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CONTRACT N0. �1
04
ST AMENDMENT TO CITY SECRETARY CONTRACT NO. 47288
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68 aREAS the City of Fort Worth ("City") and Day Resource Center for the Homeless,
Solutions ("Agency"), a Texas non-profit corporation made and entered into City
Secretary Contract No. 47288 ("Contract");
WHEREAS,the Contract provides funding to Agency pursuant to a grant received by City
from the United States Department of Housing and Urban Development ("HUD") through the
Emergency Solutions Grant Program ("ESG");
WHEREAS, Program consisted of daytime emergency shelter services, including basic
personal facilities;
WHEREAS,Agency discontinued their daytime emergency shelter services due to closure
of their facility on December 14, 2016;
WHEREAS, as a result of the closure, the unexpended ESG funds in the amount of
$104,110.19 were rescinded from Agency;
WHEREAS, Agency continues to operate at different locations and provides prevention
and rapid re-housing services to homeless persons and persons at risk of homelessness;
WHEREAS, City has remaining ESG balances in the amount of$22,372.17 from 2015-16
activities that must be expensed by September 30, 2017;
WHEREAS, it is the mutual desire of City and Agency to amend the Contract to award
Agency remaining 2015-16 ESG funds to provide needed services to City citizens and comply
with federal expenditure regulations.
NOW, THEREFORE, City and Agency hereby agree to amend the Contract as follows:
I.
EXHIBIT "A" —PROGRAM SUMMARY attached to the Contract is hereby revised
and replaced with the attached EXHIBIT "A" —PROGRAM SUMMARY REVISED 03/2017.
EXHIBIT "B" —BUDGET attached to the Contract is hereby revised and replaced with
the attached EXHIBIT "B"—BUDGET REVISED 03/2017.
II.
This amendment is effective as of the Effective Date of the Contract.
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
Amendment No. 1 to CSC No.47288 -_Page 1
Day Resource Center for the Homeless dba DRC Solutions(ESG) Rev. 03/2017
III.
All terms and conditions of the Contract not amended herein remain unaffected and in full
force and effect, are binding on the Parties and are hereby ratified by the Parties. Capitalized terms
not defined herein shall have the meanings assigned to them in the Contract.
[SIGNATURES APPEAR ON FOLLOWING PAGE]
Amendment No. 1 to CSC No.47288 Page 2
Day Resource Center for the Homeless dba DRC Solutions (ESG) Rev. 03/2017
ACCEPTED Al�TD AGREEDo
DAPIt+SOURCE CIEI`\\t 1TIER FOR
TfflE HODVi EL SS CITY OF FORT WORTH
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By: By:
B ce Frankel Fernando Costa, Assistant City Manager
Title:Executive Director
ATTEST: APPROVED AS TO IF,OPOU Al\\TD
ILIEGALNTY:
C ty Sepe Paige Meb e, ssistant City Attorney
M&C: - f79V
1295 Certification No. 2016-65529
Date: August 9, 2016
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OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
Amendment No. 1 to CSC No.47288 Page 3
Day Resource Center for the Homeless dba DRC Solutions(ESG) Rev.03/2017
DAY RESOURCE CENTER FOR THE EXHIBIT "A"
HOMELESS DBA DRC SOLUTIONS
Homeless Day Shelter/Prevention Services PROGRAM SUMMARY
PROGRAM SUMMARY
(ESG)
October 1, 2016 to September 30, 2017 $59,353.98
PERIOD AMOUNT
Capitalized terms not defined herein shall have meanings assigned them in the Contract.
PROGRAM 10/1/2016-12/31/2016:
The Program provides homeless persons access to daytime emergency shelter services, including
basic personal facilities such as showers and laundry, and access to co-located counseling and case
management services.
ESG Funds will be used to pay for the salaries and fringe benefits of Program employees involved
with case management and daily operations of the facility.
Agency will be transitioning Program services to another homeless services provider at some point
during Contract Term. Agency will provide City with a 60 day notice of when transition will
occur. Once transition occurs, Contract will be terminated and all ESG Funds awarded but unpaid
to Agency pursuant to the Contract shall be immediately rescinded and Agency shall have no
further right to such funds.
