CR 07-024 Approval of State Contract Authorizing the Hopkins Fire Dept to Con as a MHMCATG~TY OF
February 27, 2007 y O P K I N s Council Report 2007-024
Approval of State Contract Authorizing the Hopkins Fire Department to Continue
as a State of Minnesota Hazardous Materials Chemical Assessment Team
Proposed Action.
Staff recommends approval of the following motion: Move to adopt Resolution 2007-
017 approving the signing of the agreement with the State of Minnesota authorizing
the Hopkins Fire Department to continue to provide a State Hazardous Material
Chemical Assessment Team.
Overview.
The current contract with the State of Minnesota for providing a Chemical Assessment
Team will expire on June 30th. A new one year contract for July, 1st 2007 through June
30th 2012 has been given to us by the State for our signatures. There have been no
changes from the current contract.
Primary Issues to Consider.
o Have there been any problems with this program so far? No.
o Has the fire protection in Hopkins suffered when the team was activated? No.
o Has this program been good for Hopkins? Yes. Our people are higher trained and better
equipped with no additional City funding.
Supporting Information.
o Resolution #2007-017
O RFP for Proposal for State Chemical Assessment Team
Cv~~-
Dale Specken
Fire Chief
.•' ~ ^
~r~ D~ artmEn
Ho tcins F
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~ 101 17th Avenue South • Hopkins, Minnesota 55343 • (952) 548-6451
.~, ~ .
Proposal for tate emical Assessment Team
1. TYPE OF TEAM PROPOSED
The Hopkins Fire Department would like to be considered for part of the regional
response as
-~ a Hazardous Materials Chemical Assessment Team.
2. COMPOSITION OF THE TEAM:
The Hopkins Fire Department Chemical Assessment Team will be solely of
members of the Hopkins Fire Department.
The Hopkins Fire Department is a public entity.
3. POINT OF CONTACT FOR TEAM DISPATCH:
. The Hopkins Fire department Chemical Assessment Team will be dispatched
through the City of Hopkins Dispatch Center
located at 1010 1St Street S o, Hopkins Minn. 5 5 3 43 .
I~Ton-emergency Number: 952-938-8885
Responsible Person Connie Kurtz
~- ~ Title: Administrative Services Manager
;~,
4. POINT OF CONTAOT: -
The Hopkins Fire Department Chemical Assessment Team is under the
authority of Fire Chief:
Chief Dale Specken
Hopkins Fire Department
101 17~ Ave South
Hopkins Minnesota 55343
952-548-6451
5. EMPLOYER DESIGNATION:
The Hopkins Fire Department Chemical Assessment Team will be under the
authority of the Fire Chief.
The Fire Chief has been appointed by the City of Hopkins as the employer's
representative in the matter regarding
the fire department. The person listed above would be the employer responsible for
the employer's requirements of this proposal.
6. MEMBERSHIP OF THE PROPOSED TEAM
MEMBER
Mark Butler
Kevin Den Hartog
Brennan Palmer
Garrett Gmiet
Mat Hobbs
Curt Mackey
Pat Sandon -
Rod Shoberg
_ Dale Specken
Chris Spencer
Paul Ahles
' Michael Tungesvick
Dean Benham
PaulOdden
LEVEL
Specialist
Specialist
Technician
Specialist
Specialist
Specialist
Specialist
Specialist
Specialist
Specialist
Specialist
Technician
Specialist
Technician
7. TEAM TRAINING
The Hopkins Fire Department Chemical Assessment Team does monthly training 3
hours per month
12 months out of the year. We also do quarterly training session that are 6 hours in
Length. All members are required
to make 75% of all training session. Members also attend other conferences, seminar-
and class put on by .
the Technical College and ODP Class. Some of the classes are as follow: Midwest Haz
Mat Conference,
MOA Drill, Work with CST on Haz Mat Drill, Rad. Training, Explosive Training,
EMMR Training, West Metro Tech Show,
Bombs Target & Tactics, Anhydrous Tanks Training, Cobra Training, Branch & safety
Officer, Monitors Training,
212 course St Cloud, Huntsville IC Training Haz Mat for tanker.
