HomeMy WebLinkAboutResolution - 2018-R0446 - PO With Daco Fire Safety Equipment - 12/17/2018Resolution No. 2018-RO446
Item No. 6.17
December 17, 2018
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 fo
and on behalf of the City of Lubbock, Purchase Order No. 31042453 for the purchase of
Rosenbauer 1250 Custom Pumper as per H-GAC Contract FS12-17, by and between the City o
Lubbock and Daco Fire Safety Equipment of Lubbock, Texas, and related documents. Saic
Purchase Order 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 December 17, 2018
L,
DANIEL M. POPE, MA OR
ATTEST:
--p Z1411�� R
Rebe ca Garza, City Secretary
APPROVED AS TO CONTENT.
Scott Snider, Assistant City Manager
APPROVED AS TO FORM:
I 1A A rX 4--
elli Leisure, Assistant City Attorney
ccdocs/RES.PurchaseOrd 31042453 - Daco Fire Safety Equipment
November 28, 2018
City of
Lubbock_ PURCHASE ORDER
TEXAS
TO: DACO FIRE SAFETY EQUIPMENT
PO BOX 5006
201 AVE R
LUBBOCK TX 79456
Page - 1
Date - 11/28/2018
Order Number 31042453 000 OP
Branch/Plant 3526
SHIP TO: CITY OF LUBBOCK
FLEET SERVICES
206 MUNICIPAL DRIVE
LUBBOCK TX 79404
INVOICE TO: CITY OF LUBBOCK ,
ACCOUNTSPAYABLE I
P.O. BOX 2000
LUBBOCK, TX 79457 BY: i
Marta Alvarez, Director of Purchasing & Contract Management
Ordered 11/28/2018 Freight
Requested 1/13/2020 Taken By S GONZALEZ
Delivery MOBBS L REQ 53094 H-GAC CONTRACT FS12-17
Description/Supplier Item Ordered
Rosenbauer 1250 Custom Pumper 2.000
CC 5615
Terms NET 30 DAYS
Unit Cost UM
699,994.0000 EA
Extension Request Date
1,3 99,988.00 1 / 13 /2020
Total Order
1,399,988.00
This purchase order encumbers funds in the amount of $1,399,988 awarded to Daco Fire Safety Equipment of Lubbock, TX on
December 17 , 2018. The following is incorporated into and made part of this purchase order by reference: Houston -
Galveston Area Council (HGAC) FS 12-17 dated November 19, 2108 from Daco Fire Safety Equipment of Lubbock, TX. Resolution
# 901 R-R(1446
CITY OF LUBBOCK ATTEST:
Daniel M. Pope, Mayor qe cca Garza, City Secretary
Seller and Buyer agree as
folio%% S:
PURCHASE ORDER
TER%IS AND CONDITIONS
IMPORTAN'T: READ C•AREFULLl
STANDARD TERMS AND CONDITIONS
CITY OF LUBBOCK,TX
1 SELLER TO PACKAGE GOODS Sella will package goods to aeemdanee with good commercial practice
Each shipping container shaft be clarity and patttmedtfy marked as follows (a) Sdia's now and address,
(b) Cmtsig ice's came. eddress and purchase order or purchase release mamba and the supply agreement number
ifapphcaW1c)Comarmaourabaand Total number of commas, cg boa I of 4 bow, and (d) the rmmber
of the aMama aiming the packing slip Sella shall bear eoa of packaging wlas othwAiw pro WW floods
shall be suitably packed to secure It sum tramponatiom costs and To conform with r quiteman of common
casTias anal ally applicable tpoclacatbma Buys O co-m m wdg)ushall be final ails coml=r ,c om shipments
rot aeeompaniedby peckuig ha.
