INVITATION FOR BIDS - BidNet

17
INVITATION FOR BIDS BID # 2022-32 Collection & Disposal of Disaster Generated Debris In Compliance with FEMA Category A Public Assistance Prepared by: The City of Bowling Green 1017 College Street Bowling Green, KY 42101 Phone 270 393-3000 www.bgky.org

Transcript of INVITATION FOR BIDS - BidNet

INVITATION FOR BIDS

BID # 2022-32

Collection & Disposal of Disaster Generated Debris In Compliance with FEMA Category A Public Assistance

Prepared by:

The City of Bowling Green 1017 College Street

Bowling Green, KY 42101

Phone 270 393-3000

www.bgky.org

2

INVITATION FOR BIDS

BID #2022-32

Sealed bids will be received in the Procurement Manager’s Office, City Hall Annex, 1017 College Street, Bowling Green, Kentucky, until Wednesday, February 16, 2022 at 10:00 a.m. CT for the

Collection & Disposal of Disaster Generated Debris All bids must be turned in to the Procurement Manager’s Office, City Hall Annex, 1017 College Street, Bowling Green, KY, no later than 10:00 a.m. CT on date of bid opening. Bids cannot be accepted at any other location. Bids will be opened thereupon or about 10:05 a.m. CT, Wednesday, February 16, 2022, at a public bid opening in the Commission Chamber of City Hall, 1001 College Street, Bowling Green, Kentucky. Bids must be received by the designated date and time and none will be considered thereafter. The City of Bowling Green, Kentucky reserves the right to reject any and all bids received, and to select that bid which it determines to be in its best interest. The award of this bid will be made on the basis of the Best Evaluated Bid Price as permitted in KRS 45A.365. All bid forms, information, and specifications regarding this bid are available on our web site at www.bgky.org/bids. You are to submit your bid in a clearly marked sealed envelope. The clearly marked sealed envelope shall include the bid number and description listed above. The City of Bowling Green, Kentucky is not responsible for the premature opening of, or the failure to open, a sealed bid not properly addressed or identified. Respondents are invited to be present for the opening of the bids submitted.

FOR THE CITY OF BOWLING GREEN, KENTUCKY

S/Jeffery B. Meisel, City Manager ATTEST: S/Meghan VanMeter, Procurement Manager

3

GENERAL INSTRUCTIONS TO RESPONDENTS

A. OFFICIAL CLOCK

Bids will be accepted until 10:00 a.m. CT in the Procurement Manager’s Office, City Hall Annex, 1017 College Street, Bowling Green, Kentucky. Bids cannot be accepted at any other location. The official clock is the digital, radio controlled, automatically synchronized clock located in the Procurement Manager’s Office, City Hall Annex, 1017 College Street, Bowling Green, Kentucky. B. CALCULATION ERROR(S) In the event of a calculation error on the bid form, unit price shall prevail. C. QUESTIONS AND ADDENDA

This bid is offered by the Procurement Manager. Respondents shall carefully examine this bid and any addenda issued by the Procurement Manager and posted on the website. Failure to include signed addenda in the bid submission will result in rejection of the bid. Respondents shall seek clarification of any ambiguity, conflict, omission, or other error in this bid “in writing.” Oral comments or communications do not form any part of this bid offering. Questions should be addressed to the Procurement Manager in writing by February 7, 2022. Questions submitted after this date will not be answered. If the answer materially affects this procurement, the information will be issued in an addendum, posted on the website. Written communications should be addressed as follows:

City of Bowling Green Procurement Manager’s Office

1017 College Street Bowling Green, Kentucky 42101

OR E-mail [email protected]

D. RESPONSIBILITY OF BIDDERS FORM

The City of Bowling Green, Kentucky issues in all bid offerings a Responsibility of Bidders form that MUST be completed by the Respondent and attached to the bid form in order for the Respondent to be considered for a bid award. This is a mandatory form that must be attached to the bid form and in accordance with KRS 45A.395, all information submitted thereon is deemed to be confidential and therefore exempt from Kentucky Open Records Law. E. BASIS OF BID AWARD

The City of Bowling Green, Kentucky has selected to award this bid offering in compliance with KRS 45A.365 that allows the award to be made on the basis of best evaluated bid price: (Reference Section 3 – Pricing Work) F. RECIPROCAL PREFERENCE FOR RESIDENT RESPONDENTS

Prior to a contract being awarded to the lowest responsible and responsive Respondent, a resident Respondent of the Commonwealth of Kentucky shall be given a preference against a nonresident Respondent registered in any state that gives or requires a preference to Respondents from that state. The preference shall be equal to the preference given or required by the state of the nonresident Respondent in compliance with KRS 45A.494.

