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HomeMy WebLinkAbout2024-217-E-Solid Waste-New River Tire Recycling-Loading, transport, and recycling disposal of scrap tiresRevised 01/24 NORTH CAROLINA CONTRACT AMENDMENT ORANGE COUNTY THIS CONTRACT AMENDMENT (“Amendment”) is made and entered into this 1 day of May 2024 by and between ORANGE COUNTY (hereinafter referred to as “County”) and New River Tire Recycling, LLC (hereinafter referred to as “Provider”). WITNESSETH: THAT WHEREAS, the County and Provider entered into a contract dated May 1, 2017, as amended on May 1, 2022 (hereinafter the “Original Agreement”), for the provision of services for the recycling of scrap tires; and WHEREAS, the County and Provider desire to amend the Original Agreement while keeping in effect all terms and conditions of the Original Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration of the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: 1. Section 4a is amended to reflect a term of May 1, 2024, to June 30, 2027. 2. Section 5 is amended to reflect a maximum payable not-to-exceed amount of $250,000 per year. 3. Except for the changes made herein, the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event there is a conflict between the terms of the Original Agreement and the terms of this Amendment, this Amendment shall control. IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above written. ORANGE COUNTY PROVIDER ______________________________ __________________________________ Bonnie Hammersley Benjamin Bryant County Manager New River Tire Recycling DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 owner Revised 01/24 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: New River Tire Recycling, Inc. Vendor Contact Person: Benjamin Bryant Phone: 276-728-0201 Address: P.O.Box 1752 City Pilot Mountain State: NC Zip: 27401 Department: Solid Wast Amount: 750,000 Purpose: Loading, transport, and recycling/disposal of scrap tires. Budget Code(s): 5031020-630003 Vendor # 64480 Vendor Status with NCSOS: Active Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: 2017) (Most Recent Amendment 2022) Effective Date May 1, 2024 End Date June 30, 2027 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: 04/02/24 ); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: 04/02/24) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception (# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. This agreement is approved as to technical form and content. Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer ___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 4/10/2024 4/11/2024 4/11/2024 4/11/2024 Revised 01/24 DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 Revised 06/21 NORTH CAROLINA CONTRACT AMENDMENT ORANGE COUNTY THIS CONTRACT AMENDMENT (“Amendment”) is made and entered into this __1st_ day of _____May_______, 2022_ by and between ORANGE COUNTY (hereinafter referred to as “County”) and New River Tire Recycling, Inc. (hereinafter referred to as “Provider”). WITNESSETH: THAT WHEREAS, the County and Provider entered into a contract dated June 1, 2017, (hereinafter the “Original Agreement”), for the recycling of scrap tires; and WHEREAS, the County and Provider desire to amend the Original Agreement while keeping in effect all terms and conditions of the Original Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration of the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: 1. Section 3 ii is amended to reflect the information contained in Attachment A hereto. 2. Section 4a is amended to reflect a term of May 1, 2022 to April 30 2024. 3. Section 5 is amended to reflect a maximum payable not-to-exceed amount of $250,000 per year. 4. Except for the changes made herein, the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event there is a conflict between the terms of the Original Agreement and the terms of this Amendment, this Amendment shall control. IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above written. ORANGE COUNTY PROVIDER ______________________________ __________________________________ Bonnie Hammersley New River Tire Recycling, Inc.____ County Manager ________ DocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3 owner DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 Attachment A Orange County Solid Waste 1514 Eubanks Road Chapel Hill, NC 27516 After reviewing the contract between New River Tire Recycling, LLC and Orange County Solid Waste, a price increase will go into effect on May 1st, 2022. The current per ton price is $73.50 and $53.50 if brought to our facility. The new pricing will be as follows: $175.00 per ton- NRTR picks up at Orange County Solid Waste $150.00 per ton- Orange County bring to our (NRTR) facility $250.00 per ton for tires on rims $350.00 per ton for dirty tires/foreign debris (The entire load will be charged the upcharg e) $400.00 per ton for OTR’s and Skid Steer tracks (OTR’s are considered anything 5’ tall/wide and bigger; the entire load will be up charged) A fuel surcharge will be charged per load, except when brought to our location: $3.00-$3.25 = $20.00 $3.26-$3.50 = $40.00 $3.51-$3.75 = $60.00 $3.76-$4.00 = $80.00 This format will continue indefinitely. Orange County Solid Waste will be responsible for loading NRTR when picked up. _____ Yes, I agree to these terms _____No, I would like to decline these terms _________________________________ _________________ Signature of Orange County Representative Date _________________________________ Printed Name Thank you, Ben Bryant- Owner DocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 Revised 06/21 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: New River Tire Recycling, LLC Party/Vendor Contact Person: Ben Bryant Contact Phone: Party/Vendor Address: P.O. Box 1752 City Pilot Mountain State: NC Zip: 27041 Department: Solid Waste Amount: $500,000 ($250,000 per year) Purpose: Loading, Transporting, and Recycling or Disposal of Scrap Tires Budget Code(s): 50352020-630003 Vendor # (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date May 1, 2022 Approved by Board Yes No Agenda Date: May 3, 2022 --- For Section XIV. c. contracts only, Approved by Board in Current FY Budget Yes No This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3 5/25/2022 5/25/2022 6/7/2022 6/7/2022 DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 Revised 2/17 1 [Departmental Use Only] TITLE FY NORTH CAROLINA SERVICES AGREEMENT OVER $90,000.00 RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter “Agreement”), made and entered into this 1st day of June, 2017, (“Effective Date”) by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and New River Tire Recycling, LLC, (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Services Agreement (“Agreement”) is for professional services to be rendered by Provider to County with respect to (insert type of project): loading, transporting, and recycling or disposal of scrap tires ii) By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 10% of the whole upon County’ Task one. Upon the County’ http://www.orangecountync.gov/departments/purchasing_division/contracts.php DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 — Department Director’s Signature DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19E 5/11/2017 5/11/2017 5/16/2017 5/16/2017 DocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 ATTACHMENT A: SUBCONTRACTORS Contractors desiring to utilize subcontractors to load tires for Orange County must receive prior written County approval before subcontractors perform any services for the County. The County is willing to contact the subcontractor when it is time for loading, but must be provided with valid contact information for the subcontractor. Living wage standards apply to both the Contractor and subcontractor. CONTRACTOR RESPONSIBILITIES (Or whatever we call it in our Contracts) The Contractor shall be responsible for: • Providing adequate equipment at the County’s Construction and Demolition Landfill (1514 Eubanks Road Chapel Hill) to receive and load tires Monday through Friday from 7:00 a.m. to 3:00 p.m. and Saturday 8:00 a.m. to 12:00 p.m. . Changes in hours will be communicated to the Contractor with 30 days’ notice. Contractor staffing should be used to load tires. The County will not assist in loading tires. The County Project Manager should be informed of any changes to load staffing at County facilities. The County shall have the right to approve and reject subcontractors that will be working on County property; • Providing open top trailers, and loading open top trailers at least three times per week or as otherwise directed by the County. If the open top trailer system results in tires on the asphalt pad being stored overnight, the Contractor will modify the program to include two or three 50 foot tractor trailers and load the trailers on a regular basis. Any other program modification must be submitted in writing and approved by the County Project Manager. • Removing all loaded trailers within one (1) business day.  Scrap tires waiting to be loaded, are only allowed on the concrete pad. No scrap tires should be stored on the asphalt pad overnight.  Reporting the weight of the materials collected to the County; • Charging the County according to the Price Sheet; • Moving and placing collection containers as requested by the County; and • Utilizing containers and trailers that are safe, do not contain holes or graffiti and are clearly labeled. DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 REQUEST FOR PROPOSALS RFP 5231 ORANGE COUNTY Tire Recycling Program Orange County 200 S. Cameron Street P.O. BOX 8181 HILLSBOROUGH, NC 27278 February 2017 CONTACT PERSON: David Cannell, Purchasing Agent dcannell@orangecountync.gov. or (919) 245-2651 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 1 Table of Contents Section I (General Requirements/Overview of Program) ........................................................................... 3 Submission Instructions ............................................................................................................................ 3 Purpose of Program ................................................................................................................................. 3 Overview of Requirements ....................................................................................................................... 3 RFP Evaluation Process ............................................................................................................................ 3 Proposal Negotiations .............................................................................................................................. 4 E-Verify ..................................................................................................................................................... 4 Living Wage .............................................................................................................................................. 4 North Carolina Sales Tax .......................................................................................................................... 4 Iran Divestment Act ................................................................................................................................. 4 Public Information.................................................................................................................................... 4 Terms of Agreement ................................................................................................................................ 