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NATURAL GAS DISTRIBUTION MAIN & SERVICED LINE LOCATINGCONTRACT This CONTRACT made and entered this f� day of February, 2013, by and between the CITY OF CLEARWATER, FL (d/b/a Clearwater Gas System), a municipal corporation of the State of Florida, 400 North Myrtle Avenue, Clearwater, FL, hereinafter called "CGS", and HEATH CONSULTANTS INCORPORATED a DELAWARE corporation, 9030 Monroe Road, Houston, TX, having hereinafter called the "CONTRACTOR". WITNESSETH: That the parties to this contract each in consideration of the undertakings, promises and agreement on the part of the other herein contained, do hereby undertake, promise and agree as follows: The Contractor, and his or its successor, assigns, executors or administrators, in consideration of the sums of money as herein after set forth to be paid by CGS and to the Contractor, shall and will at their own cost and expense perform all labor, furnish all materials, tools, electronics, devices and equipment for the following: "Natural Gas Distribution Main & Service Line Locating" As defined in RFP 04-13 in the amount of $300,000. In accordance with such proposal and such other special provisions and drawings, if any, which will be submitted by CGS, together with any advertisement, instructions to bidder, general conditions, proposal and bond, which may be hereto attached, and any drawings if any, which may be herein referred to, are hereby made a part of this contract, and all of said work to be performed and completed by the contractor and its successors and assigns shall be fully completed in a good and workmanlike manner to the satisfaction of CGS, the provision of the services including but not limited to those services as described in Exhibit "A" attached hereto and incorporated herein ("Scope of Services"). If the Contractor should fail to comply with any of the terms, conditions, provisions or stipulations as contained herein within the time specified for completion of the work to be performed by the Contractor, then CGS, may at its option, avail itself of any or all remedies provided on its behalf and shall have the right to proceed to complete such work as Contractor is obligated to perform in accordance with the provisions as contained herein. CGS shall recover all costs of such remedial action from the contractor for their failure to perform. THE CONTRACTOR AND HIS OR ITS SUCCESSORS AND ASSIGNS DOES HEREBY AGREE TO ASSUME THE DEFENSE OF ANY LEGAL ACTION WHICH MAY BE BROUGHT AGAINST CGS AS A RESULT OF THE CONTRACTOR'S ACTIVITIES OR RELATED DEFICIENCIES ARISING OUT OF THIS CONTRACT AND FURTHERMORE, IN CONSIDERATION OF THE TERMS, STIPULATIONS AND CONDITIONS AS CONTAINED HEREIN, AGREES TO HOLD CGS FREE AND HARMLESS FROM ANY AND ALL CLAIMS FOR DAMAGES, COSTS OF SUITS, JUDGMENTS OR DECREES RESULTING FROM ANY CLAIMS MADE UNDER THIS CONTRACT AGAINST CGS OR THE CONTRACTOR OR THE CONTRACTOR'S SUB-CONTRACTORS, AGENTS, SERVANTS OR EMPLOYEES RESULTING FROM ACTIVITIES BY THE AFOREMENTIONED CONTRACTOR, SUB-CONTRACTOR, AGENT SERVANTS OR EMPLOYEES. UNLESS SUCH CLAIMS ARE A RESULT OF THE CITY'S NEGLIGENCE. NOTHING HEREIN SHALL BE CONSTRUED TO WAIVE OR MODIFY THE PROVISIONS OF SECTION 768.28, FLORIDA STATUTES, OR THE DOCTRINE OF SOVEREIGN IMMUNITY. In addition to the foregoing provisions, the Contractor agrees to conform to the following requirements: The term of this agreement shall begin March 1, 2013 and terminate on February 28, 2014. Thereafter, this agreement may be renewed, up to three times, on a yearly basis, if Contractor agrees to hold their prices/rates the same for the entire renewal period. Any amendment must be made in writing and agreed to by both parties. 2. The Contractor agrees to receive the compensation/rates stated in the Proposal attached hereto as Exhibit "B", in full compensation for furnishing material, tools, equipment and labor necessary to perform Locate Services within CGS's Service Territory. CGS and Contractor agree that there are no minimum requirements for purchase in this Agreement; the Contractor, for such consideration, shall be responsible for all claims, causes of action, loss or damages arising out of the nature of the work aforesaid or from any action of the elements; or from any unforeseen obstruction or difficulties which may be encountered of every description connected with the work, and furnishing the materials, until their final completion and acceptance. UNLESS SUCH CLAIMS ARE A RESULT OF THE CITY'S NEGLIGENCE. NOTHING HEREIN SHALL BE CONSTRUED TO WAIVE OR MODIFY THE PROVISIONS OF SECTION 768.28, FLORIDA STATUTES, OR THE DOCTRINE OF SOVEREIGN IMMLJNITY. Any increase ar decrease in compensation shall be effective only when incorporated in a written amendment to this Contract, executed by the Parties hereto. 3. To prevent disputes, it is agreed by and between the parties to this Contract that CGS or its authorized representative shall in all cases determine the quality and quantity of the work to be paid for under this Contract, and CGS shall determine questions in relation to lines, levels and dimensions of work. 4. Payment shall be made in accordance with provisions as outlined. Contractor shall render invoices and statements to CGS on a monthly basis. Each statement shall be paid under the guidelines of FL State Statute 218 (Florida Prompt Payment Act). Mail Invoices To: Clearwater Gas System Attn: Accounts Payable 400 N. Myrtle Ave Clearwater, FL 33755 5. The Contract Documents shall consist of all sections contained in RFP 04-13 and Contractor's Proposal to support the requirements within the RFP, attached hereto as Exhibit C and B, respectively. All of which are familiar to the Contractor and which are hereby incorporated herein by reference. 6. This agreement, together with these documents, forms the contract, and they are as fully a part of the Contract as if hereto attached or herein repeated. 7. Contractor shall at all times furnish adequate tools, testing supplies, appliances, equipment, a sufficient number of properly OQ certified skilled workmen (as defined in the RFP), and a sufficient amount of materials and supplies of proper quality to efficiently and promptly prosecute the work provided for herein and shall promptly pay for all material purchased and shall pay all workmen each week, and if required by CGS, shall obtain and furnish CGS weekly with signed receipts from all workmen showing the date of payment, the amount paid, number of hours paid for, the days on which said work was performed, the classifcation of the labor so paid, and the rate of wage per hour paid and shall supply CGS weekly with two (2) copies of the payroll verified by an affidavit. Contractor shall, as often as requested by CGS, furnish a sworn statement showing all parties who furnished labor or materials to the Contractor, with their names and addresses and the amount due or to become due each. A like statement may be required from any subcontractor of the Contractor. 8. Contractor employees and their subcontractors must meet the requirements and intent of the Code of Federal Regulations (CFR) 49 Part 192.801, 192.803, 192.805, 192.807 and 192.809 relating to "Operator Qualification" with mandatory knowledge, skill and abilities, training to be completed by March 1, 2013. The contractor must state in writing that their Operator Qualification plan is in conformance with the intent of Federal Operator Qualifcation Regulations and is at least equal to and applicable to Clearwater Gas System's ASME B31Q Operator Qualification Plan. OQ and all Training Documentation shall be furnished upon request. The Contractor's Operator Qualification Plan must also explain how their employees have the ability to identify and react to natural gas related Abnormal Operating Conditions that may be encountered while working on the gas pipeline facility. Contractor Employee Operator Qualification, Knowledge, Skill and Ability records will be kept for a 5 year period. Failure to provide proof of Operator Qualification compliance, and successful maintenance will disqualify the bidder from performance of the awarded bid. Training records shall be made available to CGS for auditing. 9. The Contractor agrees that it has in place, or will implement a Drug and Alcohol Training and Testing Program for their employees that comply with the requirements of the United States Department of Transportation, Title 49, Pipeline Safety Regulations, Part 199. A copy of the Alcohol and Drug Testing Program has been included in the response to the Request for Proposal. The contractor will also furnish quarterly statistical reports to CGS to show active compliance. 10. Should the Contractor default in any of the provisions of this contract and CGS employs an attorney to enforce or construe any provision hereof or to collect damages for breach of the agreement or to recover on any bonds provided for herein, the Contractor and/or his surety agree to pay CGS such reasonable attorney's fees as CGS may expend therein. As against the obligations contained herein, the Contractor and his surety waive all rights of exemption. 11. The undersigned Contractor has carefully reviewed and familiar all contract documents, and is responsible for having heretofore, or shall be responsible at such time as it becomes necessary, examined the location and route of all proposed work, and is satisfied as to the character of said route, the location of surface and underground obstructions and nature thereof, the nature of the ground water table conditions and other physical characteristics of the work and the work site in order that he may include in the price which he has bid and the price of this contract all costs pertaining to the work. 12. This contract shall not be construed for or against any party because that party wrote it. 13. The Contractor and CGS for themselves, their heirs, executars, administrators, successors, and assigns, hereby agree to the full performance of the covenants herein contained. Assignment by the Contractor of any portion or all of this Contract or Contractor's obligations and rights under this Contract shall not be effective without the written consent of CGS, which, may be withheld at CGS's discretion. 14. In connection with the performance of work under this contract, the Contractor agrees not to discriminate against any employee or applicant for employment because of race, sex, religion, color, or national origin. The aforesaid provision shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; lay-off or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Contractor agrees to post hereafter in conspicuous places, available for employees or applicants for employment, notices to be provided by the contracting offcer setting forth the provisions of the non-discrimination clause. 15. The Contractor further agrees to insert the foregoing provisions in all contracts hereunder, including contracts or agreements with labor unions and/or worker's representatives, except sub-contractors for standard commercial supplies or raw materials. 16. It is mutually agreed between the parties hereto that time is of the essence of this contract, particularly in light of the mandatory timeframes as set forth in Florida Statute 556 (Underground Facility Damage Prevention and Safety), as may be amended from time to time, and in the event that the work to be performed by the Contractor is not completed within the time stipulated herein, it is then further agreed that CGS may deduct from such sums or compensation as may be due to the Contractor the sum of $1,000.00 per dav for each day that the work to be performed by the Contractor remains incomplete beyond the time limit speci�ed herein, which sum of $1,000.00 aer dav shall only and solely represent damages which CGS has sustained by reason of the failure of the Contractor to complete the work within the time stipulated, it being further agreed that this sum is not to be construed as a penalty but is only to be construed as liquidated damages for failure of the Contractor to complete and perform all work within the time period as specified in this contract or CGS may terminate this Contract immediately, being obligated to Contractor only for compensation duly earned for work completed, minus any amounts provided for in this paragraph. 17. It is further mutually agreed between CGS and the Contractor that if, any time after the execution of this contract and the surety bond which is attached hereto for the faithful performance of the terms and conditions as contained herein by the Contractor, that CGS shall at any time deem the surety or sureties upon such performance bond to be unsatisfactory or if, for any reason, the said bond ceases to be adequate in amount to cover the performance of the work the Contractor shall, at his Of its own expense, within ten (10) days after receipt of written notice from CGS to do so, furnish an additional bond or bonds in such term and amounts and with such surety or sureties as shall be satisfactory to CGS. If such an event occurs, no further payment shall be made to the Contractor under the terms and provisions of this contract until such new or additional security bond guaranteeing the faithful performance of the work under the terms hereof shall be completed and furnished to the City in a form satisfactory to it. 18. NOTICES AND CHANGES OF ADDRESS Any notice requires or permitted to be given by the provisions of this Contract shall be conclusively deemed to have been received by a party hereto on the date it is hand delivered to such party at the address indicated below (or at such other address as such party shall specify to the other party in writing), or on the fifth (St") business day after the day on which such notice is mailed and properly addressed. Heath Consultants Incorporated Ga La e Name VicePresident, Operations Title 9030 Monroe Road, Houston, TX. 77061 713-844-1303 Telephone # 713-844-1309 Facsimile # Email: .�lape(a�heathus.com 19. TERMINATION OF CONTRACT Clearwater Gas System (CGS) Brian Lan ille Name Operations Mana eg r Title 400 N Myrtle Ave Clearwater, Florida 33755 727-562-4900 Telephone # 727-562-4902 Facsimile # If Contractor shall fail to fulfill any of its obligations hereunder, this Contract shall be in default, the City may terminate the Contract, and Contractor shall be paid only for work completed. 20. CONFORMANCE WITH LAWS Contractor agrees to comply with all applicable federal, state and local laws during the life of this Contract, including but not limited to Florida Statute 556 under which a material portion of this Contract will be fulfilled. 21. GOVERNING LAW AND VENUE The laws of the State of Florida shall govern this Contract, and any action brought by either party shall lie in Pinellas County, Florida. IN WITNESS WHEREOF, the parties to the agreement have hereunto set their hands and seals and have executed this Contract, in duplicate, the day and year first above written. (CONTRACTOR SEAL) ."(} � • " �'; , � � �.� � ;r„ ��� `, F , ! ` "' n, o , N �' l-�-. r �, � . c;: ��; � .. .,. ;', � - % , � �c;- � o�� , . ;,c��� Countersigned: � G((�A��Q I� C� t�[�S George N. Cretekos Mayor APPROVED AS TO FORM: :_-- . � Laura Mahony Assistant City Attorney FOR THE CONTRACTOR By: Name: ry La e Title: Vice President, Operations rtness for t ra or CITY OF CLEARWATER, FLORIDA By: .t�'��v� � William B. Horne, II City Manager ATTEST: �tiLa,� � Rosemarie Call City Clerk a��p�,oF,y,��,/� , �► � ,�t � � � a..�C c ;_ � �-- .. �._ `-_ _ � Exhibit A Scope of Services Provide underground facility locating services as directed by CGS. Locating services will include emergency, short notice and regular locating request for CGS owned facilities and be performed during normal business hours from 7am - 4pm, Monday — Friday and during non- business hours, as approved by CGS. Contractor will charge CGS the following rates for services rendered hereunder: •$ 8.75 Per ticket received from Florida Sunshine (including all ticket revisions and updates) •$ 8.75 Per ticket for emergency locates services (business hours only) •$ 44.00 Per hour for After hours/emergency locates (only with CGS request or approval) •$11.00 Per quarter hour Projects (exceeding 60 minutes) •$ 44.00 Damage Investigation Fee (flat fee) Contractor acknowledges that all Locate Ticket records are the property of CGS. CGS will notify Florida Sunshine State One Call (FL Sunshine) of its engagement with Contractor. CGS shall pay ticket fees assessed by FL Sunshine directly. Receive and record Locate Requests from CGS during Business Days as a part of normal business and receive and record Locate Requests from FL Sunshine during normal business hours. Locate Requests may be issued to contractor during non-business hours on an emergency basis only and must be approved by CGS. Contractor to provide sufficient qualified staff, office and field locating equipment to adequately perform locating services for CGS. Also provide compatible two-way communication with existing or future communication systems between office, staff and FL Sunshine. For each Locate Request, review CGS facilities maps, determine where conflicts exist between proposed excavation and CGS facilities and locate those areas in the time frame specified by State Statute 556 (currently two business days). Respond to and site visit every Locate Request from FL Sunshine and locate any and all facilities belonging to CGS, included in the description on the Locate Request and in the time frame specified by FL State Statute 556 (currently two business days). Complete all Locate Requests in the time frame specified by FL State Statute 556 (currently two business days) and close out these Locate Requests with the proper response to FL Sunshine. When requested by CGS, Contractor shall provide one free site visit, at a previously located ticket, to verify locate with the excavator to ensure the safeTy and accuracy of the work performed. Use equipment capable of distinguishing CGS facilities from that of other underground utilities. Locate service lines and other facilities in Right of Ways and Easements to a reasonable distance onto private property. Shovel or vacuum excavate pipelines and segments that are difficult to locate, repair broken wire segments and install/maintain locate stations to complete locates Use a marking medium such as: paint andlor flags. Colors are to be in accordance with state law and industry standards. Designate a single point of contact between Contractor and CGS to serve as a liaison for receipt of CGS facility maps. Contractor shall be responsible for requesting revised copies of CGS facility maps. Contractor shall retain and safeguard CGS system maps and records. Maps and records shall not be disclosed to or made available to any entity without the expressed written consent of CGS. Contact CGS for assistance after having e�chausted reasonable efforts to locate any identifiable, but un-locatable facilities, notify the Excavator of the presence of CGS's facilities and inform Excavator to suspend any digging activities until CGS personnel are on site. Obtain name, phone number and other pertinent information of Excavator person or persons notified of locates not being completed for any reason, whether responded to with Positive Response Codes. Notify CGS of any discrepancies or omissions in the records or other information provided to Contractor by CGS to the extent such discrepancies and omissions can be determined by Contractar. Draw simple as-builts, when main is found in different location than CGS records depict Establish positive working relationships with contractors and maintain clear communication channels to ensure the safety of the system and the public. Gas locates shall include propane tanks and related underground piping systems. In addition, will include master meter underground infrastructure at Royal Stewart Arms, Mission Hills and Ridgecrest per local agreements. Allow CGS to back charge for locates passed-on that were accomplished with minimal effort. Contractor is responsible for any late ticket charges and may be charged for any missed locate damages, pending investigation. Exhibit B Contractor Proposal Heaih �onsuttants lncorparated N�vem�cr 19, 2U1� Mr. Michael Murray I'rirch��in� �anager Purehasing Divisian nf the Gity of (`learw�3ter l f?0 ���zth Myrtle Avenue Glearr�vvater, Fia.3375G �il�,: (}4-1 i t�lat���� (��s C)r�tributic�t� Main & Service Line t,ocating 13eE�r �/fr. Murr�Y: Heath C;c>nsultants Incc�rparated (Heath) is pleascd to present the attached line locatin�; prapc3sal for the City of Clearwater. I1�is techni�a[ proposal �c�ntains specific information about our operations so our cticnts can determit�e the value of �ur scrviee. Heatli is cc�rnmittec� to providing high qua�ity service ta our clic;nt:� at a competit�ve price. 1n rcviewin�; the IZ�'3' reyuirctnei�ts Heath �;e�nsultants rec�uests the tE�llc�win�, e;xcc�iic�z�s tc� the t�eyuircments; P�;e 3 t tnsuranc.� ttequirements ___ Heath cannot providc thre€; (�) year tail 4overd�e following termination or exgiration af the A�ree:merxt. Our instirance is provided on an ann��al k�sis. Pa�e 13 4. i 1c�ld I-��rmles�lindenz��itic��ti��n: F1e�ase ac��i thi� phrasc; to end of the last setrt�ncr;; "unles4 sct�h eluims` �xre u result of the City's ou�n ne�Ii�enc�c�_ '` Pa�e 13 S. Ilold HamiEess/Inclen�nificatin�l: P3ease deletc th� words "sE�nt via eertified mctil, return receiPt rc�quc�st�d,". 1'd�;e 13 �`I:I�"I'IFICA"I'F OF IN5[�I�ANCEICLRTI�IEi) (:OPi�� ()1� �'t::}�,)CIt;S: Fle�z�c strike the ��rase in thc first paragraph last l'zne: "revised, e�r c�btai���:� fr�»n t�ther insurers." Corpc�rate Headquart�r�€: �030 f�anroe Raad, Houston, Texas 7�461-5229 Phone: �(713j 8d4-13t70 � �a�c, {7i3) 844-93(?9 �ectior� 10 contains the pro�c�s�.l pricing she�t �.n� aII requi��d hid dacuments. Thank you for tne apportunit�� to submit th?s prapc�sal. If yo� have a.ny questions a�- cl�r�QSe �o contract aur services, feel free to contact me at 71.i-844-1304. SFncerelv, Ciary Lape Vice Presic�ent, Operations C�: ��rick 3�I�nsQr. Jol� C�apr�an Statement of Qua[ifications References � � What Heath Provides �: , Damage Prevention Procedu�res Education and Training Quality Assurance Procedures ��: Quality Control Procedures gF v ` r ��.,t ��" •3�;. �s � ��,,` ��` i n�� � � �� . L^t'�k'�fifi ".��� "�� �' �.c fi'�' ' � = � • � � � � � � � 3 ��,�i�� �.�� r� w ,�' - ��t n � _ ::..� >-: � ? - ,�' < � �° C '?gY M afi < �P�.� �t 'E; �1.�... '2 +,� ,: �. �`T "x ¢a',`' � ♦ . a < ?*' , � z'4 � °s � �� ,„� � f i 1 % i �,� ��� �F �s � �..�` SECTION ONE STATEMENT OF QUALIFICATIONS HEATH CONSULTANTS INCORPORATED STATEMENT OF QUALIFICATIONS Heath Consultants Incorporated was founded in 1933, and has been in business for over seventy eight (78) years. We have committed to continually iinproving our � field techniques with an in-house training department focused on ` II providing the best field training in the industry. I�eath Consultants is �� ��� recognized as the premier "world class" provider of services to the Utility Protection and Damage Prevention markets. We have extensive experience in the natural gas industry providing services related �-;�� � specifically to underground systems. These services include gas ; ., leakage surveys, cathodic protection services and underground facility locating; also we provide water accountability services to the water industry. Heath Consultants has been called upon by many companies around the world to perform special investigations and provide expert witness testimony. Heath has a qualified and experienced management team that provides strong direction that focuses on customer service and satisfaction. We have an excellent track record with utilities throu�;hout the United States and abroad. Our extensive experience, local presence and dedicated national recruiter allow us to meet project coordination, scheduling needs and staffing requirements. Currently, Heath Consultants employs approximately 600 people in the United States who specialize in utility protection and damage prevention services. The Damage Prevention Services (DPS) division ensures a full service utility markout pro�nam. DPS' direct supervisors called Project Managers, unlike Project Managers with othcr service providers, have no sales responsibility. Each member of the DPS is committed to completing the required tasks accurately and on-time. DPS can receive the One Call tickets directly, eliminating; your labor costs of processing the tickets. Mapping is one of the most crucial tools in preventing; utility damage, therefore Heath provides a resource of knowledge to accurately update your• inapping database. Heath Consultants Incorporated strives to maintain a positive and respectable employee image; for both our clients and us. All employees are supplied shirts and hats that have the company logo prominently displayed on them. All employees are also given employee photo ID cards. Company vehicles display our logos on both doors and an 800 number on the back asking, "How is my driving?" with the unit number. The equipinent provided for the technician is the bes�l equipment currently available. ERICK R. JOHNSON e.johnson@heathus.com DIRECTOR OF SERVICES, SOUTHEAST EXPERIENCE HEATH CONSUI,TANTS, INCORPORATED, Chattanooga, TN 2/2009 - Present Director of Services — Southeast I.eader of operations for a provider of various utility services. These services include Gas Leak Survey, Meter Reading, Underground I,ocating, Cathodic Protection, etc. Responsibilities consisted of leading the regional operations of all Heath Consultants services in l l states. Coordinate activities between: management, field personnel, the corporate office, suppliers, customers, etc. Develop the annual budget. Oversee and track the division Profit & Loss. SM&P UTILITY RESOURCES, INC., Carmel, IN 11 /1994 — 1/2009 Director of Trainin a� nd Quality Control 10/2006 — l 0/2008 Responsibilities consist of directing the company's management development and technical training. Leader of a team of 19 trainers and 3 training managers. Develop and write curriculum and job aids for inanagelnent and technical courses. 'I'each management courses dealing with skills in areas such as performance management, financial, interpersonal, customer service, etc. Manage and mentor the technical instructors based in multiple states. Developed a companywide Continuous Education prob am with on line testing and tracking. Safet_y Mana�er 9/ 1/03 - 10/ 1/06 Trainin�ana�er 4/30/99 — 9/l/03 General Mana�er 2/20/98 — 4/30/99 Responsibilities consisted of managing the regional operations of SM&P's locating services. Contacting potential new customers. Supervise office operations. Coordinate activities between: field personnel, the office, suppliers, customers, dispatch, etc. Directly supervise middle management personnel, including two district rnanagers (180 employees). Develop the annual budget. Oversee and track the district5l'rofit & Loss. District Mana�er I 1 /14/94 - 2/20/98 THE FISHEL COMPANY, Pelham, AL 4/20/92 - 1]/13/94 Division Mana�er 10/22/93 - 11/13/94 Responsibilities consist of managing the state wide engineering and construction operations. Coordinated engineering and construction forces to complete turnkev telephone and gas line projects for our customers. Estimating and putting together bid proposals. Contacting potential new customers. Directly supervise middle management personnel. Supervise office operations. Coardinate activities between the field, suppliers, customers, subcontractors, etc The annual revenue for this division leadership. Project En�ineer En ineer . Oversee and track the division Profit & Loss. �new from $200K to $2 million through my GENERAL TELEPHONE OF THE SOUTH, Durham, NC Technical Instructor — OSP En�ineer - OSP LAWRENCE COUNTY HIGH SCHOOL, Louisa, KY Industrial Arts Teacher - Coach BALL STATE UNIVERSITY,1VIuncie, IN Graduate Assistant EDUCATION 9/ ] /92 - 10/21 /93 4/20/92 - 9/1/92 1982 - 1992 ] 986 - 1992 1982 - 1986 1980 - 1982 1979 - 1980 M.A.E. (Master of Arts in Education), Industrial Education, Ball State University, Muncie, IN B.S. (Bachelor of Science), Industrial Education, Morehead State University, Morehead, KY Morehead State University Xavier University General Telephone Training Other Training: Emergency Medical Technician Training Supervision and Organization in Vocational Schools Planning, Developing and Evaluating 'I'raining All Outside Plant courses (cable, construction, engineering) DDI Train the Trainer (Leadership/Management classes) Continuous Improvement Concepts Targeted Interviewing Performance Management Supervisor Training Various courses in Leadership, Management and Training ��{��C� ��_:�L�f�;1' ��i"CijC�C.� t'ci}��'t?t, �., : ri�.���Z�.CA�t. 1l l� i�! ll t t_ "� K� L:�l.!� ?_-�1�.4���..c_�t:4 C ��..,��,� �`t�� ��''r ; r >��.'.`.!_i�i f�.:��'�(�i�;� • Nine (9) years experience with Heath Consultants Incorporated • University of Phoenix �'�Q������;���:�"_� �;ni�����I�e�� ���i���C.'i1'i � �1�. • Management responsibility for four (S) gas leak survey projects located in the Southeastern United States: 1) Centerpoint Energy, Arkansas, 2008 to January 2011 2) Atmos Energy — 3 TN locations, 2010 to present 3) TECO Energy — St Petersburg/Ft Myers, FL, 2010 to present 4) Jackson Energy, Jackson, TN , 2008 to present S) Traveling short term surveys in AL, AR, KY, MO, MS, TN 2008 to present `�`��h��i�.