2010 0291

CONTRACT AGREEMENT
OWNER - CONTRACTOR AGREEMENT
10ITB71094K-DB Fuel Dispenser Replacement

Contractor: United Pump and Controls, Inc. Contractors (Trade Name) Address: 305 Shawnee North Drive Telephone: (770) 662-0440 Project No. 101TB71094K-DB
Suite 300 Suwanee, Georgia 30024 Contact: James E. Young Facsimile: (770) 729-0682
THIS AGREEMENT is effective as of the day of , 2010, by and between Fulton County, a political subdivision of the State of Georgia (hereinafter called the "County"), and the above named CONTRACTOR in accordance with all provisions of this Construction agreement, consisting of the following Contract Documents: General Conditions Scope of Work and Technical Specifications Bid Form Acknowledgement of each addendum Bid Bond Payment Bond Performance Bond Compensation Purchasing Forms Office of Contract Compliance Forms Risk Management Insurance Provision Forms WITNESSETH: That the said Contractor has agreed, and by these presents does agree with the said County, for and in consideration of a Contract Price of sixty-eight thousand four hundred dollars ($68,400) and other good and valuable consideration,
and under the penalty expressed on Bonds hereto attached, to furnish all equipment, tools, materials, and appurtenances for the replacement of existing fuel dispensers description necessary to carry out and complete in good, firm, and substantial, and workmanlike manner, the Work specified, in strict conformity with the Specifications hereinafter set forth, which the bid submittals made by the Contractor, General Conditions, Special Provisions, Detailed Specifications, Exhibits, and this Agreement, shall all form essential parts of this Contract. The Work covered by this Contract includes all Work indicated on Plans and Specifications and listed in the Bid entitled: Project Number: 10ITB71094K-DB Fuel Dispenser Replacement The Contractor shall commence the Work with adequate force and equipment within 10 days from receipt of Notice to Proceed from the County, and shall complete the work within one hundred and twenty 120 calendar days from the Notice to Proceed or the date work begins, whichever comes first. The Contractor shall remain responsible for performing, in accordance with the terms of the contract, all work assigned prior to the expiration of the said calendar days allowed for completion of the work even if the work is not completed until after the expiration of such days. As full compensation for the faithful performance of this Contract, the County shall pay the Contractor in accordance with the General Conditions and the prices stipulated in the Bid, hereto attached. It is further mutually agreed between the parties hereto that if, at any time after the execution of this Agreement and the Surety Bonds hereto attached for its faithful performance, the County shall deem the surety or sureties upon such bonds to be unsatisfactory, or, if, for any reason, such bonds cease to be adequate to cover the performance of the Work, the Contractor shall, at his expense, within five days after receipt of notice from the County so to do, furnish an additional bond or bonds in such form and amount, and with such surety or sureties as shall be satisfactory to the County. In such event no further payment to the Contractor shall be deemed to be due under this Agreement until such new or additional security for the faithful performance of the Work shall be furnished in manner and form satisfactory to the County. The Contractor hereby assumes the entire responsibility and liability for any and all injury to or death of any and all persons, including the Contractor's agents, servants, and employees, and in addition thereto, for any and all damages to property caused by or resulting from or arising out of any act or omission in connection with this contract or the prosecution of work hereunder, whether caused by the Contractor or the Contractor's agents, Servants, or employees, or by any of the Contractor's subcontractors or suppliers, and the Contractor shall indemnify and hold harmless the County, the Construction Manager, or any of their subcontractors from and against any and all loss and/or expense which they or any of them may suffer or pay as a result of claims or suits due to, because of, or arising out of any and all such injuries, deaths
and/or damage, irrespective of County or Construction Manager negligence (except that no party shall be indemnified for their own sole negligence). The Contractor, if requested, shall assume and defend at the Contractor's own expense, any suit, action or other legal proceedings arising there from, and the Contractor hereby agrees to satisfy, pay, and cause to be discharged of record any judgment which may be rendered against the County and the Construction Manager arising there from. In the event of any such loss, expense, damage, or injury, or if any claim or demand for damages as heretofore set forth is made against the County or the Construction Manager, the County may withhold from any payment due or thereafter to become due to the Contractor under the terms of this Contract, an amount sufficient in its judgment to protect and indemnify it and the Construction Manager from any and all claims, expense, loss, damages, or injury; and the County, in its discretion, may require the Contractor to furnish a surety bond satisfactory to the County providing for such protection and indemnity, which bond shall be furnished by the Contractor within five (5) days after written demand has been made therefore. The expense of said Bond shall be borne by the Contractor. This Contract constitutes the full agreement between the parties, and the Contractor shall not sublet, assign, transfer, pledge, convey, sell or otherwise dispose of the whole or any part of this Contract or his right, title, or interest therein to any person, firm or corporation without the previous consent of the County in writing. Subject to applicable provisions of law, this Contract shall be in full force and effect as a Contract, from the date on which a fully executed and approved counterpart hereof is delivered to the Contractor and shall remain and continue in full force and effect until after the expiration of any guarantee period and the Contractor and his sureties are finally released by the County. This agreement was approved by the Fulton County Board of Commissioner on March 17, 2010, item# 10-0291.
[SIGNA TURES NEXT PA GE]
IN WITNESS THEREOF, the Parties hereto have caused this Contract to be executed by their duly authorized representatives as attested and witnessed and their corporate seals to be hereunto affixed as of the day and year date first above written. OWNER: FULTON COUNTY, GEORGIA
CONTRACTOR: United Pump , Inc.
John H. Eaves, Commission Chair Board of Commissioners ATTEST:
E. Young- ice PresidantComfnercial Divisi ÂTTEST:
-A
ark Massey Ma to the Commission (Seal) Clerk
Secretary/ Assistant Secretary (Affix Corporate Seal)
APPROVED AS TO FORM:
Office of the County Attorney APPROVED AS TO CONTENT:
David Ricks-Director General Services/Public Works Department
IE # TM
RECESS MEETING
GENERAL CONDITIONS
T.
Contractors Compliance with All Assurances and/Or Promises Made In Response To Procurement Should any Bidder submit a response to the County promising to provide a certain level of service for either the scope of work, MFBE participation, or any other matter, including where such promise or assurance is greater than what is required by the procurement documents, and should this response containing the promise or assurance be accepted by the County and made a part of the Contract Documents, then this degree or level of service promised by the bidder relating to the scope of work, MFBE participation, or other matter shall be considered to be a material part of the Agreement between the bidder and the County, such that the bidder's failure to provide the agreed upon degree or level of service or participation shall be a material breach of the Agreement giving the County just cause to terminate the Agreement for cause, pursuant to the General Conditions of the Agreement.
U.
Georgia Security and Immigration Compliance Act (1) Effective as of July 1, 2007, and pursuant to O.C.G.A. 13-10-91, every public employer, every contractor of a public employer, and every subcontractor of a public employer's contractor must register and participate in a federal work authorization program as follows: (a) No public employer shall enter into a contract for the physical performance of services within this state unless the contractor registers and participates in a federal work authorization program to verify the work eligibility information all new employees. No contractor or subcontractor who enters into a contract with a public employer shall enter into such a contract or subcontract in connection with the physical performance of services within this state unless such contractor or subcontractor registers and participates in a federal work authorization program to verify the work eligibility information of all new employees.
(b)
(2)
In accordance with O.C.G.A. 13-10-91, the requirements of paragraphs (a) and (b) of paragraph (1) shall apply to public employers, their contractors and subcontractors, as follows: (a) (b) (c) On or after July 1, 2007, to public employers, contractors, or subcontractors of 500 or more employees; On or after July 1, 2008, to public employers, contractors or subcontractors of 100 or more employees; and On or after July 1, 2009, to all other public employers, their contractors, or subcontractors.
See Section 00420, Purchasing Forms & Instructions for declarations and affidavits. V. Bid General Requirements The following information pertains to the submission of a Bid to Fulton County, and contains instructions on how Bids must be presented in order to be considered. Listed below are the requirements for all Bidders interested in doing business with Fulton County.
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1.
The Bid sheets included in this Invitation to Bid ("Bid") must be fully completed and returned with the Bid unless otherwise specified in writing by the Purchasing Department. Type or neatly print the date, company name, and the full legal name and title of the person(s) signing the Bid in the place provided at the bottom of each Bid sheet. Any additional sheets submitted must contain the same signature and Bidder information. All signatures must be executed by person(s) having contracting authority for the Bidder
2.
3. Absolutely no fax Bids or reproduction Bids will be accepted, except that photocopies may be submitted in addition to the original when multiple copies of the Bid are specifically requested in the solicitation. 4. The envelope in which the Bid response is submitted must be sealed and clearly labeled with the Bid number, project title, due date and time, and the name of the company or individual submitting the proposal. Bids must be received by the opening date and time shown on this Bid in order to be considered. The Purchasing Agent has no obligation to consider Bids which are not in properly marked envelopes. Contract Compliance submittals shall be submitted in a separate sealed envelope or package.
5. The original and the required number of copies of the Bid must be returned to: Fulton County Purchasing Agent Fulton County Department of Purchasing and Contract Compliance 130 Peachtree Street, S.W., Suite 1168 Atlanta, Georgia 30303 Any inquiries, questions, clarifications or suggestions regarding this solicitation should be submitted in writing to the Purchasing Contact Person. Contact with any other County personnel in regard to a current solicitation is strictly prohibited in accordance with Fulton County "No Contact Provision" policy outlined in S35 and in Section 00020, Invitation to Bid. 6. Show information and prices in the format requested. Prices are to be quoted F.O.B. Destination, and must include all costs chargeable to the Contractor executing the Contract, including taxes. Unless otherwise provided in the Contract, Fulton County shall have no liability for any cost not included in the price. The Contractor shall provide Fulton County the benefit through a reduction in price of any decrease in the Contractor's costs by reason of any tax exemption based upon Fulton County's status as a tax-exempt entity.
7. All prices Bid must be audited by the Bidder to ensure correctness before the Bid is submitted. The Bidder is solely responsible for the accuracy of information placed on a Bid sheet, including prices. Clerical or mathematical error is insufficient to void a successful Bid but a Bidder may withdraw a sealed Bid prior to opening without a penalty. 8. All prices must be submitted in the format requested and less all trade discounts. When multiple items are being Bid, Bidder must show both the unit price and the total extended price for each item. When applicable, the Bidder must include an additional lump sum Bid for groups or items. In the event a Bidder is offering an additional discount on groups of items, Bidder must indicate the total lump sum Bid for the particular group of items before any extra discount, the amount of
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extra discount, and the net total for the particular group. extension error, unit pricing shall prevail. 9.
In the event of an
By submitting a signed Bid, Bidder agrees to accept an award made as a result of that Bid under the terms and conditions spelled out in the Bid documents. In the event of a conflict between the different Bid documents, the County's cover Contract (if used) shall have precedence, followed in order by the Invitation to Bid, Purchase Order, Bid, Contractor's Warranty Agreement, Maintenance Agreement, and/or other Contractor provided agreements.
