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HomeMy WebLinkAboutResolution - 2016-R0275 - Contract - Craftsman Printers - Bus Wraps - 08/11/2016Resolution No. 2016-RO275 Item No. 4.20 August 11, 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. 12998 for long-term vinyl wrap removal, printing. and installation for Citibus, as per ITB 16 -12933 -SS, by and between the City of Lubbock and Craftsman Printers, 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 August 11, 2016 DANIEL M. P PE, MAYOR ATTEST: �p CL4_e_� _V — e ecea Garza, City , ecreta APPROVED AS TO CONTENT: Bill HoyG,krton, APPROVED AS TO FORM: r Just' Pr itt, A sistant City Attorney ccdocsAES. Contract 12998 - Craftsman Pruners - Citibus Vinyl Wrap July 27, 2016 Resolution No. 2016-RO275 Contract 12998 City of Lubbock, TX Contract for Long Term Vinyl Wrap Printing, Installation and Removal for Citibus THIS CONTRACT made and entered into this 11th day of August, 2016, by and between the City of Lubbock ("City"), and Craftsman Printers, Inc., ("Contractor"). WITNESSETH: WHEREAS, the City of Lubbock duly advertised for bids for Long Term Vinyl Wrap Printing, Installation and Removal for Citibus 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 Secondary contract with said Contractor covering the purchase and delivery of the said Long Term Vinyl Wrap Printing, Installation and Removal for Citibus. 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, Long Term Vinyl Wrap Printing, Installation and Removal for Citibus and more specifically referred to as Items One thru Twenty -One 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. S: Purchase/Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus 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 GENERAL LIABILITY ® Commercial General Liability ❑ Other ❑ Claims Made ® Occurrence ❑ W/Heavy Equipment ❑ To Include Products of Complete Operation Endorsements PROFESSIONAL LIABILITY AUTOMOTIVE LIABILITY ® Any Auto ❑ Scheduled Autos ❑ Non -Owned Autos EXCESS LIABILITY ❑ Umbrella Form GARAGE LIABILITY ❑ Any Auto ❑ All Owned Autos ❑ Hired Autos ❑ BUILDER'S RISK ❑ INSTALLATION FLOATER ❑ POLLUTION ❑ CARGO ® WORKERS COMPENSATION — STATUTORY ® EMPLOYERS' LIABILITY COMBINED SINGLE LIMIT General Aggregate $1,000,000 Products-Comp/Op AGG 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 $1,000,000 Each Occurrence Aggregate Auto Only - Each Accident Each Accident Aggregate ❑ 100% of the Total Contract Price ❑ 100% of the Total Material Costs AMOUNTS OR OCCUPATIONAL MEDICAL AND DISABILITY $500,000 BOTHER: 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 of completed operations endorsement. ® Waiver of subrogation in favor of the City of Lubbock on all coverages, except The City of Lubbock shall be named a primary additional insured with a waiver of subrogation in favor of the City on all coverage's. All copies of the Certificates of Insurance shall reference the contract number for which the insurance is being supplied. 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; S: Purchase/Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus 2 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 13th 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. 7. 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 S: Purchase/Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus 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 -12933 - 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 L BOCK Daniel M. Pop &, Mayor A TEST: t'4 4 '_ X ' Reb tcca Garza, City Secr ary APPROVEDA TO CONTE Bill How on, Assistant Ci 1 Manager APPROVED AS TO Justin City Attorney ON TRACTOR BY W Authorized Representative Print Name Address5 City, State, Zip Code S Purchase/Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus 4 City of Lubbock, Tx ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Specifications SCOPE: This solicitation is an Invitation for Bid to establish an annual price contract for Long Term Vinyl Wrap Printing, Installation and Removal for Citibus. This work will be done on Contractor's site. No guarantee of Volume. The City of Lubbock does not guarantee any specific amount of compensation volume, minimum or maximum. Amounts, quantities listed on the bid form are estimates only. II. PRINTING OF VINYL WRAPS YEAR MAKE and MODEL