HomeMy WebLinkAboutResolution - 2021-R0149 - Contract 15726 with Chameleon Industries, Inc. 4.27.2021Resolution No. 2021-R0149
Item No. 6.13
April 27, 2021
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute
for and on behalf of the City of Lubbock, Contract No. 15726 for the purchase of aluminum
sulfate for the Northwest Water Reclamation Plant per ITB 21-15726-CM, by and between
the City of Lubbock and Chameleon Industries, Inc., of Mesquite, Texas, and related
documents. Said Contract is attached hereto and incorporated in this resolution as if fully set
forth herein and shall be included in the minutes of the City Council.
Passed by the City Council on April 27, 2021
DANIEL M. POPE, MAYOR
ATTEST:
02=� )X7 -
Re&eckgarza, City Secret
APPROVED AS TO CONTENT:
Jesica McEachern, Assistant t anager
APPROVED AS TO FORM:
-7
— - Ax�'— -
Ryan roo , Assistant C11ity Attorney
ccdocs/RES.Contract 15726 Aluminum Sulfate for the Northwest Water Reclamation Plant
March 30, 2021
Resolution No. 2021-R0149
Contract 15726
City of Lubbock, TX
Contract for
Aluminum Sulfate for the Northwest Water Reclamation Plant
THIS CONTRACT made and entered into this27thday of April 2021, by and between the City of
Lubbock ("City"), and Chameleon Industries. Inc., ("Contractor").
WITNESSETH:
WHEREAS, the City of Lubbock duly advertised for bids for Aluminum Sulfate for the Northwest Water
Reclamation Plant and bids were received and duly opened as required by law; and
WHEREAS, after careful consideration of the bid submitted by Contractor, the City authorized the execution,
in the name of the City of Lubbock a contract with said Contractor covering the purchase and delivery of the said
Aluminum Sulfate for the Northwest Water Reclamation Plant.
NOW, THEREFORE, in consideration of the mutual agreement contained herein, as well as the financial
consideration hereinafter referred to, the parties hereby covenant and agree as follows:
1. In accordance with City's specifications and Contractor's bid, copies of which are attached hereto and made
part hereof, Contractor will deliver to the City, Aluminum Sulfate for the Northwest Water Reclamation Plant
and more specifically referred to as Items one (1) on the bid submitted by the Contractor or in the specifications
attached hereto.
2. The City promises and agrees to employ, and does employ, the Contractor to cause to be done the work
provided for in this Contract and to complete and finish the same according to the attached specifications,
offer, and terms and conditions contained herein.
3. The contract shall be for a term of one (1) year, with the option of two (2), one year extensions, said date of
term beginning upon formal approval. All stated annual quantities are approximations of usage during the time
period to be covered by pricing established by this bid. Actual usage may be more or less. Order quantities
will be determined by actual need. The City of Lubbock does not guarantee any specific amount of
compensation, volume, minimum, or maximum amount of services under this bid and resulting contract. The
Contractor must maintain the insurance coverage required during the term of this contract including any
extensions. It is the responsibility of the Contractor to ensure that valid insurance is on file with the Purchasing
and Contract Management Department as required by contract or contract may be terminated for non-
compliance.
4. Prices quoted shall be set for a period for one (1) year, said date of term beginning upon City Council date of
formal approval. The rate may be adjusted upward or downward at this time at a percentage not to exceed the
effective change in Consumer Price Index (CPI) or Product Price Index (PPI), whichever is most appropriate
for the specific contract for the previous 12-months at the City's discretion, the effective change rate shall be
based on either the local or national index average rage for all items. If agreement cannot be reached, the
contract is terminated at the end of the current contract period.
5. This contract shall remain in effect until the first of the following occurs: (1) the expiration date, (2)
performance of services ordered, or (3) termination of by either party with a 30 day written notice. The City of
Lubbock reserves the right to award the canceled contract to the next lowest and best bidder as it deems to be
in the best interest of the city.
6. Contractor shall at all times be an independent contractor and not an agent or representative of City with regard
to performance of the Services. Contractor shall not represent that it is, or hold itself out as, an agent or
representative of City. In no event shall Contractor be authorized to enter into any agreement or undertaking
for or on behalf of City.
