HomeMy WebLinkAboutContract 55173 City Secretary Contract No. 55173
FORT WORTH,
VENDOR SERVICES AGREEMENT
This VENDOR SERVICES AGREEMENT ("Agreement") is made and entered into by and
between the CITY OF FORT WORTH("City"),a Texas home rule municipal corporation and S3DVBE
dba Western Fire Supply Corp.("Vendor"), 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 Vendor 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. One time Purchase of Solo Rescue - SCBA DEGON Washer Unit,
related parts, and installation. Exhibit "A," - Scope of Services more specifically describes the services
to be provided hereunder.
2. Term. This Agreement shall begin on the date signed by the Assistant City Manager below
("Effective Date")and shall expire one year from the effective date("Expiration Date"),unless terminated
earlier in accordance with this Agreement("Initial Term").
3. Compensation. City shall pay Vendor in accordance with the fee schedule of Vendor
personnel who perform services under this Agreement in accordance with the provisions of this Agreement
and Exhibit "B,"—Price Schedule. Total payment made under this Agreement by City shall not exceed
Twenty four Thousand Four Hundred and Sixty-one Dollars($24,461.00).Payments for the following
years shall be as described in Exhibit B. Vendor 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 Vendor not
specified by this Agreement unless City first approves such expenses in writing.
4. Termination.
4.1. Written Notice. City or Vendor may terminate this Agreement at any time and for
any reason by providing the other party with 30 days'written notice of termination.
OFFICIAL RECORD
CITY SECRETARY
Vendor Services Agreement
FT.WORTH, TX
City Secretary Contract No.
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 Vendor
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 Vendor for services actually rendered up to
the effective date of termination and Vendor 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, Vendor shall provide City with copies of all
completed or partially completed documents prepared under this Agreement. In the event Vendor
has received access to City Information or data as a requirement to perform services hereunder,
Vendor 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.Vendor hereby warrants to City that Vendor has made full
disclosure in writing of any existing or potential conflicts of interest related to Vendor's services
under this Agreement.In the event that any conflicts of interest arise after the Effective Date of this
Agreement,Vendor hereby agrees immediately to make full disclosure to City in writing.
5.2 Confidential Information.Vendor,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 Public Information Act. City is a government entity under the laws of the State of
Texas and all documents held or maintained by City are subject to disclosure under the Texas Public
Information Act.In the event there is a request for information marked Confidential or Proprietary,
City shall promptly notify Seller. It will be the responsibility of Seller to submit reasons objecting
to disclosure. A determination on whether such reasons are sufficient will not be decided by City,
but by the Office of the Attorney General of the State of Texas or by a court of competent
jurisdiction.
5.4 Unauthorized Access.Vendor 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. Vendor 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,
Vendor 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. Vendor agrees that City shall,until the expiration of three(3)years after
final payment under this contract, or the fmal 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 Vendor involving transactions
relating to this Agreement at no additional cost to City. Vendor agrees that City shall have access during
normal working hours to all necessary Vendor facilities and shall be provided adequate and appropriate
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work space in order to conduct audits in compliance with the provisions of this section. City shall give
Vendor reasonable advance notice of intended audits.
7. Independent Contractor. It is expressly understood and agreed that Vendor shall operate
as an independent contractor as to all rights and privileges and work performed under this Agreement, and
not as agent, representative or employee of City. Subject to and in accordance with the conditions and
provisions of this Agreement, Vendor 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,Vendors and subVendors.Vendor acknowledges that the doctrine of respondeat superior shall
not apply as between City, its officers, agents, servants and employees, and Vendor, its officers, agents,
employees, servants, Vendors and subVendors. Vendor further agrees that nothing herein shall be
construed as the creation of a partnership or joint enterprise between City and Vendor. It is further
understood that City shall in no way be considered a Co-employer or a Joint employer of Vendor or any
officers, agents, servants, employees or subVendor of Vendor. Neither Vendor, nor any officers, agents,
servants, employees or subVendor of Vendor shall be entitled to any employment benefits from City.
