APPLICATION FOR

City of Rohnert ParkNon-Exclusive Temporary Construction and Demolition Debris Collection Service

REVISED September 25, 2017

APPLICATION INSTRUCTIONS AND APPLICATION

The following information is provided to assist the Applicant in completing the application forproviding Non-Exclusive Temporary Construction and Demolition Debris CollectionService within the City of Rohnert Park. Proposers. Applicants must complete theApplication by filling out the information in the shaded text boxesand attaching the required insurance documents and the performance bond or letter of credit. Applicants may also attach supplemental information, such as facility permits.

Section 1 – Company and Subcontractor Identification

Applicant must provide the Business Name or Name of Company or Corporation, along with company or corporate office address and phone information and D.B.A., if applicable. For corporations, do not enter corporate headquarters of the Parent Corporation.

Applicant must also provide the name and address, and phone number of all subcontractors directly involved in collection, processing or disposal operations.

Section 2 – Company Qualifications

A.Qualifications of the Applicant. Applicants must identify the key staff persons (includingApplicant’s supervisor and the Agreement Manager assigned to the City). This should include each person’s name, qualifications, and job responsibilities.

B.Address & Phone Number. Applicant must provide local contact information and a Citybusiness License number.

C.References. Applicants must provide a minimum of three (3) governmental clients that the City may contact to conduct a reference check. The Applicant must be providing or have provided similar services as requested herein to the municipality within the last three (3) years.

D.Litigation History.

  • The Applicant must provide a history for the last five (5) years of all claims settlements, arbitrations, litigation proceedings, and civil actions involving $50,000 or more, and all criminal actions in which the company, its parent company, subsidiaries, all partners, or principals were involved.
  • The Applicant shall provide a list of all enforcement actions taken against it during the last five (5) years by any regulatory agency such as, but not limited to, the United States Environmental Protection Agency, CalRecycle, Air Quality Management District or a Local Enforcement Agency pursuant to Section 43209 of the Public Resources Code. The list shall include the name of the regulatory agency and the date of the enforcement action.
  • The Applicant shall list all instances where it has had a permit, franchise, license, entitlement, or business licenses that have been revoked or suspended in the last five (5) years.
  • The Applicant must list any liquidated damages, administrative fines, charges, or assessments that total $15,000 or greater in any one (1) calendar year during the last five (5) years that have been paid by the Applicant to a public agency as a result of solid waste management services provided by Applicant.
  • The Applicant must list any claims against a bid, application, or performance bond and the results and failure to receive a bid, proposal, or performance bond, or any contractual defaults or termination in the last five (5) years.

C. Insurance. The Applicant must submit a commitment letter from a qualified insurance carrier as part of their Application. If the Franchisee fails to maintain the required insurance coverage or to provide the required Certificates of Insurance to the City at any time during the term of the Agreement, the Franchisee’sAgreementwill be immediately terminated and the Franchisee will not be able to re-apply for Non-Exclusive Temporary Construction and Demolition Debris Collection Servicesuntil after the term of the awarded Agreements have expired.In addition, if Applicants do not submit certificates of insurance by December 1, 2017, Application will be rejected.

D. Performance Bond. A performance bond in an amount of Ten ThousandDollars ($10,000)in a form acceptable to the Citymust be submitted by theFranchisee(s) within ten (10) calendar days from the date the Cityawardsand executes the Agreement(s).The performance bond shall be executed by a surety company licensed to do business in the State of California; approved by the City; and included on the list of surety companies approved by the Treasurer of the United States.If the Applicant does not include a performance bond as part of its Application, theymust provide, as a part of the Application, a letter of credit from a State of California Licensed Surety Company acceptable to the City in form and content.

As an alternative to the performance bond required by the Agreement, at City’s option, Franchisee may deposit withthe City an irrevocable letter of credit as set forth in the Agreement, but no later than ten (10) calendar days from the date the City approves and executes the Agreement.

