3900 Euclid Avenue | Cleveland, OH 44115 | P: (216) 881-6600 | F: (216) 881-2330

TO ALL PROSPECTIVE BIDDERS:

Thank you for requesting/accepting our bid information. The documents listed below are

enclosed. It is expected that all interested bidders will read and understand the District requirements

set forth in the documents. Those documents which have an (*) asterisk before them require

completion and signature(s) in the manner specified on each document and returned with bid.

. Notice to Bidders

. Resolution 102-83 (Purchase of Domestic Material)

. Resolution 44-09 (District to utilize Small, Disadvantaged, Minority,

Women-owned Business Enterprises as subcontractors)

. Resolution Pages (Taking of Bids)

* . Envelope Cover Information Sheet (if download from the web) or Envelope

Cover for your mailed bid.

* . Standard Purchase Bid Form and Signature Page

* . Invitation and Bid Sheet(s)

. Bid Bond (Form D) - (Not required)

. Certified, Official or Cashier’s Check (Not required)

. Consent of Surety with Certified, Official or Cashier’s Check (Not required)

* . Non-Collusion Affidavit (3 pages)

* . Checklist for Required Documents

. Standard Form of Instructions to Bidders (6 pages)

. General Conditions (5 pages)

. Supplemental General Conditions (multiple pages)

* . Detail Specifications (multiple pages) * May need to be filled out and

returned with bid for requirement of the bidding process.

. Performance Bond (Not required)

. Agreement (sample form, for your information only)

The enclosed bid envelope cover sheet or address and bid information should be used when

submitting your bid. If a company envelope, express mail or courier service envelope is used the bid

name, bid file number and opening date must appear on the mailing label. THE DISTRICT SHALL

TAKE NO RESPONSIBILITY FOR UNIDENTIFIED BIDS WHICH ARE INADVERTENTLY

OPENED EARLY AND MAY HAVE TO BE EXCLUDED FROM CONSIDERATION. Bids must

be received before the date and time indicated on the Notice to Bidders.

If you have any questions, please contact the District Purchasing Department.

W:/Wdocs/Operations/Bid Specs/TO ALL PROSPECTIVE BIDDERS PAGE

NOTICE TO BIDDERS

Sealed bids will be received by the Director of Finance of the Northeast Ohio Regional Sewer District, 3900 Euclid Ave., Cleveland, Ohio 44115, until 2:00 p.m. official local time on the date indicated below. At that time, all bids will be opened and read aloud in the Public Meeting Room at the Northeast Ohio Regional Sewer District, 3900 Euclid Ave., Cleveland, Ohio 44115. All bids must be submitted on the forms available at the office of the Director of Finance, from whom detail specifications may be obtained or www.neorsd.org/bids for free bid packages and any addendum updates. Bid File No. RFQ- 1326 Resolution No. 302-13 Opening Date: Tuesday, January 14, 2014 An one (1) year requirement contract, for the purchase of 191,820 gallons of Liquid Sodium Bisulfite for use at all Wastewater Treatment Plants. Bidders may conduct site inspections of the District treatment plants, in order to observe the existing facilities, bulk storage tanks, unloading connections and feeding equipment. See Section SGC-4 for details and contact information in order to make your appointment. No bid bond and no performance bond for this bid. If you have any questions call Ramona Lowery at 216-881-6600 ext.6424. Purchasing Manager P.d. December 31, 2013

January 7, 2014

NORTHEAST OHIO REGIONAL SEWER DISTRICT RESOLUTION NO. 302-13

--------------------------------------------------------------------------------------Authorizing the taking of bids for a one (1) year requirement contract for 191,820 gallons of liquid sodium bisulfite for use at the Easterly, Southerly and Westerly Wastewater Treatment Plants. --------------------------------------------------------------------------------------

WHEREAS, it is necessary to provide for 191,820 gallons of liquid sodium

bisulfite for use at the Easterly, Southerly and Westerly Wastewater Treatment Plants; and

WHEREAS, the estimated cost for 191,820 gallons of liquid sodium bisulfite for use at the Easterly, Southerly and Westerly Wastewater Treatment Plants requires that competitive bids be received;

NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF THE NORTHEAST OHIO REGIONAL SEWER DISTRICT:

Section 1. That this Board finds that 191,820 gallons of liquid sodium bisulfite for use at the Easterly, Southerly and Westerly Wastewater Treatment Plants is an ordinary and necessary expense to be incurred in the efficient operation of the District.

Section 2. That this Board hereby authorizes the Executive Director to advertise for bids for a one (1) year requirement contract to provide 191,820 gallons of liquid sodium bisulfite for use at the Easterly, Southerly and Westerly Wastewater Treatment Plants.

Section 3. That this Board hereby authorizes the Executive Director to evaluate said bids and to make a recommendation to this Board for award of a contract to the lowest and best bidder.

Section 4. That this Board declares that all formal actions of the Board concerning and relating to the adoption of this resolution and that all deliberations of the Board and any of its committees that resulted in said formal action were conducted in meetings open to the public and in compliance with all legal requirements, including Section 121.22 of the Ohio Revised Code.

Rev. 8/1/11 3900 Euclid Avenue | Cleveland, OH 44115 | P: (216) 881-6600 | F: (216) 881-2330

STANDARD PURCHASE BID FORM

REQUIREMENT PURCHASE BID FORM

FROM

To the Director of Finance

(COMPANY

NAME)

BID FOR

______________________________________________________________________

___________________________________________________________ _

The Undersigned proposes to furnish the above materials, supplies or equipment, and to accept as full compensation therefore the price per unit multiplied by the number of units of such commodity purchased hereunder, (which units and prices therefore are set forth in the schedule of items hereto attached and made part of this bid) and subject to any discount set forth in this bid.

The Undersigned further certifies that he (as an individual, firm or corporation making this

bid) is not in arrears or default to the District upon any debt or contract, nor is a defaulter as surety or otherwise upon any obligation to said District nor has failed to perform faithfully any previous contract with said District and that there is no suit or claim pending as to any such arrears or default.