VEHICLE TYPE QUANTITY 2000 Nova RTS (0001, 0003-0009) 35'Diesel Bus 8 2000 Nova RTS (2060-2065) OPT 40' Diesel Bus 6 2000 Nova LF (2001-2012) 40'low Floor Diesel Bus 12 2001 Nova LF (2101-2118) 40' low Floor Diesel Bus 18 2001 Nova RTS 0111,0112,0114 35' Diesel Bus 3 2004 Gilli LF 0401-0406) 35' Diesel Bus 6 2006 Gilli LF 0601-0607 35' Diesel Bus 7 2009 Gilli LF (0901-0906) 30' Hybrid Bus 6 2011 Gilli LF (1101-1102) 35' H brid Bus 2 2013 Gilli LF (1301-1304) 35' H brid Bus 4 TOTAL FULL SIZE 72 A. The vinyl and vision to be quoted is as follows: B. Vinyl: Avery mpiI005ezrs with Avery dol 1060 over laminate OR APPROVED EQUAL C. Vision or window perforated vinyl: Clear Focus Classic Vue 8mil 2 year with Avery dol 1060 over laminate OR APPROVED EQUAL D. Companies are to provide their own templates for the bus vinyl, Citibus and or contractor will provide the art work in Adobe CS Illustrator. III. INSTALLATION 1. Installation of Vinyl wraps will be done at the contractors place of business 2. Buses will be available for work an average of 6 days per week 8:00a.m. to 1 I :00p.m., dependent on fleet needs. Buses will be washed by Citibus through our bus washer, and any additional cleaning or cleaning materials will be part of the bid price. 3. Contractor will provide a two year warranty on installed vinyl. Additionally no glue or material will be applied to hold the vinyl in place that will damage the underlying paint finish or that is not easily removable, any prior damage should be noted before vinyl is installed. All existing markings, ADA Handicap or other decals, logos, unit numbers or previous wraps, unless deemed unnecessary, must be removed prior to new wrap installation. All decals, marking, unit numbers, etc., are to be replaced with new as part of the job. 4. Vendor must repair or replace any section of the wrap that peels, tears, bubbles or fades 5. Installation time should be less than 5 days per full vinyl wrap, if more time is needed verbal approval must be received from Citibus Director of Maintenance. 6. Failure to meet the negotiated turnaround time will result in a percentage deduction from the cost of installation per written mutual agreement. This percentage will be negotiated 7. Photos of final vinyl wrap shall be emailed to the Director of Marketing for Proof of Performance (POP) Purchase/Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus 37 IV. REMOVAL 1. Removal of Vinyl wraps will be performed at Citibus. 2. Vendor will be required to remove the wrap and ensure that no paint will peel froth the bus. In the event the paint does peel, it is to be noted in writing and a photo taken for determination of responsibility by the Director of Maintenance. 3. Removal time should be less than 5 days; if more time is needed verbal approval must be received from Citibus Director of Maintenance. 4. Photo of vinyl removal shall be emailed to the Director of Maintenance for POP V. REFERENCES: Supply a minimum of three references, which shall include the name and address of the company, contact name, telephone number and type of service provided. V1. DOCUMENTS: Bidder must submit the following forms with their bid. Failure to do so may deem the bid non-responsive: 1. Statement of Eligibility 2. Affidavit of Non -Collusion 3. Insurance Affidavit 4. List of Similar Contracts 5. Buy America Certificate VII. TERM: The contract shall be for a term of one (1) year, said date of term beginning upon formal approval. The contract may be renewed for an additional two (1) year terms under the same terms and conditions upon written agreement from both parties. 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 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, or refuse to comply with any requests which would cause Citibus to be in violation of the FTA terms and conditions. S: Purchase/Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus 38 REVISED 2 Bid Form Long Term Vinyl Wrap Printing, Installation and Removal for Citibus City of Lubbock, TX ITB 16 -12933 -SS In compliance with the Invitation to Bid 16 -12933 -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 prices are obviously unbalanced (either in excess of or below reasonably expected values), or irregularities of any kind. The Invitation to Bid 16 -12933 -SS is by reference incorporated in this contract. The Bid Form must be completed in blue or black ink or by typewriter. Nova RTS (000 1. 