2 SHIPMENT UNDER RESERYA TION PROHIBITED Sala a arm mdurmood to strip the goods under
raen'uWe reed m tedaof a bdl ! lading will opaute - a uxida of sooda
TITLE AND RISK OF LOSS The tick and risk of loss of the goods shall not pass to Buyer until Buyer
aeha ly raaves and takes possession of the goods a the pour - pates of delivery
4, NO REPLACEMENT OF DEFECTIVE TENDER Esi ry tender of dchvery of goods most fully comply
with all provision ofthis confect as to time ofdehvtay. quality and The like if a Taulcr is mane witidt dais tTM
fully conform flux shall comeaute a breach and Sella shall not haws the right To submaute a comf wining tender
povid a wham the trm hbr perTotmance has oft yet argued. The Sage may masomably notify Buyer of her
attention to cure and may that mace a conforming tads within the c row Time but rmi afterward
5 INVOICES A PAYMENTS a SCIIet shall mbmu aepuaic it orca in duptrate am each purchase
order or porehwe release after each deliver) tin owes shag indicate the purchase order or purchase release
comber errs the supply agreement aumlw iE spphcab4 invoices .hall be aemixtd and trtmsportatrw chmges
if nary. shall be listed separately A copy of the bill of IaNng, and the Freight wsybUt w•hm applicable, should
be sashed m the mvoitt Matl To Aceonms Payable, Cmy of Lubbock. P O Box 2000. Lubbock. Terns
79457 Payment shah oat be due until the above insawm oars are submitted after del.m
GRATUITIES Tbc Bu)a tow by omen odic. rothe Sella cancel Ibis contra urahoum hebTlny u
Sella if if determined by Buyer that grmuamn. in the form of mTenamnmcat gifts or othc im were offered
or given by the Sella d my ago m mpresetanivc of the Sena tc an) iffica m crapbyee A this Cuy
Lubbock with a - to occurring a comma of sonuurg Caimabk trcarmmt Atth respect the awarding or
amending or tlr making of any detamamws with respect to the perfonamg of such a contract in the eaem
This contract at canceled by Buyer pursuant to this provision. Buyer shall be entitled. in a dtmm to any other
rights and remedies to mower Or wbhhoW the smuum of the cos incurred b) Seller in providing inch gratuities
r SPECIAL TOOT S S TEST ETZI IPMENT If the Pie stated on the tote hereof includes the cos of any
special tooling or special ten at rsupmemu fabricated or mqu iced by Sena fin The purpose of filling This order
such special roofing equipment and any process sheds ndaed Thereto Mall become the property of the Buyer
and to the aim foible shah be identified by The Sena as such
I WARRANTY -PRICE a The price to be pad by the Buyer shall be that commuted in Seller s bid
wbwb Sella watrses to be no bigher than Seller's anfeni proccu on Orders by others far products of The kind
ad spccifieatina cow aced by this agreement far similar quatnafes under strudar of hkc cooditos and mcthads
of purchase In the main Seller breach- this warrauy. the prices of the Germ shall be reduced to the
Sally-s curmm prices on orders by mhon or m the abanewe ROM may caned this contract without
liability to Sella fin broth a Seller - actual expense b The Sella warrants That On pee>an or selling agcw%
has been employed or raained - solicit or secure This contract upon in agreemmm or understandmg for
commission. perc"c, bmkaage, or com®geut fee excepting bow fide employees of bone We amabtished
commercial or selling agencies mou named 4 the Sella for the purpusc of toeuriag business For laeach of
atcatma of this wartmu) the Buys &hall l nit the right as addition to any other right of rights to cancel this
contract without Itabdmy and to deduct from the contract price, or otherwise mcova without liability and to
deduct from the conran pill dhawse, mco.er car full swum of tech coaunusma pacentag . brokerage
or comasgem for
9 WARRANTY-PRUDI' T Sella shall rot Limit x misk any bmphiod w—I— and any attempt to do
shall ra da This comma odstdc m the option of the Buyer Sella warrants thin the goods furnished will
conform to the specification, drauangs and desurpttam lined in the bud invitation. add to the sempde(s) Rffwjhed
by the Stiffs. if any tit the evens of - conflict or between the specifications, drawings, and daatptirm, the
