The URL can be used to link to this page

Home My WebLink AboutC2017-530 - 9/19/2017 - NA 2017-530 i 9/19/17 Coastal Bend Demolition Inc. SMALL CONSTRUCTION CONTRACT AGREEMENT THE STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF NUECES This CONSTRUCTION AGREEMENT is between the City of Corpus Christi, a Texas home-rule municipal corporation ("CITY"), acting through its duly authorized City Manager or designee, the Director of Engineering Services or City Engineer, and Coastal Bend Demolition, Inc. ("CONTRACTOR"), acting by and through its duly authorized representative, Vernon Carr (Name), President (Title). The parties agree as follows: WITNESSETH: 1. CONTRACTOR shall construct and complete certain improvements in accordance with the plans and specifications described in Exhibit"A"(attached and incorporated herein), perform all work as provided in said plans and specifications, and do such additional work as may be considered necessary to complete the work in a satisfactory and acceptable manner (the "Work"). The CITY reserves the right to make such changes in the plans and specifications and in the character of the work as may be necessary or desirable. Authorization for all changes must be made in writing. The CONTRACTOR shall furnish all labor, tools, material, machinery, equipment and incidentals necessary to the prosecution of the Work unless otherwise provided by the written terms of the plans and specifications. 2. The work described in Exhibit"A" shall be completed within 30 Calendar Days of Notice To Proceed. 3. In consideration of the completion of the above-described Work, the CITY agrees to pay to CONTRACTOR the lump sum amount of SEVENTEEN THOUSAND, FIVE HUNDRED AND NO/100 (517,500.001 for City Project SCC #E17012 Nueces County Emergency Services District #2 Office Building Demolition. Said payment shall be conditioned upon the acceptance of the work by the "CITY" as certified by its final inspection following the receipt of notice from the "CONTRACTOR" that the work is completed and ready for acceptance. Upon completion of work and before acceptance and final payment is made, the "CONTRACTOR" shall clean and remove from the work site all surplus and discarded materials, temporary structures, and debris of every kind in order to leave the work site in a neat, orderly condition, equal to that which originally existed. The"CONTRACTOR"shall submit a notarized affidavit that bills for all labor, equipment, materials and supplies associated with the project have been paid before final payment is released. Small Construction Agreement Page 1 of 3 Proj. No. E17012 Nueces County Emergency Services Dist#2 Bldg Demo Rev. 09/2017 INDEXED CITY OF CORPUS CHRISTI— ENGINEERING SERVICES NOTICE OF SMALL CONSTRUCTION CONTRACT —�\ The City of Corpus Christi, Texas is accepting sealed bids for Small Construction • �� Contract: ` NUECES COUNTY EMERGENCY SERVICES DISTRICT#2 OFFICE i BUILDING DEMOLITION — PROJECT NO. E17012 / Bids will be received on: WEDNESDAY, AUGUST 9, 2017 AT 2:00 P.M. All hard copy bids shall be delivered in a sealed envelope marked clearly on the outside ENGINEERING with the Project Number and Name by no later than the date and time specified in this SERVICES notice. Sealed envelopes will be delivered to: PO Box 9277 CITY OF CORPUS CHRISTI Corpus Christi CITY SECRETARY'S OFFICE— 1ST Floor City Hall Texas 78469-9277 1201 LEOPARD STREET Phone 361-826-3500 CORPUS CHRISTI, TX 78469 Fax 361-880-3501 e%ww.cctexas.cam Electronic Bids may be submitted through the Civcast website at www.civcastusa.com. Traffic Engineering 1201 Leopard St. All bids will be publicly opened and read aloud at City Hall, Third Floor, Engineering Corpus Christi Services, Smartboard Conference Room. Any bid received after closing time will not be Texas 78401 accepted. Phone361-826-3547 Fax 361-826-3545 Bidding documents for this Small Construction Contract are only available through the Traffic Signals City Engineering's E-Procurement provider, Civcast, at: www.civcastusa.com 2525 Hyecia St. Corpus Christi Bidding documents may be downloaded and/or viewed free of charge at this website. It Texas 78415 is the downloader's responsibility to determine that a complete set of documents, as Phone 361-826-1610 defined in the Agreement, are received. Fax 361-826-427=4 A pre-bid conference will be held at City Hall 3rd Floor, Engineerinq Services Construction Inspection Smartboard Conference Room on Wednesday, August 2, 2017, at 10:00 a.m.. 4917 l lolly Rd..Bldg,5 Corpus Christi This Small Construction Project is estimated to be less than $50,000 and will not require Texas 78411 a bid bond. Phone 361-826-3555 Fax 361-826-3520 The Bid submittal for the project will consist of the executed Bid Proposal form with executed Disclosure of Interest form, and any other submittals specified in the Contract Documents. Proposal form must be signed by an authorized representative of the company. The City reserves the right to reject any and all Bids, including without limitation, non-conforming, non-responsive or conditional Bids. Upon award, a successful bidder will be required to submit insurance for the project as outlined in Notice to Contractors B of the Contract Documents, within ten (10) calendar days of notice of award. Successful Bidder will also be required to provide a good and sufficient Payment Bond from a surety company authorized to do business in the State of Texas, if the award is over$25,000. L J.H. dmonds, P.E. — Director of Engineering Services Director of Engineering Services ENGINEERING SERVICES CITY OF CORPUS CHRISTI, TEXAS SMALL CONSTRUCTION CONTRACT (SCC) PROPOSAL DATE: Proposal of A corporation organized and existing under the laws of the State of or A Partnership or Individual doing business as To: The City of Corpus Christi, Texas Ladies/Gentlemen- The undersigned hereby proposes to furnish all labor and materials, tools, and necessary equipment, and to perform the work required for: NUECES COUNTY EMERGENCY SERVICES DISTRICT#2 OFFICE BUILDING DEMOLITION - PROJECT NO. E17012 at the locations set out by the plans and specifications and in strict accordance with the contract documents as set forth in the following proposal. Page 1 Proj. No. E17012 Rev. 1/2017 PROPOSAL FOR SMALL CONSTRUCTION CONTRACT NUECES COUNTY EMERGENCY SERVICES DISTRICT#2 OFFICE BUILDING DEMOLITION PROJECT NO. E17012 Proposal Submitted By: Bid Date: August 9, 2017, Wednesday, 2:00 p.m. Location: City Hall, 1201 Leopard Corpus Christi, Texas Project Scope: The scope of services for this project consists of: Asbestos abatement and the complete removal of approximately 3600 square feet of building and concrete foundation 3' below grade, in accordance with the asbestos abatement requirements and demolition requirements as specified in the bidding documents in Exhibit A, Attachments 1, 2, 3, 4, 5 and 6. All work will be in accordance with the attached drawings and labor wage rates (see Attachments No. 1, 2, 3, 4, 5 and 6) along with full compliance with all applicable regulatory requirements (if applicable). The contractor shall obtain all necessary permits and pay ALL fees (if applicable). The bids will be evaluated based on the lowest responsible total bid. Time of Completion: 30 Calendar Days Addendum Acknowledged: Page 2 Proj. No. E17012 Rev. 1/2017 PROPOSAL FOR SMALL CONSTRUCTION CONTRACT NUECES COUNTY EMERGENCY SERVICES DISTRICT #2 OFFICE BUILDING DEMOLITION PROJECT NO. E17012 Bid ($) Item Qty Unit Item Description Total Cost 1 1 LS Building Demolition 2 1 LS Asbestos Abatement TOTAL BASE BID: Page 3 Proj. No. E17012 Rev. 1/2017 PROPOSAL FOR SMALL CONSTRUCTION CONTRACT NUECES COUNTY EMERGENCY SERVICES DISTRICT #2 OFFICE BUILDING DEMOLITION PROJECT NO. E17012 Contract Requirements: 1. Contractor must submit the attached Disclosure of Interest form fully completed and executed and acknowledge any addenda issued for the project. 2. All work will be in accordance with specifications and Davis and Bacon Wage Rates as provided in all Attachments included in Exhibit A. 3. Work is anticipated to be a Small Construction Contract under $50,000. A Bid Bond is not required. 4. The successful contractor will be required to submit proof of insurance as per Exhibit B of the contract, within ten days of award notification. If award is over $25,000, successful contractor is required to provide a Payment Bond from a surety company authorized to do business in the State of Texas. 5. The contractor will be required to provide an Affidavit Waiver of Lien at completion of construction and prior to final payment processing. 6. In determining the partial payment to be made to the Contractor, the City will retain five percent (5%) of the total approximate estimate, unless otherwise stated, and will deduct payments previously made. No partial payment will be made when the said estimate or the estimates of work performed since the last previous estimate is less than One Hundred Dollars ($100.00). All retainage is due and payable to the Contractor upon successful completion of the project and will be included in the final payment to the Contractor. Page 4 Proj. No. E17012 Rev. 1/2017 Proposal Submitted By: Authorized Signature Print Name and Title Company Name Address City St Zip Phone No./ Fax No. Cell No. E-Mail Address Page 5 Proj. No. E17012 Rev. 1/2017 clot City of Corpus Christi CITY OF CORPUS CHRISTI DISCLOSURE OF INTEREST City of Corpus Christi Ordinance 17112, as amended, requires all persons or firms seeking to do business with the City to provide the following information. Every question must be answered. If the question is not applicable, answer with "NA". See reverse side for Filing Requirements, Certifications and definitions. COMPANY NAME: P. O. BOX: STREET ADDRESS: CITY/ ZIP STATE FIRM IS: 1. Cor oration 2. Partnershi 3. Sole Owner El4. Association 5. Other p DISCLOSURE QUESTIONS If additional space is necessary, please use the reverse side of this page or attach separate sheet. 1. State the names of each "employee"of the City of Corpus Christi having an "ownership interest"constituting 3% or more of the ownership in the above named "firm." Name Job Title and City Department (if known) 2. State the names of each "official' of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Name Title 3. State the names of each "board member" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Name Board, Commission or Committee 4. State the names of each employee or officer of a "consultant" for the City of Corpus Christi who worked on any matter related to the subject of this contract and has an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Name Consultant Page 6 Proj. No. E17012 Rev. 1/2017 FILING REQUIREMENTS If a person who requests official action on a matter knows that the requested action will confer an economic benefit on any City official or employee that is distinguishable from the effect that the action will have on members of the public in general or a substantial segment thereof, you shall disclose that fact in a signed writing to the City official, employee or body that has been requested to act in the matter, unless the interest of the City official or employee in the matter is apparent. The disclosure shall also be made in a signed writing filed with the City Secretary. [Ethics Ordinance Section 2-349 (d)] CERTIFICATION I certify that all information provided is true and correct as of the date of this statement, that I have not knowingly withheld disclosure of any information requested; and that supplemental statements will be promptly submitted to the City of Corpus Christi, Texas as changes occur. Certifying Person: Title: (Type or Print) Signature of Certifying Person: Date: DEFINITIONS a. "Board member." A member of any board, commission, or committee appointed by the City Council of the City of Corpus Christi, Texas. b. "Economic benefit". An action that is likely to affect an economic interest if it is likely to have an effect on that interest that is distinguishable from its effect on members of the public in general or a substantial segment thereof. c. "Employee."Any person employed by the City of Corpus Christi, Texas either on a full or part-time basis, but not as an independent contractor. d. "Firm." Any entity operated for economic gain, whether professional, industrial or commercial, and whether established to produce or deal with a product or service, including but not limited to, entities operated in the form of sole proprietorship, as self-employed person, partnership, corporation, joint stock company, joint venture, receivership or trust, and entities which for purposes of taxation are treated as non-profit organizations. e. "Official." The Mayor, members of the City Council, City Manager, Deputy City Manager, Assistant City Managers, Department and Division Heads, and Municipal Court Judges of the City of Corpus Christi, Texas. f. "Ownership Interest." Legal or equitable interest, whether actually or constructively held, in a firm, including when such interest is held through an agent, trust, estate, or holding entity. "Constructively held" refers to holdings or control established through voting trusts, proxies, or special terms of venture or partnership agreements." g. "Consultant." Any person or firm, such as engineers and architects, hired by the City of Corpus Christi for the purpose of professional consultation and recommendation. Page 7 Proj. No. E17012 Rev. 1/2017 EXHIBIT "A" NUECES COUNTY EMERGENCY SERVICES DISTRICT #2 OFFICE BUILDING DEMOLITION PROJECT NO. E17012 1. Scope of Services: Contractor is responsible for asbestos abatement and complete removal of an approximately 3600 square foot building and concrete foundation, 3' below grade. All work will be in accordance with all attached documents, including labor wage rates (see Attachments 1, 2, 3, 4, 5 and 6). 2. Time of Completion The Contractor shall be prepared to begin work within ten (10) calendar days from the date of a formal Notice to Proceed. All work shall be completed within 30 calendar days. For every calendar day used in excess of the calendar days specified herein, the Contractor shall be assessed $250.00 per day as liquidated damages. 3. City's Representative For this project Ernesto De La Garza, P.E., Construction Management Engineer shall be the City's representative on all matters concerning the project. The City's Representative shall work with the contractor on matters affecting the program. All work shall be completed in a manner satisfactory and acceptable to the City representative as a strict requirement for fulfilling the contract. 4. Pre-Bid Conference A pre-bid conference will be held at City Hall 3rd Floor, Engineering Services Smartboard Conference Room, on August 2, 2017 at 10:00 a.m.. Pre-Bid will be conducted by Melanie Gavlik, P.E. — City Project Manager. Project No. E17012 Exhibit "A"— Page 1 ATTACHMENT 1 ASBESTOS ABATEMENT REQUIREMENTS Attachment 1 ASBESTOS ABATEMENT REQUIREMENTS The following items are to be complied with: 1. Contractor must perform the asbestos abatement on the structure(s) located at the following address: 1201 Laguna Shores Road. 2. Contractor must obtain and provide copies of all necessary permit(s) from either the City of Corpus Christi, Nueces County and/or the State of Texas pertaining to Asbestos Abatement. 3. The Contractor must submit and provide payment for a receipt of 10-day notification with the Texas Department of State Health Services before demolition can begin. 4. Contractor must visually inspect the property to insure that utilities are disconnected and properly capped or sealed off prior to any work being performed. Coordinate with Construction Inspection to schedule inspection. 5. The structure contains asbestos materials—please refer to the Public Building Asbestos Survey Repo rt/Tu rnstone EH&S, Inc. Project Number: 17-0444 dated April 26, 2017, included in Attachment 2. Nueces County Emergency Services District No. 2-Office Building Demolition/E17012 ATTACHMENT#1 - Page 1 ATTACHMENT 2 ASBESTOS SURVEY REPORT AND ANALYTICAL DATA PIT UBLIC BUILDING ASBESTOS SURVEY REPORT Conducted at: Vacant Building 1201 Laguna Shores Corpus Christi, Texas For: Ms. Melanie Gavlik City of Corpus Christi Corpus Christi, Texas Conducted by: Turnstone EH&S, Inc. Asbestos Consultant Agency Texas Department of State Health Services License No. 100408 226 Enterprize Pkwy Ste 116 Corpus Christi, Texas 78405 Phone: 361-289-2510 Samples Collected: April 26, 2017 Turnstone EMS,Inc.Job#17-0444 Asbestos Survey for Public Building Attachment#2 Page 1 of 33 May 10, 2017 Ms. Melanie Gavlik City of Corpus Christi Corpus Christi, Texas RE: Limited Asbestos Building Survey Location: Vacant Building at 1201 Shores in Corpus Christi, Texas Lagunat�l Turnstone EH&S, Inc., Licensed Asbestos Agency(License No. 100408) Dear Ms. Gavlik: On April 26, 2017, Turnstone EH&S (Turnstone) conducted an asbestos survey in the vacant building located at 1201 Laguna Shores in Corpus Christi, Texas, to determine whether asbestos- containing materials (ACM) are present. The information being gathered will be stored for future use of the site. The client requested a three-day turnaround for the analysis results. Building Notes: The building is listed at 3600 square feet, single story and sits on a concrete slab. The exterior walls are cinder block and the interior walls are sheetrock and cinder block. The roof is pitched and covered by composition shingles. Windows are single-pane. It is classified as a"Public" building and is currently vacant. Additional Building Notes: The roof has major damage. Licensing: Turnstone is a Texas Department of State Health Services (TDSHS) Licensed Asbestos Consultant Agency (License#100408). The samples were collected by TDSHS Licensed Asbestos Consultant Mr. Tim Chaney(Lic. No. 105670) of Turnstone. After a comprehensive inspection, the Turnstone inspector identified nineteen(19) Homogeneous Areas and collected a total of sixty-one (61) samples. Turnstone EH&S,Inc.Job#17-0444 Asbestos Survey for Public Building Attachment#2 Page 2 of 33 (2 fR M. Sampling Protocols: The inspector based on the inspectors' experience, selected locations for sample collection to be representative of the suspect materials. Sampling protocols meet the standards of the Occupational Safety and Health Administration(OSHA), Environmental Protection Agency (EPA), Asbestos Hazard Emergency Response Act(AHERA), and the Texas Department of State Health Services (TDSHS). Sampling Analysis: Following strict chain-of-custody procedures, the samples were shipped overnight for analysis to Crisp Analytical Laboratories, L.L.C. in Carrollton, Texas. The National Voluntary Laboratory Accreditation Program (NVLAP) for bulk asbestos fiber analysis and airborne fiber analysis accredits Crisp Analytical Laboratories. They are a TDSHS Licensed Asbestos Laboratory (License #30-0235). The samples were analyzed for asbestos content by the Polarized Light Microscopy (PLM) method as specified by the EPA Interim improved method EPA-600 / R- 93/116. Based on Laboratory analysis: Asbestos greater than I%, the limit referenced by EPA 40 CFR Part 763, WAS FOUND IN THE FOLLOWING AREAS/MATERIALS: • Homogeneous Areas #1 and 2 (Samples #1-6), the sheetrock and joint compound and texture ("popcorn") found on the garage area ceiling to the South of the building, contained Chrysotile Asbestos in the 2% range. The sheetrock is not ACM but the sheetrock is attached to the joint compound and texturing. The Inspector estimates the area of coverage at—900 square feet. • Homogeneous Areas #3 and 4 (samples #7-12), the sheetrock and joint compound and texture("popcorn") found in the same area on the upper North wall, contained Chrysotile Asbestos in the 2%range. The sheetrock is not ACM but is attached to the joint compound and texturing The Inspector estimates the area of coverage at—150 square feet. ® Homogeneous Areas #8 and 9 (Samples#26-31),the tan floor the and floor mastic attaching it, contained Chrysotile Asbestos in the 24% range. It was observed in the two rooms north of the garage and the room nearest the shop/storage area. The Inspector estimates its coverage at—326 square feet. • Homogeneous Areas #13 and 14 (Samples#43-50),the"popcorn"ceiling texture and sheetrock found in the large central room, contained Chrysotile Asbestos in the 2% range. It was found in the small room in the center of the building. The sheetrock is not ACM, Turnstone EMS,Inc.Job#17-0444 Asbestos Survey for Public Building Attachment#2 Page 3 of 33 qtr irzi but the texturing is attached to the sheetrock. The Inspector estimates the extent of coverage at 1,150 square feet. ® Homogeneous Areas#15 and 16 (Samples #51-56),the joint compound and sheetrock found in the large central room, contained Chrysotile Asbestos in the 2%range. It was found in the small room in the center of the building. The sheetrock is not ACM, but is attached by the ACM joint compound. The Inspector estimates the area at—590 square feet. Although the Turnstone technician made every effort to adequately sample the selected materials, the client should be aware that Asbestos Containing Materials may exist within systems that were inaccessible at the time of the survey, and which may be exposed during renovation/demolition activities. If previously unidentified materials are discovered during renovations/demolitions, they should be tested for asbestos content before disturbance. For more details, refer to the attached Lab Analysis Report, the Chain-of-Custody Form, Bulk Sampling Form signed by the Asbestos Consultant/Inspector, Mr. Chaney and in the last section, a Sample Location Drawing. If you have any questions about this report, please call us at (361) 289-2510. Thank you for allowing us to assist with your project. Tim Chaney, President Tumstone EH&S, Inc. TDSHS Asbestos Consultant Lic.