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Contract - Loftin Equipment Co. - 1/10/2019 ffUCBuyCONTRAcr PRICING WORKSHEET Contract late For Catalog&Price Sheet TA pe Pu clinses No.: GEO?-1� Prepared.- Worksheet is prepared by Contractor and��v,�n to End Use j'a lei 'iss�c,4, both docuniews MUST befi7 ed to H- AC 71-7-993-4548. Thereire pk' a��e pe car print loorblj7. Buying :City of Rotund Rack Water(Forest Creek 2-Carnousgl) Contractor. :Loftin Equipment Co, Agency.• Contact Prepared Person: By. Dictert Iry. Phone: I'hotte. 281-310-6858;Extension 313 Fax: k:mall: Email: :bdietertt<z,lcittinerluip.coixi FCatalog/Price Sheet Filler Industrial Generator Model 100REOZ.IF(Gi41100ROEZJF)w/ KSS 225 amp ATS Name. General Description of Product: �...... . Kohler IUt?IZEnI tt Diesel Engine(;rnerator,set up for 277/480�'.�C1.. ........ ,3 phase(P:t�....... ..,c I of 3) ti:Catalti l�rtce.Sheet ltcrtis:liclti tii�eftastd lteitti e I3ilo�i ttacl. ........... ....... ...... ... .. r:t,ticlrtloti .. . ...... ............. ttl 4lreet.tf.ive.'w"*ary ., I, . R Buren Description Unit Pr Total I GM81567-GA5 IOOREOZJF. 12V,60Hr 15,600'. 15600 t '337178 60H z,277148QV,Wve.31'h,4W(voltage code) 0: Ct 1 :GM77931-MAI Alternator 4R9 X1,36{) 1 1360 I :GM66071.-1VIAI Unit Mounted Radiator,50C 24170; 2400 1 'GM66077-MA43 Skid/Tank,24 hour,4RX,209 Gallon Capacity 5270" 5270 I ::GM19874-KA] UL2200 Listing 0 0 1 'G,'w•180020-MAI Standard Duty Air Intake 165 161 I :Gh177544-MA2 DE0000,31"h Controller 1575 11+71 1 'GM79244-MAI-BLK Control&Harness,DEC3000 850: 850 1 GM75749-KA5 Accessory Inner 1'ane:I Controller 105: 105 Total ofall pages 42754' 0 1 HG AC Contract Discount oE24%off List Pricing -10,260.96 -10260.96 "Total From Other Sheets,if Any: 11429 Subtotal A:1=493.04 32493.04 B;.t.tt ubltstte?d:{� #torts.Acer55oi-r:or Se vice:rtt*t�t�y-:I#t (tiic.C:#iiI?'ubllslitlp;i, te in • . . iefe:k3elo f:= it Slic er af +ecedA sacnY uz. (duan Description Unit Pr 'Total I 'Change controller to latest APN1402 1 1 ti {f 0 Total From Other Sheets,If Any: Subtotal B: Check:Total cost of Unpublished Options(13)eannot exceed 25°t�of the total of the.Base Unit Price plus Published Options(A+B). For this transaction the percentage i5: iJ°`ia �Y.... y C�Other�;llotvances`Discounts:Tracie=.h s;.Frei til,Malie Rcadv�:or,i��ES'6ell neotis.Chhr tis: >, i Ia g Freight and start-up in Round Rock,TX 3750 One time special discount -4152.04 Subtotal C: -41)2.1}# I c >sv c-v ate 13 -• 15 weeks D'.-"To Ial1'u:a-chase Ptice{���-B+C} 321192 -46 (0 V-4 CONTItNCT PRICING WORKSHEET Contract Date -,rEO.2-1812-Dee-18 ff"CBUY For Catalog& .Price Sheet Type Purchases No.: Prepared: I This Worksheet is prepared by C"ontractor audgriven to End Uver. If a PO is issued, both d6cuntents MUST befaxedtoH-GA C@ 713-993-4548. Tlzerefortiple(isetilpeorprint l(,'gibtv. Buying 1 "tin :city ofRoutid Rock Chlorimitor Contractor: LotEquipment Co. Agency: Contact Prepared 11crson: :Btyan Dietert By: 1111011u. pholle. :231-310-6858:Extension 313 'a v Fax: L ina i 1: Email: loilinequip.com Catalog!Price Sheet oiller industrial diesel engine driven generator model 50REOZK((!.\150REOZK Price List) Il Name: I General Description offler 50RF.OZK rated 52 kW,78 amps standby at 2177/4SO VAC,3 phase,0.8 Power Factor(PAGE I of 3) of Product: A.-Ca0log i Pifte Sheet Items.beinaOui-.chitsed. Itemizi 13004:_ . ..... ........ Unit Quall Description Pr Total IGIN491435-GA2 l"ngine 50REOZK. 