HomeMy WebLinkAboutContract 52403 Agreement No. 18-00103981
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bF S�CR0 P� CITY OF FORT WORTH
CONTRACT RENEWAL NOTICE CITY SECRETARY
CONTRACT No. 5a qO3
May 1, 2019
Horizon Lab Systems LLC
900 Ridgefield Drive Suite 150
Raleigh,NC 27609-9001
Re: NOTICE OF CONTRACT RENEWAL
SS1 8-00 1 03 98 1 (also known as Sole Source Agreement between City of Fort Worth(the "City") and Horizon Lab
Systems LLC (formerly dba"Chemware LLC. ("Horizon") dated April 4, 2018 ("the Agreement"))Renewal Term No.
l: May 01, 2019 to April 30, 2020
The above referenced Sole Source Agreement expires on April 30,2019. Pursuant to the Agreement, renewals are at the
mutual agreement of the parties. This letter is to inform you that the City requests renewal of the agreement for an
additional one year period, which will begin immediately upon the expiration of the current term and will end on April 30,
2020. All other terms and conditions of the Contract remain unchanged. Please return this signed Contract Renewal
Notice,along with a copy of your current insurance certificate,to the address set forth below. Please log onto
BuySpeed Online at http://fortworthtexas.,_�ov/purchasing to insure that your company information is correct and up-to-
date.
If you have any questions concerning this Contract Renewal Notice, please contact me at the telephone number listed
below.
Sincerely yours,
Rick Brents
Sr. IT Business Planner
Water IT, Water Department
Rick.Brents(cU.fortworthtexas.
817-392-8453 - Direct
817-392-8699 - Fax
I hereby agree to the renewal of the Software Maintenance Renewal(as defined in the Contract)pursuant to and in
accordance with the terms and conditions of the Contract.
By: _Eric Din feg Ider Date: _May 3, 2019
Printed Name and Title
Signature
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,U
Agreement No. 18-00103981
CITY OF FORT WORTH:
APPROVED AS TO FORM AND LEGALITY:
JB St ng, Assistant Ci Attorney
Date:
APPROVED FOR CITY OF FORT WORTH:
RECOMMENDED
Chris Harder, Director, Water Department
Date:
Jay Chapa, Assistant City Manager
Date: & ` C —( j
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.
William Bailey, Apt/mg IT Manager, Water Department
Date: 5-3-I 9
ATTEST:
Mary y K ser, C e reta
✓ # •; :S
Date: l� t�a'�� 1'� •• f OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX
NRr -70r'1111i �
HORIZONm LIMS
January 23, 2019
Purchasing Division
City of Fort Worth
City Hall, Lower Level
200 Texas Street
Fort Worth,Texas 76102
RE: HORIZON LIMS Supplier
To Whom It May Concern:
HORIZON Data Systems, LLC. is the sole supplier and authorized Service Company for the HORIZON-
Laboratory Information Management System, including software maintenance and updates, HORIZON
Data Management,and instrument interfacing products.Additional software,services or training
relating to the HORIZON products are not available from any other supplier source. Any upgrade for
HORIZON LIMS will not affect the current maintenance agreement.
Sincerely,
Christopher T.Couch
VP, Business Development
919.896.7740
ccouch@ horizon lims.com
Form Request for Taxpayer Give Form to the
(Rev.Oaober2018) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to www.irs.gov/FormIN9 for instructions and the latest Information.
1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank.
The F.Dohmen Co, sole member of HORIZON Lab Systems, LLC
2 Business name/disregarded entity name,if different from above
HORIZON Lab Systems,LLC
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check on one of the 4 Exemptions codes a
¢� Pe y P� ( PPN only to
m following seven boxes. certain entities,not individuals;see
a instructions on page 3):
o ❑ Individual/sole proprietor or El Corporation ❑� S Corporation ❑ Partnership ❑Trust/estate
c single-member LLC Exempt payee code(if any)
0
�? ❑ Limited liability company.Enter the tax classification(C--C corporation,S=S corporation,P=Partnership)►
`o ._`. Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
w LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is ode(if any)
du another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that c
t is disregarded from the owner should check the appropriate box for the lax classification of its owner.
u ❑ Other(see instructions)► vw� la•ccounn�+m'ntarrQ outsCe era US,,
y 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
8601 Six Forks Road,Suite 160
6 City,state,and ZIP code
Raleigh, NC 27615
7 List account numbers)here(optional}
Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN.However,for a FM -M -=
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other
entities,it is your employer identification number(EIN).if you do not have a number,see How to get a
TIN,later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
M39 - 0 2 4 6 0 M6O
Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.1 am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(it any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign
Signature ofbl
Here U.S.person► Date►
d5
General-i nstructio corm--199S-DlU-(dlvidendsrinc4uc inglhose-fromstocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISO(various types of income,prizes,awards,or gross
noted. proceeds)
Future developments.For the latest information about developments .Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FcrmW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(1TIN),adoption .Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Fort W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What Is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
Page 1 of 2
FORT WORTH CITY OF FORT WORTH P.O. DATE: 5/1/2018
Purchase Order Blanket Order Number
PO-18-00103981-1
SHOW THIS NUMBER ON ALL
PACKAGES,INVOICES AND
SHIPPING PAPERS.
