HomeMy WebLinkAboutResolution - 2016-R0020 - Precision Body Works - 01/14/2016Resolution No.2016-R0020
Item No.6.21
January 14,2016
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 behalfof the City of Lubbock.Contract No.12590 as per RFP 16-12590-TF for body
work and accident damage repairfor Citibus vehicles,by and between the Cityof Lubbock and
Precision Body Works,of Lubbock,Texas,and related documents.Said Contract is attached
hereto and incorporated in this resolution as if fully set forth herein and shall be included in the
minutes of the City Council.
Passed by the City Council on January 14.2016
ATTEST:
aJIaa^c^
Rebqcca Garza, City Secreta
APPROVED AS TO CONTENT:
Bill I Iowerton.Assistant City Manager
APPROVED AS TO FORM:
/Justin Ij.Pruitt.Assistant City Attorney
ccdocs/Rl:S.Contract 12590 -Precision Body Works-Citibus Repairs
December 16.2015
sbN.MAYOR
Resolution No. 2016-R0020
Contract 12590
City of Lubbock, TX
Body Work and Accident Damage Repair for Citibus Vehicles
Service Agreement
This Service Agreement (this "Agreement') is entered into as of the 14" day of January,
2016 ("Effective Date") by and between Precision Body Works, (the Contractor), and the City of
Lubbock (the "City").
RECITALS
WHEREAS, the City has issued a Request for Proposals 16-12590-TF, Body Work and Accident
Damage Repair for Citibus Vehicles.
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 Body Work and
Accident Damage Repair for Citibus Vehicles 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 — Specifications
3. Exhibit B — Pricing Sheet
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 C attached hereto.
Article 1 Services
1.1 The contract shall be for a term of one year with the option of two, one year extensions, said
date of term beginning upon formal approval. The City of Lubbock does not guarantee any
specific amount of compensation, volume, minimum, or maximum amount of services
under this proposal and resulting contract.
1.2 The Contractor shall not assign any interest in this Agreement and shall not transfer any
interest in the Agreement, whatsoever, without prior consent of the City.
1.3 All funds for payment by the City under this Agreement 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
Agreement, the City will terminate the Agreement, 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 Agreement is spent,
whichever event occurs fast. If at any time funds are not appropriated for the continuance
of this Agreement, cancellation shall be accepted by the contractor 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 Agreement beyond the date of termination.
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. This
Agreement is performable in, and venue of any action related or pertaining to this
Agreement shall lie in, Lubbock, Texas.
2.2 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.
2.3 This Agreement may be executed in counterparts, each of which shall be deemed an
original.
2.4 In the event any provision of this Agreement is held illegal or invalid, the remaining
provisions of this Agreement shall not be affected thereby.
2.5 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.
2.6 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.
2.7 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.
2.8 This agreement includes incorporation of Federal Transit Administration (FTA) Terms. The
preceding provisions include, in part, certain Standard Terms and Conditions required by
the Department of Transportation (DOT), whether or not expressly set forth in the
preceding contract provisions. All contractual provisions required by DOT, as set forth in
FTA Circular 4220.1 F, are hereby incorporated by reference. Anything to the contrary
herein notwithstanding, all FTA mandated terms shall be deemed to control in the event of
a conflict with other provisions contained in this agreement. The Contractor shall not
perform any act, fail to perform any act, or refuse to comply with any requests which would
cause Citibus to be in violation of the FTA terms and conditions.
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 do.
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.
IN WITNESS WHEREOF, this Agreement is executed as of the Effective Date.
CITY OF LUBBOCK, TX:
Glen C. Ro n, Mayor
ATTEST:
Re cca Garza, City Secre try
I:\a7:Z�>i/x7
Bill How�yfon, Assistant City
APPROVED AS TO FORM:
w
t
Justin Pru t Assi ant ity Attorney
CONTRACTOR:
P nted Nilme
Title
EXHIBIT A
City of Lubbock, TX
Body Work and Accident Damage Repair for Citibus Vehicles
RFP 16-12590-TF
Specifications
SCOPE OF WORK
Citibus intends to enter into a contract with one or more qualified contractors to famish paint
and body repairs for Citibus Transit Units to include, but will not be limited to the following:
Accident Repairs, Vehicle Paint Services, Common Body Repairs on Transit Buses, and Common
Body Repairs on Body on Chassis Vehicles
F� �5fi]III;iILf�i�fid.�
2.1. The bidder must have a complete body shop meeting the following minimum requirements:
2.1.1. Paint Booth
2.1.2. Frame and straightening machines with qualified operator (on -site or under
contract).