0003-0009) 35' Diesel Bus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST 1 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Printing, per3i $ $ (�/� • �/ vL�l/ w specification 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation $$ ' �� •� gq!50. per specification 3 14 EA Full/Full Wrap, bumper to bumper, $ $ both sides and rear, Removal, per� � nl) W DO specification • 4 14 EA Half Bus, one side no rear, Printing, per specification $ I $ 1612w.u0 5 14 EA Half Bus, one side no rear,$ Installation, per specification % -700 - $ "l. 6 14 EA Half Bus, one side no rear, Removal, per specification $ 2W n^ �—W • (%(j $ •� 7 14 EA Below Windows, one side only, no rear Printing, per specification $ON^ I• VLJ $ • �o 8 14 EA Below Windows, one side only, no rear Installation, per specification $$ Ml n � D56 9 14 EA Below Windows, one side only, no rear Removal, per specification $ MM ��• W $ 700 10 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Printing per WUU A �{ (�'yl'). CC��[[���� co specification 11 14 EA King Kong wrap, between wheel wells floor to ceiling, Installation, $ MM 3 r—) • (Jl/ $ 6060 per s ecification 12 14 EA King Kong wrap, between wheel wells floor to ceiling, Removal per100. $ � $ 1� An W specification 13 14 EA Back only, with back bumper, Printing, per specification $ 1 IN). DD PTLA-/ $ 6�M VU 14 14 EA Back only, with back bumper, Installation, per specification $ �• $ /� n,^ �i"` • (JV 15 14 EA Back only, with back bumper, Removal, per specification $!y> •00 $ 1060. co 16 14 EA Headline Banner, one side only, Printing, per specification $ 2,65-00 � � (� 17 14 EA Headline Banner, one side only, Installation, per specification $ 26^^ • (J(f $ r �,� 18 14 EA Headline Banner, one side only, $ ��• �V $ �Jrri� DO Removal, per specification • 19 14 EA King 30" X 144" banner one side, �y� 1205 I CO Printing, per specification -C V • 20 14 EA King 30" X 144" banner one side, Installation, per specification $ • ��/ $ f/) �� • W 21 14 EA King 30" X 144" banner one side, $ � DO $ 700.DD � Removal, per specification • • Total $ ' • CO S: Purchase/Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Nova RTS (2060-2065) OPT 40' Diesel Bus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST 1 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Printing, per $ A'750. f V') $ specification / w W 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation, $ , j� tt -- $ 0 2rWU/- ^f (�f J per specification 3 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Removal, per—TC0. $ $ �• M Vl.� s ecification 4 14 EA Half Bus, one side no rear, Printing, per specification. $$ fin Lr IRS• 5 14 EA Half Bus, one side no rear, OV) $ �� Installation, per specification • (/[/ 6 14 EA Half Bus, one side no rear, $ Removal, per specification 7 14 EA Below Windows, one side only, no $ '' 01) $ ��. rear Printing,per specification 8 14 EA Below Windows, one side only, no $ • nn $ rear Installation, per specification 9 14 EA Below Windows, one side only, no $ 60. 0O $ rear Removal, per specification 10 14 EA King Kong wrap, between wheel wells floor to ceiling, Printing per $ -100 • DD {{ $ Oifte U) �"tL�r//�u�� Cil/ s ecification 11 14 EA King Kong wrap, between wheel wells floor to ceiling, Installation, $ • DD $ ✓'� per specification .J��• 12 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Removal per IT - 00 i ��. 1`�W 00 specification 13 14 EA Back only, with back bumper, $ /� /►� DV $ �D Printing,per specification tl1/ • cJIV - 14 14 EA Back only, with back bumper, $ n $ /rn Installation, per specification VO �l�•DO 15 14 EA Back only, with back bumper, Removal per specification $� M . LA,1 $ e�• �0 ` 16 14 EA Headline Banner, one side only,$ M $ �. co Printing,per specification • VlJ 17 14 EA Headline Banner, one side only, $ DO $ ^^ Installation, per specification • r -)J 18 14 EA Headline Banner, one side only, Removal, per specification $ 745. $ 19 14 EA King 30" X 144" banner one side, $ I Z,5• CVhh $ Printing, per specification 20 14 EA King 30" X 144" banner one side, $ �. ^^ Installation, per specification [J�J 21 14 EA King 30" X 144" banner one side, Removal, per specification $ • $ -700. W Total $ IOV M- 00 S: Purchase laid Docs- ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Nova LF (2001-2012) 40' Low Floor Diesel Bus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST 1 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Printing, per $ ►D $ �z Db specification �rtt0 • 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation, $ '�• oa $ Z0,AM�w per specification 3 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Removal, per $ fv,700 • $ �• specification 4 14 EA Half Bus, one side no rear,$ Printing, per specification �`[" RO.