HomeMy WebLinkAboutResolution - 2017-R0401 - Deere & Company - 10/26/2017Resolution No. 2017-RO401
Item No. 6.16
October 26, 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. 31035748 for the purchase of one John
Deere 5085E Utility Tractor as per BuyBoard 529-17, by and between the City of Lubbock and
Deere & Company of Cary, North Carolina, 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 October 26, 2017
k
DANIEL M. POPE, MAYOR
F.11611k,16
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Reb cca Garza, City Secretar
APPROVED AS TO CONTENT•
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Scott Snider, Assistant City Manager
APPROVED AS TO FORM:
Ke li Leisure, Assistant City Attorney
ccdocs: RES.Purchase Order 31035748.John Deere 5058E Utility Tractor
10.10.2017
`'- City of
Lubbock
TEXAS
PURCHASE ORDER
TO: DEERE & COMPANY
2000 JOHN DEERE RUN
CARY North Carolina 27513
Page - 1
Date - 10/0912017
Order Number 31035748 000 OP
Branch/Plant 3526
SHIP TO: CITY OF LUBBOCK
FLEET SERVICES
206 MUNICIPAL DRIVE
LUBBOCK Texas 79404
INVOICE TO: CITY OF LUBBOCK
ACCOUNTSPAYABLE
P.O. BOX 2000
LUBBOCK, TX 79457 BY-*Myr
Marta Alv ez, Director of Purchasing & Contract Management
Ordered 10i0912017 Freight
Requested 11127/2017 Taken By
Delivery J LOERWALD REQ 50921 BUYBOARD 529-17
Description/Supplier Item Ordered Unit Cost UM
5085E Utility Tractor 1.000 51,132.9800 EA
CC 5221
Terms NET 30 DAYS
S GONZALEZ
Extension Request Date
51,132.98 11; 27/ 2017
Total Order
51,132.98
This purchase order encumbers funds in the amount of $51,132.98.00 awarded to Deere & Company of Cary, NC, on
October 26 , 2017. The following is incorporated into and made part of this purchase order by reference:
Quote Number 16132162 dated September 27, 2017 from Deere & Company of Cary, NC and BuyBoard #529-17.
Resolution # 2017-RO401
CITY OF LUBBOCK
Daniel M. Pope, Mayor
ATTEST:
Re cca Garza, City Secretary
Seller and Buyer agree as
follows:
PURCHASE ORDER
TERMS AND CONDITIONS
IMPORTANT: READ CAREFULLY
STANDARD TERMS AND CONDITIONS
CITY OF LUBBOCK, TX
I SELLER TO PACKAGE GOODS Seller w ill package goods in accordance with good commercial practice.
Each shipping container shall be clearly and per manerak marked as follows (a) Seller's name and address.
(b) Consignee's name, address and purchase order or purchase release number and the supply aamment number
if applicable. (cl Container number and total number of containers a L. box I of q boxes, and (d) the number
of the container bearing the packing slip Seller shall bear cost of packaging unless others se pros ided 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 conclusi%e on shipments
not accompanied by packing lists
2. SHMNIENT UNDER RESERVATION PROHIBITED Seller is not authorized to ship the goods under
reservation and no tender of a bill of lading w ell 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 Bu%er until Buyer
actually receives and takes possession of the goods at the point or points of deln en
q. NO REPLACEMENT OF DEFECTIVE TENDER Even tender of deh%ay of goods must fully comply
with all provisions of this contract as to time of delt%en quality 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 reasonabh nonfy Buyer of his
intention to cure and may then make a conforming tender w ithin the contract time but not aflemard
5. INVOICES S PAYMENTS a. S e I I e r shall submit separate invoices in duplicate one each purchase
order or purchase release after each delve en 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 %%zybdl when applicable• should
be attached to the invoice, Mail To Accounts Pa%able Cin of Lubbock P O Box 2000 Lubbock Texas
79457. Pavmem shall not be due until the abo%c instruments are submitted after deln en
6, GRATUITIES. The Buva rtu%. by v%niten notice to the Seller, cancel this contract without habnlin to
Seller if it is determined by Buyer that gratuities in the form of entertainment gifts or otherwise were offered
or green 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 nuking of am determinations w ith 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 any other
rights and remedies to reco%er or u uhhold the amount of the cost incurred by Seller in pro%iding such gratuities
7 SPECIAL TOOLS S 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 b% the Seller as such
S WARRANTY -PRICE a. The price to be paid by the Buya 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 wv aranty the prices of the hors shall be reduced to the
Suller's current prices on orders by others. or in the altarame Buyer may cancel this contract without
liabilit% to Seller for breach or Seller s actual expense b The Seller %earrams 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
viciation of this %vamnq the Buyer shall have the right in addition to any other right of rights to cancel this
contract without liabrhn and to deduct from the contract price, or otherwise recover without Iiabdit% and to
deduct from the contract priceor otherwise reco%er the full amount of such commission, percentage brokerage
or contingent fee
