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HomeMy WebLinkAboutResolution - 2017-R0113 - O'tool Plastic Pipe, Inc. - 03_23_2017Resolution No. 2017-RO 113 Item No. 6.9 March 23, 2017 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute for and on behalf of the City of Lubbock, Contract No. 13141 and related documents for irrigation parts and PVC supplies as per ITB 17-13141-KM, by and between the City of Lubbock and O'Tool Plastic Pipe, Inc., of Lubbock, Texas. 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; Rebe ca Garza, City SecrelaU APPROVED AS TO CONTENT: <S"kS V%A Scott Snider, Assistant City Manager APPROVED AS TO FORM: 1 Justi rui , Assi tant City Attorney March 23, 2017 DANIEL M. POPE, MAYOR ccdocs/RES. Contract 13141 — O'Tool Plastic Pipe, Inc. — Irrigation Parts & PVC Supplies February 2, 2017 Resolution No. 2017-RO113 CONTRACT NO. 13141 CITY OF LUBBOCK, TX IRRIGATION PARTS AND PVC SUPPLIES THIS CONTRACT made and entered into this 23rd day of March, 2017, by and between the City of Lubbock ("City"), and O'Tool Plastic Pine, Inc., ("Contractor"). WITNESSETH: WHEREAS, the City of Lubbock duly advertised for bids for Irrigation Parts and PVC Supplies and bids were received and duly opened as required by law; and WHEREAS, after careful consideration of the bid submitted by Contractor, the City of Lubbock has heretofore adopted a resolution authorizing the acceptance of such bid, and the execution, in the name of the City of Lubbock a contract with said Contractor covering the purchase and delivery of the said Irrigation Parts and PVC Supplies. NOW, THEREFORE, in consideration of the mutual agreement contained herein, as well as the financial consideration hereinafter referred to, the parties hereby covenant and agree as follows: In accordance with City's specifications and Contractor's bid, copies of which specifications and bid are attached hereto and made part hereof, Contractor will deliver to the City, Irrigation Parts and PVC Supplies, and more specifically referred to as items one thru twelve, fifteen thru twenty-four, twenty-seven thru twenty- nine, thirty-three thru thirty-nine and forty-three thru fifty-three on the bid submitted by the Contractor or in the bid form attached hereto. 2. The City promises and agrees to employ, and does employ, the Contractor to cause to be done the work provided for in this Contract and to complete and finish the same according to the attached specifications, offer, and terms and conditions contained herein. 3. The contract shall be for a term of one year, with the option of four, one year extensions, said date of term beginning upon formal approval. The rates may be adjusted upward or downward every six (6) months at a percentage not to exceed the effective change in the Consumer Price Index (CPI) or Product Price Index (PPI), whichever is most appropriate for the specific contract for the previous six (6) months. Written consent from both parties is required for all price adjustments. At the City's discretion, the effective change rate shall be based on either the local or national index average rate for all items. If agreement cannot be reached, the contract is terminated at the end of the current contract period. 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. 4. This contract shall remain in effect until the expiration date, performance of services ordered, or termination of by either party with a thirty (30) day written notice. Such written notice must state the reason for cancellation. 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. Contractor shall at all times be an independent contractor and not an agent or representative of City with regard to performance of the Services. Contractor shall not represent that it is, or old itself out as, an agent or representative of City. In no event shall Contractor be authorized to enter into any agreement or undertaking for or on behalf of City. At any time during the term of the contract, or thereafter, the City, or a duly authorized audit representative of the City, 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 the 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 thirty (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. INSURANCE SECTION A. Prior to the approval of this contract by the City, the Contractor shall furnish a completed Insurance Certificate to the City, which shall be completed by an agent authorized to bind the named underwriter(s) to the coverages, limits, and termination provisions shown thereon, and which shall furnish and contain all required information referenced or indicated thereon. THE CITY SHALL HAVE NO DUTY TO PAY OR PERFORM UNDER THIS CONTRACT UNTIL SUCH CERTIFICATE SHALL HAVE BEEN