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HomeMy WebLinkAboutResolution - 2016-R0099 - BCS Catering - 03/10/2016Resolution No.2016-R0099 Item No.5.14 March 10,2016 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 behalf of the City of Lubbock,Contract No. 12673 for meal services for senior citizens at five senior citizen centers,by and between the City of Lubbock and BCS Catering,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 March 10.2016 . GLEN C.ROBERTSON,MAYOR ATTEST: jW^, Rebecca Garza, City Secretary APPROVED AS TO CONTE Scott Snider,Assistant City Manager APPROVED AS TO FORM: Justin Pfuitt,Assistant City Attorney ccdocs/RES. Contract 12673 - BCS Catering - Senior Citizen Meals February 22.2016 Resolution No. 2016-R0099 FOOD SERVICE CONTRACT Contract 12673 This contract, (the "Contract"), effective as of April 3. 2016, (the "Effective Date"), is by and between the City of Lubbock, (the "City"), a Texas municipal corporation, and BCS Catering, (the "Contractor") whose principal place of business is 1212 Avenue K. Lubbock. TX 79401. WITNESSETH WHEREAS, the City requires a contractor to procure and prepare catered meals for the Lubbock Senior Citizen Meal Program Monday through Friday, with the exception of City -observed holidays; and WHEREAS, the Contractor is a qualified food service contractor; and WHEREAS, the City desires to contract with Contractor to furnish the midday meal for the Lubbock Senior Citizen Meal Program, which is offered at five senior centers; and NOW THEREFORE, for and in consideration of the terms, covenants and conditions set forth in this Contract, the City and Contractor hereby agrees as follows: ARTICLE I TERMS OF CONTRACT The term of this Contract shall be a period of one year, commencing on April 3, 2016. The City and the Contractor may, upon written mutual consent, extend the contract two additional one-year periods. The rate may be adjusted upward or downward at this time at a percentage not to exceed the effective change in the Consumer Price Index (CPI) or Product Price Index (PPI), whichever is most appropriate for the specific contract for the previous twelve -months at the City's discretion, the effective change rate shall be based on either the local or national index average rate for all items. If agreement cannot be reached, the contract is terminated at the end of the current contract period. Such price negotiations shall be completed in writing a minimum of ninety (90) days before the expiration of said Contract. ARTICLE H COMPENSATION Contractor shall be paid in accordance with Exhibit A, attached hereto, and made a part of this Contract. ARTICLE III TERMINATION A. Termination Without Cause. Either parry may terminate this Contract at any time upon ninety (90) days' prior written notice to the other of the intention to terminate this Contract. B. Termination For Cause. In the event either party breaches a material provision hereof ("Cause"), the non -breaching parry shall give the other party notice of such Cause. In the event the Cause is remedied within ten (10) days in the case of failure to make payment when due or ninety (90) days in the case of any other Cause, the notice shall be null and void. If such Cause is not remedied within the specified period, this Agreement shall terminate upon the expiration of such remedy period. The rights of termination referred to in this Contract are not intended to be exclusive and are in addition to any other rights available to either party at law or in equity. ARTICLE IV REPRESENTATIONS AND WARRANTIES A. Existence. Contractor is in good standing under the laws of the State of Texas and is qualified to carry on its business in the State of Texas. B. Power. Contractor has the power to enter into and perform this Contract and all other activities contemplated hereby. C. Authorization. Execution, delivery, and performance of this Contract and the activities contemplated hereby have been duly and validly authorized by the Contractor. This Contract constitutes legal, valid, and binding obligations of the Contractor and is enforceable in accordance with the terms thereof. D. Contractor. Contractor maintains a professional staff and employs, as needed, other qualified specialists experienced in furnishing meals, and are familiar with all laws, rules, and regulations, both state and federal, including, without limitation the applicable laws, regarding the activities contemplated hereby. E. Performance. Contractor will and shall conduct all activities contemplated by this Contract in a good and workmanlike manner and comply with all laws, rules, and regulations, both state and federal, relating to furnishing meals, as contemplated hereby. If any of the activities of the Contractor, or omissions of the activities required herein, shall cause, in whole or in part, liability or loss on the party