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HomeMy WebLinkAboutResolution - 2022-R0413 - Contract 16673 with Space Savers Inc. 10.11.22Resolution No. 2022-RO413 Item No. 6.6 October 11, 2022 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock is hereby authorized and directed to execute for and on behalf of the City of Lubbock, Contract No. 16673, as per ITB 22-16673-KM, for alternate daily cover for the West Texas Region Disposal Facility Landfill, by and between the City of Lubbock and Space Savers, Inc. of Keller, Texas, and related documents. Said Contract is attached hereto and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council on ATTEST: Reb cca Garza, City Se ret APPROVED AS TO CONTENT: Erik Rejino, Assistant City Manager APPROVED AS TO FORM: Rydn Woke, Assistant City Attorney RES.Contract No. 16673-Space Savers, Inc. 9. l 3.22 October 11, 2022 Q11>2 TRAY P M OR Resolution No. 2022-RO413 Contract 16673 City of Lubbock Contract for Alternate Daily Cover for West Texas Region Disposal Facility Landfill THIS CONTRACT made and entered into this 1 lth day of October , 2022, by and between the City of Lubbock ("City"), and Space Savers, Inc. , ("Contractor"). WITNESSETH: WHEREAS, the City of Lubbock duly advertised for bids for Alternate Daily Cover for West Texas Region Disposal Facility Landfill and bids were received and duly opened as required by law; and WHEREAS, after careful consideration of the bid submitted by Contractor, the City authorized the execution, in the name of the City of Lubbock a contract with said Contractor covering the purchase and delivery of the said Alternate Daily Cover for West Texas Region Disposal Facility Landfill. 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: 1. In accordance with City's specifications and Contractor's bid, copies of which are attached hereto and made part hereof, Contractor will deliver to the City, Alternate Daily Cover for West Texas Region Disposal Facility Landfill and more specifically referred to as Items 1-1 on the bid submitted by the Contractor or in the specifications 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 (1) year, with the option of four (4), one year extensions, said date of term beginning upon formal approval. This Contract will renew automatically for the additional terms, unless either Party gives 90-day written notice to terminate the Contract. 4. All stated annual quantities are approximations of usage during the time period to be covered by pricing established by this bid. Actual usage may be more or less. Order quantities will be determined by actual need. The City of Lubbock does not guarantee any specific amount of compensation, volume, minimum, or maximum amount of services under this bid and resulting contract. 5. The Contractor must maintain the insurance coverage required during the term of this contract including any extensions. It is the responsibility of the Contractor to ensure that valid insurance is on file with the Purchasing and Contract Management Department as required by contract or contract may be terminated for non-compliance. 6. A) Prices quoted shall be guaranteed for a period for six (6) months upon City approval. The rate may be adjusted at the City's discretion for the effective change in Consumer Price Index (CPI) or Product Price Index (PPI) as appropriate. B) Further, if the Contractor can provide documentation for actual charges for material, labor, etc. that demonstrates that the change in CPI or PPI is not sufficient, the Contractor shall provide such documentation to the City, and at the City's sole discretion, the contractual rate may be further adjusted. If agreement regarding a new rate cannot be reached, the City shall terminate at the end of the current contract period. C) If an adjustment to pricing is granted under this section, the Contractor must provide the Director of Purchasing and Contract Management written, quarterly documentation to justify the ongoing adjustment. If no such documentation is timely received, the rate will automatically revert to the initial, awarded rate. 7. This contract shall remain in effect until the first of the following occurs: (1) the expiration date, (2) performance of services ordered, or (3) termination of by either party with a 30 day written notice. The City of Lubbock reserves the right to award the canceled contract to the next lowest and best bidder as it deems to be in the best interest of the city. 8. 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 hold 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. 