THE UNDERSIGNED UNDERSTANDS THAT THE DISTRICT RESERVES THE RIGHT

TO REJECT ANY OR ALL BIDS. The firm, corporation, or individual name _________________________________

MUST BE SIGNED IN SPACE INDICATED Sign _________________________________

Name Typed or Printed _________________________________

Title of Officer _________________________________

Business Address of Bidder _________________________________

BIDDER MUST

COMPLETE AND SIGN State Where Incorporated ___________________________________

INVITATION AND BID NORTHEAST OHIO REGIONAL SEWER DISTRICT

3900 Euclid Avenue

Cleveland, Ohio 44115

PHONE: (216) 881-6600 · FAX: (216) 881-2330

TITLE OF BID BID FILE NO.

SODIUM BISULFITE SOLUTION RFQ-1326

RESOLUTION NO. ADOPTED

X REQUIREMENT PURCHASE 302-13 Dec. 19, 2013

BID OPENING ADVERTISEMENT DATES

TUESDAY, JAN. 14, 2014 AT 2:00 P.M. DEC. 31, 2013 & JAN. 7, 2014 PD

OFFICIAL LOCAL TIME www.neorsd.org/neorsd_bids.php

ONE YEAR CONTRACT Extended

Estimated Quantity Unit Submitted

38% Sodium Bisulfite Solution at 11.0 lb/gal Price Bid Summary

126,364 gallons , delivered F.O.B. 1,390,000 wet lbs X $ /wet lb = $

Easterly, Southerly and Westerly WWTPs

in tanker truck loads of nominal 4,000 gal/load

65,455 gallons , delivered F.O.B. 720,000 wet lbs X $ /wet lb = $

Easterly, Southerly and Westerly WWTPs Total amount of submitted bid = $

in tanker truck loads of nominal 1,000 - 3,000 gal/load

Manufacturer's Name:

Percentage of sodium bisulfite solution by weight to be furnished: %

Maximum lead-time from notification of order to delivery: days

NOTE: Unit prices shall include delivery charges and other charges or fees to be assessed by the bidder.

Bidders must include with their bids, the required information described in Sections SGC-7, SGC-9 & SGC-10.

PAYMENT DISCOUNT

(If left blank it will be an

automatic 2% 30 days

per IB-11-C)

%

days

Name of Company Zip

Authorized Signature

Street Address State

Date Phone No.

Page 1 of 1

NOTE: This Affidavit properly executed and containing all required information must accompany

your Bid. IF YOU FAIL TO COMPLY YOUR BID WILL NOT BE CONSIDERED.

_______________________________________________________________________________

STATE OF OHIO } NON-COLLUSION AFFIDAVIT

CUYAHOGA COUNTY} SS

being first

duly sworn deposes and says:

Individual only: That he is an individual doing business under the name of _________________

at , in the City

of , State of ____________________________

Partnership only: That he is the duly authorized representative of a partnership dong business

under the name of _______________________________________________

_____________________________________in the City

of, ___________________________State of ___________________________

Corporation only: That he is the duly authorized, qualified and acting _____________________

of_________________________________________, a corporation organized

and existing under the laws of the State of ___________________________

and that he, said partnership or said corporation, is filing herewith a bid to the Northeast Ohio

Regional Sewer District in conformity with the foregoing specifications;

Individual only: Affiant further says that the following is a complete and accurate list of the

names and addresses of all persons interested in said proposed contract:

________________________________________________________________

________________________________________________________________

________________________________________________________________

Affiant further says that he is represented by the following attorneys:

________________________________________________________________

and is also represented by the following resident agents in Cuyahoga County,

Ohio ___________________________________________________________

________________________________________________________________

Partnership only: Affiant further says that the following is a complete and accurate list of the

names and addresses of the members of said partnership:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Affiant further says that said partnership is represented by the following

attorneys:

_______________________________________________________________

_______________________________________________________________

and is also represented by the following resident agents in Cuyahoga County,

Ohio: _________________________________________________________

Corporation only: Affiant further says that the following is a complete and accurate list of the

officers, directors and attorneys of said corporation:

President Directors:

Vice President

Secretary

Treasurer

Cleveland Manager or Agent

Attorneys

Statutory Agent

And the following officers are duly authorized to execute contracts on behalf of said corporation:

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Affiant further says that the bid filed herewith is not made in the interest of or on behalf of any

undisclosed person, partnership, company, association, organization or corporation; that such bid is

genuine and not collusive or sham; that said bidder has not, directly or indirectly, induced or solicited

any other bidder to put in a false or sham bid and has not, directly or indirectly, colluded, conspired,

connived or agreed with any bidder or anyone else to put in a sham bid, or that anyone shall refrain

from bidding; that said bidder has not in any manner, directly or indirectly, sought by agreement,

communication or conference with anyone to fix the bid price or said bidder or of any bid price or that

of any other bidder, or to secure any advantage against Northeast Ohio Regional Sewer District or

anyone interested in the proposed contract; that all statements contained in such bid are true; that said

bidder has not, directly or indirectly, submitted his bid or any breakdown thereof or the contents

thereof, or divulged information or data relative thereto, or paid or agreed to pay, directly or

indirectly, any money, or other valuable consideration for assistance or aid rendered or to be rendered

in procuring or attempting to procure the contract above referred to, to any corporation, partnership,

company, association, organization, or to any member or agent thereof, or to any other individual,

except to such person or persons as hereinabove disclosed to have a partnership or other financial

interest with said bidder in his general business; and further that said bidder will not pay or agree to

pay, directly or indirectly, any money or other valuable consideration to any corporation, partnership,

company, association, organization or to any member or agent thereof, or to any other individual, for

aid or assistance in securing contract above referred to in the

event the same is awarded to __________________________________________________________

_________________________________________________________________________________

(name or individual, partnership or corporation)

Further affiant saith not.

(SIGN HERE) _____________________________________

Sworn to before me and subscribed in my presence this day

of ,

A.D., 20 . ______________________________________

(Notary Public)

Checklist for Required Documents to be returned when bidding for:

Sodium Bisulfite Solution

Bid Number RFQ- 1326

Resolution Number 302-13

Mark with X Item

Envelope with Bid Information on outside of envelope

Standard Purchase Bid Form and Signature Page

Invitation and Bid Form Sheet completed

Non-Collusion Affidavit

Checklist for Required Documents completed and signed

Information (MSDS sheet) must be submitted with bid as stated in Sec. SGC-7

Information (A through E) must be submitted with bid as stated in Sec. SGC-9

(A) Bidder's information on prodution and delivery with bid as stated in Sec. SGC-10

(B) Technical data and MSDS Sheets with bid as stated in Sec. SGC-10

(C)Mercury content not greater than 0.005 ppm with bid as stated in Sec. SGC-10

(D)Newly produced and current production information with bid as stated in Sec. SGC-10

Please sign and date below, that you have provided the above mentioned information for the bid process

Name of Company: ______________________________________

______________________________________

Print your Name

________________________Sign your Name

Date: _____________________________

Rev. 04/09/13 IB-1

STANDARD FORM OF INSTRUCTIONS

TO BIDDERS, GENERAL CONDITIONS

AND BID FOR PURCHASES

-IB-

IB - 1 ADVERTISEMENT: Information concerning title of Bid, Resolution Number of the Board of Trustees of the Northeast

Ohio Regional Sewer District, hereafter designated as NEORSD, and place and dates of

advertisement appears in Legal Notice to Bidders.

