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2017-210 Agrmt- H20 Innovation USA, Inc.
H2O INNOVATION USA. INC. EQUIPMENT RENTAL AGREEMENT (LEASE) THIS AGREEMENT, made the 19th day of July , 2017, by and between the City of Ashland, hereafter called the Lessee, and H2O Innovation USA, Inc., hereafter called the Lessor. Lessee and Lessor, for the consideration hereafter named, agree as follows: Under the General Conditions of Lease attached to this sheet, Lessor hereby leases to Lessee all Pilot equipment named and identified in the following "Proposal For The Supply of an Ultrafiltration Pilot System," for use at such location and at such rental rate for approximately such time as is therein stated. Lessor shall furnish such equipment, F.O.B., in operative condition. Unloading and Loading of Pilot equipment shall be the responsibility of Lessee and/or selected Contractor(s). LIST OF EQ UIPMENT Description Location of Duration of Lessor Rental Rental Rate of equipment equipment Identification Rate Per Unit (daily, Equipment use use Number Article $ monthly) OF Membrane Ashland WTP 3 months, TBD NA 15,000 flat $5,000 each Pilot Assembly Rate for 3 mon. Additional mon. Lessor and Lessee, for themselves, their successors, executors, administrators and assigns, agree to the full performance of the covenants herein contained. IN WITNESS WHEREOF, they have executed this Agreement the day and year first above written: David Faber -VP Capital Sales H2O Innovation USA, Inc. A*c AOJ461 P~~l,z tl~ar~~r 1 r. c3-Vlr ; City of Ashland By: P R EC. Ashland t. C Attorney Dat Page I of 5 H2O Innovation USA, Inc. Rental Agreement I GENERAL CONDITIONS OF EQUIPMENT RENTAL AGREEMENT The conditions of lease here below stated, together with the Agreement set forth on the reverse side of this sheet and the Lessor's Commercial Offer no. P-17032 dated July 11, 2017 (attached here to), constitute a contract between the parties therein named which contract is hereafter referred to as "this Agreement". 1) RENTAL PERIOD. The Rental period shall cover all time consumed in transporting the Equipment, including the date of legal delivery to a public carrier for transit to Lessee and upon return of the Equipment, the date of legal delivery by such carrier to Lessor, or if no public carrier is used, shall include the date upon which transit to Lessee begins and the date upon which transit from Lessee ends at Lessor's unloading point. 2) RENTAL CHARGES. Lessee shall pay rental for the entire Rental Period on each article of equipment named in the List of Equipment, at the rate therein stipulated and in accordance with the following: a) Monthly Rental Rates shall not be subject to any deductions on account of any non-working time in the month. The amount of rent payable for any fraction of a month at the beginning or end of the Rental Period shall be the monthly rental rate, prorated according to the number of calendar days in such fraction. b) Daily Rental Rates shall not be subject to deductions for any non-working time in the day and shall be paid for each calendar day in the month except Sundays and legal holidays upon which the equipment is not operated. Daily and monthly rental rates stipulated in the List of Equipment contemplate an operating day of a regular single shift of eight (8) hours, and for each hour over such eight (8) hours that the equipment is operated these rates shall be increased six (6) percent of the daily rate throughout such period as the equipment is so operated. c) Unit of Work Rates shall be paid for each unit of work in which the equipment participates, and the amount of rental shall, unless otherwise agreed in writing be determined by the number of units shown in the supervising engineer's or architect's estimates. 3) PAYMENT. The rent for any and every item of Equipment described in the List of Equipment shall be the,amount therein designated and is payable in advance on the first day of each month. Lessee shall pay Lessor interest at twelve percent-(12%) or the highest lawful rate, whichever is greater, on any delinquent payment from the date when such payment was due until paid and on any other sum for breach of this Agreement, from the date of the breach, and expenses of collection or suit, including actual attorneys' fees. Lessor shall bill Lessee at the end of every month during the rental period. 4) SECURITY DEPOSIT. Any security deposit paid by Lessee to Lessor is paid to guarantee Lessee's full and faithful performance of all terms, conditions and provisions of this Agreement. If Lessee shall so perform, an equal sum shall be repaid without interest to Lessee at the termination of this Agreement. Page 2 of S H2O Innovation USA, Inc. Rental Agreement i 5) FEES, ASSESSMENTS, AND TAXES PAID BY LESSEE. Lessee shall pay all license fees, assessments, and sales, use, property and excise, and other taxes or hereafter imposed, and relating to Lessee's use or possession of the Equipment. 6) RECALL NOTICE. Lessor may recall any or all Equipment upon ten (10) days written notice to Lessee and the Lessee may return any or all Equipment upon a like notice to the Lessor. 7) MAINTENANCE AND OPERATION. Lessee shall not remove, alter, disfigure or cover up any numbering, lettering, or insignia displayed upon the Equipment, and shall see that the Equipment is not subjected to careless, unusually or needlessly rough usage; and Lessee shall at his own expense maintain the Equipment and its appurtenances in good repair and operative condition, and return it in such condition to Lessor, ordinary wear and tear resulting from proper use thereof alone expected. 8) REPAIRS. The expense of all repairs made during the Rental Period, including labor, material, parts and other items shall be paid by Lessee. 9) OPERATORS. Unless otherwise mutually agreed in writing, Lessee shall supply and pay all operators on the Equipment during the Rental Period. All operators shall be competent. Should Lessor furnish any operators or other workmen for the Equipment, they shall be employees of Lessee during the Rental Period, and Lessee shall pay them salary or wages and all other applicable costs. Lessee shall provide and pay for all workmen's compensation insurance and pay all payroll taxes required by law and applying to such operators and workman. 10) DISCLAIMER OF WARRENTIES. LESSOR, BEING NEITHER THE MANUFACTURER, NOR A SUPPLIER, NOR A DEALER IN THE EQUIPMENT, MAKES NO WARRENTIES, EXPRESS OR IMPLIED, AS TO ANY MATTER WHATSOEVER, INCLUDING, WITHOUT LIMITATION, THE CONDITION OF THE EQUIPMENT, ITS MERCHANTABILITY, ITS DESIGN, ITS CAPACITY, ITS PERFORMANCE, ITS MATERIAL, ITS WORKMANSHIP, ITS FITNESS FOR ANY PARTICULAR PURPOSE, OR THAT IT WILL MEET THE REQUIREMENTS OF ANY LAWS, RULES, SPECIFICATIONS, OR CONTRACTS WHICH PROVIDE FOR SPECIFIC APPARATUS OR SPECIAL METHODS. LESSOR FURTHER DISCLAIMS ANY LIABILITY WHATSOEVER FOR LOSS, DAMAGE, OR INJURY TO LESSEE OR THIRD PARTIES AS A RESULT OF ANY DEFECTS, LATENT OR OTHERWISE, IN THE EQUIPMENT. AS TO LESSOR, LESSEE LEASES THE EQUIPMENT "AS IS". LESSOR SHALL NOT BE LIABLE IN ANY EVENT TO LESSEE FOR ANY LOSS, DELAY, OR DAMAGE OF ANY KIND OR CHARACTER R SULTING FROM DEFECTS IN, OR INEFFICIENCY OF, EQUIPMENT HEREBY LEASED OR ACCIDENTAL BREAKAGE THEREOF. 