BLXXX-21

COMPANY NAME:

December 08, 2021

INVITATION TO BID

BL134-21

The Gwinnett County Board of Commissioners is soliciting competitive sealed bids from qualified suppliers for the Purchase of Safety Shoes on an Annual Contract with four (4) one-year options to renew for various Gwinnett County Departments.

Bids should be typed or submitted in ink and returned in a sealed container marked on the outside with the BL# and Company Name. Bids will be received until 2:50 P.M. local time on December 30, 2021, at the Gwinnett County Financial Services - Purchasing Division – 2nd Floor, 75 Langley Drive, Lawrenceville, Georgia 30046. Any bid received after this date and time will not be accepted. Bids will be publicly opened and read at 3:00 P.M. Apparent bid results will be available the following business day on the website www.gwinnettcounty.com.

Questions regarding bids should be directed to Brittany Taylor, Purchasing Associate II, at Brittany.K.Taylor@GwinnettCounty.com or by calling 770-822-7759, no later than December 15, 2021. Bids are legal and binding upon the bidder when submitted. All bids should be submitted in duplicate.

Gwinnett County does not discriminate on the basis of disability in the admission or access to its programs or activities. Any requests for reasonable accommodations required by individuals to fully participate in any open meeting, program or activity of Gwinnett County Government should be directed to the ADA Coordinator at the Gwinnett County Justice and Administration Center, 770-822-8165.

The written bid documents supersede any verbal or written prior communications between the parties.

Award will be made to the suppliers submitting the lowest responsive and responsible bid. Gwinnett County reserves the right to reject any or all bids to waive technicalities and to make an award deemed in its best interest. Bids may be split or awarded in entirety. Gwinnett County reserves the option to negotiate terms, conditions, and pricing with the lowest responsive, responsible bidder(s) at its discretion.

Award notification will be posted after award on the County website, www.gwinnettcounty.com and companies submitting a bid will be notified via email.

We look forward to your bid and appreciate your interest in Gwinnett County.

Brittany Taylor

Brittany Taylor Purchasing Associate II

The following pages should be returned in duplicate as your bid: Bid Schedule, Pages 4-23 References, Page 24 Code of Ethics Affidavit, Page 25 E-Verify Affidavit, Page 26 http://www.gwinnettcounty.com/ mailto:Brittany.K.Taylor@GwinnettCounty.com

BL134-21 PAGE 2

SCOPE OF WORK

This contract will be utilized by multiple user departments which may have varying ship to addresses. The successful low bidder(s) will provide shoes in a timely and efficient manner. Delays in manufacturing and delivery causes delays on the job and/or prohibit County employees from being able to perform their work. Therefore, it is the County’s intention to exercise its right set forth under the General Instructions to Bidders, Section XII. DELIVERY FAILURES, if such actions should occur. The County reserves the right to cancel any purchase order if delivery is not made within the contracted delivery terms. Therefore, it is the responsibility of the vendor to provide accurate and realistic delivery terms on their bid submittal.

*Existing contracts are in place for products included in this bid. At the discretion of Gwinnett County, contract orders for a given product under this contract will not commence until the existing contract or contract renewal period expires per the table below: Items #1-73 are currently on BL059-19, this contract expires on July 20, 2022. Items #74-85 are currently on PA027-20, this contract expires on February 18, 2022.

Item# BL# Expiration

Section A: #1-73 BL059-19 07/20/2022

Section A: #74-85 PA027-20 02/18/2022

Section B: #1-8 BL059-19 07/20/2022

I. REQUIREMENTS

A. The use of brand name is not for restrictive purposes or to limit competition, but to assist suppliers in determining the standard of quality Gwinnett County is seeking. It should be understood that items equaling or surpassing the quality level are also acceptable. Gwinnett County shall be the sole determinant of acceptability of all approved equivalents. It is the supplier's responsibility to prove equivalent products equal or exceed the quality level of the product(s) specified. If quoting an equivalent product, specifications/brochures should be submitted with quote.

When quoting an equivalent product, supplier represents:

• Equivalent product has been personally investigated and determined to be equal to or superior in all respects to that specified.

• Product identification, including manufacturer's name and address should be provided as part of quote document.

B. Quantities are approximate for annual usage. Orders will be placed on an “as needed” basis.

Orders must be filled regardless of quantity and/or dollar amount. The appropriate Gwinnett County department should be notified prior to deliveries, or as soon as orders are ready for pick up.

C. Unit prices must be FOB destination prepaid and allowed delivered to various Gwinnett County locations. Gwinnett County reserves the right to pick up shoes at vendor location.

D. Since employees may be required to travel to the vendor’s site to pick up shoes, location may be taken into consideration in determining award.

BL134-21 PAGE 3

E. Gwinnett County requires vendor to provide a “Shoe Mobile”, as needed, to measure and provide boot/shoes at various locations throughout Gwinnett County.

i. Currently, a ticket for approval to purchase is given to staff, that ticket is then taken to the awarded vendor and used to receive a pair of shoes. At that point in time, the vendor gives a receipt to the staff member and sends the invoice to disbursements.

ii. Gwinnett County will consider paperless options for securing products in this contract.

Please submit a paperless option on the space provided on the Bid Schedule if one is available The County will select the process with the awarded vendor.

F. Gwinnett County employees will provide supplier an authorization form. This form will state which shoes are available to this employee. Gwinnett County will NOT be responsible for payment of any shoe sold to a Gwinnett County employee not authorized by each division/department.

G. Successful supplier is responsible for measuring all employees.

H. Gwinnett County will accept only first run quality, no seconds.

I. Successful supplier should maintain ample stock of all shoes awarded under this contract in order to meet the delivery times specified in their bid.

J. It will be responsibility of the supplier to incur any additional shipping costs associated with shipment of wrong sizes/not true sizes.

K. All shoes and boots must have steel or fiberglass toe and be ANSI and OSHA approved standard

ANSI I/75 C/75 or as indicated.

L. Gwinnett County reserves the right to request samples prior to award for evaluation. Samples should be provided upon request within five (5) business days. Failure to provide samples, when required, may result in rejection of bid. It will be the responsibility of the supplier to incur all costs associated with the samples. All samples are to be identified by brand name and must include the manufacturer and/or style number and the corresponding item number indicated on the bid schedule should also be indicated on each sample.

BL134-21 PAGE 4

COMPANY NAME: _______________________________________________________________________________________________________

FAILURE TO RETURN THIS PAGE AS PART OF YOUR BID DOCUMENT MAY RESULT IN REJECTION OF BID.

BID SCHEDULE

ITEM

APPROX.

