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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. — A­4eL�u Signature Laur(e- z1WV/ey Printed Name 3�/,5_ 2b20 Title Ind Name o Or aniza ion Date POST OFFICE BOX 12428 AUSTIN, TEXAS 78711 * 512-936-0100 * cov.TEXAS.cov § � k o �$ q}N ■ fig; w lu LL f 4 1 3 3 ■. § � � \ >. \ § ■ | > . - L ■ § 2 ° — ■ '� :2 k =� LU � (K 7 >� a • >.;2U-6 ---C 7 G CD; §�2 ~ �k §k 2G lu of .. 4 w. � / torN s&u /u■ k � ■� �Ecn uJ k � ) ■ u ) � — acr C 2 E B § / J LM c 2 ' § E k ■ a; u_�. a= t § . § Ell I 0(o I "D3 ([/I Finance A sc 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 m C SZLI � d vb to vutidov Ua12,c4 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 Miff 11o'4Q D p City of Round Rock �ilk Z NVendGr umber 221 E. Main Street Round Rock, TX 78664 62724 aJ 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