11) INDEMNITY. To the extent permitted under ORS 30.260-30.300 (Oregon Tort Claims), Lessee shall indemnify Lessor against, and hold Lessor harmless, unless Lessor is found or judged negligent, from any and all claims, actions, suits, proceedings, costs, expenses, damages, and Page 3 of 5 H2O Innovation USA, Inc. Rental Agreement liabilities, including attorney's fees, arising out of, connected with, or resulting from the Equipment or the Lease, including without limitation, the manufacture, selection, delivery, leasing, renting, control, possession, use, operation, maintenance or return of the equipment. Lessee shall further indemnify Lessor, and hold Lessor harmless from all loss and damage to the equipment during the rental period. Lessee recognizes and agrees that included in this indemnity clause, but not by way of limitation, is Lessee's assumption of any and all liability for injury: disability and death of workmen and other persons caused by the operation, use, control, handling, or transportation of the Equipment during the Rental Period. Neither party shall be liable for consequential damages, except if Lessor is found or judged negligent. 12) RISK OF LOSS. Lessor shall not be responsible for loss or damage to property, material, or equipment belonging to Lessee, its agents, employees, suppliers, or anyone directly or indirectly employed by Lessee while said material property, or equipment is in Lessor's care, custody, control or under Lessor's physical control. Lessee is encouraged to obtain appropriate equipment, material, or installation floater insurance against such risk of loss. Lessee shall assume responsibility and be liable for the Equipment upon delivery, all the way up until its return to Lessor, and Lessee will obtain and maintain sufficient insurance coverage. 13) INSPECTION: CONCLUSIVE PRESUMPTIONS. Lessee shall inspect the Equipment within three (3) business days after receipt thereof. Unless Lessee within said period of time gives written notice to Lessor, specifying any defect in or other proper objection to the Equipment. Lessee-agrees that it shall be conclusively presumed, as between Lessor and Lessee, that Lessee has fully inspected and acknowledged that the Equipment is in full compliance with the terms of this agreement, in good condition and repair, and that Lessee is satisfied with and has accepted the Equipment in such good condition and repair. Lessor shall have the right at any time to enter the premises occupied by the Equipment and shall be given free access thereto and afforded necessary facilities for the purpose of inspection. 14) OWNERSHIP. Lessor shall at all times retain ownership and title of the Equipment. Lessee shall give Lessor immediate notice in the event that any of said Equipment is levied upon or is about to become liable or is threatened with seizure, and Lessee shall indemnify Lessor against all loss and damages caused by such action. The Equipment shall remain at the Ashland Water Treatment Plant location at all times, and shall not be moved without the prior written consent of Lessor. 15) DEFAULT,- REMEDIES. If (a) Lessee shall default in the payment of any rent or in making any other payment hereunder when due, or (b) Lessee shall default in the payment- when due of any indebtedness of Lessee to Lessor arising independently of this lease, or (c) Lessee shall default in the performance of any other covenant herein and such default shall continue for five days after written notice hereof to Lessee by Lessor, or (d) Lessee becomes insolvent or makes an assignment for the benefit of creditors, or (e) Lessee applies for or consents-to the appointment of a receiver, trustee, or liquidator of Lessee or of all or a substantial part of the assets of Lessee under the Bankruptcy Act, -or any amendment thereto (including, without limitation, a petition for reorganization, arrangement, or extension) or under any other insolvency law or law providing for the relief of debtors, then, if and to the extent permitted by applicable law. Lessor shall have Page 4 of 5 H20 Innovation USA, Inc. Rental Agreement the right to under any other insolvency law or law providing for the relief of debtors, Page 5 of 5 H2O Innovation USA, Inc. Rental Agreement then, if and to the extent permitted by applicable law. Lessor shall have the right to exercise any one or more of the following remedies. (a) To declare the entire amount of rent hereunder immediately due and payable as to any or all items of the Equipment, without notice or demand to Lessee. (b) To sue for and recover all rents, and other payments, then accrued or thereafter accruing, with respect to any or all items of the Equipment. (c) To take possession of any or all items of the Equipment without demand, notice, or legal process, wherever they may be located. Lessee hereby waives any and all damages occasioned by such taking of possession. Any said taking of possession shall not constitute a termination of this lease as to any or all items of Equipment unless Lessor expressly so notifies Lessee in writing. (d) To terminate this lease as to any or all items of Equipment. (e) To pursue any other remedy at law or in equality. Notwithstanding any said repossession, or any other action which Lessor may take, Lessee shall be and remain liable for the full performance of all obligations on the part of Lessee to be performed under this Lease. All such remedies are cumulative, and may be exercised concurrently or separately. 16) NO SUBLETTING ASSIGNMENT. No Equipment shall be sublet by Lessee, nor shall he assign or transfer any interest in this Agreement without written consent of Lessor. Lessor may assign this Agreement without notice. Subject to the foregoing, this Agreement inures to the benefit of, and is binding upon, the heirs, successors, and assigns of the parties hereto. 17) REMEDIES CUMULATIVE: NO WAIVER; SEVERABILITY. All remedies of Lessor hereunder are cumulative and may, to the extent pemtitted by law, be exercised concurrently or separately, and the exercise of any one remedy shall not be deemed to be an election of such remedy or to preclude the exercise of any other remedy. No failure on the part of the Lessor to exercise and no delay in exercising, any right or remedy, hereby shall operate as a waiver thereof, nor shall any single or partial exercise by Lessor of any right or remedy hereunder preclude any other or further exercise thereof or the exercise of any other right or remedy. If any term or provision of this lease is found invalid, it shall not affect the validity and enforcement of all remaining terms and provisions of this lease. 