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HomeMy Public PortalAbout027-2020 - Sanitation - Polydyne Inc. - Supplying Polymer for Rotary Drum ThickenerAGREEMENT THIS AGREEMENT is made and entered into this 2S day of2020, by and between the City of Richmond, Indiana, a municipal corporation acting by and through its Board of Sanitary Commissioners, 50 North 5" Street, Richmond, Indiana 47374 (hereinafter referred to as the "City") and Polydyne Inc., One Chemical Plant Rd. Riceboro, GA 31323 (hereinafter referred to as the "Contractor"). SECTION I. STATEMENT AND SUBJECT OF WORK City hereby retains Contractor for providing polymer for the rotary drum thickener for the Richmond Sanitary District (hereinafter referred to as the "District") in order to meet the needs of the District and the rotary drum thickener. City sent a Request for Quotes on January 17, 2020, seeking quotes for providing Polymer for the District to be used for the rotary drum thickener. The Request for Quotes is attached hereto and incorporated herein by reference as Exhibit "A". The response of Contractor, dated February 10, 2020, consisting of nineteen pages and is contained in Exhibit `B", which Exhibit `B" is attached hereto and incorporated herein by reference and made a part of this Agreement. Per the response of Contractor, Contractor shall provide Polymer (Neat) at a cost of $1.15 per pound and a cost of $2,645.00 per tote of 2300 pounds of Polymer. Should any provisions, terms, or conditions contained in any of the documents attached hereto as Exhibits, or in any of the documents incorporated by reference herein, conflict with any of the provisions, terms, or conditions of this Agreement, this Agreement shall be controlling. 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 signed by Contractor in accordance with Indiana Code 22-5-1.7-11(a)(2);and 3. A purchase order has been issued by the Purchasing Department. SECTION H. 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. SECTION III. COMPENSATION City shall pay Contractor a sum riot to exceed $1.15 per pound of Polymer (Neat) and a sum not to exceed $2,645.00 per tote of Polymer, with said tote consisting of 2,300 pounds. The price rate per pound of Polymer (Neat) and the cost per tote of Polymer on a 2,300 pound tote are set forth in Exhibit `B". Contract No. 27-2020 Page 1 of 6 SECTION IV. TERM OF AGREEMENT This Agreement shall become effective when signed by all the parties hereto and shall continue in effect- through and including December 31, 2020, with an option to renew, if exercised by City, for year 2021 at the same cost set forth in Exhibit `B" and an option to renew, if exercised by City, for year 2022 at the same cost set forth in Exhibit `B". 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 five (5) working 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. In the event of such termination, 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. This Agreement may also be terminated, in whole or in part, by mutual Agreement of the parties by setting forth the reasons for such termination, the effective date, and in the case of partial termination, the portion to be terminated. 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 Contractor or by anysub-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 Page 2 of 6 B. Employer's Liability $100,000 C. Comprehensive General Liability Section 1. Bodily Injury Section 2. Property Damage D. Comprehensive Auto Liability (if applicable) Section 1. Bodily Injury Section.2. Property Damage $1,000,000 each occurrence $2,000,000 aggregate $1,000,000 each occurrence $1,000,000 each person $1,000,000 each occurrence $1,000,000 each occurrence E. Comprehensive Umbrella Liability $1,000,000 each occurrence $2,000,000 each 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 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 VIII. IRAN INVESTMENT ACTIVITIES Page 3 of 6 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. 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; 3. 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. 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 Page 4of6- 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. 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. Any person executing this Contract in a representative capacity hereby warrants that he or she has authorization, in writing, by his or her principal to execute this Contract on behalf of the Contractor and that such authorization has not been revoked or rescinded. Page 5of6 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 By: ue Miller, President Aman Bakshi; ice=President By: M*ns,ember Date: alas-h-7paz APPROVED: F . Sno City of Richmo d, Indiana Date: 0 0 ZD "CONTRACTOR" POLYDYNE INC. By: Printed: Boyd Stanle Title: Vice -President Date: March 10, 2020 Page 6 of 6 EXhi" b" Proposal Sheet for Polymer Description Estimated 20,000 +/- pounds of neat polymer (lbs dry weight) Each vendor shall quote price per dry pound of neat polymer in liquid state delivered to the Wastewater Treatment Plant and transferred to the District's storage room in accordance with the attached Minimum Specifications. In addition to the quoted price per dry pound of neat polymer, Vendor is to state, based upon jar or onsite testing, estimated amount of neat polymer in pounds per dry ton of solids of quoted product required to meet the below minimum specifications. Also, include the percent of active polymer per pound of polymer. Neat pounds of polymer/dry ton of solids Percent active polymer/pound