IB - 2 BIDS: Sealed Bids endorsed and designated in the "Title Bid" section of the Bid form(s) will be received

at the office of Director of Finance of the NEORSD, 3900 Euclid Avenue, Cleveland, OH 44115,

until 2:00 p.m. official time of the date indicated in the "Bid Opening" in the Legal Notice to Bidders.

Bids received prior to the advertised hour of opening will be securely kept sealed. The Officer

whose duty it is to open them will decide when the specified time has arrived, and no Bid

received thereafter will be considered. Bids will be opened and publicly read aloud, irrespective

of any irregularities therein, at the Northeast Ohio Regional Sewer District’s public meeting room,

3900 Euclid Avenue, Cleveland, OH 44115. All Bids received in conformity with these contract

Documents shall, as soon as practicable, be tabulated and become public record.

IB-3 FORM OF BID:

A. Every Bid must be submitted on the original forms supplied by NEORSD. Copies of the

original Bid forms supplied by the NEORSD will be considered an alteration of our departure

from said forms. Every Bid shall give the price of each and every Item of work quoted on, in

figures (digits), and must contain the full name of every person, firm or corporation

interested in the Bid, and the address of the person, firm or the president and secretary of the

corporation bidding; and if a corporation, the Bid must give the name and the state in which

it is incorporated.

B. The Bid, with all papers bound thereto must be submitted unmutilated with the envelope

cover sheet, which is furnished by NEORSD in your electronic bid package and placed on

the front or back of your envelope.

C. The NEORSD may consider as informal any Bid on which there is an alteration of or

departure from the original Bid Form hereto attached and its option may reject the same.

NOTE: All of this bound information must be kept intact, and, together with any

addenda issued, must be returned with the Bid, otherwise the Bid may be considered

informal.

Rev. 04/09/13 IB-2

D. The award of the Contract, if awarded, will be made to the lowest and best bidder whose Bid

complies with all requirements prescribed, on the basis of utilizing the lowest priced

acceptable alternatives for items where alternate Bids are taken. In no case will an award of

a contract be made until all necessary investigations have been completed regarding the

qualifications of the Bidder to whom it is proposed to award the Contract and all alternate

Bids, if any, have been evaluated. The successful Bidder will be notified by letter mailed to

the address shown on his Bid that his Bid has been accepted and that he has been awarded

the Contract.

E. No Bid will be accepted from, or contract awarded to, any person, firm or corporation that is

in arrears or is in default to the NEORSD upon any debt or contract, or that is a defaulter as

surety or otherwise, upon any obligation to said NEORSD, or has failed to perform faithfully

any previous contract with the NEORSD.

IB-4 NAME OF BIDDER: Each Bid must be clearly signed with the full name and address of each person, firm or

corporation interested in it. In case of a partnership, the firm name and address and name and

address of each individual party must be given.

IB-5 SIGNATURE OF BIDDER: A. The firm, Corporate or individual name of the Bidder must be signed by the Bidder in the

space provided for the signature on the Bid blank. If the Bidder is a corporation, the name of

the corporation, the name and title of the officer duly authorized to sign for the corporation,

the business address of such Officer-Bidder and the name of the state in which the

corporation is chartered must be given. If the Bidder is a partnership, the signature of at least

one of the partners must follow the firm name, using the term "member of firm". If the

Bidder is an individual, use the term, "doing business as" or "sole owner".

B. All successful Bidders who are corporate bodies shall furnish at the time of the execution of

the Contract a resolution of the Directors of the Corporation, bearing the Seal of the

Corporation evidencing authority of the officer signing the Contract to do so; likewise, agents

of Bonding Companies shall furnish Power of Attorney, bearing the Seal of the Company,

evidencing such agents’ authority to execute the particular type of Bond to be returned.

Rev. 04/09/13 IB-3

IB-6 BIDDERS AFFIDAVITS: A. Each Bidder is required to submit with his Bid an affidavit stating that neither he nor his

agents, nor any other party for him has paid or agreed to pay, directly or indirectly, any

person, firm or corporation money or other valuable consideration for assistance in procuring

or attempting to procure the contract herein referred to, and further agreeing that no such

money or reward will be hereafter paid. This affidavit must be on the form which is attached

hereto.

B. Each Bidder which is a foreign corporation, that is, a corporation not chartered in Ohio but

licensed to do business in Ohio, is required to submit with his Bid an affidavit duly executed

by the President, Vice President or General Manager of the corporation stating that said

foreign corporation has, in accordance with the provisions of the Revised Code of the State

of Ohio, obtained a certificate authorizing it to do business in the State of Ohio. (The

certificate or certified copies of such certificate may be obtained from the Office of the

Secretary of State, Columbus, Ohio.)

IB-7 BID BOND OR CERTIFIED, OFFICIAL OR CASHIER’S CHECK: Not required.

IB-8 DISPOSITION OF BID BOND OR (CERTIFIED, OFFICIAL OR CASHIER’S CHECK):

Not applicable.

IB-9 WITHDRAWAL OF BID: No Bid will be allowed to be withdrawn after it has been deposited with the Director of Finance of

the NEORSD until all Bids have been opened, in accordance with the requirements of Ohio

Revised Code Section 9.31.

IB-10 EXPLANATIONS, WRITTEN OR ORAL: Any Bidder finding a discrepancy or omission in the specifications or having any doubt as to their

meaning shall immediately notify the Director of the NEORSD or his designated

representative. The Director will respond by sending written notices of instructions to all Bidders.

The NEORSD will not be responsible for any oral instructions.