Agency office and Program services will be provided at 1415 E. Lancaster,Fort Worth, TX 76102,
Monday through Saturday, 7:30 a.m. to 4:30 p.m., and on Sundays, 12:30 p.m. to 4:30 p.m.
Benefits Eligibility services will only be provided at the Mabee Center, 1855 E. Lancaster Avenue,
Fort Worth, TX 76102; Presbyterian Night Shelter, 2400 Cypress Street, Fort Worth, TX 76102;
and Union Gospel Mission, 1331 E. Lancaster Avenue, Fort Worth, TX 76102, Monday through
Friday, 9:00 a.m. to 4:00 p.m., with evening appointments upon request.
PROGRAM 04/05/2017-9/30/2017:
The Program provides homeless prevention services for individuals and families who are at risk
of homelessness as defined by HUD, including short-term financial assistance for rent and/or
utilities. Case Managers will conduct a needs assessment,budget planning and provide referrals to
clients as needed. Any financial assistance will be short-term not to exceed 3 months.
ESG Funds will be used to pay for financial assistance in the form of rent and/or utility payments,
including arrears if necessary.
Amendment No. 1 to CSC 48417 Page 1
Day Resource Center for the Homeless dba DRC Solutions
Agency's administrative office is located at 1000 Macon Street, Suite 205, Fort Worth, TX 76102.
Clients will be screened over the phone and will be scheduled face-to-face appointments at one of
the following two locations: The Transfer Center at 1100 E. Lancaster Ave,Fort Worth, TX 76102
or Palm Tree Apartments at 2625 Race St, Fort Worth, TX 76111.
REGULATORY CLASSIFICATION:
Service Category (if more than one category, specify amount for each): ESG Emergency Shelter
Component
Regulatory Citation(s): 24 CFR 576.102
Agency will maintain documentation which verifies that 100% of the clients served are homeless
based on current HUD definitions.
Service Category (if more than one category, specify amount for each): ESG Emergency Shelter
Component
Regulatory Citation(s): 24 CFR 576.103
Agency will maintain documentation that 100% of clients served are at risk of homelessness as
defined by HUD AND that the client's household has annual income at or below 30% of AMI,
and that the client lacks sufficient resources and support networks to retain housing. Agency will
also maintain documentation on eligibility for the housing unit for which financial assistance is
provided, including rental amounts and compliance with ESG Minimum Habitability Standards
PROGRAM GOALS 10/1/2016-12/31/2016:
Minimum Number of Fort Worth Clients to be Served: The Program must serve a minimum
of 3,600 Unduplicated Clients from Fort Worth as shown by the monthly reports on Attachment
III.
PROGRAM GOALS 04/05/2017-9/30/2017:
Minimum Number of Fort Worth Clients to be Served: The Program must serve a minimum
of 20 Unduplicated Clients from Fort Worth as shown by the monthly reports on Attachment
III.
ESG PSA CONTRACT 2016-2017—EXHIBIT"A"—PROGRAM SUMMARY Page 2
Day Resource Center for the Homeless dba DRC Solutions
EXHIBIT "B" -BUDGET
jAccountj Grant Budget Increase Decrease Total
EMERGENCY SHELTER
ESSENTIAL SERVICES
Salaries 1001 $ 135,858.00 $ 101,496.82 $ 34,361.18
FICA 1002 $ 5,234.00 $ 2,613.37 $ 2,620.63
Life/Disability Insurance 1003
Health/Dental Insurance 1004
Unemployment-State 1005
Worker's Compensation 1006
Office Supplies 1007
Food Supplies 1008
Insurance 1009
Accounting 1010
Contract Labor Security(City needs copy of
contract before expenses can be reimbursed) 1011
OtherO 1012
SHELTER OPERATIONS
Maintenance 2001
Security 2002
Insurance 2003
Utilities 2004
Supplies 2005
Repairs 2006
OtherO 2007
SUBTOTAL EMERGENCY SHELTER $ 141,092.00 $ 104,110.19 $ 36,981.81
HOUSINGRELOCATION AND STABILIZATION
PREVENTION
Salaries 3001
FICA 3002
Life/Disability Insurance 3003
Health/Dental Insurance 3004
Unemployment-State 3005
Worker's Compensation 3006
OtherO 3007
REHOUSING
Salaries 4001
FICA 4002
Life/Disability Insurance 4003
Health/Dental Insurance 4004
Unemployment-State 4005
Worker's Compensation 4006
Other() 4007
SUBTOTAL HR&S
Amendment No. 1 to CSC 48417
Day Resource Center for the Homeless dba DRC Solutions Page 1
FINANCIAL ASSISTANCE
PREVENTION
Rental Assistance 5001 $ 20,000.00 $ 20,000.00
Utility Payments 5002 $ 2,372.17 $ 2,372.17
REHOUSING
Rental Assistance 6001
Security Deposits 6002
Utility Deposits 6003
Utility Payments 6004
