Bell Gardens City Council
May 11, 2026

E

XHIBIT C

MASTER INTERGOVERNMENTAL COOPERATIVE PURCHASING AGREEMENT,

EXAMPLE
M

ASTER INTERGOVERNMENTAL COOPERATIVE PURCHASING AGREEMENT T
his Master Intergovernmental Cooperative Purchasing Agreement (this “Agreement”) is entered into by and between those certain government agencies that execute a Principal Procurement Agency Certificate (“Principal Procurement Agencies ”) with National Intergovernmental Purchasing Alliance Company , a Delaware corporation d/b/a OMNIA Partners, Public Sector and/or Communities Program Management, LLC, a California limited liability company d/b/a U.S.

Communities (collectively, “OMNIA Partners”) to be appended and made a part hereof and such other public agencies (“ Participating Public Agencies ”) who register to participate in the cooperative purchasing programs administered by OMNIA Partners and its affiliates and subsidiaries (collectively, the “OMNIA Partners Parties”) by either registering on the OMNIA Partners website (www.omniapartners.com/publicsector or any successor website) , or by executing a copy of this Agreement.

RE
CITALS
WHEREAS, after a competitive solicitation and selection process by Principal Procurement Agencies, in compliance with their own policies, procedures, rules and regulations, a number of suppliers have entered into “ Master Agreements” (herein so called) to provide a variety of goods, products and services (“ Products”) to the applicable Principal Procurement Agency and the Participating Public Agencies;
WHEREAS, Master Agreements are made available by Principal Procurement Agencies through the OMNIA Partners Parties and provide that Participating Public Agencies may purchase Products on the same terms, conditions and pricing as the Principal Procurement Agency, subject to any applicable federal and/or local purchasing ordinances and the laws of the State of purchase; and WHEREAS, in addition to Master Agreements, the OMNIA Partners Parties may from time to time offer Participating Public Agencies the opportunity to acquire Products through other group purchasing agreements.

NOW, THEREFORE, in consideration of the mutual promises contained in this Agreement, and of the mutual benefits to result, the parties hereby agree as follows:

1. Each party will facilitate the cooperative procurement of Products.

2. T
he Participating Public Agencies shall procure Products in accordance with and subject to the relevant federal, state and local statutes, ordinances, rules and regulations that govern Participating Public Agency’s procurement practices. The Participating Public Agencies hereby acknowledge and agree that it is the intent of the parties that all provisions of this Agreement and that Principal Procurement Agencies’ participation in the program described herein comply with all applicable laws, including but not limited to the requirements of 42 C.F.R. § 1001.952( j), as may be amended from time to time. The Participating Public Agencies further acknowledge and agree that they are solely responsible for their compliance with all applicable “safe harbor” regulations, �����������������
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i
ncluding but not limited to any and all obligations to fully and accurately report discounts and incentives.

3. T
he Participating Public Agency represents and warrants that the Participating Public Agency is not a hospital or other healthcare provider and is not purchasing Products on behalf of a hospital or healthcare provider.

4. T
he cooperative use of Master Agreements shall be in accordance with the terms and conditions of the Master Agreements, except as modification of those terms and conditions is otherwise required by applicable federal, state or local law, policies or procedures.

5. T
he Principal Procurement Agencies will make available, upon reasonable request, Master Agreement information which ma y assist in improving the procurement of Products by the Participating Public Agencies.

6. T
he Participating Public Agency agrees the OMNIA Partners Parties may provide access to group purchasing organization (“ GPO”) agreements directly or indirectly by enrolling the Participating Public Agency in another GPO’s purchasing program provided the purchase of Products through the OMNIA Partners Parties or any other GPO shall be at the Participating Public Agency’s sole discretion.

7. T
he Participating Public Agencies (each a “Procuring Party ”) that procure Products through any Master Agreement or GPO Product supply agreement (each a “ GPO Contract”) will make timely payments to the distributor, manufacturer or other vendor (collectively, “Supplier”) for Products received in accordance with the terms and conditions of the Master Agreement or GPO Contract, as applicable. Payment for Products and inspections and acceptance of Products ordered by the Procuring Party shall be the exclusive obligation of such Procuring Party. Disputes between Procuring Party and any Supplier shall be resolved in accordance with the law and venue rules of the State of purchase unless otherwise agreed to by the Procuring Party and Supplier.

8. T
he Procuring Party shall not use this Agreement as a method for obtaining additional concessions or reduced prices for purchase of similar products or services outside of the Master Agreement. Master Agreements may be structured with not -to-exceed pricing, in which cases the Supplier may offer the Procuring Party and the Procuring Party may accept lower pricing or additional concessions for purchase of Products through a Master Agreement.

9. T
he Procuring Party shall be responsible for the ordering of Products under this Agreement. A non-procuring party shall not be liable in any fashion for any violation by a Procuring Party, and, to the extent permitted by applicable law, the Procuring Party shall hold non-procuring party harmless from any liability that may arise from the acts or omissions of the Procuring Party.

10. W

ITHOUT LIMITING THE GENERALITY OF THE FOREGOING, THE OMNIA

PARTNERS PARTIES EXPRESSLY DISCLAIM ALL EXPRESS OR IMPLIED

REPRESENTATIONS AND WARRANTIES REGARDING ANY PRODUCT, MASTER AGREEMENT AND GPO CONTRACT. THE OMNIA PARTNER S PARTIES SHALL NOT BE

LIABLE IN ANY WAY FOR ANY SPECIAL, INCIDENTAL, INDIRECT, CONSEQUENTIAL,

EXEMPLARY, PUNITIVE, OR RELIANCE DAMAGES, EVEN IF THE OMNIA PARTNERS PARTIES ARE ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. FURTHER, THE

PROCURING PARTY ACKNOWLEDGES AND AGREES THAT THE OMNIA PARTNERS

PARTIES SHALL HAVE NO LIABILITY FOR ANY ACT OR OMISSION BY A SUPPLIER OR �����������������
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OT
HER PARTY UNDER A MASTER AGREEMENT OR GPO CONTRACT.

11. T
his Agreement shall remain in effect until termination by either party giving thirty (30) days’ written notice to the other party. The provisions of Paragraphs 6 - 10 hereof shall survive any such termination.

12. T
his Agreement shall take effect upon (i) execution of the Principal Procurement Agency Certificate, or (ii) registration on the O MNIA Partners website or the execution of this Agreement by a Participating Public Agency, as applicable.

NATIONAL INTERGOVERNMENTAL

PURCHASING ALLIANCE COMPANY,

A DELAWARE CORPORATION D/B/A

OMNIA PARTNERS, PUBLIC SECTOR

AND/OR COMMUNITIES PROGRAM

MANAGEMENT, LLC, A CALIFORNIA

LIMITED LIABILITY COMPANY D/B/A
U.S. COMMUNITIES
Authorized Signature Signature
Sarah E. Vavra
Name Name
Sr. Vice President, Public Sector Contracting
Title and Agency Name Title
Date Date
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Requirements for National Cooperative Contract

EXHIBIT D

PRINCIPAL PROCUREMENT AGENCY CERTIFICATE, EXAMPLE

PRINCIPAL

PROCUREMENT AGENCY CERTIFICATE
In its capacity as a P rincipal Proc urement Age ncy (as defined below) for National Intergovernmental Purchasing Alliance Company, a Delaware corporation d/b/a OMNIA Partners, Public Sector (“OMNIA Partners”), [NAME OF P PA] agrees to pursue Master Agreeme nts for Products as specified in the attached Exhibits to this Principal Procurement Agency Certificate.

I hereby acknowledge, in my capacity as _____________ of and on behalf of [ NAME OF PPA] (“Principal Procurement Agency”), that I have read and hereby agree to the general terms and conditions set forth in the attached Master Intergovernm ental Cooperative Purchasing Agree ment regulating the use of the Master Agreements and purchase of Products that from time to time are made available by Principal Procurement Agencies to Participating Pub lic Agencies nationwide through OMNIA Partners.

I understand that the purchase of one or mor e Products under the provisions of the Master Intergovernmental Cooperative Purchasing Agreement is at the sole and complete discretion of the Participating Public Agency.

Authorized Signature, [PRINCIPAL PROCUREMENT AGENCY]
Signature
Name
Title
Date

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Requirements for National Cooperative Contract

EX

HIBIT E

CONTRACT SALES REPORTING TEMPLATE
Co
ntract Sales Report submitted electronically in Microsoft Excel:
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Requirements for National Cooperative Contract

EXHIBIT F

FEDERAL FUNDS CERTIFICATIONS

FEDERAL CERTIFICATIONS
ADDENDUM FOR AGREEMENT FUNDED BY U.S. FEDERAL GRANT
TO
WHOM IT MAY CONCERN:

Par
ticipating Agencies may elect to use federal funds to purchase under the Master Agreement. This form should be completed and returned.

DEFINITIONS
Contract means a legal instrument by which a non–Federal entity purchases property or services needed to carry out the project or program under a Federal award. The term as used in this part does not include a legal instrument, even if the non –Federal entity considers it a contract, when the substance of the transaction meets the definition of a Federal award or subaward Cont
ractor means an entity that receives a contract as defined in Contract.

Co
operative agreement means a legal instrument of financial assistance between a Federal awarding agency or pass -through entity and a non–Federal entity that, consistent with 31 U.S.C. 6302– 6305:
(a) Is used to enter into a relationship the principal purpose of which is to transfer anything of value from the Federal awarding agency or pass-through entity to the non –Federal entity to carry out a public purpose authorized by a law of the United States (see 31 U.S.C. 6101(3)); and not to acquire property or services for the Federal government or pass-through entity's direct benefit or use;
(b) Is distinguished from a grant in that it provides for substantial involvement between the Federal awarding agency or pass-through entity and the non –Federal entity in carrying out the activity contemplated by the Federal award. (c) The term does not include:
(1) A cooperative research and development agreement as defined in 15 U.S.C. 3710a; or (2) An agreement that provides only:
(i) Direct United States Government cash assistance to an individual; (ii) A subsidy;
(iii) A loan;
(iv) A loan guarantee; or
(v) Insurance.

Fed
eral awarding agency means the Federal agency that provides a Federal award directly to a non –Federal entity Fed
eral award has the meaning, depending on the context, in either paragraph (a) or (b) of this section:
(a)(1) The Federal financial assistance that a non– Federal entity receives directly from a Federal awarding agency or indirectly from a pass -through entity, as described in § 200.101 Applicability; or (2) The cost -reimbursement contract under the Federal Acq uisition Regulations that a non– Federal entity receives directly from a Federal awarding agency or indirectly from a pass -through entity, as described in § 200.101 Applicability.
(b) The instrument setting forth the terms and conditions. The instrument is the grant agreement, cooperative agreement, other agreement for assistance covered in paragraph (b) of § 200.40 Federal financial assistance, or the cost - reimbursement contract awarded under the Federal Acquisition Regulations. (c) Federal award does not include other contracts that a Federal agency uses to buy goods or services from a contractor or a contract to operate Federal government owned, contractor operated facilities (GOCOs). (d) See also definitions of Federal financial assistance, grant agreement, and cooperative agreement.

No
n–Federal entity means a state, local government, Indian tribe, institution of higher education (IHE), or nonprofit organization that carries out a Federal award as a recipient or subrecipient.

Nonpr
ofit organization means any corporation, trust, association, cooperative, or other organization, not including IHEs, that:
(a) Is operated primarily for scientific, educational, service, charitable, or similar purposes in the public interest; (b) Is not organized primarily for profit; and
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(c) Uses net proceeds to maintain, improve, or expand the operations of the organization.

Obligati
ons means, when used in connection with a non –Federal entity's utilization of funds under a Federal award, orders placed for property and services, contracts and subawards made, and similar transactions during a given period that require payment by the non–Federal entity during the same or a future period.

Pass-through
entity means a non–Federal entity that provides a subaward to a subrecipient to carry out part of a Federal program.

Recipie
nt means a non –Federal entity that receives a Federal award directly from a Federal awarding agency to carry out an activity under a Federal program. The term recipient does not include subrecipients.

Simpli
fied acquisition threshold means the dollar amount below which a non –Federal entity may purchase property or services using small purchase methods. Non–Federal entities adopt small purchase procedures in order to expedite the purchase of items costing less than the simplified acquisition threshold. The simplified acquisition threshold is set by the Federal Acquisition Regulation at 48 CFR Subpart 2.1 (Definitions) and in accordance with 41 U.S.C. 1908. As of the publication of this par t, the simplified acquisition threshold is $ 250,000, but this threshold is periodically adjusted for inflation. (Also see definition of § 200.67 Micro - purchase.)
Subawar
d means an award provided by a pass -through entity to a subrecipient for the subrecipi ent to carry out part of a Federal award received by the pass -through entity. It does not include payments to a contractor or payments to an individual that is a beneficiary of a Federal program. A subaward may be provided through any form of legal agreement, including an agreement that the pass-through entity considers a contract.

Subreci
pient means a non– Federal entity that receives a subaward from a pass -through entity to carry out part of a Federal program; but does not include an individual that is a beneficiary of such program. A subrecipient may also be a recipient of other Federal awards directly from a Federal awarding agency.

Termin
ation means the ending of a Federal award, in whole or in part at any time prior to the planned end of period of performance.

The follow
ing certifications and pr ovisions may be req uired and ap ply when Participating Agency expends federal funds for any purchase resulting from this procurement process. Pursuant to 2 C.F.R. § 200.326, all contracts, including small purchases, awarded by the Participating Agency and the Participating Agency’s subcontractors shall contain the procurement provisions of Appendix II to Part 200, as applicable.

APPENDIX II TO 2 CFR PART 200
(A) Contracts for more than the simplified acquisition threshold currently set at $250,000, which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils) as a uthorized by 41 U.S.C. 1908, must a ddress a dministrative, c ontractual, or leg al remed ies in instance s w here contractors violate or breach contract terms, and provide for such sanctions and penalties as appropriate.

Pursuant to Federal Rule (A) above, when a Participating Agency expends federal funds, the Participating Agency reserves all rights and privileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract by either party.

Does offeror agree? YES Initials of Authorized Representative of offeror (B) Termination for c ause and for c onvenience by the gra ntee or s ubgrantee in cluding the ma nner by wh ich it will b e effected and the basis for settlement. (All contracts in excess of $10,000) Pursuant to Federal Rule (B) above, when a Participating Agency expends federal funds, the Participating Agency reserves the right to immediately terminate any a greement in excess of $10,000 resulting from this procurement process in the event of a breach or default of the agreement by Offeror as detailed in the terms of the contract.

Does offeror agree? YES Initials of Authorized Representative of offeror (C) Equal E mployment O pportunity. Except as otherwise pro vided u nder 41 CFR Part 60, all c ontracts that meet th e definition of “feder ally assisted construction contract” in 41 CFR Part 60- 1.3 must include the equal opportunity clause provided under 41 CF R
60-1.4(b), in accordan ce with Exec utive Order 11246, “Equal Employment Oppor tunity” (30 CF R 12319, 12935, 3 CFR Part, 1964-19 65 Comp., p. 339), as amended by Exec utive Order 11375, “Amending Executive Order 11246 Relating to E qual E mployment Opportunity,” and i mplementing regulation s at 41 CFR part 60, “Office of Feder al Contract Compliance Programs, Equal Employment Opportunity, Department of Labor.” �����������������
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Pursuant to Feder al Rule (C) above, when a Participating Agency expends federal funds on a ny fed erally assisted constr uction contract, the equal opportunity clause is incorporated by reference herein.

Does offeror agree to abide by the above? YES Initials of Authorized Representative of offeror (D) Davis - Bacon Ac t, as ame nded ( 40 U.S.C. 3141-314 8). Wh en re quired by Feder al pr ogram legislation, all prim e con
struction c ontracts in exce ss of $2 ,000 awarded by non-Federal e ntities must in clude a pro vision for c ompliance wi
th the Davis-Bacon Act (40 U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations (29 CFR Part 5, “La bor Sta ndards Provisions Ap plicable to Contracts Covering Feder ally Financed and Assisted Construction”). In accordan ce with the statute, contractors must be re quired to p ay wages t o laborers and mechanics at a rate not less th an the prev ailing wag es specif ied in a wage determination made by the Secretary of La bor. In addition, contractors must be required to pay wages not less than once a week. The non-Federal entity must place a copy of the current prevailing wage determination issued by the Department of Labor in each solicitation. The decision to award a co ntract or s ubcontract must be co nditioned upon the acc eptance of the wage determ ination. The non - Federal entity must re port all suspe cted or report ed violations to the Feder al awarding agency. The cont racts must also i nclude a provision for comp liance with the Copeland “Anti- Kickback” Act ( 40 U.S.C. 314 5), as supp lemented by Department of Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Gra nts from the United States”) . The Act pro vides that each contractor or subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up an y part of the c ompensation to wh ich he or sh e is otherwise entitled. The non -Federal e ntity mu st report all suspected or reported violations to the Federal awarding agency.

Purs uant to Feder al Rule ( D) ab ove, when a Participating Agency expends federal funds d uring the term of an award for all contracts and subgrants for construction or repair, offeror will be in compliance with all applicable Davis-Bacon Act provisions.

Does offeror agree? YES Initials of Authorized Representative of offeror (E) Contract Work Hours and Safety Sta ndards Act (40 U.S.C. 3701-370 8). Where applicable, all contracts awarded by the non-Federal entity in excess of $100 ,000 that involve the e mployment of me chanics or laborers must include a provision for compliance with 40 U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 U.S.C. 3702 of the Act, each contractor must be re quired to compute the wages of every me chanic and laborer on the basis of a standard work week of 40 hours. Work in excess o f the standard work week is perm issible provided that the worker is compensated at a rate of not less than one and a h alf times the basic rate of p ay for all hours worked in excess of
40 hours in the work week. The requirements o f 40 U.S.C. 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence.

Pursuant to Feder al Rule (E) above, when a Participating Agency expends federal funds, offeror cer tifies that offeror will be in compliance with all applicable provisions of the Contract Work Hours and S afety Standards Act during the term of an award for all contracts by Participating Agency resulting from this procurement process.

Does offeror agree? YES Initials of Authorized Representative of offeror (F) Rights to Inv entions Made Under a Contract or Agreement. If the Feder al award me ets the definition of “fund ing a
greement” under 37 CFR §401 .2 ( a) and the recip ient or s ubrecipient wish es to e nter i nto a c ontract with a sm all bu
siness firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or resear ch work under that “funding agre ement,” the recip ient or subrecipient mus t comply with the requirements of 37 CFR Part 401, “Rights to Inventions Made by N onprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements,” and an y implementing regulations issued by the awarding agency.

Pursuant to Federal Rule (F) above, when federal funds are expended by Participating Agency, the offeror certifies that during the term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror agrees to comply with all applicable requirements as referenced in Federal Rule (F) above.

Does offeror agree? YES Initials of Authorized Representative of offeror (G) Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251-1387), as amended— Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non - Federal award to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401- 7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251- 1387). Violations must be re ported to the Federal awarding agen cy and the Regional O ffice of the En vironmental Protection Agency (EPA) �����������������
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Pursuant to Federal Rule (G) above, when federal funds are expended by Participating Agency, the offeror certifies that during the term of an award for all contracts by Participating Agency member r esulting from this procurement process, the offeror a grees to comply with all applicable requirements as referenced in Federal Rule (G) above.

Does offeror agree? YES Initials of Authorized Representative of offeror (H) Debarment and Suspen sion (Executive Orders 125 49 and 12689)—A c ontract award (see 2 CFR 180.220) must not be m
ade to parties listed on the government wide exclusions in the System for Award Management (SAM), in accordance with the Executive Office of the President Office of Management and Budget (OMB) guidelines at 2 CFR 180 that i mplement Executive Orders 12549 (3 CFR part 19 86 Comp., p. 18 9) an d 12689 (3 CFR part 19 89 Comp., p. 235), “Debarment and Suspension.” SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as wel
l as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549.

Pursuant to Federal Rule (H) above, when federal funds are expend ed by Participating Agency, the offeror certifies that during the term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror certifies that neither it n or its pr incipals is pr esently deba rred, suspended, proposed f or deba rment, declared ineligible, or voluntarily ex cluded f rom participation by any federal department or agency. If at any time during the term of an award the offeror or its principals becomes debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation by any federal department or agency, the offeror will notify the Participating Agency.

Does offeror agree? YES Initials of Authorized Representative of offeror (I) Byrd Anti-Lobbying Amendment ( 31 U.S.C. 1352)— Contractors that a pply or b id for an award exceeding $100 ,000 must
file the required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or e mployee of Congress, or an e mployee of a me mber of Congress in connection with obtaining any Feder al c ontract, grant or any other awar d cover ed by 31 U.S.C. 1352. Each t ier must also disclose any lobbying with non-Federal funds that takes p lace in connection with obt aining any Feder al award. Such disclosures are forwarded from tier to tier up to the non-Federal award.

Pursuant to Federal Rule (I) above, when federal funds are expended by Participating Agency, the offeror certifies that during the term and after the awarded term of an award for all contracts by Participating Agency resulting from this procurement process, the offeror certifies that it is in compliance with all applicable provisions of the Byrd A nti-Lobbying Amendment (31 U.S.C. 1352). T he undersigned further certifies that:
(1) No Federal appropriated funds have been paid or will be paid for on behalf of the undersigned, to any person for influencing or attempting to influence an officer or em ployee of any agency, a Member of Congress, an officer or employee of congress, or an employee of a Member of Congress in connection with the awarding of a Federal contract, the making of a Federal grant, the making of a Federal loan, the entering into a cooperative agreement, and the extension, continuation, renewal, amendment, or modification of
a Federal contract, grant, loan, or cooperative agreement. (2) If any funds other than Feder al appro priated funds have be en pa id or will be pa id to any person for influencing or attempting to influence an officer or em ployee of any agency, a Member of Congress, an officer or employee of congress, or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report Lobbying”, in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all covered sub- awards exceeding $100,000 in Federal funds at all appropriate tiers and that all subrecipients shall certify and disclose accordingly.

Does offeror agree? YES Initials of Authorized Representative of offeror

RECORD RETENTION REQUIREMENTS FOR CONTRACTS INVOLVING FEDERAL FUNDS When federal funds are expended by Participating Agency for any contract resulting from this procurement process, offeror certifies that it wi ll comply with the record r etention requirements detailed in 2 CFR § 200 .333. The offeror further certifies that offeror will retain all records as req uired by 2 CFR § 20 0.333 for a p eriod of three ye ars after gran tees or subgrantees subm it final expenditure reports or quarterly or annual financial reports, as applicable, and all other pending matters are closed.

D
oes offeror agree? YES Initials of Authorized Representative of offeror

CERTIFICATION OF COMPLIANCE WITH THE ENERGY POLICY AND CONSERVATION ACT When Participating Agency expends federal funds for any contract resulting from this procuremen t process, offeror certifies that it will com ply with the manda tory stand ards an d p olicies r elating to ener gy efficiency which are contained in the s tate ener gy conservation plan issued in compliance with the Energy Policy and Conservation Act (42 U.S.C. 6321 et seq.; 49 C.F.R. Part 18). �����������������
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Does offeror agree? YES Initials of Authorized Representative of offeror

CERTIFICATION OF COMPLIANCE WITH BUY AMERICA PROVISIONS To the extent purchases are made with Federal Highway Administration, Federal Railroad Administration, or Federal Transit Administration funds, offeror certifies that its products comply with all applicable provisions of the Buy America Act and agrees to provide such certification or applicable waiver with respect to specific products to any Participating Agency upon request.

Purchases made in accordance with the Buy America Act must still follow the applicable procurement rules calling for free and open competition.

Does offeror agree? YES Initials of Authorized Representative of offeror CERTIFICATION OF ACCESS TO RECORDS – 2 C.F.R. § 200.336 Offeror agrees that the Inspector General of the Agency or any of their duly authorized representatives shall have access to any documents, papers, or other records of offeror that are p ertinent to offeror’s discharge of its obligations under the Contract for the purpose of ma king au dits, exam inations, excerpts, and tran scriptions. T he rig ht also includes timely an d reasonable access to offeror’s personnel for the purpose of interview and discussion relating to such documents.

Does offeror agree? YES Initials of Authorized Representative of offeror

CERTIFICATION OF APPLICABILITY TO SUBCONTRACTORS
Offeror agrees that all contracts it awards pursuant to the Contract shall be bound by the foregoing terms and conditions.

Does offeror agree? YES Initials of Authorized Representative of offeror O
fferor agrees to comply with all federal, state, and local laws, rules, regulations and ordinances, as applicable. It is further acknowledged that offeror certifies compliance with all provisions, laws, acts, regulations, etc. as specifically noted above.

Offe
ror’s Name: ____________________________________________________________________________________________ A
ddress, City, State, and Zip Code: _____________________________________________________________________________

Phone
Number:___________________________________ F ax Number: ______________________________________ P
rinted Name and Title of Authorized Representative:______________________________________________________________________ E
mail Address: ____________________________________________________________________________________________ Sig
nature of Authorized Representative: ____________________________________Date: _____________________________ Robertson Recreational Surfaces
2414 W 12th St #5 Tempe, AZ 85281
800-858-0519
(602) 340-0402
Tom DiScipio, VP of Installations
[email protected]
2/9/2023
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FEMA SPECIAL CONDITIONS
A
warded Supplier(s) may need to respond to events and losses where products and services are needed for the immediate and initial response to emergency situations such as, but not limited to, water damage, fire damage, vandalism cleanup, biohazard cleanup, sewage decontamination, deodorization, and/or wind damage during a disaster or emergency situation. By submitting a proposal, the Supplier is accepted these FEMA Special Conditions required by the Federal Emergency Management Agency (FEMA). “
Contract” in the below pages under FEMA SPECIAL CONDITIONS is also referred to and defined as the “Master Agreement”.
“
Contractor” in the below pages under FEMA SPECIAL CONDITIONS is also referred to and defined as “Supplier” or “Awarded Supplier”.

C
onflicts of Interest
No employee, officer, or agent may participate in the selection, award, or administration of a contract supported by a FEMA award if he or she has a real or apparent conflict of interest. Such a conflict would arise when the employee, officer, or agent, any member of his or her immediate family, his or her partner, or an organization which employs or is about to employ any of these parties, has a financial or other interest in or a tangible personal benefit from a firm considered for award. 2 C.F.R. § 200.318(c)(1); See also Standard Form 424D, ¶ 7; Standard Form 424B, ¶ 3. i. FEMA considers a “financial interest” to be the potential for gain or loss to the employee, officer, or agent, any member of his or her immediate family, his or her partner, or an organiz ation which employs or is about to employ any of these parties as a result of the particular procurement. The prohibited financial interest may arise from ownership of certain financial instruments or investments such as stock, bonds, or real estate, or from a salary, indebtedness, job offer, or similar interest that might be affected by the particular procurement. ii. FEMA considers an “apparent” conflict of interest to exist where an actual conflict does not exist, but where a reasonable person with knowledge of the relevant facts would question the impartiality of the employee, officer, or agent participating in the procurement. c. Gifts. The officers, employees, and agents of the Participating Public Agency nor the Participating Public Agency (“NFE”) mus t neither solicit nor accept gratuities, favors, or anything of monetary value from contractors or parties to subcontracts.

However, NFE’s may set standards for situations in which the financial interest is de minimus, not substantial, or the gift is an unsolicited item of nominal value. 2 C.F.R. § 200.318(c)(1). d. Violations. The NFE’s written standards of conduct must provide for disciplinary actions to be applied for violations of such standards by officers, employees, or agents of the NFE. 2 C.F.R. § 200.318(c)(1). For example, the penalty for a NFE’s employee may be dismissal, and the penalty for a contractor might be the termination of the contract.

C
ontractor Integrity
A contractor must have a satisfactory record of integrity and business ethics. Contractors that are debarred or suspended as described in Chapter III, ¶ 6.d must be rejected and cannot receive contract awards at any level.

P
ublic Policy
A contractor must comply with the public policies of the Federal Government and state, local government, or tribal government. This includes, among other things, past and current compliance with the:
a. E
qual opportunity and nondiscrimination laws
b. F
ive affirmative steps described at 2 C.F.R. § 200.321(b) for all subcontracting under contracts supported by FEMA financial assistance; and FEMA Procurement Guidance June 21, 2016 Page IV - 7 c
. A
pplicable prevailing wage laws, regulations, and executive orders A
ffirmative Steps
For any subcontracting opportunities, Contractor must take the following Affirmative steps:

1. Placing qualified small and minority businesses and women's business enterprises on solicitation lists;

2. Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources;

3. Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterpr ises;

4. Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; and �����������������
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5. Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce.

Prevailing Wage Requirements
When applicable, the awarded Contractor (s) and any and all subcontractor(s) agree to comply with all laws regarding prevailing wage rates including the Davis -Bacon Act, applicable to this solicitation and/or Participating Public Agencies. The Participating Public Agency shall notify the Contractor of the applicable pricing/prevailing wage rates and must apply any local wage rates requested. The Contractor and any subcontractor(s) shall comply with the prevailing wage rates set by the Participating Public Agency.

F
ederal Requirements
If products and services are issued in response to an emergency or disaster recovery the items below, located in this FEMA Special Conditions section of the Federal Funds Certifications, are activated and required when federal funding may be utilized.
2 C.F.R. § 200.326 and 2 C.F.R. Part 200, Appendix II, Required Contract Clauses

1. Termination for Convenience:

The right to terminate this Contract for the convenience of the Participating Public Agency is retained by the Participating Public Agency. In the event of a termination for convenience by the Participating Public Agency , the Participating Public Agency shall, at least ten (10) calendar days in advance, deliver written notice of the termination for convenience to Contractor . Upon Contractor ’s receipt of such written notice, Contractor immediately shall cease the performance of the Work and shall take reasonable and appropriate action to secure and protect the Work then in place. Contractor shall then be paid by the Participating Public Agency, in accordance with the terms and provisions of the Contract Documents, an amount not to exceed the actual labor costs incurred, the actual cost of all materials installed and the actual cost of all materials stored at the project site or away from the project site, as approved in writing by the Participating Public Agency but not yet paid for and which cannot be returned, and actual, reasonable and documented demobilization costs, if any, paid by Contractor and approved by the Participating Public Agency in connection with the Scope of Work in place which is completed as of the date of termination by the Participating Public Agency and that is in conformance with the Contract Documents, less all amounts previously paid for the Work. No amount ever shall be owed or paid to Contractor for lost or anticipated profits on any part of the Scope of Work not performed or for consequential damages of any kind.

2. Equal Employment Opportunity:

The Participating Public Agency highly encourages Contractors to implement Affirmative Action practices in their employment programs. This means Contractor should not discriminate against any employee or applicant for employment because of race, color, religion, sex, pregnancy, sexual orientation, political belief or affiliation, age, disability or genetic information.

D
uring the performance of this contract, the contractor agrees as follows:
(1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, sexual orientation, gender identity, or national origin. Such action shall include, but not be limited to the following: Employment, upgrading, demotion, or transfer, recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause.
(2)
T
he contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin. (3) T
he contractor will not discharge or in any other manner discriminate against any employee or applicant for employment because such employee or applicant has inquired about, discussed, or disclosed the �����������������
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compensation of the employee or applicant or another employee or applicant. This provision shall not apply to instances in which an employee who has access to the compensation information of other employees or applicants as a part of such employee's essential job functions discloses the compensation of such other employees or applicants to individuals who do not otherwise have access to such information, unless such disclosure is in response to a formal complaint or charge, in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or is consistent with the contractor's legal duty to furnish information.
(4) The contractor will send to each labor union or representative of workers with wh ich it has a collective bargaining agreement or other contract or understanding, a notice to be provided by the agency contracting officer, advising the labor union or workers' representative of the contractor's commitments under section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment.
(5)
T
he contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. (6)
T
he contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by the rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (7) I
n the event of the contractor 's non-compliance with the nondiscrimination clauses of this contract or with any of such rules, regulations, or orders, this contract may be canceled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts in accordance wit h pr
ocedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (8) The contractor will include the provisions of paragraphs (1) through (8) in every subcontract or purchas e or
der unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The contractor will take such action with respect to any subcontract or purchase order as may be directed by the Secretary of Labor as a means of enforcing such provisions including sanctions for noncompliance: Provided, however, that in the event the contractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction, the contractor may request the Unite d S
tates to enter into such litigation to protect the interests of the United States.

3. “During the performance of this contract, the contractor agrees as follows:
(1) The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment without regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to th e
f
ollowing: Employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; an d s
election for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. (2) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive considerations for employment without regard to race, color, religion, sex, or national origin.
(3) The contractor will send to each labor union or representative of workers with which he has
a collective bargaining agreement or other contract or understanding, a notice t
o be provided advising the said labor union or workers' representatives of the contractor's commitments under this section, and shall post copies of the notice i n c
onspicuous places available to employees and applicants for employment. �����������������
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(4) The contractor will comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. (5) The contractor will furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, a nd ac
counts by the administering agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules, regulations, and orders. (6) In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, this contract may be canceled, terminated, or suspended in whole or in part and the contractor may b e decl
ared ineligible for further Government contracts or federally assisted construction contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions as may be imposed and remedies invoked as provi ded in Executive Order 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. (7) The contractor will include the portion of the sentence immediately precedi ng par
agraph (1) and the provisions of paragraphs (1) through (7) in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontractor or vendor. The c
ontractor will take such action with respect to any subcontract or purchase order as the administering agency may direct as a means of enforcing such provisions, including sanctions for noncompliance: Provided, however, That in the event a c
ontractor becomes involved in, or is threatened with, litigation with a subcontractor or vendor as a result of such direction by the administering agency the contractor may request the United States to enter into such litigation to protect the interests of t
he United States.”

