HomeMy Public PortalAbout038-2013 - Sanitary - JCI Jones Chemical Inc. - Chlorine and SuAGREEN[ENT ORIGINAL
THIS AGREEMENT made and entered into this a5k,^'day of 2013, by
and referred to as Contract No. 38-2013 between the City of Richmond, Indiana, a municipal
corporation acting by and through its Board of Sanitary Commissioners (hereinafter._ referred to as
the "City") and JCI Jones Chemicals, Inc., 600 Bethel Avenue, Beech Grove, Indiana 46107
(hereinafter referred to as the "Contractor").
SECTION 1. STATEMENT AND SUBJECT OF WORK
City hereby retains Contractor for the purchase and delivery of Liquid Chlorine. atld Sulfur
Dioxide to City's Wastewater Treatment Plant (WWTP).
A Request for Quotes dated January 23, 2013 has been made available for inspection by
Contractor, is on file in the office of the Department of Sanitation, and is hereby incorporated by
reference and made a part of this Agreement. Contractor agrees to abide by the same.
The response of Contractor to said Request for Quotes is attached hereto as Exhibit "A," which
Exhibit is dated February 7, 2013, consisting of nine (9) pages, and is hereby incorporated by
reference and made a part of this Agreement. Contractor shall provide all items and services
listed on Exhibit "A."
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.
The Contractor shall furnish all labor, material, equipment, and services necessary for the proper
completion of all work specified.
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 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.
SECTION III. COMPENSATION
City shall pay Contractor a sum not to exceed Four Hundred Forty Dollars and Zero Cents
($440.00) per ton of Liquid Chlorine, delivered, and Six Hundred Fifteen Dollars and Zero Cents
($615.00) per ton of Sulfur Dioxide, delivered, for the term of the agreement.
Contract No. 38-2013
Page 1 of 6
SECTION 1V. TERM OF AGREEMENT
This Agreement shall become effective April 1, 2013 and shall continue in effect until March 31,
2016.
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 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.
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 the 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 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.
Covera
A. Worker's Compensation &
Disability Requirements
B. Employer's Liability
C. Comprehensive General Liability
Limits
Statutory
$100,000
Page 2 of 6
Section 1. Bodily Injury
Section 2. Property Damage
D. Comprehensive Auto Liability
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
$1,000,000 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-I1 (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.
Page 3of6
SECTION VIII. 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 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:
1. 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 otthe Agreement; and
4. That this Agreement may be canceled or tenninated 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.
Page 4 of 6
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 parry. 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 5 of 6
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" ."CONTRACTOR'
THE CITY OF RICHMOND, JCI JONES CHEMICALS, INC.
INDIANA by and through its
Board of Sanitary Commissioners
4
n D 0� 12i..� ba
_By.. BY J -
Sue Miller, President
Printed: LD17'W0b no
Zvi. Title: ►? 7YY�1
Gil Klose, V e President
ns ember
Date:
-3 -/.-j—/,3
APPROVEDC.
Sarah L. Hutton, Mayor
Date: 3
113
Page 6 of 6
PRICE REQUEST
arYOFMCIMOND
DEPAit't1&MOF SA1UA1"i0N THIS z8 NOT .t l�l ORDER.
2380 LIBERTY Ai'�t ttJ AUCHM a"ID, It LWA 47374
YHOM (765) 9837450#11=765) 962 2669
VENDOR
INSTRUCTIONS
This is a request for a price for the services of materials
�t✓� �0 ]l0S ChemicalInc.
described below. Any additional speeltleflons may be
attached hereto. This Is NOT an order and the City reserves
the right to accept a[[ or part, of dec€Ina Ilia entire proposal.
600 Bethel Avenue
please complete your full name and phone number below
with signature,, itemize all prices and charges where
Beech Grove, IN. 461.07
regvestcd; and attach any explanation for any svbstitut[on to
specifications alto fed, Return Ina seated envolope, In care of
RlGhmond Sanitary District Board of Commissloners to
the admin[stralton building at the address above by the
specified date and time to be considered.
DATE:
REPLY i1 WT BE IN BY.
