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Participating-Contractor-Application5.7.19 Revised 5.7.2019 Contractor Application MSD Project Clear Rainscaping Small Grants Program Contractor Timeline for the 2018-19 Round: 1. Submit Contractor Application & Insurance Documentation 2. Participating Contractors mandatory Orientation – May 23rd, 8am to 9:30am 3. Landowners attend orientation – by June 22nd 4. Landowners consult with Participating Contractors or proceed with DIY project 5. Landowner Applications due August 1st 6. Awards announced week of September 9th 7. Rainscaping features to be installed Fall 2019 & Spring of 2020 8. Completion packets from landowners due May 11th, 2020. Once completed, signed and return with copies of requirements by email or mail to: Rob Kennedy, Rainscaping Coordinator MSD Project Clear Rainscaping Small Grants c/o Missouri Botanical Garden – Sustainability Division 4651 Shaw Blvd. St. Louis, MO 63110 Phone Number: 314.577.0202 Email: Rainscaping@mobot.org Scope of Work Offered (select all that apply) Design features offered: circle features available for design below: (leave blank if design work is not being offered) Note if Certified Landscape Architect is doing design work Rain Gardens | Lawn Alternatives | Bioswales | Woodland Restoration (invasive removal) | Permeable Pavers | Rain Barrels/Cisterns | Green Roofs Installation features offered: circle features available for installation below: (leave blank if your group does not install those features or do installation work) Rain Gardens | Lawn Alternatives | Bioswales | Woodland Restoration (invasive removal) | Permeable Pavers | Rain Barrels/Cisterns | Green Roofs Contractor Data Company Name: Date Prepared: DBA (if applicable): Tax ID: Ownership Structure: [Corporation / Partnership / Proprietorship / Limited Liability Company] Principal(s): Company Address: City: State: Zip Code: Other Address: City: State: Zip Code: Revised 5.7.2019 Licensing and Professional Requirements Formed and operating as a duly registered business in the State of Missouri [ ] Insurance Certificate attached, with Additional Insured and minimum limits as follows (NOTE: We may add additional insured(s) in the future): Missouri Botanical Garden EarthWays Center – CBEC-West 4651 Shaw Boulevard St. Louis, MO 63110 Minimum Limits: Worker's Compensation Insurance, if applicable - $500,000 General Liability Insurance - $1,000,000/occurrence; $2,000,000 aggregate Commercial Automobile Insurance - $1,000,000 [ ] Initial here to certify understanding that if you are offering services in one of the contractor categories via an agreement you have with another company, you must provide a copy of that formal agreement as proof that your business can offer those services. [ ] Additional Requirements Initial here to confirm your understanding and agreement to use industry best practices and to be open to all quality control assessments for installing professional Rainscaping features. [ ] Business Phone: Website: Contact Last Name: Email Address: Contact First Name: Number of Employees: The following questions are for MSD’s data collection only. They are not requirements for signing up to be a Participating Contractor. Is the company a Minority Owned or Women Owned (MBE/WBE) Business? [ Yes / No ] What percentage of your workforce is made up of minorities? women? (please answer both) Revised 5.7.2019 Participating Contractor Confirmation Contractor representative, by signing below, certifies the above information and attached information is accurate and hereby gives permission for Rainscaping Small Grants Program and its representatives to independently verify this information Contractor representative certifies to having read and understood the Contractor Guide and the program guidelines in the Rainscaping Small Grants Program Application and hereby agrees to comply with program requirements as set forth therein and as may be amended from time to time by the Program and posted to http://www.projectclearstl.org/smallgrants/. Contractor representative certifies to following the Rain scaping design and installation guidelines as articulated in Missouri Botanical Garden's online RainScaping Guide at www.mobot.org/rainscaping Contractor representative understands that participation in the Orientation (5/23/19) is required to become a Participating Contractor in the Rainscaping Small Grants Program. Participation only implies that Metropolitan St. Louis Sewer District (MSD) and Missouri Botanical Garden (MBG) confirms you received the information and agreed to participation requirements but DOES NOT imply that MSD or MBG can certify the expertise or recommend or recognize the quality of work of your contractors participating in the program. The representative signing below agrees to all of the above and additionally certifies they are authorized to sign this document on behalf of the contracting firm listed herein. Contractor Representative Signature and Date: ________________________________________________________ If you have questions regarding the program guidelines or contractor application process, please email rainscaping@mobot.org. If you need to speak to someone, please call the general program phone number at 314-577- 0202. Additional resources are available online at www.mobot.org/rainscaping and http://www.projectclearstl.org/smallgrants/.