HomeMy WebLinkAboutResolution - 2017-R0027 - Tommy Klein Construction - 02/09/2017Resolution No.2017-R0027
Item No.6.19
February 9,2017
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. 13099 for Patterson Library Renovations, by
and between the City of Lubbock and Tommy Klein Construction,Inc., 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 February 9,2017 .
ATTEST:
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Ret ecca Garza,City Secretary
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APPROVED AS TO CONTENT:
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Mark Yearwooa,Assistant City Manager
APPROVED AS TO FORM:
Kelli Leisure,Assistant City Attorney
ccdocs/RES.Contract-Tommy Klein Construction
January 3,2017
DANIEL M.POPE,MAYOR
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:
2017-150557
Date Filed:
01/04/2017
Date Acknowledged:
01/05/2017
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Tommy Klein Construction, Inc.
Lubbock, TX United States
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
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.
13099
Patterson Library Renovations
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling I
Intermediary
Klein, Tommy
Lubbock, TX United States
X
Klein, Karen
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.etnics.state.tx.us versiuri vl.U.ZI I
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
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:
2017-150557
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Tommy Klein Construction, Inc.
Lubbock, TX United States
Date Filed:
01/04/2017
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:
g 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.
13099
Patterson Library Renovations
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
Klein, Tommy
Lubbock, TX United States
X
Klein, Karen
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.
CRYSTAL HAR'I��;
I Sty PuE ic, a of TM
ec�
ECp*
,
MIYC n E>I�IesORI.201 Signature of authorized agent of
contracting business entity
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said this the
514- day of �JII
20_to certify which, witness my hand and seal of office.
0/ Ym
0 u6 is
Signal re of officer administering oath Print6d name of officer administering oath
Title officer administering oath
Forms provided by Texas Ethics Commission vwwv.ethics.state.tx.us Version V1.0.277