34145-
CITY OF MARCO ISLAND
50 BALD BAGIB DIUVE
MARCO ISLAND PI. 34145-35211
9 EMllARQ. MARCO ISLAh'D I CBNTRAL OFFICE
401 BALD EAGLE DlUVE
15950 MARCO ISLAND FL 34145.271
EMBARQ
55'S LAKE BORD.E.R DRIVE FLAPKA0206
APOPKA FL 32703
CITY OF NAPL.BS - WATER PLAN'T Z
9 1000 FLBISCHMANN BOtJLEV ARD
21ZO NAPLES FL 34102
CITY OF NAPIBS
380 RlVERSIOB ClRCLB
NAPLES PL 34102-
CITY OF NAPt..:SS . WWTP
9 1400nrIRDAVENUBNORTH
2119 NAPLBS FL 34102.
c:ITY OF NAPLES
380 RlVBRSIDB ClRCLB
NAPLBS FL 34102-
CLASSIC BBNTt.EY VULAcm
9 2315 LBISURB LANE
32254 NAPLES PL 34110
CLASSICRBSIOENCBS BYKYATr
2315 LEISURE LANE
NAPLBS PL 34110
CLUB AT TEE STRAND
9 5BOO STRA.ND BOUL VBARD
2791~ NAPLBS PL 34110.139
THE CLUB AT THE STRAND
5800 STRAND BOULEVARD
NAPLES PL 34110.
9 CLUB PELICAN BA Y
6650WATEROATE. WAY
9624 NAPLES PI:. 341~.
THECLUBPEUCANBAY
707 G1JU1 PARK DRIVE
NAPLBS FL 34108-
EMBARQ. NAPLES ICfNI'RAL OFFICE
9 10201 NORT.HTAMIAMITRAIL
22570 NAPrE.S PL 341~
EMBARQ
SSS lAKB BORDER DRIVE PL.A.PKA0206
APOPKA PI.. 32703
EMBAIil.Q - NAPLES I NAPLBS AlRPORT Iil.LS
9 3150 Iil.ADIO ROAD
22537 NAPrE.S PI, 34104-
EMBARQ
55S lAKB BORDER DIUVE PLAPKAOZ06
APOPKA PL 32703
BMBAR.Q
555 Lo\KE BORDER DRIVE FLAPKA~06
APOli'KA PL 32703
BMBAIil.Q - NAPLES I NAPLBS MOOIil.lNG CBNTRAL OPPJeB
9 990 26 t\ VENUE NORTH
15951 NAPLBS PL 34103.
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Agenda Item ~--Jo. 16F2
November 10, 2009
P191~tlgf 18
LEPClSERC P"'-&..al ~.3 d
Cod. -r- ..... reIII
P G U A - GOLDEN GATE W1'P . 2184
9 430000LDENGATEPARKWAY
z184 N~ PL 34116
9 aARG!ULO-PARM1
15000 E!.AS1' us HlGHWAY 41
26355 NAPLES PL 34114-
MaWDI Add.....
FLORIDA OOVBB.NMBNTAL UTlLlTY AUTHORITY
280 WEICIV A SPRINGS ROAD. surm 203
LONGWOOD PL 32779
GARGIULO
15000 Dt.DUS HIGHWAY 41 NORnl:
NAPLES PI.. 34110-
GAAGIULO . GULF COAST FARM 1
\I 14 A VBNUB SOl1I'HEAST NBAR. GOLDBN GATE.
2223 NAPLES FL 34114-
GARGIULO
15000 OLD us lnGRWA Y 41 NORnl:
N:\PLBS FL 34110.
GARGIULO. S W F FARMS
\I 5870 COUNTY ROAD 858
6855 NAPLES PI. 34120-
GARGIULO
15000 OLD US HIOHW A Y 41 NORTH
NAPLES PI. 34110.
