HomeMy WebLinkAboutContract #: 986 - From: 07-01-2017 To: 06-30-2018 - Harcros Chemicals - Town of North AndoverMia
TOWN OF NORTH ANDOVER
CONTRACT
(GOODS / SERVICES)
CONTRACT #qbt
DATE: 012-d 7- 0-)10/ 7
This Contract is entered into on, or as of, this date by and between the Town of North
Andover (the "Town"), and
Contractor: Harcros Chemicals, Inc.
Address: 8 Capitol Street
Nashua, NH 03063
Telephone Number: 603-880-0535
Fax Number:
1. This is a Contract for the procurement of the following:
Copper Sulfate (fine) for the period of July 1, 2017 through June 30, 2018 in accordance
with the bid issued by the Northeast/Merrimack Valley Chemical Consortium
2. The Contract price to be paid to the Contractor by the Town of North Andover is:
$1.38 per dry pound
3. Payment will be made as follows:
Upon delivery and receipt of invoice (net 30)
4. Definitions
4.1 Acceptance:All Contracts require proper acceptance of the described goods or
services by the Town of North Andover. Proper acceptance shall be understood to
include inspection of goods and certification of acceptable performance for services
by authorized representatives of the Town to insure that the goods or services are
complete and are as specified in the Contract.
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page I
4.2 Contract Documents: All documents relative to the Contract including (where used)
Invitation to Bid, Request for Proposals, Instructions to Bidders/Proposers, Proposal
Form, General Conditions, Supplementary General Conditions, General
Specifications, Other Specifications included in Project Manual, Drawings, and all
Addenda issued during the bidding period or proposal. The Contract documents are
complementary, and what is called for by any one shall be as binding as if called for
by all. The intention of the document is to include all labor and materials, equipment
and transportation necessary for the proper performance of the Contract.
4.3 The Contractor: The "other party" to any Contract with the Town. This term shall
(as the sense and particular Contract so require) include Vendor, Contractor,
Engineer, or other label used to identify the other party in the particular Contract.
Use of the term "Contractor" shall be understood to refer to any other such label used.
The Contractor's relationship to the Town is that of an independent contractor and
not that of an agent or employee of the Town.
4.4 Date of Substantial Performance: The date when the work is sufficiently complete,
the services are performed, or the goods delivered, in accordance with Contract
documents, as modified by approved Amendments and Change Orders.
4.5 Goods: Goods, Supplies or Materials.
4.6 Sub -Contractor: Those having a direct Contract with the Contractor. The term
includes one who furnished material worked to a special design according to the
Drawings or Specifications of this work, but does not include one who merely
furnishes material not so worked.
4.7 Work: The services or materials contracted for, or both.
5. Term of Contract and Time for Performance
This Contract shall be fully performed by the Contractor in accordance with the provisions
of the Contract Documents on or before June 30, 2018, unless extended pursuant to a
provision for extension contained in the Contract documents at the sole discretion of the
Town, and not subject to assent by the Contractor, and subject to the availability and
appropriation of funds as certified by the Town Accountant. The time limits stated in the
Contract documents are of the essence of the Contract.
6. Subject to Appropriation
Notwithstanding anything in the Contract documents to the contrary, any and all payments
which the Town is required to make under this Contract shall be subject to appropriation or
other availability of funds as certified by the Town Accountant. The Town may immediately
terminate or suspend this Agreement without liability on the part of the Town for damages,
penalties or other charges in the event the appropriation funding this Agreement is terminated
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 2
or reduced to an amount which will be insufficient to support anticipated future obligations
under this Agreement.
7. Permits and Approvals
Permits, Licenses, Approvals and all other legal or administrative prerequisites to its
performance of the Contract shall be secured and paid for by the Contractor.
Termination and Default
8.1 Without Cause. The Town may terminate this Contract at its sole discretion on seven
(7) calendar days' notice when in the best interests of the Town by providing notice to
the Contractor, which shall be in writing and shall be deemed delivered and received
when given in person to the Contractor, or when received by fax, express mail, certified
mail return receipt requested, regular mail postage prepaid or delivered by any other
appropriate method evidencing actual receipt by the Contractor. Upon termination
without cause, Contractor will be paid for services rendered to the date of termination.
8.2 For Cause. If the Contractor is determined by the Town to be in default of any term or
condition of this Contract, the Town may terminate this Contract on seven (7) days'
notice by providing notice to the Contractor, which shall be in writing and shall be
deemed delivered and received when given in person to the Contractor, or when
received by fax, express mail, certified mail return receipt requested, regular mail
postage prepaid or delivered by any other appropriate method evidencing actual receipt
by the Contractor.
8.3 Default. The following shall constitute events of a default under the Contract:
1) any material misrepresentation made by the Contractor to the Town; 2) any failure
to perform any of its obligations under this Contract including, but not limited to
the following: (i) failure to commence performance of this Contract at the time
specified in this Contract due to a reason or circumstance within the Contractor's
reasonable control, (ii) failure to perform this Contract with sufficient personnel
and equipment or with sufficient material to ensure the completion of this Contract
within the specified time due to a reason or circumstance within the Contractor's
reasonable control, (iii) failure to perform this Contract in a manner reasonably
satisfactory to the Town, (iv) failure to promptly re -perform within a reasonable
time the services that were rejected by the Town as unsatisfactory, or erroneous,
(v) discontinuance of the services for reasons not beyond the Contractor's
reasonable control, (vi) failure to comply with a material term of this Contract,
including, but not limited to, the provision of insurance and non-discrimination,
(vii) any other acts specifically and expressly stated in this Contract as constituting
a basis for termination of this Contract, and (viii) failure to comply with any and
all requirements of federal or state law and/or regulations, and Town bylaws and/or
regulations.
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 3
9. The Contractor's Breach and the Town's Remedies
Failure of the Contractor to comply with any of the terms or conditions of this Contract shall
be deemed a material breach of this Contract, and the Town of North Andover shall have
all the rights and remedies provided in the Contract documents, the right to cancel, terminate,
or suspend the Contract in whole or in part, the right to maintain any and all actions at law
or in equity or other proceedings with respect to a breach of this Contract, including damages
and specific performance, and the right to select among the remedies available to it by all of
the above.
From any sums due to the Contractor for services, the Town may keep the whole or any part
of the amount for expenses, losses and damages incurred by the Town as a consequence of
procuring services as a result of any failure, omission or mistake of the Contractor in
providing services as provided in this Contract.
10. Statutory pliance
10.1 This Contract will be construed and governed by the provisions of applicable federal,
state and local laws and regulations; and wherever any provision of the Contract or
Contract documents shall conflict with any provision or requirement of federal, state
or local law or regulation, then the provisions of law and regulation shall control.