7. Insurance Requirements
SECTION A. Prior to the approval of this contract by the City, the Contractor shall furnish a completed Insurance
Certificate to the City, which shall be completed by an agent authorized to bind the named underwriter(s) to the
coverages, limits, and termination provisions shown thereon, and which shall furnish and contain all required
information referenced or indicated thereon. THE CITY SHALL HAVE NO DUTY TO PAY OR PERFORM UNDER
THIS CONTRACT UNTIL SUCH CERTIFICATE SHALL HAVE BEEN DELIVERED TO THE CITY.
SECTION B. The City reserves the right to review the insurance requirements of this section during the effective
period of the contract and to require adjustment of insurance coverages and their limits when deemed necessary and
prudent by the City based upon changes in statutory law, court decisions, or the claims history of the industry as well
as the Contractor.
SECTION C. Subject to the Contractor's right to maintain reasonable deductibles in such amounts as are approved by
the City, the Contractor shall obtain and maintain in full force and effect for the duration of this contract, and any
extension hereof, at Contractor's sole expense, insurance coverage written by companies approved by the State of Texas
and acceptable to the City, in the following tvpe(s) and amount(s):
TYPE OF INSURANCE
GENERAL LIABILITY
M Commercial General Liability
❑ Claims Made ® Occurrence
❑ W/Heavy Equipment
❑ To Include Products of Complete Operation Endorsements
IONAL LIABILITY
n
AUTOMOTIVE LIABILITY
M Any Auto
❑ Scheduled Autos
❑ Non -Owned Autos
EXCESS LIABILITY
❑ Umbrella Form
GARAGE LIABILITY
M Any Auto
❑ All Owned Autos
❑ Hired Autos
❑ BUILDER'S RISK
❑ INSTALLATION FLOATER
❑ CARGO
® POLLUTION
COMBINED SINGLE LIMIT
General Aggregate $1,000,000
Products-Comp/Op AGG X
Personal & Adv. Injury X
Contractual Liability X
Fire Damage (Any one Fire)
Med Exp (Any one Person)
General Aggregate
Per Occurrence $1,000,000
Each Occurrence
Aggregate
Auto Only - Each Accident $1,000,000
Other than Auto Only:
Each Accident
Aggregate
❑ 100% of the Total Contract Price
❑ 100% of the Total Material Costs
$1,000,000
M WORKERS COMPENSATION - STATUTORY AMOUNTS OR
OCCUPATIONAL MEDICAL AND DISABILITY
M EMPLOYERS' LIABILITY $1,000,000
OTHER: COPIES OF ENDOSEMENTS ARE REQUIRED
M City of Lubbock named as additional insured on Auto. General Liability on a primary and non-contributory bases.
M To include products of completed operations endorsement.
M Waiver of subrogation in favor of the City of Lubbock on all coverages, except
IMPORTANT: POLICY ENDORSEMENTS
The Contractor will provide copies of the policies without expense, to the City and all endorsements thereto
and may make any reasonable request for deletion, revision, or modification of particular policy terms,
conditions, limitations, or exclusions (except where policy provisions are established by law or regulation
binding upon either of the parties hereto or the underwriter of any of such policies). Upon such request by the
City, the Contractor shall exercise reasonable efforts to accomplish such changes in policy coverages, and shall pay
the cost thereof. Any costs will be paid by the Contractor.
REQUIRED PROVISIONS
The Contractor agrees that with respect to the above required insurance, all insurance contracts and certificate(s) of
insurance will contain and state, in writing, on the certificate or its attachment, the following required provisions:
a. Name the City of Lubbock and its officers, employees, and elected representatives as additional insureds, (as
the interest of each insured may appear) as to all applicable coverage;
b. Provide for 30 days' notice to the City for cancellation, nonrenewal, or material change;
c. Provide for notice to the City at the address shown below by registered mail;
d. The Contractor agrees to waive subrogation against the City of Lubbock, its officers, employees, and elected
representatives for injuries, including death, property damage, or any other loss to the extent same may be
covered by the proceeds of insurance;
e. Provide that all provisions of this contract concerning liability, duty, and standard of care together with the
indemnification provision, shall be underwritten by contractual liability coverage sufficient to include such
obligations within applicable policies.