10. A Bidder may submit only one (1) Bid response for each specific Bid solicitation unless otherwise authorized in the specifications. 11. All prices submitted by the Bidder to Fulton County must be guaranteed by the authorized person(s) against any price increase for the time period designated in the Bid specifications, and Fulton County must be given the benefit of any price decrease occurring during such designated time period. 12. All items Bid must be new. Used, rebuilt and refurbished items will not be considered unless specifically authorized by Fulton County in the written specifications. 13. All Bidders must specify in the Bid response the earliest actual delivery date for each item unless otherwise specified in writing by Fulton County. The delivery date may be a factor in deciding the Bidder's capability to perform. 14. A successful Bidder's delivery ticket(s) and invoice(s) must list each item separately and must show Fulton County's purchase order number as well as the proper department and address to which delivery was made, as listed on the purchase order or in the Bidder's contract with Fulton County. 15. Unless clearly shown as "no substitute" or words to that effect, any items in this invitation to Bid which have been identified, described or referenced by a brand name or trade name are for reference only. Such identification is intended to be descriptive but not restrictive, and is to indicate the general quality and characteristics of products that may be offered. Each item Bid must be individually identified as to whether it is a specified item or an equivalent item by typing or printing after the item(s): The brand name; model or manufacturer's number, or identification regularly used in the trade. Deviations from the specifications must be clearly and fully listed on the Bid sheet, including photographs or cuts, specifications, and dimensions of the proposed "alternate". Fulton County is the sole judge of "exact equivalent", or "alternate". The factors to be considered are: function, design, materials, construction, workmanship, finishes, operating features, overall quality, local service facilities, warranty terms and service, and other relevant features of item(s) Bid. 16. For all Bids, Fulton County reserves the right to request representative samples. If requested, samples must be delivered at the Bidder's cost within three (3) business days. Samples are submitted at the risk of the Bidder and may be subjected to destructive tests by Fulton County. Samples must be plainly tagged with Fulton County's Bid number, item name, manufacturer, and the name of the Bidder. 17. Item(s) Bid must be complete and ready to operate. No obvious omissions of components or necessary parts shall be made even though the specifications may not detail or mention them. Unit(s) must be furnished with factory installed
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25. All Bidders must comply with all Fulton County Purchasing laws, policies, and procedures, non-discrimination in contracting and procurement ordinances, and relevant state and federal laws including but not limited to compliance with EEOC hiring guidelines and requirements under the Americans with Disabilities Act. Successful Bidder must obtain all permits, licenses, and inspections as required and furnish all labor, materials, insurance, equipment, tools, supervision, and incidentals necessary to accomplish the work in these specifications. 26. If a successful Bidder is unable or unwilling to enter into a Contract with Fulton County subsequent to being granted an award, or who fails to perform in accordance with the Bid specifications the Bidder will be subject to damages and all other relief allowed by law. 27. Successful Bidders contract directly with Fulton County and are the party or parties obligated to perform. Contracts may not be assigned and any failure to perform the Contract in accordance with the specifications will constitute a breach of Contract and may result in a Bidder being found to be "non-responsive" in the future. 28. In case of default by the successful Bidder, Fulton County may procure the articles for services from another source and hold the successful Bidder responsible for any resulting excess cost. 29. The County may award any Bid in whole or in part to one or more vendors or reject all Bids and/or waive any technicalities if it is in the best interests of the County to do so. In the event that all Bids are not rejected, Bids for items including goods, materials, equipment, and services will be awarded to the lowest "responsible" Bidder(s) as determined by Fulton County. Submitting the lowest Bid, as published at the Bid opening, does not constitute an award or the mutual expectation of an award of a Contract and purchase order. For purposes of this notice and the attached Bid sheets, a purchase order is a Contract to provide items including goods, materials, equipment, and services and is intended to have the full force and effect of a Contract. A breach of the terms and conditions of a purchase order constitutes a breach of Contract. 30. Bids for projects that are solicited pursuant to the Georgia Local Government Public Works Construction Law (O.C.G.A. 36-91-1 et seq.) may withdrawn as follows: Competitive sealed Bids ("Bid") may not be revoked or withdrawn until 60 days after the time set by the governmental entity for opening of Bids. At the end of this time period, the Bid will cease to be valid, unless the Bidder provides written notice to the County prior to the scheduled expiration date that the Bid will be extended for a time period specified by the County. 31. In the evaluation of the Bids, any award will be subject to the Bid being: a. Compliant to the specification - meets form, fit, and function requirements stated or implied in the specification. b. Lowest cost to the County over projected useful life. c. Administratively Compliant - Including all required bonds, insurance, established quality of work and general reputation, financial responsibility, relevant experience, and related criteria.
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32. All proposals and Bids submitted to Fulton County are subject to the Georgia "Open Records Act", Official Code of Georgia, Annotated (O.C.G.A.) 50-18-70 et seq. 33. All proposals and Bids submitted to Fulton County involving Utility Contracting are subject to the Georgia law governing licensing of Utility Contractors, O.C.G.A. 43-14-8.2(h). The Utility Contractor License number of the person who will perform the utility work shall be written on the face of the Bid envelope. 34. The apparent silence of this specification, and any supplement thereto, as to details, of the omission from it of a detailed description concerning any point, will be regarded as meaning only the best commercial practices are to prevail. Only materials of the highest quality, correct type, size, and design are to be used. All interpretations of this specification will be made upon the basis of this statement, with Fulton County interpretation to prevail. 35. It is the policy of Fulton County that the evaluation and award process for County contracts shall be free from both actual and perceived impropriety, and that contacts between potential vendors and County officials, elected officials and staff regarding pending awards of County contracts shall be prohibited. a. No person, firm, or business entity, however situated or composed, obtaining a copy of or responding to this solicitation, shall initiate or continue any verbal or written communication regarding this solicitation with any County officer, elected official, employee, or designated County representative, between the date of the issuance of this solicitation and the date of the County Manager's recommendation to the Board of Commissioners for award of the subject contract, except as may otherwise be specifically authorized and permitted by the terms and conditions of this solicitation.
b. All verbal and written communications initiated by such person, firm, or entity regarding this solicitation, if same are authorized and permitted by the terms and conditions of this solicitation, shall be directed to the Purchasing Agent. c. Any violation of this prohibition of the initiation or continuation of verbal or written communications with County officers, elected officials, employees, or designated County representatives shall result in a written finding by the Purchasing Agent that the submitted Bid or proposal of the person, firm, or entity in violation is "non-responsive", and same shall not be considered for award.
36. Any Bidder intending to respond to this solicitation as a Joint Venture must submit an executed Joint Venture Agreement with this Bid. This agreement must designate those persons or entities authorized to execute documents or otherwise bind the Joint Venture in all transactions with Fulton County, or are accompanied by a document, binding upon the Joint Venture and its constituent members, making such designation. Bids from Joint Ventures that do not include these documents will be rejected as being "non-responsive". 37. Any Bidder intending to respond to this solicitation must complete all of the Procurement Affidavit Forms provided in this solicitation. Bids that do not include these completed documents will be rejected as being "non-responsive".
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SCOPE OF WORK And TECHNICAL SPECIFICATIONS
SPECIFICATIONS Please respond to each of the following specifications with Compliance (C), Non-Compliance (NC). or Exception (E) 1. 1.1. 1.2. Intent It is the intent of Fulton County to purchase the Fuel Dispensers required to manage the fueling for Fulton County's fleet of vehicles and equipment. The thirteen Fuel Dispensers are to be installed at eight (8) sites and will include two (2) DualHose Remote Electronic Dispensers for unleaded gasoline, two (2) Dual-Hose Remote Electronic Suction Dispenser for unleaded gasoline, two (2) Single-Hose Remote Electronic Dispensers for unleaded gasoline, two (2) Single-Hose Remote Electronic Suction Dispenser for unleaded gasoline, two (2) Single-Hose Remote Electronic Dispensers for diesel fuel, and three (3) Single-Hose Remote Electronic Suction Dispenser for Diesel fuel (Ultra-Low Sulfur Diesel - (ULSD)). The installation of these Dispensers should include all work required to ensure that the Dispensers are fully operational in conjunction with the existing system. The Dispenser models utilized in creation of the specifications for unleaded and diesel Dispensers represent examples of single-hose and dual-hose models that meet the minimum requirements specified herein; models equaling or exceeding these standards will be considered. Dispensers must be equipped with High Hose mounts. ( C ) ^ (NC) (E)
1.3.
1.3.1. 1.3.2.
Dispensers must utilize High-Speed pumps - Minimum of 12 gallons per minute (GPM) with Remote Electronic Dispenser for gasoline, 15 gallons per minute (GPM) with Electronic Suction Pump for gasoline and 12 gallons GPM with Electronic Suction Pump or Remote Electronic Dispenser for diesel (C) K . (NC) _ (E) _ Dispensers must meet all applicable Federal, State, and County standards including Stage I and II Vapor Recovery for unleaded fuel. (C)^L (NC) (E)
1.3.3.
1.3.3.1.1. One site, the Big Creek Pumping Station, will not require Vapor Recovery for the two unleaded Remote Electronic Dispensers to be located there. 1.3.4. Dispensers must be modular for ease of maintenance and part replacement and include selfdiagnostics. Keys to the Dispenser panels must be provided to the Fulton County Fuel Manager to enable maintenance, part replacements, and diagnostics. (C)X(NC)_(E)_ Dispensers must include an audible alarm to preve/?it driue-off with nozzle. Dispensers must allow for termination of transaction upon removal of nozzle External filtration must be provided for all Dispensers. (C) X (NC) (E)
1.3.5. 1.3.6. 1.3.7.
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2. Scope of Work 2.1. Work Summary Will include, but is not limited tot the manufacture, delivery, assembly, installation, and testing of the specified units. AH tools, manpower, supplies, equipment rental, pedestal modification cost (if applicable), etc., needed to complete the job. Additionally, the Dispensers offered must be equipped with all standard manufacturer's components. 2.2. Execution 2.2.1 Removal of the existing Dispensers without causing any damage. Disposal of removed Dispensers is the responsibility of the contractor.
2.2.2. Turnkey installation of the new Dispensers at the eight sites per the County's Instructions including connection to the existing fuel storage system, installation of conduit, and any other construction as necessary. 2.2.3. The successful bidder must submit to Fulton County a complete shop drawing of the proposed installation of all Dispensers per the assigned sites for approval prior to actual installation 3. Specifications 3.1 Dispensers to be purchased 3.1.1 Two (2) Dual-Hose Remote Electronic Dispensers for Unleaded Fuel with Vapor Recovery per assigned sites 3.1.1.1 One (1) Dispenser to be installed at: South Service Center 5600 Stonewall Tell Road Union City, GA 30349 3.1.1.2 One (1) Dispenser to be installed at North Service Center 7741 Roswell Road Roswell, GA 30075 3.1.2 Two (2) Dual-Hose Remote Electronic Suction dispenser for Unleaded Fuel with Vapor Recovery per assigned sites 3.1.2.1 One (1) dispenser to be installed at: Central Maintenance Facility Lower island 895 Marietta Boulevard Atlanta, GA 30318 3.1.2.2 One (1) dispenser to be installed at: Central Maintenance Facility Upper Island 895 Marietta Boulevard Atlanta, GA 30318
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3.1.3 Two (2) Single-Hose Remote Electronic Dispensers for Unleaded Fuel without Vapor Recovery per assigned sites 3.1.3.1 Two (2) Dispensers to be Installed at: Big Creek Pumping Station 1030 Roswell-Marietta Highway Roswell, GA 30075 3.1.4 Two (2) Single-Hose Remote Electronic Suction Dispenser for Unleaded Fuel with Vapor Recovery per assigned sites 3.1.4.1 One (1) dispenser to be installed at: Stonewall Camp 5601 Stonewell Tell Road Union City, GA 30349 3.1.4.2 One (1) Dispenser to be installed at: Willis Mills 125 Willis Mills Road Atlanta, GA 30311 3.1.5 Two (2) Single Hose Remote Electronic Dispensers for Diesel Fuel per assigned sites 3.1.5.1 One (1) Dispenser to be installed at: Big Creek Pumping Station 1030 Roswell-Marietta Highway Roswell, GA 30075 3.1.5.2 One (1) Dispenser to be installed at: Charlie Brown Airport 3920 Aviation Circle Atlanta, GA 30336 3.1.6 Three Single-Hose Remote Electronic Suction Dispenser for Diesel Fuel per assigned sites 3.1.6.1 One (1) Dispenser to be installed at Central Maintenance Facility Lower Island 895 Marietta Boulevard Atlanta, GA 30318 3.1.6.2 One (1) Dispenser to be installed at: Stonewall Camp 5601 Stoneweli Tell Road Union City, GA 30349 3.1.6.3 One (1) Dispenser to be installed at: Willis Mills
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101TB71094K-DB Fuel Dispenser Replacement
125 Willis Mills Road Atlanta, GA 30311 Note: for the following specifications, the configuration will be for one or two outlets hoses dependent upon the specifications listed above (3.1 through 3.6) Please respond to each of the following specifications with Compliance (C), Non-Compliance (NO, or Exception (E) Exception(s)can be entered at the end of section following Specification 3.11.1 3.2 Configuration 3.2.1 3.2.2 Provision for dispensing one fuel product from one or two hose outlets Product iniet/Outiet Connections 3.2.2.1 For Remote Electronic Suction Dispenser 1-1/2 inch NPT250-lb. ground joint union 3.2.2.2 For Remote Electronic Dispenser-1 product inlet connection of 1-1/2 inch NPT Pipe 3.2.2.3 One or two product outlet connection(s) of 1 inch NPT including a removable 1 inch x 3/4 inch reducer bushing(s). 3.2.3 One or Two Side mounted nozzle boot(s) which is island oriented to allow dispensing from either the front or rear island traffic lane. For Remote Electronic Suction Dispenser - for 1 self-contained (suction) style v-belt driven positive displacement pump(s) and 1 one HP Continuous Duty electric motor(s). One or two volumetric positive displacement, piston style meter(s)
(C)^L (NC) _ (E) _

