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HomeMy WebLinkAboutResolution - 2023-R0232 - Contract 17233 with Bolt Furniture Delivery & Installation 5.9.23Resolution No. 2023-RO232 Item No. 6.12 May 9, 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. 17233 for Moving and Relocation Services, by and between the City of Lubbock and Bolt Furniture Delivery & Installation, 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 • : 6WO-6 a_ ���ZK�I�(III�i�Il1A Erik Rejino, Assistant City Manager FORM: May 9, 2023 , � ��rr 7: -�- - TRAY PA E, MAYOR irst Assistant City Attorney ccdocs/RES.Contract-Bolt Furniture Delivery April 20, 2023 Resolution No. 2023-R0232 City of Lubbock Moving and Relocation Services Agreement Contract 17233 This Service Agreement (this "Agreement") is entered into as of the 9 day of May 2023 ("Effective Date") by and between Bolt Furniture Delivery & Installation, Inc. (the Contractor), and the City of Lubbock (the "City"). RECITALS WHEREAS, the City has issued a Request for Proposals 23-17079-DH Moving and Relocation Services and WHEREAS, the proposal submitted by the Contractor has been selected as the proposal which best meets the needs of the City for this service; and WHEREAS, Contractor desires to perform as an independent contractor to provide Moving and Relocation Services, upon terms and conditions maintained in this Agreement; and NOW THEREFORE, for and in consideration of the mutual promises contained herein, the City and Contractor agree as follows: City and Contractor acknowledge the Agreement consists of the following exhibits which are attached hereto and incorporated herein by reference, listed in their order of priority in the event of inconsistent or contradictory provisions: 1. This Agreement 2. Exhibit A — General Requirements 3. Exhibit B — Best and Final Offer 4. Exhibit C — Insurance Requirements Scope of Work Contractor shall provide the services that are specified in Exhibit A. The Contractor shall comply with all the applicable requirements set forth in Exhibit B and Exhibit C attached hereto. Article 1 1.1 The contract shall be for a term of one (1) year, with the option of four (4), one (1) year extensions, said date of term beginning upon formal approval. The contract may be renewed for up to four (4) additional one (1) year terms under the same term and conditions upon written agreement from both parties. 1.2 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. 1.3 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. 1.4 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. 1.5 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. Article 2 Miscellaneous. 2.1 This Agreement is made in the State of Texas and shall for all purposes be construed in accordance with the laws of said State, without reference to choice of law provisions. 2.2 This Agreement is performable in, and venue of any action related or pertaining to this Agreement shall lie in, Lubbock, Texas. 2.3 This Agreement and its Exhibits contains the entire agreement between the City and Contractor and supersedes any and all previous agreements, written or oral, between the parties relating to the subject matter hereof. No amendment or modification of the terms of this Agreement shall be binding upon the parties unless reduced to writing and signed by both parties. 2.4 This Agreement may be executed in counterparts, each of which shall be deemed an original. 2.5 In the event any provision of this Agreement is held illegal or invalid, the remaining provisions of this Agreement shall not be affected thereby. 2.6 The waiver of a breach of any provision of this Agreement by any parties or the failure of any parties otherwise to insist upon strict performance of any provision hereof shall not constitute a waiver of any subsequent breach or of any subsequent failure to perform. 2.7 This Agreement shall be binding upon and inure to the benefit of the parties and their respective heirs, representatives and successors and may be assigned by Contractor or the City to any successor only on the written approval of the other party. 2.8 All claims, disputes, and other matters in question between the Parties arising out of or relating to this Agreement or the breach thereof, shall be formally discussed and negotiated between the Parties for resolution. In the event that the Parties are unable to resolve the claims, disputes, or other matters in question within 30 days of written notification from the aggrieved Party to the other Party, the aggrieved Party shall be free to pursue all remedies available at law or in equity. 2.9 At any time during the term of the contract, or thereafter, the City, or a duly authorized audit representative of the City or the State of Texas, at its expense and at reasonable times, reserves the right to audit Contractor's records and books relevant to all services provided to the City under this Contract. In the event such an audit by the City reveals any errors or overpayments by the City, Contractor shall refund the City the full amount of such overpayments within 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. 2.10 The City reserves the right to exercise any right or remedy 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. 2.11 The contractor shall not assign or sublet the contract, or any portion of the contract, without written consent from the Director of Purchasing and Contract Management. Should consent be given, the Contractor shall insure the Subcontractor or shall provide proof of insurance from the Subcontractor that complies with all contract insurance requirements document, this provision shall control. 2.12 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. 