Where applicable to the Contract, the provisions of the Massachusetts General Laws
are incorporated by reference into this Contract, including, but not limited to, the
following:
M.G.L. Chapter 30B — Procurement of Goods and Services.
M.G.L. Chapter 30, Sec. 39, et seq: - Public Works Contracts.
M.G.L. Chapter 149, Section 44A, et seq: Public Buildings Contracts.
10.2 Wherever applicable law mandates the inclusion of any term and provision into a
municipal contract, then it shall be understood that this Agreement shall import such
term or provision into this Contract. To whatever extent any provision of this
Contract shall be inconsistent with any law or regulation limiting the power or
liability of cities and towns, such law or regulation shall control.
10.3 The Contractor shall give all notices and comply with all laws and regulations bearing
on the performance of the Contract. If the Contractor performs the Contract in
violation of any applicable law or regulation, the Contractor shall bear all costs
arising therefrom.
10.4 The Contractor shall keep itself fully informed of all existing and future State and
National Laws and Municipal By-laws and Regulations and of all orders and decrees
of any bodies or tribunals having jurisdiction in any manner affecting those engaged
or employed in the work, of the materials used in the work or in any way affecting
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 4
the conduct of the work. If any discrepancy or inconsistency is discovered in the
Drawings, Specifications, Scope of Business or Contract for this work in violation of
any such law, by-law, regulation, order or decree, it shall forthwith report the same
in writing to the Town. It shall, at all times, itself observe and comply with all such
existing and future laws, by-laws, regulations, orders and decrees; and shall protect
and indemnify the Town of North Andover, and its duly appointed agents against any
claim or liability arising from or based on any violation whether by it or its agents,
employees or subcontractors of any such law, by-law, regulation or decree.
11. Conflict of Interest
Both the Town and the Contractor acknowledge the provisions of the State Conflict of
Interest Law (General Laws c268A), and this Contract expressly prohibits any activity which
shall constitute a violation of that law. The Contractor shall be deemed to have investigated
the application of M.G.L. c268A to the performance of this Contract; and by executing the
Contract documents the Contractor certifies to the Town that neither it nor its agents,
employees, or subcontractors are thereby in violation of General Laws Chapter 268A.
12. Certification of Tax Compliance
This Contract must include a certification of tax compliance by the Contractor, as required
by General Laws c62C, Section 49A (Requirement of Tax Compliance by All Contractors
Providing Goods, Services, or Real Estate Space to the Commonwealth or Subdivision).
13. Affirmative Action; Non -Discrimination
The Contractor will carry out the obligations of this Contract in full compliance with all of
the requirements imposed by or pursuant to General Laws c 151 B (Law Against
Discrimination) and any executive orders, rules, regulations, and requirements of the
Commonwealth of Massachusetts as they may from time to time be amended.
The Contractor shall comply with all federal and state laws, rules and regulations promoting
fair employment practices or prohibiting employment discrimination and unfair labor
practices and shall not discriminate in the hiring of any applicant for employment nor shall
any qualified employee be demoted, discharged or otherwise subject to discrimination in the
tenure, position, promotional opportunities, wages, benefits or terms and conditions of their
employment because of race, color, national origin, ancestry, age, sex, religion, disability,
handicap, sexual orientation or for exercising any rights afforded by law.
14. Condition of Enforceability Against the Town
This Contract is only binding upon, and enforceable against, the Town if. (1) the Contract is
signed by the Town Manager or its designee; and (2) endorsed with approval by the Town
Accountant as to appropriation or availability of funds; and (3) endorsed with approval by the
Town Counsel as to form.
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 5
15. Corporate Contractor
If the Contractor is a corporation, it shall endorse upon this Contract (or attach hereto) its
Clerk's Certificate or if a Limited Liability Corporation, a Manager's Certificate or other
documentation satisfactory to the Town certifying the corporate capacity and authority of the
party signing this Contract for the corporation. Such certificate shall be accompanied by a
letter or other instrument stating that such authority continues in full force and effect as of
the date the Contract is executed by the Contractor. This Contract shall not be enforceable
against the Town of North Andover unless and until the Contractor complies with this
section.
The Contractor, if a foreign corporation, shall comply with the provisions of the General
Laws, c181, §3, and any Acts and Amendments thereof, and in addition thereto, relating to
the appointment of the Commissioner of Corporations as its attorney, shall file with the
Commissioner of Corporations a Power of Attorney and duly authenticated copies of its
Charter or Certificate of Incorporation; and said Contractor shall comply with all the laws of
the Commonwealth.
16. Liability of Public Officials
To the full extent permitted by law, no official, employee, agent or representative of the
Town of North Andover shall be individually or personally liable on any obligation of the
Town under this Contract.
17. Indemnification
The Contractor shall indemnify, defend and save harmless the Town, the Town's officers,
attorneys, agents and employees, from and against any and all damages, liabilities, actions,
suits, proceedings, claims, demands, losses, costs, expenses, recoveries and judgments of
every nature and description (including reasonable attorneys' fees) that may arise in whole
or in part out of or in connection with the work being performed or to be performed, or out
of any act or omission by the Contractor, its employees, agents, subcontractors, material men,
and anyone directly or indirectly employed by any of them or anyone for whose acts any of
them may be liable, regardless of whether or not it is caused in part by any party indemnified
hereunder. The Contractor further agrees to reimburse the Town for damage to its property
caused by the Contractor, its employees, agents, subcontractors or material men, and anyone
directly or indirectly employed by any of them or anyone for whose acts any of them may be
liable, including damages caused by his, its' or their use of faulty, defective, or unsuitable
material or equipment, unless the damage is caused by the Town's gross negligence or willful
misconduct. The existence of insurance shall in no way limit the scope of the Contractor's
indemnification under this contract.
18. Workers Compensation Insurance
The Contractor shall provide by insurance for the payment of compensation and the
furnishing of other benefits under Chapter 152 of the General Laws of Massachusetts (The
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 6
Worker's Compensation Act) to all employees of the Contractor who are subject to the
provisions of Chapter 152 of the General Laws of Massachusetts.
Failure to provide and continue in force such insurance during the period of this Contract
shall be deemed a material breach of this Contract, shall operate as an immediate termination
thereof, and the Contractor shall indemnify the Town for all losses, claims, and actions
resulting from the failure to provide the insurance required by this Article.
The Contractor shall furnish to the Town evidence of such insurance prior to the execution
of this Contract in a form satisfactory to the Town before the same shall be binding on the
parties thereto, except if specifically waived by the Town.