4

GENERAL INSTRUCTIONS TO RESPONDENTS

G. INSPECTION OF RESPONDENT’S PLANT AND PLACE OF BUSINESS

The City of Bowling Green, Kentucky reserves the right to inspect the plant facilities and place of business of any Respondent participating in this bid offering. H. RETENTION OF RECORDS

The successful Respondent shall be required to maintain, for a period of five (5) years from the date of final payment to the Respondent, all books and records pertaining to this bid offering. I. BUSINESS TAX STATUS

In order to receive a bid award from the City of Bowling Green, Kentucky, a Respondent must not be delinquent on any ad valorem taxes, including penalty and interest charges, due to the City for real or personal properties owned by the Respondent, or any one or more of its corporate officers. Inquiries can be directed to the Treasury Division, City Hall Annex, 270-393-3000. J. BUSINESS STATUS AND REGISTRATION REQUIREMENTS

In order to receive a bid award from the City of Bowling Green, Kentucky, a Respondent must be properly registered with the Occupational License Division to do business in the City. If a Respondent is already registered, all of their applicable license accounts must be in “good standing” with the City. Good standing is defined as having all fees, including penalty and interest charges, relating to employee wages, and business net profits, paid in full with appropriate reporting forms filed in the offices of the City’s License Division. Inquiries can be directed to the License Division, City Hall Annex, 270-393-3000. K. CONFLICTS, GRATUITIES, AND KICK-BACKS PROHIBITED

The City of Bowling Green, Kentucky adheres to the provisions of KRS 45A.455, paragraphs (1) through (5) relative to conflicts of interests, gratuities, kick-backs, and use of confidential information in all bid offerings. L. SUPPORTING DOCUMENTATION

Respondents are encouraged to submit with their bid any literature, warranty information, and other documentation to support the Respondent’s compliance with the specifications contained in this bid package.

M. BID RETRACTION

Respondents are advised that bids submitted as part of this bid offering may not be withdrawn for a minimum of 120 days following the public bid opening unless circumstances justify consideration by the Procurement Manager of a release from this provision. Requests to withdraw a bid must be in writing and received by the City of Bowling Green, Kentucky within twenty-four hours of the public bid opening.

5

GENERAL INSTRUCTIONS TO RESPONDENTS

N. RIGHT TO REJECT AND AWARD BID

The City of Bowling Green, Kentucky reserves the right to reject any and all bids received in response to this bid offering, and to waive any informality in this bid offering. The award of a contract shall be at the sole discretion of the City of Bowling Green, Kentucky. The award will be made to the responsible Respondent whose bid is determined to be the most advantageous to the City, taking into consideration the evaluation factors set forth in this bid package. The City of Bowling Green may make the award without further discussion of the bids submitted. Therefore, the bid should be submitted initially on the most favorable terms which the Respondent can bid with respect to price, product, service, and technical capability. The contents of the bid of the selected Respondent will become the basis for the City of Bowling Green, Kentucky’s contractual obligation when the award is made. O. BID IDENTIFICATION

Respondents are to submit their bid in a sealed envelope. The Respondent is required to clearly mark their bid material with the bid number and description set forth in the “Invitation for Bids.” This instruction is provided as a means to ensure proper delivery, handling, and public announcement of a Respondent’s response at the official bid opening date, and time. Bids in the form of e-mails, telegrams, telephone calls, facsimiles, or telex messages will not be accepted. P. BID SUBMISSION

Prior to entering into a contract with the City of Bowling Green, the successful Respondent(s) must provide the following information:

1. The name of every company bearing an interest in the proposed goods and services to be provided in this bid offering.

2. The name, title, address, and telephone number of individuals with authority to

contractually bind the Respondent; and,

3. A designated person(s) who can be contacted by the City of Bowling Green, Kentucky during the bid evaluation period. This information shall include the person’s name, title, address, telephone number, FAX number, and Internet E-mail address if available.

