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HomeMy Public PortalAbout029-2016 - Sanitary - Kimtrade Chemicals - Treatment PlantAGREEMENT ORIGINAL THIS AGREEMENT made and entered into this 0 day of !� r , 2016, and referred to as Contract No. 29-2016 by and between the City of Richmond, Indiana, a municipal corporation acting by and through its Board of Sanitary Commissioners (referred to as the "City"), and Chemtrade Chemicals US, LLC, 90 East Halsey Road, Parsippany, NJ 07054 (hereinafter referred to as the "Contractor"). SECTION 1. STATEMENT AND SUBJECT OF WORK City hereby retains Contractor for the furnishing of Liquid Aluminum Sulfate in a liquid state to be delivered directly to the City's Wastewater Treatment Plant and transferred to the District's bulk storage tanks in accordance with the Minimum Specifications, which is attached hereto and incorporated by reference herein as Exhibit "A". Contractor shall attach a MSDS sheet upon delivery of the above -referenced product. Contractor shall further perform a bench test at least once per year to determine performance and requirement of the product for the benefit of the City at no cost to the City. City shall have the unlimited discretion to refuse to take delivery of the product due to unsafe conditions associated with the product and/or delivery of the same; and if the City chooses to exercise its option to refuse to take delivery of the product, it shall not be held responsible for any charges associated therewith. Contractor shall supply experienced/safe drivers and equipment in performing its duties associated with this Agreement. Contractor shall set forth the delivery time within two (2) days subsequent to its receipt of any order placed by City relative to this Agreement. A Request for Quote has been made available for inspection by Contractor, is on file in the office of the Department of Sanitation for the City of Richmond, consisting of two (2) typewritten pages, which is attached hereto and incorporated by reference herein as Exhibit `B". The response of Contractor to said Request for Quote is attached hereto and incorporated by reference herein as Exhibit "B", consisting of one (1) typewritten page. Should any provisions, terms, or conditions contained in any of the documents attached hereto and incorporated by reference herein as Exhibits, conflict with any of the provisions, terms, or conditions of this Agreement, this Agreement shall be controlling. The Contractor shall furnish all labor, material, equipment, and services necessary for the proper completion of all work specified. Contractor shall submit statements or bills monthly. No performance of services shall commence until the following has been met: 1. The City is in receipt of any required certificates of insurance and/or warranties; 2. The City is in receipt of any required affidavit(s) signed by Contractor in accordance with I.C. § 22-5-1.7-11(a)(2); and 3. A purchase order has been issued by the Purchasing Department. SECTION II. STATUS OF CONTRACTOR Contractor shall be deemed to be an independent contractor and is not an employee or agent of the City of Richmond. The Contractor shall provide, at its own expense, competent supervision of the work. Contract No. 29-2016 Page SECTION III. COMPENSATION City shall pay Contractor at the rates indicated in Exhibit "B". Specifically, City shall pay the sum of Three Hundred Fifty-four Dollars and 00/100 ($354.00) per dry ton of the product described above with an estimated amount to be Two Hundred Twenty Thousand (220,000) tons of product per year. SECTION IV. TERM OF AGREEMENT This Agreement shall become effective when signed by all of the parties hereto and shall continue in effect until in effect for a period of three (3) years unless the parties extend this Agreement by a written and signed Addendum. Notwithstanding the term of this Agreement, City may terminate this Agreement in whole or in part, for cause, at any time by giving at least thirty (30) days written notice specifying the effective date and the reasons for termination which shall include but not be limited to the following: a. failure, for any reason of the Contractor to fulfill in a timely manner its obligations under this Agreement; b. submission of a report, other work product, or advice, whether oral or written, by the Contractor to the City that is incorrect, incomplete, or does not meet reasonable professional standards in any material respect; c. ineffective or improper use of funds provided under this Agreement; d. suspension or termination of the grant funding to the City under which this Agreement is made; or e. unavailability of sufficient funds to make payment on this Agreement. This Agreement may also be terminated by either the City or the Contractor, in whole or in part, by mutual Agreement setting forth the reasons for such termination, the effective date, and in the case of partial termination, the portion to be terminated. This Agreement may also be terminated by either the City or the Contractor, without cause, by giving at least thirty (30) days written notice to the other party. In the event of termination of this Agreement, the City shall be required to make payment for all work performed prior to the date this Agreement is terminated, but shall be relieved of any other responsibility herein. SECTION V. INDEMNIFICATION AND INSURANCE Contractor agrees to obtain insurance and to indemnify the City for any damage or injury to person or property or any other claims which may arise from the Contractor's conduct or performance of this Agreement, either intentionally or negligently; provided, however, that nothing contained in this Agreement shall be construed as rendering the Contractor liable for acts of the City, its officers, agents, or employees. Contractor shall as a prerequisite to this Agreement, purchase and thereafter maintain such insurance as will protect it from the claims set forth below which may arise out of or result from the Contractor's operations under this Agreement, whether such operations by the Page Contractor or by any sub -contractors or by anyone directly or indirectly employed by any of them, or by anyone for whose acts the Contractor may be held responsible. Coverage Limits A. Worker's Compensation & Statutory Disability Requirements B. Employer's Liability $100,000 C. Comprehensive General Liability Section 1. Bodily Injury $1,000,000 each occurrence $2,000,000 aggregate Section 2. Property Damage $1,000,000 each occurrence D. Comprehensive Auto Liability Section 1. Bodily Injury $1,000,000 each person $1,000,000 each occurrence Section 2. Property Damage $1,000,000 each occurrence E. Comprehensive Umbrella Liability $1,000,000 each occurrence $1,000,000 aggregate F. Malpractice/Errors & Omissions Insurance $1,000,000 each occurrence $2,000,000 aggregate SECTION VI. COMPLIANCE WITH WORKER'S COMPENSATION LAW Contractor shall comply with all provisions of the Indiana Worker's Compensation law, and shall, before commencing work under this Agreement, provide the City a certificate of insurance, or a certificate from the industrial board showing that the Contractor has complied with Indiana Code Sections 22-3-2-5, 22-3-5-1 and 22-3-5-2. If Contractor is an out of state employer and therefore subject to another state's worker's compensation law, Contractor may choose to comply with all provisions of its home state's worker's compensation law and provide the City proof of such compliance in lieu of complying with the provisions of the Indiana Worker's Compensation Law. SECTION VII. COMPLIANCE WITH INDIANA E-VERIFY PROGRAM REQUIREMENTS Pursuant to Indiana Code 22-5-1.7, Contractor is required to enroll in and verify the work eligibility status of all newly hired employees of the contractor through the Indiana E-Verify program. Contractor is not required to verify the work eligibility status of all newly hired employees of the contractor through the Indiana E-Verify program if the Indiana E-Verify program no longer exists. Prior to the performance of this Agreement, Contractor shall provide to the City its signed Affidavit affirming that Contractor does not knowingly employ an unauthorized alien in accordance with IC 22-5-1.7-11 (a) (2). In the event Contractor violates IC 22-5-1.7 the Contractor shall be required to remedy the violation not later than thirty (30) days after the City notifies the Contractor of the violation. If Contractor fails to remedy the Page violation within the thirty (30) day period provided above, the City shall consider the Contractor to be in breach of this Agreement and this Agreement will be terminated. If the City determines that terminating this Agreement would be detrimental to the public interest or public property, the City may allow this Agreement to remain in effect until the City procures a new contractor. If this Agreement is terminated under this section, then pursuant to IC 22-5- 1.7-13 (c) the Contractor will remain liable to the City for actual damages. SECTION VIH. IRAN INVESTMENT ACTIVITIES Pursuant to Indiana Code (IC) 5-22-16.5, Contractor certifies that Contractor is not engaged in investment activities in Iran. In the event Board determines during the course of this Agreement that this certification is no longer valid, Board shall notify Contractor in writing of said determination and shall give contractor ninety (90) days within which to respond to the written notice. In the event Contractor fails to demonstrate to the Board that the Contractor has ceased investment activities in Iran within ninety (90) days after the written notice is given to the Contractor, the Board may proceed with any remedies it may have pursuant to IC 5-22-16.5. In the event the Board determines during the course of this Agreement that this certification is no longer valid and said determination is not refuted by