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Home My WebLink AboutContract 55987 CSC No. 55987 FORT WORTH CITY OF FORT WORTH COOPERATIVE PURCHASE AGREEMENT This Cooperative Purchase Agreement ("Agreement") is entered into by and between Mobile Mini, Inc. ("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— Seller's Quote, Scope of Services or Purchase Order; 3. Exhibit B—Cooperative Agency Contract(e.g.,NJPA, DIR, BuyBoard); and 4. Exhibit C—Conflict of Interest Questionnaire. Exhibits A, B, and C 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 A pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all exhibits thereto. City shall pay Vendor in accordance with the fee schedule in Exhibit A 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 not to exceed Fifty Thousand Dollars ($50,000.00). 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 be for one year beginning on June 1,2021 and ending on May 31, 2022. City shall be able to renew this agreement for one (1) one-year renewal options by written agreement of the parties. 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. Vendor will not provide a representation or warranty that the units that will be delivered are "new", but rather that they will be delivered in "good working and operating condition". Notices required pursuant to the provisions of this Agreement shall be conclusively determined to have been delivered when (1) hand-delivered to the other party, its agents, employees, servants or representatives, (2) delivered by facsimile with electronic confirmation of the transmission, or (3) received by the other party by United States Mail, registered, return receipt requested, addressed as follows: To CITY: To VENDOR: City of Fort Worth Mobile Mini, Inc. Attn: Jesus J. Chapa, Deputy City Manager Chad Holan, Director of National Accounts 200 Texas Street 4646 E. Van Buren 9400 Fort Worth, TX 76102-6314 Phoenix,AZ 85008 Facsimile: (817) 392-8654 Email: cholan@mobilemini.com With copy to Fort Worth City Attorney's Office With a copy to Mobile Mini's Legal at same address Department at same address The undersigned represents and warrants that he or she has the power and authority to execute this Agreement and bind the respective Vendor. [SIGNATURE PAGE FOLLOWS] ACCEPTED AND AGREED: CITY OF FORT WORTH CONTRACT COMPLIANCE MANAGER: By signing I acknowledge that I am the person responsible for the monitoring and T„�� (,�,� administration of this contract, including By: Jesus J.Chapa(Ju I l 202117:21 CDT) ensuring all performance and reporting Name: Jesus J. Chapa requirements. Title: Deputy City Manager APPROVAL RECOMMENDED: �k�. By: Sasha Kane(Jul2,202115:58 CDT) Name: Sasha Kane NGWMwlef Title: Sr. Contract Compliance Specialist By: Neil Noakes(Jul 10,202112:59 CDT) Name: Neil Noakes APPROVED AS TO FORM AND Title: Chief of Police o�°EORT�ad LEGALITY: ° °0�9�d ATTEST: !`o o-�d *00 ° d �a rEXXI , Name: Taylor Paris kl' By: ��nnao4b Title: Assistant City Attorney Name: Ron Gonzales Title: Acting City Secretary CONTRACT AUTHORIZATION: M&C: (None Required) Date Approved: Form 1295 Certification No.: N/A Mobil Mini, Inc. By: Za � 6/30/21 Name: Priscilla Lara Title: Risk Management Assistant OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Exhibit A—Seller's Quote, Scope of Services or Purchase Order; Page 1 of 4 mo6►l 9m►ni Quotation STORAGE SO!LITIONS ran"v.mobilemini.corn Branch Location: " 954Q FM 1384, i Justin,TX 76247 Sal usprrsoo Name;]y1or L311 man Phone 9:(214)233.3204 Fst N:7321 Fax ti: r•,mail:aiil 1ma11 d:nu3hi 611i Eli.-11 J , Customer: Deliver To: Quotation:Mental Offsite Standard FORT WORTIT POLICE DEPARTMENT FORT WORT]I POLICE DFPARTMF NT N urn her:0001503186 505 W FELIX ST 2500 Brennan Ave Delivery Date: 03109.2021 PORT W01011,TX 76115 Fort Worth,TX76RY-&107 Quote expires: 04:07.20-2 Qty I Product Uescriptiott.,&, Additional Information Period Price Per ltem 3 40'STANDARD CONTAINER TIPS CONTRACT#190301 Per Period $122.00 N 3 LLW Per Period $19 91 3 PPE Per Period $0.00 3 DELIVERY one Time $0.00 N 3 PICKUP one Timc $0.00 N 5 4W STANDARD TRI CAM CONTAINER TIP$CONTRACT#190301 Per Period $122.00 N 5 LLW Per Period $18.91 5 PPE Per Period $5.12 5 DELIVERY One Time $0.00 N 3 PICKUP One Time $0.00 N 3 20'STANDARD TRI CAM CONTAINER TIPS CON'l RACT#190301 Per Period $96,W N 3 LLW Per Period $14.58 3 PPE Per Period $4.03 3 DELIVERY One Time $0.00 N 3 PICKUP One Time $0.00 N 6 4W PREMIUM TUNNEL CONTAINER TIPS CONTRACT#190301 Per Period $133.00 N 6 LLW Per Period $20.62 6 PPE Per Period $5.59 6 DELIVERY one Time $0.00N Page 2 of 4 6 PICKUP One Time $0.00 N l CONTAINI;II-STk;I';L W-STANDARD TRICAM-RC TIPS CONTRACT#190301 Per Period $122.00 N l LLW Per Period $18.91 1 PPE Per Period $5.12 1 DELIVERY One Time $0.00 N 1 PICKUP One Time $0.00 N Tolxls: Total Rental Charges $2,599.89 Total One-rime Charges $0.00 Total Taxes $0.00 Total Initial Charges $2,599.98 Total Recurring Charges $2,598.88 a^ T=Taxable N=Not Taxable Exhibit B —Cooperative Agency Contract(e.g., NJPA, DIR, BuyBoard) TIPS VENDOR AGREEMENT Between Mobile Mini Inc. and (Company Name) THE INTERLOCAL PURCHASING SYSTEM{TIPS), a Department of Texas Education Service Center Region 8 for RFP 190301 Portable Storage General Information The Vendor Agreement("Agreement")made and entered into by and between The Interlocal Purchasing System(hereinafter referred to as"TIPS"respectfully)a government cooperative purchasing program authorized by the Region 8 Education Service Center,having its principal place of business at 4845 US Hwy 271 North,Pittsburg,Texas 75686.This Agreement consists of the provisions set forth below,including provisions of all Attachments referenced herein.In the event of a conflict between the provisions set forth below and those contained in any Attachment,the provisions set forth shall control unless otherwise agreed by the parties in writing and by signature and date on the attachment. The vendor Agreement shall Include and incorporate by reference this Agreement,the terms and conditions,special terms and conditions,any agreed upon amendments,as well as all of the sections of the solicitation as posted,including any addenda and the awarded vendor's proposal.Once signed,if an awarded vendor's proposal varies or is unclear in any way from the TIPS Agreement, TIPS,at its sole discretion,will decide which provision will prevail unless otherwise specifically agreed in writing by the parties. A Purchase Order,Agreement or Contract its the TIPS Member's approval providingthe authority to proceed with the negotiated delivery order under the Agreement. Special terms and conditions as agreed to between the vendor and TIPS Member should be added as addendums to the Purchase Order,Agreement or Contract. Items such as certificate of insurance,bonding requirements,small or disadvantaged business goals are some of the addendums possible. Non-JOC Vendor Agreement Ver.05052018.rp Page 1 Terms and Conditions rre ight All quotes to members shall provide a line item for cost for freight or shipping regardless if there is a charge or not. If no charge for freight or shipping,indicate by stating"No Charge"or "$0","included in price"or other similar indication. Otherwise,all shipping,freight or delivery changes shall be passed through to the TIPS Member at cost with no markup and said charges shall be agreed by the TIPS Member. Warranty Conditions All new supplies equipment and services shall include manufacturer's minimum standard worrontyunless otherwise agreed to in writing.Vendor shall be legally permitted to sell all products offered for sale to TIPS Members.All goods proposed and sold shall be new unless clearly stated in writing. Customer Support The Vendor shall provide timely and accurate customer support for orders to TIPS Members as agreed by the Parties.Vendors shall respond to such requests within a commercially reasonable time after receipt of the request. If support and/or training is a line item sold or packaged with a sale,support shall be as agreed with the TIPS Member. Agreements Agreements for purchase will normally be put into effect by means of a purchase order(s) executed by authorized agents of the TIPS Member participating government entities, but other means of placing an order may be used at the Member's discretion. Tax exempt status Most TIPS Members are tax exempt and the related laws and/or regulations of the controlling jurisdiction(s)of the TIPS Member shall apply. Assignments of Agreements No assignment of Agreement may be made without the prior notification of TIPS. Written approval of TIPS shall not be unreasonably withheld. Payment for delivered goods and services can only be made to the awarded Vendor,Vendor designated reseller or vendor assigned company. Disclosures 1. Vendor and TIPS affirms that he/she or any authorized employees or agents has not given,offered to give,nor intends to give at anytime hereafter any economic opportunity,future employment,gift,loan,gratuity,special discount,trip,favor or service to a public servant in connection with this Agreement. iVon-JOC Vendor Agreement Ve r.09052018.rp Page 2 2. Vendor shall attach,in writing,a complete description of any and all relationships that might be considered a conflict of interest in doing business with the TIPS program. 