4. Davis Bacon Act and Copeland Anti-Kickback Act.
a. Applicability of Davis -Bacon Act. The Davis -Bacon Act only applies to the emergency Management Preparedness Grant Program, Homeland Security Grant Program, Nonprofit Security Grant Program, Tribal Homeland Security Grant Program, Port Security Grant Program, and Transit Security Grant Program. It does not apply to other FEMA grant and cooperative agreement programs, including the Public Assistance Program. b. All prime construction contracts in excess of $2,000 awarded by non-Federal entities must include a provision for compliance with the Davis-Bacon Act (40 U.S.C. §§ 3141-3144 and 3146
-3148) as supplemented by Department of Labor regulations at 29 C.F.R. Part 5 (Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted Construction)). See 2 C.F.R. Part 200, Appendix II, ¶ D. c. In accordance with the statute, contractors must be required to pay wages to laborers and mec
hanics at a rate not less than the prevailing wages specified in a wage determination made by the Secretary of Labor. In addition, contractors must be requir ed to pay wages not less than once a week.
d. The non-Federal entity must place a copy of the current prevailing wage determinatio n i
ssued by the Department of Labor in each solicitation. The decision to award a contract or subcontract must be conditioned upon the acceptance of the wage determination. The non
-Federal entity must report all suspected or reported violations to the Federal awarding agency.
e. In contracts subject to the Davis -Bacon Act, the contracts must also include a provision �����������������
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for compliance with the Copeland “Anti- Kickback” Act (40 U.S.C. § 3145), as supplemented by Department of Labor regulations at 29 C.F.R. Part 3 (Contractors and Subcontractors on Public Building or Public Work Financed in Whole or in Part by Loans or Grants from the United States). The Copeland Anti - Kickback Act provides that each contractor or subrecipient must be prohibited from inducing, by any means, any person employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. The non- Federal entity must report all suspected or reported violations to FEMA.
f. The regulation at 29 C.F.R. § 5.5(a) does provide the required contract clause that applies to compliance with both the Davis-Bacon and Copeland Acts. However, as discussed in the previous subsection, the Davis-Bacon Act does not apply to Public Assistance recipients and subrecipients. In situations where the Davis-Bacon Act does not apply, neither does the Copeland “Anti -Kickback Act. ” However, for purposes of grant programs where bot h clauses do apply, FEMA requires the following contract clause:
“C
ompliance with the Copeland “Anti-Kickback” Act.
(1) Contractor. The contractor shall comply with 18 U.S.C. § 874, 40U.S.C. § 3145, and t
he requirements of 29 C.F.R. pt. 3 as may be applicable, which are incorporated by reference into this contract.
(2) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clause above and such other clauses as the FEMA may by appropriate instructions require, and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for the compliance by any subcontractor or lower tier subcontractor with all of these contract clauses
(3) Breach. A breach of the contract clauses above may be grounds for termination of the contract, and for debarment as a contractor and subcontractor as provided in 29 C.F.R. § 5.12.”

5. Contract Work Hours and Safety Standards Act.
a. Applicability: This requirement applies to all FEMA grant and cooperative agreement programs.
b. Where applicable (see 40 U.S.C. § 3701), all contracts awarded by the non- Federal entity in excess of $100,000 that involve the employment of mechanics or laborers must include a pr
ovision for compliance with 40 U.S.C. §§ 3702 and 3704, as supplemented by Department of Labor regulations at 29 C.F.R. Part 5. See 2 C.F.R. Part 200, Appendix II, ¶ E. c. Under 40 U.S.C. § 3702, each contractor must be required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours worked in excess of 40 hour
s in the work week.
d. The requirements of 40 U.S.C. § 3704 are applicable to construction work and provide that no laborer or mechanic must be required to work in surroundings or under worki ng
c
onditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open mar
ket, or contracts for transportation or transmission of intelligence. e. The regulation at 29 C.F.R. § 5.5(b) provides the required contract clause concerning compliance with the Contract Work Hours and Safety Standards Act:
“C
ompliance with the Contract Work Hours and Safety Standards Act. �����������������
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(1) Overtime requirements. No contractor or subcontractor contracting for any part of the contract work which may require or involve the employment of laborers or mechanics shall require or permit any such laborer or mechanic in any workweek in which he or she is employed on such work to work in excess of forty hours in such workweek unless such laborer or mechanic receives compensation at a rate not less than one and one- half times the basic rate of pay for all hours worked in excess of forty hours in such workweek.
(2) Violation; liability for unpaid wages; liquidated damages . In the event of any violation of the clause set forth in paragraph (1) of this section the contractor and any subcontractor responsible therefor shall be liable for the unpaid wages. In addition, such contractor and subcontractor shall be liable to the United States (in the case of work done under contract for the District of Columbia or a territory, to such District or to such territory), for liquidated damages. Such liquidated damages shall be computed with respect to each individual laborer or mechanic, including watchmen and guards, employed in violation of the clause set forth in paragr ap h
(
1) of
this section, in the sum of $10 for each calendar day on which such individual was required or permitted to work in excess of the standard workweek of forty hours without payment of the overtime wages required by the clause set forth in paragraph (1) of this section.
(3) Withholding for unpaid wages and liquidated damages. The (write in the name of the Federal agency or the loan or grant recipient) shall upon its own action or upon written request of an authorized representative of the Department of Labor withhold or cause to be withheld, from any moneys payable on account of work perf ormed by the contractor or subcontractor under any such contract or any other Federal contract with the same prime contractor, or any other federally -assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by t he
s
ame prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause set forth in paragraph (2) of this section.
(4) Subcontracts. The contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraph (1) through (4) of this section and also a clause requiring the subcontractors to include these clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower tier subcontractor with the clauses set forth in paragraphs (1) through (4) of this section.”

6. Rights to Inventions Made Under a Contract or Agreement. a. Stafford Act Disaster Grants. This requirement does not apply to the Public Assistance, Hazard Mitigation Grant Program, Fire Management Assistance Grant Program, Crisis Counseling Assistance and Training Grant Program, Disaster Case Management Grant Program, and Federal Assistance to Individuals and Households – Other Needs Assistanc e
G
rant Program, as
F
EMA awards under these programs do not meet the definition of “funding agreement.” b. If the FEMA award meets the definition of “funding agreement” under 37 C.F.R.§ 401.2(a) and the non-Federal entity wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that “funding agreement,” the non-Federal entity must comply with the requirements of 37 C.F.R. Part 401 (Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and C
ooperative Agreements), and any implementing regulations issued by FEMA. See 2 C.F.R.

Part 200, Appendix II, ¶ F.
c. The regulation at 37 C.F.R. § 401.2(a) currently defines “funding agreement” as any contract, �����������������
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grant, or cooperative agreement entered into between any Federal agency, other than t he Tennessee Valley Authority, and any contractor for the performance of experimental, developmental, or research work funded in whole or in part by the Federal government. This term also includes any assignment, substitution of parties, or subcontract of any type entered into for the performance of experimental, developmental, or research work under a funding agreement as defined in the first sentence of this paragraph.

7. Clean Air Act and the Federal Water Pollution Control Act . Contracts of amounts in excess of $150,000 must contain a provision that requires the contractor to agree to comply with all applicable standards, orders, or regulations issued pursuant to the Clean Air Act (42 U.S.C.§§ 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. §§ 1251-1387). Violations must be reported to FEMA and the Regional Office of the Environmental Protection Agency. See 2 C.F.R. Part 200, Appendix II, ¶ G.
a. The following provides a sample contract clause concerning compliance for contracts of amounts in excess of $150,000:
“C
lean Air Act
(1) The contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act, as amended, 42 U.S.C.§ 7401 et seq. (2) The contractor agrees to report each violation to the (name of the state agency or local or Indian tribal government) and understands and agrees that the (name of the state agency or local or Indian tribal government) will, in turn, report each violation as required to assure notification to the (name of recipient), Federal Emergency Management Agency, and the appropriate Environmental Protection Agency Regional Office. (3) The contractor agrees to include these requirements in each subcontract exceeding $150,000 financed in whole or in part with Federal assistance provided by FEMA.

F
ederal Water Pollution Control Act
(1) The contractor agrees to comply with all applicable standards, orders or regulations issued pursuant to the Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251 et seq.
(2) The contractor agrees to report each violation to the (name of the state agency or local or Indian tribal government) and understands and agrees that the (name of the state agency or local or Indian tribal government) will, in turn, report each violation as required to assure notification to the (name of recipient), Federal Emergency Management Agency, and the appropriate Environmental Protection Agency Regional Office.
(3) The contractor agrees to include these requirements in each subcontract exceeding $150,000 financed in whole or in part with Federal assistance provided by FEMA.”

8. Debarment and Suspension.
a. Applicability: This requirement applies to all FEMA grant and cooperative agreement programs.
b. Non-federal entities and contractors are subject to the debarment and suspension regulations implementing Executive Order 12549, Debarment and Suspension (1986) and Executive Order 12689, Debarment and Suspension (1989) at 2 C.F.R. Part 180 and the Department of Homeland Security’s regulations at 2 C.F.R. Part 3000 (Non procurement Debarment and Suspension).
c. These regulations restrict awards, subawards, and contracts with certain parties that are Robertson Recreato
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debarred, suspended, or otherwise excluded from or ineligible for participation in Federal assistance programs and activities. See 2 C.F.R. Part 200, Appendix II, ¶ H; and Procurement Guidance for Recipients and Subrecipients Under 2 C.F.R. Part 200 (Uniform Rules):

Supplement to the Public Assistance Procurement Disaster Assistance Team (PDAT) Field Manual Chapter IV, ¶ 6.d, and Appendix C, ¶ 2 [hereinafter PDAT Supplement]. A contract award must not be made to parties listed in the SAM Exclusions. SAM Exclusions is the list maintained by the General Services Administration that contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. SAM exclusions can be accessed at www.sam.gov. See 2 C.F.R. § 180.530; PDAT Supplement, Chapter IV, ¶ 6.d and Appendix C, ¶ 2.
d. In general, an “excluded” party cannot receive a Federal grant award or a contract within the meaning of a “covered transaction,” to include subawards and subcontracts. This includes parties that receive Federal funding indirectly, such as contractors to recipients and subrecipients. The key to the exclusion is whether there is a “covered transaction,” which is any non-procurement transaction (unless excepted) at either a “primary” or “secondary” tier.

Although “covered transactions” do not include contracts awarded by the Federal Government for purposes of the non- procurement common rule and DHS’s implementing regulations, it does include some contracts awarded by recipients and subrecipient. e. Specifically, a covered transaction includes the following contracts for goods or services:
(1) The contract is awarded by a recipient or subrecipient in the amount of at least $25,000. (2) The contract requires the approval of FEMA, regardless of amount. (3) The contract is for federally required audit services. (4) A subcontract is also a covered transaction if it is awarded by the contractor of a recipient or subrecipient and requires either the approval of FEMA or is in excess of $25,000.
d. The following provides a debarment and suspension clause. It incorporates an optional method of verifying that contractors are not excluded or disqualified:
“S
uspension and Debarment
(1) This contract is a covered transaction for purposes of 2 C.F.R. pt. 180 and 2 C.F.R. pt. 3000. As such the contractor is required to verify that none of the contractor, its principals (defined at 2 C.F.R. § 180.995), or its affiliates (defined at 2 C.F.R. § 180.905) are excluded (defined at 2 C.F.R.§ 180.940) or disqualified (defined at 2 C.F.R. § 180.
935).
(2) The contractor must comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C and must include a requirement to comply with these regulations in any lower tier covered transaction it enters into.
(3) This certification is a material representation of fact relied upon by (insert name of subrecipient). If it is later determined that the contractor did not comply with 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C, in addition to remedies availabl e t
o (name of state agency serving as recipient and name of subrecipient), the Federal Government may pursue available remedies, including but not limited to suspensi on and/
or debarment.
(4) The bidder or proposer agrees to comply with the requirements of 2 C.F.R. pt. 180, subpart C and 2 C.F.R. pt. 3000, subpart C while this offer is valid and throughout the period of any contract that may arise from this offer. The bidder or proposer further agrees to include a provision requiring such compliance in its lower tier cover ed
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transactions.”

9. Byrd Anti-Lobbying Amendment.
a. Applicability: This requirement applies to all FEMA grant and cooperative agreement programs.
b. Contractors that apply or bid for an award of $100,000 or more must file the required certification. See 2 C.F.R. Part 200, Appendix II, ¶ I; 44 C.F.R. Part 18; PDAT Supplement, Chapter IV, 6.c; Appendix C, ¶ 4.
c. Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an emp
loyee of a member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. § 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award.

Such disclosures are forwarded from tier to tier up to the non- Federal award. See PDAT Supplement, Chapter IV, ¶ 6.c and Appendix C, ¶ 4.
d. The following provides a Byrd Anti-Lobbying contract clause:
“By
rd Anti-Lobbying Amendment, 31 U.S.C. § 1352 (as amended) C
ontractors who apply or bid for an award of $100,000 or more shall file the required certification.

Each tier certifies to the tier above that it will not and has not used Federal appropriated funds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Congress in connection with obtaining any Federal contract, grant, or any other award covered by 31 U.S.C. § 1352. Each tier shall also disclose any lobbying with non- Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to tier up to the recipient.”
APPENDIX A, 44 C.F.R. PART 18 – CERTIFICATION REGARDING LOBBYING C
ertification for Contracts, Grants, Loans, and Cooperative Agreements (To be submitted with each bid or offer exceeding $100,000)
The undersigned [Contractor] certifies, to the best of his or her knowledge, that:

1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Mem
ber of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperativ e agr
eement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement.

2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form- LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions.
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3. The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by 31, U.S.C. § 1352 (as amended by the Lobbying Disclosure Act of 1995). Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.

The Contractor, , certifies or affirms the truthfulness and accuracy of each statement of its certification and disclosure, if any. In addition, the Contractor understands and agrees that the provisions of 31 U.S.C. § 3801 et seq., apply to this certification and disclosure, if any.

S
ignature of Contractor’s Authorized Official
N
ame and Title of Contractor’s Authorized Official
D
ate”

10. Procurement of Recovered Materials.
a. Applicability: This requirement applies to all FEMA grant and cooperative agreement programs.
b. A non-Federal entity that is a state agency or agency of a political subdivision of a state and i
ts contractors must comply with Section 6002 of the Solid Waste Disposal Act, Pub. L. No. 89 -272 (1965) (codified as amended by the Resource Conservation and Recovery Act at 42 U.S.C. § 6962). See 2 C.F.R. Part 200, Appendix II, ¶ J; 2 C.F.R. § 200.322; PDAT Supplement, Chapter V, ¶ 7.
c. The requirements of Section 6002 include procuring only items designated in guidelines of the EPA at 40 C.F.R. Part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price of the item exceeds $10,000 or the value of the quantity acquired by the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy and resource recovery; and establishing an affirmativ e pr
ocurement program for procurement of recovered materials identified in the EPA guidelines.
d. The following provides the clause that a state agency or agency of a political subdivision of a state and its contractors can include in contracts meeting the above contract thresholds:
“
(1) In the performance of this contract, the Contractor shall make maximum use of products containing recovered materials that are EPA - designated items unless the product cannot be acquired—
(i) Competitively within a timeframe providing for compliance with the contract performance schedule;
Robertson Surfaces
2/9/2023
Tom DiScipio, VP of Installations
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(ii) Meeting contract performance requirements; or
(iii) At a reasonable price.
(
2) I
nformation about this requirement, along with the list of EPA- designate items, is available at EPA’s Comprehensive Procurement Guidelines web site, https://www.epa.gov/smm/comprehensive- procurement-guideline-cpg-program.”

11. Additional FEMA Requirements.
a. The Uniform Rules authorize FEMA to require additional provisions for non- Federal entity contracts. FEMA, pursuant to this authority, requires or recommends the following:
b. Changes.

T
o be eligible for FEMA assistance under the non- Federal entity’s FEMA grant or cooperative agreement, the cost of the change, modification, change order, or constructive change must be allowable, allocable, within the scope of its grant or cooperative agreement, and reasonable for the completion of project scope. FEMA recommends, therefore, that a non-Federal entity include a changes clause in its contract that describes how, if at all, changes can be made by either party to alter the method, price, or schedule of the work without breaching the contract. The language of the clause may differ depending on the nature of the contract and the end-item procured.
c. Access to Records.

A
ll non-Federal entities must place into their contracts a provision that all contractors and their successors, transferees, assignees, and subcontractors acknowledge and agree to comply with applicable provisions governing Department and FEMA access to records, accounts, documents, information, facilities, and staff. See DHS Standard Terms and Conditions, v 3.0, ¶ XXVI (2013).
d. The following provides a contract clause regarding access to records:
“A
ccess to Records. The following access to records requirements apply to this contract:
(1) The contractor agrees to provide (insert name of state agency or local or Indian tribal government), (insert name of recipient), the FEMA Administrator, the Comptroller General of the United States, or any of their authorized representatives access to any books, documents, papers, and records of the Contractor which are directly pertinent to this contract for the purposes of making audits, examinations, excerpts, and
t
ranscriptions.
(2) The Contractor agrees to permit any of the foregoing parties to reproduce by any means whatsoever or to copy excerpts and transcriptions as reasonably needed. (3) The contractor agrees to provide the FEMA Administrator or his authorized representatives access to construction or other work sites pertaining to the work being completed under the contract.”

12. DHS Seal, Logo, and Flags.
a. All non-Federal entities must place in their contracts a provision that a contractor shall not use the DHS seal(s), logos, crests, or reproductions of flags or likenesses of DHS agency officials without specific FEMA pre- approval. See DHS Standard Terms and Conditions, v �����������������
Version January 29, 2021

3.0, ¶ XXV (2013).
b. The following provides a contract clause regarding DHS Seal, Logo, and Flags: “The contractor shall not use the DHS seal(s), logos, crests, or reproductions of flags or likenesses of DHS agency officials without specific FEMA pre- approval.”

13. Compliance with Federal Law, Regulations, and Executive Orders. a. All non-Federal entities must place into their contracts an acknowledgement that FEMA financial assistance will be used to fund the contract along with the requirement that the contractor will comply with all applicable federal law, regulations, executive orders, and FEMA policies, procedures, and directives.
b. The following provides a contract clause regarding Compliance with Federal Law, Regulations, and Executive Orders: “This is an acknowledgement that FEMA financial assistance will be used to fund the contract only. The contractor will comply will all applicable federal law, regulations, executive orders, FEMA policies, procedures, and directives.”

14. No Obligation by Federal Government.
a. The non-Federal entity must include a provision in its contract that states that the Federal Government is not a party to the contract and is not subject to any obligations or liabilities to the non-Federal entity, contractor, or any other party pertaining to any matter resulting from the contract.
b. The following provides a contract clause regarding no obligation by the Federal Government: “The Federal Government is not a party to this contract and is not subject to any obligations or liabilities to the non-Federal entity, contractor, or any other party pertaining to any matter resulting from the contract.”

15. Program Fraud and False or Fraudulent Statements or Related Acts. a. The non-Federal entity must include a provision in its contract that the contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements) applies to its actions pertaining to the contract. b. The following provides a contract clause regarding Fraud and False or Fraudulent or Related Acts : “The contractor acknowledges that 31 U.S.C. Chap. 38 (Administrative Remedies for False Claims and Statements) applies to the contractor’s actions pertaining to this contract.”
Additional contract clauses per 2 C.F.R. § 200.325
For applicable construction/reconstruction/renovation and related services: A payment and performance bond are both required for 100 percent of the contract price. A “performance bond” is one executed in connection with a contract to secure fulfillment of all the contractor’s obligations under such contract. A “payment bond” is one executed in connection with a contract to assure payment as required by law of all persons supplying labor and material in the execution of the work provided in the contract.

Offeror agrees to comply with all terms and conditions outlined in the FEMA Special Conditions section of this solicitation.

Offeror’s Name:
______________________________________________________________________________________ ______
Address, City, State, and Zip Code:

Robertson Recreational Surfaces
�����������������
Version January 29, 2021
_____________________________________________________________________________ P
hone Number:___________________________ _Fax Number:
______________________________________
P
rinted Name and Title of Authorized
Representative:_____________________________________________________________ E
mail Address:
_____________________________________________________________________________________ _______
Si
gnature of Authorized Representative: ___ _________________________________ Date:
________________________________
2414 W 12th St #5 Tempe, AZ 85281
800-858-0519
(602) 340-0402
Tom DiScipio, VP of Installations
[email protected]
2/9/2023
�����������������
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EX

HIBIT G

NEW JERSEY BUSINESS COMPLIANCE
NEW J

ERSEY BUSINESS COMPLIANCE
Suppl
iers intending to do business in the State of New Jersey must comply with policies and procedures required under New Jersey statues. All offerors submitting proposals must complete the following forms specific to the State of New Jersey. Completed forms should be submitted with the offeror’s response to the RFP. Failure to complete the New Jersey packet will impact OMNIA Partners’ ability to promote the Master Agreement in the State of New Jersey.

DOC #
1 Ownership Disclosure Form
DOC #2 Non-Collusion Affidavit
DOC #3 Affirmative Action Affidavit
DOC #4 Political Contribution Disclosure Form
DOC #5 Stockholder Disclosure Certification
DOC #6 Certification of Non-Involvement in Prohibited Activities in Iran DOC #7 New Jersey Business Registration Certificate
Ne
w Jersey suppliers are required to comply with the following New Jersey statutes when applicable:
• all an
ti-discrimination laws, including those contained in N.J.S.A. 10:2-1 through N.J.S.A. 10:2-14, N.J.S.A. 10:5-1, and N.J.S.A. 10:5-31 through 10:5-38; • Pr
evailing Wage Act, N.J.S.A. 34:11-56.26, for all contracts within the contemplation of the Act;
• Publ
ic Works Contractor Registration Act, N.J.S.A. 34:11-56.26; and • Bi
d and Performance Security, as required by the applicable municipal or state statutes. �����������������
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DOC #1
STATEM

ENT OF OWNERSHIP DISCLOSURE
N.J.S.A. 52:25-24.2 (P.L. 1977, c.33, as amended by P.L. 2016, c.43) This statement shall be completed, certified to, and included with all bid and proposal submissions.

Failure to submit the required information is cause for automatic rejection of the bid or proposal.

Name of Organization:_______________________________________________________ Organiz
ation Address:_______________________________________________________ Part I Check the box that represents the type of business organization:
Sole Proprietorship (skip Parts II and III, execute certification in Part IV) Non-Profit Corporation (skip Parts II and III, execute certification in Part IV) For-Profit Corporation (any type) Limited Liability Company (LLC) Partnership Limited Partnership Limited Liability Partnership (LLP) Other (be specific): ______________________________________________ Part II
 The list below contains the names and addresses of all stockholders in the corporation who own 10 percent or more of its stock, of any class, or of all individual partners in the partnership who own a 10 percent or greater interest therein, or of all members in the limited liability company who own a 10 percent or greater interest therein, as the case may be. (COMPLETE THE LIST BELOW IN THIS SECTION) OR
 No one stockholder in the corporation owns 10 percent or more of its stock, of any class, or no individual partner in the partnership owns a 10 percent or greater interest therein, or no member in the limited liability company owns a 10 percent or greater interest therein, as the case may be. (SKIP TO PART IV) (Please attach additional sheets if more space is needed):

Name of Individual or Business Entity Home Address (for Individuals) or Business Address 2414 W 12th St #5 Tempe, AZ 85281
Robertson Recreational Surfaces
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Part II
I DISCLOSURE OF 10% OR GREATER OWNERSHIP IN THE STOCKHOLDERS,

PARTNERS OR LLC MEMBERS LISTED IN PART II
If a bidder has a direct or indirect parent entity which is publicly traded, and any person holds a 10 percent or greater beneficial interest in the publicly traded parent entity as of the last annual federal Security and Exchange Commission (SEC) or foreign equivalent filing, ownership disclosure can be met by providing links to the website(s) containing the last annual filing(s) with the federal Securities and Exchange Commission (or foreign equivalent) that contain the name and address of each person holding a 10% or greater beneficial interest in the publicly traded parent entity, along with the relevant page numbers of the filing(s) that contain the information on each such person. Attach additional sheets if more space is needed.

Website (URL) containing the last annual SEC (or foreign equivalent) filing Page #’s Please list the names and addresses of each stockholder, partner or member owning a 10 percent or greater interest in any corresponding corporation, partnership and/or limited liability company (LLC) listed in Part II other than for any publicly traded parent entities referenced above. The disclosure shall be continued until names and addresses of every noncorporate stockholder, and individual partner, and member exceeding the 10 percent ownership criteria established pursuant to N.J.S.A. 52:25-24.2 has been listed. Attach additional sheets if more space is needed.

Stockholder/Partner/Member and Corresponding
Entity Listed in Part II
Home Address (for Individuals) or Business Address
Part IV Certification
I, being duly sworn upon my oath, hereby represent that the foregoing information and any attachments thereto to the best of my knowledge are true and complete. I acknowledge: that I am authorized to execute this certification on behalf of the bidder/proposer; that the <name of contracting unit> is relying on the information contained herein and that I am under a continuing obligation from the date of this certification through the completion of any contracts with <type of contracting unit> to notify the <type of contracting unit> in writing of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification, and if I do so, I am subject to criminal prosecution under the law and that it will constitute a material breach of my agreement(s) with the, permitting the <type of contracting unit> to declare any contract(s) resulting from this certification void and unenforceable.

Full N
ame (Print): Titl
e:

Signature: Date:

Tom DiScipio
VP of Installation
2/9/2023
�����������������
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DOC #2
NON-CO

LLUSION AFFIDAVIT

STANDARD BID DOCUMENT REFERENCE
Reference: VII-H
Name of Form: NON-COLLUSION AFFIDAVIT
Statutory Reference: No specific statutory reference
State Statutory Reference N.J.S.A. 52:34-15
Instructions Reference: Statutory and Other Requirements VII-H Description:

The Owner’s use of this form is optional. It is used to ensure that the bidder has not participated in any collusion with any other bidder or Owner representative or otherwise taken any action in restraint of free and competitive bidding.
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DOC #3
AFFIRM

ATIVE ACTION AFFIDAVIT
(P.L. 1975, C.127)
Compan
y Name:

Street:

City, State, Zip Code:

Propo
sal Certification:

Indicate below company’s compliance with New Jersey Affirmative Action regulations. Company’s proposal will be accepted even if company is not in compliance at this time. No contract and/or purchase order may be issued, however, until all Affirmative Action requirements are met.

Requi
red Affirmative Action Evidence:

Procurement, Professional & Service Contracts (Exhibit A) Vendors must submit with proposal:

1. A photo copy of their Federal Letter of Affirmative Action Plan Approval OR

2. A photo copy
of their Certificate of Employee Information Report
OR

3. A comp
lete Affirmative Action Employee Information Report (AA302) ________ Public
Work – Over $50,000 Total Project Cost:

A. No approved Federal or New Jersey Affirmative Action Plan. We will complete Report Form AA201-A upon receipt from the
B. Approved
Federal or New Jersey Plan – certificate enclosed
I furt
her certify that the statements and information contained herein, are complete and correct to the best of my knowledge and belief.
_______________________ _________________________________ Dat
e Au thorized Signature and Title
Robertson Recreational Surfaces
2414 W 12th St #5
Tempe, AZ 85281
2/9/2023
VP of Installation
�����������������
D
oc #3
Affirmative Action Affidavit
R
obertson Recreational Surfaces does not have any employees that reside in New Jersey. For any projects in New Jersey, we execute them through a sister company of ours who holds a New Jersey Public Works License. A copy of that license is below.

D
oc #6
Attached
Doc #7
Please see below and reference text found above about working with a local partner. �����������������
D
oc #8
*PlayCore has a policy in place for providing equal opportunity to all employees and applicants for employment, in accordance with all applicable equal employment opportunities/affirmative action laws, directives and regulations of federal, state and local governing bodies or agencies.

Al
so, see below
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DOC
#3, continued
P.L. 1995, c
. 127 (N.J.A.C. 17:27)

MANDATORY AFFIRMATIVE ACTION LANGUAGE

PROCUREMENT, PROFESSIONAL AND SERVICE

CONTRACTS
During the performance of this contract, the contractor agrees as follows:

The contractor or subcontractor, where applicable, will not discriminate against any employee or applicant for employment because of age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation. The contractor will take affirmative action to ensure that such applicants are recruited and employed, and that employees are treated during emplo yment, without regard to their age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation. Such action shall include, but not be limited to the following:
employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided by the Public Agency Compliance Officer setting forth provisions of this non-discrimination clause.

The contractor or subcontractor, where applicable will, in all solicitations or advertisement for employees placed by or on behalf of the contractor, state that all qualified applicants will receive consideration for employment without regard to age, race, creed, color, national origin, ancestry, marital status, sex, affectional or sexual orientation.

The contractor or subcontractor, where applicable, will send to each labor union or representative of workers with which it has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency contracting officer advising the labor union or workers' representative of the contractor's commitments under this act and shall post copies of the notice in conspicuous places available to employees and applicants for employment.

The contractor or subcontractor, where applicable, agrees to comply with any regulations promulgated by the Treasurer pursuant to P.L. 1975, c. 127, as amended and supplemented from time to time and the Americans with Disabilities Act.

The contractor or subcontractor agrees to attempt in good faith to employ minority and fem ale workers trade consistent with the applicable county employment goal prescribed by N.J.A.C. 17:27- 5.2 promulgated by the Treasurer pursuant to P.L. 1975, C.127, as amended and supplemented from time to time or in accordance with a binding determination of the applicable county employment goals determined by the Affirmative Action Office pursuant to N.J.A.C. 17:27- 5.2 promulgated by the Treasurer pursuant to P.L. 1975, C.127, as amended and supplemented from time to time.

The contractor or subcontractor agrees to inform in writing appropriate recruitment agencies in the area, including employment agencies, placement bureaus, colleges, universities, labor unions, that it does not discriminate on the basis of age, creed, color, national origin, ancestry, mar ital status, sex, affectional or sexual orientation, and that it will discontinue the use of any recruitment agency which engages in direct or indirect discriminatory practices.

The contractor or subcontractor agrees to revise any of it testing procedures, if necessary, to assure that all personnel testing conforms with the principles of job- related testing, as established by the statutes and court decisions of the state of New Jersey and as established by applicable Federal law and applicable Federal court decisions.

The contractor or subcontractor agrees to review all procedures relating to transfer, upgrading, downgrading and lay- off to ensure that all such actions are taken without regard to age, creed, color, national origin, ancestry, marital status, s ex, affectional or sexual orientation, and conform with the applicable employment goals, consistent with the statutes and court decisions of the State of New Jersey, and applicable Federal law and applicable Federal court decisions.

The contractor and its subcontractors shall furnish such reports or other documents to the Affirmative Action Office as may be requested by the office from time to time in order to carry out the purposes of these regulations, and public agencies shall furnish such information as may be requested by the Affirmative Action Office for conducting a compliance investigation pursuant to Subchapter 10 of the Administrative Code (NJAC 17:27) . __________
______________________________________
Signature of Procurement Agent
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#4
C. 2
71 POLITICAL CONTRIBUTION DISCLOSURE FORM
Public Agency Instructions
This page provides guidance to public agencies entering into contracts with business entities that are required to file Political Contribution Disclosure forms with the agency. It is not intended to be provided to contractors. What follows are instructions on the use of form local units can provide to contractors that are required to disclose political contributions pursuant to N.J.S.A. 19:44A-20.26 (P.L. 2005, c. 271, s.2). Additional information on the process is available in Local Finance Notice 2006-1 ( http://www.nj.gov/dca/divisions/dlgs/resources/lfns_2006.html). Please refer back to these instructions for the appropriate links, as the Local Finance Notices include links that are no longer operational.

1. The disclosure is required for all contracts in excess of $17,500 that are not awarded pursuant to a “fair and open” process (N.J.S.A. 19:44A-20.7).

2. Due to the potential length of some contractor submissions, the public agency should consider allowing data to be submitted in electronic form (i.e., spreadsheet, pdf file, etc.). Submissions must be kept with the contract documents or in an appropriate computer file and be available for public access. The form is worded to accept this alternate submission. The text should be amended if electronic submission will not be allowed.

3. The submission must be received from the contractor and on file at least 10 days prior to award of the contract.

Resolutions of award should reflect that the disclosure has been received and is on file.

4. The contractor must disclose contributions made to candidate and party committees covering a wide range of public agencies, including all public agencies that have elected officials in the county of the public agency, state legislative positions, and various state entities. The Division of Local Government Se rvices recommends that contractors be provided a list of the affected agencies. This will assist contractors in determining the campaign and political committees of the officials and candidates affected by the disclosure. a. The Division has prepared model disclosure forms for each county. They can be downloaded from the “County PCD Forms” link on the Pay- to-Play web site at http://www.nj.gov/dca/divisions/dlgs/programs/lpcl.html#1 2 .

They will be updated from time-to-time as necessary.
b. A public agency using these forms should edit them to properly reflect the correct legislative district(s). As t
he forms are county- based, they list all legislativ e districts in each county. Districts that do not represent the public agency should be removed from the lists.
c. Some contractors may find it easier to provide a single list that covers all contributions, regardless of the county.

These submissions are appropriate and should be accepted. d. The form may be used “as-is”, subject to edits as described herein. e. The “Contractor Instructions” sheet is intended to be provided with the form. It is recommended that the Instructions and the form be printed on the same piece of paper. The form notes that the Instructions are printed on the back of the form; where that is not the case, the text should be edited accordingly. f. The form is a Word document and can be edited to meet local needs, and posted for download on web sites, used as an e-mail attachment, or provided as a printed document.

5. I
t is recommended that the contractor also complete a “Stockholder Disclosure Certification.” This will assist the local unit in its obligation to ensure that contractor did not make any prohibited contributions to the committees listed on the Business Entity Disclosure Certification in the 12 months prior to the contract (See Local Finance Notice 2006-7 for additional information on this obligation a t ht
tp://www.nj.gov/dca/divisions/dlgs/resources/lfns_2006.html). A sample Certification form is part of this package and the instruction to complete it is included in the Contractor Instructions. NOTE: This section is not applicable to Boards of Education.
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D
OC #4, continued
C. 2
71 POLITICAL CONTRIBUTION DISCLOSURE FORM
Contractor Instructions
Business entities (contractors) receiving contracts from a public agency that are NOT awarded pursuant to a “fair and open” process (defined at N.J.S.A. 19:44A-20.7) are subject to the provisions of P.L. 2005, c. 271, s.2 (N.J.S.A. 19:44A-

20.26). This law provides that 10 days prior to the award of such a contract, the contractor shall disclose contributions to:
• a
ny State, county, or municipal committee of a political party • any legislative leadership committee*
• a
ny continuing political committee (a.k.a., political action committee) • any candidate committee of a candidate for, or holder of, an elective office:
o of the public entity awarding the contract
o of that county in which that public entity is located o of another public entity within that county
o or of a legislative district in which that public entity is located or, when the public entity is a county, of any legislative district which includes all or part of the county T
he disclosure must list reportable contributions to any of the committees that excee d $300 per election cycle that were made during the 12 months prior to award of the contract. See N.J.S.A. 19:44A-8 and 19:44A-16 for more details on reportable contributions.

