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R2021-244 2021-11-08RESOLUTION NO. R2021-244 A Resolution of the City Council of the City of Pearland, Texas, renewing a unit supply contract with Envirodyne Laboratories, Inc., for water, wastewater and pretreatment laboratory testing services, in the estimated amount of $120,000.00, for the period of November 20, 2021 through November 19, 2022. BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF PEARLAND, TEXAS: Section 1. That the City obtained competitive bids for water, wastewater and pretreatment laboratory testing services and such bids have been evaluated. Section 2. That the City Council hereby renews a unit supply contract with Envirodyne Laboratories, Inc., in the unit price amounts reflected in Exhibit “A” attached hereto. Section 3. The City Manager or his designee is hereby authorized to execute a unit supply contract for water, wastewater and pretreatment laboratory testing services. PASSED, APPROVED and ADOPTED this the 8th day of November, A.D., 2021. ________________________________ J. KEVIN COLE MAYOR ATTEST: ________________________________ CRYSTAL N. ROAN, TRMC, CMC CITY SECRETARY APPROVED AS TO FORM: ________________________________ DARRIN M. COKER CITY ATTORNEY DocuSign Envelope ID: 4425C475-1C4E-415F-979C-C85354242D9E DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D Exhibit A ove0 City of Pearland 3519 Liberty Drive , g.',11111' ,(/' ' '4,),,A Pearland, TX 77581 "" 0011,11,01 SUPPLY CONTRACT NO. 0920-58 Water, Wastewater and Pretreatment Laboratory Testing THIS Contract ("Contract") is entered into by and between the City of Pearland, a Texas home- rule municipal corporation ("City") and Contractor ("Contractor"), and consisting of the following parts: I, Summary of Contract Terms II. Signatures III. Standard Contractual Provisions IV° Special Terms and Conditions V. Additional Contract Attachments I. Summary of Contract Terms. Contractor: Envirodyne Laboratories Inc. 11011 Brooklet Dr., Ste 230 Houston, TX 77099 Description of Supplies: Contractor will provide water, wastewater and pretreatment laboratory testing services, for the City of Pearland, as needed, per the specifications of Bid #0920-58. Contract Amount: Unit Price Contract, Estimated Amount of$120,000°00 Effective Date: November 20, 2021 End Date: November 19, 2022 Renewals: One (1) renewal option available Resolution No/Bid No. 0920-58 II. Signatures k7a'sia E bPEARL AND SLULL balc_Vi r„ Et I ULLU24gb CONTRACTOR ,, tit' t i il ' 1 . kt_ ,..)1.1?W --, Purchasing Officer Date Title: l,./;{) 1 Vi.i1ir ce , DocuSigned by: acui Putirsow Date: i,,i:pit(/ ,2,7i,/, 1 "— . ..csitibevcuogett *Signed by: Date _ Superintendent/Manager Director Deputy/Assistant City Manager City Manager *City Contract Signature Authority: Superintendent/Manager— up to $10,000 Director- $10,001 - $30,000 City Manager/Deputy/Assistant City Manager- $30,001 + City Council Resolution over $50,000 Supply Contract Standard Form Page I of 6 Approved as to Legal Form 6.28.2021 DocuSign Envelope ID:8CDO1D6A-3F56-4064-6316-E215C53BCF1D Ill. Standard Contract Provisions WHEREAS, Contractor has bid to provide supplies ("Supplies") in response to h equest for Bid/Proposal or Quote No. 0920-58 ("Solicitation"), which Solicitation includes the required scope of work and all specifications and which Solicitation and the Contractor's bid or proposal response, as applicable, are incorporated by reference in this Contract as Exhibits 11 and 2, respectively, as if each were fully set out here in its entirety, NOW, THEREFORE, City and Contractor agree as follows: 1. Scope. Contractor will provide Supplies in accordance with the attached Scope of Work, as detailed in Attachment A, the content of which is incorporated by reference into this Contract as if fully set out here in its entirety, and in accordance with Exhibit 2. 