9 WARRANTY -PRODUCT Seller shall not limit 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 thebid rot nation, and to thesample(s) furnished
by The Seller, dam In the event of a conflict or between the specifications. drawings and descriptions the
specifications shall go%cm. Notwithstanding am provisions contained in the contractual agreement. the Seller
represents and warrants fault -bee performance and fault -free result in the processing date and date related data
(including, but not limited to calculating. comparing and sequencing) of all hardware. software and firnware
products deli%ered and sery ices pro%ided under this Contract, indi%idually or in combination as the cue may
be from the effective due of this Contract The obligations conlamed herem appt, to products and sere ices
provided by the Seller its sub- Seller or any third pam involved in the creation or development of the products
and services to be delivered to the City of Lubbock under this Contract Failure to comply w ith am of the
obligations contained herein. may result in the City of Lubbock availing itself of any of its rights under the
la%v and under this Contract including, but not limited to, its right pertaining to Termination or default The
warranties contained herem are separate and discrete from any other warranties specified in this Contract
and we not subject to any disclaimer of warranty, implied or expressed. or limitation of the Seller's liability
which ma, be specified in this Contract, its appendices, its schedules. its annexes or any document incorporated
in this Contract but 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 Safer and Health Act of IWO In the
event the product does not conform to OSHA standards. Buyer pas, return the product for correction or
replacement at the Seller s expense In the event Seller fails to make the appropriate Llw"MMon within a
reasonable time, correction made by Buycr w ell be at the Seller's expense
I I NO WARRANTY BY BUYER AGAINST LNFRINGEMENTS As part of this contract for sale Seller
agrees to ascertain whether goods manufactured in accordance w ith the specifications attached to this agreement
will giro rise to the rightful claim of any third person by way of infringement of the like Buyer makes no
warranty that the production of goods according to the specification w ill not gi%e rue to such a claim, and in no
event shall Buyer be liable to Seller for indemnification in the e%ent 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 notif, the
Buya to this effect in writing within two weeks after the signing ofthis agreement If Buyer does not receive
notice and is subsequently held liable for the infringement or the like. Sella will save Buyer harmless If
Sella in good faith ascertains the production of the goods in accordance with the specifications will result in
infringement or the like. the contract shall benull and %aid
12. NON APPROPRIATION All funds for payment by The Cin under this contract are subject to The
a%ailabnlit, of an annual appropriation for this purpose by the City In the event of monappropriatinn of funds
by the City Council of the City of Lubbock for the goods or services provided under the contmcl. the Cin 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 sen ices co%ered b, this contract
is spent. whichever elect occurs first If at am nme 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 gi%e
such notice shall be of no effect and the Cin_ shall not be obligated under this contract beyond the date of
termination
I I RIGHT Or iw,i ( I li )\ lie..:I .I -ell In a tt:r n 'l I I iris) cvt Ill, L ds at deln en bcf Ir a ceptiog
[Item
N CANCELLATION Buyer shall haze the right to cancel for default all or any pan of the undelivered
portion of this order if Sella breaches any of the terms hereof including warranties of Sella or if the Sella
becomes insolvent or commits acts of hankruptc, Such right of cancellation is in addition to and not in
lieu of an% other remedies which Buyer nta, have in law or equity
Is TERMINATION The perfo rnanceof% cirk under this order may be terminated in whole. or in pan by the
Buyer in accordance with this provision. Termination of work hereunder shall be effected by the dch%er%
of the Sella of a "Nonce of Termination" specifying the extent to which performance of` ork under the
order is terminated and the date upon which such termination becomes effect i%a Such right or lamination ination t
in addition to and not in lieu of the rights of Buyer set forth in Clause 14. herein
16 FORCE MAJEURE Neither party shall be held responsible for losses. resulting if the fulfillment
of an% terns of pro%isions of this contract is delayed or pre%ented by any cause not w whin the control of the
pain whose performance is interfered w ith, and which by the exercise of reasonable diligence said party is
unable to prevent
17 ASSIGNMENT -DELEGATION No right or interest in this contract shall be assigned or deleeation of
any obligation made by Seller without the written permission of the Buyer Any attempted assignment or
delegation b% Seller shall be w holly %aid and totally ineffective for all purpose unless made in conformity w rah
this paragraph.