v y ( C ) X . (NC) _ (E) _
. , ( C ) X (NC) _ (E) _
(C) _ (NC)
(E)
3.2.4
( C ) X (NC) _ (E) _ (C)X_ (NC) _ (E) _
3.2.5 3.3
Performance - The Dispenser must have: 3.3.1 Maximum Flow Rate 3.3.1.1 For Remote Electronic Suction Dispenser A maximum (1) flow rate of fifteen (15) gallons per minute (C) ) (NC) _ (E) _ For Remote Electronic Dispenser - A Maximum (1) flow rate of twelve (12) gallons per minute
3.3.1.2
(C) ^
(NC) _ (E) _
3.3.1.3
Maximum Flow Rate is optimal rates during testing. Actual rates will vary depending upon installation conditions and accessories such as hoses, nozzles, swivels, etc. and choice of horsepower rating.
3.4
Construction. The dispenser must have:

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3.4.1 3.4.2 3.4.3
A corrosion resistant frame. Corrosion-resistant steel top cover. Black powder coated, corrosion-resistant side panels. Black powder coated, corrosion-resistant upper cabinet door. Lower doors are powder coated base paint and corrosion-resistant 3.4.5.1 For Unleaded Fuel Dispensers, the color will be "White" 3.4.5.2 For Diesel Fuel Dispensers, the color will be "Green" (at no additional cost over "White")
3.4.4
3.4.5
(C)Y.(NC)_(E) (C)X(NC)_(E)
3.4.6 3.4.7
AH doors must be secured by locks. The design of the Dispenser must prevent rain or snow from entering the electronic enclosure Nominal dimensions must be for a High hose style cabinet
(C)X(NC)_(E). (C))(NC)_(E).
3.4.8
3.5
Hydraulic System 3.5.1 For Remote Electronic Suction Dispenser (one or two hose configurations) 3.5.2.1 Each pumping unit must have: 3.5.1.1.1 3.5.1.1.2 Self lubricating bearings A drain plug \n filter cover to facilitate spill resistant filter changes A minimum dry suction capability of 12 Inches High A minimum wet suction capability of 21 Inches High ( C ) X (NC) _ (E).
(C)X(NC)_(E)_
3.5.1.1.3 3.5.1.1.4
3.5.2 For Remote Electronic Dispenser (one or two hose configurations) One shut-off control valve(s) for smooth 3.5.2.1 hydraulic flow and prevention of fuel flow while the dispenser is in the "off1 state (C)X.(NC)_(E) 3.5.2.2 One inlet check valve(s) to prevent fuel flow backward at the dispenser inlet
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(C)X(NC)_(E)
3.5.2.3
One replaceable paper filter(s)
(C)) (NC) _ (E) _
3.5.3 One or two volumetric, positive displacement piston meter(s). Each meter must have: 3.5.3.1 A design that relies upon the CPU and software to perform calibration Adjustments electronically. The meter must not have any mechanical means to alter the calibration setting performed by the CPU 3.5.3.2 The ability to measure in US Gallons 3.5.3.3 Accuracy of +/- 0.3% from 1.5 GPM to 26 GPM 3.5.3.4 3/4 inch 24 VDC solenoid valve 3.6 Electrical Power Requirements. The Dispenser must have: 3.6.1 One electronic computer module designed to be safe for UL Class 1, Division 1 hazardous locations. The electronic computer module must have: 3.6.1.1 Provision to operate the electronic controls with nominal voltage of 115v 60Hz, 1 Phase with a tolerance of plus or minus 24% and a cycle range of 48 to 62 Hz
( C ) X (NC) _ (E) _
3.6.1.2
For Remote Electronic Suction dispenser only Single 1-Horse-power, 115v60Hz, 1 Phase, Continuous Duty Cycle, Explosion Proof Motor for Underwriter Laboratories listed use in Class 1, Group D hazardous locations (C)
kM
3.7
Electronic Computer per Hose. The Dispenser must have: 3.7.1 One electronic computer module designed to be safe for UL Class 1, Division 1 hazardous locations. The electronic computer module must have: Design which includes the CPU, Power Supply, LCD Displays with backlighting, Battery Backup, electronic meter calibration, RS-485 Fleet Card System communication interface, electromechanical analog totalizer and wiring terminal strips for field wiring termination One Auxiliary Display Board for Side 2 of the cabinet Fifteen (15) minutes of Battery Backup
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(C)
3.7.1.1
3.7.1.2 3.7.1.3
Display power during a VAC power loss, including the ability to Recall the last transaction amount after the displays blank out 3.7.1.4 One electronic pulsar that is self monitoring to prevent product flow in the event of a malfunction. This pulsar must have provision to attach a wire seal to make it tamper-proof One dispenser Handle Switch for positive on/off operation. This handle switch must be electronically inter-locked so that the transaction display resets to zero each time the switch is turned to the "On11 position. The handle and nozzle boot assembly must be constructed so that the nozzle cannot be replaced in the boot/cradle unless the handle . switch is in the "Off' position (C) X. (NC) _ (E) _ The transaction displays of the electronic computer module must each have: 3.7.1.6.1 One LCD to display each transaction. The LCD must have high contrast black characters of at (east 1" (2.54cm) height 3.7.1.6.2 Capability to display six (6) digits for a single transaction. For Gallons the display must be 999.999 maximum 3.7.1.6.3 Capability to display accumulative, non-resettable electronic transaction hose totals. For Gallons the display must be 99,999,999.999 maximum.
3.7.1.5
3.7.1.6
(C)X(NC)_(E)_
(C)V(NC)_(E)_
3.7.1.7
Accumulative, non-resettable Electromechanical totalizer for hose totals must be visible from the main LCD Display window without opening the upper cabinet doors Automatic Error Code numbers displayed on main LCD for each common functional or component failure during system operation Built-in technician activated software diagnostics with error codes to troubleshoot and isolate the area of malfunction Electronic Calibration of the meter setting and must provide a physical switch to access the electronic calibration mode. This switch must have a security provision to attach a seal wire
127
3.7.1.8
3.7.1.9
3.7.1.10
3.7.1.11
Capability to operate in temperatures ranging from -30C to +50C at 95% noncondensing humidity without heaters or cooling fans
. (C) X (NC) _ (E) _
3.8
Fuel Compatibility. The Dispenser must have: 3.8.1 Unleaded 3.8.1.1 Product ID panels to read: 3.8.1.1.1 Label: UNLEADED 3.8.1.1.2 Foreground Color: white 3.8.1.1.3 Background Color: black 3.8.1.2 The nozzle handle color is "Black" 3.8.2 Diesel 3.8.2.1 Product ID panels to read: 3.8.2.1.1 Label: Label: ULTRA LOW SULFUR DIESEL 3.8.2.1.2 3.8.2.1.3 Foreground Color: white Background Color: black (C)X(NC) _ ( E ) _ (C))(NC)_(E)_ (C)^(NC) _ ( E ) _
(C) X " ( N C ) _ (E) _ (C)> (NC) _ (E) _
(C) ) (NC) _ (E) _ (C) ) (NC) _ (E) _ ( C ) ) (NC) _ (E) _
3.8.2.2 The nozzle handle color is "Green" 3.9 Approvals. The Dispenser must have: 3.9.1 Underwriters Laboratories listing for the use for which it is intended. The U.L. label must be permanently affixed to the side of the dispenser 3.9.2 N. T. E. P. Certificate of Conformance for the use for which it is intended available upon request
(C)^* (NC)
(E)
. (C) j K (NC) _ (E) _
3.10
The Dispenser must include the following: 3.10.1 Connectivity to a Fuel Management System. 3.10.2 Inclusion of an explosion proof lower cabinet junction box wiring from junction box to upper cabinet area furnished and Installed by others 3.10.3. All external field wiring, including hardwiring and conduit, that is required to and from the building to this fuel cabinet and the Fuel Management System are to be furnished and installed by, and are the responsibility of, the installing contractor.
128
(C) JX (NC)
(E)
(C)^ (NC)
(E)
(C) X (NC)
(E)
3.11
Warranty 3.11.1 The vendor must guarantee the products to be free of defects of material and/or workmanship for a period of at least one (1) year from the date of delivery. Any additional warranty offered by the vendor should be so stipulated in the proposal documents. If, during the warranty period, such faults develop, the successful vendor agrees to replace the unit or part affected without cost to the Board.
(C) X (NC) _ (E) _
3.12
Exceptions noted above (denote Specification Number):
4,Testing 4.1 The complete Dispensers must be installed to Fulton County's satisfaction. The complete Dispensers must be tested after installation in the presence of Fulton County authorized representatives
5.1 The complete Dispensers and any additional equipments must be delivered to the eight fueling sites. 5.2 Delivery will be made Monday through Friday, 8:00 AM 3:00 PM local time. The bidder is responsible for off-loading the dispensers from the delivery Vehicle Bid Items All bid items must be net, including loading, unloading, and delivery to Atlanta, GA
129
BID FORMS
SECTION 00300
BID FORM
Submitted To: Fulton County Government Submitted By: For: 10ITB71094K-DB Fuel Dispenser Replacement Submitted on
$ i7C^^L/L/ Te h undersigned, as Bidder, hereby declares that the only person or persons interested in the Bid as principal or principals is or are named herein and that no other person than herein mentioned has any interest in this Bid or in the Contract to be entered into; that this Bid is made without connection with any other person, company or parties making a Bid; and that it is in all respects fair and in good faith without collusion or fraud. The Bidder further declares that he has examined the site of the work and informed himself fully in regard to all conditions pertaining to the place where the work is to be done; that he has examined the Drawings and Specifications for the work and contractual documents relative thereto, and has read all instructions to Bidders and General Conditions furnished prior to the openings of bids; that he has satisfied himself relative to the work to be performed. The Bidder proposes and agrees, if this Bid is accepted, to contract with the Board of Commissioners of Fulton County, Atlanta, Georgia, in the form of contact specified, to furnish all necessary materials, equipment, machinery, tools, apparatus, means of transportation and labor necessary, and to complete the construction of the work in full and complete accordance with the shown, noted, and reasonably intended requirements of the Specifications and Contract Documents to the full and entire satisfaction of the Board of Commissioners of Fulton County, Atlanta, Georgia, with a definite understanding that no money will be allowed for extra work except as set forth in the attached General Conditions and Contract Documents for the following prices. THE BASE BID IS THE AMOUNT UPON WHICH THE BIDDER WILL BE FORMALLY EVALUATED AND WHICH WILL BE USED TO DETERMINE THE LOWEST RESPONSIBLE BIDDER. The base bid may not be withdrawn or modified for a period of sixty (60) days following the receipt of bids. BASE BID AMOUNT (Do not include any Bid Alternates) (Dollar Amount In Numbers) (Dollar Amount in Words) The Bidder agrees hereby to commence work under this Contract, with adequate personnel and equipment, on a date to be specified in a written order of the Contracting Officer and to fully complete all work under this Contract within One Hundred and Twenty (120) consecutive calendar days from and including said date. (&Cs * ~
20
The Bidder declares that he understands that the quantities shown for the unit prices items are subject to either increase or decrease, and that should the quantities of any of the items of work be increased, the Bidder proposes to do the additional work at the unit prices stated herein; and should the quantities be decreased, the Bidder also understands that payment will be made on the basis of actual quantities at the unit price bid and will make no claim for anticipated profits for any decrease in quantities; and that actual quantities will be determined upon completion of work, at which time adjustments will be made to the contract amount by direct increase or decrease. The Bidder furthermore agrees that, in the case of a failure on his part to execute the Contract Agreement and Bonds within ten days after receipt of conformed contract documents for execution, the Bid Bond accompanying his bid and the monies payable thereon shall be paid into the funds of theJDwrier as licAiidatedidamaaes for such failure.
Dollars according to the conditions of "Instructions to Bidders" and provisions
thereof.
The undersigned acknowledges receipt of the following addenda (list by the number and date appearing on each addendum) and thereby affirms that its Bid considers and incorporates any modifications to the originally issued Bidding Documents included therein. ADDENDUM # ADDENDUM # ADDENDUM # ADDENDUM # BIDDER: Signed by: DATED DATED DATED DATED
\a\4\0i /9/09
Title: Business Adcfrifss:
3O5S
Business Phone
: "77^
GA
[State/County]
Bidder's Contractor License No:
License Expiration Date:
21
10ITB71094K-DB Fuel Dfspenser Replacement
Note: If the Bidder is a corporation, the Bid shall be signed by an officer of the corporation; if a partnership, it shall be signed by a partner. If signed by others, authority for signature shall be attached. The full name and addresses of persons or parties interested in the foregoing Bid, as principals, are as follows:
END OF SECTION
22
Acknowledgement of each ADDENDUM
25
10ITB71094K-DB; Fuel Dispenser Replacement Addendum 1 Page 2
NOTE: Q&A Question: Can the Bid bond be waived? Answer: No Question: Is the Primary bidder required to have a General Contractor's License or can the subcontractor, utilized for the work, have the General Contractor's License? Answer: The Georgia General Contractor's License is not required for this project. Questfon: I did not see where it is stipulated that the new dispensers must be able to interface with the existing fuel management system. Please clarify this requirement? Answer: On page 121, Specification 12, the last sentence states "The installation of these dispensers should include all work required to ensure that the dispensers are fully operational in conjunction with the existing system. ACKNOWLEDGEMENT OF ADDENDUM NO. 1 The undersigned bidder acknowledges receipt of this addendum by returning one (1) copy of this form with the bid package to the Purchasing Department, Fulton County Public Safety Building, 130 Peachtree Street, Suite 1168, Atlanta, Georgia 30303 by the ITB due date and time.
This is to acknowlesJSjgs_receipt of Addendum No. 1, 2009.
day of
Legal Name of Bidder jgnature of Authorized Representative
mmmms&m ^'
130 Peachtree Street, S.WMSuite 1168 -Atlanta, GA30303 (404) 612-5800
'"' Winner 2 0 0 0 - 2 0 0 9 Achievement of Excellence In Procurement Award National Purchasing Institute
101TB71094K-DB; Fuel Dispenser Replacement Addendum 2 Page 3
ACKNOWLEDGEMENT OF ADDENDUM NO. 2 The undersigned bidder acknowledges receipt of this addendum by returning one (1) copy of this form with the bid package to the Purchasing & Contract Compliance Department, Fulton County Public Safety Building, 130 Peachtree Street, Suite 1168, Atlanta, Georgia 30303 by Thursday, December 17, 2009 at 11:00am. This is to ackngwjedge receipt of Addendum No. 2, / , S 20 Legal Name of Bidder nature of Authorized Representative Title day of
T>
"" Winner 2000 - 2009 Achievement of Excellence In Procurement Award Natlonat Purchasing Institute
130 Peachtree Street, S.W.,Suite 1168 Atlanta, GA 30303 (404) 612-5800
BID SECURITY
REGIONS
CASHIERS CHECK
12/16/2009
61-1/620
500 2877023
Purchaser/ Purchased For
United Pump and Controls, Inc. / Bid 101TB71094K-DB
THREE THOUSAND FOUR HUNDRED TWENTY DOLLARS AND 00 CENTS
$3,420.00
PAY TO THE ORDER OF: F u l t o n COUflty
Authorized Signature
Branch (3X02128 CCQ02128
^^
" BOO 53 7 70 E
H O & S O O O O m : OOOO?i. 26 5 in-
PAYMENT BOND
SECTION 00620
PAYMENT BOND
No Contract with Fulton County for work to be done shall be valid for any purpose unless the Contractor provides a Payment Bond with good and sufficient surety payable to Fulton County for the use and protection of all sub-contractors and all persons supplying labor, materials, machinery, and equipment in the prosecution of the work provided for in the Contract. The Payment Bond shall be in the amount of 100% of the total contract amount, payable by the terms of the Contract, and shall be written on the following form. Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business in the State of Georgia. Attestation for the corporation must be by the corporate officer; for a partnership by another partner; for an individual by a notary with the corporate seal.
71
Duplicate 10ITB71094K-DB Fuel Dispenser Replacement
5 B# B-9110903
PAYMENT BOND
KNOW ALL MEN BY THESE PRESENTS that UNITED PUMP AND CONTROLS, INC.
(hereinafter called the "Principal") and THE CINCINNATI l N S u W c T f f i f | g | e r

(Insert name of Surety)
caNed t h e
"Surety"), are held and firmly bound unto FULTON COUNTY, a political subdivision of the State of Georgia (hereinafter called the "Owner"), its successors and assigns as obligee, in the penal sum of 6 8 . 4 0 0 . (100% of contract amount], lawful money of the United States of America, for the payment of which the Principal and the Surety bind themselves, their administrators, executors, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has entered, or is about to enter, into a certain written contract with the Owner, dated , which is incorporated herein by reference in its entirety (hereinafter called the "Contract"), for construction-type services of a project known as Fuel Dispenser Replacement, as more particularly described in the Contract (hereinafter called the "Project"); NOW, THEREFORE, the condition of this obligation is such that if the Principal shall promptly make payment to all persons working on or supplying labor or materials under the Contract, and any amendments thereto, with regard to labor or materials furnished and used in the Project, and with regard to labor or materials furnished but not so used, then this obligation shall be void; but otherwise it shall remain in full force and effect. 1 A "Claimant1 shall be defined herein as any subcontractor, person, party, partnership, corporation or the entity furnishing labor, services or materials used, or reasonably required for use, in the performance of the Contract, without regard to whether such labor, services or materials were sold, leased or rented, and without regard to whether such Claimant is or is not in privities of contract with the Principal or any subcontractor performing work on the Project, including, but not limited to, the following labor, services, or materials: water, gas, power, light, heat, oil, gasoline, telephone service or rental of equipment directly applicable to the Contract. In the event a Claimant files a lien against the property of the Owner, and the Principal fails or refuses to satisfy or remove it promptly, the Surety shall satisfy or remove the lien promptly upon written notice from the Owner, either by bond or as otherwise provided in the Contract. The Surety hereby waives notice of any and all modifications, omissions, additions, changes, alterations, extensions of time, changes in the payment terms, and any other amendments in or about the Contract and agrees that the obligations undertaken by this Bond shall not be impaired in any manner by reason of any such modifications, omissions, additions, changes, alterations, extensions of time, changes in payment terms, and amendments. The Surety hereby agrees that this Bond shall be deemed amended automatically and immediately, without formal or separate amendments hereto, upon any amendment or modifications to the Contract, so as to bind the Principal and Surety, jointly and severally, to the full payment of any Claimant under the Contract, as amended or modified, provided only that the Surety shall not be liable for more than the penal sum of the Bond, as specified in the first paragraph hereof. This Bond is made for the use and benefit of all persons, firms, and corporations who or which may furnish any materials or perform any labor for or on account of the construction-type services to be performed or supplied under the Contract, and any amendments thereto, and they and each of them may sue hereon.
2.
3.
4.
5.
72
6.
No action may be maintained on this Bond after one (1) year from the date the last services, labor, or materials were provided under the Contract by the Claimant prosecuting said action. This Bond is intended to comply with O.C.GA Section 13-10-1, and shall be interpreted so as to comply with the minimum requirements thereof. However, in the event the express language of this Bond extends protection to the Owner beyond that contemplated by O.C.G.A. Section 13-10-1, or any other statutory law applicable to this Project, then the additional protection shall be enforced in favor of the Owner, whether or not such protection is found in the applicable statutes.
7.
73
IN WITNESS WHEREOF the undersigned have caused this instrument to be executed and their respective corporate seals to be affixed and attested by their duly authorized representatives this 3RD day of MARCH , 2010 . UNITED PUMP AND CONTROLS, B j p . (Principal) By: B J BENTON, PRESIDENT
(SEAL)
Attest:
Secretai
THE CINCINNATI INSURANCE COMPANY ^2 (SEAL) (Surety) J By:

RICHARD M JOHNSON,/^TTORNEY-IN-FACT
Attest:
'Secretary
6200 S, GILMORE ROAD, FAIRFIELD, OHIO 45014
(Address of Surety's Home Office)
(Resident Agent of Surety)//
74
THE CINCINNATI INSURANCE COMPANY Fairfield, Ohio POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That THE CINCINNATI INSURANCE COMPANY, a corporation organized under the laws of the State of Ohio, and having its principal office in the City of Fairfield, Ohio, does hereby constitute and appoint Richard M. Johnson of Nor cross, Georgia its true and lawful Attorney(s)-in-Fact to sign, execute, seal and deliver on its behalf as Surety, and as its act and deed, any and all bonds, policies, undertakings, or other like instruments, as follows: Any such obligations in the United States, up to Twenty Five Million and No/100 Dollars ($25,000,000-00)This appointment is made under and by authority of the following resolution passed by the Board of Directors of said Company at a meeting held in the principal office of the Company, a quorum being present and voting, on the 6th day of December, 1958, which resolution is still in effect: "RESOLVED, that the President or any Vice President be hereby authorized, and empowered to appoint Attorneys-inFact of the Company to execute any and all bonds, policies, undertakings, or other like instruments on behalf of the Corporation, and may authorize any officer or any such Attorney-in-Fact to affix the corporate seal; and may with or without cause modify or revoke any such appointment or authority. Any such writings so executed by such Attorneys-inFact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company." This Power of Attorney is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of the Company at a meeting duly called and held on the 7th day of December, 1973. "RESOLVED, that the signature of the President or a Vice President and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the signature of the Secretary or Assistant Secretary and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power of certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certified by certificate so executed and sealed shall, with respect to any bond or undertaking to which it is attached, continue to be valid and binding on the Company." IN WITNESS WHEREOF, THE CINCINNATI INSURANCE COMPANY has caused these presents to be sealed with its corporate seal, duly attested by its Vice President this 10th day of October, 2008. THE C M ^ J J f f l l INSURANCE COMPANY
Vice President A? STATE OF OHIO COUNTY OF BUTLER ) ss: )
On this 10th day of October, 2008, before me came the above-named Vice President of THE CINCINNATI INSURANCE COMPANY, to me personally known to be the officer described herein, and aclcnowledged that the seal affixed to the preceding instrument is the corporate seal of said Company and the corporate seal and the signature of the officer were duly affixed and subscribed to said instrument by the authority and direction of said corporation.
//MARK J. HU JLLER, Attorney at Law