Rev. 04/09/13 IB-4

IB-11 PRICE BIDS AND DISCOUNTS: A. Unit Price

The Bid price shall be per unit of items to be bid on, stated in figures in the spaces so

provided.

B. Trade Discounts

When the Bidder offers a trade discount, the amount of such discount shall be stated on the

Bid blank. Where the Bidder submits his quotation by filing his catalog, price list and

discount, such documents shall be made part of the Bid and must be separately signed by the

same person and in the same manner as used on the Bid form.

C. Discount for Prompt Payment

A discount of two percent (2%) will be taken on payment made within thirty (30) days from

the invoice date for materials, supplies, equipment or nonprofessional services, unless the

Bidder offers a different discount or indicates otherwise in the space provided on the Bid

blank.

IB-12 BIDDER’S DESCRIPTION OF ITEMS: A. Bidders shall furnish with their Bids complete descriptions of the items they propose to

furnish under the terms of the Bid.

B. The NEORSD may require Bidders to furnish additional information and/or specifications

concerning items to be purchased under the terms of the Bid.

IB-13 BRAND NAMES AND SUBSTITUTIONS: Any brand or trade names referred to herein are for identification purposes only. Such

references do not limit the bidder to the identified brands, provided the alternates offered by the

bidder are equal in quality, function to the level of those specified, and are approved by the

accepting facility’s end-user. When bidders list a trade name and/or catalog number, NEORSD

will assume the item meets the specifications, unless the submission clearly states it is an alternate,

and describes specifically how it differs from the item specified. Multiple or alternative bids will

not be accepted unless authorized in the specifications. Notwithstanding anything to the contrary

herein, when any bid item contains the words “No Substitution”, “No Sub”, or any other

substantially similar notation, the brand, manufacturer name and/or product number specified for

such bid item shall be the only acceptable brand, manufacturer name and/or product number. In

such cases, alternate products will not be considered.

Rev. 04/09/13 IB-5

IB-14 SAMPLES: Upon request by the NEORSD the Bidders shall provide samples of the items they propose to furnish

under the terms of the Invitation and Bid.

IB-15 TIME OF DELIVERY: Bidders must state in their Bids the time necessary to deliver the items they propose to furnish.

THIS TIME MUST BE STATED IN CALENDAR DAYS.

IB-16 DISCOUNT USED TO DETERMINE LOWEST AND BEST BID: In determining the lowest and best Bid, the NEORSD will consider all Bids on a basis of the net

price to be paid after deduction of the discount specified or calculated according to Section IB-11

(C), except that if the terms specified by the Bidder require payment in less than fifteen (15) days

from the date of the invoice, the discount offered will not be deducted from the price named in the

Bid to determine the lowest and best Bidder, and the Bid will be considered only on the basis of the

unit price actually named in the Bid. But if, notwithstanding the provisions of this paragraph, such

Bid is determined to be the lowest and best Bid, the NEORSD reserves the right to accept the terms

named in the Bid if such terms are to the advantage of the NEORSD as a basis for payment of

invoices only, but not in any case as a basis for determining the lowest and best Bidder.

IB-17 EQUAL EMPLOYMENT OPPORTUNITY: There shall be no discrimination exercised against any citizen in the employment of labor, whether

skilled or unskilled, under this Contract; such discrimination shall be deemed to be a material breach

of the Contract.

Federally Assisted Contracts: In the case of those contracts receiving federal assistance, the

contractors and subcontractors shall be required to comply with all federally- mandated

requirements regarding provision of equal employment opportunities and submit a copy of their

Monthly Manpower Utilization Report, and any other federally- required documentation, to the

NEORSD as well as the appropriate federal official(s) or agency(ies) involved therein. Non-

compliance with this section may subject the contractor to such penalties and sanctions as

prescribed under applicable federal laws.

Paragraphs IB-18 and IB-19 apply only if requirement contract Bid block is marked on Page 1.

REQUIREMENT CONTRACT

IB-18 REQUIREMENT CONTRACT DEFINED:

A. An award of a contract made under this Bid will be termed a requirement contract.

B. A requirement contract imposes a duty on the contractor to provide such supplies, material or

equipment which is set forth in the Bid, as may be required by the NEORSD during the life

of the contract.

IB-19 AMOUNT OF PURCHASE UNDER THE REQUIREMENT CONTRACT: The total amount to be ordered under the contract awarded on this Bid shall not be less than five

percent (5%).

IB-20 SGC AND DC DOCUMENTS: When in question of what documents prevail, the written SGC and DS of each bid package will

supersede the IB Documents.

Rev. 04/09/13 IB-6

Revised 4/09/13

GC-1

GENERAL CONDITIONS

-GC-

GC-1 REJECTION OR ACCEPTANCE OF BIDS:

The NEORSD reserves the right to reject any or all bids, and any part or parts of any bids, and also the

right to waive any informalities in the bid. In awarding a contract, the NEORSD reserves the right

to consider, in addition to price and discount, all elements entering into the question of determining the

ability of the bidder to perform the contract satisfactorily. Any bid which is incomplete, conditional,

obscure, or which contains additions not called for or irregularities of any kind, may be rejected within

the discretion of the NEORSD.

GC-2 EVIDENCE OF ABILITY TO FULFILL CONTRACT: Bidders must present evidence to the NEORSD, when required to do so, to show that they are fully

competent and have the necessary source of supply, facilities and pecuniary resources to fulfill the

conditions of the contract and specifications.

GC-3 TIME OF AWARD:

The Board of Trustees of the NEORSD shall make and award or reject all bids within ninety (90) days

following the opening of bids, unless further time is required to analyze the bids. Any extension of time

beyond that date shall be subject to agreement between the Bidders and the NEORSD.

GC-4 AWARD OF CONTRACT: No contract shall be awarded without the approval of the Board of Trustees, and only to the lowest and

best bidder.

GC-5 PERFORMANCE BOND: Performance Bond not required.

Revised 4/09/13

GC-2

GC-6 RELEASE OF BOND: Not applicable.

GC-7 CANCELLATION OF CONTRACT:

The NEORSD shall have the right to cancel a contract if, in the opinion of the Director of the NEORSD,

the delivery of materials, supplies or equipment are not in accordance with the contract specifications, and

the seller is given notice in writing of such deficiencies and is afforded reasonable time to comply with

the provisions of the contract but fails to do so.

