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HomeMy WebLinkAboutContract 56210 QRT OR CSC No. 56210 CITY OF FORT NORTH COOPERATIVE PURCHASE AGREEMENT This Cooperative Purchase Agreement("Agreement")is entered into by and between Elliott Electric Supply("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—BuyBoard 577-18,then Exhibit A—City's Terms and Conditions shall control,but only to the extent allowable under the BuyBoard 577-18. 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 One Hundred Thousand Dollars ($100,000.00). 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 July 22, 2021 and ending 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: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX To CITY: To VENDOR: City of Fort Worth Elliott Electric Supply,Inc. Attn: Jesus J. Chapa, Deputy City Manager PO Box 630610 200 Texas Street Nacogdoches,TX 75963 Fort Worth, TX 76102-6314 Facsimile: 936-569-1836 Facsimile: (817) 392-8654 With copy to Fort Worth City Attorney's Office 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. CITY OF FORT WORTH: CONTRACT COMPLIANCE MANAGER: By signing I acknowledge that I am the person ByAsus J.Chapa(Aug A,202111:05 CDT) responsible for the monitoring and administration Name: Jesus J. Chapa, of this contract,including ensuring all performance Title: Deputy City Manager and reporting requirements. Date: APPROVAL RECOMMENDED: By: Name: Cynthia Garcia Title: Assistant Finance Director Reciinald Zeno By:Reg nl ald Zeno(Aug 24,202110:20 CDT) APPROVED AS TO FORM AND LEGALITY: Name: Reginald Zeno Title: Chief Financial Services Officer ba4nnnnq / ..... 6— ppF FORT�aa ATTEST: Q°ooppOOppo°�jOad By.TaylorP is(Aug 24,202110:27 CDT) _° Name: Taylor Paris pv oo o=d Title: Assistant City Attorney �D`IGZGG� GD`IIGZGGI oar°°°°°°°°°oo a� By:Ronald P.Gonzales(Aug 24,2021 11:30 CDT) alj�nEXp$o4 CONTRACT AUTHORIZATION• Name: Ronald P. Gonzales M&C: . Title: Acting City Secretary VENDOR: By: � � ATTEST: Name: Robert A.Flores By: _ �— Title: Treasurer Name: Christoph resin Title: Accounting Supervisor Date: July 21,2021 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Exhibit A - City's Terms and Conditions 1.0 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. 2.0 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 Fort Worth. 3.0 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 the City. 4.0 PROHIBITION AGAINST PERSONAL INTEREST IN CONTRACTS 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) 5.0 ORDERS 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 the part of the Seller without an approved contract number, purchase order number, or release number issued by the Buyer may result in rejection of delivery, return of goods at the Seller's cost and/or non- payment. 6.0 SELLER TO PACKAGE GOODS 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. PART- III 7.0 SHIPMENT UNDER RESERVATION PROHIBITED 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. 9.0 DELIVERY TERMS AND TRANSPORTATION CHARGES 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. 10.0 PLACE OF DELIVERY 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's request. 13.0 PRICE WARRANTY 13.1 The price to be paid by Buyer shall be that contained in Seller's proposals which Seller warrants to be no higher than Seller's current prices on orders by others for products and services of the kind and specification covered by this agreement for similar quantities under like conditions and methods of purchase. In the event Seller breaches this warranty, the prices of the items shall be reduced to the prices contained in Seller's proposals, or in the alternative upon Buyer's option, Buyer shall have the right to cancel this contract without any liability to Seller for breach or for Seller's actual expense. Such remedies are in addition to and not in lieu of any other remedies which Buyer may have in law or equity. 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 PART- III 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 amount thereof. 14.0 PRODUCT WARRANTY 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. 15.0 SAFETY WARRANTY 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. 16.0 SOFTWARE LICENSE TO SELLER 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 PART- III 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. 18.0 OWNERSHIP OF WORK PRODUCT 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 Product") 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 and on behalf of its vendors 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. PART- III 20.0 CANCELLATION 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. 21.0 TERMINATION 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. 22.0 ASSIGNMENT/DELEGATION 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 WAIVER 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. 24.0 MODIFICATIONS 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 not apply. PART- III 26.0 APPLICABLE LAW/VENUE 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 of Texas. 27.0 INDEPENDENT CONTRACTOR(S) 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 respondent 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. 28.0 LIABILITY AND INDEMNIFICATION 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 OR EMPLOYEES. 28.2 INDEMNIFICATION - 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. 31.0 NOTICES TO PARTIES 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 PART- III 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. 32.0 NON-DISCRIMINATION 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. 33.0 IMMIGRATION NATIONALITY ACT 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 (1-9), maintain photocopies of all supporting employment eligibility and identity documentation for all employees, and upon request, provide City with copies of all 1-9 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 by Vendor. 34.0 HEALTH, SAFETY, AND ENVIRONMENTAL REQUIREMENTS 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 books, computer disks, digital files, documents, papers and records of the Seller involving transactions relating to this contract, including any and all records maintained pursuant to Section 31 of this Agreement. 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. PART- III 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 this agreement. 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"company"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 52 through 58. Exhibit C - Cooperative Agency Contract BoardVendor C• -ct Informatio Vendor Name Elliott Electric Supply Contact Chris Petty Phone Number 5123398750 Email chrispetty@elliottelectric.com Website www.elliottelectric.com Federal ID 75-1423734 Accepts RFQs Yes Address Line 1 12555 Harris Branch Pkwy#105 Vendor City Manor Vendor Zip 78653 Vendor State TX Vendor Country USA Delivery Days 3 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 Alaska, Arkansas, Georgia, Kansas, Louisiana, New Mexico, Oklahoma, Texas 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 7/15/2021 3:25:22 PM Apzo vendor contract • - • Return Policy Merchandise returned will be subject to the manufacturer's returned goods authorization terms and conditions Additional Dealers See Additional Dealers/Distributors for dealer list. Additional Info null 7/15/2021 3:25:22 PM AvBoardP.O.Box 400,Austin,Texas 78767 800.695.2919•info@buyboard.com •buyboard.com November 3, 2020 Sent via email to: chrispettyCcDelliottelectric.com Chris Petty Elliott Electric Supply 12555 Harris Branch Pkwy#105 Manor, TX 78653 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.org 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.org. We appreciate your interest in The Local Government Purchasing Cooperative. Sincerely, Lisa Maraden Contract Administrator final renewal v.02.13.2020 Endorsed by TASAV VVIL0 ; . PFBoard® Cooperative Purchasing P.D.Box 400 Austin, TX 78 76 7-04 00 800.695.2919 / 512.467.0222 1 Fax:800.211.5454 buyboard.conf 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 BuyBoard® 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, Arturo Salinas Department Director, Cooperative Procurement v.6.5 The Local Government Purchasing Cooperative is endorsed by the Texas Association of School Boards, T� Texas Municipal League,Texas Association of Counties,and the Texas Association of School Administrators. National School Hafiwral A,vfJrasinp Cunyera+ive Endorsed by 'NSBA' Beards Association November 13, 2018 Welcome to BuyBoard! Re: Notice ofNationa/Purchasing 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 BuyBoard® 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, Arturo Salinas Department Director, Cooperative Procurement v.6.5 Woo P.O. box 4i!O,Austin,2Texas 781767-i7400 800.695.2919•buyboard.com Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com PROPOSERS AGREEMENT AND SIGNATURE Proposal Name: Building Maintenance, Repair and Proposal Due Date/Opening Date and Time: Operations Supplies and Equipment May 3, 2018 at 4:00 PM Location of Proposal Opening: Texas Association of School Boards, Inc. BuyBoard Department Proposal Number: 577-18 12007 Research Blvd. Austin,TX 78759 Anticipated Cooperative Board Meeting Date: Contract Time Period: December 1, 2018 October 2018 through November 30, 2019 with two (2) possible one-year renewals. Elliott Electric Supply 5-2-2018 Name of Proposing Company Date 10605 Delta Dr. • Street Address Signature of Authorized Company Official Austin, TX 78758 Chris Petty City, State, Zip Printed Name of Authorized Company Official 512-339-8750 South West Regional Manager Telephone Number of Authorized Company Official Position or Title of Authorized Company Official 512-339-6732 75-2721701 Fax Number of Authorized Company Official Federal ID Number Page 8 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com The proposing company ("you"or"your") hereby acknowledges and agrees as follows: 1. You have carefully examined and understand all Cooperative information and documentation associated with this Proposal Invitation, including the Instructions to Proposers, General 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 products or services submitted 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 deviations and exceptions to the Requirements have been noted in your Proposal and no others will be claimed; 4. If the Cooperative accepts any part of your Proposal and awards you a contract, you will furnish all awarded products or services at the prices quoted and in strict compliance with the Requirements (unless specific exceptions are noted in the Proposal and accepted by the Cooperative), including