Q. PRESENTATIONS AND DEMONSTRATIONS

If, in the opinion of the City of Bowling Green, Kentucky, Respondent presentations or demonstrations are desired as part of the evaluation process, the City of Bowling Green, Kentucky will notify one or more of the responsive Respondents to make arrangements for the date, time, and place for such a presentation or demonstration. R. DISPOSITION OF BIDS

All materials submitted in response to this bid offering will become the property of the City of Bowing Green, Kentucky. One (1) copy of each bid shall be retained for the official files and will become a public record after an award is made by the City of Bowling Green, Kentucky, and thus open for public inspection. It is understood that the bid will become a part of the official file without obligation on the part of the City of Bowling Green, Kentucky except as to the disclosure restrictions contained in paragraph S below.

6

GENERAL INSTRUCTIONS TO RESPONDENTS

S. DISCLOSURE

In compliance with Kentucky Revised Statutes, Chapter 45A, and the Kentucky Open Records Act, trade secrets or proprietary information submitted by a Respondent in connection with this procurement shall not be subject to public disclosure. However, the Respondent must invoke this protection prior to, or upon submission of the data or other materials, and must identify the specific area or scope of data or other materials to be protected and state the reasons why protection is necessary. An all-inclusive statement that the entire bid is proprietary is unacceptable. A statement that costs are to be protected is also unacceptable. Disputes over disclosure will be resolved by the City Manager based on legal advice provided by the City of Bowling Green, Kentucky’s Law Department. T. COST INCURRED IN RESPONDING

This bid offering does not commit the City of Bowling Green, Kentucky to pay any costs incurred in the preparation and submission of bids or in making necessary studies or designs, nor does it commit the City of Bowling Green, Kentucky to enter into a contract. U. PRIME RESPONDENT RESPONSIBILITIES

If the Respondent’s response includes goods and services provided by others, the Respondent will be required to act as the prime Contractor for all such items and must assume full responsibility for the procurement, delivery, and quality of such goods and services. The Respondent will be considered the sole point of contact with regard to all stipulations, including payment of all charges and the meeting of all contractual requirements resulting from this bid offering. V. LAWS AND REGULATIONS

The Model Procurement statutes of the Commonwealth of Kentucky and any applicable Code of the City of Bowling Green, Kentucky shall govern this bid. W. INSURANCE REQUIREMENTS

Prior to entering into a contract with the City of Bowling Green, the successful Respondent(s) must provide a Certificate of Insurance showing proof of insurance, which meets or exceeds requirements set forth in “General Service Provider – GS5AP” (included with this bid package).

X. DISPUTE RESOLUTION

Contract documents establish a procedure to resolve conflicts that may arise during construction. The procedures include identifying the causes of the conflict, the filing and handling of claims and the uses of consultants in resolving conflicts. The City of Bowling Green eliminates mandatory binding arbitration language in the contract documents, but attempts to resolve conflicts without the necessity of litigation through negotiation and mediation.

7

Special Instructions

SECTION 1 - GENERAL A. The work includes furnishing materials, equipment, and labor necessary for the cleanup, demolition, removal, reduction, and disposal of debris generated by storms on and about December 11, 2021 and declared a disaster under 4630-DR-KY as directed by the City during the contract period. B. If work has been requested by the City issued prior to the expiration of the contract but the expiration date has passed before the work was commenced or finished, then the work must still be completed by the Contractor awarded by this contract. C. Contractor will be assuming this role from an existing contractor selected by the City during the immediate aftermath of the disaster. Selected contractor will be expected to work closely with the current contractor during the transition of duties. D. Contractor is expected to have a project manager in the City within 24 hours of Notice-to-Proceed and begin hauling operations within 72 hours of same. E. The City is currently using the services of a separate debris monitoring contractor and is also currently advertising for these services as well. The winning debris contractor must work amicably with the City’s disaster debris monitoring contractor. F. Contract Length

a. This contract will extend for 90 calendar days from the notice to proceed, days lost for inclement weather will be added to the end of the contract at the discretion of the City.