3. The Vendor affirms that,to the best of his/her knowledge,the offer has been arrived at independently,and is submitted without collusion with anyone to obtain information or gain any favoritism that would in any way limit corn petition or give an unfair advantage over other vendors in the award of this Agreement. Renewal of Agreements The Agreement with TIPS is for three(3)years with an option for renewal for an additional one (1)consecutive year. The scheduled Agreement termination date shall be the last date of the month of the last month of the agreement's legal effect. Example:if the agreement is scheduled to end on May 23, the anniversary date of the award,it would actually be extended to May 33 in the last month of the last year the con tracf is active. Automatic Renewal Clauses Incorporated in Awarded Vendor Agreements with TIPS Members Resulting from the Solicitation and with the Vendor Named in this Agreement. No Agreement for goods or services with a TIPS Member by the awarded vendor named in this Agreement that results from the solicitation award named in this Agreement,may incorporate an automatic renewal clause with which the TIPS Member must comply. All renewal terms incorporated in an Agreement by the vendor with the TIPS Member shall only be valid and enforceable when the vendor receives written confirmation by purchase order or executed Agreement issued by the TIPS Member for any renewal period. The purpose of this clause is to avoid a TIPS Member inadvertently renewing an Agreement during a period in which the governing body of the TIPS Member has not properly appropriated and budgeted the funds to satisfy the Agreement renewal. This term is not negotiable and any Agreement between a TIPS Member and a TIPS awarded vendor with an automatic renewal clause that conflicts with these terms is rendered void and unenforceable. Shipments The Vendor shall ship,deliver or provide ordered products or services within a commercially reasonable time after the receipt of the order from the TIPS Member.If a delay in said delivery is anticipated,the Vendor shall notify TIPS Member as to why delivery is delayed and shall provide an estimated time for completion of the order.TIPS or the requesting entity may cancel the order if estimated delivery time is not acceptable or not as agreed. Invoices The awarded vendor shall submit invoices or payment requests to the TIPS Member participating entity clearly stating"Per TIPS Agreement#xxxxxxx or similarly identifyingthe Agreement. Each invoice or pay request shall include the TIPS Member's purchase order number or other identifying designation as provided in the order by the TIPS Member. If applicable,the shipment tracking number or pertinent information for verification of TIPS Member receipt shall be made available upon request. Non-JOC Vend or Agreement Ver.09052018.rp Page 3 Payments The TIPS Member will make payments directly to the Vendor or vendor assigned dealer after receiving invoice or in compliance with applicable statute,whichever is the greater time or as otherwise provided by an agreement of the parties. Pricing Price increases will be honored according to the terms of the solicitation. All pricing submitted to TIPS shall include the participation fee,as provided in the solicitation,to be remitted to TIPS by the Vendor. Vendor will not show adding the fee to the invoice presented to TIPS Member customer. Failure to render the participation fee to TIPS shall constitute a breach of this agreement and shall be grounds for termination of this agreement and any other agreement held with TIPS. Participation Fees The Participation Fee that was published as part of the Solicitation and the fee published is the legally effective fee,along with any Fee conditions stated in the RFP. Collection of the fees by TIPS is required under Texas Government Code§791.011 Et seq.Vendor or vendor assigned dealer Agreements to pay the participation fee for all Agreement sales to TIPS on a monthly scheduled report or as otherwise agreed by the parties.Vendor must login to the TIPS database and use the"Submission Report"section to report sales.The Vendor or vendor assigned dealers are responsible for keeping record of all sales that go through the TIPS Agreement and submitting same to TIPS. Failure to pay the participation fee will result in termination of Agreement and possible legal action. Please contact TIPS at tips@tips-usa.com or call(866)839-8477 if you have questions about paying fees. Indemnity The Vendor agrees to indemnify and hold harmless and defend TIPS,TIPS Member(s),officers and employees from and against all claims and suits by third parties for damages,injuries to persons(including death),property damages,losses,and expenses including court costs and reasonable attorney's fees,arising out of,or resulting from,Vendor's work under this Agreement,including all such causes of action based upon common,constitutional,or statutory law,or based in whole or in part,upon allegations of negligent or intentional acts on the part of the Vendor,its officers,employees,agents,subcontractors,licensees,or invitees. Parties found liable shall pay their proportionate share of damages as agreed by the parties or as ordered by a court of competent jurisdiction over the case. NO LIMITATION OF LIABILITY FOR DAMAGES FOR PERSONAL INJURY OR PROPERTY DAMAGE ARE PERMITTED OR AGREED BY TIPS/ESC Region 8. Per Texas Education Code§44.032(f),and pursuant to its requirements only,reasonable Attorney's fees are recoverable by the prevailing party in any dispute resulting in litigation. Non-JOC Vend or Agreement Ver.09052018.rp Page 4 State of Texas Franchise Tax By signature hereon,the bidder hereby certifies that he/she is not currently delinquent in the payment of any franchise taxes owed the State of Texas under Chapter 171,Tax Code. Miscellaneous The Vendor acknowledges and agrees that continued participation in TIPS is subject to TIPS sole discretion and that any Vendor may be removed from the participation in the Program at any time with or without cause. Nothing in the Agreement or in any other communication between TIPS and the Vendor may be construed as a guarantee that TIPS or TIPS Members will submit any orders at any time.TIPS reserves the right to request additional proposals for items or services already on Agreement at any time. Purchase Order Pricing/Product Deviation If a deviation of pricing/product on a purchase order or contract modification occurs,TIPS is to be notified within 48 hours of receipt of order. Termination for Convenience TIPS reserves the right to terminatethis agreementfor cause or no cause for convenience with a thirty-day written notice.Termination for convenience is required under Federal Regulations 2 CFR part 200.All purchase orders presented to the Vendor by a TIPS Member prior to the actual termination of this agreement shall be honored at the option of the TIPS Member.The awarded vendor may terminate the agreement with ninety(90)days written notice to TIPS 4845 US Hwy North,Pittsburg,Texas 75686. The vendor will be paid for goods and services delivered prior to the termination provided that the goods and services were delivered in accordance with the terms and conditions of the terminated agreement. TIPS Member Purchasing Procedures Purchase orders or their equal are issued by participating TIPS Memberto the awarded vendor and should indicate on the order that the purchase is per the applicable TIPS Agreement number.Orders are typically emailed to TIPS at tipspo@tips-usa.com. Awarded vendor delivers goods/services directly to the participating member. Awarded vendor invoices the participating TIPS Member directly. Awarded vendor receives payment directly from the participating member. Awarded vendor reports sales monthly to TIPS(unless prior arrangements have been made with TIPS for an alternative submission schedule). Licenses Awarded vendor shall maintain in current status all federal,state and local licenses,bonds and permits required for the operation of the business conducted by awarded vendor.Awarded vendor shall remain fully informed of and in compliance with all ordinances and regulations pertainingto the lawful provision of goods or services under the Agreement.TIPS and TIS Members reserves the right to stop work and/or cancel Agreement of any awarded vendor whose license(s)expire,lapse,are suspended or terminated subject to a 30-day cure period unless prohibited by applicable statue or regulation. Non-JQC Vend or Agreement Ver.09052018.rp Page 5 N ovatio n If awarded vendor sells or transfers all assets or the entire portion of the assets used to perform this Agreement,a successor in interest must guarantee to perform all obligations under this Agreement.A simple change of name agreement will not change the Agreement obligations of awarded vendor. Site Requirements(only when applicable to service orjob) Cleanup:Awarded vendor shall clean up and remove all debris and rubbish resulting from their work as required or directed by TIPS Member. Upon completion of work,the premises shall be left in good repair and an orderly,neat,clean and unobstructed condition. Preparation:Awarded vendor shall not begin a project for which TIPS Member has not prepared the site,unless awarded vendor does the preparation work at no cost,or until TIPS Member includes the cost of site preparation in a purchase order. Site preparation includes,but is not limited to: moving furniture,installing wiring for networks or power,and similar pre-installation requirements. Registered sex offender restrictions: For work to be performed at schools,awarded vendor agrees that no employee of a sub-contractor who has been adjudicated to be a registered sex offender will perform work at any time when students are,or reasonably expected to be, present.Awarded vendor agrees that a violation of this condition shall be considered a material breach and may result in the cancellation of the purchase order at the TIPS Member's discretion. Awarded vendor must identify any additional costs associated with compliance of this term. If no costs are specified,compliance with this term will be provided at no additional charge. Safety measures:Awarded vendor shall take all reasonable precautions for the safety of employees on the worksite,and shall erect and properly maintain all necessary safeguards for protection of workers and the public.Awarded vendor shall post warning signs against all hazards created by the operation and work in progress. Proper precautions shall be taken pursuant to state law and standard practices to protect workers,general public and existing structures from injury or damage. Smoking Persons working under Agreement shall adhere to the TIPS Member's or local smoking statutes,codes or policies. Marketing Awarded vendor agrees to allow TIPS to use their name and logo within TIPS website, marketing materials and advertisement subject to any reasonable restrictions provided to TIPS in the Proposal to the Solicitation. The Vendor may submit an acceptable use directive for Vendor's names and logos whit which TIPS agrees to comply. Any use of TI PS name and logo or any form of pubiicity,inclusive of press release, regardingthis Agreement by awarded vendor must have prior approval from TIPS which will not be unreasonably withheld. Request may be made by email to TIPS@TIPS-USA.COM. Non-JOC Ve nd or Agreement Ve r.09052018.rp Page 6 Supplemental agreements The TIPS Member entity participating in the TIPS Agreement and awarded vendor may enter into a separate supplemental agreement or contract to further