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2023-083 PO 20240033- Northstar Chemical Inc
Purchase Order. 'afi CITY RECORDER Fiscal Year 2024 Page: 1 of: 1 • 3 VV-61 = `11'431E a 5 ELN :T B City of Ashland =._---= � 20 E. Main ATTN: Accounts Payable Purchase L Ashland, OR 97520 Order# 20240033 T Phone: 541/552-2010 O Email: payable@ashland.or.us E NORTHSTAR CHEMICAL, INC H C/O Water Treatment Plant N PO BOX 6860 I 90 North Mountain Ave D PORTLAND, OR 97228-6860 P Ashland, OR 97520 OR Email: AR@NORTHSTARCHEMICAL.COM . Phone: 541/488-5345 T Fax: 541/552-2329 $ROWTa mtx9 Wie; �s [um� e'�`I 11=1 ta--"'- Is r... < � r -4.P. ..., i _- I— Alistair Andre 6 Q-@ ra erica few �.n-vy Tl .�9 �==��&&t ti'_�+ e_k• .''-=a' _— 07/21/2023 3463 FOB ASHLAND OR/NET30 Ci Accounts Payable :=4 WA_ gt.nr&,*Mxterittircillifoev WTP Chemicals 1 Polydyne Moe 106 PWG Flocculant 10.0 LOAD $3,400.00 $34,000.00 Load: 2,000 Lbs (4 each/500 Lb drums) Cost per load/order: $3,400.00 Delivery included in price Project Account: ***************GL SUMMARY*****,********** 081900-601500 $34,000.00 • • • 1 • • By:V ' ' % • Date: ' " z3 Authorized Signatge 34 000.00 FORM #3 • CITY OF • A request for Purchase OrderD d----0 F ASHLAND • i .REQUISITION Date of request: 7)17)?3 • Required date for delivery: Vendor Name NORTHSTAR CHEMICAL INC • Address,City,State,Zip • Contact Name&Telephone Number • Email address J . SOURCING METHOD . ❑ Exempt from Competitive Bidding Invitation to Bid ❑ Emergency ❑ Reason for exemption: Date approved by Council:6/20/2023 IDForm#13,Written findings and Authorization ❑ AMC 2.50 (Attach copy of council communication) El Written quote or proposal attached ❑ Written quote or proposal attached (If council approval required,attach copy of CC) ❑ Small Procurement ❑ Request for Proposal Cooperative Procurement Not exceeding$5,000 . Date approved by Council_ ❑ State of Oregon ❑ Direct Award _(Attach copy of council communication) Contract# ❑ Verbal/Written bid(s)or proposal(s) ❑ Request for Qualifications(Public Works) ❑ State of Washington Date approved by Council: r Contract# . (Attach copy of council communication) ❑ Other government agency contract Intermediate Procurement ❑ Sole Source Agency GOODS&SERVICES ❑ Applicable Form(#5,6,7 or 8) Contract# Greater than$5,000 and less than$100,000 0 Written quote or proposal attached Intergovernmental Agreement • 0 (3)Written bids&solicitation attached ❑ Form#4,Personal Services$5K to$75K Agency PERSONAL SERVICES Date approved by Council: ❑ Annual cost to City does not exceed$25,000. • Greater than$5,000 and less than$75,000 Valid until: (Date) Agreement approved by Legal and approved/signed by ❑ Less than$35,000,by direct appointment ❑ Special Procurement City Administrator.AMC 2.50.070(4) ❑ (3)Written proposals&solicitation attached El Form#9,Request for Approval • ❑ Annual cost to City exceeds$25,000,Council ❑ Form#4,Personal Services$5K to$75K 0 Written quote or proposal attached approval required.(Attach copy of council communication) Date approved by Council: Valid until:_ __•(Date) " Description of SERVICES TOTAL COST $ Item# Quantity Unit Description of MATERIALS Unit Price Total Cost 1 10 2000lbs POLYDYNE MOE 106 PWG COAGULANT 4 500LB BARRELS 3,400.00 $34,000.00 . • / , ❑ Per attached quotelproposal TOTAL COST • (`e' to ' o/ 2 ) $34,000..00 Project Number Account Numb Account Number - Account Number - . *Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures. . IT Director in coil boration with department to approve all hardware and software purchases: IT Director Date Support-Yes/No By signing this reqs l:'tion form,t certify that the City's public contracting requirements have been satisfied. Employ,-----_-:‘ Department Head: a ar, 7.17.2-3 e �� �'�: al to 6 ..3'than$5,000) Department Manas erlSupervisor: 'City Manager:/ (Greater __. (Greatertha 35 0 Funds appropriated for current fiscal year, SS / NO IA ��11 AI A Finance Director-(Eq .-oo\ereefer than$5,000) , Dat Comments: . Form#3-Requisition . • Council Business Meeting • • June 20,2023 H "oi'il� f1 c 1 ITB - Chemicals for Water and Wastewater Treatment Plants ' i �.�t��4,' {�)�1<`R11t1`v .:;,:; e Michael Morrison Operations Deputy Director • �i r • : michael.morrison(ashland.or.us 541-552-2325 • • 5"1te nLTypQ;; ;; :1' Requested by Council ❑ Update 0 Request for Approval ❑x Presentation ❑ SUMMARY • The Water and Wastewater Treatment Plants procure chemicals that are required to maintain consistent treatment plant operations and meet water quality standards as required by the Oregon Health Authority (water) and the Department of Environmental Quality (wastewater).Approval is being requested to award public contracts to the lowest bidders that meet the individual chemical specifications resulting from a formal competitive sealed bid (lnvitation.to Bid) • • POLICIES;PLANS&GOALS SUPPORTED City Council Goals:•. • • Essential Service • o Water • o Wastewater • •Continue to leverage resources to develop and/or enhance Value Services' • Department Goals: . • Maintain existing infrastructure to meet regulatory requirements and minimize life-cycle costs. • Deliver tirnely life cycle capital improvement projects: • Maintain and improve infrastructurethat enhances the