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Contract - We Build Fun - 5/11/2017 PO BOX 29 '* Allen, TX 75013 We . ..... Phone: 972-727-0653 Fax: 972-396-4994 Miracle. of Norfh and z Central Texas Customer Information: Date: 4/5/2017 Katie Baker Est. Delivery: Consultant: The City of Round Rock Parks & Recreation Department Josh Bailey 301 W. Bagdad Ave Round Rock, TX 78664 Project: Play For All Expansion Buy Board Contract#512-16/Buy Board Vendor ID-2904 ITEM QTY DESCRIPTION EACH TOTAL Miracle Recreation Generation Swing 61-42593599854 1 Miracle Recreation- 5 inch O.D.frame arch swing with Generation $2,751.00 $2,751.00 Swing Seat Discount 1 Buy Board Discount -$413.00 -$413.00 Freight 1 Freight $278.00 $278.00 Install 1 webuildfun,inc, installation $1,080.00 $1,080.00 Total $3,696.00 USA Shade Shade 1 USA Shade- 55 ft,x 23 ft.x 16 ft.entry Joined Panorama $22,180.00 $22,180.00 Discount 1 Buy Board Discount -$1,109.00 -$1,109.00 Anchor Bolts 1 Anchor Bolts required for install $360.00 $360.00 Drawings 1 Sealed engineered drawings $850.00 $850.00 Freight 1 Freight $900.00 $900.00 Installation 1 Installation of the shade quoted above $16,535.00 $16,535.00 Total $39,716.00 Combined Quote Total $43,412.00 **Notes** *Price assumes all site work done by"other"unless noted above *Price assumes all drainage away from the play area by"other" unless noted above *Price assumes border by"other" unless noted above Thank you for the opportunity to provide this quotel If tax exempt, please provide tax exemption certificate In addition to manufacturer's warranty on materials, labor is warranted by webuildfun, inc.for 12 months from,Job completion if webuildfun, inc. provides the original installation Josh Bailey Prepared By: Approved by: *In the event rock is encountered,charges may be assessed. *It is the responsibility of the owner to obtain permits(unless specified above). *It is the responsibility of the owner to locate all underground utility lines.Webuidlufn will assist with this by requesting a line locate from Dig Test,at the owner's request. *webuildfun,inc. Will make every reasonable effort to respect all marked utility lines,and will repair damage webuildfun,inc,causes to *webuildfun,inc,will not be responsible for damage to unmarked utilties *Re-establishment of disturbed grass areas is not included in this quote and if necessary,is to be provided by owner *Prices are guaranteed for 30 days from date listed on quote. CERTIFICATE OF INTERESTED PARTIES FORM 1.295 101`1 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. 2017-198466 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 04/26/2017 being filed. City of Round Rock Date Acknowledged: g 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. Play for all Abilities Park Ex Playground Equipment/Site Amenities/Surfacing 4 Nature of interest 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 r 6 AFFIDAVIT I swear,or affirm,under enalty of perjury,that the dbove disclosure is true and correct. .,rw...�orrrruw•dw "AROL PAINTER .o•` �trlota{v Public,,,State of Texas t ° = C omn1.Exni,ns 06-30-2020 �oii Notch+y i:,) i:+:i.753$-4 Sign uthorized agent of contracting business entity AFFIX NOTARY STAMP/SEAL ABOVE Sworn to and subscribed before me,by the said Vince Allen this the 26 day of April 20 17 to certify which,witness my hand and seal of office. Janie Carol Painter Office Administrator Signatu 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 V1.0.883 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. 2017-198466 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 04/26/2017 being filed. City of Round Rock Date Acknowledged: 05/04/2017 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. Play for all Abilities Park Ex Playground Equipment/Site Amenities/Surfacing 4 Nature of interest 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 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 V1.0.883