Loading...
Contract - Patin Construction - 6/23/2016City of Round Rock, Texas Contract Forms Standard Form of Agreement: Section 00500 City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor AGREEMENT made as of th C day of S� in the year 2016 . BETWEEN the Owner: City of Round Rock, Texas (hereafter "Owner" or "City") 221 East Main Street Round Rock, Texas 78664 and the Contractor Patin Construction, LLC ("Contractor") 3800 W 2nd Street Taylor, TX 76574 The Project is described as: SUNRISE RD MEDIAN CONSTRUCTION Engineer is: KENNEDY CONSULTING INC. TBPE Red. No. F-926 205 E. UNIVERSITY AVENUE, SUITE 450 GEORGETOWN TEXAS 78626 For and in consideration of the mutual terms, conditions and covenants of this Agreement and all accompanying documents between Owner and Contractor, the receipt and sufficiency of which are hereby acknowledged, Owner and Contractor agree as follows: ARTICLE I THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement, Conditions of the Contract (General, Supplementary and other Conditions) Drawings, Specifications, Addenda issued prior to execution of this Agreement, other documents lined in this Agreement and Modifications issued after execution of this Agreement; these form the Contract, and are 'a MY apart of the Contract as if attached to this Agreement or repeated herein. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations, representations or agreements, °jet written or oral. An enumeration of the Contract Documents, other than Modifications, appears in Article 7. 41'1CLE 2 THE WORK OF THIS CONTRACT Contractor shall fully execute the Work described in the Contract Documents, except to the extent specifically wed in the Contract Documents to be the responsibility of others. 'rY-Tn1l6 Page 1 of 5 Standard Form of Agreement ARTICLE 3 DATE OF COMMENCEMENT; DATE OF SUBSTANTIAL COMPLETION; DATE OF FINAL COMPLETION 3.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a Notice to Proceed issued by Owner. 3,2 The Contract Time shall be measured from the date delineated in the Notice to Proceed. 3.3 Contractor shall commence Work within ten from the date delineated in the Notice to Proceed. 110) calendar days Contractor shall achieve Substantial Completion of the items of Work listed on Attachment A to this nent no later than N/A (N/A ) calendar days from issuance by Owner of Notice to Proceed, Contractor shall achieve Substantial Completion of the entire Work no later than 6(0 ) calendar days from issuance by Owner of Notice to Proceed, subject to nents of this Contract Time as provided in the Contract Documents. 3,5 If Contractor fails to achieve Substantial Completion of the Work (or any portion thereof) on or before the date(s) specified for Substantial Completion in the Agreement, Contractor shall pay to Owner, as liquidated damages, the sum of five hundred and No/100 Dollars (s 500 ) for each calendar day that Substantial Completion is delayed after the date(s) Tecifted for Substantial Completion. It is hereby agreed that the liquidated damages to which Owner is entitled hereunder are a reasonable forecast of just compensation for the harm that would be caused by Contractor's failure to achieve Substantial Completion of the Work (or any portion thereof) on or before the date(s) specified for Substantial Completion in the Agreement. It is agreed that the harm that would be caused by such failure, which includes loss of expected use of the Proj ect areas, provision of alternative storage facilities and rescheduling of moving and occupancy rtes, is one that is incapable or very difficult of accurate estimation. It is hereby agreed that if Substantial Completion of the Work (or any portion thereof) is not achieved on or