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HomeMy WebLinkAboutResolution - 2020-R0402 - PO31055667 with Warren Cat_001Resolution No. 2020-RO402 Item No. 6.14 November 17, 2020 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, Purchase Order No. 31055667 for the purchase of Caterpillar Model: 120JOY Motor Grader as per TX BuyBoard 597-19, by and between the City of Lubbock and Warren Cat of Lubbock, Texas, and related documents. Said Purchase Order 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 November 17, 2020 DANIEL M. POPE, MAYOR ATTEST: Reb cca Garza, City Sect tary APPROVED AS TO CONTENT: City Manager APPROVED AS TO FORM: e li Assis it 0 ttome ccdocs/RES.PurchaseOrd 31055667-WarrenCat si-10.21.20 AlsI,i City of Lubbock TEXAS PURCHASE ORDER TO: WARREN CAT 702 E SLATON ROAD LUBBOCK TX 79404 Page - 1 Date - 10/20/2020 Order Number 31055667 000 OP Branch/Plant 3526 SHIP TO: CITY OF LUBBOCK FLEET SERVICES 206 MUNICIPAL DRIVE LUBBOCK TX 79404 INVOICE TO: CT FY OF LU13BOCK ACCOUNTSPAYABLE P.O. BOX 2000 LUBBOCK, TX 79457 BY: Marta Alvarez, Director Aarlresurg & Contract Management Ordered 10/20/2020 Freight Requested 10/20/2020 Taken By Delivery PER B TAYLOR REQ 56531 BUYBOARD 597-19/QUOTE 23614901 Description/Supplier Item Ordered Unit Cost UM 2021 CAT 120JOY MOTOR GRADER 1.000 264,750.0000 EA CC 5812 Terms NET 10 EOM INSURANCE REQUIRED: C MULLEN Extension Request Date 264,750.00 10/20/2020 Total Order 264,750.00 Commercial General Liability, per occurrence- $1,000,000 Worker's Compensation Amounts- $500,000 or Employer's Liability - $1,000,000. Copies of endorsements are required. General Aggregate. To include products of complete operations endorsement, Personal & Adv. Injury, and Contractual Liability Automotive Liability- Combined Single limit for Any Auto - $1,000,000 City of Lubbock is named as an additional insured on a primary and non-contributory basis with a waiver of subrogation in favor of the City of Lubbock on liability coverages. To include products of completed operations endorsements. Waiver of subrogation provided on the workers' compensation. CITY OF LUBBOC Daniel M. Pope, Mayor ATTEST: Rebe c Garza, City S cre ary Rev. 1/2020 Seller and Buyer agree as follows: PURCHASE ORDER TERMS AND CONDITIONS IMPORTANT: READ CAREFULLY STANDARD TERMS AND CONDITIONS CITY OF LUBBOCK, TX 1, SELLER TO PACKAGE GOODS. Seiler will package goods in accordance with good commercial practice. Each shipping container shall be clearly and permanently marked as follows (a) Seller's name and address, (b) Consignee's name, address and purchase order or purchase release number and the supply agreement number if applicable, (c) Container number and total number of containers, e.g. box 1 of 4 boxes, and (d) the number of the container bearing the packing slip. Seller shall bear cost of packaging unless otherwise provided. Goods shall be suitably packed to secure lowest transportation costs and to conform with requirements of common carriers and any applicable specifications. Buyer's count or weight shall be final and conclusive on shipments not accompanied by packing lists. 2. SHIPMENT UNDER RESERVATION PROHIBITED. Seller is not authorized to ship the goods under reservation and no tender of a bill of lading will operate as a tender of goods. 3. TITLE AND RISK OF LOSS. The title and risk of loss of the goods shall not pass to Buyer until Buyer actually receives and takes possession of the goods at the point or points of delivery. 4. NO REPLACEMENT OF DEFECTIVE TENDER. Every tender of delivery of goods must fully comply with all provisions of this contract as to time of delivery, quality and the like. If a tender is made which does not fully conform, this shall constitute a breach and Seller shall not have the right to substitute a conforming tender, provided, where the time for performance has not yet expired, the Seller may reasonably notify Buyer of his intention to cure and may then make a conforming tender within the contract time but not afterward. S. INVOICES & PAYMENTS. a. S c 11 c r shall submit separate invoices, in duplicate, one each purchase order or purchase release after each delivery. Invoices shall indicate the purchase order or purchase release number and the supply agreement number if applicable. invoices shall be itemized and transportation charges, if any, shall be listed separately. A copy of the bill of lading, and the freight waybill when applicable, should be attached to the invoice. Mail To: Accounts Payable. City of Lubbock, P. 0. Box 2000, Lubbock, Texas 79457. Payment shall not be due until the above instruments are submitted after delivery. 