WoHBcaiom shall gowem Notwbtsrmdmg any provtsods contained in the contractual apectnm. the Sella
represents and warcamu huh -five performance and fault -five result in the processing dart and date related data
tmcluf iog, but am United to cdtuhrmg comparing And sequencing) of all hardware software and firmware
products delivered and senor provided under this Comma. mdividuakly or to combim ion. as the case may
be from the effector due of this Contract The obbguioo continued been apply to ptodocu and senices
provided by The Seger. as ab Sdia or any thins parry it aNcd as the crcanon or dnrbpracm of the products
and &avica to be delivered m the City of Lubbock under tha Contract Failure to comply with my of The
abbgurum confirmed haver oar) result m the City of Lubbock availmg itself of any of at rghs under the
ksw and under this Cauraa includingbut not imtttd to. its Tight pit ud" to to rmnrnon or defath The
wanamax contained herein are repatriate and discrete beta any other w'astamics specified in this Contra
ad are not subject to any daclmma of warmary, impbed or expressed, or limitation of the Seller's lability
which rosy be specified in This Comma us dppeadiees as scbcda lcs. its mmexo or any document incorporated
To thin Contract by reference
10 SAFETY WARRANT} Sella warrants that the product sold to the Buyer exalt conform ToMemandards
promulgated by the I. S Department of Labor trader the Occupational Safety and Health Act of 1970 to The
even the product does am comhsrm to OSHA setdads Buaa may return the product for correction Or
replacement at the Sdlla's expense In the event Seller fait to make are appropriate cormction within a
reasonable time. coaertisn mac b) Buyer will be at the Sailor s expersse
11 NO W ARRANTY B t Bl YEA AGAINST INFRINGEMENTS A. pen of this conuxt for role Sella
agrees to aacriam whetter goods mlmfaetmed in tcwrdame with the speciRwuom wriched to tha agreement
will give roe to the rightful Claim of any thud person by way of whinge min of the Like Buyer makes no
wromml, this the production ofgaods according To the spordi a on "I nut give roe to witch a cam, and in m
nart shell Buyer be bible to Seller for iodenutificafon or the mart That Seller is sued on The grounds of
Mlraigemm of the id a If Sella m ofthe opmion that m t or the like will rnuh he will mnlj the
Buyer w this affect a writing wlthm Two weeksafter the itgnng Tiffin agreement If Buya doer nit roceive
notice and is suMequenriy held liable fin she mfrrogemm m do like, Seller will saar Buys harmless If
Sala in good faith ocenams the production of the goods in accordance with the gxsifi®tons will result in
whuigerom or the like. The contract shall he null and )oak
f2 NON APPROPRIATION All hurls for payment by the Cif) under thin contract ere subject to the
amlahaliy, of m amain appropriation for" purpose by titer Cny In The event of mmppryuwioo of farads
by the City C rivac l of the Ca) of Lubbock fordae goods a s sviea provided under the contract. the City will
terminate the contract without tart uurmo chap or fiber Liability on the last day of the ihencumem fiscal
yea or wbm the appmpratnn mode for the the-cturm yet, for the goal ar seni es em•aed by This contract
a spew whichever chrss occurs Exert if at any nine funds are Out appropriated for the continuance of this
comfort - Hank call is aeeeplad b the Seflet Thirst, days prior writs notice, but failure to give
,"a i - . the ( shall d the
Ion
13 RIGHH OF fNSPE( TION Buyer shalt have the right to inspect titer gads a akly o) before acceptrmg
Wan
14 CANCF.1-LATION Buyer shall We the right to wtxti for defauh all m any pan of the umdkkvered
person of this order if Sid or breeches any of the tams baef including wmmnties of Sella or If the Sella
fs—mes imohm or commis acts of hmdrntptry Suds ugh oleancetluion in Wrinkin to and Our in
hell of any other mairdhes which Buyer mart have in law or court)
15 TF RhBNATION The perftrrmana of work under this order may be ttamm vied in wfsole, Or m pan b) the
Buyer in accordance with this provision Termination of work hereuodcr shaft be effected by the delivery
of the Seller of a `Nara of Termination" spectljmg the extent To which performance of work tinder if.