Vendor 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 subVendor.
8. Liability and Indemnification.
8.1 LIABILITY- VENDOR 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
VENDOR,ITS OFFICERS,AGENTS,SERVANTS OR EMPLOYEES.
8.2 GENERAL INDEMNIFICATION- VENDOR HEREBY COVENANTS AND
AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS,
AGENTS,SERVANTS AND EMPLOYEES,FROMAND AGAINST ANYAND ALL CLAIMS
OR LAWSUITS OFANYKIND OR CHARACTER, WHETHER REAL OR ASSERTED, FOR
EITHER PROPERTYDAMAGE OR LOSS(INCLUDINGALLEGED DAMAGE OR LOSS TO
VENDOR'S BUSINESS AND ANY RESULTING 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 CAUSED BY THE
NEGLIGENT ACTS OR OMISSIONS OR MALFEASANCE OF VENDOR, ITS OFFICERS,
AGENTS,SERVANTS OR EMPLOYEES.
9. Assignment and Subcontractine.
9.1 Assignment. Vendor 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 Vendor under which
the assignee agrees to be bound by the duties and obligations of Vendor under this Agreement.
Vendor and Assignee shall be jointly liable for all obligations of Vendor under this Agreement
prior to the effective date of the assignment.
9.2 Subcontract. If City grants consent to a subcontract, sub Vendor shall execute a
written agreement with Vendor referencing this Agreement under which sub Vendor shall agree to
be bound by the duties and obligations of Vendor under this Agreement as such duties and
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obligations may apply. Vendor shall provide City with a fully executed copy of any such
subcontract.
10. Insurance. Vendor 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 Vendor, 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
(d) Professional Liability(Errors&Omissions):
$1,000,000- Each Claim Limit
$1,000,000- Aggregate Limit
Professional Liability coverage may be provided through an endorsement to the
Commercial General Liability (CGL) policy, or a separate policy specific to
Professional E&O. Either is acceptable if coverage meets all other requirements.
Coverage shall be claims-made,and maintained for the duration of the contractual
agreement and for two (2) years following completion of services provided. An
annual certificate of insurance shall be submitted to City to evidence coverage.
10.2 General Requirements
(a) The commercial general liability and automobile liability policies shall
name City as an additional insured thereon, as its interests may appear. The term
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City shall include its employees, officers, officials, agents, and volunteers in
respect to the contracted services.
(b) The workers' compensation policy shall include a Waiver of Subrogation
(Right of Recovery)in favor of City.
(c) 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.
(d) 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.
(e) Any failure on the part of City to request required insurance
documentation shall not constitute a waiver of the insurance requirement.
(f) Certificates of Insurance evidencing that Vendor has obtained all required
insurance shall be delivered to the City prior to Vendor proceeding with any work
pursuant to this Agreement.
11. Compliance with Laws,Ordinances,Rules and Reeulations. Vendor 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
Vendor of any violation of such laws, ordinances, rules or regulations, Vendor shall immediately desist
from and correct the violation.
12. Non-Discrimination Covenant. Vendor, for itself, its personal representatives, assigns,
subVendors and successors in interest, as part of the consideration herein, agrees that in the performance
of Vendor'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 VENDOR,ITS
PERSONAL REPRESENTATIVES, ASSIGNS, SUBVENDORSS OR SUCCESSORS IN
INTEREST, VENDOR 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:
Vendor Services Agreement Page 5 of 16
City Secretary Contract No.
To CITY: To VENDOR:
City of Fort Worth S3DVBE dba Western Fire
Attn: Valerie Washington Melisa Smith,Director of Contracts
Assistant City Manager 3941 Park Dr. Suite 20-142
200 Texas Street El Dorado Hills,Ca 95762-454
Fort Worth, TX 76102-6314 Facsimile:
Facsimile: (817)392-8654
With copy to Fort Worth City Attorney's Office
at same address
14. Solicitation of Employees. Neither City nor Vendor 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.
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 Vendor 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
Vendor'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 Maieure. City and Vendor 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
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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 Vendor, their assigns and successors in interest, as
to the matters contained herein.Any 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. Vendor 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 Vendor's
option,Vendor 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 Vendor for the nonconforming
services.