economic vitality of the community. • Evaluate all city infrastructure.regarding planning management and financial resources. BACKGROUND AND ADDITIONAL INFORMATION . The previouspublic contracts awarded for these chemicals were approved by the City Council on June 15, 2021,for a term that began July 1,2021,and will end on June 30,2023. • The contracts in need of approval now resulted from a formal competitive sealed bid (Invitation to Bid) and eight (8) bids were received in response to this ITB. This ITB allows for multiple contract awards and individual contracts will be awarded to the lowest responsible.and responsive bidders for each of the chemicals.The term for these public contracts will begin on July 1,2023,and end on June 30,2024. • In accordance with AMC 2.50.080(C),the City Council acting as the Local Contract Review Board is . required to approve the award of public contract(s) resulting from a formal competitive sealed bid. In accordance with AMC 2.50.070(1),the multiple contracts resulting from a single ITB exceeds the delegated authority of$100,000.00 for Goods and Services (type of procurement) and thus requires Council approval. • Page 1 of 2 • • Fa fir.,xcc', . • • rim Council Business Meeting - . • • The City's intent is to award the public contracts for chemicals as follows: • {!j Ha.� Fi '1, � +f4. ,#} � +i.�.�' ,.�:.�y'c.�.r:�x' rtq n0. 'x. `y� -'S_ t ''��?- �'1 �"t�: r3 r, v � ,,-q fd: ->��C 1'; is M ,. , iV4:.r1. -. ."' iC"�,1t u "4•.'K• ? ,^ Eshfnatedtnu 41i4i 'r 4t P'a 9' i,C•' Z,y, �� [tzt -�-c��CostlOrtder, � ostEshinatei. ri a�`Waterea� ent P1*ane try �r Bt1s< I,,x.of orldersforFyYi �FY202'4aFYa20T�4` n - :',:„-,':.2.-e,29 '3.-,,--,; c.: ;_� t 7 _ 's. S� ,-. ....://'"1,-. .,.....__.�:L''ir '..a.�wry. d. �.p � ,1e�. . .-.1tr4,.. .a..:A., ... :: _3 Dii'.Yf. '�3:-_.,,i?._ ' Cascade Columbia . Chemical#1 ALUMINUM SULFATE Distribution 13 $7,034.40 $91.447.20 Company . Cascade Columbia Chemical#2 SODIUM HYPOCHLORITE Distribution • 13 $5,032.50 65,422.50 Company . Chemical#3 CYTEC SUPERFLOC C-573 • NorthStar Chemical 9 $3,400.00 30,600.00 FLOCCULANT Inc. CYTEC SUPERFLOC N-300 LMW Cascade Columbia Chemical#4 FLOCCULANT Distribution 6 $1,649.20 9,89520 Company Chemical#5 SODA ASH DENSE FREE FLOWING TR International 13 $4,657.50 60,547.50 Trading Company • SODIUM CARBONATE Chemical#6 PEROXYHYDRATE,FREE FLOWING— No bids received - "GREENCLEAN" - �. t , ,-!; ,V i Total'Eshma e,,44. 1: F -1024 $257,91140 W - I Estimated number . Cost/Order Cost Estimate" astewater Tres tment Plant, Bidder ,of orders for k'Y FY 2024 FX 2024 . ':.., _ ,' , ,! k, .2024, - i '. :, , . . ., Cascade Columbia Chemical#7 SODIUM HYPOCHLORITE Distribution 6 $2,013.00 $12,078.00 • Company - Cascade Columbia Chemical#8 CITRIC ACID Distribution • 2 . $7,205.00' 14,410.00 • Company Cascade Columbia Chemical#9 ALUMINUM SULFATE Distribution 18 $5,899.50 106,191.00 • Company • ' , - ' Total Estimated Autounts'—FY 2024 $132,679,00 FISCAL IMPACTS . • Funds are budgeted each fiscal year for all of the chemicals required for use at each of the plants. DISCUSSION QUESTIONS ' • SUGGESTED NEXT STEPS . Staff recommends the public contracts be awarded per the table above and attached bid tab. REFERENCES&ATTACHMENTS • ITB Bid Tab for Chemicals • . • ' Page 2of2 • • • • • • • • • 2023 BID TAB-Invitation to Bid Chemicals for Water&Wastewater Treatment Plants • Bids due by 2:00:00 PM(PST)May 23,2023 • • • Firm pricing July 1,2023 to June 30,2024 • , • ' Cnseade ' Chemtride c ''t b " �, ,L W ---- y Y cambia •,! JCI Jones , 'NorthstarChemical;.r Shannon Chemicell,Thatcher Company�of Thornton,Musso and:-.TRInterm8onnl'•...�'1)td¢r- o . occulan -or-Pct d nem Ckcmrrals'USi EcoServhce5L'LC,,ch-0,1„1,, USA,I e 0. • e -occulent(gb Dc m--,--- ' _ 3 LLC c• - _-.. In'1. t.- i Inc.-;`.:',.7.;;. t _Corpara6on Cn'4'.' a doe. _ Delfe.--,,aInc. Trading Comp t!.•. .. i •- . f ubstih two) pang - l r - c *'tsi "c`nr`.` :^( Manufacturer Cytec NO BID . 'NO BID NO BID ''P'olydyne 2vIOSti: NO'BID NO BID NO BID NO BID Late-Received bid 4�'°�•?1Q6PWGT-�`> 05/24/2023 Price per pound(Lb) $2,31/lbs. -'$1_70/lb t- Cost per 500 Lb drum $1,155.00 • `,',!•--7/5$8.50-.007-1..177.-:',! Cost per order-4 each 500 lb ' -'u'-">"'° • drums $4,620.00 53;4_bo.oC. • -, Deliverychargeper order Delivery is P--5-1""`-" g S0l00�"�--'; inc]uded in price ''""---"--S":"_,-,"- _., ; Conunents -'ri,..a.-',.c` 1i • OFIEMiGAJ o111JPP a (�umtrndg ;' ir, 5 , • istnbu iq JCI'Joaes Northstar Chwlcal S6nnnon Chemkni Thatcher coin a¢ of Thornton Musso,and TRlntem:tiopaii" i t " 6- DIstnbu6on C7tcmtcals USq,BeoServlces LLC t 3 " fl; .I Y • 1(4440 r:US Ilia: Chem�cd--Ina - ,.. C• -: ,-_bon ,..'''•' Inc .]3ellemiu,Ina Tndm'^ :.pm, ty�•0(4 Company 1I' r a t ,e'..-,--,— . Manufacturer eo:=,.Y NO BID NO BID NO BID NO BID NO BID NO BID • NO BID Late-Received bid ' NO BID 05/24/2023 Price per pound(Lb) - $3:74/liis'- . • Costper25kg or 55.12 Lb bag ' • ` '-" •-` 55.12 Lb bag _ _$206:25= ,`' Cost per order-(8)bags ---$1;64920' • • Delivery charge per order Deltvery:zs,•,., •'included in Price', - Comments ct>aeade , eHEMICAL- o -- ,Citemtrade•. Y. e i . Y 1 r. , Columbhn JC{Jonet ,i_NorthstarChemhcal Shonnon;Chenuca�ThatcherCom an or+'homEon Musso and Is TRInternafconat« y= Soda e L• D1sttribution ,^�h"'micaLt USs: Ecd�;Servlees LLC Cfiemicols Ina• Ina --'r•;°c"� Co oratia¢ "F :Ca6fornin Ina Bell�in;Ina -.