GC-8 ASSIGNMENT OF CONTRACT:

The contractor shall not assign, transfer, convey or otherwise dispose of the contract, or his right to

execute it or any part thereof, or assign, by power of attorney or otherwise, any of the monies due or to

become due under the contract, except by previous consent of the Board of Trustees of the NEORSD in

writing endorsed thereon or attached hereto, and the giving of any such consent to a particular

assignment, shall not dispense with the necessity of such consent to any further or other assignments.

Such assignments, transfer, or conveyance shall not be valid until filed in the office of the Director of

Finance of the NEORSD.

GC-9 DELAY FOR CAUSES BEYOND CONTROL: If the contractor be delayed in the compliance with the terms of the contract by strikes, lockouts, fire,

unusual delay by common carriers, unavoidable casualties, or any cause beyond the contractor’s

control, including orders, limitations or restrictions of any Government agency having jurisdiction over

the subject matter of the contract, or by delay authorized by the NEORSD, or by any cause for which the

Director shall decide to justify the delay, then for all such delays and suspensions, the contractor shall be

allowed one calendar day extension beyond the time fixed for compliance with the terms of his

contract for each and every calendar day of such delay so caused in the completion of the work, the same

to be ascertained by the Director.

GC-10 PATENT:

The contractor shall be required to pay all royalties and license fees and shall hold and save the

NEORSD and its officers, agents, servants and employees harmless from liability of any nature or kind,

including cost and expenses for, or on account of, any patented or unpatented invention, process, article,

or appliance manufactured or used in the performance of the contract, including its use by the

NEORSD, unless otherwise specifically stipulated in the contract documents. In this respect the

contractor shall defend all suits or claims for infringement of any patent or license rights.

Revised 4/09/13

GC-3

GC-11 DELIVERY: Bidders shall agree to make requested delivery of materials, supplies or equipment upon the written

purchase order of the Director of the NEORSD and no delivery shall be accepted unless such written

purchase order has first been issued.

GC-12 LABORATORY TESTS:

The NEORSD reserves the right to test all materials, equipment or supplies delivered during the life of

the contract, at a laboratory to be designated by the Director of the NEORSD. Where the results of

such test shows the materials, equipment or supplies are not equal to the specifications, then the expense

of making such test shall be paid by the contractor.

GC-13 FAILURE TO MEET SPECIFICATIONS: The delivery of any materials, supplies or equipment under the contract which do not conform to

contract specifications will be rejected and the contractor notified immediately. Such rejection and the

reason therefore, shall be in writing.

The contractor may, if time for performance has not expired, reasonably notify the Director of the

NEORSD of his intention to cure and may then within the contract time make conforming delivery.

If the said contractor fails to effect immediate replacement of such rejected materials, supplies or

equipment, the NEORSD will purchase such materials, supplies and equipment of the character

required, on the open market. The contractor and his surety shall be liable to NEORSD for any excess

cost and expense incurred by the NEORSD.

GC-14 SAFEGUARDS: Any equipment to be furnished by the terms of this bid, shall be provided with safety controls, guards

and housings meeting the requirements of the safety standards of the Industrial Commission and the

Department of Industrial Relations of Ohio, and the cost be included as part of the bid.

GC-15 STATE OR FEDERAL TAXES: A. The NEORSD is exempt from all sales, excise and transportation taxes, except State of

Ohio gasoline tax. The price or prices bid shall be exclusive of all such taxes and will be

so construed.

Revised 4/09/13

GC-4

B. The bid prices are subject to increase by the amount of any additional tax imposed by the

Federal Government or the State of Ohio to which the District is not exempt,

subsequent to the receipt of bids. Such claims for increased prices must be

presented to the NEORSD within thirty (30) days after such tax becomes

effective and supported by evidence satisfactory to the Legal Department of the

NEORSD. Should the increase in bid prices require an increase in the contract price,

such increase shall be subject to approval by the Board of Trustees of the District.

C. The contract price is subject to reduction by the amount which an applicable tax is reduced

during the period of the contract.

GC-16 SOCIAL SECURITIES ACT: The contractor shall be and remain an independent contractor with respect to all services performed

under said contract, and agrees to and accepts full and exclusive liability for the payment of any and

all contributions or taxes for social security, unemployment insurance, old age retirement benefits,

pensions or annuities now or hereafter imposed under any state or federal law, which are measured

by the wages, salaries, or other remuneration paid to persons employed by the contractor on work

performed under the terms of this contract, and further agrees to obey all lawful rules and regulations

and to meet all lawful requirements with are now or hereafter may be issued or promulgated under

said respective laws by any duly authorized state or federal officials; and said contractor also agrees

to indemnify and save harmless the NEORSD from any such contributions or taxes or liability

therefore.

GC-17 FREIGHT ON DIRECT SHIPMENT TO THE NEORSD: The freight prices stated in the bid are to be in accordance with lawful freight or cartage charges in

existence at the time the bid is made, and bid prices shall be increased or decreased by changes in the

freight or cartage rates provided that claims for additional freight or cartage be presented to the

NEORSD within thirty (30) days after said increase in freight or cartage rates becomes effective.

Reduction in freight or cartage prices will be deducted from the contract price. Should the increase in bid

prices require an increase in the contract price, such increase shall be subject to approval by the Board of

Trustees of the District.

GC-18 PAYMENT: Payment shall be made for the net number of units accepted after due and proper delivery, accompanied

by invoices at the bid price per unit, less discount for prompt payment if appropriate.

GC-19 STATE INDUSTRIAL COMPENSATION: The contractor shall, during the term of this contract, subscribe to and comply with the Worker’s

Compensation Laws of the State of Ohio and pay such premiums as may be required and to save said

NEORSD harmless from any and all liability arising from said act. The Contractor shall also furnish at the

time of delivery of this contract and at such other times as may be applicable a copy of the current official

certificate or receipt to show the payments herein-before referred.

GC-20 FORCE MAJEURE Neither party to this Agreement shall be deemed in default in the performance of its obligations if that

party is prevented or delayed from performing by forces beyond its control, (Hereinafter “Force

Majeure”) including, without limitation, acts of God or of a public enemy; acts of a municipal, state,

federal or other governmental legislative, administrative or judicial entity; any catastrophe resulting

from flood, fire, extreme weather conditions, explosion; labor disturbances; and other cause beyond the

control of the non-performing party. Contractor may be granted a time extension and cost adjustment

for its performance based on the duration of the Force Majeure.

