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HomeMy WebLinkAboutResolution - 2017-R0042 - Freese And Nichols - 02_09_2017Resolution No. 2017-R0042 Item No. 5.14 February 9, 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, a Professional Services Agreement for the construction of Pump Station Number 10, by and between the City of Lubbock and Freese and Nichols, Inc., 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 Februar; 9, 2017 DANIEL M. POPE, MAYOR ATTEST: Reb cca Garza, City Secret APPROVED AS TO CONTENT: P.E., Director of Public Works Xhn Turpin, P.Er Water Utilities Engineer APPROVED AS TO FORM: .a vw:ccdocs/RESTSA-Freese & Nichols, Inc. January 24, 2017 f Resolution No. 2017-R0042 CONTRACT NO. 13249 PROFESSIONAL SERVICES CONTRACT STATE OF TEXAS § COUNTY OF LUBBOCK § This contract, (the "Contract" or "Agreement"), effective as of the — day of, 2017 (the "Effective Date"), is by and between the City of Lubbock, (the "City"), a Texas home rule municipal corporation, and Freese and Nichols, Inc., ("ENGINEER") a Texas professional corporation authorized to conduct business in Texas. WITNESSETH WHEREAS, the City desires to obtain professional engineering services related to the General Construction Representation and Onsite Resident Representation for the construction of Pump Station Number 10 (the "Activities"); and WHEREAS, ENGINEER has a professional staff experienced and is qualified to provide professional engineering services related to Activities, and will provide the services, as defined below, for the price provided herein, said price stipulated by City and Engineer to be a fair and reasonable price; and WHEREAS, the City desires to contract with ENGINEER to provide professional engineering services related to the Activities and Engineer desires to provide the Services related to same. NOW THEREFORE, for and in consideration of the terms, covenants and conditions set forth in this Contract, the City and ENGINEER hereby agree as follows: ARTICLE I. TERM The term of this Contract commences on the Effective Date and continues without interruption for a term of 600 days, as set forth in Exhibit "A", attached to and made a part of this Agreement for all purposes. If the Engineer determines that additional time is required to complete the Services, the City Engineer, may , but is not obligated to, in his discretion, execute an agreement to grant up to an additional six (6) months of time so long as the amount of the consideration does not increase. An amendment to this agreement resulting in an increase in the amount of the consideration must be approved by the City acting through its governing body. FNI Professional Agreement Page 1 of 26 ARTICLE II. SERVICES AND COMPENSATION A. Engineer shall conduct all activities and within such timeframes as set forth on Exhibit "A", attached hereto (the "Services"). B. ENGINEER shall receive as consideration to be paid for the performance of the Services set forth in General, Basic Services, and Special Services based on hourly rates, not to exceed $1,230,248.00, per Exhibit "A", Exhibit "B", and Exhibit "C". ARTICLE III. TERMINATION A. General. City may terminate this Contract, for any reason or convenience, upon thirty (30) days written notice to ENGINEER. In the event this Agreement is so terminated, the City shall only pay Engineer for services actually performed by Engineer up to the date Engineer is deemed to have received notice of termination as provided herein. B. Termination and Remedies. In the event ENGINEER breaches any term and/or provision of this Contract, the City shall be entitled to exercise any right or remedy available to it by this Contract, at law, equity, or otherwise, including without limitation, termination of this Contract and assertion of an action for damages and/or injunctive relief. The exercise of any right or remedy shall not preclude the concurrent or subsequent exercise of any right or remedy and all other rights and remedies shall be cumulative. ARTICLE IV. NON - ARBITRATION The City reserves the right to exercise any right or remedy available 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 document, this provision shall control. ARTICLE V. REPRESENTATIONS AND WARRANTIES A. Existence. ENGINEER is a corporation duly organized, validly existing, and in good standing under the laws of the State of Texas and is qualified to carry on its business in the State of Texas. FNI Professional Agreement Page 2 of 26 B. Corporate Power. ENGINEER has the corporate power to enter into and perform this Contract and all other activities contemplated hereby. C. Authorization. Execution, delivery, and performance of this Contract and the activities contemplated hereby have been duly and validly authorized by all the requisite corporate action on the part of ENGINEER. This Contract constitutes legal, valid, and binding obligations of the ENGINEER and is enforceable in accordance with the terms thereof. D. Engineer. ENGINEER maintains a professional staff and employs, as needed, other qualified specialists experienced in providing the Services, and are familiar with all laws, rules, and regulations, both state and federal, including, without limitation the applicable laws, regarding the activities contemplated hereby. E. Performance. ENGINEER will and shall conduct all activities contemplated by this Contract in accordance with the standard of care, skill and diligence normally provided by a professional person in performance of similar professional engineering services, and comply with all applicable laws, rules, and regulations, both state and federal, relating to professional engineering services, as contemplated hereby. F. Use of Copyrighted Material. ENGINEER warrants that any materials provided by ENGINEER for use by City pursuant to this Contract shall not contain any proprietary material owned by any other party that is protected under the Copyright Act or any other law, statute, rule, order, regulation or ordinance relating to the use or reproduction of materials. ENGINEER shall be solely responsible for ensuring that any materials provided by ENGINEER pursuant to this Contract satisfy this requirement and ENGINEER agrees to indemnify and hold City harmless from all liability or loss caused to City or by to which City is exposed on account of ENGINEER's failure to perform this duty. ARTICLE VI. SCOPE OF WORK ENGINEER shall accomplish the following: Professional Engineering Services related to the General and Onsite Construction Representation of the Pump Station Number 10, as defined and provided in Exhibits "A, B and C". FNI Professional Agreement Page 3 of 26 ARTICLE VII. INDEPENDENT CONTRACTOR STATUS ENGINEER and City agree that ENGINEER shall perform the duties under this Contract as an independent contractor and shall be considered as independent