N
.J.S.A. 19:44A-20.26 itemizes the parties from whom contributions must be disclosed when a business entity is not a natural person. This includes the following:
• individuals with an “interest” ownership or control of more than 10% of the profits or assets of a business entity or 10% of the stock in the case of a business entity that is a corporation for profit • all principals, partners, officers, or directors of the business entity or their spouses • any subsidiaries directly or indirectly controlled by the business entity • IRS Code Section 527 New Jersey based organizations, directly or indirectly controlled by the business entity and filing as continuing political committees, (PACs).

W
hen the business entity is a natural person, “a contribution by that person’s spouse or child, residing therewith, shall be deemed to be a contribution by the business entity.” [ N.J.S.A. 19:44A-20.26(b)] The contributor must be listed on the disclosure.

A
ny business entity that fails to comply with the disclosure provisions shall be subject to a fine imposed by ELEC in an amount to be determined by the Commission which may be based upon the amount that the business entity failed to report.

T
he enclosed list of agencies is provided to assist the contractor in identifying those public agencies whose elected official and/or candidate campaign committees are affected by the disclosure requirement. It is the contractor’s responsibility to identify the specific committees to which contributions may have been made and need to be disclosed. The disclosed information may exceed the minimum requirement.

T
he enclosed form, a content-consistent facsimile, or an electronic data file containing the required details (along with a signed cover sheet) may be used as the contractor’s submission and is disclosable to the public under the Open Public Records Act.

T
he contractor must also complete the attached Stockholder Disclosure Certification. This will assist the agency in meeting its obligations under the law. NOTE: This section does not apply to Board of Education contracts. * N .J.S.A. 19:44A-3(s): “The term "legislative leadership committee" means a committee established, authorized to be established, or designated by the President of the Senate, the Minority Leader of the Senate, the Speaker of the General Assembly or the Minority Leader of the General Assembly pursuant to section 16 of P.L.1993, c.65 (C.19:44A -10.1) for the purpose of receiving contributions and making expenditures.” �����������������
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OC #4, continued
C. 271 POLITICAL CONTRIBUTION DISCLOSURE FORM
Required Pursuant to N.J.S.A. 19:44A-20.26
This form or its permitted facsimile must be submitted to the local unit no later than 10 days prior to the award of the contract.

Part I – Vendor Information
Vendor Name:

Address:

City: State: Zip:

T
he undersigned being authorized to certify, hereby certifies that the submission provided herein represents compliance with the provisions of N.J.S.A. 19:44A-20.26 and as represented by the Instructions accompanying this form.
_________
______________ _______________________ ________________________ Signature Printed Name Title
Part II – Contribution Disclosure
Disclosure requirement: Pursuant to N.J.S.A. 19:44A-20.26 this disclosure must include all reportable political contributions (more than $300 per election cycle) over the 12 months prior to submission to the committees of the government entities listed on the form provided by the local unit.  Check here if disclosure is provided in electronic form Contributor Name Recipient Name Date Dollar Amount
$

Check here if the information is continued on subsequent page(s) Robertson Recreational Surfaces
2414 W 12th St #5
AZ
Tempe
85281
Tom DiScipio
VP of Installations
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D
OC #4, continued
L
ist of Agencies with Elected Officials Required for Political Contribution Disclosure N.J.S.A. 19:44A-20.26
C
ounty Name:

State: Governor, and Legislative Leadership Committees
Legislative District #s:

State Senator and two members of the General Assembly per district.

Co
unty:

Freeholders County Clerk Sheriff
{County Executive} Surrogate
M
unicipalities (Mayor and members of governing body, regardless of title):

US

ERS SHOULD CREATE THEIR OWN FORM, OR DOWNLOAD

FROM THE PAY TO PLAY SECTION OF THE DLGS WEBSITE A
COUNTY-BASED, CUSTOMIZABLE FORM.
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DOC
#6
C
ertification of Non-Involvement in Prohibited Activities in Iran Pursuant to N.J.S.A. 52:32-58, Offerors must certify that neither the Offeror, nor any of its parents, subsidiaries, and/or affiliates (as defined in N.J.S.A. 52:32 – 56(e) (3)), is listed on the Department of the Treasury’s List of Persons or Entities Engaging in Prohibited Investment Activities in Iran and that neither is involved in any of the investment activities set forth in N.J.S.A. 52:32 – 56(f).

O
fferors wishing to do business in New Jersey through this contract must fill out the Certification of Non-Involvement in Prohibited Activities in Iran here:
http://www.state.nj.us/humanservices/dfd/info/standard/fdc/disclosure_investmentact.pdf.

O
fferors should submit the above form completed with their proposal. �����������������

DISCLOSURE OF INVESTMENT ACTIVITIES IN IRAN FORM

STATE OF NEW JERSEY

DEPARTMENT OF THE TREASURY - DIVISION OF PURCHASE AND PROPERTY 33 WEST STATE STREET, P.O. BOX 230 TRENTON, NEW JERSEY 08625 -0230 DPP Rev. 12.13.2021
BID SOLICITATION # AND TITLE:

VENDOR NAME:

Pursuant to N.J.S.A. 52:32-57, et s
eq. (P.L. 2012, c.25 and P.L. 2021, c.4) any person or entity that submits a bid or proposal or otherwise proposes to enter into or renew a contract must certify that neither the person nor entity, nor any of its parents, subsidiaries, or affiliates, is identified on the New Jersey Department of the Treasury’s Chapter 25 List as a person or entity engaged in investment activities in Iran. The Chapter 25 list is found on the Division’s website at https://www.state.nj.us/treasury/purchase/pdf/Chapter25List.pdf. Vendors/Bidders must review this list prior to completing the below certification. If the Director of the Division of Purchase and Property finds a person or entity to be in violation of the law, s/he shall take action as may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party.

CHECK THE APPROPRIATE BOX
I certify, pursuant to N.J.S.A. 52:32-57, et seq. (P.L. 2012, c.25 and P.L. 2021, c.4), that neither the Vendor/Bidder listed above nor any of its parents, subsidiaries, or affiliates is listed on the New Jersey Department of the Treasury’s Chapter 25 List of entities determined to be engaged in prohibited activities in Iran.

OR
I am unable to certify as above because the Vendor/Bidder and/or one or more of its parents, subsidiaries, or affiliates is listed on the New Jersey Department of the Treasury’s Chapter 25 List. I will provide a detailed, accurate and precise description of the activities of the Vendor/Bidder, or one of its parents, subsidiaries or affiliates, has engaged in regarding investment activities in Iran by completing the information requested below.

Entity Engaged in Investment Activities
Relationship to Vendor/ Bidder
Description of Activities
Duration of Engagement
Anticipated Cessation Date
*Attach Additional Sheets If Necessary.

CERTIFICATION
I, the undersigned, certify that I am authorized to execute this certification on behalf of the Vendor, that the foregoing information and any attachments hereto, to the best of my knowledge are true and complete. I acknowledge that the State of New Jersey is relying on the information contained herein, and that the Vendor is under a continuing obligation from the date of this certification through the completion of any contract(s) with the State to notify the State in writing of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification. If I do so, I may be subject to criminal prosecution under the law, and it will constitute a material breach of my contract(s) with the State, permitting the State to declare any contract(s) resulting from this certification void and unenforceable.

Signature Date
Print Name and Title
23-02 Playground and Recreational Surface Products and Services Robertson Recreational Surfaces
Tom DiScipio, VP of Installations
02/09/2023
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#7
NE

W JERSEY BUSINESS REGISTRATION CERTIFICATE
(N.J.S.A. 52:32-44)
Offerors wishing to do business in New Jersey must submit their State Division of Revenue issued Business Registration Certificate with their proposal here. Failure to do so will disqualify the Offeror from offering products or services in New Jersey through any resulting contract. h
ttps://www.njportal.com/DOR/BusinessRegistration/
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Requirements for National Cooperative Contract

DOC #8
EE

OAA EVIDENCE
Eq
ual Employment Opportunity/Affirmative Action
Goods, Professional Services & General Service Projects EEO/AA Evidence
Vendors are required to submit evidence of compliance with N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 in order to be considered a responsible vendor.

One of the following must be included with submission:
• Copy of Letter of Federal Approval
• Certificate of Employee Information Report
• Fully Executed Form AA302
• Fully Executed EEO-1 Report
See the guidelines at: http://www.state.nj.us/treasury/contract_compliance/pdf/pa.pdf for further information.

I certify that my bid package includes the required evidence per the above list and State website.

Name: ______________________________ Title: _____________________ Si
gnature: ___________________________ Date: _____________________ Tom DiScipio VP of Installations
02/09/2023
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Version January 29, 2021

CERTIFICATION
I, the undersigned, certify that I am authorized to execute this certification on behalf of the Vendor/Bidder, that the foregoing information and any attachments hereto, to the best of my knowledge are true and complete. I acknowledge that the State of New Jersey is relying on the information contained herein, and that the Vendor/Bidder is under a continuing obligation from the date of this certification through the completion of any contract(s) with the State to notify the State in writing of any changes to the information contained herein; that I am aware that it is a criminal offense to make a false statement or misrepresentation in this certification. If I do so, I will be subject to criminal prosecution under the law, and it will constitute a material breach of my agreement(s) with the State, permitting the State to declare any contract(s) resulting from this certification to be void and unenforceable.

DOC #9

MCBRIDE-PRINCIPLES

MACBRIDE PRINCIPALS FORM
_____________________
VENDOR’S/BIDDER’S REQUIREMENT

TO PROVIDE A CERTIFICATION IN COMPLIANCE WITH THE MACBRIDE PRINCIPALS AND NORTHERN IRELAND ACT OF 1989
Pursuant to Public Law 1995, c. 134, a responsible Vendor/Bidder selected, after public bidding, by the Director of the Division of Purchase and Property, pursuant to N.J.S.A. 52:34-12, must complete the certification below by checking one of the two options listed below and signing where indicated. If a Vendor/Bidder that would otherwise be awarded a purchase, contract or agreement does not complete the certification, then the Director may determine, in accordance with applicable law and rules, that it is in the best interest of the State to award the purchase, contract or agreement to another Vendor/Bidder that has completed the certification and has submitted a bid within five (5) percent of the most advantageous bid. If the Director finds contractors to be in violation of the principals that are the subject of this law, he/she shall take such action as may be appropriate and provided by law, rule or contract, including but not limited to, imposing sanctions, seeking compliance, recovering damages, declaring the party in default and seeking debarment or suspension of the party.

I, the undersigned, on behalf the Vendor/Bidder, certify pursuant to N.J.S.A. 52:34-12.2 that:

CHECK THE APPROPRIATE BOX
The Vendor/Bidder has no business operations in Northern Ireland; or OR
The Vendor/Bidder will take lawful steps in good faith to conduct any business operations it has in Northern Ireland in accordance with the MacBride principals of nondiscrimination in employment as set forth in section 2 of P.L. 1987, c. 177 (N.J.S.A. 52:18A-89.5) and in conformance with the United Kingdom’s Fair Employment (Northern Ireland) Act of 1989, and permit independent monitoring of its compliance with those principals.

Signature Date
Print Name and Title

STATE OF NEW JERSEY DEPARTMENT OF THE TREASURY

DIVISION OF PURCHASE AND PROPERTY
33 WEST STATE STREET, P.O. BOX 230
TRENTON, NEW JERSEY 08625-0230
BID SOLICITATION #: VENDOR/BIDDER:

X
23-02 Robertson Recreational Surfaces
Tom DiScipio, VP of Installations
02/09/2023
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Version January 29, 2021
EX

HIBIT H

ADVERTISING COMPLIANCE REQUIREMENT
Pursuant to certain state notice provisions, including but not limited to Oregon Revised Statutes Chapter 279A.220, the following public agencies and political subdivisions of the referenced public agencies are eligible to register with OMNIA Partners and access the Master Agreement contract award made pursuant to this solicitation, and are hereby given notice of the foregoing request for proposals for purposes of complying with the procedural requirements of said statutes:

Nationwide:

State of Alabama State of Hawaii State of Massachusetts State of New Mexico State of South Dakota
State of Alaska State of Idaho State of Michigan State of New York State of Tennessee State of Arizona State of Illinois State of Minnesota State of North Carolina State of Texas State of Arkansas State of Indiana State of Mississippi State of North Dakota State of Utah State of California State of Iowa State of Missouri State of Ohio State of Vermont State of Colorado State of Kansas State of Montana State of Oklahoma State of Virginia State of Connecticut State of Kentucky State of Nebraska State of Oregon State of Washington State of Delaware State of Louisiana State of Nevada State of Pennsylvania State of West Virginia
State of Florida State of Maine State of New Hampshire State of Rhode Island State of Wisconsin State of Georgia State of Maryland State of New Jersey State of South Carolina State of Wyoming District of Columbia
L
ists of political subdivisions and local governments in the above referenced states / districts may be found at http://www.usa.gov/Agencies/State_and_Territories.shtml and https://www.usa.gov/local-governments.

C
ertain Public Agencies and Political Subdivisions:

CIT

IES, TOWNS, VILLAGES AND BOROUGHS
INCLUDING BUT NOT LIMITED TO:

BAKER CITY GOLF COURSE, OR

CITY OF ADAIR VILLAGE, OR

CITY OF ASHLAND, OR

CITY OF AUMSVILLE, OR

CITY OF AURORA, OR

CITY OF BAKER, OR

CITY OF BATON ROUGE, LA

CITY OF BEAVERTON, OR

CITY OF BEND, OR

CITY OF BOARDMAN, OR

CITY OF BONANAZA, OR

CITY OF BOSSIER CITY, LA

CITY OF BROOKINGS, OR

CITY OF BURNS, OR

CITY OF CANBY, OR

CITY OF CANYONVILLE, OR

CITY OF CLATSKANIE, OR

CITY OF COBURG, OR

CITY OF CONDON, OR

CITY OF COQUILLE, OR

CITY OF CORVALLI, OR

CITY OF CORVALLIS PARKS AND RECREATION

DEPARTMENT, OR

CITY OF COTTAGE GROVE, OR

CITY OF DONALD, OR

CITY OF EUGENE, OR

CITY OF FOREST GROVE, OR

CITY OF GOLD HILL, OR

CITY OF GRANTS PASS, OR

CITY OF GRESHAM, OR

CITY OF HILLSBORO, OR

CITY OF INDEPENDENCE, OR

CITY AND COUNTY OF HONOLULU, HI

CITY OF KENNER, LA

CITY OF LA GRANDE, OR

CITY OF LAFAYETTE, LA

CITY OF LAKE CHARLES, OR

CITY OF LEBANON, OR

CITY OF MCMINNVILLE, OR

CITY OF MEDFORD, OR

CITY OF METAIRIE, LA

CITY OF MILL CITY, OR

CITY OF MILWAUKIE, OR

CITY OF MONROE, LA

CITY OF MOSIER, OR

CITY OF NEW ORLEANS, LA

CITY OF NORTH PLAINS, OR

CITY OF OREGON CITY, OR

CITY OF PILOT ROCK, OR

CITY OF PORTLAND, OR

CITY OF POWERS, OR

CITY OF PRINEVILLE, OR

CITY OF REDMOND, OR

CITY OF REEDSPORT, OR

CITY OF RIDDLE, OR

CITY OF ROGUE RIVER, OR

CITY OF ROSEBURG, OR

CITY OF SALEM, OR

CITY OF SANDY, OR

CITY OF SCAPPOOSE, OR

CITY OF SHADY COVE, OR

CITY OF SHERWOOD, OR

CITY OF SHREVEPORT, LA

CITY OF SILVERTON, OR

CITY OF SPRINGFIELD, OR
CITY OF ST. HELENS, OR
CITY OF ST. PAUL, OR

CITY OF SULPHUR, LA

CITY OF TIGARD, OR

CITY OF TROUTDALE, OR
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Version January 29, 2021

CITY OF TUALATIN, OR

CITY OF WALKER, LA

CITY OF WARRENTON, OR

CITY OF WEST LINN, OR

CITY OF WILSONVILLE, OR

CITY OF WINSTON, OR

CITY OF WOODBURN, OR

LEAGUE OF OREGON CITES

THE CITY OF HAPPY VALLEY OREGON

ALPINE, UT

ALTA, UT

ALTAMONT, UT

ALTON, UT

AMALGA, UT

AMERICAN FORK CITY, UT

ANNABELLA, UT

ANTIMONY, UT

APPLE VALLEY, UT

AURORA, UT

BALLARD, UT

BEAR RIVER CITY, UT

BEAVER, UT

BICKNELL, UT

BIG WATER, UT

BLANDING, UT

BLUFFDALE, UT

BOULDER, UT

CITY OF BOUNTIFUL, UT

BRIAN HEAD, UT

BRIGHAM CITY CORPORATION, UT

BRYCE CANYON CITY, UT

CANNONVILLE, UT

CASTLE DALE, UT

CASTLE VALLEY, UT

CITY OF CEDAR CITY, UT

CEDAR FORT, UT

CITY OF CEDAR HILLS, UT

CENTERFIELD, UT

CENTERVILLE CITY CORPORATION, UT

CENTRAL VALLEY, UT

CHARLESTON, UT

CIRCLEVILLE, UT

CLARKSTON, UT

CLAWSON, UT

CLEARFIELD, UT

CLEVELAND, UT

CLINTON CITY CORPORATION, UT

COALVILLE, UT

CORINNE, UT

CORNISH, UT

COTTONWOOD HEIGHTS, UT

DANIEL, UT

DELTA, UT

DEWEYVILLE, UT

DRAPER CITY, UT

DUCHESNE, UT

EAGLE MOUNTAIN, UT

EAST CARBON, UT

ELK RIDGE, UT

ELMO, UT

ELSINORE, UT

ELWOOD, UT

EMERY, UT

ENOCH, UT

ENTERPRISE, UT

EPHRAIM, UT

ESCALANTE, UT

EUREKA, UT

FAIRFIELD, UT

FAIRVIEW, UT

FARMINGTON, UT

FARR WEST, UT

FAYETTE, UT

FERRON, UT

FIELDING, UT

FILLMORE, UT

FOUNTAIN GREEN, UT

FRANCIS, UT

FRUIT HEIGHTS, UT

GARDEN CITY, UT

GARLAND, UT

GENOLA, UT

GLENDALE, UT

GLENWOOD, UT

GOSHEN, UT

GRANTSVILLE, UT

GREEN RIVER, UT

GUNNISON, UT

HANKSVILLE, UT

HARRISVILLE, UT

HATCH, UT

HEBER CITY CORPORATION, UT

HELPER, UT

HENEFER, UT

HENRIEVILLE, UT

HERRIMAN, UT

HIDEOUT, UT

HIGHLAND, UT
HI

LDALE, UT

HINCKLEY, UT

HOLDEN, UT

HOLLADAY, UT

HONEYVILLE, UT

HOOPER, UT

HOWELL, UT

HUNTINGTON, UT

HUNTSVILLE, UT

CITY OF HURRICANE, UT

HYDE PARK, UT

HYRUM, UT

INDEPENDENCE, UT

IVINS, UT

JOSEPH, UT

JUNCTION, UT

KAMAS, UT

KANAB, UT

KANARRAVILLE, UT

KANOSH, UT

KAYSVILLE, UT

KINGSTON, UT

KOOSHAREM, UT

LAKETOWN, UT

LA VERKIN, UT

LAYTON, UT

LEAMINGTON, UT

LEEDS, UT

LEHI CITY CORPORATION, UT

LEVAN, UT

LEWISTON, UT

LINDON, UT

LOA, UT

LOGAN CITY, UT

LYMAN, UT
L

YNNDYL, UT
�����������������
Version January 29, 2021

MANILA, UT

MANTI, UT

MANTUA, UT

MAPLETON, UT

MARRIOTT-SLATERVILLE, UT

MARYSVALE, UT

MAYFIELD, UT

MEADOW, UT

MENDON, UT
MIDVALE CITY INC., UT

MIDWAY, UT

MILFORD, UT

MILLVILLE, UT

MINERSVILLE, UT

MOAB, UT

MONA, UT

MONROE, UT

CITY OF MONTICELLO, UT

MORGAN, UT

MORONI, UT

MOUNT PLEASANT, UT

MURRAY CITY CORPORATION, UT

MYTON, UT

NAPLES, UT

NEPHI, UT

NEW HARMONY, UT

NEWTON, UT

NIBLEY, UT

NORTH LOGAN, UT

NORTH OGDEN, UT

NORTH SALT LAKE CITY, UT

OAK CITY, UT

OAKLEY, UT

OGDEN CITY CORPORATION, UT

OPHIR, UT

ORANGEVILLE, UT

ORDERVILLE, UT

OREM, UT

PANGUITCH, UT

PARADISE, UT

PARAGONAH, UT

PARK CITY, UT

PAROWAN, UT

PAYSON, UT

PERRY, UT

PLAIN CITY, UT

PLEASANT GROVE CITY, UT

PLEASANT VIEW, UT

PLYMOUTH, UT

PORTAGE, UT

PRICE, UT

PROVIDENCE, UT

PROVO, UT

RANDOLPH, UT

REDMOND, UT

RICHFIELD, UT

RICHMOND, UT

RIVERDALE, UT

RIVER HEIGHTS, UT

RIVERTON CITY, UT

ROCKVILLE, UT

ROCKY RIDGE, UT

ROOSEVELT CITY CORPORATION, UT

ROY, UT

RUSH VALLEY, UT
CITY OF ST. GEORGE, UT

SALEM, UT

SALINA, UT

SALT LAKE CITY CORPORATION, UT

SANDY, UT

SANTA CLARA, UT

SANTAQUIN, UT

SARATOGA SPRINGS, UT

SCIPIO, UT

SCOFIELD, UT

SIGURD, UT

SMITHFIELD, UT

SNOWVILLE, UT

CITY OF SOUTH JORDAN, UT

SOUTH OGDEN, UT

CITY OF SOUTH SALT LAKE, UT

SOUTH WEBER, UT

SPANISH FORK, UT

SPRING CITY, UT

SPRINGDALE, UT

SPRINGVILLE, UT

STERLING, UT

STOCKTON, UT

SUNNYSIDE, UT

SUNSET CITY CORP, UT

SYRACUSE, UT

TABIONA, UT

CITY OF TAYLORSVILLE, UT

TOOELE CITY CORPORATION, UT

TOQUERVILLE, UT

TORREY, UT

TREMONTON CITY, UT

TRENTON, UT
T

ROPIC, UT

UINTAH, UT

VERNAL CITY, UT

VERNON, UT

VINEYARD, UT

VIRGIN, UT

WALES, UT

WALLSBURG, UT

WASHINGTON CITY, UT

WASHINGTON TERRACE, UT

WELLINGTON, UT

WELLSVILLE, UT

WENDOVER, UT

WEST BOUNTIFUL, UT

WEST HAVEN, UT

WEST JORDAN, UT

WEST POINT, UT

WEST VALLEY CITY, UT

WILLARD, UT

WOODLAND HILLS, UT

WOODRUFF, UT

WOODS CROSS, UT
CO

UNTIES AND PARISHES INCLUDING BUT NOT
LIMITED TO:

ASCENSION PARISH, LA

ASCENSION PARISH, LA, CLEAR OF COURT

CADDO PARISH, LA

CALCASIEU PARISH, LA
CALCASIEU PARISH SHERIFF’S OFFICE, LA

CITY AND COUNTY OF HONOLULU, HI

CLACKAMAS COUNTY, OR

CLACKAMAS COUNTY DEPT OF TRANSPORTATION,
OR

CLATSOP COUNTY, OR

COLUMBIA COUNTY, OR
�����������������

Version January 29, 2021

COOS COUNTY, OR

COOS COUNTY HIGHWAY DEPARTMENT, OR

COUNTY OF HAWAII, OR

CROOK COUNTY, OR

CROOK COUNTY ROAD DEPARTMENT, OR

CURRY COUNTY, OR

DESCHUTES COUNTY, OR

DOUGLAS COUNTY, OR

EAST BATON ROUGE PARISH, LA

GILLIAM COUNTY, OR

GRANT COUNTY, OR

HARNEY COUNTY, OR

HARNEY COUNTY SHERIFFS OFFICE, OR

HAWAII COUNTY, HI

HOOD RIVER COUNTY, OR

JACKSON COUNTY, OR

JEFFERSON COUNTY, OR

JEFFERSON PARISH, LA

JOSEPHINE COUNTY GOVERNMENT, OR

LAFAYETTE CONSOLIDATED GOVERNMENT, LA

LAFAYETTE PARISH, LA

LAFAYETTE PARISH CONVENTION & VISITORS

COMMISSION

LAFOURCHE PARISH, LA

KAUAI COUNTY, HI

KLAMATH COUNTY, OR

LAKE COUNTY, OR

LANE COUNTY, OR

LINCOLN COUNTY, OR

LINN COUNTY, OR

LIVINGSTON PARISH, LA

MALHEUR COUNTY, OR

MAUI COUNTY, HI

MARION COUNTY, SALEM, OR

MORROW COUNTY, OR

MULTNOMAH COUNTY, OR

MULTNOMAH COUNTY BUSINESS AND

COMMUNITY SERVICES, OR

MULTNOMAH COUNTY SHERIFFS OFFICE, OR

MULTNOMAH LAW LIBRARY, OR

ORLEANS PARISH, LA

PLAQUEMINES PARISH, LA

POLK COUNTY, OR

RAPIDES PARISH, LA

SAINT CHARLES PARISH, LA

SAINT CHARLES PARISH PUBLIC SCHOOLS, LA

SAINT LANDRY PARISH, LA

SAINT TAMMANY PARISH, LA

SHERMAN COUNTY, OR

TERREBONNE PARISH, LA

TILLAMOOK COUNTY, OR

TILLAMOOK COUNTY SHERIFF'S OFFICE, OR

TILLAMOOK COUNTY GENERAL HOSPITAL, OR

UMATILLA COUNTY, OR

UNION COUNTY, OR

WALLOWA COUNTY, OR

WASCO COUNTY, OR

WASHINGTON COUNTY, OR

WEST BATON ROUGE PARISH, LA

WHEELER COUNTY, OR

YAMHILL COUNTY, OR

COUNTY OF BOX ELDER, UT

COUNTY OF CACHE, UT

COUNTY OF RICH, UT

COUNTY OF WEBER, UT

COUNTY OF MORGAN, UT

COUNTY OF DAVIS, UT

COUNTY OF SUMMIT, UT

COUNTY OF DAGGETT, UT

COUNTY OF SALT LAKE, UT

COUNTY OF TOOELE, UT

COUNTY OF UTAH, UT

COUNTY OF WASATCH, UT

COUNTY OF DUCHESNE, UT

COUNTY OF UINTAH, UT

COUNTY OF CARBON, UT

COUNTY OF SANPETE, UT

COUNTY OF JUAB, UT

COUNTY OF MILLARD, UT

COUNTY OF SEVIER, UT

COUNTY OF EMERY, UT

COUNTY OF GRAND, UT

COUNTY OF BEVER, UT

COUNTY OF PIUTE, UT

COUNTY OF WAYNE, UT

COUNTY OF SAN JUAN, UT

COUNTY OF GARFIELD, UT

COUNTY OF KANE, UT

COUNTY OF IRON, UT

COUNTY OF WASHINGTON, UT

OTHER AGENCIES INCLUDING ASSOCIATIONS,

BOARDS, DISTRICTS, COMMISSIONS, COUNCILS,

PUBLIC CORPORATIONS, PUBLIC DEVELOPMENT

AUTHORITIES, RESERVATIONS AND UTILITIES
INCLUDING BUT NOT LIMITED TO:

ADAIR R.F.P.D., OR

ADEL WATER IMPROVEMENT DISTRICT, OR
ADRIAN R.F.P.D., OR

AGNESS COMMUNITY LIBRARY, OR
AGNESS-ILLAHE R.F.P.D., OR

AGRICULTURE EDUCATION SERVICE EXTENSION

DISTRICT, OR
ALDER CREEK-BARLOW WATER DISTRICT NO. 29,
OR

ALFALFA FIRE DISTRICT, OR
ALSEA R.F.P.D., OR

ALSEA RIVIERA WATER IMPROVEMENT DISTRICT,
OR

AMITY FIRE DISTRICT, OR

ANTELOPE MEADOWS SPECIAL ROAD DISTRICT, OR

APPLE ROGUE DISTRICT IMPROVEMENT COMPANY,
OR
APPLEGATE VALLEY R.F.P.D. #9, OR

ARCH CAPE DOMESTIC WATER SUPPLY DISTRICT,
OR

ARCH CAPE SANITARY DISTRICT, OR

ARNOLD IRRIGATION DISTRICT, OR

ASH CREEK WATER CONTROL DISTRICT, OR

ATHENA CEMETERY MAINTENANCE DISTRICT, OR
AUMSVILLE R.F.P.D., OR
AURORA R.F.P.D., OR
AZALEA R.F.P.D., OR

BADGER IMPROVEMENT DISTRICT, OR
BAILEY-SPENCER R.F.P.D., OR

BAKER COUNTY LIBRARY DISTRICT, OR
BAKER R.F.P.D., OR

BAKER RIVERTON ROAD DISTRICT, OR

BAKER VALLEY IRRIGATION DISTRICT, OR
BAKER VALLEY S.W.C.D., OR

BAKER VALLEY VECTOR CONTROL DISTRICT, OR

BANDON CRANBERRY WATER CONTROL DISTRICT,
OR
BANDON R.F.P.D., OR
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Version January 29, 2021

BANKS FIRE DISTRICT, OR
BANKS FIRE DISTRICT #13, OR

BAR L RANCH ROAD DISTRICT, OR

BARLOW WATER IMPROVEMENT DISTRICT, OR

BASIN AMBULANCE SERVICE DISTRICT, OR

BASIN TRANSIT SERVICE TRANSPORTATION

DISTRICT, OR

BATON ROUGE WATER COMPANY

BAY AREA HEALTH DISTRICT, OR

BAYSHORE SPECIAL ROAD DISTRICT, OR

BEAR VALLEY SPECIAL ROAD DISTRICT, OR

BEAVER CREEK WATER CONTROL DISTRICT, OR

BEAVER DRAINAGE IMPROVEMENT COMPANY,
INC., OR

BEAVER SLOUGH DRAINAGE DISTRICT, OR

BEAVER SPECIAL ROAD DISTRICT, OR

BEAVER WATER DISTRICT, OR
BELLE MER S.I.G.L. TRACTS SPECIAL ROAD

DISTRICT, OR

BEND METRO PARK AND RECREATION DISTRICT
BENTON S.W.C.D., OR

BERNDT SUBDIVISION WATER IMPROVEMENT

DISTRICT, OR

BEVERLY BEACH WATER DISTRICT, OR
BIENVILLE PARISH FIRE PROTECTION DISTRICT 6,
LA

BIG BEND IRRIGATION DISTRICT, OR

BIGGS SERVICE DISTRICT, OR

BLACK BUTTE RANCH DEPARTMENT OF POLICE

SERVICES, OR
BLACK BUTTE RANCH R.F.P.D., OR

BLACK MOUNTAIN WATER DISTRICT, OR
BLODGETT-SUMMIT R.F.P.D., OR

BLUE MOUNTAIN HOSPITAL DISTRICT, OR

BLUE MOUNTAIN TRANSLATOR DISTRICT, OR

BLUE RIVER PARK & RECREATION DISTRICT, OR

BLUE RIVER WATER DISTRICT, OR
BLY R.F.P.D., OR

BLY VECTOR CONTROL DISTRICT, OR

BLY WATER AND SANITARY DISTRICT, OR

BOARDMAN CEMETERY MAINTENANCE DISTRICT,
OR

BOARDMAN PARK AND RECREATION DISTRICT
BOARDMAN R.F.P.D., OR

BONANZA BIG SPRINGS PARK & RECREATION

DISTRICT, OR

BONANZA MEMORIAL PARK CEMETERY DISTRICT,
OR
BONANZA R.F.P.D., OR

BONANZA-LANGELL VALLEY VECTOR CONTROL

DISTRICT, OR
BORING WATER DISTRICT #24, OR

BOULDER CREEK RETREAT SPECIAL ROAD

DISTRICT, OR
BRIDGE R.F.P.D., OR

BROOKS COMMUNITY SERVICE DISTRICT, OR
BROWNSVILLE R.F.P.D., OR

BUELL-RED PRAIRIE WATER DISTRICT, OR
BUNKER HILL R.F.P.D. #1, OR

BUNKER HILL SANITARY DISTRICT, OR

BURLINGTON WATER DISTRICT, OR

BURNT RIVER IRRIGATION DISTRICT, OR
BURNT RIVER S.W.C.D., OR
CALAPOOIA R.F.P.D., OR
CAMAS VALLEY R.F.P.D., OR

CAMELLIA PARK SANITARY DISTRICT, OR

CAMMANN ROAD DISTRICT, OR

CAMP SHERMAN ROAD DISTRICT, OR

CANBY AREA TRANSIT, OR
CANBY R.F.P.D. #62, OR

CANBY UTILITY BOARD, OR
CANNON BEACH R.F.P.D., OR

CANYONVILLE SOUTH UMPQUA FIRE DISTRICT, OR
CAPE FERRELO R.F.P.D., OR

CAPE FOULWEATHER SANITARY DISTRICT, OR

CARLSON PRIMROSE SPECIAL ROAD DISTRICT, OR

CARMEL BEACH WATER DISTRICT, OR
CASCADE VIEW ESTATES TRACT 2, OR

CEDAR CREST SPECIAL ROAD DISTRICT, OR

CEDAR TRAILS SPECIAL ROAD DISTRICT, OR
CEDAR VALLEY - NORTH BANK R.F.P.D., OR

CENTRAL CASCADES FIRE AND EMS, OR

CENTRAL CITY ECONOMIC OPPORTUNITY CORP, LA
CENTRAL LINCOLN P.U.D., OR

CENTRAL OREGON COAST FIRE & RESCUE

DISTRICT, OR

CENTRAL OREGON INTERGOVERNMENTAL

COUNCIL

CENTRAL OREGON IRRIGATION DISTRICT, OR

CHAPARRAL WATER CONTROL DISTRICT, OR

CHARLESTON FIRE DISTRICT, OR

CHARLESTON SANITARY DISTRICT, OR

CHARLOTTE ANN WATER DISTRICT, OR

CHEHALEM PARK & RECREATION DISTRICT, OR

CHEHALEM PARK AND RECREATION DISTRICT
CHEMULT R.F.P.D., OR
CHENOWITH WATER P.U.D., OR

CHERRIOTS, OR

CHETCO COMMUNITY PUBLIC LIBRARY DISTRICT,
OR

CHILOQUIN VECTOR CONTROL DISTRICT, OR
CHILOQUIN-AGENCY LAKE R.F.P.D., OR

CHINOOK DRIVE SPECIAL ROAD DISTRICT, OR

CHR DISTRICT IMPROVEMENT COMPANY, OR
C

HRISTMAS VALLEY DOMESTIC WATER DISTRICT,
OR

CHRISTMAS VALLEY PARK & RECREATION

DISTRICT, OR
CHRISTMAS VALLEY R.F.P.D., OR

CITY OF BOGALUSA SCHOOL BOARD, LA
CLACKAMAS COUNTY FIRE DISTRICT #1, OR
CLACKAMAS COUNTY SERVICE DISTRICT #1, OR

CLACKAMAS COUNTY VECTOR CONTROL

DISTRICT, OR

CLACKAMAS RIVER WATER

CLACKAMAS RIVER WATER, OR
CLACKAMAS S.W.C.D., OR

CLATSKANIE DRAINAGE IMPROVEMENT

COMPANY, OR

CLATSKANIE LIBRARY DISTRICT, OR
CLATSKANIE P.U.D., OR

CLATSKANIE PARK & RECREATION DISTRICT, OR

CLATSKANIE PEOPLE'S UTILITY DISTRICT
CLATSKANIE R.F.P.D., OR

CLATSOP CARE CENTER HEALTH DISTRICT, OR
CLATSOP COUNTY S.W.C.D., OR
CLATSOP DRAINAGE IMPROVEMENT COMPANY #15,
INC., OR

CLEAN WATER SERVICES

CLEAN WATER SERVICES, OR
CLOVERDALE R.F.P.D., OR

CLOVERDALE SANITARY DISTRICT, OR

CLOVERDALE WATER DISTRICT, OR

COALEDO DRAINAGE DISTRICT, OR
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Version January 29, 2021

