002

NOTICE OF CONTRACT RENEWAL

State Of Missouri Office Of Administration Division Of Purchasing

POBox809 Jefferson City MO 65102-0809

httpoamogovpurchasing

CONTRACT TITLECONTRACT NUMBER

Air Purifying Respiratory Protective SmokeFire Escape Hoods and Related Accessories

CCI 70782001

CONTRACT PERIODAMENDMENT NUMBER

August 28 2019 through August 27 2020

SAM l1 VENDOR NUMBERMissourlBUYS SYSTEM JDREQUISJTIONREQUESf NUMBER

5223476860 0 MB00093705 NR 931 YYY19708613

STATE AGENCYS NAME AND ADDRESSCONTRACTOR NAME AND ADDRESS

Missouri Department ofCorrections 1200 Clint Moore Road Unit 15 EJmridge Protection Products LLC

Various Agency Locations throughout the State of Boca Raton FL 33487 Missouri

ACCEPTED BY THE STATE OF MISSOURI AS FOLLOWS

Contract CC 17078200 I is hereby amended pursuant to the attached amendment 002 dated 62019

BUYER CONTACT INFORMATIONBUYER Email Vincenthollisoamogov

Vincent Hollis Phone (573) 751- 2497 Fax (573) 526-9816 DATE

SIGNAffi~(1 ~ pound~poundLof1 DIRECTOR OF PURCHASING

~-~ Karen S Boeger

Contract CC170782001 Page2

PRICING PAGE The products shall conform to themandatory specifications contained herein The vendor shall submitfirm fixed prices for all line items (1 through 6) listed below All ricin shallbe uoted FOB Destination Frei t Pre aid and Allowied and shall bcent considereq firm for the duration ofthe contract erioq

Line Item l UNSPSC Code 46182004

Respiration Air SupplyingSefContained Breathing Apparatus or Accessories S~o~ile Hood

2nd Renewal Contract Period

Finn Fixed Price per Each

Must protectagainst the following particles Soot AerosolsAnthrax Ricin Smallpox Radioictive Particles Must protect against the following gases Carbon Monoxide Hydrogen middotsulfide Sarin Smoke Hydrogen Cyanide Ghlorine Ammonia Sulfur Dioxide CS CN art4 QC Must be able to wifhsu$d up to 1700degF radiant heat at95n Must have high visibility reflective strips MgtOve and at each side ofthe face Must protect lungs head eyes and face Must be constructed ofclear material for unobstructed field ofview Must have silicone neck dam Must be able to be ~edwitb eyeglass~ beards and long hair Mustuse twqi HEPA Pl00 filters Must be maintenance free Must be latex free Must be a one-time use product Mrist be one size Maximum weight I 5 pounds Must have a minimum shelf life offive (5) years Must bemiddot packaged ina puncture and water proof laminate barrier vacuum sealed in foil pouch Mustbe certified to American National Standard for Air Purifying Respiratory Smoke Escape Devices Must be National Institute for Occupational Safety and Health certified in accord~ce with 42 CFR 84 Must be manufactured to International Organization for Standardization (ISO) 9001 2008 Standard

$16973EA

BrandModel Referen~ iEvac SmokeFire Hood EBP-900 or equivalent

State Brand Bidding __________ Model No EBP-900

Estimated Quantity 150 EA

Contract CC17078200l Page4

UNSPSCCode 46182004 Contract Period Firm Fixed Price

Respiration Air Supplying SelfContainedBreathingApparatus or Accessories rEach Double WallMtuntRack for line lteJJJ l

Must bescrew mount and designed to hold two (2) SmokeFire Hoods listed ip lineitem 1

Discontinued BrandModel Reference iEyac Dcoble Wall Raellt EBP-306 or equivalent

State Brand Bi4ding _________ State ModelNo EBP306

Frtimated Quantity 7S SA

Lineltem5 UNSPSCCode 46182004

Respiration Air SupplyingSelfConlaiMd Breathing Apparatus orkcessori~

2nd )teilewal Contract Period F~ Fixed Price

Each Carrying Pouchfor Line Item 1 middot

Desi~ to hoid one (1) SmokeFire Hood listed in lirie itemmiddott Attaches to belt Constructedofnylon

BrandModel Reference ffivac Carry Pouch EBP-270 or equivaknt

StateBrand Bidding _________ State Model No EBP-270

Estimated Qualitity 25 EA

$1799EA

2ndRe-iILineltan6 UN$PSC C(de 46182004 Coatraet Period

--------------------------------------=--=--=--=--=--=--=--=--=---=-----=

Contract CC17078200l Page4

UNSPSCCode 46182004 Contract Period Firm Fixed Price

Respiration Air Supplying SelfContainedBreathingApparatus or Accessories rEach Double WallMtuntRack for line lteJJJ l

Must bescrew mount and designed to hold two (2) SmokeFire Hoods listed ip lineitem 1

Discontinued BrandModel Reference iEyac Dcoble Wall Raellt EBP-306 or equivalent

State Brand Bi4ding _________ State ModelNo EBP306

Frtimated Quantity 7S SA

Lineltem5 UNSPSCCode 46182004

Respiration Air SupplyingSelfConlaiMd Breathing Apparatus orkcessori~

2nd )teilewal Contract Period F~ Fixed Price

Each Carrying Pouchfor Line Item 1 middot

Desi~ to hoid one (1) SmokeFire Hood listed in lirie itemmiddott Attaches to belt Constructedofnylon

BrandModel Reference ffivac Carry Pouch EBP-270 or equivaknt

StateBrand Bidding _________ State Model No EBP-270

Estimated Qualitity 25 EA

$1799EA

2ndRe-iILineltan6 UN$PSC C(de 46182004 Coatraet Period

--------------------------------------=--=--=--=--=--=--=--=--=---=-----=

NOTICE OF AWARD

State Of Missouri Office Of Administration Division Of Purchasing

POBox809 Jefferson City MO 65102-0809

httpoamogovpurchasing

SOLICITATION NUMBER CONTRACT TITLE

IFBC30034901700782 Air Purifying Respiratory Protective SmokeFire Escape Hoods and Related Accessories