ANNUAL

QTY

DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

UNIT

PRICE

TOTAL

PRICE

Section A – Departments of Community Services, Planning and Development & Transportation

1 23 EA

Wolverine 4707 Men’s 11” Boot, Brown, pull-on, Wellington, non-insulated, full leather uppers, removable cushion insole, steel shank, rubber outer sole, steel toe, electrical hazard. ASTM F2412-05 PT99 1/75 C/75. Size: M & XW 7-14, or approved equivalent

2 2 EA

HYTEST K13610 Men’s 6” Boot, black, lace up, waterproof, non-insulated, full grain leather uppers, cambrelle lining, waterproof membrane, rubber sole, composite or steel toe, electrical hazard.

ASTM F2412-05 PT99 I/75 C/75. Size: M & W 4-14, or approved equivalent

3 4 EA

WOLVERINE W04405 Men’s 6” Boot, brown, lace-up, waterproof, non-insulated, full grain leather uppers, cambrelle lining, waterproof membrane, rubber lug sole, composite or steel toe, electrical hazard.

ASMTM F2412-05 PT99 I/75 C/75. Size: M 7-14 W 7-13, or approved equivalent

4 3 EA

Florsheim FS2416 Men’s shoes, black oxford, plain toe, lace-up, full grain leather uppers, casual lightweight, cambrelle lining, removable cushion insole, slip/oil resistant, electrical hazard, polyurethane soft outsole, padded collar, steel or composite toe ASTM F2412-05 PT99 I/75 C/75. Size: M & W 6-14, or approved equivalent

5 15 EA

HYTEST K12170/12171 Women’s 6” Boot or hiker style, Black/Brown, lace-up, plain toe, membrane-waterproof, non-insulated, electrical hazard, rubber lug outsole, passed collar, steel or composite toe, ASTM F2421-05 PT99 1/75 C/75. Size: M & W 5.5-11, or approved equivalent

6 24 EA

Thorogood TG804-6191 Men’s 8” side-zip boot, brown, waterproof leather uppers, steel toe cap, removable cushion insole, light weight outsole, steel shank, waterproof construction, ASTM F2412-05 PT99 I/75 C/75.EH. Size: M & W 7-12, 13, 14, or approved equivalent

BL134-21 PAGE 5

COMPANY NAME: _____________________________________________________________________________________________________________________

BID SCHEDULE CONTINUED

APPROX.

ANNUAL

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DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

UNIT

PRICE

TOTAL

PRICE

7 1 EA

HYTEST K23086, 23085 Men’s 6” boot, full grain leather, extra wide toe cap, full cushion insole, slip & oil resistant outsole, meets ASTM F2412- 05 PT99 I/75 C/75 EH. Size: 4E 8-12, 13, or approved equivalent

8 6 EA

Nautilus Steel Toe Work Shoe Model # N1392, ANSI/ASTM I75 & C75 Approved, Full Grain, Water Resistant, Nubuck Leather Upper, Ergonomically Designed Wide Area Toe Cap, Removable Anti-Fatigue Polyurethane Sock Liner, EVA Midsole for Maximum Comfort, Highly Durable, Slip & Oil Resistant Outsole. Size: 7 medium/wide/extra wide

– 17 medium/ wide/ extra wide, or approved equivalent

9 1 EA

Nautilus Steel Toe Work Shoe # N1317, ANSI/ASTM I75 & C75 Approved, Nylon & Leather Upper, Ergonomically Designed "Wide Area" Composite Alloy Safety Toe Cap, Removable, Anti-Fatigue Polyurethane Insole, EVA Midsole for Maximum Comfort, Highly Durable, Slip and Oil Resistant Firm Support Outsole with Shank for Stability, No Exposed Metal on Upper, Color - Black/Silver/Red.

Size: 7 medium/wide – 15 medium/wide, or approved equivalent

10 1 EA

Florsheim FE 860 steel toes boots, electrical hazard, slip resistant, ASTM F2413-11M I/75 C/75. Size: 6 to 16, or approved equivalent

11 2 EA

Reebok RB4490, composite toe, static dissipating, slip resistant, ASTM F2413-11M I/75 C/75. Size: 6 to 16, or approved equivalent

12 1 EA

Reebok RB449, ITE toe, static dissipating, ASTM F2413-11M I/75 C/75 Size: 6 to 16, or approved equivalent

13 1 EA

Timberland Pro TL47001 Men’s 6” boot, full grain leather, meets ASTM F2412-05 PT99 I/75 C/75 EH. Size: 4E 8-12, 13, Men’s Sizes M7-15,W7- 15, or approved equivalent

BL134-21 PAGE 6

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

QTY

DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

UNIT

PRICE

TOTAL

PRICE

14 1 EA

Women’s Hytest K11160-Black, Water resistant Hiker with Composite toe, Women’s med Sizes 6-12 and wide 6-12, or approved equivalent

15 10 EA

Reebok Hiker RB4555-Black, Water resistant Hiker with Composite toe, Sizes 6-15 and wide 6-14 and Extra Wide 8-13, or approved equivalent

16 7 EA

Reebok Hiker RB4444-Brown, Water resistant Hiker with Composite toe Sizes 6-15 and wide 6-14 and Extra Wide 8-13, or approved equivalent

17 17 EA

W10314 Wolverine , Waterproof 6 in Composite Toe, Brown Electrical Hazard, Waterproof nubuck leather upper. Moisture managing mesh with waterproof membrane lining. Removable EPX anti fatigue footbed.

Footbed. PU midsole. Rubber lug outsole. Nylon shank. Direct attach construction, or approved equivalent

18 10 EA

Wolverine WW8399 – Bonaventure, Men’s 6” Hiker, Black - Waterproof Full Grain Leather Upper, Wave Mesh Lining. Removable Air Cell Pu Cushion Footbed with Aniti Microbial Mesh Sock Liner. Compression Molded Eva Midsole. Rubber Lug Outsole. Composite Toe. Eh Astm F2413-11 M I/75, C/75, Eh Compliant. Wide Width – All Sizes, or approved equivalent

19 10 EA

ROCKPORT WGRK6640 – More Energy, Men’s 6” Hiker, Brown - Waterproof Tumbled Full Grain Leather. Moisture Wicking Nylon Mesh Lining with Hydro-Defense Waterproof Bootie. Removable Eva Cushion Insert with Adiprene Shock Absorbing Heel and Rebounding Forepart Pad. Dual Density, Direct Attached Pu Midsole. Rubber Traction Outsole. Composite Toe. Eh. Waterproof. 100% Nonmetallic. Astm F2413-11 M I/75, C/75, Eh Compliant- All Sizes, or approved equivalent

BL134-21 PAGE 7

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

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DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

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PRICE

20 17 EA

TIMBERLAND PRO HELIX – TMA1RW4, Men’s 8”, Brown - Distressed Full Grain Leather Upper. Molded Timberland Pro Rubber Toe Protector. Breathable, Moisture Wicking Lining with Antimicrobial Treatment and Waterproof Membrane. Blood Borne Pathogen Feature.