All members of the Hopkins Fire Department's Hazardous Materials/CAT Team have
had training that meets CFR Title 29, Section 1910.120 and is in compliance to NFPA
472 along with meeting the requirements of Minnesota Rules, 7514.0600, Subparts 1, 3 .
8. STAFFING PLAN FOR MINIMUM NUMBER OF
RESPONSE- PERSONNEL:
As an on call fire department all members of the team will be available 24 hours
a day, 7 days a week.
Therefore we will be able to meet the required staffing level. The Hopkins Fire
Department will respond 4 members
at a minimum of 2 Specialists and 2 Technicians. Our proposed normal response
will be 3 Specialists and 1 Technician.
One of the responding Specialists will be a command level officer.
We feel that under our current set up there will be no problem getting the required
number of responders.
We have a total of 15 people on the team and 5 more in training.
9. GEOGRAPHIC LOCATION OF THE PROPOSED
TEAM:
The City of Hopkins' Fire Department has only one fire station, which is part of the
city's government center located at 101 17~' Ave So.
Hopkins, MN. This is the location where the current Hazardous Materials Team is
housed and from which the proposed state team will be responding
10. RESPONSE EQUIPMENT AND VEHICLES:
The Hopkins Fire Department is requesting the us_e of a state-owned vehicle and
trailer. The Hopkins Fire Department understands
that the City will be responsible for insurance coverage for the vehicle and
trailer.(see attached) The Hopkins Fire Department will
incorporate the vehicle and trailer into its Fire Department Vehicle Maintenance
Plan. All repairs will be done by the Hopkins Public
works Department located 1600 Excelsior Blvd. Hopkins MN 55343. This will
provide for monthly checks and
routine maintenance activities to be carried out on a regular basis. The vehicle will
be located in a space located at 101 17~ Ave South
in Hopkins. This is a heated space owned by the City. The Hopkins Fire
Department will be using the compensation for capital equipment to
cover all, of the cost of capital equipment not provided by the state. The Hopkins
Fire Deparhnent will use equipment provided by the
State for response (see attached list) we will also use equipment purchase and
supplied by the deparhnent. The Hopkins Fire Department
will respond to all incidents with 4 people and 1 duty chief. See staffing plan for
scheduling and maintaining minimum level of staffing.
Minimum level of personnel responding will be at the technician level. Additional
vehicles that may be used for response area 1995 Ford Crown Victoria, a 2006 Dodge
Durango and a 1995 Chevy Suburban.
11. TEAM EXPERIENCE:
The Hopkins Fire Department Hazardous Materials Response Team has been in
existence for over 15 years.
It has been providing Specialist response to our city during this period of time. The
team provides support to the
Southwest Fire League which is a mutual aid association of 13 communities in
south and west Hennepin County.
We have a vehicle and equipment to do all required tech/spec. response in our area.
The team has responded to
Chlorine problems in Hopkins, Edina, and St Louis Park we have responded to
corrosive incidents in
St Louis Park and the City of Minnetonka. We have supported our police
department in a drug lab raid and bomb incident.
We have responded to chlorinated solvent spills in Chanhassen and Eden Prairie.
We have responded to many flammable and combustible liquid spills including a
recent puncture
of a diesel tank on a rail locomotive. We will respond to roughly 50 hazardous
materials calls on an annual basis ranging
in severity from a liquid problem at a traffic accident to a run away polymerization
at a local fixed facility.
12. MEDICAL SUPPORT OFFICER:
Even though the requirement for a medical support officer applies to full teams we
have 2 specialist/medics as part o£
our response team. They serve as the medic officer for the team. 99% of the
members of the team
are EMT` s with BLS skills.