CONTRACT NUMBER CONTRACT PERIOD

cc170782001 August 28 2017 through August 27 2018

REQUISITIONREQUEST NUMBER SAM II VENDOR NUMBER1tlissouriBUYS SYSTEM ID

NR 931 YYYl7709083 5223476860 0 I MB00093705

CONTRACTOR NAME AND ADDRESS STATE AGENCYS NAME AND ADDRESS

Elmridge Protection Products Missouri Department of Corrections 6401 East Rogers Circle Various Agency Locations Throughout the Unit 12 State of Missouri Boca Raton FL 33487

ACCEPTED BY THE STATE OF MISSOURI AS FOLLOWS

The bid submitted by Elmridge Protection Products in response to SOLICIT A TI ONOPPORTUNITY (OPP) NO IFBC30034901700782 including the attached letter from Barbara Greenstein dated 32217 is accepted in its entirety

BUYER

Kristina Cramer

BUYER CONTACT INFORMATION

Email kristinacrameroamogov Phone (573) 751- 1695 Fax (573) 526-9816

SIGNATURE OF BUYER

j~~~ DATE

March 23 2017

DIRECTOR OF PURCHASING

~~ Karen S Boeger

3222017 IFBC30034901700782 - Air Purifying Respiratory SmokeFire Escape Hoods amp Accessories for DOC (Formal)

Supplier Information Elmridge Protection Products

I General Categories r Agency Specific Information Scorecard ACH Validations

Main Contact infomation

Main Contact

Phone

Email

Fax Address

Purchase Orders Dispatcl1ed to

PO Contact Phone

Email

Fax Address

Solicitation Notifications Sent to

Solicitation Contact

Phone

Email

Fax Address

Remittance Contact Information

Remittance Contact

Phone

Email

Fax

Address

Other Company Information

Enterprise Type

HQ Supplier Exempt from W-9 Withholding

Doing Business As

Medical or Legal Service Provider

State In Which Incorporated

WebProcure Contract Received

WebProcure Contract Received Date

Federal Tax ID

DUNS Number (Unique Identifier)

Barbara Greenstein

561-244-8337

infoelmridgeprotectioncom

561-244-8339 6401 E Rogers Circle Unit 12 Boca Raton FL 33487 United States

Barbara Greenstein

561-244-8337

infoelmridgeprotectioncom

561-244-8339

6401 E Rogers Circle Unit 12 Boca Raton FL 33487 United States

Barbara Greenstein

561-244-8337

infoelmridgeprotectioncom

561-244-8339 6401 E Rogers Circle Unit 12 Boca Raton FL 33487 United States

Barbara Greenstein

561-244-8337

nfoelmridgeprotectloncom

561-244-8339

6401 E Rogers Circle Unit 12 Boca Raton FL 33487 United States

Limited Liability Company - C Corporation y

N

NA N

FL N

NA

NA

- ( -~~~---middot-~ ~-~_

j Payment Types

httpswebprocureperfectcomReviewDocsstatemobid=62866 12

3222017 IFBC30034901700782- Air Purifying Respiratory SmokeFire Escape Hoods amp Accessories for DOC (Formal)

Buyer-Created N

WebProcure Usage Terms Accepted 10132015On

Buying Organizations Additional Terms Accepted 10132015

WebProcure System Supplier ID 93705

Supplier Created in External(Financial) System Y

TPID A7A4583D-6A9A-4910-ACF2-483469C78E58

TPShortname elm001

External(Financial) System Supplier IDMB00093705

Attachments

Name Category Create Date 2015 W-9pdf W-9 Nov s 2015

Close

httpswebprocureperfectcomRevieNDocsstatemobid=62866 22

March 22 2017

State of Missouri Kristina Cramer State of Missouri Office of Administration Division of Purchasfog 301 West Bigh Street Room 630 Post Office Box 809 Jefferson City Missouri 65102-0809

Re Brick and Mottar Status in the State of Missouri

Dear Kristina

Please allow this to confirm that Elmridge Protection Products LLC does not maintain a brick and Mortar fixed location within the State of Missouri

Elrnridge Protection Products LLC maintains its headquarters in the State of Florida and conducts business throughout the United States

If you require additional infom1ation please do not hesitate to contact me (561) 244-8337

Cc Ira J Gurvitch Managing Patiner

6401 E Rogers Circle Unit 12 Boca Raton FL 33487 5612448337 bull infoElmridgeProtectioncom bull wwwElmridgeProtectioncom

Cost Data From MissouriBUYS

Elmridge Protection Products IFBC30034901700782

Supplier Name Product Number

I ITotal lltem BidUnit Quantity Unit

Evaluated Item Total IAddI Item Field 1 AddI Item Field 2

Page 1 of2

Elmridge Protection Products IFBC30034901700782

AddI Item Field 3 IAddI Item Field 4

--bull middot--m IIBlillll- - lllffl ifiI I i 1bull woibullbull

I

-_BliHllllmiddot~middot1middotbullmiddott - middot1 111 middot1u J __m(11_ bull bull bull

Page2 of2

G-lR1bGC PfDbullrccr ul) PRorvc-rsmiddot LLC IFBC30034901700782 -31~ W i 7 Page 23

EXHIBIT A

DOMESTIC PRODUCTS PROCUREMENT ACT ltBUY AMERICAN) PREFERENCE

In accordance with sections 34350-34359 RS Mo the vendor is instructed tb provide inforlllation regarding- the Point_ of manufacturcmiddotfor each of the products being hid so that lhe p_roducfs eligibHity for the_Domestic Products Procurlment Act (Buy American) Preforencc _can be determined Thfa infimnation is requested for the finished product only _not for (Omponents of the finished product The vendor may be- rcmiddotquired to provide supporting documentation indicating proof of compliance

