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Home My WebLink AboutContract 56706 CSC No. 56706 FORT WORTH CITY OF FORT WORTH COOPERATIVE PURCHASE AGREEMENT This Cooperative Purchase Agreement ("Agreement") is entered into by and between MasterTurf Products and Service, Inc. ("Vendor") and the City of Fort Worth ("City"), a Texas home rule municipality. The Cooperative Purchase Agreement includes the following documents, which shall be construed in the order of precedence in which they are listed: 1. This Cooperative Purchase Agreement; 2. Exhibit A— Seller's Quote, Scope of Services or Purchase Order; 3. Exhibit B —Cooperative Agency Contract(e.g.,NJPA, DIR, BuyBoard); and 4. Exhibit C—Conflict of Interest Questionnaire. Exhibits A, B, and C, which are attached hereto and incorporated herein, are made a part of this Agreement for all purposes. Vendor agrees to provide City with the services and goods included in Exhibit B pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all exhibits thereto. City shall pay Vendor in accordance with the fee schedule in Exhibit A and in accordance with the provisions of this Agreement. Total payment made under this Agreement for the first year by City shall be in the amount of FIFTEEN THOUSAND DOLLARS ($15,000.00). Vendor shall not provide any additional items or services or bill for expenses incurred for City not specified by this Agreement unless City requests and approves in writing the additional costs for such services. City shall not be liable for any additional expenses of Vendor not specified by this Agreement unless City first approves such expenses in writing. The term of this Agreement shall be for one year beginning on June 01,2021 and ending on May 31, 2022. City shall be able to renew this Agreement for one (1) one-year renewal option by written Agreement of the parties. Vendor agrees that City shall, until the expiration of three (3) years after final payment under this Agreement, or the final conclusion of any audit commenced during the said three years, have access to and the right to examine at reasonable times any directly pertinent books, documents, papers and records, including, but not limited to, all electronic records, of Vendor involving transactions relating to this Agreement at no additional cost to City. Vendor agrees that City shall have access during normal working hours to all necessary Vendor facilities and shall be provided adequate and appropriate work space in order to conduct audits in compliance with the provisions of this section. City shall give Vendor reasonable advance notice of intended audits. 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 MasterTurf Products & Service, Inc. Attn: Fernando Costa, Assistant City Manager Stan Standridge, Jr., Vice-President 200 Texas Street 1852 Norwood Plz. Ste. 201 Fort Worth, TX 76102-6314 Hurst, TX 76054 Facsimile: (817) 392-8654 Facsimile: 817-494-3322 With a copy to Fort Worth City Attorney's Office at the 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: I d2_ By signing, I acknowledge that I am the person By: Fernando Costa(Nov 19,202114:46 CST) responsible for the monitoring and administration Name: Fernando Costa of this contract, including ensuring all performance Title: Assistant City Manager and reporting requirements. Date: Nov 19,2021 APPROVAL RECOMMENDED: By: Name: Erin Roden Title: Administrative Assistant By: 444oan APPROVED AS TO FORM AND LEGALITY: Name: Roger Venables ppF Fonr 4� ao ad ° Title: Director oo ATTEST: By: ad °°°°°°°°°°°° a Name: Thomas Royce Hansen aa�nE�aAS�pp Title: Assistant City Attorney By: � ^^°'' CONTRACT AUTHORIZATION: Name: Ronald P Gonzales M&C: 20-0777 Title: Acting City Secretary VENDOR: MasterTu*-Stan W,Jr. ATTES By: By: — N Name: AN9t l-Wg.ep.145 Title: Vice-President Title: 044l e-L- ASS%S-katy+ Date: �� / i Date: `� I I $ 1 OFFICIAL RECORD f CITY SECRETARY FT.WORTH, TX AwBoard® Exhibit Cooperativehirchasing P.O. Box 400 Austin, TX 78767-0400 800.695,2919 J 512,4W 0222 / Fax.609.211.5454 huyhoard.com PRICE SHEET ADVISORY The following pages were presented as part of the proposal response from the vendor. These pages were used as part of the evaluation of the vendor's proposal, and are included