DELIVERED TO THE CITY. INSURANCE COVERAGE REQUIRED SECTION B. The City reserves the right to review the insurance requirements of this section during the effective period of the contract and to require adjustment of insurance coverages and their limits when deemed necessary and prudent by the City based upon changes in statutory law, court decisions, or the claims history of the industry as well as the Contractor. SECTION C. The Contractor shall obtain and maintain in full force and effect for the duration of this contract, and any extension hereof, at Contractor's sole expense, insurance coverage written by companies approved by the State of Texas and acceptable to the City, in the following type(s) and amount(s): TYPE OF INSURANCE GENERAL LIABILITY ® Commercial General Liability ❑ Other ❑ Claims Made ® Occurrence ❑ W/Heavy Equipment ❑ To Include Products of Complete Operation Endorsements COMBINED SINGLE LIMIT General Aggregate $1,000,000 Products-Comp/Op AGG X Personal & Adv. Injury X Contractual Liability X Fire Damage (Any one Fire) Med Exp (Any one Person) PROFESSIONAL LIABILITY ❑ General Aggregate $ AUTOMOTIVE LIABILITY ® Any Auto ❑ Scheduled Autos ❑ Non -Owned Autos EXCESS LIABILITY ❑ Umbrella Form GARAGE LIABILITY ❑ Any Auto ❑ BUILDER'S RISK ❑ INSTALLATION FLOATER ❑ All Owned Autos ❑ Hired Autos General Aggregate Combined Single Limit $1,000,000 Each Occurrence Aggregate Auto Only - Each Accident Each Accident Aggregate ❑ 100% of the Total Contract Price ❑ 100% of the Total Material Costs ❑ POLLUTION ❑ CARGO ® WORKERS COMPENSATION — STATUTORY AMOUNTS OR OCCUPATIONAL MEDICAL AND DISABILITY ® EMPLOYERS' LIABILITY $1,000,000 OTHER: COPIES OF ENDOSEMENTS ARE REQUIRED ® City of Lubbock named as additional insured on Auto/General Liability on a primary and non-contributory basis. ® To include products of completed operations endorsement. ® Waiver of subrogation in favor of the City of Lubbock on all coverages, except The City of Lubbock shall be named as an additional insured on a primary and non-contributory basis and shall include waivers of subrogation in favor of the City on all coverage's. Copies of the Certificates of Insurance and all applicable endorsements are required. ADDITIONAL POLICY ENDORSEMENTS The City shall be entitled, upon request, and without expense, to receive copies of the policies and all endorsements thereto and may make any reasonable request for deletion, revision, or modification of particular policy terms, conditions, limitations, or exclusions (except where policy provisions are established by law or regulation binding upon either of the parties hereto or the underwriter of any of such policies). Upon such request by the City, the Contractor shall exercise reasonable efforts to accomplish such changes in policy coverages, and shall pay the cost thereof. REQUIRED PROVISIONS The Contractor agrees that with respect to the above required insurance, all insurance contracts and certificate(s) of insurance will contain and state, in writing, on the certificate or its attachment, the following required provisions: a. Name the City of Lubbock and its officers, employees, and elected representatives as additional insureds, (as the interest of each insured may appear) as to all applicable coverage; b. Provide for 30 days notice to the City for cancellation, nonrenewal, or material change; c. Provide for notice to the City at the address shown below by registered mail; d. The Contractor agrees to waive subrogation against the City of Lubbock, its officers, employees, and elected representatives for injuries, including death, property damage, or any other loss to the extent same may be covered by the proceeds of insurance; e. Provide that all provisions of this contract concerning liability, duty, and standard of care together with the indemnification provision, shall be underwritten by contractual liability coverage sufficient to include such obligations within applicable policies. NOTICES The Contractor shall notify the City in the event of any change in coverage and shall give such notices not less than 30 days prior the change, which notice must be accompanied by a replacement CERTIFICATE OF INSURANCE. All notices shall be given to the City at the following address: Marta Alvarez, Director of Purchasing and Contract Management City of Lubbock 1625 13' Street, Room 204 Lubbock, Texas 79401 SECTION D. Approval, disapproval, or failure to act by the City regarding any insurance supplied by the Contractor shall not relieve the Contractor of full responsibility or liability for damages and accidents as set forth in the contract documents. Neither shall the bankruptcy, insolvency, or denial of liability by the insurance company exonerate the Contractor from liability. 