# 105670 Turnstone EFI&S,Inc.Job#17-0444 Asbestos Survey for Public Building Attachment#2 Page 4 of 33 L"M )C Q A av�, Bulk Asbestos leis Results And Chain-of-Custody Form Turnstone EMS,Inc.Job#16-0444 Asbestos Survey for Public Building Attachment#2 Page 5 of 33 ��&�� L.L.C. K�� - L.L.C. �� .�� ~---~� ...~~.�..~~� ___~- �� 1929Old Denton Road 12232 Industriolex, Suite 32 Dedicated to Carrollton TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 ~ | Phone 225-751-5632 Fax 972-242-2798 ' Fax 225-751-5634 Materials Characterization ~ Bulk Asbestos Analysis Laboratory Analysis Rmpmrt- Polarized Light Jun/stoneEHS At n: Tim Chaney 22GEnterphzoPkwy Ste. 11G Customer Project: 17'O4441201 Laguna Shores Corpus Christi,TX784O5 Reference#: CAL17042517JD Date: 5/3/2017 Analysis and Method Summary of polarized light microscopy(PLM/Stereomicroscopy bulk asbestos analysis)using the methods described in 40CFR Part 763 Appendix EuoSubpart E(Interim and EPA 000/R'83/118(|mpmvnd). The sample iufirst viewed with the aid o/astereomicroscope.Numerous liquid slide preparations are created for analysis under the polarized microscope where identifications and quantifications are preformed.Calibrated liquid refractive oils are used as liquid mouting medium.These oils are used for identification(dispersion staining).A calibrated visual estimation is reported,should any asbestiform mineral be present.Other techniques such as acid washing are used in conjugation with refractive oils for detection of smaller quantities of asbestos.All asbestos percentages are based on calibrated visual estimation traceable to NIST standards for regulated asbestos.Traceability to measurement and calibration is achieved by using known amounts and types of asbestos from standards where analyst and laboratory accuracy are measured. As little as 0.001%asbestos can be detected in favorable samples,while detection in unfavorable samples may approach the detection limit ofO.50%(well above the laboratory definition oftraco). Discussion Vermiculite containing samples may contain trace amounts of actinolite/tremolite.When not detected by PLM,these samples should be analyzed using TEM methods and/or water separation techniques.Suspected actinolite/vermiculite presence will be indicated through the sample comment section ofthis report. Fibrous talc containing samples may contain a regulated asbestos fiber known as anthophyllite. Under certain conditions the same fiber may actually contain both talc and anthophyllite(a phenomenon called intergrowth).Again,TEM detection methods are recommended.CALabs PLM report comments will denote suspected amounts of asbestiform anthophyllite with talc,where further analysis is recommended. Some samples(floor tiles,aurfeuinga.etc.)may contain fibers too small 0obodelectable byPLM analysis and should beanalyzed byTEM bulk pmmun|o. A"trace asbestos"will be reported if the analyst observes f ar less than I%asbestos.CA Labs def ines"trace asbestos"as a f ew f ibers detected bythe analyst inseveral preparations and will indicate oasuch under these circumstances. Since allowable variation in quantification of samples close to 1%is high,<1%may be reported. Such results are ideal for point counting,and the technique is mandatory for friable samples(NESHAP,Nov. 1990 and clarification letter 8 May 1991)under 1%percent asbestos or"trace asbestos". morder tnmake all initial PLM reports issued from CA Labs NESHAP compliant,all<1%asbestos results(except floor tiles)will be point counted umnnadditional charge. Qualifications CALabs iaaccredited ty the National Voluntary Accreditation Program(NVLAP)for selected test methods for airborne fiber analysis(TEM),and for bulk asbestos fiber analysis(PILM).CA Labs is also accredited by AIHA LAP, LLC.in the PLM asbestos field of testing for Industrial Hygiene.All analysts have completed college courses or hold a degree in a natural science(geology,biology,or environmental science).Recognition by a state professional board in one these disciplines is preferred,but not required.Extensive in-house training programs are used to augment the educational background of the analyst.The Laboratory Director and Quality Manager have received supplemental McCrone Research training for asbestos identification.Analysis performed auCrisp Analytical Labs,LLC 192SOld Denton Road Carrollton,TX 75006 Dallas /VVLAPLab Code 200349-0TEMIPLM TCE0#T/047045/3-/5-3 TDH38'0235 A/HALAP, LLC Laboratory#1U2g2Q Attachment#2 Page 6o[33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge,LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Overview of Project Sample Material Containing Asbestos Customer Project: 17-0444 1201 Laguna Shores CA Labs Project#: CAL17042517JD Sample# Layer Analysts Physical Description of Asbestos type/ # Subsample calibrated visual List of Affected Building estimate percent Material Types white surfaced tan compound 0444-1 1-1 white surfaced tan compound 2%Chrysotile tan compound(beneath tape) tan floor tile black mastic 0444-2 2-1 white surfaced tan compound 2%Chrysotile white textured surfacing tan surfaced white compound 0444-3 3-1 white surfaced tan compound 2%Chrysotile 0444-7 7-1 white surfaced tan compound 2%Chrysotile 7-2 tan compound(beneath tape) 2%Chrysotile 0444-8 8-1 white surfaced tan compound 2%Chrysotile 8-2 tan compound(beneath tape) 2%Chrysotile 0444-9 9-1 white surfaced tan compound 2%Chrysotile Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#TlO4704513-15-3 TDH30-0235 AIHA LAP, LLC Laboratory#102929 Glossary of abbreviations(non-asbestos fibers and non-fibrous minerals): ca -carbonate pe-perlite fg-fiberglass pa-palygorskite(clay) gypsum-gypsum qu-quartz mw-mineral wool bi-binder wo-wollastinite or-organic to-tale ma-matrix sy-synthetic ml-mica ce-cellulose ve-vermiculite br-brucite of-other ka-kaolin(clay) This report relates to the items tested.This report is not to be used by the customer to claim product certification,approval or endorsement by NVLAP,NIST,AlHA LAP,LLC,or any other agency of the federal government.This report may not be reproduced except in full without written permission from CA Labs.These results are submitted pursuant to CA Labs'current terms and sale,condition of sale,including the company's standard warranty and limitations of liability provisions and no responsibility or liability is assumed for the manner in which the results are used or interpreted.Unless notified in writing to return the samples covered by this report,CA Labs will store the samples for a period of ninety(90)days before discarding.A shipping or handling fee may be assessed for the return of any samples. Attachment#2 Page 7 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriolex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge,LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Overview of Project Sample Material Containing Asbestos Customer Project: 17-0444 1201 Laguna Shores CA Labs Project#: CAU 7042517J D Sample# Layer Analysts Physical Description of Asbestos type/ # Subsample calibrated visual List of Affected Building estimate percent Material Types 9-2 tan compound(beneath tape) 2%Chrysotile 0444- 26,29- 26,0444-29 1 tan floor the 3%chrysotile 0444- 27,30- 27,0444-30 1 tan floor the 3%Chrysotile 0444- 2831- 28,0444-31 1 tan floor the 4%Chrysotile 2831- black mastic 2%Chrysotile 0444-44 44-1 white textured surfacing 2%Chrysotile 0444-45 45-1 white textured surfacing 2%Chrysotile 0444-46 46-1 white textured surfacing 2%chrysotile Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#TI04704513-15-3 TDH30-0235 AIHA LAP, LLC Laboratory#102929 Glossary of abbreviations(non-asbestos fibers and non-fibrous minerals): ca -carbonate pe-perlite fg-fiberglass pa-palygorskite(clay) gypsum-gypsum qu-quartz mw-mineral wool bi-binder wo-wollastinite or-organic to-talc me-matrix sy-synthetic mi-mica cc-cellulose ve-vermiculite br-brucite of-other ka-kaolin(clay) This report relates to the items tested.This report is not to be used by the customer to claim product certification,approval or endorsement by NVLAP,NIST,AIHA LAP,LLC,or any other agency of the federal government.This report may not be reproduced except in full without written permission from CA Labs.These results are submitted pursuant to CA Labs'current terms and sale,condition of sale,including the company's standard warranty and limitations of liability provisions and no responsibility or liability is assumed for the manner in which the results are used or interpreted.Unless notified in writing to return the samples covered by this report,CA Labs will store the samples for a period of ninety(90)days before discarding.A shipping or handling fee may be assessed for the return of any samples. Attachment#2 Page 8 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Overview of Project Sample Material Containing Asbestos Customer Project: 17-0444 1201 Laguna Shores CA Labs Project#: CAL17042517JD Sample# Layer Analysts Physical Description of Asbestos type/ # Subsample calibrated visual List of Affected Building estimate percent Material Types 0444-47 47-1 white textured surfacing 2%Chrysotile 0444-48 48-1 white textured surfacing 2%Chrysotile 0444-51 51-1 tan surfaced white compound 2% Chrysotile Dallas NVLAP Lab Code 200349-0 TEMIPLM TCEQ#TI04704513-15-3 TDH30-0235 AIHA LAP, LLC Laboratory#102929 Glossary of abbreviations(non-asbestos fibers and non-fibrous minerals): ca -carbonate pe-perlite fg-fiberglass pa-palygorskite(clay) gypsum-gypsum qu-quartz mw-mineral wool bi-binder we-wallastinite or-organic to-talc ma-matrix sy-synthetic mi-mica cc-cellulose ve-vermiculite br-brucite of-other ka-kaolin(clay) This report relates to the items tested.This report is not to be used by the customer to claim product certification,approval or endorsement by NVLAP,NIST,ANA LAP,LLC,or any other agency of the federal government.This report may not be reproduced except in full without written permission from CA Labs.These results are submitted pursuant to CA Labs'current terms and sale,condition of sale,including the company's standard warranty and limitations of liability provisions and no responsibility or liability is assumed for the manner in which the results are used or interpreted.Unless notified in writing to return the samples covered by this report,CA Labs will store the samples for a period of ninety(90)days before discarding.A shipping or handling fee may be assessed for the return of any samples. Attachment#2 Page 9 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriolex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Tumstone EHS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30arn Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent percent us estimate percent (Y/N) 0444-1 1-1 white surfaced tan compound n 2%Chrysotile 98%mi,bi,ca 0444-2 2-1 white surfaced tan compound n 2%Chrysotile 98%mi,bi,ca 0444-3 3-1 white surfaced tan compound n 2%Chrysotile 98%mi,bi,ca 0444-4 4-1 white drywall with brown paper n None Detected 23%ce 77%qu,gy 0444-5 5-1 white drywall with brown paper n None Detected 22%ce 78%qu,gy 0444-6 6-1 white drywall with brown paper n None Detected 21%ce 79%qu,gy 0444-7 7-1 white surfaced tan compound n 2%Chrysotile 98%mi,bi,ca Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#T104704513-15-3 TDH 30-0235 AIHA LAP, LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining/backe line method. ca carbonate mi-mica fg-fiberglass ce-cellulose gy gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder of-other we-wollastonite ka-kaolin(clay) or-organic pe-perlite to-talc pa-palygorskite(clay) Approved Signatories: ma-matrix qu-quartz sy-synthetic Julio Robles QAC Technical Manager Analyst Leslie Crisp, P.G. Chad Lytle 1.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.AnthGphyllite in association with Fibrous Talc 2.Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association wth Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9.<I%Result point counted positive 5.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 10 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industrialex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge,LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Turnstone EHS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30am Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Corn Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent percent us estimate percent (Y/N) 7-2 tan compound(beneath tape) y 2%Chrysotile 98%mi,ca 0444-8 8-1 white surfaced tan compound n 2%Chrysotile 98%mi,bi,ca 8-2 tan compound(beneath tape) y 2%Chrysotile 98%mi,bi,ca 0444-9 9-1 white surfaced tan compound n 2%Chrysotile 98%mi,bi,ca 9-2 tan compound(beneath We) y 2%Chrysotile 98%mi,ca 0444-10 10-1 white drywall with brown paper n None Detected 23%ce 77%qu,gy 0444-11 11-1 white drywall with brown paper n None Detected 22%ce 78%qu,gy Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#TI04704513-15-3 TDH30-0235 AIHA LAP, LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining/becke line method. ca-carbonate mi-mica fg-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder of-other we-wollastonite ka-kaolin(clay) or-organic pe-perlite to-talc pa-palygorskite(clay) Approved Signatories: ma-matrix qu-quarte sy-synthetic Julio Robles QAC Technical Manager Analyst Leslie Crisp, P.G. Chad Lytle 1.FireDamage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophyllite in association with Fibrous Talc Z Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association with Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9.a 1%Result point counted positive 1.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 11 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex, Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge,LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Tumstone EHS CAL1 7042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30arn Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent percent us estimate percent (Y/N) 0444-12 12-1 white drywall with brown paper n None Detected 23%ce 77%qu,gy white sealant with paper and 0444-13 13-1 foil n None Detected 21%ce 79%qu,bi,ot 13-2 yellow insulation y None Detected 100%fg white sealant with paper and 0444-14 14-1 foil n None Detected 23%ce 77%qu,bi,ot 14-2 yellow insulation y None Detected 100%fg white sealant with paper and 0444-15 15-1 foil n None Detected 19%ce 81%qu,bi,ot 15-2 yellow insulation y None Detected 100%fg Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#T104704513-15-3 TDH 30-0235 AIHA LAP,LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining/becke line method. ca -carbonate mi-mica fg-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder at-other we-wollastonite ka-kaolin(clay) or-organic pe-perlite to-talc pa-palygorskite(clay) Approved Signatories: me-matrix qu-quartz sy-synthetic Julio Robles QAC Technical Manager Analyst Leslie Crisp, P.G. Chad Lytle 1.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophyllite in association venh Fibrous Talc 2.Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials I Actinolite in association with Vermiculite 8.Favorable scenario for valor separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9,<1%Result point counted positive 5.Not enough sample to analyze M TEM analysis suggested Attachment#2 Page 12 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 industriplex, Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Tumstone EHS CAU 7042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30am Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent I percent us estimate percent (Y/N) 0444-16 16-1 white surfaced white compound n None Detected 100%mi,bi,ca 16-2 white compound(beneath tape) y None Detected 100%mi,ca 0444-17 17-1 white surfaced white compound n None Detected 100%mi,bi,ca 17-2 white compound(beneath tape) y None Detected 100%mi,ca 0444-18 18-1 white surfaced white compound n None Detected 100%mi,bi,ca 0444-19 19-1 white surfaced white compound n None Detected 100%mi,bi,ca 19-2 white compound(beneath tape) y None Detected 100%mi,ca Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#T104704513-15-3 TDH 30-0235 AIHA LAP, LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining J becke line method. ca-carbonate mi-mica fg-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool tor-brucite bi-binder of-other wo-wollastonite ka-kaolin(clay) or-organic pe-perlite to-talc pa-palygorskite(clay) Approved Signatories: ma-matrix qu-quartz sy-synthetic Julio Robles OAC Technical Manager Analyst Leslie Crisp,P.G. Chad Lytle 1.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anmophyllite in association with Fibrous Talc 2.Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association with Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9. <1%Result point counted positive 5.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 13 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex, Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge,LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Turnstone ENS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30arn Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type I percent percent us estimate percent (Y/N) 0444-20 20-1 white surfaced white compound n None Detected 100%mi,bi,ca 20-2 white compound(beneath tape) y None Detected 100%mi,ca 0444-21 21-1 white surfaced white compound n None Detected 100%mi,bi,ca 21-2 white compound(beneath tape) y None Detected 100%mica 0444-22 22-1 white surfaced white compound n None Detected 100%mi,bi,ca 0444-23 23-1 white drywall with brown paper n None Detected 22%ce 78%qu,gy 0444-24 24-1 white drywall with brown paper n None Detected 24%ce 76%qu,gy Dallas NnAP Lab Code 200349-0 TEM/PLM TCEQ#TlO4704513-15-3 TDH30-0235 AIHA LAP,LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining I becke line method. ca -carbonate mi-mica fg-fiberglass cc-cellulose gy-gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder of-other wo-wollastonite ka-kaolin(clay) or-organic pe-perlite to-talc pa-palygorskite(clay) Approved Signatories: ma-matrix qu-quartz sy-synthetic i_C—, ,by Julio Robles QAC Technical Manager Analyst Leslie Crisp,P.G. Chad Lytle 1.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophyllire in association With Fibrous Talc 2.Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association with Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9. c 1%Result point counted positive li.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 14 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge,LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Turnstone EHS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30am Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent percent us estimate percent (Y/N) 0444-25 25-1 white difyym//with brown paper n None Detected 23%ce 77%qu,gy 0444- 26,29- 26,0444-29 1 tan floor tile y 3%Chrysotile 97%qu,ca 26,29- 2 black mastic y None Detected 100%gy,bi 0444- 27,30- 27,0444-30 1 tan floor tile y 3%Chrysotile 97%qu,ca 27,30- 2 black mastic y None Detected 100%gy,bi 0444- 28,31- 28,0444-31 1 tan floor tile y 4%Chrysotile 96%qu,ca 28,31- 2 black mastic y 2%Chrysotile 98%gy,bi Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#T104704513-15-3 TDH 30-0235 AIHA LAP, LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining/becke line method. Ga -carbonate mi-mica fg-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder of-other we-wollastonite ka-kaolin(clay) or-organic pe-perlite to-tale pa-palygorskite(clay) Approved Signatories: me-matrix qu-quartz sy-synthetic AAZ!��_ 1 67 Julio Robles QAC Technical Manager Analyst Leslie Crisp,P.G. Chad Lytle 1.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophyllite in association with Fibrous Talc 2,Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association with Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9.,1%Result point counted positive 5.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 15 of 33 CA Labs Crisp Analytical, L.L.C. CA Labs, L.L.C. 1929 Old Denton Road 12232 Industriplex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Turnstone EHS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30arn Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type J Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent percent us estimate percent (Y/N) 0444-32 32-1 tan surfaced white compound n None Detected 100%mi,bi,ca 32-2 white drywall with brown paper n None Detected 20%ce 80%qu,gy 0444-33 33-1 tan surfaced white compound n None Detected 100%mi,bi,ca 0444-34 34-1 tan surfaced white compound n None Detected 100%mi,bi,ca 0444-35 35-1 tan surfaced white compound in None Detected 100%mi,bi,ca 0444-36 36-1 tan surfaced white compound n None Detected 100%mi,bi,ca 0444-37 37-1 white drywall with brown paper n None Detected 22%ce 78%qu,gy Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#7104704513-15-3 TDH 30-0235 AIHA LAP, LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCl acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining/becke line method. ca -carbonate mi-mica fg-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool Dr-brucite bi-binder of-other wo-wollastonite ka-kaolin(clay) or-organic pe-partite to-tale pa-palygorskite(clay) Approved Signatories: me-matrix qu-quartz sy-synthetic Julio Robles OAC Technical Manager Analyst Leslie Crisp,P.G. Chad Lytle I.