2. Term. This Contract is for one (1) year, with performance commencing upon the effective date or the date of issuance of the notice to proceed issued by the Contract Administrator or the Purchasing Division, or upon the performance date listed in the notice to proceed, whichever is later. The parties may mutually extend the Term of this Contract for up to one (1) additional one-year periods ("Option Period(s)"), provided, the parties do so by written amendment prior to the expiration of the original term or the then-current Option Period, The City's extension authorization must be executed by the City Manager or designee, 3. Compensation and Payment. This Contract is for an amount not to exceed $120,000.00, subject to approved extensions and changes. Payment will be made for Supplies completed and accepted by the City within thirty (30) days of acceptance, subject to receipt of an acceptable invoice. Contractor shall invoice no more frequently than once per month. All pricing must be in accordance with the attached Bid/Pricing Schedule, as shown in Attachment B, the content of which is incorporated, in its entirety, by reference into this Contract, Any amount not expended during the initial term or any option period may, at the City's discretion, be allocated for use in the next option period. Invoices will be emailed to the following email address with a copy provided to the Contract Administrator: City of Pearland Attn: Accounts Payable arelintspqyptule(rDpearlandtxgpv 4. Contract Administrator. The Contract Administrator designated by the City is responsible for approval of all phases of performance and operations under this Contract, including deductions for non-performance and authorizations for payment. The City's Contract Administrator for this Contract is as follows: Name: Sue Ellen Arredondo Department: Engineering & Public Works Phone: 281,652,1946 Email: sarredondo@purtictx.net S. Insurance; Bonds. (A) Before performance can begin under this Contract, the Contractor must deliver a Certificate of Insurance ("COI"), as proof of the required insurance coverages, to the Contract Administrator. Additionally, the COI must state that the City shall be provided Supply Contract Standard Form Page 2 of 6 Approved as to Legal Form 6.28.2021 DocuSign Envelope ID:8CDO1D6A-3F56-4064-6316-E215C53BCF1D no less than thirty (30) days advance written notice of cancellation, material change in coverage, or intent not to renew any of the policies. The City must be named as an additional insured. The City Attorney must be given copies of all insurance policies within ten (10) days of the City Manager or his designee's written request, Insurance requirements are as stated in Attachment C, the entirety of which is incorporated by reference into this Contract. (B) I Contractor shall provide any required payment bond, performance bond, or both, prior to commencement of performance under this Agreement. The terms, conditions, and amounts of the bonds and appropriate surety information shall be included in the RFB/RFP or as may be added to Attachment C, and such content, the entirety of which, shall be incorporated into this Contract y, 6. Purchase Release Order. For multiple-release purchases of Supplies to be provided by the Contractor over a period of time, the City will exercise its right to specify time, place and quantity of Supplies to be delivered in the following manner: the authorized City department or division shall send to Contractor a purchase release order signed by an authorized agent of the department or division. The purchase release order shall refer to this Contract, and Supplies shall not be rendered until the Contractor receives the signed purchase release order, 7. Inspection and Acceptance. City may inspect all Supplies before acceptance. Any Supplies or products that are provided but not accepted by the City must be corrected or re-worked immediately at no charge to the City. If immediate correction or re-working at no charge cannot be made by the Contractor, replacement Supplies may be procured by the City on the open market and any costs incurred, including additional costs over the item's bid/proposal price, shall be paid by the Contractor within thirty (30) days of receipt of City's invoice. 8. Warranty. (A) The Contractor warrants that all products supplied under this Contract are new, quality items that are free from defects, fit for their intended purpose, and of good material and workmanship. The Contractor warrants that it has clear title to the products and that the products are free of liens or encumbrances, (B) In addition, the products purchased under this Contract shall be warranted by the Contractor or, if indicated in Attachment D by the manufacturer, for the period stated therein. Attachment D, the entirety of which, is incorporated into this Contract. 