HomeMy WebLinkAboutContract 55860FaRT VVoRTH
CSC N o. 55860
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between Dealers
Electrical Supply, Co ("Vendor") and the City of Fort Worth, ("City"), a Texas home rule municipality.
The Cooperative Purchase Agreement includes the following documents which shall be construed in the
order of precedence in which they are listed:
1. This Cooperative Purchase Agreement;
2. Exhibit A— City's Terms and Conditions;
3. Exhibit B— Seller's Quote, Scope of Services or Purchase Order;
4. Exhibit C— Cooperative Agency Contract (e.g., NJPA, DIR, BuyBoard); and
5. Exhibit D— Conflict of Interest Questionnaire.
Exhibits A, B, C, and D which are attached hereto and incorporated herein, are made a part of
this Agreement for all purposes. Vendor agrees to provide City with the services and goods included in
Exhibit B pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all
eXhibits thereto. In the event of a conflict between Exhibit A— City's Terms and Conditions and EXhibit
C—[Cooperative Agency Contract], then Exhibit A— City's Terms and Conditions shall control, but
only to the eXtent allowable under the [Cooperative Agency Contract].
City shall pay Vendor in accordance with the fee schedule in EXhibit B and in accordance with
the provisions of this Agreement. Total payment made under this Agreement for the first year by City
shall be in the amount of $100,000.00 Dollars. Vendor shall not provide any additional items or 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.
The term of this Agreement shall begin on June 21, 2021 and end on November 30, 2021 with
no options to renew.
Vendor agrees that City shall, until the expiration of three (3) years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said three years, have access to
and the right to examine at reasonable times any directly pertinent books, documents, papers and records,
including, but not limited to, all electronic records, of 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 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.
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: � QFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
To CITY:
City of Fort Worth
Attn: Jesus J Chapa, Deputy City Manager
200 Texas Street
Fort Worth, TX 76102-6314
Facsimile: (817) 392-8654
With copy to Fort Worth City Attorney's Office
at same address
To VENDOR:
June 16th 2021
dealers electrical supply co.
2320 Columbus Avenue HQ
aco, exas
Facsimile: 254-756-0133
The undersigned represents and warrants that he or she has the power and authority to execute this
Agreement and bind the respective Vendor.
CITY OF FORT WORTH:
T�S.U�-
B�7;Jesus J. Chapa (Jun 16, 202116:57 CDT)
Name: Jesus J Chapa,
Title: Deputy City Manager
Date:
APPROVAL RECOMMENDED:
CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the person
responsible for the monitoring and administration
of this contract, including ensuring all performance
and reporting requirements.
By: ��-_
Name: Cynthia Garcia
Title: Assistant Finance Director
By:�eb��a��� u�� �6, �o�� �6:�6 �or� APPROVED AS TO FORM AND LEGALITY:
Name: Reginald Zeno
Title: Chief Financial Services Officer
ATTEST:
BY: ���� �� U
Name: Mary J Kayser
Title: City Secretary
�- v
ppFoF�RT�ad
�� o ����
o �
�o 0
0
�g o=
Vo 0
o a
o �
0
���o o �F
o �
d,. °�0000a�° �
B : � �,..-�—
Y
Name: Taylor Paris
Title: Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C:
VENDOR:
�une 1 btn ZUZ 1
By:
Name: ary ona son
Title: ice resi en a es an .
Date: June 16th, 2021
ATTEST:
By:
Name:
Title:
OFFICIAL REC�RD
CITY SECRETARY
FT. W�RTH, TX
Exhibit A- City's Terms and Conditions
1.0
2.0
3.0
4.0
5.0
DEFINITION OF BUYER
The City of Fort Worth, its officers, agents, servants, authorized employees, vendors and
subvendors who act on behalf of various City departments, bodies or agencies.
DEFINITION OF SELLER
The consultant, Contractor(s), supplier, Contractor(s)or other provider of goods and/or services,
its officers, agents, servants, employees, vendors and subvendors who act on behalf of the entity
under a contract with the City of FortWorth.
PUBLIC INFORMATION
Any information submitted to the City of Fort Worth (the "City") may be requested by a member of
the public under the Texas Public Information Act. See TEX. GOV'T CODE ANN. §§ 552.002,
552.128(c) (West Supp. 2006). If the City receives a request for a Seller's proprietary information,
the Seller listed in the request will be notified and given an opportunity to make arguments to
the Texas Attorney General's Office (the "AG") regarding reasons the Seller believes that its
information may not lawfully be released. If Seller does not make arguments or the AG rejects the
arguments Seller makes, Seller's information will be released without penalty to theCity.
'`•• •► - -► : •►_ ► : ► •► :'
No officer or employee of Buyer shall have a financial interest, direct or indirect, in any contract
with Buyer or be financially interested, directly or indirectly, in the sale to Buyer of any land,
materials, supplies or services, except on behalf of Buyer as an officer or employee. Any willful
violation of this section shall constitute malfeasance in office, and any officer or employee found
guilty thereof shall thereby forfeit his office or position. Any violation of this section with the
knowledge, expressed or implied, of the person or corporation contracting with the City Council
shall render the contract invalid by the City Manager or the City Council. (Chapter XXVII,
Section 16, City of Fort Worth Charter)
�7:7��-
5.0 No employees of the Buyer or its officers, agents, servants, vendors or subvendors
who act on behalf of various City departments, bodies or agencies are authorized to
place orders for goods and/or services without providing approved contract numbers,
purchase order numbers, or release numbers issued by the Buyer. The only exceptions
are Purchasing Card orders and emergencies pursuant to Texas Local Government
Code Section 252.022(a)(1), (2), or (3). In the case of emergencies, the Buyer's
Purchasing Division will place such orders.
5.1 Acceptance of an order and delivery on
contract number, purchas
may result in rejection of
payment.
6.0 SELLER TO PACKAGE GOODS
e order number
delivery, return
the part of the Seller without an approved
, or release number issued by the Buyer
of goods at the Seller's cost and/or non-
Seller will package goods in accordance with good commercial practice. Each shipping container,
shall be clearly and permanently marked as follows: (a) Seller's name and address: (b)
Consignee's name, address and purchase order or purchase change order number; (c) Container
number and total number of containers, e.g., box 1 of 4 boxes; and (d) Number of the container
bearing the packing slip. Seller shall bear the cost of packaging unless otherwise provided.
Goods shall be suitably packed to secure lowest transportation costs and to conform to
requirements of common carriers and any applicable specifications. Buyer's count or weight shall
be final and conclusive on shipments not accompanied by packing lists.
� ■ � 11 \ \ � � � � \ � � � ■ �
Seller is not authorized to ship the goods under reservation, and no tender of a bill of lading will
operate as a tender of goods.
8.0 TITLE AND RISK OF LOSS
The title and risk of loss of the goods shall not pass to Buyer until Buyer actually receives and
takes possession of the goods at the point or points of delivery after inspection and acceptance of
the goods.
• � � :�� _►• ;_► ••- •► ._:
Freight terms shall be F.O.B. Destination, Freight Prepaid and Allowed, unless delivery terms are
specified otherwise in Seller's proposals. Buyer agrees to reimburse Seller for transportation
costs in the amount specified in Seller's proposals or actual costs, whichever is lower, if the quoted
delivery terms do not include transportation costs; provided, Buyer shall have the right to
designate what method of transportation shall be used to ship the goods.
�� • . ;
The place of delivery shall be set forth in the "Ship to" block of the purchase order, purchase
change order, or release order.
11.0 RIGHT OF INSPECTION
Buyer shall have the right to inspect the goods upon delivery before accepting them. Seller shall
be responsible for all charges for the return to Seller of any goods rejected as being
nonconforming under the specifications.
12.0 INVOICES
12.1 Seller shall submit separate invoices in duplicate, on each purchase order or purchase
change order after each delivery. Invoices shall indicate the purchase order or purchase
change order number. Invoices shall be itemized and transportation charges, if any,
shall be listed separately. A copy of the bill of lading and the freight waybill, when
applicable, should be attached to the invoice. Seller shall mail or deliver invoices to
Buyer's Department and address as set forth in the block of the purchase order,
purchase change order or release order entitled "Ship to." Payment shall not be made
until the above instruments have been submitted after delivery and acceptance of the
goods and/or services.
12.2 Seller shall not include Federal Excise, State or City Sales Tax in its invoices. The Buyer
shall furnish a tax exemption certificate upon Seller'srequest.
� •: � _::_►
13.1 The price to be paid by Buyer shall be that contained in Seller's proposals.
13.2 Seller warrants that no person or selling agency has been employed or retained to solicit
or secure this contract upon an agreement or understanding for commission, percentage,
brokerage or contingent fee, excepting employees of an established commercial or selling
agency that is maintained by Seller for the purpose of securing business. For breach or
violation of this warranty, Buyer shall have the right, in addition to any other right or rights
arising pursuant to said purchase(s), to cancel this contract without liability and to
deduct from the contract price such commission percentage, brokerage or
contingent fee, or otherwise to recover the full amountthereof.
� 1 ' [ • � � � � \ �
Seller shall not limit or exclude any express or implied warranties and any attempt to do so shall
render this contract voidable at the option of Buyer. Seller warrants that the goods furnished will
conform to Buyer's specifications, drawings and descriptions listed in the proposal invitation, and
the sample(s) furnished by Seller, if any. In the event of a conflict between Buyer's
specifications, drawings, and descriptions, Buyer's specifications shall govern.
1 � _::_►
Seller warrants that the product sold to Buyer shall conform to the standards promulgated by the
U.S. Department of Labor under the Occupational Safety and Health Act (OSHA) of 1970, as
amended. In the event the product does not conform to OSHA standards, Buyer may return the
product for correction or replacement at Seller's expense. In the event Seller fails to make
appropriate correction within a reasonable time, any correction made by Buyer will be at Seller's
expense. Where no correction is or can be made, Seller shall refund all monies received for such
goods within thirty (30) days after request is made by Buyer in writing and received by Seller.
Notice is considered to have been received upon hand delivery, or otherwise in accordance with
Section 29.0 of these terms and conditions. Failure to make such refund shall constitute breach
and cause this contract to terminate immediately.
•1 � 1_: ► • :
If this purchase is for the license of software products and/or services, and unless otherwise
agreed, Seller hereby grants to Buyer, a perpetual, irrevocable, non-exclusive, nontransferable,
royalty free license to use the software. This software is "proprietary" to Seller, and is licensed
and provided to the Buyer for its sole use for purposes under this Agreement and any attached
work orders or invoices. The City may not use or share this software without permission of the
Seller; however Buyer may make copies of the software expressly for backup purposes.
17.0 WARRANTY AGAINST INFRINGEMENT OF INTELLECTUAL PROPERTY
17.1 The SELLER warrants that all Deliverables, or any part thereof, furnished
hereunder, including but not limited to: programs, documentation, software,
analyses, applications, methods, ways, and processes (in this Section each
individually referred to as a"Deliverable" and collectively as the "Deliverables,")
do not infringe upon or violate any patent, copyrights, trademarks, service marks,
trade secrets, or any intellectual property rights or other third party proprietary
rights, in the performance of services under this Agreement.
17.2 SELLER shall be liable and responsible for any and all claims made against the
City for infringement of any patent, copyright, trademark, service mark, trade
secret, or other intellectual property rights by the use of or supplying of any
Deliverable(s) in the course of performance or completion of, or in any way
connected with providing the services, or the City's continued use of the
Deliverable(s) hereunder.
17.3 SELLER agrees to indemnify, defend, settle, or pay, at its own cost and expense,
including the payment of attorney's fees, any claim or action against the City
for infringement of any patent, copyright, trade mark, service mark, trade secret,
or other intellectual property right arising from City's use of the Deliverable(s), or
any part thereof, in accordance with this Agreement, it being understood that this
agreement to indemnify, defend, settle or pay shall not apply if the City modifies
or misuses the Deliverable(s). So long as SELLER bears the cost and expense of
payment for claims or actions against the City pursuant to this section 8, SELLER
shall have the right to conduct the defense of any such claim or action and
all negotiations for its settlement or compromise and to settle or compromise any
such claim; however, City shall have the right to fully participate in any and all
such settlement, negotiations, or lawsuit as necessary to protect the City's
interest, and City agrees to cooperate with SELLER in doing so. In the event City,
for whatever reason, assumes the responsibility for payment of costs and
expenses for any claim or action brought against the City for infringement arising
under this Agreement, the City shall have the sole right to conduct the defense of
any such claim or action and all negotiations for its settlement or compromise
and to settle or compromise any such claim; however, SELLER shall fully
participate and cooperate with the City in defense of such claim or action. City
agrees to give SELLER timely written notice of any such claim or action, with
copies of all papers City may receive relating thereto. Notwithstanding the
foregoing, the City's assumption of payment of costs or expenses shall not
eliminate SELLER's duty to indemnify the City under this Agreement. If the
Deliverable(s), or any part thereof, is held to infringe and the use thereof is enjoined
or restrained or, if as a result of a settlement or compromise, such use is materially
adversely restricted, SELLER shall, at its own expense and as City's sole remedy,
either: (a) procure for City the right to continue to use the Deliverable(s); or (b)
modify the Deliverable(s) to make them/it non-infringing, provided that such
modification does not materially adversely affect City's authorized use of
the Deliverable(s); or (c) replace the Deliverable(s) with equally suitable,
compatible, and functionally equivalent non-infringing Deliverable(s) at no
additional charge to City; or (d) if none of the foregoing alternatives is reasonably
available to SELLER, terminate this Agreement, and refund all amounts paid to
SELLER by the City, subsequent to which termination City may seek any and all
remedies available to City under law.
: � �I►��GII;��i � • - - - • � �
Seller agrees that any and all analyses, evaluations, reports, memoranda, letters, ideas, processes,
methods, programs, and manuals that were developed, prepared, conceived, made or suggested
by the Seller for the City pursuant to a Work Order, including all such developments as are
originated or conceived during the term of the Contract and that are completed or reduced to writing
thereafter (the "Work ProducY') and Seller acknowledges that such Work Product may be
considered "work(s) made for hire" and will be and remain the exclusive property of the City. To the
extent that the Work Product, under applicable law, may not be considered work(s) made for hire,
Seller hereby agrees that this Agreement effectively transfers, grants, conveys, and assigns
exclusively to Buyer, all rights, title and ownership interests, including copyright, which Seller may
have in any Work Product or any tangible media embodying such Work Product, without the
necessity of any further consideration, and Buyer shall be entitled to obtain and hold in its own
name, all Intellectual Property rights in and to the Work Product. Seller for itself hereby waives any
property interest in such Work Product.
19.0 NETWORK ACCESS
The City owns and operates a computing environment and network (collectively the "Network"). If
Seller requires access, whether onsite or remote, to the City's network to provide services
hereunder, and the Seller is required to utilize the Internet, Intranet, email, City database, or other
network application, Seller shall separately execute the City's Network Access Agreement prior to
providing such services. A copy of the City's standard Network Access Agreement can be provided
upon request.
� � _. � ►
Buyer shall have the right to cancel this contract immediately for default on all or any part of the
undelivered portion of this order if Seller breaches any of the terms hereof, including warranties of
Seller. Such right of cancellation is in addition to and not in lieu of any other remedies, which Buyer
may have in law or equity.
� :�� ►_ •►
The performance of work or purchase of goods under this order may be terminated in whole or in
part by Buyer, with or without cause, at any time upon the delivery to Seller of a written "Notice of
Termination" specifying the extent to which performance of work or the goods to be purchased
under the order is terminated and the date upon which such termination becomes effective. Such
right of termination is in addition to and not in lieu of any other termination rights of Buyer as set
forth herein.
� ►�� � •►
No interest, obligation or right of Seller, including the right to receive payment, under this contract
shall be assigned or delegated to another entity without the express written consent of Buyer. Any
attempted assignment or delegation of Seller shall be wholly void and totally ineffective for all
purposes unless made in conformity with this paragraph. Prior to Buyer giving its consent, Seller
agrees that Seller shall provide, at no additional cost to Buyer, all documents, as determined by
Buyer, that are reasonable and necessary to verify Seller's legal status and transfer of rights,
interests, or obligations to another entity. The documents that may be requested include, but are
not limited to, Articles of Incorporation and related amendments, Certificate of Merger, IRS Form
W-9 to verify tax identification number, etc. Buyer reserves the right to withhold all payments to any
entity other than Seller, if Seller is not in compliance with this provision. If Seller fails to provide
necessary information in accordance with this section, Buyer shall not be liable for any penalties,
fees or interest resulting therefrom.
23.0 AIVE
No claim or right arising out of a breach of this contract can be discharged in whole or in part by a
waiver or renunciation of the claim or right unless the waiver or renunciation is supported by
consideration in writing and is signed by the aggrieved party.
� � u•. ��
This contract can be modified or rescinded only by a written agreement signed by both parties.
25.0 THE AGREEMENT
In the absence of an otherwise negotiated contract, or unless stated otherwise, the Agreement
between Buyer and Seller shall consist of these Standard Terms and Conditions together with any
applicable proposal documents published by the Buyer and Seller's Response to such proposal
(the "contract documents"). This Agreement is intended by the parties as a final expression of their
agreement and is intended also as a complete and exclusive statement of the terms of their
agreement. No course of prior dealings between the parties and no usage of trade shall be relevant
to supplement or explain any term used in this Agreement. Acceptance of or acquiescence in a
course of performance under this Agreement shall not be relevant to determine the meaning of this
Agreement even though the accepting or acquiescing party has knowledge of the performance and
opportunity for objection. Whenever a term defined by the Uniform Commercial Code (UCC) is
used in this Agreement, the definition contained in the UCC shall control. In the event of a conflict
between the contract documents, the order of precedence shall be these Standard Terms and
Conditions, the Buyer's published proposal documents and the Seller's response. If Buyer and
Seller have otherwise negotiated a contract, this Agreement shall notapply.
•1 1 ►
This agreement shall be governed by the Uniform Commercial Code wherever the term "Uniform
Commercial Code" or "UCC" is used. It shall be construed as meaning the Uniform Commercial
Code as adopted and amended in the State of Texas. Both parties agree that venue for any
litigation arising from this contract shall be in Fort Worth, Tarrant County, Texas. This contract shall
be governed, construed and enforced under the laws of the State ofTexas.
1 ► � ' ► � ► ����7:76��
Seller shall operate hereunder as an independent Contractor(s) and not as an officer, agent,
servant or employee of Buyer. Seller shall have exclusive control of, and the exclusive right to
control, the details of its operations hereunder, and all persons performing same, and shall be
solely responsible for the acts and omissions of its officers, agents, employees, vendors and sub-
vendors. The doctrine of respondeat superior shall not apply as between Buyer and Seller, its
officers, agents, employees, vendors and subvendors. Nothing herein shall be construed as
creating a partnership or joint enterprise between Buyer and Seller, its officers, agents,
employees, vendors and subvendors.
:� �.� .� u► •.
28.1 LIABILITY - SELLER 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
SELLER, ITS OFFICERS, AGENTS, SERVANTS OREMPLOYEES.
28.2 1NDEMNIFICATION - SELLER HEREBY COVENANTS AND AGREES TO INDEMNIFY,
HOLD HARMLESS AND DEFEND THE CITY (ALSO REFERRED TO AS BUYER), ITS
OFFICERS, AGENTS, SERVANTS AND EMPLOYEES, FROM AND AGAINST ANY
AND ALL CLAIMS OR LAWSUITS OF ANY KIND OR CHARACTER, WHETHER REAL
OR ASSERTED, FOR EITHER PROPERTY DAMAGE OR LOSS (INCLUDING
ALLEGED DAMAGE OR LOSS TO SELLER'S BUSINESS, AND ANY RESULTING
LOST PROFITS) PERSONAL INJURY, INCLUDING DEATH, TO ANY AND ALL
PERSONS, AND DAMAGES FOR CLAIMS OF INTELLECTUAL PROPERTY
INFRINGEMENT, ARISING OUT OF OR IN CONNECTION WITH THIS AGREEMENT,
TO THE EXTENT CAUSED BY THE ACTS OR OMISSIONS OF SELLER, ITS
OFFICERS, AGENTS, SUBCONTRACTOR(S)S, SERVANTS OR EMPLOYEES.
29.0 SEVERABILITY
In case any one or more of the provisions contained in this agreement shall for any reason,
be held to be invalid, illegal or unenforceable in any respect, such invalidity, illegality or
unenforceability shall not affect any other provision of this agreement, which agreement shall be
construed as if such invalid, illegal or unenforceable provision had never been contained herein.
30.0 FISCAL FUNDING LIMITATION
In the event no funds or insufficient funds are appropriated and budgeted in any fiscal period for
payments due under this contract, then Buyer will immediately notify Seller of such occurrence
and this contract shall be terminated on the last day of the fiscal period for which funds have been
appropriated without penalty or expense to Buyer of any kind whatsoever, except to the portions
of annual payments herein agreed upon for which funds shall have been appropriated and
budgeted or are otherwise available.
� ►• � •_;
Notices addressed to Buyer pursuant to the provisions hereof shall be conclusively determined to
have been delivered three (3) business days following the day such notice is deposited in the
United States mail, in a sealed envelope with sufficient postage attached, addressed to
Purchasing Manager, City of Fort Worth, Purchasing Division, 200 Texas Street, Fort Worth,
Texas 76102. Notices to Seller shall be conclusively determined to have been delivered three (3)
business days following the day such notice is deposited in the United States mail, in a sealed
envelope with sufficient postage attached, addressed to the address given by Seller in its
response to Buyer's invitation to proposals. Or if sent via express courier or hand delivery,
notice is considered received upon delivery.
1 ►•► � : 11 ►_ •►
This contract is made and entered into with reference specifically to Chapter 17, Article III,
Division 3("Employment Practices"), of the City Code of the City of Fort Worth (1986), as
amended, and Seller hereby covenants and agrees that Seller, its employees, officers,
agents, vendors or subvendors, have fully complied with all provisions of same and that no
employee, participant, applicant, Contractor(s)or subContractor(s)has been discriminated against
according to the terms of such Ordinance by Seller, its employees, officers, agents,
Contractor(s)or subvendors herein.
� uu :_ • - •._ -
City actively supports the Immigration & Nationality Act (INA) which includes provisions addressing
employment eligibility, employment verification, and nondiscrimination. Vendor shall verify the
identity and employment eligibility of all employees who perform work under this Agreement.
Vendor shall complete the Employment Eligibility Verification Form (I-9), maintain photocopies of
all supporting employment eligibility and identity documentation for all employees, and upon
request, provide City with copies of all I-9 forms and supporting eligibility documentation for each
employee who performs work under this Agreement. Vendor shall establish appropriate procedures
and controls so that no services will be performed by any employee who is not legally eligible to
perform such services. Vendor shall provide City with a certification letter that it has complied with
the verification requirements required by this Agreement. Vendor shall indemnify City from any
penalties or liabilities due to violations of this provision. City shall have the right to immediately
terminate this Agreement for violations of this provision byVendor.
� � :I�_1��:�'�_1�1'A_1�I�7�I:Z�]�li����►�i��:7Xe1�D�7���i1����'�
Services, products, materials, and supplies provided by the Seller must meet or exceed all
applicable health, safety, and the environmental laws, requirements, and standards. In addition,
Seller agrees to obtain and pay, at its own expense, for all licenses, permits, certificates, and
inspections necessary to provide the products or to perform the services hereunder. Seller shall
indemnify Buyer from any penalties or liabilities due to violations of this provision. Buyer shall
have the right to immediately terminate this Agreement for violations of this provision by Seller.
35.0 RIGHT TO AUDIT
Seller agrees that the Buyer, or Buyer's authorized representative, shall, until the expiration of
three (3) years after final payment under this contract, and at no additional cost to Buyer, have
access to and the right to examine and copy any directly pertinent invoices, pick tickets, and
other pertinent records of the Seller involving transactions related to this contract. Seller agrees
that the Buyer shall have access, during normal working hours, to all necessary Seller facilities,
and shall be provided adequate and appropriate workspace, in order to conduct audits in
compliance with the provisions of this section. Buyer shall pay Seller for reasonable costs of any
copying in accordance with the standards set forth in the Texas Administrative Code. The Buyer
shall give Seller reasonable advance written notice of intended audits, but no less than ten
(10) business days.
36.0 DISABILITY
In accordance with the provisions of the Americans With Disabilities Act of 1990 (ADA), Seller
warrants that it and any and all of its subvendors will not unlawfully discriminate on the basis of
disability in the provision of services to general public, nor in the availability, terms and/or
conditions of employment for applicants for employment with, or employees of Seller or any of its
subvendors. Seller warrants it will fully comply with ADA's provisions and any other applicable
federal, state and local laws concerning disability and will defend, indemnify and hold Buyer
harmless against any claims or allegations asserted by third parties or subvendors against Buyer
arising out of Seller's and/or its subvendor's alleged failure to comply with the above-referenced
laws concerning disability discrimination in the performance of thisagreement.
37.0 DISPUTE RESOLUTION
If either Buyer or Seller has a claim, dispute, or other matter in question for breach of duty,
obligations, services rendered or any warranty that arises under this Agreement, the parties shall
first attempt to resolve the matter through this dispute resolution process. The disputing party shall
notify the other party in writing as soon as practicable after discovering the claim, dispute, or
breach. The notice shall state the nature of the dispute and list the party's specific reasons for
such dispute. Within ten (10) business days of receipt of the notice, both parties shall make a
good faith effort, either through email, mail, phone conference, in person meetings, or other
reasonable means to resolve any claim, dispute, breach or other matter in question that may arise
out of, or in connection with this Agreement. If the parties fail to resolve the dispute within sixty
(60) days of the date of receipt of the notice of the dispute, then the parties may submit the matter
to non-binding mediation upon written consent of authorized representatives of both parties in
accordance with the Industry Arbitration Rules of the American Arbitration Association or other
applicable rules governing mediation then in effect. If the parties cannot resolve the dispute
through mediation, then either party shall have the right to exercise any and all remedies available
under law regarding the dispute.
38.0 PROHIBITION ON CONTRACTING WITH COMPANIES THAT BOYCOTT ISRAEL
Seller 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 "compan�' shall have the
meanings ascribed to those terms in Section 808.001 of the Texas Government Code. By signing
this contract, Seller certifies that Seller's signature provides written verification to the City that
Seller: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract.
Revised August 31, 2017.
Exhibit B— Seller's Quote, Scope of Services or Purchase Order
See Exhibit C pages 82 through 88.
Vendor Name Dealers Electrical Supply, Co.