-Trndr�ri-tem n ; `Unlvnr OSA Inc ((3 i lura rbt) s Company r LLC q t P r r s Fi ,lug Y e s . ' , ---= . Late-Received bid Manufacturer - Tata NO BID NO BID NO BID NO BID NO BID NO BID tiGenPcis=Alkzlr NO BID ,'ti~, 4':---_-.,:o 05/24/2023 Number of pounds(Lbs.)per bag 50 lbs. - ..5o ,- - Number of bags per pallet 55 bags - 54 Price per pound(Lb) 10.3697/lbs. $0951 Cost per order 270 bags(5) $5,083.375 ---cl pallets (our pallets are 275 .,:i..,:.-.2-$4;§57I513. . bags/5 pallets) •4. Delivery-charge per order Delivery isTnclude'd Comments ••=r^` -_ •included in'price _ ? ' • • • • Bid Tab-Page2of4 • • ' • • - • 2023 BID TAB-Invitation to Bid Chemicals for Water&Wastewater Treatment Plants • Bids due by 2:00:00 PM(PST)May 23,2023 • • Firm pricing July 1,2023 to June 30,2024 . u=- —c''-';'-,::',-;-.-'-;,-;1Q-,-` -r .- .�;.: , :i_7. T 4_4 ,rU: -.L..1,--,c 1.. Iw ,,r.tst.4,.t it r .1.;.43 t CHl M1id�AL�41 oWTl' • C6emtrade,'. '-r �i;-'j a'aad;r TR Int,t-a',.„ianalr v% :' ' mt*-�?- t, • ` = = JCI Jones '':Northst Ciaemtmi ShnanonClicmleal Thatcher Com an of Thornton,Ntoss_,,, y r. , AlummumSulfate-Eco Cofumbtnt -."t Y : 'radio omp `'i7-..rvarUSA,lnc Chemlals US Eco S-- :,s�LLC f p E • S¢rvi`esarC°ascade.Colttmtrin „bistr76uttao LLC _ Chemitnls,Iae. -;'�no� �-"�1Corporetwn t �.Cnit�orain Ine� l,t••.'Bel[�min,lae. ,4`aT�dma ,,CGmpen�y x����� �a:.�i (No Substitution) - Compaa9 ` J r. rr� -c:-<,. - 7 ,. _i_ _.�. �_, .n ... ,., � .-_ ,�;' `� ,, : _ Thatcher Company of Late-Received bid Manufacturer -,Chem7ade,-* NO BID NO BID NO BID NO BID NO BID ' California,Ina NO BID NO BID 05/24/2023 Number of pounds(Lbs.)per gallon.:'; 2023 BID TAB-Invitation to Bid Chemicals for Water&Wastewater Treatment Plants . Bids due by 2:00:00 PM(PST)May 23,2023 • . Firm pricing July 1,2023 to June 30,2024 • • :' rr.- _ •:.,::;;T"--7, c t .1 'to!t , ,"r r ti{ h t L"- . '5'a, !' t .t-a _.4.1"? s+ At'-t,",. • CHSNIICA #60c "( , d j a j vs .cw:p "'4 .+'`4 �a iyu{r Cilie C _ rF (.- �i. j-, g l y �.,Chemtrade _ J_. i s ri t' � ,� i -, tf"� Sodium Cnrbcnnte '5'.Ca'[um6n -i ': . JCI`Jr_n, -NoreheNr:001ca�,+ .S i-•°4 iChemteai,:Tbatdt <7?mpnny4f Thornton,Masso,a t�TRIrEeeran and 'r - die:t - 'a•'-'77--71-,,,-'`heaueals'USEea,5ervreesLLC',Chemfe�nls,Sur �` '�"'alai;� '',':-.7i2 R 4`Cor ration � �,Cnlifo ia,Ine �� $cl►emfu, c TrabmbCompa�n,Y� e+.�r�'••r;k Perax lrydmte,.• ee,(�.o Dtstrifite!]an1 c'. + T- tom. ` Y4: in �•-.tw�-. �' So +.. 4;t TII•. t!.� �• y"gy��-k r �'�,� c .. - ,; - t' $ - R 'Greertclean' o E urvalenE CAai nn �- _ c: � �. x _ 'ti a.�. � rn � s - ;,k o -� u _ y.,t � yT',.,' •( QP 9 ) n H- -t' t y., ,,,' "c r= r a� n,t':y ,Yj3 ,, -e _-.7. .r to " ,o•`g.31:',-;'-.,"", :r ?'t'" .i'^r;. i R tvecl.6id^ - - - Late- ece Manufacturer NO BIDL J NO BID NO BID NO BID NO BID NO BID NO BID NO BID• NO BID 05/24/2023 Number of pounds(Lbs.)per bag - _ . Number of bags per pallet ' • • Price per pound(Lb) ' Cost per order 160 bags(4) • pallets • • . . • Delivery charge per order ' • Comments -- 0 Ca9CAde •' - CHSMICA4#7=lTi(v [ ColumbiYa •ChheuemcnraIle74 'Or„S•e rvlcesl LCx SCJones MorthstnrChemlenl; „ShanneuChemlenl`-Thatcher•CnmpaoyolThoratoa,Memo and" 4RInte.nalronaa£'' Univar,T Sodium RzrEalhata Egli 'Distr{buton - TfC • 7 _ Chwalenls Ins, `, Inc; Cor uraton ", •CnCoruln,Inc ' ,Bcl1emiiiInc __ TmdtngCom�nny '---,"`f`r ISA,Inc,. i•~tin .. ; -1-:-.`":',$'k ;„ . , q _ Late-Received bid Manufacturer Iasn•Iua,. NO BID NO BID NO BID NO BID _NO BID NO BID NO BID NO BID 05/24/2023 Number of gallons per tote4-'275'ga Th'na: • Price per gallon(gal) 'e$3.66I'ga(i*n' ; •• . . Cost per tote '.;`S};606130'` , . Cost per load/order(2)totes - $ 01300'Z. • Delivery charge per order _ Aelipety i's=.G .. _ • r tncluded'inprlce • • Comments• -, , . Shmm�n Chemlcnl Thatcher Com aay of Casrnde 'Ch t++!d? Thornton Mosso and TR•Internattonnl J ? •- C EMiCAL.tfB�CP,QS'ttfP Coltimpra ChcmlculsU$ >;eo,Serv3cesLZG Jmicals .4.. ;Norf6stnr.Ghemlcol„ Yoga' Inc-'r -1411eailaIac 'T''dlri''Company''''"'"•----"'""'-`-=----c CitricL` 1r7 D1strihtarn ZI.L C4emicnls,Inc, Vic �.'ornoration Ca tl• • Comp$ r. rp • Northstar Chemical, ' Shannon Chemical NO BID Thornton,Musso and NO BID Late-Received bid •Manufacturer yCascadaGbitmtbto•' NO BID ''NO BID NO BID Inc. Corporation 'Bellemin,Inc. . 05/24/2023 . Number of gallons per tote "r 275 gallons -" 270 Gallons per tote 330 Gallons ' 330 Price_per gallon(gal) .513.10'/llon.n $13.35 per gallon $32.77/gallon $16.75 '--•n-x. $10,814.10/330 gallon . Cost per tote E'$3;602;50i:;'';• $3,605.50 $5,527.50 ",y. -- y tote Cost per load/order(2)totes r”' 5-4205.00 • $7,209+00 $21,628.20 $11,055.00 Delivery charge per order _77eiivery,is $0.,00 included $0.00 S. included in price,' Commcross - _ , .,- • • 5 Torras:0%,Net 30 days .. • Bid Tab-Page 3 of 4 • • • • • • 2023 BID TAB-Invitation to Bid Chemicals for Water&Wastewater Treatment Plants • • Bids due by 2:00:00 PM(PST)May 23,2023 • Firm pricing July 1,2023 to June 30,2024 • • • r Ca3cnQn Ch• etatrade , ,.;. CJIE I•`I5 9-W VT r Columbia: .Ch h U JOE-Jones •Northstar�C6erni al,•. Shannon,rChemicel `Thatcher Company of:Thorhton,,M__usso and. 3R Intern t nal iA1nmipumrSulrate erwca s - coEco.Serr}ces,LLC. Chemicals,Inc ' • Inc:,: Corporation Californin,Inc.