HALBAKAt.A CONSTlilUcnON
9 5758 TAYLOR ROAD
31660 NAPI.BS PI.. 34109-182
HA.I..EA.!C.A1. CONSTaucnoN
S7.58TAYLORIlOAD
NA.PL.BS PL 34109-1IZ9
r..BVBL 3 COMMUNICATIONS. NAPLES HUT
9 396020 PLACB SO't.lTHWE'.ST . NAPLES HUT
32936 NAPLES PI.
LEVEL 3 CO.MMUNICATIONS
543 INDUSTRlAL DRNB
LEWISBBRRV PA 17339
9 OLD COUJBR GOLF CLUB
797 W AI.XBll.ElLT ROi'J)
35531 NAPLES PI.. 34110
SAMS CLUB - STORE 6364
9 2550 lMMOXAI..BB ROi'J)
29655 NAPUlS PI. 34110.
THE OLD COILIER OOLP CLUB lNC
790 MAIN HOUSE DRIY.B
NAPLES PI.. 34110
SAMS BAST INC - CORPORATE COMPLIANCB
50a SO'L"mWRS'I' 8 STREB'!
llENTONVU..LB AR 72712-0505
SYNGENrASBBDS - NAPLBS
!l 10290 GRBSNWA Y aoi'J)
36191 NAPLES FL 34114
SYNGBNT A SEBDS
7500 OLSON MBMOlUAL HlGHW A Y
OOLDEN V AILEY MN .55421
WlNDST A.R CLUB
\l 4343 YACHT HARBORDRJVB
35132 NAPLES PI.. 3411Z
WlNDSTAR. CLUB, INC
1700 WINDSTAR BOULEV AR.D
NAPLES PL 3411z
B.3
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MyFlorldaMarketPlace
Aqenda Item No. 16F2
~ November 10, 2009
PaB81111cg 18
Attachment C
FINANCIAL INVOICE FORM
FOR
HAZARDOUS MATERIALS HAZARDS ANAL YSIS UPDATE
COUNTY: ., __~__'_"__
PURCHASE ORDER #
AMOUNT
REQUESTED
BY THE RECIPIENT
AMOUNT APPROVED
BY THE
DIVISION
1. First Payment (45% of contraet amoum) $
(50% Hazards Analyses completed/submitted)
2. Second Paymem (45% of contrac1e.mount) $
(50% Hazards Analyses completedlaubmitttd)
3. Final Payment(10% of contract amount) $
(approval, distribution & notification)
$
$
$
TOTAL AMOUNT $
$
(To be oompleted by
the Division)
I certify that to the best of my knowledge and belief the billed costs are In aooordance with the terms
of the Agreement.
Signature of Authorized OtficiallTitle
Date
TOTAL AMOUNT TO BE PAID AS OF
THIS INVOICE $
(To be completed by the Division)
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Agenda Item No. 16F2
November 10, 2009
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Attachment 0
FACfLf"I"'I( INFOltMA"Ot-l
Facility Name {per Attachment B} (..acUity .,.ge)
. FOlCility Physical <ld;;lr." (Facility page)
SERC Code Identification number {per Attachment 8. I.e. SEAC#XXXXX} (Department Field on F8clllty p."e)
Latltud. & ~ngltud.ln degr.../mlnutnluconda {I.e. 30,1917 - 84.S6Z1} (Map Data tab an Facility page)
Facility Emergency Coordinator name, title, phol'le IIllneludlng 24 hr. number} (Contect tab on Faolllty pege)
Transportation Route(s) {from county line 10 the faell~y} (Note. tab on Facility page)
Evacuation Aoute(s) to exit the vulnerable zone (Not.....b on Peclllty page)
HistorIcal Accident Record (If non., pl.... note} (Not.. tab on Fac:i1ity page)
H-Az.A.Rl> IJ)SNi1FICA"ON (for each Extremely Hazardoul Subltance on Bite)
Proper chemical name(s) (Chemical I" Inventory pegelllt})
Chemical Ablltract Service (CAS) number (Chemical in Inventory page{s})
Natural physiCal state {I.e. mixture, PUnt. liquid, solid, Ga.!!} {Chemical In II'lventory puge{.}, PhYlil'C111 State and Quantity tab)
Maximum quantity on-site in pounds (ChemIClllI in Inventory p.;g~sJ, Physical sate and Quantity tab)
Amount In largest container or Interconnected containers (Chemical I" Inventory ~el.}' Phyalc.tll State and Quantity tab)
Type and design of storage container(e) {i.e. cylinder, sl.el drum, carboy .tc,} (ChomiOllI in Inventory pagels}, Location tab)
Nature of the hazard {I.e., aCl.ltll. chronle. fire, prenol.lr8 e1e} (Chemical I" Inventory pegell}. Physic.' Stetlll and Quantity tab)
VIALN~1'laILl'TJ "t-IALY.'iIS (tor each Extremely Hazarc:1ou. Sub.tance on lite)
Estimat. vulnerable zone {threat zone} radius (bottom of Sce/lill'io Pilge{lI))
Facility Population (unlnanned facilitIes minimum of one 18 requIred tor malntenanett personnel} (ID Codee tab on Facility page)
Critical Facllitin {name of facilitIes and max occupancy tor each} [If none, piau. note] (Not.. tab on Scenario pagels})
Estimate Total Exposed Populatlon(s) {facility + general pol'ulatlon + crltlc&J faclUtlesJ (Notes tab on Soenarlo page{e})
R./SiC. ANALYSIS (for each Extremely Hazardous Sub'lBnce on lite) (SCenario p.ge{s})
