CM-2019-0328 - 10/25/2019COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) -
COMMUNITY HOUSING REPAIR AND REHABILITATION
HOMEOWNER AGREEMENT
This CDBG Commun .
jV Housing Repair d Rehabilitation Homeowner Agreement
(Agreement), is made this day of (6�!i� . 2019, between the CITY OF
ROUND ROCK, Texas, 221 East Main Street, Round Rock, Texas (CITY), and Vega Maryann
Dela, a single woman, whose address is 1902 Easton Drive, Round Rock, Texas, 78664
(HOMEOWNERS).
RECITALS
WHEREAS, the CITY has been awarded grant funds which may be spent by the CITY for
the provision of certain services authorized under the U.S. Department of Housing and Urban
Development (HUD) Community Development Block Grant (CDBG) Program; and
WHEREAS, CITY wishes to assist qualified homeowners in the minor rehabilitation of their
residence by providing a grant to pay a contractor for labor, materials and equipment to be utilized
in the rehabilitation; and
WHEREAS, HOMEOWNER has qualified for the rehabilitation of Lot twenty-five (25),
Block E, Greenhill Section three, a subdivision in Williamson County, Texas according to the map
or plat of record in Cabinet D, Slide 111, Plat Records, Williamson County, Texas, also known as
1902 Easton Drive, Round Rock, Texas 78664, as specified in the Work Write -Up Bid Document,
attached hereto and incorporated herein as Exhibit "A".
NOW THEREFORE, for and in consideration of the mutual promises and covenants set
forth herein, and other good and valuable consideration, the receipt and sufficiency of which are
hereby acknowledged, the CITY and HOMEOWNER agree as follows:
ARTICLE 1
GENERAL REQUIREMENTS
1.1 CITY will pay a contractor, by separate agreement attached hereto and incorporated herein
as Exhibit "C" (Contractor's Agreement), $21,585.00, (Contract Price) for labor, materials
and equipment utilized in the rehabilitation of HOMEOWNER's above -referenced
property, as specified in the Work Write -Up Bid Document. Funds will not be used to pay
HOMEOWNER or members of its family.
1.2 The Contract Price and any approved change orders will not total more than $26,981.25.
ARTICLE 2
HOMEOWNER'S RESPONSIBILITIES
2.1 HOMEOWNER has qualified for a grant under the Low to Moderate Income guidelines as
set forth in Section 8, Income Limits established and amended annually by HUD, attached
hereto and incorporated herein as Exhibit "B".
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2.2 HOMEOWNER has resided in and been the owner(s) of the residence to be rehabilitated
for at least one (1) year prior to the submission of its application.
2.3 The residence to be rehabilitated is not Iocated in a flood zone area as defined in CITY's
Flood Insurance Map, produced by the Federal Emergency Management Agency, or if it is
located in a flood zone, HOMEOWNER has sufficient flood insurance, which
HOMEOWNER will keep current for at least five (5) years after receiving the award.
2.4 All property taxes on the property are paid up to date, including CITY, County and
applicable School District Taxes.
2.5 The residence is not under a Contract for Deed, or any similar purchase agreement, in
which HOMEOWNER does not obtain legal title until final payment is made.
HOMEOWNER has not received HUD Program assistance for the preceding five (5)
years.
2.6 HOMEOWNER understands and agrees that the work performed by contractor will be
inspected by the Construction Advisor, as defined in the City of Round Rock Housing
Repair and Rehabilitation Program Policies and Procedures, and a City Inspector before
any funds are paid out and the rehabilitation is completed.
ARTICLE 3
OTHER PROGRAM REQUIREMENTS
3.1 DISCRIMINATION. HOMEOWNER will not exclude any person from participation in,
deny the benefits of or subject the person to discrimination under any of the contractor's
activities while receiving federal financial assistance on the grounds of race, color,
religion, sex, national origin, age or disability.