contractor under this Agreement and/or in its activities hereunder for all purposes. ENGINEER has the sole discretion to determine the manner in which the services are to be performed. During the performance of the Services under this Agreement, Engineer and Engineer's employees and/or subconsultants, will not be considered, for any purpose, employees or agents of the City within the meaning or the application of any federal, state or local law or regulation, including without limitation, laws, rules or regulations regarding or related to unemployment insurance, old age benefits, workers compensation, labor, personal injury or taxes of any kind. ARTICLE Vlll. INSURANCE Engineer shall procure and carry, at its sole cost and expense through the life of this Agreement, except as otherwise provided herein, insurance protection as hereinafter specified, in form and substance satisfactory to City, carried with an insurance company authorized to transact business in the state of Texas, covering all aspects and risks of loss of all operations in connection with this Agreement, including without limitation, the indemnity obligations set forth herein. Engineer shall obtain and maintain in full force and effect during the term of this Agreement, and shall cause each approved subcontractor or subconsultant of Engineer to obtain and maintain in full force and effect during the term of this Agreement, commercial general liability, professional liability and automobile liability coverage for non -owned and hired vehicles with insurance carriers admitted to do business in the state of Texas. The insurance companies must carry a Best's Rating of A-VII or better. All policies except Professional Liability will be written on per occurrence basis, subject to the following minimum limits of liability: Commercial General Liability: Per Occurrence Limit: $1,000,000 General Aggregate Limit: $2,000,000 Professional Liability: Combined Single Limit: $1,000,000 Automobile Liability: Combined Single Limit for any auto: $1,000,000 Per Occurrence Employer's Liability: $1,000,000 FNI Professional Agreement Page 4 of 26 Engineer shall further cause any approved subcontractor or subconsultant to procure and carry, during the term of this Agreement, Professional Liability coverage, as specified above for Engineer, protecting City against losses caused by the professional negligence of the approved subcontractor or subconsultant. The City shall be listed as a primary and noncontributory additional insured with respect to the Automobile Liability and Commercial General Liability and shall be granted a waiver of subrogation under those policies. Engineer shall provide a Certificate of Insurance to the City as evidence of coverage. Certificate shall provide 30 days notice of cancellation. A copy of the additional insured endorsement and waiver of subrogation attached to the policy will be included in the Certificate. Engineer shall elect to obtain worker's compensation coverage pursuant to Section 406.002 of the Texas Labor Code. Further, Engineer shall maintain said coverage throughout the term of this Agreement and shall comply with all provisions of Title 5 of the Texas Labor Code to ensure that the Engineer maintains said coverage. The Engineer may maintain Occupational Accident and Disability Insurance in lieu of Worker's Compensation. In either event, the policy must be endorsed to include a waiver of subrogation in favor of the City of Lubbock. If at any time during the life of the Agreement or any extension hereof, Engineer fails to maintain the required insurance in full force and effect, Engineer shall be in breach hereof and all work under the Agreement shall be discontinued immediately. Notwithstanding anything contained herein to the contrary, the professional liability policy shall be maintained, at Engineer's sole cost and expense. The retroactive date shall be no later than the commencement of the performance of this contract and the discovery period (possibly through tail coverage) shall be no less than ten (10) years after the completion of work specified in the contract. The provisions of this Article VIII shall survive the termination or expiration of this Agreement. ARTICLE IX. EMPLOYMENT OF AGENTS/RETAINING OF CONSULTANTS ENGINEER may employ or retain consultants, contractors, or third parties (any of which are referred to herein as "subconsultant"), to perform certain duties of ENGINEER, as set forth on Exhibit "A, B, and C", attached hereto, under this Contract, provided that City approves the retaining of Subconsultants. ENGINEER is at all times responsible to City to perform the Services as provided in this Agreement and ENGINEER is in no event relieved of any obligation under this Contract upon retainage of any approved Subconsultant. Any agent and/or Subconsultant retained and/or employed by ENGINEER shall be required by ENGINEER to carry, for the protection and benefit of the City and ENGINEER and naming said third parties as additional insureds, insurance as described above in this Contract. FNI Professional Agreement Page 5 of 26 ENGINEER represents that such services are either under applicable value thresholds or are otherwise exempt from notice and/or bid requirements under Texas Law. ARTICLE X. CONFIDENTIALITY ENGINEER 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. ARTICLE XI. INDEMNITY ENGINEER 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 ATTORNEY'S 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 ENGINEER, ITS AGENTS, EMPLOYEES, AND/OR SUBCONSULTANTS, RELATED TO THE PERFORMANCE, OPERATIONS OR OMISSIONS UNDER THIS CONTRACT AND/OR THE USE OF OCCUPATION OF CITY OWNED PROPERTY. THE INDEMNITY OBLIGATION PROVIDED HEREIN SHALL SURVIVE THE EXPIRATION OR TERMINATION OF THIS AGREEMENT. ARTICLE XII. COMPLIANCE WITH APPLICABLE LAWS ENGINEER shall comply with all applicable federal, state and local laws, statutes, ordinances, rules and regulations relating, in any way, manner or form, to the activities under this Contract, and any amendments thereto. ARTICLE XIII. NOTICE A. General. Whenever notice from ENGINEER to City or City to ENGINEER is required or permitted by this Contract and no other method of notice is provided, such notice shall be given by (1) actual delivery of the written notice to the other party by hand (in which case such notice shall be effective upon delivery); (2) facsimile (in which case such notice shall be effective upon delivery); or (3) by depositing the written notice in the United States mail, properly addressed to the other party at the address provided in this FNI Professional Agreement Page 6 of 26 article, registered or certified mail, return receipt requested, in which case such notice shall be effective on the third business day after such notice is so deposited. B. ENGINEER 's Address. ENGINEER 's address