without limitation the Requirements related 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 Invitation; 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 have clearly identified on the included form any information in your Proposal that you believe to be confidential or proprietary or that you do not consider to be public information subject to public disclosure under a Texas Public Information Act request or similar public information law; 6. The individual signing this Agreement is duly authorized to enter into the contractual relationship represented by this Proposal Invitation 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 required in the Requirements; 7. You have carefully reviewed your Proposal, and certify that all information provided is true, complete and accurate, and you authorize the Cooperative to take such action as it deems appropriate to verify such information; and 8. Any misstatement, falsification, or omission in your Proposal, whenever or however discovered, 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 provided for in the General Terms and Conditions or by law. Page 9 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com VENDOR CONTACT INFORMATION Company: Elliott Electric Suuply Vendor Contact Name and Mailing Address for Notices: Chris Petty 10605 Delta Dr. Austin, TX 78758 Companywebsite: http://www.elliottelectric.com/ Purchase Orders: Purchase orders from Cooperative members will be available through the Internet or by facsimile. Option 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 option to assist them with retrieving their orders. Cl tD ion 2: Fax. Vendors need a designated fax line available at all times to receive purchase orders. Please choose only one (1) of the following options for receipt of purchase orders and provide the requested information: 0 I will use the INTERNET to receive purchase orders. E-mail Address: chrispetty@elliottelectric.com Internet Contact: Chris Petty Phone: 512-339-8750 Alternate E-mail Address: mikehogan@elliottelectric.com Alternate Internet Contact: Mike Hogan Phone: 512-339-8750 ❑ I will receive purchase orders via FAX. Fax Number: Fax Contact: Phone: ❑ Purchase orders may be received by any Designated Dealer identified on my company's Dealer Designation form as provided to the Cooperative administrator. I understand that my company shall remain responsible for the Contract and the performance of all Designated Dealers under and in accordance with the Contract. Reauest for Ouotes ("RFO"): Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses for the receipt of RFQs: E-mail Address: chrispetty@elliottelectric.com Alternate E-mail Address: mikehogan@elliottelectric.com Page 10 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com Invoices: Your company will be billed monthly for the service fee due under a contract awarded under this Proposal Invitation. All invoices are available on the BuyBoard website and e-mail notifications will be sent when they are ready to be retrieved. Please provide the following address, contact and e-mail information for receipt of service fee invoices and related communications: Please choose only one (1) of the following options for receipt of invoices and provide the requested information: 0 Service fee invoices and related communications should be provided directly to my company at: Mailing address: 10605 Delta Dr Department: City. Austin State: Texas Zip Code• 78758 Contact Name: Chris Petty Phone: 512-339-8750 Fax: 512-339-6732 E-mail Address: chrispetty@elliottelectric.com Alternative E-mail Address: mikehogan@elliottelectric.com ❑ In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following billing agent": Mailing address: Department: City: State: Zip Code: Contact Name: Phone: Fax: E-mail Address: Alternative E-mail Address: ❑ In lieu of my company, I request 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 provided to the Cooperative administrator." **If Vendor authorizes a billing agent or Designated Dealer(s) to receive and process service fee in voices, In accordance with the General Terms and Conditions of the Contract, Vendor specifically acknowledges and agrees that nothing in that designation shall relieve Vendor of its responsibilities and obligations under the Contract including,but not limited to,payment of allservice fees under any Contract awarded Vendor. Page 11 of 69 Proposal Forms CONST v.01.12.2018 PCooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com FELONY CONVICTION DISCLOSURE AND DEBARMENT CERTIFICATION FELONY CONVICTION DISCLOSURE Subsection (a) of Section 44.034 of the Texas Education Code (Notification of Criminal History of Contractor) states: "A person or 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 has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony." Section 44.034 further states in Subsection (b): "A school district 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 district must compensate the person or business entity for services performed before the termination of the contract." Please check(i/)one of the following: ❑ My company Is a publicly-held corporation. (Advance notice requirement does not apply to publicly-held corporation.) ■❑ 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 convicted of a felony: Name of Felon(s): Details of Conviction(s): By signature below, I certify that the above information is true, complete and accurate and that I am authorized by my company to make this certification. Elliott Electric Supply L � Company Name Chris Petty Signature of Authorized Company Official Printed Name DEBARMENT CERTIFICATION Neither my company nor an owner or principal of my company has been debarred, suspended or otherwise made ineligible for participation in Federal Assistance programs under Executive Order 12549, "Debarment and Suspension," as described in the Federal Register and Rules and Regulations. Neither my company nor an owner or principal of my company is currently 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 Cooperative and all Cooperative members with pending purchases or seeking to purchase from my company if my company or an owner or principal 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 regulatory authority. By signature below, I certify that the above is true, complete and accurate and that I am authorized by my company to make this certification. Elliott Electric Supply Company Name Chris Petty Signature of Authorized Company Official Printed Name Page 12 of 69 Proposal Forms CONST v.01.12.2018 PCooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com RESIDENT/NONRESIDENT 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 Texas, including a contractor whose ultimate parent company or majority owner has its principal place 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 check(i/)one of the following_ ❑■ I certify that my company is a Resident Proposer. ❑ I certify that my company is a Nonresident Proposer. If your company is a Nonresident Proposer, you must provide the following information for your resident state (the state in which your company's principal place of business is located): Company Name Address City 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 prescribed amount or percentage to receive a comparable contract? ❑ Yes ❑ No B. What is the prescribed amount or percentage? $ or % VENDOR EMPLOYMENT CERTIFICATION Section 44.031(b) of the Texas Education 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 vendor or the vendor'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 company or majority owner has its principal place of business in Texas, does your company, ultimate parent company, or majority owner employ at least 500 people in Texas? Please check W)one of the followina: 0 Yes ❑ No By signature below, I certify that the information in Sections 1 (Resident/Nonresident Certification) and 2 (Vendor Employment Certification) above is true, complete and accurate and that I am authorized by my company to make this certification. Elliott Electric Supply Company Name Chris Petty Signature of Authorized Company Official Printed Name Page 13 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com NO ISRAEL BOYCOTT CERTIFICATION Effective 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 written verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the contract. (TEx. Gov'T CODE Ch. 2270) "Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, 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 CODE§808.001(1). By signature below, I certify and verify that Vendor does not boycott Israel and will not boycott Israel during the term of any contract awarded under this Proposal Invitation, that this certification is true, complete and accurate, and that I am authorized by my company to make this certification. Elliott Electric Supply Company Name Chris Petty Signature of Authorized Company Official Printed Name NO EXCLUDED NATION OR FOREIGN TERRORIST ORGANIZATION CERTIFICATION Effective September 1, 2017, Chapter 2252 of the Texas Government Code provides that a Texas governmental entity may not enter into a contract with a company engaged in active business operations with Sudan, Iran, or a foreign terrorist organization —specifically, any company identified on a list prepared and maintained by the Texas Comptroller under Texas Government Code §§806.051, 807.051, or 2252.153. (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 certify and verify that Vendor is not on the Texas Comptroller's list identified above; that this certification is true, complete and accurate; and that I am authorized by my company to make this certification. Elliott Electric Supply Company Name Chris Petty Signature of Authorized Company Official Printed Name Page 14 of 69 Proposal Forms CONST v.01.12.2018 PCooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com HISTORICALLY UNDERUTILIZED BUSINESS CERTIFICATION A proposer that has been certified as a Historically Underutilized Business (also known as a Minority/Women Business Enterprise or "MWBE" and all referred to in this form as a "HUB") is encouraged to indicate its HUB certification status when responding to this Proposal Invitation. The electronic catalogs will indicate HUB certifications for vendors that properly indicate and document their HUB certification on this form. Please check(1/) all that apply: ❑ I certify that my company has been certified as a HUB in the following categories: ❑ Minority Owned Business ❑ Women Owned Business ❑ Service-Disabled Veteran Owned Business (veteran defined by 38 U.S.C. §101(2),who has a service-connected disability as defined by 38 U.S.C. § 101(16),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: 0 My company has NOT been certified as a HUB. By signature below, I certify that the above is true, complete and accurate and that I am authorized by my company to make this certification. Elliott Electric Supply Company Name Chris Petty Printed Name Signature of Authorized Company Official Page 15 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com CONSTRUCTION-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 contract 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 2254 of the Texas Government Code) and other applicable law and local policy. The Advisory, available at buyboard.com/Vendor/Resources.aspx, 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 affirmation. 