18.1 The Contractor further understands and agrees that in rendering services to the town
under this Contract that the Contractor is an independent contractor and not an
employee of the Town, that the Contractor is not covered by the Town's Workers'
Compensation, or liability insurance, that the Contractor shall not make any claim
against the Town, its officers, agents and employees and that the Contractor
indemnifies, holds harmless, and releases the Town from any claims of the Contractor
or of any other party that may arise in whole or in part out of or in connection with
the work being performed by the Contractor.
19. Documents, Materials, Etc.
Any materials, reports, information, data, etc. given to or prepared or assembled by the
Contractor under this Contract are to be kept confidential and shall not be made available to
any individual or organization by the Contractor (except agents, servants, or employees of
the Contractor) without the prior written approval of the Town, except as otherwise required
by law. The Contractor shall comply with the provisions of Chapter 66 and Chapter 66A of
the General Laws of Massachusetts as they relates to public documents, and all other state
and federal laws and regulations relating to confidentiality, security, privacy and use of
confidential data.
Any materials produced in whole or in part under this Contract shall not be subject to
copyright, except by the Town, in the United States or any other country. The Town shall
have unrestricted authority to, without payment of any royalty, commission, or additional fee
of any type or nature, publicly disclose, reproduce, distribute and otherwise use, and
authorize others to use, in whole or in part, any reports, data or other materials prepared under
this Contract.
All data, reports, programs, software, equipment, furnishings, and any other documentation
or product paid for by the Town shall vest in the Town. The Contractor shall at all times,
during or after termination of this Contract, obtain the prior written approval of the Town
before making any statement bearing on the work performed or data collected under this
Contract to the press or issues any material for publication through any medium.
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 7
20. Confidentiali
The Contractor shall comply with M.G.L. c66A if the Contractor becomes a "holder" of
"personal data". The Contractor shall also protect the physical security and restrict any
access to personal or other Town data in the Contractor's possession, or used by the
Contractor in the performance of this Contract, which shall include, but is not limited to the
Town's public records, documents, files, software, equipment or systems.
21. Record -Keeping and Retention, Inspection of Records
The Contractor shall maintain records, books, files and other data as specified in this Contract
and in such detail as shall properly substantiate claims for payment under this Contract, for
a minimum retention period of seven (7) years beginning on the first day after the final
payment under this Contract, or such longer period as is necessary for the resolution of any
litigation, claim, negotiation, audit or other inquiry involving this Contract. The Town shall
have access during the Contractor's regular business hours and upon reasonable prior notice,
to such records, including on-site reviews and reproduction of such records at a reasonable
expense.
22. Assignment
The Contractor shall not assign or delegate, in whole or in part or otherwise transfer any
liability, responsibility, obligation, duty or interest under this Contract without the written
approval of the Town.
23. Subcontracting By Contractor
Any subcontract entered into by the Contractor for the purposes of fulfilling the obligations
under this Contract must be in writing, authorized in advance by the Town and shall be
consistent with and subject to the provisions of this Contract. Subcontracts will not relieve
or discharge the Contractor from any duty, obligation, responsibility or liability arising under
this Contract. The Town is entitled to copies of all subcontracts and shall not be bound by
any provisions contained in a subcontract to which it is not a party.
24. Risk of Loss
The Contractor shall bear the risk of loss for any Contractor materials used for this Contract
and for all deliveries, and personal or other data which is in the possession of the Contractor
or used by the Contractor in the performance of this Contract until possession, ownership
and full legal title to the deliverables are transferred to and accepted by the Town.
25. Minimum Wage/Prevailing Wage
The Contractor will carry out the obligations of this Contract in full compliance with all of
the requirements imposed by or pursuant to General Laws c151, § 1, et seq. (Minimum Wage
Law) and any executive orders, rules, regulations, and requirements of the Commonwealth
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 8
of Massachusetts as they may from time to time be amended. The Contractor will at all times
comply with the wage rates as determined by the Commissioner of the Department of Labor
and Industries, under the provisions of General Laws c149, §§26 to 27D (Prevailing Wage
Law), as shall be in force and as amended. The Contractor will, in addition to any other
submissions required by the Prevailing Wage Law, submit certified weekly payrolls to the
Town with the information described in General Laws c149, §2713.
26. Audit, Inspection and Recordkeeping
At any time during normal business hours, and as often as the Town may deem it reasonably
necessary, there shall be available in the office of the Contractor for the purpose of audit,
examination, and/or to make excerpts or transcript all records, contracts, invoices, materials,
payrolls, records of personnel, conditions of employment and other data relating to all
matters covered by this Agreement.
27. Payment
The Town agrees to make all reasonable efforts to pay to the Contractor the sum set forth in
the Contractor's bid or proposal within thirty (30) days of receipt of an invoice detailing the
work completed and acceptance from the Town of the work completed.
28. Waiver and Amendment
Amendments, or waivers of any additional term, condition, covenant, duty or obligation
contained in this Contract may be made only by written amendment executed by all
signatories to the original Contract, prior to the effective date of the amendment.
To the extent allowed by law, any conditions, duties, and obligations contained in this
Contract may be waived only by written agreement by both parties.
Forbearance or indulgence in any form or manner by a party shall not be construed as a
waiver, nor in any manner limit the legal or equitable remedies available to that party. No
waiver by either party of any default or breach shall constitute a waiver of any subsequent
default or breach of a similar or different matter.
29. Forum and Choice of Law
This Contract and any performance herein shall be governed by and be construed in
accordance with the laws of the Commonwealth of Massachusetts. Any and all proceedings
or actions relating to subject matter herein shall be brought and maintained in the courts of
the Commonwealth of Massachusetts, which shall have exclusive jurisdiction thereof. This
paragraph shall not be construed to limit any other legal rights of the parties.
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 9
30. Notices
Any notice permitted or required under the provisions of this Contract to be given or served
by either of the parties hereto upon the other party hereto shall be in writing and signed in
the name or on the behalf of the parry giving or serving the same. Notice shall be deemed to
have been received at the time of actual service or three (3) business days after the date of a
certified or registered mailing properly addressed. Notice to the Contractor shall be deemed
sufficient if sent to the address set forth in the Contract and to the Town of North Andover
by being sent to the Town Manager, Town Hall, 120 Main Street, North Andover,
Massachusetts 01845.
31. Binding on Successors
This Contract shall be binding upon the Contractor, its assigns, transferees, and/or successors
in interest (and where not corporate, the heirs and estate of the Contractor).
32. Complete Contract
This instrument, together with its endorsed supplements, and the other components of the
contract documents, constitutes the entire contract between the parties, with no agreements
other than those incorporated herein.
