HomeMy WebLinkAboutResolution - 2018-R0444 - PO With Deere & Company - 12_17_2018Resolution No. 2018-RO444
Item No. 6.15
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 for
and on behalf of the City of Lubbock, Purchase Order No. 31042466 for the purchase of John
Deere R20 Flex Wing Rotary Cutter as per RFP Buy Board 529-17, by and between the City of
Lubbock and Deere & Company of Cary, North Carolina, and related documents. Said 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
DANIEL M. POPE, MAYOR
ATTEST:
Reta Garza, City Secre ary
APPROVED AS TO CONTENT:
Scott Snider, Assistant City Manager
APPROVED AS TO FORM:
& hm�
K lli Leisure, Assistant City Attorney
ccdocs/RES.-PurchaseOrd 31042466 — John Deere R20 Flex Wing Rotary Cutter
December 6, 2018
City of
Lubbock
TEXAS
TO:
PURCHASE ORDER
DEERE & COMPANY
2000 JOHN DEERE RUN
CARY NC 27513
SHIP TO:
Page -
Date -
Order Number
1
12/6/2018
31042466 000 OP
526
CITY OF LUBBOCK
FLEET SERVICES
206 MUNICIPAL DRIVE
LUBBOCK TX 79404
INVOICE TO: CITY OF LUBBOCK
ACCOUNTSPAYABLE
P.O. BOX 2000
LUBBOCK, TX 79457 BY:
Maria Alvarez, Director of Purchasing & Contract Management
Ordered 12/3/2018 Freight
Requested 1/3/2019 Taken By J MONTES
Delivery J LOERWALD REQ 53103 BUY BOARD 529-17
Description/Supplier Item
John Deere R20 Flex Wing
Rotary Cutter - CC 4416
John Deere R20 Flex Wing
Rotary Cutter - CC 5815
Terms NET 30 DAYS
Ordered Unit Cost UM
1.000 29,121.3000 EA
I.000 29.12I.3000 EA
Extension Request Date
29,121.30 1/3/2019
Total Order
29,121.30 1/3/2019
58,242.60
This purchase order encumbers funds in the amount of $58,242.60 awarded to Deere & Company of Cary,
NC on December 17 2018. The following is incorporated into and made part of this purchase order by
reference: Buy Board 529-17 from Deere & Company of Cary, NC. Resolution # 2018-R0444
City of Lubb c ATTEST:
Daniel M. Pope, Mayor Rebtcca Garza, City Secret
Seller and Buyer agree as
follows:
PURCHASE ORDER
TERMS AND CONDITIONS
IMPORTANT: READ CAREFULLY
STANDARD TERMS AND CONDITIONS
CITY OF LUBBOCK, T%
I. SELLER TO PACKAGE GOODS. Seller will package goods in accordance with good commercial practice.
Each shipping container shall be clearly and permanently marked as follows (a) Seller's name and address,
(b) Consignee s name, address and purchase order or purchase release number and the supply agreement number
if applicable, (c) Container number and total number of containers, e.g. box 1 of 4 boxes, and (d) the number
of the container bearing the packing slip. Seller shall bear cost of packaging unless otherwise provided. Goods
shall be suitably packed to secure lowest transportation costs and to conform with requirements of common
carriers and any applicable specifications. Buyer's count or weight shall be final and conclusive on shipments
not accompanied by packing lists.
2. SHIPMENT UNDER RESERVATION PROHIBITED. Seller is not authorized to ship the goods under
reservation and no tender of a bill of lading will operate as a tender of goods.
3. TITLE AND RISK OF LOSS. The title and risk of loss of the goods shall not pass to Buyer until Buyer
actually receives and takes possession of the goods at the point or points of deliv ry.