Qualifying for-the Domestic PJoducts_ Preference f product qualifies for the pretCfcnce if one of the following circumstances exist bull if manufactured or produced in UH US or bull if the product Js impmied into the lJS-but is covered by ail existing international trade treaty law agr(ement or regulation that

affords the specific product the same status aS a product 1nt1nufactured or produced in the US or bull ifomiddotnJy one line of products is manufocturcd or produced in the US

Non-Doruestic Product If the product is not manufactured 01 ploduced in the US and does notOtherwise qualify us domestic then it will be considered nonshydomestic and not eligible for the piCference

THE VENDOR MlST COMPLETE THE FOLLOWING APPLICABLE TABLES TO CERTIFY WHETHER (Table I j ALL products bid are manufactured Or produced i_n the os aild qualif) for the Domestic Products Proc11rement Ael Preference OR (Tabie -i) ALL products bid are manufacturcd Or _produced outside the US and do not otherwise qualify for the Domestic P~oducentis-Procun~ment Act Preference OR (Tables3-6) Ntinill J)rl)ducts bid foll into ihe priOr two cutegorjes so an itcm~by~itein middotcertification is necessary

The vendor is responsible for certifving the information provided on the exhibit is accurate by signing Where indicated 11t the ertd of the exhibit

TABLE I ~ALL PRODUCTS MANUFACTURED OR PRODUCED IN US (cli iblefor reforence Check the box to the right ifALL products bid arc MANUFACTURED OR PRODUCl1D IN THE US

TABLE 2 - ALL PRODUCTS MANUFACTURED OR PRODUCED OUTSIDE US AND DONT QUAUFY FOR PREFERENCE (ineli ible for reference)

Check the box to tl1e right if ALL prnducts bid are MANUiACTURED OR PRODUCED OUTSIDE Tl-IE US and DO NOT OTHEltWISE V QUALIFY for th Domestic Products Procurerilei1t Act Preference f

TABLES 3 THROUGH 6 - ITEM BY ITEM CERTIFICATION (NOT ALL PRODUCTS BID FALL INTO PRIOR TVO TABLES) bull For thosmiddotI line iteiils fo1bull which a US-man1factured _01middot produced product is_ liid complete Tablemiddot 3 bull For those line items which are inmiufaduted or produced middotoutside tlJc US that do notqualify for the Domestic Prbducts Procurement Act PreferencC1 complete fable4

bull For those line items which are not mnnufncturcct 01middot produced i11 the US but for which there is a US trademiddot tretty law agreement or regulution in compliance with section 34359 RSMo conlpletc Titble 5 bullFor-tboSe lii1e items which tire not manufactured ormiddotproduced in the US but for which th~re is only one US Manufacturer ofthat product odine of ptoductS compkte Table 6

TABLE3 llS-MANUFACTURED OR PRODUCED PRODUCTS (Eligible for Preference) bull List item numbers of products bid that ate US~manufa_cturcd or produced and therefore qualify for the Domestic Products Procurement Act

Preference

bull Listmiddotus citi and state whelc nroducts bid arc manufoctmicrored or produced Item US CitvState Where ManufacturedProduced Hbullm US CitvState Where MairnfacturedProduced

TABLE4 _ [OREIGN-MA~UFACTllRbullD OR PRODUCED PRODUCTS (Not Eli~ible for Prferencebull list item n_urnbers 9fproducts bid lhat are foreign inanufactuled or ploduced and do n-ot othenvise qualify for themiddot D~nllestic Products

Procuremtnt ActPrcforence bull L_ist country where product bid is manufactured or produced

Item Countrv Where ManufacturedProduced Item Countrv Vhere ManufacturedProducedE 2 Jc sltl tt)I 1~1u f~f f~bull-Zo j bullmiddottA(

nP ~ C i1 stmiddot 3o5 CHi v I [f--bullhi ( u r l Mf ~f C11

I (Exhibit continues on next page)

IFBC3003490 l700782 Page 24

EXHIBIT A continued DOMESTIC PRODUCTS PROCUREMENT ACT (BUY AMERICAN) PREFERENCE

TABLE 5 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT US TRADF TREATY LAW AGREEMENT OR REGULATION APPLmS Eligible for Preference)

bull List item numbers of products bid that are foreign mmw-ilctured or produced but qualify for the Domestic Products Procurement Act Prcforcnce because a US Trade Treaty Law Agreement or Regulation applies

bull ldentit) country where proposed foreign-made product is manufactured or produced bull ldcntii) name ofapplicnble US Trade Treaty Law Agreement or Regulation that allows product to be brought into the US dutytariff-free bull Identi6 website URL for the US Trade Treaty Law Agreement or Regtlation bull NOTE As an imported prnduct ifan impon tariff is applied to the item it does not quuli-fY for the preference Tn additioti middotbullMost Favored

Nationmiddotmiddot status docs not allow annHcation of the nreference ttnkss tile oroduct enters the US dutytariff-free Item Country Where Proposed ForeignMMade Product is Name of Applicable US Official Website URL for the US

ManufactliredProduccd Trade Treaty Law Treaty_ Law Agteementor Regulation Agreement or Rc1rnlntion

IrPri $Pa C I ) $ Rr_GY middot~t bull rgte i-e ~ Vj J_ pound rsP---gtr-- j C tL- C d S middot raquo ltc- bull j

TABLE 6 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT ONLY ONE US MANUFACTURER PRODUCES PRODUCT OR LINE OF PARTICULAR GOOD Eli2ible for Preference)bull List item numbers ofproducts bid that arc foreign manufactured or_produced but quality tor the Domestic Prnducts Procurement Act

