HomeMy WebLinkAboutResolution - 2017-R0418 - Deerwood Construction - 11/16/2017 (2)Resolution No. 2017-RO418
Item No. 6.5
November 16, 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, Contract No. 13614 for the Overton Water Line Replacement
as per RFP 18-13614-TF, by and between the City of Lubbock and Deerwood Construction, Inc.,
of Lubbock, 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 November 16, 2017
DANIEL M. POPE, MAYOR
ATTEST:
Re - ec t
Garza, City Secretary
APPROVED AS TO CONTENT:
Mark 'i�-qarwoA, Assistant City Manager
APPROVED AS TO FORM:
Kelli Leisure, Assistant City Attorney
ccdocs/RES.Public Works Contract 13614.Overton Water Line Replacement
10.25.2017
Contract is viewable in the
Office of the City Secretary
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.
2017-275621
Deerwood Construction, Inc.
Lubbock, TX United States
Date Filed:
10/24/2017
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 Texas
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.
RFP 18-13614-TF
Overton Water Line Replacement
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
Patterson, Jan
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.
�pR� rye • i '�I �! ETTE G ROGERS
TA10 PUBLIC
'•".. of Texas
'FoF;;:•' �u,r'::. Exp. 10 15 2020 Signature of authorized agent of contracting business entity
YYYhY
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said �j �L -�1 ((_,( L L � 4y L �-- ,this the day of
20��, to certify which, witness my hand and seal of office.
�(�-�t c
Signature of officef administeri9b 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 1.295
1 of.1
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:
2017-275621
Date Filed:
10/24/2017
Date Acknowledged:
11/03/2017
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Deerwood Construction, Inc.
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 Texas
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.
RFP 18-13614-TF
Overton Water Line Replacement
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
Patterson, Jan
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