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Contract - Mid America Golf - 11/9/2017 City of Round Rock, Texas Contract Forms Standard Form of Agreement for Competitive Sealed Proposal: Section 00500 City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor FA AGREEMENT made as of the 4114 ( S)day of•s••.,•Iaun.,Ve year 2017. BETWEEN the Owner: City of Round Rock, Texas(hereafter"Owner"or"City") 221 East Main Street Round Rock,Texas 78664 and the Contractor Mid-America Golf&Landscape Inc. ("Contractor") 1621 Southeast Summit Street Lee's Summit,Missouri 64081 The Project is described as: Golf Course Bridge Repair and Replacement, located at Forest Creek Golf Club, 99 Twin Ridge Parkway,Round Rock,Texas, 78664. The Engineer is: Freese And Nichols,Inc. 10431 Morado Circle, Suite 300 Austin,Texas 78759 For and in consideration of the mutual terms, conditions and covenants of this Agreement and all accompanying documents between Owner and Contractor, the receipt and sufficiency of which are hereby acknowledged, Owner and Contractor agree as follows: ARTICLE I THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement, Conditions of the Contract (General, Supplementary and other Conditions), Drawings, Specifications, Addenda issued prior to execution of this Agreement, other documents listed in this Agreement and Modifications issued after execution of this Agreement; these form the Contract, and are as fully a part of the Contract as if attached to this Agreement or repeated herein. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations, representations or agreements, either written or oral. An enumeration of the Contract Documents, other than Modifications,appears in Article 7. ARTICLE 2 THE WORK OF THIS CONTRACT Contractor shall fully execute the Work described in the Contract Documents, except to the extent specifically indicated in the Contract Documents to be the responsibility of others. 00500 Page 1 of 6 Standard Form of Agreement 00389388/ss2 K..201" 9'33 I ARTICLE 3 DATE OF COMMENCEMENT; DATE OF SUBSTANTIAL COMPLETION;DATE OF FINAL COMPLETION 3.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a Notice to Proceed issued by Owner. 3.2 The Contract Time shall be measured from the date delineated in the Notice to Proceed. 3.3 Contractor shall commenceWo rk within ten (10) calendar days from the date delineated in the Notice to Proceed. 1 3.4 Contractor shall achieve Substantial Completion of the entire Work no later than One Hundred Fifty(150) days from the Notice to Proceed, subject to adjustments of this Contract Time as provided in the Contract Documents. 3.5 If Contractor fails to achieve Substantial Completion of the Work(or any portion thereof) on or before the date(s) specified for Substantial Completion in the Agreement, Contractor shall pay to Owner, as liquidated damages,the sum of Five Hundred and No/l00 Dollars($500.00)for each calendar day that Substantial Completion is delayed after the date(s) specified for Substantial Completion. It is hereby agreed that the liquidated damages to which Owner is entitled hereunder are a reasonable forecast of just compensation for the harm that would be caused by Contractor's failure to achieve Substantial Completion of the Work (or any portion thereof) on or before the date(s) specified for Substantial Completion in the Agreement. It is agreed that the harm that would be caused by such failure, which includes loss of expected use of the Project areas, provision of alternative storage facilities and rescheduling of moving and occupancy dates, is one that is incapable or very difficult of accurate estimation. It is hereby agreed that if Substantial Completion of the Work(or any portion thereof)is not achieved on or before thirty (30)days after the date(s)specified for Substantial Completion in the Agreement,the Owner shall have the option to either collect liquidated damages as set forth herein or to thereafter rely on its remedies under the Contract Documents and at law and in equity, including without limitation, the recovery of actual damages. The date(s) I specified for Substantial Completion of the Work (or any portion thereof) in the Agreement shall be subject to adjustment as provided in the Contract Documents. 3.6 Contractor shall achieve Final Completion of the entire Work no later than One Hundred Fifty (150) days from the Notice to Proceed. ARTICLE 4 CONTRACT SUM 1 4.1 Owner shall pay Contractor the Contract Sum in current funds for Contractor'sp erformance of the Contract. The Contract Sum shall be Three Hundred Eleven Thousand Two Hundred Sixty and No/100 Dollars ($311,260.00), subject to additions and deductions as provided in the Contract Documents. 