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Home My WebLink About20241875.tiffRESOLUTION RE: APPROVE APPLICATION FOR SUPPLEMENTAL REIMBURSEMENT FOR PETROLEUM STORAGE TANK REMEDIATION AT FUELING FACILITY (1113 H STREET, GREELEY) PERFORMED BY PALMETTO ENVIRONMENTAL GROUP, LLC, AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with an Application for Supplemental Reimbursement for Petroleum Storage Tank Remediation at Fueling Facility (1113 H Street, Greeley) from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Fleet Services, Accounting Department, and Palmetto Environmental Group, LLC, to the Colorado Department of Labor and Employment, Division of Oil and Public Safety, commencing upon full execution of signatures, with further terms and conditions being as stated in said application, and WHEREAS, after review, the Board deems it advisable to approve said application, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Application for Supplemental Reimbursement for Petroleum Storage Tank Remediation at Fueling Facility (1113 H Street, Greeley) from the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Fleet Services, Accounting Department, and Palmetto Environmental Group, LLC, to the Colorado Department of Labor and Employment, Division of Oil and Public Safety, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. cc . FT(DS/FA), AGT(cp/cD) QS/r6//y 2024-1875 AC0023 FT0004 BG0026 APPLICATION FOR SUPPLEMENTAL REIMBURSEMENT FOR PETROLEUM STORAGE TANK REMEDIATION AT FUELING FACILITY (1113 H STREET, GREELEY) PERFORMED BY PALMETTO ENVIRONMENTAL GROUP, LLC PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 10th day of July, A.D., 2024. ATTEST: didt44) Weld County Clerk to the Board BYK .W oi tic APP Deputy Clerk to the Board ORM: y A torney \ Date of signature: "IZZI E1 SLa ktV v't BOARD OF COUNTY COMMISSIONERS WELD COUNTY Ke Perry L. ike Freeman Pro-Tem USED tt K. James ri Saine 2024-1875 AC0023 FT0004 BG0026 C;on-va.ci- l 8R -col BOARD OF COUNTY COMMISSIONERS PASS -AROUND REVIEW PASS -AROUND TITLE: Colorado Petroleum Tank Storage Fund Reimbursement DEPARTMENT: Accounting/Fleet Services DATE: June 25, 2024 PERSON REQUESTING: Chris D'Ovidio/David Springer Brief description of the problem/issue: During construction work on the Greeley fuel site in 2021 there was contamination found under the site. The Palmetto Environmental Group was hired to clean up the contamination. The state requires that the contamination be monitored for seven years after it was found. The cost of the environmental services for this are eligible for reimbursement from the Colorado Petroleum Storage Tank Fund. The work completed in 2023 by Palmetto totaled $32,785.51. The Palmetto group is now asking for the board's signature on a Colorado Petroleum Storage Tank Fund reimbursement request so the County can be reimbursed the cost of the cleanup. The reimbursement request is $32,785.51, the amount of the environmental services preformed by the Palmetto Group. This is a similar process the board agreed to when for the work performed by Palmetto 2021 and 2022. What options exist for the Board? (include consequences, impacts, costs, etc. of options): Signing the request will reimburse the county for the $32,785.51 costs incurred for the cleanup. Recommendation: We recommend the boards signs the request to receive the reimbursement. Approve Schedule Recommendation ��Work Session Other/Comments: Kevin D Ross, Chair `"/�t`'' Perry L. Buck, Pro -Tern Scott K. James Mike Freeman Of. Lori Saine 7/10 2024-1875 0 00Z3 P-0004 EGOOZ(0 COLORADO PETROLEUM STORAGE SUPPLEMENTAL REIMBURSEMENT APPLICATION TANK FUND Short Form S (2017) This form should be used, and can only be used, on Supplemental Reimbursement Applications when the Applicant has already established