Anti-Fatigue Technology Pu Footbed for Shock Absorption and Energy Return. Pu Midsole. Timberland Pro Rubber Outsole Is Oil, Heat Abrasion and Slip Resistant. Direct Attached Construction. Composite Toe. Eh. Wp. Astm F2413-11 M I/75, C/75, Eh Compliant – All Sizes, or approved equivalent

21 1 EA

Men's Carhartt CMF6371 6" Rugged Flex Boot CT, waterproof membrane, oil, chemical and slip resistant. Composite toe, or approved equivalent

22 24 EA

KEEN UTILITY – KN1016962 – Davenport, Men’s 6” Hiker, Shitake/Forest Night - Waterproof Nubuck Upper With Pu Coated Waterproof Suede. Moisture Wicking Lining with Keen. Dry Waterproof, Breathable Membrane. Removable Metatomical Dual Density Eva Footbed. Cleansport Nxt Treatement For Natural Odor Protection. Pu Midsole. Oil And Slip Resistant, Nonmarking Rubber Outsole With 90 Degree Heel Breast. 100% Nonmetallic. Composite Toe. Eh. Astm F2413-11 M I/75, C/75, Eh Compliant. Wide Width – All Sizes, or approved equivalent

23 5 EA

MEN’S 6”TL26078 - TIMBERLAND PRO TITAN, WATERPROOF - Dark Brown Men’s Med 7-12,13,14,15, Men’s Wide 7-12,13,14,15 / XW 7-12,13,14,15, Waterproof Full Grain Leather, Moisture Channeling Antimicrobial Mesh Lining, Polyurethane Midsole, Safety Toe, SR WP ST EH, or approved equivalent

BL134-21 PAGE 8

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

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DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

UNIT

PRICE

TOTAL

PRICE

24 1 EA

Florsheim FS2700 Casual Moc Toe Oxford; resistant to oil, chemicals, and abrasives, composite toe, 100% Non-metallic, ASTM F2413-05, or approved equivalent

25 5 EA

HYTEST – 10800, Unisex Oxford - Full Grain, Waterproof Leather

Upper. Mesh Lining. Removable Eva Pesu Iii Full Cushion Footbed.

Waterproof. Comp Toe. Eh. Astm F2413-11 M I/75, C/75, Eh

Compliant. Wide Width – All Sizes, or approved equivalent

26 20 EA

ARIAT – 1200, MEN’S BROWN SLIP ON WELLINGTON

- Waterproof Pro Shuts Out the Wet and Snow. Ariat’s Ats Max Platform Provides Maximum Torsional Stability for Reduction of Foot Fatigue and Proper Body Alignment. The Sole Pairs a Lightweight, Cushioning Eva Midsole with Ariat’s Highly Abrasion Resistant Oil and Slip Resisting Duratread Outsole for The Ideal Combination of Comfort and Durability. Features Ariat’s Unique, Patent-Pending U-Turn Entry System, Allowing Easy Entry with A True Fit Regardless of Foot Shape.

Composite Toe. Astm F2413-11 M I/75, C/75, Eh Compliant. Wide Width – All Sizes, or approved equivalent

27 2 EA

WOLVERINE – WW10180 / WW10181 PIPER, Women’s 6”, Brown / Black - Waterproof Roughneck Leather, Non Metallic Hardware. Wave Mesh Lining with Waterproof Membrane. Removable Air Cell Pu Cushion Insole. Compression Molded Eva Midsole. Oil and Slip Resistant Rubber Outsole. Composite Toe. Eh. Astm F2413-11 F I/75, C/75 Eh Compliant. All Sizes, or approved equivalent

BL134-21 PAGE 9

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

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DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

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PRICE

28 2 EA

MERRELL – MLJ15876, MOAB 2 Vent Mid, Women’s 6” Hiker, Black

- Waterproof Leather and Textile Upper. Breathable Mesh Lining.

Merrell M Select Dry Impermeable Waterproof Membrane. Nonmetallic Hardware. Abrasion Resistant Rubber Toe Overlay. Molded Tpu Heel Counter. Kinetic Fit Elite Eva Contoured Footbed. Oil And Slip Resistant Merrell M Select Grip Rubber Outsole. Waterproof. Composite Toe. Eh.

Astm F2413-11 F I/75, C/75, Eh Compliant. All Sizes, or approved equivalent

29 10 EA

Justin Boots: JBWK2104, JBWK2101 Tanker Black/Brown Steel toe

11” steel toe work boot 7D-15EE (all sizes), or approved equivalent

30 2 EA

Wolverine - W10383, Women’s Merlin Waterproof Composite-toe 6” work boot Brown, waterproof membrane and mesh lining Non-metallic hardware; removable polyurethane footbed; EVA midsole;

nylon shank; All Sizes and Widths, or approved equivalent

31 10 EA

Justin Driscoll Mahogany – WK2111 11-inch steel toe pull-on workboot All Sizes and Widths (7D-15EE), or approved equivalent

32 10 EA

Justin Mechanoc Brown – WK2120 11-inch steel toe work boot All Sizes and Widths (7D-15EE), or approved equivalent

33 2 EA

SR MAX SRM 265 Denali black women’s waterproof, comp toe, EH, nonmetallic hiker style Waterproof, oiled tumbled leather upper.

Waterproof membrane bootie. PU cup insole. Molded phylon midsole.