b. The contract may be extended an additional three months at the request of the City, if agreeable to the contractor. SECTION 2 - DESCRIPTION OF WORK 1. Debris Removal from Public Property: Removal of debris from public rights of way, public property, and other locations as directed by the City. 2. Debris Removal from Private Property: Should an imminent threat to life, safety, and health to the general public be present on private property, the Contractor, as directed by the City, will accomplish the removal of debris from private property. This item will be monitored for strict compliance with FEMA regulations regarding eligibility. 3. Debris Management Site (DMS): The Contractor will prepare and maintain a sufficient DMS facility to accept and process all eligible storm debris. Preparation and maintenance shall include maintenance of the DMS approach and interior road(s) for the entire period of debris hauling, including provision of roads for ingress and egress. Each facility shall include a roofed inspection tower sufficient for a minimum of three (3) inspectors for the inspection of all incoming and exiting loads. 4. All debris shall be processed in accordance with local, state, and federal law, standards and regulations. Processing shall include, but is not limited to, reduction by grinding and/or incineration when approved by the City. Prior to reduction, all debris shall be segregated between vegetative debris, construction, and demolition debris, recyclable debris, white goods, and hazardous waste.

8

Special Instructions

5. Generated Hazardous Waste Abatement: Abatement of hazardous waste identified by the City in accordance with all applicable Federal, State, and local laws, standards and regulations. 6. Debris Disposal: Disposal of all eligible debris, reduced debris, ash residue, and other products of the debris management processed as directed by the City in accordance with all applicable Federal, State, and local laws, standards and regulations. 7. Documentation and Inspections: Storm debris shall be subject to inspection by the City and its representatives. Inspections will be to insure compliance with the contract and applicable local, state, and federal laws. The Contractor will, at all times, provide the City and its representatives access to all work sites and disposal areas. The City, or City’s representatives, will have in place at the DMS, personnel to verify and maintain records regarding the contents and cubic yards of the vehicles entering and leaving the DMS. The Contractor will assist the City, or City’s representatives, in preparation of the Federal (FEMA), and State reports for any potential reimbursement. The Contractor will work closely with the State Division of Emergency Management, FEMA and other applicable State and Federal Agencies to ensure that eligible debris collection and data documentation is appropriately addressed. 8. Work Sites: The City, or City’s representatives, will establish and approve all sites that the Contractor will be allowed to work. The Contractor will remove all eligible debris and leave the site from which the debris was removed in a clean and neat condition. This condition of the work site shall be equal to or better than the original condition of the site. 9. White goods: The Contractor may expect to encounter white goods available for disposal. White goods will constitute household appliances. The Contractor will dispose of all white goods encountered in accordance with applicable Federal, State, and local laws. 10. Hazardous Stumps: The Contractor shall remove all stumps that are determined to be hazardous to public access and as directed by the City. Stumps will be approved for removal by the City, or City’s representatives. Documentation before, during, and after stump removal must be according to FEMA Guidelines. 11. Clean Fill Dirt: The Contractor shall place compacted fill dirt in ruts created by equipment, holes created by removal of hazardous stumps, and other areas that pose a hazard to public access upon direction by the City. This clean fill dirt shall be compacted as directed by the City. This is incidental to the work and not a separate unit cost. 12. Documentation and Recovery Process: Contractor will provide the following in addition to debris removal:

a. Maintain documentation of recovery process b. Provide weekly written records and oral status as requested by the City c. Review documentation for accuracy and quantity d. Provide work documentation for FEMA reimbursement e. These costs for the documentation and recovery process shall be included in the

items in the pricing attachments (Attachments A).

13. The work will be compliant with any Federal rule, regulation, or policy relating to disaster debris.

9

Special Instructions

14. The contractor is responsible for all traffic control and flagmen as directed by the Manual on Uniform Traffic Control Devices.

15. The contractor is responsible for all Before-U-Dig (811) utility locates when necessary.

16. If street closings are required, the contractor must request a street closure through the Public Works Department at least 5 days prior to street closing for work. SECTION 3 – PRICING & REQUIRED SUBMITTALS 3.1 BIDDING WEIGHT

A. All bids will be evaluated on a point system. Points will be awarded on a relative scale. B. Submissions will be ranked in the categories of price, qualifications, and reputation. One

point is awarded to the least favorable submission for each category, with the maximum number of points determined by the total number of qualified submittals (i.e. for five qualified submittals, the most favorable score for a category is 5).