�:I ��p��2���� • Natural Gas Leakage Detection • Pinpointing of Gas Leakage • Underground Pipe & Cable Locating �������ic�i Tr������� • Gas Leak Pinpointing — Heath Consultants • Pipe & Cable Location — Heath Consultants • Damage investigations �?��F��s�Q���. i�.�TjI�.�:`�'t'IU'�'� _!��f� C��L�F'�'�`I:^_L.� • American Gas Association • American Public Gas Association • Sauthern Gas Assaciation — OQ Evaluator and Trainer ASSOCIATIONS th Consultants Incorporated has active memberships in all the associations listed below. Our employees sc:rve as Board and/or Committee Members where indicatcd. Association 1. Alabama Natural (ias Association 2. American Gas Association 3. American Public Gas Association 4. American Society of Gas Engineers 5. Arkansas Gas Association 6. Energy Association of Pennsylvania 7. Florida Natural Gas Association A. Gas Piping Technology Committee _ Gas Technology Institute 10. Georgia Municipal Association 11. Guild of Ancient Supplers 12. Gulf Coast Measurement Society 13. Houston Pipeliner's Association 14. Illinois Municipal Utilities Association Membership, Board & Committee Provide Information Training Mike Koby Paul D. Wehnert - Uistribution Operations & Maintenance Committee (DCM); Operations Engineering and Service Associates Committee (Past Chairman) Gary Lape - Corrosion Comnvttee Paul D. Wehnert Paul D. Wehnert Mike Koby - 'I�raining Committee George Lomax, Ken Cowher John Chapman George Lomax Manufacturers Division; Operations & Maintenance Subcommittee; Damage Prevention/�mergency Response Subcommittee Paul D.Wehnert -'I�ask Force Member John Chapman Paul D. Wehnert - Past Mayor George Lomax - District #7 Milton Heath IIl - District #3 Roy Montemarano - District #3 Paul D. Wehnert Paul D. Wehnert , Milton Heath, III Drew Yando 15. Interstate Natural Gas Association of America Milton Heath, 11I 16. Iowa Association of Municipal Utilities Cody Neukom 17. Kentucky Gas Association Mike Koby - Soard of Directors, Education Commrttee 18. Louisiana Gas Associatian Gerald Sims - Damage Prevention Committee, Board of Directors l9. Middle Tennessee Gas Association Mike Koby 20. Midwest Energy Association Drew Yando, Codv Neukom 21. Mississippi Natural Gas Association Gerald Sims 22. Missouri Association of Natural Gas Drew Yando Operators # of �Company Individual Memberships l�'�embership 2 X X X 1 X 1 X 2 1 X ] X 1 6 X 2 3 ] X X 1 X X X X 1 X 1 X 4 X 1 X ] X Association 23. Northeast Gas Association 24. Ohio Gas Association 25. Oklahoma Gas Association 26. Southern Gas Association 27. Tennessee Association of Utility Districts 28. Tennessee Gas Association 29. Texas Gas Association 30. West Tennessee Gas Association 31. Western Enerby Institute Membership, Board & Committee Information Ed Miliczki, George Lomax, Ken Cowher Eric Six — Board Member Gerald Sims - Board of llirectors Paul D. Wehnert - Associate Member Committee Mike Koby, Erick Johnson Mike Koby — D&O Committee, Affiliate Committee Erick Johnson Paul ll. Wehnert - Treasurer Gerald Sims - Education Committee Gary Lape, Robert Botello Mike Kob,y, Erick Johnson # of �,^om an Provide Individual p y Training �qemberships Nlembership X 3 X X l 1 X X 5 X X 2 2 X X 4 X 2 1 X SECTION TWO REFERENCES DAMAGE PREVENTION REFERENCES TENNESSEE MIDDLE TENNESSEE GAS Ed Kelley — Vice President 1036 West Broad Street Smithville, TN 37166 (615) 597-4300 ckelley(cvmtng.com ATMOS ENERGY CORPORATION Wayne Turner - Operations Manager 200 Noah Drive Franklin, TN 37064 (615) 794-2596 wayne.turner@ahnosenergy.coin ELECTRIC POWER BOARD Wendell Boring - Senior Manager, Construction and Maintenance 536 Market Street Chattanooga, TN 37422 (423) 648-3254 boringwd@epb.net PIEDMONT NATURAL GAS - NASHVILLE GAS Robert E. Garner, P.E. - Construction Superintendent 665 Mainstream Drive Nashville, TN 37228 (6] 5) 734-1770 � B obby. Garner@pi edmontng. com CLEVELAND UTILITIES Tom Wheeler — General Manager 2435 Guthrie Ave. N. W. Cleveland, TN 37320-2730 (423)472-4521 N LORIDA TECO Leroy (Roy) McLeod — Division Manager ] 920 9th Ave N St. Pctersburg, FL 33713 (727) 826-3240 1 xmcleod�cr�,tecoenergy. com GEORGIA GEORGIA POWER Jim Weldon — Manager, Cable Locating 241 Ralph McGill Blvd NE Mail Bin 20024 Atlanta, GA 30308-3374 404-506-6510 j awel don@southernco. com NORTH GEORGIA ELECTRIC MEMBERSHIP CORPORATION Danny Hales — Manager of Contractor Services 1850 Cleveland Highway Dalton, GA 30722-1407 (706) 259-9441 dhales@ngeme.com OKLAHOMA OKLAHOMA ELECTRIC COOPERATIVE Randy Simmons - Manager of Operations 242 24th Ave Northwest Norman, Ok 73069 (405)321-2014 rsim�nons(c�okcoop.org TEXAS ATMOS ENERGY Pete Pedersen P.O. Box 650205 Dallas, TX 75265 (214) 206-2791 peter.pedersen@atmosenergy. com PENNSYLVANIA EQUITABLE GAS Jack Mackin---Director of Operations 225 North Shore Drive Pittsburgh, PA 15212-5861 (412) 395-3576 jmackin�cr�,equitablegas. com rleath Consultants Incorporatec! . HEATH CONSULTAI�TS LOCATING r�T FAULT Dt�1�Ir�GE DATA November 2�11 - Ocfober 2012 � at Fault Per ��curacy Customer Tickets Damaaes 1 per 1,000 % Piedmont 46,478 4 11,620 0.086 99.991 % Atmos Energy 28,812 2 14,406 0.069 99.993°/a Chattanooga EPB 32,682 Q 0/ 33,327 0.000 100.d00% North GA Electric 15,804 � 0! 15,804 0.000 10d.000% Comcast Corporation 32,322 i 32,322 0.031 99.997% TtV American Watee 19,688 2 9,844 0.102 99.990% Hixson lltilities 5,083 0 0/ 5,244 0_000 100.000% Cieveland Electric 6,152 � 6,152 d.163 99.984°/o Cleveland Water/Sewer 7,370 Q 0/ 7,370 0.000 100.000% ALL** 194,391 10 19,439 0.051 99.995% *"Several sma!!er utitities with no damages are not included. lndustry Standard 30,000 10 3,000 0.333 99.967% industry Average 30,000 15 2,000 0.500 99.950% � SECTION THREE WHAT HEATH PROVIDES WHAT HEATH PROVIDES Damage Prevention Heath ensures a full service utility markout pro�,nam. Supervision Heath provides experienced supervisors to oversee daily operation, maintain communication with you the client, conduct field assessments of the technicians' job performance and conduct quality control inspections of field personnel. Staffing & Training Heath maintains both a full time recruiter and an education coordinator. All employees inust complete field training and qualification testing. Quality Assurance Regular on site evaluations are done with the Field Technician to assess a number of areas such as knowledge of line locating procedures, client relations, equipment calibration and vehicle maintenance. Quality Control Re-surveys are done on portions of a Field Technician's work. The re-survey confirms that all detectable facilities have been located appropriately and within the compliance dates. The results are then reviewed with the Field Technician. Customer Satisfaction Surveys Heath Consultants' Corporate office conducts customer satisfaction surveys once a year providing customers a direct method of evaluating our performance and providing us with feed back on our overal] operation. The surveys are sent to customers within the organization that deal with the project and our employees on a first hand basis. When the results have been tabulated Heath can then determine the areas of operation that we are strong and where there is room for improvement. One Call Center Interfacing We can receive the One Call tickets directly, eliminating your labor costs of processing the tickets. We use state-of=the-art ticket processing software called TransLore to ensure the most efiicient results. Positive Response Heath provides an automated positive response directly from our ticket management system (TransLore) to the appropriate one call center. A response is issued immediately on completion of the locate for each of the parties on the ticket for which we are responsible. The positive response is provided in whatever fornlat and via whatever transfer mechanism has been requested by the one call center. The positive response will he repeated until an acknowledgeinent message has been received fram the one-call center. Drug & Alcohol Heath Consultants follows the drug and alcohol testing requirements outlined by the Department of Transportation. Safety Safety is a key eleinent with Heath Consultants. Regular safety ineetings are held and information is provided to the employees. Uniforms & Transportation Heath's technicians are full time employees with benefits. They wear a company uniform and drive easily identified company vehicles. We take pride in presenting a professional iinage to your customers, on your behalf. SUPPORT SERVICES Heath Consultants Incorporated also offers a wide variety of services to the utility industry, including but not limited to the following: Unauthorized Pole Attachment Surveys Are you losing significant revenue? Do you have any idea how much? Heath can help, by auditing your poles and their attachments we can generate a significant revenue that is rightfully yours. Why allow other utilities, your competitor in some cases to continue inaking money using your assets? With the changing market arena, auditing your poles is a must. While auditing your poles we can look for space violations from other utilities, including space and guys. We can also provide you with asset inventory infonnation such as street light locations and types for your mapping systems. Meter Reading Heath can provide accurate, timely documentation of ineter reads for client billing purposes. Heath has had a reputation for training and providing reliable tield personnel for over 70 years. Customers value Heath for being quick to respond and giving the needed attention to detail that is necessary to provide quality service in the ineter reading industry. Instrument Repair The experienced staff at Heath Consultants will keep your field instruments in prime condition. We repair all heath products, manufactured and distributed. We also repair most competitor combustible gas indicators, multi-funetion gas detectors, flame ionization detectors, odor analysis equipment, mobile units, and pipe, cable and valve locators. We have repair facilities conveniently located across the United States. Training With our combined expertise, Heath and AEGIS (Associated Electric & Gas Insurance Services) have been able to provide the utility industry with the highest quality of training provided by dedicated professionals. We can offer "hands on" field training and testing can be performed in conjunction with either classes or field training in order to ineet company, state or federal requirements. Leakage Pro�,�ram Management, First Response, Gas Leak Pinpointing, and Utility Locating are just a few of the courses offered. Also available is computer simulation software for training personnel that are involved in leak/odor investigation and emergency response. Additional Services • GIS/GPS Data Collection • Valve Locate & Exercise • Indoor Meter Inspection • Corrosion Readings • Sign & Marker Replacement • Safety Audits SECTION FOUR DAMAGE PREVENTION PROCEDURES lieath Consultants Incorporated HEA'I'H CONSULTANTS LOCATING �T FAULT DAMr�GE DATA. November 2011 - Ociober 2012 At Fault Per Accuracy Customer Tickets Damages 1 per 1,000 % Piedmont 46,478 4 19,620 0.086 99.991% Atmos Energy 28,812 2 14,406 0.069 99.993% Chattanooga EPB 32,682 0 t� / 33,327 0.000 100.000°/Q North GA Electric 15,804 0 0/15,804 0.000 100.000% Comcast Corporation 32,322 � 32,322 0.031 99.997% TN Americar� Water 19,688 2 g,844 0.102 99.990% Hixson Utilities 5,083 0 ff / 5,244 0.000 'i 00.000% Cleveland Efectric 6,152 1 6,152 0.163 99.984°/a Cleveland Water/Sewee 7,370 0 Q/ 7,370 0.000 100.000% ALL** 194,391 10 19,439 0.051 99.995% **Severa! smaller utilities with no damages are not inc/uded. Industry Standard 30,000 10 Industry Average 30,000 15 � 3,000 2.000 0.333 0.500 99.967% j 99.950% Dama�e Procedures (Client Level) The client shall notify Heath Consultants' project ottice of all occurrences of damages. A ineeting between client member and Heath Consultants' project member will determine responsibility for the damage. At this tiine, a dainage investigation report (field portion) is completed by a Heath Consultants' project member. Any damage determined to be the responsibility of Heath Consultants should be invoiced to the project office and sent to the Division office in Houston within 10 working days. Establish monthly meetings to discuss questionable damages. Damage Procedures (Division Office Level) Clients should mail invoices to the Houston office where a log of damages is kept as to date received, amount of invoice, date invoice is faxed to project oftice. At this point, the invoice is logged as pending. At the project level, the faxed invoice is reviewed and approved for payment. The appropriate back-up is attached to the faxed invoice and sent to the Houston office. When the Houston office receives the invoice from the project offices, the log of damages is completed as to date received from project office, and date purchase order is processed. Damage Procedures (Project Level) • Heath (project level) gets call about damaged utility • Damage is documented on damage log • First alert--office notifies closest field personnel to respond far initial investigation • Office personnel begins research for ticket • Upon arrival to damaged utility scene, 1 st responder asks office personnel for ticket research findings • If 1 st responder is not a member of management, member of management should be called to document actual da�nage • Heath personnel should complete field part of da�nagc report • Damage report is turned in to designated Heath personnel for completion of damage report • Damage report is signed by appropriate project level management • AT FAULT DAMAGE REPORTS ONLY--Copied and sent to QA Dept. • NOT AT FAULT DAMAGE REPORTS kept at project level QA Leader will provide locators with training and a training rcport for all at fault dainages. SECTION FIVE EDUCATION AND TRAINING TRAINING PROGRAM In compliance with the Operator Qualification Rule and DOT Regulations Heath's training protocol varies as to the types of services being provided. Based upon the function that a technician is hired to perform technicians will receive varying degrees of the following training: • Up to forty hour classroom • Up to six weeks field training • Possible qualification test(s) Quality Assurance Program • Tagging program • Survey audit • On site supervision - Monthly, yuarterly and annual review process Refresher Training Heath Consultants Incorporated maintains both a full time recruiter and education training and development manager to maintain a reservoir of qualified and trained technicians prepared to meet and exceed client expectations. OPERATOR QUALIFICATION PLAN Purpose: The purpose of this plan outlines the process Heath Consultants Incorporated (hereto fore referred to as the "company") utilizes to comply with 49 CFR 192 "Operator Qualification" (OQ Rule). The effective date of this written plan is Apri127, 2001. 1. Definitions 1.1. Abnormal operating conditions — defined in 49 CFR 192.803 as a condition that indicates a malfunction of a component or deviation from normal operations that may indicate a condition exceeding design limits or result in a hazard(s) to persons or the environment. 1.2. Evaluation — detined in 49 CFR 192.803 as a process established by the company to determine an individual's ability to performed a covered task by any of the following methods: 1.2.1. Written examination 1.2.2. Oral examination l.2.3. Work performance history review 1.2.4. Direct observation during the job 1.2.5. Performance on the job 12.6. On the job training 1.2.7. Simulations 1.2.8. Other forms of assessment 1.3. Integrity — the pipelines ability to operate safely and to withstand stresses imposed during operations. 1.4. Quali�ed — defined in 49 CFR 192.803 as an individual who has been evaluated and can perform assigned covered tasks and can recognize and react to abnormal operating conditions encountered on the job. 1.5. Transitional — qualification completed by October 28, 2002 of individuals who have been performing a covered task on a regular basis prior to August 27, 1999 (and have continued to do so). 1.6. Pipeline facility — defined in 49 CFR 192.3 as. new and existing pipeline, rights-of-way, and any equipment, facility, or building used in the transportation of gas or in the treatment of gas during the course of transportation. 1.7. Covered task — defined in 49 CFR 192.803(a) as an activity identified by the company as meeting all of the following: (Four — part rule) 1.7.1. The activity is perfonned on the pipeline facility. 1.7.2. Is an operations and maintenance task. 1.7.3. Is performed as a requirement of 49 CFR 192. 1.7.4. Affects the operation or integrity of the pipeline. 2. Identification of covered tasks — 49 CFR 192.805(a) 2.1. This program includes a list of performed covered task(s) identified by the company using criteria set forth in the OQ Rule and as shown in l.7 above. Regulatory Agencies and Operators, the company provides service for, can request ainendments to the list. (Amendment 1) 3. Evaluations — 49 CFR 192.805(b) 3.1. Company personnel currently performing "covered tasks" on the I�nplementation Date of the OQ Rule (August 27, 1999) qualify under "Transitional" clause or "Work History" Note: "Work History" will not be used as the sole evaluation method after October 28, 2002. 3.2. Any person not previously qualified shall qualify according to guidelines set forth in the company's training and development pro�nams. The progam(s) involving "covered tasks" includes at least one method of evaluation described in the OQ Rule and as shown in l .2 above. � 3.3. Evaluation methods and evaluators include inanagement designated intcrnal personnel and materials, approved outside resources, and Operators we provide service for; along with Regulatory Agencies' recommendations. 4. Non-Qualified Individuals — 49 CFR 192.805(c) 4.1. Non-Qualitied individuals can perform covered tasks only under direct supervision of a qualified person(s) of the company or operator. The qualified person assumes responsibility, ensuring safe performance of covered task: including being in position to take immediate corrective action in necessary. 5. Evaluations Following Incidents — 49 CFR 192.805(d) 5.1. If determined by the company, Operator or Regulatory Agency, qualified person(s) contributed to an incident involving a covered task, the company ensures involved person(s) will no longer perform covered tasks without direct supervision until evaluated and deemed qualified by company and or Operator. 5.2. If company or Operator reasonably deeins person(s) is no longer qualified to perfonn covered task, identified person(s) may no longer perform covered task without direct supervision until evaluated and qualified by company and or Operator. 6. Evaluations Related to Performance — 49 CFR 192.805(e) 6.1. The company or Operator requires an individual to be evaluated if there is reason to believe that the individual is no longer qualified to perform a covered task. This could occur if the individual displays unsatisfactory performance of the task or there is any reason to believe the individual can no longer perform the covered task in a qualified manner. 6.2. If the company or Operator has reason to believe that an individual is no longer qualified to perform a task due to unsatisfactory performance or any other reason, the individual's status will be revised to non-qualified, and will be restricted from independently performing the covered task until evaluated and qualified in accordance to l.2 above. 6.3. The company will be responsible for detennining if an individual is no longer qualified to perform a covered task due to unsatisfactory performance or other reasons and will ensure that the individual is evaluated and qualified before resuming performance of the covered task. Evaluation methods and evaluators include management designated internal personnel and materials, approved outsidc resources, and Operators wc provide service for: along with Regulatory Agencies' recommendations. 7. Communication of Changes — 49 CFR 192.805( fl 7.1. The company realizes the constant changes in the industry impacting the performance of covered tasks. These changes shall be communicated to the qualiticd personnel in the most efficient and effective manner available to the company. Channels of communication include, but are not limited to: redesi�m of internal program(s) and material including evaluation if necessary, written bulletins, electronic generated notices, ainendments to the OQ Plan, and/or recommendations from Regulatory Agencies or Operators. 8. Evaluation Intervals — 49 CFR 192.805(g) 8.1. All personnel performing covered tasks and participating in the company's quality program shall subsequently re-qualify no later than the end of the third calendar year since their last recorded qualification. The evaluation shall include at least one of the methods described in 1.2 above. Any person(s) who has not performed a specific covered task during a rolling twelve month period, must qualify before performing specific task; evaluation to include at least one method indicated in 1.2 above. 9. Record Keeping — 49 CFR 192.807 9.1. The company will provide documentation of qualified personnel including identification of the person, covered task qualified to perform, date of qualification and method of evaluation. 9.2. The company shall maintain these records for no less than a tive-year period following the last qualification date of each person, including person(s) leaving the co�npany. 9.3. This information is available to Regulatory Agencies and Uperators having a vested interest. 9.4. The current method of maintaining records are electronic data and hard copy: at corporate headquarters and regional locations. Programs and locations may change as technology improves. 10. Implementation — 49 CFR 192 The company complies with the dates and requirements stated in the OQ Rule. (Work History cutoff date, August 27, l 999: Effective date of the rule, October 26, l 999; Publication date of written plan, April 27, 2001; Date after which all persons perfonning covered tasks are yualified under this plan, October 28, 2002.) Covered Task List 1. Leak Survey 1.1. Perform leakage surveys: Transmission lines — 49 CFR 192.706 1.2. Perform leakage surveys: Distribution lines — 49 CFR 192.723 2. Patrolling 2.1. Patrolling transmission lines — 49 CFR 192.705 2.2. Patrolling distribution lines — 49 CFR 192.721 3. Line Locating 3.1. Locate and teinporarily mark buried pipelines in an excavation area — 49 CFR 192.614(c)(5) 3.2. Standby for prevention of damage to pipclines — 49 CFR 192.614(c)(6) 4. Corrosion Control 4.1. Monitor/test for cathodic protection — 49 CFR 192.465(a) 4.2. Monitor/test for atmospheric corrosion - 49 CFR 192.481 5. Valve Maintenance 5.1. Operate valve to discontinue service to a customer — 49 CFR 192.727(d) 5.2. Inspect/maintain distribution valves — 49 CFR 192_747 Pre-Productive Field Test Date: Locator's Name: YES SAFETY Does locator know what confined space is? ❑ Does locator know our confined space policy? ❑ Does locator know to wear safety vest and face oncoming traffic when working in or near roadway? ❑ Does locator know to stay away from blowing gas and not to use electronic equipment or telephones near blowing gas? ❑ Does locator know the flammable limits of natural gas? ❑ Does locator know to wear hard hat in construction areas? ❑ PAPERWORK Does locator know how to fill out log sheets properly? ❑ Does locator know how to fill out time sheers properly? ❑ Does locator know how to communicate with Contractor and document? ❑ Does locator know how to fill out tickets properly? ❑ NO N/A ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ■ ■ � ■ ■ ■ ■ ■ PROCEDURES Does locator know proper marking procedures for the following: Paint Flags Offset Safe Dig Does locator know proper grounding procedures? Does locator know the procedures for an emergency locate? YES ■ ■ ■ ■ � ❑■ LOCATING Does locator know how to hook up conductively? ❑ Does locator know how to use the inductive clamp? ❑ Does the locator know how and when to locate inductively? How? ❑ When? ❑ Does locator know not to ground over other utilities? ❑ Does locator know how to read tickets and determine locate area? ❑ Does locator know how to take pictures and document pictures properly? ❑ NO ❑ ❑ ❑ ❑ ❑ ❑■ � 1 � ■ ■ ■ N/A Ci7 ■ ■ ■ ■ ,] ■ ■ ■ ■ �■ ❑ ❑ ❑ ❑ YES Does locator know to look for services crossing road when work is in roadway? ❑ Does locator know how to spot valve and manholes, test stations, pedestals, reg stations, transformers, etc? ❑ Does locator know where gas lines are insulated? o Can locator identify an anode less riser? ❑ Can locator read utility mapping for the following: Gas ❑ Electric ❑ Telephone ❑ CATV ❑ Water ❑ Sewer ❑ EQUIPMENT Can locator properly change batteries in all equipment? ❑ Does the locator know the proper operation of the following: LS-800 ❑ LS-990 ❑ LS-300 ❑ Sure-Lock 8.1 ❑ • ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ N/A ❑ ■ ■ ■ ■ ■ ■ ■ ■ ■ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Sure-Lock 81 Sure-Lock 480 50-60 cycles Pipe Horn Ball Locator YES ❑ ■ ■ ■ �� PAINT Does locator know the utility paint color codes? Electric Red ❑ Telephone Orange ❑ Gas Yellow ❑ Sewer Green ❑ Water Blue ❑ CATV Orange/Purple ❑ VEHICLE Does locator know when and how to check oil in truck? ❑ Does locator know when to have oil in truck changed? ❑ Does locator know how to use the Wright Express Card?❑ What is your Write Express pin number? ❑ NO ❑ ❑ ❑ ❑ �' ■ ■ ■ ��■ �■ �■ ■ �■ �■ ■ N/A ❑ ❑ ❑ ❑ ❑ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■� YES NO N/A VISION STATEMENT Does locator know our Vision Statement? ❑ ❑ ❑ Locator's Signature Trainer/Instructor's Name Approved to become billable (Must have Trainerllnstructor's Signature) Comments: SECTION SIX QUALITY ASSURANCE & QUALITY CONTROL PROCEDURES QUALITY ASSURANCE PROGRAM The Quality Assurance Program was developed to help reduce the frequency of damages incurredl by underground facilities. Each of Heath Consultants Incorporated Damage Prevention Division's locating projects is staffed with a Q.A. leader. It is this person's responsibility to assure that all field personnel are following proper locating procedures. This is accomplished by performing field audits and on sight training. The purpose of these audits is to help prevent the same situation from occurring again. The frequency of the audits will be determined by specs included in specific project contracts or if none are included, by Divisional, Field Services and Quality Assurance Managers. Along with verifying the accuracy of locates the Q.A. leader will also check for proper and accurate documentation of all field paperwork. The Quality Assurance Leaders will also monitor all training being done on their specific projects. All locators must pass both a written and a field test before they are allowed to complete one-call tickets on their own. All of the information collected by the Q.A. Leader is sent to the Q.A. Manager, who then completes the monthly reports. These reports are then sent to the specific customer contacts and the project managers for further follow up with their field supervisors. The members of the Quality Assurance Department are not responsible for the protit/loss of the projects; however, they must be mindful of productivity, efficiency and cost when reviewing field technicians and project operations. Their quality assurance efforts provide key support to the Project Managers in their efforts to provide a quality service in a profitable manner. In addition to Quality Assurance Audits, the QA Team is responsible for the tracking and maintenance of Damages. In a perfect world, damages would not occur; unfortunately it is an every day part of life in this industry. Our best efforts must be made to eliminate "at-fault" damages and educate the excavators in the process. Overseeing and auditing damages will help us develop and efficient operation with a minimized liability. AUDITING PROCEDURES General Quality Assurance Leaders will perform audits on a random rotation that ensures that every locator is audited. Re-auditing may occur at any time when problems occur and it is deemed necessary. Request for a locator to be audited can be made at any time. Audit Procedure: 1. Audits will be conducted in a consistent, unbiased manner. 2. Crew Leaders, Team Leaders, QA Leaders, Trainers and Project Managers may conduct audits. 3. A minimum of 3% of locates per year will be audited unless a contract specifies a higher percentage. 4. Every technician will be audited a minimum of once each quarter. Technicians with less than 6 months with Heath will be audited a minimum of once each month. 5. Audits shal] be docuinented at each damage site. 6. The field technician will be evaluated on a minimum of the following items: ■ Accuracy of the facility locate ■ Clarity of the locate marks • Complete coverage of the instructions on the ticket • Daily production • Proper locate documentation 7. The QA Leader will ineet with the technician to discuss the audits in a timely manner. 