SR Max Maxtrax oil and slip resistant rubber outsole. Comp TOE EH, security friendly. ASTM F2413-11F1/75,C/75, EH compliant SRM265 sizes 5-11, or approved equivalent

BL134-21 PAGE 10

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

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DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

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34 2 EA

SR MAX SRM479 BOONE WOMENS, BLACK, COMP TOW, EH HIKER

Style SRM 479 leather upper. Mesh Linings. Molded PU Cup removable footbed. SR Max Maxtrax slip resistant rubber outsole. Comp TOE EH, security friendly. ASTM F2413-11 F1/75,C/75, EH compliant. Sizes 6- 10, or approved equivalent

35 2 EA

SR MAX SRM295 BLACKBEAR WOMEN’S, 8-INCH, WP INSULATED,

COMP TGOE WORK BOOT. Style SRN295 Waterproof oiled, full grain leather upper Mesh Linings Waterproof bootie. 400 grams Thinsulate insulation. PU cup removable insole Molded phylon midsole. SR Max Maxtrax slip resistant rubber outsole. Metal free . Comp Toe ASTM F2413-11 F1/75,C/75, EH compliant sizes 6-10, or approved equivalent

36 2 EA

511 TACTICAL FEL12145 ATAC SHIELD, WOMENS BLACK COMPTOE,

EH, PR, 8 INCH BOOT Style FEL12145 Full grain leather upper, Side zip closure. Moisture wicking lining with blood borne pathogen resistant membrane. Cushioned footbed with shock Mitigation Systems for optional shock absorption. Puncture resistant board. Oil and slip resistant rubber outsole. Comp toe ASTM F2413-11 F1/75,C/75, EH/PR compliant sizes 6-10, or approved equivalent

37 2 EA

SR MAX SRM260 KOBUK WOMENS, SLIP RESISTANT WATERPROOF,

SOFT TOE BLACK HIKER Style SRM260 Waterproof oiled tumbled leather upper. Waterproof bootie construction. Tailbrelle linings.

Molded removable PU Cup insole. Molded phylon midsole. SR MAX slip resistant rubber sole outsole. Soft tow, No safety toecap. All Sizes, or approved equivalent

38 5 EA

IRON AGE IA0160 HAULER Composite toe, electrical hazard protection, permabond polyurethane outsole, waterproof, padded collar, full grain leather upper; AST< F2412-05 PT99 1/75 C/75, Size N 8-13, M & W 7-14, or approved equivalent

BL134-21 PAGE 11

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

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DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

UNIT

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39 15 EA

TIMBERLAND PRO TM65016 Waterproof leather with seam sealed direct attach PVC midsole construction; anti-microbial linings and footbed cover; contoured shock diffusion plate; waterproof; 200g insulation; Timberland PRO heat, slip and abrasion resistant rubber lug outsole; steel toe; ASTM F2412-05 PT99 I/75 C/75 - Size M & XW 7-14, or approved equivalent

40 5 EA

WORK ZONE WZS651-BL Waterproof oiled leather; moisture absorbing lining; 200g Thinsulate insulation; slip and oil resistant flex dual density PU outsole; steel toe; ASTM F2412-05 PT99 I/75 C/75,Size M & W 4-14, or approved equivalent

41 5 EA

WORK ZONE WZS651-BROWN Waterproof oiled leather; moisture absorbing lining; 200g Thinsulate insulation; slip and oil resistant flex dual density PU outsole; steel toe; ASTM F2412-05 PT99 I/75 C/75 Size M & W 4-14, or approved equivalent

42 27 EA

HYTEST 12271 UNISEX Waterproof action leather upper; breathable comfort mesh lining; removable PESU III EVA footbed; EVA comfort midsole; apex oil and slip resistant rubber outsole; steel toe;

waterproof; ASTM F2413-11 M I/75 C/75 EH compliant Size M 7-14 W 7-13, or approved equivalent

43 5 EA

CAROLINA BOOT CA 5520 6” boot, leather upper, composite safety toe, waterproof; Polyurethane footbed; EVA midsole; cushion insole;

electrical hazard; non-metallic shank; oil and slip resistant outsole;

ASTM F2412-05 PT99 I/75 C/75, Size M & W 6-14, or approved equivalent

44 12 EA

HYTEST 13811 6” boot, waterproof; full grain leather upper; abrasion resistant mesh lining with waterproof membrane; molded PU high energy performance insole with molded EVA stabilizer and foam footbed; Dura-Tech oil and slip resistant rubber outsole; composite toe;

ASTM F2421-05 PT99 I/75 C/75 - Size M & W 3-14, or approved equivalent

BL134-21 PAGE 12

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

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45 5 EA

THOROGOOD TG804-4808 MENS 7” BOOT waterproof leather uppers, steel toe cap, removable cushion insole, light weight outsole, steel shank, waterproof construction; ASTM F2412-05 PT99 I/75 C/75 EH- Size 4E 8-12, 13, or approved equivalent

46 10 EA

WOLVERINE WW4626 6” BOOT full grain leather upper, PK mesh lining;

removable full cushion insole; compression molded EVA midsole;

cement construction, nylon shank, oil and slip resistant rubber outsole, abrasion resistant, composite toe- Size 7 medium/wide – 15 medium/wide, or approved equivalent

47 5 EA

WOLVERINE WW2287 full grain waterproof leather; wave mesh lining;

MultiShox removable full cushion footbed; PU midsole; contour welt construction; rubber lug outsole; waterproof; steel toe; slip resistant;

ASTM F2413-05 standards Size 7-14 medium/wide, or approved equivalent

48 4 EA

WOLVERINE WW10180 BROWN WOMENS 6” BOOT waterproof roughneck leather; nonmetallic hardware; wave mesh lining with waterproof membrane; removable air cell PU cushion insole;

compression molded EVA midsole; oil and slip resistant rubber outsole; composite toe; ASTM F2413-11M I/75 C/75- Women’s sizes 6-16, or approved equivalent

49 2 EA

WOLVERINE WW10181 BLACK WOMENS 6” BOOT waterproof roughneck leather; nonmetallic hardware; wave mesh lining with waterproof membrane; removable air cell PU cushion insole;

compression molded EVA midsole; oil and slip resistant rubber outsole; composite toe; ASTM F2413-11M I/75 C/75, Women’s sizes 6-16, or approved equivalent

BL134-21 PAGE 13

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

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50 11 EA

TIMBERLAND PRO TM26078 BROWN 6” BOOT soft upper; anti-microbial spacer mesh lining; open cell PU footbed with Outlast Adaptive Comfort technology; PU cushioned midsole; Timberland PRO oil slip and abrasion resistant rubber outsole; Titan Alloy safety toe;

ASTM F2413-11M I/75 C/75- Size 7-15 and 7-15 wide, or approved equivalent

51 5 EA

TIMBERLAND PRO TM50507 BLACK 6’ BOOT soft upper; anti-microbial spacer mesh lining; open cell PU footbed with Outlast Adaptive Comfort technology; PU cushioned midsole; Timberland PRO oil slip and abrasion resistant rubber outsole; Titan Alloy safety toe; ASTM F2413-11M I/75 C/75 -Size 7-15 and 7-15 wide, or approved equivalent

52 5 EA

WOLVERINE WW10314 BROWN 6” BOOT waterproof upper leather;

wave mesh lining with Wolverine PC Dry waterproof membrane; dual density PU EPX anti-fatigue footbed; PU midsole; slip resistant rubber outsole; direct attached construction; composite toe; ASTM F2413- 11M I/75 C/75- Size 7-14 and 7-13 wide, or approved equivalent

