HomeMy WebLinkAboutContract 42673CITY SECRETARY
CONTRACT NO. 41\0 +3
STATE OF TEXAS §
§ KNOWN ALL BY THESE PRESENTS:
COUNTY OF TARRANT §
This Contract is entered into by and between the City of Fort Worth ( "City "), a
home -rule municipality located within Tarrant, Denton, Parker, and Wise
Counties, Texas, acting through Charles Daniels, its duly authorized Assistant
City Manager, and Andrey Osiatynski ( "Contractor ") doing business as
ActionableCustomerinsights, a sole proprietorship. City and Contractor may be
referred to herein individually as a Party, or collectively as the Parties.
WITNESSETH:
That for and in consideration of mutual covenants and agreements herein
contained, the Parties hereto mutually agree as follows:
ARTICLE 1.
DEFINITIONS
Ci�rt r means the City of Fort Worth.
Contract Documents means this contract and attachments, contractor's proposal
and bid documents, attachments, amendments, and appendices.
Contractor means Andrey Osiatynski dba ActionableCustomerinsights.
Unlimited rights as used in this contract, means the right of the City to use,
disclose, reproduce, prepare derivative works, distribute copies to the public, and
perform publicly and display publicly, in any manner and for any purpose, and to
have or permit others to do so.
ARTICLE 2.
SERVICES
Contractor hereby agrees to perform as an independent contractor the services
set forth in the Scope of Work attached hereto as Attachment "A ". These
services shall be referred to as the City -wide Customer Service Analysis of Fort
Worth Delivery of Solid Waste Services or "Project ".
Additional services, if any, will be requested in writing by the City. City shall not
pay for any work performed by Contractor or its subcontractors, subcontractors
and /or suppliers that has not been ordered in writing. Contractor shall not be
compensated for any work that is verbally ordered by any person and shall rely
only upon duly authorized written agreements to conduct work. �._�
i OFF6CiAL RECORD �
ZIT'Y Sr` QUTARY
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ARTICLE 3.
COMPENSATION
Section 1.
Contractor shall be compensated in accordance with the Fee Schedule shown in
Attachment "B ". Payment shall be considered full compensation for all labor,
materials, supplies, and equipment necessary to complete the services described
in Attachment "A ", however the total fee paid by the City shall not exceed a total
of eighteen thousand dollars ($18,000) unless the City and the Contractor
mutually agree upon a fee amount for additional services and amend this
Agreement in writing accordingly.
Section 2.
The Contractor shall provide monthly invoices to the City. Payment for services
rendered shall be due within thirty (30) days of the City's receipt of a deliverable
item and receipt by City of Contractor's invoice for payment of same. In the
event of a disputed or contested billing, only that portion so contested may be
withheld from payment, and the undisputed portion will be paid. No interest will
accrue on any contested portion of the billing until mutually resolved. City will
exercise reasonableness in contesting any billing or portion thereof.
ARTICLE 4.
TERM
Unless terminated pursuant to the terms herein, this Agreement shall be for a
term of one year, beginning upon the date of its execution, or until the completion
of the subject matter contemplated herein, whichever occurs later.
ARTICLE 5.
INDEPENDENT CONTRACTOR
Contractor shall operate hereunder as an independent contractor, and not as an
officer, agent, servant, or employee of the City. Contractor shall have exclusive
control of and the exclusive right to control the details of its work to be performed
hereunder and all persons performing same, and shall be solely responsible for
the acts and omissions of its officers, agents, employees, contractors and
subcontractors. The doctrine of respondeat superior shall not apply as between
City and Contractor, its officers, agents, employees, contractors, and
subcontractors, and nothing herein shall be construed as creating a partnership
or joint venture between City and Contractor.
ARTICLE 6.
PROFESSIONAL COMPETENCE AND INDEMNIFICATION
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Work performed by Contractor shall comply in all aspects with all applicable
local, state and federal laws and with all applicable rules and regulations
promulgated by the local, state and national governmental agencies. Approval
by the City shall not constitute or be deemed to be a release of the responsibility
and liability of Contractor or its officers, agents, employees, contractors and
subcontractors for the accuracy and competency of its services performed
hereunder, which shall be performed in accordance with the applicable
professional standard of care.