PAYMENT TERMS:
DELIVERY REQUIRED:
JANUARY 23, 2043
10:00 AM, FEBRUARY 12, 2013
UPON RECEIPT OF INVOICE
DELIVERED
This is a request for quotes, valid for Three Year (starting approximately 4MI2013 and ending March 3'i, 2016) for the
Listed items:
Liquid Aluminum Sulfate
See Attached Specifications & Bid Sheet
Liquid Chlorine (012)
See Attached Specifications & Bid Sheet
Sulfur Dioxide (802)
See Attached Specifications & Bid Sheet
Quotes Valid Until7�
Return ails sheet In a s fed envelope addressed to-
]RIchmondSnnitaryDistrict
Denise Johnson, Customer Svc Mgr
2380 Ltberty Avsnue
Ott hmond, IN 41374
RE, Chemical Quotes
Questions? Call Karen Rodenburg, 7Ei5=983�7480.
STATE TAX EXEMPTION #003424900-00'1
E We
r
NAME OF FIRM QUOTING:
� a l `1'��eSC emi cols, l��c.
AU7rrORr�r;O BY SlONATUt;t:
lia- oral saing 0wr6aa
ME
IX/ 7 Lou
DATE PHONE NUMSE:R
1
r
iEXHIBIT .-A— PAGE ____aiw q
PROPOSAL SHDET FOR
CHLORIlND (02)
PP CE
1?RS C�PTIC3i�t
Estimated 30 +1- tons of Chlorine per year
$ c? a /ton
Tank Deposit (if any) $ gk /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 OftechnicaI 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/l/13
to 3/31/16). If emergencies occur with Vendors manufacturer andlor 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 Sanitaiy 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 fox any charges. Vendor is to supply experienced/safe drivers and
equipment.
Vendor is to state delivery time after receipt of order IQ
t
Au# orized Signature
Contact Person
3.
Date
77-11)7
Phone Number
LDrra r) eCDjO10)JO cl
J-0) t�QY'S
Company Name
P mend -forms 1V7"
EXHIEIT—L PAGE --�—OF—�—
CediQcato ttttlber 20071221-MH18026
Repod Reference 06.1anuary 1995
issae pate- 2007 December 21
.18suerd to: JCz Jones Chemicals Inc
suite 900
1515 Ringling-Blvd
Sarasota FL 34236
nw, is to eer`* tliat sunny Sol (r) Chlorine
r-epresentafive samples of Maximum Use Level 30 rng/L
Page 1 of 2
Underwritors
Laboratories Incx0
flYG been IILVG'Stl !!ted 11y Ulif BI`it't'ifenv Lr�l�or tnliQ.s Irte.0 i�t
accordance IPit ! tile St(lnd(I)YI b� hlfliaftc - 011 fl!!s C rtt,`fIC[!iC'.
trrfulnrrl(,$) for Safety: ANSI/NSF Standaxd 60 - Dtinls-ing Water Treatment Chemicals
Aefelitlonal Afornzatlon: See addendum fot factOfY locations
01,1y tlrose prodnets bearing #Ira U1, Clnssif eatf an Mark should be considered as
being covered by UL's Classifleatfoo 011d F011OW-Up Sc1`vlce.
�nr,y
The 13L Classification Mark inoludew UL in a circle symbol: �� u+Itli the woad
"CLASSMED" {as shown.); a coritrol number (niay be alpbanurneric) tassiWletl by UL., a
statement to indicate the extent of UL's evaluuetion of this produot; and, the produet oalegrory
nt►rue (groduel i(ieatity) as indicated in the (appropriate UL Directwy.
Look for the UL Classification !bark on the product
EXHIBIT PAGE 3 OF.`-
GeTifrcateNunmber 20071221-MH18026
RepodRefereilce fly January 1995
Issuefate 2o07Deoember2i
Page 2 of 2
underwriters
� L.
This is to verify that representative samples of the product as speared on this certificate wear, tested
according to the current UL requirements.
