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CM-10-01-010AGREEMENT FOR DIRECT PAYMENT TO MOVER County: Williamson County ROW CSJ: Project: City of Round Rock Intermodal Transit and Parking Facility ( Li Parcel: The undersigned displacee hereby agrees that payment for relocating the personal property identified on the attached inventory and belonging to Austin Group for the Elderly from 110 South Brown, Round Rock, TX 78681 to 475 Round Rock West Drive, Suite 120, Round Rock, TX 78681 will be made to Berger Transfer & Storage / Allied Van Lines upon receipt by the City of Round Rock of the unpaid invoice. The City of Round Rock reserves the right and responsibility of determining the "reasonable and necessary" charges for the move as is customary in the industry. The displacee also agrees to furnish any necessary IRS documentation to the service provider required by this payment. Austin Group for the Elderly Representative' s Signature 7 Berger Transfer & Storage / A11ie Lines Representative's Signature The C. o . Round Rock Representative's Signature R Nusa. , Manact' (AD Date: 1/ ci 7/c Date: �4 /e Date: SAM_0030 SAM_0043 SAM_0038 SAM_0025 SAM_0035 SAM_0029 SAM_0042 SAM_0037 SAM_0026 SAM_0034 SAM_0046 SAM_0041 SAM_0024 SAM_0027 SAM_0033 SAM_0045 SAM_0040 SAM_0022 SAM_0028 SAM_0032 SAM_0044 SAM_0039 SAM_0023 SAM_0036 SAM_0031 TrMIneloa Form ROW-R-CE Rev. 5/2003 GSD-EPC Page 1 of 1 CERTIFICATION OF ELIGIBILITY ROW CSJ: Parcel: Displacee: Austin Group for the Elderly I certify that myself and any other party(ies) with a financial interest in this relocation assistance claim are either: [J Citizens or Nationals of the United States or n Aliens lawfully present in the United States If an Alien lawfully present in the United States, supporting documentation will be required. If an incorporated business, farm or non-profit organization, I certify that I have signature authority for this entity and such entity is lawfully present in the United States. Date: Claimant Date: Claimant BERG£R!' MS, INC • DALLAS 111 REGAL ROW DALLAS, TX 75247 214/638.3980.800/678-3980 TxDOT No. 005850382 PROPOSAL FOR SE.fVIA,E 15415 INC •DA� 3021 PIC HOUSTON 16ER 7 GREEN MOUNTAIN IXI SAN ANTONIO Contract# AUSTIN, TX 78728 HOUSTON, TX 77092 SAN ANTONIO, TX 78247 512/834-7777 . 800/876-2374 713/688-0381 •800/231-6432 210/507-5980 . 866/363-0510 iif-Proposed charges sat r.,,.. .,_.^,w are BINDING AND GUARANTEED - -- - o ser.•ces !istec ' NOTICE BELOW. 'i' "..,... da_a r_.a.,,: Sc IMPORTANT 0 Proposed o; arses se: forth herein are NOT TO chargess shet be rteaerrrihee s .•,. have heart cor_ _�_ s e.. of exceed :heernoch'se: forth below under Lttax'^_.es Not o Ex_?0TTN N.0,CE 2__0wCI Price is governed by pre-exlst:na contract IMPORTANT NOTICES A. This proposal is for listed items and services only. Additional items and services may result in additional costs. B. Shipper shall be required to pay for all charges prior to unloading in cash or by certified check or money order, except as maybe otherwise agreed in writing between carrier and shipper C. Carrier's Liability for loss or damage :S L; ,'.:TED TO 5.50 PEP POUND PEP, ARTICLE_ unless carrier and shipper agree in writing to a higher limit of carrier liability. D. To the extent charges proposed are based on a hourly rate: Shipper agrees that the number of hours is not needed for this proposal and will be determined when the move is completed. Shipper's Initial E Carrier and Shipper agree that any additional items or services