Subject to any applicable provisions of Texas Local Government Code Section
271.904, the Contractor shall indemnify, hold harmless, and defend the City
against liability for any damage caused by or resulting from an act of negligence,
intentional tort, intellectual property infringement, or failure to pay a subcontractor
or supplier committed by the Contractor or Contractor's agent, contractor under
contract, or another entity over which the Contractor's exercises control.
ARTICLE 7.
INTELLECTUAL PROPERTY
Section 1.
Rights in data.
The City shall have unlimited rights in all data delivered under this contract, and
in all data first produced in the performance of this contract.
Section 2.
Intellectual property rights and ownership.
All work product developed by Contractor under this contract shall be the sole
property of the City and the City shall have unlimited rights in such work product.
All work product developed by Contractor under this contract shall be considered
"work for hire" and rights, title, and interests to all intellectual property shall vest
in the City. Contactor affirmatively, by executing this contract, disclaims all such
intellectual property interests in favor of the City.
In the event that any rights, title, or interest shall by operation of law or otherwise
fail to vest in the City or become void or voidable, Contractor shall a) transfer all
rights, title, and interest to intellectual property to the City, or alternatively and at
the discretion of the City the Contractor shall b) grant an unlimited and exclusive
license for publication, sale, reproduction, or use by the City and its authorized
sublicensees of all intellectual property developed under this contract.
Contractor agrees to timely execute any documents or take any other actions as
may reasonably be necessary, or as the City may reasonably request, to perfect
the City's ownership, license, or other rights to any work product.
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Contractor shall not use, sell, transfer, or authorize a third party to use any work
product, copyrights, trademarks, or other intellectual property (or derivatives
thereof) of the work product developed under this contract without the express
written consent of the City.
ARTICLE 8.
INSURANCE
Section 1.
Contractor shall not commence work under this Agreement until it has obtained
all insurance required under this Article and the City has approved such
insurance, nor shall Contractor allow any subcontractor to commence work on its
subcontract until all similar insurance of the subcontractor has been so obtained
and approval given by the City; provided, however, Contractor may elect to add
any subcontractor as an additional insured under its liability policies.
Automobile Liability
$500,000 each accident (or reasonably equivalent limits
of coverage if written on a split limits basis). Coverage
shall be on any vehicle used in the course of the
Project.
Worker's Compensation
Required if the Contractor will use employees in performance
of this contract:
Coverage A: statutory limits
Coverage B: $100,000 each accident
$500,000 disease - policy limit
$100,000 disease - each employee
Section 2.
Additional Insurance Requirements
a. Except for employer's liability insurance coverage under Contractor's
worker's compensation insurance policy, the City, its officers, and
employees shall be endorsed as an additional insured on Contractor's
insurance policies required under this Article.
b. Certificates of insurance shall be delivered to the City prior to
commencement of work.
c. Any failure on part of the City to request required insurance
documentation shall not constitute a waiver of the insurance
requirements specified herein.
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d. Each insurance policy shall be endorsed to provide the City a minimum
thirty days notice of cancellation per standard ISO ACORD form wording.
e. Insurers must be authorized to do business in the State of Texas and
have a current A.M. Best rating of A: VII or equivalent measure of
financial strength and solvency.
f. Other than worker's compensation insurance, in lieu of traditional
insurance, City may consider alternative coverage or risk treatment
measures through insurance pools or risk retention groups. The City
must approve in writing any alternative coverage.
g. City shall not be responsible for the direct payment of insurance
premium costs for Contractor's insurance.
h. Contractor's insurance policies shall each be endorsed to provide that
such insurance is primary protection and any self- funded or
commercial coverage maintained by City shall not be called upon to
contribute to loss recovery.
i. In the course of the Agreement, Contractor shall report, in a timely
manner, to City's officially designated contract administrator any known
loss occurrence which could give rise to a liability claim or lawsuit or
which could result in a property loss.
j. Contractor's liability shall not be limited to the specified amounts of
insurance required herein.
k. In the event of a material claim against the Contractor and upon the
request of City, Contractor shall provide complete copies of all
insurance policies required by these Agreement documents.