3.2 INTEREST OF MEMBERS, OFFICERS, EMPLOYEES OF PUBLIC BODY,
MEMBERS OF LOCAL GOVERNING BODY, OR OTHER PUBLIC OFFICIALS. No
member, officer, or employee of CITY, or its designees or agents, no member of the City
Council, and no other public official of CITY during his/her tenure or for one (1) year
thereafter, will have any interest, direct or indirect, in any contract or subcontract, or the
proceeds thereof, for work to be performed in connection with the program assisted under
this Agreement.
3.3 PROHIBITION OF BONUS OR COMMISSION. The assistance provided under this
Agreement will not be used in payment of any bonus or commission for the purpose of
obtaining CITY approval of the application for such assistance.
3.4 STATUTE OF LIMITATIONS. As between the parties to this Agreement, as to all acts
or failures to act by either party to this Agreement, any applicable statute of limitations
will commence to run and any alleged cause of action will be deemed to have accrued in
any and all events when the party commencing said cause of action knew or should have
known of the existence of the subject act(s) or failure(s) to act.
3.5 INDEMNIFICATION. HOMEOWNER will defend, indemnify, and hold CITY, its
2.
successors, assigns, officers, employees and elected officials harmless from and against
all suits, actions, legal proceedings, claims, demands, damages, costs, expenses,
attorney's fees, and any and all other costs or fees arising out of, or incident to,
concerning or resulting from this Agreement, no matter how, or to whom, such loss may
occur. Nothing herein will be deemed to limit the rights of CITY or HOMEOWNER
(including, but not limited to the right to seek contribution) against any third party who
may be liable for an indemnified claim.
3.6 CHANGE ORDERS. HOMEOWNER expressly agrees that no material changes or
alterations in the Work Write -Up Bid Document or Contract Price provided above will be
made unless in writing, mutually agreed to by HOMEOWNER and the CONTRACTOR,
and authorized by CITY.
3.7 TERMS. All references in this Agreement to any particular gender are for convenience
only and will be construed and interpreted to be of the appropriate gender. For the
purposes of this Agreement the term "will" is mandatory.
3.8 SEVERABILITY. Should any provision in this Agreement be found or deemed to be
invalid, this Agreement will be construed as not containing such provision, and all other
provisions which are otherwise lawful will remain in full force and effect, and to this end
the provisions of this Agreement are declared to be severable.
3.9 PUBLIC INFORMATION ACT. The City of Round Rock is governed by the Texas
Public Information Act, Chapter 552 of the Texas Government Code. This Agreement
and all written information generated under this Agreement may be subject to release
under this Act.
ARTICLE 4
SUSPENSION AND TERMINATION
4.1 If HOMEOWNER fails to fulfill in a timely and proper manner their obligations under
this Agreement, or violates any of the terms or conditions of this Agreement, then
HOMEOWNER will have ten (10) days from the date it receives written notice from
CITY directing it to cure or correct the defects or failures to comply. Should
HOMEOWNER fail to make corrections as directed by CITY, and such breach of
contract results in a violation of federal law or regulation for which CITY receives a
demand of reimbursement of grant funds from HUD or its successor, CITY may
terminate this Agreement immediately, and may recover from HOMEOWNER the
amount sought by HUD for reimbursement, up to the full amount of the award.
4.2 HOMEOWNER will not be relieved of the liability to the CITY for damages sustained by
CITY by virtue of any breach of this Agreement by HOMEOWNER.
4.3 If CITY becomes aware of any HOMEOWNER activity which could jeopardize CITY's
position with HUD and cause CITY to return CDBG funds or other federal funds
received by CITY, CITY may take appropriate action, including injunctive relief against
HOMEOWNER, to terminate or prevent the activity. Failure of CITY to exercise this
right will not constitute a waiver by CITY of its right to demand payment or to seek any
3.
other relief in law or in equity to which it may be entitled.
ARTICLE 5
ATTORNEY'S FEES
5.1 Any panty to this Agreement who prevails in any legal proceedings between the parties
regarding this Agreement will be entitled to recover court costs and reasonable attorney's
fees from the non -prevailing party.
ARTICLE 6
VENUE AND REMEDIES
6.1 This Agreement is governed by the laws of the State of Texas. Exclusive venue for any
dispute arising under this Agreement is in Williamson County, Texas.
