CM-2026-105 - 4/17/2026 COMMUNITY DEVELOPMENT BLOCK GRANT(CDBG) -
COMMUNITY HOUSING REPAIR AND REHABILITATION PROGRAM
CONTRACTOR AGREEMENT
This CDBG Community Housing, Repair and ehabilitation Program Contractor
Agreement (Agreement), is made this `/,142lay of I'd , 2026, between the
CITY OF ROUND ROCK, Texas, 221 East Main Street, ound Rock, Texas ("CITY"), and GN
REMODELING,LLC, 183 Balch Road, Elgin, Texas 78621 ("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 issued its "Invitation for Bid" for the provision of such labor, materials
and equipment; and
WHEREAS, CITY has determined that the CONTRACTOR is the lowest responsible
bidder; and
WHEREAS, CITY will pay CONTRACTOR for labor, materials and equipment to be
utilized in the rehabilitation of MESA RIDGE SEC 1, BLOCK H, LOT 1, Williamson County,
Texas, also known as 1509 London Road, Round Rock, Texas 78664 (the "Property"), as
specified in the CITY'S Invitation for Bid designated IFB No. 26-009 and CONTRACTOR's BID
RESPONSE for CDBG Home Repairs—Location#1 (collectively the"Bid Documents"), attached
hereto and incorporated herein as Exhibit"A,"by reference for all purposes;
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 Twenty Thousand Four Hundred Fifty and No/100
($20,450.00) ("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 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
etti2-02Ce
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
2023 Community Housing Repair and Rehabilitation Program Policies and Procedures.
1.3 CONTRACTOR will not deviate from the work described in the Bid Documents without a
change order from CITY. Any such change order will be included in 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$5,112.50.
1.5 All work specified in the Bid Documents will be satisfactorily completed within ninety
(90) days from the date of the Notice to Proceed.
1.6 There shall be no Bid Document line item deletions.
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 Bid Documents, 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 Bid Documents 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 termination 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
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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 Bid Documents,
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 Bid Documents, attached
hereto and incorporated herein as Exhibit "A" and that such 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
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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 Bid Documents 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 Bid Documents or price provided above will be made unless in writing,
mutually agreed to by the homeowner and CONTRACTOR, and authorized by CITY.
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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
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.
3.16 PERFORMANCE. In performing this Agreement, CONTRACTOR will comply with all
local, state, and federal laws.
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.
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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 5
PAYMENTS
5.1 For work completed by CONTRACTOR, as described in the Bid Documents, 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
COMPLIANCE WITH LAWS,CHARTERS AND ORDINANCES
8.1 CONTRACTOR, its agents, employees and subcontractors shall use best efforts to
comply with applicable federal and state laws, the Charter and Ordinances of the CITY,
as amended, and with all applicable rules and regulations promulgated by local, state and
national boards,bureaus and agencies.
8.2 In accordance with Chapter 2271, Texas Government Code, a governmental entity may
not enter into a contract with a company for goods and services unless the contract
contains written verification from the company that it: (1) does not boycott Israel; and(2)
will not boycott Israel during the term of this Agreement. The signatory executing this
Agreement on behalf of CONTRACTOR verifies CONTRACTOR does not boycott
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Israel and will not boycott Israel during the term of this Agreement.
ARTICLE 9
SUCCESSORS AND ASSIGNS
9.1 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 10
ENUMERATION OF CONTRACT DOCUMENTS
10.1 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:
(1) Bid Document(Exhibit"A")
(2) W9 Form(Exhibit"B").
ARTICLE 11
ACKNOWLEDGMENT
11.1 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.
[Signatures on the following page.]
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This Agreement is effective as of the date first written above.
CONTRACTOR: CITY:
GN REMODELING, LLC CITY OF ROUND ROCK
J.-A) M Nub
Name B .o�cs Bennett, City M er
Owner
Title
8
EXHIBIT"A"
BID DOCUMENTS
9
Exhibit "A"
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ROUND ROCK TEXAS
PURCHASING DIVISION
City of Round Rock, Texas
Purchasing Division
221 East Main Street
Round Rock, Texas 78664-5299
www.roundrocktexas.gov
INVITATION FOR BID (IFB)
COMMUNITY DEVELOPMENT BLOCK GRANT
(CDBG) HOME REPAIRS
SOLICITATION NUMBER 26-009
FEBRUARY 2026
Exhibit "A"
City of Round Rock
Community Development Block Grant(CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
COMMUNITY DEVELOPMENT BLOCK GRANT(CDBG) HOME REPAIRS
PART I
GENERAL REQUIREMENTS
1. INTRODUCTION: The City of Round Rock, hereinafter"the City," seeks bids from firms experienced in
home repair to provide all material, labor, and services to repair three(3) residential homes in accordance
with the Federal Community Development Block Grant (CDBG) Program.
The City of Round Rock Home Repair Program is a Community Development Block Grant (CDBG) Housing
and Urban Development (HUD)-funded program. The primary program objectives are to make health and
safety-related repairs to owner-occupied homes, giving priority to very low-income applicants, income-
eligible elderly, and disabled occupants.
2. SOLICITATION PACKET: This solicitation packet is comprised of the following-
Description Index
Part I—General Requirements Page(s)2-6
Part II —Definitions, Standard Terms and Conditions, and Insurance Page 7
Requirements
Part III—Supplemental Terms and Conditions Page(s) 8-9
Part IV—Scope of Work/Specifications Page(s) 10
Attachment A—Reference Sheet Separate Attachment
Attachment B—Subcontractor Information Form Separate Attachment
Attachment C—Bid Sheet Separate Attachment
Attachment D—Prevailing Wage Rates Separate Attachment
Attachment E-Location#1 Separate Attachment
Attachment F- Location#2 Separate Attachment
Attachment G-Location#3 Separate Attachment
Attachment H-CDBG Federal Requirements Separate Attachment
Attachment I -SAM Registration Separate Attachment
Attachment J - Debarment Certification Separate Attachment
Attachment K-W-9 Form Separate Attachment
Attachment L-Conflict of Interest Affidavit and Info Separate Attachment
Attachment M -Equal Employment Certification Separate Attachment
Attachment N-Clean Air and Water Certification Separate Attachment
Attachment 0-Certification of Non-Lobbying Separate Attachment
Attachment P- Non-Collusion Affidavit Separate Attachment
Page 2 of 10
Exhibit "A"
City of Round Rock
Community Development Block Grant (CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
Attachment Q-MBE WBE Information and Worksheet Separate Attachment
Attachment R- Section 3 FAQ and Certification Separate Attachment
3. SCHEDULE OF EVENTS: It is the City's intention to follow the solicitation timeline below.
EVENT DATE
Solicitation released Wednesday 02/18/2026 3:00 PM CST
Mandatory Pre-Bid meeting/site visit Tuesday 02/24/2026 9:00 AM CST
Deadline for submission of questions Friday 02/27/2026 5:00 PM CST
DEADLINE FOR SUBMISSIONS Monday 03/11/02/2026 2:00 PM CST
Deadline to evaluate submissions Friday 03/18/2026 5:00 PM CST
All questions regarding the solicitation shall be submitted through Bonfire by 5:00 PM, CST on the due date
noted above. A copy of all questions submitted and the City's response to the questions shall be posted on
the City's webpage in the form of an addendum at:
https://roundrocktexas.bonfirehub.com
The City reserves the right to modify these dates. Notice of date change will be posted to the City's website:
https://roundrocktexas.bonfirehub.com
4. SOLICITATION UPDATES: Respondents shall be responsible for monitoring the City's website at
https://roundrocktexas.bonfirehub.com for any updates pertaining to the solicitation described herein. Various
updates may include addendums, cancellations, notifications, and any other pertinent information necessary
for the submission of a correct and accurate response. The City will not be held responsible for any further
communication beyond updating the website.
5. MANDATORY PRE-PROPOSAL MEETING, SITE VISIT, AND/OR INSPECTION: A pre-bid meeting/site visit,
and inspection will be conducted to fully acquaint Respondents with the facilities, difficulties, and/or
restrictions inherent in the services specified. The pre-proposal meeting/site visit will be conducted on the
date specified in PART I, Section 3-Schedule of Events.
A. Attendance at the pre-bid meeting/site visit is mandatory. Respondents shall sign-in at the pre-bid
meeting to document their attendance. Immediately following the pre-bid meeting, a site visit tour will be
conducted to enable Respondents to determine labor, equipment, supplies and materials necessary to
perform the services specified herein. Respondents shall sign-in at each site of the tour to document
their attendance. The City reserves the right to determine a response"not available for award" if the
Respondent fails to attend the mandatory pre-bid meeting and site visit tour which shall initially begin at:
City Hall Council Chambers
221 East Main Street
Round Rock, Texas 78664
B. Respondents will be responsible for their own transportation for the site visit tour.
C. Respondents are strongly encouraged to bring a copy of the solicitation document with them to the pre-
proposal meeting /site visit.
D. It is the responsibility of the Respondent to examine each facility and determine quantity, amounts, take
precise measurements, determine material requirements, equipment requirements, labor requirements
and other solicitation related details during said site visits.
Page 3 of 10
Exhibit "A"
City of Round Rock
Community Development Block Grant(CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
6. RESPONSE DUE DATE: Appropriately submitted responses are due at or before 2:00 PM, on the due date
noted in PART I, Section 3—Schedule of Events. The Offeror shall respond via the City's electronic bidding
platform, Bonfire: https://roundrocktexas.bonfirehub.com
A. This Invitation for Bid (IFB) does not commit the City to contract for any supply or service.
B. No paper or submittals outside of Bonfire will be accepted by the City.
C. Responses cannot be altered or amended after digital opening.
D. No response can be withdrawn after opening without written approval from the City for an acceptable
reason.
E. The City will not be bound by any oral statement or offer made contrary to the written specifications.
F. Samples and/or copies shall be provided at the Respondent's expense and shall become the property of
the City.
7. RESPONDENT QUALIFICATIONS: The City has established the following minimum qualifications.
Respondents who do not meet the minimum qualifications will not be considered for award. The Respondent
shall:
A. Be firms, corporations, individuals, or partnerships normally engaged in providing CDBG home repairs as
specified herein and have adequate organization, facilities, equipment, financial capability, and personnel
to ensure prompt and efficient service to the City.
B. In order to confirm financial stability, the City may choose to review audited financial statements at any
time throughout the IFB evaluation process. Upon request, the Respondent shall provide two years audited
financial statements, including any notes or supplemental schedules within 2 business days of the original
request.
C. Be domiciled in or have a home office inside the United States. Respondents domiciled outside the United
States, or not having a home office inside the United States will not be included for consideration in this
IFB process.
In order to do business with the City of Round Rock you must be registered with the City's Vendor Database.
To register, go to: https://roundrocktxvendors.munisselfservice.comNendors/default.aspx
8. RESPONSE REQUIREMENTS: The Respondent, by electronically submitting their Offer, acknowledges that
he/she is an authorized representative of the Vendor, has received and read the entire document packet
sections defined above including all documents incorporated by reference, and agrees to be bound by the
terms therein. The Respondent shall include the following information with their bid response:
❑ Attachment A—Reference Sheet
❑ Attachment B—Subcontractor Information Form
❑ Attachment C—Bid Sheet
❑ Attachments I-R
❑ Acknowledged Addenda(if applicable)
❑ Acknowledgment that the respondent is located within Central Texas
9. BEST VALUE EVALUATION AND CRITERIA: The City reserves the right to reject any or all responses, or to
accept any response deemed most advantageous, or to waive any irregularities or informalities in the
response received that best serves the interest and at the sole discretion of the City. All solicitations received
may be evaluated based on the best value for the City. In determining best value, the City may consider:
A. Purchase price.
B. Reputation of Respondent and of Respondent's goods and services.
C. Quality of the Respondent's goods and services.
D. The extent to which the goods and services meet the City's needs.
E. Respondent's past performance with the City.
F. The total long-term cost to the City to acquire the Respondent's goods or services.
G. Any relevant criteria specifically listed in the solicitation.
Page 4 of 10
Exhibit "A"
City of Round Rock
Community Development Block Grant(CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
H. If the solicitation is evaluated with points, the respondent must earn a minimum of 15 points on criteria not
related to cost in order to be considered for contract award.
Respondents may be contacted for clarification of bid and/or to discuss details of the services they are
proposing.