The three radmm {Ril1k ASlessmentlat the bottom of the SCENARIO PAGE(S) wlll meet the four reaulrements below
Rate probability of release {I.e., low, medium or high}
Ra.te severity of consequences of human injury {l,c" low, medi\.lm or high}
Rate severity of con.lquencell of damage to grorJ.rtv fL,. low, medium or high}
Rate severity of coneequ.nce. of environmental IXPosur. {La" low, medium or high}
ON.SIT'6 VISIT"S (within the contract period)
COmple1ed hazards analysis site viSit certlflca.tlon form (submitted electronically or hard copy)
Sit, plan map (SUbmitted eleotronlcally) for each facility, with SERC cod. number and with sufficient detail to Identify:
Location of major building(s)
Location of contalner(s) of Extremely Hazardous Substance(s)
Location of major str.et(s) and entranca(s)
North arrow
I.M.z.Ai'~~ At-lALYSI.!!: CO~T"Ct+5t'..J(:LI.oI;T"ANb CAM50 ~""Il)15
The data in the Facility Inlonn8t[on, Hazard Identification, Vuln.rability Analyshs and Risk Analyshs
sections noted above shell be submitted electronically in a CAMEOfm zip file format
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AqencJa Item i\lo. 16F2
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Attachment E
Name of Facility (Please print)
Name of County (Please print)
State Emergency Response Commission (SERe) Code
Name of Facility Representative (Please print)
Facility Representative Signature
Site Visit Date
Name of Inspector (Please print)
Inspector's Signature
Site Visit Date
The individuals sianina above certify that a hazards analvsis site visit was conducted on the above date,
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Agenda Item No. 16F2
November 10, 2009
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,-
ATTACHMENT "F"
METHOD OF COMPENSATION
1,0 PURPOSE:
This Attachment defmes the limits of compensation to be made to the County for the services set
forth in Attachment "Au and the method by which payments shall be made.
2,0 COMPENSA TION:
For the satisfactory performance of services detailed in Attaclunent "An, the County shall be
paid the amounts in accordance with Schedule of Deliverables and Payments in Attachment "A"
fur a maximum contract value of $7.086.00.
3.0 PAYMENTS:
The County shaU submit an original signature invoice (3 copies) in a format acceptable to the
Division. Payment for services shall be made at amounts shown in Attachment "A", as approved
by the Division.
Invoices shall be submitted to:
Florida Division of Emergency Management
Tim Date. Planning Mana~
2555 Shumard Oak Blvd.
Tallahassee. FL 32399-2100
4.0 DETAn..s OF COSTS AND FEES:
Detail s of the County's bllllng rates for these services are contained in Attachment "A", attached
hereto and made a part hereof.
5.0
TANGIBLE PERSONAL PROPERTY:
--
-
This contract does not involve the purchase of Tangible Personal Property, as defined in Chapter
273, F.S.
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Aaenda item No. 16F2
~ November 10, 2009
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ATTACHMENT G
ADDITIONAL TERMS AND CONDITIONS
1. A later date may be agreed upon in writing by both parties to this Agreement.
2. The Division will be the sole auihorlty for determining extenuaiing circumstances and
granting extensions to the deliverable deadline,
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Agenda Item No. 16F2
November 10, 2009
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HAZARD ANALYSIS UPDATE
SCOPE OF WORK ACCEPTANCE
The governmental entity indentified in the Scope of Work agrees to fully perform the
specified services in Attachment A, Purpose, Requirements, Scope and Schedule of
Deliverables and Schedule of Payments and all other supporting documentation attached
to this Purchase Order.
Please sign and return this acceptance form prior to commencement of services to:
Tim Date, Planning Manager
2555 Shumard Oak Blvd.
Tallahassee, Florida 32399-2100
ATI'EST:
Dwight E. Brock, Clerk of Courts
BOARD OF CDUNrY Cll'IMISSIONERS
cx)LLIER cx)UNTY, FlDRIDA
By:
By:
J:orma Fiala, Chairman
Dated:
(Seal)
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