13. EXISTING/PROPOSED TRAINING AND EXERCISE
PROGRAM:
All of the team's initial and refresher training has been done by Hennepin
Technical College.
Their training program is known nationally for its level of excellence. All
technicians have taken over 100 hours of initial training.
All specialists have had over 200 hours of training all through Hennepin Technical
College.
All, members, have been taking on an average. 12 to 24 hours of refresher training
each year.
his training includes seminars and classes provided through the technical colleges,
National Fire Academy,
and regional and national programs. The team does 12 annual 3 hour drills per year.
The team participates in the drills in other cities when requested including: Mall of
America Drill (MBA )Work with CST on two Haz Mat
Drills in the City of Hopkins, participated in drills with the City of Minnetonka.
And the City of Hamburg. The City of Hopkins will participate in any drills or
exercises as requested by local authorities within our response area.
14. TEAM DEVELOPMENT:
As a' current contracted State Chemical Assessment Team, the Hopkins Fire
• Department's Hazardous Materials Team exceeds the minimum standards required by
• Minnesota Rules, Chapter 7514 and has all of the required equipment and vehicles. This
team is ready to respond immediately upon completion of the contracting process.
15. DIRECT AND IN-DIRECT SUPPORT
The Hopkins Fire Department will contribute some tool and supplies to the operation
of the team. Any funding received by the
City of Hopkins and the Hopkins Fire Department will only be used to support the
Chemical Assessment Team.
The Hopkins Fire Department will maintain all vehicles and equipment provide by the
state. The City of Hopkins will also supply Computers, officer furniture, copy machine
and other office supplies to supplement administration of the team.
Indirect costs: Direct costs:
Office space - $1,000/year Postage - $35/year
Non-vehicle storage space - $1,000/year Adm. Support - $1,200/year
Computer use -, $250/year Uniform pants - $1,000
Copier use - $500/year Contractor compensation cost
overruns - As needed
Vehicle insurance - $1,000/year
16. TEAM RESPONSE COSTS
A. Team personnel cost: $75 per hour per person, 5 responders `
B. Additional wage costs for local call back personnel: $20 per person responding to
the Hopkins Fire Station but not responding
to the incident.
C. Vehicle operating costs: $100 per hour plus $50.00 per additional vehicle.
D. Costs of consumable supplies used: (based on actual cost incurred.)
E. Cost of repair or replacement of damaged or destroyed equipment: (based on
actual cost incurred.).
F. Communication costs: including long distance, cellular phone and satellite
phones (based on actual cost incurred.)
G. Administrative costs directly resulting from emergency response: Up to $500 per
state authorized emergency response
H. Costs incurred in the use of special equipment: (based on actual cost incurred.).
I. Costs incurred in the use of special technical assistance: (based on actual cost
incurred.). .
J. Cost associated with providing support to clean-up operations when requested:
(based on actual cost incurred.). '
K. Costs associated with providing standby technical assistance when requested: $75
. per hour per person, on a case by case basis _
L. Other direct costs incurred by the team as a result of the response: (based on
actual cost incurred.). ~.
17. Deployment Time:
The Hopkins Fire Department Hazardous Materials Response/CAT Team will be able
to deploy on an average of less than 10 minutes.
18. Response Time:
Based on our current primary CAT response area, the Hopkins Fire Department
Hazardous Materials Response/CAT Team will be able to respond to the western edge of
Renville County in 2.5 hours or less.
19. Geographic Jurisdiction:
The normal response area for the Hopkins Fire Department, including the Hazardous
Materials Response Team, is the geographic boundaries of the City of Hopkins. '
20. Workers' Compensation:
The City of Hopkins Fire Department is prepared to submit acceptable evidence of
compliance to worker's compensation insurance coverage requirements when
requested.