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. Elliott Electric Supply Company Name Chris Petty Signature of Authorized Company Official Printed Name 5-2-2018 Date Page 16 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com DEVIATION AND COMPLIANCE If your company intends to deviate from the General Terms and Conditions, Proposal Specifications or other requirements associated with this Proposal Invitation, you MUST list all 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 deviation. In the absence of any deviation identified and described in accordance with the above, your company must fully comply with the General Terms and Conditions, Proposal Specifications and all other requirements associated with this Proposal Invitation if awarded a contract under this Proposal Invitation. A deviation will not be effective unless accepted by the Cooperative. The Cooperative may, in its sole discretion, seek clarification from and/or communicate with Proposer(s) regarding any submitted deviation, consistent with general procurement principles of fair competition. The Cooperative reserves the right to accept or reject a proposal based upon any submitted deviation. Please check(-/) one of the followina: ■❑ NO; Deviations ❑ YeS; Deviations List and fully explain any deviations you are submitting: PLEASE PROVIDE THE FOLLOWING INFORMATION: 1. Shipping Via: ❑■ Common Carrier ❑■ Company Truck ❑ Prepaid and Add to Invoice ❑ Other: 2. Payment Terms: ■❑ Net 30 days ❑ 1% in 10/Net 30 days ❑ Other: 3. Number of Days for Delivery: 3 ARO 4. Vendor Reference/Quote Number: 5. State your return policy: Merchandise returned will be subject to the "manufacturer's" returned goods authorization terms and conditions 6. Are electronic payments acceptable? ■❑Yes ❑ No 7. Are credit card payments acceptable? ❑Yes ❑■ No Elliott Electric Supply Company Name Chris Petty Signature of Authorized Company Official Printed Name Page 17 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com LOCATION /AUTHORIZED SELLER LISTINGS If you have more than one location/authorized seller that will service a contract awarded under this Proposal Invitation, please list each location/authorized seller below. If additional sheets are required, please duplicate this form as necessary. NOTE: Awarded Vendors shall remain responsible for all aspects of the Contract, including processing of Purchase Orders, and shall be responsible for the performance of all locations and authorized sellers under and in accordance with the Contract. If you are a product manufacturer and wish to designate Designated Dealers as defined in the General Terms and Conditions to receive Cooperative member Purchase Orders on your behalf, you must complete the Manufacturer Designated Dealer form. Elliott Electric Supply Company Name 10605 Delta Dr. Address Austin Texas 78758 City State Zip 512-339-8750 512-339-6732 Phone Number Fax Number Chris Petty Contact Person See attached list of all stores. Contact will be Chris Petty for all stores. Company Name Address City State Zip Phone Number Fax Number Contact Person Page 18 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 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 behalf, you must complete this form for each dealer you wish to designate. Regardless of any Designated Dealers submitted by Vendor, Vendor specifically 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 the Contract, including payment of Cooperative service fees on all Purchase Orders submitted to Vendor or any Designated Dealer. In accordance with the General Terms and Conditions, an awarded Vendor shall 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 subject to all remedies for default thereunder, including, but not limited to suspension and termination of Vendor's Contract for nonpayment of service fees. If awarded, Vendor authorizes the Cooperative, in its sole discretion, to list any Vendor Designated Dealers in the BuyBoard system and to receive Purchase Orders directly from Cooperative members on behalf of Vendor. To the extent a Vendor with Designated Dealers receives a Purchase Order directly, it shall be the responsibility of Vendor to appropriately process such Purchase Order in accordance with the Contract, including but not limited to timely forwarding such Purchase Order to a Designated Dealer for processing. The 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 Dealer to cease accepting Purchase Orders or otherwise acting on Vendor's behalf under the Contract. Further, the Cooperative's administrator shall be authorized to remove or suspend any or all Designated Dealers from the BuyBoard at any time in its sole discretion. If you wish to designate a dealer to service a contract awarded under this Proposal Invitation, please list the Designated Dealer below and have this form signed by an official of your company authorized to make such designation. If you wish to designate multiple dealers, please duplicate this form as necessary. Designated Dealer Name Designated Dealer Address City State Zip Phone Number Fax Number Email address Designated Dealer Tax ID Number* (*attach W-9) Designated Dealer Contact Person Your Company Name Signature of Authorized Company Official Page 19 of 69 Proposal Forms CONST v.01.12.2018 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com TEXAS REGIONAL SERVICE DESIGNATION The Cooperative (referred to as"Texas Cooperative" 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 regions for different products or services included in your proposal,you must complete and submit a separate Texas Regional Service Designation form for each group of products and clearly indicate the products or services to which the designation applies in the space provided at the end of this form. By designating a region or regions, you are certifying that you are authorized and willing to provide the proposed products and services in those regions. Designating regions in which you are either unable or unwilling to provide the specified products and services shall be grounds for either rejection of your proposal or,If awarded, termination of your Contract. 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 Service Centers 0 I will service Texas Cooperative members wi'"' statewide. ❑ I will not service Texas Cooperative members statewide. I will only service members in the regions checked below: Region Headauarters ❑ 1 Edinburg _- �' ❑ 2 Corpus Christi u ❑ 3 Victoria R_ �" ,t ❑ 4 Houston " ❑ 5 Beaumont 3 ❑ 6 Huntsville �µ ❑ 7 Kilgore f ❑ 8 Mount Pleasant ❑ 9 Wichita Falls ❑ 10 Richardson ❑ 11 Fort Worth " ❑ 12 Waco ❑ 13 Austin "'" ❑ 14 Abilene -- ❑ 15 San Angelo ❑ 16 Amarillo Elliott Electric Supply ❑ 17 Lubbock ❑ 18 Midland Company Name ❑ 19 El Paso ��%{ ❑ 20 San Antonio Signature of Authorized Company Official Chris Petty ❑ I will not service members Printed Name of the Texas Cooperative. Page 20 of 69 Proposal Forms CONST v.01.12.2018 M78oard Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com If this Texas Regional 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 applies here: Page 21 of 69 Proposal Forms CONST v.01.12.2018 %78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com STATE SERVICE DESIGNATION The Cooperative offers vendors 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 plan to service the entire United States, or will service only the specific states indicated. (Note:If you plan to service Texas Cooperative members, be sure that you complete the Texas Regional Service Designation form.) If you serve different states for different products or services included in your proposal,you must complete and submit a separate State Service Designation form for each group of products and clearly indicate the products or services to which the designation applies in the space provided at the end of this form. By designating a state or states,you are certifying that you are authorized and willing to provide the proposed products and services in those states Designating states in which you are either unable or unwilling to provide the specified products and services shall be grounds for either rejection of your proposal or, if awarded, termination of your Contract. Please check(-/) all that aooly: ❑ I will service all states in the United States. ❑■ I will not service all states in the United States. I will service only the states checked below: ❑ Alabama ❑ Alaska ❑ Nebraska ❑■ Arizona ❑ Nevada ❑■ Arkansas ❑ New Hampshire ❑ California (Public Contract Code 20118&20652) ❑ New Jersey ❑ Colorado ■❑ New Mexico ❑ Connecticut ❑ New York ❑ Delaware ❑ North Carolina ❑ District of Columbia ❑ North Dakota ❑ Florida ❑ Ohio ❑■ Georgia ■❑ Oklahoma ❑ Hawaii ❑ Oregon ❑ Idaho ❑ Pennsylvania ❑ Illinois ❑ Rhode Island ❑ Indiana ❑ South Carolina ❑ Iowa ❑ South Dakota ❑■ Kansas ❑ Tennessee ❑ Kentucky ■❑ Texas ❑■ Louisiana ❑ Utah ❑ Maine ❑ Vermont ❑ Maryland ❑ Virginia ❑ Massachusetts ❑ Washington ❑ Michigan ❑ West Virginia ❑ Minnesota ❑ Wisconsin ❑ Mississippi ❑ Wyoming ❑ Missouri ❑ Montana Page 22 of 69 Proposal Forms CONST v.01.12.2018 PVBoard® C00perative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com This form will be used to ensure that you can service other governmental entities throughout the United States as indicated. Your signature below confirms that you understand your service commitments during the term of a contract awarded under this proposal. Elliott Electric Supply Company Name �. Chris Petty Signature of Authorized 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 applies here: Page 23 of 69 Proposal Forms CONST v.01.12.2018 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com NATIONAL PURCHASING COOPERATIVE VENDOR AWARD AGREEMENT In accordance with the Terms and Conditions associated with this Proposal Invitation, a contract awarded under this Proposal Invitation may be "piggy-backed" by another governmental entity. The National Purchasing Cooperative is an intergovernmental purchasing cooperative formed by certain school districts outside of Texas to serve its members throughout the United States. If you agree to be considered for a piggy-back award by the National Purchasing Cooperative, you agree to the following terms and agree to serve National Purchasing Cooperative members in the states you have indicated on the State Service Designation 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 Local Government Purchasing Cooperative ("Texas Cooperative") awards Vendor a contract under this Proposal Invitation ("Underlying Award"), the National Purchasing Cooperative ("National Cooperative") may - but is not required to -"piggy-back"on 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 provided for herein. 