of the City, it shall be deemed that the Contractor did not perform said activities (or omitted the performance of said activities) in a good and workmanlike manner. ARTICLE V SCOPE OF WORK A. General. Contractor shall furnish a midday meal Monday through Friday throughout the year except on designated holidays, as requested by City, for the Lubbock Senior Citizens Meal Program. The Contractor is responsible for cooking and transporting the meals to the five City of Lubbock senior centers. Contractor is not required to serve the meal after delivery of the meals at each site. City shall be responsible for serving at the five sites: Homestead Senior Program, Lubbock Senior Center, Rawlings Community Center, Simmons Community Center and Trejo Supercenter. The Contractor will be responsible for picking up the Contractor's serving pans on the next delivery day from the five sites to be cleaned by the Contractor. Three complete sets of pans will be used on a rotating basis so that a separate trip to pick up the pans will not be necessary. City will notify Contractor by 3:00 p.m. each day how many meals for each location are required for the following day. The Contractor shall maintain food service, preparation, and storage areas in a sanitary condition at all times, employ and train food service employees for said facility, use standard food cost control methods, furnish supervisory personnel in setting up and maintaining the facilities operation at a high standard, do all buying and record -keeping, including payrolls. C. Meal Schedule. Lunch shall be from 12:00 Noon to 1:00 p.m. or as set by the City. The midday meal shall be provided Monday through Friday, with the exception of designated holidays. Contractor will have meals ready by approximately 10:00-10:30 a.m. to insure timely delivery to the five senior centers. D. Food and Ouality Standards. All foods shall be prepared from Standardized Menus and Recipes as provided to the Contractor from the City to ensure consistent quality and to meet grant requirements. These requirements ensure the provision of safe and nutritious meals that comply with the most recent Dietary Guidelines for Americans (DGA) jointly issued and updated every five years by the United States Department of Agriculture (USDA) and Health and Human Services (DHHS). These menus and recipes provide to each eligible individual a minimum of33 1/3% of the Dietary Reference Index established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences where one meal per day is served. The Standardized Menus and Recipes have been received by the City from the South Plains Association of Governments (SPAG) and have been approved by the Licensed Dietitian for the South Plains Area Agency on Aging. 2. Meals shall consist of the specified menu quantities from the SPAG approved menu. No substitutions are allowed. Contractor shall provide disposable eating utensils and service ware including plates, bowls (for soups and stews as needed) and plastic service ware to include forks, spoons and knifes (as needed). "Sporks" and other fork/spoon combinations shall not be allowed. 4. Contractor shall provide butter or margarine, condiments and salad dressings suitable for elderly consumers and as specified by the SPAG menus and recipes where applicable. 5. Contractor shall use pan liners in the serving pans for any hot, baked food items. Cold items or unbaked hot items do not need pan liners. 6. Contractor shall ensure that meals are at the proper temperature when loaded into transport to the five senior and upon arrival at each site. Hot food shall be at least 135 degrees Fahrenheit or higher, cold food at least 41 degrees Fahrenheit or lower and frozen food is to be at 32 degrees Fahrenheit or lower. Proper transport equipment shall be used to maintain the necessary holding temperatures. 7. Food used in the preparation of meals shall meet the following minimum standards. a. Canned fruits shall be USDA Grade A or Fancy. b. Fresh fruit and vegetables shall be U.S. Fancy, U.S. No. 1 or better. c. Eggs and dairy products shall be USDA Grade A or better. d. Pork shall be No. I and tender with a minimum of fat. e. Poultry shall be USDA Grade A. f. Ground beef shall be lean USDA Grade Utility or better. g. One %2 pint of 2% low -fat milk shall be served with each meal. h. No salt or pepper shall be added to the food during preparation unless otherwise noted in the approved recipe. Iodized salt shall be available and black pepper for seasoning during food consumption. Seasonings in addition to those listed in the approved recipes shall be approved by the SPAG Licensed Dietitian. i. Contractor shall preserve the nutritional value and safety of food when purchasing, receiving, preparing and delivering to the designated sites. 