8. The QA Leader will submit a memo with recommendations to a Manager at the Project office. THE FIELD AUDIT The field audit will be the priine resource in the expected success of our Quality Assurance Plan. Audit Evaluation The field technician will be evaluated on a minimum of the following items: • Accuracy of the facility locate • Clarity of the locate marks • Complete coverage of the instructions on the ticket • Daily production • Proper locate documentation Unacceptable Audit An unacceptable audit represents a locate where facilities were in danger of being damaged due to poor field perfonnance. A score of this nature would result in any one or a combination of the following: • Employee suspension or dismissal • Written reprimand • Additional training • Training report Below-Standard Audit Where facilities were not in danger of being damaged, due to field practices where the field locate lacked important attention to detail in some manner, the following will occur: • Verbal coaching or counseling • Additional training • Training report Acceptable Audit An acceptable audit represents a locate where all efforts were made to protect all customer facilities. In addition, the locator has gone above standards and provided extra infonnation to the excavator involved. Audit Scores Audit Scoring The following scores for each locate and an overall audit score will be used: • Excellent (E) • Satisfactory (S) • Needs Improvement (N) � Unsatisfactory (U) Note: The above scores will be based on the QA Audit Procedure itein number 6. The overall audit score will be at the discretion the auditor based on overall audit scores and severity of any inadequate scores. For tracking purposes, an `E' or `S' will be considered Adequate (`pass' on the old forn�), while `N' or `U' will be considered Inadequatc (`fail' on the old form). I will send a new Daily Summary form to your office with the next envelope from Houston. DAMAGE PROCEDURES 1. The client shall notify Heath Consultants' Project office of all occurrences of damages. 2. The Project office will give the client the next number in the damage log and fill in all available information in the log. 3. A Crew Leader or above will be dispatched to the damage site by the Project office. 4. A`Damage Investigation Report' is completed at the damage site. (A QA report will also be generated.) 5. For at fault damages, training of the technician shall be conducted on-site and a training report generated. 6. Remaining information for the damage log is filled in when the damage investigation is turned in to the Project office. In most cases this should occur the same day as the damagt� but no later than one working day after the damage. 7. A project supervisor will fill out the damage close out section of the `Damage Investigation Report'. 8. The original damage log and all original damage information will be turned in to the Division office weekly. Any damages not received with the log will be followed up with a call to the Project office. 9. The Division office will make a folder far each damage with the damage number on the tab of the folder and file them by Project and number. 10. The damages will be entered into a database from the damage log. The log will be filed at the front of the tile with the damages for each Project. l l. A meeting between the client and Heath Consultants may be needed to detennine responsibility for the damages. 12. Damage invoices are sent to the Division office in Houston These will be copied to the project office if they came from the client to the Houston Office. 13. Invoices will be matched to the damage file to detennine responsibility. If Heath is at fault, Project Manager approval is required if over $2000.00 14. If Heath is at fault, the invoice will be forwarded to the QA Manager and then the Corporatc Accounting Department for payment. If an invoice is received for a damage where Heath was detennined not to be at fault, the Project office will be informed and further discussions with the client will need to take place. FIELD EQUIPMENT Heath Consultants has a unique competitive advantage over other service providers because we not only manufacture the equipment that is utilized in the field but we also perform services with our equipment which gives our in-house field experts the opportunity to provide us with valuable input and feedback on the products design and function in the field. Heath utilizes the latest technology in the field. Depending on the survey, conditions, and contract requirements, all or select equipment as described below inay be used in the performance of your survey. Sure-LockTM All Pro This multi-frequency pipe and cable locator is designed to increase locating accuracy and productivity. With a broad spectrum of frequencies, ranging from 8.1 K to 480 kHz, a field technician can easily locate audio, radio, and ultra-high frequencies. The All Pro even finds poor conductors such as bare steel, cast iron, unbonded cable, broken tracer wire and helps verify dead end utilities. One unique feature is continuous depth reading, which helps us from straying off the intended target. Sure-LockTM Utility Pro The Utility Pro radio frequency locator works well on all buried utilities with conductive capabilities. The Utility Pro has an active 81 K hertz frequency with depth and left-right, it also has a passive frequency of 50-60 hertz without depth or left-right. This model can be used both conductivity (connected directly to the utility) or inductively (setting the transmitter over the path of the utility). Excellent results have been achieved on gas, water, electric, telephone, and cable TV. Sure-LockTM Distance Pro The Distance Pro audio frequency locator works great for conductive locating and for gas transmission lines, cable (electric, telephone, and TV), tracer wire, and any good conductor buried in the ground. The Distance Pro uses a 3-watt transmitter with a high power setting for those really long locates. A special feature called "impedance matching" puts the maximum amount of signal on the target conductor for inereased distance and accuracy. SECTION EIGHT DRUG & ALCOHOL POLICY - EXCERPT �• HEATN i�(�ISIILTANTS Policy Subject: Heath Consultants Incorporated Policv Manual Dru� and Alcolzol Abuse Prevention Issued By: HR Approved By: C'HH F.'ff'ective Date: 10/03 Complying with U.S. Department of Transportation Regulations 49 CFR Parts 40 and 199 In order to protect employees, the public and Company property from any danger that may resul�t from the use of drugs, and to meet our obligations under applicable federal regulations, Heath is committed to assuring that all employees perform their duties free from the influence of illegal or inappropriately used drugs, and we will consider any job applicant who illegally uses drugs to be: ineligible for employment with Heath. It is our objective to provide and maintain a safe, drug- free work environment. All employees are required to abide by this policy as a condition of employment. Alcohol Use/Illegal Drug Use/Criminal Drug Convictions: Employees who inappropriately use alcohol or who use, distribute, buy, sell, transfer or possess illegal or prohibited drugs in any amount, at any time on Company premises, in a Company vehicle or while performing any work-related activities, whether on or off Company premises, will be subject to disciplinary action up to and including discharge. For purposes of this policy, an "illegal drug" is any controlled substance that cannot be legally obtained, or that, although available legally, has been obtained illegally. A"controlled substance" is any substance listed on Schedules I through V of the federal Controlled Substances Act. "Prohibited drugs" are marijuana, cocaine, opiates, amphetamines and phencyclidine (PCP), the five drugs that the United States Department of Transportation ("DOT") has specifically named under Federal regulations (49 CFR Part 40 and Part 199). The conduct prohibited by this policy includes use of any illegal or prohibited drug not only during working time, but also prior to reporting to work and during breaks and meal periods. Violation is grounds for immediate termination of employment. Under the authority of the Federal Drug-Free Workplace Act, this policy requires employees to report any conviction for a criminal drug violation in our workplace, within five days after the conviction. The steps the Company takes next will depend upon the nature of the conviction, the employee's record with the Company and whether or not the employee is in a safety-sensitive position. Discipline, up to and including termination will be imposed. Use of Prescription Drugs: Employees who are undergoing medical treatment with a prescribed drug or controlled substance, or who are taking an over- the-counter drug that may alter their physical or mental ability, must report or have thcir physician report this fact to their supervisors. An employee may be required to provide the Company with a copy of the prescription and/or other medical verification. It may be necessary to change an employee's job assi�mment while the employee is undergoing such treatment, or, if no suitable position is available, the employee may be placed on a medical leave of absence. Purchase, sale or transfer of a prescription drug by one employee to or from another while on Company premises or while performing any work-related activities, whether on or off Company premises, is prohibited. Violations may result in termination of employment. Drug Testing: All offers of employment for any position with the Company will be conditioned upon the satisfactory results of a physical examination and a test for the five DOT- specified "prohibited drugs." The physical and drug test will be done at Company expense. In addition, under the DOT regulations all employees in the following "covered" positions will be subject to randoin testing for the five prohibited drugs: Division Mgr./Dir. Of Services Education Manager Field Services Manager Field Technician Project Manager QA Leader Technica] Svcs Specialist Sales Consultant QA Manager Team Leader Meter Readers Senior Field Technician Other positions may be added in the future if it is determined that the duties of the position include safety-sensitive activities under DOT regulations. Whenever the Company determines that there is reasonable basis to suspect that an employee has violated the policy regarding use of any illegal or prohibited drug while on Company premises or while performing any work- related activities, whether on or off Company preinises, that employee will be required to undergo drug testing. Covered employees will also be required to undergo drug testing following certain kinds of accidents as defined in the DOT regulations. Employees who are perfonning non-covered positions must first pass a pre-placement drug test for the five prohibited drugs before being promoted to, transferred into, or otherwise allowed to perform the duties of a covered position. Such employees immediately become subject to the random, reasonable cause and post-accident testing requirements of these positions. Drug Testing Procedures: All Company-required drug testing will be by urinalysis and will be performed at Company expense. Testing will be conducted by a laboratory certified under the Guidelines for Federal Workplace Drug Testing of the US Department of Health and Human Services. Test specimens will be subject to an initial screening test and, if the result is positive, will be subject to a second, confirmatory test by gas chromatography/mass spectrometry or an equally reliable methodology. Any employee to be tested for drugs is required to give written conscnt to the testing and to sigri a release authorizing the testing laboratory to provide the test results to the Company. Failure to give consent or to sign the release is grounds for itnmediate tennination of einployinent. Test results will be maintained by the Company's Medical Review Officer (a physician wit�;� specialized training in substance abuse detection and treatment), who will advise the Company only as to whether the test results were negative or positive. A copy of the results of a Company- required test would be provided to the employee tested upon written request. An employee whosf; drug test result is positive may request that the original sample be retested, at the employee's expense, if that request is made within sixty days. Consequences of a Confirmed Positive Drug Test or Refusal to Submit to a Drug Test: An� employee who has a positive drug test result, or who refuses to submit to a drug te.st, is subjec�` to immediate terrszination of employmen� Drug testing for at-fault vehicle accidents and workers compensation: Employees will be required to take a drug and alcohol test after any at-fault vehicle accidents and/or worker compensation accidents. Employee Assistance Program: The Company will periodically display and distribute educational materials to all employees regarding the dangers and consequences of drug use. In addition, in the Heath Anti-drug Plan and in the Employee Manual issued to each employee wil] be printed a list of NATIONAL HOTLINE NUMBERS that employees can use to seek assistance for drug and alcohol abuse and related problems. Finally, supervisors will receive additional, specialized training in identifying symptoms of probable drug use for making "reasonable cause" determinations. Each employee will receive a copy of the Company's Anti-Drug Plan, together with a copy of the anti-drug policy, and will be required to sign a statement acknowledging that he/she has received and read these documents and that he/she understands the consequences of any violation of this policy. Distribution: All employees SECTION NINE SAFETY POLICY & MANUAL Safety Policy Manual For Heath Consultants Incorporated Services Business Unit . m _ Ya� _ ��:��,�t �t � ' ^ �. 3, ^ ,n� w ; � °���. � � � � � � � � fi"x Y' � � :r 1 `�'" � F ,� Safety Policy Table of Contents 1 Objective 1 II Policy I III Applicability 2 IV Implementation 2 V Administration 2 VI Notifications VII Reporting Injuries VIII Process Safety Management/Contractor Responsibilities IX Hazard Identification & Risk Assessment X Working Alone XI Hazard Communications XII Noise Exposure/Hearing Conservation XIII Basic Safety Rules A. General Safety B. General Field Safety C. Leak Survey Safety D. Contract Locating Safety E. Meter Reading Safety XN Ladder Safety XV Emergency Action Plan XVI Fire Extinguisher Program XVII Benzene Awareness XVIII Bloodborne Pathogens XIX Asbestos Awareness XX Confined Space/ Permit Contined Space XXI Electrical Safety: Qualified/Non-Qualified XXII I,ockouUTag-Out XXIII Respiratory Protection XXIV Rigging Material Handling XXV Treching/Shoring/Excavations XXVI Recordkeeping A. Training Records B. Medical Records C. OSHA Records D. Sharps Injury Log XXVII Enfarcement of Safety Policy XXVIII Attachments A. Job Safety Checklist B. Approach Distances for Qualified Employees (Electrical) C. Employee Acknowledgment 1 OBJEC'rNE The Safety Policy of Heath Consultants Incorporated is designed to comply with the Standards of the Occupational Safery and Health Administration, and to endeavor to maintain a safe and injury/iilness free workplace. A copy of the OSHA Safety and Health Standards 1926 and 1910 are available for all employees use and reference. "I'hese Standards shall be available in the home office at all times and will be sent to the jobsite on request. (Also available on OSHA web site at "http://www. osha.gov/index.html") Compliance with the following Safety Policy and all items contained therein is mandatory for all employees of the compariy. 'I'he authorization and responsibility for enforcement in the services business unit has been given primarily to the v:ice president of operation.s through the training & development department. 'The directors of services and project managers share in this responsibility as well. II POLICY It is company policy that accident prevention be a prime concern of all employees. This includes the safety and well being of our employees, subcontractors, and customers, as well as the prevention of wasteful, inefficient operations, and damage to property and equipment. It is the policy of Heath Consultants to provide and maintain safe and healthful working conditions, and to follow operating practices that will safeguard all employees and other persons involved, and result in safe working conditions and an efficient operation. Every employee, supervisar and management member is penonally responsible for reporting hazardous conditioms and unsafe work procedures that can cause injury to fellow employees or damage property. Each employee also has a personal responsibility to act in a safe and responsible manner in all phases of our company's operations, and at all times while c�n company property. Special policy note regarding entry to "confined space:" Heath requires its employees to have proper training and equipme;nt prior to entering a confined space. If you have not received the confined space training, or if you are trained, but do not have the required safety equipment, you must not enter a confined space. Doing so will result in the immediate termination of you.r employment with Heath. 'Total compliance to all rules and regulations set forth in the special and separate confined space training will be adhered to. A Heath identification card with an expiration date will be issued that indicates that the employe:e has had confined space training. III APPLICABILITY This Safety Policy applies to all employees of Fleath Consultants Incorporated, regardless of position within the compam�. The Safety Rules contained herein apply to all subcontractors and anyone who is on a company project site. Every employee is expected to comply with the Safety Policy, as well as OSHA Heaith and Safety Standards. IV IMPLEMENTATION Thiti Safety Policy supports six fundamental means of maximum employee involvement: Management commitment to safety. Minimum frequency of monthly "tool box" safety meetings at all jobsites. Effective job safety training for all categories of employees. Job hazard analysis provided to all employees. Audio and/or visual safety presentations given at jobsites or project meetings by the project manager. Various incentive awards for exemplary safety perfonnance where applicable. The project manager wil] meet with project employees at least once a month to evaluate all areas of safety and m,.�ke recommendations to the company vice president of operations. �' ADMINISTRATION The Safety Policy will be carried out according to guidelines established and published in this and other related procedures. Specific instructions and assistance will be provided by the training and development department as requested. Ea�ch supervisor will be responsible for meeting all of the requirements of the Safety Policy, and for maintaining an effective accident prevention effort within his or her area of responsibility. Each supervisor must also ensure that all accidents are thoroughly investigated and reported to the corporate human resources department on the same day of the occurrenr,e. Violations of the Safety Policy, such as not following verbal or written safety procedures, guidelines, rules, horse play, failure to wear selected PPE, abuse of selected PPE, etc., will result in disciplinary actions up to and including termination. VI NOTIFICATIONS A. In Cuse of Sei-iou.c bijccr-t- or Death After the injured has been taken to the hospital, the supervisor shall notify the corporate human resources olfice and th.e project nianager as soon as possible. Statements from wimesses shall be taken. Statements are to be signed by witnesses and should include the time and date. Photographs of the area where tl�e incident occurred and any other relevaut items are to be taken. The project m�nager will assist in the investigation. 7'he completed accident report form will be tient to th t human resowces of}ice. B. In Cuse of bz.s��ection br OSHA Ins��ector . e corpora e The supervisor must notify the training and development department that an OSHA Inspector is on the _jobsite. It is th.e responsibility of all employees to make the inspectors visit on the jobsite as pleasant and timely as possible. VII REPORTING OF INJURIES While all incidents should be investigated, the extent of such investigation shall reflect the seriousness of the incident utilizin;.t a root cause analysis process or other similar method. Required incidents must be verbally reported to OSHA within 8 hours of their diseovery. Incidents must also be reported to the owner client as soon as possible or in a timely manner (within 24 hours of incident). Individual responsibilities for reporting and investigation must be pre-determined and assigned prior to incidents. Personnel must be trained in their roles and responsibilities for incident response and incident investigation techniques. Training requirements relative to incident investigation and reporting (Awareness, First Responder, Investigation, and traininE; frequency) should be identified in the program. Equipment may include some or all of the following items; wntin�� equipment such as pens/paper, measurement equipment such as tape measwes and rulers, cameras, small tools, audio recorder, PPE, marking devices such as ilags, equipment manuals, ctc. Initial identification of evidenee immediately following the incident might include a listing o1� people, cquipment, a��.nd materials involved and a recording of environmental factors such as weather, illumination, temperature, noise, ventilation, r-:tc. Evidence such as people, positions of equipment, parts, and papers must be preserved, secured, and collected through notes, photographs, witness statements, flagging, and impoundment of documents and equipment. Witness interviews and statements must be collected. Locating witnesses, ensuring unbiased testimony, obtaining appropriate interview locations, and use of trained interviewers should be detailed. The need for follow-up interviews should also be addressed. Incident invesCigations should result in corrective aetions. Written incident reports should be prepared and include an incident report form and a detailed narrative statement concerning the event�s. The format of the narrative report may include an introduction, methodology, summary of the incide�rit, investigation board member names, narrative of the event, findings and recommendations. Photographs, witness statemencs, drawings, etc. should be included. Lessons learned should be reviewed and communicated. Changes to processes must be placed into effect to prevent reoccurrence or similar events. All employees wil] be held accountable for filling out a"Supervisor's Report of Accident" with their supervisor, immediate:ly after an injury occurs, even if inedical treatment is not required. (Notice must be made at or near the time of the injury and on the same day of the injury.) Employees must report the injury to their supervisor. A casual mentioning of the injury will not be sufficient. Failure to report an injury immediately (meaning at or near the time of the injury and on the same day of the injury) is ,3 violation of the Safety Policy, and may result in immediate termination, in accordance with company policy. Supervisors are required to submit the report of accident to their division offices as soon as possible. Notification must be made to the HR department of the injury. If the employee needs medical attention, the supervisor will assist the employee i:n arriving at a medical facility for treatmem (if needed). The supervisor will remain with the employee until the treatment ha:; been completed or employee is admitted into a treatment facility (i.e. hospital). It is the supervisor's responsibility to ensune the employee gets home safely. Once an employee has been released by the treatment facility, the supervisor may be requirer_l to drive the employee to his/her home to ensure their safe arrival. Vehicle accidents where no employee injury has occurred, should be reported on an "Automobile I,oss Report". VIII PROCF,SS SAFE`TY MANAGEMENT/ CONTRACTOR RF,SPONSIBILITIES Each employee must be trained in the work practices nccessary to perform his/her job by Heath Consultants Incorporated. Each employee will be instructed in the known potential fire, explosion or toxic release hazards related to hislher job and the process and the applicable provisions of the emergency action plan. Records which contain the identity of the employee, the date of training & the means used to verify that the emplo.yee understood the training will be maintained in the Human Resources Department. The purpose of Process Safety Management is to prevent or minimi-r.e the consequences of catastrophic releases of tox.ic, reactive, flammable or explosive chemicals during normal work activities we provide to our clients. Employees shall abide by Heath Consultants safe work practices during operations such as: lockoudtagout, confined space entry, opening process equipment or piping, controls over entrance to facility, and PPE reyuirements. Employees shall advise the Heath Consultants of any unique hazards present or found during work activities. Employees shall not perform hot work until a hot work pern�it is obtained from Heath Consultants. The permit shall documc:nt that the fire prevention and protection requirements have been implemented prior to beginning the hot work operations. Employees must immediately report all accidents, injuries and near misses (see Reporting Injuries Section XII). An incide;nt investigation must be initiated within 48 hours. Resolutions and corrective actions must be documented and maintained 5 years. All Heath Consultants employees will respect the confdentiality of trade secret information when the process safe:ty information is released to them. IX HAZARD IDENTIFICATION & RISK ASSESSMENT The hazard identification process will identify potential hazards by the use of Job Safety Analysis (JSA) facility wide or arra specific analysis/inspections. The program is to ensure the fvllowing: To ensure employees are actively involved in the haz.ard identification process, JSA's are to be performed by management personnel while observing employees performing their job functions. Results from JSA's are to be communicated with all employees within that job function. JSA's are to be used for routine and non-routine activities as well as new processes, changes in operation, products or services as appiicable. Identified harards are classified/prioritized and addressed based on the risk associated with the task. Risk analysis will be conducted for probability and severity using past performance measures and management input. Findings will be addressed and mitigated through the Safety Department recommendations, policy revisions, dedicated assignment, implemented controis or appropriate documentation of completion. Einployees will be trained in the hazard identification process ii�cluding the use and care of proper PPE. X WORKING ALONE A hazard assessment shall address hazards and identify control measures in order to minimiz.e nsk associated with working alone. To establish an effective means of communication between the lone employee and designated eheck, radio, cellular or satel;lite phones, electronic monitoring devices or other forms of direct, reliable correspondence will be used. Individuals must be monitored at regular intervals, or the individual contacts the employer at pre-determined intervals based on determinations made in the risk assessment. The management staff is responsible for check-in with the lone employee at regular intervals. A backup form of communication in the event primary correspondence is unavailable will be established using one of the effective means of communication. Documentation of the employee status at the check in intervals must be obtained. Specific procedures for emergency response including provisions for contacting appropriate local officials will be establishf;d based on determinations made in the risk assessment. Employee search will be necessary based on the following criteria: 1) Lone employee check-in not obtained for more than two intervals. 2) Primary and back-up forms of communication failure. XI HA7.ARD COMMUNICATIONS The company has established a written Hazard Communication program. All current and newly hired employees potentially exposed to chemicals must attend a HAZCOM training program. The program was developed to inform and train employe�;�s concerning the use and dangers associated with hazardous chemicals, controlling hazards, proper labeling of containers and understanding the use of Material Safety Data Sheets (MSUS). (See Iiazard Communication Manual) XII NOISE EXPOSURE/HEARING CONSERVATION Heath Consultants shall institute a training program tbr all employees who are exposed to action level noise. The trainir.ig shall be repeated annually for each employee. "Training shall be updated consistent to changes in PPE and work processes. Heath shall make available to affected employees copies of the noise exposure procedures and shall also post a copy in trie workpiace. Heath shall also allow the Assistant Secretary and the Director access to records. Heath shall administer a continuing effective hearing conservation program when employees are exposed to sound leve:ls greater than RS dbA on an 8 hour time-weighted average basis. When information indicates that employee exposure ma.y equal/exceed the 8 hr time-weighted avg. of 85 decibels, the employer shall implement a monitoring program to identif:y employees to be included in the hearing conservation program. 