12V,601 Iz 11100: 11100 -,G%M19874-KA1 UL2200 Listing 0 1222661 Nameplate:Standby 130T Rise 0 0 . .333708 Volta-e: 6014z.277/480V,Wye,Ph.4W 0 Alternator and nIOUnting:4P5X.Brushless,Recoil ilectab le 4000: -1000 I Cooling. Unit tMounted Radiator,50C 1800: 1800 :GIM93704-MA I Skid and N40untilig:SkidiTank, 133 Gillon(24 liour,UL142,mounted) 44001 4400 1 `G I89827- "trt2 Air Intake:I leavDuty 120: 120 :;G1>[77389-1t A3 Controller:DE'0000,3 Ph 1575: 1575 G1M89505-NlAl-BLK Control&1larness.DEC3000 850^1 8 5 0 Total of all pages 31421' 0 HGACContract Discount ot'24%off List Pricing -7541.04* 15-11.04 Total From Other Sheets,If Any: 7576 n'V Subtot,,,,il A 23S-179.961 ut, x B.U",n p tj 1)1 i s.tied Optid.n s,�A c dessoryb r Se n,i,ice i tems-I tern izd,MOW-A Mic 11'Addit i o tin 15 Nect I f Neema ry' (,Note,'-titi'pub*li'stied,.Ite'iii:;nra w1v Nvh'*11\N ere�not st,lbnlltiedl�-and.priced ill uMtracto.r'.,-,,b.1d.) Description unit pr Total Quan Upgrade controller to latestest AM4,101 0 to Total from Other Sheets,If Any: Subtotal 13:11 Check: ['()tal cost of Unpublished()pti()rl, j(13)cannot exceed 25940 of the total of For this transaction the percentageMli) is. the.13-ase Unit Price plus Published OPti011S(A4 C,Other Alldwances,I Di.Oounts Tra&_'Ins'Freight;M.aW Rew1v OrNliscellabeous Charg,es Freight and Start Up-Round Rock,TX 3,066 -1351,90 One time only special discount Stjbtot..Il C:11 1714.04 I?cClrrerw7::L3at:: +B+Q: 12 - 13 Weeks taLTurchase Price(A' HGACBUY CONTRA6PRI+C:INC WORKSHEET Contract Date For Catalog& Price Sheet Type Purchases io.: CE02-18 Prepared: 12-Dec-18 This Worksheet isprepared by Contractor and given to End User. If a PO is issued, both document S hefaxed to C 713-99-3-4548.1 Therefore please type orpr int legibly. l3u'r n :City of Round Rock Water(Forest Creek 3-Trevino) Contractor: :Loftin Equipment Co. ContactPrclaared Person: lty :Bryan Dietert Phone: Phone: .281-310-6858,Extension 303 Fax: Email: Email: ibdietert(rilo tinequip.coni Catalaw,!Price Sheet tme: IFK(�hler industrial diesel engine driven generator model aOREOZK(GM130REOZK Price List)w/KSS Its0 Amp ATS C,cner:ti Description t�cscri of l'rod�ycMohler 30RtiOZK rated 3l M,47 amps standlry at 277/480 VAC.3 phase,0.8 Poser factor(PAG t of 3) :1.Ci:iti�.l.I'x til. hex t Reins. tl I,purch.tsccl: ,Itt mire I3elei�r lrt,tch: tl ittottal 5htlet l '.N cessarw. Quan Descriptiontliiit Pr Total I ':GIN°191476-GA1 Engine 30R1OZK, 12V,601"1r 7450: 7850 I GM191336-Krll UL2200 Listin- 01 {) 1 :222661 Nameplate:Standby 130"C Rise 0 0 I :333704 Voltage: 601;-Iz,277i480V,Wye,3Ph,4t''�' 0: () 1 :GM88320-MIA12 Alternator and mounting:4D8.3.Brushless,Reconneetable 3120); 3120 1 :GM88199-MA3 Cooling: Unit Miounted Radiator.50C 1650 1650 I :GM90278-MAI Skill and Mounting;Skid/Tank,80 Gallon(24 Dour,UL 142,mounted) 3290: :3290 I :GM95613-MAI Air Intake:Heavy Duty 1501 150 1 G11089461-MIAI-BLK Controller:DEC3000,3 Ph 2295: 2295 ICjM88335-KA14 Enclosure,installed:Sound Attenuated,Steel 4450: 4550 Total of all pages 27928: (} 1 HGAC Contract Discount of 241%off List Pricing -6702.72: -6702.7`' Total Froin father Sheets,If Any: 4723 Subtotal Adj 21225.24 B..Gtiitblislicil:Up.ores«. cssory orSer tcc..tetos: Irei x .�3e t�v..;a;f#:ie1t;add tcunal feet 1Ss. ,... (\c�tz.'.Lnliui�tt�itt:tl Itis arc;;<tn} ti�1i�c1i��er(riot tiubrtittetl Kidd:prtc.e'd itl ct?ritr.zt.tcar.;,1�u1.