Contact Daryl Donaldson
Phone Number 2547567251
Phone Extension 260
Email daryld@dealerselectrical.com
Website www.dealerselectrical.com
FederallD 74-1972120
Accepts RFQs Yes
Address Line 1 2320 Columbus Ave.
Vendor City Waco
Vendor Zip 76701
Vendor State TX
Vendor Country USA
Delivery Days 10
Freight Terms FOB Destination
Payment Terms Net 30 days
Shipping Terms Pre-paid and added to invoice
Ship Via Common Carrier
Is Designated Dealer No
EDGAR Forms Received Yes
Service-Disabled Veteran Owned No
Minority Owned No
Women Owned No
Is National Yes
No Excluded Foreign Terrorist Orgs Yes
No Israel Boycott Certificate Yes
Is MWBE No
Regions Served All Texas Regions
States Served Colorado, Illinois, New Mexico, North Dakota, Oklahoma,
Texas, Wyoming
Contract Name Building Maintenance, Repair, Operations Supplies and
Equipment
Contract # 577-18
Effective Date 12/01/2018
Expiration Date 11/30/2021
Quote Reference Number 577-18
6/14/2021 8:56:54 AM
Exhibit C- Cooperative Agency Contract
Additional Dealers See Additional Dealers/Distributors for dealer list.
Additionallnfo null
6/14/2021 8:56:54 AM
Return Policy Stock items returnable with buyer paying return freight,
non-stock returns are per manufacturer policy
�u � �
� 1 1 1 1
r=�
November 3, 2020
Daryl Donaldson
Dealers Electrical Supply, Co.
2320 Columbus Ave.
Waco, TX 76701
P.�. Box 4a4, Austin, Texas 78767
800.895.2919 • infa@buyboard.com • bwyhoard.com
Sent via email to: darvldCa�dealerselectrical.com
Re: Building Maintenance, Repair, Operations Supplies and Equipment
BuyBoard Contract 577-18
The Local Government Purchasing Cooperative (BuyBoard) awarded your company a contract under
Building Maintenance, Repair, Operations Supplies and Equipment, Contract 577-18, for which the current
term is set to expire November 30, 2020. At this time, the BuyBoard is renewing your contract through
November 30, 2021. This will be the final renewal of this contract.
All discounts, terms, and conditions of your contract will remain the same. If you agree to this renewal, there
is nothing you need to do. However, if you do not agree to this renewal, you must notify me via email at
lisa.maraden@tasb.or� prior to the start of the renewal term.
If you have questions or comments concerning this renewal, please contact me as soon as possible at
lisa.maraden@tasb.or�. We appreciate your interest in The Local Government Purchasing Cooperative.
Sincerely,
� ����
Lisa Maraden
Contract Administrator
final renewal v.02.13.2020
A� TASAr �r� �
Endorsed 6y �
&.t�' �'
� Board �
Caaperative Purchasiny
P.O. 8ax 400
Austin, TX 787G7-D40U
800.695.2913 f 572.467.0222 J Fax: 80U.217.5d54
6ayboard.com
October 24, 2018
Welcome to BuyBoard!
Re: Notice of The Local Government Purchasing Cooperative Award
Proposal Name and Number: Building Maintenance, Repair and Operations Supplies and Equipment,
Proposal No. 577-18
Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company a
BuyBoardO contract based on the above-referenced Proposal. The contract is effective 12/1/2018 through
11/30/2019, with two possible one-year renewals. The contract documents are those identified in Section 3 of
the General Terms and Conditions of the specifications.
To view the items your company has been awarded, please review the proposal tabulation No. 577-18 on the
following web-site: www.buyboard.com/vendor. Only items marked as awarded to your company can be sold
through the BuyBoard contract. In addition, on this website you will find the membership list which will provide
you with the names of all entities with membership in our purchasing cooperative.
Enclosed with this letter you will find the following documents:
1. Vendor Quick Reference Guide 2. BuyBoard License and Identity Standards
You are advised that receipt of a purchase order directly from a Cooperative member is not within
the guidelines of the Cooperative. Accepting purchase orders directly from Cooperative members may
result in a violation of the State of Texas competitive bid statute and termination of this Cooperative BuyBoard
contract. Therefore, all purchase orders must be processed through the BuyBoard in order to
comply. Please forward by email to info@buyboard.com any order received directly from a Cooperative
member. If you inadvertently process a purchase order sent directly to you by a Cooperative member, please
fax the order to the above number and note it as RECORD ONLY to prevent duplication.
As an awarded vendor a BuyBoard user id and password will be sent via e-mail 2 to 3 business
days prior to the start of your contract.
On behalf of the Texas Association of School Boards, we appreciate your interest in the Cooperative and we
are looking forward to your participation in the program. If you have any questions, please contact
Cooperative Procurement Staff at 800-695-2919.
Sincerely,
_ ��},�--t __-_ „�
Arturo Salinas
Department Director, Cooperative Procurement
v.6.5
,w —v�— The L oca! Govemment Purchasrng Cooperative is errdarsed 6y fhe Iexas Assaciation of Schoa! Boards,
����� T� Texas Municrpal League, Iexas Assocration of Cnunfies, and the Texas Associatrnrr at Schao! Adminisfratnrs
�a
.1. ►
/S�
�� tatius2�1 S.hunl
Endorsed by 15�A k��,ar�. As.�,ci:�ci�,t�
November 13, 2018
Welcome to BuyBoard!
Re: Notice ofNationalPurchasing Cooperative Piggy-BackAward
Proposal Name and Number: Building Maintenance, Repair and Operation Supplies and Equipment,
Proposal No. 577-18
Congratulations, The National Purchasing Cooperative (National Cooperative) has awarded your company a Buy6oard0
contract based on the above-referenced Proposal. As provided for in the Proposal and your National Purchasing
Cooperative Vendor Award Agreement, you are authorized to sell the goods and services awarded under the Proposal to
National Cooperative members in states other than Texas through the BuyBoard. The contract is effective 12/1/2018
through 11/30/2019, with two possible one-year renewals.
The National Cooperative membership list is available at our website www.buyboard.com/vendor. The list identifies the
current members that may purchase awarded goods and services under your National Cooperative BuyBoard contract.
You are advised that receipt of a purchase order directly from a National Cooperative member is not within
BuyBoard guidelines. Accepting purchase orders directly from Cooperative members may result in a violation of
applicable competitive procurement law and termination of this National Cooperative BuyBoard contract. Therefore, all
purchase orders from National Cooperative members must be processed through the BuyBoard. Please
forward by e-mail to info@buyboard.com any order received directly from a National Cooperative member. If you
inadvertently process a purchase order sent directly to you by a National Cooperative member, please fax the order to the
above number and note it as RECORD ONLY to prevent duplication.
As an awarded vendor a BuyBoard user id and password will be sent via e-mail 2 to 3 business
days prior to the start of your contract.
On behalf of the National Cooperative, we are looking forward to your participation in the program. If you have any
questions, please contact Cooperative Procurement Staff at 800-695-2919.
Sincerely,
/� --
t_ _ —
, ,z �
Arturo Salinas
Department Director, Cooperative Procurement
v.6.5
� �
P. �. Box 4DD, Austin, Texas 78767-D4D0
800.695.2919 • 6uy6aard.com �
� Board�
Cooperative Purchasing
J.z007 Research Boulevard • Auskin, Texas 78759-z439 � PH; $0�-695-2919 • FAX: 800-211-5454 • buyhoard,com
PROPOSER'S AGREEMENT AND SYGRIATURE
Proposal_Name: Building Maintenance, Repair and Pro osal Due Date O enin Date and 7ime:
Operations Supplies and Equipment May 3, 2018 at 4:00 PM
Proposal Number: 577-18
Contract Time Period: pecember 1, 2018
through November 30, 2019 with two (2) possible
one-year renewals.
I.ocation of Proposal OpeninA:
Texas Association of School Boards, Inc.
BuyBoard Department
12007 Research Blvd.
Austin, TX 76759
Anticipated Cooperative Board Meetina Date:
October 2018
Dealers Eiectrical Supply Co.
Name of Proposing Company
2320 Calumbus Ave.
Street Address
Waco, Texas 76701
City, State, Zip
254-756-7251
Telephone Number of Au�horized Company Official
254-756-0133
Fax Number of Authorized Company Offcial
April 24, 2018
pate
�
Signatur of Au ho ' d Company pfFicial
Daryl Donaldsan
Printed Name of Authorized Company OfFicial
Vice President Sales and Marketing
Position or T'ttle oF Authorized Company OfFcial
74-1972120
�ederal ID Number
Page 8 oF 69
Proposal Forms CONS7 �.01, ] 2.2018
! Board�
Cooperative Purahasing
12007 Research 8oulevard � Austln, Texas 78759-2439 • PH: 800-695-�9J.9 • FAX: 800-�11-5454 • buvboard.com
The proposing company (�'you" or "your") hereby acknowledges and agrees as follows:
1, You have earefully examined and understand all Cooperative information and doeumentation associated with this
Proposal Invitation, including the Instructions to Proposers, Generaf Terms and Conditions, attachments/forms, item
specifications, and line items {collectively "Requirements");
2, By your response ("Proposal'� to this Proposal Invitation, you propose to supply the p�-oducts or ser�ices submitCed at
the prices quoted in your Proposal and in strict compliance with the Requirements, unless specific deviations or
exceptions are noted in the Proposal;
3, Any and all de�iations and exceptions to the Requirements have been noted in your Proposal and no others will be
claimed;
If the Cooperative accepts any park of your Proposal and awards you a contract, you will furnish all awarded produc�s
or services at the prices quoted and in strict compliance with the Requirements (unless specific exceptions are noted in
the Proposai and accepted by the Cooperati�e), including without Ifmitation the Requirements re[ated to:
a. conducting business with Cooperative members, including ofFering pricing to members that is the best you ofFer
compared to similar customers;
b. payment of a service fee in the amount specified and as provided for in this Proposal In�itation;
c, the possible award of a piggy-back contract by another governmental entity or nonprofit entity, in which event
you will offer the awarded goods and services in accordance with the Requirements; and
d. submitting price sheets or catalogs in the proper format as required by the Cooperative as a prerequisite to
activation of your contract;
5. You ha�e clearly identified on the included form any information in your Proposal that you believe to be confidential or
proprletary or that you do not consider to be public information subject to public disclosure under a Texas Public
Information Act request or s€milar public information law;
6. The indi�idual signing this Agreement is duly authorized to enter into the contractual relationship represented by this
Proposal In�itation on your behalf and bind you to the Requirements, and such individual (and any individual signing a
form) is authorized and has the requisite knowledge to provide the information and make the representations and
certifications �equired in the Requirements;
7. You have carefully re�iewed your Proposal, and certify that all information provided is true, complete and accurate,
and you authorize the Cooperati�e to take such ac�lon as it deems appropriate to verify such information; and
8, Any misstatement, falsification, or omission in your Proposal, whene�er or however disco�ered, may disqualify you
from consideration for a contract award under this Proposal Invitation or result in termination of an award or any other
remedy or action pro�ided for in the General Terms and Conditions or by law.
Page 9 of 69
Proposal Forms CONST v.01.12,2018
� Board�
Cooperaffve Purchasing
12QOT ftesearch Boulevard • Austin, 7exas 78759-2h39 • PH: 800-695-2919 • FAX; SOD-211-5454 • buyboard.com
VEIVDOR CONTACT INFORMATIQN
Company: Dealers Electrical Supply Co.
Vendor Contact Name and MaiEing Address for Notices: Daryf Don�ldson, 2320 Columbus Ave, Waco, TX 76701
Company Website: www.dealerse[ectrical.com
Purchase Orders: Purchase orders from Cooperative members will be available through the Internet or by facsimile.
0 tp ion 1: Internet. Vendors need Internet access and at least one e-mail address so that notification of new
orders can be sent to the Internet contact when a new purchase order arrives. An information guide will be
provided to vendors that choose this optlon to assist them with retrieving their orders.
Q tion 2: Fax. Vendors need a designated fax line available at all times to receive purchase orders.
Please choose onl� one [i) of the following options �or receipt of purchase orders and pro�ide the requested
information:
�
�
I will use the INTERNET to receive purchas� orders.
�-mail Address: daryld@dealersefectrical.com
�nternet Contact: Daryl Donaldson, V.P. Sales
Phone; 254-756-7251
Alternate E-maik Address;
Alternate Internet Contact:
Phone:
I wlll recei�e purchase orders via FAX.
Fax Number:
Fax Contact:
Phone:
❑ Purchase orders may be received by any Designated Dealer identified on my company's Dealer �esignation
form as provided io the Cooperative adminisiraior. I understand that my company shall remain responsible for the
Contract and the performance of ali Designated Dealers under and in accordance with the Contract,
Request �or Quotes ("RFQ"]: Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses
for the receipt of RFQs:
E-mail Address; daryld@dealerselectrical.com
Alternate E-mail Address:
Page 10 of 69
Proposal Forms CONST v,01.12.2018
s Board�
Caoperative Purchasfng
12007 Researc� Boulevard • Austin, Texas 78759-2439 • PH: 80Q-695-2919 • FAX: 800-211-5454 • buybnard.Gom
invoices: Your campany w€iE be bflled mon�hly for �he service fee due under a contract awarded under this Proposal
In�itation. All in�oices are available on the BuyBoard website and e-mail notifications will be sent when they
are ready to be retrieved. Please provlde the fallowing address, conYact and e-mail information for receip� of service fee
in�oices and related communications:
Please choose only one (i) of the following options for receipt of in�oices and pro�ide the requested
information:
�]■ Service fee Involces and related communications should be pro�ided directly to my company a�:
Mailing address: P.O. Box 2676 Departmentr Sales and Marketing
City: �aC° state: Texas zip Code: 76i02-2676
Contact Name: Daryl Donaldson Phone: 254-756-7251
Fax: 25�-�56-0133 E-mai) Address: daryld@dealerselectrical.com
Alternative E-mail Address:
❑ In lieu of my company, I request and authorize all ser�Ece fee invoices to be provided direc�ly to the following billing
agent**:
Mailing address; Departmenk:
City: � State: Zip Code:
Con�act Name.
Phone:
Fax: E-mail Address:
Alterna�i�e E-mail Address:
❑ In lieu of my company, I reques� and authorize service fee invoices to be provided to the Designated Dealer(s)
receiving the purchase order(s) to which the invoiced service fees relate at the address and contact information designated
on my company`s Dealer Designation form as pro�ided to the Cooperative administrator,**
�� If Vendor authorizes a 6illing agent or Designated Dealer(s) to receive and process service fee invoices,
in accordance wlth the Genera! Terms and Conditions of the Contract, Vendor speci�cally acknowledges and
agrees that nothing in that designatlon shall relleve Vendor ofits respons/hllltles and obligat/ons under the
Contract inc/uding, but not Iimited to, payment of aU service fees under any Coatract ar�varded Vendor.
Page il oF 69
Proposal Forms CDNST v,Oi.12.2018
� Board �
Cooperative Pr�rahasing
12007 Research Boulevard � Aust€n, Texas 78759-2439 � PH: 800-69S-Z919 • FAX; 800-211.-545�F • u�g��,Q,�
FELONY CONVICTION DISCLOSURE AND DEBARMENT CERTIFICATION
FELOPIY CONVxCTION DYSCLOSURE
Subsection (a) of SectEon 44.034 of the Texas Edutation Code (Notification of CriminaN Fliskory of Contrackor)
SF.at�S: "A person or business entity that enters into a contract with a school district must give ad�ance notice to the district
if the person or an owner or operator has been convicted of a felony. The notice must include a general description af the
conduct resulting in the con�iction of a felony."
SecCion 44.034 further staCes in Sub5ecCion (b): "A school district may termfnate a contract with a person or
business entiry if the district determines that the person or business entity failed to give notice as required by Subsectian
(a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity
for ser�ices performed before the termination of the contract."
Please check (�/l one of the followEng;
❑*My company is a publicly-held corporation. {Advance notice requirement does not apply to publicly-held corporailon.)
0■ My company is not owned or operated by anyone who has been convicted of a felony.
❑ My company is owned/operated by the following individual(s) who has/have been con�icted of a felony:
f�ame of Felon{s):
petails of Conviction(s):
By signature below, I certify that the abo�e information is true, complete and accurate and that I am authorized by my
company to make this certification.
* Dealers is an employee-owned cornpany. To the best of my knowledge, no officer or director of Dealers has
ever been con�icted of a felor�y. Dealers Electrical Su I Co.
� Campany Name
Chris Lanham
Signat f Autho zed Company Official Printed f�ame
D�BARMENT CERTIFYCATION
Nelther my company nor an owner or principal of my company has been debarred, suspended ar otherwise made ineligible
for participation in Federal Ass'tstance pragrams under Executive Qrder 12549, "bebarment and Suspension," as described
in the Federal Register and Rules and Regulations. Neither my company nor an owner or principal of my company is
currentiy listed on the government-wide exclusions in SAM, debarred, suspended, or otherwise excluded by agencies or
declared ineligible under any statutory or regulatory authority, My company agrees to immediately notify the Cooperati�e
and all Cooperative members with pending purchases or seeking to purchase from my company if my company or an
owner or princ�pal is later listed on the government-wide exclusions in SAM, or is debarred, suspended, or otherwise
excluded by agencies or declared ineligible under any statutory or reguiatory authority.
By signature below, I certify that the above is true, complete and accurate and that I am aut�orized by my company to
make t�is certification,
Dealers Electrical Supply Co.
Company Name
�
� Chris Lanham
S9gnature of orized ompany Official Printed Name
Page 12 of 69
Proposal Forms CONST v.D1,12,2�i6
� Board �
Caapera[Fve Purchasing
L2007 Research Boulevard • Austin, Texas 78759-2439 • PH; 500-695-2919 • FAX: B00-211-5454 • huyboard.com
RESIDENT/ IVONR�SIDENT CERTIFICATION
Chapter 2252, Subchapter A, of the Texas Government Code establishes certain requirements applicable to proposers who
are not Texas residents. Under the statute, a"resident" proposer is a person whose principal place of business is in 7exas,
including a contractor whose uitimate parent company or majority owner has its principak pface of business in Texas. A
"nonresident" proposer is a person who is not a Texas resident. Please indicate the status of your company as a"resident"
proposer or a"nonresident" proposer under these definitions,
Please checl< (�/) one of the followin�
■[� I cer�ify that my company is a Resident Proposer.
❑ I certffy that my company is a Nanresident Prapaser.
If your company is a Nonresident Proposer, you must pro�ide the following information for your resident state (the state in
which your company's principa! place of business is located):
Company Name
City
Address
State zip Code
A. Does your resident state require a proposer whose principal place of business is in Texas to under-price proposers
whose resident state is the same as yours by a prescr{bed amount or percentage to recei�e a comparable contract?
❑ Yes ❑ fVo
B. What is Che prescribed amounC or percentage? $ or %
V�NDOR EMPLOYMENT CERTIFICAT�ON
Section 44,031{b) of the Texas �ducation Code establishes certain criteria that a school district must consider when
determining to whom to award a contract. Among the criteria for certain contracts is whether the �endor or the �endor's
ultimate parent or majority owner (i) has its principal place of business in Texas; or (ii) employs at least 500 people in
Texas.
If neither your company nor the ultimate parent mmpany or majority owner has its principal place of business in Texas,
does your company, ultimate parent company, or majority own�r employ at least 500 peopie in Texas?
Please check {�/) one of the following_
� Yes ❑ No
By signature below, I certify that the information in Sections 1(Resident/No��resident CerCification) and 2(Vendor
Employment Certi�cation) above is true, complete and accurate and that I am authorized by my company to make this
certification.
Deaiers Electrical Supply Ca.
Company Name
� � Chris Lanham
5ignatu Authoriz Company Official Printed Name
Page 13 of 69
Proposal Farms CONST v.01.12.2018
� Board �
Cooperative Ar►rehasinp
12407 Research Boulevard • Austin, Texas 76759-2439 � PH: 800-595-2919 • FAX; 64a-z1i.-5454 • b�yboard.corrE
NO YSRAEL BOYCOTT CERTIFICATION
�fFective September 1, 2017, a Texas governmental entity may not enter into a contract with a company for goods or
services unless the contract contains a wrikten verification from the company that it; (1) does not boycott Tsrael; and (2)
will not boyrntt Lsrael during the term of the contract. (TEx. Gov'r CooE Ch. 2270)
"Boycokt Israel�r means refusing to deal with, terminating business activities with, or otF�erwise taking any action that is
intended to penaEize, inflict economic harm on, or iimit commercial relations specifically witF� Tsrael, or with a person or
entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business
purposes. Tex, Gov'T Cope §808.001(1).
By signature below, I certify and verify that Vendor does not boycott Israel and will not boycott Israei d�ring the term of
any contract awarded under this Proposal Invitation, that this cer�ification is true, complete and accurate, and that I am
authorized by my company to make this certification.
Dealers Electrical Supply Co.
Company Name
Chris Lanham
L
Signatur uthoriz Company Official Printed Name
NO EXCLUDED NATION OR FOREIGN TERRORIST ORGANYZATYON CERT�FTCATION
�fFective 5eptember 1, 2017, Chapter 22�2 of the Texas Government Code provides that a Texas governmental entity may
not enter into a contract witF� a company engaged in active business operations with Sudan, Tran, or a foreign terrorist
organization — specifically, any company identiFied on a list prepared and maintained by khe Texas Comptroller under Texas
Government Code ��606.051, 607.051, or 2252. �53. (A company that the U.S. Government affirmatively declares to be
excluded from its federal sanctions regime relating to Sudan, Iran, or any federal sanctions regime relating to a foreign
terrorist organization is not subject to the contract prohibition.)
By signature below, I cer�ify and verify that Vendor is not on the Texas Comptroller's list identified above; that this
certiflcation Is true, complete and accurate; and that I am aukhorized by my company to make tF�is certification,
Dealers Efectrical Supply Co.
Company Name
�.
� Chris Lanham
Signatu f Auth �zed Company OfFiaal Printed Name
Page 14 of 69
Proposal Forms CONST v.01.12,2018
� Bo�rd�
Cooperative Purshasing
12007 Research Boulevard • Austin, Texas 78759-2439 � PH; B00-695-2919 • FAX: 800-�11-5q5�4 • k��ybo� .c.om
HISTORICALLY UNDERUTILIZED BUSIN�SS C�RTY�YCATION
A proposer that has been certified as a Historically llnderutilized Business (also known as a M9nority/Wamen Business
Enterprise or "MWBE" and all referred to in this form as a"HU8`� is encouraged to indicate its HUB certification status
when respanding ta this proposal In�itation. The electronic catalogs will indicate H118 certifications for �endors that
properly indicate and document their HUB certificat9on on this form.
Please check (�Cl all that a�plv:
❑ I certify that my company has been certified as a Hl1B in the following categories:
❑ Minority Owned Susiness
❑ Women Owned Susiness
❑ Service-Disabled Veteran Owned Business (veteran defined by �8 U.S.C. §101(2), who has a
service-connected disability as defined by 38 U,S.C. §]�Ox(]�6), and who has a disability rating
of 20% or more as determined by the U. S. Department of Veterans Affairs or Department of
Defense)
Certification Number:
Name of Certifying Agency:
� My company has NOT been certified as a H118,
By signature be[ow, I certify that the above is true, complete and accurate and that I am authorized by my
company to make this certification.
Dealers Electrical Supply Co.
Company Name
Chris Lanham
Printed Name
�
Signature of
Page 15 of 69
Proposal Forms CONST v,01.12.2018
� Board�
Cooperative Purchasiag
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-Z919 • FAX: 800-211-5454 • buvboard.com
CONSTRUCTIt�N-RELATED GOODS AND SERVICES AFFIRMATION
A contract awarded under this Proposal Invitation covers only the specific goods and services awarded by the BuyBoard. As
explained in the BuyBoard Procurement and Construction Related Goods and Services Advisory for Texas Members
("Advisory"), Texas law prohibits the procurement of architecture or engineering services through a
purchasing cooperative. This BuyBoard cantract does not include such services. Architecture or engineering
services must be procured by a Cooperative member separately, in accordance with the Professional
Services Procurement Act (Chapter 2�54 of the Texas Government Code} and other applicable law and local
policy.
ihe Advisory, available at buyboard,com/Vendor/Resources.as�, provides an overview of certain legal requirements that
are potentially relevant to a Cooperative member's procurement of construction or construction-related goods and services,
including those for projects that may involve or require architecture, engineering or independent testing services. A copy
of the Advisory can also be provided upon request.
By signature below, the undersigned affirms that Proposer has obtained a copy of the Advisory, has read and understands
the Advisory, and is authorized by Proposer to make this afFrmation. If Proposer sells construction-related goods or
services to a Cooperative member under a BuyBoard contract awarded under this Proposal Invitation, Proposer will comply
with the Advisory and applicable legal requirements, make a good faith effort to make its Cooperative member customers
or potential Cooperative member customers aware of such requirements, and provide a Cooperative member with a copy
of the Advisory before executing a Member Construction Contract with the member or accepting the member's purchase
order for construction-related goods or services, whichever comes first.
Dealers Electrical Supply Co.
Company Name
� � Chris Lanham
Signat f Auth ized Company Official Printed Name
03/22/2018
Date
Page 16 of 69
Proposal Forms CONST v.01.12.2018
� Boa�d �
Coopsra[ive Purchasiag
12007 Research Boulevard • Austin, 7exas 7B759-2439 • PH: 500-695-2919 � FAX; B00-211-5454 • buyboard,com
D�ViAT�ON AND COMPL�ANCE
Tf your company intends to deviate from the General 7erms and Conditions, Proposal Specifications or other requirements
associated with this Proposal Invitation, you MUST list ail such deviations on this form, and provide complete and detailed
information regarding the deviations on this form or an attachment to this form. The Cooperative will consider any
deviations in its contract award decision, and reserves the right to accept or reject a proposal based upon any submitted
devlation,
In the absence of any deviation identified and described in accordance with the abo�e, your company must fully comply
with the General Terms and Conditions, Proposal Specifications and a�l other requirements associated with this Proposal
Invitation if awarded a contract under this Proposal Invitation. A deviation will not be effective un(ess accepted by the
Cooperative. The Caoperative may, in its sole discretion, seek clarifcation from and/or communicate with Proposer(s)
regarding any submitted deviation, consistent with general procurement principles of Fair competition. The Cooperative
reserves the rigF�t to accept or re�ect a proposa! based upon any submitted deviatian.
