Contract - Halff Associates, Inc. - 6/22/2017 SUPPLEMENTAL AGREEMENT NO. 1
TO "CITY OF ROUND ROCK AGREEMENT
FOR PROFESSIONAL CONSULTING SERVICES FOR
DESIGN SERVICES
WITH
HALFF ASSOCIATES,INC."
CITY OF ROUND ROCK §
STATE OF TEXAS § KNOW ALL BY THESE PRESENTS:
COUNTY OF TRAVIS §
COUNTY OF WILLIAMSON §
THIS SUPPLEMENTAL AGREEMENT NO. 1 to "City of Round Rock Agreement for
Professional Consulting Services for Design Services with Halff Associates, Inc.," related to the
Heritage Trail West Project, hereinafter called "Supplemental Agreement No. 1," is made by and
between the City of Round Rock, Texas, a home-rule municipality, hereinafter called the "City"
and Halff Associates, Inc., hereinafter called the "Consultant."
WHEREAS, the City and Consultant executed the referenced "City of Round Rock
Agreement for Professional Consulting Services for Design Services," hereinafter called the
"Agreement," on July 23, 2015; and
WHEREAS, the City desires to amend the Scope of Services to add additional services
for the Heritage Trail West Project, including design, construction documents, specifications,
construction observation, and FEMA permitting for trail and parks along Brushy Creek from
Chisholm Trail to Mays Street; and
WHEREAS, it is necessary to amend the Scope of Services, the Fee and the Term of
services provided in the Agreement;
NOW THEREFORE, in consideration of the mutual promises and obligations in the
Agreement and this Supplemental Agreement No. 1, the City and Consultant agree that said
Agreement is amended and supplemented as follows:
I.
Section 1.0 of the Agreement is hereby amended to read as follows:
1.0 EFFECTIVE DATE, DURATION, AND TERM
This Agreement shall be effective on the date this Agreement has been signed by each
party hereto, and shall remain in full force and effect until it expires by operation of the term
00379095/ss2
indicated herein, or is terminated or extended as provided herein.
The term of this Agreement shall be until full and satisfactory completion of the work
specified herein is achieved in accordance with Section 3.0, which is estimated to be completed
no later than December of 2018.
II.
Section 3.0 of the Agreement is hereby amended to read as follows:
3.0 SCOPE OF SERVICES
Consultant shall satisfactorily provide all services described herein and as set forth in
Exhibit`B" and the Addendum to Exhibit"B."
Consultant shall perform the Scope of Services in accordance with the Tentative Work
Schedule set forth in Exhibit"C" and the Addendum to Exhibit"C."
III.
Section 5.0 of the Agreement is hereby amended to read as follows:
5.0 CONTRACT AMOUNT
Not-to-Exceed Fee: In consideration for the professional consulting services to be
performed by Consultant, City agrees to pay Consultant an amount not-to-exceed ThFee
Hundred-Sixty Five Thousand No/Doha -s ($365-0000) Four Hundred Fifty-Nine
Thousand Eight Hundred and No/100 Dollars ($459,800.00), in accordance with Exhibit "D"
entitled "Fee Schedule," and the Supplemental Exhibit "D," which document is attached hereto
and incorporated herein by reference for all purposes, in payment for services and the Scope of
Services deliverables as delineated in Exhibit`B" and the Addendum to Exhibit "B."
IV.
This Supplemental Agreement No. 1 shall amend the original Agreement only as set forth
herein with no other changes in terms or conditions of the original Agreement.
[Signatures appear on the following page.]
2
IN WITNESS WHEREOF, the City and Consultant have executed this Supplemental
Agreement No. 1 to be effective as of the last date of due execution by both parties.
CITY OF ROUND ROCK, TEXAS HALFF ASSOCIATES, INC.
By: By:
Printed Name: 14Printed Name: a ucc,NC.J
Title: Title: "k
Date Signed: Date Signed: G4aol
ATTEST:
By: 7�NM ,AI
N*
Sara L. White, City Clerk
FOR CITY, PROVED LTO ORM:
By: ML ,
Stephay L. Sheets, City Attorney
3
ADDENDUM TO EXHIBIT B: SCOPE OF CONSULTANT'S BASIC SERVICES
General Scope
The purpose of the services proposed herein is to provide professional consulting services
necessary for the development of the Heritage Trail West project. It is the Consultants intent to
work in effective cooperation with the City to achieve an efficient and acceptable implementation
of the project.
Program
In addition to the original scope, Consultant shall provide services as later described for, but not
limited to the following general program elements.