COBURG FIRE DISTRICT, OR

COLESTIN RURAL FIRE DISTRICT, OR
COLTON R.F.P.D., OR
COLTON WATER DISTRICT #11, OR
COLUMBIA 911 COMMUNICATIONS DISTRICT, OR
COLUMBIA COUNTY 4-H & EXTENSION SERVICE

DISTRICT, OR

COLUMBIA DRAINAGE VECTOR CONTROL, OR

COLUMBIA IMPROVEMENT DISTRICT, OR
COLUMBIA R.F.P.D., OR

COLUMBIA RIVER FIRE & RESCUE, OR

COLUMBIA RIVER PUD, OR
COLUMBIA S.W.C.D., OR
COLUMBIA S.W.C.D., OR

CONFEDERATED TRIBES OF THE UMATILLA INDIAN

RESERVATION

COOS COUNTY AIRPORT DISTRICT, OR

COOS COUNTY AIRPORT DISTRICT, OR

COOS COUNTY AREA TRANSIT SERVICE DISTRICT,
OR

COOS COUNTY AREA TRANSIT SERVICE DISTRICT,
OR

COOS FOREST PROTECTIVE ASSOCIATION
COOS S.W.C.D., OR
COQUILLE R.F.P.D., OR

COQUILLE VALLEY HOSPITAL DISTRICT, OR

CORBETT WATER DISTRICT, OR
CORNELIUS R.F.P.D., OR

CORP RANCH ROAD WATER IMPROVEMENT, OR
CORVALLIS R.F.P.D., OR

COUNTRY CLUB ESTATES SPECIAL WATER

DISTRICT, OR

COUNTRY CLUB WATER DISTRICT, OR

COUNTRY ESTATES ROAD DISTRICT, OR

COVE CEMETERY MAINTENANCE DISTRICT, OR

COVE ORCHARD SEWER SERVICE DISTRICT, OR
COVE R.F.P.D., OR
CRESCENT R.F.P.D., OR

CRESCENT SANITARY DISTRICT, OR

CRESCENT WATER SUPPLY AND IMPROVEMENT

DISTRICT, OR

CROOK COUNTY AGRICULTURE EXTENSION

SERVICE DISTRICT, OR

CROOK COUNTY CEMETERY DISTRICT, OR

CROOK COUNTY FIRE AND RESCUE, OR

CROOK COUNTY PARKS & RECREATION DISTRICT,
OR
CROOK COUNTY S.W.C.D., OR

CROOK COUNTY VECTOR CONTROL DISTRICT, OR
CROOKED RIVER RANCH R.F.P.D., OR

CROOKED RIVER RANCH SPECIAL ROAD DISTRICT,
OR

CRYSTAL SPRINGS WATER DISTRICT, OR
CURRY COUNTY 4-H & EXTENSION SERVICE

DISTRICT, OR

CURRY COUNTY PUBLIC TRANSIT SERVICE

DISTRICT, OR
CURRY COUNTY S.W.C.D., OR

CURRY HEALTH DISTRICT, OR

CURRY PUBLIC LIBRARY DISTRICT, OR
DALLAS CEMETERY DISTRICT #4, OR

DARLEY DRIVE SPECIAL ROAD DISTRICT, OR
DAVID CROCKETT STEAM FIRE COMPANY #1, LA
DAYS CREEK R.F.P.D., OR

DAYTON FIRE DISTRICT, OR

DEAN MINARD WATER DISTRICT, OR

DEE IRRIGATION DISTRICT, OR

DEER ISLAND DRAINAGE IMPROVEMENT

COMPANY, OR

DELL BROGAN CEMETERY MAINTENANCE

DISTRICT, OR
DEPOE BAY R.F.P.D., OR
DESCHUTES COUNTY 911 SERVICE DISTRICT, OR
DESCHUTES COUNTY R.F.P.D. #2, OR

DESCHUTES PUBLIC LIBRARY DISTRICT, OR
DESCHUTES S.W.C.D., OR

DESCHUTES VALLEY WATER DISTRICT, OR

DEVILS LAKE WATER IMPROVEMENT DISTRICT, OR
DEXTER R.F.P.D., OR

DEXTER SANITARY DISTRICT, OR
DORA-SITKUM R.F.P.D., OR
DOUGLAS COUNTY FIRE DISTRICT #2, OR
DOUGLAS S.W.C.D., OR
DRAKES CROSSING R.F.P.D., OR
DRRH SPECIAL ROAD DISTRICT #6, OR

DRY GULCH DITCH DISTRICT IMPROVEMENT

COMPANY, OR

DUFUR RECREATION DISTRICT, OR

DUMBECK LANE DOMESTIC WATER SUPPLY, OR
DUNDEE R.F.P.D., OR

DURKEE COMMUNITY BUILDING PRESERVATION

DISTRICT, OR

EAGLE POINT IRRIGATION DISTRICT, OR

EAGLE VALLEY CEMETERY MAINTENANCE

DISTRICT, OR
EAGLE VALLEY R.F.P.D., OR
EAGLE VALLEY S.W.C.D., OR

EAST FORK IRRIGATION DISTRICT, OR
EAST MULTNOMAH S.W.C.D., OR

EAST SALEM SERVICE DISTRICT, OR

EAST UMATILLA CHEMICAL CONTROL DISTRICT,
OR

EAST UMATILLA COUNTY AMBULANCE AREA

HEALTH DISTRICT, OR
EAST UMATILLA COUNTY R.F.P.D., OR

EAST VALLEY WATER DISTRICT, OR

ELGIN COMMUNITY PARKS & RECREATION

DISTRICT, OR

ELGIN HEALTH DISTRICT, OR
E
LGIN R.F.P.D., OR

ELKTON ESTATES PHASE II SPECIAL ROAD

DISTRICT, OR
ELKTON R.F.P.D., OR
EMERALD P.U.D., OR

ENTERPRISE IRRIGATION DISTRICT, OR

ESTACADA CEMETERY MAINTENANCE DISTRICT,
OR
ESTACADA R.F.P.D. #69, OR
EUGENE R.F.P.D. # 1, OR

EUGENE WATER AND ELECTRIC BOARD
EVANS VALLEY FIRE DISTRICT #6, OR
FAIR OAKS R.F.P.D., OR
FAIRVIEW R.F.P.D., OR

FAIRVIEW WATER DISTRICT, OR

FALCON HEIGHTS WATER AND SEWER, OR

FALCON-COVE BEACH WATER DISTRICT, OR

FALL RIVER ESTATES SPECIAL ROAD DISTRICT, OR

FARGO INTERCHANGE SERVICE DISTRICT, OR

FARMERS IRRIGATION DISTRICT, OR

FAT ELK DRAINAGE DISTRICT, OR

FERN RIDGE PUBLIC LIBRARY DISTRICT, OR

FERN VALLEY ESTATES IMPROVEMENT DISTRICT,
OR

FOR FAR ROAD DISTRICT, OR
�����������������
Version January 29, 2021
FOREST GROVE R.F.P.D., OR

FOREST VIEW SPECIAL ROAD DISTRICT, OR
FORT ROCK-SILVER LAKE S.W.C.D., OR

FOUR RIVERS VECTOR CONTROL DISTRICT, OR

FOX CEMETERY MAINTENANCE DISTRICT, OR
GARDINER R.F.P.D., OR

GARDINER SANITARY DISTRICT, OR
GARIBALDI R.F.P.D., OR
GASTON R.F.P.D., OR
GATES R.F.P.D., OR
GEARHART R.F.P.D., OR
GILLIAM S.W.C.D., OR

GLENDALE AMBULANCE DISTRICT, OR
GLENDALE R.F.P.D., OR

GLENEDEN BEACH SPECIAL ROAD DISTRICT, OR

GLENEDEN SANITARY DISTRICT, OR

GLENWOOD WATER DISTRICT, OR

GLIDE - IDLEYLD SANITARY DISTRICT, OR
GLIDE R.F.P.D., OR
GOLD BEACH - WEDDERBURN R.F.P.D., OR

GOLD HILL IRRIGATION DISTRICT, OR

GOLDFINCH ROAD DISTRICT, OR
GOSHEN R.F.P.D., OR

GOVERNMENT CAMP ROAD DISTRICT, OR

GOVERNMENT CAMP SANITARY DISTRICT, OR

GRAND PRAIRIE WATER CONTROL DISTRICT, OR

GRAND RONDE SANITARY DISTRICT, OR

GRANT COUNTY TRANSPORTATION DISTRICT, OR
GRANT S.W.C.D., OR

GRANTS PASS IRRIGATION DISTRICT, OR
GREATER BOWEN VALLEY R.F.P.D., OR
GREATER ST. HELENS PARK & RECREATION

DISTRICT, OR

GREATER TOLEDO POOL RECREATION DISTRICT,
OR

GREEN KNOLLS SPECIAL ROAD DISTRICT, OR

GREEN SANITARY DISTRICT, OR
GREENACRES R.F.P.D., OR

GREENBERRY IRRIGATION DISTRICT, OR

GREENSPRINGS RURAL FIRE DISTRICT, OR

HAHLEN ROAD SPECIAL DISTRICT, OR

HAINES CEMETERY MAINTENANCE DISTRICT, OR

HAINES FIRE PROTECTION DISTRICT, OR
HALSEY-SHEDD R.F.P.D., OR
HAMLET R.F.P.D., OR
HARBOR R.F.P.D., OR

HARBOR SANITARY DISTRICT, OR
HARBOR WATER P.U.D., OR

HARNEY COUNTY HEALTH DISTRICT, OR
HARNEY S.W.C.D., OR

HARPER SOUTH SIDE IRRIGATION DISTRICT, OR

HARRISBURG FIRE AND RESCUE, OR
HAUSER R.F.P.D., OR

HAZELDELL RURAL FIRE DISTRICT, OR

HEBO JOINT WATER-SANITARY AUTHORITY, OR
HECETA WATER P.U.D., OR
HELIX CEMETERY MAINTENANCE DISTRICT #4, OR

HELIX PARK & RECREATION DISTRICT, OR
HELIX R.F.P.D. #7-411, OR

HEPPNER CEMETERY MAINTENANCE DISTRICT, OR
HEPPNER R.F.P.D., OR

HEPPNER WATER CONTROL DISTRICT, OR

HEREFORD COMMUNITY HALL RECREATION

DISTRICT, OR

HERMISTON CEMETERY DISTRICT, OR

HERMISTON IRRIGATION DISTRICT, OR

HIDDEN VALLEY MOBILE ESTATES IMPROVEMENT

DISTRICT, OR

HIGH DESERT PARK & RECREATION DISTRICT, OR

HIGHLAND SUBDIVISION WATER DISTRICT, OR

HONOLULU INTERNATIONAL AIRPORT

HOOD RIVER COUNTY LIBRARY DISTRICT, OR

HOOD RIVER COUNTY TRANSPORTATION DISTRICT,
OR
HOOD RIVER S.W.C.D., OR

HOOD RIVER VALLEY PARKS & RECREATION

DISTRICT, OR
HOODLAND FIRE DISTRICT #74
HOODLAND FIRE DISTRICT #74, OR

HORSEFLY IRRIGATION DISTRICT, OR
HOSKINS-KINGS VALLEY R.F.P.D., OR

HOUSING AUTHORITY OF PORTLAND
HUBBARD R.F.P.D., OR

HUDSON BAY DISTRICT IMPROVEMENT COMPANY,
OR

I N (KAY) YOUNG DITCH DISTRICT IMPROVEMENT

COMPANY, OR

ICE FOUNTAIN WATER DISTRICT, OR

IDAHO POINT SPECIAL ROAD DISTRICT, OR

IDANHA-DETROIT RURAL FIRE PROTECTION

DISTRICT, OR

ILLINOIS VALLEY FIRE DISTRICT
ILLINOIS VALLEY R.F.P.D., OR
ILLINOIS VALLEY S.W.C.D., OR
IMBLER R.F.P.D., OR
INTERLACHEN WATER P.U.D., OR

IONE LIBRARY DISTRICT, OR
IONE R.F.P.D. #6-
604, OR

IRONSIDE CEMETERY MAINTENANCE DISTRICT, OR
IRONSIDE RURAL ROAD DISTRICT #5, OR

IRRIGON PARK & RECREATION DISTRICT, OR
IRRIGON R.F.P.D., OR

ISLAND CITY AREA SANITATION DISTRICT, OR

ISLAND CITY CEMETERY MAINTENANCE DISTRICT,
OR

JACK PINE VILLAGE SPECIAL ROAD DISTRICT, OR
JACKSON COUNTY FIRE DISTRICT #3, OR
JACKSON COUNTY FIRE DISTRICT #4, OR
JACKSON COUNTY FIRE DISTRICT #5, OR

JACKSON COUNTY LIBRARY DISTRICT, OR

JACKSON COUNTY VECTOR CONTROL DISTRICT, OR
JACKSON S.W.C.D., OR

JASPER KNOLLS WATER DISTRICT, OR

JEFFERSON COUNTY EMERGENCY MEDICAL

SERVICE DISTRICT, OR
JEFFERSON COUNTY FIRE DISTRICT #1, OR

JEFFERSON COUNTY LIBRARY DISTRICT, OR
JEFFERSON COUNTY S.W.C.D., OR

JEFFERSON PARK & RECREATION DISTRICT, OR
JEFFERSON R.F.P.D., OR

JOB'S DRAINAGE DISTRICT, OR

JOHN DAY WATER DISTRICT, OR

JOHN DAY-CANYON CITY PARKS & RECREATION

DISTRICT, OR
JOHN DAY-FERNHILL R.F.P.D. #5-108, OR

JORDAN VALLEY CEMETERY DISTRICT, OR

JORDAN VALLEY IRRIGATION DISTRICT, OR

JOSEPHINE COMMUNITY LIBRARY DISTRICT, OR
JOSEPHINE COUNTY 4-H & EXTENSION SERVICE

DISTRICT, OR
JOSEPHINE COUNTY 911 AGENCY, OR
JUNCTION CITY R.F.P.D., OR

JUNCTION CITY WATER CONTROL DISTRICT, OR
�����������������
Version January 29, 2021

JUNIPER BUTTE ROAD DISTRICT, OR

JUNIPER CANYON WATER CONTROL DISTRICT, OR

JUNIPER FLAT DISTRICT IMPROVEMENT COMPANY,
OR
JUNIPER FLAT R.F.P.D., OR

JUNO NONPROFIT WATER IMPROVEMENT

DISTRICT, OR
KEATING R.F.P.D., OR
KEATING S.W.C.D., OR
KEIZER R.F.P.D., OR

KELLOGG RURAL FIRE DISTRICT, OR

KENO IRRIGATION DISTRICT, OR

KENO PINES ROAD DISTRICT, OR
KENO R.F.P.D., OR

KENT WATER DISTRICT, OR

KERBY WATER DISTRICT, OR

K-GB-LB WATER DISTRICT, OR

KILCHIS WATER DISTRICT, OR
KLAMATH 9-1-1 COMMUNICATIONS DISTRICT, OR

KLAMATH BASIN IMPROVEMENT DISTRICT, OR

KLAMATH COUNTY DRAINAGE SERVICE DISTRICT,
OR

KLAMATH COUNTY EXTENSION SERVICE DISTRICT,
OR
KLAMATH COUNTY FIRE DISTRICT #1, OR
KLAMATH COUNTY FIRE DISTRICT #3, OR
KLAMATH COUNTY FIRE DISTRICT #4, OR
KLAMATH COUNTY FIRE DISTRICT #5, OR

KLAMATH COUNTY LIBRARY SERVICE DISTRICT,
OR

KLAMATH COUNTY PREDATORY ANIMAL

CONTROL DISTRICT, OR

KLAMATH DRAINAGE DISTRICT, OR

KLAMATH FALLS FOREST ESTATES SPECIAL ROAD
DISTRICT UNIT #2, OR

KLAMATH INTEROPERABILITY RADIO GROUP, OR

KLAMATH IRRIGATION DISTRICT, OR

KLAMATH RIVER ACRES SPECIAL ROAD DISTRICT,
OR
KLAMATH S.W.C.D., OR

KLAMATH VECTOR CONTROL DISTRICT, OR
KNAPPA-SVENSEN-BURNSIDE R.F.P.D., OR

LA GRANDE CEMETERY MAINTENANCE DISTRICT,
OR
LA GRANDE R.F.P.D., OR

LA PINE PARK & RECREATION DISTRICT, OR
LA PINE R.F.P.D., OR

LABISH VILLAGE SEWAGE & DRAINAGE, OR

LACOMB IRRIGATION DISTRICT, OR

LAFAYETTE AIRPORT COMMISSION, LA
LAFOURCHE PARISH HEALTH UNIT – DHH-OPH
REGION 3

LAIDLAW WATER DISTRICT, OR

LAKE CHINOOK FIRE & RESCUE, OR
LAKE COUNTY 4-H & EXTENSION SERVICE

DISTRICT, OR

LAKE COUNTY LIBRARY DISTRICT, OR
LAKE CREEK R.F.P.D. - JACKSON, OR
LAKE CREEK R.F.P.D. - LANE COUNTY, OR

LAKE DISTRICT HOSPITAL, OR
LAKE GROVE R.F.P.D. NO. 57, OR

LAKE GROVE WATER DISTRICT, OR

LAKE LABISH WATER CONTROL DISTRICT, OR

LAKE POINT SPECIAL ROAD DISTRICT, OR
LAKESIDE R.F.P.D. #4, OR

LAKESIDE WATER DISTRICT, OR
LAKEVIEW R.F.P.D., OR
LAKEVIEW S.W.C.D., OR

LAMONTAI IMPROVEMENT DISTRICT, OR

LANE FIRE AUTHORITY, OR

LANE LIBRARY DISTRICT, OR

LANE TRANSIT DISTRICT, OR

LANGELL VALLEY IRRIGATION DISTRICT, OR

LANGLOIS PUBLIC LIBRARY, OR
LANGLOIS R.F.P.D., OR

LANGLOIS WATER DISTRICT, OR

LAZY RIVER SPECIAL ROAD DISTRICT, OR

LEBANON AQUATIC DISTRICT, OR
LEBANON R.F.P.D., OR
LEWIS & CLARK R.F.P.D., OR

LINCOLN COUNTY LIBRARY DISTRICT, OR
LINCOLN S.W.C.D., OR

LINN COUNTY EMERGENCY TELEPHONE AGENCY,
OR
LINN S.W.C.D., OR

LITTLE MUDDY CREEK WATER CONTROL, OR

LITTLE NESTUCCA DRAINAGE DISTRICT, OR

LITTLE SWITZERLAND SPECIAL ROAD DISTRICT, OR

LONE PINE IRRIGATION DISTRICT, OR

LONG PRAIRIE WATER DISTRICT, OR

LOOKINGGLASS OLALLA WATER CONTROL

DISTRICT, OR

LOOKINGGLASS RURAL FIRE DISTRICT, OR
LORANE R.F.P.D., OR

LOST & BOULDER DITCH IMPROVEMENT DISTRICT,
OR

LOST CREEK PARK SPECIAL ROAD DISTRICT, OR

LOUISIANA PUBLIC SERVICE COMMISSION, LA

LOUISIANA WATER WORKS
LOWELL R.F.P.D., OR
LOWER MCKAY CREEK R.F.P.D., OR
L

OWER MCKAY CREEK WATER CONTROL

DISTRICT, OR

LOWER POWDER RIVER IRRIGATION DISTRICT, OR

LOWER SILETZ WATER DISTRICT, OR

LOWER UMPQUA HOSPITAL DISTRICT, OR

LOWER UMPQUA PARK & RECREATION DISTRICT,
OR

LOWER VALLEY WATER IMPROVEMENT DISTRICT,
OR
LUCE LONG DITCH DISTRICT IMPROVEMENT CO.,
OR

LUSTED WATER DISTRICT, OR
LYONS R.F.P.D., OR

LYONS-MEHAMA WATER DISTRICT, OR

MADRAS AQUATIC CENTER DISTRICT, OR

MAKAI SPECIAL ROAD DISTRICT, OR
MALHEUR COUNTY S.W.C.D., OR

MALHEUR COUNTY VECTOR CONTROL DISTRICT,
OR

MALHEUR DISTRICT IMPROVEMENT COMPANY, OR

MALHEUR DRAINAGE DISTRICT, OR

MALHEUR MEMORIAL HEALTH DISTRICT, OR

MALIN COMMUNITY CEMETERY MAINTENANCE

DISTRICT, OR

MALIN COMMUNITY PARK & RECREATION

DISTRICT, OR

MALIN IRRIGATION DISTRICT, OR
MALIN R.F.P.D., OR

MAPLETON FIRE DEPARTMENT, OR

MAPLETON WATER DISTRICT, OR

MARCOLA WATER DISTRICT, OR
MARION COUNTY EXTENSION & 4H SERVICE

DISTRICT, OR
�����������������
Version January 29, 2021
MARION COUNTY FIRE DISTRICT #1, OR

MARION JACK IMPROVEMENT DISTRICT, OR
MARION S.W.C.D., OR

MARY'S RIVER ESTATES ROAD DISTRICT, OR

MCDONALD FOREST ESTATES SPECIAL ROAD

DISTRICT, OR

MCKAY ACRES IMPROVEMENT DISTRICT, OR
MCKAY DAM R.F.P.D. # 7-410, OR

MCKENZIE FIRE & RESCUE, OR

MCKENZIE PALISADES WATER SUPPLY

CORPORATION, OR
MCMINNVILLE R.F.P.D., OR
MCNULTY WATER P.U.D., OR

MEADOWS DRAINAGE DISTRICT, OR

MEDFORD IRRIGATION DISTRICT, OR
MEDFORD R.F.P.D. #2, OR

MEDFORD WATER COMMISSION
MEDICAL SPRINGS R.F.P.D., OR

MELHEUR COUNTY JAIL, OR

MERLIN COMMUNITY PARK DISTRICT, OR

MERRILL CEMETERY MAINTENANCE DISTRICT, OR

MERRILL PARK DISTRICT, OR
MERRILL R.F.P.D., OR

METRO REGIONAL GOVERNMENT

METRO REGIONAL PARKS

METROPOLITAN EXPOSITION RECREATION

COMMISSION

METROPOLITAN SERVICE DISTRICT (METRO)

MID COUNTY CEMETERY MAINTENANCE DISTRICT,
OR

MID-COLUMBIA FIRE AND RESCUE, OR

MIDDLE FORK IRRIGATION DISTRICT, OR

MIDLAND COMMUNITY PARK, OR

MIDLAND DRAINAGE IMPROVEMENT DISTRICT, OR

MILES CROSSING SANITARY SEWER DISTRICT, OR
MILL CITY R.F.P.D. #2-303, OR

MILL FOUR DRAINAGE DISTRICT, OR

MILLICOMA RIVER PARK & RECREATION DISTRICT,
OR
MILLINGTON R.F.P.D. #5, OR

MILO VOLUNTEER FIRE DEPARTMENT, OR

MILTON-FREEWATER AMBULANCE SERVICE AREA

HEALTH DISTRICT, OR

MILTON-FREEWATER WATER CONTROL DISTRICT,
OR

MIROCO SPECIAL ROAD DISTRICT, OR
MIST-BIRKENFELD R.F.P.D., OR

MODOC POINT IRRIGATION DISTRICT, OR

MODOC POINT SANITARY DISTRICT, OR
MOHAWK VALLEY R.F.P.D., OR

MOLALLA AQUATIC DISTRICT, OR
MOLALLA R.F.P.D. #73, OR
MONITOR R.F.P.D., OR
MONROE R.F.P.D., OR

MONUMENT CEMETERY MAINTENANCE DISTRICT,
OR
MONUMENT S.W.C.D., OR

MOOREA DRIVE SPECIAL ROAD DISTRICT, OR
MORO R.F.P.D., OR

MORROW COUNTY HEALTH DISTRICT, OR

MORROW COUNTY UNIFIED RECREATION

DISTRICT, OR
MORROW S.W.C.D., OR

MOSIER FIRE DISTRICT, OR

MOUNTAIN DRIVE SPECIAL ROAD DISTRICT, OR
MT. ANGEL R.F.P.D., OR
MT. HOOD IRRIGATION DISTRICT, OR
MT. LAKI CEMETERY DISTRICT, OR
MT. VERNON R.F.P.D., OR
MULINO WATER DISTRICT #1, OR
MULTNOMAH COUNTY DRAINAGE DISTRICT #1, OR
MULTNOMAH COUNTY R.F.P.D. #10, OR
MULTNOMAH COUNTY R.F.P.D. #14, OR

MULTNOMAH EDUCATION SERVICE DISTRICT
MYRTLE CREEK R.F.P.D., OR

NEAH-KAH-NIE WATER DISTRICT, OR
NEDONNA R.F.P.D., OR

NEHALEM BAY FIRE AND RESCUE, OR

NEHALEM BAY HEALTH DISTRICT, OR

NEHALEM BAY WASTEWATER AGENCY, OR

NESIKA BEACH-OPHIR WATER DISTRICT, OR

NESKOWIN REGIONAL SANITARY AUTHORITY, OR

NESKOWIN REGIONAL WATER DISTRICT, OR
NESTUCCA R.F.P.D., OR

NETARTS WATER DISTRICT, OR
NETARTS-OCEANSIDE R.F.P.D., OR

NETARTS-OCEANSIDE SANITARY DISTRICT, OR

NEW BRIDGE WATER SUPPLY DISTRICT, OR

NEW CARLTON FIRE DISTRICT, OR

NEW ORLEANS REDEVELOPMENT AUTHORITY, LA
NEW PINE CREEK R.F.P.D., OR
NEWBERG R.F.P.D., OR

NEWBERRY ESTATES SPECIAL ROAD DISTRICT, OR
NEWPORT R.F.P.D., OR

NEWT YOUNG DITCH DISTRICT IMPROVEMENT

COMPANY, OR
NORTH ALBANY R.F.P.D., OR
NOR
TH BAY R.F.P.D. #9, OR

NORTH CLACKAMAS PARKS & RECREATION

DISTRICT, OR

NORTH COUNTY RECREATION DISTRICT, OR

NORTH DOUGLAS COUNTY FIRE & EMS, OR

NORTH DOUGLAS PARK & RECREATION DISTRICT,
OR

NORTH GILLIAM COUNTY HEALTH DISTRICT, OR
NORTH GILLIAM COUNTY R.F.P.D., OR

NORTH LAKE HEALTH DISTRICT, OR

NORTH LEBANON WATER CONTROL DISTRICT, OR
NORTH LINCOLN FIRE & RESCUE DISTRICT #1, OR

NORTH LINCOLN HEALTH DISTRICT, OR

NORTH MORROW VECTOR CONTROL DISTRICT, OR
NORTH SHERMAN COUNTY R.F.P.D, OR

NORTH UNIT IRRIGATION DISTRICT, OR

NORTHEAST OREGON HOUSING AUTHORITY, OR

NORTHEAST WHEELER COUNTY HEALTH DISTRICT,
OR
NORTHERN WASCO COUNTY P.U.D., OR

NORTHERN WASCO COUNTY PARK & RECREATION

DISTRICT, OR

NYE DITCH USERS DISTRICT IMPROVEMENT, OR
NYSSA ROAD ASSESSMENT DISTRICT #2, OR

NYSSA RURAL FIRE DISTRICT, OR

NYSSA-ARCADIA DRAINAGE DISTRICT, OR

OAK LODGE WATER SERVICES, OR
OAKLAND R.F.P.D., OR

OAKVILLE COMMUNITY CENTER, OR

OCEANSIDE WATER DISTRICT, OR

OCHOCO IRRIGATION DISTRICT, OR

OCHOCO WEST WATER AND SANITARY

AUTHORITY, OR

ODELL SANITARY DISTRICT, OR

OLD OWYHEE DITCH IMPROVEMENT DISTRICT, OR

OLNEY-WALLUSKI FIRE & RESCUE DISTRICT, OR

ONTARIO LIBRARY DISTRICT, OR
�����������������

Version January 29, 2021

ONTARIO R.F.P.D., OR
OPHIR R.F.P.D., OR

OREGON COAST COMMUNITY ACTION

OREGON HOUSING AND COMMUNITY SERVICES

OREGON INTERNATIONAL PORT OF COOS BAY, OR

OREGON LEGISLATIVE ADMINISTRATION
OREGON OUTBACK R.F.P.D., OR

OREGON POINT, OR

OREGON TRAIL LIBRARY DISTRICT, OR

OTTER ROCK WATER DISTRICT, OR
OWW UNIT #2 SANITARY DISTRICT, OR

OWYHEE CEMETERY MAINTENANCE DISTRICT, OR

OWYHEE IRRIGATION DISTRICT, OR

PACIFIC CITY JOINT WATER-SANITARY

AUTHORITY, OR

PACIFIC COMMUNITIES HEALTH DISTRICT, OR
PACIFIC RIVIERA #3 SPECIAL ROAD DISTRICT, OR

PALATINE HILL WATER DISTRICT, OR

PALMER CREEK WATER DISTRICT IMPROVEMENT

COMPANY, OR

PANORAMIC ACCESS SPECIAL ROAD DISTRICT, OR

PANTHER CREEK ROAD DISTRICT, OR

PANTHER CREEK WATER DISTRICT, OR
PARKDALE R.F.P.D., OR

PARKDALE SANITARY DISTRICT, OR
PENINSULA DRAINAGE DISTRICT #1, OR
PENINSULA DRAINAGE DISTRICT #2, OR

PHILOMATH FIRE AND RESCUE, OR

PILOT ROCK CEMETERY MAINTENANCE DISTRICT
#5, OR

PILOT ROCK PARK & RECREATION DISTRICT, OR
PILOT ROCK R.F.P.D., OR

PINE EAGLE HEALTH DISTRICT, OR

PINE FLAT DISTRICT IMPROVEMENT COMPANY, OR

PINE GROVE IRRIGATION DISTRICT, OR

PINE GROVE WATER DISTRICT-KLAMATH FALLS,
OR

PINE GROVE WATER DISTRICT-MAUPIN, OR

PINE VALLEY CEMETERY DISTRICT, OR
PINE VALLEY R.F.P.D., OR

PINEWOOD COUNTRY ESTATES SPECIAL ROAD

DISTRICT, OR

PIONEER DISTRICT IMPROVEMENT COMPANY, OR

PISTOL RIVER CEMETERY MAINTENANCE

DISTRICT, OR

PISTOL RIVER FIRE DISTRICT, OR
PLEASANT HILL R.F.P.D., OR

PLEASANT HOME WATER DISTRICT, OR

POCAHONTAS MINING AND IRRIGATION DISTRICT,
OR

POE VALLEY IMPROVEMENT DISTRICT, OR

POE VALLEY PARK & RECREATION DISTRICT, OR

POE VALLEY VECTOR CONTROL DISTRICT, OR
POLK COUNTY FIRE DISTRICT #1, OR
POLK S.W.C.D., OR

POMPADOUR WATER IMPROVEMENT DISTRICT, OR

PONDEROSA PINES EAST SPECIAL ROAD DISTRICT,
OR

PORT OF ALSEA, OR

PORT OF ARLINGTON, OR

PORT OF ASTORIA, OR

PORT OF BANDON, OR

PORT OF BRANDON, OR

PORT OF BROOKINGS HARBOR, OR

PORT OF CASCADE LOCKS, OR

PORT OF COQUILLE RIVER, OR

PORT OF GARIBALDI, OR

PORT OF GOLD BEACH, OR

PORT OF HOOD RIVER, OR

PORT OF MORGAN CITY, LA

PORT OF MORROW, OR

PORT OF NEHALEM, OR

PORT OF NEWPORT, OR

PORT OF PORT ORFORD, OR

PORT OF PORTLAND, OR

PORT OF SIUSLAW, OR
PORT OF ST. HELENS, OR

PORT OF THE DALLES, OR

PORT OF TILLAMOOK BAY, OR

PORT OF TOLEDO, OR

PORT OF UMATILLA, OR

PORT OF UMPQUA, OR

PORT ORFORD CEMETERY MAINTENANCE

DISTRICT, OR

PORT ORFORD PUBLIC LIBRARY DISTRICT, OR
PORT ORFORD R.F.P.D., OR

PORTLAND DEVELOPMENT COMMISSION, OR

PORTLAND FIRE AND RESCUE

PORTLAND HOUSING CENTER, OR
POWDER R.F.P.D., OR
POWDER RIVER R.F.P.D., OR

POWDER VALLEY WATER CONTROL DISTRICT, OR

POWERS HEALTH DISTRICT, OR

PRAIRIE CEMETERY MAINTENANCE DISTRICT, OR

PRINEVILLE LAKE ACRES SPECIAL ROAD DISTRICT
#1, OR
PROSPECT R.F.P.D., OR

QUAIL VALLEY PARK IMPROVEMENT DISTRICT, OR

QUEENER IRRIGATION IMPROVEMENT DISTRICT,
OR

RAINBOW WATER DISTRICT, OR

RAINIER CEMETERY DISTRICT, OR

RAINIER DRAINAGE IMPROVEMENT COMPANY, OR

RALEIGH WATER DISTRICT, OR

REDMOND AREA PARK & RECREATION DISTRICT,
OR

REDMOND FIRE AND RESCUE, OR

RIDDLE FIRE PROTECTION DISTRICT, OR

RIDGEWOOD DISTRICT IMPROVEMENT COMPANY,
OR

RIDGEWOOD ROAD DISTRICT, OR

RIETH SANITARY DISTRICT, OR

RIETH WATER DISTRICT, OR

RIMROCK WEST IMPROVEMENT DISTRICT, OR

RINK CREEK WATER DISTRICT, OR

RIVER BEND ESTATES SPECIAL ROAD DISTRICT, OR

RIVER FOREST ACRES SPECIAL ROAD DISTRICT, OR

RIVER MEADOWS IMPROVEMENT DISTRICT, OR

RIVER PINES ESTATES SPECIAL ROAD DISTRICT, OR

RIVER ROAD PARK & RECREATION DISTRICT, OR

RIVER ROAD WATER DISTRICT, OR

RIVERBEND RIVERBANK WATER IMPROVEMENT

DISTRICT, OR
RIVERDALE R.F.P.D. 11-JT, OR

RIVERGROVE WATER DISTRICT, OR

RIVERSIDE MISSION WATER CONTROL DISTRICT,
OR
RIVERSIDE R.F.P.D. #7-406, OR

RIVERSIDE WATER DISTRICT, OR

ROBERTS CREEK WATER DISTRICT, OR

ROCK CREEK DISTRICT IMPROVEMENT, OR

ROCK CREEK WATER DISTRICT, OR
ROCKWOOD WATER P.U.D., OR

ROCKY POINT FIRE & EMS, OR
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Version January 29, 2021
ROGUE RIVER R.F.P.D., OR

