HomeMy WebLinkAboutResolution - 2016-R0225 - Lubbock Wrecker Services - 07/14/2016Resolution No.2016-R0225
Item No.6.11
July 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
onbehalfof the City of Lubbock.Contract No.12842 for heavy duty towing services as per ITB
16-12842-SS,by and betweenthe Cityof Lubbock and Lubbock WreckerServices,of Lubbock.
Texas,and related documents.Said Contract is attached hereto and incorporated in this
resolution as if fullyset forth hereinandshall be included inthe minutesof the City Council.
Passed bv the City Council on July 14.2016
DANIEL M.POPE,MAYOR
ATTEST:
Rebecca Garza,City Secretary
ent/1APPROVEDASTOCONTENT
lUfftr^^Mck^
Scott Snider,Assistant City Manager
APPROVED AS TO FORM:
Justi
^±C
ssisrant City Attorney
ccdocs/RIZS.Contract 12842 -I.ubbock Wrecker Services -Heavy Dutv Towing Services
June 14.2016
Resolution No. 2016-RO225
Contract 12842
City of Lubbock, TX
Contract for Services
Heavy Duty Towing
THIS CONTRACT made and entered into this 14th day of July, 2016, by and between the City of Lubbock
("City"), and Lubbock Wrecker Services, ("Contractor").
WHEREAS, the City of Lubbock duly advertised for bids for Heavy Duty Towing and bids were received
and duly opened as required by law; and
WHEREAS, after careful consideration of the bid submitted by Contractor, the City authorized the
execution, in the name of the City of Lubbock a contract with said Contractor covering the purchase and delivery
of the said Heavy Duty Towing.
NOW, THEREFORE, in consideration of the mutual agreement contained herein, as well as the financial
consideration hereinafter referred to, the parties hereby covenant and agree as follows:
1. In accordance with City's specifications and Contractor's bid, copies of which are attached hereto and
made part hereof, Contractor will deliver to the City, Heavy Duty Towing and more specifically referred
to as Items One thru Six on the bid submitted by the Contractor or in the specifications attached hereto.
2. The City promises and agrees to employ, and does employ, the Contractor to cause to be done the work
provided for in this Contract and to complete and finish the same according to the attached specifications,
offer, and terms and conditions contained herein.
3. The Contractor shall perform the work according to the procedures outlined in the Bid Form and
Specifications attached hereto. 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 does not guarantee any
specific amount of compensation, volume, minimum or maximum amount of services under this contract.
4. This contract shall remain in effect until the expiration date, performance of services ordered, or
termination of by either party with a thirty (30) day written notice. Such written notice must state the
reason for cancellation. 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.
5. Contractor shall at all times be an independent contractor and not an agent or representative of City with
regard to performance of the Services. Contractor shall not represent that it is, or hold itself out as, an
agent or representative of City. In no event shall Contractor be authorized to enter into any agreement or
undertaking for or on behalf of City.
6. 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. 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 OF INSURANCE
JERAL LIABILITY
Commercial General Liability ❑ Other
Claims Made ® Occurrence
W/Heavy Equipment
To Include Products of Complete Operation Endorsements
LIABILITY
LIABILITY
Any Auto
Scheduled Autos
Non -Owned Autos
'ESS LIABILITY
Umbrella Forth
❑ All Owned Autos
❑ Hired Autos
COMBINED SINGLE LIMIT
General Aggregate $L000,000
Products-Comp/Op AGO x
Personal & Adv. Injury X
Contractual Liability X
Fire Damage (Any one Fire)
Med Exp (Any one Person)
General Aggregate $
Combined Single Limit
Per Occurrence $L000,00
Each Occurrence
Aggregate
:AGE LIABILITY
Any Auto
Auto Only - Each Accident 1,000,000
Each Accident Aggregate _
BUILDER'S RISK
❑ 100%of the Total Contract Price
INSTALLATION FLOATER
❑ 100% of the Total Material Costs
POLLUTION
CARGO
_
WORKERS COMPENSATION — STATUTORY
AMOUNTS OR OCCUPATIONAL MEDICAL AND DISABILITY
EMPLOYERS' LIABILITY
COPIES OF ENDOSEMENTS ARE REQUIRED
City of Lubbock named as additional insured on Auto/General Liability on a primary and non-contributory basis.
To include products ofcompleted operations endorsement.
