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HomeMy WebLinkAboutResolution - 2022-R0384 - Contract 16720 with Bruckner Truck & Equipment - Citibus 9.13.22Resolution No. 2022-RO384 Item No. 5.22 September 13, 2022 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. 16720, as per RFP 22-16534-KM, for body work and accident damage repair for Citibus vehicles, by and between the City of Lubbock and Bruckner Truck and Equipment 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 ATTEST: eD'&'—K Rebe ca Garza, City Sec APPROVED AS TO CO Bill How&n,'Deputy City Manager APPROVED AS TO FORM: Ry Bro e, AA'stafft City Attorney RES.Contract No. 16720-Bruckner "Truck and Equipment 8.1.22 September 13, 2022 Resolution No. 2022-R0384 Contract 16720 City of Lubbock Body Work and Accident Damage Repair for Citibus Vehicles Agreement This Service Agreement (this "Agreement") is entered into as of the 13dday of s,ber 2022 ("Effective Date") by and between Bruckner Truck and Equipment (the Contractor), and the City of Lubbock (the "City"). RECITALS WHEREAS, the City has issued a Request for Proposals 22-16534-KM, Body Work and Accident Damage Repair for Citibus Vehicles and WHEREAS, the proposal submitted by the Contractor has been selected as the proposal which best meets the needs of the City for this service; and WHEREAS, Contractor desires to perform as an independent contractor to provide Body Work and Accident Damage Repair for Citibus Vehicles, upon terms and conditions maintained in this Agreement; and NOW THEREFORE, for and in consideration of the mutual promises contained herein, the City and Contractor agree as follows: City and Contractor acknowledge the Agreement consists of the following exhibits which are attached hereto and incorporated herein by reference, listed in their order of priority in the event of inconsistent or contradictory provisions: 1. This Agreement 2. Exhibit A — General Requirements 3. Exhibit B — Best and Final Offer 4. Exhibit C — Insurance Requirements Scope of Work Contractor shall provide the services that are specified in Exhibit A. The Contractor shall comply with all the applicable requirements set forth in Exhibit B and Exhibit C attached hereto. Article 1 1.1 The contract shall be for a term of one year, with the option of two, 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. 1.2 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 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. 1.3 The Contractor shall not assign any interest in this Agreement and shall not transfer any interest in the Agreement, whatsoever, without prior consent of the City. 1.4 All funds for payment by the City under this Agreement 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 Agreement, the City will terminate the Agreement, 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 Agreement is spent, whichever event occurs first. If at any time funds are not appropriated for the continuance of this Agreement, cancellation shall be accepted by the contractor 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 Agreement beyond the date of termination. 1.5 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. Article 2 Miscellaneous. 2.1 This Agreement is made in the State of Texas and shall for all purposes be construed in accordance with the laws of said State, without reference to choice of law provisions. 2.2 This Agreement is performable in, and venue of any action related or pertaining to this Agreement shall lie in, Lubbock, Texas. 2.3 This Agreement and its Exhibits contains the entire agreement between the City and Contractor and supersedes any and all previous agreements, written or oral, between the parties relating to the subject matter hereof. No amendment or modification of the terms of this Agreement shall be binding upon the parties unless reduced to writing and signed by both parties. 2.4 This Agreement may be executed in counterparts, each of which shall be deemed an original. 2.5 In the event any provision of this Agreement is held illegal or invalid, the remaining provisions of this Agreement shall not be affected thereby. 2.6 The waiver of a breach of any provision of this Agreement by any parties or the failure of any parties otherwise to insist upon strict performance of any provision hereof shall not constitute a waiver of any subsequent breach or of any subsequent failure to perform. 2.7 This Agreement shall be binding upon and inure to the benefit of the parties and their respective heirs, representatives and successors and may be assigned by Contractor or the City to any successor only on the written approval of the other party. 2.8 All claims, disputes, and other matters in question between the Parties arising out of or relating to this Agreement or the breach thereof, shall be formally discussed and negotiated between the Parties for resolution. In the event that the Parties are unable to resolve the claims, disputes, or other matters in question within 30 days of written notification from the aggrieved Party to the other Party, the aggrieved Party shall be free to pursue all remedies available at law or in equity. 