order s fammaed and the date upon which such termination bnemts effective Such ngtt or termination is
m addition to and not in lieu of the rights of Buys sit forth of Clause 14, barren
16 FOR('F NIAIF.I!RF Neither puny shall be held responsible for bases. rmushmg if the fldfdhacm
of an� terms of pmvisiocs of this contras is delayed or prevented by any crone trot within die control of dtc
parry whose performance i interfered wish, and which by the exercise of reasonable diligave mid pony a
unable It pmtat
17 ASSIGN MENT•DELEGATION No right or mterat in this commit shall be assigned or ddegrow of
any obligation made by Sella without the wrmw Cn permgn of the Buyer Any attempted anigmoem or
drkgmion by Seller stall be wJm4 vod and finally htefliortive fat all purpose Turku mock in mnf dimity with
thisparagraph
19 WAIVER No claim m rWM erumg our of ■ btmk o f this c mraa can be dmchwgtd o whole m m pan
by a warier at renunciation of the claim err right finless the warva or mmincraswr is supported by
mnsidcrauon and s m wrauig rigned by the aggnned pare
1 INTERPRETATION -PAROLE El tDENCF The writing, plea any spaeiBemnns fin bids and
performance provided bs Buyer in its tdvatiserrsm x bids, and any other donaoaus provided by
Seller as fan of ha bid is ataded by The pama as a final expression of Thei agmauem and attended aso
as a complete and exchisne statement of the turns of then agreement Whnn•er a tam defined by the
Uniform Commereol Code a used in this agreement the definition cautioned in the Code is to commi
20 APPLICABLE LAW This agreement shall be governed br the t arfonn Commercial Code Whaeewa
the term -inform Commercial Code- s usedn skint be consumed a m—nuo the L'oiferm C'mumacal
C ode , adeprod in the State of Texas - eHoct %r and in force on the date of this agiceme t
21 RIGHT FO AS,SCRA.K E Whemmer am pang - his wraran in gcod Cato has reason to tptaton
the afber pony's went to perform he may demand thin The Mho part' give whoa auteanae or its intent to
perform In the even that a demand is track and no assurance s given within Crve [5) days. the danamdiTg
party mar treat this toduur as as mnic4wory repudduiai of the comrar
22 INDEMNIFICATION Sella shall indemnify keep and saver harmless the Buyer us agres offfcuds and
employees, agar ail tglurie. deaths. loss. claims, paten claims, suiu lahiht ies, judgmeon, costs
and expensn wbkb may in mywmr segue against the Bus er m consequence of the aram'ang o f thus Contras
of which may anywise result therefrom. whether or nor it shall be alleged or daermiaed that the a w
caused through negligence or amuston of the Sella or hs employees, cur of the subSeilo or assignee or its
Tloyees, if any. and the Sella shall at his own expense upper ek(end and pay all charges of into
all costs and Odra ci peones wrung therefrom of incurred m connection thorcmilh, and. if any judgment
&hall be rodaal ¢gaol thin Bu)re many such axim the Shca shalt at as owe espertses. satisfy and
discharge the note Sella aepreaaly understands and agees that mbond required by this cantrat, or
otbaw•se provided by Sala shall m a way limn the responsibitby to indemnify keep and save homlrss
and defend the Buyer as herein prowideL
23 TINIF It a hereby expressly eased and understood that tuck is of the essence for the performance of
this contract and failure by contract to meet the tune spcciftcmiom of this agramem will cause Seders To
he in default oohs agreement
24 Nlak The Cay of Lubbock hereby notiGa all bidden that in regard to any contract entered into
pu mimn to Thus ralucst mrsomy, and women business enterprises will be aRorded equal oppomWunin to
submit bark in response to this im, dawn and will our be discrmuwted agaraa an the grounds of race color.
sit or ustunlorigin or onixidamion for m award
25 NON -ARBITRATION The City reserves the right to servos any ngh - hotted) to it bit Laws oomram
equity. or oduc-m se including without f®anion, the rtgh to seek arty ad all fixes of nhef in a court of
cotupetan jurisdiction Funba. the City stall not be subject To anyarbarmwn process prior to exercising
its unrestricted right to seek judicial maredy The ramifies set Pooh hmtut arecum rlsilvr and ant exciwive.