C. The City plans to award this contract to one vendor in full. D. Weight Division based on Points:

Price=40% Reputation=30% Qualifications=30%

3.2 PRICING

In an effort to fairly compare prices, our evaluators will use an example scenario. The scenario will outline a series of debris type, amounts, handling methods, and hauling distances. The submitted rate sheets will be used to establish the cost of the example scenario to establish which submitters prices are lowest through highest. Please Submit Unit Pricing on Bid Form below. 3.3 QUALIFICATIONS Firms must provide a brief profile of their company. The profile should highlight the company’s experience in the industry, relevant staff experience, experience with similar jobs, and availability of necessary subcontractors and equipment. 3.4 REPUTATION Firms must provide at least three references that can speak to the quality and expediency of their work. Work must have been provided to these references within the last five years. Describe and explain any disputes, litigations, arbitration, mediation, or other claims for a period of five years prior to this submittal.

10

BID FORM

#2022-32

TO: City of Bowling Green c/o Procurement Manager’s Office 1017 College Street Bowling Green, KY 42101 FROM: ___________________________________ Phone: _________________________ ____________________________________ Fax: ___________________________ ____________________________________ E-Mail _________________________

The undersigned hereby certifies that to the best of his knowledge and belief, the cost or

pricing data submitted herein is accurate, complete and current as of the date set forth hereon: (Reference KRS 45A.405)

The undersigned hereby certifies that he has carefully examined the specifications and is familiar with the type of service/equipment/supplies to be furnished as set forth.

The undersigned proposes to furnish the supplies and/or equipment that will perform in a satisfactory manner and that is in accordance with the specifications set forth, for the following price:

ROW Debris

Item # Description Haul Distance Unit of Measure Unit Price

1 Eligible ROW Vegetative Debris Removal (Collect & Haul) - Work consists of removal and transport of vegetative debris on the ROW to DMS. *NOTE 1

0-10 Miles PER CY

10.1 - 20 Miles PER CY

20.1 - 30 Miles PER CY

2

Eligible ROW Vegetative Debris Removal (Collect & Haul) - Work consists of removal and transport of vegetative debris on the ROW to an approved designated disposal facility. *NOTE 2

0-10 Miles PER CY

10.1 - 20 Miles PER CY

20.1 - 30 Miles PER CY

3 Eligible ROW C&D Debris Removal (Collect and Haul) - Work consists of removal and transport of C&D debris on the ROW to a DMS. *NOTE 1

0-10 Miles PER CY

10.1 - 20 Miles PER CY

20.1 - 30 Miles PER CY

4 Eligible ROW C&D Debris Removal (Collect and Haul) - Work consists of removal and transport of C&D debris on the ROW to a designated disposal facility. *NOTE 2

0-10 Miles PER CY

10.1 - 20 Miles PER CY

20.1 - 30 Miles PER CY

11

DMS Management and Reduction

5 DMS Management and Operations N/A PER CY

6

Reduction Through Grinding - Work consists of the management and operation of DMS(s) for acceptance, management, segregation, staging and reduction of disaster related debris through grinding.

N/A PER CY

7

Reduction Through Air Curtain Incineration - Work consists of management and operation of DMS(s) for acceptance, management, segregation, staging and reduction of disaster related debris through air curtain incineration.

N/A PER CY

8

Reduction Through Controlled Open Burning - Work consists of management and operation of DMS(s) for acceptance, management, segregation, staging and reduction of disaster related debris through controlled open burning.

N/A PER CY

9 C&D Reduction by compaction. N/A PER CY

10 Remediation of DMS Site N/A LS

11

Haul-Out of Reduced Debris to a Designated Final Disposal Site - Work consists of loading and transport of reduced debris from DMS to a final disposal facility. *NOTE 2

0-10 Miles PER CY

10.1 - 20 Miles PER CY

20.1 - 30 Miles PER CY

Tree Work

12 Removal of Eligible Hazardous Trees - Work consists of removing hazardous trees.

12a 6 inch - 12.99 inch diameter N/A PER TREE 12b 12 inch - 23.99 inch diameter N/A PER TREE 12c 24 inch to 35.99 inch diameter N/A PER TREE 12d 36 inch to 47.99 inch diameter N/A PER TREE 12e 48 inch or larger diameter N/A PER TREE

13 Removal of Eligible Hazardous Limbs - Work consists of removing (cutting) hazardous limbs from trees - unit price per tree.