ARTICLE 9.
TRANSFER OR ASSIGNMENT
City and Contractor each bind themselves, and their lawful successors and
assigns, to this Agreement. Contractor has been engaged as a consequence of
Contractor's specific and unique skills; Assignment will only be granted under
unusual circumstances and at the sole discretion of the City. Contractor, its
lawful successors and assigns, shall not assign, sublet or transfer any interest in
this Agreement without prior written consent of the City.
ARTICLE 10.
RIGHT TO AUDIT
(a) Contractor agrees that the City shall, until the expiration of three (3) years
after final payment under this Agreement, have access to and the right to
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examine any directly pertinent books, documents, papers and records of
Contractor involving transactions relating to this Agreement. Contractor
agrees that the City shall have access during normal working hours to all
necessary facilities and shall be provided adequate and appropriate
workspace in order to conduct audits in compliance with the provisions of this
section. City shall give Contractor reasonable advance notice of intended
audits.
(b) Contractor further agrees to include in all its subcontracts hereunder, a
provision to the effect that the subcontracting contractor agrees that the City
shall, until the expiration of three (3) years after final payment under the
subcontract, have access to and the right to examine any directly pertinent
books, documents, papers and records of such subcontractor, involving
transactions to the subcontract, and further, that City shall have access during
normal working hours to all subcontractor facilities, and shall be provided
adequate and appropriate work space in order to conduct audits in
compliance with the provisions of this article. City shall give Contractor and
any subcontractor reasonable advance notice of intended audit.
(c) Contractor and subcontractors agree to photocopy such documents as may be
requested by the City. The City agrees to reimburse Contractor for the cost of
copies at the rate published in the Texas Administrative Code in effect as of the
time copying is performed.
ARTICLE 11.
NON - DISCRIMINATION
During the performance of this contract, Contractor shall not discriminate in its
employment practices and shall comply with all applicable provisions of Chapter
17, Article III of the Code of the City of Fort Worth.
Contractor agrees not to discriminate against any employee or applicant for
employment because of because of age, race, color, religion, sex, disability,
national origin, sexual orientation, transgender, gender identity or gender
expression in any manner involving employment, including the recruitment of
applicants for employment, advertising, hiring, layoff, recall, termination of
employment, promotion, demotion, transfer, compensation, employment
classification, training and selection for training or any other terms, conditions or
privileges of employment.
Contractor agrees to post in conspicuous places, available to employees and
applicants for employment, notices setting forth the provisions of the non-
discrimination clause.
Contractor also agrees that in all solicitations or advertisements for employees
placed by or on behalf of this contract, that Contractor is an equal opportunity
employer.
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Notices, advertisements, and solicitations placed in accordance with federal law,
rule or regulation shall be deemed sufficient for the purpose of meeting the
requirements of this section.
ARTICLE 12.
RESERVED
ARTICLE 13.
OBSERVE AND COMPLY
Contractor shall at all times observe and comply with all federal, state, and local
laws and regulations and with all City ordinances and regulations which in any way
affect this Agreement and the work hereunder, and shall observe and comply with
all orders, laws ordinances and regulations which may exist or may be enacted
later by governing bodies having jurisdiction or authority for such enactment. No
plea of misunderstanding or ignorance thereof shall be considered. Contractor
agrees to defend, indemnify and hold harmless City and all of its officers, agents
and employees from and against all claims or liability arising out of the violation of
any such order, law, ordinance, or regulation, whether it be by itself or its
employees.
ARTICLE 14.
DEFAULT
If at any time during the terms of this contract, the work of the Contractor fails to
meet the specifications of the Contract Documents or to meet the standards of duty,
care, or proficiency of a reasonable and competent Contractor, City may notify the
Contractor of the deficiency in writing. Failure of the Contractor to correct such
deficiency and complete the work required under this contract to the satisfaction of
the City within ten (10) days after written notice shall constitute default, and shall
result in termination of this contract.