of polymer Each vendor shall attach the chemical analysis of their material to the 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 of product for RSD at no cost. Vendor may submit one (1) quart of chemical for testing purposes. Any load of 'bad' polymer that does not meet performance specifications will be reimbursed to RSD at no cost. Quote will be for the year of.2020 with two (2) 2021 and 2022, one (1).year options to renew. If emergencies occur with the 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 cost 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. pg. 1 of 4 Vendor is to state delivery time after receipt of order days. Authorized Signature Contact Person Company Name Date Phone Number pg. 2-of 4 Minimum Specification for Polymer Cationic flocculant capable of meeting the below solids thickening and capture rates with fourteen (14) pounds or less of neat Bidder Complies polymer/dry ton of solids within the specified Yes No r hydraulic and solids loading rates. Delivery shall be made by vehicles properly equipped to transfer polymer into the District's storage room without spillage. 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 7:30am to 1:30pm Monday through Friday with exceptions for. holidays. The District's orders will.be for approximately 500 gallons each. The District shall have the right to require a small sample from each load for laboratory purposes. pg. 3 of 4 Rotary Drum Thickener Performance Specifications Item Waste Activated Sludge Feed Solids Concentration (% Dry Weight Solids) Less than/equal to 1.0 Feed Solids Volatile Content (%) Less than/ equal to 85 Feed Solids pH 6.0-9.0 Hydraulic Capacity (GPM) 100-200 Minimum Thickened Sludge. Concentration (% Dry Weight Solids Capture (%) 5 Maximum Thickened Sludge Concentration (% Dry Weight Solids Capture (%) 7 Minimum Solids Capture (%) 95 Maximum Neat Polymer Usage (Ibs Dry Weight Polymer/Ton Dry Weight Sludge) 14 %=percent; GPM=gallons per minute; Ibs=pounds pg. 4 of 4 PRICE REQUEST R o �{ o s u a * �f l ypi If • CITY OF RICHMOND DEPARTMENT OF SANITATION 2380 LIBERTY AVENUE.RICHMOND, INDIANA 47374 PHONE (765) 983-7450.FAX (765) 962-2669 THIS IS NOT AN ORDER VENDOR I INSTRUCTIONS This is a request for a price for the services of materials described below. Any additional specifications may be Pold ne attached hereto. This is NOT an order and the City reserves y y the right to accept all or part, or decline the entire proposal. One Chemical Plant Road Please complete your full name and phone number below with signature; itemize all prices and charges where Riceboro, GA 31323 requested; and attach any explanation for any substitution to specifications altered. Return in a sealed envelope, in care of Richmond Sanitary District Board of Commissioners to the administration building at the address above by the specified date and time to be considered. DATE: REPLY S January 17, 2020 I 11 O:OOAM on February 11, 2020 I PAYMUPON RECEIPT OF INVOICE I DELIVERYDELIVEREDIVEREDRED: DESCRIPTION This is a request for quotes for purchasing polymer from 2020 through 2022. Please see attached specifications and bid sheets. Please include a Certificate of Insurance (including Workman's Compensation) with quote. E-Verify requirements and Indiana Local Preference Claims will apply to this quote, information enclosed. Please return this sheet and the proposal sheet by the above due date, in a sealed envelope to : Richmond Sanitary District Denise Johnson, Customer Service Manager 2380 Liberty Avenue Richmond, IN 47374 12/31/20 Re: Polymer Quoted Valid Until: Questions? Call Pat Smoker at 765-983-7480. STATE TAX EXEMPTION # 003121909-001 Richmond nitary District NAME OF FIRM QUOTING: Polydyne Inc. BY: Boyd Stan ey A HORRED BY SIGNATURE Vice -President 02/05/20 DATE (912)880-2035 PHONE NUMBER TITLE Proposal Sheet for Polymer Description Estimated 20,000 +/- pounds of neat polymer (lbs dry weight) Each vendor shall quote price per dry pound of neat polymer in liquid state delivered to the Wastewater Treatment Plant and transferred to the District's storage room in accordance with the attached Minimum Specifications. In addition to the quoted price per dry pound of neat polymer, Vendor is to state, based upon jar or onsite testing, estimated amount of neat polymer in pounds per dry ton of solids of quoted product required to meet the below minimum specifications. Also, include the percent of active polymer per pound of polymer. 11.00 Neat pounds of polymer/dry ton of solids 41.0% Percent active polymer/pound of polymer Each vendor shall attach the chemical analysis of their material to the 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 of product for RSD at no cost. Vendor may submit one (1) quart of chemical for testing purposes. Any load of 'bad' polymerthat does not meet performance specifications will be reimbursed to RSD at no cost. Quote will be for the year of 2020 with two (2) 2021 and 2022, one (1) year options to renew. If emergencies occur with the 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 cost 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. � � �'-04 1? a Vendor is to state delivery time after receipt of order. Authorized Signature Boyd Stanley, Vice -President Contact Person Polydyne Inc. Company Name 3 - 7 Business A.R.O. days. 02/05/20 Date (912) 880-2035 Phone Number P C9 � I ,,q 1 of ; Minimum Specification for Polymer Cationic flocculant capable of meeting the below solids thickening and capture rates with Bidder Complies fourteen (14) pounds or less of neat polymer/dry ton of solids within the specified Yes No hydraulic and solids loading rates. X Delivery shall be made by vehicles properly equipped to transfer polymer into the District's storage room without spillage. 