• Conditional Letter of Map Revision (CLOMR) and Letter of Map Revision (LOMR)for sections
of Brushy Creek later defined.
• Structural support to the eroded bank along the southern bank of Brushy Creek, at the
existing pedestrian bridge under IH35.
• Domestic water to service a family restroom located next to the Cantina building along
Chisholm Trail Rd.
• Adjust the WPAP to incorporate the Stagecoach Inn and restroom building at the Cantina site.
Basic Services
In addition to the original scope of basic services and above stated general scope and program
previously defined,The Consultant will provide: Plans, specifications and OPCC to be included
with the Heritage Trail West project.
Task 3: Construction Documents
The Consultant will develop working/construction drawings and technical specifications necessary
to construct the work. Construction drawings may include, but not be limited to the following
information: structural walls, utilities, grading, drainage, dimension control/layout,
erosion/sedimentation/tree protection, site construction details, incorporating Stagecoach Inn
building footprint, water line for new restroom building, and electrical details. Consultant shall
compliment drawings with Contract Documents and Technical Specifications including quantity
take-offs, which describe materials, systems and equipment, workmanship, quality and
performance criteria required for the construction of the work. Consultant shall coordinate any
utility needs and adjustment with the City and utility service provider(s).
• Prepare ninety percent(90%) construction drawings, specifications/project manual and
OPCC including appropriate escalation factors and contingencies.
• Review 90% construction drawings, specifications/project manual and OPCC with City.
• Prepare one hundred percent(100%) construction drawings, specifications, reports,
permit applications and other documents required for permitting and construction; update
OPCC including appropriate escalation factors and contingencies.
*Deliverable quantities to be determined by City, billed as reimbursable expenses.
Opinions of Probable Construction Costs(OPCC)
Opinions of probable construction costs provided by the Consultant are based on the Consultant's
familiarity with the construction industry and are provided only to assist the City's budget planning,
such opinions shall not be construed to provide a guarantee or warranty of the actual construction
costs at the time construction bids are solicited or construction contracts negotiated. Unless
expressly agreed in writing and signed by the parties, no fixed limit of construction costs is
established as a condition of this Agreement by the furnishing of opinions of probable construction
costs.
HALFF Associates, inc.
Page 1 of 6
Task 4:Project Design Survey
The Consultant shall include the following services:
• Conduct horizontal and vertical control survey on State Plane Grid and North American
Vertical Datum of 1988, NAVD88
• A topographic survey with one-foot contours of the eroded bank under the IH-35 pedestrian
bridge and survey ordinary high water mark for CLOMR study.
• Amend existing survey provided by City.
Task 6:Bidding Assistance
The Consultant shall provide services as defined in Prime Agreement Exhibit B for added scope
items.
Task 7:Construction Phase Services
The Consultant shall provide construction observation services as defined in
Prime Agreement Exhibit B for added scope items.
Task 8:Environmental Services
The Consultant's Environmental Scientist shall work with the floodplain engineers and surveyors to
identify the ordinary high water mark along Brushy Creek to aid in the CLOMR study.
Task A.1: FEMA Conditional/Letter of Map Revision
The following is Halff Associates, Inc. (Halff) proposed scope and fee to prepare and submit a
detailed hydraulic analysis and floodplain and floodway delineation of Brushy Creek in Williamson
County. The section of creek being proposed to be improved with trail and park improvements is
located approximately 620 feet upstream of Chisholm Trail extending downstream to A. W. Grimes
and is approximately 2.4 stream miles in length. The study reach is located on FEMA FIRM Panel
48491 C0490E and 48491 C0495E.
This proposal is separated into two tasks which will consists of a Conditional Letter of Map
Revision (CLOMR) and Letter of Map Revision (LOMR). Halff understands the Heritage Trail
project is separated into three phases. Halff is currently preparing construction documents for
Phase 1 extending from upstream of Chisholm Trail to Mays Street. Phase 2 extends from Mays
Street to Georgetown Street and is being prepared by SRA. Finally,Weltz and Prete is working on
Phase 3 extending from Georgetown Street to A. W. Grimes Blvd. Halff understands the City will
have design plans completed for Phase 1 and 3 to prepare a C/LOMR submittal this year. A
C/LOMR submittal for Phase 2 will be submitted at a later date when construction plans are
available.
This proposal assumes that Halff will obtain all required information including 100% signed and
sealed construction documents and environmental assessments for the CLOMR submittals and
as-built plans for the LOMR submittal. The proposal also assumes an Environmental Assessment
has been conducted for all Phases of the Heritage Trail Project and will be provided to Halff as
required as part of a FEMA CLOMR submittal. If an Environmental Assessment is needed for
Phase 3, Halff will request additional services at that time. Halff also understands that Upper
Brushy Creek is currently under FEMA review and preliminary FEMA models will be used as
baseline models in the development of the post-project hydraulic models.