ARTICLE 7
SUCCESSORS AND ASSIGNS
7.1 CITY and HOMEOWNER, respectively, bind themselves, their successors, assigns and
legal representatives to the other party to this Agreement and to the successors, assigns
and legal representatives of the other party with respect to all covenants of this
Agreement. Neither CITY nor HOMEOWNER will assign, sublet, or transfer any
interest in this Agreement without the written consent of the other party.
ARTICLE 8
ENUMERATION OF CONTRACT DOCUMENTS
8.1 This Agreement represents the entire and integrated agreement between CITY and
HOMEOWNER for the work specified in Exhibit "A" and supersedes all prior
negotiations, representations, or agreements either written or oral. This Agreement may
be amended only by written instrument signed by CITY and HOMEOWNER. The
Agreement contains the following exhibits attached to and incorporated in this
Agreement for all purposes:
(1) Work Write -Up Bid Document (Exhibit "A")
(2) HUD Section 8 Income Limits (Exhibit "B")
(3) Contractor's Agreement (Exhibit "C")
This Agreement is effective as of the date first written above.
HOMEOWNER:
CITY:
City of Round Rock, Texas
dill
Vega Mary #-D_ii Qty
EXHIBIT "A"
WORK WRITE-UP BID DOCUMENT
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EXHIBIT
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EXHIBIT "B"
INCOME LIMITS
MAXIMUM INCOME CHART
Household Size
Maximum Income 80% of the Area Median
1 person
$48,200
2 persons
$55,050
3 persons
$61950
4 persons
$68,800
5 persons
$74,350
6 eersons
$79,850
7 persons
$85,850
8 persons
$90,850
Source: U.S. Department of Housing & Urban Development. These income figures are
subject to change annually.
6.
EXHIBIT "C"
CONTRACTOR'S AGREEMENT
7.
EXHIBIT
COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) -
COMMUNITY HOUSING REPAIR AND REHABILITATION PROGRAM
CONTRACTOR AGREEMENT
This CDBG Community Housing Repair and Rehabilitation Program Contractor
Agreement (Agreement), is made this day of , 2019, between the
CITY OF ROUND ROCK, Texas, 221 East Main Street, Round Rock, Texas ("CITY"), and
Farnum Enterprises, Inc., dba B&O Construction, 16238 Highway 620, Suite F-405, Austin, Tx
78717 ("CONTRACTOR").
RECITALS
WHEREAS, CITY has been awarded grant funds which may be spent by CITY for the
provision of certain services authorized under the U.S. Department of Housing and Urban
Development (HUD) Community Development Block Grant (CDBG) Program; and
WHEREAS, CITY wishes to assist qualified homeowners in the minor rehabilitation of their
residence by providing a grant to pay CONTRACTOR for labor, materials and equipment to be
utilized in the rehabilitation; and
WHEREAS, CITY will pay CONTRACTOR for labor, materials and equipment to be
utilized in the rehabilitation of hot twenty-five (25), Block E, Greenhill Section three, a
subdivision in Williamson County, Texas according to the map or plat of record in Cabinet D,
Slide I 11, Plat Records, Williamson County, Texas, also known as 1902 Easton Drive, Round
Rock, Texas 78664, (the "Property"), as specified in the Work Write -Up Bid Document, attached
hereto and incorporated herein as Exhibit "A".
Now therefore, for and in consideration of the mutual promises and covenants set forth herein,
and other good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, CITY and CONTRACTOR agree as follows:
ARTICLE 1
GENERAL REQUIREMENTS
1.1 CITY will pay CONTRACTOR $21,585.00 ("Contract Amount"). Funds will not be used
to pay the homeowner or members of its family.
1.2 Payment will be made by CITY for all work described in the Work Write -Up Bid
Document after all of such work is found to be satisfactorily completed and inspected by
the Construction Advisor, as defined in the City of Round Rock Minor Home Repair
Program Policies and Procedures, and the CITY Inspector. CITY will pay
CONTRACTOR for work in accordance with CITY'S Prompt Payment Policy, as defined
in the City of Round Rock 2019 Community Housing Repair and Rehabilitation Program
Policies and Procedures.