Please check (�j one of the following_
■❑ No; De�iaeions
❑ YES; Re�iaeions
List and Fully explain any deviations you are submitting:
PL�ASE PROVIDE THE FOLLOWING INFORMATION:
i, Shipping Via: ❑■ Cammon Carrier ❑■ Company Truck ■❑ Prepaid and Add ta Invoice ❑ Other:
2. Payment Terms: ■0 Net 30 days ❑ 1°10 in 10/Net 30 days ❑ Other:
3. Number of Days for Delivery: � a ARO
4. Vendor ReFerence/Quote Number: ���-� $
5. state your return palicy: Stock items �eturnable freight prepaid by BuyBoard Member. Non Stack Items
are subject to manufacturer ret�rn palicy. All material must be in resaleable canditian.
fi. Are electranic payments acceptable? �Yes ❑ No
7, Are credit card payments acceptable? ■❑Yes ❑ No
Daryl Donaldson, V.P. Sales
Printed Name
Page 17 0€ fi9
Praposal Forms CONST v,01.iZ.2018
� Board �
Gooperalive Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 • PH; 800-695-2919 • FAX: 800-211-5454 • buvboard.com
LOCATYON/AUTHORIZED SELLER LISTIN„GS
Ifi you have more than one location/authorized seller that wilE service a contrack awarded under this Proposal Invitation,
please list each location/authorized sei[er below. If additional sheets are required, please duplicate this form as necessary.
NQTE; Awarded Vendors shall remain responsible for a11 aspects of t�e Contract, including processing of Purc�ase Orders,
and shall be responsible for the performance of all locations and authorized se[lers under and in accordan�e with the
Contract. Ifi you are a product manufiac�urer and wish to designate Designated Dealers as defined in the General Terms
and Conditlons to receive Cooperative member Purc�ase Orders on your behalf, you must complete the Manufacturer
Qesignated Deafer fiorm.
See all the dealers elecfirical supp�y [ocation listed individually as follows on each page.
Company Name
Address
City
Phone Number
Contack Person
Company Name
Address
City
Phone Number
Contact Person
State zip
Fax Number
State Zip
Fax Number
Page 18 of 69
Proposal Forms CDNST v.01.12.2018
�„
dealers electrical supply co.
BRANCH ROS I FK EtfecFive 04119120'18
Corporate OHice P.O. Box 2676
2320 Columbus Ave
Remit to Address: P.O. Box 2535
Waco, Texas
Federal Tax I.D. Number 74-1972120
Texas Sales Tax Number 1-74-1972120-8
1. Waco Greg Bracey P.O. Box 1730
Mclennan Co. 1416 Franklin Ave.
2. Bryan M1,t �;e Jetty P.O. Box 3009
8razos Co. 419 Dellwood Street
3. Tyler David Jones P.O. Box 1�10
Smith Co. 3�6 S. PalaceAve.
4. Temple Scott Weddle P.O. Box 923
8ell Co. 4013 Bell Dr.
5. Austin � Randy Kinsey P.O. Box 14&24 �
Travis Co. 6714 N. Lamar
6. Longview Ste:e Hicks P.O. Box 1D72
Gregg Co. 349 W. Cotton
7. Marshall John Tayior P.O. Box 687
Harrison Co. � 506 W. Houston �
8. Fort Worth Tony Pierce P.O. Box 7578
Tarrant Co. 713 N. Beach
9. Luflcin � Justin Kipp P.O. Box 1783 �
Angelina Co. 401 Atkfnson Dc
�0. Dallas Robert Grafi P.O. Box 540695
Dallas Co. 2580 Manana
11. Texarkana � Marty Long P.O. Drawer 38 =�
__ Bowie Co. 1804 Waterall
12. Waco Lighting Greg 6racey P.O. Box �150
McLennan Co. 1418 Franklin Ava.
13. Sherman Glenn Waidrum P.O. Box 1205
Grayson Co. 1616 Baker Rd.
14. Houston Danny Ma�ors P.O. Box 16160
Harris Co. 4433 Airline Dr.
15. Greenville Travis Morrison P.O. Box 1458
Hunt Co. 2629 Traders Rd.
16. Paleslfne Ricky Floyd P.O. Box �489
Anderson Co. 2230 W. Reaoan St.
17. Kerrville � Robert Zuberbueler P.O. Box 290627
Kerr Co. 428 Schreiner Street
18. San Marcos Rodney Hodge (Ops) P.O. Box 845
Hays Co. 616 Texas Ave.
19. irving Nathan SchaAz P.O. Box 15358fi �
Dallas Co. 3831 Coniians Rd_
2D. Bryan Lighting Keiiy Sisco P.O. Box 4489
Brazos Co. 101 Koenig Street
21. Denton Kim Troth P.O. Box 2066 `
Denton Co. 716 E. Hickory
22. Cleburne Tony Pierce P.O. Box �.11
Jahnson Co. 112D E. Henderson
23. Plano Roger Miuer P.O. Box 940'169
Collin Co. 911 J. Piace
24 Houston South Dennis Sims P.O. Box 1206�
Harris Co. 5220 Old Galveston Rd.
25. Duncanville Mike Dandridge P.O. Box 361059
,s,- Dallas Co. 1 i Q7 S.Cedar Ridge
26. San Antonio P.O. Box 17UQG
Bexar Co. 2400 Freedom St.
27. Austin (South) Andrew Hed�ick P.O. Box 150293
Travis Co. 4700 Sunsef Trail �
28. San Antonio (Wesl) P.O. Box 680967
Bexar Co. 8786 Timber Path
29. Marble Falls Tim Phillips � P.O. Box 425
# Burnet Co. 2709 Commerce St.
76702-2676 (254)756-7251
76701-1041 Fax (254)756-0133
76702-2535 HR Fax (254)750-8171
New Mexico CRS I.D. Number D2-121645-002
Oklahoma Tax iVumber 094795
76703-113D (254)756-4441 MR
76701-7793 Faz (25a�756-0316
77805-3009 (979� 775-6500 CR
77801-2544 Fax �979�779-0236
75710-1110 (903)593-7357 ER
75702-7049 Fax (903) 593-970i
76503-0923 (254)773-5271 SR
76502-4841 Fax (254)770-0380
7876111624 (512) 459-5423 SR
78752-3504 Fax (512)459-0635
75606-'1072 (903) 758-3317 ER
75601-6223 Fax (903)236-3154
75670-D687 (903)935-7865 ER
75670-3933 Fax (903)935-9873
76111-7578 (817)831-0054 �:4R
76111-59a4 Fax (8171831-9738
75901-'1783 (936) 634-5591 ER
75901-3155 Fax (936)639-3867
75354-0695 (214)358-5222 MR
75220-12D6 Fax (214)358-1087
7550�-0038 (903)794-3596 ER
75501-3639 Fax (903) 792-4820
76703-1130 (254�750-37�6 PAR
76701-1793 Fax (254) 756-0316
75091-1205 (903) 893-'1177 MR
75090-2143 Fax (903)893-7536
77222-6�6D (713) 681-652� CR
77022-2927 Fax {7�3)694-4535
75403-1458 (903) 454-3073 ER
75401 Fax (903)454-3743
75802-1489 (903�725-3205 ER
75801-2247 Fax (903)723-3691
78029-U627 (834)896-Q555 SR
78028-4470 Fax (830)896-7137
78667-0845 (5�2�396-5454 SR
78666-5200 Fax (512)396-5457
75015-3586 (972)790-�000 MR
7506�-3914 Fax (972}986-21�7
77805-44SU (979) 775-1697 CR
77801-2128 Fax (979�775-4158
76202-2066 (940) 566-35�5 A4R
762D5�302 Fax (940)566-5645
7fi033-0811 (817�641-3621 MR
76Q31-5233 Fax (817) 556-0232
75094-6�69 (972}A22-Z726 MR
75074-8536 Fax (972)422-0472
7721�-2665 (713)944-3098 CR
77017-6146 Fax (713)944-4387
75138-iD59 (972)7Q9-Q025 MR
75�37-307d Fax (972)7D9-d654
78217-7D00 (210)828-9995 SR
78217-4423 Fax t210i828-0701
78715-0293 (St2)892-5910 SR
78745-'1313 Faz (512)892-1481
76268-0967 (210)520-3397 SR
78250-4314 Fax (210)520-3950
78654-0425 (B30)693-9191 SR
78654-3924 Fax (830)798-1000
Page 1 of 3
30. EI Pasa
�FB. iVluskogee
����e 4:����
��� C P
50. Oklahoma
fi�� 1 ��`�'
+�
?,��,� ' .
52. Tulsa
56. �enver, CO
SITE WAREHOUSES
87. Sweeny P66
Lake Charles PB6
Jim Fowler
EI Paso Co.
��e`�����K
Peie Hernand
DonaAna Cv.
� ��� � �i
Ben Gillespie
Tarrant Co.
�ri � t ��S
���g� ��
Orlando Cruz
Cameron Co,
� a���
Ric Olivarez
Hidalgo Co.
B[ac��� o �J��;
� .����
Chris Anders❑
Nueces Co.
-,�� �� $ �
� � .
Saotf Weddle
Sall Co.
il `-0 w e"�
,��a e �C�� �
Chris Wear
Lamar Co.
I'�O�C
Allen Bailey
�ryan Ca.
�`� �` fs0�'
�,ie ' . �. �s��'c-'
Storey Merrill
Oklahoma Co.
�.",�� �.�
P� e �_
Charles Collins
Tulsa Co.
Larry Vieih
Denver
Royal Eleclric Supply, Agent
Phlladelphia, PA
. ;- �- ����,- �
������g����� �f �"
��
�Ll���,.��t::����
Brad McWherier
8randon Gray
P ea �' I . ����;�., �
Joe I]uke
Wesflake, LA
P,O, Box 26279 79926-6279 (915) 775-B70a WR
9050 Kasirin St. 78807-1705 Fax (915) 772-�+711
���fi ������Q�+ *: ��' w+ ' ; 7�'��7c11�Qq �, �_� �, �28i19'�3 �Q797 �R-
��!�r�?��r �1��,8�3�+�d s.�_�... � �4 ���,7��t��;`[Su?. �_ � EFax _._`.�',?�� 8�3 95?g .. ..�..
P.O. Bax 1120 BBOa4-1120 (575) 526-4010 WR
'f844 A WestAmadorAve B80p5 4009 Fax (575) 526 4149
,� a� :
�+-'������������� �� �t ������,. � 75�,��4,������ �` �� Faitk ��s4�:��$03��$72 $�/53 r �R
� � _ <�.. �� �,�,, � _ _ � (� _ J,., T � « �
P,O. Box 530131 75053-0131 (972) 206-0725 MR�
2000 S. Gteat Soulhwest Pk 75a51-3507 Fax (972) 2D6-0717
��p.�o'���,'SE��.C��.�� �.`��.�_..:_,f `.� FB���� 22��¢�`..r_.:a rFek ..?� �ers��.Sz?Q?J�8�0 0090 _,. n �R.
P.O. Box 1750 78551-1750 {956} A25-8690 WR
402 Norih T. St. 78550-8011 Fax (7956) 425-8788
P �BO�<2 �"��'�'�'ia,c�'� �L,�„$7b 2�'��l�,��S ,,�.`',��"ys�,'"r����,;z]�s.,Q �g`�.7��.3'� h v'��
�� � 1 kida_� ��� ���'� � $75D7„�i�: �ea'+�,=��7i .�''�,5�.�' �,��50�� �'71'2 $2 ��. ,1
� _.-.:� .m.�. ��.�.._ .�z� , :�%.� r � �
P.O. Box 5967 78502-5967 (956) 630-2233 WR
1401 East UpesAve 78501 b548 Fax (956) 834 3844
���c8 ""�$S�r��`����,{;�a, �7J�3�708@ , F � a: �„ �F ��.97$�25� 96�0 CR:
��
���'e",�.D��"Gfee)1�Sf ����a��._..:�7763����'.._.:..�.F��`���?r,'.,�97������969��'_..s:.._:
P.O. Box4747 78A69-A7A7 (361} 299-2222 CR
1833 N. Padre Island Dr. 78408-2331 Fax (361) 298-5555
� �. �' u��������'��f 62A8� 28���?����.����7$�`v_���'�.�sxn.��.
P.a. Box 788 7654D-0788 (254) 628-9002 SR
A05 Commeroe f]r. 76543-4037 Fax (254) fi28-0468
�'��'�,=690�.��{';��"����a���'.� ��%79�88`'9066� � s��"^���3 ° y.�432�,�685584 {^. F411JR
z a� �: bs �s ��,�° z: ��t°a- P€
� i.���i Si,r�� �. ��� ��7�����5:��`_�`"_� F���i_.��:�?�32) 368.�.4�.33 �� �:'
P.O. Bax 631Q 75461-6310 (903) 78�1-0091 ER
3430 Pine Mill Rd 75460 A939 Fax {903) 784 6619
s � �"��� �'�'� ����k � t 5%�4 e0� � z���,���, ct��°'� 9� � � '��.5�
e
" � T £ ;D � g�xp"��� �� �' ���;� '�T`������� �e _�E �'
�.� .,�. � � T3.x�i ..����: � $Z� ,�� afc"��� e�. 0 8 � � � -�
P.O. Box 7D8 7�+742-07fl8 (SBQ) 924-2464 MR
15 W. Elm Slreet 74701-41fl5 Fax (580) 920-0322
�P�O�B���y`���,��„n ���'i z.�y`�s �����'3s$ - ��� ���ye��; �.���¢�6�7���p � ��M NFi
,z,C C ' �'r� � 3 .:,�' �:3`�,r7900�,. _ ? . � � �`�� � .�' �..��8�6} � ,�� �2:�,..�.� u
�:� � �.� d� ,.� � � �� 42�
P.O. Box 7549 744fl2-1549 (918) 683-500a NR
1400 N. Main 74A01-4,�A45 Fax (818� 683-3035
�OO� 4 �S ��" "�"£' ��.���a�����?g�� ��`�` � ��w �� %�5��}�/�� $000 � �::aS-�
,��.a�,�a Q'��������i�?a�.������,������.�x �� _����e� �asoo� ��w� �<
P,O. 6ox 272366 73187-2368 (405) 782-040D NR
8500 W. Reno Ava 73127 2952 Fax (405) 782-04a4
� �.�� 7�90� 278 ;�z���'4�� � ��8�65'�76 567��` ��,(�1�'i
� ,.:"� ��_ � �._ �e�:�� _ ..�������..����x����.���������'��;�
P.O. Box 580190 74158-fl19a (91 B) 835-7672 � NR
6920 E. 131h 51. 7A112-561fi Fax (916) 835-0583
ty�p ti�' `' p"p �,�_ t� �r � i�4« t�`� 2 0 fl�3'8� °� .� F" �'u����a:`�3_ Ois ��"� �'�� s�riPi
�9.�,�= _ ��,��� ������� ?� ��.Ea �; ��.,�' � '}�6�6;�.9T�5 ��..�;;�
P.Q, Box 42 70037-OOA2 (5Q4} 684-8747 KA
213 Gunther Lane 70037-3757 Fax (504} 684-8748
s ^�^^^s� � � . ir � � �.u�'� � 5�� 5 "��t,�'�`a��r �"� `� � ��/7 9 �Q �B D t�"'� '��({�
� �hi`r1.�`�' � 5h� 2°� "��iy.�� ��n2�- 'd`.����; �"6,'€.='.
� �� E �-' ���'������.'���'���.��X,��z����°�,2�365?_�._ti:Y`�'
P.O. Bax 176D8 8029 7 (3�3) 592-2800 KA
5506 Havana St. Suiie B 80239 Fax (3fl3) 592-2806
221-1200 !(A
P,a. Box b95
Hwy 35 SouEh Q FM524
Gaie 13 - MRO Whse #4
P Q�B x�1����a��;,���,�
3�fl���/�1,' !L�� a' ;i����p
P. O. 8ox 11�}5
2200 Old Spanish Trail
Page 2 oF 3
{979}491-2987 CR
77463 Fax (979)491-2104
(979)481-26i0
7�6Qfj � �'-"�^? '"z� r,e<d � 5�'s` ^•� 580 B'%-49 +� g ;NQ
�'H i� ��Y Fjd � � �`V.. � �� J�. �a . L�
7480�,:��,�"� &�� ��Fa3� �`�e�?'�` � 5 �}�67�6$�'ik�. E..w.- =
766fi9-19A5 (337)49i-5249 KA
70669 Fax (337) 491-5y58
REGION MANAGERS
Raniel Dreessen NR (fi11)
DennyMejors CR (801)
Scott Fields SR (505)
Keh McCully MR (6D4)
Ken Franks �R (600)
Randy Urbina WR (605)
SALES MANAG�RS
{4fl5) 787-b553 John Marlin
(713) 891-6521 Michaal PoweA
{512) 459-5423 Doug Cameron
(972)298-2111
{903) 593-4809
(915) i75-9700
(514� (713)891-6521
(60A} {972) 298-2'f1'I
{b03} (903) 593-7357
KEY ACCOUNTS
Sieve May (642) (254) 754-2820
CRE�IT OFFICES
Julie Hawingian
Amber Drotar (808)
RobEn Stanfleld (667)
(605)
Kim Trimm (604)
Jeannie Valentin (611)
Jenei Ta�eirne
NOiES:
IN�USTRIAL AUTOMATION GROUP
Jeff Martin {903)593-7357
Curtis Mertin {543) (9fl3)503-7357
Kurt Brouwer {514) (73 3) 691-6521
{254)758-7251
(903) 593-3fl98
(713) 691-8521
(915) 775-9700
(972) 298-2111 �uncanville Regional & Credit Office
(405) 787-5553 iifl7 S.Ceder Ridge Sie. B
(512) A59-5A23 �uncan�ille, TX 75137
(972)298-2111 Fax(972)298-2251
Paga 3 of 3
� �o�rr�l�
Cooperatfve l�urchssfng
12407 Itesearch Boule�rard ' Austin, T�x�s 78759���}39 � PH: �00-595��919 • FA}(: $p0,2i.x�5454 • b�y��q�.. ��.�um
�.4C�iTION/AU7'�IOFiIZ�D SELLER LYSTINGS
If you have mare than one [�catfon/authorized seller th�t w[il service a contract awarded und�r this Proposal Invltation,
piease list each location/authorized seller belaw. Y� additional sheets are requlred! ple�se dupilcate this form as necessary.
NOTC: /�warded 1lendors shall remain responslble �nr �li asp�cts of the Contrac�, fncluding processing of Purchase Ord�rs,
and shall be responsible for the performance of all iacarions and authorized sell�rs under and in aocordanca with the
Contract, zf you are a product manufacturer �nd wish to designate Deslgnatsd Dealers as defined in ths General Terms
and Cohditlon5 to rece9v� �ooperaklve member Purchase Orders on your behalP, you must complete the Manufac�ur�r
De�ignated Dealer form.
Dealers Electrical Supply
�ampany Name
4220-A 2nd Sf. NW
Address
Albuquerque
clCy
505-880-� 344
NM
5tat�
505-880-0090
87107-224�
zip
phane Nur�ber Fax Numbar
K. C. Ratka or Daryl Donaldson 254-756-7251 ext.260
Con�ac� Person
Dealers Electrical Supply
Company Name
�0�0 W. 5th Ave.
,Address
Amarillo
��y
806-376�5567
TX
5tate
806-376-9473
791D1-1110
�
Phone Number Fax Number
Rick Abers or Daryl Donaldson 254-756-725� ext.26�
Contact Person
Page ia oF69
Proposal FoRns CDNST v.O1.12,20J.4
� ��r�r�l�
�oo�er€��fve 1°r�x�iaa�9n�r
i.2Q07 Research Bo�l�vard • A�stin� Texas 78759�24�9 � pH: �00-695�29t9 = F,4X: �UO-2�.L�5454 � b.uvl�t7�rd.Corn
LOCATi�N/AU'iHCfRiZ�D �ELLE��„LI3TTN�S
If you have more than on� location/a�athnrized sel[er that wtll service a cantrac� awarded under ti�is Rropos�l xnvitation,
please lls� each location/autharlxed seller belaw. IP addit�onal sheeCs are requlred, please duplicate this form as necessary,
.�pi'�: Awarded V�ndors sh�l! remaln re�po�sibl� far all aspecCs of'th� Can�racCr fncl�ding praaessin� of Purrhase Ord�rs,
and shall be respansibls far the p�rform�nc� of all locatians and authorlxed sellers under and in acoprd�rrce with the
Can�ract, zf you are a praducl• rnanuYa�tur�r �nd wish i�a desPgnate qesEgnated Deaiers as deflned in the General Terms
�nd C�ndltions tio r�ceive Cooperative member Purchase Orders on yaur bek�al�, you must completa the Manufacturer
Designated Deal�r fnrm.
Dealers Electrical Supply
C�mpany fVame
6714 N. Lamar
Address
Austin � TX
dry Sta�e
5 � 2-459-5423
5 � 2-459-063v
78752-3504
��p
Rhane Number Fax lUumber
Randy Kinsey vr Daryl Donaldson 254-756-7251 e�.2�0
Gani�ach Person
Dealers Electrical �upply
Company Name
4700 Sunset Trail
Addr�s
Austin
c��y ---
512-892-59 � 0
TX
��
512-892-1481
78i45-1313
z�p
Phone Number �ax Number
Andrew Hedrick or Daryl Donaldson 254-756-7251 �xt. 260
Cont�ct Rerso�i
Aage 1� of &9
Propasal POKms CAN5T v.01,12,�010
� ������
G�ape�dtive P�r►�c1,as9ng
120Q7 R�s��rch Bouievard � Auslin, Texas 78759•2�F39 • AH: �QO-6�5�2919 • FAX: SUO-��.xkS454 ��uvf�4�Y�l.�om
�oc�r�a� rr�v�zz�o s���.E� zN�s
If you have more than on� locatlon/suthor(zed selE�r that wlll seMce a can�ract awarded under this Proposal invitation,
pfease IisC eaeh locatton/authorl�ed seller below. If addEtional sheets ara requkr�d, please dupticate this form as necessary.
IVOT�: Auu�rd�d V�nd�r� �h�11 remain respoi�slbl� for all �spec�s af �h� Cor�tr�act, includir�g processfn� oF Pu�chase Or�l�rs,
�nd s�alf be responsibfe for fk�e perFormance of all lacatlans and autllarlxed sell�rs under and in accordance wi�h the
Contrac�. If you are a product manufa�urer and w�§h ia designate [7�sfgnated Dealers as det�nsd in �he G�r��ral �"errns
and Conditior�s to rec�ivs Cooperative m�mber P�rchase Orders on ytiur b�half, you must complet� the Manufacturer
Deslgnated i7ealer farm.
Dealers E�ec�r�cal �upp�y
C:ampany Name
213 Gun#her Lane
Address
Belle Chasse LA 70037-3157
--- - -- -- -
ciky State zf�r
50�w684-8�47 5�4-���-874�
Phona Piumber Fax Number
Joe Duke or Daryl Donaldson 254-756-725� ext.260
�ontach Rersan
Dealers Electrica! Supply
�ompany f�ame
2�4 N, Cedar St.
A�dr�s
Borger
ci�y
806�274-442�
T'X
s�a�e
806�274-4422
%900`%--4026
zip
Phorie Numb�r Fax I�umber
Linda� Wat�an or Daryi Donaldson 254�-756-7251 ext.260
CantacC pers�n
Page 18 of 69
Proposal Fotrns CONST v.Dl.i.2.2418
; �����1°
&°ara�reraefive f'rrr�laaslnp
i2407 ktesp�rch Souievard • Austln, 7e�cas 78759-2439 • pM: 84fl�95»2919 • FA?(; 8pp-�1X�5454 •�,�yi ��or'r
L,.. , ATT„ I R ER LYSTTroGS
O G, � �. o� N��.��,.A U'T � 0�„„�„�,i Z E� S E,���������..,.�.��
If yau have more �han one IocakionJauthorlaed sall�r that wfli servlce a cantract award�d under this Proposal Ynvitat[an,
plea�e li� each location/aut�arixed sefler b�law. If addikfonai sheets are r�quired, please dupl�cate thls form as �et�ss�ry,
1���'�: �I+�ards�l ll�ndors �hall remain r�sponslbfe Par �II aspecks a� the Contract, fncfuding prooessEng of �urcha�e Ord�rs,
�ru� shall b� respansible for khe perForm�nce oF al! lacations and authorixed se{Iers undar and ir► acoordence wlth the
Conrrac�. If you are a product manufacturer and wish to d�signat� Deslgnated Dealers as deflnec! in the Ganeral Tarms
�nd CandiCaans bo recetve Cooperat�va memlaer Purchase Orders on your behal�, yau musk complel� the Manufacl,vrer
D�slgnated Deal�r �orm,
DeaBers Electrical Supp��
Company Name
2000 E. Tom Green St.
�S�I'655 _...T
B�enham TX 77833-5127
� �-.... ..._..T; .T,_ ,. ,
���y sta�� ��p ,.. ,...„.,�
979-25 � -9�00 979--251-9��0
�h�n� Numb�r � ������� �^•��•��.�.�.�yW Fex Number
�rad Rohde or Daryl Donaldson 254-75�-7251 ext.260
�on�c� Person
Deafers Eiecirical �upp[y
Company Name
419 De�lwood �t.
Addr��
� rya n TX 778� 1�2544
Cl�y — - SCate � ��� Z[p
979-775��500 979-779-023�
Phone Number � Fax Num6er
IV��ke Jetty or D�ry1 Don�ld�on 254-756�725� ext.260
�vrrtacl Pe�san
Page i.8 of b9
Propnsal Forms CONsr v.oi,iz,a,p1,8
� �o�r�l �
Coapsr�lf�v� Purchasing
12p07 Research �oulsvard ' AUsI•ill� TeX�S 7$759-2439 � Pl�: $00-695�2919 � FAX; �Up-z��»5454 •�iy�
LOCAT�IANI_AUT�IQ,R�Z��? 5�,,,l.LER LISTINGS
If yau have mare khan one [ocatianjauthorfzed sel[�r t�at wlll service a con�ract awarded under this Proposal Xnvf#ation,
please IfsC each locatfon/authorized sellar belaw. IP additianal sheets are required, ple�se dupllcate this farm as neoessary,
N4TC; Awarded Vendors shall remain responslh�l� for �p aspec�s aP the C,antract, Including processing af Purchase Orders,
and shall be respansibl� for the perForm�nce of al! focations and aukhorized sellers under and in accordance wl�h the
Contrack, If you are a prpduci: manufac�urer �nd wish to designate deslgnated De�lers as deflned in the General Terms
and Cond�tions ta receive Cooperative membef Purchase Orders an yaur behal�, you must complei� the NlanuFacf�urer
D�slgn��ed De�ler form.