26. Immigration Nationality Act. Vendor 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,Vendor shall provide City with copies of all I-9
forms and supporting eligibility documentation for each employee who performs work under this
Agreement. Vendor 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 Vendor employee who is not legally eligible to
perform such services. VENDOR SHALL INDEMNIFY CITY AND HOLD CITY HARMLESS
FROM ANY PENALTIES, LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS
PARAGRAPH BY VENDOR, VENDOR'S EMPLOYEES, SUBCONTRACTORS, AGENTS, OR
LICENSEES. City, upon written notice to Vendor, shall have the right to immediately terminate this
Agreement for violations of this provision by Vendor.
27. Ownership of Work Product. City shall be the sole and exclusive owner of all reports,
work papers, procedures, guides, and documentation, created, published, displayed, and/or produced in
conjunction with the services provided under this Agreement(collectively,"Work Product"). Further,City
shall be the sole and exclusive owner of all copyright,patent,trademark,trade secret and other proprietary
rights in and to the Work Product. Ownership of the Work Product shall inure to the benefit of City from
the date of conception, creation or fixation of the Work Product in a tangible medium of expression
(whichever occurs first).Each copyrightable aspect of the Work Product shall be considered a"work-made-
for-hire" within the meaning of the Copyright Act of 1976, as amended. If and to the extent such Work
Product,or any part thereof,is not considered a"work-made-for-hire"within the meaning of the Copyright
Act of 1976, as amended,Vendor hereby expressly assigns to City all exclusive right, title and interest in
and to the Work Product,and all copies thereof,and in and to the copyright,patent,trademark,trade secret,
and all other proprietary rights therein, that City may have or obtain, without further consideration, free
from any claim,lien for balance due,or rights of retention thereto on the part of City.
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
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City Secretary Contract No.
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 Vendor 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. Vendor 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 Vendor 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.
30. No Boycott of Israel. If Vendor has fewer than 10 employees or this Agreement is for
less than $100,000, this section does not apply. Vendor 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,Vendor certifies that Vendor's signature provides written
verification to the City that Vendor: (1)does not boycott Israel; and(2)will not boycott Israel during
the term of the contract.
IN WITNESS WHEREOF,the parties hereto have executed this Agreement in multiples.
(signature page follows)
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City Secretary Contract No.
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
Ya.Cet te-i LAfhd2 .'V' this contract,including ensuring all performance and
By:Valerie Washington(Jan 15,2 110:09 CST) reporting requirements.
Name: Valerie Washington
Title: Assistant City Manager
Date: Jan 15 2921
By: Mark Rauscher(Jan 14,202113:59 CST)
Name: Mark Rauscher
APPROVAL RECOMMENDED: Title: Fire Assistant Director
APPROVED AS TO FORM AND LEGALITY:
By: J s Davis(Jan 14,202117:10 CST)
Name: Jim Davis
Title: Fire Chief C�I��JfA,d�l2� G2l���Q
q-o4vnnnb By: Christopher A stria(Jan 15,202109:29 CST)
,apF°FORT�aa
A p °,�toa� Name: Christopher Austria
ATTEST: 0 1.o °op Title: Assistant City Attorney
o
�vo
°o
°=d
o* CONTRACT AUTHORIZATION:
000
By. alto�f dd a44 1 M&C: N/A 24089-03-2020(March 19,2020)and
��dd444
24161-04-2020(April 7,2020)
Name: Mary Kayser 1295: N/A
Title: City Secretary
VENDOR:
S3DVBE dba Western Fire Supply,Corp.