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophyllite in association with Fibrous Talc 2.Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association with Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer notanalyzed-attached to previous positive layer and contamination is suspected 9.a 1%Result point counted positive 5.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 16 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Turnstone EHS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30arn Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent percent us estimate percent (Y/N) 0444-38 38-1 white drywall with brown paper n None Detected 23%ce 77%qu,gy 0444-39 39-1 white drywall with brown paper n None Detected 24%ce 76%qu,gy 0444-40 40-1 tan sealant y None Detected 4%ce 96%qu,mi,bi 0444-41 41-1 tan sealant y None Detected 3%ce 97%qu,mi,bi 0444-42 42-1 tan sealant y None Detected 4%ce 96%qu,mi,bi 0444-43 43-1 white textured surfacing y None Detected 100%mi,bi,ca 0444-44 44-1 white textured surfacing y 2%Chrysotile 98%mi,bi,ca Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#TI04704513-15-3 TDH30-0235 AIHA LAP,LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-931116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining becke line method. ca -carbonate mi-mica fg-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder of-other wo-wollastonite ka-kaolin(clay) or-organic pe-perlite to-talc pa-palygorskile(clay) Approved Signatories: ma-matrix qu-quartz sy-synthetic Julio Robles QAC Technical Manager Analyst Leslie Crisp,P.G. Chad Lytle t.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophyllite in association with Fibrous Talc "Fire Damage no significant fiber damages affecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association with Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9. <1%Result point counted positive 5.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 17 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex, Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Turnstone EHS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi, TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30am Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent percent us estimate percent (Y/N) 0444-45 45-1 white textured surfacing y 2%Chrysotile 98%qu,bi,ca 0444-46 46-1 white textured surfacing y 2%Chrysotile 98%qu,bi,ca 0444-47 47-1 white textured surfacing y 2%Chrysotile 98%qu,bi,ca 0444-48 48-1 white textured surfacing n 2%Chrysotile 98%qu,bi,ca 48-2 white drywall with brown paper n None Detected 21%ce 79%qu,gy 0444-49 49-1 white drywall with brown paper n None Detected 23%ce 77%qu,gy 0444-50 50-1 white drywall with brown paper n None Detected 22%ce 78%qu,gy Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#TI04704513-15-3 TDH30-0235 AIHA LAP,LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining/becke line method. ca -carbonate mi-mica fg-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder of-other wo-wollastonite ka-kaolin(clay) or-organic pe-partite to-talc pa-palygorskite(clay) Approved Signatories: me-matrix qu-quartz sy-synthetic Julio Robles QAC Technical Manager Analyst Leslie Crisp,P.G. Chad Lytle 1.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophyllite in association with Fibrous Talc 2.Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials �l A, 'tirelite in association with Vermiculite S.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9,<1%Result point counted positive 5."o,enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 18 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex,Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: Tumstone EMS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi,TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30am Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneo calibrated visual type/percent 1 percent us estimate percent (Y/N) 0444-51 51-1 tan surfaced white compound n 2%Chrysotile 98%mi,bi,ca green surfaced white 0444-52 52-1 compound n None Detected 100%mi,bi,ca green surfaced white 0444-53 53-1 compound n None Detected 100%mi,bi,ca 0444-54 54-1 white drywall with brown paper n None Detected 22%ce 78%qu,gy 0444-55 55-1 white drywall with brown paper n None Detected 23%ce 77%qu,gy 0444-56 56-1 white drywall with brown paper y None Detected 24%ce 76%qu,gy 0444-57 57-1 brown fibrous paneling y None Detected 100%ce Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#T104704513-15-3 TDH 30-0235 AIHA LAP, LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCL acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining/becke line method. ca -carbonate mi-mica Ig-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder of-other we-wollastonite ka-kaolin(clay) or-organic pe-perlite to-talc pa-palygorskite(clay) Approved Signatories: ma-matrix qu-quartz sy-synthetic Julio Robles QAC Technical Manager Analyst Leslie Crisp,P.G. Chad Lytle 1.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophylifile in association with Fibrous Talc 2.Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association with Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9. ,1%Result point counted positive 5.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 19 of 33 Crisp Analytical, L.L.C. CA Labs, L.L.C. CA Labs 1929 Old Denton Road 12232 Industriplex, Suite 32 Dedicated to Carrollton, TX 75006 Baton Rouge, LA 70809 Quality Phone 972-242-2754 Phone 225-751-5632 Fax 972-242-2798 Fax 225-751-5634 Polarized Light Asbestiform Materials Characterization Customer Info: Attn: Tim Chaney Customer Project: CA Labs Project#: TurnstoneEHS CAL17042517JD 226 Enterprize Pkwy Ste. 116 Corpus Christi, TX 78405 17-0444 1201 Laguna Shores Date: 5/3/2017 Turnaround Time: Samples Received: 4/28/17 10:30arn Phone# 361-289-2510 3 Days Date Of Sampling: 4/26/2017 Fax# 361-289-2511 Purchase Order#: Sample# Com Layer Analysts Physical Description of Homo- Asbestos type Non-asbestos fiber Non-fibrous type ment # Subsample geneci calibrated visual type/percent percent us estimate percent (Y/N) 0444-58 58-1 brown fibrous paneling y None Detected 100%ce 0444-59 59-1 brown fibrous paneling y None Detected 100%ce 0444-60 60-1 black felt y None Detected 23%ce 77%qu,bi black roofing shingle with tan 0444-61 61-1 gravel y None Detected 12%fg 88%qu,bi Dallas NVLAP Lab Code 200349-0 TEM/PLM TCEQ#TI04704513-15-3 TDH30-0235 AIHA LAP, LLC Laboratory#102929 Analysis Method:Interim(40CFR Part 763 Appendix E to Subpart E)/Improved(EPA-600/R-93/116). All samples received in good condition unless noted. Preparation Method:HCl acid washing for carbonate based samples,chemical reduction for organically bound components,oil immersion for identification of asbestos types by dispersion attaining becke line method. ca -carbonate ml-mica fg-fiberglass ce-cellulose gy-gypsum ve-vermiculite mw-mineral wool br-brucite bi-binder of-other wo-wollastonite ka-kaolin(clay) or-organic pe-perlite to-talc pa-palygorskite(clay) Approved Signatories: ma-matrix qu-quartz sy-synthetic Julio Robles OAC Technical Manager Analyst Leslie Crisp,P.G. Chad Lytle 1.Fire Damage significant fiber damage-reported percentages reflect unaltered fibers 6.Anthophyllhe in association with Fibrous Talc 2.Fire Damage no significant fiber damages effecting fibrous percentages 7.Contamination suspected from other building materials 3.Actinolite in association with Vermiculite 8.Favorable scenario for water separation on vermiculite for possible analysis by another method 4.Layer not analyzed-attached to previous positive layer and contamination is suspected 9. ,1%Result point counted positive 5.Not enough sample to analyze 10.TEM analysis suggested Attachment#2 Page 20 of 33 ui 0 C) 00 =) :v .6 vcr- Tr 0 E 0 LU LZ Z 13 0 ej oc oo E Qj 0 Uf Lo wvl , - 2 0 " 0 @j C Or- 10, C a z M rq W M 0 C� 0) UJ a 00 cc o E 0 8 t; 0: I Cwt z 0 M t 0 M CL Cr -C W CL -a M kA E M LL 0 tu 3: --Q � I W z j '4; 0 Cr Cr 4 4t U e ft Ln w < CO La to cc M Cu E Ea to o o c an 2� Co a. CL M IL Cu M :M Z0 40 o LU -0 Cl 0 0 w E Uw CL i6 Wo Ln (n w "0 E E r, o P w E v (D CL 0 LL c c o 0 u LL on 0 CL g cc oj uj -wj 0 -T u u Ln M Cr CL 0) .7; r C O .C > M -ilnl9w , Wo 0 M C CL al M ro M C u < ui M CF3 L Attachment#2-Page 21 of 33 SAMPLT; LOCATION 1)A`I'F/'1'[I1•iE VOLUME - a14 RELINQUISHED i3Y� btu ��IitiCt IVIs[} l3Y: , � -- ��/�� jp.►�(9. !DATE SMNATURVDATR RELINQ0 1SHET} 13l`:—T _ Y: _ SIGNATtIRfi/1?A'I'i� ---�� SIf:NA"1'ttRIiJI)rl'1'I; Attachment#2 Page 22 of 33 SAMPLE# — LOCATION - I?r+I"I'I'si'I'{nIE� VQLUh'IE I P 3 f 1 i 1 1 1 t I 1 l !f f ( f } t ? {Z6IrFiVQU[SF{FI) F3Y f R1,CG(Vi l) 13Y• TE j SICNA'1'1)l2C iUA'i'1? I Cl ti �`. E RFL{NQUISHED BY: _ R1 CElVEI) BY: S IG,NATO RJUDATF SICNA 1'CIkF.JUA'f'fi Attachment#2 Page 23 of 33 t-ntit: BULK SAMPLING FORMS Turnstone EH&S,Inc.Job#16-0444 Asbestos Survey for Public Building Attachment#2 Page 24 of 33 TURNS EH&S,Inc. ti BULK SAMPLING GENERAL INFORMATION (Complete one of these forms for each buildin )l Project Name: CI'7-,., Inspection Date(s): Project Address: ' City/St./Zip: ,, �' Client Address: 4 � Count ----- City/St./Zip: Inspector(s): ! / Inspector(s) License No(s): Client P.O. Na.: Client Project No.: Clieat Contact: General Description of Structure(check all that apply): Single Story_Multi-Story_ If Multi-Story, how many? Approximate total area: s.f. � Foundation: Slab ZPier and Beam_ Basement_ Blocks_ Other 1. Y t Roof: Pitched Built Up (flat)_Metal_ Other ,r { Exterior Walls: Wood Brick— Cinder Blockfir' Metal_ Other Interior Walls: Drywall /Plaster_ Wood Paneling_ Cinder Block Other f i Windows (and glass doors): Single Pane_ Multi-Pane— Both_ Current or Most Recent Use: Is the Building a: Public School K-12_ Public Bldg Federal Bldg— Commercial Bldg— Is the building: Currently Occupied Vacant Abandoned Other : Building is to be: Entirely Demolished_ Partially Demolished_Entirely Renovated_ Partially Renovated—None of these_ Other If partially demolished, partially renovated, or other, explain: E 1 Has Building been declared Structurally Unsound: Yes_ No_ Unknownl_ Ask for a drawing of the building floor plan{s). Additional Notes and Comments: i Y I 1A V" `yy i i Turnstone Project No.: Inspector(s): ! (Print) ign Attachment#2 Page 25 of 33 i . BULK SAMPLING FORM TURNSTONE EH&S j i Project Name: Date: 17 Pro] #:_.I 7:7:�p i HA#:—L Material and Desc.: l.) f TS SURF MISC Sample#'s Homogeneous Material Locations: A'W44 o14 4-1Q' N Condition G `V Mate ial Amount Sq t/ in Ft/Cu Ft TT,riab e on-Friable i HA#: Material and Desc.: SIIQ Q 'D ck I' TSI SURF(TI Sample#'s Homogeneous Material Locations: �/^ ` 1 I Condition G L'S� Material Amount q Ft Lin Ft/Cu Ft J�0 O riable Non-Friable i I HA#: Material and Desc.: TSI SURF MISC Sample#'s Homogeneous Material Locations: Condition G D� L i M 'al Amount q F in Ft/Cu Ft i 0 ria I Non-Friable f HA#: Material and Desc.: ♦ TSI SURF ISC HA#A V1 I Sample#'s -::do Homogeneous Material Locations: Condition G D(f) Ma *al Amount j qFt in Ft/Cu Ft I f �Q iabl Non-Friable i Inspector(s):�`� �,.� C�h y Page-of Attachment#2-Page 26 of 33 BULK SAMPLING FORM —-- - ... -- ---- -- - - --------TURNSTONE EH&S..__...- - - Project Naive: Date: Proj #: HA#:_�r Material and Desc.: A DKul IIQ 5+, L TSI SURF Q1 C Sample#'s h; Homogeneous Material Locations: 0 � ConditiongD S I V e. 6.tk. -*al Amount q Pt/ in Ft/Cu Ft ;2- Fria �T on-Friable HA #: Material and Desc.:• Q ":t COM Ou 4 0` 66 11 TS[ SURF ISC Sample #'s d Homoge neous Material Locations: eX Ikf('► V) W KE Condition G Do l Arnotmt k-1 , q Ft/ n Ft/Cu Ft _ao N�� Q, 2 rC� r a e Non-Friable " /V�, HA#: -7 Material and Desc.: S e Q�'Y'b �' h TSI SURF ISC Sample#'s Homogeneous Material Locations: Condition " dr �..y+� G✓Z � � (ij Material Amount aq t/ in Ft/Cu Ft � (gag _ F�af Non-Friable HA #:_ Material and Desc.: Q Y 2 Li D4y- {'QW v� TSI SU MISC Sample #'s v Homogeneous Material Locations: v2 )^(��Yvl S . awl Condition G Do Material Amount q F Lin Ft/Cu Ft - _- F iable Non-Friabl Inspector(s): Page v�of Attachment#2-Page 27 of33 BULK SAMPLING FORM TURNSTONE EH&S Proj ect Name: Date: Proj #: HA#: Material and Desc.: �-�- TSI SURF MISC Sample#'s 4� Homogeneous Material Locations: s _ C�� ConditionD S Mat r I Amount d q Ft/ in Ft/Cu Ft Friable I:fon- ilable HA #:10 Material and Desc.: O; �Jr1 oar. f� TSI SURF MISC Sample #'s Homogeneous Material Locations: ��JL4a Y,rp'y, Condition G� "Jalerial Amount Sq Ft in Ft/Cu Ft _3s Friable Non-Friable HA#:JL Material and Desc.: --' TSI SURF ISC Sample#'s Homogeneous Material Locations:F Condition G c _ Material Amount q / in Ft/Cu Ft l 02 6 Friable Non-Friable Hj#: � Material and Desc.: Cu.� 2 Q (,�t4 TSI SURF ISC S #'s d Homogeneous Material Locations: _ Conditio G D S � 51 �.� Q5S �Qe � Soh L � M ria Amount — 41 q ' n Ft/Cu Ft S Friable -- on- riable Inspector(s): Page 3 of Attachment#2-Page 28 of 33 BULK SAMPLING FORM TURNSTONE EH&S Project Date: Proj #: Name: HA#:�� Material and Desc.: CAei — G TSI SU MISC i Sam le#'s Homogeneous Material Locations: ` g &r"M Condition G I S JM4terial Amount I INi Sq Ft in Ft/Cu Ft l� ria e Non-Friable i i f HA#:4Q- Material and Desc.: Sh,�.c,� ' TSI SURF MI C Sample Ws ! p Homogeneous Material Locations: sl.. Q_ 4-� I !`I f Condition G DO 1 Amount q Ft/ Ft/Cu Ft E = ria le Non-Friable s i HA#: Material and Desc.: cw► j TS UR MISC Sample#'s I - _ Homogeneous Material Locations: i Condition G 1 M erial Amount SalISq Ft/ in Ft/Cu Ft 1 i f ria le i I —on--Tr iable I HA#: Material and Desc.: 32 6 L TSI SURF&S Sample#'s Homogeneous Material Locations: I Condition G ll 0 � LFq irai' I Amount n Ft/Cu Ft E riabl Non-Friable , i Inspector(s): ', Page of f Attachment#2-Page 29 of 33 BULK SAMPLING FORM TURNSTONE EH&S Project Name: I-Z pl vt, u . b .1UY-Lc Date: i... -�, TS 17 �� Pro' #: vy HA#:2 Material and Desc.: ea; toorel TSI SURF tISC Sample#'s �^ Homogeneous Material Locations: (;M AJ '*Vv ea E 57;,4a) _ Condition af 10 Material Amount tFt�Lin Ft/Cu Ft Fri on-Friable HA#11i Material and Desc.: L- TSI SURF IS Sample#'s 7%4,, dd Condition G D� Homogeneous Material Locations: Y`dd Material Amount Q U Sq F in Ft/Cu Ft Friable on-Friab e " HA#: Material and Desc.: TSI SURF Sample#'s _ p Homogeneous Material Locations: � y,^eK^...C. 'l�c Condition G DO d w -Lk d Material Amount q Ft/ in Ft/Cu Ft Friable HA#: Material and Desc.: TSI SURF MISC Sample#'s Homogeneous Material Locations: Condition G D S Material Amount Sq Ft/Lin Ft/Cu Ft Friable Non-Friable Inspector(s): _rl w`- G.. DS Page J of.5 Attachment#2-Page 30 of 33 SAMPLE LOCATION DRAWING Turnstone EMS,Inc.Job 9 16-0444 Asbestos Survey for Public Building Attachment#2 Page 31 of 33 bi I 1 !9 t. Lr t e o►�1 33 ��'� �y i � � � ,✓ 1 r . 71 1 _ Attachment#2 Page 32 of 33 sKoe, •�.aw5•e Fla-t- s WaIIS �-, �, - �''1 � �..�. nor i �LA 82,1 L G u Y V1VI (�_ 4 o.o T.1 e Lk PG t ) t � ami ��fe Flucr� '� r7,17 F Attachment#2 Page 33 of 33 ATTACHMENT 3 DEMOLITION REQUIREMENTS Attachment 3 DEMOLITION REQUIREMENTS The following items are to be complied with: 1. Contractor must demolish the structure(s) located at the following address: 1201 Laguna Shores Road. 2. Contractor must obtain demolition permit from Development Services Department located at 2406 Leopard Street (361-826-3240) prior to any demolition work and call for a final inspection and state notification. 3. Contractor must leave all fencing intact and in the same state of repair as existing unless specified otherwise. 4. Contractor must visually inspect the property to insure that utilities are disconnected and properly capped or sealed off prior to any work being performed. Coordinate with Construction Inspection to schedule inspection. 5. Contractor must remove all concrete including pier foundations and concrete steps. Concrete foundations are to be removed at a depth of 3' below grade. 6. Contractor must remove pipes to a depth of not less than 4 inches below grade. Contractor will make sure the limits of demolition is free of any ruts, depressions, or mounds of dirt. Dirt must be placed where needed on the property and backfilled so that ponding does not occur; and if needed level existing grade. 7. Contractor must remove all other loose equipment, boxes, containers, bricks, stones, concrete rubble, metals, construction materials, and other debris from limits of demolition and properly dispose at a Texas Commission on Environmental Quality(TCEQ) registered landfill or registered Recycling Facility. 8. The structure contains asbestos materials—please refer to the Public Building Asbestos Survey Report/Turnstone EH&S, Inc. Project Number: 17-0444 dated April 26, 2017, included in Attachment 2. 9. Photographs are required. One (1) photograph before work is started and one (1) after the work is completed. Both photographs are to be taken at the same location and angle. Address and date each photograph. If photographs are not submitted at the completion of the job, penalties may be imposed or payment withheld. Nueces County Emergency Services District#2-Office Building Demolition/E17012 ATTACHMENT#3 - Page 1 ATTACHMENT 4 LOCATION MAP ATTACHMENT 4 N ward Island OCE?an - �r o, y401SAID PROJECT LOCATION 357 ho 1201 Laguna Shores Rd Ak N• •S Il I �1 f 'r -5 m .�� 17106 N Guo : . . 4 � ��Qdrri ��fi Rw c 11� m` PD dor FLOUR BLUFF a .,i 1p Waldron 0/' JQ field Nolf 422 a LOCATION MAP NOT TO SCALE Project Number: E17012 r., Nueces County Emergency Services ATTACHMENT 4 District #2 CITY OF CORPUS CHRISTI,TEXAS Office Building Demolition DEPARTMENT OF ENGINEERING SERVICES ATTACHMENT 5 VICINITY MAP ATTACHMENT 5 r , Q 4- VP AMIL k F . - �,- ,: Laguna Shores Rd t C T 1201 Laguna Shores Rd To be demolished F 4, VICINITY MAP .=jp. NOT TO SCALE Project Number: E17012 Nueces County Emergency Services ATTACHMENT 5 District #2 CITY OF CORPUS CHRISTI,TEXAS Office Building Demolition DEPARTMENT OF ENGINEERING SERVICES ATTACHMENT 6 WAGE RATES General Decision Number: TX170031 01/06/2017 TX31 Superseded General Decision Number: TX20160031 State: Texas Construction Type: Heavy Counties: Nueces and San Patricio Counties in Texas. HEAVY CONSTRUCTION PROJECTS (including Sewer and Water Line Construction and Drainage Projects) Note: Under Executive Order (EO) 13658, an hourly minimum wage of $10.20 for calendar year 2017 applies to all contracts subject to the Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2015. If this contract is covered by the EO, the contractor must pay all workers in any classification listed on this wage determination at least $10.20 per hour (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract in calendar year 2017. The EO minimum wage rate will be adjusted annually. Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Modification Number Publication Date 0 01/06/2017 * SUTX1987-001 12/01/1987 Rates Fringes CARPENTER (Excluding Form Setting) . . . . . . . . . . . . . . . . . . . . . . . . .$ 9.05 Concrete Finisher. . . . . . . . . . . . . . . .$ 7.56 ELECTRICIAN. . . . . . . . . . . . . . . . . . . . . .$ 13.37 2.58 Laborers: Common. . . . . . . . . . . . . . . . . . . . . .$ 7.25 Utility. . . . . . . . . . . . . . . . . . . . .$ 7.68 Power equipment operators: Backhoe. . . . . . . . . . . . . . . . . . . . .$ 9.21 Motor Grader. . . . . . . . . . . . . . . .$ 8.72 ---------------------------------------------------------------- WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. ---------------------------------------------------------------- Note: Executive Order (EO) 13706, Establishing Paid Sick Leave Attachment#6 Page 1 of 9 for Federal Contractors applies to all contracts subject to the Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2017. If this contract is covered by the E0, the contractor must provide employees with 1 hour of paid sick leave for every 30 hours they work, up to 56 hours of paid sick leave each year. Employees must be permitted to use paid sick leave for their own illness, injury or other health-related needs, including preventive care; to assist a family member (or person who is like family to the employee) who is ill, injured, or has other health-related needs, including preventive care; or for reasons resulting from, or to assist a family member (or person who is like family to the employee) who is a victim of, domestic violence, sexual assault, or stalking. Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses (29CFR 5.5 (a) (1) (ii) ) . ---------------------------------------------------------------- The body of each wage determination lists the classification and wage rates that have been found to be prevailing for the cited type(s) of construction in the area covered by the wage determination. The classifications are listed in alphabetical order of "identifiers" that indicate whether the particular rate is a union rate (current union negotiated rate for local) , a survey rate (weighted average rate) or a union average rate (weighted union average rate) . Union Rate Identifiers A four letter classification abbreviation identifier enclosed in dotted lines beginning with characters other than "SU" or "UAVG" denotes that the union classification and rate were prevailing for that classification in the survey. Example: PLUM0198-005 07/01/2014. PLUM is an abbreviation identifier of the union which prevailed in the survey for this classification, which in this example would be Plumbers. 0198 indicates the local union number or district council number where applicable, i.e., Plumbers Local 0198. The next number, 005 in the example, is an internal number used in processing the wage determination. 