10. CERTIFICATE OF INTERESTED PARTIES: Section 2252.908 of the Texas Government Code requires the
successful offeror to complete a Form 1295"Certificate of Interested Parties"that is signed for a contract
award requiring council authorization. The"Certificate of Interested Parties"form must be completed on the
Texas Ethics Commission website, printed, signed, and submitted to the City by the authorized agent of the
Business Entity with acknowledgment that disclosure is made under oath and under penalty of perjury prior to
final contract execution. Link to Texas Ethics Commission Webpage:
https://www.ethics.state.tx.us/whatsnew/elf info form1295.htm
11. EX PARTE COMMUNICATION: Please note that to ensure the proper and fair evaluation of a bid, the City of
Round Rock prohibits ex parte communication (e.g., unsolicited) initiated by the Bidder to the City Official,
Employee, City Consultant, or Evaluation Team member evaluating or considering the bids prior to the time a
bid decision has been made. Communication between Bidder and the City will be initiated by the appropriate
City Official or Employee in order to obtain information or clarification needed to develop a proper and
accurate evaluation of the bid. Ex parte communication may be grounds for disqualifying the offending Bidder
from consideration or award of the bid then in evaluation, or any future bid.
12. OPPORTUNITY TO PROTEST: The Purchasing Manager for the City of Round Rock ("City"), in consultation
with the City Attorney, shall have the authority to settle or resolve any dispute concerning the solicitation or
award of a contract. The Purchasing Manager may solicit written responses to the protest from other
interested parties. The aggrieved person must prepare his or her complaint in writing and send it by
electronic mail to the City's Purchasing Department at protest@roundrocktexas.gov.
In the event of a timely protest, the City shall not proceed further with the solicitation or award of a contract
unless it is determined that the award must take place without delay, to protect the best interests of the City.
The procedures for notifying the City of an alleged deficiency or filing a protest are listed below. If you fail to
comply with any of these requirements, the Purchasing Office may dismiss your complaint or protest.
A. Prior to Offer Due Date: If you are a prospective offeror for the award of a contract("Offeror") and you
become aware of the facts regarding what you believe is a deficiency in the solicitation process before the
due date for receipt of offers in response to a solicitation ("Offers"), you must notify the City in writing of
the alleged deficiency before that date, giving the City an opportunity to resolve the situation prior to the
Offer due date.
B. After Offer Due Date: If you submit an Offer to the City and you believe that there has been a deficiency
in the solicitation process or the award, you have the opportunity to protest the solicitation process, or the
recommended award as follows:
i. You must file a written notice of your intent to protest within four(4)working days of the date that you
know or should have known of the facts relating to the protest. If you do not file a written notice of
intent within this time, you have waived all rights to protest the solicitation process or the award.
ii. You must file your formal written protest within ten (10)working days of the date that you know or
should have known of the facts relating to the protest unless you know of the facts before the Offer
has been closed. If you know of the facts before those dates, you must notify the City as stated in
section (A) above.
iii. You must submit your protest in writing and must include the following information:
a. your name, address, telephone number, and email address.
b. the solicitation number.
c. a specific identification of the statutory or regulatory provision that you are alleging has been
violated.
d. a detailed statement of the factual grounds for your protest, including copies of any relevant
documents.
e. a statement of any issues of law or fact that you contend must be resolved; and
f. a statement of the argument and authority that you offer in support of your protest.
iv. Your protest must be concise and presented logically and factually to help with the City's review.
Page 5 of 10
Exhibit "A"
City of Round Rock
Community Development Block Grant(CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
C. Receipt of Timely Protest: When the City receives a timely and complete written protest, the Purchasing
Manager, with assistance from the City Attorney, shall make one of the following determinations:
i. Determine that a violation of rules and statutes has occurred prior to the award of the contract and
inform you and other interested parties of the determination. The City will prepare updated solicitation
documents and will re-solicit.
ii. Determine that no violation of rules or statutes has occurred and inform you and other interested
parties of the decision by letter. The reasons for the determination will be presented in the letter.
iii. Determine that a violation of rules and statutes has occurred after the award of the contract and
inform you and other interested parties of the determination. However, the awarded contract will not
be canceled. As needed, corrective actions may be taken with purchasing or any other pertinent City
staff.
iv. A determination will usually be made within fifteen (15) business days after receipt of the formal
protest.
v. Any written decisions by the Purchasing Manager shall be the final administrative action for
the City.
All documentation pertaining to a protest will be kept on file at the City and are subject to open records
requests.
Page 6 of 10
Exhibit "A"
City of Round Rock
Community Development Block Grant(CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
PART II
DEFINITIONS, STANDARD TERMS AND CONDITIONS
AND INSURANCE REQUIREMENTS
1. DEFINITIONS, STANDARD TERMS AND CONDITIONS: By submitting a response to this solicitation, the
Respondent agrees that the City's Definitions and Standard Terms and Conditions, in effect at the time of
release of the solicitation, shall govern unless specifically provided otherwise in a separate agreement or on
the face of a purchase order. These can be obtained from the City's website at:
https://www.roundrocktexas.gov/city-departments/purchasinq/. In addition, the Supplemental Terms and
Conditions listed in Section III, shall also be enforced as part of the contract.
2. INSURANCE: The Respondent shall meet or exceed all insurance requirements set forth in Standard
Insurance Requirements. The City's Standard Insurance Requirements document can be viewed and
downloaded from the City's website at: https://www.roundrocktexas.gov/city-departments/purchasing/
Page 7 of 10
Exhibit "A"
City of Round Rock
Community Development Block Grant(CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
PART III
SUPPLEMENTAL TERMS AND CONDITIONS
1. AGREEMENT TERM: The term of the Agreement shall begin from date of award and shall remain in full
force until inspection and acceptance of the completed project.
2. SUBCONTRACTORS If Subcontractors will be used the Respondent is required to complete and submit with
their proposal response Attachment B: Subcontractor Information Form. The Contractor shall be fully
responsible to the City for all acts and omissions of the Subcontractors just as the Contractor is responsible
for the Contractors own acts and omissions. The Contractor shall:
A. Require that all deliverables to be provided by the Subcontractor be provided in strict accordance with the
provisions, specifications, and terms of the Contract.
B. Require that all Subcontractors obtain and maintain, throughout the term of their agreement, primary
insurance in the type and amounts specified for the Contractor, with the City being named as an
additional insured; and
C. Require that the Subcontractor indemnify and hold the City harmless to the same extent as the Contractor
is required to indemnify the City.
D. Awarded Contractor is required to submit a list of all subcontractors for approval by the City prior to use of
any subcontractors throughout the term of the contract.
3. PREVAILING WAGE: Pursuant to Chapter 2258 of the Texas Government Code, a worker employed on a
public work project by a city must be paid: (1) not less than the general prevailing wage rate of per diem
wages for work of a similar character in the locality in which the work is performed; and (2) not less than the
general prevailing rate of per diem wages for legal holiday and overtime work. In accordance with Chapter
2258.022, the City adopted through Resolution No. R-2016-3760 the wage rates set forth by the Texas
Workforce Commission for the Austin-Round Rock Area as the general prevailing wage rate for the City's
public works contracts.A contractor or subcontractor who is awarded a contract by the City shall pay not less
than the rates set forth in Attachment D and comply with all applicable sections of Chapter 2258.
Attachment D—Prevailing Rates are posted in this Solicitation Document on the Bonfire Portal
https://roundrocktexas.bonfirehub.com
4. SAFETY: The City reserves the right to remove any employee from City property for violation of federal,
state, and local health, safety and environmental laws, ordinances, rules, and regulations. The Respondent
shall:
A. Ensure that all employees comply with all Occupational Safety and Health Administration (OSHA), State
and City safety and occupational health standards and other applicable federal, state, and local health,
safety, and environmental laws ordinances, rules, and regulations in the performance of these services.
B. Be held responsible for the safety of their employees and unsafe acts or conditions that may cause injury
or damage to any persons or property within and around the work site. In case of conflict, the most
stringent safety requirement shall govern.
C. Indemnify and hold the City harmless from and against all claims, demands, suits, actions,judgments,
fines penalties and liability of every kind arising from the breach of the Contractor's obligations under this
paragraph.
5. WORKFORCE: Successful Respondent shall:
A. Ensure Respondent's employees perform the services in a timely, professional, and efficient manner.
B. Ensure Respondent's employees, while working on City property, wear a company uniform that clearly
identifies them as the Respondent's employee.
C. Employ all personnel for work in accordance with the requirements set forth by the United States
Department of Labor. The City reserves the right to verify citizenship or right to work in the United States.
Page 8 of 10
Exhibit "A"
City of Round Rock
Community Development Block Grant(CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
6. PRICING: The Respondent shall determine and submit a fixed cost for the work and shall include all
incidental costs, labor, overhead charges, travel, payroll expenses, freight, equipment acquisition and
maintenance, demurrage, fuel surcharges, delivery charges, costs associated with obtaining permits,
insurance, bonds, and risk management. No separate line-item charges shall be permitted for either
response or invoice purposes.
7. ACCEPTANCE/INSPECTION: Acceptance/Inspection should not take more than five(5)working days. The
Contractor will be notified within the time frame if the services delivered are not in full compliance with the
specifications. In the event the services are not performed to the satisfaction of the City the Contractor shall
agree to reperform services to specification at no additional cost to the City. If any agreement or purchase
order is cancelled for non-acceptance, the needed services may be purchased elsewhere.
8. PERFORMANCE REVIEW: The City reserves the right to review the awarded Contractor's performance
anytime during the contract term.
9. ORDER QUANTITY: The quantities shown on the solicitation are estimates only. No guarantee of any
minimum or maximum purchase is made or implied. The City will only order the services/goods needed to
satisfy requirements within budgetary constraints, which may be more or less than indicated.
10. AWARD: The City reserves the right to enter into an Agreement or a Purchase Order with a single award,
split award, primary and secondary award, non-award, or use any combination that best serves the interest
and at the sole discretion of the City. Respondents to the solicitation will be notified when City staff
recommendation of award has been made. The award announcement will be posted to the City's website at
https://roundrocktexas.bonfirehub.com once City Council has approved the recommendation of award and the
agreement has been executed.
11. POST AWARD MEETING: The City and successful Respondent(s) may have a post award meeting to
discuss, but not be limited to the following:
A. The method to provide a smooth and orderly transition of services performed from the current contractor.
B. Provide City contact(s) information for implementation of agreement.
C. Identify specific milestones, goals, and strategies to meet objectives.
12. POINT OF CONTACT/ DESIGNATED REPRESENTATIVE:
A. Contractor's point of contact: In order to maintain consistent standards of quality work performed
across the City, the City shall be provided with a designated and identified point of contact upon award of
the contract to include contact information. The City's designated representative shall be notified by the
Respondent immediately should the point of contact change.
B. The City's designated representative: The City's designated representative shall be:
Elizabeth Alvarado
Coordinator-CDBG
Community& Neighborhood Services
Phone: 512-341-3328
E-mail: ealvaradoroundrocktexas.gov
C. Do not contact the individual listed above with questions or comments regarding this solicitation during
the solicitation process.
Page 9 of 10
Exhibit "A"
City of Round Rock
Community Development Block Grant(CDBG) Home Repairs
IFB 26-009
Commodity Code: 909-62
February 2026
PART IV
SCOPE OF WORK
1. INTRODUCTION: The City of Round Rock seeks to contract with qualified Contractors to provide all material,
labor, and services to repair residential homes in accordance with the Federal Community Development Block
Grant Program (CDBG).
2. PURPOSE: This Invitation for Bid describes services to repair the exterior and/or interior of residential
structures as identified on the bid sheet provided herein. Services shall include, but not be limited to,
repairing, or replacing flooring, countertops, fixtures, tile work, flooring, sheet rock, plumbing, HVAC, outdoor
siding, roof, and other residential items. Repairs made shall ensure contracted work meets all applicable
Federal, State, and Local building codes.
3. CONTRACTOR RESPONSIBILITIES:The Contractor shall-
A. Provide all personnel, supplies, and equipment needed to complete specified repairs.
B. Coordinate with the City to develop a project schedule that is mutually agreeable to both parties.
C. Provide a list of responsible representatives with names,titles, addresses of Contractor(s), and
telephone numbers shall be furnished to the City.
D. Be responsible for the reinstallation of any existing items that are required to be removed to
accommodate another repair(i.e., the reinstallation of a toilet that was removed to repair a bathtub).
E. Leave all excess interior and exterior paint with homeowner in sealed containers.
F. Provide remnant or"off market" products that are in new or like new condition. Colors that do not match
existing colors or are a neutral tone shall have the homeowner's approval.
G. Upon completion of the repairs, remove and properly dispose of all containers, surplus material, and
debris from said repairs and leave the site in a clean and orderly condition.
H. All repairs specified within this solicitation shall be completed to a"move-in ready"condition, clean, and
functional.