18) EXPENSES. Lessee shall pay Lessor all costs and expenses, including attorneys' fees, incurred by Lessor in exercising any of its rights or remedies hereunder or enforcing any of the terms, conditions, or provisions hereof. 19) ENTIRE AGREEMENT. This instrument constitutes the entire agreement between Lessor and Lessee; and it-shall not be -amended, altered or changed except by a written agreement signed by the parties hereto. Page 6 of 5 II20 Innovation USA, Inc. Rental Agreement 21 3 i JLss i ewd~ 3 t _ i's". w xI t M r 4P ` to a Project Name: H2O Innovation/BASF OF Pilot Date: July 11, 2017 Proposal number: P-17032 Revision Number: 02 Submitted To: Submitted by: Kevin Caldwell David Faber Senior Project Manager Director - System Sales City of Ashland H2O Innovation 20 East Main St. 1048 La Mirada Court Ashland, OR 97520 Vista, CA 92081 541-552-2414 760-685-5418 Kevin. Caldwell(a)ashland.or.us david.faber(a~_h2oinnovation.com TABLE OF CONTENTS Table of Contents 2 SECTION 3 - Remote Access and Data Logging 4 SECTION 4 - Commercial Offer 5 2.1 Pricing 5 2.2 Payment Terms 5 2.3 Optional Technical Service 5 Appendix A - P&IDs Appendix B - OF Pilot Brochure I~ s H2O Innovation/BASF OF Pilot- P-17032 -July-2017 h20, Feed water into the pilot unit is assumed to be by others. A feed water supply at 35 gpm with minimum 25 psi is required. Note that if the feed pump is powered through the pilot's control panel, and 60A service would be required. Shipping and commissioning is also included as part of the H2O Innovation package. A brochure of the OF pilot unit has been included as Appendix B. The brochure outlines basic installation and utility/ power requirements. Equipment provided by BASF/inge includes: • OF Pilot skid and ancillary equipment (see P&ID) • One BASF/inge OF membrane module • All other labor associated with the system, which includes: o Troubleshooting o Repairs o Replacement o Extra trips to site o Analysis of data o Report writing In addition, the following is not in H2O Innovation's scope of supply and is entirely by others: • Unloading, uncrating, installation and installation supervision. Installation will, at minimum, require a forklift and possibly a crane/hoist. • Upon equipment arrival on site, if any unforeseen damage or structural repairs are required, Customer will notify Shipping Company & H2O Innovation prior to commencement of any repairs beyond original quoted scope noted above. Any additional charges for such items will be noted in writing and approved by H2O Innovation Project Manager before scope of work is started. • Controls, unless stated otherwise. • Isolation valves outside the equipment tanks. • Design, equipment supply and installation of membrane removal system (such as an overhead crane). • Walkway, platforms, handrails, grating, and access ladders/stairs unless stated otherwise. • Chemicals • Automatic samplers or other test equipment and performance test. • Compatibility -of equipment materials of construction with process environment. • Supply and installation of electrical connection and interconnecting wiring. • Supply and installation of interconnecting piping • Any other auxiliary equipment or service not detailed above • Any and alt site work, equipment installation, piping or-electrical installation, civil work. • Any and all weather protection, buildings or sheds of any kind. • Any and all Permits for the site. • Interconnecting piping between system and Raw or Treated water supply. • Plumbing of Treated-Water to point-of use/discharge. • Electrical Service required to Supplied Control / Power to Panel. • Embedded posts and anchor. • Any and all lab and hand held water quality test equipment or calibration equipment. H2O Innovation/BASF OF Pilot - P-17032- July-2017 PQr 'P' h20-'_1__V • Disposal or handling of any and all waste produced. REMOTE ACCESS AND DATA LOGGING Hardware is included with the pilot unit to facilitate remote access capability and data logging. This includes an Advantech industrial PC for logging the data, fortigate firewall, Seirra wireless cellular modem and antennae, as well as a Factory T-alkView SE runtime license. H2O Innovation can provide technical services for setting up remote access at a -project site location as follows: • Sites using a wireless connection. Technical services by H2O Innovation's IT department would be provided at a lump sum cost of $500 (USD) per project site. • Sites using a customer's hardwired connection. Technical services by H2O Innovation's IT department would be charged at an hourly rate of $100 (USD), plus any expenses charged at cost plus 15%. IT services are charged at an hourly rate for this scenario as we cannot estimate the complexities of navigating through private firewall systems and IT security protocols at existing water treatment plants. Above quoted rates are exclusive of taxes. Please note that all cost associated with internet service providers at site and/or third party data service coverage plans including any installation fees and service provider equipment rentals is the responsibility of others. Data logging for purposes of monitoring pilot performance would be provided by means of data files that are compiled and saved to the pilot's Advantech PC. Data files would be extracted by the customer/consultant by remotely connecting to the pilot and selecting the appropriate files. Data file extraction would be required at least every 30 days. Data would be logged by CSV data files and would include such raw values as feed and production flow, backpulse flow, feed and filtrate pressures, feed and filtrate turbidities, feed temperature, as well as MIT data (start pressure, end pressure, pressure decay rate). H2O Innovation/BASF OF Pilot- P-17032 -July-2017 c COMMERCIAL OFFER 1.1 PRICING One (1) FiberFlex Pilot unit for three months $15,000 (1) Pricing is exclusive of taxes. I (3) Shipping FCA, H2O Innovation manufacturing facility, Champlin, MN. 1.2 PAYMENT TERMS Our commercial offer is based on the following payment terms: /47,0 2.., 1-6 k'-d e,1 y ,W#K-&kIy 309A U This offer is based on the technical equipment selections of the two previous FiberFlexTM pilots that H2O Innovation has built and therefore there is no need for a technical engineering submittal and review process. This proposal supersedes all previous proposals and correspondence. 