Okaloosa County BOCC — February 18, 2014 — Insituform Technologies 14-14 — reading text

material alterations of such policies, and the Certificates of Insurance, shall so provide. C. All certificates shall be subject to Okaloosa County’s approval of adequacy of protection and the satisfactory character of the Insurer. County reserves the right to approve or reject all deductible/SIR above $10,000. D. The Certificates of Insurance shall disclose any and all deductibles or self-insured retentions (SIRs). County requests that all deductibles or SIRs be no greater than $10,000. However, CONTRACTORS having insurance with higher deductibles may submit a bid without penalty reflecting the pricing for their deductible provided that CONTRACTOR also submits a brief company financial statement. E. All deductibles or SIRs, whether approved by Okaloosa County or not, shall be the CONTRACTOR’s full responsibility. In particular, the CONTRACTOR shall afford full coverage as specified herein to entities listed as Additional Insured. F. In no way will the entities listed as Additional Insured be responsible for, pay for, be damaged by, or limited to coverage required by this schedule due to the existence of a deductible or SIR. Specific written approval from Okaloosa County will only be provided upon demonsiration that the CONTRACTOR has the financial capability and funds necessary to cover the responsibilities incurred as a result of the deductible or SIR. G. In the event of failure of the CONTRACTOR to furnish and maintain said insurance and to furnish satisfactory evidence thereof, Okaloosa County shall have the right (but not the obligation) to take out and maintain insurance on the project. All costs for the coverage will be paid by CONTRACTOR upon presentation of a bill. General Terms Any type of insurance or increase of limits of liability not described above which the CONTRACTOR required for its own protection or on account of statute shall be its own responsibility and at its own expense. The carrying of the insurance described shall in no way be interpreted as relieving the CONTRACTOR of any responsibility under this contract. Should the CONTRACTOR engage a subcontractor or sub-subcontractor, the same conditions will apply under _ this agreement to each subcontractor and sub- subcontractor. The CONTRACTOR hereby waives all rights of subrogation against Okaloosa County and its Consultants and other indemnities of the CONTRACTOR under all the foregoing policies of insurance. Umbrella Insurance The CONTRACTOR shall have the right to meet the liability insurance requirements with the purchase of an umbrella insurance policy. In all instances, the combination of primary and umbrella liability coverage must equal or exceed the minimum liability insurance limits stated in this agreement. Page 24 E-VERIFY COMPLIANCE CERTIFICATION In accordance with Okaloosa County Policy and Executive Order Number 11-116 from the office of the Governor of the State of Florida, Bidder hereby certifies that the U.S. Department of Homeland Security's E-Verify system will be used to verify the employment eligibility of all new employees hired by the contractor during the contract term, and shall expressly require any subcontractors performing work or providing services pursuant to the contract to likewise utilize the U.S. Department of Homeland Security's E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term; and shall provide documentation of such verification to the OWNER Upon request. As the person authorized to sign this statement, | certify that this company complies/will comply fully with the above requirements. DATE: December 4, 2013 SIGNATURE: taal Poa COMPANY: Insituform Technologies, LLC NAME: Diane Partridge (Typed or Printed) ADDRESS: 17988 Edison Avenue TITLE: Contracting and Attesting Officer Chesterfield, MO 63005 E-MAIL: dpartridge@insituform.com PHONE NO.: (636) 530-8000 re Page 25 INDEMNIFICATION AND HOLD HARMLESS To the fullest extent permitted by law, CONTRACTOR shall indemnify and hold harmless COUNTY, its officers and employees from liabilities, damages, losses, and costs including but not limited to reasonable attorney fees, to the extent caused by the negligence, recklessness, or intentional wrongful conduct of the CONTRACTOR and other persons employed or utilized by the CONTRACTOR in the performance of this Agreement. Insituform Technologies, LLC Bidder’s Company Name 17988 Edison Avenue Chesterfield, MO 63005 Physical Address 17988 Edison Avenue Chesterfield, MO 63005 Mailing Address (636) 530-8000 Phone Number N/A Cellular Number December 4, 2013 Authorized Signature — Manu) Diane Partridge Authorized Signature — Typed Contracting and Attesting Officer Title (636) 530-8701 FAX Number Tad Powell, P.M. (205) 281-2555 DATE After-Hours Number(s) Page 26 CONFLICT OF INTEREST DISCLOSURE FORM For purposes of determining any possible conflict of interest, alll bidders/proposers, must disclose if any Okaloosa Board of County Commissioner, employee(s), elected Officials(s), of if any of its agencies is also an owner, corporate officer, agency, employee, etc., of their business. Indicate either “yes” (a county employee, elected official, or agency is also associated with your business), or “no”. If yes, give person(s) name(s) and position(s) with your business. YES NO__ xX NAME(S) POSITION(S) FIRM NAME: Insituform Technologies, LLC BY (PRINTED): Diane Partridge ~ BY (SIGNATURE): Lbianc Sindy Age TITLE: Contracting and Attesting Officer ADDRESS: 17988 Edison Avenue Chesterfield, MO 63005 PHONE NO. (636) 530-8000 ee Page 27 DRUG-FREE WORKPLACE CERTIFICATION THE BELOW SIGNED BIDDER CERTIFIES that it has implemented a drug-free workplace program. In order to have a drug-free workplace program, a business shall: 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are under quote a copy of the statement specified in subsection 1. 