9. Quality/Quantity Adjustments. Any quantities indicated on the Bid/Pricing Schedule are estimates only and do not obligate the City to order or accept more than the City's actual requirements nor do the estimates restrict the City from ordering less than its actual needs during the term of the Contract including any Option Period, Substitutions and deviations from the City's product requirements or specifications are prohibited without the prior written approval of the Contract Administrator. 10. Non-Appropriation. The continuation of this Contract after the close of any fiscal year of the City, which fiscal year ends on September 30th annually, is subject to appropriations and budget approval specifically covering this Contract as an expenditure in said budget, and it is within the sole discretion of the City's City Council to determine whether or not to fund this Contract. The City does not represent that this budget item will be adopted, as said determination is within the City Council's sole discretion when adopting each budget. 11. Independent Contractor. Contractor shall perform all work required by this Contract as an Supply Contract Standard Form Page 3 of 6 Approved us to Legal Form 6.28.2021 DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D independent contractor and will furnish such Supplies in its own manner and method, and under no circumstances or conditions will any agent, servant or employee of the Contractor be considered an employee of the City. 12. Amendments. This Contract may be amended or modified only in writing and executed by authorized representatives of both parties. 13. Waiver. No waiver by either party of any breach of any term or condition of this Contract waives any subsequent breach of the same. 14. Taxes. The Contractor covenants to pay payroll taxes, Medicare taxes, FICA taxes, unemployment taxes and all other applicable taxes. Upon request, the City Manager shall be provided proof of payment of these taxes within 15 days of such request. 15. Notice. Any notice required under this Contract must be given by hand delivery, or certified mail, postage prepaid, and is deemed received on the day hand-delivered or on the third day after postmark if sent by certified mail. Notice must be sent as follows: IF TO CITY: City of Pearland Attn: Laurie Rodriguez Title: Environmental Services Superintendent Address: 3501 East Orange Street, Pearland, TX 77581 Phone: 281,652.1813 IF TO CONTRACTOR: Envirodyne Laboratories Inc. Attn: Tanny Busby Title: President Address: 11011 Brooklet Dr., Ste 230, Houston, TX 77099 Phone: 281,568.7880 16. Liability and Indemnity. ANY PROVISION OF ANY ATTACHED CONTRACT DOCUMENT THAT LIMITS THE CONTRACTOR'S LIABILITY TO THE CITY OR RELEASES THE CONTRACTOR FROM LIABILITY TO THE CITY FOR ACTUAL OR COMPENSATORY DAMAGES, LOSS, OR COSTS ARISING FROM THE PERFORMANCE OF THIS CONTRACT OR THAT PROVIDES FOR CONTRACTUAL INDEMNITY BY ONE PARTY TO THE OTHER PARTY TO THIS CONTRACT IS NOT APPLICABLE OR EFFECTIVE UNDER THIS CONTRACT. EXCEPT WHERE AN ADDITIONAL CONTRACT DOCUMENT PROVIDED BY THE CITY PROVIDES OTHERWISE, EACH PARTY TO THIS CONTRACT IS RESPONSIBLE FOR DEFENDING AGAINST AND LIABLE FOR PAYING ANY CLAIM, SUIT, OR JUDGMENT FOR DAMAGES, LOSS, OR COSTS ARISING FROM THAT PARTY'S NEGLIGENT ACTS OR OMISSIONS IN THE PERFORMANCE OF THIS CONTRACT IN ACCORDANCE WITH APPLICABLE LAW. THIS PROVISION DOES NOT AFFECT THE RIGHT OF EITHER PARTY TO THIS CONTRACT WHO IS SUED BY A THIRD PARTY FOR ACTS OR OMISSIONS ARISING FROM THIS CONTRACT TO BRING IN THE OTHER PARTY TO THIS CONTRACT AS A THIRD_ PARTY DEFENDANT AS ALLOWED BY LAW. 17. Dispute Resolution Procedures. The Contractor and City desire an expeditious means to resolve any disputes that may arise between them regarding this Contract. If either party Supply Cantioct Standard Farm Page 4 of 6 Approved as to Legal Form 6.28.2021 DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D disputes any matter relating to this Contract, the parties agree to try in good faith, before bringing any legal action, to settle the dispute by submitting the matter to mediation before a third party who will be selected by agreement of the parties. The parties will each pay one-half of the mediator's fees, 18. Attorney's Fees. Should either party to this Contract bring suit against the other party for breach of contract or for any other cause relating to this Contract, neither party will seek or be entitled to an award of attorney's fees or other costs relating to the suit. 19. Termination. (A) City