HomeMy WebLinkAboutResolution - 2023-R0002 - Contract 16948 with Polydyne, Inc. 1.10.23Resolution No. 2023-R0002
Item No. 5.2.2
January 10, 2023
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. 16948, as per ITB 23-16948-SB, for liquid
polymer for sludge handling, by and between the City of Lubbock and Polydyne Inc., and
related documents. Said Contract is attached hereto and incorporated in this resolution as if
fully set forth herein and shall be included in the minutes of the City Council.
Passed by the City Council on January 10, 2023
ATTEST:
Reb ca Garza, City Se e ry
APPROVED AS TO CONTENT:
.,
Erik Rejino, Assistant City Manager
APPROVED AS TO FORM:
Ry Br ke, Assistant City Attorney
RES.Contract No. 16948, Polydyne Inc.
12.9.22
Resolution No. 2023-R0002
City of Lubbock
Contract for
ITB 23-16948-SB
Liquid Polymer for Sludge Handling
Contract 16948
THIS CONTRACT made and entered into this IOthday of January . 20'23,by and between the
City of Lubbock ("City"), and Polvdvne. Inc. , ("Contractor").
WHEREAS, the City of Lubbock duly advertised for bids for Liquid Polymer for Sludge
Handling 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 Liquid Polymer for Sludge Handling
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, Liquid Polymer for Sludge
Handling, and more specifically referred to as Item #0-1 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 two (2), 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. 23-
16948-SB, 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.
vj-�'e� A7
Rebe ca Garza, City SecrWry
VED AS TO
Aubrey SpearAirectof of Water Utilities
AS TO
City Attorney
CONTRACTOR
BY Z'�, �
Au oriz Representative
Boyd Stanley, Sr. Vice-Presi t
Print Name
One Chemical Plant Road
Address
Riceboro, GA 31323
City, State, Zip Code
City of Lubbock
ITB 23-16948-SB
Liquid Polymer for Sludge Handling
at the Southeast Water Reclamation Plant
SPECIFICATIONS
1. INTENT
It is the intent of these specifications to describe the Polymer to be used to dewater the
sludge for the RDT's and Centerfuges at the City of Lubbock Southeast Water Reclamation
Plant.
PRODUCT SPECIFICATION
The polymer purchased for use at the City of Lubbock Southeast Water Reclamation Plant
shall contain no soluble inorganic or organic substances capable of producing deleterious
or injurious effects. The polymer must have Certification for use in waste water treatment
plants. Bidder shall submit a certificate of analysis which will include the specific gravity,
Cationicity, Active Polyacrylamide, Density and Freezing Point. The material safety data
sheets (MSDS) for the product shall also be submitted with the bid. Due to the fact that
successful Polymer will separate the solids as needed by state permit it is that the bidders
be a manufacturer of liquid Polymer. In any event, all products used. The same Polymers
manufacturer must be used throughout the term of the contract. Throughout the term of
the contract, the successful bidder may not change the formulation of the Polymer in
any way without the express written consent of the Waste Water Treatment Plant
Superintendent. No exceptions, an unauthorized change in the formulation of the
product will result in contract termination.
2. PRODUCT PERFORMANCE
Products to be considered for bid will be tested by the manufacturer using standard jar
testing methods at the City's site. A sample of the product being tested will be left at the
facility for additional jar testing by Operations personnel, if additional pilot plant testing is
necessary an additional amount of sample will be required. At the City's discretion full
plant testing will be required based on results of previous tests; the City will pay for a full
delivery (approximately 48,000 lbs.) at the price submitted in the bid document to conduct
full plant testing. Waste Water Treatment Operations personnel will evaluate product
performance based on sludge dryness and sludge separation. References will be thoroughly
checked and will figure prominently into the selection of a successful bidder.
3. PRODUCT QUALITY PER LOAD
Upon delivery of each load of product, the transport driver must present a certificate of
analysis containing Cationicity 80° o Active Polyacrylamide Min. 410/' Specific
Gravityl.01 -1.05 Freezing Point 7F. Density 8.5-8.6 lb/gal As stated in the product
specifications, A delivered product that exhibits any unusual color or appearance compared
to previous acceptable deliveries will be refused, as will deliveries containing any form of
foreign material. If the product meets the required minimum standards, the product may
then be off loaded into the storage tanks. If desired, the vendor may provide their own
hydrometer and perform an additional specific gravity analysis in the presence of the plant
operations staff. In the event the product does not meet the required minimum standards,
the load will be refused and the vendor must provide another acceptable load within forty
eight (48) hours. No additional freight or shipping charges shall be assessed by vendor.