` ;•Ballantine Inc. r:Trading;Campany Umvnr VSA Manufacturer Thatcher Company of Late-Received bid • Chemtrade 'Chemtrade Eco Services LLC NO BID NO BID NO BID NO BID NO BID California,Inc. 05/24/2023 Number of pounds(Lbs.)per gallon 1]tO8:lb5t/gal' 11.134 11.1 in solution u_ { 11.09 Number of dry pounds(Lbs.)pei• 5.34 5.34 5,41 • • gallon product/,'Ralloi� —- $675.00* • • FOR CONVERSION • • Price per dry ton '$493.00.DSV:.PURPOSE ONLY, $640.00 $285.00 • = -- ;;:r. PRICE EQUATES • TO • • $1.8225/GALLON • • • $5 899'50 per Cost per order-4;SOOgallons .4,SfJ0gallpn5 `; $8,201.25 $7,680.00 $3,462.75 IJebvgry is •Delivery charge per order •included'in price," Included N/A $2,250.00 - Comments Delivery included in Appendices A and B form price part of our proposal • • • • •• • • • • • • • • • • • • • • Bid Tab-Page 4 of 4 WATER TREATMENT PLANT CHEMICALS—FY 2024 • CONTRACTOR: Northstar Chemical, Inc. CITY OF ASH LAN D CONTACT: Matt Werger,Executive Vice President City Hall ADDRESS: 14200 SW Tualatin-Sherwood Road, 20 East Main Street Sherwood, OR 97140 Ashland, Oregon 97520 Telephone: 541/488-5345(WTP) PHONE: 503-625-3770 EMAIL: bidsnw@northstarchemical.com This Goods and Services Agreement (hereinafter "Agreement") isentered into by and between the City of Ashland,an Oregon municipal corporation(hereinafter"City")and Northstar Chemical,Inc.,a foreign business corporation ("hereinafter,"Contractor"), for Water Treatment Plant'Chemical4. 1. CONTRACTOR'S.OBLIGATIONS 1.1. Provide WTP chemicals as specified in the Invitation to Bid released April 21,2023 and as set forth in the "SUPPORTING DOCUMENTS" attached hereto and, by this reference, incorporated herein. Contractor expressly acknowledges that time is of the essence of any completion date set forth in the SUPPORTING DOCUMENTS, and that no waiver or extension of such deadline may be authorized except in the same manner as herein provided for authority to exceed the maximum compensation. The goods and services defined and described in the "SUPPORTING DOCUMENTS" shall hereinafter be, collectively referred to as "Work." 1.2 Contractor shall obtain and maintain during the term of this Agreement and until City's final acceptance of all Work received hereunder, a policy or policies of liability insurance including commercial general liability insurance with a combined single limit, or the equivalent, of not less than $2,000,000 (two million dollars)per occurrence for Bodily Injury and Property Damage. 1.2.1 The insurance required in this Article shall include the following coverages: • Comprehensive General or Commercial General Liability, including personal injury, contractual liability, and products/completed operations coverage; and • Automobile Liability. • Workers' Compensation 1.2.2 Each policy of such insurance shall be on an "occurrence" and not a "claims made" form, and shall: • Name as•.additional insured "the City of Ashland,. Oregon, its officers, agents and employees" with respect to claims arising out of the provision of Work under this Agreement; • Apply to each named and additional named insured as though a separate policy had been issued to each,provided that the policy limits shall not be increased thereby; • Apply as primary coverage for each additional named insured except to the extent that two or more such policies are intended to "layer" coverage and, taken together, they provide total coverage from the first dollar of liability; • . Contractor shall immediately notify the City of any change in insurance coverage. • Contractor shall supply an endorsement naming the City,its officers,employees and agents as additional insureds by the Effective Date of this Agreement; and • Be evidenced by a certificate or certificates of such insurance approved by the City. Page 1 of 6: Goods and Services Agreement between the City of Ashland and Northstar Chemical,Inc. • 1.3 All subject employers working under this Agreement are either employers that will comply with ORS 656.017 or employers that are exempt under ORS 656.126. As evidence of the insurance required by this Agreement, the Contractor shall.furnish an acceptable insurance certificate prior to commencing any Work under this Agreement. 1.4 Contractor agrees that no person shall,on the grounds of race, color, religion, creed, sex, marital status, familial status or domestic partnership, national origin, age, mental or physical disability, sexual orientation, gender identity or source of income, suffer discrimination in the performance of this Agreement when employed by Contractor. Contractor agrees to comply with all applicable requirements of federal and state civil rights and rehabilitation statutes, rules and regulations. Further, Contractor agrees not to discriminate against a disadvantaged business enterprise,minority-owned business,woman- owned business,a business that a service-disabled veteran owns or an emerging small business enterprise certified under ORS'200:055,in awarding subcontracts as required by ORS 279A.110. 