2.9 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. 2.10 The City reserves the right to exercise any right or remedy 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 do. 2.11 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 of insurance from the Subcontractor that complies with all contract insurance requirements document, this provision shall control. 2.12 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. 2.13 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. 2.14 Contracts with Companies Engaged in Business with Iran, Sudan, or Foreign Terrorist Organization Prohibited. Pursuant to Section 2252.152 of the Texas Government Code, prohibits the City from entering into a contract with a vendor that is identified by The Comptroller as a company known to have contracts with or provide supplies or service with Iran, Sudan or a foreign terrorist organization. 2.15 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 contract 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. 2.16 No Boycott of Israel. Pursuant to Section 2271.002 of the Texas Government Code, a) This section applies only to a contract that: (1) is between a governmental entity and a company with 10 or more full-time employees; and (2) has a value of $100,000 or more that is to be paid wholly or partly from public funds of the governmental entity. (b) A governmental entity may not enter into a contract with a company for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. 2.17 Texas Government Code 2274. By entering into this Agreement, Contractor verifies that: (1) it does not, and will not for the duration of the contract, have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and will not discriminate during the term of the contract against a firearm entity or firearm trade association. 2.18 Contractor represents and warrants that: (1) it does not, and will not for the duration of the contract, boycott energy companies or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not boycott energy companies; and will not boycott energy companies during the term of the Agreement. This verification is not required for an agreement where a governmental entity determines that these requirements are inconsistent with the governmental entity's constitutional or statutory duties related to the issuance, incurrence, or management of debt obligations or the deposit, custody, management, borrowing, or investment of funds. 2.19 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. 2.20 Indemnify. 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 attorneys 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. -----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 K BY Tra ne, or ATTEST: - P!4�" &:� Rebe a Garza, City Secre ry APPROV S TO CONTENT: Ile? Chris Mandrel l, Gener Manager of Citibus APPROVED AS TO FORM Ryan oo , Assis ant ►ty Acc ant rrmt Name I17,5 16t Address / x _ -7 City, State, Zip Code µ Exhibit A City of Lubbock RFP 22-16534-KM Body Work and Accident Damage Repair for Citibus Vehicles GENERAL REQUIREMENTS 1. SCOPE OF WORK Citibus intends to enter into a contract with one or more qualified contractors to furnish paint and body repairs for Citibus Transit Units to include, but will not be limited to the following: Accident Repairs, Vehicle Paint Services, Common Body Repairs on Transit Buses, and Common Body Repairs on Body on Chassis Vehicles. Citibus intends to enter into contracts with multiple qualified body shops in order to ensure timely completion of repairs. 2. REQUIREMENTS 2.1. The proposer must have a complete body shop meeting the following minimum requirements: 2.1.1. Paint Booth 2.1.2. Frame and straightening machines with qualified operator (on -site or under contract). 2.1.3. The contractor awarded the contract must also have the capability to do body and paint work indoors during inclement weather. The indoor area must be large enough to handle Citibus Units. 2.2. The work proposed in this contract shall be performed at the successful proposer's (hereinafter referred to as "Contractor") place of business. 2.3. The successful Contractor agrees to assume full liability and responsibility for all units and contents (including radios and other standard or installed equipment), placed in its custody by Citibus under this contract. 2.4. The body shop MUST be able to transport the vehicles to and from the body shop location and the Citibus facility. Citibus will not transport vehicles to and from the contractor's body shop location. 2.5. This contract shall cover the following types of vehicles: 2.5.1. Citibus Transit Bus Units 2.5.2. Body on Chassis Vehicles 2.6. Contractor must be able to start work on the vehicle within 14 days, if not Citibus will move to the next awarded contractor. 