define the level of service requirements over and above the minimum defined in this Agreement i.e.invoice requirements, ordering requirements,specialized delivery,etc.Any supplemental agreement or contract developed as a result of this Agreement is exclusively between the participating entity and awarded vendor.TIPS,its agents,TIPS Members and employees shall not be made party to any claim for breach of such agreement unless named and agreed by the Party in question in writing in the agreement. If a vendor submitting a Proposal requires TIPS and/or TIPS Member to sign an additional agreement,those agreements shall comply with the award made by TIPS to the Vendor.Supplemental Vendor's Agreement documents may not became part of TIPS's Agreement with vendor unless and until an authorized representative of TIPS reviews and approves it. TIPS permits TIPS Members to negotiate additional terms and conditions with the Vendor for the provision of goods or services under the Vendor's TIPS Agreement. Survival Clause All applicable agreements,contracts,software license agreements,warranties or service agreements that were entered into between Vendor and TIPS or the TIPS Member Customer under the terms and conditions of this Agreement shall survive the expiration or termination of this Agreement.All Orders,Purchase Orders issued or contracts executed by TIPS or a TIPS Member and accepted by the Vendor prior to the expiration or termination of this agreement, shall survive expiration or termination of the Agreement,subject to previously agreed terms and conditions agreed by the parties or as otherwise specified herein relating to termination of this agreement. Legal obligations It is the responding vendor's responsibility to be aware of and comply with all local,state and federal laws govern ingthe sale of products/services identified in this Solicitation and any awarded Agreem ent th ereof.Applicable laws and regulations must be followed even if not specifically identified herein. Audit rights Due to transparency statutes and public accountability requirements of TIPS and TIPS Members',the awarded Vendor shall,at their sole expense,maintain appropriate due diligence of all purchases made by TIPS Member that utilizes this Agreement.TIPS and Region 8 ESC each reserve the right to audit the accounting of TIPS related purchases for a period of three(3) years from the time such purchases are made.This audit right shall survive term ination of this Agreementfor a period of one(1)year from the effective date of termination. In order to ensure and confirm compliance with this agreement,TIPS shall have authority to conduct audits of Awarded Vendor's pricing that is offered to TIPS Members with 34 days'notice unless the audit is ordered by a Court Order or by a Government Agency with authority to do so without notice. Notwithstanding the foregoing,in the event that TIPS is made aware of any pricing Non-JQC Vend or Agreement Ver.09052018.rp Page 7 being offered to eligible entities that is materially inconsistent with the pricing under this agreement,TIPS shall have the ability to conduct the audit internally or may engage a third- party auditing firm to investigate any possible non-complying conduct or may terminate the Agreement according to the terms of this Agreement. In the event of an audit,the requested materials shall be reasonably provided in the time,format and at the location acceptable to Region 8 ES or TIPS. Force Majeure If by reason of Force Majeure,either party hereto shall be rendered unable wholly or in part to carry out its obligations under this Agreementthen such party shall give notice and fully particulars of Force Majeure in writing to the other party within a reasonable time after occurrence of the event or cause relied upon,and the obligation of the party giving such notice, so far as it is affected by such Force Majeure,shall be suspended duringthe continuance of the inability then claimed,except as hereinafter provided,but for no longer period,and such party shall endeavor to remove or overcome such inability with ali reasonable dispatch. Project Delivery Order Procedures The TIPS Member havingap prove d and signed an interlocaI agreement,or other TIPS Membership document,may make a request of the awarded vendor under this Agreement when the TIPS Member desires goods or services awarded to the Vendor. Notification may occur via phone,the web,courier,email,fax,or in person. Upon notification of a pending request,the awarded vendor shall acknowledge the TIPS Member's request as soon as passible,but must make contact with the TIPS Member within two working days. Status of TIPS Members as Related to This Agreement TIPS Members stand in the place of TIPS as related to this agreement and have the same access to the proposal information and all related documents. TIPS Members have all the same rights under the awarded Agreement as TIPS. Vendor's Resellers as Related to This Agreement Vendor's Named Resellers under this Agreement shall comply with all terms and conditions of this agreement and all addenda or incorporated documents.All actions related to sales by Authorized Vendor's Resellers under this Agreement are the responsibility of the Awarded Vendor. Support Requirements If there is a dispute between the awarded vendor and TIPS Member,TIPS or its representatives will assist in conflict resolution or third party if requested by either party.TIPS,or its representatives,reserves the right to inspect any project and audit the awarded vendors TIPS project files,documentation and correspondence related to the requesting Member's order. If there are confidentiality requirements by either party,TIPS shall comply to the extent permitted by law. iVon-JOC Vendor Agreement Ve r.09052018.rp Page 8 Incorporation of Solicitation The TIPS Solicitation,whether a Request for Proposals,the Request for Competitive Sealed Proposals or Request far Qualifications solicitation,or other,the Vendor's response to same and all associated documents and forms made part of the solicitation process,including any addenda,that resulted in the execution of this agreement are hereby incorporated by reference into this agreement as if copied verbatim. SECTION HEADERS OR TITLES THE SECTON HEADERS OR TITLES WITHIN THIS DOCUMENTARE MERE LY GUI DES FOR CONVENIENCE AND ARE NOT FOR CLASSIFICATION OR LIMITING OF THE RESPONSIBILITIES OF THE PARTIES TO THIS DOCUMENT. NEW STATUTORY REQUIREMENT EFFETIVE SEPTEMBER 1,2017. Texas governmental entities are prohibited from doing business with companies that fail t❑ certify to this condition as required by Texas Government Code Sec.2270. By executing this agreement,you certify that you are authorized to bind the undersigned Vendor and that your company(1)does not boycott Israel;and(2) will not boycott Israel duringthe term of the Agreement. You certify that your company is not listed on and we do not do business with companies that are on the Texas Comptroller of Public Accounts list of Designated Foreign Terrorists Organizations per Texas Gov't Code 2270.0153 found at https://com ptroll er.texas.gov/purchasing/docs/fo re ign-te rro ri st.p df You certify that if the certified statements above become untrue at any time during the life of this Agreement that the Vendor will notify TIPS within 1 business day of the change by a letter on your letterhead from an authorized representative of the Vendor stating the non- compliance decision and the TIPS Agreement number and description at: Attention:General Counsel ESC Region 8/The Interlocal Purchasing System(TIPS) 4845 Highway 271 North Pittsburg,TH,75686 And by an email sent to bids@tips-usa.com Insurance Requirements The undersigned Vendor agrees to maintain the below minimum insurance requirements for TIPS Contract Holders. General Liability $1,000,000 each Occurrence/Aggregate Automobile Liability $300,000 Includes owned,hired&non-awned Workers'Compensation Statutory limits Umbrella Liability $1,000,000 When the contractor or its subcontractors are liable for any damages or claims,the contractors' Non-JOC Vendor Agreement Ve r.09052018.rp Page 9 policy,when the Vendor is responsible for the claim,must be primary over any other valid and collectible insurance carried by the District.Any immunity available to TIPS or TIPS Members shall not be used as a defense by the contractor's insurance policy. The coverages and limits are to be considered minimum requirements and in no way Iimitthe liability of the Contractor(s). Insurance shall be written by a carrier with an A-;VI or better rating in accordance with current A.M. Best Key Rating Guide. Only deductibles applicable to property damage are acceptable. "Claims made"policies will not be accepted. Vendor's required minimum coverage shall not be suspended,voided,cancelled,non-renewed or reduced in coverage or in limits unless replaced by a policy that provides the minimum required coverage except after thirty(30)days prior written notice by certified mail,return receipt requested has been given to TIPS or the TIPS Member if a project or pending delivery of an order is ongoing. Upon request,certified copies of all insurance policies shall be furnished to the TIPS or the TIPS Member. Special Terms and Conditions Agreements: All vendor orders received form TIPS Members must be emailed to TIPS attipspo@tips-usa.com.Should a TIPS Member send an order directto vendor,it is the vendor's responsibility to forward a copy of the order to TIPS at the email above within 3 business days and confirm its receipt with TIPS. VeiWor Encouraging Members to bypass TIPS agreement:Encouraging entities to purchase directly from the Vendor or through another agreement,when the Member has requested using the TIPS cooperative Agreement or price,and thereby bypassing the TIPS Agreement is a violation of the terms and conditions of this Agreement and will result in removal of the Vendor from the TIPS Program. Order Confirmation:All TIPS Member Agreement purchase orders are approved daily by TIPS and sent to vendor. The vendor should confirm receipt of orders to the TIPS Member(customer)within 3 business days. Vendor custom website for TIPS: If Vendor is hosting a custom TIPS webs ite, updated pricing when effective.TIPS shall be notified when prices change in accordance with the award. Back Ordered Products: If product is not expected to ship within the time provided to the TIPS member by the Vendor,customer is to be notified