HomeMy WebLinkAboutContract 53567 c
CSC No. 53567
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� coos SUPPLIER SERVICES AGREEMENT
This SUPPLIER SERVICES AGREEMENT ("Agreement") is made and entered into by and
between the CITY OF FORT WORTH ("City"), a Texas home rule municipal corporation, and THE
SOUTHWESTERN BAPTIST THEOLOGICAL SEMINARY ("Supplier"), a Texas Nonprofit
Corporation, each individually referred to as a"party"and collectively referred to as the"parties."
AGREEMENT DOCUMENTS:
The Agreement documents shall include the following:
1. This Supplier Services Agreement;
2. Exhibit A—Scope of Services;
3. Exhibit B—Price Schedule; and
4. Exhibit C—Verification of Signature Authority Form.
Exhibits A,B and C,which are attached hereto and incorporated herein,are made a part of this Agreement
for all purposes. In the event of any conflict between the terms and conditions of Exhibits A, B or C and
the terms and conditions set forth in the body of this Agreement,the terms and conditions of this Agreement
shall control
1. SCOPE OF SERVICES.
Supplier shall provide conference venue and food services for the Citizens On Patrol (COP)
Conference 2020 for the City of Fort Worth (City) Police Department(FWPD). Exhibit "A," - Scope of
Services more specifically describes the services to be provided hereunder.
2. TERM.
This Agreement shall begin on February 1,2020("Effective Date") and shall expire on July 31,
2020"Expiration Date"),unless terminated earlier in accordance with this Agreement("Initial Term").
3. COMPENSATION.
City shall pay Supplier in accordance with the provisions of this Agreement and Exhibit `B," —
Price Schedule,attached hereto. Total payment made under this Agreement for the first year by City shall
not exceed the amount of $29,803.00. Supplier shall not perform any additional services or bill for
expenses incurred for City not specified by this Agreement unless City requests and approves in writing the
additional costs for such services. City shall not be liable for any additional expenses of Supplier not
specified by this Agreement unless City first approves such expenses in writing. Supplier agrees to reserve
a block of 30 on-site guest rooms,for three nights,for conference attendees.Guest Rooms shall be available
at a rate of$100, per night, for each room. Conference attendees are responsible for the payment of their
own guest rooms.The City shall,in no way,be responsible for payment of the guest rooms,or for reserving
the block,and Supplier hereby agrees it will not seek compensation from the City for payment of any guest
room reservation.
20-0015 Supplier Services AgreementAgec�i"1�"
FT. WURTH,TIC
4. TERMINATION.
4.1. Written Notice. City or Supplier may terminate this Agreement at any time and for any
reason by providing the other party with 30 days' written notice of termination.
4.2 Non-appropriation of Funds. In the event no funds or insufficient funds are appropriated
by City in any fiscal period for any payments due hereunder, City will notify Supplier of such occurrence
and this Agreement shall terminate on the last day of the fiscal period for which appropriations were
received without penalty or expense to City of any kind whatsoever, except as to the portions of the
payments herein agreed upon for which funds have been appropriated.
4.3 Duties and Obligations of the Parties. In the event that this Agreement is terminated prior
to the Expiration Date, City shall pay Supplier for services actually rendered up to the effective date of
termination and Supplier shall continue to provide City with services requested by City and in accordance
with this Agreement up to the effective date of termination. Upon termination of this Agreement for any
reason,Supplier shall provide City with copies of all completed or partially completed documents prepared
under this Agreement.In the event Supplier has received access to City Information or data as a requirement
to perform services hereunder, Supplier shall return all City provided data to City in a machine readable
format or other format deemed acceptable to City.
5. DISCLOSURE OF CONFLICTS AND CONFIDENTIAL INFORMATION.
5.1 Disclosure of Conflicts. Supplier hereby warrants to City that Supplier has made full
disclosure in writing of any existing or potential conflicts of interest related to Supplier's services under this
Agreement. In the event that any conflicts of interest arise after the Effective Date of this Agreement,
Supplier hereby agrees immediately to make full disclosure to City in writing.
5.2 Confidential Information. Supplier,for itself and its officers,agents and employees,agrees
that it shall treat all information provided to it by City("City Information") as confidential and shall not
disclose any such information to a third party without the prior written approval of City.