eligibility for reimbursement of remediation costs relative to this occurrence The nature of this Supplemental Reimbursement Application is: [Select all that apply] Additional costs not previously reimbursed. X Other (Explain). List RAP # of last application previously filed for this remediation: Applicant's Full Legal Name: Weld County Government Social Security # or Federal Tax ID # 84-6000813 Contact Person: Chris D'Ovidio Phone # 970.400.4445 Fax # Mailing Address: Street: 1150 O Street Email: cdovidio@weldgov.com City: Greeley State ID.CO Zip 80631 Reimbursement Mailing Address (if different): Remit Entity: Street: City: State ' Zip Email Applicant is (select one): Government Site Name: Weld County Fueling Facility Site Address: Street: 1113 H Street City: Greeley State CO Zip 80632 Complete this section only if you want the representative to be the primary contact and copied on ail correspondence. Applicant's Representative (if applicable) Name Palmetto Environmental Group Address 4995 York St. Email: mail@palmetto-environmental.com City Denver State CO Zip 80216 Phone # 303.825.8117 Fax # 303.534.5049 Total from Listing of Costs, last column: $32,785.51 Less reimbursement from any other source (see #5): NET REIMBURSEMENT REQUEST: $32,785.51 Dates of work covered by this application: From: 10/13/23 To: 12/29/23 • '2S"#C. ,��'}:� PN.'v'a 1 � x��rta "d- *Y�. 0 u.3 � ?�S�eY�yt'' ` REV 8/4/17 `Prior versions of this application will not be accepted Page 1 of 4 020025—/ i 7 REIMBURSEMENT INFORMATION 1 Will there be additional reimbursement applications for this release? Yes 2 Have any of the costs submitted for reimbursement already been submitted with another reimbursement application? If yes, identify these costs and explain why you are resubmitting these costs: No 3 Do any of the costs submitted for reimbursement cover a time period for which you have already received, or requested reimbursement? If yes, identify these costs and explain why you are resubmitting them: 10 No 4 Except for any contractual relationship established in response to this remediation, is there any relationship - personal, financial, or otherwise - between Applicant and any company or person who performed work for which reimbursement is claimed'? If yes, explain: No 5 Has Applicant received, or does Applicant expect to receive, compensation for corrective action costs from ANY source other than the Colorado Petroleum Storage Tank Fund, including lawsuits, settlements, judgments, contributions from other parties'? If yes, state amount of other reimbursement: $ . Identify source of reimbursement, including court case name and number,IIIID No if applicable: Note; tf there have been any changes to insurance from that submitted with the Original Application, provide uptlated torn with tltia-Applicatiorr(in the same format as the Original Application). 6 Do any costs claimed for reimbursement represent work performed by the Applicant or Applicant's employees? If yes, submit the Affidavits Regarding Work Performed by Applicant. No , 7 8 Has the Legal Name, Remit Entity or Address, Mailing Address or Tax Payer Identification Number changed since the submittal of the Original or last Supplemental Reimbursement Application? If so, please submit a W-9 (scanned signature is acceptable) - see Completing App Instructions tab.ID No W-9 - If you answered yes to question 7, attach a W-9 to this application and explain any changes here. REV 8/4/17 *Prior versions of this application will not be accepted Page 2 of 4 By submitting this application, the Applicant affirms and agrees that: 1. The Applicant certifies, under penalty of law, that Applicant is the appropriate person to request reimbursement, and that this document and all attachments were prepared under Applicant's direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. 