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HomeMy WebLinkAboutContract 49257 ``' CITY SECRETARY l , o CONTRACT NO. r -- CITY OF FORT WORTH, TEXAS ,.. N ep Y ST ARD AGREEMENT FOR ENGINEERING RELATED PROFESSIONAL ' SERVICES This AGREEMENT is between the City of Fort Worth, a Texas home-rule municipality (the "CITY"), and Stantec Consulting Services Inc., authorized to do business in Texas, (the "ENGINEER"), for a PROJECT generally described as: Crowley at Sycamore School Intersection Improvements. Article I Scope of Services The Scope of Services is set forth in Attachment A. Article II Compensation The ENGINEER's compensation shall be in the amount of not-to-exceed $400,000 as set forth in Attachment B. Article III Terms of Payment Payments to the ENGINEER will be made as follows: A. Invoice and Payment (1) The Engineer shall provide the City sufficient documentation, including but not limited to meeting the requirements set forth in Attachment D to this AGREEMENT, to reasonably substantiate the invoices. (2) The ENGINEER will issue monthly invoices for all work performed under this AGREEMENT. Invoices are due and payable within 30 days of receipt. (3) Upon completion of services enumerated in Article I, the final payment of any balance will be due within 30 days of receipt of the final invoice. (4) In the event of a disputed or contested billing, only that portion so contested City of Fort Worth,Texas LOFFICIAL Standard Agreement for Engineering Related Design Services Revised Page 1 of 16 12.22.2016JTX will be withheld from payment, and the undisputed portion will be paid. The CITY will exercise reasonableness in contesting any bill or portion thereof. No interest will accrue on any contested portion of the billing until mutually resolved. (5) If the CITY fails to make payment in full to ENGINEER for billings contested in good faith within 60 days of the amount due, the ENGINEER may, after giving 7 days' written notice to CITY, suspend services under this AGREEMENT until paid in full. In the event of suspension of services, the ENGINEER shall have no liability to CITY for delays or damages caused the CITY because of such suspension of services. Article IV Obligations of the Engineer Amendments to Article IV, if any, are included in Attachment C. A. General The ENGINEER will serve as the CITY's professional engineering representative under this Agreement, providing professional engineering consultation and advice and furnishing customary services incidental thereto. B. Standard of Care The ENGINEER shall perform its services: (1) with the professional skill and care ordinarily provided by competent engineers practicing in the same or similar locality and under the same or similar circumstances and professional license; and (2) as expeditiously as is prudent considering the ordinary professional skill and care of a competent engineer. C. Subsurface Investigations (1) The ENGINEER shall advise the CITY with regard to the necessity for subcontract work such as special surveys, tests, test borings, or other subsurface investigations in connection with design and engineering work to be performed hereunder. The ENGINEER shall also advise the CITY concerning the results of same. Such surveys, tests, and investigations shall be furnished by the CITY, unless otherwise specified in Attachment A. City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:12.22.2016 Page 2 of 16 (2) In soils, foundation, groundwater, and other subsurface investigations, the actual characteristics may vary significantly between successive test points and sample intervals and at locations other than where observations, exploration, and investigations have been made. Because of the inherent uncertainties in subsurface evaluations, changed or unanticipated underground conditions may occur that could affect the total PROJECT cost and/or execution. These conditions and cost/execution effects are not the responsibility of the ENGINEER. D. Preparation of Engineering Drawings The ENGINEER will provide to the CITY the original drawings of all plans in ink on reproducible mylar sheets and electronic files in .pdf format, or as otherwise approved by CITY, which shall become the property of the CITY. CITY may use such drawings in any manner it desires; provided, however, that the ENGINEER shall not be liable for the use of such drawings for any project other than the PROJECT described herein. E. Engineer's Personnel at Construction Site (1) The presence or duties of the ENGINEER's personnel at a construction site, whether as on-site representatives or otherwise, do not make the ENGINEER or its personnel in any way responsible for those duties that belong to the CITY and/or the CITY's construction contractors or other entities, and do not relieve the construction contractors or any other entity of their obligations, duties, and responsibilities, including, but not limited to, all construction methods, means, techniques, sequences, and procedures necessary for coordinating and completing all portions of the construction work in accordance with the Contract Documents and any health or safety precautions required by such construction work. The ENGINEER and its personnel have no authority to exercise any control over any construction contractor or other entity or their employees in connection with their work or any health or safety precautions. (2) Except to the extent of specific site visits expressly detailed and set forth in Attachment A, the ENGINEER or its personnel shall have no obligation or responsibility to visit the construction site to become familiar with the progress or quality of the completed work on the PROJECT or to determine, in general, if the work on the PROJECT is being performed in a manner indicating that the PROJECT, when completed, will be in accordance with the Contract Documents, nor shall anything in the Contract Documents or the agreement between CITY and ENGINEER be construed as requiring ENGINEER to make exhaustive or continuous on-site inspections to City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:1222.2016 Page 3 of 16 discover latent defects in the work or otherwise check the quality or quantity of the work on the PROJECT. If the ENGINEER makes on-site observation(s) of a deviation from the Contract Documents, the ENGINEER shall inform the CITY. (3) When professional certification of performance or characteristics of materials, systems or equipment is reasonably required to perform the services set forth in the Scope of Services, the ENGINEER shall be entitled to rely upon such certification to establish materials, systems or equipment and performance criteria to be required in the Contract Documents. F. Opinions of Probable Cost, Financial Considerations, and Schedules (1) The ENGINEER shall provide opinions of probable costs based on the current available information at the time of preparation, in accordance with Attachment A. (2) In providing opinions of cost, financial analyses, economic feasibility projections, and schedules for the PROJECT, the ENGINEER has no control over cost or price of labor and materials; unknown or latent conditions of existing