Waiver ofsubrogation in favor ofthe City of Lubbock on all coverages. except
The City of Lubbock shall be named as an additional insured on a primary and non-contributory basis and shall include
a waiver of subrogation in favor of the City on all liability coverage's except professional liability. A waiver on
subrogation will be required on workers comp coverages. All Copies of the Certificates of Insurance and all applicable
endorsements are required.
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.
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 insureds, (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.
Neither the City nor the Contractor shall assign, transfer or encumber any rights, duties or interests
accruing from this Contract without the written consent of the other.
8. The City reserves the right to exercise any right or remedy available to it by law, contract, equity, or
otherwise, including without limitation, the right to seek any and all forms of relief in a court of competent
jurisdiction. Further, the City shall not be subject to any arbitration process prior to exercising its
unrestricted right to seek judicial remedy. The remedies set forth herein are cumulative and not exclusive,
and may be exercised concurrently. To the extent of any conflict between this provision and another
provision in, or related to, this document, this provision shall control.
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 thirty (30) days of such audit findings, or the City,
at its option, reserves the right to deduct such amounts owing the City from any payments due Contractor.
10. All funds for payment by the city under this contract are subject to the availability of an annual
appropriation for this purpose by the City. In the event of nonappropriation of funds by the City Council
of the city of Lubbock for the goods or services provided under the contract, the City will terminate the
contract, without termination charge or other liability, on the last day of the then -current fiscal year or
when the appropriation made for the then -current year for the goods or services covered by this contract
is spent, whichever event occurs first. If at any time funds are not appropriated for the continuance of this
contract, cancellation shall be accepted by the Seller on 30 days prior written notice, but failure to give
such notice shall be of no effect and the City shall not be obligated under this contract beyond the date of
termination.
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 on insurance from the Subcontractor that
complies with all contract insurance requirements.
12. This Contract consists of the following documents set forth herein; Invitation to Bid No. 16-12842-SS,
Specifications, and the Bid Form.
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 LU OCK
DANIEL M. POPE, MAYOR
ATTEST:
becca Garza, City ecretary-
CONTRAQT-ORR ,Q
BY SI�J ✓��
Authorized Representative
Scott Brown
Print Name
12806 PR 2230
Address
Lubbock, TX 79423
APPR!� )ASpTO C NT: City, State, Zip Code
t/,V\ ;-V�
Scott Snider, Assistant City Manager
AS TO FORM:
City Attorney
S: Purchase/Bid Docs/ITB 16-12842-SS Heavy Duty Towing
Bid Form
Heavy Duty Towing Services
City of Lubbock, TX
ITB 16-12842-SS
In compliance with the Invitation to Bid 16-12842-SS, the undersigned Bidder having examined the Invitation to Bid and
Specifications, and being familiar with the conditions to be met, hereby submits the following Bid for furnishing the material,
equipment, labor and everything necessary for providing the items listed below and agrees to deliver said items at the locations
and for the prices set forth on this form. A bid will be subject to being considered irregular and may be rejected if it shows
omissions, alterations of form, conditional alternate bids, additions or alternates in lieu of the items specified, if the unit
l prices are obviously unbalanced (either in excess of or below reasonably expected values), or irregularities of any kind. The
l Invitation to Bid 16-12842-SS is by reference incorporated in this contract. The Bid Form must be completed in blue or
black ink or by typewriter.
ITEM
DESCRIPTION
QT>
Unit
Per Unit
Extended Cost
1.
Class 6-7-8 19,501 lbs. —
250
Each
$225.00
$56,250.00
33,001 lbs. and over
2.
Compaction Equipment
12
Each
$300.00
$3,600.00
3.
Earthmoving Equipment
12
Each
$300.00
$3,600.00
4.
Lifting & Material Handling
6
Each
$300.00
$1,800.00
Equipment
5.
Road Maintenance
12
Each
$300.00
$3,600.00
Equipment
6
Per mile charge for more than 25 miles outside of city limits 1
$3.25
Unless otherwise specified herein, the City may award the bid either item -by —item or on an all -or -none basis for any
The City of Lubbock is seeking a contract for Heavy Duty Towing Services with one or more contractors. In order to
assure adequate coverage, the City may make multiple awards, selecting multiple vendors to provide the products
desired, if multiple awards are in the best interest of the City. A decision to make a multiple award of this Bid, however,
is an option reserved by the City, based on the needs of the City.
PAYMENT TERMS AND DISCOUNTS - Bidder offers a prompt payment discount of _%, net calendar days.