within 3 business days and appropriate action taken based on customer request. Page 11 of 11 will be the TIPS Vendor Agreement Signature Page Non-JQC Vend or Agreement Ver.09052018.rp Page 10 TIPS Vendor Agreement Signature Form RFP 190301 Portable Storage Company Name Mobile Mini Address 4646 E Van Buren #400 CityPhoenix State AZ Zip 85008 Phone 602-799-9907 Fax Email of Authorized Representative elennon@mobilemini.com Name of Authorized Representative Ed Lennon Title National Account Manager Signature of Authorized Representative Date 5-15-2019 TIPS Authorized Representative Name Meredith Barton Title Vice-President of Operations TIPS Authorized Representative Signature �'— Approved by ESC Region 8 4MU6 Y1 �CAW Date 5/29/19 Page 11 of 11 The Interlocal Purchasing Systern (TIPS Cooperative) Supplier Response Bid information Contact Infarmatian Ship to Information Bid Creator Rick Powell General Address Region 8 Education Address Counsel/Procurement Service Center Compliance Officer 4845 US Highway 271 Email ri c k.powe I I @t i ps-u sa.corn North Contact Phone (903)575-2689 Pittsburg,TX 75686 Fax Contact Kristie Collins Department Building Bid Number 190301 Department Title Portable Storage Building Floor/Room Bid Type RFP Telephone Issue Date 3/7/201908:00 AM(CT) FloorlRoom Fax Close Date 511 71201 9 03:00:00 PM(CT) Telephone +1 (866)839-8477 Email Fax +1 (866)839-8472 Email bidsQtips-usa.com Supplier Information Company Mobile Mini; Inc. Address 4646 East Van Buren Phoenix,AZ 85008 Cc ntact Department Building Floor/Room Telephone (480)894-6311 x1713 Fax (480)894-6433 Email Submitted 511 51201 9 03:33:04 PM(CT) Total $0.00 By submitting your response,you certify that you are authorized to represent and bind your company. Signature Ed Lennon Email elennon@mobilemini.com Supplier Notes Agreed to vendor agreement but wanted to document that our rental units are not new nor are our containers far sale Bid Notes Bid Activities Bid Messages 190301 -Mobile Mini, Inc. -Page 1 of 22 Date Subject Message 05/10/19 addendum note There is no need to address the addendum as it was only a correction of solicitation number on the specifications document.You may disregard any instruction in the system to address the addendum. Bid Attributes Please review the following and respond where necessary # Name Note Response 1 Yes-No Disadvantaged/MinorityMornen Business Enterprise- NO WMIWBE[Required by some participating governmental entities]Venda certifies that their firm is a D/M/WBE? Vendor must upload proof of certification to the-Response Attachments"DIMMBE CERTIFICATES section- 2 Yes-No Historically Underutilized Business-HUB(Required by No some participating governmental entities)Vendor certifies that their firm is a HUB as defined by the State of Texas at https//comptrdIor.texas.govipurrhasingtvendor�hub/ or in a HUBZcne as defined by the US Small Business Administration at httpsi/Mrww.sba-gov/offices/n eadqu a rters/ohp Proof of one or both may be submitted.Vendor must upload proof ofcertifica[ion to the"Response Attachments"HUB CERTIFICATES section. 3 Yes-No The Vendor can provide services and/or products to a1150 Yes US States? 4 States Served: If answer is NO to question#3,please list which states can be served.[Example:AR,OK,TX] 5 Company and/or Product Description: This irrformation will appear on the TIPS website in the Mobile Mini Inc.is the world's company profile section,if awarded a TIPS contract.[Limit leading provider of portable storage 750 characters.] solutions,committed to providing our customerswith superior services and access to a high-quality and diverse fleet-As of March 31,2019, our network includes 139 locations in the US.Over the last thirty-five years,Mobile Mini Storage Solutions has become the world's leading provider of highly-customized portable storage solutions.With a total rental fleet of over 196,400 storage containers and office units, you can trust Mobile Mini to have the solutions you need.Whether your needs are short-or long-term, we have the rental and purchasing options right for you- 6 Primary Contact Name Primary Contact Name Ed Lennon 7 Primary Contact Title Primary Contact Title National Account Manager 8 Primary Contact Email Primary Contact Email elennonamobilemini.cam 9 Primary Contact Phone Enter 10 digit phone number.[No dashes or extensions] 602-799-9907 Example:8668398477 10 Primary Contact Fax Enter 10 digit phone number.[No dashes or extensions] Example:8668398477 190301 Mobile Mini, Inc.-Page 2 of 22 11 Primary Contact Mobile Enter 10 digit phone numhor.(No dashes or extensions] 602-799-9907 Example:8668398477 12 Secondary Contact Name Secondary Contact Name Chad Hdan 13 Secondary Contact Title Secondary Contact Title Sales Manager 14 Secondary Contact Email Secondary Contact Email chola n@ mobilemin I-corn 15 Secondary Contact Phone Enter 10 digit phone number.(No dashes or extensions] 800-950-6464 ext3711 Example:8668398477 16 Secondary Contact Fax Enter 10 digit phone number.(No dashes or extensions) (480)281-3500 Example:8668398477 17 Secondary Contact Mobile Enter 10 digit phone numher.(No dashes or extensions) 480-825-3016 Example:8668398477 18 Admin Fee Contact Name Admin Fee Contact Name.This person is responsible for Jason Spencer paying the admin fee to TIPS. 19 Admin Fee Contact Email Admin Fee Contact Email jspencer@mobilemini.corn 20 Admin Fee Contact Phone Enter 10 digit phone number.(No dashes or extensions) 800-950-6464 ext 7635 Example:8668398477 21 Purchase Order Contact Name Purchase Order Contact Name.This person is responsible Ed Lennon for receiving Purchase Orders from TIPS. 22 Purchase Order Contact Email Purchase Order Contact Email elennong mob il ern ini.corn 23 Purchase Order Contact Phone Enter 10 digit phone number.(Nodashes or extensions) 6027999907 Example:8668398477 24 Company Website Company Website(Format-www.cornpany.com) www.moUlea ini.com 25 Federal ID Number: Federal ID Number also known as the Employer Identification Number.(Format-12-3456789) 26 Primary Address Primary Address 4646 E Van Buren 9 400 27 Primary Address City Primary Address City Phoenix 28 Primary Address State Primary Address State(2 Dig itAbbrevi all ony A2 29 Primary Address Zip Primary Address Zip 85008 30 Search Wads: Please list search words to be posted in the TIPS Storage,container,conex,connex, database about your company that TIPS Website users sea container,office,ground level might search.Words may be product names, office,pods,mobile mini,mini manufacturers,or other words associated with the mobile,security office,office trailer, category of award.YDLI MAY NOT LIST temporary storage,mobile office, NON-CATEGORY ITEMS.(Limit 500 words)(Format: mobile container,sea box,40 box, product,paper,construction,manufacturer name,etc.) 20 box,40 container,20 container 31 Do you want TIPS Members to be able to spend Most of our members receive Federal Government grants No Federal grant funds with you if awarded?Is it and they make up a significant portion of their budgets. your intent to be able to sell to our members The members need to know if your company is willing to regardless of the fund source,whether it be local, sell to them when they spend federal budget funds on their state or federal? purchase.There are attributes that follow that are provisions from the federal regulations in 2 CFR part 200. Your answers will determine if your award will be designated as Federal or Education Department General Administrative Regulations(EDGAR)compliant. Do you want TIPS Members to be able to spend Federal grant funds with you if awarded and is it your intent to be 190301 -Mobile Mini, Inc.-Page 3 of 22 able to sell to our members regardless of the fund source, whether it he local,state or federal? 32 Yes-No Certification of Residency(Required by the State of Yes Texas)The vendor's ultimate parent company or majority owner: (A)has its principal place of business in Texas; OR (B)employs at feast 500 persons in Texas? 33 Company Residence(City) Vendor's principal place of business is in the city of? Phoenix 34 Company Residence(State) Vendor's principal place of business is in the state of? AZ 35 Discount Offered-CAUTION READ CAREFULLY Remember this is a MINIMUM discount percentage so,he 15% BECAUSE VENDORS FREQUENTLY MAKE sure the discount percentage inserted here can be applied MISTAKES ON THIS ATTRIBUTE QUESTION to ANY OFFERING OF GOODS OR SERVICES THROUGH OUT THE LIFE OF THE CONTRACT CAUTION:BE CERTAIN YOU CAN HONOR THIS MINIMUM DISCOUNT PERCENTAGE ON ANY OFFERED SERVICE OR GOOD. What is the MINIMUM percentage discount off of any item or seance you offer to TIPS Members that is in your regular catalog(as defined in the R F P document), website,store or shelf pricing?The resulting price of any goods or services Catalog list prices after this discount is applied is a ceiling on your pricing and not a floor because, in order to he more competitive in the individual circumstance,you may offer a larger discount depending on the items or services purchased and the quantity at time of sale.Must answer with a number between 0%and 100%. 36 TIPS administration fee By submitting a proposal,I agree that all pricing submitted (No Response Required) to TIPS shall include the participation fee,as designated in the solicitation or as otherwise agreed in writing and shall be remitted to TIPS by the Vendor as agreed in the Vendor agreement.I agree that the fee shall not and will not be added by the vendor as a separate line item on a TIPS member invoice,quote,proposal or any other written communications with the TIPS member. 37 Yes-No Vendor agrees to remit to TIPS the required administration Yes fee? Region 8 is required by Texas Government Code§791 to be compensated for its work and thus, failure to agree shall render your response void and it will not be considered. 38 Yes-No Do you offer additional discounts to TIPS members for Yes large order quantities or large scope of work? 39 Years Experience Company years experience in this category?This is an 36 evaluation criterion worth a maximum of 10 points.See R F P for more information. 40 Resellers: Does the vendor have resellers that it will name under this No contract?Re sellers are defined as other companies that sell your products under an agreement with you,the awarded vendor of TIPS. BIGmart is a reseller of ACME brand televisions.If ACME were a TIPS awarded vendor,then ACME would list BIGmart as a reseller. applicable,vendor should download the Resell ar/Dealers spreadsheet from the Attachments section,fill out the form and submit the document in the'Response Attachments' RESELLERS section. 