Moving Costs 6005
Motel/Hotel Vouchers 6006
SUBTOTAL FINANCIAL ASSISTANCE
HOMELESS MANAGEMENT INFORMATION SYSTEM(BMIS)
HMIS Software Costs* 7001
SUBTOTAL HMIS
BUDGET TOTAL $ 141,092.00 $ 22,372.17 $ 104,110.19 $ 59,353.98
*HMIS Software costs are eligible for reimbursement beginning January 20,2017
Amendment No. 1 to CSC 48417
Day Resource Center for the Homeless dba DRC Solutions Page 2
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract,including
ensuring all performance and reporting requirements.
Barbara Asbury
Title
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature
M&C Review Page 1 of 6
Official site of the City of Fort Worth,Texas
CITY COUNCIL AGENDA FORTWORTH
COUNCIL ACTION: Approved on 8/9/2016 -Ordinance No. 22351-08-2016
CONTINUED FROM A PREVIOUS WEEK
DATE: 8/2/2016 REFERENCE G-18793 LOG NAME: 19NS HUDACTIONPLAN PY2016-
NO.: 2017
CODE: G TYPE: NON- PUBLIC YES
CONSENT HEARING:
SUBJECT: Conduct Two Public Hearings and Approve the City's 2016-2017 Action Plan for the Use of
Federal Grant Funds in the Amount of$10,094,608.00 from the United States Department
of Housing and Urban Development from the Community Development Block Grant,
HOME Investment Partnerships Program, Emergency Solutions Grant and Housing
Opportunities for Persons with AIDS Grant Programs, Authorize Collection and Use of
Program Income, Authorize Waiver of Application of Indirect Cost Rates, Authorize
Execution of Related Contracts and Adopt Appropriation Ordinance (ALL COUNCIL
DISTRICTS)
RECOMMENDATION:
It is recommended that the City Council:
1. Conduct two public hearings to allow citizen input and consideration of the City's 2016-2017 Action Plan
for use of federal grant funds from the United States Department of Housing and Urban Development in the
amount of$10,094,608.00 for the Community Development Block Grant, HOME Investment Partnerships
Program, Emergency Solutions Grant and Housing Opportunities for Person with AIDS grant programs and
for the use of program income from activities using prior years' federal grant funds;
2. Approve the City's 2016-2017 Action Plan for submission to the United States Department of Housing
and Urban Development including allocations of grant funds to particular programs and activities as detailed
below;
3. Authorize the collection and use of an estimated $130,000.00 of program income, which resulted from
activities using prior years' Community Development Block Grant fund, for the City's Priority Repair
Program;
4. Authorize the collection and use of an estimated $1,200,000 of program income, which resulted from
activities using prior years' HOME Investment Partnerships Program funds, for the completion of the Hardy
and HFC Terrell Single-Family housing development projects and 10 percent for administrative costs as
detailed below;
5. Authorize the City Manager or his designee to execute contracts for one-year terms with the agencies
listed in Tables 1, 2 and 3 below, for Program Year 2016-2017 for Community Development Block Grant,
Emergency Solutions Grant and Housing Opportunities for Persons with AIDS grant funds, contingent upon
receipt of funding and satisfactory completion of an Environmental Review and all regulatory
requirements;
6. Authorize the City Manager or his designee to extend the contracts for up to one year if an agency or
department requests an extension and such extension is necessary for completion of the program or to
amend the contracts if necessary to achieve program goals provided any amendment is within the scope of
the program and in compliance with City policies and all applicable laws and regulations governing the use
of federal grant funds;
7. Authorize a waiver of indirect cost rates as applicable for the Grants Fund in accordance with the City's
Administrative Regulations; and
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8. Adopt the attached appropriation ordinance increasing the estimated receipts and appropriations to the
Grants Fund in the total amount of$10,094,608.00 consisting of$6,414,009.00 in Community Development
Block Grant funds, $2,078,039.00 in HOME Investment Partnerships Program funds, $570,031.00 in
Emergency Solutions Grant funds and $1,032,529.00 in Housing Opportunities for Persons with AIDS grant
funds, plus any program income, all subject to receipt of such funds.