NOTICES
The Contractor shall notify the City in the event of any change in coverage and shall give such notices not less than 30
days prior the change, which notice must be accompanied by a replacement CERTIFICATE OF INSURANCE.
All notices shall be given to the City at the following address:
Marta Alvarez, Director of Purchasing & Contract Management
City of Lubbock
1314 Avenue K, Floor 9
Lubbock, Texas 79401
SECTION D. Approval, disapproval, or failure to act by the City regarding any insurance supplied by the Contractor
shall not relieve the Contractor of full responsibility or liability for damages and accidents as set forth in the contract
documents. Neither shall the bankruptcy, insolvency, or denial of liability by the insurance company exonerate the
Contractor from liability.
8. Neither the City nor the Contractor shall assign, transfer or encumber any rights, duties or interests accruing
from this Contract without the written consent of the other.
9. The City reserves the right to exercise any right or remedy available to it by law, contract, equity, or otherwise,
including without limitation, the right to seek any and all forms of relief in a court of competent jurisdiction.
Further, the City shall not be subject to any arbitration process prior to exercising its unrestricted right to seek
judicial remedy. The remedies set forth herein are cumulative and not exclusive, and may be exercised
concurrently. To the extent of any conflict between this provision and another provision in, or related to, this
document, this provision shall control.
10. At any time during the term of the contract, or thereafter, the City, or a duly authorized audit representative of
the City or the State of Texas, at its expense and at reasonable times, reserves the right to audit Contractor's
records and books relevant to all services provided to the City under this Contract. In the event such an audit
by the City reveals any errors or overpayments by the City, Contractor shall refund the City the full amount of
such overpayments within 30 days of such audit findings, or the City, at its option, reserves the right to deduct
such amounts owing the City from any payments due Contractor.
11. All funds for payment by the City under this contract are subject to the availability of an annual appropriation
for this purpose by the City. In the event of non -appropriation of funds by the City Council of the City of
Lubbock for the goods or services provided under the contract, the City will terminate the contract, without
termination charge or other liability, on the last day of the then -current fiscal year or when the appropriation
made for the then -current year for the goods or services covered by this contract is spent, whichever event
occurs first. If at any time funds are not appropriated for the continuance of this contract, cancellation shall be
accepted by the Seller on 30 days prior written notice, but failure to give such notice shall be of no effect and
the City shall not be obligated under this contract beyond the date of termination.
12. The Contractor shall not assign or sublet the contract, or any portion of the contract, without written consent
from the Director of Purchasing and Contract Management. Should consent be given, the Contractor shall
insure the Subcontractor or shall provide proof on insurance from the Subcontractor that complies with all
contract Insurance requirements.
13. Contractor acknowledges by supplying any Goods or Services that the Contractor has read, fully understands,
and will be in full compliance with all terms and conditions and the descriptive material contained herein and
any additional associated documents and Amendments. The City disclaims any terms and conditions provided
by the Contractor unless agreed upon in writing by the parties. In the event of conflict between these terms and
conditions and any terms and conditions provided by the Contractor, the terms and conditions provided herein
shall prevail. The terms and conditions provided herein are the final terms agreed upon by the parties, and any
prior conflicting terms shall be of no force or effect.
14. TEXAS GOVERNMENT CODE SECTION 2252.152
The Contractor (i) does not engage in business with Iran, Sudan or any foreign terrorist organization and (ii)
it is not listed by the Texas Comptroller under Section 2252.153, Texas Government Code, as a company
known to have contracts with or provide supplies or services to a foreign terrorist organization. As used in
the immediately preceding sentence, "foreign terrorist organization" shall have the meaning given such
term in Section 2252.151, Texas Government Code.
15. TEXAS PUBLIC INFORMATION ACT
The requirements of Subchapter J, Chapter 552, Government Code, may apply to this contract and
the contractor or vendor agrees that the contract can be terminated if the contractor or vendor
knowingly or intentionally fails to comply with a requirement of that subchapter.