Contractor in the manner set forth in IC 5-22-16.5, the Board reserves the right to consider the Contractor to be in breach of this Agreement and terminate the agreement upon the expiration of the ninety (90) day period set forth above. SECTION IX. PROHIBITION AGAINST DISCRIMINATION A. Pursuant to Indiana Code 22-9-1-10, Contractor, any sub -contractor, or any person acting on behalf of Contractor or any sub -contractor shall not discriminate against any employee or applicant for employment to be employed in the performance of this Agreement, with respect to hire, tenure, terms, conditions or privileges of employment or any matter directly or indirectly related to employment, because of race, religion, color, sex, disability, national origin, or ancestry. B. Pursuant to Indiana Code 5-16-6-1, the Contractor agrees: That in the hiring of employees for the performance of work under this Agreement of any subcontract hereunder, Contractor, any subcontractor, or any person acting on behalf of Contractor or any sub -contractor, shall not discriminate by reason of race, religion, color, sex, national origin or ancestry against any citizen of the State of Indiana who is qualified and available to perform the work to which the employment relates; 2. That Contractor, any sub -contractor, or any person action on behalf of Contractor or any sub -contractor shall in no manner discriminate against or intimidate any employee hired for the performance of work under this Agreement on account of race, religion, color, sex, national origin or ancestry; That there may be deducted from the amount payable to Contractor by the City under this Agreement, a penalty of five dollars ($5.00) for each person for each calendar day during which such person was discriminated against or intimidated in violation of the provisions of the Agreement; and 4. That this Agreement may be canceled or terminated by the City and all money due or to become due hereunder may be forfeited, for a second or any subsequent violation of the terms or conditions of this section of the Agreement. Page C. Violation of the terms or conditions of this Agreement relating to discrimination or intimidation shall be considered a material breach of this Agreement. SECTION X. RELEASE OF LIABILITY Contractor hereby agrees to release and hold harmless the City and all officers, employees, or agents of the same from all liability which may arise in the course of Contractor's performance of its obligations pursuant to this Agreement. SECTION XI. MISCELLANEOUS This Agreement is personal to the parties hereto and neither party may assign or delegate any of its rights or obligations hereunder without the prior written consent of the other party. Any such delegation or assignment, without the prior written consent of the other party, shall be null and void. This Agreement shall be controlled by and interpreted according to Indiana law and shall be binding upon the parties, their successors and assigns. This document constitutes the entire Agreement between the parties, although it may be altered or amended in whole or in part at any time by filing with the Agreement a written instrument setting forth such changes signed by both parties. By executing this Agreement the parties agree that this document supersedes any previous discussion, negotiation, or conversation relating to the subject matter contained herein. This Agreement may be simultaneously executed in several counterparts, each of which shall be an original and all of which shall constitute but one and the same instrument. The parties hereto submit to jurisdiction of the courts of Wayne County, Indiana, and any suit arising out of this Contract must be filed in said courts. The parties specifically agree that no arbitration or mediation shall be required prior to the commencement of legal proceedings in said Courts. By executing this Agreement, Contractor is estopped from bringing suit or any other action in any alternative forum, venue, or in front of any other tribunal, court, or administrative body other than the Circuit or Superior Courts of Wayne County, Indiana, regardless of any right Contractor may have to bring such suit in front of other tribunals or in other venues. Any person executing this Contract in a representative capacity hereby warrants that he/she has been duly authorized by his or her principal to execute this Contract. In the event of any breach of this Agreement by Contractor, and in addition to any other damages or remedies, Contractor shall be liable for all costs incurred by City in its efforts to enforce this Agreement, including but not limited to, City's reasonable attorney's fees. In the event that an ambiguity, question of intent, or a need for interpretation of this Agreement arises, this Agreement shall be construed as if drafted jointly by the parties, and no presumption or burden of proof shall arise favoring or disfavoring any party by virtue of the authorship of any of the provisions of this Agreement. Page IN WITNESS WHEREOF, the parties have executed this Agreement at Richmond, Indiana, as of the day and year first written above, although signatures may be affixed on different dates. "CITY" The City of Richmond, Indiana, by and through its Board of Sanitary Commissioners .,5z� - — Sue Miller, President Dated: APPROVED: Dated: "CONTRACTOR" Chemtrade Chemicals US, LLC By: _ �k Evz' (Printed): ELIZABETH RYNO Title: MARKETING SPECIALIST Dated: MAY 6, 2016 6 1 Page PROPOSAL SHEET FOR LIQUID ALUNIINUM SULFATE (Al2(SO4 )3 14 H2O) DESCRIPTION Estimated 220,000 +/- gallons of Aluminum Sulfate per year PRICE $354.00 /dry ton Each vendor shall quote price per dry ton of Aluminum Sulfate in liquid state delivered to the Wastewater Plant and transferred to the District's bulk storage tanks in accordance with the attached "Minimum Specifications". Each vendor shall attach the chemical analysis of his material to proposal sheet. Each vendor shall attach a MSDS sheet upon delivery of the product. Each vendor shall state the time period for which the quoted price shall remain valid. Vendor may be required to submit samples of technical evaluation prior to quote award. Testing to be performed by independent lab at no cost to RSD. Vendor to perform bench test at least once a year to determine performance and requirement of product for RSD at no cost. Vendor may submit a minimum of one (1) quart of chemical. Quote will be for three (3) year period of time after award of quote (approximately 4/1/16 to 3/31/19). If emergencies occur with Vendor's Manufacturer and/or manufacturing of the product, the Vendor will be held responsible for providing product to the District at quoted price. Vendor is to include all shipping costs in the price quote.. Richmond Sanitary District will not pay any shipping. Richmond Sanitary District has authority to refuse delivery due to unsafe manner and not be held responsible for any charges. Vendor is to supply experienced/safe drivers and equipment. Vendor is to state delivery time after receipt of order 1 - 2 DAYS Auth nzeo d Signature ELIZABETH RYNO Contact Person CHEMTRADE CHEMICALS US L-LC S Company. Name FEBRUARY 17, 2016 Date 800 441 2659 Phone Number 0 PROPOSAL SHEET FOR CHLORINE (CIz) DESCRIPTION PRICE Estimated 30 +/- tons of Chlorine per year $ NO BID /ton Tank Deposit (if any) $ NO BID /ton Each vendor shall attach the chemical analysis of his material to proposal sheet. Each vendor shall attach a MSDS sheet upon delivery of the product. Each vendor shall state the time period for which the quoted price shall remain valid. Vendor may be required to submit samples of technical evaluation prior to quote award. Testing to be performed by independent lab at no cost to RSD. Quote will be for three (3) year period of time after award of quote (approximately 4/1/16 to 3/31/19). If emergencies occur with Vendor's manufacturer and/or manufacturing of the product, the Vendor will be held responsible for providing product to the District at quoted price. Vendor is to include all shipping costs in the price quote. Richmond Sanitary District will not pay any shipping. Vendor is to include all tank deposit charges in the price quote if any. Richmond Sanitary District has authority to refuse delivery due to unsafe manner and not be held responsible for any charges. Vendor is to supply experienced/safe drivers and equipment. Vendor is to state delivery time after receipt of order N / A Authorized Signature ELI IABEM RYNO Contact Person aiBC BADE CHENICALS US LLC Company Name _ FEBRUARY 17, 2016 Date 800 441 2659 Phone Number PROPOSAL SHEET FOR SULFUR DIOXIDE (SO2) DESCRIPTION. PRICE Estimated 35 +!