1.5 In all solicitations either by competitive bidding or negotiation made by Contractor for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Contractor.of the Contractor's obligations under this Agreement and Title VI of the Civil Rights Act of 1964 and other federal nondiscrimination laws. 1.6 Living Wage Requirements: If the amount of this Agreement is $25,335.05 or more, Contractor is required to comply with Chapter 3.12 of the Ashland Municipal Code by paying a living wage,as defined in that chapter, to all employees performing Work under this Agreement and to any Subcontractor who performs 50% or more of the Work under this Agreement. Contractor is also required to post the notice attached hereto as "Exhibit A"predominantly in areas where it will be seen by all employees. 2. CITY'S OBLIGATIONS 2.1 City shall pay Contractor the amounts as follows and as provided herein as full compensation for the Chemicals specified,below and in the SUPPORTING DOCUMENTS. til n „ . ee Esttmated.number+ Cost/OO rder Cost Estimate' Watee t reatment4rlant Bidder *'fxR . wl ��° � ny . �„ � orders�for�+,FY 2024 RY�2024 "� ;i� e ��.F '�,�:.,., v '�£'" 2�,.�.P,�"x... �� . t .,:bw �.E�'.t ,dui:. � �:: - _��^�� .x W.i� h. :.. �144 `.3S4.i tt�.w �`lis:" Ri�.. Chemical#3 CYTEC FLOCCULANT LOC C-573 NorthStar Chemical Inc. 9 $3,400.00 30,600.00 FLOCCULANT 'a a i x � a.+, "a a c 'F�' n a.e `ev�vyar s�..nrri `S3 d w^a �.r sm+a E I s *x ' " � ' ,•:''/ �" . . rg: ` ;TotaltEstimate,,d nt F,Y2024 $30,600.00 2.2 In no event shall Contractor's total of all compensation and reimbursement under this Agreement exceed the sum of$34,000.00 (thirty-four thousand dollars), without express, written approval from the City official whose signature appears below, or such official's successor in office. Contractor expressly acknowledges that no other person has authority to order or authorize additional Work which would cause this maximum sum to be exceeded and that any authorization from the responsible official must be in writing. Contractor further acknowledges that any Work delivered or expenses incurred without authorization as provided herein is done at Contractor's own risk and as a volunteer without expectation of compensation or reimbursement. 3. GENERAL PROVISIONS 3.1 This is a non-exclusive Agreement. City is not obligated to.procure any specific amount of Work from Contractor and is free to procure similar types of goods and services from other Contractors in its sole discretion. Page 2 of 6: Goods and Services Agreement between the City of Ashland and Northstar Chemical,Inc. • 32 Contractor is an independent contractor and not an employeeor agent of the City for any purpose. 3.3 Contractor is not entitled to,and expressly waives all claims to City benefits such as health and disability insurance,paid leave, and retirement. 3.4 Contractor shall not assign this Agreement or subcontract any portion of the Work to be provided hereunder without the prior written consent of the City.' Any attempted assignment or subcontract without written consent of the City shall be void. Contractor shall be fully responsible for the acts or omissions of any assigns or subcontractors and of all persons employed by them, andthe approval by the City of any assignment or subcontract shall not create any contractual relation between the assignee or subcontractor and the City. 3.5 This Agreement embodies the full and complete understanding of the parties respecting the subject matter hereof It supersedes all prior agreements,negotiations, and representations between the parties, whether written or oral. 3.6 This Agreement may be amended only by written instrument executed with the same formalities as this Agreement. • 3.7 The following laws of the State of Oregon are hereby incorporatedby reference into this Agreement: ORS 279B.220, 279B..230 and 279B.235. 3.8 This Agreement shall be governed by the laws of the State of Oregon without regard to conflict of laws principles. Exclusive venue for litigation of any action arising under this Agreement shall be in the Circuit Court of the State of Oregon for Jackson County unless exclusive jurisdiction is in federal court, in which case exclusive venue shall be in the federal district court for the district of Oregon. Each party expressly waives any and all rights to`maintain an action under this Agreement in any other venue, and expressly consents that, upon motion of the other party, any case may be dismissed or its venue transferred, as appropriate, so as to effectuate this choice of venue. 3.9 Contractor shall defend, save, hold harmless and indemnify the City and its officers, employees and agents from and against any and all claims,suits,actions,losses,damages,liabilities,costs,and expenses of any nature resulting from, arising out of, or relating to the activities of Contractor or its officers, employees, contractors,'or agents under this Agreement. 3.10 Neither party to this Agreement shall hold the other responsible for damages or delay in performance caused by acts of God, strikes, lockouts,accidents, or other events beyond the control of the other or the other's officers, employees or agents. 