equipment or structures that may affect operation or maintenance costs; competitive bidding procedures and market conditions; time or quality of performance by third parties; quality, type, management, or direction of operating personnel; and other economic and operational factors that may materially affect the ultimate PROJECT cost or schedule. Therefore, the ENGINEER makes no warranty that the CITY's actual PROJECT costs, financial aspects, economic feasibility, or schedules will not vary from the ENGINEER's opinions, analyses, projections, or estimates. G. Construction Progress Payments Recommendations by the ENGINEER to the CITY for periodic construction progress payments to the construction contractor will be based on the ENGINEER's knowledge, information, and belief from selective sampling and observation that the work has progressed to the point indicated. Such recommendations do not represent that continuous or detailed examinations have been made by the ENGINEER to ascertain that the construction contractor has completed the work in exact accordance with the Contract Documents; that the final work will be acceptable in all respects; that the ENGINEER has made an examination to ascertain how or for what purpose the construction contractor has used the moneys paid; that title to any of the work, materials, or equipment has passed to the CITY free and clear of liens, claims, security interests, or encumbrances; or that there are not other matters at issue between the CITY and the construction contractor that City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date: 12.22.2016 Page 4 of 16 affect the amount that should be paid. H. Record Drawings Record drawings, if required, will be prepared, in part, on the basis of information compiled and furnished by others, and may not always represent the exact location, type of various components, or exact manner in which the PROJECT was finally constructed. The ENGINEER is not responsible for any errors or omissions in the information from others that is incorporated into the record drawings. I. Minority Business and Small Business Enterprise (MBE)(SBE) Participation In accord with the City of Fort Worth Business Diversity Ordinance No. 20020-12-2011, as amended, the City has goals for the participation of minority business enterprises and/or small business enterprises in City contracts. Engineer acknowledges the MBE and SBE goals established for this contract and its accepted written commitment to MBE and SBE participation. Any misrepresentation of facts (other than a negligent misrepresentation) and/or the commission of fraud by the Engineer may result in the termination of this Agreement and debarment from participating in City contracts for a period of time of not less than three (3) years. J. Right to Audit (1) ENGINEER agrees that the CITY shall, until the expiration of five (5) years after final payment under this contract, have access to and the right to examine and photocopy any directly pertinent books, documents, papers and records of the ENGINEER involving transactions relating to this contract. ENGINEER agrees that the CITY shall have access during normal working hours to all necessary ENGINEER facilities and shall be provided adequate and appropriate work space in order to conduct audits in compliance with the provisions of this section. The CITY shall give ENGINEER reasonable advance notice of intended audits. (2) ENGINEER further agrees to include in all its subconsultant agreements hereunder a provision to the effect that the subconsultant agrees that the CITY shall, until the expiration of five (5) years after final payment under the subcontract, have access to and the right to examine and photocopy any directly pertinent books, documents, papers and records of such subconsultant, involving transactions to the subcontract, and further, that the CITY shall have access during normal working hours to all subconsultant facilities, and shall be provided adequate and appropriate work space, in order to conduct audits in compliance with the provisions of this article City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date: 12.22.2016 Page 5 of 16 together with subsection (3) hereof, CITY shall give subconsultant reasonable advance notice of intended audits. (3) ENGINEER and subconsultant agree to photocopy such documents as may be requested by the CITY. The CITY agrees to reimburse ENGINEER for the cost of copies at the rate published in the Texas Administrative Code in effect as of the time copying is performed. K. INSURANCE (1) ENGINEER'S INSURANCE a. Commercial General Liability — the ENGINEER shall maintain commercial general liability (CGL) and, if necessary, commercial umbrella insurance with a limit of not less than $1,000,000.00 per each occurrence with a $2,000,000.00 aggregate. If such Commercial General Liability insurance contains a general aggregate limit, it shall apply separately to this PROJECT or location. i. The CITY shall be included as an insured with all rights of defense under the CGL, using ISO additional insured endorsement or a substitute providing equivalent coverage, and under the commercial umbrella, if any. This insurance shall apply as primary insurance with respect to any other insurance or self- insurance programs afforded to the CITY. The Commercial General Liability insurance policy shall have no exclusions or endorsements that would alter or nullify: premises/operations, products/completed operations, contractual, personal injury, or advertising injury, which are normally contained within the policy, unless the CITY specifically approves such exclusions in writing. ii. ENGINEER waives all rights against the CITY and its agents, officers, directors and employees for recovery of damages to the extent these damages are covered by the commercial general liability or commercial umbrella liability insurance maintained in accordance with this agreement. b. Business Auto — the ENGINEER shall maintain business auto liability and, if necessary, commercial umbrella liability insurance with a limit of not less than $1,000,000 each accident. Such insurance shall cover liability arising out of "any auto", including owned, hired, and non-owned autos, when said vehicle is used in the course of the PROJECT. If the engineer owns no vehicles, coverage for hired or non-owned is acceptable. i. ENGINEER waives all rights against the CITY and its agents, officers, directors and employees for recovery of damages to the City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:12.22.2016 Page 6 of 16 extent these damages are covered by the business auto liability or commercial umbrella liability insurance obtained by ENGINEER pursuant to this agreement or under any applicable auto physical damage coverage. c. Workers' Compensation —ENGINEER shall maintain workers compensation and employers liability insurance and, if necessary, commercial umbrella liability insurance with a limit of not less than $100,000.00 each accident for bodily injury by accident or $100,000.00 each employee for bodily injury by disease, with $500,000.00 policy limit. i. ENGINEER waives all rights against