18 11 AVER No claim or right arising out of a breach of this contract can be discharged in whole or in pan
by a %%amen or renunciation of the claim or light unless the waiver or renunciation is supported b%
consideration and is in writing signed by the aggrieved parr
19 INTERPRETATION -PAROLE EVIDENCE This writing. plus any specifications for bids and
performance provided by Buyer in its advertisement for bids, and any other documents pro%ided by
Sella aspan of his bid, is intended by the parties as a final expression of thew agreement and intended aho
as a complete and exclusive statement of the terms of thew agreement. W'hene%er a term defined by the
Uniform Commercial Code is used in this agreement, the definition contained in the Code rs to control
20 APPLICABLE LAW This agreement shall be governed by the Uniform Commercial Code Merm%cr
the term "Uniform Commercial Code" is used. it shall be ccnstmed as meaning the Uniform Commercial
Code as adopted in the State of Texas as effective and in force on the date of this agreement
I RIGHT TO .ASSURANCE W'hene%er one pan) to this contract in good faith has reason to question
the other pany's intent to perform he ma% demand that the other party gi%e written assurance of his intent to
perform In the e%eni that a demand is made and no assurance is given within five (5) days, the demanding
patty may treat this failure as an anticipation repudiation of the contract.
_2 INDEMNIFICATION 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 anywuse accrue against the Buyer inconsequence of the granting of this Contract
or which may amv%nse 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 employ em. or of the subSeller or assignee or its
employees, if any. and the Seller shall, at his ow%n expense. appear, defend and pay all charges of attorneys
and all costs and other expenses arising therefrom of incurred in connection therewith, and, If am judgment
shall be rendered against the Buyer in any such action, the Sella shall. at its own expenses. satisfy and
discharge the same Seller expressly understands and agrees that any bond required by this contract, or
otherwise provided b% Sellershall in no way limn the responsibility to indemnify keep and save harmless
and defend the Buyer as herein provided
23 TIME It is hereby expressly agreed and undastood that time is of the essence for the performance of
this contract, and failure by contract to meet the time specifications of this agreement %%ill cause Seller to
be in default of this agreement.
24 NIBE The City of Lubbock hereby notifies all bidders that in regard to an, contract entered Into
pursuant to this request, minority and women business enterprises will be afforded equal opportunities to
submit bids in response to this imitation 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 mmcdy to it by law contract
equity or otherwise including ww shout limitation, the right to seek any and all forms of relief in a court of
competent jurisdiction. Further, the City shall not he subject to any arbitration process prior to exercising
its unrestricted right to seek judicial remedy The remedies set forth herein ue cumulative and not exclusi%e
and rtuy be exercised concurrently To the extent of any conflict between this provision and another pm%ision
in or related to, this document this pro%ision shall control.
