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HomeMy WebLinkAboutResolution - 2017-R0373 - PO With Ennis Paint - 10/12/2017Resolution No.2017-R0373 Item No.6.19 October 12,2017 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,Purchase Order No.25100898 by and between the City of Lubbock and Ennis Paint, Inc.of Thomasville,NC for Runway and Taxiway Marking Paint per ITB 17-13538-KW,and related documents.Said Purchase Order 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 ATTEST: Rabecca Garza,City Secietar APPROVED AS TO CONTENT sL October 12,2017 DANIEL M.POPE,MAtfOR frft^ Bill Howerton,Assistant City Mmiager APPR erwifite,Tirst Assistant City Attorney vwxcdocs/RES.POC 25100898-Runway andTaxiwayMarkingPaint 09.19.2017 *Lub6o"C'k PURCHASE ORDER TEXi,3 TO: ENNIS-FLINT, INC 115 TODD CT THOMASVILLE North Carolina 27360 Page - Date - Order Number Branch/Plant 1 09/05/2017 25100898 000 OP 4613 SHIP TO: CITY OF LUBBOCK LUBBOCK PRESTON SMITH INTERNATIONAL AIRPORT LUBBOCK Texas 79401 INVOICE TO: CITY OF LUBBOCK ACCOUNTS PAYABLE P.O. BOX 2000 LUBBOCK, Tx 79457 BY: lk Marta.Az, rector of Purchasing & Contract Management Ordered 09/05/2017 Freight Requested 10/25/2017 Taken By Delivery A ROSE REQ 50762 ITB 17-13538-KW Description/Supplier Item Runway & Taxiway Marking Paint Terms NET 30 DAYS K WRIGHT Ordered Unit Cost UM Extension Request Date 1.000 37,925.0000 EA 37,925.00 10/25/2017 Total Order 37,925.00 The purchase order contract 25100898 for Runway and Taxiway Paint is awarded to Ennis Paint, Inc. of Thomasville NC for $37,925 per year. The purchase order contract is awarded by unit price. This award is based on the estimated quantities and actual expenditures which may be more or less depending on the actual need. The price per unit will not change and expenditures will not exceed appropriated funds. The contract shall be for one year with the option of two one-year extensions.The following are incorporated into and made a part of this purchase order by reference: Bid Form submitted by your firm, Specifications and General Conditions of the ITB 17-13538-KW. Resolution # 2017-RO173 CITY OF LUBBOCK Daniel M. Pope, Mayor ATTEST: "ca, City Secretary Seller and Buyer agree as follows: TERMS AND CONDITIONS IMPORTANT: READ CAREFULLY STANDARD TERMS AND CONDITIONS CITY OF LUBBOCK. TX 1 SELLER TO PACKAGE GOODS Seller will package goods in accordance with good commercial practice Each shipping container shall be clearly and permanently marked as follows (a) Seller's name and address. (b) Consignee's name, address and purchase order or purchase release number and the supply agreement number if applicable, (c) Container number and total number of containers, e g box 1 of 4 boxes, and (d) the number of the container bearing the packing slip Seller shall bear cost of packaging unless otherwise provided Goods shall be suitably packed to secure lowest transportation costs and to conform with requirements of common carriers and any applicable specifications Buyer's count or weight shall be final and conclusive on shipments not accompanied by packing lists SHIPMENT UNDER RESERVATION PROHIBITED Seller is not authorized to ship the goods under reservation and no tender of a bill of lading will operate as a tender of goods 3 TITLE AND RISK OF LOSS The title and risk of loss of the goods shall not pass to Buyer until Buyer actually receives and takes possession of the goods at the point or points of delivery 4 NO REPLACEMENT OF DEFECTIVE TENDER Every tender of delivery of goods must folly comply with all provisions of this contract as to time of delivery. qualm and the like if a tender is made which does not fully conform. this shall constitute a breach and Seller shall not have the right to substitute a conforming tender, provided, where the time for performance has not yet expired, the Seller may reasonably notify Buyer of his intention to cure and may then make a conforming tender within the contract time but not afterward 5 INVOICES d PAYMENTS a S e 11 e r shall submit separate invoices, in duplicate, one each purchase order or purchase release after each delivery Invoices shall indicate the purchase order or purchase release number and the supply agreement number if applicable Invoices shall be itemized and transportation charges, if any, shall be listed separately A copy of the bill of lading, and the freight waybill when applicable. should be attached to the invoice Mail To Accounts Payable, City of Lubbock, P 0 Box 2000. Lubbock, Texas 79457 Pavrneni shall not be due until the above instruments are submitted after delivery 6 GRATUITIES The Buyer may. by written notice to the Seller, cancel this contract without liability to Seller if it is determined by Buyer that gratuities, in the form of entertainment, gifts or otherwise, were offered or given by the Seller. or any agent or representative of the Seller. to any officer or employee of the Cm of