Dealers Electrical Supply
Company Name
1120 E. Henderson
Addrass
Cleburne TX 76031-5233
� � , ..,, „ ,..,,..�
Cl�y 5take ��
817-641-3621 817-556�0232
Phone Number Fax Number � ������
Tony Pierce or Daryl Donaldson 254-756-7251 ext.260
Contact Person
Dealers E[ecfrical Supply
Campany Name
1833 N. Padre Island Dr.
address
Corpus Chrisfi
c�ty
361-299-2222
TX
st�t�
, , ,,,,., .,,,.,,,... ,
361-299�5555
7840�-2331
z��
Phar�e Number Fax Number
Chris Anderson or Daryl Donaldson 254�756-�7251 exf.260
Contact Person
Page 18 of G9
PropoSal Forms CONST v.0'A,12,7Af.8
� ������
Cuopar�tf�r� Pyrclua8ln�
12047 R�s�earch Souie�+ard • AusUn, T�xas 7875�l-�,�439 • AH; 800-695-2919 • FAX: 800-�i.1�5454 � bl�ybn�rcj,Gom
M.l'?C�4T��NIAU"iHDRIZED ��LLER �,XSTiNGS
If you hav� more than on� locatlon/authorfzed selier t�at wi11 servica a cantrack aw�rded under this Propasai In�itakion,
pl�ase fisC each tocat[onlautharized seller b�Eow, IP additional sheeCs are raqulred, ple�se dupilcare this form as neaessary,
NCIT�. Award�� Vendors �ha}! rwtnatn re��onslbl� �ar a!1 �spects oPthe Contract, Endudir�g procassin� oP Pe�rchas� Orders,
�nd s�all he r�spansibl� for the perFormance og all iocaklons and authorized �Ilers ur�der and fn acc:ar�ance wlth the
Cantrac�, If you are a produci: manufa�rer and wish �o d�signate Des�gnated Dealers as deflned in the Gen�ral 7erm5
�nd Candltiar� to receive Coaperative m�mber Purchase Orders on yaur behalf, you must comple4e the Manufac�urer
Desfgnated Deal�r form.
D�al�r� E6ectrical �upply
Company EVame
400 N. Main
A�dr�ss
Corsicana
a�y
903-�72-� 2� 1
TX
Skal�
903-872�97�3
75110-4628
�i�
phane Nur�her �ax Mumber
B�ranch Manager or Dary! Donaidson 254-756-7�5� ext.260
ConCact Person
D�aler� Electrical Supp�y
�o�npany i�am�
2�5�0 Manana
I�ddr�s§
Dalla� 1�X 75220-1206
Gity Stat� Zlp
214-35�-5222 2� 4-35�-1 ��7
Ahone Number �ax Numbar
Rob�rt �raff or Dary� Donald�on 254�756m7251 ext.26D
Contact Person
PHge 18 of 69
Propasal Fonns GONST v.01.i2,2418
, ������ .
�oo���tfve �^ur�hs�l�r�
12007 Rese2rch Boulev�rd • Auslin, Texas �875y-2439 • pH: 800-&95��97.9 • FAX: B44�21�-5454 •�iybo m
LO�A7�4�N/A4JTN�ORIZ�D �ELLER L,�STTNG�
If you have more than one loeatlonjauChorEzed self�r th�C wtll �eivlce a contract awarded und�r this Proposal invita�lon,
please IIsC each iocatfanlaut,�orized seller b�low. YP additlanal sheets a� requirad, please duplkcaCe thls farm as neaessary,
fVU'��; �ward�d V�nclors sh�tE r�main responsl�le far ali aspec�s af the Cor�tra�, inelrading proc�essin� a� Purch�s� Qrd�rs,
and sfi�all b� responsible for �ha perFarmance of all �ocatlons and auChnrized seller� under and ii� accordance wlth the
ContraeC, z� you are a pradueL' manu�acturer and wvish to d�.signate l]es�gnakQd De�{ers as deflned in th� C,eneral Terms
and Cptrditlons tio receivs Caoper��lve member Purchase Orders an your behalP, you must complets the Manuf�cturer
Deslgn�ted Dealer farm.
De�lers IElectr�cal Supply
Company 9Uame
716 E. Hickory
Address
Denton TX 76245-4302
ciry Stak� Zip
�0�-566-3515 9�0�566-5645
Phone iVumher Fax Number
Kim 'Troth or Qaryl Donaldson 25�-756-7251 ext.260
CantacE Persan
Dealers Electrical Supply
Comp�ny Name
5500 Havana St. Suite B
Adciress
Denver
Clty
303-592-2�00
GO
���
303-592-2�06
�0239
Zip
Ahone Number Fax �lutnber
Larry Vieth or Daryl Donaldson 25��756�7251 e�.26D
Can�ac� Persan
Paga ia of 69
Propos�l Polms CONSF vAi.i2,2p�,$
� ������
�'arr�aer�ti�g N'ur�fi�in8
3.2007 Researd� Baul�rard • Austir�, Texas 787S9�Z434 • PH: 8p0-695»29i4 • FAX; �30Q-z11�545� •,��a ,,�p�,
L�CATZt1N IAUTHOR�ZED SELLER �.xSTZiVG�
If you ha�e more than one IocaCion/aut�orized self�r that wlll servlce a c�ntract awarded under this Propasal In�itation,
please list each foc�tion/au�horize� seller below. If additlonal shee� a� r�quir�d, p�ea� dupiiGate thls form as neeessary.
NC]T�a l�v��rded Venclr�r� sha!! remain re�ponslla�� for ��i asp�cks af �e Gontra�k, (ncludir�j pracessin� at pur�ha�e Onder�,
and shall be r�spansible for the perForm�n�e of ail iocakions and autharized sellers und�r and in aocordance �ith the
Contra�C. xf you are a�rpduc� manuPa�turer and wEsh to designate pesignated Dealers as deflned in the General Terms
�nci Conditlons t.� recei�e Cooperative member Purchase Orders on yo�r behalf, you must cornplete the Mar�ufa�turer
peslgna�d l�eal�r f�rm.
Deal�r� Electrical Supply
G4mpany 1Varne
� 107 S. C�dar Ridge Dr.
Addr�ss
Duncan�ille TX 75137-3070
, -- - _. .. -
aty st�� �p
972-709�0025 972-709-4654
Phane Number Fax Number
Mike Dandridge or Daryl Donald�on 254-756-7251 ext.260
ConkacC PErson
D�a�er� Elec�rical Supply
Company Name
15 W. �Irr� St.
��a����
Durant
Clty
580-924-2464
OK
��
5�0-920-0322
7��0�-�� 05
Z[p
Phone Number �ax Numb�r
�Il�n �ailey or D��I Dona#ds�n 254�756--7251 �xt.260
Canract P�r�an
Page ii� oi 69
Propagal f�aryns �ON5T v.D112,2018
� ������
�ioparaPfv� Par�iaaaln�
12007 Researcn 8aul�vard � Aus�ln, i'ek�s 78759-2439 • Pl-I: 800�95��9�.9 • FAX; $�0,2�.x�5454 ��iUy�� d cpm
LOCATIONIAUTHORrZEQ S�LLER LISTiN�S
if you har�e more than one locatEon/aUtharized selfer that will service a contra� awarded under ihis Proposel Ynvitation,
pl�a�e lfst eaCh lacatEonjauthOP(�ed 5ellel' belOw. iP add(tional sheet� are requlred, please duplieate this form as necessary.
P�Q`CC� I�ward�.d V�ndors sha11 rem�in re�ponsibl� for aR �specCs af the ConYrack, InGlud�ng �raae�sin� pf Purch��e Ord�rs,
and shal� b� r�ponsfbis fpr ti�e p�rFormante of all facations a�d autharl�d seliers urrder and in acmrdanc� with the
Contr�C, XP yau ar� a producC manul�cCurar and wish to daslgnate Designa�d Dealers as deflned ir� the General Terms
�nd C�ndltions to receive Caopera�ive member Purchase Orders on your behalf, you must cornplete the Maroufacturer
Deslgnated Dealer inrm,
Dealers Elec�rical 5upply
�ompany 1Vams -- . — - y—�-
1050 Kastrin 5�.
Adaress
EI Paso TX 79907W1705
G�y � 5tat� �ip
9 � 5-775-970� 915-772-�4711
Phone Numbsr Fax Number
Jim Fowler or Daryl Donaldson 254-756-7251 ex#.260
Conl�ct Persor� �
Dea�ers Electrical �upp�y
Company Name
7� 3 N. Beach St.
Address �
FOr# VVorth TX 76111-5944
Clty S�ate Zip
�17-�31-�054 �� 7-83� �9738�
Phone Mum��r �ax Number
iony P�erc� or Daryl L�analdson 2�4�75��7251 �x#.260
GanYaCt Person �
Aay� 18 of 64
Pro}�as�l �o�ms C9NST v.ax.�2,2018
� ������
��oF�rative P�rr�JrB.�Bn,�
i2007 Research Souievard • Austln, Texas 78769-2439 • PHr 80D-695-2919 • FWC: 8Ua��ix�S454 ��ukt�a���J c�„nm
M�OC�i4TpNIAUTHDRiZED SELLER LZSTTIVG�
IF you h�v� more �han or�� faCation/authorfzed self�r that will servlce a canl:�act �warcl�d under this Praposal Invikation,
pl�ase IisC each locationJaukhorix�d selier below. IP �ddiCional sheets ara r�qulred, please duplicate this form as neaessary.
NQT'�: A�w�rd�d Vendars sha�l ��matn respanslble fi�r all aspec�s �g the Contra�C, fnc�uding procs�sin� pf Purchase Orders,
and s�+a11 be responsible for i�ie per�orm�noe of all tocatlons and aut�QrPz�d seli�rs undar and fn a�aordance wlth the
ConkracC. If you are a product manufacturer and wish �o designate I]es�gnaf�d De�fers as detined in the General Terms
�nd Conditio�s Co r�ce{va Coopera�ive member Purchase Orders on yo�ar b�half, you tnust oornplei�a the Man�fi�ctur�r
DesignaCed Dealer farm.
Dea�er� El+�ctrical Supply
Cpmpany N�me
� 00 Madison �aks A�e.
Address
Georgetown TX 78626-7835
�ry --- --- -- �at� �ip
512-763-�000 5� 2-7fi3-�60�
�hQne idumber Fax Idumhsr
Terry Pigg or Daryl Donaldson 254�-i5G-7251 ext.260
Conl�ct Person
Dealers Electrical Supply
Company Name
200Q S. Great Svuthwest Pkwy
�1ddr��� r - - w - —
Grand Prairf� TX i5D51-350i
Cl�y 5tate �Ip
972-206��725 972-206-�717
Phone Numher Fax Num�er
��n G�ile�pi� or Daryl Dona�ds�n 254-75��725� ext.260
Cantact �'erson
Page 18 of 69
Proposal r-arms CONSr v.o�.�2,2a1.8
� ������
�acip�gdflr� p'urclla�f��
12007 f�ese�rch Boult�rard � AusLin, Texas 7B7S9-��39 � PH: SOp-�95»�91.9 • F,4�; �00-��.x»5454 ��i y�c�
�.C)C/�T�d)N�A�iTHQ�t,�Z�D SELLER L�STINGS
If yau �a�e mare than an� [�catlonJautharfzed seller that wlll servlce a contract awarcled unde� this Propasel Invitatian,
please Iist each IocationJautharlaed s�lle� bel�w. Xf addition�l sheets ar� r�qulred, pk��se duplicake this form as necessary.
N9T�: �wardsd Ven�ors shall re�afn respansl�►lm for all aspeccts af the Corrtract, fncl�dir� processing of Purcha�� Order�,
�nd shall t� responsible for 1he performance o� all locakions and authorlxed sellers und�r and in a�cordanr.� with �h�
ContracC. If yau are a praduct manufacturer and wlsh to deslgnate I�eslgnabed Dealers as defined 1n the Gen�r�l Terms
and �onditlans to reaei�e Cooperative member P�srchase Orders on your behaff, yau must camplel� the Manufacturer
Daslgnat�d D�aler Form.
Deai�rs Electrica{ Supp�y
Company N�ame
2629 Traders Rd.
Addr�s�
Green�ille
ary
903-454-3a73
TX
5tate
903-�54�3743
7540'�
x��
phQne Number Fax Number
T�a�is Morrison or Daryl Donaidson 254-756-i25 � ext.2fia
ConCac� Person
Deale�s Elecfrical Supply
Company Name
402 I�orth T. St.
Addr��� �
Harlingen TX 78550-so11
Gl�j+
956�-425-8690
S�ate
95�-425-8798
2ip
Ph�ne Number �ax Number �
C�r��ndo �ruz or Daryl Don�ld�on 254��?56-7251 �xt.260
Con�acl' P�rson
Paga in of Gl
Prnpaqal Porms CdNST v.A1.i2.�018
� ������
4""�npaa�tfs►e P+ffrX�#ra�dn�p
12007 FtQsearch soulevard • Austin, Texas 78759-2439 • PH: 8p0-696�2919 � FAX; 8��-zii»5454 ��yy�tJ,,��
LO�ATiON AUTHORTZ�,LLER,�LTS,TZ,NGS
If y�u have more rhan ane locatipn/authorized seller tiF�at wtll service � cnntract atuard�d under t}�is Praposal Inuitation,
please Ifs� each locatianJaukhorEzed seller below. If additlonal sheeC� ara r�qulred, please duplicate this form a,s necessary.
NC��'�; �tw�rdsd Vendors shafi rem�in resporrsfbf� for al! as�,ecks aP the Cantracr, lncfuding processfng aF Purchaye �rder�,
�nd shall be responslble for the p�rFormar�c�: aP all locatlor�s and authoriz�cl sellers under and in acoordanee with tha
Contract, xf you arc� a prpducL- manufactur�r and wish to designate Designa��d pealers as deflned in the C�ener�l Terms
and CondEtlans ta receive Cnoperative m�mber Purchas� Orders pn your behalf, ypu must cor�plete the Manufacturer
Desfgnated Dealer farm.
Dealers Electrica[ Supply
�ompany Name
4433 Airline Dr,
Address
HOI�S�On TX 77022-2927
�ky - State ��p �'T
i13-691-�521 77 3-694tl4535
..___ , .. ,..., ,.,..,..,,.....,,,,_. ....�
Phone Numbar Fax Number
Danny Majors or Daryl Donaldson 254-756-7251 ext.260
Conl�ct Person
Dealers Electrical Supply
Comparry Nam�
5220 Old Gal�eston Rd.
�tddr�ss
Houston
,, ,, ,,,,,,, ,,,,,,,,,,,,,,,,,,.�
c�tv
713-944-3098
TX
sr;��
713-944T4387
i7017-�6146
zi�
Phone Numb�r Fax Number
D�nni� Sirro� or Daryl Donaldson 254�756-72�1 �x#.260
Cantact P�rso�
Page 18 of &9
Propasal frolrns CONST v.U1..12,2018
� ������
Cnr�p�rsFiv� 1'iirc�as►nPd
i2p47 ttesearch soulev�rd * Aus�Jn, �e�cas 78759-2h39 • PH; 800-6�5-�9].9 • FAf(; 80U-2�X�5454 •�uy����� Cnr�
�C��ATTONI�AUTH�RIZED SELLER �,�STIM��
If you hava more tJ�an on� lacationJauthorized selier that wlll servlce a contra�t awarded under �his Proposal �nvitatlon,
please lfst each focattonfautharizsd se11�r belaw. Y� addit�on�i sheets ar� required, ple�se dupllC�ke t�ls forEn as netessary.
Ndl'�� /�w�rc�e� llendors shali remaln responsibl� for �!! aspecks af #�e Contr�c�, fncludir� processinc� of Purchase Drders,
and shall b� respanslble for tha perfarmance o� aIE locatlons and autharixed sellers un�er and in ac,�ardence with the
Contr�ct. IP yat� �re a producl man�faGtur�r �nd wish �o design�te �esignai�ed Deaier� as defined in the General Terms
a1tc1 Canditlons ta reeeive Coapera�ive tnember Purcha5� Order� on your behal�, yo� mu5t complete the Manufa��r�r
oesignated Q�al�r fnrm.
Dealers E�ectrical Supply
Company Name
383� Conflans Rd.
Addr�ss
lrving
c;ty
972-790-700a
TX
5ta��
972�9�6�2107
75061 �3914
�ip
phan� I�umbe�' Fax Number
IVathan Schartz or Daryl Dona�dson 254-756-725� ext.260
GnnY�ac� Person
D�alers Electrical Supply
Campany Name
428 Schreiner St.
ldtlr�5
Kerrville
citiy
830-896-0555
TX
s�t�
$30-$96-7137
7802�-4470
z�p
P1�on� �fumb�r �ax Plumb�r
Robert Zub��bu�ler � or Daryl Dona�dson 254-756�7251 ext.2fi0
Contact; persan
P�ge 18 af G9
Propo5�1 Fom1s CONST v.O1.L2,2018
� ������
�or�wrati�� l�urck�►ng
12007 Resear� �oule+rard • Austfn, Texas 78759�2439 � PH: 804-695�2919 • F,N(; a04-211-5954 •�y r�d,,�
Lo�►�rzoNlAv�r�o�z� S�r.��� LrsTx�v��
lf yau �►ave more than one iocaCEonJauthorlxed sel[er that will servlce � cantract awarded undar th!s Proposal Ynvikatlon,
please list each IacationJauthorized seller belaw. If addiClanai sheets �re r�quired, pEe�se dupiica�e thls farm a5 neeessary.
N{JT�: f�w�rdec� U�ndors shall remain re�ponslbl� far �!! aspeck� QP the ContraGt, Including pro�essing �f Purcf�as� �]rd�rs,
and shaff bE r$sponsCbl� for the perFormance of all tocatians and auChorized sellers und�r and in acr�rdanc� with the
Contract. If yvu are a producl: man�f�cturer and wish ta� de�gnate k7esignai�ed [3sal�rs as defined in the C,pneral Terms
�nd Condltions to reaeiv� Caop�r�h�ve member Pur+chase Orders on your bel�al�, you must complele the Manufacturer
Deslgn�ted Daaler tnrm.
Dealers Electrical Supply
Company fVame
405 Commerce Dr.
Address
�Cilleen
C9ky
25�-62�-9002
TX
5tat�
�54�62�-046�
76543-4037
�p
�hona Numbsr Pax Number
Scott Weddle or Daryl Donaldson 254�756-7251 ext.260
ConYacC Person
Dealers Electrical Supply
�omparry Name
1 �44-A West Amador Ave.
l�tldr�ss
Las Cruces
���v ----
575-526�4014
��
s�te
575-�526-4149
::11 �11'
Zip
Phorye Number Fax lVumber
Pe�e Hernande� or Darya Donald�on 254-756�7251 ext.260
Cor�act �erson
Poge 18 of 64
Propasa� Ponns CONST v,01.i2.24i8
� ������
�aaj�erst3de Pur�lanalr�
12Q07 Resear�h Boulevard ' AUs1,i�� 7'ex"d5 7$759-�439 • AM: 8Q0-69S-�91.9 • FAX; SbU�Z�.x»5454 • b Dm
. T�ONIAUTH,C}RTZED SE„LL�p� L�STiNGS
__O C A , �.�_,�
If you have mare than bne lQcatian/authorized ssller that wil� servlce a contr��t awarded under this Proposal Invikatian,
pl�ase lis� each focationJaukhorized sell�r belc�w. Yf addf4ia��l sheets are requlred, pl�a� du�llcate this form as necessary.
ND7'�: /�warr�ed �endar� sh�ll remain respans9ble for a�� as�O�cY� ai' the Csncra�, induding proeessin� aP Pur�ha�� {)r�ders,
�nd shaq be r�spansible �or the pexfiorm�nce of all locakions and authorlx�ci sel�ers under and ln acCordance with the
Contrack. Xf you are a praduct manufackure� �nd wlsh to des�gnate I�esEgna�ed De�lers as defined in the General Terms
and CandltlQns ho recetv� Cooperative m�mber Purchase Drders vn your behal�, Yau musk oomple�a the Manufackurer
Deslgnakad Dealer fnrm.
D�a��rs Electric�l Supp�y
Company Name
349 W. Cotton
Addr�ss _._.- -
Longrriew iX 75606-6223
�_� ....�� �--- _
C9tY StatQ Zip
903-�75�-3�1 i 903-236-3� 54
_ . , , ,.,...__._,._..__.,
Phone iVumbe� ... � ����_—�—�.�..�—. �ax Number �
Ste�e Hicks or Daryl Donaldson 254-756µ7251 ext.260
Contac� p�rson
Dealers Electric�l Supply
C.amPany Narrje
401 Atkinson Dr.
Addr�§
Lufkin
TX
s�e T�
759Q1-3155
c�ty
936-634-5591
936-639-3�67
�P
PhonQ Number ��x Number ���
Ju�tin �ipp or Da�l Donald�on 254-75�-7251 ext.260
Cantack Person
Page 18 of 69
Pro�iusal Fohns CoIdST v.ol.i2,?A18
� ������
�aD�ar�raRtv� l�urclx�fn�
12007 Research soulevard • Auslin, "iexas 787��•2h39 � pFt: 80Q-695»2919 • FAX: SQQ-Z11�595� '�laY6?n..�€'{�,Com
.�„ �
LOC��►T�tyN/A�THO�IZEb SELLER �.XSTINCS
If yau hava mvre than or�� lo�attor�J�t�thorized seller that wlll servlce � cor�ract awarded under thls Proposal znvitatlon,
please lis� each focationJauthorixed seller below, �P additlon�l s�ee�s are requlred, ple�s� dupl9cake thls form as neoessary.
N�T�: Awarded 1lendors shali remain re�panslbi� f�ar all aspects oPthe G�ntra�, �ncluding processfn� of P�rchase Ord�r�,
�nd sfi�all be responsibfs fo� the p�rfarma�tce vf ail �ocaklons and autil�or9zed sellers under and in aacard$nc;� with ifi�e
Con�ract, If you ar� a p�aduct manuf�ct�rer �nd wish to d�s�gr�ate pesigna#ed []ealers as deflne� in the Gener�i T�rms
and Conditiona ho r�ceiv� CooperakEve member Purchase Dr��rs an yvur bef�alf, yau must camplei�e the Manufae�urer
Deslgna�d Daai�r form.
Dealers Electricaf Supply
Company Name
2709 Commerce St.
Address
Marble Falls TX 78654-392�
, _ -�-- — -__ --
Clty �� �P
8�0-693-919� �30-79�-� 00�
�hon� Numher F�x Number
Tim Phillips or Daryl Donaldson 254�756-7251 ext.260
Cor�ka�C P�rsan
Dealers Electrical Supply
Company IVam�
506 VV. Houston
�aa�:�
Marshall
city -- -
903-935-7865
IDfX
SCa�
903-935-9873
75�70-3933
z�p
Ph�ne {�umber rax 9�umber
John Taylar �r Dar�l Dona�dson 2�4-756-72�� �xt.260
Cantaci �ersvn
Pag� 18 oF b9
Proposai r•arms �or�sr v.oi.i2,aa�.s
� ������
�u�rsr�Five Purch�d��
120p7 �tese�rr�h Saule�rard • Austinr Texas 78759-�439 • PH: 8p�-895-293.9 � FI�(; �q0-�i.X�5454 • b.uY���,�rd.�4rrt
�.�}GAT�ON]A41TH_QRiZE� LLE1� �.YST�NGiS
zf you I�aue rr+ore than otte focaCionJauthorized sel[er that �viE! servlca a cantr�ct award�d under this Praposal Ynvitation,
please lis� each IpcativnJauthori�ed seller belaw. Xf additianaf she�s are required, please dupilcate this farm as necessary.
hIC�T�: �tward�d �lendar� �ha�i remain respor�sll�i� for all aspects a�#he Contra�t, fncluding processEn� of Pui'chase Drders,
�n� sha[I be �spons[ble for the psrFarm�nce aF all locatlons and authorix�ci sellers under and in acaordanca with the
ContracC. zf you are a pro�ucC manufacl'urer �nd wish ta des�gnate pesignated Dealers as de�ned in the Gene�al T�rms
�ncf Conditlons to reoeiue Cooperaklve member Purchase Orders pn your behalf, you r�u5t complete the ManufactUr�r
DesignaCed ��aler form.
Deaiers IElec�rica� Supply
Company Name
1401 Upas A�e.
Aadress ---
McAllen
a�y
956-630-2233
TX
State
''r�'1 :�1
7850�-5546
Zip
Ph�ne N�mbsr Fax t�umber
Ric �livarez or Da�yl Donaldson 254-756-7251 ext.260
Can�acC Porsan
Dealers Electrical Supply
Company I�ame
1400 N. Main St.
�tddr�ss
Muskogee
C1tar
918-683-50Oa
OK
srate
918-683-3035
74401-4445
Zip
Phone fVumb�r Fax lVumber
���rey Merr�ll or Dary� Donald�on 254-756-7251 eact.26�
C.��tact Persan
Aage 18 of G9
Prnuaeal Porms CQId5T v.01.L2.2018
� ������
4'so��PaPfve Purcht�afn,g
12007 Rese�rch Boulevard • A�slin, Texas 78759-��139 • Pi-I: 800-695»�9i9 • FAX; BOQ-Z�.X�5454 •�I�vbc�ard.cam
LOCATIQNIAU7HO,�tiZED �E,LLE1� LXSTTN�S
If you hav� more than an� [�cationJauthorfzed sell�r that wili service a contra� avu�rd�d under this Praposal InvEta�Ion,
�lease list each lacation/authorized sell�r bel�v�t. If addltion�l sheets are requlr�d, please dup�icat� this form as necessary.
�I(3T�: 1�+��rd�c1 V�nd�r� �h�ll E-�main respons�hle for at{ asp�ch5 af the Comcrac�, IncEudirx� proressinp �F Purci�ase Qrd�r�,
�nd si�all be responsible for tha petfiormance of all Iocatlons and aut�orized s�iEers under and 1n acCordance wlth the
Cont��c�, xf you are a product r�anufackurer �nd wish to �eslgnate 17esEgna�ed D�lers as d�flned in the General Terms
an� �vndltlons �o receive Cqoperative member Purchase Orders vn yflur behaff, you must complebe the ManuPactu�r
Q�signaked Deafer farm.