4.2 The Contract Sum does not include the following alternates which may be accepted during the term of this Agreement by the City at the sole discretion of the City for the prices set forth below and in the Bid Proposal: Alternate#1 —Addition of$15,000.00 Alternate#2—Addition of$2,400.00 ARTICLE 5 PAYMENTS 5.1 PROGRESS PAYMENTS 5.1.1 Based upon Applications for Payment submitted to Engineer and Owner by Contractor, and Certificates for Payment issued by Engineer and not disputed by Owner and/or Owner's lender, Owner shall make progress Page 2 of 6 1. I payments on account of the Contract Sum to Contractor as provided below, in Article 14 of the City of Round Rock General Conditions, and elsewhere in the Contract Documents. 5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month. 5.1.3 Provided that an Application for Payment is received by Engineer and Owner, and Engineer issues a Certificate of Payment not later than the tenth (10th) day of a month, Owner shall make payment to Contractor not later than the tenth(10th) day of the next month. If an Application for Payment is received by Engineer and Owner after the application date fixed above,payment shall be made by Owner not later than one month after the Engineer issues a Certificate for Payment. 5.1.4 Each Application for Payment shall be based on the most recent schedule of values submitted pp Y by Contractor in accordance with the Contract Documents. The schedule of values shall allocate the entire Contract Sum among the various portions of the Work. The schedule of values shall be prepared in such form and supported by such data to substantiate its accuracy as Engineer and Owner may require. This schedule, unless objected to by Engineer or Owner,shall be used as a basis for reviewing Contractor's Applications for Payment. 5.1.5 Applications for Payment shall warrant the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.1.6 Subject to other provisions of the Contract Documents, the amount of each progress payment shall be computed as provided in Article 14 of the City of Round Rock General Conditions. 5.1.7 Except with Owner's prior written approval, Contractor shall not make advance payments to suppliers for materials or equipment which have not been delivered and stored at the site. 5.2 FINAL PAYMENT 5.2.1 Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by Owner to Contractor when: .1 Contractor has fully performed the Contract except for Contractor's responsibility to correct Work, and to satisfy other requirements, if any,which extend beyond final payment; and .2 a final Certificate for Payment has been issued by Engineer. 5.2.2 Owner's final payment to Contractor shall be made no later than thirty (30) days after the issuance of Engineer's final Certificate for Payment. In no event shall final payment be required to be made prior to thirty(30) days after all Work on the Contract has been fully performed. Defects in the Work discovered prior to fmal payment shall be treated as non-conforming Work and shall be corrected by Contractor prior to fmal payment, and shall not be treated as warranty items. ARTICLE 6 TERMINATION OR SUSPENSION 6.1 The Contract may be terminated by Owner or Contractor as provided in Article 15 of the City of Round 111 Rock General Conditions. 6.2 The Work may be suspended by Owner as provided in Article 15 of the City of Round Rock General Conditions. I 1 I Page 3 of 6 S I ARTICLE 7 ENUMERATION OF CONTRACT DOCUMENTS 7.1 The Contract Documents, except for Modifications issued after execution of this Agreement, are enumerated as follows: 7.1.1 The Agreement is this executed version of the City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor for Competitive Sealed Proposals, as modified. 7.1.2 The General Conditions are the "City of Round Rock Contract Forms 00700," General Conditions, as modified. 7.1.3 The Supplementary, Special, and other Conditions of the Contract are those contained in the Project Manual dated November 9,2017. 7.1.4 The Specifications are those contained in the Project Manual dated November 9,2017.. 7.1.5 The Drawings, if any,are those contained in the Project Manual dated November 9,2017. 7.1.6 The Insurance&Construction Bond Forms of the Contract are those contained in the Project Manual dated November 9,2017. 7.1.7 The Notice to Bidders,Instructions to Bidders,Bid Form,and Addenda,if any, are those contained in the Project Manual dated November 9,2017. 