and numbers for the purposes of notice are: Freese and Nichols, Inc. Attn: Nick Lester, P.E. 4055 International Plaza, Suite 200 Fort Worth, Texas 76109 Telephone: (817) 735-7300 Facsimile: (817) 735-7491 C. City's Address. The City's address and numbers for the purposes of notice are: City of Lubbock Attn: John Turpin, P.E. P. 0. Box 2000 1625 13th Street Lubbock, Texas 79457 Telephone: (806) 775 — 2342 Facsimile: (806) 775 — 3344 D. Change of Address. Either party may change its address or numbers for purposes of notice by giving written notice to the other party as provided herein, referring specifically to this Contract, and setting forth such new address or numbers. The address or numbers shall become effective on the 15th day after such notice is effective. ARTICLE XIV. CITY -PROVIDED DATA City shall furnish ENGINEER non -confidential studies, reports and other available data in the possession of the City pertinent to ENGINEER's Services, so long as City is entitled to rely on such studies, reports and other data for the performance of ENGINEER's Services under this Contract (the "Provided Data"). ENGINEER shall be entitled to use and rely, so long as such reliance is reasonable, upon all such Provided Data. FNI Professional Agreement Page 7 of 26 ARTICLE XV. MISCELLANEOUS A. Captions. The captions for the articles and sections in this Contract are inserted in this Contract strictly for the parties' convenience in identifying the provisions to this Contract and shall not be given any effect in construing this Contract. B. Audit. ENGINEER shall provide access to its corporate books and records to the City. The City may audit, at its expense and during normal business hours, ENGINEER's books and records with respect to this Contract between ENGINEER and City. C. Records. ENGINEER shall maintain records that are necessary to substantiate the services provided by ENGINEER. City. D. Assignability. ENGINEER may not assign this Contract without the prior written approval of the E. Successor and Assigns. This Contract binds and inures to the benefit of the City and ENGINEER, and in the case of City, its respective successors, legal representatives, and assigns, and in the case of ENGINEER, its permitted successors and assigns. F. Construction and Venue. THIS CONTRACT SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS. THIS CONTRACT IS PERFORMABLE IN LUBBOCK COUNTY, TEXAS. THE PARTIES HERETO HEREBY IRREVOCABLY CONSENT TO THE SOLE AND EXCLUSIVE JURISDICTION AND VENUE OF THE COURTS OF COMPETENT JURISDICTION OF THE STATE OF TEXAS, COUNTY OF LUBBOCK, FOR THE PURPOSES OF ALL LEGAL PROCEEDINGS ARISING OUT OF OR RELATING TO THIS CONTRACT OR THE ACTIONS THAT ARE CONTEMPLATED HEREBY. G. Severability. If any provision of this Contract is ever held to be invalid or ineffective by any court of competent jurisdiction with respect to any person or circumstances, the remainder of this Contract and the application of such provision to persons and/or circumstances other than those with respect to which it is held invalid or ineffective shall not be affected thereby. FNI Professional Agreement Page 8 of 26 H. Amendment. No amendment, modification, or alteration of the terms of this Contract shall be binding unless such amendment, modification, or alteration is in writing, dated subsequent to this Contract, and duly authorized and executed by ENGINEER and City. Entire Agreement. This Contract, including Exhibits "A", "B", & "C" attached hereto, contains the entire Contract between the City and ENGINEER, and there are no other written or oral promises, conditions, warranties, or representations relating to or affecting the matters contemplated herein. J. No Joint Enterprise. Nothing contained herein shall be construed to imply a joint venture, joint enterprise, partnership or principal — agent relationship between ENGINEER and the City. K. Documents Owned by City. Any and all documents, drawings and specifications prepared by ENGINEER as part of the Services hereunder, shall become the property of the City when ENGINEER has been compensated as set forth in Article II, above. The ENGINEER shall make copies of any and all work products for its files. L. Notice of Waiver. A waiver by either City or ENGINEER of a breach of this Agreement must be in writing and duly authorized to be effective. In the event either party shall execute and deliver such waiver, such waiver shall not affect the waiving party's rights with respect to any other or subsequent breach. M. Third Party Activities. Nothing in this Agreement shall be construed to provide any rights or benefits whatsoever to any party other than City and ENGINEER. N. 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 non -appropriation of funds by the CITY Council of the CITY of Lubbock for the goods or services provided under this 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 for the then -current year for the services covered by this Contract is spent, whichever event occurs first (the "Non -Appropriation Date"). If at any 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 CITY shall not be obligated under this Contract beyond the Non -Appropriation Date. FNI Professional Agreement Page 9 of 26 EXECUTED as of the Effective Date hereof, ATTEST: Re ecca Garza, City Secreta APPROVED AS TO CONTENT: Michael G. Keenum, P.E., City Engineer es Engineer CITY OF LUBBOCK L"JV Daniel M. Pope, Mayor FREESE AND NICHOLS, INC. By: _ /� 4Ae Name: Nicholas Lester, P.E. Title: Vice President FNI Professional Agreement Page 10 of 26 *N:if1TY71 SCOPE OF SERVICES FOR: PUMP STATION NUMBER 10 GENERAL AND RESIDENT REPRESENTATION GENERAL: A. Pump Station Number 10 (The "Project") includes the following facilities: 1. One new 15 MGD vertical turbine in can pump station 2. Repair of existing partially buried ground storage tank 3. 24-48 inch yard piping and tie-ins 4. Demolition of existing Pump Station Number 10 5. Site grading, fence replacement, and concrete paving BASIC SERVICES: The Basic Services include the project administration, construction phase services, resident representation services during construction, startup services, commissioning, and personnel training as requested by the City (Sometimes referred to as "OWNER"). Engineer (Sometimes referred to as "FNI") shall render the following professional services in connection with the development of the Project: A. CONSTRUCTION PHASE: Upon completion of the bid or negotiation phase services, FNI will proceed with the performance of construction phase services as described below. FNI will endeavor to protect Owner in providing these services however, it is understood that FNI does not guarantee the Contractor's performance, nor is FNI responsible for supervision of the Contractor's operation and employees. FNI shall not be responsible for the means, methods, techniques, sequences or procedures of construction selected by the Contractor, or any safety precautions and programs relating in any way to the condition of the premises, the work of the Contractor or any Subcontractor. FNI shall not be responsible for the acts or omissions of any person (except its own employees or agents) at the Project site or otherwise performing any of the work of the Project. 