Section 3 – Technical Approach

Applicantsmust provide a description of the manner in which the requested services are to be provided. At a minimum, Applicants shall include the following information in their Application:

  1. How Applicants will reduce wear-and-tear on City’s streets by preventing overloaded or over weight containers or trucks, preventing damage to streets caused by containers, their placement, or the weight.
  2. Methods used to tarp or cover loads used to prevent litter or material blowing or spilling from containers.
  3. Customer outreach and Load Inspection program to prevent the acceptance and hauling of unacceptable material or Exempt Waste. Also, when unacceptable or Exempt Waste is found in the loads, how it will be handled.
  4. Vehicle and container maintenance program, including response/replacement/repair time for vehicles on route.
  5. Hazardous Waste and Universal Waste Management protocol.
  6. Health and safety management procedures.
  7. Applicants must provide an inventory for all vehicles (active or backups) to be used for collection pursuant to this Agreement and documentation that the vehicles are permitted by the local permitting agency. Underthevehicle storage location, please indicate the type of surface of the vehicle parking area (i.e. asphalt, concrete, gravel, dirt, etc.). If no vehicle maintenance shop exists onsite, please indicate where vehicles are serviced.
  8. Applicants must provide information for the Recycling, Transfer/Processing, and Disposal facilities they will be using, including any facilities located outside of Sonoma County. Facilities to be used including documentation of state and local permits, processing methods, methods used to determine amounts diverted (by type of material) and residual amount, and disposal location(s) for residual material. Note that the City is requiring Franchisees to deliver residual or disposal material to the Sonoma County Landfill/Transfer Station System.

Section 4 – Minimum Diversion Requirements

Applicant toacknowledge responsibility for delivering all materials collected to a permitted and licensed Processing Facility for processing prior to disposal, to meet the Minimum Diversion Requirements for City of Rohnert Park.

Section 5 – Franchise Fee

Applicant to acknowledge the payment of the City’sFranchise Fee of fifteen percent (15%) of all gross revenues, will be made on a quarterlybasis.

Section 6 – Reimbursement for the Cost of Procurement

Applicant to acknowledgereimbursement to the City for the cost of this procurement process within 30 days after the award of the Agreement. The reimbursement cost for this procurement process set by the Citywill be up to $75,000, and will be shared equally between all Applicants that are awarded an Agreement.

Section 7 – Application Certification

Applicant to carefully review the Application Certification section of the application prior to signing it. The Applicant must sign this certification on behalf of the company.

Section 8 – Forms A-C

Applicant must complete and include in their Application Forms A, B and C, in the order the forms are listed in Application. Applicants shall use only the forms and format provided. Any deviation from those provided will result in automatic disqualification.

Section 9 – Proposed Initial Maximum Rates

Applicant to specify the initial maximum customer rates the Applicantproposes, in the event that Applicant is the only Franchisee operating in the Cityas described in Section 2.4.7 of the RFP document. Rates to be provided include pull only and per ton processing fees.