By: 11
Name: Melisa Smith
Title: Director of Contracts
Date: Jan 13,2021
OFFICIAL RECORD
CITY SECRETARY
Vendor Services Agreement
FT.WORTH, TX
EXHIBIT A
SCOPE OF SERVICES
Vendor shall provide a Solo Rescue SCBA-1 Decontamination Washer or Equal including:
• Heavy Duty Basket with holder for 2 single or double SCBA
• Holder for 2 large air Cylinders(Jumbo Flasks)
• Gear Holder for Gloves and Boots
• Voltage for the Washer shall be 3ph 208-240 V/60Hz 40A
• Additional Gear Holder
• Metered Detergent Dosing Pump
• Installation of 1 Solo Rescue Machine
* Price includes all cost associated including but not limited to delivery and/or fuel
charges.
*No additional charges will be accepted or paid by the City.
*Unit Installation will be at SCBA,400 Grand Ave.,Fort Worth,TX 76106.
Vendor Services Agreement—Exhibit A Page 10 of 16
EXHIBIT B
PRICE SCHEDULE
FORT WORTH:,
CITY OF FORT WORTH BID OFFER
Event ID Page Invited:
CFW01-21-0041 __ 1 Registration ID#0000004121
Event Round Version
1 1
Event Name
RFQt Solo Rescue SCBA Decon Washer Submit To: City of Fort Worth
Start Time Finish Time PURCHASING DIVISION
1z 22 2oso 15:00:00 CST o1 09 2021 15:00:00 CST LOWER LEVEL CITY HALL
200 TEXAS ST.
Fort Worth TX 76102
United States
Email: FMSPurchasingResponses@fortworthtexas.gov
Event Description
The City of Fort Worth seeks bids from qualified bidders for a one time purchase to provide Solo Rescue
SCBA Decon Washer for the City of Fort Worth Fire Department as specified in the attached Request For
Quote(RFQQ
Terms&Conditions
No Pre-Bid meeting
Late quotes will not be considered for award unless bidders are notified otherwise.Late bids will be returned
or destroyed.Quotes may be withdrawn at any time prior to the official opening by written notification.
Quotes may not be altered,amended or withdrawn after the"Finish Time/End Date Time".
Quote must be submitted on this form.
Freight and all other delivery charges shall be included in the unit price(s).
The City is exempt from Federal Excise and State Sales Tax,therefore,tax must not be included in the quote
price.
Items quoted must meet or exceed City of Fort Worth Specifications;however,The City of Fort Worth may
consider and accept alternate quotes if specified herein when most advantageous to the City. The City
reserves the right,however,to hold to City Specifications and to determine"or equal"status.The City
reserves the right to accept or reject in part or whole any quote submitted,and to waive any technicalities
for the best interest of the City
Note:See Section 15, Quotations of Part ll, Scope of Services and/or Specifications for list of documents
shall be submit with the quote.
Document List:
1)Cover Sheet
2 Signing Sheet
3 Price/Offer Sheet(s)
4 Part II-Scope of Services and/or Specifications
Attachment A-Conflict of Interest Disc
Attachment B-Bidders Contact Information
Attachment C-Reference Sheet
Attachment D-How to Register with the City of Fort Worth
Attachment E-Automated Invoice Processing
Attachment F-No Bid Sheet
Attachment G-Detailed Scope of Services/Specifications
RFQt 21-0041 Solo Rescue SCBA Decon Washer
1 of 33
Vendor Services Agreement—Exhibit B Page 11 of 16
City Secretary Contract No.
FORT WORTH
— 4" CITY OF FORT WORTH BID OFFER
Event ID - Page Invited. Registration l DO 0000OD4121
.21-0041 _ 2
Everd Round Version
1 1 _—
Event Name
gpot solo eeecue SCBA Decon Maahcl_ Submit To: City of Fort Worth
Start Time Finish Time PURCHASING DIVISION
12 2z12020 15:00:00 CST 01 04 1 0 o 5:00:00 LOWER LEVEL CITY HALL
CST 200 TEXAS ST.