1. Assist Owner in conducting pre -construction conference(s) with the Contractor(s), review construction schedules prepared by the Contractor(s) pursuant to the requirements of the construction contract, and prepare a proposed estimate of monthly cash requirements of the Project from information provided by the Construction Contractor. FNI Professional Agreement Page 11 of 26 2. Establish communication procedures with the Owner and contractor. Submit monthly reports of construction progress. Reports will describe construction progress in general terms and summarize project costs, cash flow, construction schedule and pending and approved contract modifications. 3. Establish and maintain a project documentation system consistent with the requirements of the construction contract documents. Monitor the processing of contractor's submittals and provide for filing and retrieval of project documentation. Produce monthly reports indicating the status of all submittals in the review process. Review contractor's submittals, including, requests for information, modification requests, shop drawings, schedules, and other submittals in accordance with the requirements of the construction contract documents for the projects. Monitor the progress of the contractor in sending and processing submittals to see that documentation is being processed in accordance with schedules. 4. Based on FNI's observations as an experienced and qualified design professional and review of the Payment Requests and supporting documentation submitted by Contractor, determine the amount that FNI recommends Contractor be paid on monthly and final estimates, pursuant to the General Conditions of the Construction Contract. 5. Make two site visits per month to observe the progress and the quality of work and to attempt to determine in general if the work is proceeding in accordance with the Construction Contract Documents. In this effort FNI will endeavor to protect the Owner against defects and deficiencies in the work of Contractors and will report any observed deficiencies to Owner. Visits to the site in excess of the specified number are an additional service. 6. Notify the contractor of non -conforming work observed on site visits. Review quality related documents provided by the contractor such as test reports, equipment installation reports or other documentation required by the Construction contract documents. 7. Coordinate the work of testing laboratories and inspection bureaus required for the testing or inspection of materials, witnessed tests, factory testing, etc. for quality control of the Project. 8. Interpret the drawings and specifications for Owner and Contractor(s). Investigations, analyses, and studies requested by the Contractor(s) and approved by Owner, for substitutions of FNI Professional Agreement Page 12 of 26 equipment and/or materials or deviations from the drawings and specifications is an additional service. 9. Establish procedures for administering constructive changes to the construction contracts. Process contract modifications and negotiate with the contractor on behalf of the Owner to determine the cost and time impacts of these changes. Prepare change order documentation for approved changes for execution by the Owner. Documentation of field orders, where cost to Owner is not impacted, will also be prepared. Investigations, analyses, studies or design for substitutions of equipment or materials, corrections of defective or deficient work of the contractor or other deviations from the construction contract documents requested by the contractor and approved by the Owner are an additional service. Substitutions of materials or equipment or design modifications requested by the Owner are an additional service. 10. Prepare documentation for contract modifications required to implement modifications in the design of the project. Receive and evaluate notices of contractor claims and make recommendations to the Owner on the merit and value of the claim on the basis of information submitted by the contractor or available in project documentation. Endeavor to negotiate a settlement value with the Contractor on behalf of the Owner if appropriate. Providing these services to review or evaluate construction contractor(s) claim(s), supported by causes not within the control of FNI are an additional service. 11. Assist in the transfer of and acceptance by the construction contractor of any Owner furnished equipment or materials. 12. Conduct, in company with Owner's representative, a final review of the Project for conformance with the design concept of the Project and general compliance with the Construction Contract Documents. Prepare a list of deficiencies to be corrected by the contractor before recommendation of final payment. Assist the City in obtaining legal releases, permits, warranties, spare parts, and keys from the contractor. Review and comment on the certificate of completion and the recommendation for final payment to the Contractor(s). Visiting the site to review completed work in excess of two trips are an additional service. 13. Revise the construction drawings in accordance with the information furnished by construction Contractor(s) reflecting changes in the Project made during construction. Five (5) half -sized FNI Professional Agreement Page 13 of 26 sets and Two (2) full-sized sets of prints of "Record Drawings" shall be provided by FNI to Owner. SPECIAL SERVICES: FNI shall render the following special services in connection with The Project: A. MATERIALS TESTING: FNI will retain and monitor and direct, through a subcontract, the efforts of a construction materials testing firm (CMT) to perform the following testing services on an as needed basis including but not limited to: 1. Soil proctors and nuclear density testing 2. Embedment material proctors and nuclear density testing 3. Flexible base proctors and nuclear density testing 4. Concrete cylinders and testing (slump, entrained air content, temperature, compression testing) 5. Asphalt sampling, cores, and nuclear density testing if required 6. Other testing or special inspection as needed 7. General administration and project management FNI Professional Agreement Page 14 of 26 TIME OF PERFORMANCE: FNI is authorized to commence work on The Project upon execution of this AGREEMENT and agrees to complete the services in accordance with the following schedule: • 600 calendar days from the Notice to Proceed. If