U NOTARY PUBLIC - STATE OF OHIO My commission has no expiration date. Section 147.03 O.R.C.
I, the undersigned Secretary or Assistant Secretary of THE CINCINNATI INSURANCE COMPANY, hereby certify that the above is a true and correct copy of the Original Power of Attorney issued by said Company, and do hereby further certify that the said Power of Attorney is still in full force and effect. GIVEN under my hand and seal of said Company at Fairfield, Ohio. 3RD day of MARCH 2010 Secretary
BN-1005 (10/08)
PERFORMANCE BOND
28
SECTION 00610
PERFORMANCE BOND
No contract with Fulton County for work to be done shall be valid for any purpose unless the Contractor provides a Performance Bond with good and sufficient surety payable to, in favor of, and for the protection of Fulton County. The Performance Bond shall be in the amount of 100% of the total contract amount, payable by the terms of the Contract, and shall be written on the following form. Surety companies executing Bonds must appear on the Treasury Department's most current list (Circular 570 as amended) and be authorized to transact business as a surety in Georgia. Attestation for the corporation must be by the corporate officer; for a partnership by another partner; for an individual by a notary with the corporate seal.
67
Duplicate 10ITB71094K-DB Fuel Dispenser Replacement
5 B# B-9110903
PERFORMANCE BOND KNOW ALL MEN BY THESE PRESENTS that UNITED PUMP AND CONTROLS, INC.
(Insert name of Contractor)
(hereinafter called the "Principal") and THE CINCINNATI INSURANCE COfffi&Sinafter called the
(Insert name of Surety)
"Surety"), are held and firmly bound unto FULTON COUNTY, a political subdivision of the State of Georgia (hereinafter called the "Owner"), its successors and assigns, in the penal sum of 68,400 [100% of contract amount], lawful money of the United States of America, for the payment of which the Principal and the Surety bind themselves, their administrators, executors, successors and assigns, jointly and severally, firmly by these presents. WHEREAS, the Principal has entered, or is about to enter, into a certain written contract with the Owner, dated , which is incorporated herein by reference in its entirety (hereinafter called the "Contract"), for construction-type services of a project known as Fuel Dispenser Replacement, as more particularly described in the Contract (hereinafter called the "Project"); NOW, THEREFORE, the conditions of this obligation are as follows, that if the Principal shall fully and completely perform all the undertakings, covenants, terms, conditions, warranties, and guarantees contained in the Contract, including all modifications, amendments, changes, deletions, additions, and alterations thereto that may hereafter be made, then this obligation shall be void; otherwise it shall remain in full force and effect. Whenever the Principal shall be, and declared by the Owner to be, in default under the Construction-Type Contract, the Surety shall promptly remedy the default as follows: 1. Complete the Contract in accordance with its terms and conditions; or, at the sole option of the Owner, Obtain a bid or bids for completing the Contract in accordance with its terms and conditions, and upon determination by the Surety and the Owner of the lowest responsible bidder, arrange for a contract between such bidder and Owner and make available as the work progresses (even though there should be a default or succession of defaults under the Contract or contracts of completion arranged under this paragraph) sufficient funds to pay the cost of completion less the balance of the contract price; but not exceeding, including other costs and damages for which the Surety may be liable hereunder, the penal sum set forth in the first paragraph hereof, as may be adjusted, and the Surety shall make available and pay to the Owner the funds required by this Paragraph prior to the payment of the Owner of the balance of the contract price, or any portion thereof. The term "balance of the contract price," as used in this paragraph, shall mean the total amount payable by the Owner to the Contractor under the Contract, and any amendments thereto, less the amount paid by the Owner to the Contractor; or, at the sole option of the Owner, Allow Owner to complete the work and reimburse the Owner for all reasonable costs incurred in completing the work.
2.
3.
In addition to performing as required in the above paragraphs, the Surety shall indemnify and hold harmless the Owner from any and all losses, liability and damages, claims, judgments, liens, costs and fees of every description, including reasonable attorney's fees, litigation costs and expert witness fees, which the Owner may incur, sustain or suffer by reason of the failure or default on the part of the Principal in the performance of any or all of the terms, provisions, and requirements of the Contract, including any and all amendments and modifications thereto, or incurred by the Owner in making good any such failure of performance on the part of the Principal.
68
The Surety shall commence performance of its obligations and undertakings under this Bond promptly and without delay, after written notice from the Owner to the Surety. The Surety hereby waives notice of any and all modifications, omissions, additions, changes, alterations, extensions of time, changes in payment terms, and any other amendments in or about the Contract, and agrees that the obligations undertaken by this Bond shall not be impaired in any manner by reason of any such modifications, omissions, additions, changes, alterations, extensions of time, change in payment terms, and amendments. The Surety hereby agrees that this Bond shall be deemed amended automatically and immediately, without formal or separate amendments hereto, upon any amendment to the Contract, so as to bind the Principal and the Surety to the full and faithful performance of the Contract as so amended or modified, and so as to increase the penal sum to the adjusted Contract Price of the Contract. No right of action shall accrue on this Bond to or for the use of any person, entity or corporation other than the Owner and any other obligee named herein, or their executors, administrators, successors or assigns. This Bond is intended to comply with O.C.G.A. Section 36-91-1 et seq., and shall be interpreted so; as to comply with; the minimum requirements thereof. However, in the event the express language of this Bond extends protection to; the Owner beyond that contemplated by O.C.G.A. Section 36-91-1 et seq. and O.C.G.A. Section 13-10-1, as amended, or any other statutory law applicable to this Project, then the additional protection shall be enforced in favor of the Owner, whether or not such protection is found in the applicable statutes.
69
IN WITNESS WHEREOF the undersigned have caused this instrument to be executed and their respective corporate seals to be affixed and attested by their duly authorized representatives this 3RD day of MARCH , 2010 . UNITED PUMP AND CONTROLS, INC. (Principal) (SEAL)
By:. B J BENTON, PRESI6ENT

Attest:
SecretarxX
THE CINCINNATI INSURANCE COMPANY

/? (Surety) / / By: (SEAL) / /
/ L _ RICHARD Tf JOHNSCW, ATTORNEY-IN-FACT
' Secretary
6200 S. GILMORE ROAD, FAIRFIELD, OHIO 45014 (Address of Surety's Home Office)
(Resident Agent of Suret^f {/
70
COMPENSATION
PRICE INFORMATION
SITE - LOCATION
South Service Center 5600 Stonewall Tell Rd. Union City, GA. 30349 North Service Center 7741 Roswell Road Roswell, GA. 30075 Central Maintenance Facility 895 Marietta, Blvd. Atlanta, GA. 30318 Central Maintenance Facility 895 Marietta, Blvd. Atlanta, GA. 30318 Central Maintenance Facility 895 Marietta, Blvd. Atlanta, GA. 30318 Big Creek Pumping Station 1030 Roswell Highway Roswell, GA, 30075 Big Creek Pumping Station 1030 Roswell Highway Roswell, GA, 30075 Stonewall Camp 5601 Stonewall Tell Rd. Union City, GA. 30349 Stonewall Camp 5601 Stonewall Tell Rd. Union City, GA. 30349 Charlie Brown Airport 392^ Aviation Circle Atlanta, GA. 30336 Willis Mills 125 Willis Mills Rd. Atlanta, GA. 30311 Willis Mills 125 Willis Mills Rd. Atlanta, GA. 30311
TYPE DISPENSER MATERIAL INSTALLATION COST COST

1 dispenser, 2 hoses Unleaded, Submerged 1 dispenser, 2 hoses Unleaded, Submerged 1 dispenser, 2 hoses Unleaded, Suction
TOTAL COST
^07 L
7,871
1 dispenser, 2 hoses Unleaded, Submerged
k
&oo'
1 dispenser, 1 hose Diesel, Suction
2 dispenser, 1 hose Unleaded, Submerged
L
itQlQ800^
1 dispenser, 1 hose Diesel Submerged 1 dispenser, 1 hose Unleaded, Suction 1 dispenser, 1 hose Diesel, Suction 1 dispenser, 1 hose Diesel, Submerged 1 dispenser, 1 hose Unleaded, Suction 1 dispenser, 1 hose Diesel, Suction
<8co
W*
5o47'
AtWl
ULA Cosjs.
United
Pump and Controls, Inc.
305 Shawnee North Dr. #300 Suwanee, GA 30024-2299
HEREIN 'SELLER' B U Y E R Fulton County Govt. South Service Center. 5600 Stonewall Tell Rd. Union City, GA 30349 Phone: Fax: ACCT. NO. 12/17/2009 REP #
Quotation and Contract

Equipment, Tanks, Parts and Supplies for the Transport, Storage, Measurement and Dispensing of Petroleum Products. Phone: (770) 662-0440 Fax: (770) 729-0682 Attention:[_
SELLER QUOTES TO SUPPLY THE EQUIPMENT AND/OR SERVICES SET FORTH HEREIN SUBJECT TO THE TERMS AND CONDITIONS APPEARING ON THE FRONT HEREOF AND ATTACHED: M EXHIBIT A", TERMS AND CONDITIONS OF SALE AND/OR SERVICE.
J O B
TERMS Net 45 Days. QUOTE # 12170901
Install Gasoline Dispenser.
DELIVERY APPROXIMATELY 4 To 6 Weeks.
UNITED PUMP AND CONTROLS, INC.

Enter Salesperson Name
115 New Buyer's Authorized Signature ACCEPTANCE OF QUOTATION: T e h

| Manager
QTY. 1 1 1 1 1 2 2 2 2 2 2 1
PRODUCT NUMBER DESCRIPTION Bennett 3712SNR-24 Remot High Hose cabinet electronic dispenser. 1 Product, Non stock * 2 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Non stock Bennett J. Junction Box Lower Hydraulic Area. Non stock Bennett SO. Spin-On Filter. Non stock Constructed of Galvanized Steel and Powder coated painted w/colors as required. Non stock Bennett BV. Balanced Vapor Recovery option. Non stock Flexing MAXXIMASY100. 101 Balanced Vapor Hose Assy. Non stock Flexing MAXXIM ASY10.1 1 Balanced Vapor Whip Hose Assy. Non stock OPW-11VF-47-0427 Long Spout Balanced Nozzle. Non stock OPW-66CLP-5100 Stage-ll Reconnectable Breakaway. Non stock OPW-38CS-0380 Balanced adaptor. Non stock Installation Remove old dispenser. Install new Bennett dispenser and purge, calibrate and connect it to existing Fuel controller. Perform State required Stage-ll testing. (Does not include repairs required to comply with Stage-ll unless related to United's work.)
UNIT PRICE $4,547.00 $189.00 91.00 35.00 49.00 152.00 58.00 170.00 93.00 85.00 1,090.00
$ $ $ $ $ $ $ $ $ $
SUB-IOIAL:
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
EXTENDED 4,547.00 189.00 91.00 35.00 - 98.00 304.00 116.00 340.00 186.00 170.00 1,090.00 7,166.00
E^^H
^ ^ ^ _ ^^^^^^^^B SHIPPING ^^^H /,166.00 ^sfiliasUjgJHi $ - ^HStifiliiSBS^H
H i
T TL O A:
IMPORTANT: THIS QUOTATION IS GOOD THIRTY (30) DAYS FROM DATE. SUBJECT TO ALL THE TERMS AND CONDITIONS ON THE FACE AND ATTACHED, INCLUDING THE DISCLAIMER OF WARRANTIES AND
S:\Sales\Quotes\Fulton County 1 Govt Union City 1215O9.xls
United
HEREIN 'SELLER' B U Y E R Fulton County Govt. North Service Center 7741 Roswell Rd. Roswel, GA 30075 Phone: Fax: ACCT. NO. 12/17/2009
rid terms and coaditious nrc hereby

Equipment, Tanks, Parts and Supplies for the Transport, Storage, Measurement and Dispensing of Petroleum Products. Phone: (770) 662-0440 Fax: (770) 729-0682 Attention:
SELLER QUOTES TO SUPPLY THE EQUIPMENT AND/OR SERVICES SET FORTH HEREIN SUBJECT TO THE TERMS AND CONDITIONS APPEARING ON THE FRONT HEREOF AND ATTACHED: n EXHIBIT A", TERMS AND CONDITIONS OF SALE AND/OR SERVICE.
J O B
Install Gasoline Dispenser.
REP #
DELIVERY APPROXIMATELY
TERMS Net 45 Days.
QUOTE #
12170902

ACCEPTANCE OF QUOTATION: n,c
115 New Buyer's Authorized Signature
4 To 6 Weeks.

[Manager
QTY. 1 1 1 1 1 2 2 2 2 2 2 1
PRODUCT NUMBER DESCRIPTION Non stock Bennett 3712SNR-24 Remot High Hose cabinet electronic dispenser. 1 Product, 2 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Non stock Bennett J. Junction Box Lower Hydraulic Area. Non stock jBennett SO. Spin-On Filter. Non stock Constructed of Galvanized Steel and Powder coated painted w/colors as required. Non stock Bennett BV. Balanced Vapor Recovery option. Non stock Flexing MAXXIMASY100. 10' Balanced Vapor Hose Assy. Non stock Flexing MAXXIM ASY10. 11 Balanced Vapor Whip Hose Assy. Non stock OPW-11VF-47-0427 Long Spout Balanced Nozzle. Non stock OPW-66CLP-5100 Stage-ll Reconnectable Breakaway. Non stock OPW-38CS-0380 Balanced adaptor. Non stock Installation Remove old dispenser. Install new Bennett dispenser and purge, calibrate and connect it to existing Fuel controller. Perform State required Stage-ll testing. (Does not include repairs required to comply with Stage-ll unless related to United's work.) SHIPPING CHARGES
UNIT PRICE
$4,547.00 $ $ $189.00 $ 91.00 $ 35.00 $ $ 49.00 $ 152.00 $ 58.00 $ 170.00 $ 93.00 $ 85.00 $ $ 1,090.00 $ $ $ $
EXTENDED
4,547.00 189.00 91.00 35.00 98.00 304.00 116.00 340.00 186.00 170.00 1,090.00 -
$ $ $ $ $ $ $ $ $ $
SUB-TOTAL:
SALES TAX:
TOTAL:
7,166.00
WARRANTIES AND
IMPORTANT: THIS QUOTATION IS GOOD THIRTY (30) DAYS FROM DATE. SUBJECT TO ALL THE TERMS AND CONDITIONS ON THE FACE AND ATTACHED, INCLUDING THE DISC
S:\Sales\Quotes\Futton County 2 Govt Roswell 1215D9.xls
United
HEREIN'SELLER' B U Y E R Fulton County Govt. Central Maint. Facility. 895 Manotta Blvd. Atlanta, GA 30318 Phone: Fax: ACCT. NO. 12/17/2009 REP #

Equipment, Tanks, Parts and Supplies for the Transport, Storage, Measurement and Dispensing of Petroleum Products. Phone: (770) 662-0440 Fax: (770) 729-0682
Attention:
SELLER QUOTES TO SUPPLY THE EQUIPMENT AND/OR SERVICES SET FORTH HEREIN SUBJECT TO THE TERMS AND CONDITIONS APPEARING ON THE FRONT HEREOF AND ATTACHED: " EXHIBIT A \ TERMS AND CONDITIONS OF SALE AND/OR SERVICE.
J O B
Install Gasoline Suction Pump.
TERMS Net 45 Days.
QUOTE # 12170903

New 115 Buyer's Authorized Signature ACCEPTANCE OF QUOTATION: mc

[Manager
QTY. 1 1 1 1 1 2 2 2 2 2 2 1
PRODUCT NUMBER DESCRIPTION Bennett 3712SNS-8 Remot High Hose cabinet electronic Heavy Duty Suction Pump. Non stock 1 Product, 2 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Non stock Non stock Bennett J. Junction Box Lower Hydraulic Area. Bennett SO. Spin-On Filter Non stock Constructed of Galvanized Steel and Powder coated painted w/colors as required. Non stock Bennett BV. Balanced Vapor Recovery option. Non stock Flexing MAXXIMASY100. 10' Balanced Vapor Hose Assy. Non stock Flexing MAXXIM ASY10.1' Balanced Vapor Whip Hose Assy. Non stock OPW-11VF-47-0427 Long Spout Balanced Nozzle. Non stock OPW-66CLP-5100 Stage-ll Reconnectable Breakaway. Non stock OPW-38CS-0380 Balanced adaptor. Non stock Installation Remove old dispenser. Install new Bennett dispenser and purge, calibrate and connect it to existing Fuel controller. Perform State required Stage-ll testing. (Does not include repairs required to comply with Stage-ll unless related to United's work.)
UNIT PRICE $5,252.00 $189.00 91.00 35.00 49.00 152.00 58.00 170.00 93.00 85.00 1,090.00
$ $ $ $ $ $ $ $ $ $
r$ [$
$ $ $ $
EXTENDED 5,252.00 189.00 91.00 35.00 98.00 304.00 116.00 340.00 186.00 170.00 1,090.00
$ $ $ $ $
$ $ $ $ $ $ $
1 IMPORTANT: THIS QUOTATION IS GOOD THIRTY (30) DAYS FROM DATE.
SUB-TOTAL:
Q ^ H KEHIiltl
S L S TAX: AE
^HHHH^H SHHHI^H
S I PN HP I G C A GS HR E
! BS U
7,871.00
TTL OA:
I>
SUBJECT TO ALL THE TERMS AND CONDITIONS ON THE FACE AND ATTACHED, INCLUDING THE Dli
S:\Sales\Quotes\Fulton County 3 Govt Suction Atlanta 121509.xls
United
Pump and Controls, Inc,
HEREIN 'SELLER' B U Y E R Fulton County Govt. Central Maint. Facility. 895 Manotta Blvd. Atlanta, GA 30318 Phone: Fax: ACCT. NO. 12/17/2009
ACCEPTANCE OF QUOTATION:

Attention:[_
SELLER QUOTES TO SUPPLY THE EQUIPMENT AND/OR SERVICES SET FORTH HEREIN SUBJECT TO THE TERMS AND CONDITIONS APPEARING ON THE FRONT HEREOF AND ATTACHED: " EXHIBIT A", TERMS AND CONDITIONS OF SALE AND/OR SERVICE.
J O B
Install Gasoline Dispenser
REP # 115
TERMS
Net 4 5 D a y s .
QUOTE #
UNITED PUMP AND CONTROLS, INC. UNITED PUMP AND CONTROLS, INC.
Manager
New
4 To 6 Weeks.
I 1 2 1 7 0 9 0 4 Enter Salesperson Name
Buyer s Authorized Signature
| QTY. 1 1 1 1 1 2 2 2 2 2 2 1
PRODUCT NUMBER DESCRIPTION Bennett 3712SNR-24 Remot High Hose cabinet electronic dispenser. 1 Product, Non stock 2 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Non stock Bennett J. Junction Box Lower Hydraulic Area. Non stock Bennett SO. Spin-On Filter. Non stock Constructed of Galvanized Steel and Powder coated painted w/colors as required. Non stock Bennett BV. Balanced Vapor Recovery option. Non stock Flexing MAXXIMASY100. 101 Balanced Vapor Hose Assy. Non stock Flexing MAXXIM ASY10. 11 Balanced Vapor Whip Hose Assy. Non stock OPW-11VF-47-0427 Long Spout Balanced Nozzle. Non stock OPW-66CLP-5100 Stage-ll Reconnectable Breakaway. Non stock OPW-38CS-0380 Balanced adaptor. Non stock Installation Remove old dispenser. Install new Bennett dispenser and purge, calibrate and connect it to existing Fuel controller. Perform State required Stage-ll testing. (Does not include repairs required to comply with Stage-ll unless related to United's work.)
UNIT PRICE $4,547.00 $189.00 91.00 35.00 49.00 152.00 58.00 170.00 93.00 85.00 1,090.00
$ $ $ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
EXTENDED 4,547.00 189.00 91.00 35.00 98.00 304.00 116.00 340.00 186.00 170.00 1,090.00 7,166.00
^^^B
SUB-IOIAL:
^^^^^^^^M
-
E ^ ^ H /, 166.00 ^2fiUaUi23^H $
SHIPPING ^^^B ^HflmfiSiiSBS^H
jfHI
TOTAL:
/1PORTANT: THIS QUOTATION IS GOOD THIRTY (30) DAYS FROM DATE. SUBJECT TO ALL THE TERMS AND CONDITIONS ON THE FACE AND ATTACHED, INCLUDING THE DISCLAIMER OF WARRANTIES AND
S:\Sales\Quotes\Fulton County 4 Govt Disp Atlanta 121509.xls
United
305 Shawnee North Dr. #300 Suwanee, GA 30024-2299 (HEREIN'SELLER' I B U Y E R Fulton County Govt. Central Maint. Facility. 895 Manotta Blvd. Atlanta, GA 30318 Phone: Fax: ACCT. NO. 12/17/2009
prices, specifications and lemis ;uid conditious are hereby accepted.

J O B
Install Diesel Suction Pump.
REP # 115
TERMS Net 45 Days.
QUOTE #
12170905

New
Buyer's Authorized Signature ACCEPTANCE OF QUOTATION: n*

Manager
i QTY. 1 1 1 1 1 1 1 1 1 1 1
PRODUCT NUMBER DESCRIPTION Bennett 3711HNS-3. Remot High Hose cabinet electronic Heavy Duty Suction Pump. Non stock 1 Product, 1 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Non stock Bennett J. Junction Box Lower Hydraulic Area. Non stock Bennett SO. Spin-On Filter. Non stock Constructed of Galvanized Steel and Powder coated painted w/colors as required. Non stock Non stock Non stock Non stock Non stock Non stock Installation Flexing FLX-HW301000. 1" X 10' Hose w/swivel end. Flexing FLX-HW300009 1" X 9" Whip Hose. OPW-7HB-0100 Automatic Diesel Nozzle w/Green cover. OPW-66V-1300. 1" Breakaway. OPW-8HG-0100. 1" Green Splash Guard. Remove old Suction Pump. Install new Bennett Suction Pump and purge, calibrate and connect it to existing Fuel controller. Includes performance and payment Bond cost.
UNIT PRICE $3,035.00 $189.00 91.00 35.00 80.00 19.00 95.00 54.00 5.00 800.00
$ $ $ $ $ $ $ $ $
SUB-IOIAL:
^ ^ ^ _ l i i ^ ^ ^ H HHSIBI
^ ^ ^ ^ ^ ^ ^ ^ H
SHIPPING
^ ^ ^ _
SALES I AX:
i^^^^^^^^fl
CHARGbS
^^^H
1
^ H
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
EXTENDED 3,035.00
1
189.00 91.00 35.00 80.00 19.00 95.00 54.00 5.00 800.00 4,403.00
TOTAL:
S:\Sales\Quotes\Fulton County 5 Govt Diesel Suction Atlanta 121509.xls
United
HEREIN 'SELLER' B U Y E R Fulton County Govt. Big Creek Pumping St. 1030 Roswell Hwy. Roswel, GA 30075 Phone: Fax: ACCT. NO. 12/17/2009 ACCEPTANCE OF QUOTATION: REP #
Quotation and Contract Equipment, Tanks, Parts and Supplies for the Transport, Storage, Measurement and Dispensing of Petroleum Products. Phone: (770) 662-0440 Fax: (770) 729-0682
Attention:
SELLER QUOTES TO SUPPLY THE EQUIPMENT AND/OR SERVICES SET FORTH HEREIN SUBJECT TO THE TERMS AND CONDITIONS APPEARING ON THE FRONT HEREOF AND ATTACHED: M EXHIBIT A". TERMS AND CONDITIONS OF SALE AND/OR SERVICE.
J O B
Install 2 Gasoline Dispensers.
TERMS
Net 4 5 Days.
QUOTE #
Manager
New 115 Buyer's Authorized Signature
4 To 6 Weeks.
| 1 2 1 7 0 9 0 6 |Enter Salesperson Name
| QTY. 2 2 2 2 2 2 2 2 2 2 1
PRODUCT NUMBER
Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Installation
DESCRIPTION Bennett 3711SNR-19. Remot High Hose cabinet electronic Dispenser. 1 Product, 1 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Bennett J. Junction Box Lower Hydraulic Area. Bennett SO. Spin-On Filter. Constructed of Galvanized Steel and Powder coated painted w/colors as required. Flexing FLX-HW201000. 3/4" X 10' Hose w/swivel end. Flexing FLX-HW200009. 3/4" X 9" Whip Hose. OPW-11BP-0400 Automatic Gasoline Nozzle w/Black cover. OPW-66V-0300. 3/4" Breakaway. OPW-8BL-0400. 3/4" Black Splash Guard. Remove old dispensers. Install 2 new Bennett dispensers and purge, calibrate and connect it to existing Fuel controller. Includes performance and payment Bond cost.
UNIT PRICE $2,620.00 $189.00 91.00 35.00 53.00 13.00 46.00 25.00 4.00 1,600.00
$ $ $ $ $ $ $ $ $
SUB-TOTAL:
^ ^ ^ _ E ^ ^ H WH38BBI
SALES I AX:
^ ^ ^ ^ ^ ^ ^ ^ H I^^^^^^^^l
SHIPPING CHAKGLS
^ ^ ^ B ^ ^ ^ H
1 ^ H
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
!$
EXTENDED 5,240.00 378.00 182.00 70.00 106.00 26.00 92.00 50.00 8.00 1,600.00 7,752.00
TOTAL:
S:\Sales\Quotes\Fulton County 6 Govt Gas Disp Roswel 121509.xls
United
305 Shawnee North Dr. #300 Suwanee, GA 30024-2299 HEREIN 'SELLER' B U Y E R Fulton County Govt. Big Creek Pumping St. 1030 Roswell Hwy. Roswell, GA 30075 Phone: Fax: ACCT. NO. 12/17/2009
prices, specifications and tcniis and conditions arc hereb

SELLER QUOTES TO SUPPLY THE EQUIPMENT AND/OR SERVICES SET FORTH HEREIN SUBJECT TO THE TERMS AND CONDITIONS APPEARING ON THE FRONT HEREOF AND ATTACHED: M EXHIBIT A", TERMS AND CONDITIONS OF SALE AND/OR SERVICE.
Install Diesel Dispenser.
o
B
REP # 115
TERMS Net 45 Days.
QUOTE #
Manager
New
I 1 2 1 7 0 9 0 7 Enter Salesperson Name
Buyer's Authorized Signature
QTY. 1 1 1 1 1 1 1 1 1 1 1
PRODUCT NUMBER Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Installation
DESCRIPTION Bennett 3711SNR-19. Remot High Hose cabinet electronic Dispenser. 1 Product, 1 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Bennett J. Junction Box Lower Hydraulic Area. Bennett SO. Spin-On Filter. Constructed of Galvanized Steel and Powder coated painted w/colors as required. Flexing FLX-HW301000. 1" X 10' Hose w/swivel end. Flexing FLX-HW300009 1" X 9" Whip Hose. OPW-7HB-0100 Automatic Diesel Nozzle w/Green cover. OPW-66V-1300. 1" Breakaway. OPW-8HG-0100. 1" Green Splash Guard. Remove old Suction Pump. Install new Bennett Suction Pump and purge, calibrate and connect it to existing Fuel controller. Includes performance and payment Bond cost.
UNIT PRICE $2,620.00
$ $ $ $ $ $ $ $ $
SUB-IOJAL:
$ $ $189.00 $ 91.00 $ 35.00 $ $ $ 80.00 $ 19.00 $ 95.00 $ 54.00 $ 5.00 $ $ 800.00 $ $ $ $ $ $
EXTENDED 2,620.00 189.00 91.00 35.00 80.00 19.00 95.00 54.00 5.00 800.00 3,988.00
^ ^ ^ _ KJHHH
^ ^ ^ ^ ^ ^ ^ ^ B
SHIPPING
^ ^ ^ _ ^ H TOTAL:
IMPORTANT: THIS QUOTATION IS GOOD THIRTY (30) DAYS FROM DATE. SUBJECT TO ALL THE TERMS AND CONDITIONS ON THE FACE AND ATTACHED, INCLUDING THE DISCLAIMER OF WARRANTIES AND LIMITATIONS OF REMEDIES, AND SHALL BECOME A CONTRACT WHEN SIGNED AND RETURNED BY BUYER TO SELLER AND ACCEPTED IN WRITING BY SELLER.
S:\Sales\Quotes\Fulton County 7 Govt Diesel Disp Roswel 121509.xls
United
HEREIN'SELLER' B U Y E R Fulton County Govt. Stonewall Camp. 5601 Stonewall Tell Rd. Union City, GA 30349 Phone: Fax: ACCT. NO. 12/17/2009 ACCEPTANCE OF QUOTATION: REP #

Attention:
J O B
DELIVERY APPROXIMATELY 4 TO 6 WeekS. |
TERMS Net 45 Days.
QUOTE #
New I 115 I Buyer s Authorized Signature
| 1 2 1 7 0 9 0 8 JEnter Salesperson Name UNITED PUMP AND CONTROLS, INC.

Manager
QTY. 1 1 1 1 1 1 1 1 1 1 1 1
PRODUCT NUMBER DESCRIPTION Non stock Bennett 3711-HNS-3. Remot High Hose cabinet electronic Heavy Duty Suction Pump. 1 Product, 1 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Non stock Bennett J. Junction Box Lower Hydraulic Area. Non stock Bennett SO. Spin-On Filter. Non stock Constructed of Galvanized Steel and Powder coated painted w/colors as required. Non stock Non stock Bennett BV. Balanced Vapor Recovery option. Flexing MAXXIMASY100. 10' Balanced Vapor Hose Assy. Non stock Flexing MAXXIM ASY10.1' Balanced Vapor Whip Hose Assy. Non stock OPW-11VF-47-0427 Long Spout Balanced Nozzle. Non stock OPW-66CLP-5100 Stage-ll Reconnectable Breakaway. Non stock OPW-38CS-0380 Balanced adaptor. Non stock Installation Remove old dispenser. Install new Bennett dispenser and purge, calibrate and connect it to existing Fuel controller. Perform State required Stage-ll testing. (Does not include repairs required to comply with Stage-ll unless related to United's work.)
UNIT PRICE $3,035.00 $189.00 91.00 35.00 49.00 152.00 58.00 170.00 93.00 85.00 1,090.00
$ $ $ $ $ $ $ $ $ $
B^^H
I SUB-101AL: R t ^ ^ ^ HR S M B S I
SALES I AX:
^^^^^^^^M i^^^^^^^^H
S I PN HP I G
^^^B
CHARGbS
^^^H
1
^ H
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
EXTENDED 3,035.00 189.00 91.00 35.00 49.00 152.00 58.00 170.00 93.00 85.00 1,090.00 5,047.00
TOTAL:
IMPORTANT: THIS QUOTATION IS GOOD THIRTY (30) DAYS FROM DATE. SUBJECT TO ALL THE TERMS AND CONDITIONS ON THE FACE AND ATTACHED, INCLUDING THE DISCLAIMER OF WARRANTIES AN[ LIMITATIONS OF REMEDIES, AND SHALL BECOME A CONTRACT WHEN SIGNED AND RETURNED BY BUYER TO SELLER AND ACCEPTED IN WRITING BY SELLER.
S:\Sales\Quotes\Fulton County 8 Govt Union City Gas Suction 121509.xls
United
HEREIN 'SELLER' B U Y E R Fulton County Govt. Stonewall Camp. 5601 Stonewall Tell Rd. Union City, GA 30340 Phone: Fax: ACCT. NO. REP #
Quotation and Contract Equipment, Tanks, Parts and Supplies for the Transport, Storage, Measurement and Dispensing of Petroleum Products. Phone: (770) 662-0440 Fax: (770) 729-0682
Attention:[_
J O B
TERMS Net 45 Days.
QUOTE #
Manager
115 New Buyer's Authorized Signature ACCEPTANCE OF QUOTATION: T e h
12/17/2009
4 To 6 Weeks.
1 2 1 7 0 9 0 9 Enter Salesperson Name
1 QTY. 1
1 1 1 1
PRODUCT NUMBER Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Installation
DESCRIPTION Bennett 3711HNS-3. Remot High Hose cabinet electronic Heavy Duty Suction Pump. 1 Product, 1 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Bennett J. Junction Box Lower Hydraulic Area. Bennett SO. Spin-On Filter. Constructed of Galvanized Steel and Powder coated painted w/colors as required. Flexing FLX-HW301000. 1"X 10' Hose w/swivel end. Flexing FLX-HW300009 1" X 9" Whip Hose. OPW-7HB-0100 Automatic Diesel Nozzle w/Green cover. OPW-66V-1300. 1" Breakaway. OPW-8HG-0100. 1" Green Splash Guard. Remove old Suction Pump. Install new Bennett Suction Pump and purge, calibrate and connect it to existing Fuel controller. Includes performance and payment Bond cost.
UNIT PRICE $3,035.00
$ $ $ $ $ $ $ $ $
1
1 1
1 1 1
SUB-IOIAL:
$ $ $189.00 $ 91.00 $ 35.00 $ $ $ 80.00 $ 19.00 $ 95.00 $ 54.00 $ 5.00 $ $ 800.00 $ $ $ $ $ $
EXTENDED 3,035.00
-
189.00 91.00 35.00