DISCUSSION:
The City's 2016-2017 Action Plan summarizes the major housing and community development activities
and proposed expenditures for the program year beginning October 1, 2016 and ending September 30,
2017 for use of federal grant funds totaling $10,094,608.00 from the United States Department of Housing
and Urban Development (HUD) for Community Development Block Grant (CDBG), HOME Investment
Partnerships Program (HOME), Emergency Solutions Grant (ESG) and Housing Opportunities for Persons
with AIDS (HOPWA) grant programs. It also summarizes the use of program income resulting from
activities using prior years' CDBG and HOME funds, for which the primary purpose is to benefit low and
moderate income City of Fort Worth residents. ESG funds primarily benefit homeless persons and HOPWA
funds primarily benefit low and moderate income persons with HIV/AIDS.
Staff developed initial recommendations for the allocation of the estimated funding from HUD, which were
adopted by the Community Development Council (CDC) on May 11, 2016 and were presented to the
Housing & Neighborhood Services Committee on May 3, 2016 and to the City Council at the Pre-Council
meeting on June 7, 2016. After these presentations, Staff developed revised recommendations which were
to be presented to the CDC at its meeting on July 13, 2016, but the meeting was not held due to the lack of
a quorum. A full explanation of revisions, including a comparison of the initial recommendations to the
revised recommendations, are set forth in the informal report presented to the City Council on August 2,
2016.
Notice of a 30-day public comment period from July 1, 2016 to August 1, 2016 was published in the Fort
Worth Star-Telegram on June 30, 2016. Any comments received are maintained by the Neighborhood
Services Department in accordance with federal regulations. The City is required to hold two public
hearings as part of the HUD-required citizen participation process. Initially, the first public hearing was
scheduled to be held at the CDC meeting on July 13, 2016 with a second public hearing scheduled for
August 2, 2016 at the City Council meeting. Because the CDC was unable to meet on July 13, 2016, these
dates were amended to reflect the first public hearing at the City Council meeting on August 2, 2016 with
the second public hearing to be held at the City Council meeting on August 9, 2016. Due to the revised
hearing dates, the public comment period was extended until August 8, 2016 and a notice of public
hearings and extension of public comment period was published in the Fort Worth Star-Telegram on July
17, 2016.
A summary of the Staffs final funding recommendations is provided below and in Tables 1, 2 and
3. Additionally, a spreadsheet of all specific funding recommendations is attached. The 2016-2017 Action
Plan must be submitted to HUD by August 15, 2016.
A waiver of indirect costs is being requested.
CDBG
For Program Year 2016-2017, it is recommended that the amount of$6,414,009.00 in CDBG funds and the
estimated amount of$130,000.00 of CDBG program income totaling $6,544,009.00 be allocated as follows:
Public Services - $962,101.00
This item includes social services for low to moderate income, disabled and disadvantaged populations.
Housing Program Services - $2,133,328.20
This item includes funding for the City's Priority Repair Program, Cowtown Brush-Up, homebuyer and
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housing services, accessibility modifications to the homes of senior and/or disabled individuals and related
project delivery costs for these programs.
Infrastructure Projects & Public Facilities - $1,295,000.00
This item includes funding for the SafeHaven of Tarrant County: Domestic Violence Shelter ADA
Improvements, CFW Planning & Development: Lake Como Neighborhood Sidewalk and Lighting Project
(Phase II), CFW Parks & Recreation Department: Bunche Park and CFW Code
Compliance: Neighborhood Improvements - Demolition and Clearance.