FNI's services are delayed through no fault of FNI, FNI shall be entitled to adjust contract schedule consistent with the number of days of delay. In the event FNI asserts that it is entitled to additional time, it shall provide notice to the OWNER as soon as reasonably practicable after the event allegedly causing such delay shall occur ("Delay Event"), but in no event to exceed five (5) business days after the occurrence of the Delay Event. FNI shall use and exercise all diligence to promptly remove or remediate such Delay Event. In the event notice of the Delay Event shall not be provided as prescribed herein, FNI shall not be entitled to relief from schedule as provided in this AGREEMENT. These delays may include but are not limited to delays in OWNER or regulatory reviews, delays on the flow of information to be provided to FNI, except any delays occasioned by subcontracts or sub consultants of FNI, and governmental approvals. These delays may result in an adjustment to compensation. FNI Professional Agreement Page 15 of 26 EXHBIT A, PART 2, ADDITIONAL SERVICES PUMP STATION NUMBER 10 GENERAL AND RESIDENT REPRESENTATION ADDITIONAL SERVICES: Additional Services to be performed by FNI, if authorized by Owner, which are not included in the above described General Service, Basic Services, and Special Services, are, except as may otherwise provided to be performed by FNI, described as follows: A. Field layouts or the furnishing of construction line and grade surveys. B. Providing services to investigate existing conditions or facilities, or to make measured drawings thereof, or to verify the accuracy of drawings or other information furnished by Owner. C. Providing renderings, model, and mock-ups requested by the Owner. D. Making revisions to drawings, specifications or other documents when such revisions are 1) not consistent with approvals or instructions previously given by Owner or 2) due to other causes not solely within the control of FNI. E. Providing consultation concerning the replacement of any Work damaged by fire or other cause during the construction, and providing services as may be required in connection with the replacement of such Work. F. Investigations involving consideration of operation, maintenance and overhead expenses, and the preparation of rate schedules, earnings and expense statements, feasibility studies, appraisals, evaluations, assessment schedules, and material audits or inventories required for certification of force account construction performed by Owner. G. Preparing applications and supporting documents for government grants, loans, or planning advances and providing data for detailed applications. H. Providing shop, mill, field or laboratory inspection of materials and equipment. Observe factory tests of equipment at any site remote to the project or observing tests required as a result of equipment failing the initial test. I. Preparing Operation and Maintenance Manuals or conducting operator training. J. Preparing data and reports for assistance to Owner in preparation for hearings before regulatory agencies, courts, arbitration panels or any mediator, giving testimony, personally or by deposition, and preparations therefore before any regulatory agency, court, arbitration panel or mediator. FNI Professional Agreement Page 16 of 26 K. Assisting Owner in preparing for, or appearing at litigation, mediation, arbitration, dispute review boards, or other legal and/or administrative proceedings in the defense or prosecution of claims disputes with Contractor(s). L. Performing investigations, studies and analyses of substitutions of equipment and/or materials or deviations from the drawings and specifications. M. Assisting Owner in the defense or prosecution of litigation in connection with or in addition to those services contemplated by this AGREEMENT. Such services, if any, shall be furnished by FNI on a fee basis negotiated by the respective parties outside of and in addition to this AGREEMENT. This provision shall not apply to any expense related to a legal action to which FNI is a party. N. Providing environmental support services including the design and implementation of ecological baseline studies, environmental monitoring, impact assessment and analyses, permitting assistance, and other assistance required to address environmental issues. O. Performing investigations, studies, and analysis of work proposed by construction contractors to correct defective work. P. Design, contract modifications, studies or analysis required to comply with local, State, Federal or other regulatory agencies that become effective after the date of this agreement. Q. Services required to resolve bid protests or to rebid the projects for any reason other than fault of any type or degree of FNI. R. Visits to the site in excess of the number of trips included in the General Services, Basic Services, or Special Services for periodic site visits, coordination meetings, or contract completion activities. S. Any service required as a result of default of the contractor(s) or the failure, for any reason, of the contractor(s) to complete work within the contract time. T. Providing services after the completion of the construction phase not specifically listed in Article I. U. Providing services made necessary because of unforeseen, concealed, or differing site conditions or due to the presence of hazardous substances in any form, except as noted in the scope of services. V. Providing value engineering studies or reviews of cost savings proposed by others. W. Prepurchase or preselection or any alternate contract structure or number of contracts other than stipulated in Exhibit A — Basic Services. FNI Professional Agreement Page 17 of 26 X. Provide any services after the satisfactory conclusion and completion of the General Services, Basic Services, and Special Services of the Project. Y. Provide follow-up professional services during Contractors warranty period. FNI Professional Agreement Page 18 of 26 EXHBIT A, PART 3, RESPONSIBILITIES OF THE OWNER PUMP STATION NUMBER 10 GENERAL AND RESIDENT REPRESENTATION RESPONSIBILITIES OF OWNER: Owner shall perform the following in a timely manner so as not to delay the services of FNI: A. Owner recognizes and expects that certain Change Orders, herein so called, may be required. Any responsibility of Engineer for the costs of Covered Changed Orders will be determined on the basis of applicable contractual obligations and professional liability standards. For purposes of this paragraph, the responsibility of Engineer for the costs of Change Orders will not include: • any costs that Owner would have incurred if the Change Order work had been included originally in the Contract Documents and its lack of inclusion was not due, in whole or in part, to any fault, error, or omission of Engineer