1.3 CONTRACTOR will not deviate from the work described in the Work Write -Up Bid
Document without a change order from CITY. Any such change order will be included in
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an amendment to this Agreement. The Contract Amount and any change orders shall not
exceed a total amount equal to a twenty-five (25) percent increase in the original Contract
Amount.
1.4 The Contract Amount and any approved change orders will not total more than the
amount of $26,981.25.
1.5 All work specified in the Work Write -Up Bid Document will be satisfactorily completed
within ninety (90) days from the date of the Notice to Proceed.
1.6 Work Write -Up Bid Document line item deletions: None
ARTICLE 2
CONTRACTOR'S RESPONSIBILITIES
2.1 CONTRACTOR will ensure that all work performed under this Agreement is permitted
and inspected by CITY's Building Inspection Division. CONTRACTOR agrees to be duly
licensed under CITY ordinances and State laws and be responsible for obtaining the
building permit.
2.2 CONTRACTOR understands that it is solely responsible for meeting the terms and
conditions of this Agreement. If CONTRACTOR fails to properly perform or complete
any of the work specified in the Work Write -Up Bid Document, CONTRACTOR will not
receive funding for any work that is found to be improperly performed or incomplete.
2.3 CONTRACTOR understands that all work described in the Work Write -Up Bid Document
with the exception of line items deleted under Section 1.6 must be completed before any
funds will be paid out.
2.4 CONTRACTOR understands that the job will be inspected by a CITY Inspector and
Construction Advisor before any funds will be paid out.
2.5 CITY will provide a Notice to Proceed to CONTRACTOR to commence work.
CONTRACTOR agrees to start work within thirty (30) calendar days after receipt of the
Notice to Proceed. If CONTRACTOR fails to commence work within thirty (30) days
from the date on the Notice to Proceed, CITY will have the right to terminate this
Agreement, by providing a written notice of tennination to CONTRACTOR.
2.6 CONTRACTOR agrees to complete the work within ninety (90) days from the date of the
Notice to Proceed. If completion is delayed for reasons beyond the CONTRACTOR's
control, CONTRACTOR will provide timely notice to CITY of the reasons for such delay.
If such good cause is claimed by CONTRACTOR, it will be CONTRACTOR'S obligation
to substantiate its claim by adequate documentation.
2.7 CONTRACTOR affirms that it has not been debarred from performing federal contract
work.
ARTICLE 3
OTHER PROGRAM REQUIREMENTS
3.1 PERMITS AND CODES. CONTRACTOR agrees to secure and pay for all necessary
permits and licenses required for CONTRACTOR'S performance and to adhere to
applicable local codes and requirements whether or not covered by the Work Write -Up
Bid Document, including any CONTRACTOR registration requirements.
3.2 DISCRIMINATION. CONTRACTOR will not exclude any person from participation in,
deny the benefits of or subject the person to discrimination under any of the
CONTRACTOR's activities while receiving federal financial assistance on the grounds
of race, color, religion, sex, national origin, age or disability.
3.3 WARRANTY. CONTRACTOR agrees to provide a full one-year warranty to the
homeowner, said warranty will extend to subsequent owners of the property to be
improved. The warranty will provide that improvements, hardware, and fixtures of
whatever kind or nature installed or constructed on said property by the CONTRACTOR
are of good quality and free from defects in workmanship or materials or deficiencies
subject to the warranty provided in this paragraph. CONTRACTOR and CITY agree,
however, that the warranty set forth in this paragraph will apply only to such deficiencies
and defects as to which homeowner or subsequent owners will have given written notice
by certified mail to the CONTRACTOR, at its principal place of business, within one (1)
year from the date of the final inspection and acceptance by the CITY Inspector that all
work under the Agreement has been completed.
3.4 BID. CONTRACTOR acknowledges that it has prepared the Work Write -Up Bid
Document, attached hereto and incorporated herein as Exhibit "A" and that such Work
Write -Up Bid Document is accurate and consistent as to the name of CONTRACTOR,
scope of work that the CONTRACTOR will under -take, and price. CONTRACTOR
acknowledges the performance requirement established in the write up and warrants that
all work undertaken will conform to said specifications.