before thirty (30) days after the date(s) specified for substantial Completion in the Agreement, the Owner shall have the option to either collect liquidated damages as set efth herein or to thereafter rely on its remedies under the Contract Documents and at law and in equity, including +ithout limitation, the recovery of actual damages. The date(s) specified for Substantial Completion of the Work (or tY portion thereof) in the Agreement shall be subject to adjustment as provided in the Contract Documents. Contractor shall achieve Final Completion of the entire Work no later than seventy 10 —) calendar days from issuance by Owner of Notice to Proceed. WICLE 4 CONTRACT SUM lI Owner shall pay Contractor the Contract Sum in current funds for Contractor's performance of the Contract hContract Sum shall be seven hundred ninetv six thousand three hundred seventv ), subject to additions and deductions as provided in the Contract Documents. x Does � the Contract Sum include alternates which are described in the Bid Form? • Yeses Ifyes, please provide details below: Page 2 of 5 Standard Form of Agreement ARTICLE 5 PAYMENTS 5.1 PROGRESS PAYMENTS 5.1.1 Based upon Applications for Payment submitted to Engineer and Owner by Contractor, and Certificates for payment issued by Engineer and not disputed by Owner and/or Owner's lender, Owner shall snake progress payments on account of the Contract Sum to Contractor as provided below, in Article 14 of the City of Round Rock General Conditions, and elsewhere in the Contract Documents. 5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month. 5.1.3 Provided that an Application for Payment is received by Engineer and Owner, and Engineer issues a Certificate of Payment not later than the tenth (10th) day of a month, Owner shall make payment to Contractor not later than the tenth (10th) day of the next month. If an Application for Payment is received by Engineer and Owner after the application date fixed above, payment shall be made by Owner not later than one month after the Engineer issues a Certificate for Payment. 51.4 Each Application for Payment shall be based on the most recent schedule of values submitted by Contractor in accordance with the Contract Documents. The schedule of values shall allocate the entire Contract Sum among the various portions of the Work. The schedule of values shall be prepared in such form and supported by such data to substantiate its accuracy as Engineer and Owner may require. This schedule, unless objected to by Engineer or Owner, shall be used as a basis for reviewing Contractor's Applications for Payment. 5.1.5 Applications for Payment shall warrant the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.1.6 Subject to other provisions of the Contract Documents, the amount of each progress payment shall be computed as provided in Article 14 of the City of Round Rock General Conditions. 5.1.1 Except with Owner's prior written approval, Contractor shall not make advance payments to suppliers for materials or equipment which have not been delivered and stored at the site. FINAL PAYMENT 1 Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by Owner to Contractor when: 1 Contractor has fully performed the Contract except for Contractor's responsibility to correct Work, and to satisfy other requirements, if any, which extend beyond final payment; and L .2 a final Certificate for Payment has been issued by Engineer. rOwner's final payment to Contractor shall be made no later than thirty (30) days after the issuance of eer's final Certificate for Payment. In no event shall final payment be required to be made prior to thirty (30) �Z after all Work on the Contract has been fully performed. Defects