} : : .. : '' " Quttn Description Unit Pr Total 1 ii.Upgrade controller to lateste;st APM402 1: 0 NOTE THAT INCLUDED 40 AiMP BREAKER WILL I..DvIIT 1J,NIT TO BELOW 30 kW ti 0 Total From Other Sheets,If Any: Subtotal B: Check:"Dotal cost tat Unpublished Options(B)cannot exceed 25'()(lythe total of For this transaction the percentage is: ()0�, the Base Unit Price plus Published Options(A+B"). IL I +C:Clther:. lla�vtnces l iset�urtts,.;fridc=ins r ci ht,: .it. Iteady:iti ivt.isceis.('liarges ... Freight and Start Up-Round Rock,Tl 2,966 tine time only special discount -2609.2'3 Subtotal C:: 356.72 el very;DaTc: 13 - 15 WeeksIF D.-T6tal Ptiechase Price:(A+B+C);: 2 1.58 3 (A P L* MUCBWCONTRACT PRICING WORKSHEET Contract Date, For Catalog 5, Price Slleet'I' e Purchases GE02-�18 12-Dec-18 ' 3'P No.: Prepared: This Worksheet isprepared by Contractor andgiven to End User. if"a PO is issue4both documents MUST he faxed tri -GAC , 713.993-4548. Th r4br plentse 4pe gar prion legibly. City int Round Reck.Water(Forest Creek 4-Bav l Jill) Contractor: Loltin Equipment Co. :t;;encv: Contact Prepared Person: Bryan Dietert tiv: Phone: Phone: 281-310-6858;Extension 313 Fav Fuk: I.iva;;c Email: :bdietert(t loftinetluip.cotn Catalog t Price Sheet Kohler industrial diesel engine driven,encrator model 40REOZK(GM40REOZK Price List)`/KSS 200 Arnp ATS Name: a General Description Kot ter 4tiREOZK rated 40 t .166 anips,standby at 120!240 VAC,I phase,1.0 Potier Factor(PACE I or3) or Product: 1. atalog:t l'i xt sheet Items bttd purchased:-It ttre:l3G(aw-: tf ch 1►ttcllittrn�ri:Sl�cet If'`:' 4sAYX Quan DescriptionUnit Pr Total 1 ;G 91435-GAI Engine 40REOZK, IZV,601-11 9383 9-1183 I GIN119874-KA1 t t-2200 Listing 0. 0 1 :222661 Nameplate:Standby 1.30"C Rise 0; 0 I :33:3702 Voltage: 60Hz, 1201240V,Wye.Single Ph,T (}; Ci 1 :GN195642-MA3 Alternator and mountin4g:4Q7BX,Brushless,SINGLE PFIASE ONLY 34003J100 1 ?GM89480-MAI Coaling: Unit M0Unted Radiator,50C 1800; 1800 I :G,�I93704-�r1'AI Skid and I�rlounting:SkidlTartk, 1.33 Gallon(24 hour,U.L142,mounted) 4400: 4,400 1 :GM8982.7- 4 A2 Air Intake:Heavy Duty 120: I20 1 :GM77389-M.A4 Controller:DEC3€00,Single Ph 15751 1575 1 :G,1I8950a-N1A1-BLK Control&Harness,DEC3000 850: 850 Total of al l pages 3186 11 0 1 HGAC Contract Discount of 241'0 off List Pricing 7646.64: -7646.64 Total From father Sheets,If Any: 1033; Subtotal A: 24214.36 I3:�1-in utilish �a3lrtiorts r� ccs tiry�...... 't.tenect If Ne essay {Noi Lln"plibtisliccItcnrc a�Cr not n ubsii t ctnericciietitr utpr'S . {duan DescriptionUnit Pr Total 1 :Upgrade controller to latestest APM402 1: 1 0 0 0 "Total From Other Sheets,If Any: Subtotal B: Chet k:Total cost of Unpublished Options(131 cannot e treed 25%of the total of For this transaction the percentage is: 0%, the Bast;Unit Price plus Published Options(A-1-13). IL I C.f}alter: lluwances,:- isctiui�ts.Ti:de=lnS;:Frcil;llf;l Inhc:) eaciy.nr, tiscellancon C'ttarges: Frei-lit and Start Up-Round Rock,TX 3,066 One time only slpecial discount -i 11��.36 Subtotal C: 1946.64 Delis a y;Date:: 12- 13 Weeks I),;'Totiirl"Fillreha"se I'>�=icc (A+8+C} : Z6l 62 CONTRACT PRICING WORKSHEET Contract Date For Catalog& Price Sheet' -*pe Purchases No.: GE02-18 Prepat•e(l: This ff7o• sheet is prepared by Contractor and given to End User if a Ptd is issued. both documents be faxed to J 11C @ 7.13-99.3-4548. Thertfibreplease ;fie tF sprint legibly. i3uYiiig :City of Round lock Water(Forest Creek I-I•lilton) Contractor; lottin E(Iuipment.Co. A1gencvl. Contact Prepared Person: `: :Brvan Dictert Phone: Phone: 181-310-6558;Extension 313 t'ax: Fax: Email: r.mait: ::bdietert cl:loftitne(ltaip.coni �aCatalog!'Price Sheet varve: Kohler Industrial Generator Model 150REOZJ1-'(GM 150R.OEZJF)acid K..SS Series 225 Amp ATS General Description of Product, I Kohler 1T-oRFOZ..JF Diesel EnAne Generator.set up for 2771480 VAC three phase and 22S amp Vit:tlfl alt ATS 1..0<tt<tto f Prlec:Sheet:Yie�iis'6eit'6 aitch S0&*—:tten1i' 8 �� r. .:. 