4. NO REPLACEMENT OF DEFECTIVE TENDER. Every tender of delivery of goods must fully comply
with all provisions of this contract as to time of delivery, quality and the like. If a tender is made which does not
fully conform, this shall constitute a breach and Seller shall not have the right to substitute a conforming lender.
provided, where the time for performance has not yet expired, the Seller may reasonably notify Buyer of his
intention to cure and may then make a conforming tender within the contract time but not aftervard.
5. INVOICES & PAYMENTS. a. S e I I e r shall submit separate invoices, in duplicate, one each purchase
order or purchase release after each delivery. invoices shall indicate the purchase order or purchase release
number and the supply agreement number if applicable. Invoices shall be itemized and transportation charges,
if any, shall be listed separately. A copy of the bill of lading, and the freight waybill when applicable, should
be attached to the invoice. Mail To: Accounts Payable, City of Lubbock. P. O. Box 2000. Lubbock, Texas
79457. Payment shall not be due until the above instruments are submitted after delivery,
6, GRATUITIES. The Buyer may, by written notice to the Seller, cancel this contract without liability to
Seller if it is determined by Buyer that gratuities, in the form of entertainment, gifts or otherwise, were offered
or given by the Seller, or any agent or representative of the Seller, to any officer or employee of the Cityof
Lubbock with a view to securing a contract or securing favorable treatment with respect to the awarding or
amending, or the making of any determinations with respect to the performing of such a contract. In the evem
this contract is canceled by Buyer pursuant to this provision. Buyer shall be entitled. in addition to any other
rights and remedies, to recover or withhold the amount of the cost incurred by Seller in providing such gratuities.
7. SPECIAL TOOLS & TEST EQUIPMENT. If the price stated on the face hereof includes the cost of any
special tooling or special test equipment fabricated or required by Seller for the purpose of filling this order,
such special tooling equipment and any process sheets related thereto shall become the property of the Buyer
and to the extent feasible shill) be identified by the Seller as such.
8. WARRANTY -PRICE. a. The price to be paid by the Buyer shall be that contained in Seller's bid
which Seller warrants to be no higher than Seller's current process on orders by others for products of the kind
and specification covered by this agreement for similar quantities under similar of like conditions and methods
of purchase. In the event Seller breaches this warranty, the prices of the items shall be reduced to the
Seller s current prices on orders by others• or in the alternative. Buyer may cancel this contract without
liability to Seller for bleach or Seller's actual expense. b. The Seller warrants that no person or selling agency
has been employed or retained to solicit or secure this contract upon an agreement or understanding for
commission, percentage, brokerage, or contingent fee excepting bona fide employees of bona fide established
commercial or selling agencies maintained by the Seller for the purpose of securing business. For breach of
vitiation of this warranty the Buyer shall have the right in addition to any other right of rights to cancel this
contract without liability and to deduct from the contract price, or otherwise recover without liability and to
deduct from the contract price. or otherwise recover the full amount of such commission, percentage, brokerage
or contingent fee.
9. WARRANTY -PRODUCT. Seller shall not limit or exclude any implied warranties and any attempt to do
so shall render this contract voidable at the option of the Buyer. Seller warrants that the goods furnished will
con form to the specification. drawings, and descriptions listed in the bid invitation. and to the samplc(s) furnished
by the Seller, if any. In the event of a conflict or between the specifications, drawings. and descriptions. the
specifications shall govern, Notwithstanding any provisions contained in the contractual ageement, the Seller
represents and warrants fault -free performance and fault -free result in the processing date and date related data
(including, but not limited to calculating, comparing and sequencing) of all hardware, software and firmware
products delivered and services provided under this Contract• individually or in combination, as the case may
be from the effective date of this Contract. The obligations contained herein apply to products and services
provided by the Seller, its sub- Seller or any third party involved in the creation or development of the products
and services to be delivered to the City of Lubbock under this Contract. Failure to comply with any of the
obligations contained herein, may result in the City of Lubbock availing itself of any of its rights under the
law and under this Contract including, but not limited to. its right pertaining to termination or default. The
warranties contained herein are separate and discrete firm any other warranties specified in this Contract,
and are not subject to any disclaimer of warranty, implied or expressed, or limitation of the Sellers liability
which may be specified in this Contract, its appendices, its schedules, its annexes or any document incorporated
in this Contract by reference.