in the Work discovered prior to final payment Abe treated as non -conforming Work and shall be corrected by Contractor prior to final payment, and shall not Itk%ted as warranty items. kknOLE 6 TERMINATION OR SUSPENSION 4d c�GThe Contract may be terminated by Owner or Contractor as provided in Article 15 of the City of Round e r Conditions. Page 3 of 5 6 Owner agrees to pay Contractor from available funds for satisfactory performance of this Agreement in ;cordance with the bid or proposal submitted therefor, subject to proper additions and deductions, all as provided in ie General Conditions, Supplemental Conditions, and Special Conditions of this Agreement, and Owner agrees to lake payments on account thereof as provided therein. Lack of funds shall render this Agreement null and void to e extent funds are not available. This Agreement is a commitment of City of Round Rock's current revenues only. Although this Agreement is drawn by Owner, both parties hereto expressly agree and assert that, in the of any dispute over its meaning or application, this Agreement shall be interpreted reasonably and fairly, and r more strongly for nor against either party. This Agreement shall be enforceable in Round Rock, Texas, and if legal action is necessary by either party respect to the enforcement of any or all of the terms or conditions herein, exclusive venue for same shall lie in .amson County, Texas. This Agreement shall be governed by and construed in accordance withthe laws and decisions of the State of Texas. Both parties hereby expressly agree that no claims or disputes between the parties arising out of or relating Agreement or a breach thereof shall be decided by an arbitration proceeding, including without limitation, needing under the Federal Arbitration Act (9 USC Section 1-14) or any applicable state arbitration statute. The parties, by execution of this Agreement, bind themselves, their heirs, successors, assigns, and legal tatives for the full and faithful performance of the terms and provisions hereof. This Agreement is entered into as of the day and year first written above and is executed in at least three (3) copies, of which one is to be delivered to Contractor, one to Engineer for use in the administration of the , and the remainder to Owner. OF RO D RR�OC TEXAS L, AvIA TO FORM: Page 5 of 5 CONTRACTOR Printed Name: Title: Date Signed: l _ PERFORMANCE BOND BOND NO.: 70125364 STATE OF TEXAS KNOW ALL BY THESE PRESENTS: OF WILLIAMSON Patin Construction, LL of the City of Taylor , County of amcon , and State of Texas , as Principal, and The Guarantee Company of North America USA sized under the law of the State of Texas to act as surety on bonds for principals, are held kmly bound unto THE CITY OF ROUND ROCK, TEXAS, (Owner), in the penal sum of 1 Six Thousand Three Hi 98 ($ $796,370.00 ) for the payment whereof, well and truly to be made the said adpal and Surety bind themselves, and their heirs, administrators, executors, successors and signs, jointly and severally, by these presents: EAS, the Princi al as entered intq a certain written Agreement with the Owner dated the 14,- / day of S , 20_ to which the Agreement is referred to and made a part hereof lly and to the same extent as if copied at length consisting of. Sunrise Rd Median Construction ime of the Project: , THEREFORE, THE CONDITIONS OF THIS OBLIGATION IS SUCH, that if the said Pal shall faithfully perform said Agreement and shall, in all respects, duly and faithfully ve and perform all and singular the covenants, conditions and agreements in and by said aIent, agreed and covenanted by the Principal to be observed and performed, including but invited to, the repair of any and all defects