Preterence btcause only one US Manufacturer pr9duccs the product or line of a particular good bull Identify country where proposed foreign-made proltluct is manufactured or produced bull Identity sole US manufacturer name

bull lltlentifv name of sole US manufactured oroductline ofparticulur 2ood Item Country Vhere Proposed Foreign-Made Product is Sole US Manufacturer Name of Sole US Mnnufalttured Product

ManufacturedProduced Nnme or Line of Particular Good i11middot1 -j ~~-- t I f t f U-t (~C-yen1Cipoundgfltl i -Jbull)iC- SM O kC If Abull I

Iflt_ JI~ LLJllt--ggt~gty ltltgt~ CL LyentvJ t_ len HOCgt r

middotr The vendor is resnons1ble for cert yml the in ormation orov1ded 011 tlus exhibit is accurate hv shmin2 below I hereby certify that the information provided herein is true and correct and complies with all provisions of seclions 34350 to 34359 RSMo understandthat any misrepresentation herein constitutes the comission ofmiddota class A misdemeanor

~ ( SIGNATURE (Ifsubmitting bid ekctron~aly sctlnntbull t~

r-~ e signature is acceptabfo)

COMPANY NAME c- Re I I ( ( P~or-CCTrorJ fRoDVc-TS

1 LLG

MO 3QQ-i-J02N (HG)

I

Elmridge Protection Products IFBC30034901700782

Supplier Name Product Number

I ITotal lltem BidUnit Quantity Unit

Evaluated Item Total IAddI Item Field 1 AddI Item Field 2

Page 1 of2

Elmridge Protection Products IFBC30034901700782

AddI Item Field 3 IAddI Item Field 4

--bull middot--m IIBlillll- - lllffl ifiI I i 1bull woibullbull

I

-_BliHllllmiddot~middot1middotbullmiddott - middot1 111 middot1u J __m(11_ bull bull bull

Page2 of2

G-lR1bGC PfDbullrccr ul) PRorvc-rsmiddot LLC IFBC30034901700782 -31~ W i 7 Page 23

EXHIBIT A

DOMESTIC PRODUCTS PROCUREMENT ACT ltBUY AMERICAN) PREFERENCE

In accordance with sections 34350-34359 RS Mo the vendor is instructed tb provide inforlllation regarding- the Point_ of manufacturcmiddotfor each of the products being hid so that lhe p_roducfs eligibHity for the_Domestic Products Procurlment Act (Buy American) Preforencc _can be determined Thfa infimnation is requested for the finished product only _not for (Omponents of the finished product The vendor may be- rcmiddotquired to provide supporting documentation indicating proof of compliance

Qualifying for-the Domestic PJoducts_ Preference f product qualifies for the pretCfcnce if one of the following circumstances exist bull if manufactured or produced in UH US or bull if the product Js impmied into the lJS-but is covered by ail existing international trade treaty law agr(ement or regulation that

affords the specific product the same status aS a product 1nt1nufactured or produced in the US or bull ifomiddotnJy one line of products is manufocturcd or produced in the US

Non-Doruestic Product If the product is not manufactured 01 ploduced in the US and does notOtherwise qualify us domestic then it will be considered nonshydomestic and not eligible for the piCference

THE VENDOR MlST COMPLETE THE FOLLOWING APPLICABLE TABLES TO CERTIFY WHETHER (Table I j ALL products bid are manufactured Or produced i_n the os aild qualif) for the Domestic Products Proc11rement Ael Preference OR (Tabie -i) ALL products bid are manufacturcd Or _produced outside the US and do not otherwise qualify for the Domestic P~oducentis-Procun~ment Act Preference OR (Tables3-6) Ntinill J)rl)ducts bid foll into ihe priOr two cutegorjes so an itcm~by~itein middotcertification is necessary

The vendor is responsible for certifving the information provided on the exhibit is accurate by signing Where indicated 11t the ertd of the exhibit

TABLE I ~ALL PRODUCTS MANUFACTURED OR PRODUCED IN US (cli iblefor reforence Check the box to the right ifALL products bid arc MANUFACTURED OR PRODUCl1D IN THE US

TABLE 2 - ALL PRODUCTS MANUFACTURED OR PRODUCED OUTSIDE US AND DONT QUAUFY FOR PREFERENCE (ineli ible for reference)

Check the box to tl1e right if ALL prnducts bid are MANUiACTURED OR PRODUCED OUTSIDE Tl-IE US and DO NOT OTHEltWISE V QUALIFY for th Domestic Products Procurerilei1t Act Preference f

TABLES 3 THROUGH 6 - ITEM BY ITEM CERTIFICATION (NOT ALL PRODUCTS BID FALL INTO PRIOR TVO TABLES) bull For thosmiddotI line iteiils fo1bull which a US-man1factured _01middot produced product is_ liid complete Tablemiddot 3 bull For those line items which are inmiufaduted or produced middotoutside tlJc US that do notqualify for the Domestic Prbducts Procurement Act PreferencC1 complete fable4

bull For those line items which are not mnnufncturcct 01middot produced i11 the US but for which there is a US trademiddot tretty law agreement or regulution in compliance with section 34359 RSMo conlpletc Titble 5 bullFor-tboSe lii1e items which tire not manufactured ormiddotproduced in the US but for which th~re is only one US Manufacturer ofthat product odine of ptoductS compkte Table 6

TABLE3 llS-MANUFACTURED OR PRODUCED PRODUCTS (Eligible for Preference) bull List item numbers of products bid that ate US~manufa_cturcd or produced and therefore qualify for the Domestic Products Procurement Act

Preference

bull Listmiddotus citi and state whelc nroducts bid arc manufoctmicrored or produced Item US CitvState Where ManufacturedProduced Hbullm US CitvState Where MairnfacturedProduced