3.11 If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable, such provision shall not affect the other provisions, but such unenforceable provision shall be deemed modified to the extent necessary to render it enforceable, preserving to the fullest extent permitted the intent of Contractor and the City set forth in this Agreement. 3.12 Deliveries will be F.O.B destination. Contractor shall pay all transportation and handling charges for the Goods. Contractor is responsible and liable for loss or damage until final inspection and acceptance of the Goods by the City. Contractor remains liable for latent defects, fraud, and warranties. 3.13 The City may inspect and test the Goods. The City may reject non-conforming Goods and require Contractor to correct them without charge or deliver them at a reduced price, as,negotiated.If Contractor does not cure any defects within a reasonable time, the City may reject the Goods and cancel this Page 3 of 6: Goods and Services Agreement between the City of Ashland and Northstar Chemical,Inc. 1 � Agreement in whole or in part. This paragraph does not affect or limit the City's rights, including its rights under the Uniform Commercial Code, ORS Chapter 72 (UCC). 3.14 Contractor represents and warrants that the.Goods are new, current, and fully warranted by the manufacturer. Delivered Goods will comply with SUPPORTING DOCUMENTS and be free from defects in labor, material and manufacture. Contractor shall transfer all warranties to the City. 4. SUPPORTING DOCUMENTS The following documents are,by this reference,expressly incorporated in this Agreement,and are collectively referred to in this Agreement as the "SUPPORTING DOCUMENTS:" • Exhibit A: The Contractor's complete written bid signed May 10,2023. 4.2 This Agreement and the SUPPORTING DOCUMENTS shall be construed to be mutually complimentary and supplementary wherever possible. In the event of a conflict which cannot be so resolved, the provisions of this Agreement itself shall control over any conflicting provisions in any of the SUPPORTING DOCUMENTS. In the event of conflict between provisions of two of the SUPPORTING DOCUMENTS,the several supporting documents shall be given precedence in the order listed in Article 4.1. 5. REMEDIES 5.1 In the event Contractor is in default of this Agreement, City may, at its option, pursue any or all of the remedies available to it under this Agreement and at law or in equity,including, but not limited to: 5.1.1 Termination of this Agreement; 5.1.2 Withholding all monies due for the Work that Contractor has failed to deliver within any scheduled completion dates or any. Work that have been delivered inadequately or defectively; 5.1.3 Initiation of an action or proceeding for damages, specific performance, or declaratory or injunctive relief; 5.1.4 These remedies are cumulative to the extent the remedies are not inconsistent,and City may pursue any remedy or remedies singly, collectively, successively or in any order whatsoever. 5.2 In no event shall City be liable to Contractor for any expenses related to termination of this Agreement or for anticipated profits. If previous amounts paid to Contractor exceed the amount due, Contractor shall pay immediately any excess to City upon written demand provided. • 6. TERM AND TERMINATION 6.1 Term This Agreement shall be effective from the date of execution on behalf of the City as set forth below (the "Effective Date") and shall continue in full force and effect until June 30, 2024, unless sooner terminated as provided in Subsection 6.2. 6.2 Termination 6.2.1 The City and Contractor may terminate this Agreement by mutual agreement at any time. 6.2.2 The City may, upon not less than thirty (30) days' prior written notice, terminate this Agreement for any reason deemed appropriate in its sole discretion. 6.2.3 Either party may terminate this Agreement, with cause,by not less than fourteen (14) days' prior written notice if the cause is not cured within that fourteen (14) day period after written notice. Such termination is in addition to and not in lieu of any other remedy at law or equity. Page 4 of 6: Goods and Services Agreement between the City of Ashland and Northstar Chemical,Inc. 7. NOTICE Whenever notice is required or permitted to be given under this Agreement, such notice shall be given in writing to the other party by personal delivery, by sending via a reputable commercial overnight courier, or by mailing using registered or certified United States mail, return receipt requested, postage prepaid, to the address set forth below: If to the City: City of Ashland Attention: Alistair Andre, Water Treatment Plant Supervisor 90 N. Mountain Avenue Ashland, Oregon 97520 0 Telephone: (541) 488-5345 • With a copy to: City of Ashland Attention: Legal Department 20 E. Main Street Ashland, Oregon 97520 Telephone: (541) 488-5350 If to Contractor: • Northstar Chemical, Inc. Attention: bidsnw@northstarchemical.com 14200 SW Tualatin-Sherwood Road Sherwood, OR 97140 • Telephone: 503-625-3770 0 8. WAIVER OF BREACH One or more waivers or failures to object by either party to the other's breach of any provision,term,condition, or covenant contained in this Agreement shall not be construed as a waiver of any'subsequent breach,whether or not of the same nature. 