in said work occasioned by and resulting from in materials furnished by or workmanship of, the Principal in performing the Work Eby said Agreement and occurring within a period of twelve (12) months from the date of mpletion and all other covenants and conditions, according to the true intent and If said Agreement and the Plans and Specifications hereto annexed, then this obligation 1"1id; otherwise to remain in full force and effect; HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253, 'rnment code, as amended, and all liabilities on this bond shall be determined in With the provisions of said Chapter 2253 to the same extent as if it were copied at Page 1 Performance Bond iFTORMANCE BOND (continued) Vety, for value received, stipulates and agrees that no change, extension of time, alteration or Otion to the term of the Agreement, or to the Work performed thereunder, or the Plans, 0cifIcations, or drawings accompanying the same, shall in anywise affect its obligation on this 0d, and it does hereby waive notice of any such change, extension of time, alteration or jition to the terms of the Agreement, or to the work to be performed thereunder. S WHEREOF, the said Principal and Surety have signed and sealed this instrument day of .Tilly , 2016 . LLC Name Fess: 3800 West 2nd Street Taylor, TX 76574 Agent leth Nitsche led Name E Austin Nt Address State & Zip Code The Guarantee Company of North America USA Surety Kenneth Nitsche Printed Name By: Title: orne -In-Fact Add ess: One Towne Square, Suite 1470 Southfield Michigan Page 2 Performance Bond PAYMENT BOND BOND NO.: 70125364 STATE OF TEXAS § § KNOW ALL MEN BY THESE PRESENTS: NTY OF WILLIAMSON § Lt Patin Construction, LLC , of the City of Taylor , County of ,amson , and State of Texas as Principal, and The Guarantee Company of North America orized under the laws of the State of Texas to act as Surety on Bonds for Principals, are held USA firmly bound unto THE CITY OF ROUND ROCK, (OWNER), and all subcontractors, kers, laborers, mechanics and suppliers as their interest may appear, all of whom shall have right to sue upon this bond, in the penal sum of mHundred Ninety Six Thousand Three Hundred Seventy Dollars and Zero Cents Dollars 196,370.00 ) for the payment whereof, well and truly be made the dPrincipal and Surety bind themselves and their heirs, administrators, executors, successors, dassigns, jointly and severally, by these presents: EREAS, the Principal has entered into a certain written Agreement with the Owner, dated ,G��. day of , 20 ,h, to which Agreement is ,by referred to and made a part hereof as Odly and to the same extent as if copied at length ein consisting of: Sunrise Rd Median Construction ne of the Project). N, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said 14al shall well and truly pay all subcontractors, workers, laborers, mechanics, and suppliers, monies to them owing by said Principals for subcontracts, work, labor, equipment, supplies !Materials done and furnished for the construction of the improvements of said Agreement, this obligation shall be and become null and void; otherwise to remain in full force and 11ED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253, Government code, as amended, and all liabilities on this bond shall be determined in F with the provisions of said Chapter 2253 to the same extent as if it were copied at Page 1 Payment Bond PMENT BOND (continued) pty, for value received, stipulates and agrees that no change, extension of time, alteration or otion to the terms of the Agreement, or to the Work performed thereunder, or the plans, it fications or drawings accompanying the same shall in anywise affect it's obligation on this ,anal it does