8. Contractor shall ensure that the overall appearance of the meals must meet or exceed commercial food service standards, including the food's color, odor and taste. Specifications to certify the above mentioned minimum quality standards shall be on file in Contractor's kitchen for review by City. The City shall work with the Contractor to provide feedback on issues related to patrons' response to the meals. Contractor shall do a minimum of one test tray per center during the contract period. The results of these tests should be submitted to the City by the I" working day of the next month. E. Inspection. City may inspect the food service facilities, at any time, to determine compliance with this Contract. City may, at the Contractor's expense, have food analyzed at a laboratory to determine compliance with specifications. In the event food analyzed is determined to be in compliance with specifications the City shall reimburse Contractor for the laboratory expenses. F. Menu. 1. Standardized Weekly Menus and Recipes will be provided to the Contractor by the City to meet the most recent Dietary Guidelines for Americans (DGA) jointly issued and updated every five years by the United States Department of Agriculture (USDA) and Health and Human Services (DHHS) for individuals aged 60 or above. 2. Each monthly calendar menu cycle shall be submitted to the Contractor by the City not less than fifteen days (15) days prior to implementation. Any issues the Contractor may have with the menus should be discussed with the City upon receipt of the monthly menu schedule. 3. All meals shall be served as planned. No individual item substitutions are allowed by SPAG. F. Reports. Contractor shall submit a quarterly self -assessment report to City. The self - assessment report form shall address the following: consumer satisfaction, condition of equipment, meal shortages, and deficiencies from previous reports, temperature or quality refusals of food and any other information requested by City. ARTICLE VI CONTRACTOR COVENANTS A. To conduct or permit no business or act that is a nuisance or may be in violation of any federal, state, or local law or ordinance; B. To guarantee the quality, safety and wholesomeness of all food served not withstanding any inspections or supervision by the City of Lubbock Health Department. All food service areas regardless of use shall at all times be accessible and subject to inspection by the City. Said persons may sample any food served for any meal. Food determined to be unsatisfactory shall not be served. C. To provide any equipment, vehicles, labor, and any other materials not provided by the City necessary to complete the required work. The Contractor shall be responsible for the maintenance and repair of his own equipment, vehicles, and the availability, presences and supervision of his employees. D. To be responsible for delivering the meals to the five sites: Homestead Senior Program, Rawlings Community Center, Simmons Community Center and Trejo Supercenter; and for picking up serving pans for cleaning. Three complete sets of pans will be used on a rotating basis so that a separate trip to pick up the pans will not be necessary. At the beginning of the contract, the City may provide additional pans to the Contractor if needed. At the termination of the contract, the same number of pans provided will be returned to the City by the Contractor. E. To agree not to use any subcontractor to fulfill any items or conditions of the contract without prior written consent of the City. F. To maintain in a condition satisfactory to the City and to adhere to the highest standards of cleanliness practices to ensure continuous sanitation in all functions and matters related to the food service program. G. To obtain a City of Lubbock Health Department Food permit and keep at least one person on site at all times with a current food handling certification. H. To wash, rinse, and sanitize all pots, pans, dishes, utensils, and other service equipment in accordance with the City of Lubbock Health Department regulations. I. To maintain all food service equipment, carts, surfaces, storage areas, and all other areas associated with food service in a manner and conditions of sanitation permissible under the regulations of the City Health Department. J. To be responsible for the repair and replacement of any damages to public or private property during the term of the contract and caused by the Contractor or the Contractor's representative. K. To employ, train, and supervise all employees and management, as necessary to efficiently perform the foregoing services and functions. ARTICLE VII CITY COVENANTS A. City shall be responsible for serving all meals to its patrons. B. City will fax the Contractor by 3:00 p.m. each day how many meals are required for each location for the following serving day. ARTICLE VIII INSURANCE A. General. Contractor shall procure and carry, at its sole cost