Unless otherwise indicated on the Bid Form, payment terms will be NET THIRTY DAYS. The City will pay the successful
bidder within thirty days after the receipt of a correct invoice or after the date of acceptance, whichever event occurs later.
Discounts for prompt payment requiring payment by the City within a stipulated number of days will be interpreted as
-- applying within the stipulated number of calendar days after the date of receipt by the City of a correct invoice or after the
date of acceptance that meets contract requirements, whichever event occurs later. Discounts for payment in less than ten
days will not be considered.
MOST FAVOURED PRICING: The Bidder certifies that the price quoted is not in excess of the lowest price charged anyone
else, including its most favoured customer, for like quality and quantity of the products/services; does not include an element
of profit on the sale in excess of that normally obtained by the Bidder on the sale of products/services of like quality and
quantity; and does not include any provision for discounts to selling agents. If at any time during the contract period, the
supplier should sell or offer for sale to any other customer, an equal or less quantity of similar contract products of like or
better quality, at a lower net price(s) than provided herein, supplier agrees to notify the City and sell same product(s) at the
lower price(s) on all deliveries made during the period in which such lower price(s) is effective.
INTERLOCAL PURCHASING (optional): The City desires to make available to other local governmental entities of the
State of Texas, by mutual agreement with the successful bidder, and properly authorized interlocal purchasing agreements as
provided for by the Interlocal Cooperation Act (Chapter 791, Government Code). the right to purchase the same services, at
S:PurchaseBid Docs1rM 16-12942-SS Heavy Duty Towing Servi=
4 ORIGINAL
the prices quoted, for the period of this contract. Each bidder shall indicate on the Bid Form in the space provided below if
he/she will honor Political Subdivision orders in addition to orders from the City of Lubbock. Should these other
governmental entities decide to participate in this contract, would you (the bidder) agree that all terms, conditions,
specifications, and pricing would apply?
[_ Other governmental entities that might have interests in this contract are Frenship Independent School District,
Lubbock Housing Authority, Lubbock County, Lubbock County Hospital District, Lubbock Independent School
District, South Plains Association of Governments, City of Texarkana, Texas Tech University, West Texas Municipal
Power Agency, Lynn County, and City of Wolfforth.
YES ✓ NO
• If you (the bidder) checked YES, the following will apply:
( • Governmental entities utilizing Interlocal Agreements for Cooperative Purchasing with the City of Lubbock will be
eligible, but not obligated, to purchase materials/services under the contract(s) awarded as a result of this solicitation.
( All purchases by governmental entities other than the City of Lubbock will be billed directly to that governmental
I entity and paid by that governmental entity. City of Lubbock will not be responsible for another governmental
LLL entity's debts. Each governmental entity will order their own materials/service as needed.
THIS BID IS SUBMITTED BY Lubbock Wrecker Service Inc a corporation organized under the laws of the State of
(. Texas , or a partnership consisting of or individual trading as
of the City of Lubbock
[ , Firm: Lubbock Wrecker Service Inc.
Address: 3209 Slaton Hwy.
City: Lubbock State: Texas zip 79404
Bidder acknowledges receipt of the following addenda:
r
[-. Addenda No. Date
Addenda No. Date
Addenda No. Date
Addenda No. Date
7 MIWBE Firm:1 I Woman Black American Native American
Hispanic American Asian Pacific Americ Other (Specify)
Any entity or person that manufactures, distributes, converts new motor vehicles (or represents an entity that manufactures,
distributes, or converts new motor vehicles) or is in the business of buying, exchanging, or selling new motor vehicles is
required under the Tex. Occ. Code. Chapter 2301 to be licensed by Motor Vehicle Division of the Texas Department of
Transportation. In order for a bid to be in compliance with the Motor Vehicle Commission Code, the bidder must hold and
provide all applicable current valid licenses issued by the State of Texas:
1. Name and Manufacture's License No.
2. Name and Converter's License No.
3. Name and Representative's License No.
_ 4. Name and Franchise Dealer's License No.
General Distinguishing No. (Franchised TX dealer)
By �CO L �� Date: 6-1-2016
Authorized Representative - must sign by hand
Officer Name and Title: Scott Brown, President
Please Print
Business Telephone Number 8067481044 FAX: 806-745-1362
S:Purchase/Bid Dms/rrB 16-12842-SS Heavy Duty Towing Services
5 ORIGINAL
City of Lubbock, Texas
Purchasing and Contract Management
Heavy Duty Towing Services
ITB 16-12842-SS
SPECIFICATIONS
Scone of Work
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 may select two contractors to perform the towing
service. The second contractor will be back-up for the first contractor should they not be able to
respond or fail to meet expectations.
