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R-2017-4320 - 4/13/2017 RESOLUTION NO. R-2017-4320 WHEREAS, the City of Round Rock ("City") desires to purchase playground equipment for the Veterans Park Improvement Project, and WHEREAS, the City is a member of the Texas Government Statewide Purchasing Cooperative ("Buy Board"), and WHEREAS, Webuildfun, Inc. is an approved vendor of the Buy Board, and WHEREAS, the City wishes to issue a purchase order to Webuildfun, Inc.,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 Webuildfun, Inc. for the purchase of playground equipment for the Veterans Park Improvement Project. 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 formally acted upon, all as required by the Open Meetings Act, Chapter 551, Texas Government Code, as amended. RESOLVED this 13th day of April, 2017. ALAN MCGRAW, Mayor City of Round Rock, Texas ATTEST: -. ln; SARA L. WHITE, City Clerk 01 12.17C4,W7754W CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos.i-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. 2017-168589 Webuildfun, Inc Allen,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 02/17/2017 being filed. City of Round Rock Parks&Recreation 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. Round Rack Veteran's Memorial Playground equipment and surfacing 4 Nature of Interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary 5 Check only if there Is NO Interested Party. X 6 AFFIDAVIT I swear,or affirm,under penalty of perjury,thattheabove disclosure is true and correct. E v'crrh,� J Lary CAROL PAINTER / I Notary Public,8ta[e of Texas Comm.Expires 06-30-2020 Vince Allen 11,mo` Notary ID 12657538.4 Signatu of authorized agent of contracting business amity AFFIX NOTARY STAMP/SEAL ABOVE Sworn to and subscribed before me,by the said Vince Allen this the 17 day of February 20 17 ,to certify which,witness my hand and seal of office. Janie Carol Painter Secretary nature o officer administe Printed name of officer administering oath 1'ille of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 lafl 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. 2017-168589 Webuildfun, Inc Allen,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 02/17/2017 being filed. City of Round Rock Parks&Recreation Date Acknowledged: 04/11/2017 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. Round Rock Veteran's Memorial Playground equipment and surfacing Nature of interest 4 Name of Interested Party City,State,Country(place of business) (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. X 6 AFFIDAVIT I swear,or affirm,under penally 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 V1.0.277