33. Contractor Certifications
33.1 By signing this contract, the Contractor certifies under the penalties of perjury that
pursuant to General Laws c62C §49A, the Contractor has filed all state tax returns,
paid all taxes and complied with all laws of the Commonwealth relating to taxes; and
that pursuant to General Laws c151A, §19A, the Contractor has complied with all
laws of the Commonwealth relating to contributions and payments in lieu of
contributions.
33.2 By signing this contract, the Contractor certifies under the penalties of perjury that
this contract has been obtained in good faith and without collusion or fraud with any
other person. As such in this certification, the word "person" shall mean any natural
person, business, partnership, corporation, union, committee, client or other
organization, entity or group of individuals.
33.3 Qualifications. The Contractor. certifies it is qualified and shall at all times remain
qualified to perform this Contract, that performance shall be timely and meet or
exceed industry standards for the performance required, including obtaining requisite
licenses, registrations, permits, resources for performance, and sufficient
professional, liability, and other appropriate insurance to cover the performance. If
the Contractor is a corporation, the Contractor certifies that it is in good standing with
the office of the Secretary of State. If the Contractor is a foreign business, the
Contractor certifies that it is listed under the Secretary of State's website as licensed
to do business in Massachusetts, as required by law.
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 10
33.4 Business Ethics and Fraud, Waste and Abuse Prevention. The Contractor certifies
that performance under this Contract, in addition to meeting the terms of the Contract,
will be made using ethical business standards and good stewardship of taxpayer and
other public funding and resources to prevent fraud, waste and abuse.
33.5 Debarment. The Contractor certifies that neither it nor any of its subcontractors are
currently debarred or suspended by the federal or state government under any law or
regulations including, Executive Order 147, M.G.L. c29, §29F, M.G.L. c30, §39R,
M.G.L. c149, §27C, M.G.L. c149, §44C, M.G.L. c149, §148B and M.G.L. c152,
§25C.
34. Additional Provisions:
34.1 Applicable to Contracts for the Procurement of Goods
34.1.1 "Goods" shall mean Goods, Supplies, or Materials, as described in the
Contract.
34.1.2 Change Orders:
Change orders for contracts subject to M.G.L. c30B may not increase the total
contract price by more than twenty-five (25.0%) percent and shall be in compliance
with Massachusetts General Laws c30B, § 13.
This Contract for purchase includes the following delivery, installation or setup
requirements:
Delivery to North Andover Water Treatment Plant, 420 Great Pond Road,
North Andover, MA 01845
34.2 Applicable to Contracts for Services
34.2.1 "Services" shall mean furnishing of labor, time, or effort by the Contractor.
This term shall not include employment agreements, collective bargaining
agreements, or grant agreements.
34.2.2 Change Orders:
Change orders for contracts subject to Massachusetts General Laws c30B
may not increase the total contract price by more than twenty-five (25%) per
cent and shall be in compliance with Massachusetts General Laws c30B, §13.
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 11
34.2.3 Minimum Wage/Prevailing Wage:
The Contractor will carry out the obligations of this Contract in full
compliance with all of the requirements imposed by or pursuant to General
Laws c151, §1, et seq. (Minimum Wage Law) and any executive orders,
rules, regulations, and requirements of the Commonwealth of Massachusetts
as they may from time to time be amended. The Contractor will at all times
comply with the wage rates as determined by the Commissioner of the
Department of Labor and Industries, under the provisions of General Laws
c149, §§26 to 27D (Prevailing Wage Law), as shall be in force and as
amended. The Contractor will, in addition to any other submissions required
by the Prevailing Wage Law, submit certified weekly payrolls to the Town
with the information described in General Laws c 149, §27B.
34.2.4 Insurance:
The Contractor shall obtain and maintain the following insurance:
34.2.4.1 Workers Compensation Insurance of the scope and amount required
by the laws of the Commonwealth of Massachusetts.
34.2.4.2 Broad Form Commercial General Liability coverage with limits of
at least $1 Million per occurrence and $2 Million aggregate, and
which shall cover bodily injury, death, or property damage arising
out of the work.
34.2.4.3 Automobile Liability Coverage, including coverage for owned,
hired, or borrowed vehicles with limits of at least $1 Million per
person, and $1 Million per accident. The intent of the Specifications
regarding insurance is to specify minimum coverage and minimum
limits of liability acceptable under the Contract. However, it shall
be the Contractor's responsibility to purchase and maintain
insurance of such character and in such amounts as will adequately
protect it and the Town from and against all claims, damages, losses
and expenses resulting from exposure to any casualty liability in the
performance of the work.
34.2.4.3 All required insurance shall be certified by a duly authorized
representative of the insurers on the "MIIA" or "ACORD"
Certificate of Insurance form incorporated into and made a part of
this agreement. Properly executed certificates signifying adequate
coverage in effect for the duration of the contract with renewal
certificates issued not less than 30 days prior to expiration of a
policy period, must be submitted to the Town prior to
commencement of this Contract.
34.2.4.4 The Town shall be named as an additional insured on the above
referenced liability policies, and the Contractor's insurance shall be
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 12
the primary coverage. The cost of such insurance, including required
endorsements or amendments, shall be the sole responsibility of the
Contractor.
34.2.4.5 Contractual liability must recognize the indemnities contained in
this Agreement.
34.2.4.6 Coverages are to be maintained for a period of two (2) years after
final payment.
34.2.4.7 The Contractor shall maintain all required insurance in full force and
effect as required by this Contract or the Contractor shall be in
material breach hereof.
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 13
IN WITNESS WHEREOF the parties have hereto and to two other identical instruments set
forth their hands the day and year first above written.
THE TOWN
% k' 4, � ('-' �
Division/Department Head
Town Manager Date
APPROVED AS TO FORM:
A"It,7%Z
wn Counsel Date
THE CONTRACTOR
Company Name
S' ature Date
Print Name & Title
Federal I entification
No.:3-193 SO6,)
CERTIFICATION AS TO AVAILABILITY OF FUNDS:
4�� , �00 1 qbLoo
Town AWcountant '- —'.' 0 Date
(Rev 1-2016) Contract by and between Town of North Andover and Harcross Chemicals, Inc. Page 14
HARCROS
May 2, 2017
Northeast/Merrimack Valley Chemical Consortium
Littleton Light and Water Conference Room
39 Ayer Road
Littleton, MA 01460
To Whom It May Concern:
Please be advised that James Grady is hereby appointed, constituted and designated as
agent and attorney-in-fact of the Corporation with full power and authority to act on
behalf of this Corporation in all negotiations, bidding, concerns and transactions with the
Northeast/Merrimack Valley Chemical Consortium at the Littleton Water Department, or
any of its agencies, departments, employees or agents. This includes the execution of all
papers, documents, affidavits, bonds, sureties, contracts and acts and to receive and
receipt thereof all purchase orders pertaining to the Bid for the Northeast/Merrimack
Valley Chemical Consortium, Invitation to cooperative Bid Fiscal Year 2017-18 form
July 1, 2017 to June 30, 2018.