190301 -Mobile Mini, Inc.-Page 4 of 22 41 Pricing discount percentage are guaranteed for? Does the vendor agrees to honor the proposed pricing YES discount percentage off regular catalog(as defined in the R F P document),website,store or shelf pricing for the term of the award? 42 Right of Refusal Does the proposing vender wish to reserve the right not to No perform under the awarded agreement with a TIPS member at vendor's discretion? 43 NON-COLLUSIVE BIDDING CERTIFICATE By submission of this bid or proposal,the Bidder certifies (No Response Required) that: 1)This bid or proposal has been independently arrived at without cdlusion with any other Bidder or with any Competitor; 2)This bid or proposal has not been knowingly disclosed and will not be knowingly disclosed,prior to the opening of bids,or proposals for this project,to any other Bidder, Competitor or potential competitor: 3)No attempt has been or will be made to induce any other person,partnership or corporation to submit or not to submit a bid or proposal, 4)The person signing this bid or proposal certifies that he has fully informed himself regarding the accuracy of the statements contained in this certification,and under the penalties being applicable to the Bidder as wall as to the person signing in its behalf. Not a negotiable term.Failure to agree will render your proposal non-responsive and it will not be considered. 44 CONFLICT OF INTEREST QUESTIONNAIRE- Do you have any CONFLICT OF INTEREST TO REPORT No FORM CIQ-Do you have any CONFLICT OF OR DISCLOSE under this statutory requirement?YES or INTEREST TO REPORT OR DISCLOSE under NO you have a conflict of interest as described in this this statutory requirement? form or the Local Government Code Chapter 176,cited therein-you are required to complete and file with TIPS. may find the Blank CIO form on our web site at: Copy and Paste the fdlrnwing link into a new browser or tab: https:/Awww.tips-usa.com/assetsldocu men tsldoc s/C IQ.pdf There is an optional upload for this form provided if you have a conflict and must file the form. 45 Filing of Form CIO If yes(above),have you filed a form CIO by uploading the form to this RFP as directed above? 46 Regulatory Standing I certify to TIPS for the proposal attached that my Yes company is in good standing with all governmental agencies Federal or state that regulate any part of our business operations.If not,please explain in the next attribute question. 47 Regulatory Standing Regulatory Standing explanation of no answer on previous question. 190301 -Mobile Mini, Inc.-Page 5 of 22 48 Antitrust Certification Statements(Tex. By submission of this bid or proposal,the Bidder certifies (No Response Required) Government Code§2155.005) that: I affirm under penalty of perjury of the laws of the State of Texas that- (I)I am duly authonzed to execute this contract on my own behalf or on behalf of the company,corporation,firm, partnership or individual(Company)listed below; (2)In connection with this bid,neither I nor any representative of the Company has+ndated any provision of the Texas Free Enterprise and Antitrust Act,Tex.Bus. &Comm.Code Chapter 15; (3)In connection with this hid,neither I nor any representative of the Company has violated any federal antitrust law; (4)Neither I nor any representative of the Company has directly or indirectly communicated any of the contents of this bid to a competitor of the Company or any other company,corporation,firm,partnership or individual engaged in the same line of business as the Company. 190301 -Mobile Mini, Inc.-Page 6 of 22 49 Suspension or Debarment Instructions Instructions for Certification: By answering yes to the [No Response Required] next Attribute question below,the vendor and prospective lower tier participant is providing the certification set out herein in accordance with these instructions. 2.The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into.If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certMoation in addition to other remedies available to the federal government,the department or agencywith which this transaction originated may pursue available remedies,including suspension and 1 or debarment. 3.The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant teams that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4.The terms"covered transaction,""debarred," "suspended;"ineligible,""lower tier covered transaction," 'participants,''person,"'primary covered transaction," -principal,"'proposal'and'Voluntarily excluded,'as used in this clause,have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549.You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations- 5-The prospective lower tier participant agrees by submitting this form that,should the proposed covered transaction be entered into,it shall not knowingly enter into any lower tier covered transaction with a person who is debarred,suspended,declared ineligible or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. fi.The prospective lower tier participant further agrees by submitting this form that it will include this clause titled 'Certification Regarding Debarment,Suspension, Ineligibility and Voluntary Exclusion-Lower Tier Covered Transaction"without modification in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7.A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred,suspended, ineligible or voluntarily excluded from the covered transaction,unless it knows that the certification is erroneous.A participant may decide the method and frequency by which it determines the eligibility of its principals.Each participant may,but is not required to, check the Nonprocurement List. 8.Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause.The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 190301 -Mobile Mini, Inc.-Page 7 of 22 9.Except for transactions authorized under paragraph 5 of these instructions,if a participant in a covered transaction knowingly enters into a louver tier covered transaction with a person who is suspended,debarred,ineligible or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government,the department or agencywith which this transaction originated may pursue available remedies, including suspension and 1 or debarment. 50 Suspension or Debarment Certification By answering yes,you certify that no federal suspension Yes or debarment is in place,which would prelude receiving a federally funded contract as described above. and Suspension(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 OMB guidelines at 2 CFR 180 that implement Executive Orders 12549(3 CFR part 1986 Comp.,p.189)and 12689(3 CFR part 1989 Camp.,p.235),'Debarment and Suspension."SAM Exclusions containsthe names of parties debarred,suspended,or otherwise excluded by agencies,as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. By answering yes,you certify that no federal suspension or debarment is in place,which would preclude receiving a federally funded contract as described above. 190301 -Mobile Mini, Inc.-Page 8 of 22 51 Non-Discrimination Statement and Certification In accordance with Federal civil rights law,all U.S. Yes Departments,including the U.S.Department of Agriculture (USDA)civil rights regulations and policies,the USDA,its Agencies,offices,and employees,and institutions participating in or administering USDA programs are prohibited from discriminating based on race,color, national origin,religion,sex,gender identity(including gender expression),sexual orientation,disability,age, marital status,family/parental status,income derived from a public assistance program,political beliefs,or reprisal or retaliation for prior civil rights activity,in any program or activity conducted or funded by USDA(not all bases apply to all programs).Remedies and complaint filing deadlines vary by program or incident. Persons with disabilities who require alternative means of communication for program information(e.g.,Braille,large print,audiolape,American Sign Language,etc.)should contact the responsible Agency or USDA's TARGET Center at(202)720-2600(voice and TTY)or contact USDA through the Federal Relay Service at(800) 877-8339.Additionally,program information may be made available in languages other than English. To file a program discrimination complaint,complete the USDA Program Discrimination Complaint Form,AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form.To request a copy of the complaint form,call(866)632-9992.Submit your completed form or letter to USDA by:(1)mail:U.S. Department of Agriculture,Office of the Assistant Secretary for Civil Rights,1400 Independence Avenue, SW,Washington,D.C.20250-9410;(2)fax:(202) 690-7442;or(3) email:program-intake@tjscle.gov. VI of the Education Amendments of 1972;Section 504 of the Rehabilitation Act of 1973.the Age Discrimination Act of 1975;Ttle 7 CFR Parts 15,15a,and 15b;the Americans with Disabilities Act;and PINS Instruction 113-1,Civil Rights Compliance and Enforcement—Nutrition Programs and Activities) U.S.Departments,including the USDA are equal opportunity provider,employer,and lender. Not a negotiable term.Failure to agree by answering YES will render your proposal non-responsive and it will not be considered.I certify that in the performance of a contract with TIPS or its members,that our company will conform to the foregoing antt-discrimination statement and comply with the cited and all other applicable laws and regulations. 52 2 CFR PART 200 Contract Provisions Required Federal contract provisions of Federal (No Response Required) Explanation Regulations for Contracts for contracts with ESC Region 8 and TIPS Members: following provisions are required to be in place and agreed if the procurement is funded in any part with federal funds. The ESC Region 8 and TIPS Members are the subgrantee or Subrecipient by definition.Most of the provisions are located in 2 CFR PART 200-Appendix II to Part 200—Contract Prom sions for Non-Federal Entity Contracts Under Federal Awards at 2 CFR PART 200.Others are included within 2 CFR part 200 et al. In addition to other provisions required by the Federal agency or non-Federal entity,all contracts made by the 190301 -Mobile Mini, Inc.-Page 9 of 22 non-Federal entity under the Federal award must contain provisions covering the following,as applicable. 