07/01/2014 is the effective date of the most current negotiated rate, which in this example is July 1, 2014. Union prevailing wage rates are updated to reflect all rate changes in the collective bargaining agreement (CBA) governing this classification and rate. Survey Rate Identifiers Attachment#6 Page 2 of 9 Classifications listed under the "SU" identifier indicate that no one rate prevailed for this classification in the survey and the published rate is derived by computing a weighted average rate based on all the rates reported in the survey for that classification. As this weighted average rate includes all rates reported in the survey, it may include both union and non-union rates. Example: SULA2012-007 5/13/2014. SU indicates the rates are survey rates based on a weighted average calculation of rates and are not majority rates. LA indicates the State of Louisiana. 2012 is the year of survey on which these classifications and rates are based. The next number, 007 in the example, is an internal number used in producing the wage determination. 5/13/2014 indicates the survey completion date for the classifications and rates under that identifier. Survey wage rates are not updated and remain in effect until a new survey is conducted. Union Average Rate Identifiers Classification(s) listed under the UAVG identifier indicate that no single majority rate prevailed for those classifications; however, 100% of the data reported for the classifications was union data. EXAMPLE: UAVG-OH-0010 08/29/2014. UAVG indicates that the rate is a weighted union average rate. OH indicates the state. The next number, 0010 in the example, is an internal number used in producing the wage determination. 08/29/2014 indicates the survey completion date for the classifications and rates under that identifier. A UAVG rate will be updated once a year, usually in January of each year, to reflect a weighted average of the current negotiated/CBA rate of the union locals from which the rate is based. ---------------------------------------------------------------- WAGE DETERMINATION APPEALS PROCESS 1.) Has there been an initial decision in the matter? This can be: * an existing published wage determination * a survey underlying a wage determination * a Wage and Hour Division letter setting forth a position on a wage determination matter * a conformance (additional classification and rate) ruling On survey related matters, initial contact, including requests for summaries of surveys, should be with the Wage and Hour Regional Office for the area in which the survey was conducted because those Regional Offices have responsibility for the Davis-Bacon survey program. If the response from this initial contact is not satisfactory, then the process described in 2.) and 3.) should be followed. Attachment#6 Page 3 of 9 With regard to any other matter not yet ripe for the formal process described here, initial contact should be with the Branch of Construction Wage Determinations. Write to: Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 2.) If the answer to the question in 1.) is yes, then an interested party (those affected by the action) can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7) . Write to: Wage and Hour Administrator U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 The request should be accompanied by a full statement of the interested party's position and by any information (wage payment data, project description, area practice material, etc.) that the requestor considers relevant to the issue. 3.) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative Review Board (formerly the Wage Appeals Board) . Write to: Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 4.) All decisions by the Administrative Review Board are final. ---------------------------------------------------------------- ---------------------------------------------------------------- END OF GENERAL DECISION Attachment#6 Page 4 of 9 b1za/zV i 1 nnps:uwww.wool.gov/waouscantes/cavisoaconi i A AZ.avo ry=1 General Decision Number: TX170342 04/14/2017 TX342 Superseded General Decision Number: TX20160342 State: Texas Construction Type: Building Counties: Aransas, Nueces and San Patricio Counties in Texas. BUILDING CONSTRUCTION PROJECTS (does not include single family homes or apartments up to and including 4 stories). Note: Under Executive Order (EO) 13658, an hourly minimum wage of $10.20 for calendar year 2017 applies to all contracts subject to the Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2015. If this contract is covered by the EO, the contractor must pay all workers in any classification listed on this wage determination at least $10.20 (or the applicable wage rate listed on this wage determination, if it is higher) for all hours spent performing on the contract in calendar year 2017. The EO minimum wage rate will be adjusted annually. Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Modification Number Publication Date 0 01/06/2017 1 04/14/2017 * BOIL0074-003 01/01/2017 Rates Fringes BOILERMAKER...... . . . .... .. .. . . . . .$ 28.00 22.35 ---------------------------------------------------------------- ELECO278-002 08/28/2016 Rates Fringes ELECTRICIAN. . . . .... .. . . ......... .$ 25.20 7.91 ---------------------------------------------------------------- ENGIO178-005 06/01/2014 Rates Fringes POWER EQUIPMENT OPERATOR (1) Tower Crane. .... .. .. . . . .$ 29.00 10.60 (2) Cranes with Pile Driving or Caisson Attachment and Hydraulic Crane 60 tons and above. .. ..$ 28.75 10.60 (3) Hydraulic cranes 59 Tons and under. . . . . ... .. .. ..$ 27.50 10.60 ---------------------------------------------------------------- IRON0084-011 06/01/2015 Rates Fringes IRONWORKER, ORNAMENTAL. . .... . ... .$ 23.02 6.35 ---------------------------------------------------------------- Attachment#6 SUTX2014-068 07/21/2014 Page 5 of 9 h"ne•11—inl AwKI r-1 114 d/L0IGU l 1 nips:/t W W W.WOD Lgo W waouscaitiesioavi soaconi 1 A34L.oVD!V=I Rates Fringes BRICKLAYER...... . . . .. ... .. . . . . . . .$ 20.04 0.00 CARPENTER... . . ..... . . ..... .. .. . . .$ 15.21 0.00 CEMENT MASON/CONCRETE FINISHER. . .$ 15.33 0.00 INSULATOR - MECHANICAL (Duct, Pipe & Mechanical System Insulation). .. ... .. . . . . . . .$ 19.77 7.13 IRONWORKER, REINFORCING. . . .. . . . . .$ 12.27 0.00 IRONWORKER, STRUCTURAL.. .. . . . . . . .$ 22.16 5.26 LABORER: Common or General. . . . . .$ 9.68 0.00 LABORER: Mason Tender - Brick. . .$ 11.36 0.00 LABORER: Mason Tender - Cement/Concrete.. ... . ... .. .. .. .. .$ 10.58 0.00 LABORER: Pipelayer.. .. ........ . .$ 12.49 2.13 LABORER: Roof Tearoff. . . ... .... .$ 11.28 0.00 OPERATOR: Backhoe/Excavator/Trackhoe. . . . . . .$ 14.25 0.00 OPERATOR: Bobcat/Skid Steer/Skid Loader. .. . .. .. . . . . . . ..$ 13.93 0.00 OPERATOR: Bulldozer. .... .. .. .. ..$ 18.29 1.31 OPERATOR: Drill.... . . . . ... .. .. ..$ 16.22 0.34 OPERATOR: Forklift. .. . . . . .. .. .. .$ 14.83 0.00 OPERATOR: Grader/Blade. ........ .$ 13.37 0.00 OPERATOR: Loader..... . . . . . . . . . . .$ 13.55 0.94 OPERATOR: Mechanic... . . . . . . . . . . .$ 17.52 3.33 OPERATOR: Paver (Asphalt, Aggregate, and Concrete).. . . . . . . .$ 16.03 0.00 OPERATOR: Roller... . ...... . .. . . .$ 12.70 0.00 PAINTER (Brush, Roller, and Spray).. ... . .. .... .. . ..... . . . . . . .$ 14.45 0.00 PIPEFITTER.. .. . .. ... . .. ... .. . . .. .$ 25.80 8.55 PLUMBER. .. . ...... ... . ... .. . . .. . . .$ 25.64 8.16 ROOFER....... .. . . .. .... . .. . . .. . . .$ 13.75 0.00 SHEET METAL WORKER (HVAC Duct Installation Only). .. ... .. . . .. . . .$ 22.73 7.52 SHEET METAL WORKER, Excludes Attachment#6 Page 6 of 9 hHnrlfun�roruurinl nnvluirinUcrafilccltiavich�rnnlTX4d9�1vh7v_i 9/ri otzottu i I naps:uwww.waoi.govrwoouscamesioavisoacon/i A,-AZ.avo rv=i HVAC Duct Installation. . .. . . .. . . .$ 21.13 6.53 TILE FINISHER... .. . . . .. . ... .... ..$ 11.22 0.00 TILE SETTER. .. . . . . ..... . . . . . . . . . .$ 14.74 0.00 TRUCK DRIVER: Dump Truck. . . . .. ..$ 12.39 1.18 TRUCK DRIVER: Flatbed Truck. . . ..$ 19.65 8.57 TRUCK DRIVER: Semi-Trailer Truck.... ... . . . .... . . . . . . . . . . . . . .$ 12.50 0.00 TRUCK DRIVER: Water Truck. . . . . . .$ 12.00 4.11 ---------------------------------------------------------------- WELDERS - Receive rate prescribed for craft performing operation to which welding is incidental. ---------------------------------------------------------------- Note: Executive Order (EO) 13706, Establishing Paid Sick Leave for Federal Contractors applies to all contracts subject to the Davis-Bacon Act for which the contract is awarded (and any solicitation was issued) on or after January 1, 2017. If this contract is covered by the E0, the contractor must provide employees with 1 hour of paid sick leave for every 30 hours they work, up to 56 hours of paid sick leave each year. Employees must be permitted to use paid sick leave for their own illness, injury or other health-related needs, including preventive care; to assist a family member (or person who is like family to the employee) who is ill, injured, or has other health-related needs, including preventive care; or for reasons resulting from, or to assist a family member (or person who is like family to the employee) who is a victim of, domestic violence, sexual assault, or stalking. Additional information on contractor requirements and worker protections under the EO is available at www.dol.gov/whd/govcontracts. Unlisted classifications needed for work not included within the scope of the classifications listed may be added after award only as provided in the labor standards contract clauses (29CFR 5.5 (a) (1) (ii)). ---------------------------------------------------------------- The body of each wage determination lists the classification and wage rates that have been found to be prevailing for the cited type(s) of construction in the area covered by the wage determination. The classifications are listed in alphabetical order of "identifiers" that indicate whether the particular rate is a union rate (current union negotiated rate for local), a survey rate (weighted average rate) or a union average rate (weighted union average rate). Union Rate Identifiers A four letter classification abbreviation identifier enclosed in dotted lines beginning with characters other than "SU" or "UAVG" denotes that the union classification and rate were prevailing for that classification in the survey. Example: PLUM0198-005 07/01/2014. PLUM is an abbreviation identifier of Attachment#6 Page 7 of 9 h"r%a-/unuu w4^1 nnulurAnUero£InetrhuiehornnlfY'�d9 fluh9.r_1 474 a/zo/Lu I/ nttps:uwww.waoi.govtwaouscarnesraavisoaconl i xs4t.ovo!v=i the union which prevailed in the survey for this classification, which in this example would be Plumbers. 0198 indicates the local union number or district council number where applicable, i.e., Plumbers Local 0198. The next number, 005 in the example, is an internal number used in processing the wage determination. 07/01/2014 is the effective date of the most current negotiated rate, which in this example is July 1, 2014. Union prevailing wage rates are updated to reflect all rate changes in the collective bargaining agreement (CBA) governing this classification and rate. Survey Rate Identifiers Classifications listed under the "SU" identifier indicate that no one rate prevailed for this classification in the survey and the published rate is derived by computing a weighted average rate based on all the rates reported in the survey for that classification. As this weighted average rate includes all rates reported in the survey, it may include both union and non-union rates. Example: SULA2012-007 5/13/2014. SU indicates the rates are survey rates based on a weighted average calculation of rates and are not majority rates. LA indicates the State of Louisiana. 2012 is the year of survey on which these classifications and rates are based. The next number, 007 in the example, is an internal number used in producing the wage determination. 5/13/2014 indicates the survey completion date for the classifications and rates under that identifier. Survey wage rates are not updated and remain in effect until a new survey is conducted. Union Average Rate Identifiers Classification(s) listed under the UAVG identifier indicate that no single majority rate prevailed for those classifications; however, 100% of the data reported for the classifications was union data. EXAMPLE: UAVG-OH-0010 08/29/2014. UAVG indicates that the rate is a weighted union average rate. OH indicates the state. The next number, 0010 in the example, is an internal number used in producing the wage determination. 08/29/2014 indicates the survey completion date for the classifications and rates under that identifier. A UAVG rate will be updated once a year, usually in January of each year, to reflect a weighted average of the current negotiated/CBA rate of the union locals from which the rate is based. ---------------------------------------------------------------- WAGE DETERMINATION APPEALS PROCESS 1.) Has there been an initial decision in the matter? This can be: * an existing published wage determination * a survey underlying a wage determination * a Wage and Hour Division letter setting forth a position on a wage determination matter * a conformance (additional classification and rate) ruling Attachment#6 Page 8 of 9 hH�c llunwiw/inl nnuhu'inl/er�filoclrh»ich�r�nlTYZd9 Auh?z.e� A19 01DO/LU 1! ntips:tt W W W.wool.goviwaoiiscaiiiestoavisoaconl 1 AW4L.0V0+V='I On survey related matters, initial contact, including requests for summaries of surveys, should be with the Wage and Hour Regional Office for the area in which the survey was conducted because those Regional Offices have responsibility for the Davis-Bacon survey program. If the response from this initial contact is not satisfactory, then the process described in 2.) and 3.) should be followed. With regard to any other matter not yet ripe for the formal process described here, initial contact should be with the Branch of Construction Wage Determinations. Write to: Branch of Construction Wage Determinations Wage and Hour Division U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 2.) If the answer to the question in 1.) is yes, then an interested party (those affected by the action) can request review and reconsideration from the Wage and Hour Administrator (See 29 CFR Part 1.8 and 29 CFR Part 7). Write to: Wage and Hour Administrator U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 The request should be accompanied by a full statement of the interested party's position and by any information (wage payment data, project description, area practice material, etc.) that the requestor considers relevant to the issue. 3.) If the decision of the Administrator is not favorable, an interested party may appeal directly to the Administrative Review Board (formerly the Wage Appeals Board). Write to: Administrative Review Board U.S. Department of Labor 200 Constitution Avenue, N.W. Washington, DC 20210 4.) All decisions by the Administrative Review Board are final. END OF GENERAL DECISION Attachment#6 Page 9 of 9 httnc•/hAMAMwrinl r4%th?%r=1 q/q EXHIBIT B INSURANCE REQUIREMENTS L CONTRACTOR'S LIABILITY INSURANCE A. Contractor must not commence work under this contract until all insurance required has been obtained and such insurance has been approved by the City. Contractor must not allow any subcontractor, to commence work until all similar insurance required of any subcontractor has been obtained. B. Contractor must furnish to the City's Risk Manager and Code Enforcement Director one (1) copy of Certificates of Insurance with applicable policy endorsements showing the following minimum coverage by an insurance company(s) acceptable to the City's Risk Manager. The City must be listed as an additional insured on the General liability and Auto Liability policies by endorsement, and a waiver of subrogation endorsement is required on all applicable policies. Endorsements must be provided with Certificate of Insurance. Project name and/or number must be listed in Description Box of Certificate of Insurance. TYPE OF INSURANCE MINIMUM INSURANCE COVERAGE 30-day advance written notice of Bodily Injury and Property Damage cancellation, non-renewal, material change Per occurrence - aggregate or termination required on all certificates and policies. COMMERCIAL GENERAL LIABILITY $1,000,000 Per Occurrence including: $2,000,000 Aggregate 1. Commercial Broad Form 2. Premises—Operations 3. Products/ Completed Operations 4. Contractual Liability 5. Independent Contractors 6. Personal Injury- Advertising Injury AUTO LIABILITY(including) $1,000,000 Combined Single Limit 1. Owned 2. Hired and Non-Owned 3. Rented/Leased WORKERS'S COMPENSATION Statutory and complies with Part 11 of this (All States Endorsement if Company is not Exhibit. domiciled in Texas) Employers Liability $500,000/$500,000/$500,000 C. In the event of accidents of any kind related to this contract, Contractor must furnish the Risk Manager with copies of all reports of any accidents within 10 days of the accident. Small Construction Contract#E17012 Page 1 of 3 Feb-2017 IL ADDITIONAL REQUIREMENTS A. Applicable for paid employees, Contractor must obtain workers' compensation coverage through a licensed insurance company. The coverage must be written on a policy and endorsements approved by the Texas Department of Insurance. The workers' compensation coverage provided must be in statutory amounts according to the Texas Department of Insurance, Division of Workers' Compensation. An All States Endorsement shall be required if Contractor is not domiciled in the State of Texas. B. Contractor shall obtain and maintain in full force and effect for the duration of this Contract, and any extension hereof, at Contractor's sole expense, insurance coverage written on an occurrence basis by companies authorized and admitted to do business in the State of Texas and with an A.M. Best's rating of no less than A- VII. C. Contractor shall be required to submit renewal certificates of insurance throughout the term of this contract and any extensions within 10 days of the policy expiration dates. All notices under this Exhibit shall be given to City at the following address: City of Corpus Christi Attn: Risk Manager P.O. Box 9277 Corpus Christi, TX 78469-9277 D. Contractor agrees that, with respect to the above required insurance, all insurance policies are to contain or be endorsed to contain the following required provisions: • List the City and its officers, officials, employees, and volunteers, as additional insureds by endorsement with regard to operations, completed operations, and activities of or on behalf of the named insured performed under contract with the City,with the exception of the workers' compensation policy; • Provide for an endorsement that the "other insurance" clause shall not apply to the City of Corpus Christi where the City is an additional insured shown on the policy; • Workers' compensation and employers' liability policies will provide a waiver of subrogation in favor of the City; and • Provide thirty(30)calendar days advance written notice directly to City of any, cancellation,non-renewal, material change or termination in coverage and not less than ten(10)calendar days advance written notice for nonpayment of premium. E. Within five (5) calendar days of a cancellation, non-renewal, material change or termination of coverage, Contractor shall provide a replacement Certificate of Insurance and applicable endorsements to City. City shall have the option to suspend Contractor's performance should there be a lapse in coverage at any time during this contract. Failure to provide and to maintain the required insurance shall constitute a material breach of this contract. Small Construction Contract#E17012 Page 2 of 3 Feb-2017 F. In addition to any other remedies the City may have upon Contractor's failure to provide and maintain any insurance or policy endorsements to the extent and within the time herein required,the City shall have the right to order Contractor to stop work hereunder, and/or withhold any payment(s) which become due to Contractor hereunder until Contractor demonstrates compliance with the requirements hereof. G. Nothing herein contained shall be construed as limiting in any way the extent to which Contractor may be held responsible for payments of damages to persons or property resulting from Contractor's or its subcontractor's performance of the work covered under this contract. H. It is agreed that Contractor's insurance shall be deemed primary and non-contributory with respect to any insurance or self insurance carried by the City of Corpus Christi for liability arising out of operations under this contract. I. It is understood and agreed that the insurance required is in addition to and separate from any other obligation contained in this contract. 