1.3 OPTIONAL TECHNICAL SERVICE H2O Innovation can provide technical service for the pilot unit - in the form of site visits, or having the pilot unit shipped to our Champlin, MN manufacturing facility for routine maintenance. For site visits, H2O can provide a specialized technician for services such as: • Installation and piping interconnection • Maintenance service for pilot equipment • Decommissioning • Additional work where the customer-may elect to use H2O Innovation Technical services for site visits can be provided by a qualified service technician at a daily rate of_$1,000 (USD) per day plus travel and living expenses charged at cost plus 15%. For strop-based maintenance service, H2O Innovation would charge an hourly rate of-$75 (USD) per hour for a trained technician, with materials and parts charged at cost plus 20%. For shop- based maintenance, it is assumed the cost of shipping the pilot unit to and from Champlin MN would be by others. H2O Innovation/BASF OF Pilot - P-17032- July-2017 VALVE SYMBOLS FLOWMETER SYMBOLS PIPING ABBREVIATIONS MISCELLANEOUS EQUIPMENT SYMBOLS FLOW INSTRUMENTS ANALYTICAL INSTRUMENTS N OPEN N.CLOSED - ,t )ISSS l1SSTAINLE555TEF1, FAH FWWAIARRI HIGH AAH ANALYTICAL ALARM 111011 BALL ROTAMETEA W/ y)I SS JW .S'fAINLFbS STEEL TC\ FAL FWWALANAI LUW AAL ANALYTICAL ALARM LOW NN y~ RUTAAIETER INTEGRAL C~ 1MMERACD HEATER I+VF1 Pt" V-BALL NF,F.VI.i. vA1.YF. 116L SS LOW CARBON I IS STAINLESS STEEL ^NR^ FCV FLOW CONTROL VALVE AE ANA YTICA INDICATO )WL68 WW'CARBON JDI6TNNLES86TEEL CARTRIDIiF.MITER FE FLOW ELEMEM AI ANALYTICAL L INDICATOR I' DJ J' ,j BUTTERFLY ~ CPV CHLORINATED MLYV" I. CI ILORIDE HOUSING TC IN-LINE HEATER FI FWR'INDICATOR AC ANAL INDICATMO CONTROLLER f 1 UTAPII0.AON THERMAL CS CARTON STEEL MC FLOW INDICATING CONTROLLER AR ANAL SWITCH, IIIOH TE0. DI DUCTILE IAUN FIT FI.UWINDICATINO TRANSAIETTE FITER AAH ANALY OCAL 'DCAL SWITCH IION D pQ H GATK NDPE HIGH-DENSITY MLYETNYLENE FR FWW RECORDING ASL AN ALYTICAL9WD'CULUW D INTEGRAL REMOTE PE POLYETHYLENE LT FSH FLOW SWITCH IDGII AT ANALY KCAL I RANSMI FOLK w GLOBE IVC POLYVINt'LCFILORIDE ULTRAPGNICLMI, FAL FLOW SWTCH WIV AY ANAL)TIC.ALSVNAI. CONVERT, DP. OR UH. NEEDLE I 1 v MAGNETIC 0.LC6 RUBBER LINE]CARBUN SIFE.1. AUFUAIATIC STRAINER 'ER01BRGTTEA N FLAW CONTROL OR(NJ/OFF VALVE MISCELLANEOUS INSTRUMENTS JOW SCII. 3CIIEDULE FQ FLAW TOTALIZER I« PLUG M,tl" M SIDE BTANDARD DIMENSION RATIO FY FLOW SIGNAL CONVERT, VP, OR SOIJA HMS HAND SWITCH I IIHAND SWItCl1 MSRIUN INDICATOR m SAAIPLPIDPAiN ❑ ❑ SILCNCE0. 49 11 CURRENEDMIC.ATIR CIIECK nJI~Qm1n "Nf PADDLE LINE SYMBOLOGY ~u1 FLOATATYLE LEVEL P RESSURE INSTRUMENTS W1 TDTALIi.ER MDIC4TOR W W BACKFWAV PREVLNTER IpJ MAIN PROCESS LINE" SWITCH PAtI PRESSURE ALARPI HIGH RC RPEED CONTROLLER SECONDARY PROCESS LINE AI PAL SESSUREALARAIWW M PEED ALARM TOR INJF.CTON QUILL PC IREF RFNTROLLE0. YA MOTD MOTOR ALARM VORTEX - PROCE6FtM6. BY OTHERS MO'IU0.IZED MIXER CHEMICAL PCV 3EI.F RED F.O PRA, CONTROL. VAt.VF. ~t7 "C1' R.9" VC MOTOR CONTROL LWAY. LOJ -o- COMM LINK (4Y. PLC TO NMI) t ST-n~wiv CONTAINMENT PDH DIFFERENTIAL PRFS3uRE HIGH yl MOTOR UNKJFF INDICATOR COMM LINK In. PLC TO DCS) PDI DIFFERENTIAL PRESSURE INDICATOR EI POSITION INDICATOR T FT STATIC MIXER PDIT DIFF PRESS INDICATMO TRANSMITTER ZIC SWITCH CLOSE INDICATOR EIECTRWWBUNO _V PRESSURE REWUTINO CALIBRATION PDSH FEREF.TIAL PRE SWITCH HiOH ZIO SWITCH OPEN INDICATOR 7f CPNRIFICE ~-N--- PNEURATIC LINE M. TA.4P COIAJAIN PO ?REF fiURE OAI'OE IBC ttM111UN.9W'ITCH C-1.0 LINE RIMPER PI PRESSURE INDICATOR I ZSO PUSGIUN SWITCH UPFN 'VCI `I'Ljy1~1+11"- CKPRLF6URL C BA 1 AI MOIOA PIC PRESSUREINDICATINOCONTROLLER ZT McMON TRANSMITTER C REGULATING PIPE DLFCONTINIIATION PIT P0.EURE INDICATINGTRANSMITTER MEMBRANE Z, roeITONE0. INSI RUMENTATION SYMBOLS y ~.J EWCTUR OR VE_u "I PRMIURE 6W1TCH HIGH PLOW DIRECTION ARROWS VALVES & EQUIPMENT FLOW CONTROL I..~1 S SELF PR ITCHLOW 1" )I6 SS 6CH.lU LINER SIZE/ Y STRAINER I AC AIR CUMPRFSAUR I. ALLY MCONTROL RI Y S V L SMI VALVE DESCRIPTION ATE0.IALIDENTIFIER UV -1-S" ARV AIR RELEASE VALVE MOUNTED PANEL I~CONICALOR PT PRESSURE fRESS PREASLIRE TRr.9MITR:R AS AIR SUPPLY I-WA1 SULIMOI13 SMDBOUNDARY F^ lMYUW\RY SIR,\INER Pt' P0.E938WNAL Coerv'ERT, W, OR SOLN DISCRETE INSTRUMENT KI_D BY HIV Ime_rI= D BLOIVER NOT BY H.O Imova4o AIR C'UMPRE93UR PSLH PRESSURE SWITCH IOW HIGH IT BULK TOTE IWAY SDLENOID " "~I p PU LSATKJN DAMPENEp X PR MARY PIC OR DCS / L/lG A' REVISION Q5 DIAPHRAUAI O LEVEL INSTRUMENTS CBD COARSE BUBBLE DIFFUSER G1IAREDC(JNTAOL POREDI'E CV CHECK VALVE yyy 1-WAI'SOLFI:ViD m , DISf4aCEAlEM' Iw11 LEVEL ALARM HIGH ED FDUCTOR LINES TOTROM OTHER SHEETS © FLOW ORIFICE -1LIC LAL LEVEL"_ LOW F X®' SECONDARY PLC OR DC3 BLOWER FILTER DESCRIPTION LCV SELF RED LEVEL CONTROL VALVE ISO ME BUBBLE DIFFUSER SHARED CONTRUL All RELEASE CUTAWI SHTI 12~ RUPTURE, DISK (PRESSURE) LE LEVEL ELEMENT FL FAIL LAST (DEFAULT IF NOT SHOWN) _ Q DESTNAON REOFlIF.RATIVE W LEVELGAUGE !TJ VACUUM BREAKER M1~J' COMPUTER FUNCTION I RUPTURE DISK (VACUUM) BLOWER PC FAILCLUBED ® LI LEVEL INDICATOR M FAIL OPEN PUMPSYMBOLS INSTRUMENT FUNCTIONS SPECTACLE BLIND L IF.'JEI. INNCAT1Nf GI.IER PUG CALIDRATUN CUUWIN LEE R LEVEL INDICATINGTRAII IRANSAIITI'ER R 56NIIRF. RKISASK . CENTRIFUGAL H HEATER NORMALLY SIGNAL SRO!-E93MG FUNCTION CEN'IRINOAL II NVNORMALLY RAIALLYLY CLW L'LCISED) BWWER LS LEVEL SWITCH HIGH HCV HAND CUN1Rq,VALVE B P LSL LEVEL SWITCH LOW B O AVTOIM.W' UAL ~ COARSE BUBBLE DIFFUBEN BEER HEA1'LR fi LUKE OAi JWEIR LT LV ELTRAN CONTROL R MITTIER HI' HAND VALVE LuI OL ADDFTION/SUMM.AnVN F-1 FINE BUBBLE DIFFUAER LV L IV EL ONA,FF VALVE RI MR VALVE ACTUATOR SYMBOLS O DIFFERENTIAL CHEMICAL METERING RFFRIGi.RATF.D LY LFVF.L SINFRVLUR 810NAL CONVERT. " VP, OR SULN I'M MIXER AIR DRYER TEMPERATURE INSTRUMENTS ' pt1Rlp PNEUMATIC OI INTERLOCK LUDIC RNCTIUN AT RESIN TRAP (FAIL LASTPO8ITONN m 0 FILTER TAN TFAIPERA'EURF ALARM HIGH ST SPILL T\NK AVF.RAONO \LA~/ DIAPHRAOAI TAL TEMPERATURE ALARM LOW' ®F.C. PNEUMA'fiC INSTRUMENT CONNECTIONS PWWCHAAIBER .C TEMPERATURECONTROLLER STA 1ANSTRAINER FAIL CLOSE OIHREAUED ~ EOCKEIUT;ID WELDED TE TCMPERATURF. 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PI']IP IM101, DRAWING REVISION l£ED TITLE ERW-SE E ogo1-4v,vo ,o NHOV~T Or+ xXE io XEMXO REV REVISION DESCRIPTION DRAWN LHNO ENG APPVD h O H CHEMICAL DOSING PROCESS 81NSTRUMENTATION DIAGRAM .wdFJrn " - WATER TREATMENT SYSTEM SCALE DRAWxNC NUMBER REVISwN P-57437-C01-0800 DG DO 13/100/1016 INITIAL RELEASE M P N/A J V J V M B DU NO'SU(E wtlVTS SHEET 4 :3 2 1 4 3 2 1 , D D Sp wI PsJ N" POI, 14" POI.,' AI1'I ('lllllllll .\IN CI)AIl'HFS'SI Ik il\ !)~iNI PCl'-95X)4 4\-JtT)5 IYA !)ST)3 Ct !J `vv~ 'IV rE UOUOLEa z]ue.l rn. ml u. 4-111lw on. rn IEx 1-ot4(10 I\'SI"RI 1I4.11 \IN 1(OOAIkUI Pd41 C (I L ,ET4:R C V TU 30 CEA1 tip ",SI Fl CfIIU]II) II\ ~156v1 Pl'I-YS[ili )5l~)t I\-YS"II (-\-v 4.v"I - TV 1'4 AfODl'IJS' B B I ID \ IIS A A Il' za wx .ans y I. .1111111 IV S -RIOF \I>I\SIXINI I IHIY\HI. S PR \ 101 I) S 1 I OIE CUAIYR4 N J -F, z. SRID "0' 1'1 . 