9. Insurance Requirements — No Insurance Required 10. 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. 11. 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. 12. At any time during the term of the contract, or thereafter, the City, or a duly authorized audit representative of the City or the State of Texas, at its expense and at reasonable times, reserves the right to audit Contractor's records and books relevant to all services provided to the City under this Contract. In the event such an audit by the City reveals any errors or overpayments by the City, Contractor shall refund the City the full amount of such overpayments within 30 days of such audit findings, or the City, at its option, reserves the right to deduct such amounts owing the City from any payments due Contractor. 13. 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 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 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. 14. 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 on insurance from the Subcontractor that complies with all contract Insurance requirements. 15. Contractor acknowledges by supplying any Goods or Services that the Contractor has read, fully understands, and will be in full compliance with all terms and conditions and the descriptive material contained herein and any additional associated documents and Amendments. The City disclaims any terms and conditions provided by the Contractor unless agreed upon in writing by the parties. In the event of conflict between these terms and conditions and any terms and conditions provided by the Contractor, the terms and conditions provided herein shall prevail. The terms and conditions provided herein are the final terms agreed upon by the parties, and any prior conflicting terms shall be of no force or effect. 16. The Contractor (i) does not engage in business with Iran, Sudan or any foreign terrorist organization and (ii) it is not listed by the Texas Comptroller under Section 2252.153, Texas Government Code, as a company known to have contracts with or provide supplies or services to a foreign terrorist organization. As used in the immediately preceding sentence, "foreign terrorist organization" shall have the meaning given such term in Section 2252.151, Texas Government Code. 17. The requirements of Subchapter J, Chapter 552, Government Code, may apply to this contract and the contractor or vendor agrees that the contract can be terminated if the contractor or vendor knowingly or intentionally fails to comply with a requirement of that subchapter. To the extent Subchapter J, Chapter 552, Government Code applies to this agreement, Contractor agrees to: (1) preserve all contracting information related to the contact as provided by the records retention requirements applicable to the governmental body for the duration of the contract; (2) promptly provide to the governmental body any contracting information related to the contract that is in the custody or possession of the entity on request of the governmental body; and (3) on completion of the contract, either: (A) provide at no cost to the governmental body all contracting information related to the contract that is in the custody or possession of the entity; or (B) preserve the contracting information related to the contract as provided by the records retention requirements applicable to the governmental body. 18. Pursuant to Section 2271.002 of the Texas Government Code, a) This section applies only to a contract that: (1) is between a governmental entity and a company with 10 or more full-time employees; and (2) has a value of $100,000 or more that is to be paid wholly or partly from public funds of the governmental entity. (b) A governmental entity may not enter into a contract with a company for goods or services unless the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. 19. By entering into this Agreement, Contractor verifies that: (1) it does not, and will not for the duration of the contract, have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and will not discriminate during the term of the contract against a firearm entity or firearm trade association. Contractor represents and warrants that: (1) it does not, and will not for the duration of the contract, boycott energy companies or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not boycott energy companies; and will not boycott energy companies during the term of the Agreement. This verification is not required for an agreement where a governmental entity determines that these requirements are inconsistent with the governmental entity's constitutional or statutory duties related to the issuance, incurrence, or management of debt obligations or the deposit, custody, management, borrowing, or investment of funds. 