Task A1: CLOMR Preparation and Submittal— Phase 1 and 3
The purpose of this task is to prepare supporting documentation in a FEMA compliant
format necessary to request a Conditional Letter of Map Revision (CLOMR)for Phase 1
and 3 for a length of approximately 1.8 stream miles of Brushy Creek. This scope of work
includes one meeting with Weltz and Prete to discuss the Phase 3 results.
A. Conduct a site visit to fully understand the project scope of the proposed project,
obtain site photos, and to gather hydraulic data parameters such as channel and
overbank roughness.
B. Obtain best available data including preliminary FEMA hydraulic models and
associated GIS data, existing survey, LiDAR terrain and contour data, soils data,
Environmental Assessment of the project area, final Heritage Trail design plans
HALFF Associates, inc.
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signed and sealed by a licensed engineer.
C. Develop FEMA models including Duplicate Effective, Corrected Effective, Pre-
Project, and Post-Project hydraulic models. Development of these models will be
based on preliminary FEMA models for the Upper Brushy Creek watershed study
recently completed. Preliminary FEMA discharges (10%, 2%, 1%, and 0.2%) annual
chance floodplains will be utilized and no hydrologic models will be developed for this
submittal.
D. Prepare a CLOMR submittal to include required items including a narrative of
CLOMR request detailing study parameters of the proposed project, an exhibit of the
Annotated FIRM showing the proposed floodplain and floodway modifications, FEMA
compliant flood profiles showing the 10%, 2%, 1%, and 0.2% annual chance
floodplains, Flood Insurance Study (FIS)tables, prepare FEMA MT-2 CLOMR forms,
and preparation of written notification of impacted properties if required by FEMA.
E. Coordination with City Floodplain Administrator for review and city approval. CLOMR
submittal to FEMA for review and coordination of administrative review and technical
review. The scope assumes one meeting with the City and two comment iterations
with FEMA.
* FEMA CLOMR review fee of approximately$6,500 will be paid for by the client.
Task A2: CLOMR Preparation and Submittal—Phase 2
The purpose of this task is to prepare supporting documentation in a FEMA compliant format
necessary to request a Conditional Letter of Map Revision (CLOMR)for Phase 2 for a length of
approximately 0.6 stream miles of Brushy Creek. This scope of work includes one meeting with
SRA to discuss the Phase 2 results.
A. Conduct a site visit to fully understand the project scope of the proposed project,
obtain site photos, and to gather hydraulic data parameters such as channel and
overbank roughness.
B. Obtain best available data including preliminary FEMA hydraulic models and
associated GIS data, existing survey, LiDAR terrain and contour data, soils data,
Environmental Assessment of the project area, final Heritage Trail design plans
signed and sealed by a licensed engineer.
C. Develop FEMA models including Duplicate Effective, Corrected Effective, Pre-
Project, and Post-Project hydraulic models. Development of these models will be
based on preliminary FEMA models for the Upper Brushy Creek watershed study
recently completed. Preliminary FEMA discharges (10%, 2%, 1%, and 0.2%) annual
chance floodplains will be utilized and no hydrologic models will be developed for this
submittal. Halff will ensure proper water surface elevation tie-ins of Phase 2 to Phase
1 upstream and Phase 3 downstream study limits.
D. Prepare a CLOMR submittal to include required items including a narrative of
CLOMR request detailing study parameters of the proposed project, an exhibit of the
Annotated FIRM showing the proposed floodplain and floodway modifications, FEMA
compliant flood profiles showing the 10%, 2%, 1%, and 0.2% annual chance
floodplains, Flood Insurance Study (FIS)tables, prepare FEMA MT-2 CLOMR forms,
and preparation of written notification of impacted properties if required by FEMA.
E. Coordination with City Floodplain Administrator for review and city approval. CLOMR
submittal to FEMA for review and coordination of administrative review and technical
review. The scope assumes one meeting with the City and two comment iterations
with FEMA.
* FEMA CLOMR review fee of approximately$6,500 will be paid for by the client.
Task A3: LOMR Preparation and Submittal
The purpose of this task is to prepare supporting documentation in a FEMA compliant format
necessary to request a Letter of Map Revision (LOMR)for Phase 1, 2, and 3 for approximately 2.4
stream miles of Brushy Creek.
A. Conduct a site visit to ensure as-builts match the field conditions, obtain site photos,
and to gather hydraulic data parameters such as channel and overbank roughness.
