Contract - T. Gray Utility Co. - 12/21/2017 (2) City of Round Rock, Texas Contract Forms
Standard Form of Agreement: Section 00500
City,of Round Rack, Texas
Standard Form of Agreement between
Owner and Contractor
AGREEMENT made as of the ettotk
day of 40in the year 20 18 .
BETWEEN the Owner: City of Round Rock,Texas(hereafter"Owner"or"City")
221 East Main.Street
Round'Rock,Texas 78664
and the Contractor T.Gray Utility&Rehab Co.,LLC ("Contractor")
PO Box 2176
Cypress,TX 77410
The Project is described as: 2016 Wastewater Collection System Rehabilitation
Basins BC-01,.BC20-Z,CC32-Z,CC34-Z,CC35-Z,CC37-Z,
LC-09,LC15-Z,`LC16-Z,LC17-Z,LC18-Z,&LC19-Z
Ma/holes,Open£Ct,and Point Repairs
The Engineer is: Kasberg,Patrick&Associates,LP
Brenton L.Burney,P.E.
10085 South Main Street
Georgetown,Texas 78626
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
of er Conditions), D wings, Speeifiegious,Addenda issued prior to.exe gtio 3 of this Agreement,,other docp gents
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 fay execute the Waxy ctescaed in the Contr4ct.Co Pitt pts,except to the extel?t specifically
indicated in the Contract Documents to be the responsibility of others.
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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 Proceedrissuedby Owner.
3.2 The Contract Time shall be measured from the date delineated in the Notice to Proceed.
3.3 Contractor shall commence Work within ten ( 10 ) calendar days
from the date delineated in the Notice to Proceed.
3.4 Contractor shall achieve Substantial Completion of the items of Work listed on Attachment A to this
Agreement no later than N/A ,( N/A )calendar days from issuance by Owner of Notice to
Proceed, and Contractor shall achieve Substantial Completion of the entire Work no later than
two hundred-seventy ( 270 )calendar days from issuance by Owner of 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 two hundred-fifty dollars and No/100
Dollars($ 250.00 ) for each calendar day that Substantial Completion is delayed after the date(s)
specified for Substantial Completion. It is hereby agreed that the liquklated 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)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 three hundred
( 300 )calendar days from issuance by Owner of Notice to Proceed.
ARTICLE 4 CONTRACT SUM
4.1 Owner shall pay Contractor the Contract Snm,in current funds for Contractor's performance of the Contract.
The Contract Sum shall be one million three hundred sixty-two thousand eight hundred
($ 1,362,800.00 ),subject to additions and deductions as provided in the Contract Documents.
4.2 Does the Contract Sum include alternates which are described in the Bid Form?
No X . Yes .If yes,please provide details below:
N/A N/A
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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 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
111
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
Pissues a Certificate for Payment.
5.1.4 Each Application for Payment shall be based on the most recent schedule of values submitted by Contractor
in accordance with the Contract Documents.The schedule of values shall allocate the entire Contract Sum among the
111 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.
111 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
t5.2.1 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
pY
Engineer's final Certificate for Payment. In no event shall final payment be required to be made prior to thirty(30)
111 days after all Work on the Contract has been fully performed.Defects in the Work discovered prior to final payment
shall be treated as non-conforming Work and shall be corrected by Contractor prior to final 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 Rock
General Conditions.
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6.2 The Work may be suspended by Owner as provided in Article 15 of the City of Round Rock General
Conditions.
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,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 October 2017
7.1.4 The Specifications are those contained in the Project Manual dated October 2017
p
7.1.5 The Drawings,if any,are those contained in the Project Manual dated October 2017
7.1.6 The Insurance&Construction Bond Forms of the Contract are those contained in the Project Manual dated
October 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 October 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 bocuments are as follows:
N/A
eARTICLE 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: Eddie Zapata,Senior Project Manager
City of Round Rock
11 2008 Enterprise Drive
Round Rock,TX 78664
111 8.3 Contractor's representative is: Marcus E.Tamez-President
281-455-0899 PH
281-254-7995 FAX
marcus.tamez@tgrayutiiity.com
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.
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I 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
Ithe 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
III 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
I Williamson County, Texas. This Agreement Shall be,governed by and construed in accordance with the laws and
court decisions of the State of Texas.
1 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.
Ill8.10 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.
This Agreement is entered into as of the day and year first written above and is executed in at least three(3)
I 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.
