R-2016-3679 - 8/11/2016 RESOLUTION NO. R-2016-3679
WHEREAS, the City of Round Rock ("City") desires to purchase three (3) 2017 F-Series
Trucks for the Utility Department and Transportation Department, and
WHEREAS, the City is a member of the Texas Government Statewide Purchasing
Cooperative ("Buy Board"), and
WHEREAS, Silsbee Ford is an approved vendor of the Buy Board, and
WHEREAS,the City wishes to issue a purchase order to Silsbee Ford,Now Therefore
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK, TEXAS,
That the City Manager is hereby authorized and directed to issue a purchase order to Silsbee
Ford for the purchase of three (3) 2017 F-Series Trucks for the Utility Department and Transportation
Department.
The City Council hereby finds and declares that written notice of the date, hour, place and
subject of the meeting at which this Resolution was adopted was posted and that such meeting was
open to the public as required by law at all times during which this Resolution and the subject matter
hereof were discussed, considered and fonnally acted upon, all as required by the Open Meetings Act,
Chapter 551, Texas Government Code, as amended.
RESOLVED this 11th day of Augusts, 2016.
ALAN MCGRAW, Mayor
City of Round Rock, Texas
ATTEST:
SARA L. WHITE, City Clerk
0112.1604;00361883
CERTIFICATE OF INTERESTED PARTIES FORM 1295
1of1
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2016-81732
SILSBEE FORD,INC
SILSBEE,TX United States Date Filed:
2, Nanio°of govorttntentalenttty orstate.agency;that is anarty io-she:contract'FoYwhich°titeformas
07/08/2016
being filed.
CITY OF ROUND ROCK Date Acknowledged:
3 Provide the identification number used by the govemmental 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.
FLEET VEHICLES
PURCHASE OF VARIOUS FLEET AUTOMOBILES AND TRUCKS
Nature of Interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
DONALSON.DREW SILSBEE,TX United States X
5 Check only if there Is NO Interested Party. �ry
LJ
6 AFFIDAVIT
I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
SHIRLEY IRENE PAYNE f"
My Commission Expires r/--, -pt�✓c< c, ->
April 16,2019 'Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said --JY4 fZ R 0>J R U ►��- this the day of
20, I U, ._,to certify which,witness my hand and seal of office,
SI a re p of'cer administering oath Printed name of officer.a lministe ring.dath Title of officer administering oath
1.Forms provided by Texas Ethics Commission www.ethics.stateax.us Version V10.1021
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2016-81732
SILSBEE FORD, INC
SILSBEE,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 07/08/2016
being filed.
CITY OF ROUND ROCK Date Acknowledged:
07/12/2016
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.
FLEET VEHICLES
PURCHASE OF VARIOUS FLEET AUTOMOBILES AND TRUCKS
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
DONALSON, DREW SILSBEE,TX United States X
5 Check only if there is NO Interested Party. ❑
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 Version V1.0.1021