V Vendor Number:0000039861 WATER DEPARTMENT
E CHEMWARE LLC S INFORMATION TECHNICAL SERVICES
CHEMWARE LLC H 200 Texas
N 190 N MILWAUKEE STREET I FORT WORTH,TX 76102
p MILWAUKEE,WI 53202 P
R O Phone: (817)392-1111
INVOICES: Direct Invoices In DUPLICATE to the address shown. MAIL INVOICE IN DUPLICATE TO:
STANDARD PURCHASING TERMS AND CONDITIONS set forth in the B WATER DEPARTMENT
City of Fort Worth's Bid or Quotation, are incorporated herein by I INFORMATION TECHNICAL SERVICES
reference and become a part of this order. L 200 Texas
L FORT WORTH,TX 76102
T
O Phone: (817)392-1111
Account Code:5 60 0 1-060 3 00 1-5 33 05 0 0----- Payment Terms: Net 30
Shipping Terms: Destination,Prepaid&Allowed
Bid No.: Delivery Calendar Day(s)A.R.O.: 0
Item Requisition Quantity Unit Unit Price Total
#
1 Agreement authorized by the Assistant Director of Purchasing on April 30,2018,
for the Water Department. The agreement shall begin May 1,2018 and end April
30,2019 with 3 options to renew automatically for up to 3 additional one-year
periods exercised in accordance with the agreement specifications.This
agreement is not to exceed $46,242.00 annually. Total for complete 5 year
contract not to exceed$184,968.00.
All prices,terms and conditions of the agreement shall be as stated in PO 18-
00103981.
The maximum amount authorized by this purchase agreement shall not exceed
$46,242.00. Accepting orders that exceed$46,242.00 are in violation of this award
and payment of such unauthorized amounts will not be the responsibility of the City
of Fort Worth.
Upon accepting a release order from our user department/division for this
agreement,please insure you are provided a purchase order number and a release
Invoices must be mailed to the ordering department/division releasing
service/commodity and the invoice shall contain:
1) Bid number;2)Department Purchase Order Number;3)Release Number;4)
Department Name;5)Address where service/commodity was delivered.
2 HORIZON Software Maintenance Renewal I Item#WA-703 1 5/l/2018-4/30/2019 1 EA $43,260.00 $43,260.00
LN/FY/Account Code Dollar Amount
2/18/56001-0604012-5610603---- $10,815.00
2/1 8/5 6 001-07040 1 2-56 1 0603----- $10,815.00
2/1 8/5600 1-06 030 0 1-5 3 3050 0----- $10,815.00
2/18/56001-0703001-5330500----- $10,815.00
3 Oracle Software Maintenance Renewal i Item#WA-704 1 5/1/2018-4/30/2019 1 EA $2,982.00 $2,982.00
Page 2 of 2
LN/FY/Account Code Dollar Amount
3/1 8/5600 1-06040 1 2-56 1 0603----- $745.50
3/1 8/5600 1-07040 1 2-56 1 0603----- $745.50
3/18/56001-0603001-5330500----- $745.50
3/18/56001-0703001-5330500----- $745.50
TOTAL: $46,242.00
APPROVED:
Rev.20091027 By: Sarath Padar
Phone#: (817) 392-8579
BUYER
Soto, Vania Elizabeth
From: Strong,JB
Sent: Wednesday,June 12, 2019 1:19 PM
To: Soto, Vania Elizabeth; Brents, Rick
Subject: RE:Question about Amendment to SS 18-00103981
1 think that's correct.
John B. Strong(JB)
Assistant City Attorney
200 Texas St.
Fort Worth,TX 76102
(817)392-7627
John.Strong@fortworthtexas.g_o_v
City of Fort Worth— Working together to build a strong community.
FORTWORTH.
RECIPIENTS-PLEASE CONTACT ME PRIOR TO FORWARDING MESSAGES DESIGNATED AS
ATTORNEY-CLIENT COMMUNICATIONS.
This e-mail and any files transmitted with it are confidential and are intended solely for the use of the individual or entity
to which they are addressed. This communication may contain material protected by the attorney-client privilege. If you
are not the intended recipient or the person responsible for delivering the e-mail to the intended recipient,be advised that
you have received this e-mail in error and that any use,dissemination, forwarding,printing,or copying of this e-mail is
strictly prohibited.If you have received this e-mail in error,please immediately notify John B. Strong at the City of Fort
Worth City Attorney's Office(817) 392-7627.
From:Soto,Vania Elizabeth
Sent:Wednesday,June 12,2019 9:57 AM
To: Brents, Rick<Rich a rd.Bre nts@fo rtwo rthtexa s.gov>;Strong,JB<John.Strong@fortworthtexas.gov>
Subject:Question about Amendment to SS 18-00103981
It looks like this Renewal letter is for a contract that was done with Purchasing as a PO and didn't get sent to CSO for
recording. So my question is does this contract need a new contract number?Just making sure everyone is okay with that
since there is no original CSC No.to attach it to.
Vania E. Soto
Administrative Assistant
City Secretary's Office
817-392-6090
V ania.S otona.fortworthtexas.g_ov
i