and may be exercised wmcuhrmity To the extent army conflict bawtxr this provision and another pravawn
in or related tr this document the provision shall control
26 RIGHT TO Al on At any Tmr during the term of the comma or thertiafla the a a) in a day
authorized auda representative of the Car) or the State of Tetras at as expense mad at reasonable tomes
resavn the right to audit Comtraars momils and books relmam to all sm,ua pix idtd to the Car) under
this Corarw M the cant such an alit by the City roofs an) neon or rimipa)memt by dw Cdy
Coutimcor shall refund the City the tuft amount of such maps)mms within Tiiny (30) days of such
audit findings at the City at as Option. resa.a the right to ekdua such amomna owing the City from my
payments due Comoscurr
27 HOI SE HIL.l 2015 Kh, Ed12015 signed by The Governor as hoe 14 2011 and effectne on January
1 X 14. authorities apasby to be imposed on a person who commas for cenaur swica with a goveriu marl
may and who bib to properly classify' their workers Thu applies to subeomncton well Contractors and
subcommarin who fail to properly Oasaify mdiw iduas perfarmmg work under a govarmersud contract will be
penalized $200 air each indrvduul this has been nusclassifed, (Texas Government Code Sea3mn 2153 0011
2S ASSIGNING OR SUBLETTING Tiff (•ONTRACT The Comraavr shell nor avrgn or suhln the axrinroch
or an) portion of the contra without wane came+ from the Director of Purchasing and Corms
Maoagancto Should consent he grim the Contractor shall ttsure the Subcontractor or shall pmside proof an
assurance from the Subcommuir that cxnphes with all contra Imraote rerrya®as
29 HOl SE HILL 1295 DISCLOSURE OF INTERESTED PARTIES Howe Hill 1295 adopted by the 114th
4gslisute aimed Jn52 909. Train Oovarmo m Code Section 2252 "IT requires a basin corny entering
into caram comraaa with a gover micaW einy x note army To file with the govm ma tal array or sate
agency a dscosum of interested panics at the time The business entry submits the signed commit to the
o- .crmaemA m, „e "'o, a ern:. in,lnsc. its rot anpimm� F.mn i'_+t arc isatlairk at
w t trh i flAa ll/le Aa du4u W i kUa.t_i bs saivwa'nir mot trooW u. �nr.•eo ids rhr L onv,<ior Iru real
fully undastaiwh- and will be in full compliance wab all tams and conditions and the daasprve nnwaal
e0ntamed haeni old sour addoaowl a>3aCialed rHawximmi and Ainetdment The Goy disxlama ally lanai eras
conditions provided by the Contractor unless agreed upon in wramg by the parties In the event or eodi
between these terns and eandaeonts and any irrrs and conditions provided by the Contractor the tars read
conditions prmbkd bacni shall prevail The terms and cotduiots provided haen ate the final tams a peed
upon by the patron. and army prior conflicting tans "I be arm force or eflas
By In the p ' order the Von& acne tho a or Bit Tt l - and th dung
the tam ' this Agcsmrim (C omr, as applicable) 1 u Iiayccat isteml that tom a &-fbxd a Texas
Ginamnm Code Seeim 8 ' 001 amended
CONTRACT PRICING V�'ORKSHEET
HGACBuyFor MOTOR VEHICLES Only
Contract
FSI2-17
No.:
Date
11i19i2018
Prepared:
This Worksheet is prepared by Contractor and given to End User. If a PO is issued, both documents
MUST be faxed to H-GAC @ 713-993-4548. Therefore please type or print legibly.
Buying :City of Lubbock (TX)
Agency:
Contractor: DACO FIRE EQUIPMENT
Contact
Person:
Prepared ED BEENE
By:
Phone: 806-775-2171
Phone: '817-281-4172
Fax:
Fax:
Emaii:
Email: 'ed@dacofire.com
Product VC05
Code:
Description: 'Rosenbauer Commander, 4-Dr Full -Tilt, Alum Pumper, Ext Alum Body, S/Axle, 1500 GPM Pump, Side
odticflf iri Base f:1Pic' ef:C '' :
r. it LTnii e. F ontra ct ar.s H GAC:Confracf::::::::::::::::::::::::::::::::::::::: :::::: >:::::' 459326
................................................................................................................... ... ............... ... ......