To the extent Subchapter J, Chapter 552, Government Code applies to this agreement, Contractor agrees to:
(1) preserve all contracting information related to the contact as provided by the records retention requirements
applicable to the governmental body for the duration of the contract; (2) promptly provide to the governmental
body any contracting information related to the contract that is in the custody or possession of the entity on
request of the governmental body; and (3) on completion of the contract, either: (A) provide at no cost to the
governmental body all contracting information related to the contract that is in the custody or possession of the
entity; or (B) preserve the contracting information related to the contract as provided by the records retention
requirements applicable to the governmental body.
16. TEXAS GOVERNMENT CODE 2271.002
The Contractor warrants that it complies with Chapter 2271.002 of the Texas Government Code by verifying
that:
(1) The Contractor does not boycott Israel; and
(2) The Contractor will not boycott Israel during the term of the Agreement.
Pursuant to Section 2271.002, Texas Government Code:
1. "Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise
taking any action that is intended to penalize, inflict economic harm on, or limit commercial
relations specifically with Israel, or with a person or entity doing business in Israel or in an
Israeli -controlled territory, but does not include an action made for ordinary business
purposes; and
2. "Company" means a for profit sole proprietorship, organization, association, corporation,
partnership, joint venture, limited partnership, limited liability partnership, or any limited
liability company, including a wholly owned subsidiary, majority -owned subsidiary, parent
company or affiliate of those entities or business associations that exist to make a profit.
17. CONFIDENTIALITY
The Contractor shall retain all information received from or concerning the City and the City's business in
strictest confidence and shall not reveal such information to third parties without prior written consent of the
City, unless otherwise required by law.
18. INDEMNITY
The Contractor shall indemnify and save harmless the city of Lubbock and its elected officials, officers, agents,
and employees from all suits, actions, losses, damages, claims, or liability of any kind, character, type, or
description, including without limiting the generality of the foregoing, all expenses of litigation, court costs,
and attorney's fees, for injury or death to any person, or injury to any property, received or sustained by any
person or persons or property, to the extent arising out of, related to or occasioned by, the negligent acts of the
Contractor, its agents, employees, and/or subcontractors, related to the performance, operations or omissions
under this agreement and/or the use or occupation of city owned property. The indemnity obligation provided
herein shall survive the expiration or termination of this agreement.
19. This Contract consists of the following documents set forth herein; Invitation to Bid No. 21-15726-CM,
Specifications, and the Bid Form.
-----INTENTIONALLY LEFT BLANK-----
IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed the day and year first
above written. Executed in triplicate.
CITY O LUBBO
Daniel M. Pope, Mayor
A ST:
1bZ=:U �� —
Rebecka Garza, City Secretary
APPROVED AS TO CONTENT:
Waste w er Treatment
Print Name Date
APPROVED AS TO FOR
R B oke, sist City Attor
CONTRACTOR
BY � .�/�
Autho ' l Represen ative
Jason L Garza
Print Name
PO Box 853027
Address
Mesquite TX 75185
City, State, Zip Code
City of Lubbock, TX
Purchasing and Contract Management
ITB 21-15726-CM
Aluminum Sulfate for the Northwest Water Reclamation Plant
Specifications
1. INTENT
It is the intent of these specifications to describe the Aluminum Sulfate (Alum, Al2(SO4)3 14
H2O) to be ordered and delivered to existing alum storage tank on an "as needed" basis to the
Northwest Water Reclamation Plant (NWRP). The alum will be used in the wastewater treatment
processes to assist in the reduction of phosphorus.
2. PRODUCT SPECIFICATION
Alum shall meet the requirements of AWWA B403 and conform to the following physical
and chemical properties:
Chemical Formula:
Appearance:
Specific Gravity:
Baume:
pH (neat):
Freezing Point:
A1203:
Basicity:
Dry 17% Alum:
Al2(SO4)3.14H2O.
Clear to amber or light green liquid.
1.32 — 1.34 @ 60°F.
35.15 — 36.80 @ 60°F.
1.8 — 2.4.
3 .- 25°F.
8.0 — 8.4 %.