Termination for Convenience. Under this paragraph, the City may terminate this Contract during its term at any time for the City's own convenience where the Contractor is not in default by giving written notice to Contractor. If the City terminates this Contract under this paragraph, the City will pay the Contractor for all Supplies provided in accordance with this Contract to the date of termination, (B) Termination for Default. Either party to this Contract may terminate this Contract as provided in this paragraph if the other party fails to comply with its terms. The party alleging the default shall provide the other party notice of the default in writing citing the terms of the Contract that have been breached and what action the defaulting party must take to cure the default. If the party in default fails to cure the default as specified in the notice,the party giving the notice of default may terminate this Contract by written notice to the other party, specifying the date of termination. Termination of this Contract pursuant to this paragraph does not affect the right of either party to seek remedies for breach of the Contract as allowed by law, including any damages or costs suffered by either party. 20. Owner's Manual and Preventative Maintenance. Contractor agrees to provide a copy of the owner's manual and/or preventative maintenance guidelines or instructions if available for any equipment purchased by the City pursuant to this Contract. Contractor must provide such documentation upon delivery of such equipment and prior to receipt of the final payment by the City. 21. Limitation of Liability. The City's maximum liability under this Contract is limited to the total amount of compensation listed in this Contract. In no event shall the City be liable for incidental, consequential or special damages. 22. Assignment. No assignment of this Contract by the Contractor, or of any right or interest contained herein, is effective unless the City Manager first gives written consent to such assignment. The performance of this Contract by the Contractor is of the essence of this Contract, and the City Manager's right to withhold consent to such assignment is within the sole discretion of the City Manager on any ground whatsoever, 23. Severability. Each provision of this Contract is considered to be severable and, if, for any reason, any provision or part of this Contract is determined to be invalid and contrary to applicable law, such invalidity shall not impair the operation of nor affect those portions of this Contract that are valid, but this Contract shall be construed and enforced in all respects as if the invalid or unenforceable provision or part had been omitted. 24. Order of Precedence. In the event of any conflicts or inconsistencies between this Contract, its attachments, and exhibits, such conflicts and inconsistencies will be resolved by reference to the documents in the following order of priority: Supply Contract Standard Form Page 5 of 6 Approved as to Legal Form 6.28.2021 DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D A, this Contract (excluding attachments and exhibits); B, its attachments: C. the bid solicitation document including any addenda (Exhibit 1): then, D. the Contractor's bid response (Exhibit 2). 25. Certificate of Interested Parties. Contractor agrees to comply with Texas Government Code Section 2252,908, as it may be amended, and to complete Form 1295 "Certificate of Interested Parties" as part of this Contract if required by said statute for items approved by City Council, 26. Governing Law. Contractor agrees to comply with all federal, Texas, and City laws in the performance of this Contract. The applicable law for any legal disputes arising out of this Contract is the law of the State of Texas, and such form and venue for such disputes is the appropriate district, county, or justice court in and for Brazoria County, Texas, 27. H.B. 89. In accordance with Chapter 2270 of the Texas Government Code, the signatory executing this contract on behalf of company verifies that the company does not boycott Israel and will not boycott Israel during the term of this contract, This clause is subject to companies with ten or more full time employees and the contract value is $100,000 or more that is to be paid wholly or partially with public funds of the governmental entity. 