I
OWNER CONTRACTOR
CITY O" 'OUND 'OCK EXAS T.Gray Ut. ity&Re,h.. I o,
/ AZ ,
Printe• ame: q"f Keil V) Printed Name: Marcus E.Tamez
,/�
Title V 1'`. Title: President
IDate Signed: 2...t .ttf Date Signed: 01/12/2018
IATTEST:
C94"-- - (7161a__
City Clerk
II
FOR i Y,APPROVED • S TO FORM:
III I
4,it
4V�. ' 1
City Atto ey
p
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Bond No. CNB-30237-00
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PERFORMANCE BOND
THE STATE OF TEXAS §
§ KNOW ALL BY THESE PRESENTS:
COUNTY OF WILLIAMSON §
That T Gray Utility& Rehab Co., LLC of the City of Houston , County of
Harris , and State of Texas , as Principal, and Insurors Indemnity Company
authorized under the law of the State of Texas to act as surety on bonds for principals, are held
and firmly bound unto THE CITY OF ROUND ROCK, TEXAS,(Owner),in the penal sum of
One Million Three Hundred Sixty-Two Eight Hundred and 00/100
Dollars (S 1,362,800.00 ) for the payment whereof, well and truly to be made the said
Principal and Surety bind themselves, and their heirs, administrators, executors, successors and
assigns,jointly and severally, by these presents:
WHEREAS,the Principal has entered into a certain written Agreement with the Owner dated the
day of , 20193 to which the Agreement is
hereby referred to and made a part hereof as fully an to the same extent as if copied at length
herein consisting of: 2016 Wastewater Collection System Rehabilitation -
Manhole, Open Cut, and Point Repairs
(Name of the Project)
T 1 t
NOW, THEREFORE, THE CONDITIONS OF THIS OBLIGATION IS SUCH, that if the said
Principal shall faithfully perform said Agreement and shall, in all respects, duly and faithfully
observe and perform all and singular the covenants, conditions and agreements in and by said
�
Agreement, agreed and covenanted by the Principal to be observed and performed, including but
not limited to, the repair of any and all defects in said work occasioned by and resulting from
defects in materials furnished by or workmanship of, the Principal in performing the Work
covered by said Agreement and occurring within a period of twelve (12)months from the date of
Final Completion and all other covenants and conditions, according to the true intent and
111 meaning of said Agreement and the Plans and Specifications hereto annexed,then this obligation
shall be void; otherwise to remain in full force and effect;
PROVIDED, HOWEVER,that this bond is executed pursuant to the provisions of Chapter 2253,
Texas Government code, as amended, and all liabilities on this bond shall be determined in
accordance with the provisions of said Chapter 2253 to the same extent as if it were copied at
length herein.
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00610 7-2009 Performance Bond
00090656
PERFORMANCE BOND (continued)
Surety, for value received, stipulates and agrees that no change, extension of time, alteration or
addition to the term of the Agreement, or to the Work performed thereunder, or the Plans,
Specifications, or drawings accompanying the same, shall in anywise affect its obligation on this
bond, and it does hereby waive notice of any such change, extension of time, alteration or
addition to the terms of the Agreement, or to the work to be performed thereunder.
IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this instrument
this ztatO day of J 4AJ(J , 20 i&
T Gray Utility& Rehab Co., LLC Insurors Indemnity Company
Principal Surety
1 i15 E Justin McQuain
Printed Name/ Printed Name
By: L BY: 1t . 1) ITA „4
'Title: '/ f,Q Title: At orney-in-Fact
Address: 5039 Steffani Lane Address: 225 South 5th St.
Houston, TX 77041 Waco,TX 76701
Resident Agent of Surety:
l4tWi la/rata/on
S ignaure
Justin McQuain
Printed Name
25025 N. 1-45 Frwy., Ste. 525
Street Address
The Woodlands, TX 77380
City, State &Zip Code
Page 2
00610 7-2009 Performance Bond
00090656
Bond No. CNB-30237-00
1
PAYMENT BOND
THE STATE OF TEXAS §
§ KNOW ALL MEN BY THESE PRESENTS:
COUNTY OF WILLIAMSON §
That T Gray Utility& Rehab Co. LLCof the City
of Houston County of
Harris , and State of Texas as Principal, and Insurors Indemnity Company
authorized under the laws of the State of Texas to act as Surety on Bonds for Principals, are held
and firmly bound unto THE CITY OF ROUND ROCK, (OWNER), and all subcontractors,
workers, laborers, mechanics and suppliers as their interest may appear, all of whom shall have
the right to sue upon this bond, in the penal sum of
One Million Sixty-Two Three Hundred Sixty Two Thousand Eight Hundred and 001100 Dollars
($ 1,362,800.00 ) for the payment whereof, well and truly be made the
said Principal and Surety bind themselves and their heirs, administrators, executors, successors,
and assigns,jointly and severally,by these presents:
WHEREAS, the Principal has entered into a certain written Agreement with the Owner, dated
the day of , 20 lb, to which A eement is
hereby referred to and made a part hereof as fully and to e same extent as if copied at length
herein consisting of: 2016 Wastewater Collection System Rehabilitation-
Manhole, Open Cut, and Point Repairs
(Name of the Project)
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said
Principal shall well and truly pay all subcontractors, workers, laborers, mechanics, and suppliers,
all monies to them owing by said Principals for subcontracts, work, labor, equipment, supplies
and materials done and furnished for the construction of the improvements of said Agreement,
then this obligation shall be and become null and void; otherwise to remain in full force and
effect.