B. Obtain best available data including CLOMR hydraulic models and associated GIS
HALFF Associates, inc.
Page 3 of 5
data submitted for the CLOMR submittal, as-built survey, LiDAR terrain and contour
data, soils data, as-built Heritage Trail design plans signed and sealed by a licensed
engineer.
C. Develop and update the CLOMR models submitted to FEMA including Duplicate
Effective, Corrected Effective, Pre-Project, and Post-Project hydraulic models.
Development of these models will be based on preliminary FEMA for the Upper
Brushy Creek watershed study recently completed. Preliminary FEMA discharges
(10%, 2%, 1%, and 0.2%) annual chance floodplains will be used and no hydrologic
models will be developed for this submittal.
D. Prepare a LOMR submittal to include required items including a narrative of CLOMR
request detailing study parameters of the proposed project, an exhibit of the
Annotated FIRM showing the proposed floodplain and floodway modifications, FEMA
compliant flood profiles showing the 10%, 2%, 1%, and 0.2% annual chance
floodplains, Flood Insurance Study (FIS) tables, prepare FEMA MT-2 LOMR forms,
and preparation of written notification of impacted properties if required by FEMA.
E. Coordination with City Floodplain Administrator for review and city approval. LOMR
submittal to FEMA for review and coordination of administrative review and technical
review. The scope assumes one meeting with the City and two comment iterations
with FEMA.
* FEMA LOMR review fee of approximately$9,000 will be paid for by the client.
Task A4: Subsurface Utility Investigation
Halff will perform SUE in accordance with ASCE CI/ASCE 38-02 "Standard Guideline for the
Collection and Depiction of Existing Subsurface Utility Data." This standard defines the following
Quality Levels:
A. Quality Level A: Precise horizontal and vertical location of utilities obtained by the
actual exposure (or verification of previously exposed and surveyed utilities) and
subsequent measurement of subsurface utilities, usually at a specific point. Minimally
intrusive excavation equipment is typically used to minimize the potential for utility
damage. A precise horizontal and vertical location, as well as other utility attributes,
is shown on plan documents.
B.
C. Quality Level B: Information obtained through the application of appropriate surface
geophysical methods to determine the existence and approximate horizontal position
of subsurface utilities. Quality Level B data should be reproducible by surface
geophysics at any point of their depiction. This information is surveyed to applicable
tolerances defined by the project and reduced onto plan documents.
D.
E. Quality Level C: Information obtained by surveying and plotting visible above-ground
utility features and by using professional judgment in correlating this information to
Quality Level D information.
F.
G. Quality Level D: Information derived from existing records or oral recollections.
Halff's services will be performed in a manner consistent with that degree of skill and care
ordinarily exercised by members of the same profession currently practicing under similar
circumstances.
Locating (Vacuum Excavation)—Level A
Up to one (1) test hole will be performed on the 30"storm sewer at a location specified by the City
and/or Halff's Design Engineer. Halff will dig an 8" x 8"test hole, record the depth, backfill and
compact the hole, and restore the surface to its original condition. An iron rod with cap or"x-cut"
will be set to mark the location of the test hole.
Halff will make a good faith effort to locate all utilities, but shall be compensated for work
performed even if the utility is not located.
SUE Deliverables/CADD
HALFF Associates, inc.
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A Test Hole Data Form will be completed and submitted to the City for each hole performed
indicating depth, size, and material of utility. Electronic files will also be provided in Microstation
format along with PDFs.