6. GRATUITIES. The Buyer may, by written notice to the Seller, cancel this contract without liability to Seller if it is determined by Buyer that gratuities, in the form of entertainment, gifts or otherwise, were offered or given by the Seller, or any agent or representative of the Seller, to any officer or employee of the City of Lubbock with a view to securing a contract or securing favorable treatment with respect to the awarding or amending, or the making of any determinations with respect to the performing of such a contract. In the event this contract is canceled by Buyer pursuant to this provision, Buyer shall be entitled, in addition to any other rights and remedies, to recover or withhold the amount of the cost incurred by Seiler in providing such gratuities. 7. SPECIAL TOOLS & TEST EQUIPMENT. If the price stated on the face hereof includes the cost of any special tooling or special test equipment fabricated or required by Seiler for the purpose of filling this order, such special tooling equipment and any process sheets related thereto shall become the property of the Buyer and to the extent feasible shall be identified by the Seller as such. S. WARRANTY -PRICE. a. The price to be paid by the Buyer shall be that contained in Seller's bid which Seller warrants to be no higher than Seller's current process on orders by others for products of the kind and specification covered by this agreement for similar quantities under similar of like conditions and methods of purchase. In the event Seller breaches this warranty, the prices of the items shall be reduced to the Seller's current prices on orders by others, or in the alterative. Buyer may cancel this contract without liability to Seller for breach or Seller's actual expense. b. The Seller warrants that no person or selling agency has been employed or retained to solicit or secure this contract upon an agreement or understanding for commission, percentage, brokerage, or contingent fee excepting bona fide employees of bona fide established commercial or selling agencies maintained by the Seller for the purpose of securing business. For breach of viciation of this warranty the Buyer shall have the right in addition to any other right of rights to cancel this contract without liability and to deduct from the contract price, or otherwise recover without liability and to deduct from the contract price, or otherwise recover the full amount of such commission, percentage, brokerage or contingent fee. 9. WARRANTY -PRODUCT. Seller shall not limit or exclude any implied warranties and any attempt to do so shall render this contract voidable at the option of the Buyer. Seller warrants that the goods furnished will conform to the specification, drawings, and descriptions listed in the bid invitation, and to thesample(s) furnished by the Seller, if any. In the event of a conflict or between the specifications, drawings, and descriptions, the specifications shall govern. Notwithstanding any provisions contained in the contractual agreement, the Seiler represents and warrants fault -free performance and fault -free result in the processing date and date related data (including, but not limited to calculating, comparing and sequencing) of all hardware, software and firmware products delivered and services provided under this Contract, individually or in combination, as the case may be from the effective date of this Contract. The obligations contained herein apply to products and services provided by the Seller, its sub- Seiler or any third party involved in the creation or development of the products and services to be delivered to the City of Lubbock under this Contract. Failure to comply with any of the obligations contained herein, may result in the City of Lubbock availing itself of any of its rights under the law and under this Contract including, but not limited to, its right pertaining to termination or default. The warranties contained herein are separate and discrete from any other warranties specified in this Contract, and are not subject to any disclaimer of warranty, implied or expressed, or limitation of the Seller's liability which may be specified in this Contract, its appendices, its schedules, its annexes or any document incorporated in this Contract by reference. 