2. The Applicant is the owner/operator or duly authorized agent of the owner/operator responsible for this Site. The Applicant is and shall be responsible for assuring compliance with all applicable State and federal regulations. 3. The information submitted by the Applicant, to the best of Applicant's knowledge and belief, is true, accurate and complete. Applicant understands that this application will be submitted by the Colorado Department of Labor and Employment (CDLE or State) for consideration by the Petroleum Storage Tank Committee (Committee). Upon demand by the Committee, Applicant agrees to return the entire award Applicant may receive or any other amount the Committee considers appropriate if (a) Applicant misrepresented or omitted any fact, either in writing or orally, relevant to the determinations made by the Committee or the COLE; or (b) Applicant fails to complete, to the Committee's or the CDLE's satisfaction, the corrective action. 4. The Applicant shall not be entitled to obtain any other reimbursement from any source other than the State for the same costs or work reimbursed by the State. Any reimbursement the Applicant receives or is entitled to receive, including insurance proceeds, is and shall be the property of the State of Colorado to the extent of payment(s) made to the Applicant by the State from the Petroleum Storage Tank Fund. Upon receipt of any such reimbursement from a source other than the State, Applicant shall immediately report and pay such reimbursement to the State. 5. To the extent payment is made from the Petroleum Storage Tank Fund, the Applicant hereby assigns to the State of Colorado any rights the Applicant may have which may allow the Applicant to seek and obtain recovery from any other entity for the costs or work reimbursed by the State, including the right to recover from insurance companies. 6. The Applicant shall not submit any further claims for reimbursement from the State for the Site(s) and work identified in this application, other than an amendment to the application or protest of the Fund Payment Report, if any, for work not heretofore reimbursed. 7. Applicant shall indemnify, save, and hold harmless the State, its employees and agents, and the Committee against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees and related costs, incurred as a result of any act, omission or misrepresentation by the Applicant, or its employees, agents, subcontractors, or assignees pursuant to the terms of this application. As to governmental entity Applicants, no term or condition of this application shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection, or other provisions, of the Colorado Governmental Immunity Act, CRS 24-10-101 et seq., or the Federal Tort Claims Act, 28 USC 2671 et seq., as applicable, as now or hereafter amended. 8. In addition to any other legal rights the State of Colorado may have, the State shall have audit and on -site inspection rights for 3 years after oavment_ 9. The remediation services and supplies for which expenses are listed in this application were performed and/or purchased at the most reasonable rates available for compliance. 10. The Applicant shall provide all formal or informal environmental assessment information to any future owner upon request. 11. In the event the Applicant breaches any of the terms, conditions or requirements of this application , the State of Colorado, in addition to any other remedies, at law or equity, shall be entitled to immediate repayment on demand of all amounts paid to the Applicant; and in the event that the State is required to take legal action to enforce any of the provisions contained herein, the State shall be entitled, in addition to damages, to its costs and reasonable attorney fees and related expenses incurred in connection with such enforcement. 