26 RIGHT TO AUDIT At any time during the term of the contract, or thereafter. the Cny. or a duly
authorized audit representative of the Cny or the State of Texas. at its expense and at reasonable times
resenes 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 enors or overpayments by the City
Contractor shall refund the Cny the full amount of such overpayments within thin, (30) days of such
audit findings. or the Cin at its option, reserves the right to deduct such amounts owing the City from any
payments due Contractor
27 HOUSE BILL 2015 House Bill 2011, signed by the Governor on June la, 2013 and effecme on lanuan
1 2061 authorizes a penalty to be imposed on a person who contracts for certain services with a got emmenal
enttn and who fads to properly classify their %corkers. This applies to subcontractors as well. Contractors and
subcontractors who fad to pmpah classify indi%iduals performing work under a governmental contract well be
penalized S200 for each indn idual that hasbeen misclassified. (Texas Government Code Section'_ 155 001)
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
Management Should consent begi%en the Contractor shall insure the Subcontractor or shall pro%ide 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 b, the Sglh
Legislature, created S2252 908. Texas Go%emment Code. Section 2252.908 requires a business ent % entering
into certain contracts with a go%emmental entity or state agent, to file with the governmental emit or state
agency a disclosure of interested parties at the time the business entity submits the signed contract to the
governmental entity or state agency Instructions for completing Form 1295 are available at
him /wwxv ci lubbock tx us departmental-websites denartmentsiourchasine vendor -information
30 CONTRACTOR ACKNOWLEDGES. by supplying am 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 an% additional associated documents and Amendments The City disclaims am terns 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 an, terms and conditions provided by the Contractor, the terns and
conditions pro%ided herein shall pre%ail The terns and conditions provided herein tie the final terms aaced
upon by the parties. and any prior conflicting terns shall be of no force or effect.
31 House Bill 89, effecti%c September 1, 2017. amended the Texas Government Code to add Chapter'_'_70.
Prohibition on Contracts with Companies Boycotting Israel Effecti%e September I, 2017, a stale agency and a
political suhilnismn (which include a cin) inn not civel a contract with a ennipm for goods or sal ices
unless the contract contains a writicn %enficat-1 II -ail the compare% IIIat (i) it does not Hn%eolt Isiacl and (u)
will not Boycott Israel cluing the t tin of the conlmct
By accepting this purchase order, the Vendor (Professional or other applicable term defining the contracting
party) vmfies 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
Rey 9'_017
JOHN DEERE
ALL PURCHASE ORDERS MUST BE MADE OUT
TO (VENDOR):
Deere & Company
2000 John Deere Run
Cary, NC 27513
FED ID: 36-2382580; DUNS#: 60-7690989
Prepared For:
City Of Lubbock - Parks
TX
N HURS
ALL PURCHASE ORDERS MUST BE SENT
TO DELIVERING DEALER:
Hurst Farm Supply, Inc.
4801 Highway 84
Lubbock, TX 79416
806-762-0638
Quote Summary
Delivering Dealer:
Hurst Farm Supply, Inc.
William Murphy
4801 Highway 84
Lubbock, TX 79416
Phone: 806-762-0638
kris@hurstfs.com
BUYBOARD PRICING WAS USED Quote ID: 16132162
Created On: 27 September 2017
TO OBTAIN MAXMIUM Last Modified On: 27 September 2017
DISCOUNTS.. Expiration Date: 31 October 2017
Equipment Summary Suggested List Selling Price Qty Extended
JOHN DEERE 5085E Utility Tractor $ 61,606.00 $ 51,132.98 X 1 - $ 51,132.98
Contract: TX BuyBoard Grounds Mtnc Equipment, Irrigation Parts, Supplies & Installation 529-17 (PG 67)
Price Effective Date: September 27, 2017
Equipment Total $ 51,132.98
Includes Fees and Non -contract items Quote Summary
Equipment Total $ 51,132.98
Trade In
SubTotal
$ 51,132.98
Est. Service
$ 0.00
Agreement Tax
Total
$ 51.132.98
Down Payment
(0.00)
Rental Applied
(0.00)
Balance Due
$ 51,132.98
Salesperson : X Accepted By: X
Confidential
JOHN DEERE
Selling Equipment
Quote Id: 16132162 Customer Name:
ALL PURCHASE ORDERS MUST BE MADE OUT
TO (VENDOR):
Deere & Company
2000 John Deere Run
Cary, NC 27513
FED ID: 36-2382580; DUNS#: 60-7690989
ALL PURCHASE ORDERS MUST BE SENT
TO DELIVERING DEALER:
Hurst Farm Supply, Inc.