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 7:30am to 1:30pm Monday through Friday with exceptions for holidays. The District's orders will be for approximately 500 gallons each. The District shall have the right to require a small sample from each load X for laboratory purposes. — Rotary Drum Thickener Performance Specifications Item Waste Activated Sludge Feed Solids Concentration (% Dry Weight Solids) Less than/equal to 1.0 Feed Solids Volatile Content (%) Less than/ equal to 85 Feed Solids pH 6.0-9.0 Hydraulic Capacity (GPM) 100-200 Minimum Thickened Sludge Concentration (% Dry Weight Solids Capture (%) 5 Maximum Thickened Sludge Concentration (% Dry Weight Solids Capture (%) 7 Minimum Solids Capture (%) 95 Maximum Neat Polymer Usage (Ibs Dry Weight Polymer/Ton Dry Weight Sludge) 14 %=percent; GPM=gallons per minute; Ibs=pounds PRICE REQUEST FOR ROTARY DRUM THICKENER POLYMER Price Request Sheet RICHMOND SANITARY DISTRICT 23 80 Liberty Avenue Richmond, IN 47374 (765) 983-7450 . Contractor Name: Polydyne Inc. Date: 02/05/20 Clarifloc CE-2191 Polymer for Secondary Sludge Cost per pound of Polymer (Neat) Cost per tote of Polymer Polymer for Secondary Sludge Cost per pound of Polymer (Neat) Cost per tote of Polymer Polymer for Secondary Sludge Cost per pound of Polymer (Neat) Cost per tote of Polymer Year 1 (2020) m 1.15O/T.h_ $ 2,645.00 per 2300 Lb. Tote Year 2 (2021) $ 1.150/Lb. $ 2,645.00 per 2300 Lb. Tote Year 3 (2022) m 1.150/Lb. $ 2,645.00 per 2300 Lb. Tote Indiana Local Treference Claim: Definitions: Affected Co — 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 Preferrence 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 to4ndiana 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 fiends 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, Polydyne Inc. is a Delaware Corporation located in Riceboro, GA. I NDIANA LOCAL PREFERENCE CLAIM (Only 01 out this Part if claiming to •lie 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. p9gaF�4 POST BID SUBbf rTAL 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: Price Request for Polymer 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 S ecuuri y Numbers IE-Verifyy Requiremeaats: 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 22-5-1.7-11 (a) (2); and 3. A purchase order has been issued by the Purchasing Department. a a a a am a a33aaamnanman aaamaaaRon aaanman aaaanaaaaaaanaaanMRaamaaamRaman Raman aaaHOaQaam"IN COWLIANCE WITH INDJCANA IE-VERIFY PROGRAM R EQUIREYENTS 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 (3 0) 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. Affidavit of Employment Eligibility Verification The Contractor, Polydyne Inc. , affirms 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 contracted 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 ofthe term of a contract with a subcontractor. I hereby verify under the penalty of perjury that the foregoing statement is true. Dated this 5th day of February 20 20 . Boyd Stanley, Vice -President (printed name) IRAN 1NVESTIVMENT 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 refitted 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. Company ID Number: 115171 INFORMATION REQUIRED FOR THE E-VERIFY PROGRAM Information relating to your Company: Company Name: SNF Holding Co Company Facility Address: One Chemical Plant Road Riceboro, GA 31323 Company Alternate Address: P O Box 250 Riceboro, GA 31323 County or Parish: LIBERTY Employer Identification Number: 510329277 North American Industry Classification Systems Code: 325 Parent Company: SNF Holding Company 1,000 to Number of Employees: 2,499 Number of Sites Verified for: 7 Are you verifying for more than I site? If yes, please provide the number of sites verified for in each State. MISSISSIPPI I site(s) . GEORGIA 1 site(s) . MICHIGAN 1 site(s) . WASHINGTON 1 site(s) . PENNSYLVANIA 1 site(s) . ILLINOIS 1 site(s) . CALIFORNIA 1 site(s) Information relating to the Program Administrator(s) for your Company on policy questions or operational problems: Name: Linda Adams Telephone Number: (912) 884 - 3366 .ext 410410 Fax Number: (912) 880 - 8034 E-mail Address: LindaA@SNFHC.com Name: Jane Frost Telephone Number: (912) 884 - 8712 Fax Number: (912) 880 - 8034 E-mail Address: JaneF@SNFHC.com p 13 0� /0' Company ID Number: 115171 The foregoing constitutes the full agreement on this subject between the SSA, DHS, and the Employer. The individuals whose signatures appear below represent that they are authorized to enter into this MOU on behalf of the Employer and DHS respectively. To be accepted as a participant in E-Verify, you should only sign the Employer's Section of the signature page. If you have any questions, contact E-Verify Operations at 888-464- 4218. Employer SNF Holding Co James Carlson Name (Please type or print) Electronically Signed Signature Title 04/21/2008 Date Department of Homeland Security — Verification Division USCIS Verification Division Name (Please type or print) Title Electronically Signed 04/21/2008 Signature Date � J N 0 � 1.9 F�egistration Page 1 of 1 Exit E-Ve 1 Employment Eligibility Verification Your company is now registered for E-Verify. All Users will receive their User name and Passwords via email. If the email is not received within 48 hours, please contact Office of Verification at 888-464-4218. Please DO NOT REGISTER