Contractor shall not be deemed to be in default because of any failure to perform
under this contract if the failure arises solely from causes beyond the control of the
Contractor and without any fault or negligence by the Contractor. Such causes
shall include acts of God, acts of war or terrorism, fires, floods, epidemics,
quarantine restrictions, labor strikes, freight embargoes, and events of unusually
severe weather.
ARTICLE 15.
TERMINATION
City may terminate this contract without cause by giving thirty (30) days written
notice to Contractor. In the event of termination, any work in progress will continue
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to completion unless otherwise specified in the notice of termination. If the City
terminates this contract under this provision, City shall pay Contractor for all
services performed prior to the termination. Termination shall be without prejudice
to any other remedy the City may have.
All data and completed or partially completed documents and work product
prepared under this contract shall be promptly turned over to the City upon
termination of this contract.
ARTICLE 16.
VENUE AND JURISDICTION
If any action, whether real or asserted, at law or in equity, arises on the basis of
any provision of this Agreement, venue for such action shall lie in state courts
located in Tarrant County, Texas or the United States District Court for the
Northern District of Texas — Fort Worth Division. This Agreement shall be
construed in accordance with the laws of the State of Texas.
ARTICLE 17.
SEVERABILITY
The provisions of this Agreement are severable, and if any word, phrase, clause,
sentence, paragraph, section or other part of this Agreement or the application
thereof to any person or circumstance shall ever be held by any court of
competent jurisdiction to be invalid or unconstitutional for any reason, the
remainder of this Agreement and the application of such word, phrase, clause,
sentence, paragraph, section, or other part of this Agreement to other persons or
circumstances shall not be affected thereby and this Agreement shall be
construed as if such invalid or unconstitutional portion had never been contained
therein.
ARTICLE 18.
NOTICES
Notices to be provided hereunder shall be sufficient if forwarded to the other
Party by hand - delivery or via U.S. Postal Service certified mail return receipt
requested, postage prepaid, to the address of the other Party shown below:
If to the City: City of Fort Worth
Code Compliance Department, Solid Waste Div.
Attn: Kim Mote, Assistant Director
1000 Throckmorton Street
Fort Worth, Texas 76102 -6311
If to the Contractor:
Andrey Osiatynski dba:
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ActionableCustomerinsights
2501 Clearwood Drive
Arlington, TX 76014
ARTICLE 19.
RIGHTS AND REMEDIES NOT WAIVED
In no event shall the making by the City of any payment to Contractor constitute
or be construed as a waiver by the City of any breach of covenant, or any default
which may then exist, on the part of Contractor, and the making of any such
payment by the City while any such breach or default exists shall in no way
impair or prejudice any right or remedy available to the City with respect to such
breach or default. Any waiver by either party of any provision or condition of the
contract shall not be construed or decreed to be a waiver of any other provision
or condition of this Contract, nor a waiver of a subsequent breach of the same
provision or condition, unless such waiver be expressed in writing by the party to
be bound.
All costs and attorneys fees incurred by the City in the enforcement of any provision
of this contract shall be paid by the Contractor.
The remedies provided for herein are in addition to any other remedies available to
the City elsewhere in this contract and by law.
ARTICLE 20.
HEADINGS
The headings contained herein are for the convenience in reference and are not
intended to define or limit the scope of any provision of this Agreement.
ARTICLE 21.
COUNTERPARTS
This Agreement may be executed in one or more counterparts and each
counterpart shall, for all purposes, be deemed an original, but all such
counterparts shall together constitute but one and the same instrument.
ARTICLE 22.
NO THIRD -PARTY BENEFICIARIES
This Agreement shall inure only to the benefit of the parties hereto and third
persons not privy hereto shall not, in any form or manner, be considered a third
party beneficiary of this Agreement. Each party hereto shall be solely
responsible for the fulfillment of its own contracts or commitments.
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ARTICLE 23.
CONTRACT CONSTRUCTION
The parties acknowledge that each party and, if it so chooses, its counsel have
reviewed and revised this Agreement and that the normal rule of construction to
the effect that any ambiguities are to be resolved against the drafting party must
not be employed in the interpretation of this Agreement or any amendments or
exhibits hereto. The paragraph headings contained herein are for the
convenience in reference and are not intended to define or limit the scope of any
provision of this Contract.