N/A PER TREE

14 Removal of Hazardous Stumps - Work consists of the removing hazardous stumps, backfill, transport and final disposal - all inclusive price.

N/A PER STUMP

14a 24 inch to 36.99 inch diameter N/A PER STUMP 14b 37 inch to 48.99 inch diameter N/A PER STUMP 14c 49 inch and larger diameter N/A PER STUMP

12

Specialty Debris

Item # Description Haul Distance Unit of Measure Unit Price

15

Eligible Household Hazardous Waste Removal, Transportation and Disposal - Work consists of the removal, transportation and disposal of eligible household hazardous waste (HHW).

N/A PER POUND

16 Eligible Passenger Vehicle Removal from ROW and hauled to Client provided site (2 Axle Vehicle)

N/A PER UNIT

25

Eligible Small Motorized Equipment Removal and Disposal - Work consists of collection, oil and fuel recovery and disposal and recycling at an approved facility.

N/A PER UNIT

26

Eligible White Goods Removal and Recycling - Work consists of all labor, equipment, fuel and miscellaneous costs for removal, transportation and Disposal/Recycling of white goods.

N/A PER UNIT

27 Refrigerant recovery and decontamination. N/A PER UNIT

28 Eligible Electronic Waste (E-Waste) - Work consists of the removal, transpiration to approved Disposal/Recycling Facility

N/A PER UNIT

29 Eligible Dead Animal Carcasses - Work consists of the recovery and disposal of dead animal carcasses.

N/A PER POUND

NOTES: 1. For all miles hauled over 30, please add $0.XX/ cy / mile. 2. For all miles hauled over 30 miles, please add $0.XX / cy / mile. 3. All tipping fees will be a pass through cost.

NOTES:

The Contractor will pay tipping fee at final disposal site(s) and back charge City at cost. Includes management of site remediation. All stumps placed on the right of way by citizens are vegetative debris Invoices to be based on incoming load tickets. Invoices to be based on outgoing load tickets.

13

BID FORM (page 4) – Bid #2022-32

Please respond with three (3) complete copies of the bid. The original shall be clearly marked. The Respondent, herein certifies by signature, that all specifications have been reviewed and that any variations to the City’s specifications, including both exceptions to, or enhancements to same, are clearly spelled out in an attachment to this bid. _________________________ (Signature) The Respondent, herein certifies by signature, that all addendums issued to this bid offering, if any, have been reviewed and the Respondent is fully aware of the implications of the addendums on the bid offering, and that a copy of each issued addendum is signed and attached hereto as evidence of receipt. __________________________________ (Signature) The Respondent, herein certifies by signature, that the Responsibility of Bidders Form has been fully completed and attached hereto as part of the bid. ______________________________ (Signature) Are there any exceptions to the specific specifications set forth on bid? Yes_____ No_____ If yes, please explain._____________________________________________________ Company or Individual Name ___________________________________________ Doing business as (DBA) ___________________________________________ Street Address ___________________________________________ P.O. Box Number ___________________________________________ City, State, Extended Zip Code ___________________________________________ _________________________________________________ Official Name (Printed) ________________________________________________ Official Signature _________________________________________________ Date Signed

14

RESPONSIBILITY OF BIDDER FORM This form must be completed in full and submitted with bid. Misrepresentation or failure to complete will automatically disqualify bid. All information is confidential and exempt from the Open Records Law, pursuant to KRS 45A.395. NAME___________________________________________________Phone# (___)________________ ADDRESS___________________________________________________________________________ Street or PO Box City State Zip Code 1. Type of services/supplies provided in normal course of business:_______________________ 2. Length of time in business:______________________________ 3. Experience in providing bid-required services/supplies:_______________________________ 4. Currently a party/defendant in lawsuit(s)? ( ) Yes ( ) No If yes, explain. ____________________________________________________________________________ 5. State past history as party/defendant in lawsuit(s) ____________________________________________________________________________ 6. Name of contract/product liability insurance carrier:_________________________________ Limits: $______________________________________ 7. If construction bid: (a) how many other projects currently ongoing?________________________________

