CN-370000-LE810-BCE2023.pdf

OER_13 (Effective 7-01-2017)

Florida Department of Environmental Protection

Office of Emergency Response

WORK AUTHORIZATION FORM

Required Signatures: Adobe Signature or Original Ink Supplemental WAF

Contractor: ____________________________________ DEP Incident # ______________________ Contract #: ___________ Rep: ____________________ Incident Date _______________________ Site Name: ____________________________________ OSC: ______________________________ Location: ______________________________________ Phone: Office______________________ City: __________________County: _________________ Cell ________________________

Description of Work: Respond Immediately Call OSC to set date/time__________________________________

Spill Response Overpack Drums Transport drums to TSA Abandoned Drum:

Remove Soil Sampling Transport Drums to TSDF Analysis of samples collected by OER

Other:

Suspected Materials, and amounts: _____________________________________________________________________________________

Level of Effort: (Check all that apply) Use Subcontractor per OSC

Personnel Vehicles Equipment

Supervisor: ____ Response Truck Overpack Drums: Visqueen

Recovery Tech: ____ Straight Truck 55-gal. Drums: Roll-off Containers: ___________

Field Chemist: ____ Vacuum Truck Sampling Gear EPA Level 1 Vapor Detector

Equip. Oper.: ____ Pickup or Van Sampling Gear EPA Level 2 PPE Level: __________________

Other: ____________ Backhoe or Similar Other: ________________ MOT

Contract Rate: ____________

Comments: ___________________________________________________________________________________________________________

Analytical & Disposal Arrangements: (analytical will usually be listed on Chain-of-Custody or other form)

Via Contractor Via Subcontractor Other: __________________________

Profile Wastes as:

Work Assignment Type: fixed price Not to Exceed estimate amount: $___________________________

Funding Information: (information provided by OER budget rep., budget rep to sign after WAF executed, but prior to transmittal to F&A)

Project No. Organization Code EO Object Code Fund Category/Yr Amount

Approved:

DEP Representative: __________________________ Signature: _______________________________ Date: __________________

Contractor Rep: __________________________ Signature: ___________________________________ Date: __________________

Budget Rep: __________________________ Signature: __________________________________ Date: __________________

Deliverable will be reviewed and evaluated by the DEP Contract Manager to ensure appropriate documentation reviewed and/or provided and that the documentation submitted is complete, accurate, and submitted timely

Scope of Services Staffing and Monitoring Support Services for Blackjack Creek Field

DEPARTMENT OF ENVIRONMENTAL PROTECTION

SCOPE OF SERVICES

STAFFING AND MONITORING SUPPORT SERVICES FOR BLACKJACK CREEK FIELD

SUMMARY

Contractor shall provide services to secure and provide qualified labor for continuation of essential site environmental and safety monitoring services at the Blackjack Creek Treatment (Separation) Plant and the associated Blackjack Creek Oil and Gas Wellfield (collectively, the Blackjack Creek Field ) located southeast of Jay, Florida. Such services shall provide essential site environmental and safety monitoring activities for the Blackjack Creek Field facilities in preparation for potential plant decommissioning, and for field well plugging and abandoning activities to be performed by a separate Department contractor. Contractor shall also provide labor at the Blackjack Creek Field to assist with evaluation, containment, and removal of any pollutant at the site.

For the purposes of this Scope of Services, Contractor agrees to assist the Florida Department of Environmental Protection (DEP or Department) by providing an expected period of services of more than 6 months for essential labor services at Blackjack Creek Field described above. Contractor agrees that services under this Scope of Services will not begin until issuance of the Work Authorization Form (WAF) under State Contract LE810.

Gerald Walker, Oil & Gas Administrator Phone: (850) 524-8405 Email: Gerald.a.Walker@FloridaDEP.gov

Cindy Mulkey, Deputy Director, Division of Water Resource Management Phone: (850) 717-9110 Email: Cindy.Mulkey@dep.state.fl.us

John Coates, Director, Division of Water Resource Management Phone: (850) 245-8709 Email: John.Coates@FloridaDEP.gov

Project Manager for this Scope of Services shall be:

Marty Lee, Environmental Specialist Phone: (850) 675-6558 Email: Marty.M.Lee@FloridaDEP.gov

SECTION 1, TASKS:

Task 1. Onboard Qualified Staff and Safety Training

Contractor will start to provide services on the day of the execution of this Work Authorization, to seek available information for recruiting staffing resources to provide site monitoring and environmental operational services at the Blackjack Creek Field, and to secure those employees (onboard), or other qualified employees with knowledge and skills necessary to perform environmentally sensitive monitoring, operations, and maintenance activities at the Blackjack Creek Field, for those positions identified in Task 2 below, for future payroll periods within the defined limits of the Section 2, Payment Provisions below. At a minimum onboarding services, to provide staffing for each of the positions identified in Section 2 below (or other similarly qualified staff with comparable knowledge and skills), shall include the following activities:

1. Compile available worker requirements and employee information as needed from Black Creek Energy, LLC (BCE) and the Department to identify the Contractors worker safety standards for the Contractor.