not included in this proposal and the maximum charges therefor may be set forth in an addendum hereto or a substitute proposal executed by carrier and shipper. F. Shipper acknowledges receipt of Your,Rigcts and Pesponsibii;5es Una, . _._ Mo:,_ Texas cerhpnLert. Shipper's Initial /J?'7 ORIGIN /1/ Shipper Al/ 6r&-� Loading ddress //1i0Sf� City ,C✓.vc./ c&C State -7c Zip ?IL-CTV County Phone PROPOSED COST OF SERVICES DESTINATION Consignee Deliveryddress Ori mac: /t City ,Pc c/( State '75Z Zip 7S761 / Phone County Transportation Costs 1. Transportation: Tariff # of Miles Est. Weight/igOOO Ib. Moving as Ib. Trans Charge 2. Additional Transportation Charges (Item 170): _O Origin 7 Destination 3. Local Services: Vans / Men . ' Estimated Hours 9 Rate Per Hour /6), • CC. ) 4. Travel Time Charges: PROPOSED COST OF SERVICES Valuation/Insurance 5. Di Insurance 0 Valuation for Transportation Protection Selected: ❑ Depreciation Value/` ^1leplacement Value -'No Deductible ❑ Deductible Amt. S ){.. Requested Amt- $ C:Li' t per 5100.00 or fraction thereof 7(_' C �J PROPOSED COST OF SERVICES PROPOSED CHARGES / 4/re- PROPOSED CHARGES Storage 6. A) Storage: Weight B) Warehouse Handling: C) Extended Valuation: D) Pick-up or Delivery: PROPOSED COST OF SERVICES Ib First Day @ per 100 Ib + Add'I Day(s) @ Weight lbs @ per 100 lbs Weight Ib per 100 Ib. Charge S Other Services 7. Special Servicing of Appliances: 3 Orig 0 Dest. 8. Piano or Organ Handling Charge(s): $ / Flight carry: @ $ 9. A) Elevator/Stair D Orig. Elevator @ Stairs - No. of Flights @ Distance Ft. @ B) Distance: D Des 'Elevator CO Stairs - No. of Flights @ Distance Ft. @ 10. Bulky Item(s): (1) /r AIV 5 SZ'- Qi (2) $ (3) $ (Auto -Make Model Yr Wt ) 11. Containers, Packing, Unpacking (see detail below) PROPOSED CHARGES PROPOSED CHARGES SO -0T) PACKING & UNPACKING SERVICE Items Quantity Containers Rate Amount Packing Quantity Rate i Amount Unpacking Quantity ! Rate Amount Dish Pack Cartons: Less than 3 cubic ft. 3 cubic feet I I 4.5 cubic feet I 6 cubic feet 6.5 cubic feet Wardrobe Ctn.. not less than 10 cu- ft. Mattress Carton: Crib Twin (not exceeding 35' X 751 Double (notexceeding 54' X 755 ') King/Queen (exceeding 54' X 751 Lonq/S (39' X 80') Corrugated Containers Crates (gross measurement -see below): Add Container. Packing & Unpacking Totals insert sum total line 11. Total Container Charges S Total Packing ng Charges 5Charges Total Unpacking S 12. Labor 13. Extra Stop(s) Man/Men for Hours @ per man/hour 14. Third Party Charges: 15. Other Charges/Other Local Charges: Shippers Billing Address PACKING DATE(S) ' Pick-up Period Delivery Period TOTAL PROPOSED CHARGES i Earliest . Earliest _ _ - MAXIMUM BINDING CHARGES ' /920.0t5 Latest Latest ______._ MAXIMUM CHARGES NOT TO EXCEED Preferretl/ Preferred Estimator ��G'L moi~ Date //,',//Issuing Agent g,r� 1-77:-/----- Code Shtpp rte, Date City/State/Zip /" ., TX Phone _.F. y -7» 7 ' © FORM 4185 REORDER FROM SOUTHWEST MOVERS ASSOCIATION. AUSTIN, „, 512-476-0187 DATE: January 8, 2010 SUBJECT: City Manager Approval —January 15, 2010 ITEM: Consider executing an Agreement for Direct Payment to Mover with Berger Transfer & Storage / Allied Van Lines for relocation expenses of Austin Group for the Elderly in connection with their vacation of the property for the Intermodal Transit and Parking Facility Project. Department: Staff Person: Legal Steve Sheets/Don Childs Justification: To assist in the relocation of personal property belonging to Austin Group for the Elderly. Strategic