7.1.8 If this Agreement covers construction involving federal funds, thereby requiring inclusion of mandated contract clauses, such federally required clauses are those contained in the "City of Round Rock Contract Forms 03000,"Federally Required Contract Clauses, as modified. 7.1.9 Other documents, if any, forming part of the Contract Documents are as follows: Alternates 1 and 2 set forth in the attached Bid Proposal ARTICLE 8 MISCELLANEOUS PROVISIONS 8.1 Where reference is made in this Agreement to a provision of any document, the reference refers to that provision as amended or supplemented by other provisions of the Contract Documents. 8.2 Owner's representative is: Brian Stillman, Sports Facilities&Operations Manager Sport Management&Tourism 221 East Main Street Round Rock, TX 78664 8.3 Contractor's representative is: Kirk Grego Mid-America Golf&Landscape Inc. 1621 Southeast Summit Street Lees Summit,MO 64081 8.4 Neither Owner's nor Contractor's representative shall be changed without ten (10) days' written notice to the other party. 8.5 Waiver of any breach of this Agreement shall not constitute waiver of any subsequent breach. I Page 4 of 6 I P 8.6 Owner agrees to pay Contractor from available funds for satisfactory performance of this Agreement in accordance with the bid or proposal submitted therefor, subject to proper additions and deductions,all as provided in the General Conditions, Supplemental Conditions, and Special Conditions of this Agreement, and Owner agrees to make payments on account thereof as provided therein. Lack of funds shall render this Agreement null and void to the extent funds are not available. This Agreement is a commitment of City of Round Rock's current revenues only. 8.7 Although this Agreement is drawn by Owner, both parties hereto expressly agree and assert that, in the event of any dispute over its meaning or application, this Agreement shall be interpreted reasonably and fairly, and neither more strongly for nor against either party. 8.8 This Agreement shall be enforceable in Round Rock, Texas, and if legal action is necessary by either party with respect to the enforcement of any or all of the terms or conditions herein, exclusive venue for same shall lie in Williamson County, Texas. This Agreement shall be governed by and construed in accordance with the laws and court decisions of the State of Texas. 8.9 Both parties hereby expressly agree that no claims or disputes between the parties arising out of or relating to this Agreement or a breach thereof shall be decided by an arbitration proceeding, including without limitation, any proceeding under the Federal Arbitration Act(9 USC Section 1-14)or any applicable state arbitration statute. 8.10 The parties, by execution of this Agreement, bind themselves, their heirs, successors, assigns, and legal representatives for the full and faithful performance of the terms and provisions hereof. I I P on the followingpage.] [Signatures p g ] P P P This Agreement is entered into as of the day and year first written above and is executed in at least three(3) ioriginal copies, of which one is to be delivered to Contractor, one to Engineer for use in the administration of the Contract, and the remainder to Owner. This Agreement is entered into as of the day and year first written above and is executed in at least three(3)original copies, of which one is to be delivered to Contractor, one to Engineer for use in the administration of the Contract, and the remainder to Owner. Page 5 of 6 p I OWNER CONTRACTOR CITY OF R ND ROCK,T 'AS MID-AMERICA G LF& LANDSCAPE INC. 11 Printed Na e: ,ri/ Printed Name: 1 ��r� Title 14Title: ,aSax_____prige4C&ILIA, Date Signed: [1' l * 19— Date Signed: (� (3 f, I ATTEST: (1(0)1(9/-‘ City lerk FOR CITY APPROVED AS TO FORM: City Attorney I I I I 1 I I I Page 6 of 6 I -moi 'j ACQ® CERTIFICATE E DATE(MMIDD/YYYY) RTIFICATE OF LIABILITY INSURANCE 11/9/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 0 BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the Icertificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Nathan Hoover Thomas McGee, L.C. PHONE FAX 920 Main Street (A/c.No.Ext):816-842-4800 (A/c,No):816-472-5018 E-MAIL I Suite 1700 P.O. Box 419013 ADDREss:nhoover@thomasmcgee.com Kansas City MO 64105 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:BITCO National Ins Co* 20109 i INSURED MIDAM-3 INSURER B:BITCO General Ins Corp* 20095 I! Mid-America Golf&Landscape, Inc. INSURER c:Continental Casualty Company* 20443 