CM-2020-072 - 3/13/2020GOVERNOR 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 off documents to eventsfund@aov.texas. ao_v.
To accommodate large files, secure file transfers are available upon request
Regarding the Events Trust Fund Disbursement Request in the amount of $11,762.00, for the NIRSA National Flag
Football Championships {name of the event} I, Laurie Hadley (name of authorized official}, approve of each cost
submitted for disbursement from the trust fund. I 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
C, 2�'� POST OFFICE BOX 12428 AUSTIN, TEXAS 78711 * 512-936-0100 * cov.TExns.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: Andrea Saiz
Primary Contact Phone Number: 512-218-7021
Primary Contact Email: asaiz@roundrocktexas.gov
Signatory must be someone the applying entity has determined is eligible to bind the applying entity.
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Signature
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Printed Name
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Title Ind Name o Or aniza ion Date
POST OFFICE BOX 12428 AUSTIN, TEXAS 78711 * 512-936-0100 * cov.TEXAS.cov
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Finance A
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Account Number: 71050001-5424
Vendorg 62724
NIRSA SERVICES CORPORATION
4185 SW RESEARCH WAY
CORVALLIS, OR 97333
Needed
Contract NCM20190136
Project ID
or Descri Lion
Contract Paid
Amount to Date
This
Payment
Balance
Remaining
NIRSA NATIONAL FLAG FOOTBALL
11,762.00
0.00
11.762.00
0.00
CHAMPIONSHIPS
Host Partner Agreement
11,762.00
0.00
11,762.00
0.00
CM-2019-0136
RECEIVED JUN 06 2019
YNSC
NIRSA Services Corporation
NIRSA
4165 SW Research Way
Corvallis, OR 97333
Phone:541-766.8211 Fax:541-766-8284
BILL City of Round Rock, Texas
TO: 221 East Main Street
Round Rock, TX 78664
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DESCRIPTION / MEMO
Right Fee for 2019 NIRSA National Flag Football Championships
January 3-5, 2020
CREDIT CARD REMITTANCE
FAX T0: 541.766.8284
j VISA - MASTERCARD -i AMEX o DISCOVER
CREDIT CARD NUMBER: -
PAYMENT AMOUNT: S
CARD HOLDER'S NAME:
SIGNATURE:
INVOICE
INVOICE #: INV-02370
DATE: 05/22/2019
DUE DATE: 06/21/2019
TOTAL AMOUNT: S 11,762.00
BALANCE DUE: $ 11,762.00
AMOUNT
11,762.00
TOTAL AMOUNT: [ $11.762.00
EXPIRATION DATE /
JUN U 2019
S•. ................
Involce Datr: D5/22/2019 Terms: Dur Date: 06)21 /2019 Custamer ID: C-10482
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City of Round Rock
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umber
221 E. Main Street Round Rock, TX 78664 62724
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Phn. (512) 218-5400
M�1�
PaY Forty Six Thousand Seven Hundred Sixty Two Dollars and 00 cents'#"'""
To The NIRSA SERVICES CORP
Order Of 4185 SW RESEARCH WAY
CORVALLIS, OR 97333
City of Round Rock, Round Rock, TX 78664 Page 1 of 1
Check Check
Dale Number
06/14/2019 10047558
$46,762.00
FILE COPY
NON-NEGOTIABLE
Check Number. 10047568
Invoice Date
' _Invoice_Number—
Desc
Invoice Amount
05122/2019
INV-02370
HOST PARTNER FLAG FTBALL CM-2019-0136
$11,762.00
___-- DOC 1D# 106703
05/22/2019
INV-02369
HOST PARTNER NATL SOCCER CM-2019-0117
$35,000,00
DOC ID# 106704
Vendor No: - "- Vendor Name
Check No.
Check Date
C_ heck Amount _
62724 NIRSA SERVICES CORP
1004755E
06/14/2019
$46,762.00
City of Round Rock
?ROUND R°`K Agenda Item Summary
Agenda Number:
Title: Consider authorizing an Events Trust Fund Disbursement Request in
association with the NIRSA National Flag Football Championships at the
Round Rock Multipurpose Complex.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 3/13/2020
Dept Director: Susan Morgan, CFO
Cost:
Indexes:
Attachments: Nirsa Flag Football - Disbursement Packet
Department: Finance Department
Text of Legislative File CM-2020-072
Consider authorizing an Events Trust Fund Disbursement Request in association with the
NIRSA National Flag Football Championships at the Round Rock Multipurpose 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 May 2019 on CM-2019-0136.
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 the NIRSA National Flag
Football Championships, held at the Round Rock Multipurpose Complex from
01/03/20-01/05/2020. The disbursement amount being requested is $11,762.00.
City of Round Rock Page 7 Printed on 3n=020