CDBG Economic Development - $740,778.80
This item is the City's annual payment on its Section 108 loan from HUD. This item is the City's annual
payment of its Section 108 loan from HUD. The Section 108 Program is a loan guarantee program, which
enables CDBG grantees to borrow up to five times the annual entitlement grant.
CDBG Estimated Program Income - $130,000.00
This item includes funding for the City's Priority Repair Program. CDBG program income that is received
which is over the estimated amount but not used for the City's Priority Repair Program will be allocated to
priority activities in the City's Consolidated Plan subject to Council approval.
CDBG General Administration - $1,282,801.00
This item includes costs for administering the CDBG grant including allocations for Financial Management
Services, Internal Audit, Planning and Development Departments.
HOME
For Program Year 2016-2017, it is recommended that the amount of$2,078,039.00 in HOME funds and the
estimated amount of$1,200,000.00 of HOME program income be allocated as follows:
Homebuyers Assistance Program (HAP) - $960,236.00
This item includes funding for down payment and/or closing cost assistance to low and moderate income
homebuyers.
Community Development Housing Organizations (CHDO) Set Aside - $402,500.00
HUD requires that a minimum of 15 percent of HOME funds be allocated to CHDO's for affordable housing
projects and CHDO administrative operating costs. These funds will be used by Tarrant County Housing
Partnership, Inc. (TCHP), a CHDO, for the completion of the Hillside/Morningside Single-Family Infill
Development (COUNCIL DISTRICT 8). The houses will be sold to homebuyers making at or below 80
percent of the area median income as set by HUD.
Rental Housing Development—$507,500.00
This item includes the construction of seven one-bedroom accessible apartments by Mental Health Housing
Development Corporation to serve citizens that are low-to-moderate income and disabled (COUNCIL
DISTRICT 3).
HOME General Administration —$207,803.00
This item includes costs for administering the HOME grant.
HOME Estimated Program Income - $1,200,000.00
This item includes funding for completion of the Hardy and HFC Terrell Single-Family Infill Projects. HOME
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program income that is received which is over the estimated amount but not used for the Hardy and HFC
Terrell Single-Family Infill Projects will be allocated to priority activities in the City's Consolidated Plan
subject to Council approval. HUD allows the City to take 10 percent of any HOME program income to be
used for the costs for administering the HOME grant.
HOPWA
For Program Year 2016-2017, it is recommended that the amount of$1,032,529.00 in HOPWA funds be
allocated as follows:
Non-Profit Service Providers - $1,001,554.00
HOPWA Program Administration —$30,975.00
ESG
For Program Year 2016-2017, it is recommended that the amount of$570,031.00 in ESG funds be
allocated as follows:
Non-Profit Service Providers - $527,279.00
ESG Program Administration —$42,752.00
CONTRACT RECOMMENDATIONS
The CDC and Staff recommend that contracts be executed with the listed agencies for the amounts shown
in the following tables:
Community Development Block Grant Contracts:
Table 1 —CDBG Agencies
Organization Program Amount
AB Christian Learning Center After-School Tutoring $ 45,486.00
Camp Fire First Texas Step Up Program $ 78,905.00
Cenikor Foundation Substance Abuse Services $ 110,000.00
Girls Inc. of Tarrant County Education, Prevention and $ 110,000.00
Leadership Program
Meals on Wheels Inc. of Tarrant Home Delivered Meals $ 75,000.00
County
Presbyterian Night Shelter Moving Home Program $ 75,000.00
Senior Citizen Services of Greater Connecting Seniors to the $ 100,000.00
Tarrant County, Inc. Community
Tarrant County Housing Homebuyer Counseling $ 116,000.00
Partnership, Inc. and Education
The Ladder Alliance Computer Skills Training $ 86,710.00
Program
United Community Centers Educational Enrichment $ 90,000.00
Program
YMCA of Metropolitan Fort Worth Early Childhood Education $ 75,000.00
CDBG Public Service Subtotal $ 962,101.00
Project Ramp $ 100,000.00
