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Home My WebLink AboutResolution - 2016-R0434 - Purchase Order - DACO Fire Safety Equipment Co. - SCBA Masks And Equipment - 12/01/2016Resolution No.2016-R0434 Item No.5.19 December 1.2016 RESOLUTION BE IT RESOLVED BY II IE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock,Purchase Order No. 10017261,encumbering funds in the amount of $155,365.00,awarded to DACO Fire Safety Equipment Co.of Lubbock,TX,under Buy Board Contract No.432-13.for Self-Contained Breathing Apparatus (SCBA) Masks and related equipment,fees and expenses,and related documents. Passed by the City Council this 1st Hav of December 2016. DANIEL M.POPE.MAYOR ATTEST: "^^JU^t^ Rebecca Garza.City Secreta L APPROVED AS TO CONTENT: Lance Phelps,Fire Rescue Chief APPROVED John jisiani City Attorney Mbbdomcitv data\citvatt\CCDOCS\Rl:S.Oaeo POI0017261 SCBAMasks.20l6.doc n `•.- Lubbock TEXAS PURCHASE ORDER TO: DACO FIRE SAFETY EQUIPMENT 201 AVENUE R PO BOX 5006 LUBBOCK Texas 79408 5006 SHIP TO: Page - I Date - 11/08/2016 Order Number 10017261 000 OP CITY OF LUBBOCK CENTRAL FIRE STATION RAULSALAZAR 1515 EAST URSULINE LUBBOCK Texas 79401 INVOICE TO: CITY OF LUBBOCK ACCOUNTSPAYABLE P.O. BOX .BOX202000 LUBBOCK, TX 79457 BY: 6�/ Marta Alv z, Direor of Purchasing & Contract Management Ordered 11/08/2016 Freight Requested 01/15/2017 Taken By S SUMMERS Delivery PER R SALAZAR REQ #48818 BUYBOARD 432-13 Description/Supplier Item Ordered Unit Cost UM Extension Request Date Scott Epic 3 Voice Amp 126.000 360.0000 EA 45,360.00 01/15/2017 Scott PN 2011275-01 AV3000 HT Mask Small 39.000 245.0000 EA 9,555.00 01/15/2017 Scott PN 201215-27 AV3000 HT Mask Medium 285.000 245.0000 EA 69,825.00 01/15/2017 Scott PN 201215-28 AV3000 HT Mask Large 125.000 245.0000 EA 30,625.00 01/15/2017 Scott PN 201215-29 Total Order Terms NET 30 DAYS 155,365.00 This purchase order encumbers funds in the amount of $155,365.00 awarded Daco Fire Equipment of Lubbock, TX on December 1, 2016. The following is incorporated into and made part of this purchase order by reference BuyBoard Contract 432-13 Daco Fire Equipment of Lubbock, TX Resolution # 2O1 F-R0434 CITY OF LUBB Daniel M. Pope, Mayor ATTEST: n _ I C14� J�� — Re ec a Garza, City Secretary DACO FIRE EQUIPMENT 201 AVE R PO BOX 5006 LUBBOCK, TX 79408 Phone # Fax # 8067630808 806-763-9151 Name / Address LUBBOCK, CITY OF PO BOX 2000 LUBBOCK, TX 79456 Ship To LUBBOCK FIRE DEPT. 1515 EAST URSULINE LUBBOCK, TX 79401 Estimate Date Estimate # I1/8/2016 2617 Terms Rep FOB Net 30 GD Item Description Qty Rate Total SCO201275-01 EPIC3 VOICE AMPLIFIER 126 360.00 45,360.00 SCO201215-27 AV-3000 HT; SMALL W/KEVLAR HEADNET 4 STRAP 39 245.00 9,555.00 AND R.S. COMMS BRACKET SCO201215-28 AV-3000 HT; MEDIUM W/KEVLAR HEADNET 4 285 245.00 69,825.00 STRAP AND R.S. COMMS BRACKET SCO201215-29 AV-3000 HT; LARGE W/KEVLAR HEADNET 4 STRAP 125 245.00 30,625.00 AND R.S. COMMS BRACKET BUYBOARD CONTRACT# 432.13 Subtotal $155,365.00 Sales Tax (0.0%) $0.00 Total $155,365.00 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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: 2016-132075 Date Filed: 11/02/2016 Date Acknowledged: 11/09/2016 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Daco Fire Equipment Lubbock, TX United States 2 Name of governmental entity or state agency that is a parry to the contract for which the form is being filed. City of Lubbock 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 432-13 Scott Facepieces 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 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 CERTIFICATE OF INTERESTED PARTIES FORM 1295 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. 2016-132075 Daco Fire Equipment Lubbock, TX United States Date Filed: 11/02/2016 2 Name of governmental entity or state agency that is a parry 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. 432-13 Scott Facepieces 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. ••"".. STEVE DAVIS P4. •�: NOTARY PUBLIC ' :,r• ID# 8758481 o State of Texas :''�q Q°j• OW QF Comm.. Exp. 0 3-18-2018 Signature of itt orized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said AVONNE OFENSTEZN , this the 2 day of NOVEMBER 20__L4:�___, to certify which, witness my hand and seal of office. STEVE bAVZS NOTARI,, f. Signature of off c r 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