4 Provisions of Goods and Services ............................................................................................................ 5 Placement of Orders ................................................................................................................................ 5 Invoicing and Payment ............................................................................................................................. 5 Section II (Special Provisions) ...................................................................................................................... 5 Background ............................................................................................................................................... 5 General ..................................................................................................................................................... 6 Pricing ....................................................................................................................................................... 6 Adequate Labor, Equipment and Facilities .............................................................................................. 6 Visits ......................................................................................................................................................... 7 Pickup ....................................................................................................................................................... 7 Response Time ......................................................................................................................................... 7 Record Keeping ........................................................................................................................................ 7 Price and Type of Bid ............................................................................................................................... 8 Contract Period ........................................................................................................................................ 8 Current System......................................................................................................................................... 8 Basis for Award ........................................................................................................................................ 9 CPI Adjustments ....................................................................................................................................... 9 Discrepancies ........................................................................................................................................... 9 Recycling Requirements ........................................................................................................................... 9 Subcontracting ......................................................................................................................................... 9 Permitting Requirements ......................................................................................................................... 9 Additional Requirements ....................................................................................................................... 10 Section III (Bid Documents) ........................................................................................................................ 11 Quotation Sheet ..................................................................................................................................... 11 Reference List ......................................................................................................................................... 12 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 Offeror’s demonstrated experience in Offeror’s ability to recycle 75% of the tires collected from Orange County. DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 Revised 6/16 1 [Departmental Use Only] TITLE FY NORTH CAROLINA SERVICES AGREEMENT OVER $90,000.00 RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter “Agreement”), made and entered into this day of , 20 , (“Effective Date”) by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") and , (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Services Agreement (“Agreement”) is for professional services to be rendered by Provider to County with respect to (insert type of project): ii) By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Provider is solely responsible for the professional DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 10% of the whole upon County’ Task one. Upon the County’s acknowledgement that the DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 http://www.orangecountync.gov/departments/purchasing_division/contracts.php DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 STATE OF NORTH CAROLINA AFFIDAVIT ORANGE COUNTY ************************** I, ____________________________(the individual attesting below), being duly authorized by and on behalf of ________________________________ (the entity bidding on project hereinafter "Employer") after first being duly sworn hereby swears or affirms as follows: 1. Employer understands that E-Verify is the federal E-Verify program operated by the United States Department of Homeland Security and other federal agencies, or any successor or equivalent program used to verify the work authorization of newly hired employees pursuant to federal law in accordance with NCGS §64-25(5). 2. Employer understands that Employers Must Use E-Verify. Each employer, after hiring an employee to work in the United States, shall verify the work authorization of the employee through E-Verify in accordance with NCGS§64-26(a). 