Lubbock with a view to securing a contract or securing favorable treatment with respect to the awarding or amending, or the making of any determinations with respect to the performing of such a contract In the event this contract is canceled by Buyer pursuant to this provision, Buyer shall be entitled, in addition to anv other rights and remedies, to recover or withhold the amount of the cost incurred by Seller in providing such gratuities 7 SPECIAL. TOOLS R TEST EQUIPMENT If the price stated on the face hereof includes the cost of any special tooling or special test equipment fabricated or required by Seller for the purpose of filling this order, such special tooling equipment and any process sheets related thereto shall become the property of the Buyer and to the extent feasible shall be identified by the Seller as such 8 WARRANTY -PRICE a The price to be paid by the Buyer shall be that contained in Seller's bid which Seller warrants to be no higher than Seller's current process on orders by others for products of the kind and specification covered by this agreement for similar quantities under similar of like conditions and methods of purchase In the event Seller breaches this warranty. the prices of the items shall be reduced to the Seller's current prices on orders by others, or in the alternative Buyer may cancel this contract without liability to Seller for breach or Sellers actual expense b The Seller warrants that no person or selling agency has been employed or retained to solicit or secure this contract upon an agreement or understanding for commission, percentage, brokerage, or contingent fee excepting bona fide employees of bona fide established commercial or selling agencies maintained by the Seller for the purpose of securing business For breach of viation of this warranty the Buyer shall have the right in addition to any other right of rights to cancel this contract without liability and to deduct from the contract price, or otherwise recover without liability and to deduct from the contract price, or otherwise recover the full amount of such commisstoq percentage. brokerage or contingent fee 9 WARRANTY -PRODUCT Seller shall not limn or exclude any implied warranties and any attempt to do so shall render this contract voidable at the option of the Buyer Seller warrants that the goods furnished will conform to the specification. drawings, and descriptions listed in the bid imitation, and to the sample(s) furnished by the Seller, if any. In the event of a conflict or between the specifications, drawings, and descriptions, the specifications shall govern Notwithstanding my provisions contained in the contractual agreement. the Seller represents and warrants fault -free performance and fault -free result in the processing date and date related data (including. but not hmuted to calculating, comparing and sequencmu) of all hardware. software and firmware products delivered and services provided under this Contractmdnidually or in combination, as the case may be from the effective date of this Contract The obligations contained herein apply to products and services provided by the Seller, its sub- Seller or any third party imoh ed in the creation or development of the products and sen ices to be delivered to the City of Lubbock under this Contract Failure to comply with any of the obligations contained herein, may result in the City of Lubbock availing itself of any of its rights under the law and under this Contract including, but not limited to, its right pertaining to termination or default The warranties contained herein are separate and discrete from any other warranties specified in this Contract, and are not subject to any disclaimer of warranty. implied or expressed, or limitation of the Seller's liability which may be specified in this Contract, its appendices, its schedules, its annexes or any document incorporated in this Contract by reference 10 SAFETY WARRANTY Seller warrants that the product sold to the Buyer shall conform to the standards promulgated by the U S Department of Labor under the Occupational Safety and Health .Act of 1970 In the event the product does not conform to OSHA standards. Buyer may return the product for correction or replacement at the Seller's expense In the event Seller fads to make the appropriate correction within a reasonable time, correction made by Buyer will be at the Seller's expense I I NO WARRANTY BY BUYER AGAINST INFRINGENEEN'TS As part of this contract for sale Seller agrees to ascertain whether goods manufactured in accordance with the specifications attached to this agreement will give rise to the rightful claim of any third person byway of infringement of the like Buyer makes no warranty that the production of goods according to the specification will not give rise to such a claim and in no event shall Buyer be liable to Seller for indemnification in the event that Seller is sued on the