ADDENDUM TO EXHIBIT C: SCHEDULE
Refer to revised schedule provided on January 20th, 2017
SUPPLEMENTAL EXHIBIT D: COMPENSATION FOR SERVICES
The Consultant's "Scope of Services" and associated Base Fees for providing professional
services for this project shall be according to the terms in this Agreement and outlined as follows:
Basic Services Initial Supplementa Total Fee
Agreement I Agreement
Task 1: Project Management 1 $ 10,550 0 $ 10,550
Coordination
Task 2: Design Development $ 39,400 0 $ 39,400
Task 3: Construction $ 193,550 $ 14,200 $ 207,750
Documents
Task 4: Project Design Survey $ 2,000 $ 4,100 $ 6,100
Task 5: Regulatory Entitlement $33,350 0 0
Permitting
Task 5.1:WPAP (TCEQ) $ 1,100 0 $ 1,100
Task 5.2: TxDot $ 5,800 0 $ 5,800
Task 5.3:TAS (TDLR- $ 5,800 0 $ 5,800
Accessibility Compliance)
Task 5.4: Bldg. &Site Permits $ 5,800 0 $ 5,800
DSO Services
Task 5.5: Union Pacific $ 4,800 0 $ 4,800
Railroad
Task 5.6: Texas Historical $ 1,800 0 $ 1,800
Commission & RRHPC
Task 6: Bidding Assistance $ 20,150 $ 500 $ 20,650
Task 7: Construction Phase $ 60,850 $2,600 $ 63,450
Services
Task 8: Environmental $ 2,650 $ 1,100 $ 3,750
Services
Task 12: Reimbursable $ 2,500 0 $ 2,500
Expenses
Task A.1: CLOMR 1 and 3 0 $30,900 $ 30,900
Preparation and Submittal
Task A.2:CLOMR 2 0 $ 17,100 $ 17,100
Preparation and Submittal
Task A.3: LOMR Preparation 0 $22,800 $22,800
and Submittal
Task A.4:Subsurface Utility 0 $ 1,500 $ 1,500
Evaluation -1 1
Total Fee $365,000 $94,800 7$459,800-
Note: If additional services are required beyond the scope enumerated, then additional
compensation will be requested. City shall be notified and authorize additional services and
compensation beyond the total fee prior to Consultant performing requested services.
HALFF Associates, inc.
Page 5 of 5
CERTIFICATE OF INTERESTED PARTIES FORM 1295
1of2
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-222225
Halff Assocaites, Inc
Richardson,TX United States Date Filed:
Z Name of governmental entity or state agency that is a party to the contract for which the form Is 06/12/2017
being filed.
City of Round Rock 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.
000000
Design of Heritage Trail West park and trail system.
4 Nature of interest
Name of Interested Party City,State,Country(place of business
(check applicable)
Controlling Intermediary
Bucchin,Matt Austin,TX United States X
Zapalac,Russell Austin,TX United States X
Tanksley,Dan Richardson,TX United States X
Skipwith,Walter Richardson,TX United States X
Murray, Menton McAllen,TX United States X
Plugge,Roman Richardson,TX United States X
Moya, Mike Austin,TX United States X
Kunz, Pat Richardson,TX United States X
Kuhn, Greg Richardson,TX United States X
Killen,Russell Richardson,TX United States X
Ickert,Andrew Fort Worth,TX United States X
Jackson,Todd Austin,TX United States X
Edwards, Mark. Richardson,TX United States X
Craig, Matthew Richardson,TX United States X
Bargainer,Tim Austin,TX United States X
Adams,Bobby Houston,TX United States X
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883
No Text
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
2of2
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-222225
Halff Assocaites, Inc
Richardson,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/12/2017
being filed.
City of Round Rock 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.
000000
Design of Heritage Trail West park and trail system.
4
Nature of interest
Name of Interested Parry City,State,Country(place of business) (check applicable)
Controlling I Intermediary
5 Check only if there is NO Interested Party. D
6 A� I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
MELISSA POWERS
Notary ID N 130428410
My Commission Expires
L November 3,2018 _
Sign kiure of authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE (�
Sworn to and subscribed before me,by the said t t `6`� J U— this the day of 7YLeN-k—
20� to certify which,witness my hand and seal of office.
1d
Signature of officer administering oath Printed name of officer administering oath Title of officer ministering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883
No Text
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1of2
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-222225
Halff Assocaites, Inc
Richardson,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/12/2017
being filed.
City of Round Rock Date Acknowledged:
06/14/2017
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.
000000
Design of Heritage Trail West park and trail system.
4
Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
Bucchin, Matt Austin,TX United States X
Zapalac, Russell Austin,TX United States X
Tanksley, Dan Richardson,TX United States X
Skipwith,Walter Richardson,TX United States X
Murray, Menton McAllen,TX United States X
Plugge, Roman Richardson,TX United States X
Moya, Mike Austin,TX United States X
Kunz, Pat Richardson, TX United States X
Kuhn,Greg Richardson,TX United States X
Killen, Russell Richardson,TX United States X
Ickert,Andrew Fort Worth,TX United States X
Jackson,Todd Austin,TX United States X
Edwards, Mark Richardson,TX United States X
Craig, Matthew Richardson,TX United States X
Bargainer,Tim Austin,TX United States X
Adams, Bobby Houston,TX United States X
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883
No Text
CERTIFICATE OF INTERESTED PARTIES FORM 3.295
2 of 2
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-222225
Halff Assocaites, Inc
Richardson,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/12/2017
being filed.
City of Round Rock Date Acknowledged:
06/14/2017
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.
000000
Design of Heritage Trail West park and trail system.
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
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 V1.0.883
No Text