12. At all times during the performance of this remediation, the Applicant shall strictly adhere to all applicable federal and state laws, rules and regulations that have been or may hereafter be established, including without limitation 42 USC 6991 and CRS 8-20.5-101, et seq., and associated regulations. 13. The State may allocate more or less funds to the remediation described in this Application than the amount requested by the Applicant. Once the reimbursement request is approved, the State will issue a Fund Payment Report, substantially in the form of Exhibit B, documenting the amount that will be processed and paid. 14. The Committee has the authority and the right to designate funds be paid to Applicants on pro -rata basis when the Petroleum Storage Tank Fund balance prevents payment in full, pursuant to CRS 8-20.5-206(e)(2). 15. Each additional request by Applicant for reimbursement from the Petroleum Storage Tank Fund must be submitted on a new supplemental application. Any additional payment by the State shall be conditioned upon the issuance by the Committee of a new Fund Payment Report for oavment_ 16. Pursuant to 7 CCR 1101-14, Article 8, the Applicant may file a protest of the Fund Payment Report if the Applicant disputes a decision by the Committee, as stated on the Fund Payment Report. The Applicant may petition the Committee to review its decision. A Protest must be submitted within 60 days of the date of the Fund Payment Report. See 7 CCR 1101-14, 8-6. The Applicant shall use the form of Protest of Fund Payment Report provided by the Division of Oil and Public Safety of the Colorado Department of Labor and Employment. 17. The maximum amount to be paid by the State, if any, in connection with this reimbursement request shall be authorized by the Committee in the Fund Payment Report. 18. The payment by the State and acceptance by the Applicant of any reimbursement amounts requested under this application shall be deemed to be good and sufficient consideration for the promises, certifications and affirmations made by Applicant in this Application. REV 8/4/17 `Prior versions of this application will not be accepted Page 3 of 4 Signatory Page Applicant: Weld County Government Legal Name of Applicant 84-6000813 Social Sec JUL 1 0 2024 Signature of Applicant or Authorized Officer Kevin D. Ross, Chair - Board of Weld Cou issioners Date Print Name Title t�ft9rized fficer, ATTEST: By: rk o the Board the :oard 1, Complete if this is a replacement signatory page PREQ# If you have any questions please consult the OPS website and/or contact OPS at (303) 318-8525. EMAIL TO: Idle PSTReimbursementAppsGistate.co.us OPS website: https://ops.colorado.gov/ Revised 4/18/24 *Prior versions of this application will not be accepted otoati, /87 Page 4 of 4 COLORADO PETROLEUM STORAGE TANK FUND Photocopy additional pages as necessary LISTING OF COSTS Primary Invoice #1 Contractor Name Dates of Work' mdxx/xx xx/xx/xx Beginning Ending Proof of Payment Invoice Amount Amount Submitted for Reimbursements Canceled Check' Other4 Check # Check Amt 20057 Palmetto 10/13/23 12/29/23 AFF $3,560.00 $3,560.00 498312 Palmetto 10/13/23 12/29/23 AFF $29,225.51 $29,225.51 TOTAL SUBMITTED FOR REIMBURSEMENT CONSIDERATION: 1 List all PRIMARY invoices. If invoice does not clearly identify work performed, add that information to the invoice copy submitted with the application. 2 List invoices in order by the date of work performed. 3 If proof of payment is by canceled check, back of canceled check is also required if the dollar amount is not encoded by the bank on the front of the check. 4 If proof of payment is by payee affidavit or CPA Certification, use following codes: AFF = Affidavit. CPA = CPA Certification of Payment. Use CDLE Forms. 