R-2019-0320 - 8/8/2019 RESOLUTION NO. R-2019-0320
WHEREAS, the City of Round Rock ("City") desires to purchase nasal narcan spray for the
Fire Department, and
WHEREAS, the City is a member of the Texas Government Statewide Purchasing
Cooperative("Buy Board"), and
WHEREAS, Bound Tree Medical is an approved vendor of the Buy Board, and
WHEREAS,the City wishes to issue a purchase order to Bound Tree Medical,Now Therefore
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS,
That the City Manager is hereby authorized and directed to issue a purchase order to Bound
Tree Medical to purchase nasal narcan spray for the Fire Department.
The City Council hereby finds and declares that written notice of the date, hour, place and
subject of the meeting at which this Resolution was adopted was posted and that such meeting was
open to the public as required by law at all times during which this Resolution and the subject matter
hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act,
Chapter 551, Texas Government Code, as amended.
RESOLVED this 8th day of August, 2019.
— / Z
CRAI RG ayor
City of ound R66k, Texas
ATTEST:
SARA L. WHITE, City Clerk
0112.1902;00428637
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Bound Tree
Qumaoon#: 07v1512019
Account Number: i1426i'E5H}POU1
BILL-TO SHIP-TO
ROUND ROCK FIRE DEPARTMENT ROUND ROCK FIRE DEPARTMENT
un1eJOE o|maG0OBLVD onon8ATT|8SCHOOL no
ROUND ROCK,Tx7oeo* ROUND ROCK,rxrusu*'on7
Ship Method: ^$1uUNoFRT
Payment Terms: CREDIT CARD PMT
Contact Name Bound Tree BuyBoord#53O'17
Phone Number .
Quote Total $244J72.80
JohnnyKa||uo
8uundtreo|Account Manager
5ODOTuttle Crossing Blvd |Dublin, OH43O1G
Phone: 281'3O9-{483| Fax�
iohnny.ha||us@Uoundtme|
Sales tax will brapplied tocustomers who are not exempt.
Shipping charges will be prepaid and added to the invoice unless otherwise stated.
This quotation/ovalid until the quote expires mthe manufacturer's price mBound Tree Medical increases
To place an order, please visit our website at www.boundtree,com, login and add to your shopping cart
orcall(8OO)53&Q523
fax(ODO)257-5713
Bound Tree Medical 16000Too/ecros,/nm Blvd.,Dublin omu{Telephone noosao'o5z3
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. 2019.518095
Bound Tree Medical, LLC
Dublin, OH United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 07/17/2019
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.
530-17
First Aid, Emergency Medical,and Athletic Trainer Supplies and Equ pment
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
Christopher Fyffe 12/28/1984
My name is and my date of birth is
My address is 5000 Tuttle Crossing Blvd, Dublin Ohio 43016 US
(street) (city) (state) (zip colo) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in Dublin County, State of Ohio on the_22,___day of Jul __,2019
.0 _._..........
* ,r(month) (year)
Stgnalu-e of author,zed agerf contra ng business ent>ty
Ocr=3arant)
Forms provided by Texas Ethics Commission www.ethics.State.tx.LIS Version V1,1.391`8039c
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. 2019-518095
Bound Tree Medical, LLC
Dublin, OH United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 07/17/2019
being filed.
City of Round Rock Date Acknowledged:
08/07/2019
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.
530-17
First Aid, Emergency Medical, and Athletic Trainer Supplies and Equipment
Nature of interest
4
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 V1.1.39f8039c