HomeMy WebLinkAboutResolution - 2019-R0016 - Utility Contractors Of America - 01/22/2019Resolution No. 2019-R0016
Item No. 8.9
January 22, 2019
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 Contract No. 14354 for Canyon Lakes Sanitary
Sewer Interceptor Rehabilitation — Phase 2 as per RFP 19-14354-TF, by and between the City of
Lubbock and Utility Contractors of America, 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 January 22, 2019
DANIEL M. POPE, MAYOR
ATTEST:
. �Q" --4 - �X�
Reb cca Garza, City Se &
APPROVED AS TO CONTENT:
, Assistant City Manager
APPROVED AS TO FORM:
I&A'et�
elli Leisure, Assistant City Attorney
ccdocs/RES. PO. CONTRACT — Canyon Lakes Sanitary Sewer Interceptor Rehabilitation — Phase 2
December 12, 2018
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
iofl
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.
2018-434769
Utility Contractors of America, Inc.
Lubbock, TX United States
Date Filed:
12/17/2018
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.
14354
Canyon Lakes Sanitary Sewer Interceptor Rehabilitation - Phase 2
4 Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
Ziegner, Jonathan
Lubbock, TX United States
X
Lane, Ty
Lubbock, TX United States
X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My address is / NFoO .i v �, T -AZifl , 0. s.
(street) city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in V lAbgk County, State of ' & n , on the 1 7 day of Ph { , 20IT).
(month) (year)
f
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711
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.
2018-434769
Utility Contractors of America, Inc.
Lubbock, TX United States
Date Filed:
12/17/2018
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:
12/18/2018
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
14354
Canyon Lakes Sanitary Sewer Interceptor Rehabilitation - Phase 2
4
Party
Name of Interested P
City, State, Court lace of business
ty, Country (P )
Nature of interest
check applicable)
( PP )
Controlling
Intermediary
Ziegner, Jonathan
Lubbock, TX United States
X
Lane, Ty
Lubbock, TX United States
X
5
Check only if there is NO Interested Party. El
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)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711