and expense through the life of this Contract insurance protection hereinafter specified, in form and substance satisfactory to the City. City must approve all policies prior to the commencement of any activities whether performed by the Contractor, subcontractor, agents, or third parties. The insurance carrier must be an insurance company authorized to transact business in the State of Texas and have a Best's Financial rating of A:VII. A Certificate of Insurance specifying each and all coverage shall be submitted to City prior to the execution of this Contract. Written notice of cancellation or will be provided thirty (30) days in advance of cancellation. B. Required Coverage. Contractor shall obtain and maintain policies of insurance throughout the Contract term in limits specified below. 1. Workers' Compensation and Employers Liability Insurance: Contractor shall elect to obtain workers' compensation coverage pursuant to Section 406.002 of the Texas Labor Code. Further, Contractor shall maintain said coverage throughout the term of this Lease and shall comply with all provision of Title 5 of the Texas Labor Code to ensure that the Contractor maintains said coverage. Any tennination of workers' compensation insurance coverage by Contractor or any cancellation or non -renewal of workers' compensation insurance coverage for the Contractor shall be a material breach of this contract. The contractor may maintain Occupational Accident and Disability Insurance in lieu of Workers' Compensation. In either event, the policy must be endorsed to include a waiver of subrogation in favor of the City of Lubbock Workers' Compensation. Employer's Liability with limits of at least $500,000 each accident, $500,000 by disease policy limit, and $500,000 by disease each employee shall also be obtained and maintained throughout the term of this Lease. 2. General Liability: Contractor's insurance shall contain broad form contractual liability with a combined single limit of a minimum of $500,000 each occurrence and in the aggregate and shall include the following: Bodily Injury and Property Damage; Broad Form Contractual Liability; Personal Injury and Advertising Injury; Fire legal liability, and Products and completed operations. Business Automobile Liability: Contractor's insurance shall contain a combined single limit of at least $500,000 per occurrence, and include coverage for but not limited to the following: Bodily injury and property damage; and any and all vehicles owned, used or hired. 4. Other Insurance Requirements: Contractor's general liability insurance policies through policy endorsement must include wording, which states that the policy shall be primary and non-contributory with respect to any insurance carried by City of Lubbock. The certificate of insurance described below must reflect that the above wording is included in evidenced policies. All policies must be endorsed to include a waiver of subrogation in favor of the City of Lubbock. C. Cooperation on Claims. City agrees to provide immediate written notice to Contractor of all losses or claims for which it will seek indemnity from Contractor under this agreement. City agrees not to incur any cost or expense without the approval of Contractor and further agrees to fully cooperate with Contractor in the investigation, defense and settlement of such claims. D. Subcontractors. The Contractor shall require each subcontractor with whom it contracts to provide activities as contemplated by this Contract, to obtain proof of insurance coverage as set forth herein, and to provide to Contractor, prior to such person performing any such activities, a Certificate of Insurance establishing such coverage. ARTICLE IX INDEMNITY To the extent allowable by the laws of the State of Texas, Contractor and City shall defend, indemnify and hold each other harmless from and against all claims, liability, loss and expense, including reasonable collection expenses, attorney's fees and court costs which may arise because of the negligence, misconduct, or other fault of the indemnifying party, its agents or employees in the performance of its obligations under the Contract. The obligations in this section are intended to be within the limits of liability found in the Texas Tort Claims Act. This clause shall survive termination of the Contract. ARTICLE X INDEPENDENT CONTRACTOR STATUS Contractor and City agree that Contractor shall perform the duties under this Contract as an independent contractor. The Contractor has the sole discretion to determine the manner in which the services are to be performed. ARTICLE XI EMPLOYMENT OF AGENTS Contractor may employ or retain agents, consultants, contractors, or third parties, to perform certain duties of Contractor under this Contract provided that Contractor is in no event relieved of any obligation under this Contract. Any such