In the event of any conflict between this contract and any other contract
documents, then the terms of this contract shall govern.
ARTICLE 24.
ENTIRETY
This contract, the contract documents and any other documents incorporated by
reference herein are binding upon the parties and contain all the terms and
conditions agreed to by the City and Contractor, and no other contracts, oral or
otherwise, regarding the subject matter of this contract or any part thereof shall
have any validity or bind any of the parties hereto. In the event of any conflict
between this contract and any other contract documents, then the terms of this
contract shall govern.
(Remainder of Page Intentionally Left Blank)
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ATTACHMENT A.
SCOPE OF WORK
The attached proposal by Action ableC ustome rl ns ig hts hereby incorporated into
this contract and the portions of the proposal describing a) the scope of work, b)
the deliverables, and c) the key personnel are agreed among the parties as
specific terms of this contract:
Background and Objectives
One of six strategic goals adopted by the Fort Worth City Council is: to create
and maintain a clean, attractive city. Additionally, city's organizational priorities
include:
• Communication
• Customer service
• Diversity
• Customer feedback is sought and valued.
Related to this strategic goal and organizational priorities Waste Services
Division of Fort Worth Code Compliance Department is planning to conduct
customer service research to provide actionable input for:
1. Understanding and evaluating resident satisfaction levels with such
solid waste services as: curbside collections, drop -off stations, the
city call center and Division's public education /outreach efforts.
2. Evaluation and fine - tuning of the Division's ongoing communication
efforts aiming at increased participation and reduced contamination
(incorrect use of recycle bins) in the city's recycling program.
3. Planning and implementation of the future communication and
education programs with highest possible return in terms of
increased participation and reduced contamination.
Requirements
The proposed research design should include:
• In -depth input from all pertinent Department and Division team
members.
• Critical review of earlier research conducted for the Division — to
assure that the new research is building on rather than just
duplicating the earlier results.
• Utilizing the available "hard data" about current levels of use of
waste services, recycling and of contamination in the different
sectors of the city.
• Input from a diverse population of residents, neighborhood and
homeowner associations and other pertinent groups that are
deemed appropriate and representative of the city's residents.
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Design Specifications
ActionableCustomerinsights proposes conducting this research in three steps —
with each consecutive step building on the results from the previous one:
Step 1 — Socratic Interviews with Team Members; Review of Earlier
Research and Analysis of the Relevant Quantitative Data:
During this step, ActionableCustomerinsights would conduct Socratic Depth
Interviews with the pertinent members of the Code Compliance Department and
Waste Service Division Team members as well as representative "stakeholders"
from neighborhood and homeowner associations.
The primary purpose of such Socratic Interviews (each scheduled to last about
60 minutes) is to provide the interviewed respondent an opportunity to reflect on
and verbalize their ideas and intuitions on the key challenges and opportunities.
These challenges and opportunities will serve as the primary focus in the next
steps of the research process and the Division's ongoing and future
communication programs.
In some ways, this process of Socratic Interviews is an alternative to the more
familiar format of a group brainstorming process. By giving each participating
Team member plenty of time to "muse" about and articulate their relevant
experiences and ideas, as well as having a moderator facilitate expressions of
their thoughts through a "Socratic Dialogue" — these interviews tend to produce
important insights that are normally not presented during the agenda - driven,
everyday business interactions, or for that matter, in the context of group -
oriented brainstorming exercises.
The results of the Socratic Interviews will then guide ActionableCustomerinsights'
critical review and analysis of:
• Earlier research results.
• All the available and relevant quantitative ( "behavioral ") data.
This would include analysis of (among other things) data reflecting trends in:
o Fort Worth residents' participation in the City's recycling programs
and relative contamination — compared:
• By different neighborhoods, zip codes and demographics.
• Over time — including, following Division's communication
and outreach efforts.
The primary aim for this analysis will be (like in the case of Socratic Interviews
with Team members) to identify the issues /questions that Step 2 and Step 3 of
the research process should address and key challenges and opportunities that
the Division's future communication programs should focus on.