Factory Locations:
Barberton, OR
Beech Grove, IN
Caledonia, NY_
Charlotte, NC
Jacksonville, FL
Meirimack, NH
Milford, VA
River view, ll�('
Tacoma, WA
Torrence, CA
Warwick,NY
m
EXHIBIT_ PAGE • -�--OF
{rf+/ii�ilyVY YLVli LOfYv Yrasa 1V•a,,70fY}a VV+ VVua+r 4LiVu,aVNf.1� .4aa4 VvwM 1 ++Y.�+•/•Naav yywrw•r.�y
• QA�T�-3
' sJ t7J�Joa7 4r.adXtiJ+LiiJ t�i •h'1•• • ...
Raw Material speci fiVati on
' Cix�c�acis�.e $seorxs
Chi or a (gaseauei C12
color (as gas)
Color (as liquid) Auer
odor Pungent~; irritating
nYaani a Tmx�u�C
Ch3.oxoi Qxm 1001 ppm Maximum
C=%on 100 PPM it
�3:n=gAni.c ._�mpuriti g
Non-volatile fesi.due 50 Ppm it
Always read aAd follow tho produ=- � abed and Material safetyr Data
Shoot (MOS) .
This raw matorial is manufactured xezuIt;i ng in a green-yexlov gas
or ,whyn dompressed, an ami)er liquid, its has a puagant, ivritat ing
adOX *is considered t=iG by inhalati =-. It ja napcQmhust:i.ble by
;Ltsejf,, yet auppovtS Combusti oxi through exi datriou r
T11.s Specification i,a oitad in part" to coAf-orm two Rnvirunmon.t;al
• Proteati.om Aqency critexi.a for use in the manufacture of sodium
laypaeh�.c�xa.Go.
,Tones Chemicalat Inc. will Set 5paci.ffjCation$ for raw materials at
its di scresaiaon according to a Ser, apeci ficati Ml critexr a a-3d
iairpnt. Qf uad a
tv. 01/31./94
EXHIBITS PAGE 6- 0FF
MINIMUM SpEt CIF ICATION FOR
. LIQUID CHLORINE, (C12)
gfdder Cora lies
YES NO
1
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 fl-am the District.
The District will admit delivery from 7:30 am to 1:30 pin,
Monday through Friday, (unless Holiday).
jej
EXHIBIT n PAGE QF `�
PROPOSAL SMET FOR
SULFUR DIOXIDB (SO2)
DSCRIPTION PRICE
00
D+
Estimated 3 S +1- tons of Sulfur Dioxide per year $ 69 % ltan
Tank Deposit (if any) /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/l/13
`
to 3/31/16)..jf 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 zs 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 c
Authorized Signature
701
Date
47?-/079
Contact Person
- Phone Number
ICI Ci o-Ws1r)C
Company Name- 30
P%M
EJCHIBiT �. P10GE 7 OF �
V611ti't 4vvv t1wal d.V. JV r vrvr N r vti... ..v .vw v.......-.�,-...,r ....,. .��.. ... — .�„r• _
r
1 ti
aws QM:CC,LO r ENO.
Raw material speci.i i.�ataton
3. dA
Sul:eur Dioxide (Liquid)
��� 99.9°s minimum `
MC?s�u�A BV PPm maximum
Residue- 40 ppm maximum
' 20 pPm max�.mum
Aridity (as 1sp4)
color (as 3.ivq di water White
color (as gas) cc��caxl sss
Od6v Pungent sul.fax
r,
Always xead and gal.jaw the groduat IIbei and Mater;�'�A. 5hfety Pita
Skeet WDS} .
MAK3.a.ticM
This raw material a v found as a aoloxless. gas r Whe odor compressed,
w�t;er wh',. liquid. xt has a. 9J1a*, pungent
Sulfur dioxide c sOl-ublO in wI.te
aonaadered toxi,o lay ix1halatiOA,
alcohol and ehther and toxins suIZurous RO'd (H2So,) revLdil,y. It
i
s
goncombustible .
'ones Chemicals, Inc. V1,11 Vet sPGCjfjGatjQns far raw materials •at
jts d�scvession according to A set OPP-Uificati.on cr'tari.a and
intent 09 use.