7. Neither the City nor the Contractor shall assign, transfer or encumber any rights, duties or interests accruing from this Contract without the written consent of the other. 8. 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. 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 thirty (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. 10. 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 nonappropriation of funds by the City Council of the city of Lubbock for the goods or services provided tinder the 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 goods or services covered by this contract is spent, whichever event occurs first. 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 date of termination. 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 12. This Contract consists of the following documents set forth herein; Invitation to Bid 17-13141-KM, the Bid Form and Specifications. IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed the day and year first above written. Executed in triplicate. CITY OF LUBB CK: Daniel M. Pope, Ma or ATTEST: Reb cca Garza, City Secretary _ U APPROVED AS TO CO Faul , Parks and Recre APPROVED AS TO FORM: �//41 Justin ruitt Assista t City Attorney COJ TOR: By Authorized Representative's Si nature Pat Simek Print Name BOX 1917 Address LUBBOCK,TX 79408 City, State, Zip Code on City of Lubbock, TX ITB 17-13141-KM Irrigation Parts and PVC Supplies Specifications Intent The city of Lubbock intends to purchase irrigation parts, equipment, supplies, hardware, tools and materials for the use primarily for the repair, maintenance and up -keep of existing facilities at various sites across town. The City needs to have a proper source of supply that is responsive, readily available and able to meet the City's requirements with minimum delay in acquisition and/or delivery. Statement of Needs Bidder represents and warrants that all items are new and not used or reconditioned and are not of such age or so deteriorated as to impair their usefulness or safety and that the goods, materials, supplies or components offered are current production models of the respective manufacturer. This bid is for discount pricing on attached price list and will be awarded to multiple vendors. Bidders may bid on all or part of the list. Bidders may add irrigation, PVC, supplies and equipment showing the discounted pricing for materials not on the supplied list by providing a second sheet for such additions. Do not add items to the Bid Form. The City Parks and Recreation Department is requesting the irrigation and PVC supplies for park use to be either picked up by park staff or delivered to the park site by the vendor depending on quantities. Contract Period The contract shall be for a term of one (1) year with the option of four (4), one (1) year extensions. Delivery Location Deliveries will be made inside the city limits of Lubbock, TX or to the address below at the preference of the Parks and Recreation Department. City of Lubbock Parks and Recreation — Park Maintenance 308 Municipal Dr. Lubbock, TX 79403 Page 33 of 37 City of Lubbock, Texas Purchasing and Contract Management BID FORM In compliance with the Invitation to Bid 17-13141-KM, the undersigned Bidder having examined the Invitation to Bid and Specifications, and being familiar with the conditions to be met, hereby submits the following Bid for furnishing the material, equipment, labor and everything necessary for providing the items listed below and agrees to deliver said items at the locations and for the prices set forth on this form. The invitation to Bid 17-13141-KM is by reference incorporated in this contract. The Bid Form must be completed in blue or black ink or by typewriter. Item Description Discount Offered Off (Retail/Catalog) Please List Discount Delivery Fee * Restock Fee Delivery Days ARO** 1. All Spears Wholegoods spearsmfg . com % 10 0 $ 0 3 2. All Spears Repair Parts spearsmfg . eom 10 0 0 3 3. All Lasco Wholegoods lascofittings.com 40 0 0 3 4. All Lasco Repair Parts lascofittings.com 10 0 0 3 5. All DWV Wholegoods laseofittings . com 60 0 0 3 6. All DWV Repair Parts lascofittings.com 20 0 0 3 7. All Febco Wholegoods febeoonline . com 10 0 0 5-7 8. All FebcoRepair Parts febcoonline.com list 0 0 5-7 9. All Rainbird Wholegoods rainbird. com 30 0 0 5-7 10 All Rainbird Repair Parts rainbird. com list 0 0 5-7 H. All Hunter Wholegoods hun ter i ndu s tries. Iom 30 0 0 2-3 Pate 4 of 37 item Description Discount Offered Off (Retail/Catalog) Please List Discount Delivery Fee * Restock Fee Delivery Days ARO*' 12. All Hunter Repair Parts hunterindustries. om list 0 0 3-4 15. All ADS Wholegoods ads -pipe .com list 0 