2017 Insurance Requirements Engineering Services General Demolition 02/23/17 sw Risk Management Small Construction Contract#E17012 Page 3 of 3 Feb-2017 NOTICE TO CONTRACTORS - B r WORKER' S COMPENSATION INSURANCE REQUIRE W.NTS Page 1 of 11 Texas Adr m*istrative Code TITLE 28 INSURANCE PART 2 TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION CHAPTER 110 REQUIRED NOTICES OF COVERAGE SUBCHAPTER B EMPLOYER NOTICES RULE§110.110 Reporting Requirements for Building or Construction Projects for Governmental Entities (a)The following words and terms,when used in this rule, shall have the following meanings, unless the context clearly indicates otherwise.Terms not defined in this rule shall have the meaning defined in the Texas Labor Code, if so defined. (1)Certificate of coverage(certificate)--A copy of a certificate of insurance,a certificate of authority to self-insure issued by the commission,or a workers'compensation coverage agreement(TWCC-81,TWCC-82, TWCC-83,or TWCC-84),showing statutory workers' compensation insurance coverage for the person's or entity's employees(including those subject to a coverage agreement)providing services on a project,for the duration of the project. (2)Building or construction--Has the meaning defined in the Texas Labor Code, §406.096(e)(1). (3)Contractor--A person bidding for or awarded a building or construction project by a governmental entity. (4)Coverage--Workers'compensation insurance meeting the statutory requirements of the Texas Labor Code, §401.011(44). (5)Coverage agreement--A written agreement on form TWCC-81, form TWCC-82,form TWCC-83,or form TWCC-84,filed with the Texas Workers'Compensation Commission which establishes a relationship between the parties for purposes of the Texas Workers'Compensation Act,pursuant to the Texas Labor Code,Chapter 406,Subchapters F and G,as one of employer/employee and establishes who will be responsible for providing workers' compensation coverage for persons providing services on the project. (6)Duration of the project—Includes the time from the beginning of work on the project until the work on the project has been completed and accepted by the governmental entity. (7)Persons providing services on the project("subcontractor" in §406.096 of the Act)--With the exception of persons excluded under subsections(h)and(i)of this section,includes all persons or entities performing all or part of the services the contractor has undertaken to perform on the project,regardless of whether that person contracted directly with the contractor and regardless of whether that person has employees.This includes but is not limited to independent contractors,subcontractors,leasing companies,motor carriers,owner-operators,employees of any such entity,or employees of any entity furnishing persons to perform services on the project. Page 2 of 11 "Services" includes but is not limited to providing,hauling,or delivering equipment or materials, or providing labor,transportation,or other service related to a project. "Services"does not include activities unrelated to the project,such as food/beverage vendors,office supply deliveries,and delivery of portable toilets. (8)Project--Includes the provision of all services related to a building or construction contract for a governmental entity. (b)Providing or causing to be provided a certificate of coverage pursuant to this rule is a representation by the insured that all employees of the insured who are providing services on the project are covered by workers'compensation coverage,that the coverage is based on proper reporting of classification codes and payroll amounts, and that all coverage agreements have been filed with the appropriate insurance carrier or,in the case of a self-insured,with the commission's Division of Self-Insurance Regulation. Providing false or misleading certificates of coverage, or failing to provide or maintain required coverage,or failing to report any change that materially affects the provision of coverage may subject the contractor or other person providing services on the project to administrative penalties,criminal penalties,civil penalties,or other civil actions. (c)A governmental entity that enters into a building or construction contract on a project shall: (1) include in the bid specifications,all the provisions of paragraph(7) of this subsection,using the language required by paragraph(7)of this subsection; (2)as part of the contract,using the language required by paragraph(7)of this subsection, require the contractor to perform as required in subsection(d)of this section; (3)obtain from the contractor a certificate of coverage for each person providing services on the project,prior to that person beginning work on the project; (4)obtain from the contractor a new certificate of coverage showing extension of coverage: (A)before the end of the current coverage period, if the contractor's current certificate of coverage shows that the coverage period ends during the duration of the project;and (B)no later than seven days after the expiration of the coverage for each other person providing services on the project whose current certificate shows that the coverage period ends during the duration of the project; (5)retain certificates of coverage on file for the duration of the project and for three years thereafter; (6)provide a copy of the certificates of coverage to the commission upon request and to any person entitled to them by law;and (7)use the language contained in the following Figure 1 for bid specifications and contracts, without any additional words or changes,except those required to accommodate the specific document in which they are contained or to impose stricter standards of documentation:Attached QEaphic Page 3 of 11 (d)A contractor shall: (1)provide coverage for its employees providing services on a project, for the duration of the project based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements; (2)provide a certificate of coverage showing workers'compensation coverage to the governmental entity prior to beginning work on the project; (3)provide the governmental entity,prior to the end of the coverage period,a new certificate of coverage showing extension of coverage, if the coverage period shown on the contractor's current certificate of coverage ends during the duration of the project; (4)obtain from each person providing services on a project,and provide to the governmental entity: (A)a certificate of coverage,prior to that person beginning work on the project, so the governmental entity will have on file certificates of coverage showing coverage for all persons providing services on the project; and (B)no later than seven days after receipt by the contractor, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (5)retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (6)notify the governmental entity in writing by certified mail or personal delivery,within ten days after the contractor knew or should have known,of any change that materially affects the provision of coverage of any person providing services on the project; (7)post a notice on each project site informing all persons providing services on the project that they are required to be covered, and stating how a person may verify current coverage and report failure to provide coverage.This notice does not satisfy other posting requirements imposed by the Act or other commission rules. This notice must be printed with a title in at least 30 point bold type and text in at least 19 point normal type, and shall be in both English and Spanish and any other language common to the worker population.The text for the notices shall be the following text provided by the commission on the sample notice,without any additional words or changes:Attached Graphic (8)contractually require each person with whom it contracts to provide services on a project to: (A)provide coverage based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements for all of its employees providing services on the project, for the duration of the project; (B)provide a certificate of coverage to the contractor prior to that person beginning work on the project; (C)include in all contracts to provide services on the project the language in subsection(e)(3) of this section; Page 4 of 11 (D)provide the contractor,prior to the end of the coverage period,a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (E)obtain from each other person with whom it contracts,and provide to the contractor: (i)a certificate of coverage,prior to the other person beginning work on the project;and (ii)prior to the end of the coverage period,a new certificate of coverage showing extension of the coverage period,if the coverage period shown on the current certificate of coverage ends during the duration of the project; (F)retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (G)notify the governmental entity in writing by certified mail or personal delivery,within ten days after the person knew or should have known,of any change that materially affects the provision of coverage of any person providing services on the project;and (I)contractually require each other person with whom it contracts,to perform as required by subparagraphs(A)-(I)of this paragraph,with the certificate of coverage to be provided to the person for whom they are providing services. (e)A person providing services on a project,other than a contractor, shall: (1)provide coverage for its employees providing services on a project, for the duration of the project based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements; (2)provide a certificate of coverage as required by its contract to provide services on the project,prior to beginning work on the project; (3)have the following language in its contract to provide services on the project: `By signing this contract or providing or causing to be provided a certificate of coverage,the person signing this contract is representing to the governmental entity that all employees of the person signing this contract who will provide services on the project will be covered by workers'compensation coverage for the duration of the project,that the coverage will be based on proper reporting of classification codes and payroll amounts,and that all coverage agreements will be filed with the appropriate insurance carrier or, in the case of a self-insured,with the commission's Division of Self-Insurance Regulation. Providing false or misleading information may subject the contractor to administrative penalties,criminal penalties,civil penalties, or other civil actions." (4)provide the person for whom it is providing services on the project,prior to the end of the coverage period shown on its current certificate of coverage,a new certificate showing extension of coverage,if the coverage period shown on the certificate of coverage ends during the duration of the project; (5)obtain from each person providing services on a project under contract to it,and provide as required by its contract: (A)a certificate of coverage,prior to the other person beginning work on the project;and (B)prior to the end of the coverage period,a new certificate of coverage showing extension of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the project; Page 5ofII (6)retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (7)notify the governmental entity in writing by certified mail or personal delivery,of any change that materially affects the provision of coverage of any person providing services on the project and send the notice within ten days after the person knew or should have known of the change;and (8)contractually require each other person with whom it contracts to: (A)provide coverage based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements for all of its employees providing services on the project, for the duration of the project; (B)provide a certificate of coverage to it prior to that other person beginning work on the project; (C)include in all contracts to provide services on the project the language in paragraph(3)of this subsection; (D)provide,prior to the end of the coverage period, a new certificate of coverage showing extension of the coverage period,if the coverage period shown on the current certificate of coverage ends during the duration of the project; (E)obtain from each other person under contract to it to provide services on the project,and provide as required by its contract: (i)a certificate of coverage,prior to the other person beginning work on the project;and (ii)prior to the end of the coverage period, a new certificate of coverage showing extension of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the contract; (F)retain all required certificates of coverage on file for the duration of the project and for one year thereafter; (G)notify the governmental entity in writing by certified mail or personal delivery,within ten days alter the person knew or should have known,of any change that materially affects the provision of coverage of any person providing services on the project; and (H)contractually require each person with whom it contracts,to perform as required by this subparagraph and subparagraphs(A)-(G)of this paragraph,with the certificate of coverage to be provided to the person for whom they are providing services. (f)If any provision of this rule or its application to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of this rule that can be given effect without the invalid provision or application,and to this end the provisions of this rule are declared to be severable. (g)This rule is applicable for building or construction contracts advertised for bid by a governmental entity on or after September 1, 1994. This rule is also applicable for those building or construction contracts entered into on or after September 1, 1994,which are not required by law to be advertised for bid. Page 6 of 11 (h)The coverage requirement in this rule does not apply to motor carriers who are required pursuant to Texas Civil Statutes, Article 6675c,to register with the Texas Department of Transportation and who provide accidental insurance coverage pursuant to Texas Civil Statutes, Article 6675c, §40). (i)The coverage requirement in this rule does not apply to sole proprietors,partners,and corporate officers who meet the requirements of the Act, §406.097(c),and who are explicitly excluded from coverage in accordance with the Act, §406.097(a) (as added by House Bill 1089, 74th Legislature, 1995, §1.20). This subsection applies only to sole proprietors,partners,and corporate executive officers who are excluded from coverage in an insurance policy or certificate of authority to self-insure that is delivered, issued for delivery, or renewed on or after January 1, 1996. Source Note: The provisions of this §110.110 adopted to be effective September 1, 1994, 19 TexReg 5715,amended to be effective November 6, 1995,20 TexReg 8609 Page 7 of 11 T28S 110.110(d)('7) "REQUIRED WORKERS'COMPENSATION COVERAGE" "The law requires that each person working on this site or providing services related to this construction project must be covered by workers'compensation insurance. This includes persons providing, hauling, or delivering equipment or materials, or providing labor or transportation or other service related to the project, regardless of the identity of their employer or status as an employee.if "Call the Texas Workers'Compensation Commission at 512-440-3789 to receive information on the legal requirement for coverage, to verify whether your employer has provided the required coverage, or to report an employer's failure to provide coverage." Page 8 of 11 T28S 110.110(c)(7) Article . Workers'Compensation Insurance Coverage. A. Definitions: Certificate of coverage ("cert f Cate')-A copy of a certificate of insurance, a certificate of authority to self-insure issued by the commission, or a coverage agreement('IWCC=-81, TWCC' 82, TWCC-83, or TWCC-84), showing statutory workers'compensation insurance coverage for the person's or entity's employees providing services on a project,for the duration of the project. Duration of the project-includes the time from the beginning of the work on the project until the contractor's/person's work on the project has been completed and accepted by the governmental entity. Persons providing services on the project("subcontractor"in§406.096) - includes all persons or entities performing all or part of the services the contractor has undertaken to perform on the project, regardless of whether that person contracted directly with the contractor and regardless of whether that person has employees. This includes, without limitation, independent contractors, subcontractors, leasing companies, motor carriers, owner-operators, employees of any such entity, or employees of any entity which furnishes persons to provide services on the project. "Services"include, without limitation,providing, hauling, or delivering equipment or materials, or providing labor, transportation, or other service related to a project. "Services" does not include activities unrelated to the project, such as foodlbeverage vendors, office supply deliveries, and delivery ofportable toilets. B. The contractor shall provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements, which meets the statutory requirements of Texas Labor Code, Section 401.011(44)for all employees of the contractor providing services on the project,for the duration of the project. C. The Contractor must provide a certificate of coverage to the governmental entity prior to being awarded the contract. D. If the coverage period shown on the contractor's current certificate of coverage ends during the duration of the project, the contractor must,prior to the end of the coverage period,file a new certificate of coverage with the governmental entity showing that coverage has been extended. E. The contractor shall obtain from each person providing services on a project, and provide to the governmental entity: (1)a certificate of coverage,prior to that person beginning work on the project, so the governmental entity will have on file certificates of coverage showing coverage for all persons providing services on the project,and (2) no later than seven days after receipt by the contractor, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project. Page 9 of 11 F. The contractor shall retain all required certificates of coverage for the duration of the project and for one year thereafter. G. The contractor shall notes the governmental entity in writing by certified mail or personal delivery, within 10 days after the contractor knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project. H. The contractor shall post on each project site a notice, in the text,form and manner prescribed by the Texas Workers'Compensation Commission, informing all persons providing services on the project that they are required to be covered, and stating how a person may verify coverage and report lack of coverage. L The contractor shall contractually require each person with whom it contracts to provide services on a project, to: (1)provide coverage, based on proper reporting of classification codes and payroll amounts and filing of any coverage agreements, which meets the statutory requirements of Texas Labor Cade, Section 401.011(44)for all of its employees providing services on the project,for the duration of the project; (2)provide to the contractor,prior to that person beginning work on the project, a certificate of coverage showing that coverage is being provided for all employees of the person providing services on the project,for the duration of the project; (3)provide the contractor,prior to the end of the coverage period, a new certificate of coverage showing extension of coverage, if the coverage period shown on the current certificate of coverage ends during the duration of the project, (4)obtain from each other person with whom it contracts, and provide to the contractor: (a)a certificate of coverage,prior to the other person beginning work on the project;and (b)a new certificate of coverage showing extension of coverage,prior to the end of the coverage period, if the coverage period shown on the current certificate of coverage ends during the duration of the project; (S)retain all required certificates of coverage on file far the duration of the project and for one year thereafter; (6)notes the governmental entity in writing by certified mail or personal delivery, within 10 days after the person knew or should have known, of any change that materially affects the provision of coverage of any person providing services on the project,and (7)contractually require each person with whom it contracts, toperform as required by paragraphs(1) - (7), with the certificates of coverage to be provided to the person for whom they are providing services. J. By signing this contract or providing or causing to be provided a certificate of coverage, the contractor is representing to the governmental entity that all employees of the contractor who will provide services on the project will be covered by workers'compensation coverage for the duration of the project, that the coverage will be based on proper reporting of classification codes and payroll amounts, and that all coverage agreements will be filed with the appropriate insurance carrier or, in the case of a self-insured, with the commission's Division of Self- Page 10 of 11 Insurance Regulation. Providing false or misleading information may subject the contractor to administrative penalties, criminal penalties, civil penalties, or other civil actions. K The contractor's failure to comply with any of these provisions is a breach of contract by the contractor which entitles the governmental entity to declare the contract void if the contractor does not remedy the breach within ten days after receipt of notice of breach from the governmental entity. Page 11 of 11 The following blank forms are included for information only SMALL CONSTRUCTION CONTRACT AGREEMENT THE STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF NUECES This CONSTRUCTION AGREEMENT is between the City of Corpus Christi, a Texas home-rule municipal corporation ('CITY"), acting through its duly authorized City Manager or designee, the Director of Engineering Services or City Engineer, and _('CONTRACTOR"), acting by and through its duly authorized representative, _ (Name), (Title). The parties agree as follows: WITNESSETH: 1. CONTRACTOR shall construct and complete certain improvements in accordance with the plans and specifications described in Exhibit"A" (attached and incorporated herein), perform all work as provided in said plans and specifications, and do such additional work as may be considered necessary to complete the work in a satisfactory and acceptable manner (the "Work"). The CITY reserves the right to make such changes in the plans and specifications and in the character of the work as may be necessary or desirable. Authorization for all changes must be made in writing. The CONTRACTOR shall furnish all labor, tools, material, machinery, equipment and incidentals necessary to the prosecution of the Work unless otherwise provided by the written terms of the plans and specifications. 