(b) how many bids currently submitted elsewhere?______________________________ (c) have books been audited by CPA? ( ) Yes ( ) No Date of last audit______________________ * 8. City of Bowling Green Occupational License No. _________________________________ 9. List of reference (public or private) and contact person for whom similar services/supplies provided: Name of Firm Address Contact Person ____________________________________________________________________________ Name of Firm Address Contact Person Name of Firm Address Contact Person *Note: If more space is needed, please attach separate sheet(s). I, _____________________________, do solemnly swear that to the best of my knowledge and belief the above is true and accurate statement of facts. Signed________________________________________Date______________________ State of______________________________ County of____________________________ Sworn to and subscribed before, me, a Notary Public, this ____________day of ______________________, 20___. My commission expires ___________________ ______________________________________________ Notary Public *Required by City of Bowling Green Code of Ordinances

15

GENERAL SERVICE PROVIDER – GS5AP

STANDARD HOLD HARMLESS & INDEMNIFICATION CLAUSE,

AND INSURANCE REQUIREMENTS FORM

I. STANDARD HOLD HARMLESS AND INDEMNIFICATION CLAUSE

To the extent caused by Service Provider’s negligent acts, errors, or omissions, the Service Provider agrees to hold harmless and indemnify the City of Bowling Green, its elected and appointed officials and officers, employees and agents (“City”) from all liability, claims, damages, losses and expenses, including court costs and attorneys’ fees, arising out of or resulting, directly or indirectly, from the Service Provider’s (or Service Provider’s subcontractor’s) performance or breach of the contract. This Hold Harmless and Indemnification Clause shall in no way be limited by any financial responsibility or insurance requirements and shall survive the termination of this Contract.

II. INSURANCE The Service Provider shall not commence work under this Contract until all insurance required under the Contract Document has been obtained and copies of policies or certificates thereof are submitted and approved by myCOI and the City of Bowling Green’s Human Resources & Risk Management Department. The Service Provider shall not allow any subcontractor to commence work until the insurance required of such subcontractor has been obtained and copies of Certificates of Insurance retained by Service Provider evidencing proof of coverage. Prior to commencing work, the Service Provider shall maintain continuous liability coverage written on an occurrence basis or, if a claims made basis, with an extended coverage provision (ERP) option of not less than three years. Coverage will be provided through insurance companies licensed to do business in the State of Kentucky with a Best Rating of A- or better. Without limiting Service Provider indemnification requirements, it is agreed that Service Provider shall maintain in force at all times during the performance of this agreement the following policy or policies of insurance covering its operations, and require subcontractor, if subcontracting is authorized, to procure and maintain these same policies until final acceptance of the work by the City of Bowling Green. The City of Bowling Green may require Service Provider to supply proof of subcontractor’s insurance via Certificate of Insurance, or at City of Bowling Green’s option, actual copies of policies. The insurance to be procured and maintained and the minimum Limits of Liability shall be as follows, unless different Limits are specified by addendum to the Contract:

1. COMMERCIAL GENERAL LIABILITY – Including contractual liability, bodily injury and

property damage combined at a minimum of $5,000,000 for each occurrence; personal and advertising injury of $5,000,000 any one person or organization and $5,000,000 in the aggregate.

2. AUTOMOBILE LIABILITY, insuring all Owned, Non-Owned and Hired Motor Vehicles. The

minimum coverage Liability Limit is $1,000,000 Combined Single Limit for any one accident. The Limit of Liability may be subject to increase according to any applicable State or Federal Transportation Regulations.

3. WORKERS' COMPENSATION insuring the employers' obligations under Kentucky Revised

Statutes Chapter 342 at Statutory Limits and EMPLOYERS' LIABILITY - $1,000,000 each accident, $1,000,000 each employee and $1,000,000 policy limit.