4. CITY RESPONSIBILITIES:The City will-
A. Provide the addresses of the locations once the Contracts are awarded.
B. Monitor and inspect the home repairs.
C. Coordinate all work and schedule with the successful Contractor(s)and Homeowners.
D. Provide final approval for the required repairs.
E. The City has conducted lead-based paint testing on structures built prior to 1978. Reports of lead-based
paint will be provided for any structure where lead-based paint was detected
Page 10 of 10
Exhibit "A"
ATTACHMENT A
REFERENCE SHEET
PLEASE COMPLETE AND RETURN THIS FORM WITH THE SOLICITATION RESPONSE
SOLICITATION NUMBER: IFB 26-009
RESPONDENT'S NAME: Hector Velascluez DATE 3-09-26
Provide the name, address, telephone number and E-MAIL of at least three(3)valid Municipal,
Government agencies or firms of comparable size that have utilized services that are similar in type and
capacity within the last two(2)years. City of Round Rock references are not applicable. References may
be checked prior to award. If references cannot be confirmed or if any negative responses are received it
may result in the disqualification of submittal.
1. Company's Name Interfaith Action Central Texas
Name of Contact Claire Meade
Title of Contact project Coordinator
E-Mail Address CMeade@interfaithtexas.org
Present Address 901 Trinity St
City, State,Zip Code Austin Tx 78701
Telephone Number (512 ) 739-4323 Fax Number: (
2. Company's Name Austin Urban League
Name of Contact Jovita Lopez
Title of Contact Project Coordinator
E-Mail Address Jovita_lopez@aaul.org
Present Address 8011 Cameron Rd Suite A-101
City, State, Zip Code Austin Tx78754
Telephone Number (737 ) 285-8444 Fax Number: (
3. Company's Name
Name of Contact Cynthia Hernandez
Title of Contact Home Owner(client)
E-Mail Address
Present Address 2100 Riverview St
City, State,Zip Code Austin Tx 78702
Telephone Number (512)698-6874 Fax Number: (
FAILURE TO PROVIDE THE REQUIRED INFORMATION WITH THE SOLICITATION RESPONSE MAY
AUTOMATICALLY DISQUALIFY THE RESPONSE FROM CONSIDERATION FOR AWARD.
Exhibit "A"
ATTACHMENT B
SUBCONTRACTOR INFORMATION FORM
COMPLETE AND RETURN THIS FORM WITH THE SOLICITATION RESPONSE
SOLICITATION NUMBER: IFB-26-009
RESPONDENT'S NAME: _ GN Remodeling LLC DATE: 03/10/26
• CIRCLE ONE - NO, I WILL NOT USE SUBCONTRACTORS ON THIS CONTRACT NO
YES, I INTEND TO USE SUBCONTRACTORS ON THIS CONTRACT YES
If yes complete the information below
1. Subcontractor Name
Name of Contact
E-Mail Address
Address
City, State, Zip Code
Telephone Number ( ) Fax Number: ( )
Describe work to be
performed
Percentage of contract 0/0 work to be performed
2. Subcontractor Name
Name of Contact
Title of Contact
E-Mail Address
Address
City, State, Zip Code
Telephone Number ( ) Fax Number: ( )
Describe work to be
performed
Percentage of contract %
work to be performed
• Add additional pages as needed
Exhibit "A"
Attachment C- Bid Sheet
Solicitation Number: IFB 26-009
Solicitation Description: CDBG HOME REPAIRS
The Respondent represents that they are submitting a binding offer and are authorized to bind the respondent to fully comply with the
solicitation documents contained in IFB No. 26-009 CDBG Home Repairs. The Respondent acknowledges that they have received and read
the entire solicitation packet, attachments, addendums, and all documents incorporated by reference, and agrees to be bound by the terms
therein.
Special Instructions: Be advised that exceptions taken to any portion of the solicitation will jeopardize acceptance of the bid. Alternative bids
will not be considered and unauthorized modifications to the bid sheet format will result in the rejection of the bid. The City reserves the
right to choose which repairs will be completed based on budget and the budget may not include all repairs listed per location.
NOTE: You must bid all line items for a location,there are 3 separate locations.Only 1 contractor will be awarded per location.
Location #1
LINE AREA DESCRIPTION LINE ITEM TOTAL
Exterior
Remove and install new"like"siding or hardie board on all sides of home except
1 Siding rear right side of chimney where there is minimal damage on the backside. $4,600.00
Include required flashing.
2 Fascia Replace fascia on right side only. Paint ALL fascia around entire house(2 coats). $2,600.00
3 Trim Remove old trim and install new trim around front door and back door. Paint to $600.00
match (2 coats)
Windows
4 Garden Window Remove garden window and replace with standard window(40x33)double pane. $700.00
Weatherize(caulk/seal). Include trim and paint(2 coats) if necessary.
•
5 Bay Window The center window pane has a bullet hole. Replace broken pane.Window is $450.00
30x42.
Roof
3 Roof Replace roof with"like"asphalt shingles including roof deck and required flashing. $11,500.00
COMPANY NAME:
GN Remodeling LLC
PRINTED NAME OF
AUTHORIZED Luis M.Nunez
REPRESENTATIVE:
SIGNATURE Luis M.Nunez
PHONE NUMBER: 512-652-8517
EMAIL ADDRESS: Gnremodelingllcna gmail.com
Page 1 of 3
Exhibit "A"
ATTACHMENT D PREVAILING WAGE
2016 ANNUAL TEXAS WORKFORCE COMMISSION
WAGE RATES
Construction and Extraction Occupations Hourly $12.32
First-Line Supervisors of Construction Trades and Extraction Workers Hourly $18.79
Brickmasons and Blockmasons Hourly $20.94
Carpenters Hourly $13.28
Floor Layers, Except Carpet, Wood, and Hard Tile Hourly $12.00
Tile and Marble Setters Hourly $12.20
Cement Masons and Concrete Finishers Hourly $12.92
Construction Laborers Hourly $10.81
Paving,Surfacing, &Tamping Equipment Operators Hourly $12.41
Pile-Driver Operators Hourly $14.65
Operating Engineers and Other Construction Equipment Hourly $13.80
Drywall and Ceiling Tile Installers Hourly $14.28
Electricians Hourly $15.80
Glaziers Hourly $13.08
Insulation Workers, Floor, Ceiling, and Wall Hourly $13.29
Insulation Workers, Mechanical Hourly $14.52
Painters,Construction and Maintenance Hourly $12.25
Pipelayers Hourly $13.19
Plumbers, Pipefitters,and Steamfitters Hourly $14.46
Reinforcing Iron and Rebar Workers Hourly $13.87
Roofers Hourly $12.38
Sheet Metal Workers Hourly $13.25
Structural Iron and Steel Workers Hourly $14.75
Helpers-Brickmasons, Blockmasons,Stonemasons,and Tile and Marble Hourly $12.36
Setters
Helpers-Carpenters Hourly $8.17
Helpers-Electricians Hourly $8.78
Helpers-Pipelayers, Plumbers, Pipefitters, and Steamfitters Hourly $10.04
Helpers-Construction Trades,All Other Hourly $10.34
Construction and Building Inspectors Hourly $19.15
Fence Erectors Hourly $12.17
Hazardous Materials Removal Workers Hourly $12.98
Highway Maintenance Workers Hourly $13.44
Septic Tank Servicers and Sewer Pipe Cleaners Hourly $12.05
Construction and Related Works,All Others Hourly $13.34
Derrick Operators, Oil and Gas Hourly $10.38
Service Unit Operators,Oil,Gas and Mining Hourly $13.22
Earth Drillers, Except Oil and Gas Hourly $16.45
Rock Splitters,Quarry Hourly $10.65
Roustabouts, Oil and Gas Hourly $11.69
Installation, Maintenance,and Repair Occupations Hourly $12.59
First-Line Supervisors of Mechanics, Installers, and Repairers Hourly $19.61
1
Exhibit "A"
ATTACHMENT E- PREVAILING WAGE
2016 ANNUAL TEXAS WORKFORCE COMMISSION WAGE
RATES
Computer,Automated Teller&Office Machinery Repairers Hourly $10.93
Radio Mechanics Hourly $14.11
Telecommunications Equipment Installers and Repair Hourly $15.62
Electric Motor, Power Tool, and Related Repairs Hourly $13.76
Electrical and Electronics Repairers, Commercial and Residential Hourly $16.12
Electrical and Electronic Repairers, Powerhouse Substation,and Relay Hourly $22.18
Electronic Equipment Installers and Repairers, Motor Vehicles Hourly $13.30
Security and Fire Alarm Systems Installers Hourly $17.79
Aircraft Mechanic and Service Technicians Hourly $21.97
Automotive Body and Related Repairs Hourly $15.89
Automotive Glass Installers and Repairers Hourly $14.29
Automotive Service Technicians and Mechanics Hourly $13.38
Bus&Truck Mechanics &Diesel Engine Specialists Hourly $15.61
Farm Equipment Mechanics Hourly $11.52
Mobile Heavy Equipment, Except Engines Hourly $14.84
Motorboat Mechanics Hourly $13.38
Motorcycle Mechanics Hourly $10.79
Outdoor Power Equipment&Other Small Engine Mechanics Hourly $10.31
Recreational Vehicle Service Technicians Hourly $12.75
Tire Repairers and Changers Hourly $10.45
Control and Valve Installers and Repairers, Except Mechanical Door Hourly $14.82
Heating, Air Conditioning and Refrigeration Mechanics and Installers Hourly $16.15
Home Appliance Hourly $13.04
Industrial Machinery Mechanics Hourly $15.74
Maintenance Workers, Machinery Hourly $15.31
Millwrights Hourly $15.79
Electrical Power-Line Installers and Repairers Hourly $15.94
Telecommunications Line Installers and Repairers Hourly $13.68
Medical Equipment Repairers Hourly $19.05
Precision Instrument Repairers, Other Hourly $14.40
Maintenance and Repair Workers,General Hourly $11.42
Coin,Vending, and Amusement Machine Servicers and Repairers Hourly $10.00
Locksmiths and Safe Repairers Hourly $12.93
Helpers-Installation, Maintenance, and Repair Workers Hourly $8.30
Installation, Maintenance& Repair Workers, Other Hourly $10.61
Production Occupations Hourly $10.43
First Line Supervisors of Production and Operating Workers Hourly $19.08
Electrical and Electronic Equipment Assemblers Hourly $11.81
Electromechanical Equipment Assemblers Hourly $15.04
Structural Metal Fabricators and Fitters Hourly $14.88
Team Assemblers Hourly $9.19
Timing Device Assemblers,Adjusters&Calibrators Hourly $16.33
2
Exhibit "A"
ATTACHMENT E- PREVAILING WAGE
2016 ANNUAL TEXAS WORKFORCE COMMISSION WAGE
RATES
Assemblies and Fabricators,All Other Hourly $10.10
Computer Controlled Machine Tool operators, Metal and Plastic Hourly $12.70
Numerical Tool and Process Control Programmers Hourly $20.26
Extruding and Drawing Machine Setters Hourly $12.14
Cutting, Punching, and Press Machine Setters,Operators Hourly $10.91
Grinding, Lapping, Polishing and Buffing Machine Hourly $10.58
Lathe and Turning Machine Tool Setters, Operators Hourly $13.47
Machinists Hourly $14.96
3
Exhibit "A"
Location #1 Attachment E - CDBG Home Repair 26-009
Exterior - Siding, Facia, Door Trim
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Remove old trim and install new Replace fascia on right side only. Paint
trim around front door and back ALL fascia around entire house (2
door. Paint to match (2 coats) coats).
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Remove and install new "like" siding or hardie board on all sides except backside
where there is minimal damage. Include required flashing.
Exhibit "A"
Location #1 Windows
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Remove garden window and replace with The center window pane has a bullet hole.
standard window (40x33) double pane. Replace broken pane. Window is 30x42.
Weatherize (caulk/seal). Include trim and paint
(2 coats) if necessary.
Exhibit "A"
Location #1 Roof
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Replace roof with "like" asphalt shingles including roof deck and required flashing.
Exhibit "A"
Attachment H
I. CDBG Required Certifications
All required certifications should be reviewed, completed, and submitted with
the final bid/proposal packet. If these documents are not submitted, the
submittal will be deemed non-responsive and disqualified from possible
award.
a. Prospective contractor/vendor is required to have an active registration in
the System for Award Management (SAM). Instructions on how to register
are included. The website link for registration is www.sam.gov
b. The Certification Regarding Debarment and Suspension from must be
completed and submitted with final proposals.
c. The Request for Taxpayer Identification Number and Certification form must
be completed and submitted with final bid/quote.
d. Prospective contractor/vendor must review the Conflict-of-Interest
Summary of Rules for CDBG Contractors. The affidavit must be reviewed,
signed, and submitted. ANY possible conflict of interest must be reported.
e. Prospective contractor/vendor must complete and submit the Certification
Regarding Equal Employment Opportunity.
f. Prospective contractor/vendor should complete and submit the Clean Air
and Water Certification, if applicable.
g. Prospective contractor/vendor should complete and submit the Certification
on Non-Lobbying Activities. Additional information is included.
h. Prospective contractor/vendor must complete and submit the Non-Collusion
Affidavit. Additional information is included.
i. Information regarding use of Minority-Owned Business Enterprises/Women
Owned Business Enterprises is included.
j. If this project is subject to Section 3 compliance as explained in the
Instructions to Bidders, the documents should be reviewed and completed
as applicable.