hereby waive notice of any such change, extension of time, alteration or ion to the terms of the contract, or to the work to be performed thereunder. VITNESS WHEREOF, the said Principal and Surety have signed and sealed this Instrument 6th — day of July , 20 16 LLC The Guarantee Company of North America USA -� Surety ted Name - - t 3800 West 2nd Street Taylor, TX 76574 Agent Kenneth Nitsche Printed Name By: Title: orne -In-Fact Addr ss: One Towne Square, Suite 1470 Southfield, Michigan 48076 Page 2 Payment Bond Client#: 46421 PATINCON RDTM CERTIFICATE OF LIABILITY INSURANCE DATE 8016 fIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS JE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED NTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. VT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the holder in lieu of such endorsement(s). le Group IUstin TX 78942-3299 66f) T NAME: Carla West NAME: PHONE979-540-2208 FAX A/C, No, Ext : A/C, No): E-MAIL carlaw thenitsche rOU ADDRESS: 9 p•COm INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Cincinnati Insurance Company 10677 Patin Construction LLC Taylor, r, 2nd Street TX 76574 Taylor, INSURER B: RSUI Indemnity Company 22314 INSURER C: Texas Mutual Insurance Company 22945 INSURER D: P Y Cincinnati Insurance Com an 10677 INSURER E: INSURER F: CERTIFICATE NUMBER: REVISION NUMBER: 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD HSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. F INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS 'LIABILITY GENERAL LIABILITY ADE a OCCUR 000 90ed:2,000 EPP0166349 10/25/2013 10/25/201 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $10,000 PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GREGATELIMIT APPLIES PER: PRO- ICY X PRO LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 $ LIABILITY *%EDSCHEDULED A UTOS BITOS X NON -OWNED AUTOS Olt Car EBA0166349 10/25/2015 10/25/201 COEaMBINED accidentSINGLE LIMIT $11,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident $ LIAR X OccuR UAB X CMS-MADE X RETENTION $0 EPP0166349 10/25/2013 10125/2016 EACH OCCURRENCE $5 000 000 AGGREGATE s5,000,000 $ PELT A IONILII 5' LIABILITY ORIPARTNER/EXECUTIVE YIN EREXCLUDED? [N] �) seder OE OPERATIONS below NIA 0001212733 6/03/2016 06/03/201 X WC STATU- OTH- TORY LIMITS EH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 �Ibrella NHA074949 2/29/2016 10125/2016 $5,000,000 11M51 LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 44edian Construction 410"y Consulting Inc., TBPE Reg. No F-926, 205 E. University Ave. Suite 450, Georgetown, Tx ptions) `'tyQf of Round Rock E• Main st end Rock, TX 7866,' of 2 ELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 087 l ri r LU ZZ Y O J Cd CL C 0 v Eq a X - I- U a o p o a U N � O tU 'C o r 0 T N Ni 'c � Q C � c fA W 000 N o o 0 0 o o 0 0 o o 0 0 o o 0 o o o 0 0 o o 0q o 0 0 0 o o 0 So o o 0 0 0 0 0 0 000000000000000 0 0 0 0 to o 0 0 0 0 o 0 0 0 0 0 o 0 O O N W m 0 0 0 0 0 0 w 0 tf) 0 0 0 0 0 m V J O t� M g r CO o o m O O m d' m O '- O m n N w m O m m m V M m h V V m O O m N m V n O1 o O V V M m n O N h O N O tD m N 1� O O V O N (O tD m J N V 0 M N n M f- N m V M m IT 0 r 0 I- r N O r. r th m M V M - r r m r (O N N N C p �•' m •� a r C X to M o 0 m M (n M M'(9 M w w t9 W o w (9 w M M M 69 w W m t9 f9 w (9 m (9 M w (R (9 M co (9 CO 3 0 r O O O O O o O O O O O O O O O O O O O O O O O O O O O O O O o 0 O O 0 0 O O 0 0 O O 0 0 O O 0 0 O o r N N N m M O O O O O O O O O O O O O O O O O O w O N N O O o w w N o O O t] O O O O V' m r m w N r r N ID M 0 o 0 0 0 M M M C o N W f- O N N N r p t0 m r m N N M M r O o m M N N r w N(D O N V O r r f+ O N tO m M M M M M M M a N O N IL F Z y o o 0 0 0 o 0 0 o o 0 0 0 o N