PROVIDED, HOWEVER,that this bond is executed pursuant to the provisions of Chapter 2253,
Texas Government code, as amended, and all liabilities on this bond shall be determined in
accordance with the provisions of said Chapter 2253 to the same extent as if it were copied at
length herein.
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00090656
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PAYMENT BOND(continued)
•
Surety, for value received, stipulates and agrees that no change, extension of time, alteration or
addition to the terms of the Agreement, or to the Work performed thereunder, or the plans,
specifications or drawings accompanying the same shall in anywise affect it's obligation on this
bond, and it does hereby waive notice of any such change, extension of time, alteration or
111 addition to the terms of the contract, or to the work to be performed thereunder.
IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this Instrument
this awv day of d4/404-41 , 20 it e..
T Gray Utility& Rehab Co., LLC Insurors Indemnity Company
Prin i al Surety
4eNg' .Z44�i Justin McQuain
Printed Name Printed Name
By: Z=D BY:41,46411-171(Lalz_VWft_
Title: O / Title: 7 orney-in-Fact
Address: 5039 Steffani Lane Address:
225 South 5th St.
Houston, TX 77041 Waco, TX 76701
Resident Agent of Surety:
AAY Aure
Justin McQuain
Printed Name
25025 N. 1-45 Frwy., Ste. 525
Street Address
The Woodlands, TX 77380
Page 2
00620 7-2009 Payment Bond
00090656
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AC'°'RE'® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY)
,---- 01/17/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
ii
III CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES 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
iiiterms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
NAME
TWFG-PARKER/HOWARD INSURANCE (A/CC,No,Ext): FAX
No):
827 VILLAGE SQUARE ADDRESS:0
TOMBALL,TX 77375 INSURER(S)AFFORDING COVERAGE NAIC t/
FAX 281-351-1454 INSURERA: LLOYDS BEST#085202#1991 SEE*BELOW A1122000
INSURED T.GRAY UTILITY&REHAB CO. LLC INSURER B: TEXAS MUTUAL INS A.M.BEST RATED(A)# 22945
DBA SPACE CITY PAVING, LLC INSURER C: PROGRESSIVE COUNTY MUTUAL INS.A.M.BEST RATED(A+)003690 29203
C/O MARCUS TAMEZ INSURER D:
PO BOX 2176 INSURER E:
CYPRESS,TX 77410 INSURER F:
COVERAGES CERTIFICATE NUMBER: 108730 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
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.LIMIT S SHOWN SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE INSR WVD_ POLICY NUMBER POLICY EFF POLICY EXP LIMITS
_ AMM/DDr'YYYYL(MMIDD/YYYYZ
A GENERAL LIABILITY X X DTWGC52843 12-14-17 12-14-18 EACH OCCURRENCE $ _ 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISESO(Ea occurrence) $ 100,000
0 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ rj,0_00
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000
X POLICY PRO-
JECT
RO I _ $
JECT LOC
C AUTOMOBILE LIABILITY X X 03627238-2 3-30-17 3-30-18 (Ea aoold DS SINGLE LIMIT $ 1,000,000
ANY AUTO BODILY INJURY(Per person) $
III ALL OWNED x SCHEDULED
BODILY INJURY(Per accident) $
AUTOS AUTOS
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
AUTOS (Per accident) $ I
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE
0 EXCESS UAB CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
BWORKERS COMPENSATION
AND EMPLOYERS'LIABILITY X 0001322672 3-30-2017 3-30-18 X�ORY LIMITS OER
IP ANY PROPRIETOR/PARTNER/EXECUTIVE YINNIA E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? Y -- -"-
(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
III
DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) _
CERTIFICATE OF INSURANCE DOES NOT SUPERSEDE POLICY WORDING
0 STATEMENTS MADE ON THIS CERTIFICATE DO NOT SUPERSEDE POLICY WORDING. STATE OF TEXAS OPERATION. THIS
CERTIFICATE IS ISSUED IN ACCORDANCE WITH TEXAS SENATE BILL 425.. LLOYDS #085202 A RATING WRITTEN THROUGH RSI
INTERNATIONAL, INC TDI LIC#2144 AS LOCAL MGA.. LLOYDS SYNDICATE#1991
CITY OF ROUND ROCK LISTED AS ADDITIONAL INSURED.A WAIVER OF SUBROGATION APPLIES TO CERTIFICATE HOLDER. 30 DAY
INOTICE APPLIES.JOB:2016 WASTEWATER COLLECTION SYSTEM REHABILITATION-MANHOLE REPAIR,OPEN CUT,&POINT
REPAIR
_CERTIFICATE HOLDER CANCELLATION
Il CITY MANAGER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
CITY OF ROUND ROCK ACCORDANCE WITH THE POLICY PROVISIONS.