'The employer shall establish & maintain an audiometric testing program by making audiometric testing available to all employees whose exposures equal or exceed an 8-hr. time;- weighted avg. 85 decibels. Within 6 months of an employee's first exposure at or above the action level, the employer shall establish a valid baseline audiogram against which future audiograms can be compared. When a mobile van is used, the baseline shall be established within 1 yr. Testing to establish a baseline audiogram shall be preceded by at least 14 hours without exposure to workplace noise. Hearing protection may be used to meet the requirement. Employees shall also be notified to avoid high levels of noise. At least annually after obtaining the baseline audiogram, the employer shall obtain a new audiogram for each emplo��ee exposed at or above an 8-hour time-weighted average of 85 decibels. F,ach employee's annual audio�ram shall be compared to that employee's baseline audiogram to determine if the audiogram is valid and if a standard threshold shift has occurred.. If a comparison of the annual audiogram to the baseline audiogram indicates a standard threshold shift, the employee shall be informed of this fact in writing, within 21 days of the determination. If a threshold shift has occurred, use of hearing protection shall be re-evaluated and/or refitted and if necessary a medical evaluation may be required. Hearing protection shall be provided at no cost to employee(s). Hearing protection shall be replaced as necessary. Employers shall ensure that hearing protectors are worn. Employees shall be properly trained in the use, care & fitting of protectors. Heath shall evaluate hearing protection for the specific noise environmen�ti in which the protector will be used, shall maintain accurate record of all employee exposure measurements and that all records are maintained as required by the regulation. XIII BASIC SAFETY RULES Your safety and health are very important. Some ways that you can avoid injury are: Learn to recogni-r.e the hazards that cause accidcnts and the ways to get hazards corrected. When you see an unsafe condition or work method, tell your supervisor so that action can be taken before someone gets hurt. If there is doubt about the safety of a job, ask questions. Your supervisor or other employees can help. Become knowledgeable about ail the safety practices of your job. 7'he performance of every job must always be based on the safest practice to protect you, your coworkers, and the general public. A person(s) who has a valid certificate in first aid training, the American Red Cross or equivalent shall be available at work sites to render emergency first aid. Protect yourself. Wear the personal protective equipment required to do the job safely. Provisions shall be made prior to commencement of a project for prompt medical attention in case of serious injury. First aid supplies shall be easily accessible when required. First aid kits shall consist of appropriate items which will be adequate for the environment in which they are used. For construction operations, items shall be stored in a weather proof container with individual sealed packages of each type of item. Employers should ensure the availability of adequate first-aid supplies, and periodically reassess the demand for supplies and adjust their inventories. I'or construction operations, first aid kids shall be checkcd before being sent out to each job and at least weekly.Proper equipment for prompt transportation of the injured person to a physician or hospital or a communication system for contacting necessary ambulance service shall be provided. In areas where 9l 1 is not available 'I'he telephone numbers of the physicians, hospitals or ambulances shall be conspicuously posted. Support safety efforts at your location, get involved; you can make the program work. You have the primary responsibility for your own safety. A. General Safety ]. Compliance with applicable federal, state, counCy, city, client, and company safety rules and regulations i:; a condition of employment. 2. All injuries, regardless of how minor, must be reported to your supervisor and the corporate human resourc:es department immediately. An employee who fails to fill out a" Supervisor's Report of Accident " with their supervisor, and send it to the corporate human resources department can be issued a safety violation nol:ice (Employee Warning Notice) and may be subject to termination, in accordance with company policy. In the event of an at fault accident involving personal injury or damage to property, all employees involved in any way will be required to submit to drug testing. 3. Field technician's clothing must provide adequate protection to the body. Heath uniform shirts with sleeves (shor� or long) and long pants will be worn at all times. No shorts are to be worn on projects. Closed toe shoes are reyuired. 4. All personnel will be required to attend safety meetings and record attendance on the Safety Meeting Report as stipulated by project requirements in order to meet OSHA Safety Standards. 5. Firearms, alcoholic bevera�es or illegal drugs are not allowed on company property or in company vehicics at �my time. When drugs are prescribed by a physician, the immediate supervisor must be informed. "I'he use or possess:ion of illegal drugs or alcoholic beverages on the jobsite will result in immediate termination. 6. Housekeeping shall be an inte��ral part of every job. Supervisors and employees are responsible for keeping th�eir work areas clean and hazard-free. T'his may in some cases be your company vehicle. For Field Office/Shop Keep work area clean and organized. Keep walking areas free from tripping hazards (catpets/cords) Stack material safely and neatly. Do not let objects protrude from a stack, pile, etc. Keep sidewallcs, comdors, and aisles clear. Use trashcans for debris only. Keep oily shop rags and other flammables in a separate safety container. Clean up spills immediatcly. Clean and pick up debris, tools, or other materials regularly and frequently. Be familiar with appropriate evacuation route. Guards shall be in place and operable at all times while the tool is in use. The guard may not be manipulated in such way that will compromise its integrity or compromise the protection in which intended. Guarding shall meet the requirements set forth in ANSI B15.1. Where the eyes or body of any person may be exposed to injurious corrosive materials, suitable facilities shall be provided within the work area For Field Keep a clear path where walking. Wear safety vest. Watch for traffic when in street. Wear work boots or shoes (tennis shoes arc not pennitted). Watch every step especially on unstable ground. Keep the cab and bed of truck free of trash. 7. Ergonomics • Adjust chair height so that your upper legs are horizontal and feet are ilat on floor, adjust chair to sit up strai;_�ht and obtain proper back support. • Avoid tilting or turning head to view computer monitor or to hold telephone. • Ensure forearms and wrists are level and not resting on hard or sharp edges. • Ensure that computer table is just below forearn�/wrist height and that the work station provides adequ,ate legroom. • Place keyboard and mouse at a comfortable distance from body. • Alternate tasks to break up extended periods on the computer. Be sure to stretch and exercise the ne� k, shoulder, and back muscles if sitting for long periods of time at a desk or computer. Stretching releases tension and reduces the chances of muscle strain and fatigue. 8. Drinking water containers if provided are to be used for drinking water and ice only. "Tampering with or placing items such as drink containers in the water cooler may result in immediate termination. The "common dnnkin� cup" is not allowed. Only disposablc cups will be used. � 9. Material Handling and Lifting: Many injuries are caused by improper lifting, carrying too heavy a load, failure to observe proper foot and hand clearances and failure to wear proper protective equipment. • Inspect materials for slivcrs, jagged edges, burrs, and rough and slippery surfaces before handlinc7. • Clear path of hazards. � • Size up the load and plan before lifting. Know where and when you will let the load down. • Keep hands ciean of oil or grease when handling material. • Get help when moving heavy loads. Request assistance in moving office furniture and files. • Be sure you have a secure grip when picking up or lifting. I,et the other persons know what you are going to do, get their response, and then do it. • Break a load into smaller parts, if possible, to make carrying easier. • Do not perform awkward lifts, unnecessary bending, or long reaches. • Do backbends before lifting. • Stand close to the load. • Have firm footing. • Spread your feet apart with one foot in front of the other. • Face the object. • Bend your knees. • Straddle the load as best you can. • Grasp the load firmly. • Tighten stomach muscles. • Take a deep breath. • Lift slowly and smoothly without jerking. • Do not twist body - move feet instead. • Beware of pinch points. • Keep the "S" curve (hollow) in your back by arching the back. • If the load slips from your hands, don't attempt to catch it�! • Hold the load firmly. Keep the load close. • Dodt lift the load higher than needed. • Don't twist with the load. Pivot on your feet if' you must turn with the load. • Keep one foot in front of the other in order to maintain your balance. • Set the load down easily. 10. Hand and Power Tools: Whcther furnished by the employer or [he employee, the tools shall be maintained in a s,:�fe condition. Any tool which is not in compliance with any applicable requirement of this part is prohibited and shall be identified as unsafe by tagging or locking the controls to render them inoperable. Employees using hand and power tools and exposed to the hazard of falling, flying, abrasive, and splashing objects, or exposed to harmful dust, fumes, mists vapors, or gases shall be provided with particular PPE necessary to protect them from the hazard. 11. "Horseplay" on a jobsite is strictly prohibited. Running on the jobsite is allowed only in extreme emergencies. 12. Glass containers or bottles of any kind are not permitted on jobsites or in company vehicles. 13. Fire Prevention: The best fire protection is fire prevention. Observe the following basic rules for a good fire prevention program. Control Ignition Sources • Maintain good housekeeping and observe smoking policy. • Keep electrical equipment in good working order. • No smoking around flammables or excavations. • Ignition sources include but not limited to: Matches, flames, open lights, electrical switches, ares, static electricity, excessive heat or friction, lightning, and cigarettes. Pour flarnmable and combustible liquids from UL approved containers when filling and servicing gasoline powered compressors, generators, and diesel powered engines. Avoid spilling fuel onto hot engines, and keep otrier ignition sources away from fuel. Familiarize yourself with the location, operation, and proper application of all fire extinguishers. Supervisors w�ill ensure that fire extinguishers have an inspection tag and are inspected as required. • Type/size of extinguisher is suitable for intended use. • Unit fully charged. • When possible, check to see if the extinguishing powder is not caked on the bottom of the unit. • Extinguisher has been hydrostatically tested and tagged per recommended code. • Readily accessible and at correct location. Flammable liquid storage and transfer • Keep all flammable or combustible liquids, gasoline, thimiers, etc., in UL or FM approved containers. For quantities of one gallon or less, only the original container or approved metal safety cans shall be used f��r storage and handling of flanunable liquids. No more than 25 gallons of these type liquids will be stared in a building out�tiide a fire resistant cabinet. The cabinet will be labeled "Flammable - Keep Fire Away." •� Flammable liquids will not be used for cleaning or washing. • When pumping flammable or combustible liquids by hand from portable containers or drums, bond with tlie storage and the fill container by attaching alligator clips with a copper wire between the two containers. • Do not punch nail holes in the top of the storage containers. Use an appropriate flammable liquid transfer pump or drum vent. • Do not allow persons with lighted tobacco products to enter the area where flammable liyuids are stored �:�r transferred. l4. Driving Vehicles (See also Company Vehicle Policy Manual): • Only authorized employees will drive a motor vehicle in the course and scope of work or operate a compa:ny- owned vehicle. • Dnvers should be appropriately assessed, licensed, and trained to operate the vehicle. • Drivers shall not operate a motor vehicle while under the influence of alcohol, illegal drugs, or prescription ar over-the counter medications that might impair their driving skills. • Authorized drivers will report any collision or traffic violation while driving on company duties to the appropriate personnel (refer to the Vehicle Safety Policy). • Loads shall be secure and shall not exceed the manufacturer's specifications and legal limits for the vehicle. • 1'he vehicle shall be fit for its purpose. • 7'he vehicles shall be maintained in safe working order. • Seatbelts shall be worn by all occupants at all times whenever a vehicle is in motion. • Authorized drivers will follow safe driving practices utilizing the Smith System Uriving techniques. Drivers must be certified in the Smith System Driving techniques prior to operating a company owned vehicle. • Cell phones shall be used only when safe driving techniques can be followed in accordance with state and ]ocal laws. • When parking, "pull through" or back into the space, unless doing so would create a greater hazard. Wlhen backing your vehicle, get help if possible. Check behind your vehicle before getting in the driver's seat. • When fueling your vehicle leave ali potential ignition sources in the vehicle. i.e. cell phones, pagers, lightr:rs. Never talk on the phone while fueling as this could, in unique circumstances, cause fuel vapors to ign�ite resulting in a fire or explosion and serious injury. 15. Report all unsafe conditions and near accidents to the project manager so corrective action can be taken. 16. All OSHA Safety Standards concerning confined space entry will be followed. SEE SEPARA'TE CONFINI�D SPACE SAPETY PROGRAM IF APPROPRIATE, SECTION XX. B. General Field Safety 1. Poison Piants: Poison ivy: Vine or low shrub. Triple leaflets, edges smooth or irregularly toothed. Berries white or cream colored. Loses leaves for winter. Like sumac and oak, the poison remains on branches and roots. Poison Oak: Shrub 12 to 30" high; sometimes a vine. Tnple leaflets; short, smooth hair underneath. F,arly, berries fuzzy and white; later, dun colored. A plant is dark green spring and summer, bnght red in fall and loses leaves for winter. Poison Sumac: Shrub, 3 to 15" high. Seven to 13 leaflets per stem, smooth edged. Usually in swampy area If you suspect you have been exposed to any poisonous plants, apply the appropriate lotion as soon as possible. Always follow the directions when applying. Clean equipment and clothing with thc appropriate lotion making sure you follow the directions. 2. Dog Bites: It's rare to find a Heath field employee who has never encountered an unfriendly dog while perforn�ing his or her daily work. While some field employecs have managed to avoid unhappy encounters with canines, others have not been so fortun;3,te. This section will hclp you to identify and minimize possibly threatening situations. It is especially true in regard to dog bite prevention that it is better to be anned with information and never need to use it, than the other way around. Iieath Field employees are provided with an umbrella used to create a bamer between themselves and canines. A video demonstration will display the proper use of an umbrella to fend off a dog. Remember the following to help prevent dog bites. Dog I3ite Prevention: • Remember, any dog is a potential biter. • Look for "Bad Dog" signs on gates or fences. • Do not enter a customer's premises if there is a bad dog unless the dog has been securely restrained or is removed from the area. • Never believe a dog's owner who says: "but he wodt bite" ar"I can hold him, don't worry." • Be prepared when entering any premises where a dog is located, never turn you back on the dog and h,:�ve your umbrella ready. • Shout to attract a dog's attention. • Be cautious of dogs on a leash. • Look for dogs in shaded areas in the summer. • Stay calm but be aggressive in defending yourself from a dog with the umbrella. • Talk to others along your route to learn about the locations of bad dogs. • Don't agitate a dog. • Don't offer your hand to a dog or turn your back on a dog. • Dogs always see you as an intruder. • With a firm, crisp, steady voice, tell the dog "No," "Down," or "Go Home." • Kick your knee into its chest or head if the dog leaps at you. • If you are being attacked, stand your ground and brace yourself by turning to the side. T'his will prcvent t:he dog from knocking you over. • The dog umbrella is your best protection. If the dog is attacking, deploy the umbrella --this sound and visual barrier will distract and confuse him. The dog may retreat, not knowing what has just occurred. lf the dog continues attacking, continue holding the umbrella in his face and back away toward the gate c�r a place of refuge. DO NOT TRY "I'O RLJN! In most cases the dog will be faster than you. Remember, a U:�rn umbrella is much easier to repair than an injured leg, etc. • Assume a fetal position with hands over your neck and head if the dog knocks you down. • When you are leaving the yard, do not turn your back on the dog as you are going out the gate. The dog (even a"friendly" dog) may think it has you "on the run" and turn ferocious. If Bitten: • Wash a dog bite wound with soap and water, rinse with wann water, cover with sterile gauze and see; a doctor as soon as possible. • All dog bites should be reported to the police as a safety measure. • Observe details when bitten by a strange dog, such as: What color is the dog'? Does it have a collar? Wl�at size is the dog'? Does the dog have any wounds`? Where did the attack occur'? In what direction did the dog head? Did the dog behave strangely before the attack'? • IYs important to find the dog so that the doctar can determine whether the victim needs anti-rab:ies trearinent. If possible, restrain the dog for animal-control authorities. If there is no passible way to restrain the animal, make sure you can describe the animal and the events. 3. Feet, Footwear and Walking "I�he most common cause of injury for field technicians is injury to the feet or ankles. USE YROPER FOOZ'WEAR. The use of walking boots with lace tops are strongly rccommended, both for protection for the feet and for support of the ankles. Some technicians prefer to wear athletic shoes because they are somewhat cooler in hot weather, but they will often provide inadequate footing on slick surfaces, and provide inadequate protection for the feet and ankles. (In some areas they are prohibited-check with your supervisor.) In addition, use caution in walking. Do not step on an object, especially if you can step over it -- you may not be able to tell if it is sturdy enough to hold you unlil it is too late. If you are not certain about your footing, i.e. a possible slick surface, etc., make an effort to walk in another direction. Waikin� Into Yards -- Homeowners are becoming more cautious about strangers coming into their yards. Shout "GAS COMPANY" or something akin to that before going into the yard. This will alert the owner of your presence as well as inform them as to who you are. This has been known to reduce the number of negative encounters with people. REMEMBER, THE HOMEOWNER EXPECI'S YOU 1'O ACT LIKE A UTILI"I'Y WORKER If the homeowner comes out of the house while you are in the yard, a friendly greeting or a cheerful voice telling them something like "checking or locating the gas lines" or "reading your ineter" will answer the inevitable question, plus keeping the conversation on a positive note. In addition, while in the yard, avoid at all cost looking in the windows. A homeowner who thinks you are "peeping" will at least be panicky or irritated -- and this may net a call to the police, or worse. If a homeowner does not want you to come into the yard, do not try to force the issue -- back off, and report it to the utility company. Chemicals on Lawns -- More and more people are using lawn services to spray chemicals on their lawns. Use caution, as these chemicals, especially the insecticides, are toxic. If you are required to walk across yards that you suspect have been treated with dangerous chemicals, consider the use of rubber soled footwear. Head -- When you are watching where you are walking and where you are placing your instrument probe, it is easy to overlook obstacles that are head-high, such as window air conditioners, branches, or boats or campers, etc. WATCH WHERE YOU ARF.. GOING! Hard hats are required for anyone working in the field. One will be provided for you as a part of the personal protection equipment issued to each employee. Management must wear a hard hat when working in the field. Working in T'raffic -- If you are walking in or on streets or in ]ligh traffic areas, the use of a safety vest and other high visibility clothing is recommended. Although in some instances it may be necessary to work out in the street, the majority of' your work can be done safely and effectively along the curb. In cases where it is necessary to work out in the street, make certain you are FACING TRAFFIC and watching out for cars. A passing driver could get distracted by watching you and not watch where he/she is driving. Ankle sprains and strains. • Consider all ankle injuries as serious. • Immobilize the ankle, use ice, and contact your supervisor for further help and instructions. • If the ankle is sprained or strained, reduce swelling and pain by: Elevating the injured ankle above the heart by about 4-5 inches. Applying an ice pack for the first 24 hours (5 minutes every 30 minutes). Do not allow your foot to dangle over a chair or bed. Excessive fluid can collect in the ankle, which increa.�es the pain and slows the healing. 4. Working Outside: Heat: • Your body is designcd to operate within a fairly narrow temperature range. If your body temperature goes i:oo high, you get sick. • Heat exhaustion is a risk when it is hot. You'll probably get dizzy and sweaty, but iYs not life-threatening. • Heat stroke is much more serious. It is also a hazard in hot conditions, and can send your body temperaturc l�i��h enough to cause confusion, inational behavior, conwlsions, unconsciousness, coma and even death. • Another problem is sunburn or sunstroke from getting too much sun when you are not use to it. Knowing the symptoms of heat stress can keep those symptoms from getting out of hand. I'he symptoms t�at indicate heat stress can also be symptoms of other health problems, but if it's hot and you are working outside, heat stress is probably your prime hazard. You usually start by feeling hot, uncomfortable, and just not ready to do much. 'I'hat's not serious, but i� is probably a sign that you should rest out of the heat for a minute. Here are the symptoms that could indicate a serious problem: Dizziness Rapid heartbeat Nausea Cramps Headache Excessive sweating Chest pain Breathing problems Great weakness Diarnc�a Even worse are these signs of heatstroke: High temperature Hot red, dry skin Rapid pulse • If you have, or see someone with, heatstroke or sunstroke symptoms, assume that any of these symptoms meam a serious problem. Take immediate action if it's hot and you feel weak, dizzy, sweaty or nauseous. Pay attention to cramps and to anyone who tells you that you look pale. • In any of those circumstances, get to a cooler area — shade or a cool building. Lie down, loosen your clothing, and put cool compresses on your skin. Drink fluids. • Action is a must Get medical help. And get yourself — or any victim — to a cool spot and loosen clothing. • It is important to cool the body down quickly. Use cool compresses, water, even a hose for the job. Don't try to give fluids to an unconscious person. • If you get sunburned, rinse or soak with cool water or cold compresses. If you're sunburned, but have;n't blistered, you can use a mild nonmedicated cream. But blisters can be serious; see a doctor. To help prevent heat problems you can: Wear loose clothing Cover as much of your body as possible Wear a brimmed hat in the sun Use sun block and apply it often Eat regular, well-balanced meals Avoid hot or heavy food Don't take salt tablets without a doctor's permission Drink lots of fluids, avoiding alcohol or caffeine Be aware that water, sand and concrete reflect the sun and make it stronger. Cold: • Very cold temperatures, like very hot ones, can be hazardous to your health. But most of the proble;ms associated with cold can be prevented by proper dress and some sensible practices. The two most common hazards in the cold are frostbite and hypothermia. Both are caused by exposure to the cold long enough that your body temperature gets dangerously low. Hypothermia can take you by surprise because you can get it even when the temperatures are above freezi:n�. Windy conditions, physical exhaustion, and wet clothing can all make you more prone to hypothermia. ` With hypothermia, you first feel cold, then pain in the extremities. You'll shiver, which is how the body trie:;� to raise its temperature. Other symptoms include: Numbness and/or stiffness Poor coordination Drowsiness Slow or irregular breathing or heart rate Slurred speech Cool skin Puffy face Confusion Apathy • As you can see, many of these syrnptoms are not unusua] and could mean different things. Sut if you are expos,ed to cold conditions, take them seriously and take steps to relieve them. • "I'he first thing to do is to get where it is warm. Get out of any frozen, wet, or tight clothes and into warm clofhes or blankets. Drink something warm, decaffeinated, and nonalcoholic. • For hypotherniia, call for medical help and keep covered with blankets or something similar. Don't use kiot baths, electric blankets, or hot water bottles. 'To help prevent cold problems you can: Wear layers of loose dry clothing Cotton or wool under layers / waterproof top layer Be sure to cover head, hands, feet and face Dry or change wet clothing immediately Keep moving in the cold Take regular breaks in warm area5 Move to a warm area if you feel very cold or numb Drink warm nonalcoholic decaffeinated beverages Limit exposure to the cold, especially if it's windy or humid 5. Personal Protective Equipment (PPE): • Proper training includes at least, when PPE is necessary, what PPE is necessary; how to properly don, doff. adjus�t & wear PPE; the ]imitations of PPE; the proper care, maintenance, useful life & disposal of PPE_ • Retraining of the employee is required when the workplace changes, making the earlier training obsolete; the type� of PPE changes; or when the employee demonstrates lack of use, improper use, or insufficient skill or understanding. The certification must include the employee name, the dates of training, and the certification subject. • PPE is provided, used and maintained in a sanitary and reliable condition, required by reasons of hazards of processes or environment to protect body parts from inhalation, absorption or physical contact. • If employee-owned equipment is permitted, the employer must be responsible for the assurances of its adequary, maintenance & sanitation. • (Performance of a written and signed hazard assessment.) The hazard assessment must indicate a detern�ination if hazards are present or are likely to be present, which necessitate the use oF PPE. Certifier's name, signature, date(s) & identification of assessment documents. • If hazards are present or likely to be present, selection of, and reasons for selection of PPE should be given to the employee. • Sclected PPE must be fitted to each affected employee, (fitting, including proper donning, doffing, cleaning, and maintenance.) • Defective or damaged PPE shall NOT be used. • Employees using hand and power tools and exposed to the hazard of falling, flying, abrasive, and splashing objects, or exposed to harmful dust, fumes, mis�ti vapors, or gases shall be provided with particular PPE necessary to protect them from the hazard. C. Leak Survey (Gas) Flame Ionization equipment shall be checked daily before being used. All fuel and calibration gas shall be shut off rmd hoses disconnected from bottles and manifolds at the end of the work day. Caps shall be replaced on bottles when ��au�?es are removed. 