ROGUE RIVER VALLEY IRRIGATION DISTRICT, OR

ROGUE VALLEY SEWER SERVICES, OR

ROGUE VALLEY SEWER, OR

ROGUE VALLEY TRANSPORTATION DISTRICT, OR

ROSEBURG URBAN SANITARY AUTHORITY, OR

ROSEWOOD ESTATES ROAD DISTRICT, OR

ROW RIVER VALLEY WATER DISTRICT, OR
RURAL ROAD ASSESSMENT DISTRICT #3, OR
RURAL ROAD ASSESSMENT DISTRICT #4, OR

SAINT LANDRY PARISH TOURIST COMMISSION
SAINT MARY PARISH REC DISTRICT 2
SAINT MARY PARISH REC DISTRICT 3
SAINT TAMMANY FIRE DISTRICT 4, LA

SALEM AREA MASS TRANSIT DISTRICT, OR

SALEM MASS TRANSIT DISTRICT
SALEM SUBURBAN R.F.P.D., OR

SALISHAN SANITARY DISTRICT, OR

SALMON RIVER PARK SPECIAL ROAD DISTRICT, OR

SALMON RIVER PARK WATER IMPROVEMENT

DISTRICT, OR

SALMONBERRY TRAIL INTERGOVERNMENTAL

AGENCY, OR

SANDPIPER VILLAGE SPECIAL ROAD DISTRICT, OR

SANDY DRAINAGE IMPROVEMENT COMPANY, OR
SANDY R.F.P.D. #72, OR
SANTA CLARA R.F.P.D., OR

SANTA CLARA WATER DISTRICT, OR

SANTIAM WATER CONTROL DISTRICT, OR

SAUVIE ISLAND DRAINAGE IMPROVEMENT

COMPANY, OR
SAUVIE ISLAND VOLUNTEER FIRE DISTRICT #30J,
OR

SCAPPOOSE DRAINAGE IMPROVEMENT COMPANY,
OR

SCAPPOOSE PUBLIC LIBRARY DISTRICT, OR
SCAPPOOSE R.F.P.D., OR
SCIO R.F.P.D., OR
SCOTTSBURG R.F.P.D., OR
SEAL ROCK R.F.P.D., OR

SEAL ROCK WATER DISTRICT, OR

SEWERAGE AND WATER BOARD OF NEW ORLEANS,
LA

SHANGRI-LA WATER DISTRICT, OR

SHASTA VIEW IRRIGATION DISTRICT, OR

SHELLEY ROAD CREST ACRES WATER DISTRICT,
OR

SHERIDAN FIRE DISTRICT, OR

SHERMAN COUNTY HEALTH DISTRICT, OR
SHERMAN COUNTY S.W.C.D., OR

SHORELINE SANITARY DISTRICT, OR

SILETZ KEYS SANITARY DISTRICT, OR
SILETZ R.F.P.D., OR

SILVER FALLS LIBRARY DISTRICT, OR

SILVER LAKE IRRIGATION DISTRICT, OR
SILVER LAKE R.F.P.D., OR

SILVER SANDS SPECIAL ROAD DISTRICT, OR
SILVERTON R.F.P.D. NO. 2, OR

SISTERS PARKS & RECREATION DISTRICT, OR
SISTERS-CAMP SHERMAN R.F.P.D., OR

SIUSLAW PUBLIC LIBRARY DISTRICT, OR
SIUSLAW S.W.C.D., OR

SIUSLAW VALLEY FIRE AND RESCUE, OR
SIXES R.F.P.D., OR

SKIPANON WATER CONTROL DISTRICT, OR

SKYLINE VIEW DISTRICT IMPROVEMENT

COMPANY, OR

SLEEPY HOLLOW WATER DISTRICT, OR

SMITH DITCH DISTRICT IMPROVEMENT COMPANY,
OR

SOUTH CLACKAMAS TRANSPORTATION DISTRICT,
OR

SOUTH COUNTY HEALTH DISTRICT, OR

SOUTH FORK WATER BOARD, OR

SOUTH GILLIAM COUNTY CEMETERY DISTRICT, OR

SOUTH GILLIAM COUNTY HEALTH DISTRICT, OR
SOUTH GILLIAM COUNTY R.F.P.D. VI-301, OR

SOUTH LAFOURCHE LEVEE DISTRICT, LA

SOUTH LANE COUNTY FIRE & RESCUE, OR

SOUTH SANTIAM RIVER WATER CONTROL

DISTRICT, OR

SOUTH SHERMAN FIRE DISTRICT, OR

SOUTH SUBURBAN SANITARY DISTRICT, OR

SOUTH WASCO PARK & RECREATION DISTRICT, OR

SOUTHERN COOS HEALTH DISTRICT, OR

SOUTHERN CURRY CEMETERY MAINTENANCE

DISTRICT, OR

SOUTHVIEW IMPROVEMENT DISTRICT, OR

SOUTHWEST LINCOLN COUNTY WATER DISTRICT,
OR
SOUTHWESTERN POLK COUNTY R.F.P.D., OR

SOUTHWOOD PARK WATER DISTRICT, OR
SPECIAL ROAD DISTRICT #1, OR
SPECIAL ROAD DISTRICT #8, OR

SPRING RIVER SPECIAL ROAD DISTRICT, OR

SPRINGFIELD UTILITY BOARD, OR
ST. PAUL R.F.P.D., OR
STANFIELD CEMETERY DISTRICT #6, OR

STANFIELD IRRIGATION DISTRICT, OR

STARR CREEK ROAD DISTRICT, OR

STARWOOD SANITARY DISTRICT, OR

STAYTON FIRE DISTRICT, OR

SUBLIMITY FIRE DISTRICT, OR

SUBURBAN EAST SALEM WATER DISTRICT, OR
S

UBURBAN LIGHTING DISTRICT, OR

SUCCOR CREEK DISTRICT IMPROVEMENT

COMPANY, OR

SUMMER LAKE IRRIGATION DISTRICT, OR

SUMMERVILLE CEMETERY MAINTENANCE

DISTRICT, OR
SUMNER R.F.P.D., OR

SUN MOUNTAIN SPECIAL ROAD DISTRICT, OR

SUNDOWN SANITATION DISTRICT, OR

SUNFOREST ESTATES SPECIAL ROAD DISTRICT, OR

SUNNYSIDE IRRIGATION DISTRICT, OR

SUNRISE WATER AUTHORITY, OR

SUNRIVER SERVICE DISTRICT, OR

SUNSET EMPIRE PARK & RECREATION DISTRICT,
OR

SUNSET EMPIRE TRANSPORTATION DISTRICT, OR

SURFLAND ROAD DISTRICT, OR

SUTHERLIN VALLEY RECREATION DISTRICT, OR

SUTHERLIN WATER CONTROL DISTRICT, OR

SWALLEY IRRIGATION DISTRICT, OR

SWEET HOME CEMETERY MAINTENANCE DISTRICT,
OR

SWEET HOME FIRE & AMBULANCE DISTRICT, OR
SWISSHOME-DEADWOOD R.F.P.D., OR

TABLE ROCK DISTRICT IMPROVEMENT COMPANY,
OR

TALENT IRRIGATION DISTRICT, OR
TANGENT R.F.P.D., OR
TENMILE R.F.P.D., OR

TERREBONNE DOMESTIC WATER DISTRICT, OR
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Version January 29, 2021

THE DALLES IRRIGATION DISTRICT, OR
THOMAS CREEK-WESTSIDE R.F.P.D., OR

THREE RIVERS RANCH ROAD DISTRICT, OR

THREE SISTERS IRRIGATION DISTRICT, OR

TIGARD TUALATIN AQUATIC DISTRICT, OR

TIGARD WATER DISTRICT, OR

TILLAMOOK BAY FLOOD IMPROVEMENT DISTRICT,
OR

TILLAMOOK COUNTY EMERGENCY

COMMUNICATIONS DISTRICT, OR
TILLAMOOK COUNTY S.W.C.D., OR

TILLAMOOK COUNTY TRANSPORTATION DISTRICT,
OR

TILLAMOOK FIRE DISTRICT, OR
TILLAMOOK P.U.D., OR
TILLER R.F.P.D., OR

TOBIN DITCH DISTRICT IMPROVEMENT COMPANY,
OR
TOLEDO R.F.P.D., OR

TONE WATER DISTRICT, OR

TOOLEY WATER DISTRICT, OR

TRASK DRAINAGE DISTRICT, OR
TRI CITY R.F.P.D. #4, OR

TRI-CITY WATER & SANITARY AUTHORITY, OR

TRI-COUNTY METROPOLITAN TRANSPORTATION

DISTRICT OF OREGON

TRIMET, OR

TUALATIN HILLS PARK & RECREATION DISTRICT

TUALATIN HILLS PARK & RECREATION DISTRICT,
OR
TUALATIN S.W.C.D., OR

TUALATIN VALLEY FIRE & RESCUE

TUALATIN VALLEY FIRE & RESCUE, OR

TUALATIN VALLEY IRRIGATION DISTRICT, OR

TUALATIN VALLEY WATER DISTRICT

TUALATIN VALLEY WATER DISTRICT, OR

TUMALO IRRIGATION DISTRICT, OR

TURNER FIRE DISTRICT, OR

TWIN ROCKS SANITARY DISTRICT, OR

TWO RIVERS NORTH SPECIAL ROAD DISTRICT, OR
TWO RIVERS S.W.C.D., OR

TWO RIVERS SPECIAL ROAD DISTRICT, OR
TYGH VALLEY R.F.P.D., OR

TYGH VALLEY WATER DISTRICT, OR
UMATILLA COUNTY FIRE DISTRICT #1, OR
UMATILLA COUNTY S.W.C.D., OR

UMATILLA COUNTY SPECIAL LIBRARY DISTRICT,
OR

UMATILLA HOSPITAL DISTRICT, OR
UMATILLA R.F.P.D. #7-405, OR

UMATILLA-MORROW RADIO AND DATA DISTRICT,
OR
UMPQUA S.W.C.D., OR

UNION CEMETERY MAINTENANCE DISTRICT, OR

UNION COUNTY SOLID WASTE DISPOSAL DISTRICT,
OR

UNION COUNTY VECTOR CONTROL DISTRICT, OR

UNION GAP SANITARY DISTRICT, OR

UNION GAP WATER DISTRICT, OR

UNION HEALTH DISTRICT, OR
UNION R.F.P.D., OR
UNION S.W.C.D., OR

UNITY COMMUNITY PARK & RECREATION

DISTRICT, OR

UPPER CLEVELAND RAPIDS ROAD DISTRICT, OR
UPPER MCKENZIE R.F.P.D., OR
UPPER WILLAMETTE S.W.C.D., OR

VALE OREGON IRRIGATION DISTRICT, OR

VALE RURAL FIRE PROTECTION DISTRICT, OR

VALLEY ACRES SPECIAL ROAD DISTRICT, OR

VALLEY VIEW CEMETERY MAINTENANCE

DISTRICT, OR

VALLEY VIEW WATER DISTRICT, OR

VANDEVERT ACRES SPECIAL ROAD DISTRICT, OR
VERNONIA R.F.P.D., OR

VINEYARD MOUNTAIN PARK & RECREATION

DISTRICT, OR

VINEYARD MOUNTAIN SPECIAL ROAD DISTRICT,
OR

WALLA WALLA RIVER IRRIGATION DISTRICT, OR

WALLOWA COUNTY HEALTH CARE DISTRICT, OR

WALLOWA LAKE COUNTY SERVICE DISTRICT, OR

WALLOWA LAKE IRRIGATION DISTRICT, OR
WALLOWA LAKE R.F.P.D., OR
WALLOWA S.W.C.D., OR
WALLOWA VALLEY IMPROVEMENT DISTRICT #1,
OR
WAMIC R.F.P.D., OR

WAMIC WATER & SANITARY AUTHORITY, OR

WARMSPRINGS IRRIGATION DISTRICT, OR
WASCO COUNTY S.W.C.D., OR

WATER ENVIRONMENT SERVICES, OR

WATER WONDERLAND IMPROVEMENT DISTRICT,
OR

WATERBURY & ALLEN DITCH IMPROVEMENT

DISTRICT, OR

WATSECO-BARVIEW WATER DISTRICT, OR

WAUNA WATER DISTRICT, OR

WEDDERBURN SANITARY DISTRICT, OR

WEST EAGLE VALLEY WATER CONTROL DISTRICT,
OR

WEST EXTENSION IRRIGATION DISTRICT, OR

WEST LABISH DRAINAGE & WATER CONTROL

IMPROVEMENT DISTRICT, OR
WEST MULTNOMAH S.W.C.D., OR
WEST SIDE R.F.P.D., OR

WEST SLOPE WATER DISTRICT, OR
W

EST UMATILLA MOSQUITO CONTROL DISTRICT,
OR

WEST VALLEY FIRE DISTRICT, OR

WESTERN HEIGHTS SPECIAL ROAD DISTRICT, OR

WESTERN LANE AMBULANCE DISTRICT, OR

WESTLAND IRRIGATION DISTRICT, OR

WESTON ATHENA MEMORIAL HALL PARK &

RECREATION DISTRICT, OR
WESTON CEMETERY DISTRICT #2, OR

WESTPORT FIRE AND RESCUE, OR

WESTRIDGE WATER SUPPLY CORPORATION, OR

WESTWOOD HILLS ROAD DISTRICT, OR

WESTWOOD VILLAGE ROAD DISTRICT, OR
WHEELER S.W.C.D., OR

WHITE RIVER HEALTH DISTRICT, OR

WIARD MEMORIAL PARK DISTRICT, OR

WICKIUP WATER DISTRICT, OR
WILLAKENZIE R.F.P.D., OR

WILLAMALANE PARK & RECREATION DISTRICT, OR

WILLAMALANE PARK AND RECREATION DISTRICT

WILLAMETTE HUMANE SOCIETY

WILLAMETTE RIVER WATER COALITION, OR
WILLIAMS R.F.P.D., OR

WILLOW CREEK PARK DISTRICT, OR

WILLOW DALE WATER DISTRICT, OR

WILSON RIVER WATER DISTRICT, OR
WINCHESTER BAY R.F.P.D., OR
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Version January 29, 2021

WINCHESTER BAY SANITARY DISTRICT, OR
WINCHUCK R.F.P.D., OR
WINSTON-DILLARD R.F.P.D., OR

WINSTON-DILLARD WATER DISTRICT, OR
WOLF CREEK R.F.P.D., OR

WOOD RIVER DISTRICT IMPROVEMENT COMPANY,
OR
WOODBURN R.F.P.D. NO. 6, OR

WOODLAND PARK SPECIAL ROAD DISTRICT, OR

WOODS ROAD DISTRICT, OR

WRIGHT CREEK ROAD WATER IMPROVEMENT

DISTRICT, OR

WY'EAST FIRE DISTRICT, OR
YACHATS R.F.P.D., OR

YAMHILL COUNTY TRANSIT AREA, OR

YAMHILL FIRE PROTECTION DISTRICT, OR

YAMHILL SWCD, OR

YONCALLA PARK & RECREATION DISTRICT, OR

YOUNGS RIVER-LEWIS & CLARK WATER DISTRICT,
OR
ZUMWALT R.F.P.D., OR
K-
12 INCLUDING BUT NOT LIMITED TO:

ACADIA PARISH SCHOOL BOARD

BEAVERTON SCHOOL DISTRICT

BEND-LA PINE SCHOOL DISTRICT

BOGALUSA HIGH SCHOOL, LA

BOSSIER PARISH SCHOOL BOARD

BROOKING HARBOR SCHOOL DISTRICT

CADDO PARISH SCHOOL DISTRICT

CALCASIEU PARISH SCHOOL DISTRICT

CANBY SCHOOL DISTRICT

CANYONVILLE CHRISTIAN ACADEMY

CASCADE SCHOOL DISTRICT

CASCADES ACADEMY OF CENTRAL OREGON

CENTENNIAL SCHOOL DISTRICT

CENTRAL CATHOLIC HIGH SCHOOL
CENTRAL POINT SCHOOL DISTRICT NO.6
CENTRAL SCHOOL DISTRICT 13J
COOS BAY SCHOOL DISTRICT NO.9
CORVALLIS SCHOOL DISTRICT 509J
COUNTY OF YAMHILL SCHOOL DISTRICT 29

CULVER SCHOOL DISTRICT
DALLAS SCHOOL DISTRICT NO.2

DAVID DOUGLAS SCHOOL DISTRICT
DAYTON SCHOOL DISTRICT NO.8

DE LA SALLE N CATHOLIC HS
DESCHUTES COUNTY SCHOOL DISTRICT NO.6

DOUGLAS EDUCATIONAL DISTRICT SERVICE
DUFUR SCHOOL DISTRICT NO.29

EAST BATON ROUGE PARISH SCHOOL DISTRICT
ESTACADA SCHOOL DISTRICT NO.10B

FOREST GROVE SCHOOL DISTRICT

GEORGE MIDDLE SCHOOL

GLADSTONE SCHOOL DISTRICT
GRANTS PASS SCHOOL DISTRICT 7

GREATER ALBANY PUBLIC SCHOOL DISTRICT

GRESHAM BARLOW JOINT SCHOOL DISTRICT

HEAD START OF LANE COUNTY

HIGH DESERT EDUCATION SERVICE DISTRICT

HILLSBORO SCHOOL DISTRICT

HOOD RIVER COUNTY SCHOOL DISTRICT
JACKSON CO SCHOOL DIST NO.9
JEFFERSON COUNTY SCHOOL DISTRICT 509-J

JEFFERSON PARISH SCHOOL DISTRICT

JEFFERSON SCHOOL DISTRICT

JUNCTION CITY SCHOOLS, OR

KLAMATH COUNTY SCHOOL DISTRICT

KLAMATH FALLS CITY SCHOOLS

LAFAYETTE PARISH SCHOOL DISTRICT
LAKE OSWEGO SCHOOL DISTRICT 7J
LANE COUNTY SCHOOL DISTRICT 4J

LINCOLN COUNTY SCHOOL DISTRICT
LINN CO. SCHOOL DIST. 95C

LIVINGSTON PARISH SCHOOL DISTRICT

LOST RIVER JR/SR HIGH SCHOOL
LOWELL SCHOOL DISTRICT NO.71
SALEM-KEIZER PUBLIC SCHOOLS 24J
MARION COUNTY SCHOOL DISTRICT 103

MARIST HIGH SCHOOL, OR

MCMINNVILLE SCHOOL DISTRICT NOAO
MEDFORD SCHOOL DISTRICT 549C

MITCH CHARTER SCHOOL
MONROE SCHOOL DISTRICT NO.1J

MORROW COUNTY SCHOOL DIST, OR

MULTNOMAH EDUCATION SERVICE DISTRICT

MULTISENSORY LEARNING ACADEMY
MYRTLE PINT SCHOOL DISTRICT 41
NEAH-KAH-NIE DISTRICT NO.56

NEWBERG PUBLIC SCHOOLS
NESTUCCA VALLEY SCHOOL DISTRICT NO.101

NOBEL LEARNING COMMUNITIES
NORTH BEND SCHOOL DISTRICT 13

NORTH CLACKAMAS SCHOOL DISTRICT

NORTH DOUGLAS SCHOOL DISTRICT
NORTH WASCO CITY SCHOOL DISTRICT 21

NORTHWEST REGIONAL EDUCATION SERVICE

DISTRICT

ONTARIO MIDDLE SCHOOL
OREGON TRAIL SCHOOL DISTRICT NOA6

ORLEANS PARISH SCHOOL DISTRICT

PHOENIX-TALENT SCHOOL DISTRICT NOA

PLEASANT HILL SCHOOL DISTRICT

PORTLAND JEWISH ACADEMY

PORTLAND PUBLIC SCHOOLS

RAPIDES PARISH SCHOOL DISTRICT

REDMOND SCHOOL DISTRICT

REYNOLDS SCHOOL DISTRICT

ROGUE RIVER SCHOOL DISTRICT

ROSEBURG PUBLIC SCHOOLS
SCAPPOOSE SCHOOL DISTRICT 1J

SAINT TAMMANY PARISH SCHOOL BOARD, LA
SEASIDE SCHOOL DISTRICT 10
SHERWOOD SCHOOL DISTRICT 88J
SILVER FALLS SCHOOL DISTRICT 4J
SOUTH LANE SCHOOL DISTRICT 45J3

SOUTHERN OREGON EDUCATION SERVICE

DISTRICT

SPRINGFIELD PUBLIC SCHOOLS

SUTHERLIN SCHOOL DISTRICT
S
WEET HOME SCHOOL DISTRICT NO.55

TERREBONNE PARISH SCHOOL DISTRICT

THE CATLIN GABEL SCHOOL

TIGARD-TUALATIN SCHOOL DISTRICT

UMATILLA MORROW ESD

WEST LINN WILSONVILLE SCHOOL DISTRICT

WILLAMETTE EDUCATION SERVICE DISTRICT

WOODBURN SCHOOL DISTRICT

YONCALLA SCHOOL DISTRICT

ACADEMY FOR MATH ENGINEERING & SCIENCE
(AMES), UT

ALIANZA ACADEMY, UT

ALPINE DISTRICT, UT

AMERICAN LEADERSHIP ACADEMY, UT
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Version January 29, 2021

AMERICAN PREPARATORY ACADEMY, UT

BAER CANYON HIGH SCHOOL FOR SPORTS &

MEDICAL SCIENCES, UT

BEAR RIVER CHARTER SCHOOL, UT

BEAVER SCHOOL DISTRICT, UT

BEEHIVE SCIENCE & TECHNOLOGY ACADEMY
(BSTA) , UT

BOX ELDER SCHOOL DISTRICT, UT

CBA CENTER, UT

CACHE SCHOOL DISTRICT, UT

CANYON RIM ACADEMY, UT

CANYONS DISTRICT, UT

CARBON SCHOOL DISTRICT, UT

CHANNING HALL, UT

CHARTER SCHOOL LEWIS ACADEMY, UT

CITY ACADEMY, UT

DAGGETT SCHOOL DISTRICT, UT

DAVINCI ACADEMY, UT

DAVIS DISTRICT, UT

DUAL IMMERSION ACADEMY, UT

DUCHESNE SCHOOL DISTRICT, UT

EARLY LIGHT ACADEMY AT DAYBREAK, UT

EAST HOLLYWOOD HIGH, UT

EDITH BOWEN LABORATORY SCHOOL, UT

EMERSON ALCOTT ACADEMY, UT

EMERY SCHOOL DISTRICT, UT

ENTHEOS ACADEMY, UT

EXCELSIOR ACADEMY, UT

FAST FORWARD HIGH, UT

FREEDOM ACADEMY, UT

GARFIELD SCHOOL DISTRICT, UT

GATEWAY PREPARATORY ACADEMY, UT

GEORGE WASHINGTON ACADEMY, UT

GOOD FOUNDATION ACADEMY, UT

GRAND SCHOOL DISTRICT, UT

GRANITE DISTRICT, UT

GUADALUPE SCHOOL, UT

HAWTHORN ACADEMY, UT

INTECH COLLEGIATE HIGH SCHOOL, UT

IRON SCHOOL DISTRICT, UT

ITINERIS EARLY COLLEGE HIGH, UT

JOHN HANCOCK CHARTER SCHOOL, UT

JORDAN DISTRICT, UT

JUAB SCHOOL DISTRICT, UT

KANE SCHOOL DISTRICT, UT

KARL G MAESER PREPARATORY ACADEMY, UT

LAKEVIEW ACADEMY, UT

LEGACY PREPARATORY ACADEMY, UT

LIBERTY ACADEMY, UT

LINCOLN ACADEMY, UT

LOGAN SCHOOL DISTRICT, UT

MARIA MONTESSORI ACADEMY, UT

MERIT COLLEGE PREPARATORY ACADEMY, UT

MILLARD SCHOOL DISTRICT, UT

MOAB CHARTER SCHOOL, UT

MONTICELLO ACADEMY, UT

MORGAN SCHOOL DISTRICT, UT

MOUNTAINVILLE ACADEMY, UT

MURRAY SCHOOL DISTRICT, UT

NAVIGATOR POINTE ACADEMY, UT

NEBO SCHOOL DISTRICT, UT

NO UT ACAD FOR MATH ENGINEERING & SCIENCE
(NUAMES), UT

NOAH WEBSTER ACADEMY, UT

NORTH DAVIS PREPARATORY ACADEMY, UT

NORTH SANPETE SCHOOL DISTRICT, UT

NORTH STAR ACADEMY, UT

NORTH SUMMIT SCHOOL DISTRICT, UT

ODYSSEY CHARTER SCHOOL, UT

OGDEN PREPARATORY ACADEMY, UT

OGDEN SCHOOL DISTRICT, UT

OPEN CLASSROOM, UT

OPEN HIGH SCHOOL OF UTAH, UT

OQUIRRH MOUNTAIN CHARTER SCHOOL, UT

PARADIGM HIGH SCHOOL, UT

PARK CITY SCHOOL DISTRICT, UT

PINNACLE CANYON ACADEMY, UT

PIUTE SCHOOL DISTRICT, UT

PROVIDENCE HALL, UT

PROVO SCHOOL DISTRICT, UT

QUAIL RUN PRIMARY SCHOOL, UT

QUEST ACADEMY, UT

RANCHES ACADEMY, UT

REAGAN ACADEMY, UT

RENAISSANCE ACADEMY, UT

RICH SCHOOL DISTRICT, UT

ROCKWELL CHARTER HIGH SCHOOL, UT

SALT LAKE ARTS ACADEMY, UT

SALT LAKE CENTER FOR SCIENCE EDUCATION, UT

SALT LAKE SCHOOL DISTRICT, UT

SALT LAKE SCHOOL FOR THE PERFORMING ARTS,
UT

SAN JUAN SCHOOL DISTRICT, UT

SEVIER SCHOOL DISTRICT, UT

SOLDIER HOLLOW CHARTER SCHOOL, UT

SOUTH SANPETE SCHOOL DISTRICT, UT

SOUTH SUMMIT SCHOOL DISTRICT, UT

SPECTRUM ACADEMY, UT
S

UCCESS ACADEMY, UT

SUCCESS SCHOOL, UT

SUMMIT ACADEMY, UT

SUMMIT ACADEMY HIGH SCHOOL, UT

SYRACUSE ARTS ACADEMY, UT

THOMAS EDISON - NORTH, UT

TIMPANOGOS ACADEMY, UT

TINTIC SCHOOL DISTRICT, UT

TOOELE SCHOOL DISTRICT, UT

TUACAHN HIGH SCHOOL FOR THE PERFORMING

ARTS, UT

UINTAH RIVER HIGH, UT

UINTAH SCHOOL DISTRICT, UT

UTAH CONNECTIONS ACADEMY, UT

UTAH COUNTY ACADEMY OF SCIENCE, UT

UTAH ELECTRONIC HIGH SCHOOL, UT

UTAH SCHOOLS FOR DEAF & BLIND, UT

UTAH STATE OFFICE OF EDUCATION, UT

UTAH VIRTUAL ACADEMY, UT

VENTURE ACADEMY, UT

VISTA AT ENTRADA SCHOOL OF PERFORMING

ARTS AND TECHNOLOGY, UT

WALDEN SCHOOL OF LIBERAL ARTS, UT

WASATCH PEAK ACADEMY, UT

WASATCH SCHOOL DISTRICT, UT

WASHINGTON SCHOOL DISTRICT, UT

WAYNE SCHOOL DISTRICT, UT

WEBER SCHOOL DISTRICT, UT

WEILENMANN SCHOOL OF DISCOVERY, UT
H

IGHER EDUCATION

ARGOSY UNIVERSITY

BATON ROUGE COMMUNITY COLLEGE, LA

BIRTHINGWAY COLLEGE OF MIDWIFERY

BLUE MOUNTAIN COMMUNITY COLLEGE

BRIGHAM YOUNG UNIVERSITY - HAWAII
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Version January 29, 2021

CENTRAL OREGON COMMUNITY COLLEGE

CENTENARY COLLEGE OF LOUISIANA

CHEMEKETA COMMUNITY COLLEGE

CLACKAMAS COMMUNITY COLLEGE

COLLEGE OF THE MARSHALL ISLANDS

COLUMBIA GORGE COMMUNITY COLLEGE

CONCORDIA UNIVERSITY

GEORGE FOX UNIVERSITY

KLAMATH COMMUNITY COLLEGE DISTRICT

LANE COMMUNITY COLLEGE

LEWIS AND CLARK COLLEGE

LINFIELD COLLEGE

LINN-BENTON COMMUNITY COLLEGE

LOUISIANA COLLEGE, LA

LOUISIANA STATE UNIVERSITY

LOUISIANA STATE UNIVERSITY HEALTH SERVICES

MARYLHURST UNIVERSITY
MT. HOOD COMMUNITY COLLEGE

MULTNOMAH BIBLE COLLEGE

NATIONAL COLLEGE OF NATURAL MEDICINE

NORTHWEST CHRISTIAN COLLEGE

OREGON HEALTH AND SCIENCE UNIVERSITY

OREGON INSTITUTE OF TECHNOLOGY

OREGON STATE UNIVERSITY

OREGON UNIVERSITY SYSTEM

PACIFIC UNIVERSITY

PIONEER PACIFIC COLLEGE

PORTLAND COMMUNITY COLLEGE

PORTLAND STATE UNIVERSITY

REED COLLEGE

RESEARCH CORPORATION OF THE UNIVERSITY OF
HAWAII

ROGUE COMMUNITY COLLEGE

SOUTHEASTERN LOUISIANA UNIVERSITY

SOUTHERN OREGON UNIVERSITY (OREGON

UNIVERSITY SYSTEM)

SOUTHWESTERN OREGON COMMUNITY COLLEGE

TULANE UNIVERSITY

TILLAMOOK BAY COMMUNITY COLLEGE

UMPQUA COMMUNITY COLLEGE

UNIVERSITY OF HAWAII BOARD OF REGENTS

UNIVERSITY OF HAWAII-HONOLULU COMMUNITY

COLLEGE

UNIVERSITY OF OREGON-GRADUATE SCHOOL

UNIVERSITY OF PORTLAND

UNIVERSITY OF NEW ORLEANS

WESTERN OREGON UNIVERSITY

WESTERN STATES CHIROPRACTIC COLLEGE

WILLAMETTE UNIVERSITY

XAVIER UNIVERSITY

UTAH SYSTEM OF HIGHER EDUCATION, UT

UNIVERSITY OF UTAH, UT

UTAH STATE UNIVERSITY, UT

WEBER STATE UNIVERSITY, UT

SOUTHERN UTAH UNIVERSITY, UT

SNOW COLLEGE, UT

DIXIE STATE COLLEGE, UT

COLLEGE OF EASTERN UTAH, UT

UTAH VALLEY UNIVERSITY, UT

SALT LAKE COMMUNITY COLLEGE, UT

UTAH COLLEGE OF APPLIED TECHNOLOGY, UT
S

TATE AGENCIES
ADMIN. SERVICES OFFICE

BOARD OF MEDICAL EXAMINERS

HAWAII CHILD SUPPORT ENFORCEMENT AGENCY

HAWAII DEPARTMENT OF TRANSPORTATION

HAWAII HEALTH SYSTEMS CORPORATION

OFFICE OF MEDICAL ASSISTANCE PROGRAMS

OFFICE OF THE STATE TREASURER

OREGON BOARD OF ARCHITECTS

OREGON CHILD DEVELOPMENT COALITION

OREGON DEPARTMENT OF EDUCATION

OREGON DEPARTMENT OF FORESTRY

OREGON DEPT OF TRANSPORTATION
OREGON DEPT. OF EDUCATION

OREGON LOTTERY

OREGON OFFICE OF ENERGY

OREGON STATE BOARD OF NURSING

OREGON STATE DEPT OF CORRECTIONS

OREGON STATE POLICE

OREGON TOURISM COMMISSION

OREGON TRAVEL INFORMATION COUNCIL

SANTIAM CANYON COMMUNICATION CENTER
SEIU LOCAL 503, OPEU

SOH- JUDICIARY CONTRACTS AND PURCH

STATE DEPARTMENT OF DEFENSE, STATE OF
HAWAII

STATE OF HAWAII
STATE OF HAWAII, DEPT. OF EDUCATION

STATE OF LOUISIANA
STATE OF LOUISIANA DEPT. OF EDUCATION
STATE OF LOUISIANA, 26

TH JUDICIAL DISTRICT

ATTORNEY

STATE OF UTAH
�����������������
Noteworthy Projects
Frisbie Park
Rialto, CA
Unique equipment and bright colors make
this poured installation a destination for
community members.
�����������������
Noteworthy Projects
Shipwreck Park
Dana Point, CA
A highly designed, compliant surface using
colors that complemented the theme of a
ship on the ocean.
�����������������
Noteworthy Projects
Springs Reserve Butterfly Playground
Las Vegas, NV
Directly adjacent to an existing butterfly habitat, this project continued the butterfly theme through its
plant selection and hardscape elements
�����������������
Noteworthy Projects
Jeff Triplett Community Center
Sanford, FL
Complete sports theme park in Florida featuring
complex surface design and unique play equipment
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Noteworthy Projects
Blue Cross Blue Shield Healthy Place
Chattanooga, TN
Surfacing for an inclusive and equitable play space
in conjunction with community partner to build
healthy spaces for all
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Surfacing Regional Contact Map
Territory 1
Contact: Frank Horwath, Regional
Manager
510-260-9025 |
[email protected]

Territory 2
Contact: Vince Brantley, Regional
Manager
714-904-8219 |
[email protected]

Contact: David Purcell, Sales Manager
760-809-1875 |
[email protected]

Territory 3
Contact: Stephen Ross, Sales Manager
602-281-8833 |
[email protected]

Territory 4
Contact: Lisha Butler, Regional Manager
210-385-8261 |
[email protected]

Territory 5
Contact: Glenn Haab, Regional Manager
954-882-1366 | [email protected]

Territory 6
Contact: Karim Odeh, Regional Manager
931-265-6562 |
[email protected]

Territory 7
Contact: Aaron Henry, Sales Manager
901-417-0401 |
[email protected]

Fibar Sales - Nationwide
Rob Addis
847-220-0116 | [email protected]
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Surfacing Corporate Contacts
East Coast Operations
The Surfacing Group
6091 Seneca St. Bldg. A
Elma, NY 14059
West Coast Operations
The Surfacing Group
2140 E. Cedar Street
Tempe, AZ 85281
Office Locations:

PlayCore Corporate
544 Chestnut St
Chattanooga, TN 37402
Matt Brandon
Senior Vice President
and Group Manager
The Surfacing Group
Tom Discipio
Vice President
East Coast Operations
The Surfacing Group
Bill Stafford
General Manager
West Coast Operations
The Surfacing Group
Brad Graben
Director of Finance
The Surfacing Group
Lizette Figueroa
Director of HR
The Surfacing Group
Georgia Womack Tippens
Director of Marketing
The Surfacing Group
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Form W-9
(Rev. October 2018)
Department of the Treasury
Internal Revenue Service
Request for Taxpayer
Identification Number and Certification
a Go to www.irs.gov/FormW9 for instructions and the latest information.