10. SAFETY WARRANTY. Seller warrants that the product sold to the Buyer shall conform to the standards promulgated by the U. S. Department of Labor under the Occupational Safety and Health Act of 1970. In the event the product does not conform to OSHA standards, Buyer may return the product for correction or replacement at the Seller's expense. In the event Seiler fails to make the appropriate correction within a reasonable time, correction made by Buyer will be at the Seller's expense. 11. NO WARRANTY BY BUYER AGAINST INFRINGEMENTS. As part of this contract for sale Seller agrees to ascertain whether goods manufactured in accordance with the specifications attached to this agreement will give rise to the rightful claim of any third person by way of infringement of time like. Buyer makes no warranty that the production of goods according to the specification will not give rise to such a claim, and in no event shall Buyer be liable to Seller for indemnification in the event that Seller is sued on the grounds of infringement of the like. If Seller is of the opinion that an infringement or the like will result, he will notify time Buyer to this effect in writing within two weeks after the signing of this agreement. If Buyer does not receive notice and is subsequently held liable for the infringement or the like, Seller will save Buyer harmless. If Seller in good faith ascertains the production of the goods in accordance with the specifications will result in infringement or the like, the contract shall be null and void. 12. NON APPROPRIATION. All funds for payment by the City under this contract are subject to (lie 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 thirty (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. 13. RIGHT OF INSPECTION. Buyer shall have the right to inspect the goods at delivery before accepting them 14. CANCELLATION. Buyer shall have the right to camel for default all or any part of the undelivered portion of this order if Seiler breaches any of the terms hereof including warranties of Seller or if the Seller becomes insolvent or commits acts of bankruptcy. Such right of cancellation is in addition to and not in lieu of any other remedies which Buyer may have in law or equity. 15. TERMINATION. The performance ofwork under this order may be terminated in whole, or in part by the Buyer in accordance with this provision. Termination of work hereunder shall be effected by the delivery of the Seiler of a "Notice of Termination" specifying the extent to which performance of work under the order is terminated and the date upon which such termination becomes effective. Such right or termination is in addition to and not in lieu of the rights of Buyer set forth in Clause 14, herein. 16. FORCE MAJEURE. Neither party shall be held responsible for losses, resulting if the fulfillment of any terms of provisions of this contract is delayed or prevented by any cause not within the control of the party whose performance is interfered with, and which by the exercise of reasonable diligence said party is unable to prevent. 17. ASSIGNMENT -DELEGATION. No right or interest in this contract shall be assigned or delegation of any obligation made by Seller without the written permission of the Buyer Any attempted assignment or delegation by Seller shall be wholly void and totally ineffective for all purpose unless made in conformitywith this paragraph. 18. WAIVER. No claim or right arising out of a breach of this contract can be discharged in whole or in part by a waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by the aggrieved party. 19. INTERPRETATION -PAROLE EVIDENCE. This writing, plus any specifications for bids and performance provided by Buyer in its advertisement for bids, and any other documents provided by Seller as part of his bid, is intended by the parties as a final expression of their agreement and intended also as a complete and exclusive statement of the terms of their agreement. Whenever a term defined by the Uniform Commercial Code is used in this agreement, the definition contained in the Code is to control. 