2. Compressed Gas Cylinders: In working with the Hydrogen Flame Ionization equipment, you are continually exposed to the use of compressed gasscs, such as the "Mother Tank" for the 40/60 Hydrogen/Nitrogen fuel, the lecture bottles for the portable instrument and d1e bottles of calibration gas. Remember, FAMILIARITY BREEDS DISRESPECT. Always maintain your respect lor th��se bottles, as they contain very high pressures of highly flammable fuel. If treated properly, however, they should nevcr present a hazard to you. • Keep valve closed and protective caps on cylinders not in use. • Keep cylinders away from direct flanie, heat and sources of ignition. • Regulators are to be removed from cylinders when not in use. • Use proper lifting methods for cylinders. Do not lifr by the valve or protective cap. • Do not use oil or grease as a lubricant on valves or regulators. Transfillin:.7 -- In transfilling your lecture bottles, always make sure you are using the transfiller that was designed for your instrument. The transfiller has an orifice inside to keep the lecture bottle from filling too fast — if it fills too fast, it may present a hazard due to heat build-up. Make certain you use a wrench to tighten both fittings snug -- to not try to hand tighten them. SEE YOUR INSTRUMENT PROCEDURE MANUAL FOR INSTRUCTIONS AS "I'O HOW TO TRANSFILL. The use of safety glasses while transfilling is recommended. Pressure - Your lecture bottles are certified at 1750 PSI - DO NOT EXCELD 'TI�IS PRESSURE. In order to maintain their certification, mother tanks must be re-tested on a penodic basis. The lecture bottles do not need recertification. 'Transporting - You may be required to transport your mother tank in your vehicle on a periodic basis, at Icast while transferring from one work location to another. NEVER TRANSPORT THE TANK WI"I'I�OUT "I'I�E CAP IN PLACE. "I�he tank should be anchored in a vertical or horizontal position in a location that will be protected. In any case, transport the tank in your vehicle so that it will not roll or slide around, and it will be pmtected in the event of an impact. (Also remember that it is illegal and dangerous to carry any compressed or flammable gas cylinders on board an airplane or checked with luggage.) Handling the 'I�anks - The most dangerous possibility of a tank accident is the top or valve assembly on a mother tank getting broken off. The greatest likelihood of this happening would occur from dropping the tank. A FUI.L "TANK WITH 'T'HE TOP BROKEN OFF HAS BEEN KNOWN TO TRAVEL, IN A ROCKF_.T-LIKE FASHION WITH NOTHING STANDING IN ITS WAY! Temperature -- Avoid storing the tanks in an area in which they could be exposed to high temperatures. The aluminum mother tanks, which are becoming popular for our use because of their relatively light weight, can become distorted if they are exposed to a temperature of 140 degrees Fahrenheit (WHICH CAN OCCUK IN AN ENCLOSED VEHICLE IN DIRECT SUNLIGHT!) "I'he aluminum tanks have a strip of Heat-sensitive paint on them, either around the neck or vertically along the side. If the tank is exposed to high enough heat to be a danger to the tank, this paint will change color. IF THIS fIAPPENS, UO NOT USE THE TANK UNDER ANY CIRCUMS"I'ANCES. IF IT IS POSSIBLE, RELIEVE THE PRESSURI; BY EMPTYING IT INTO AN OPEN AND SAI'E ATMOSPHERE, AND HAVE IT REPLACED IMMEDIATELY. Threads - Routinely inspect the threads on your lecture bottles, transfiller and lecture bottle regulator. If the threads are partially stripped or "pulled" or bent toward the end of the threaded orifice, there is a danger of the fitting coming apart while under pressure. In addition, if one tank, for example, has damaged threads, it will damage the threads on the transfiller and regulator, which in turn will damage the threads on any other tank which it comes in contact with. In addition, BE CAREFUL OF TURNING A FITTING TOO TIGF3'T. THE FITTINGS ARE BRASS (RELATIVELY SOFT) AND CAN EASILY BE DAMAGED BY TIGHTENING THEM TOO MUCH. Also on DP3s and DP4s, check the "O" rings on the bottles and replace if damaged. Can-�g the Tanks -- The steel mother tanks weigh around 66 pounds and the aluminum tank.l weigh around 35 pounds. When it is necessary to move the tanks, especially when carrying them, be careful to avoid back injury. Use a hand truck whenever possible. WHEN LIFTING A TANK, USE WISDOM. KNEEL DOWN, KEEPING THE BACK UPRIGHT: GRASP "THE T'ANK, AND DO THE LIFTING WITH YOUR LEGS. DO NOT BEND OVF,R WHILE CARRYING A TANK. (See section on "Material Handling and Lifting.") 3. Leak Survey (Water) Misuse of the ��eath AQUA SCOPE can cause permanent damage to the ear drums. When using the AQUASCOPE, be sure to have the microphones firmly placed and stationary prior to depressing the "Listen" control switch. Also, be certain that the volume control is set properly so that high volume noise is not directed into the ear through the head set when the "I.isten" control switch is depressed. The position of "4" to "6" is recommended. It is aiso wise to keep in mind that when using the AQUA SCOPE, your ability to hear other noises, such as approaching traf�ic, is severely restricted. For that reason, be sure to visually check your surroundings constantly while surveying. Ii is also advisable to always wear a safety vest when working in traffic areas. 4. Plunger Bar Safety: "I'he plunger bar is designed to make it easy for you to put your test holes in the ground during the course of the le:ak survey. But misused it can inflict great injury on you or someone around you -- DO NOT TAKE THIS INSTRUMEI'�i"I' I=OR GRANTED. Make sure the �uide plu� is ti�ht -- On most of the plunger bars, the insulated coating extends 1/4 to 1/2 inch below the steel threads inside the handle. MAKF, CERTAIN TI�A"I"I'HE GUIDE PLUG IS TURNED INTO THE STEEL HANDLE, NOT JUS"I' THE INSULATED COATING. Failure to do this can cause the bar to come apart when taking it out, and can very easily cause injury. How to put in bar holes. Place the end of the rod on the ground at the point where you want the hole, then position the rod in a vertical position. (UO NOT TRY TO "STAB" THE GROUND AND LOWER THE HANDLE IN ONE MOTION. A MIS-AIMED BAR CAN GLANCE OFF A CURB OR ROCK AND GO THROUGI� YOUR FOO"I'.) Raise the bar with one or both hands then bring the handle down, allowing the weight of the handle to drive the rod into the ground. Do not try to force the bar into the ground by the strength of your shoulders or back -- at the very least you will be working much harder than you have to; and you run the risk of straining a muscle in your shoulders or back, to say nothing of raising blisters on your hands. How to take the bar out of the ground -- Place your feet firmly on the ground, knees slightly bent, and your back straight. Raise the handle with your hands, allowing the weight of the handle to pull the rod out of the ground. Be sure to keep your head clear -- people have been known to knock themselves out by hitting themselves in the chin. How to put in exnanded holes. If the ground is very hard, it may require several downward strokes oi� the handle to put the hole in as deep as you may want it. If this is the case, it may be difficult to pull back out. You can make it easier by bending or "swirling" the bar around every few strokes, to make the hole larger than thc diameter of the rod. "I�his will reduce the "drag" on the side of the rod and make it easier to take out of the ground. Lookin� for other utilities. — In determining where to put your test holes, make certain you watch for any other underground utilities. "READ" THE STREET! The presence of telephone manholes surely indicates the presence of underground cables; these may or may not run straight between the manholes. No overhead power line, or a drop at a power pole, or splice box or transformer, indicates the presence of underground power lines. Watch for curb boxes on the gas and water lines, or any other indications of underground utilities, including 'TV Cable, street lights, traffic lights, hidden "dog fences", sprinkler systems, heated sidewalks, to name a few. IN PUTTING YOUR BAR INTO THE GROUND, BE WATCHFUL FOR ANY UNDUE RESISTANCE IN THE GROUND WHICH MAY BE CAUSED BY AN UNDERGROUND UTILITY, AND INSTANTLY RESPOND BY NOT POUNDING ANYMORE. Lookin� for Test Locations -- In addition to watching for other utilities, look for appropriate locations to insert the rod into the ground by noting 1) expansion joints in concrete 2) broken asphalt or concrete, often indicatin�� a soft underlayment 3) trenches which may be softer than the surrounding area but will probably have a utility underneath. How to carrv the bar -- The most practical way to carry the bar is to grasp the rod about I 2 to 18" below the bottom of the handle, then rest the handle on your shoulder with the bar at a near-vertical angle up to about 45 degrees. MAKE CF,RTAIN YOU GRASP THE ROD FAR ENOUGH DOWN SO THAT YOUR HAND DOES NOT GET PINCHED IN BETWEEN THE ROD AND THE HANDLE. By doing this, you have the end of the rod in front of where you can see it. DO NOT PLACE THE HANDLE OVER YOUR SHOULDER WITH THE ROD BEHIND YOU. YOU WILL BE UNABLE TO WATCF� 1T, AND YOU RUN THE RISK OF INJURING SOMEONE AROUND YOU. Straiehtenin�; the bar — If you bend the rod, make certain you straighten it. This may be done by placing it into a previous hole in the pavement, or in a trailer hitch, etc. on a vehicle bumper, ctc. Do not use a bent rod -- you may be risking injury by doing so, plus the bar may not go into the ground in the direction you want. "Take note, that if you bend the rod once it causes it to lose some of its "temper" and it will bend more easily a second time D. Contract Locating 1. Equipment: Connecting the transmitter—NEVER connect the transmitter directly to power carrying cables without iirst checking for and turning off any power sources if possible. If connecting to a power source with a SURE-LOCK- be ccrtain the model of SURE-LOCK used is capable of being directly connected to live 50-60 hertz power sources up to 240 VAC. All models do not have this capability (Hot Box). Be certain the transmitter POWER is offbefore handling the ciips on the conductive assembly. Some transmitters can deliver over 100 volts of signal which is capable of producing electrica] shock if not carefully handled. Grounding Rod—When using the grounding spike, it should be firmly driven into the soil. When driving the spike always bend at the knees, facing the area you will be working. DO NOT drive or remove the spike while bending at an awkward angle or while having to make a long reach. Always remove the spike slowly and smoothly, without jerking. Shovel Safety: • Shovel edges shall be kept trimmed and handles checked for splinters and cracks. • Gloves should be worn to help prevent blisters or splinters. • Workers should wear safety shoes with sturdy soles. • You should have yow feet well separated to get good balance and spring in the knees. The leg muscle vvill take much of the load. • "To reduce the chance of injury, the ball of'the foot (not the arch) shall be used to press the shovel into the ground. � • If you cannot press the shovel into the ground with one foot, DO NOT attempt jumping on the shovel with both feet to drive the tip in. • DO NOT TRY AND "STAB" THE GROUND. The shovel can glance off of a curb, rock or riser and �cut into your foot. • When digging, be watchful for any undue resistance in the ground which may be caused by an underground utility. Verify that it is not before continuing to dig. • Work with a gentle prying action and dig at an angle, so the shovel will slide along the surface of the wi:re, conduit or pipe. • When lifting dirt out of the hole, don't grip close to the bottom of the shovel or too far at the end of the handle, because this causes strain on your back. Grip in the middle and continue the upward motion of lifting the dirt, ALWAYS KEEPING YOUR BACK STRAIGH7'. • Don't shovel a heavier load than you can lift. 2. Safe Driving: (Also see section VIII) I.ocators clock many hours on the road between locates. Often locators find themselves trying to read a map, read the locate request and drive all at the same time. This is the number one cause of rear end collision involving Utility Locators. YOU SHOULD ALWAYS TAKE 'rHE TIME TO PULL OVER AND GET YOUR BEARINGS STRAIGHT BF,FORE PROCEF.DING. Never leave your vehicle running while out on a job site. The vehicle transmission could somehow engage causing the vehicle to start rolling. This could result in property damage or injury. It could also result in vehicle theft. 3. On-site Hazards: When arriving at a requested location a visual inspection of the worksite is important to first identify any safety hazards in the work area. There are many safety obstacles that may be encountered on the locators work site. . Work is often performed in and around roadways, and around construction equipment. Look for vehicles or equipment moving in your work area and make sure you are visible to the operator. Wearing a brightly colored safety vest will help you be readily visible. A hard hat may also be required when working around construction sites. Always be on the lookout for any work being performed overhead. This could be cranes being used, workers in boom lifts, roofers working on top of buildings and workers on scaffolding, where the danger is being struck by dropped or falling objects. A hard hat can help prevent serious injury. A locator may face unfriendly dogs on the wark site. (See section on "Dog Bites".) Be aware of the many tripping hazards that you might encounter on the work site. Especially while trying to get avvay from other dangers. E. Meter Reading Refer to bullets A& B in this section. XIV LADDER SAFETY • I.adder rungs, clea�s, and steps shall be parallel, level, and unifonnly spaced, when the ladder is in position for use.. • Ladders shall be inspected by a competent person for visible defects on a periodic basis and after any occurrence 11nat could affect their safe use. Defective ladders shall be tagged and placed out of service. • Place ladders on stable, level surface. Do not stand on top two rungs, or top of step ladders. Do not to carry anything in hands that could cause injury in case of fall, and face the ladder when ascending or descending. • The ladder side rails shall extend at least 3 feet (.9m) above the upper landing surface. When ladders are not able to be extended then the ladder shall be secured at itti top to a rigid support that will not deflect. Extension ladclers should be placed at a 4:1 ratio. • Ladders shall not be loaded beyond the maximum intended load for which they were built, nor beyond the manufacturer's rated capacity. • Ladders shall be used only for the purpose for which they were designed. XV EMERGENCY ACTION PI.AN The written emergency action plan is available for review by employees by contacting the Heath Safety I�epartment at the corporate office or the Director of Services in the local district office. (Locations with ] 0 or fewer employee; may communicate the plan orally to employees.) Procedures for reporting a fire or other emergency: Coroorate Office: Employees can activate the alarn► system on any desktop telephone by dialing "9999". The distinct and recogni-r.able evacuation message will then be transmitted throughout the building. Division Office: Employees will sound an alarm by direct voice communication provided all employees can hear the alarnl. F.mergency evacuation, type of evacuation and exit route assignments: All employees must familiarize themselves with the provided evacuation routs, including muster points, based on the type of evacuation alarni that is activated. Safety Leaders are established to assist employees in evacuation procedures. After evacuation, Safety Leaders are to perform head coun�5 at muster points to ensure all personnel have evacuated the building. Review of the emergency action plan with employees will occur: When the plan is developed or the employee is assigned initially to a job. When the employee's responsibilities under the plan change. When the plan is changed. Employees who need more information about ihe plan or an explanation of their duties under the plan can contact the Iieath Safety Department for assistance. XVI FIRE EXTINGUISHER PROGRAM Corporate Policy Statement "I'he Occupational Safety and Health Act of 1970 clearly states our common goal of safe and healthful working conditic�ns. The safety and health of our employees continues to be the first consideration in the operation of this business. Safety and health in our business must be a part of every operation. Without question it is every employee's responsibilir�� at all levels. It is ttie intent of this company to comply with all laws. To do this we must constantly be aware of conditions in all work areas that can produce injuries. No employee is required to work at a job he or she knows is not safe on c�althfuL Your cooperation in detecting hazards and, in turn, controiling them is a condition of your employment. Inform your supervisor immediately of any situation beyond your ability or authority to correct. The personal safety and health of each employee of this company is of primary importance. The prevention of occupationally-induced injuries and illnesses is of such consequence that it will be given precedence over opera�ting productiviry whenever necessary. To the greatest degree possible, management will provide all mechanical and physical facilities required for personal safety and health in keeping with the highest standards. We will maintain a safety and health probram conforming to the best management practices of organizations of this typc. 7'0 be successful, such a program must embody the proper attitudes toward injury and illness prevention not only on the part of supervisors and employees, but also between each employee and his or her co-workers. Only through such a cooperative effort can a safety program in the best interest of all be established and preserved. Uur objective is a safety and health program that will reduce the number of injuries and illnesses to an absolute minimum, not merely in keeping with, but surpassin;, the best experience of operations similar to ours. Our goal is nothing less than zero accidents and injuries. STANDARD PRAC"TICE INSTRUCTION DATE: Julv 3. 2008 SUBJECT: Fire Extinguisher Program REGULA'I'ORY STANDARDS: OSHA - 29 CFK 1910.157 NFPA 10 BASIS: Over 150 major fires occur in workplaces on an annual basis. Fire is the third leading cause of accidental death:� in the United States. The Occupational Safety and Health Administration (OSHA) has established Federal regulations in 29 Code of Federal Regulation (CFR), § 1910.157 for portable fire extinguishers and their use. OSHA has a general directive for employers to maintain a work place free of hazards. Under authority of this directive, OSHA requires that "employers sh.all provide portable fire extinguishers and shall mount, locate, and identify them so that they are readily accessible to employees without subjecting employees to possible injury." OSHA requires that education and training be provided to employees as well. CENERAL: Heath Consultants Inc (HCI) will ensure that potential fire hazards within our facility(s) are evaluated. "I"his standard practice instruction is intended to address comprehensively the issues of; evaluating and identifying potential :Eire hazards, providing fire fighting equipment, and providing training concerning these hazards to employees. RESPONSIBII,ITY: The company Safety Manager is F3oyd Goodman. He is solely responsible for all facets of 1 his program and has full authority to make necessary decisions to ensure success of the program. The Safety Manager is the sole person authorized to amend these instructions and is authorized to halt any operation of the company where there is danger of serious personal injury. Contents of the Fire Extin�uisher Program for Incipient Fires 1. Written Program 2. Selection and Distribution of Fire Extinguishers 3. Labeling Of Fire Extinguishers 4. General Requirements 5. Inspection, Maintenance, And Testing 6. Training And Education Heath Consultants Incorporated Fire Extinguisher Program for Incipient Fires 1. Written Program - HCI will review and evaluate this standard practice instruction: • On an annuai basis • When changes occur to 29 CFR, that prompt revision of this document • When facility operational changes occur that require a revision of this document • When there is an accident or close-call that relates to this area of safety • Review the program any time these procedures fail Effective implementalion of this program requires support from all levels of management within this company. This writ:ten program will be communicated to all personnel that are affected by it. It encompasses the total workplace, regardless of the number of workers employed or the number of work shifts. It is designed to establish clear goals and objectives. 2. Selection and Di�trib � ion - Portable fire extin��uishers shall be providcd for employee use and selected and distribu:ted based on the classes of anticipated workplace fires and on the size and degree of the hazard which would affect their use. Fire extinguishers used by this company are for four classes of fires: Class A Fire Extinguishers - Use on ordinary combustibles or fibrous material, such as wood, paper, cloth, rubber and so:me plastics. Travel distance for employees to any extinguisher is 75 feet (22.9 m) or less. Class B Fire Extinguishers - Use on flammable or combustible liquids such as gasoline, kerosene, paint, paint thinners and propane. Travel distance from the Class B ha•r.ard area to any extinguisher is 50 feet (15.2 m) or less. Class C Fire Extinguishers - Use on energized electrical equipment, such as appliances, switches, panel boxes and po�arer toois. "I�ravel distance from the Class C haz.ard area to any extinguishing agent is 50 feet (15.2 m) or less. Class D Fire Extinguishers - Use on combustible metals, such as magnesium, titanium, potassium and sodium. Travel distance from the combustible metal working area to any extinguishing agent is 75 feet (22.9 m) or less. _. .ab lin� Of Fire Exting �ics,,h r,g - All fire extinguishers used by this company will be labeled in accordance with NF1PA 10, Standard for Portable Fire Extinguishers. Locations where fire extinguishers are mounted will also comply with NFPA 10 for labeling purposes. 4. C'.eneral Rey �ir men - HCI has provided portable fire extinguishers for employee use in the event of an incipient fi��e. All tire extinguishers shall be mounted no higher and no lower than four (4) feet from the floor. The following key persorn�iel have specifc responsibilities. A. Safety Manager Manage the Fire Extinguisher Program. Schedule the proper training for employees. Update the program when necessary. Record and maintain training records. Ensure monthly/annual inspections are being conducted. B. Maintenance Supervisor Replace used and damaged iire extinguisher(s). Reporting to either the Safety Manager or Purchasing that the fire extinguisher has been used or damaged. C. Department and First Line Supervisors Ensure all fire extinguishers are accessible. Ensure employees are aware of where extinguishers are located. Make sure extinguishers are clean and are free from obstructions. Rcport to the Safety Manager that a fire extinguisher has been used or damaged. All fire extinguishers shall be maintained as follows: Numbered to identify their proper location (see attached master list) Fully charged and in operable condition Clean and free of defects Readily accessible at all times Note: HCI will not use portable fire extinguishers using carbon tetrachloride or chlorobromomethane extinguishin� agents. Portable fire extinguishers that have soldered or riveted shell self-generating soda acid or self-generating foam or ;,as cartridge water type portable fire extinguishers which are operated by inverting the extinguisher to rupture the cartridge or to initiate an uncontrollable pressure generating chemical reaction to expel the agent shall be removed from the facillity permanently. 5. In�ection. Maintenance. And Testing - HCI is responsible for the inspection, maintenance, and testing for al] tire extinguishers on the premises. HCI will assure that all portable fire extinguishers are subject to the followin�: Monthly visual inspections Annual maintenance check Six (6) year tear down maintenance Twelve (12) year hydrostatic test Extinguishers are promptly recharged Extinguishers are compatible 6. Training And F.d�cation - The purpose of this section is to establish training procedures which are necessary for the proper use and understanding of a fire and extinguishing the fire. Selected employees will be provided with an educational program to familiarize them with the general principles of fire extinguisher use and the hazards involved with incipient sta.ge fire fighting. Training will require annual updating to ensure the proper procedures are being followed. Initial Training Outlioe A. General principles of a fire B. Hazards employed with an incipient stage fire(s) C. When to "back off' (evacuate) of an incipient stage fire(s) D. General fire principles of a fire extinguisher E. Hazards employed with the use a fire extinguisher F. Use of a fire extinguisher (hands-on) Retraining - Retraining shall reestablish employee proficiency and introduce new or revised control methods and procedut•�es, as necessary. Retraining shall be provided for all authorized and affected employees whenever there is: • A change in job assignment. • A change in machines, equipment or processes that present a new potential fire hazard. • There is a change in the fire prevention procedures. • This employer has reason to believe that there are deviations from or inadequacies in the employee's knowledge or use of fire extinguishers or fire prevention procedures. Training Documentation All training will be documented and each employee's understanding will be subject to a"hands-on" test. Documentation wil] consist of, as a minimum, the employee's name, the trainer's name, the date of the training, and an outline of training provided. Certification - This employer shall certify that employee training has been accomplished and is being kept up to date. XVII BEN7,F,NE AWARENESS 1. Possible locations where employees may be exposed to Benzene during their job functions are: Petroleum refining sites 1�ank Gauging (tanks at producing, pipeline & refining operations) Field maintenance 2. The characteristics of Benzene: Benzene is toxic, colorless, has an aromatic odor, is not soluble in water and is flammable. 3. Some of the health effec�s of Benzene: Eye and skin imtations, short term effects: breathless, imtable, euphoric, etc. 4. Necessary PPE required: Boots, gloves, sleeves, aprons, eic. Eye and face protection. 5. Safety precautions: Benzene liquid is highly flammable and vapors may form explosive mixtures in air. Fire extinguishers must be readily available. Smoking is prohibited in areas where Benzene is used or stored. 6. Specific contingency/emergency plans: Employer should be aware of Owners contingency plan provisions. Employees must be informed where benzene is used in host facility and aware of additional plant safety rules. XVIII BLOODBORNE PATHOGENS Exposure incident means a specific eye, mouth, or other mucous membrane, nonintact skin, or parenteral contact with blood or other potentially infectious material that results from the performance of an employee's duties. Those employers with employee's who might experience an occupational exposure to bloodborne pathogens as a result of their participation in an emergency first-aid response team, but only as a collateral duty, are still required to comply with the followin� standard. Administration of Post-Exposure and Follow-up The Heath Safety Department ensures that health-care professional(s) responsible for employee's hepatitis B vaccination, post-exposure evaluation, and follow-up are given a copy of OSHA's bloodborne pathogens standard. 'I'he Heath Safety Department ensures that the health-care professional evaluating an employee after an exposure incid''�ent receives the following: A dcscription of the employee's job duties relevant to the exposure incident Route(s) of exposure Circumstances of exposure If possible, results of the source individual's blood test Relevant employee medical records, including vaccination status The Heath Safety Department provides the employee with a copy of the evaluating health-care professional's written opin:ion within 15 days after completion of the evaluation. Procedures for Evaluating the Circumstances Sunounding and Exposure Incident "I'he Heath Safety Department will review the circumstances of all exposure incident to determine: Engineering controls in use at the time Work practices followed A description of the device being used (including type and brand) Protective equipment or clothing that was used a the time of the exposure incident (gloves, eye shield) L,ocation of the incident (OR, ER, patient room) Procedure being periormed when the incident occurred Employee's training The Heath Safety Department will record all percutaneous injuries from contaminated sharps in a Sharps Injury Log. If revisions to this ECP are necessary the Heath Safety Department will ensure that appropriate changes are made. (Chan;;es may include an evaluation of safer devices and adding employees to the exposure determination list.) Employee Training All employees who have occupational exposure to boodborne pathogens receive initial and annual training conducted by the Heath Safety Department. All employees who have occupational exposure to bloodborne pathogens receive training on the epidemiology, symptoms, and transmission of bloodborne pathogen diseases. In addition, thc training program covers, at a minimum, the following elements: 1) A copy and explanation of the OSHA bloodborne pathogen standard. 