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Rehabilitation, Education and
Advocacy for Persons with
Handicaps, dba REACH, Inc.**
Total CDBG Contracts $1,062,101.00
**REACH will be funded from the CDBG Housing Programs and Services budget
Housing Opportunities For Persons With AIDS Contracts:
Table 2 — HOPWA Agencies
Organization Program Amount
Tarrant County Samaritan Housing, Administration (seven $ 485,844.00
Inc. percent), Supportive
Services and Facility Based
housing Subsidy
Assistance
AIDS Outreach Center, Inc. Supportive Services, $ 515,710.00
Tenant Based Rental
Assistance (TBRA), and
Short Term Rent Mortgage
and Utility Assistance
(STRMU)
Total HOPWA Contracts $1,001,554.00
Emergency Solutions Grant Contracts:
Table 3 — ESG Agencies
Organization Program Amount
Presbyterian Night Shelter Emergency Shelter and $100,275.00
Case Management
SafeHaven of Tarrant County SafeSolutions for Fort $ 75,000.00
Worth
Day Resource Center for the Homeless Day Shelter $141,092.00
Homeless
The Salvation Army, a Georgia Home Sweet Home- $116,360.00
Corporation Homeless Prevention
Center for Transforming Lives Rapid Rehousing $ 94,552.00
Total ESG Contracts $527,279.00
These programs are available in ALL COUNCIL DISTRICTS.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendations, adoption of the
attached appropriation ordinance and receipt of grant funds, funds will be available in the current operating
budget, as appropriated, of the Grants Fund. This is a reimbursement grant. The Neighborhood Services
Department has the responsibility to validate the availability of funds prior to an expenditure being made.
TO
Fund Department Account Project Program Activity Budget Reference# Amount
ID ID Year (Chartfield 2)
21001 0190463 4310013 10XXXX CDBG 9919XX $6,414,009.00
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TO
Fund Department Account Project Program Activity Budget Reference# Amount
ID ID Year (Chartfield 2)
21001 0190463 5XXXXXX 10XXXX CDBG 9919XX $6,414,009.00
21001 0190463 4310013 10XXXX HOME 9919XX $2,078,039.00
21001 0190463 5XXXXXX 10XXXX HOME 9919XX $2,078,039.0
21001 0190463 4310013 10XXXX ESG 9919XX $570,031.00
21001 0190463 5XXXXXX 10XXXX ESG 9919XX $570,031.00
21001 0190463 4310013 10XXXX HOPWA 9919XX $1,032,529.00
21001 0190463 5XXXXXX 10XXXX HOPWA 9919XX $1,032,529.00
21001 1 0190463 4921001 10XXXX CDBG 9919XX $130,000.00
21001 0190463 5XXXXXX 10XXXX CDBG 9919XX $130,000.0
21001 0190463 1 4921001 1 1OXXXXI HOME 9919XX $1,200,000.0
21001 0190463 1 5XXXXXX I 1OXXXXI HOME I 9919XX 1 $1,200,000.00
FROM
Fund Department Account Project Program Activity Budget Reference# Amount
ID ID Year (Cha field 2)
Submitted for City Manager's Office by: Fernando Costa (6122)
Originating Department Head: Aubrey Thagard (8187)
Additional Information Contact: Diana Carranza (7369)
Barbara Asbury (7331)
ATTACHMENTS
19NS HUDACTIONPLANPY2016-2017 Grant AO.docx
Action Plan 16-17 FINAL MandC Slides.pdf
Form 1295.pdf
SAM Search.pdf
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CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1of1
77
Complete Nos.l-4 and 5 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
I Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2016-65529
DRC(Day Resource Center for the Homeless)
Fort Worth,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party tot the contract for which the form is 06/03/2016
being filed.
City of Fort Worth 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.
47288
Emergency day shelter for the homeless
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
i
4
5 Check only if there is NO Interested Party.
X
6 AFFIDAVIT I swear,or affirm,under penalty of peoury,that the above disclosure Is true and correct.
o'` �.`'�• TAMALJONESNotary PubliTexasComm.Exp201811110 NotafyID22 Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP I SEAL ABOVE
Sworn to and subscribed before me,by the said f'-!*�.this the a-( day of ^
Zl? ,to certify which,witness my hand and seal of office.
C CR UrIQ Ut r
gnature of off?:er nIs Bring oath Printed name of officer administering oath Title of offic dministering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.1021