111)4.U IP I4\T IS P:,RI 4 III F 11 SAID 11 "Cl., SOI.E1011) E iOTE DRAWING REVISION ONIESSNOTE TITLE OTHERNASE EPROPERT.o ..-1 N ARE TO RO.- REV REVISION DESCRIPTION DRAWN CHKD END ARPVD h2blpAIR COMPRESSOR SYSTEM - AIR SCOUR & MIT AS SEPARATE LINES PROCESS 8 INSTRUMENTATION DIAGRAM Ell „o~T Vak1m WATER TREATMENT SYSTEM SCALE DRAVnNC NUURER REwsION .1 ALL "'°•"'P P- 57437- C01 -0950 00 00 131092016 INITIAL RELEASE m p iv N/A J V M B w xNOT SC+EE GRIVIS SHEET 4 ls$ 'T$],C~ Department of the Treasury MIRSIaterval Revenue;3e"ice' In reply refer to: 0443359470 QGDEN UT 84201-0038 Sep. 26, Z016 LTR 147C 0 20-5584930 0000010 00 0-6 0-0 12 0-!) BOBC: LM H2O INNOVATION USA INC Z ANNIE--LEMIEUX 330 RUE-SAINT VALLIE-R- EST QUEBEC G1K 9C5 CANADA 000106 Employer identification number: 20-5584930 Dear Taxpayer: Thank you for your inquiry of Sep. 15, 2016. Your employer identification number (EIN) is 20-5584930. Please keep this letter in your permanent records. Enter your name and EIN on all federal business tax returns and on related corresp-andence. You can get any of the forms or publications mentioned in this letter by calling 1-800-TAX-FORM (1-800-829-3676)-or visiting our website at www..irs.gov/formspubs. If you have questions, you can call us toll free at 1-800-829-0115. If you prefer, you can write to us at the address at the top of the first page of this letter. When you write, include this letter and provide in the spaces below, your telephone number with the hours we can reach you. Keep a copy of this letter for your records. Telephone number ( ) Hours 0443389470 Sep. 26, 2016 LTR 147C 0 20-5584930 000000. 00 00001206 H2O INNOVATION USA INC % ANNIE LEMIEU-X 330 RUE SAINT VALLIER EST QUEBEC 61K 9C5 CANADA Sincerely yours, V Jan Runyen Prog:-am Manager, AM OPS 2 Enclosures: Copy of this letter Contract Clauses for contracts with ProfessiionalSEtvices Contractors for projects funded by Safe Drinking Water financing SAM Registration and DUNS number are required for all entities that enter into direct contracts with the recipients of Safe Drinking Water Revolving-roan funds SAMi'FZagisiration: http://ww.sam.gov/portal/public/SAM/ DUNSNunt)erhttp:l/www.dnb.com/get-a- RZ 1H~6~adio S I~StQ ~n~. duns-number.html NOTE The SAM registry on expires annually and mat bekept active until the SDVRY prqed is dosed 6& H g I q q'97 Language to be included verbatim in contracts according to any accompanying instructions 1. Source of Funds Work under this contract is funded by the federal Safe Drinking Water Revolving Loan Fund through the Oregon Business Development Department and a partnership of Local and/or Private Funds. Whistleblower (language to be included in all construction contracts and subcontracts) "Contractor receiving SDWRLF.funds shall under or through this contract to, post notice of the rights and remedies provided to whistleblowers under No Fear Act Pub.-L.107-174. 29 CFR 4 1614.703 (d)." 3 Non Discrimination 'The contractor shall not discriminate on the basis of race, color,-national origin or sex in the performance of this contract. The contractor shall carry out applicable requirements of 40 CFR part 33 in the award and administration of contracts awarded under EPA financial assistance agreements. Failure by the contractor to carry out these requirements is a material breach of this contract which may result in the termination of this contract or-other legally available remedies." 4. Termination for-Cause and for Convenience & Breaclrof Contract (language to be-included in all construction contracts and subcontracts in-excess of $10,000:) "Contractor shall address termination -for-cause and for convenience,-including_the manner by which it will be effected and-he basis for settlement. In addition, contractor shall address administrative, .contractual, or legal remedies-in instances where-contractors violate or breach-contractterms, and- -provide for such sanctions and penalties as appropriate-." S. Intellectual Property (language to be included in all contracts:) "Contractor hereby grants to-the U.S. E.P.A. a royalty-free, nonexclusive, and irrevocable license to reproduce, publish or otherwise use, and to authorize others to use, for federal government purposes, any intellectual property developed under this contract. Contractor shall secure from third parties the same license in the name of the U.S. E.P.A. regarding any intellectual property developed by third parties as subcontractors to perform this project, or developed under contract with the Contractor specifically to enable Contractor's obligations related to this project." 6. Inspections; Information (language to be included in all construction contracts and subcontracts:) "Contractor shall permit, and cause its subcontractors to allow [insert name of wotersystem Owner], the State of Oregon, the federal government and any party designated by them to: (1) Examine, visit and inspect, at any and all reasonable times, the property, if any, constituting the Project. (2) Inspect and make copies of any accounts, books and records, including, without limitation, its records regarding receipts, disbursement, contracts, and any other matters relating to the Project, and to its financial standing, and shall supply such reports and information as reasonably requested. (3) Interview any officer or employee of the Contractor, or its subcontractors, regarding the Project. Contractor shall retain all records related to the Project for three years after final payments are made and any pending matters are closed." 7. Environmental and Natural Resource Laws (include the following language in all contracts and subcontracts in excess of $100,000:) "Contractor shall comply with all applicable standards, orders, or requirements issued under section 306 of the Clean Air Act (42 U.S.C. 1857(h)), section 508 of the Clean Water Act (33 U.S.C. 1368), Executive- Order 11738, and Environmental-Protection Agency regulations (40 CFR part15). 8. Procurement of Recovered Materials (include the following language in all contracts and subcontracts in excess of $IO,OOD:) "Contractor must comply-with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act, including procurement of recovered materials in a manner designated in guidelines of-the Environmental Protection-Agency (EPA) at 40-CFR part 247." 9. Prohibition on the-Use of federal runds for Lobbying(Certification Regarding Lobbying form follows, for any-contrazts in excess-of$100,000)- (foorm follows) CERTIFICATIDN REGARDING -LOBBYING (Awards to Contractors and Subcontractors in excess of $100,000) The undersigned certifies, to the"best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or-will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal -contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352; title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not-less than $10,000 and not more than $100,000 for each such failure. Signed i Title V?