related thereto, • Any costs that are due to unforeseen site conditions, or • Any costs that are due to changes made by the Owner. • Any costs that are incurred due to the negligence of the construction contractor Wherever used in this document, the term Engineer includes Engineer's officers, directors, partners, employees, agents, and Engineers Consultants. B. Designate in writing a person to act as Owner's representative with respect to the services to be rendered under this AGREEMENT. Such person shall have contract authority to transmit instructions, receive information, interpret and define Owner's policies and decisions with respect to FNI's services for the Project. C. Provide all criteria and full information as to Owner's requirements for the Project, including design objectives and constraints, space, capacity and performance requirements, flexibility and expandability, and any budgetary limitations; and furnish copies of all design and construction standards which Owner will require to be included in the drawings and specifications. FNI Professional Agreement Page 19 of 26 D. Assist FNI by placing at FNI's disposal all available information pertinent to the Project including previous reports and any other data relative to design or construction of the Project as provided in this AGREEMENT. E. Arrange for access to and make all provisions for FNI to enter upon public and private property as required for FNI to perform services under this AGREEMENT. F. Examine all studies, reports, sketches, drawings, specifications, proposals and other documents presented by FNI, obtain advice of an attorney, insurance counselor and other consultants as Owner deems appropriate for such examination and render in writing decisions pertaining thereto within a reasonable time so as not to delay the services of FNI. G. Furnish approvals and permits from all governmental authorities having jurisdiction over the Project and such approvals and consents from others as may be necessary for completion of the Project, except as otherwise the responsibility of FNI as provided in this AGREEEMENT. H. Attend the pre -bid conference, bid opening, preconstruction conference, construction progress and otherjob related meetings and substantial completion inspections and final payment inspections. Give prompt written notice to FNI whenever Owner observes or otherwise becomes aware of any development that affects the scope or timing of FNI's services. Furnish, or direct FNI to provide, Additional Services as stipulated in Exhibit "A," Part 2, if deemed necessary by Owner. K. Bear all costs incident to compliance with the requirements of this Exhibit "A", Part 3. L, Provide the following services, unless provided specifically otherwise in this Agreement: a. Pay all permits fees and mitigation cost. b. Provide advertisement for bids in local publications as required. FNI Professional Agreement Page 20 of 26 EXHIBIT B — BUDGET PUMP STATION NUMBER 10 GENERAL AND RESIDENT REPRESENTATION CITY and ENGINEER have established a not -to -exceed budget of $1,230,248.00 to complete all services under this AGREEMENT. This amount will not be exceeded without a contract amendment. CITY will pay the ENGINEER hourly, for services identified in Exhibit A, based on ENGINEERS Fee Schedule presented as EXHIBIT D. Subconsultant services will be billed at cost to ENGINEER with a 10 percent handling fee. The Budget is presented for the services of ENGINEER under this AGREEMENT are provided in this Exhibit B. CITY and ENGINEER agree to allow redistribution of funds between Tasks as appropriate to allow flexibility in providing the needed services within the not -to -exceed budget. ENGINEER agrees to complete these services as delineated above. Should there be a Change in Scope of Work or Time of Performance, then this can result in an amendment to this contract which shall be negotiated at that time. The budget assumes that all work will be completed within 625 calendar days from the Notice to Proceed. FNI Professional Agreement Page 21 of 26 EXHIBIT C, PROJECT REPRESENTATION PUMP STATION 10 GENERAL AND RESIDENT REPRESENTATION A. The ENGINEER will provide the following construction phase staff for construction of Pump Station 10 as follows: Resident Project Rep Resident Project Rep 55 hours per week for 31 weeks 60 hours per week for 48 weeks Specialty Inspection and Commissioning Assistance 200 hours as necessary B. The ENGINEER will have a Resident Project Representative on the Site. The duties, responsibilities and the limitations of authority of the Resident Project Representative, and designated assistants, are as follows: 1. Resident Project Representative is ENGINEER's agent at the site, will act as directed by and under the supervision of ENGINEER, and will confer with ENGINEER regarding Resident Project Representative's actions. Resident Project Representative's dealings in matters pertaining to the on -site Work shall in general be with ENGINEER and CONTRACTOR, keeping Owner advised as necessary. Resident Project Representative's dealings with Subcontractors shall only be through or with full knowledge and approval of CONTRACTOR. Resident Project Representative shall generally communicate with Owner with the knowledge of and under the direction of ENGINEER. C. Duties and Responsibilities of Resident Project Representative: 1. Schedules: Review the progress schedule, schedule of Shop Drawing submittals and schedules of values prepared by CONTRACTOR and consult with ENGINEER concerning acceptability. 2. Conferences and Meetings: Attend meetings with CONTRACTOR, such as preconstruction conferences, progress meetings, job conferences and other project - related meetings, and prepare and circulate copies of minutes thereof. 3. Liaison: a. Serve as ENGINEER's liaison with CONTRACTOR, working principally through CONTRACTOR's superintendent and assist in understanding the intent of Contract FNI Professional Agreement Page 22 of 26 Documents; and assist ENGINEER in serving as Owner's liaison with CONTRACTOR when CONTRACTOR's operations affect Owner's on -site operations. b. Assist in obtaining from Owner additional details or information, when required for proper execution of the Work. 4. Shop Drawings and Samples: a. Receive Samples which are furnished at the Site by CONTRACTOR, and notify ENGINEER of availability of Samples for examination. b. Advise ENGINEER and CONTRACTOR of the commencement of any Work requiring a Shop Drawing or Sample if the submittal has not been approved by ENGINEER. 