20. The Contractor shall retain all information received from or concerning the City and the City's business in strictest confidence and shall not reveal such information to third parties without prior written consent of the City, unless otherwise required by law. 21. The Contractor shall indemnify and save harmless the city of Lubbock and its elected officials, officers, agents, and employees from all suits, actions, losses, damages, claims, or liability of any kind, character, type, or description, including without limiting the generality of the foregoing, all expenses of litigation, court costs, and 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 the Contractor, its agents, employees, and/or subcontractors, related to the performance, operations or omissions under this agreement and/or the use or occupation of city owned property. The indemnity obligation provided herein shall survive the expiration or termination of this agreement. 22. This Contract consists of the following documents set forth herein; Invitation to Bid No. 22- 16673-KM, Specifications, and the Bid Form. -----INTENTIONALLY LEFT BLANK----- IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed the day and year first above written. Executed in triplicate. CONTRAC R.,-�� BY gff" Auorized Representative Kevin T. Carel Print Name 136 Pecan Street Address Keller, TX 76248 APPROVED AS TO CONTENT: City, State, Zip Code :Z�f� Bre aney, DirgiWtokolid Waste APPROVED AS TO Ryan $Vool , Asgistart City Attorney City of Lubbock ITB 22-16673-KM Alternate Daily Cover for Landfill Specifications The City of Lubbock is soliciting bids to establish pricing for a slurry -type Alternate Daily Cover, hereinafter called ADC, material is to be used at the West Texas Region Disposal Facility. This material will be mixed with water and applied in a spray to the landfill workface. The ADC will be applied to the landfill workface on an average of 5 days per week and using approximately 36 bags per week. Product requirements: The ADC must: • Be a product that is manufactured and marketed to the solid waste industry for ADC application. • Produce a cover that will perform equivalent to six inches of soil when applied according to the manufacturer's specifications. • Meet all Environmental Protection Agency (EPA) 40 CFR 258.21 and Texas Administrative Code (TAC) 30 TAC 330.165 (d) (1) requirements including control of disease vectors, fires, odors, blowing litter, dust, and scavenging without presenting a threat to human health and the environment. • Not contribute to air -borne irritants. • Have the ability of being applied in any temperature, light to moderate rainfall, and in winds up to 35 miles per hour. • Prefer a green tinted material. • Be available in single bags that are 50 pounds in weight. • Have the capability of being applied with a Finn T90 hydro seeder equipped with an 800 gallon water tank. Material delivery: Delivery is included in the bid pricing. There will be no additional delivery or shipping charges. Items required to be submitted with bid: • Safety Data Sheet (SDS) must be submitted with the bid to affirm that the product is non -toxic and not a threat to human health and the environment. Bidders must submit a minimum of three (3) references from landfills operating in Texas using the vendor's product. Submittals prior to bid award: The apparent low bidder will be required to submit within ten business days of notification, and prior to award of contract: • 12 bags for the landfill to test for product performance and compatibility with existing application equipment, at no additional cost to the City. • Failure to submit the product for testing within ten business days of the request, will result in forfeiture of contract. Length of contract: The contract shall be for a term of one (1) year, with the option of four (4), one-year extensions, said date of term beginning upon formal approval. All stated annual quantities are approximations of usage during the time period to be covered by pricing established by this bid. Actual usage may be more or less. Order quantities will be determined by actual need. The City of Lubbock does not guarantee any specific amount of compensation, volume, minimum, or maximum amount of services under this bid and resulting contract. The Contractor