Mark Loethen
Vice President and CFO
Employee 0,-, r, t>
5200 Speaker Road I Kansas City, KS 66106 1 (913) 321.3131 1 www.harcros.com
UNANIMOUS WRITTEN CONSENT OF THE BOARD OF DIRECTORS OF
HARCROS CHEMICALS INC.
05/21/2012
The undersigned, being all of the directors of Harcros Chemicals Inc., a Kansas
Corporation (the "Corporation'), unanimously adopted at a duly called and held meeting of the
Board of Directors at which a quorum was present and acting throughout:
RESOLVED that each of the persons be, and he hereby is, elected to the offices set opposite his
name, to serve at the pleasure of the board of directors until the next annual election of officers
by the board of directors or until his successor shall have been elected and qualified:
NAME OFFICE
Kevin G. Mirner President and Chief Executive Officer
Mark A. Loethen Vice President and Chief Financial Officer, Treasurer
Peter P. Radford Vice President Manufacturing, Secretary
Peter J. Savage Chairman
RESOLVED that any one of the above named individuals is hereby authorized on behalf of this
Corporation to execute, or to delegate the execution of any and all contracts for the sale and
supply of goods, wares and merchandise or the providing of services by the Corporation, such
execution and delivery to evidence conclusively the approval thereof by the Board of Directors.
11'e' 6 -/' � '-� � �
Peter J. Savage, Chairman
Peter P. Radford
Kevin . Mimer
dA4L6oethen4g��-
CERTIFICATIONS
CERTIFICATE OF NON -COLLUSION
The undersigned certifies under penalties of perjury that this bid or proposal has been made and
submitted in good faith and without collusion or fraud with any other person. As used in this
certification, the word "person" shall mean natural person, business, partnership, corporation,
committee, union, club or other organization, entity, or group of individuals.
Signature oq'Y.m
Print Name & Titl
Date 7/n/n
Company Name
CERTIFICATE OF TAX COMPLIANCE
Pursuant to Chapter 62C of the Massachusetts General Laws, Section 49A (b), I
SGL �'►�j e S , authorized signatory for Ha'al--co, S 61" (ols
Name of individual Name of contractor
do hereby certify under the pains and penalties of perjury that said contractor has complied with
all laws of the Commonwealth of Massachusetts, and the Town of North Andover, relating to
taxes, permit or other fees, reporting of employees and contractors, and withholding and
remitting child support.
00,-bA A;A� -
SigUture Date
TOWN OF NORTH ANDOVER
120 MAIN STREET
NORTH ANDOVER, MASSACHUSETTS 01845
Raymond T Santilli ° . A TEL (978) 688-9516
Assistant Town Manager x
'` � ' '` FAX (978) 688-9556
June 7, 2017
Mr. James Grady, Regional Manager
Harcros Chemicals, Inc.
8 Capitol Street
Nashua, NH 03063
Dear Mr. Grady:
The Town of North Andover has decided to award a contract to Harcros Chemicals, Inc.
to provide specific chemicals for the Water Treatment Plant for the period of July 1, 2017
through June 30, 2018, with one additional one-year renewal solely at the discretion of the Town,
per the bid issued by the Northeast/Merrimack Valley Chemical Consortium.
Enclosed please find three (3) original standard Town of North Andover contracts for
appropriate review and signature. Please return the signed contract documents and all required
accompanying paperwork to my attention as soon as possible.
If you have any questions and/or concerns, please call me.
Sincerely,
Raymond T. Santilli
Assistant Town Manager
Enclosures
NORTH EAST/MERRIMACK VALLEY CHEMICAL CONSORTIUM
FISCAL YEAR 2017-2018
OFFICIAL BID FORM -- III (revised May 1, 2017).
DATE:
VENDOR:
Harcros Chemicals
NOTE:
BID PRICES MUST BE PER UNIT SPECIFIED ON THIS BID DORM
ITEM
CHEMICAL
UNIT TYPE
UNIT BID
PER
NO.
1
ALUMINUM CHLOROHYDRATE
1,000 GAL
GAL.
(ACH)
BULK
No Bid
2
ALUMINUM SULFATE - 50%
BULK
SOLUTION
(1,000 =1,500
No Bid
:GALLON
Unrefined Bauxite Ore & Sulfuric
gallon
Acid Preparation
deliveries
NSF 60/ANSI
3
ALUMINUM SULFATE - 50%
BULK
SOLUTION
(2,000-5,000
No Bid
GALLON
Unrefined Bauxite Ore & Sulfuric
gallon
Acid Preparation
deliveries)
NSF 60/ANSI
4
ALUMINUM SULFATE - 50%
BULK
SOLUTION
(1,000-1,500
No Bid
GALLON
Other Prep Method
gallon
Alternative Bid
deliveries
NSF 60/ANSI
5
ALUMINUM SULFATE -50%
BULK
SOLUTION
(2,000— 5,000
No Bid
GALLON
Other Prep Method
gallon
Alternative Bid
deliveries)
NSF 60/ANS!
6
AMMONIA GAS
150 LB.
No Bid
LB.
CYLINDER
7
AMMONIUM SULFATE
50 LB. BAG
S0.6388/Ib.
DRY LB.
8
AMMONIIUM SULFATE
GAL.
No Bid
GAL.
(40% SOLUTION)
9
ANTHRACITE
60+ LBS. BAGS
No Bid
CU.FT.
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 1 of 10.
10
AQUEOUS AMMONIA
GAL.
No Bid
GAL.
MUST BE 26° BAUMt (29%)
11
ASCORBIC ACID
24/26.5 LBS*
$4.6000,nb.
DRY LB.
*55 lb. box
PALLET
12
CALCIQUEST ORTHO
30 GAL. DRUM
No Bid
GAL.
(PHOSPHORIC ACID)
13
CALCIQUEST ORTHO
15 GAL. DRUM
No Bid
GAL.
(PHOSPHORIC ACID)
14
CALCIUM CHLORIDE
50 LB. BAG
$0.266111b.
DRY LB.
15
CALCIUiM CHLORIDE
SUPERSACK
$0.2661/ib.
DRY LB.
16
CALCIUM HYPOCHLORITE
PALLET/50-50"
$2.3500/lb.
