Loading...
Agenda 05/27/2025 Item #16C 2 (Award of Invitation to Bid No. 24-8307 to Chemical Injection Partners Florida, LLC, as the Primary Vendor, and Razorback, LLC, as the Secondary Vendor, for Deep Injection Well System Preventative Maintenance and Repairs)5/27/2025 Item # 16.C.2 ID# 2025-1388 Executive Summary Recommendation to approve the award of Invitation to Bid No. 24-8307 to Chemical Injection Partners Florida, LLC, as the Primary Vendor, and Razorback, LLC, as the Secondary Vendor, for Deep Injection Well System Preventative Maintenance and Repairs and authorize the Chairman to sign the attached Agreements. OBJECTIVE: To provide preventative maintenance, inspection, and repair services for the Deep Injection Well (DIW) system and the Master Leachate Pump Station (MLPS) at the Collier County Landfill. CONSIDERATIONS: The DIW and MLPS systems are essential to the operation of the Collier County Landfill for liquids management. Routine maintenance, inspections, and repairs are necessary to ensure those systems function properly, minimizing the risk of system failures and ensuring compliance with environmental and operational standards. This preventative maintenance is critical to minimizing environmental risk, maintaining system reliability, and avoiding costly emergency repairs. On December 19, 2024, the Procurement Services Division issued Invitation to Bid No. 24-8307 for Deep Injection Well System Preventative Maintenance and Repairs. The County received two responsive and responsible bids by the February 11, 2025, submission deadline. Staff recommends awarding the attached Agreement No. 24-8307 to Chemical Injection Partners Florida, LLC, as the Primary Vendor, with Razorback, LLC, as the Secondary Vendor, to ensure continuity and flexibility in addressing maintenance and repair needs as they arise. The results of the Invitation to Bid appear in the table below. Respondents: Company Name City County State Amount Responsive/Responsible Chemical Injection Partners Florida, LLC Sarasota Sarasota FL $55,550.00 Yes/Yes Razorback, LLC Tarpon Springs Pinellas FL $56,105.00 Yes/Yes Chemical Injection Partners Florida, LLC offered the lowest, responsible and responsive bid and is recommended as the Primary vendor with Razorback, LLC as the Secondary vendor. Both companies meet the requirements of the Invitation to Bid to deliver the required services and have demonstrated the capacity to fulfill the terms of the Agreement. This dual award approach ensures that the County has a reliable backup vendor to ensure timely service delivery, should a need arise. This item is consistent with the Infrastructure and Asset Management element of the Collier County Strategic Plan to optimize the useful life of all public infrastructure and resources through proper planning and preventative maintenance. FISCAL IMPACT: The annual cost of this contract will vary based on several factors, such as age of system components, required equipment run time, type of service repair, and can be impacted by emergency disasters. No single quote for a single repair project shall exceed $200,000. Funds are available and budgeted in the Solid Waste Disposal Fund (4070) budget approved by the Collier County Board of Commissioners on September 19, 2024. GROWTH MANAGEMENT IMPACT: There are no Growth Management impacts associated with this action. LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires majority vote for Board approval. —SRT RECOMMENDATIONS: Recommendation to approve the award of Invitation to Bid No. 24-8307 to Chemical Injection Partners Florida, LLC, as the Primary Vendor, and Razorback, LLC, as the Secondary Vendor, for Deep Page 5925 of 7924 5/27/2025 Item # 16.C.2 ID# 2025-1388 Injection Well System Preventative Maintenance and Repairs and authorize the Chairman to sign the attached Agreements. PREPARED BY: Brett Rice, Environmental Specialist II, Solid & Hazardous Waste Management Division Kari Hodgson, P.E., Director, Solid & Hazardous Waste Management Division ATTACHMENTS: 1. 24-8307 Solicitation 2. 24-8307 Bid Tab 3. 24-8307 - NORA 4. 24-8307 Contract VS_Chemical Injection.rev 5. 24-8307 Chemical Injection_Bid Packet 6. 24-8307 Chemical Injection Insurance Requirements 7. 24-8307 Contract VS_Razorback.Rev1 8. 24-8307 Razorback_Bid Packet 9. 24-8307 Razorback Insurance Requirements Page 5926 of 7924   COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS INVITATION TO BID (ITB) FOR DEEP INJECTION WELL SYSTEM PREVENTATIVE MAINTENANCE AND REPAIRS SOLICITATION NO.: 24-8307 LISA OIEN, PROCUREMENT STRATEGIST PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FLORIDA 34112 TELEPHONE: (239) 252-8935 Lisa.Oien@colliercountyfl.gov (Email) This solicitation document is prepared in a Microsoft Word format. Any alterations to this document made by the Bidder may be grounds for rejection of the bid, cancellation of any subsequent award, or any other legal remedies available to the Collier County Government. Page 5927 of 7924 SOLICITATION PUBLIC NOTICE INVITATION TO BID (ITB) NUMBER: 24-8307 PROJECT TITLE: DEEP INJECTION WELL SYSTEM PREVENTATIVE MAINTENANCE AND REPAIRS PRE- BID MEETING: January 9, 2024, at 10:00 AM EST LOCATION: Collier County Landfill, located at 3730 White Lake Blvd. Naples, FL. 34117 DUE DATE: January 28, 2025, at 3:00 PM EST PLACE OF BID OPENING: PROCUREMENT SERVICES DIVISION 3295 TAMIAMI TRAIL EAST, BLDG C-2 NAPLES, FL 34112 All bids shall be submitted online via the Collier County Procurement Services Division Online Bidding System: https://procurement.opengov.com/ INTRODUCTION As requested by the Solid Hazardous Waste Division (hereinafter, the “Division”), 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 Commissioners Procurement Ordinance. County departments anticipate spending $55,000 annually; however, with aging equipment and County growth, it is anticipated future spend may exceed this amount. BACKGROUND The Solid & Hazardous Waste Management Division is seeking qualified vendors capable of inspecting, maintaining, and making repairs as needed to the County Landfill Deep Injection Well (DIW) system. The DIW system includes the components that make up the DIW and the components of the associated Master Leachate Pump Station (MLPS). These services are needed to maintain the functionality of this essential system and keep its components in good working order. Routine inspections/preventative maintenance and needed repairs are required to ensure continued operations of the DIW system and to identify and address potential problems before a possible failure of the system. The Collier County Landfill Deep Injection Well currently takes all the leachate flow from the landfill’s MLPS into the (on-site) leachate storage tanks which introduce the leachate into the DIW (based on flows). All maintenance and service repair work performed must ensure proper function and operation of the system’s equipment twenty-four hours a day, seven days a week and three hundred and sixty-five days a year (24/7/365). For more information please reference: Exhibit A – Landfill DIW/MLPS Site Locations Exhibit B – DIW/MLPS Site Specifications Exhibit C – Operational Guide Exhibit D – Example Preventative Maintenance Schedule Presently, County Staff monitors, inspects and maintains the components of the DIW system. FEMA funding may be used, in part, in support of this service and the vendor must comply with all FEMA grant requirements for any such work. TERM OF CONTRACT The contract term, if awards are made is intended to be for (3) years with two (2) one (1) year renewal options. Page 5928 of 7924 Prices shall remain firm for the initial term of this contract. A Purchase Order shall survive Contract expiration to allow completion of work commenced prior to the contract expiration date. Blanket Purchase Orders will not survive the contract expiration date. Surcharges will not be accepted in conjunction with this contract, and such charges should be incorporated into the pricing structure. 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 Vendor 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. FEMA funding may be used, in part, in support of this procurement. All goods are FOB destination and must be suitably packed and prepared to secure the lowest transportation rates and to comply 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 price as outlined below:  Lowest Total Bid  Collier County reserves the right to select one, or more than one supplier, 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:  Identify Primary, Secondary and Tertiary Awardees  Should the Primary not be able to support the work request, the department will move to the Secondary and then Tertiary as necessary.  The County reserves the right to issue a formal contract or standard County Purchase Order for the award of this solicitation. DETAILED SCOPE OF WORK The Solid & Hazardous Waste Management Division is seeking qualified Vendors to provide inspections, required reporting, preventative maintenance, and repair services on an as needed basis for County owned deep injection well (DIW) and master leachate pump station (MLPS). 1. LOCATION: Collier County Landfill 3730 White Lake Blvd. Naples, FL 34117 2. VENDOR REQUIREMENTS 2.1. Vendor must schedule all site visits with County staff. 2.2. Vendor must sign-in at the Scalehouse prior to coming on site. 2.3. For each site visit, the awarded Vendor will provide an Inspection/Maintenance Service Report. The Report should include the following:  Record of inspection including all findings/remarks for each system component  All preventative maintenance items completed  Recommend repairs, if applicable Page 5929 of 7924 The Inspection/Maintenance Service Report must be completed and submitted by Vendor to County Representative upon preventative maintenance completion or within five (5) business days if repairs are recommended. 2.4. The Vendor shall use a County provided Inspection/Maintenance Service Report if requested to do so by the County. 2.5. All system inspections and observations and servicing shall be documented, including notations of repair, cleaning, replacements, etc. 3. PREVENTATIVE MAINTENANCE AND REPAIRS 3.1. Exhibits C – Operational Guide and Exhibit D – Example Preventative Maintenance Schedule should be used as reference. These documents are subject to change as needed. 3.2. The Vendor shall inspect and maintain all operational components of the system in accordance with the Operational Guide (Exhibit C). Examples include inspection, correction, repair, protection, and functional testing of system components included but not limited to:  HOA (Hand - Off - Auto) switches positions  Electrical cabinet/panel spring clips  All padlocks (e.g. lubricated) (all gates, valves panels, etc.). 3.3. Work associated with electrical controls and panels. Inspection, testing, cleaning, and repair or replace, as necessary, for system components, included but not limited to:  Exterior of cabinets/panels (i.e., rust, corrosion, etc.)  Interior of cabinets/panels (i.e., water intrusion, insects, etc.)  Rubber seals  Locks  Light and alarm systems  Cooling systems  Filters 3.4. Inspect, clean, test, repair/replace operational system components of the DIW, included but not limited to safety features:  Fence and Gates  Site Lights (functioning during night and off during day)  Containment walls (interior and exterior), pads, and tank exteriors  Level sensing devices (mechanical float, or transducer)  Discharge pipes 3.5. Quarterly clean sediment and debris from the containment-sumps; and pressure wash sump pumps. 3.6. Run pumps manually to ensure proper operation without unusual sounds or leaks. 3.7. All system inspections and observations shall be documented, including notations of repair, cleaning, replacements, etc. 3.8. Clean debris from three (3) DIW pump filter baskets. 3.9. The Vendor will make all necessary repairs to bring the DIW/MLPS to proper operating condition. 3.10. If a repair is recommended, the Vendor will provide a quote to the County Representative within three (3) business days from the date of the inspection, unless it is determined to be an urgent repair, then the Vendor shall work with the County Representative for a quick resolution. 3.11. Should minor repairs or replacement parts be required or recommended by the Vendor while performing the preventative maintenance, and the Vendor is able to repair or replace during the preventative maintenance service, the Vendor shall provide a quote for any parts and labor related to the minor repair in writing prior to the repair and obtain the County Representative or their designee’s approval. Labor rates and markup shall be in accordance with the Fee Schedule. 3.12. No single quote for a single repair project shall exceed $200,000. The County does reserve the right to competitively bid any repair project, if deemed in the best interest of the County. The County also reserves the right to separately purchase Page 5930 of 7924 equipment required for the job and may request the Vendor to provide delivery and installation services. 3.13. The County Representative shall determine if the quote provided is fair, reasonable and within an acceptable spend threshold. 3.14. Labor rates and applicable markups shall be in accordance with the Fee Schedule. 3.15. Hourly labor rates shall be inclusive of all overhead, insurance, profit, travel, and use of company owned equipment (excluding rental equipment). 3.16. Should the Vendor need to hire a subcontractor, the subcontractor charges may be invoiced at cost plus 15% markup. A copy of the subcontractor’s invoice shall be required with the Vendor’s invoice. The subcontractor’s hourly rate may not exceed the Vendor’s hourly rates listed on the Fee Schedule. 3.17. Parts and materials must conform to the Collier County Vertical Standards, otherwise, they will require written approval from the County Representative or their designee. 3.18. Parts and materials may be invoiced at cost plus 10% markup. Parts/ materials with a single item amount of $500.00 or more shall require the Vendor to provide backup documentation. All shipping or freight charges must have backup documentation regardless of amount. Should the Vendor need to rent equipment to complete the project, rental charges may be invoiced at cost plus 10% markup. A copy of the rental receipt, regardless of amount, showing the cost shall be required with the Vendor’s invoice. Ancillary charges may be transferred to the County in the actual amount; however, mark-ups will not be allowed on taxes, freight/shipping, and/or permits. 4. WORK HOURS AND VENDOR CONTACT 4.1. Normal business hours shall be 7:00am to 5:00pm, Monday through Friday, excluding County observed holidays. After hours are considered to be requests outside of the normal business hours, weekends and County observed holidays or in the event of a declared local state of emergency and vendor shall be paid 1.5x straight time applicable in accordance with the Fee Schedule. 4.2. The Vendor shall provide a company contact name, phone number and email address for all requests and shall be available twenty-four (24) hours per day, 365 days per year. 4.3. The County will issue a Purchase Order prior to commencement of work. No work shall be performed until the Vendor is in receipt of an approved purchase order. 5. RESPONSE TIMES FOR REPAIRS/REPLACEMENTS 5.1. Normal Request  Vendor shall acknowledge a service request via email or phone call within one (1) business day from the time the County issued the request and begin work within five (5) business days of the initial request.  Additional response time may be approved in writing by the County. 5.2. Urgent Work Request  Vendor shall acknowledge an urgent request via email or phone call within two (2) hours of the request being sent by the County and shall coordinate with the County Representative for arrival time needed.  Vendor shall be paid 1.5x straight time hourly rate(s) in accordance with the Fee Schedule for urgent work requests regardless of the day or time the work is performed. 6. PRICE MODIFICATIONS 6.1 The Vendor may request a price modification no less than one hundred twenty (120) days prior to the end of the initial contract period.  Retroactive price adjustments are not authorized.  Submit price increase requests in writing by email to the County Representative or designee no less than 120 days before the end of the initial contract period. Vendor shall provide supporting documentation justifying price increases (examples: Vendor's material agreements, distributor invoices, proof of fuel increases, etc.) If there is no documented Proof, price modifications will not be considered.  County Representative or designee shall analyze prices to determine if increases are fair and reasonable. Page 5931 of 7924  During the review process, the Vendor shall continue to fill all purchase orders received at the current agreement prices.  