2. Screening of perspective employees to meet insurance, and other routine employee screening criteria of the Contractor, and confirmation of employment eligibility through the U.S. Department of Homeland

-Verify system;

3. An evaluation of employee training needs and delivery of new or updated training to meet working safety and environmental training requirements for each of the following training subjects at a minimum: OSHA 40-HAZWOPER (29 CFR 1910.120) or 8-hour Refresher where applicable, H2S monitoring, Respiratory Protection - Fit Test, Contractor site-specific safety training, Confined Space Entry, RCRA and DOT hazardous Waste, Fire Safety, and lock out and tag out procedures.

The Contractor shall not be responsible for any actions or omissions of any BCE employees, that may be hired by Contractor, prior to the date of employment by Contractor.

Task 1. Deliverables

Contractor shall provide the following:

1. Copies of information confirming those individual workers who are onboarded under Task 1, the position description for the position filled by the employee, and years of applicable work experience as evaluated by the Contractor for each employee hired by the Contractor.

2. Copies of certificates or other documentation for completion of the environmental and worker safety trainings identified under Task 1.

Task 2. Provide Ongoing Minimum Labor/Staffing Requirements

Contractor shall meet the staffing requirements and oversee the performance of the general tasks under the Project Manager for the Blackjack Creek Field as follows:

1. Contractor shall provide onboarding services, then staffing support 24 hours per day, seven days per week for ongoing site environmental and safety monitoring activities. This will require a minimum of 10 full-time employees to cover three 8-hr shifts, that shall also include two employees per shift minimum excepting for unexpected worker absence, for the following defined positions and numbers:

Blackjack Creek Field Position

Number of Positions, fulltime equivalents Contractor Project Manager/Engineer 0.5 Blackjack Creek Field Plant Manager 1 Operation and Maintenance Lead 2 Senior O&M Field Technician 1 O&M Field Technician II 3 O&M Field Technician I 3

2. Contractor support staff shall continue to provide monitoring for all existing Hydrogen Sulfide (H2S) monitors, including at well pads, in accordance with accepted industry standards and manufacturers recommendations;

3. Contractor support staff shall monitor H2S levels at the plant and immediately implement safety and emergency plans as necessary;

4. Contractor support staff shall continue to provide monitoring and record keeping for wellhead and casing pressures during each scheduled shift.

5. Contractor support staff shall monitor for any releases into the environment and respond immediately in accordance with state and federal regulations.

6. Contractor support staff shall conduct regular maintenance and inspections of all Blackjack Creek Field equipment in accordance with existing operations and maintenance plans and report any issues or necessary repairs to the Project Manager for the Blackjack Creek Field.

7. Contract shall obtain a written Supplemental Work Authorization for any consumables or supplies determined to be necessary in the performance of Task 2.

8. Use of vehicles and other items identified on Attachment B Rate Schedule, shall be approved by a Supplemental Work Authorization pursuant to the term of Contract No. LE810.

Task 2. Deliverables

Contractor shall provide the following:

1. Employee hours worked during each weekly billing period or portion thereof, identifying the Blackjack Creek Field position served by the employee, and associated hourly rate for documented straight or overtime time hours in accordance with Section 2, Payment Provisions below; and

2. Tabulation, for the applicable period, including a description of each employee position provided for the Blackjack Creek Field, hours provided per employee, associated costs for the applicable period, and cumulative costs per position for each position filled under this task.; and

3. Backup documentation of timesheets, or other similar information, documenting the hours worked by each employee during the applicable period.

SECTION 2, PAYMENT PROVISIONS

1. Deliverables will be reviewed by the Department to confirm they are complete, accurate, and timely.

2. Contractor shall bill the Department on at least a monthly basis for services provided under Task 1 and Task 2, and may bill the Department for services provided under Task 1 and Task 2 after each 14 day period at the Contractor s sole discretion.

3. The Contractor shall be paid for providing onboarding services, including appropriate site environmental and safety trainings for staff recruited, evaluated by Contractor, and employed by the Contractor for work performed under Task 2, in accordance with the description and number of positions as identified in Task 1 above as follows:

Service

Lump Sum Amount, per Position Filled

Onboarding qualified personnel, each position recruited and with a fulltime equivalent person

$3,500

Completed minimum training topics, as described under Task 1

$5,000

4. The Contractor shall provide staffing under Task 2 at the rates/titles below, which are expected to generally be a continuation of labor resources currently employed for the Blackjack Creek Field, or similarly qualified personnel. The term fulltime equivalents shall mean a person generally working 40 hours per weekly period. Under this Scope of Services, the billable rates shall be as follows:

Blackjack Creek Field Position

Number of Positions, fulltime equivalents

Straight Time Cost

Per Hour

Overtime Rate Per Hour

Contractor Project Manager/Engineer 0.5 $100.00 $150.00 BJCF Plant Manager 1 $85.00 $127.50 Operation and Maintenance Lead 2 $70.00 $105.00 Senior O&M Field Technician 1 $65.00 $97.50 O&M Field Technician II 3 $59.00 $88.50 O&M Field Technician I 3 $53.00 $79.50

Total: 10.5