4. TECHNICAL SUPPORT
Vendor shall provide acceptable technical support and response time whenever problems
are encountered relating to product use and/or performance. Acceptable technical support
will include routine site visits at least every three (3) months to consulting with operations
staff on any questions or problems with the product. A telephone response time of one (1)
business day is required of vendor in cases of product performance problems. A site visit
by the vendor may be requested by the owner if owner feels it is necessary to solve any
significant problem related to product performance. If a non -routine site visit is requested,
the vendor will have five (5) business days to respond and arrive on -site. All technical
support will be at no cost to the owner.
5. BID ACCEPTANCE
Product performance will be required to meet optimum quality performance. The
evaluation of bids will include testing procedures for sludge separation and dryness of the
sludge. The bid will be awarded based plant performance, cost effectiveness, and reference
checks.
6. QUANTITIES AND PRICING
The anticipated annual consumption of an aluminum sulfate is one tanker load every seven
to ten days. Prices quoted for product shall be FOB North Lubbock Waste Water treatment
Plant Lubbock, Texas. Listed quantities are estimates only for pricing purposes. Actual
usage may vary.
7. DELIVERY / SECURITY
Successful vendor shall be required to deliver the product to the Lubbock Waste Water
Treatment Plant in bulk tank truck within 2 weeks after order is placed. Unloading to plant
storage tanks is to be performed by the driver under the direction of operations personnel.
Successful vendor shall provide any and all special equipment necessary to perform
unloading at no cost to the City of Lubbock. All deliveries will be unloaded between the
hours of 8:00 A.M. and 6:00 P.M., Monday through Friday. No exceptions will be made
unless prior approval is agreed upon with the waste water treatment plant's operations
personnel. The transporter is required to furnish certified, dated, and stamped weight
tickets with each load of product, before and after unloading. All delivery people will
display photo security ID upon arrival at the site. All delivery vehicles shall meet OSHA
and DOT regulations and be operated in a safe manner while on site.
All delivery personnel will be identified by the vendor before arrival at the site; preferably
at the time an order is placed. Upon arrival at the Waste Water Treatment Plant, delivery
personnel will check in at the main building before proceeding to the unloading site. The
driver will be met at the security gate by plant personnel and must present photo
identification. All shipments shall be sealed and the seal will be broken only in the
presence of the plant representative. If any of the security measures are violated, the
shipment will be refused.
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 0 %, net
30 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?
u
#0-1
Items
Liquid Polymer, as specified
City of Lubbock
23-16948-SB
Liquid Polymer for Sludge Handling
BID TABLE
Polydyne Inc.
Location Riceboro, GA
Total Cost $82,080.00
Delivery
Quantity Days
Required UOM ARO UnitPrice
48000 LBS 10 - 20 days $ 1.71
TotalCost
$82,080.00
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 X 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.
ADDENDA
Bidder acknowledges receipt of addenda issued in regard to this solicitation:
Addenda No. 1
Date I IA 0/2022
Addenda No. 2
Date 11 / 11 /2022
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.
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 the company must sign the following section. Failure to execute this
portion may result in bid rejection.
THIS BID IS SUBMITTED BY POLYDYNE INC. a
corporation organized under the laws of the State of DELAWARE , or a partnership consisting of
or individual trading as
the City of
Tax ID No.: 34-1810283
Address: 1 Chemical Plant Road
City: Riceboro State: GA Zip: 31323
M/WBE Firm: I Woman Black American Native American
Hispanic American Asian Pacific American Other (Specify)
Please complete the information below.
By DDate: 11/14/2022
A hor' ed Representative - st sign by hand
Officer Name and Title: Bo tanley, Sr. Vice -President
Business Telephone Number (800) 848-7659 Option 2 FAX: (912) 880-2078
E-mail Address: bids@,polydvneinc.com
of
CERTIFICATE OF INTERESTED PARTIES
FORM ZL9rJ
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:
2022-960014
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
City of Lubbock
Lubbock, TX United States
Date Filed:
11/30/2022
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
Polydyne Inc.
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.
Contract 16948
Liquid Polymer for Sludge Handling
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
5 Check only if there is NO Interested Party. ❑
X
6 UNSWORN DECLARATION
My name is 'Boyd Stnnl= Sr Vice-PrPcident and my date of birth is
My address is One Chemical Plant Road Riceboro GA 31323 USA
(street) (city) (state) (zip code) (country)
1 declare under penalty of perjury that the foregoing is true and correct.
Executed in Liberty County, State of GA on the 30 day of NovembeX 20 22
(month) (year)
Signature of authorized agent co tracting business entity
(Declara )
corms provlaeo oy 1 exas Etnlcs c;ommission www.ethics.state.tx.us — Version V3.5.1.eb87ef42
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.
2022-960014
City of Lubbock
Lubbock, TX United States
Date Filed:
11/30/2022
2
Name of governmental entity or state agency that is a parry to the contract for which the form is
being filed.
Polydyne Inc.
Date Acknowledged:
12/02/2022
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.
Contract 16948
Liquid Polymer for Sludge Handling
4
Name of Interested Parry
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
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 V3.5.1.eb87ef42