TABLE4 _ [OREIGN-MA~UFACTllRbullD OR PRODUCED PRODUCTS (Not Eli~ible for Prferencebull list item n_urnbers 9fproducts bid lhat are foreign inanufactuled or ploduced and do n-ot othenvise qualify for themiddot D~nllestic Products

Procuremtnt ActPrcforence bull L_ist country where product bid is manufactured or produced

Item Countrv Where ManufacturedProduced Item Countrv Vhere ManufacturedProducedE 2 Jc sltl tt)I 1~1u f~f f~bull-Zo j bullmiddottA(

nP ~ C i1 stmiddot 3o5 CHi v I [f--bullhi ( u r l Mf ~f C11

I (Exhibit continues on next page)

IFBC3003490 l700782 Page 24

EXHIBIT A continued DOMESTIC PRODUCTS PROCUREMENT ACT (BUY AMERICAN) PREFERENCE

TABLE 5 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT US TRADF TREATY LAW AGREEMENT OR REGULATION APPLmS Eligible for Preference)

bull List item numbers of products bid that are foreign mmw-ilctured or produced but qualify for the Domestic Products Procurement Act Prcforcnce because a US Trade Treaty Law Agreement or Regulation applies

bull ldentit) country where proposed foreign-made product is manufactured or produced bull ldcntii) name ofapplicnble US Trade Treaty Law Agreement or Regulation that allows product to be brought into the US dutytariff-free bull Identi6 website URL for the US Trade Treaty Law Agreement or Regtlation bull NOTE As an imported prnduct ifan impon tariff is applied to the item it does not quuli-fY for the preference Tn additioti middotbullMost Favored

Nationmiddotmiddot status docs not allow annHcation of the nreference ttnkss tile oroduct enters the US dutytariff-free Item Country Where Proposed ForeignMMade Product is Name of Applicable US Official Website URL for the US

ManufactliredProduccd Trade Treaty Law Treaty_ Law Agteementor Regulation Agreement or Rc1rnlntion

IrPri $Pa C I ) $ Rr_GY middot~t bull rgte i-e ~ Vj J_ pound rsP---gtr-- j C tL- C d S middot raquo ltc- bull j

TABLE 6 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT ONLY ONE US MANUFACTURER PRODUCES PRODUCT OR LINE OF PARTICULAR GOOD Eli2ible for Preference)bull List item numbers ofproducts bid that arc foreign manufactured or_produced but quality tor the Domestic Prnducts Procurement Act

Preterence btcause only one US Manufacturer pr9duccs the product or line of a particular good bull Identify country where proposed foreign-made proltluct is manufactured or produced bull Identity sole US manufacturer name

bull lltlentifv name of sole US manufactured oroductline ofparticulur 2ood Item Country Vhere Proposed Foreign-Made Product is Sole US Manufacturer Name of Sole US Mnnufalttured Product

ManufacturedProduced Nnme or Line of Particular Good i11middot1 -j ~~-- t I f t f U-t (~C-yen1Cipoundgfltl i -Jbull)iC- SM O kC If Abull I

Iflt_ JI~ LLJllt--ggt~gty ltltgt~ CL LyentvJ t_ len HOCgt r

middotr The vendor is resnons1ble for cert yml the in ormation orov1ded 011 tlus exhibit is accurate hv shmin2 below I hereby certify that the information provided herein is true and correct and complies with all provisions of seclions 34350 to 34359 RSMo understandthat any misrepresentation herein constitutes the comission ofmiddota class A misdemeanor

~ ( SIGNATURE (Ifsubmitting bid ekctron~aly sctlnntbull t~

r-~ e signature is acceptabfo)

COMPANY NAME c- Re I I ( ( P~or-CCTrorJ fRoDVc-TS

1 LLG

MO 3QQ-i-J02N (HG)

I

Elmridge Protection Products IFBC30034901700782

AddI Item Field 3 IAddI Item Field 4

--bull middot--m IIBlillll- - lllffl ifiI I i 1bull woibullbull

I

-_BliHllllmiddot~middot1middotbullmiddott - middot1 111 middot1u J __m(11_ bull bull bull

Page2 of2

G-lR1bGC PfDbullrccr ul) PRorvc-rsmiddot LLC IFBC30034901700782 -31~ W i 7 Page 23

EXHIBIT A

DOMESTIC PRODUCTS PROCUREMENT ACT ltBUY AMERICAN) PREFERENCE

In accordance with sections 34350-34359 RS Mo the vendor is instructed tb provide inforlllation regarding- the Point_ of manufacturcmiddotfor each of the products being hid so that lhe p_roducfs eligibHity for the_Domestic Products Procurlment Act (Buy American) Preforencc _can be determined Thfa infimnation is requested for the finished product only _not for (Omponents of the finished product The vendor may be- rcmiddotquired to provide supporting documentation indicating proof of compliance

Qualifying for-the Domestic PJoducts_ Preference f product qualifies for the pretCfcnce if one of the following circumstances exist bull if manufactured or produced in UH US or bull if the product Js impmied into the lJS-but is covered by ail existing international trade treaty law agr(ement or regulation that

affords the specific product the same status aS a product 1nt1nufactured or produced in the US or bull ifomiddotnJy one line of products is manufocturcd or produced in the US

Non-Doruestic Product If the product is not manufactured 01 ploduced in the US and does notOtherwise qualify us domestic then it will be considered nonshydomestic and not eligible for the piCference

THE VENDOR MlST COMPLETE THE FOLLOWING APPLICABLE TABLES TO CERTIFY WHETHER (Table I j ALL products bid are manufactured Or produced i_n the os aild qualif) for the Domestic Products Proc11rement Ael Preference OR (Tabie -i) ALL products bid are manufacturcd Or _produced outside the US and do not otherwise qualify for the Domestic P~oducentis-Procun~ment Act Preference OR (Tables3-6) Ntinill J)rl)ducts bid foll into ihe priOr two cutegorjes so an itcm~by~itein middotcertification is necessary