Paragraphs GC-21 and GC-22 apply only if the requirement contract bid block is marked on bid Page 1.

REQUIREMENT CONTRACT

GC-21 DURATION OF CONTRACT:

The proposed contract shall be effective upon its execution by the NEORSD and for the purpose of

accepting delivery shall continue in full force and effect for the term stated in the contract (or until

appropriated and approved funds have been expended) unless otherwise indicated.

GC-22 REDUCTION IN PRICES: The contractor agrees that if the price to the general trade is reduced while the contract is in effect, the

NEORSD will receive the benefit of such reduction immediately. However, if the contract price is below the

price to the general trade at the time the contract is awarded, the reduction provision will be effective only

when the recognized price to the general trade reaches a lower level than the contract price, or when the

contractor reduces his own price to a level lower than the contract price.

GC-23 SGC AND DS BID DOCUMENTS: When in question of what documents prevail, the written SGC and DS of each bid package will

supersede the GC documents.

Revised 4/9/13

GC-5

SGC-1

SUPPLEMENTAL GENERAL CONDITIONS (SGC)

Sodium Bisulfite Solution

SGC-1 PURPOSE OF THIS BID

The purpose of this bid, and the requirement contract awarded following an evaluation of the

bids received, is to provide sodium bisulfite solution for the purpose of dechlorinating the

wastewater effluent flows at the Easterly WWTP, Southerly WWTP and Westerly WWTP, of the

Northeast Ohio Regional Sewer District (District). The contract shall be for twelve (12) months

or until funds appropriated are exhausted, which ever should occur first from the effective date of

the contract.

SGC-2 BIDDER QUALIFICATIONS

In order for a bid to be considered for a contractual award, the bidder must be capable of

supplying the product and quantity specified for the contract duration. In addition, the specified

product being bid must be compatible with the present operation and facilities.

SGC-3 BID INQUIRIES

All questions regarding any irregularities and requests for information should be submitted via e-

mail to the Operation and Maintenance Manager, Ramona Lowery at loweryr@neorsd.org and

they will be answered as soon as is practicable. Those questions developing information that

should be available to all persons or firms submitting a bid, in the opinion of the District, will be

distributed as an addendum to the bid documents. The District will not be responsible for any

oral instructions and/or opinions. Questions will not be answered after 12:00 noon on January 9,

2014.

SGC-4 SITE INSPECTIONS

Bidders may conduct site inspections of the District treatment plants in order to observe the

existing facilities, including but not limited to the bulk storage tanks, unloading connection(s)

and feeding equipment. The inspection shall be conducted only after contacting the Assistant

Superintendents at the treatment plants to arrange a time for the inspections. The Plants’

telephone numbers and addresses are:

Easterly WWTP

14021 Lakeshore Blvd.

Cleveland, OH 44110

(216) 531-4892

Southerly WWTP

6000 Canal Rd.

Cuyahoga Hts., OH

44125 (216) 641-3200

Westerly WWTP

5800 Cleveland Memorial Shwy.

Cleveland, Ohio 44102

(216) 961-2187

SGC-5 DELIVERIES

The sodium bisulfite solution to be supplied under the terms of the contract awarded from this

bid shall be delivered after telephone or written notice to the supplier by the Plant Superintendent

or designated representative. The sodium bisulfite solution shall be delivered at the stated bid

price, F.O.B. to the District treatment plants. Any freight, delivery, demurrage or special

handling charges are to be included in the bid price. Special handling includes fuel surcharges.

The addresses of the plants are noted above.

Orders for deliveries shall be placed based on operational requirements. All deliveries will be

accepted between the hours of 8:00 a.m. and 2:30 p.m., Monday through Friday. No deliveries

will be accepted on weekends or District holidays unless otherwise arranged for by the Plant

Superintendent or his designated representative.

SGC-2

SGC-6 DELIVERY QUANTITIES AND RESPONSIBILITIES

The sodium bisulfite solution shall be delivered in the quantities described in Section DS-5 and

listed on the Bid Form. The solution shall meet the specifications in Section DS-2 and be fresh,

unused and in current production. The bidder is responsible for shipping the sodium bisulfite

solution in conformance with all current federal, state and local regulations. Bulk sodium

bisulfite solution deliveries shall be transported and delivered in well-maintained and clean

tanker trucks. The tankers must arrive on-site with an air compressor capable of off-loading the

solution, properly sized and tight fitting connections and well maintained unloading hoses. The

cost to contain and clean-up spills of sodium bisulfite solution and/or any fines due as a result of

environmental violations occurring as a result of driver negligence and/or poorly maintained

fittings, piping, valves on the tanker truck, or poorly maintained hoses provided by the trucking

company shall be paid by the bidder awarded the contract. The District shall have the option to

deduct any such costs from amounts owed to the bidder.

SGC-7 MSDS LABELING

The bidder shall provide with the bid a Material Safety Data Sheet (MSDS) for the

manufactured sodium bisulfite solution being bid. In addition, the bidder awarded the

contract shall provide a Material Safety Data Sheet at the time and location of each delivery.

Failure to provide the above may result in the District not accepting delivery of the chemical. All

costs associated with non-acceptance shall be those of the bidder.

SGC-8 APPROXIMATE QUANTITY

The maximum quantity of sodium bisulfite solution to be furnished under the terms and

specifications of this contract is estimated to be approximately 191,820 gallons per year. By

submission of a bid, the bidder warrants that it is understood that this estimate was prepared by

the District for the purpose of comparison of bids and that the estimated quantity is not

guaranteed, but is approximate only. In addition, the bidder warrants that it is understood that the

District reserves the right to vary the amount purchased, as the Executive Director may deem in

the best interests of the District, subject only to the minimum quantity listed in Section IB-l9 and

the maximum dollar amount authorized by the contract.

SGC-9 BID PACKAGE – BID FORM

Each bidder must provide an authorized signature and company information on each page

of the Invitation and Bid form provided. The data to be completed by the bidder on the Bid

form includes the following:

A. The unit prices of delivered sodium bisulfite solution and the unofficial extended prices

based on the estimated quantities listed.

B. The Extended Submitted Bid Summary = sum of the extended unit prices.

C. The name of the sodium bisulfite solution manufacturer(s).

D. The percentage of sodium bisulfite solution by weight to be furnished.

E. The maximum lead-time necessary from a notification of order to delivery.

SGC-3

SGC-10 BID PACKAGE – ADDITIONAL INFORMATION

Each bidder must also include with the bid package the following written information:

A. Assurance that the bidder’s production and delivery capabilities will be sufficient to

supply the solution to all three District treatment plants.