O O o O Op o o O 0 o O O o 0 O OO o o O o o O O o o O M 0 0 O r o o (p O o o O O o o O O o o O O o w O m o o 0 0 0 0 N m Z O O M W M Vl O r r m n N r V N O N n O IQ o N O Or N m M co O o mr-- m o O r m N N N at N N m (D m V N r O o O N NN O O N oO _ r (D r 0 0 ov (ji N V u) O` O m N r (V O V V mf` M r' M m tD N O O N M h r m t' r r N r r n. oO N N r V p 60 Q p O (9 (� f9 f9 t9 M E9 (9 f9 (!) M f9 t9 M fA !9 M f9 M m fA IA (R t9 l!f (A (9 fA M f9 F9 f9 (R m fA FA (9 G U 0 UN w 0 0 0 0 o o 0 0 o o 0 0 0 O tD O o o O O o o O O o 0 O O 0 0 O O o o O O o o O O o to O V o _ O m 0 0 n O 0 0 O O o o O O o o O O o In O m o o 0 0 o 0 N C U O V fCl tri O In N N O O o O N o o 0 0 0 (O m V Ih t` In r N NI M 0 0 0 0 0 (D M O It w'r M p O .- �-• M r N M O co N m N N N o O m u7 r r M OO N N O o N m O r N r N N N U a Oi r N r rn z w D o 69 (A m M w w W o :9 (9 (9 M w t9 w (A w w M M 69 69 w (9 M o w o w M M W w m w W h 0 V Rt h p N d F v C O O C _ y Q Lu z m y 0v(L O > S mU0 amu) m9w > EL pwa 9 m ~~~ Q m O W O r (L U} o I o w a;a ¢ Y - 2 2 2 >g z m 2 LLUS w m za a a d y ¢ >w w = a a a z z ce z wI-- p• o o w (n v v m J as 2 Z w W W o w 1 I- Y !_ m w o Z w w w w W O O a Q 4 r O S W m O O Q (d/J N f- Wj t- W (� a w z m m W I- w !- fn m E- Q O w a o a YQ U w m w W a z 00 w z w w z Z O O 0 Z W ° z O » O O U m m c2 O g w O N z m o O z `� (n z z w w J W 3( -I -r z 000a aQo4a }r Jz v" o (9N o �a �c�000 v wwwQF O w m n w W w w Q J 00000m?m? Z m W m m m Dom .. v U< t9 m W W W m v D z U U z z m Q Q U U` U U m M LL LL U U Lj z O J w a 0 O O 2 2 2 2 of m 0 0 O O 0 0 U N W O z M J J J o 2 woo0coLLIm m J J J Q�wwwo V >>zw(n(n(nc9zzzz�r�oor U U U U U N O_ w iv iv iN r g ci U ti of Q °• J a a s F w Z¢ z o w O O D U U U w w w w O 0 F z g U U U U` zdda I" W m0wQQQaaoo�(�w 2 m m m li fY 0 O w W wt aaaazzzzm 0 0 -00 0 0 w, 'o w w nm w w Q>>>> w w w a Ix U X Q X X 2 2 N m z U O w _O w U w Z U` C'J Z !- t- h, U U 0 0 U U 0>0 Z D' z 0 tY w J > J O O Fn Fn 0 000 LLa J U m sa O 0 v) O w Z W L w W W ww>>OOOww(? m w W "- �?n.OU000000JJJJww z 0 z Z z Z W W w w U m wmwww D. W w w w M m S x 2 O 0 D_ z c1 CL U D. m m 010 U O W W W W O W U? fL z>>> O! M N M M O O V m t` V V M V• tf] t9 I� m 0 0 m O 0 o M O O N m 0 N 0 0 M 0 O Cl) O O m m O m O m O O m (D O O m m o o m (D O O m m O N m m 0 N 0 0 N (D 0 0 m O 0 t0 H Z V V V' ID tp 0 0 0 m m O N N N M m m N N N N N N N N V V V' V O v m N N m w N m W W W W F- W W W W W F H W W W E W W f LL' I - F F f H f H W o a. N U = < LL LL w >. }} Z z Z ty„ tL (L LL a )- LL LL LL>' w LL tL LL LL LL LL LL QQ¢ Q W a W a Q W t- J 0 J (n (7 (n o O O J J J 0 w 0 0 0 J 0 J J J J J J J J W LL] W W W W X F- O r W Z Q ry r (D t� N O o) V N m Ln M (` (D V' O N r N 0 V m N M O m N N M Iq O Of M w O N tp N IO O N M V ma. o 0 N V m r m N CO •- m N CO D. r r r M r N a O 0 m m W W U) r N M V N m t` m 01 O r N M V tIi tD t` m tP O r N N N N M V N N M m N N n m N N m o N M N M co M V Cl) M Ill m M M h M m 0 Z }J ZZ XO >1 C za CD- C U �M Y O wo 4 � J Z m w FF- W Q O m U O O O O O O O O O O O O O O O O O O O O O O o o o o o c o o o n n o o o c o o o O o O O O o O p O O V' O N 1n 0 0 0 0 0 0 0 0 0 0 0 0 M N W m O N c) O O m V' m 0 0 0 0 0 0 F- N V (D O O O M m m M r N 117 O O o 0 0 0 n O O N (D r at m O m M In n (n O m m O V m J mM m (D O N m m M V' O to M M O O M o 0 0 M o N h �"' N n O r n m M (n m m N O (D r - M (D (D M 117 In n n r M N N MQ O V' O O O O n O M M r M n V' N N V' (D r V: M M r - J o r N M (V (V --M— r r N M N r r N V O Q .0 m 69 69 ffl FA 69 V7 69 49 HY (n 69 19 49 E9 M M w M w w w o w w w M M M M M M M M M M Ow w w o M N 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CHE, O O O O O O m O n V t` n p p p p p p 0 0 0 p p C7 h V' V' V. . n n o 0 r n O CO (�) M O (n to �" N N N o N (n (n O O Vi O O O r N N r r M V' O O N U MM (n to m m M M O ON mM M M tD M MOm00 0 to NLD, r N (n (n (n O N 1A 0 69 (n M 69 w o w (n w (n w M 69 M 69 N 0 M w M M V) M (n M m m w M !9 M fA fA FA 69 O O O N m m In V' 0 0 (D O O O O O o O N 0 0 0 0 0 N O O O O O N 0 0 0 0 0 0 0 0 0 0 0 N O O O M m m N O O O n O o O O o O O N O O O O O h O O O O O n O N o O O O O (n O (n o mF- (D V' mCl)m N ( V' M VU) m O O O O O O N O n 0 0 M N In O r 0 0 (O O V 00 (O O (() O V' N O OD (0 Z D) V M n to 00 n 0 m N M O 117 0 0 0 0 0 (D O M o O n D) m (D O In O V' 117 M (D n N O (D n M m m ' M M v 1' U) to m r to n M O V' O O M O M V' o n N m M tP N M h n CO V' N M N r n M (D M O 1n 20 U M �'- N r M m m N m M M m M r M r N r a o g v a U Q p O fA (A (n f9 f9 !9 t9 fn (n fA (n W M (n 43 M 49 Fn M (A (fl M (9 (9 (9 WO 000 M W W W W W W M 00069 C 0�D O O M M lD M O O m O O O O O O O N O 0 0 0 0 (n m O O O O (n 0 0 0 0 0 0 0 0 0 0 0 U W O O O n N m to m O O m m O O O O O O N O O O O O n N O 0 0 0 n 0 m 0 0 0 0 0 117 O (() O H e U M Cl) M m m h r N N U) r M 0 0 0 0 0 0 tb O —0 O r 0 r In N fO O O O O r m t0 to O O t0 (D m D V' V' V' N m M N O O O O O m O t2 O r to o N h 0 n � N N N m V' o O M (n M V' (n r N N M N N U d m (D N N r M CO V' c v InW to V3 69 fn M (n 69 (n 69 0 (n 69 0 119 m 0 t9 (9 En (n (n 69 W 69 W 69 10 to Fn 69 FA (n M M M M (n M (A (A (9 fn J_ J_ 00 J J m o C � ` Y - O J M a- o 'a�D�Nv}i�� 0 0� a U fu r,- YYYYYY `*� (- W ¢Q¢QQQZZ J N N N Y Y O w Lr ? z F-F-�i m❑ d p O W w w W W W 2 2 - O ¢ c In a ui�Luwww Z z io�Nu}i� vuxi � N C � Z U' J W W W W W W Z Z N 2 U (n Z 0 »»» w wC7C7C7C7C9C9U(9 M J J❑ m O O Q¢ Q Q Q Q 2 2 z Z Z Z z Z Z Z C W W ;d- ❑ J X J D_ LL m LL 0- LL w w — 3 c O z(n OWODUUUU»YYYYYYYY (n W Y ¢ a W W<<< W< Q ZZJ F- 2"v'm�vO�(n w(n(¢n U U 0 00 oZ oaJ Jm (nz U �2}<����J ��F N Z Z Z O Z Z- °- = ILLY, W W W LL LL n. 2 LL LL W W W W W W w w F - z 000000vOo aw 000000gS UUNM V' w a>>>>2^2222 �2 D_ m 22 c2 TL 2Z>M2O0 W W O M V' C M N z x 0 0 0 0 W of w w w W O O W W W W W W W W Z Z Q Q❑ 2 O � 2 2 2iw W W W W W 2 2>>>>>>>> Y Y W W W Z C9 C9 U' C7 C7�U' QQa O ❑ W W W WS2SSZS R:W¢<000Q.¢Q¢Wm �� � � N �F- Z . I I F -F F F - F - F- 2 z° aaaaaaaa< ❑ v v ¢ ¢ a ¢ ¢ ¢ r r > m z ¢ z z z z }- - }-} - - -}- W W W W m(n N �.7-.7-tT m���m20 Jiv JiN Ji�7 M v ,ZOO UZZ Z Z ^ 1-} r❑F-❑F-❑F-❑F-❑F❑I-O�OF-1-Wa? W2WW2WWWWpO WW22W H J r r LL Q. LL O Z N N N N N N W W N N N N N N N N mF t-pa��� ��IXIrwwww ^-"=1w��w���x» v v0o w w J J J J J JC90 4UUuw>>>> 00 mm00000000¢¢ w W w w F i m m m m m m w w wa ❑ (DM M(n U U U U UUtnNw J F -F- ¢CL 0-(L F-F-F-F-t-F-ool-F-{-F-F-F-1-F-aa C9 C7 C9 C9(L LLLLLLOW W NU UUUODULUWWW W W W W WWWW D. D_ C7 C9 C9 C9 K LL 0❑ z Z Z Z Z W W W W W W (y W W W W W W W W W W W m M m m Y X (D (D (D (n (n N 1- F- F- m W N N N N --7 J J J J J J J J J J J J J J J M� W W W W Q Q W W W W W W W O W W W W O Q Y Y Y } Y W W W W W W W W W W W W W W W W Q Q > > > a m m F- F- F- F- F- F- Z Z Z LL LL LL O O O co N O M M V V 0 N M :m O O MO O 00 O O O O O 000000 r 0 0 0 �r (D (D (D (D m (D w W m W co m co W w m O m N Z N N N N N N v V' V' "t V' V' m (D m n 00 m O M 0 0 0 0 M M m m CO m m m m W m m m m m m m m m m O O n h n n 1� t: n n r r n r n n n n r n r n n tD m m m m W w to m m m (D N m w m m m n m m m m m m m m m m m m m m m m m m m m m co m w0.O F F F F F- F- f F F F F F- F- F F F F F- (Y w w w K W w K x W w a K w W K w w ry W of W K Ir (n U F- S¢ Q:<< 2 LL LL LL U. LL LL Q¢ Q¢¢¢(n OLLQ¢LLLLLL LLLL 19 LL¢¢Q: z W W W W W W J J J J J J W W W W W W J 2 J W w J J J J J W W J W J J J J W W J W W W X F U F- m M N In m N h h h N N N n N N N n m R Z V' m N tD m (D M m m V' M �'- r M m r +'- N M m m ry M N M D -a. j V' M n m h CO n M w r M Qo m M p N M V to m h m M 0 