5 List only ALLOWABLE costs. If amount requested differs from invoice amount, identify on the invoice any cost for which reimbursement is NOT requested. $32,785.51 rdPALMETTO PALMETTO . :iNV{RONTUNTAL 6ROUB LLC ,Nwosico C.P.Y avit: Proof of Payment (Revised 1 /512016) This form should be used when an applicant submits an affidavit as proof of payment for costs claimed for reimbursement. This form is not required if copies of canceled checks or other bank confirmations of payment are provided. Please note the following requirements. • This form must be reproduced on the company letterhead of the payee (not the applicants letterhead). Affidavits that are not on the payee's letterhead will not be accepted. • This form must be signed by the payee, not the applicant. • Use a separate affidavit for each contractor. • Do not use this form if there is any affiliation or relationship between the applicant and the payee. More information is available in Section 8-2 (b) (2) of the Petroleum Storage Tank Regulations. Applicant Name: Site Name: Site Address: City: 1 Greeley Weld County Government Weld County Fueling Facility 1113 H Street Applicant' in mi { State: I CO Payee Information and C.ertificati in ZIP: 180632 Check the following, as appropriate. I, being first duly sworn upon oath and being of lawful age, state that the following invoices relative to the referenced application for reimbursement from the Colorado Petroleum Storage Tank Fund have been paid in full by the applicant. © I, being first duly sworn upon oath and being of lawful age, state that the following invoices relative to the referenced application for reimbursement from the Colorado Petroleum Storage Tank Fund will be paid in full by the applicant upon receipt of the reimbursement in accordance with a promissory agreement. o Provide a signed and notarized copy of the agreement. Invoice # 20087 Invoice Date 5/2/24 Amount Paid $3,560.00 Invoice # 498312 Invoice Date 6/10/24 Amount Paid $29,225.51 • I further state that there is no relationship or affiliation between myself and the applicant. • i hereby certify that the foregoing information is correct to the best of my knowledge, information and belief. I understand there are severe civil and/or criminal penalties for any false statement or misrepresentation of a material fact, knowing it to be false, or failing to disclose a material fact with the intent to defraud. Signature: Date: Printed Name: I John D. Drafts Company (Payee) Name: l Palmetto Environmental Group Company (Payee) Mailing Address: 4995 York St City: Denver I Title: Principal Phone #: 303.825.8117 State: 1 CO I ZIP: 1 80216 Notary Public Certification; Subscribed and sworn to before me in the county of this day of Notary Public Printed Name: Signature: My Commission Expires: , State of (303) 825-8117 ' 4995 York Street o Denver, Colorado 80216. mail@palmetto-environmentai.com CORE&SAW CUTTING THE COMPETITION 15854 E Otero Or Centennial, CO 80112 (720) 799-0101 dispatch@coreandsaw.com BILL TO Palmetto Environmental 4995 York Street Denver CO 80216 (412) 535-3223 JOB# DATE 1029761706- 12/19/2023 1029761706- 1113 H Street Greeley, CO 80631 DATE INVOICE# TERMS DUE DATE PO/REF# DESCRIPTION Invoice 12/19/2023 12490 NET 15 01'03/2024 SERVICE LOCATION Palmetto Environmental 1113 H Street Greeley CO 80631 (412) 535-3223 11 Cores 12"DIA through slab 9"-10" thick Job Charges Core Drilling 11 Cores 12"DIA through slab 9"-10" thick OTHER Regular work hours Mon -Fri 7am to 5pm. Customer will provide lift if cores are more than 8 feet off the ground X-ray, GPR, locate, etc, is excluded. Damages resulting from failure to X-ray, GPR, locate, etc. are the sole responsibility of customer. Price include general wet vacuum