-
80.00 19.00 95.00 54.00 5.00

-
800.00
-
^ ^ ^ _
B^^^H
^ ^ ^ ^ ^ ^ ^ ^ H
SHIPPING
^ ^ ^ B
^ H TOTAL: 4,403.00
IMPORTANT: THIS QUOTATION IS GOOD THIRTY (30) DAYS FROM DATE. SUBJECT TO ALL THE TERMS AND CONDITIONS ON THE FACE AND ATTACHED, INCLUDING THE DISCLAIMER OF WARRANTIES ANL LIMITATIONS OF REMEDIES, AND SHALL BECOME A CONTRACT WHEN SIGNED AND RETURNED BY BUYER TO SELLER AND ACCEPTED IN WRITING BY SELLER.
S:VSales\Quotes\Futton County 9 Govt Diesel Disp. Union City 121509.xls
United
305 Shawnee North Dr. #300 Sxiwanee,GA 30024-2299
HEREIN 'SELLER' B U Y E R Fulton County Govt. Charlie Brown Airport. 3929 Aviation Circle Atlanta, GA 30336 Phone: Fax: ACCT. NO. 12/17/2009
ACCEPTANCE OF QUOTATION: i
prices, specifications and terms ;uid conditions nrc hereby accepted

Attention:
J O B
REP #
TERMS Net 45 Days.
QUOTE #
121709010

115 New Buyer's Authorized Signature
4 To 6 Weeks.

Manager
QTY. 1 1 1 1 1 1 1 1 1 1 1
PRODUCT NUMBER DESCRIPTION Bennett 3711SNR-19. Remot High Hose cabinet electronic Dispenser. Non stock 1 Product, 1 Hose, 2 Sided, Side Load. Non stock Bennett P.4 Channel Pulse1 Output. Compatible with Tech-21 Fuel controller. Bennett J. Junction Box Lower Hydraulic Area. Non stock Bennett SO. Spin-On Filter. Non stock Constructed of Galvanized Steel and Powder coated painted w/colors as required. Non stock Non stock Non stock Non stock Non stock Non stock Installation Flexing FLX-HW301000. 1" X 10' Hose w/swivel end. Flexing FLX-HW300009 1" X 9" Whip Hose. OPW-7HB-0100 Automatic Diesel Nozzle w/Green cover. OPW-66V-1300. 1" Breakaway. OPW-8HG-0100. 1" Green Splash Guard. Remove old Suction Pump. Install new Bennett Suction Pump and purge, calibrate and connect it to existing Fuel controller. Includes performance and payment Bond cost.
UNIT PRICE $2,620.00 $189.00 91.00 35.00 80.00 19.00 95.00 54.00 5.00 800.00
$ $ $ $ $ $ $ $ $
SUB-IOIAL:
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
EXTENDED 2,620.00 189.00 91.00 35.00 80.00 19.00 95.00 54.00 5.00 800.00 3,988.00
^^^B
E ^ ^ HB5EEEISI
SALES I AX:
^^^^^^^^M f^^^^^^^H
SHIPPING
CHAKGbS
^^^^g ^^^^|
^ H
TOTAL:
S:\Sales\Quotes\Fulton County 10 Govt Air Port Diesel Disp Atlanta 121509.xls
United
HEREIN 'SELLER' B U Y E R Fulton County Govt. Wills Mills. 125 Wills Mills Rd. Atlanta, GA 30311 Phone: Fax: ACCT. NO. REP #
Quotation and Contract Equipment, Tanks, Parts and Supplies for the Transport, Storage, Measurement and Dispensing of Petroleum Products. Phone: (770) 662-0440 Fax: (770) 729-0682 Attention:[ J O
TERMS Net 45 Days.
QUOTE #
Manager
12/17/2009
New
115
4 To 6 Weeks.
1 2 1 7 0 9 0 1 1 Enter Salesperson Name
Buyer's Authorized Signature
| QTY. 1
1
PRODUCT NUMBER Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Non stock Installation
1 1 1 1
1 1 1 1 1
DESCRIPTION Bennett 3711-HNS-3. Remot High Hose cabinet electronic Heavy Duty Suction Pump. 1 Product, 1 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Bennett J. Junction Box Lower Hydraulic Area. Bennett SO. Spin-On Filter. Constructed of Galvanized Steel and Powder coated painted w/colors as required. Bennett BV. Balanced Vapor Recovery option. Flexing MAXXIMASY100. 10' Balanced Vapor Hose Assy. Flexing MAXXIM ASY10. t Balanced Vapor Whip Hose Assy. OPW-11VF-47-0427 Long Spout Balanced Nozzle. OPW-66CLP-5100 Stage-!l Reconnectable Breakaway. OPW-38CS-0380 Balanced adaptor. Remove old dispenser. Install new Bennett dispenser and purge, calibrate and connect it to existing Fuel controller. Perform State required Stage-ll testing. (Does not include repairs required to comply with Stage-ll unless related to United's work.)
UNIT PRICE $3,035.00 $189.00 91.00 35.00

-
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $
-
$ $ <& $ $ $ $ $ $
EXTENDED 3,035.00 189.00 91.00 35.00

-
49.00 152.00 58.00 170.00 93.00 85.00 1,090.00
49.00 152.00 58.00 170.00 93.00 85.00 1,090.00 5,047.00
I|
^ ^ ^ B
SUB-IOIAL: B ! ^ ^ HEHEflilti
SALES IAX:
^ ^ ^ ^ ^ ^ ^ ^ H f^^^^^^^H
SHIPPING CHARGbS
^ ^ ^ ^ | ^ ^ ^ ^ |
TOTAL:
S:\Sales\Quotes\Futton County 11 Wills Mills Gas Suction 121509.xls
United
HEREIN 'SELLER' B U Y E R Fulton County Govt. Wills Mills. 125 Wills Mills Rd. Atlanta, GA 30311 Phone: Fax: ACCT. NO. 12/17/2009 New REP # 115

Attention:
J O B
Install Diesel Suction Pump.
TERMS Net 45 Days.
QUOTE # 121709012

Buyer's Authorized Signature ACCEPTANCE OF QUOTATION: TI,C

Manager
QTY. 1 1 1 1 1 1 1 1 1 1 1
PRODUCT NUMBER DESCRIPTION Bennett 3711HNS-3. Remot High Hose cabinet electronic Heavy Duty Suction Pump. Non stock 1 Product, 1 Hose, 2 Sided, Side Load. Bennett P.4 Channel Pulse Output. Compatible with Tech-21 Fuel controller. Non stock Bennett J. Junction Box Lower Hydraulic Area. Non stock Bennett SO. Spin-On Filter. Non stock Constructed of Galvanized Steel and Powder coated painted w/colors as required. Non stock Non stock Non stock Non stock Non stock Non stock Installation Flexing FLX-HW301000. 1" X 10' Hose w/swivel end. Flexing FLX-HW300009 1" X 9" Whip Hose. OPW-7HB-0100 Automatic Diesel Nozzle w/Green cover. OPW-66V-1300. 1" Breakaway. OPW-8HG-0100. 1" Green Splash Guard. Remove old Suction Pump. Install new Bennett Suction Pump and purge, calibrate and connect it to existing Fuel controller. Includes performance and payment Bond cost.
UNIT PRICE $3,035.00 $189.00 91.00 35.00 80.00 19.00 95.00 54.00 5.00 800.00
$ $ $ $ $ $ $ $ $
SUB-IOIAL:
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $
EXTENDED 3,035.00 189.00 91.00 35.00 80.00 19.00 95.00 54.00 5.00 800.00 4,403.00
^ ^ ^ _ fc^^^H EBHKlil
SALES 1 AX:
^ ^ ^ ^ ^ ^ ^ ^ H K^^^^^^^^^H
SHIPPING ^ ^ ^ ^ | CHAKGbS ^^^^H
TOTAL:
S:\Sales\Quotes\Fulton County Govt 12 Wills Mills Diesel Suction Atlanta 121509.XIS
PURCHASING FORMS
FORM A:
NON-COLLUSION AFFIDAVIT OF BIDDER/OFFEROR
STATE OF GEORGIA COUNTY OF FULTON
I, certify that pursuant to Fulton County Code Section ^ 2-320 (11), this bid or proposal Is madeJvithout prior understanding, agreement or connection with any corporation, firm or person submitting a bid for the same work, labor or service to be done or the supplies, materials or equipment to be furnished and is in all respects fair and without collusion or fraud. I understand collusive bidding is a violation of state and federal law and can result in fines, prison sentences and civil damages awards. I agree to abide by all conditions of this bid or proposal and certify that I am authorized to sign this bid or proposal for the bidder
C.G.A. Section 36-91-21 (d) and (e), _ has not, by itself or with others, directly or indirectly, prevented o(J attempted to prevent competition in such bidding or proposals by any means whatsoever. Affiant further states that (s)he has not prevented or endeavored to prevent anyone from making a bid or offer on the project by any means whatever, nor has Affiant caused or induced another to withdraw a bid or offer for the work. yy^ M Affiant further states that the said offer of b r f j t f i i f c K U r l U ^ W ^ t v i T ^ T o n a fide, and that no one has gone to any supplier and attempted to get such person or company to furnish the materials to the bidder only, or if furnished to any other bidder, that the material shall be at a higher price.
tes that pursuant
(PRES/DENTA/ICE PRE Sworri to and subscribed befofe me this S(0
ECRETAF^/ASSISTANT SECRETARY) (Affix corporate seal here, if a corporation)
Notary Public:, County: Commission Expires: <///1 ^ / *^ &3
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IF THE OFFEROR IS A PARTNERSHIP, ALL OF THE PARTNERS AND ANY OFFICER, AGENT, OR OTHER PERSON WHO MAY HAVE REPRESENTED OR ACTED FOR THEM IN BIDDING FOR OR PROCURING THE CONTRACT SHALL ALSO MAKE THIS OATH. IF THE OFFEROR IS A CORPORATION, ALL OFFICERS, AGENTS, OR OTHER PERSONS WHO MAY HAVE ACTED FOR OR REPRESENTED THE CORPORATION IN BIDDING FOR OR PROCURING THE CONTRACT SHALL MAKE THE OATH.
)1
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FORM B: FULTON COUNTY CERTIFICATE OF ACCEPTANCE OF BID/PROPOSAL REQUIREMENTS

This Is To Certify That On This DavBidder/Proposer Acknowledges That He/She Has Read This Bid Document, Pages I To l&rj Inclusive, Including Addendum(s) ^L To ^L . And/Or Appendices To , In Its Entirety, And Agrees That No Pages Or Parts Of The Document Have Been Omitted, That He/She Understands, Accepts And Agrees To Fully Comply With The Requirements Therein, And That The Undersigned Is Authorized By The Bidding/Proposing Company To Submit The Bid/Proposal Herein And To Legally Obligate The Bidder/Proposer s Thereto. /j ~^ ft Company: Signature: Name: Title: Date:
\-3--\U-Q^
(Corporate Seal)
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FORM C3: GEORGIA PROFESSIONAL LICENSE CERTIFICATION

NOTE: Please complete thfs form for the work your firm will perform on this project. Contractor's Name:
Performing work as; Prime Contractor x v Professional License Type; Professional License Number:
Sub-Contractor
Expiration Date of License: I certify that the above infojwatiqn is jrue and correct and that the classification noted is applicable to tie Bid for Vr
i7)
COPY OF LICENSE)
(APPLICABLE)
FORM D: CERTIFICATION REGARDING DEBARMENT

(1) The Offeror certifies that neither it or its subcontractors is presently debarred, suspended, proposed for debarment, declared ineligible, or otherwise excluded from doing business with any government agency. Any such exclusion may cause prohibition of your firm from participating in any procurement by the Fulton County Government. (2) If the Offeror is unable to certify to any of the statements in this certification, such Offeror or subcontractor shall attach an explanation to this bid or proposal. INSTRUCTIONS FOR CERTIFICATION By signing and submitting this certification, the Offeror is providing the certification set out below: (1) The certification in this clause is a material representation of fact upon which reliance will be placed. If it is later determined that the prospective vendor knowingly rendered a false certification, the Purchasing Agent may pursue all available remedies, including suspension and/or debarment, for withdrawal of award or termination of a contract. (2) The prospective Offeror shall provide immediate written notice to the Purchasing Agent if at anytime the Offeror learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. (3) Offeror shall be under a continuing duty to immediately inform the Purchasing Agent in writing of any changes, if as a result of such changes, the Offeror certification regarding debarment is affected. DEBARMENT ORDINANCE The following Section 2-322 of Fulton County Code of Laws establishes the procedure for the debarment of contractors. Authority to suspend. After reasonable notice to the entity involved and reasonable opportunity for that entity to be heard, the Purchasing Agent, after consultation with user department, the County Manager and the County Attorney shall have the authority to suspend an entity for cause from consideration for award of county contracts. As used in this section, the term entity means any business entity, individual, firm, contractor, subcontractor or business corporation, partnership, limited liability corporation, firm, contractor, subcontractor or business structured; provided, further, that any such entity shall also be subject to suspension under this section if any of its constituents, members, subcontractors at any tier of such entity's and the entity, or any constituent or member, knew or should have known of the commission of the act. The suspension shall be for a period not to exceed three (3) years unless cause is based on a felony conviction for an offense related or associated with fraudulent contracting or misappropriation of funds wherein the suspension shall not exceed seven (7) years. Causes for Suspension. The causes for suspension include: (1) Conviction for commission of a criminal offense as an incident to obtain or attempting to obtain a public or private contract or subcontract, or in performance of such contract or subcontract; Conviction of state or federal statutes of embezzlement, theft, forgery, bribery, falsification or destruction of records, receiving stolen property or other offense
(2)
34
indicating a lack of business integrity or business honesty which currently, seriously and directly affects responsibility as a county contractor. (3) Conviction of state or federal anti-trust statues arising out of the solicitation and submission of bids and proposals; Violation of contract provisions, as set forth below, of a character which is regarded by the Purchasing Agent to be so serious as to justify suspension action: a. b. Failure to perform in accordance with the specifications within a time limit provided in a county contract; A recent record of failure to perform or unsatisfactory performance in accordance with the terms of one or more contracts; provided, that failure to perform or unsatisfactory performance caused by acts beyond the control of the contractor shall not be considered to be a basis for suspension; Material representation of the composition of the ownership or workforce or business entity certified to the county as a minority business enterprise; or Falsification of any documents.
(4)
c. d. (5) (6)
For violation of the ethical standards set forth in Fulton County Code Chapter 9, Code of Ethics. Knowing misrepresentation to the county, of the use which a majority owned contractor intends to make a minority business enterprise (a business entity at least 51 percent of which is owned and controlled by minority persons, as defined in Fulton County Code Chapter 6, Article B, Minority Business Enterprise Affirmative Action Program and certified as such by the County) as a subcontractor or a joint venture partner, In performing work under contract with the County.
Failure to fully and truthfully provide the information required, may result in the disqualification of your bid/proposal from consideration or termination of the Contract, once awarded. This document must be completed and included as a part of the bid/proposal package along with other required documents. [SIGNATURES ON NEXT PAGE]
35
Under penalty of perjury, I declare that I have examined this certification and all attachments hereto, if applicable, to the best of my knowledge and belief, and all statements contained hereto are true, correct, and complete. On this / o day of
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FORM E: DISCLOSURE FORM AND QUESTIONNAIRE