0 5-7 16. All ADS Repair Parts . ads-pipe.com list 0 0 5-7 17. All TORO Wholegoods toro . com 30 0 0 3-4 18. All TORO Repair Parts t o ro . coin list 0 0 3-4 19. All Bermad Wholegoods bermadinc.com/USA 10 0 0 7-10 20. All Bermad Repair Parts bermadinc.com/USP list 0 0 7 -10 2l. All Irritrol Wholegoods irritrol . com 30 0 0 5-7 22_ All Irritrol Repair Parts irritrol.com list 0 0 5-7 23 All Weathermatic Wholegoods weathermatic .com 30 0 0 3-4 24 All Weathermatic Repair Parts weathermatic.com list 0 0 3-4 All RainMaster wnoiegooas All RainMaster Repair - Parts Page 5 of 37 Item Description Discount Offered Off (Retail/Catalog) Please List Discount Delivery Fee* Restock Fee Delivery** Days ARO 27. All Netifim Wholegoods (must be able to provide w/o check valve) ne to f imu s a .eom 10 0 0 5-7 28. All NetiftmRepair Parts netafimusa.com list 0 0 5-7 29 All Valve Boxes (various sizes, manufacturers, and lockable) ndspro . com 10 0 0 5-7 18/13 Multi -Strand y mga ion Control r 33. All Hotboxes(various sizes and manufacturers) hubbellpowersyste s .com list 0 0 21-28 34. All Data Industrial Flow Sensors (to include wire) i r r i t r o l. coin 10 0 0 10 -14 35. All ADS Wholegoods ads -pipe . com list 0 0 5-7 36. All ADS Repair Parts ads -pipe .eom list 0 0 5-7 '7' All Quaintam Metal Gasket Couplings smith-blair.com 10 0 0 5-7 38. All Nelson Wholegoods lrnelson.com 10 0 0 7-10 39. All Nelson Repair Parts 1 me l s on . com list 0 0 7-10 Page 6 of37 Discount Offered Off Delivery Item Description (Retail/Catalog) Discount Delivery Fee * Restock Fee Days ARO,** Please List All Greenlee 43. All Midwest Wholegoods midwestinstrument Com list 0 0 7-10 44. All Buckner ucknersuperior, coin 20 0 0 7-10 Wholegoods 45_ All Buckner Repair Parts bucknersuperior.c m list 0 0 7--10 46 All Champion Wholegoods championirrigatio . com 10 0 0 7---10 47 All Champion Repair championirrigatio eom list 0 0 7-10 Parts All Class 900 PVC Pipe Pipe: pipelif e . com list 48. and Fittings 0 0 3-5 Fittings: sigmaco. com 20 All Class 200 PVC Pipe Pipe: P iPelife. com list 49 and Fittings 0 0 3-5 Fittings:lg ascofittin .com 40 All SCT-I.40 PVC. Pipe Pipe:p ipe 1 i f e. c om list 50. and Fittings 0 0 3-5 1'ittings:lascofittings . com 40 Pipe:pipelife.com list 51 All SCH.SO PVC Pipe and Fittings Fittings: g lascofittin s.com 20 0 0 3-5 All Irrigation Plumbing Supplies. including but. 52. not limited lo: PVC Cement, Primer, Teflon Otoo l . com 10 0 0 3-5 Ta e, Wire S lice Kits. 53. All Polypipe and Otool .com 10 0 0 3-5 Fittings Page 7 of 37 * Delivery fee shall be a flat rate for delivery within a 25-mile radius of the City of Lubbock. **Days After Receipt of Order (ARO) In order to be considered for the award of this bid, bidders must meet the following criteria: 1. Must be a stocking dealer of the items bid. 2. Distribution office must be within a 25-mile radius of the City of Lubbock, Texas. Unless otherwise specified herein, the City may award the bid either item -by —item or on an all -or -none basis for any item or group of items shown on the bid. The City of Lubbock is seeking a contract for Irrigation Parts and PVC Supplies with one or more contractors. In order to assure adequate coverage, the City may make multiple awards, selecting multiple vendors to provide the products desired, if multiple awards are in the best interest of the City. A decision to make a multiple award of this Bid, however, is an option reserved by the City, based on the needs of the City. The City of Lubbock reserves the right to reject any or all bids, reject any particular item on a quote, and to waive immaterial formalities. PAYMENT TERMS AND DISCOUNTS - Bidder offers a prompt payment discount of 0 %, net _ calendar days. Discounts will not be considered in determining low bid. Unless otherwise indicated on the Bid Form, payment terms will be NET THIRTY DAYS. The City will pay the successful bidder within thirty days after the receipt of a correct invoice or after the date of acceptance, whichever event occurs later. Discounts for prompt payment requiring payment by the City within a stipulated number of days will be interpreted as applying within the stipulated number of calendar days after the date of receipt by the City of a correct invoice or after the date of acceptance that meets contract requirements, whichever event occurs later, Discounts for payment in less than ton days will not be considered. MOST FAVOURED PRICING: The Bidder certifies that the price quoted is not in excess of the lowest price charged anyone else, including its most favoured customer, for like quality and quantity of the products/services; does not include an element of profit on the sale in excess of that normally obtained by the Bidder