Fort Worth TX 76102
United States
Email: FMSPurchallingResponses@fonworthtexas.gov
The undersigned,by his/her signature,represents that he/she is submitting a binding offer and is authorized
to bind the respondent to fully comply with the solicitation document contained herein.The Authorized Person,
by s going and submitting,acknowledges that he/she has received and read the entire document packet sections
defined above including all documents incorporated by reference,and agrees to be bound by the terms therein.
Documents are hereby incorporated Into this Solicitation by reference,with the same force and effect as if
they were Incorporated in full text.The period for acceptance of this quote will be ninety(90)calendar days
after'Finish time/End Date Time'.
Legal Name and r1/b/e:S3DVBE dba Western Fire Supply
Address:3941 Parrk Dr.Suite 20-142
City,State,zip: El Dorado Hills,Ca 95762-4549
Bidder/Supplied ID with City of Fort Wort/Federal ID Number(TIN): 82-5035008
Name of the Authodzed Representative: Melisa Smith
Title: Director of Contracts
Signature of the Authorized Representative and Dale: 17 1/04/2021
Email Address: melisatfft3dV 2 com
Phone Number (916)62."332_
Will agreement be available for Cooperative Agreement use'?Yes NO
('See Section 7, Cooperative Purchasing of Fart II, Scope of Se ces andcations)
RFQt 21-0041 Solo Rescue SCBA Decon Washer
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City Secretary Contract No.
FORT WORTH
CITY OF FORT WORTH BID OFFER
Event ID P;,q, Invded. Negistration IUM 0000004121
CFW01-21-0041
Event Round 1laralon
1 _
Event Name
RFQt Solo Rescue SCBA_Decon washer Submit To: City of Fort Worth
Start Time Finish Time PURCHASING DIVISION
12 22/2020 15_00:09 CST o1/0{/2021 15:oo:oo CST LOWER LEVEL CITY HALL
200 TEXAS ST.
Fort Worth TX 76102
United States
Email: FMSPurchasingResponses@fortworthtexas.gov
Line Details
Line: 1
Description: Qtv Unit _- _UnkPrice -_ — Total
Sob Rescue-SCBA DECON Washer 1.00 EA
Brand Name or Include Manufacturer 22,966.00 22,966
Equal
Line: 2
Description QtV Unit _Ur*Prko Talal
Additional Gear Holder 1.00 EA
Brand Name or Include Manufacturer
Equal_ 220.00 220.00
Line: 3
Deacrlptlorr Qty Unit _ UnkPrka _ Tom
Metered Detergent Dosing Pump Brand 1.00 EA
Name or Include Manufacturer Equal [7 j.00 275.E
Line: 4 W
Description: Qty_ Unk UnkPrla_ Told
Install unit at SCBA.400 Grand Ave., 1.00 EA _ I
Fort Worth,TX 76106 [1, 0.00 1 r000.00 1
Total Bid Amount
RFQI 21-0041 Solo Rescue SCBA Decon Washer
3 of 33
ATTACHMENT A
CONFLICT OF INTEREST DISCLOSURE
Pursuant to Chapter 176 of the Local Government Code,any person or agent of a person who contracts or
seeks to contract for the sale or purchase of property,goods,or services with a local governmental entity
(i.e.The City of Fort Worth)must disclose in the Questionnaire Forms CIQ("Questionnaire")the persons
affiliation or business relationship that might cause a conflict of interest with the local govemmental entity.
By law,the Questionnaire must be filed with the Fort Worth City Secretary no later than seven days after
the date the person begins contract discussions or negotiations with the City,or submits an application or
response to a request for proposals or bids, correspondence, or another writing related to potential
agreement with the City. Updated Questionnaires must be filed in conformance with Chapter 176.
A copy of the Questionnaires Form CIQ is enclosed with submittal documents. The form is also available
at https://www.ethics,state.tx.us/data/forms/conflict/CIQ.pdf
If you have any questions about compliance,please consult your own legal counsel. Compliance is the
individual responsibility of each person or agent of a person who is subject to the filing requirement. An
offense under Chapter 176 is a Class C misdemeanor.