-Capital Equipment Sales Date 07/26/17 R-Iml -F, MEMBRANE FILTRATION EQUIPMENT MANUFACTURER (MfEM) PRE-QUALIFICATION DOCUMENTS FOR CITY OF ASHLAND WATER TREATMENT PLANT Ashland, Oregon Work under this contract is funded by the federal Safe Drinking Water Revolving Loan Fund through Business Oregon and a partnership of Local and/or Private Funds. APRIL 2017 KELLER PROJECT NO. 217002 PREPARED BY: PREPARED FOR: f pw,~ KE L L E-.R - - a-ssociate-s cirv of -7 SHLAND - 1005 NW GALVESTON AVENUE, SUITE 220 20-EASTIVIIAIN STREET- BEND, OR97703- ASHLAND, OR 97520 .(T:-)-503-490-2041 (T) 541552 2414 - bryanblack@kellerassociat-es.cam kevin.caldwell@ashland.orms _ i- 21700zm 3 CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002. NOTICE INVITING MEMBRANE FILTRATION QUIPMENT MANUFACTURERS TO PRE-QUALIFY TO BID ASHLAND WTP MEMBRANE FILTRATION EQUIPMENT RECEIPT OF QUALIFICATION INFORMATION. The Water Treatment Plant .(WTP) Membrane Filtration Equipment Manufacturer (MFEM) digital Statements of Qualifications (SOQs) will be received by the City of Ashland's consultant at the following email address until 2:00-PM Pacific local time on May 23, 2017. MFEM's are encouraged to follow up with a telephone call to confirm submittal receipt. Bryan Black, Keller Associates brvanblack ankellerassociates.com (503) 490-2041 VENDORS: The pre-qualification procedure will select and pre-qualify MFEMs to perform pilot testing and potentially bid to supply membrane filtration equipment for the Ashland WTP (Project). Bids will only be accepted from those MFEMs that are pre-qualified by the City and successfully pass the pilot test. No other MFEMs will be eligible to bid on this Project. DESCRIPTION OF WORK: The Work involves pilot testing and potentially furnishing membrane filtration system goods and services for a new water treatment plant. OBTAINING PRE-QUALIFICATION DOCUMENTS: Pre-qualification Documents may be obtained by contacting Bryan Black at the email address or telephone number noted above. PROJECT ADMINISTRATION: All communications relative to this work shall be directed to Bryan Black. Questions received less than 5 days prior to the date for opening the pre-qualification proposals may not be answered. SOURCE OF FUNDING: Work under this contract is fundedby the federal Safe Drinking Water Revolving Loan Fund through Business Oregon and a partnership of Local and/or Private Funds. -CITY'S RIGHTS RESERVED: The City reserves the right to reject any or all SOQs, to waive any formality in the Pre-qualification Information, and to terminate this process at any time for any reason. City of Ashland Dates Advertised: May 9, 5, and 12, 2017 MEMBRANE FILTRATION EQUIPMENT MANUFACTURER NOTICE NM - 1 CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002 MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION REQUIREMENTS 9 i GENERAL: The City of Ashland, Oregon (City) is requesting statements of qualifications (SOQs) from qualified Membrane Filtration Equipment Manufacturers (MFEMs) with systems suitable for municipal water treatment. The membrane filtration system will be used in a new water treatment plant (WTP) with an-ultimate capacity in the range of 10 million gallons per day (MGD). The-City's raw water supply is pressurized, and only membrane filters driven by positive pressure will be considered. The membrane filters must have excellent chemical and mechanical resistance with a demonstrated history of maintaining membrane integrity. The City will select up to three NIFEMs to participate in pilot testing. Only MFEMs / equipment that have been pre-qualified through this process and have successfully completed pilot testing will be allowed to bid or propose on the-project to supply membrane filtration goods and services for the new WTP. MINIMUM QUALIFICATIONS: Selection to participate in pilot-testing and the Request for Proposal or the Invitation to Bid process will be based on meeting the following required minimum criteria: • Equipment approved as an alternative filtration technology by the State of California Department of Public Health on California Surface Water Treatment Rule, Alternative Filtration Technology Summary, CDPH DDWEM Technical Programs Branch - August 2011. • Positive pressure-driven membrane system configuration. Vacuum-driven or submerged membrane systems will not be considered. • Nominal-pore size < 0.2 micron that meets requirements of surface water treatment filtration as defined by US EPA in its Long Term 2 Surface Water Treatment Rule and latest edition of the Membrane Filtration Guidance Manual. • Acceptable membrane materials: polyvinylidene difluoride (PVdF), polyether sulfone (PES), or ceramic. • Ability to tolerate up to 60 pounds per square inch (psi) feedwater pressure. • Commitment to provide a pilot-scale treatment unit for testing in Ashland, Oregon, from July 15 through November 15, 2017. • Very high oxidant tolerance; tolerance over a wide pH-range (pH 1 to pH 13); coagulant [aluminum sulfate (Alum); aluminum ch lorohydrate (ACH), polyalumirum chloride (PAC])] tolerant. • NSF 61 Certification. • Total worldwide installed capacity of at least 200 MGD. MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION REQUIREMENTS VPQR - 1 CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002 o At least two USA municipal drinking water treatment facilities under contract or operating with a total capacity equal to or more than 15 MGD. QUALIFICATION EVALUATION: MFEMs / equipment meeting the minimum qualifications will be further evaluated to prepare a pre-qualified list of up to three. The City reserves the right to reject any submittal, including without limitation the right to reject any or all non-conforming or non-responsive submittals. The City also reserves the right to waive any and all informalities in i selection of the MFEMs for participation in this process. Proceeding to the bidding or proposal phase requires the approval of the membrane system for use in filtering surface water by the State of Oregon Health Authority, Drinking Water Services. The City reserves the right to terminate this process at anytime, for any'reason. Preparation of SOQs and subsequent materials shall be at the sole expense of the proposer. Subsequent activities for pre-qualified MFEMs will include submission of electronic process and instrumentation diagrams, and specifications, in native file format; coordination in planning the pilot test; completing the pilot test; and others. I Should review of the submittals received indicate that there are more than three MFEMs that satisfy the minimum selection criteria, the City will select from the qualified MFEMs using the following selection criteria and weighting. • Favorable references (30%). • Fiber breakage, membrane integrity, and