0 — 0.4 %.
48.2%.
Impurities:
Alum shall contain no soluble material or organic substances in quantities capable of
producing deleterious or injurious effects to the health of those consuming a water that has
been treated properly with aluminum sulfate.
Total water-soluble iron: 0.35% on a basis of 8.0% A1203 (9% as Al).
Verification - Sampling and testing of product for compliance with physical and chemical
property requirements shall be as outlined in AWWA B403.
Existing Alum Tank Specifications - The City owns and utilizes the following alum tank for
storage:
No. of tanks 1.
Tank volume 6,000 gallons.
Tank fill connection 1.5" with 1.5" quick connect.
Max. allowable fill pressure atmospheric tank.
Certification
Aluminum sulfate can be used as a direct additive used in the treatment of potable water and/or
wastewater. This material should be certified as suitable for contact with, or treatment of,
drinking water by an accredited certification organization in accordance with NSF/ANSI 60.
Evaluation shall be accomplished in accordance with requirements that are not less restrictive
than those listed in NSF/ANSI 60. Certification shall be accomplished by a certification
organization accredited by the American National Standards Institute.
Upon request by the City, Vendor shall be required to submit an affidavit of compliance with
AWWA B304 and the Vendor's Drinking Water Treatment Chemical Certification (NSF
Standard Number 60).
3. PRODUCT QUALITY PER LOAD
Upon delivery of each load of product, the transport driver must present a certificate of analysis
containing specific gravity and pH. As stated in the product specifications, the pH must be within
the range of 1.8 to 2.4. A delivered product that exhibits any unusual color or appearance
compared to previous acceptable deliveries will be refused, as will deliveries containing any form
of foreign material. In the event the product does not meet the required minimum standards, the
load will be refused and the vendor must provide another acceptable load within forty-eight (48)
hours. No additional freight or shipping charges shall be assessed by vendor.
4. TECHNICAL SUPPORT
Vendor shall provide acceptable technical support and response time whenever problems are
encountered relating to product use and/or performance. Acceptable technical support will
include routine site visits and consulting with operations staff on any questions or problems with
the product. A telephone response time of one (1) business day is required of vendor in cases of
product performance problems. A site visit by the vendor may be requested by the owner if owner
feels it is necessary to solve any significant problem related to product performance. If a non -
routine site visit is requested, the vendor will have five (5) business days to respond and arrive
on -site. All technical support will be at no cost to the owner.
5. BID ACCEPTANCE
The bid will be awarded based on time of delivery, cost per gallon, and reference checks.
6. QUANTITIES AND PRICING
The anticipated annual consumption of an aluminum sulfate use is 150,000 gallons more or less.
Prices quoted for product shall be FOB Northwest Water Reclamation Plant, 4107 N County
Road 1900, Lubbock, Texas. Pricing shall be firm for a period of three years. Written consent
from both parties is required for all price adjustments. Listed quantities are estimates only for
pricing purposes. Actual usage may vary.
7. DELIVERY / SECURITY
Successful vendor shall be required to deliver the product to the City of Lubbock Northwest
Water Reclamation Plant in bulk tank truck within three (3) days after order is placed. Unloading
to plant storage tank is to be performed by the driver under the direction of operations personnel.
Successful vendor shall provide any and all special equipment necessary to perform unloading at
no cost to the City of Lubbock. All deliveries will be unloaded between the hours of 8:00 A.M.
and 3:00 P.M., Monday through Friday. No exceptions will be made unless prior approval is
agreed upon with the water reclamation plant's operations personnel. The transporter is required
to furnish certified, dated, and stamped weight tickets with each load of product, before and after
unloading. All delivery people will display photo security ID upon arrival at the site. All delivery
vehicles shall meet OSHA and DOT regulations and be operated in a safe manner while on site.
All delivery personnel will be identified by the vendor before arrival at the site; preferably at the
time an order is placed. Upon arrival at the Water Reclamation Plant, delivery personnel will
check in at the security gate before proceeding to the unloading site. The driver will be met at the
security gate by plant personnel and must present photo identification. All shipments shall be
sealed and the seal will be broken only in the presence of the plant representative. If any of the
security measures are violated, the shipment will be refused.