2.7. Contractor agrees that work assigned under this contract shall receive priority over the other work in its shop unless specific prior approval has been obtained from Citibus. 3. FEDERAL AND STATE SAFETY REGULATIONS 3.1. Contractor shall comply with all federal and state safety regulation including but not limited to Occupational, Safety and Health Administration (OSHA) and the Department of Workforce Development (DWD) regulations. This agreement includes incorporation of Federal Transit Administration (FTA) Terms. The preceding provisions include, in part, certain Standard Terms and Conditions required by the Department of Transportation (DOT), whether or not expressly set forth in the preceding contract provisions. All contractual provisions required by DOT, as set forth in FTA Circular 4220.1 F, are hereby incorporated by reference. Anything to the contrary herein notwithstanding, all FTA mandated terms shall be deemed to control in the event of a conflict with other provisions contained in this agreement. The Contractor shall not perform any act, fail to perform any act, or refuse to comply with any requests which would cause Bus to be in violation of the FTA terms and conditions. 3.2. All Environmental Protection Agency (EPA) rules and regulations must be fooled by the Contractor. 4. COST ESTIMATES 4.1. Individual cost estimates for each unit or piece of equipment will be provided by the contractor before any actual work will commence. These estimates will include time of completion, hours of labor, and an itemized listing of replacement repair parts. Estimates shall be priced per item with replacement repair parts showing crash guide list or applicable industry standards. 4.2. All estimates shall be complete and include all parts and charges with the exception of "hidden' damage, which may not be obvious until repairs are initiated. All estimates shall be completed and available for review within 24 hours of delivery of the vehicle. No repairs shall be initiated until Citibus Representative reviews the estimate and gives the contractor notice to proceed with the work. 4.3. In no instance shall any repairs costing more than the approved estimate be performed without first notifying the Citibus or designated representative and providing a supplemental estimate indicating additional parts and labor charges. THE CITY SHALL RESERVE THE RIGHT TO VERIFY, THROUGH INDEPENDENT APPRAISAL, IF THE REPAIRS ARE REQUIRED. 4.4. All labor will be estimated and invoiced at the hourly rate set forth on the Proposal Submittal Form. All replacement repair parts will be invoiced at vendor list price less percentage as listed in Bid Form of this ITB. Price is based on an hourly labor rate, cost per hour. 5. BODYWORK AND PAINTING REQUIREMENTS 5.1. Contractor must be able to perform complete body repairs as well as paint transit units. 5.2. There will be no penalty for Citibus to supply parts if this will lower costs. 5.3. There is a maximum mark-up of 15% for parts to be used. 5.4. DuPont Paint or approved equal is to be utilized. 6. PROTECTION OF VEHICLES 6.1. It shall be the responsibility of the contractor to fully protect, at all times, city property entrusted to their care. The contractor shall reimburse the city for any and all damages to city property while in their care, such as unwarranted wear and tear, acts of vandalism and malicious mischief, any and all physical damages, including acts of commission and/or omission by the contractor's employees and others. Damages will be billed at invoicing costs to replace or repair such damage and may be deducted from any outstanding amounts owed the contractor. The contractor further agrees to pay to the city any outstanding claims within 30 days after notification from Citibus Department. 6.2. Contractor must maintain insurance coverage as required by Citibus and the City of Lubbock. 7. COMPLETION AND DELIVERY TIME 7.1. Contractor will discuss a due date with Citibus staff for each repair to be documented and noted by each party. If more time is required, prior approval must been obtained from the Citibus. If the due date is not met by the Contractor, a $300 per day non useable vehicle charge will be assessed and subtracted from the final repair invoice. 