grounds of infringement of the like If Seller is of the opinion that an infringement or the like will result, he will notify the Buyer to this effect in writing within two weeks after the signing of this agreement If Buyer does not receive notice and is subsequently held liable for the infringement or the like. Seller will save Buyer harmless If Seiler in good faith ascertains the production of the goods in accordance with the specifications will result in infringement or the like, the contract shall be null and void 12 NON APPROPRIATION 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 nonappropriation 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 forthe then -current year for the goods or services covered by this contract is spent, whichever event occurs first If at my time funds are not appropriated for the continuance of this contract, cancellation shall be accepted by the Seller on thirty (30) days prior written notice, but failure to give such notice shall be of no effect and the CaN shall tint be ,bh_.ted under this contract beyond the date of temmnation 13 RIGHT OF INSPECTION Buyer shall have the right to inspect the goods at delivery before accepting them. portion of this order ifSeller breaches any of the terms hereof including warranties of Seller or if the Seller becomes insolvent or commits acts of bankruptcy Such right of cancellation is in addition to and not in lieu of any other remedies which Buyer may have in law or equity 15 TERNUNATION The performance of work under this order may be terminated in whole, or in part by the Buyer in accordance with this provision Termination of work hereunder shall be effected by the delivery of the Seller of a 'Notice of Termination" specifying the extent to which performance of work under the order is terminated and the date upon which such termination becomes effective Such right or termination is in addition to and not in lieu of the rights of Buyer set forth in Clause 14, herein 16 FORCE NlAJEURE Neither party shall be held responsible for losses, resulting if the fulfillment of any terms of provisions of this contract is delayed or prevented by any cause not within the control of the pain whose performance is interfered with, and which by the exercise of reasonable diheence said party is unable to prevent 17 ASSIGNMENT -DELEGATION No right or interest in this contract shall be assigned or delegation of any obligation made by Seller without the written permission of the Buyer Any attempted assignment or delegation by Seller shall be wholly void and totally ineffective for all purpose unless made in conformity with this paragraph I8 WAIVER No claim or right arising out of a breach of this contract can be discharged in whole or in part by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by the aggrieved party 19 INTERPRETATION -PAROLE EVIDENCE This writing, plus any specifications for bids and performance provided by Buyer in its advertisement for bids, and any other docummtsprovided by Seller as part of his bid. is intended by the parties as a final expression of their agreement and intended also as a complete and exclusive statement of the terms of their agreement Whenever a term defined by the Uniform Commercial Code is used in this agreement, the definition contained in the Code is to control 20 APPLICABLE LAW This agreement shall be governed by the Uniform Commercial Code Whereecer the term" Uniform Commercial Code" is used, it shall be construed as meaning the Uniform Commercial Code as adopted in the State of Texas as effective and in force on the date of this agreement 21 RIGHT TO ASSURANCE Whenever one pan) to this contract in good faith has reason to question the other party's intent to perform he may demand that the other party give written assurance of his intent to perform In the event that a demand is made and no assurance is given within five (5) days, the demanding party may treat this failure as an anticipatory repudiation of the contract 22 INDENIMFICA 'rION Seller shall indemnify. keep and save harmless the Buyer, its agents, officials and employees, against all injuries, deaths, loss, damages, claims, patent claims, suits, liabilities, Judgments. costs and expenses. which may in anywise accrue against the Buyer in consequence of the granting of this Contract or which may anywise result therefrom, whether or not it shall be alleged or determined that the act was caused through negligence or omission of the Seller or its employees, or of the subSeller or assignee or its employees. if any. and the Seller shall, at his own expense. appear, defend and pay all charges of attomeys and all costs and other expenses arising therefrom of incurred in connection therewith, and, if any judgment shall be rendered against the Buyer many such action, the Seller shall. at its own expenses, sansfy and discharge the same Seller expressly understands and agrees that any bond