the CITY and its agents, officers, directors and employees for recovery of damages to the extent these damages are covered by workers compensation and employer's liability or commercial umbrella insurance obtained by ENGINEER pursuant to this agreement. d. Professional Liability — the ENGINEER shall maintain professional liability, a claims-made policy, with a minimum of $1,000,000.00 per claim and aggregate. The policy shall contain a retroactive date prior to the date of the contract or the first date of services to be performed, whichever is earlier. Coverage shall be maintained for a period of 5 years following the completion of the contract. An annual certificate of insurance specifically referencing this project shall be submitted to the CITY for each year following completion of the contract. (2) GENERAL INSURANCE REQUIREMENTS a. Certificates of insurance evidencing that the ENGINEER has obtained all required insurance shall be attached to this AGREEMENT prior to its execution. b. Applicable policies shall be endorsed to name the CITY an Additional Insured thereon, subject to any defense provided by the policy, as its interests may appear. The term CITY shall include its employees, officers, officials, agents, and volunteers as respects the contracted services. c. Certificate(s) of insurance shall document that insurance coverage specified in this agreement are provided under applicable policies documented thereon. d. Any failure on part of the CITY to attach the required insurance documentation hereto shall not constitute a waiver of the insurance requirements. City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date: 12.22.2016 Page 7 of 16 e. A minimum of thirty (30) days notice of cancellation in coverage shall be provided to the CITY. A ten (10) days notice shall be acceptable in the event of non-payment of premium. Notice shall be sent to the respective Department Director (by name), City of Fort Worth, 1000 Throckmorton, Fort Worth, Texas 76102. f. Insurers for all policies must be authorized to do business in the State of Texas and have a minimum rating of A:V or greater, in the current A.M. Best Key Rating Guide or have reasonably equivalent financial strength and solvency to the satisfaction of Risk Management. g. Any deductible or self insured retention up to $25,000.00 that would change or alter the requirements herein is subject to approval by the CITY in writing, if coverage is not provided on a first-dollar basis. The CITY, at it sole discretion, may consent to alternative coverage maintained through insurance pools or risk retention groups. Dedicated financial resources or letters of credit may also be acceptable to the CITY. h. Applicable policies shall each be endorsed with a waiver of subrogation in favor of the CITY as respects the PROJECT. i. Lines of coverage, other than Professional Liability, underwritten on a claims-made basis, shall contain a retroactive date coincident with or prior to the date of the contractual agreement. The certificate of insurance shall state both the retroactive date and that the coverage is claims-made. j. Coverages, whether written on an occurrence or claims-made basis, shall be maintained without interruption nor restrictive modification or changes from date of commencement of the PROJECT until final payment and termination of any coverage required to be maintained after final payments. k. The CITY shall not be responsible for the direct payment of any insurance premiums required by this agreement. I. Sub consultants and subcontractors to/of the ENGINEER shall be required by the ENGINEER to maintain the same or reasonably equivalent insurance coverage as required for the ENGINEER. When sub consultants/subcontractors maintain insurance coverage, ENGINEER shall provide CITY with documentation thereof on a certificate of insurance. City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date: 12.22.2016 Page 8 of 16 L. Independent Consultant The ENGINEER agrees to perform all services as an independent consultant and not as a subcontractor, agent, or employee of the CITY. The doctrine of respondeat superior shall not apply. M. Disclosure The ENGINEER acknowledges to the CITY that it has made full disclosure in writing of any existing conflicts of interest or potential conflicts of interest, including personal financial interest, direct or indirect, in property abutting the proposed PROJECT and business relationships with abutting property cities. The ENGINEER further acknowledges that it will make disclosure in writing of any conflicts of interest that develop subsequent to the signing of this contract and prior to final payment under the contract. N. Asbestos or Hazardous Substances (1) If asbestos or hazardous substances in any form are encountered or suspected, the ENGINEER will stop its own work in the affected portions of the PROJECT to permit testing and evaluation. (2) If asbestos or other hazardous substances are suspected, the CITY may request the ENGINEER to assist in obtaining the services of a qualified subcontractor to manage the remediation activities of the PROJECT. O. Permitting Authorities - Design Changes If permitting authorities require design changes so as to comply with published design criteria and/or current engineering practice standards which the ENGINEER should have been aware of at the time this Agreement was executed, the ENGINEER shall revise plans and specifications, as required, at its own cost and expense. However, if design changes are required due to the changes in the permitting authorities' published design criteria and/or practice standards criteria which are published after the date of this Agreement which the ENGINEER could not have been reasonably aware of, the ENGINEER shall notify the CITY of such changes and an adjustment in compensation will be made through an amendment to this AGREEMENT. P. Schedule ENGINEER shall manage the PROJECT in accordance with the schedule developed per Attachment D to this AGREEMENT. City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date: 12.22.2016 Page 9 of 16 Article V Obligations of the City Amendments to Article V, if any, are included in Attachment C. A. City-Furnished Data ENGINEER may rely upon the accuracy, timeliness, and completeness of the information provided by the CITY. B. Access to Facilities and Property The CITY will make its facilities accessible to the ENGINEER as required for the ENGINEER's performance of its services. The CITY will perform, at no cost to the ENGINEER, such tests of equipment, machinery, pipelines, and other components of the CITY's facilities as may be required in connection with the ENGINEER's services. The CITY will be responsible for all acts of the CITY's personnel. C. Advertisements, Permits, and Access Unless otherwise agreed to in the Scope of Services, the CITY will obtain, arrange, and pay for all advertisements for bids; permits and licenses required by local, state, or federal authorities; and land, easements, rights- of-way, and access necessary for the ENGINEER's services or PROJECT construction. D. Timely Review The CITY will examine the ENGINEER's