Exhibit "A"
Attachment I
SYSTEM FOR AWARD MANAGEMENT
REGISTRATION AND ACTIVATION
Any business choosing to bid or provide proposals on Federally Funded
projects, must be currently REGISTERED and ACTIVE IN THE System for
Awards Management (SAM) database, at the time of bid opening. The
database is the primary federal registrant portal for the collecting,validating,
storing,and disseminating data on federal awards. SAM is an official website
of the U.S. Government and there is not cost to register on this site.
1. Does your organization have ACTIVE REGISTRATION status with SAM.gov?
YES NO
2. If so, please provide your organization's Unique Entity ID (UEI#):
Bidders are required to provide the UEI#. To register, please access the
following internet website: http://sam.gov .
What is the UEI?
Beginning April 2, 2022, the federal government will stop using the DUNS
number issues by DUN and Bradstreet to uniquely identify entities. At this
point, entities doing business with the federal government will use a Unique
Entity Identifier (UEI) number assigned in the SAM.gov and will not longer
use a third-party website to obtain their identifier number. Entities are able
to manage organizational information, such as legal business name and
physical address associated with UEI number, directly from SAM.gov .
How do I register with SAM?
To register with SAM, go to the System for Award Management (SAM) site.
Follow the online instructions to complete SAM registration. If you have any
questions, please contact the Federal Service Desk at www.FSC.gov . Their
phone number is (866) 606-8220.
Exhibit "A"
Attachment J
Certification Regarding u.S.Department of Housing
Debarment and Suspension and Urban Development
Certification A: Certification Regarding Debarment,
Suspension and Other Responsibility Matters — Primary
Covered Transactions
1.The prospective primary participant certifies to the best of its knowledge 4. The prospective primary participant shall provide Immediate
and belief that its pnncipals: written notice to the department or agency to whom this proposal is
submitted if at any time the prospective primary participant learns
a. Are not presently debarred, suspended, proposed for debarment, that Its certification was erroneous when submitted or has become
declared ineligible,or voluntarily excluded from covered transactions by erroneous by reason of changed circumstances.
any Federal debarment or agency:
5. The terms covered transaction, debarred, suspended,
b. Have not within a three-year period preceding this proposal, been Ineligible, lower tier covered transaction,participant, person,
convicted of or had a civil judgment rendered against them for commission primary covered transaction, principal, proposal, and
of fraud or a criminal offense in connection with obtaining,attempting to voluntarily excluded, as used in this clause,have the meanings
obtain, or performing a public (Federal. State, or local) transaction or set out In the Definitions and Coverage sections of the rules
contract under a public transaction,violation of Federal or State anttbust implementing Executive Order 12549 You may contact the
statutes or commission of embezzlement, theft, forgery, bribery, department or agency to which this proposal is being submitted for
falsification,or destruction of records,making false statement,or receiving assistance in obtaining a copy of these regulations.
stolen property;
6. The prospective primary participant agrees by submitting this
c.Are not presently indicted for or otherwise criminally or civilly charged by proposal that,should the proposed covered transaction be entered
a governmental entity(Federal, State or local)with commission of any of into,it shalt not knowingly enter any lower tier covered transaction
the offenses enumerated in paragraph(1)(b)of this certification;and with a person who is debarred, suspended,declared ineligible,or
voluntarily excluded from participation in this covered transaction,
d.Have not within a three-year period preceding this application/proposal unless authorized by the department or agency entering Into this
had one or more public transactions(Federal,State or local)terminated for transaction.
cause or default.
7.The prospective primary participant further agrees by submitting
2.Where the prospective primary participant is unable to certify to any of this proposal that it will include the clause titled 'Certification
the statement in this certification,such prospective participant shall attach Regarding Debarment, Suspension, ineligibility and Voluntary
an explanation to this proposal. Exclusion — Lower Tier Covered Transaction' provided by the
department or agency entering into this covered transaction,without
Instructions for Certification(A) modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions
1. By signing and submitting this proposal, the prospective primary
participant is providing the certification set out below. 8 A participant in a covered transaction may rely upon a
certification of a prospective participant in a lower tier covered
2.The inability of a person to provide the certification required below will transaction that it is not debarred, suspended, ineligible, or
not necessarily result In dental of participation in this covered transaction, voluntarily excluded form the covered transaction,unless it knows
The prospective participant shall submit an explanation of why it cannot that the certification is erroneous. A participant may decide the
provide the certification set out below. The certification or explanation will method and frequency by which it determines this eligibility of its
be considered in connection with the department or agency's principals. Each participant may,but is not required to,check the
determination whether to enter into this transaction. However,failure of Non-procurement list
the prospective primary participant to furnish a certification of the
prospective primary participant to furnish a certification or an explanation 9.Nothing contained in the foregoing shall be construed to require
shall disqualify such person from participation in this transaction. establishment of a system of records In order to render in good faith
the certification required by this clause. The knowledge and
3.The certification in this clause is a material representation of fact upon information of a participant is not required to exceed that which is
which reliance was in place when the department or agency determined to normally possessed by a prudent person in the ordinary course of
enter into this transaction. If it is later determined that the prospective business dealings.
primary participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government, the 10.Except for transactions authorized under paragraph(6)of these
department or agency may terminate this transaction for cause or default. instructions, if a participant in a covered transaction knowingly
enters into a lower tier covered transaction with a person who is
suspended, debared, ineligible, or voluntarily excluded from
participation in this transaction, in addition to other remedies
available to the Federal Government, the department or agency
may terminate this transaction for cause of default.
Page 1 of 2 form HUD-2992(3/98)
Exhibit "A"
Certification B: Certification Regarding Debarment, Suspension,
Ineligible and Voluntary Exclusion-Lower Tier Covered Transactions
1. The prospective lower tier participant certifies, by submission of this 5.The prospective lower bar participant agrees by submitting this
proposal,that neither it not its prncipals Is presently debarred,suspended, proposal that,should the proposed covered transaction be entered
proposed for debarment, declared ineligible, or voluntarily excluded from into,it shall not knowingly enter into an lower tier transaction with a
participation in this transaction by any Federal department or agency. person who is debarred. suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction,
2.Where the prospective lower ben participant a unable to testify to any of unless authorized by the department or agency with which this
the statements in this certification,such prospective participant shall attach transaction originated.
an explanation to this proposal.
6. The prospective lower tier participant further agrees by
Instructions for Certification(B) submitting this proposal that it will include this clause titled
'Certification Regarding Debarment, Suspension, Ineligibility and
1. By signing and submitting this proposal, the prospective lower tier Voluntary Exclusion- Lower Tier Covered Transaction,' without
participant is providing the certification set out below. modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions.
2.The certification in this clause is a matenat representation of fact upon
which reliance was placed when this transaction was entered into. If it is 7. A participant in a covered transaction may rely upon a
later determined that the prospective lower tier participant knowingly certification of a prospective participant in a tower tier covered
rendered an erroneous certification,in addition to other remedies available transaction that it is not debarred, suspended, ineligible, or
to the Federal Government, the department or agency with which this voluntarily excluded from the covered transaction,unless it knows
transaction originated may pursue available remedies,including suspension that the certification is erroneous. A participant may decide the
end/or debarment. method and frequency by which it determines the eligibility of its
principals. Each participant may,but is not required to,check the
3 The prospective lower tier participant shall provide immediate written Non-procurement list.
notice to the person to which this proposal is submitted if at any time the
prospective lower tier participant learns that its certification was erroneous 8 Nothing contained in the foregoing shall be construed to require
when submitted or has become by reason of changed circumstances establishment of a system of records in order to render in good
faith the certification required by this clause. The knowledge and
4 The terms covered transaction, debarred, suspended, Ineligible, information of a participant is not required to exceed that which is
lower tier covered transaction, participant, person,primary covered normally possessed by a prudent person in the ordinary course of
transaction,principal,proposal,and voluntarily excluded,as used in business dealings
this clause, have the meanings set out In the Definitions and Coverage
sections of rules implementing Executive Order 12549. You may contact 9.Except for transactions authorized under paragraph(5)of these
the person to which this proposal is submitted for assistance in obtaining a instructions, if a participant in a lower covered transaction
copy of these regulations knowingly enters into a lower tier covered transaction with a person
who is suspended,debarred,ineligible,or voluntarily excluded from
participation in this transaction, in addition to other remedies
available to the Federal Government the department or agency
with which this transaction originated may pursue available
remedies including suspension and/or debarment
Applicant Date
Signature of Authorized Certifying Official Title
Page 2 of 2 form HUD-2992(3/98)
Exhibit "A"
Form
Request for Taxpayer Give form to the
(Rev.March 2024) Identification Number and Certification requester.Do not
Department of the Treasury Go to www.irs.gov/FormW9 for instructions and the latest information. send to the IRS.
Internal Revenue Service
Before you begin.For guidance related to the purpose of Form W-9,see Purpose of Form,below.
1 Name of entity/individual.An entry is required.(For a sole proprietor or disregarded entity,enter the owner's name on line 1,and enter the business/disregarded
entity's name on line 2.)
2 Business name/disregarded entity name,if different from above.
GN Remodeling LLC
c'") 3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1.Check 4 Exemptions(codes apply only to
c only one of the following seven boxes. certain entities,not individuals;
0 see instructions on page 3):
c ❑ Individual/sole proprietor ❑ C corporation ❑ S corporation ❑ Partnership ❑ Trust/estate
0
✓❑ LLC.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership) . . . . Exempt payee code(if any)
a.o Note:Check the"LLC"box above and,in the entry space,enter the appropriate code(C,S,or P)for the tax
classification of the LLC,unless it is a disregarded entity.A disregarded entity should instead check the appropriate Exemption from Foreign Account Tax
o w box for the tax classification of its owner. Compliance Act(FATCA)reporting
c ❑ Other(see instructions) code(if any)
•cS
a 3b If on line 3a you checked"Partnership"or"Trust/estate,"or checked"LLC"and entered"P"as its tax classification,
y and you are providing this form to a partnership,trust,or estate in which you have an ownership interest,check (Applies to accounts maintained
to this box if you have any foreign partners,owners,or beneficiaries.See instructions ❑ outside the United States.)
a) 5 Address(number,street,and apt.or suite no.).See instructions. Requester's name and address(optional)
183 Balch Rd
6 City,state,and ZIP code
Elgin,Tx 78621
7 List account number(s)here(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN). However,for a
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other - -
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a or
TIN,later.
Employer identification number
Note:If the account is in more than one name,see the instructions for line 1.See also What Name and
Number To Give the Requester for guidelines on whose number to enter. 8 5 - 3 9 3 8 0 8 2
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax retum.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and,generally,payments
other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of
Here U.S.person yv\s M Nunez Date
01/27/26
General Instructions New line 3b has been added to this form.A flow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise foreign partners,owners,or beneficiaries when it provides the Form W-9
noted. to another flow-through entity in which it has an ownership interest.This
Future developments.For the latest information about developments change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions,such as legislation enacted regarding the status of its indirect foreign partners,owners,or
after they were published,go to www.irs.gov/FormW9. beneficiaries,so that it can satisfy any applicable reporting
requirements.For example,a partnership that has any indirect foreign
What's New partners may be required to complete Schedules K-2 and K-3.See the
Partnership Instructions for Schedules K-2 and K-3(Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line.An LLC that is a disregarded entity should check the Purpose of Form
appropriate box for the tax classification of its owner.Otherwise,it
should check the"LLC"box and enter its appropriate tax classification. An individual or entity(Form W-9 requester)who is required to file an
information return with the IRS is giving you this form because they
Cat.No.10231X Form W-9(Rev.3-2024)
Exhibit "A"
Form W-9(Rev.3-2024) Page 2
must obtain your correct taxpayer identification number(TIN),which Foreign person.If you are a foreign person or the U.S.branch of a
may be your social security number(SSN),individual taxpayer foreign bank that has elected to be treated as a U.S.person(under
identification number(ITIN),adoption taxpayer identification number Regulations section 1.1441-1(b)(2)(iv)or other applicable section for
(ATIN),or employer identification number(EIN),to report on an chapter 3 or 4 purposes),do not use Form W-9.Instead,use the
information return the amount paid to you,or other amount reportable appropriate Form W-8 or Form 8233(see Pub.515).If you are a
on an information return.Examples of information returns include,but qualified foreign pension fund under Regulations section 1.897(I)-1(d),or
are not limited to,the following. a partnership that is wholly owned by qualified foreign pension funds,
•Form 1099-INT(interest earned or paid). that is treated as a non-foreign person for purposes of section 1445
withholding,do not use Form W-9.Instead,use Form W-8EXP(or other
•Form 1099-DIV(dividends,including those from stocks or mutual certification of non-foreign status).
funds).