Dealers Electrical Supply
Company Nam�
2400 Vllest 42nd St.
Addresa
Odessa TX 79764-6309
Cliy._._�....�,m.. .mm S�at� �ip
4�2w368-558� 432-36�-4833
P�ane Number Fax Mumber
Dil�an Beck o� Daryl Don�ldson 254-75G-7251 ext.260
Contac� Persan
Dealers Electrical Supply
fiompany I��me
8500 VII. Reno Ave.
Adar�
�kRahoma City �K
c��y ...,...� s�a�
405-�78�-0400
405-782-0404
73� 27-2952
z�p
Phone Number Fax Number
�t�ve Strozie� o� Daryl Donaldson 254-756-725� �xt.2�0
�an�ac�: ��rsnn
Page 18 of $9
Proposal Pomas CONST v.o1.12,7A18
� ������
Cooperaifve PershAsing
1�007 Researcl7 �oulevard • Auskl��� 7exas 78759�2439 • PM; 80b-695-2919 � FAX; saa•Z1�i�s454 •},��.�y�,�,oard.cnrn
LOCAT�C3N AUT�IORTZEp S�LLER, LiSTTNG'i5e
If you have more khan ane [ocation/aukhor[zed seller that wili service a contra�.t awarded under this Proposal Invitarion,
please Ifs� each Eocation/authorized seller b�l�w. I� addikfohal sheets are required, ple�se d�pilcate this form �s necessary,
h�OT�: Awarded Vendors shall remain respons3ble for all aspacks of the Contract, incfuding processing of Purchase Orders,
�n� shall be responsible for the perFormance oF all focatlons and autharized sellera under and ih acaardance with khe
ConCrac�. If you are a produc� manufacturei� and wis� to dasignate aesEgnated De�l�rs as defined in the G�n�ral Tertns
and Conditions to rec.ei�e Coopera�i�e m�mber Purchase Orders on yow� hehalf, you must completa the Manufacturer
Deslgnaked Dealer form.
Dealers E�ectrica! Supply
Company Name
2230 W. Reagan St.
Ad d ress
Palestine
city
903-729-3205
�r:�
State
903-723-3691
75801-2247
�ip
Phone Number �ax Numher
Ricky Floyd or Daryl Donaldson 254-756-725� ext.260
Cont�et P�rson
Dealers Electrical Supply
Company 1Vame
3430 Pine Mill Rd.
�ddr��s
Paris
TX
75460-4939
, , ...,,,.. -- _ _ . .
Clty S�ate Zf p
903-784-001 � 903-784-6619
Phone Nu , .�..,� ...... ........... � , ,.�
�mber �ax Number
Chris Wear or Daryl Donaldson 254-756�7'251 ext.260
Conta�t f�erson
Page 18 of 84
ProryaSal Farms CUN5T v.01.i2,2618
� �o�rd �
cnaye,ratfve P'ursh�.vfnp
12007 Rese�rch �oul�vard • Auslin, T2x�s 78759-2439 • PM; 840-fi95�2919 � FAX; Bfl4-2��,�5454 • boa
Lt].CATTON�_144JTHO,RT��p S�,LLER �,TST„�,l,,,,,NGS
Ifi yau have more than dn� [acatfdn/auGhorfzed sell�r that wll) servlce a contract awarded under this Proposal In�itation,
please lis� each locationlauthorixed seller below. I� additfonal sheets are requlred, pleas� duplicate this form as necessary,
NO7C; Awardad Vendars shall remain responslble for �I! asp�Cs of' the Contra�, fncluding processing of Purchase Orders,
�nd shaU be responsible for the per�ormance of all focatlons and aurhorized sellers under and in accordance with t�e
Contract. �F you are a prpduct manufacturer and wish to d�.signate aesignatsd Dealers as defilned in the General Terms
�nd Conditions ta recef�e Cooperative member PurcMase Orciers on your behalf, you rt�ust complete the ManufaCturer
Designat�d D�afer farm.
Dealers Electrical Supply
Company Name
91 � J. Place
Address
Plano
Ciky
972-422-2720
TX
Skate
972-422-0472
75074-8536
zip
Phone hlumbsr ����.�.��.�....�_._�� ' �ax Number �
Roger Miller or Daryl Donaldson 254-75fi-7251 ext.2B0
Cont�ct Person
Dealers Electrical Supply
Compahy Nama
928 N. Federal Bl�d.
Address
Ri�erton
cicy
307-85G-174'f
VVY
s��t�
307-856-9185
82501
Zip
Phone Number Fax Numb�r
Josh Saltsga�er or Dary� Donaldson 254-i56-725� ext.26D
Contact Person
Page iB of 69
Prauasal frorms CDNST v.a1.12.7A18
� �o�r�l �
Cauparative PrrrchasPn�
12007 Research Boulevard � Auskin, 'ieK�s 78759�2439 • PH; 844-695�2919 � FAX; B00-211-545�4 ��yi b �i
L_OCAT�ONIAiJTHORTZEp ��,,,LLER �.iSTI„NGS
If you have mare than an� [ocattonJauthorized seE[er that v�rlll service a cantract awarded under this �roposal �rivitatlon,
please lis� each locatfan/authorized seller below. �F additfanal sheets are requlr��, please dupllca�e this form as necessary.
NQT�; Awarded Vendars shall rem�in r�sponslhle far ali aspec�s pF th� Contrac�, Including pracassin� of Purthase Orders,
and shall be respbnsibl� for the pertormance pf all Eocakions and authorized selfers under and in ac�ardance with the
Cantrack. If you are a product manufacturer �nd wish i:o des�gnate Designated Dealers as dafln�d in tha General Terms
and Conditians to receive Cooperaklva member Purchase Orders on your behalP, you musk completa the Manuf�cturer
Designated Deal�r for�n.
Dealers Electrical Supply
Company Name
2400 Freedom St.
Address � �
San Antonio TX 78217-4423
Clty state Zip
210-828-9995 2 � 0-828-0701
g��na iVumb�r T� Fax Number �
Daryl Donaldson 254-756-7251 ext.260
Conkact Persan
Dealers Electrical Supply
Company Nam�
8786 Timber Path
A�a�$
San Anton[o TX 78250-43�4
Clty 5rak� Zf p
2� 0-520-3397 21 D-52Q-3950
Rhone N�m�er ��x Number
Daryl Donaldson 254-756�725� ext.26D
Car�tact Person
Page 18 of G9
AYopa9dl FOYms CON5T vA1.17.,7,p1.8
� ������
l:�o��ilwe l�urchs�sdn�
120Q7 Research �oulevard • Ausi�n� Texa� 78'759•2439 • pH: SUO-695�2�19 ��AfL� 8d0-21].�5454 • bu�pn�r ��m
LO�AT�QNIAU'iHi�RiZ�D SELL�R L�.ST�NGS
1f yau hav� more than on� Ioca�lanJ�utharized sei[�r �at wili servlce a cantract awarded under this Pro�osa! Invfkation,
ple�se Ifs� �ach IocaCionJauthorized seller be�ow. if �dditlonai she�s are r�quired, please dtrpllcare this form as ner.essary.
IV[�T�: Av���sd Vendar� �h�fi remain respon�lbla for �ll �sp�ks of the ContracC, including processfn� oF purcha�e Ord�rs,
and sh�ll be respansible for tiie p�rform�noe of a�f Icxati�as an� authorixa� sellers und�r and 9n acGardance wlth the
Con�ra�t. xf yau ar� a praduct m�nufacturer and wish i.o designate De�ignatad Dealers as defined in the General Terms
and Condltions tio receiva Coaperarive member Purchase Orders on yaur behalf, You mu5t c.trmPlet:e the Manufacturer
De�lgnat�d De�ler fnrm,
Dealers E�ectricai Supp6y
Gompany Name
616 Texas A�e.
Address
San Marcos
Cltiy
512-396-54�54
TX
Stat�
5'! 2-396-545i
7ssss-5zoo
�
Phone Numb�r Fax Number
Branch Manager or Daryl Dona�dson 254-755-7251 ext.260
Contac� P�rs�n
Dealers Electrica! Supply
Company Name
2�15 industrial Rd.
l�Idress
�anta Fe
City
505-47� -2i 31
NM
5ta1�e
�05-471-2192
87507-3119
Zip
Phone i�umber �� �ax Alumber
� C Ratka or �3�ryl Donal��on 254-756-7251 ext.260
Cotrtact Person
P��g418 of 69
Propasak I'otms GONST v.41.12,201$
� ������
Caop�ratirre Purahasla�
12007 Research Soule�ard • A�sl1n, Tex�s 78759�2439 � PM: 800-895�29].9 • FAX; a0D�2i,1»5�}5� •�y�4,�.com
LQCIo►TI�N AilT�iOR�ZED SEI.LER LISTTNGS
Ifi yau have mare than or�e lQcaCfonJau�horized seller that wlll servlce a contrac� awarded under th9s Proposal Znvitatlon,
please lis� each IocatlonJauthorized seller below. If addltEo�al sheets are required, please dupl;cate this form as necessary.
NOTC: Awardsd 1lendors shall remain responslbl� for all aspeck� of the Cantract, fncluding prooessing oF Purchase Orders,
�nd shall b� responsible for the performan�e of all facations and au�horiz�d seller� under and in accordanc� with th�
Contract. zf you are a product manufacture�• �nd wish ta d�signate pesignated De�lers as defined in the General Terms
and Conditions to receivs CooperaEive m�mber Purchase (lydsrs on your behalf, you musC complei�e th� M�n�tfacturer
Desfgnaked Dealer form.
Dealers Electrical Supply
Campany Name
1616 Baker Rd.
Address
Sherman
aty
9Q3�893� 1177
TX
State
903-893-7536
75Q90-2143
�
Phone Number Fax IVumber
Glenn Vllaldrum or Daryl Donaldson 254�756�7251 ext.260
Contac� P�rson
Dea�ers Elecfrical Supply
Gompany iVame
12730 Sugar Ridge Bl�d.
Address
Stafford
�itv
281-933-0797
TX
st�t� -- -- -
281-933-9529
i7477-3118
ZIp „, , ,,,,,,,,,,, ,_
Phone Number Fax hfumber
Joe Webber or Daryl Donaldson 254-756-7251 ext.260
Contact person
Page iQ of 69
Propasal Forms GONST v.01.17.,2018
� ��r�r��
�aal�arstfve Nrrrchasln�
i2007 Res�arch Soulevard • Auslin, Texas 78759���139 • PFI: B00-695�29].9 • F�J(; 500-2i.1-5454 • b�yj�, rd.cum
LOC14T�t�N /AUTHO,R��ED S�,LLER LxSTI,NGS
Tf you have more tihan one IacationJauthoriz�d selEer that uvill service a contract awarded under khis Pra�osal Ynv[tatifln,
please Ifst each IocakianJaukhorized seller below, XP �dditiona] sheets are required, please duplicake this form as necessary,
NOT�: Awarded Vendars shail remain responsihle for all aspects of the Contract, Including processfn� oF Purchase prders,
and shall be responsible far the performance oP all locations and autharfzed sellers under and in accordanc� with the
ContracC, zfi yau �re a praducl• manufaeturer �nd wish �o deslgnate pesignated Dealers as d�flned in the Gen�ral Tarms
and Conditlons to receive Cooperative me�nber Purchas� Orders on your behal�, you must cflmplei� the Manufacturer
[]esignated Aealer fiorm.
Dealers E[ectrical Supply
�ompany Name • T �
555 South Hillcrest Dr.
Address
Sulphur Springs
c�ry
903-438-2222
TX
Skake
903-438-4545
75482-3601
Zip
Phone Number Fax Number
Travis Morrison or Daryl Donaldson 254-756-7251 ext.260
ConYact P�rsfln
Dealers Electrical Supply
Company Name
4013 Bell Dr.
Addr�ss
Temple TX 76502�4841
Clty Srate `__ �Ip �.,._
254-773-5271 254-770-0380
Phone Number ��x I�urr�ber
Scott Weddfe or Daryl Donaldson 254-756-7251 ext.260
Contact person
Page 18 of 69
Proposal Forms CONST v.01.12,241.8
� ������
Cao►ysr�tfve Parsha�l�p�
12007 R�search Roulevard • AusCin, Texas 78759-2439 � PH; 9q0-695»?919 • FAX; �Dq-Zi,1-5454 �.�iy�� {y,�,�
_ / __ �,��,._ „� , 1� �. I S T I N G S
O C A.T I O_N A iJ T H O R I Z� p S� L,,,L E�,.,,__., �
If you ha�e more than one [ocatfon/authorized sell�r that wfll service a contract awarded under this Prapps�l Invitat[on,
please lis� eaGh IocatfonJauthorized seller be�ow. If additlanal sh�ets are required, please duplicate this form as necEss�ry.
NOTE; Awar�ed Vendors shall remain responslble for all asp�cts a� the Contrac�, 1nCluding processln� of Purchase drders,
�nd shall be respans[ble far �he performance o� all locatians and authorized sellers undei� and in acaordance with the
Contract, IP you are a product manufat�urer and wish to designate ❑esignatsd Dealers as deflned in the General Terms
�nd Condit�ons to receiv� Cooperative member Purchase Order� pn your behalF, you must complete the Manu��cturer
Resignated Dealer form.
Dealers Electrical Supply
Company Name
1804 Waterall
Address
Texarkana TX 75501 T3639
City � Stat� z�p ."
903-794-3596 903-792-4820
Phone Number F�x Number m�
�larty Long or Daryl Donaldson 254-756-7251 ext.260
Gon�acC Person
Dealers Electrical Supply
Company Name
6920 E. 13th St.
Addr�ss
Tulsa
C1ty
918�835�7672
OK
SEate
915-835-0583
74112-5616
Zlp �
Phone Numb�r Fax Number T� ���..��.- �r
Charles Collins or Daryl Donaldson 254-756-7251 ext.260
Contaci� Person
Page 18 of 69
Proposal 1'vrms CoNST u�i.12.2018
� ������
CuopsralfVe 1"urcb�Irrg
12p07 Ftesearch Boul�vard • Austin, Texas 78759-2h39 � pM; n44-fi95�2�19 • FAX; a0D-211�5954 ��y o 0
M�oc�ariory IAvr��Rzz�q 5�,,,�„�,ER M..ISTTNGS„
If you have mare khan one location/authorfaed sel[er that wdl servfce a cantract awarded under this Praposal �nvita�iort,
please Ifst esch lacationjauthorized seller beEuw. If additional sheets are requlred, please duplicate thi� form as necessary,
h�OT�: Awardad Vendors shall remain respan�lble for all aspec�s af the Contract, Including processin� of Purchase Orders,
�nd shall be responslble for th� p�r�ormance a� all iocatlons and autharized sellers under and ln accor�anc� with the
Conkract, zf you �re a produ�l manufaeturer and wish �o des�gnate pesEgnatad Deale�s as defined in the Gen�ral �'�rtns
�nd Conditions to receive CoQperakIve member Purchase qrders on your be�alf, yau must aomplete the Nlanufacturer
Designated Dealer form.
Dealers Electrical Supply
Company Nam�
316 S. Palace A�e.
Address _ _--
Tyler TX 75702�7049
Clty State 7�p � '..
903-593-7357 9D3�593-9701
Phone Number Fax Number
Da�id Jones or Daryl Donaldson 254-756W7251 ext.260
�ontact Person
Dealers Electrical Supply
Company Name
1416 Franklin A�e.
Address
Wa co
Clty
254-756-4441
TX
State � � �.�.���....�
254-756-0316
76701-1793
�[p
phone f�umber �ax Number
Greg Bracey or Daryl Donaldson 254-756-7251 ext.26�
Contact Person
Page 18 oF fi9
Proposal Forms C6N5T u01.22,24�.8
� l�����I�
CaopBr�tfve Aurch�slnp
12007 Research Bouls�ard � Austin, Texds �875�-�439 ° PM: B00-�95�29�.9 � F,�t; a4fl-2i.1�5454 • boa • o
LDCIa►TTDN /A4JTHO,R���D SE,I,:LE� LIST,�„N,GS
If yo� have m4re than one locatfonJauthorized seller that will servlc� a contract awarded und�r this Proposal Invitat[oro,
please lis� each IocatianJauthorized s�ller belaw, If additlonal sheets are requlred, pl�as� duplicate this form as n�cessary.
NOT�: Award�d V�ndar5 5hall r�main r�sponslhle for all aspecks of the Cont�act, including processing of purchase Orders,
�nd shall be respansible for the perform�nce oP all lacations and authorized sellers under and in accordance with the
Conkract. If you are a�rod�ct manufacturer and wish to deslgnate Deslgnated Dealers as deflned in the General Terms
�nd Conditians to receiv� Coo�eraklve memb�r P�rchase Orciers on yqur behalf� you m�st Camplete the Manufacturer
Designat�d pealer farm.
Dealers Electrical Supply
Company Name
40 � 12th Street
Address ""`-'
Watford City ND 58854
Ciry 5tate Zi p
701-842-3650 701-842-3653
Phone Number � Fax Num�er
Jarrod Adams or Daryl Donaldson 254-756-7251 ext,260
Conk�cC persor�
Dealers Electrical Supply
Company Name
137� Vaughn Rd.
Addr�s
Wood Ri�er
C1ty
6 � SW258w0655
IL
SC�C�
618-258-0863
62095
'�' �'
Phone Number Fax Numb�r
Tra�is Laper or Daryl Donaldson 254-756�725� ext.260
Contact P�rson
Page 18 of 69
Propa9al FormS CDNST u.01.12,2p�.�
� Board �
Cnoperative Purchasing
120p7 Research Boulevard • Austln, 7exas 78759�2439 • PH: 800-695-2919 • FAX: 800-211-5454 � buyboard.com
MANUFACTURER DEALER DESIGNATION
If Vendor is a manufacturer that sells products through a dealer network and wishes to designate a dealer or multiple
dealers ("Designated Dealers`� to receive Cooperative member Purchase Orders on Vendor's beha[f, you must complete
this form for each dealer you wish to designate.
Regardless of any Designated Dealers submitted by Vendor, Vendor specificafly agrees and acknowledges that any such
designations are for Vendor's convenience only and shall not, if Vendor is awarded a Contract, relieve Vendor of any
obligations under t�e Contract, including payment of Cooperative service fees on all Purchase Orders submit�ed to Vendor
or any Designated Dealer. In accordance with the General Terms and Conditions, an awarded Vendor shail remain
responsible and liable for all of its obligations under the Contract and the perFormance of both Vendor and any of Vendor's
Designated Dealers under and in accordance with the Contract and remain subjeck to all remedies for default thereunder,
including, but not limited to suspension and termination of Vendor's Contrat� for nonpayment of service fees,
If awarded, Vendor authorizes t�e Cooperakive, in its sole disc�etion, to list any Vendor Designated Dealers in the BuyBoard
system and to receive Purchase Orders directly from Cooperative members on behalf of Vendor. 7o the extent a Vendor
with Designated Dealers receives a Purchase Or�er directly, it shall be the responsibility of Vendor to appropriately process
such Purchase Order in accordance with the Contract, including b�t not iimited to timely forwarding such Purchase Order to
a Designated Dealer for processing.
i'he Cooperative reserves the right, in its sole discretion, to refuse addition of, or request removal of, any Designated
Dealer, and Vendor agrees to immediately require such Designated Deaier to cease accepting Purchase Orders or otherwise
acking on Vendor's behalf under khe Contract. Further, the Cooperatl�e's administrakor shaff be authorized to remove or
suspend any or all Designated Dealers from the B�yBoard at any time in its sole �iscretion.
If you wish to designate a dealer to service a contract awarded �nder this Proposal Invitation, please list the Designated
Dealer below and have this form signed by an ofFcial of your company aukhorized to make such designation. Zf you wish
to designate multiple �ea[ers, please duplicate this form as necessary.
Designate� Dealer Name
Designated Dea�er Address
City
Phone Number
Email address
Designated Dealer Contact Person
Your Company Name
State Zip
Fax Number
Designated Dealer 7ax ID Number* (*attach W-9)
5ignat�re of Authorized Company Official
Page 19 of 69
Proposal Forms CONST v,01.12,20f8
� Board�
Cooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 � PH: 800-695-Z919 • FAX: 800-211-5454 • buvhoard.corn
TEXAS REGIONAL SERVICE DESIGNATION
The Cooperative (referred to as "Texas Coaperative" in this form and in the State Service Designation form) offers vendors
the opportunity to service its members throughout the entire State of Texas. If you do not plan to service all Texas
Cooperative members statewide, you must indicate the specific regions you will service on this form. If you propose to
serve different �egions fo� different p�oducts or services included in your proposa/, you must comp/ete and
submit a sepa�ate Texas Regiona/ Service Designation form for each group of products and clea�ly indicate
the products or services to which the designation applies in the space provided at the end of this fo�m. By
designating a region or regions, you are ceriifying that you a�e authorized and wil/ing to provide the
proposed products and services in those regions. Designating regions in which you a�e either unab/e or
unwilling to provide the specified p�oducts and services shall be grounds for eithe� rejection of your
p�oposa/ or, if awarded, te�mination of you� Cont�act. Additionally, if you do not plan to service Texas Cooperative
members (i.e., if you will service only states other than Texas), you must so indicate on this form.
Regional Education Servi�e Centers
�_. .. i .
;.
,.,�.._ �`1 i - ''.I..-
I>.,,, �:,._ , ., ,_
���,� i ��� � �� _ �T� - - -.
— - ,� ''' _
�--��� .� � • _ • �
,
.. ,.
,,.��._ �_. ..,, � ._,.,,._.., ..,
� I :' 14'�I:` � .,
;j g �� � �. -����k
M -� ^� I�
�..
�, 1 � .
� �
� - -- �I ?• _ ;.
� ,,. - — -
'� � �':
�_ ��'' I � ,
� �„ �' 1�'
� , • • .�.
\-n , �= . ���. : 4
• "
� y�Q ;� " . .
� ,.,
, \ I � ..�
;.-�— I� '--•_
. „ � j:
:�_ : ';
dealers e�ctrio'al supply co.
Com
Signat re of Authorized Company Official
Dary, Donaldson, V.P. Sales
Printed Name
Page 2D of 69
0 I will service Texas
Cooperative members
statewide.
❑ I will not service Texas
Cooperative members
statewide. I will only
service members in the
regions checked below:
O
❑
❑
❑
a
❑
°a
❑
a
❑
❑
❑
a
❑
❑
Re4 ion
1
2
3
4
6
�
8
9
io
��
12
13
14
15
16
17
18
19
20
Headauarters
Edinburg
Corpus Christi
Victoria
Houston
Beaumont
Huntsville
Kilgore
Mount Pleasant
Wichita Falls
Richardson
Fort Worth
Waco
Austi n
Abilene
San Angelo
Amarillo
Lubbock
Midland
EI Paso
San Antonio
❑ I will not service members
of the Texas Cooperative.
Proposal Forms CONST v.01.12.2018
� Board �
Caoperative PurahasPeg
12007 Research Boulevard • Austin, Texas 76759-2439 • PH; 800-695-2,9i9 � FAX; B00-2,1i�54S4 • buvboard,com
Ifi this Texas Regional Servlce Designation form applies to only one or some of the pfoducts and services proposed by
Vendor, list the products and services to which this form applies here:
Page 21 of 69
Proposal �orms CONST v.U1.12.2018
� Board�
Conperative Purchasing
12007 Research BouEevard • Austin, Texas 78759-2439 • PH: 860-695-2919 • FAX: 800-211-5454 • buybo�rd.cnm
STATE SERVICE DESIGNATION
The Cooperative ofFers �endors the opportunity to service other governmental entities in the United States, including
intergovernmental purchasing cooperatives such as the National Purchasing Cooperative BuyBoard. You must complete
this form if you pla� to ser�ice the entire United States, or will service only the specific states indicated. (Note: I1`you p/an
to service rexas Cooperative mem6ers, 6e sure that you complete the Te,ras Regiona/ Service Deslgnation form,)
If you serve d/fferent states for d/ffereni products or servlces /ncluded In your proposal, you must complete
and su6m/t' a separare State Service Designation form for each group of producrs and c/ear/y ind/cate the
products or services to wrhich the deslgnatlon appl/es in the space provided at the end of this form. By
des/gnating a state or states, you are certifying thai you are authoNzed and wllling io provide the proposed
product's and servlces In those stares Deslgnaring states In which you are elfher una6/e or unwilling to
provlde the specifled products and services shall 6e grounds for elther reject'lon of your proposal or, if
awarded, terminarion of your Contract,
Please check (�) all that a�plv:
❑ I will service all states in the United States.
� I will not service all states in the United States, I will service o�ly the states checked below:
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
❑
■❑
❑
❑
❑
❑
�❑
❑
❑
❑
❑
❑
❑
❑
❑
Alabama
Alaska
Arizona
Arkansas
California (Public Contract Code 20116 & 20652)
Colorado
Connecticut
Delaware
District o� Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisia�a
Mai�e
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Mo nta na
❑ Nebraska
❑ Nevada
❑ New Hampshire
❑ New Jersey
■❑ New Mexico
❑ New York
❑ North Caroli�a
❑■ North Dakota
❑ Ohio
■❑ Oklahoma
❑ Qregon
❑ Pennsyl�ania
❑ Rhode Island
❑ South Carolina
❑ South Dakota
❑ Te�nessee
0 Texas
❑ Utah
❑ Vermont
❑ Virg'tnia
❑ Washington
❑ West Virginia
❑ Wisco�sin
❑� Wyoming
Page 22 of 69
Proposal Forms CONST �.01,12,2018
� Board�
Cnoperative Purchasing
12007 Research Boulevard � Austin, Texas 78759-2439 � pH: BOfl-695-2919 • FAX: 800-211-5454 • buyboard.com
This form wlll be used to ensure that you can service other governmental entities throughout the L�nited States as
indicated. Your signature below confi�ms that you understand your senrice commitments during the term of a
contract awarded under this proposal.
dealers electrical supply co.
Company Name
� �---� Daryl Dona{dson, V.P. Sales
of � u� orized Company Official Printed Name
If this State Service Designation form applies to only one or some of the products and services proposed by Vendor,
list the products and services to which this form applfes here:
Page 23 oF fi9
Proposal Forms CONST v.01.12.20i8
� Board �
Cooperative Purchasiag
iz007 Research Boule�ard • AusCin, 7exas 78754-z439 • PH: 500-695-2919 • FAX: B00-211-5454 • buyhoard.com
NATlONAL PURCHASING COOPERATNE VENDQR AWARD AGREEMENT
In accordance with the Terms and Conditions assaciated with this Proposal Invi�ation, a contract awarded un�er this
Propasal Invitation may be "piggy-backed" by another governmental entity. The National Purchasing Cooperati�e is an
intergo�ernmental purchasing cooperative formed by certain school districts outside of Texas to serve its members
throughout the United 5tates. If you agree to be considered for a piggy-back award by the Natianal Purchasing
Cooperative, you agree to the fallowing terms and agree to serve National Purchasing Cooperative members in the states
you have indicated on the 5tate 5ervice Deslgnation form, in your Proposal.