4. In the statement specified in subsection 1, notify the employees that, as a condition of working on the commodities or contractual services that are under quote, the employee will abide by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contendere to, any violation of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in, drug abuse assistance or rehabilitation program if such is available in employee's community, by any employee who is convicted. 6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign this statement, | certify that this firm complies fully with the above requirements. ~ DATE: December 4, 2013 SIGNATURE: LVeapre f A f~ COMPANY: Insituform Technologies, LLC NAME; Diane Partridge (Typed or Printed) ADDRESS: 17988 Edison Avenue TITLE; Contracting and Attesting Officer Chesterfield, MO 63005 E-MAIL: dpartridge@insituform.com PHONE NO.: (636) 530-8000 Page 28 RECYCLED CONTENT FORM 1. ls the material in the above: Virgin__X or Recycled (Check the applicable blank). if recycled, what percentage %. Product Description: _A new Cured-in-Place (CIPP), Insitupipe using fluid or air pressure to install a flexible felt tube saturated with a liquid thermosetting resin. The water is then heated, or steam introduced to harden the resin. the process results in a continuous tight-fitting plastic pipe. 2. Ils your product packaged and/or shipped in material containing recycled content? Yes No x Specify: 3. Is your product recyclable after it has reached its intended end use? Yes No__ x Specify: The above is not applicable if there is only a personal service involved with no product involvement. Name of Bidder: Insituform Technologies, LLC LOCAL PREFERENCE DATA SHEET Okaloosa County grants a preference to in-county bidders only when bids are received from firms located in states, municipalities or other political subdivisions which offer preference to bidders located in such political subdivisions. The amount of preference given to local bidders will be the same as that given by the state, county, municipality or other political subdivisions in which the out-of-county bidder is located. If the political subdivision in which a bidder is located offers a preference to its local firms, that bidder must plainly state the extent of such preference to include the amount and type preference offered. Any bidder failing to indicate such preference will be removed from the County bid list and any and all bids from that firm will be rejected. Does the state, county, municipality or political subdivision in which your firm is located offer a preference to their local bidders2 If “YES,” list below the extend of such preference. (If your firm is located in Okaloosa County, you will check “YES"-reciprocal only.) YES NO Xx If yes, you must identify how you confirmed this information or who you spoke with within your area of business location below: ——— - (sf / ¢ Insituform Technologies, LLC a nual Bidder’s Company Name Authorized Signature — Ma Diane Partridge Contracting and Attesting Officer Printed Name December 4, 2013 Date Page 30 LIST OF SUBCONTRACTORS The BIDDER expressly agrees that: 1. If awarded the contract as a result of the proposal, the subcontractors used in the prosecution of the work will be those listed below. 2, The following list includes all subcontractors who will perform work on this project. 3s The subcontractors listed below are financially responsible and are qualified to do the work required. 4. Use of any of the subcontractors is subject to the approval of the County and Engineer. CATEGORY NAME OF SUBCONTRACTOR ADDRESS ; _ | aoe) West E-45 Seavitd FM. Vv. CLEAN AND cor | Sovth SNousTR al Seog M6BIE PL. bb) 2195 wesTonte Prekulay JpOT Repaias |Riawkenshys (out ReacTNg DoTHAN AL. 26% Insituform Technologies, LLC be a: < Abts CONTRACTOR'S NAME AUTHORIZED SIGNATURE Diane Partridge Contracting and Attesting Officer TITLE Page 31 >, STATE OF FLORIDA : \ DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 25) CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 HOWTON, RICHARD TAYLOR INSITUFORM TECHNOLOGIES LLC 1860 FREEMAN PARKWAY MABELTON GA 30126 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida’s economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www. myfloridalicense.com. : There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. ‘ Our mission at the Departmentis: License Efficiently, Regulate Fairly. We. constantly strive to serve you better so that you can serve your customers. . Thank you for doing business in Florida, and