The vendor is responsible for certifving the information provided on the exhibit is accurate by signing Where indicated 11t the ertd of the exhibit

TABLE I ~ALL PRODUCTS MANUFACTURED OR PRODUCED IN US (cli iblefor reforence Check the box to the right ifALL products bid arc MANUFACTURED OR PRODUCl1D IN THE US

TABLE 2 - ALL PRODUCTS MANUFACTURED OR PRODUCED OUTSIDE US AND DONT QUAUFY FOR PREFERENCE (ineli ible for reference)

Check the box to tl1e right if ALL prnducts bid are MANUiACTURED OR PRODUCED OUTSIDE Tl-IE US and DO NOT OTHEltWISE V QUALIFY for th Domestic Products Procurerilei1t Act Preference f

TABLES 3 THROUGH 6 - ITEM BY ITEM CERTIFICATION (NOT ALL PRODUCTS BID FALL INTO PRIOR TVO TABLES) bull For thosmiddotI line iteiils fo1bull which a US-man1factured _01middot produced product is_ liid complete Tablemiddot 3 bull For those line items which are inmiufaduted or produced middotoutside tlJc US that do notqualify for the Domestic Prbducts Procurement Act PreferencC1 complete fable4

bull For those line items which are not mnnufncturcct 01middot produced i11 the US but for which there is a US trademiddot tretty law agreement or regulution in compliance with section 34359 RSMo conlpletc Titble 5 bullFor-tboSe lii1e items which tire not manufactured ormiddotproduced in the US but for which th~re is only one US Manufacturer ofthat product odine of ptoductS compkte Table 6

TABLE3 llS-MANUFACTURED OR PRODUCED PRODUCTS (Eligible for Preference) bull List item numbers of products bid that ate US~manufa_cturcd or produced and therefore qualify for the Domestic Products Procurement Act

Preference

bull Listmiddotus citi and state whelc nroducts bid arc manufoctmicrored or produced Item US CitvState Where ManufacturedProduced Hbullm US CitvState Where MairnfacturedProduced

TABLE4 _ [OREIGN-MA~UFACTllRbullD OR PRODUCED PRODUCTS (Not Eli~ible for Prferencebull list item n_urnbers 9fproducts bid lhat are foreign inanufactuled or ploduced and do n-ot othenvise qualify for themiddot D~nllestic Products

Procuremtnt ActPrcforence bull L_ist country where product bid is manufactured or produced

Item Countrv Where ManufacturedProduced Item Countrv Vhere ManufacturedProducedE 2 Jc sltl tt)I 1~1u f~f f~bull-Zo j bullmiddottA(

nP ~ C i1 stmiddot 3o5 CHi v I [f--bullhi ( u r l Mf ~f C11

I (Exhibit continues on next page)

IFBC3003490 l700782 Page 24

EXHIBIT A continued DOMESTIC PRODUCTS PROCUREMENT ACT (BUY AMERICAN) PREFERENCE

TABLE 5 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT US TRADF TREATY LAW AGREEMENT OR REGULATION APPLmS Eligible for Preference)

bull List item numbers of products bid that are foreign mmw-ilctured or produced but qualify for the Domestic Products Procurement Act Prcforcnce because a US Trade Treaty Law Agreement or Regulation applies

bull ldentit) country where proposed foreign-made product is manufactured or produced bull ldcntii) name ofapplicnble US Trade Treaty Law Agreement or Regulation that allows product to be brought into the US dutytariff-free bull Identi6 website URL for the US Trade Treaty Law Agreement or Regtlation bull NOTE As an imported prnduct ifan impon tariff is applied to the item it does not quuli-fY for the preference Tn additioti middotbullMost Favored

Nationmiddotmiddot status docs not allow annHcation of the nreference ttnkss tile oroduct enters the US dutytariff-free Item Country Where Proposed ForeignMMade Product is Name of Applicable US Official Website URL for the US

ManufactliredProduccd Trade Treaty Law Treaty_ Law Agteementor Regulation Agreement or Rc1rnlntion

IrPri $Pa C I ) $ Rr_GY middot~t bull rgte i-e ~ Vj J_ pound rsP---gtr-- j C tL- C d S middot raquo ltc- bull j

TABLE 6 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT ONLY ONE US MANUFACTURER PRODUCES PRODUCT OR LINE OF PARTICULAR GOOD Eli2ible for Preference)bull List item numbers ofproducts bid that arc foreign manufactured or_produced but quality tor the Domestic Prnducts Procurement Act

Preterence btcause only one US Manufacturer pr9duccs the product or line of a particular good bull Identify country where proposed foreign-made proltluct is manufactured or produced bull Identity sole US manufacturer name

bull lltlentifv name of sole US manufactured oroductline ofparticulur 2ood Item Country Vhere Proposed Foreign-Made Product is Sole US Manufacturer Name of Sole US Mnnufalttured Product

ManufacturedProduced Nnme or Line of Particular Good i11middot1 -j ~~-- t I f t f U-t (~C-yen1Cipoundgfltl i -Jbull)iC- SM O kC If Abull I

Iflt_ JI~ LLJllt--ggt~gty ltltgt~ CL LyentvJ t_ len HOCgt r

middotr The vendor is resnons1ble for cert yml the in ormation orov1ded 011 tlus exhibit is accurate hv shmin2 below I hereby certify that the information provided herein is true and correct and complies with all provisions of seclions 34350 to 34359 RSMo understandthat any misrepresentation herein constitutes the comission ofmiddota class A misdemeanor

~ ( SIGNATURE (Ifsubmitting bid ekctron~aly sctlnntbull t~

r-~ e signature is acceptabfo)