here as reference items only. The pricing shown on these pages may or may not be in effect during the contract. Connie W Burkett, CTSBO Contract Administrator BuyBoard +— Te The local Government Purchasing Cooperative is endorsed by the Texas Association orschool Boards, ® TML Texas Municipai League,Texas Association of Counties and the Texas Association of School Administrators. .0. a MasterTurf Products and Service, Inc. 1852 Norwood Plaza Suite 201 Hurst,Tx.76054 Office(817)494-3222 Cell(817)929-0166 Fax(817)494-3322 December 5, 2019 The Local Government Purchasing Cooperative Attn: Proposal Administration Manager 12007 Research Boulevard Austin, Tx. 78759 The following information is being provided as requested per Grounds Maintenance Equipment, Irrigation Parts, Supplies & Installation# 529-17: MTPS Pricelist: Products Description Price Extended Price Infill Synthetic Turf- 14,400 or less $ 14.00 per sq. ft. $ 14.00 per sq. ft. Infill Synthetic Turf- 25,000 or less $ 12.00 per sq. ft. $ 12.00 per sq. ft. Infill Synthetic Turf- 80,000 or less $ 9.50 per sq. ft. $ 9.50 per sq. ft. Infill Synthetic Turf- 110,000 or less $ 8.00 per sq. ft. $ 8.00 per sq. ft. Note: Stabilization of existing subgrade will be determined upon evaluation. This applies only to Infill Synthetic Turf athletic fields. *Masterseal Conditioner $ 2.7777 $ 2.7777 /250.00 (Per Pound/ 901b Bag Only) *Masterseal Infield Mix with $ 49.60 per ton $ 49.60 Conditioner *Mastereal Topdressing Material $ 28.50 per ton $ 28.50 (For Athletic Grass Surfaces) *Masterseal Drainage System (6" Multi-Flow) per square foot $ 2.50 $ 2.50 (12" Multi-Flow) per square foot $ 3.00 $ 3.00 (18" Multi-Flow)per square foot $ 3.95 $ 3.95 *Grozyme III (Soil Catalyst& Root Growth $ 85.00 per gallon $ 85.00 Enhancer) Freight not included in above prices. 8.00 per sq. ft. 8.00 per sq. ft. * Note: Discounts are based on Quantity Ordered MTPS Pricelist: Flat Rate Pricing **Laser Grading - $ 2,000.00 $ 2,000.00 **Tilling - $ 1,500.00 $ 1,500.00 ** Flat Rate for infield dirt portion of the Baseball or Softball field. MTPS Pricelist: Service Rates Aerification - $ 160.00 Per Hour Topdressing - $ 160.00 Per Hour Verticutting - $ 220.00 Per Hour Clipping Removal - $ 125.00 Per Hour Chemical & Fertilizier - $ 220.00 Per Hour+ $ Chemical Spraying Applications Chemical and Fertilizer Applications do not include material. Material can be supplied by either MasterTurf or Customer. The above applies to all Standard UIL(High School),NCAA, CITY/MUNICIPALITY Fields (Per Field) *** Aerification and Vericutting is a 2/Hour Minimum charge,but we always go 2 directions when completing these services or applications. Sod Installation Pricing Price Standard Adult Softball Field (85,000 sf) $ Call for pricing Standard High School (UIL)Baseball Field (90,000 sf) $ Call for pricing Standard High School (UIL) Softball Field(33,500 sf) $ Call for pricing Standard University/College Baseball Field(120,000 sf) $ Call for pricing Standard University/College Softball Field (33,500 sf) $ Call for pricing * Depends on Location, if freight is included or not in above pricing MTPS Pricelist: Labor Rates Items 43 - 46: Labor Rates will vary based on type of work being performed: $ 25.00 — 87.50 MTPS Pricelist: Mobilization Rates May be applied upon location of job or project. Based on one way trip charge or mileage surcharge, but always in the customers best interest. Each job or project will be quoted separately as needed. We look forward to earning your business and should you have any questions, feel free to contact me at(817) 929-0166 at your convenience. Sine S an Masterturf Products and Service, Inc. Exhibit B ' Board® P.O.Box 400,Austin,Texas 78767 800.695.2919•info@buyboard.com •buyboard.com April 26, 2021 Sent via email to: stan(d)masterturfproducts.com Stan Stanridge, Jr. MasterTurf Products and Services, Inc. 1852 Norwood Plz. Ste. 201 Hurst TX 76054 Re: Grounds Maintenance Equipment, Irrigation Parts, Supplies and Installations BuyBoard Contract 611-20 The Local Government Purchasing Cooperative (BuyBoard) awarded your company a contract under Grounds Maintenance Equipment, Irrigation Parts, Supplies and Installations, Contract 611-20 effective June 1, 2020 through May 31, 2021, with two possible one-year renewals. At this time, the BuyBoard is renewing your contract through May 31, 2022. 