HomeMy WebLinkAboutContract 39303ry SECRETARY o
QNTr,ACT NO 3
AGREEMENT BETWEEN THE CITY OF FORT WORTH
AND DEVON NOWLIN FOR CONCEPTUAL DESIGN OF PUBLIC
ARUDESIGN ENHANCEMENTS FOR THE CLEARFORK MAIN
STREET BRIDGE
This Agreement is entered into this J day of Q Q�kCV� , 2009, by
and between the CITY OF FORT WORTH, a municipal corporation, of the State of Texas, (the
"City") acting by and through Fernando Costa, its duly authorized Assistant City Manager and
DEVON NOWLIN (the "Artist") of 400 Frontier Street, River Oaks, TX 76114. City has
designated the Arts Council of Fort Worth and Tarrant County, Inc. (the "Contract Manager") to
manage this Agreement on its behalf. The Contract Manager shall act through its Public Art
Project Manager.
WHEREAS, City is implementing the Fort Worth Public Art Program pursuant to the
Chapter 2, Sections 2-56 through 2-61 of the Fort Worth Code of Ordinances, (the "City Code"),
in order to create an enhanced visual environment for Fort Worth residents, to commemorate
City's rich cultural and ethnic diversity, to integrate the design work of artists into the
development of City's capital infrastructure improvements and to promote tourism and economic
vitality in City through the artistic design of public spaces; and,
WHEREAS, City is designing and constructing a new four -lane vehicular bridge across
the Trinity River, more particularly described as extending Stonegate Boulevard from the
intersection at Hulen Street and connect to the planned Edwards Ranch development to the west
in Fort Worth, TX, and more specifically, the west abutment wall as shown on Exhibit "A",
attached hereto and made apart hereof for all purposes (the "Site"); and,
WHEREAS, City desires to include integral public art /design enhancements that would
improve this bridge and allow for a more unified pedestrian -friendly crossing; and,
WHEREAS, the Fort Worth Art Commission has recommended funds from the 2007
Critical Capital Needs Fund to design and implement public art /design enhancements for the
Clearfork Main Street Bridge (the "Artwork"); and,
WHEREAS, Artist was selected from the Fort Worth Public Art program's Pre -Qualified
List of Emerging Artists and approved by the Fort Worth Art Commission ("FWAC") and
participated in a design charrette on July 23 -24, 2009; and,
iAl.. RECORD
FT, WORTH, TX
WHEREAS, the FWAC has recommended that Artist be retained to develop a conceptual
design for public artwork to be incorporated into the Clearfork Main Street bridge in
coordination with artist Tommy Fitzpatrick (the "Other Artist"), who is addressing the opposite
wall, and in association with artist advisor Brad Goldberg (the "Advisory Artist"); and,
WHEREAS, City and Artist wish to set out the terms and conditions for Artist's
participation in the Clearfork Main Street bridge project, including coordination with City's
project consultant (the "Project Consultant").
NOW, THEREFORE, City and Artist for and in consideration of the covenants and
agreements hereinafter set forth, the sufficiency of which is hereby acknowledged, agree as
follows:
ARTICLE 1
SCOPE OF SERVICES AND DELIVERABLES
1.1 Scope of Services.
a. Artist shall develop an integral conceptual design for a work of public art for the west
abutment wall of the Clearfork Main Street Bridge (the "Conceptual Design") in a timely
manner in collaboration with City's designated project consultants that is feasible both in
terms of budget and construction methods.
b. Artist, in coordination with the Other Artist, the Advisory Artist and Project Consultant,
shall determine the artistic expression, scope, design, color, size, material, and texture of
the Conceptual Design, subject to review and acceptance by City as set forth in this
Agreement.
c. Artist shall meet and coordinate with the Project Consultant to research the feasibility of
the design and to ensure proper integration of the Conceptual Design into the Site and
into the construction documents, as may be necessary.
d. Artist shall present a preliminary design to the designated community stakeholders
group, City Council Member and City officials for input.
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1.2. Conceptual Design Deliverables
a. Artist shall provide services and all supplies, materials, and equipment necessary to
provide certain deliverables, as set forth in this Section 1.2.ad.—iv. (collectively, the
"Conceptual Design Deliverables") to City for approval. Conceptual Design Deliverables
shall consist of the following:
i. Sketches, mockups, technical and budget information, or any other
information including proposed or potential methods of construction and
installation as may be reasonably requested by the Project Consultants in
order to incorporate Artist's conceptual design into drawings, renderings,
models, etc., being prepared the Project Consultants for baseline bid
documents. These deliverables shall be forwarded to the Project
Consultants in. a timely manner.
ii. Detailed design illustrations of the Conceptual Design for the Site;
these illustrations shall be at least 20" x 30" mounted on foam core
and/or in a high resolution digital format, such as JPEG or TIF
files.
iii. Written narrative descriptions, including the concept, dimensions,
materials, proposed or potential methods of construction and installation,
and maintenance requirements.
iv. Identify potential experienced and qualified fabricators) to execute the
Artwork by obtaining material samples/examples of comparable work by
selected fabricator(s) and obtaining written estimate(s).
v. Conceptual budget, with written estimates using the form in Exhibit "B",
attached hereto and made apart hereof for all purposes, in an amount not to
exceed $51,875.
b. Deadline for submission of Conceptual Design Deliverables may be extended by mutual
written agreement between Artist and the City.
c. Upon approval, Artist shall provide the Conceptual Design presentation materials to the
Contract Manager to become part of City's Public Art archive.
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d. Upon request by Artist, City, the Project Consultant and/or project manager shall furnish
all information, materials, and assistance required by Artist to the extent such materials
are available and accessible.
drawings of the Site, if available.
1.3. Implementation Budget Total.
City, upon request, shall also provide correct scaled
Artist shall develop a Conceptual Design that is financially feasible relative to the budget for
implementation. It is understood that the budget for implementation of the Artwork is estimated
at FIFTY-ONE THOUSAND EIGHT HUNDRED SEVENTY-FIVE DOLLARS AND NO
CENTS ($51,875), including any required engineering, materials, labor, fabrication, delivery,
installation, insurance, transportation, travel, contingency and all associated costs for the
in I
esgn.
ARTICLE 2
COMPENSATION AND PAYMENT SCHEDULE
2.1. Fee.
City shall pay Artist a fee in the amount of FIVE THOUSAND DOLLARS AND NO CENTS
5 000), which shall constitute full compensation for all services and materials to be performed
and furnished by Artist under this Agreement. The fee shall be paid in the following
installments, each installment to represent full and final payment for all services and materials
provided prior to the due date thereof:
a. Two Thousand Five Hundred Dollars and No Cents ($2,500) upon execution of
this Agreement, recognizing that Artist will invest time and expense in
preliminary design team coordination with the Advisory Artist, Project Consultant
and City.
b. Two Thousand Five Hundred Dollars and No Cents ($2,500) within thirty (30)
days after Artist submits "Conceptual Design Deliverables", as required in
Section 1.2.ad.4v. of this Agreement and makes a presentation of the Conceptual
Design to stakeholders, City representatives and the Fort Worth Art Commission.
2.2. Sales Taxes.
City is atax-exempt organization and no state or local sales taxes or federal excise taxes shall be
due upon the Project. City shall supply Artist with the "Texas Sales Tax and Local Sales Tax
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Exemption Certificate," attached hereto and made apart hereof for all purposes as Exhibit
for use by Artist in the fulfillment of this Agreement.
2.3. Artist's Expenses.
Artist shall be responsible for the payments of all expenses incurred during the performance of
this Agreement, including but not limited to services, materials, mailing/shipping charges and
insurance on submissions to City, cost of all travel, and costs for Artist's agents, consultants,
and/or employees necessary for the proper performance of the services required under this
Agreement.
ARTICLE 3
OWNERSHIP OF DESIGN AND REPRODUCTION RIGHTS
The Conceptual Design and all other work product under this Agreement shall become property
of City, without restriction on future use, except as provided below. Artist shall retain copyright
and other intellectual property rights in and to the Conceptual Design. By execution of this
Agreement, Artist grants to City a perpetual, irrevocable license to graphically depict or display
the Conceptual Design for any non-commercial purpose whatsoever; for purposes of this
limitation, any graphic depiction or display of the Conceptual Design intended to promote or
benefit City, its public services or its public purposes, regardless of whether or not a fee is
charged to the public, or whether revenue is otherwise received by City, shall be deemed a non-
commercial purpose. Notwithstanding the above limitation, Artist agrees and understands that
nothing in this paragraph shall affect or limit City's absolute, unrestricted rights incidental to
City's full ownership of the final artwork to alter, change, modify, destroy, remove, move,
replace, operate, maintain, transport, sell or transfer, in whole or in part, the final artwork when
City deems it necessary within its discretion, in order to otherwise exercise City's powers and
responsibility in regard to public works and improvements, in furtherance of City's operations or
for any other reason. City agrees to credit Artist as the creator and copyright holder when it
graphically depicts or displays the Conceptual Design.
ARTICLE 4
WARRANTY
The Conceptual Design shall be the original product of Artist's own creative efforts. Artist
warrants that the Conceptual Design is and will be original and agrees to assume the defense of,
and INDEMNIFY AND HOLD HARMLESS, CITY, ITS OFFICERS, EMPLOYEES,
AGENTS, AND CONTRACTORS FROM AND AGAINST ALL CLAIMS, LOSSES,
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DAMAGES, ACTIONS OR EXPENSES OF EVERY TYPE AND DESCRIPTION,
INCLUDING ATTORNEY' S FEES, TO WHICH THEY MAY BE SUBJECTED ARISING
OUT OF CITY'S USE OR POSSESSION OF THE CONCEPTUAL DESIGN BY REASON OF
AN ALLEGED OR ACTUAL COPYRIGHT VIOLATION OR OTHER LACK OF
OWNERSHIP, AUTHORSHIP, OR ORIGINALITY.
ARTICLE 5
ARTIST AS INDEPENDENT CONTRACTOR
Artist shall perform all work and services hereunder as an independent contractor, and not as an
officer, agent, servant or employee of City. Artist shall have exclusive control of, and the
exclusive right to control the details of the work performed hereunder, and all persons
performing same, and shall be solely responsible for the acts and omissions of his/her officers,
agents, employees and subcontractors. Nothing herein shall be construed as creating a
partnership or joint venture between City and Artist, his/her officers, agents, employees and
subcontractors, and doctrine of respondeat superior has no application as between City and
Artist.
ARTICLE 6
INDEMNIFICATION
(a) ARTIST COVENANTS AND AGREES TO INDEMNIFY, HOLD HARMLESS AND
DEFEND, AT ITS OWN EXPENSE, CITY AND ITS OFFICERS, AGENTS, SERVANTS,
AND EMPLOYEES FROM AND AGAINST ANY AND ALL CLAIMS OR SUITS FOR
PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH,
TO ANY AND ALL PERSONS, OF WHATSOEVER KIND OR CHARACTER, WHETHER
REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THE
EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR
NONPERFORMANCE OF THIS AGREEMENT AND/OR THE OPERATIONS,
ACTIVITIES AND SERVICES DESCRIBED HEREIN; AND ARTIST HEREBY ASSUMES
ALL LIABILITY AND RESPONSIBILITY OF CITY AND ITS OFFICERS, AGENTS,
SERVANTS, AND EMPLOYEES FOR ANY AND ALL CLAIMS OR SUITS FOR
PROPERTY LOSS OR DAMAGE AND/OR PERSONAL INJURY, INCLUDING DEATH,
TO ANY AND ALL PERSONS, OF WHATSOEVER KINDS OR CHARACTER,
WHETHER REAL OR ASSERTED, ARISING OUT OF OR IN CONNECTION WITH THE
EXECUTION, PERFORMANCE, ATTEMPTED PERFORMANCE OR NON-
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PERFORMANCE OF THIS AGREEMENT AND/OR THE OPERATIONS, ACTIVITIES
AND SERVICES DESCRIBED HEREIN. ARTIST LIKEWISE COVENANTS AND
AGREES TO AND DOES HEREBY INDEMNIFY AND HOLD HARMLESS CITY FROM
AND AGAINST ANY AND ALL INJURY, DAMAGE OR DESTRUCTION OF PROPERTY
OF CITY, ARISING OUT OF OR IN CONNECTION WITH ALL ACTS OR OMISSIONS
OF ARTIST, ITS OFFICERS, MEMBERS, AGENTS, EMPLOYEES,
SUBCONTRACTORS, INVITEES, LICENSEES, OR PROGRAM PARTICIPANTS.
(b) ARTIST AGREES TO AND SHALL RELEASE CITY, ITS AGENTS, EMPLOYEES,
OFFICERS AND LEGAL REPRESENTATIVES FROM ALL LIABILITY FOR INJURY,
DEATH, DAMAGE OR LOSS TO PERSONS OR PROPERTY SUSTAINED BY ARTIST
N CONNECTION WITH OR INCIDENTAL TO PERFORMANCE UNDER THIS
AGREEMENT.
(C) THIS ARTICLE 6 SHALL SURVIVE THE EXPIRATION OR TERMINATION OF
THIS AGREEMENT.
ARTICLE 7
EQUAL OPPORTUNITY
a. Artist shall not discriminate against any employee or applicant for employment
because of age, disability, race, color, religion, sex, sexual orientation, national origin, or familial
status. Artist shall take affirmative action to ensure that employees are treated equally during
employment, without regard to their age, disability, race, color, religion, sex, sexual orientation,
national origin, or familial status. Such action shall include but not be limited to the following:
Employment, upgrading, demotion, transfer, recruitment or pay or other forms of compensations,
and selection for training, including apprenticeship. Artist agrees to post in conspicuous places,
available to employees and applications for employment, notices to be provided by City setting
forth the provision of this nondiscrimination clause.
b. Artist shall in all solicitation or advertisements for employment placed on or on
behalf of Artist, state that all qualified applicants shall receive consideration for employment
without regard to race, color, religion, sex, sexual orientation, or national origin.
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c. Artist shall furnish all information and reports requested by City, and shall permit
access to its books, records, and accounts for purposes of investigation to ascertain compliance
with such rules and regulations.
d. In the event of Artist noncompliance with the nondiscrimination clauses of this
Agreement, this Agreement may be canceled, terminated, or suspended in whole or in part, and
Artist may be debarred from further agreements with City.
ARTICLE 8
MISCELLANEOUS
8.1. Compliance.
Artist shall comply with all Federal, State and City statutes, ordinances and regulations
applicable to the performance of Artist services under this Agreement.
8.2. Entire Agreement.
This writing embodies the entire agreement and understanding between the parties hereto, and
there are no other agreements and understandings, oral or written, with reference to the subject
matter hereof that are not merged herein and superseded hereby.
8.3. Amendments.
No alteration, change, modification or amendment of the terms of this Agreement shall be valid
or effective unless made in writing and signed by both parties hereto and approved by
appropriate action of City.
8.4. Waiver.
No waiver of performance by either party shall be construed as or operate as a waiver of any
subsequent default of any terms, covenants, and conditions of this Agreement. The payment or
acceptance of fees for any period after a default shall not be deemed a waiver of any right or
acceptance of defective performance.
8.5. Governing Law and Venue.
If any action, whether real or asserted, at law or in equity, arises on the basis of any provision of
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. This
Agreement shall be construed in accordance with the laws of the State of Texas.
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8.6. Successors and Assigns.
Neither party hereto shall assign, sublet or transfer its interest herein without prior written
consent of the other party, and any attempted assignment, sublease or transfer of all or any part
hereof without such prior written consent shall be void. This Agreement shall be binding upon
and shall inure to the benefit of City and Artist and its respective successors and permitted
assigns.
8.7. No Third -Party Beneficiaries.
The provisions and conditions of this Agreement are solely for the benefit of City and Artist, and
any lawful successor or assign, and are not intended to create any rights, contractual or
otherwise, to any other person or entity.
8.8 Severability.
If any provision of this Agreement shall be 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.
8.�. Force Majeure.
It is expressly understood and agreed by the parties to this Agreement that if the performance of
any obligations hereunder is delayed by reason of war; civil commotion; acts of God; inclement
weather; governmental restrictions, regulations, or interferences; fires; strikes; lockouts, national
disasters; riots; material or labor restrictions; transportation problems; or any other circumstances
which are reasonably beyond the control of the party obligated or permitted under the terms of
this Agreement to do or perform the same, regardless of whether any such circumstance is
similar to any of those enumerated or not, the party so obligated or permitted shall be excused
from doing or performing the same during such period of delay, so that the time period
applicable to such design or construction requirement shall be extended for a period of time
equal to the period such party was delayed.
8.10. Contract Construction.
The parties acknowledge that each party and, if it so chooses, its counsel have reviewed and
revised this Agreement and that the normal rule of construction to the effect that any ambiguities
are to be resolved against the drafting party must not be employed in the interpretation of this
Agreement or any amendments or exhibits hereto.
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8.11. Fiscal Funding Out.
If for any reason, at any time during any term of this Agreement, the City Council fails to
appropriate funds sufficient for City to fulfill its obligations under this Agreement, City may
terminate this Agreement to be effective on the later of (i) thirty (30) days following delivery by
City to Artist of written notice of City's intention to terminate or (ii) the last date for which
funding has been appropriated by City Council for the purposes set forth in this Agreement.
8.12. Captions.
Captions and headings used in this Agreement are for reference purposes only and shall not be
deemed a part of this Agreement.
8.13. Artist's Address.
Artist shall notify the Contract Manager of changes in address.
8.14. Surviving Covenants.
The covenants and obligations set forth in this Agreement shall not survive the death or legal
incapacity of Artist.
8.15 City's Right to Com 1p ete.
In the event of the death or legal incapacity of Artist, City shall have the right to complete the
Conceptual Design and shall give credit to Artist, as appropriate.
8.16. Right to Audit.
The Artist agrees that City will have the right to audit the financial and business records of the
Artist that relate to the Conceptual Design (collectively "Records") at any time during the Term
of this Agreement and for three (3) years thereafter in order to determine compliance with this
Agreement. Throughout the Term of this Agreement and for three (3) years thereafter, the Artist
shall make all Records available to City on 1000 Throckmorton Street, Fort Worth, Texas or at
another location in City acceptable to both parties following reasonable advance notice by City
and shall otherwise cooperate fully with City during any audit. Notwithstanding anything to the
contrary herein, this Section 8.16 shall survive expiration or earlier termination of this
Agreement.
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8.17. Certified MWBE.
If applicable, Artist shall make its best effort to become a certified Minority/Women Business
Enterprise (M/WBE) firm with a certifying agency whose certification is accepted by City under
City's M/WBE ordinance.
ARTICLE 9
NOTICES
All notices, requests, demands, and other communications which are required or permitted to be
given under this Agreement shall be in writing and shall be deemed to have been duly given
upon the delivery or receipt thereof, as the case may be, if delivered personally or sent by
registered or certified mail, return receipt requested, postage prepaid, as follows:
1. CITY OF FORT WORTH: Fernando Costa, Assistant City Manager
City Manager's Office
City of Fort Worth
1000 Throckmorton Street
Fort Worth, TX 76102
Copies to: David Yett, City Attorney
Law Department
1000 Throckmorton Street
Fort Worth, TX 76102
Martha Peters, Public Art Director
Arts Council of Fort Worth &Tarrant County
1300 Gendy Street
Fort Worth, TX 76107
2. ARTIST Devon Nowlin
400 Frontier Street
River Oaks, TX 76ll4
[SIGNATURES APPEAR ON THE FOLLOWING PAGE.]
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IN WITNESS HEREOF, the parties hereto have executed this Agreement on this day and
year first written above.
CITY OF FORT WORTH
Fernando Costa
Assistant City Manager
ARTIST
Devon Nowlin
APPROVED AS TO FORM: O*N '�� �+r.
ATTESTED BY: ii
ann D. Guzman Marty Hendrix
Assistant City Attorney City Secretary
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OFFICIAL RECO�iC� i�
k
C� ry ISECRETARY
�To WORTH, TX
Exhibit A: The Site
CIearfork Main Street Bridge
sib
2008
$tonegate f3ridge 30 Visualization ...
13
Exhibit B: Budget Form
ARTIST'S FEE #2C{?a}
TRAVEL
For artists who We mcr? than SO mile-s {tcm F4 iy Worthl
Aitiar?
Car Rental
Per Diem Expenses at 1_ per clay
Mileage at 1 ar mll?
INSURANCE
AtnaMred Vehicle Liability
Genetal Liability fcn Artist i Sul: Ctnvact(:as
Worker's C:Jmp. i Ernl:loyer's Liability
Met, as applicable
Cost Increases?: Pioi?cted Increase in OF ist Insurance 12 hicoths In Future
ADMINISTRATIVE EXPENSES
Phctie,Fax
6eih•?ri Shii:{:irr� ifor .cr7?sl:c•n:1=n:?, sarnpl_s, nnad?Is, drtrrincgs ev)
Rept==saraphic S:ery i,e
SuriAks
Cost Imieases?: Projected Imrease In CostAclrmin 12 Mcinths In Future
RROFESSIONAL CONSULTANT FEES
applicable, drawing must be signed aml sealed by a professianal registered to practice
io the State o1 Texas.)
Aroinl?ct'
Swriural Engin??r`
Eiecti Val Engineer'
%arcs?r.=ator'
Phcnogiaplrsi (for dxurnematlon of oJmplet: _t•orotk)'
Cnh,w
Cost hrieases?: Pfojectal Imrease in Ccst Consultants Fees 12 hlctuhs In Future
MATERIALS
(Please attach a complete I'�t c4 mat?rL�is. Itemize all anti.j:ated aspects arxJ
oni�>nenw with per unI aJfit estimates)
Mat?rials' Total
Cost Imilases?: Projei ted Imrease in Ccst Material& 12 Mcmhs In Future
FABRICATION COSTS
illn;IUd:- anti Ilen7iZ? all pOrtiJlifi Cfi hub=;ca7tracte._ttoo crk and watk t:J be aJnnl::feted I.'
artl&:I
Anises Labor t__ hcuis at 3� per hJwj Total
Sul:=?antract?i Lahco�r' rTctal't
Faailih,`E:lulpment Rental ittssd exclusiyety for this I:toje;iy relai^:I to fahi;atian
Cost l mcreases?: Proj cted Increase in Cost Fahlr atton 12 Nicoths In Future
SITE PREPARATION
Lrde costs c ryer?d b!, FYJPA, City of FortW ttili or �Ah?is;i
T-st Drilihr�i`
14
Renxr.•al'
Lanciscapinp' In ij et bn'
Elecidcal M.:=Jilicatbns'
Waiii Wo[Wechanical Devices
Calr-:t'
Cost Increases?: Projected Incseas_ In cast Sire preparation 12 ►= Goths In Future
TRANSPORTATION
Materials to Fal:+Vstion Site'
Fnhhed Work to Installation Sic,'
Cn4W
Cost In;tcasas?: Piojwted Imxease in Cost TtansIxilation 12 himthe In Future
BASE MOUNTING
Base
Mountin47 Devices and C•>mpc:vents
Fuundetbn'Fcoting
Other
Cost increases?: Projected Inmeaw in Cost WuntirtyFccting 12 Mcatths In Future
INSTALLATION COSTS
{C._sts must inolude allovran a for after It:lurs instaliatkm. if al:f�li.aL• le. Please attach a
o>mplete list of equipment and individual estimatesvrhh this formj
SDI. contract= I Lair:v'
ScaHcldirti'
Equornent Rental related to installaton'
Off-dw R�licac=anit�'
Traffic Barriers'
Storage Facility Pental'
City Permits
Display Devv4s
Firelss=�iir�`
Site Rv*wst;ratic�n'
trI>:t'
Cost lweasee?: Projected increase in Ow4t installation 12 fica lts In Futura
LIGHTING
Designers'
Fixtures'
Bulbs'
She Prelerati=n'
Insialimbn'
Costinaseass?: Projected lfraease In 0•4st Lighting 12 Maths In Fuutre
GRAND TOTALIIPICINtlIn{J ►31412G12ti Cost IIfCIoiso, H fitly}
PI4fl32 018N3 911y IteCe953fy f1Uf23 15Pr92
PrSparetl By:
Girte:
1J
Exhibit U Sales Tax Exemption
T�xAs c>✓R7�lcarr ar rxEn�Tloly
I claim an exemption
from
payment of
sales
and use taxes
for the pt>rchase of taxable
items described below
or on
the attached
order
or invoice.
Description of Items (or au attached order or invoice)'1'o I3e Purchased:
Ca\lii�i1;9
I clahn this exemption for the following reason:
Name of exempt organization: Ci of Iro�t Wottlr
Sales and Use Tax Permit Number 1-is-60005z8-G
Project far which matorials and supplies ate pwchased:
I understand that I will be liable for payment of sales tax, which may become due f'or
failtue to comply with the provisions of the state, city, and/or metropolitan transit
anthotity sales and use tax laws and comptroller rules regarding exempt purchases
Liability for the tax will be determined by the price paid for the taxable items purchased
or the Lair market rental value for the period of time used
I understand that it is a nusdemeartor to give an exemption certificate to the seller for
taxable items which I know, at the time of the purchase, will be used iu a manner other
than that expensed in this certificate and, upon conviction, may be fined up to $500 per
offense
Tax Exempt Status Due to Being a Govenunent<31 Entity
Purchaser: Citv of Fort Worth
Street Address: 1000 Throelauortou Street
City, Stzrte, Zip Code: Fort Worth, Texas 7G102
SignHere: '— Date: 02/07/2007 Phone: ($171392-8325
This certificate does not require a number to be valid.. Sates and use tax "exemption
numbers" or "tax exempt" numbers do not exist.
This certificate should be furrrished to the supplier Do not send the completed certificate
to the Cotnptroller of Public Accounts.