Results of the Step 1 would be presented to and discussed with the Division's
Communication Team and will then be used to help us zero -in on the most
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important issues for the Step 2 research (observational research and qualitative
input from residents) — including definition of the most promising respondent -
sample as well as the most important issues /questions that should be covered in
our research with these respondents.
Step 2 — Observational Research and Qualitative Input from Selected
Residents:
This step would consist of two stages:
A. Observational ( "ethnographic ") "walk alongs" with the members of
The Blue Crew — in a few neighborhoods representing varying
levels of participation in recycling program and different types and
relative degrees of contamination problems.
B. In -depth qualitative input from selected residents from the
neighborhoods with different levels of participation and
contamination problems.
Re A:
The observational "walk alongs" should be conducted as the first stage of the
Step 2 research. They will involve ActionableCustomerinsights' project leader
following The Blue Crew on their regular routes through a few selected
neighborhoods. In addition to observing the work of The Blue Crew, the project
leader will be actively listening to the Crew's comments about varying patterns of
participation and contamination observed.
Also — whenever possible -- the residents who are identified by the members of
The Blue Crew as "representing" the different levels of participation and
contamination would be invited to participate in the stage B (qualitative input).
Re B:
This stage of Step 2 research could be executed using any combination of in-
person and phone interviews and /or traditional or mini (4 -5 participants) focus
groups. (Consultant will look to Client to assist with setting up these interviews
and /or mini groups.)
In addition, we recommend the use of an Online (Bulletin Board) Qualitative
Research to be completed by about 25 residents (at least 30 respondents would
be recruited). Respondents would be selected to represent the key segments of
target audiences as identified in the Step 1 and stage A above.
The interviews would be conducted over a period of 2 -3 days — with respondents
answering a number of open- ended, essay -style questions "at their convenience"
but before the next set of questions is posted.
Specific questions and issues to be covered in the Bulletin Board Online
Qualitative will be developed based on the discussions of findings from the Step
1 of the research process with the Division's Communication Team.
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Some of these question -areas are likely to include:
• Respondents' thoughts and feelings about (including their satisfaction
levels with) the City's Solid Waste Services — with particular focus on
recycling program.
• Specific and detailed descriptions of their consideration and decision
making processes about participating in the recycling program.
■ Respondents who don't participate would be asked what (if
anything) could get them started.
• Respondents who participate in recycling program would be asked to
describe:
• What got them to participate and what keeps them going?
• Their learning process about how to "recycle right."
• Any practical solutions they developed (over time) that make
"recycling right" easier for them.
• Any problems and opportunities for improvement they see with
the recycling program.
• All respondents would be asked about their reactions to different types
of the Division's communications about Solid Waste Services — with
particular focus on recycling program.
■ The Online Bulletin Board Qualitative study format will allow us
to present to the respondents visual stimuli and to ask them to
comment in some detail on these different communication
elements.
o Participants' would be also asked to talk about what they see as
currently "missing" in terms of communications about Solid Waste
services.
Results of the Step 2 would be presented to the Division's Communication
Team. The following discussion of these results would be used to:
• Develop ideas for fine- tuning of Division's current communication
programs and to begin planning of the future programs
• Finalize definition of executional details of the Step 3.
Step 3 — Quantitative Survey with Representative Sample of Residents:
The specific methodological and executional details of this last research step
such as: exact screening questions to be used to select participants and specific
questions to be used in the survey — will be determined based on the learning
from the preceding research steps (1 & 2) and by the follow -up discussions with
the Division's Communication Team.
However, currently envisioned, outline of this step includes:
• Sending online survey to the City's resident email database representing:
■ All of the City's key geographic and demographic groups.
• Recommended primary data collection methodology: online questionnaire.
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■ Supplemented, if and where necessary, with traditional mail
questionnaire.
o Questioning areas should, among other things, include:
• Respondents' satisfaction with the different Solid Waste
Services.
• Their perceptions of and attitudes toward recycling program.
• Their thoughts and feelings about Division's current and future
communication programs.
Results of this last step of the research process would be integrated into the final
presentation of the results of the whole research process to the Code
Compliance Department and Waste Services Division Combined Leadership
Team.