Nonresident alien who becomes a resident alien.Generally,only a
•Form 1099-MISC(various types of income,prizes,awards,or gross
nonresident alien individual may use the terms of a tax treaty to reduce
proceeds). or eliminate U.S.tax on certain types of income.However,most tax
•Form 1099-NEC(nonemployee compensation). treaties contain a provision known as a saving clause.Exceptions
•Form 1099-B(stock or mutual fund sales and certain other specified in the saving clause may permit an exemption from tax to
transactions by brokers). continue for certain types of income even after the payee has otherwise
•Form 1099-S(proceeds from real estate transactions). become a U.S.resident alien for tax purposes.
If you are a U.S.resident alien who is relying on an exception
•Form 1099-K(merchant card and third party network transactions).
contained in the saving clause of a tax treaty to claim an exemption
•Form 1098(home mortgage interest), 1098-E(student loan interest), from U.S.tax on certain types of income,you must attach a statement
and 1098-T(tuition). to Form W-9 that specifies the following five items.
•Form 1099-C(canceled debt). 1.The treaty country.Generally,this must be the same treaty under
•Form 1099-A(acquisition or abandonment of secured property). which you claimed exemption from tax as a nonresident alien.
Use Form W-9 only if you are a U.S.person(including a resident 2.The treaty article addressing the income.
alien),to provide your correct TIN. 3.The article number(or location)in the tax treaty that contains the
Caution:If you don't return Form W-9 to the requester with a TIN,you saving clause and its exceptions.
might be subject to backup withholding.See What is backup 4.The type and amount of income that qualifies for the exemption
withholding,later. from tax.
By signing the filled-out form,you: 5.Sufficient facts to justify the exemption from tax under the terms of
1.Certify that the TIN you are giving is correct(or you are waiting for a the treaty article.
number to be issued); Example.Article 20 of the U.S.-China income tax treaty allows an
2.Certify that you are not subject to backup withholding;or exemption from tax for scholarship income received by a Chinese
student temporarily present in the United States.Under U.S.law,this
3.Claim exemption from backup withholding if you are a U.S.exempt student will become a resident alien for tax purposes if their stay in the
payee;and United States exceeds 5 calendar years. However,paragraph 2 of the
4.Certify to your non-foreign status for purposes of withholding under first Protocol to the U.S.-China treaty(dated April 30,1984)allows the
chapter 3 or 4 of the Code(if applicable);and provisions of Article 20 to continue to apply even after the Chinese
5.Certify that FATCA code(s)entered on this form(if any)indicating student becomes a resident alien of the United States.A Chinese
that you are exempt from the FATCA reporting is correct.See What Is student who qualifies for this exception(under paragraph 2 of the first
FATCA Reporting,later,for further information. Protocol)and is relying on this exception to claim an exemption from tax
on their scholarship or fellowship income would attach to Form W-9 a
Note:If you are a U.S.person and a requester gives you a form other
statement that includes the information described above to support that
than Form W-9 to request your TIN,you must use the requester's form if exemption.
it is substantially similar to this Form W-9.
If you are a nonresident alien or a foreign entity,give the requester the
Definition of a U.S.person.For federal tax purposes,you are appropriate completed Form W-8 or Form 8233.
considered a U.S.person if you are:
•An individual who is a U.S.citizen or U.S.resident alien; Backup Withholding
•A partnership,corporation,company,or association created or What is backup withholding?Persons making certain payments to you
organized in the United States or under the laws of the United States; must under certain conditions withhold and pay to the IRS 24%of such
•An estate(other than a foreign estate);or payments.This is called"backup withholding."Payments that may be
•A domestic trust(as defined in Regulations section 301.7701-7). subject to backup withholding include,but are not limited to,interest,
tax-exempt interest,dividends,broker and barter exchange
Establishing U.S.status for purposes of chapter 3 and chapter 4 transactions,rents,royalties,nonemployee pay,payments made in
withholding.Payments made to foreign persons,including certain settlement of payment card and third-party network transactions,and
distributions,allocations of income,or transfers of sales proceeds,may certain payments from fishing boat operators.Real estate transactions
be subject to withholding under chapter 3 or chapter 4 of the Code are not subject to backup withholding.
(sections 1441-1474).Under those rules,if a Form W-9 or other You will not be subject to backup withholding on payments you receive
certification of non-foreign status has not been received,a withholding if you give the requester your correct TIN,make the proper certifications,
agent,transferee,or partnership(payor)generally applies presumption and report all your taxable interest and dividends on your tax return.
rules that may require the payor to withhold applicable tax from the
recipient,owner,transferor,or partner(payee).See Pub.515, Payments you receive will be subject to backup withholding if:
Withholding of Tax on Nonresident Aliens and Foreign Entities. 1.You do not furnish your TIN to the requester;
The following persons must provide Form W-9 to the payor for 2.You do not certify your TIN when required(see the instructions for
purposes of establishing its non-foreign status. Part II for details);
•In the case of a disregarded entity with a U.S.owner,the U.S.owner 3.The IRS tells the requester that you furnished an incorrect TIN;
of the disregarded entity and not the disregarded entity. 4.The IRS tells you that you are subject to backup withholding
•In the case of a grantor trust with a U.S.grantor or other U.S.owner, because you did not report all your interest and dividends on your tax
generally,the U.S.grantor or other U.S.owner of the grantor trust and return(for reportable interest and dividends only);or
not the grantor trust. 5.You do not certify to the requester that you are not subject to
•In the case of a U.S.trust(other than a grantor trust),the U.S.trust backup withholding,as described in item 4 under"By signing the filled-
and not the beneficiaries of the trust. out form"above(for reportable interest and dividend accounts opened
See Pub.515 for more information on providing a Form W-9 or a after 1983 only).
certification of non-foreign status to avoid withholding.
Exhibit "A"
Form W-9(Rev.3-2024) Page 3
Certain payees and payments are exempt from backup withholding. example,if a foreign LLC that is treated as a disregarded entity for U.S.
See Exempt payee code,later,and the separate Instructions for the federal tax purposes has a single owner that is a U.S.person,the U.S.
Requester of Form W-9 for more information. owner's name is required to be provided on line 1.If the direct owner of
See also Establishing U.S.status for purposes of chapter 3 and the entity is also a disregarded entity,enter the first owner that is not
chapter 4 withholding,earlier. disregarded for federal tax purposes.Enter the disregarded entity's
name on line 2.If the owner of the disregarded entity is a foreign person,
What Is FATCA Reporting? the owner must complete an appropriate Form W-8 instead of a Form
W-9. This is the case even if the foreign person has a U.S.TIN.
The Foreign Account Tax Compliance Act(FATCA)requires a
participating foreign financial institution to report all U.S.account Line 2
holders that are specified U.S.persons.Certain payees are exempt from If you have a business name,trade name,DBA name,or disregarded
FATCA reporting.See Exemption from FATCA reporting code,later,and entity name,enter it on line 2.
the Instructions for the Requester of Form W-9 for more information.
Line 3a
Updating Your Information Check the appropriate box on line 3a for the U.S.federal tax
You must provide updated information to any person to whom you classification of the person whose name is entered on line 1.Check only
claimed to be an exempt payee if you are no longer an exempt payee one box on line 3a.
and anticipate receiving reportable payments in the future from this
person.For example,you may need to provide updated information if IF the entity/individual on line 1 THEN check the box for...
you are a C corporation that elects to be an S corporation,or if you are is a(n)...
no longer tax exempt.In addition,you must furnish a new Form W-9 if • Corporation Corporation.
the name or TIN changes for the account,for example,if the grantor of a • Individual or Individual/sole proprietor.
grantor trust dies.
• Sole proprietorship
Penalties • LLC classified as a partnership Limited liability company and
Failure to furnish TIN.If you fail to furnish your correct TIN to a for U.S.federal tax purposes or enter the appropriate tax
requester,you are subject to a penalty of$50 for each such failure • LLC that has filed Form 8832 or classification:
unless your failure is due to reasonable cause and not to willful neglect. 2553 electing to be taxed as a P=Partnership,
Civil penalty for false information with respect to withholding.If you corporation C=C corporation,or
make a false statement with no reasonable basis that results in no S=S corporation.
backup withholding,you are subject to a$500 penalty. • Partnership Partnership.
Criminal penalty for falsifying information.Willfully falsifying • Trust/estate Trust/estate.
certifications or affirmations may subject you to criminal penalties
including fines and/or imprisonment. Line 3b
Misuse of TINs.If the requester discloses or uses TINs in violation of Check this box if you are a partnership(including an LLC classified as a
federal law,the requester may be subject to civil and criminal penalties. partnership for U.S.federal tax purposes),trust,or estate that has any
foreign partners,owners,or beneficiaries,and you are providing this
Specific Instructions form to a partnership,trust,or estate,in which you have an ownership
interest.You must check the box on line 3b if you receive a Form W-8
Line 1 (or documentary evidence)from any partner,owner,or beneficiary
You must enter one of the following on this line;do not leave this line establishing foreign status or if you receive a Form W-9 from any
partner,owner,or beneficiary that has checked the box on line 3b.
blank.The name should match the name on your tax return.
Note:A partnership that provides a Form W-9 and checks box 3b may
If this Form W-9 is for a joint account(other than an account be required to complete Schedules K-2 and K-3(Form 1065).For more
maintained by a foreign financial institution(FFI)),list first,and then information,see the Partnership Instructions for Schedules K-2 and K-3
circle,the name of the person or entity whose number you entered in (Form 1065).
Part I of Form W-9.If you are providing Form W-9 to an FFI to document
a joint account,each holder of the account that is a U.S.person must If you are required to complete line 3b but fail to do so,you may not
provide a Form W-9. receive the information necessary to file a correct information return with
the IRS or furnish a correct payee statement to your partners or
•Individual.Generally,enter the name shown on your tax return.If you beneficiaries.See,for example,sections 6698,6722,and 6724 for
have changed your last name without informing the Social Security penalties that may apply.
Administration(SSA)of the name change,enter your first name,the last
name as shown on your social security card,and your new last name. Line 4 Exemptions
Note for ITIN applicant:Enter your individual name as it was entered If you are exempt from backup withholding and/or FATCA reporting,
on your Form W-7 application,line 1 a.This should also be the same as enter in the appropriate space on line 4 any code(s)that may apply to
the name you entered on the Form 1040 you filed with your application. you.
•Sole proprietor.Enter your individual name as shown on your Form Exempt payee code.
1040 on line 1.Enter your business,trade,or"doing business as"(DBA) • General)
name on line 2. y,individuals(including sole proprietors)are not exempt from
backup withholding.
•Partnership,C corporation,S corporation,or LLC,other than a • Except as provided below,corporations are exempt from backup
disregarded entity.Enter the entity's name as shown on the entity's tax withholding for certain payments,including interest and dividends.
return on line 1 and any business,trade,or DBA name on line 2.
• Corporations are not exempt from backup withholding for payments
•Other entities.Enter your name as shown on required U.S.federal tax made in settlement of payment card or third-party network transactions.
documents on line 1.This name should match the name shown on the
charter or other legal document creating the entity.Enter any business, • Corporations are not exempt from backup withholding with respect to
trade,or DBA name on line 2. attorneys'fees or gross proceeds paid to attorneys,and corporations
•Disregarded entity.In general,a business entity that has a single that provide medical or health care services are not exempt with respect
owner,including an LLC,and is not a corporation,is disregarded as an to payments reportable on Form 1099-MISC.
entity separate from its owner(a disregarded entity).See Regulations The following codes identify payees that are exempt from backup
section 301.7701-2(c)(2).A disregarded entity should check the withholding.Enter the appropriate code in the space on line 4.
appropriate box for the tax classification of its owner.Enter the owner's 1—An organization exempt from tax under section 501(a),any IRA,or
name on line 1.The name of the owner entered on line 1 should never a custodial account under section 403(b)(7)if the account satisfies the
be a disregarded entity.The name on line 1 should be the name shown requirements of section 401(f)(2).
on the income tax return on which the income should be reported.For
Exhibit "A"
Form W-9(Rev.3-2024) Page 4
2—The United States or any of its agencies or instrumentalities. F—A dealer in securities,commodities,or derivative financial
3—A state,the District of Columbia,a U.S.commonwealth or territory, instruments(including notional principal contracts,futures,forwards,
or any of their political subdivisions or instrumentalities. and options)that is registered as such under the laws of the United
States or any state.
4—A foreign government or any of its political subdivisions,agencies,
or instrumentalities. G—A real estate investment trust.
5—A corporation. H—A regulated investment company as defined in section 851 or an
entity registered at all times during the tax year under the Investment
6—A dealer in securities or commodities required to register in the Company Act of 1940.