221 E. MAIN ST.
0 ROUND ROCK,TX 78664 AUTHORIZED REPRES , . VE •
I 4 .III. ,
6 1'18-2010 ACORD CORPORATION. All rights reserved.
0 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
KAKASBERG, PATRICK & ASSOCIATES, LP
CONSULTING ENGINEERS
Texas Firm F-510
Temple RICK N.KASBERG,P.E. GeoMeto,.vn
One South Main Street R.DA`VID PATRICK,P.E.,CFM 1008 South Main Street
Temple,"rexas 76501 THOMAS D.VALLE,P.E. Georgetown,Texas 78626
(254)773-3731 GINGER R.TOLBERT,P.E. (512)819-9478
ALVIN R."TRAE"SUTTON,I.11,P.E.,CFM
JOHN A.SIMCIK,P.E.,CFM
November 21,2017
Mr.Eddie Zapata
City of Round Rock.
2008 Enterprise Drive
Round Rock,Texas 78664
Re: City of Round Rock
2016 WW Collection System Rehab—Manhole Rehab, Point Repairs,&Open Cut
Round Rock,Texas
Dear Mr. Zapata,
Attached is the Bid Tabulation Sheet for the bids received until 2:30 PM on Thursday,November 9, 2017 for
the above referenced project. This project was publicly advertised in Pflugerville Pflag on October 26`x' and
November I", and in the Round Rock Leader on October 28h and November 4t'. Competitive bids were
received from four(4)contractors.
The 2016 WW Collection System Rehab Manhole Rehab, Point Repairs, & Open Cut project primarily
consists of approximately 24 manhole cone repairs, 60 bench/trough repairs, 16 bolt/gasket replacements, 1
frame realignment, 1.2 internal chimney seals, 7 external chimney seals, 13 cover/frame replacements, 810
vertical feet of cementitious coating, 51 lower 18" grout repairs, 300 vertical feet of complete rehab, 950
linear feet of 6" service line replacement with 33 cleanouts, approximately 3,130 linear feet of open cut
installation/replacement ranging in size from 6" to 12", 3 internal drop assemblies, 1 new manhole
installation, 75 point repairs, 1 removal of rocks/end cap installation, 56 linear feet of 6" abandonment, and
various other bid items relating to traffic safety,trench safety,preconstruction&post-construction videos,site
preparation,post-construction testing,site restoration and clean-up activities.
The low qualified bidder for the project is T. Gray Utility Co. out of Cypress, Texas with a total bid of
$1,362,800.00. The bids ranged from $1,362,800.00 to $3,006,561.68. Our final Opinion of Probable Cost
for this project was $2,009,025. As we have no previous experience with T. Gray Utility Co., we have
reviewed their related work experience and references. As a result,we recommend that a contract be awarded
to T.Gray Utility Co, in the amount of$1.,362,800.00.If you have questions,please call.
Sincerely,
Brenton L.Burney, P.E.,CFM
BLB/
xc: KPA 2017-102-40
THE CITY OF ROUND ROCK, BIDS EXTENDED}AND CHECKED
Utilities&Environmental Services
2008 Enterprise Drive BY: Brenton L.Burne y,PC,CFM
Round Rock, Texas 78664 DATE: 11113/2017
BID TABULATION
SHEET: I of 7
CONTRACT:2016 WW Collection System Rehab- T.Gray Utility Co. T Construction,LLC Austin Underground,Inc National Power Roddin;;Corp.