2.1.3. The contractor awarded the contract must also have the capability to do body and
paint work indoors during inclement weather. The indoor area must be large
enough to handle Citibus Units.
2.2. The work proposed in this contract shall be performed at the successful bidder's
(hereinafter referred to as "Contractor") place of business.
2.3. The successful Contractor agrees to assume full liability and responsibility for all units and
contents (including radios and other standard or installed equipment), placed in its custody
by Citibus under this contract.
2.4. Citibus will not transport buses to and from the contractor's body shop location.
2.5. This contract shall cover the following types of vehicles:
2.5.1. Citibus Transit Bus Units
2.5.2. Body on Chassis Vehicles
2.6. Contractor agrees that work assigned under this contract shall receive priority over
the other work in its shop unless specific prior approval has been obtained from
Citibus.
3. FEDERAL AND STATE SAFETY REGULATIONS
3.1 Contractor shall comply with all federal and state safety regulation including but not limited
to Occupational, Safety and Health Administration (OSHA) and the Department of
Workforce Development (DWD) regulations. This agreement includes incorporation of
Federal Transit Administration (FTA) Terms. The preceding provisions include, in part,
certain Standard Terms and Conditions required by the Department of Transportation
(DOT), whether or not expressly set forth in the preceding contract provisions. All
.S Turru 6M D00%R 15-12590-TF Body Work and Amdem Da c RValr for Cab%V<Nale 23
City of Lubbock, TX
Body Work and Accident Damage Repair for Citibus Vehicles
RFP 16-12590-TF
Specifications
contractual provisions required by DOT, as set forth in FTA Circular 4220.1F, are hereby
incorporated by reference. Anything to the contrary herein notwithstanding, all FTA
mandated terms shall be deemed to control in the event of a conflict with other provisions
contained in this agreement. The Contractor shall not perform any act, fail to perform any
act, or refuse to comply with any requests which would cause Bus to be in violation of the
FTA terms and conditions.
3.2 All Environmental Protection Agency (EPA) rules and regulations must be fooled by the
Contractor
4. COST ESTIMATES
4.1. Individual cost estimates for each unit or piece of equipment will be provided by the
contractor before any actual work will commence. These estimates will include time of
completion, hours of labor, and an itemized listing of replacement repair parts. Estimates
shall be priced per item with replacement repair parts showing crash guide list or applicable
industry standards.
4.2. All estimates shall be complete and include all parts and charges with the exception of
"hidden" damage, which may not be obvious until repairs are initiated. All estimates shall
be completed and available for review within 24 hours of delivery of the vehicle. No repairs
shall be initiated until Citibus Representative reviews the estimate and gives the contractor
notice to proceed with the work.
4.3. In no instance shall any repairs costing more than the approved estimate be performed
without first notifying the Citibus or designated representative and providing a
supplemental estimate indicating additional parts and labor charges. THE CITY SHALL
RESERVE THE RIGHT TO VERIFY, THROUGH INDEPENDENT APPRAISAL, IF
THE REPAIRS ARE REQUIRED.
4.4. All labor will be estimated and invoiced at the hourly rate set forth on the Proposal
Submittal Form. All replacement repair parts will be invoiced at vendor list price less
percentage as listed in Bid Form of this ITB. Price is based on an hourly labor rate, cost per
hour.
5. BODYWORK AND PAINTING REQUIREMENTS
5.1 Contractor must be able to perform complete body repairs as well as paint transit units.
5.2 There will be no penalty for Citibus to supply parts if this will lower costs.
5.3 There is a maximum mark-up of 15% for parts to be used.
5.4 DuPont Paint or approved equal is to be utilized.
9:W Cc BW Da Mr 1613590-TF Body Work a Amd D> c Rqw for fil3�Ve e,r 24
City of Lubbock, TX
Body Work and Accident Damage Repair for Citibus Vehicles
RFP 16-12590-TF
Specifications
7. PROTECTION OF VEHICLES
7.1 It shall be the responsibility of the contractor to fully protect, at all times, city property
entrusted to their care. The contractor shall reimburse the city for any and all damages to
city property while in their care, such as unwarranted wear and tear, acts of vandalism and
malicious mischief, any and all physical damages, including acts of commission and/or
omission by the contractor's employees and others. Damages will be billed at invoicing
costs to replace or repair such damage and may be deducted from any outstanding amounts
owed the contractor. The contractor further agrees to pay to the city any outstanding claims
within 30 days after notification from Citibus Department.