related history (50%). • Number of service, engineering, and manufacturing support staMocations (20%). All eligible MFEMs-that can meet these criteria shall submit digital SOQs by email or other electronic -method to Bryan Black at brvanblack@kellerassociates.com, 503.490-2041, to be received by May 23, 2[117, by 2:00-PM Pacific local time. It is recommended that the proposer call to confirm receipt. The submittal documentation shall include the attached Qualifications Statement, all documentation requested in this RFQ, and any additional information deemed relevant by the MFEM. MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION REQUIREMENTS VPQR - 2 s CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002 MEMBRANE.FILTRATION EQUIPMENT MANUFACTURER (MFEM) QUALIFICATIONS STATEMENT SUBMITTED TO: Bryan Black, PE Keller Associates 1005 NW GALVESTON AVENUE, SUITE 220 BEND, OR 97703 (T) 503 490 2041 bryanblack@kellerassociates.com SUBMITTED FOR: MEMBRANE FILTRATION GOODS AND SERVICES, ASHLAND, OREGON SUBMITTED BY: Name of Organization: Name of Representative Individual: Title: Business Address: Telephone No.: Email.: Fax No.: MFEM QUALIFICATIONS STATEMENT VQS - I CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002 GENERAL BUSINESS INFORMATION Check i£ ❑ Corporation ❑ Partnership ❑ Joint Venture ❑ Sole Proprietorship If Corporation: A. Date and Province/State of Incorporation: I B. List of Executive Officers: NAME TrrLE i i If Partnership: A. Date and Province/State of Organization: B. Names of Current General Partners: C. Type of Partnership ❑ General ❑ Publicly Traded ❑ Limited ❑ Other (describe) If Joint Venture: A. Date and State of Organization: Name, _Address, _and For-of Organization of Joint-Venture Partners (Indicate managing partner by-an asterisk MFEM-QUALIFICATIONS STATEMENT VQS - 2 ti CITY OF ASHLAND WATER TREATMENT PLANT PhEMBRANE FILTRATION EQUIPMENT MANUFACTIURER PRE-QUALIFICATION 217002 If Solle Proprietorship: A. Date and Province/State of Organization: B. Name and Address of Owner or Owners: FINANCIAL 1.0 Provide the following for your surety: Surety Company: Agent: Address: Telephone No.: 2.0 What is your approximate total bonding capacity? ❑ $500,000 to $2,000,000 ❑ $2,000,000 to $500,000 ❑ $5,000,000 to $10,000,000 ❑ $10,000,000 or more 3.0 Provide the following with respect to an accredited banking institution familiar with your organization. Name of Bank: Address: Account Manager: Telephone No.: 4.0 Attach a financial' statement, prepared on an accrual basis;_ n. a farm that clearly indicates MFEM's assets, liabilities, and net-worth. Date of financial statement: Name of firm preparing statement: MFEM QUALIFICATIONS STATEMENT VQS - 3 1 CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION. 217002 SYSTEM DESCRIPTION Provide basic information about the membrane system submitted for consideration as indicated below: 1.0 Wbat is the name of the membrane system submitted for consideration (indicate MF or UF)? 2.0 The City will only consider membrane filers designated as micro- or ultra-filters with a nour£nal pore size of :S 0.2 um. Indicate the membrane module product name, membrane material, and nominal pore size. Does the proposed membrane system meet requirements of surface water treatment filtration as defined by US EPA in its Long Term 2 Surface Water Treatment Rule and latest edition of the Membrane Filtration Guidance Manual? ❑ Yes ❑ No 3.0- Due to the available driving head, the City is only considering membrane system configurations driven bypositive pressure. Submerged or vacuum-driven system will not be considered Is the proposed membrane system enclosed and driven by positive pressure? ❑ Yes ❑ No 4.0 Indicate the maximum and minimum driving force utilized by the system. Minimum driving force psi Maximum driving force psi 5.0 The City will only consider membrane system that can-tolerate up to 60 psi. feedwater pressure. Indicate the maximum feedwater pressure that can be tolerated by the membrane systt= / module- Maximum feedwater pressure psi 6.0 How is the membrane system flow-pattern configured? W ' ~ [I Inside-out ❑ Outside-in- MFEM QUALIFICATIONS STATEMENT VQS - 4 CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002 3.0 Membrane Material - Membrane material shall be polyi inylidene di fluoride (PVdF), polyether sulfone (PEE), or ceramic - which have high oxidant tolerance according to the American JEater lTjorks Association Manual of If'ater Supply Practices M53 "Alicrofilhation and U'It?ajiltration Membranes for Drinking FVater" The MFEM certifies that the membrane material is PWdF, PES, or ceramic. ❑ Yes ❑ No 4.0 Coagulant/Oxidant Tolerance - The project requires membrane filter materials with very high oxidant tolerance; tolerance over a wide pH range (pH I to pI-I I3); ability to use coagulants [aluminum sulfate (Alum), aluminum chlorohydrate (ACH), polyaluminum chloride (PACT)] in direct filtration mode. The following list of coagulants or oxidants are the only exceptions not approved for use with the membrane system specified above: 1) 2) 3) 4) 5) 6) The MFEM certifies that the exposure to coagulants or oxidants used in the WTP will not be grounds for revoking or invalidating the membrane module replacement warranty except as noted above ❑ Yes ❑ No 5.0 Fiber Breakage / Membrane Integrity - The MFEM shall provide a history/background data report on-fiber breakage / repair and membrane integrity for the proposed membrane system. The MFEM shall describe the expected frequency of membrane integrity loss along with methods to verify and restoremembrane integrity. Has this documentation been included? ❑ Yes ❑ No MFEM QUALIFICATIONS STATEMENT VQS - 6 i CITY OF ASHT1 AND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002 6.0 System Capacity - (1) The MFEM shall have at least 200 MGD of total installed water 3 treatment capacity using micro- or ultra-filtration membrane modules and systems of the same type proposed for this project. (2) The MFEM shall have previously completed, or be under contract to complete, at least two municipal drinking water treatment facilities within the USA with a combined capacity of at least 15 MGD. The referenced previous experience in (1) and (2) shall be for the specific membrane system proposed for this work. i 6.1 The MFEM certifies that the following installations utilize micro- or ultra-filtration membrane modules and systems for the production of municipal drinking water, and that these facilities combined have a capacity of at least 200 MGD. List the facilities used to satisfy the above criteria in the following table. Include a separate attached if needed. I MFEM QUALIFICATIONS STATEMENT VQS - 7 CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION VENpOR PRE-QUALIFICATION 217002 DATES OF- INSTALLED CONTINUOUS CAPACITY