required by this contract, or otherwise provided by Seller, shall in no way limn the responsibdrc7 to indemnify. keep and save harmless and defend the Buyer as herein provided 23 TIME It is hereby expressly agreed and understood that time is of the essence for the performance of this contract, and failure by contract to meet the time specifications of this agreement will cause Seller to be in default of this agreement 24 MBE The Ca% of Lubbock hereby notifies all bidders that in regard to any contract entered into pursuant to this request, minority and women business enterprises will be afforded equal opportunities to submit bids in response to this invitation and will not be discriminated against on the grounds of race. color, sex or natural origin in consideration for an award 25 NON -ARBITRATION The City reserves the right to exercise any right or remedy to it by law, contract, Nutty, 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 my conflict between this provision and another provision in. or related to, this document. this provision shall control 26 RIGHT TO AUDIT At any time during the term of the contract, or thereafter. the Cm, 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 semces 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 Crty the full amount of such overpavments within thirty (30) days of such audit findings, or the Cav at its option, reserves the right to deduct such amounts owing the City from any payments due Contractor 27 HOUSE BILL 2015 House Bill 2015, signed by the Governor on June 14, 2013 and effective on January 1. 2014, authorizes a penalty to be imposed on a person who contracts for certain services with a governmental entity and who fails to properly classify them workers This applies to subcontractors w well Contractors and subcontractors who fail to properly classdv individuals performing work under a governmental contract will be penalized S200 for each individual that has been misclassifred (Texas Government Code Section 2155 001) 28 ASSIGNING OR SUBLETTING THE CONTRACT 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 hfanagement 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 29 HOUSE BILL 1295 DISCLOSURE OF INTERESTED PARTIES House Bill 1295. adopted by the 84th Legislature, created §2252 908. Texas Government Code Section 2252 908 requires a business entity entering into certain contracts with a govemmental entity or state agency to file with the governmental entity or state agency a disclosure of interested parties at the time the business entity submits the signed contract to the gmemmental entty or state agency Instructions for completing Form 1295 are available at htm:,'/www.ci.luhbock,tx uv'departmental-websites/deoanmentslmurch,,tsim/vendor infarrnation 30 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 wring 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 terns and conditions provided herein are the final terms agreed upon by the panics, and any prior conflicting terns shall be of- force nr eflect Rev 71-1016 14 CANCELLATION Buyer shall have the right to cancel for default all or any part of the undelivered TERMS AND CONDITIONS IMPORTANT: READ CAREFULLY STANDARD TERMS AND CONDITIONS CITY OF LUBBOCK, TX 31. House Bill 89. effective September 1, 2017, amended the Texas Government Code to add Chapter 2270, Prohibition on Contracts with Companies Boycotting Israel. Effective September 1, 2017, a state agency and a political subdivision (which includes a city) may not enter a contract with a company for goods or services unless the contract contains a written verification from the company that; (i) it does not Boycott Israel; and (ii) will not Boycott Israel during the term of the contract. By accepting this purchase order, the Vendor (Professional or other applicable term defining the contracting party) verifies that it does not Boycott Israel, and agrees that during the term of this Agreement (Contract as applicable) will not Boycott Israel as that term is defined in Texas Government Code Section 808.001, as amended. Rev. 9/2017 City of Lubbock, TX ITB 17-13538-KW Runway and Taxiway Marking Paint I. Scope The City of Lubbock is seeking bids for runway and taxiway marking paint at the Lubbock Preston Smith International Airport. II. General Requirements Paint shall meet Federal Specification TT-P-1952E Type II water -borne lead free paint, https://www.faa.gov/regulations_policies/faa—regulations/, in accordance with FAA Advisory Circular 150/5370-10E. 2. Vendor must provide written documentation that the product being bid meets the required specifications. 3. Paint is for runway/taxiway striping and must be suitable for use on concrete and asphalt surfaces. 4. White and Yellow paint shall be delivered in 330-gallon lots in 55-gallon sealed containers. 5. Black and Red paint shall be delivered in 5-gallon sealed containers. 