2) An explanation of our ECP and how to obtain a copy. 3) An explanation of inethods to recognize tasks and other activities that may involve exposure to blood and OPIM, including what constitutes an exposure incident. 4) An explanation of the use and limitations of engineering controls, work practice, and PPE. 5) An explanation of types, uses, location, removal, handling, decontamination, and disposal of PPE. 6) An explanation of the basis for PPE selection. 7) Information on the hepatitis B vaccine (including information of its efficacy, safety, method of administration, and the benefits of being vaccinated) and that the vaccinc will be offered free of charge. 8) Information on the appropriate actions to take and persons to contact in an emergency involving blood or OPIM. 9) An explanation of the procedure to follow if an exposure incident occurs, including the method of reparting the incident and the medical follow-up that will be made available. 10) Information on the post-exposure evaluation and follow-up that the employer is required to provide for the emplo�ree following an exposure incident. l 1) An explanation of signs, labels, and color coding required by the standard and used at this facility. l2) Employers who have personnel trained in First Aid and are expected to provide emergency care. 13) Under circumstances in which differential between body fluids is difficult or impossible, all body fluids will be considered potentially infectious. 14) If provision of hand-washing facilities are not feasible, the employer shall provide either an appropriate antise�-�tic hand cleanser in conjunction with cloth/paper towels or antiseptic towelettes. 15) Specimens of blood or other potentially infectious materials must be put in leak proof bags for handling, storage ,_ind transporl. 16) All equipment or environmental surfaces shall be cleaned & decontaminated after contact with blood or ot:her infectious materials. 17) An opportunity for interactive questions and answers. When the possibility of occupational exposure is present, PPE is to be provided at no cost to the employee such as gloves, gowns, etc. PPE shall be used unless the employer shows that employees temporarily declined to use PPE under rare circumstances. The employer shall ensure that appropriate PPE in the appropriate sizes is readily accessible. PPE should. be cleaned, laundered & properly disposed. The employer shall repair & rcplace PPE as needed to maintain its effectiveness. Training materials for this facility are available at the Heath Safety Department offices. XIX ASBESTOS AWARENESS Asbestos awareness training is required for employees whose work activities may contact asbestos containing material (ACM) or presumed asbestos containing material (PACM) but do not disturb the ACM or PACM during their work activities. Asbestos materials are used in the manufacture of heat-resistant clothing, automotive brake and clutch linings, and a variery of building materials including insulation, soundproofing, floor tiles, roofing felts, ceiling tiles, asbestos-cement pipe and sheet, and fire-resistant drywall. Asbestos is also present in pipe and boiler insulation materials, pipeline wrap and in sprayecl-on materials located on beams, in crawlspaces, and between walls. Exposure to asbestos has been shown to cause lung cancer, asbestosis, mesothelioma, and cancer of the stomach and colon. Signs and labels shall identify the material which is present, its location, and appropriate work practices which, if follov✓ed, will ensure that asbestos containing material (ACM) and/or presumed asbestos containing material (PACM) will not be disturbed. If employees working immediately adjacent to a Class I asbestos jobs are exposed to asbestos due to the inadeq�.iate containment of such job, their employer shall either remove the employees from the area unti] the enclosure breach is repaired or pertorm an initial exposure assessment. XX CONFINED SPACE / PERMIT CONFINF,D SPACE Fach affccted employee must be trained prior to initial assignment, prior to a change in assigned dutics, if a new hazard ]has been created or special deviations have occurred. The certification shall include employee name, trainer signature/initials, dates of training. Certification must be made available to employees & their authorized representative. The work area must include provisions & procedures for pedestnan, vehicle & other barriers as necessary to protect entrants from external hazards & a method for verifying that conditions in the permit space are acceptable for entry during its duration. An attendant must be on duty outside the confined space for the duration of entry operations. A single attendant will monitor no more than one confined space at any time. Entrant, Attendan�ti and Entry Supervisor definitions: An "entranP' is the employee who will enter the confined space to perform a certain task. This employee must be trained to perform the task as well as the entry and exit procedures of the confined space. The entrant also participates in testing of �:the atmosphere and must sign the entry permit stating he has performed the atmospheric testing. An "attendant" is an employee who monitors the confined space from above ground. The attendant is not allowed to enter ithe confined space for any reason and is to provide monitoring of the public or vehicular traffic and atmospheric conditions using testing equipment prior to and during the work to bc performed. "I'he attendant is to also summon emergency personnel in the event of an emergency, prevent unauthorized entry into the conf ned space, and provide first aid if necessary. An "entry supervisor" is an employee who ensures the confined space permit is completed prior to any work being perforn��ed within the confined space. The entry supervisor must address preparation, issuance, use, termination or cancellation of the entry permit. Entry permit means the written or printed document that controls entry into a confined space. Pern;�its completed by Heath Consultan�s are for Heath Consultant employees only. No other employees from other employers :�re allowed to enter the confined space on the IIeath Consultants permit. Employees, or their representatives, must be given an opportunity to request the space be re-evaluated. Entrants or their representatives are given an opportunity to participate in and review calibrated air monitoring data before entry. Review and revision of the pennit space program, using tl�e canceled permits retained within 1 year after each entry, as necessary, will ensure that employees are protected. Note: A single annual review covering al] entries performed during a I 2- month period may be performed. If no entry is performed during a 12-month period, no review is necessary. Rescue services must be either: Provided by the host facility, or Provided by an ou�tiide service which is given an opportunity to examine the entry site, practice rescue, and decline as appropriate, or Provided by the employer by selecting a rescue team that is equipped and trained to perform tlle needed rescue services. Heath Consultants will not enter a confined space where immediately dangerous to life and health (IDLH) conditions are present while work is being performed. XXI EI.ECTRICAL SAFETY: QUALIFIED / NON-QUALIFIED Training requirements for employees in safety related work practices that pertain to their respective job assignments: (Iie.ath Consultants employees are considered Non-Qualified individuals and must adhere to the following requirements) Safe wark practices shall be employed to prevent electric shock or other injuries resulting from either direct or indirect electrical contacts when work is performed near or on equipment or circuits which are or may be energized. Conductors and parts of electrical equipment that have been de-energized but not been locked or tagged out shall be treated as live parts. While any employee is exposed to contact with parts of fixed electric equipment or circuit5 which have been de- energized, the circuits energizing the parts shall be locked out or tagged or both, (see I.ockout/'I'ag-out procedures, Section XVIII). "I'he LockoudTag-out procedure applies to work performed on exposed live parts (involving either direct contact or by means of tools or materials) or near enough to them for employees to be exposed to any hazard they present. Only qualified persons may work on electric circuit parts or equipment that has not been de-energized. Such persons shall be made familiar with the use of special precautionary techniques, PPE, insulating & shielding matenals, and insulated tools. Vehicular and mechanical equipment: Any vehicle or mechanical equipment capable of having parts of its structure elevated near energized overhead lines shall be operated so that a clearance of lOft. is maintained. If the voltage is higher than SOkV, the clearance shall be increased 4 in. for every l OkV over that voltage. However, under any of the following conditions, the clearance may be reduced: If the vehicle is in transit with its structure lowered, the clearance may be reduced to 4 ft. If the voltage is higher than SOkV, the clearance shall be increased 4 in. for every l OkV over that voltage. If insulating barriers are installed to prevent contact with the lines, and if the barriers are rated for the voltage of the line being guarded and are not a part of or an attachment to the vehicle or its raised structure, the clearance may be reduced to a distance within the designed working dimensions of the insulating barrier. If the equipment is an aerial lift insulated for the voltage involved, and if the work is performed by a qualified person, the clearance( between the un-insulated portion of the aerial lift and the power line) may be reduced to the distance given in "Approach Distances" table, Attachment B. Employees standing on the ground may not contact the vehicle or mechanical equipment or any of its attachments, unless: The employee is using protective equipment rated for the voltage, or The equipment is located so that no un-insulated part of its structure (that portion of the structure that provides a conductive path to employees on the ground) can come closer to the line than permitted. If any vehicle or mechanical equipment capable of having parts of its structure elevated near energized overhead lines is intentionally grounded, employees working on the ground near the point of grounding may not stand at the grounding location whenever there is possibility of overhead line contact. Additional precautions, such as the use of barricades or insulation, shall be taken to protect employees from hazardous ground potentials, depending on earth resistivity and fault currents, which can develop within the first few feet or more outward from the grounding point. When working under overhead ]ines, the ]ines shall be de-cnergi-r.ed and grounded or other protective measures shall be provided before work is started. Unqualified employee clearance distances are 10' for SOkV plus 4" for every additional l OkV. Employees may not enter spaces containing exposed energized parts unless illumination is provided that enables the employees to work safely. Protective shields, protective barriers or insulating materials as necessary shall be provided while working in confined or enclosed work spaces where electrical hazards may exist. Portable ladders shall have non-conductive side rails (see Section XI Ladder Safety for more info). Conductive items of jewelry or clothing shall not be worn unless they are rendered non-conductive by covering, wrapping or other insulating means. XXII LOCKOUT / TAGOUT The following procedures will be followed to lockout and tag-out energy sources prior to any maintenance or repair work performed on equipment or in work areas where the potential for equipment to become energized: Potential energy may include any source of electrical, mechanical, hydraulic, pneumatic, chemical, thermal, or other energy. LockoudTag-out devices shall indicate the identity of the employee applying the device. Supervisors shall perform periodic inspections to ensure procedures and requirements are being followed. certified review of the inspection including date, equipment, employees & the inspector should be documented. Before an authorized or affected employee turns off a machine or equipment, the authorized employee shall have knowledge of the type & magnitude of the energy, the hazards of the energy to be controlled, & the methods or means to control the energy. The machine or equipment shall be tumed off or shutdown using the procedures established for the machine or equipment. An orderly shutdown must be utilized to avoid any additional or increased hazard(s) to employees as a result of the equipment stoppage. All energy isolating devices that are needed to control the energy to tlie macliine or equipment shall be physically located & operated in such a manner as to isolate the machine or equipment from the enerQy source. Following the application of lockout or tag-out devices to energy isolating devices, all potentially hazardous stored or residual energy shall be relieved, disconnected, restrained & otherwise rendered safe. If there is a possibility of re-accumulation of stored energy level, verification of isolation shall be continued until the servicing or maintenance is completed, or until the possibility of such accumulation no longer exists. Prior to starting work on machines or equipment that have been locked or tagged out; the authorized employee shall verify that isolation & de-energization of the machine or equipment have been accomplished. Groups of workers in different crais, departments, etc. shall be notified of the lockoubtag out of any equipmcnt within the area or any employee who enters the area at the time the equipment is locked out/tagged-out. Notifications should afford the group of employees a leve] of protection equal to that provided by a personal lockout or tag-out device. The authorized employee should ascertain the exposure status of individual group members. Each employee shall attach a personal lockout or ta� out device to the group's device while he/she is working & then removes it when finished. During shift change or personnel changes, there should be sutiicient notifications to ensure the continuity of lockout or tag-out procedures. Documentation should be specific. The training must include recognition of hazardous energy source, type & magnitude of energy available, methods & means necessary for energy isolation & control. Each authorized employee shall receive adequate training. The training should address that all affected employees are instructed in the purpose & use of the energy control procedure. There should be training provisions included for any other employee whose work operations are or may be in an area where energy control procedures may be utilized. The employee training should also address when tag-out systems are used including the limitations of a tag (tags are waming devices & do not provide physical restraint). 'I'he training should also include that a tag is not to be removed without authorization. The tag is never to be ignored or defeated in any way. Retraining is required when there is a change in job assignments, in machines, a change in the energy control procedures, or a new hazard is introduced. All training and/or retraining must be documented, signed & certified. � XXIII RESPIRATORY PROTECTTON The employee must be trained in the knowledge of respirators, tit, use, limitations, emergency situations, wearing, fit checks, maintenance & storage, medical signs & symptoms of effective use, and �eneral requirements of the OSHA standard. "The training must be provided before requiring the employee to use the respirator and annually thereafter. Respirators are to be used when engineering control measures are not feasible or during emergency situations with high exposure. Respirators shall be provided which are applicable and suitable for purpose intended (exposure to harmful vapors or oxygen deficient atmospheres). "The respiratory program administrator shall be the Heath Safety Manager who is knowledgeable of the complexiry of the program, able to conduct evaluations and have the proper training. Kespirators are required to be provided free to the employee. Hazards must be identified and NIOSH certified respirators must be selected and provided based on those hazards and factors affecting performance. Medical evaluation prior to fit-testing must be confidential, during normal working hours, convenient, understandable, and the employee given chance to discuss results with the physician or other licensed health care professional (PLHCP). Employees are required to pass qualitative fit test (QLFT) or quantitative fit test (QNFT) before initial use, if a different respirator is used, and annually. Anything that can affect the seal must be prohibited and include facial hair, glasses, etc. Respirators with tight fitting face pieces shall not be worn by employees who have facial hair that comes between the sealing surface of the face piece and the face or that interferes with valve function. The program administrator must address appropriate surveillance, and ensure employees leave the area to wash, change cartridges, or if they detect break-through or resistance. Working in IDLH atmospheres is not allowed. Respirators are required to be provided in a clean and sanitary manner using manufacturer's procedures. Storage shall include protection from damage or contamination. For emergency use respirators; stored accessible, clearly marked. Inspections shall be performed in the following intervals for the rated respirator: Routine use - before use and during cleaning. Emergency use- monthly, and before and after each use. Escape-only use - before being carried into workplace. XXIV RIGGING MA'I'ERIAL HANDLING Kigging equipment shall be inspected to ensure it is safe. Rigging equipment for material handling shall be inspected prior to use on each shift and as necessary during its use to ensure that it is safe. Defective equipment shall not be used and removed from service immediately. Rigging eyuipment shall not be loaded beyond its recommended safe working load and load identification shall be attached to the rigging. ° Rigging equipment not in use shall be removed from the immediate work area so as not to present a hazard to employees. Tag lines shall be used unless their use creates an unsafe condition. Hooks on overhaul ball assemblies, lower load blocks, or other attachment assemblies shall be of a type that can be closed and locked, eliminating the hook throat opening. Alternatively, an alloy anchor type shackle with a bolt, nut and retaining pin may be used. All employees shall be kept clear of loads about to be lifted and of suspended loads. XXV TRENCHING / SHORING / EXCAVATIONS T�he location of underground installations shall be determined before excavation. When utility companies or owners can�iot respond to a request to locate underground utility installations within 24 hours, or cannot establish exact location of these installations, the employer may proceed, provided the employer does so with caution and provided detection equipment or other acceptable means to locate utility installations are used. Trench excavations shall have ramps, ladders, stairs, etc.; the means of egress must be within 25 feet of lateral travel :For employees. For exposure to public traffic, the employees shall be provided reflective vests, etc. There should be some me.ans to protect against falls from walkways or pedestrian crossings. Examples could include railings or guardrails. Employees should not work under loads of digging equipment where loads may fall. Employees must be protected from water accumulation, including the use of shields, and must be inspected by a competent person before work begins. Competent persons should examine the possibility of cavc-ins, failures or protective systems, etc. If problems are found, provisions should be made for immediate personnel removaL The competent person should be specified and his du�ties described. Duties might include: inspections prior to entry, atmospheric testing, and removal of workers if conditions dicU3�te. Tests should be conducted for air contaminants (oxygen, flammable gases, etc. and provide ventilation where necessary. Soil classifications must be determined by testing and protective systems designed according to soil classifications. XXVI RECORUKEEPING A. Training Records Training records are completed for each employee upon completion of training. These documents will be kepy for at lf°ast three years at Heath Consultants Iluman Resources ofiices. The training records include: The dates oi the training sessions The contents or.a summary of the training sessions The names and qualifications of persons conducting the training The names and job titles of all persons attending the training sessions Employee training records are provided upon request to the employee's authorized representative within I S working days. Suck requests should be addressed to Heath Safety Department. B. Medical Records Medical records are maintained for each employee with occupational exposure in accordance with 29 CFR 1910.10.?0, "Access to Employee Exposure and Medical Records." Heath Human Resources Department is responsible for maintenance of the required medical records. "I�hese confidential records are kept in the Heath Human Resource Department Offices for at least the duration of employment plus 30 years. Employee medical records are provided upon request of the employee or to anyone having written consent of the emplo;��ee within 15 working days. Such requests should be sent to the Heath Safety Uepartment. C. OSHA Recordkeeping An exposure incident is evaluated to determine if the case meets OSHA's recordkeeping requirements (29 CFR 1904). T'his determination and the recording activities are done by Heath's Human Resources Department. D. Sharps Injury I.og In addition to the 1904 recordkeeping requirements, all percutaneous injuries from contaminated sharps are also recorded i:n a Sharps Injury I.og. All incidences must include at least: Date of injury Type and brand of device involved (syringe, suture needle) Department or work area where the incident occurred Explanation of how the incident occurred This log is reviewed as part of the annual program evaluation and maintained for at least five years following the end of the calendar year covered. Ii'a copy is requested by anyone, it must have any personal identifiers removed from the report. XXVII ENFORCEMF,NT OF SAFETY POLICY Safety violation notice(s) shall be issued to any employee, subcontractor, or anyone on the jobsite violating the safety rule;; or regulations by the project manager or supervisor. Project Managers or Supervisors will meet with employee(s) to discuss the infraction & inform individual(s) of the rule or procedure that was violated and the corrective action to be taken. Any violation of safety rules can result in suspension or immediate termination. Any employee receiving three (3) written general violations within a six (6) month period shall be terminated. Issuance of a safety violation notice for failure to use any required safety equipment or for failure to report a job injury (at the time of the injury) may result in immediate termination, in accordance with company policy. It is understood that Heath Consultants Incorporated is not restricting itself to the above rules and regulations. Additional rules and regulations as dictated by the job will be issued and posted as needed. If you have any questions regarding any of these policies contact yow supervisor. JOB SAFETY CI�ECKLIST ATTACHMENT A The following Job Safety Checklist has been condensed and edited from the Occupational Safety and Health Act, Part 19:?6, Construction Safety and IIealth Regulation.5. NOTE: Not all items required in all job functions. A. Safety Rules Shirts with sleeves worn. Closed toe shoes worn. -- _ Work areas safe and clean. _ No use of alcoholic beverages or controlled substances. _ Drug testing of employees involved in accident(s) resulting in personal injury or property damage. B. Recordkeeping OSHA poster "You Have a Right to a Safe and Healthfu] Workplace" posted. OSHA " 300 Log of Occupational Injuries and Illnesses" posted from February 1 to Apri130 only. Safety meeting sign-in logs (Attachment C) maintained in a folder with a copy forwarded to the corporate ofl�ice weekly. C. Housekeeping and Sanitation General neatness. Regular disposal of trash. _ Passageways, driveways, and walkways clear. Waste containers provided and used. Adequate supply of drinking water. Sanitary facilities adequate and clean. Adequate ventilation. D. First Aid First aid stations with supplies and equipment. "The expiration dates of supplies checked monthly. Expired supplies discarded. Trained first aid personnel. Injuries promptly and properly reported. E. Personal Protective Equipment Hard hats. Eye and face protection. F. Fire Protection Fire extinguishers charged and identified. "No Smoking" signs posted. Flammable and combustible material storage area. Fuel containers labeled. G. Hand Tools Tools inspected. H. Flame Ioni7.ation Fuel Compressed gas cylinders secured in vertical position. __ _ __ Hoses inspected. _ Cylinders, caps, valves, couplings, regulators, and hoses free of oil and grease. _ _ Caps on cylinders in storage in place. I. Motor Vehicles __ _ Lights, brakes, tires, horn, etc., inspected at regular intervals. -- _ No overloaded vehicles. _ ____._--- No riding on the edge of or in pickup truck beds. Fire extinguishers installed and readily available. Seat belts worn at all times. _____ Proper labeling and safety decals present. ("How's My Driving") ATTACHMENT B ELECTRICAL SAFETY QUALIFIED/NON-QUALIFIED EMPLOYEES APPROACH DISTANCE TABLE Voltage Range (Phase To Phase) Minirnum Approach Distance 300V and less Avoid Coniact Over 300V, not over 750V 1 ft. 0 in. (30.5 cm) Over 750V, noi over 2kV 1 ft. 6 in. {4b cm) �ver 2kV, not over 15kV 2 ft. 0 in. (61 cm Over 15kV, not over 37kV 3 ft. 0 in. (91 cm Over 37kV, not over 87.SkV 3 ft. 6 in. (107 cm Over 87.SkV, not over 121kV 4 ft. 0 in. (122 cm Over 121 kV, not over 140kV 4 ft. 6 in. ( i 37 cm ATTACHM ENT C Safety Manual EMPLOYEE ACKNOWLEDGMENT I state that I have attended safety orientation, and have read and received a copy of the Heath Consultants Incorporated safety rules and regulations. I further state that I understand these rules and acknowledge that compliance with the safety rules and regulations is a condition of employment. If I violate the safety rules or fail to report an injury to my supervisor immediately, I understa.nd that I am subject to termination, in accordance with company policy. - ---- - . _ EMPI,OYEE NA1v1E (PRINTED AND SIGNATURE) DATE SUPLRVISOR NAME (PRINTED AND SIGNATURE) DATE cc: Supervisor Human Resources SECTION TEN PRICING AND REQUIRED BID DOCUMENTS Heath Consuitants Incorporaied HEATI� CONSULTANTS INCORPORAT�I3 LINE LOCATING 04-13: GAS DISTRIBITTION MAIN & SERVICE LINE LQ�CATING PRICING SHEET •$8.75 Per Ticket for Pan�llas �ounty ����� �� nf�jT L�� _ ._ �._..,.,� _...._....-.,__.,____.�.� • $8.75 Per Ticket for Pascc� �ounty •$8.75 Per Emergency 'I'icke� during narmal business hours for Pinellas County �$8.75 Per Emergency Tac�et during normal business �eaurs for Pasca County Corpocate Headquar�ers: 9(}30 Monroe Road, Houston, Texas 77a6�-5229 Phone: (7i31 844-1300 • Fax: (7t3) 844-i309 PROPOSAL TO: City of Clearwater (d/b/a Clearwater Gas System) The following proposal is submitted in accordance with RFP #04-13, inviting proposals to be received until 1 1/ 21 /.1 2 for the "Natural Gas Distribution Main & Service Line Locating". Having carefully examined the RFP document and being familiar with the various conditions of the work, the undersigned herein agrees to furnish all materials required and to perfoim all labor necessary to satisfactorily complete such work. Accompanying this proposal is a Certified or Cashier's Check or Bid Bond in the amount of ten percent (10%) of the bid total drawn upon the bid bond, Traveler' s BANK and made payable to the City of Clearwater, to serve as bid security. The undersigned hereby certifies that this proposal is genuine and not sham or collusive, or made in the interest or in behalf of any person, firm, or corporation not herein named and that the undersi�med has not directly or indirectly induced or solicited any other bidder to submit a sham bid, or any other person, firm or corporation to refrain from bidding, and that the undersigned has not in any manner sought by collusion to secure for himself an advantage over any other bidder. ATTEST: { i t �,' ! ' r r °��'.� �='�, t �'1 � r � �:� ca`, .� ,wr.,�5�:- .�° r�, fi r �;�>� , , Corporate Secretary AFFIX CORPORATE SEAL, if a corporation i� Heath.Consultants Incorporated Bidder's Business Name ,� �, . � By �� f/+,/� E `_�i � Officer (or Principal) Senior Vice President Title Business Address: 9030 Monroe Road Houston, TX 77061 Business City/State/Zip Code 713-844-1300 Business Telephone Number CONTRACTOR'S AFFIDAVIT STATE OF FLORIDA COUNTY OF Before me, the undersigned, a Notary Public, duly commissioned, qualified and acting in and for said County and State personally appeared Paul Wehnert (Individual, Partner, or duly authorized representative of Corporate Contractor) who being duly sworn according to law deposes and says that all labor, material and outstanding claims and indebtedness of whatever nature arising out of the performance of the contract of the (Owner) with HeatYL_C�nG»ltant� Tnc-orp�rated (Contractor)havebeenpaidinfull. (Individual, Partner, or duly authorized representative of Corporate Contractor) Sworn to and subscribed before me this' `_��ay of `� � , 201• . . . •R '. Notary Public � f.