2.13 Contracts with Companies Engaged in Business with Iran, Sudan, or Foreign Terrorist Organization Prohibited. Pursuant to Section 2252.152 of the Texas Government Code, prohibits the City from entering into a contract with a vendor that is identified by The Comptroller as a company known to have contracts with or provide supplies or service with Iran, Sudan or a foreign terrorist organization. 2.14 Texas Public Information Act. 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 contract 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. 2.15 No Boycott of Israel. 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. 2.16 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. 2.17 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. 2.18 Confidentiality. 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. 2.19 Indemnify. 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. IN WITNESS WHEREOF, the parties hereto have caused this Contract to be executed the day and year first above written. Executed in triplicate. CITY OF L Tray Payne, A ST: I 'fvv� Courtney Paz, CVY Secr APPROVED AS TO Director of 172kilities CONTRACTOR BY: Authorized Repr/esentati6,n ve j l pr5 Print Name C:a/ I/ Address City, State, Zip Code Exhibit A City of Lubbock, TX RFP 23-17079-DH Moving and Relocation Services General Requirements 1 INTENT The City of Lubbock, Texas is seeking proposals from experienced and qualified vendors for Moving and Relocation Services to accomplish the relocation of several city departments as required. The City of Lubbock is seeking a contract for moving and relocation services with one or more contractors. In order to assure adequate coverage, the City may make multiple awards, selecting multiple vendors to provide the services desired, if multiple awards are in the best interest of the City. A decision to make a multiple award, however, is an option reserved by the City, based on the needs of the City. 2 SCOPE OF WORK 1. Scope. Moving services for office furniture, fixtures, materials, appliances, supplies and equipment typically found in city hall departmental settings. Department moves may vary in scope, size and frequency. All labor, supervision, tools, equipment, transportation, permits, fees, taxes, incidentals and materials necessary to perform moves are to be included and provided by the contractor. 2. Locations. Moves will occur building -to -building and department -to -department. All such locations are within the City of Lubbock (Texas). 3. Supervision. The Contractor shall submit an organizational chart showing the structure of the management team from on -site supervision staff up to the local division manager and/or person ultimately responsible for the performance of this contract. The Contractor shall supply competent and thoroughly trained "onsite" supervisor(s) to check, inspect and maintain records (inventory/manifests) of all work performed. Supervisor(s) shall possess and demonstrate a thorough knowledge and understanding of the designated work assignments, the tools and equipment employed in the execution of this contract, and the rules, regulations and standards of the City. The supervisor(s) shall also possess a superior working knowledge of conversational English for required communications with the City representative(s). The onsite supervisor(s) shall be available and accountable during all working hours to oversee performance of all obligations under this contract. 4. Pre -move Supplies. The Contractor shall provide 1,500 standard 2 CF (1'x2') cardboard boxes, with sufficient tape to secure those boxes, to the City representative for distribution to Department Coordinators for City -employee use in pre -packing of equipment and/or pre -identified confidential resources. The contractor will be responsible for final packing and relocating of "confidential resources" as described in Item 5 below. The proposal shall also include a "unit price" for a standard 2 CF (I'x2') cardboard box with sufficient tape to secure the box to allow for the City to obtain additional pre -move boxes if/as required. 5. Furniture, Materials and Equipment, Records Furniture - includes but is not limited to items identified by Owner: 0 Standalone Office Furniture - Desks, chairs, bookcases, credenzas, filing cabinets, etc. Exhibit A • Modular Systems Furniture — Office furniture that typically requires assembly of partitions, desks, overhead bins, file cabinets, map/plan cabinets, shelving/stacked systems, etc. • Systems Equipment — computers, printers, plotters, scanners (relocate only). The contractor will be required to disassemble/assemble, takedown/setup furniture/shelving if needed for relocation. However, the City reserves the right to utilize other contractors to perform such work when purchasing new furniture, reconfiguring or refurbishing existing. The City may also use its own employees for work with any COL property. Materials and Equipment - includes but is not limited to items identified by Owner: Various materials and equipment throughout its facilities. Items may vary from everyday common types to those specific to certain industries. Please Note: Confidential resources will require "secure" handling, (i.e. monitored packing & tamper -proof tape), and may include City provided escort to ensure confidentiality during the entire relocation process (see "5.1 Special Equipment" below). Records — Citizens records may be those stored in designated record keeping facilities, or those maintained by specific departments. Please Note: Confidential resources will require "secure" handling (i.e. monitored packing & tamper -proof tape), and may include City -provided escort to ensure confidentiality during the entire relocation process. Hazardous Materials - The contractor will not be required to handle, store or transport hazardous materials. These will be arranged for separately. 