Give Form to the
requester. Do not
send to the IRS.

Print or type.

See Specific Instructions on page 3.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes.

Individual/sole proprietor or
single-member LLC
C Corporation S Corporation Partnership Trust/estate
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) a Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner.

Other (see instructions) a
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 accounts maintained outside the U.S.)
5 Address (number, street, and apt. or suite no.) See instructions. 6 City, state, and ZIP code
Requester’s name and address (optional)
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.

Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.

Social security number
––
or
Employer identification number
–
Part II Certification
Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal 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. I am a U.S. citizen or other U.S. person (defined below); and

4. The FATCA code(s) 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 or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.

Sign
Here
Signature of
U.S. person a Date a
General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.

Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.

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 (ITIN), 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-DIV (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 TIN, you might be subject to backup withholding. See What is backup withholding, later.

Cat. No. 10231X Form W-9 (Rev. 10-2018)
Robertson Industries, Inc.
✔
5 2414 W 12th St, Ste 5
Tempe, AZ 85281
8 6 068663 5
nds, you are not required to sign the ce
ctions
01/02/2023
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Proposed Authorized Users:

Flexground -
2140 E Cedar St
Tempe, AZ 85281
(Provider of surfacing products and solutions mentioned within this solicitation)

Rubber Designs -
105 US-411
Ranger, GA 30734
(Provider of surfacing products and solutions mentioned within this solicitation)

Water Odyssey -
4600 Texas Hwy 123
San Marcos, TX 78666
(Provider of aquatic equipment mentioned within this solicitation)

Fibar –
80 Business Park Dr #300
Armonk, NY 10504
(Provider of surfacing products and solutions mentioned within this solicitation)

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American Recycling Center, Inc.
655 Wabassee Drive Owosso, MI 48867
Office: 989.725.5100 Fax: 989.725.5122

01/2023

Installer:

Current Status is in Good Standing

To Whom It May Concern:

American Recycling Center, Inc. is a material supplier to the safety surface industry. Since 1993 we have been a quality material supplier of the components for the installation of rubber surfaces, playgrounds & running track’s.

This letter should be used for educational purposes:

Recycled black rubber, this is to include ALL black raw material stock, is consistently mixed in holding cells as it is manufactured to ensure quality and consistency. Because of this it is understood that specific origination locations of the raw materials and /or type of recycled polymer percentages can only be implied.

American Recycling Center, Inc. does certify that directly or through a raw material vendor obtains recycled black rubber (includes SBR and/or SBR tires) Materials from Kansas.

If you have any additional questions, please feel free to contact me at any time.

Rochelle Hall Miller
American Recycling Center, Inc.
989.413-7602
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TAB 4 –

• Qualification and Experience
• References
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C) Qualification and Experience

i. Provide a brief history of the Offeror, including year it was established and corporate office location.

Robertson was founded in 1991 as a company that focused on the installation of pool decks for both commercial and residential applications. Years later, it has evolved, along side it’s partners, into the largest company in America that provides safety surfacing solutions for Playgrounds and outdoor spaces.

Robertson has included in its offerings a full suite of recreational safety surfacing options and has expanded its reach to cover a nationwide footprint. By growing capacity with regards to sales, installation, and customer service Robertson has cemented themselves as an industry leader in the play surfacing space.

Robertson Recreational Surfaces was the first surfacing company to join the Playcore family, which now includes 6 other surfacing companies. The partnership with Playcore has only helped to boost Robertson’s name and message to even more users that play on and are protected by its safe surfaces.

Robertson’s corporate head quarter is located in Tempe, AZ.

ii. Describe the Offeror’s reputation in the marketplace.

Robertson Recreational Surfaces and its partners are the largest surfacing operation in the United States. We have reached this size due to providing a quality product and customer service to all our users and customers. Our reputation is that of an industry leader who excels not only in terms of sales volume but also service and a commitment to do right by our customers. The growth of our reach has not altered our attention to detail and dedication to satisfying our customers. We continue to do outreach in the architectural world to provide cutting edge products for high design spaces and remain leaders in the world of specifications and details widely used in public solicitations across the country.

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iii. Describe the Offeror’s Reputation of products and services in the marketplace.

The reputation of Robertson product in the marketplace is evident in how commonly it is used as the driver of specifications in public bids. Schools, municipalities, architects and engineers continue to request Robertson’s surfacing products when building RFP’s across the country. Customers are satisfied not only with the product itself with the longevity of it and continue to request us as their recreational surfacing solutions.

Robertson’s commitment to excellent service can also be seen in our multi-year agreements entered with various cities and school districts. While some focus on new builds, others are contracts to maintain an uphold parks and school play spaces for years on end, trusting Robertson and our installers to continue keeping their spaces safe and aesthetically pleasing for the length of those contracts.

iv. Describe the Offeror’s experience and qualifications of key employees.

Robertson’s excellence comes from the experience and knowledge of our staff.

Across all divisions of Robertson – sales, manufacturing, installation, marketing, accounting, human resources, etc – you will find employees who have a passion for their job and a long history of performing it to a high standard.

Our key employees are industry experts with long term experience in the play and recreation market, with the most junior members of our leadership team boasting 5+ years of experience and our most senior 25+ years. The sharing of knowledge and experience is part of our culture as we move to build a team of people that can always serve as resources and subject matter experts to the customers who trust us with their projects.

The knowledge and experience does not stop with our leadership team. We consider every employee vital to our success and continue to make training and best practices a common theme in our organization. Robertson and our partners have made sure to always have employees certified to necessary safety regulatory boards as well as have participation in those boards as well, ensuring we remain with our finger to the pulse of all things recreational surfacing.

v. Describe the Offeror’s experience working with the government sector.

Given the nature of our products and services, the government sector makes up the vast majority our business. Most of our customers are school districts and �����������������
municipalities. We work with the government sector every day, communicating and collaborating continuously to meet their needs. While executing the multiple phases of a project (planning, purchasing, installing, maintaining) we work with government agencies, entities, and employees at every level – teachers, principals, superintendents, maintenance, public works, parks and recreation, administration, accounting, purchasing, and many more.

Our long-term history and daily experience working with the government sector is a driving force for our interest in being a part of cooperative purchasing agreements. We have seen through firsthand experience the tremendous value of a cooperative purchasing agreement to provide schools and cities with not only a quality, vetted, product, but also at a competitive market price.

vi. Describe past litigation, bankruptcy, reorganization, state investigations of entity or current officers and directors.

There are no instances of bankruptcy or investigation to report. Regarding reorganization, Robertson Recreational Surfaces joined the Playcore family in 2007 and is now one of 7 companies under the Playcore umbrella. Throughout the acquisitions of other surfacing entities as sister companies, Robertson has shifted and reorganized however we saw fit in order to always provide our customers with the best products and competitive prices. Whether it was incorporating new employees into our model, changing our sales and installation models, using new research and analysis, or adopting new products or ways to improve our current products, we have always been invested in learning and improvement.

vii. Provide a minimum of 5 customer references relating to the products and services within this RFP. Include entity name, contact name and title, contact phone and email, city, state, years serviced, description of services and annual volume.

References provided within this tab

viii. Provide any additional information relevant to this section

Additional documents attached

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Customer Reviews
“With the assistance of Robertson Surfacing, the Parks and Recreation Department assessed the condition of our poured in place installations and created a multi-year Maintenance/Renewal Program.  We are currently three years into the program and have used Robertson for reconditioning, repairs, replacement, as well as new installations.  Their work has consistently exceeded our expectations.  They are well organized and dependable besides being pleasure to work with.  We look forward to their continued support with all our safety surface needs.”
Robert Blankenship
Park Project Manager, Parks and Recreation Department of Mesquite, Texas "Robertson Surfacing’s dedicated management and professional sales team is always available and offer good, better, and best solutions that assist us in mitigating our unitary surfacing hazards. The install times are flexible and the turn around on orders is always met. Thank you for being the surfacing solution we can count on."
Nathan Frettoloso
Parks and Recreation, City of Irving
""Georgetown Parks and Recreation has been very impressed with the professionalism of Robertson Recreational Surfaces. Lisha has outstanding customer service and willing to work with us through the process. She is extremely knowledgeable about the products and provides answers to any question. The install crew proved to be very experienced and met our deadlines. We have used other installers and their quality of work was not up to Robertson standards. The City of Georgetown takes pride in the creating outdoor spaces for everyone to enjoy and Robertson Recreational Surfaces holds those same values. I highly recommend Robertson for your next project."
Jamie Beran
Park Superintendent, Georgetown, Texas
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Customer Reviews
"I have been with the school district for seven years and have established a good working relationship with Tot Turf on our playground surface repair needs. Anytime we have needed repairs performed on our artificial turf or PIP surfaces, Tot Turf has always responded in a reasonable time frame to investigate the problem, send a proposal and make the repair once approved to proceed. They have been highly reliable on all of our needs whether turf or PIP and have replaced a lot of our worn out Turf surfaces over these past seven years as well.

They are a reliable and responsive company to our playground surface safety needs and we will continue to use them in this new year and beyond." Ron Martin
Director of Maintenance, Martin County School District, Stuart, Florida "It is always a pleasure working with {our rep} at Robertson Tot Turf. He is always willing to listen to your needs and responds with professionalism and consideration. He is knowledgeable and diligent, turns over his quotes quickly and he gives a 110% effort to assure that his customers are satisfied from the start of the project to the end. Thanks for all that you do!"
Terri Barber
Northern California Playworks, Inc.
"{Our Rep} has been a very communicative representative for Tot turf throughout these years.

I’ve enjoyed his thorough feedback, short and precise information, and quick responses with such positive energy. In addition, when he was not available right at the time of our inquiry, he assigned his colleagues to contact us which was very helpful. He has also met with us at a playground reviewing the safety rubber condition after years of use and provided us with useful information to remediate the problem. He is one of the best representatives I have encountered so far."
Maya Nagasaka
Miller Company Landscape Architects, San Francisco, California �����������������
References / Projects of over $100,000
2022 - Municipalities and School Districts
City of Irvine – City Wide Playground Surfacing Contract Remove and replace existing playground surfacing with new IPEMA compliant PIP Surfacing October 2022 to June 30, 2023 - $990,000
Tay Chor (949) 724-7322 [email protected]
Clark County School District - District Wide Maintenance Contract Provide Tot Turf ReFresh Roll Coats on all PIP Playground Surfaces and make needed repairs – 240 Schools with 3 Pads each
February 2022 to June 30, 2023 - $2,300,000
Doug Diaz (702) 715-3148 [email protected]
San Bernardino City School District, District Wide PIP Surfacing contract – 12-9050 Furnish and install PIP surfacing for all schools throughout the district for 3 years.

February 2103 to 2017 - $2,895,000 over 3 years
Stan Thomas, (909) 388-6100 – [email protected] San Bernardino City School District, Maintenance Contract - 17-21872 Provide regular maintenance and repair services for all schools throughout the district for 5 years.

November 2107 to Current
San Bernardino City School District
Stan Thomas, (909) 388-6100
$3,000,000+ over 5 years
City of Newport Beach - Multi Park Renovation Project – 17-22340 Replace existing playground surfacing with new IPEMA compliant PIP and Synthetic Turf Surfacing, totaling 9,566 SF
December 2017 - $117,993
Kathryne Cho (949) 644-3014 – [email protected]
City of Eastvale – JCSD – Orchard & Huber Parks
Remove and replace existing playground surfacing with new IPEMA compliant PIP Surfacing 2022 - $267,093
Travis Viseth (951) 727-3524 – [email protected]
City of Garden Grove – Garden Grove Park
Furnish and install new PIP surfacing – Includes Rocket Ship Runway Design July 2022 - $101,500
Janet Pelayo (323) 253-6268 - [email protected]
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Statement of Qualifications
Robertson started in Arizona in 1991 and was a pioneer in recreational surfacing installations. It was the Americans with Disabilities Act (ADA) and the Consumer Product Safety Commission (CPSC) regulations that propelled us into the certified playground safety surfacing world to help provide the ultimate in accessibility while meeting all safety guidelines. We continue to install safer surfaces for commercial playgrounds and recreational spaces to this day. With a National Brand and reputation of being a leader in our industry, we have expanded our services to include aquatic, fitness, open trail and sport court surfacing as well. Our core values are centered around exceeding expectations in the industry and to our customers. Our commitment to our customers is that our products and services will meet or exceed ASTM and IPEMA certifications for safer recreational surfaces. Robertson also promises forthright customer support, credible installation services, and dependable maintenance solutions that will provide peace of mind before, during, and after our work is done.

Our Southern California Service Center employs over 24 Members making up 5 to 7 working crews per day, in addition, we have 2 crews in Northern CA, 2 in Arizona and 2 in Nevada that we can pull from to meet any deadline our customers challenge us with. The AVERAGE tenure of our employees is 9+ years, there experience and attention to detail, along with knowing the regulations, compliancy requirements and appropriate working environments, make Robertson the highest qualified team to trust your safety surfacing projects with. All crew members have also been fingerprinted and approved to work in the most sensitive environments.

Access to materials; PlayCore, our parent company, has been acquiring material manufactures and distributors over the last few years, assuring we will always have access to the highest quality of materials, best pricing and no delays.

PlayCore, and all entities carry the highest rated bonding capacity and insurance requirements. Financials are also available by request and appropriate NDA being signed.

All Surfacing Products are IPEMA Certified and
compliant to ASTM 1292 as well as all other safety
surfacing requirements.
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SECTION 32 18 16.13

PLAYGROUND RESILIENT SURFACING

TOTTURF POURED IN PLACE (PIP) TPV

PART 1 - GENERAL

1.01 WORK SCOPE

A. Furnish labor, material, and equipment necessary to install the poured -in-place, resilient surfacing system as shown on the drawings and specified herein.

a. Work shall include, but not be limited to the following: layout; excavation; backfill; furnishing and installing of base material; furnishing and installing of poured -in- place, resilient surfa cing and all other incidental work to provide a co mplete resilient surfacing system.

b. Poured in place playground surfacing shall consist of a polyurethane binder mixed with recycled rubber, which will make up the attenuation cushion layer. The attenuation cushion layer is capped with TPV granu les, mixed with a polyurethane binder creating the Wear Course.

c. Surfaces shall comply with ADA and CPSC guidelines as well as ASTM Standards. Manufacturer is to be certified by IPEMA, a third -party testing organization for playground surfaces and equipment.

1.02 PERFORMANCE REQUIREMENTS

A. Area Safety: Poured in place within playground use zones shall meet or exceed the performance requirements of the CPSC, ADA and Fall Height Test ASTM F1292 -18.

The surface must yie ld both a peak deceleration of no more than 200 G -max a nd a Head Injury Criteria (HIC) value of no more than 1,000 for a head -first fall from the highest accessible portion of play equipment being installed as shown on drawings.

IPEMA certification is required. (ASTM F1292-18, section 15 The laboratory test used to determine critical fall height shall have been conducted on surfacing material samples identical in design, materials, components, and thickness and manufactured as the installed playground surface).

B. Accessibility: NOTE: Children’s o utdoor play areas shall be in compliance with the Uniform Federal Accessibility Standards (UFAS) FED -STD-795 and the Architectural �����������������

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and Engineer Instructions (9AEI) Design Criteria.

C. The requirements of the Americans wit h Disabilities Act. Accessibility Guid elines (ADAAG) 28 CFR Part 36 that provide equal or greater accessibility than the requirements of UFAS must also be met in children’s outdoor play areas.

D. Poured in place surfaces intended to serve as accessible paths of travel for persons with disabilities shall be firm, stable and slip resistant, and shall meet the requirements of ASTM F 1951-14 and ASTM F1292-18.

1.03 APPLICABLE STANDARDS

A. ASTM International

B. ASTM D2047 - Standard test method for determining the s tatic coefficient of friction of ceram ic tile and other like surfaces by the horizontal dynamometer pull meter method. This standard replaces ASTM C1028.

C. ASTM D412 – Standard test methods for vulcanized rubber and thermoplastic rubbers and thermoplastic elastomers-tension.

D. ASTM D624 - Standard test method for tear strength of conventional vulcanized rubber and thermoplastic elastomers.

E. ASTM D2859 – Standard test method for flammability of finished textile floor covering materials.

F. ASTM E303 – Standard test method for measuring surfacing frictional properties using the British Pendulum tester.

G. ASTM F1292 -18 – Standard specification for impact attenuation of surface systems under and around playground equipment.

H. ASTM F1951 – Standard specification for de termination of accessibility of surface systems under and around playground equipment.

1.04 Poured in place surfaces shall be manufactured and installed by trained, experienced company employees or certified installers who have successfully completed the “Certified Installers Training Program” required by Robertson Industries Inc. �����������������

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1.05 SUBMITTALS: THE FOLLOWING SHALL BE SUBMITTED

A. The Contractor shall submit a complete set of the material submittals, as required, including manufacturer’s name and address , specific trade names, catalog and mo del numbers, illustrations and descriptive mate rial, and samples of the proposed material for this project clearly marked as to proposed items for approval by the Owner’s representative.

B. Products submitted as equal mu st include hard copies of manufactures written specifications, warranty, purchase and use of materials.

C. Manufacturer’s descriptive data and installation instructions.

D. Manufacturer’s details showing depths of wear course and sub -base materials, anchoring systems and edge details.

E. Upon reques t, a listing of a t least five installations where products similar to these proposed for use have been installed and have been in service for a minimum period of three years. The list shall include owner or purchaser, address of installation, date of installation, contact person, and phone number.

F. A signed statement by an authorized official certifying that the surfacing system meets the requirements of ASTM F1292 -18, section 15 for a head -first fall from the highest accessible portion of the specified playground equipment.

G. A signed s tatement from the manufacturer of the poured in place surfacing attesting that all materials under this section shall be installed only by the Manufacturer’s Trained Installers.

H. A Certificate of Insurance shall be provided by the Manufacturer for poured in place surfacing for use as playground safety surfacing, covering general and product liability, of not less than $1,000,000 for each occurrence, $2,000,000 general aggregate, with an excess/umbrella liability of $25,000,000. The issuing underwrite shall be AA rated.

I. IPEMA Certification mandatory

1.06 Delivery, Storage and Handling: Materials and equipment shall be delivered and stored in accordance with the manufacturer’s recommendations.
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1.07 Project Site Conditions: Pour ed in Place surfacing must be installed on a dry sub - surface, with no prospect of rain within the initial drying period, and within the recommend temperature range of the manufacturer. Installation in weather condition of extreme heat, cold (less than 55°F ), and/or high humidity may affect cure time, and the structural integrity of the final product. Immediate surrounding sites must be reasonably free of dust conditions or this could affect the final surface look.

1.08 Sequencing and Scheduling: Poured in Place surfac ing s hall be installed after all playground equipment, shade structures, signs and any other items that will be within the surfacing area. Coordinate with General Contractor.

1.09 Surface installation coordinated by manufacturer representative.

1.10 Warranty: Poured in Place surface shall maintain required impact attenuation characteristics and be guaranteed against defects in workmanship AND material for a limited five-year period or as specified and agreed upon per alternate contract. Warranty will be specific to maintenance requirements and performance standards of completed product. Warranty is void if not installed by Manufacturers Trained and Certified Poured in Place Surfacing Installers.

1.11 Testing: NOTE: Critical Fall Height Fou r feet t hrough 1 0 feet have been tested in accordance with Section 15 – Critical Fall Height Test Procedure of ASTM F1292-18.

PART 2 – PRODUCTS

2.01 Safety surfacing shall consist of both recycled and synthetic m aterials meeting the requirements of t his specification. The type of safety surfacing shall be Robertson Industries Inc., manufactured and installed by Robertson Industries Inc., or it’s Certified Installers. Telephone: (800) 858-0519.

2.02 PRODUCT SCOPE

A. Poured in Place Surface: The poured i n place surf ace shall consist of recycled rubber mixed with a polyurethane binder, then capped with TPV granules mixed with an aliphatic binder or aromatic binder.

B. It shall consist of a uniform material manufactured i n such a way that the top portion meets the requirements specified herein for wear surface. �����������������

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C. The type of safety surfacing shall be a poured-in-place system and shall be indicated on the drawings.

2.03 ATTENUATION CUSHION LAYER SECTION

A. Impact attenuation cushion layer consists of these materials; recycled styrene butadiene rubber (SBR) and/or cryogenic crumb rubber and/or pre consumer postindustrial reclaimed scrap rubber adhered with a 100% solids polyurethane binder to form a resilient porous material.

B. Strands of SBR may vary from 0.5 mm – 2.0 mm in th ickness by 3.0 mm – 20 mm in length.

C. Chunk Premium Black Rubber Granules are 5/8” granules: This rubber is pre -consumer, post-industrial, reclaimed rubber, granulated through a 5/8” screen and contains less than 2% dust.

D. SBR Crumb Rubber (5-9 Mesh) using sieve analysis ASTM D5644 with a fiber content of .1% or less mixed in.

E. Binder shall be between 7-12% of the total weight of the material and shall provide 100 % coating of the particles.

F. The attenuation cushion layer shall be compatible w ith the wear c ourse and must meet requirements herein for impact attenuation.

2.04 WEAR COURSE

A. Wear course shall consist Thermal Plastic Vulcanized (TPV) granules with polyurethane binder formulated to pro duce an eve n, uniform, seamless surface.

Installation of surfacing shall be seamless (unless otherwise agreed upon by owner).

B. TPV shall be peroxide cured with an TPV content of 26% and shall include a processing aid to prevent hardness with 26% poly content to maintain dynamic testing characteristics, weatherization and UV stability.

C. ASTM D2240 (Shore A) hardness of 55 -65, not less than 26 percent rubber �����������������

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hydrocarbons.

D. Size of TPV granules shall be 1 -4mm across OR .5 -1.5mm across. Binder shall be not less than 20% o f total weight of rubber used in the wear surface and shall provide 100% coating of the particles.

E. Thickness of wear course shall be a minimum .5” (12.7 mm).

F. The wear course shall be porous.

2.05 BINDER

A. No Toluene Diphenyl Isocyanate (TDI) shall be used.

B. No filler materials shall be use d in urethane such as plasticizers and the catalyzing agent shall contain no heavy metals.

C. Weight of polyurethane shall be no less than 8.5 lbs. /gal (1.02 Kg/1) and no more than

9.5 lbs. /gal (1.14 Kg/1).

D. Manufacturer is permitted to modify the type of u rethane requir ed to match extreme weather conditions. Substitutions must be equal to or exceed original quality.

2.06 TOT TURF ADVANTAGE INSERTS

A. Insert – Thermal Plastic Vulcanized (TPV) angular granules with a (Shore A) hardness of 65° A ± 5 and particle size between .5-1.5 mm shall be used.

B. Thickness of the Insert shall be .5”

C. Insert shall be porous.

D. Aromatic or aliphatic urethane to be used as a binder.

E. Location –Insert to be installed under swings, swing bays, slide exits (unless otherwise noted in drawings). Customer to approve location of wear mat inserts. �����������������

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©2020 Robertson Recreational Surfaces, A PlayCore Company. 800-858-0519 www.totturf.com All rights reserved. All information contained is subject to change without notice. 7

F. Standard Color .5 -1.5mm to be used. Colors include four standard colors: Terra Cotta Red, Blue, Green, and Beige.

G. Size: Swing bay use locations shall hav e Inserts inclusive of all outside b ay structure poles. Singular swings and slide exits shall be 4’x4’x.5” in thickness.

2.07 MATERIALS

A. Wear Course – TPV Granules
Manufacturers: Rosehill Polymers
As Distributed by: Robertson Industries Inc. (800) 858-0519 Location Used: Playground Area

B. Attenuation cushion layer – Robertson Industries Inc. Shredded and/or Chunk Rubber
As Distributed by: Robertson Industries Inc. (800) 858-0519 Location Used: Playground Area
C. Binder – Aromatic VORAMER MR Products
Manufacturer: DOW Chemical
As Distributed by: Robertson Industries Inc. (800) 858-0519 Location Used: Playground Area

D. Binder – Aromatic Urethane Stobielast® S 1020
Manufacturer: Stockmeier Urethanes, USA, Inc.

As Distributed by: Robertson Industries, Inc. (800) 858-0519 Location Used: Playground Area
E. Binder – Aliphatic Urethane Premium, Non-Ambering
Manufacturer: Accella Polyurethane Systems
As Distributed by: Robertson Industries Inc. (800) 858-0519 Location Used: Playground Area

F. Chunk Premium Black Rubber Granules
Manufacturer: American Recycling Center, Inc. (989) 725-5100 655 Wabassee Drive
Owosso, MI 48867
As Distributed by: Robertson Industries Inc. (800) 858-0519 Location Used: Playground Area

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09/2020

©2020 Robertson Recreational Surfaces, A PlayCore Company. 800-858-0519 www.totturf.com All rights reserved. All information contained is subject to change without notice. 8

PART 3 – EXECUTION

3.01 SITE PREPARATION

A. Finished Grade/Slope: Verify that finished elevations or adjacent areas are as indicated on the architectural or site plans, that the appropriate sub -grade elevation has been established for the safety surface to be installed, and th at the subsurface has b een installed per architectural, site or equipment plans while meeting accessibility and use zones requirements.

B. Aggregate Sub Base: Tolerance of aggregate sub -base shall be within .5” in depth.

Verify that aggregate sub -base has be en fully compacted. Per ADA Guidelines:
compacted Aggregate sub-base – 4” of .75” minus irregular stone with fines compacted to 95% in 2” watered lifts.

C. Concrete Sub-Base: Tolerance of concrete or bituminous sub -base shall be with .125” (3.0 mm) in 10’ (3 050 mm). Per ADA Guidel ines: Concrete a minimum of 3’ – 4’ at a minimum 2500 PSI. Concrete must cure for 7 days prior to application of attenuation cushion layer. Concrete must cure 21 days if wear course is to be applied directly to concrete surface. If p oured in place surfacin g is installed, v erify that the concrete sub - base has cured (all areas appear white in color usually at 7 days) and that all concrete curing compounds and other deleterious substances that might adversely affect adhesion have been removed. Surface shall be clean and dry.

D. Asphalt Sub -Base: Asphalt cure time requires 21 -28 days. Once the new asphalt has cured, it must be pressure washed prior to the surfacing being installed. The contractor shall be responsible for flooding the pad to ensure proper slope an d tolerance. Any areas holding enough water to cover a flat nickel shall be patched prior to the arrival of our installation crews.

E. Drainage: Verify that sub -surfacing drainage, if required, has been installed to provide positive drainage.

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09/2020

©2020 Robertson Recreational Surfaces, A PlayCore Company. 800-858-0519 www.totturf.com All rights reserved. All information contained is subject to change without notice. 9

3.02 INSTALLATION

A. Poured in Place Surfacing: Components of the poured in place surfacing shall be mixed on site in a rotating tumbler to ensure components are thoroughly mixed and are in accordance with manufactures recommendations. Installati on of surfacing s hall be seamless up t o 2,000 squa re feet per day. Material shall cover all foundations and fill around all elements penetrating the surface.

B. Attenuation Cushion Layer: Whenever practical, attenuation cushion layer of surfacing material sh all be installed in one continuous pou r on the sam e day of up to 2,000 square feet. When a second pour is required, step the seam (see detail) and fully coat the step of the previous work with polyurethane binder to ensure 100% bond with new work. Apply adhesive in small q uantities so that new attenuation cushion layer can be placed before the adhesive dries.

C. Wear Course: Wear course must be quality peroxide cured TPV granules. wear surface shall be bonded to attenuation cushion layer. If necessary, additi onal primer will be used between the a ttenuation c ushion layer and wear course. Apply adhesive to attenuation cushion layer in small quantities allowing the wear course to be applied before adhesive dries. Surface shall be hand troweled to a smooth, even f inish. Expect continuous and seamless up to 2,000 square feet per day (contact sales representative for seamless in excess of 2,000 square feet). Where seams are required due to color change, size or adverse weather, a step configuration will be constructe d to maintain wear course integrity. The edge of initial pour shall be coated with adhesive and wearing surface mixture shall be immediately applied. Pads with multiple seams are encouraged to include a top coat of urethane before being placed into use. B utt joint seams are not acceptable except for repairs. Under special conditions and with Owners written approval seams may be permitted in same color pad. Consult with Manufacturer for specific applications.

D. Perimeter: For installations over existing conc rete, the perimeter shall be saw cut t o provide a keyway 1” deep x 1” wide, or formed during the pour, with surfacing rolled down into the void. Primer adhesive must be applied to all sides of the void. When connecting to a concrete curb or border, the ins ide vertical edge shall be primed with adhesive and the final 2” of the attenuation cushion layer shall be tapered to allow the wear surface material to be 1.5”– 2” thick where it joins the concrete.

E. Asphalt: When installing over new asphalt, a curb or oth er type of border is recommended aroun d the entire pad to separate the new surface from other ground materials. Primer adhesive must be applied to the inside vertical edge of the border before poured in place surface installation.
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©2020 Robertson Recreational Surfaces, A PlayCore Company. 800-858-0519 www.totturf.com All rights reserved. All information contained is subject to change without notice. 10

F. Asphalt: When installing over existing asphalt, a key way cut of 1” deep by 1” side for the poured in place to taper into and terminate with required ADA slope.

G. Thickness: Construction methods such as the use of measured screeds or guides shall be employed to ensure that the ful l depth of specified surfacing materia l is install ed.

Surfacing system thickness throughout the playground equipment use zone shall be as required to meet the impact attenuation requirements specified herein.

H. Clean Up: Manufacturer installers shall work t o m inimize excessive adhesive on adjacent surfaces or play equipment. Spills of excess adhesive shall be promptly cleaned.

I. Protection: The safety surface shall be allowed to fully cure in accordance with Manufacturer’s instructions. The surface shall be protected by the owner from all traffic during the curing period of at a minimum of 48 hours or as instructed by the Manufacturer.

J. Manufacturer Services: For poured in place safety surfacing, a Manufacturer’s representative who is experienced in the insta llation of playground safety surfacing shall be pr ovided. The representative shall supervise the installation to ensure that the system meets the impact attenuation requirements as specified herein.

3.03 SITE AREA CLEAN UP

The site shall be kept clean and free of tools, trash, and debris and installation materials daily. Products may be stored on site during installation with appropriate protective measures and approval by the Owner’s representative.

END OF DOCUMENT

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TAB 5 –
• Value Add
�����������������
d) Value Add
i. Provide any additional information related to products and services Offeror proposes to enhance and add value to the Contract.

