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Contract - Prime Construction - 4/26/2018 I 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 AGREEMENT made as of the 404,114, 4a)day of p4�the year 2018. BETWEEN the Owner: City of Round Rock,Texas(hereafter"Owner"or"City") 221 East Main Street iRound Rock,Texas 78664 and the Contractor: Ritter,Botkin Prime Construction Company,Inc. ("Contractor") 20907 Martin Lane Pflugerville,Texas 78660 0 The Project is described as: Round Rock Fire Station No.9—Phase Two 2721 Sam Bass Road Round Rock,Texas 78681 1111 The Architect is: 2P Consultants HCE Consulting Engineers HDR Structural Engineering I 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 ,tiii,_ 00399209/ss2 R2oia4.3' '4 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. 111 3.3 Contractor shall commence Work within ten (10) calendar days from the date delineated in the Notice to Proceed. 111 3.4 Contractor shall achieve Substantial Completion of the entire Work no later than ninety(90)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 One Hundred and No/100 Dollars($100.00)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) 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 five (105) days from issuance by Owner of Notice to Proceed. ARTICLE 4 CONTRACT SUM 4.1 Owner shall pay Contractor the Contract Sum in current funds for Contractor's performance of the Contract.The Contract Sum shall be Four Hundred Twenty-Five Thousand Five Hundred Seventy-Four Dollars and No/100 Dollars($425,574.00),subject to additions and deductions as provided in the Contract Documents. 4.2 The Contract Sum is based upon the following alternates which are described in the Contract Documents and are hereby accepted by Owner: No Alternates Page 2 of 6 I ARTICLE 5 PAYMENTS 5.1 PROGRESS PAYMENTS 5.1.1 Based upon Applications for Payment submitted to Architect and Owner by Contractor,and Certificates for Payment issued by Architect 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 Architect and Owner, and Architect 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 Architect and Owner after the application date fixed above,payment shall be made by Owner not later than one month after the Architect issues 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 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 Architect and Owner may require. This schedule, unless objected to by Architect 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. r 5.1.6 Subject to other provisions of the Contract Documents, the amount of eachY ress ro payment shall be p g p 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 P Y Work,and to satisfy other requirements,if any,which extend beyond final payment;and .2 a final Certificate for Payment has been issued by Architect. 5.2.2 Owner's final payment to Contractor shall be made no later than thirty (30) days after the issuance of Architect'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 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. Page 3 of 6 6.2 ConditionsThe. Work may be suspended by Owner as provided in Article 15 of the City of Round Rock General 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 April 26,2018. 7.1.4 The Specifications are those contained in the Project Manual dated April 26,2018. 7.1.5 The Drawings,if any,are those contained in the Project Manual dated April 26,2018. 7.1.6 The Insurance&Construction Bond Forms of the Contract are those contained in the Project Manual dated April 26,2018. 7.1.7 The Notice to Bidders,Instructions to Bidders,Bid Form,and Addenda,if any,are those contained in the Project Manual dated April 26,2018. 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: Contractor's Proposal dated 3/29/18;Supplemental dated 3/28/18 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: Matthew Smith Superintendent Building Construction General Services Department 212 Commerce Road Round Rock,Texas 78664 8.3 Contractor's representative is: Brian Ritter President Ritter,Botkin Prime Construction Company Inc. 20907 Martin Lane Pflugerville,Texas 78660 Page 4 of 6 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. 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 In accordance with Chapter 2270, Texas Government Code, a governmental entity may not enter into a contract with a company for goods or services unless the contract contains written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of this contract. The signatory executing this Agreement on behalf of Contractor verifies Contractor does not boycott Israel and will not boycott Israel during the term of this Agreement. 8.9 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. 8.10 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. 8.11 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. [Signatures on the following page.] Page 5 of 6 i 1 I 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 Architect 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 Architect for use in the administration of the Contract,and the remainder to Owner. I OWNER CONTRACTOR CITY OF ROUND ROCK,TEXAS RITTER,BOIL ' ' E CONSTRUCTION �' .