7.2 Contractor must maintain insurance coverage as required by Citibus and the City of
Lubbock.
8. COMPLETION AND DELIVERY TIME
Contractor will discuss a due date with Citibus staff for each repair to be documented and noted by
each party. If more time is required, prior approval must been obtained from the Citibus. If the
due date is not met by the Contractor, a $300 per day non useable vehicle charge will be assessed
and subtracted from the final repair invoice.
e�Vffi lrinkrv[.I:II WAIJ r1Mvrry
The contractor agrees the service furnished to be of the highest quality, complying with
specifications, and free from all defects in materials and workmanship for a period of one (1) year
from the date of acceptance. Replacements and body repairs under this warranty are to be made by
the contractor at no cost and to the satisfaction of the city.
1. CONTRACT TERM
The contract shall be for a term of one year with the option of two, one year extensions, said date of
term beginning upon formal approval. The City of Lubbock does not guarantee any specific amount
of compensation, volume, minimum, or maximum amount of services under this proposal and
resulting contract.
This agreement includes incorporation of Federal Transit Administration (FTA) Terms. The preceding
provisions include, in part, certain Standard Terms and Conditions required by the Department of
Transportation (DOT), whether or not expressly set forth in the preceding contract provisions. All
contractual provisions required by DOT, as set forth in FTA Circular 4220.1F, are hereby incorporated
by reference. Anything to the contrary herein notwithstanding, all FTA mandated terms shall be
deemed to control in the event of a conflict with other provisions contained in this agreement. The
Contractor shall not perform any act, fail to perform any act, or refuse to comply with any requests
which would cause Citibus to be in violation of the FTA terms and conditions.
S:)Rooa Bid DoaM 16. 1 B90-W Body Work" Awd Da ge Bepv for Cit3 VoWod 25
City of Lubbock, TX
Body Work and Accident Damage Repair for Citibus Vehicles
RFP 16-12590-TF
Specifications
11. EVALUATION CRITERIA
Each proposal will be evaluated for full compliance with the RFP instructions to the offeror and the
mandatory terms and conditions set forth within the RFP document. The objective of the evaluation
will be to recommend the firms who are most responsive to the herein described needs of the City.
The proposal will be evaluated on the following criteria:
A. 30% = Qualifications, experience and references
B. 20% = Quality of materials and workmanship
C. 25% = Cost
D. 25% = References
12. PROPOSAL FORMAT
a) Proposals should provide a straightforward, concise description of the Offeror's
capabilities to satisfy the requirements of the RFP. Emphasis should be on completeness,
clarity of content, and conveyance of the information requested by the City.
b) The proposal should be bound in a single volume where practical. All documentation
submitted with the proposal should be bound in that single volume.
c) If the proposal includes any comment over and above the specific information requested
in the RFP, it is to be included as a separate appendix to the proposal.
d) The proposal must be organized into the following response item sections and submitted
in an indexed binder.
i) Cover letter addressed to the Honorable Mayor and City Council that states the
Offeror's understanding of the services to be provided. Include any additional
information believed necessary that is not requested elsewhere in the RFP.
ii) A description of the methodology to be used to complete the project to include, but
not be limited to, how recommendations will be formulated and commitment of
adequate appropriate resources to the project.
iii) Offeror's specific expertise in areas pertinent to the project to include a listing and
brief description of similar projects completed (with the dates of completion) or in
progress and a list of references by name, address, and telephone number for each
project listed. This list of projects in progress shall include the phase of work that
each project is currently in (i.e. design, bid, construction), and the estimated
completion date.
iv) A brochure of past work, with emphasis on comparable projects.
v) List of principal(s) of the Proposer and amount of time that principal(s) will be
involved in the project.