2. In the event National Cooperative awards Vendor a Piggy-Back Award, the National Cooperative Administrator ("BuyBoard Administrator") will 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 action is required of Vendor in order for the Piggy-Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no interlineations or changes to this Agreement by Vendor will be binding on National 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 Cooperative 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 and more favorable terms and conditions than those in the Underlying Award. 4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State Service Designation Form of this Proposal Invitation. 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 shall not be more often than monthly). Further, upon request, Vendor shall provide National Cooperative with copies of all purchase orders generated from National Cooperative members for purposes of reviewing and verifying purchase activity. Vendor further agrees that National Cooperative shall have the right, upon reasonable written notice, to review Vendor's records pertaining to purchases made by National Cooperative members in order to verify the accuracy of service fees. 6. Vendor agrees that the Underlying Award, including its 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 National 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 to this Agreement, and that nothing in this Agreement has application to other third parties, including the Texas Cooperative. In the event of conflict between this Agreement and the terms of the Underlying Award, the terms of this Agreement shall control, and then only to the extent necessary to reconcile the conflict. Proposal Forms CONST v.01.12.2018 Page 24 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • 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 court of Alexandria, Virginia. 8. Vendor acknowledges and agrees that the award of a Piggy-Back Award is within the sole discretion of National Cooperative, and that this Agreement does not take effect 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. Elliott Electric Supply 527-18 Name of Vendor �L�r ,. Proposal Invitation Number Chris Petty Signature of Authorized Company Official Printed Name of Authorized Company Official 5-2-2018 Date Proposal Forms CONST v.01.12.2018 Page 25 of 69 %78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com FEDERAL AND STATE/PURCHASING COOPERATIVE 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 ability 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: $ . (The period of the 12 month period is / ). 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). 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 Proposer currently serves, or in the past has served, as an awarded vendor. Rows should be added to accommodate as many purchasing cooperatives as required. CURRENT FORMER VENDOR (Y/N)? — AWARDED PURCHASING VENDOR? • •D GROUPD•• •• 1. Federal General Services Administration 2. T-PASS (state of Texas) 3. U.S. Communities Purchasing Alliance 4. National IPA/TCPN 5. Houston-Galveston Area Council (HGAC) 6. National Joint Powers Alliance (NJPA) 7. E&I Cooperative 8. The Interlocal Purchasing System (TIPS) 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(%): Proposed Discount(%): Explanation: Proposal Forms CONST v.01.12.2018 Page 26 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com By signature below, I certify that the above is true, complete and accurate and that I am authorized by my company to make this certification. Elliott Electric Supply Company Name C� Chris Petty Signature of Authorized Company Official Printed Name Proposal Forms CONST v.01.12.2018 Page 27 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com GOVERNMENTAL REFERENCES For your Proposal to be considered, you must supply a minimum of five (5) individual governmental 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 prices/discounts stated in your Proposal with the prices/discounts you offer other governmental customers. Attach additional pages if necessary. Quantity/ Entity Name Contact Phone# Email Address Discount Volume ,.Leander ISD, N/A, 512-434-5000, N/A, 2%/EES Catalog, N/A z City of Cedar Park, N/A, 512-401-5150, N/A, 2%/EES Catalog, N/A Jaylor ISD, N/A, 512-365-1391 , N/A, 2%/EES Catalog, N/A 4.1-ampasas ISD, N/A, 512-556-8224, N/A, 2%/EES Catalog, N/A 5.City of Austin, N/A, 512-322-6235, N/A, 2%/EES Catalog, N/A Do you ever modify your written policies or standard governmental sales practices as identified in the above chart to give better discounts (lower prices) than indicated? YES ■❑ NO ❑ If YES, please explain: Quoted projects, discounts for larger quantities. By signature below, I certify that the above is true and correct and that I am authorized by my company to make this certification. Elliott Electric Supply Company Name Signature of Authorized Company Official Chris Petty Printed Name Proposal Forms CONST v.01.12.2018 Page 28 of 69 %78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • 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 BuyBoard contract, and how you will continue to support the BuyBoard for the duration of the contract period.) Attach additional pages if necessary. Our marketing strategy is to call on all customers with our outside sales force. We have 148 stores serving Texas, Louisiana, Arkansas, New Mexico, Oklahoma, Arizona, Georgia, and Kansas. Each of those stores has it's own sales force. Elliott Electric Supply Comnanv Name J Signature of Authorized Company official Chris Petty Printed Name Proposal Forms CONST v.01.12.2018 Page 29 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com CONFIDENTIAL/PROPRIETARY INFORMATION A. Public Disclosure Laws All Proposals, forms, documentation, or other materials submitted by Vendor to the Cooperative in response to this Proposal Invitation, including catalogs and pricelists, may be subject to the disclosure requirements of the Texas Public Information 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) that Proposer considers proprietary or confidential. If Proposer fails to properly identify the information, the Cooperative shall have no obligation to notify Vendor or seek protection of such information from public disclosure should a member of the public or other third party request access to the information under the Texas Public Information Act or similar disclosure law. Proposer will 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 (including forms, documentation, or other materials submitted with the Proposal) contain information which Vendor considers proprietary or confidential? Please check N)one of the following: ❑E NO, I certify that none of the information included with this Proposal is considered confidential or proprietary. YES, I certify that this Proposal contains information considered confidential or proprietary and all such information is specifically identified 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 information sufficient to make the information readily identifiable. The Cooperative and its Administrator will not be responsible for a Proposer's failure to clearly identify information considered confidential or proprietary. Further, by submitting a Proposal, Proposer acknowledges that the Cooperative and its Administrator will disclose information when required by law, even if such information has been identified herein as information the vendor considers confidential or proprietary. Confidential / Proprietary Information: (Attach addition/sheets if needed.) Proposal Forms CONST v.01.12.2018 Page 30 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com B. Cooyriaht Information Does your Proposal (including forms, documentation, or other materials submitted with the Proposal) contain copyright information? Please check(A one of the following ❑— NO, Proposal (including forms, documentation, or other materials submitted with the Proposal) does not contain copyright information. ❑ YES, Proposal (including forms, documentation, or other materials submitted with the Proposal)does contain copyright information. If you responded "YES", identify below the specific documents or pages containing copyright information. Copyright Information: (Attach additional sheets if needed.) C.Consent to Release Confidential/Proprietary/Cowriaht Information to BuyBoard Members BuyBoard members (Cooperative 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 will be responsible for the use or distribution of information by BuyBoard members or any other party. D.Consent to Release Proposal Tabulation 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 tabulation for the Contract including Vendor name; proposed catalog/pricelist 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 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. Elliott Electric Supply Company Name Signature of Authorized Company Official Chris Petty Printed Name 5-2-2018 Date Proposal Forms CONST v.01.12.2018 Page 31 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com VENDOR BUSINESS NAME By submitting a Proposal, Proposer is seeking to enter into a legal contract with the Cooperative. As such, a Proposer must be an individual or legal 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: Elliott Electric Supply (List the/eaa/name of the company seeking to contract with the Cooperative. Do NOT/1st an assumed name,dba, aka, etc.here. Such information may be,provided below. If you are submitting a joint,proposal with another entity to,provide the same,proposed goods or services, each submitting entity should complete a separate vendor information form. Separately operating legal business entities, even if aifliated entities, which,propose to,provide goods or services separately must submit their own Proposals.) Please check(A one of the following Tvne of Business: Individual/Sole