Section 1: Applicant and Subcontractor Identification
A. Business Name OR Name of Applicant’s Corporation
B. Street Address of Business Owner OR Corporation (Street, City, State, Zip)
C. Business PhoneBusiness Fax E-mail or Website
D. Primary Contact Person for All Correspondence for Applicant Phone
E. Type of Organization (Check one)
Individual (Owner/Operator) / Limited Partnership / Joint Venture
Husband and Wife / Limited Liability Company / Unincorporated Association – Other than a Partnership
Corporation / Business Trust
General Partnership / Co-Partners / Public Agency
F. If Applicant is an affiliate of a Recycling operations of another corporation, the Applicant shall list the names and addresses of the parent or subsidiary companies, together with a description of their business interests and/or ownership.
G. If Applicant is a joint venture or other combination of persons and corporations, identify separately the names and addresses of each member of the joint venture or combined effort, together with their percentage interest.
H. If Applicant is using subcontractors for services under the terms of the Agreement, the Applicant must identifythe subcontractor addresses, contact person, phone number, and responsibility of each subcontractor.
Section 2: Company Qualifications
A. Key Staff:
Company Executive Officer
Years of Experience in Solid Waste
Title Phone
Financial Officer
Title Phone
Years of Experience in Solid Waste
Operations Manager
Title Phone
Years of Experience in Solid Waste
Total number of Employees:
B. Address & Phone:
Local Business Office Address
(Physical Address, City, State, Zip Code)
Business Office Phone Local Business Office Fax
City Business License No.
C. References
Reference No. 1:Name ,Title , Phone Number
Services Provided
Reference No. 2:Name ,Title , Phone Number
Services Provided
Reference No. 3: Name,Title, Phone Number
Services Provided
D. Litigation History. Check all that apply and attach documentation if required:
None
Claims of $50,000 or more. Explanation:
Enforcement action. Explanation:
Revocation or suspension. Explanation:
Liquidated damages of $15,000 or more. Explanation:
Claims against bid, application, or performance bond, or any contractual defaults or terminations. Explanation:
E. Insurance. Check box and attach documentation as required.
Attached letter of commitment from a qualified insurance carrier
D. Performance Bond. Please check the box that applies.
Attached Performance Bond
Attached Performance Bond Commitment Letter from a California Surety Company
Attached Letter of Credit

Section 3: Technical Approach (Equipment, Facilities, & Services)

A. Method to reduce wear-and-tear and damage on City’s streets
B. Methods used to tarp or cover loads
C. Customer outreach and load inspection program
D. Vehicle and container maintenance program
E. Hazardous Waste and Universal Waste Management Protocol
F. Health and safety management procedures
G. Vehicles: Please enter the total number of collection vehicles to be operated within the City of Rohnert Park under this Application:
Applicantmust complete the following vehicle inventory and attach a copy of the local agency permit for each vehicle, including the current registration, license and most recent BIT inspection. The inventory must include all vehicles proposed for use by the Applicant for services under the terms of the Agreement, including any vehicles used as backup vehicles.
Make / Model Number / Capacity/GVWR
(Tons) / Year / Vehicle Identification No. (VIN#) / Vehicle
License No. / Fuel Type
Provide a general description of the site(s) where vehicles are stored, either overnight or during non-utilization periods:
Site Address:
City Name or Unincorporated County?
Type of Surface in Vehicle Parking Area?(Concrete, Asphalt, Gravel, Base Rock, Dirt, etc.)
Vehicle Maintenance Shop Onsite? Yes No
General Description (Attach additional sheets and/or site map as necessary):
H. Facilities to be used. Please indicate in the table below the Recycling, Transfer/Processing, & Disposal facilities your company uses or intends to use for material collected under this Agreement within the City of Rohnert Park.
Recycling Facility(s)
Facility Name / Address / Material Types Accepted / Processing/
Tip Fee / Daily Permitted Capacity (TPD) / LocalLand Use Permit Number / CalRecycle
SWFP#
Transfer / Processing Facility(ies)
Facility Name / Address / Material Types Accepted / Processing/
Tip Fee / Daily Permitted Capacity (TPD) / LocalLand Use Permit Number / CalRecycle
SWFP#
Disposal Facility(s)
Facility Name / Processing/Tip Fee
Sonoma County Landfill/Transfer System

Section 4: Minimum Diversion Requirements

The Franchisee will be responsible for delivering all materials the Franchisee collects to a permitted and licensed Processing Facility for processing prior to disposal. / ______
Signature

Section 5: Franchise Fee

The Franchise Fee will be paid directly to the City on a quarterly basis by the fifteenth (15th) day of the followingquarter. / 15% / ______
Signature