5.1 Special Equipment. Equipment that requires special training and experience to connect/ disconnect, move, transport or setup is exempt. The Contractor will, however, provide final packing, sealing and transport of computers, phones and other office -required electronic systems, mail -processing equipment, etc. if/as required (also see Section 2, item 5 above for "secure" handling requirements). Please Note that such special "system" equipment will be moved separately (in advance of) other items to allow system providers to render such systems available for use ahead of occupancy as City employees will be expected to continue operations immediately upon arrival. To preserve operational use, the City reserves the right to use vendors that specialize in disconnecting/connecting, servicing, supporting and moving of this type of equipment. Some equipment may require licensing and/or permitting from appropriate regulatory agencies. 5.2 Warrantied Furniture and Equipment. Some existing furniture may be under warranty from the supplying vendor and may require disassembly and reassembly by a designated vendor only. Under these circumstances the City reserves the right to use such vendors to preserve the terms of the warranty. 5.3 Protection of Property. The contractor will ensure City property is properly prepped and protected for safe moving. Finishes of furniture, millwork, flooring, walls, doors, ceilings, stairways and windows must retain their pre -move appearance and function. Proper equipment and/or vehicles must be utilized for transport. The contractor assumes all responsibility for damaged or lost property and must resolve any such issues within 30 days of discovery through repair, replacement or reimbursement. The contractor must work with designated City representative in doing so. 5.4 Storage. The City maintains some of its own warehousing facilities, however utilization of contractor storage, including climate -controlled facilities, may be sought should the need arise. The contractor's facilities will be bonded and insured, and City property must be inventoried and properly stored. High -value and Confidential items, as determined by the City, must have additional security measures in place. Exhibit A Temporary overnight tractor trailer storage may also be utilized if during a move time or resource constraints do not permit unloading until the next workday. The trailer must be secured and staged in an area approved by the assigned City representative. 5.5 Safety. The contractor will perform all work in a safe manner, adhering to OSHA and State DOA guidelines, with proper technique and equipment in order to preserve the safety of all contractors, visitors and City employees. At no time will the contractor perform any act that is unsafe. To ensure safety within and for the community, all Proposers are reminded that the following rules and considerations will be required when providing moving services for this RFP: • Pedestrians have the right of way at all times. • All traffic signs, lights or other indicators are to be obeyed. This is of utmost importance whenever pedestrians are present. • Driving on sidewalks, unless otherwise posted, is forbidden. Violators will be ticketed and chronic violators may be barred from doing business with the City in future. In those areas where sidewalk driving is permitted and required, drivers must employ adequate skills so as to avoid disruption of other services and/or crews. • Drivers are required to shut off engines while loading and unloading. When determined as necessary, the contractor will temporarily close off areas to pedestrian traffic to prevent potential injury to bystanders when large or heavy equipment is being moved or used and provide appropriate safety apparel to their employees when needed. A City representative will work with the contractor to coordinate City notifications if/when needed. Contractor employees will also wear uniforms with their company name while working. Contractor vehicles must not park in fire lanes, on sidewalks, in landscaped areas or any area not intended for vehicles. 5.6 Utilization. The service will be utilized by the City on an as -needed basis only. Frequency of use, size and scope of moves may vary and is not guaranteed. Contractors will not use another contractor's co -located resources (i.e. dumpsters) without the express written permission of the providing entity. 5.7 Communication and Authorization. An appointed City representative will be the single contact point for the contractor, through which requests, direction, coordination and authorization will be communicated. 6. Industrial Powered Trucks (Forklifts). Most City locations do not have a forklift on site with qualified operators that will be available to assist the contractor with loading/unloading palletized items. Regardless, contractor employees are not allowed to operate City -owned forklifts even if available. The contractor must supply a forklift and a certified operator (per OSHA requirements) if/when needed. Exhibit B City of Lubbock, TX Purchasing and Contract Management Vendor Acknowledgement Form The City of Lubbock reserves the right to accept or reject any and all. The City of Lubbock Charter states that no officer or employee of the City can benefit from any contract, job, work or service for the municipality or be interested in the sale to the City of any supplies, equipment, material or articles purchased. Will any officer or employee of the City, or member of their immediate family, benefit from the award of this proposal to the above firm? YES X NO THE OFFEROR HEREBY ACKNOWLEDGES RECEIPT