B. Technical data sheets and Material Safety Data Sheets (MSDS).

C. Assurance that the sodium bisulfite solution does not contain mercury in a concentration

greater than 0.005 ppm.

D. Warranty that guarantees for a twelve (12) month period that the commodity furnished is

newly manufactured and in current production.

SGC-11 BID SUBMITTAL

The bidder must return all required information by the Bid Opening date/time. The information

includes completing all the contents of the bid package and providing the additional information

discussed in Sections SGC-7, SGC-9 and SGC-10. Bidders are advised that they are to

sequentially number and initial the lower or upper right hand corner of each page of their

submitted bid prior to sealing and presenting the bid to the Northeast Ohio Regional Sewer

District. These documents will become a part of the finalized contract with the successful

bidder.

SGC-12 BID EVALUATION

The District shall be the sole judge of whether the sodium bisulfite solution proposed by the

bidder meets the specific needs of the District and shall evaluate qualified bids on the basis of

cost, compatibility and availability. The District reserves the right to accept or reject any or all

bids received.

SGC-13 DAMAGE TO DISTRICT PROPERTY

The vendor is responsible to immediately repair any buildings, roadways, pieces of equipment, or

other District property damaged during the execution of the work specified herein. If the vendor

fails to make repairs in a reasonable time, the District will make the necessary repairs and deduct

the repair costs (materials and labor) from the next invoice(s) submitted by the vendor.

SGC-14 VENDOR INSURANCE FOR EMPLOYEES AND VEHICLES

The vendor shall maintain during the term of this contract general liability and property damage

insurance for its employees and vehicles. Such policies shall not be less than $1,000,000.00 per

occurrence. The policies shall include medical payments, business vehicle insurance including,

but not limited to, comprehensive coverage, collision, personal and bodily injury, uninsured

motorists, property damage; and fire and casualty insurance to the vendor’s buildings and

equipment. The vendor is solely responsible for the health and safety of the vendor’s employees,

and all vendor-owned or leased equipment.

SGC-4

SGC-15 INSURANCE FOR PUBLIC PROTECTION

In addition to protection for the vendor’s employees and vehicles, the vendor shall take out and

maintain during the life of this contract public liability and public property damage insurance

wherein the District is named as an additional insured to protect the District from all claims or

damages from personal injury, including accidental death, as well as from claims for property

damage which may arise out of the performance of the work hereunder. A certificate of insurance

evidencing each policy or policies shall be deposited with the District before the commencement

of any work under the contract.

The District reserves the right to refuse the insurance policies and demand other insurance if the

policy language, insurance company’s ability to make payments and/or any other reason makes

the policy unacceptable in the sole judgment of the District. The vendor shall replace the policy

with insurance acceptable to the District. Failure to do so may result in the not being awarded the

contract. In addition, with respect to the contract involved the vendor shall have the insurance

company write into the policy the following language: “thirty days prior to any reduction of the

insurance coverage or cancellation of the policy, the District (Attention Office of the Director of

Law) shall be notified.”

The amount of the insurance shall be as follows:

Public Liability Insurance - in the amount not less than $1,000,000.00 for injuries,

including accidental death, to any one person, and for each additional person involved

(two or more persons).

Public Property Damage Insurance - in the amount not less than $1,000,000.00 in any

occurrences to cover damages caused during the execution of this contract to vehicles and

any other properties.

SGC-16 INDEMNITY CLAUSE

The vendor shall indemnify, keep and save harmless the District and its respective officers,

agents and employees, against all suits or claims that may be based upon any injury to persons or

property that may occur, or that may be alleged to have occurred in the course or as the result of

the performance of all or any part of this contract by the vendor, whether or not it shall be

claimed that the injury was caused by a negligent act or omission of the vendor or its employee,

and whether or not the person(s) injured or whose property was damaged were third parties or

employees of the vendor, and the vendor shall at its own expense defend the District in all

litigation, pay all attorney’s fees and all costs and other expenses arising out of the litigation or

claim incurred in connection therewith; and shall, at its own expense, satisfy and cause to be

discharged such judgments as may be obtained against the District, or any of its officers, agents

or employees. Nothing herein shall be construed to limit the vendor’s indemnification obligations

to the limits of insurance provided. The indemnification obligations shall survive any termination

of the contract.

In case of any and all claims against the District and its officers, agents or employees, by any

employee of the vendor, its agents, anyone directly or indirectly employed by any of them, or

anyone for whose acts any of them may be liable, the indemnification obligation of the above

paragraph shall not be limited in any way by any limitation on the amount or type of damages,

compensation or benefits payable by or for the vendor’s, or other person under applicable

worker’s or workmen’s compensations benefit or disability laws, it being clearly agreed and

understood by the parties hereto that the vendor expressly waives any immunity the vendor might

have had under such laws. By executing the contract, the vendor acknowledges that the parties

have mutually negotiated the foregoing waiver.

SGC-5

SGC-17 PREVENTION OF NUISANCES

The contractor is responsible to leave the work site in a clean and safe condition and preventing

the creation of any and all nuisances, including but not limited to: noises; odors; spills of polymer

and vehicle fluids. The cost to clean-up spills of polymer occurring as a result of driver

negligence and/or poorly maintained tanker equipment; hoses, etc. shall be paid by the contractor

(deducted from the cost of the load).

No liquid will be permitted to drain or be washed down into any floor drains or storm sewer

catch basin. The storm water outfalls from the District treatment plants have permits issued by

the State of Ohio Environmental Protection Agency (OEPA) to discharge only storm water. Any

environmental fines or other violations occurring as a result of negligence shall be paid directly

by the contractor. In addition, any District costs involved with the investigation and clean up of

any spills caused by the contractor will be deducted from the most current invoice(s).

SGC-18 CONTRACT CANCELLATION

In the event the vendor does not fully comply with the conditions and obligations of this

agreement and these specifications, the District shall have the right to terminate this agreement.

The District shall have the right to terminate this agreement for convenience in the event that the

District’s Executive Director determines it to be in the best interest of the District.