� 5 14 EA Half Bus, one side no rear, $ ! [A1• W W $ /J `"'�� 60 Installation, per specification • 6 14 EA Half Bus, one side no rear, Removal, per specification $ •;ALJ L�i',(,J" $ 7• ^� G 00 7 14 EA Below Windows, one side only, no $ (nn. D0 $ , I Dc) �`-j'�' rear Printing, per specification LV 8 14 EA Below Windows, one side only, no $ rear Installation, per specification 9 14 EA Below Windows, one side only, no $ �O• DO $ �• O� rear Removal, per specification 10 14 EA King Kong wrap, between wheel wells floor to ceiling, Printing per $ DD• —(00.00 $ n specification ` W • 11 14 EA King Kong wrap, between wheel wells floor to ceiling, Installation,• $ �O $ 5W per specification 12 14 EA King Kong wrap, between wheel wells floor to ceiling, Removal per $ 100-00 $ `4W. 00 s ecification 13 14 EA Back only, with back bumper, $$ ,)n Printin , per specification • W 14 14 EA Back only, with back bumper, $ �O• DO $ � /n M �^ Installation, per specification • 15 14 EA Back only, with back bumper, $•� $ 1059. DD Removal, per specification 16 14 EA Headline Banner, one side only, $ ��• $v Printing, per specification 17 14 EA Headline Banner, one side only, $ CJS. W q�n Z' $ Installation, per specification • W 18 14 EA Headline Banner, one side only, $ ?j�. �/1 [ $ Removal, per specification j • 19 14 EA King 30" X 144" banner one side, $ � lJ(J $ � 7�. ^� 00 Printing, per specification •�/� :.ALJ 20 14 EA King 30" X 144" banner one side, Installation, per specification $ I J • OV $ o� • 00 21 14 EA King 30" X 144" banner one side, Removal, per specification $�D �O $ �. Total $ � � /„���• ^T S: Purchase Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Nova LF (2101-2118) 40' Low Floor Diesel Bus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST 1 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Printing, per�Zl5•� $ $ specification 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation, $ '�•Wxf�• w $ per s specification t3C 3 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Removal, perR• $ W $ DD specification 4 14 EA Half Bus, one side no rear, Printing, per specification $ � q� • $ f q,000-00 ��• ^ ,� /00 5 14 EA Half Bus, one side no rear, $MM ��•W $ �•� Installation, ers specification 6 14 EA Half Bus, one side no rear, $.�M ^� $ vo Removal, ers specification • 7 14 EA Below Windows, one side only, no $ r}N n/)$ • IJV 1400-00 rear Printing, ers specification 8 14 EA Below Windows, one side only, no $ 16.CJ Dh $ n5D n rear Installation, ers specification V'J • j%O 9 14 EA Below Windows, one side only, no $ ��• ,�^ $ �Oco rear Removal, ers specification • 10 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Printing per —(00 • I specification 11 14 EA King Kong wrap, between wheel wells floor to ceiling, Installation, $ qx• 0v/�•D� $ per s specification 12 14 EA King Kong wrap, between wheel wells floor to ceiling, Removal per $ 100-00 $ • specification 13 14 EA Back only, with back bumper, $I f,• D� ^�'W $ 6j_)• Printing,ers specification ;�lQ 14 14 EA Back only, with back bumper, $ �• $ � 1 CO. DO �- Installation, ers specification �l W 15 14 EA Back only, with back bumper, $$ �5� � I Removal, ers specification V.�i• 16 14 EA Headline Banner, one side only, $$ 10 ernAn Printing,ers specification , �J• IJIJ 17 14 EA Headline Banner, one side only, $ $ Installation, perspecification a�.�j\• 18 14 EA Headline Banner, one side only, $• ' Removal, ers specification �(J LA./ 19 14 EA King 30" X 144" banner one side, $ 1 •��•�O $ �•��'n• ^^ M lJV Printing, ers specification `71 20 14 EA King 30" X 144" banner one side, $!�• n� $ �O Installation, ers specification ! LIV • [/^D 21 14 EA King 30" X 144" banner one side, $ �•� h� $ �^� Removal, ers specification • V �f Total $ I a S: Purchaser Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Nova RTS (0111. 