Following the discussion of this final presentation to the Combined Leadership
Team — the results of the research process would be used for:
• "Creative Fine Tuning" of the Division's ongoing communication programs.
• Development of new strategic and tactical ideas for the Division's future
communication programs.
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ATTACHMENT B.
FEE SCHEDULE
Prices for professional services rendered under this contract will be as specified
in the schedule below. The agreed price for professional services shall be based
upon a flat rate for each deliverable. The total fee for services under this contract
shall not exceed eighteen thousand dollars ($18,000).
• The agreed fee to conduct Step 1 (Socratic Interviews and Analysis of
Quantitative Data) is: $4,500.
• The agreed fee to conduct Step 2 is $5,500. (The City of Fort Worth will help
with setting up the qualitative interviews and groups — including: respondent
recruiting and incentives; and providing room to conduct groups in.)
• The agreed fee to conduct Step 3 is $8,000. (The City of Fort Worth will
execute emailing of the questionnaire and offer incentives — in a form of a
drawing of prizes — to respondents.)
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IN WITNESS THEREOF, the parties hereto have made and executed this
Agreement in multiple originals the day and year first above written, in Fort
Worth, Tarrant County, Texas.
CITY OF FORT WORTH:
ilesf��G�i/
Daniels
Assistant City Manager
12. / *. //
Date Signed
RE MEN D: Z2?z�
Kim Mote
Asst. Director, Code Compliance Dept.
APPROVED AS TO FORM AND
LEGALITY:
/( 4
Assistant City Attorney
NO M&C �tt;QUIRED
ATTEST:
Ash -City Secretary
WJG
Date
ANDREY OSIATYNSKI DBA
ACTIONABLECUSTOMERINSIGHTS
Andrey Osiatynski
Owner
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Contract - Customer Service Analysis of CFW Solid Waste Services
City of Fort Worth and Andrey Osiatynski dba ActionableCustomerinsights
OFFICIAL RECD'
CITY SECRET;.
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GO GOVERNMENT EMPLOYEES INSURANCE COMPANY
Washington DC VERIFICATION OF COVERAGE
(SEE BELOW UNDER CAUTIONARY NOTE)
INSURED Policy Number: 4060209410
Effective Date: 08 -28 -11
INNA SHTARKMAN Expiration Date: 02 -28 -12
ANDRZEJ S OSIATYNSKI Registered State:TEXAS
2501 CLFARWOOD DR
ARLINGTON_ TX 76014 -1716
To whom it may concern:
This letter is to verify that we have issued the policyholder coverage under the above policy number for the dates indicated in the effec-
tive and expiration date fields for the vehicle listed. This should serve as proof that the below mentioned vehicle meets or exceeds the
financial responsibility requirement for your state.
This verification of coverage does not amend, extend or alter the coverage afforded by this policy.
Vehicle Year: 2004
Make: TOYOTA
Model: CAMRY
VIN: 4T1BE30K34U875810
COVERAGES LIMITS
BODILY INJURY LIABILITY $500,000/$500,000
PROPERTY DAMAGE LIABILITY $100,000
COMPREHENSIVE
COLLISION
Lienholder X_ Additional Insured Interested Party
CITY OF FT WORTH
1000 THROCKMORTON ST
FORT WORTH, TX 76102
Additional Information:
Issued 11/15/ 2011
If you have any additional questions, please call 1- 800 -841 -3000
DEDUCTIBLES
$1,000 DED
$1,000 DED
CAUTIONARY NOTE: THE CURRENT COVERAGES, L MTS, AND DEDUCTIBLES MAYDOTER FROM THE COVERAGES, LII1IITs, AND DEDUCTIBLES IN EFFECT AT OTHER
111WES DURING THE POLICYPERIOD. THIS VERIFICATION OF COVERAGE REFLECTS THE COVERAGES, L WTS AND DEDUCTIBLES AS OF THE ISSUED DATE OF THIS
DOCITMFNT WHICH IS SHOWN UNDER "ADDTTTONAI. INFORMATION" OR IF AN ISSITY.D DATE IS NOT SHOWN. THY. DATE OF THIS FACSIMn,F..
U -33 10-07