5. Review of Work, Rejection of Defective Work, Inspections and Tests: a. Conduct on -site observations of the Work in progress to determine if the Work is in general proceeding in accordance with the Contract Documents. b. Report to ENGINEER whenever Resident Project Representative believes that any Work will not produce a completed Project that conforms generally to the Contract Documents or will prejudice the integrity of the design concept of the completed Project as a functioning whole as indicated in the Contract Documents, or has been damaged, or does not meet the requirements of any inspection, test or approval required to be made; and advise ENGINEER of Work the Resident Project Representative believes should be corrected or rejected or should be uncovered for observation, or requires special testing, inspection or approval. C. Verify that tests, equipment and systems start-up and operating and maintenance training are conducted in the presence of appropriate personnel, and the CONTRACTOR maintains adequate records thereof; and observe record and report to ENGINEER appropriate details relative to the test procedures and start-ups. d. Accompany visiting inspectors representing public or other agencies having jurisdiction over the Project, record the results of these inspections and report to ENGINEER. 6. Interpretation of Contract Documents: Report to ENGINEER when clarifications and interpretations of the Contract Documents are needed and transmit to CONTRACTOR clarifications and interpretations as issued by ENGINEER. FNI Professional Agreement Page 23 of 26 7. Request for Revisions: Consider and evaluate CONTRACTOR's suggestions for revisions to Drawings or Specifications and report with Resident Project Representative's recommendations to ENGINEER. Transmit to CONTRACTOR in writing decisions as issued by ENGINEER. 8. Records: a. Maintain at the job site orderly files for correspondence, reports of job conferences, Shop Drawings and Samples, reproductions of original Contract Documents, including all Work Change Directives, Addenda, Change Orders, Field Orders, Written Amendments, additional Drawings issued subsequent to the execution of the Contract, ENGINEER's clarifications and interpretations of the Contract Documents, progress reports, submittals and correspondence received from and delivered to CONTRACTOR and other Project related documents. 9. Reports: a. Furnish to ENGINEER periodic reports as required of progress of the work and of CONTRACTOR's compliance with the progress schedule and schedule of Shop Drawings and Sample submittals. b. Consult with ENGINEER in advance of scheduled major tests, inspections or start of important phases of the Work. C. Draft proposed Written Amendments, Change Orders and Work Change Directives, obtaining backup material from CONTRACTOR and recommend to ENGINEER Written Amendments, Change Orders, Work Change Directives, and Field Orders. d. Report immediately to ENGINEER and Owner the occurrence of any accident. 10. Payment Requests: Review Applications for Payment with CONTRACTOR for compliance with the established procedure for their submission and forward with recommendations to Owner, noting particularly the relationship of the payment requested to the schedule of values, Work completed and materials and equipment at the Site but not incorporated in the Work. 11. Certificates, Maintenance and Operation Manuals: During the course of the Work, verify that certificates, maintenance and operation manuals and other data required to be assembled and furnished by CONTRACTOR are applicable to the items actually FNI Professional Agreement Page 24 of 26 installed and in accordance with the Contract Documents, and have this material delivered to ENGINEER for review and forwarding to Owner prior to final payment for the Work. 12. Completion: a. Before ENGINEER issues a Certificate of Substantial Completion, submit to CONTRACTOR a list of observed items requiring completion or correction. b. Observe whether CONTRACTOR has performed inspections required by laws or regulations, ordinances, codes or order applicable to the Work, including but not limited to those to be performed by public agencies having jurisdiction over the Work. C. Conduct a final inspection in the company of ENGINEER, Owner and CONTRACTOR and prepare a final list of items to be completed or corrected. d. Observe whether all items on final list have been completed or corrected and make recommendations to ENGINEER concerning acceptance. D. Limitations of Authority of Resident Project Representative: 1. Shall not authorize any deviation from the Contract Documents or substitution of materials or equipment (including "or -equal" items), unless authorized by ENGINEER. 2. Shall not exceed limitations of ENGINEER's authority as set forth in Agreement or the Contract Documents. 3. Shall not undertake any of the responsibilities of CONTRACTOR, Subcontractor, Suppliers, or CONTRACTOR's superintendent. 4. Shall not advise on, issue directions relative to or assume control over any aspect of the means, methods, techniques, sequences or procedures of construction unless such advice or directions are specifically required by the Contract Documents. S. Shall not advise on, issue directions regarding or assume control over safety precautions and programs in connection with the Work or any activities or operations of Owner or CONTRACTOR. 6. Shall not accept shop drawing or sample submittals from anyone other than the CONTRACTOR. 7. Shall not participate in specialized field or laboratory tests or inspections conducted by others, except as specifically authorized by ENGINEER. FNI Professional Agreement Page 25 of 26 EXHIBIT D, HOURLY RATE SCHEDULE COMPENSATION PUMP STATION 10 GENERAL AND RESIDENT REPRESENTATION COMPENSATION Not to Exceed: Compensation to FNI for Basic Services in Exhibit A shall be computed on the basis of the Schedule of Charges, but shall not exceed One Mllrion Two Hundred Thirty Thousand Two Hundred Forty -Eight Dollars ($1,230,248.00). If FNI sees the Scope of Services changing so that Additional Services are needed, including but not limited to those services described as Additional Services in Exhibit A, FNI will notify CITY for CITY's approval before proceeding. Additional Services shall be computed based on the Schedule of Charges. Schedule of Charges: Position Rate Position Rate PRINCIPAL 389 3D VISUALIZATION COORDINATOR 190 GROUP MANAGER 272 ENVIRONMENTAL SCIENTIST VII 243 ENGINEER V,11 295 ENVIRONMENTAL SCIENTIST VI 212 ENGINEER VII 289 ENVIRONMENTAL SCIENTIST V 179 ENGINEER VI 251 ENVIRONMENTAL SCIENTIST IV 156 ENGINEER V 196 ENVIRONMENTAL SCIENTIST III 134 ENGINEER N 179 ENVIRONMENTAL SCIENTIST 11 94 ENGINEER III 159 ENVIRONMENTAL SCIENTIST 1 93 ENGINEER II 150 ARCHITECT VI 214 ENGINEER 124 ARCHITECTV 194 ELECTRICAL ENGINEER VI 238 ARCHITECT N 156 ELECTRICAL ENGINEER V 192 ARCHITECT III 150 ELECTRICAL ENGINEER N 158 ARCHITECT 11 121 ELECTRICAL ENGINEER III 145 ARCHITECT 1 104 ELECTRICAL ENGINEER 11 140 PLANNER VI 226 ELECTRICAL ENGINEER 1 133 PLANNER V 174 MECHANICAL ENGINEER VI 228 PLANNER N 137 MECHANICAL ENGINEER V 202 PLANNER III 