0112.0114) 35'Diesel Rus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST , _1 +,I- 1 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Printing, per S.60 J DD $ [, �y�• specification 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation, $ f j- $ l� fY) ` ✓�l per specification / 3 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Removal, per $ • DO $ C0[• DD ww specification �� 4 14 EA Half Bus, one side no rear, Printing, per specification $ 22 ppyyo� 9 `JW. DD $ 1912M. DD 5 14 EA Half Bus, one side no rear, Installation, per specification $ ��!D• DD "� �W • +Dv 6 14 EA Half Bus, one side no rear, $•� $ DD �. Removal, per specification 7 14 EA Below Windows, one side only, no rear Printing,per specification $ ^ OD• (^� $ '00. DO 8 14 EA Below Windows, one side only, no $ M $ `l!J(J• o rear Installation, per specification W 9 14 EA Below Windows, one side only, no $��• $ —700. 00 rear Removal, per specification L4-1.1 10 14 EA King Kong wrap, between wheel wells floor to ceiling, Printing per $• o� $ �• specification W 11 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Installation, �� !! (JV • M w per specification �� .W 12 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Removal per• LV j �f�• DO — C«/ specification 13 14 EA Back only, with back bumper, $ *D D h $ ^n Printing, per specification • lJV (f 0to- '10 :��J��(l!jj (qq���f 14 14 EA Back only, with back bumper, $ Oo $ q oo. Installation, per specification • Vt) 15 14 EA Back only, with back bumper, $$ ®® 05 Removal, per specification l J• (J• CJV 16 14 EA Headline Banner, one side only, $ ^h �5 $ Printing,per specification . (JC/ . 17 14 EA Headline Banner, one side only, $ �� DO $ !1a. CO Installation, per specification 18 14 EA Headline Banner, one side only, $ ��� $ - nw Removal, per specification • 19 14 EA King 30" X 144" banner one side, per specification $7� D� $ / /Y)Printin 6. W 20 14 EA King 30" X 144" banner one side, Installation, per specification $ DO • $ n . �/ 21 14 EA King 30" X 144" banner one side, Removal, per specification $ D• DO $ 7�• DD Total J$ ! Q . /GO, S: Purchase Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Gillis LF (0401-0406131;' Diecpl R,.c ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST 1 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Printing, per $ %—Fba VO $ Lit? 000. D specification 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation, $ •DD '�. DD per specification 3 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Removal,s per' $ Wauu ecification 4 14 EA Half Bus, one side no rear, Printing, per specification $ 1.3 � ;J $ �j M p W. Do 5 14 EA Half Bus, one side no rear, Installation, per specification $ `-� ( • 00 $ �,pfp. ©D 6 14 EA Half Bus, one side no rear, Removal, per specification $� � $ � DO 7 14 EA Below Windows, one side only, no rear Printing, per specification $ l Ob . oo $ 1 • oo 8 14 EA Below Windows, one side only, no $ $ I^ rear Installation, per specification `�• 9 14 EA Below Windows, one side only, no $ ®• DO $ �• �v rear Removal, per specification 10 14 EA King Kong wrap, between wheel wells floor to ceiling, Printing pera $ RV-00 j�/'�•s ft ecification 11 14 EA King Kong wrap, between wheel wells floor to ceiling, Installation, $ 37�1�� $ •.J �� per specification .•JJ�• • 12 14 EA King Kong wrap, between wheel wells floor to ceiling, Removal per $ 1o©. $ j T specification 13 14 EA Back only, with back bumper, $ , r 1V �oD $ o Do Printing,per specification (' • . 14 14 EA Back only, with back bumper, Installation, per specification $ ,I ^ •LA.1 $/ n„A 4 (. DD 15 14 EA Back only, with back bumper, Removal, per specification $ r/)$ l/�J �d • DD 16 14 EA Headline Banner, one side only, Printing,per specification $ (.10-1 iWn $ O 17 14 EA Headline Banner, one side only, Installation, per specification $ MM • WD. $ DD 18 14 EA Headline Banner, one side only, $�� �^ $ �• nn Removal, per specification 19 14 EA King 30" X 144" banner one side, Printing, per specification $ 12,6400 ��, DO $ 1750 ���. 20 14 EA King 30" X 144" banner one side, Installation, per specification $ —715 • nO (� 21 14 EA King 30" X 144" banner one side, per specification $ �O � • $ —too - DORemoval, Total $ jq? , I,..