Price modification requests are not guaranteed. If approved, the Procurement Director or designee will notify the Vendor in writing with the effective date of an approved price modification.  The Procurement Director has the authority to approve price adjustments in accordance with the Procurement Ordinance, as amended. The Fee Schedule shall be modified with the price increases, or an amendment process as required, and uploaded into the County's Finance system. 7. SAFETY 7.1. The awarded Vendors shall comply with all Occupational Safety and Health Administration (OSHA), Environmental Protection Agency (EPA), the National Institute of Occupational Safety Hazards (NIOSH), the American National Standards Institute (ANSI), the National Fire Protection Association (NFPA), the Crane Manufacturers Association of America, Inc. (CMAA), National Electric Code (NEC), American Society of Mechanical Engineers (ASME), State and County regulations while performing work under the resultant Contract. Vendor 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. 7.2. Barricades shall be provided and utilized by the Vendor when work is performed in public areas, or when deemed necessary by the County. 7.3. Hazardous conditions shall be immediately reported to the County. VENDOR CHECKLIST ***Vendor should check off each of the following items as the necessary action is completed (please see, Vendor Check List)*** Page 5932 of 7924 Hours*Rate Per Hour Total Price Rate Per Hour Total Price 40 $120.00 $4,800.00 $ 147.00 $5,880.00 350 $90.00 $31,500.00 $ 120.00 $42,000.00 350 $55.00 $19,250.00 23.50$ $8,225.00 Total Bid $55,550.00 Total Bid $56,105.00 10% 10% 15% 1.5 X Straight Time Hourly Date: February 11, 2025 Number of Notifications Sent: 2,612 Number of Bids Viewed: 680 Number of Bids Received: 2 Signed Addendums (2)YES YES Opened By: Matt Webster Witnessed By: Barbara Lance Project Manager: Brett Rice Procurement Strategist: Matt Webster Bid Schedule Required Documents YES Chemical Injection Partners Florida, LLC Razorback LLC Form 1: Vendor Declaration Statement Form 2: Conflict of Interest Certification Affidavit Form 3: Immigration Affidavit Certification YES YES YES YES YES YES YES/NO YES YES YES YES YES/NO YES* YES* YES* YES YES YES YES Form 4: Reference Questionnaire Form 5: Grants Proivision Package W-9 Sun Biz E-Verify After Hours and Urgent Work Markups, After Hours and Urgent Work Description Supervisor Chemical Injection Partners Florida, LLC *Quantities listed are for evaluation purposes only. Parts and Materials Markup Percent Rental Equipment Markup Percent Subcontractor Markup Percent 24-8307 Deep Injection Well System Prevantative Maintenance and Repairs Bid Tabulation All lines must be completed, or bidder may be deemed non-responsive. Service Technician Helper Razorback LLCSECONDARYPRIMARY Page 5933 of 7924 Notice of Recommended Award Solicitation: 24-8307 Title: Deep Injection Well System Preventative Maintenance and Repairs Due Date and Time: February 11th, 2025, at 3:00 PM EST Respondents: Company Name City County State Amount Responsive/Responsible Chemical Injection Partners Florida, LLC Sarasota Sarasota FL $55,550.00 Yes/Yes Razorback LLC Tarpon Springs Pinellas FL $56,105.00 Yes/Yes Utilized Local Vendor Preference: Yes No Recommended Vendor(s) For Award: On December 19th, 2024, the Procurement Services Division released notices for Invitation to Bid #24-8307 Deep Injection Well System Preventative Maintenance and Repairs. Two thousand six hundred and twelve (2,612) notifications were sent, and six hundred and eighty (680) vendors viewed the solicitation information. The bid due date was extended by 14 days, and staff performed vendor outreach to promote competition. Two (2) bids were received by the submission deadline of February 11th, 2025. Chemical Injection Partners Florida, LLC and Razorback LLC were deemed both responsive and responsible, with Chemical Injection Partners Florida, LLC having minor irregularities. Staff recommends awarding to a Primary and Secondary Vendor as noted below: Primary: Chemical Injection Partners Florida, LLC Secondary: Razorback LLC Contract Driven Purchase Order Driven Required Signatures Project Manager: Procurement Strategist: Procurement Services Director: __________________________________ _________________ Sandra Srnka Date Docusign Envelope ID: 81A9E8CA-DDF2-4C47-BC7C-6FED748B9751 2/21/2025 2/21/2025 2/21/2025 Page 5934 of 7924 Page 5935 of 7924 Page 5936 of 7924 Page 5937 of 7924 Page 5938 of 7924 Page 5939 of 7924 Page 5940 of 7924 Page 5941 of 7924 Page 5942 of 7924 Page 5943 of 7924 Page 5944 of 7924 Page 5945 of 7924 Page 5946 of 7924 Page 5947 of 7924 Page 5948 of 7924 Page 5949 of 7924 Page 5950 of 7924 Page 5951 of 7924 Page 5952 of 7924 Page 5953 of 7924 Page 5954 of 7924 Page 5955 of 7924 Page 5956 of 7924 Page 5957 of 7924 Page 5958 of 7924 Page 5959 of 7924 Page 5960 of 7924 Page 5961 of 7924 Page 5962 of 7924 Page 5963 of 7924 Page 5964 of 7924 Page 5965 of 7924 Page 5966 of 7924 Page 5967 of 7924 Page 5968 of 7924 Page 5969 of 7924 Page 5970 of 7924 Page 5971 of 7924 Page 5972 of 7924 Page 5973 of 7924 Page 5974 of 7924 Page 5975 of 7924 Page 5976 of 7924 Page 5977 of 7924 Page 5978 of 7924 Page 5979 of 7924 Page 5980 of 7924 Page 5981 of 7924 Page 5982 of 7924 Page 5983 of 7924 Page 5984 of 7924 Page 5985 of 7924 Page 5986 of 7924 Page 5987 of 7924 Page 5988 of 7924 Page 5989 of 7924 Page 5990 of 7924 Page 5991 of 7924 Page 5992 of 7924 Page 5993 of 7924 Page 5994 of 7924 Page 5995 of 7924 Page 5996 of 7924 Page 5997 of 7924 Page 5998 of 7924 Page 5999 of 7924 Page 6000 of 7924 Page 6001 of 7924 Page 6002 of 7924 Page 6003 of 7924 Page 6004 of 7924 Page 6005 of 7924 Page 6006 of 7924 Page 6007 of 7924 Page 6008 of 7924 Page 6009 of 7924 Page 6010 of 7924 Page 6011 of 7924 Page 6012 of 7924 Page 6013 of 7924 Page 6014 of 7924 Page 6015 of 7924 Page 6016 of 7924 Page 6017 of 7924 Page 6018 of 7924 Page 6019 of 7924 Page 6020 of 7924 Page 6021 of 7924 Page 6022 of 7924 Page 6023 of 7924 Page 6024 of 7924 Page 6025 of 7924 Page 6026 of 7924 Page 6027 of 7924 Page 6028 of 7924 Page 6029 of 7924 Page 6030 of 7924 Page 6031 of 7924 Page 6032 of 7924 Page 6033 of 7924 Page 6034 of 7924 Page 6035 of 7924 Page 6036 of 7924 Page 6037 of 7924 County of Collier, FL Procurement -, - 3299 Tamiami Trail, East Naples, FL 34112 [CHEMICAL INJECTION PARTNERS FLORIDA LLC] RESPONSE DOCUMENT REPORT GEN No. 24-8307 Deep Injection Well System Preventative Maintenance and Repairs RESPONSE DEADLINE: February 11, 2025 at 3:00 pm Report Generated: Tuesday, February 11, 2025 Chemical Injection Partners Florida LLC Response CONTACT INFORMATION Company: Chemical Injection Partners Florida LLC Email: mindy.helding@cipsolutions.com Contact: Mindy Helding Address: 6230 University Pkwy Ste 201 Sarasota, FL 34240 Phone: N/A Website: N/A Submission Date: Feb 11, 2025 1:34 PM (Eastern Time) Page 6038 of 7924 [CHEMICAL INJECTION PARTNERS FLORIDA LLC] RESPONSE DOCUMENT REPORT GEN No. 24-8307 Deep Injection Well System Preventative Maintenance and Repairs [CHEMICAL INJECTION PARTNERS FLORIDA LLC] RESPONSE DOCUMENT REPORT undefined - Deep Injection Well System Preventative Maintenance and Repairs Page 2 ADDENDA CONFIRMATION Addendum #1 Confirmed Jan 28, 2025 1:03 PM by Mindy Helding Addendum #2 Confirmed Jan 28, 2025 1:03 PM by Mindy Helding QUESTIONNAIRE 1. I certify that I have read, understood and agree to the terms in this solicitation, and that I am authorized to submit this r esponse on behalf of my company.* Confirmed 2. General Bid Instructions has been acknowledged and accepted.* Confirmed 3. Collier County Purchase Order Terms and Conditions have been acknowledged and accepted.* Confirmed 4. Insurance Requirements* Vendor Acknowledges Insurance Requirement and is prepared to produce the required insurance certificate(s) within five (5) days of the County's issuance of a Notice of Recommended Award. Confirmed Page 6039 of 7924 [CHEMICAL INJECTION PARTNERS FLORIDA LLC] RESPONSE DOCUMENT REPORT GEN No. 24-8307 Deep Injection Well System Preventative Maintenance and Repairs [CHEMICAL INJECTION PARTNERS FLORIDA LLC] RESPONSE DOCUMENT REPORT undefined - Deep Injection Well System Preventative Maintenance and Repairs Page 3 5. County Required Forms BID SCHEDULE* Please upload completed Bid Schedule in Microsoft Excel format. 24-8307__Bid_Schedule_Chemical_Injection_Partners_Florida_LLC.xlsx VENDOR DECLARATION STATEMENT (FORM 1)* Form_1.pdf CONFLICT OF INTEREST CERTIFICATION AFFIDAVIT (FORM 2)* Form_2_Signed.pdf PROOF OF STATUS FROM DIVISION OF CORPORATIONS - FLORIDA DEPARTMENT OF STATE (IF WORK PERFORMED IN THE STATE) - HTTP://DOS.MYFLORIDA.COM/SUNBIZ/ SHOULD BE ATTACHED WITH YOUR SUBMITTAL* Articles_for_Organization.pdf IMMIGRATION AFFIDAVIT CERTIFICATION (FORM 3)* Form_3_Signed.pdf E-VERIFY MEMORANDUM OF UNDERSTANDING OR COMPANY PROFILE PAGE* EVerify_MOU.pdf REFERENCE QUESTIONNAIRES (FORM 4)* Please provide 2-3 References Form_4_Laudicina.pdf Reference.Barath.pdf Baker_Reference.pdf GRANT PROVISIONS AND ASSURANCES PACKAGE (FORM 5).* Combined_FEMA_forms.pdf Page 6040 of 7924 [CHEMICAL INJECTION PARTNERS FLORIDA LLC] RESPONSE DOCUMENT REPORT GEN No. 24-8307 Deep Injection Well System Preventative Maintenance and Repairs [CHEMICAL INJECTION PARTNERS FLORIDA LLC] RESPONSE DOCUMENT REPORT undefined - Deep Injection Well System Preventative Maintenance and Repairs Page 4 VENDOR W-9 FORM* W9_CIP_FL_Signed.pdf ALL SIGNED ADDENDA, IF APPLICABLE. Signed_Addendums.pdf ALL OTHER REQUIRED DOCUMENTATION, AS APPLICABLE. No response submitted PRICE TABLES TOTAL BID AMOUNT Submit line-item pricing via Bid Schedule in Microsoft Excel format. Line Item Description Quantity Unit of Measure Unit Cost Total 1 TOTAL BID AMOUNT 1 EACH $55,550.00 $55,550.00 TOTAL $55,550.00 Page 6041 of 7924 Form 1: Vendor Declaration Statement BOARD OF COUNTY COMMISSIONERS Collier County Government Complex Naples, Florida 34112 Dear Commissioners: 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 hereby declares the instructions, purchase order terms and conditions, requirements, and specifications/scope of work of this solicitation have been fully examined and accepted. The Vendor agrees, if this solicitation submittal is accepted by Collier County, to accept a Purchase Order as a form of a formal contract or to execute a Collier County formal contract for purposes of establishing a contractual relationship between the Vendor and Collier County, for the performance of all requirements to which this solicitation pertains. The Vendor states that the submitted is based upon the documents listed by the above referenced solicitation. The Vendor agrees to comply with the requirements in accordance with the terms, conditions and specifications denoted herein and according to the pricing submitted as a part of the Vendor’s bids. 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 work that is a result of this awarded contract. IN WITNESS WHEREOF, WE have hereunto subscribed our names on this _____ day of _____________, 20__ in the County of _______________, in the State of _____________. 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: Email: Signature by: (Typed and written) Title: January 25 Sarasota Florida Chemical Injection Partners Florida LLC 6230 University Parkway Suite 201 Sarasota, FL 34240 941-253-0250 mindy.helding@cipsolutions.com 28th Executive Assistant Mindy Helding 93-3139462 Page 6042 of 7924 Additional Contact Information Send payments to: (required if different from above) Company name used as payee 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: Same as above Same as above Page 6043 of 7924 Page 6044 of 7924 Page 6045 of 7924 Page 6046 of 7924 Page 6047 of 7924 Company ID Number: THE E-VERIFY MEMORANDUM OF UNDERSTANDING FOR EMPLOYERS ARTICLE I PURPOSE AND AUTHORITY The parties to this agreement are the Department of Homeland Security (DHS) and (Employer). The purpose of this agreement is to set forth terms and conditions which the Employer will follow while participating in E-Verify. E-Verify is a program that electronically confirms an employee’s eligibility to work in the United States after completion of Form I-9, Employment Eligibility Verification (Form I-9). This Memorandum of Understanding (MOU) explains certain features of the E-Verify program and describes specific responsibilities of the Employer, the Social Security Administration (SSA), and DHS. Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA), Pub. L. 104-208, 110 Stat. 3009, as amended (8 U.S.C. § 1324a note). The Federal Acquisition Regulation (FAR) Subpart 22.18, “Employment Eligibility Verification” and Executive Order 12989, as amended, provide authority for Federal contractors and subcontractors (Federal contractor) to use E-Verify to verify the employment eligibility of certain employees working on Federal contracts. ARTICLE II RESPONSIBILITIES A. RESPONSIBILITIES OF THE EMPLOYER 1.The Employer agrees to display the following notices supplied by DHS in a prominent place that is clearly visible to prospective employees and all employees who are to be verified through the system: a.Notice of E-Verify Participation b.Notice of Right to Work 2.The Employer agrees to provide to the SSA and DHS the names, titles, addresses, and telephone numbers of the Employer representatives to be contacted about E-Verify. The Employer also agrees to keep such information current by providing updated information to SSA and DHS whenever the representatives’ contact information changes. 3.The Employer agrees to grant E-Verify access only to current employees who need E-Verify access. Employers must promptly terminate an employee’s E-Verify access if the employer is separated from the company or no longer needs access to E-Verify. Page 1 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 Chemical Injection Partners Florida 2609593 Page 6048 of 7924 Company ID Number: 4.The Employer agrees to become familiar with and comply with the most recent version of the E-Verify User Manual. 5.The Employer agrees that any Employer Representative who will create E-Verify cases will complete the E-Verify Tutorial before that individual creates any cases. a.The Employer agrees that all Employer representatives will take the refresher tutorials when prompted by E-Verify in order to continue using E-Verify. Failure to complete a refresher tutorial will prevent the Employer Representative from continued use of E-Verify. 6.The Employer agrees to comply with current Form I-9 procedures, with two exceptions: a.If an employee presents a "List B" identity document, the Employer agrees to only accept "List B" documents that contain a photo. (List B documents identified in 8 C.F.R. § 274a.2(b)(1)(B)) can be presented during the Form I-9 process to establish identity.) If an employee objects to the photo requirement for religious reasons, the Employer should contact E-Verify at 888-464-4218. b.If an employee presents a DHS Form I-551 (Permanent Resident Card), Form I-766 (Employment Authorization Document), or U.S. Passport or Passport Card to complete Form I-9, the Employer agrees to make a photocopy of the document and to retain the photocopy with the employee’s Form I-9. The Employer will use the photocopy to verify the photo and to assist DHS with its review of photo mismatches that employees contest. DHS may in the future designate other documents that activate the photo screening tool. Note: Subject only to the exceptions noted previously in this paragraph, employees still retain the right to present any List A, or List B and List C, document(s) to complete the Form I-9. 7.The Employer agrees to record the case verification number on the employee's Form I-9 or to print the screen containing the case verification number and attach it to the employee's Form I-9. 