HomeMy WebLinkAboutResolution - 2016-R0312 - Contract - CSA Construction Inc - Improvement To Water Treatment Plants - 09/08/2016Resolution No.2016-R0312
Item No.5.12
September 8,2016
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. 12943 for Improvements to the North and
South Water Treatment Plants,by and between the City of Lubbock and CSA Construction,Inc..
of Houston, 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 September 8, 2016 .
DANIEL M.POPE.MAYOR
ATTEST:
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Rebedca Garza. City Seer
APPROVED AS TO CONTENT:
.Woodyfaflklin,P.E., Director of Public Works
APPROVED AS TO FORM:
RES.Contract-Nbr 12943,CSA Construction Inc
8.17.16
CERTIFICATE OF INTERESTED PARTIES FORM 1.295
1 of 1
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:
2016-100033
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
CSA Construction, Inc.
Houston, TX United States
Date Filed:
08/16/2016
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, Texas
Date Acknowledged:
08/16/2016
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.
RFP 16-12943-TF
Improvements to the North and South Water Treatment Plants
4 Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
Austin, Rich
Chappell Hill, TX United States
X
Mayfield, Richard
Cypress, TX United States
X
Craig, George
Houston, 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
corms proviaea oy i exas ttnics commission vA w.etrncs.state.tx.us Version V1.0.277
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
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Complete Nos. 1-4 and 6 it there are interested parses,
OFFICE USE ONLY
Complete Nos. 1, 2, 3, 5, and 61 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.
CSA Construction, Inc.
2016-100033
Houston, TX United States
Date Filed:
0811612016
2 Name of governmental entity or state agency that is a party to the contract for w ich the form rs
being filed.
City of Lubbock, Texas
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.
RFP 16-12943-TF
Improvements to the North and South Water Treatment Plants
4
Nature of interest
Name of Interested Party
City, State, Country (place of business)
(check applicable)
Controlling
Intermediary
Austin, Rich
Chappell Hill, TX United States
X
Mayfield, Richard
Cypress, TX United States
X
Craig, George
Houston, TX United States
X
5 Check only If there is NO Interested Party. ❑
6 AFFIDAVIT I swear, or affirm, under penalty of rjury, that the above di losure Is true and correct.
A." MARI0RY F117ABEfH SANDERS
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3 MyNtxyIDN1266P0359
i �2020
..... .. PxaaNgust
' ,„g,�• Signature of authorized agent of comracti business Ury
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said George Craig mis the 16th day of August
2016 to certify which, witness my hand and seal of office.
/r&hd1�1 111 L \%A/lpwutc Marjory E. Sanders Notary Public
9ignatate of of cer administering oath Printed name of officer administering oath Title of officer administering oath
unns provided by texas Eibics Commission www.etmcs.state.tx.us Version V1.0.277