�• DO S: Purchase Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Gilli2 LF (0601-0607) 35' Diesel Bus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST 1 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Printing, per�, $ $ specification vv Mo.Lon. 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation, $ ' �Z5•f V) $ /Q� � / c ers specification 3 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Removal, per $ W.00 $ j��� v � specification 4 14 EA Half Bus, one side no rear, Printing, per specification $ 1300.00 $ M 18 2M•W 5 14 EA Half Bus, one side no rear, o $7o.Q0 $ ^�•o ('� Installation, ers specification 6 14 EA Half Bus, one side no rear, $ Z&.00 �y, DO Removal, ers specification 7 14 EA Below Windows, one side only, no rear Printing, ers specification $ '�• DO $ �/�oDO `'i" . 8 14 EA Below Windows, one side only, no $ 7`J5• 1O $ D�p�• rear Installation, perspecification CCJJ 9 14 EA Below Windows, one side only, no n $ 5V� $ ��• ,fin rear Removal, ers specification • CA./ 10 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Printing per W). Db•fvN s ecification 11 14 EA King Kong wrap, between wheel$ wells floor to ceiling, Installation, 5. DO $ -52,95D.2� b per s specification ✓ G . 12 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Removal per ! Do. DO 14W- 00 _i �� s ecification 13 14 EA Back only, with back bumper, Printing,ers specification $$ ri • UU M 6k 00. W 14 14 EA Back only, with back bumper, $ $ LMA9.w Installation, ers specification •� 15 14 EA Back only, with back bumper, Removal, ers specification $�. DD $ � 0ID•DD 16 14 EA Headline Banner, one side only, $�� � $ 350 n0 Printing,ers specification • lJ 17 14 EA Headline Banner, one side only, $��• ^,� $ 350• DO Installation, ers specification W (/ 18 14 EA Headline Banner, one side only, $ 25•M $h' DO 0 Removal, ers specification (�f 19 14 EA King 30" X 144" banner one side, ^,� $ � L� $ � ��D. Printing,ers specification • (� 20 14 EA King 30"X 144" banner one side, $ h 0 $ Installation, ers specification 1660-01) 21 14 EA King 30" X 144" banner one side,$ Removal, ers specification V- 7d� Total $ I 4?,Ir&. DD S: Purchase Bid Docs/rfB 16 -12933 -SS Long Term Vinyl wrap Printing, Installation and Removal for Citibus UWE LF (0901-0906) 30' Hvhrid Rus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST 1 14 EA Full/Full Wrap, bumper to bumper, $ $ both sides and rear, Printing, per j �• co �� L�ti(J • co specification wV 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation, $ 't1f •00 LL11 awl/ vvll�� $ I vl / • f�/� vow per specification 3 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Removal, per $ Linn $ 5000. to specification 4 14 EA Half Bus, one side no rear, Printing, per specification $/��, � 1/� $ 171, ��•� 5 14 EA Half Bus, one side no rear, Installation, per specification $$ .� ,^� 1Y 6 14 EA Half Bus, one side no rear, Removal, per specification $$ .� . co 7 14 EA Below Windows, one side only, no $�D• n� $ -71Arear CO Printing,per specification (/�f 8 14 EA Below Windows, one side only, no rear Installation, per specification $ 75•f� rJ (J� 9 14 EA Below Windows, one side only, no rear Removal, per specification $ 6!D•� ;,J $ • )/) (� 10 14 EA King Kong wrap, between wheel wells floor to ceiling, Printing per $ 5fv). $ W VV/ 700• specification 11 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Installation,2 ^A, M &U / 1�D� /fin �" per specification &V W 12 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Removal per ' LV DD �� /I / /� ` DD specification L)U • 13 14 EA Back only, with back bumper, $M M �-�(�f $ 5�(sl_MUfJ DO Printing, per specification • LA -1 • 14 14 EA Back only, with back bumper, Installation, per specification $$ 350.0�.� 15 14 EA Back only, with back bumper, Removal, per specification $$ -6•�. 16 14 EA Headline Banner, one side only, Printing, per specification $ d ",•co $ 9JU 17 14 EA Headline Banner, one side only, $ Z5•D)f �• Installation, per specification w 18 14 EA Headline Banner, one side only, $ M $ per specification • c".Removal, 19 14 EA King 30" X 144" banner one side, Printing, rintin per specification $ I� M G'� • (/(J � n^ $ 0-M • w 20 14 EA King 30" X 144" banner one side, $ $ ��[� M Installation, per specification O • Ctty. W 21 14 EA King 30-X 144" banner one side, $ 'rte ^h -TU $ M-M co Removal, per specification P [0 ��(Q�J Total $ I Iq n'7 S: Purchase Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Gillig LF (1101-1102) 35' Hvhrid Bus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST l 14 EA Full/Full Wrap, bumper to bumper, $ $ both sides and rear, Printing, per S 6An. �✓L W specification ll/W 2 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Installation, $ 1%j5 • � 1 CC.