53 2 CFR PART 200 Contracts Contracts for more than the simplified acquisition threshold Yes currently set at$150,000,which is the inflation adjusted amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils)as authorized by 41 U.S.C.1908,must address administrative,contractual,or legal remedies in instances where contractors violate or breach contract terms,and provide for such sanctions and penalties as appropriate. Notice,Pursuant to the above,when federal funds are expended by ESC Region 8 and TIPS Members,ESC Region 8 and TIPS Members reserves all rights and privileges under the applicable laws and regulations with respect to this procurement in the event of breach of contract by either party. Does vendor agree? 54 2 CFR PART 200 Termination Termination for cause and for convenience by the grantee Yes or subgrantee including the manner by which it will he effected and the basis for settlement.(All contracts in excess of S10,000) Pursuant to the above,when federal funds are expended by ESC Region 8 and TIPS Members,ESC Region 8 and TIPS Members reserves the right to terminate any agreement in excess of$10,000 resulting from this procurement process for cause after giving the vendor an appropriate opportunity and up to 30 days,to cure the causal breach of terms and conditions.ESC Region 8 and TIPS Members reserves the right to terminate any agreement in excess of$10,000 resulting from this procurement process for convenience with 30 days notice in writing to the awarded vendor.The vendor would be compensated for work performed and goods procured as of the termination date it for convenience of the ESC Region 8 and TIPS Members.Any award under this procurement process is not exclusive and the ESC Region 8 and TIPS reserves the right to purchase goods and services from other vendors when it is in the best interest of the ESC Region 8 and TIPS. Does vendor agree? 55 2 CFR PART 200 Clean Air Act Clean Air Act(42 U.S.C.7401-7671q.)and the Federal Yes Water Pollution Control Act(33 U.S.C.1251-1387),as amended—Contrails and subgrants of amounts in excess of$150,000 must contain a provision that requires the non-Fed ore I award to agree to comply with all applicable standards,orders or regulations issued pursuant to the Clean Air Act(42 U.S.C.7401-7671q)and the Federal Water Pollution Control Act as amended(33 U.S.C. 1251-1387).Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency(EPA). Pursuant to the Clean Air Act,et at above,when federal funds are expended by ESC Region 8 and TIPS Members, ESC Region 8 and TIPS Members requires that the proposer certify that during the term of an award by the ESC Region a and TIPS Members resulting from this procurement process the vendor agrees to comply with all of the above regulations,including all of the terms listed and referenced therein. 1903❑1 -Mobile Mini, Inc.-Page 10 of 22 Does vendor agree] 56 2 CFR PART 200 Byrd Anti-Lobbying Byrd Anti-Lobbying Amendment(31 U.S.C. Yes Amendment 1352)- Ccntmctors that apply or bid for an award exceeding$100,000 must file the required certification. Each tier certifies 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 influence 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 wth attaining any Federal contract,grant or any other award covered by 31 U.S.C.1352.Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award.Such disclosures are forwarded from tier to tier up to the non-Federal award. Pursuant to the above,when federal funds are expended by ESC Region 8 and TIPS Members,ESC Region 8 and TIPS Members requires the proposer certify that during the term and during the life of any contract with ESC Region 8 and TIPS Members resulting from this procurement process the vendor certifies to the terms included or referenced herein. Does vendor agree? 57 2 CPR PART 200 Federal Rule Compliance with all applicable standards,orders,or Yes requirements issued under section 306 of the Clean Air Act(42 U.S.C.1857(h)),section 508 of the Clean Water Act(33 U.S.C.1368),Executive Order 11738,and Environmental Protection Agency regulations(40 CFR part 15).(Contracts,subcontracts,and subgrants of amounts in excess of$100.000) Pursuant to the above,when federal funds are expended by ESC Region 8 and TIPS Members,ESC Region 8 and TIPS Members requires the proposer certify that in performance of the contracts,subcontracts,and subgrants of amounts in excess of$100,000,the vendor will be in compliance with all applicable standards,orders,or requirements issued under section 306 of the Clean Air Act(42 U.S.C.1857(h)),section 508 of the Clean Water Act(33 U.S.C.1368),Executive Order 11738,and Environmental Protection Agency regulations(40 CFR part 15). Does vendor certify that it is in compliance with the Clean Air Act? 58 2 CFR PART 200 Procurement of Recovered A non-Federal entity that is a state agency or agency of a Yes Materials political subdivision of a state and its contractors must comply with section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act.The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency(EPA)at 40 CFR part 247 that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition,where the purchase price of the item exceeds$10,000 or the value of the quantity acquired during the preceding fiscal year exceeded$10,000;procuring solid waste management services in a manner that maximizes energy and resource recovery;and estab]ishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. 190301 -Mobile Mini, Inc.-Page 11 of 22 Does vendor certify that it is in compliance with the Solid Waste Disposal Act as described above? 59 Certification Regarding Lobbying Applicable to Grants,Subgrants,Cooperative Agreements, I HAVE NOT Lobbied per above and Contracts Exceeding$100,000 in Federal Funds Submission of this certification is a prerequisite for making or entering into this transaction and is imposed by section 1352.Title 31,U.S.Code.This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into.Any person who fails to file the required certification shall be subject to a civil penalty of not less than 510,000 and not more than$100,000 for each such failure. undersigned certifies,to the best of his or her knowledge and belief,that: (I)No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of congress,or an employee of a Member of Congress in connection with the awarding of a Federal contract,the making of a Federal grant,the making of a Federal loan,the entering into a cooperative agreement,and the extension,continuation,renewal, amendment,or modification of a Federal contract,grant, loan,or cooperative agreement. (2)If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing of attempting to influence an officer or employee of any agency,a Member of Congress,an officer or employee of congress,or an employee of a Member of Congress in connection with this Federal grant or cooperative agreement,the undersigned shall complete and submit Standard Form-LLL,"disclosure Form to Report Lobbying," in accordance with its instructions. (3)The undersigned shall require that the language of this certification he included in the award documents for all covered sutrawards exceeding$100,000 in Federal funds at all appropriate tiers and that all subreciplents shall certify and disclose accordingly. 60 If you answered"I HAVE lobbied per above to the IF you answered"I HAVE lobbied"per above Attribute (No Response Required) previous question. question,you must download the Lobbying Report "Standard From LLL,disclosure Form to Report Lobbying" which includes instruction on completing the form, complete and submit it in the Response Attachments section as a report of the lobbying activities you performed or paid others to perform. 61 Subcontracting with small and minority Do you ever anticipate the possibility of subcontracting any NO businesses,women's business enterprises,and of your work under this award if you are successful? labor surplus area firms. IF NO,DO NOT ANSWER THE NEXT ATTRIBUTE QUESTION. .IF YES,and ONLY IF YES,you must answer the next question YES if you want a TIPS Member to be authorized to spend Federal Grant Funds for Procurement. 190301 -Mobile Mini, Inc.-Page 12 of 22 fit ONLY IF YES TO THE PREVIOUS QUEST10N ONLY IF YES TO THE PREVIOUS QUESTION OR if you OR ifyou ever do subcontract any part of your ever do subcontract any part of your performance under performa n ce u nde r In e T I PS Agre ement,do you the TIPS Agreement, agree to comply with the following federal do you agree to comply with the fdIowing federal requirements? requirements? Federal Regulation 2 C F R§200.321 Contracting with small and mi n ority bu sin e sses,women's business enterprises,and labor surplus area firrns.(a)The non-Federal entity must take all necessary affirmative steps to assure that minority businesses,women's business enterprises,and labor surplus area firms are used when possible- (b)Affirmative steps must include:(1)Placing qualified small and minority businesses and women's business enterprises on solicitation lists; (2)Assuring that small and minority businesses,and women's business enterprises are solicited whenever they are potential sources; (3)Dividing total requirements,when economically feasible, into sm site rt ask s or quantities to permit maximum participation by small and min only businesses,and women's business enterprises; (4)Establishing delivery schedules,where the requirement permits,which encourage participation by small and minority businesses,and women's business enterprises; (5)Using the services and assistance,as appropriate,of such organizations as the Small Business Administration and the Minority Business development Agency of the Department of Commerce;and (6)Requiring the prime contractor,if subcontracts are to be let,to take the affirmative steps listed in paragraphs(l) through(5)of this section. 