Proprietor Corporation X Limited Liability Company Partnership Other If other, identify State of Incorporation (if applicable): Texas Federal Employer Identification Number: 75-272 1 70 (Vendor must include a completed IRS W-9 form with their proposal) List the Name(s) by which Vendor, if awarded, wishes to be identified on the BuyBoard: (Note. If different than the Name of Proposing Company listed above, only valid trade names(dba, aka, etc.)of the Proposing Company may be used and a copy of your Assumed Name Certlhcate(s),if apolicable,must be attached.) Proposal Forms CONST v.01.12.2018 Page 32 of 69 Form Request for Taxpayer Give Form to the (Rev.December2014) Identification Number and Certification requester. not I send to the Department of the Treasury IRS. Internal Revenue Service i Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. Elliott Electric Supply 2 Business name/disregarded entity name,if different from above N m c) 3 Check appropriate box for federal tax classification;check only one of the following seven boxes: 4 Exemptions(codes apply only to c certain entities,not individuals;see 0 ❑Individual/sole proprietor or C Corporation ❑ S Corporation ❑ Partnership ❑TnasUestate instructions on page 3): a� single member LLC Exempt payee code(if any) 5,° Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► p � Note.For a single-member LLG that is disregarded,do not check LLC;check the appropriate box in the line above for Exemption from FATCA reporting c y the tax classification of the single-member owner. code(if any) (Applies to accounts maintained outside ire U.S.) ri ❑Other(see instructions) 5 Address(number,street,and apt.or suite no.) Requester's name and address(optional) U a P O Box 630610 N m 6 City,state,and ZIP code 0) Nacogdoches,TX 75963-0610 7 List account numbers)here(optional) OffitVII Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number backup withholding.For individuals,this is generally your social security number(page However,for a TT] —� resident alien,sole proprietor,or disregarded entity,see the Part 1 instructions on page 3.For other entities,it is your employer identification number(EIN).If you do not have a number,see Now to get a TIN on page 3. or Note.If the account is in more than one name,see the instructions for line 1 and the chart on page 4 for Employer identification number guidelines on whose number to enter. 7 5 — 1 1 4 1 2 3 1 7 M34 Certification Under penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2. 1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3. 1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(f any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 3. Sign $Ignature of � Here U.S.person► Q Date► -r General Instructions •Form 1098(home mortgage interest),1098-E(student loan interest),1098-T (tuition) Section references are to the Internal Revenue Code unless otherwise noted. •Form 1099-0(canceled debt) Future developments.Information about developments affecting Form W-9(such •Form 1099-A(acquisition or abandonment of secured property) as legislation enacted after we release it)is at wwwJrs.gov/fw9. Use Form W-9 only if you are a U.S.person(including a resident alien),to Purpose of Form provide your correct TIN. An individual or entity(Form W-9 requester)who is required to file an information If you do not return Form W-9 to the requester with a TIN,you might be subject return with the IRS must obtain your correct taxpayer identification number(TIN) to backup withholding.See What is backup withholding?on page 2. which may be your social security number(SSN),individual taxpayer identification By signing the filled-out form,you: number(ITIN),adoption taxpayer identification number(ATIN),or employer 1.Certify that the TIN you are giving is correct(or you are waiting for a number identification number(FIN),to report on an information return the amount paid to to be issued), you,or other amount reportable on an information return.Examples of information returns include,but are not limited to,the following: 2.Certify that you are not subject to backup withholding,or •Form 1099-INT[merest earned or paid) 3.Claim exemption from backup withholding if you are a U.S.exempt payee.If applicable,you are also certifying that as a U.S.person,your allocable share of •Form 1099-DIV(dividends,including those from stocks or mutual funds) any partnership income from a U.S.trade or business is not subject to the •Form 1099-MISC(various types of income,prizes,awards,or gross proceeds) withholding tax on foreign partners'share of effectively connected income,and •Form 1099-B(stock or mutual fund sales and certain other transactions by 4.Certify that FATCA code(s)entered on this form(if any)indicating that you are brokers) exempt from the FATCA reporting,is correct.See What is FATCA reporting?on •Form 1099-S(proceeds from real estate transactions) page 2 for further information. •Form 1099-K(merchant card and third party network transactions) Gat.No.10231X Form W-9(Rev.12-2014) %78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com EDGAR VENDOR CERTIFICATION (2 CFR Part 200 and Appendix II) When a Cooperative member seeks to procure goods and services using funds under a federal grant or contract, specific 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 Requirements for Federal Awards, 2 CFR 200 (sometimes referred to as the "Uniform Guidance" or new "EDGAR'). All Vendors submitting proposals must complete this EDGAR Certification Form regarding Vendor's willingness and ability to comply with certain 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 their 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 below, Vendor should certify Vendors agreement and ability to comply, where applicable, by having Vendor's authorized representative complete and initial the applicable boxes and sign the acknowledgment at the end of this form. If you fail to complete any item in this form, the Cooperative will consider and may list the Vendors response on the BuyBoard as "NO,ff the Vendor is unable or unwilling to comply, A "NO" response to any of the items may, if applicable, impact the ability of a Cooperative member to purchase from the Vendor using federal funds. 1. Vendor Violation or Breach of Contract Terms: Contracts for more than the simplified acquisition threshold 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 USC 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. Provisions regarding Vendor default are included in the BuyBoard General Terms and Conditions, including Section 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 contract, or Member Construction Contract agreed upon by Vendor 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 available under law or in equity. By submitting a Proposal, you agree to these Vendor violation and breach of contract terms. 2. Termination for Cause or Convenience: For any Cooperative member purchase or contract in excess of $10,000 made using federal funds, you agree that the following term and condition shall apply: The Cooperative member may terminate or cancel any purchase order under this Contract at any time, with or without cause, by providing seven (7) business days advance written notice to the Vendor. If this Agreement is terminated in accordance with this Paragraph, the Cooperative member shall only be required to pay Vendor for goods or services delivered to the Cooperative member prior to the termination and not otherwise returned in accordance with Vendor's return policy. If the Cooperative member has paid Vendor for goods or services not yet provided as of the date of termination, Vendor shall immediately refund such payment(s). If an alternate 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, ancillary agreement, or Member Construction Contract agreed to by the Vendor, the Cooperative member's provision shall control. Proposal Forms CONST v.01.12.2018 Page 33 of 69 Board Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com 3. Equal Employment Opportunity: Except as otherwise provided under 41 CFR Part 60, all Cooperative member purchases or contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 shall be deemed to include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR Part 60,"Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor." The equal opportunity clause provided under 41 CFR 60-1.4(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 Part 60-1.3 and Vendor agrees that it shall comply with such provision. 4. Davis-Bacon Act: When required by Federal program legislation, Vendor agrees that, for all Cooperative member prime construction contracts/purchases in excess of $2,000, Vendor shall comply with the Davis-Bacon Act (40 USC 3141-3144, and 3146- 3148) as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to Contracts Covering Federally 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 applies, the award of the purchase to the Vendor is conditioned upon Vendor's acceptance of the wage determination. Vendor further agrees that it shall also comply with the Copeland "Anti-Kickback"Act (40 USC 3145), as supplemented by Department 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 employed in the construction, completion, or repair of public work, to give up any part of the compensation to which he or she is otherwise entitled. 5. Contract Work Hours and Safety Standards Act: Where applicable, for all Cooperative member contracts or purchases in excess of$100,000 that involve the employment of mechanics or laborers, Vendor agrees to comply with 40 USC 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR Part 5). Under 40 USC 3702 of the Act, Vendor is required to compute the wages of every mechanic and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible provided that the worker 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 construction work and provide that no laborer or mechanic must be required to work in surroundings or under working conditions which are unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles ordinarily available on the open market, or contracts for transportation or transmission of intelligence. 