agents, contractors, or third parties retained and/or employed by Contractor shall be required to carry, for the protection and benefit of the City and Contractor and naming said third parties as additional insured, insurance as described in Article VI Insurance of this Contract. ARTICLE XII COMPLIANCE WITH APPLICABLE LAWS Contractor shall comply with all applicable federal, state and local laws, statutes, ordinances, rules and regulations relating, in any way, manner or form, to the activities under this Contract, and any amendments thereto. ARTICLE XIII CONFIDENTIALITY 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. ARTICLE XIV NOTICE A. General. Whenever notice from contractor to City or City to Contractor is required or permitted by this Contract and no other method of notice is provided, such notice shall be given by (1) actual delivery of the written notice to the other party by hand, (2) or other reasonable means (in which case such notice shall be effective upon delivery), or (3) by depositing the written notice in the United States mail, properly addressed to the other party at the address provided in this article, registered or certified mail, return receipt requested, in which case such notice shall be effective on the third business day after such notice is so deposited. B. Contractor's Address. Contractor's address and numbers for the purpose of notice are: Name: BCS Catering Attn: Carlos RTiel Address: 2812 4 Street, Suite A City, State, Zip: Lubbock, TX 79415 Telephone: 806-781-2211 Facsimile: C. City's Address. The City's address and numbers for the purposes of notice are: City of Lubbock Attn: City Secretary's Office P.O. Box 2000 1625 13a' Street, Room 206 Lubbock, TX 79457 Telephone: (806) 775-2061 Facsimile: (806) 775-3983 With Copy To: City of Lubbock Attn: Nancy Neill P.O. Box 2000 1611 105h Street Lubbock, TX 79457 Telephone: (806) 775-2685 Facsimile: (806) 775-2686 D. Change of Address. Either party may change its address or numbers for purposes of notice by giving written notice to the other party, referring specifically to this Contract, and setting forth such new address or numbers. The address or numbers shall become effective on the 15a' day after such notice is effective. ARTICLE XV PURCHASINGANVENTORY The BCS Catering shall purchase and pay for all food, supplies and services utilized for the food services to be provided by the BCS Catering under this Contract. ARTICLE XVI MISCELLANEOUS A. Captions. The captions for the articles and sections in this Contract are inserted in this Contract strictly for the parties' convenience in identifying the provisions to this Contract and shall not be given any effect in construing this Contract. B. Audit. Contractor shall provide access to its books and records to the City. The City may audit, at its expense and during normal business hours, Contractor's books and records with respect to this Contract between the Contractor and City. C. Records. Contractor shall maintain records that are necessary to substantiate the services provided by the Contractor. D. Assignability. This Agreement may not be assigned by either party without the written consent of the other party, except that Contractor may, without prior approval and without exoneration of any of its responsibilities, assign this Agreement to any affiliate or wholly - owned subsidiary. E. Funding. The Parties understand and acknowledge that the funding of this Agreement is contained in each Party's annual budget and is subject to the approval of each Party in each fiscal year. The Parties further agree that should the governing body of any of the Parties fail to approve a budget which includes sufficient funds for the continuance of this Agreement, or should the governing body of any of the Parties fail to certify funds for any reason, then and upon the occurrence of such event, this Agreement shall terminate as to that Party and the Party shall then have no further obligation to the any other Party. When the funds budgeted or certified during any fiscal year by a Party to discharge its obligations under this Agreement are expended, any other Party's sole and exclusive remedy shall be to terminate this Agreement. F. Successor and Assigns. This Contract binds and inures to the benefit of the City, Contractor, and their respective successors, legal representatives, and assigns. G. Construction and Venue. THIS CONTRACT SHALL BE GOVERNED BY AND CONSTRUED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS. THE PARTIES HERETO HEREBY IRREVOCABLY CONSENT TO THE EXCLUSIVE JURISDICTION AND VENUE OF THE COURTS OF THE STATE OF TEXAS, COUNTY OF LUBBOCK, FOR THE PURPOSES OF ALL LEGAL PROCEEDINGS ARISING OUT OF OR RELATING TO THIS CONTRACT OR THE ACTIONS THAT ARE CONTEMPLATED HEREBY. H. Severability. If any provision of this Contract is ever held to be invalid or ineffective by any