63 Indemnification The ESC Region 8 and TIPS is a Texas Political Yes Subdivision and a local governmental entity;therefore,is prohibited from indemnifying third parties pursuant to the Texas Constitution(Article 3,Section 52)except as specifically provided by law or as ordered by a court of competent jurisdiction.A provision in a contract to indemnify or hold a party harmless is a promise to pay for any expenses the indemnified party incurs,if a specfied event occurs,such as breaching the terms of the contract or negligently performing duties under the contract.Article III,Section 49 of the Texas Constitution states that"no debt shall be created by or on behalf of the State..."The Attorney General has counseled that a contractually imposed obligation of indemnity creates a"debt"in the constitutional sense.Tex.Att'y Gen.Op.No.MW-475 (1982).Contract clauses which require the System or institutions to indemnify must be deleted or qualified with"to the extent permitted by the Constitution and Laws of the State of Texas."Liquidated damages,attorneys fees,waiver of vendor's liability,and waiver of statutes of limitations clauses should also be deleted or qualified with"to the extent permitted by the Constitution and laws 190301 -Mobile Mini, Inc.-Page 13 of 22 of State of Texas." Not a negotiable term.Failure to agree will render your proposal non-responsive and it will not he considered.Do you agree to these terms? 64 Remedies The parties shall be entitled to exercise any right or Yes,I Agree remedy available to it either at law or in equity,subject to the choice of law,venue and seance of process clauses limitations agreed herein. Nothing in this agreement shall commit the TIPS to an arbitration resolution of any disagreement under any circumstances.Any Claim arising out of or related to the Contract,except for those specifically waived under the terms of the Contract,may,after denial of the Board of Directors,be subject to mediation at the request of either party.Any issues not resolved hereunder MAY be referred to non-binding mediation to be conducted by a mutually agreed upon mediator as a prerequisite to the filing of anylawsuit over such issue(s). The parties shall share dre mediator's fee and any associated filing fee equally.Mediation shall be held in Camp or Titus County, Texas.Agreements reached in mediation shall be reduced to writing,and will he subject to the approval by the District's Board of Directors,signed by the Parties if approved by the Board of Directors,and,if signed,shall thereafter be enforceable as provided by the laws of the State of Texas. Do you agree to these terms? 85 Remedies Explanation of No Answer 66 Choice of Law The agreement between the Vendor and TIPSIESC Yes Region 8 and any addenda or other additions resulting from this procurement process,however described,shall be governed by,construed and enforced in accordance with the laws of the State of Texas,regardless of any conflict of laws principles. THIS DOES NOT APPLY to a vendors agreement entered into with a TIPS Member,as the Member may be located outside Texas. Not a negotiableterm.Failure to agree will render your proposal non-responsive and it will not he considered.Do you agree to these terms? 190301 -Mobile Mini, Inc.-Page 14 of 22 67 Jurisdiction and Service of Process Any Proceeding arising out of or relating to this Yes procurement process or any contract issued by TIPS resulting from or any contemplated transaction shall be brought in a court of competent jurisdiction in Camp County,Texas and each of the parties irrevocably submits to the ex clu sive ju risdiction of said court in any such proceedng,waives any objection it may now or hereafter have to venue or to convenience of forum,agrees that all claims in respect of the Proceeding shall be heard and determined only in any such court,and agrees not to bring any proceeding arising out of or relating to this procurement process or any contract resulting from or any contemplated transaction in any other court. The parties agree that either or bath of them may file a copy of this paragraph with arty court as written evidence of the knowing, voluntary and freely bargained for agreement between the parties irrevocably to waive any objections to venue or to convenience of forum. Process in any Proceeding referred to in the first sentence of this Section may be served on any party anywhere in the world.Venue clauses in contracts with TIPS members may be determined by the parties. Not a negotiable term.Failure to agree will render your Proposal non-responsive and it will not he considered.Do you agree to these terms? 68 Infringement(s) The successful vendor will be expected to indemnify and Yes,I Agree hold harmless the TIPS and its empioyees,officers, agents,representatives,contractors,assignees and designees from any and all third party claims and judgments involving infringement ofpatent,copyright, trade secrets,trade or service marks,and any other intellectual or intangible property rights attributed to or claims based on the Vendor's proposal or Vendors performance of contracts awarded and approved. Do you agree to these terms? 69 Irrfring erne nt(s)Explanation of No Answer 70 Contract Governance Any contract made or entered into by the TIPS is subject Yes to and is to be governed by Section 271.151 et seq,Tex Loc Gov't Code.Otherwise,TIPS does not waive its governmental immunities from suit or liability except to the extent expressly waived by other applicable laws in clear and unambiguous language. 190301 -Mobile Mini, Inc.-Page 15 of 22 71 Payment Terms and Funding Out Clause Payment Terms: Yes TIPS or TIPS members shall not be liable for interest or late payment fees on past due balances at a rate higher than permitted by the laws or regulations of the jurisdiction of the TIPS Member. Funding Out Clause: Vendor agrees to abide by the laws and regulations, including Texas Local Government Code§271.903.or any statutory or regulatory limitations ofthe jurisdiction of any TIPS Member which governs contracts entered into by the Vendor and TIPS or a TIPS Member that requires all contracts approved by TIPS or a TIPS Member are subject to the budgeting and appropriation of currently available funds by the entity or its governing body. See statute(s)for specifics or consult your legal counsel. Not a negotiable term.Failure to agree will render your proposal non-responsive and it will not be considered. Do you agree to these terms? 72 Insurance and Fingerprint Requirements Insurance (No Response Required) Information If applicable and your staff will be on TIPS member premises for delivery,training or installation etc.andlor with an automobile,you must carry automobile insurance as required by law.You may be asked to provide proof of insurance. It is possible that a vendor may be subject to Chapter 22 of the Texas Education Code.The Texas Education Code, Chapter 22,Section 22.0834.Statutory language may be found at:http:/Avww-statules-Iegis-state-tx.us/ If the vendor has staff that meet both of these criterion. will have continuing duties related to the contracted services;and (2)has or will have direct contact with students you have"revered"employees for purposes of completing the attached form. TIPS recommends all vendors consult their legal counsel for guidance in compliance with this law.If you have questions on how to comply,see below.If you have questions on compliance with this code section,contact the Texas Department of Public Safety Non-Criminal Justice Unit,Access and Dissemination Bureau, FAST-FACT at NCJD(Ptxdps.state.tx.us and you should send an email identifying you as a contractor to a Texas Independent Schad District or ESC Region 8 and TIPS.Texas DPS phone number is(512)424-2474. form in the next attribute to complete entitled: Texas Education Code Chapter 22 Contractor Certification for Contractor Employees 190301 -Mobile Mini, Inc.-Page 16 of 22 73 Texas Education Code Chapter 22 Contractor Introduction:Texas Education Code Chapter 22 requires Some Certification for Contractor Employees entities that contract with school districts to provide services to obtain criminal history record information regarding covered employees.Contractors must certify to the district that they have complied.Covered employees with disqualifying criminal histories are prohibited from serving at a school district- Definitions:Covered employees:Employees of a contractor or subcontractor who have or will have continuing duties related to the service to be performed at the District and have or will have direct contact with students.The District will he the final arbiter of what constitutes direct contact with students.Disqualifying criminal history:Any conviction or other cri"nal history information designated by the District,or one of the following offenses,if at the time of the offense,the victim was under 18 or enrolled in a public schod: (a)a felony offense under Title 5,Texas Penal Code.(b) an offense for which a defendant is required to register as a sex offender under Chapter 62,Texas Code of Criminal Procedure.or(c)an equivalent offense under federal law or the laws of another state. certify that: (Section A) of the employees of Contractor and any subcontractors are covered employees,as defined above.If this box is checked,I further certify that Contractor has taken precautions or imposed conditions to ensure that the employees of Contractor and any subcontractor will not become covered employees.Contractor will maintain these precautions or conditions throughout the time the contracted services are provided. (Section B)or all of the employees of Contractor and any subcordractor are covered employees.If this box is checked,I further certify that: (1)Contractor has obtained all required criminal history record information regarding its covered employees.None of the covered employees has a disqualifying criminal history- (2)If Contractor receives information that a covered employee subsequently has a reported criminal history, Contractor will immediately remove the covered employee from contract duties and notify the District in writing within 3 business days. (3)Upon request,Contractor will provide the District with the name and any other requested information of covered employees so that the District may obtain criminal history record information on the covered employees. (4)If the District objects to the assignment of a covered employee on the basis of the covered employee's criminal history record information,Contractor agrees to discontinue using that covered employee to provide services at the District. Noncompliance or misrepresentation regarding this certification may be grounds for contract termination. 190301 -Mobile Mini, Inc.