cleanup. Excludes preparation, all layout, protection, patching and repair, and final cleanup. Price includes 1 mobilization. Standby rate is $200/hour Minimum charge is 480$. *Cost of the work may increase due to additional unexpected work. Job Subtotal Job Total Signed By: PRE -WORK SIGNATURE 12/19/2023 01:39 pm Bryan Mills CUSTOMER MESSAGE Qty 11.00 0.00 Signed By: 12/19/2023 01:39 pm Invoice Total: Deposits (-): Payments (-): Total Due: Rate $250.00 $0.00 Total $2,750.00 $0.00 $2,750.00 $2,750.00 POST -WORK SIGNATURE Bryan Mills $2,750.00 $0.00 $0.00 $2,750.00 Eagle Synergistic PO Box 18397 Golden, CO 80402 US 720-475-0022 BILL TO Palmetto Environmental Group PURCHASE ORDER Greeley DPT LOCATION Greeley, CO Drilling (2' well, auger, <50') (2.1) (7822 Geoprobe) (BP) 12.20- 12.21.23----- Mobilization/Demobilization 2.2 2" well completion (2.4) Decontamination 2.8 Potholing (8.14) (Vermeer) (LC/HJ) 12.20-12.21 Potholing Mileage (per mile)18.16) INVOICE 1361 -- DATE 12/21/2023 TERMS Net 30 JOB 8 23.293D 165 33.50 5,527.50 270 5.00 1,350.00 165 27.50 4,537.50 2 188.00 376.00 11 298.00 3,278.00 135 4.00 540.00 Soil Disposal {Hydrovac) (not dig and hauler 55 Gal.)J 1.1) 4 165_00 660.00 Drums (14,4) We appreciate your business! If you have any questions, please let us know. *Please note our new REMITTANCE NAME & ADDRESS: THIS INVOICE HAS BEEN ASSIGNED TO: SPECTRUM COMMERICAL FINANCE PLEASE REMIT DIRECTLY TO SPECTRUM Commercial Finance LB #3245 PO Box 9438 Minneapolis, MN 55440-9438 Thank youl- Eagle Synergistic 4 100.00 400.00 $1 6,669.00 eneratn++r azne and ?Aging Addmsa der err- ConrpenyNarne ar#2'CampanyNara a RMOAN 5.. NONHAZARDOUS !ASTE..MANIFEST . t3enm'ntinpi pardon (Kd0arapq taw "t dlJ�� F+hant :t igna%od t'1 FaclIity Name. and Site Address VYaata. i hiRP :t3ama'arict • spriptlart :'. Nona U . _EPA or OPT >°e gu€ante • Non U&:EPA tar. DO'T .regulated. contaminated water/diesel• mix petatnleum cont rfnatedSo€l/S€utty r Beneficial Reu lReeyclinc 2 , -GENERA On CERIt MAYON, ::txaru' 24.: Tra *poliar: f A—,40, .odgam } :Printscftl9iDati Ns mat Recelpt caf.Materiats. Cartwright 'ransp ac A .:/u cnawledgaraent rif R eeipt OGMated' 1 'Ds pan lridiaa0apa Gertifii,atia• of1pt. III^ -460410-4 .3 waste �naterlai rAl:tepalatfonepml*11ts'pis.l'.at H.3ardsroi' Aannai,: ('�'ace° Sold To: Accounts Payable Palmetto Environmental 4995 York Street Denver, CO 80216 303-825-8117 x107 INVOICE Pace Analytical Services, LLG43-3821637 Pace Analytical National 82.0814289 Pace Analytical Gulf Coast 45-4027089 Pace Analytical Services, LLC 9608 Lolrat Blvd. Lenexa, KS 66219 Phone: (913)5995665 Date: 01/08/2024 Invoice #: 2460199099 Customer PO#: Terms: Net 30 Days Due Date: 02/07/2024 Total Due: $1,815.00 Please Remit To: Pace Analytical Services, LLC P.O. Box 684056 Chicago, IL 60695-4056 I i Nt7miter/C►lent IA 60-533532 / Palmetto ace Prefect Mg Heather Wilson Net 30 Days Client Prefect: 1113 H ST. Pace Project No: 60444760 Report Sent To: John Drafts, Palmetto Environmental Comments: Quantity Unit Description 1 Ea . 8260 MSV GRO and BTEX 10 Ea 8260 MSV GRO and BTEX 11 Ea Sample Disposal 11 Ea TPH-DRO Client Name: Palmetto Sample Received: 12/29/2023 ANALYTICAL CHARGES Method Matrix EPA 5035A/8260 Solid EPA8260 Solid Miscellaneous Charges Solid EPA8015B Solid Samples Received for analysis: Lab ID Client Sample ID 60444760001 MW-03RR@7.5'-8.5' 60444760002 MW -13@5'-6' 60444760003 MW -14@5'-6' 60444760004 MW -15@5'-6' 60444760005 MW -16@5'-6' 60444760006 MW -17@5'-6' 60444760007 MW -18%5'-6' 60444760008 MW -19@5'-6' Price $75.00 $75.00 $0.00 $90.00 Total $75,00 $750,00 $0.00 $990.00 Analytical Subtotal $1,815.00 Total Number of Charges 33 Received 12/29/2023 12/29/2023 12/29/2023 12/29/2023 12/29/2023 12/29/2023 12/29/2023 12/29/2023 Total Invoice Amount $1,815.00 