28. Public Information Act Requirements. This paragraph applies only to agreements that have a stated expenditure of at least $1,000,000 or that result in the expenditure of at least $1,000,000 by the City. The requirements of Subchapter J, Chapter 552, Government Code, regarding certain entities requirement to provide contracting information to governmental bodies in connection with a public information request, may apply to this contract and the Contractor agrees that the contract can be terminated if the Contractor knowingly or intentionally fails to comply with a requirement of that subchapter. 29. Entire Contract. This Contract constitutes the entire agreement between the parties concerning the subject matter of this Contract and supersedes all prior negotiations, arrangements, agreements, and understandings, either oral or written, between the parties. IV. Special Terms and Conditions. None, V. Additional Contract Documents Attached and Incorporated by Reference: Attachment A: Scope of Work Attachment B: Bid/Pricing Schedule Attachment C: Insurance and Bond Requirements Attachment D: Warranty Requirements Incorporated by Reference Only: Exhibit 1: RFB/RFP/Quote Dated#0920-58 Exhibit 2: Contractor's Bid/Proposal Response Supply Contract Standard Form Pogo 6 of 6 Approved as to I.egal Form 6.28.2021 DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D ATTACHMENT A — SCOPE OF WORK Scope of services shall consist of the contractor providing water, wastewater and pretreatment laboratory testing services for the City of Pearland, as needed, per the specifications of Bid #0920- 58. Pricing is as follows per contractor's response to the same, as listed per Attachment B. DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D ATTACHMENT B - BID/PRICING SCHEDULE Hid 0 05,2955.8 'Tljt.Ira 1N m at and IN a a1r9araIa r 1,abotalory 5aL001a 5 Artrrur1 Gorr 11,105.1 frin11112,15101.0„. LINE '',...LI:LE1/S. 1.ota,40 ror505 vv,c.“._ Tin,„ r),,,,,,,„Iplvo. uo,,, 0.71( j tin 0 I PACIVAGE GI t , I , 1 !;%NAST CWA'TERIPR EijIFIEENTrME!NT , . Cartortncooke,40 Ovv55 arN553V Oxylan 111 Dc4"5913d EA 1. 1040 110..00 1,2 1 iliactiontarar Grrarlon Datnarrd IIA ! 1040!! t,9.00 ,1„3 11E119500 ilarautraL !ISA ! 1554111 $9081 I 1.4 1'Irma r Starratalard Sollars !EA I 1501311 15,00 $4,03 1.5 13101,551a Strai.amalvd 51r:11th !EA I 750 1 'r,6 !.I,QUO D iraaahrod Sotlata !EA ! 115111! $7„00 .__,..,..._,.„,.. I,I !%I otal Sorala !LA 1 /5411 15„0 0 ,,.. 1,9 !Sir VortaIrre 134,:arr:15 !EA 1 'I50, 14,.00 ; 11 1,9 1 Ai 5„11115.0 II„Vi ta 55599,9 is I EEA ! 154119! 11%001 r rr..'"1,IC l!r.115.torrI ,Lu da 1.12,19ot alrrat-rtrI Sor k ! 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EA 16601 $5,00 1 11 e,400 I.q u r Volaalou Suppon el Seeds EA 1,4001 , $4.06 1.12 E rESnl Co olaarrnn(annual sludge) EA 5 58,041 Fr1ut r llEharactenstes t.eacha1En 4 et 1.1 FLIP uuMo4Lq ")leclu"4rar 0e.Oh Nu E .0�0 a r 5 25.00, 11 15 FLIP'-VOCo LA 5 560.00 1.16E FCLP-1EVOMC1 EA 1 5 $150,00 1,1Y TC P-Orearechlenne pnclaraaoerl Fla 95.G0 1 10 Ya 4..P®He:llaalrnlelrl IE"A 130.w.a 1.19 V ychlonrlalt l l'uvphen ... EA 5 $4.5,001 1.2(1 Patnt aalaar EA I 5 $5.00 541armnl°alait0 Metals 1 21 3A 1311.Pollutant 101aNhS44Aag. n II4,13 EA 0 � 1 5,00 Metals (SI A1,5e fd,I .CauoPb,MMMn Hu,1„Nd,iSoA5. �' 1.22 2r4) EA1 6 $1 5W , 1 2E) '1 nlO Polnoaleor Hydoecypeons EA 00 640.001 40 C1111'1 1 24 11.1i1 all(arvaoo: EA 60 545„001 1"25 SoPladeo EA 20 $20.00' 5 Total B alalrnhl tetra, n EA 20 $10. ; 1 2/ N+1role N Nellie EA 25 $15 1.10 5 otau19 13 re,01 Compounds 5 0 58.0�0' rl 0 Compounds EA ! 5 5125.00 1.311 Betutene,Toluene,Etlayul n rne,Xyleng EA 20 45.00 1;a1 Phenols EA5 $31000 1 11 tyararre,I olal 5 Amenable ,00 1 33 Illexayolent ClChtornage EA 5 $10.001, 1.34 SS0leteo 20, 115,600 135" Co00luctivOy A 20 $7.r'V 1 an Cnernrcal Oxygen Demand EA 20 516.4 !II 2 PA( 01F 2 p'tA1, WA"1Ct1 1 I 2.1 1 real Cogloceou(,PlA) EA 3000 59,00 2.2 l letorw.'ul(opllnc Platt Count (A 140 $25,301 2.3 0`rncrralry OW Standards EA 35 5150.0' ' 2 4 ,Secondary OW Standards EA 3F, $1 00 2,�0 Coo sAlprre„a 1'A 35 $32„00 2.6, Cro1,5 Beta EA 35 $32,00 2.2 t el ECOP!n tar EA 150 $25.00 2 8 !Valetta Depute ,undo E.iA 2 50.0'1'1 PACKAGE 0.'VENDOR PERFORMED 3 C COLLECTION 1 1 3.1 8amon Coanclw0al'or pH "r,A 1 05 ,rya Atter HaurelErrtergencySt ple y 2 Collecl n I EA 15 0,00 0.0 After Rau',e110)1 6a4644e66y.Via:l,mya EA 15 $0,00, 3,4 BuslneS1"Hours•Samgle Colloctiorl FA, 15 .00,, DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D