EXHIBIT _�_ PAGE _'�_OP_jj Rev,
MINIMUM SpEt CIFIICATION FOR
SULFUR DIOME (SOi,)
J
Sulfur Dioxide shall be 99.9% minimum (by volume)
produot. 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 containexs and valves shall meet AWWA,
DOT and applicable Federal Standards for handling and
storage of sulfas dioxide.
Delivery shall be made by vehicles properly equipped to
unload one -tots containers, District has overhead crane
inside building for off-loading. Track trailer must be
able to navigate through overhead doors. Delivery shall
not be made at the convenience ofthe 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 7t30 am to 1c30 pm,
Monday through Friday, (unless Holiday).
Bidder Com lies
YES NO
in
�TC1�r�
EXHIBIT PAGE SOP 9
ACC CERTIFICATE OF LIABILITY INSURANCE
DATE
a%21/20p> 3 YI
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 pollcy(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 endorsernent(s).
PRODUCER WA#712152 1-206-343-2323
BaCiC Group, LLC dba MCM
Bacic Pacific insurance Services. LLC #OY82099
1325 Fourth Avenue, Suite 2100
ACT
NAME:
PHONE FAX
NO'
ADDRESS:
INSURER 5 AFFORDING COVERAGE
NAIC q
Seattle, WA 98101
INSURERA; CFIARTIS SPECIALTY INS CO
26883
INSURED
INSURERB. NATIONAL UNION FIRE INS CO OF PITTS
19445
INSURERC: COMMERCE a I=USTRY INS CO
19410
JCI Jones Chemicals
Inc
1765 Ringling Blvd
INSURERD:
INSURER E
Sarasota, FL 34236
INSURER F :
COVERAGES CERTIFICATE NUMBER: 31666354 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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
A55I
SUBR
POLICY NUMBER
POLICY
O Dp EFF
PMIDD EXP
LIMITS
A
GENERAL LIABILITY
B014240603
01/01/1
01/01/14
EACH OCCURRENCE 1
$ 1,D00,000
PR DAMMISES (Ea AG attune e
$ 300,000
X COMMERCIALGE.NERALLIABILITY
MED EXP Anyone person
S 25,000
CLAIMS -MADE OCCUR
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMPIOPAGG
$ 2,000,000
Ewa 8 rt) E M
�iY t
$
1,000,000
B
riPOLICY % PE O X LOC
AUTOMOBILE LIABILITY
I
I
CA57759
01 Ol
4 01 1-COMBINED
BODILY INJURY (Per person)
$
X ANY AUTO
EDGILY INJURY (Per accident)
$
ALL AUTOS OWNED 8CUHr2SULED
HIRED AUTOS NON -OWNED
PROPERTY DAMAGE
er dent
$
A
UMBRELLALIAB
X
OCCUR
NGUI4240892
D1/01/1
01/01/14
EACH OCCURRENCE
$25,000,000
X
AGGREGATE
$ 25, 000, 000
EXCESSLfAB
al -AIMS -MADE
DED RETENTION$
$
C
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOWPARTNEWEXECUTIVE YIN
WC12948425
WC12948424
01/01/1
01/01/1
Ol/41/14
01/01/14
X WCSL4TU OTH-
El, EACH ACCIDENT
$ 1,000,000
E.L.DISEAB E-EA Empt-oyrmtE
$ 1,004■000
O FFICERIMEMIBER EXCLUDED?
(Mandatory inNH)
N/A
E.L. DISEASE-bOLICY LIMIT
$ 1 000, 000
0 es, desrliba under
US- dos
OF OPERATIONS below
A
Pollution Legal Liability
EG14240603
01 01/1
01/131/14
Each as 11000,000
DESCRIFRON OF OPERATIONS LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
Exhibit of Insurance for Bid.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE"
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTKORFZED REPRESENTATIVE j� n
USA /
lJ'IV86-GUIVA%oVMLJLVRrVRMII%Jt%. ^11Tty„w,Gay.--
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
n,zo1-1-1ri n a