8.The Employer agrees that, although it participates in E-Verify, the Employer has a responsibility to complete, retain, and make available for inspection Forms I-9 that relate to its employees, or from other requirements of applicable regulations or laws, including the obligation to comply with the anti- discrimination requirements of section 274B of the INA with respect to Form I-9 procedures. a.The following modified requirements are the only exceptions to an Employer’s obligation to not employ unauthorized workers and comply with the anti-discrimination provision of the INA: (1) List B identity documents must have photos, as described in paragraph 6 above; (2) When an Employer confirms the identity and employment eligibility of newly hired employee using E-Verify procedures, the Employer establishes a rebuttable presumption that it has not violated section 274A(a)(1)(A) of the Immigration and Nationality Act (INA) with respect to the hiring of that employee; (3) If the Employer receives a final nonconfirmation for an employee, but continues to employ that person, the Employer must notify DHS and the Employer is subject to a civil money penalty between $550 and $1,100 for each failure to notify DHS of continued employment following a final nonconfirmation; (4) If the Employer continues to employ an employee after receiving a final nonconfirmation, then the Employer is subject to a rebuttable presumption that it has knowingly Page 2 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6049 of 7924 Company ID Number: employed an unauthorized alien in violation of section 274A(a)(1)(A); and (5) no E-Verify participant is civilly or criminally liable under any law for any action taken in good faith based on information provided through the E-Verify. b.DHS reserves the right to conduct Form I-9 compliance inspections, as well as any other enforcement or compliance activity authorized by law, including site visits, to ensure proper use of E-Verify. 9.The Employer is strictly prohibited from creating an E-Verify case before the employee has been hired, meaning that a firm offer of employment was extended and accepted and Form I-9 was completed. The Employer agrees to create an E-Verify case for new employees within three Employer business days after each employee has been hired (after both Sections 1 and 2 of Form I-9 have been completed), and to complete as many steps of the E-Verify process as are necessary according to the E-Verify User Manual. If E-Verify is temporarily unavailable, the three-day time period will be extended until it is again operational in order to accommodate the Employer's attempting, in good faith, to make inquiries during the period of unavailability. 10.The Employer agrees not to use E-Verify for pre-employment screening of job applicants, in support of any unlawful employment practice, or for any other use that this MOU or the E-Verify User Manual does not authorize. 11.The Employer must use E-Verify for all new employees. The Employer will not verify selectively and will not verify employees hired before the effective date of this MOU. Employers who are Federal contractors may qualify for exceptions to this requirement as described in Article II.B of this MOU. 12.The Employer agrees to follow appropriate procedures (see Article III below) regarding tentative nonconfirmations. The Employer must promptly notify employees in private of the finding and provide them with the notice and letter containing information specific to the employee’s E-Verify case. The Employer agrees to provide both the English and the translated notice and letter for employees with limited English proficiency to employees. The Employer agrees to provide written referral instructions to employees and instruct affected employees to bring the English copy of the letter to the SSA. The Employer must allow employees to contest the finding, and not take adverse action against employees if they choose to contest the finding, while their case is still pending. Further, when employees contest a tentative nonconfirmation based upon a photo mismatch, the Employer must take additional steps (see Article III.B. below) to contact DHS with information necessary to resolve the challenge. 13.The Employer agrees not to take any adverse action against an employee based upon the employee's perceived employment eligibility status while SSA or DHS is processing the verification request unless the Employer obtains knowledge (as defined in 8 C.F.R. § 274a.1(l)) that the employee is not work authorized. The Employer understands that an initial inability of the SSA or DHS automated verification system to verify work authorization, a tentative nonconfirmation, a case in continuance (indicating the need for additional time for the government to resolve a case), or the finding of a photo mismatch, does not establish, and should not be interpreted as, evidence that the employee is not work authorized. In any of such cases, the employee must be provided a full and fair opportunity to contest the finding, and if he or she does so, the employee may not be terminated or suffer any adverse employment consequences based upon the employee’s perceived employment eligibility status Page 3 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6050 of 7924 Company ID Number: (including denying, reducing, or extending work hours, delaying or preventing training, requiring an employee to work in poorer conditions, withholding pay, refusing to assign the employee to a Federal contract or other assignment, or otherwise assuming that he or she is unauthorized to work) until and unless secondary verification by SSA or DHS has been completed and a final nonconfirmation has been issued. If the employee does not choose to contest a tentative nonconfirmation or a photo mismatch or if a secondary verification is completed and a final nonconfirmation is issued, then the Employer can find the employee is not work authorized and terminate the employee’s employment. Employers or employees with questions about a final nonconfirmation may call E-Verify at 1-888-464-4218 (customer service) or 1-888-897-7781 (worker hotline). 14.The Employer agrees to comply with Title VII of the Civil Rights Act of 1964 and section 274B of the INA as applicable by not discriminating unlawfully against any individual in hiring, firing, employment eligibility verification, or recruitment or referral practices because of his or her national origin or citizenship status, or by committing discriminatory documentary practices. The Employer understands that such illegal practices can include selective verification or use of E-Verify except as provided in part D below, or discharging or refusing to hire employees because they appear or sound “foreign” or have received tentative nonconfirmations. The Employer further understands that any violation of the immigration-related unfair employment practices provisions in section 274B of the INA could subject the Employer to civil penalties, back pay awards, and other sanctions, and violations of Title VII could subject the Employer to back pay awards, compensatory and punitive damages. Violations of either section 274B of the INA or Title VII may also lead to the termination of its participation in E-Verify. If the Employer has any questions relating to the anti-discrimination provision, it should contact OSC at 1-800-255-8155 or 1-800-237-2515 (TDD). 15.The Employer agrees that it will use the information it receives from E-Verify only to confirm the employment eligibility of employees as authorized by this MOU. The Employer agrees that it will safeguard this information, and means of access to it (such as PINS and passwords), to ensure that it is not used for any other purpose and as necessary to protect its confidentiality, including ensuring that it is not disseminated to any person other than employees of the Employer who are authorized to perform the Employer's responsibilities under this MOU, except for such dissemination as may be authorized in advance by SSA or DHS for legitimate purposes. 16.The Employer agrees to notify DHS immediately in the event of a breach of personal information. Breaches are defined as loss of control or unauthorized access to E-Verify personal data. All suspected or confirmed breaches should be reported by calling 1-888-464-4218 or via email at E-Verify@uscis.dhs.gov. Please use “Privacy Incident – Password” in the subject line of your email when sending a breach report to E-Verify. 17.The Employer acknowledges that the information it receives from SSA is governed by the Privacy Act (5 U.S.C. § 552a(i)(1) and (3)) and the Social Security Act (42 U.S.C. 1306(a)). Any person who obtains this information under false pretenses or uses it for any purpose other than as provided for in this MOU may be subject to criminal penalties. 18.The Employer agrees to cooperate with DHS and SSA in their compliance monitoring and evaluation of E-Verify, which includes permitting DHS, SSA, their contractors and other agents, upon Page 4 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6051 of 7924 Company ID Number: reasonable notice, to review Forms I-9 and other employment records and to interview it and its employees regarding the Employer’s use of E-Verify, and to respond in a prompt and accurate manner to DHS requests for information relating to their participation in E-Verify. 19.The Employer shall not make any false or unauthorized claims or references about its participation in E-Verify on its website, in advertising materials, or other media. The Employer shall not describe its services as federally-approved, federally-certified, or federally-recognized, or use language with a similar intent on its website or other materials provided to the public. Entering into this MOU does not mean that E-Verify endorses or authorizes your E-Verify services and any claim to that effect is false. 20.The Employer shall not state in its website or other public documents that any language used therein has been provided or approved by DHS, USCIS or the Verification Division, without first obtaining the prior written consent of DHS. 21.The Employer agrees that E-Verify trademarks and logos may be used only under license by DHS/USCIS (see M-795 (Web)) and, other than pursuant to the specific terms of such license, may not be used in any manner that might imply that the Employer’s services, products, websites, or publications are sponsored by, endorsed by, licensed by, or affiliated with DHS, USCIS, or E-Verify. 22.The Employer understands that if it uses E-Verify procedures for any purpose other than as authorized by this MOU, the Employer may be subject to appropriate legal action and termination of its participation in E-Verify according to this MOU. B. RESPONSIBILITIES OF FEDERAL CONTRACTORS 1.If the Employer is a Federal contractor with the FAR E-Verify clause subject to the employment verification terms in Subpart 22.18 of the FAR, it will become familiar with and comply with the most current version of the E-Verify User Manual for Federal Contractors as well as the E-Verify Supplemental Guide for Federal Contractors. 2.In addition to the responsibilities of every employer outlined in this MOU, the Employer understands that if it is a Federal contractor subject to the employment verification terms in Subpart 22.18 of the FAR it must verify the employment eligibility of any “employee assigned to the contract” (as defined in FAR 22.1801). Once an employee has been verified through E-Verify by the Employer, the Employer may not create a second case for the employee through E-Verify. a.An Employer that is not enrolled in E-Verify as a Federal contractor at the time of a contract award must enroll as a Federal contractor in the E-Verify program within 30 calendar days of contract award and, within 90 days of enrollment, begin to verify employment eligibility of new hires using E-Verify. The Employer must verify those employees who are working in the United States, whether or not they are assigned to the contract. Once the Employer begins verifying new hires, such verification of new hires must be initiated within three business days after the hire date. Once enrolled in E-Verify as a Federal contractor, the Employer must begin verification of employees assigned to the contract within 90 calendar days after the date of enrollment or within 30 days of an employee’s assignment to the contract, whichever date is later. Page 5 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6052 of 7924 Company ID Number: b.Employers enrolled in E-Verify as a Federal contractor for 90 days or more at the time of a contract award must use E-Verify to begin verification of employment eligibility for new hires of the Employer who are working in the United States, whether or not assigned to the contract, within three business days after the date of hire. If the Employer is enrolled in E-Verify as a Federal contractor for 90 calendar days or less at the time of contract award, the Employer must, within 90 days of enrollment, begin to use E-Verify to initiate verification of new hires of the contractor who are working in the United States, whether or not assigned to the contract. Such verification of new hires must be initiated within three business days after the date of hire. An Employer enrolled as a Federal contractor in E-Verify must begin verification of each employee assigned to the contract within 90 calendar days after date of contract award or within 30 days after assignment to the contract, whichever is later. c.Federal contractors that are institutions of higher education (as defined at 20 U.S.C. 1001(a)), state or local governments, governments of Federally recognized Indian tribes, or sureties performing under a takeover agreement entered into with a Federal agency under a performance bond may choose to only verify new and existing employees assigned to the Federal contract. Such Federal contractors may, however, elect to verify all new hires, and/or all existing employees hired after November 6, 1986. Employers in this category must begin verification of employees assigned to the contract within 90 calendar days after the date of enrollment or within 30 days of an employee’s assignment to the contract, whichever date is later. d.Upon enrollment, Employers who are Federal contractors may elect to verify employment eligibility of all existing employees working in the United States who were hired after November 6, 1986, instead of verifying only those employees assigned to a covered Federal contract. After enrollment, Employers must elect to verify existing staff following DHS procedures and begin E-Verify verification of all existing employees within 180 days after the election. e. The Employer may use a previously completed Form I-9 as the basis for creating an E-Verify case for an employee assigned to a contract as long as: i.That Form I-9 is complete (including the SSN) and complies with Article II.A.6, ii.The employee’s work authorization has not expired, and iii.The Employer has reviewed the Form I-9 information either in person or in communications with the employee to ensure that the employee’s Section 1, Form I-9 attestation has not changed (including, but not limited to, a lawful permanent resident alien having become a naturalized U.S. citizen). f.The Employer shall complete a new Form I-9 consistent with Article II.A.6 or update the previous Form I-9 to provide the necessary information if: i.The Employer cannot determine that Form I-9 complies with Article II.A.6, ii.The employee’s basis for work authorization as attested in Section 1 has expired or changed, or iii.The Form I-9 contains no SSN or is otherwise incomplete. Note: If Section 1 of Form I-9 is otherwise valid and up-to-date and the form otherwise complies with Page 6 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6053 of 7924 Company ID Number: Article II.C.5, but reflects documentation (such as a U.S. passport or Form I-551) that expired after completing Form I-9, the Employer shall not require the production of additional documentation, or use the photo screening tool described in Article II.A.5, subject to any additional or superseding instructions that may be provided on this subject in the E-Verify User Manual. g.The Employer agrees not to require a second verification using E-Verify of any assigned employee who has previously been verified as a newly hired employee under this MOU or to authorize verification of any existing employee by any Employer that is not a Federal contractor based on this Article. 3. The Employer understands that if it is a Federal contractor, its compliance with this MOU is a performance requirement under the terms of the Federal contract or subcontract, and the Employer consents to the release of information relating to compliance with its verification responsibilities under this MOU to contracting officers or other officials authorized to review the Employer’s compliance with Federal contracting requirements. C. RESPONSIBILITIES OF SSA 1.SSA agrees to allow DHS to compare data provided by the Employer against SSA’s database. SSA sends DHS confirmation that the data sent either matches or does not match the information in SSA’s database. 2.SSA agrees to safeguard the information the Employer provides through E-Verify procedures. SSA also agrees to limit access to such information, as is appropriate by law, to individuals responsible for the verification of Social Security numbers or responsible for evaluation of E-Verify or such other persons or entities who may be authorized by SSA as governed by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and SSA regulations (20 CFR Part 401). 3.SSA agrees to provide case results from its database within three Federal Government work days of the initial inquiry. E-Verify provides the information to the Employer. 