5.3 Unauthorized Access. Supplier shall store and maintain City Information in a secure
manner and shall not allow unauthorized users to access, modify, delete or otherwise corrupt City
Information in any way. Supplier shall notify City immediately if the security or integrity of any City
Information has been compromised or is believed to have been compromised, in which event, Supplier
shall, in good faith, use all commercially reasonable efforts to cooperate with City in identifying what
information has been accessed by unauthorized means and shall fully cooperate with City to protect such
City Information from further unauthorized disclosure.
6. RIGHT TO AUDIT.
Supplier agrees that City shall,until the expiration of three(3)years after final payment under this
contract,or the final conclusion of any audit commenced during the said three years,have access to and the
right to examine at reasonable times any directly pertinent books,documents,papers and records,including,
but not limited to,all electronic records,of Supplier involving transactions relating to this Agreement at no
additional cost to City. Supplier agrees that City shall have access during normal working hours to all
necessary Supplier facilities and shall be provided adequate and appropriate work space in order to conduct
audits in compliance with the provisions of this section. City shall give Supplier reasonable advance notice
of intended audits.
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7. INDEPENDENT CONTRACTOR.
It is expressly understood and agreed that Supplier shall operate as an independent contractor as to
all rights and privileges and work performed under this Agreement, and not as an agent, representative or
employee of City. Subject to and in accordance with the terms of this Agreement, Supplier shall have the
exclusive right to control the details of its operations and activities and be solely responsible for the acts
and omissions of its officers, agents, servants, employees, consultants and sub suppliers. Supplier
acknowledges that the doctrine of respondeat superior shall not apply as between City,its officers,agents,
servants and employees,and Supplier,its officers,agents,employees,servants,Suppliers and sub supplier.
Supplier further agrees that nothing herein shall be construed as the creation of a partnership or joint
enterprise between City and Supplier. It is further understood that City shall in no way be considered a Co-
employer or a Joint employer of Supplier or any officers, agents, servants, employees or sub supplier of
Supplier. Neither Supplier,nor any officers, agents, servants, employees or sub supplier of Supplier shall
be entitled to any employment benefits from City. Supplier shall be responsible and liable for any and all
payment and reporting of taxes on behalf of itself, and any of its officers, agents, servants, employees or
sub supplier.
8. LIABILITY AND INDEMNIFICATION.
8.1 LIABILITY-SUPPLIER SHALL BE LIABLE AND RESPONSIBLE FOR ANY AND
ALL PROPERTY LOSS, PROPERTY DAMAGE AND/OR PERSONAL INJURY, INCLUDING
DEATH, TO ANY AND ALL PERSONS, OF ANY KIND OR CHARACTER, WHETHER REAL OR
ASSERTED, TO THE EXTENT CAUSED BY THE NEGLIGENT ACT(S) OR OMISSION(S),
MALFEASANCE OR INTENTIONAL MISCONDUCT OF SUPPLIER, ITS OFFICERS, AGENTS,
SERVANTS OR EMPLOYEES.
8.2 GENERAL INDEMNIFICATION - SUPPLIER HEREBY COVENANTS AND
AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS, AGENTS,
SERVANTS AND EMPLOYEES, FROM AND AGAINST ANY AND ALL CLAIMS OR LAWSUITS
OF ANY KIND OR CHARACTER, WHETHER REAL OR ASSERTED, FOR EITHER PROPERTY
DAMAGE OR LOSS (INCLUDING ALLEGED DAMAGE OR LOSS TO SUPPLIER'S BUSINESS
AND ANYRESULTING LOST PROFITS)AND/OR PERSONAL INJURY,INCLUDING DEATH, TO
ANY AND ALL PERSONS,ARISING OUT OF OR IN CONNECTION WITH THIS AGREEMENT,
TO THE EXTENT CA USED BY THE NEGLIGENT ACTS OR OMISSIONS OR MALFEASANCE OF
SUPPLIER,ITS OFFICERS,AGENTS,SERVANTS OR EMPLOYEES.
9. ASSIGNMENT AND SUBCONTRACTING.
9.1 Assignment. Supplier shall not assign or subcontract any of its duties,obligations or rights
under this Agreement without the prior written consent of City. If City grants consent to an assignment,the
assignee shall execute a written agreement with City and Supplier under which the assignee agrees to be
bound by the duties and obligations of Supplier under this Agreement. Supplier and Assignee shall be
jointly liable for all obligations of Supplier under this Agreement prior to the effective date of the
assignment.