- tons of Sulfur Dioxide per year $ NO BID /ton Tank Deposit (if any) $ NO BID /ton Each vendor shall attach the chemical analysis of his material to proposal sheet. Each vendor shall attach a MSDS sheet upon delivery of the product Each vendor shall state the time period for which the quoted price shall remain valid. Vendor may be required to submit samples of technical evaluation prior to quote award. Testing to be performed by independent lab at no cost to RSD. Quote will be for three (3) year period of time after award of quote (approximately 4/1/16 to 3/31/19). If emergencies occur with Vendor's manufacturer and/or manufacturing of the product, the Vendor will be held responsible for providing product to the District at quoted price. Vendor is to include all shipping costs in the price quote. Richmond Sanitary District will not pay any shipping. Vendor is to include all tank deposit charges in the price quote if any. Richmond Sanitary District has authority to refuse delivery due to unsafe manner and not be held responsible for any charges. Vendor is to supply experienced/safe drivers and equipment. Vendor is to state delivery time after receipt of order N / A LWC, Authorized Signature ELI7ABETH RYNO Contact Person CHFMRADE CHEMICALS US LLC Company Name FEBRUARY 17, 2016 Date 800 '441 2659 Phone Number MINIMUM SPECIFICATION FOR LIQUID CHLORINE (Clz) N / A Bidder Complies YES NO Liquid Chlorine shall be 99.5% minimum (by volume) and not have a moisture content exceeding 0.01 %. chlorine to be delivered in standard one- ton containers. chlorine containers and valves shall meet AWWA, DOT, and Federal Standards for Chlorine Institute. Delivery shall be made by vehicles properly equipped to unload one -ton containers, District has overhead crane inside building for off-loading. Truck trailer must be able to navigate through -overhead doors. Delivery shall not be made at the convenience of the Vendor. They shall be made within a reasonable length of time following either a written or telephoned order from the District. The District will admit delivery from 7:30 am to 1:3.0 pm, Monday through Friday, (unless Holiday). MINIMUM SPECIFICATION FOR LIQUID ALUMINUM SULFATE (Al2(SO4 )314 H2O) Liquid Aluminum Sulfate shall, contain water-soluble aluminum of not less than 4.23% as Al or 8.0% as A1203. It shall be composed of 48.5% dry Aluminum Sulfate and have a density of 11.14 pounds per gallon. The water - insoluble matter shall not exceed 0.2%. The delivered mixture shall meet the AWWA standard for Aluminum Sulfate (B403-88). The product shall be analyzed for metals (cadmium, copper, chromium, lead, nickel, mercury, molybdenum, zinc) and date submitted as part of bid specs. Delivery shall be made by vehicles properly equipped to transfer liquid Aluminum Sulfate into the District's bulk storage tanks without spillage. Deliveries shall not be made at the convenience of the Vendor. They shall be made within a reasonable length of time following either a written or telephoned order from the District. The District will admit delivery from 7:30 am to 1:30 pm, Monday through Friday (unless Holiday). The District orders will be for approximately 4,000 gallons each. The District shall have the right to require a small sample from each load for laboratory purposes. I Bidder Complies YES NO x x MINIMUM SPECIFICATION FOR SULFUR DIOXIDE (SO2) N /.A Bidder Complies Sulfur Dioxide shall be 99.9% minimum (by volume) YES NO product.. Moisture content shall not exceed 27.8 ppm. sulfur acid content shall not exceed 8.0 ppm. Sulfur dioxide shall be delivered in standard one -ton containers. _ sulfur dioxide containers and valves shall meet AWWA, DOT and applicable Federal Standards for handling and storage of sulfur dioxide. Delivery shall be made by vehicles properly equipped to unload one -ton containers, District has overhead crane inside building for off-loading. Truck trailer must be able to navigate through overhead doors. Delivery shall not be made at the convenience of the Vendor. They shall be made within -a reasonable -length of time following either a written or telephoned order from the District. The District will admit delivery from 7:30 am to 1:30 pm, Monday through Friday, (unless Holiday). I 01 RICHMOND SANITARY DISTRICT 2016 Chemical Quotes Receipt Verification Form E-Verification Form filled out Local Preference Form filled out Certificate of Liability/Worker's Comp Form Iran Activity Form Please include all wai7anty information -with bid. Authorf ed Signature CHENUME CHEMICALS US LLC Company Name 90 EAST HALSEY ROAD Company Adchess (800) "1-2659 Phone Numbez Yes X No Yes X No Yes X No Yes X No FMUARY 19, 2016 Date ELIZABETH RYNO Contact Person PARSIPPANY, NJ 07054 City, State, Zip 0 Affidavit of Employment Eligibility Verification The, Contractor, CHEMTRADE CHEMICALS US LLC afU=s under the penalties of perjury that Contractor does not knowingly employ an unauthorized alien. If Contractor is self-employed and does not employ any employees, Contractor verifies he or she is. a United States citizen or qualified alien. The Contractor has not knowingly employed or co_ ntracted with an unauthorized alien and shall not retain an employee or contract with • a person that the Contractor subsequently learns is an - unauthorized alien. Pursuant to Indiana Code 22-5-1.7, Contractor has enrolled in and verified the work .eligibility. status .of all newly hired employees of the contractor through the Indiana E-Verify program. The Contractor has required Contractor's' subcontractors to certify to the Contractor that the subcontractor does not knowingly employ or contract with an unauthorized alien: and that the subcontractor has enrolled and is participating in the E-Verify program. The Contractor will maintain this certification throughout the: duration of the term of a contract with a subcontractor. I Hereby verify under the penalty ofperjury that the foregoing.staterhenf is true. Dated this .19 day of FEBRUARY 2016 (sgna . e) ` ELIZABETH RYND, MARKETING SPECIALIST (printed name) E-Verify Requirements: Definitions: E-Verify Proms — A electronic verification of work authorization program of the Illegal Immigration Reform and Immigration Responsibility Act of 1996 (P.L. 104-208), Division C, Title IV,s.403 (a), as amended, operated by the United States Department of Homeland Security or successor work authorization program designated by the United States Depart of Homeland Security or other federal agency authorized to verify the work authorization status of newly hired employees under the Immigration Reform and control Act of 1986 (P.L. 99-603). No performance of services shall commence until the following has been met: 1. The City is in receipt of any required certificates of insurance; 2. The City is in receipt of any required affidavit signed by Contractor in accordance with Indiana Code 22-5-1.7-1 1.(a) (2); and 3. A -purchase order has been issued by the Purchasing Department. COMPLIANCE WITH n''DIANA E-VERIFY PROGRAM REQUIREMENTS - Pursuant to Indiana Code 22.5.1,7, Contractor is required to enroll in and verify the work eligibility status of all newly hired employees of the contractor through the Indiana E-Verify program. Contractor is not required to verify the work eligibility status of all newly hired employees of the contractor through the Indiana E-Verify program if the Indiana E-Verify program no longer exists. Prior to the performance of the Agreement, Contractor shall provide to the City its signed Affidavit affirming that Contractor does not knowingly employ an unauthorized alien in accordance with IC 22-5-1.7 (a) (2). In the event Contractor violates IC 22-5-1.7 the Contractor shall be required to remedy the violation no later than thirty (30) days after the City notifies the Contractor of the violation. If the Contractor fails to remedy the violation within the thirty (30) day period provided above, the City shall consider the Contractor to be in breach of this Agreement and this Agreement will be terminated. If the City determines that terminating this Agreement would be detrimental to the public interest or public property, the City may allow this Agreement to remain in effect until the City procures a new contractor. If this Agreement is terminated under. this section, then pursuant to IC 22-5-1.7-13 (c) the Contractor will remain liable to the City for actual damages. Indiana Local Preference Claim: Defriitions: Affected County —Wayne County or an adjacent county. Local Indiana Business — A business whose principal place of business is in an Affected County; a business -that pays a majority of its payroll (in dollar volume) to residents of Affected Counties; or a business that employees residents of Affected Counties as a majority of its employees. Local Preference Documentation If the Bidder is claiming local preference as defined by Indiana Code 5-22-15-20.9, it shall include such claim with its Bid. In addition the Bidder shall submit, as a Post -Bid submittal,, all documentation required by the Local Indiana Preference form. If the Bidder is a Joint Venture and is claiming local preference pursuant to Indiana Code 5-22-15-20.9, the Bidder shall submit all post bid documentation as required by the Post -Bid submittals. In determining_whether the Joint Venture qualifies as a Local Indiana Business, as defined by Indiana Code 5-22-15-20.9, the Owner will evaluate the Joint Venture by combining each business's total payroll, payroll paid to residents of Affected Counties, total number. of employees, and total number of employees who are residents of Affected Counties. Further, each part of the Joint Venture shall submit the location of it's principal place of business will be a consideration in whether the Joint Venture qualifies as a local Indiana business. The Owner will determine whether the Joint Venture qualifies as a Local Indiana business. The total overall Joint Venture must qualify as a Local Indiana Business to receive the local preference as defined in Indiana Code 5-22-15-20.9. Subject to Indiana Code 5-22-.15-20.9, award of the Contract will be made to the lowest, responsive and responsible Bidder, where the Bid is reasonable and does not exceed the funds available for the project. The Owner reserves the right to reject all Bids and may waive or allow a Bidder to correct errors, omissions or other irregularities in Bid Documents that are found not to have afforded the Bidder a substantial competitive advantage over other Bidders. NOT APPLICABLE INDIANA LOCAL PREFERENCE CLAIM (Only fill out this Partif claiming to be a Local Indiana Business) Pursuant to Indiana Code 5-22-15-20.9, (Name of Business) Claims a local Indiana business preference for the bid for Project in Wayne County, Indiana. (Name of Project) The Claim of applicability of the Local Indiana Business preference is based upon the following (Check all that apply) ❑ 1. The location of the Business's principal place of business is: A) in Wayne County, or B) in an adjacent county ❑ 2. The majority of the business's payroll, for the previous twelve (12) months from the date of this Bid, is to residents in Wayne or an adjacent county. ❑ 3. The majority of the business's employee's, for the previous twelve (12) months from the date of this Bid, are residents of Wayne or an adjacent county. If business is deemed to be the apparent low bidder, business shall provide information pursuant to Post -Bid submittal (Local Indiana Business Preference), to substantiate the claim of a local Indiana business. NOT APPLICABLE POST BID SUBMITTAL Local Indiana Business Preference Pursuant to the City of Richmond Bidding and Contract Requirements, this application for the local Indiana business, pursuant to Indiana Code section 5-22-15-20.9, is hereby submitted for the Project listed below by Bidder/Applicant (hereinafter Bidder). (Use additional sheets if necessary.) Date Bid Submitted: Project Name: Bidder: Contact Name: Principal Place of Business: Project Number: Phone Number: Number of Months Address has been Principal Place of Business: Number of all Employees for the twelve (12) months prior to the date of Bid submission: Number of Employees who were residents of Affected Counties for the twelve (12) months prior to the date of Bide submission: 1. If the Bidder claims it is a local Indiana business because the Bidder's principal place of business is in Wayne County or an adjacent county, give a statement explaining the reasons the business considers the location named as the business's principal place of business: 2. In order to claim local preference pursuant to Indiana Code section 5-22-15-20.9, the Bidder must supply below its total payroll and the amount of the business's payroll paid t residents of Affected Counties for the previous twelve (12) months from the date of the Bid. a. Total Amount of payroll paid to all employees of Bidder in the previous twelve (12) months from the date of the Bid: $ b. Total Amount of payroll paid to residents of affected counties for the previous twelve (12) months from the date of the Bid: Bidder shall supply supporting payroll records sufficient for Owner to establish the above representations. When supplying supporting records, Bidder shall redact all Social Security Numbers ' ARTICLE F . INSTRUCTIONS TO BIDDERS INDEM1,MCATION, INSURANCE, AND PROTECTION OF LWES AND PROPERTY . F.1 1NDEMNIffCATI0N F.1.1 ' The contractor shall idemrufy and hold harmless the City of Richmond and its . . officers. and employees from and against all claims, damages, losses, expenses, including but not limited to attorney's fees, arising out of or resulting from the performance of the contract, provided that any such claim, damage, loss or expense (a) is attributable to bodilyuijury, siclmess; disease or death, or to injury to or destruction of tangible property (other than goods, materials and equipment furnished under this contract) including the loss. -Of use resulting ; herefrom, and (b) is caused.in whale ox iii part by any negligent act or omission of the contractor, any subcontractor, or anyone directly employed by any of them or anyone for whole acts any of them znay be liable, regardless of whether or not it is caused'in part by a party" indemnified hereunder. F.1.2 In any and all claims against the City or any of ifs officers or employees by any employee of the contractor, any subcontractor, anyone directly or indirectly employed by: any of them or anyone for whose. acts any of fhemmay bL. able, the indemnification .obligation under this paragraph G. -1 shall not be limited in any Yvay by any limitation of the amount or type of -damages, compensation or benefits payable by or for the contractor or any sub -contractor under worker's or workmen's compensation acts, disability benefit acts or other employee benefit acts. F.2 WORKEWS COMPENSATTONINSLI ANCE Fox contracts involving performance of work pursuant to the!pxbvisions of Indiana. Code IQ 22=3-2-14 (a) bidders are required to furnish a certificate from .the Indiana Worker's Board showing that such bidder has complied with IC 22- 3-2--5,. 22-3-51 and IC 22-5-5-2. F.3 INSURANCE The Contractor shall, as prerequisite to this Agreement, purchase and thereafter maintain 'such insurance as will protect hum from the claims set -forth below' which may arise out of or result from the Contractor's operations :under this Agreement, whether such operations by the Contractor or byany Sub-' " coniYactois or by anyone who directly ox indirectly employed by any of them, or }fir annyone for whose acts any of them may be liable-. ? Coverage 'Limits _ A. Worker's:Compensatiori & .: Statutory Disability Requirements. B. Employ-6r's Liability $100,00D C. Comprehensive Genial Liability Section 1. Bodily Injury $1,006,000 each. occurrence $2,000,000 aggregate -Section 2. Property Damage $1;000,000 each occurrence D. Comprehensive Auto Liability ` Section 1. ' Bodily Injury $1,000,000 each person $1,000,000 each occurrence Section 2.. Property Damage $1,0003000 each. occurrence E. Comprehensive Umbrella Liability $1,000,000 each occurrence $1,000,000 .each aggregate F.] .iNDEMNIF F. 1.1 F. 1.2 WORKER'S F. 2.1 F. 3.1 A. B. C. ARTICLE F INSTRUCTIONS TO BIDDERS INDEMNIFICATION, INSURANCE, AND PROTECTION OF LIVES AND PROPERTY. CATION The contractor shall indemnify and hold harmless the City of Richmond and its officers and employees from and against all claims, damages, losses, expenses, including but not limited to attorney's fees, arising out of or resulting from the performance of the contract, provided that any such claim, damage, loss or expense (a) is attributable to bodily injury, sickness, disease or death, or to injury to or destruction of tangible property (other than goods, materials and equipment furnished under this contract) including the loss of use resulting there from, and (b) is caused in whole or in part by any negligent act or omission of the contractor, any' subcontractor, or anyone directly employed by any of them or anyone for whole acts any of them may be liable, regardless of whether or not it,is caused in part by a party indemnified hereunder. In any and all claims against the City or any of its officers or employees by any employee of the contractor, any subcontractor; anyone directly or indirectly employed by any ofthem or anyone for whose acts any of them may be liable, the indemnification obligation under this paragraph G. 1 shall not be limited in any way by any limitation ofthe amount or type of damages, compensation or benefits payable by or for the contractor or any sub -contractor under worker's or workmen's compensation acts, disability benefit acts or other employee benefit acts. COMPENSATION INSURANCE For contracts involving performance of work pursuant to the provisions of Indiana Code IC 22- 3-2-14 (a) bidders are required to furnish a certificate from the Indiana Worker's Board showing that such bidder has complied with IC 22-3-2-5, 22-3-5-1 and IC 22-3-5-2. The Contractor shall, as prerequisite to this Agreement, purchase and thereafter maintain such insurance as will protect him from the claims set forth below which may arise out of or result from the Contractor's operations under this Agreement, whether such operations by the Contractor or by any Sub -contractors or by anyone who directly or indirectly employed by any of them, or by anyone for whose acts any of them may be liable. Coverage Limits Worker's Compensation & Statutory Disability Requirements Employer's Liability $100,000 Comprehensive General Liability Section 1. Bodily Injury $1,000,000 each occurrence $2,000,000 aggregate Section 2. Property Damage $1,000,000 each occurrence F.3.1 (con't) D. Comprehensive Auto Liability Section 1. Bodily Injury $1,000,006 each person $1,000,000 each occurrence Section 2. Property Damage $1,000,000 each occurrence E. Comprehensive Umbrella Liability $1,000,00.0 each occurrence $2,000,000 each aggregate F. Malpractice/Errors & Omissions $I,000,000 per claim Insurance $2,000,000 each aggregate ARTICLE G INSTRUCTIONS TO BIDDERS GENERAL CONDITIONS OF THE CONTRACT PAYMENI S G. I.1 The City is not subject to federal excise taxes. Federal Tax Exemption Registry Number is 35- 6001174. G. 1.2 The City is not subject to the Indiana sales and use taxes on the purchase of goods and other materials. Where the contract includes the combination of labor and material, the contractor shall pay the Indiana sales and use taxes on the materials only. METHOD F INVOICING FOR PAYMENT G. 2.1 No contract will be official for services or materials unless a purchase order has been issued. G. 2.2 Contractor shall bill the City: (a) on regular invoice form giving a complete and detailed description ofthe goods delivered, including purchase order number; and (b) if the contractor allows a cash discount, the period of time in which the City must make payment to gtialify for discounts shall be computed from the date the City received the invoice (completely filled out), or the date the goods are delivered and accepted, whichever may be later, and shall be for not less than thirty (30) days and (c) if more than one shipment is made under the contract, the City will make partial payments on a basis that is agreeable to both parties. G. 2.3 Payments under this contract will be made in the manner provided by law for payments of claims against the City. G. 2.4 No payment will be made for production overruns in excess of the quantity ordered by the City (unless with prior written approval). G. 2.5 No payment shall constitute an acceptance of any goods or services not in accordance with the requirements of the contract. G. 2.6 Schedule of values may be used in contractual work. City will so designate if applicable. (See Invitation for Bid Page) NIAGES FOR DELAYED DELIVERY AND/OR CONTRACTUAL SERVICES G. 3.1 In the event delivery of completed item or items bid and/or unaccomplished contractual completion date is delayed beyond