FACILITYNAMEfTYPE OWNERNAMF. CONTACT NAME TELEPIIONENO. EMAILADDRESS OPERATION (MOD) I i i E i i i i i TOTAL INSTALLED CAPACITY: (Attach 8eparaty sheet, if necessary, listing additional facilities.) i I MFEM QUALIFICATIONS STATEMENT VQS - 8 CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002 6.2 The MFEM certifies that it has previously completed or currently has a contract to provide equipment and services for at least two municipal drinking water-treatment facilities in the USA with a combined capacity of at least 15 MGD. ❑ Yes ❑ No List the facilities used to satisfy the above criteria. Attach additional pages as necessary. (#1) Location Capacity MGD Contact Telephone No. (#2) Location Capacity MGD Contact Telephone No. 7.0 Favorable References - Submittal documentation shall include a list of at least five reference projects in operation (including owner contact information, name, phone, and email). Has this documentation been included? ❑ Yes ❑ No 8:0 Service Support - The MFEM shall provide a-table listing the number of service, engineering, and MFEM support staff and locations in the USA, along with a brief summary describing the support. Has this documentation been included? ❑ Yes ❑ No MFEM QUALIFICATIONS STATEMENT VQS - 9 CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 217002 9.-0 Membrane Pilot Unit Availability - The pilot unit will be fully assembled and skid- feed and filtrate pressure monitors (to mounted. It will include en-line instruments: calculate transmenibrane Pressures); and feed and filtrate turbidimeters, temperature, and flow to calculate flux and recovei)z The pilot will include satellite communications for control and remote data collection. AfFE11 labor will include set-up, connnissioning, and start-up; remote operation and data collection; monthly site visits with chemical cleaning; pilot decoinniissioning/shipping; and pilot report preparation. The pilot unit, including- labor and reporting, will be made available for $5, 000 per month for a minimum of 3 months. The MFEM certifies that a membrane pilot unit meeting the above description and ancillary equipment are reserved for use by Ashland between the dates of July 15 and November 15, 2017. ❑ Yes ❑ No 10.0 Membrane System Manufacturing Ability - The MFEM shall have the ability to manufacture 10 MGD capacity of micro- or ultra-filtration membrane units (racks, trains, etc.) and ancillary equipment within 6 months of the notice to commence fabrication of the equipment: ❑ Yes ❑ No Indicate annual manufacturing capacity in number of units and capacity for the type and kind of membrane units proposed. units MGD 11.0 Tine MFEM has reviewed the attached document entitled "Contract Clauses for contracts with Professional Services Contractors for projects funded by Safe Drinking Water financing"and agrees to comply with its terms. ❑ Yes ❑ No MFEM QUALIFICATIONS STATEMENT VQS - 10 e r CITY OF ASHLAND WATER TREATMENT PLANT MEMBRANE' FILTRATION EQUIPMENT MANUFACTURER PRE-QUALIFICATION 2I7002 ACKNOWLEDGMENTS The undersigned certifies under oath the truth and accuracy of all statements and of all answers to questions made herein. {1 t I Dated this day of 2017. Organization: (Print or Type Name) By: Title: ' i (Seal, if corporation) I Swam to before me this day of in the County of State (Province) of (Notary Public) My commission expires (Seal) END OF SECTION MFEM QUALIFICATIONS STATEMENT VQS - 11 I t Purchase Order Fiscal Year 2018 Page: 1 of: 1 THIS PO NUMBER MUST APPEAR ON ALL INVOICES. AND SHIPPING DOCUMENTS. B City of Ashland _ ATTN: Accounts Payable L 20 E. Main Purchase L Ashland, OR 97520 Order # 20180905 T Phone: 541/552-2010 O Email: payable@ashland.or.us V H2O INNOVATION USA, INC H C/O Engineering Division E 8900 109TH AVE N I 51 Winburn Way N P Ashland, OR 97520 D SUITE 1000 Phone: 541/488-5347 O CHAMPLIN, MN 55316 T Fax: 541/488-6006 R O Vendor Phone Number = 17 Ve o► ax Numb F~ stdisifren 1 mt~sr =>e~i _ry Reference Kevin Caldwell Date Ordered Vendor Number E2 mi uIre E=t ~`Ti 1V1Q-0 ~rrri De _a_ ment/Locatidon - 08/02/2017 3596 Cit Accounts Payable Item# Qescrt_trQn//R rt - TO _=-Unit Price Extended -Price Filtration Pilot Testing 1 Pilot testing OF Membrane Pilot Assembly equipment for new 1 $15,000.0000 $15,000.00 WTP per the attached H2O Innovation USA, Inc. Equipment Rental Agreement (Lease) Project Account: E-201531-999 GL SUMMARY 081900 704200 $15,000.00 By Date: j thorized Sig ire FAO Total _ $15,000.00 FORM #3 CITY of ASHLAND REQUISITION ~request: July 25, 2017 equlred date for dekvei-y: ASA Vendor Name H?n Innrvatinn I ISA Inr. Address, City, State, Zip 1048 La Mirada Court Vista. CA 92081 Contact Name & Telephone Number David Faber, 760-685-5418 Fax Number David.faber@h20innovation.com SOURCING METHOD ❑ Exempt from Competitive Bidding ❑ Emergency ❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization ❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached ❑ Written quote or proposal attached -(Attach co of council communication _ If council approval required, attach co of CC -E] Small Procurement Cooperative Procurement Less than $5,000 ❑ Request for Proposal (Copies on file) ❑ State of Oregon ate approved by Council: ❑ Direct Award R Contract # ❑ Verbal/Written quote(s) or proposal(s) (Attach copy of council communication) ❑ State of Washington Intermediate Procurement ❑ Sole Source Contract # GOODS & SERVICES v f ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract $5,000 to $100,000 Written quote or proposal attached Agency ® (3j Written quotes and soli to vl~a ar ❑ Form #4, Personal Services $5K to $75K Contract # PERSONAL SERVICES ❑ Special Procurement Intergovernmental Agreement $5,000 to $75,000 ❑ Form #9, Request for Approval ❑ Agency ❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council: ❑ (3) Written proposals/written solicitation Date approved by Council: (Date) ❑ Form #4, Personal Services $5K to $75K Valid until: Date - (Attach copy of council communication) Description of SERVICES q~ l/ Total Cost Pilot WTP rental per the attached agreement $15,000.00 (3 month study period) Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST ® Per attached quotelproposal- $ Project Number 2015-31 Account Number 081900-704200 'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. IT Director in collaboration with department to approve all hardware and software purchases: IT Director Date Support -Yet-/ No By signing this requisition for I certify that_fbe City's public contracting requirements have been satisfied. Employee: l Department Head: 7- 1 (Equal to or greater than $5,000) Department Manager./Supervisor: City Administrator: (Equal to or greater than $25,000) Funds appropriated for current fiscal year. KS 7Y NO Fi fiance Dir r (Equal to or greater than $5,000) Date Comments: Form #3 - Requisition