9. CONTRACTOR'S COMPLIANCE WITH TAX LAWS 9.1 Contractor represents and warrants to the City that: 9.1.1 Contractor shall,throughout the term of this Agreement, including any extensions hereof, comply with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Contractor; and (iii) Any rules, regulations; charter provisions, or ordinances that implement or enforce any of the foregoing tax laws or provisions. 9.1.2 Contractor, for a period of no fewer than six (6) calendar years preceding the Effective Date of this Agreement, has faithfully complied with: (i) All tax laws of the State of Oregon, including but not limited to ORS 305.620 and ORS chapters 316, 317, and 318; (ii) Any tax provisions imposed by a political subdivision of the State of Oregon applicable to Contractor; and (iii) Any rules, regulations, charter provisions, or ordinances that implement or enforce any of • the foregoing tax laws or provisions. Page 5 of 6: Goods and Services Agreement between the City of Ashland and Northstar Chemical,Inc. 9.2 Contractor's failure to comply with the tax laws of the State of Oregon and all applicable tax laws of any political subdivision of the State of Oregon shall constitute a material breach of this Agreement. Further, any violation of Contractor's warranty, as set forth in this Article 9, shall constitute a material breach of this Agreement. Any material breach of this Agreement shall entitle the City to terminate this Agreement and to seek damages and any other relief available under this Agreement,at law,or in equity. IN WITNESS WHEREOF the parties have caused this Agreement to be signed in their respective names by their duly authorized representatives as of the dates set forth below. CITY OF ASHLAND: / NORTHSTAR CHEMICAL,INC. By: %s /. By: rt anager ignature 56-serk ° L - Lessarct Matt Werger Printed Name Printed Name 0/2-3 Executive Vice President Date Title 7/25/2023 Date i (W-9is to be submitted with this signed Agreement) Purchase Order No. g g ) AP" i . P AS TO FORM: Assistant City A omey IZ 2 Date • Page 6 of 6: Goods and Services Agreement between the City of Ashland and Northstar Chemical,Inc. Client#: 1617270 , .' NORTHCHEIO . ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE 0 ) 7/26/2023 THIS CERTIFICATE IS ISSUED ASA 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER . , . ' • . . NAMEACT Stephanie Ruppenstein ' • USI Insurance Services,LLC . - . PHONE 628 201-9001' FAX (A/C,No,Ext): - (A/C,No): • Lic#OG11911•` steh.ru' E-MAIL enstein usl co 575 Market Street,Suite 3750 ' ADDRESS: P PP @ m INSURER(S)AFFORDING COVERAGE NAIL# San Francisco,CA 94105 INSURER A:Everest Indemnity Insurance Company10851 ; ' , INSURED INSURER B:SAIF Corporation 36196 Northstar Chemical Inc. Everest Denali Insurance Com an 16044 14200 S.W.Tualatin-Sherwood Road INSURER c: Compan •INSURER D: Sherwood,OR 97140 ' , • . INSURER E: 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, • EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR R • TYPE OF INSURANCE • ADDL SUBR POLICY EFF POLICY EXP LIMITS INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EF2ML00088221 07/01/2023 06/01/2024ACHOCCURRENCE $1,000,000 `- X CLAIMS-MADE X OCCUR . PAqEM3Ea oaurene $300,000 • . MED EXP(Any one person) $25,000 • . PERSONAL&ADVINJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 • • POLICY X ECT X LOCPRODUCTS-COMP/OPAGG $2,000,000 - • OTHER:• . POLLUTION $1,000,000 ' C AUTOMOBILE LIABILITY EF2CA00025221 07/01/2023 06/01/2024(Ee aBoideDtSINGLE LIMIT' $1,000,000 X ANY AUTO , X BODILY INJURY(Per person) $ OWNED '— SCHEDULED , BODILY INJURY(Per accident) $ " AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $• AUTOS ONLY •_ AUTOS ONLY ' (Per accident) . • ' ' XMCS90INCL. , $ ' • A X UMBRELLA LIAB . X OCCUR EF2C000085221 07/01/2023 06/01/2024 EACH OCCURRENCE $5,000,000 EXCESS LIAB . ' CLAIMS-MADE '', . • AGGREGATE , $5,000,000 DED RETENTION$ $ • , B WORKERS COMPENSATION 976980 P 07/01/2023 06/01/2024 X ER T E OTH- ' ' • • AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N . E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A , (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under • DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 ' • DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) • City of Ashland is named as additional insured as it relates to general liability and auto liability in ' accordance with the terms and conditions of the policy.The above coverage is primary and non-contributory .' ' where required by written contract.Umbrella follows form as it relates to additional insureds. ; ' , - • CERTIFICATE HOLDER ' CANCELLATION • • • Cit of Ashland • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE yTHE EXPIRATION DATE THEREOF, NOTICE'WILL BE DELIVERED IN 20 East Main Street • ACCORDANCE WITH THE POLICY PROVISIONS. Ashland,OR 97520 ' • , . ' • AUTHORIZED REPRESENTATIVE ~. , © 8-2015 ACORD CORPORATION.All rights reserved:, , ACORD 25(2016/03) 1 of 1 •The ACORD name and logo are registered marks of ACORD • , #S40675841/M40624444 PYBZP • , • • POLICY NUMBER: EF2CA00025-221 • COMMERCIAL AUTO• CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM ' BUSINESS AUTO COVERAGE FORM • :MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. • This endorsement identifies person(s) or organization(s) who are "insureds"for Covered Autos Liability Coverage under the.Who Is An Insured provision Of the Coverage Form.