CM-2018-1830 - 8/27/2018GOVERNOR GREG ABBOTT
ECONOMIC DEVELOPMENT & TOURISM
Events Trust Fund Disbursement Request
Events Trust Fund, Major Events Reimbursement Program or Motor Sports Racing Trust Fund
The Applicant shall complete this form to request a disbursement for an approved Events Trust Fund
application, along with supporting documentation. This request and all supporting documentation must
be submitted no later than 180 days after the conclusion of the event.
Disbursement will only be made to the Applicant.
For a request submitted by a Local Organizing Committee, documentation shall be submitted showing the prior
approval of the disbursement request by each endorsing entity. TAC Rule § 184.41(a)(6).
Please submit all documents to eventsfund0gov.texas.gov.
To accommodate large files, secure file transfers are available upon request.
Regarding the Events Trust Fund Disbursement Request in the amount of26,000, for the 2018 Women's
4 I wllliAus
Collegiate Lacrosse Associates National Championships {name of the event} I, {name of authorized
official}, approve of each cost submitted for disbursement from the trust fund. I certify that each cost is
necessary to fulfill obligations under the Event Support Contract. 1 certify that the funds will not be used for the
purpose of soliciting the relocation of a professional sports franchise already located in this state; and that no
costs sought for disbursement from the trust fund are also being disbursed by another entity. I also certify that I
have the authority to make this certification statement on behalf of the applying entity, and I take responsibility
for the disbursement being requested.
Please provide the following information:
Entity Disbursement is being made to: City of Round Rock
Federal Tax ID Number: 746017485
Texas Tax ID Number: 17460174851
.-avk-'1.3O POST OFFIcc BOX 12428 AUSTIN, TEXAS 78711 * 512-936-0100 * cov.TFxAS.Gov
General explanation of costs that the disbursement request represents: Rights Fee
Note: Disclosure of Information under the Public Information Act. All disbursement documentation
submitted to the Office of the Governor (OOG) is subject to disclosure under the Texas Public Information Act,
Chapter 552 of the Texas Government Code ("the Act"), whether created or produced by the applicant or by any
third -party. If it is necessary to include proprietary or otherwise confidential information in the documents
submitted, that particular information should be clearly identified as such. Merely making a blanket claim that all
documents are protected from disclosure because they may contain some proprietary or confidential
information is not acceptable, and will not render the information confidential. Any information which is not
clearly identified as proprietary or confidential will be released in accordance with the Act.
Does the disbursement request documentation contain any items marked as confidential and/or proprietary?
Yes ❑ No
Primary Contact for Disbursement Request: Debra Doss
Primary Contact Phone Number: 512-218-5436
Primary Contact Email: ddoss@roundrocktexas.gov
Signatory must be someone the applying entity has determined is eligible to bind the applying entity.
Signatu e
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Title and Name o Organization
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Printed Name
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POST OFFICE BOX 12428 AUSTIN, TEXAS 78711 * 512-936-0100 * GOV.TEXAS.GOV
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Dix 25-Oct-21It7
MemberlD 000008204577-0
City of Round Rock
Attn Nancy Yawn
231 £ Main St Ste 150
Round Rack. TX 78664-5267
US Lacrosse
2 Lovepm Circle, Sparks, MD. 211.5+2, USA
Phone; 410-235-6882 Fav 410-366.6735 Emall; infufa•uslacrnsac.org
INVOICE
Fagc 1 of 1
Order Number 1006351103
Order Date 25 -Oct -2017
Invoice Number 0004425477
Link
Product Fulfil Status Status
Qty Cnl[ Price Ditcnunr Coupon \dJustmeat Total
\czt Due Datc Nest Duc Amount
WCLA_BIDINCO\11:-WCLA Did Income Active Active 1 26,00000 DUO 000 000 2600000
Shipping
000
Tar
000
Order Total
26,000 00
Paid to Date
000
Current Amount Due-
26,000 00
Please detach the lo%cr portion and return it with your payment fhanA you
Customer 000008204577-0 CLIV of Round Rock
Order No. 1006251103 Invuacc No ODU4425477 Balance Duc(L Slj7
26,000 00
Credit Card N
Credit Cants Accepted - (AE:, MS VS)
Send payments to US Lacrosse
2 Lovelon Circle
Sparks, MD 21152
Up Date
Amount
►'� City of Round Rock Vendor
221 E Main Street Number
�Y Round Ronk, TX 78664 61829
Phn (512} 218-54047
Pay Twenty Six Thousand Dollars and 00 cents ****•*
To The US LACROSSE
Order Of 2 LOVETON CIRCLE
SPARKS, MD 21152
City of Round Rock, Round Rock, TX 78664 Page 1 _.f 1
Check Check
Date Number
11/17/2017 10037380
$26,000.00
FILE COPY
NON-NEGOTIABLE
Check Number: 10037380
Invoice Date
irivoice Number
Description
Invoice Amount
10/25/2017
1006251103
HOST PARTNER AGREEMENT - CM -20
$26,000.00
DOC ID# 53260
Vetxler`Na-- Vendor Flame check No. ch4m* Date . Check Amount
61829 US LACROSSE 10037380 11117/2017 1 $26,000.00
City of Round Rock
IM-3 ROCK Agenda Item Summary
XA'�
Agenda Number:
Title: Consider authorizing an Events Trust Fund Disbursement Request in
association with the 2018 Women's Collegiate Lacrosse National
Championships.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 8/24/2018
Dept Director: Susan Morgan, CFO
Cost:
Indexes:
Attachments: 2018 Women's Collegiate Lacrosse National Championships
Department: Finance Department
Text of Legislative File CM -2018-1830
Consider authorizing an Events Trust Fund Disbursement Request in association with the
2018 Women's Collegiate Lacrosse National Championships.
The Events Trust Fund Program is a program for local governments and local organizing
committees to apply for State funds to help pay for qualified expenses associated with an
event, to which both the State and City must contribute. The Events Trust Fund application
associated with this event was approved in December 2017 on CM -2017-1576. The
disbursement amount being requested is $26,000.
The disbursement request is the final step in the Events Trust Fund program from the
Governor's Office. The City is seeking disbursement from the State for the 2018 Women's
Collegiate Lacrosse National Championships, held at the Round Rock Multipurpose
Sports Complex from 05109118-05112118.
City of Round Rock page 1 Printed on 8/23/1016