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.maradena-tasb.org prior to the start of the renewal term. Reminder: Once a BuyBoard contract is awarded, vendors must generate a minimum of$15,000 annually or they may not be offered a contract renewal. If you have questions or comments concerning this renewal, please contact me as soon as possible at lisa.maradena.tasb.org. We appreciate your interest in The Local Government Purchasing Cooperative. Sincerely, Lisa Maraden Contract Administrator 1"renewal v.02.13.2020 Endorsed by � TASA' i rr PFBoard® Capperative Purchasing P.O. Box 400 Austin, TX 78767-0400 609.695.2919 / 512.467.0222 / Fax:800.211.5454 buyhoard.com April 29, 2020 Sent Via Email: stan@masterturfproducts.com Stan Stanridge, Jr. MasterTurf Products and Services, Inc. 1852 Norwood Plz. Ste. 201 Hurst, TX 76054 Welcome to BuyBoard! Re: Notice of The Local Government Purchasing Cooperative Award Proposal Name and Number: Grounds Maintenance Equipment, Irrigation Parts, Supplies and Installation, Proposal No. 611-20 Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company a BuyBoard® contract based on the above-referenced Proposal. The contract is effective 6/1/2020 through 5/31/2021, 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. 611-20 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 email the order info@buyboard.com 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, = Tea Texas Municipal League, Texas Association of Counties,and the Texas Association of School Administrators.W.' i Bna�d® %National School Endorsed by 'NSBA' Boards Association April 29, 2020 Sent Via Email: stan@masterturfproducts.com Stan Stanridge,Jr. MasterTurf Products and Services, Inc. 1852 Norwood Plz. Ste. 201 Hurst,TX 76054 Welcome to BuyBoard! Re: Notice of Nation/Purchasing Cooperative Award Proposal Name and Number: Grounds Maintenance Equipment, Irrigation Parts, Supplies and Installation, Proposal No. 611-20 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 6/1/2020 through 5/31/2021, 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 P.O.Box 400,Austin, Texas 78767-0400 800.695.2919•buyboard.com Board U U Cnapersave Purchasfny 12007 Research Boulevard - Austin,Texas 78759-2439 , PH: 800-695-2919 ' FAX: 800-211-5454 ' bu boy ard.com PROPOSER"S AGREEMENT AND SIGNATURE Proposal Name: Grounds Maintenance Proposal Due Date/Opening Date and Time: Equipment, Irrigation Parts, Supplies and Installation December 5, 2019 at 4:00 PM Location of Proposal ORening: Texas Association of School Boards, Inc. BuyBoard Department Proposal Number: 611-20 12007 Research Blvd. Austin,TX 78759 Anticipated cooperative Board Meeting Date: Contract Time Period: April 2020 June 1, 2020 through May 31, 2021 with two (2) possible one-year renewals. PlgurT� Lroug-6 � y,GS Inc Name of Proposing Company Date Ada. 37- Street Address Signature of Authorized Cam any Eeial City, State, Ap Printed Name of Authorized Company Official � e� Vim. t Telephone Number of Authorized Company Official Position or Title of Authorized Company Official C D-� yqL/ 334 go - g0 9L10,5 Fax Number of Authorized Company Official Federal I❑ lumber Page 10 of 72 Proposal Forms COMM/SVCS v.09.12.2019 S D__ZUBoard Cooperative Purchasing 12007 Research Boulevard ' Austin,Texas 78759-2439 , PH: 800-695-2919 ' FAX: 800-211-5454 " buyboard.com VENDOR CONTACT INFORMATION Name of Company: M X ferT" ;u I0C Vendor Proposal/Contract Contact Name: ta4?dr1A Vender Proposal/Contract Contact E-mail Address: S jzw,j r e, m(A/ s kr ftWfr9duf,,tV. 00 Vendor Contact Mailing Address for Proposal/Contract Notices: ®1 uod �� • r�k• 26) Company Website: W YV V Purchase Orders: All purchase orders from Cooperative members will be available through the 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 to assist them with retrieving their orders. Please select options below for receipt of purchase orders and provide the requested information: I will use the internet to receive purchase orders at the following address: Purchase Order E-mail Address: ffix fcf 4t-+'r r ,� wots- com -7 