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Contract - Caldwell Country Chevrolet - 11/14/2019 QUOTE# OOAA-SLV CONTRACT PRICING WORKSHEET End User: CITY OF ROUND ROCK Contractor: CALDWELL COUNTRY Contact Name: SCOTT PARKER CALDWELL COUNTRY Email: SPARKER@ROUNDROCKTEXAS.GOV Prepared By: Averyt Knapp Phone #: 512-218-3298 Email: aknapp@caldwellcountry.com 512-844-1248 Fax #: Phone #: 979-567-6116 Location City & State: ROUND ROCK Fax #: 979-567-0853 Date Prepared: OCTOBER 2, 2019 Address: P. 0. Box 27, Caldwell, TX 77836 Contract Number: BUY BOARD #521-16 Tax ID # 14-1856872 Product Description: 2020 CHEVROLET 1500 SILVERADO 4X2 CREW CAB CC10543 A Base Price & Options: $29,440 B Fleet Quote Option: Code Description Cost Code Description Cost 4X2-CREW CAB, LT INCL PACKAGE, 5.3L-V8, 40-20-40 JET BLACK CLOTH INTERIOR, LPO ALL WEATHER TECH OEM GM FLOOR LINER F&R, THREE KEYS & TWO REMOTES GM WARRANTY INCL CALDWELL COUNTRY 5YR/100,000 MILES PO BOX 27 POWERTRAIN @ N/C CALDWELL, TEXAS 77836 Subtotal B INCL C Unpublished Options Code Description Cost Code Description Cost Subtotal C D Other Price Adjustments (Installation, Delivery, Etc...) Subtotal D JINCL E Unit Cost Before Fee & Non-Equipment Charges(A+B+C+D) $29,440 Quantity Ordered 1 Subtotal E $29,440 F Non-Equipment Charges (Trade-In, Warranty, Etc...) BUY BOARD FEE $400 G. Color of Vehicle: HAVANA BROWN METALLIC (W/JET BLACK CLOTH) �- lq'oq-t6 INTERIOR) H. Total Purchase Price (E+F) 1 $29,840 Estimated Delivery Date: 90-120 DAYS APPX QUOTE# OOAA-LT CONTRACT PRICING WORKSHEET End User: CITY OF ROUND ROCK Contractor: CALDWELL COUNTRY Contact Name: SCOTT PARKER CALDWELL COUNTRY Email: SPARKER@ROUNDROCKTEXAS.GOV Prepared By: Averyt Knapp Phone #: 512-218-3298 Email: aknapp@caldwellcountry.com 512-844-1248 Fax #: Phone #: 979-567-6116 Location City & State: ROUND ROCK Fax #: 979-567-0853 Date Prepared: OCTOBER 2, 2019 Address: P. 0. Box 27, Caldwell, TX 77836 Contract Number: BUY BOARD #521-16 Tax ID # 14-1856872 Product Description: 2020 CHEVROLET TAHOE CC15706 A Base Price & Options: $42,975 B Fleet Quote Option: Code Description Cost Code Description Cost LT PACKAGE, 4X2, JET INCL BLACK/DARK ASS LEATHER INTERIOR, LPO ALL WEATHER TECH OEM GM MATS FRONT AND REAR, THREE KEYS AND TWO REMOTES TOTAL GM WARRANTY INCL CALDWELL COUNTRY 5YR/100,000 MILES PO BOX 27 POWERTRAIN @ N/C CALDWELL, TEXAS 77836 Subtotal B INCL C Unpublished Options Code Description Cost Code Description Cost Subtotal C D Other Price Adjustments (Installation, Delivery, Etc...) Subtotal D INCL E Unit Cost Before Fee & Non-Equipment Charges(A+B+C+D) $42,975 Quantity Ordered 1 Subtotal E $42,975 F Non-Equipment Charges (Trade-In, Warranty, Etc...) BUY BOARD FEE $400 G. Color of Vehicle: WHITE (W/JET BLACK/DK ASH LEATHER INTERIOR) H. Total Purchase Price (E+F) 1 $43,375 Estimated Delivery Date: 90 DAYS APPX 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. Caldwell Country Chevrolet 2019-557596 Caldwell,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 11/01/2019 being filed. City of Round rock Date Acknowledged: 3 Provide the identification number used by the govemmental 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 Vehicles 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary Way,Stephen Caldwell,TX United States X Hildebrand,Jon Caldwell,TX United States X Knapp,Averyt Caldwell,TX United States X 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is 1&u ky� Mh p _ and my date of birth is My address is -7 l ,�}( -77 (fit) (City) �(-state) (z1p fie) (�oountryy)) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of 1 ��M,� on the ,day of�201 . (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.3a6aaf7d CERTIFICATE OF INTERESTED PARTIES FORM 3.295 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. 2019-557596 Caldwell Country Chevrolet Caldwell,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 11/01/2019 being filed. City of Round rock Date Acknowledged: 11/04/2019 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. 000000 Vehicles 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary Way, Stephen Caldwell,TX United States X Hildebrand ,Jon Caldwell,TX United States X Knapp,Averyt Caldwell, TX United States X 5 Check only if there is NO Interested Party. ❑ 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 V1.1.3a6aaf7d