53 15 EA

WOLVERINE WW10326 BLACK 6” BOOT waterproof upper leather;

wave mesh lining with Wolverine PC Dry waterproof membrane; dual density PU EPX anti-fatigue footbed; PU midsole; slip resistant rubber outsole; direct attached construction; composite toe; ASTM F2413- 11M I/75 C/75- Size 7-14 and 7-13 wide, or approved equivalent

54 28 EA

WOLVERINE WW10318 WELLINGTON BOOT waterproof upper leather;

wave mesh lining with Wolverine PC Dry waterproof membrane; dual density PU EPX anti-fatigue footbed; PU midsole; slip resistant rubber outsole; direct attached construction; composite toe; ASTM F2413- 11M I/75 C/75- Size 7-14 and 7-13 wide, or approved equivalent

BL134-21 PAGE 14

COMPANY NAME: _____________________________________________________________________________________________________________________

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55 20 EA

SR MAX SRM2600 BROWN BOOT waterproof, oiled, tumbled leather upper; waterproof bootie construction; nylon mesh lining; molded removable PU cup insole; molded phylon midsole; SR Max MaxTrax slip resistant rubber outsole; composite toe; EH; ASTM F2413-11 M I/75 C/75; EH compliant- Size 8-15 and 8-14 wide and 8-14 extra wide, or approved equivalent

56 20 EA

SR MAX SRM2600 BLACK BOOT waterproof, oiled, tumbled leather upper; waterproof bootie construction; nylon mesh lining; molded removable PU cup insole; molded phylon midsole; SR Max MaxTrax slip resistant rubber outsole; composite toe; EH; ASTM F2413-11 M I/75 C/75; EH compliant- Size 7-16 and 7-16 wide and 7-16 extra wide, or approved equivalent

57 14 EA

ARIAT AR1200 WATERPROOF PRO abrasion resistant oil and slip resisting; EVA midsole; Duratread outsole; U-turn Entry System;

composite toe; ASTM F2413-11 M I/75 C/75; EH compliant Size 7.5D-14D and 7.5EE-14EE, or approved equivalent

58 14 EA

REEBOK WGRB4041 UNISEX BLACK SHOE mesh with leather webbing upper; moisture wicking nylon mesh lining; Memory Tech Massage removable cushion footbed; Sublite EVA cushion midsole with oil and slip resistant rubber heel and forepart flex pads; XTR alloy toe; EH ASTM F2413-11 M I/75 C/75; EH compliant -Size 7-16, or approved equivalent

59 14 EA

REEBOK WGRB4141 MENS BLACK SHOE microfiber and mesh upper;

moisture wicking mesh lining; Memory Tech Massage removable cushion footbed; Sublite EVA cushion midsole with oil and slip resistant rubber heel and forepart pads; XTR alloy toe; SD with dual resistor technology; no exposed metal on upper; ASTM F2413-1 M I/75 C/75; SD compliant- Size 7-14, or approved equivalent

BL134-21 PAGE 15

COMPANY NAME: _____________________________________________________________________________________________________________________

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60 2 EA

REEBOK WGRB416 WOMENS SHOE leather with micro web upper;

moisture wicking nylon mesh lining; removable FootFuel injected EVA cushion footbed; Sublite EVA cushion midsole; slip resistant rubber outsole; no exposed metal on upper; steel toe; SD with dual resistor technology; ASTM F2413-11 F I/75 C/75 SD compliant- Size 6-11, or approved equivalent

61 5 EA

KEEN UTILITY KN1007965 abrasion resistant touch tec leather;

compression molded EVA midsole; Keen Dry waterproof breathable membrane; locking metal hooks and lacing eyelets; oil and slip resistant no-marking rubber outsole; ASTM F2413-11 M I/75 C/75 EH compliant Size 7-15, 7D-15D, 7EE-15EE, or approved equivalent

62 1 EA

HYTEST 12200 RYLIE WATER REPELLENT METATARSAL GUARD

COMPOSITE TOE 6” HIKER waterproof full grain leather upper;

moisture wicking mesh lining; internal metatarsal guard; removable EVA cushioned footbed; oil and slip resistant rubber outsole; cement construction; ASTM F2413-18 M I/75 C75; EH compliant Size 4-14M AND 4-14W, or approved equivalent

63 1 EA

HYTEST 12561 NICKEL METATARSAL GUARD STEEL TOE 6” HIKER

suede leather and mesh upper; moisture wicking mesh lining; internal metatarsal guard; removable memory foam and EVA cushioned footbed; EVA cushioned midsole; oil and slip resistant rubber outsole;

cement construction; ASTM F2413-18 M I/75 C/75 Size 4-14M AND 4-14W, or approved equivalent

64 1 EA

HYTEST 17320 MYRA WOMENS COMPOSITE TOE SHOE leather upper;

moisture wicking mesh lining; removable EVA cushioned footbed; EVA cushioned midsole; oil and slip resistant rubber outsole; cement construction; ASTM F2413-18 M I/75 C75 - Size 5-11M AND 5-11W, or approved equivalent

BL134-21 PAGE 16

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

QTY

DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

UNIT

PRICE

TOTAL

PRICE

65 3 EA

WOLVERINE 10678 WOMENS JETSTREAM CARBONMAX SAFETY

TOE SHOE breathable mesh and TPU upper; moisture wicking mesh lining; memory foam footbed; slip resistant rubber lug outsole;

lightweight cement construction; nylon shank; composite toe; ASTM F2413-18 M I/75 C/75 Size 5-10, or approved equivalent

66 1 EA

SR MAX SRM4790 BOONE MENS SLIP RESISTANT BLACK

COMPOSITE TOE HI TOP ATHLETIC SHOE slip resistant; oil resistant; composite toe - Size 7-16M AND 7-16EW, or approved equivalent

67 1 EA

SR MAX SRM610 DOVER WOMENS BLACK, SLIP RESISTANT,

ATHLETIC SNEAKER slip resistant, oil resistant, Size 2-12M and 2-12EW, or approved equivalent

68 1 EA

SR MAX SRM6100 DOVER MENS BLACK, SLIP RESISTANT,

ATHLETIC SNEAKER slip resistant, oil resistant Size 7-16M and 7- 16EW, or approved equivalent

69 1 EA

Bates 8” tactical sport size zip boot, black, or equivalent, all sizes (Men & Women), or approved equivalent