AGAIN. IMPORTANT: You should print the MOU, and share itwith your Human Resources Manager, legal counsel, and other appropriate staff. View MOU U.S. Department of Homeland Security l U.S. Citizenship and Immi rg ation Services l� v G https://www.vis-dhs.com/EmployerRegistration/Registration.aspx?JS=YES 4/21 /2008 AC�R 7 0 � CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 2/6i2020 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 Phone No.: (212) 488-0200 Fax No.: (212) 488-0220 EPIC Insurance Brokers & Consultants 350 Hudson Street — 4th Floor CONTACT NAME: PHONE FAX /C IN Ext: A/C No: WC, EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # New York, NY 10014 INSURER A: AIG SPECIALTY INSURANCE COMPANY 26883 INSURED INSURER B: COMMERCE & INDUSTRY INSURANCE COMPANY 19410 INSURER C: HARTFORD FIRE INSURANCE COMPANY 19682 Polydyne Inc. One Chemical Plant Road INSURER D: PO Box 250 INSURER E: Riceboro GA 31323 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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, EXCLUSIONSAND CONDITIONS OFSUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIDCLAIMS. INSR LTR TYPE ADDL INSD SUER WVD POLICYNUMBER POLICY EFF IMM113DIYYYYi POLICYEXP imminpryYYYi LIMITS A X COMMERCIALGENERALLIABILITY Y EG14362834 12/31/2019 12/31/2020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE � OCCUR PREMISES (RENTED . oNccu ante $500,000 MED EXP (Any one person) $25,000 PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 GEN'L POLICY ❑ PRO- ❑ JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: B AUTOMOBILE LIABILITY Y CA4691818 12/31/2019 12/31/2020 COEaMacccINED idenent INGLELIMIT $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ X ALL OWNED SCHEDULED AUTOS AUTOS HIREDAUTOS IXNON-OWNED AUTOS PROPERTY DAMAGE Per accident $ $ A UMBRELLA LIAB X OCCUR EGU18403155 12/31/2019 12/31/2020 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 X EXCESSLIAB CLAIMS -MADE DED I I RETENTIONS $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y ANY PROPRIETORMARTNEMEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) (Mandatory NIA 1OWNR30600 12/31/2019 12/31/2020 X PER oTH- STATUTE E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101, Additional Remarks Schedule, maybe attached If more space is required) EVIDENCE OF INSURANCE RE: POLYMER 30 DAY CANCELLATION CLAUSE INCLUDED CERTIFIGATE HOLDER GAIVGtLLA I IUIV City of Richmond / Richmond Sanitary District 2380 Liberty Avenue Richmond, VA 43734 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISION Oc 99RR-2014 ACORD CORPORATION. All rahts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD V 5 c� 0� it SNF POLYDYNE CUSTOMER NAME: OA#: CERTIFICATE OF ANALYSIS Polydyne Inc. ONE CHEMICAL PLANT ROAD RICEBORO GA 31323 POLYDYNE PRODUCT NAME: CLARIFLOC CE-2191 PURCHASE ORDER NR : DATE : 09/20/2019 AMOUNT: QUALITY CONTROL QC BATCH NUMBER UNIT SPECIFICATION RC23/3648M TEST BULK VISCOSITY cps 300 - 2000 780 1010 A NON VOLATILE SOLIDS % 43.5 - 50.5 49.1 1050 A UL BROOKFIELD VISCOSITY cps 2.50 - 3.30 2.51 1019 A RESIDUAL ACRYLAMIDE Win 0 - 999 300 1001 A Date : 09/20/2019 Signature Michael Reed If the # symbol appears in the QC -TEST column, then the data on that line is given for information only, and does not constitute a specification. If ND appears in the result column, that means under the limit of detection. For Personal Care ingredients, the generic name is corresponding to the INCI name. SUP NR: OG-0098 REVISION: 04 SNF PO-LYDYNE CLARIFLOC CE-2191 POLYMER PRINCIPAL USES MANUFACTURING SPECIFICATIONS CLARIFLOC CE-2191 is a high charge cationic polyacrylamide Total Solids 43.5 : 50.5 % in emulsion form that is used as a flocculant in a wide variety of Residual AcAm < 1000 ppm municipal wastewater treatment applications. It has been successfully Neat Viscosity 300 - 2000 cPs J applied in all liquid/solids separation systems including clarification, UL Viscosity 2.5 - 3.3 cPs thickening, and dewatering. TYPICAL PROPERTIES Physical Form Clear to Milky White Liquid Cationicity 60 % Active Polyacrylamide Min. 41 % Freezing Point 7 F. (-14 C.) Density 8.5 -.8.7 Specific Gravity 1.02 - 1.04 PREPARATION AND FEEDING CLARIFLOC CE-2191 is a single component emulsion polymer that must be pre -diluted in water before use. In most cases, this product should not be applied neat. One method for dilution is adding the neat polymer into the vortex of a mixed tank at a concentration between 0.25-1.0% polymer (0.5% is optimum) by weight. The polymer can also be injected through a number of commercially available systems thatprovide in -line mechanical mixing. The best feed systems use initial high energy mixing (>1000 rpm) for a short time (<30 sec) to achieve good dispersion followed by low energy mixing (<400 rpm) for a longer time (10-30 min). Polymer solutions should be aged for 15-60 minutes for best results. Solution shelf life is 8-16 hours. MATERIALS OF CONSTRUCTION Cross -linked polyethylene, fiberglass, stainless steel or lined steel are the preferred materials of construction for bulk tanks. Avoid natural rubber and Buna-N gaskets as these materials swell when placed in contact with neat polymer. Unlined mild steel, black iron, galvanized steel, copper or brass are not recommended in any part of the feed system. Stainless steel, Viton or Teflon are the best choices for pump heads. For feed lines, use PVC or reinforced Tygon tubing. HANDLING AND STORAGE Suggested in -plant storage life is 6 months in unopened drums. For best results, store at 50-80 F. Bulk tanks should be mixed by periodically