�o�Y °��� � i�?�,NCY LEE � 2 .z��' ;C�iARY PUBLIC t � * State o! 7ezas � SEAL ? Jl���"''� �mm. Exp. 12/22/2012 � .. - , <..,..�- � „�....�,...9.....�.......r Commission expires: __ ° � ` ` • � lb CONTRACTOR'S RELEASE KNOW ALL MEN BY THESE PRESENTS that Paul Wehnert a Contractor in the County of Harri s and State of m__PXa�__ , do hereby acknowledge that Heath Consultants (Contractor) this day has had and received of and from the City of Clearwater, the sum of One Dollar and other valuable consideration in full satisfaction and payment of all sums of money owing, payable and belonging to (Contractor) by any means whatsoever, for on account of a certain agreement between the said City of Clearwater and Heath_ Consultants Incorporated_ (Contractor) dated. NOW THEREFORE, the said Heath Consultants (Contractor)(for myself; my heirs, executors and administrators)(for itself, its successors and assigns) do by these presents remise, release, quitclaim and forever discharge the said City of Clearwater, its successors and assigns, of and from all claims and demands arising from or in connection with the said agreement dated , and of and from all, and all manner of action and actions, cause and causes of action and actions, suits, debts, dues, sums and sums of money, accounts, reckonings, bonds, bills, specialties, covenants, contracts, agreements, promises, variances, damages, judgments, extents, executions, claims and demand, whatsoever in law or equity, or otherwise which against the said City of Clearwater, its successors or assigns, the Contractor, its heirs, successors and assigns ever had, now have, or which (I, my heirs, executors, or administrators)(it, its successors and assigns) hereafter can, shall or may have, for, upon or by reason of any matter cause or thing whatsoever, from the beginning of the world to the date of these presents. IN WITNESS WHEREOF, presents to be duly executed the _ day of� Signed, Sealed and Delivered in the presence of: ATTEST: � ��_ _, < , � � ���� �� =z . -.s � '. �`� ��'� r�-~x° `,_. � (Secretary) . TE SEAL, , <: : _ (Contractor) has caused these 201 (SEAL) (Individual Contractor) (SEAL) (Partnership Contractor) (SEAL) (Partner) � � �, ;H�ath Ct�nsult,ants Incc�rporated ° �(Cbkporation) si /, !� � � Y/�i ` � �f � �i By 1 �ir �.r.:. � (President•or Vice President) BID BOND TRAVELERS CASUALTY ANQ SURETY COMPANY OF AMERICA, Hartford, Connecticut 06183 KNOWN ALL BY THESE PRESENTS, That we, HEATH CONSULTANTS, INC, a::> Principal, and Travelers Casualty and Surety Company of America, as Surety, are helc:l and firmly bound unto CITY OF CLEARWATER - FLORIDA, as Obligee, in the sum o�f Twenty Eight Thousand Eight Hundred Seventy Five Dollars ($28,875) for the paymen� of which we bind ourselves, and our successors and assigns, jointly and severally, a::� provided herein. WHEREAS, Principal has submitted or is about to submit a bid to the Obligee on <;� contract for NATURAL GAS DISTRIBUTION MAIN & SERVICE LINE LOCATINC:� ("Project"). NOW, THEREFORE, the condition of this bond is that if Obligee accepts Principal's bid, and Principal enters into a contract with Obligee in conformance with the terms of thE� bid and provides such bond or bonds as may be specified in the bidding or contrac1r documents, then this obligation shall be void; otherwise Principal and Surety will pay tc:� Obligee the difference between the amount of Principal's bid and the amount for whict�i Obligee shall in good faith contract with another person or entity to perform the work; covered by Principal's bid, but in no event shall Surety's and Principal's liability exceec;l the penal sum of this bond. Signed this day of , 2012. #1EATH CONSULT � '' ' P �� ,' ' ` ' ('/ � ��} ! � i %; By: �,r; �� �' r � � � �;7 �[�t i .1 . ITS, INCORPORATED ipal) ; ;' Travelers Casualty and Surety Company of America � ;, , ��!`�/r.��.. ; i�.�.14 � �t/�G�.C2-'' By: __� Mary Helen Buras, Attorney-in-Fact -__�_���---�_- --- -- _.�_ ----- - _ . _-__ -_:-� _- --_ --- - - - - _ _ :_- _�__ _ . -- -- -=_- =-= _ - =.-_ _ _ -_ WARNING: THfS POWER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER ; ��d���$ Ei�I� lr��R'Q��.��?`i� ��������� `� �'armington f'asualey �`ompan} Fidelity and Guaranty Fnsurance Company �idelity and Guaranty Insuranee Flnderwriters, i�c. St. Pau! Fire and Marine Insurance i.a�:npany St. Paul Uuardian Iasurance Compan}� Attorney-In Fact No. ��4�g� St. Paui Mercury Ensurance f:ompaay 'd'ravelers Casualty and Surety Company Teavelers CasualEy and Surety Company of l�merica United States Fidelity and Guaranty Company E'ertificate No. � O �� `�' � � � � � KNOW ALL 1VIF,N �3Y TI-lF,SF, PRESENTS: That St. Yaul Fire and Marine Insurance Company, St. Paul Guardian Insurance Company and St. Paul Mercur� Insurance Company are coiporat�ons duly or�anized under the laws of the State of Minncsota, that Fazmin�ton Casualty Company, Travelers Casualty and Surery Cu�t�pany, and Travelers Casualty and Surety Company of America are corporations duly or�anized under the laws of the State of Connecticut, that United States Fidelity and Uuaranty Company is a corporation duly organized under the laws of the State of Maryland, tnat Fidelity and Guaranty Insurance Compa�y is a corporation duly organized under the laws of the Stat�e of Iowa, and that Fidelity and Guaranty Insurance Underwriters, Inc., is a corporation duly organizcd under the laws of the State o� Wisconsin (herein collectively callcd the "Companies"), and that the Companies do hereby make, constitute and appoint Anthony H. Morelos, Robert F. Dean, and Mary Helen Buras of the City of __ KOUSIOri ___. State of __ TeXSS __ _____ _ , their true and lawful Attorneyl's)-in-Fact, each in thcir sep irxte capacity if more thxn one is named above, to sign, execute, scal and aeknowledge any and all bouds, teco�nizanccs, conditional nndertakin�s and other writin}s obli�arory ir, the nature Chereof on behalf of the Companies in their business of guarantceina the fidelity of persais, guarantceing thc pea-1-nrmance oi contracts and executin� or �uaranteeing bonds and undertakings reyuircd or pPrmin�:d in anc :�ciions �r pmceedin=s allowed by law. TN WI'TNFSS {��HEKE£)F, the Companies have caused this instrument t�, bc signc� and their corE�orate seals to hc iiereto affixcd, this _._ OCtober 20 l l y of ---- Farmin;ton Casaalty ('omp�uy Fidelity and Guaranty Insurance t'unepan� Fidelity and Guaranty Insuraucr Elnderwriters, Inc. St. Paul Fire and Marine Insurance E'ompany S4 Yaul Guardian Insorance Company 7th St. Pau[ Tvlircury Intarance �'ompany Travelers Casualty and Surety Company Travelers E;asualty and Surety C�mpany of America LJnited States Fidclity and Guaranty Company 1jI�.� F1Rk �„� =� I +/'�....�.r�",. TY A J�� �r.su,�� � "„Ii ��V 6 '40 - ��N .kSG r p1 �NSUqq..,,, Jp� Nos ..;�*„"sux�r \pC�j�YAHO T oqwyV�'eq J ,L v O 0.POR �9 ' J:� /-� �t s. ,,c ¢� >�z LQ:' . �'��.y? Q c Q O��it U TL 9 s > : 4 . � S'pt"� � Gi O �(� • p� § F<.t� A Z : W:: (i : 9 / � 5 � (� � ` fn ��A1iD @y. .� T` /�: >f.,m� .�pRPORNTf.;t�: y � �m` y' � NKdI Z nl 9 8 2S ; � � 9%% a 1951 =, :. '. ; � �? ~ +n % � t : o : ,a, HnRTFOAD. �' �� � � ` a 77396� 4'y`�'+�c�'- ° � ' a s c�. = aS k: A L,�or ' od:_SEAL;a ; ,� ;,o ":yt OoNtt' ;�� o� � `t,�. o�<' 4�'�. � � K � ,/�d9'1 � y • "`' °'' A`� �"F;;:�' �``.'S.;Aa+,,' ��� 'bt ..��' �''� . +�';�� laH State of Connccti�ur City of Hartford s1. i �Y' _ __ _ _— — . _ __ - - -- ��'_•--c— - Geore � "Choropsnn. cnior ice President 7th October 2011 On this the _____.______ day of ___ ,___ ___ , before me personally a}�pcarcd Gec�rve W. "I'hontpson, who acknowledged himself to be the Senior Vice President of Farmin�too Casualty Company, Fidelity and Guaranty Insurance Company_ Fidclity and Guaranty Insurance Underwriters, Inc., St. Pau1 Firc and Nt:�rine Insurance Company, St. Paul Guardian Insurance Company, St. Paul Mercury Insurance ('onipany, Travelers Casualt;� and Surety Company, Travelers Casualty and Surety Company of America, and United States Fide�liCy and Guaranry Company, and thait':��e, as such, bein� authori•r.ed so to do, executed rhe foreooing instrwnent for che purposes th�rein contained by si�ning on bel�alf of the corporations by l�imself as .: duh� a��ithonzed officer. � I �,,T� �� rn Witness VVhereof, ] hcieunto set my hand and oPficial seal_ ����t _____���v�� d. • �.J✓�!" `^'!� �: �(_�ommission expires tiu �i)il, dav oi June. 2O1 C�. � c d-� ``- �,,.. ?� �:.•..� �: �T�t�r,� Prh�ic � �'���� i �EG'F'�"� I i i 58440-6-11 Printed in U.S.A. WARNING: THIS PONiER OF ATTORNEY IS INVALID WITHOUT THE RED BORDER HEATH CONSULTANTS INCORPORATED SECRETARY'S CERTIFICATE I, Pamela S. Mickel of Houston, Texas, do hereby certify that I am SECRETARY of HEATH CONSULTANTS INCORPORATED, a Delaware Corporation having its principal place of business at yo3o Monroe Road, Houston, Texas, and that at the July a�, aou Board Meeting held in Houston, Texas of Directors it was unanimously VOTED: That Authorized Officers of the Corporation: Carolyn Heath Haag, President, Chairman of the Board; Graham G. Midgley, Chief Executive Officer (CEO}; Gary J. Lape, Vice President, Operations; Paul D. Wehnert, Vice President/Sales and Marketing and Mark D. Huber, Vice President/CFO, and each of them individually hereby is, authorized and empowered, (i) to prepare or cause to be prepared, execute, enseal and deliver or cause to be delivered, in the name and on behalf of the Corporation, any and all documents, agreements and instruments to effectuate any of the foregoing resolutions or any of the transactions contemplated thereby, all with such changes therein as any such Authorized Officer may deem necessary or desirable, and (ii) to take such action, or to cause others to take such action, in the name and on behalf of the Corporation, as may in the judgment of any such Authorized Officer so acting be necessary or appropriate in connection with, or in furtherance of, any of the foregoing resolutions or any of the transactions contemplated thereby, the execution and delivery of any such document, agreement or instrument or the taking of any such action being conclusive evidence of such Authorized Officer's authority hereunder to so act. I further certify that said vote remains in full force and effect and has not been replaced, altered, amended or rescinded. 1 DATED. .t��,;�'���'s�^�:��`. r �'r Carporate Seal A true record. ATTEST: ' y �R/'�� ��...GA.+C+�.� { � '€�'*""`�"y�� f " _ Pamela S. Mickel, Secretary :x 6 f C F , � ,.-..._ . r Client#: 12925 HEATCONSI ACORD,M CERTIFICATE O� LI/�BILITY INSURANCE DATE(MM�DDfYYYY) 11/1512012 i nis ceRT�FicATE iS ISSUED AS A MATTER OF INFORMRTION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 'fHIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIIE:S BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE:D iEPRESENTATIVE 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 eredorsement. A statement on this certificate does not confer righl:s to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT • NAME: Linda Fontenot Dean & Draper Ins. Agcy., LP P„oNE - -- - �(AIC, No, Ext): 7� 3 SZ%-0444 . I(p,A1C, No�• _713 52'i-0457 3131 West Alabama s-MAi� 4th Floor , aooRESS: _ _ � INSURER�S) AFFORDING COVERAGE I NAIC # INSURED ...---- - - -----. __.__._._. .-_. _- . __-- --... _..--� INSURER B wberty I sutlance Corporation e C -._ �`'6042 .. .. ouston, TX 7709 -- _ i 2404 Heath Consultants Inc. ',r,suReR c�-ibert Mutual Insurance Co �'�3043 �I 9030 Monroe Rd. �---- _-y--- ____________ __._ __ _ �_ _ Houston, TX 77069 �_iNSUReR � ; — __-- -- __________ _ ; - - '��. INSURER E : i _.__ _____._________.__ .._ .____ l.__.._ _. .. ._ COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: � rna i� i u �,tK I IYY I HH 1 1 Ht I'ULIGIES OF INSURANCE USTEU 6ELOW HAVE BEEN ISSUED TO THE INSUkED NAMED ABOVE FOR TNE POUCY PERIOD INDICA7ED. NOTWITHSTl1NDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHI(:N THIS CERTIFICAiE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE iERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. �IMITS SHOWN MAY I-IAVE BEEN REDUCED BY PAID CLAIMS. INSR � � � �� � �� � � � � - 'ADDI SUBR �� � POLICY EFF POLICY EXP ' - � LTR TYPE OF INSURANCE I � -- --.._.---- .._.____ I _YWVD, ___._. POLICYNUMBER----.--. .{MM/DDIYYYY) (MM/DDIYYYY�-�,---- ------LIMITS..___... _-_-._--.... A GENERALLIABILITY --- ,�NSR I I TBKZ91452436032�� 7/30/2012 07/30/2013� e,acHOCCUKkENCe i$2,QQQ,QQQ X COMMERCIAL GENERAI LIABILITY I I DAMAGE TO RFNT[D �- �_r�Hennises tE� ��«e��P� s 300,OiD0 _ _ -- - - - - __ ___ � l CLAIMS-MADF ��i� � OCCUR �I; I � MED EXP (Any one person) $ � ��OQI� I I , A B C .. .__.__._ _.._-----.___ : � �. , i _ � _ __ ___ GEN't AGGREGATE LIMII APPLIES PER'. I I , f r - — � . _ --t— �--------. . _ -- —.._. . _-- nuromosi�e unsiuTV 1 � _ _ .. __ __� � ASKZ91452436022 r�Ho �JFCT lOC � XI ANY AUTO I' ! I � 1 ALl OWNCD SCNtUULED � I AUTOS AUTOS '��.. I X HIKED AUTOS X NON-OWNEO I �',, '' AUTOS - -- i I I �( UMBRELLA LIAB ��( � OCCUR I I TH7Z91452436062 I EXCESS LIAB � � CLAIMS-MADE I j I DED II XI RETENTIONS�OOOO � _ I I _ .---`--J._ ------------ __- --_------------- - r I i WORKERS COMPENSATION � '.. '� WA1Z9D452436042 AND EMPLOYERS' LIABIL�TY � '. ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N i '�, OFF'ICER/MEMBER EXCLUDED? N/ A I �'� (Mandatory in NH) (--� � � ' If yes Aescnbe under I ,I ,� _�-�--- - ----� _ .'___ .. _.__. _.... -----... DES( RIPTION OF OPERATIONS below � . ._. . _____.—_.___-_. � i _.__..- -----_.....- 7/30l2012 7/30/2012 --- -- 07I30l201 PERSONAL & ADV INJUf2Y GENERALAGGREGATE PHODUC7S - COMP/OP AGG BODILV INJURY (Per person) BODILY INJURY (Per arc-idenij PROPERTY DAMl�GE I� (Per accident) � 52,�Ua,00U ._ _ _____. _-._. - . 52,D�a,�a� _ � - _ �1,000,000 � -- 5 � EACHOCCURR[NCE � S�O,OOI),OOO 07����2����_ . __ . . �AGGREGATE S�O�OOQ�OOO --- ---- --_.__.— 730/2012 07l30/201 i WC STATU- OTH- !�_!r9B�UMJT� _ _ �R. _ _ _ _ E.L EACH_ACCIDENT S� OOO,OOO � � E i oisEnsE Ea rnnr��ovtE � s1,000.000 EL DISEASE - POLICY LIMIT J S�,OOO.00O DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 701, Additio�ai Remarks Schedule, if more space is required) The General Liability policy includes a bianket additional insured and waiver of subrogation endorsement LG3180 0907 policy contains a special enclorsement with the primary and noncontributory wording per form LB2410 1010 to the certificate hoider only when there is a written contract between the named insured and the certificate holder ihaQ requires such status. Poticy include a blanket 30 day notice of cancellation endorsement LIM9901 0511 to the certificate holder only when there is a written contract (See Attached Descriptions) TE HOLDER City of Clearwater Attn.: Clearwater Gas Systems P.O. Box 4748 Clearwater, FL 33758-4748 ACORD 25 (2010/OS) 1 of 2 #S305418/M283344 CANCELLA SHOUID ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELI\IERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AU': HCRIZcD REFP,ESE�TA7iVt �O 1988-2010 ACORD CORPORATION. All right:=_; reserved. The ACORD name and logo are registered marks of ACORD LFF DESCRB��'I�i�S (C�ntinued fr�m Page 1) ur�ween ine named insured and the certificate holder that requi6es such status. '—�e Auto Liability policy provide a blanket additional insured endorsement CA2048 0299 waiver of brogation endorsement CA0444 0310 to the certificate holder oniy when there is a writt�en contract between the named insured and the certificate holder that requires such status. Poiicy include a blanket 30 day notice of cancellation endorsement LIM9901 0511 to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Workers Compesation policy provide a blanket waiver of subrogation endorsement WC420304 to the � certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. Policy include a bianket 60 day notice of canceliation endorsement WM90180611 to the certi�cate holder only when there is a written contract between the named insured and the certificate holder that requires such status. SAGITTA 25.3 (2010/OS) Z OY 1 #S305418/M283344 ., � r t i � . x ' Exhibit C Request for Proposal � � � � � � � REQUEST FOR PROPOSALS CITY OF CLEARWATER, FLORIDA Notice is hereby given that the City of Clearwater will be receiving sealed proposals at the City's Purchasing Division, 100 South Myrtle Avenue, Clearwater, FL 33756 for: Natural Gas Distribution Main � Service Line Locating RFP NO. 04-13 PROPOSAL DUE DATE: WEDNESDAY, NOVEMBER 21, 2012, 4:00 PM EST AT THE CITY OF CLEARWATER PURCHASING DIVISION The City is seeking experienced and qualified firms that demonstrate the highest level of ability, professionalism and expertise. Six (6) copies of each proposal shall be submitted in a sealed envelope and plainly marked: "Request for Proposal for Natural Gas Distribution Main 8� Service Line Locating, RFP NO. 04-13" Issued at Clearwater, Florida, this 22"d day of October, 2012. Prepared By: 8rian Langille, PE, CEM Operations Manager Clearwater Gas System 400 N Myrtle Ave Clearwater, FL 33755 TABLE OF CONTENTS OVERVIEW 1 SPECIFIC REQUIREMENTS 4 SITE VISIT 4 PROPOSALSUBMITTAL 5 SELECTION COMMIITEE 5 TENTATIVE SCHEDULE 6 FAMILIARITY WITH LAWS 6 RFP INQUIRIES AND ADDENDA 6 APPROPRIATIONS CLAUSE 6 PUBLIC ENTITIES CRIME STATEMENT 7 BID SECURITY 7 DRUG-FREE WORKPLACE REQUIREMENTS 7 OPERATOR QUALIFICATION 8 BID PROTEST PROCEDURE 9 NO CORRECTIONS CLAUSE 9 RETENTION/DISPOSAL OF RFPS CLAUSE 9 LEGAL NAME CLAUSE 9 OPENNESS OF PROCUREMENT CLAUSE 9 NO COLLUSION CLAUSE 10 QUALIFICATIONS OF VENDORS 10 EXECUTION OF CONTRACT 11 TIME OF COMPLETION 11 INSURANCE REQUIREMENTS 11 INFORMALITY WAIVING/BID REJECTIONS CLAUSE 15 PROPOSAL 16 CERTIFIED CHECK, CASH OR BID BOND 17 CONTRACTOR'S AFFIDAVIT 18 CONTRACTOR'S RELEASE 19 STATEMENT OF SURETY COMPANY 20 PERFORMANCE - PAYMENT BOND 21 CERTIFICATE OF INSURANCE 23 OVERVIEW The City of Clearwater ("City"), d/b/a Clearwater Gas System ("CGS"), owns and operates a natural gas distribution system ("System") within portions of Pinellas and Pasco County, Florida. CGS has approximately 840 miles of distribution gas mains that operates between 8— 60 PSI and serves approximately 18,000 natural gas customers over a 330 square mile service territory. Proposals are now sought from qualified companies ("Locator") to provide natural gas main & service line locating services for CGS's distribution System. CGS generally serves natural gas to north Pinellas County (i.e., north of Ulmerton Rd) and Southwest Pasco County (Pinellas/Pasco county line to State Rd 52 and Ehren Cutoff Rd). In addition, CGS serves the beach communities from Clearwater down to Redington Beach. Currently, CGS performs all line-spotting functions with two (2) internal employees. However, CGS would like to outsource this job function to a qualified Locator. The expectation is the Locator will be able to work independently, with minimal assistance/supervision from CGS. Below is some general information on our distribution system, along with a company profile. Miles of Number of Sunshine Tickets County Main Service lines Received Located Pinellas 688 20,200 25,000 9,000 Pasco 152 3,800 5,000 2,500 Total 840 24,000 33,000 11,500 Additional information, such as GIS shapefles, depicting the exact location of our main & service locations can be made available upon request. Our current method of receiving locate tickets is through the Irthnet (FL Sunshine) website. Each line locator has a laptop in their vehicle to receive electronic tickets throughout the work day. CLEARWATER GAS SYSTEM - OVERVIEW (A DEPARTMENT OF THE CITY OF CLEARWATER) � SERVING THE COMMiJNITY ENERGY NEEDS FOR 89 YEARS (SINCE 1923) KEY SER�'ICE CH�I2ACTERIS'I`ICS & UATA � � �wx, .� � 9 a`± �� ��,�«,M. "�. ,, Y�. WiR RK11EY � fErctGWT�HEY � ��: � KLLSBl1HJLtiM1 GWNf Y . WM�iIN �;� ..�..y.t. a,�N �. �e4 ; W�� ti�� _,�x,�� ew� ra�..enr V TAMPA BAY / SUNCOAST AREA • NATUI2AL & PROPANE GAS SERVICE • GAS APPLIANCE SAI.ES & SERVICE • I�iSTALLATION OF INSIDE CUSTOh�IER GAS PIPING • DO14fESTIC AND COti�VIERCIAL GAS �PPLL�NCE & EQLnPMENT SERVICE • 330 SQL?ARE 1bIILES OF SERVTCE TERRITORY • 840 AIII,ES OF NIAIIV PIPF..I.INES • SERVE 2011-iCnVICIPAL AREAS: BELLFAIR INDIAN ROCKS BF,ACH PINFI.LAS P.1RK {LP) BELLEAIIt BEACH INDI?.N SHORES PORT RICHEY BELLEAII2 BLUFFS LARGO REDINGTON BEACH I3FLLEAIR SHORE VSADEIRABEACH �LP} REDINGTON SHORES CLlARWA'I1;R NEWPORTRICIiEY SAFE'TYIiARBOR lltiNtilllN NORTH REDINGTON BEaCH SE:�4II� OLE (LP) OLDSMAR TARPON SPRINGS �ND L1vINCORPORATED NORTI�RY FINELLAS & SOiTTfi�VF,STERN & CF,NTRAL PASCO COL�iVTiES: PINELLAS COL;NTl PASC� COl11VT'Y AREASSERVED AREASSERVED CRYSTAL,BEACH ANCLOTE F,AST LAKE BEXI.FY RANCH PLATIIER SOtiND (LPl CONNERTON Hr1RBOR BLtiFFS ELFERS HIGHPOINT HOLIC7AY GZONA LAND O' L.AKES P.ALM HARBOR MOONLAKE ODF;SSA SEI2F,NOV A "IRINITY • 2U,OU0 CUSTOlb1ERS (18,000 natural � 2,OU0 propane) • 79 EMPLO]c'EES • $36 MILLIOPT ANNU:�L OPERATIIVG RE�'E_NUES • 12,�155 ;VIM73TUIUAY PF.r1it DF.,I��i:'�1�� (1/9l2010) • 12,000 N[MBTUIDAY PF..AK CONTR4C'C DF,MAIVI) • SUPPLIER: FLORIDA GAS TRANS�IISSIOI� (FGT) �� 2 TAMPA 6AYf SUNGQAST AREA - FLC'�RIDA - LastUpdated 10/2012 2011 PE�lSA Report 2.k9LE3 OF MAINS MI SYSTEMAT END OFYEAR MATERIAL UNKNOVIM Y" 6R LESS OVER 2" THRU 4" OVER 4" THRU 8" OYER 8" THRU 12" OYER 12" TOTAL STE�� ?fNJO 1%3.�800 32.000 52500 :�riiAl O.00r ^Ofi..O� C�I;GTILE IR�JN 0.60�� O.UO� UA00 OAJCI :;�.t10U OAUf,� 0.000 C(JPPER 0 0p0 t� GOu O.MC! Q OOQ G.p(N) 09D�3 Q C100 t.ASTVvROUGHT �.� t��.SDU B.t+�t! OQ00 i�iaj0 0.66G 16.60G IkCN PI.F.yTIC PV�� O.OGG 0.CC0 �7.Q�0 U.O�hI :I.UC�i 20�a? Ci-�00 PLAST!CFE G.th?Q Sn2JOQ 83&�70 R7S00 t:000 O.GuO 613400 PLASTIC AES 0.�10Q �,.OiC 0 U(N O.�Op 4�ifi0 0.40U 0.000 O7HEF PLAST�C O.00Q ;7.000 0 CiQO O.tltl� � 000 OA00 0.000 OTHER 0.0� u.000 0�000 O.Q�(1 00� ODOD O.DOn TOTAL 0.000 5964U0 t2190G 1�OGUU Q�0 0.000 83EBfJ0 3.NVNBER OF Sf:RY10ES q'I SYSTEM AT END OF YEAR AVERAGE SERVICE'LEN6TH:100 . MATEWAL. UNKNOWN 1"OR�LESS OVER.1"THRU2" OYER2"THRU4" OVER4"THRUB" 8VER8" TOTAL STEEt p.p00 65440�JQ 111.W0 1'.OUO O.ic);) 6�A00� 6E32.009 D! �CT€lE IR+�N 0.�?Ott G ODU O.QC�U 0 OOG ��.G00 n.00Q t� O�JU CQPPcR 0.000 0 �00 O.UW 0.�7�J0 �^.^00 0.0�0 QrF�O CASTlWR��JGHT O..Di10 OA00 tI.CK� C.� Q000 O.CiOG. 0.000 q2t'�N P�ASTIC PVC O.00p b.OQO 0�0 OAOI QGOD 0 �Ot� U.000 FLr'+,STIG PE 0 OGU if,C92.b00 tIlA3.ORR 13�A1t7 6.300 OACG tE:i4B.OG0 FLA&T{C.4&S OA00 O.n�p O.ppp pno0 �.pr)0 (1-0OG Qn(� OTtiEk�PLASTIC U�.000 U.��ZG 09(19 6.000 0.�:6� 0000 0.000 dTHER 4.000 f�;�.u� O,O�JO �.UOG O.COC, 0.000 �A01 T6TRL 0.400 21�+5.� i55aAG0 3C�.000 G:JUC� O.G40 2'.�6G.l;r,u 4.MLE8 OF NWIN t1ND NUN6ER OF SERVICES BY DECADE OF INST/1LLATiON UNKNOYMI PRE-1940 19C0-'1944 '1950-1959 195019&9 1870-79T9 1980-1988 1990-1�9 2�20�9 2010-2019 TOTAL MI�ESt?F p..00U 63.1A)0 54AOU 54000 59.i1"Utl ?&.�JJU '�.i600G 215Q00 185500 1"3E(30 r;38.3iN MANV NI�MSERtJF u0W iSfi4000 :•Ei2000 1F80.t?[?� 21+U51.lOC� ?U170GG 2°C�;!)00 "<3i?0U00 ?<16000 1A23.04�0 2:?584D0(: SERVK'.,ES SPECIFIC REQUIREMENTS Below are items/requirements that need to be included in the Proposal to CGS. • Provide a cost to perform line spotting services for the following: o Pinellas County o Pasco County o Include a cost breakdown (i.e., daily and/or cost per ticket) for EACH county • Cost to perform emergency locate tickets for System • Respond to emergency locates during normal business hours o CGS to respond to afterhours emergency locates • Vendor will supply their own locating equipment, possibly to include Ground Penetrating Radar (GPR) o CGS to supply paint, flags, marker poles, tracer wire and connectors • Must utilize Operator Qualified (OQ) employees • Must complete locate within the 48 hour timeline as required by FL Statute 556. • Shovel or vacuum excavates high priority pipelines and segments that are difficult to locate • Repair broken wire segments and install/maintain locate stations to complete locates • Work with contractors to identify located segments • Respond for follow-up questions or clarifcations • Vendor is responsible for any late ticket charges • Vendor may be charged for any missed locate damages, pending investigation • Draw simple as-builts, when main is found in different location than CGS records show � Communicate with CGS personnel to identify any abnormal operating conditions SITE VISIT To better prepare a response/proposal to this RFP, each proposer may visit the CGS Administrative & Operations facility @ 400 N Myrtle Ave, Clearwater, FL. Arrangements to visit the Site can be made by contacting Mr. Brian Langille, Operations Manager, Clearwater Gas System, via telephone at (727) 562-4911 or via email at brian.lan i�(�a,clearwater as.com. Appointments will be scheduled between Oct 30th — Nov 19tn. PROPOSAL SUBMITTAL Six (6) copies of the proposal shall be submitted to: If submitted by mail: Michael Murray Purchasing Manager Purchasing Division of the City of Clearwater P.O. Box 4748 Clearwater, Florida 33758 If submitted in person: Michael Murray Purchasing Manager Purchasing Division of the City of Clearwater 100 South Myrtle Avenue Clearwater, FL 33756 Note: All copies must be submitted and received by City/CGS no later than 4:00 p.m. on Friday, November 16, 2012. SELECTION COMMITTEE Selection Committee will consist of a minimum of five (5) employees from certain departments within the City of Clearwater. The Committee will choose the top 2-3 vendors, based on initial RFP submittals, for a scheduled interview in Clearwater. After interviews are complete, the Committee will score the companies based on the criteria below: Items of Consideration Maximum Points 1. Annual cost 25 2. Company experience: Line locating services 25 3. Manager experience: 20 4. Company proposal/presentation 15 5. Company references 15 Total possible points 100 The services solicited will be evaluated on the basis of competitive proposals. Evaluation criteria will include your time and materials submittal, as well as experience and availability to provide necessary manpower and expertise to accomplish the work in a timely and cost-efficient manner. Proposers shall not be entitled to payment for any expenses incurred in the preparation of its proposal. TENTATIVE SCHEDULE Oct 22°d: Advertise RFP Oct 30 — Nov 19th: Site visits (if necessary) Nov 21St: RFP submittal due date (4pm) Nov 26 — 30`h: Vendor presentations (Clearwater) Dec 3`d: Select vendor for project Dec 20`": City Council approval Jan 2013: Commence locating services FAMILIARITY WITH LAWS Each consultant shall be responsible for full and complete compliance with, and by submitting a proposal certifies that it is familiar with, all federal, state and local laws, ordinances, rules and regulations. RFP INQUIRIES AND ADDENDA Each proposer shall examine all RFP documents and shall judge all matters relating to the adequacy of such documents. Any inquiries, suggestions or requests concerning interpretation, clarification, or additional information pertaining to the RFP shall be made in writing a minimum of five (5) working days prior to the due date specifed herein to City's Purchasing Manager, Michael Murray, at P.O. Box 4748, Clearwater, FL 33758-4748; or Fax (727) 562-4635. Facsimiles must have a cover sheet which shall include, at a minimum, the proposer's name, address, number of pages transmitted, phone number, and facsimile number. Inquiries may also be emailed to Michael.Murray�u,myclearwater.com. Neither City nor CGS shall be responsible for oral interpretations given by any City or CGS employee, representative, or others. The issuance of a written addendum is the only official method whereby interpretation, clarification, or additional information may be i� ven. If any addenda are issued to this RFP, City/CGS will attempt to notify all proposers who have secured the same. It shall be the responsibility of each proposer, however, to contact City's Purchasing Manager at (727) 562-4633 to determine if any addenda were issued and to make such addenda a part of the proposal prior to the submission of a proposal. APPROPRIATIONS CLAUSE City, as a governmental entity, is subject to the appropriation of funds by its legislative body in an amount sufficient to allow the continuation of its performance in accordance with the terms and conditions of the Agreement for each and every fiscal year following the fiscal year in which this contract is executed and entered into and for which the Agreement shall remain in effect. Upon receipt of notice that sufficient funds are not available to continue its full and faithful performance of the Agreement, City/CGS shall provide prompt written notice of such event. Effective thirty (30) days after giving such notice or upon the expiration of the period of time for which the funds were appropriated, whichever occurs first, City/CGS shall thereafter be released of all further obligations in any way related to the Agreement. PUBLIC ENTITIES CRIME STATEMENT Pursuant to Florida Statute 287-132-133, effective July l, 1989, the City of Clearwater, as a public entity, may not accept any proposal from, award any contract to, or