1. Please provide the names and business addresses of each of the Offeror's firm's officers and directors. For the purposes of this form, the term "Offerer" means an entity that responds to a solicitation for a County contract by either submitting a proposal in response to a Request for Proposal or a Request for Qualification or a Bid in response to an Invitation to Bid. Describe accurately, fully and completely, their respective relationships with said Offeror, including their ownership interests and their anticipated role in the management and operations of said Offeror. 2. 3. Please describe the general development of said Offeror's business during the past five (5) years, or such shorter period of time that said Offeror has been in business. Please state whether any employee, agent or representative of said Offeror who is or will be directly involved in the subject project has or had within the last five (5) years: (i) directly or indirectly had a business relationship with Fulton County; (ii) directly or indirectly received revenues from Fulton County; or (iii) directly or indirectly receives revenues from the result of conducting business on Fulton County property or pursuant to any contract with Fulton County. Please describe in detail any such relationship.
LITIGATION DISCLOSURE: Failure to fully and truthfully disclose the information required, may result in the disqualification of your bid or proposal from consideration or termination of the Contract, once awarded. 1. Please state whether any of the following events have occurred In the last five (5) years with respect to said Offeror. If any answer is yes, explain fully the following: (a) whether a petition under the federal bankruptcy laws or state insolvency laws was filed by or against said Offeror, or a receiver fiscal agent or similar officer was appointed by a court for the business or property of said Offeror; whether Offeror was subject of any order, judgment, or decree not subsequently reversed, suspended or vacated by any court of competent jurisdiction, permanently enjoining said Offeror from engaging in any type of business practice, or otherwise eliminating any type of business practice; and whether said Offeror's business was the subject of any civil or criminal proceeding in which there was a final adjudication adverse to said or Offeror, which directly arose from activities conducted by the business unit or corporate division of said Offeror which submitted a bid or proposal for the subject project. If so please explain.
(b)
(c)
2.
Have you or any member of your firm or team to be assigned to this engagement been indicted or convicted of a criminal offense within theJaeHtê (5) years? Circle One: YES
3.
Have you or any member of your firm or team ever been terminated (for cause or otherwise) from any work being performed for Fulton County or any other Federal, State or Local Government? Circle One: YES
37
4.
Have you or any member of your firm or team been involved in any claim or litigation adverse to Fulton County or any other Federal, State or Local Government, or private entity during the last three (3) years?
Circle One:
YES
( N O
5.
Has any offeror, member of offeror's team, or officer of any of them (with respect to any matter involving the business practices or activities of his or her employer), been notified within the five (5) years preceding the date of this offer that any of them are the target of a criminal investigation, grand jury investigation, or civil enforcement proceeding?
Circle One:
YES
NO
If you have answered "YES11 to any of the above questions, please indicate the name(s) of the person(s), the nature, and the status and/or outcome of the information, indictment, conviction, termination, claim or litigation, the name of the court and the file or reference number of the case, as applicable. Any such information should be provided on a separate page, attached to this form and submitted with your proposal. NOTE: If any response to any question set forth in this questionnaire has been disclosed in any other document, a response may be made by attaching a copy of such disclosure. (For example, said Offeror's most recent filings with the Securities and Exchange Commission ("SEC") may be provided if they are responsive to certain items within the questionnaire.) However, for purposes of clarity, Offeror should correlate its responses with the exhibits by identifying the exhibit and its relevant text. Disclosures must specifically address, completely respond and comply with all information requested and fully answer all questions requested by Fulton County. Such disclosure must be submitted at the time of the bid or proposal submission and included as a part of the bid/proposal submitted for this project. Disclosure is required for Offeror's, joint venture partners and first-tier subcontractors. Failure to provide required disclosure, submit officially signed and notarized documents or respond to any and all information requested/required by Fulton County can result in the bid/proposal declared as non-responsive. This document must be completed and included as a part of the bid/proposal package along with other required documents. [SIGNATURES ON NEXT PAGE]
Under penalty or\f perjury, I declare that I have examined this questionnaire and all attachments hereto, if applicable, to the best of my knowledge and belief, and ad statements contained hereto are true, correct, and complete. On this
Sworn to and subscribed before mev this /(* day of
LsdM
(Notary Public) Commission Expires (Date)
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FORM F:
DECLARATION OF EMPLOYEE-NUMBER CATEGORIES
Please affirmatively indicate by checking the appropriate box the employeenumber category applicable to your company: 500 or more employees 100 or more employees fewer than 100 employees
Company Name: I certiiy that the above classification is true and correct.
Date:
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FORM G: GEORGIA SECURITY AND IMMIGRATION CONTRACTOR AFFIDAVIT AND AGREEMENT Instructions: Contractors must attest to compliance with the requirements of O.C.CA 13-1091 and the Georgia Department of Labor Rule 300-10-01-.02 by executing the Contractor Affidavit provided. The affidavit should be executed by Contractors who have indicated on Form F, Declaration of Employee-Number Categories, that they have 100 or more employees.
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STATE OF GEORGIA COUNTY OF FULTON

FORM G: GEORGIA SECURITY AND IMMIGRATION CONTRACTOR AFFIDAVIT AND AGREEMENT
By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. 1310-91, statingaffirmatively that the individual, firm or corporation which is engaged In the physical performance Tbf^pervices un<fep/*'a jconfract^with [insert name of prime contractor] L S \ $ J TVW^qwiC&mH<\S>jLW^ on behalf of Fulton County Government has reqistlred with and Is participating In a federal work authorization program* [any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), P.L 99-603], in accordance with the applicability provisions and deadlines established in O.C.G.A. 13-10-91. The undersigned further agrees that, should it employ or contract with any subcontractor(s) in connection with the physical performance of services to this contract with Fulton County Government, contractor will secure from such subcontractor(s) similar verification of compliance with O.C.G.A/ 13-10-91 on the Subcontractor Affidavit provided in Rule 300-10-01-.08 or a substantially similar form. Contractor further agrees to maintain records of such compliance and provide a copy of each such verification to the Fulton County Government at the time the subcontractor(s) is retained to perform such service.
Title of Authorised Officer or Agent of Sttbeontraotor
Printed Name of Authorized Officer or Agent
Sworn to and subscribed before me this
/ &
day of
Notary Public:
AJÂ
County:
Commission Expires:.
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NOTE: * As of the effective date of O.C.G.A. 13-10-91, the applicable federal work authorization program is the "EEV/Basic Pilot Program" operated by the U.S. Citizenshrp and Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social Security Administration (SSA).
43
OFFICE OF CONTRACT COMPLIANCE FORMS
31
REQUIRED FORMS AND EBO PLAN: In order to be compliant with the Intent and provisions of the Fulton County Non-Dlscrimlnatlon In Purchasing and Contracting Ordinance (99-0960), bidders/proposers mast submit the following completed documents. Failure to provide this Information shall result in the bid/proposal being deemed non-responsive: Exhibit A - Promise of Non-Discrimination (for Prime and each Sub-contractor) Exhibit B - Employment Report (for Prime and each Sub-contractor) Exhibit C - Schedule of Intended Subcontractor Utilization Exhibit D - Letter of Intent to Perform As a Subcontractor or Provide Materials or Services. Exhibit E - Declaration Regarding Subcontractor Practices Exhibit F - Joint Venture Disclosure Affidavit Equal Business Opportunity Plan (EBO Plan) - This document is not a form. It is a statement created by the bidder/proposer on its company letter head addressing the EBO Plan requirements. All Contract Compliance documents (Exhibits A - F and EBO Plan) are to be placed in a separate sealed envelope clearly marked "Contract Compliance". The EBO Plan must be submitted on company letterhead. These documents are considered part of and should be submitted with the Technical Proposal. The following document must be completed as instructed if awarded the bid: Exhibit G - Prime Contractor's Subcontractor Utilization Report
48
EXHIBIT A - PROMISE OF NON-DISCRIMINATION

"Know all persons by these presents, that I/WE (
Title
Firm Name
Hereinafter "Company"), in consideration of the privilege to bid on or obtain contracts funded, in whole or in part, by Fulton County, hereby consent, covenant and agree as follows: (1) No person shall be excluded from participation in, denied the benefit of, or otherwise discriminated against on the basis of race, color, national origin or gender in connection with any bid submitted to Fulton County for the performance of any resulting there from, (2) That it is and shall be the policy of this Company to provide equal opportunity to all businesses seeking to contract or otherwise interested in contracting with this Company without regard to the race, color, gender or national origin of the ownership of this business, (3) That the promises of non-discrimination as made and set forth herein shall be continuing in nature and shall remain in full force and effect without interruption, (4) That the promise of non-discrimination as made and set forth herein shall be made a part of, and incorporated by reference into, any contract or portion thereof which this Company may hereafter obtain, (5) That the failure of this Company to satisfactorily discharge any of the promises of nondiscrimination as made and set forth herein shall constitute a material breach of contract entitling the Board to declare the contract in default and to exercise any and all applicable rights and remedies, including but not limited to cancellation of the contract, termination of the contract, suspension and debarment from future contracting opportunities, and withholding and/or forfeiture of compensation due and owning on a contract; and (6) That the bidder shall provide such information as may be required by the Director of Contract Compliance pursuant.toacîon 4.4y of the Fulton County Non-Discrimination in Purchasing and ContractinojQffllnanc
SIGNATURE:, ADDRESSL, I ^ ^ ^ ^^y^wy/VVulu
, I M U H ^ I' r U ^ C ^ - * > ^ v* *- ^ 5 0 tJ
TELEPHON^tslOMBER:
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EXHIBIT B - EMPLOYMENT REPORT

The demographic employment make-up for the bidder must be identified and submitted with this bid/proposal. In addition, if subcontractors will be utilized by the bidder/proposer to complete this project, then the demographic employment make-up of the subcontractors) must be identified and submitted with this bid. EMPLOYEES
CATEGORY Mafe/Femafe Mgmt/Official Professional (Arch., P.E., etc.) Supervisors Office/ Clerical Craftsmen Laborers Others < * i
NATIVE INDIAN M F
AFRICAN AMERICAN M F
ASIAN AMERICAN M F
HISPANIC AMERICAN M F
CACUSIAN AMERICAN
OTHER M F
A I
I
J /
7
I I
i II 3
(Specify) >^VtS
TOTALS
FIRM'S NAME: ADDRESS:
/i te- î ifc 3oo
TELEPHONE NUMBER:. This completed Submitted isK Bidder/Proposer Date Completed:, Subcontractor
50
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1QIT371C94K-DB Fuel Dispenser Replacement
EXHIBIT C - SCHEDULE OF INTENDED SUBCONTRACTOR UTILIZATION

If the bldcter/proposer intends to subcontract any portion of this scope of work/servtaetef, this form must foe completed and submitted with th bfd/proposaL All prims bidders/proposers must Include Letter(a) of Intent (Exhibit D) In the bid document for all subcontractors wfysrwill be utilized under th& scope of work/gervrces. Prime Blddgr/Froposer: ITB/RFP NUMBER: Project Name or Description of Wqrk/Servlce(a \ _ \ _^-*-w__
\ 1. My firm, as Prime Bidder/Proposer on thte scoaei\f work/servlce(s) l$ is not minority or female owned and controlled biisjêss, (Please indicate below tha portion of work, Including, percentage of bid amount that your firm will carry out directly):
If the Prime Bidder/Proposer is aKtolnt Venture, pleas complete Exhibit F: Joint Venture Disclosure Affidavit and attach^ copy of Hh& executed Joint Venture Agreement. 2. Sub-Contractors (Indudlncp4upp]iers) to be utilized In the performance of this scope of work/servloe(s), If awarded, are:
SUBCONTRATOR NAME:. ADDRESS:, ,.
z
JDOUNTY CERTIFIED**..
PHONE; CONTACT PERSON: ETHNIC WORK BE PERFORMED;
ILAft VALUE OF WORK; $_
PERCENTAGE VALUE:
*EthnFo Oroupsj African American <AABE); Asian American (ABE); Hispanic American (HBE); Nativo American (NABE); White Femald American (WFBE); **lf yesF attach copy of recent oertfflcatlon letter.
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06
10!TBri024KDB Fuel DJspanser Replacement
EXHIBIT C-SCHEDULE OF INTENDED SUBCONTRACTOR UTILIZATION

SUBCONTRATOR NAME: ADDRESS:
/ / / _. . ... /
_COUNTY CERTIFIED** ERCENTAGE VALI \\im_ y
PHONE: CONTACT PERSON: ETHNIC GROUP*: WORK TO BE PERFORMED:. DOLLAR VALUE OF WORK: $ SUBCONTRATOR NAME:_ ADDRESS: PHONE:_. CONTACT PeRSON:,. ETHNIC GROUP*:. .. WORK TO B PeKFORMED:__ DOLLAR VALUH OF WORK: * SUBCONTRATOR NAME:. ADDRESS: _ _
./.
\ ^ \
J /
j\~
\\\ doUM^Y CERTtFtED*^ DU^TY RCENTAGE VALUE:.
y>
J4
PHONE:
OOhTTAOT P ^ R S O N L
ETHNIC GROUP*: WORK TO BE PERFORMED:/ DOLLAR VALUE OF W O R K ^ Z SUBCONTRATOR NAME: ADDRESS:
COUNTY CERTIFIED*
CONTACT PERg ETHNIC GROl WORK TO &jdPERFORMED:. DOLLAR VALUE OF WORK:
^COUNTY CERTIFiED**_ ^PERCENTAGE VALUE:
*EthriLc Groups; African American (AABE); Asian American (ABE); Hispanic ran (HBEJ; Native American (NABE); White Female American (WFBE); **If yes, attach copy of mc/nt certification tetter.
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101TB71Q94K-D6 Fuel Dispenser Replacmnt
EXHIBIT C ~ SCHEDULE OF INTENDED SUBCONTRACTOR urfliz UTILIZATION

1 Total Dollar Value of Subcontractor Agreements: ($) [ jfofol Percentage Value; (%) ~ f ~ "
CERTIFICATION: The undersigned certifies thatft&tehehas reafl, understands and agrees to be bound by the Bid provisions, Including the accompanyfng Exjtfoits and other terms and conditions regarding sub-contractor utilization. The undersigned jfeirther certffles that he/she is legally authorized by the Bidder to make the statement endrepresentationin this Exhibit and that said statements and representations are true and coirecua the best of hte/her knowledge and belief. The undersigned understands and agrees that if arty of the statements and representations ar$ made by the Bidder knowing them to be false, c/if thara is a failure of the intentions, objectives and commitments set forth herein without prfoj^fippravgl of the County, then in any such event the Contractor's acts or failure to act, a$ the caê may be, shad constitute & material breech of the contract, entitling the County to termlnate^ne Contract for default The right to so terminate shall be \n addition to, and in lieu of, any g#fer rights and remedies the County may havs for other defaults under the contract Signature/Title: Firm or Corporate Name: / Address: /
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1QITB71094K-DB Fuel Disposal 1 Replacement
EXHIBIT D
LETTER Of INTENT TO PERFORM AS A SUBCONTRACTOR OR PROVIDE MATERIALS OR5ERV1CES This form must b completed by ALL known subcontractors/suppliers and admitted with the bid. The Prime Contractor must submit Utters of Intent for ALL known subtfontraetors/supplters at time of bid aubmlasfon, / To: (Name of Prim Contractor Firm) From: (Name, of Subcontractor Firm)
ITB/RFP Number:
Project Name;
z.
/ Project Commence Date Project Completion Date Estimated Dollar Amount
The undersigned i | prepaited to\pfiff5rnr?N*ôowlng described work or provide matartete or $ervicss in connecttbn With flj ^ v e proje^&pecity in detail particular work items, materials, or performed o n
Description of Work \
//
v /\ /
\
(Subcontractor)
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09
' - DECLARATION REGARDING SUBCONTRACTING