must maintain the insurance coverage required during the term of this contract including any extensions. It is the responsibility of the Contractor to ensure that valid insurance is on file with the Purchasing and Contract Management Department as required by contract or contract may be terminated for non-compliance. City of Lubbock, TX Purchasing and Contract Management Vendor Acknowledgement Form In compliance with the Invitation to Bid, the undersigned Bidder having examined the Invitation to Bid, instructions to bidders, General Conditions of the Agreement, 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 and agrees to deliver said items at the locations and for the prices set forth on the bid form and/or the bid table associated with this bid. A bid will be subject to being considered irregular and may be rejected if it shows omissions, alterations of form, conditional alternate bids, additions or alternates in lieu of the items specified, if the unit prices are obviously unbalanced (either in excess of or below reasonably expected values), or irregularities of any kind. The Invitation to Bid is by reference incorporated in this contract. Where applicable, prices are quoted as: F.O.B. Destination, Freight Pre -Paid and Allowed Where applicable, delivery days are: Days After Receipt of Order (ARO) 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 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. PAYMENT TERMS AND DISCOUNTS - Bidder offers a prompt payment discount of %, 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 ten days will not be considered. MOST FAVORED PRICING: The Bidder certifies that the price quoted is not in excess of the lowest price charged anyone else, including its most favored 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? City of Lubbock ITB 22-16673-KM Alternate Daily Cover for West Texas Region Disposal Facility Landfill Bid Form Space Savers, Inc. Location Keller, TX Total Cost $31,416.00 Delivery Quantity Days Unit Total # Items Required UOM ARO Price Cost #0-+ - Bag-- -1&Bid— -ale Bid - — d- aster-anache"pesi-fisa6em. ,� #1-1 Alternate Daily Cover (Slurry mix) 1760 401b Bag9 30 $17.85 $31,416.00 as per attached specifications. 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 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 of this 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. oIITWV1._ Bidder acknowledges receipt of addenda issued in regard to this solicitation: Addenda No. Date Addenda No. Date Addenda No. Date Addenda No. Date INSURANCE REQUIREMENTS I, the undersigned Bidder certify that the insurance requirements contained in this bid document have been reviewed by me and my Insurance Agent/Broker. If I am awarded this contract by the City of Lubbock, I will be able to, within ten (10) business days after being notified of such award by the City of Lubbock, furnish a valid insurance certificate to the City meeting all of the requirements defined in this bid. If the time requirement specified above is not met, the City has the right to reject this proposal and award the contract to another contractor. If you have any questions concerning these requirements, please contact the Director of Purchasing & Contract Management for the City of Lubbock at (806) 775-2572. SUSPENSION AND DEBARMENT CERTIFICATION Federal Law (A-102 Common Rule and OMB Circular A-110) prohibits non -Federal entities from contracting with or making sub -awards under covered transactions to parties that are suspended or debarred or whose principals are suspended or debarred. Covered transactions include procurement contracts for goods or services equal to or in excess of $25,000 and all non -procurement transactions (e.g., sub -awards to sub - recipients). Contractors receiving individual awards of $25,000 or more and all sub -recipients must certify that their organization and its principals are not suspended or debarred by a Federal agency. Before an award of $25,000 or more can be made to your firm, you must certify that your organization and its principals are not suspended or debarred by a Federal agency. I, the undersigned agent for the firm named below, certify that neither this firm nor its principals are suspended or debarred by a Federal agency. TEXAS GOVERNMENT CODE SECTION 2252.152 The undersigned representative of the undersigned company or business, being an adult over the age of eighteen (18) years of age, pursuant to Texas Government Code, Chapter 2252, Section 2252.152, certify that the company named above is not listed on the website