3.5 REMOVAL OF DEBRIS. Upon completion of work CONTRACTOR agrees to remove
all construction debris and surplus material from the Property and leave the Property in a
neat and clean condition.
3.6 SUBCONTRACTORS. CONTRACTOR agrees that all the warranties contained herein
will apply to all work performed under this Agreement, including that performed by any
Subcontractors.
3.7 FRAUDULENT ACTS. CONTRACTOR nor any of its officers, partners, owners,
agents, representatives, employees, subcontractors or parties in interest has in any way
colluded, conspired, connived or agreed, directly or indirectly with any other bidder,
firm, or person to submit a collusive or sham bid in connection with CONTRACTOR for
which the bid has been submitted or to refrain from bidding in connection with this
Agreement, or has in any manner, directly or indirectly, sought by agreement or collusion
or communication or conference with any other bidder, firm, or person to fix any
overhead, profit, or cost element of the bid price shown in the Work Write -Up Bid
3
Document or the bid price of any other bidder, or to secure through any collusion,
conspiracy, connivance, or unlawful agreement, any advantage against CITY or any
person interested in this Agreement; and the price or prices quoted are fair and proper and
are not tainted by any collusion, conspiracy, connivance or unlawful agreement on the
part of CONTRACTOR or any of its agents, representatives, owners, employees, or
parties in interest.
3.8 INTEREST OF MEMBERS, OFFICERS, EMPLOYEES OF PUBLIC BODY,
MEMBERS OF LOCAL GOVERNING BODY, OR OTHER PUBLIC OFFICIALS. No
member, officer, or employee of CITY, or its designees or agents, no member of the City
Council, and no other public official of CITY during his/her tenure or for one (1) year
thereafter, will have any interest, direct or indirect, in any contract or subcontract, or the
proceeds thereof, for work to be performed in connection with the program assisted under
this Agreement.
3.9 PROHIBITION OF BONUS OR COMMISSION. The assistance provided under this
Agreement will not be used in payment of any bonus or commission for the purpose of
obtaining CITY approval of the application for such assistance.
3.10 STATUTE OF LIMITATIONS. As between the parties to this Agreement, as to all acts
or failures to act by either party to this Agreement, any applicable statute of limitations
will commence to run and any alleged cause of action will be deemed to have accrued in
any and all events when the party commencing said cause of action knew or should have
known of the existence of the subject act(s) or failure(s) to act.
3.11 INDEMNIFICATION. CONTRACTOR will defend, indemnify, and hold CITY, its
successors, assigns, officers, employees and elected officials harmless from and against
all suits, actions, legal proceedings, claims, demands, damages, costs, expenses,
attorney's fees, and any and all other costs or fees arising out of, or incident to,
concerning or resulting from the fault of CONTRACTOR, or CONTRACTOR's agents,
employees, or subcontractors, in the performance of CONTRACTOR's obligations under
this Agreement, no matter how, or to whom, such loss may occur. Nothing herein will be
deemed to limit the rights of CITY or CONTRACTOR (including, but not limited to the
right to seek contribution) against any third party who may be liable for an indemnified
claim.
3.12 CHANGE ORDERS. CONTRACTOR expressly agrees that no material changes or
alterations in the Work Write -Up Bid Document or price provided above will be made
unless in writing, mutually agreed to by the homeowner and CONTRACTOR, and
authorized by CITY.
3.13 TERMS. All references in this Agreement to any particular gender are for convenience
only and will be construed and interpreted to be of the appropriate gender. For the
purposes of this Agreement the term "will" is mandatory.
3.14 SEVERABILITY. Should any provision in this Agreement be found or deemed to be
invalid, this Agreement will be construed as not containing such provision, and all other
4
provisions which are otherwise lawful will remain in full force and effect, and to this end
the provisions of this Agreement are declared to be severable.
3.15 PUBLIC INFORMATION ACT. The CITY is governed by the Texas Public Information
Act, Chapter 552 of the Texas Government Code. This Agreement and all written
information generated under this Agreement may be subject to release under this Act.