United States,the District of Columbia,or a U.S.commonwealth or
territory. I—A common trust fund as defined in section 584(a).
7—A futures commission merchant registered with the Commodity J—A bank as defined in section 581.
Futures Trading Commission. K—A broker.
8—A real estate investment trust. L—A trust exempt from tax under section 664 or described in section
9—An entity registered at all times during the tax year under the 4947(a)(1).
Investment Company Act of 1940. M—A tax-exempt trust under a section 403(b)plan or section 457(g)
10—A common trust fund operated by a bank under section 584(a). plan.
11—A financial institution as defined under section 581. Note:You may wish to consult with the financial institution requesting
this form to determine whether the FATCA code and/or exempt payee
12—A middleman known in the investment community as a nominee or code should be completed.
custodian.
13—A trust exempt from tax under section 664 or described in section Line 5
4947. Enter your address(number,street,and apartment or suite number).
The following chart shows types of payments that may be exempt This is where the requester of this Form W-9 will mail your information
from backup withholding.The chart applies to the exempt payees listed returns.If this address differs from the one the requester already has on
above, 1 through 13. file,enter"NEW"at the top.If a new address is provided,there is still a
chance the old address will be used until the payor changes your
IF the payment is for... THEN the payment is exempt address in their records.
for...
• Interest and dividend payments All exempt payees except Line 6
for 7. Enter your city,state,and ZIP code.
• Broker transactions Exempt payees 1 through 4 and 6 Part I. Taxpayer Identification Number (TIN)
through 11 and all C corporations.
S corporations must not enter an Enter your TIN in the appropriate box.If you are a resident alien and
exempt payee code because they you do not have,and are not eligible to get,an SSN,your TIN is your
are exempt only for sales of IRS ITIN.Enter it in the entry space for the Social security number.If you
noncovered securities acquired do not have an ITIN,see How to get a TIN below.
prior to 2012. If you are a sole proprietor and you have an EIN,you may enter either
• Barter exchange transactions Exempt payees 1 through 4. your SSN or EIN.
and patronage dividends If you are a single-member LLC that is disregarded as an entity
• Payments over$600 required to Generally,exempt payees separate from its owner,enter the owner's SSN(or EIN,if the owner has
be reported and direct sales over 1 through 5.2 one).If the LLC is classified as a corporation or partnership,enter the
$5,0001 entity's EIN.
• Payments made in settlement of Exempt payees 1 through 4. Note:See What Name and Number To Give the Requester,later,for
payment card or third-party further clarification of name and TIN combinations.
network transactions How to get a TIN.If you do not have a TIN,apply for one immediately.
1SeeForm 1099 MISC, Miscellaneouslnformation, anditsinstructions. To apply for an SSN,get Form SS-5,Application for a Social Security
Card,from your local SSA office or get this form online at
2How ever,the following paym ents m ade to a corporation and www.SSA.gov.You may also get this form by calling 800-772-1213.Use
reportable on Form 1 0 9 9-M IS C are not e x e m p t from backup Form W-7,Application for IRS Individual Taxpayer Identification
withholding: medical and health care paym ents, attorneys'fees, gross Number,to apply for an ITIN,or Form SS-4,Application for Employer
proceeds paid to an attorney reportable under section 6 0 4 5)f), and Identification Number,to apply for an EIN.You can apply for an EIN
paym ents for services paid by a federal executive agency. online by accessing the IRSwebsiteatwww.irs.gov/E/N.Go to
Exemption from FATCA reporting code.The following codes identify www.irs.gov/Forms to view,download,or print Form W-7 and/or Form
payees that are exempt from reporting under FATCA.These codes SS-4.Or,you can go to www.irs.gov/OrderForms to place an order and
apply to persons submitting this form for accounts maintained outside have Form W-7 and/or Form SS-4 mailed to you within 15 business
of the United States by certain foreign financial institutions.Therefore,if days.
you are only submitting this form for an account you hold in the United If you are asked to complete Form W-9 but do not have a TIN,apply
States,you may leave this field blank.Consult with the person for a TIN and enter"Applied For"in the space for the TIN,sign and date
requesting this form if you are uncertain if the financial institution is the form,and give it to the requester.For interest and dividend
subject to these requirements.A requester may indicate that a code is payments,and certain payments made with respect to readily tradable
not required by providing you with a Form W-9 with"Not Applicable"(or instruments,you will generally have 60 days to get a TIN and give it to
any similar indication)entered on the line for a FATCA exemption code. the requester before you are subject to backup withholding on
A—An organization exempt from tax under section 501(a)or any payments.The 60-day rule does not apply to other types of payments.
individual retirement plan as defined in section 7701(a)(37). You will be subject to backup withholding on all such payments until
B—The United States or any of its agencies or instrumentalities. you provide your TIN to the requester.
C—A state,the District of Columbia,a U.S.commonwealth or Note:Entering"Applied For"means that you have already applied for a
territory,or any of their political subdivisions or instrumentalities. TIN or that you intend to apply for one soon.See also Establishing U.S.
status for purposes of chapter 3 and chapter 4 withholding,earlier,for
D—A corporation the stock of which is regularly traded on one or when you may instead be subject to withholding under chapter 3 or 4 of
more established securities markets,as described in Regulations the Code.
section 1.1472-1(c)(1)(i).
Caution:A disregarded U.S.entity that has a foreign owner must use
E—A corporation that is a member of the same expanded affiliated the appropriate Form W-8.
group as a corporation described in Regulations section 1.1472-1(c)(1)(i).
Exhibit "A"
Form W-9(Rev.3-2024) Page 5
Part II. Certification For this type of account: Give name and EIN of:
To establish to the withholding agent that you are a U.S.person,or 8.Disregarded entity not owned by an The owner
resident alien,sign Form W-9.You may be requested to sign by the individual
withholding agent even if item 1,4,or 5 below indicates otherwise. 9.A valid trust,estate,or pension trust Legal entity4
For a joint account,only the person whose TIN is shown in Part I 10.Corporation or LLC electing corporate The corporation
should sign(when required).In the case of a disregarded entity,the status on Form 8832 or Form 2553
person identified on line 1 must sign.Exempt payees,see Exempt payee 11.Association,club,religious,charitable, The organization
code,earlier. educational,or other tax-exempt
Signature requirements.Complete the certification as indicated in organization
items 1 through 5 below. 12.Partnership or multi-member LLC The partnership
1.Interest,dividend,and barter exchange accounts opened 13.A broker or registered nominee The broker or nominee
before 1984 and broker accounts considered active during 1983. 14.Account with the Department of The public entity
You must give your correct TIN,but you do not have to sign the Agriculture in the name of a public
certification. entity(such as a state or local
government,school district,or prison)
2.Interest,dividend,broker,and barter exchange accounts that receives agricultural program
opened after 1983 and broker accounts considered inactive during payments
1983.You must sign the certification or backup withholding will apply.If 15.Grantor trust filing Form 1041 or The trust
you are subject to backup withholding and you are merely providing under the Optional Filing Method 2,
your correct TIN to the requester,you must cross out item 2 in the requiring Form 1099(see Regulations
certification before signing the form. section 1.671-4(b)(2)(i)(B))"
3.Real estate transactions.You must sign the certification.You may L is t first and circle the ram eat the person whose number you furnish.
cross out item 2 of the certification. If only one person on a joint account has an SSN,that person's number
4.Other payments.You must give your correct TIN,but you do not m u s t be furnished.
have to sign the certification unless you have been notified that you
have previously given an incorrect TIN."Other payments"include ZC ire le th e m in a is n a m e a n d furnish the m in o is SSN.
payments made in the course of the requester's trade or business for 3You m ust show your individual nam e on line 1,and enter your business
rents,royalties,goods(other than bills for merchandise),medical and or D B A name, if a n y,o n line 2. You may use a it h e r y o u r S S N o r E I N (if
health care services(including payments to corporations),payments to you have o n e), but the IRS encourages you to use your SSN.
anonemployeeforservices,payments made in settlement of payment 'List first and circle the name of the trust,estate,or pension trust. (Do
card and third-party network transactions,payments to certain fishing not furnish the TIN of the personal representative or trustee unless the
boat crew members and fishermen,and gross proceeds paid to legal entity itself is not designated in the account title.)
attorneys(including payments to corporations).
Note:The grantor must also provide a Form W-9 to the trustee of the
5.Mortgage interest paid by you,acquisition or abandonment of trust.
secured property,cancellation of debt,qualified tuition program
payments(under section 529),ABLE accounts(under section 529A), *'For more information on optional filing methods for grantor trusts,see
IRA,Coverdell ESA,Archer MSA or HSA contributions or the Instructions for Form 1041.
distributions,and pension distributions.You must give your correct Note:If no name is circled when more than one name is listed,the
TIN,but you do not have to sign the certification. number will be considered to be that of the first name listed.
What Name and Number To Give the Requester Secure Your Tax Records From Identity Theft
For this type of account: Give name and SSN of: Identity theft occurs when someone uses your personal information,
1.Individual The individual such as your name,SSN,or other identifying information,without your
2.Two or more individuals(joint account) The actual owner of the account or, permission to commit fraud or other crimes.An identity thief may use
other than an account maintained by if combined funds,the first individual your SSN to get a job or may file a tax return using your SSN to receive
an FFI on the accounts a refund.
3.Two or more U.S.persons Each holder of the account To reduce your risk:
(joint account maintained by an FFI) •Protect your SSN,
4.Custodial account of a minor The minor2 •Ensure your employer is protecting your SSN,and
(Uniform Gift to Minors Act) •Be careful when choosing a tax return preparer.
5.a.The usual revocable savings trust The grantor-trustees
(grantor is also trustee) If your tax records are affected by identity theft and you receive a
b.So-called trust account that is not The actual owner' notice from the IRS,respond right away to the name and phone number
a legal or valid trust under state law printed on the IRS notice or letter.
6.Sole proprietorship or disregarded The owner3 If your tax records are not currently affected by identity theft but you
entity owned by an individual think you are at risk due to a lost or stolen purse or wallet,questionable
credit card activity,or a questionable credit report,contact the IRS
7.Grantor trust filing under Optional The grantor' Identity Theft Hotline at 800-908-4490 or submit Form 14039.
Filing Method 1(see Regulations
section 1.671-4(b)(2)(i)(A)(** For more information,see Pub.5027,Identity Theft Information for
Taxpayers.
Exhibit "A"
Form W-9(Rev.3-2024) Page 6
Victims of identity theft who are experiencing economic harm or a Privacy Act Notice
systemic problem,or are seeking help in resolving tax problems that
have not been resolved through normal channels,may be eligible for Section 6109 of the Internal Revenue Code requires you to provide your
Taxpayer Advocate Service(TAS)assistance.You can reach TAS by correct TIN to persons(including federal agencies)who are required to
calling the TAS toll-free case intake line at 877-777-4778 or TTYITDD file information returns with the IRS to report interest,dividends,or
800-829-4059. certain other income paid to you;mortgage interest you paid;the
Protect yourself from suspicious emails or phishing schemes. acquisition or abandonment of secured property;the cancellation of
debt;or contributions you made to an IRA,Archer MSA,or HSA.The
Phishing is the creation and use of email and websites designed to
mimic legitimate business emails and websites.The most common act person collecting this form uses the information on the form to file
information returns with the IRS,reporting the above information.
is sending an email to a user falsely claiming to be an established
legitimate enterprise in an attempt to scam the user into surrendering JusticRoutine usesr civil o this information include and giving it cities,to states,the Department of
private information that will be used for identity theft. Columbia,fara and criminal litigationel to oie fo the District of
and U.S.commonwealths and territories for use in
The IRS does not initiate contacts with taxpayers via emails.Also,the administering their laws.The information may also be disclosed to other
IRS does not request personal detailed information through email or ask countries under a treaty,to federal and state agencies to enforce civil
taxpayers for the PIN numbers,passwords,or similar secret access and criminal laws,or to federal law enforcement and intelligence
information for their credit card,bank,or other financial accounts. agencies to combat terrorism.You must provide your TIN whether or not
If you receive an unsolicited email claiming to be from the IRS, you are required to file a tax return.Under section 3406,payors must
forward this message to phishing@irs.gov.You may also report misuse generally withhold a percentage of taxable interest,dividends,and
of the IRS name,logo,or other IRS property to the Treasury Inspector certain other payments to a payee who does not give a TIN to the payor.
General for Tax Administration(TIGTA)at 800-366-4484.You can Certain penalties may also apply for providing false or fraudulent
forward suspicious emails to the Federal Trade Commission at information.
spam@uce.gov or report them at www.ftc.gov/complaint.You can
contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT(877-438-4338).
If you have been the victim of identity theft,see www.IdentityTheft.gov
and Pub.5027.
Go to www.irs.gov/ldentityTheft to learn more about identity theft and
how to reduce your risk.