8. WORKMANSHIP WARRANTY 8.1. The contractor agrees the service furnished to be of the highest quality, complying with specifications, and free from all defects in materials and workmanship for a period of one (1) year from the date of acceptance. Replacements and body repairs under this warranty are to be made by the contractor at no cost and to the satisfaction of the city. 9. CONTRACT TERM 9.1. The contract shall be for a term of one year with the option of two, one year extensions, said date of term beginning upon formal approval. The City of Lubbock does not guarantee any specific amount of compensation, volume, minimum, or maximum amount of services under this proposal and resulting contract. This agreement includes incorporation of Federal Transit Administration (FTA) Terms. The preceding provisions include, in part, certain Standard Terms and Conditions required by the Department of Transportation (DOT), whether or not expressly set forth in the preceding contract provisions. All contractual provisions required by DOT, as set forth in FTA Circular 4220.1F, are hereby incorporated by reference. Anything to the contrary herein notwithstanding, all FTA mandated terms shall be deemed to control in the event of a conflict with other provisions contained in this agreement. The Contractor shall not perform any act, fail to perform any act, or refuse to comply with any requests which would cause Citibus to be in violation of the FTA terms and conditions. 10. EVALUATION CRITERIA 10.1. The following criteria will be used to evaluate and rank submittals: 10.1.1. Qualifications, Experience — 30 Points 10.1.2. Quality of Materials and Workmanship — 20 Points 10.1.3. Cost — 25 Points 10.1.4. References — 25 Points Exhibit B City of Lubbock RFP 22-16534-KM Body Work and Accident Damage Repair for Citibus Bruckner Trucks and Equipment BAFO Vehicle Auto Body & Collision Repair Price Sheet PRICE SHEET INSTRUCTIONS - Enter the unit price in the column indicated in the BLUE fields. Please use this spread sheet within the Excel program so that the Extended Cost can automatically be calculated. Pricing quoted on this price sheet must remain firm for the term of the contract. Any exception taken per the specifications' or price sheet may be deemed non -responsive, if not approved by way of addendum. The proposal will be awarded by group, the City reserves the right to award what is most advantageous to the City to the vendor(s) meeting specifications. It is the proposer's responsibility to verify all calculations. The Percentage Discount (example: -10, -15, -20, etc..) & Unit Price listed must remain firm for the term of the contract. Awards will be based on proposal rankings. BODY SHOP REPAIRS FOR HEAVY DUTY (TRUCKS/EQUIPMENT AND TRANSIT VEHICLES OVER 1 TON) Item# Description Rates Annual Estimated Usage Unit Estimated Amount Enter Mark -Up Part Percentage Discount Extended Cost 1 Body Labor Rate $115.00 500 Hours $ 57,500.00 -15 0 $ 57,500.00 2 Paint Labor Rate $115.00 500 Hours $ 57,500.00 $ 57,500.00 3 Paint Materials ; Supplies Rate $115.00 500 Hours $ 57,500.00 $ 57,500.00 4 Mechanical Repair Rate $12S.00 500 Hours $ 65,200.00 $ 62,500.00 5 Frame Uni-body Labor Rate $115.00 500 Hours $ 57,500.00 $ 57,500.00 6 Parts Item# Description nnua Estimated Usage Unit Unit Price for Towing Extended Cost 7 owing to om City Location (Two-way Trip) 100 Each $450.00 $ 45,000.00 HEAVY DUTY TOTAL $ 337,500.00 Rev. 1 - 03/25/10 Doc#BDPS-FRM-117 Exhibit C Commercial General Liability Requirements: $1M occurrence / $2M aggregate (can be combined with an Excess Liability to meet requirement). CGL is required in ALL contracts. It is perhaps the most important of all insurance policies in a contractual relationship. It insures the Contractor has broad liability coverage for contractual activities and for completed operations. Automobile Liability Requirements: $ I M/occurrence is needed Workers Compensation and Employer Liability Requirements: Statutory. If the vendor is an independent contractor with no employees and are exempt from providing Workers' Compensation coverage, they must sign a waiver (obtained from COL Purchasing) and include a copy of their driver's license. Special Insurances Garage Liability Requirements: No less than $2,000,000 combined single limit. Gamekeepers Legal Liability Requirements: No less than $1,000,000 per location. • The City of Lubbock (including its officials, employees and volunteers) shall be afforded additional insured status on a primary and non-contributory basis on all liability policies except professional liabilities and workers' comp. • Waivers of Subrogation are required for CGL, AL, and WC. • To Include Products of Completed Operations endorsement. • Carrier will provide a 30-day written notice of cancellation, 10-day written notice for non- payment. • Carriers must meet an A.M. Best rating of A- or better. • Subcontractors must carry same limits as listed above. CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft 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. 2022-921112 Bruckner Truck Sales Inc Lubbock, TX United States Date Filed: 08/11/2022 2 Name of governmentall entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Date Acknowledged: 08/11/2022 3 Provide the identification number used by the governmental entity or state agency to track or identity the contract, and provide a description of the services, goods, or other property to be provided under the contract. 