INSURANCE REQUIREMENTS I, the undersigned Vendor certify that the insurance requirements 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. Exhibit B City of Lubbock RFP 23-17079-DH Moving and Relocation Services Price Proposal Sheet BAFO Bolt Furniture Delivery & Installation, Inc. Location Lubbock, TX Total $258,288.50 # Quantity Required Unit Total Item Description (+/-) UOM Price Cost HOUrly Rate #1-1 Hourly Rate for 1 Box Truck and 1 Driver/Mover 1000 Hourly $76.00 $76,000.00 # 1-2 Hourly Rate for 1 Mover 1000 Hourly $45.00 $45,000.00 #1-3 Hourly Rate for I Supervisor 1000 Hourly $60.00 $60,000.00 #14 Hourly Rate for Travel Time Itemized Separately 1000 Hourly $76.00 $76,000.00 #2-1 Mileage Rate Itemized Separately 1 Miles $2.00 $2.00 #2-2 Overnight Charges Per Night 1 Nights $150.00 $150.00 #2-3 Fuel Surcharge 1 Flat Rate $50.00 $50.00 #24 Fuel Surcharge 1 Per Mile $2.00 $2.00 3 Products #3-1 Moving Box (1.5 Cubic Foot/Taped) 1 EA $4.00 $4.00 #3-2 Moving Box (2 Cubic Foot/Taped) 1 EA $5.00 $5.00 #3-3 Moving Box (3 Cubic Foot/Taped) 1 EA $6.00 $6.00 #34 Moving Box (4 Cubic Foot/Taped) I EA $7.00 $7.00 #3-5 2 Wheel Dolly I EA $10.00 $10.00 #3-6 Panel Cart 1 EA $20.00 $20.00 #3-7 Speed Pack I EA $72.00 $72.00 #3-8 Plastic Stretch Wrap 1 EA $30.00 $30.00 #3-9 4 Wheel Dolly I EA $3.00 $3.00 4 Misc Rates and Fees #4-1 Forklift (Daily Rate) 1 Daily $ 475 $ 475 #4-2 Temporary Storage Fees 1 Square Feet $2.50 $2.50 #4-3 Temporary Storage Fees 1 Time $200 $200 #4-4 Packing Material Delivery Fees 1 EA $250 $250 Exhibit B VENDOR ACKNOWLEDGEMENT In compliance with this procurement, the undersigned offeror having examined the request for proposal, instructions to offerors, documents associated with the request for proposals, and being familiar with the conditions to be met, has reviewed the 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 An individual authorized to bind the company must sign the following section. Failure to execute this portion may result in proposal rejection. Authorized Signature Alisha Gregg Print/Type Name Bolt Furniture Delivery & Installation, Inc. Company Name CEO Title February 7, 2023 Date 2131 Baylor Dr. Address Lubbock, Texas 79415 City, State Zip Code Contact for questions, clarifications, etc. Name and Title: Alisha Gregg, CEO Mailing Address: PO Box 94667 City, State, Zip: Lubbock, Texas 79493-4667 Telephone No: 806.412.4796 Fax No: N/A E-Mail: agregg@boltfdi.com Exhibit C Insurance Requirements Commercial General Liability Requirements: $IM occurrence / $2M aggregate (can be combined with an Excess Liability to meet requirement). CGL is required in ALL contracts. It is perhaps the most important of all insurance policies in a contractual relationship. It insures the Contractor has broad liability coverage for contractual activities and for completed operations. Commercial General Liability to include Products — Completion/OP, Personal and Advertising Injury, Contractual Liability, Fire Damage (any one fire), and Medical Expenses (any one person). Automobile Liability Requirements: $1 M/occurrence is needed Workers Compensation and Employer Liability Requirements: Statutory. If the vendor is an independent contractor with no employees and are exempt from providing Workers' Compensation coverage, they must sign a waiver (obtained from COL Purchasing) and include a copy of their driver's license.. Employer Liability ($1 M) is required with Workers Compensation. Carrier Cargo Liability Requirements: Motor Carrier Cargo Insurance is required for this project and must cover, at minimum, the value of the full load that is being hauled. Bailee's Coverage Requirements: Bailee's Coverage is needed for this project. Minimum coverage limits should at least be equal to what it would cost to recreate, restore, or replace the property being entrusted to the contractor, including research. Bailee's Coverage Amount: 100000 * The City of Lubbock (including its officials, employees and volunteers) shall be afforded additional insured status on a primary and non-contributory basis on all liability policies except professional liabilities and workers' comp. * Waivers of Subrogation are required for CGL, AL, and WC. * To Include Products of Completed Operations endorsement. * Carrier will provide a 30-day written notice of cancellation, 10-day written notice for non- payment. * Carriers must meet an A.M. Best rating of A- or better. * Subcontractors must carry same limits as listed above CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1 - 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2023-1010490 Date Filed: 04/21/2023 Date Acknowledged: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Bolt Furniture. Delivery. Installation Lubbock, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. RFP 23-17079-DH Moving and Rel Moving/Relocation local 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 '�y ' "" q� and my date of birth is My address is 2131 Baylor Dr. Lubbock , TX , 79415 USA (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 V3.5.1.7bd706d4 CERTIFICATE OF INTERESTED PARTIES FORM 1295 lofl Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2023-1010490 Bolt Furniture. Delivery. Installation Lubbock, TX United States Date Filed: 04/21/2023 2 Name of governmental entity or state agency that is a parry to the contract for which the form is being filed. City of Lubbock Date Acknowledged: 04/21/2023 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. RFP 23-17079-DH Moving and Rel Moving/Relocation local Nature of interest 4 Name of Interested Party City,State, Country (place of business) (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 orovided by Texas Ethics Commission www.ethics.state.tx.us Version V3.5.1.7bd706d4