By signing this form, Proposer (referred to in this Agreement as "Vendor"') agrees as follows:
1. Vendor acknowledges that if The �ocal Go�ernment Purchasing Cooperative ("Texas Cooperative'� awards Vendor a
contract under this Praposal Invitation {"Underlying Award"}, the National Purchasing Cooperati�e ("Nationai Cooperati�e")
may - but is not required to -"piggy-laack" an or re-award all or a portion of that Underlying Award ("Piggy-Back Award"}.
By signing this National Cooperative Vendor Award Agreement {"Agreement"}, Vendor accepts and agrees to be bound by
any such Piggy-Back Award as pro�ided for herein.
2. In the event National Cooperat€ve awards Vendor a Piggy-Back Award, the National Cooperati�e A�ministrator
("BuyBoard Administrator") wiff notify Vendor in writing of such Piggy-Back Award, which award shall commence on the
efFective date stated in the Notice and end on the expiration date of the Underlying Award, subject to annual renewals as
authorized in writing by the BuyBoard Administrator. Vendor agrees that no further signature or other ackion is required of
Vendor in order for the Piggy-Back Award and this Agreement to be bin�ing upon Vendor. Vendor further agrees that no
inter[ineations or changes to this Agreement by Vendor will be binding on Nationa! Cooperative, unless such changes are
agreed to by its BuyBoard Administrator in writing.
3, Vendor agrees that it shall offer its goods and services to National Cooperati�e members at the same unit pricing and
same general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underlying
Award. However, nothing in this Agreement prevents Vendor from offering National Cooperative members better {i,e.,
lower) competitive pricing an� more favorable terms and conditions than those in the Underlying Award.
�+, Ven�or hereby agrees and confirms that it wlll sen�e those states it has designate� on the 5tate Service pesignation
Form of this Proposal In�itation. Any changes to the states designated on the State Service Designation Form must be
approved in writing by the BuyBoard Administrator,
5. Vendor agrees to pay National Cooperative the service fee provided for in the Underlying Award based on the amount of
purchases generated from National Cooperative members through the Piggy-Back Award. Vendor shall remit payment to
National Cooperative on such schedule as it specifies (which shail not be more of�en than monthly}, Further, upon
request, Vendor shall provide National Cooperattve with copies of all purchase orders generated from National Cooperative
members for purposes of reviewing and verifying purchase activity, Vendor furkher agrees that National Cooperative shall
have the right, upon reasonabie wrltten notice, to review Ven�or`s records pertaining to purchases made by National
Caoperati�e members in order to verify the accuracy of service fees.
6. Vendor agrees that the Underlying Award, including i�s General Terms and Conditions, are adopted by reference to the
fullest extent such provisions can reasonably apply to the post-proposal/contract award phase. The rights and
responsibilities that would ordinarily Inure to the Texas Cooperative pursuant to the Underlying Award shall inure to
Nationa! Cooperative; and, conversely, the rights and responsibilities that would ordinarily inure to Vendor in the Underlying
Award shall inure to Vendor in this Agreement. Vendor recognizes and agrees that Vendor and National Cooperative are the
only parties ta this Agreement, and that nothing in this Agreement has application to other third parties, Including the
Texas Caaperati�e. In the event of conflict between this Agreement and the terms of the Underlying Award, the terms of
this Agreement shall contrai, and then only to the extent necessary to reconcile the conflict.
Proposal Forms CONST v.01,12,2�18
Page 24 of 69
! Board�
Cooperative Purchasfng
12007 Itesearch Boulevard • Auskin, 7exas 78759-Z439 � PH: 800-695-2919 � FAX: 800-211-5454 � buyboard.com
7. This Agreement shall be governed and construed in accordance with the laws of the State of Rhode Island and venue
for any dispute shall lie In the federal district caurt of Alexandria, Virginia,
8, Vendor acknowledges and agrees that the award of a Piggy-Back Award is within the sole d'tscretion of National
Cooperative, and that this Agreement does not take eFFec� unless and until National Cooperative awards Vendor a Piggy-
Back Award and the BuyBoard Administrator notifies Vendor in writing of such Piggy-Back Award as provided for herein.
WHEREFORE, by signing below Vendor agrees to the foregoing and warrants that it has the authority to enter into this
Agreement,
dealers e,�€ct�icaf s��ply co.
Na me
re of 1�uth�rized Company pfficial
577� 18
Proposal Invitation Number
Daryl Donaldson, V.P. Sales
Printed Name of Authorized Company OfFcial
April 24, 2018
Date
Page 25 oF 69
Proposal Forms CONST v.01.i2.2fli8
� Board�
Cooperative Purchasing
1z007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • FAX: 600-211-5454 • buyboard,com
FEDERAL ANQ S�'ATE/ PURCHASING COOPERATNE EXPERIENCE
The Cooperative strives to provide its members with the best services and products at the best prices available from
vendors with the technical resources and abiliry to serve Cooperative members. Please respond to the following questions.
1. Provide the dollar value of sales to or through purchasing cooperatives at or based on an established catalog or
market price during the previous 12-month period or the last fiscal year: $ 1.315.00 .{The period of the 12
month period is 01 /01 /17 / 12/31 /17 ). In the event that a dollar value is not an appropriate measure of the sales,
provide and describe your own measure of the sales of the item(s). *we do not disclose information on customers.
2. By submitting a proposal, you agree that, based on your written discounting policies, the discounts you offer the
Cooperative are equal to or better than the best price you offer other purchasing cooperatives for the same items
under equivalent circumstances.
3. Provide the information requested below for other purchasing cooperatives for which Praposer currently serves, or in
the past has served, as an awarded vendor. Rows should be added to accommodate as many purchasing
cooperatives as required,
•� ��� �� �
• • m�' • •�
'• ��• �•
1, Federal General Services Administration No
2. T-PASS (State of Texas) NQ
3. U.S. Communities Purchasing Alliance No
4. National IPA/TCPN No
5. Houston-Galveston Area Council {H�ac) No
6. National ]oint Powers Alliance (NJPA) No
7. E&I Cooperative No
8. The Interlocal Purchasing System (TIPS) Yes No MRO
9. Other
❑ MY COMPANY DOES NOT CURRENTLY HAVE ANY OF THE ABOVE OR SIMILAR TYPE CONTRACTS.
CURRENT BUYBOARD VENDORS
If you are a current BuyBoard vendor in the same contract category as proposed in this Proposal Invitation, indicate the
discount for your current BuyBoard contract and the proposed discount in this Proposal. Explain any difference between
your current and proposed discounts.
Current Discount (%): 0-Net Pricing
Proposed Discount (%): Z�%sec1,3,4-10% sec iq
Explanation: Members prefer to see the discount vs. Net Pricing. We can do both to get best pricing.
Branches apply the best competitive pricing discounts at time of purchase to insure competitive levels.
Proposal Forms CONST v.01.12.2018
Page 26 of 69
� Board �
Caoperative Purchasing
12007 Research Boule�ard • Austin, Texas 78759-2439 • PH; 80D-69S-2919 • FAX; 80D-211-5454 • buvboard,com
By signature beiow, I certify that the above is true, complete and aaurate and that I am authorized by my company to
make this certif�catlor�.
lers electrical supply co.
Company Name
��,(,�� Daryl Donaldson, V.P. Sales
Signature of Au orized Company OfFicial Printed Name
Proposal Forms CONST v.01.12,2018
Page 27 of 69
� Board �
Caoperative Pr�rehasing
12007 Research Boulevard • AustEn, Texas 78759-2�F39 � PH: 800-fi95-Z919 • FAX; 80a-211-5454 • buyboard,cam
GOVERNMENTAL REFERENCES
For your Proposal to be considered, you must supply a minimum of five (5) indivldual governmen�al entity references. The
Cooperative may contact any and all references provided as part of the Proposal evaluation. Provide the information
requested below, including the existing price/discounts you ofFer each customer, The Cooperative may determine whether
prices/discounts are fair and reasonable by comparing pricesJdiscoun�s stated in your Proposal with the pricesJdiscounts
you offer other governmen�al customers, Attach additional pages ff necessary.
Quantity/
Entitv Name ___ _. Contact PF�one# Email Address Discount ,, Volume w
1 City of Amarillo Trae Kepley 806-37$-3039 trae.kepley@amarillo.go� 0°/a net pricing
Z Aransas County !SD Gerald Goodwin 361-790-2250 ggoodwin@acisd.org 0% net pric�ng
3 Dallas County James Gay 214-653-7434 Jmaes.gay@dallascounty.org 0% net pricing
City of Brenham Kyle Branham 979-337-7537 kbranham@cityofbrenham.org 0% net pricing
City of Waco Kelly Fiolecek 2�4-750-8�33 kellyh@wacotx.go� 0% net pricing
Do you ever modify your written policies or standard governmental sales practices as identif�ed in the above chart to give
better discounts (lower prices) �han indicated? YES ❑ NO ■❑ If YES, please explain;
Vlle discount products in response to product �olume, types of products and other factors to pro�ide
best competititi�e pricing to BuyBoard members. Vlle do not discfose the purchase dollars of any
customers. In 2017 BuyBoard members reported purchases from dealers electrical of $1,838,697.65.
By slgnature below, I ce�tify that the above is true and correct and �hat I am authorized by my company to make �his
certiflcation.
dealers e
Company
Signat re of A�tl�ori;
Darvl Donaldson
Printed Name
supply co.
Company OfFcial
Proposa4 Forms CON57 v.�1.J.2.2018
Page 28 oF 69
� Board�
Cooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 � FAX: 8�0-211-5454 • buyboard.com
MARKETING STRATEGY
For your Proposal to be considered, you must submit the Marketing Strategy you will use if the Cooperative accepts all or
part of your Proposal. (Example: Explain how your company will initially inform Cooperative members of your BuyBoa�d
contract, and ho�v you rvi11 continue to support the BuyBoard for the duration of the contract period.)
Attach additional pages if necessary.
dealers electrical supply has been promoting the BuyBoard Cooperative to the members via many
methods. Direct contact from outside sales to members. Posting on our company website that dealers
is a Supplier Vendor. We utilize the BuyBoard logo on all our newsletters, company promotions,
tradeshows and any digital format to promote the Ca-ap. We also do training in our company sales
meetings, management meetings and with customer members on the advantages of doing business
with a BuyBoard Supplier, supporting the BuyBoard process and bringing information on products
and services. We were granted permission from BuyBoard marketing to utilize the logo via email
in 2016. We support the co-op and are committed to the members to be their supplier af choice.
dealers elec�l supply co.
Company N me/
C;�,� •
Signatu of A ho ized Company Official
Daryl Donaldson, V.P. Sales
Printed Name
Proposal Forms CONST v.01,12.2018
Page 29 of 69
� Boa�d �
Cooperative Purehasing�
12007 Research Boulevard • Austfn, Texas 78759-2439 • PH: 800-595-2919 • FAX; 840-211-5454 • buyboard.cam
CONFTDENTIAL PROPRIETARY INFORMATION
A. Public Disclosure Laws
All Proposals, forms, documentakion, or other materials su6mitted by Vendor to the Cooperati�e in response to this
Proposal Invitation, including catalogs and pricelists, may be subject to the disclosure requirements of the Texas Pu61ic
Tnformation Act �Texas Government Code chapter 552.001, et seq.} or similar disclosure law. Proposer must clearly
identify on this form any information in its Proposal (including forms, documentation, or other materials submitted with the
Proposal} thak Proposer cansiders proprietary or rnnfidential. If Proposer fails to properly identify the information, the
Cooperative shall have no obligation to notify Vendor or seek protection of such informatian from public disclosure should a
member of the pub[ic or other third party request access to the information under the Texas Public Informakion AcC or
similar disclosure law. Proposer wiil be notified of any third party request for information in a Proposal that Proposer has
identified in this form as proprietary or confidential,
Does your Proposal (Encluding forms, documentation, or other materials submitted with the Proposal) contain informakion
which Vendor considers proprietary or confidentiai?
Aleas� check (� ane oF the followinq:
❑■ N�, I certify that none of the informatlon included with this Propnsa[ is considered confidential or proprietary.
� YES, I certify that this Proposal contains information considered confidentiai or proprietary and all such information is
specifically identlFled on this form,
If you responded "YES ; you must identify below the specific information you consider confidential or proprietary. List each
page number, form number, or other informakion sufFicient to make the information readily ldentifiable. The Cooperative
and its Administrator will not be respons961e for a Proposer`s failure to deariy identify informakion considered confdential or
proprietary, Further, by submitting a Proposal, Proposer acknowledges that the Cooperative and its Administrator will
d9sclose information when required by law, even if such informatlon has been 9dentified herein as information the vendor
considers confidential or proprietary.
Confidential / Proprie�ary Information:
(A[tach aodditlonal sheets if needed.)
Proposal Farms CONST v.01.7.2.2018
Page 30 of 69
� Board �
Caoperative Pyrehasing
1Z007 Research Boulevard • Austin, 7exas 78759-2439 • PH: 800-695-2919 • FAX; 800-211-5454 •�{yboard�cvm
B. Copyri�ht Inf�rmation
Does your Proposal (including forms, documentation, or other materials submitted with the Proposal) contain copyright
information?
Please check (�(} ona oF the following;
� N�, Proposal (including forms, documentation, or other materials submit�ed with the Prapasal) does not
contaln copyright information.
� YES, Proposal (including forms, documenration, or other materials submitted with the Proposal) does
contain copyright informatlon.
If you responded "YES", identify below the specific documents or pages containing copyright information,
Copyright Information:
(Attach add/h'onal sheels If needed.J
C. C[msent to Release ConfidentialjRroprietarv/Copvriuht Information to BuvBoarcl Members
BuyBoard members (Coaperative and nonprofit members} seeking to make purchases through the BuyBoard may wish to
view information included in the Proposals of awarded Vendors. If you identified information on this form as confidential,
proprietary, or subject to copyright, and you are awarded a BuyBoard contract, your acceptance of the BuyBoard contract
award constitutes your consent to the disclosure of such information to BuyBoard members, including posting of such
information on the secure BuyBoard website for members, Note: Neither the Cooperative nor its Administrator wi11 be
responsible for the use or distribution of information by BuyBoard members or any other parry,
D. Consent ta Release Rroposal Tabulatian
Notwithstanding anything in this Confidential/Proprietary Information form to the contrary, by submitting a Proposal,
Vendor consents and agrees that, upon Contract award, the Cooperative may publically release, including posting on the
public BuyBoard website, a copy of the proposal tabu�ation for the Contract including Vendor name; proposed
catalog/prlcefist name�s); proposed percentage discount�s), hourly labor rate(s}, or other specified pricing; and Vendor
award or non-award information.
By signature below, I certify that the informat�on in this form is true, complete, and accurate and that I am authorized by
my company to�`ak'� this certiflcation and all consents and agreements contained herein.
dealers el ctric sup
Company ame ,
Signatur� of Au�Yforized Company Official
Daryl Donaldsan, V.P. Sales
Printed Name
April 24, 2018
Date
Proposal Forms CONST v.41.1�.�fli6
Page 31 of 69
� Board�
Cooperative Pr►rchasing
12007 Research Boulevard • Austln, Texas 7$759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyp���rd„com
VENDOR BUSYNESS NAM�
By submitting a Proposal, Proposer is seeking to enter into a lega{ contract with the Cooperati�e, As such, a Proposer must
be an individual or fegal business entity capable of entering into a binding contract. Proposers, must completely and
accurately provide the information requested below or your Proposal may be deemed non-responsive.
Name of Proposing Company; Dealers EleCtriCal Supply Ca.
(Llst the leaal name of rhe mmpanyseekt��g to coniract wlth the Cooperatrve. Do NOT list an assu�ned name, dba, aka, etc, here, 5uch infarrnaHorr may
6e provided 6elow, If you are submittlrrg a jolnt proposa/ with ar�other enilty to pro�ide the same praposed goods or services, each su6mittrng errh'ty
should complete a separate vendor mformatlon form. Separately operafrng legal 6usiness entides, even If aftlllated entitres, whtch propose to provide
goods or servrces separdte/y must submrt their own Proposals.J
Please check {� one oF the Following;,
l�pe of Business:
Indi�idual/Sole Proprietor
Corporation x
Limited Liability Company
Partnership
Other If other, identify
5tate of Incorporation pf appiicabie):
Texas
Federal Employer ldentification Number;
74-1972120
(I/endar must include a ctvmpleted ` form with tfreir proposal)
List the Name(s) by w�ich Vendor� if awarded, wishes to be identified on the BuyBoard: (Note: If differenf fhan the Name of
Proposing Company Irsted a6ove, only valid trade names (d6a, aka, etc.J of the proposing Company may be used and a copy of your Assumed Name
Cerlifrcate(s), if applicable, must 6e attached,)
Proposal Forms CONSTv,01..12,2flie
Page 32 of 69
Form ���
(Rev. November 2017}
oeparlment of the Treasury
Infemal Revanue Service
Ftequest for Taxpayer
Ident'rfication Number and Certification
► Go to www.irs.gov/FurmW9 for insfructions and the latest information.
Give Form ta the
requaster. Do not
send to the IRS.
Name (as shown on your Income tax return), Name Is requlred on this Ilna; do not leave t3�is line blank.
Dealers Electrical 5upply Co.
z�sus�ness name�aisregaraea enmy name, ir aitterent trom abova
ai
d
�
a
c
0
N
p> C
G O
��
a �
c�
.t e
a o
!t
U
a
Q
N
as
�
3 Check approprlata box for federal tax classiflcetion of the person whosa name is entered on Ilne 1. Check only one oF the 4 Exemptlons (codes apply onEy to
following seven boxas. certain entitlas, not Indlvlduals; see
Instructions on page 3}:
❑ lndividual/sofe proprietor or ❑ C CorporaYion ❑✓ 5 Corporatlon ❑ Partnershlp ❑ TrusUestate
single-mem�ar LLG Exempt payee code (if any) �j
❑ Limlted Ilabllity company. Enter tha tex classiflcatEon {G-G corporation, S�5 corporatfan, P=Pertnership) ►
Note: Check the appropriata box in the line ebove for the tax classificatlon o( the single-member owner. Do not check Exemptlon from FATGA raporting
LLC Ef the LLG is classified as a single-member LLG thet is disregarded from the ovmer unless the owner of the L�C is code (if any)
enother LLC that Is noi disregarded from the owner for U.S, federa[ tax purposes. Otherwfse, a single-mamber LLG that
is disragarded from the owner shou]d check the appropriaie box for the tax cleseification oF its owner.
[f Dther (see Instructlons} ► �aP�r�s � a�counrs man,rernedaursrda rna u,s,�
5 Address (number, street, and apt, or suite no,} See Instructlons. Requester's name and address (optional)
P.O. Box 2676
Clty, stata, and Z[P code
Waco, 7exas 76702
List account numberfs� here
�,� l axpayer ldentiticatian Number [T1N)
Enter yaur TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
backup withholding. �or individuals, this Is generally your social security numqer (SSN). However, for a
resldent alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identificatlon number {EIN). If you do not have a number, see Now fo get a
TIN, later.
Note: If the account is in more than one name, see the instructions for llne 1. Also see What Name and
IVumber To G7ve ihe Requester for guidelines on whose number to enter.
I social security numher
� rm ^�
or
Emplayer ldantiiicaiion number
7 4- 1 9 7 2 1 2 0
Under p�nalties of perjury, I ceriify that:
1. The number shown on this form is my correct Yaxpayer identifcation number (or I am waiting for a number to be issued to me); and
2. I am not subject to backup wlthholding because; (a) I am exempt from backup withholding, or (q) I have not been notified by the Internal Revenue
Serrice (IRS) that I am subjecY to backup withholding as a resulk of a failure to report all interest or di�idends, or {c} the IR5 has notified me that I am
no longer subJect to backup withholding; and
3. I am a U,S, citizen or other fJ.S. person (defined below); and
4. The FATCA code{s) entered on thls #orm (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you ha�e been notified by the IRS that you are currently sub]ect to backup withholding because
you ha�e failed to report all interest and dividends on your tau return. For real estate iransactlons, ltem 2 does not apply. For mortgage inYerest pald,
acqulslt€on or abandonment of secured property, cancellation of debt, coniributions to an individual retlrement arrangement (IRA), and generally, payments
other than interest and divldends, you are not required to�sign the certlficallon, but you must provide your correct TIN, See the instructfons for Part Ik, iater.
�Egn Signatureof
Here U.S. pers�n ►
aate > 04104/2p 18
Generallnstruc#ibrrs /
Section references are to the Internal Revenue Code unless otherwise
noted,
Future developments. For the latest information abouk developments
related to Form W-9 and its Instructions, such as legislation enacted
after they were published, go to www.lrs.govlFormW9.
P�rpose of Form
An individual or entity (Form W-9 requester) wha is required to fiie an
information return with the IRS must obtain your correct texpayer
identification number (TINj whlch may be your social security number
(SSN}, individual taxpayer ldentificatlon number {ITIN), adoption
taxpayer Edentification number (ATIiV}, or employer identification number
{EINJ, to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of in#ormation
returns inciude, but are nat Ilmited to, the following.
• Form 1099-INT {Interest earned or paid)
• Form 1099-DN (dividends, including those from stocks or mutual
funds}
• Form 1 D99-MISC (various types of income, prizes, awards, or gross
proceeds}
• Form 1 D99-B (stock or mutual fund sales and certain oiher
transactians by brokers)
• Form 1 D99-5 (proceeds frorn real estate transactionsj
• Form 1099-K (merchant card and third party networlc transactlans)
•�orm 1 b98 {home mortgage interest), 1098-E (student Eoan interest),
1 o98-T (tuitlon)
• �orm 1 b99-C (canceled debt}
• Form 1099-A {acqulsltion or abandonment of secured property)
fJse Form W-9 only if you are a U.S. person (including a resident
alien}, to provide your correcY T1N.
!f you do not refurn Form W-9 to ihe reqvester with a TlN, you might
be subfect to backup wlthholding. See WhaE is backup withholding,
later,
Cat. No. 10231X Formw-9 {Rev. 11-2017)
� Board�
�aoperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 • PH: 800-695-2919 • FAX; 800-2i1-5454 • buyboard.car�
EDGAR V�NDOR C�RTIFICATYON
(� C�R Part 204 and Appendix II)
When a Cooperative member seeks to procure goods and services us9ng funds under a federak grant ar contract, speciflc
federal laws, regulations, and requirements may apply in addition to those under state law. This includes, but is not limited
to, the procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit �tequirements for
Federal Awards, 2 CFR 200 (sometimes referred to as the "Uniform Guidance" or new "EDGAR"}. A[I Vendors submitting
proposals must camplete this EDGAR Certification Form regarding Vendor`s willingness and ability to comply with certa9n
requirements which may be applicable to specific Cooperative member purchases using federal grant funds. This
completed form will be made available to Cooperative members for the9r use while considering their purchasing options
when using federal grant funds. Cooperative members may also require Vendors to enter into ancillary agreements, in
addition to the BuyBoard contract's general terms and conditions, to address the member's specific contractual needs,
including contract requirements for a procurement using federal grants or contracts.
For each of the Items 6e/ow, I/endor should certify Vendors agreement and a6ility to comply, rvhere
applicable, 6y hav/ng Vendor's authorized representative complete and init/al the applicable boxes and slgn
the acknoryledgment at the end of thls form. If you fal/ to complete any Item in this form, the Cooperative
rvill cons/der and may list the Vendor's response on the BuyBoard as "ND,'`the Vendor /s unable or unwllling
to comply, A"NO" response ta any af the items may, if applicable, impact the ability of a Cooperative member to
purchase from the Vendor using federal funds,
i. Vendor Violation or Breach of Contract 7erms:
Contrac�s for more than the simplified acquisition threshold currently set at $150,000, which is the inflation adjusted
amount determined by the Civilian Agency Acquisitian Council and the Defense Acquisition Regulations Council (Councils)
as authorized by 41 USC 1908, must address administrative, contractual, or Eegal remedies in instances where contractors
violate or breach contract terms, and provide for such sanctions and penalties as appropriate.
Provisions regarding Vendor default are included in the BuyBoard General Terms and Conditions, including Sect�on E,18,
Remedies for Default and Termination of Contract. Any Contract award will be subject to such BuyBoard General Terms
and Conditions, as well as any additional terms and conditions in any Purchase Order, Cooperative member ancillary
cantract, or Member Construction Contract agreed upon by Vendar and the Cooperative member which must be consistent
with and protect the Cooperative member at least to the same extent as the BuyBoard Terms and Conditions.
The remedies under the Contract are in addition to any other remedies that may be ava�[able under law or in equity. By
submitting a Proposal, you agree to these Vendor violation and breach of contract terms.
2. 7ermination for Cause or Con�enience:
For any Cooperative member purchase or contract in excess of $f0,000 made using federaf funds, you agree that the
following term and condition shall apply:
The Cooperatrue mem6er may terminate or cance/ any purchase order under this Contract at any flme, with or without
cause, 6y providrng seuen (7) 6usiness days aduance wrltten noNce to the I/endor, lf this Agreement is terminated in
acctardance wrth this Paragraph, the Cooperative mem6er shall only 6e required to pay I/endor for goads or services
delivered to the Cooperative mem6er prior to the termination and not othen�vise returned rn accordance with i�endor's
return policy, lf the Cooperative member has paid !/endor for goods or seryices not yet pro�ided as of the date of
terminatron, k�endor shall immediatety refund such payment(s),
If an a[ternate provision for termination of a Cooperative member purchase for cause and convenience, including the
manner by which it will be effected and the basis for settlement, is included in the Cooperative member`s purchase order,
ancll[ary agreem�nt, ar Member Construction Contract agreed to by the Vendor, the Coope�ative member's provision shali
control.