-Page 17 of 22 74 Texas Business and Commerce Code§272 SB 807 prohibits construction contracts to have provisions (No Response Required) Requirements as of 9-1-2017 requiring the contract to be subject to the laws of another state,to be required to litigate the contract in another state,or to require arbitration in another state.A contrail with such provisions is voidable.Under this new statute,a "construction contract"includes contracts,subcontracts,or agreements with(among others)architects,engineers, contractors,construction managers,equipment lessors,or materials suppliers."Construction contracts"are for the design,construction,aVteration,renovation,remodeling,or repair of any building or improvement to real property,or for furnishing materials or equipment for the project.The term also includes moving,demolition,or excavation.BY RESPONDING TO THIS SOLICITATION,AND WHEN APPLICABLE,THE PROPOSER AGREES TO COMPLY WITH THE TEXAS BUSINESS AND COMMERCE CODE §272 WHEN EXECUTING CONTRACTS WITH TIPS MEMBERS THAT ARE TEXAS GOVERNMENT ENTITIES. 75 Texas Government Code 2270 Verification Form Texas Government Code 2270 Verification Form YES Texas 2017 House Bill 89 he been signed into law by the governor and as of September 1,2017 will be codified as Texas Government Code§2270 and 808 et seq. The relevant section addressed by this form reads as follows: Texas Government Code Sec.2270.002.PROVISION REQUIRED IN CONTRACT.A governmental entity may not enter into a contract with a company for goods or services unless the contract contains a written verification from the company that 1:(1)does not boycott Israel:and (2)will not boycott Israel during the term of the contrail.engaged by ESC Region 8lfhe Interlocal Purchasing System(TIPS) 4845 Highway 271 North Pittsburg,TX,75686 verify by this writing that the above-named company affirms that it(1)does net boycott Israel;and(2)will not boycott Israel during the term of this contract,or any contract with the above-named Texas governmental entity in the future.I further affirm that if our company's position on this issue is reversed and this affirmation is no longer valid,that the above-named Texas governmental entity will be notified in writing within one(1)business day and we understand that our company's failure to affirm and comply with the requirements of Texas Government Code 2270 et seq.shall be grounds for immediate contract termination without penalty to the above-named Texas governmental entity. AND our company is not listed on and we do not do business with companies that are on the the Texas Comptroller of Public Accounts list of Designated Foreign Terrorists Organizations per Texas Gov't Cade 2270.0153 found at https://corn ptrd I er.texa s.gov/pu rch a sing/docs4orei gn-terrorist.pdf I swear and affirm that the above is true and correct. 1903❑1 -Mobile Mini, Inc.-Page 18 of 22 76 Logos and other company marks Please upload your company logo to be added to your (No Response Required) individual profile page on the TIPS website.If any particular specifications are required for use of your company logo,please upload that information under the "Logo and Other Comparry Marks"section under the -Response Attachment"tab.Preferred Logo Format:300 x 225 px-.png,.eps,.jpeg preferred Potential uses of company logo: Your Vendor Profile Page of TIPS website Potentially on TIPS website scroll bar for Top Performing Vendors TIPS Quarterly eNewsletter sent to TIPS Members Co-branding Flyers and or email blasts to our TIPS Members(Permission and approval will he obtained before publishing) 77 Solicitation Deviation/Compliance Does the vendor agree with the General Conditions Yes Standard Terms and Conditions or Item Specifications listed in this proposal invitation? 78 Solicitation Exceptions/Deviations Explanation If the bidder intends to deviate from the General Conditions Standard Terms and Conditions or Item Specifications listed in this proposal invitation,all such deviations must be listed on this attribute,with complete and detailed conditions and infatuation included or attached. TIPS will consider any deviations in its proposal award decisions,and TIPS reserves the right to accept or reject any bid based upon an y devi ations indicated below or in any attachments or inclusions. In the absence of any deviation entry on this attribute,the proposer assures TIPS of their full compliance with the Standard Terms and Conditions,Item Specifications,and al!other information contained in this Solicitation. 79 Agreement Deviation/Compliance Does the vendor agree with the language in the Vendor Yes Agreement? 80 Agreement aceptions/Deviations Explanation If the proposing Vendor desires to deviate form the Vendor Agreement language,all such deviations must be listed on this attribute,with complete and detailed conditions and information included. TIPS will consider any deviations in its proposal award decisions,and TIPS reserves the right to accept or reject any proposal based upon any deviations indicated below.In the absence of any deviation entry on this attribute,the proposer assures TIPS of their full compliance with the Vendor Agreement. 190301 -Mobile Mini, Inc.-Page 19 of 22 81 Felony Conviction Notice Texas Education Code,Section 44.034,Notification of A.Firm is a publicly held Criminal History,Subsection(a),states"a person or corporation. business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony.The notice must include a general description of the conduct resulting in the conviction of a felony.'Subsection(b)states`a school distriot may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection(a)or misrepresented the conduct resulting in the conviction. The di slid ct must compensate the person or business entity for services perrormed before the termination of the contract."(c)This section does not apply to a publicly held corporation.The person completing this proposal certifies that they are authonzed to provide the answer to this question. Select A.,13.or C. A.My firm is a publicly held corporation;therefore,this reporting requirement is not applicable. OR B.My firm is not owned nor operated by anyone who has been convicted of a felony,OR C.My firm is owned or operated by the following individuals)who hasRiave been convicted of a felony.[if you answer C below,you are required to provide information in the next attribute. 82 If you answered C.My Firm is owned or operated If you answered C.My Firm is owned or operated by a by a felon to the previous question,you are felon to the previous question,you must provide the REQUIRED TO ANSWER THE FOLLOWING following information. QUESTIONS. 1.Name of Felon(s) 2.The named person's role in the firm,and 3.Details of Conviction(s). 83 Lang Term Cast Evaluation Criterion#4. READ CAREFULLY and see in the R F P document under increases will be 5%or less "Proposal Scoring and Evaluation annually per question Pants will be assigned to this criterion based on your answer to this Attribute.Points are awarded ifyou agree not increase your catatog prices(as defined herein)more than X%annually over the previous year for years two and three and potentially year four,unless an exigent circumstance exists in the marketplace and the excess price increase which exceeds X%annually is supported by documentation provided by you and your suppliers and shared with TIPS,if requested.If you agree NOT to increase prices more than 5%,except when justified by supporting documentation,you are awarded 10 points;if 6%to 14%,except when justified by supporting documentation,you receive 1 to 9 pants incrementally. Price increases 14%or greater,except when justified by supporting documentation,receive 9 pants. 190301 -Mobile Mini, Inc.-Page 20 of 22 84 Required Confidentiality Claim Form Required Confidentiality Claim Form [No Response Required] This completed form is required by TIPS. By submitting a response to this solicitation you agree to download from the Attachments section,complete according to the instructions on the form,then uploading the completed form,with any confidential attachments,if applicable,to the Response Attachments section titled Confidentiality Form in order to provide to TIPS the completed form titled, CONFIDENTIALITY CLAIM FORM.By completing this process,you pmvde us with the information we require to comply with the open record laws of the State of Texas as they may apply to your proposal submission.If you do not provide the form with your proposal,an award will not he made if your proposal is qualified for ana ward.until TIPS has an accurate,completed form from you. Read the form carefully before completing and if you have any questions,email Rick Powell at TIPS at rick.powell@_ti ps-u sa.com 190301 -Mobile Mini, Inc.-Page 21 of 22 Line items Response Total: $0.00 1903❑T -Mobile Mini, Inc.-Page 22 of 22 Exhibit C—Conflict of Interest Questionnaire. CONFLICT OF INTEREST QUESTIONNAIRE FORM C1Q For vendor doing business with local governmental entity This questionnaire reflects changes made to the law by H.B.23,ttgth Leg.,Regular Session. OFFICE USEONLY This quesfionnaire is being filed in accordance with Chapter 176,Local Government Code, ❑ele necenea by avendor who has a business relationship as defined by Section 176.001(1-a)with a locat governmental entity and the vendor meets requirements under Section 176.006(a). Bylaw 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 statementtobefiled.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. t Name of vendor who has a business relationship with local governmental entity. 2 Check this box if you are filing an update to a previously tiled 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 tiled questionnaire was incomplete or inaccurate.) s Name of local government officer about whom the information in this section is being disclosed. Name of Officer This section(item 3 including subparts A.B,C,&D) must be compteted for each officer with whom the vendor has an employment or other business relationship as defined by Section 176.061(1a),Local Govemment Code. Attach additional pages in this Form CIO as necessary. A. Is the local government officer named in this section receiving or likely to receive taxable income,other than investment income,from the vendor? Yes El No B.Is the vendor receiving or likely to receive taxable income,other than investment income,from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? "Yes 71 No C. Is the filer of this questionnaire employed by 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 mere? "Yes 71 No D.Describe each employment or business and family relationship with the local government officer named in this section. 4 Signatire cf vendor doing business with the governmental entity Dam Adopted W712015