3.I6 PERFORMANCE. In performing this Agreement, CONTRACTOR will comply with all
local, state, and federal Iaws.
3.17 LIEN WAIVERS. CONTRACTOR agrees to protect, defend, and indemnify homeowner
and CITY from any claims for unpaid work, labor, or materials with respect to
CONTRACTOR'S performance. Final payment will not be paid until the
CONTRACTOR has delivered to CITY complete release of all liens for work completed
arising out of CONTRACTOR'S performance or a receipt in full, covering all labor and
materials for which a lien could be filed or a bond satisfactory to the homeowner and
CITY indemnifying him against any lien.
3.18 REPORTING REQUIREMENTS. CONTRACTOR agrees to submit a W9 Form,
attached hereto and incorporated herein as Exhibit "B" to fulfill reporting requirements
with the Internal Revenue Service.
ARTICLE 4
SUSPENSION AND TERMINATION
4.1 If CONTRACTOR fails to fulfill in a timely and proper manner its obligations under this
Agreement, or violates any of the terms or conditions of this Agreement, then the
CONTRACTOR will have ten (10) days from the date it receives written notice from
CITY directing it to cure or correct the defects. If CONTRACTOR fails to cure or
correct the defects as required by this agreement, CITY will have the right to terminate
this Agreement and to select a substitute CONTRACTOR. If the expense of finishing the
work exceeds the amount of this Agreement, CONTRACTOR will pay the difference to
CITY. Should CONTRACTOR fail to make corrections as directed by CITY, and such
breach of contract results in a violation of federal law or regulation for which CITY
receives a demand of reimbursement of grant funds from HUD or its successor, CITY
may terminate this Agreement immediately, and may recover from CONTRACTOR the
amount sought by HUD for reimbursement, up to the full amount of funds
CONTRACTOR received from CITY.
4.2 CONTRACTOR will not be relieved of the liability to CITY for damages sustained by
the CITY by virtue of any breach of this Agreement by CONTRACTOR. CITY may
withhold payment to CONTRACTOR until the amount of monetary damages due CITY
from CONTRACTOR is determined.
4.3 If CITY becomes aware of any CONTRACTOR activity which could jeopardize CITY's
position with HUD and cause CITY to return CDBG funds or other federal funds
received by CITY, CITY may take appropriate action, including injunctive relief against
CONTRACTOR, to terminate or prevent the activity. Failure of CITY to exercise this
right will not constitute a waiver by CITY of its right to demand payment or to seek any
other relief in law or in equity to which it may be entitled.
ARTICLE S
PAYMENTS
5.1 For work completed by CONTRACTOR, as described in the Work Write -Up Bid
Document, CITY agrees to pay CONTRACTOR the Contract Amount after all of such
work is found to be satisfactorily completed and is inspected by the Construction Advisor
and CITY Inspector, in accordance with the CITY'S Prompt Payment Policy.
ARTICLE 6
ATTORNEY'S FEES
6.1 Any party to this Agreement who prevails in any legal proceedings between the parties
regarding this Agreement will be entitled to recover court costs and reasonable attorney's
fees from the non -prevailing party.
ARTICLE 7
VENUE AND REMEDIES
7.1 This Agreement is governed by the laws of the State of Texas. Exclusive venue for any
dispute arising under this Agreement is in Williamson County, Texas.
ARTICLE 8
SUCCESSORS AND ASSIGNS
8.1 CITY and CONTRACTOR, respectively, bind themselves, their successors, assigns and
legal representatives to the other party to this Agreement and to the successors, assigns
and legal representatives of the other party with respect to all covenants of this
Agreement. Except for CONTRACTOR'S assignment of mechanic's lien contracts and
mechanic's lien notes to the CITY pursuant to Paragraph 1.7, neither CITY nor
CONTRACTOR will assign, sublet, or transfer any interest in this Agreement without the
written consent of the other party.