bidder's specified date, the City of Richmond will assess certain damages of /day. Certain damages will apply in all cases except the following: In the event delivery and/or completion of contract shall be necessarily delayed because of strike, injunction, government controls, or by reason of any other cause of circumstances beyond the control of the contractor, the time of completion of delivery shall be extended by a number of days to be determined in each instance by mutual agreement between the City of Richmond and the contractor. Should there be damages assessed, the City will have the right to deduct the damages from the payment to be made to contractor. - MAN INVESTMENT ACTIVITIES Pursuant to Indiana Code (IC) 5-22-16.5, Contractor certifies that Contractor is not engaged in investment activities in Iran. In the event City determines during the course of this Agreement that this certification is no longer valid, City shall notify Contractor in writing of said determination and shall give contractor ninety (90) days within which to respond to the written notice. In the event Contractor fails to demonstrate to the City that the Contractor has ceased investment activities in Iran within ninety (90) days after the written notice is given to the Contractor, the City may proceed with any remedies it may have pursuant to IC 5-22- 16.5. In the event the City determines during the course of this Agreement that this certification is no longer valid and said determination is not refuted by Contractor in the manner set. forth in IC 5-22-16.5, the City reserves the right to consider the Contractor to be in breach of this Agreement and terminate the agreement upon the expiration of the ninety (90) day period set forth above. E-Verify 1Vcicwmc Uscr ID losl Loaln Employment Eligibility Verification Pauline Mayes PAiAY1064 12:30 Pl1- M,'0411014 Log Out Click any 0 for help Home Company Information r,.y Cnscs New Case Company Name: Chemtrade View Cases Search Cases Company ID Number: 759558 My Profile Doing Business As (DBA) Edit Profile Name: Change Password DUNS Number: Change Security Ouesfions My Company Physical Location: Mailing Address: Edit Company Profile Address 1: 90 E. Halsey Rd Address 1: Add New User Address 2: Address 2: View Existing Users City: Parsippany City: Close Company Account State: NJ State: My Reports Zip Code: 07054 Zip Code: View Reports County: MORRIS My ReSOUrces View Essential Resources Additional Information: Take Tutorial Employer Identification Number:930384442 View User Manual Total Number of Employees: 50010999 Share Ideas Parent Organization: Contact Us Administrator: Organization Designation: Employer Category: None of these categories apply NAICS Code: 325 - CHEMICAL MANUFACTURING Total Hiring Sites: 37 Total Points of Contact: 1 Viemi fvlOU U.S. Department of Homeland Security - wvrw.dhs.gov U.S. Citizenship and Immigralion Services - vnvw.uscis.gov View 1 Edit View /Edit View /Edit View! Edit Accessibility Download Viewers https://e-verify.uscis.gov/emp/EmployerWizard.aspx 3/4/2014 Water Chemicals Group 90 East Halsey Road Parsippany, NJ 07054 Tel: 973-515-0900 Fax: 973-5154461 ORDER CONTACT, EMERGENCY CONTACT AND TECHNICAL SERVICE INFORMATION Normal operating business hours are Monday — Friday 8:00 AM to 5:00 PM E.S.T. To place orders, contact your Customer Service Representative: Sylvie Bonin Ph: 1-800-571-1138 E-mail: cssorders@chemtradelogistics.com After normal business hours, for emergencies and orders please call 1-514-513-7401 and the on -call Customer Service Representative will be available to assist you. This number will also be provided if you call the regular Customer Service line. For Technical Service please call (315) 478-2323 or visit our website at: http://www.chemtradelogisties.com Corporate/Sales Office Chemtrade Chemicals US, LLC 90 East Halsey Road Parsippany, NJ 07054 Lisa Brownlee, Business Mgr Ph: (973) 515-1840 Email: LBrownlee(a,chemtradelogistics. com For Bid/Contract Information: Elizabeth Ryno Ph: (800) 441-2659 OR (973) 515-1858 Fax: (973) 515-4461 BRyno@chemtradelogistics.com Bidsga,chemtradelogistics.com Keith Buckey, Sales Rep Mobile: (419) 908 - 0005 Email: KBuckUgehemtradelogi stics. com DELEGATION OF AUTHORITY I, Mark Davis, President and Chief Executive Officer of Chemtrade Chemicals US LLC, a Delaware limited liability company ("Chemtrade"), do hereby delegate and appoint the following agents of Chemtrade to execute all municipal contracts and instruments, including bids, proposals and quotations, which in the ordinary course of business are processed by the Marketing Group of the company: Parul Kachhia-Patel Lisa Brownlee Paul Peters Elizabeth Ryno Leilina Gossa Ann Hopler Rizlene Idrissi-Kaitouni Andrew Hoffman Michele Schroeher Set forth below is a certified copy of the resolution of Chemtrade authorizing such action. Dated as of the 9th day of September, 2015 :,. Mark Davis President and Chief Executive Officer CERTIFICATE OF SECRETARY I, Susan Pare, hereby certify that I am the Corporate Secretary of Chemtrade Chemicals US LLC ("Chemtrade") and that set forth below is a true and correct copy of the resolution of the Board of Managers of Chemtrade, adopted by unanimous written consent as of the I e day of November, 2003 and that the same has not been modified or revoked and is on the date hereof in full force and effect: RESOLVED that any officer of the Company be, and he hereby is, authorized to delegate, with the right of further delegation, to any other officer, employee or agent of the Company, all or any part of the authority granted to them by the Board of Managers; and that any such delegations may be general or specific and subject to such limitations and restrictions as the delegating officer shall determine. I FURTHER CERTIFY that Mark Davis is the duly elected President and Chief Executive Officer of Chemtrade and holds such offices on the date hereof, that Mr. Davis, in his capacity as President and Chief Executive Officer is authorized to represent and bind Chemtrade in all matters including, but not limited to, contracts and that set forth below is the genuine signature of such officer:.: Mark Davis President and Chief Executive Officer IN WITNESS WHEREOF, I have hereunto set my hand and have caused the seal of the Company to be affixed effective this 9th day of September, 2015. Seal Susan Pare Corporate Secretary 90 East Halsey Road Parsippany. NJ 07054 Tel: 800-441-2659 WATER TREATMENT GROUP cHEMrRAaE LIQUID ALUMINUM SULFATE 90 EAST HALSEY ROAD, PARSIPPANY, NJ 07054 TEL: (973) 515-0500 FAX: (973) 515-4461 Chemtrade Chemicals certifies that all grades of Aluminum Sulfate as produced by our manufacturing locations will meets National Sanitation Foundation Standard 60 and ANSI/AWWA B 403-09 standard in every respect. Material Safety Data Sheet, NSF Certification and related technical information is attached for review. Elizabelh Ryno Marketing Specialist WATER CHEMICALS ANALYTICAL SERVICES REPORT OF ANALYSIS To: RICHMOND, IN -BID Req. Date: cc: Beth Ryno Lab. Log # SAMPLES: Liquid Alum, Standard (hydrate) - 2015 Semi -Annual Audit Lot# MD5091002 ORIGIN: Middletown All analyses are reported as PPM unless stated otherwise PARAMETER Concentration PARAMETER As <2 % A1203 (total by wt) Ba <1 % A1203 (free by wt) Be <1 % Insolubles (by wt) Ca 39 % Fe203 (total soluble by wt) Cd <1 Co <1 Turbidity (NTU) Cr <1 Cu <1 Appearance Fe 10 Hg <0.5 K 3 Mg 11 Mn <1 Mo <1 Na 189 Ni <1 P <1 Pb <1.5 Sb <1.5 Se <2 Si <1 Sn <1 Sr <1 Ti <1 TI <1.5 V <1 Zn 6 Zr <1 9/14/2015 5091401 Concentration 8.1 0.05 0,005 0.001 4.2 Clear / Slight Tint NOTES: Product within specification for all parameters analyzed. Analysts Record Report Date Stephanie Ulman TCESL06/102 12/8/2015 Andrew Carr 091715-0921 BY - 2/17/2016 Chemtrade Chemicals is not engaged In the business of consulting or providing technical, operational or safety advice for a fee. Any such advice provided herein has been furnished as an accommodation and without charge and is made without any warranty of representation as to its completeness, accuracy, fitness for a particular purpose or any other matter. The recipient's use or non-use of such advice is made solely at the discretion and risk of the recipient. 2/17/2016; 5091401 Middletown CHEMTRADE hitp://www.ch.emtradelogistiescom Liquid Alum PRODUCT DATA SHEET CHARACTERISTICS Liquid Alum is a clear, light green, slight yellow, brown, amber or orange -like tinted solution. It is a cationic inorganic coagulant and flocculant suitable for industrial and municipal water and wastewater treatment applications. NSF/ANSI Standard 60: Drinking Water Chemicals - Health Effects; Certified TYPICAL PROPERTIES Formula: Aqueous solution of aluminum sulfate C.A.S. 10043-01-3 (Aluminum sulfate) pH (neat) 1.4 - 2.6 Specific Gravity @ 210C (70°F) 1.30 - 1.35 Freezing Point -16°C (4°F) Density, lbs./gal., US 10.8 - 11.3 Aluminum as All, % 4.2 - 4.5 Aluminum as A1203, % 8.0 - 8.4 Aluminum as AI2(SO4)3•14H2O (Dry Alum), % 46 - 49 PRODUCT USES Municipal and industrial water and wastewater treatment for the removal of turbidity, color, suspended solids and phosphorus. Sludge compaction and volume reduction. Lagoon treatment. Oily wastewater clarification and dissolved air flotation. Emulsion breaking. Fixing rosin sizes on paper fibers. Paper machine drainage and retention aid. Paper machine pitch control. SHIPPING CONTAINERS Bulk transport Bulk car 275 US gal. one way container 55 US gal, plastic drum SHIPPING REGULATIONS (US DOT / TDG) Proper Shipping Name: Corrosive Liquid, Acidic, Inorganic, N.O.S. (Contains Aluminum Sulfate) Hazard Class: 8 ID Number: UN3264 Packing Group: Ili The US EPA reportable quantity (RQ) for aluminum sulfate is 5,000 lbs. PRODUCT SAFETY INFORMATION Causes serious eye damage. Do not breathe vapors, mist or spray. Wash hands, forearms, and other exposed