8. TERM AND CONDITIONS
The contract shall be for a term of one (1) year, with the option of two (2), one year extensions,
said date of term beginning upon formal approval. All stated annual quantities are approximations
of usage during the time period to be covered by pricing established by this bid. Actual usage
may be more or less. Order quantities will be determined by actual need. The City of Lubbock
does not guarantee any specific amount of compensation, volume, minimum, or maximum
amount of services under this bid and resulting contract. The Contractor must maintain the
insurance coverage required during the term of this contract including any extensions. It is the
responsibility of the Contractor to ensure that valid insurance is on file with the Purchasing and
Contract Management Department as required by contract or contract may be terminated for non-
compliance.
This contract shall remain in effect until the first of the following occurs: (1) the expiration date,
(2) performance of services ordered, or (3) termination of by either party with a 30-day written
notice. The City of Lubbock reserves the right to award the canceled contract to the next lowest
and best bidder as it deems to be in the best interest of the City.
BID FORM
City of Lubbock, TX
Purchasing and Contract Management
Aluminum Sulfate for the Northwest Water Reclamation Plant
ITB No. 21-15726-CM
In compliance with the Invitation to Bid 21-15726-CM, the undersigned Bidder having examined the Invitation to Bid and
Specifications, and being familiar with the conditions to be met, hereby submits the following Bid for furnishing the material,
equipment, labor and everything necessary for providing the items listed below and agrees to deliver said items at the locations
and for the prices set forth on this form. A bid will be subject to being considered irregular and may be rejected if it shows
omissions, alterations of form, conditional alternate bids, additions or alternates in lieu of the items specified, if the unit
prices are obviously unbalanced (either in excess of or below reasonably expected values), or irregularities of any kind. The
Invitation to Bid 21-15726-CM is by reference incorporated in this contract. The Bid Form must be completed in blue or
black ink or by typewriter.
QTY
UNIT
EXTENDED
"Delivery
ITEM
(+/-)
UOM
DESCRIPTION
PRICE*
COST
days ARO
(a)
(b)
(a x b)
1
150,000
GAL
48% Aluminum Sulfate, as per
1.022
153,300
48 hrs
specifications
*PRICE: F.O.B. Destination, Freight Pre -Paid and Allowed "Days After Receipt of Order (ARO)
Unless otherwise specified herein, the City may award the bid either item -by —item or on an all -or -none basis for any
item or group of items shown on the bid.
The City of Lubbock is seeking a contract for with one or more contractors. In order to assure adequate coverage, the
City may make multiple awards, selecting multiple vendors to provide the products desired, if multiple awards are in
the best interest of the City. A decision to make a multiple award of this Bid, however, is an option reserved by the
City, based on the needs of the City.
PAYMENT TERMS AND DISCOUNTS - Bidder offers a prompt payment discount of 0 %, net 3(Wendar days.
Discounts will not be considered in determining low bid. Unless otherwise indicated on the Bid Form, payment terms will
be NET THIRTY DAYS. The City will pay the successful bidder within thirty days after the receipt of a correct invoice or
after the date of acceptance, whichever event occurs later. Discounts for prompt payment requiring payment by the City
within a stipulated number of days will be interpreted as applying within the stipulated number of calendar days after the date
of receipt by the City of a correct invoice or after the date of acceptance that meets contract requirements, whichever event
occurs later. Discounts for payment in less than ten days will not be considered.
MOST FAVORED PRICING: The Bidder certifies that the price quoted is not in excess of the lowest price charged anyone
else, including its most favored customer, for like quality and quantity of the products/services; does not include an element
of profit on the sale in excess of that normally obtained by the Bidder on the sale of products/services of like quality and
quantity; and does not include any provision for discounts to selling agents. If at any time during the contract period, the
supplier should sell or offer for sale to any other customer, an equal or less quantity of similar contract products of like or
better quality, at a lower net price(s) than provided herein, supplier agrees to notify the City and sell same product(s) at the
lower price(s) on all deliveries made during the period in which such lower price(s) is effective.