N M V (n m n m M O N Cl) V' tD m n m m v 0 to M N In tD to (n (n O m m m (D 10 0 m m m m n n n n n r - 00, n h n h co CCL Q. p O U EO O tD O _a O w < M U r W z W W O Xrn WZLLJ N0m a 00 W a: w V J z W U n 2,:>: J a W p Z F F" W K 35 K,mJOU°Zw�wCF~70�� ,Ep �r2�Ho��`�r-- 1 0 (n W W zw — Z } W S} W Y H N Y�(n1-0 < Z W OU¢O c O > U U W- N �UWj ¢(n QZm JY=`r wU)0-1 m >wry 04 U�NF-dim ¢Uw�P�cLZ¢W wx¢¢ ,�, D- z�F- m W z0n.UU F- 2¢ W W O w W� cG V Xa-OWOUZF—W W mOOOO W Un el) (n U) (n W ZFWF--0-19LJ E 2 �7>_>_>_2pr W aF-1-hF- Cy W>>>>> W -j m 2 00 0 0 0 m r N M V M r r C 0 0 0 0 0 0 0 W W (o (D W (D (D N W U F Z C\jl NI N (NI N a)l ol O —1 C\11 co V M (D c H 2 7 X O! K CL: a� m wIIco WI co `I d 3 w � ;' swi � p�j•2�� LL z: •�: i �C-9J i O O OO O O 000000000 p O O Oa O V O 0 0 0 0 0 0 0q p F- N 0 0 0 0 (o o) 0 0 0 0 0 o N (V p J Z = M V W V O O M to W W r O MaM-- M N N M r- V V N V M V M M J O r V r (o M M O N M co (D 2 N Doo O O O O o 0 0 0 0 0 0 0 o LU 0 0 0 0 0 V Ih 0 0 0 0 0 0 0 0 U U M o to o o M N o o o o M o (V V C Q' M M W o) V O m M 0t2 MN N M (O V f` N V V V N M V O N M- (D LL F r Z (A (9 (9 w 69 19 E9 f9 69 Qi (9 (A 69 69 w 000r.00000000000 co y O O O (0 0 0 0 0 0 0 0 0 0 0 0 D {- V O O (fj (o 0 0 0 0 0 0 0 0 0 0 0 m o Z O N O O O r 0 LO N m r• CO W M N 00 O O M f� N W (D r W N M M N M o O N of (o (N M (N co N M N V ti a p U Q m oCO 69 49 69 w 69 (9 69 6% (9 69 (9 (9 w 69 69 ._ c u 'a2 O v WO 000t-00000000000 O O W O 0 0 0 0 0 0 0 0 0 0 U voouiMM rDa00000v L O Q.' O O M M N m N O O O O Fh M r• N o1 W M W M n N U d o) r (VW W N Cl) �- V' w W M M (A 09 (9 w w 69 (9 (9 69 19 69 (9 � O tD O _a O w < M U r W z W W O Xrn WZLLJ N0m a 00 W a: w V J z W U n 2,:>: J a W p Z F F" W K 35 K,mJOU°Zw�wCF~70�� ,Ep �r2�Ho��`�r-- 1 0 (n W W zw — Z } W S} W Y H N Y�(n1-0 < Z W OU¢O c O > U U W- N �UWj ¢(n QZm JY=`r wU)0-1 m >wry 04 U�NF-dim ¢Uw�P�cLZ¢W wx¢¢ ,�, D- z�F- m W z0n.UU F- 2¢ W W O w W� cG V Xa-OWOUZF—W W mOOOO W Un el) (n U) (n W ZFWF--0-19LJ E 2 �7>_>_>_2pr W aF-1-hF- Cy W>>>>> W -j m 2 00 0 0 0 m r N M V M r r C 0 0 0 0 0 0 0 W W (o (D W (D (D N W U F Z C\jl NI N (NI N a)l ol O —1 C\11 co V M (D c H 2 7 X O! K CL: a� m wIIco WI co `I d 3 w � ;' swi � p�j•2�� LL z: •�: i �C-9J i CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f1 Complete Nos. 1 - 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-64851 Patin Construction LLC Taylor, TX United States Date Filed: 06/02/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Round Rock Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2016 Sunrise Road Median Construction 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. 71 X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury; that-the-abovedisclosureis true and correct. VICTORIA L. FILLMAN Notary Public, State of Texas Z -� My Commission Expires November 15, 2016 Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Swor to and subscribed before me, by the said ! �(� j. �� this the day of 20, to certify which, witness my hand and seal of office. � c % V ;" k T Lu ,L Ivt-) Vi'u*ioy LAI v§jgnature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.1021 Forms provided by Texas Ethics Commission www.ethics.state.tx.us versiun vl.u.lv41 CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2016-64851 Date Filed: 06/02/2016 Date Acknowledged: 06/03/2016 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Patin Construction LLC Taylor, TX United States 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Round Rock 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 2016 Sunrise Road Median Construction 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said this the day of 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us versiun vl.u.lv41