2. The work described in Exhibit "A" shall be completed within _Calendar Days of Notice To Proceed. 3. In consideration of the completion of the above-described Work, the CITY agrees to pay to CONTRACTOR the lump sum amount of THOUSAND, HUNDRED AND /100 ($ ) for City Project #. Said payment shall be conditioned upon the acceptance of the work by the 'CITY" as certified by its final inspection following the receipt of notice from the"CONTRACTOR"that the work is completed and ready for acceptance. Upon completion of work and before acceptance and final payment is made, the "CONTRACTOR" shall clean and remove from the work site all surplus and discarded materials, temporary structures, and debris of every kind in order to leave the work site in a neat, orderly condition, equal to that which originally existed. The"CONTRACTOR"shall submit a notarized affidavit that bills for all labor, equipment, materials and supplies associated with the project have been paid before final payment is released. Small Construction Agreement Page 1 of 3 Proi. No. Rev. 07/2017 4. All work shall be performed in a workmanlike manner and to the satisfaction of the CITY. The CITY shall determine the quality and acceptability of materials furnished, work performed, manner of performance, rate of progress of the Work, sequence of construction, and interpretation of the plans and specifications. 5. The CONTRACTOR agrees to comply with all insurance requirements as contained in Exhibit"B" (Insurance Requirements) and Notice To Contractors B (Worker's Compensation Coverage for Building or Construction Projects for Government Entities). 6. The CONTRACTOR will be required to provide a good and sufficient Payment Bond from a surety company authorized to do business in the State of Texas, if the award is over $25,000. 7. The CONTRACTOR shall, at all times, observe and comply with City, federal, state and county laws, ordinances or regulations which in any manner affect the conduct of the Work. The CONTRACTOR shall be responsible for procuring all legally required building, plumbing, electrical and other permits and licenses, pay all charges and fees, and give all notices necessary and incidental to the due and lawful prosecution of the Work, unless otherwise provided by the written terms of the plans and specifications. S. This Agreement or the Work provided may not be assigned or subcontracted by CONTRACTOR without the written permission of the CITY. Small Construction Agreement Page 2 of 3 Proj. No. Rev. 07/2017 IN WITNESS WHEREOF this Agreement is executed. CITY OF CORPUS CHRISTI CONTRACTOR: Valerie Gray, P.E. Company Executive Director of Public Works Original Authorized Signature APPROVED AS TO LEGAL FORM: Asst. City Attorney Address City, State, Zip Phone Funding Source Email Small Construction Agreement Page 3 of 3 Proj. No. Rev. 07/2017 PAYMENT BOND BOND# Contractor as Principal Surety Name: Name: Mailing address (principal place of business): Mailing address (principal place of business): Physical address (principal place of business): Owner Name: City of Corpus Christi,Texas Mailing address : Engineering Services 1201 Leopard Street Surety is a corporation organized and existing Corpus Christi, Texas 78401 under the laws of the state of: By submitting this Bond, Surety affirms its authority to do business in the State of Texas and Contract its license to execute bonds in the State of Texas. Small Construction Contract Protect No. E17012 Nueces County Emergency Telephone (main number): Services District No. 2 Office Building Demolition Telephone (for notice of claim): Local Agent for Surety Name: Date of Award: Address: Contract Price: Bond Telephone: Email: Date of Bond: The address of the surety company to which any (Date of Bond cannot be earlier than Effective Date of notice of claim should be sent may be obtained Contract) from the Texas Dept. of Insurance by calling the following toll-free number.1-800-252-3439 Payment Bond Form 006116- 1 Corpus Christi Standards—Small Constr. Contract Proj.#E17012 1-2017 Surety and Contractor,intending to be legally bound and obligated to Owner do each cause this Payment Bond to be duly executed on its behalf by its authorized officer, agent or representative. The Principal and Surety bind themselves, and their heirs, administrators, executors, successors and assigns,jointly and severally to this bond. The condition of this obligation is such that if the Contractor as Principal pays all claimants providing labor or materials to him or to a Subcontractor in the prosecution of the Work required by the Contract then this obligation shall be null and void;otherwise the obligation is to remain in full force and effect. Provisions of the bond shall be pursuant to the terms and provisions of Chapter 2253 and Chapter 2269 of the Texas Government Code as amended and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter to the same extent as if it were copied at length herein. Venue shall lie exclusively in Nueces County, Texas for any legal action. Contractor as Principal Surety Signature: Signature: Name: Name: Title: Title: Email Address: Email Address: (Attach Power of Attorney and place surety seal below) END OF SECTION Payment Bond Form 006116-2 Corpus Christi Standards—Small Constr. Contract Proj.#E17012 1-2017 AFFIDAVIT AND WAIVER OF LIEN BY CONTRACTOR STATE OF TEXAS COUNTY OF Personally appeared before me,the undersigned authority in and for said State and County, (Name/Title) of (Name of Company) which firm is hereinafter called "Contractor", who being duly sworn states on oath that he has personal knowledge of the following: 1. Contractor has paid in full all debts, obligations, and liabilities (including, without limitation, all debts, obligations, and liabilities for labor, materials, equipment or services, and for all local, state or federal taxes) which have been incurred by Contractor, or which are claimed by others to have been incurred by Contractor, or which have arisen in conjunction with work done, or labor, materials, equipment or services furnished by Contractor under contract with the City of Corpus Christi on the (Project Name) 2. This Affidavit and Waiver is made and given upon and in exchange for final payment of all sums due Contractor by the City of Corpus Christi under the terms of said contract. In consideration therefor, Contractor waives and releases any and all claims and any and all liens or rights to liens which Contractor has or may have against the City of Corpus Christi for amounts due and owing to Contractor by virtue of Contractor furnishing the labor, materials, equipment or services referred to above. The above statements are made by (Name) of (Name of Company) individually and on behalf of the Contractor. (Name and Title) (Company name) Sworn to and subscribed before me on (Date). Notary Public State of Texas Commission Expires ENGINEERING SERVICES CITY OF CORPUS CHRISTI, TEXAS SMALL CONSTRUCTION CONTRACT SCC PROPOSAL DATE: O&/;ZD( 7 Proposal of 00340- 1 �� Demo lr �ivr7 lr�c. A corporation_organized and existing under the laws of the State of I C as or A Partnership or Individual doing business as To: The City of Corpus Christi, Texas Ladies/Gentlemen: The undersigned hereby proposes to furnish all labor and materials, tools, and necessary equipment, and to perform the work required for: NUECES COUNTY EMERGENCY SERVICES DISTRICT #2 OFFICE BUILDING DEMOLITION - PROJECT NO. E17012 at the locations set out by the plans and specifications and in strict accordance with the contract documents as set forth in the following proposal. Page 1 Proj. No. E17012 Rev. 112017 PROPOSAL FOR SMALL CONSTRUCTION CONTRACT NUECES COUNTY EMERGENCY SERVICES DISTRICT #2 OFFICE BUILDING DEMOLITION PROJECT NO. E17012 Proposal Submitted By: LasAa-\ '&dna �CYYI!plt l0h�l '1Y1C Bid Date: August 9, 2017, Wednesday, 2:00 p.m. Location: City Hall, 1201 Leopard Corpus Christi, Texas Project Scope: The scope of services for this project consists of: Asbestos abatement and the complete removal of approximately 3600 square feet of building and concrete foundation 3' below grade, in accordance with the asbestos abatement requirements and demolition requirements as specified in the bidding documents in Exhibit A, Attachments 1, 2, 3, 4, 5 and 6. All work will be in accordance with the attached drawings and labor wage rates (see Attachments No. 1, 2, 3, 4, 5 and 6) along with full compliance with all applicable regulatory requirements (if applicable). The contractor shall obtain all necessary permits and pay ALL fees (if applicable). The bids will be evaluated based on the lowest responsible total bid. Time of Completion: 30 Calendar Days Addendum Acknowledged: Page 2 Proj. No. E17012 3„ Rev. 1/2017 PROPOSAL FOR SMALL CONSTRUCTION CONTRACT NUECES COUNTY EMERGENCY SERVICES DISTRICT#2 OFFICE BUILDING DEMOLITION PROJECT NO. E17012 Bid ($) Item Qty Unit Item Description Total Cost 1 1 LS Building Demolition �1�,�'� 00 2 1 LS Asbestos Abatement A Y, Q7 CO . 00 TOTAL BASE BID: � � � �,-y,� 00 Page 3 Proj. No. E17012 Rev. 112017 PROPOSAL FOR SMALL CONSTRUCTION CONTRACT NUECES COUNTY EMERGENCY SERVICES DISTRICT#2 OFFICE BUILDING DEMOLITION PROJECT NO. E17012 Contract Requirements: 1. Contractor must submit the attached Disclosure of Interest form fully completed and executed and acknowledge any addenda issued for the project. 2. All work will be in accordance with specifications and Davis and Bacon Wage Rates as provided in all Attachments included in Exhibit A. 3. Work is anticipated to be a Small Construction Contract under$50,000. A Bid Bond is not required. 4. The successful contractor will be required to submit proof of insurance as per Exhibit B of the contract, within ten days of award notification. If award is over $25,000, successful contractor is required to provide a Payment Bond from a surety company authorized to do business in the State of Texas. 5. The contractor will be required to provide an Affidavit Waiver of Lien at completion of construction and prior to final payment processing. 6. In determining the partial payment to be made to the Contractor, the City will retain five percent (5%) of the total approximate estimate, unless otherwise stated, and will deduct payments previously made. No partial payment will be made when the said estimate or the estimates of work performed since the last previous estimate is less than One Hundred Dollars ($100.00). All retainage is due and payable to the Contractor upon successful completion of the project and will be included in the final payment to the Contractor. Page 4 Proj.No. E17012 Rev. 112017 Proposal Submitted By: �Authorized In C)Signature eo"( kAf_n� Print �lName and Title DcMo�Ak,u) Company Name uo�Tu�,p7 0a Address I City I St Zip �S(DI- 851- CA t�� 8cOto—51 Phone No] Fax No. --�(`- T4 2.q q 2 Cell No. �exr�0►n of Coo�S�a�be�c�cxYto�i-'�tav�.�+nrl E-Mail Address Page 5 Proj. No, E17012 Rev. 112017 City of- Carpus Christi CITY OF CORPUS CHRISTI DISCLOSURE OF INTEREST City of Corpus Christi Ordinance 17112, as amended, requires all persons or firms seeking to do business with the City to provide the following information. Every question must be answered. If the question is not applica le, answer with"NA". See reverse side for Filing Requirements, Certifications and definitions. COMPANY NAME: �QSQ� � 1JeO 1'l L i�Y�l 1'C•Ic P. O. BOX: STREET ADDRESS: STATE �\JV T FIRM IS: 1. Corporation 2. Partnership ❑� 3. Sole Owner ❑ 4. Association LJ 5. Other H DISCLOSURE QUESTIONS If additional space is necessary, please use the reverse side of this page or attach separate sheet. 1. State the names of each"employee"of the City of Corpus Christi having an"ownership interest" constituting 3% or more of the ownership in the above named"firm." Nampa Job Title and City Department (if known) 2. State the names of each "official" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Name Title 3. State the names of each "board member" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named"firm." Name �I A Board, Commission or Committee 4. State the names of each employee or officer of a"consultant"for the City of Corpus Christi who worked on any matter related to the subject of this contract and has an"ownership interest"constituting 3% or more of the ownership in the above named "firm." Name Consultant Page B Proj. No. E17012 Rev. 112017 FILING REQUIREMENTS If a person who requests official action on a matter knows that the requested action will confer an economic benefit on any City official or employee that is distinguishable from the effect that the action will have on members of the public in general or a substantial segment thereof, you shall disclose that fact in a signed writing to the City official, employee or body that has been requested to act in the matter, unless the interest of the City official or employee in the matter is apparent. The disclosure shall also be made in a signed writing filed with the City Secretary. [Ethics Ordinance Section 2-349 (d)] CERTIFICATION I certify that all information provided is true and correct as of the date of this statement, that I have not knowingly withheld disclosure of any information requested; and that supplemental statements will be promptly submitted to the City of Corpus Christi, Texas as changes occur. Certifying Person: \� miri ecaa Tit{e: (Type or Print) Signature of Certifying Person: Date: DEFINITIONS a. "Board member." A member of any board, commission, or committee appointed by the City Council of the City of Corpus Christi, Texas. b. "Economic benefit". An action that is likely to affect an economic interest if it is likely to have an effect on that interest that is distinguishable from its effect on members of the public in general or a substantial segment thereof. c. "Employee."Any person employed by the City of Corpus Christi, Texas either on a full or part-time basis, but not as an independent contractor. d. "Firm," Any entity operated for economic gain, whether professional, industrial or commercial, and whether established to produce or deal with a product or service, including but not limited to, entities operated in the form of sole proprietorship, as self-employed person, partnership, corporation, joint stock company, joint venture, receivership or trust, and entities which for purposes of taxation are treated as non-profit organizations. e. "Official." The Mayor, members of the City Council, City Manager, Deputy City Manager, Assistant City Managers, Department and Division Heads, and Municipal Court Judges of the City of Corpus Christi, Texas. f. "Ownership Interest." Legal or equitable interest, whether actually or constructively held, in a firm, including when such interest is held through an agent, trust, estate, or holding entity. "Constructively held" refers to holdings or control established through voting trusts, proxies, or special terms of venture or partnership agreements." g. "Consultant." Any person or firm, such as engineers and architects, hired by the City of Corpus Christi for the purpose of professional consultation and recommendation. Page 7 Proj. No. E17012 Rev. 112017 0nd t DEMOLITION , INC . 606 Tulip Street Corpus Christi,Tx 78408 (361)851-0464 Nueces County Emergency Services District #2 Office Building Demolition — Project No. E17012 Contractor's Statement of Qualifications Request for Competitive Sealed Proposals Table of Contents 1. Proposal 2. Work in Progress 3. Recently Completed Jobs 4. Franchise Tax Account Status/ Letter of Good Standing/ Bonding Letter S. Asbestos License 6. OSHA 300/ EMR 7. Certificate of Insurance EXHIBIT "X NUECES COUNTY EMERGENCY SERVICES DISTRICT#2 OFFICE BUILDING DEMOLITION PROJECT NO. E17012 1. Scope of Services: Contractor is responsible for asbestos abatement and complete removal of an approximately 3600 square foot building and concrete foundation, 3' below grade. All work will be in accordance with all attached documents, including labor wage rates (see Attachments 1, 2, 3, 4, 5 and 6). 2. Time of Completion The Contractor shall be prepared to begin work within ten (10) calendar days from the date of a formal Notice to Proceed. All work shall be completed within 30 calendar days. For every calendar day used in excess of the calendar days specified herein, the Contractor shall be assessed $250.00 per day as liquidated damages. 3. City's Representative For this project Ernesto De La Garza, P.E., Construction Management Engineer shall be the City's representative on all matters concerning the project. The City's Representative shall work with the contractor on matters affecting the program. All work shall be completed in a manner satisfactory and acceptable to the City representative as a strict requirement for fulfilling the contract. 4. Pre-Bid Conference A pre-bid conference will be held at City Hall Yd Floor, Engineering Services Smartboard Conference Room, on August 2. 2017 at 10:00 a.m.. Pre-Bid will be conducted by Melanie Gavlik, P.E. —City Project Manager. Project No. E17012 Exhibit"A"—Page 1 4 ATTACHMENT 1 ASBESTOS ABATEMENT REQUIREMENTS Attachment 1 ASBESTOS ABATEMENT REQUIREMENTS The following items are to be complied with: 1. Contractor must perform the asbestos abatement on the structure(s) located at the following address:1201 Laguna Shores Road. 2. Contractor must obtain and provide copies of all necessary permit(s)from either the City of Corpus Christi, Nueces County and/or the State of Texas pertaining to Asbestos Abatement. 3. The Contractor must submit and provide payment for a receipt of 10-day notification with the Texas Department of State Health Services before demolition can begin. 4. Contractor must visually inspect the property to insure that utilities are disconnected and properly capped or sealed off prior to any work being performed. Coordinate with Construction Inspection to schedule inspection. 5. The structure contains asbestos materials—please refer to the Public Building Asbestos Survey Report/Turnstone EH&S, Inc. Project Number: 17-0444 dated April 26, 2017, included in Attachment 2. Nueces County Emergency Services District No.2-Office Building Demolition/E17012 ATTACHMENT#1-Page 1 ATTACHMENT 2 ASBESTOS SURVEY REPORT AND ANALYTICAL DATA m PUBLIC BUILDING ASBESTOS SURVEY REPORT Conducted at: Vacant Building 1201 Laguna Shores Corpus Christi, Texas For: IIs. Melanie Gavlik City of Corpus Christi Corpus Christi, Texas Conducted by: Turnstone EH&S, Inc. Asbestos Consultant Agency Texas Department of State Health Services License No. 100408 226 Enterprize Pkwy Ste 116 Corpus Christi,Texas 78405 Phone:361-289-2510 Samples Collected: April 26,2017 Turnstone EH&S,Inc.Job#17-0444 Asbestos Survey for Public Building Attachment#2 Page 1 of 33 my.: May 10, 2017 Ms.Melanie Gavlik City of Corpus Christi Corpus Christi,Texas RE: Limited Asbestos Building Survey Location: Vacant Building at 1201 Laguna Shores in Corpus Christi,Texas Turnstone EH&S, Inc., Licensed Asbestos Agency(License No. 100408) Dear Ms. Gavlik: On April 26,2017, Turnstone EH&S (Turnstone)conducted an asbestos survey in the vacant building located at 1201 Laguna Shores in Corpus Christi,Texas,to determine whether asbestos- containing materials(ACM)are present. The information being gathered will be stored for future use of the site. The client requested a three-day turnaround for the analysis results. Building Notes: The building is listed at 3600 square feet,single story and sits on a concrete slab. The exterior walls are cinder block and the interior walls are sheetrock and cinder block. The roof is pitched and covered by composition shingles. Windows are single-pane. It is classified as a"Public" building and is currently vacant. Additional Building Notes: The roof has major damage. Licensing: Turnstone is a Texas Department of State Health Services (TDSHS) Licensed Asbestos Consultant Agency(License#100408). The samples were collected by TDSHS Licensed Asbestos Consultant Mr. Tim Chaney(Lic.No. 105670)of Turnstone. After a comprehensive inspection, the Turnstone inspector identified nineteen(19)Homogeneous Areas and collected a total of sixty-one (61) samples. Turnstone EH&S,Inc.Job#27-0444 Asbestos Survey for Public Building Attachment#2 Page 2 of 33 Sampling Protocols: The inspector based on the inspectors' experience, selected locations for sample collection to be representative of the suspect materials. Sampling protocols meet the standards of the Occupational Safety and Health Administration(OSHA),Environmental Protection Agency (EPA), Asbestos Hazard Emergency Response Act(AHERA),and the Texas Department of State Health Services (TDSHS). Sampling Analysis: Following strict chain-of-custody procedures,the samples were shipped overnight for analysis to Crisp Analytical Laboratories, L.L.C. in Carrollton, Texas. The National Voluntary Laboratory Accreditation Program (NVLAP) for bulk asbestos fiber analysis and airborne fiber analysis accredits Crisp Analytical Laboratories. They are a TDSHS Licensed Asbestos Laboratory (License #30-0235). The samples were analyzed for asbestos content by the Polarized Light Microscopy (PLM) method as specified by the EPA Interim improved method EPA-600 / R- 93/116. Based on Laboratory analysis: Asbestos greater than 1%,the limit referenced by EPA 40 CFR Part 763, WAS FOUND IN THE FOLLOWING AREAS/MATERIALS: • Homogeneous Areas#1 and 2 (Samples#1-6), the sheetrock and joint compound and texture("popcorn") found on the garage area ceiling to the South of the building, contained Chrysotile Asbestos in the 2%range. The sheetrock is not ACM but the sheetrock is attached to the joint compound and texturing.The Inspector estimates the area of coverage at—900 square feet. • Homogeneous Areas#3 and 4(samples#7-12),the sheetrock and joint compound and texture("popcorn") found in the same area on the upper North wall,contained Chrysotile Asbestos in the 2%range. The sheetrock is not ACM but is attached to the joint compound and texturing The Inspector estimates the area of coverage at—150 square feet. • Homogeneous Areas#8 and 9 (Samples#26-31),the tan floor tile and floor mastic attaching it,contained Chrysotile Asbestos in the 2-41/o range. It was observed in the two rooms north of the garage and the room nearest the shop/storage area. The Inspector estimates its coverage at—326 square feet. • Homogeneous Areas#13 and 14(Samples#43-50),the"popcorn"ceiling texture and sheetrock found in the large central room, contained Chrysotile Asbestos in the 2%range. It was found in the small room in the center of the building.The sheetrock is not ACM, Turnstone EH&S,Inc.Job!