Manhole Rehab,Point Repairs,&Open Cut Cypress,TX Mouton,TX ,Jonestown,TX Austin,TX
LOCATION: 2003 Enterprise Drive,Round Rock,TX Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes
DATE: November 9,2017,2:30 PNI Addendum No I?Yes Addendum No I?Yes Addendum No I?Yes Addendum No I?Yes
Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes
APPROX. UNTT UNIT UNIT UNIT
ITEM t. ITEM DESCRIPTION QTY. UNIT PRICE COST PRICE COSI' PRICE COST PRICE COST
Mobilization, Bonds and Insurance, not-to-
I exceed 5%of the Base Bid Amount, 1 LS $50,000.00 550,000.00 S65,000.00 $65,000.00 $90,000.00 $90,000.00 $147,500.00 $147,500.00
Provide a DVD containing Video of Project
Sites Before the Start of Construction on the
2 Project 1 LS 1 $9,500.00 $9,500.00 $2,000.00 $2,000.00 $16,000.00 $16,000.00 $15,000.00 $15,000.00
Implement a Traffic Safety Plan (Vehicular
and Pedestrian) Signed by a P.E. for Work
3 Located in or Near the Roadway l I.S $3,000.00 $3,000.00 $25,000.00 $25,000.00 $6,500.00 $6,500.00 $115,507.50 $115,507,50
Prepare, Submit, and Implement a Trench
Safety Plan for Signed by P.E., in
Conformance with State Law & OSI-IA,
Including All Materials Required to
4 Implement I LS $3,000.00 $3,000.00 $35,000.00 $35,000.00 $6,500.00 $6,500.00 $4,283.75 $4,283.75
Prepare Stormwater Pollution Prevention Plan,
Including Submission to and Receiving
Permits from Texas Commission on
5 Environmental Quality(TCEQ) I LS $5,000.00 $5,000M $15,000.00 $15,000.00 $6,500.00 $6,500.00 $9,775.00 $9,775.00
Furnish all Materials, Equipment, Tools &
Labor Necessary for Vacuum Testing of
Manholes in Accordance with Technical
6 JSpecification 200 EA $165.00 $33,000.00 $415.00 $83,000.00 $420.00 $84,000.00 $325.00 $65,000.00
SHEETTOTAL: 5103,500.00 1 $225,000.00 $209,500.00 1 5357,066.25
THE CITY OF ROUND ROCK IRDS EXTENDED AND CHECKED
Utilities & Environmental Services
2008 Enterprise Drive BY: Brenton L.Burney,PE,CFAI
Round Rock, Texas 78664 DATE 11/13/2017
DID TABULATION
SHEET: 2 of 7
CONTRACT:2016 WW Collection System Rehab- T.Gray Utility Co. T Construction,LLC Austin Underground,Inc National Power Rodding Corp.
Manhole Rehab,Point Repairs,&Open Cut Cypress,TY Mouton,'FX Jonestown,TX Austin,TX
LOCATION: 2008 Enterprise Drive,Round Rock,TX Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes
DATE: November 9,2017,2:30 PNI Addendum No 1?Yes Addendum No I?Yes Addendum No I?Yes Addendum No I?Yes
Bid Bond? Yes Bid Bond? 'Yes Bid Bond? Yes Bid Bond? Yes
APPROX. UNIT UNIT UNIT UNIT
ITEM h ITEINI DESCRIPTION QTY. UNIT PRICE COST PRICE COST PRICE COST PRICE COST
Furnish all Materials, Equipment. "fools &
Labor Necessary to Repair Manhole Cone,
? Including Any Required Bypass Pumping 24 EA $380.00 $9,120.00 $1,315.00 $31,560.00 $1,400.00 $33,600.00 $250.00 $6,000.00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Repair Manhole
Bench/Trough, Including Any Required
8 Bypass Pumping 60 EA $700.00 $42,000.00 $895.00 $53,700.00 $1,600.00 $96,000.00 $700.00 $42,000.00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Install Bolts/Gasket for
9 Bolted Cover of Manhole 16 EA 5400.00 $6,400,00 $395.00 $6,320.00 $260.00 $4,160,00 574.75 $1,196,00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Replace
Adjustments/Realign Manhole Frame,
Including Lawn Surface Restoration to
0 Existing Conditions 1 EA $1,500.00 $1,500.00 $1,840.00 $1,840.00 $1,800.00 $1,800.00 $3,551.20 $3,551 20
Furnish all Materials, Equipment, Tools &
Labor Necessary to Install Internal Chimney
Seal for Manhole, Including Any Required
I i lBypass Pumping I2 EA $1,060.00 $12,720,00 $1,100.00 $13,200.00 $1,600.00 $19,200.00 $500.00 $6,000.00
SHEET TOTAL: 571,740.00 1 1 5106,620.00 I I 5154,760.00 I I $58,747.20
THE CITE'OF ROUND ROCK BIDS EXTENDED AND CHECKED
Utilities&Environmental Services
2008 Enterprise Drive BY: Brenton L.Burney,PE,CFM