Plan Relevance: Mobility and Connectivity Strategic Initiative 2060 Vision: Residents and visitors will have alternative choices for transportation including public transportation options, pedestrian/biking options and personal vehicle. Funding: Cost: $1,990.00 (estimated) Source of funds: 2002 G.O. Bonds Outside Resources (if applicable): Public Comment (if applicable): UPDATED APRIL 2008 00180033.DOC 05/12/2009 Request for City Council/City Manager Action City Council Ci] City Manager Submit completed form for all City Manager and City Council approvals. Department Name: Legal Contact Person: Don Childs / Lisa Dworaczyk 1 Rose McMillin Contractor/Vendor: Berger Transfer & Storage / Allied Van Lines Project Mgr/Resource: magrozirercromm Original Documents Received: Project Name: Intermodal Transit and Parking Facility Project Coordinator: Assigned Attorney: Steve Sheets/Don Childs City Council or City Manager Approval Date: Agenda Wording Funding Source: 2002 General Obligation Bonds Additional funding Source: AMOunt: $1,990.00 (Estimate) Account Number: 15 -Jan -10 Consider executing an Agreement for Direct Payment to Mover with Berger Transfer & Storage / Allied Van Lines for relocation expenses of Austin Group for the Elderly in connection with their vacation of the property for the Intenradal Transit and Parking Facility Project. Finance Information Is Funding Required? Yes I i 1 No t I l Initial Construction Contract Construction Contract Amendment # _ Change Order Change in Quantity Unforeseen Circumstances Initial Professional Services Agreement Supplemental Professional Service Agreement Purchasing/Service Agreement Purchase Order Item(s) to be purchased E1Other (Please clearly identify action on lines below) Agreement FINANCE N/A Approved 0 n ao APPROVALS Yrmplated ONLYby Finance) Finance Approval Amount $1,990.00 (Estimate) Finance/CIP L. Olsen Date 01/12 1 0 yl Delaney 01113/2010 Finance/Acct E. Wilson Date 01/13/2010 Finance D r Date Purchasing EE Bowden Date 01/12/2010 Budget P. Bryan Date 01/12/2010 Once approvals have been obtained, please forward the RFA, blue sheet, backup information and originals to City Secretary, Sara White. ITEMS WILL NOT BE PLACED ON THE COUNCIL AGENDA WITHOUT FINANCE AND LEGAL APPROVAL PRIOR TO SUBMISSION. Required for Submission of ALL City Council and City Manager Items Project Mgr. Signature: Dept. Director Signature: 'City Attorney Signature:: Date: Date: Date: C:\Documents and Settings\rmcmillin\Local Settings\Temp ark Intpet iles OLK352\1-15-10 Rose_Legal_RFA Agmt for Direct Pa REVISED 01132)2010 City Manager Signature: Date: J J . yment to Mover (0018002).XLS *City Attorney signature is required for all i ems. LEGAL DEPARTMENT APPROVAL FOR CITY COUNCIL/CITY MANAGER ACTION Required for Submission of ALL City Council and City Manager Items Department Name: Legal Project Mgr/Resource: Steve Sheets/Don Childs Council Action: ORDINANCE Agenda Wording Project Name: Intermodal Transit and Parking Facility ContractorNendor: Berger Transfer & Storage / Allied Van Lines F-7 RESOLUTION City Manager Approval CMA Wording Consider executing an Agreement for Direct Payment to Mover with Berger Transfer & Storage / Allied Van Lines for relocation expenses of Austin Group for the Elderly in connection with their vacation of the property for the Intermodal Transit and Parking Facility Project. Attorney Approval 'Attorney Notes/Comments 1 Date //,/,/ O:\wdox\SCClnts\0199\7123-BROWN\M ISC\00180042.XLS Updated 6/3/08