of the Comptroller of the State of Texas concerning the listing of companies that are identified under Section 806.051, Section 807.051 or Section 2253.153. I further certify that should the above -named company enter into a contract that is on said listing of companies on the website of the Comptroller of the State of Texas, which do business with Iran, Sudan or any Foreign Terrorist Organization, I will immediately notify the City of Lubbock Purchasing and Contract Department. TEXAS GOVERNMENT CODE SECTION 2271.002 Company hereby certifies the following: 1. Company does not boycott Israel; and 2. Company will not boycott Israel during the term of the contract. The following definitions apply to this state statute: (1) "Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli -controlled territory, but does not include an action made for ordinary business purposes; and (2) "Company" means an organization, association, corporation, partnership, joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majority -owned subsidiary, parent company, or affiliate of those entities or business associations that exists to make a profit. This Certification is required from a Company if the Company has 10 or more full-time employees and the contract for goods or services (which includes contracts formed through purchase orders) has a value of $100,000 or more that is to be paid wholly or partly from public funds of the governmental entity. TEXAS GOVERNMENT CODE 2274 By entering into this Agreement, Contractor verifies that: (1) it does not, and will not for the duration of the contract, have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and will not discriminate during the term of the contract against a firearm entity or firearm trade association. Contractor represents and warrants that: (1) it does not, and will not for the duration of the contract, boycott energy companies or (2) the verification required by Section 2274.002 of the Texas Government Code does not apply to the contract. If Contractor is a company with 10 or more full-time employees and if this Agreement has a value of at least $100,000 or more, Contractor verifies that, pursuant to Texas Government Code Chapter 2274, it does not boycott energy companies; and will not boycott energy companies during the term of the Agreement. This verification is not required for an agreement where a governmental entity determines that these requirements are inconsistent with the governmental entity's constitutional or statutory duties related to the issuance, incurrence, or management of debt obligations or the deposit, custody, management, borrowing, or investment of funds. FEDERAL AND STATE SAFETY REGULATIONS Contractor shall comply with all federal and state safety regulation including but not limited to Occupational, Safety and Health Administration (OSHA) and the Department of Workforce Development (DWD) regulations. This agreement includes incorporation of Federal Transit Administration (FTA) Terms. The preceding provisions include, in part, certain Standard Terms and Conditions required by the Department of Transportation (DOT), whether or not expressly set forth in the preceding contract provisions. All contractual provisions required by DOT, as set forth in FTA Circular 4220.1 F, are hereby incorporated by reference. Anything to the contrary herein notwithstanding, all FTA mandated terms shall be deemed to control in the event of a conflict with other provisions contained in this agreement. The Contractor shall not perform any act, fail to perform any act, or refuse to comply with any requests which would cause Bus to be in violation of the FTA terms and conditions. All Environmental Protection Agency (EPA) rules and regulations must be followed by the Contractor. MASTER AGREEMENT For Federal Transit Administration Agreements authorized by 49 U.S.C. chapter 53, Title 23, United States Code (Highways), the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users, as amended by the SAFETEA-LU Technical Corrections Act of 2008, the Transportation Equity Act for the 21 st Century, as amended, the National Capital Transportation Act of 1969, as amended, the American Recovery and Reinvestment Act of 2009, Pub. L. 111-5, February 17, 2009, or other Federal laws that FTA administers. https://www.transit.dot.gov/funding_grantee-resources.'sample-fta-agreements/fta- rg ant -agreements The Master Agreement can be found in its entirety on the City of Lubbock website www.ci.lubbock.tx.us INCOMPLETE INFORMATION Failure to complete or provide any of the information