court of competent jurisdiction with respect to any person or circumstances, the remainder of this Contract and the application of such provision to persons and/or circumstances other than those with respect to which it is held invalid or ineffective shall not be affected thereby. I. Amendment. No amendment, modification, or alteration of the terms of this Contract shall be binding unless such amendment, modification, or alteration is in writing, dated subsequent to this Contract, and duly executed by the Contractor and City. Entire Agreement. This Contract, including Exhibits A and B, hereto, contains the Entire Contract between the City and Contractor, and there are no other written or oral promises, conditions, warranties, or representations relating to or affecting the matters contemplated herein. K. Public Information. This Agreement is public information. To the extent, if any, that any provision of this Agreement is in conflict with Tex. Gov't. Code Ann. Chapter 552 et seq., as amended (the "Texas Public Information Act") the same shall be of no force and effect. L. No Personal Liability. Nothing in this Agreement is construed as creating any personal liability on the part of any employee, officer or agent of any public body that may be a party to this Agreement. M. No Joint Enterprise. This Agreement is not intended to, and shall not be construed to, create any joint enterprise between or among the parties. N. Sovereign Immunity Acknowledged and Retained. THE PARTIES EXPRESSLY ACKNOWLEDGE AND AGREE THAT NO PROVISION OF THIS AGREEMENT IS IN ANY WAY INTENDED TO CONSTITUTE A WAIVER BY ANY PARTY OF ANY IMMUNITIES FROM SUIT OR LIABILITY THAT A PARTY MAY HAVE BY OPERATION OF LAW. THE PARTIES RETAIN ALL GOVERNMENTAL IMMUNITIES. O. NON -ARBITRATION. 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 Agreement, the former shall control. EXECUTED as of the Effective Date hereof. CITY OF LUBBOCK GLEN-S. ROBERTSON, MAYOR ATTEST: qReSGSer arza cety, Director, Parks and APPROVED AS TO FORM: Justin rui Assis tj ity Att ney S:�eU id DaaI 16 126?}M, Mm1 Smim for Senior 06 For (CONTRACTOR): Signature C �j P �t� Address SPPmch eUd MmQ"I&126i3-SS,M®I Swim for Smior Chia EXHIBIT A COMPENSATION Contractor shall provide an estimated 31,500 meals during the term of the Contract for: $ /'I.'7er meal including delivery A. Billine. No later than fifteen (15) days after the end of each Accounting period, Contractor shall submit to City an invoice for amounts due. City shall pay the invoiced amount within thirty (30) days after the invoice date and shall pay interest on any amount not paid when due at the rate of one and one-half percent (1.5%) each month from due date until paid. B. Accountine Periods. "Accounting Periods" shall be designated by the Contractor as either two consecutive calendar weeks or twenty-six (26) accounting periods or as two times per month or twenty-four (24) accounting periods or as one time per month or twelve (12) accounting periods.. S:�id Q0mV 1612673SS, Meal Smice for S w Citizens EXHIBIT B OFFICIAL CITY HOLIDAYS New Year's Day Martin Luther King Day Good Friday Memorial Day Independence Day Labor Day Thanksgiving Day Friday After Thanksgiving Christmas Eve Christmas Day CERTIFICATE OF INTERESTED PARTIES FORM 3.295 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. 2016-22263 BCS Catering Lubbock, TX United States Date Filed: 03/0712016 2 Name of governmental entity or state agency that is a party tot the contract for which the form is being filed. Parks and Recreation 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 goods or services to he provided under the contract 12673 Senior Food Service Program 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Rangel, Carlos 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. TABITHA FRAGER _(f Notary PUGIic, State of iexos .\ ..... Cnmm. Expues 04-28 2019 NOlary ID 123940619 Signature of autfiaTffe-d-agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said , this the day of 20lgO , to certify which, witness my hand and seal of office. Signature of officer administ& g oath Printed name of officer administe6hig oath Title of officer dministering oath CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll 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: 2016-22263 Date Filed: 03/07/2016 Date Acknowledged: 03/09/2016 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. BCS Catering Lubbock, TX United States 2 Name of governmental entity or state agency that is a party tot the contract for which the form is being filed. Parks and Recreation 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 12673 Senior Food Service Program 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary Rangel, Carlos 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 Sworn 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 V1.0.312