studies, reports, sketches, drawings, specifications, proposals, and other documents; obtain advice of an attorney, insurance counselor, accountant, auditor, bond and financial advisors, and other consultants as the CITY deems appropriate; and render in writing decisions required by the CITY in a timely manner in accordance with the project schedule prepared in accordance with Attachment D. E. Prompt Notice The CITY will give prompt written notice to the ENGINEER whenever CITY observes or becomes aware of any development that affects the scope or timing of the ENGINEER's services or of any defect in the work of the ENGINEER or construction contractors. City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:12.22.2016 Page 10 of 16 F. Asbestos or Hazardous Substances Release. (1) CITY acknowledges ENGINEER will perform part of the work at CITY's facilities that may contain hazardous materials, including asbestos containing materials, or conditions, and that ENGINEER had no prior role in the generation, treatment, storage, or disposition of such materials. In consideration of the associated risks that may give rise to claims by third parties or employees of City, City hereby releases ENGINEER from any damage or liability related to the presence of such materials. (2) The release required above shall not apply in the event the discharge, release or escape of hazardous substances, contaminants, or asbestos is a result of ENGINEER's negligence or if ENGINEER brings such hazardous substance, contaminant or asbestos onto the project. G. Contractor Indemnification and Claims The CITY agrees to include in all construction contracts the provisions of Article IV.E. regarding the ENGINEER's Personnel at Construction Site, and provisions providing for contractor indemnification of the CITY and the ENGINEER for contractor's negligence. H. Contractor Claims and Third-Party Beneficiaries (1) The CITY agrees to include the following clause in all contracts with construction contractors and equipment or materials suppliers: "Contractors, subcontractors and equipment and materials suppliers on the PROJECT, or their sureties, shall maintain no direct action against the ENGINEER, its officers, employees, and subcontractors, for any claim arising out of, in connection with, or resulting from the engineering services performed. Only the CITY will be the beneficiary of any undertaking by the ENGINEER." (2) This AGREEMENT gives no rights or benefits to anyone other than the CITY and the ENGINEER and there are no third-party beneficiaries. (3) The CITY will include in each agreement it enters into with any other entity or person regarding the PROJECT a provision that such entity or person shall have no third-party beneficiary rights under this Agreement. (4) Nothing contained in this Section H. shall be construed as a waiver of any right the CITY has to bring a claim against ENGINEER. City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:12.22.2016 Page 11 of 16 I. CITY's Insurance (1) The CITY may maintain property insurance on certain pre-existing structures associated with the PROJECT. (2) The CITY will ensure that Builders Risk/installation insurance is maintained at the replacement cost value of the PROJECT. The CITY may provide ENGINEER a copy of the policy or documentation of such on a certificate of insurance. (3) The CITY will specify that the Builders Risk/Installation insurance shall be comprehensive in coverage appropriate to the PROJECT risks. J. Litigation Assistance The Scope of Services does not include costs of the ENGINEER for required or requested assistance to support, prepare, document, bring, defend, or assist in litigation undertaken or defended by the CITY. In the event CITY requests such services of the ENGINEER, this AGREEMENT shall be amended or a separate agreement will be negotiated between the parties. K. Changes The CITY may make or approve changes within the general Scope of Services in this AGREEMENT. If such changes affect the ENGINEER's cost of or time required for performance of the services, an equitable adjustment will be made through an amendment to this AGREEMENT with appropriate CITY approval. Article VI General Legal Provisions Amendments to Article VI, if any, are included in Attachment C. A. Authorization to Proceed ENGINEER shall be authorized to proceed with this AGREEMENT upon receipt of a written Notice to Proceed from the CITY. B. Reuse of Project Documents All designs, drawings, specifications, documents, and other work products of the ENGINEER, whether in hard copy or in electronic form, are instruments of service for this PROJECT, whether the PROJECT is completed or not. City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:12.22.2016 Page 12 of 16 Reuse, change, or alteration by the CITY or by others acting through or on behalf of the CITY of any such instruments of service without the written permission of the ENGINEER will be at the CITY's sole risk. The CITY shall own the final designs, drawings, specifications and documents. C. Force Majeure The ENGINEER is not responsible for damages or delay in performance caused by acts of God, strikes, lockouts, accidents, or other events beyond the control of the ENGINEER that prevent ENGINEER's performance of its obligations hereunder. D. Termination (1) This AGREEMENT may be terminated a.) for convenience only by the City on 30 days' written notice. b.) by either the CITY or the ENGINEER for cause if either party fails substantially to perform through no fault of the other and the nonperforming party does not commence correction of such nonperformance within 5 days of written notice or thereafter fails to diligently complete the correction. (2) If this AGREEMENT is terminated for the convenience of the City, the ENGINEER will be paid for termination expenses as follows: a.) Cost of reproduction of partial or complete studies, plans, specifications or other forms of ENGINEER'S work product; b.) Out-of-pocket expenses for purchasing electronic data files and other data storage supplies or services; C.) The time requirements for the ENGINEER'S personnel to document the work underway at the time of the CITY'S termination for convenience so that the work effort is suitable for long time storage. (3) Prior to proceeding with termination services, the ENGINEER will submit to the CITY an itemized statement of all termination expenses. The CITY'S approval will be obtained in writing prior to proceeding with termination services. E. Suspension, Delay, or Interruption to Work The CITY may suspend, delay, or interrupt the services of the ENGINEER City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:12.22.2016 Page 13 of 16 for the convenience of the CITY. In the event of such suspension, delay, or interruption, an equitable adjustment in the PROJECT's schedule, commitment and cost of the ENGINEER's personnel and subcontractors, and ENGINEER's compensation will be made. F. Indemnification In accordance with Texas Local Government Code Section 271.904, the ENGINEER shall indemnify or hold harmless the CITY against liability for any damage committed by the ENGINEER or ENGINEER's agent, consultant under