4.SSA agrees to update SSA records as necessary if the employee who contests the SSA tentative nonconfirmation visits an SSA field office and provides the required evidence. If the employee visits an SSA field office within the eight Federal Government work days from the date of referral to SSA, SSA agrees to update SSA records, if appropriate, within the eight-day period unless SSA determines that more than eight days may be necessary. In such cases, SSA will provide additional instructions to the employee. If the employee does not visit SSA in the time allowed, E-Verify may provide a final nonconfirmation to the employer. Note: If an Employer experiences technical problems, or has a policy question, the employer should contact E-Verify at 1-888-464-4218. D. RESPONSIBILITIES OF DHS 1.DHS agrees to provide the Employer with selected data from DHS databases to enable the Employer to conduct, to the extent authorized by this MOU: a.Automated verification checks on alien employees by electronic means, and Page 7 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6054 of 7924 Company ID Number: b. Photo verification checks (when available) on employees. 2. DHS agrees to assist the Employer with operational problems associated with the Employer's participation in E-Verify. DHS agrees to provide the Employer names, titles, addresses, and telephone numbers of DHS representatives to be contacted during the E-Verify process. 3. DHS agrees to provide to the Employer with access to E-Verify training materials as well as an E-Verify User Manual that contain instructions on E-Verify policies, procedures, and requirements for both SSA and DHS, including restrictions on the use of E-Verify. 4.DHS agrees to train Employers on all important changes made to E-Verify through the use of mandatory refresher tutorials and updates to the E-Verify User Manual. Even without changes to E-Verify, DHS reserves the right to require employers to take mandatory refresher tutorials. 5.DHS agrees to provide to the Employer a notice, which indicates the Employer's participation in E-Verify. DHS also agrees to provide to the Employer anti-discrimination notices issued by the Office of Special Counsel for Immigration-Related Unfair Employment Practices (OSC), Civil Rights Division, U.S. Department of Justice. 6.DHS agrees to issue each of the Employer’s E-Verify users a unique user identification number and password that permits them to log in to E-Verify. 7.DHS agrees to safeguard the information the Employer provides, and to limit access to such information to individuals responsible for the verification process, for evaluation of E-Verify, or to such other persons or entities as may be authorized by applicable law. Information will be used only to verify the accuracy of Social Security numbers and employment eligibility, to enforce the INA and Federal criminal laws, and to administer Federal contracting requirements. 8.DHS agrees to provide a means of automated verification that provides (in conjunction with SSA verification procedures) confirmation or tentative nonconfirmation of employees' employment eligibility within three Federal Government work days of the initial inquiry. 9.DHS agrees to provide a means of secondary verification (including updating DHS records) for employees who contest DHS tentative nonconfirmations and photo mismatch tentative nonconfirmations. This provides final confirmation or nonconfirmation of the employees' employment eligibility within 10 Federal Government work days of the date of referral to DHS, unless DHS determines that more than 10 days may be necessary. In such cases, DHS will provide additional verification instructions. ARTICLE III REFERRAL OF INDIVIDUALS TO SSA AND DHS A. REFERRAL TO SSA 1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must print the notice as directed by E-Verify. The Employer must promptly notify employees in private of the finding and provide them with the notice and letter containing information specific to the employee’s E-Verify case. Page 8 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6055 of 7924 Company ID Number: The Employer also agrees to provide both the English and the translated notice and letter for employees with limited English proficiency to employees. The Employer agrees to provide written referral instructions to employees and instruct affected employees to bring the English copy of the letter to the SSA. The Employer must allow employees to contest the finding, and not take adverse action against employees if they choose to contest the finding, while their case is still pending. 2.The Employer agrees to obtain the employee’s response about whether he or she will contest the tentative nonconfirmation as soon as possible after the Employer receives the tentative nonconfirmation. Only the employee may determine whether he or she will contest the tentative nonconfirmation. 3.After a tentative nonconfirmation, the Employer will refer employees to SSA field offices only as directed by E-Verify. The Employer must record the case verification number, review the employee information submitted to E-Verify to identify any errors, and find out whether the employee contests the tentative nonconfirmation. The Employer will transmit the Social Security number, or any other corrected employee information that SSA requests, to SSA for verification again if this review indicates a need to do so. 4.The Employer will instruct the employee to visit an SSA office within eight Federal Government work days. SSA will electronically transmit the result of the referral to the Employer within 10 Federal Government work days of the referral unless it determines that more than 10 days is necessary. 5.While waiting for case results, the Employer agrees to check the E-Verify system regularly for case updates. 6.The Employer agrees not to ask the employee to obtain a printout from the Social Security Administration number database (the Numident) or other written verification of the SSN from the SSA. B. REFERRAL TO DHS 1.If the Employer receives a tentative nonconfirmation issued by DHS, the Employer must promptly notify employees in private of the finding and provide them with the notice and letter containing information specific to the employee’s E-Verify case. The Employer also agrees to provide both the English and the translated notice and letter for employees with limited English proficiency to employees. The Employer must allow employees to contest the finding, and not take adverse action against employees if they choose to contest the finding, while their case is still pending. 2.The Employer agrees to obtain the employee’s response about whether he or she will contest the tentative nonconfirmation as soon as possible after the Employer receives the tentative nonconfirmation. Only the employee may determine whether he or she will contest the tentative nonconfirmation. 3.The Employer agrees to refer individuals to DHS only when the employee chooses to contest a tentative nonconfirmation. 4.If the employee contests a tentative nonconfirmation issued by DHS, the Employer will instruct the Page 9 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6056 of 7924 Company ID Number: employee to contact DHS through its toll-free hotline (as found on the referral letter) within eight Federal Government work days. 5.If the Employer finds a photo mismatch, the Employer must provide the photo mismatch tentative nonconfirmation notice and follow the instructions outlined in paragraph 1 of this section for tentative nonconfirmations, generally. 6.The Employer agrees that if an employee contests a tentative nonconfirmation based upon a photo mismatch, the Employer will send a copy of the employee’s Form I-551, Form I-766, U.S. Passport, or passport card to DHS for review by: a.Scanning and uploading the document, or b.Sending a photocopy of the document by express mail (furnished and paid for by the employer). 7.The Employer understands that if it cannot determine whether there is a photo match/mismatch, the Employer must forward the employee’s documentation to DHS as described in the preceding paragraph. The Employer agrees to resolve the case as specified by the DHS representative who will determine the photo match or mismatch. 8.DHS will electronically transmit the result of the referral to the Employer within 10 Federal Government work days of the referral unless it determines that more than 10 days is necessary. 9.While waiting for case results, the Employer agrees to check the E-Verify system regularly for case updates. ARTICLE IV SERVICE PROVISIONS A. NO SERVICE FEES 1. SSA and DHS will not charge the Employer for verification services performed under this MOU. The Employer is responsible for providing equipment needed to make inquiries. To access E-Verify, an Employer will need a personal computer with Internet access. ARTICLE V MODIFICATION AND TERMINATION A. MODIFICATION 1. This MOU is effective upon the signature of all parties and shall continue in effect for as long as the SSA and DHS operates the E-Verify program unless modified in writing by the mutual consent of all parties. 2. Any and all E-Verify system enhancements by DHS or SSA, including but not limited to E-Verify checking against additional data sources and instituting new verification policies or procedures, will be covered under this MOU and will not cause the need for a supplemental MOU that outlines these changes. Page 10 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6057 of 7924 Company ID Number: B. TERMINATION 1.The Employer may terminate this MOU and its participation in E-Verify at any time upon 30 days prior written notice to the other parties. 2.Notwithstanding Article V, part A of this MOU, DHS may terminate this MOU, and thereby the Employer’s participation in E-Verify, with or without notice at any time if deemed necessary because of the requirements of law or policy, or upon a determination by SSA or DHS that there has been a breach of system integrity or security by the Employer, or a failure on the part of the Employer to comply with established E-Verify procedures and/or legal requirements. The Employer understands that if it is a Federal contractor, termination of this MOU by any party for any reason may negatively affect the performance of its contractual responsibilities. Similarly, the Employer understands that if it is in a state where E-Verify is mandatory, termination of this by any party MOU may negatively affect the Employer’s business. 3.An Employer that is a Federal contractor may terminate this MOU when the Federal contract that requires its participation in E-Verify is terminated or completed. In such cases, the Federal contractor must provide written notice to DHS. If an Employer that is a Federal contractor fails to provide such notice, then that Employer will remain an E-Verify participant, will remain bound by the terms of this MOU that apply to non- Federal contractor participants, and will be required to use the E-Verify p rocedures to verify the employment eligibility of all newly hired employees. 4.The Employer agrees that E-Verify is not liable for any losses, financial or otherwise, if the Employer is terminated from E-Verify. ARTICLE VI PARTIES A.Some or all SSA and DHS responsibilities under this MOU may be performed by contractor(s), and SSA and DHS may adjust verification responsibilities between each other as necessary. By separate agreement with DHS, SSA has agreed to perform its responsibilities as described in this MOU. B.Nothing in this MOU is intended, or should be construed, to create any right or benefit, substantive or procedural, enforceable at law by any third party against the United States, its agencies, officers, or employees, or against the Employer, its agents, officers, or employees. C.The Employer may not assign, directly or indirectly, whether by operation of law, change of control or merger, all or any part of its rights or obligations under this MOU without the prior written consent of DHS, which consent shall not be unreasonably withheld or delayed. Any attempt to sublicense, assign, or transfer any of the rights, duties, or obligations herein is void. D.Each party shall be solely responsible for defending any claim or action against it arising out of or related to E-Verify or this MOU, whether civil or criminal, and for any liability wherefrom, including (but not limited to) any dispute between the Employer and any other person or entity regarding the applicability of Section 403(d) of IIRIRA to any action taken or allegedly taken by the Employer. Page 11 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6058 of 7924 Company ID Number: E. The Employer understands that its participation in E-Verify is not confidential information and may be disclosed as authorized or required by law and DHS or SSA policy, including but not limited to, Congressional oversight, E-Verify publicity and media inquiries, determinations of compliance with Federal contractual requirements, and responses to inquiries under the Freedom of Information Act (FOIA). F. The individuals whose signatures appear below represent that they are authorized to enter into this MOU on behalf of the Employer and DHS respectively. The Employer understands that any inaccurate statement, representation, data or other information provided to DHS may subject the Employer, its subcontractors, its employees, or its representatives to: (1) prosecution for false statements pursuant to 18 U.S.C. 1001 and/or; (2) immediate termination of its MOU and/or; (3) possible debarment or suspension. G. The foregoing constitutes the full agreement on this subject between DHS and the Employer. To be accepted as an E-Verify participant, you should only sign the Employer’s Section of the signature page. If you have any questions, contact E-Verify at 1-888-464-4218. Page 12 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6059 of 7924 Company ID Number: Approved by: Employer Name (Please Type or Print) Title Signature Date Department of Homeland Security – Verification Division Name (Please Type or Print) Title Signature Date Page 13 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 USCIS Verification Division 01/23/2025 Mark Stout Electronically Signed Chemical Injection Partners Florida 01/23/2025 Electronically Signed 2609593 Page 6060 of 7924 Company ID Number: Information Required for the E-Verify Program Information relating to your Company: Company Name Company Facility Address Company Alternate Address County or Parish Employer Identification Number North American Industry Classification Systems Code Parent Company Number of Employees Number of Sites Verified for Page 14 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 Chemical Injection Partners Florida SARASOTA 541 6230 University Parkway Suite 201 Sarasota, FL 34240 10 to 19 2609593 6230 University Parkway Suite 201 Sarasota, FL 34240 933139462 1 site(s) Page 6061 of 7924 Company ID Number: Are you verifying for more than 1 site? If yes, please provide the number of sites verified for in each State: Page 15 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 FL 1 2609593 Page 6062 of 7924 Company ID Number: Information relating to the Program Administrator(s) for your Company on policy questions or operational problems: Page 16 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 Email 4327018510 Mark Stout 2609593 Name Phone Number Fax mark.stout@cipsolutions.com Page 6063 of 7924 Company ID Number: This list represents the first 20 Program Administrators listed for this company. Page 17 of 17 E-Verify MOU for Employers | Revision Date 06/01/13 2609593 Page 6064 of 7924 Form 4 Reference Questionnaire (USE ONE FORM FOR EACH REQUIRED REFERENCE) Solicitation: Reference Questionnaire for: (Name of Company Requesting Reference Information) (Name of Individuals Requesting Reference Information) Name: (Evaluator completing reference questionnaire) Company: (Evaluator’s Company completing reference) Email: FAX: Telephone: Collier County has implemented a process that collects reference information on firms and their key personnel to be used in the selection of firms to perform this project. The Name of the Company listed in the Subject above has listed you as a client for which they have previously performed work. Please complete the survey. Please rate each criteria to the best of your knowledge on a scale of 1 to 10, with 10 representing that you were very satisifed (and would hire the firm/individual again) and 1 representing that you were very unsatisfied (and would never hire the firm/indivdiual again). If you do not have sufficient knowledge of past performance in a particular area, leave it blank and the item or form will be scored “0.” Project Description: ___________________________ Completion Date: _____________________________ Project Budget: _______________________________ Project Number of Days: _______________________ Item Criteria Score (must be completed) 1 Ability to manage the project costs (minimize change orders to scope). 