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Contract - Silsbee Ford - 5/27/2021A. PRODUCT PRICING SUMMARY COODBOV 21 - S OOO VEHICLE'S VENDOR --Silsbee Ford, 1211 Hwy 96 N., Silsbee TX 77656 End User: CIT)' Of ROUND ROCK Contact: SC01T PARKER Email: Product Description: 2021 I'ORD INTERCEPTOR UTILITY AWD Bid Item: Prepared by: GLEN ANGEU r Phone: 409-880-9191 Email: range!1e.cowboyf1eet@Qmat1_com Date: April 22, 2021 A. Rase Price: 1 S 32,932.00 Code Options Bid Price Code Options Bid Price 99B 3.3L V6 $ - EX F 131 .A¢: K 17A REAR A/C 1 610.00 INT C.I.0111 HI'C KETSIRFAR VINYL 51R LED SPOTLIGHTS $ 360.00 SYNC (11AND FREE) 60A GRILL WIRING $ 50.00 4 KFYS 86T RR TAILLAMP HSG. $ 60.00 CRUISE 55F KEYLESS ENTRY $ 340.00 SYNC (HAND FREE) PRE DRILLED HEADLAMP HOUSING POWER WINDOWS/LUCKS AN1/FNI/CD/ REAR CAMERA Togal of R. Published Options:1 S 1,420.001 Published Option Discount (5%) S (71.00) r' �rlr�itinn�l flntinnc Innr to PYrPo(t 790/ni W&= 0_5 0/0 Options Bid Price Options Bid Price 2 YR. REG 3: DOC FEE S 166.75 DISCOUNT $ (92.00) INSTALL RADIO 5 112.00 K. L- Floor Plan Interest (for in -stock and/or equipped vehicles): Lot Insurance (for in -stock and/or equipped vehicles): Contract Price Adjustment: FNDWENCY EQi1iPMC-NT Additional Delivery Charge: 295 miles Subtotal: Quantity Ordered I K = Trade in: GOODBUY Administrative Fee (S300 per purchase order) TOTAL PURCHASE PRICE INCLUDING GOODBUY FEE Tovil of C. Unpublished Options:1 S 186.75 1 S - 5 - S 17,674.47 $ 516.25 S 52,658.47 S 52,658.47 S - S 300.00 S 52,958.47 R-2o2t-lam c.00uBur° 21 4, gorr"0o0"o vtiHico.Es Vf•.nIDOEB--Siisbcc Fora9, l2S l Iles•a• 9G N.., Siisbec 7'X 77GSG End User: CITY ()F NO.'PdD ROCK Contact: SCOYT PAR6:iR �n:aiB: 1°roduct Description: 2GD2i FORD INTL•'RCrP1U[d IfTILI'I�Y AWI') A. Bid Item: B. F.acton O mons Code O 2 tioaas 99B J.3L V6 5 IIA REAR A/C S S1K LEUSPOTI.IGII"CS S 60A GltILL WIRING E MUM KGT RR 1AILLAM11 I IS,: $ SSF KEYLESS ENl RY PRE DRILLED }il'k'aLAMP HOUSING PUWER iL'INUUWtiI.(iC:KS AM/FM/CD! REAR ("AMtRA C. A(IdlCi011AI Options IIBuI IU!%Ctpd ZS%I O 2flows z vR. rirc. & roc FEE s INSTALL ezAnco S Prepared by: Gi.L:N ANGF.I.I.1' Phone: 409-880-9191 C Email: qanq�lie.co�vbovfleet(ai4mael corn 22, 2021 Date: April A. Bose Price: $ 329932.U0 Bid Price EX'1' BLACK GIO.UO IN7'CLOTH BiJCKE'I'SJREAii VINYL 3(i4D.U0 SYNC (HAND FREE) 5D,i30 4 Kf:Y3 Gn.00 CRU(SF 390.W SYNC (iIAiJD fRF:f:I Total of B. Published Opfaons:L$ Published Option Discount (5°/,) S = (71.00) S= 0.5 % Bid Prate O'cions Bid Price 16G.75 DISC(DUN F S 192.001 M=Z2C=C2Z2== i f 2.00 Tot11 of C. Unpublished Options:[ S 186.75 [a A a rloor Plea, Interest (food iii-stick and/or equipped vehicles).,0 Lot Insurance (for in-s-tock vin4l/or equipped vehicles): Co11tr.fCt Price AdjllstfTBtnt: G. At,dittowa! Delivery Charge: 295 H. Sfl,biutsd: la Qu.intity- Ordered U 1� X T rip i d e in : C;()DBU1' r8cln,;ni s f r adifive rice {5300 per purcbv.ige order) Le "1*01"'Al., PURCHASE PRICE INCLUDING GOODBI V FFE --------------- --------------------- .... .... . . . ------ ------------- ------------- ------------------- ........... CERTIF1CATE i3F INTERESTED PARTIES. FORM 1295 ---------- ........... ----------------------------- ---------- --------- ---------- ----- ------------- . . . . ........ .. ............. . ... .............. ......... .... .. . ......... ........ .......... .. . ............ � CoInplete Nos. 1 4 and 6 if there are interestedpar#i�s. OFFICE USEONLY Cumofete Nos. 1., 2, 3, 5, and 6 it. there art: po interested payt>es. CERi'1F1CaTiON C)F FILING .... .. . .... .. .............. . ....... ... ... - ----------- - ------- ---- ----- WNW . :I Name of business entity filing form,and the.city, s tat e a ndcountry of .the.businessentityptace' �s Certificate Number;- :2021-738371 of business. SILSBEE FORD Beaumont, TX United States aateFfled; . . ............... . .......... ------ 1, 2 iVane o goveentity .ovwr_ ,state%10,94.W. agency 't1iaf is a _1WIIA e .o....n....... r,act.whIzntne�orm:'ts 014'202 being,filed., :_Date Acknowledged. CITY OF ROUND ROCK ........... . .......... ...... --- -- ------------------------ ------------- -- ------------ ----- ------- ...... ............. ... ------------------ -- ...... --------------- __ N..