20. APPLICABLE LAW. This agreement shall be governed by the Uniform Commercial Code. Wherecvcr the term "Uniform Commercial Code" is used, it shall be construed as meaning the Uniform Commercial Code as adopted in the State of Texas as effective and in force on the date of this agreement. 21. RIGHT TO ASSURANCE. Whenever one party to this contract in good faith has reason to question the other party's intent to perform he may demand that the other party give written assurance of his intent to perform. In the event that a demand is made and no assurance is given within five (5) days, the demanding party may treat this failure as an anticipatory repudiation of the contract. 22. INDEMNIFICATION. Seller shall indemnify, keep and save harmless the Buyer, its agents, officials and employees, against all injuries, deaths, loss, damages, claims, patent claims, suits, liabilities, judgments, costs and expenses, which may in anywise accrue against the Buyer in consequence of the granting of this Contract or which may anywise result therefrom, whether or not it shall be alleged or determined that the act was caused through negligence or omission of the Seller or its employees, or of the subSeller or assignee or its employees, if any, and the Seller shall, at his own expense, appear, defend and pay all charges of attorneys and all costs and other expenses arising therefrom of incurred in connection therewith, and, if any judgment shall be rendered against the Buyer in any such action, the Seller shall, at its own expenses, satisfy and discharge the same Seiler expressly understands and agrees that any bond required by this contract, or otherwise provided by Seiler, shall in no way limit the responsibility to indemnify, keep and save harmless and defend the Buyer as herein provided. 23. TIME. it is hereby expressly agreed and understood that time is of the essence for the performance of this contract, and failure by contract to meet the time specifications of this agreement will cause Seller to be in default of this agreement. 24. MBE. The City of Lubbock hereby notifies all bidders that in regard to any contract entered into pursuant to this request, minority and women business enterprises will be afforded equal opportunities to submit bids in response to this invitation and will not be discriminated against on the grounds of race, color, sex or natural origin in consideration for an award. 25. NON -ARBITRATION. The City reserves the right to exercise any right or remedy to it by law, contract, equity, or otherwise, including without limitation, the right to seek any and ail 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. 26. RIGHT TO AUDIT. 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. 27. HOUSE BILL 2015. House Bill 2015, signed by the Governor on June 14, 2013 and effective on January I, 2014, authorizes a penalty to be imposed on a person who contracts for certain services with a governmental entity and who fails to properly classify their workers. This applies to subcontractors as well. Contractors and subcontractors who fail to properly classify individuals performing work under a governmental contract will be penalized $200 for each individual that has been misclassified. (Texas Government Code Section 2155.001). 28. ASSIGNING OR SUBLETTING THE CONTRACT. 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. 29. HOUSE BILL 1295 DISCLOSURE OF INTERESTED PARTIES. House Bill 1295, adopted by the 84th Legislature, created §2252.908, Texas Government Code. Section 2252.908 requires a business entity entering into certain contracts with a governmental entity or state agency to file with the governmental entity or state agency a disclosure of interested parties at the time the business entity submits the signed contract to the governmental entity or state agency. instructions for completing Form 1295 are available at: hiip: www.ci.lubbock.tx.us/departmental-websites`dcpartnmcnts'ourchasing vendor -information 30. CONTRACTOR ACKNOWLEDGES, by supplying any Goods or Services that the Contractor has read, fully understands, and will be in full compliance with all terms and conditions and the descriptive material contained herein and any additional associated documents and Amendments. The City disclaims any terms and conditions provided by the Contractor unless agreed upon in writing by the parties. In the event of conflict between these terms and conditions and any terms and conditions provided by the Contractor, the tems and conditions provided herein shall prevail. The terms and conditions provided herein are the final tens agreed upon by the parties, and any prior conflicting terms shall be of no force or effect. 