COMPANY NAME c- Re I I ( ( P~or-CCTrorJ fRoDVc-TS

1 LLG

MO 3QQ-i-J02N (HG)

I

G-lR1bGC PfDbullrccr ul) PRorvc-rsmiddot LLC IFBC30034901700782 -31~ W i 7 Page 23

EXHIBIT A

DOMESTIC PRODUCTS PROCUREMENT ACT ltBUY AMERICAN) PREFERENCE

In accordance with sections 34350-34359 RS Mo the vendor is instructed tb provide inforlllation regarding- the Point_ of manufacturcmiddotfor each of the products being hid so that lhe p_roducfs eligibHity for the_Domestic Products Procurlment Act (Buy American) Preforencc _can be determined Thfa infimnation is requested for the finished product only _not for (Omponents of the finished product The vendor may be- rcmiddotquired to provide supporting documentation indicating proof of compliance

Qualifying for-the Domestic PJoducts_ Preference f product qualifies for the pretCfcnce if one of the following circumstances exist bull if manufactured or produced in UH US or bull if the product Js impmied into the lJS-but is covered by ail existing international trade treaty law agr(ement or regulation that

affords the specific product the same status aS a product 1nt1nufactured or produced in the US or bull ifomiddotnJy one line of products is manufocturcd or produced in the US

Non-Doruestic Product If the product is not manufactured 01 ploduced in the US and does notOtherwise qualify us domestic then it will be considered nonshydomestic and not eligible for the piCference

THE VENDOR MlST COMPLETE THE FOLLOWING APPLICABLE TABLES TO CERTIFY WHETHER (Table I j ALL products bid are manufactured Or produced i_n the os aild qualif) for the Domestic Products Proc11rement Ael Preference OR (Tabie -i) ALL products bid are manufacturcd Or _produced outside the US and do not otherwise qualify for the Domestic P~oducentis-Procun~ment Act Preference OR (Tables3-6) Ntinill J)rl)ducts bid foll into ihe priOr two cutegorjes so an itcm~by~itein middotcertification is necessary

The vendor is responsible for certifving the information provided on the exhibit is accurate by signing Where indicated 11t the ertd of the exhibit

TABLE I ~ALL PRODUCTS MANUFACTURED OR PRODUCED IN US (cli iblefor reforence Check the box to the right ifALL products bid arc MANUFACTURED OR PRODUCl1D IN THE US

TABLE 2 - ALL PRODUCTS MANUFACTURED OR PRODUCED OUTSIDE US AND DONT QUAUFY FOR PREFERENCE (ineli ible for reference)

Check the box to tl1e right if ALL prnducts bid are MANUiACTURED OR PRODUCED OUTSIDE Tl-IE US and DO NOT OTHEltWISE V QUALIFY for th Domestic Products Procurerilei1t Act Preference f

TABLES 3 THROUGH 6 - ITEM BY ITEM CERTIFICATION (NOT ALL PRODUCTS BID FALL INTO PRIOR TVO TABLES) bull For thosmiddotI line iteiils fo1bull which a US-man1factured _01middot produced product is_ liid complete Tablemiddot 3 bull For those line items which are inmiufaduted or produced middotoutside tlJc US that do notqualify for the Domestic Prbducts Procurement Act PreferencC1 complete fable4

bull For those line items which are not mnnufncturcct 01middot produced i11 the US but for which there is a US trademiddot tretty law agreement or regulution in compliance with section 34359 RSMo conlpletc Titble 5 bullFor-tboSe lii1e items which tire not manufactured ormiddotproduced in the US but for which th~re is only one US Manufacturer ofthat product odine of ptoductS compkte Table 6

TABLE3 llS-MANUFACTURED OR PRODUCED PRODUCTS (Eligible for Preference) bull List item numbers of products bid that ate US~manufa_cturcd or produced and therefore qualify for the Domestic Products Procurement Act

Preference

bull Listmiddotus citi and state whelc nroducts bid arc manufoctmicrored or produced Item US CitvState Where ManufacturedProduced Hbullm US CitvState Where MairnfacturedProduced

TABLE4 _ [OREIGN-MA~UFACTllRbullD OR PRODUCED PRODUCTS (Not Eli~ible for Prferencebull list item n_urnbers 9fproducts bid lhat are foreign inanufactuled or ploduced and do n-ot othenvise qualify for themiddot D~nllestic Products

Procuremtnt ActPrcforence bull L_ist country where product bid is manufactured or produced

Item Countrv Where ManufacturedProduced Item Countrv Vhere ManufacturedProducedE 2 Jc sltl tt)I 1~1u f~f f~bull-Zo j bullmiddottA(

nP ~ C i1 stmiddot 3o5 CHi v I [f--bullhi ( u r l Mf ~f C11

I (Exhibit continues on next page)

IFBC3003490 l700782 Page 24

EXHIBIT A continued DOMESTIC PRODUCTS PROCUREMENT ACT (BUY AMERICAN) PREFERENCE

TABLE 5 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT US TRADF TREATY LAW AGREEMENT OR REGULATION APPLmS Eligible for Preference)

bull List item numbers of products bid that are foreign mmw-ilctured or produced but qualify for the Domestic Products Procurement Act Prcforcnce because a US Trade Treaty Law Agreement or Regulation applies

bull ldentit) country where proposed foreign-made product is manufactured or produced bull ldcntii) name ofapplicnble US Trade Treaty Law Agreement or Regulation that allows product to be brought into the US dutytariff-free bull Identi6 website URL for the US Trade Treaty Law Agreement or Regtlation bull NOTE As an imported prnduct ifan impon tariff is applied to the item it does not quuli-fY for the preference Tn additioti middotbullMost Favored

Nationmiddotmiddot status docs not allow annHcation of the nreference ttnkss tile oroduct enters the US dutytariff-free Item Country Where Proposed ForeignMMade Product is Name of Applicable US Official Website URL for the US