� $ per specification 3 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Removal, per $ $ % &M -LA -1 specification 4 14 EA Half Bus, one side no rear, Printing, per specification $ • � /�� $ � ,�yl� UU 5 14 EA Half Bus, one side no rear, Installation, per specification $ /� 700 • W $ ,,�/� qOM. VD 6 14 EA Half Bus, one side no rear, Removal, per specification $ ��MM ,,ttyy�� !x • �.�-/' $ 7 14 EA Below Windows, one side only, no rear Printing,per specification $ /� f W •n� W $ ' • QO 8 14 EA Below Windows, one side only, no rear Installation, per specification /V-)$ $�• W ��o• �n UV 9 14 EA I Below Windows, one side only, no rear Removal, per specification $�D . oO $ �• ^� UV 10 14 EA King Kong wrap, between wheel wells floor to ceiling, Printing per $ &Co. DO $ • OCw0 tl(�lJ s ecification 11 14 EA King Kong wrap, between wheel wells floor to ceiling, Installation,3`75. $ // W $ .0c)er specification 12 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Removal per I ��* Ilw• (J(J specification 13 14 EA Back only, with back bumper, Printing, per specification $ / L M • � —TW $ /-M• ,�^ �(!(N 00 14 14 EA Back only, with back bumper, $ 350' Installation, per specification {� • 15 14 EA Back only, with back bumper, Removal, per specification $ —145� $ l�®• W 16 14 EA Headline Banner, one side only, Printing, per specification $ • $ n�D. �J 17 14 EA Headline Banner, one side only, Installation, per specification $ ��.� $ �D. WM 18 14 EA Headline Banner, one side only, $��• �^ $ �. ^� Removal, per specification W LIV 19 14 EA King 30" X 144" banner one side, Printing, per specification $ � Z5 •oO $ r M { 7�0- DO 20 14 EA King 30" X 144" banner one side, $M ��• $ m5D� nO Installation, per specification UU lJ 21 14 EA King 30" X 144" banner one side, $ 150- Removal, per specification • (J(l Total $ ��/ L150. 0 S: Purchase: Bid Docs/ITB 16 -12933 -SS Long Term Vinyl Wrap Printing, Installation and Removal for Citibus Gillis LF (1301-1304) 35' Hvbrid Bus ITEM QTY UOM DESCRIPTION UNIT PRICE EXTENDED COST 1 14 EA Full/Full Wrap, bumper to bumper, both sides and rear, Printing, per $ �6 ` 00 $ zo a. 00 specification 2 14 EA Full/Full Wrap, bumper to bumper, $ $ both sides and rear, Installation, `� L� "1 1�r©•�/'j w per s specification 3 14 EA Full/Full Wrap, bumper to bumper, $ $ both sides and rear, Removal, per /��• � Qi(�• M specification 4 14 EA I Half Bus, one side no rear, Printing, per specification $ t $ �8� •w 5 14 EA Half Bus, one side no rear, Installation, ers specification $ 7W-0/0 $ �h W 6 14 EA Half Bus, one side no rear, Removal, ers specification $ %/f'�) MM L—VL/ • r' 0 $ LA, / 7 14 EA Below Windows, one side only, no rear Printing,ers specification $ �� �O $ 8 14 EA Below Windows, one side only, no $ y45•CO $ 1056. rear Installation, ers specification ` V^0 9 14 EA Below Windows, one side only, no $. n� $ y�D. Do rear Removal, ers specification L41--1` 10 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Printing per UID• ��• D0 specification 11 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Installation, J��• /�,n, ���• DD per specification 12 14 EA King Kong wrap, between wheel $ $ wells floor to ceiling, Removal per 1 oD . 6 DO NCO.s specification 13 14 EA Back only, with back bumper, Printing, perspecification $ / L1�1• /�h 'TW VCJ $ �DD� �o 14 14 EA Back only, with back bumper, Installation, perspecification $ n� 15 14 EA Back only, with back bumper, Removal, perspecification $ 75•Do $ 1050 -Do 16 14 EA Headline Banner, one side only, Printing, perspecification $ U • 00 $ ZALIL/. 17 14 EA Headline Banner, one side only, Installation, ers specification $ F,45. 0� $ `�•� 18 14 EA Headline Banner, one side only, Removal, ers specification $ � [J^CJ 0 • $ 5� CD •MM 19 14 EA King 30" X 144" banner one side, Printing, ers specification $ )�� Q(J ! CJ $ f 75o W 20 14 EA King 30" X 144" banner one side, Installation, ers specification $ 75'� $ � �O . 