If the bidder/proposer doss not intend to subcontract any portion of the scopôf work * ), thfe form must be completed and submitted with the bid. .Hereby decfares that it fs my/ouj^tent to
(Bidder)
Perform 100% of th& work required foe (IFB/RFp Numjtfr) umb^r (Description of Work) In making this declaration, the bfdder/proposer states the fblk 1. That the bidder does not customarily subp&ntract elements of this type project, and normally performs and has the cajfebiiiiy to perform and will perform ll efemante of the work on this project wjlfi his/her own current work forces; if ft should become necessary to ^contract some portion of the work at a later date* the bidder will comply With all requirements of the County's NonDiscrimination Ordinance in isrovfaing equal opportunities to all firms to subcontract the work. The determination to subcontract Borne portion of the work at a fater date shall be medfe fr good M h and the County reserves the right to require additional Information to substantiate a bldfer'z dacision to subcontract work following the awarjj'of the contract. Nothing contained in this provision shall be employed to circumvent the spirit and intent of the County's NonDiscrimination Ordinances; The bidder wj[j jrfrovide, upon request, Information sufficient for the County to verify Item Nurj[*6er one.
2.
3.
OR/ZED C O M P A N / R E P R E S E N T A T I V E
Jftle:_
. Date:
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10
iOITSjrid94K*DP Fuel DlspanEsrReptacamant
EXHIBIT F - JOINT VENTURE DISCLOSURE AFFIDAVIT JFB No. Project Name. Thf$ form must be completed and submitted with the bid ff a Joint Venturp"approach is to ba undertaken. The firms fisted below do hereby declare that thay have entered intou/jofnt venture agreement pursuant to the above mentioned project. The Informetton requestedbelow Is to dearly Identify and explain the exteht of participation of each firm in the proposetffofnt venture. All Items must be properly &<$dr*$$ed before the business entity can be evaiuat* 1. Firms: 1) Name of Business: Street Address: County: Nature of Business:. 2) Name of Business: Street Address: _ yT City/State/Zip: / County: / Nature of Bua>fess: 3) Name of Business:. (
ature of Business:^ NAME OMOINT VENTURE (If applicable}
PRjfJClPAL OFFfCK; )FFiCE PHONE:
CO 10nB71D-S4KîB Fuel Dbpenser
EXWBiT G - PRIME CONTRACTOR/SUBCONTRACTOR UTILIZATION REPORT

This report is required to be submitted by the tenfr day of each month, vwth a copy of your paymentfinvofce{sdiedute of vaGues/payment appTjs&km) to Contract Compliance. F a t e to comply may result E the County commencing proceedings to Impose sanctions on tie successful bfcfcter, in addjpirTto purchasing any n c f e r availa&te JegaJ remedy. Sancftins may fndude the suêndmg of any paymsrit or part thereisf,temnfriationor canceMan cf the psfibact, znd the denial to 3artiicjpgte in any Mine contracts awarded by Fulton County, PROJECT MAME: ftEPOffnNG PERIOD / PROJECT NUMBER: FROM: / PROJECT LOCATION: TO: / PIRI&IECOWTRACTOR Name: Contract Award Date ContmotAwand Amounl Cfi^tgeOpder wnount Omlnact Perfod toDate
CJO
CJ1 LD
uD C3 en CD K3
/
Address: TefephiHie*; ;
/ /
AlflOUPfT OF REQUISITION THfS P E R I O f i ^ . TOTAL AlfiOU^f^ REQUISITION TO DATH;|_ TOTAL J ^ O U M T REQLBSITTON TO DATE:!^ SUBCONTnÂCTORûTILIZATION (add addifional rovs as necessary) Requisition Contract P&nod AjrbQLint Paid To Amount ^ ^ Contract Starting Date Ending Date "Ftiis FêrkHf Date Amxxjrtl
/ / / /
i WaiTieofSulW3Dfi*rac6or
Descnpffon of Wiajfc
s
/
TOTALS Executed By;
/ (Printed Name)
END OF SECTION m
INSURANCE AND RISK MANAGEMENT PROVISION FORMS
32
SECTION 00490
Insurance and Risk Management Provisions Equipment Replacement/Installation
It is Fulton County Government's practice to obtain Certificates of Insurance from our Contractors and Vendors. Insurance must be written by a licensed agent in a company licensed to write insurance in the State of Georgia, with an A.M. Best rating of at least A- VI, subject to final approval by Fulton County. Respondents shall submit with the bid/proposal evidence of insurability satisfactory to Fulton County Government as to form and content. Either of the following forms of evidence is acceptable: A letter from an insurance carrier stating that upon your firm/company being the successful Bidder/Respondent that a Certificate of Insurance shall be issued in compliance with the Insurance and Risk Management Provisions outlined below. A Certificate of Insurance complying with the Insurance and Risk Management Provisions outlined below (Request for Bid/Proposal number and Project Name, Number and Description must appear on the Certificate of Insurance). A combination of a specific policy written with an umbrella policy covering liabilities in excess of the required limits is acceptable to achieve the applicable insurance coverage levels.
Upon award, the Contractor/Vendor must maintain at their expense, insurance with policy limits equal to or greater than the limits described below. Proof of insurance must be provided to Fulton County Government prior to the start of any activities/construction as described in the bid document(s). Any and all Insurance Coverage(s) and Bonds required under the terms and conditions of the contract shall be maintained during the entire length of the contract, including any extensions or renewals thereto, and until all work has been completed to the satisfaction of Fulton County Government. Accordingly the Respondent shall provide a certificate evidencing the following: 1. WORKERS COMPENSATION/EMPLOYER'S LIABILITY INSURANCE STATUTORY (In compliance with the Georgia Workers Compensation Acts, including but not limited to U.S. Longshoremen and Harbor Workers Act and any other State or Federal Acts or Provisions in which jurisdiction may be granted) 2. Employer's Liability Insurance BY ACCIDENT EACH ACCIDENT $500,000 Employer's Liability Insurance BY DISEASE POLICY LIMIT $500,000 Employer's Liability Insurance BY DISEASE EACH EMPLOYEE $500,000 **To include U.S. Longshoremen and Harbor Workers Act** 2. COMMERCIAL GENERAL LIABILITY INSURANCE (Including contractual Liability Insurance) Bodily Injury and Property Damage Liability Each Occurrence (Other than Products/Completed Operations)General Aggregate $2,000,000 $1,000,000
Products\Completed Operation Aggregate Limit $2,000,000 Personal and Advertising Injury Limits $1,000,000 Fire Damage Limits $100,000 **To Include Per Project/Location Aggregate and Completed Operations for 3 Years after final payment**
3. BUSINESS AUTOMOBILE LIABILITY INSURANCE Combined Single Limits Each Occurrence (Including operation of non-owned, owned, and hired automobiles). **Broadened Pollution Endorsement CA9948 and MCS 90** 4. UMBRELLA LIABILITY Each Occurrence
$ 1,000,000
$2,000,000
5. CONTRACTORS POLLUTION LIABILITY Each Occurrence $1,000,000 **Or by endorsement to General Liability Policy for sudden and accidental** If Pollution provided by General Liability Endorsement and sudden and accidental, Completed Operations would not be a requirement.
Certificates of Insurance
Certificates shall state that the policy or policies shall not expire, be cancelled or altered without at least sixty (60) days prior written notice to Fulton County Government. Policies and Certificates of Insurance are to list Fulton County Government as an Additional Insured (except for Workers' Compensation) and shall conform to all terms and conditions (including coverage of the indemnification and hold harmless agreement) contained in the Insurance and Risk Management Provisions. The General Liability Additional Insured language should apply to on-going and completed-operations, using ISO form CG 2010 (11/85 version) or equivalent. If Fulton County Government shall so request, the Respondent, Contractor or Vendor will furnish the County for its inspection and approval such policies of insurance with all endorsements, or confirmed specimens thereof certified by the insurance company to be true and correct copies. The insurance for the additional insureds shall be as broad as the coverage provided for the named insured contractor. It shall apply as Primary Insurance before any other insurance or self-insurance, including any deductible, non-contributory, and Waiver of Subrogation provided to the Additional Insureds. Additional Insured under the General Liability, Auto Liability, Umbrella Policies (with exception of Workers Compensation and Professional Liability), with no Cross Suits exclusion.
Important: It is understood that Insurance in no way Limits the Liability of the Contractor/Vendor.
USE OF PREMISES Contractor/Vendor shall confine its apparatus, the storage of materials and the operations of its workers to limits/requirements indicated by law, ordinance, permits and any restrictions of Fulton County Government and shall not unreasonably encumber the premises with its materials.
PROTECTION OF PROPERTY Contractor/Vendor will adequately protect its own work from damage, will protect Fulton County Government's property from damage or loss and will take all necessary precautions during the progress of the work to protect all persons and the property of others from damage or loss. Contractor/Vendor shall take all necessary precautions for the safety of employees of the work and shall comply with all applicable provisions of the Federal, State and local safety laws and building codes to prevent accidents or injury to persons on, about, or adjacent to the premises where work is being performed. Contractor/Vendor shall erect and properly maintain at all times as required by the conditions and progress of the work, all necessary safeguards for the protection of its employees, Fulton County Government employees and the public and shall post all applicable signage and other warning devices t protect against potential hazards for the work being performed.
INDEMNIFICATION AND HOLD HARMLESS AGREEMENT To the fullest extent of the Law, Contractor/Vendor hereby agrees to release, indemnify, defend and hold harmless Fulton County, its Commissioners, officers, employees, subcontractors, successors, assigns and agents, from and against any and all losses (including death), claims, damages, liabilities, costs and expenses (including but not limited to all actions, proceedings, or investigations in respect thereof and any costs of judgments, settlements, court costs, attorney's fees or expenses, regardless of the outcome of any such action, proceeding, or investigation), caused by, relating to, based upon or arising out of any act or omission by Contractor/Vendor, its directors, officers, employees, subcontractors, successors, assigns or agents, or otherwise in connection (directly or indirectly) with its acceptance, or the performance, or nonperformance, of its obligations under these agreements. Such obligations shall not be construed to negate, abridge or otherwise reduce any other rights or obligations of indemnity which would otherwise exist as to any party or person as set forth in this paragraph. Contractor/Vendor's obligation to protect, defend, indemnify and hold harmless, as set forth hereinabove, shall also include, but is not limited to, any matter arising out of any actual or alleged infringement of any patent, trademark, copyright, or service mark, or other actual or alleged unfair competition disparagement of product or service, or other tort or any type whatsoever, or any actual or alleged violation of trade regulations. Contractor/Vendor further agrees to protect, defend, indemnify and hold harmless Fulton County, its Commissioners, officers, employees, subcontractors, successors, assigns and agents from and against any and all claims or liability for compensation under the Worker's Compensation Act, Disability Benefits Act, or any other employee benefits act arising out of injuries sustained by any employees of Contractor/Vendor. These indemnities shall not be limited by reason of the listing of any insurance coverage.
If the bid/quotation involves construction services Contractor/Vendor will be responsible fully for any and all damage to the work during the course of construction, until the point of Final acceptance by Fulton County. FULTON COUNTY ACKNOWLEDGES THAT ALL PROVISIONS OF THIS INDEMNITY AGREEMENT MAY NOT BE APPLICABLE TO THE CONTRACTOR/VENDOR'S BUSINESS. TO THE EXTENT THAT CONTRACTOR/VENDOR MAY DEMONSTRATE SUCH NONAPPLICABILITY, FULTON COUNTY MAY NEGOTIATE AMENDMENTS TO THIS AGREEMENT AS THE CIRCUMSTANCES DICTATE. CONTRACTOR/VENDOR ACKNOWLEDGES HAVING READ, UNDERSTANDING, AND AGREEING TO COMPLY WITH THIS INDEMNIFICATION AND HOLD HARMLESS AGREEMENT, AND THE REPRESENTATIVE OF THE CONTRACTOR/VENDOR IDENTIFIED BELOW IS AUTHORIZED TO SIGN CONTRACTS ON BEHALF OF THE RESPONDING CONTRACT OR/VENB.OJ
COMPANY: NAME :
DATE:
.SIGNAT /VtQi
J^C\WXCS t l '
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TITLE:
ACORQU
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
PRODUCER (.770)447-6547 FAX (770)447-8353 CoTffliercial Insurance Agency POB 2647 Norcross, CA 30091 SURED United Pump & Controls 305 Shawnee North Drive # 300 Suwanee, G 30024 A
I
04/07/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
NAIC# INSURERS AFFORDING COVERAGE INSURER A: Steadfast Insurance Company INSURERB: The Netherlands I n s Co INSURERc: Princeton Excess and Surplus Lin es Ins Co
INSURER D: INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS ADD LTR INSR TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE | X | OCCUR POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY POLICY EXPIRATION DATE (MM/DD/YYYY LIMITS EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG
GPL 5436967 0
10/01/2009
10/01/2010
~x
w/ Pollution
$ $ $ $ $ $
1,000,000 500,000 5,000 1,000,000 2,000,000 2,000,000
n POLICYrxis^ n ^ c
AU1rOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS
BA 9634086 10/01/2009
10/01/2010
COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person)
1,000,000
B
X X
SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS CON
$ $ $ $ $ $ $ $ $ $ $ $ $ $
'REHENSIVE DED: $ 100C COLLISION DED: $ 1000
BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident)
GARAGE LIABILITY ANY AUTO
AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY:

E AA C C A G Q
EXCESS / UMBRELLA LIABILITY
94A3FO000026300 10/01/2009
10/01/2010
EACH OCCURRENCE AGGREGATE
X 1 OCCUR
1 CLAIMS MADE
2,000,000 2,000,000
C
DEDUCTIBLE RETENTION $ Y WC STATUTORY LIMITS OTHER
WORKERS COMPENSATION AND EMPLOYERS1 LIABILITY y ANY PROPRIETOR/PARTNER/EXECUTIVB OFFICER/MEMBER EXCLUDED? 1 Mandatory in NH) ' yes, describe under PECIAL PROVISIONS below OTHER
W 9637684 10/01/2009 C
f N
10/01/2010
1 '
E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L DISEASE - POLICY LIMIT
1,000,000 1,000,000 1,000,000
ulton County Government is named as an Additional Insured. Coverage is on a Primary and ton-Contributory basis and a Waiver of Subrogation applies in favor of the Additional Insured.
CERTIFICATE HOLDER Fulton County Government Purchasing Department Attn; Darlene A Banks 130 Peachtree Street SW Suite 1168 Atlanta, GA 30303-345 ACORD 25 (2009/01)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE
Richard Johnson/MS 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2009/01)

2010 0291

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CONTRACT AGREEMENT

OWNER - CONTRACTOR AGREEMENT

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

[SIGNA TURES NEXT PA GE]

10ITB71094K-DB Fuel Dispenser Replacement

John H. Eaves, Commission Chair Board of Commissioners ATTEST:

E. Young- ice PresidantComfnercial Divisi ^ATTEST:

ark Massey Ma to the Commission (Seal) Clerk

Secretary/ Assistant Secretary (Affix Corporate Seal)

Office of the County Attorney APPROVED AS TO CONTENT:

David Ricks-Director General Services/Public Works Department

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

SCOPE OF WORK And TECHNICAL SPECIFICATIONS

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

1.3.5. 1.3.6. 1.3.7.

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

101TB71094K-DB Fuel Dispenser Replacement

(C)^L (NC) _ (E) _

( C ) X (NC) _ (E) _ (C)X_ (NC) _ (E) _

Construction. The dispenser must have:

10ITB71094K-DB Fuel Dispenser Replacement

3.4.1 3.4.2 3.4.3

101TB71094K-DB Fuel Dispenser Replacement

One replaceable paper filter(s)

(C)) (NC) _ (E) _

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

. (C) X (NC) _ (E) _

(C) X " ( N C ) _ (E) _ (C)> (NC) _ (E) _

(C) ) (NC) _ (E) _ (C) ) (NC) _ (E) _ ( C ) ) (NC) _ (E) _

. (C) j K (NC) _ (E) _

10ITB71094K-DB Fuel Dispenser Replacement

(C) X (NC) _ (E) _

Exceptions noted above (denote Specification Number):

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB Fuel Dispenser Replacement

Dollars according to the conditions of "Instructions to Bidders" and provisions

Title: Business Adcfrifss:

Bidder's Contractor License No:

License Expiration Date:

10ITB71094K-DB Fuel Dfspenser Replacement

Acknowledgement of each ADDENDUM

10ITB71094K-DB Fuel Dispenser Replacement

10ITB71094K-DB; Fuel Dispenser Replacement Addendum 1 Page 2

Legal Name of Bidder jgnature of Authorized Representative

'"' Winner 2 0 0 0 - 2 0 0 9 Achievement of Excellence In Procurement Award National Purchasing Institute

101TB71094K-DB; Fuel Dispenser Replacement Addendum 2 Page 3

130 Peachtree Street, S.W.,Suite 1168 Atlanta, GA 30303 (404) 612-5800

United Pump and Controls, Inc. / Bid 101TB71094K-DB

THREE THOUSAND FOUR HUNDRED TWENTY DOLLARS AND 00 CENTS

PAY TO THE ORDER OF: F u l t o n COUflty

Branch (3X02128 CCQ02128