Robertson Recreational Surfaces is committed to continuous innovation and improvement of our products and services. We are not satisfied with being the industry leader in play surfacing today, we aim to continue to be in perpetuity. We have detailed in this proposal the value we will bring from a sales and operational capacity, so now we would like to expand on some other benefits of partnering with Robertson and the sister companies we work in conjunction with to bring the best value to our customer base.

We have made vertical integration a strategy at Robertson and our surfacing group a t large to being the value of a streamlined product to all we do business with. By controlling aspects of raw material sourcing as well as installation of products we are able to provide an added layer of quality control to all of the projects we manage. As an added benefit, when appropriate, we have the capability to influence portions of our supply chain to meet deadlines and other needs of customers to a greater extent than an operation that relies on outside channels to function.

The value of an expansive operation does not stop at logistics alone, but also positions us to be a full-service provider, offering a full suite of products and services to serve the recreational surfacing market, as well as other products we are proposing within this solicitation. We provide vast options of surfacing types for play surfacing, including poured-in- place rubber, interlocking tiles, artificial turf, bonded rubber, engineered wood fiber, and rubberized mulch. Outside of these “traditional” options, our ancillary products also serve a number of other customer needs with regards to surfacing including aquatic surfacing options for splash pads and water play areas (as well as equipment for these areas), tennis, pickleball, and basketball resurfacing products, game tiles, and more.

In order to provide the highest quality solutions to any of our customers we are very careful to source high quality raw materials and combine them with quality installation labor to ensure top notch performance. With respect to poured-in-place rubber (the most commonly sold product outside of engineered woof fiber), we elected to install Gezolan EPDM and Rosehill TPV as our wear course rubber as we found these were industry leading raw materials. �����������������
A higher polymer content, better color retention under UV testing, and sole sourcing are a few of the benefits of these rubber options. We also work closely with urethane manufacturers to offer the ideal urethane options given
each project's conditions (humidity, temperature, etc.). This ensures proper curing and longevity of the installed product. Our installation crews are all either employees of Robertson or certified sub-contractors, meaning we have vetted their work prior to assigning them to our projects and to represent our company in the field.

Considering that play is at the heart of what we do, providing safe and compliant products and services is of paramount importance at Robertson. We are not content with just being compliant to regulatory boards, but aim for an Above Compliance position, which is a commitment of all of the companies within our parent company’s umbrella. Our products are certified to IPEMA (International Playground Equipment Manufacturer’s Association), as well as ASTM (American Society of Testing and Materials) and ADA (Americans with Disabilities Act). In the past and present, members of our organization have sat in boards and been members of a few of the aforementioned regulatory agencies, showing our commitment to keep our finger on the pulse of safe, responsible play products.

Outside of sales and installation, we also offer extensive warranty and maintenance programs. We want to ensure our users continue to enjoy a quality product as long as possible.

In this section we have included some maintenance guides and service instructions on how to properly manage our installations for maximum longevity.

Please refer to additional documents in this section about the additional values we bring.

�����������������
15+ employee crews plus partnerships with the best
install contractors all over the nation - average tenured crew is 7 years
Innovators in the surfacing industry with install
techniques and product solutions
We are part of a larger group of surfacing providers that are vertically integrated - we supply and service
Best practices experts who strive on education and
continued learning for better and safer community play
and recreation.

We are a recreational and playground safety surfacing
company - IT'S ALL WE DO!
Why
Robertson
Stability with resources
across the US
Full Service Provider from
product to install to
maintenance and repairs
�����������������
Robertson's Added Value
Specifications
Thermal Plastic Vulcanized (TPV) angular
granules with a (Shore A) hardness of 65° A ±
5 and particle size between .5 – 1.5 mm
Thickness: 1/2 – 5/8 inch
Binder: Aromatic or aliphatic urethane
Location: TPV Insert to be installed under
swings, swing bays, slide exits. Customer to
approve location of wear mat inserts
Color: Terra Cotta Red, Blue, Green, or Beige
(Additional colors and shapes available at an
additional cost)
Size: Slide exits are approximately 4’ x 4’.

Swings will be 4’ deep and will cover swing
bay area (insert size specifications may vary
pending equipment)
www.roberstonsurfaces.com
Stepped seams:

High quality seams
provide 50% more
joined surface area
than competitors’
seams to separation

SUPREME ADVANTAGE INSERTS
installed with smaller supreme granules
allowing for increased bonding capacity
providing a strong, more durable wear
course
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Robertson's Added Value
Color & Design Options
100% Black
Black with less than 50% of other colors
50% Black with Standard colors
25% Black with Standard colors
100% Standard EPDM colors Aromatic
100% Standard EPDM colors Aliphatic
100% Standard TPV colors Aromatic
100% Standard TPV colors Aliphatic
100% Premium EPDM colors Aromatic
100% Premium EPDM colors Aliphatic
100% Premium TPV colors Aromatic
100% Premium TPV colors Aliphatic
Supreme TPV Aliphatic
Basic Wave Patterns
Detailed Wave Patterns
Basic Design Elements
Detailed Design Elements
Custom / Vertical
COLORS:

DESIGN:
50/50 Standard and Black
100% Standard EPDM Aromatic
with Basic Wave Patterns
100% Premium TPV Aliphatic with Extensive
Patterns & Detailed Design
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Our Vendor Partners
Exclusive North American Suppliers for
Quality Playground Surfacing Granules
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About TPV Premium Rubber
Traditional rubber safety surfaces in the past were installed using EPDM (ethylene propylene diene monomer). EPDM is a common generic term that is used for colored rubber. Depending on the manufacture at the time, including those manufactures that are no longer in business today. There was a wide range of products in the market place that ranged from top quality (produced in a plant with rigid quality standards), to those that made a product that were labeled “Just good enough”. These sub standard products had numerous failures, color lot issues, and even pigment releasing. In addition to that, some EPDM rubber granules were often formulated with sulphur, clay fillers, plasticizers and heavy metals such as Zinc. Polymer content had been reduced to as low as to include only 16% of its actual name sake EPDM (ethylene propylene diene monomer).

American Recycling Center, Inc (our supplier) with a synergy from Rosehill Polymers in the UK has made some strategic decisions to change the quality of colored rubber offerings in North America and to utilize the advancements in technology to do so. And because of that today you will see installs of Rosehill TPV around the globe with such high profile projects listed to it’s credit at the Olympics in London, Russia and Brazil.

This advancement of premium colored rubber has been branded Rosehill TPV. Starting off with no less that 22-24 % polymer, this polymer is essentially a cousin to EPDM in the elastomer arena, and the technology allowed it to fill the quality gap that was missing in safety surface materials. The Rosehill TPV elastomers are the high-performance elastomers that combine the best attributes of vulcanized rubber – such as flexibility and low compression set – with the processing ease of thermoplastics. This process is the solution to the color range issues that have always been an ongoing issue with traditional generic brands EPDM’s.

When comparing colored rubber in the safety surface industry, make sure to clarify the source of their materials. Currently there is only one Rosehill TPV brand that is proprietary and has been tested and proven by top installers of running tracks and playgrounds alike. �����������������
AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

SAFETY DATA SHEET
03/29/2021
Rosehill TPV Colored Rubber Granules ( Virgin Material NOT RECYCLED )

SECTION 1: IDENTIFICATION OF THE SUBSTANCE/MIXTURE AND OF THE COMPANY/UNDERTAKING Product identifier
Product name: Rosehill TPV
Product Weight: 55 lb bags

Details of the supplier of the safety data sheet
Supplier: American Recycling Center, Inc.
655 Wabassee Drive
Owosso, MI 48867

Emergency telephone number
24-Hour Emergency Phone number: 800-424-9300
Customer Information Center: 989-725-5100

SECTION 2: HAZARDS IDENTIFICATION
Classification of the substance or mixture
Not regarded as a health or environmental hazard under current legislation.

Environment: The product is not expected to be hazardous to the environment.

Human Health: No specific hazards.

SECTION 3: COMPOSITION/INFORMATION ON INGREDIENTS
Mixtures
Composition Comments: Does not contain any harmful or hazardous ingredients.

SECTION 4: FIRST AID MEASURES
Description of first aid measures
General information: No recommendation given.

After inhalation: Not relevant
After skin contact: Not relevant.

After eye contact: Dust in the eyes: Do not rub eye.

After swallowing: Not relevant.

Information for doctor: Treat symptomatically

SECTION 5: FIREFIGHTING MEASURES
Extinguishing media
Suitable extinguishing agents:

Larger fires: Alcohol resistant foam, water spray, fog or mist. Small fires: water spray, dry powder or carbon dioxide, dry chemicals, sand, dolomite, etc.

Special hazards arising from the substance or mixture
Not classified as flammable but will burn. Carbon Monoxide may be evolved if incomplete combustion occurs.

Advice for firefighters
Protective equipment:

Self-contained breathing apparatus and full protective clothing must be worn in case of fire.

SECTION 6: ACCIDENTAL RELEASE MEASURES
Personal precautions, protective equipment and emergency procedures Personal Precautions:

For personal protection, see Section 8.

Environmental Precautions:

Not regarded as dangerous to the environment.

Additional information:

Not relevant.
�����������������
AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

SECTION 7: HANDLING AND STORAGE
Usage Precautions:

No specific usage precautions noted.

Usage Description:

No special requirements.

Storage Precautions:

Store in closed original container in a dry place.

SECTION 8: EXPOSURE CONTROLS/PERSONAL PROTECTION
Exposure Limits
None established
Personal Protection
Protective Equipment:

Gloves

Engineering Measures
Not relevant.

Respiratory Equipment
Not relevant.

Hand Protection
For prolonged or repeated skin contact use suitable protective gloves.

Eye Protection
Eye protection may be necessary depending on use.

Other Protection:

Not relevant.

SECTION 9: PHYSICAL AND CHEMICAL PROPERTIES
Appearance
Physical State Granular
Color Various colors
Odor Odorless
Solubility in water Insoluble in water
(by weight)
Relative Density 0.20
Bulk Density 1.55kg/l
Viscosity Solid 25
Flash Point >200 Celsius (392 Fahrenheit)

Particle Size (Micron) 500-5000

SECTION 10: STABILITY AND REACTIVITY
Stability
Stable under normal temperature conditions and recommended use.

Chemical stability:

Stable under recommended storage conditions. See Storage, Section 7.

Conditions to Avoid:

None known.

Hazardous Polymerization:

Not relevant
Materials to Avoid:

No incompatible groups noted.

SECTION 11: TOXICOLOGICAL INFORMATION
Skin Contact:

No specific health warnings noted.

Eye Contact:
�����������������
AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

No specific health warnings noted.

Health Warnings
No specific health warnings noted.

SECTION 12: ECOLOGICAL INFORMATION
Toxicity
Not regarded as dangerous for the environment.

Mobility
Not relevant, due to the form of the product.

Bioaccumulation
The product is not bio accumulating.

Degradability
The product is not readily biodegradable.

Fish Acute & Prolonged Toxicity
Not considered toxic to fish.

SECTION 13: DISPOSAL CONSIDERATIONS
Disposal Methods
Incinerate in suitable combustion chamber, or dispose of on site landfill area.

SECTION 14: TRANSPORT INFORMATION
General:

The product is not covered by international regulation on the transport of dangerous goods (IMDG, IATA, ADR/RID). No transport warning sign required.

Road Transport Notes:

Not classified
Rail Transport Notes:

Not classified
Sea Transport Notes:

Not classified
Air Transport Notes:

Not classified

SECTION 15: REGULATORY INFORMATION
Risk Phrases NC Not Classified
Safety Phrases NC Not Classified

SECTION 16: OTHER INFORMATION

California Prop. 65
This product does not contain any chemicals known to State of California to cause cancer, birth defects, or any other reproductive harm.

This information is based on our present knowledge. However, this shall not constitute a guarantee for any Specific product features and shall not establish a legally valid contractual relationship.

American Recycling Center urges each customer or recipient of this SDS to study it carefully and consult appropriate expertise, as necessary or appropriate, to become aware of and understand the data contained in this SDS and any hazards associated with the product. The information herein is provided in good faith and believed to be accurate as of the effective date of the SDS. However, no warranty, expressed or implied, is given. Regulatory requirements are subject to change and may differ between various locations.

It is the buyer’s/user’s responsibility to ensure that its activities comply with all applicable federal, state, provincial and local laws. The information presented here pertains only to the product as shipped. Since conditions for use of the product are not under the control of American Recycling Center, it is the buyer’s/user’s duty to determine the conditions necessary for the safe use of this product.

�����������������
AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

This information is not intended to convey all specific regulatory or operational requirements/information relating to this product. Additional transportation system information can be obtained through an authorized sales or customer service representative. It is the responsibility of the transporting organization to follow all applicable laws, regulations and rules relating to the transportation of the material.

Due to the proliferation of sources for information such as manufacturer-specific SDSs, American Recycling Center, Inc. is not and cannot be responsible for SDSs obtained from any source other than American Recycling Center, Inc. If you have obtained an American Recycling Center, Inc SDS from a non American Recycling Center, Inc. source or if you are not sure that the SDS is current, please contact American Recycling Center, Inc. for the most current version.

Contact: Customer Service 989 -725 -5100

The information herein is to assist customers in determining whether our products are suitable for their applications. Our products are intended for sale to industrial and commercial customers. We request that customers inspect and test our products before use and satisfy themselves as to contents and suitability. We warrant that our products will meet our written specifications. Nothing herein shall constitute and other warranty express or implied, including any warranty of merchantability or fitness, nor is protection from any law or patent to be inferred. All patent rights are reserved. The exclusive remedy for all proven claims is replacement of our materials and in no event shall we be liable for special, incidental or consequential damages.

American Recycling Center, Inc
655 Wabassee Drive, Owosso, MI 48867
(989) 725-5100 www.americanrecycling.com
�����������������
AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

SAFETY DATA SHEET
This form may be used to comply with OSHA’s Hazard Communication Standard, 29 CFR 1910.1200 and WHMIS Canadian Legislation. 03/29/2021
Premium Recycled Rubber Granules ( 5/8, ½ , 1-5mm, 1-4mm, 1-3.5mm, 1.3mm, .5-2mm )

SECTION 1: IDENTIFICATION OF THE SUBSTANCE/MIXTURE AND OF THE COMPANY/UNDERTAKING

Product Identifier
Product Name: 5/8 Chunk Premium Black Rubber Granules Chemical Family: Polymeric (fully processed) Cured.

Specific Materials: EPDM, SBR (high quality virgin industrial polymers) Pre consumer Post industrial Reclaimed Scrap Rubber

Product Weight: 50 lb bags

Details of the supplier of the safety data sheet:

Supplier: American Recycling Center, Inc.
655 Wabassee Drive
Owosso, MI 48867

Emergency Telephone Number
24-Hour Emergency Phone number: 800-424-9300
Customer Information Center: 989-725-5100

SECTION 2: HAZARDS IDENTIFICATION
Non-Hazardous as defined by OSHA Hazard Communication Standard CFR Title 29 Part 1910.1200 and the WHMIS Canadian Legislation.

SECTION 3: COMPOSITION/INFORMATION ON INGREDIENTS
Specific Gravity (H20 = 1): 1.15 – 1.20
Solubility in water: Insoluble
Appearance & Odor: Granular, Black – Mild Characteristic Odor % of Volatiles by volume: None

SECTION 4: FIRST AID MEASURES
Inhalation: Not Relevant
Eye Contact: Avoid Dust in Eyes, Do Not Rub eye.

Effects of Ingestion: None expected. Treat Symptomatically First Aid Procedures: Not expected to require First Aid

SECTION 5: FIREFIGHTING MEASURES
Extinguisher Media:

Standard fire extinguisher, water, CO2 Foam, Water fog, Water spray, Protein type air foam, Dry Chemical.

Special Fire Fighting Procedures:

Regular procedures for rubber fires.

Wear self-contained breathing apparatus.

Treat as a hydrocarbon fire.

Unusual Fire & Explosion Hazards:

NONE

SECTION 6: ACCIDENTAL RELEASE MEASURES
Not Relevant
No special procedures necessary.

Waste disposal method:

Sweep, vacuum into disposal containers
Dispose of according to Federal, State, and local regulations

SECTION 7: HANDLING AND STORAGE
�����������������
AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

Ventilation: Local exhaust
Eye Protection: Safety glasses
Precautions in handling:

Personal hygiene: frequent washing with soap and water of exposed areas, remove and clean solid clothing.

Precautions in storage: Normal material storage

SECTION 8: EXPOSURE CONTROLS/PERSONAL PROTECTION
Protective Equipment
Hand Protection

For prolonged or repeated skin contact use suitable protective gloves Use eye protection when necessary depending on use

SECTION 9: PHYSICAL AND CHEMICAL PROPERTIES
Appearance
Appearance Granular
Color black
Odor Odorless.

Solubility Insoluble in water

SECTION 10: STABILITY AND REACTIVITY
Stable under normal temperature conditions and its designed use Conditions to avoid: Do not heat above ambient temperature. Do not store near flame or ignition source.

Hazardous Polymerization: Will not occur

SECTION 11: TOXICOLOGICAL INFORMATION
Skin contact No specific health warnings noted.

Eye contact No specific health warnings noted.

Health Warnings No specific health warnings noted.

SECTION 12: ECOLOGICAL INFORMATION
Eco toxicity: Not regarded as dangerous for the environment Not regarded to be toxic to fish
Degradability The product is not biodegradable

SECTION 13: DISPOSAL CONSIDERATIONS
Dispose of in accordance with Local, State, and Federal Regulations Dispose of at authorized landfill

SECTION 14: TRANSPORT INFORMATION
No transport warning sign required

SECTION 15: REGULATORY INFORMATION
Not Relevant

SECTION 16: OTHER INFORMATION
CALIFORNIA PROPOSITION 65:

SAFE DRINKING WATER AND TOXIC ENFORCEMENT ACT: TITLE 22 CALIFORNIA CODE OF REGULATIONS: California Proposition 65 provides for labeling and disclosure of the presence of a chemical(s) known to the State of California to cause cancer or reproductive toxicity. This product does contain carbon black that is bound in the rubber, therefore if used as designed it is not found to be listed as an airborne, unbound particle.

This information is based on our present knowledge. However, this shall not constitute a guarantee for any Specific product features and shall not establish a legally valid contractual relationship.

American Recycling Center urges each customer or recipient of this SDS to study it carefully and consult appropriate expertise, as necessary or appropriate, to become aware of and understand the data contained in this SDS and any hazards associated with the product. The information herein is provided in good faith and believed to be accurate as of the effective date of the SDS. However, no warranty, expressed or �����������������
AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

implied, is given. Regulatory requirements are subject to change and may differ between various locations.

It is the buyer’s/user’s responsibility to ensure that its activities comply with all applicable federal, state, provincial and local laws. The information presented here pertains only to the product as shipped. Since conditions for use of the product are not under the control of American Recycling Center, it is the buyer’s/user’s duty to determine the conditions necessary for the safe use of this product.

This information is not intended to convey all specific regulatory or operational requirements/information relating to this product.

Additional transportation system information can be obtained through an authorized sales or customer service representative. It is the responsibility of the transporting organization to follow all applicable laws, regulations and rules relating to the transportation of the material.

Due to the proliferation of sources for information such as manufacturer-specific SDSs, American Recycling Center, Inc. is not and cannot be responsible for SDSs obtained from any source other than American Recycling Center, Inc. If you have obtained an American Recycling Center, Inc SDS from a non American Recycling Center, Inc. source or if you are not sure that the SDS is current, please contact American Recycling Center, Inc. for the most current version.

Department issuing M(M)SDS: EH&S Delivery
Contact: Customer Service 989-725-5100

The information herein is to assist customers in determining whether our products are suitable for their applications. Our products are intended for sale to industrial and commercial customers. We request that customers inspect and test our products before use and satisfy themselves as to contents and suitability. We warrant that our products will meet our written specifications. Nothing herein shall constitute and other warranty express or implied, including any warranty of merchantability or fitness, nor is protection from any law or patent to be inferred. All patent rights are reserved. The exclusive remedy for all proven claims is replacement of our materials and in no event shall we be liable for special, incidental or consequential damages.

American Recycling Center, Inc
655 Wabassee Drive, Owosso, MI 48867
(989) 725-5100 www.americanrecycling.com
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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

SAFETY DATA SHEET
03/29/2021
PremARC® 60-80 Urethane Binder ( Aromatic )

SECTION 1: IDENTIFICATION OF THE SUBSTANCE/MIXTURE AND OF THE COMPANY/UNDERTAKING Product identifier:

Product Name: PremARC ® 60-80 Urethane Binder
Material Type: Isocyanate
Product Material Weight: 45 lbs Pail / 475 lbs Drums

Details of the supplier of the safety data sheet
Supplier: American Recycling Center, Inc.
655 Wabassee Drive
Owosso, MI 48867

Emergency telephone number:
24-Hour Emergency Phone number: 800-424-9300
Customer Information Center: 989-725-5100

SECTION 2: HAZARDS IDENTIFICATION
Classification of the substance or mixture
This material is hazardous under the criteria of the Federal OSHA Hazard Communication Standard 29CFR 1910.1200.

Skin irritation - Category 2
Eye irritation - Category 2B
Respiratory sensitization - Category 1
Skin sensitization - Category 1
Carcinogenicity - Category 2
Specific target organ toxicity - single exposure - Category 3 Specific target organ toxicity - repeated exposure - Category 2 - Inhalation Label elements
Hazard pictograms

Signal word: DANGER!
Hazards
Causes skin and eye irritation.

May cause an allergic skin reaction.

May cause allergy or asthma symptoms or breathing difficulties if inhaled.

May cause respiratory irritation.

Suspected of causing cancer.

May cause damage to organs (Respiratory Tract) through prolonged or repeated exposure if inhaled.

Precautionary statements
Prevention
Obtain special instructions before use.

Do not handle until all safety precautions have been read and understood.

Do not breathe dust/ fume/ gas/ mist/ vapors/ spray.
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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

Wash skin thoroughly after handling.

Use only outdoors or in a well-ventilated area.

Contaminated work clothing should not be allowed out of the workplace.

Wear protective gloves.

Use personal protective equipment as required.

In case of inadequate ventilation wear respiratory protection.

Response
IF ON SKIN: Wash with plenty of soap and water.

IF INHALED: Remove victim to fresh air and keep at rest in a position comfortable for breathing.

Call a POISON CENTER or doctor/ physician if you feel unwell.

IF IN EYES: Rinse cautiously with water for several minutes. Remove contact lenses, if present and easy to do. Continue Storage
Store in a well-ventilated place. Keep container tightly closed.

Store locked up.

Disposal
Dispose of contents/ container to an approved waste disposal plant.

Other hazards
no data available

SECTION 3: COMPOSITION/INFORMATION ON INGREDIENTS
Mixtures
· Chemical characterization: This product is a mixture.

Polymethylenepolyphenyl polyisocyanate, 53862-89-8 > 60.0 - < 90.0 % polypropyleneglycol copolymer

Diphenylmethane Diisocyanate, 9016-87-9 > 10.0 - < 30.0 % isomers and homologues

4,4' -Methylenediphenyl diisocyanate 101-68-8 > 7.0 - < 13.0 %

Note
Note: CAS 101-68-8 is an MDI isomer that is part of CAS 9016-87-9.

SECTION 4: FIRST AID MEASURES
Description of first aid measures
Description of first aid measures
General advice:

If potential for exposure exists refer to Section 8 for specific personal protective equipment. First Aid responders should pay attention to self-protection and use the recommended protective clothing (chemical resistant gloves, splash protection).

Inhalation:

Move person to fresh air. If not breathing, give artificial respiration; if by mouth to mouth use rescuer protection (pocket mask, etc). If breathing is difficult, oxygen should be administered by qualified personnel. Call a physician or transport to a medical facility.

Skin contact:

Remove material from skin immediately by washing with soap and plenty of water. Remove contaminated clothing and shoes while washing. Seek medical attention if irritation persists. Wash clothing before reuse. An MDI skin decontamination study demonstrated that cleaning very soon after exposure is important, and that a polyglycol-based skin cleanser or corn oil may be more effective than soap and water. Discard items which cannot be decontaminated, including leather articles such as shoes, belts and watchbands. Suitable emergency safety shower facility should be available in work area.

Eye contact:

Component CASRN Concentration
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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

Immediately flush eyes with water; remove contact lenses, if present, after the first 5 minutes, then continue flushing eyes for at least 15 minutes. Obtain medical attention without delay, preferably from an ophthalmologist. Suitable emergency eye wash facility should be immediately available.

Ingestion:

If swallowed, seek medical attention. Do not induce vomiting unless directed to do so by medical personnel.

Most important symptoms and effects, both acute and delayed:

Aside from the information found under Description of first aid measures (above) and Indication of immediate medical attention and special treatment needed (below), any additional important symptoms and effects are described in Section 11:

Toxicology Information.

Indication of any immediate medical attention and special treatment needed Notes to physician: Excessive exposure may aggravate preexisting asthma and other respiratory disorders (e.g. emphysema, bronchitis, reactive airways dysfunction syndrome). Maintain adequate ventilation and oxygenation of the patient. May cause asthma-like (reactive airways) symptoms.

Bronchodilators, expectorants, antitussives and corticosteroids may be of help. May cause respiratory sensitization or asthma- like symptoms. Bronchodilators, expectorants and antitussives may be of help. Treat bronchospasm with inhaled beta2 agonist and oral or parenteral corticosteroids. Respiratory symptoms, including pulmonary edema, may be delayed. Persons receiving significant exposure should be observed 24-48 hours for signs of respiratory distress. If you are sensitized to diisocyanates, consult your physician regarding working with other respiratory irritants or sensitizers. Treatment of exposure should be directed at the control of symptoms and the clinical condition of the patient.

SECTION 5: FIREFIGHTING MEASURES
Extinguishing media
Suitable extinguishing media:

Water fog or fine spray. Dry chemical fire extinguishers. Carbon dioxide fire extinguishers. Foam. Alcohol resistant foams (ATC type) are preferred. General purpose synthetic foams (including AFFF) or protein foams may function but will be less effective.

Unsuitable extinguishing media:

Do not use direct water stream. May spread fire.

Special hazards arising from the substance or mixture
Hazardous combustion products:

During a fire, smoke may contain the original material in addition to combustion products of varying composition which may be toxic and/or irritating. Combustion products may include and are not limited to: Nitrogen oxides. Isocyanates. Hydrogen cyanide. Carbon monoxide. Carbon dioxide.

Unusual Fire and Explosion Hazards:

Material reacts slowly with water, releasing carbon dioxide which can cause pressure buildup and rupture of closed containers.

Elevated temperatures accelerate this reaction. Container may rupture from gas generation in a fire situation. Violent steam generation or eruption may occur upon application of direct water stream to hot liquids. Dense smoke is produced when product burns. Electrically ground and bond all equipment.

Advice for firefighters
Fire Fighting Procedures:

Keep people away. Isolate fire and deny unnecessary entry. Stay upwind. Keep out of low areas where gases (fumes) can accumulate. Water is not recommended but may be applied in large quantities as a fine spray when other extinguishing agents are not available. Fight fire from protected location or safe distance. Consider the use of unmanned hose holders or monitor nozzles. Immediately withdraw all personnel from the area in case of rising sound from venting safety device or discoloration of the container. Do not use direct water stream. May spread fire. Move container from fire area if this is possible without hazard. Use water spray to cool fire-exposed containers and fire-affected zone until fire is out. Contain fire water run- off if possible. Fire water run-off, if not contained, may cause environmental damage. Review the "Accidental Release Measures" and the "Ecological Information" sections of this (M)SDS.

Special protective equipment for firefighters:

Wear positive-pressure self-contained breathing apparatus (SCBA) and protective firefighting clothing (includes firefighting helmet, coat, trousers, boots, and gloves). Avoid contact with this material during firefighting operations. If contact is likely, change to full chemical resistant firefighting clothing with self-contained breathing apparatus. If this is not available, wear full chemical resistant clothing with self-contained breathing apparatus and fight fire from a remote location. For protective equipment in post-fire or non-fire clean-up situations, refer to the relevant sections.

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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

SECTION 6: ACCIDENTAL RELEASE MEASURES
Personal precautions, protective equipment and emergency procedures:

Isolate area. Keep unnecessary and unprotected personnel from entering the area. Refer to section 7, Handling, for additional precautionary measures. Keep personnel out of low areas. Keep upwind of spill. Spilled material may cause a slipping hazard.

Ventilate area of leak or spill. If available, use foam to smother or suppress. See Section 10 for more specific information. Use appropriate safety equipment. For additional information, refer to Section 8, Exposure Controls and Personal Protection.

Environmental precautions:

Prevent from entering into soil, ditches, sewers, waterways and/or groundwater. See Section 12, Ecological Information.

Methods and materials for containment and cleaning up:

Contain spilled material if possible. Absorb with materials such as: Dirt. Vermiculite. Sand. Clay. Do NOT use absorbent materials such as: Cement powder (Note: may generate heat). Collect in suitable and properly labeled open containers. Do not place in sealed containers. Suitable containers include: Metal drums. Plastic drums. Polylined fiber pacs. Wash the spill site with large quantities of water. Attempt to neutralize by adding suitable decontaminant solution: Formulation 1: sodium carbonate 5 - 10%; liquid detergent 0.2 - 2%; water to make up to 100%, OR Formulation 2: concentrated ammonia solution 3 - 8%; liquid detergent 0.2 - 2%; water to make up to 100%. If ammonia is used, use good ventilation to prevent vapor exposure. Contact your supplier for clean-up assistance. See Section 13, Disposal Considerations, for additional information.

SECTION 7: HANDLING AND STORAGE
Precautions for safe handling:

Avoid contact with eyes, skin, and clothing. Avoid prolonged or repeated contact with skin. Avoid breathing vapor. Wash thoroughly after handling. Use with adequate ventilation. Keep container closed. See Section 8, EXPOSURE CONTROLS AND PERSONAL PROTECTION.

Spills of these organic materials on hot fibrous insulations may lead to lowering of the autoignition temperatures possibly resulting in spontaneous combustion.

Conditions for safe storage:

Store in a dry place. Protect from atmospheric moisture. Do not store product contaminated with water to prevent potential hazardous reaction. See Section 10 for more specific information. Additional storage and handling information on this product may be obtained by calling your sales or customer service contact.

Storage stability Storage temperature: Storage Period:
24 - 41 °C (75 - 106 °F) 6 Month

SECTION 8: EXPOSURE CONTROLS/PERSONAL PROTECTION
Additional information about design of technical systems:

No further data; see item 7.

Control parameters:

Component Regulation Type of listing Value/Notation
4,4' -Methylenediphenyl
diisocyanate
ACGIH TWA 0.005 ppm

OSHA Z-1

C

0.2 mg/m3 0.02 ppm

Additional information: The lists that were valid during the creation were used as basis.

Exposure controls
Engineering controls:

Use only with adequate ventilation. Local exhaust ventilation may be necessary for some operations. Provide general and/or local exhaust ventilation to control airborne levels below the exposure guidelines. Exhaust systems should be designed to move the air away from the source of vapor/aerosol generation and people working at this point. The odor and irritancy of this material are inadequate to warn of excessive exposure.

Individual protection measures
Eye/face protection:

Use chemical goggles.
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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

Skin protection
Hand protection:

Use gloves chemically resistant to this material. Examples of preferred glove barrier materials include: Butyl rubber.

Chlorinated polyethylene. Polyethylene. Ethyl vinyl alcohol laminate ("EVAL"). Examples of acceptable glove barrier materials include: Neoprene. Nitrile/butadiene rubber ("nitrile" or "NBR"). Polyvinyl chloride ("PVC" or "vinyl"). Viton. NOTICE: The selection of a specific glove for a particular application and duration of use in a workplace should also take into account all relevant workplace factors such as, but not limited to: Other chemicals which may be handled, physical requirements (cut/puncture protection, dexterity, thermal protection), potential body reactions to glove materials, as well as the instructions/specifications provided by the glove supplier.

Other protection:

Use protective clothing chemically resistant to this material. Selection of specific items such as face shield, boots, apron, or full body suit will depend on the task.

Respiratory protection:

Atmospheric levels should be maintained below the exposure guideline. When atmospheric levels may exceed the exposure guideline, use an approved air-purifying respirator equipped with an organic vapor sorbent and a particle filter. For situations where the atmospheric levels may exceed the level for which an air-purifying respirator is effective, use a positive-pressure air-supplying respirator (air line or self-contained breathing apparatus). For emergency response or for situations where the atmospheric level is unknown, use an approved positive-pressure self-contained breathing apparatus or positive-pressure air line with auxiliary self-contained air supply.

The following should be effective types of air-purifying respirators: Organic vapor cartridge with a particulate pre-filter.

SECTION 9: PHYSICAL AND CHEMICAL PROPERTIES
Information on basic physical and chemical properties
General Information
Appearance
Form Liquid
Color Red to brown
Odor Characteristic
Odor Threshold 0.4 ppm Based on Literature for MDI. Odor is inadequate warning of excessive exposure. pH-value No test data available

Change in condition:

Melting Point No test data available

Freezing Point No test data available
Boiling Point(760mmHg) > 100 °C ( > 212 °F) Literature

Flash Point closed cup > 150 °C ( > 302 °F)
Estimated.

Evaporation Rate No test data available
(Butyl Acetate = 1)

Flammability Not applicable to liquids
(solid, gas)
.

Explosion Limits:

Lower: No test data available
Upper: No test data available

Vapor Pressure < 0.00001 mmHg at 25 °C (77 °F)
Literature

Relative Vapor Density (air =
1)
No test data available
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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

Relative Density (water = 1) 1.09 at 25 °C (77 °F) / 25 °C ASTM D891
Water solubility insoluble

Partition coefficient: n-
octanol/water
no data available
Auto-ignition temperature No test data available
Decomposition
temperature
No test data available
Kinematic Viscosity 2,500 cSt at 25 °C (77 °F)
ASTM D4878
Explosive properties Not explosive
Oxidizing properties No
Molecular weight No test data available

NOTE: The physical data presented above are typical values and should not be construed as a specification.

SECTION 10: STABILITY AND REACTIVITY
Reactivity:

Products based on diisocyanates like TDI and MDI react with many materials to release heat. The reaction rate increases with temperature as well as with increased contact; these reactions can become violent. Contact is increased by stirring or if the other material acts as a solvent. Products based on diisocyanates such as TDI and MDI are not soluble in water and will sink to the bottom, but react slowly at the interface. The reaction forms carbon dioxide gas and a layer of solid polyurea.