2 Ability to maintain project schedule (complete on-time or early). 3 Quality of work. 4 Quality of consultative advice provided on the project. 5 Professionalism and ability to manage personnel. 6 Project administration (completed documents, final invoice, final product turnover; invoices; manuals or going forward documentation, etc.) 7 Ability to verbally communicate and document information clearly and succinctly. 8 Abiltity to manage risks and unexpected project circumstances. 9 Ability to follow contract documents, policies, procedures, rules, regulations, etc. 10 Overall comfort level with hiring the company in the future (customer satisfaction). TOTAL SCORE OF ALL ITEMS Chemical Injection Partners Florida LLC Mark Stout Brent Laudicina Southeast Regional Water Reclamation Facility brent.laudicina@mymanatee.org 941-792-8811 ext 8025 Ongoing 10 10 10 10 10 10 10 10 10 10 15 Million Maint&Ops of Piney Point Treatment Plant and Injection Well 5 Year Page 6065 of 7924 Page 6066 of 7924 Page 6067 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 1 11/24 FEDERAL EMERGENCY MANAGEMENT AGENCY PUBLIC ASSISTANCE The supplemental conditions contained in this section are intended to cooperate with, to supplement, and to modify the general conditions and other specifications. In cases of disagreement with any other section of this contract, the Supplemental Conditions shall govern. This is an acknowledgement that FEMA financial assistance will be used to fund all or a portion of the contract. Pursuant uniform requirements of federal awards (2 CFR Part 200.23) the definition of CONTRACTOR is an entity that receives a Contract / Purchase Order. Compliance with Federal Law, Regulations and Executive Orders: The Sub-Recipient (County) agrees to include in the subcontract that (i) the subcontractor is bound by the terms of the Federally-Funded Subaward and Grant Agreement, (ii) the subcontractor is bound by all applicable state and Federal laws and regulations, and (iii) the subcontractor shall hold the County 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. Specifically, the Contractor shall be responsible for being knowledgeable and performing any and all services under this contract in accordance with the following governing regulations along with all applicable Federal law, regulations, executive orders, FEMA policies, procedures, and directives. o 2 C.F.R. Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards o 44 C.F.R. Part 206 o The Robert T. Stafford Disaster Relief and Emergency Assistance Act, Public Law 93- 288, as amended, 42 U.S.C. 5121 et seq., and Related Authorities o FEMA Public Assistance Program and Policy Guide Page 6068 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 2 11/24 Access to Records: 1) The contractor agrees to provide the County, the Florida Department of Emergency Management, the FEMA 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 Administrator or his authorized representatives’ access to construction or other work sites pertaining to the work being completed under the contract. (4) In compliance with section 1225 of the Disaster Recovery Act of 2018, the County and the Contractor acknowledge and agree that no language in this contract is intended to prohibit audits or internal reviews by the FEMA Administrator or the Comptroller General of the United States. Buy Clean: The County encourages the use of environmentally friendly construction practices in the performance of this Agreement. In particular, the County encourages that the performance of this agreement includes considering the use of low-carbon materials which have substantially lower levels of embodied greenhouse-gas emissions associated with all relevant stages of production, use, and disposal, as compared to estimated industry averages of similar materials or products as demonstrated by their environmental product declaration. Changes: To be allowable under a FEMA grant or cooperative agreement award, the cost of any contract change, modification, amendment, addendum, change order, or constructive change must be necessary, allowable, allocable, within the scope of the grant or cooperative agreement, reasonable for the scope of work, and otherwise allowable. DHS Seal, Logo, and Flags: The County must obtain written permission from Department of Homeland Security prior to using the DHS seals, logos, crests, or reproductions of flags, or likenesses of DHS agency officials. This includes use of DHS component (e.g., FEMA, CISA, etc.) seals, logos, crests, or reproductions of flags, or likenesses of component officials. The contractor shall not use the DHS seal(s), logos, crests, or reproductions of flags or likenesses of DHS agency officials without specific FEMA pre- approval. Domestic Preference for Procurements: The Contractor should, to the greatest extent practicable and consistent with law, provide a preference for the purchase, acquisition, or use of goods, products, or materials produced in the United States. This includes, but is not limited to, iron, aluminum, steel, cement, and other manufactured products. For purposes of this section: ‘‘Produced in the United States’’ means, for iron and steel products, that all manufacturing processes, from the initial melting stage through the application of coatings, occurred in the United States. Build America, Buy America Act (BABAA): FEMA Public Assistance Funding is not subject to Buy America preference pursuant the following guidance: Programs and Definitions: Build America, Buy America Act | FEMA.gov License and Delivery of Works Subject to Copyright and Data Rights: The Contractor grants to the County, a paid-up, royalty-free, nonexclusive, irrevocable, worldwide license in data first produced in the performance of this contract to reproduce, publish, or otherwise use, including prepare derivative works, distribute copies to the public, and perform publicly and display publicly such data. For data required by the contract but not first produced in the performance of this contract, the Contractor will identify such data and grant to the County or acquires on its behalf a license of the same scope as for data first produced in the performance of this contract. Data, as used herein, shall include any work subject to copyright under 17 U.S.C. § 102, for example, any written reports or literary works, software and/or source code, music, choreography, pictures or images, graphics, sculptures, videos, motion pictures or other audiovisual works, sound and/or video recordings, and architectural works. Upon or before the completion of this contract, the Contractor will deliver to the County data first produced in the performance of this contract and data Page 6069 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 3 11/24 required by the contract but not first produced in the performance of this contract in formats acceptable by the County. 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. Prohibition on Covered Telecommunications Equipment or Services: (a) Definitions. As used in this clause, the terms backhaul; covered foreign country; covered telecommunications equipment or services; interconnection arrangements; roaming; substantial or essential component; and telecommunications equipment or services have the meaning as defined in FEMA Policy, #405-143-1 Prohibitions on Expending FEMA Award Funds forcovered Telecommunications Equipment or Services As used in this clause – (b) Prohibitions. (1) Section 889(b) of the John S. McCain National Defense Authorization Act for Fiscal Year2019, Pub. L. No. 115-232, and 2 C.F.R. § 200.216 prohibit the head of an executive agency on or after Aug.13, 2020, from obligating or expending grant, cooperative agreement, loan, or loan guarantee funds on certain telecommunications products or from certain entities for national security reasons. (2) Unless an exception in paragraph (c) of this clause applies, the contractor and its subcontractors may not use grant, cooperative agreement, loan, or loan guarantee funds from the Federal Emergency Management Agency to: (i) Procure or obtain any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology of any system; (ii) Enter into, extend, or renew a contract to procure or obtain any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology of any system; (iii) Enter into, extend, or renew contracts with entities that use covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system; or (iv) Provide, as part of its performance of this contract, subcontract, or other contractual instrument, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. (c) Exceptions. (1) This clause does not prohibit contractors from providing — (i). A service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or (ii). Telecommunications equipment that cannot route or redirect user data traffic or permit visibility into any user data or packets that such equipment transmits or otherwise handles. (2) By necessary implication and regulation, the prohibitions also do not apply to: (i). Covered telecommunications equipment or services that: a. Are not used as a substantial or essential component of any system; and b. Are not used as critical technology of any system. (ii). Other telecommunications equipment or services that are not considered covered telecommunications equipment or services. (3) Reporting requirement. Page 6070 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 4 11/24 (1) In the event the contractor identifies covered telecommunications equipment or services used as a substantial or essential component of any system, or as critical technology as part of any system, during contract performance, or the contractor is notified of such by a subcontractor at any tier or by any other source, the contractor shall report the information in paragraph (d)(2) of this clause to the recipient or subrecipient, unless elsewhere in this contract are established procedures for reporting the information. (2) The Contractor shall report the following information pursuant to paragraph (d)(1) of this clause: (i) Within one business day from the date of such identification or notification: The contract number; the order number(s), if applicable; supplier name; supplier unique entity identifier (if known); supplier Commercial and Government Entity (CAGE) code (if known); brand; model number (original equipment manufacturer number, manufacturer part number, or wholesaler number); item description; and any readily available information about mitigation actions undertaken or recommended. (ii) Within 10 business days of submitting the information in paragraph (d)(2)(i) of this clause: Any further available information about mitigation actions undertaken or recommended. In addition, the contractor shall describe the efforts it undertook to prevent use or submission of covered telecommunications equipment or services, and any additional efforts that will be incorporated to prevent future use or submission of covered telecommunications equipment or services. (e) Subcontracts. The Contractor shall insert the substance of this clause, including this paragraph(e), in all subcontracts and other contractual instruments. Providing Good, Safe Job to Workers: Pursuant to FEMA Information Bulletin No. 520, the contractor will comply with all applicable federal labor and employment laws. To maximize cost efficiency and quality of work, the contractor commits to strong labor standards and protections for the project workforce by creating an effective plan for ensuring high-quality jobs and complying with federal labor and employment laws. The contractor acknowledges applicable minimum wage, overtime, prevailing wage, and health and safety requirements, and will incorporate Good Jobs Principles wherever appropriate and to the greatest extent practicable. Rights to Inventions Made Under a Contract or Agreement: Exempt from FEMA Public Assistance Funding Socioeconomic Contracting: The Contractor is encouraged to take all necessary steps identified in 2 C.F.R. § 200.321(b)(1)-(5) to ensure small businesses, minority businesses, women’s business enterprises, veteran owned businesses, and labor surplus area firms are considered when possible. Such consideration means: (1) These business types are included on solicitation lists; (2) These business types are solicited whenever they are deemed eligible as potential sources; (3) Dividing procurement transactions into separate procurements to permit maximum participation by these business types; (4) Establishing delivery schedules (for example, the percentage of an order to be delivered by a given date of each month) that encourage participation by these business types; (5) Utilizing organizations such as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce; and (6) Requiring a contractor under a Federal award to apply this section to subcontracts. Suspension and Debarment: (1) This contract is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R. pt. 3000. As such the contractor is required to verify that none of the contractor, its principals (defined at 2 C.F.R. § 180.995), or its affiliates (defined at 2 C.F.R. § 180.905) are excluded (defined at 2 C.F.R. § 180.940) or disqualified (defined at 2 C.F.R. § 180.935). (2) The contractor must comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C and must include a requirement to comply with these regulations in any lower tier covered transaction it enters into. (3) This certification is a material representation of fact relied upon by the County. If it is later determined that the contractor did not comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies available to the County, the Federal Government may pursue available remedies, including but not limited to suspension and/or debarment. (4) The bidder or proposer agrees to comply with the requirements of 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C while this offer is valid and throughout the period of any contract Page 6071 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 5 11/24 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. Contractors must sign and submit a debarment certification to the County with each bid or offer. See Certifications and Assurances and the end of this document. Procurement of Recovered Materials (§200.323) (Over $10,000): In the performance of this contract, the Contractor shall make maximum use of products containing recovered materials that are EPA- designated items unless the product cannot be acquired — a) Competitively within a timeframe providing for compliance with the contract performance schedule; b) Meeting contract performance requirements; or c) At a reasonable price. Information about this requirement, along with the list of EPA-designated items, is available at EPA’s Comprehensive Procurement Guidelines webpage: Comprehensive Procurement Guideline (CPG) Program | US EPA. The Contractor also agrees to comply with all other applicable requirements of Section 6002 of the Solid Waste Disposal Act. The Contactor should, to the greatest extent practicable and consistent with the law, purchase, acquire, or use products and services that can be reused, refurbished, or recycled; contain recycled content, are biobased, or are energy and water efficient; and are sustainable. Termination for Cause and Convenience (over $10,000): See Standard Purchase Order and/or Contract Terms and Conditions Byrd Anti-Lobbying Amendment (31 U.S.C. § 1352 (as amended) (over $100,000): Contractors who apply or bid for an award of more than $100,000 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 County who in turn will forward the certification(s) to the federal agency. Contractors must sign and submit a lobbying certification to the County with each bid or offer exceeding $100,000. See Certifications and Assurances and the end of this document. Contract Work Hours and Safety Standards Act (CWHSSA) (40 U.S.C. 3701-3708) (over $100,000): Where applicable, all contracts awarded by the solicitor in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Compliance with the Contract Work Hours and Safety Standards Act. (1) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. (2) Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph (b)(1) of this section the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages and interest from the date of the underpayment. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the Page 6072 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 6 11/24 District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchpersons and guards, employed in violation of the clause set forth in paragraph (b)(1) of this section, in the sum of $32 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (b)(1). (3) Withholding for unpaid wages and liquidated damages— (i) Withholding Process. The County may, upon its own action, or must, upon written request of an authorized representative of the Department of Labor, withhold or cause to be withheld from the contractor so much of the accrued payments or advances as may be considered necessary to satisfy the liabilities of the prime contractor or any subcontractor for any unpaid wages; monetary relief, including interest; and liquidated damages required by the clauses set forth in this paragraph (b) on this contract, any other federal contract with the same prime contractor, or any other federally assisted contract subject to the Contract Work Hours and Safety Standards Act that is held by the same prime contractor (as defined in § 5.2). The necessary funds may be withheld from the contractor under this contract, any other federal contract with the same prime contractor, or any other federally assisted contract that is subject to the Contract Work Hours and Safety Standards Act and is held by the same prime contractor, regardless of whether the other contract was awarded or assisted by the same agency, and such funds may be used to satisfy the contractor liability for which the funds were withheld. (ii) (ii) Priority to withheld funds. The Department has priority to funds withheld or to be withheld in accordance with paragraph (a)(2)(i) or (b)(3)(i) of this section, or both, over claims to those funds by: (A) A contractor's surety(ies), including without limitation performance bond sureties and payment bond sureties; (B) A contracting agency for its reprocurement costs; (C) A trustee(s) (either a court-appointed trustee or a U.S. trustee, or both) in bankruptcy of a contractor, or a contractor's bankruptcy estate; (D) A contractor's assignee(s); (E) A contractor's successor(s); or (F) A claim asserted under the Prompt Payment Act, 31 U.S.C. 3901-3907. (4) Subcontracts. The contractor or subcontractor must insert in any subcontracts the clauses set forth in paragraphs (b)(1) through (5) of this section and a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor is responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (b)(1) through (5). In the event of any violations of these clauses, the prime contractor, and any subcontractor(s) responsible will be liable for any unpaid wages and monetary relief, including interest from the date of the underpayment or loss, due to any workers of lower-tier subcontractors, and associated liquidated damages and may be subject to debarment, as appropriate. (5) Anti-retaliation. It is unlawful for any person to discharge, demote, intimidate, threaten, restrain, coerce, blacklist, harass, or in any other manner discriminate against, or to cause any person to discharge, demote, intimidate, threaten, restrain, coerce, blacklist, harass, or in any other manner discriminate against, any worker or job applicant for: Page 6073 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 7 11/24 (i) Notifying any contractor of any conduct which the worker reasonably believes constitutes a violation of the Contract Work Hours and Safety Standards Act (CWHSSA) or its implementing regulations in this part; (ii) Filing any complaint, initiating, or causing to be initiated any proceeding, or otherwise asserting or seeking to assert on behalf of themselves or others any right or protection under CWHSSA or this part; (iii) Cooperating in any investigation or other compliance action, or testifying in any proceeding under CWHSSA or this part; or (iv) Informing any other person about their rights under CWHSSA or this part.” Further Compliance with the Contract Work Hours and Safety Standards Act. (1) The contractor or subcontractor must maintain regular payrolls and other basic records during the course of the work and must preserve them for a period of three years after all the work on the prime contract is completed for all laborers and mechanics, including guards and watchpersons, working on the contract. Such records must contain the name; last known address, telephone number, and email address; and social security number of each such worker; each worker’s correct classification(s) of work performed; hourly rates of wages paid; daily and weekly number of hours actually worked; deductions made; and actual wages paid. (2) Records to be maintained under this provision must be made available by the contractor or subcontractor for inspection, copying, or transcription by authorized representatives of the Department of Homeland Security, the Federal Emergency Management Agency, and the Department of Labor, and the contractor or subcontractor will permit such representatives to interview workers during working hours on the job.” Clean Air 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 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. 3. 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. 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 Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251 et seq. 2. 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. 3. 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. Administrative, Contractual, or Legal Remedies (over $250,000): 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. Page 6074 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 8 11/24 CONSTRUCTION ACTIVITIES Equal Employment Opportunity Clause (§60-1.4): Except as otherwise provided under 41 C.F.R. Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 C.F.R. § 60-1.3 must include the equal opportunity clause provided under 41 C.F.R. § 60- 1.4. During the performance of this contract, the contractor agrees as follows: (1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. (3) The contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the contractor's legal duty to furnish information. (4) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (5) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. (6) The contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (7) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled, terminated, or suspended in whole or in part an the contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (8) The contractor will include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (8) in every subcontract or purchase order unless exempted by rules, Page 6075 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 9 11/24 regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the contractor may request the United States to enter into such litigation to protect the interests of the United States. Davis Bacon Act: Exempt under FEMA Public Assistance Funding Copeland Anti-Kickback Act: Exempt under FEMA Public Assistance Funding Page 6076 of 7924 Page 6077 of 7924 Tax ID # 93-3139462 Application for UEI in progress Page 6078 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 12 11/24 Chemical Injection Partners Florida LLC 93-3139462 N/A N/A N/A N/A N/A N/A Chemical Injection Partners Florida LLC February 11, 2025 Executive Assistant mindy.helding@cipsolutions.com 941-253-0250 N/A Page 6079 of 7924 Page 6080 of 7924 Page 6081 of 7924 Page 6082 of 7924 Page 6083 of 7924 INSURANCE REQUIREMENTS COVERSHEET Project Name Vendor Name Solicitation/Contract No. Attachments Risk Approved Insurance Requirements Risk Approved Insurance Certificate(s) Comments Attachments Approved by Risk Management Division Approval: Page 6084 of 7924 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 3/19/2025 McAnally Wilkins Insurance,An Alliant Company P.O.Box 60810 Midland TX 79711 Eri Mize 432-685-9350 432-685-9399 eri@mcanallywilkins.com License#:15714884 Berkley National Insurance Com 38911 CHEMINJ-01 Argonaut Insurance Company 19801ChemicalInjectionPartners,Florida LLC 6230 University Parkway Suite 201 Sarasota FL 34240 Berkley Regional Insurance Com 29580 Hanover Insurance Company 22292 Crum &Forster Specialty Insur 44520 Admiral Insurance Company 24856 1511467743 A X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X EGL005240812 12/31/2024 12/31/2025 2,000,000 C 1,000,000 X X X ECA 3167598-12 12/31/2024 12/31/2025 A F X X 10,000,000 X EUL005240912 025095861X 12/31/2024 12/31/2024 12/31/2025 12/31/2025 10,000,000 X 10,000 B XWC92905880474412/31/2024 12/31/2025 1,000,000 1,000,000 1,000,000 E D D Contractors Pollution Liability Leased/Rented Equip from Others MTC PKC-114901-01 IHD J258923 02 IHD J258923 02 12/31/2024 12/31/2024 12/31/2024 12/31/2025 12/31/2025 12/31/2025 Limit Limit Property in Transit $5,000,000 $200,000 $100,000 All policies except Workers'Compensation include a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status.All policies include a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it.Policies certified contain 30-day notice of cancellation. The Umbrella/Excess Liability follows form of the General Liability,Auto Liability and Employers Liability,pursuant to the terms,conditions and exclusions of the policies.The General Liability policy &the Business Auto policies include a special endorsement that contains “primary &non-contributory”wording.The Workers’Compensation includes an alternate employer endorsement that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it. ITB Number 24-8307 Collier County Board of County Commissioners 3295 Tamiami Trail E. Naples FL 34112 Page 6085 of 7924 Page 6086 of 7924 Page 6087 of 7924 Page 6088 of 7924 Page 6089 of 7924 Page 6090 of 7924 Page 6091 of 7924 Page 6092 of 7924 Page 6093 of 7924 Page 6094 of 7924 Page 6095 of 7924 Page 6096 of 7924 Page 6097 of 7924 Page 6098 of 7924 Page 6099 of 7924 Page 6100 of 7924 Page 6101 of 7924 Page 6102 of 7924 Page 6103 of 7924 Page 6104 of 7924 Page 6105 of 7924 Page 6106 of 7924 Page 6107 of 7924 Page 6108 of 7924 Page 6109 of 7924 Page 6110 of 7924 Page 6111 of 7924 Page 6112 of 7924 Page 6113 of 7924 Page 6114 of 7924 Page 6115 of 7924 Page 6116 of 7924 Page 6117 of 7924 Page 6118 of 7924 Page 6119 of 7924 Page 6120 of 7924 Page 6121 of 7924 Page 6122 of 7924 Page 6123 of 7924 Page 6124 of 7924 Page 6125 of 7924 Page 6126 of 7924 Page 6127 of 7924 Page 6128 of 7924 Page 6129 of 7924 Page 6130 of 7924 Page 6131 of 7924 Page 6132 of 7924 Page 6133 of 7924 Page 6134 of 7924 Page 6135 of 7924 Page 6136 of 7924 Page 6137 of 7924 Page 6138 of 7924 Page 6139 of 7924 Page 6140 of 7924 Page 6141 of 7924 Page 6142 of 7924 Page 6143 of 7924 Page 6144 of 7924 Page 6145 of 7924 Page 6146 of 7924 Page 6147 of 7924 Page 6148 of 7924 Page 6149 of 7924 Page 6150 of 7924 Page 6151 of 7924 Page 6152 of 7924 Page 6153 of 7924 Page 6154 of 7924 Page 6155 of 7924 Page 6156 of 7924 Page 6157 of 7924 Page 6158 of 7924 Page 6159 of 7924 Page 6160 of 7924 Page 6161 of 7924 Page 6162 of 7924 Page 6163 of 7924 Page 6164 of 7924 Page 6165 of 7924 Page 6166 of 7924 Page 6167 of 7924 Page 6168 of 7924 Page 6169 of 7924 Page 6170 of 7924 Page 6171 of 7924 Page 6172 of 7924 Page 6173 of 7924 Page 6174 of 7924 Page 6175 of 7924 Page 6176 of 7924 Page 6177 of 7924 Page 6178 of 7924 Page 6179 of 7924 Page 6180 of 7924 Page 6181 of 7924 Page 6182 of 7924 Page 6183 of 7924 Page 6184 of 7924 Page 6185 of 7924 Page 6186 of 7924 Page 6187 of 7924 Page 6188 of 7924 Page 6189 of 7924 Page 6190 of 7924 County of Collier, FL Procurement -, - 3299 Tamiami Trail, East Naples, FL 34112 [RAZORBACK LLC] RESPONSE DOCUMENT REPORT GEN No. 24-8307 Deep Injection Well System Preventative Maintenance and Repairs RESPONSE DEADLINE: February 11, 2025 at 3:00 pm Report Generated: Tuesday, February 11, 2025 Razorback LLC Response CONTACT INFORMATION Company: Razorback LLC Email: bidding@razorbackllc.com Contact: Anthony Houllis Address: 177 Anclote Road Tarpon Springs, FL 34689 Phone: N/A Website: https://www.razorbackllc.com/ Submission Date: Feb 11, 2025 1:35 PM (Eastern Time) Page 6191 of 7924 [RAZORBACK LLC] RESPONSE DOCUMENT REPORT GEN No. 24-8307 Deep Injection Well System Preventative Maintenance and Repairs [RAZORBACK LLC] RESPONSE DOCUMENT REPORT undefined - Deep Injection Well System Preventative Maintenance and Repairs Page 2 ADDENDA CONFIRMATION Addendum #1 Confirmed Jan 25, 2025 1:55 PM by Anthony Houllis Addendum #2 Confirmed Jan 25, 2025 1:55 PM by Anthony Houllis QUESTIONNAIRE 1. I certify that I have read, understood and agree to the terms in this solicitation, and that I am authorized to submit this r esponse on behalf of my company.* Confirmed 2. General Bid Instructions has been acknowledged and accepted.* Confirmed 3. Collier County Purchase Order Terms and Conditions have been acknowledged and accepted.* Confirmed 4. Insurance Requirements* Vendor Acknowledges Insurance Requirement and is prepared to produce the required insurance certificate(s) within five (5) days of the County's issuance of a Notice of Recommended Award. Confirmed Page 6192 of 7924 [RAZORBACK LLC] RESPONSE DOCUMENT REPORT GEN No. 24-8307 Deep Injection Well System Preventative Maintenance and Repairs [RAZORBACK LLC] RESPONSE DOCUMENT REPORT undefined - Deep Injection Well System Preventative Maintenance and Repairs Page 3 5. County Required Forms BID SCHEDULE* Please upload completed Bid Schedule in Microsoft Excel format. 24-8307_Bid_Schedule_-_Razorback_LLC.xlsx VENDOR DECLARATION STATEMENT (FORM 1)* 24-8307_-_Form_1_Vendor_Declaration_Statement_-_Razorback_LLC.pdf CONFLICT OF INTEREST CERTIFICATION AFFIDAVIT (FORM 2)* 24-8307_-_Form_2_Conflict_of_Interest_Certification_-_Razorback_LLC.pdf PROOF OF STATUS FROM DIVISION OF CORPORATIONS - FLORIDA DEPARTMENT OF STATE (IF WORK PERFORMED IN THE STATE) - HTTP://DOS.MYFLORIDA.COM/SUNBIZ/ SHOULD BE ATTACHED WITH YOUR SUBMITTAL* Sunbiz_2024.pdf Florida_Good_Standing_Cert_2024.pdf IMMIGRATION AFFIDAVIT CERTIFICATION (FORM 3)* 24-8307_-_Form_3_Immigration_Affidavit_Certification_-_Razorback_LLC.pdf E-VERIFY MEMORANDUM OF UNDERSTANDING OR COMPANY PROFILE PAGE* E_Verify_Registration.pdf REFERENCE QUESTIONNAIRES (FORM 4)* Please provide 2-3 References 24-8307_-_Form_4_-_References_-_Razorback_LLC.pdf GRANT PROVISIONS AND ASSURANCES PACKAGE (FORM 5).* 24-8307_FPP_FEMA_10.1.24_-_Razorback_LLC.pdf Page 6193 of 7924 [RAZORBACK LLC] RESPONSE DOCUMENT REPORT GEN No. 24-8307 Deep Injection Well System Preventative Maintenance and Repairs [RAZORBACK LLC] RESPONSE DOCUMENT REPORT undefined - Deep Injection Well System Preventative Maintenance and Repairs Page 4 VENDOR W-9 FORM* 2024_Razorback_LLC_W-9.pdf ALL SIGNED ADDENDA, IF APPLICABLE. 24-8307_Addendum_#1_-_Razorback_LLC.pdf 24-8307_Addendum_#2_-_Razorback_LLC.pdf ALL OTHER REQUIRED DOCUMENTATION, AS APPLICABLE. 