areas thoroughly after handling. Wear eye protection, protective clothing, and protective gloves. Anyone procuring, using or disposing of these products or their containers must be familiar with the appropriate safety and handling precautions. Such information may be found in the Safety Data Sheets (SDS) for these products or you may contact Chemtrade at 416-496-5856. In the event of an emergency with these products, call the 24 hour Emergency Number: USA (CHEMTREC) 800-424-9300 or Canada (CANUTEC) 613-996-6666. For additional information contact: Syracuse Technical Center 315-478-2323 or 800-255-7589 CHE-5001 P-1 Water Treatment Chemicals Customer Service 844-204-9675 Revision Date: October 27, 2015 All information, statements, data, advice and/or recommendations, Including, without limitation, those relating to storage, loadinglunloading. piping and transportation (collectively referred to herein as 'infomationj are believed to be accurate and reliable. However, no representation or warranty, express or implied, is made as to Its completeness, accuracy, fitness for a particular purpose or any other matter, including, without limitation, that the practice or application of any such information is free of palert infringement or other Intellectual property misappropriation. Chemtrade Logistics Inc and its affiliates (collectively, "Chemtrade) are not engaged in the business of providing technical, operational, engineering or safety information for a fee, and, therefore, any such Information provided herein has been fumished as an accommodation and without charge. All information provided herein is intended for use by persons having requisite knowledge, skill and experience in the chemical industry. Chemtrade shall not be responsible or liable for the use, application or implementation of the informallon provided herein, and all such information is to be used at the risk and in the sole judgment and discretion, of such persons, their employees, advisors and agents. ,- Liquid Alum CHEM TRADE Safety Data Sheet According to Federal Register/ Vol. 77, No. 58/ Monday, March 26, 2012 / Rules and Regulations \\ Revision Date:10/22/15 Date of Issue: 05/01/15 Version: 1.2 Product Identifier Product Form: Mixture Product Name: Liquid Alum Formula: AI2(SO4)3*14 H2O (Dry Equivalent) Intended Use of the Product Alum is used as a coagulating agent in municipal and industrial water and wastewater treatment and as an additive in papermaking. Name, Address, and Telephone of the Responsible Party Manufacturer CHEMTRADE LOGISTICS INC. 155 Gordon Baker Road Suite 300 Toronto, Ontario M21-1 3N5 For SDS Info: (416) 496-5856 www.chemtradelogistics.com Emergency Telephone Number Emergency Number Canada: CANUTEC +1-613-996-6666 / US: CHEMTREC+1-800-424-9300 Chemtrade Emergency Contact: (866) 416-4404 For Chemical Emergency, Spill, Leak, Fire, Exposure, or Accident, call CHEMTREC — Day or Night ,SECTIONIDENTIFICATION Classification of the Substance or Mixture Classification (GHS-US) Met. Corr. 1 H290 Skin Corr. 1A H314 Eye Dam. 1 H318 Aquatic Acute 3 H402 Full text of H-phrases: see section 16 Label Elements GHS-US Labeling Hazard Pictograms (GHS-US) Signal Word (GHS-US) Hazard Statements (GHS-US) GHsos Danger H290 - May be corrosive to metals H314 - Causes severe skin burns and eye damage H318 - Causes serious eye damage H402 - Harmful to aquatic life Precautionary Statements (GHS-US) : P234 - Keep only in original container. P260 - Do not breathe vapors, mist, or spray. P264 - Wash hands, forearms, and other exposed areas thoroughly after handling. P273 - Avoid release to the environment. P280 - Wear eye protection, protective clothing, protective gloves. P301+P330+P331- If swallowed: rinse mouth. Do NOT induce vomiting. P303+P361+P353 - If on skin (or hair): Take off immediately all contaminated clothing. Rinse skin with water/shower. P304+P340 - IF INHALED: Remove person to fresh air and keep at rest in a position comfortable for breathing. 13305+13351+13338 - IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to do. Continue rinsing. Revision Date:10/22/15 EN (English US) SDS#: CHE-50015 1/7 Liquid Alum Safety Data Sheet According to Federal Register / Vol. 77, No. 58 / Monday, March 26, 2012 / Rules and Regulations P310 - Immediately call a doctor. P321- Specific treatment (see section 4 on this SDS). P363 - Wash contaminated clothing before reuse. P390 - Absorb spillage to prevent material damage. P405 - Store locked up. P406 - Store in corrosive resistant container with a resistant inner liner. P501- Dispose of contents/container in accordance with local, regional, national, and international regulations. Other Hazards Other Hazards Not Contributing to the Classification: Exposure may aggravate those with pre-existing eye, skin, or respiratory conditions. Unknown Acute Toxicity (GHS-US) Not available SECTION 3: COMPOSITION/INFORMATIO-N ON INGREDIENTS Name Product identifier % (w/w) Classification (GHS-US) Water (CAS No) 7732-18-5 30 - 60 Not classified Sulfuric acid, aluminum salt (3:2) (CAS No) 10043-01-3 30 - 60 Met. Corr. 1, H290 Eye Dam. 1, H318 Aquatic Acute 3, H402 *As AI2(SO4)3.14 H2O (Dry Aluminum Sulfate). The specific chemical identity and/or exact percentage of composition have been withheld as a trade secret [29 CFR 1910.12001. A range of concentration as prescribed by the Controlled Products Regulations has been used where necessary, due to varying composition. Full text of H-phrases: see section 16 Description of First Aid Measures General: Never give anything by mouth to an unconscious person. If you feel unwell, seek medical advice (show the label if possible). Inhalation: Remove to fresh air and keep at rest in a position comfortable for breathing. Obtain medical attention if breathing difficulty persists. Skin Contact: Rinse immediately with plenty of water. Obtain medical attention if irritation develops or persists. Eye Contact: Rinse cautiously with water for at least 15 minutes. Remove contact lenses, if present and easy to do. Continue rinsing. Obtain medical attention. Ingestion: Do NOT induce vomiting. Rinse mouth. Immediately call a POISON CENTER or doctor/physician. Most Important Symptoms and Effects Both Acute and Delayed General: Causes severe skin burns and eye damage. Inhalation: May cause respiratory irritation. Skin Contact: Redness. Pain. Serious skin burns. Blisters. Eye Contact: Redness. Pain. Blurred vision. Severe burns. Causes permanent damage to the cornea, iris, or conjunctiva. Ingestion: Ingestion is likely to be harmful or have adverse effects. Chronic Symptoms: None expected under normal conditions of use. Indication of Any Immediate Medical Attention and Special Treatment Needed If you feel unwell, seek medical advice (show the label where possible). iSECTION Extinguishing Media Suitable Extinguishing Media: Use extinguishing media appropriate for surrounding fire. Unsuitable Extinguishing Media: Do not use a heavy water stream. Use of heavy stream of water may spread fire. Special Hazards Arising From the Substance or Mixture Fire Hazard: Not considered flammable but may burn at high temperatures. Explosion Hazard: Product is not explosive. Reactivity: Hazardous reactions will not occur under normal conditions. Liquid alum may react with some metals, to give flammable, potentially explosive hydrogen gas. Hydrogen gas can accumulate to explosive concentrations inside confined spaces. Revision Date:10/22/15 EN (English US) SDS#: CHE-50015 2/7 Liquid Alum Safety Data Sheet According to Federal Register / Vol. 77, No. 58 / Monday, March 26, 2012 / Rules and Regulations Advice for Firefighters Precautionary Measures Fire: Not available Firefighting Instructions: Use water spray or fog for cooling exposed containers. In case of major fire and large quantities: Evacuate area. Fight fire remotely due to the risk of explosion. Protection During Firefighting: Do not enter fire area without proper protective equipment, including respiratory protection. Hazardous Combustion Products: Forms aluminum oxide, sulfur dioxide and/or sulfur trioxide at temperatures above 760°C (1400°F) or when dry alum is encompassed in a fire involving other burning materials. Other Information: Refer to Section 9 for flammability properties. Reference to Other Sections Refer to section 9 for flammability properties. Personal Precautions, Protective Equipment and Emergency Procedures General Measures: Avoid all contact with skin, eyes, or clothing. Avoid breathing (dust, vapor, mist, gas). For Non -Emergency Personnel Protective Equipment: Use appropriate personal protection equipment (PPE). Emergency Procedures: Evacuate unnecessary personnel. For Emergency Personnel Protective Equipment: Equip cleanup crew with proper protection. Emergency Procedures: Stop leak if safe to do so. Eliminate ignition sources. Ventilate area. Environmental Precautions Prevent entry to sewers and public waters. Notify authorities if liquid enters sewers or public waters. Methods and Material for Containment and Cleaning Up For Containment: Contain any spills with dikes or absorbents to prevent migration and entry into sewers or streams. Methods for Cleaning Up: Collect spillage. Dispose in a safe manner in accordance with local/national regulations. Reference to Other Sections See Heading 8. Exposure controls and personal protection. •N 7: HANDLING AND STORA Precautions for Safe Handling Hygiene Measures: Handle in accordance with good industrial hygiene and safety procedures. Wash hands and other exposed areas with mild soap and water before eating, drinking or smoking and when leaving work. Use good housekeeping practices during storage, transfer, handling, to avoid excessive dust accumulation. Protect from moisture. Conditions for Safe Storage, Including Any Incompatibilities Technical Measures: Comply with applicable regulations. Storage