9.2 Subcontract. If City grants consent to a subcontract, sub supplier shall execute a written
agreement with Supplier referencing this Agreement under which sub supplier shall agree to be bound by
the duties and obligations of Supplier under this Agreement as such duties and obligations may apply.
Supplier shall provide City with a fully executed copy of any such subcontract.
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9.3 Failure of either any assignee or sub supplier to execute a separate,written, agreement, as
required by this agreement, shall not be deemed a waiver of that requirement by the City.
10. INSURANCE.
Supplier shall provide City with certificate(s) of insurance documenting policies of the following
types and minimum coverage limits that are to be in effect prior to commencement of any work pursuant
to this Agreement:
10.1 Coverage and Limits
(a) Commercial General Liability:
$1,000,000- Each Occurrence
$2,000,000- Aggregate
(b) Automobile Liability:
$1,000,000- Each occurrence on a combined single limit basis
Coverage shall be on any vehicle used by Supplier, its employees, agents,
representatives in the course of providing services under this Agreement. "Any
vehicle" shall be any vehicle owned,hired and non-owned.
(c) Worker's Compensation:
Statutory limits according to the Texas Workers' Compensation Act or any other
state workers' compensation laws where the work is being performed
Employers' liability
$100,000- Bodily Injury by accident; each accident/occurrence
$100,000- Bodily Injury by disease; each employee
$500,000- Bodily Injury by disease;policy limit
10.2 General Requirements
(a) A minimum of Thirty (30) days' notice of cancellation or reduction in limits of
coverage shall be provided to City. Ten(10)days'notice shall be acceptable in the
event of non-payment of premium.Notice shall be sent to the Risk Manager, City
of Fort Worth,200 Texas Street,Fort Worth,Texas 76102,with copies to the Fort
Worth City Attorney at the same address.
(b) The insurers for all policies must be licensed and/or approved to do business in the
State of Texas. All insurers must have a minimum rating of A-VII in the current
A.M.Best Key Rating Guide,or have reasonably equivalent financial strength and
solvency to the satisfaction of Risk Management. If the rating is below that
required,written approval of Risk Management is required.
(c) Any failure on the part of City to request required insurance documentation shall
not constitute a waiver of the insurance requirement.
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(d) Certificates of Insurance evidencing that Supplier has obtained all required
insurance shall be delivered to the City prior to Supplier proceeding with any work
pursuant to this Agreement.
11. COMPLIANCE WITH LAWS,ORDINANCES,RULES AND REGULATIONS.
Supplier agrees that in the performance of its obligations hereunder, it shall comply with all
applicable federal, state and local laws, ordinances,rules and regulations and that any work it produces in
connection with this Agreement will also comply with all applicable federal, state and local laws,
ordinances,rules and regulations. If City notifies Supplier of any violation of such laws, ordinances,rules
or regulations, Supplier shall immediately desist from and correct the violation.
12. NON-DISCRIMINATION COVENANT.
Supplier,for itself,its personal representatives,assigns,sub suppliers and successors in interest,as
part of the consideration herein, agrees that in the performance of Supplier's duties and obligations
hereunder,it shall not discriminate in the treatment or employment of any individual or group of individuals
on any basis prohibited by law. IF ANY CLAIM ARISES FROM AN ALLEGED VIOLATION OF
THIS NON-DISCRIMINATION COVENANT BY SUPPLIER, ITS PERSONAL
REPRESENTATIVES, ASSIGNS, SUB SUPPLIERS OR SUCCESSORS IN INTEREST,
SUPPLIER AGREES TO ASSUME SUCH LIABILITY AND TO INDEMNIFY AND DEFEND
CITY AND HOLD CITY HARMLESS FROM SUCH CLAIM.
13. NOTICES.
Notices required pursuant to the provisions of this Agreement shall be conclusively determined to
have been delivered when (1) hand-delivered to the other party, its agents, employees, servants or
representatives,(2)delivered by facsimile with electronic confirmation of the transmission,or(3)received
by the other party by United States Mail,registered,return receipt requested, addressed as follows:
To CITY: To SUPPLIER:
City of Fort Worth The Southwestern Baptist Theological Seminary.