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 recipient or subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance or experimental, developmental, or research work under that "funding agreement," the recipient or 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 above requirements when applicable. Proposal Forms CONST v.01.12.2018 Page 34 of 69 %78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com 7. Clean Air Act and Federal Water Pollution Control Act: Clean Air Act (42 USC 7401-7671q.) and the Federal Water Pollution Control Act (33 USC 1251-1387), 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 all applicable standards, orders, or regulations issued pursuant to the Clean Air Act (42 USC 7401- 7671q.) and the Federal Water Pollution Control Act, as amended (33 USC 1251-1387). Violations must be reported to the Federal awarding agency and the Regional Office 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 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 1966 Comp. p. 189) and 12689 (3 CFR Part 1989 Comp. p. 235), "Debarment and Suspension." SAM Exclusions contains the 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. 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 authority 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 if Vendor is later listed on the government-wide exclusions in SAM, 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 USC 1352) -- Vendors 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 with obtaining any Federal contract, grant or any other award covered by 31 USC 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. As applicable, Vendor agrees to file all certifications and disclosures required by, and otherwise comply with,the Byrd Anti-Lobbying Amendment (31 USC 1352). 10. Procurement of Recovered Materials: For Cooperative member purchases utilizing Federal funds, Vendor agrees to comply with Section 6002 of the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act where applicable and provide such information and certifications as a Cooperative member may require to confirm estimates and otherwise comply. 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 establishing an affirmative procurement program for procurement of recovered materials identified in the EPA guidelines. 11. Profit 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. See, 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 CONST v.01.12.2018 Page 35 of 69 %78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com 12. General Compliance and Cooperation 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. Vendor Certification: 1P YES, I agree or Vendor Certification Item No. NO, I do NOT agree Initial 1. Vendor Violation or Breach of Contract Terms Yes C P 2. Termination for Cause or Convenience Yes C P 3. Equal Employment Opportunity Yes C P 4. Davis-Bacon Act Yes C P 5. Contract Work Hours and Safety Standards Act Yes C P 6. Right to Inventions Made Under a Contract or Agreement Yes C P 7. Clean Air Act and Federal Water Pollution Control Act Yes C P 8. Debarment and Suspension Yes C P 9. Byrd Anti-Lobbying Amendment Yes C P 10. Procurement of Recovered Materials Yes C P 11. Profit as a Separate Element of Price Yes C P 12. General Compliance and Cooperation with Cooperative Members Yes C P 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. Elliott Electric Supply Company Name Signature of Authorized Company Official Chris Petty Printed Name Proposal Forms CONST v.01.12.2018 Page 36 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com PROPOSAL INVITATION QUESTIONNAIRE The 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 questions/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 your Proposal 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 transaction that would significantly alter its business or result in acquisition by another entity. 46 years. Not for sale. 2. Describe Proposer's direct experience (not as a subcontractor) performing the work proposed under this contract. Include a brief description of the projects you have completed for Texas governmental entities in the last 5 years, and include for each the project name, scope, value, and date, and the name of the procuring government entity and entity contact person. Identify the contracts that best represent Proposer's capabilities relative to this contract. 3. Describe the resources Proposer has to manage staff and successfully perform the Work contemplated under this Contract. State the number and summarize the experience of company personnel who may be utilized for the Work, including those who will be available to Cooperative members for assistance with project development, technical issues, and product selection for Work associated with this Contract. Proposal Forms CONST v.01.12.2018 Page 37 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com 4. The Contract does not include architectural or engineering services, which must be procured separately, outside of the Cooperative, in accordance with Chapter 2254 of the Texas Government Code (Professional Services Procurement Act). If you are performing work under the contract on a project that requires the services of an architect or professional engineer, how will you work with a Cooperative member and its designated architect or engineer with respect to services that must be procured outside the contract? 5. Describe the tasks and functions that can be completed by Proposer in-house without the use of a subcontractor or other third party. 6. Describe Proposer's financial capability to perform the Contract. State or describe the firm's financial 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, have been a debtor parry to a bankruptcy, receivership, or insolvency proceeding in the last 7 years, and identify any such debtor party by name and relationship to or position with your firm. 7. Does your company have 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. Proposal Forms CONST v.01.12.2018 Page 38 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com 8. List all contracts, if any, in the last 10 years on which Proposer has defaulted, failed to complete or deliver the work, or that have been terminated for any reason. Include any contract for which the surety was notified of a potential claim in regards to a payment or performance bond. For each such contract, 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. 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 the last 10 years brought against your firm, or any of the firm's past or present owners, principal shareholders or stockholders, officers, agents or employees, that relates to or arises from a contract similar to this Contract or the work contemplated under this Contract. Provide the style of the lawsuit or proceeding (name of parties and court or tribunal in which filed), if applicable, nature of the claim, and resolution or current status. 10. Describe in detail the quality control system Proposer will use, including third party auditing certification, to support the long-term performance and structural strength of the products to be used in a project under the Contract. 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. Proposal Forms CONST v.01.12.2018 Page 39 of 69 M78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com 12. Describe in detail all documented safety issues, if any, that have involved Proposer in the last three (3) years related to the type of work contemplated under this contract. Provide a 3-year history of your firm's workers compensation experience modifier. By signature below, I certify that the information contained in and/or attached to this Proposal Invitation Questionnaire in response to the above questions is true and correct and that I am authorized by my company to make this certification. Elliott Electric Supply Company Name Signature of Authorized Company Official Proposal Forms CONST v.01.12.2018 Page 40 of 69 %78oard� Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com REQUIRED FORMS CHECKLIST (Please check(v)the following) 0 Completed: Proposer's Agreement and Signature 0 Completed: Vendor Contact Information 0 Completed: Felony Conviction Disclosure and Debarment Certification 0 Completed: Resident/Nonresident Certification 0 Completed: No Israel Boycott Certification 0 Completed: No Excluded Nation or Foreign Terrorist Organization Certification 0 Completed: Historically Underutilized Business (HUB) Certification) 0 Completed: Construction Related Goods and Services Affirmation 0 Completed: Deviation/Compliance 0 Completed: Location/Authorized Seller Listings 0 Completed: Manufacturer Dealer Designation 0 Completed: Texas Regional Service Designation 0 Completed: State Service Designation 0 Completed: National Purchasing Cooperative Vendor Award Agreement 0 Completed: Federal and State/Purchasing Cooperative Experience 0 Completed: Governmental References 0 Completed: Marketing Strategy 0 Completed: Confidential/Proprietary Information 0 Completed: Vendor Business Name with IRS Form W-9 0 Completed: EDGAR Vendor Certification 0 Completed: Proposal Invitation Questionnaire 0 Completed: Required Forms Checklist 0 Completed: Proposal Specification Form with Catalogs/Pricelists *Catalogs/Pricelists must be submitted with proposal response or response will not be considered. 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Box 630610 Nacogdoches,TX 75964-1240 Nacogdoches,TX 759 ELLIOTT ELECTRIC SUPPLY Office: (936)5 9-118463-0610 Office: (936)569-1184 Fax:(936)569-1836 0 Fax(936):569-1836 #1 NACOGDOCHES #9 Waxahachie #17 Galena Park #24 Athens 3804 South Street 706 Solon Rd. 1915 Turning Basin Suite 500 1755 Enterprise Street Nacogdoches,TX 75964-7263 Waxahachie,TX 75165-0000 Houston,TX 77029-0000 Athens,TX 75751-0000 Office: (936)569-7941 Office: (972)937-6965 Office: (713)675-6700 Office: (903)675-7999 Fax: (936)560-4685 Fax:(972)937-6968 Fax:(713)675-6777 Fax:(903)675-9414 Store Manager: Store Manager: Store Manager: Store Manager: •Allen Watson •Allan Creamier •Brian Combs •Paul Godwin •Jerry Camp •Casey McIver #10 Huntsville •Shane Sampson #25 Ft. Worth #2 TYLER 402 Hwy 190 East 6312A Airport Freeway 3706 Frankston Hwy Huntsville,TX 77340-0000 #18 West Dallas Ft.Worth,TX 76117-0000 Tyler,TX 75701-0000 Office: (936)439-0658 13405 Stemmons Frwy Office: (682)647-1594 Office: (903)509-9882 Fax:(936)439-9182 Farmers Branch,TX 75234-0 Fax:(682)647-1528 Fax: (903)509-9832 Store Manager: Office: (214)351-0785 Store Manager: Store Manager: •Tim Watkins Fax:(972)241-1564 •Cody Sears •Richard Ogden Store Manager: •Jerry Camp #11 Greenville •Lance Knight #26 Terrell 2805 Poplar 1300 Hwy 34 South #3 BOSSIER CITY Greenville,TX 75401-0000 #19 Denton Terrell,TX 75160-0000 2414 Montgomery Ln. Office: (903)454-3354 4221 Mesa Office: (972)563-2224 Bossier City, LA 71111-0000 Fax:(903)454-8926 Denton,TX 76207-3437 Fax:(972)563-2227 Office: (318)746-5712 Store Manager: Office: (940)381-9070 Store Manager: Fax: (318)746-8036 •Chad Oats Fax:(940)380-0325 •Chad Oats Store Manager: Store Manager: •Sharon Elliott #12 Arlington Branch •Jordan Smith #27 BCOWnWOOd 2900 East Pioneer Parkway Suite 170 4300 Danhill