Purchase Order Contact: Phone: _812 y ��`� ��`� Alternate Purchase Order E-mail Address: Alternate Purchase Order Contact: d � Z— Phone: - `1 r ❑ Purchase orders may be received by the Designated Dealer(s) 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. Request for Quotes("RFO"1: Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses for the receipt of RFQs: RFQ E-mail Address: C)S• cvf n ^�RFQ Contact: o , -e )z Phone: 1 `� V—3'0`J' 4/2_9, Alternate RFQ E-mail Address: 0�;l 0 ftf*Y( Waocu. Oafy7 Alternate RFQ Contact: 1 C4 11� _CLU_ C Phone: 4- l Page 12 of 72 Proposal Forms COMM/SVCS VA9,12,2019 3 &578oard� U %j Cooperative Purchasing 12007 Research Boulevard ' Austin,Texas 78759-2439 • PH: 800-695-2919 ` FAX: 800-211-5454 , huyboard.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: &(Service fee invoices and related communications should be provided directly to my company at: Invoice Mailing address: 161 �� -2� S�"�� Department: City: OW State: ! _Zip Cede: L4�0 S� Contact Name: ') Phone: U d - J q� j'?°?a Invoice Fax: n�-q'?q-&-3;1 c/� Invoice E-mail Address:S 1GSr ��G�LfGtf Alternative Invoice E-mail Address: i0pb a Mai?y11 t_?CAd4414LtS- ('drn ❑ In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following billing agent**: Billing agent Mailing address: Department: City: State: Zip Code: Billing Agent Contact Name: Phone: Billing Agent Fax: Billing Agent E-mail Address: Alternative Billing Agent E-mail Address: ** If Vendor authorizes a billing agent to receive and process service fee invoices, 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 all service fees under any Contract awarded Vendor. Page 13 of 72 Proposal Forms COMMJ5VC5 V.09.12.2019 &USoard� Cooperative Purchasing 12007 Research Boulevard , Austin,Texas 78759-2439 • PH: 800-695-2919 • FAX: 800-211-5454 - buyboard.cam 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 (V)one of the following: /My company is a publicly-held Corporation. (Advance notice requirement does not apply to publicly-held corporative.) My company is not owned or operated by anyone who has been convicted of a felony. ❑ My company is ownedloperated 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. cm Company Name I kil - Signature of Authorized Ccfnpa&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. 4Z U company Name '1 {St ,rridd��. t11� Signature of Authorized C mpa y Official Printed Name Page 14 of 72 Proposal Forms COMM/5VC5 v.09.12.2019 oard wouperativePurchasing 12007 Research Boulevard ' Austin,Texas 78759-2439 ' PH: 800-695-2919 ' FAX: 800-211-5454 ' bu bow ard.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 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 fame 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 0/0 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 one of the followin : ❑ Yes ❑ No By signature below, I certify that the information in Sections 1 (ResidentlNonresident Certification) and 2 (Vendor Employment CerbTIcation) above its true, complete and accurate and that I am authorized by my company to make this certification. Company Name Signature of Authorized C&npaly Official Printed Name Page 15 of 72 Proposal Farms COMMJSVCS v.69.12.2019 Board Caaperative Purchasing 12007 Research Boulevard 'Austin,Texas 78759-2439 • PH: 800-595-2919 • FAX: 800-211-5454 ' buyboard.com NO ISRAEL BOYCOTT CERTIFICATION Effective September 1, 2017, as amended effective May 7, 2019 (H.B. 793), a Texas governmental entity may not enter into a contract with a value of $100,000 or more that is to be paid wholly or partly from public funds with a company (excluding a sole proprietorship) that has 10 or more full-time employees 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. GWr CODE Ch. 2270). Accordingly, this certification form is included to the extent required by law. "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`1 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. or4 ens ay=, r�:�� Company Name Signature of Authorized 46m4ny Official Printed Name Note., If Vendor does not wish to make this certification,return the blank form in lieu of completed certification. 