LBS
**25 lb. pail
LBS BAGS
17
CALCIUM HYPOCHLORITE
LESS THAN **
$23500/1b.
LBS
**25 lb. pail
PALLET - 50 LBS
BAGS
18
CALCIUM HYPOCHLORITE
55 LBS
No Bid
LBS
(Accu -Tab Blue SI by Fillion
PAILS
Associates)
19
CALCIUM HYPOCHLORITE
55 LBS.
No Bid
LBS.
(Accu -Tab 51 by Axiall LLC)
PAILS
20
CALCIUM NITRATE
50 LB. BAG
$0.4125/lb.
DRY LB.
21
CARBON DIOXIDE
BULK
No Bid
LB.
22
CARBON POWDERED
BULK
No Bid
TON
23
CARBON POWDERED
SUPERSACK
No Bid
DRY LB.
24
CAUSTIC SODA-
BULK
$0.1475/wet lb.
WET LB.
25% SOLUTION
(500 —1,500)
gallon
deliveries
25
CAUSTIC SODA-
BULK
$0.1225/wet lb.
WET LB.
25% SOLUTION
(2,000— 5,000
gallon
deliveries)
26
CAUSTIC SODA-
55 GAL. DRUM
$0.1449/wet lb.
WET LB.
25% SOLUTION
27
CAUSTIC SODA -
330 GAL. TOTE
$0.1384/wet lb.
WET LB.
25 % SOLUTION
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 2 of 10.
28
CAUSTIC SODA-
BULK
$02450/wet ib.
WET LB.
50% SOLUTION
(500-1,500
gall gallon
deliveries)
29
CAUSTIC SODA-
BULK
$0.2050/wet lb.
WET LB.
50% SOLUTION
(2,000 — 5,000
gallon
deliveries)
30
CHLORINE- DRY (HTH)
50 I.B. PAILS
$2.3500/lb.
DRY I.B.
*25 lb. Pail.
31
CHLORINE
1 TON *T
No Bid
LB.
CYLINDER
32
CHLORINE
150 LB.
No Bid
LB.
CYLINDER
33
CITRIC ACID 50%
250 GAL TOTE
$0.6125/lb.
WET LB.
34
CITRIC ACID 50%
55 GAL.DRUM
$0.5825/lb.
WET LB.
35
CITRIC ACID 50% POWDER
50 LB
S,0.7725!lb.
DRY LB.
BAGS/PALLET
36
COPPER SULFATE
50 LB. BAG
Large: $1.8800/lb.
DRY LB.
Fine: $1.3800/lb.
37
FERRIC CHLORIDE -
BULK
No Bid
DRY LB.
U.S. ONLY 32%-38%
38
FERRIC CHLORIDE -
55 GAL. DRUM
$0.8500/lb.
DRY LB.
U.S. ONLY 32%-38%
39
FERRIC CHLORIDE -
BULK
No Bid
DRY.LB.
FOREIGN: 32%-38%
(alternative bid)
40
FERRIC CHLORIDE-
55 GAL.DRUM
No Bid
DRY.L8.
FOREIGN: 32% - 38%
(alternative bid)
41
HYDROFLUOSILICIC ACID- 24%
BULK
WET LB.
0.2251 /,lb
42
HYDROFLUOSILICIC ACID- 24%
55 GAL. DRUM
WET LB.
$0.3496/1
43
HYDROFLUOSILICIC ACID- 2451,
300 - 350 gallon
WET LB.
totes
lib Bid
44
LIME (HYDRATED)
50 LB BAGS
$0 1721/ib.
DRY LB.
45
LIQUID OXYGEN
BULK
No Bid
GAL.
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 3 of 10.
46
LIQUID POLYPHOSPHATE
30 GAL. DRUM
No Bid
WET LB.
(CALCIQUEST 5050 OR EQUAL)
47
LIQUID POLYPHOSPHATE (CARUS
BULK
No Bid
WET LB.
8500 OR EQUAL)
48
MANGANESE GREENSAND
BULK
No Bid
CU FT.
49
MANGANESE GREENSAND PLUS
BULK
No Bid
CU FT.
(alternate bid)
50
METHANOL (100%)
55 GAL DRUM
No Bid
GAL.
51
MURIATICACID-20° BAUME
BULK
$1.6664/e1.
GAL.
(1,000— 3,000
gallon
deliveries)
52
MURIATIC ACID -20" BAUME
55 GAL DRUM
No Bid
GAL.
INHIBITED - NSF Certified
53
MURIATIC ACID- 20' BAUME
520 LB. DRUM'$0.1742/1b.
LB.
X500 lb. drum
54
MURIATIC ACID- 10* BAUME
BULK
No Bid
GAL.
(1,000 to 3,000
gallon
deliveries)
55
MURIATIC ACID -15%
TOTE BULK
No Bid
GAL.
(300-350 gal)
56
MURIATIC ACID- 20' BAUME
PUMPTED TOTE
$1.6327/gl.
GAL.
(300-350 gal)
557
ORTHO-POLYPHOSPHATE
BULK
No Bid
LB.
(AQUAMAG OR EQUAL)
558
ORTHO-POLYPHOSPHATE
55 GAL. DRUM
No Bid
LB.
(AQUAMAG OR EQUAL)
59
ORTHO-POLYPHOSPHATE
30 GALLON
No Bid
LB.
(50%-50% Blend)
DRUM
60
PHOSPHATE (LIQUID)
30 GALLON
No Bid
GAL-
(SHANNON SLI 5225 OR CARUS
DRUMS
8100)
61
PHOSPHORIC ACID
15 GAL. DRUM
51.1500!lb.
WET LB.
75% SOLUTION
62
POLYALUMINUM CHLORIDE
BULK
No Bid
GAL
(HOLLAND PC -H 180 or EQUAL)
63
POLYALUMINUM CHLORIDE
275 GAL TOTE
No Bid
GAL
(HOLLAND PC -H180 or EQUAL)
64
POLYALUMINUM CHLORIDE
BULK
No Bid
GAL.
(HOLLAND EPIC-WW58 or
EQUAL)
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 4 of 10.
65
POTASSIUM HYDROXIDE- 45%
BULK
$0.4388/lb.
WET LB.
(406-1,500 gal.
Deliveries)
66
POTASSIUM HYDROXIDE- 45%
BULK
$03750/lb.
WET LB.
(2,000-5,000
gal. deliveries)
67
POTASSIUM HYDROXIDE- 45%
TOTE
$0.3721/lb.
WET LB.
68
POTASSIUM HYDROXIDE- 45%
55 GAL. DRUM
$0373411b.
WET I.B.
69
POTASSIUM PERMANGANATE
55 LB. DRUM
$3.2430/lb.