-M. ..0 to track or identify t'he contract, and provide a .3 s 3 h�pv the enfity -or state agencyProvide the "dentification - e.r.m.o.wid description of the services, goods, or other property to be provided under the contract, GOOD, -BUY CONTRACT 21-8F000 PURCHASE mOF POLICE VEHICLES - - - --------------------- --- .... ... . .. - — ------------------------- --------------------- ------- Nature of interest 4 Name *f tnteresied Party City, State, Country (place of business) (check applicable.)IControfflhg ntermedla.............. ........................ ...............------- ------------ ------...... .. ..... ... . JASPER, �TX United States x C�O'NAI.SON, DREW . ...... ... .. ....... . . .......... . ..... .......... ....... ... . ............ ................... ... ...... . ...... . ........ ..... ------ --------- .......... ------ --- ---------- -------------- MOOM --------- --------------------------- -- ...... ------- ----- ........ ......... .... . .. ...... . . . . ... . . . ... ... ...... ----------- - ------- - - - -------------- --------------- ....... --------------- 6*11000,000 i ------------ -- -------- ------- . . ........ ..... .... . .. ... . ... ......... .............. . .......... ------------------------ ------ --- ---- ---------------- ---------------------------------- ........... .... . ........ . ... .. . . ........................... ......... --------------- . ---------------------- ------------------------------------- ----------------- ---- .. ... ...... .... ................ . . . ...... . Mob" ........................ ...... . .......... .. ....... ........ ........ -------- .............. woo= ........... ............ ........... ........... ........ ........ ... .. . . . . . . . . . . . .... .... ....... .... .. -------- ----- -- -- - ------------- ---- - - ------- --------- . A ---- ----------------------------- -- -------- ----- -- ---- ----- - ....... . . . . . . . . . . . ------- ----- ...... ... ... ........ ... - — ---- — ----- ------ --- --- .. ....... . .... ... .... . ......... ------------------ -- ---- ------ -- -------------- -- -- ....... ------------------------ -0-0— OilOkowv- ..........-------- .............. . . . . . . . .... 5 Check only if there is Nt) Interested, Party., . .............. ..................... ... . .... . ............ ...... ... --------------- 04.. ---------- ..... . . ------ ---------- .... . .. ....... .......... . ......... E U NS1lVC3RN ---0E.r7-- �RATl0N My[ame is ---------- —MMM, and iv dif tirih i - iow X A oil ........ ... DOOR My address .. . .... Y) % I declare under perialty of perjury that throregaing e is true and r%onred. ....... ... n. ft z3t.; uzn the 00rity" btate 0 1 0 ---- . F W. ------------- -- * VA i In i.-, r ---------------- --- -------------- ... .... ............ - -------- .... ..... -- ----------- ---- - -- ------- ------- . . ..... ... ....... Dow" ......... ... CA Version e i F�i'�•P 1s p34ivido--d by� J'*e- xlents t*�thics ssion CERTIFICATE OF INTERESTED PARTIES FORM 1295 10fl Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos, 1, 2, 39 5, and s 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. 2021-738371 SILSBEE FORD Beaumont, 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 04/14/2021 being filed. CITY OF ROUND ROCK Date Acknowledged: 04/19/2021 g 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. GOOD -BUY CONTRACT 21m8F000 PURCHASE OF POLICE VEHICLES Nature of interest 4 Name of Interested PartyCity,State Country of business) a licable PP Controlling Intermediary DONALSON, DREW JASPER, 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 I - �9 (street) (city) (state) (zip code) (country) 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,ethicsstate,tx,us version vi.i.cenavba