requested in this Request for Proposal, including references, and/or additional information as information as indicated, may results in disqualification by reason of "non -responsiveness". CONTRACTOR ACKNOWLEDGEMENT In compliance with this solicitation, the undersigned bidder, having examined the bid documents, instructions to bidders, documents associated with the invitation to bid, and being familiar with the conditions to be met has reviewed the above information regarding: • Insurance Requirements • Suspension and Debarment Certification • Texas Government Code Section 2252.152 • Texas Government Code Section 2271.002 • Texas Government Code 2274 • Federal and State Regulations • Master Agreement SUBMISSION INFORMATION An individual authorized to bind pany must sign the following section. Failure to execute this portion may result in bid rejection. THIS BID IS SUBMITTED BY SPACE SAVERS, INC. a corporation organized under the laws of the State of Texas , or a partnership consisting of the City of Tax ID No.: 742-2440 Address: 136 Pecan Street City: Keller M/WBE Finn: LIM or individual trading as State: TX Zip: 76248 Woman Black American Native American Hispanic American Asian Pacific American Other (Specify) Please Representative - must sign by hand Officer'Name and Title: Kevin T. Carel Business Telephone Number 817-991-7370 E-mail Address: Kevin@SpaceSaversADC.com below. Date: L-/ 4?4E7 FAX: 817-337-0041 of CERTIFICATE OF INTERESTED PARTIES FORM 1295 loft Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2022-930915 Space Savers, Inc. Keller, TX United States Date Filed: 09/07/2022 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Texas 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 16673 Supply of Spray Slurry Alternate Daily Cover 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. a X 6 UNSWORN DECLARATION My name is Kevin Carel and my date of birth is My address is 136 Pecan Street Keller TX 43248 USA (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct Executed in Tarrant County, State of Texas on the 8th da of September 20 22 nth) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission WWw.ethics.state.tx.us Version V1.1.191b5cdc CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2022-930915 Space Savers, Inc. Keller, TX United States Date Filed: 09/07/2022 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Texas Date Acknowledged: 09/07/2022 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. 16673 Supply of Spray Slurry Alternate Daily Cover 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 V1.1.191b5cdc Brenda Haney Changed On Description Before After Current Balance Cost of Good/Services Additional Info 06/21/2022 Geo Rules Caller Type None Submittal —Received $26,615.00 Plan (PUR-2022-16673) O6/21/2022 End Date [none] 6/21/2022 $26,615.00 Plan workflow step text: (Initial Approvals O6/21/2022 Workflow Status Started Passed $26,615.00 Plan workflow step text: (Initial Approvals) O6/27/2022 Geo Rules Caller Type None Submittal —Received $26,615.00 Plan (PUR-2022-16673) O6/27/2022 Approved User ID [none] Haney, Brenda $26,615.00 Item Review (Purchasing Approval) O6/27/2022 Completed No Yes $26,615.00 Item Review (Purchasing Approval) O6/27/2022 Complete Date [none] 6/27/2022 $26,615.00 Item Review (Purchasing Approval) 06/27/2022 Item Review Status ID Under Review Approved $26,615.00 Item Review (Purchasing Approval) 06/27/2022 ItemReviewStatusName Under Review Approved $26,615.00 Item Review (Purchasing Approval) O6/27/2022 Passed No Yes $26,615.00 Item Review (Purchasing Approval) O6127/2022 StatusChangedDate [none] 6/27/2022 $26,615.00 Item Review (Purchasing Approval) Cheryl Brock Changed On Description Before After Current Balance Cost of Good/Services Additional Info O6/21/2022 Geo Rules Caller Type None Submittal —Received $26,615.00 Plan (PUR-2022-16673) 06/21/2022 Completed No Yes $26.615.00 Plan Submittal Item Review (Budget Director) 06/21/2022 Complete Date [none] 6/21/2022 $26,615.00 Plan Submittal Item Review (Budget Director) O6/21/2022 Item Review Status ID Under Review Approved $26.615.00 Plan Submittal Item Review (Budget Director) O6/21/2022 Passed No Yes $26,615.00 Plan Submittal Item Review (Budget Director) O6/21/2022 Submittal Status ID Under Review Approved $26,615.00 Plan submittal text: (6/21/2022) 09/09/2022 Geo Rules Caller Type None Submittal —Received $26,615.00 Plan (PUR-2022-16673) 09/09/2022 Completed No Yes $26,615.00 Plan Submittal Item Review (Budget Director) 09/09/2022 Complete Date [none] 9/9/2022 $26,615.00 