6. All paint shall be delivered within seven days of receipt of purchase order. Supplier must certify specifications on outside of each container. MSDS sheets must come with each shipment. All shipments of paint must be delivered on pallets. See the following page for a sample purchase order, (Exhibit A). III. Term and Conditions 1. The supply agreement shall be for a term of three years. All quantities shall be on a "more or less" basis. 2. Price must include all delivery charges to: Lubbock Preston Smith International Airport 5401 MLK Blvd. Lubbock, Texas 79401. City of i ubbocr BID FORM Runway and Taxiway Paint City of Lubbock, TX ITB 17-13538-KW Sid ITS 17-13538-KW In compliance with the Invitation to Bid 17-13i38-KW, the undersigned Bidder having examined the Invitation to Bid and Specifications, and being familiar with the conditions to be met, hereby submit 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 alienates 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 anv kind. The invitation to Bid 17-13538-KVV is by reference incorporated in this contract. The Bid Form must be completed in blue or black ink or by typewriter. QTY UNIT OF LNiT EXTENDED DELIVERY ITEM (+) ;MEASURE DESCRIPTION PRICE* COST DAYS ARO** 1. 2,000 Gallons White Runway and Taxiway Marking S S Paint, as per specifications 9.15/gal 18,300.00 , 2. 1,200 Gallons Yellow Runway and Taxiway Marking Paint, as per specifications 9.00/gal 10,800.00 _ 1 3. 400 Gallons Black Runway and Taxiway ;`'larking Paint, as per specifications 9.25,igal 3,700.00 7 4. 500 Gallons Red Ruriway and Taxiway Marking Paint, as per specifications 10.25/gal 5,125.00 7 Total Cost (items 1-4) S 3-975.00 *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 Citv of Lubbock is seeking a supply agreement for runway/taxiway marking paint 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 TE%%JS AND DISCOUNTS - Bidder offers a prompt payment discount of 0 °°, net 30calendar days. Discounts will not be considered in determining low bid. Unless other -vise 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 FAVOURED PRICING: The Bidder certifies that the price quoted is not in excess of the lowest price charged anyone else, including its most favoured 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 orless quantity of similar contract products of like or 818/2017 1 04 PM p r. City of Lubbock I i-a 1 . ,.,c3a-<.. ,- 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.'scrvice as needed. THIS BID IS SUBMITTED BY Ennis Paint, Inc. a corporation organized under the laws of the State of TX _ , or a partnership consisting of Firm: Ennis Paint, Inc. Address: 115 Todd Court City: Thomasville Bidder acknowledges receipt of the following addenda: Addenda No. n/a Date Addenda No. Date M/WBE Firm: or individual trading as of the City of Thomasville, NC State: NC Zip 27360 Woman I Black American I I Native American Hispanic American f Asian Pacific Americj I Other (SveciN) By Authorized Representative -must sign h) hand Officer Name and Title: Zina Brooks -Vice President Please Print Business Telephone Number 336-308-3769 FAX: 336-475-7900 E-mail Address: contracts@ennisflint.com 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 FORAI 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. 812/2017 1:04 PM p. 7 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. 2017-256404 Ennis Paint, Inc. Thomasville, NC United States Date Filed: 09/05/2017 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, TX Date Acknowledged: 09/07/2017 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. ITB 17-13538-KW Runway and Taxiway Marking Paint 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Greer, Laura Thomasville, NC United States X Vetter, Steve Thomasville, NC United States X Soule, Matt Thomasville, NC United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said this the day of 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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. 2017-256404 Ennis Paint, Inc. Thomasville, NC United States Date Filed: 09/05/2017 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, TX 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. ITB 17-13538-KW Runway and Taxiway Marking Paint 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Greer, Laura Thomasville, INC United States X Vetter, Steve Thomasville, NC United States X Soule, Matt Thomasville, NC United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Z�- 9 ► . Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE �" ' Sworn to and subscribed before me, by the said _ r\ tti— & rLe,r this the C. — day of 20 �, to certify evhich, witness my hand and seal of office. Upt1RYIPtJ& CRYSTAL S. GENTRY Randolph Count Sig ure of officer administering oat)r Printed name of officer admi%e lt�ission xpiresTit of officer administering oath pn 22, 2020 corms proviaea by t exas rinks commission www.etnics.state.tx.uS',,�,, ;,; �� Version V1.0.3337 y7,CIAt"o