Attn: Jesus J. Chapa,Assistant City Manager Director of Events Management
200 Texas Street 1701 West Boyce
Fort Worth,TX 76102-6314 Fort Worth,TX 76115
Facsimile: (817)392-8654 Telephone: 817-923-1921
With copy to Fort Worth City Attorney's Office at
same address
14. SOLICITATION OF EMPLOYEES.
Neither City nor Supplier shall, during the term of this Agreement and additionally for a period of
one year after its termination, solicit for employment or employ, whether as employee or independent
contractor,any person who is or has been employed by the other during the term of this Agreement,without
the prior written consent of the person's employer.Notwithstanding the foregoing,this provision shall not
apply to an employee of either party who responds to a general solicitation of advertisement of employment
by either party.
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15. GOVERNMENTAL POWERS.
It is understood and agreed that by execution of this Agreement, City does not waive or surrender
any of its governmental powers or immunities.
16. NO WAIVER.
The failure of City or Supplier to insist upon the performance of any term or provision of this
Agreement or to exercise any right granted herein shall not constitute a waiver of City's or Supplier's
respective right to insist upon appropriate performance or to assert any such right on any future occasion.
17. GOVERNING LAW/VENUE.
This Agreement shall be construed in accordance with the laws of the State of Texas. If any action,
whether real or asserted, at law or in equity, is brought pursuant to this Agreement, venue for such action
shall lie in state courts located in Tarrant County,Texas or the United States District Court for the Northern
District of Texas,Fort Worth Division.
18. SEVERABILITY.
If any provision of this Agreement is held to be invalid, illegal or unenforceable, the validity,
legality and enforceability of the remaining provisions shall not in any way be affected or impaired.
19. FORCE MAJEURE.
City and Supplier shall exercise their best efforts to meet their respective duties and obligations as
set forth in this Agreement,but shall not be held liable for any delay or omission in performance due to
force majeure or other causes beyond their reasonable control, including, but not limited to, compliance
with any government law, ordinance or regulation, acts of God, acts of the public enemy, fires, strikes,
lockouts, natural disasters, wars, riots, material or labor restrictions by any governmental authority,
transportation problems and/or any other similar causes.
20. HEADINGS NOT CONTROLLING.
Headings and titles used in this Agreement are for reference purposes only, shall not be deemed a
part of this Agreement,and are not intended to define or limit the scope of any provision of this Agreement.
21. REVIEW OF COUNSEL.
The parties acknowledge that each party and its counsel have reviewed and revised this Agreement
and that the normal rules of construction to the effect that any ambiguities are to be resolved against the
drafting party shall not be employed in the interpretation of this Agreement or Exhibits A,B,and C.
22. AMENDMENTS/MODIFICATIONS/EXTENSIONS.
No amendment,modification, or extension of this Agreement shall be binding upon a party hereto
unless set forth in a written instrument,which is executed by an authorized representative of each party.
23. ENTIRETY OF AGREEMENT.
This Agreement, including Exhibits A, B and C, contains the entire understanding and agreement
between City and Supplier,their assigns and successors in interest,as to the matters contained herein.Any
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prior or contemporaneous oral or written agreement is hereby declared null and void to the extent in conflict
with any provision of this Agreement.
24. COUNTERPARTS.
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 one and the same
instrument.
25. WARRANTY OF SERVICES.
Supplier warrants that its services will be of a high quality and conform to generally prevailing
industry standards.City must give written notice of any breach of this warranty within thirty(30)days from
the date that the services are completed. In such event, at Supplier's option, Supplier shall either (a) use
commercially reasonable efforts to re-perform the services in a manner that conforms with the warranty,or
(b)refund the fees paid by City to Supplier for the nonconforming services.
26. IMMIGRATION NATIONALITY ACT.
Supplier shall verify the identity and employment eligibility of its employees who perform work
under this Agreement, including completing the Employment Eligibility Verification Form (I-9). Upon
request by City, Supplier shall provide City with copies of all I-9 forms and supporting eligibility
documentation for each employee who performs work under this Agreement. Supplier shall adhere to all
Federal and State laws as well as establish appropriate procedures and controls so that no services will be
performed by any Supplier employee who is not legally eligible to perform such services. SUPPLIER
SHALL INDEMNIFY CITY AND HOLD CITY HARMLESS FROM ANY PENALTIES,
LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS PARAGRAPH BY SUPPLIER,
SUPPLIER'S EMPLOYEES,SUBCONTRACTORS,AGENTS,OR LICENSEES.City,upon written
notice to Supplier, shall have the right to immediately terminate this Agreement for violations of this
provision by Supplier.