LB.
(U.S. ONLY)
70
POTASSIUM PERMANGANATE
330 LB. DRUM
$3,1730/lb.
LB.
(U.S. ONLY)
71
POTASSIUM PERMANGANATE
5 LB. PAILS
No Bid
LB.
(U.S. ONLY)
72
POTASSIUM PERMANGANATE
55 I.B. DRUM
S3.2430/lb.
LB.
(FOREIGN- Alternative Bid)
73
POTASSIUM PERMANGANATE
330 LB. DRUM
$3.1730/lb.
LB.
(FOREIGN - Alternative Bid)
74
POTASSIUM PERMANGANATE
5 LB. PAILS
No Bid
LB.
(FOREIGN -Alternative Bid)
75
SODIUM ALUMINATE- 38%
BULK
No Bid
WET LB.
(AWWA 8405 — LATEST)
.59 69S.-9"
N/A
13R k8'
77
SODIUM BICARBONATE
BULK
No Bid
DRY LB.
(AWWA/NSF 60)
78
SODIUM BICARBONATE
50 LBS. BAG
DRY LB.
(AWWA/NSF 60)
Full Truckload
NO BID
Release
79
SODIUM BICARBONATE
50 LBS. BAG
DRY LB.
(WASTEWATER)
Full Truckload
0.3290/1b
Release
79A
SODIUM BICARBONATE
50 LBS. BAG
DRY LB.
(WASTEWATER)
Per Pallet
0.3290/lb
80
SODIUM BISULFITE-
BULK
No Bid
WETLB.
38% SOLUTION
1,000 GAL+
81
SODIUM BISULFITE-
MINI -BULK
$0.2735/lb.*
WET LB.
38% SOLUTION
< 800 GAL
82
SODIUM BISULFITE-
55 GAL. DRUM
S0.1978/11i
WET LB.
38% SOLUTION
*Sodium Bisulfate "mini bulk" to be done as a tote transfer.
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 5 of 10.
83
SODIUM CARBONATE
50 LB. BAG
DRY LB.
SODA ASH- DENSE
$0.2692/lb
83A
SODIUM CARBONATE
SUPER SACKS
DRY LB.
SODA ASH -DENSE
No Bid
84
SODIUM CARBONATE
BULK
DRY LB.
SODA ASH- DENSE
$371.85
85
SODIUM CHLORIDE
50 LB. BAG
No Bid
DRY LB.
86
SODIUM CHLORITE—
BULK
No Bid
WET LB.
25% SOLUTION — U.S. ONLY
87
SODIUM CHLORITE-
55 GAL DRUM
No Bid
WET LB.
25% SOLUTION – U.S. ONLY
88
SODIUM CHLORITE – 25%
BULK
No Bid
WET LB.
FOREIGN (alternate bid)
89
SODIUM CHLORITE- 25%
55 GAL DRUM
No Bid
WET LB.
FOREIGN (alternate bid)
90
SODIUM CHLORITE –
BULK
No Bid
WET LB.
25% SOLUTION – non-AWWA for
wastewater use only
91
SODIUM CHLORITE-
55 GAL DRUM
No Bid
—
WET LB.
25% SOLUTION – non-AWWA for
wastewater use on[
92
SODIUM CHLORITE –
55 GAL. DRUM
No Bid
DRY LB.
(SAFE-T-CHLOR SOLID)
93
SODIUM FLUORIDE
LESS THAN FULL
No Bid
DRY LB.
U.S. ONLY
40 BAG
PALLETS OF 50
LB. BAGS
94
SODIUM FLUORIDE
FULL 40 BAG
No gid
DRY LB.
U.S ONLY
PALLETS OF 50
LB. BAGS
95
SODIUM FLUORIDE
LESS THAN FULL
$0.652517b.
DRY LB.
FOREIGN
40 BAG
(alternative bid)
PALLETS OF 50
LB. BAGS
96
SODIUM FLUORIDE
FULL 40 BAG
$0.6325f1b.
DRY LB.
FOREIGN
PALLETS OF 50
(alternative bid)
LB. BAGS
97
SODIUM HEXAMETAPHOSPHATE
50 LB. BAG
S1.8400;1b.
DRY LB.
98
Sodium Hexametaphosphate55
GAL DRUM
No Bid
WET LB.
PRISTINE SK-7641
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 6 of 10.
99
SODIUM HYPOCHLORITE -5%
250 GAL TOTE
No Bid
WET LB.
100
SODIUM HYPOCHLORITE -12.5%
5 GAL CARBOYS
No Bid
WET LB.
101
SODIUM HYPOCHLORITE -12.5%
500-2,000 gal.
No Bid
WET LB.
BULK
102
SODIUM HYPOCHLORITE -15%
BULK
No Bid
WET LB.
(400-1,500 gal.
deliveries)
103
SODIUM HYPOCHLORITE -15%
BULK
No Bid
WET I.B.
Certified Refrigerated Storage
(400-1,500 gal.
and Delivery (Alternative Bid)
deliveries)
104
SODIUM HYPOCHLORITE -15%
BULK
No Bid
WET LB.
(2,000-5,000
gal. deliveries)
105
SODIUM HYPOCHLORITE -15%
BULK
No Bid
WET LB.
Certified Refrigerated Storage
(2,000-5,000
and Delivery (Alternative Bid)
gal. deliveries)
106
SODIUM HYPOCHLORITE -15%
55 GAL. DRUMS
$0.130511b.
WET I.B.
107
SODIUM HYPOCHLORITE- 15%
30 GAL.
S0.1920/lb.
WET LB.
CONTAINER
108
SODIUM HYPOCHLORITE -15%
15 GAL.
50.268211b.
WET I.B.
CONTAINER
109
SODIUM HYPOCHLORITE -15%
5 GAL.
No Bid
WET LB.
CONTAINER
110
SODIUM HYPOCHLORITE -15%
1 GAL
No Bid
WET LB.
CONTAINER
1i 1
SODIUMSILICOFLUORIDE
50 LB. BAG
$0.5319Jib.
DRY LB.
112
SODIUM THIOSULFATE (penta-
25 KG BAGS
S1.07081g.
DRY KG.
hydrate)
113
ZINC HEXAMETAPHOSPHATE
50 LB. BAG
No Bid
DRY I.B.
(V-937 OR EQUAL)
114
ZINC ORTHOPHOSPHATE
BULK
No Bid
WET LB.
(V-970 OR EQUAL)
115
ZINC ORTHOPHOSPHATE
55 GAL. DRUM
No Bid
WET LB.
116
ZINC ORTHOPHOSPHATE
50 LB. PAIL
No Bid
DRY LB.