24-8307_-_Collier_County_Solicitation_-_Additional_Documents_-_Razorback_LLC.pdf PRICE TABLES TOTAL BID AMOUNT Submit line-item pricing via Bid Schedule in Microsoft Excel format. Line Item Description Quantity Unit of Measure Unit Cost Total 1 TOTAL BID AMOUNT 1 EACH $56,105.00 $56,105.00 TOTAL $56,105.00 Page 6194 of 7924 Page 6195 of 7924 Page 6196 of 7924 Page 6197 of 7924 Document Number FEI/EIN Number Date Filed State Status Last Event Event Date Filed Department of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Florida Limited Liability Company RAZORBACK LLC Filing Information L08000089307 26-3447303 09/18/2008 FL ACTIVE REINSTATEMENT 02/22/2011 Principal Address 177 Anclote Road TARPON SPRINGS, FL 34689 Changed: 02/08/2021 Mailing Address 177 Anclote Road TARPON SPRINGS, FL 34689 Changed: 02/08/2021 Registered Agent Name & Address HOULLIS, ANTHONY M 276 KNOLLWOOD ROAD TARPON SPRINGS, FL 34688 Authorized Person(s) Detail Name & Address Title MGRM HOULLIS, ANTHONY M 276 KNOLLWOOD ROAD TARPON SPRINGS, FL 34688 Annual Reports Report Year Filed Date 2022 01/26/2022 D C Florida Department of State Page 6198 of 7924 2023 01/23/2023 2024 02/08/2024 Document Images 02/08/2024 -- ANNUAL REPORT View image in PDF format 01/23/2023 -- ANNUAL REPORT View image in PDF format 01/26/2022 -- ANNUAL REPORT View image in PDF format 02/08/2021 -- ANNUAL REPORT View image in PDF format 01/21/2020 -- ANNUAL REPORT View image in PDF format 02/21/2019 -- ANNUAL REPORT View image in PDF format 01/15/2018 -- ANNUAL REPORT View image in PDF format 04/05/2017 -- ANNUAL REPORT View image in PDF format 02/01/2016 -- ANNUAL REPORT View image in PDF format 01/11/2015 -- ANNUAL REPORT View image in PDF format 01/16/2014 -- ANNUAL REPORT View image in PDF format 01/18/2013 -- ANNUAL REPORT View image in PDF format 01/05/2012 -- ANNUAL REPORT View image in PDF format 02/22/2011 -- REINSTATEMENT View image in PDF format 03/04/2009 -- ANNUAL REPORT View image in PDF format 09/18/2008 -- Florida Limited Liability View image in PDF format Florida Department of State, Division of Corporations Page 6199 of 7924 State of Florida Department of State I certify from the records of this office that RAZORBACK LLC is a limited liability company organized under the laws of the State of Florida,filed on September 18,2008. The document number of this limited liability company is L08000089307. I further certify that said limited liability company has paid all fees due this office through December 31,2024,that its most recent annual report was filed on February 8,2024,and that its status is active. Given under my hand and the Great Seal of the State of Florida at Tallahassee,the Capital,this the Twenty-sixth day of February, 2024 Tracking Number:6472851876CU To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateOfStatus/CertificateAuthentication Page 6200 of 7924 Page 6201 of 7924 Page 6202 of 7924 Page 6203 of 7924 Razorback LLC David Lambert William Vazquez DOI, National Park Service william_vazquez@nps.gov 470-819-0934 Rehabilitate Wasterwater Treatment Plant $805,500 02/12/2021 207 Days 9 9 10 10 10 10 10 10 10 10 98 Page 6204 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 1 11/24 FEDERAL EMERGENCY MANAGEMENT AGENCY PUBLIC ASSISTANCE The supplemental conditions contained in this section are intended to cooperate with, to supplement, and to modify the general conditions and other specifications. In cases of disagreement with any other section of this contract, the Supplemental Conditions shall govern. This is an acknowledgement that FEMA financial assistance will be used to fund all or a portion of the contract. Pursuant uniform requirements of federal awards (2 CFR Part 200.23) the definition of CONTRACTOR is an entity that receives a Contract / Purchase Order. Compliance with Federal Law, Regulations and Executive Orders: The Sub-Recipient (County) agrees to include in the subcontract that (i) the subcontractor is bound by the terms of the Federally-Funded Subaward and Grant Agreement, (ii) the subcontractor is bound by all applicable state and Federal laws and regulations, and (iii) the subcontractor shall hold the County 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. Specifically, the Contractor shall be responsible for being knowledgeable and performing any and all services under this contract in accordance with the following governing regulations along with all applicable Federal law, regulations, executive orders, FEMA policies, procedures, and directives. o 2 C.F.R. Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards o 44 C.F.R. Part 206 o The Robert T. Stafford Disaster Relief and Emergency Assistance Act, Public Law 93- 288, as amended, 42 U.S.C. 5121 et seq., and Related Authorities o FEMA Public Assistance Program and Policy Guide Page 6205 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 2 11/24 Access to Records: 1) The contractor agrees to provide the County, the Florida Department of Emergency Management, the FEMA 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 Administrator or his authorized representatives’ access to construction or other work sites pertaining to the work being completed under the contract. (4) In compliance with section 1225 of the Disaster Recovery Act of 2018, the County and the Contractor acknowledge and agree that no language in this contract is intended to prohibit audits or internal reviews by the FEMA Administrator or the Comptroller General of the United States. Buy Clean: The County encourages the use of environmentally friendly construction practices in the performance of this Agreement. In particular, the County encourages that the performance of this agreement includes considering the use of low-carbon materials which have substantially lower levels of embodied greenhouse-gas emissions associated with all relevant stages of production, use, and disposal, as compared to estimated industry averages of similar materials or products as demonstrated by their environmental product declaration. Changes: To be allowable under a FEMA grant or cooperative agreement award, the cost of any contract change, modification, amendment, addendum, change order, or constructive change must be necessary, allowable, allocable, within the scope of the grant or cooperative agreement, reasonable for the scope of work, and otherwise allowable. DHS Seal, Logo, and Flags: The County must obtain written permission from Department of Homeland Security prior to using the DHS seals, logos, crests, or reproductions of flags, or likenesses of DHS agency officials. This includes use of DHS component (e.g., FEMA, CISA, etc.) seals, logos, crests, or reproductions of flags, or likenesses of component officials. The contractor shall not use the DHS seal(s), logos, crests, or reproductions of flags or likenesses of DHS agency officials without specific FEMA pre- approval. Domestic Preference for Procurements: The Contractor should, to the greatest extent practicable and consistent with law, provide a preference for the purchase, acquisition, or use of goods, products, or materials produced in the United States. This includes, but is not limited to, iron, aluminum, steel, cement, and other manufactured products. For purposes of this section: ‘‘Produced in the United States’’ means, for iron and steel products, that all manufacturing processes, from the initial melting stage through the application of coatings, occurred in the United States. Build America, Buy America Act (BABAA): FEMA Public Assistance Funding is not subject to Buy America preference pursuant the following guidance: Programs and Definitions: Build America, Buy America Act | FEMA.gov License and Delivery of Works Subject to Copyright and Data Rights: The Contractor grants to the County, a paid-up, royalty-free, nonexclusive, irrevocable, worldwide license in data first produced in the performance of this contract to reproduce, publish, or otherwise use, including prepare derivative works, distribute copies to the public, and perform publicly and display publicly such data. For data required by the contract but not first produced in the performance of this contract, the Contractor will identify such data and grant to the County or acquires on its behalf a license of the same scope as for data first produced in the performance of this contract. Data, as used herein, shall include any work subject to copyright under 17 U.S.C. § 102, for example, any written reports or literary works, software and/or source code, music, choreography, pictures or images, graphics, sculptures, videos, motion pictures or other audiovisual works, sound and/or video recordings, and architectural works. Upon or before the completion of this contract, the Contractor will deliver to the County data first produced in the performance of this contract and data Page 6206 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 3 11/24 required by the contract but not first produced in the performance of this contract in formats acceptable by the County. 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. Prohibition on Covered Telecommunications Equipment or Services: (a) Definitions. As used in this clause, the terms backhaul; covered foreign country; covered telecommunications equipment or services; interconnection arrangements; roaming; substantial or essential component; and telecommunications equipment or services have the meaning as defined in FEMA Policy, #405-143-1 Prohibitions on Expending FEMA Award Funds forcovered Telecommunications Equipment or Services As used in this clause – (b) Prohibitions. (1) Section 889(b) of the John S. McCain National Defense Authorization Act for Fiscal Year2019, Pub. L. No. 115-232, and 2 C.F.R. § 200.216 prohibit the head of an executive agency on or after Aug.13, 2020, from obligating or expending grant, cooperative agreement, loan, or loan guarantee funds on certain telecommunications products or from certain entities for national security reasons. (2) Unless an exception in paragraph (c) of this clause applies, the contractor and its subcontractors may not use grant, cooperative agreement, loan, or loan guarantee funds from the Federal Emergency Management Agency to: (i) Procure or obtain any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology of any system; (ii) Enter into, extend, or renew a contract to procure or obtain any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology of any system; (iii) Enter into, extend, or renew contracts with entities that use covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system; or (iv) Provide, as part of its performance of this contract, subcontract, or other contractual instrument, any equipment, system, or service that uses covered telecommunications equipment or services as a substantial or essential component of any system, or as critical technology as part of any system. (c) Exceptions. (1) This clause does not prohibit contractors from providing — (i). A service that connects to the facilities of a third-party, such as backhaul, roaming, or interconnection arrangements; or (ii). Telecommunications equipment that cannot route or redirect user data traffic or permit visibility into any user data or packets that such equipment transmits or otherwise handles. (2) By necessary implication and regulation, the prohibitions also do not apply to: (i). Covered telecommunications equipment or services that: a. Are not used as a substantial or essential component of any system; and b. Are not used as critical technology of any system. (ii). Other telecommunications equipment or services that are not considered covered telecommunications equipment or services. (3) Reporting requirement. Page 6207 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 4 11/24 (1) In the event the contractor identifies covered telecommunications equipment or services used as a substantial or essential component of any system, or as critical technology as part of any system, during contract performance, or the contractor is notified of such by a subcontractor at any tier or by any other source, the contractor shall report the information in paragraph (d)(2) of this clause to the recipient or subrecipient, unless elsewhere in this contract are established procedures for reporting the information. (2) The Contractor shall report the following information pursuant to paragraph (d)(1) of this clause: (i) Within one business day from the date of such identification or notification: The contract number; the order number(s), if applicable; supplier name; supplier unique entity identifier (if known); supplier Commercial and Government Entity (CAGE) code (if known); brand; model number (original equipment manufacturer number, manufacturer part number, or wholesaler number); item description; and any readily available information about mitigation actions undertaken or recommended. (ii) Within 10 business days of submitting the information in paragraph (d)(2)(i) of this clause: Any further available information about mitigation actions undertaken or recommended. In addition, the contractor shall describe the efforts it undertook to prevent use or submission of covered telecommunications equipment or services, and any additional efforts that will be incorporated to prevent future use or submission of covered telecommunications equipment or services. (e) Subcontracts. The Contractor shall insert the substance of this clause, including this paragraph(e), in all subcontracts and other contractual instruments. Providing Good, Safe Job to Workers: Pursuant to FEMA Information Bulletin No. 520, the contractor will comply with all applicable federal labor and employment laws. To maximize cost efficiency and quality of work, the contractor commits to strong labor standards and protections for the project workforce by creating an effective plan for ensuring high-quality jobs and complying with federal labor and employment laws. The contractor acknowledges applicable minimum wage, overtime, prevailing wage, and health and safety requirements, and will incorporate Good Jobs Principles wherever appropriate and to the greatest extent practicable. Rights to Inventions Made Under a Contract or Agreement: Exempt from FEMA Public Assistance Funding Socioeconomic Contracting: The Contractor is encouraged to take all necessary steps identified in 2 C.F.R. § 200.321(b)(1)-(5) to ensure small businesses, minority businesses, women’s business enterprises, veteran owned businesses, and labor surplus area firms are considered when possible. Such consideration means: (1) These business types are included on solicitation lists; (2) These business types are solicited whenever they are deemed eligible as potential sources; (3) Dividing procurement transactions into separate procurements to permit maximum participation by these business types; (4) Establishing delivery schedules (for example, the percentage of an order to be delivered by a given date of each month) that encourage participation by these business types; (5) Utilizing organizations such as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce; and (6) Requiring a contractor under a Federal award to apply this section to subcontracts. Suspension and Debarment: (1) This contract is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R. pt. 3000. As such the contractor is required to verify that none of the contractor, its principals (defined at 2 C.F.R. § 180.995), or its affiliates (defined at 2 C.F.R. § 180.905) are excluded (defined at 2 C.F.R. § 180.940) or disqualified (defined at 2 C.F.R. § 180.935). (2) The contractor must comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C and must include a requirement to comply with these regulations in any lower tier covered transaction it enters into. (3) This certification is a material representation of fact relied upon by the County. If it is later determined that the contractor did not comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies available to the County, the Federal Government may pursue available remedies, including but not limited to suspension and/or debarment. (4) The bidder or proposer agrees to comply with the requirements of 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C while this offer is valid and throughout the period of any contract Page 6208 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 5 11/24 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. Contractors must sign and submit a debarment certification to the County with each bid or offer. See Certifications and Assurances and the end of this document. Procurement of Recovered Materials (§200.323) (Over $10,000): In the performance of this contract, the Contractor shall make maximum use of products containing recovered materials that are EPA- designated items unless the product cannot be acquired — a) Competitively within a timeframe providing for compliance with the contract performance schedule; b) Meeting contract performance requirements; or c) At a reasonable price. Information about this requirement, along with the list of EPA-designated items, is available at EPA’s Comprehensive Procurement Guidelines webpage: Comprehensive Procurement Guideline (CPG) Program | US EPA. The Contractor also agrees to comply with all other applicable requirements of Section 6002 of the Solid Waste Disposal Act. The Contactor should, to the greatest extent practicable and consistent with the law, purchase, acquire, or use products and services that can be reused, refurbished, or recycled; contain recycled content, are biobased, or are energy and water efficient; and are sustainable. Termination for Cause and Convenience (over $10,000): See Standard Purchase Order and/or Contract Terms and Conditions Byrd Anti-Lobbying Amendment (31 U.S.C. § 1352 (as amended) (over $100,000): Contractors who apply or bid for an award of more than $100,000 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 County who in turn will forward the certification(s) to the federal agency. Contractors must sign and submit a lobbying certification to the County with each bid or offer exceeding $100,000. See Certifications and Assurances and the end of this document. Contract Work Hours and Safety Standards Act (CWHSSA) (40 U.S.C. 3701-3708) (over $100,000): Where applicable, all contracts awarded by the solicitor in excess of $100,000 that involve the employment of mechanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Compliance with the Contract Work Hours and Safety Standards Act. (1) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked in excess of forty hours in such workweek. (2) Violation; liability for unpaid wages; liquidated damages. In the event of any violation of the clause set forth in paragraph (b)(1) of this section the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages and interest from the date of the underpayment. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the Page 6209 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 6 11/24 District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchpersons and guards, employed in violation of the clause set forth in paragraph (b)(1) of this section, in the sum of $32 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (b)(1). (3) Withholding for unpaid wages and liquidated damages— (i) Withholding Process. The County may, upon its own action, or must, upon written request of an authorized representative of the Department of Labor, withhold or cause to be withheld from the contractor so much of the accrued payments or advances as may be considered necessary to satisfy the liabilities of the prime contractor or any subcontractor for any unpaid wages; monetary relief, including interest; and liquidated damages required by the clauses set forth in this paragraph (b) on this contract, any other federal contract with the same prime contractor, or any other federally assisted contract subject to the Contract Work Hours and Safety Standards Act that is held by the same prime contractor (as defined in § 5.2). The necessary funds may be withheld from the contractor under this contract, any other federal contract with the same prime contractor, or any other federally assisted contract that is subject to the Contract Work Hours and Safety Standards Act and is held by the same prime contractor, regardless of whether the other contract was awarded or assisted by the same agency, and such funds may be used to satisfy the contractor liability for which the funds were withheld. (ii) (ii) Priority to withheld funds. The Department has priority to funds withheld or to be withheld in accordance with paragraph (a)(2)(i) or (b)(3)(i) of this section, or both, over claims to those funds by: (A) A contractor's surety(ies), including without limitation performance bond sureties and payment bond sureties; (B) A contracting agency for its reprocurement costs; (C) A trustee(s) (either a court-appointed trustee or a U.S. trustee, or both) in bankruptcy of a contractor, or a contractor's bankruptcy estate; (D) A contractor's assignee(s); (E) A contractor's successor(s); or (F) A claim asserted under the Prompt Payment Act, 31 U.S.C. 3901-3907. (4) Subcontracts. The contractor or subcontractor must insert in any subcontracts the clauses set forth in paragraphs (b)(1) through (5) of this section and a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor is responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (b)(1) through (5). In the event of any violations of these clauses, the prime contractor, and any subcontractor(s) responsible will be liable for any unpaid wages and monetary relief, including interest from the date of the underpayment or loss, due to any workers of lower-tier subcontractors, and associated liquidated damages and may be subject to debarment, as appropriate. (5) Anti-retaliation. It is unlawful for any person to discharge, demote, intimidate, threaten, restrain, coerce, blacklist, harass, or in any other manner discriminate against, or to cause any person to discharge, demote, intimidate, threaten, restrain, coerce, blacklist, harass, or in any other manner discriminate against, any worker or job applicant for: Page 6210 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 7 11/24 (i) Notifying any contractor of any conduct which the worker reasonably believes constitutes a violation of the Contract Work Hours and Safety Standards Act (CWHSSA) or its implementing regulations in this part; (ii) Filing any complaint, initiating, or causing to be initiated any proceeding, or otherwise asserting or seeking to assert on behalf of themselves or others any right or protection under CWHSSA or this part; (iii) Cooperating in any investigation or other compliance action, or testifying in any proceeding under CWHSSA or this part; or (iv) Informing any other person about their rights under CWHSSA or this part.” Further Compliance with the Contract Work Hours and Safety Standards Act. (1) The contractor or subcontractor must maintain regular payrolls and other basic records during the course of the work and must preserve them for a period of three years after all the work on the prime contract is completed for all laborers and mechanics, including guards and watchpersons, working on the contract. Such records must contain the name; last known address, telephone number, and email address; and social security number of each such worker; each worker’s correct classification(s) of work performed; hourly rates of wages paid; daily and weekly number of hours actually worked; deductions made; and actual wages paid. (2) Records to be maintained under this provision must be made available by the contractor or subcontractor for inspection, copying, or transcription by authorized representatives of the Department of Homeland Security, the Federal Emergency Management Agency, and the Department of Labor, and the contractor or subcontractor will permit such representatives to interview workers during working hours on the job.” Clean Air 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 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. 3. 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. 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 Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251 et seq. 2. 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. 3. 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. Administrative, Contractual, or Legal Remedies (over $250,000): 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. Page 6211 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 8 11/24 CONSTRUCTION ACTIVITIES Equal Employment Opportunity Clause (§60-1.4): Except as otherwise provided under 41 C.F.R. Part 60, all contracts that meet the definition of “federally assisted construction contract” in 41 C.F.R. § 60-1.3 must include the equal opportunity clause provided under 41 C.F.R. § 60- 1.4. During the performance of this contract, the contractor agrees as follows: (1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. (3) The contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the contractor's legal duty to furnish information. (4) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of the contractor's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. (5) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. (6) The contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (7) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled, terminated, or suspended in whole or in part an the contractor may be declared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (8) The contractor will include the portion of the sentence immediately preceding paragraph (1) and the provisions of paragraphs (1) through (8) in every subcontract or purchase order unless exempted by rules, Page 6212 of 7924 EXHIBIT I FEDERAL CONTRACT PROVISIONS AND ASSURANCES EXHIBIT I ‐ 9 11/24 regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, that in the event a contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency, the contractor may request the United States to enter into such litigation to protect the interests of the United States. Davis Bacon Act: Exempt under FEMA Public Assistance Funding Copeland Anti-Kickback Act: Exempt under FEMA Public Assistance Funding Page 6213 of 7924 Page 6214 of 7924 Page 6215 of 7924 Page 6216 of 7924 Page 6217 of 7924 Page 6218 of 7924 Addendum #1 Date: January 24, 2025 From: Matthew Webster, Procurement Strategist To: Interested Bidders Subject: Addendum #1 Solicitation # 24-8307 Deep Injection Well System Preventative Maintenance and Repairs This Addendum has been issued for the following items identifying clarifications, changes, deletions, and/or additions to the original solicitation documents and bid schedule for the above referenced solicitation: CHANGES: Bid Due Date Extension: The County will extend the bid for 14 days as follows: The “Question Submission Deadline” has been extended from: January 21, 2025, at 5:00 pm EST to February 4, 2025, at 5:00 pm EST. The “Proposal Submission Deadline” has been extended from: January 28, 2025, at 3:00 pm to February 11, 2025 at 3:00 pm EST. If you require additional information, please post a question on our OpenGov (https://procurement.opengov.com) bidding platform under the solicitation for this project. Please sign below and return a copy of this Addendum with your submittal for the above referenced solicitation. (Signature) Date (Name of Firm) Email: Matthew.Webster@colliercountyfl.gov Telephone: (239) 252-8491 01/24/2025 Razorback LLC Anthony Houllis Page 6219 of 7924 Addendum #2 Date: January 24, 2025 From: Matthew Webster, Procurement Strategist To: Interested Bidders Subject: Addendum #2 Solicitation # 24-8307 Deep Injection Well System Preventative Maintenance and Repairs This Addendum has been issued for the following items identifying clarifications, changes, deletions, and/or additions to the original solicitation documents and bid schedule for the above referenced solicitation: CHANGES: OpenGov Vendor Questionnaire: Change: 5.7. Certification for Claiming Status as a Local Business to 5.7 Reference Questionnaire (Form 4). -Please provide 2 -3 References Change: 5.9. Reference Questionnaires (Form 5) to 5.8 Grant Provisions and Assurances package (Form 5). Delete: 5.8. Business Tax Receipt Delete: 5.12. Grant Federal Provisions Package* If you require additional information, please post a question on our OpenGov (https://procurement.opengov.com) bidding platform under the solicitation for this project. Please sign below and return a copy of this Addendum with your submittal for the above referenced solicitation. (Signature) Date (Name of Firm) Email: Matthew.Webster@colliercountyfl.gov Telephone: (239) 252-8491 01/24/2025 Razorback LLC Page 6220 of 7924 Page 6221 of 7924 Melanie S. Griffin, SecretaryRon DeSantis, GovernorSTATE OF FLORIDADEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATIONCONSTRUCTION INDUSTRY LICENSING BOARDTHE GENERAL CONTRACTOR HEREIN IS CERTIFIED UNDER THEPROVISIONS OF CHAPTER 489, FLORIDA STATUTESHOULLIS, ANTHONY MICHAELDo not alter this document in any form.RAZORBACK LLCLICENSE NUMBER: CGC1526612EXPIRATION DATE: AUGUST 31, 2026This is your license. It is unlawful for anyone other than the licensee to use this document.177 ANCLOTE RDTARPON SPRINGS FL 34689Always verify licenses online at MyFloridaLicense.comISSUED: 05/20/2024Page 6222 of 7924 State of Florida Department of State I certify from the records of this office that RAZORBACK LLC is a limited liability company organized under the laws of the State of Florida,filed on September 18,2008. The document number of this limited liability company is L08000089307. I further certify that said limited liability company has paid all fees due this office through December 31,2024,that its most recent annual report was filed on February 8,2024,and that its status is active. Given under my hand and the Great Seal of the State of Florida at Tallahassee,the Capital,this the Twenty-sixth day of February, 2024 Tracking Number:6472851876CU To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateOfStatus/CertificateAuthentication Page 6223 of 7924 Document Number FEI/EIN Number Date Filed State Status Last Event Event Date Filed Department of State / Division of Corporations / Search Records / Search by Entity Name / Detail by Entity Name Florida Limited Liability Company RAZORBACK LLC Filing Information L08000089307 26-3447303 09/18/2008 FL ACTIVE REINSTATEMENT 02/22/2011 Principal Address 177 Anclote Road TARPON SPRINGS, FL 34689 Changed: 02/08/2021 Mailing Address 177 Anclote Road TARPON SPRINGS, FL 34689 Changed: 02/08/2021 Registered Agent Name & Address HOULLIS, ANTHONY M 276 KNOLLWOOD ROAD TARPON SPRINGS, FL 34688 Authorized Person(s) Detail Name & Address Title MGRM HOULLIS, ANTHONY M 276 KNOLLWOOD ROAD TARPON SPRINGS, FL 34688 Annual Reports Report Year Filed Date 2022 01/26/2022 D C Florida Department of State Page 6224 of 7924 2023 01/23/2023 2024 02/08/2024 Document Images 02/08/2024 -- ANNUAL REPORT View image in PDF format 01/23/2023 -- ANNUAL REPORT View image in PDF format 01/26/2022 -- ANNUAL REPORT View image in PDF format 02/08/2021 -- ANNUAL REPORT View image in PDF format 01/21/2020 -- ANNUAL REPORT View image in PDF format 02/21/2019 -- ANNUAL REPORT View image in PDF format 01/15/2018 -- ANNUAL REPORT View image in PDF format 04/05/2017 -- ANNUAL REPORT View image in PDF format 02/01/2016 -- ANNUAL REPORT View image in PDF format 01/11/2015 -- ANNUAL REPORT View image in PDF format 01/16/2014 -- ANNUAL REPORT View image in PDF format 01/18/2013 -- ANNUAL REPORT View image in PDF format 01/05/2012 -- ANNUAL REPORT View image in PDF format 02/22/2011 -- REINSTATEMENT View image in PDF format 03/04/2009 -- ANNUAL REPORT View image in PDF format 09/18/2008 -- Florida Limited Liability View image in PDF format Florida Department of State, Division of Corporations Page 6225 of 7924 Page 6226 of 7924 Page 6227 of 7924 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 11/1/2024 Stahl &Associates Insurance Inc. 3939 Tampa Road Oldsmar FL 34677 Denise D'Abato 813-818-5300 813-818-5396 DDAbato@higginbotham.net Auto-Owners Insurance Company 18988 37990 Landmark American Insurance Company 33138RazorbackLLC 177 Anclote Road Tarpon Springs FL 34689 Shield Indemnity Incorporated 16762 Palms Specialty Insurance Company,Inc.17327 Federal Insurance Company 20281 349608594 B X 1,000,000 X 50,000 5,000 1,000,000 2,000,000 X LHA114714 7/8/2024 7/8/2025 2,000,000 A 1,000,000 X 5181816000 6/16/2024 6/16/2025 C X 3,000,000 X 02-EXS-500196-01 7/8/2024 7/8/2025 3,000,000 D E CONTRACTORS POLLUTION LIABILITY INLAND MARINE PACS03-00148 4547-19-71 EUC 7/8/2024 10/1/2024 7/8/2025 10/1/2025 OCCURENCE.AGGREGATE LEASED/RENTED EQUIP $1m/$2m $200,000 Excess liability provides coverage over general liability and auto liability. FOR PROPOSAL PURPOSES ONLY Page 6228 of 7924 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 5/9/2024 SUNZ Insurance Solutions, LLC. ID: (TLR) c/o TLR of Bonita, Inc 700 Central Ave, Suite 500 St. Petersburg, FL 33701 727-520-7676 x 3 727-525-3862 SUNZ Insurance Company 34762 A WC039-00001-024 6/1/2024 6/1/2025 3 WC039-00001-023 6/1/2023 6/1/2024 1,000,000.00 1,000,000.00 1,000,000.00 Rick Leonard Workers' Comp Department certs@encorehr.com TLR of Bonita, Inc dba EnterpriseHR 700 Central Avenue Suite 500 St. Petersburg FL 33701 79922951 Client Effective: 09/28/2020 441 Razorback LLC 177 Anclote Road Tarpon Sptings FL 34689 Coverage Provided for all leased employees but not subcontractors of: Razorback LLC 79922951 | TLR of Bonita PEO 039 MASTER CERT | Rosemary Young | 5/9/2024 1:52:16 PM (EDT) | Page 1 of 1 Page 6229 of 7924 INSURANCE REQUIREMENTS COVERSHEET Project Name Vendor Name Solicitation/Contract No. Attachments Risk Approved Insurance Requirements Risk Approved Insurance Certificate(s) Comments Attachments Approved by Risk Management Division Approval: Page 6230 of 7924 Page 6231 of 7924 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 3/18/2025 Stahl &Associates Insurance Inc. 3939 Tampa Road Oldsmar FL 34677 Denise D'Abato 813-818-5300 813-818-5396 DDAbato@higginbotham.net Auto-Owners Insurance Company 18988 37990 Landmark American Insurance Company 33138RazorbackLLC 177 Anclote Road Tarpon Springs FL 34689 Shield Indemnity Incorporated 16762 Palms Specialty Insurance Company,Inc.17327 Federal Insurance Company 20281 1413922166 B X 1,000,000 X 50,000 5,000 1,000,000 2,000,000 X Y LHA114714 7/8/2024 7/8/2025 2,000,000 A 1,000,000 X Y 5181816000 6/16/2024 6/16/2025 C X 3,000,000 X 02-EXS-500196-01 7/8/2024 7/8/2025 3,000,000 D E CONTRACTORS POLLUTION LIABILITY INLAND MARINE PACS03-00148 4547-19-71 EUC 7/8/2024 10/1/2024 7/8/2025 10/1/2025 OCCURENCE/AGGREGATE LEASED/RENTED EQUIP $1m/$2m $200,000 Excess liability provides coverage over general liability and auto liability. Collier County Board of County Commissioners is included as additional insured on a primary and non-contributory basis for general liability and auto liability for any and all work performed in Collier County,as required by written contract. Collier County Board of County Commissioners 3295 Tamiami Trail E. Naples FL 34112 Page 6232 of 7924 03/18/2025 PrimeGroup Insurance Services, Inc. 5215 W. Laurel St. Suite 100 Tampa FL 33607 Jennifer Barjas (844) 631-4901 (813) 885-4311 jbarjas@primegroupins.com Razorback LLC 177 Anclote Rd Tarpon Springs FL 34689 American Interstate Ins Co 31895 CL2531232786 A N Y AVWCFL3354282025 04/01/2025 04/01/2026 1,000,000 1,000,000 1,000,000 Waiver of Subrogation for Workers Compensation per blanket form (attached) if required by written contract and subject to policy terms, conditions, and exclusions. Project #24-8307; Deep Injection Well System Preventative Maintenance and Repairs Collier County Board of Commissioners 3295 Tamiami Trail East Naples FL 34112 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 Page 6233 of 7924