NOTE: If you are not aware ofa Conflictof Interest in any businessrelationshipthatyou might have
with the City,state Vendor name in the#1,use N/A in each of the areason the form.However,a
signature is required in the#7 box in all cases.
RFQt 21-0041 Solo Rescue SCBA Decon Washer
10 of 33
Vendor Services Agreement—Exhibit C Page 14 of 16
City Secretary Contract No.
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIO
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B.23.84th Leg.,Regular Session. OFFICEUSEONLY
This queslionnairo is being tiled In i dance with Chapter 176.Local Govornmonl Code,by a—d.who pale pecevetl
has a b..1m ss relationship as defined by Section 176,001(I n)with a local governmental entity and the
,anon meets requirements under Section 176.006(11).
By law Ihw que9lbnnalre must be filed with the records edroloision.,or the local governmental entity not later
than the 70 business day after the date the vendor becomes aware of feels that require the stalooranl to be
hied Sae Suclmo 178006(a.1),Local Govom am Code.
A vendor commIT6 an offense If The vendor knowingly violates Section 176.006.Local Government Code.An
offense under this section is a misdemeaoor.
1 Name of vendor who has a business relationship with local governmental entity.
S3DVBE dba Western Fire Supply
2
Check this box il you are filing an update toepreviously tiled questlonnalra.(The law requires that you file an updated
completed questionnaire with the appropriate fling authority not later than the 71h business day after the dale on which
you became aware that the originally bled questionnaire was incomplete or inaccurate.)
3 Nameof lout government officer about whom the Information is being disclosed.
n/a
Name of Orrcer
4 Describe each employment or other business relationship with the local government officer,or a family member of the
officer,as described by Section 176.003(a)(2XA).Also describe any family relationship with the local government officer.
Complete subparts A and B for each employment or business relationship described.Attach additional pages to this Form
CIO as necessary.
A. Is lho local government officer or a family member of the officer receiving or likely to receive taxable income,
olhor than Investment Income,from the vendor?
0 Yes M No
B.Is the vendor receiving or likely to receive taxable Income,other than investment income,from or at the direction
of the local government officer or a family member of the officer AND the taxable income Is not received from the
local governmental entity?
a Yes V No
6 Describe each employment or business relationship that the vendor named in Seogon i maintains with a corporation or
other business entity with respect to which the lout government officer serves ea an officer or director.or holds an
ownership Interest of one percent or more,
n/a
6
ElChock this box if the vendor has given the bell government oflieer or a family member of the oltieer one or more gibe
asdescribed in Section 176.003(a)(2)(B),excluding gifts described in Section 176.003(a-1).
1 LgV021
Signaluro of vendor doing busines m a govemermal entity Dale
Form provided by Texas Ethics Commission www.ethlcs.state.lx.us Revised ttrd02015
RFQt 21-0041 Solo Rescue SCBA Decon Washer
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City Secretary Contract No.
EXHIBIT C
VERIFICATION OF SIGNATURE AUTHORITY
S3DVBE dba Western Fire
Melisa Smith,Director of Contracts
3941 Park Dr. Suite 20-142
El Dorado Hills,Ca 95762-454
Execution of this Signature Verification Form ("Form") hereby certifies that the following
individuals and/or positions have the authority to legally bind Vendor and to execute any agreement,
amendment or change order on behalf of Vendor. Such binding authority has been granted by proper order,
resolution, ordinance or other authorization of Vendor. City is fully entitled to rely on the warranty and
representation set forth in this Form in entering into any agreement or amendment with Vendor. Vendor
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 Vendor.
1. Name: Melisa Smith
Position: Directo o Contracts
Signature
2. Name:
Position:
Signature
3. Name:
Position:
Signature
Name:
Signature of President/CEO
Other Title:
Date: 01/13/2021
Signature: C7�2�ZGlG`f�12 Signature: '�W
,reg Z ckney(Jan 13,202 16:29 PST)
Email: greg@s3dvbe.com Email: joe@s3dvbe.com