(CARUS 3050 OR EQUAL)
117
ZINC ORTHOPHOSPHATE
30 GAL. DRUMS
No Bid
GAL.
(SHANNON SLC 32108 CARUS
3180)
Official Bad Form and Signature Pages (Fiscal Year 2017-18) Page 7 of 10.
118
ZINC ORTHOPHOSPHATE
BULK
No Bid
WET LB.
(SLI -932 OR EQUAL)
119
ZINC ORTHOPHOSPHATE
BULK
No Bid
WET LB.
(V-939 OR EQUAL)
120
ZINC ORTHOPHOSPHATE
BULK
No Bid
WET LB.
(UPZ-511 OR EQUAL)
121
ZINC ORTHOPHOSPHATE
BULK
No Bid
WET LB.
(SLI -939 OR EQUAL)
122
Emergency Pumping and Storage
Daily Fee:
No Bid
Chemicals that
Tanker to support temporary on-
bulk pumping
site storage for utility that needs
and storage will
to repair containment vessel.
support:
PROPOSAL FROM:
Harcros Chemicals_ Inc.
8Capiwl Street
hiashua. NH 03063
Telephone: 603-880-0535 email: NashuaCs(ql.harcros.com
to furnish chemicals in accordance with specifications attached, it being further
understood that the Town reserves the right to make an award on the basis of quotations received for any
and/or on the basis of the aggregate total for all items on which quotations received.
The Bidder acknowledges receipt of the following Addenda:
Signature:
Ja es Grady, Regional �Ma���
Sir:
In accordance with the advertisement of the Northeast/Merrimack Valley Chemical Consortium inviting
proposals for furnishing Chemicals in conformity with the attached specifications, Uwe hereby certify
that I am/we are, the only person (s) interested in this proposal as principal(s); that it is made without
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 8 of 10.
collusion with any person, firm, or corporation, that an examination has been made of the specifications;
and that the equipment/materials will be delivered within the time specified, at the 1:ollowing prices.
M.GNATURES
(If an Individual)
Date , 2017
Signature of Bidder:
Business Name .DDB/A:
Business Address:
(if a co -partnership)
Date
2017
(Owner and Proprietor)
Firm Name: (SEAL)
By: - (SEMI )
Business Address:
Names and Addresses of all Members of Finn
(ifa corporation)
Please see attached.
Date
, 2017
(SEAL)
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 9 of 10.
Corporate Name:
Nesnt or Authorized Agent's
James ady, Regoinal Manager
Business Address: Harcros Chemicals, Inc.
8 Capitol Street
Nashua, NH 03063
* Statement of authorization, duly signed by proper authority, to be attached hereto.
Attest: PIease see attached.
I certify under the penalty of perjury that L to the best of my knowledge, have filed all state tax returns
and paid all state taxes required under law.
*Signature of Individual or Corporate Name (Mandatory): Harcros Chemicals Inc.
By: Corporate Officer (Mandatory, if Applicable):lesVdy,',
B-1 Mana
*Approval of contract or other agreement will not be granted unless this certification clause is signed
by the applicant.
WARRANT IES/GUARANTEES
All prospective bidders on items that carry warranties and/or guarantees must include with their sealed
proposal a copy of the warranties and/or guarantees of major components as well as a copy of the
warranties and/or guarantees on the items being bid/proposal if applicable.
The bidder must make arrangements to assure the owner that the warranties or guarantees can be
assigned to the owner. The owner's intent is to use the extent of the coverage in the warranties or
guarantees as part of the awarding procedure.
Official Bid Form and Signature Pages (Fiscal Year 2017-18) Page 10 of 10.
Form W'9 Request for Taxpayer Give Form to the
(Rev. December 20Identification Number and Certification requester. Do not
Department of the Treasury
ury Send t0 the IRS.
Internal Revenue Service
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
HARCROS CHEMICALS INC
N
N
Oi
a
0
N
as
,-0
L
0
CN
•C C
a�
m
CL
y
xu
a�
name, it different from above
3 Check appropriate box for federal tax classification; check only one of the following seven boxes:
❑ Individual/sole proprietor or ❑ C Corporation Z S Corporation ❑ Partnership ❑ Trust/estate
single -member LLC
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) 10 -
Note.
Note. For a single -member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for
the tax classification of the single -member owner.
LJ Other (see instructions) 11-
5
5 Address (number, street, and apt. or suite no.)
5200 SPEAKER ROAD
6 City, state, and ZIP code
KANSAS CITY, KS 66106
7 List account number(s) here (optionaD
name
4 Exemptions (codes apply only to
certain entities, not individuals; see
instructions on page 3):
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
(Applies to ecoounfs reeintemed ouhae• A• U.S.)
JIM Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, fora -M-'FFM
resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
T)N on page 3. or
Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for I Employer identification number
guidelines on whose number to enter.
4 3 - 1 9 3 5 0 6 2
LiMAM cerrlTlcaiton
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer Identification number (or I am wafting for a number to be issued to me);•and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Intemai Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA codes) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply, For mortgage
interest paid, acquisition 9( abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other khan interest and dividends, you are not regt�red to sign the certification, but you must provide your correct TIN. See the
instructions on page 3.11 T /
HSignature_� k• ! I V
Here u.S. persons► Date ►
General
Section references are to the Internal Revenue Code unless otherwise noted.
Future developments. Information about developments affecting Form W-9 (such
as legislation enacted after we release it) is at www.irs.gov/fw9.
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an information
return with the IRS must obtain your correct taxpayer identification number (TIN)
which may be your social security number (SSN), individual taxpayer identification
number (ITIM, adoption taxpayer identification number (ATIN), or employer
identification number (EIN), to report on an information return the amount paid to
you, or other amount reportable on an information return. Examples of information
returns include, but are not limited to, the following:
• Form 1099 -INT (interest earned or paid)
• Form 1099 -DN (dividends, including those from stocks or mutual funds)
• Form 1099-MISC (various types of income, prizes, awards, or gross proceeds)
• Form 1099-B (stock or mutual fund sales and certain other transactions by
brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T
(tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident alien), to
provide your correct TIN.
If you do not return Form W-9 to the requester -with a,77N, you might be subject
to backup withholding. See What is backup withholding? on page 2.
By signing the filled -out form, you:
1. Certify that the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding if you area U.S, exempt payee. If
applicable, you are also certifying that as a U.S. person, your allocable share of
any partnership income from a U.S. trade or business is not subject to the
withholding tax on foreign partners' share of effectively connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct. See What is FATCA reporting? on
page 2 for further information.
Cat. No. 10231X Form W-9 (Rev. 12-2014)