10. SAFETY WARRANTY. Seller warrants that the product sold to the Buyer shall conform to the standards
promulgated by the U. S. Department of Labor under the Occupational Safety and Health Act of 1970, In the
event the product does not conform to OSHA standards, Buyer may retum the product for correction or
replacement at the Seller's expense. In the event Seller fails to make the appropriate correction within a
reasonable time, correction made by Buyer will be at the Seller s expense.
11. NO WARRANTY BY BUYER AGAINST INFRINGEMENTS. As pan of this contract for sale Seller
agrees to ascertain whether goods manufactured in accordance with the specifications attached to this agreement
will give rise to the rightful claim of any third person by way of infringement of the like. Buyer, makes no
warranty that the production ofgoods according to the specification will not give rise to such a claim. and in no
event shall Buyer be liable to Seller for indemnification in the event that Seller is sued on the grounds of
infringement of the like. If Seller is of the opinion that an infringement or the like will result, he will notify the
Buyer to this effect in writing within two weeks after the signing ofthis agreement. If Buyer does not receive
notice and is subsequently held liable for the infringement or the like, Seller will save Buyer harmless. if
Seller in good faith ascertains the production of the goods in accordance with the specifications will result in
infringement or the like, the contract shall be null and void.
12. NON APPROPRIATION. All funds for payment by the City under this contract are subject to the
availability of an annual appropriation far 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 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 rut 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.
13. RIGHT OF NSPECTION Buyer shall have the right to inspect the goods at delivery before accepting
them.
14. CANCELLATION, Buyer shall have the right to cancel for delaull all or any part ul the undelivered
portion of this order if Seller breaches any of the terms hereof including warranties of Seller or if the Seller
becomes insolvent or commits acts of banluvptcy. Such right of cancellation is in addition to and not in
lieu of any other remedies which Buyer may have in law or equity.
1.5. TERMINATION. The performance of work under this order troy be terminated in whole, or in part by the
Buyer in accordance with this provision. Termination of work hereunder shall be effected by the delivery
of the Seller of a Nouce of Termination" specifying the extent to which performance of work under the
order is terminated and the date upon which such termination becomes effective. Such right or termination is
in addition to and not in lieu of the rights of Buyer set forth in Clause 14, herein.
16. FORCE MAJEURE. Neither party shall be held responsible for losses, resulting if the fulfillment
of any terms of provisions of this contract is delayed or prevented by any cause not within the control of the
party whose performance is interfered with, and which by the exercise of reasonable diligence said party is
unable to prevent.
I T ASSIGNMENT -DELEGATION. No right or interest in this contract shall be assigned or delegation of
any obligation made by Seller without the written permission of the Buyer. Any attempted assignment or
delegation by Seller shall be wholly void and totally ineffective for all purpose unless made in conformity with
this paragraph.
I8. WAIVER. No claim or right arising out of a breach of this contract can be discharged in whole or in part
by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by
consideration and is in writing signed by the aggrieved party.
19. INTERPRETATION -PAROLE EVIDENCE. This writing, plus any specifications for bids and
performance provided by Buyer in its advertisement for bids, and any other documents prodded by
Seller as pan of his bid. is intended by the parties as a final expression of their agreement and intended also
as a complete and exclusive statement of the terms of their agreement. Whenever a term defined by the
Uniform Commercial Code is used in this agreement. the definition contained in the Code is to control.
20. APPLICABLE LAW. This agreement shall be governed by the Uniform Commercial Code Wherever
the term' Uniform Commercial Code' is used, it shall be construed as meaning the Uniform Commercial
Code as adopted in the State of Texas m effective and in force on the date of this agreement.