28. SIGNATURE AUTHORITY.
The person signing this Agreement hereby warrants that he/she has the legal authority to execute
this Agreement on behalf of the respective party,and that such binding authority has been granted by proper
order,resolution,ordinance or other authorization of the entity.This Agreement and any amendment hereto,
may be executed by any authorized representative of Supplier whose name,title and signature is affixed on
the Verification of Signature Authority Form,which is attached hereto as Exhibit"C". Each party is fully
entitled to rely on these warranties and representations in entering into this Agreement or any amendment
hereto.
29. CHANGE IN COMPANY NAME OR OWNERSHIP
Supplier shall notify City's Purchasing Manager, in writing, of a company name, ownership, or
address change for the purpose of maintaining updated City records.The president of Supplier or authorized
official must sign the letter. A letter indicating changes in a company name or ownership must be
accompanied with supporting legal documentation such as an updated W-9, documents filed with the state
indicating such change, copy of the board of director's resolution approving the action, or an executed
merger or acquisition agreement. Failure to provide the specified documentation so may adversely impact
future invoice payments.
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30. PROHIBITION ON CONTRACTING WITH COMPANIES THAT BOYCOTT ISRAEL
If Supplier has fewer than ten employees or the Agreement is for less than $100,000, this section
does not apply. Supplier acknowledges that in accordance with Chapter 2270 of the Texas Government
Code,the City is prohibited from entering into a contract with a company for goods or services unless the
contract contains a written verification from the company that it: (1) does not boycott Israel; and(2) will
not boycott Israel during the term of the contract. The terms "boycott Israel" and"company" shall have
the meanings ascribed to those terms in Section 808.001 of the Texas Government Code. By signing this
contract, Supplier certifies that Supplier's signature provides written verification to the City that
Supplier: (1)does not boycott Israel; and(2)will not boycott Israel during the term of the contract.
(Signature page follows)
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ACCEPTED AND AGREED:
CITY OF FORT WORTH CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the
person responsible for the monitoring and
administration of this contract, including
By: JesuslChapa(Feb 24, 020) ensuring all performance and reporting
Name: Jesus J. Chapa requirements.
Title: Assistant City Manager
Date: L
By. James C.Stockton(Feb 13,2020)
APPROVAL RECOMMENDED: Name: James Stockton
Title: Police Captain
�ywir"i �iyUS �„ APPROVED AS TO FORM AND
By: Edwin Kraus(Feb 17,2020) � �C ....... LEGALITY:
Name: Edwin Kraus
Title: Chief of Police
ATTEST: ` * By: Tayi r Paris(Feb 24,2020)
Name: Taylor Paris
Title: Assistant City Attorney
r
By, Mary J.K r(Fe_ ,2020) CONTRACT AUTHORIZATION:
Name: Mary J. Kayser M&C: (None Required)
Title: City Secretary Date Approved:
Form 1295 Certification No.: N/A
SOUTHWESTERN BAPTIST
THEOLOGICAL SEMINA Y
By:
Name: Colby dams
Title: Vice sident for Strategic Initiatives,
Chief of Staff
i
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EXHIBIT A
SCOPE OF SERVICES
Supplier will provide City with the conference venue space and necessary services consistent with the schedule more specifically
described below. Further, Supplier agrees to reserve a block of 30 guest rooms for conference attendees for three nights at a rate of
$100 per night,or a total cost of$300,for each room. Conference attendees will be responsible for payment of their own guest
room.
2020 Texas Citizens on Patrol Conference in Fort Worth
Fort Worth has been selected to host the 2020 Texas Citizens on Patrol Conference. The conference is scheduled to take place the
evening of Thursday,July 9,2020 through the morning of July 12,2020 with up to 175 attendees expected.Attendees come from
different cities all over the state of Texas and a few will attend from surrounding states.
Food : Audio Visual
Requirements
Friday,6:00 General Opening Session:On Friday Breakfast dining area with buffet Breakfast seating/tables for Breakfast with coffee, PA/Microphone
AM to 09:30 morning,a large ballroom that holds 175 line 175 persons. water,tea.Utensils, system,podium
AM attendees will be needed for the general plates,napkins,
opening session. lemon,creamer,
sugar.Menu to be
determined(TBD)
with successful
supplier.
Friday,12:00 Luncheon Buffet for 175 attendees Lunch dining area with buffet Luncheon seating/tables for Luncheon buffet line
Noon to 1:30 line 175 persons service with main
PM course and two sides
and salad with
dessert.Coffee,tea,
soda and water.
Utensils,plates,
napkins,lemon,
creamer,sugar.Menu
TBD.
Friday,10:00 Breakout Sessions:several rooms willbe Need 6-8 breakout rooms Each breakout room wouldbe Coffee,tea,water, LCD Projector,
AM to 5:00 needed for individual workshops set up for 25 attendees in a soda and snacks screen in each
PM classroom style (TBD),lemon, breakout room
creamer,sugar. PA/Microphone
Saturday, Breakfast for 175 attendees Breakfast seating tables for Breakfast with coffee,
07:00 AM to 175 Dersons water,tea.Utensils.
08:30 AM plates,napkins,
lemon,creamer,
sugar.Menu TBD.
Saturday, Breakout Sessions:several rooms willbe Need 6-8 breakout rooms Each breakout room would be Coffee,tea,water, LCD Projector,
09:00 AM to needed for individual workshops set up for 25 attendees in a soda and snacks screen in each
12:00 Noon classroom style (TBD).Lemon, breakout room
creamer,sugar.
Saturday, Lunch for 175 attendees Luncheon seating/tables for Box lunches for 175
12:00 Noon to 175 persons persons.Coffee,tea,
1:30 PM soda,and water.
Lemon,creamer,
sugar.Menu TBD.
Saturday, Breakout Sessions:several rooms willbe Need 6-8 breakout rooms Each breakout room would be Coffee,tea,water LCD Projector,
1:30 PM to needed for individual workshops set up for 25 attendees in a soda and snacks screen in each
5:00 PM classroom style (TBD). breakout room
PA/Microphone
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Saturday, Closing Banquet Need a ballroom that holds 175 22-round tables with 8 chairs Plated dinner with PA/Microphone
6:30pm to banquet style with a stage each and tablecloths included side dish,vegetable, system,podium
11:30pm salad,&dessert,
coffee,tea,soda and
water for 175 guests
Utensils,plates,
napkins,lemon,
creamer,sugar
Other items needed in proposals
Free on site parking for attendees
Area for 5 exhibitors/vendor tables
Storage room/area to hold goodie bags,materials,etc.
Dates I I Conference
July 9--12,2020
Desired
1)Within 2 miles of the FWPD Headquarters and Training Facility located at 505 W.Felix Street,Fort Worth,Texas 76115
2)Centralized location to Fort Worth West ofI-35
3)Within 1 mile of either I-20 orI-30
4)Non-smoking facility
5)At least 30 hotel rooms available onsite
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EXHIBIT B
PRICE SCHEDULE
Item Estimated Cost
Hotel rooms(30 onsite)for 3
nights 9,000(to be paid by
conference attendees)
Friday breakfast 1,920
Friday buffet lunch 3,670
Saturday breakfast 1,920
Saturday boxed lunch 2,712
Saturday plated dinner 5,105
Friday snacks for breakout
sessions 1,542
Saturday snacks for breakout
sessions(2 breakout session times)
3,084
Venue space: Room 150(Friday),
Breakout sessions(Friday),Room
150(Saturday),Breakout Sessions
(Saturday) 9,850
Estimated Total: $38,803.00
City Payment Responsibility: $29,803
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EXHIBIT C
VERIFICATION OF SIGNATURE AUTHORITY
Southwestern Baptist Theological Seminary.
2001 W. Seminary Drive
Fort Worth,TX 76115
Execution of this Signature Verification Form ("Form") hereby certifies that the following individuals
and/or positions have the authority to legally bind Supplier and to execute any agreement, amendment or
change order on behalf of Supplier. Such binding authority has been granted by proper order, resolution,
ordinance or other authorization of Supplier.City is fully entitled to rely on the warranty and representation
set forth in this Form in entering into any agreement or amendment with Supplier. Supplier will submit an
updated Form within ten (10) business days if there are any changes to the signatory authority. City is
entitled to rely on any current executed Form until it receives a revised Form that has been properly executed
by Supplier.
1. Name:
Position:
Signature
2. Name:
Position:
Signature
3. Name:
Position:
Signature
Name:
Signature of President/CEO
Other Title:
Date:
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