16720 Heavy duty truck and trailer parts and service 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Bruckner, Brian Amarillo, TX United States X Bruckner, Chris Amarillo, TX United States X Moody, James Amarillo, TX United States X McCambell, Chip Amarillo, TX United States X Murphy, Brian Amarillo, TX United States X Barton, Welsey Lubbock, 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) corms provlaea Dy l exas ttnlcs c;ommisslon www.etnlcs.state.tx.us Version V1.1.191b5cdc CERTIFICATE OF INTERESTED PARTIES FORM 1295 iota Complete Nos, 1- 4 and 6 it there are interested parties. 7-7 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. 2022-921112 Bruckner Truck Sales Inc Lubbock, TX United States Date Filed: 08/11/2022 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. 16720 Heavy duty truck and trailer parts and service 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Bruckner, Brian Amarillo, TX United States X Bruckner, Chris Amarillo, TX United States X Moody, James Amarillo, TX United States X McCambell, Chip Amarillo, TX United States X Murphy, Brian Amarillo, TX United States X Barton, Welsey Lubbock, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION r� } My name is W P- e l� 1� YG ( !`� ) and my date of birth is My address is F �cl _ �,�1 L&Vo -C Y, Tx- -� 9 40LI A (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed inL... ul o l oci( County, State of�CXa S on the day of 2012a. {m� (year) 1 0l authorized agent of contracting business entity (Declarant) F-orms proviaea By Texas Etnics Commission www.ethics.state.tx.us Version V1.1.191b5cdc Cheryl Brock Changed On Description Before 07/21/2022 Geo Rules Caller Type None 07/21/2022 Completed No 07/21/2022 Complete Date [none] 07/21/2022 Item Review Status ID Under Review 07/21/2022 Passed No 07/21/2022 Submittal Status ID Under Review 08/04/2022 Geo Rules Caller Type None 08/04/2022 Completed No 08/04/2022 Complete Date [none] 08/04/2022 Item Review Status ID Under Review 08/04/2022 Passed No 08/04/2022 Submittal Status ID Under Review Jill MacDougall Changed On Description Before 07/21/2022 Geo Rules Caller Type None 07/21/2022 Plan Note added 07/21/2022 Assigned User ID 07/21/2022 Completed 07/21/2022 Complete Date 07/21/2022 Item Review Status ID 07/21/2022 Passed 07/21/2022 Submittal Status ID 08/01/2022 Geo Rules Caller Type 08/01/2022 Plan Note added 08/01/2022 Assigned User ID 08/01/2022 Completed 08/01/2022 Complete Date After Submittal —Received Yes 7/21 /2022 Approved Yes Approved Submittal —Received Yes 8/4/2022 Approved Yes Requires Resubmission After Submittal —Received Morrison, Lainey MacDougall, Jill No Yes [none] 7/21/2022 Under Review Approved No Yes Under Review Approved None Submittal —Received Morrison, Lainey MacDougall, Jill No Yes [none] 8/1/2022 Current Balance Cost of Good/Services Additional Info $193,539.00 $50,000.00 Plan (PUR-2022-16720) $193,539.00 $50,000.00 Plan Submittal Item Review (Budget Director) $193,539.00 $50,000.00 Plan Submittal Item Review (Budget Director) $193,539.00 $50,000.00 Plan Submittal Item Review (Budget Director) $193,539.00 $50,000.00 Plan Submittal Item Review (Budget Director) $193,539.00 $50,000.00 Plan submittal text: (7/19/2022) $193,539.00 $50,000.00 Plan (PUR-2022-16720) $193,539.00 $50,000.00 Plan Submittal Item Review (Budget Director) $193.539.00 $50,000.00 Plan Submittal Item Review (Budget Director) $193,539.00 $50,000.00 Plan Submittal Item Review (Budget Director) $193,539.00 $50,000.00 Plan Submittal Item Review (Budget Director) $193,539.00 $50,000.00 Plan submittal text: (8/1/2022) Current Balance Cost of Good/Services Additional Info $193,539.00 $50,000.00 Plan (PUR-2022-16720) $193,539.00 $50,000.00 Plan note text: (Insurance requirements are appropriate) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan submittal text: (7/19/2022) $193,539.00 $50,000.00 Plan (PUR-2022-16720) $193,539.00 $50,000.00 Plan note text: (Needs certificate of insurance for commercial general liability and auto liability coverages and the additional insured and waiver of subrogation endorsements for both of those policies) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) August 18, 2022 Page 1 of 2 08/01/2022 Item Review Status ID Under Review Requires Resubmission Lainey Morrison Changed On Description Before After 08/15/2022 Geo Rules Caller Type None Submittal —Received 08/15/2022 Completed No Yes 08/15/2022 Complete Date [none] 8/15/2022 08/15/2022 Item Review Status ID Under Review Approved 08/15/2022 Passed No Yes 08/15/2022 Submittal Status ID Under Review Approved $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) Current Balance Cost of Good/Services Additional Info $193,539.00 $50,000.00 Plan (PUR-2022-16720) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan Submittal Item Review (Risk Management Coordinator) $193,539.00 $50,000.00 Plan submittal text: (8/5/2022) August 18, 2022 Page 2 of 2