CM-2018-1831 - 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.00v.
To accommodate large files, secure file transfers are available upon request.
Regarding the Events Trust Fund Disbursement Request in the amount of $40,575, for the US Quidditch Cup 11
oil Ii Ax4A-
{name of the event} 1, y {name of authorized official), approve of each cost submitted for
disbursement from the trust fund. 1 certify that each cost is necessary to fulfill obligations under the Event
Support Contract. I 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
�- % POST OFFICE BOX 12428 AUSTIN, TEXAS 78711 * 512-936-0100 * GOV.TEXAS.COV
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.
Signatur
Title and Name orOrganizatiorY
I Jr v� ,1 j r �vts
Printed Name
-- a7 Ile
Date
POST OFFICE Box 12428 AUSTIN, TEXAs 78711 * 512-436-0100 * Gov.TEXAS.Gov
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PO Box 79304 -
Charlotte, NC 28271
SOLO TO-,
Nancy Yawn
City of Round Rock
RECEIPT DATE January 4. 2018
PREPAID or COLLECT COLLECT
Contact Nanry Yawn
City of Round Rock
CUANTIYY DESCRIPTION UNIT PRICE AMOUNT
1
US Quidditch Cup 11 Bid Fee
S 40,575.00
$40,575.00
0�V
�1
�l 5
SUBTOTAL
40.575.00
AMOUNT PAID
0.00
540,575.00
DIRECT ALL INQUIRIES TO: MAKE ALL CHECKS PAYABLE TO:
PAY THIS
Sarah Woolsey, USO Executive Director US Ouklditch. Inc.
AMOUNT
sarah waalseyQUsauidd'Ich.nro
(704)962-5099 y
PO Bax 79304
Charlotte, NC 28271
Tax ID number. 27-2204129
Vendor A i'! 00
�,4puN0 Ro
City of Round Rock Vendor
"�r'+ 221 E. Main Street Number
Sir Round Rock, TX 7866 61700
4
Phn (512) 218-5400
Pay Forty Thousand Five Hundred Seventy Five Dollars and 00 cents ****'*
To The US QUIDDITCH, INC.
Grder Of PO BOX 79304
CHARLOTTE, NC 28271
City of Round Rock, Round Rock, TX 78664 Page 1 of 1
Check Check
Date Number
01/12/2018 10038171
$40,575.00
FILE COPY
NON-NEGOTIABLE
Check Number: 10038171
Invoice Date
Invoke Number
Description
Invoice Amount
01/0412018
58266
HOST PARTNER AGREEMENT CM -20171560
$40,57500
DOC ID# 58266
Vendor No.
Vendor Name
Check No.
Check Date
Check Amount
61700
US QUIDDITCH, INC.
10038171
01/12/2018
1 $40,575.00
City of Round Rock
ROUND ROCK
TE)TAc, Agenda item Summary
Agenda Number:
Title: Consider authorizing an Events Trust Fund Disbursement Request in
association with US Quidditch Cup 11 at the Multipurpose Sports Complex
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 8/24/2018
Dept Director: Susan Morgan, CFO
Cost:
Indexes:
Attachments: US Quidditch Cup 11 at the Multipurpose Sports Complex
Department: Finance Department
Text of Legislative File CM -2018-1831
Consider authorizing an Events Trust Fund Disbursement Request in association with US
Quidditch Cup 11 at the Multipurpose Sports Complex
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 -2017-1573. The
disbursement amount being requested is $40,575.
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 US Quidditch Cup
11, held at the Round Rock Multipurpose Sports Complex from 04/14/18-04/15/18.
City of Round Rock Page i Printed on WN2078