If paying by credit card, a 2.5% surcharge of $45.38 will be assessed, PAY $1,860.38 A 2.5% CREDIT CARD SURCHAGE OF $45.38 MAY BE ADDED TO ANY CREDIT CARD PAYMENT. DEBIT AND ACH/E-CHECKS INCUR NO ADDITIONAL FEES. "*1.5% MONTHLY FINANCE CHARGE ASSESSED AFTER 30 DAYS OR TERMS OF CONTRACT. PLEASE REFERENCE THE INVOICE NUMBER ON ALL REMITTANCE ADVICE. AN EQUAL OPPORTUNITY EMPLOYER Please complete and return copy of invoice with your payment. INVOICE TOTAL $1,815.00 Amount Paid: $ Check No: Customer No: 60-533532 Invoice No: 2460199099 Page 1 of 2 ('ace Sold To: Accounts Payable Palmetto Environmental 4995 York Street Denver, CO 80216 303-825-8117 x107 INVOICE Pace Analytical Son/Ices, LLC 41-1821817 Pace Analytical National 62-0814289 Pace Analytical Gulf Coast 45-4027089 rigNat:60.533532 / Palmetto Client Project: 1113 HST. Pace Project No: 60444760 Report Sent To: John Drafts, Palmetto Environmental Comments: Samples Received for analysts: Lab ID Client Sample ID Received 60444760009 MW -20@5'-6' 60444760010 MW -21@5'-6' 60444760011 MW22@5'-6' 12/29/2023 12/29/2023 12/29/2823 Pace Analytical Services, LLC 9608 Loiret Blvd. Lenexa. KS 66219 Phone: (913)599.6855 Date: 01/08/2024 Invoice #: 2489199099 Customer PO#: Terms: Net 30 Days 02/07/2024 Due Date: Total Due: $1,815.00 Please Remit To: Pace Analytical Services, LLC P.O. Box 684056 Chicago, IL 60695-4056 kaletaWitir Heather Wilson Net 30 Days Client Name: Palmetto Sample Received:12/29/2023 If you have any questions, please contact Heather Wilson et Pace. Phone: 1(913)583-1407 Email:: heatherwilson@pace/abs.com A 2,5% CREDIT CARD SURCHAGE OF $45.38 MAYBE ADDED TO ANY CREDIT CARD PAYMENT. DEBIT Page 202 AND ACH/E-CHECKS INCUR NO ADDITIONAL FEES, "1.5% MONTHLY FINANCE CHARGE ASSESSED AFTER 30 DAYS OR TERMS OF CONTRACT. PLEASE REFERENCE THE INVOICE NUMBER ON ALL REMITTANCE ADVICE. AN EQUAL OPPORTUNITY EMPLOYER ontract F Entity Information Entity Name* Entity ID* PALMETTO ENVIRONMENTAL @00034965 GROUP LLC New Entity? Contract Name* Contract ID COLORADO PETROLEUM TANK STORAGE FUND 8467 REIMBURSEMENT APPLICATION Contract Status CTB REVIEW Contract Lead * CDOVIDID Contract Lead Email cdovidio@weldgov.com;c pattelli@weldgov.com Parent Contract ID Requires Board Approval YES Department Project # Contract Description * THE PALMETTO GROUP HAS COMPLETED SOME ENVIRONMENTAL CLEANUP AT THE GREELEY FUEL SITE. THE COST OF THEIR SERVICE IS ELIGIBLE TO BE REIMBURSED BY THE COLORADO STORAGE TANK FUND. THIS ITEM IS THE APPLICATION FOR THAT REIMBURSEMENT. Contract Description 2 Contract Type * Department AGREEMENT ACCOUNTING Amount* Department Email $32,785.51 CM- Accounting@weldgov.com Renewable NO Department Head Email CM -Accounting - Automatic Renewal DeptHead@weldgov.com Grant County Attorney GENERAL COUNTY ATTORNEY EMAIL IGA County Attorney Email CM- COUNTYATTORNEY@WEL DGOV.COM Requested BOCC Agenda Due Date Date* 07/06/2024 07/10/2024 Will a work session with BOCC be required?* NO Does Contract require Purchasing Dept. to be included? If this is a renewal enter previous Contract ID If this is part of a MSA enter MSA Contract ID Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts are not in OnBase Contract Dates Effective Date Termination Notice Period Contact Information Review Date* 12/31/2023 Committed Delivery Date Renewal Date Expiration Date* 12/31/2023 Contact Info Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2 Purchasing Purchasing Approver Purchasing Approved Date Approval Process Department Head Finance Approver Legal Counsel CHRIS D'OVIDIO CHRIS D'OVIDIO BYRON HOWELL DH Approved Date Finance Approved Date Legal Counsel Approved Date 07/03/2024 07/03/2024 07/03/2024 Final Approval BOCC Approved Tyler Ref # AG 071024 BOCC Signed Date Originator CDOVIDIO BOCC Agenda Date 07/10/2024 Hello