21. Other Insurance:
The City of Hopkins Fire Department is prepared to provide the state with a certificate
of insurance naming the state as an additional insured under the policy covering all
loaned or leased vehicles, owned vehicles used in state response, and loaned or
leased equipment when requested. The amounts of coverage will be according to state
guidelines. -
21. ~~ References:
Scott Gerber
Fire Chief
Excelsior Fire District
Chief Edgar Belland
Chief of Police
City of Medina
2052 County Road 24
Medina, MN 55340
(763) 473-9209
edbelland(a,ci.medina.mn.us
Chief Luke Stemmer
Fire Chief
City of St Louis Park
5005 Minnetonka Blvd.
St. Louis Park, MN 55416
lstemmer(a,stlouispark. orb
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Sate Of Minnesota -Affirmative Action Certification
your response to this solicitation is or could be in excess of $100,000, complete the information requested below
to determine whether you are subject to the Minnesota Human Rights Act(Minnesota Statutes 363A.36) certification
requirement, and to provide documentation of compliance if necessary. It is your sole responsibility to provide this
information ancp-if required-to apply for Human Rights certification prior to the due date and fine of the bid or
proposal and to obtain Human Rights certification prior to the execution of the contract. The State of Minnesota is
under no obligation to delay proceeding with a contract until a company receives Human Rights certification
BOX ~1-For companies which have employed more than 40 fuIl-time employees within
Minnesota on any single working day during the previous 12 months. Ali other companies
proceed to BOX B.
Your response will be rejecta~ unless your business:
has a current Certificate of Compliance issued by the Minnesota Department of Human
Rights (MDHR)
-OY- .
has submitted an affirmative action plan to the MDHR, which the Department received prior
to the date and time the responses are due.
Check one of the following statements ifyou have employed more than 40 full-time employees in
Minnesota on any single working day during the previous 12 months:
^ We have a current Certificate of Compliance issued by the MDHR.Proceed to BOX C. Include a
copy of your certificate with your response.
^ We do not have a current Certificate of Compliance. However, we submitted an Affirmative Action
Plan to the MDHR for approval, which the Department received on (date). [If
the date is the same as the response due date, indicate thetime your plan was received:
(time). Proceed to BOX C.
^ - We do not have a Certificate of Compliance, nor has the MDHR received an Affirmative Action Plan
from our company. We acknowledge that our response will be rejected. Proceed to BOX C.
Contact the Minnesota Department of Human Rights for assistance. (See below for contact
information.) .
Please note: Certificates of Compliance must be issued by the Minnesota Department of Human Rights.
Affirmative Action Plans approved by the Federal government, a county, or a municipality must still be
received, "reviewed, and approved by the Minnesota Department of Human Rights before a certificate can
be issued.
BOX B -For those companies not described in E3®X ,~,
Check below. _
~j We have not employed more than 40 full-time employees on any single working day in Minnesota
within the previous 12 months. Proceed to BOX C.
BOX C -For all companies
By signing this statement, you certify that the information provided is accurate and that you are authorized
to sign on behalf of the responder. You also certify that you are in compliance with federal affirmative
action requirements that may apply to your company. (These requirements are generally triggered only by
participating as a prime or subcontractor on federal projects or contracts Contractors are alerted to these
requirements by the federal government.} "
Name of Company: ~ ~ ~ ~: ~ ~5 ~ ~ `~- tJ c.~R~, c m <..~ ~ Date 3 -- ~ - ~ ~
Authorized Signature: Telephone number: ~~ z ` ~~~' " ~ ~
L.
Printed Name: ~ t~ ~ t' S ~'rc, {c~-,~ Title: ~ ~-,,~ ~ ~; ,c ~
Affirmative Action Certif~ation Page, Revised 8/04-MDHR
Minnesota Department of Public Safety
I-lazardous Materials Regional Response Team Program
Request for Proposal -Sample Cost Proposal Sheet
Respondent:
Type of Team Proposed: ~_ Chemical Assessment Team
Proposed Team Response Costs
Team Personnel Costs:
List the actual costs for year one (1) of a contact and the estimated costs for year two (2)
of a contract. Personnel costs should include wages and fringe benefits (if applicable).