contract, or another entity over which the ENGINEER exercises control to the extent that the damage is caused by or resulting from an act of negligence, intentional tort, intellectual property infringement, or failure to pay a subcontractor or supplier. CITY is entitled to recover its reasonable attorney's fees in proportion to the ENGINEER's liability. G. Assignment Neither party shall assign all or any part of this AGREEMENT without the prior written consent of the other party. H. Interpretation Limitations on liability and indemnities in this AGREEMENT are business understandings between the parties and shall apply to all the different theories of recovery, including breach of contract or warranty, tort including negligence, strict or statutory liability, or any other cause of action, except for willful misconduct or gross negligence for limitations of liability and sole negligence for indemnification. Parties mean the CITY and the ENGINEER, and their officers, employees, agents, and subcontractors. I. Jurisdiction The law of the State of Texas shall govern the validity of this AGREEMENT, its interpretation and performance, and any other claims related to it. The venue for any litigation related to this AGREEMENT shall be Tarrant County, Texas. City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:12.22.2016 Page 14 of 16 J. Severability and Survival If any of the provisions contained in this AGREEMENT are held for any reason to be invalid, illegal, or unenforceable in any respect, such invalidity, illegality, or unenforceability will not affect any other provision, and this AGREEMENT shall be construed as if such invalid, illegal, or unenforceable provision had never been contained herein. Articles V.F., VI.B., VI.D., VI.F., VI.H., and VI.I. shall survive termination of this AGREEMENT for any cause. K. Observe and Comply ENGINEER shall at all times observe and comply with all federal and State laws and regulations and with all City ordinances and regulations which in any way affect this AGREEMENT and the work hereunder, and shall observe and comply with all orders, laws ordinances and regulations which may exist or may be enacted later by governing bodies having jurisdiction or authority for such enactment. No plea of misunderstanding or ignorance thereof shall be considered. ENGINEER agrees to defend, indemnify and hold harmless CITY and all of its officers, agents and employees from and against all claims or liability arising out of the violation of any such order, law, ordinance, or regulation, whether it be by itself or its employees. Article VII Attachments, Schedules and Counterparts This AGREEMENT, including its attachments and schedules, constitutes the entire AGREEMENT, which supersedes all prior written or oral understandings, and may only be changed by a written amendment executed by both parties. This Agreement may be executed in one or more counterparts and each counterpart shall, for all purposes, be deemed an original, but all such counterparts shall together constitute but one and the same instrument. The following attachments and schedules are hereby made a part of this AGREEMENT: Attachment A- Scope of Services Attachment B - Compensation Attachment C -Amendments to Standard Agreement for Engineering Services Attachment D - Project Schedule Attachment E - Location Map City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services Revised Date:12.22.2016 Page 15 of 16 Duly executed by each party's designated representative to be effective on the date subscribed by the City's designated Assistant City Manager. BY: BY: CITY OF FORT WORTH ENGINEER Stantec Consulting Services Inc. Jesus J. Chapa Susan Langdon, PE, PTOE Assistant City Manager Principal Date: '1 b//7 Date:_ U't°l 271�Lc ', 1, APPROVAL RECOMMENDED: By: �� 6„1 4,J Dougla . Wiersig, P.E. Director, Department of Transportation/Public Works Contract Compliance Manager: APPROVED AS TO FORM AND LEGALITY By signing, I acknowledge that I am the person responsible for the monitoring and administration of this contract, including By: ensuring all performance and reporting Douglas W. Black requirements. Sr. Assistant City Attorney A4/97- William Todd Estes, PE Program Manager Transportation/ Public Wo t O� Form 1295 No. ATTEST: ►-- U. * M&C No. C-28288 ary ' ser 7EX City S cre ary M&C Date: June 20, 2017 City of Fort Worth,Texas Standard Agreement for Engineering Related Design Services OFFICIAL RE F Page Revis16 of 16 12.22.2016 CITY SECRETARY FT.wORTH,TX ATTACHMENT "A" Scope for Design Services for Crowley at Sycamore School Intersection Improvements The scope set forth herein defines the work to be performed by the ENGINEER in completing the project. Both the CITY and ENGINEER have attempted to clearly define the work to be performed and address the needs of the Project. OBJECTIVE The objective of this project is to prepare construction documents for paving and intersection improvements for the intersection of Crowley Road at Sycamore School Road. The intersection improvements should consider alternative intersection designs to improve traffic flow. The engineer should evaluate the traffic flow at adjacent intersections that could impact the study intersection, including Everman Parkway at Sycamore School Road. The project will include project management services, design, and construction phase services. WORK TO BE PERFORMED ENGINEER hereby agrees to perform intersection improvement studies and design for the intersection of Crowley Road at Sycamore School Road on a task order basis as may be requested by the CITY during the term of this AGREEMENT. Work under this AGREEMENT will be performed on a Work Authorization basis. The CITY will request services for each Work Authorization. The ENGINEER shall prepare scope, fee, and schedule as necessary to perform the services requested for each Work Authorization within 10 working days of the CITY's request. Each Work Authorization shall include scope of services as Attachment "A". This scope will outline tasks required to complete the Work Authorization. For each task the scope shall include a detailed description of the task, outline any assumptions, and list the required deliverables. Each Work Authorization shall include Attachment "B" detailing the compensation for the Work Authorization. Compensation will be based upon hours agreed to by the CITY and the ENGINEER for each Work Authorization. Compensation will be based on the Schedule of Rates in Attachment "B" of this agreement. The fee will include an estimate of reimbursable and sub-consultant cost for each Work Authorization. Compensation for each Work Authorization shall be Lump Sum. If the Work Authorization requires a schedule it shall be attached as Attachment "D". City of Fort Worth,Texas Attachment A PMO Release Date:07.23.2012 Page 1 of 1 ATTACHMENT B COMPENSATION Design Services for Crowley at Sycamore School Intersection Improvements City Project No. 101016 Time and Materials with Rate Schedule Project I. Compensation A. The ENGINEER shall be compensated for personnel time, non-labor expenses, and subcontract expenses in performing services enumerated in Attachment A as