- / COMPAN_...„--„ 1,� .ftiring _ _ EJ7 ' Printed Name:L/,► "" I liarimbi r Printed Name: L. .0' .,:�� r�t� 111 Title: `y1�b IL Title: "te.. .:&74 ^ � Date Signed: '9•(0'L ) Date Signed: /�j —t/I I ATTEST: I __WM/ , 4.312A— City Clerk I FOR •,, Y,APPROVED AS 0 FORM: /I11; l L • 176 City Atto -y P I ry Page 6 of 6 Bond NO.CA2479123 11 GREATEC,qN GREAT AMERICAN INSURANCE COMPANY OF NEW YORK INSURANCE GROUP New York 1 I Performance Bond Any singular reference to Contractor,Surety,Owner or other party shall be considered plural where applicable. CONTRACTOR: SURETY: (Name, legal status and address) (Name, legal status and principal place of business) Ritter Botkin Prime Construction Great American Insurance Company, Inc. Company of New York 20907 Martin Lane 301 E 4th Street Pflugerville, TX 78660 Cincinnati, OH 45202 OWNER: (Name, legal status and address) City of Round Rock, Texas 221 East Main Street Round Rock, Texas 78664 CONSTRUCTION CONTRACT Date: March 29, 2 018 Amount: Four Hundred Twenty-Five Thousand usand Five Hundred Seventy-Four Four Dollars & No/100($425,574.00) Description: Round Rock Fire Station No. 9-Phase Two - Renovations (Name andlocation)Round Rock Fire Station No. 9-Phase Two, 2721 Sam Bass Road, Round Rock, TX 78681 I BOND Date: April 13, 2018 (Not earlier than Construction Contract Date) Amount: Four Hundred Twenty-Five Thousand Five Hundred Seventy-Four Dollars & No/100 ($425,574.00 Modifications to this Bond: IR None ❑ See Section 16 CONTRACTOR AS i INCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Ritter Botkin Pr, Titenstruction Company, GREAT AM RICA IN URANCE COMPANY OF NEW YORK Inc. -.. i --- 44 Signature: A l Name and Title: Name and Tiff!: i / Or R1-4#- - A!S;-;otlg,e-11- John Diggs, A torney in Fact (Any additional signatures appear on the last page of this Performance Bond.) , (FOR INFORMATION ONLY--Name, address and telephone) OWNER'S REPRESENTATIVE: AGENT or BROKER: (Architect, Engineer or other party) TIA Group, LLC 8000 IH 10 West #950 San Antonio, TX 78230 The Company executing this bond vouches that this document conforms to American Institute of Architects Document A312-2010 Edition GANY Perf A312(10/10) 1 Bond No.CA2479123 GREAT GREAT AMERICAN INSURANCE COMPANY OF NEW YORK AMERICAN INSURANCE GROUP New York Payment Bond Any singular reference to Contractor,Surety,Owner or other party shall be considered plural where applicable. CONTRACTOR: SURETY: (Name, legal status and address) (Name, legal status and principal place of business) Ritter Botkin Prime Construction Great American Insurance 9 Company, Inc. Company of New York 20907 Martin Lane 301 F 4th Street Pflugerville, TX 78660 Cincinnati, OH 45202 OWNER: (Name, legal status and address) City of Round Rock, Texas 221 East Main Street Round Rock, Texas 78664 CONSTRUCTION CONTRACT Date: March 29, 2018 Amount: Four Hundred Twenty-Five Thousand Five Hundred Seventy-Four Dollars & No/100($425,574.00) Description: Round Rock Fire Station No. 9-Phase Two Renovations (Name and location)Round Rock Fire Station No.9-Phase Two, 2721 Sam Bass Road, Round Rock TX 78681 BOND Date: April 13, 2018 (Not earlier than Construction Contract Date) Amount: Four Hundred Twenty-Five Thousand Five Hundred Seventy-Four Dollars & No/100($425,574.00) Modifications to this Bond: ® None ❑ See Section 18 CONTRACTOR AS PRINCIPAL SURETY Company: (Corporate Seal) Company: (Corporate Seal) Ritter Botkin Prim_ .nstruction Company Inc GREAT AME IC INSURANCE COMPANY OF NEW YORK "'Signature: ���' Signature: _.._ Name and Title: Name and Tit : 4.3fte-4,4, /fre..c d4--se l John Diggs, Attorney in Fact (Any additional signatures appear on the last page of this Performance Bond.) (FOR INFORMATION ONLY--Name, address and telephone) OWNER'S REPRESENTATIVE: AGENT or BROKER: (Architect, Engineer or other party) TIA Group LLC 8000 IH 10 West #950 Sant°nio, TX 78230 :111• Company executi ng this bond vouches that this document conforms to American Institute of Architects Document A312-2010 Edition PYmt A312(10/10) 1 ACORN® CERTIFICATE INSURANCE DATE(MM/DD/YYYY) �. OF LIABILITY 4/13/2018 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 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 certificate holder in lieu of such endorsement(s). ^PRODUCER CONTACT NAME: Tammy Pearce TIA - TCOR, LLC PHONE (210)428-2541 FAX (A/C,No,Ext): (A/C,No): 8000 IH-10 West #950 =Ls: INSURER(S)AFFORDING COVERAGE NAIC# San Antonio TX 78230 INSURERA:Continental Casualty Co. 20443 INSURED INSURER B:Continental Insurance Company 35289 Ritter Botkin Prime Construction Company, Inc. INSURER C:Service Lloyds 43389 20907 Martin Lane INSURER D: INSURER E: Pflugerville TX 78660-7728 INSURERF: + COVERAGES CERTIFICATE NUMBER:Master 17/18 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSD wyo., POLICY NUMBER IMM/DD/YYYY (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 6050038464 7/3/2017 7/1/2018 15,000 MED EXP(Any one person) $ X Contractual Liability PERSONAL&ADV INJURY $ 1,000,000 GE"L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X ECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 B X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 6050038450 7/3/20177/1/2018 BODILY INJURY(Per accident) $ AUTOS AUTOS rl XHIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) single limit $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 IDED RETENTION$ 6050038447 7/3/2017 7/1/2018 $ WORKERS COMPENSATION X PER 0TH- AND EMPLOYERS'LIABILITY STATUTE ER RI ANY PROPRIETOR/PARTNER/EXECUTIVE Y N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A C (Mandatory in NH) WC0030163-2017A 7/1/2017 7/1/2018 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 • A Contractors Equipment 6050038464 7/3/2017 7/1/2018 Leased&Rented $300,000 Inland Marine Form Deductible $1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) P 9 ) The General Liability and Auto Policies include an Automatic Blanket Additional Insured endorsement when there is a written contract that requires such status. The General Liability, Auto & Workers Compensation policies provide a Blanket Waiver of Subrogation. General Liability is Primary & Non Contributory as required by written contract. A 30 Day Notice of Cancellation is provided on All policies; 10 days for Non Payment of Premium. Policy 6050038464 includes Contractors Installation Floater $50,000 any one jobsite and $50,000 Temporary Storage. CERTIFICATE HOLDER CANCELLATION Cit SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Round Rock, Texas East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 221 ACCORDANCE WITH THE POLICY PROVISIONS. Round Rock, TX 78664 IAUTHORIZED REPRESENTATIVE Tom Street/PEARCT �1t.4r a-- c �- ANgp25D 2S(2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved. (201401) The ACORD name and logo are registered marks of ACORD Competitive Sealed Proposal Ranking for: Fire Station 9 Phase 2 'a a v v Y y a '^ o ° m Ln a l7 w v vS 3 ° o CL c o Z u u p_ � t0 N a V Contractor Name Base Price Alternates Totals Total Cost U 41 a, ' "= W ¢ >.e :t + W ° z CO° a o r- o m M c o Total Points a L N z .L a ry ra a s v X u -a a M w .o c o `o H 0 M U ►L a Prime Construction Y Y Y $463,327.00 $463,327.00 (Lowest Priced Proposal/Proposer's Price)X 40=Price Score 40.00 18.25 18.00 17.63 -1.50 92.38 1 TJR Construction Y Y Y $506,163.99 $506,163.99 -[ (Lowest Priced Proposal/Proposer's Price)X 40=Price Score 36.61 16.50 11.25 11.25 -1.00 74.61 Veritas Construction Y Y Y $508,000.00 $508,000.00 (Lowest Priced Proposal/Proposer's Price)X 40=Price Score 36.48 13.00 13.88 15.00 -0.75 77.61 3 HB Construction Y Y 1_1 $514,999.00 $514,999.00est Priced Proposal/Proposer's Price)K 40=Price Score 35.99 11.00 16.75 7.00 -1.25 69.49 Majestic Services Y Y Y $577,777.00 $577,777.00 (Lowest Priced Proposal/Proposer's Price)X 40=Price Score 32.08 16.63 16.00 15.25 -1.75 78.20 2 Navcon Y Y Y $596,480.00 $596,480.00 (Lowest Priced Proposal/Proposer's Price)X 40=Price Score 31.07 14.25 19.50 10.25 -2.00 73.07 $0.00 (Lowest Priced Proposal/Proposer's Price)X40=Price Score #DIV/0! 0.00 1 0.00 0.00 0.00 #DIV/0! $0.0CttDIV/O! (Lowest Priced Proposal Proposer's Price)X 40=Price Score 0.00 0.00 0.00 0.00 #DIV/0! $0.00 (Lowest Priced Proposal/Proposer's Price)X40=Price Score #DIV/0! 0.00 0.00 0.00 0.00 #DIV/0! $0.00 (Lowest Priced Proposal/Proposer's Price)X 40=Price Score F#D /0! 0.001 0.00 0.00 0.00 #DIV/0! Selection Committee: Richard Will, Matthew Smith, Gary Lawrence,Shane Glasier Date: 3/20/2018 CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f1 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. 2018-332963 Ritter, Botkin Prime Construction Company Inc. Pflugerville,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 0410212018 being filed. City of Round Rack,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. 000000 City of Round Rock Fire Station#9 Phase 2 Project Nature ofinterest 4 Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary 5 Check only if there i Interested Party. X 6 UNSWORN My name is Brian Ritter , and my date of birth is 4-2-18 My address is 20907 Martin Ln Pflugerville TX 78660 , Travis (street) (city) (state) (zip code) (country) 1 declare under penalty of perjury that the foregoing is true and correct. Executed in l ( (_ -� County, State of ,on the day of ,20 . (month} (year) My Notary ID#130837549 S nature kiahorized a n of contracting business entity Expires September 26,2020 ( grant) Y?•..• Forms provided by .ethics.state.tx.us Version V1,0.5523 CERTIFICATE OF INTERESTED PARTIES FORM 1.295 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. 2018-332963 Ritter, Botkin Prime Construction Company Inc. Pflugerville,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 04/02/2018 being filed. City of Round Rock,TX Date Acknowledged: 04/19/2018 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 City of Round Rock Fire Station#9 Phase 2 Project 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION My name is and my date of birth is My address is (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of on the day of 20 (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.5523