Round Rock, Texas 78664 DATE: 11/13/2017
BID TABULATION
SHEET:3 of 7
CONTRACT:2016 WW Collection System Rehab- T.Gray Utility Co. T Construction,LLC Austin Underground,Inc National Power Rodding Corp,
Manhole Rehab,Point Repairs,&Open Cut Cypress,TX Houton,TX Jonestown,TX Austin,TX
LOCATION: 2008 Enterprise Drive,Round Rock,TX Statement of Safety?Yes Statement of Safety?Yes Statement of Safety". Yes Statement of Safety?Yes
DATE: November 9,2017,2:30 PM Addendum No 1?Yes Addendum No 1?Yes Addendum No 1?Yes Addendum No I?Yes
Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes
APPROX. UNIT UNIT UNIT UNIT
I'T'EM A ITEM DESCRIP'T'ION QTY. UNIT PRICE COST PRICE COST PRICE COST PRICE COST
Furnish all Materials, Equipment, Tools &
Labor Necessary to Install External Chimney
Seal for Manhole, Including Any Required
Bypass Pumping and Lawn Surface
12 Restoration to Existing Conditions 6 EA $1,900.00 $11,400.00 $3,890.00 $23,340.00 $2,300.00 $13,800.00 $2,817.50 $16,905.00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Install. External Chimney
Seal for Manhole, Including Any Required
Bypass Pumping and Asphalt Surface
13 Restoration to Existing Conditions I EA $3,100.00 $3,100.00 $3,890.00 $3,890.00 $3,300.00 $3,300.00 $4,873.70 $4,873.70
Furnish all Materials, Equipment, Tools &
Labor Necessary to Replace Manhole
Cover/Frame/Frame Seal, Including Lawn
14 jSurface Restoration to Existing Conditions 2 EA $975.00 $1,950,00 $3,890.00 $7,780.00 $1,800.00 $3,600.00 $2,788.75 $5,577.50
Furnish all Materials, Equipment, Tools &
Labor Necessary to Replace Manhole
Cover/Frame/Frame Seal, Including Asphalt
15 Surface Restoration to Existing Conditions 9 EA $2,100.00 $18,900.00 $3,890.00 $35,010.00 $3,300.00 $29,700.00 $5,419.95 $48,779.55
Furnish all Materials, Equipment, Tools &
Labor Necessary to Replace Manhole
Cover/Frame/Frame Seal, Including Concrete
16 Surface Restoration to Existing Conditions
2 EA $1,250.00 $2,500.00 $3,890.00 $7,780.00 $4,700.00 $9,400.00 $5,649.95 $11,299.90
Furnish all Materials, Equipment, Tools &
Labor Necessary for Cementitious Coating o
Manhole, Including Any Required Bypass
17 Pumping 810 VF $93.00 $75,330.00 $195.00 $157,950.00 $170.00 $137,700.00 $150.00 $121,500.00
SHEET'TOTAL: S113,1.80.00 5235,750.00 $197,500.00 $208,935.65
THE CITY OF ROUND ROCK BIDS EXTENDED AND CHECKED
Utilities&Environmental Services
2008 Enterprise Drive BY: Brenton L.Burney,PE,CFM
Round Roel., Texas 78664 DATE: 11/13/2017
BID TABULATION
SHEET:4 of 7
CONTRACT:201.6 WW Collection System Rehab- T.Gray Utility Co. T Construction,LLC Austin Underground,Inc National Power Rodding Corp.
Manhole Rehab,Point Repairs,&Open Cut Cypress,TX Houton,TX Jonestown,TX Austin,TX
LOCATION: 2008 Enterp rise Drive,Round Rock,TX Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes
DATE: November 9,2017,2:30 PM Addendum No I?Yes Addendum No I?Yes Addendum No 1?Yes Addendum No I?Yes
Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes
APPROX. UNIT UNIT UNIT UNIT
ITEi<I ITEMDESCRIPTIONQTY. UNIT PRICE COST PRICE COST PRICE COST PRICE COST
Furnish all Materials, Equipment, Tools &
Labor Necessary to Grout Lower 18 Inches o
Manhole, Including Any Required Bypass
18 Pumping 51 EA $320.00 $16,320.00 $750.00 $38,250.00 $1,200.00 $61,200.00 $750.00 $38,250.00
Furnish all Materials, Equipment, Tools &
Labor Necessary for Complete Manhole
Rehab, Including Any Required Bypass
19 Pumping 300 VF $255.00 $76,500.00 $195.00 $58,500.00 $360.00 $108,000.00 $250.00 $75,000.00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Locate; Remove and
Replace 6 Inch Service Line, Including Any
Required Bypass Pumping and Surface
20 Restoration to Existing Conditions 950 LF $78.00 $74,100.00 $68.00 $64,600.00 $280.00 $266,000.00 $251.52 $238,944.00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Install 6 Inch Cleanout.