Section 6: Reimbursement for the Cost of Procurement

Maximum reimbursement for cost of the procurement process set by the City. This amount will be shared equally between all Applicants that are awarded an Agreement. / Up to $75,000 / ______
Signature
Section 7
APPLICATION CERTIFICATION
I understand that Non-Exclusive Temporary Construction and Demolition Debris Collection Service Agreements are issued pursuant to the RFP issued by the City of Rohnert Park. All Temporary Construction and Demolition Debris Collection Services shall be provided by the Franchisee. Sub-contracting and other forms of transferring obligations and/or responsibilities imposed by the Franchisee are prohibited.
I hereby certify that the information in this Application is true and correct, that the operation will be conducted in accordance with the information contained and certified herein.
  • I have signed and attached the City’sDraft Non-Exclusive Temporary Construction and Demolition Debris Collection Service Agreement.
  • I have examined, understood, and agreed to all Service Area Conditions, Service Area Requirements, and the Draft Non-Exclusive Temporary Construction and Demolition Debris Collection Services Agreement.
  • I have thoroughly reviewed the requirements of the Draft Non-Exclusive Temporary Construction and Demolition Debris Collection Service Agreement as described in this RFP and related documents, its enclosures, and all addenda, by listing each addendumby date received, and my company has conducted all due diligence necessary to confirm material facts upon which the Application is based.
  • I acknowledge that my company does not currently have any outstanding payments of any kind, including but not limited to assessed liquidated damages or administrative charges received as part of providing services, due to the City or the counties of: Contra Costa, Lake, Marin, Mendocino, Napa, San Francisco, Solano and Sonoma at the time of submitting this Application.
  • I acknowledge that my company will be responsible for delivering all collected materials to a permitted and licensed Processing Facility for processing prior to disposal to meet the Minimum Diversion Requirements set by the City.
  • I acknowledge that my company will deliver all residual or disposal material collected under the City’s Non-Exclusive Temporary Construction and Demolition Debris Collection Service Agreement to the Sonoma County Landfill/Transfer Station System.
  • I acknowledge that my company will pay the City’s Franchise Fee of 15% of all gross revenue, paid monthly.
  • I acknowledge that my company will make payment of an amount up to $75,000 (consisting of payment of from $10,715 up to $75,000,depending on the number of Franchises, as the $75,000 amount will be split evenly among Franchisees) to the City. The reimbursement for the cost of this procurement will be made to the City in two (2) equal payments. The first payment shall be submitted to the City no later than January 15, 2018 and the second payment shall be submitted to the City no later than January 15, 2019.

Name: / ______
Signature
Title: / Date:

Section 8Form ACERTIFICATION OF NON-GRATUITIES

TO: THE CITY OF ROHNERT PARK
CERTIFICATION
This is a written certification, signed under penalty of perjury, stating that no persons acting on behalf of have paid, or offered or attempted to pay, any elected or appointed official, officer or employee of the City any compensation or consideration, in any form whatsoever, in connection with obtaining or entering into this Agreement.
Name: / Title:
______
Signature / Date:

Section 8Form BNON-COLLUSION AFFIDAVIT OF APPLICANT

State of County of
, being duly sworn, deposes and says that:
1.He/She isof the Applicant that has submitted the attached Application;
2.He/She is fully informed respecting the preparation and contents of the attached Application and of all pertinent circumstances respecting such Application;
3.Such Application is genuine and is not a collusive or sham Application; and
4.Neither said Applicant nor any of its officers, partners, owners, agents, representatives, employees, or parties in interest, including this affiant, has in any way colluded, connived, or agreed, directly or indirectly, with any other Applicant, firm or person to submit a collusive or sham Application in connection with the Agreement for which the attached Application has been submitted or to refrain from proposing in connection with such Agreement, or has in any manner, directly or indirectly, sought by agreement or collision or communication or conference with any other Applicant, firm, or person to fix the price or prices in the attached RFP, or of any other Applicant, or to fix any overhead, profit or cost component of the Application or the response of any other Applicant, or to secure through any collusion, connivance, or unlawful agreement any advantage against The City of Rohnert Park, CA or any person interested in the proposed Agreement.
5.The rate proposal in Section 9 of this Application is fair and proper and is not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the Applicantor any of its agents, representatives, owners, employees, or parties in interest, including this affiant.
6.Applicant must list the name of any and all other solid waste service providers and/or affiliates that it has a “non-compete” agreement with that prohibits the other solid waste services provider from proposing on services as requested in this RFP. Failure to disclose this information may result in immediate disqualification from this RFP process.
(Signed) (Title)
Subscribed and sworn to before me this day of , 2017
My Commission Expires:
Notary Public, State of California