-This endorsement does not alter coverage provided in the Coverage Form. - This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. • Named Insured: . Endorsement Effective Date: SCHEDULE Name Of Person(s) Or Organization(s): ALL PERSONS OR ORGANIZATIONS AS REQUIRED BY' WRITTEN CONTRACT WITH THE NAMED INSURED. THE WRITTEN CONTRACT MUST BE SIGNED PRIOR TO THE DATE OF THE "ACCIDENT" . , Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured - provision contained in Paragraph Al. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2.' of. Section I — Covered Autos " Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 INSURED COPY 47 i { EF2CA00025221 '4 COMMERCIAL AUTO • • ECA 24 509 04 14 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - , ' OTHER INSURANCE CONDITION - BLANKET • • This endorsement modifies insurance provided under the,following: • BUSINESS AUTO COVERAGE PART Paragraph c. of the Other Insurance General • Condition is replaced by the following: c. Regardless of the provisions of Paragraph a. above, this Coverage Form's Liability Coverage is " primary and,we will not seek contribution from any other insurance for any liability assumed under an "insured. contract" that requires liability to be , _ assumed on a primary noncontributory basis. , Additionally, only the coverage and limit of . insurance requirements of the "insured contract" shall apply, and" in no event shall those , requirements exceed the coverage and limits of insurance provided under this policy. ti • • • • • • • • • ECA 24 509 04 14 Copyright, Everest Reinsurance Company,2014 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., used with its permission INSURED COPY y . POLICY NUMBER: EF2ML00088-221 • COMMERCIAL GENERAL LIABILITY j CG20370413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR • CONTRACTORS -COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations As required by written contract signed by both parties prior to loss: • • I Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for "bodily injury" or If coverage provided to the additional insured is property damage"caused, in whole or in part, by required by a.contract or agreement, the most we your work" at the location designated and will pay on behalf of the additional insured is the described in the Schedule of this endorsement amount of insurance: performed for that additional insured and included in the "products-completed operations 1. Required by the contract or agreement; or hazard". 2. Available under the applicable Limits of However: Insurance shown in the Declarations; 1. The insurance afforded to such additional whichever is less. insured only applies to the extent permitted This endorsement shall not increase the applicable by law; and Limits of Insurance shown in the Declarations. 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to - provide for such additional insured. • CG 20 37 0413 ©Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: EF2ML00088-221 EVEREST ENVIRONMENTAL PLUS ECG 24 699 09 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NONCONTRIBUTORY - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: EVEREST ENVIRONMENTAL PLUS COVERAGE FORM SCHEDULE Designated Person or Organization: Information required to complete this Schedule, if not shown above,will be shown in the Declarations.. The following is added to the Other Insurance Condition and supersedes any provision to the contrary: Primary And Noncontributory Insurance This insurance is primary to and we will not seek contribution from any other insurance available to the person or organization designated in the Schedule above which you have agreed to insure under this Policy provided that: (1) Such person or organization is an insured under this Policy; and• (2) An"insured contract" requires this insurance to be primary. All other terms and conditions of this Policy remain unchanged. • • • ECG 24 699 09 18 Copyright, Everest Reinsurance Company, 2018 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., used with its permission. L • POLICY NUMBER:. EF2ML00088-221 INTERLINE EIL 04 522 10 18 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: EVEREST CONTRACTORS ENVIRONMENTAL PLUS COVERAGE PART EVEREST ENVIRONMENTAL PLUS COVERAGE PART SCHEDULE Name of Person or Organization: • As required by written contract signed by both parties prior to loss. Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II—Who Is An Insured is amended to include as an insured the person(s)or organization(s)shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds,the following exclusion is added: This insurance does not apply to "bodily injury", "property damage", "environmental damage" or other damage, cost or expense occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s)at the site of the covered operations has been completed; or (2) That portion of"your work" out of which/the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions of this Policy remain unchanged. EIL 04 522 10 1.8 Copyright,Everest Reinsurance Company 2018 Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., used with its permission.