ManufactliredProduccd Trade Treaty Law Treaty_ Law Agteementor Regulation Agreement or Rc1rnlntion

IrPri $Pa C I ) $ Rr_GY middot~t bull rgte i-e ~ Vj J_ pound rsP---gtr-- j C tL- C d S middot raquo ltc- bull j

TABLE 6 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT ONLY ONE US MANUFACTURER PRODUCES PRODUCT OR LINE OF PARTICULAR GOOD Eli2ible for Preference)bull List item numbers ofproducts bid that arc foreign manufactured or_produced but quality tor the Domestic Prnducts Procurement Act

Preterence btcause only one US Manufacturer pr9duccs the product or line of a particular good bull Identify country where proposed foreign-made proltluct is manufactured or produced bull Identity sole US manufacturer name

bull lltlentifv name of sole US manufactured oroductline ofparticulur 2ood Item Country Vhere Proposed Foreign-Made Product is Sole US Manufacturer Name of Sole US Mnnufalttured Product

ManufacturedProduced Nnme or Line of Particular Good i11middot1 -j ~~-- t I f t f U-t (~C-yen1Cipoundgfltl i -Jbull)iC- SM O kC If Abull I

Iflt_ JI~ LLJllt--ggt~gty ltltgt~ CL LyentvJ t_ len HOCgt r

middotr The vendor is resnons1ble for cert yml the in ormation orov1ded 011 tlus exhibit is accurate hv shmin2 below I hereby certify that the information provided herein is true and correct and complies with all provisions of seclions 34350 to 34359 RSMo understandthat any misrepresentation herein constitutes the comission ofmiddota class A misdemeanor

~ ( SIGNATURE (Ifsubmitting bid ekctron~aly sctlnntbull t~

r-~ e signature is acceptabfo)

COMPANY NAME c- Re I I ( ( P~or-CCTrorJ fRoDVc-TS

1 LLG

MO 3QQ-i-J02N (HG)

I

IFBC3003490 l700782 Page 24

EXHIBIT A continued DOMESTIC PRODUCTS PROCUREMENT ACT (BUY AMERICAN) PREFERENCE

TABLE 5 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT US TRADF TREATY LAW AGREEMENT OR REGULATION APPLmS Eligible for Preference)

bull List item numbers of products bid that are foreign mmw-ilctured or produced but qualify for the Domestic Products Procurement Act Prcforcnce because a US Trade Treaty Law Agreement or Regulation applies

bull ldentit) country where proposed foreign-made product is manufactured or produced bull ldcntii) name ofapplicnble US Trade Treaty Law Agreement or Regulation that allows product to be brought into the US dutytariff-free bull Identi6 website URL for the US Trade Treaty Law Agreement or Regtlation bull NOTE As an imported prnduct ifan impon tariff is applied to the item it does not quuli-fY for the preference Tn additioti middotbullMost Favored

Nationmiddotmiddot status docs not allow annHcation of the nreference ttnkss tile oroduct enters the US dutytariff-free Item Country Where Proposed ForeignMMade Product is Name of Applicable US Official Website URL for the US

ManufactliredProduccd Trade Treaty Law Treaty_ Law Agteementor Regulation Agreement or Rc1rnlntion

IrPri $Pa C I ) $ Rr_GY middot~t bull rgte i-e ~ Vj J_ pound rsP---gtr-- j C tL- C d S middot raquo ltc- bull j

TABLE 6 -- FOREIGN-MANUFACTURED OR PRODUCED PRODUCTS BUT ONLY ONE US MANUFACTURER PRODUCES PRODUCT OR LINE OF PARTICULAR GOOD Eli2ible for Preference)bull List item numbers ofproducts bid that arc foreign manufactured or_produced but quality tor the Domestic Prnducts Procurement Act

Preterence btcause only one US Manufacturer pr9duccs the product or line of a particular good bull Identify country where proposed foreign-made proltluct is manufactured or produced bull Identity sole US manufacturer name

bull lltlentifv name of sole US manufactured oroductline ofparticulur 2ood Item Country Vhere Proposed Foreign-Made Product is Sole US Manufacturer Name of Sole US Mnnufalttured Product

ManufacturedProduced Nnme or Line of Particular Good i11middot1 -j ~~-- t I f t f U-t (~C-yen1Cipoundgfltl i -Jbull)iC- SM O kC If Abull I

Iflt_ JI~ LLJllt--ggt~gty ltltgt~ CL LyentvJ t_ len HOCgt r

middotr The vendor is resnons1ble for cert yml the in ormation orov1ded 011 tlus exhibit is accurate hv shmin2 below I hereby certify that the information provided herein is true and correct and complies with all provisions of seclions 34350 to 34359 RSMo understandthat any misrepresentation herein constitutes the comission ofmiddota class A misdemeanor

~ ( SIGNATURE (Ifsubmitting bid ekctron~aly sctlnntbull t~

r-~ e signature is acceptabfo)

COMPANY NAME c- Re I I ( ( P~or-CCTrorJ fRoDVc-TS

1 LLG

MO 3QQ-i-J02N (HG)

I

3222017 WebProcure Supplier Documents

Supplier Documents for Formal Solicitation IFBC30034901700782

Supplier Attachments

Done

Solicitation-level Attachments

Type Document

~ MissouriBuys-2017-Exhibit Apdf (BMSVendorltemDocstatemoMissouriBuys-2017-

Exhibit_Apdf ac=viewpublicbiddocsampbid=62866ampdocid=41937 4ampoid=93705ampowner _type=ampowner _id=93705)

Actions

bullbullbull

httpswebprocureperfectcomNendorBidltemEditstatemoaction=reviewsupp1erdocsampmode=viewampbiditemid=-1ampinsidebms=1ampbid=62866ampvendor=trueampbu 11