on the sale of products/services of like quality and quantity; and does not include any provision for discounts to selling agents. If at any time during the contract period, the supplier should sell or offer for sale to any other customer, an equal or less quantity of similar contract products of like or better quality, at a lower net price(s) than provided herein, supplier agrees to notify the City and sell same product(s) at the lower price(s) on all deliveries made during the period in which such lower price(s) is effective. INTERLOCAL PURCHASING (optional): The City desires to make available to other local governmental entities of the State of Texas, by mutual agreement with the successful bidder, and properly authorized interlocal purchasing agreements as provided for by the Interlocal Cooperation Act (Chapter 791, Government Code), the right to purchase the same services, at the prices quoted, for the period of this contract. Each bidder shall indicate on the Bid Form in the space provided below if he/she will honor Political Subdivision orders in addition to orders from the City of Lubbock. Should these other governmental entities decide to participate in this contract, would you (the bidder) agree that all terms, conditions, specifications, and pricing would apply? Other governmental entities that might have interests in this contract are Frenship Independent School District, Lubbock Housing Authority, Lubbock County, Lubbock County Hospital District, Lubbock Independent School District, South Plains Association of Governments, City of Texarkana, Texas Tech University, West Texas Municipal Power Agency, Lynn County, and City of Wolfforth. YES XX NO • If you (the bidder) checked YES, the following will apply: • Governmental entities utilizing Interlocal Agreements for Cooperative Purchasing with the City of Lubbock will be eligible, but not obligated, to purchase materials/services under the contract(s) awarded as a result ofthis solicitation. All purchases by governmental entities other than the City of Lubbock will be billed directly to that governmental entity and paid by that governmental entity. City of Lubbock will not be responsible for another governmental entity's debts. Each governmental entity will order their own materials/service as needed, THIS BID IS SUBMITTED BY O'Tool Plastic Pipe Inc. a corporation organized under the laws of the State of TEXAS , or a partnership consisting of or an individual trading as Firm: 07ool Plastic Pipe Inc. Page 8 of 37 of the city of Lubbock Address: BOX 1917 City: Lubbock Bidder acknowledges receipt of the following addenda: Addenda No. Addenda No. Addenda No. Addenda No. M/WBE Firm: l By Date Date Date Date State:TEXAS Zip79408 Woman Black American Native American Hispanic American Asian Pacific American Other (Specify) Awhorized Reoresentative - mast sign by hand Officer Name and Title: Pat Simek, general manager Please Print Business Telephone Number 806-762-1822 E-Mail Address: psimek@otool.com FOR CITY USE ONLY Bid Form Item Number(s) Awarded to Above Named Firm/Individual: FAX: 806-762-1452 Date of Award by City Council (for bids over .S25,000): Date P.O./Contract Issued: LABEL THE OUTSIDE OF YOUR SEALED BID WITH THE ITB NUMBER, THE CLOSING DATE AND TIME, AND YOUR COMPANY NAME AND ADDRESS. Li Page 9 of 37 1 CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2017-164086 Date Filed: 02/08/2017 Date Acknowledged: 02/09/2017 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. O'Tool Plastic Pipe Inc. Lubbock, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock 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. ITB 17-13141-KM irrigation annual contract 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary City of Lubbock Lubbock, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said this the day of 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 3.295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2017-164086 O'Tool Plastic Pipe Inc. Lubbock, TX United States Date Filed: 02/08/2017 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: 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. ITB 17-13141-KM irrigation annual contract 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary City of Lubbock Lubbock, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Y DEANNA BRADFORD Notary Public, State of Texas ".` My Commission Expires aROF ' MAY 28, 2018 Signatur6 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. V TM ' Y'��' �� �lA'7►1�tC'i Signature of officer minis inistering oath Title of offic r administering oath kD v DE-ANNA BRADFORD Forms provided by Texas Ethic 6 1i vLw 7 ' "" y �"p" �_;.e i .st tx.us Version V1.0.277 My Commis5i011 Ct i MAY 28, 2018