21. RIGHT TO ASSURANCE. Whenever one party to this contract in good faith has reason to question
the other parry's intent to perform he may demand that the other party give written assurance of his intent to
perform. In the event that a demand is made and no assurance is given within five (5) days, the demanding
party may treat this failure as an anticipatory repudiation of the contract.
22. INDEMNIFICATION. Seller shall indemnify, keep and save harmless the Buyer, its agents, officials and
employees, against all injuries, deaths, loss, damages. claims, patent claims, suits, liabilities, judgments, costs
and expenses, which may in anywise accrue against the Buyer in consequence of the granting of this Contract
or which may anywise result therefi'om, whether m not it shall be alleged or determined that the act was
caused through negligence or omission of the Seller or its employees, or of the subSeller or assignee or its
employees, if any, and the Seller shall, at his own expense, appear, defend and pay all charges of attorneys
and all costs and other expenses arising therefrom of incurred in connection therewith, and, if any judgment
shall be rendered against the Buyer in any such action, the Seller shall, at its own expenses, satisfy and
discharge the same Seller expressly understands and agrees that any bond required by this contract, or
otherwise provided by Seller, shall in no way limit the responsibility to indemnify, keep and save harmless
and defend the Buyer as herein provided.
23. TIME. It is hereby expressly agreed and understood that time is of the essence for the performance of
this contract, and failure by contract to meet the time specifications of this agreement will cause Seller to
be in default of this agreement.
24. MBE. The City of Lubbock hereby notifies all bidders that in regard to any contract entered into
pursuant to this request. minority and women business enterprises will be afforded equal opportunities to
submit bids in response to this invitation and will not be discriminated against on the grounds of race. color.
sex or natural origin in consideration for an award.
25. NON -ARBITRATION. The City reserves the night to exercise any right or remedy to it by law, contract•
equity, or otherwise, including without limitation, the right to seek any and all fora 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.
26. RIGHT TO AUDIT. At any time during the tern 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 ofsuch 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.
27. HOUSE BILL 2015. House Bill 2015, signed by the Governor on June 14, 2013 and effective on January
I, 2014, authorizes a penalty to be imposed on a person who contracts for certain services with a governmental
entity and who fails to properly classify their workers. This applies to subcontractors as well Contractors and
subcontractors who fail to properly classify individuals performing work under a governmental contract will be
penalized $200 for each individual that has been misclassifted. (Texas Govemment Code Section 2155.001).
28, ASSIGNING OR SUBLETTING THE CONTRACT. The Contractor shall not assignor sublet the contract,
or any portion of the contract, without written consent hom 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.
29, HOUSE BILL 1295 DISCLOSURE OF INTERESTED PARTIES. House Bill 1295, adopted by the 34th
Legislature. created §2252.908. Texas Government Code. Section 2252.908 requires a business entity entering
into certain contracts with a governmental entity or state agency to file with the governmental entity or state
agency a disclosure of interested patina at the time the business entity submits the signed contract to the
governmental entity or state agency. Instructions for completing Form 1295 are available at:
hhup://www.ci.lubbock.mus/deoartmental-websites/depar* nt< p gyre wingNendor-information
30. CONTRACTOR ACKNOWLEDGES, by supplying any Goods or Services that the Contractor has read.
fully understands, and will be in full compliance with all terrors 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 panics. 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 terra ag eed
upon by the parties. and any prior conflicting terms shall be of no forec or effect.
31. By accepting this purchase order, the Vendor verities that it does not Boycott Israel, and agrees that during
the term of this Agreement (Contract as applicable) will not Boycott Israel as that term is defined in Texas
Government Code Section $08, 001. as amended.