1621 SE Summit Avenue Lee's Summit MO 64081 INSURER D INSURER E: I INSURER F: COVERAGES CERTIFICATE NUMBER:380435200 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS r CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, I! EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP {MM/DD/YYYY) (MM/DD/YYYY) LIMITS A GENERAL LIABILITY Y CLP3651287 3/25/2017 3/25/2018 EACH OCCURRENCE $1,000,000 li! DAMAGE TO X COMMERCIAL GENERAL LIABILITY PREM SES(Ea occurrence) $100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 i GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 —1 POLICY X JE LOC $ A AUTOMOBILE LIABILITY Y CAP3651288 3/25/2017 3/25/2018 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 _ -.1111 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ $ B X UMBRELLA LIAR X OCCUR Y CUP2809599 3/25/2017 3/25/2018 EACH OCCURRENCE $8,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $8,000,000 DED X RETENTION$10,000 $ A WORKERS COMPENSATION WC3651289 3/25/2017 3/25/2018 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 C Installation Floater 5091789109 3/25/2017 3/25/2018 Limit 5,000,000 Ded 5,000 IDESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: Golf Course Bridge Repair and Replacement located at Forest Creek Golf Club, 99 Twin Ridge Parkway, Round Rock, TX 78664$311,26C The City of Round Rock is included as additional insured with respect to all policies except Workers Compensation and Employers Liability. Should any of the above described policies be cancelled or changed before the expiration date thereof, the issuing company will mail thirty (30)days written notice to the certificate holder named below. ICERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Manager THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I City of Round Rock ACCORDANCE WITH THE POLICY PROVISIONS. 221 E. Main Street Round Rock TX 78664 AUTHORIZED REPRESENTATIVE I I fr)//r- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I 4 I THE AMERICAN INSTITUTE OF ARCHITECTS 111 *4.4 i ;.-.0,,„:4k, IBond No.90140474 AIA Document A312 i Performance Bond i Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. ICONTRACTOR (Name and Address): SURETY (Name and Principal Place of Business): Mid-America Golf& Landscape, Inc. The Guarantee Company of North America USA I 1621 SE Summit Street One Towne Square, Suite 1470 Lee's Summit, MO 64081 Southfield, MI 48076-3725 OWNER (Name and Address): 1 City of Round Rock, Texas 221 East Main Street I Round Rock, TX 78664 CONSTRUCTION CONTRACT Date: Amount: ($311,260.00 ) Three Hundred Eleven Thousand Two Hundred Sixty Dollars and 00/100 IDescription (Name and Ldcation):Golf Course Bridge Repair and Replacement located at forest Creek Golf Club, 99 Twin Ridge Pkwy., Round Rock, TX 78664 BOND Date (Not earlier than Construction Contract Date): Amount: ($311,260.00 ) Three Hundred Eleven Thousand Two Hundred Sixty Dollars and 00/100 Modifications to this Bond: in None 0 See Page 3 1 CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Mid-Ame,.rica calf Lan sc e, Inc. The Guarantee Company of orth i icri ii ✓ �' S natli � " � Signature: J ��„ ,�� � .� Name a9 Titl Is1� r'ddAA �'.�,,��*/ � Name and Title: Linda L. Nutt ,r i'-, ' .` ` / . ® tt 4 cV�� Attorney-in-Fact ` j- (Any additional signatures appear on page 3) `et/7./., Surety Phone No. 248-281-0281 x,6�0 t AM- ,''. (FOR INFORMATION ONLY—Name, Address and Telephone) r'k' AGENT or BROKER: OWNER'S REPRESENTATIVE (Architect, Engineer or Thomas McGee, L.C. other party): PO Box 419013 Freese and Nichols, Inc. Kansas City, MO 64141-6013 10431 Morado Circle, Suite 300 816-842-4800 Austin, TX 78759 AIA DOCUMENT A312•PERFORMANCE BOND AND PAYMENT BOND•DECEMBER 1984 ED. •AIA a. THE AMERICAN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON,D.C.20006 THIRD PRINTING•MARCH 1987 1� 1.t-� I THE AMERICAN INSTITUTE OF ARCHITECTS I ._' N//il,1 J.j/�� I •w y IBond No. 90140474 IA/A Document A312 Payment Bond i Any singular reference to Contractor, Surety, Owner or other party shall be considered plural where applicable. . CONTRACTOR (Name and Address): SURETY (Name and Principal Place of Business): Mid-America Golf& Landscape, Inc. The Guarantee Company of North America USA 1621 SE Summit Street One Towne Square, Suite 1470 Lee's Summit, MO 64081 Southfield, MI 48076-3725 OWNER (Name and Address): City of Round Rock, Texas 221 East Main Street Round Rock, TX 78664 CONSTRUCTION CONTRACT Date: • Amount: ($311,260.00 ) Three Hundred Eleven Thousand Two Hundred Sixty Dollars and 00/100 Description (Name and Location): Golf Course Bridge Repair and Replacement located at forest Creek Golf Club, 99 Twin Ridge Pkwy., Round Rock, TX 78664 BOND Date (Not earlier than Construction Contract Date): Amount: ($ 311,260.00 ) Three Hundred Eleven Thousand Two Hundred Sixty Dollars and 00/100 • Modifications to this Bond: LJ None ❑ See Page 6 ..CONTRACTOR AS PRINCIPAL SURETY , i C.CI I,pany • (Corporate Seal) Company: Cor -al .