follows: i. Personnel Time. Personnel time shall be compensated based upon hours worked directly in performing the PROJECT multiplied by the appropriate Labor Category Rate for the ENGINEER's team member performing the work. Labor Category Rate as presented in the rate schedule table below is the rate for each labor category performing the work and includes all direct salaries, overhead, and profit. Labor Category Rate ($/hour) Project Director $221 Project Manager $201 Sr. Project Engineer $178 Project Engineer $152 EIT $122 CADD $105 Administrative $95 ii. Non-Labor Expenses. Non-labor expenses shall be reimbursed as Direct Expenses at invoice or internal office cost. Direct Expenses (non-labor) include, but are not limited to, mileage, travel and lodging expenses, mail, supplies, printing and reproduction services, other direct expenses associated with delivery of the work; plus applicable sales, use, value added, business transfer, gross receipts, or other similar taxes. iii. Subcontract Expenses. Subcontract expenses and outside services shall be reimbursed at cost to ENGINEER plus a markup of ten percent (10%). iv. Budgets. ENGINEER will make reasonable efforts to complete the work within the budget and will keep the City informed of progress toward that end so that the budget or work effort can be adjusted if found necessary. ENGINEER is not obligated to incur costs beyond the indicated budgets, as may be adjusted, nor is the City obligated to pay ENGINEER beyond these limits. City of Fort Worth,Texas Attachment B PMO Official Release Date:8.09.2012 Page 1 of 4 B-1 ATTACHMENT B COMPENSATION If ENGINEER projects, in the course of providing the necessary services, that the PROJECT cost presented in Article 2 of this Agreement will be exceeded, whether by change in scope of the project, increased costs or other conditions, the ENGINEER shall immediately report such fact to the City and, if so instructed by the City, shall suspend all work hereunder. When any budget has been increased, ENGINEER's excess costs expended prior to such increase will be allowable to the same extent as if such costs had been incurred after the approved increase. B. The ENGINEER shall be paid monthly payments as described in Section II - Method of Payment. II. Method of Payment A. The ENGINEER shall be paid by the City based upon an invoice created on the basis of statements prepared from the books and records of account of the ENGINEER, based on the actual hours and costs expended by the ENGINEER in performing the work. B. Each invoice shall be verified as to its accuracy and compliance with the terms of this Agreement by an officer of the ENGINEER. C. ENGINEER shall prepare and submit invoices in the format and including content as presented in Exhibit B-1. D. Payment of invoices will be subject to certification by the City that such work has been performed. III. Progress Reports A. The ENGINEER shall prepare and submit to the designated representative of the Transportation and Public Works Department monthly progress reports and schedules in the format required by the City. City of Fort Worth,Texas Attachment B PMO Official Release Date:8.09.2012 Page 2 of 4 B-2 ATTACHMENT B COMPENSATION IV. Summary of Total Project Fees Firm Primary Responsibility Fee Amount % Prime Consultant Stantec Consulting Engineering Services $300,000 75% Services Inc. Proposed MBE/SBE Sub-Consultants Hayden Consultants, Engineering, Survey/SUE $98,386.50 24.6% Inc. Gram Traffic North Traffic data collection $1,613.50 0.4% Texas, Inc. Non-MBE/SBE Consultants TOTAL $ $400,000 100% Project Number& Name Total Fee MBE/SBE Fee MBE/SBE $ $400,000 $ $100,000 25% % City MBE/SBE Goal = 25 % Consultant Committed Goal = 25 % City of Fort Worth,Texas Attachment B PMO Official Release Date:8.09.2012 Page 3 of 4 B-3 EXHIBIT "B-1" ENGINEER INVOICE (Supplement to Attachment B) To be included with each Task Order. City of Fort Worth,Texas Attachment B PMO Official Release Date:8.09.2012 Page 4 of 4 B-4 ATTACHMENT "C" CHANGES AND AMENDMENTS TO STANDARD AGREEMENT Design Services for Crowley at Sycamore School Intersection Improvements City Project No. 101016 The following changes were made to the standard agreement and approved by the CITY. • The words "or material change" were deleted from insurance item 2e. • The words "in excess of$25,000" were changed to "up to $25,000" in insurance item 2g. • Insurance item 2i referring to the CITY requesting ENGINEER'S insurance policies was removed. City of Fort Worth,Texas Attachment C PMO Release Date:05.19.2010 Page 1 of 1 Consulting Contract Schedule Specifications FO RT WO RT H City of Fort Worth Capital Improvement Program Attachment D -Project Schedule This PROTECT requires a Tier 3 schedule as defined herein and in the City's Schedule Guidance Document. D1. CONSULTING SERVICES SCHEDULE DEVELOPMENT: The CONSULTANT shall prepare schedules for consulting services that meet the requirements described in this specification, showing by Critical Path Method (CPM) the planned sequence and timing of the Work associated with the Agreement. All submittals shall be submitted in PDF format, and schedule files shall also be submitted in native file format (i.e. file formats associated with the scheduling software). The approved scheduling software systems for creating the schedule files are: - Primavera (Version 6.1 or later or approved by CITY) - Primavera Contractor (Version 6.1 or later or approved by CITY) - Microsoft Project(Version 2003/2007 or later or approved by CITY)(PHASING OUT) D2. BASELINE CONSULTING SERVICES SCHEDULE: Following notice-to-proceed, the CONSULTANT shall develop, submit and review the draft detailed baseline consulting services schedule with the CITY to demonstrate the CONSULTANT's understanding of the Agreement requirements and approach for performing the work. The CONSULTANT will prepare the final detailed baseline consulting services schedule based on CITY comments, if any, and submit to the CITY no later than the submittal of the first project invoice. The following guidelines shall be adhered to in preparing the baseline schedule, and as described in further detail in the CITY's Schedule Guidance Document. a. The scope shall be subdivided by work breakdown structure (WBS) representing the tasks, subtasks,and activities associated with delivering the work. b. The schedule shall accurately describe the major work activities, key milestones, and dependencies/relationships as appropriate to the work. c. The schedule should include appropriate meetings, review periods, critical decision points,including third party utility dependencies and reviewing agencies. D3. PROGRESS CONSULTING SERVICES SCHEDULE: The CONSULTANT shall prepare and submit monthly to the CITY for approval the updated schedule in accordance with D1 and D2 and the CITY's Schedule Guidance Document inclusive. As the Work progresses, the CONSULTANT shall enter into the schedule and record actual progress as described in the CITY's Schedule Guidance Document. The updated schedule submittal shall also include a concise schedule narrative that highlights the following,if appropriate and applicable: • Changes in the critical path, • Expected schedule changes, • Potential delays, • Opportunities to expedite the schedule, • Coordination issues the CITY should be aware of or can assist with, City of Fort Worth,Texas Attachment D PMO Release Date:02.15.2011 Page 1 of 2 • Other schedule-related issues that the CONSULTANT wishes to communicate to the CITY. D4. PERFORMANCE AND CONSULTING SERVICES SCHEDULE: If the work accomplished falls behind that scheduled due to factors within the CONSULTANT's control, the CONSULTANT shall take such action as necessary to improve the progress of the Work. In addition, the CITY may require the CONSULTANT to submit a revised schedule demonstrating the proposed plan to make up the delay in schedule progress and to ensure completion of the Work within the allotted Agreement time. D5. SCHEDULE TIERS SPECIAL INSTRUCTIONS: The requirements for the schedule are determined based on the nature and needs of the project. The schedule tier for this project is stated at the top of this document. CONSULTANT shall submit each schedule relying on the CITY's current Schedule Guidance Document. D6. SCHEDULE SUBMITTAL AND PAYMENT: As stated in III.A.(1). of the Agreement, CONSULTANT shall provide the information required by Attachment D. CONSULTANT's monthly invoices will not be accepted and processed for payment without monthly schedule updates that are submitted in the time and manner required by Attachment D and the CITY's current Schedule Guidance Document. City of Fort Worth,Texas Attachment D PMO Release Date:02.15.2011 Page 2 of 2 Attachment E Crowley at Sycamore School Intersection Improvements City Project No. 10 10 16 1i e }} Y,L 3 � ar a I r + _ * Parkway , _ *y , i 1 F PROJECT � Project Location 4 Crowley at Sycamore School w Intersection Improvements City Project No. 10 10 16 Fort Ad' r ' City of Fort Worth, Texas Mayor and Council Communication COUNCIL ACTION: Approved on 6/20/2017 DATE: Tuesday, June 20, 2017 REFERENCE NO.: C-28288 LOG NAME: 202018 JUMP START PROJECTS SUBJECT: Authorize Execution of Engineering Services Task Order Agreements with Eleven Engineering Consulting Firms in Amounts Ranging from $140,000.00 to $870,000.00 for Design Services, Construction and Project Management Support to Advance High Priority Projects Needed to Improve Safety and Capacity as Identified by Staff for the Anticipated 2018 Bond Program (COUNCIL DISTRICTS 2, 4, 6, 7 and 8) RECOMMENDATION: It is recommended that the City Council: 1. Authorize the execution of an Engineering Services Agreement with Burns & McDonnell, Engineering Company, Inc., for design of transportation improvements along Cromwell Marine Creek Road, from Boat Club Road to Marine Creek Parkway (101012), in an amount not to exceed $400,000.00; 2. Authorize the execution of an Engineering Services Agreement with Carrillo Engineering, LLC, for design of transportation improvements at the intersection of Hulen Street and Granbury Road (101017), in an amount not to exceed $400,000.00; 3. Authorize the execution of an Engineering Services Agreement with Criado &Associates, Inc., for an alignment study and design of transportation improvements along Bailey Boswell Road, from Blue Mound Road to State Highway 287 (101018), in an amount not to exceed $400,000.00; 4. Authorize the execution of an Engineering Services Agreement with Freese & Nichols, Inc., for design of transportation improvements along Risinger Road, from Crowley Road to Interstate 35 West (C01811), in an amount not to exceed $400,000.00; 5. Authorize the execution of an Engineering Services Agreement with Halff Associates, Inc., for design of transportation improvements along Beach Street, from its current northern terminus north to Keller Haslet Road, and along Westport Parkway, from Keller Haslet Road to Alta Vista Boulevard (101019), in an amount not to exceed $475,000.00; 6. Authorize the execution of an Engineering Services Agreement with HDR, Inc., for design of transportation improvements along Avondale Haslet Road, from Willow Creek Drive to Haslet County Line Road/FM 156 (101014), in an amount not to exceed $400,000.00; 7. Authorize the execution of an Engineering Services Agreement with Kimley-Horn and Associates, Inc., for design of transportation improvements along Bonds Ranch Road, from Hawks Landing Road to Blue Mound Road/FM 156 (101009), in an amount not to exceed $870,000.00; 8. Authorize the execution of an Engineering Services Agreement with Lee Engineering, LLC, for design of transportation improvements at the intersection of Park Vista Boulevard and Keller Haslet Road (101020), Logname: 202018 JUMP START PROJECTS Page 1 of 5 in an amount not to exceed $400,000.00; 9. Authorize the execution of an Engineering Services Agreement with Pacheco Koch Consulting Engineers, Inc., for design of transportation improvements at the intersection of Kroger Drive with State Highway 377 and Basswood Boulevard and State Highway 377 (101015), in an amount not to exceed $400,000.00; 10. Authorize the execution of an Engineering Services Agreement with Stantec Consulting Services, Inc., for design of transportation improvements at the intersection of Crowley Road and Sycamore School Road (101016), in an amount not to exceed $400,000.00; and 11. Authorize the execution of an Engineering Services Agreement with Wier&Associates, Inc., for an alignment study and design of transportation improvements along Golden Triangle Boulevard, from Interstate Highway 35 West to Golden Heights Road (101013), in an amount not to exceed $140,000.00. DISCUSSION: In preparation for the 2018 Bond Program, Staff proposes to utilize $10,000,000.00 to begin design and acquire property necessary for the construction of projects that are considered high priority needs relating to capacity and safety improvements to the infrastructure of the City of Fort Worth. This effort will enable Staff to begin property acquisition and design of the following projects: ��Arterial Projects FJump Start Engineering Contract City Project Total Scope Firm Award Management Appropriation Cromwell Marine Creek Road Burns and Partial Design McDonnell from Boat Club Road Project $400,000.00 $100,000.00 $500,000.00 to Marine Creek Management (New Award) Parkway (CPN 101012) (CD 2) Hulen Street& Partial Design Carrillo Granbury Rd. Project Engineering, Inc. $400,000.00 $100,000.00 $500,000.00 (CPN101017) (CD 6) Management (New Award) Bailey Boswell Road Alignment Study Criado & & Partial Design Associates, Inc. $400,000.00 $100,000.00 $500,000.00 from Blue Mound Project Road to SH287 (CPN Management (New Award) 101018) (CD 2) Risinger Road Freese & Design Nichols, Inc. from Crowley Road to Completion $400,000.00 $100,000.00 $500,000.00 Interstate 35 West Project (CPN C01811) (CDs Management (Existing 6 & 8) Contract) Beach Street& Westport Parkway Partial Design Project $475,000.00 $100,000.00 $575,000.00 from northern Management terminus to Keller Halff Associates, Haslet Road and then Inc. Logname: 202018 JUMP START PROJECTS Page 2 of 5 to Alta Vista (New Award) Boulevard (CPN 101019) (CD 7) Arterial Projects Jump Start Engineering Contract NTE City Project—I Total Scope Firm Management I Appropriation Avondale Haslet Rd. From Willow Creek Partial Design HDR, Inc. Drive to Haslet Project $400,000.00 $100,000.00 $500,000.00 County Line Management (New Award) Rd./FM 156 (CPN 101014) (CD 7) Bonds Ranch Rd. Partial Design Property Phase 2 Kimley-Horn & Acquisition: Property Associates, Inc $850,000.00 From Hawks Landing Acquisition $870,000.00 $1,850,000.00 Rd. to Blue Mound (Contract Rd/FM 156 Project Continuation) Project Management: (CPN101009) (CD 7) Management $130,000.00 Park Vista Lee Engineering, rd Bouleva & Keller Partial Design Inc. Project $400,000.00 $100,000.00 $500,000.00 Haslet Rd.and (CPN101020) (CD 7) Management (New Award) 377 Intersections Pacheco Koch at Kroger and at Partial Design Consulting Basswood Project Engineers, Inc. $400,000.00 $100,000.00 $500,000.00 (CPN101015) (CD 4) Management (New Award) Blue Mound Rd. Property from Willow Springs Design Pacheco Koch Acquisition: Rd. to Approximately Completion Consulting $1,400,000.00 500 linear feet east of Property Engineers, Inc. the northbound Acquisition $200,000.00 Project $1,700,000.00 frontage rd. of State Project (Contract Management: Highway 287 Continuation) (CPNCO2161) (CD 7)I Management $100,000.00 Golden Triangle Boulevard Alignment Study Wier& From Interstate Associates, Inc. $160,000.00 $40,000.00 $200,000.00 Highway 35 West to Project Golden Heights Rd. Management (New Award) (CPN101013) (CD 7) Crowley Road & Partial Design Sycamore School Stantec Road (CPN101016) Project (New Award) $400,000.00 $100,000.00 $500,000.00 (CD 8) Management Keller Hicks Road Project and Katy Road Management N/A N/A $100,000.00 $100,000.00 (CPN100146) (CD 7) F F Logname: 202018 JUMP START PROJECTS Page 3 of 5 Funding for these Jump Start Projects was authorized on May 16, 2017 Mayor and Council Communication (M&C G-19009) in the amount of$10M. The scopes outlined will serve to further define the project risks and requirements to prepare reliable cost estimates for delivery through construction and close-out. All engineering firms recommended for new contract awards in this Mayor and Council Communication have been selected based on Transportation and Public Works' Request for Qualifications advertised in the Fort Worth Star-Telegram on January 5, 2017 and January 12, 2017. Those submittals were received and reviewed by Transportation and Public Works staff in January 2017 with each respondent submitting Statements of Qualifications representative of the work required for the projects listed in this Mayor and Council Communication. M/WBE OFFICE —All engineering contracts are in compliance with the City's BDE Ordinance. New contract awards are committing to 25 percent SBE participation on their respective Contracts. The City's SBE goal for the total contract value is 25 percent. a) Burns & McDonnell Engineering Company, Inc., is in compliance with the City's BDE Ordinance by committing to 25 percent SBE participation on this project. b) Carrillo Engineering, LLC, is in compliance with the City's BDE Ordinance by committing to 23 percent SBE participation on this project. Additionally, Carrillo Engineering, LLC, is a certified M/WBE firm. c) Criado & Associates, Inc., is in compliance with the City's BDE Ordinance by committing to 25 percent SBE participation on this project. Additionally, Criado &Associates, Inc., is a certified M/WBE firm. d) Halff Associates, Inc., is in compliance with the City's BDE Ordinance by committing to 25 percent SBE participation on this project. e) HDR, Inc., is in compliance with the City's BDE Ordinance by committing to 25 percent SBE participation on this project. f) Kimley-Horn and Associates, Inc., is in compliance with the City's BDE Ordinance by committing to 12 percent SBE participation on this project. g) Lee Engineering, LLC, is in compliance with the City's BDE Ordinance by committing to 25 percent SBE participation on this project. h) Pacheco Koch Consulting Engineers, Inc., is in compliance with the City's BDE Ordinance by committing to 25 percent SBE participation on this project. Additionally, Pacheco Koch Consulting Engineers, Inc., is a certified M/WBE firm. i) Stantec Consulting Services, Inc., is in compliance with the City's BDE Ordinance by committing to 25 percent SBE participation on this project. j) Wier&Associates, Inc., is in compliance with the City's BDE Ordinance by committing to 25 percent SBE participation on this project. k) Freese & Nichols, Inc., a waiver of the goal for SBE subcontracting requirements was requested by the Department and approved by the M/WBE Office in accordance with the BDE Ordinance, because the purchase of goods or services from source(s) where subcontracting or supplier opportunities are negligible. These projects are located in COUNCIL DISTRICTS 2, 4, 6, 7 and 8. Logname: 202018 JUMP START PROJECTS Page 4 of 5 FISCAL INFORMATION / CERTIFICATION: The Director of Finance certifies that funds are available in the 2017 Tax Notes Capital Project Fund and that prior to an expenditure being made, the department has the responsibility to validate the availability of funds FUND IDENTIFIERS (FIDs): TO Fund Department ccoun Project Program ctivity Budget Reference # moun ID ID Year (Chartfield 2) FROM Fund Department ccoun Project JProgram ctivityJ Budget Reference # moun ID ID Year (Chartfield 2) CERTIFICATIONS: Submitted for City Manager's Office by: Jay Chapa (5804) Originating Department Head: Douglas Wiersig (7801) Additional Information Contact: Kim Arnold (2552) ATTACHMENTS 1. Form 1295 for 11 Companies.pdf (Public) 2. SBE JUMPSTART PROJECTS - Task Order Compliance Memo.pd (CFW Internal) Logname: 202018 JUMP START PROJECTS Page 5 of 5 CERTIFICATE OF INTERESTED PARTIES FORM 1295 loll 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 I Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2017-211145 Stantec Consulting Services Inc Dallas,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 05/22/2017 being filed. City of Fort Worth Date Ac n ledg 5d,. 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and prov de a description of the services,goods,or other property to be provided under the contract. 101016-CROWLEY-SYCAMORE INTE Engineering and Design services for improvements to the Crowley-Sycamore School Road intersection Nature of interest 4 Name of Interested Party City,State,Country(place of business) (check applicable) Controlling I Intermediary Stone,Jeff Rochester,NY United States X Murray,Scott Lexington,KY United States X Gomes,Robert Edmonton Alberta Canada X Lefaivre,Daniel Edmonton Alberta Canada X DiManno,Tino Calgary Alberta Canada 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. PIV19% PEGGY R.TOWNER � .�= Notary Public,State of Texas My Commission Expires December 02, 2017 Signature of authoriza nl of contracting business entity AFFIX NOTARY STAMP/SEAL ABOVE Sworn to and subscribed before me,by the said /IIY!5 �. C 1/f. ,this the day of 20_,�L_,to certify which,witness my hand and seal of office, i a e of officer administering oath Printe of officer administering oath Title of officer admM istering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883