31. HB 89 The Contractor warrants that it complies with Chapter 2270.001 of the Texas Government Code by verifying that:([) The Contractor does not boycott Israel; and(2) The Contractor will not boycott Israel during the term of the Agreement. 32. The Contractor (i) does not engage in business with Iran, Sudan or any foreign terrorist organization and (ii) it is not listed by the Texas Comptroller under Section 2252.153, Texas Goverment Code, as a company known to have contracts with or provide supplies or services to a foreign terrorist organization. 33. TEXAS PUBLIC INFORMATION ACT. The requirements of Subchapter J, Chapter 552. Government Code, may apply to this contract and the contractor or vendor agrees that the contract can be terminated if the contractor or vendor knowingly or intentionally fails to comply with a requirement of that subchapter. 34. Pursuant to Section 552.234(c) of the Texas Goverment Code, the City of Lubbock has designated the following email address for which public information requests may be made by an entailed request: orr(a mylubbock.us, Please send this request to this email address for it to be processed. REV. 1 2020 Warren Quote 236149-01 PEA RREN Quote 236149-01 October 19, 2020 CITY OF LUBBOCK PO BOX 2000 LUBBOCK Texas 79457-0001 Attention:TIM MERRITT Dear TIM MERRITT, Thank you for this opportunity to quote Caterpillar products for your business needs. We are pleased to quote the following for your purchase consideration. One (1) New CATERPILLAR Model: 120JOY Motor Graders with all standard equipment in addition to the additional specifications listed below: STOCK NUMBER:N/A SERIAL NUMBER:N/A YEAR:2021 We wish to thank you for the opportunity of quoting on your equipment needs. This quotation is valid for 30 days, after which time we reserve the right to re -quote. If there are any questions, please do not hesitate to contact me. Sincerely, Koley Schaffner Machine Sales Representative Page 1 of 5 Warren Quote 236149-01 One (1) New CATERPILLAR Model: 120JOY Motor Graders with all standard equipment in addition to the additional specifications listed below: STANDARD EQUIPMENT POWERTRAIN-Air cleaner, dual stage dry type radial -engine derate, and idle control. -seal with service indicator through --Optimized VHP Plus -messenger and automatic dust ejector --Engine ECO mode -Air-to-air after cooler (ATAAC)--Fuel-water separator -Brakes, oil disc, four-wheel, hydraulic -Parking brake, multi -disc, sealed -Demand fan, hydraulic -and oil cooled -Differential, lock/unlock, auto -Priming pump, fuel -Drain, engine oil, ecology -Transmission, 8 speed forward and 6-Engine:-speed reverse, power shift, direct--C7.1 diesel, with automatic -drive ELECTRICAL -Alarm, back -up -Batteries, maintenance free -Alternator, -Electrical system, 24V OPERATOR ENVIRONMENT -Display, digital speed and gear -Ladders, cab, left and right side -Gauge, machine level -Message operator information display, -Gauges (analog) inside the cab -meter, hour, digital - (includes fuel, articulation, engine -ISO 6394 (70% fan speed}coolant temp, engine RPM, and -Throttle control, electronic -hydraulic oil temp) SAFETY AND SECURITY -Clutch, circle drive slip -Ground level engine shutdown -Doors, engine compartment, -Seat belt, retractable 76.2 (3") TIRES, RIMS, AND WHEELS -A partial allowance for tires -piece rims is included in the base -on 254mm x 609mm (10"x24") multi --machine weight and price OTHER STANDARD EQUIPMENT -CD ROM parts book -transmission, coolant, fuel -Doors, service compartment, -Tool box -locking -Fuel tank, 225 liters (59 gallon) -SOS ports, engine, hydraulic, -Radiator, cleanout access Page 2 of 5 Warren Quote 236149-01 MACHINE SPECIFICATIONS Description Reference No 12014A MOTOR GRADER 467-7423 TIRES, 14.OR24 BS VUT * L2 MP 252-0720 HEATER, ENGINE COOLANT, 120V 255-1336 PUSH PLATE, COUNTERWEIGHT 336-1559 DRAIN, GRAVITY, ENGINE OIL 422-6603 STARTING AID 422-6605 LIGHTS, SERVICE, INTERNAL 435-9816 MOLDBOARD, 