:: ttp115het�:E1 ti00$:�:Reouze:li0 4w:?:Att*0i<:: 440106al ihi 0 {s) :it 4 0..'O'W a`y:=�=:It d-440 ���i+�lt: f,'q&--% �escr�• tip�i:jif:. �ii`:i�ile.:::: :
....................................................... ........................................)i.........................
(:P:lote Publ(s1i:Qptions:ars optibils wljicFi were:suiimtted:a�id priced.ri;Coritractor•$Md ).. .
................................... ......................................................................... .................... ...............
Description Cost
Description Cost
Subtotal From Additional Sheet(s): 167684
Subtotal B: 167684
P . p ...
:=: Itemiz ': Blair l: a ..ach add% Tonal: sheet :s : iE necessar:::::::::::::::............:::::::::::::::::::::::::::::::::: :
+C:;:�Jrt ublished:0 :lions..........e........t......... t............(.)............y............................................................
....................................................................................................................................................
CNote :U ubtistii ttoiis a:items wliioli:ai+ere:not stibtiittcdand: rieeil in:Giiiitraotor's lsid::::::::.:.:.:.:.:.::::::::':':::::=::::.:.:.:.::::::.::::.:.:.:.:.:.:::::::::::.:
................�.......................................... ................ )................. .
...............................................................................................................................................
Description Cost
Description Cost
Subtotal From Additional Sheet(s),
81915
Subtotal C: ' 81915
Check: Total cost of Unpublished Options (C) cannot exceed 25% of the total of the Base Unit: For this transaction the percentage is: 13%
Price plus Published Options (A+B).
l . ..t_ .:,. o .e . .. i ._..:e.::ca ._ .. .. "scounts A+.$...:: >: " ":. >:::::::::::::::::::: :
D: Tota .Cos B.ef r . f►uy.#ppl txbl . T,., de.1n. Other Alli...p.. s f.Di........( ...................... ..............
Quantity Ordered �
X Subtotal of A + B + C:
708925
= Subtotal D: € 141 7850
E::H=GA :U_tder:Proces§ylig_ivt►dr e:(Alrioun:t:Per:Current:PoltCy}::::::::::::::::::::::.... .......... ....... ::: SubtotalE: 2000
h&.A ' w ces %:5 ...I Disc 'nts 1:Frei lit%:Iiittalla2ivn::::::.:::::::::: >:;::::: ' :::::::::::: ;« :::::::::::::::::: ' :;:;::::: >:::,::.:.: :
F. Trtide .... (:.... . I.. an .... }.e ... 00T1 g . . ..... .... .. .... .... ....... ... _... ... .
Description Cost Description Cost
Chassis Prepayment Discount-2 Trucks i -19862
IF Subtotal F: -19862
cIi o paw- `395 C: o(�t : PUt ltaSC. 110I7+ + ..:: 1399988
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1of1
Complete Nos. 1- 4 and 6 if there are interested parties.
OFFICE USE ONLY
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
CERTIFICATION OF FILING
Certificate Number:
1
Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2018-428020
Daco Fire Equipment
Lubbock, TX United States
Date Filed:
11/26/2018
2
Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
Lubbock, City of
Date Acknowledged:
g
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
HGAC FS12-17
2 Fire Trucks
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
5
Check only if there is NO Interested Party. ❑
X
6
UNSWORN DECLARATION s
,
My address is
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
J pp"" �
Executed in ! ( id�t � County, State of on the day ofWw-,20 -IL
(month) (year)
av VONNE OFENSTEIN
NOTARY PUBLIC
*: ID#124068962
State of Texas 1,
pTfoF
Comm. Exp.07-05-2020 �— Signature of authorized agent f contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
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.
2018-428020
Daco Fire Equipment
Lubbock, TX United States
Date Filed:
11/26/2018
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
Lubbock, City of
Date Acknowledged:
11/29/2018
g 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.
HGAC FS12-17
2 Fire Trucks
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
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)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711