1a. ',P. ....... elo. ....ttncit.;AdtlftIoti� f l?t et If c�. s.ir. ..... .. .. Quan DescriptionUnit Pr Total 1 G1V181645-GA I 150REOZJF, 12V,601-12 2,550; 22550 1 ;333708 60Hz,277/48OV,3Ph,4W 0: t► 1 :GM779 31-MA t O Alternator 4R 13,E X7,1 t)() 7100 I ':GM703384-MAI Usnit Mountcd Radiator,50C3()00; 3000 1 :GNI 70385-i'VIAl Skill,44" 925 925 I :GN- 11(1874-KA.1 U1.22001-isting (} p 1 :GM79245-MAI Standard Duty Air Intake 2013. ?p0 I :G ,177544-MA4 DEC3000,3.Ph Controller 1575: 1575 I :G tifi79249-%MAI-BLK Control&.1-larness,DEC3000 640: tr1{) 1 :G%M75749-KA.5 Accessory Inner Panel.Controller 105: 105 Total of all pages 54796: 0 1 HGAC Contract Discount of 24%gaff List.Pricing -13,151.04- -13151.04 Total From Other Sheets,1f Any: 18701 Subtotal A. 41 6144.96 B::Utioublis td 0 d6ns,.A&vc sori�n><•S.. Jc0:items iteiatife 1306 t-:- +fifac lcicl.itioit;tl`licet If NeceStiary i . ole:tin bI'S1"�cl lteti s.p re�i j tuliit +vi*rc n(at suliftii tt•cI tticl:`i icet!iii �i�i rac.tir, �i I �... . t < ...p . �.tt l t.). (duan D scription Emit Pr Total I 'Upgrade controller to latest AP:v1402 l: 1 0 :Note: (quotation includes St(I UL 142 tank,if special options or LIL 2085 is required please call for price 0 Note: This is a 3 ptlge quotation,please see tabs below 0 ..Total From Other Sheets,If:filly: Subtotaf B: � Check:Total cost of Unpublished Options(13)cannot exceed 25%)of the total of the base Unit Price plus Published Options(A=B). For this transaction the percentage is: C.Other: lta�r aces l)tsctiui�ts,:'Trade-las I't-eight,•,N14ke:Readr iii ?lisrell:i�iteQus Cltfir es: Freight and start-tip in Round Rock,TX 4122 One tithe special discount -4901.96 Subtotal C: -779.96 Defiv ery:Date, 13 - 14 weeks T�.T+�tal k?�>Cr�h�i<se Prig (�+�fC} 40866 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. 2018-426865 Loftin Equipment Co Houston,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 11/19/2018 being filed. City of Round Rock Date Acknowledged: 11/21/2018 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 Purchase of Equipment from Loftin Equipment Co through HGAC Cooperative Purchasing Contract GE02-18 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 I , (street) (city) (state) (zip code) (country) 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 V1.0.6711 CERTIFICATE 4F INTERESTED PARTIES FORM 1295 10f1 Complete Nos.1-4 and 4 if there are interested parties. OFFICE USE ONLY Cvrnplete 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. 2018-426865 Loftin Equipment Co Houston,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 11/19/2018 being filed. City of Round Rock 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 Purchase of Equipment from Loftin Equipment Co through HGAC Cooperative Purchasing Contract GE02-18 Nature of interest 4 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 UNSWORN DECLARATION My name is Bryan Dietert and my date of birth is 10-29-1962 My address is 6113 Bri ttinoore Read Houston TX 77041 USA (street) (city) (state) (zip code) (Country) I declare under penalty of perjury that the foregoing is true and correct. Executed in Harris County, State of Texas on the19 t�ay of Novembe�rp 18 (month) (year) r +� Sign re of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711