Contractor's Duties and Responsibilities
The work covered by this bid consists of towing services for disabled City -owned, heavy-duty vehicles
or equipment identified by designated City personnel. The disabled vehicles or equipment will range
from Class 6 up to Class 8, including but not limited to trucks, vans, tractors trailers, including vehicles
with or without trailers or other equipment and vehicles that may be unloaded or loaded with materials
and/or equipment. The towing contract will also include construction equipment such as bulldozers,
backhoes, etc.
The Bidder shall provide tow vehicles capable of towing heavy-duty vehicles and equipment (from
19,501 lbs. to 33,001 lbs. gross vehicle weight and greater). The Bidder will be notified of the
approximate location of the vehicle or equipment type including make, model, color, and if possible the
vehicle license plate number. Towed vehicles or equipment shall be moved to the City's Fleet
Department, unless another location is specified.
(a) Towing Services shall be available 24 hours per day. The towing company will be given 20
minutes to respond to the call. No exceptions will be allowed.
(b) The Bidder will be responsible for any work required to render the disabled vehicle or equipment
for towing such as retrieval, up righting, removal of parts, etc. In addition, the Bidder shall be
responsible for the removal of any debris including, but not limited to, glass, and other items at the
site of the required towing.
(c) The charge for a local tow shall cover any towing for a vehicle or equipment within a 25 mile radius
of Lubbock County. Any additional mileage shall be indicated on the bid form under additional
mileage.
(d) The Bidder shall have and maintain appropriate insurance to cover any damage done to any vehicle
or equipment being towed under this contract by whatever means. This shall include any damage
done during retrieval, hauling/towing and disconnection or unloading or any other means.
(e) The quantities on the bid form are estimates only. The City of Lubbock does not guarantee a certain
number of calls. This contract shall be for any and all calls placed by the City regardless of the
quantities indicated.
(f) The Bidder will be required to cooperate with designated City personnel and to follow the
instructions. Bidder's towing vehicles shall be able to tow using the method or other methods that
are standards of the industry.
STurchaseJBid Does/ITB 16-12842-SS Heavy Duty Towing Services
28
(g) All firms bidding must have been in business for at least three years and meet all Federal, State and
City laws, ordinances, licensing, and regulations relating to the wrecker service business.
Requirements:
Federal Occupational Safety and Health Act:
The Bidder agrees to comply with the conditions of the Federal Occupational Safety and Health Act of
1970, the Texas Industrial Safety and Health Act of 1970, and the standards and regulations issued
thereunder, and certify that all items furnished or used under the order will conform to and comply with
said standards and regulations. Bidder further agrees to indemnify and hold harmless the City of Lubbock
and its employees from damages assessed as a result of Bidder's failure to comply with the Acts and the
standards issued thereunder and for the failure of the items furnished under this order to so comply.
(a) Bidder further agrees to indemnify and hold the City and its officers and employees harmless from
any liability to the owner of the vehicle or equipment towed, Bidder's employees, and all other
persons for any loss, costs, or injuries to persons or property resulting from the acts or omissions of
Bidder or its agents. Bidder shall pay all damages to vehicles or equipment entrusted to its custody
as the result of its negligence.
(b) The Bidder is responsible for the hiring and training of qualified personnel. Bidder is responsible for
maintaining and staffing the auto pound with sufficient personnel to ensure its efficient operation.
The Bidder remains responsible for the conduct and actions of each of its employees.
(c) Bidder's employees or representatives are prohibited from consuming any alcoholic beverages, using
illicit drugs, or carrying/possessing any firearm or weapons in the tow truck or on City property.
Response to Requests for Towine Service
Bidder shall arrive at the location of the vehicle or equipment to be towed within one hour after being
requested to provide towing services. If Bidder fails to arrive within the prescribed time, if necessary,
another towing service may be contacted by the City and neither the City nor any of its officers or
employees shall be liable for any fee, cost or expense incurred in such a situation. Failure to respond in a
timely manner, as indicated above, more than three times in a thirty (30) day period shall be grounds for
terminating this agreement.
Type of Equipment
Compaction Equipment to include but not limited to Static Compactors and Vibratory Compactors.