recirculating the contents bottom to top. Bulk tanks can also be fitted with an agitator type mixer that reaches the bottom 2 feet of the tank. Drums and bins should be mixed very well before first use and weekly after that. Do not allow emulsion polymers to freeze. Should freezing occur, allow the product to thaw thoroughly in a heated area and mix well before attempting to use it. For spills of CLARIFLOC CE-2191 , sprinkle vermiculite or equivalent absorbant over the spill area and sweep the material into approved chemical disposal containers. Do not spray water onto a spill because the resulting gel is very difficult to clean up. SAFETY INFORMATION CLARIFLOC CE-2191 is a mildly acidic product that can irritate the skin and eyes and should be handled accordingly. Gloves, goggles and apron are highly recommended. Anyone responsible for the procure-ment, use or disposal of this product should familiarize themselves with the appropriate safety and handling precautions involved. Such information is outlined in the POLYDYNE Material Safety Data Sheet. In the event of an emergency with this product, contact Chemtrec anytime day or night at (800) 424-9300. SHIPPING CLARIFLOC CE-2191 Polymer is shipped in 55 gallon drums containing 450 pounds net or in 275 gallon totes containing 2300 pounds. Bulk quantities are also available. ADDITIONAL INFORMATION To place an order or obtain technical information from anywhere in the continental United States, call toll free: [8001848-7659 For additional information, please refer to the Safety Data Sheet (SDS) All statements, information and data.given herein.are believed to be accurate, but are presented.withouiwarranty, expressed or implied. Statements concerning possible use are made without representation or warranty that any such use is free of patent infringement, and is not a recommendation to infringe.on any patent. The user should not assume that all safety measures are indicated or that other measures may not required. Any determination of the suitability of a particular product for any use contemplated by the user is the sole responsibility of thenser. © 2016 SNF Holding Company POlYDYNE SAFETY DATA SHEET According to U.S. Code of Federal Regulations 29 CFR 1910.1200, Hazard Communication. SECTION 1: Identification of the substance/mixture and of the company/undertaking 1.1. Product identifier Product name: CLARIFLOC CE-2191 Type of product Mixture. 1.2. Relevant identified uses of the substance or mixture and uses advised against Identified uses: Processing aid for industrial applications. Uses advised against None. 1.3. Details of the supplier of the safety data sheet Polydyne Inc. Company. 1� Chemical Plant Road PO BOX 279, Riceboro, GA 31323 United States Telephone: 1-800•-848-7659 Telefax: (912)-884-8770 E-mail address: - 1.4. Emergency telephone number 24-hour emergency number. 1-800-424-9300 SECTION 2: Hazards identification 2.1. Classification of the substance or mixture Classification according to paragraph (d) of 29 CFR 1910.1200: Not classified. 2.2. Label elements Labelling according to paragraph (f) of 29 CFR 1910,1200: 0 Print Date: 0510212020 Revision date: 10/14/2019 Page: 1 / 14 SAFETY DATA SHEET Hazard symbol(s): None. CLARIFLOC CE-2191 Signal word: None. Hazard statement(s): None. Precautionary statement(s): None. 2.3. Other hazards Spills produce extremely slippery surfaces. For explanation of abbreviations see Section 16. SECTION 3: Compositionfinformation on ingredients 3.1. Substances Not applicable, this product is a mixture. 3.2. Mixtures This product is a mixture. Hazardous components Distillates (petroleum), hydrotreated light Concentrationl-range: 20 - 30% CAS Number: 64742-47-8 Classification according to paragraph (d) Asp. Tox. 1;H304 of 29 CFR 1910.1200: Notes Does not result in classification of the mixture if the kinematic viscosity is greater than 20.5 mmz/s measured at 40°C. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Concentrationl-range: < 5% CAS Number., 69011-36-5 Classification according to paragraph (d) Acute Tox. 4;H302, Eye Dam. 1;H318 of 29 CFR 1910.1200: For explanation of abbreviations see section 16 Print Date: 0510212020 Revision date: 10/14/2019 Page: 2 / 14 SAFETY DATA SHEET SECTION 4: First aid measures CLARIFLOC CE-2191 4.1. Description of first aid measures Inhalation: Move to fresh air. No hazards which require special first aid measures. Skin contact: Wash off immediately with soap and plenty of water while removing all contaminated clothes and shoes. In case of persistent skin irritation, consult a physician. Eye contact: Rinse immediately with plenty of water, also under the eyelids, for at least 15 minutes. Get medical attention immediately. Ingestion: Rinse mouth with water. Do NOT induce vomiting. Call a physician or poison control centre immediately. 4.2. Most important symptoms and effects, both acute and delayed None under normal use. 4.3. Indication of any immediate medical attention and special treatment needed None reasonably foreseeable. Other information: None. SECTION 5: Firefighting measures 5.1. Extinguishing media Suitable extinguishing media: Water. Water spray. Foam. Carbon dioxide (CO2). Dry powder. Warning! Spills produce extremely slippery surfaces. Unsuitable extinguishing media: None known. 5.2. Special hazards arising from the substance or mixture Hazardous decomposition products: Ammonia. Carbon oxides (COx). Nitrogen oxides (NOx). Hydrogen chloride. Hydrogen cyanide (hydrocyanic acid) may be produced in the event of combustion in an oxygen deficient atmosphere. 