4801 Highway 84
Lubbock, TX 79416
806-762-0638
JOHN DEERE 5085E Utility Tractor
Contract: TX BuyBoard Grounds Mtnc Equipment, Irrigation
Suggested List *
Parts, Supplies & Installation 529-17 (PG 67)
$ 61,606.00
Price Effective Date: September
27, 2017
Selling Price *
$ 51,132.98
* Price per item - includes Fees and Non -contract items
Code
Description
Qty List Price Discount%
Discount
Contract Extended
Amount
Price Contract
Price
696BLV
5085E Utility Tractor
1 $ 48,559.00
17.00
$ 8,255.03 $ 40,303.97 $ 40.303.97
Standard Options - Per Unit
0409
English Operators Manual
1 $ 0.00
17.00
$ 0.00
$ 0.00 $ 0.00
and Decal Kit
1383
24F/12R PowrReverser
1 $ 1,475.00
17.00
$ 250.75
$ 1,224.25 $ 1,224.25
Transmission - 540/540E
2050
Standard Cab
1 $ 9,117.00
17.00
$ 1,549.89
$ 7,567.11 $ 7,567,11
2120
Air Suspension Seat
1 $ 710.00
17.00
$ 120.70
$ 589.30 $ 589,30
3025
Deluxe Cornerpost Exhaust
1 $ 503.00
17.00
$ 85.51
$ 417.49 $ 417.49
3320
Dual Stackable Rear SCV's
1 $ 0.00
17.00
$ 0.00
$ 0.00 $ 0.00
with Lever Control
3420
Dual Stackable Mid Valves
1 $ 1,242.00
17.00
$ 211.14
$ 1,030.86 $ 1,030.86
with Joystick Control
5911
18.4 - 30 In. 8PR R1 Bias
1 $ 0.00
17.00
$ 0.00
$ 0.00 $ 0.00
6040
MFWD (4 Wheel Drive)
1 $ 0.00
17.00
$ 0.00
$ 0.00 $ 0.00
6701
12.4 - 24 In, 8PR R1 Bias
1 $ 0.00
17.00
$ 0.00
$ 0.00 $ 0.00
Standard Options Total
$ 13,047.00
$ 2,217.99 $ 10,829.01 $10,829.01
Value Added Services $ 0.00 $ 0.00 $ 0.00
Total
Suggested Price $ 51,132.98
Confidential
CERTIFICATE OF INTERESTED PARTIES
FORM 3.295
lofl
Complete Nos. 1 - 4 and 6 if there are interested parties.
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
OFFICE USE ONLY
CERTIFICATION OF FILING
Certificate Number:
2017-273348
Date Filed:
10/17/2017
Date Acknowledged:
10/17/2017
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
HURST FARM SUPPLY
LUBBOCK, TX United States
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
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.
31035748
JOHN DEERE EQUIPMENT
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
HURST FARM SUPPLY
LUBBOCK, TX 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:
2017-273348
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
HURST FARM SUPPLY
LUBBOCK, TX United States
Date Filed:
10/17/2017
2 Name of governmental entityor state agency that is a party tot 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.
31035748
JOHN DEERE EQUIPMENT
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
HURST FARM SUPPLY
LUBBOCK, TX United States
X
5 Check only if there is NO Interested Parry. ❑
6 AFFIDAVIT I swear, or affi under pe It. of perjury, hat the above disclosure is true and correct.
SONYA MURPHY
Nobly Public, State of Too
E
My Cmniisft Ezpiree 02.19.201
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said 1 this the -th_ day of oc-6bee
200 to certify which, witness my hand and seal of office.
rA Uf I (
' Sig;kUfi of officer d i t ring oatV Printed boe of office i stering ath Title of offi r administering oath
0111w WOVIucu uy i caas cuuus Cummission www.etnics.state.tx.us Version V1.0.3337