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County Judge or Presiding Officer Authorized to Sign Contract. The presiding officer of The County’s governing body who is authorized to execute this instrument by order duly recorded may execute this contract on behalf of The County. WITNESS the signatures of all parties in duplicate originals this the day of , 2021. Authorized Signature XXXXXXXXXX COUNTY: SERVICE PROVIDER: Authorized Signature Exhibit (Proposal/Statement of Work, dated January 26, 2021) January 26, 2021 Xxxxxxxxxx County Facilities Maintenance Division 0000 XX Xxxxx Xxxx Xxxxxxxxxx, Xxxxx 00000 Attn: Xx. Xxx Xxxxxxxxx Phone: (000) 000-0000 E-mail: xxx.xxxxxxxxx@xxxxx.xxx RE: Children s Advocacy Center Asbestos Survey Xxxxxxxxxx County Children s Advocacy Center 0000 Xxxxxxxxx Xxxxx Xxxx Xxxxxxxxxx, Xxxxx 00000 SSCI Project No.: 55023 Xx. Xxxxxxxxx: Separation Systems Consultants, Inc. (SSCI) respectfully submits this proposal to perform an Asbestos Survey of the Children s Advocacy Center (CAC) located at 0000 Xxxxxxxxx Xxxxx Xxxx xx Xxxxxxxxxx, Xxxxx 00000 (Site). The Site is identified on the Xxxxxxxxxx Central Appraisal District (WCAD) as property ID No. P456434. SSCI understands that the survey is being performed to identify Asbestos Containing Materials (ACM) during renovation activities of the on- site building(s). It is SSCI s understanding that the renovations entail building an add-on to the existing structure. The proposed survey includes identification of ACM within the hallway where the proposed building will connect to the existing building. vices are provided below. A sbestos Survey The Asbestos Survey will be conducted in accordance with the Environmental Protection Agency (EPA) National Emissions Standards for Hazardous Air Pollutants (NESHAP) requirements and the Texas Asbestos Health Protection Rules (TAHPR). The sampling will be performed by a Texas Department of State Health Services (TDSHS) licensed Asbestos Inspector under the direction of a TDSHS licensed Individual Asbestos Management Planner. The objective of the survey is to identify friable and non-friable ACMs in the buildings on-site. The findings of the sampling event will be presented in a survey report. If ACMs are identified, Page 1 Separation Systems Consultants, Inc. 00000 Xx Xxxxxx Xxxx, Xxxxx 000 Xxxxxxx, Xxxxx 00000 Phone: (000) 000-0000 Fax: (000) 000-0000 xxxxxxxxx@xxxxxxxxxxxxxxxxx.xxx Children s Advocacy Center Asbestos Survey Xxxxxxxxxx County Children s Advocacy Center 0000 Xxxxxxxxx Xxxxx Xxxx, Xxxxxxxxxx, Xxxxx 00000 SSCI Project No.: 55023 the owner will be able to use the survey report to obtain construction permits and aid the preparation of asbestos abatement specifications. Suspected ACMs to be sampled include surface materials (sprayed-on or troweled-on materials), thermal insulation materials (pipe insulation, wrapping, etc.) and miscellaneous materials (floor tiles, ceiling tiles, drywall, mastics, etc). Samples will be collected using destructive methods necessary to identify suspected ACMs. SSCI will sample only those materials which are reasonably accessible. If additional materials are discovered during the demolition process, SSCI is not accountable for any costs associated with the sampling of those materials, or project delays associated with their discovery. SSCI estimates that no more than thirty (30) samples of suspected ACMs will be collected from the interior and exterior of the on-site buildings for analysis. The samples will be collected following EPA and TAHPR protocols. The samples will be analyzed using Polarized Light Microscopy (PLM) by a TDSHS-licensed laboratory and analyzed on a standard five (5) business day turnaround. Positive stop analysis will be requested at the laboratory. Positive stop analysis means that once a sample has been identified to contain greater than 1% asbestos, the subsequent samples will not be analyzed. The samples will be transported to the laboratory under chain-of-custody procedures. Friable samples reported to contain >1% but <5% asbestos can be analyzed using the Point- Count Technique (PCT). However, PCT analysis is not recommended on non-friable ACMs. Non-friable Organically Bound (NOBs) materials such as floor tile, mastic, and roofing may contain asbestos fibers that are tightly bound to the matrix and thus are not easily isolated. Fibers may not be detected by PLM resulting in inconsistent results. NOBs may be analyzed at the C y gravimetric reduction or a similar method, and then analyzed by PLM. Point-count or NOB analysis will be provided upon request and for an additional fee. R eporting, Cost, and Schedule SSCI will provide the services outlined within this proposal for a fixed fee of $2,505.00. invoices are payable upon receipt. SSCI is prepared to begin work upon written notice to proceed. Samples will be analyzed on a standard five (5) business day turnaround timeframe. A final report for the Site will be provided within two (2) weeks from receipt of final laboratory results. A breakdown of the costs is provided in the following table: Asbestos Survey for Demolition Children's Advocacy Center 0000 XX Xxxxx Xxxx, Xxxxxxxxxx, XX 00000 SSCI Project No. 55023 Description Quantity Rate Units Amount Asbestos Survey for Renovation Principal 1 $200.00 Hour $200.00 Project Manager 2 $85.00 Hour $170.00 Children s Advocacy Center Asbestos Survey Xxxxxxxxxx County Children s Advocacy Center 0000 Xxxxxxxxx Xxxxx Xxxx, Xxxxxxxxxx, Xxxxx 00000 SSCI Project No.: 55023 Licensed Asbestos Inspector 10 $75.00 Hour $750.00 Asbestos PLM Analysis (5-Day TAT) 30 $10.00 Each $300.00 Vehicle 1 $95.00 Day $95.00 Sub Total $1,515.00 Reporting Project Manager 2 $85.00 Hour $170.00 Licensed Asbestos Inspector 2 $75.00 Hour $150.00 Environmental Technician 8 $70.00 Hour $560.00 Clerical 2 $55.00 Hour $110.00 Sub Total $990.00 TOTAL $2,505.00 R eporting, Cost, and Schedule SSCI s scope of services and fee structure is based on the following assumptions: Right-of-entry will be provided by the client. Project meetings with the client or other entities will be limited to one (1) meeting during the performance of the proposed scope of services. Additional meetings may result in additional fees; Field activities will be completed over the course of one (1) day. More than one (1) day may result in additional fees; and No more than forty-five (45) samples of suspected ACM will be collected from the Site for analysis. Greater than forty-five (45) samples will result in additional fees. SSCI will issue a change order if the assessment of additional fees is required. SSCI will not proceed with services not outlined within this proposal without written authorization from the client. SSCI appreciates the opportunity to provide this proposal. To authorize the scope of work, please sign the authorization block below and return via facsimile at (000) 000-0000 or by e-mail at xxxxxxxxx@xxxxxxxxxxxxxxxxx.xxx. Should you have any questions or comments, please contact me at (000) 000-0000. Sincerely, Xxxxxxx Xxxxxxxx Project Manager Children s Advocacy Center Asbestos Survey Xxxxxxxxxx County Children s Advocacy Center 0000 Xxxxxxxxx Xxxxx Xxxx, Xxxxxxxxxx, Xxxxx 00000 SSCI Project No.: 55023 SSCI r sixty (60) days from the date of this letter. Accepted in accordance with the terms and conditions of this proposal 55023: Authorized Signature Date

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