70 2 EA

Reebok WGRB039 Sublite Work, Women's, Black, Comp Toe, SD, Low Athletic, all sizes (6-12), all widths (M & W), Style: WGRB039, or approved equivalent

71 2 EA

Reebok WGRB046 SubLite Cushion Work Women's, Navy/Pink, Alloy Toe, EH, Low Athletic, all sizes (6-11) and all widths (M & W), Style:

WGRB046, or approved equivalent

72 2 EA

HYTEST 17402 Alpha XERGY, Women's, Nano Toe, SD, Casual Oxford, black and Teal Fade, all sizes (5-11), all widths, Style: 17402, or approved equivalent

BL134-21 PAGE 17

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

QTY

DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

UNIT

PRICE

TOTAL

PRICE

73 12 EA

Justin Keavan, Men’s Steel Toe, EH, Mt, WP Pull on boot, Brown, all sizes (7--14), all widths (D, EE) Style: WK4570, or approved equivalent

74 17 EA

Justin Switch, Men’s Composite Toe, EH Square Toe, 11” boot, all colors, all sizes (7-14), all widths (B, D, EE), Style: WK4812, or approved equivalent

75 5 EA

Ariat WorkHog Waterproof Composite Toe Work Boot, All Colors (aged bark, oily distressed brown, dark copper), all sizes (7-14), all widths (B, D, EE), Style: 10008635 (aged bark); 10001200 (oily distressed brown);

10001203 (dark copper), or approved equivalent

76 2 EA

GeorgiaBoot Giant Revamp Steel Toe Inter Met-Guard Waterproof Work Boot, brown, all sizes (8-14), all widths (M, W), Style: GB00322, or approved equivalent

77 5 EA

ARIAT – AR10017420 Workhog, Men’s Comp Toe, EH, WP, Pull on Boot, Waterproof leather upper. Mesh lining. EVA midsole. Oil and slip resistant Duratread outsold with 90-degree heel breast. Patented U- Turn Entry system. ATS Max Technology for stability and foot-fatigue reduction. Waterproof PRO construction. Goodyear welt construction.

Comp toe. EH. WP. ASTM F2413-18 M/I/C EH compliant, or approved equivalent

78 5 EA

ARIAT – 1943 Men’s Brown 8 Inch Workhog Boot Composite Toe SR Waterproof, Ariat ATS Max platform provides an extra level of stability.

Waterproof Pro construction shuts out rain, snow, and water. 8-inch lacer with removable kiltie. EVA cushioning midsole combined with Duratread oil and slip resisting outsole. Goodyear welt construction.

ASTM F2413-18 M/I/C EH compliant, or approved equivalent

SECTION A TOTAL $

BL134-21 PAGE 18

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

QTY

DESCRIPTION MANUF. & NO. DELIVERY A.R.O.

UNIT

PRICE

TOTAL

PRICE

SECTION B – DEPARTMENT OF WATER RESOURCES

1 30 EA

Wolverine WW8399 – Bonaventure, Men’s 6” Hiker, Black - Waterproof Full Grain Leather Upper, Wave Mesh Lining. Removable Air Cell Pu Cushion Footbed with Aniti Microbial Mesh Sock Liner. Compression Molded Eva Midsole. Rubber Lug Outsole. Composite Toe. Eh Astm F2413-11 M I/75, C/75, Eh Compliant. Wide Width – All Sizes, or approved equivalent

2 10 EA

ROCKPORT WGRK6640 – More Energy, Men’s 6” Hiker, Brown - Waterproof Tumbled Full Grain Leather. Moisture Wicking Nylon Mesh Lining with Hydro-Defense Waterproof Bootie. Removable Eva Cushion Insert with Adiprene Shock Absorbing Heel and Rebounding Forepart Pad. Dual Density, Direct Attached Pu Midsole. Rubber Traction Outsole. Composite Toe. Eh. Waterproof. 100% Nonmetallic. Astm F2413-11 M I/75, C/75, Eh Compliant- All Sizes, or approved equivalent

3 35 EA

TIMBERLAND PRO HELIX – TMA1RW4, Men’s 8”, Brown - Distressed Full Grain Leather Upper. Molded Timberland Pro Rubber Toe Protector. Breathable, Moisture Wicking Lining with Antimicrobial Treatment and Waterproof Membrane. Blood Borne Pathogen Feature.

Anti-Fatigue Technology Pu Footbed for Shock Absorption and Energy Return. Pu Midsole. Timberland Pro Rubber Outsole Is Oil, Heat Abrasion and Slip Resistant. Direct Attached Construction. Composite Toe. Eh. Wp. Astm F2413-11 M I/75, C/75, Eh Compliant – All Sizes, or approved equivalent

BL134-21 PAGE 19

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

QTY

DESCRIPTION

MANUF. &

NO.

DELIVERY

A.R.O.

UNIT

PRICE

TOTAL

PRICE

SECTION B – DEPARTMENT OF WATER RESOURCES CONTINUED

4 30 EA

Timberland PRO TMA1Q54 Hypercharge, Men’s Comp Toe, EH WP, 6-inch boot. Full grain leather upper. Breathable and moisture wicking lining with anti-microbial treatment. Anti-Fatigure Technology PU footbed. EVA midsole.

Nonmarking, slip, abrasion, and oil resistant Timberlant PRO rubber outsole with Ladder Lock heel is heat resistant to 572 degrees F> Comp toe with CarbonShield technology. EH. Waterproof construction. ASTM F2413-18 M/ I/ C EH compliant or approved equivalent

5 30 EA

KEEN Utility KN1024184 Chicago, Black, Men’s, Comp Toe, EH WP, 6 Inch Boot. Leather upper. KEEN.DRY waterproof, breatherable membrane.

Removable metatomical PU footbed. KEEN.ReGEN cushion midsole. Oil and slip resistant rubber outsole is heat resistant to 572 degrees F.90-degree heel breast. Carbon Fiber toe. EH. WP. ASTM F2413-18 M / I / C EH compliant. – All Sizes, or approved equivalent

6 10 EA

Timberland Pro TM50508 Dark Brown, Men’s TiTAN Comp Toe, EH, 6 Inch Work Boot. Soft upper leather to minimize break-in time. Nonmetallic hardware. Anti-microbial, spacer mesh linings. Ortholite footbed with Dryz Intellitemp X-static moisture, temperature, and anti-microbial management. PU cushioned midsole. Timberland PRO oil, slip and abrasion resistant rubber outsole. TiTAN nonmetallic safety toe. EH. ASTM F2413-18 M/I/C EH compliant or approved equivalent

7 5 EA

Florsheim FS2700 Casual Moc Toe Oxford; resistant to oil, chemicals, and abrasives, composite toe, 100% Non-metallic, ASTM F2413-05, or approved

BL134-21 PAGE 20

COMPANY NAME: _____________________________________________________________________________________________________________________

APPROX.