Rev. 10:2017
ip Y�
lUI[\:i
ALL PURCHASE ORDERS MUST BE MADE OUT
TO (VENDOR):
Deere 8, Company
2000 John Deere Run
Cary, NC 27513
FED ID: 36-2382580: DUNS#: 60-7690989
Prepared For:
City Of Lubbock Fleet Services
204 Municipal Dr
Lubbock, TX 79403
Business: 806-300-0000
ALL PURCHASE ORDERS MUST BE SENT
TO DELIVERING DEALER:
Hurst Farm Supply. Inc.
4801 Highway 84
Lubbock, TX 79416
806-762-0638
Quote Summary
Delivering Dealer:
Hurst Farm Supply, Inc.
William Murphy
4801 Highway 84
Lubbock, TX 79416
Phone: 806-762-0638
kris@hurstfs.com
BUYBOARD STATE CONTRACT Quote ID: 18557444
Created On: 20 November 2018
WAS USED TO OBTAIN MAXIMUM Last Modified On: 21 November 2018
DISCOUNTS. Expiration Date: 31 December 2018
Equipment Summary Suggested List Selling Price Qty
JOHN DEERE R20 Flex Wing Rotary $ 37.335.00 $ 29,121,30 X 2
cutter
Contract: TX BuyBoard Grounds Mtnc Equip, Irrigation 529-17 (PG 67 CG 70)
Price Effective Date: November 20, 2018
Equipment Total
` Includes Fees and Non -contract items
Salesperson: X
Quote Summary
Equipment Total
Trade In
SubTotal
Est. Service
Agreement Tax
Total
Down Payment
Rental Applied
Balance Due
Confrdenhal
Accepted By : X
Extended
5 58.242.60
$ 58,242.60
$ 58,242.60
$ 58,242.60
$ 0.00
$ 58,242.60
(0.00)
(0,00)
$ 58,242.60
s
J+C HN DEERE
Selling Equipment%
Quote Id: 18557444 Customer Name: CITY OF LUBBOCK FLEET SERVICES
ALL PURCHASE ORDERS MUST BE MADE OUT
ALL PURCHASE ORDERS MUST BE SENT
TO (VENDOR):
TO DELIVERING DEALER:
Deere & Company
Hurst Farm Supply, Inc.
2000 John Deere Run
4801 Highway 84
Cary, NC 27513
Lubbock, TX 79416
FED ID: 36-2382580: DUNS* 60-7690989
806-762-0638
JOHN DEERE R20 Flex Wing Rotary cutter
Contract: TX BuyBoard Grounds Mtnc Equip, Irrigation Suggested List
529-17 (PG 67 CG 70) $ 37,335.00
Price Effective Date: November 20, 2018 Selling Price ;
$ 29,121.30
Price per item - includes Fees and Non -contract items
Code Description Qty List Price Discount% Discount Contract Extended
Amount Price Contract
Price
2360P R20 Flex Wing Rotary cutter 2 $ 36,983.00 22.00 $ 8,136.26 $ 28,846.74 $ 57,693,48
Standard Options - Per Unit
0202 United States 2 $ 0.00 22.00 $ 0.00 $ 0.00 $ 0.00
3035 6 Foam -Filled Tires - 2 $ 352.00 22.00 $ 77.44 $ 274.56 $ 549.12
(Double center, single on
wings) - Severe duty ag tires
3541 1000 RPM Driveline - 1 3/8" 2
$ 0.00
22.00 $ 0.00
$ 0.00
$ 0.00
coupler - Cat 6
3641 1000 RPM - 125 hp 2
$ 0,00
22.00 $ 0.00
$ 0.00
$ 0.00
Gearbox - Commercial duty
5120 Ball Type Hitch 2
$ 0.00
22.00 $ 0.00
$ 0.00
$ 0.00
5280 Rigid Casting Tongue 2
$ 0.00
22.00 $ 0.00
$ 0.00
$ 0.00
Standard Options Total
$ 352.06
$ 77.44
$ 274.56
$ 549.12
Price
Confidential
$ 58,242.60
Privacy and Data Policy Overview
HURST FARM SUPPLY, INC.