`' Mi , merlca an ape nc. Q �FCo -- The Guarante- Company of N. h Ame L_ _ - le, . S• ignature Signature: �� , ;`�,Il ' N-ame-and Title:10k i kG' Gor ` Name and Title: Linda L. Nutt oma g•v" �,`�� ' C" I t 4S�r4..,� Attorney-in-Fact tion P'' (Any additional signatures appear on ,.1A>�I�R�o g pp page 6) Surety Phone No. 248-281-0281 x 66012 (FOR INFORMATION ONLY—Name, Address and Telephone) AGENT or BROKER: OWNER'S REPRESENTATIVE (Architect, Engineer or Thomas McGee, L.C. other party): PO Box 419013 Freese and Nichols, Inc. Kansas City, MO 64141-6013 10431 Morado Circle, Suite 300 _____:.§.±L2..8164800 Austin, TX 78759 AIA 0 EMT A312•PERFORMANCE BOND AND PAYMENT BOND•DECEMBER 1984 E .•MA 0 - . THIR E:AN INSTITUTE OF ARCHITECTS,1735 NEW YORK AVE.,N.W.,WASHINGTON, D.C.20006 A312-1984 4 0 PRINTING.�1ARCH 1987 competitive Sealed Proposal Ranking for: Forest Creek Golf Course Renovation Sch C t�ROUNCO)ROCK`EEXAS COu � M o m > > 3 o a ° a LU a, y a o +. o z u u 4J to i m N r 3 CL +� U Y Contractor Name e c Base Price Alternates Totals Total Cost v v a Y � U Q > 0 o z m �, o c 0 r +' oa c Total Points < a, u a & N C .L a m v a` �. W (D �. � Q f9 4 v `- u z a a �, � a M M w o c o o +- 1q L M U LL a Mid America Golf $311,260.00 $17,400.00 $328,660.00 (Lowest Priced Proposal/Proposer's Price)X 40= Price Score 40.00 17.57 16.00 14.00 -2.00 85.57 1 JCP Bridge&Concrete $477,100.00 $13,300.00 $490,400.00 (Lowest Priced Proposal/Proposer's Price)X 40= Price Score 26.81 19.86 20.00 18.00 0.00 84.66 2 Proposer's Name 7- -1 $0.00 (Lowest Priced Proposal/Proposer's Price)X 40= Price Score #DIV/o! 0.00 0.00 0.00 0.00 #DIV/0! Proposer's Name $0.00 (Lowest Priced Proposal/Proposer's Price)X 40= Price Score #DIV/0! 0.0TOO.0 0 0.00 0.00 #DIV/o! Proposer's Name $0.00 (Lowest Priced Proposal/Proposer's Price)X 40= Price Score #DIV/0! 0.00 0.00LO-00 0.00FDIV/01 Proposer's Name :: $0.00T I - (Lowest Priced Proposal/Proposer's Price)X40= Price Score #DIV/0! 0.00 0.00 0.00 0.00 #DIV/0! Proposer's Name $0.00 (Lowest Priced Proposal/Proposer's Price)X 40= Price Score #DIV/0! 0.00 0.00 0.00 0.00 #DIV/o! Proposer's Name I -t $0.00 (Lowest Priced Proposal/Proposer's Price)X40= Price Score #DIV/0! 0.00 0.00 0.00 0.00 #DIV/o! M Proposer's Name $0.00 (Lowest Priced Proposal/Proposer's Price)X 40= Price Score #DIV/0! 0.00 0.00 0.00 0.00 #DIV/0! 1 Proposer's Name $0.00 --r- �- (Lowest Priced Proposol/Proposer's Price)X 40= Price Score #D1V/0! 0.00 0.00 0.00 0.00 #DIV/0! Date: 10/11/2017 ,�' i p r: 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 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2017-277436 Mid-America Golf and Landscape, Inc. Lees Summit,MO United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 10/27/2017 {. being filed. i City of Round Rock,TX 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. Bridge Repair and Replacement Forest Creek Golf Club Bridge Repair and Replacements Nature of interest 4 Name of Interested Party City,State,Country(place of business) (check applicable) Controlling intermediary r it I? l a i! it i 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. i MICHELE V.VALENTINE Notary Public•Notary Seal State of Missouri,Jackson County Commission Number 13695299 My Commission Expires Jan 3,2021 Signature of authorized agent of contracting business entity I; E 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. ka&t�_� l ' x r rg ture of officer administering oath Printed name of officer administering oath Title of o icer administering oath j Fortes provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337 f ii f! 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 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2017-277437 Mid-America Golf and Landscape, Inc. Lees Summit, MO United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 10/27/2017 being filed. City of Round Rock, TX Date Acknowledged: 11/02/2017 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. Irrigation Renovation Forest Creek Golf Club Irrigation Renovation 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. 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 V1.0.3337