Conditions: Store in a dry, cool and well -ventilated place. Keep container closed when not in use. Keep/Store away from direct sunlight, extremely high or low temperatures and incompatible materials. Incompatible Materials: Strong bases. Special Rules on Packaging: Store in original container or corrosive resistant and/or lined container. Specific End Use(s) For professional use only. Control Parameters For substances listed in section 3 that are not listed here, there are no established Exposure limits from the manufacturer, supplier, importer, or the appropriate advisory agency including: ACGIH (TLV), NIOSH (REL), OSHA (PEL), Canadian provincial governments, or the Mexican government. Exposure Controls Appropriate Engineering Controls: Ensure adequate ventilation, especially in confined areas. Emergency eye wash fountains and safety showers should be available in the immediate vicinity of any potential exposure. Ensure all national/local regulations are observed. Personal Protective Equipment: Protective goggles. Gloves. Protective clothing. Materials for Protective Clothing: Chemically resistant materials and fabrics. Hand Protection: Wear chemically resistant protective gloves. Revision Date:10/22/15 EN (English US) SDS#: CHE-5001S 3/7 Liquid Alum Safety Data Sheet According to Federal Register / Vol. 77, No. 58 / Monday, March 26, 2012 / Rules and Regulations Eye Protection: Chemical goggles or safety glasses. Skin and Body Protection: Wear suitable protective clothing. Respiratory Protection: Use NIOSH-approved dust mask if dust has the potential to become airborne. Environmental Exposure Controls: Do not allow the product to be released into the environment. Consumer Exposure Controls: Do not eat, drink or smoke during use Information on Basic Physical and Chemical Properties Physical State . Liquid Appearance Odor Odor Threshold pH Melting Point Freezing Point Boiling Point Flash Point Auto -ignition Temperature Decomposition Temperature Flammability (solid, gas) Lower Flammable Limit Upper Flammable Limit Vapor Pressure Relative Vapor Density at 20 °C Relative Density Specific Gravity Solubility Partition Coefficient: N-Octanol/Water Clear, light green, slight yellow, brow, amber, or orange like tint Odorless Not available 1.4 - 2.6 Not applicable -15.56 °C (4'F) 101 °C (213.80 °F) Not flammable Not available Not available Not applicable Not available Not available Not available Not available Not available 1.30-1.35 Water: Completely miscible in water. Not available Viscosity . Not available Explosion Data — Sensitivity to Mechanical Impact Not expected to present an explosion hazard due to mechanical impact. Explosion Data — Sensitivity to Static Discharge Not expected to present an explosion hazard due to static discharge. �SECTION Reactivity: Hazardous reactions will not occur under normal conditions. Liquid alum may react with some metals, to give flammable, potentially explosive hydrogen gas. Hydrogen gas can accumulate to explosive concentrations inside confined spaces. Chemical Stability: Stable under recommended handling and storage conditions (see section 7). Possibility of Hazardous Reactions: Hazardous polymerization will not occur. Conditions to Avoid: Direct sunlight. Extremely high or low temperatures. Ignition sources. Incompatible materials. Moisture. Incompatible Materials: Strong bases. Metals. Hazardous Decomposition Products: Oxides of aluminum. The decomposition products are corrosive and hazardous to health. SECTION• • • •• • Information on Toxicological Effects - Product Acute Toxicity: Not classified LD50 and LC50 Data: Not available Skin Corrosion/Irritation: Causes severe skin burns and eye damage. pH:1.5 - 2.5 Serious Eye Damage/Irritation: Causes serious eye damage. pH:1.5 - 2.5 Respiratory or Skin Sensitization: Not classified Germ Cell Mutagenicity: Not classified Teratogenicity: Not available Revision Date:10/22/15 EN (English US) SDS#: CHE-5001S 4/7 Liquid Alum Safety Data Sheet According to Federal Register/ Vol. 77, No. 58 / Monday, March 26, 2012 / Rules and Regulations Carcinogenicity: Not classified Specific Target Organ Toxicity (Repeated Exposure): Not classified Reproductive Toxicity: Not classified Specific Target Organ Toxicity (Single Exposure): Not classified Aspiration Hazard: Not classified Symptoms/Injuries After Inhalation: May cause respiratory irritation. Symptoms/Injuries After Skin Contact: Redness. Pain. Serious skin burns. Blisters. Symptoms/Injuries After Eye Contact: Redness. Pain. Blurred vision. Severe burns. Causes permanent damage to the cornea, iris, or conjunctiva. Symptoms/Injuries After Ingestion: Ingestion is likely to be harmful or have adverse effects. Chronic Symptoms: None expected under normal conditions of use. Information on Toxicological Effects - Ingredient(s) LD50 and LC50 Data: Water (7732-19-5) LD50 Oral Rat > 90000 mg/kg SECTION 12: ECOLOGICAL INFORMATION Toxicity Not classified Persistence and Degradability Not available Bioaccumulative Potential Not available Mobility in Soil Not available Other Adverse Effects Other Information, Avoid release to the environment. SECTION' •CONSIDERATIONS Waste Disposal Recommendations: Dispose of waste material in accordance with all local, regional, national, and international regulations. Ecoloev — Waste Materials: Avoid release to the environment. 14.1 In Accordance with DOT Proper Shipping Name CORROSIVE LIQUID, ACIDIC, INORGANIC, N.O.S. (CONTAINS ALUMINUM SULFATE) Hazard Class S Identification Number UN3264I'll 4011-1 Label Codes 8 Packing Group III ERG Number 154 14.2 In Accordance with IMDG Proper Shipping Name : CORROSIVE LIQUID, ACIDIC, INORGANIC, N.O.S. (CONTAINS ALUMINUM SULFATE) Hazard Class 8 Identification Number UN3264 Packing Group III Label Codes 8 EmS-No. (Fire) F-A EmS-No. (Spillage) : S-B Revision Date: 10/22/15 EN (English US) SDS#: CHE-5001S 5/7 Liquid Alum Safety Data Sheet According to Federal Register / Vol. 77, No. 58 / Monday, March 26, 2012 / Rules and Regulations 24.3 In Accordance with IATA Proper Shipping Name Packing Group Identification Number Hazard Class Label Codes ERG Code (IATA) 14.4 In Accordance with TDG Proper Shipping Name Packing Group Hazard Class Identification Number Label Codes US Federal Regulations CORROSIVE LIQUID, ACIDIC, INORGANIC, N.O.S. (CONTAINS ALUMINUM SULFATE) III UN3264, 8 8 , 8L CORROSIVE LIQUID, ACIDIC, INORGANIC, N.O.S. (CONTAINS ALUMINUM SULFATE) III 8 UN3264 8 Liquid Alum Clean Water Act Ingredient Name Reportable Quantities Aluminum sulfate (10043-01-3) 5000 lb (2270 kg) Liquid Alum SARA Section 311/312 Hazard Classes Immediate (acute) health hazard Water (7732-18-5) Listed on the United States TSCA (Toxic Substances Control Act) inventory Sulfuric acid, aluminum salt (3:2) (10043-01-3) Listed on the United States TSCA (Toxic Substances Control Act) inventory US State Regulations Liquid Alum Sulfuric acid, aluminum salt (3:2) (10043-01-3) U.S. - Massachusetts - Right To Know List U.S. - New Jersey - Right to Know Hazardous Substance List U.S. - Pennsylvania - RTK (Right to Know) - Environmental Hazard List U.S. - Pennsylvania - RTK (Right to Know) List Canadian Regulations Liquid Alum WHMIS Classification Class D Division 2 Subdivision B - Toxic material causing other toxic effects Class E - Corrosive Material T.T Ott \\ h Water (7732-18-5) Listed on the Canadian DSL (Domestic Substances List) WHMIS Classification I Uncontrolled product according to WHMIS classification criteria Sulfuric acid, aluminum salt (3:2) (10043-01-3) Listed on the Canadian DSL (Domestic Substances List) Revision Date: 10/22/15 EN (English US) SDS#: CHE-5001S by Liquid Alum Safety Data Sheet According to Federal Register / Vol. 77, No. 58 / Monday, March 26, 2012 / Rules and Regulations WHMIS Classification Class E - Corrosive Material This product has been classified in accordance with the hazard criteria of the Controlled Products Regulations (CPR) and the SDS contains all of the information required by CPR. SECTION 16: OTHER INFORMATION, INCLUDING DATE OF PREPARATION OR LAST REVISION Revision Date 10/22/15 Revision Summary Sections 9 and 16 Other Information This document has been prepared in accordance with the SDS requirements of the OSHA Hazard Communication Standard 29 CFR 1910.1200. GHS Full Text Phrases: Aquatic Acute 3 Hazardous to the aquatic environment - Acute Hazard Category 3 Eye Dam. 1 Serious eye damage/eye irritation Category 1 Met. Corr. 1 Corrosive to metals Category 1 Skin Corr. 1A Skin corrosion/irritation Category 1A H290 May be corrosive to metals H314 Causes severe skin burns and eye damage H318 Causes serious eye damage H402 Harmful to aquatic life Party Responsible for the Preparation of This Document CHEMTRADE LOGISTICS, INC. For SDS Info: (416) 496-5856 Handle product with due care and avoid unnecessary contact. This information is supplied under U.S. OSHA'S "Right to Know" (29 CFR 1910.1200) and Canada's WHMIS regulations. Although certain hazards are described herein, we cannot guarantee these are the only hazards that exist. The information contained herein is based on data available to us and is believed to be true and accurate but it is not offered as a product specification. No warranty, expressed or implied, regarding the accuracy of this data, the hazards connected with the use of the product, or the results to be obtained from the use thereof, is made and Chemtrade and its affiliates assume no responsibility. Chemtrade is a member of the CIAC (Chemistry Industry Association of Canada) and adheres to the codes and principles of Responsible Care"' Responsible Care' +Gestion responsable" o..«..�.