Drive #4 Sulphur Springs Arlington,TX 76010-0 #20 Natchitoches Brownwood,TX 76801-0000 1220 Elm Street Office: (817)695-1616 500 Rapides Drive Office: (325)646-6566 Sulphur Springs,TX 75482-0000 Fax:(817)633-9062 Natchitoches, LA 71457-0000 Fax:(325)646-3777 Office: (903)885-0024 Store Manager: Office: (318)352-7414 Store Manager: Fax:(903)885-0352 •Santiago Martinez Fax:(318)352-4100 •Ross Neel Store Manager: Store Manager: •Brian Monk #13 Kilgore •Johnny Winfree #28 Tomball 1207 Energy Drive •Chris Rogers 201 South Persimmon Street #5 Henderson Kilgore,TX 75662-0000 •Bobby Garlington Tomball,TX 77375-6855 802 West Main Office: (903)984-8485 Office: (281)357-5300 Henderson,TX 75652-4459 Fax:(903)984-8193 #21 Mt. Pleasant Fax:(281)357-5005 Office: (903)657-1517 Store Manager: 1121 W. 16th Street Store Manager: Fax:(903)657-0253 •Jeffrey Lester Mt. Pleasant,TX 75455-0000 •Mike Baumann Store Manager: Office: (903)577-7311 •Kenneth Bromley #14 Shreveport Fax:(903)577-7320 #29 Round Rock 9139 Linwood Ave Store Manager: 445 Texas Avenue #6 Dallas Shreveport, LA 71106-0000 •Robert Daniel Round Rock,TX 78664-2138 11333 Petal Office: (318)688-9822 Office: (512)246-8001 Dallas,TX 75238-0000 Fax:(318)688-0702 #22 Lufkin Fax:(512)246-8002 Office: (214)503-7227 Store Manager: 2001 ATKINSON DRIVE Store Manager: Fax:(214)503-9766 •Terry Godfrey Lufkin,TX 75901-0000 •Kody King Store Manager: Office: (936)632-9733 •Lance Knight #15 Jacksonville Fax:(936)632-9736 #30 TEXARKANA 2202 East Rusk Street Store Manager: 800 Old Boston Road #7 Palestine Jacksonville,TX 75766-0000 •Michael Cates Texarkana,TX 75501-0000 1620 Highway 155 Office: (903)586-2904 Office: (903)223-6400 Palestine,TX 75801-0000 Fax:(903)586-5271 #23 Bridgeport Fax: (903)223-6700 Office: (903)723-2141 Store Manager: 204 Lake Road Store Manager: Fax:(903)723-1451 •Mark Lusk Bridgeport,TX 76426-0000 •Brad Lloyd Store Manager: Office: (940)683-5740 •Mark Lusk #16 LONGVIEW Fax:(940)683-5299 #31 Corsicana 1500 West Cotton Store Manager: 1732 South Business 287 #8 Marshall Longview,TX 75604-0000 •James Sparks Corsicana,TX 75110-0000 210 Veterans Avenue Office: (903)757-8491 Office: (903)872-9696 Marshall,TX 75672-0 Fax: (903)758-0441 Fax:(903)872-9980 Office: (903)935-9535 Store Manager: Store Manager: Fax:(903)935-3490 •Jerry Camp •Pat McGuire Store Manager: •Steve Coots •Eric Sparks Account Receivables Account Payables Purchasing&Marketing Helpdesk&Training Phone: (936)715-4008 Phone: (936)715-4013 Inventory Control:(936)715-4004 Helpdesk:(936)715-4010 Fax:(936)560-0074 Marketing: (936)715-4005 Training: (936)715-4044 2526, N Stallings Drive P.O. Box 630610 Nacogdoches,TX 75964-1240 Nacogdoches,TX 759 ELLIOTT ELECTRIC SUPPLY Office: (936)5 9-118463-0610 Office: (936)569-1184 Fax:(936)569-1836 0 Fax(936):569-1836 #32 Jasper #39 Paris #48 Killeen #56 League City 430 South Fletcher 3315 Park Place 2501 S. Fort Hood St. 1135 Butler Road Jasper,TX 75951-0000 Paris,TX 75460-0000 Killeen,TX 76542-2312 League City,TX 77573-0 Office: (409)489-0056 Office: (903)784-1916 Office: (254)554-5958 Office: (281)833-5333 Fax:(409)489-0059 Fax:(903)784-0107 Fax:(254)554-8423 Fax:(281)833-5334 Store Manager: Store Manager: Store Manager: Store Manager: •Richard Barnhart •Brian Monk •Kellen Ducey •Brian Combs •Shane Sampson #33 Humble #40 Burleson #49 HOUSTON RDC •Ricky Butts 1550 Wilson Rd. 149 North Wilson St. 8401 Westland West Blvd Humble,TX 77338-0000 Burleson,TX 76028-0000 Houston,TX 77041-0000 #57 Leesville Office: (281)548-0169 Office: (817)447-0192 Office: (281)345-1143 206 Stanton St. Fax:(281)548-0198 Fax:(817)426-1193 Fax: (281)345-7697 Leesville, LA 71446-0 Store Manager: Store Manager: Store Manager: Office: (337)238-1624 •Brian Combs •Louis Perkins •Gregory Fitzgerald Fax:(337)239-2527 •Jason Renfrow •Brian Combs Store Manager: •Shane Sampson #41 Pearland •Heather Littleton 3222 Manvel #50 Granbury #34 DFW RDC Pearland,TX 77584-0000 4510 East Hwy 377 #58 ABILENE 13405 Stemmons Frwy Office: (281)412-7049 Granbury,TX 76049-0000 4281 Crawford Dr. Farmers Branch,TX 75234-0 Fax:(281)412-7314 Office: (817)573-0675 Abilene,TX 79602 Office: (972)206-0016 Store Manager: Fax:(817)573-0776 Office: (325)793-1570 Fax: (972)352-2818 •Brian Combs Store Manager: Fax: (325)692-9649 Store Manager: •Raymond Gutierrez •Shannon Lott Store Manager: •Mark Newcomb •Shane Sampson •James Meazell •Robert Minchew #51 Cedar Park •Bryson Walker •Taylor Kulovitz #42 Waco 300 East New Hope Road Suite 308 •Nathan Miller 3325 Clay Avenue Cedar Park,TX 78613-0000 #59 Lafayette Waco,TX 76711-0000 Office: (512)260-0684 1811 N. University Suite 100 #35 Pineville Office: (254)752-3331 Fax:(512)260-7269 Lafayette, LA 70507-0000 4406 Highway 28 East Fax:(254)752-3460 Store Manager: Office: (337)235-7681 Pineville, LA 71360-0000 Store Manager: •Kody King Fax:(337)235-7725 Office: (318)767-0900 •Kellen Ducey Store Manager: Fax:(318)767-0010 #52 Weatherford •Dwight Dufour Store Manager: #43 McKinney 1830 Barnett Drive •Lane Belgard 427 Metro Park Drive Weatherford,TX 76087-0000 #60 New Braunfels Mckinney,TX 75069-0000 Office: (817)599-7964 212 Lucinda #36 Marble Falls Office: (972)542-1196 Fax:(817)599-8289 New Braunfels,TX 78130-0000 608 Industrial Blvd Fax:(972)542-2279 Store Manager: Office: (830)626-6880 Marble Falls,TX 78654-0000 Store Manager: •Lee Robinson Fax:(830)626-8075 Office: (830)693-9910 •Jenny Martin Store Manager: Fax:(830)693-0544 #53 South Austin •Greg Hayes Store Manager: #44 Ennis 2301 East Saint Elmo Rd. Suite 105 •Orion Barry 711 Lake Bardwell Dr. Austin,TX 78744-0 #61 San Antonio Ennis,TX 75119-0000 Office: (512)443-5600 5300 Bandera Road #37 Hope Office: (972)875-3413 Fax:(512)443-5601 Leon Valley,TX 78238-0000 1615 North Hazel St. Fax:(972)875-3174 Store Manager: Office: (210)522-0146 Hope,AR 71801-0000 Store Manager: •Adam Parker Fax:(210)522-0732 Office: (870)777-4225 •Austin Fitzgerald Store Manager: Fax:(870)777-4343 #54 ALEXANDRIA •Jason Pintirsch Store Manager: #46 ATLANTA 3705 Lee Street •Blain Halliday 4075 Boulder Ridge Drive Alexandria, LA 71301-0000 #62 Midland Atlanta,GA 30336-0 Office: (318)445-1336 1001 South Goode #38 Katy Office: (470)237-5352 Fax: (318)445-8356 Midland,TX 79701-0000 1722 Primewest Parkway Fax: (470)237-5353 Store Manager: Office: (432)685-3108 Katy,TX 77449-0 Store Manager: •Johnny Winfree Fax:(432)685-3706 Office: (281)828-2012 •Kevin Dodson Store Manager: Fax:(281)828-2512 #55 WEST MONROE •James Meazell Store Manager: #47 Bryan 106 Industrial Drive •Braulio Bueno •Jason Nevill 2501 Cavitt Avenue West Monroe, LA 71292-0000 •Bryson Walker Bryan,TX 77801-0 Office: (318)398-9757 •Johnny Busick Office: (979)779-6630 Fax: (318)398-9704 Fax:(979)779-6620 Store Manager: Store Manager: •Van Phillips •Quentin Risner Account Receivables Account Payables Purchasing&Marketing Helpdesk&Training Phone: (936)715-4008 Phone: (936)715-4013 Inventory Control:(936)715-4004 Helpdesk:(936)715-4010 Fax:(936)560-0074 Marketing: (936)715-4005 Training: (936)715-4044 2526, N Stallings Drive P.O. Box 630610 Nacogdoches,TX 75964-1240 Nacogdoches,TX 759 ELLIOTT ELECTRIC SUPPLY Office: (936)5 9-118463-0610 Office: (936)569-1184 Fax:(936)569-1836 0 Fax(936):569-1836 #63 San Angelo #70 Andrews #78 Plano #86 N Little Rock 3448 Sherwood Way 1201 West Broadway 2700 Summit Ave. Suite 200 1501 North Cypress Street San Angelo,TX 76901-0000 Andrews,TX 79714-0000 Plano,TX 75074-0000 N. Little Rock,AR 72114-0 Office: (325)944-7321 Office: (432)523-2423 Office: (469)467-7771 Office: (501)945-9398 Fax:(325)944-1579 Fax:(432)523-2428 Fax:(469)467-0282 Fax:(501)508-2426 Store Manager: Store Manager: Store Manager: Store Manager: •James Meazell •James Meazell •Andy Sambitan •Donald White •Bryson Walker •Braulio Bueno •Brent Ogden •Bryson Walker #79 Monroe #87 Fort Stockton 801 Sterlington Rd. 1308 North Nelson Street #64 AUSTIN RDC #71 Mansfield Monroe, LA 71203-0 Fort Stockton,TX 79735-0000 10605 Delta Drive 1501 Heritage Parkway Suite 101 Office: (318)387-1621 Office: (432)336-8730 Austin,TX 78758-0000 Mansfield,TX 76063-0000 Fax:(318)387-1763 Fax:(432)336-3279 Office: (512)339-8750 Office: (682)518-7272 Store Manager: Store Manager: Fax: (512)339-6732 Fax:(682)518-7255 •Van Phillips •James Meazell Store Manager: Store Manager: •Bryson Walker •Chris Petty •Brett Church #80 Sulphur •William Tucker 1336 Swisco Road #65 Stafford #72 Temple Sulphur, LA 70665-0000 #88 Pleasanton 10650 West Airport Suite 100 2703 Hancock Dr. Office: (337)533-8019 2569 E. Hwy 97 Stafford,TX 77477-0000 Temple,TX 76504-0000 Fax:(337)533-8055 Pleasanton,TX 78064-0000 Office: (281)879-4911 Office: (254)899-2800 Store Manager: Office: (830)569-3390 Fax:(281)879-8596 Fax:(254)899-2805 •Neil Peveto Fax:(830)569-3608 Store Manager: Store Manager: Store Manager: •Jason Nevill •Kellen Ducey #81 AMARILLO •Justin McCrary 4000 Mockingbird Ln #66 ODESSA #73 SAN ANTONIO RDC Amarillo,TX 79109-3210 #89 Searcy 5617 Andrews Hwy 9707 Broadway St Office: (806)220-0404 1612 E. Booth Road Odessa,TX 79762-0000 San Antonio,TX 78217-0 Fax: (806)220-0811 Searcy,AR 72143-0000 Office: (432)366-0008 Office: (210)646-6950 Store Manager: Office: (501)368-0309 Fax: (432)366-6045 Fax: (210)646-6192 •Chris Woodall Fax:(501)368-0619 Store Manager: Store Manager: •Bryan Mercer Store Manager: •James Meazell •Chris Petty •Rick Debord •Bryson Walker •Brandon Hatch #82 Kerrville •Johnny Busick 1200 Water St #90 Hereford #74 Vidalia Kerrville,TX 78028-0000 401 E 2ND ST #67 Ruston 6 South Hickory Office: (830)896-9240 Hereford,TX 79045-0000 2020 Farmerville Highway Vidalia, LA 71373-0000 Fax:(830)896-9244 Office: (806)364-1529 Ruston, LA 71270-0000 Office: (318)336-5113 Store Manager: Fax:(806)364-1540 Office: (318)251-9393 Fax:(318)336-5587 •Chadd Smart Store Manager: Fax:(318)255-1402 Store Manager: •Chris Woodall Store Manager: •Van Phillips #83 Gainesville •Bryan Mercer •Eric Williams 1725 East Highway 82 •Ronny Sanders #75 Borger Gainesville,TX 76240-0000 #68 Carthage 2108 South Huber Office: (940)612-1388 #91 LITTLE ROCK 3168 SW Loop 436 Borger,TX 79007-0000 Fax:(940)612-1499 5505 West 65th Street Carthage,TX 75633-0000 Office: (806)273-3085 Store Manager: Little Rock,AR 72209-0000 Office: (903)694-9924 Fax:(806)273-2487 •John Carr Office: (501)565-1785 Fax:(903)694-9928 Store Manager: Fax: (501)565-0827 Store Manager: •Chris Woodall #84 Stephenville Store Manager: •Nathan Lenox •Austin Boyd 1035 S.Graham St. •Donald White •Bryan Mercer Stephenville,TX 76401-0000 #69 Conroe Office: (254)965-8083 #92 Clovis 2323 North Frazier Suite F #76 Hobbs Fax:(254)968-2662 3205 Axtell Conroe,TX 77303-0000 1105 West Sanger Store Manager: Clovis, NM 88101-0000 Office: (936)788-6850 