Earthmoving Equipment to include but not limited to Articulated 4WD Loaders; Crawler Loaders;
Crawler Tractors; Graders; Hydraulic Excavators; Scrapers; Skid Steer Loaders; Tractor Loader
Backhoes; Tractor Loaders; Trenchers; and Wheel Dozers.
Lifting & Material Handling Equipment to include but not limited to Aerial Lifts; Cranes and
Forklifts.
Road Maintenance Equipment to include but not limited to Asphalt Pavers; Hydraulic Breakers;
Pavement Brooms; Pavement Millers; Reclaimers/Stabilizers; Road Wideners; and Concrete Cutters
STurchase/Bid Docs/ITB 16.12842-SS Heavy Duty Towing services
29
Minimum Requirements on Towing Equipment
Bidder covenants that it has at the time this contract is executed and will maintain during the entire
duration of this contract the following:
Towing Equipment:
The Bidder must have a sufficient tow truck to handle the call in time prescribed. Bidders tow truck must
meet all Federal, State and City laws, ordinances, licensing, and regulations relating to the wrecker
service business.
(a) The tow -truck must be equipped with a dolly and a flashing light as well as the necessary equipment
to clean possible debris from the ground, roadway, etc. and maintain safety at the tow scene,
including a heavy duty push broom, dust pan or shovel, and flares. All towing equipment shall be
maintained in good working order. The Bidder must be capable of towing all equipment owned by
the City for any awarded class.
(b) Any tow -truck to be used in performance of this contract shall be equipped with two-way
communication. A communication device shall be maintained in operable condition at all times.
S:Purchase/Bid Does/ITB 16-12842-SS Heavy Duty Towing services
30
City of Lubbock, TX
Fleet Services
Bid Tabulation
July 14,2016
ITB 16-12842-SS
Heavy Duty Towing Services
Item
Qty
UOM DescriptionNendor
Location
Unit Price
Extended Price
1
250
EA
Class 6-7-8 19,501 Ibs. - 33,001 and over
Lubbock Wrecker Service
Lubbock, TX
$ 225
56,250
2
12
EA
Compaction Equipment
Lubbock Wrecker Service
Lubbock, TX
300
3,600
3
12
EA
Earthmoving Equipment
Lubbock Wrecker Service
Lubbock, TX
300
3,600
4
6
EA
Lifting & Material Handling Equipment
Lubbock Wrecker Service
Lubbock, TX
300
1,800
5
12
EA
Road Maintenance Equipment
Lubbock Wrecker Service
Lubbock, TX
300
3,600
6
Per mile charge for more than 25 miles outside
of city limits
Lubbock Wrecker Service
Lubbock, TX
3
All or None
Lubbock Wrecker Service
Lubbock, TX
68,850
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
loll
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:
2016-71191
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Lubbock Wrecker Service Inc.
Lubbock, TX United States
Date Filed:
06/15/2016
2 Name of governmental entity or state agency that is a party to the contract for which the form Is
being filed.
City of Lubbock
Date Acknowledged:
06/15/2016
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.
ITB 16-12842-SS
Heavy Duty Towing
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
Wilson, Chad
Lubbock, TX United States
X
Brown, Scott
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 Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.1021
CERTIFICATE OF INTERESTED PARTIES FORM 1295
loll
Complete Nos. 1- 4 and 6 if there are interested parties.
OFFICE USE ONLY
Complete Nos, 1, 2, 3, S. 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.
2016-71191
Lubbock Wrecker Service Inc.
Lubbock, TX United States
Date Filed:
06/15/2016
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of Lubbock
Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
ITB 16-12842-SS
Heavy Duty Towing
4 Name of Interested Party
City,State, Country (place of business)
Nature of interest
(chock applicable)
Controlling
I Intermediary
Wilson, Chad
Lubbock, TX United States
X
Brown, Scott
Lubbock, TX United States
X
5 Check only if there is NO Interested Parry. ❑
6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
amun
�o4YpYI L� AMY Lc. S VENTS
,ar �=Notary Public, State of Tezas
'86?` Comm. Expires 03.07.2020 .• _, v /i�j�
Notary ID 130669963 Gfic'�
ifilagamairol Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP I SEAL ABOVE
Swory lopd subscribed before me, by the said f 11 UWI , this the 15- day of
20,P, to certify which, witness my hand and seal of office.
` ��1 l/Aliwi,A)
Signature of officer admimst Ing oath Printed name of officer administering oath Title of officer admin tering oath
Forms provided by Texas Ethics Commission www.ethics.slate.tK.us Version V1.0.1021