ATTACHMENT C — INSURANCE REQUIREMENTS Contractors performing work on City property or public right-of-way for the City of Pearland shall provide the City a certificate of insurance or a copy of their insurance policy(s) evidencing the coverages and coverage provisions identified herein. Contractors shall provide the City evidence that all subcontractors performing work on the project have the same types and amounts of coverages as required herein or that the subcontractors are included under the contractor's policy. All insurance companies and coverages must be authorized by the Texas Department of Insurance to transact business in the State of Texas and must be acceptable to the City of Pearland, Listed below are the types and amounts of insurances required. The City reserves the right to amend or require additional types and amounts of coverages. or provisions depending on the nature of the work. Type of Insurance Amount of Insurance Provisions 1. Workers° Compensation Statutory Limits City to be provided a WAIVER Employers Liability $100,000 per occurrence OF SUBROGATION and 30-day notice of cancellation or material change in coverage. 2. Commercial General Personal Injury- $1.000.000 per City to be listed as additional (Public) Liability to include person; Property Damage - insured and provided 30-day coverage for: $1,000,000 per occurrence; notice of cancellation or a) Premises/Operations General Aggregate - ' material change in coverage. b) Products/Completed $I 000,000 Operations City shall be provided 30-day c) Independent notice of cancellation or Contractors material change in coverage,. d) Personal Injury. e) ContractualLiability 3. Business Auto Liability to, Combined Single Limit- include coverage for: $ ,000,000 a) Owned/Leased vehicles b) Non-owned vehicles c) Hired vehicles Certificate of Insurance forms may be sent to Purchasing Department. DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D ATTACHMENT D —WARRANTY Items or services shall conform to the proposed specifications and all warranties as stated in the Uniform Commercial Code and be free from all defects in material, workmanship and title. DocuSign Envelope ID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D STANDARD FORM OF AGREEMENT (17T PEARL AND APPENDIX II House Bill 89 Verification I, Laura Bonjonia (Person name), the undersigned representative (hereafter referred to as "Representative") of Envirodvne Laboratories (company or business name, hereafter referred to as "Business Entity"), being an adult over the age of eighteen (18) years of age, after being duly sworn by the undersigned notary, do hereby depose and affirm the following: 1. That Representative is authorized to execute this verification on behalf of Business Entity; 2, That Business Entity does not boycott Israel and will not boycott Israel during the term of any contract that will be entered into between Business Entity and the City of Pearland, and 3. That Representative understands that the term "'boycott Israel" is defined by Texas Government Code Section 2270,001 to mean refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes. (vL-/ 7)21‘l SIGNATURE OF,f EPRESENTATIVE SUBSCRIBED AND SWORN TO BEFORE ME, the undersigned authority, on this day of (,,'( n, , 2021 Notary Public I / seN, ;.) My wi DocuSign_EnyelopeID:8CDO1 D6A-3F56-40B4-B316-E215C53BCF1 D CERTIFICATE OF INTERESTED PARTIES FORM 1295 oti Complete Nos 1-4 and 6 if there are interested parties, OFFICE USE ONLY Complete Nos. 1,2, 3,5.and 0 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2021-818218 En\Arodyne Laboratories Inc Houston, TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is " 10/28/2021 being filed. City of Pearland Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. 0920-58 Water, Wastewater and Pretreatment Laboratory Services 4 Nature of interest Name of Interested Party City,State,Country(place of business) (chock applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. 6 UNSWORN DECLARATION My name is !„410, t Vjaa „ and my date of birth is k- lir 1 1'7 7 My address is (street) (city) (state) (rep code) (dwetry) I declare urater penalty of perjury that the foregoing is true and correct. Executed in j'q;, County, State of 9`"'' !,/ .on the , day of Er. 20 (month) (year) Sognature of thorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission vwtrviLethics.stateAx,us Version V1.L191b5cdc