Including Any Required Bypass Pumping and
21 Surface Restoration to Existing Conditions
33 EA $1,685.00 $55,605.00 $360.00 $11,880.00 $1,000.00 $33,000.00 $557.75 $18,405.75
Furnish all Materials, Equipment, Tools &
Labor Necessary to Install 6 Inch Wastewater
Line by Open Cut, Including Any Required
Bypass Pumping and Surface Restoration to
22 Existing Conditions 35 LF $78,00 $2,730.00 $68.00 $2,380.00 $240.00 $8,400.00 $221.00 $7,735.00
SHEET TOTAL: a 1 $225,255.00 1 $175,610.00 $476,600.00 1 5378,334.75
THE CITY OF ROUND ROCK BIDS EXTENDED AND CHECKED
Utilities &Environmental Services
2008 Enterprise Drive BY: Brenton L.Burney,PE,CFM
Round.Rock,, Texas 78664 DATE: 11/13/2017
BID TABULATION
SHEET: 5 of 7
CONTRACT:2016 WW Collection System Rehab- T.Gray Utility Co. T Construction,LLC Austin Underground,Inc National Power Rodding Corp.
Manhole Rehab,Point Repairs,&Open Cut Cypress,TQC Houton,TX Jonestown,TX Austin,TX
LOCATION: 2008 Enterprise Drive,Round Rock,TX Statement of Safetv?Yes Statement of safety?Yes Statement of Safety?Yes Statement of Safety?Yes
DATE: November 9,2017,2:30 PM Addendum No 1?Yes Addendum No I?Yes Addendum No 1?Yes Addendum No I?Yes
Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes
APPROX. UNIT UNIT UNIT UNIT
ITEM h ITEINI DESCRIPTION QTY. UNIT PRICE COST PRICE COST PRICE COST PRICE COST
Furnish all (Materials, Equipment, "fools &
Labor Necessary to Remove and Replace 6
Inch Wastewater Line by Open Cut,Including
Any Required Bypass Pumping and Surface
Restoration to Existing Conditions
2� 8o 1-17 $82.00 $6,560.00 $68.00 55,440.00 $270.00 $21,600.00 $204.11 $16,328.80
Furnish all Materials, Equipment, "fools &
Labor Necessary to Remove 6 Inch and
Replace with 8 Inch Wastewater Line by
Open Cut, Including Any Required Bypass
Pumping and Surface Restoration to Existing
24 Conditions 140 LF $149.00 $20,860.00 $90.00 $12,600.00 $200.00 $28,000.00 $301.35 $42,189.00
Furnish all Materials, Equipment, Tools
Labor Necessary to Remove and Replace 8
Inch Wastewater Line by Open Cut,Including
An), Required Bypass Pumping and Surface
25 Restoration to Existing Conditions
825 LF $126.00 $103,950.00 $92.00 $75,900.00 $110.00 $90,750.00 $213.08 $175,791.00
Furnish all ;Materials. Equipment. Tools &
Labor Necessary to Remove 8 Inch and
Replace with 10 Inch Wastewater Line by
Open Cut, Including Any Required Bypass
Pumping and Surface Restoration to Existing
26 Conditions 650 117 $148,00 $96,200.00 $103.00 $66,950.00 $110,00 $71,500.00 $277,00 $i 80,050.00
SIII?ET TOTAL: f 1 $227,570.00 1 SI 60,890.00 $211,850.00 5414,358.80
THE CITY OF ROUND ROCK BIDS EXTENDED AND CHECKED
Utilities&Environmental Services
2008 Enterprise Drive BY: Brenton L.Burney,PE,CFM
Round Rock, Texas 78664 DATE: 11/13/2017
BID TABULATION
SHEET: 6 of 7
CONTRACT:2016 WW Collection System Rehab- T.Gray Utility Co. T Construction,LLC Austin Underground,Inc National Power Rodding Corp.
Manhole Rehab Point Repairs,&Open Cut Cypress,TX Houton,TX Jonestown,TX Austin,TX
LOCATION: 2008 Enterprise Drive,Round Rock,TX Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes
DATE: November 9,2017,2:30 Pitt Addendum No 1?Yes Addendum No i?Yes Addendum No I?Yes Addendum No I?Yes
Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes
APPROX. UNIT UNIT UNIT UNIT
ITEM A ITEM DESCRIPTION QTV. UNIT PRICE COST PRICE COST PRICE COST PRICE COST
Furnish all Materials, Equipment, 'fools &.