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 §§805.051, 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 truer complete and accurate; and that I am authorized by my company to make this certification. Seru ' Ce f Inc . Company Name Sin Sk,0 d.& . , Signature of Authorized C mpa y Official Printed Name Page 15 of 72 Proposal Forms C0MM/5VC5 v.09.12.2019 D178oard Cooperative Purchasing 12007 Research Boulevard • Austin,Texas 75759-2439 • 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 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 awned 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: My company has NOT been certified as a HUB. By signature below, I certify that the above is true, complete and accurate and that F am authorized by my company to make this certification. masttrruo Company Name Printed Signature of Authorized Com any icial Page 17 of 72 Proposal Forms COMM/SVCS v.09.12.2019 &57Board Cooperative Purchasing 12007 Research Boulevard ' Austin,Texas 78759-2439 - PH: 800-595-2919 ' 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 focal 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. l 1_� 11 1417-5,io Company Name Signature of Authorize Co any Official Printed Name Cate Page 18 of 72 Proposal Forms COMMJSVCS v.09.12.2019 &UBoard V %J 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(�Jj one of the following: ❑ NO' Deviations V� eS; Deviations List andfully explain any deviations you are submitting: st fl Va S, Waa�JM(� . 10 aw ��S PLEASE PROVIDE THE FOLLOWING INFORMATION: 1. Shipping Via: Vommon Carrier ❑ Company Truck [:] Prepaid and Add to Invoice ❑ Other: 2. Payment Terms: [2(Net 30 days ❑ 1% in 10/Net 3Q days ❑ Other: 3. Number of Days for Delivery: ARO�- 4. Vendor Reference/Quote Number: 5. State your return policy: 6. Are electronic payments acceptable? ZYes ❑ No 7. Are credit card payments acceptable? ❑Yes ZNo wia Ir-)C . Comp e ]r -Q SAW C&Z .cJ12— - Signature of Authorized ampavy Official Printed Name Page 19 of 72 Proposal Forms COMMISVCS v.09.12.2019 a578oard U W Cooperative Purchasing 12007 Research Boulevard - Austin,Texas 78759-2439 - PH: 800-695-2919 ' FAX: 800-211-5454 - buvboard.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 he 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 foram. m terTr 6t&CfT - Company Name 5a I EWM ! Address � d City State Zip 7-LIyy- 3;W S7 - L14,41-332o� Phone Number Fax Number AAA (Sj&)ar,aRZ . )� . l fi-// A. �� Contact Person Company Name Address City State Zip Phone Number Fax Number Contact Person Page 26 of 72 Proposal Forms CQMMISVCS v.09.12.2019 Board® W ooperative 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 Offic' I Page 21 of 72 Proposal Forms COMM/SVCS v.09.12.2019 DUBoard 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 �I will service Texas Cooperative members T statewide. "' °" ❑ I will not service Texas Cooperative members statewide. I will only ~° service members in the 7� regions checked below- Region Headquarters " r ®, ❑ 1 Edinburg a* L '"r f . «-.. ❑ 2 Corpus Christi "' ❑ 3 Victoria -... . ; '` ❑ 4 Houston ❑ 5 Beaumont , ❑ 6 Huntsville i '° ❑ 7 Kilgore ❑ 8 Mount Pleasant �. � •�' -.�-'S ❑ 9 Wichita Falls 1 ❑ 10 Richardson ❑ 11 Fort Worth ❑ 12 Waco ❑ 13 Austin ❑ 14 Abilene ` ' -.j' '„ ❑ 15 San Angelo ` l�� ❑ 16 Amarillo ❑ 17 Lubbock ff Sfff fIVICL Ifr— ❑ 18 Midland Com n a e ❑ 19 El Paso ❑ 20 San Antonio Signature of Authorized mp ny Official V guoa G�& I will not service members Printed Name of the Texas Cooperative. Page 22 of 72 Proposal Forms COMM/SVCS v.09.12.2019 PFBoard' 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 apply: ❑ 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 ❑ hio ❑ Georgia [Oklahoma ❑ Hawaii ❑ Oregon ❑ Idaho ❑ Pennsylvania ❑ Illinois ❑ Rhode Island ❑ Indiana ❑ South Carolina ❑ Iowa ❑ South Dakota aV Kansas ❑Tennessee ❑ Kentucky [Texas VLouisiana ❑ Utah ❑ Maine ❑ Vermont ❑ Maryland ❑ Virginia ❑ Massachusetts ❑ Washington ❑ Michigan ❑ West Virginia ❑ Minnesota ❑ Wisconsin ❑ Mississippi ❑ Wyoming ❑ Missouri ❑ Montana Page 24 of 72 Proposal Forms COMM/SVCS v.09.12.2019 Board® Cooperative Purchasing 12007 Research Boulevard ' Austin,Texas 78759-2439 , PH: 800-695-2919 • FAX: 800-211-5454 • buxboard.