S lftrt BW D06'R 16-12590-TF Body % and Mdd Da . Repw k' Ci0b. Ve . 26
City of Lubbock, TX
Body Work and Accident Damage Repair for Citibus Vehicles
RFP 16-12590-TF
Specifications
vi) List of other professionals to be used, if applicable, with a record of experience in
projects of this nature. Identification of principal(s) and percentage of time the
principal(s) will be involved in the project.
vii) The organizational structure of the employees who will be assigned to this project
along with resumes of those individuals. If a joint venture is expected, then provide
the organizational structure of the sub -contractor and resumes of those persons who
will be involved in the project.
viii) The Proposer must assure the City that he/she will to the best of his/her knowledge,
information and belief, be cognizant of, comply with, and enforce, where applicable
and to the extent required, all applicable federal or state statutes and local ordinances
including, but not limited to the Davis -Bacon Federal minimum wage requirements.
ix) Describe the Offeror's methodology for handling errors and omissions.
x) Disclosure of any obligations posing a potential conflict of interest, including service
on City boards and/or commissions and any current contracts with the City of
Lubbock. This would apply to the Proposer as well as consultants subcontracted by
the Proposer.
xi) Any material which the proponent wishes to submit and which is not specifically
requested in the above categories.
xii) Offerors are strongly encouraged to explore and implement methods for the utilization
of local resources, and to outline how they would address outreach issues in their
proposal. It is also the desire of the City that the City of Lubbock program serve, as
much as practicable, to stimulate growth in all sectors of the local business
community. Describe how your firm would facilitate this process, and provide any
relevant information about similar efforts on previous projects.
SdPord 80 Da %% 16-13590.TF B dy Work nnl Amdrnt De c Repair for CrIMm Vdtlda
EXHIBIT B
City of Lubbock, TX
Pricing Proposal Sheet
Body Work and Accident Damage Repair for Citibus Vehicles
(To be completed and returned with Proposal)
ITEM
QTY
MEASURE UNIT
DESCRIPTION
HOURLY LABOR RATE
(+�)
1.
130
Hourly
Body repair
$ �J
130
Hourly
Fender repair
$
3.
130
Hourly
Bumper repair
S S
4.
130
Hourly
Framc Repairs
S
5.
130
Hourly
Paint Services — Labor and Materials: Dupont
$
Paint or an approved equal.
S
6.
1
EA
*Pickup and delivery of buses.
S o�s�
%
7.
%
Percent %
Pans Mark -Up (%) from Vendor List Price
u
(Maximum 15!0)
S. Arth BYD ,W I& 123WTFBMywasv M. D.,r R< .for C,b V�ka
EXHIBIT C
City of Lubbock, TX
Body Work and Accident Damage Repair for Citibus Vehicles
RFP 16-12590-TF
111. INSURANCE
SECTION A. Prior to the approval of this contract by the City, the Contractor shall furnish a completed Insurance Certificate
to the City, which shall be completed by an agent authorized to bind the named underwriter(s) to the coverages, limits, and
termination provisions shown thereon, and which shall furnish and contain all required information referenced or indicated
thereon. THE CITY SHALL HAVE NO DUTY TO PAY OR PERFORM UNDER THIS CONTRACT UNTIL SUCH
CERTIFICATE SHALL HAVE BEEN DELIVERED TO THE CITY.
INSURANCE COVERAGE REQUIRED
SECTION B. The City reserves the right to review the insurance requirements of this section during the effective period of the
contract and to require adjustment of insurance coverages and their limits when deemed necessary and prudent by the City based
upon changes in statutory law, court decisions, or the claims history of the industry as well as the Contractor.
SECTION C. Subject to the Contractor's right to maintain reasonable deductibles in such amounts as are approved by the City,
the Contractor shall obtain and maintain in full force and effect for the duration of this contract, and any extension hereof, at
Contractor's sole expense, insurance coverage written by companies approved by the State of Texas and acceptable to the City,
in the following type(s) and amount(s):
TYPE AMOUNT
1. Worker's Compensation Statutory
or
Occupational Accident (Non Subscriber)
2. Commercial General (public) Liability insurance including coverage for the following:
a. Products/completed operations Combined single limit for
b. Personal injury bodily injury and property
c. Contractual liability damage of $1,000,000 per
occurrence or its equivalent.
3. Comprehensive Automobile Combined single limit of $1,000,000
Liability insurance including bodily injury and property or its equivalent.
a. Owned/leased vehicles
b. Non -owned vehicles
c. Hired vehicles
4. Garage Liability Auto only — Each Accident limit of $1,000,000
The City of Lubbock shall be named as additional insured on a primary and non-contributory basis with a
waiver of subrogation in favor of the City on all coverage's.