Attachment L
U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
CERTIFICATION OF BIDDER REGARDING EQUAL
EMPLOYMENT OPPORTUNITY
INSTRUCTIONS
This certification is required pursuant to Executive Order 11246(30 F.R.12319-25). The implementing
rules and regulations provide that any bidder or prospective contractor, or any of their proposed
subcontractors, shall state as an initial part of the bid or negotiations of the contract, whether it has
participated in any previous contract or subcontract subject to the equal opportunity clause;and, if so,
whether it has filed all compliance reports due under applicable instructions.
Where the certification indicates that the bidder has not filed a compliance report due under applicable
instructions,such bidders shall be required to submit a compliance report within seven
(7)calendar days after bid opening. No contract shall be awarded unless such report is submitted.
CERTIFICATION BY BIDDER
Bidder's Name: Luis M. Nunez
Address and Zip Code: 183 balch rd Elgin tx 78621
Bidder has participated in previous contract or subcontract subject to the Equal
Employment Opportuy Clause.
Yes No (If answer is yes,identify the most recent contract)
2 Compliance reports were required to be filed in connection with such contract or
subcontract.
Yes No �(If answer is yes, identify the most recent contract)
3. Bidder has filed all compliance reports due under applicable instructions, including SF- 100.
Yes No None Required eair__
4. If answer to Item 3 is"No",please explain in detail on the reverse side of this
certification.
Certification — The information above is true and complete to the best of my knowledge and belief.
_ Luis M. Nunez General Contractor
(Name and Title of Signer—please type)
1 \A M %Au. 03/10/26
Signature Date
HUD 4238
CERTIFICATION OF SUBCONTRACTOR REGARDING
EQUAL EMPLOYMENT OPPORTUNITY
NAME OF PRIME
CONTRACTOR:
PROJECT#:
INSTRUCTIONS
This certification is required pursuant to Executive Order 11246(30 F.R. 12319-25). The implementing rules and
regulations provide that any bidder or prospective contractor,or any of their proposed subcontractors,shall state as
an initial part of the bid or negotiations of the contract, whether it has participated in any previous contract or
subcontract subject to the equal opportunity clause;and,if so,whether it has filed all compliance reports due under
applicable instructions.
Where the certification indicates that the bidder has not filed a compliance report due under applicable instructions,
such bidders shall be required to submit a compliance report within seven
(7)calendar days after bid opening. No contract shall be awarded unless such report is submitted.
CERTIFICATION BY SUBCONTRACTOR
NAME AND ADDRESS OF SUBCONTRACTOR(Include ZIP Code)
I Subcontractor has participated in previous contract or subcontractor subject to the
Equal Employment Opportunity Clause.
Yes No (If answer is yes,identify the most recent contract)
2 Compliance reports were required to be filed in connection with such contract or
subcontract.
Yes No (If answer is yes,identify the most recent contract)
Bidder has filed all compliance reports due under applicable instructions,including SF-100.
Yes - No None Required
4 Have you ever been or are you being considered for sanction due to violation of
Executive Order 11246,as amended.
Yes No
Certification — The information above is true and complete to the best of my knowledge and belief.
(Name and Title of Signer—please type)
Signature Date
Exhibit "A"
Attachment M
CONFLICT OF INTEREST
SUMMARY OF RULES FOR CDBG CONTRACTORS
Introduction
Prospective CDBG contractors should carefully consider whether any of
their activities may give rise to an improper conflict of interest situation.
Conflict of interest situations that are not properly addressed can result
in a loss of CDBG funding to the program and/or to the city, and in some
cases can result in civil or criminal liability.
Organizations that are requesting CDBG funding should ask themselves
the following questions:
Are any of my employees or board members,
• A city employee or consultant who exercises CDBG-
related functions as part of their city position?
• A City Official?
Are any immediate family members or business associates of my
employees or beard members,
• A city employee or consultant who exercises CDBG-
related functions as part of their city position?
• A City Official?
Will any of my employees or board members receive a financial interest or
benefit from CDBG funds (other than employee salaries or personnel
benefits)? Will any immediate family members or business associates of
my employees or board members receive a financial interest or benefit
from CDBG funds (other than employee salaries or personnel benefits)?
To my knowledge, will my program or project have a financial effect on a
city official or employee wo exercises CDBG-related functions, or an
immediate family member or business associate of such person? For
Exhibit "A"
example, will any of these persons be receiving rental payments, other
business income or program services from my program?
If you can answer "yes" to any of these questions, it is possible that there
may be a conflict of interest. You should review the rules below to
determine whether an actual conflict situation is raised, and, if so, what
action needs to be taken to avoid a violation of the law. You should contact
city staff immediately if you suspect that there might be an issue.
Any contractor entering into an agreement with the City in which CDBG
funding will be utilized, will be required to warrant, and represent, to the
best of his/her knowledge at the time the contract is executed, he/she is
not aware of any improper conflict of interest as described below. Also,
the contract will obligate contractors to exercise due diligence to ensure
that no improper conflict situations occur during the contract.
The following Federal and State Conflict of Interest Laws govern activities
funded with CDBG funds:
• HUD conflict of interest regulations(24 CFR Part 570.611 and 24 CFR
Part 85.36)
• Texas Local Government Code Chapter 171.004
II. City Officials,Their Family, or Business Partners Benefitting from CDBG
Projects.
HUD Rule. The HUD conflict of interest rule prohibits any "covered
person" associated with the City (as defined below) from obtaining a
financial interest or benefit from a CDBG assisted activity or contract, of
the proceeds under any such contract, during that covered person's
tenure with the City and for one year thereafter. A "covered person" is
defined by HUD as any employee, agent,consultant,officer, or elected or
appointed official of the City who, with respect to CDBG-funded activities
under the contract: (a) exercises or has exercised any functions or
responsibilities; or, (b) is in a position to participate in a decision-making
process; or, (c) is in a position to gain inside information. City staff
members or consultants who exercise the above roles or function with
respect to the CDBG activity are considered "covered persons." For
purposes of the CDBG program, a "covered person" specifically includes
Exhibit "A"
any member of the Round Rock City Council, or any director of any board
associated with reviewing and making recommendations on the funding
for the contract,whether or not that council member or director actually
participated in the review or recommendation. "Covered person" may
also include member of other City boards and commissions, if that board
or commission has exercised functions or decision-making with respect to
the CDBG activity. The HUD rule further prohibits anyone with "family or
business ties" to the covered public official from receiving a financial
interest or benefit.
State Law. State law requires a local public official with substantial
interest in a business entity or in real property, to file, before a vote or
decision on any matter involving the business entity or the real property,
an affidavit stating the nature of the extent of the interest. The state law
required that any public official of the City, should publicly recuse
him/herself from participating in any discussions relating to the CDBG
grant-making process. Failure of the person to recuse him/herself before
the discussions begin may disqualify the organization's application for
funds.
III. Interests of persons associated with the contractor.
The HUD rule also addresses financial interests that are held by certain
persons associated with a CDBG contractor. The HUD rule prohibits any
"covered person" associated with the contractor from obtaining a
financial interest or benefit (with the exception of the use of CDBG funds
to pay salaries and other related administrative and personnel costs)from
a CDBG assisted activity or contract, or the proceeds under any such
contract, during that covered person's tenure with the contactor and for
one year thereafter. A "covered person" is defined by HUD as any
employee, agent, consultant, officer, or elected or appointed official of
the contractor who, with respect to CDBG-funded activities under the
contract: (a) exercises or has exercised any functions or responsibilities;
or (b) is in a position to participate in a decision-making process; or (c) is
in a position to gain inside information. This rule extends to those with
Exhibit "A"
whom the covered person has "family or business ties" (as defined
above). This rule would, for example, prohibit certain employees or
directors of a CDBG contractor from using CDBG funds to pay for rent on
a property owned by that employee or director, as well as family and
business associates of that person.
IV. Remedies and Sanctions.
The CDBG grant contract provides that if a CDBG contractor fails to make
a good faith effort to avoid an improper conflict of interest situation or is
responsible for the improper conflict situation, the City may (1) suspend
CDBG payments, (2) terminate the contract, (3) require reimbursement
by the contractor to the City of HUD of any amounts already disbursed
and/or (4) bar future CDBG funding of the contractor in the event HUD
suspends or terminates its rant to the city for conflict of interest reasons,
or in the event the city reasonably determines that an improper conflict
of interest situation may arise from payments under the contract. This
could happen whether or not the contractor is responsible for the
conflict-of-interest situation.
Certification:
I,the undersigned,acknowledge and certify that I have read and understand
the summary of Rules for CDBG Contractors.
Date: Company/Vendor Name:
03/10/; GN Re
Printed Name and Title: Authorized Signatory:
Luis M. 1--\)\5 tA Nmez
Exhibit "A"
CITY OF ROUND ROCK
COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM
AFFIDAVIT REGARDING CONFLICT OF INTEREST
Acknowledgement:
I, the undersigned, certify that I have read and understand the conflict of interest
regulations by the US Department of Housing and Urban Development, Community
Development Block Grant Program,including 24 CFR Part 570.611:
24 CFR Part 570.611 (b)Conflicts prohibit. No persons described in paragraph (c)
of this section who exercise or have exercised any functions or responsibilities with
respect to activities assisted with CDBG funds or wo are in a position to participate in a
decision-making process or gain inside information with regard to these activities, may
obtain a financial interest or benefit from a CDBG-assisted activity,or have an interest in
any contract, subcontract, or agreement with respect thereto, or the proceeds
thereunder,either for themselves or those with whom they have family or business ties,
during their tenure or for one year thereafter.
24 CFR Part 570.611(c)Persons covered. The conflict of interest provisions of paragraph
(b) of this section apply to any person who is an employee, agent,consultant, officer,or
elected official or appointed official to the recipient,or of any designated public agencies,
or of subrecipients that are receiving CDBG funds.
Certification:
I,the undersigned,certify and report that to the best of my knowledge,
jilt have no conflict of interest to disclose
o I have the following conflict of interest to disclose:
Date: 03/10/ Company/Vendor Name:
GN RemodE
Printed Name and Title: Authorized Signatory:
Luis M. NunE
V1S ivA NVUI`,ZL
Exhibit "A"
Attachment N
CLEAN AIR AND WATER CERTIFICATION
(For all contracts exceeding$100,000 including indefinite quantities where the
amount is expected to exceed$100,000 In any year)
The Bidder certifies that:
1. Any facility to be used in the performance of this proposed contract is not listed on
the Environmental Protection Agency List of Violating Facilities;
2. The bidder will immediately notify the Procuring Agency, before award, of the receipt
of any communication from the Administrator,or a designee,of the Environmental
Protection Agency, indicating that any facility that the Bidder proposes to use for the
performance of this contract is under consideration to be listed on the EPA List of
Violating Facilities; and
3. The Bidder will include a certification substantially the same as this certification,
including this paragraph, in every non-exempt subcontract.
Signature of Contractor's Authorized Official: ''
Name of Contractor's Authorized Official: Luis M. r
Title of Contractor's Authorized Official: General C
Date: 03/11M
Exhibit "A"
Attachment 0
CERTIFICATION ON NON-LOBBYING ACTIVITIES
CERTIFICATION FOR CONTRACTS, GRANTS, AND LOANS
The undersigned certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf
of the Undersigned,to any person for influencing or attempting to influence an
officer or employee of any agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of Congress in
connection with the awarding of any Federal contract, the making of any
Federal grant or Federal loan, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant or loan.
2. If any funds other than Federal appropriated funds have been paid or will be
paid to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with this
Federal contract, grant or loan, the undersigned shall complete and submit
Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its
instructions.
3. The undersigned shall require that the language of this certification be
included in the Award documents for all subawards at all tiers (including
contracts, subcontracts, and subgrants under grants and loans) and that all
subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352, title
31, U.S. Code. Any person who fails to file the required certification shall be subject to
a civil penalty of not less than $10,000 and not more than $100,000 for each such
failure.