Chemical stability:

Stable under recommended storage conditions. See Storage, Section 7.

Possibility of hazardous reactions:

Can occur. Exposure to elevated temperatures can cause product to decompose and generate gas. This can cause pressure build-up and/or rupturing of closed containers. Polymerization can be catalyzed by: Strong bases. Water.

Conditions to avoid:

Exposure to elevated temperatures can cause product to decompose. Generation of gas during decomposition can cause pressure in closed systems. Pressure build-up can be rapid. Avoid moisture. Material reacts slowly with water, releasing carbon dioxide which can cause pressure buildup and rupture of closed containers. Elevated temperatures accelerate this reaction.

Incompatible materials:

Avoid contact with: Acids. Alcohols. Amines. Water. Ammonia. Bases. Metal compounds. Moist air. Strong oxidizers. Products based on diisocyanates like TDI and MDI react with many materials to release heat. The reaction rate increases with temperature as well as with increased contact; these reactions can become violent. Contact is increased by stirring or if the other material acts as a solvent. Products based on diisocyanates such as TDI and MDI are not soluble in water and will sink to the bottom, but react slowly at the interface. The reaction forms carbon dioxide gas and a layer of solid polyurea. Avoid contact with metals such as: Aluminum. Zinc. Brass. Tin. Copper. Galvanized metals. Avoid contact with absorbent materials such as: Moist organic absorbents. Avoid unintended contact with polyols. The reaction of polyols and isocyanates generate heat.

Hazardous decomposition products:

Decomposition products depend upon temperature, air supply and the presence of other materials. Gases are released during decomposition.

SECTION 11: TOXICOLOGICAL INFORMATION
Toxicological information on this product or its components appear in this section when such data is available.

Acute toxicity
Acute oral toxicity
Low toxicity if swallowed. Small amounts swallowed incidentally as a result of normal handling operations are not likely to cause injury; however, swallowing larger amounts may cause injury. Observations in animals include: Gastrointestinal irritation.

As product: Single dose oral LD50 has not been determined.

LD50, Rat, > 2,000 mg/kg Estimated.
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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

Acute dermal toxicity
Prolonged skin contact is unlikely to result in absorption of harmful amounts.

The dermal LD50 has not been determined.

LD50, Rabbit, > 2,000 mg/kg Estimated.

Acute inhalation toxicity
At room temperature, vapors are minimal due to low volatility. However, certain operations may generate vapor or mist concentrations sufficient to cause respiratory irritation and other adverse effects. Such operations include those in which the material is heated, sprayed or otherwise mechanically dispersed such as drumming, venting or pumping. Excessive exposure may cause irritation to upper respiratory tract (nose and throat) and lungs. May cause pulmonary edema (fluid in the lungs.) Effects may be delayed. Decreased lung function has been associated with overexposure to isocyanates.

As product: The LC50 has not been determined.

Skin corrosion/irritation
Prolonged contact may cause skin irritation with local redness.

Material may stick to skin causing irritation upon removal.

May stain skin.

Serious eye damage/eye irritation
May cause eye irritation.

May cause slight temporary corneal injury.

Sensitization
A component in this mixture has been shown to be a skin sensitizer.

Animal studies have shown that skin contact with isocyanates may play a role in respiratory sensitization.

A component in this mixture may cause an allergic respiratory response.

MDI concentrations below the exposure guidelines may cause allergic respiratory reactions in individuals already sensitized.

Asthma-like symptoms may include coughing, difficult breathing and a feeling of tightness in the chest. Occasionally, breathing difficulties may be life threatening.

Specific Target Organ Systemic Toxicity (Single Exposure) Contains component(s) which are classified as specific target organ toxicant, single exposure, category 3.

Specific Target Organ Systemic Toxicity (Repeated Exposure) Tissue injury in the upper respiratory tract and lungs has been observed in laboratory animals after repeated excessive exposures to MDI/polymeric MDI aerosols.

Carcinogenicity
Lung tumors have been observed in laboratory animals exposed to respirable aerosol droplets of MDI/Polymeric MDI (6 mg/m3) for their lifetime. Tumors occurred concurrently with respiratory irritation and lung injury. Current exposure guidelines are expected to protect against these effects reported for MDI.

Teratogenicity
In laboratory animals, MDI/polymeric MDI did not cause birth defects; other fetal effects occurred only at high doses which were toxic to the mother.

Reproductive toxicity
No relevant data found.

Mutagenicity
Genetic toxicity data on MDI are inconclusive. MDI was weakly positive in some in vitro studies; other in vitro studies were negative. Animal mutagenicity studies were predominantly negative.

Aspiration Hazard
Based on physical properties, not likely to be an aspiration hazard. No aspiration toxicity classification

COMPONENTS INFLUENCING TOXICOLOGY:

Polymethylenepolyphenyl polyisocyanate, polypropyleneglycol copolymer Acute inhalation toxicity
At room temperature, vapors are minimal due to low volatility. However, certain operations may generate vapor or mist concentrations sufficient to cause respiratory irritation and other adverse effects. Such operations include those in which material is heated, sprayed or otherwise mechanically dispersed such as drumming, venting or pumping. Excessive exposure may cause irritation to upper respiratory tract (nose and throat) and lungs. May cause pulmonary edema (fluid on lungs). Effects may be delayed. Decreased lung function has been associated with overexposure to isocyanates.

The LC50 has not been determined.
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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

Diphenylmethane Diisocyanate, isomers and homologues
Acute inhalation toxicity
LC50, Rat, 4 Hour, dust/mist, 0.49 mg/l
For similar material(s): 2,4'-Diphenylmethane diisocyanate (CAS 5873-54-1). LC50, Rat, 4 Hour, Aerosol, 0.387 mg/l For similar material(s): 4,4'-Methylenediphenyl diisocyanate (CAS 101-68-8). LC50, Rat, 1 Hour, Aerosol, 2.24 mg/l 4,4' -Methylenediphenyl diisocyanate
Acute inhalation toxicity
LC50, Rat, 1 Hour, dust/mist, 2.24 mg/l

SECTION 12: ECOLOGICAL INFORMATION
Ecotoxicological information on this product or its components appear in this section when such data is available.

Toxicity
Acute toxicity to fish
The measured ecotoxicity is that of the hydrolyzed product, generally under conditions maximizing production of soluble species.

Material is practically non-toxic to aquatic organisms on an acute basis (LC50/EC50/EL50/LL50 >100 mg/L in the most sensitive species tested).

Based on information for a similar material:

LC50, Danio rerio (zebra fish), static test, 96 Hour, > 1,000 mg/l, OECD Test Guideline 203 or Equivalent Acute toxicity to aquatic invertebrates
Based on information for a similar material:

EC50, Daphnia magna (Water flea), static test, 24 Hour, > 1,000 mg/l, OECD Test Guideline 202 or Equivalent Acute toxicity to algae/aquatic plants
Based on information for a similar material:

NOEC, Desmodesmus subspicatus (green algae), static test, 72 Hour, Growth rate inhibition, 1,640 mg/l, OECD Test Guideline 201 or Equivalent
Toxicity to bacteria
Based on information for a similar material:

EC50, activated sludge, static test, 3 Hour, Respiration rates., > 100 mg/l Toxicity to soil-dwelling organisms
EC50, Eisenia fetida (earthworms), Based on information for a similar material: 14 d, > 1,000 mg/kg Toxicity to terrestrial plants
EC50, Avena sativa (oats), Growth inhibition, 1,000 mg/l EC50, Lactuca sativa (lettuce), Growth inhibition, 1,000 mg/l Persistence and degradability
Biodegradability:

In the aquatic and terrestrial environment, material reacts with water forming predominantly insoluble polyureas which appear to be stable. In the atmospheric environment, material is expected to have a short tropospheric half-life, based on calculations and by analogy with related diisocyanates.
10-day Window: Not applicable

Biodegradation: 0 %
Exposure time: 28 d
Method:

OECD Test Guideline 302C or Equivalent
Bioaccumulative potential
Bioaccumulation:

Bioconcentration potential is low (BCF < 100 or Log Pow < 3).

Bioconcentration factor (BCF):
92 Cyprinus carpio (Carp) 28 d
Mobility in soil
In the aquatic and terrestrial environment, movement is expected to be limited by its reaction with water forming predominantly insoluble polyureas.
������� ����������
AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

SECTION 13: DISPOSAL CONSIDERATIONS
Disposal methods:

DO NOT DUMP INTO ANY SEWERS, ON THE GROUND, OR INTO ANY BODY OF WATER. All disposal practices must be in compliance with all Federal, State/Provincial and local laws and regulations. Regulations may vary in different locations. Waste characterizations and compliance with applicable laws are the responsibility solely of the waste generator. AS YOUR

SUPPLIER, WE HAVE NO CONTROL OVER THE MANAGEMENT PRACTICES OR MANUFACTURING PROCESSES OF PARTIES HANDLING OR USING THIS MATERIAL. THE INFORMATION PRESENTED HERE PERTAINS ONLY TO THE PRODUCT AS SHIPPED IN ITS INTENDED CONDITION AS DESCRIBED IN MSDS SECTION: Composition Information. FOR UNUSED & UNCONTAMINATED PRODUCT, the preferred options include sending to a licensed, permitted: Recycler. Reclaimer. Incinerator or other thermal destruction device. For additional information, refer to: Handling & Storage Information, MSDS Section 7 Stability & Reactivity Information, MSDS Section10 Regulatory Information, MSDS Section 15

SECTION 14: TRANSPORT INFORMATION
DOT Proper shipping name Environmentally hazardous substance, liquid, n.o.s.(MDI) UN number UN 3082
Class 9
Packing group
Reportability

Classifications for SEA transport (IMO-
IMDG):

Transport in bulk according to Annex I
or II of Marpol 73/78 and the IBC or
IGC code
Classification for AIR transport
(IATA/ICAO):

III
MDI

Not regulated for transport

Consult IMO regulations before transporting ocean bulk

Not regulated for transport

This information is not intended to convey all specific regulatory or operational requirements/information relating to this product.

Transportation classifications may vary by container volume and may be influenced by regional or country variations in regulations.

Additional transportation system information can be obtained through an authorized sales or customer service representative. It is the responsibility of the transporting organization to follow all applicable laws, regulations and rules relating to the transportation of the material.

SECTION 15: REGULATORY INFORMATION
OSHA Hazard Communication Standard
This product is a "Hazardous Chemical" as defined by the OSHA Hazard Communication Standard, 29 CFR 1910.1200.

Superfund Amendments and Reauthorization Act of 1986 Title III (Emergency Planning and Community Right-to-Know Act of 1986) Sections 311 and 312
Skin Corrosion or irritation
Serious eye damage or eye irritation
Respiratory or skin sensitization
Specific target organ toxicity (single or repeated exposure) Reactivity Hazard
Superfund Amendments and Reauthorization Act of 1986 Title III (Emergency Planning and Community Right-to-Know Act of 1986) Section 313
This material does not contain any chemical components with known CAS numbers that exceed the threshold (De Minmis) reporting levels established by SARA Title III, Section 313

Components CASRN
Diphenylmethane Diisocyanate, isomers and homologues 9016-87-9 4,4' -Methylenediphenyl diisocyanate 101-68-8
Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) Section 103 Calculated RQ exceeds reasonably attainable upper limit.

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AMERICAN RECYCLING CENTER, INC.
655 WABASSEE DRIVE
OWOSSO, MI 48867
PHONE – 989-725-5100

Components CASRN RQ
4,4' -Methylenediphenyl diisocyanate 101-68-8 5000 lbs RQ

Pennsylvania Worker and Community Right-To-Know Act:

To the best of our knowledge, this product does not contain chemicals at levels which require reporting under this statute.

California Proposition 65 (Safe Drinking Water and Toxic Enforcement Act of 1986) This product contains no listed substances known to the State of California to cause cancer, birth defects or other reproductive harm, at levels which would require a warning under the statute.

United States TSCA Inventory (TSCA)
All components of this product are in compliance with the inventory listing requirements of the U.S. Toxic Substances Control Act (TSCA) Chemical Substance Inventory.

SECTION 16: OTHER INFORMATION
This information is based on our present knowledge. However, this shall not constitute a guarantee for any Specific product features and shall not establish a legally valid contractual relationship.

American Recycling Center urges each customer or recipient of this SDS to study it carefully and consult appropriate expertise, as necessary or appropriate, to become aware of and understand the data contained in this SDS and any hazards associated with the product. The information herein is provided in good faith and believed to be accurate as of the effective date of the SDS. However, no warranty, expressed or implied, is given. Regulatory requirements are subject to change and may differ between various locations.

It is the buyer’s/user’s responsibility to ensure that its activities comply with all applicable federal, state, provincial and local laws. The information presented here pertains only to the product as shipped. Since conditions for use of the product are not under the control of American Recycling Center, it is the buyer’s/user’s duty to determine the conditions necessary for the safe use of this product.

This information is not intended to convey all specific regulatory or operational requirements/information relating to this product.

Additional transportation system information can be obtained through an authorized sales or customer service representative. It is the responsibility of the transporting organization to follow all applicable laws, regulations and rules relating to the transportation of the material.

Due to the proliferation of sources for information such as manufacturer-specific SDSs, American Recycling Center, Inc. is not and cannot be responsible for SDSs obtained from any source other than American Recycling Center, Inc. If you have obtained an American Recycling Center, Inc SDS from a non American Recycling Center, Inc. source or if you are not sure that the SDS is current, please contact American Recycling Center, Inc. for the most current version.

Department issuing SDS: EH&S Delivery
Contact: Customer Service 989 -725 -5100

PremARC ® 60 -80 Urethane Binder

The information herein is to assist customers in determining whether our products are suitable for their applications. Our products are intended for sale to industrial and commercial customers. We request that customers inspect and test our products before use and satisfy themselves as to contents and suitability. We warrant that our products will meet our written specifications. Nothing herein shall constitute, and other warranty express or implied, including any warranty of merchantability or fitness, nor is protection from any law or patent to be inferred. All patent rights are reserved. The exclusive remedy for all proven claims is replacement of our materials and in no event shall we be liable for special, incidental or consequential damages.

American Recycling Center, Inc
655 Wabassee Drive, Owosso, MI 48867
(989) 725-5100 www.americanrecycling.com
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Routine Maintenance Instructions
Poured In Place Surfacing
Because poured-in-place surfacing has many positive inherent features if installed correctly at the proper critical depth for the play equipment, it is important to keep it as near to installation quality as possible. These positive features may include proper, continuous impact attenuation; a level, accessible, firm, stable, and slip-resistant surface; proper porosity or drainage provisions; attractive surface color combinations, patterns and designs; and long-term durability.

The presence of foreign objects and deposits can quickly diminish these qualities.

These include a wide range of items from sand, dirt, and stones; to leaves, tree sap, chewing gum, bird droppings, urine and blood, scuff marks, tar, and common park maintenance products such as gasoline or grease. The longer these items are left on the surfacing, the more damage they cause, so prompt maintenance is important.

The Principal Key to Effective Poured-In-Place Surface Maintenance: Keep Loose Debris Off
Loose debris such as sand, dirt, and small stones on top of unitary surfacing can produce slip hazards. In addition, fine particles can accumulate in porous openings and clog important drainage features of some surfaces, as can matting materials such as leaf litter. These particles can also be abrasive; they accelerate wear and shorten surface life. It is recommended that a regular periodic removal of this loose debris be done. It is best to vacuum porous surfaces to clear the permeable openings as well as removing top litter, but blowing can also be an effective means of achieving this. Dry sweeping or scrubbing will remove the loose litter, but can force more fine particles into porous openings of some surfaces. This should be done at least every two-three weeks, but may be necessary more often if local conditions warrant.
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Routine Maintenance Instructions (Continued)
Lawn vacuum or blower for porous surfaces or soft-bristle push broom for non-porous surfaces
Disposable rags
Disposable gloves
2 cleaning and rinsing buckets
2 small reusable pump spray containers (for vinegar and hydrogen peroxide)
Aerosol spray cleaner (Formula 409™ has been highly recommended) Orange oil cleaner
Liquid detergent
Powder cleaning compound (Borax™ has been highly recommended) STPP (Sodium Tripolyphosphate)
White Vinegar (5% acid; available at grocery stores)
Hydrogen Peroxide (3% solution; available at drug stores) Paste or powder cleanser (Goop™ and Bon Ami™ have been highly recommended)
A Basic Routine Maintenance Equipment and Supply Kit for Poured-In-Place Surfaces
Maintenance divisions with several playgrounds that have unitary surfaces may find it useful to establish a standard routine maintenance kit for these areas. Here is a recommended list of equipment and supplies for such a kit:

It is important that the maintenance division obtains the MSDS for each of these chemical products from the manufacturer. Include them in all chemical in-service training and has them on file for future reference. The quantities of these cleaning products will depend upon the amount of unitary surfacing to be maintained.
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Routine Maintenance Instructions (Continued)
Use the Right Cleaner for Problem Deposits
Elbow grease is always useful, but it helps to use the right cleaner to remove problem deposits or spills on unitary surfacing. For these tough problems, we recommend the following:

Bird Droppings or Other Excrement
Wear disposable gloves. Do not attempt to loosen any dry excrement that is stuck to the surfacing, as this could cause disease-causing fungus in the deposition to become air-borne. Remove any loose excrement. Scrub deposits with dampened Bon Ami™, Borax™ or STPP and then wash with a Borax™ or STPP solution. Soak up residue with disposable rags. Disinfect by spraying hydrogen peroxide on affected area. Let stand for at least two minutes and then spray again with vinegar. Let stand for an additional two minutes. Soak up residue with disposable rags. Double-rinse with clean water. (Do not mix hydrogen peroxide and vinegar together. Do not mix these together; spray separately for best results.)
Blood
Wear disposable gloves. Disinfect by spraying hydrogen peroxide on affected area.

Let stand for at least two minutes and then spray again with vinegar. Let stand for an additional two minutes. Soak up residue with disposable rags. Double rinse with clean water.

Chewing Gum
Apply dry ice (regular ice isn’t as effective) to freeze the gum and chip it from the surface and remove it.
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Routine Maintenance Instructions (Continued)
Gasoline
Wash with a detergent and water. Soak up with disposable rags. Double rinse with clean water.

Grass Stains
Apply orange oil cleaner. Work in and soak up with disposable rags. Double rinse with clean water.

Moss / Algae / Mildew / Mold
Saturate with hydrogen peroxide and let stand for at least five minutes. Repeat using vinegar. Soak up with disposable rags. Double rinse with clean water.

Scuff Marks
Scrub with dampened Bon Ami™, Borax™, or STPP. Double rinse with clean water.

Soda or Juice
Saturate with Formula 407™. Work in and soak up with disposable rags. Then wash with a liquid detergent, Borax™ or STPP solution. Double rinse with clean water.

Tar / Crayon / Lipstick / Tree Sap / Motor Oil / Grease Apply one or more of the following: orange oil cleaner, Goop™, or Formula 407™.

Work in and soak up with disposable rags. Then scrub with dampened Bon Ami™, Borax™ or STPP. Double rinse with clean water.

Urine / Vomit / Nasal Discharge
Wear disposable gloves. Wash with a Borax™ or STPP solution. Soak up residue with disposable rags. Disinfect by spraying on hydrogen peroxide and let stand for at least two minutes, then spraying again with vinegar and let stand for an additional two minutes. (Do not mix these together. Spray separately for best results.) Soak up residue with disposable rags. Double rinse with clean water. �����������������
Routine Maintenance Instructions (Continued)
Acetate
Ammonia
Benzene
Carbon tetrachloride
Chlorine Bleach
Glycerin
Lighter fluid
Mineral spirits
Naphtha
Petroleum distillates
Turpentine
WD40
Petroleum Jelly

AVOID HARMFUL SOLVENTS AND CLEANING PRODUCTS
The following are effective cleaning agents but they are not recommended on most unitary safety surfaces. They may be detrimental to the surfacing because, over time, they could break down the polyurethane binding component and may lead to de- plasticization of the EPDM rubber. Most are not environmentally friendly. Some also change the appearance of the cleaned area compared to the rest of the surface, or make the surface very slippery:

The information provided here is condensed from Maintaining Safe Play, the course manual of the new NPSI Playground Maintenance Service Program.

Maintenance for Snow and Ice Conditions
To remove ice or snow, Calcium Chloride is an acceptable solution. Please follow the manufacturer’s instructions for proper use.
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A Wide Variety of Products
Our high quality products maximize play
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Explore our broad range of interactive
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3 Custom capabilities
Water Odyssey specializes in creating
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.

U.L. Listed Controls
With maintenance presonnel in mind,
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SWITCHEROO™ ANCHORBASE SYSTEM
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• High quality 304 stainless steel manifolds and brass valves come standard. • Extends the life of the water management system
• Reduces maintenance
• Stands up to extreme climates

BRASS AND STAINLESS STEEL NOZZLES
• Precision machined for the ideal water effect
• Durable and resistant to rust
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• Easy to maintain

LOW-PROFILE FLANGES ARE EASY ON THE FEET
• All flanges are low-profile with rounded edges
• Rounded button-head hardware
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WATER MANAGEMENT SYSTEMS FOR EASY INSTALLATION
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ROTATIONAL JOINTS
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AQUA ARMOR™ - SUPERIOR COATING SYSTEM
• Stands up to chemicals, UV, and active play
• Structural elastomeric coating that is vandal-resistant • Easy to clean from calcium build-up

CUSTOM THEMING CAPABILITIES FOR A TRUELY UNIQUE LOOK
• Hand-crafted spray features from talented artists
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• Theming allows you to enhance your brand and create an immersive experience WATER ODYSSEY DESIGNS FOR SAFETY AND ADA COMPLIANCE.
• Key considerations are age-appropriate play areas, transition areas, traffic patterns, splash zones, play value, and overall aesthetic of the project. • Products are designed & manufactured to be in accordance with ASTM safety standards and ADA accessibility for maximum participation of ground level spray features, activators and interactive equipment.

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TAB 6 –
• Additional Required Documents (Appendix
C)
• Acknowledgement and Acceptance of
Region 4 ESC’s Open Records Policy
• Antitrust Certification
• Implementation of House Bill 1295
Certificate of Interested Parties (form 1295)
• Texas Government Code 2270 Verification
Form
• Felony Conviction Notification
• Any Additional Agreements Offeror Will
Require Participating Agencies to Sign
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Appendix C

ADDITIONAL REQUIRED DOCUMENTS
DO
C #1 Acknowledgment and Acceptance of Region 4 ESC’s Open Records Policy DO
C #2 Antitrust Certification Statements (Tex. Government Code § 2155.005) DO
C #3 Implementation of House Bill 1295 Certificate of Interested Parties (Form 1295) DO
C #4 Texas Government Code 2270 Verification Form
DO
C #5 Felony Conviction Notification
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Appendi
x C, Doc #1

ACKNOWLEDGMENT AND ACCEPTANCE
OF REGION 4 ESC’s OPEN RECORDS POLICY
OP

EN RECORDS POLICY
All proposals, information and documents submitted are subject to the Public Information Act requirements governed by the State of Texas once a Contract(s) is executed. If an Offeror believes its response, or parts of its response, may be exempted from disclosure, the Offeror must specify page- by-page and line- by-line the parts of the response, which it believes, are exempt and include detailed reasons to substantiate the exemption. Price is not confidential and will not be withheld. Any unmarked information will be considered public information and released, if requested under the Public Information Act.

The determination of whether information is confidential and not subject to disclosure is the duty of the Office of Attorney General (OAG). Region 4 ESC must provide the OAG sufficient information to render an opinion and therefore, vague and general claims to confidentiality by the Offeror are not acceptable. Region 4 ESC must comply with the opinions of the OAG. Region 4 ESC assumes no responsibility for asserting legal arguments on behalf of any Offeror. Offeror is advised to consult with their legal counsel concerning disclosure issues result ing from this procurement process and to take precautions to safeguard trade secrets and other proprietary information.

Signature below certifies complete acceptance of Region 4 ESC’s Open Records Policy, except as noted below (additional pages may be attached, if necessary).

Chec
k one of the following responses to the Acknowledgment and Acceptance of Region 4 ESC’s Open Records Policy below:

We acknowledge Region 4 ESC’s Open Records Policy and declare that no information submitted with this proposal, or any part of our proposal, is exempt from disclosure under the Public Information Act.
 W
e declare the following information to be a trade secret or proprietary and exempt from disclosure under the Public Information Act.
(No
te: Offeror must specify page-by-page and line-by-line the parts of the response, which it believes, are exempt. In addition, Offeror must include detailed reasons to substantiate the exemption(s). Price is not confident and will not be withheld. All information believed to be a trade secret or proprietary must be listed. It is further understood that failure to identify such information, in strict accordance with the instructions, will result in that information being considered public information and released, if requested under the Public Information Act.) Dat
e Authorized Signature & Title
x
VP of Installation 2/13/2023
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Appendix C
, Doc #2

ANTITRUST CERTIFICATION STATEMENTS
(Tex. Government Code § 2155.005)
Attorney General Form
I aff
irm under penalty of perjury of the laws of the State of Texas that:

1. I am dul
y authorized to execute this Contract on my own behalf or on behalf of the company, corporation, firm, partnership or individual (Company) listed below;

2. In connect
ion with this proposal, neither I nor any representative of the Company has violated any provision of the Texas Free Enterprise and Antitrust Act, Tex. Bus. & Comm. Code Chapter 15;

3. In connect
ion with this proposal, neither I nor any representative of the Company has violated any federal antitrust law; and

4. Neither I nor any representative of the Company has directly or indirectly communicated any of the contents of this proposal to a competitor of the Company or any other company, corporation, firm, partnership or individual engaged in the same line of business as the Company.

Company Contact
Signature
Printed Name
Address Position with Company
Official
Authorizing
Proposal
Signature
Phone
Printed Name
Fax
Position with Company
Robertson Recreational
Surfaces Tom DiScipio
VP of Installation
2414 W 12th Street
Tempe, AZ 85281
800-858-0519
(602) 340-0402
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Appendix C, DOC # 3
Implementation of House Bill 1295
Certificate of Interested Parties (Form 1295):

In 2015, the Texas Legislature adopted House Bill 1295, which added section 2252.908 of the Government Code. The law states that a governmental entity or state agency may not enter into certain contracts with a business entity unless the business entity submits a disclosure of interested parties to the governmental entity or state agency at the time the business entity submits the signed contract to the governmental entity or state agency. The law applies only to a contract of a governmental entity or state agency that either (1) requires an action or vote by the governing body of the entity or agency before the contract may be signed or (2) has a value of at least $1 million. The disclosure requirement applies to a contract entered into on or after January 1, 2016.

The Texas Ethics Commission was required to adopt rules necessary to implement that law, prescribe the disclosure of interested parties form, and post a copy of the form on the commission’s website. The commission adopted the Certificate of Interested Parties form (Form 1295) on October 5, 2015. The commission also adopted new rules (Chapter 46) on November 30, 2015, to implement the law. The commission does not have any additional authority to enforce or interpret House Bill 1295.

Filing Process:

Staring on January 1, 2016, the commission made available on its website a new filing application that must be used to file Form 1295. A business entity must use the application to enter the required information on Form 1295 and print a copy of the completed form, which will include a certification of filing that will contain a unique certification number. An authorized agent of the business entity must sign the printed copy of the form. The completed Form 1295 with the certification of filing must be filed with the governmental body or state agency with which the business entity is entering into the contract.

The governmental entity or state agency must notify the commission, using the commission’s filing application, of the receipt of the filed Form 1295 with the certification of filing not later than the 30th day after the date the contract binds all parties to the contract. This process is known as acknowledging the certificate. The commission will post the acknowledged Form 1295 to its website within seven business days after receiving notice from the governm ental entity or state agency. The posted acknowledged form does not contain the declaration of signature information provided by the business.

A certificate will stay in the pending state until it is acknowledged by the governmental agency.

Only acknowledged certificates are posted to the commission’s website.

Electronic Filing Application:
https://www.ethics.state.tx.us/whatsnew/elf_info_form1295.htm Frequently Asked Questions:
https://www.ethics.state.tx.us/resources/FAQs/FAQ_Form1295.php Changes to Form 1295: https://www.ethics.state.tx.us/data/filinginfo/1295Changes.pdf �����������������
Controlling
Name of Interested Party4 Nature of interest
City, State, Country (place of business)
Intermediary
(check applicable)
CERTIFICATE OF INTERESTED PARTIES 1295FORM
1 of 1
1 OFFICE USE ONLY
2 02/13/2023
Complete Nos. 1 - 4 and 6 if there are interested parties.

Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.

Name of business entity filing form, and the city, state and country of the business entity's place of business.

Robertson Recreational Surfaces
Tempe, AZ United States
Name of governmental entity or state agency that is a party to the contract for which the form is being filed.

Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 3 Region 4 Education Service Center
Playground and Recreational Surface Products and Services 23-01
2023-982510
Date Filed:

Date Acknowledged:

Certificate Number:

CERTIFICATION OF FILING
6 Signature of authorized agent of contracting business entity My name is _______________________________________________________________,

UNSWORN DECLARATION
Check only if there is NO Interested Party.5
X
My address is _______________________________________________, _______________________, and my date of birth is _______________________.

Executed in ________________________________________County, I declare under penalty of perjury that the foregoing is true and correct. (street) (state) (zip code) (country)
(year)(month)
_______, ______________, _________.

State of ________________, on the _____day of ___________, 20_____. (city)
(Declarant)
Version V3.5.1.3ac88bc0www.ethics.state.tx.usForms provided by Texas Ethics Commission Karim Odeh 01/24/1994
418 Timberlinks Drive SIgnal Mountain TN 37377 USA
Hamilton TN 13th February 23
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Appendix C, DOC # 4
T
exas Government Code 2270 Verification Form
H
ouse Bill 89 (85R Legislative Session), which adds Chapter 2270 to the Texas Government Code, provides that a governmental entity may not enter into a contract with a company without verification that the contracting vendor does not and will not boycott Israel during the term of the contract.

Fur
thermore, Senate Bill 252 (85R Legislative Session), which amends Chapter 2252 of the Texas Government Code to add Subchapter F, prohibits contracting with a company engaged in business with Iran, Sudan or a foreign terrorist organization identified on a list prepared by the Texas Comptroller.

I
, ___________________________________________________, as an authorized representative of
_____________________________________________________________, a contractor
engaged by
Insert Name of Company
Region 4 Education Service Center, 7145 West Tidwell Road, Houston, TX 77092, verify by this writing that the above-named company affirms that it (1) does not boycott Israel; and (2) will not boycott Israel during the ter m of this contract, or any contract with the above -named Texas governmental entity in the future.

A
lso, our company is not listed on and we do not do business with companies that are on the Texas Comptroller of Public Accounts list of Designated Foreign Terrorists Organizations found at https://comptroller.texas.gov/purchasing/docs/foreign-terrorist.pdf.

I fu
rther affirm that if our co mpany's position on this issue is reversed and this affirmation is no longer valid, that the above-named Texas governmental entity will be notified in writing within one (1) bus
iness day and we understand that our company's failure to affirm and comply wit h the r
equirements of Texas Government Code 2270 et seq. shall be grounds for immediate contract termination without penalty to the above-named Texas governmental entity.

I
swear and affirm that the above is true and correct.
______________________________________________
________________
Signature of Named Authorized Company Representative Date Tom DiScipio
Robertson Recreational Surfaces
2/14/2023
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Appendix C, DOC # 5

FELONY CONVICTION NOTIFICATION
S ectio n 44.034, Texas Education Code, Notification of Criminal History, Subsection (a), states “A person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony.”
S ubsection (b) states “A school district may terminate a contract with a person or business entity if t he district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for services performed befor e the termination of the contract.”
Thi s Notice is Not Required of a Publicly -Held Corporation

CRIMINAL HISTORY REVIEW OF CONTRACTOR EMPLOYEES
O fferor shall review § 22.0834, Texas Education Code and 19 Texas Administrative Code §§153.1101 and 153.1117 regarding criminal history checks of school contractor employees.

The rules define continuing duties related to contracted services, direct contact with students, covered contract employee and other relevant terms within the statute.

E xcept as otherwise provided herein, Offeror will obtain and certify in writing, before work begins, that the Offeror has received all criminal history record information that relates to an employee, applicant, agent or Subcontractor of the Offeror/Contractor or Subcontractor, if the person has or will have continuing duties related to the contracted services, and the duties are or will be performed on Region 4 ESC’s, or Participating Public Agency as applicable to the Texas Education Code, property where students are regularly present or at another location where students are regularly present. Awarded Offer(s) shall assume all expenses associated with the background checks and shall immediately remove any employee or agency who was convicted of, receive probation for, or received deferred adjudication for any felony as outlined below or any misdemeanor involving moral turpitude, from Region 4 ESC’s property or other location where students are regularly present.

Offeror/Contractor or sub-contractors may not work on Region 4 ESC’s, or Participating Public Agency where the Texas Education Code may be applicable, property where students are present when they have been convicted, received probation, or deferred adjudication for the following felony offenses:

1. Any offense against a person who was, at the time the offense occurred, under 18 years of age or enrolled at a public school;

2. Any sex offense;

3. Any crimes against persons involving:
�����������������
a. Controlled substances; or
b. Property; or

4. Any other offense Region 4 ESC, or Participating Public Agency where the Texas Education Code may be applicable, believes might compromise the safety of students, employees or property.

I , ___________________________________________________, as an authorized representative of
_____________________________________________________________, the Offeror verify
that:

A. My company is not owned nor operated by anyone who has been convicted of a felony.

Signature of Company Official: ___________________________________ Date: ________ B. My company is owned or operated by the following individual(s) who has/have been convicted of a felony:

Name of Felon(s): ___________________________________________________________ Details of Conviction(s) : ______________________________________________________ Date: _______________
C. My company is a publicly held corporate, therefore, this reporting requirement is not applicable.

Signature of Company Official: ___________________________________ Date: ________ Tom DiScipio
Robertson Recreational Surfaces
2/14/2023
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CITY OF BELL GARDENS
7100 S. GARFIELD AVE
BELL GARDENS, CA 90201
(562) 806-7700