HomeMy WebLinkAboutContract 55856-AD1 CSC No.55856-AD1
0 B U S I N E S S
S E R V I C E S
DELIVERY AND ACCEPTANCE CERTIFICATE
Company Name: City of Fort Worth
THE UNDERSIGNED HEREBY CERTIFIES THAT ALL THE EQUIPMENT DESCRIBED IN THE EQUIPMENT AGREEMENT
BETWEEN UBEO AND THE UNDERSIGNED HAS BEEN FURNISHED AND THAT DELIVERY AND INSTALLATION OF THIS
EQUIPMENT HAS BEEN FULLY COMPLETED AS REQUIRED,WITH THE DELIVERY DATE BEING ACCEPTED BY THE
UNDERSIGNED AS SATISFACTORY. FURTHER,ALL CONDITIONS,AND TERMS OF THE SAID EQUIPMENT AGREEMENT
HAVE BEEN REVIEWED AND ACKNOWLEDGED.
Agreement Number: 2744624
Equipment Agreement Date: 6/17/2021
Date of Delivery: 9/23/2021
Customer: City of Fort Worth
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Sign atu re:Valerie Washington(Sep 23,202115:45 CDT)
Signature(type or print):Valerie Washington
Title:Assistant City Manager
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
[Executed effective as of the date signed by the Assistant City Manager below.] / [ACCEPTED
AND AGREED:]
City:
BY: Valerie Washington(Sep 23,202115:45 CDT)
Name: Valerie Washington
Title: Assistant City Manager
Date: Sep 23, 2021
CITY OF FORT WORTH INTERNAL ROUTING PROCESS:
Approval Recommended: Contract Compliance Manager:
By signing I acknowledge that I am the person
responsible for the monitoring and administration
of this contract,including ensuring all
By: performance and reporting requirements.
Name: Kevin Gunn
Title: Director,IT Solutions
Aoctt.
BY: Cynthi yree(Sep 23,2021 14:51 CDT)
Approved as to Form and Legality: Name: Cynthia Tyree
Title: Sr. IT Solutions Manager
By: City Secretary: �doon���
Name: Taylor Paris oaf FORT
Title: Assistant City Attorney ��0 0k-�O-P'04(
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Contract Authorization: Name: Ronald Gonzales o d
M&C: 21-0235 Title: Acting City Secretary �� 000a
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9App5 Form: 2021703506 oval Date:4/6/2021 ����nEX
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OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX