Loading...
HomeMy WebLinkAboutContract 42866CITY SECRETARY CONTRACT NO. CITY OF FORT WORTH, TEXAS r STANDARD AGREEMENT FOR PROFESSIONAL SERVICES This AGREEMENT is between the City of Fort Worth, a Texas home -rule municipality (the "CITY"), and de Camp, Gerry, authorized to do business in Texas, an independent contractor ( "Consultant "), for a PROJECT generally described as: Traffic Signal Operations Engineering, Traffic Signal Timing Plan Development for Special Projects. Article I Scope of Services (1) Consultant hereby agrees to perform as an independent contractor the services set forth in the Scope of Services attached hereto as Attachment "A ". These services shall be performed in connection with Traffic Signal Operations Engineering, Traffic Signal Timing Plan Development for Special Projects. (2) Additional services, if any, will be requested in writing by the City. City shall not pay for any work performed by Consultant or its subconsultants, subcontractors and /or suppliers that has not been ordered in writing. It is specifically agreed that Consultant shall not be compensated for any alleged additional work resulting from oral orders of any person. Article II Compensation Consultant shall be compensated in accordance with the Fee Schedule shown in Attachment "B ". Payment shall be considered full compensation for all labor, materials, supplies, and equipment necessary to complete the services described in Attachment "A ". However the total fee paid by the City shall not exceed a total of $23,375.00 unless the City and the Consultant mutually agree upon a fee amount for additional services and amend this Agreement accordingly. The Consultant shall provide monthly invoices to the City. Payment for services rendered shall be due within thirty (30) days of the uncontested performance of the particular services so ordered and receipt by City of Consultant's invoice for payment of same. Acceptance by Consultant of said payment shall operate as and shall release the City from all claims or liabilities under this Agreement for anything related to, done, or furnished in connection with the services for which payment is made, including any act or omission of the City in connection with such services. City of Fort Worth, Texas Standard Agreement for Professional Services PMO Official Release Date 11/29/2011 Page 1 of 8 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Article III Term Unless terminated pursuant to the terms herein, this Agreement shall be for a term of two months, beginning upon the date of its execution, or until the completion of the subject matter contemplated herein, whichever occurs first. Article IV Independent Contractor Consultant shall operate hereunder as an independent contractor, and not as an officer, agent, servant, or employee of the City. Consultant shall have exclusive control of and the exclusive right to control the details of its work to be performed hereunder and all persons performing same, and shall be solely responsible for the acts and omissions of its officers, agents, employees, contractors and subcontractors. The doctrine of respondent superior shall not apply as between City and Consultant, its officers, agents, employees, contractors, and subcontractors, and nothing herein shall be construed as creating a partnership or joint venture between City and Consultant. Article V Professional Competence and Indemnification (1) Work performed by Consultant shall comply in all aspects with all applicable local, state and federal laws and with all applicable rules and regulations promulgated by the local, state and national boards, bureaus and agencies. Approval by the City shall not constitute or be deemed to be a release of the responsibility and liability of Consultant or its officers, agents, employees, contractors and subcontractors for the accuracy and competency of its services performed hereunder. (2) In accordance with Texas Local Government Code Section 271.904, the Consultant shall indemnify, hold harmless, and defend the City against liability for any damage caused by or resulting from an act of negligence, intentional tort, intellectual property infringement, or failure to pay a subcontractor or supplier committed by the Consultant or Consultant's agent, consultant under contract, or another entity over which the Consultant's exercises control. City of Fort Worth, Texas Standard Agreement for Professional Services PMO Official Release Date 11/29/2011 Page 2 of 8 Article VI Insurance (1) Consultant shall not commence work under this Agreement until it has obtained all insurance required under this Article and the City has approved such insurance, nor shall Consultant allow any subcontractor to commence work on its subcontract until all similar insurance of the subcontractor has been so obtained and approval given by the City; provided, however, Consultant may elect to add any subconsultant as an additional insured under its liability policies. Commercial General Liability $1,000,000 each occurrence $1,000,000 aggregate Automobile Liability $1,000,000 each accident (or reasonably equivalent limits of coverage if written on a split limits basis). Coverage shall be on any vehicle used in the course of the Project. Worker's Compensation Coverage A: statutory limits Coverage B: $100,000 each accident $500,000 disease - policy limit $100,000 disease - each employee (2) Additional Insurance Requirements a. Except for employer's liability insurance coverage under Consultant's worker's compensation insurance policy, the City, its officers, employees and servants shall be endorsed as an additional insured on Consultant's insurance policies. b. Certificates of insurance shall be delivered to the Transportation and Public Works, Traffic Services Division, Attention: Marisa Conlin, P.E., 1000 Throckmorton Street, Fort Worth, TX 76102, prior to commencement of work. c. Any failure on part of the City to request required insurance documentation shall not constitute a waiver of the insurance requirements specified herein. d. Each insurance policy shall be endorsed to provide the City a minimum thirty days notice of cancellation, non - renewal, and /or material change in policy terms or coverage. A ten days notice shall be acceptable in the event of non - payment of premium. City of Fort Worth, Texas Standard Agreement for Professional Services PMO Official Release Date 11/29/2011 Page 3 of 8 e. Insurers must be authorized to do business in the State of Texas and have a current A.M. Best rating of A: VII or equivalent measure of financial strength and solvency. f. Other than worker's compensation insurance, in lieu of traditional insurance, City may consider alternative coverage or risk treatment measures through insurance pools or risk retention groups. The City must approve in writing any alternative coverage. g. Workers' compensation insurance policy(s) covering employees employed on the Project shall be endorsed with a waiver of subrogation providing rights of recovery in favor of the City. h. City shall not be responsible for the direct payment of insurance premium costs for Consultant's insurance. i. Consultant's insurance policies shall each be endorsed to provide that such insurance is primary protection and any self - funded or commercial coverage maintained by City shall not be called upon to contribute to loss recovery. j. In the course of the Agreement, Consultant shall report, in a timely manner, to City's officially designated contract administrator any known loss occurrence which could give rise to a liability claim or lawsuit or which could result in a property loss. k. Consultant's liability shall not be limited to the specified amounts of insurance required herein. I. Upon the request of City, Consultant shall provide complete copies of all insurance policies required by these Agreement documents. Article VII Transfer or Assignment City and Consultant each bind themselves, and their lawful successors and assigns, to this Agreement. Consultant, its lawful successors and assigns, shall not assign, sublet or transfer any interest in this Agreement without prior written consent of the City. Article VIII Termination of Contract (1) City may terminate this Agreement for its convenience on 30 days' written notice. Either the City or the Consultant for cause may terminate this Agreement if either Party fails substantially to perform through no fault of the other and does not City of Fort Worth, Texas Standard Agreement for Professional Services PMO Official Release Date 11/29/2011 Page 4 of 8 commence correction of such nonperformance with 5 days of written notice and diligently complete the correction thereafter (2) If City chooses to terminate this Agreement under Article 8, upon receipt of notice of termination, Consultant shall discontinue services rendered up to the date of such termination and City shall compensate Consultant based upon calculations in Article 2 of this Agreement and Exhibit "B" attached hereto and incorporated herein. (3) All reports, whether partial or complete, prepared under this Agreement, including any original drawings or documents, whether furnished by the City, its officers, agents, employees, consultants, or contractors, or prepared by Consultant, shall be or become the property of the City, and shall be furnished to the City prior to or at the time such services are completed, or upon termination or expiration of this Agreement. Article IX Right to Audit (1) Consultant agrees that the City shall, until the expiration of three (3) years after final payment under this Agreement, have access to and the right to examine any directly pertinent books, documents, papers and records of Consultant involving transactions relating to this Agreement. Consultant agrees that the City shall have access during normal working hours to all necessary facilities and shall be provided adequate and appropriate workspace in order to conduct audits in compliance with the provisions of this section. City shall give Consultant reasonable advance notice of intended audits. (2) Consultant further agrees to include in all its subcontracts hereunder, a provision to the effect that the subcontracting consultant agrees that the City shall, until the expiration of three (3) years after final payment under the subcontract, have access to and the right to examine any directly pertinent books, documents, papers and records of such sub - consultant, involving transactions to the subcontract, and further, that City shall have access during normal working hours to all sub - consultant facilities, and shall be provided adequate and appropriate work space in order to conduct audits in compliance with the provisions of this article. City shall give Consultant and any sub - consultant reasonable advance notice of intended audit. (3) Consultant and sub - consultants agree to photocopy such documents as may be requested by the City. The City agrees to reimburse Consultant for the cost of copies at the rate published in the Texas Administrative Code in effect as of the time copying is performed. City of Fort Worth, Texas Standard Agreement for Professional Services PMO Official Release Date 11/29/2011 Page 5 of 8 Article X Minority and Women Business Enterprise (M/WBE) Participation In accordance with City Ordinance No. 15530, the City has goals for the participation of minority business enterprises and woman business enterprises ( "M/WBE ") in City contracts. Consultant acknowledges the MM/BE goal established for this Agreement and its commitment to meet that goal. Any misrepresentation of facts (other than a negligent misrepresentation) and /or the commission of fraud by the Consultant 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. Article XI Observe and Comply Consultant shall at all times observe and comply with all federal, state, and local 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. Consultant 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 XII Venue and Jurisdiction 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. Article XIII 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. City of Fort Worth, Texas Standard Agreement for Professional Services PMO Official Release Date 11/29/2011 Page 6 of 8 Article XIV Severability The provisions of this Agreement are severable, and if any word, phrase, clause, sentence, paragraph, section or other part of this Agreement or the application thereof to any person or circumstance shall ever be held by any court of competent jurisdiction to be invalid or unconstitutional for any reason, the remainder of this Agreement and the application of such word, phrase, clause, sentence, paragraph, section, or other part of this Agreement to other persons or circumstances shall not be affected thereby and this Agreement shall be construed as if such invalid or unconstitutional portion had never been contained therein. Article XV Notices Notices to be provided hereunder shall be sufficient if forwarded to the other Party by hand - delivery or via U.S. Postal Service certified mail return receipt requested, postage prepaid, to the address of the other Party shown below: City of Fort Worth Attn: Transportation and Public Works, Traffic Services Division 1000 Throckmorton Street Fort Worth, Texas 76102 Consultant: de Camp, Gerry Attn: Gerry de Camp, P.E., PTOE 1127 Eldridge Pkwy #300 -148 Houston, TX 77077 -1771 Article XVI Headings The headings contained herein are for the convenience in reference and are not intended to define or limit the scope of any provision of this Agreement City of Fort Worth, Texas Standard Agreement for Professional Services PMO Official Release Date 11/29/2011 Page 7 of 8 Article XVII 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 but one and the same instrument. Executed and effective this the day of 019 ATTEST: Q R 7" CITY OF FORT WORTH �� A �o000000000 aQ° od d� a o � By.. M I+P- Y T �v0 o Fernando Costa C' ry Sc���T-A-2y 0 o add Assistant City Manager APPROVED AS TO FORM ANQfWV By: (k;4z' Douglas W. Black Assistant City Attorney M &C No.: M &C Date: NO M &C REQUIRED City of Fort Worth. Texas Standard Agreement for Professional Services PMO Official Release Date 11/29/2011 Page 8 of 8 APPROVAL RECOMMENDED By: b,4 o- Doug W. Wiersig, P.E. Director, Transportation and Public Works de Camp, Gerry By: Gerry de amp, P. E. Traffic Signal Engineer OFFICIAL RECORD CITY SECRETARY FT. WORTH, rX ATTACHMENT "A" Scope for Traffic Signal Operations Engineering Traffic Signal Timing Plan Development for Special Projects 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 engineering consultant will provide task efforts in the following areas on an as- needed basis as directed by the city project manager. The work will primarily involve the timing and operations of City of Fort Worth traffic signal equipment, i.e. Type 170E controllers, BiTrans 233 software, and BiTrans QuicNet software. The work may also involve other traffic signal control equipment in use or under investigation. As much as practical, include staff in efforts below for the purpose of training and staff hands -on use of development and field implementation. WORK TO BE PERFORMED Task 1. Project Management Task 2. Traffic Signal Timing Plan Development and Deployment Task 3. Traffic Operation Analysis and Recommendation Task 4. Other Signal - Related Work as Assigned. TASK 1. PROJECT MANAGEMENT. ENGINEER will manage the work outlined in this scope to ensure efficient and effective use of ENGINEER's and CITY's time and resources. ENGINEER will manage change, communicate effectively, coordinate internally and externally as needed, and proactively address issues with the CITY's Project Manager and others as necessary to make progress on the work. 1.1. Communications and Reporting • Attend meetings with CITY Project Manager as requested. • Prepare invoices and submit in the format requested by the CITY. • Prepare and submit progress reports as requested by the CITY. • Coordinate with other agencies and entities as necessary for the proposed traffic signal retiming and / or operational changes. DELIVERABLES A. Meeting summaries with action items shall be prepared as requested by CITY staff ATTACHMENT W TO STANDARD AGREEMENT FOR ENGINEERING RELATED DESIGN SERVICES (REV 7/27/2009) PAGE 1 OF 4 B. Periodic invoices C. Periodic progress reports TASK 2. TRAFFIC SIGNAL TIMING PLAN DEVELOPMENT AND DEPLOYMENT As part of the traffic signal timing plan development the ENGINEER will perform the following tasks: 2.1 Data Collection: • Except where otherwise assigned for a specific project, direct visual observation and analysis of existing field conditions as supplemented by any existing traffic volume counts and controller timing data provided by the CITY will be adequate. 2.2 Prepare and Implement Timing Plans: • Except where otherwise assigned for a specific project, direct manual coordination pattern design using basic traffic engineering principles not requiring the use of any Synchro or other computerized signal timing programs will be satisfactory. • To the extent practical and with the approval of appropriate CITY staff members then present, implementation and fine tuning of the proposed signal timing revisions may proceed immediately following the initial observations of existing field conditions, or as soon as efficient and practical thereafter. 2.3 Signal Sequence Improvements: • Where the CITY or the ENGINEER identifies the desirability of a signal sequence revision at a complex intersection requiring controller reconfiguration prior to field implementation, the ENGINEER shall appropriately document and submit his proposal to the CITY for its approval and arrangement of implementation. • The ENGINEER shall attend and support the field implementation of his proposed revised signal operation and provide all requested explanation of and training thereon to CITY signal operations and /or maintenance staffs. DELIVERABLES A. Timing plan data as deployed in the field B. Appropriate documentation of sequence revision proposals TASK 3. TRAFFIC OPERATION ANALYSIS and RECOMMENDATION. When given a capacity improvement assignment for one or a group of adjacent signalized intersections, the ENGINEER will perform the following tasks: 3.1 Data Collection: • The ENGINEER will assess the data collection needs of each assigned intersection and prepare a data collection plan specifically for the corridor. Data collection efforts will include the following: ATTACHMENT "A" TO STANDARD AGREEMENT FOR ENGINEERING RELATED DESIGN SERVICES (REV 7/27/2009) PAGE 2 OF 4 • ENGINEER's analysis of existing turning movement counts provided by CITY • Existing timing plan information - The ENGINEER will be provided hard copies of the existing timing information for each signalized intersection from the CITY. The CITY will provide their existing SYNCHRO model for the study corridor. • Existing signal infrastructure — The ENGINEER will gather the following infrastructure and hardware information at each signalized intersection as requisite to perform his analysis: • Presence and functionality of Pedestrian Signals and Pushbuttons • Traffic Signal Head configuration • Vehicle detection locations (stop line or setback by approach) • Intersection geometrics — As requisite to perform his analysis, the ENGINEER will record the intersection geometrics for each study location. Geometrics will include the number of lanes per approach, permitted lane usage (left only, right only, shared left and through, etc.), pedestrian crossing distances, and intersection widths (for clearance calculations). 3.2 Conduct Baseline Analysis • The baseline analysis will serve to identify key issues related to traffic operations at the intersection. The following tasks will be accomplished as part of the baseline analysis: — Field Assessment — The ENGINEER will conduct a thorough field evaluation of the intersection, including a review and verification of the existing timing plans and observation of the existing traffic operations. — Prepare any studies of signal cycle and queue lengths, delays, capacity and critical lane analyses necessary to support ENGINEER's revision proposal. 3.3 Prepare Timing Plans • The ENGINEER will conduct an analysis of the intersections to determine basic operations parameters. The analysis will result in recommendations for the following operational parameters: — Cycle Length — The ENGINEER will conduct an analysis of the critical intersection(s) to determine the optimal cycle length for that intersection. — Calculate Clearance Intervals and Pedestrian Intervals — The ENGINEER will calculate, based on acceptable engineering standards, the clearance intervals (yellow plus all red) and pedestrian crossing times (walk and flashing don't walk). 3.4 Fine -Tune Timing Plans ATTACHMENT W TO STANDARD AGREEMENT FOR ENGINEERING RELATED DESIGN SERVICES (REV 7/27/2009) PAGE 3 OF 4 • Following implementation of the timing plans, the ENGINEER will work with CITY Staff to fine -tune the splits and offsets for each new timing plans. ASSUMPTIONS: • The ENGINEER will review the extended 24 hour counts collected to determine the number of timing plans required. • For preparation of timing plans, the ENGINEER will meet with the City to review results of the data collection, field observations efforts, baseline conditions, and preliminary timing plans. The ENGINEER shall incorporate comments into the development of the final optimized timings for the intersection(s). • The ENGINEER shall meet with the CITY to discuss any related CITY comments on the implemented improvements. Such comments shall be appropriately incorporated in any requested final project documentation. DELIVERABLES A. Final timing plan sheets B. Any related final documentation requested by CITY staff TASK 4. OTHER SIGNAL RELATED WORK AS ASSIGNED. Work assigned under this task may include but not be limited to: • Assisting with signal timing plan and signal sequence revision development and deployment assigned by the CITY to other engineering consultants on other contracts. • ENGINEER's retention of sub - consultants as requested or agreed to by CITY as described in mutually accepted work order documents. DELIVERABLES: As appropriate to the assignment and as directed in an authorizing written work order accepted by the ENGINEER. ATTACHMENT "A" TO STANDARD AGREEMENT FOR ENGINEERING RELATED DESIGN SERVICES (REV 7/27/2009) PAGE 4 OF 4 ATTACHMENT B COMPENSATION Design Services for Traffic Signal Operations Engineering, Traffic Signal Timing Plan Development for Special Projects City Project No. 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 Principal Engineer/Owner $170.00 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. 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. City of Fort Worth. Texas Attachment B PMO Official Release Date: 5.19.2010 Page 1 of 4 AN ATTACHMENT B COMPENSATION 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- 5.19.2010 Page 2 of 4 ATTACHMENT B COMPENSATION IV. Summary of Total Project Fees Firm Primary Responsibility Fee Amount % Prime Consultant Gerry de Camp, P.E. Traffic signal operations engineering and timing plan development 23,375.00 100 Proposed M/WBE Sub - Consultants Non -M/WBE Consultants TOTAL $ 100% Project Number & Name Total Fee M/WBE Fee M/WBE % $ $ % City M/WBE Goal = _0_% Consultant Committed Goal = _0 % City of Fort Worth, Texas Attachment B PMO Official Release Date: 5. 19,2010 Page 3 of 4 B -3 EXHIBIT "B -1" ENGINEER INVOICE (Supplement to Attachment B) Insert required invoice format following this page, including negotiated total budget and allocations of budgets across desired work types and work phases. City of Fort Worth, Texas Attachment B PMO Official Release Date: 5.19.2010 Page 4 of 4 B -4 GERRY de CAMP, P.E., PTOE TRAFFIC SIGNAL ENGINEER 1127 Eldridge Pkwy., # 300 -148 HOUSTON, TX 77077 -1771 XXXXX XX, 2012 Ms. Marisa Conlin, PE City of Fort Worth 5001 James Ave. Fort Worth, Texas 76115 Dear Marisa: DIRECT: 832.250.9408 DALLAS: 214.764.8365 FAX: 281.597.1514 GERRY.de.CAMP( GDECAMP.COM Invoice # XXXXXXXX Please accept this letter as billing for the traffic signal retiming work I've done since my last bill on our current on -call contract CS -XXXXX and purchase order # PO- XX- XXXXXXXX: Dates: Sincerely, Gerry de Camp, RE Traffic Signal Engineer Ft. Worth vendor # 32274 Description: Hours: Total hours: @ $ 170 /hr. TOTAL THIS BILLING: $ XXXXXX ATTACHMENT "C" CHANGES AND AMENDMENTS TO STANDARD AGREEMENT FOR PROFESSIONAL SERVICES ARRA Riverside Signal Project City Project No. 01431 Article VII amended to include the terms and conditions for federally funded contracts by adding: Attachment F — American Recovery & Reinvestment Act — Subrecipient's Contract Affidavit Attachment G — U.S. Department of Energy Assurance of Compliance Nondiscrimination in State Assisted Programs City of Fort Worth, Texas Attachment C PMO Release Date: 05.19.2010 Page I of I Consulting Contract Schedule Specifications FORT WORTH City of Fort Worth Capital Improvement Program Attachment D - Project Schedule Not applicable to this contract. City of Fort Worth, Texas Attachment D PK40 Release Date: 02.15.2011 Page 1 of 1 Attachment E FORT WORTH City of Fort Worth Capital Improvement Program�,,r^ Attachment E Not applicable to this contract. City of Fort Worth, Texas Attachment E Page 1 of 1 ATTACHMENT F American Recovery & Reinvestment Act — Subreciyient's Contractor Affidavit This Affidavit must be signed and sworn (notarized) I, GCYZt1r �• Q e CQ1wA an authorized representative of �j. E �� de_ C fy P. F, a [person, ole proprietorship, partnership, corporation, limited liability company, nonprofit organization, g ental entity, political subdivision, or other entity) (circle one) that is receiving ARRA funding, hereby swear and affirm that, to the best of my knowledge, internal controls, processes and procedures have been designed and implemented to help ensure that the Subrecipient Subcontractor and its use of these funds complies with the following: applicable state law; federal law, including federal reporting requirements under Section 1512 of the Act, if applicable; rules; regulations; and other relevant guidance. I further swear and affirm that all of the statements made and information provided herein, including statements made and information provided in any exhibits are true, complete, and correct, to the best of my knowledge. I understand that I am receiving ARRA funding from a governmental entity [city or county] through CPA, a Texas state agency. I understand that non - compliance with reporting requirements could be treated as a violation of the award agreement resulting in the withholding of funds, debarment, or award termination or suspension, as appropriate. I understand that it is a federal crime under 18 U.S.C. Section 1001 to, in any matter within the jurisdiction of the executive branch of the U.S. Government, knowingly and willfully make any materially false, fictitious, or fraudulent statement or representation, or to make or use any false writing or document knowing that it contains the same. I understand that presenting a false or fraudulent claim, in whole or in part, or causing same, may subject me to civil penalties as provided for in 31 U.S.C. Section 3729. I understand that it is a felony offense under Section 37. 10, Texas Penal Code, to knowingly make a false entry in, or false alteration of, a governmental record, or to make, present, or use a governmental record with knowledge of its falsity, when the actor has the intent to harm or defraud another. I understand that the offense of perjury, under Section 37.02, Texas Penal Code, is committed when a person, with intent to deceive and with knowledge of the statement's meaning, makes a false statement under oath or swears to the truth of a false statement previously made and the statement is required or authorized by law to be made under oath. I understand my obligation to track all ARRA funds and that ARRA funds cannot be comingled with Non -ARRA funds. I also understand my obligation to immediately report any known or suspected waste, fraud, and abuse of funds received under the Act to the United States Government Accountability Office at (800) 424 -5454 and the Texas State Auditor's Office at (800) 892 -8348. I further understand that I will require all subcontractors with whom I contract using funds made available under the Act to sign a similar affidavit swearing to all of the above. I hereby swear and affirm that I have read the entire affidavit, and I understand its contents. C,EESY do CAmp, P.- , b- Recipe Na e 1� cant Sig iature ubcontr tor) Geyn,r 2 Cq kLJ0 Full Name P YO b Y � e"d 0 1I Tide 30 Sq�.�4Y1iJ Oj Z Date Sworn and subscribe4 before me by the said (Printed cN�ame of Recipient's A horized Representative) this cJLJ day of J a 20_L2=. Notary Public, State of Te ' C�& Notary's printed name: \ �-� • ` V� My commission expires: 11 2y t y (Seal) U C, ELiIAN y Notary Public STATE OF TEXAS sr' \�'ofp M; Cun,r Exp 111 812012 ATTACHMENT G DOE F 1600 .5 — modified by City of Fort Worth OMB Control No. (06 -94) 1910 -0400 All Other Editions Are Obsolete U.S. DEPARTMENT OF ENERGY Assurance of Compliance Nondiscrimination in State Assisted Programs OMB Burden Disclosure Statement Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Office of Information Resources Management Policy, Plans, and Oversight, Records Management Division, HR- 422 -GTN, Paperwork Reduction Project (1910- 0400), U.S. Department of Energy, 1000 Independence Avenue, S.W., Washington, DC 20585; and to the Office of Management and Budget (OMB), Paperwork Reduction Project (1910- 0400), Washington, DC 20503. City of Fort Worth= (Hereinafter called the "Applicant ") HEREBY AGREES to comply with Title VI of the Civil Rights Act of 1964 (Pub. L. 88 -352), Section 16 of the Federal Energy Administration Act of 1974 (Pub. L. 93- 275), Section 401 of the Energy Reorganization Act of 1974 (Pub. L. 93 -438), Title IX of the Education Amendments of 1972, as amended (Pub. L. 92 -318, Pub. L. 93 -568, and Pub. L. 94 -482), Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93 -112), the Age Discrimination Act of 1977 (Pub. L. 94 -135), Title VIII of the Civil Rights Act of 1968 (Pub. L. 90 -284), the Department of Energy Organization Act of 1977 (Pub. L. 95 -91), the Energy Conservation and Production Act of 1976, as amended, (Pub. L. 94 -385) and Title 10 Code of Federal Regulations, Part 1040. In accordance with the above laws and regulations issued pursuant thereto, the Applicant agrees to assure that no person in the United States shall, on the ground of race, color, national origin, sex, age, or disability, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity in which the Applicant receives Federal assistance from the Department of Energy. Applicability and Period of Obligation In the case of any service, financial aid, covered employment, equipment, property, or structure provided, leased, or improved with Federal assistance funding extended to the Applicant by the Department of Energy, this assurance obligates the Applicant for the period during which the Federal assistance is extended. In the case of any transfer of such service, financial aid, equipment, property, or structure, this assurance obligates the transferee for the period during which Federal assistance is extended. If any personal property is so provided, this assurance obligates the Applicant for the period during which it retains ownership or possession of the property. In all other cases, this assurance obligates the Applicant for the period during which the Federal assistance is extended to the Applicant by the Department of Energy. Employment Practices Where a primary objective of the Federal assistance is to provide employment or where the Applicant's employment practices affect the delivery of services in programs or activities resulting from Federal assistance extended by the Department of Energy, the Applicant agrees not to discriminate on the ground of race, color, national origin, sex, and disability, in its employment practices. Such employment practices may include, but are not limited to, recruitment, advertising, hiring, layoff or termination, promotion, demotion, transfer, rates of pay, training and participation in upward mobility programs, or other forms of compensation and use of facilities. Subrecipient Assurance The Applicant shall require any individual, organization, or other entity with which it subcontracts, subgrants, or subleases for the purpose of providing any service, financial aid, equipment, property, or structure to comply with laws cited above. To this end, the Subrecipient shall be required to sign a written assurance form; however, the obligation of both recipient and Subrecipient to ensure compliance is not relieved by the collection or submission of written assurance forms. Data Collection and Access to Records The Applicant agrees to compile and maintain information pertaining to programs or activities developed as a result of the Applicant's receipt of Federal assistance from the Department of Energy. Such information shall include, but is not limited to the following: (1) the manner in which services are or will be provided and related data necessary for determining whether any persons are or will be denied such services on the basis of prohibited discrimination; (2) the population eligible to be serviced by race, color, national origin, sex, and disability; (3) data regarding covered employment, including use or planned use of bilingual public contact employees serving beneficiaries of the program where necessary to permit effective participation by beneficiaries unable to speak or understand English; (4) the location of existing or proposed facilities connected with the program and related information adequate for determining whether the location has or will have the effect of unnecessarily denying access to any person on the basis of prohibited discrimination; (5) the present or proposed membership by race, color, national origin, sex, and disability, in any planning or advisory body which is an integral part of the program; and (6) any additional written data determined by the Department of Energy to be relevant to the obligation to assure compliance by recipients with laws cited in the first paragraph of this assurance. The Applicant agrees to submit requested data to the Department of Energy regarding programs and activities developed by the Applicant from the use of Federal funds extended by the Department of Energy. Facilities of the Applicant (including the physical plants, buildings, or other structures) and all records, books, accounts, and other sources of information pertinent to the Applicant's compliance with the civil rights laws shall be made available for inspection during normal business hours of request of an officer or employee of the Department of Energy specifically authorized to make such inspections. Instructions in this regard will be provided by the Director, Office of Civil Rights, U. S. Department of Energy. This assurance is given in consideration of and for the purpose of obtaining any and all Federal grants, loans, contracts (excluding procurement contracts), property, discounts or other Federal assistance extended after the date hereto, to the Applicants by the Department of Energy, including installment payments on account after such date of application for Federal assistance which are approved before such date. The Applicant recognizes and agrees that such Federal assistance will be extended in reliance upon the representations and agreements made in this assurance and that the United State shall have the right to seek judicial enforcement of this assurance. This assurance is binding on the Applicant, its successors, transferees, and assignees, as well as the person(s) whose signature appears below and who is authorized to sign this assurance on behalf of the Applicant. Applicant Certification The Applicant certifies that it has complied, or that, within 90 days of the date of the grant, it will comply with all applicable requirements of 10 C.F.R. § 1040.5 (a copy will be furnished to the Applicant upon written request to DOE.) Designated Applicant Responsible Employee &127a/7 &7te- Name and Title (Printed or Typed) Telephone Number Signature Date Subrecipient/Consultaut (;uylf CAMP, -E, Name of Organization 1)2-1 Address wlt,� -� (7-) b— Authorized Official Name and Ti a (Printed or yped) — 1�-1 0 -.- � � - � � � �-4 � , Signature bvxi 0 Telephone Number 73Z --2.�o -9¢dy Telephone Number Date OFFICIAL RECORD CITY SECRETARY FT. WORTHY TX