#17-0444 Asbestos Survey for Public Building Attachment#2 Page 3 of 33 but the texturing is attached to the sheetrock. The Inspector estimates the extent of coverage at 1,150 square feet. • Homogeneous Areas#15 and 16(Samples#51-56),the joint compound and sheetrock found in the large central room,contained Chrysotile Asbestos in the 2%range. It was found in the small room in the center of the building.The sheetrock is not ACM, but is attached by the ACM joint compound. The Inspector estimates the area at—590 square feet. Although the Turnstone technician made every effort to adequately sample the selected materials, the client should be aware that Asbestos Containing Materials may exist within systems that were inaccessible at the time of the survey, and which may be exposed during renovation/demolition activities. If previously unidentified materials are discovered during renovations/demolitions,they should be tested for asbestos content before disturbance. For more details, refer to the attached Lab Analysis Report, the Chain-of-Custody Form, Bulk Sampling Form signed by the Asbestos Consultant/Inspector,Mr. Chaney and in the last section, a Sample Location Drawing. If you have any questions about this report, please call us at (361) 289-2510. Thank you for allowing us to assist with your project. Tim Chaney, President Tumstone EH&S, Inc. TDSHS Asbestos Consultant Lia# 105670 Turnstone EH&S,Inc.Job#17-0444 Asbestos Survey for Public Building Attachment#2 Page 4 of 33 i DEMOLITION, INC . 606 Tulip Street Corpus Christi,Tx 78408 (361)851-0464 WORK IN PROGRESS NASCC DEMOLITION OF BLDG.5&90 MCKINZIE JAIL ANNEX LOCATION:CORPUS CHRISTI,TX LOCATION:CORPUS CHRISTI,TX CONTRACT AMOUNT:$458,852.50 CONTRACT AMOUNT:83,032.50 PERCENT COMPLETE:63% PERCENT COMPLETE: 12% EST.DATE OF COMPLETION:DEC 2017 EST. DATE OF COMPLETION:JAN 2018 GC:SAMES INC. GC: PROGRESSIVE STRUCTURES CONTACT:SAUL MALDONADO CONTACT: CRAIG BALDREE PHONE NO.:(956)702-8880 OWNER:NAVFAC PHONE: (361)852-9651 OWNER: NUECES COUNTY CONTACT:MARIO GARZA NAS KINGSVILLE AMMO BUNKER PHONE NO.: (361)888-0426 LOCATION: KINGSVILLE,TX CONTRACT AMOUNT-$49,750.00 PRECENT COMPLETE-0% EST.DATE OF COMPLETION:UNKNOWN GC:SOLID STRUCTURES CONTACT:FRANK ARRIAGA PHONE NO.:(956)544-5459 OWNER:NAS PHONE NO.: ARCHITECT: HILLCREST NEIGHBORHOOD DEMOLITION LOCATION:CORPUS CHRISTI,TX CONTRACT AMOUNT: INDEFINITE PERCENT COMPLETE: 10% EST. DATE OF COMPLETION: 2020 OWNER:POCCA CONTACT:SONYA LOPEZ-SOSA PHONE NO.: (361)885-6607 t 1 N 0a DEMOLITION . INC. 606 Tulip Street Corpus Christi,Tx 78408 (361)851-0464 Recently Completed Projects ACSI Management Multiple Projects(Completed 2015) $68,500.00 Mr. Willard Hammonds(361)947-8893 Adventure One Management Groendyke Transportation(Completed 2014) $30,000.00 Mr. Robert Pruski (361)652-2278 Austwell- Tivoli ISD Various Bldg Demolition(Completed 2015) $24,500.00 (361)286-3212 Artesia Properties Kleberg Bank Mold Remediation(Completed 2016) $114,000.00 Chip Collins(361)336-4568 Barcom Construction Multiple Projects(Completed 2014-2016) $132,235.00 Mr.Justin McComb (361)85 1-1000 Beecroft Construction Multiple Projects(Completed 2014-2015) $130,000.00 Mr. Shannon Reynolds (361) 882-6791 BLS Construction Edna ISD&First Baptist Church(Completed 2014-2015) $100,000.00 Mr. William Key (979)637-0427 Continuation of Recently Completed Projects City of Corpus Christi Multiple Projects(Completed 2014-2016) $100,000.00 Mr.Jerry Shoemaker (361)675-0964 City of Corpus Christi Code Enforcement Multiple Projects(2015-2016) $65,155.00 Glenda Doner(361)826-3202 City of Robstown Multiple Projects(Completed 2015-2016) $30,025.00 Mrs.Lisa Benavidez(361)387-4589 Corstone Contractors LLC Natural Grocers (Completed 2016) $53,168.75 Leo Hupp(425)231-5236 Commercial Products State Comptroller(Completed 2016) $18,500.00 Morgan Hall (361)887-8249 Edna ISD Administration Bldg.(Completed 2015) $47,500.00 Mr. Robert O'Connor(361)782-3573 Fulton—Coastcon Construction Andrews Distributing(Completed 2015) $50,000.00 Mr.Mike Lipincot(361)816-2019 G & H Towing Company Baker Marine(Completed 2014) $50,000.00 Mr.Xavier Zalzerde (361)446-9606 Gideon Contracting Multiple Military Projects(Completed 2014) $100,000.00 (210)372-3090 GFP- Yates Joint Venture Military Project(2015-2016) $297,125.00 Mary Lupe Arenas(210)441-2775 Continuation Recently Completed Projects Haas - Anderson Construction POCCA North Storage Yard(Completed 2014) $30,000.00 Mr. Drew Cullen(361)853-5332 KJM Commercial Multiple Projects(Completed 2014-2016) $225,000.00 Mr.Jeremy Baugh(361)991-5600 LNV Engineering & Construction Multiple Projects(Completed 2014-2015) $250,000.00 Mr. Bryan Roach(361)883-1984 Maxwell P Dunne Funeral Home Demolition(Completed 2014) $40,000.00 Mr. Ron Alonzo(361)947-1346 MSCS, LTD CST#1848 Demolition(Completed 2016) $74,000.00 Mark Spenrath(817)781-4359 MW Builders George West Elementary(Completed 2016) $32,050.00 Mike Denton(254)778-4241 Northern White Sands Company Multiple Projects(Completed 2014-2015) $400,000.00 Mr. Mike Meyer (512)917-1070 Parker Lumber Sinton Hospital(2015-2016) $50,000.00 Chris Miller(409)347-0942 Planters Co-Op Multiple Projects(2016) $36,000.00 Jason Lee(361) 850-3408 Port of Corpus Christi Authority Multiple Projects(Completed 2014) $50,000.00 Mr. Bert Perez (361)885-6132 Continuation Recently Completed Projects Reconn Construction CST# 1828(Completed 2016) $65,700.00 Jason Tolliver(281)549-6267 Road Construction Northwest / Global Engineering NAS Kingsville(Completed 2014) $225,000.00 Mr.Matt Wagester (425)531-0371 Sam Engineering-Surveying NAS Corpus Christi(2016) $274,000.00 Saul Maldonado(956)451-5826 SLI Group Prosperity Bank(Completed 2014) $60,000.00 Mr. Morgan Mitchell (903)203-4946 South Texas Building Partners Multiple Projects(2014-2016) $92,000.00 Mr.Matt Ezell (361)815-9251 Teal Construction Company Multiple Projects(2014-2016) $141,666.49 Mr.Tom Gentry (361)882-4825 Terrell Pruett Homes Multiple Projects(Completed 2014) $60,000.00 Mr.Terrell Pruett (361)438-1221 Victory Building Team Multiple Projects(2016) $38,500.00 Mr.Jeremy Baugh(361)991-5600 Western Ocean, LTD Church Port Aransas(Completed 2015) $15,000.00 Mr. Alex Harris(361)533-7286 Continuation Recently Completed Projects Younger- Hoffman Construction Inc. Well Med Medical(Completed 2015) $25,000.00 Mr. Dan Hoffman (361)654-1520 i -anchise Search Results abouLblank r � - Franchise Tax Account Status As of : 01/03/2017 15:59:39 This Page is Not Sufficient for Filings with the Secretary of State COASTAL BEND DEMOLITION INC. Texas Taxpayer Number 32053281872 Mailing Address 606 TULIP ST CORPUS CHRISTI, TX 78408-3226 Right to Transact Business in Texas ACTIVE State of Formation TX Effective SOS Registration Date 12/10/2013 Texas SOS File Number 0801896484 Registered Agent Name VERNON CARR Registered Office Street Address 606 TULIP STREET CORPUS CHRISTI, TX 78408 �I 1/3/2017 4:00 PM CharterBank February 7, 2017 To Whom It May Concern: This letter is to introduce Coastal Bend Demolition, Inc. This customer has had two commercial checking accounts along with a personal checking account since 2013. These accounts have always been maintained in a satisfactory manner with no NSF checks. The customer also has two term notes, one secured by real estate and one secured by equipment. Both loans have always been handled in a satisfactory manner and they have also paid off several other smaller notes during their time as a Charter Bank customer. We would appreciate any favors or courtesies extended to our valued customer, Coastal Bend Demolition, Inc. Feel free to contact me at 361-884-7681 if you have any questions. Sincere Aaron A. A on Vice President, Commercial Banking Charter Bank 801 Navigation, Ste. 100 Corpus Christi, TX 78408 361-884-7681 aanderson@charterbankcc.com (381)884-7681 • Fax(361)884-2401 801 Navigation Blvd,Ste 100 Corpus Christi,Texas 78408 i IN SUTCIIS �R INDtMN17Y CON,rANtES P&C 877 2821625 225 South fifth Street Bonds Boo 933 7444 P4 Box 2683 Waco,Texas 76702-2683 March 04,2017 To whom it may concern: We are pleased to have the opportunity to recommend Coastal Bend Demolition,Inc. to you.We have handled Coastal Bend Demolition,Inc.bonding needs in the past and have always found the principals to be of the highest integrity. We have approved single bonds in the$250,000 range and an aggregate of$500,000. All normal underwriting checks have confirmed Coastal Bend Demolition,Inc.to be a contractor of the highest quality.All work references have indicated that Coastal Bend Demolition,Inc.has performed as agreed and within the specified time. We should be able to handle any reasonable bond request by Coastal Bend Demolition,Inc.. subject to our underwriting guidelines and the execution of a contract mutually agreeable to all parties. We ask that you give Coastal Bend Demolition,Inc. every consideration,and if you need additional information, please do not hesitate to call me at 254-759-3821 Sincerely, Dee illis Contract Bond Underwriter insurorsindemnity.com i TEXAS DEPARTMENT OF STATE HEALTH SERVICES COASTAL BEND DEMOLITION INC is certfiCed to perform as a Asbestos Abatement Contractor in the State of Texas within the purview of Texas Occupations Code, chapter 1954,so long as this license is not suspended or revoked and is renewed according to the rules adopted by the Texas Board of Health. V L§-- JOHN HELLERSTEDT,M.D. COMMISSIONER OF HEALTH License Number: 801061 Expiration Date: 6/16/2018 Control Number: 96330 (Void After Expiration Date) VOID IF ALTERED NON-TRANSFERABLE WORKERS COMPENSATION EXPERIENCE RATING 0AYjM'( Risk Name:COASTAL BEND DEMOLITION INC Risk ID: 421394849 Rating Effective Date:01/24/2017 Production Date: 08/26/2016 State: TEXAS State Wt Exp Excess Expected Exp Prim Act Exe Losses Ballast Act Inc Losses Act Prim Losses Losses Losses Losses t .06 5,72 9,5331 3,8111 0 23,750 0) (B (C)Exp Excess (D)Expected (E)Exp Prim (F)Act Exc (G)Ballast (H)Act Inc (l)Act Prim Losses(D-E) Losses Losses Losses(H-I) Losses Losses 1.061 5,7221 9,533 3,811 0 23,750 0 0 Primary Losses Stabilizing Value Ratable Excess Totals (Il C'(1 -A)+G (A) (F) (J) Actual 0 29,129 p 29,129 (E) C'(1 -A)+G (A) (C) (K) Expected 3,811 29,129 343 33.283 ARAP FLARAP SARAP MAARAP Exp Mod (J)1(K) Factors 88 0 Copyright 1993-2013,All rights reserved. This product Is cam".ed of compllatlons and information which are the proprietary and exclusive property of the Natonal Cou-,cil on Compensation Insurance,Inc.(NCC 1). NO further use,dissemination,sale,mnsfer,assignment or disposition of this product,in whole or in part,may be made without the print-written consent of NCCI.TWs product Is fumished'As is"As available"N11h all defects'and induces Informetlon available at the time of publication only.NCCI makes no representations or _ - warranties of arty kind relating to the product and horeby expreas!y disclaims any and a9 express,statutnry,or imps ea warranties.Irxyuding the Imptiad warraNy of merchantab,lity,fitness for a parbWar purpose,accuracy,completeness,currertnass,or correctness of any Information or product fumished hereunder.All responsibility for the use cf and for any and all results derived or obtained through the use of the product are the end users and NCCI saa:I not have any liability Iheralo Page 1 of 2 OSHA's Form 300A(Rev.0112004) Year sots le Summary of Work-Related Injuries and Illnesses U.S.Do arunentof Labor p� , oaalaaraaan4XmnaM,nitWrabem Alf esrew,mmeMs--rad aYPan 1909 intra!wrrplato Nis Summary PaQa, n if no inturzus pr --W8 m.121-17e Ipnesses occurred tlun)rg Ihp year.1ie.mamberf.ruviaw flo Lap fo YeNy Iher rhe amities are Con¢rlele Usfng(tae Lw•rournlhe NdiWarel enrrfes you made!.,oath category.1Yren wrn9 the fofffia below, Establishment Information maHrrp sura yours adtled rhe Bnllfa9 rmm awry page oYNe lap,tl you had rw cases wnte m.' Emfakyeasf renryaoyees,andrhe/rRpresenfabree hese ftdghf to mwma,the OSHA Form J00 tie Youreatabrahmenlneme COASTAL BEND DEMOLITION INC. d0"musty.TheY at hew p-IW acces-to rlo OSHA Foran 301.141.aui MM.Seo 29 CFR 1800.35,in 0.SHA's RemvdMeapnprwe,wrrunherdoraus arffre a«ess yroWa/ons rorNax loom, Street BOBTULIPSTREET Number of Cases Dy CORPUS CHRISn Slate TEXAS- zip 76108 Total number of Total number of Total number Indurryaescnption(ep„Mamrf.0 w of moloreuck Velars) cases Toter number DEMOLITION ASBESTOS&MOLD REMEDMTION CONTRACTOR deaths cases with days with job transfer er or other recordable - eway from work restlietlon cases Standard Ind,'UW Classifio9on(SIC),d u-m(sa.SIC 3715) 0 0 0 0 1 7 9 5 (G) (hl) (I) (J) OR Nedra Ame4ean lndustrid Classefiolon I"OS).hknoer(a.p,338212) 2 3 5 9 4 0 Number of trays _ Employment Information Total number of Total numberdf days of days away from job transfer or restnaon Annual aw.m oar or am f �K. Qe num p ayesa 13 O 0 Toul vor tours kw 5y a9 empoyoas laet (b ftl year 234MS Injury and Illness Types Sign here Total number of... (M) Hnowingly hlaifying arts do.ument may result In a one. (1)Injury 0 (4)Poisoning 0 (2)Skin Disorder 0 (5)Hearing Less 0 (3)Reaplmtory omy owl I nave examined Nis daamanl and That to ball of my knowledge the amides are Hue,accurate,and Condition 0 (B)All Other Illnesses 0 ;Z_crg�,_y euVva Caeobnaer tae -0464 Post this Summary page from february Ito April 30 of the year following the year covered by the form 3etPhena 1-5 Dale I'uNc iapalHg audat to YYewaedbndmta Mb,lee.Wmtlalbaverlpp SBrrixen per leganro,inCllanp lMrohramv 0.irgr b.wami su gads Na ridema4w,naramp!etemdmml urewbr9orld”emakv.Parmaea>mlral-Mwraapanerotfacokaa.9Hlarnalonunl—a dapiaycaaranllyvare ONBmsidnwba.ll Yau Aave aq mreaeb sboMdemeAlutnavy osp 4smtt+stlala CNkceat,tooted:Itsl)"hu ru d Labs.OSFV,03ceotSUkMca Roan r.3sae,209canifiA,l4n M1va NN,Waetatdm,DD 19279.Dona mMdaanrYrwJ roma Io Iwatlkg. Attention:IN.form.,let.Information relating OSHAas Form 300(Rev.01/2004) to ibyee health and must be uapd In a rnenner `* that pmtecLS lne confidentiality afemployoea to the Year 2016 student passible"I the InWn'd is being used Log of Work-Related Injuries and Illnesses for occupabenalsafetyandheaBhPwpoaes. U.S.Department of Labor Occupational Safety and Heaab Adminslrst YCUmust rabid txtl trvay rakre'aoM Injur forah,ess t,'mvey ynckss o'cm:::m;. rosdtlM wwk.Ainlya,ab trautr,days titer bun vvk,u maar.Y hoaln®tl Fonn approved OMB no.1218-0176 be"W hal aid.Ym tied dmrerad dQrFcaYxukrdffitl"r{uioa ad pine5srs Nal as diag„osed 6ya plryalda,u iraieak hm'N care(rofiina.You runs elm tome Mbk.,daleE mj:oee AdM-i the meet ac,d the ped is rmudi,ailed-listed b 29 CFP ION.8111864:17.Fed Yee to—Mo linesfor a Aro mm d You reed to.Ya mud nnpkra ai 1*0 ad il':e-:.id,4r 1(0SIM Fam Kpaeg2k"fruit IV*mhI1Ww inemmmdcd m his lam if yehenor atewlm�erauseic,amm-e,0your sod ow office 1.neo. Establishment name COASTAL BEND DEMOLITION.INC. City CORPUS CHRISTI State TEXAS Identify the person Describe the case Classify the case (A) M. Enter tt—rinberol (C) (D) (E) (F) CHECK ONLYONE box loroach—o based on days the Injured or lit Check Use"Injury,mtumn orcheosaone type case Employee')Nellte Job llbe(e.p.. Daleot Wham ttw evem occunea lo.g. Desoribe injury or6lnasa,parts of body effaced. the most serious outcome for that case: worker was: of ill— Ns. Walder) In)uryor Lcadlrgdocknonhend) endobjecVauhstancamatdimcfly[N—dor ental of mson ade perB(e g.Second degree bums on (M) Ulness right lGmam4 from acetylene torch) D on lob (moldey) Ooam ays away Hamairied at wetk Away aansler a koro work. From reCdaya n Jab lrartsler CO.,retort (days Work ) it, restriction able-- (days) N — ¢V a Z (G) H I (JII K L 411 2 17. m 15 6 WA Page totals 0 a o 1 o 1 d 1 do o p o 0 0 Be sure to transfer these totals to the Summary page(Form 300A)before you post it, o_ ,� 8 2 PUNk iaputiM hrdm tr We mllecOun d'mrvmeam is edimdtl w avapo Is„veras Pa remmw,indudun9 ortre m a a °� to re the in"-mish ad dalM the dda nce]etl,and arnots,sof ramal No cdlmtian of inlama6m. P.—ars aelr enwrtd lorespad b 8e cdleiimd inYmaEm Wi it diepoysn nrrcrdly ra(d OMBwdrd DMArr Il k,&on0 mnmml--amllMsamtimalesa ary mpx9nduYs dda mlbclacn,mYr.0 US N = Dmatrrnaq d tabs,OSHA OMm d Slttldkt,Rmn ta�'o/a,216 Cactif WmAp IoW,Wash�nptm,DC 20216.Dorid tad fire m,pdrd firms[o tNt afke. Pepe loll (1) (2) (3) (4) (5) (6) OSHA's Form 300A (Rev. 01/2004) Summary of Work -Related Injuries and Illnesses AN establishments covered by Part 1904 must complete this Srtmmary page, even N no injuries or lemmas oecunod during the year, Remember to revgw the Log to coy that the entries are comptelo Using the Loy, count the lndlv*/ua) entries you made for each category. Then write the totals below, making sura you?e added the entries from ovary page oldie log. It you hod no cases write'0.' Employees formeremployoes, and their representatives have the right to mvlow the OSHA Form 300 in Its enlioty. They also have limited access to the OSHA Form 301 grits equivalent, See 29 CFR 1904.33, In OSHA's Recordkoeping rub, for further details on rho access provisions tor these forms. Number of Cases Total number of Total number of Total number of cases Total number of deaths cases with days with Job transfer or other recordable away from work restriction cases 0 0 0 0 (G) (H) (I) (.1) Number of Days Total number of days away from .uncle Total number of days of job transfer or restriction 0 0 IK) IL) Injury and Illness Types Total number of... (M) (1) Injury o (4) Poisoning 0 (2) Skin Disorder 0 (5) Hearing Loss o {3) Respiratory Conditlon 0 (6) All Other Illnesses 0 Post this Summary page from February 1 to AprIi 30 of the year following the year covered by the form Pubic reporting burden for IN$ co0eetker of btvmetan le actinated to average 60 newton par expound. 4xiudng Csos to review the Instruction, scorch and paw he data rewind. and complo/a and review he wledian of Inkurnalixt. Poisons aro not requ/rod to respond Is to selection of bformatiwl unless it displays a eunenlyvaid OMB control number. If you hone eery common's abated -rasa estnutanar any aspects of this data adenine, contact LSDeportmonl of Leber. OSHA Office of Stabiles. Roam N.30044. 200 Cnnsetutbn Are. NW, Washleatwr. OC 20210. Do nal sold do con bled forms to this olive. Year 2015 1 U.S. Department of Labor nsauperfonat $SAtyood }teeth Admhdstat m raft arpowd OJan no 01x.170 Establishment information Your estabrishment name COASTAL BEND OEMOLSTION, INC. Street 606 TULIP STREET City CORPUS CHRISTI Slats TEXAS pip 78409 Mdushy description (e.g., Manufacture of motor lrudr Iraiiers) DEMOLrTION, ASBESTOS 8 MOLD REMEDIATION CONTRACTOR Standard Industrial Classification (SIC), if known (e.g., SIC 3715) 1 7 5 5 OR Noah American Industrial Classification (NAILS), if known (e.g., 336212) 2 3 5 e 4 0 Employment information Annual ave raga number ofemployaes 10 Total hours worked by all ompfoyees last year Sign here 19280.75 Knowingly falsifying this document may resell In a fine. ve examined this document and that to the iy knowledge the entries are true. accurate, and Company e7<.