«�ts.tidAw6www Wr 1Atln+N,&Ak. Chemtrade North America SDSTemplate Revision Date:10/22/15 EN (English US) SDS#: CHE-5001S 7/7 Lipting Category Search Page f NSF International Page 1 of 4 NSF The Public Health and Safety Organization NSF Product and Service Listings These NSF Official Listings are current as of Wednesday, February 17, 2016 at 12:15 a.m. Eastern Time. Please contact NSF International to confirm the status of any Listing, report errors, or make suggestions. Alert: NSF is concerned about fraudulent downloading and manipulation of website text. Always confum this information by clicking on the below link for the most accurate information: http://info.nsforg/Certified/PwsChemicals/Listings.asp? CompanyName=CHEMTRADE&P1antState=Ohio+OH&PlantCountry=UNITED+STATES& NSF/ANSI 6o Drinking Water Treatment Chemicals - Health Effects Chemtrade Solutions LLC (formerly General Chemical LLC) 1421 Willis Avenue Syracuse, NY 13204 United States 315-478-2323 Visit this company's website ffi=://www.chemtradelogisties.com/main/) Facility: Middletown, OH Aluminum SulfateMl Trade Designation Product Function Max Use Alum Coagulation & Flocculation 400 mg/L Aluminum Sulfate Coagulation & Flocculation 400 mg/L Clar+Ion® Al Coagulation & Flocculation 400 mg/L Clar+Ion® Aio Coagulation & Flocculation 400 mg/L Clar+Ion® A15 Coagulation & Flocculation 263 mg/L Clar+Ion® Ago Coagulation & Flocculation 208 mg/L Clar+Ion® A3 Coagulation & Flocculation 400 mg/L Clar+Ion® A5 Coagulation & Flocculation 400 mg/L Clar+Ion® A7 Coagulation & Flocculation 400 mg/L Gen+Pas® 701 Coagulation & Flocculation 400 mg/L Gen+Pas® 703 Coagulation & Flocculation 400 mg/L Gen+Pas® 705 Coagulation & Flocculation 400 mg/L Gen+Pas® 707 Coagulation & Flocculation 400 mg/L Gen+Pas® 710 Coagulation & Flocculation 400 mg/L http: //info.nsf. org/Certified/PwsChemicals/Listings.asp?CompanyName=CHEMTRADE&... 2/ 17/2016 Li4ting Category Search Page I NSF International Page 2 of 4 Gen+Pas® 715 Gen+Pas® 720 Liquid Alum Liquid Alum Acidized 0.5-10.0% Coagulation & Flocculation Coagulation & Flocculation Coagulation & Flocculation Coagulation & Flocculation 263 mg/L 208 mg/L 400mg/L 400 mg/L [AL] Based on an evaluation of health effects data, the level of aluminum in the finished drinking water shall not exceed 2 mg/L. Ferric Sulfate Trade Designation Product Function Max Use Ferric Sulfate Solution Coagulation & Flocculation 600mg/L Liquid Ferric Sulfate Coagulation & Flocculation 600mg/L Polymer Blends[ALI [I'Y] Trade Designation Product Function Max Use Clar+Ion® 4050 Coagulation & Flocculation 40omg/L Clar+Ion® 5055 Coagulation & Flocculation 40omg/L Clar+Ion® 5100 Coagulation & Flocculation 200 mg/L Clar+Ion® A402.51' Coagulation & Flocculation 40omg/L Clar+Ion® A405P Coagulation & Flocculation 400 mg/L Clar+Ion® A41oP Coagulation & Flocculation 250 mg/L Clar+Ion® A415P Coagulation & Flocculation 167 mg/L Clar+Ion® A420P Coagulation & Flocculation 125 mg/L Clar+Ion® A501.51? Coagulation & Flocculation 40omg/L Clar+Ion® A502.5P Coagulation & Flocculation 400mg/L Clar+Ion® A505P Coagulation & Flocculation 40omg/L Clar+Ion® A510P Coagulation & Flocculation 20omg/L Clar+Ion® A515P Coagulation & Flocculation 133mg/L Clar+Ion® A520P Coagulation & Flocculation loomg/L Fer+Ion® 202.5 Coagulation & Flocculation 25omg/L Fer+Ion® 205 Coagulation & Flocculation 25omg/L Fer+Ion® 210 Coagulation & Flocculation 250mg/L Fer+Ion® 302.5 Coagulation & Flocculation 25omg/L Fer+Ion® 305 Coagulation & Flocculation 25omg/L Gen+Pas®1.5B Coagulation & Flocculation 40omg/L Gen+Pas® 1oloB Coagulation & Flocculation 200 mg/L Gen+Pas® lo5A Coagulation & Flocculation 400 mg/L Gen+Pas® loA Coagulation & Flocculation 250 mg/L Gen+Pas®1oB Coagulation & Flocculation 2oomg/L Gen+Pas®15A Coagulation & Flocculation 167 mg/L Gen+Pas®15B Coagulation & Flocculation 133mg/L Gen+Pas® 2.5A Coagulation & Flocculation 400 mg/L Gen+Pas® 2.5B Coagulation & Flocculation 40omg/L Gen+Pas® 2oA Coagulation & Flocculation 125 mg/L Gen+Pas® 2oB Coagulation & Flocculation ioomg/L Gen+Pas® 55B Coagulation & Flocculation 40omg/L Gen+Pas® 5A Coagulation & Flocculation 400 mg/L Gen+Pas® 5B Coagulation & Flocculation 40omg/L http://info.nsf.org/CertifiedIPwsChemicals/Listings.asp?CompanyName=CHEMTRADE&... 2/ 17/2016 Listing Category Search Page I NSF International Page 3 of 4 [AL] Based on an evaluation of health effects data, the level of aluminum in the finished drinking water shall not exceed 2 mg/L. [PY] Polyamines Certified by NSF International comply with 40 CFR 141.111 requirements for percent monomer and dose. Facility: Toledo, OH Aluminum Sulfate[ALI Trade Designation Alum Aluminum Sulfate CIar+Ion® A5 Gen+Pas® 705 Liquid Alum Liquid Alum, Acidized 0.5-5.0 ProductFunction Max Use Coagulation & Flocculation 40omg/L Coagulation & Flocculation 40omg/L Coagulation & Flocculation 40omg/L Coagulation & Flocculation 40omg/L Coagulation & Flocculation 40omg/L Coagulation & Flocculation 40omg/L [AL] Based on an evaluation of health effects data, the level of aluminum in the finished drinking water shall not exceed 2 mg/L. Blended Phosphates Trade Designation Product Function GenPhos logo Corrosion & Scale Control GenPhos 2575 Corrosion & Scale Control GenPhos 5050 Corrosion & Scale Control GenPhos 703o Corrosion & Scale Control Calcium Hydroxide Trade Designation Product Function Cal Flo Slurry Precipitation Agent pH Adjustment Poly (Diallyldimethylammonium Chloride)(pDADMAC) Trade Designation Product Function Clar+Ion® P846 Coagulation & Flocculation Polymer Blends Trade Designation Clar+Ion® A402.5P Clar+Ion® A405P Clar+Ion® A407.5P Clar+Ion® A4ioP CIar+Ion® A415P Clar+Ion® A420P Product Function Coagulation & Flocculation Coagulation & Flocculation Coagulation & Flocculation Coagulation &-Flocculation Coagulation & Flocculation Coagulation & Flocculation Max Use lomg/L iomg/L iomg/L iomg/L Max Use i000mg/L Max Use 5omg/L Max Use 400mg/L 400mg/L 333mg/L 25omg/L 167mg/L 125mg/L http://info.nsf.org/Certified/PwsChemicals/Listings.asp?CompanyName=CHEMTRADE&... 2/ 17/2016 Listing Category Search Page I NSF International Page 4 of 4 Clar+Ion® A502.5P Coagulation & Flocculation 40omg/L Clar+Ion® A503P Coagulation & Flocculation 40omg/L Clar+Ion® A5o5P Coagulation & Flocculation 40omg/L Clar+Ion® A5o6P Coagulation & Flocculation 333mg/L Clar+Ion® A5ioP Coagulation & Flocculation 2oomg/L Gen+Pas® ioA Coagulation & Flocculation 25omg/L Gen+Pas®1oB Coagulation & Flocculation 2oomg/L Gen+Pas®15A Coagulation & Flocculation 167mg/L Gen+Pas® 2.5A Coagulation & Flocculation 40omg/L Gen+Pas® 2oA Coagulation & Flocculation 125mg/L Gen+Pas® 5A Coagulation & Flocculation 40omg/L Gen+Pas® 5B Coagulation & Flocculation 40omg/L Gen+Pas® 7.5A Coagulation & Flocculation 333mg/L Number of matching Manufacturers is i Number of matching Products is 84 Processing time was o seconds http://info.nsf.org/CertifiediPwsChemicals/Listings.asp?CompanyName=CHEMTRADE&... 2/ 17/2016 'may CERTIFICATE OF LIABILITY INSURANCE DATE 5/1/2015Yrn 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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). PRODUCER CONTACT NAME: Gerald G. Stewart Marsh Canada Limited 161 Bay Street, Suite 1400 Toronto, Ontario PHONE 416 868 7351 o, Ext : FAX 416 868 7360 (A/C No EMAIL ADDRESS: GerTy.G.Stewart@marsh.com M512S4 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Allianz Global Risk US Insurance Company 35300 INSURED INSURER B: Liberty Mutual Insurance Company 23043 Chemtrade Chemicals US LLC Liberty Mutual Fire Insurance Company 23035 90 East Halsey Road INSURER C: INSURER D: Parsippany, NJ 07054 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: CGL-Auto-WC-2015-403 REVISION NUMBER: Renewal 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP (MMIDD/YYYY LIMITS A GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY ❑❑ CLAIMS -MADE ®OCCUR Retention $100,000 ner occur CGL2005766 5/1/2015 5/I/2016 EACH OCCURRENCE $5000000 DAMAGE TO RENTED PREMISES Es occurrence $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $ 1,000,000 0 GENERAL AGGREGATE $5000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $5000000 ® POLICY ❑ JEI° ❑ LOC B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY Perperson) $ ® ANY AUTO ALL OWNED SCHEDULED ❑ AUTOS ❑ AUTOS NON -OWNED ® HIRED AUTOS ® AUTOS ❑ ❑ ASl-B71-072790-065 (M AS1-B71-072790-055 (AOS) ASI-B71-072790-075(CA) 5/1/2015 5/1/2016 BODILY INJURY Per accident)$ PROPERTY DAMAGE Per accident $ $ ❑ DED ® RETENTION $100,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN All States except Wisconsin: ® WC STATU- TORY LIMITS ❑ OTH- ER E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE NO OFFICER/MEMBEREXCLUDED? (MANDATORY IN NH) NIA WA2-B7D-072790-085 Wisconsin: WCI-B71-072790-015 5/1/2015 5/1/2016 E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES ( Attach ACORD 101, Additional Remarks Schedule, if more space is required) The General Liability CGL2005766 policy was placed by Seabury & Smith, Inc. Marsh Canada Limited has only acted in the role of a consultant to the client with respect to these placements which are indicated here for your convenience. For supplying of Liquid Aluminum CERTIFICATE HOLDER CANGELLAUIUN Richmond Sanitary District 2380 Liberty Avenue Richmond, IN 47334 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ✓ti @ 1988-2010 ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD reserved. AGENCY CUSTOMER ID: LOC A Ar 41-lk r f^ AGENCY Marsh Canada Limited POLICY NUMBER See Page 1 NAL REMARKS SCHEDULE Page 1 Of 1 NAMED INSURED Chemtrade Chemicals US LLC 90 East Halsey Road Parsippany, NJ 07054 CODE See Page 1 See Page IF EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance WC policies effective 5/1/15 - 5/1/16 Deductible Policy — All States except Wisconsin: WA2-B7D-072790-085 Guaranteed Cost Policy —Wisconsin only: WC1-B71-072790-015 Blanket Waiver of our Right to Recover from others Endorsement — Not applicable in the state of New Jersey — where required by written contract. 101 (20081011 © 2008 ACORD CORPORATION. All rights The ACORD name and logo are registered marks of ACORD