DS-1

DETAILED SPECIFICATIONS (DS)

Sodium Bisulfite Solution

DS-1 SCOPE

The bidder shall be capable of supplying the Northeast Ohio Regional Sewer District (District)

with 191,820 gallons of sodium bisulfite solution (to be bid on a wet pound basis) in the

concentration and delivery quantities listed below. The quantity is the estimated amount needed

for twelve (12) months at all three (3) District treatment plants as explained in Section SGC-8.

The specifications are listed in Section DS-2. The delivery quantities are listed in Section DS-5.

DS-2 SODIUM BISULFITE (NaHSO3) SOLUTION SPECIFICATIONS

DS-3 IMPURITIES

The sodium bisulfite solution supplied under this contract shall contain no soluble or insoluble

mineral or organic substances in quantities that would interfere with the removal of chlorine

(dechlorination) of the wastewater effluent streams at the treatment plants or would interfere with

the pumping or flow measurement of the chemical solution.

DS-4 REJECTION

A sample is taken from each load received at the Plants, and tested by the District’s analytical

services department. If any load of the sodium bisulfite solution supplied under this contract does

not meet the requirements of this contract, the District shall contact the bidder immediately to

provide notification that the load is being rejected. Reasons for rejection may include impurities,

and/or the delivery contained less than the required 38% minimum sodium bisulfite solution by

weight. The bidder may be required to remove from the treatment plant any rejected solution at

the bidder’s expense. No payment will be made, including delivery, shipping, etc. for rejected

solution not meeting the specifications of the contract.

DS-5 DELIVERY QUANTITIES

Two (2) delivery quantities are needed for this bid due to different storage capacities at the plants

and, on occasion, the need for partially full tanker truckloads.

A. Nominal 4,000 gallons per delivery, estimated at 181,820 gallons per contract.

B. In 1,000 to 3,000 gallons per delivery as requested, estimated at 10,000 gallons per

contract.

Solution Concentration: 38.0 % minimum sodium bisulfite by weight

Density: approximately 11.0 pounds per gallon @ 60 degrees F

Appearance: clear, white to light-yellow

pH: 3.4 to 4.8

Hazard: Corrosive

Mercury concentration: Less than 0.005 ppm

Iron concentration: Less than 15 ppm

DS-2

DS-6 TANKER TRUCK DELIVERY PROCEDURES

The Southerly treatment plant has certified weight scales at the entrances of the plant. Tanker

truck deliveries will be weighed full upon entry into the plants, and weighed following the

unloading of the sodium bisulfite solution. The tankers will either be weighed empty following

deliveries of full loads or weighed partially empty following the deliveries of partial loads. For

payment purposes, the net weight recorded by the District certified scales will be used to

determine the total pounds of solution delivered as explained in Section DS-8.

The Easterly and Westerly treatment plants do not have certified weight scales. For full tanker

truck deliveries, the driver must provide an original certified weight scale ticket indicating the net

pounds for the load delivered. This original weight scale ticket shall be left with the security

officer located at the entrance to the plant prior to the tanker leaving the plant.

For partially full tanker truckload deliveries, the truck may need to leave the plant to be weighed

following the unloading the partial load. The driver may proceed to the Southerly WWTP to be

weighed following unloading, or proceed to another certified scale. All weigh tickets properly

documenting the partially full tanker truck loads must be supplied to the Easterly or Westerly

WWTP as soon as practical to properly process payment. The net weight recorded on the

certified weight scale tickets will be used to determine the total pounds of solution delivered as

explained in Section DS-8.

DS-7 QUALITY CONTROL

Each tanker truck delivery shall be accompanied by a written certified analysis listing the

concentration of the percent sodium bisulfite solution by weight. The quality control laboratory

operated by the manufacturer or an independent accredited laboratory shall perform the analyses.

The cost of these analyses shall be included in the unit prices bid.

The District will take samples during the deliveries and will also perform analyses to determine

the concentration of the percent sodium bisulfite solution by weight.

DS-8 PAYMENT PROCEDURES

Payment for all deliveries will be determined using the concentration of the percent sodium

bisulfite solution by weight as explained in Section DS-7.

A. If the concentration of the percent sodium bisulfite solution by weight is 38.0 % or

greater, the unit prices bid will be used for payment. No additional payment shall be

made if the percent sodium bisulfite solution by weight is greater than 38.0 %, based on

the District’s analysis.

B. If the analysis performed by the Analytical Services Department of the District

determines that the concentration of the percent sodium bisulfite solution by weight is

less than 38.0 %, the basis for payment will be based on the following formula:

DS-3

ADJUSTED PRICE = UNIT PRICE BID x Analyzed % sodium bisulfite solution by weight

38.0 %

C. If the concentration of the percent sodium bisulfite solution by weight is 30.0 % or less,

based on the District’s analysis, no payment, including delivery, shipping, etc. will be

made. The District will determine if it will dispose of the chemical or reject the load.

If rejected, the bidder will be directed to remove the chemical from the plant at no

expense to the District as explained in Section DS-4.

Agreement

For _________________________________________________________________________________

_____________________________________________________________________________________

THIS AGREEMENT, made this _________ day of ________________two thousand and _______,

by and between the Northeast Ohio Regional Sewer District, party of the first part, duly authorized pursuant to

Resolution No. ____________ of the Board of Trustees of the said District, adopted __________________________

____________________ and ______________________________________________________________________

(a corporation organized and existing under the laws of the State of ____________________, and authorized to do

business in the State of Ohio) - (a partnership consisting of __________________________________________) (an

individual doing business as __________________________________________________________)-Contractor,

party of the second part.

WHEREAS, it was one of the conditions of said award that a formal contract should be executed by and between

the Northeast Ohio Regional Sewer District and the Contractor.

WITNESSETH:

That said party of the second part has agreed and by these presents does agree for itself, it’s representatives,

successors and assigns, with the party of the first part, as follows:

The Contractor shall furnish the following materials, supplies or equipment:

______________________________________________________________________________________________

______________________________________________________________________________________________

_________________________________ for the consideration of ____________________________________

_______________________________________________________________________($ _____________________)

Dollars. The Invitation to Bid, the General Conditions, the Specifications and the Bid, all which are incorporated

herein and made part hereof as fully as if herein rewritten, constitute this contract.

IN WITNESS WHEREOF, the parties hereunto have affixed their signature the day and year first above written.

CONTRACTOR NORTHEAST OHIO REGIONAL SEWER DISTRICT

BY ___________________________________________

BY ______________________________________________

TITLE BY ___________________________________________

______________________________________________