Additional Wade Costs for Local Callback Personnel:
List the actual costs for year one (l) of a contact and the estimated costs for year two (2)
of a contract. Personnel costs should include wages and fringe benefits (if applicable).
Vehicle Operating Costs:
List the actual costs for year one (1) of a contact and the estimated costs for year two (2)
of a contract.
Cost of Consumable Supplies Used:
Insert the statement "Costs for this item will not exceed the actual costs incurred."
Costs of Repair or Replacement of Dammed or Destroyed Equipment•
Insert the statement "Costs for this item will not exceed the actual costs incurred."
Communications Costs:
Insert the statement "Costs for this item will not exceed the actual costs incurred."
Administrative Costs:
List all anticipated administrative costs associated with a response. List the actual costs
for year one (I) of a contact,and the estimated costs for year two (2) of a contract.
• Cost Incurred in the Use of Special Equipment:
STATE OF MINNESOTA
LOCATION OF SERVICE DISCLOSURE AND CERTIFICATION
LOCATION OF SERVICE DISCLOSURE
Check all that apply:
~~ The services to be performed under the anticipated-contract as specified in our proposal will
be performed ENTIRELY within the State of Minnesota.
The services to be performed under the anticipated contract as specified in our proposal entail
work ENTIRELY within another state within the United States.
1~ The services to be performed under the anticipated contract as specified in our proposal will
be performed in part within Minnesota and in part within another state within the United
States.
^ The services to be performed under the anticipated contract as specified in our proposal DO
involve work outside the United States. Below (or attached) is a description of
(1}the identity of the company (identify if subcontractor) performing services outside the
United States;
,-
(2} the location where services under the contract will be performed; and
(3) the percentage of work (in dollars) as compared to the whole that will be conducted in
each identified foreign location.
CERTIFICATION
By signing this statement, I certify that the information provided 'above is accurate and that the
location where services have been indicated to be performed will not change during the course of
the contract without prior, written approval from the State of Minnesota.
Name of Company: -~ o~° -~ ~ ~ s ~ ~ ~ ~c_~ i _
Authorized Signature: ~ ,,~~%~~
Printed Name: ~D r~ ice. S ~c.,c y=am:-t=om'
Title: _ ~r~. C~ ~ ~-~ _
Date: .3 ~;~ - ~ `~ Telephone Number: ~j~2 ~ ~'~ ~ ~6~ ,S
Affirmative Action Certification Page, Revised 8/04- IvIDHR
Insert the statement "Costs for this item will not exceed the actual costs incurred."
Costs Incurred in the Use of Special Technical Assistance:
Insert the statement "Costs for this item will not exceed the actual costs incurred."
Costs Associated with Prbvidin~Support to Clean-Up Operations:
Insert the statement "Costs for this item will not exceed the actual costs incurred."
Costs Associated with Providing Standby Technical Assistance When Requested:
Insert the statement "Costs for this item will not exceed. the actual costs incurred."
Other Direct Costs Incurred by the Team as a Result of the Res o~ nse:
Insert the statement "Costs for this item will not exceed the actual costs incurred."
•
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i.~ed Representative
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Date
COST PROPOSAL SHEET
Hopkins Fire Department
CHEMICAL ASSESSMENT TEAM
A. Team personnel cost: $75 per hour per. person, 5 responders
B. Additional wage costs for local call back personnel: $20 per person
responding to the Hopkins Fire Station but not responding
to the incident.
C. Vehicle operating costs: $100 per hour plus $50.00 per additional vehicle.
D. Costs of consumable supplies used: (based on actual cost incurred.)
E. Cost of repair or replacement of damaged or destroyed equipment: (based
on actual cost incurred.).