4. CONTRACTORS POLLUTION LEGAL LIABILITY COVERAGE - If work requires the removal

and/or disposal of hazardous materials, the City of Bowling Green prefers coverage written on Broad Form basis. Coverage written on a site specific basis will be considered acceptable if Contractor supplies proof that the Contract site is covered. This policy shall include the City of Bowling Green as an Additional Insured and carry a minimum $1,000,000 per Occurrence and $2,000,000 Aggregate Limits.

16

Commercial General Liability, Auto Liability & Pollution Legal Liability policies shall be endorsed to contain the following provisions:

a) “The City of Bowling Green, its elected and appointed officials, employees, agents and successors and volunteers are named “Additional Insured”. The coverage shall contain no special limitations on the scope of protection afforded to the “City” and may not include terms which make the coverage excess to other insurance on which the “City” may also qualify as an additional insured.

b) The insurance coverage for the Service Provider entering into a contract shall be on a

primary and non-contributory basis for liability arising out of activities performed by or on behalf of the Service Provider entering into this contract for service including the insured’s general supervision of the premises owned, occupied or used by the Service Provider entering into this contract and ongoing operations as well as completed operations and work performed by Service Provider. Any insurance or self-insurance maintained by the City, its elected and appointed officials, employees, agents and successors and volunteers shall be excess of the Service Provider’s insurance coverage.

c) Any failure to comply with reporting provisions of the policies shall not affect coverage

provided to the City, its elected and appointed officials, employees, agents and successors and volunteers.

All Coverage

a) Each insurance policy carrier shall endeavor to provide written notice if the policy is suspended, voided, canceled, non-renewed, reduced in coverage or in limits. Lessee is required to provide 15 day advance written notice to the Lessor if the policy is to be suspended, voided, canceled, non-renewed, reduced in coverage or in limits.

b) Any deductibles or self-insured retentions must be declared to and approved by the City.

c) Certificates of Insurance (COI) as required above shall be furnished to myCOI. Registration

with myCOI is required and can be performed by either the Service Provider (Vendor) or the City of Bowling Green. Refer to the accompanying memorandum which references myCOI registration & COI Submittal Information.

So that myCOI may contact you with registration information or so that the City may go ahead and register you within the myCOI system, please provide the following information: Vendor/Company Name:

First and Last Name of Vendor/Company Contact Person:

E-Mail Address: Phone #:

Address:

City Employee Contact: If COI will be specific to the Job/Contract, list name of Job/Contract:

Insurance Agent Information (provide this information if you would like the City to register you on

myCOI*): Insurance Agent Name:

Agent’s E-Mail Address: Phone #:

17

Agent’s Address:

*If the City registers the Service Provider (Vendor), myCOI will contact the insurance agent directly. Miscellaneous Approval of the insurance by the City of Bowling Green shall not in any way relieve or decrease the liability of the Service Provider hereunder. It is expressly understood that the City of Bowling Green does not in any way represent that the specified Limits of Liability or coverage or policy forms are sufficient or adequate to protect the interest or liabilities of the Service Provider. The City shall not be obligated to review such insurance certificates, policies and endorsements, or to advise Service Provider of any deficiencies in such documents, and such receipt shall not relieve the Service Provider from or be deemed a waiver of the City’s right to insist on strict fulfillment of Service Provider’s obligations herein. Bid Bond, Performance Bond and Labor and Materials Bond Depending upon the project, a Bid Bond, Performance Bond and Labor and Materials Bond may be required. If necessary, the City’s Legal Department and/or Purchasing Agent shall provide all applicable language in a separate agreement that is to be signed by the Service Provider. OSHA/EPA Regulatory Compliance The Service Provider entering into a contract agrees to comply with all applicable Federal and State OSHA/EPA laws, rules and regulations. The Service Provider entering into the contract shall have a safety policy based upon applicable regulatory standards, a copy of which may be obtained by the City Safety/Training Manager. Authorized Service Provider Signature: Date: It is expressly understood that no employer/employee relationship is created by this agreement nor does it cause Service Provider to be an officer or official of the City of Bowling Green. By executing this agreement, the parties hereto certify that its performance will not constitute or establish a violation of any statutory or common law principle pertaining to conflict of interest, nor will it cause unlawful benefit or gain to be derived by either party.