ANNUAL

QTY

DESCRIPTION

MANUF. &

NO.

DELIVERY

A.R.O.

UNIT

PRICE

TOTAL

PRICE

SECTION B – DEPARTMENT OF WATER RESOURCES CONTINUED

8 10 EA

HYTEST – 10800, Unisex Oxford - Full Grain, Waterproof Leather Upper. Mesh Lining. Removable Eva Pesu Iii Full Cushion Footbed. Waterproof. Comp Toe.

Eh. Astm F2413-11 M I/75, C/75, Eh Compliant. Wide Width – All Sizes, or approved equivalent

9 75 EA

ARIAT – 1200, MEN’S BROWN SLIP ON WELLINGTON - Waterproof Pro Shuts Out the Wet and Snow. Ariat’s Ats Max Platform Provides Maximum Torsional Stability for Reduction of Foot Fatigue and Proper Body Alignment. The Sole Pairs a Lightweight, Cushioning Eva Midsole with Ariat’s Highly Abrasion Resistant Oil and Slip Resisting Duratread Outsole for The Ideal Combination of Comfort and Durability. Features Ariat’s Unique, Patent-Pending U-Turn Entry System, Allowing Easy Entry with A True Fit Regardless of Foot Shape.

Composite Toe. Astm F2413-11 M I/75, C/75, Eh Compliant. Wide Width – All Sizes, or approved equivalent

10 10 EA

WOLVERINE – WW10180 / WW10181 PIPER, Women’s 6”, Brown / Black - Waterproof Roughneck Leather, Non-Metallic Hardware. Wave Mesh Lining with Waterproof Membrane. Removable Air Cell Pu Cushion Insole.

Compression Molded Eva Midsole. Oil and Slip Resistant Rubber Outsole.

Composite Toe. Eh. Astm F2413-11 F I/75, C/75 Eh Compliant. All Sizes, or approved equivalent

11 10 EA

Timberland Pro TMA21QA Reaxion, Women’s 6-inch Boot, Black, Full Grain Leather Upper. Breathable and moisture wicking lining with antimicrobial treatment for odor control. Waterproof membrane. Anti-fatigue technology PU footbed. EVA midsole. TPU wrapped Aerocore midsole for maximum energy return. Oil, Slip and abrasion resistant Luggy rubber outsole. Heat resistant up to 572 degrees F. Comp toe powered by carbonshield technology. EH. WP Security friendly. ASTM F2413-18 M/I/ C EH compliant All Sizes, or approved

BL134-21 PAGE 21

COMPANY NAME: _____________________________________________________________________________________________________________________

STATE CLOSEST STOCKING LOCATION TO LAWRENCEVILLE, GA:

PLEASE STATE THE PAPERLESS PROCESS IF APPLICABLE TO YOUR COMPANY: ______________________________________________________________________________

Gwinnett County requires pricing to remain firm for the duration of the initial term of the contract. Failure to hold firm pricing for the initial term of the contract will be sufficient cause for Gwinnett County to declare bid non-responsive. Contract to begin on February 19, 2022, for items #74-85 and items #1-73 will begin on July 21, 2022.

APPROX.

ANNUAL

QTY

DESCRIPTION

MANUF. &

NO.

DELIVERY

A.R.O.

UNIT

PRICE

TOTAL

PRICE

SECTION B – DEPARTMENT OF WATER RESOURCES CONTINUED

12 75 EA

ARIAT – AR10017420 Workhog, Men’s Comp Toe, EH, WP, Pull on Boot, Waterproof leather upper. Mesh lining. EVA midsole. Oil and slip resistant Duratread outsold with 90-degree heel breast. Patented U-Turn Entry system.

ATS Max Technology for stability and foot-fatigue reduction. Waterproof PRO construction. Goodyear welt construction. Comp toe. EH. WP. ASTM F2413-18 M/I/C EH compliant, or approved equivalent

13 25 EA

Ariat AR10018567 Powerline, Men’s, Brown Comp Toe, EH, WP 8-inch Logger.

Waterproof, full grain leather upper. Molded external heel protector.

Removable kiltie. Waterproof Pro construction, 400 grams Thinsulate Ultra insulation. Shock absorbing PU midsole inserts. Vibram lug outsole. Goodyear leather welt construction. Waterproof. Comp toe. EH. ASTM F2413-18 M/ I/ C EH compliant or approved equivalent

SECTION B TOTAL $

OVERALL BID TOTAL $

COMPANY NAME: ____________________________________________________________________________________

Unless otherwise noted, quoted prices will remain firm for four (4) additional one (1) year periods. If a percentage increase/decrease will be a part of a renewal option, please note this in the space provided together with an explanation.

Option 1 Renewal _________% Increase _________% Decrease Option 2 Renewal _________% Increase _________% Decrease Option 3 Renewal _________% Increase _________% Decrease Option 4 Renewal _________% Increase _________% Decrease

Explanation:__________________________________________________________________________________

The undersigned acknowledges receipt of the following addenda, listed by number and date as issued appearing on each:

Addendum No. Date Addendum No. Date

Certification Of Non-Collusion in Bid Preparation ______________________________________________ Signature Date

The County requires that all who enter into a contract for the physical performance of services with the County must satisfy OCGA § 13-10-91 and Rule 300-10-1-02, in all manner, and such are conditions of the contract.

In compliance with the attached specifications, the undersigned acknowledges all requirements outlined in the "Instructions to Bidders" and all documents referred to therein, if this bid is accepted by the Board of Commissioners within ninety (90) days of the date of proposal opening, to furnish any or all of the items upon which prices are quoted, at the price set opposite each item, delivered to the designated point(s) within the time specified in the fee schedule. By submission of this proposal, I understand that Gwinnett County uses Electronic Payments for remittance of goods and services. Vendors should select their preferred method of electronic payment upon notice of award. For more information on electronic payments, please refer to the Electronic Payment information in the instructions to bidders.

BL134-21 PAGE 23

TERMINATION FOR CAUSE: The County may terminate this agreement for cause upon ten days prior written notice to the contractor of the contractor’s default in the performance of any term of this agreement. Such termination shall be without prejudice to any of the County’s rights or remedies by law.

TERMINATION FOR CONVENIENCE: The County may terminate this agreement for its convenience at any time upon 30 days written notice to the contractor. In the event of the County’s termination of this agreement for convenience, the contractor will be paid for those services actually performed. Partially completed performance of the agreement will be compensated based upon a signed statement of completion to be submitted by the contractor, which shall itemize each element of performance.