F. Communication costs: including long distance, cellular phone and
satellite phones (based on actual cost incurred.}
G. ~ Administrative costs directly resulting from emergency response: Up to
$500 per state authorized emergency response -
H. Costs incurred in the use of special equipment: (based on actual cost
incurred.).
I. Costs incurred in the use of special technical assistance: (based on actual
cost incurred.). ~ -
-_ J.~ Cost associated with providing support to clean-up operations when
requested: (based on actual cost incurred.).
K. Costs associated with providing standby technical assistance when
requested: $75 per hour per person, on a case by case basis ~ -
L. Other direct costs incurred by the team as a result of the response: (based
on actual cost incurred.).
Fiscal Year
2006
Allocated Reimbursement Remaining
$6,000.00 $3,163.02 $2,836.98
$17,000.00 $7,312.39 $9,687.61
$0.00 $816.55 ($816.55)
$2,000.00 $2,000.00
$3,000.00 $3,000.00
$10,000.00 $1,400.00 $8,600.00
$7,000.00 $3,986.85 $3,013.15
City of Hopkins Fire Department
1010 First Street South
Hopkins, MN 55343
Contract Number: A48431
Start Date End Date
7/1/2005 6/30/2006
Contractor°s Compensation
Capital Equipment:
Cost of capital equipment including vehicles not to exceed $6,000.00
Training:
Annual cost of training team personnel (excluding exercise training) not to exceed $17,000.00
Exercise Training: '
Annual cost of exercise training, not to exceed $0.00
Medical Examinations:
Cost of annual medical examinations for team personnel not to exceed $2,000.00
Consumable Supplies:
Initial cost of consumable supplies not to exceed $3,000.00
Administration:
Program administration costs not to exceed $10,000.00
Maintenance:
Equipment Maintance costs not to exceed $7,00.00
a CORD,, CE RTI FI CATE O F LIAB I LITY i NS U RAN CE DATE(MM/DD/YYYY)
01/11/07
PRODt)C~ 1-952-944-8885 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
• ~L-aur J. Gallagher Risk Management services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
O Prairie Lakes Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Suit:a 350
Edea Prairie, ITT 55344 •
Dav3.c3 xoward INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: RSUI IND CO 22314
Engi.z~eered Building Components
INSURER B: United States Fire Ias Co 21113
140 S Washington Avenue INSURERC:Pennsylvaaia Lumbermeas Mut Ins 14974
Nai 55343
]~isis
Ho INSURER D:
,
p
• INSURER E:
rnvF Re[~FS
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LT DD' -
POLICY NUMBER POLICY EFFECTIVE
DA DD POLICY EXPIRATION
D
LIMITS
C GENERAL LIABILITY CPP22E0020107 01/01/07 O1/O1/OS EACH OCCURRENCE $1, 000, 000
X
COMMERCIAL GENERAL LIABILITY D MA E O E TED
PREMISES Ea occurence
$ 10 0 , 00 0
CLAIMS MADE a OCCUR MED EXP (Any one person) $ 5 , 0 0 0
PERSONAL & ADV INJURY $ l r 0 0 0, 0 0 0
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS -COMP/OP AGG $ 2 . 0 0 0 , 0 0 0
POLICY PRO LOC
B AUT
X OMOBILE LIABILITY
ANY AUTO 1337225148 01/01/07 01/01/08
COMBINED SINGLE LIMIT
(Ea accident)
$1, 000, 000
X ALL OWNED AUTOS
SCHEDULED AUTOS BODILY INJURY
(Per person) $
X HIRED AUTOS
BODILY INJURY
X
NON-OWNED AUT05
(Per accident) $
X 1,000 Comp Ded
PAOPERTYDAMAGE
X
1, 0 0 0 Coll Ded
(Per accident) $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN ~ ACC $
AUTO ONLY: AGG $
A EXCESS/UMBRELLALIABILITV NH130 3 819 4 01 / 01 / 0 7
01/01/08
EACH OCCURRENCE
$ 5, 000, 000
X OCCUR ~ CLAIMS MADE AGGREGATE $ 5, 0 0 0, 0 0 0
DEDUCTIBLE $
X RETENTION $ 10 , 0 0 0 $
$ WORKERS COMPENSATION AND 4086921852 O1/O1/07 O1/Ol/OS X WCSTATU- OTH-
EMPLOYERS' LIABILITY
X
E.L. EACH ACCIDENT 5 0 0, 0 0 0
$
INC
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? EXC E.L. DISEASE - EA EMPLOYEE $ 5 0 0 , 0 0 0
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE-POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL RROVISIONS
t+~r~T~CI/~ATC LIAI 1"1CQ CONCFLI.OTIAN
~.~.... -
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Ci of Hopkins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
1010 1st Avenue South
REPRESENTATIVES.