Effective Date: September 29, 2014
This is only a summary of our Privacy and Data Policy. For more information you can review a complete
version of our Privacy and Data Policy located on our website at www.htrrstfs.corn
or by requesting a copy at privacy@hurstfs, com.
This Privacy and Data Policy Overview provides a description of the privacy and data use practices of Hurst
Farm Supply. Inc. ("us", "we" or "our") in connection with our receipt, collection and use of data and
information from you as our customer, visitor, or user, as applicable. The policy may be changed or updated
from time to time. If there is any conflict between this Overview and our full Privacy and Data Policy, the
terms of our full Privacy and Data Policy will control.
Collection of Data:
The types of information we collect and share depend on the products or services you purchase, license or
access from us or third parties through which you have authorized us to receive information (such as through
John Deere's JD Link" Telematics system). We generally receive, collect, use and share both Customer Data
(including social security numbers, names, addresses, phone numbers, and other personal information) and
Machine Data (information related to the performance, use, and location of equipment or computers with
various information collection devices) as described in this Policy (collectively "Data"). You agree to notify
all personnel that use any tracked equipment that their use and location is remotely monitored. If you
need to update or change any information which you previously provided to us then you may contact us at
privacy@hurstfs.com or (800) 477-5617.
Protection of Data:
We strive to protect your Data using commercially reasonable standards. We use a variety of commercially
reasonable security technologies to help protect your Data from unauthorized access, use, or disclosure.
However, the use of such standards and security technologies is not, and should not be considered to be, any
type of guarantee or warranty by us that your Data will not be accessed by third parties.
Sharine and Use of Data:
We use your Data to provide products, services and information to you. Some of the services are designed to
allow faster communications and responsiveness between you and us to ensure that we provide services to you
as efficiently as possible. We may also review equipment diagnostic information remotely to diagnose and
recommend equipment maintenance and repairs. We may share your information with certain third parties in,
order to better serve you upon your request or approval. These third parties may include equipment suppliers,
financing institutions or other third party service providers who assist us in providing the products and services
you request or their respective subsidiaries or affiliates. We may also share your information with our
marketing, technical, accounting, legal or other professionals to assist us in our business operations. If you
purchase products for personal, family, or household use through financing that is provided by us or facilitated
by us, you may request that we not share your personal information derived from that transaction with
unaffiliated third parties by submitting the opt -out form at the bottom of our full Privacy and Data Use Policy
located on our website.
If you have any additional questions, please contact us at privacy@hurstfs.com.
Signature Date
(Updare d September 29. 2014)
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.
2018-430477
HURST FARM SUPPLY
LUBBOCK, TX United States
Date Filed:
12/04/2018
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.
PO 31042466
JOHN DEERE
Nature of interest
4
Name of Interested Party
City, State, Country (place of business)
(check applicable)
Controlling
Intermediary
HURST FARM SUPPLY
LUBBOCK, TX United States
X
5 Check only if there is NO Interested Party. O
6 UNSWORN DECLARATION
My is �F�-{ "'"`7 is
name ,and my date of birth
of b'�t < <-
My address is ✓ �`T•60
(street) (city) (state) (zip code) (country)
I declare under pen per u that the foregoing is true and correct.
�,,,,
Executed in `'� County, State of ��� /�' the day ofL 20
on
(month) (year)
T u honz gentm Aco'ntractrusiness entity
"`
(Declarant) '---
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711
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.
2018-430477
HURST FARM SUPPLY
LUBBOCK, TX United States
Date Filed:
12/04/2018
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:
12/05/2018
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.
PO 31042466
JOHN DEERE
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
HURST FARM SUPPLY
LUBBOCK, TX United States
X
5
Check only if there is NO Interested Party. ❑
6
UNSWORN DECLARATION
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of on the day of , 20
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711