Proposal Forms CdNST v,Of.12.2018
Page 33 of 69
� Board�
Coapera[ive Purchasing
12007 Research Boulevard • Austin, Texas 78759-z439 � PH: 800-695-2919 • FAX: 800-Z1i-5454 • buvboard.com
3. Equal Emptoyment Opportunity;
Except as otherwise provided under 41 CFR Part b0, ali Cooperative member purchases or contracts that meet the
defnition of "federally assisted construction contract" in 41 CFR Part fi4-1.3 shall be deemed to include the equal
opportunity clause provided under 41 CFR b0-1.4(b), in accordance with Execut'tve Order 1124{, "Equai Employment
Opportunity" (30 FR 12319, 12935, 3 CFR Part, 19fi4-1965 Comp., p. 339), as amended by Executive Order 11375,
"Amending Executive Order 11246 Relating to Equal Emp�oyment Opporkunity," and impfementing regulations at 41 CFR
Park 5�, "O�ce of Federal Contract Compliance Programs, Equal Employment Opportunity� Department of Labor."
The equal opportunity clause provided under 41 CFR 50-1.4(b} is hereby incorporated by reference. Vendor agrees that
such provision applies to any Cooperative member purchase or contract that meets the definition of "federally assisted
construction contract" in 41 CFR Park 60-1.3 and Vendor agrees that it shal] compfy with such provision.
4. Davis-Bacon Act.
When required by Federal program legislation, Vendar agrees that, for all Cooperative rr�ember prime construction
contracts/purchases in excess of $2,00�, Vendor shall comply with the Davis-Bacon Ack (40 USC 3141-3144, and 3146-
3148) as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions AppEicable to
Contracts Covering Federal€y Financed and Assisted Construction'�, In accordance with the statute, Vendor is required to
pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determinate made by
the Secretary of Labor, In addition, Vendor shall pay wages not less than once a week.
Current prevailing wage determinations issued by the Department of Labor are available at wdol.gov. Vendor agrees that,
for any purchase to which this requirement appiies, the award of the purchase to the Vendor is conditioned upon Vendor's
acceptance of khe wage determinatian.
Vendor further agrees that it shall also comply with the Copekand "Anti-Kickback" Act {4D USC 3145}, as supplemented by
Deparkment of Labor regulations {29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work
Financed in Whole or in Part by Loans or Grants from the United States'�. The Act provides that each contractor or
subrecipient must be prohibited from inducing, by any means, any person emplayed in the construction, completion, ar
repair of public work, to give up any part of the compensation to which he ar she is otherwise entitled.
5. Contract Work Hours and Safety Standards Act:
Where applicable, for all Cooperative member contracts or purchases in excess of $1��,000 khat involve the employment of
mechanics or ]aborers, Vendor agrees to compfy with 40 USC 3702 and 3704, as supplemented by Department of Labor
regulations (29 CFR Part 5}. Under 4D USC 3702 of the Act, Vendor is required to compute the wages of every mechanic
and laborer on the basis oP a standard work week of 4� hours. Work in excess of the standard work week is permissible
provided that the wor4�er is compensated at a rate of not less than one and a half times the basic rate of pay for all hours
worked in excess of 40 hours in the work week. The requirements of 40 USC 3704 are applicable to canstruction work and
provide that no laborer ar mechanic must be required to work in surroundings or under warking canditions which are
unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles
ordinaril available on the o en market or contracts Por trans ortation or transmission of intelli ence.
6. Right to Inventions Made Under a Contract or Agreement:
If the Cooperative member's Federal award meets the definition of "funding agreement" under 37 CFR 401.2{a) and the
recipienk or subrecipient wishes ka enter into a contract with a smafl business firm or nonprofit organization regarding the
substitution of parkies, assignment or perFormance or experimental, developmental, or research work under that "funding
agreement," the recipient ar subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions
Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative
Agreements," and any implementing regulations issued by the awarding agency,
Vendor agrees to comply with the abave requirements when applicable,
Page 34 of 69
Proposal Farms CONST v.01.12.2018
� Board �
Coopera[Ive Prerehasing
12007 Research Boulevard � Austin, 7exas 78759-2439 • PH: 800-695-2919 � FAX: 800-211-5454 •�y���ar�i,cvm
7. Clean A�r Act and Federal Water Pollution Control Act:
Clean Air Act (42 U5C 740f-7671q.) and the Federal Water Pollution Control Act {33 USC f251-1367), as amended --
Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non-Federal award to
agree to comply with al[ applicable standards, orders, or regulations issued pursuant to the Clean Air Act (42 U5C 7401-
7671q.) and the Federaf Water Pollution Control Act, as amended {33 USC 1251-1367). VEolations must be reported to the
Federal awarding agency and the Regional OfFce of the Environmental Protection Agency (EPA).
When required, Vendor agrees to comply with all applicable standards, orders, or regulations issued pursuant to the Clean
Air Act and the Federal Water Pollution Control Act.
8. Debarment and Suspension:
Debarment and 5uspension {Executive Orders 12549 and 12689) — A contract award {see 2 CFR 180.220) must not be
made to parties listed on the government-wide exclusions in the System for Award Management (SAM), in accordance with
the OM8 guidelines at 2 CFR 180 that implement Executive Orders 12549 {3 CFR Part 1966 Comp. p. 1$9) and 12689 {3
CFkt Part 1989 Comp. p. 235), "Debarment and Suspension." SAM Exclusions contains the names of partles debarred,
suspended, or otherwis� excluded by agencies, as well as parties declared ine�igible under statutory or regulatory authoriry
other than Executi�e Order 125�}9.
Vendor certifies that Vendor is not currently listed on the government-wide exclusions in SAM, is not debarred, suspended,
or otherwise excluded by agencies or declared ineligible under statutory or regulatory authoriry other than Executive Order
12549, Vendor further agrees to immediately notify the Cooperative and all Cooperative members with pending purchases
or seeking to purchase from Vendor iP Vendor is later listed on the government-wide exclusions in SA�1, or is debarred,
suspended, or otherwise excluded by agencies or declared ineligible under statutory or regulatory authority other than
Executive Order 12549.
9. Byrd Anti-Lobbying Amendment:
Byrd Anti-Lobbying Amendment (31 U5C 1352) -- Vendors that apply or bid for an award exceeding $100,0�� must file the
required certification. Each tier cerkiftes to the tier above that it will not and has not used Federal appropriated funds to
pay any person or organization for influencing or attempting to �nfluence an officer or employee of any agency, a member
of Congress, officer or employee of Congress, or an employee of a member of Congress in connection wit� obtaining any
Federal contract, grant or any other award co�ered by 31 USC f352. Each tier must also disclose any lobbying with non-
Federal funds that takes place in connection with obtalning any Federal award, Such disclosures are forwarded from tier to
tier up to the non-Federal award. As applicable, Vendor agrees to file all certifications and disclosures reguEred by, and
otherwise comply with, the Byrd Anti-Lobbying Amendment (31 USC 1352}.
10. Procurement of Reco�ered Materials:
For Cooperative member purc�ases utillzing Federal funds, Vendor agrees to comply with 5ection 6002 of the Solid Waste
Disposal Act, as amended by the Resource Canservatian and Recovery Aet where appli�able and provlde such infarmation
and certif�cations as a Cooperative member may require to confirm estimates and otherwise comply. The reguirements of
Section 6�02 include procuring only items designated in guidelines of t�e Environmental Protection Agency (EPA) at 40 CFR
Part 247 that cont�in the highest percEntage of recovered materials practicable, consistent wjth maintaining a satisfactory
levef of competition, where the purchase price of the item exceeds $f0,000 or the value of the quantiry acquired during the
precedEng fiscai year exceeded $f0,000; procuring solid waste management services in a manner that maximizes energy
and resource rewvery, and establishing an affirmative procurement program for procurement of recovered materials
identified fn the EPA guidelines,
11. Pro#it as a Separate Element of Price:
For purchases using federal funds in excess of $150,000, a Cooperative member may be required to negotiate profit as a
separate element of the price. 5ee, 2 CFR 200.323{b). When required by a Cooperative member, Vendor agrees to
provide information and negotiate with the Cooperative member regarding profit as a separate element of the price for a
particular purchase. However, Vendor agrees that the total price, including profit, charged by Vendor to the Cooperative
member shall not exceed the awarded pricing, including any applicable discount, under Vendor's Cooperative Contract.
Proposal Forms CONSTv.01.i2,2pip
Page 35 of 69
� Board�
Cooperative Purchasing
1Z0�7 Research Boulevard • Austin, Texas 78759-Z439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard,com
12. General Compliance and Cooperatian with Cooperative Members:
In addition to the foregoing specific requirements, Vendor agrees, in accepting any Purchase Order from a Cooperative
member, it shall make a good faith efFort to work with Cooperative members to provide such information and to satisfy
such requirements as may apply to a particular Cooperative member purchase or purchases including, but not limited to,
applicable recordkeeping and record retention requirements.
Ven�or Certification:
YES, I agree or
Vendor Certification Item f�o. NO, I do NOT agree Initial
1. Vendor Violation or Breach of Contract Terms Yes
2. Termination for Cause or Convenience Yes
3. Equal Employment Opportunity
Yes ��
4. Davis-Bacon Act
Yes - n/a ��
5. Contract Work Hours and Safety Standards Act Yes - n/a
6. Right to Inventions Made Under a Contract or Agreement Yes
�
7. Clean Air Act and Federal Water Pollution Control Act Yes
��
8. Debarment and Suspensian
Yes ��
9. Byrd Anti-Lobbying Amendment
Yes ��
10. Procurement of Recovered Materials Yes �
11. Profit as a Separate Element of Price Yes
�
12. General Compliance and Cooperation with Cooperative Members Yes �l�
By signature below, I certify that the information in this form is true, complete, and accurate and that I am authorized by
my company to make this certification and all consents and agreements contained herein.
Dealers Electrical Supply Co.
Company ame
L Aj.
Si re of A orized Company Official
Chris Lanham
Printed Name
Proposal Forms CONST v.01.12.2018
Page 36 of 69
� Board � �
Cooperative Purehasfag
12Q07 Research Boulevard • Austin, Texas 78759-2439 � PH: 800-b95-2919 • FAX; 800-211-5454 • bu b r. m
PROPOSAI. IMVITATTON OUESTIONNAIR�
�he Cooperative will use your responses to the questions below in evaluating your Proposal and technical and financial
resources to provide the goods and perform the services {"Work'� under the BuyBoard contract contemplated by this
Proposal Invitation ("Contract'�. Proposers must fully answer each question, numbering your responses to correspond to
the ques�ions/numbers below. Proposers must complete below or attach your responses to this questionnaire, sign where
indicated below, and submit the signed questionnaire and your responses to all questions in one document with your
Proposal, You must submit the signed questionnaire and responses with yaur Propasal or the Proposal will
not be considered.
1, List the number of years Proposer has been in business and Former business names {if applicable). Note whether your
company is currently for sale or involved in any transa�tion that would significantly alter its business or result in
atquisition by another entity,
Dealers �as been in business for 72 years. Tl�e company is nat currently for sale and there are no
factars that would significantly alter our business or result in acquisition by anather entity.
2, bescribe Proposer's dire�t experience (not as a subcontractor) perForming the work proposed under this contract.
Include a brief description of the proje�ts you have completed for Texas governmental entities in the last 5 years, and
include for each the proje�t name, scope, value, and date, and the name of the pro�uring government entity and entity
contatt person. Identify the contracts that best represent Proposer's capabilities relative to this contract.
Dealers branch locations utilize the members listing ta make contact witl� all fhe members passible
in their areas to advise fhem af our ability to service their MRO, Lig�ting and ather needs. We bring
in facfory reps to assist in product selectian and propasals for retrofits, upgrades and other areas
af building needs under the MRO cantract.
3, bescribe the resources Proposer has to manage stafF and successfully perform the Work contemplated under this
Contract. State th� numb�r and summarize the experience of company personnel who may .be utilized for the Work,
including those w�o will be available to Cooperative members for assistance with project development, technical issues,
and product selection for Work associated with this Contra�t.
All BuyBoard activities are under tl�e direction of Sales and Marketing. Our 58 brancl� locations, 41
in Texas receive BuyBoard promotianal literature, all RF'Q's from BuyBaard are directed ta the
closest servicing branch. All special praject quotes are coordinated with V.P. Sales to
communicate with BuyBaard that they are priced correctly and serviced by the branc�es.
Proposal Forms CONST �,01,12.201 B
Page 37 of 69
� Board�
Cooperative Purchasing
f2007 Research Boulevard • Austin, Texas 78759-2439 � PH; 500-695-29L9 • FAX: 800-211�5454 • buyboard.com
4. The Contrac� does not include architec�ural or eng9neering services, which must be procured separately, outside of the
Cooperative, in accordance with Chapter 2254 of the Texas Government Code (Professional Services Procurement Ac�).
If you are perForming work under the contrac� on a project that requires the services of an architect or professional
engineer, how wil{ you work with a Cooperative member and its designated architect or engineer with respect to
services that must be procured outside the contract?
Our sales and manufacturers representatives work with the specifiers or engineers to meet their
requests af selected items. Being involved often times are able to offer alternatives ar value
engineered products to help with budgetary concerns. Sales and reps work on daily basis with
contractorslarchitectslengineers ta deliver the products as needed.
5. Rescribe the tasks and functions that can be completed by Proposer in-house without the use of a subcontractor or
other third party.
dealers electrical supply is a distributor af e�ectrical supplies and services. We source and distribute
name branded manufacturers. We do nat make ar praduce any products. Services that are needed
to support those products are used for technical or application needs, We stack local inventary,
we delivery timely products as needed and service BuyBaard members needs.
6. Describe Proposer's financial capability to per�orm the Contract. State or describe the firm's fEnancial strength and
rating, bonding capacity, and insurance coverage limits. State whether the firm, or any of the firm's past or present
owners, principal shareholders or stockholders, or ofFicers, ha�e been a debtor party to a bankrupt�y, receivershlp, or
Insolvency proceeding in the last 7 years, and identiiy any such debtor party by name and relationship to or pos9tion
with your firm.
Dealers has been in business for 72 years. We are a 100°/fl employee-awned campany that
is very strong financially. To the best of my knowledge, no officers or directors have been a debtor
party ta a bankrupfcy, recei�ership, or insalvency proceeding within fhe last 7 years.
7. Does your company ha�e any outstanding financial judgments and/or is it currently in default on any loan or financing
agreement? If so, provide detailed information on the nature of such items and prospects for resolution.
No. None.
Proposal Forms CONST v,01.12.2016
Page 36 of 69
� Board�
Cooperative Purchasing
12007 Research Boulevard � Austin, Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 •�uyboard.com
8. List all contracts, if any, in the last 1a years on which Proposer has defaulted, failed to complete or deliver the work, or
that have been terminated for any reason. Include any cohtract for which the surety was notified of a potential claim in
regards to a payment or performance bond, For eac� suc� contrac�, provide the project name, scope, value and date
and the name of the procuring entity. Fully explain the circumstances of the default, notice to surety, failure to
complete or deliver the work, or termination.
None known.
9. List all litigation or other legal proceedings (including arbitration proceedings and/or claims filed with a surety in
regards to a payment or performance bond}, if any, in t�e last la years brought against your firm, or any of the firm's
past or present owners, principal shareholders or stock}�olders, ofFicers, agents or employees, that relates to or arises
from a contract similar to t�fs Contract or the worlc contemplated under this Contract. Provide the style of the lawsuit
or proceeding (name of parties and court or tribunal in whic� filed}, if applicable, nature of the claim, and resolution or
current status.
None.
10� Describe in detail the quality control system Proposer will use, including third party auditing cer�ification, to support the
long-term performance and structural strength of the products to be used in a project under the Contrac�.
We are a who[esale distributor of electrical supplies. We only sell products manufactured by
companies with exceptional reputations for quality and ethical business relations.
11. If the work will require Proposer to tender performance or payment bonds, provide the name of the bonding company
or surety that will issue such bonds.
NIA
Proposal Fotms CONST v.41,12,2016
Page 39 of 69
� Board �
Cnoperallve Prrrchasing
12007 Research Boulevard • Austin, Texas 78759-2439 � PH: 804-b95-2919 • FAX: 8DD-211-5�5� • buyboard.com
12. Describe in detail all documented safety Issues, if any, that have involved Proposer in the last three {3) years re[ated to
the type of work contemplated under this contract. Provide a 3-year history of your firm's workers compensation
experience modifier.
None.
201 fi-17 = O.fi4
20�7-18 = 0.78
2018-19 = 0.73
By signature below, � certify that the information contained in and/or attached to this Proposal in�itation
Q�estionnaire in response to the abor+e questions is true and correct and that T am authorized by my
company to make this cert�fication.
Dealers Electrical Sup�ly Co.
Company Name
/�
ture Authorized Company Official
Proposal Forms CONST v,01,12,2D1$
Page 44 of 69
� Board�
Cooperative Purchasing
12007 Research Boulevard • Austin, Texas 78759-2439 � PH: 800-695-2919 • FAX: 800-211-5454 • buvboard.com
REQUIRED FORMS CHECKLIST
/ (Please check (�) the following)
/
Lj Completed: Proposer's Agreement and Signature
� Completed: Vendor Contact Information
/
LG] Completed: Felony Conviction Disclosure and Debarment Certification
1L�1 Completed: Resident/Nonresident Certification
� Completed: No Israel Boycott Certification
� Completed: No Excluded Nation or Foreign Terrorist Organization Certification
� Completed: Historically Underutilized Business (HUB) Certification)
L�' Completed: Constructian Related Goods and Services Affirmatian
� Completed: Deviation/Compliance
� Completed: Location/Authorized Seller Listings
L�" Completed: Manufacturer Dealer Designation
� Completed: Texas Regional Service Designation
� Completed: State Service Designation
� Completed: National Purchasing Cooperative Vendor Award Agreement
li/� Comoleted: Federal and State/Purchasing Cooperative Experiente
[� Completed: Governmental References
Ly" Completed: Marketing Strategy
L�'J Comple[ed: Confidential/Proprietary Infarmation
� Completed: Vendor Business Name with IRS Form W-9
� Comqleted: EDGAR Vendor Certification
Q/ Completed: Proposal Invitation Questionnaire
Ly' Completed: Required Forms Checklist
� Completed: Proposal Specification Form with Catalogs/Pricelists
*Catalogs/Pricelists must be submitted wifh proposal response or response will not be considered.
Proposal Forms CONST v.01.12,2018
Page 41 of 69
�
_
�
�
.'
Q
W
'0
C
R
�
�
�
Q
� �
� �'
C �
C �+
�+ o
u
i �
�
a o
O�
'� ��
_ �a
� �
L p,
•� o
O. n"
� O
a � �c N
�r V o
� � = a`
c0 y
� = 3
+�+ �
C �
L 7
�
C �
� j
�� �
m �
1 �
O� u
� �L
i �
n �
n o
N �
Z�
O
i�
�
_
1�1
R
�
�
Q
O
a
a�r �''
i
O � = 3
m
O
� C �a c�i
o y � �
0 3 x
`a" � W
H y
R � "� Q Q Q
C i Q+n Q Q Q
� � � �
� y tlJ V (� (� C�
C � •
p � z a L.t"> �p L.t"> cO �. V CO
� t d � � � � � � � � � �
� ++ O (D � f� CQ V h� (6 V f�
d a, �d fp � f� �� It QJ �(`�
� m �% � -O �� "� N� '� ��
+' a� U
� � �
+.
v
� � L ^ � o 0 0 0 0
,v�, o� o� y o 0 0 0 0
n� ,� `� o
� � d
� `" ° a�i � 'L
� `^ y L ° a
� �� a � o
r°i � o � �
C � c �+ w �
� �o T a�+ � R
'� � � V) U
u =
� t0 � -
� � Y � h - �
_ p a 3 0
a ,� a c
� � O � O� a � i o A vf°i O=
m +; p, �p a v� �„ F- a r° c 1- on
a � H v � � .n °c � _ � - 3 ° a u10i
> >. ry _ �n 3 a � o
O� � � � ~ p �3 'O � �,�, ufOi O `o ~ p
� � a�i w�" <( a N j 6 ro °oa j a Q a
G� � > u � iv p � �� �� �. �
a=.+ }, � L �•� � N p u� C� a w � � 9
� � �� n a v� a n v `o � c +J v
� � ra � - o� - � - � � v "-' �v `-" �
� �}' `o u° u� ° u°� � v u �' u �
� � C y 'L QI 'O •i � � � .` I- .` C
}• u a�i � O au n � D �� � � n� aa
•� lC Vl O � 61 Ql C � Ql C N�- Ql � p1
z � �, 0' O+7 D O t'j i� p• � y p,a p 1~Jl
.� C � u �u � � i � � C � �; � L � �n m �
�► f6 �"' d �� a ��� � � dy � � � u i
�' � a � G � .a c � C v~i `� � n i `� a � ,u,
ul .t = Q _ O� o O�� O� L Y O� O v
� 7 Q ^ � i o
� � v� .-. � r. O�_ � u
'- � i- � o W� o +' o =� d o �0 o a
�
�p ro .� „ `..C' ,� � u �. � � �.
t�i O� 0 +-' C O +� 7 d a"' Vl � a +' U ''_' O
� w C C C Q U C y� ._ ,` C C
a,,,1 � O�= 7 W � � rA 7 � �
o � c� L �n • o a o to t o o N o m
'- w� o a � ip 3 � C m vvi A vvi +�- vui V
a v �� o ��L N �y o �m `�° a �,� � y
� ° v, c�' � � a� o a� m:° a� v � v x� v a+
L o �n a� L*' a � L �o �� E• t v
� m � �, y = +� � o � ay c� +� c ^ +� i� � y �
� � m m� � i a � c^ v m o E v a� a a� a� a
� a� w � vi `o ro � v v ra � o a� � a� � o� e�
� �'"' 'i j L {j +�n d� �� N i N d' n. ;= i ��' o v'_'i ` v
n�r t u a u � v°�i a� v�i � c� v�i ro°� v� v�i � v v°1i o c
� n GJ Vf y f0 N� v N 3�� N J �q ro = N J+' �'G v
� � a�� � a Vf � a a n' °u a o�� c°� a o°c � r�.� a
- V
�O ' i�
.O `l � Q � U Qt
> 13 {�If � � � � C � � � � �
pf 'v� - y a � O O � Q a1 � L Q�
C C � y y C a Q, i a L- C i (0 i a% i Q7
•� o� � = o�;•� o a o� o� o�
V N a+ �i- `� aJ O' `� � `� `�- `� `� `�
a� �a a.+ c t y vi �.^�a w O.^ v O�� O.� � O� o
O � L vi p +' � Gl .-. � a 'C7 � � � N `n � 41 � .-• � O
++ '� - a L p � u� c � c� o � c� Q cn � c� a � v�
�= fA N v� a y °� a U1 (0 �,� a C v C>, � °� i�, v'� �
` �- �o � ►- � �
o>� �`� � o � m`�° rNo � a o°J � a �n � m�n �' c a, o
� �O 7�� u W t � O•� '` 7 O�� 7 p 7� 7 p 7� �
C � �'j uf p � .. � � c0 �J +�-� �U r6 � � � rD .� m � r0 .� � � �O �
d �`� 7 F�I VI f�'6 v(6 U1 (�'6 a O" U1 a"' (i'6 C U] N(i'O �'' l!1 � C�1.
>�'� o c� c �Uw� �UI-w ��> cv �c»i.i �c��
� a � � > E � �
o° g �o � v °�' z '-' N M a- u,
Z a ❑ � .`�-� 2 Vl �
i
�
0
z
0
H
6
V
�
u
W
�
a
�
0
0
�
d
�
0
�
a�
�
n
�
O
Q.
O
d
s
�
v
�
E
a
�
a
�
O
�a
._
v
v
R
�
� y
0 v
Z '�
J �
a �,
�► o
a �
� V
a .-:
a.+
G
�
�
a
.�
Q
W
�
�i+
!0
�
a
a
�
�l-
Yl
G
�
L
�
a
O
�^
W
�
.a
a. �
�
�
.
�� �
�a�.�
C
�
CA
'�
.�
7
m
�
00
ti"�
�
n
n
�
O
Z
- �
�� �
�:
.'.R .
f
�
'a
� ��
�
� �� o 0 0 0 � o 0 0
, o �:;
��
�
a�
�
V
_ �
�' �
° � p �;
' - #,T
�
L C
� � a N � L � •� +I� �
p b L a., � O.@ aa O. �� Q 7
Vl ? � C "� b � � � y � C � 'C � J u
a .� � m� - - � C
�'� � N 3 tn � b � v v �'-a 3 c^� � a c a
� a � � A p � �n � � '� I� � A p p '� � � � �
a� m� a c�8 0' �'U a.� a o a� a o a�
L� L"_ i L� Gi `�"' N � Q1 ` � J N � 9 �-. �
o f o� a o+� .a o T° � � c o, o a o d o y
v-- a+ u-. L v-- (6 �c+ `+- '-' ++ :.o � '+-- O k+ u-- 9 u-- •
N N � � � 1�J1 ` C � � C t/1 � � � Z = � ' t11 ay
$ �` 9 � c � � � � ' = c '�
�'� u � a u�'3 u c'� ��n' � u �'� u'� u a
� � �L a �L � ' �L ' �L N �L O 3 �L "L �L � �L �
Q Q. � U Q. � jq �'d p �- j] O• jp � �- p
g m° rn� � a�" o a o o �� � �rn� o � u~i � an
�. ° +� ° � a � � o ° � o ° m .°1a � I�- o � f m c10�
u L° � `a9 � `+g @ a .'S � a `�°� +' `+g c� a .'S „ +�
�� � c� �� c� � ��� c��� ��� � � �u�
�� tk � � a�i � � � � � � b � p f � � � � u � �
� o� o o. „ o o d o"�, o� o O„ o•� o��
.-, .-, y .-, �o .-, s .-, o. � .-, OG �a ,-, a ,-, 47 d
\ � \ � o Q � a � � o o � a � o +�' �
�� V� N o v V ��[) �� u � G1 U v v u V� v��+�
�° � m v V1 .` ti C N C i, .i VE C O '` •in
+-� a--� a--� — +� ' a--� IC a--� +� a-�
�u.�i � �.� � � v� �-Np.n � 3 � � �a � v � � 8
� = 8 � °' � 8 E= 8 �� $ � � 8 a� � � ° ��
-a �a � � R b -a v� � =a rn � =a 2 ,u 'a N � � v 'a N o
a.� +n „ a� � � a� N+.� a� fl, y v a � n� �,.� a.� � a��i �'fl, '�
,��, N o � � .-; .L N .;� 7� '=� +� � .-, .L�+ C '� .� � � .L fl. =
� 1� ;- +�-+ iC E a--� � .L �-' �- L � � � �-' IrA L ,�'',.. O. � � � 3
�vr � � �ri d �`-' �' c�i� � a �n a a �n � �' �' #�n ,ia � � � g v� � o
�R a� --a m � vs y rn � -a d � � o� ay a�► n
� p o a�i � � � � � � � � � � � � � � R � � � o � � a
acha aVl �Ou ah� aGc� a�. �c°� a�u aOLc aV10
� �
�^ c �
` a v � ao ¢ a� -o a� �
i L Q L C 4 L L 1r/�5 L � 1... Q L �'@
� Q. � � � Q � � O L T � y � �.� �
`� p � L +� p '� .� O .�n � O '� � ` O .� � � O , n � O , n � O N '� `°
, ^ . @ � ^ �.� Q � .a1 N ^ N fV O ^ 0} �'�j O� ^ UJ N ^ tl] ^ � V] �
� o,c! p o �� o u(n o U V1 p o.t) � a o,c� +� � U N � u ts
; �..� �- {!1 � v= � �..� L'� v L-6 v L L.L v S- � v L� �..� =- J �p
ci a cn a a � a v a� �+� n.