21 14 EA King 30" X 144" banner one side, Removal, ers specification $ `5 D.C/� $ �� Total $ /42-t450- (JLJ Unless otherwise specified herein, the City may award the bid either item-by—item or on an all -or -none basis for any item or group of items shown on the bid. S: Purchase Bid Docs/ITB 16 -12933 -SS Long Tenn Vinyl Wrap Printing, Installation and Removal for Citibus IG] w V C U a W N a A r., A n a - a r., A n A r•. 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Z Z N N -• -• - - -• IJ -• W -- C U W W J J On W IJV O N J U IJ O L N N IJ - IJ - O U W W J J a W IJ �p O N J U IJ U O U G'C, N tJ - .-- �. ..-� .--• IJ -- O U W W J J O U C` O U O U W W J J a W tJ �C O N J U IJ W ^ O L N 0 m U w r O A IJ O a U W —• OOAc tNn 5' �o < n � F CA o_ H c: o�ANOZ Y C` U L A J L O• L A A N N -�. --• N D W - In H UQCT. L4 C T. L!pnr. vl Cn- In pn= pLA Lpna< U O` 5 P: Ir c c V V H p:' J A v A U h G (1. V a n L F G n p? < L [� G p? ^ n V -" E G v: a rr Wo E c 'ra J to r c [n 3 c n E to 3- In c 3 5 E 3 y 7 n p r ^ O �: _ IF v x, N c^, cc w tg n n tg N coo H v,U J o� � oU 000U O J U c�Uo N N - - .. _. - N --• W --. in .. ❑ c c O< - N C< - G y < c O N < � C N � O n - p >" _" -- N H< N O U W UOU W J c,u J w W W N .-.u,�n �O J O N oU J a U-- N oU IF O J U c V,o ss N - 0o < c o rn o = c o c c o z c c c ^ O -er o c o - c W W o cr a c c c o c c n cc c n c In n cc V� cc Qv O In O J In pc Vi O G1 U 00 O O dJ O H O O O O L� O O O O -00 - '� cc n n r. '� 00 o p o o L O O O O O XX XX Y. X XY '/.X kX X X XX N N -• -• - - -• IJ -• W -- C U W W J J On W IJV O N J U IJ O L N N IJ - IJ - O U W W J J a W IJ �p O N J U IJ U O U G'C, N tJ - .-- �. ..-� .--• IJ -- O U W W J J O U C` O U O U W W J J a W tJ �C O N J U IJ W ^ O L N 0 m U w r O A IJ O a U W —• OOAc tNn IJ O W N 7 o 00 0 5' �o < n � F CA o_ H c: o�ANOZ U O U C` U U - U U J O U O• O U O OC U a U O N N -�. --• N -• W - In H O U W W J J fA W N �O O N J U IJ O A N O J U U O` n - tri n c N co<i O U W W J J tti W N b O IJ O U J C U N O U O L N O a U O J U a U O 7 n p r ^ O W O - O - v (T • c r c y O - c w = n C v�ovi coo v. v,U J o� � oU 000U O J U c�Uo N N - - .. _. - N --• W --. in C U W v,cv, W J cv� J � tb W N —UU �O J O N ou J c U N ov, O A N owv� O J U a V�o _" -- N O U W UOU W J c,u J w W W N .-.u,�n �O J O N oU J a U-- N oU O A N oOOU O J U c V,o ss N - 0o U N W U O A N W a A •D^. W- W O ^ O N r- U W J N J -• A W W W N W A N N O W --• O O J -- IJ L J �O C IJ In W �;J V� V� O U Qv O In O J In pc Vi O G1 U 00 O O dJ O H O O O O L� O O O O L O O O O O to O O O O O A O O O O O O N O O O O L O O O O O IJ O W N 7 o 00 0 5' �o < n � F CA o_ H c: o�ANOZ y a o 0 O Ci H n o -� cr a 11 0 j' O U O` n - tri n c N co<i - vo� n f C � C C tiCi cion 7 n p r ^ O W O - O - v (T • c r c y O c w = n • c U-' c o c w ' C) • H u, w = D. O CERTIFICATE OF INTERESTED PARTIES FORM 3.295 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: 2016-92845 Date Filed: Date Acknowledged: 08/01/2016 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Craftsman Printers Inc. Lubbock, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is08/01/2016 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. 12998 Vinyl printing 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary O'Halloran, Belinda Lubbock, TX United States X Penn, Tyler 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 V1.0.277 Forms provided by Texas Ethics Commission www. ethics. state. tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 3.295 10f1 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. 2016-92845 Craftsman Printers Inc. Lubbock, TX United States Date Filed: 08/01/2016 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. 12998 Vinyl printing 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary O'Halloran, Belinda Lubbock, TX United States X Penn, Tyler 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. ?�4 i•�Y P C CHRISTINA MAGALLANES Notary Public, State of Texas r y My Commission Expires 10.30.201,7 - - 'sr P Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Qi) �I Sworn o nd subscribed before me, b the said i this the I vt l I U(d .I l oma, 20, to certify which, witness my hand and seal of office. 5 da of - y MAA(fl bM Signature of offic ad i istering oath Printed name of offic r admin tering oath Title of officer administering oath Forms provided by Texas Ethics Commission www. ethics. state. tx.us Version V1.0.277