INTERLOCAL PURCHASING (optional): The City desires to make available to other local governmental entities of the
State of Texas, by mutual agreement with the successful bidder, and properly authorized interlocal purchasing agreements as
provided for by the Interlocal Cooperation Act (Chapter 791, Government Code), the right to purchase the same services, at
the prices quoted, for the period of this contract. Each bidder shall indicate on the Bid Form in the space provided below if
he/she will honor Political Subdivision orders in addition to orders from the City of Lubbock. Should these other
governmental entities decide to participate in this contract, would you (the bidder) agree that all terms, conditions,
specifications, and pricing would apply?
Other governmental entities that might have interests in this contract are Frenship Independent School District,
Lubbock Housing Authority, Lubbock County, Lubbock County Hospital District, Lubbock Independent School
District, South Plains Association of Governments, City of Texarkana, Texas Tech University, West Texas Municipal
Power Agency, Lynn County, and City of Wolfforth.
YES X NO
• If you (the bidder) checked YES, the following will apply:
• Governmental entities utilizing Interlocal Agreements for Cooperative Purchasing with the City of Lubbock will be
eligible, but not obligated, to purchase materials/services under the contract(s) awarded as a result of this solicitation.
All purchases by governmental entities other than the City of Lubbock will be billed directly to that governmental
entity and paid by that governmental entity. City of Lubbock will not be responsible for another governmental
entity's debts. Each governmental entity will order their own materials/service as needed.
THIS BID IS SUBMITTED BY Chameleon Industries Inca corporation organized under the laws of the State of
Texas , or a partnership consisting of or individual trading as
of the City of
Firm: Chameleon Industries Inc
Address: PO Box 853027
City:._ Mesquite State: TX Zip 75185
Bidder acknowledges receipt of the following addenda:
Addenda No. R Addenda No.
Date Date
M/WBE Firm:
By_
Author
Officer Name and Title:
Please Print
Addenda No.
Date
Addenda No.
Date
Woman I I Black American Native American
Hispanic American I I Asian Pacific Americ _ I Other (Specify)
- must sign by hand
Business Telephone Number
Jason L Garza Vice President
972.880.1493
E-mail Address: info@chameleonindustriesinc.com
17 March 2021
FAX: 972.92.8642
FOR CITY USE ONLY
Bid Form Item Number(s) Awarded to Above Named Firm/Individual:
Date of Award by City Council (for bids over $50, 000): Date P.O./Contract Issued:
RETURN COMPLETED & SIGNED BID FORM ALONG WITH CITY OF LUBBOCK SPECIFICATIONS.
LABEL THE OUTSIDE OF YOUR SEALED BID WITH THE ITB NUMBER, THE CLOSING DATE AND
TIME, AND YOUR COMPANY NAME AND ADDRESS.
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CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1 of 1
Complete Nos. 1- 4 and 6 if there are interested parties.
OFFICE USE ONLY
Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2021-735106
Chameleon Industries Inc.
Mesquite, TX United States
Date Filed:
04/06/2021
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of Lubbock
Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
15726
Aluminum Sulfate for Northwest Water Reclamation Plant
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
Garza, Faustino
Mesquite, TX United States
X
Garza, Jared
Maineville, OH United States
X
Garza, Jason
Dallas, TX United States
X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name is Jason L Garza and my date of birth is
My address is 6252 Llano Ave Dallas TX 75214 USA
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in Dallas County, State of Texas —on the 6th day of April 2021
(month) (year)
Signature of au o ed agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.ceffd98a
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
lofl
Complete Nos. 1- 4 and 6 if there are interested parties.
OFFICE USE ONLY
Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2021-735106
Chameleon Industries Inc.
Mesquite, TX United States
Date Filed:
04/06/2021
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of Lubbock
Date Acknowledged:
04/07/2021
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
15726
Aluminum Sulfate for Northwest Water Reclamation Plant
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
Garza, Faustino
Mesquite, TX United States
X
Garza, Jared
Maineville, OH United States
X
Garza, Jason
Dallas, TX United States
X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of on the day of , 20
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
r-orms proviaea Dy i exas unlcs commission www.etnics.state.tx.us Version V1.1.ceffd98a