Section 8Form CPROCESS INTEGRITY RULES

The City of Rohnert Park’sgoal for the Non-Exclusive Temporary Construction and Demolition Debris CollectionServiceRFP is to be open, objective, carefully monitored, and understandable to all. The following rules will be adhered to and enforced.
Until the City of Rohnert Park City Council awards theNon-Exclusive Temporary Construction and Demolition Debris Collection Service Franchise(s), all contact between participants and the City of Rohnert Parkshall be in writing, either by mail or email to:
By mail to:
Attn: Don Schwartz
Rohnert Park City Hall
130 Avram Avenue
Rohnert Park, CA 94928 / Or, by email to all the following three email addresses:
Don Schwartz – City of Rohnert Park
Email:
and
Carrie Baxter – R3 Consulting Group, Inc.
Email:
and
Kevin Siegel and Sergio Rudin – Special Counsel
Email: and
Any attempt to contact or interact with any elected or appointed official for the purpose of obtaining information or influencing the RFPprocess, including the selection process, will be grounds for disqualification from the selection process.
All communications between the City of Rohnert Park and anApplicant, along with the related responses, will be transmitted to all Applicantsthrough the City website.
Any applicantwho fails to recognize or utilize this process of communication will be notified of its violation and may be subject to disqualification from the selection process at the sole discretion of the City of Rohnert Park.
All applicants must acknowledge and sign this statement as part of the RFP process. Applicants that do not provide this signed statement will be disqualified from this procurement process.
On behalf of my company/agency, I understand and accept the rules established in this statement.
Company Name:
(Print or Type)
Representative: Title:
(Print or Type)
Signature ______Date:
(Sign in Ink)

Section 9: ProposedInitial Maximum Rates

Note: Proposed rates to be used in event that only one FRANCHISEE is active in the CITY.
MIXED C&D / Processing Fee: $0.00 per ton
Box Size / 8CY / 10CY / 20CY / 30CY / 40CY
Pull Only / $0.00 / $0.00 / $0.00 / $0.00 / $0.00
CLEAN CONCRETE ONLY / Processing Fee: $0.00 per ton
Box Size / 8CY / 10CY / 20CY / 30CY / 40CY
Pull Only / $0.00 / $0.00 / $0.00 / $0.00 / $0.00
CLEAN WOOD ONLY / Processing Fee: $0.00 per ton
Box Size / 8CY / 10CY / 20CY / 30CY / 40CY
Pull Only / $0.00 / $0.00 / $0.00 / $0.00 / $0.00
CLEAN GREEN WASTE ONLY / Processing Fee: $0.00 per ton
Box Size / 8CY / 10CY / 20CY / 30CY / 40CY
Pull Only / $0.00 / $0.00 / $0.00 / $0.00 / $0.00
INERTS (DIRT & ROCK) / Processing Fee: $0.00 per ton
Box Size / 8CY / 10CY / 20CY / 30CY / 40CY
Pull Only / $0.00 / $0.00 / $0.00 / $0.00 / $0.00
* All 8, 10, 20, 30 and 40 CY boxes are pull rates only; processing fee will be based on actual tons processed. The franchise fee, listed in Section 5 of this Application, will be calculated on the gross revenue per box (including collection and processing).

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