3. Employer is a person, business entity, or other organization that transacts business in this State and that employs 25 or more employees in this State. (mark Yes or No) a. YES _____, or b. NO _____ 4. Employer's subcontractors comply with E-Verify, and if Employer is the winning bidder on this project Employer will ensure compliance with E-Verify by any subcontractors subsequently hired by Employer. This ____ day of _______________, 201_. Signature of Affiant Print or Type Name: _________________________ State of North Carolina Orange County Signed and sworn to (or affirmed) before me, this the _____ day of ________________, 2014. My Commission Expires: Notary Public (Affix Official/Notarial Seal) DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 IRAN DIVESTMENT ACT CERTIFICATION REQUIRED BY N.C.G.S. 143C-6A-5(a) Name of Contractor, Vendor or Bidder: As of the date listed below, the contractor, vendor or bidder listed above, and all subcontractors utilized by the contractor, vendor or bidder listed above, is not listed on the Final Divestment List created by the State Treasurer pursuant to N.C.G.S. 143-6A-4. The undersigned hereby certifies that he or she is authorized by the contractor, vendor or bidder listed above to make the foregoing statement. Signature Date Printed Name Title Notes to persons signing this form: N.C.G.S. 143C-6A-5(a) requires this certification for bids or contracts with the State of North Carolina, a North Carolina local government, or any other political subdivision of the State of North Carolina. The certification is required at the following times:  When a bid is submitted  W hen a contract is entered into (if the certification was not alread y made when the vendor made its bid)  When a contract is renewed or assigned N.C.G.S. 143C-6A-5(b) requires that contractors with the State, a North Carolina local government, or any other political subdivision of the State of North Carolina must not utilize any subcontractor found on the State Treasurer’s Final Divestment List. The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address www.nctreasurer.com/Iran and will be updated every 180 days. *****Contractor, Vendor or Bidder – Return This Form With All Other Required Documentation***** *****Contractor, Vendor or Bidder – Return This Form With All Other Required Documentation***** DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 Section I: General Government and Administration Policy 10.0: Living Wage Contractor Policy Reviewed by: County Attorney/County Manager Approved by: County Manager Original Effective Date: April 21, 2016 Revisions: Policy Statement It is the policy of Orange County to ensure its employees, and all individuals who provide services for Orange County, are paid a living wage. Purpose To encourage all vendors and contractors to pay a living wage to all employees who perform work pursuant to a contract with Orange County. Applicability Applies to all Orange County contracts and purchases. Policy 10.1 Living Wage 10.1.1 Orange County is committed to providing its employees with a living wage and encourages all contractors and vendors doing business with Orange County to pursue the same goal. Orange County’s living wage is $13.16 per hour. To the extent possible, Orange County recommends that contractors and vendors seeking to do business with Orange County provide a living wage to their employees. 10.1.2 Prior to final execution of a contract with Orange County all contractors and vendors seeking to do business with Orange County shall submit to the County’s representative a statement indicating whether those employees who will perform work on the Orange County contract are paid at least the living wage amount set out above. If such employees do not make at least the living wage amount set out above the contractor or vendor shall indicate in the statement the actual amount paid to such employees. For bid projects this statement should be submitted as part of the bid packet. This policy may be reviewed annually and updated as needed by the Manager’s Office DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person)$ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE AXIS Surplus Insurance Company Oak River Insurance Company Progressive Southeastern Insurance Co. 4/19/2022 McGriff Insurance Services 902 Prices Fork Rd Ste 2025 Blacksburg, VA 24060 540 808-1220 540 808-1220 888-746-8791 New River Tire Recycling LLC dba RUBBERLogix PO Box 1752 Pilot Mountain, NC 27041-1752 26620 34630 38784 A X X EMP1900084504 04/18/2022 04/18/2023 1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000 C X 03353876 11/03/2021 11/03/2022 1,000,000 B N NEWC314678 04/25/2022 04/25/2023 X 1,000,000 1,000,000 1,000,000 Orange County Landfill PO Box 17177 Chapel Hill, NC 27516 1 of 1 #S29881000/M29874199 38NEWRIVClient#: 2139594 LBV 1 of 1 #S29881000/M29874199 DocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person)$ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE AXIS Surplus Insurance Company Oak River Insurance Company Selective Insurance Co of America 4/04/2024 McGriff Insurance Services LLC 902 Prices Fork Rd Ste 2025 Blacksburg, VA 24060 540 808-1220 Judy Clark 540 808-1220 888-746-8791 Judy.Clark@mcgriff.com New River Tire Recycling LLC dba RUBBERLogix PO Box 1752 Pilot Mountain, NC 27041-1752 26620 34630 12572 A X X EMP1900084505 04/18/2023 04/18/2024 1,000,000 100,000 10,000 1,000,000 2,000,000 2,000,000 C X S2406040 11/08/2023 11/08/2024 1,000,000 B N NEWC416134 04/25/2023 04/25/2024 X 1,000,000 1,000,000 1,000,000 Orange County, it's officers, agents and employees are additional insured's per written contract. Orange County Landfill PO Box 17177 Chapel Hill, NC 27516 1 of 1 #S34127171/M33566555 38NEWRIVClient#: 2139594 JACL 1 of 1 #S34127171/M33566555 DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09 This page has been left blank intentionally. DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09