transact any business in excess of the threshold amount provided in Section 287A17, F.S., for Category Two (currently $35,000) with any person or affiliate on the convicted vendor list for a period of 36 months from the date that person or affiliate was placed on the convicted vendor list unless that person of affiliate has been removed from the list pursuant to Section 287.133 (3)(�, F.S. If you submit a proposal in response to this request, you are certifying that Florida Statute 287.132 and 287.133 does not restrict your submission. BID SECURITY Each bidder must deposit a bid bond in the amount of ten percent (10%) of the total annual cost referenced in the Proposal, made payable to the City of Clearwater, which sum will serve as bid security and will be forfeited to the City of Clearwater as liquidated damages in the event an award is made and the contract and bonds are not promptly and properly executed as required. All bids may be held for a period of 60 days after receipt. All certified checks, except those accompanying the two lowest bids, will be returned by certified mail to the unsuccessful bidders within seven (7) days after the date of the bid opening. (If the signing of the contract be deferred for a period exceeding two (2) weeks, and the second low bidder desires to substitute a bid bond for his certified check and the bid bond fully guarantees his bid, he shall be permitted to do so). The certified checks accompanying the two low bids will be returned within three (3) days after the Owner and the successful bidder have executed the contract. In the event no contract award is made within the time limit specified, each certified check or bid bond will be returned upon the demand of the bidder. DRUG-FREE WORKPLACE REQUIREMENTS In order to comply with Florida Statutes, all proposers will be required to complete a Drug Free Workplace form (F.S. 287.087). Preference will be given to businesses with drug-free workplace programs. Whenever two or more proposals that are equal with respect to price, quality and service are received by the City for the procurement of commodities or contractual services, a proposal received from a business that certifies that it has implemented a drug-free workplace program shall be given preference in the award process. Established procedures for processing tie proposals will be followed if none of the tied proposers have a drug-free workplace program. In addition, the Contractor agrees that it has in place, or will implement a Drug and Alcohol Training and Testing Program for their employees that comply with the requirements of the United States Department of Transportation, Title 49, Pipeline Safety Regulations, Part 199. The contractor will also furnish quarterly statistical reports to CGS to show active compliance. The Contractor further agrees to allow access to its property and records by the Human Resources Director, or appointed designee, of the City of Clearwater. The Contractor will permit representatives of state or federal agencies who monitor the compliance of Drug and Alcohol rules/regulations access to its property and records. The contractor shall furnish quarterly statistical reports to the Operations Coordinator. Said program shall provide pre-employment, random, for cause and post accident drug training and testing (alcohol for cause testing) for all of its employees as required by Federal regulations and who are assigned to perform services for Clearwater Gas System. The contractor shall attest in writing, the following: l. That the contracting firm has an agreement with a drug testing laboratory certified by HHS/NIDA and an alcohol testing facility; 2. The name and address of the Medical Review Officer retained by the contractor for the drug and alcohol testing program; That all employees of the contractor have been drug tested pre-employment; and 4. That all employees covered by the US Department of Transportation Regulation 199 receive random, for cause and post accident drug testing and alcohol testing for cause pursuant to such regulation. Prior to doing any work for CGS, the vendor will submit a copy of their current Drug and Alcohol Testing Policy. This policy should be included in their Proposal. OPERATOR QUALIFICATION Contractor employees and their subcontractors must meet the requirements and intent of the Code of Federal Regulations (CFR) 49 Part 192.801, 192.803, 192.805, 192.807 and 192.809 relating to "Operator Quali�cation" with mandatory knowledge, skill and abilities, training to be completed by December 31, 2012. The contractor must state in writing that their Operator Qualification plan is in conformance with the intent of Federal Operator Qualification Regulations and is at least equal to and applicable to Clearwater Gas System's ASME B31Q Operator Qualification Plan. OQ and all Training Documentation shall be furnished upon request. The Contractor's Operator Qualification Plan must also explain how their employees have the ability to identify and react to natural gas related Abnormal Operating Conditions that may be encountered while working on the gas pipeline facility. Contractor Employee Operator Qualification, Knowledge, Skill and Ability records will be kept for a 5 year period. Failure to provide proof of Operator Qualification compliance, and successful maintenance will disqualify the bidder from consideration for the award of this contract. Training records shall be made availabte to CGS for auditing. BID PROTEST PROCEDURE Any actual or prospective proposer who is aggrieved in connection with the solicitation or award of a contract may seek resolution of his/her complaints by contacting the Purchasing Manager. NO CORRECTIONS CLAUSE Once a proposal is submitted, the City/CGS shall not accept any request by any proposer to correct errors or omissions in any proposal submitted. RETENTION/DISPOSAL OF RFPS CLAUSE City/CGS reserve the right to retain all proposals submitted for offcial record purposes and to use any ideas in a proposal regardless of whether that proposal is selected. Submission of a proposal indicates acceptance by the proposer of the conditions contained in this RFP and all attached exhibits, unless clearly and specifically noted in the Agreement between City/CGS and the selected proposer. City/CGS also reserves the right to dispose of any or all copies of proposals in whatever manner it deems appropriate. No copies of proposals will be returned to the proposer. LEGAL NAME CLAUSE Proposals shall clearly indicate the legal name, address and telephone number of the proposer (company, firm, partnership, individual). Proposals shall be signed above the typed or printed name and the title of the signer shall be indicated. To constitute a valid proposal, the signer must have authority to bind the proposer to the submitted proposal. OPENNESS OF PROCUREMENT CLAUSE Written proposals, other submissions, correspondence, and all records made thereof, as well as negotiations conducted pursuant to the RFP, shall be handled in compliance with Chapters 119 and 286 of Florida Statutes. Neither the City nor CGS shall give any assurance as to the confidentiality of any portion of any proposal once submitted. NO COLLUSION CLAUSE By offering a submission to the RFP, the proposer certifies that the proposer has not divulged to, discussed or compared his/her competitive proposal with other proposers and has not colluded with any other proposers or parties to this competitive proposal whatsoever. Also, the proposer certifies, and in case of joint competitive proposal each party thereto certifes as to its own organization, that in connection with the competitive proposal: a) any prices and/or cost data submitted have been arrived at independently, without consultation, communication, or agreement, for the purpose of restricting competition, as to any matter relating to such prices andlor cost data, with any other proposer or with any competitor; b) any price and/or cost data quoted for this competitive proposal have not been knowingly disclosed by the proposer, directly or indirectly to any other proposer or competitor, prior to the scheduled award of the contract; c) no attempt has been made or will be made by the proposer to induce any other person or firm to submit or not to submit a competitive proposal for the purpose of restricting competition; d) the only person or persons interested in this competitive proposal, principal or principals is/are named therein and no person, other than those named therein, has any interest in this competitive proposal or in the Agreement to be entered into; and e) no person or agency has been employed or retained to solicit or secure the Agreement upon an agreement or understanding for a commission, percentage, brokerage, or contingent fee, excepting bona fide employees or established commercial agencies maintained by the proposer for the purpose of doing business. QUALIFICATIONS OF VENDORS The Owner may make such investigations as necessary to determine the ability of the vendor to perform the work, and the vendor shall furnish to the Owner any additional information and financial data for this purpose as the Owner may require. If such an investigation fails to satisfy the Owner that the vendor is properly qualified to complete the work described in the "Specific Requirements" section of the RFP, the proposal may be rejected. In the event the vendor fails, refuses, or neglects to submit the requested additional information within ten (10) days of the date of any request for submission, the vendor's proposal guarantee (Bid Security) shall be forfeited to the use of the Owner, not as a penalty, but as liquidated damages. � In addition to qualifications previously set forth, no proposal will be considered unless the bidder, whether resident or non-resident of Florida, is properly qualified to submit a proposal in accordance with all applicable laws of the Municipality, County, and the State of Florida. EXECUTION OF CONTRACT The vendor to whom the contract is awarded must, within ten (10) calendar days following Notice of Award, present himself to the place designated in the offcial Notice of Acceptance, for signing of the contract, and to substitute for the bid security, a surety performance and payment bond in the amount of thirty per centum (30%) of the annual contract price of the work, conditioned that the vendor will faithfully perform all work of this contract and promptly pay for all materials furnished and labor supplied or performed in the execution of all work. All bonds and insurance shall be issued by companies authorized to transact business in the State of Florida. If the bidder to whom the contract is awarded fails to give bonds or execute the contract within the time specified, the amount of the proposal guarantee shall be forfeited to the Owner, not as a penalty but as liquidated damages. TIME OF COMPLETION The successful vendor shall commence work under contract on a date to be specified in a written contract from the Owner or his authorized representative. The time of completion for this contract will be 12 months from contract execution. The Contractor shall have at least two (2) weeks notice of this commencement date and shall fully complete the work described in the Contract and specifications listed in vendor's proposal, prior to the completion date. If the Contractor fails to commence work within seven (7) days of the announcement of the official starting date, this shall be just cause for the annulment of the contract. INSURANCE REQUIREMENTS The Proposer shall, at its own cost and expense, acquire and maintain (and cause contractors and subcontractors, if utilized, to acquire and maintain) during the term with the City, sufficient insurance to adequately protect the respective interest of the parties. Specifically the Proposer must carry the following minimum types and amounts of insurance on an occurrence basis or in the case of coverage that cannot be obtained on an occurrence basis, then coverage can be obtained on a claims-made basis with a minimum three (3) year tail following the termination or expiration of the Agreement. These insurance requirements shall not limit the liability of the Proposer. The City does not represent that these types or amounts of insurance to be sufficient or adequate to protect the Proposer's interests or liabilities, but are merely minimums: 11 COMMERCIAL GENERAL LIABILITY: $1,000,000 per occurrence, including but not limited to, bodily injury, personal injury, property damage, premises- operations, products/completed operations, contractual liability, independent contractors, and liability assumed under an insured contract. If Commercial General Liability Insurance or other form with a general aggregate limit is used, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. 2. AUTOMOBILE LIABILITY: $1,000,000 per accident combined single limit, for bodily injury and property damage for any owned, non-owned, hired, or borrowed automobile. 3. WORKERS' COMPENSATION: Proposer will obtain and maintain during the life of this contract, Workers' Compensation insurance in accordance with the laws of the State of Florida, for all of Proposer's employees employed at the site of the project. Coverage should include Voluntary Compensation and U.S. Longshoremen's and Harbor Worker's Act coverage where applicable. 4. EMPLOYER'S LIABILITY: $100,000 each employee, each accident, and $100,000 each employee/$500,000 policy limit for disease, and which meets all state and federal laws. Coverage must be applicable to employees, contractors, and subcontractors, if any. 5. WATERCRAFT/AIRCRAFT LIABILITY: If the Proposer's provision of services involves utilization of watercraft or aircraft, watercraft and/or aircraft liability coverage must be provided to include bodily injury and property damage arising out of ownership, maintenance or use of any watercraft or aircraft, including owned, non- owned and hired. ACCEPTABILITY OF INSURERS: Insurance must be placed with insurers with a currertt A.M. Best's rating of no less than A-VII. DEDUCTIBLES AND SELF-INSURED RETENTIONS: Any deductibles or self-insured retentions must be declared to and approved by the City. The City may require the Proposer to provide proof of ability to pay losses and related investigations, claim administration, and defense expenses within the retention. ADDITIONAL INSURED: The City is to be specifically included as an additional insured on all liability coverage described above except for the Workers' Compensation and Professional Liability coverage's. OTHER INSURANCE PROVISIONS: The General Liability and Automobile Liability policies are to contain, or be endorsed to contain, the following provisions: 1. PRIMARY INSURANCE COVERAGE: For any claims related to this Agreement, the Proposer's insurance coverage shall be primary insurance as respects the City, its 12 officers, officials, employees, and volunteers. Any insurance or self-insurance maintained by the City, its officers, officials, employees, or volunteers shall be excess of the Proposer's insurance and shall not contribute to it. 2. RIGHT OF RECOVERY: Except for Workers' Compensation, the Proposer waives its right of recovery against the City, to the extent permitted by its insurance policies. 3. SEVERABILITY OF INTEREST/CROSS LIABILITY PROVISION: The Proposer shall request that its insurers' policies include or be endorsed to include a Severability of Interest/Cross Liability provision so the City will be treated as if a separate policy were in existence without increasing the policy limits. 4. HOLD HARMLESS/INDEMNIFICATION: The Proposer shall defend, indemnify, save and hold the City harmless from any and all claims, suits, judgments and liability for death, personal injury, bodily injury, or property damage arising directly or indirectly from any performance under the Agreement, or a subsequent purchase order or contract entered into by City and Proposer, its employees, subcontractors, or assigns, including legal fees, court costs, or other legal expenses. Proposer acknowledges that it is solely responsible for complying with the terms of the Agreement or a purchase order or contract arising out of the Agreement. The City shall also be held harmless against all claims for financial loss with respect to the provision of or failure to provide professional or other services resulting in professional, malpractice, or errors or omissions liability arising out of performance of the agreement or contract, unless such claims are a result of the City's own negligence. 5. NOTICE OF CANCELLATION OR RESTRICTION: Each insurance policy required by this clause shall be endorsed to state that coverage shall not be canceled by either party, except after thirty (30) days prior written notice sent via certified mail, return receipt requested, has been given to the City. It is the Proposer's responsibility to ensure the notice requirement is met. CERTIFICATE OF INSURANCE/CERTIFIED COPIES OF POLICIES: The Proposer, if selected, will provide the City with a Certificate or Certificates of Insurance showing the existence of coverage as required by the Agreement. In addition, the Proposer will provide to the City, if asked in writing, certified copies of all policies of insurance. The Proposer will maintain the required coverage with a current Certificate or Certificates of Insurance throughout the term of the Agreement with the City. New certificates and new certified copies of policies shall be provided to the City whenever any policy is renewed, revised, or obtained from other insurers. The address where such certificates and certified policies shall be sent or delivered is as follows: City of Clearwater 13 Attention: Clearwater Gas Systems P.O. Box 4748 Clearwater, FL 33758-4748 SUBCONTRACTORS: Proposer shall require and verify all subcontractors, if used, maintain insurance, including Workers' Compensation insurance, subject to all of the requirements stated herein prior to beginning work. LOSS CONTROL/SAFETY: Precaution shall be exercised at all times by the Proposer for the protection of all persons, including employees, and property. The Proposer shall be expected to comply with all applicable laws, regulations, or ordinances related to safety and health, and shall make special efforts where appropriate to detect hazardous conditions, and shall take prompt action where loss control/safety measures should reasonably be expected. The City may order work to be stopped if conditions exists that present immediate danger to persons or property. The Proposer acknowledges that such stoppage will not shift responsibility for any damages from the Proposer to the City. ADDITIONAL INSURANCE FOR REPAIR OR SERVICE OR OTHER CONTRACTS: If checked below, the City requires the following additional provisions or types of insurance for repair or service or other contracts to afford added protection against loss which could affect the work being performed: X CONTRACTOR'S EQUIPMENT INSURANCE: Contractor's Equipment insurance is to be purchased to cover loss of equipment and machinery utilized in the performance of work by the Proposer. All risks coverage is preferred. PROFESSIONAL LIABILITY, MALPRACTICE AND/OR ERRORS OR OMISSIONS: If checked below the City requires the following terms and types of insurance for professional, malpractice, and errors or omissions liability. _X_ PROFESSIONAL LIABILITY/MALPRACTICE/ERRORS OR OMISSIONS INSURANCE: The Proposer shall purchase and maintain professional liability or malpractice or errors or omissions insurance appropriate for the type of business engaged in by the Proposer with minimum limits of $1,000,000 per occurrence. If a claims made form of coverage is provided, the retroactive date of coverage shall be no later than the inception date of claims made coverage, unless prior policy was extended indefnitely to cover prior acts. Coverage shall be extended beyond the policy year either by a supplemental extended reporting period (ERP) of as great a duration as available, and with no less coverage and with reinstated aggregate limits, or by requiring that any new policy provide a retroactive date no later than the inception date of claims made coverage. 14 WRITTEN AGREEMENT/CONTRACT: Any party providing services or products to the City will be expected to enter into a written agreement, contract or purchase order with the City that incorporates, either in writing or by reference, all of the pertinent provisions relating to insurance and insurance requirements as contained herein. A failure to do so may, at the sole discretion of the City, disqualify any Party from performing services or selling products to the City provided, however, the City reserves the right to waive any such requirements. INFORMALITY WAIVINGBID REJECTIONS CLAUSE City/CGS may reject a proposal if: a) The proposer misstates or conceals any materials fact in the proposal; or b) The proposal does not strictly conform to the law or requirements of the RFP. The City of Clearwater reserves the right to waive any informalities or to accept or reject any or all bids in part or in total and award the contract in the best interest of the City. 15 PROPOSAL TO: City of Clearwater (d/b/a Clearwater Gas System) The following proposal is submitted in accordance with RFP #04-13, inviting proposals to be received until November 9, 2012 for the "Natural Gas Distribution Main & Service Line Locating". Having carefully examined the RFP document and being familiar with the various conditions of the work, the undersigned herein agrees to furnish all materials required and to perform all labor necessary to satisfactorily complete such work. Accompanying this proposal is a Certified or Cashier's Check or Bid Bond in the amount of ten percent (10%) of the bid total drawn upon the BANK and made payable to the City of Clearwater, to serve as bid security. The undersigned hereby certifies that this proposal is genuine and not sham or collusive, or made in the interest or in behalf of any person, firm, or corporation not herein named and that the undersigned has not directly or indirectly induced or solicited any other bidder to submit a sham bid, or any other person, frm or corporation to refrain from bidding, and that the undersigned has not in any manner sought by collusion to secure for himself an advantage over any other bidder. ATTEST: Corporate Secretary AFFIX CORPORATE SEAL, if a corporation 16 Bidder's Business Name By: Offcer (or Principal) Title Business Address: Business City/State/Zip Code Business Telephone Number CERTIFIED CHECK, CASH OR BID BOND (Attach certified check, cash or bid bond here) 1� CONTRACTOR'S AFFIDAVIT STATE OF FLORIDA COUNTY OF Before me, the undersigned, a Notary Public, duly commissioned, qualified and acting in and for said County and State personally appeared (Individual, Partner, or duly authorized representative of Corporate Contractor) who being duly sworn according to law deposes and says that all labor, material and outstanding claims and indebtedness of whatever nature arising out of the performance of the contract of the (Owner) with (Contractor) have been paid in full. (Individual, Partner, or duly authorized representative of Corporate Contractor) Sworn to and subscribed before me this _ day of , 201_. Notary Public SEAL Commission expires: 18 CONTRACTOR'S RELEASE KNOW ALL MEN BY THESE PRESENTS that , a Contractor in the County of and State of , do hereby acknowledge that (Contractor) this day has had and received of and from the City of Clearwater, the sum of One Dollar and other valuable consideration in full satisfaction and payment of all sums of money owing, payable and belonging to (Contractor) by any means whatsoever, for on account of a certain agreement between the said City of Clearwater and (Contractor) dated. NOW THEREFORE, the said (Contractor)(for myself, my heirs, executors and administrators)(for itself, its successors and assigns) do by these presents remise, release, quitclaim and forever discharge the said City of Clearwater, its successors and assigns, of and from all claims and demands arising from or in connection with the said agreement dated , and of and from all, and all manner of action and actions, cause and causes of action and actions, suits, debts, dues, sums and sums of money, accounts, reckonings, bonds, bills, specialties, covenants, contracts, agreements, promises, variances, damages, judgments, extents, executions, claims and demand, whatsoever in law or equity, or otherwise which against the said City of Clearwater, its successors or assigns, the Contractor, its heirs, successors and assigns ever had, now have, or which (I, my heirs, executors, or administrators)(it, its successors and assigns) hereafter can, shall or may have, for, upon or by reason of any matter cause or thing whatsoever, from the beginning of the world to the date of these presents. IN WITNESS WHEREOF, (Contractor) has caused these presents to be du(y executed the _ day of , 201_ Signed, Sealed and Delivered in the presence of: ATTEST: (Secretary) (Individual Contractor) (Partnership Contractor) By (Partner) (Corporation) AFFIX CORPORATE SEAL, if a corporation By 19 (SEAL) SEAL) SEAL) (President or Vice President) STATEMENT OF SURETY COMPANY In accordance with the provisions of the contract dated between the City of Clearwater, Owner of and (Contractor) of , the (Surety) surety on the bond of (Contractor) after a careful examination of the books and records of said Contractor or after receipt of an affidavit from Contractor, which examination or affidavit satisfies this company that all claims for labor and materials have been satisfactorily settled, hereby approves of final payment of the said (Contractor), Contractor, and by these presents witnesseth that payment to the Contractor of the final estimates shall not relieve the Surety Company of any of its obligations to the by the said Surety Company's Bond. IN WITNESSETH WHEREOF, the said Surety Company has hereunto set its hand and seal this day of , 201_. ATTEST: SEAL C� (President, Vice President) Note: This statement, if executed by any person other than the President or Vice President of the Company, must be accompanied by a certificate of even date showing authoriry conferred upon the person so signing to execute such instruments on behalf of the Company represented. 20 PERFORMANCE - PAYMENT BOND KNOW ALL MEN BY THESE PRESENTS: That we , a Corporation (Corporation-Partnership-Sole Proprietor, Etc.), hereinafter called "Principal" and (Surety) of , State of Florida, hereinafter called the "Surety," are held and firmly bound unto the , hereinafter called "Owner" in the penal sum of Dollars, in lawful money of the United States for the payment of which sum will and truly be made, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally firmly by these presents. THE CONDITIONS OF THIS OBLIGATION is such that Whereas, the Principal entered into a certain contract with the Owner, dated the day of , 201_, a copy of which is attached hereto and made a part hereof for the construction of: Natural Gas Distribution Main & Service Line Locating NOW. THEREFORE, if the Principal shall, truly and faithfully perform its duties, all the undertakings, covenants, terms, conditions and agreements of said contract during the original term thereof, and any extensions thereof which may be granted by the Owner, with or without notice to the Surety, and if he shall satisfy all claims and demands incurred under such contract, and shall fully indemnify and save harmless the Owner from all costs and damages which it may suffer by reason of failure to do so, and shall reimburse and repay the Owner all outlay and expense which the Owner may incur in making good any default, and shall promptly make payment to all persons, firms, subcontractors, and corporations furnishing materials for or performing labor in the prosecution of the work provided for in such contract, and any authorized extension or modification thereof, including all amounts due for materials, lubricants, oil, gasoline, repairs on machinery, equipment and tools, consumed or used in connection with the construction of such work, and all insurance premiums on said work, and for all labor, performed in such work whether by subcontractor or otherwise, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, FURTHER, that the said Surety, for the value received hereby stipulates and agrees that no change, extension of time, alterations or additions to the terms of the contract or to the work to be performed hereunder or the specifications accompanying the same shall in anyway affect its obligation on this bond, and it does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the work or to the specifcations. 21 PROVIDED, FURTHER, that no iinal settlement between the Owner and the Contractor shall abridge the right of any beneficiary hereunder, whose claim may be unsatisfied. IN WITNESS WHEREOF, the said Principal and Surety have duly executed this instrument under seal in counterparts, each one of which shall be deemed an original, this the _day of _, 201_. ATTEST: (Principal) Secretary (SEAL) (Witness as to Principal) (Address) (City/State/Zip) ATTEST: (Surety) (SEAL) (Witness as to Surety) (Address) (City/State/Zip) (Principal) By (Address) (City/State/Zip) : Note: Date of Bond must not be prior to date of Contract. zz (Surety) (Address) CERTIFICATE OF INSURANCE (Attach insurance certificates here) 23