Hopkins, MN 55343 AUTHORIZED F#EPRESENTATIVE
USA S6ar~a Boschetfi (952) 918-396?
ACORD 25 (2001/QS) shabosc U AC:UKU t.:UKF'U{-fA I IVIV l ytiii
• 5528667 -
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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 rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
_ STATE OF MINNESOTA
AFFIDAVIT OF NONCOLLUSION
I swear (or affima) under the penalty of perjury:
1. That I am the Responder {if the Responder is an individual), a partner in the company (if the Responder
is a partnership), or an officer or employee of the responding corporation having authority to sign on
its behalf (if the Responder is a corporation);
2. That the attached proposal submitted in response to the Request for
Proposals has been arrived at by the Responder independently and has been submitted without
collusion with and without any agreement, understanding or planned common course of action with,
any other Responder of materials, supplies, equipment or services describedn the Request for
Proposal, designed to limit fair and open competition;
3. That the contents of the proposal have not been communicated by the Responder or its employees or
agents to any person not an employee or agent of the Responder and will not becommunicated to
any such persons prior to the official opening of the proposals; and
4. That I am fully informed regarding the accuracy of the statements made in this aff davit.
Responder's Firm Name: ~-~-~ ~' K Fyn ~ ~~ ~ i. ~ ~~~ ~- i rte. ~~ ~ _
• '~~ ~
Authorized Representative (Please Print) ~J(-~ 1.~ S~-~~l~-w-
. ~ ,r` ~'
Authorized Signature: %~
~~~
Date: ~ ~ 2~ ' ~ ~ -
Subscribed and sworn to me this ~ day of
Notary Public
PATRICIA J. ~~. My commission expires: r-~-~a~ ~
NOTARY.PUBUC - MINNE9dfA
•,,,,;~ My Commission Expires Jan. 3'1, 2010
Affirmative Action Certif~ation Page, Revised 8/04- MDHR
City of Hopkins
Hennepin County, Minnesota
RESOLUTION N0.2007-017
Approval of Contract Authorizing the Hopkins Fire Department to Continue as a
State of Minnesota Hazardous Materials Chemical Assessment Team
WHEREAS, the City of Hopkins has a trained hazardous materials team; and
WHEREAS, the members of the Hopkins Fire Department wish to continue a State of Minnesota
Hazardous Material Chemical Assessment team; and
WHEREAS, the State of Minnesota is willing to bear all costs related to such team.
NOW THEREFORE, BE IT RESOLVED, that the City of Hopkins, Minnesota enter into an
agreement with the State of Minnesota, Department of Public Safety for the purpose of the City
of Hopkins continuing to provide a hazardous materials Chemical Assessment Team for
emergency response within Minnesota.
BE IT FURTHER RESOLVED that the Mayor and City Manager are hereby authorized to
execute such agreement.
Adopted by the City Council of the City of Hopkins this 6th day of March, 2007.
By:
Eugene J. Maxwell, Mayor
ATTEST:
Terry Obermaier, City Clerk