125 MECHANICAL ENGINEER N 177 PLANNER I 103 MECHANICAL ENGINEER III 156 HYDROLOGIST V 196 PROGRAM MANAGER 11 233 HYDROLOGIST N 154 CONSTRUCTION CONTRACT ADMIN III (Manager) 195 HYDROLOGIST 111 142 CONSTRUCTION CONTRACT ADMIN III (Spec. Insp) 180 HYDROLOGIST II 130 CONSTRUCTION CONTRACT ADMIN III (CM) 145 SENIOR GEOLOGIST 152 CONSTRUCTION CONTRACT ADMIN III (RPR) 111 GEOTECHNICAL ENGINEER VI 251 CONSTRUCTION CONTRACTADMW 8 (RPR) 126 PUBLIC INVOLVEMENT COORDINATOR 143 CONSTRUCTION CONTRACT ADMIN 1(DCS 11) 118 WEB SERVICES ADMINISTRATOR 167 CONSTRUCTION CONTRACTADMIN I (DCS) 106 WORD PROCESSINGISECRETARIAL 86 DOCUMENTCONTROL CLERK 110 OPERATIONS ANALYST 155 SR DESIGNER 197 CONTRACT ADMINISTRATOR 98 DESIGNER II 168 INFORMATION SERVICES ADMINISTRATOR 85 DESIGNER 1 141 INFORMATION SERVICES CLERK III 67 CADD DESIGNER 168 INFORMATION SERVICES CLERK II 63 TECHNICIAN N 145 INFORMATION SERVICES CLERK 1 62 TECHNICIAN III 115 CO-OP 75 TECHNICIAN II 96 STORMWATER ENGINEER VII 215 TECHNICIAN 1 74 STORMWATER ENGINEER VI 198 GIS COORDINATOR 148 STORMWATER ENGINEER V 175 GIS ANALYST IV 138 STORMWATER ENGINEER N 150 GIS ANALYST III 114 STORMWATER ENGINEER 111 131 GIS ANALYST II 97 STORMWATER ENGINEER II 113 GIS ANALYST 1 75 STORMWATER ENGINEER I IDS Rates for In -House Services Technology Charge Bulk Printing and Reproduction $8.50 per hour Black and White $0.10 per copy Color $0.25 per copy Travel Plot - Bond $2.50 per plot Standard IRS Rates Plot - Color $5.75 per plot Plot - Other $5.00 per plot Binding $0.25 per binding OTHER DIRECT EXPENSES: Other direct expenses are reimbursed at actual cost times a multiplier of 1.10. They include outside printing and reproduction expense, communication expense, travel, transportation and subsistence away from the FNI office and other miscellaneous expenses directly related to the work, including costs of laboratory analysis, test, and other work required to be done by independent persons other than staff members. For Resident Representative services performed by non-FNI employees and CAD services performed In-house by non-FNI employees where FNI provides workspace and equipment tD perform such services, these services will be billed at cost times a multiplier of 2.0. This markup aDoroxmates the cost to FNI if an FNI emplovee was Derformino the same or sirnilar services. These ranges and rates will be adjusted annually in February. LUB15 FNI Professional Agreement Page 26 of 26 F— —i Mkhole, t— City of Lubbock P tet Fap summmy PS 10 Genital Rtpr "nUdlon 504,4N 1wrAle Mulled Coen Brtakdown Pow Project is 504 40. ®® � ■!r�•:,.�,,,�.�.-,,�.,.....,�,., ��..,..,.�,., � ,. ...,�. � ,,..,��,. ,..�,.!.:.... .......�, =iG>•�>•������iy����r�:�F.iliE2'lE�]ii17F,�E:�blk?C7 iT.'�l•�Gl•�t�ii��fit�t:7f�*f,��r�YSSRiLi:Li7L'��7F�[�LkTifl �� .:.......:...... ..r:,.,,�!. �����Y:��r�t!i�f�•�f�r ��ltF�il��fir�iF.�F�Rr?7L�i�7��i7�i7 �� .:.. ..... ...:...,.. :.....,,... •......, ..,.:,....,,. iGliC51•iiat•��f�fl��������i1iJr�aiZlt [ilL:Li7F�F�R#:k?:1 f�fiq,. ,� „_, �u,.,. �..,.. iL�f�!1•f:Gt•fif'fil•fif'fi�1•fi�1��f�f�iT•Lt•lE�3?:1F��:T.:TwEtSF�F�L•1<FL7 mm Prkd S • Print S Pdnt Shop - Pnnt Shop - Print Shop - hop hoP- PdMShop- EqW— t 7oltl Eap Phw 7ok Fsptneee Tern CherOe Blndh10 R&W C04. PbHU. PbOer- PloOer- MYae Travel Renal Hates Mi Other Other Effort I r! t.Ckait Story. No Flash. Load Flow & MotDr Starting I 1201 I I I I I I I I I I 2500 I I IS 3,7701 L\ReeerrrceetOLCRILtLubbwMPS 010 Cor Umbon Rep1PS 10 Generet Rep -Poe Spreadnroet 1111rt01 i Fraaea and Nkhela: Inc. UI ProjW F" Summafy Puap &atbn`10 E k 725013 1T11Jf2018 g Ua�dCoatenwkdawR Total Protect is 725,f11J IPt.- I Tnk I Employee I W W+ - I rw' I Thal Labor I Thal H prow Total H_ Effort E Total S b Effort TW41 Effrt o 8111 ��.:::.:: • c �t,7fiS7�����������Fi�1FiG1 - �:S�t�7��e�d�eeeSIfIT1�t1F?!T.1- rnrmadr++,!s�;lr-r.±-fr:rl--c.rrn�;�7E�[�[�F�E�E�F�E�E�F�F�F�� • E�iiF�'.i'IE�E�E�E�E�E�E�E�E�E�E�E�E�O L:1Ro—r—%OLCRLLLLubbockW3 Nt0 Conebuclbn RepWSfO Fee Spreadeheel•NCL Edit to W017 CERTIFICATE OF INTERESTED PARTIES FORM 1295 lofl 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. 2017-157763 Freese and Nichols, Inc. Fort Worth, TX United States Date Filed: 01/24/2017 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 Date Acknowledged: 02/07/2017 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. Contract No. 13249 Construction Representation for Pump Station Number 10 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling Intermediary Hatley, Tricia Fort Worth, TX United States X New, John San Antonio, TX United States X Payne, Jeff Dallas, TX United States X Milrany, Cindy Fort Worth, TX United States X Nichols, Mike Fort Worth, TX United States X Coltharp, Brian Fort Worth, TX United States X Pence, Robert Fort Worth, TX United States X Gooch, Tom Fort Worth, TX United States X Herchert, Robert Fort Worth, 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 V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1- 4 and 6 N there are Interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 9 there are no Interested parties. CERTIFICATION OF FILING Certificate Number. i Name of business entity filing form, and the city, state and country of the business entity's place of business. 2017-157763 Freese and Nichols, Inc. Fort Worth, TX United States Date Filed: OL2412017 • of govemm •n or state agency OW is a party to dii contract for aZ the form being flied. City of Lubbock ]Date Acknowledged. 3 Provide the Identification number used by tit• governmental entity or state agency to track or ldenttfy the contract, and provide a description of the services, goods, or other property to be provided under the contract. Contract No.13249 Construction Representation for Pump Station Number 10 4 Nature of interest Name of Interested Party City, State, Country (place of business) (dock applicable) Controlling Hadley, Tdcla Fort Worth, TX United States X New , John San Antonio, TX United States X Payne, Jeff Dallas, TX United States X Miintny, Cindy Fort Worth, TX United States X Nichols, Mike Fort Worth, TX United States X CoMu", Brian Fort Worth, TX United States X Pence, Robert Fort Worth, TX United States X Gooch, Tom Fort Worth, TX United States X Herchert, Robert Fort Worth, TX United States X 5 Check only If there Is NO 1nEeirested Party. ❑ - 5 AFFIDAVIT I swear, or of irm, under penalty of perjury, that the above disclosure Is true and comet IKLY JEAN VE Nawypdk SMOPTIEW (91* CMIL 4to" of audwft gent of : l bs ni"entry AFM NOTARY STAMP / SEAL ABOVE Sworn to and mrbaatbed before me, by the said Susanne M. Johnson tide rite 24th day of January 2017 to rmft which, witness my hand ant seal of office. ' f Publig "NaffZ�o M" isntdng oath Prleted name of officer eft oath Tide of ufff w adrrdr>tsa ft oath Form provided by Texas Eth Commission www.ethlcs.state.txta Version VL0.277