Labor Necessary to Remove 10 Inch and
Replace with 12 Inch Wastewater Line by
Open Cut. Including Any Required Bypass
Pumping and Surface Restoration to Existing
27 Conditions 1400 LF $166.00 $232,400.00 $126.00 $176,400.00 $130.00 $182,000.00 $377.35 $528,290.00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Replace/install Internal
Drop Assembly for Manhole, Including Any
Required Bypass Pumping and Surface
28 Restoration to Existing Conditions 3 EA $1,800.00 $5,400.00 $1,745.00 $5,235.00 $1,100.00 $3,300.00 $4,140.00 $12,420,00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Install Manhole Including
first Joint of Pipe in All Directions,Including
Any Required Bypass Pumping and Surface
29 Restoration to Existing Conditions
L 1 EA $12,000.00 $12,000.00 $8,500.00 $8,500.00 $7,000.00 $7,000.00 $25,506.25 $25,506.25
Furnish all Materials, Equipment, Tools &
Labor Necessary to Complete Point Repair,
Including Any Required Bypass Pumping and
30 Surface Restoration to Existing Conditions
75 EA $4,921.00 $3b9,075.00 $3,475.00 $ZG0,625.00 $5,100.00 $382,500.00 $13,586.50 $1,018,987,50
SHEET TOTAL: $618,875.00 5450,760.00 $574,800.00 51,585,203.75
THE CITY OF ROUND ROCK BIDS EXTENDED AND CHECKED
Utilities& Environmental Services
2008 Enterprise Drive BY: Brenton L.Burney,PE,CFM
Round Rock, Texas 78664 DATE: 11/13/2017
BID TABULATION
SHEET: 7 of 7
CONTRACT:2016 WW Collection System Rehab- T.Gray Utility Co. T Construction,LLC Austin Underground,Inc National Power Rodding Corp.
Manhole Rehab,Point Repairs,&Open Cut Cypress,TX Bouton,TX .Jonestown,TX Austin,Tl
LOCATION: 2008 Enterprise Drive,Round Rock TX Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes Statement of Safety?Yes
DATE: November 9,2017,2:30 PM Addendum No I?Yes Addendum No 1?Yes Addendum No l?Yes Addendum No 1?Yes
Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes Bid Bond? Yes
APPROX. UNIT UNIT UNIT UNIT
ITEM A ITEM DESCRIPTION QTY. UNITI PRICE COST PRICE COST PRICE COST PRICE COST
Furnish all Materials, Equipment, Tools &
Labor Necessary to Remove Rocks in
Wastewater Line and Install End Cap,
Including Any Required Bypass Pumping and
31 Surface Restoration to Existing Conditions
I EA $1,000.00 $1,000.00 $3,500.00 $3,500.00 $1,300.00 51,300.00 $1,500.00 $1,500.00
Furnish all Materials, Equipment, Tools &
Labor Necessary to Abandon Existing 6 Inch
Wastewater Line,Plug Lines at Manholes,and
Fill With Flowable Fill, Including Any
Required Bypass Pumping and Surface
32 Restoration to Existing Conditions
56 LF $30.00 $1,680.00 $129.00 $7,224.00 $130.00 $7,280.00 $43.13 $2,415.28
SHEET TOTAL: S2,680.00 $10,724.00 58,580.00 $3,91.5.28
GRAND TOTAL: 51,362,800.00 $1,365,354.00 $1,833,590.00 $3,006,561.68
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CERTIFICATE OF INTERESTED PARTIES FORM 1295
10f1
Complete Nos.1-A 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. 2017.292670
T.Gray Utility&Rehab Co.,LLC
Cypress,TX United States Hate Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 12/11/2017
beilag filed.
City of Round Rock,Texas 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.
2016 Collection System Rehab
2016 WW Collection System Rehab:Manhole Rehab, Point Repair and Open-Cut
a
Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
Tamez,MARCUS CYPRESS,TX United States X
5 Check only if there is NO Interested Party.
,s AFFIDAVIT
1 swear,or affirm,under p salty of perjury,,thythe ve closure is true and correct.
UAAAAAAAAAAariaAiA"A"&A"AA.LL1.VAA W
GEORGE N,TAMEZ
ID#3780215 (AJ
My Commission Expires
q�OF April 19,2021 Signature o authorized agent of contracting business entity
TWVV"VTV"VT,VVTVV,"j
AFFIX NOTARY STAMP/SEAL ABOVE
Swor i tjq and subscribed before me,by the said this the day of
20 to certify which,witness my hand and seal of office.
(*y� v
ignature of offi er administering oath Printed name of officer administering oath Title of officer administering o h
Forms provided by Texas Ethics Commission www,ethics.state,tx.us Version V1.0.3337
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. 2017-292670
T. Gray Utility&Rehab Co., LLC
Cypress,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 12/11/2017
being filed.
City of Round Rock,Texas Date Acknowledged:
12/12/2017
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.
2016 Collection System Rehab
2016 WW Collection System Rehab: Manhole Rehab, Point Repair and Open-Cut
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
Tamez, MARCUS CYPRESS,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.ethics.state.tx.us Version V1.0.3337