Legal Business Name _______________________________________________________________________

Federal Tax ID _______________________________________________________________________________

Address _____________________________________________________________________________________ Does your company currently have a location within Gwinnett County? Yes No

Representative Signature _____________________________________________________________________

Printed Name ________________________________________________________________________________

Telephone Number ________________________ Fax Number _____________________________________

E-mail address _______________________________________________________________________________

BL134-21 PAGE 24

REFERENCES

Gwinnett County requests a minimum of three (3) references where work of a similar size and scope has been completed.

Note: References should be customized for each project, rather than submitting the same set of references for every project bid. The references listed should be of similar size and scope of the project being bid on. Do not submit a project list in lieu of this form.

1. Company Name

Brief Description of Project

Completion Date

Contract Amount $ Start Dates

Contact Person Telephone

E-Mail Address

2. Company Name

Contract Amount $ Start Date

3. Company Name

Contract Amount $ Start Date

Company Name

BL134-21 PAGE 25

BL134-21, Purchase of Safety Shoes on an Annual Contract

CODE OF ETHICS AFFIDAVIT

(THIS FORM SHOULD BE FULLY COMPLETED AND RETURNED WITH

YOUR SUBMITTAL AND WILL BE REQUIRED PRIOR TO EVALUATION)

In accordance with Section 54-33 of the Gwinnett County Code of Ordinances the undersigned bidder/proposer makes the following full and complete disclosure under oath, to the best of his/her knowledge, of the name(s) of all elected officials whom it employs or who have a direct or indirect pecuniary interest in or with the bidder/proposer, its affiliates or its subcontractors:

1.

(Company Submitting Bid/Proposal)

2. (Please check one box below)

No information to disclose (complete only section 4 below)

Disclosed information below (complete section 3 & section 4 below)

3. (if additional space is required, please attach list)

Gwinnett County Elected Official Name Gwinnett County Elected Official Name

Gwinnett County Elected Official Name Gwinnett County Elected Official Name

4. Sworn to and subscribed before me this

BY: day of , 20

Authorized Officer or Agent Signature

Printed Name of Authorized Officer or Agent Notary Public

Title of Authorized Officer or Agent of Contractor (seal)

Note: See Gwinnett County Code of Ethics Ordinance EO2011, Sec. 54-33. The ordinance will be available to view in its’ entirety at www.gwinnettcounty.com

BL134-21 PAGE 26

Solicitation Name & No. BL134-21, Purchase of Safety Shoes on an Annual Contract

CONTRACTOR AFFIDAVIT AND AGREEMENT

(THIS FORM SHOULD BE FULLY COMPLETED AND RETURNED WITH YOUR SUBMITTAL)

By executing this affidavit, the undersigned contractor verifies its compliance with The Illegal

Immigration Reform Enhancements for 2013, stating affirmatively that the individual, firm, or corporation which is contracting with the Gwinnett County Board of Commissioners has registered with and is participating in a federal work authorization program* [any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security] to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act, in accordance with the applicability provisions and deadlines established therein.

The undersigned further agrees that, should it employ or contract with any subcontractor(s) in connection with the physical performance of services or the performance of labor pursuant to this contract with the Gwinnett County Board of Commissioners, contractor will secure from such subcontractor(s) similar verification of compliance with the Illegal Immigration Reform and Enforcement Act on the Subcontractor Affidavit provided in Rule 300-10-01-.08 or a substantially similar form. Contractor further agrees to maintain records of such compliance and provide a copy of each such verification to the Gwinnett County Board of Commissioners at the time the subcontractor(s) is retained to perform such service.

E-Verify * User Identification Number Date Registered

Legal Company Name

Street Address

City/State/Zip Code

BY: Authorized Officer or Agent Date (Contractor Signature)

Title of Authorized Officer or Agent of Contractor

Printed Name of Authorized Officer or Agent

SUBSCRIBED AND SWORN

BEFORE ME ON THIS THE

_______ DAY OF ______________________, 20_______

Notary Public My Commission Expires: ___________________________

* As of the effective date of O.C.G.A. 13-10-91, the applicable federal work authorization program is “E-Verify” operated by the U.S.

Citizenship and Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social Security Administration (SSA).

For Gwinnett County Use Only:

Document ID #________________

Issue Date: ___________________

Initials: ______________________

BL134-21 PAGE 27

STANDARD INSURANCE REQUIREMENTS

(For projects less than $1,000,000)

1. Statutory Workers' Compensation Insurance

(a) Employers Liability:

✓ Bodily Injury by Accident - $100,000 each accident

✓ Bodily Injury by Disease - $500,000 policy limit

✓ Bodily Injury by Disease - $100,000 each employee

2. Commercial General Liability Insurance

(a) $500,000 limit of liability per occurrence for bodily injury and property damage

(b) The following additional coverage must apply:

✓ 1986 (or later) ISO Commercial General Liability Form

✓ Dedicated Limits per Project Site or Location (CG 25 03 or CG 25 04)

✓ Additional Insured Endorsement (Form B CG 20 10 with a modification for completed operations or a separate endorsement covering Completed Operations)

✓ Blanket Contractual Liability

✓ Broad Form Property Damage

✓ Severability of Interest

✓ Underground, explosion, and collapse coverage

✓ Personal Injury (deleting both contractual and employee exclusions)

✓ Incidental Medical Malpractice

✓ Hostile Fire Pollution Wording

3. Auto Liability Insurance

(a) $500,000 limit of liability per occurrence for bodily injury and property damage

(b) Comprehensive form covering all owned, non-owned, leased, hired, and borrowed vehicles

(c) Additional Insured Endorsement

(d) Contractual Liability

4. Umbrella Liability Insurance - $1,000,000 limit of liability

(a) The following additional coverage must apply

✓ Additional Insured Endorsement

✓ Concurrency of Effective Dates with Primary

✓ Blanket Contractual Liability

✓ Drop Down Feature

✓ Care, Custody, and Control - Follow Form Primary

✓ Aggregates: Apply Where Applicable in Primary

✓ Umbrella Policy must be as broad as the primary policy

5. Gwinnett County Board of Commissioners (and any applicable Authority) should be shown as an additional insured on General Liability, Auto Liability and Umbrella Liability policies.

BL134-21 PAGE 28

6. The cancellation should provide 10 days notice for nonpayment and 30 days notice of cancellation.

7. Certificate Holder should read:

Gwinnett County Board of Commissioners 75 Langley Drive Lawrenceville, GA 30046-6935

8.…