Plan Submittal Item Review (Budget Director) 09/09/2022 Item Review Status ID Under Review Approved $26,615.00 Plan Submittal Item Review (Budget Director) 09/09/2022 Passed No Yes $26,615.00 Plan Submittal Item Review (Budget Director) 09/09/2022 Submittal Status ID Under Review Approved $26,615.00 Plan submittal text: (9/7/2022) Jesica McEachern Changed On Description Before After Current Balance Cost of Good/Services Additional Info 07/06/2022 Approved User ID [none] McEachern, Jesica $26,615.00 Item Review (Assistant City Manager/CFOtree) 07/06/2022 Completed No Yes $26,615.00 Item Review (Assistant City Manager/CFOtree) 07/06/2022 Complete Date [none] 7/6/2022 $26,615.00 Item Review (Assistant City Manager/CFOtree) 07/06/2022 Item Review Status ID Under Review Approved $26,615.00 Item Review (Assistant City Manager/CFOtree) September 21, 2022 Page 1 of 3 07/06/2022 ItemReviewStatusName Under Review Approved $26,615.00 07/06/2022 Passed No Yes $26,615.00 07/06/2022 StatusChangedDate [none] 7/6/2022 $26,615.00 Jill MacDougall Changed On Description Before After 06/21/2022 Geo Rules Caller Type None Submittal —Received 06/21/2022 Plan Note added 06/21/2022 Assigned User ID Morrison, Lainey MacDougall, Jill 06/21/2022 Completed No Yes 06/21/2022 Complete Date [none] 6/21/2022 06/21/2022 Item Review Status ID Under Review Requires Resubmission 06/21/2022 Submittal Status ID Under Review Requires Resubmission 06/28/2022 Geo Rules Caller Type None Submittal —Received 06/28/2022 Plan Note added 06/28/2022 Assigned User ID Morrison, Lainey MacDougall, Jill 06/28/2022 Completed No Yes 06/28/2022 Complete Date [none) 6/28/2022 06/28/2022 Item Review Status ID Under Review Approved 06/28/2022 Passed No Yes 06/28/2022 Submittal Status ID Under Review Approved Scott Dickson Changed On Description Before After 06/01/2022 Plan added 06/01/2022 Plan workflow status change. Department Head v.1 Auto Received: 06/01/2022 Plan workflow status change. Assistant City Manager/CFO v.1 Auto Received: 06/02/2022 Plan Description Alternate Daily Alternate Daily Cover for WTRDF Landfill Cover for WTRDF Contract. Needed for expiring contract Landfill Contract 13397 September 21, 2022 Item Review (Assistant City Manager/CFOtree) Item Review (Assistant City Manager/CFOtree) Item Review (Assistant City Manager/CFOtree) Current Balance Cost of Good/Services Additional Info $26,615.00 Plan (PUR-2022-16673) $26,615.00 Plan note text: (Needs insurance portal email attached) $26,615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan submittal text: (6/21/2022) $26,615.00 Plan (PUR-2022-16673) $26,615.00 Plan note text: (Insurance requirements are approved) $26.615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan Submittal Item Review (Risk Management Coordinator) $26,615.00 Plan submittal text: (6/27/2022) Current Balance Cost of Good/Services Additional Info $26,615.00 Plan (PUR-2022-16673) $26,615.00 Plan (PUR-2022-16673) $26,615.00 Plan (PUR-2022-16673) $26,615.00 Plan (PUR-2022-16673) Page 2 of 3 06/02/2022 06/21 /2022 06/21 /2022 06/21 /2022 06/21 /2022 O6/2112022 06/21 /2022 06/21 /2022 06/21 /2022 06/21 /2022 06/21 /2022 06/21/2022 O6/23/2022 O6/23/2022 O6/29/2022 O6/2912022 Geo Rules Caller Type None Submittal —Received $26,615.00 Plan (PUR-2022-16673) Attachment added $26,615.00 Attachment (D00058.pdf) Geo Rules Caller Type None Submittal_ Received $26,615.00 Plan (PUR-2022-16673) Geo Rules Caller Type None Submittal —Received $26,615.00 Plan (PUR-2022-16673) Plan Submittal added $26,615.00 Plan submittal text: (6/21/2022) Start Date [none] 6/21/2022 $26,615.00 Plan workflow step action text: (Budget Director) Workflow Status Not Started Started $26,615.00 Plan workflow step action text: (Budget Director) Assigned User ID Alvarez, Marta Haney, Brenda $26,615.00 Plan Submittal Item Review (Purchasing Approval) Assigned User ID Alvarez, Marta McEachern, Jesica $26,615.00 Plan Submittal Item Review (Assistant City Manager/CFOtree) Plan Submittal added $26,615.00 Plan submittal text: (6/21/2022) Start Date [none] 6/21/2022 $26,615.00 Plan workflow step action text: (Risk Management Coordinator) Workflow Status Not Started Started $26,615.00 Plan workflow step action text: (Risk Management Coordinator) Attachment added $26,615.00 Attachment (PUR-2022-16673 Insurance Email.pdf) Geo Rules Caller Type None Submittal_Received $26,615.00 Plan (PUR-2022-16673) Attachment added $26,615.00 Attachment (ADC BAFO.xlsx) Geo Rules Caller Type None Submittal —Received $26,615.00 Plan (PUR-2022-16673) September 21, 2022 Page 3 of 3