ARTICLE 9
ENUMERATION OF CONTRACT DOCUMENTS
9.1 This Agreement represents the entire and integrated agreement between CITY and
CONTRACTOR for the work specified in Exhibit "A" and supersedes all prior
negotiations, representations or agreements either written or oral. This Agreement may
be amended only by written instrument signed by CITY and CONTRACTOR. The
Agreement contains the following exhibits attached to and incorporated in this
Agreement for all purposes:
(I) Work Write -Up Bid Document (Exhibit "A")
(2) W9 Form (Exhibit "B").
C-1
ARTICLE 10
ACKNOWLEDGMENT
10.1 The above warranties are in addition to, and not in limitation of, any and all other rights
and remedies to which CITY and the homeowner, or subsequent owners, may be entitled,
at law or in equity, and will survive the conveyance of title, delivery of possession of the
Property, or other final settlement made by the homeowner and will be binding on the
undersigned notwithstanding any provision to the contrary contained in any instrument
heretofore, and thereafter executed by the homeowner.
This Agreement is effective as of the date first written above.
CONTRACTOR:
B&O Construction
Name
Title
7
CITY:
CITY OF ROUND ROCK
Laurie Hadley, City Manager
EXHIBIT "A"
WORK WRITE-UP BID DOCUMENT
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EXHIBIT "B"
W9 FORM
Fan' W9 Request for Taxpayer (live Form to the QW Ocra4at2018l Identification Number and Certification requester. Do not
send to the IRS.pepanmcrd of trio Twuuxy 6. 00 to svww.Jrs.gov1FcrmW9 for Instructions and the latest information.
In.errwl nocenus Bounce
1 FWme les grown on yew become tax retum). Name is required on tris Goa. do no. lean Paz line panful.
Famum Entorprises, Inc. dba B&O Construction
2 eusiness nsmoromogwood entity name, It urnarerd Gan above
a Chock appropdele box lar federal tax dassikiiikrr al Itra parson whose aeme Is ordered an line 1. Check only one of ft Exampaons (codes appy only to
r following germ boxes entities.certain anstruchord on not 3GrdMduatS: arta
CL
a bo P3uF saw ur 0 C C irporabon ❑ s Caporattar 0 Panrwrsh.p ❑ rnreutrstela Exerrn vp� Cuda Id earl
sin
LLC
Lrtr•ted Wbaty eampamy. Entw tits tax c4tssrlrwtron (C•C eaparstron. 5.5 caporel+an. P•Psnnort<rrrp} ►
p ' Nota: L9prck taw ap{uapnata Iroa in ora I" strove 1011010 lou Clossilrcalron u1 Ilia ernglr•rrrallnber ownor. par nal check Exemption Gan FATCA rupatinp
LLC it tau LLC is o osolsd as it singlo-member LLC Uua Is dleruganled from the owner unless the owner of the LI.Cisof No
"ho LLC Ihsl is not chsreganled tram are ownw lot US. lintwul tax purposes, Ot w+wact. a singtrmemba LLC ural code
A �► is oWegwdod from are owner OMW chock the eppropnate box rot the tax otusificahar er its owner.
ylry+n �r.[r.+.s:...+'►R.' i.a+o� Mur..
Omer sees irrsbucborrsl ►
y 5 Address (mrmbar. sural. and out. or SUNa rr34 Sae hWiructlons. Rrxprastar'a name ark! artdroee #gMxrrs4
16238 Highway 620. Sults F•40S
a City. state, and zm Crude
Austin, TX 78717
7 Lrss accoant numb iro) Imre loptrona4
ff An Ta ager Identifioatlon Number IN
Enter your TIN In Ilse appropriate box. The TIN provided must match ilia name given on Inc 1 1a avoid t3aWat aecrrdty number I�f'''111�fII�IIiiII
backup withholding. For individuals. this Is generally your social sacurlly number (SSN). However, for a _�
residanl nikn. solo proprietor, or disregarded entity, see Ilia instructions for pari I, later, For other
entities. it is your employer identification number (EIN). It you do not have a number, see Now to get a
TW later or
Nota: II she account Is in more than one name. see the instructions lar line 1. Also see What Name and �Employer WaMNieaaon number
Nwntrur To Biter 8w Regtrsster lar guidall nes on whose nstnitiber to anter.