12' PLUS - CHROME 436-3473 ALTERNATOR, 150 AMP 438-5769 GUARD, BOTTOM 453-4972 RIPPER 456-5359 CROSS SLOPE AUTO JOY 462-6506 BASE + 2 (RIP,FL) JOY 462-6518 DRAWBAR,TOP ADJUST,HYDTIP,JOY 462-6536 LANGUAGE, ENGLISH 462-6595 DECALS, ENGLISH (U.S) 462-6655 GUARD, COVER CAB, JOY 462-9053 KIT, BASE ARO 466-1296 CONVERTER, 24V TO 12V 466-1298 LIGHT,LED WARNING STROBE,JOY 466-1299 LIGHTS, CAB HALOGEN, JOY 466-1301 JOYSTICK CONTROLS, ADVANCED 466-1316 MIRRORS, EXTERNAL, BASE, JOY 466-1323 COMFORT PACKAGE, PREMIUM, JOY 466-1360 CAB, ROPS, PLUS, JOY, TND 466-1363 WEATHER, COLD TND 467-7411 CAMERA, REAR VISION, JOY 467-7439 LIGHTS, WORKING, PLUS,HAL,JOY 468-7617 PRODUCT LINK, CELLULAR PLE742 471-5509 SEAT BELT, W/ INDICATION 485-3445 REAR PANEL W/ ACCESS DOOR 498-8871 SEAT, BASE, SUSPENSION, JOY 506-2611 JUMP START RECEPTACLE 506-4261 NO ACCUMULATORS, JOY 517-0699 STARTER, HEAVY DUTY 517-0703 GLOBAL ARRANGEMENT, JOY 561-6489 LIGHTS, ARM, FOLD DOWN, LED 563-2430 LOW BAR, HALOGEN, JOY, TND 564-5009 CIRCLE SAVER 565-9664 1000 HOUR FUEL, FILTER CHANGE 574-8803 CONTROL,AUTO ARTICULATION -DEMO 575-2980 Page 3 of 5 Warren Quote 236149-01 FAN, REVERSING TND 575-7684 GROUND LEVEL, FUELING 577-8014 ENGINE, STAGE V AND T4 FINAL 590-7345 TOOTH, STRAIGHT 8J-5313 ANTIFREEZE WINDSHIELD WASHER OP-1939 ROLL ON -ROLL OFF OP-2265 FUEL ANTIFREEZE, -25C (-13F) OP-3978 SiTECH CONVERSION KIT * *SiTECH Conversion Kit, includes the following..... - Assembly, CB430 Mounting, Ram and Ball - Kit, Add -On, Grader, EM410 AccuGrade CAT - Sideshift, Stop Block - FRU — 7" Touch Display, TD510-LW w/ TPM, WiFi, and Bluetooth - 160110-504 Motor grader, 120-14A JY, AM CAT - Installation / Training / Warranty Page 4 of 5 Warren Quote 236149-01 BUYBOARD MACHINE SELLING PRICE $264,750.00 Item Number 597-19 WARRANTY Caterpillar's full machine warranty coverage for 5 years / 5,000 hours (whichever comes first). Technician travel time and mileage is a covered expense for the duration of the warrantable period of 5 year / 5,000 hours (whichever comes first). This applies to warrantable claims only. F.O.B./TERMS F.O.B.; Lubbock, Texas Thank you for allowing Warren Cat and Caterpillar to quote on your equipment needs. If you have any questions, please give me a call. Submitted by: Koley Schaffner Accepted by: Page 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORnn 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: 2020-680993 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Warren Power & Machinery, Inc. Midland, TX United States Date Filed: 10/21/2020 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. PO 31055667 Caterpillar 120 JY Motor Grader - SN; NIA - Stock Number; NIA - Purchase Price: $264,750.00 4 Name of Interested Pa y C'rtl, State Country (Place of business) Nature of interest (check applicable) Controlling intermediary Warren Equipment Company Midland, TX United States X George, Gary Midland, TX United States X Folger, Anthony Midland, TX United States X Nelson, Jim Midland, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is and my date of birth is My address is 15 SrY ;-4-1 902a . Wd 1a 7?7 A , 0` . (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in l� I�IY'1c�i County, State of Te , on the Z' d , y 20 26 . (month) (year) r Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.3a6aaf7d CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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. 2020-680993 Warren Power & Machinery, Inc. Midland, TX United States Date Filed: 10/21/2020 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: 10/21/2020 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. PO 31055667 Caterpillar 120 JY Motor Grader - SN; N/A - Stock Number; N/A - Purchase Price: $264,750.00 4 Name of Interested P �Y City, State, Count lace of business tY� Country (p } Nature of interest check applicable) ( PP ) Controlling Intermediary Warren Equipment Company Midland, TX United States X George, Gary Midland, TX United States X Folger, Anthony Midland, TX United States X Nelson, Jim Midland, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is and my date of birth is My address is , (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of , on the day of , 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms Drovided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.3a6aaf7d