�; +� a �- � +� vr +� c +� c .,� w. �. +� .,� .,�
. s C� O� C� Ol � C� fO C�(O � C� O fD ���7 v ��Q] ' q G� p7 N
� O VY a � O C'� � O tn � O cn L � a vs � � O C' � O � O C'
- t � `�° � � � � � � � � � '�''- � a � `V'�` r''"'�n � rLa � � o � � .C� b +�',,,,n r�'�o r`a a'
v. �.�. � � C�I- �a o C�m� o C�� oU�O � Vh-= �U�cn �U �a �Uacn
:�r -
�s
�+ l0 f� 00 Q� Q •--� N M
.9 -. i--� i--� �--� i--�
�.
.-,
..•
�
L
�
�
,�
�
0
N
.Q
O
�
.�
N
O
a
0
a
0
0
a
O
a
�
3
,�J+
a
�
�
�
�
E
�
•i
a
�
0
.�
c'�
�
�
.;
C
�
�
�
O
a
0
a
�
�
0
�
z
0
�
a
v
�
U
a
�
a
�
a
�
a
a
0
�
�
�
�
iv
0
[].
a
�
a�i
�
�
�
�
�
�
v
L
.a
a-
v
�
�
� �
z ��
aN
��
a .R
O f°
U
a�
��
�
��
�
�
_
Gl
�
a
.�
O�
W
�
�
�
�
�
a
a
�
�
�
�
O
�
�
L
�
a
O
r.
,�•
�
v
a,
�
�
C
O
U
N
.O
J-+
0
C
� �
L p,
�� o
� o
�i
U
�
f0
�
�
C
�
�
�
m
�
�
�1
�
n
n
�
O
Z
C
O
�+
fG
�
M
�
O
�
O
a
0
0.
0
a
r
a�i
�
�
.a
�
�
�i
�
E
U
.�
a
�
rn
0
c�
�
��; . _ �
� `�" '��
' ,d
;
_ -�" �,t
�.
�
.§ �
�
- �K� �
_ � �
N U pp
� � r
47 , x � V �
N
� � N �
�
P O O O o 0 0
���'� O O O O b 6 O
i
ai �;
Q �
� ;
H �
- � � ,p � a a UI R
� �a F� m� L Oti �� a
� ° � F o � O d m
� �? � o Q� i a y H d � vi `m
� � A � � d U � �� � �Ja
� � '� � � � . � a � C � � �a c
y R O
n. y 7� a" m° � s'„ z � v a8
L u L � L V L,� L'� L� L��
�O ,L O� O a � a �O � 10 � 40 a�
'�i a � c � � n uFi � � � � � � c
vi ' o �
s� � u a u ro u � �i _ �i '# �i !� '�
+'R � � � �—y tp
�L �L �L L �y� �L �L
.Q' � `1 � � � V � •� � � = R = 'L' f�A
- O� a O i o � o� q a O 0. O� R
� � � � � a � a �p � � [d O
> � ,�] � � a'9 � � � a � � �p o �p a �p f a
.�� U�� U�v U�C � � O U� [J 0 U fA i
� O a o o a o�= O*� o V o� o��
� a g � � a
�j r. a' � .. � �-, .� C1 �-, �-, � .� (7 'o
o d o o C1 N o o� 0 7 0 7
� o w.O o � o �.O o yj � 0 4� y o u � � u
�.� � v j� �,i � ��� � r, � � C v Q! _
+� O a-+ +-+ O +-+ � d +J a d +-+ ' +� � '
C� c C p G d C C � C a� C m G� d
� �— � v �!_— � d'� � a � �a �p.o
�► 8 S �
O(ll '� O O C'� 8� 0 0(/� p F �
u�-i [d u� C in 0 cn � u yi ,C u N� � C�
� T� ��- yaj � ,� � � N Ts a � � Q7 � f � � f
y o a, a L �p a a
� � o � �' y � a�+ o � R � '+ � � +�., � � � �
a�{-�� � � ��o a � ��q � � +�-+ C - � _ - +�-+ .��' .�w(q G7 �
�r, G�i ° tn � o` �i 3 a !� d 3 *� Gi � �� �i rn a`
T
s a� " a �" u a� o�i a a� p. `� a� � v10, a� o� v� a�
v, � 9 ui o d ui � 9 v, . o in o v, o ��p o
ra a� ra F- � ra a► ,° ra � a ro � c� �o A ro �
a� � � a� ,� o a� � � a� �� a� m� a� q a� a�
avf � a o c au� � au� a aoL a ac� am�
�
Q; � v �� � '� ' a � � 'C
E ` � m L1 �� S �
-� � Q � o �*�' �. a, �� �. �� ra
� ��,° c^ '� vo h" vo c uo � �.o cn o ,� •— �
, �� � � Q � � � � � � � 'C3 � � � �7
p�i �a W O,�n � p#�1 � O*'i_I -6 Q�7 c O,(n O, n�7 ln
? L � • ��y � �
' \.� �C \.:_7 zy \,:..7� \ U @ \,u+-+ \.� \,"m�7 N
�x- . �.� � i U] f9 � sW 7+ v �. (6 v �C '�"� v �- � � L � �- !0 � .
.N a O� in a-+ � F^ � .�' _ � a-' _ N .�-, _ � .�.� � ,�, � � N [].
=m.�� =��fl =�a� _�� =�v =� ��,�,�a
0 0�•� Q o �,� Q��� o o�. a°� a°,,, o o E O�n
uL° E,.�, uL°'°'.� u.R a�-° �.15'� �.�� �� o �+� E-p-o
ci�a� � 5�� a c'��a a c`�� o c�� oc��° 'ri c`�� ��
�` '�t' ln t0 f� 00 O� O
i�'an, , ,�1. " > ,--I ,--I ,-I ,-I ,-I rl f1f
� ;�A
£
�
O
r
�
4
u
W
M
u
a
�
a
�
a
�
a
�
�
0
�
�
�
b
a
ia
O
0.
0
ci
,a�-_+
3
a�i
.�n
�
�
�
�
a
.�
N
�
�
W �j
~ �v
� '_
Q a
�o
o�
a .-i
�
t
�
E
a
.�
O`
W
�
�
�
�
�
a
a
�
�
H
C
O
��y
•Y
�A'
W
a
O
1'3
�
�0
,a
�
�� �
�� i
� �
C
�
_
�
�
C
�
m
�
�
�
�
�
1A
O
Z
�
�
]•_
�
H
O
�
0
a
Y
^'�t �
d" �
� 4
y
ti�,
}:
ii
��
� �
� '�
�
m4
:�f
0 0 0 0 0 0 0
�.
" �
' e tx:
S
d ��
' ' t8 �
o �
a � _
a � �
O � Q a m
O � L
� � � � � +Q+ � l0 v�i � d � C a' �
�
� N 'c � a9i R w �� ±� �'010 7� A {J � N v
— L �N `J � � a +�a Y � �in I" �..,, �4,+ � �
• .-: � y u �p L c tn 3 U
�p � u {y� c � j c � u- � 7 �
7��� L� L� L y T., � a� a� a�
�
w V�++ w� u�- � � N� ��.r w„��, w' w
� Q E °c � v~i � u�'i � p, � °c � � t'n � t'n �
> > a,�_ . — N
.�w�,3 uf .�f .u��I� r3 .�a .�`� uf
�L 'I'A �� i� �L LA �L y� C �L � �L �L ;A
-� n to �� Q. = n,N n •�n io a o Q- � Q- m
GI d y � � �
f M a ��� O Ol U Ol V pl C O Ol Ol !!� Ol :�
o� �- a o•i o�� o�q `�'� a o� o� o�
� � a s' +�9 a .� *' r�a a L� � L� '�. +� �
r�.; .I9 c � �
(�; ra c ro � v� ro C•�-+ � r6 a m
a►: �.% �o � � o c� o � ui a-= � �%� �%� u�
0� � tn .� ° � b � ,�! � E °J .°o � �°-� � o � �
o a� d o� o p o a ra � o Q, o o �
•-• 'p, �y � r--� C3 r--� CY .-, "' p- � .-, Q, .-, +� .-,
O y� 7 O � O � O � 7 O 9 8 16 8 �
o O , V o y o uj o C7' vi V o � o V a y
.� C .� � .� � .� .._� [A � .. .._f �
c{j a�i ar c'�� c'� � � G7 a+ m c'G� c� c�,��u
� � 7 Q- �in � Q- bi � Of �!1 A � C �rq � .� � 47 'm
�u 'n E �' � � $ � � °u .+�i �p `�'' � v�'i �n 3 vui a 9 vui � 8
� �— �
bc.�a� v�a� ��m -�++v,� ��ad ��� ��d
� C � � L = � � � y N � @ � N �L y�,� 4J � � � � a
+J � +i _ +� A � a�-� �0 = a'�-� _ � ��-' � +�+ = a�-+ � �_ � 1d �
�p � c
.�,�9��a` �N3 �W3 ,'gR�a ��3 �Rm �N3
rn � � �
C � i71 ._ V a
��, u�i o a� a° n� a� �� � o a� ,_ � a� � o a� c. �
v� � _ �n . o �n , o � a� - � v � � � � �n , o
� c�' � � Q� � a P a�i m�� a�� y o � L- � Q o
aw.�'c� aw a aw a aY �� a� a aa 3 au� a
Ui L
"� � ti � � '� � � 'ti
' � C @ � � - � cU o �
� . ,-� � f0 }, C � Q a �
. ..S L L a--, L � L (9 ,I.,.J �. � 4" � 4' C
-�� �an�i� �� �v w C w� w� wE
� �j,� D� � �� O�n � O�n Q. D�•� E D, n � O, n �, D ir' a
•• 'a� � c � •-, '� •Q- .. �� '� .-, 'v 'ti Q- .-, a� c � ^ � � .-, .r '�
£ ` u +� ra u � u � � ,c� 6 � .0 C � � .0 � � ,u � � .� Q
r. ,`J L C U U �� L w ti� L W �� L @ � ti� L��._. `� L � ti� L LL.I
�' ` �_�via �=L � C=o cn �azw �n �� o n ��p- cn ����
fi � O C e � � O � '� � O f6 '� � O "C Ol � � O vl � � O � •� � O C .�
M a � � .0 � o j Q o ""' n � � @ [],. � rp U} o� � +� n. � ` � �
�, �, L° Q. `+9 +'� Q. � s�. +� Q-a +� c o. L°
'o�ma� oc`�u°—,'v, oc`�u,v, oc`��v��n o�� � o�cg{n oc`���
� ��I��' N � N N N N N
� !'�� �
..
,,-
�
a�
�
c
8
a--�
0
�
.�
0
a
0
a
O
D
o.
D
a
t
�
�
�
�
�
w
�
'in
7
E
�
u
a`
�
rn
0
�
�
�
�
O
�
O
a
u
W
u
a
�
�
�
0
a
O
x
a
rn
�o
0
�,
�r
�
�
a
a
O
a
�
3
�
�
m
�
0
�
.�
�
�
�
W
� �a�
z�
J �,
� o'
D
fl �
a ,-i
�
i
�
�
.'
Q
W
�
C
�
�
�
,a
� �
� �
C �
O C
:� �
� a�
�
ao
O�
� }
� �
� a
�R o
� o
a.�c�
�� V �
Q
�� O
a.
� y
� � �
C �
� �
_ �
a �
m �
1
� U
� �L
� �
^ b
� �
O �
Z
C
�
N
�
H
O
a
O
G.
� : ,..�
_ � '• ��
� �
��i � �' '
° � � � f
«
,� � �
�
�
;
�, �
�
�
Y �
O f � L L L
� � �� o 0 0 0
� �E � �� � Z Y �
V �
a' j
4
� ¢ ��
o;
�
�. O �
� � t� fFl- {fr �
L
Qi L � � L L
i� � V� L dl � �1.i A
X L c � �`—° 3 u c �' � ra
a�c +'i � o >- o u� `� � 07 >. �
m L� a }' �t�, iu ��
O 3.{�-" p�-p O,� � D'G'D p��
Q� a v� a � O n cyi u� �� a`
, z '� �j
u� !II � � u � � � W L � � •� U C
W �
c�'n p� � W� � q� O iA O+� iA W�
�1
•U li� U L �ID.1 � � � � � a.l � •�• � �
'F_ L E Ui �� � �
� �� a � � � o .a .� � � 2 a � o �
a�' � OC Z� oG u► v� o� �� pG Z�
�O a�ti � �w � c'`ri.� ��w � a�w
�
�" '�-a Q� c �w = � �v � a�� � ��
�� �° � '� �,v '� v ° '+�"+ � a�'i '+�+ � � '��+ a� �
��•= a�i"c io�.� c0a� av�i � ia�,u
; ° a r+ °u `�° "' � `� -a o +'4 � � ,� � Z
� Gl � N N � Vy iA G}' V} YI (/� y� � (%
° � � � ,�►{ C 1a � C 10 � �
+' � jII � ` V �f6 ` '4� fL� � � �f0 V V �f�
� V�� � d� Q �� C �� a 0 3 O.
N UJ 'G N
c a! — y- y- ,� � G w
� � m'3 �wa � +! �.` �3�� y Q�
� � � � � � � �' ��1 � Q � � �
L��� ` G� � Q F� � m f�O ` C 1�0
C a
P�' i n a �E � c � � z � � �ro � � c �
w � �o �a � u�' ia �'
:: +� Cl U�] G J 4% �—�i J*+ � � L N ��% �—�i
t '� C � � !l� �. � O �. � � �' � `o �' � o
�1 = � � ? •0' w � N � 7 i � v- � ,Q w
m•_a,,_ �v ���0 3E� �3a�
Q7 � y � O Q+' C N O �. � O O Q+�
�o, 00 :, : 5 = W � = C7 L a � [) � Z W �
�° � d�i � � c .°Q � .n �
� � ` � aai � � a�i �O ,� � � � �
� y J
f6 �
:� �� Q ..� ` � � ` C � s.�, C U � C 'd
� �` '� O 6 '� O � 3� i" 7 p i D
Ju� O � � = o � = ro v 'n = r�'u � = r�'a � �
-�� �•�'.D -3 a°Ji�m� a�i�n�. � ��v � � C�.�w
� va � �~�� �~�;� �~�� �~�a�i
�� L y,. O� L � � L L �
: � q a o ,� U a � `� u � � o `� �S � � `� � �.
J � � 1� � - a� � � � +-' � � C � a-.+ � L � a-+ � � �
� �C�+� � n5 UJ C Q�a UJ OJ �. O[a N� O[d ��
O � av� ro ��t1� [�0. Z�tl�m Z�tn W
. � �1,� oo �� rn o ,-� ni
,� N tV M M M
��� 5
�
0
z
0
Q
H
�
W
a
�
Q
�
0
a
O
�
a
w
0
�
�
N
m
a
9
O.
O
o.
�
�
�
�
N
�
v
�
._
�'
tC
u�
O �
z�
a�
� g
O �
a .�
1 ,
��
���
�+
C
�
a
.7
C
�
�
�
�
G1
�a
a
��
��
c�
° ��
+� o
�
a� �
ao
O�
'� �3
t�0 �
L Q
'� o
aj o
Q7
U
C
�0
C
�
C
.�
CJs
�
m
i
0�
5"�
n
^1^
�+!
O
�
�
�
.'
C
�
Yl
a
O
a
a
�
a
L
�
�
�
5
�
m
�
7
E
�
.�
,`
�
w
rn
�
V
v
-o
� �,� -
�.
�' :
�
�
� �
�
�
_�
�
S
q
0 0 0 0 0
g Z Z Z Z Z
�
� 4
� �
� �- �- �- �-
L , � '�
c
� � � � L v�' � �
fC �p �V .L- d � O� i V'O
ii C� :� 01 t� O� C
1L �� V' � �` � y� p� G
>•. O�� O� O w p V p'� N
N.� � N� N 4; G1 � t�6 y 0 a
c� y a u ro c� � c� w� c� Z'�
N �O •� � •� L � '� � � '� Q,� �
� � � � � �.�..�
Yl � �--� Y/ C Yl � � Yl � �. Y/ �% �
� O � � � � a � Z � � � ti%
.� � E .� p ,� ` � ,� ay W ,� � V
CCZ � � � CC�;° p�C � � p�G�(!l
� � W � � C � � � � � L
C�� C� i� a] c�• c
� ro
� � � � � � � � '� � 1 � R � �
U
!C (!! � l� �- � 10 �p W 10 � �f0 fG � O
�Yl ' � W O p i�ll +� '� t�l1 � a �� f�0
C� L C..c a C�� C O� = IC —
F-0 V. H FI p UJ H L� H i�
� 3 Q L� � L z � � a C L C�
'~ O � "" V � '� � � �+�- � '� +� � c
�� � aG7-+ y� � � a� VI � R� a�.� � O
o�C �@ aG o Q aG � a cC �� o�C �� �,
; L R— L� � L(� � L �--� L W ��y
(7� .O a'd �° .Q � W .G � � ,Q ii. O � „� L
.� R C� � Z� �q Vl G �p •� `�- R p O
� J d� J ay p J C Q ��� � � y�
� ��e 7� � Q 7� � QJ %� � N "� 1iJ L� ?' N �
F.. ,. y, � L � U L (U L L L L � � �
� 7 � 'J '�--� � 3 � •Er 3 O O 7 � �O
:�� � � � � � N � � �n � O � 2 IL _C a
= W � � (!1 (1} = LL w�-i
� O•L b•i p•'-�-' p•L p,� U
�
� �. v� '� fl- � d Q '� fl. � _[r{ '� d �
�� � .�� ��:� .��or �� .�
L C � 1... � L C L L ��� L C� CN
� � L � � 0 � � � a � � O � � (6 C
o� �a o'.� � o;� o� �a o:,� a
� ro � � _ � 'u 2 � v 2 � � � 2 ca � �
�a r� u c .(� c -a — � a� � � �q o�
a� �W�' � C� u��h- d��0,� d� COW
' y � � � Uy H � y H � U � � � U � � Y
.:l V � � �:1 L � �:l L � � L � � � L � Q
44 LLJ LA.� q� � lJ..l �
°- O� V� O p� O w U O� U O� U�7 >
�' o a a�i � o n a�i o o v o��� o o�� o
Z OC U') W Z� U'1 Z� CA �� Cry W � CtC [Il li 0.
..�
M � Lry lD 1�
� M M M M M
z*-
�
0
i
0
�
a
U
W
�
U
G.
�
a
N
O
o.
O
C.'
a
�
41�-�
0
�
m
rn
a
m
O
a
0
a.
L
. -�..-'
3
�
E
1]
�
N
A
�
'U
W
.�
Q
`s
�
�
w
o ��
� a
aN
� �
a �O
a ri
�
C^'
W
�
a
.?
Q
W
�
C
�
H
a7
a
a
�
�
�
�
O
�
i
N
a
O
�
C
�
.�
a
Gl
�� d
�� _
� �
c
a�
�
G
�
�
C
�
m
�
�
7"�
1
^
�
�
�
Z
�
�
`C
w
ia
H
O
a
L
a
�'-�.r�.'�� �:
X
a _ �:
kv
Y
,
E
�
�:
? � � �
r o 0 0
.� x z x
. . i„i
- : � +t�- +fl-
� �I �
'd
Z
� � � �
� � vi
m '�' � � u
°�� �� �'�
m � � v � �
.� � � � U N � C
o �
`�b ro� �� � ��
�fl, °,� �- � �n � Q �
o�G a�i o� rn ra 'i �
c°G� a�i �� +�+a
H � � �
O C � � fp �
� 10 ��� 3 ° �,�
— � � o- � �, c @
y•ao� 3� x L
= o *, o o +; +� o
� _� a �a a�
�co°�
U L-
ro
,0 Z � ,� o ,d �.
� � � � � � '� L
�
b G L lO �` � L
� 'C r��a � � � L 'G
0 3v�� os o �
a �,
� k
J �p I � J N J
�' � �p ,i' V 7' d
� .� ;� � .� � � �+
.le � C � � _� 22
� m, �u,a,�
�I7a i � � �.
.q '� � .°O
`�°a°"i `�` � �e `�°
�, � � � �- � �-
� c � � � � � o
� o o � � �
2 � �C���' 2� 2 ��^
� ' � � L � u
� [� c �a a3 ��,
+�m3C�a a�3 ���
�a� � � �j � � Q (� C �xj a �j[ � N
��� W L � La v � W L (n W L in
�
o w ��•o � o° u o° c
a +' ay .� Q. +� a� .� +� a� �fl.
o a v c r�a 6 0� v o a:�
�s z�crrwUw z�cn ���n
m m �
.,
�•
�
�
�
�
.c
�i
�
0
C
.�
�
O
fl.
O
a
`o
0
Q
0
a
s
�
�
�
�
�
�
�
�
�
E
�
u
'G
d
�
ai
0
�
E
Q'.
0
W
x
0
�
c�
LL
V
a
�
�
H
0
a
�
a
rn
�
0
m
�
�
a
a
0
�
.'��
�
�
�
7
�
v
�
�
v
v
,�
�
�o
W �y
H �
Z a
a�
�n g
O �
4 �
Exhibit D- 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 person's
affiliation or business relationship that might cause a conflict of interest with the local governmental 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 of a Conflict of Interest in any business relationship that you might have
with the City, state Vendor name in the # 1, use N/A in each of the areas on the form. However, a
signature is required in the #7 box in all cases.
PART IV
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
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 questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received
has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the
vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not later
than the 7th business day after the date the vendor becomes aware of facts that require the statement to be
filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An
offense under this section is a misdemeanor.
1 Name of vendor who has a business relationship with local governmental entity.
DEALERS ELECTRICAL SUPPLY
2
� Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated
completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
you became aware that the originally filed questionnaire was incomplete or inaccurate.)
3 Name of local government officer about whom the information is being disclosed.
N/A
Name of Officer
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)(2)(A). 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
CIQ as necessary.
N/A
A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income,
other than investment income, from the vendor?
� Yes � No N/A
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?
� Yes � No N/A
5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent or more.
N/A
6
❑Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts
as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).
7 .�'�"�'�`_
6/16/21
Signature of vendor doing business with the governmental entity Date
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021
PART IV
CONFLICT QF INT�REST GIUESTIONNAIRE
For r►endar doing business with local go�ernmental entify
Acomplete copy of Chapter 176 of the Local Govemment Code may be found at hitp:Nwww.siatutes.legis.state.tx.usl
Docs/LG/htmILG.176.htm. Fpr easy reference, below are some af the sections cited on this form.
Local Government Cade S 776AUy (1-a1: "Business relationshi�" means a connection between two or more parties
based on commercial activity of one of the parties. The ierm does not include a connection based on:
(Aj a transaction that is subject to raie or fee reguiation by a federal, state, or local governmental entity or an
age�cy af a federal, state, pr ioca� go�ernmental entity;
(Bj a transaciian conducted at a price and subject to terms available to the public; ar
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and
that is subject to regular examination by, and reporting to, that agency.
Local Government Code S 17fi.443(a](2)(A? and (B1:
(a) A local govemment officer shall file a c�nflicts disclpsure staie�nent with respect to a vendor if:
(2} thevendor:
(A) has an employment or other business relationship with the locai governmeni officer or a
family member of t�e officer that results in the officer or family member receiving taxable
income, other than investment income, that exceeds $2,5�� during the 12-rnonth period
preceding the date that the pfficer becomes aware that
{i) a contract between the local govemmental entity and vendor has been executed;
or
[ii] the locel governmental entity is considering entering into a contract with the
vendar;
(B) has gi�en to the local government oHicer or a family memper of the afficer one or more gifts
that have an aggregate value of rnorethan $10� in the 12•month period preceding the date the
offi�er hecomes aware thai:
{i] a contract beriveen the lo�al go�ernmental entity and �endor has been execuFed; or
[ii} the local gn�ernmental entity is considering entering into a contract with the �endor.
Lncal Go�ernment Cnde § 176.006ia] and [a-1]
(a] A�endor shall file a completed conflict of interest questionnaire if the vendor has a 6usiness relationship
with a lacal go�ernmental entity and:
{i f has an employment or other business relationship with a focal godernment vfficer of that Iocal
gv�ernmental entity, vr a family memper of the Qffioer, des�riped by Seotipn 175.pp3(a}{2j(A};
{2j has given a local go�ernment afficer of tnat la�al governmental entity, or a family member of the
afficer, vne or mvre gifts with the aggregate �alue specified by Sectivn i 76.003{a}[2){6}, excluding any
gift described by 5ectivn 176.fl03[a-1 ]; or
(3] has a family relatipnship with a[pCal gp�ernment aHicer �f that Ivcal g��ernmental entity.
{a-1) The completed conflict af interest questionnaire must be filed with the apprvpriate records administratvr
not later than the se�enth business day after the later of:
{1 } the date that the vendnr:
[A) begins disoussions or negotiations to enter inta a contract with the local go�ernmental
0ntity; tir
{8j submits to the ]ocal go�ernmental entity an application, responseto a request forproposals
vr bids, cvrrespondence, or another writing related to a potential oontract with the Ivcal
go�ernmental entity; or
[2] the date the �endor becvmes aware:
{Ay nf an emplvyment vr pther pusiness relativnship with a �p�al gv�ernment oHicer, �r a
family member af the oNicer, described by 5ubsection [aJ;
{B} that the vendor has gi�en one or more gifts descri�ed by Suhsection (a}; or
{C} of a family relationship with a local go�ernment officer.
Form provided by Texas EthiCs Commission www.ethiCs.state.tx.us Rewsea 1113d/2015