5.3. Advice for firefighters Protective measures: Wear self-contained breathing apparatus and protective suit. Other information: Spills produce extremely slippery surfaces. Print Date: 0510212020 Revision date:1011412019 Page: 3114 SAFETY DATA SHEET SECTION 6: Accidental release measures 6.1. Personal precautions, protective equipment and emergency procedures Personal precautions: Do not touch or walk through spilled material. Spills produce extremely slippery surfaces. Protective equipment: Wear adequate personal protective equipment (see Section 8 Exposure Controls/Personal Protection). Emergency procedures: Keep people away from spill/leak. Prevent further leakage or spillage if safe to do so. 6.2. Environmental precautions As with all chemical products, do not flush into surface water. 6.3. Methods and material for containment and cleaning up CLARIFLOC CE-2191 Small spills: Do not flush with water.Soak up with inert absorbent material. Sweep up and shovel into suitable containers for disposal. Large spills: Do not flush with water.Dam up. Soak up with inert absorbent material. Clean up promptly by.scoop or vacuum. Residues: After cleaning, flush away traces with water. 6.4. Reference to other sections SECTION 7: Handling and storage; SECTION 8: Exposure controls/personal protection; SECTION 13: Disposal considerations; SECTION 7: Handlina and storage 7.1. Precautions for safe handling Avoid contact with skin and eyes. Renders surfaces extremely slippery when spilled. When using, do not eat, drink or smoke. 7.2. Conditions for safe storage, including any incompatibilities Keep away from heat and sources of ignition. Freezing will affect the physical condition and may damage the material. Incompatible with oxidizing agents. 7.3. Specific end use(s) This information is not available. SECTION 8• Exposure controls/personal protection 8.1. Control parameters Occupational exposure limits: Print Date: 0510212020 Revision date: 10/14/2019 Page: 4 / 14 SAFETY DATA SHEET Distillates (petroleum), hydrotreated light ACGIH. 200 mg/m3 (8 hours) (vapors) 8.2. Exposure controls CLARIFLOC CE-2191 Appropriate engineering controls: Ensure adequate ventilation, especially in confined areas. Use local exhaust if misting occurs. Natural ventilation is adequate in absence of mists. Individual protection measures, such as personal protective equoment: a) Eye/face protection: Safety glasses with side -shields. b) Skin protection: i) Hand protection: PVC or other plastic material gloves. fi) Other: Wear coveralls and/or chemical apron and rubber footwear where physical contact can occur. c) Respiratory protection: No personal respiratory protective equipment normally required. d) Additional advice: Wash hands before breaks and immediately after handling the product. Wash hands before breaks and at the end of workday. Handle in accordance with good industrial hygiene and safety practice. Environmental exposure controls: Do not allow uncontrolled discharge of product into the environment. SECTION 9: Physical and chemical properties 9.1. Information on basic physical and chemical properties a) Appearance: b) Odour., c) Odour Threshold: d) pH. e) Melting poinUfreezing point: 0 Initial boiling point and boiling range: g) Flash point: h) Evaporation rate: Viscous liquid, Milky. Aliphatic. No data available. 3.5 - 6.5 @ 5 g/L (See Technical Bulletin or Product Specifications for precise value) < 50C > 100°C Does not flash. No data available. Print Date: 0510212020 Revision date:10/14/2019 Page: 5 / 14 SAFETY DATA SHEET i) Flammability (solid, gas): j) Upper/lower flammability or explosive limits: k) Vapour pressure: 1) Vapour density: m) Relative density: n) Solubility(ies): o) Partition coefficient, p) Autoignition temperature: q) Decomposition temperature: r) Viscosity: s) Explosive properties: t) Oxidizing properties: '9.2. Other information None. SECTION 10: Stability and reactivity 10.1. Reactivity Stable under recommended storage conditions. 10.2. Chemical stability Stable under recommended storage conditions. 10.3. Possibility of hazardous reactions Oxidizing agents may cause exothermic reactions. 10.4. Conditions to avoid Protect from frost, heat and sunlight. 10.5. Incompatible materials Oxidizing agents. CLARIFLOC CE-2191 Not applicable. Not expected to create explosive atmospheres. 2.3 kPa @ 20°C 0.804 g/litre @ 20°C 1.0 - 1.2 Completely miscible. Not applicable. Not applicable. > 1500C > 20.5 mmz/s @ 400C Not expected to be explosive based on the chemical structure. Not expected to be oxidising based on the chemical structure. 10.6. Hazardous decomposition products Thermal decomposition may produce: hydrogen chloride gas, nitrogen oxides (NOx), carbon oxides (COx). Ammonia. Hydrogen cyanide (hydrocyanic acid) may be produced in the event of combustion in an oxygen deficient atmosphere. Print Date: 0510212020 Revision date: 10/14/2019 Page: 6 / 14 0 SAFETY DATA SHEET SECTION 11: Toxicological information 11.1. Information on toxicological effects Information on the oroduct as auonlied: CLARIFLOC CE-2191 Acute oral toxicity: LD50/oral/rat > 5000 mg/kg (Estimated) Acute dermal toxicity: LD50/dermal/rat > 5000 mg/kg. (Estimated) Acute inhalation toxicity: The product is not expected to be toxic by inhalation. Skin corrosion/irritation: Non -irritating to skin. Serious eye damage%ye irritation: Not irritating. (OECD 437) Respiratory/skin sensitisation: Not sensitizing. Mutagenicity: Not mutagenic. Carcinogenicity: Not carcinogenic. Reproductive toxicity: Not toxic for reproduction. STOT - Single exposure: No known effects. STOT - Repeated exposure: No known effect. Aspiration hazard: Due to the viscosity, this product does not present an aspiration hazard. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Acute oral toxicity: LD50/oral/rat > 5000 mg/kg (OECD 401) Acute dermal toxicity: LD50/dermal/rabbit > 5000 mg/kg (OECD 402) Acute inhalation toxicity: LCO/inhalation/4 hours/rat >= 4951 mg/m3 (OECD 403) (Based on results obtained from tests on analogous products) Skin corrosion/irritation: Not irritating. (OECD 404) Repeated exposure may cause skin dryness or cracking. Serious eye damage%ye irritation: Not irritating. (OECD 405) Respiratory/skin sensitisation: By analogy with similar products, this product is not expected to be sensitizing. (OECD 406) Mutagenicity: Not mutagenic. (OECD 471, 473, 474, 476, 478, 479) Print Date: 0510212020 Revision date: 10/14/2019 Page: 7 / 14 SAFETY DATA SHEET Carcinogenicity. Reproductive toxicity: STOT- Single exposure: CLARIFLOC CE-2191 Carcinogenicity study in rats (OECD 451): Negative. By analogy with similar substances, this substance is not expected to be toxic for reproduction. NOAEL/rat = 300 ppm. (OECD 421) No known effects. STOT- Repeated exposure: NOAEL/oral/rat/90 days >= 3000 mg/kg/day (OECD 408) (Based on results obtained from tests on analogous products) Aspiration hazard: May be fatal if swallowed and enters airways. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Acute oral toxicity: LD50/oral/rat = 500 - 2000 mg/kg Acute dermal toxicity. LD50/dermal/rabbit > 2000 mg/kg Acute inhalation toxicity: No data available. Skin corrosion/irritation: Serious eye damage%ye irritation: Respiratory/skin sensitisation: Mutagenicity. Carcinogenicity: Reproductive toxicity. STOT - Single exposure: STOT - Repeated exposure: Aspiration hazard. Print Date: 0510212020 L Not irritating. (OECD 404) Causes serious eye irritation. (OECD 405) The results of testing on guinea pigs showed this material to be non -sensitizing. In vitro tests did not show mutagenic effects. In vivo tests did not show mutagenic effects. Based on the absence of mutagenicity, it is unlikely that the substance is carcinogenic. Two -Generation Reproduction Toxicity (OECD 416) - NOAEL/rat > 250 mg/kg/day Prenatal Development Toxicity Study (OECD 414) - NOAEL/Maternal toxicity/rat > 50 mg/kg/day - NOAEL/Developmental toxicity/rat > 50 mg/kg/day No known effects. NOAEL/oral/rat/600 days = 50 mg/kg/day No known effects. Revision date: 10/14/2019 Page: 8 / 14 SAFETY DATA SHEET SECTION 12: Ecological information 12.1. Toxicity Information on the product as supplied: Acute toxicity to fish: Acute toxicity to invertebrates: Acute toxicity to algae: Chronic toxicity to fish: Chronic toxicity to invertebrates: Toxicity to microorganisms: Effects on terrestrial organisms: Sediment toxicity. CLARIFLOC CE-2191 LC50/Fish/96 hours = 10 - 100 mg/L (Estimated) EC50/Daphnia magna/48 hours = 10 - 100 mg/L (Estimated) Algal inhibition tests are not appropriate. The flocculation characteristics of the product interfere directly in the test medium preventing homogenous distribution which invalidates the test. No data available. No data available. No data available. No data available. No data available. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Acute toxicity to fish: LCO/Oncorhynchus mykiss/96 hours > 1000 mg/L. (OECD 203) Acute toxicity to invertebrates: ECO/Daphnia magna/48 hours > 1000 mg/L (OECD 202) Acute toxicity to algae: ICO/Pseudokirchneriella subcapitata/72 hours > 1000 mg/L. (OECD 201) Chronic toxicity to fish: NOEC/Oncorhynchus mykiss/28 days > 1000 mg/L Chronic toxicity to invertebrates: NOEC/Daphnia magna/21 days > 1000 mg/L Toxicity to microorganisms: EC50/Tetrahymena pyriformis/ 48h > 1000 mg/L. Effects on terrestrial organisms: No data available. Sediment toxicity. No data available. Readily biodegradable, exposure to sediment is unlikely. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Acute toxicity to fish: LC50/Cyprinus carpio/96 hours = 1 - 10 mg/L (OECD 203) Print Date: 0510212020 Revision date: 10/14/2019 Page: 9 / 14 SAFETY DATA SHEET CLARIFLOC CE-2191 Acute toxicity to invertebrates: EC50/Daphnia/48 hours = 1 - 10 mg/L (OECD 202) Acute toxicity to algae: IC50/Desmodesmus subspicatus/72 hours = 1 - 10 mg/L (OECD 201) Chronic toxicity to fish: No data available. Chronic toxicity to invertebrates: NOEC/Daphnia magna/21 days > 1 mg/L (OECD 202) Toxicity to microorganisms: EC 10/activated sludge/17 hours > 10000 mg/L (DIN 38412-8) Effects on terrestrial organisms: No data available. Sediment toxicity: No data available. 12.2. Persistence and degradability Information on the product as suoolied. Degradation: Based on degradation data of components, this product is expected to be readily (bio)degradable. Hydrolysis: At natural pHs (>6) the polymer degrades due to hydrolysis to more than 70% in 28 days. The hydrolysis products are not harmful to aquatic organisms. Photolysis: No data available. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Degradation: Readily biodegradable. 67.6% / 28 days (OECD 301 F) ; 68.8% / 28 days (OECD 306) ; 61.2% / 61 days (OECD 304 A) Hydrolysis: Does not hydrolyse. Photolysis: No data available. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Degradation: Readily biodegradable. > 60% / 28 days (OECD 301 B) Hydrolysis: Does not hydrolyse. Photolysis: No data available. Print Date: 0510212020 Revision date: 10/14/2019 Page: 10 / 14 SAFETY DATA SHEET 12.3. Bioaccumulative potential Information on the product as supplied: The product is not expected to bioaccumulate. Partition co -efficient (Log Pow): Not applicable. Bioconcentration factor (BCF): No data available. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Partition co -efficient (Log Pow): 3 - 6 Bioconcentration factor (BCF): No data available. Poly(oxy-1,2-ethanediyl), a-tridecyl-w-hydroxy-, branched Partition co -efficient (Log Pow): > 3 Bioconcentration factor (BCF): No data available. 12.4. Mobility in soil Information on the product as supplied. No data available. Relevant information on the hazardous components: Distillates (petroleum), hydrotreated light Koc: No data available. Poly(oxy-1,24thanediyl), a-tridecyl-w-hydroxy-, branched Koc: > 5000 12.5.Other adverse effects None known. SECTION 13: Disposal considerations CLARIFLOC CE-2191 Print Date: 0510212020 Revision date: 10/14/2019 Page: 11 / 14 SAFETY DATA SHEET SECTION 13: Disposal considerations 73.1. Waste treatment methods Waste from residues/unused products: Dispose in accordance with local and national regulations. CLARIFLOC CE-2191 Contaminated packaging Rinse empty containers with water and use the rinse -water to prepare the working solution. If recycling is not practicable, dispose of in compliance with local regulations. Can be landfilled or incinerated, when in compliance with local regulations. Recycling Store containers and offer for recycling of material when in accordance with the local regulations. SECTION 14: Transport information Land transport (DOT) Not classified. Sea transport (IMDG) Not classified. Air transport (IATA) Not classified. SECTION 15: Regulatory information 15.1. Safety, health and environmental regulations/legislation specific for the substance or mixture Information on the product as supplied: TSCA Chemical Substances Inventor(: All components of this product are either listed as active on the inventory or are exempt from listing. US SARA Reporting Requirements: SARA (Section 3111312) hazard class: Not concerned. SARA Title /// Sections: Section 302 (TPQ) - Reportable Quantity. Note concerned. Section 304 - Reportable Quantity. Not concerned. Print Date: 05102/2020 Revision date: 10/14/2019 Page:12 / 14 SAFETY DATA SHEET Section 313 (De minimis concentration): Not concerned. Clean Water Act Section 311 Hazardous Substances (40 CFR 117.3) - Reportable Quantity. Not concerned. Clean AirAct Section 112(r) Accidental release prevention requirements (40 CFR 68) - Reportable Quantity: Not concerned. CERCLA Hazardous Substances List (40 CFR 302.4) - Reportable Quantity: Not concerned. RCRA status: Not RCRA hazardous. CLARIFLOC CE-2191 California Proposition 65Information: WARNING! This product contains a chemical known to the State of California to cause cancer and birth defects or other reproductive harm, Acrylanude SECTION 16: Other information NFPA and HMIS Ratinos: NFPA: Health: 0 Flammability: 1 Instability: 0 HMIS: Health: 0 Flammability: 1 Print Date: 05102/2020 Revision date: 10/14/2019 Page:13 / 14 i SAFETY DATA SHEET CLARIFLOC CE-2191 Physical Hazard: 0 PPE Code: B This data sheet contains changes from the previous version in section(s): SECTION 8. Exposure controls/personal protection, SECTION 15. Regulatory information, SECTION 16. Other Information. Key or legend to abbreviations and acronyms used in the safety data sheet: Acronyms STOT = Specific target organ toxicity Abbreviations Acute Tox. 4 = Acute toxicity Category Code 4 Asp. Tox. 1 = Aspiration hazard Category Code 1 Eye Dam 1 = Serious eye damage/eye irritation Category Code 1 Hazard statements H302 - Harmful if swallowed H304 - May be fatal if swallowed and enters airways H318 - Causes serious eye damage Training advice: Do not handle until all safety precautions have been read and understood. This SDS was prepared in accordance with the following: U.S. Code of Federal Regulations 29 CFR 1910.1200 Version: 19.0l .a ENCC046 The information provided in this Safety Data Sheet is correct to the best of our knowledge, information and belief at the date of its publication. The information given is designed only as a guidance for safe handling, use, processing, storage, transportation, disposal and release and is not to be considered a warranty or quality specification. The information relates only to the specific material designated and may not be valid for such material used in combination with any other materials or in any process, unless specified in the text. Print Date: 0510212020 Revision date: 10/14/2019 Page: 14 / 14 M==P:0L YD YNE TABULATIONS FOR BID To: City of Richmond From: Polydyne Inc. Opened: 02 11 20 Subject: Price Request - Polymer www.polydyneinc.com State: IN Fax No.: (912) 880-2078 Please provide us with tabulations on the subject bid by filling out this form or attaching your tabulations form to it. A self-addressed stamped envelope is included for your use. If possible, please fax these tabulations to the above -referenced number. Awarded: YES/NO (circle one) If YES, indicate awarded vendor with an *. If NO, indicate expected date of award. Vendor Product Year Unit Price Cost per 2300 Lb. Tote Bin Polydyne Inc. Clarifloc CE-2191 1 (2020) $1.150/Lb. $2,645.00 per 2300 Lb. Tote Polydyne Inc. Clarifloc CE-2191 2 (2021) $1.150/Lb. $2,645.00 per 2300 Lb. Tote Polydyne Inc. Clarifloc CE-2191 3 (2022) $1.150/Lb. $2,645.00 per 2300 Lb. Tote Thank you for our assistance, U . Randal Vicke y Bid and Contract Coordinator PH: (912) 880-2035 Database Number 120-015 1 Chemical Plant Road • P.O. ox 279 • Ricebor GA 31323 USA • Tel 800.848.7659 • Fax 912.880.2078