ADDITIONAL POLICY ENDORSEMENTS
The City shall be entitled, upon request, and without expense, to receive copies of the policies and all endorsements
thereto and may make any reasonable request for deletion, revision, or modification of particular policy terms,
conditions, limitations, or exclusions (except where policy provisions are established by law or regulation binding
upon either of the parties hereto or the underwriter of any of such policies). Upon such request by the City, the
Contractor shall exercise reasonable efforts to accomplish such changes in policy coverages, and shall pay the cost
thereof.
S:`Aurlus EW Da '16-1:5 TF Bally Woh end Att d. for Ci. u. Vekcles
REQUIRED PROVISIONS
The Contractor agrees that with respect to the above required insurance, all insurance contracts and certificate(s) of
insurance will contain and state, in writing, on the certificate or its attachment, the following required provisions:
a. Name the City of Lubbock and its officers, employees, and elected representatives as additional insured, (as
the interest of each insured may appear) as to all applicable coverage;
b. Provide for 30 days notice to the City for cancellation, nonrenewal, or material change;
c. Provide for notice to the City at the address shown below by registered mail;
d. The Contractor agrees to waive subrogation against the City of Lubbock, its officers, employees, and
elected representatives for injuries, including death, property damage, or any other loss to the extent same
may be covered by the proceeds of insurance;
e. Provide that all provisions of this contract concerning liability, duty, and standard of care together with the
indemnification provision, shall be underwritten by contractual liability coverage sufficient to include such
obligations within applicable policies.
NOTICES
The Contractor shall notify the City in the event of any change in coverage and shall give such notices not less than
30 days prior the change, which notice must be accompanied by a replacement CERTIFICATE OF INSURANCE.
All notices shall be given to the City at the following address:
Marta Alvarez, Director of Purchasing and Contract Management
City of Lubbock
1625 13" Street, Room 204
Lubbock, Texas 79401
SECTION D. Approval, disapproval, or failure to act by the City regarding any insurance supplied by the
Contractor shall not relieve the Contractor of full responsibility or liability for damages and accidents as set forth in
the contract documents. Neither shall the bankruptcy, insolvency, or denial of liability by the insurance company
exonerate the Contractor from liability.
S.Ttoc Bld Doo,RFF 16-125904F Body Work and Acndcro Da gc Repair for Cilbos Vol ida
CERTIFICATE OF INTERESTED PARTIES FORM 1295
nl l
Complete Nos 1- 4 antl 6 if there are Interested Parties
OFFICE USE ONLY
Complete Nos. 1. 2. 3. 5, antl 6 if there are no interested pames.
CERTIFICATION OF FILING
Certificate Number
3 Name of business entity, filing form, and the city, state and country of the business entity's place
of business.
2016-10546
Precision Body Works
Lubbock, TX United States
Date Filed:
2 Name of governmental imply or state agency that is a party to the contract for which the farm is
02108/2016
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 compact, and provide a
description of the goods or services to be provided under the contract.
12590
Body Work and Accident Damage Repair for Citibus Vehicles
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest (check applicable)
Controlling
Intermediary
Brewer, Ralson
Lubbock, TX United States
X
s Check only H there is NO Interested Parry.
❑
6 AFFIDAVIT Iswear.maBrm.underpmalryotperjury, mat the above tli5tlmeure ie Vue arttl inner'
aic d j
TA? 1. CO% ignature of authorized agent of contracting business entity
~'? 8ma�y Punuc. state of Tasas
.if,.' Ni,Commismpn101 IT
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Fgt,1,W', WRY W61MMISS48Ag®Vf
swor1n1,to' and wbscribetl before tin:, by the saitl isb 1 CvT/c✓- . this meWf) tlay of NQ/r ,
20y�. b certify which, werfeess511ry hand orb seal 1 Office.
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agnalure of o at arVinisterregavath strafed name 61 officer administering oath Title of officer minister h
Forms provided by Texas Ethics Commission www.elhics.state.fx.us Version V1.0.34944
WE
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
loft
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:
2016-10546
Date Filed:
02/08/2016
Date Acknowledged:
02/09/2016
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Precision Body Works
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 goods or services to be provided under the contract.
12590
Body Work and Accident Damage Repair for Citibus Vehicles
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest (check applicable)
Controlling
Intermediary
Brewer, Rojean
Lubbock, TX United States
X
5 Check only if there is NO Interested Party.
❑
6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP / SEAL ABOVE
Swom to and subscribed before me, by the said , this the day of
20 , to certify which, witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Tide of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.34944