= 106 30 -x81.0404 Phone Comptroller 1(000 to Dole OSHA's Form 300 (Rev. 0112004) Log of Work -Related Injuries and Illnesses Attention: This form contains information relating to employee health end must be used in a manner that protects the confidentiality of employees In the extent possible while the infomiaton le being used for occupational safety and health purposes. You must record Information about every work-related injury a teens that involves las of consciousness, led r'rded wok activity or job Ir wake. days away hen wad, a medical halOren! beyond first dd. You must duo record sign font wok+dated Injuries and illnesses that are diagnosed 6y a ph}stdan or licensed heath can professional. You must deo record wok.rdeled herbs and illnesses That meet cry d the medic recording aileda tided h 29 CFR 1904.8 through 1904.12. Foci free to use two fines for a edge case if you need to- Yw must complete an Iryyry and ulnas rodent report (OSTIA Form 301) Cr equivalent lure tor eech injury or illness recorded on bus tom. II ye/nand sore whew erase is recordable, call yam lord OSHA efficia for halo. Identify the person Describe the case Ctassify the case Establishment name Year 2015 U.S. Department of Labor Occupational Safety and Health Administration Form approved OMB no. 1218-0176 COASTAL BEND DEMOLITION, INC. City CORPUS CHRISTI State TEXAS Pthlih reportig burden fa this cogedtlai of information is estimated to average 14 nirn.tne pa moons*, inducing time to redew the indention. coater sad ggher the data nailed, and omelets and renew the odedice of hlematirn. Poison are not required locoweed tote coillocikn of information unless 4 displays a oaremty vdd DMB oohed reonber, If you haw any omrents abort lessees i males or any aspects of this data reflection, contact LiS Depat:rrenl of labor, OSHA Office of Stakes , Roan 14.3641, 200 Constilabon Ave. NW, Washington, DC 20110. Oa cot awed the completed Imes to INa odea. Be sure to transfer these totals to the Summary page (Form 300A) before you post it. Page 1ofl m E a � � o p g J .Le ro re (A 1 at (1) (2) (3) (4) (5) (6) CHECK ONLY ONE box for each case based on the most sanoua outcome for that case' the number of days the Injured or Ill worker was: Check (M) _ (1) the injury' w (2) column of iAness: ` qi co U (3) or C o 2 choose ono o c m x type i5 c t (6) (A) Case No (B) Employee's Name (C) Job Tide (e.g., %Voider) {DIEnter Dale of infury or onset of runless (mo.fday) (E) Where the event Occurred (e.g Loading dock north end) (F) Describe Injury or Illness, parts of batty affected., and objacbsubstance that directly Injured or made person ill (e.g. Second degree bums on right forearm from acetylene torch) Death. (0) Days away from work (H) Rained Remained Job transfer or restriction (I) at k wor Other record- ...able cases (J) Away From Work (days) (K) On job transferor restriction (days) (L) N/A (4) (5) Page totals o 0 0 0 0 0 0 0 0 0 0 0 Pthlih reportig burden fa this cogedtlai of information is estimated to average 14 nirn.tne pa moons*, inducing time to redew the indention. coater sad ggher the data nailed, and omelets and renew the odedice of hlematirn. Poison are not required locoweed tote coillocikn of information unless 4 displays a oaremty vdd DMB oohed reonber, If you haw any omrents abort lessees i males or any aspects of this data reflection, contact LiS Depat:rrenl of labor, OSHA Office of Stakes , Roan 14.3641, 200 Constilabon Ave. NW, Washington, DC 20110. Oa cot awed the completed Imes to INa odea. Be sure to transfer these totals to the Summary page (Form 300A) before you post it. Page 1ofl m E a � � o p g J .Le ro re (A 1 at (1) (2) (3) (4) (5) (6) OSHA's Form 300A(Rev.01/2004) Year 2014 Summary of Work-Related Injuries and Illnesses U.S.Department of Labor oacupalbnal9aiotymd Ilvaah AmminnaNbn All ovabh'shmenls cosared byparr 1904 mus(ooroplara(Ills Summary pope,evert Nno 1 Wdos or epppma 0M8 m 121oatni IUnesNs mdavmad during the year.nemmmbarlo mwe,v fffa Lap fa rvrrrythat 1,enlnes mnv mmplere cv uvrrpfhebap.coumrnarrrmPmumanrnesymumea�rwemcnurapmry.TnonwdrBmerwahbmlow, Establishment Information mBkirq sure youlH edied rho mnlnes taro eYBrypapB arthrolop.Myou had nm cases write b.' EmPlay,resromer empbyeas,end OwtrraprBsanrarham haw ft riphr lm review thm OSHA Fo/m300(n Y9urasi8hiistlmmll roma COASTAL BEND OEfat(SLfT10N INC. d—Nosly.rheyetsmhare Urdleelaccesm M rhe OSHA Foal 30f arlis-tt-Ham.S-29CFR 1904,35,to OSHA"Rocordkmr(drg oris,lorrunberdmrells an the aecasspm lstons foritess tome. Saael 609 TULIP STREET Number Of Cases " CORPUS CHRISTI Stele TEXAS Zip 76408 Tolalnumber of Total number Total numberof cases Total number of Industry desedpean(e.g.,Manufacture at molar wok vakn) deaths Cases Win days with job transfer Or other recordable DEMOLITION A56ESTOSs MDL[y RFJAEDIATIDN CONTRACTOR C away from work resWcfta cases Slanderd lndunaal Clneafriceaan(SrC),if it—(a 9,SIC 3T15) 0 D (G) (H) 1 7 9 5 (I) (J) OR Npnh Amedman Induahiel Ciesancagon(NNCS),II known(e.g..3382 12) 2 3 5 9 4 0 Number of Days - Employment Information Total number of Total number of days of days away from job transfer or restriction Annual averepe number ormmpbymas 11 L 0 0 Told hours worked by all employees last (K) (L) par 22576.5 Injury and Hlness Types Sign here Total number Df... (M) Knowingly Im,trying this domumont may result In a @,o. (1)Injury 0 (4)Poisoning g 12)Skin Disorder 0 (5)Hearing loss 0 (3)RBoplratOry Ic plot.. Ihav o>famined 7h lsdomu,nenlandlheltelhebeato mntrios arm lNaBKu2tmeod Condition 0 (6)All Other Illnesses 0 mPlom. Company...wlve cam holler �Ge Post this Summary page from February Ito April 30 of Ute year following the year covered by the form �1p one lm— oaee Fuck repa'W1p kerdmbr afemaedion al Inlerns5n h es;4nabd b rwarogn 93 mTulas mr mrpcn5o,IrxkaGrO ltna Im redew Ob nskucfi,couch wd peas.�haManeadad,.aompweorirw!mvhead�umanrnrmawn aw>xE ararrocurea:amrpandms,PWaockmdmwm.,mnvasaa dbpleyva Mmenly vaHOMB rmtldnumhcr.Ny9ulWsery w.mmnnis alvu;Vreso o�-rai bsm arty asooelsol Nl:aalao,a.lm,pnLtL U30tTaIrmN dLobar.CBIrA(NaxdSISLSYks%wall.]S:.,rprAnsllmrianhro.Nw.Wzfinalm.OC10219.DomI4vAhPC�Jrbla'ealNmiblFiscY OSHA's Form 300 (Rev. 01/2004) Log of Work -Related Injuries and Illnesses You rust record bdamdiondculway waktdatedkdoya@eta that hvohasloudaomelase esAresbidedworkmOvityalobNerdy,derstraybanwortamake!trodmad beyond a rel dd. You crud dwmood dgdl l mod -related Narks adOmuta lhdere devoted byedrtddmaucasrdMath cam prdodard. You mut deemeadea1 Mated basks and Enemas that moat alt d the ascitic remdba attain Med in 29 CFR tat&a though 1034.12. Fed tree to use Nobel la a drgb ease If you need to. You mal aarpldo an iniry dice End Illnembided copal (OSHA Fam701)amuhdadlam foreadrI(uyorelms recorded on1Netorn IIymlrendsaeehoturacseIsrxudrbb,cog yam local OSHA for Attonuon: Thea tam contains brformalbn relating to employee health and must be used In a rammer that prefabs the confdonilaiity of employees to the extent possible wide the Information Is being used for occupational safety and health purposes. denfify the person Describ's the ase Classify the terse Establishment name City CORPUS CHRISTI Year 2014 ``# U.S. Department of Labor Occupatimed Safety end Health Mmtrystmtion Fenn approved OMB no, 1218.0176 COASTAL BEND DEMOLITION, INC. State TEXAS (A) Case No. (B) Employee's Name (C) Job 7We (e.g., Walder) (D) Date of *ay or onset of Mese (moldey) Whore the oven( catered (e.g. Loafing dock north and) Describer injury a IWreaI parts o! body erected, and ob)ec!lsubemnce that directly Injured or made person S (e.g. Second degree burns on right forearm from acetylene torch) CHECK the most ONLY ONE box for each case bated on embus outcome for that case: Enter the number of days the br♦ured or AI worker man: Check CM) the 1n)ury" 1 whom of Bruno: i ¢¢ al je diose ] are type J 1 DaBN (0) iwayAway hon (H) Remahpd Jab transfer or restriction (f) at wont Other record. able cases (J) From 1No711 (days) (K) Iraneym a restriction (days) (L) # N/A (1) (2) (3) (4) (3) (6) Page totals 0 0 0 0 0 0 0 0 0 0 0 0 Pied math; beam tot Ihk edheaan d kdamrIDm h odlmafad to avenge 14 nirshs per rerixece, Indudnp rime to redoes the hnWan. search aid gager Mo dila needed, and carode ad review bre edlalien d kdamdbn. Paan mend rogdrod to rspad to thecokcem d Mon:team udeu II dsdays a currently veld OMB contrd number. II you hove tow oaamadsaxulMare odesdmaanyaeped:dededata &Wean,cadaob HS Department of tabor, OSHA CBm of Sloeakcs, Real N.36t4, 200 Coloradan Am, NW, Waddr tan, DC 20210. Oe not sad the axnddad keno to On otos er mesa totals to the Summary page (Form 300A) before you post It. Page 1 of 1 (1) (2) (3) (4) X ,JkV2 10.:r_? Zffi IETblla*T4e.1 "Es ta#htYL':;Altri'r6Y:MtliaW,Ma3##t r-41 io71,7, Car--'' !3::LG�iCi +po5!,2,70451MCCTIATIii teilIVAW,i?'Jr,I :''rri iriiAt3>v'S.adi5<'°4 ir?nagn?aMiZal•c'lagtara!?!; A4C R COAS-19 OP ID:BGM �..-- CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDA-M) 17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 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 PRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. 1PORTANT: if the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate. does not confer rights to the certificate holder in lieu of such endorsements PRODUCER C,ONTACT Brand Maox,ACSR CISR tt Carlisle Insurance Agency, Inc PHONE 1810E Main 361-664-4348 a No:361-664-1822 P 0 Drawer 3030 E-MaL Alice,TX 78333-3030 brand m carlisleins.com Daniel C Carlisle,CIC INSURERS AFFORDING COVERAGE NAIC# INSURED Coastal Bend Demolition Inc. INSURER A:Nautilus Insurance Company 606 Tulip St INSURER B:Hallmark CountyMutual Ins Co 29408 Corpus Christi,TX 78408 INSURERC:Texas Mutual Insurance Co 22945 INSURER D:Commerce&Indust 19410 INSURER E:Travelers Llo ds Insurance Co INSURER F:AIIstateCounty Mutual 29335 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. INSR 'A150—L SUB L TYPEOFINSURANCE WMVn POLICYNUMBER POUCYEFF POLICYEXP WDDAnnM LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAM -M SADE XI OCCUR ECP2017033-11 01/24/2017 0112412018 PREMISES(Ea occurrence) $ 100,00 MED EXP Any one person) S 5,00 PERSONAL 8 ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY AI OTHER: PEC 0LOC PRODUCTS-COMP/OP AGG $ 2,000,00 is AUTOMOBILE LIABILITY COMBINED SINGLE LMR Ea accident $ 1,000,00 ANY AUTO KPP1042559 02/06/2017 02106/2018 BODILY INJURY(Per person) $ ALLOWNED XSCHEDULED AUTOS I AUTOSWNE BODILY INJURY(Par oxidant) $ HIRED AUTOS NON-0D AUTOS (PaOP�ER�nDAMAGE $ $ X UMBRELLA UAB X OCCUR D EXCESS UAB CLAMS MADE BE021416224 EACH OCCURRENCE $ _1,000,00 01/24/2017 01124/2018 AGGREGATE $ 1,000,00 DEO RETENTION$ Prod s OP WORKERS COMPENSATION $ 1,000,00 AND EMPLOYERS'LUIBIUTY IN X sT4TUTE R- C OFF ICERIMANY MEEM R EXCLUDED? CtJTIVE Y® N 1 A 0001282112 01/24/2017 01/2412018 E.L.EACH ACCIDENT $ 1,000,00 (Mandatory In NH) tf yyees, ascribe under E.L.DISEASE-EA EMPLOYE $ 1,000,00 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1,000,00 A Pollution ECP2017033-11 01/24/2017 01/24/2018 Each Occ 1,000,00 E Equipment Floater 6605F533811 01124/2017 01/24/2018 LIR Equip 200,00 DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Demolition and Asbestos/Lead/Mold Abatement-State Of Texas THIS CERTIFICATE REPLACES CERTIFICATE ISSUED ON 01/25/2017 WHICH IS NULL& VOID. CERTIFICATE HOLDER CANCELLATION CITYCC2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Corpus Christi ACCORDANCE WITH THE POLICY PROVISIONS. Risk Management Dept PO Box 9277 AUTHORIZED REPRESENTATIVE Corpus Christi,TX 78469 0 11''9JJ88-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD COAs-19 PAGE 2 NOTEPAD INSURED-SNAME Coastal Bend Demolition Inc. OP ID:BGM Date 02/08/2017 Hired & Non Owned Auto Only Company Name - Allstate Policy#648263228 Effective Dates - 01/24/2017 - 01/24/2018 Liability Limit $1,000,000 Form#ECP10040410 The General Liability & Pollution policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Form#ENV20040906 The General Liability & Pollution policy includes a lanket automatic waiver of subrogation endorsement that provides waiver of subrogation status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Form#ECP10040410 The General Liability and Pollution policy contains a special endorsement with "Primary Non Contributory Wording" r Form#ENV22170707 The General Liability and Pollution policy includes an endorsement providing that 30 days notice of cancellation will be furnished to the certificate holder other than for nonpayment of premium, or 10 days notice after the policy is cancelled for nonpayment of premium Form #CA9901830513 The Commercial Auto policy includes a blanket additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status Form #CA29901830513The Commercial Auto policy includes a blanket waiver of subrogation endorsement that provides waiver of subrogation status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Form #WC4203048 The Workers Comp policy includes a blanket automatic waiver of subrogation endorsement that provides waiver of subrogation status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Form #WC420301G The Workers Comp policy includes an endorsement providing that 30 days notice of cancellation will be furnished to the certificate holder other than for nonpayment of premium, or 10 days notice after the policy is cancelled for nonpayment of premium. The Excess Liability/Umbrella Policy is Follow Form SMALL CONSTRUCTION CONTRACT AGREEMENT THE STATE OF TEXAS KNOW ALL MEN BY THESE PRESENTS: COUNTY OF NUECES This CONSTRUCTION AGREEMENT is between the City of Corpus Christi, a Texas home-rule municipal corporation ('CITY"), acting through its duly authorized City Manager or designee, the Director of Engineering Services or City Engineer, and Coastal Bend Demolition, Inc. ('CONTRACTOR"), acting by and through its duly authorized representative, Vernon Carr (Name), President (Title). The parties agree as follows: WITNESSETH: 1. CONTRACTOR shall construct and complete certain improvements in accordance with the plans and specifications described in Exhibit"A" (attached and incorporated herein), perform all work as provided in said plans and specifications, and do such additional work as may be considered necessary to complete the work in a satisfactory and acceptable manner (the "Work"). The CITY reserves the right to make such changes in the plans and specifications and in the character of the work as may be necessary or desirable. Authorization for all changes must be made in writing. The CONTRACTOR shall furnish all labor, tools, material, machinery, equipment and incidentals necessary to the prosecution of the Work unless otherwise provided by the written terms of the plans and specifications. 2. The work described in Exhibit "A" shall be completed within 30 Calendar Days of Notice To Proceed. 3. In consideration of the completion of the above-described Work, the CITY agrees to pay to CONTRACTOR the lump sum amount of SEVENTEEN THOUSAND, FIVE HUNDRED AND NO/100 ($17,500.00) for City Proiect SCC #E17012 Nueces County Emeraencv Services District #2 Office Buildina Demolition. Said payment shall be conditioned upon the acceptance of the work by the "CITY" as certified by its final inspection following the receipt of notice from the 'CONTRACTOR" that the work is completed and ready for acceptance. Upon completion of work and before acceptance and final payment is made, the 'CONTRACTOR" shall clean and remove from the work site all surplus and discarded materials, temporary structures, and debris of every kind in order to leave the work site in a neat, orderly condition, equal to that which originally existed. The"CONTRACTOR"shall submit a notarized affidavit that bills for all labor, equipment, materials and supplies associated with the project have been paid before final payment is released. Small Construction Agreement Page 1 of 3 Proi. No. E17012 Nueces County Emergency Services Dist#2 Bldg Demo Rev. 09/2017 4. All work shall be performed in a workmanlike manner and to the satisfaction of the CITY. The CITY shall determine the quality and acceptability of materials furnished, work performed, manner of performance, rate of progress of the Work, sequence of construction, and interpretation of the plans and specifications. 5. The CONTRACTOR agrees to comply with all insurance requirements as contained in Exhibit "B" (Insurance Requirements) and Notice To Contractors B (Worker's Compensation Coverage for Building or Construction Projects for Government Entities). 6. The CONTRACTOR will be required to provide a good and sufficient Payment Bond from a surety company authorized to do business in the State of Texas, if the award is over $25,000. 7. The CONTRACTOR shall, at all times, observe and comply with City, federal, state and county laws, ordinances or regulations which in any manner affect the conduct of the Work. The CONTRACTOR shall be responsible for procuring all legally required building, plumbing, electrical and other permits and licenses, pay all charges and fees, and give all notices necessary and incidental to the due and lawful prosecution of the Work, unless otherwise provided by the written terms of the plans and specifications. S. This Agreement or the Work provided may not be assigned or subcontracted by CONTRACTOR without the written permission of the CITY. Small Construction Agreement Page 2 of 3 Proj. No. E17012 Nueces County Emergency Services Dist#2 Bldg Demo Rev. 09/2017 IN WITNESS WHEREOF this Agreement is executed. CITY OF CORPUS HRISTI CONTRACTOR: I� w Coastal Bend Demolition, Inc. V I ie Gray, .E., E ec. Dir. ublic Works Company Date oN C , Hmd �m .7LM=—@-11wb-00-040p=us Date:20x7.09.1313:47:11-OW, Original Authorized Signature {"`��K _,/� /, 0.614aliy s'@ned by Jatt Eemands j_'J�J/y///JgI/(1//i/ DN.cn=JaH EdmoMs,o.au=E^4+nearing. am:1il 2017 yog180e,as 9.0'0' Dale:24 n.09.1$OB�a5.59 05`04' Jeff Edmonds, P.E., Dir. Engineering Serv. 606 Tulip St. Address APPROVED AS TO LEGAL FORM: Corpus Christi, TX 78408 City, State, Zip Aimee Alcorn-Reed 2017.09.1812:54:39.05'00` 361/851-0464 866/579-6144 Asst. City Attorney Phone Fax Vernon0coastalbenddemolition.com Email 4252042-E10054-01-4252-EXP 550910 Funding Source Small Construction Agreement Page 3 of 3 Proj. No. E17012 Nueces County Emergency Services Dist#2 Bldg Demo Rev. 09/2017 DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACTPRODUCERNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : INSURED INSURER B : INSURER C : INSURER D : 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. ADDL SUBRINSR POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITSPOLICY NUMBERLTR (MM/DD/YYYY) (MM/DD/YYYY)INSD WVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT $OTHER: COMBINED SINGLE LIMITAUTOMOBILE LIABILITY $(Ea accident) BODILY INJURY (Per person)$ANY AUTO ALL OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $HIRED AUTOS (Per accident)AUTOS $ UMBRELLA LIAB EACH OCCURRENCE $OCCUR EXCESS LIAB CLAIMS-MADE AGGREGATE $ $DED RETENTION $ PER OTH-WORKERS COMPENSATION STATUTE ERAND EMPLOYERS' LIABILITY Y / NANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $N / AOFFICER/MEMBER EXCLUDED? (Mandatory in NH)E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2014/01) COAS-19 OP ID: BGM 09/14/2017 Brandy Mattox, ACSR, CISRCarlisle Insurance Agency, Inc 1810 E Main P O Drawer 3030 Alice, TX 78333-3030 Daniel C Carlisle, CIC 361-664-4348 361-664-1822 brandym@carlisleins.com Nautilus Insurance Company AmGUARD Insruance CompanyCoastal Bend Demolition Inc. Coastal Bend Cutting And Coring 606 Tulip St Corpus Christi, TX 78408 Texas Mutual Insurance Co 22945 Commerce & Industry 19410 Travelers Lloyds Insurance Co A X 1,000,000 X ECP2017033-11 01/24/2017 01/24/2018 100,000 5,000 1,000,000 2,000,000 X 2,000,000 1,000,000 B COAU858654 06/05/2017 06/05/2018 X X X XX 1,000,000 D BE021416224 01/24/2017 01/24/2018 1,000,000 Prod Ops 1,000,000 X C 0001282112 01/24/2017 01/24/2018 1,000,000N1,000,000 1,000,000 A Pollution ECP2017033-11 01/24/2017 01/24/2018 Each Occ 1,000,000 E Equipment Floater 6605F533811 01/24/2017 01/24/2018 L/R Equip 200,000 Demolition and Asbestos/Lead/Mold Abatement - State Of Texas Project: E17012 Nueces County Emergency Services Dist#2 Bldg. Demo CITY003 City of Corpus Christi 1201 Leopard St. Corpus Christi, TX 78401 PAGENOTEPADINSURED'S NAME Date COAS-19 2 Coastal Bend Demolition Inc.OP ID: BGM 09/14/2017 Form#ECP10040816 The General Liability & Pollution policy includes a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Form#ENV20040906 The General Liability & Pollution policy includes a blanket automatic waiver of subrogation endorsement that provides waiver of subrogation status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Form#ECP10040816 The General Liability and Pollution policy contains a special endorsement with "Primary Non Contributory Wording" Form#ENV22170707 The General Liability and Pollution policy includes an endorsement providing that 30 days notice of cancellation will be furnished to the certificate holder other than for nonpayment of premium, or 10 days notice after the policy is cancelled for nonpayment of premium Form #BA99020908 The Commercial Auto policy includes a blanket additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status Form #BA99040416 The Commercial Auto policy includes a blanket waiver of subrogation endorsement that provides waiver of subrogation status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Form #WC420304B The Workers Comp policy includes a blanket automatic waiver of subrogation endorsement that provides waiver of subrogation status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Form #WC4201010194 The Workers Comp policy includes an endorsement providing that 30 days notice of cancellation will be furnished to the certificate holder other than for nonpayment of premium, or 10 days notice after the policy is cancelled for nonpayment of premium. Form #BA99040416 The Commercial Auto policy contains a special endorsement with “Primary and Noncontributory wording. The Excess Liability/Umbrella Policy is Follow Form