Hobbs, NM 88240-0000 •Ross Neel Office: (575)742-2504 Fax:(936)788-8283 Office: (575)397-2122 Fax:(575)742-2508 Store Manager: Fax:(575)397-2178 #85 Dumas Store Manager: •Jason Renfrow Store Manager: 110 Success Blvd •David Chaney •James Meazell Dumas,TX 79029-0000 •Chris Woodall •Michael Gideon Office: (806)934-4805 •Bryan Mercer •Mathew Mendez Fax:(806)717-2052 •Bryson Walker Store Manager: •Chris Woodall •Austin Boyd •Bryan Mercer Account Receivables Account Payables Purchasing&Marketing Helpdesk&Training Phone: (936)715-4008 Phone: (936)715-4013 Inventory Control:(936)715-4004 Helpdesk:(936)715-4010 Fax:(936)560-0074 Marketing: (936)715-4005 Training: (936)715-4044 2526, N Stallings Drive P.O. Box 630610 Nacogdoches,TX 75964-1240 Nacogdoches,TX 759 ELLIOTT ELECTRIC SUPPLY Office: (936)5 9-118463-0610 Office: (936)569-1184 Fax:(936)569-1836 0 Fax(936):569-1836 #93 Sweetwater #100 Galveston #107 Stuttgart #114 Hot Springs 2311 East Broadway St. 6510 Broadway St 310 West 22nd St. 411 Autumn Street Sweetwater,TX 79556-0000 Galveston,TX 77554-0000 Stuttgart,AR 72160-0000 Hot Springs,AR 71901-0000 Office: (325)236-6381 Office: (409)741-0072 Office: (870)672-7082 Office: (501)762-8210 Fax:(325)236-6186 Fax:(409)741-0433 Fax:(870)672-7086 Fax:(501)762-8211 Store Manager: Store Manager: Store Manager: Store Manager: •Coleman Clark •Brian Combs •Allen Bone •Matthew Thompson •James Meazell •Shane Sampson •Bryson Walker •Ricky Butts #108 Houston #115 Clinton 8401 Westland West Blvd 211 S.4th street #94 Cabot #101 Big Spring Houston,TX 77041-0000 clinton, OK 73601-0000 132 Professional Dr. 1308 East 4th Street Office: (713)462-9901 Office: (580)323-0034 Cabot,AR 72023-0000 Big Spring,TX 79720-0000 Fax:(713)462-4509 Fax:(580)323-0701 Office: (501)605-1780 Office: (432)264-0316 Store Manager: Store Manager: Fax:(501)605-1785 Fax:(432)264-0483 •Megan Williams •Bryan Mercer Store Manager: Store Manager: •Gary Mayes •Tim Benton •James Meazell #109 Lawton •Bryson Walker 1010 SE 1st Street #116 Cleburne #95 Mineral Wells •Jamie Roberts Lawton, OK 7350 1-0000 1820 N Main St. 201 North East 20th Ave. Office: (580)581-7270 Cleburne,TX 76033-0000 Mineral Wells,TX 76067-0000 #102 BATON ROUGE Fax:(580)215-4548 Office: (817)202-8933 Office: (940)325-5503 10440 Airline Highway Store Manager: Fax:(817)202-8998 Fax:(940)325-5544 Baton Rouge, LA 70816-0000 •Chris Woodall Store Manager: Store Manager: Office: (225)292-7746 •Bryan Mercer •Louis Perkins •Lee Robinson Fax: (225)292-7840 •Tanner Taliaferro Store Manager: #117 Pecos #96 Plainview •Bob Jones #110 LUBBOCK 166 Raul Florez Blvd. 2509 West 5th 6112 42nd Street Pecos,TX 79772-0000 Plainview,TX 79072-0000 #103 Uvalde Lubbock,TX 79407-0 Office: (432)445-1472 Office: (806)296-5518 17 Lou Stroup Drive Office: (806)698-6329 Fax:(432)445-1474 Fax:(806)291-0839 Uvalde,TX 78801-0000 Fax: (806)698-6805 Store Manager: Store Manager: Office: (830)278-1938 Store Manager: •James Meazell •Chris Woodall Fax:(830)278-1395 •Chris Woodall •Bryson Walker •Bryan Mercer Store Manager: •Bryan Mercer •William Tucker •Keagan McDermett •Shane Davenport •Keagan McDermett •Chris Courtney •Keetha Lucero #118 Duncan #104 Russellville 5150 N. Hwy 81 #97 Sherman 1715 South Knoxville #111 New Orleans Duncan,OK 73533-0000 4509 Texoma Parkway Russellville,AR 72802-0000 221 Hord St Office: (580)252-2582 Sherman,TX 75090-0000 Office: (479)967-2303 Harahan, LA 70123-0000 Fax:(580)252-2738 Office: (903)892-8041 Fax:(479)967-2306 Office: (504)264-9995 Store Manager: Fax:(903)892-8907 Store Manager: Fax:(504)264-5996 •Bryan Mercer Store Manager: •Terry Hansell Store Manager: •Kody Rackley •Jenny Martin •John King •Kenda Flowers #105 Fort Smith #119 Kenedy 5500 Wheeler Avenue #112 Bentonville 475 Boardwalk #98 San Marcos Fort Smith,AR 72901-0000 908 SE 21st Street Kenedy,TX 78119-0000 1904 Dutton Drive Office: (479)648-1902 Bentonville,AR 72712-0000 Office: (830)299-4593 San Marcos,TX 78666-0000 Fax:(479)648-1960 Office: (479)250-1930 Fax:(830)583-9886 Office: (512)392-4310 Store Manager: Fax:(479)250-1931 Store Manager: Fax:(512)392-4390 •David Christenberry Store Manager: •Ross Wendele Store Manager: •Eric Lind •David Christenberry •Adam Parker •David Haley #120 North Austin #106 SPRINGDALE 10605 Delta Drive #99 Conway 537 N 40th St #113 Wichita Falls Austin,TX 78758-0000 520 Equity Ave Springdale,AR 72762-0000 903 Mississippi Ave. Office: (512)351-3290 Conway,AR 72032-0000 Office: (479)361-2266 Wichita Falls,TX 76301-0000 Fax:(512)973-9027 Office: (501)336-8444 Fax: (479)361-9188 Office: (940)257-6832 Store Manager: Fax:(501)329-5636 Store Manager: Fax:(940)257-6833 •Mike Hogan Store Manager: •Jim Mitchell Store Manager: •Shawn Ford •Lawrence Gabbard •Tina Priddy •James Sparks •David Christenberry •Chris Hillen Account Receivables Account Payables Purchasing&Marketing Helpdesk&Training Phone: (936)715-4008 Phone: (936)715-4013 Inventory Control:(936)715-4004 Helpdesk:(936)715-4010 Fax:(936)560-0074 Marketing: (936)715-4005 Training: (936)715-4044 2526, N Stallings Drive P.O. Box 630610 Nacogdoches,TX 75964-1240 Nacogdoches,TX 759 ELLIOTT ELECTRIC SUPPLY Office: (936)5 9-118463-0610 Office: (936)569-1184 Fax:(936)569-1836 0 Fax(936):569-1836 #121 West Ft.Worth #129 N. San Antonio #136 Georgetown #146 WEST WICHITA 9609 Camp Bowie W. Blvd. 9707 Broadway St. 2450 NE Inner Loop Building 1 4100 West Walker St. Fort Worth,TX 76116-0000 San Antonio,TX 78217-0000 Georgetown,TX 78626-0 Wichita,KS 67209-0000 Office: (817)560-0585 Office: (210)646-6950 Office: (737)444-2615 Office: (316)854-0028 Fax:(817)560-0723 Fax:(210)826-1197 Fax:(737)444-2617 Fax: (316)854-0029 Store Manager: Store Manager: Store Manager: Store Manager: •Cody Sears •Danny Rodriguez •Kody King •Joe McClean #122 OKLAHOMA CITY #130 DEER PARK #137 Covington #147 Stillwater 1300 South May Ave 3700 HWY 225 Suite 100 1026 North Collins Boulevard 303 East Harried Avenue Oklahoma City,OK 73108-0000 Pasadena,TX 77503-0000 Covington, LA 70433-0000 Stillwater, OK 74075-0000 Office: (405)896-3723 Office: (281)220-3780 Office: (985)302-3016 Office: (405)880-8633 Fax: (405)272-3057 Fax: (713)740-6104 Fax:(985)249-6076 Fax:(405)880-8634 Store Manager: Store Manager: Store Manager: Store Manager: •Chris Woodall •Brian Combs •JT Thompson •Chase Stevens •Bryan Mercer •Casey McIver •Bryan Mercer •David Tanner •Shane Sampson #138 El Dorado 805 South Timberlane Drive #148 PHOENIX #124 Rogers #131 Benton El Dorado,AR 71730-0000 121 S 39th Ave#100 2214 South 8th Street 2114 Military Rd. Office: (870)639-6289 Phoenix,AZ 85009-0000 Rogers,AR 72756-0000 Benton,AR 72015-0000 Fax:(870)864-8850 Office: (480)372-4901 Office: (479)636-4190 Office: (501)303-4983 Store Manager: Fax: (480)372-4902 Fax:(479)636-5604 Fax:(501)776-4143 •Wayne Jackson Store Manager: Store Manager: Store Manager: •Chris Petty •David Christenberry •David Work #139 Magnolia •Quentin Bell •David Haley 102 Harvey Couch Blvd #132 Moore Magnolia,AR 71753-0000 #149 Pine Bluff #125 Fayetteville 2101 S Eastern Ave Office: (870)626-4277 6520 W Barraque St 2642 S.School St. Moore, OK 73160-0000 Fax:(870)234-7640 White Hall,AR 71602-0000 Fayetteville,AR 72701-0000 Office: (405)759-4139 Store Manager: Office: (870)671-4805 Office: (479)443-4948 Fax:(405)237-1928 •Van Phillips Fax:(870)671-4806 Fax:(479)443-6465 Store Manager: Store Manager: Store Manager: •Bryan Mercer #140 Pampa •Donald White •Jim Mitchell •Arron Wilson 1620 Alcock St. •David Christenberry Pampa,TX 79065-0000 #150 Rome •Tom Dawson #133 Enid Office: (806)665-0433 1461 Technology Pkwy 3507 N Van Buren Bypass Fax:(806)665-1002 Rome,GA 30165-0000 #126 Siloam Springs Enid,OK 73701-0000 Store Manager: Office: (706)622-4953 1201 East Lake Francis Dr. Office: (580)701-6818 •Bryan Mercer Fax:(706)622-4954 Siloam Springs,AR 72761-0000 Fax:(580)234-5655 •Johnnie Spotts Store Manager: Office: (479)238-1561 Store Manager: •Jamen Costner Fax:(479)238-1461 •Bryan Mercer #141 Roswell Store Manager: •Jerrid Bramwell 907 East 2nd Street •Jim Mitchell Roswell, NM 88201-0000 •David Christenberry #134 TULSA Office: (575)208-1571 •Tom Dawson 6917 E 12th Street Fax:(575)208-1572 Tulsa,OK 74112-0000 Store Manager: #127 Pearsall Office: (918)948-7825 •Bryan Mercer 1910 Business Interstate 35E Fax: (918)835-8085 •Keith Taylor Pearsall,TX 78061-0000 Store Manager: Office: (830)334-5353 •David Christenberry #144 McAllen Fax:(830)334-5757 •Chris Rozene 1701 North Jackson Suite E Store Manager: McAllen,TX 78501-0000 •Julian Garcia #135 Wichita Office: (956)331-2410 409 Lulu Fax:(956)331-2411 #128 Edmond Wichita, KS 67211-0 Store Manager: 308 Centennial Boulevard Office: (316)262-1446 •Lance Shelley Edmond, OK 73013-0 Fax:(316)262-2242 Office: (405)562-6283 Store Manager: #145 Bastrop Fax:(405)562-6284 •Joe McClean 405 Technology Drive Store Manager: Bastrop,TX 78602-0000 •Bryan Mercer Office: (512)772-2493 Fax:(512)772-2494 Store Manager: •Blaine Williams Account Receivables Account Payables Purchasing&Marketing Helpdesk&Training Phone: (936)715-4008 Phone: (936)715-4013 Inventory Control:(936)715-4004 Helpdesk:(936)715-4010 Fax:(936)560-0074 Marketing: (936)715-4005 Training: (936)715-4044 Exhibit D - Conflict of Interest Questionnaire CONFLICT OF INTEREST QUESTIONNAIRE FORM 1 For vendor doing business with local governmental entity This questionnaire reflects changes trade to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY 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 lava 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 Cade.An offense under this section is a misdemeanor- Name of vendor who has a business relationship with local governmental entity. Elliott Electric Supply,Inc. 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 filed questionnaire was incomplete or inaccurate) 3 Name of local government officer about whom the information is Teeing 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 farnily relationship with the local government officer. Complete subparts A and B for each employment or business relationship described_ Attack additional pages to this Form City as necessary. 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 1:1 No B. Is the vendor receiving or likely to receive taxable income,other than investment income,from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity? El Yes E:1 No Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other lousiness 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. 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 August 2,2021 Signature of vendor doing business with the governmental entity date Form provided by Texas Ethics Commission Page 39 of 40 www.ethics.state.tx.us Revised 1/112021