1. l , l _ o o . o a y 7
Under penalties of perjury, I cenl(y that:
1. The number shown on this form is ftry caeca Iaxpayer identification number for I am waiting for a number to be issued to me): and
2.1 am not subject to backup withholding because: (a) I am exempt from backup wilhhoklhng, or (b) I have not been notified by Ilse Internet Revenue
Service ORS) that I am subject to backup whisholdinp as a resud of a failure to report all Miscast at dMdends, or (c) the IRS has notified me that I am
no longer sutt)act to backup withholding: and
3.1 urn a U.S. citizen or other U.S. person (defined below): and
4. The FATCA coda(s) enteiud on this farm pt any) indicallng that I run oxempt from FATCA reporting is correct.
Certification Wtnrotians. You must cross out item 2 above 0 you have been nallhad by the tRS that you aro currently subject to backup wWvxA ung because
you have laded to report all miarest and dividends on your tax tettrm. Far coal estate transactions, dem 2 does not appy. For mortgage interest paid,
acquisdron or abandonment qqQecured propyly. carcaNalian of debt. contributions to an indwidual retirement arrangement fIRA), and gene". payments
other than interest and diy eat% you nt# nVt rogtdred to sign mo cerilfkatlon, but you must provide your corset TIN. See the instructions for Pad 14 later.
Sign signature of
Here u5.penon► r oats► ,�� ,[ �C(
General lnstrubtiofis f
Section references are to the Internal Revenue Code unless etttentnse
noted.
Future developments. For the latest rnlormation about developments
related to Form W9 and its Instructions, such as legislation enacted
after they vara published, no to wrvw.irs.gOWFcrmM-
Purpose of Form
An individual or entity (Form W-8 requester) who is required to fife an
information return with the IRS most obtain your correct taxpayer
Identification number f ntq witIch may be your social security number
(SSM. Individual taxpayer Identification number (MM, adoption
taxpayer identification number (ATIM, or employer Identification numlwr
(EIN). to report an an inlarmahon return the amount paid to you, or other
amount roponable oil an information rotum. Exemtples of Information
returns include, but are not limited to, the following.
• Form 10994NT fintorest earned or paid)
• Falm 1099 -DIV (dhri ! jdl hlahxfung those 1101 stocks or mutual
fund:)
• Form 10994u11SC (various types of Incoma, prizes, awards, or gross
proceeds)
• Fong 1099.8 (slack at mutual fund satus and cartnin other
transactions by brokers)
• Funn 1099-S (prucunrds hunt tool astatu uansactiniui)
• Form 1099-K (marchanl card and third party network transactions)
• Form 1098 (tomo mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1199-C (consoled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Foran W-9 only If you are a U.S. parson (including a resident
align), to provide your correct TIN.
11 you do not relum Form W-9 to the requester with a TIN, you mbghl
be subject to backup tvhhhobdbV See What as backup wilhhoidog,
later.
Cat. No. I023tk Form W-StHev. 10-20181
City of Round Rock
ROUND ROCK
Tom, Agenda Item Summary
Agenda Number:
Title: Consider executing a CDBG Home Repair Homeowner Contract with Mary
Ann De La Vega at 1902 Easton Drive.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 10/25/2019
Dept Director: Brad Wiseman
Cost: d '� 61 89 1 -as
Indexes:
Attachments: 1902 EASTON DRIVE HOMEOWNER AGREEMENT, LAF 1902 EASTON
DRIVE HOMEOWNER AGREEMENT
Department: Planning and Development Services Department
Text of Legislative File CM -2019-0328
Consider execution of a Community Development Block Grant Housing Repair Program
Homeowner Agreement for Mary Ann De La Vega at 1902 Easton Drive Rock, Texas. Ms. De
La Vega has applied and met all requirements to be eligible for the CDBG home repair
program. Improvements to her home include replacement of HVAC system, siding, vent hood,
and some plumbing and electrical repairs. The expected cost of the project is $21,585 and no
more than $26,891.25 with any necessary change orders. Selected contractor is Farnum
Enterprises dba B&O Construction.
City of Round Rock Page 9 PNnted on 10/24/2019