Luis M. Ni. General C
NAME TITLE
L\tie NI\ez 03/10/2
SIGNAT DATE
Exhibit "A"
Attachment P
NON-COLLUSION AFFIDAVIT OF PRIME BIDDER/SUBCONTRACTOR
State of Texas)
County of Williamson)
City of Round Rock)
Luis M. N
being the first duly sworn,deposes and says that:
1.He/she is of OWniof GN RemodE
(Owner,partner,etc.) (Company)
the Bidder that has submitted the attached Bid;
2.He/she is fully informed respecting the preparation and contents of the attached Bid and of all
pertinent circumstances respecting such Bid;
3.Such Bid is genuine and is not a collusive or sham Bid;
4.Neither the said Bidder nor any of its officers,partners,owners,subcontractors,agents,
representatives,employees or parties in interest including this affiant,has in any way colluded,
conspired,connived or agreed,directly or indirectly,with any other Bidder,firm or person to submit a
sham Bid in connection with the Contract for which the attached Bid has been submitted or to refrain
from bidding in connection with such Contract,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
price or prices in the attached Bid or of any other Bidder,or to fix overhead,profit or cost element of
the bid price or the bid price of any other bidder,or to secure through any collusion,conspiracy,
connivance or unlawful agreement and advantage against the City of Round Rock;
S. No member of the City Council,or any person in the employ of the City is directly or indirectly
interested in the bid,or the work to which it relates,or in any portion of the profits thereof;and,
6.The price of prices quoted in the attached Bid are fair and proper and are not tainted by any collusion,
conspiracy,connivance or unlawful agreement on the part of the Bidder or any of its agents,
representatives,owners,employees or parties in interest including this affiant;
7. I have read and understand the document and agree(s)to comply with the terms and conditions
contained as the date hereof;8.I the Bidder am not indebted to the City of Round krSck in any form or
manner.
\` � �n7
Signature: �l ,v,S '"n 1 NU11 Date: 03/10/2
Title: Notary:
(Apply Notary Seal)(Print or type names under all signatures)
Exhibit "A"
Attachment Q
INFORMATION REGARDING
THE USE OF MINORITY AND WOMEN'S BUSINESS ENTERPRISES(MBE/WBE)
Procedures for Implementation of 40 CFR Part 31.136(e)
(Minority Business Enterprise/Women's Business Enterprise)
Each bidder must fully comply with the requirements, terms, and conditions of the
Federal policy to award a fair share of sub-agreements to minority and women's
businesses. The bidder commits itself to taking affirmative actions contained herein,
prior to submission of bids or proposals.
Affirmative Actions
1. When feasible, segmenting total work requirements to permit maximum MBENVBE
participation.
2. Assuring that MBEs and WBEs are solicited whenever they are potential sources of
goods or services.This activity may include:
a. Sending letters or making other personal contacts with MBEs and WBEs
(contact CDBG for website information)or other MBE/WBEs known to the bidder.
MBEs and WBEs should be contacted when other potential subcontractors are
contacted,within reasonable time (fifteen days)prior to bid submission or closing
date for receipt of initial offers. Those letters or other contacts should
communicate the following:
i. Specific description of the work to be subcontracted;
ii. How and where to obtain a copy of plans and specifications or other
detailed information needed to prepare a detailed price quotation;
iii.Date quotation is due to the bidder;
iv. Name, address, and phone number of the person in the bidder's firm
whom the prospective MBE/WBE subcontractor should contact for
additional information.
b. Sending letters or making other personal contacts with local, state, Federal,
and private agencies and MBE/WBE associations relevant to the project. Such
contacts should provide the same information provided in the direct contacts to
MBE and WBE firms.
3. Establishing delivery schedules, if feasible, which will encourage participation by
MBEs and WBEs.
Determination of Compliance
It is to be noted that bidders must demonstrate compliance with MBE/WBE
requirements to be deemed responsible. Demonstration of compliance shall
include, but is not limited to, the following information:
1. Names, addresses, and phone numbers of MBE/WBEs expected to perform
Exhibit "A"
work;
2. Work to be performed by the MBEs and WBEs;
3. Aggregate dollar amount of work to be performed by MBEs and WBEs, showing
aggregate to MBEs and aggregate to WBEs separately;
4. Description of contacts to MBE and WBE organizations, agencies, and associates
which serve MBENVBEs, including names of organizations, agencies, and associations,
and date of contacts;
5. Description of contacts to MBEs and WBEs, including number of contacts, fields, (i.e.
equipment or material supplier,excavators, transport services, electrical subcontractors,
plumbers, etc.)and date of contacts.
To demonstrate compliance, all bidders must complete the following Minority and
Women's Business Enterprise Utilization Worksheet and submit it to the Owner with
their bid.
Exhibit "A"
This form to be submitted with Bid:
MINORITY AND WOMEN'S BUSINESS ENTERPRISE UTILIZATION
WORKSHEET
Grant Applicant
Project Number
Contractor/Engineer
Address,City,State,and Zip
Contact Person Telephone No
Amount of Contract MBE Percentage WBE Percentage:
1. MBE Subcontractor
WBE Address,City,State,Zip
Contact Person
Amount of Subcontract Tax ID Number
Scope Of Work
2. MBE ' Subcontractor
WBE Address,City,State,Zip
Contact Person
Amount of Subcontract Tax ID Number
Scope Of Work
3. MBE Subcontractor
WBE Address,City,State,Zip
Contact Person
Amount of Subcontract Tax 1D Number
Scope Of Work
4. MBE Subcontractor
WBE Address,City,State,Zip
Contact Person
Amount of Subcontract Tax [D Number
Scope Of Work
Exhibit "A"
Attachment R
SECTION 3 FREQUENTLY ASKED QUESTIONS
WHAT IS SECTION 3?
Section 3 is a provision of the Housing and Urban Development(HUD)Act of 1968 which ensures that
employment and other economic opportunities generated by certain HUD financial assistance shall,to
the greatest extent feasible, be directed to low and very low-income persons.
The City of Round Rock is committed to promoting employment,contracting,and training opportunities
to low and very low-income individuals and to business concerns who employ such individuals.
WHICH CITY OF ROUND ROCK PROJECTS ARE SUBJECT TO SECTION 3 REQUIREMENTS?
Section 3 projects include housing rehabilitation,housing construction and other public construction
(infrastructure,public facilities,park improvements etc.)assisted under the Community Development
Block Grant Program(CDBG)when the total funding amount exceeds$200,000.
WHAT IS A SECTION 3 BUSINESS CONCERN?
A Section 3 Business Concern is a business that meets at least one of the following criteria,documented
within the last 6 months:
1.At least 51%owned and controlled by low or very low income persons;or
2.Over 75%of the labor hours performed for the business over the prior 3-month period were
performed by Section 3 workers;or
3.A business at least 51%owned and controlled by current public housing residents or residents who
currently live in Section 8-assisted housing.
If your business meets the criteria as noted above,please register as a Section 3 Business Concern on
the HUD Section 3 Business Registry database here:
https://porta lapps.hud.gov/Sec3BusReg/BRegistry/What
•Please note that registry on this database DOES NOT GUARANTEE contract preference.The City of
Round Rock must still review and verify the attached certifications and provide final approval.
WHO IS A LOW-INCOME PERSON?To determine if a person is considered low-income,please refer to
the FY2021 HUD Individual Income limits included in the attached Section 3 Eligibility Guidelines.
WHO IS A"SECTION 3 WORKER"?
A Section 3 worker is any worker who currently meets,or when hired within the past 5 years met,at
least one of the following categories:
1.The worker's income for the previous or annualized calendar year is below the income limit
established by HUD;or
2.The worker is employed by a Section 3 Business Concern;or
3.The worker is a YouthBuild Participant.
Exhibit "A"
WHO IS A"TARGETED SECTION 3 WORKER"?
A Section 3 worker is any worker who currently meets,or when hired within the past 5 years met,at
least one of the following categories:
1.The worker is employed by a Section 3 Business Concern;or
2.Currently meets or when hired met,at least one of the following,documented within the past 5
years:
•living in the service area or the neighborhood of the project,as defined in 24 CFR Part 75.5;or
•Is a YouthBuild Participant.
If you have questions or need assistance,please contact the Community Development office at(512)
341-3328
Exhibit "A"
Section 3 Business Concern Certification
Instructions:
Enter the following information and select the criteria that applies to certify your
business's Section 3 Business Concern status.
Business Information
Name of Business.
Address of Business:
Name of Business Owner:
Phone Number: Email:
Preferred Contact Information
O Same as above
Name of Preferred Contact
Phone Number: Email:
Type of Business(select from the following options):
❑Corporation ❑Partnership ❑Sole Proprietorship ❑Joint Venture
Select from ONE of the following three options below that applies and provide
required documentation for verification and certification:
O At least 51% of the business is owned and controlled by low or very low income
persons (Refer to Eligibility Guidelines document).
o Most Recent Income Tax Return Statement
❑ At least 51% of the business is owned and controlled by current public housing
residents or residents who currently live in Section 8-assisted housing.
o Letter of verification from the Public Housing Authority
❑Over 75% of the labor hours performed for the business over the prior three-month
period are performed by Section 3 workers (Refer to Eligibility Guidelines document).
o Payroll Hours Log for ALL employees for the prior three-month period; and
o Payroll Hours Log for the prior three-month period showing at least 75%of total
hours were worked by Section 3 or Targeted Section 3 Workers; and
o Section 3 or Targeted Section 3 Self-Certifications for all workers included in
the 75% claim
Exhibit "A"
Business Concern Affirmation
I affirm that the above statements (on the frontside of this form) are true, complete, and
correct to the best of my knowledge and belief. I understand that businesses who
misrepresent themselves as Section 3 business concerns and report false information to
the City of Round Rock may have their contracts terminated as default and be barred
from ongoing and future considerations for contracting opportunities.
I hereby certify, under penalty of law, that the following information is correct to the best
of my knowledge.
Print Name:
Signature: Date:
Certification expires within six months of the date of signature
Information regarding Section 3 Business Concerns can be found at 24 CFR 75 5
FOR ADMINISTRATIVE USE ONLY
Is the business a Section 3 Business Concern based upon their certification and documentation
provided?
OYES ONO
Reviewer Comments:
EMPLOYERS MUST RETAIN THIS FORM IN THEIR SECTION 3 COMPUANCE FILE FOR FIVE YEARS.
EXHIBIT"B"
W9 FORM
10
Form W-9 Request for Taxpayer Give form to the
(Rev.March 2024) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service Go to www.irs.gov/FormW9 for instructions and the latest information.
Before you begin.For guidance related to the purpose of Form W-9,see Purpose of Form,below.
1 Name of entity/individual.An entry is required.(For a sole proprietor or disregarded entity,enter the owner's name on line 1,and enter the business/disregarded
entity's name on line 2.)
2 Business name/disregarded entity name,if different from above.
GN Remodeling LLC
3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1.Check 4 Exemptions(codes apply only to
c only one of the following seven boxes. certain entities,not individuals;
see instructions on page 3):
❑ Individual/sole proprietor ❑ C corporation ❑ S corporation ❑ Partnership ❑ Trust/estate
0
ai [ ❑ LLC.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership) . . . . Exempt payee code(if any)
a o Note:Check the"LLC"box above and,in the entry space,enter the appropriate code(C,S,or P)for the tax
ticlassification of the LLC,unless it is a disregarded entity.A disregarded entity should instead check the appropriate Exemption from Foreign Account Tax
o w box for the tax classification of its owner. Compliance Act(FATCA)reporting
.L Li Other(see instructions) code(if any)
a V
= 3b If on line 3a you checked"Partnership"or"Trust/estate,"or checked"LLC"and entered"P"as its tax classification,
v (Applies to accounts maintained
yand you are providing this form to a partnership,trust,or estate in which you have an ownership interest,check outside the United States.)
• this box if you have any foreign partners,owners,or beneficiaries.See instructions ❑
a) 5 Address(number,street,and apt.or suite no.).See instructions. Requester's name and address(optional)
183 Balch Rd
6 City,state,and ZIP code
Elgin,Tx 78621
7 List account number(s)here(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other - -
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a or
TIN,later.
Employer identification number
Note:If the account is in more than one name,see the instructions for line 1.See also What Name and
Number To Give the Requester for guidelines on whose number to enter. 8 5 - 3 9 3 8 0 8 2
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and,generally,payments
other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of /fin �h��Q�
Here U.S.person 1._,v'S 'r' I\1) I - Date 01/27/26
General Instructions New line 3b has been added to this form.A flow-through entity is
required to complete this line to indicate that it has direct or indirect
Section references are to the Internal Revenue Code unless otherwise foreign partners,owners,or beneficiaries when it provides the Form W-9
noted. to another flow-through entity in which it has an ownership interest.This
Future developments. For the latest information about developments change is intended to provide a flow-through entity with information
related to Form W-9 and its instructions,such as legislation enacted regarding the status of its indirect foreign partners,owners,or
after they were published,go to www.irs.gov/FormW9. beneficiaries,so that it can satisfy any applicable reporting
requirements.For example,a partnership that has any indirect foreign
What's New partners may be required to complete Schedules K-2 and K-3.See the
Partnership Instructions for Schedules K-2 and K-3(Form 1065).
Line 3a has been modified to clarify how a disregarded entity completes
this line.An LLC that is a disregarded entity should check the Purpose of Form
appropriate box for the tax classification of its owner.Otherwise,it
should check the"LLC"box and enter its appropriate tax classification. An individual or entity(Form W-9 requester)who is required to file an
information return with the IRS is giving you this form because they
Cat.No.10231X Form W-9(Rev.3-2024)