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. r�u� o cls i6w er��ce, Inc . Company Name �^ ,/,,, p p� S m sjm / o Signature of Authorized C pa 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 25 of 72 Proposal Forms COMM/SVCS v.09.12.2019 Board® 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. atu lets cc,ire. Name d Proposal Invitation Number Stan SaJ12. Signature of Authorized Corhparp Official Printed Name of Authorized Company Official 'Q5 "e-1)U-1j Date Proposal Forms COMM/SVCS v.09.12.2019 Page 27 of 72 %78oard Cooperative Purchasing 12007 Research Boulevard ' Austin,Texas 78759-2439 • PH: 800-695-2919 ' FAX: 800-211-5454 . buXboard.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. OMNIA Partners 4. Sourcewell (NIPA) 5. E&I Cooperative 6. Houston-Galveston Area Council (HGAC) 7. Choice Partners 8. The Interlocal Purchasing System (TIPS) 9. Other E/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 COMM/SVCS v.09.12.2019 Page 28 of 72 &578oard U W 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. Dd,� GL rvia. Inc . Company Name Signature of Authorized m ny Official Printed Name Proposal Forms COMM/SVCS v.09.12.2019 Page 29 of 72 &UHoard Cooperative Purchasing 12007 Research Boulevard , Austin,Texas 78759-2439 • PH: 800-695-2919 ' FAX: 800-211-5454 , buyboard.corn 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 1.Ci-Y 0� QpOe1 i L�6�d fY ao—W �l� �� "5�I ��'Yd�� G c� ��l�x . dV 2.C+$�1 Inc -irlllr fiCCrG1� �'C �e Z00 ^1�� ates �i�aeterGIrcX-�nr2 xaf-e 3. p t,�l a Sir 1 1 S Jeff �S' l`^�� q&1`6Pg7 - Z7�3'� Ara 44n J e I i5a- 4. Fri SC® is 0 Je u i mn 21 y -5114- "40 L -Fr;Sco ISA .CY9 ��- Do you ever modify your written policies or standardernmental sales practices as identified in the above chart to give better discounts (lower prices) than indicated? YES n NO ❑ If YES, please explain: r6iqh-r �,a1 Vucivafe, baSed a'� ln4, �l ,fi e®%: eA tv ya—flat ' lyktiu7S By signature below, I certify that the above is true and correct and that I am authorized by my company to make this certification. a,, Inc . ComTof Signature Authorized Sip Ebaanrilz& J� Printed Name Proposal Forms coMM/SVCS v.09.12.2019 Page 30 of 72 Board® DCooperative 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. —a call UW) U trPLO JM, S -fi-z�m 7fXA'S eoacn,e j' (' �Ya�oq . Fl Yda�1� Comps a AM Signature of Authorized Ccfmpajy Official ./ e,-" Jl2- Printed Name Proposal Forms COMM/SVCS v.09.12.2019 Page 31 of 72 ard® B W ooperative 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? Pleas check one of the followincr 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 additional sheets if needed.) Proposal Forms COMM/SVCS v.09.12.2019 Page 32 of 72 Bo and Cooperative Purchasing 12007 Research Boulevard ' Austin,Texas 78759-2439 ' PH: 800-695-2919 ' FAX: 800-211-5454 ' buyboard.com B. Copyright Information tation, or other materials submitted with the Proposal) contain copyright Does your Proposal (including forms, documen information? Please check(-v)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/Copyright 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. Q.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. serv,�✓ Ins V MmPy"Offfificial Printed Name 1,51 -®S'200 Date Proposal Forms COMM/SVCS v.09.12.2019 Page 33 of 72 Board® 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: 1��,li� �� (List the legal name of the company seeking to contract with the Cooperative. Do NOT list 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/f affiliated entities, which propose to provide goods or services separately must submit their own Proposals) Please check(-V)one of the following: Type of Business: Individual/Sole Proprietor Corporation Limited Liability Company Partnership Other If other, identify State of Incorporation (if applicable): Federal Employer Identification Number: ONU (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 Certificate(s),if applicable,must be attached.) Proposal Forms COMM/SVCS v.09.12.2019 Page 34 of 72 Give Form to the Form WM9 Request for Taxpayer requester.Do not (Re�nle Identification Number and Certification send to the IRS. DepsuryInteehown on your income tax return).Name is required on this Line;do n le this linnk. TU�Yce Oy0 2 Business name/disregarded entity name,if different from above N QI R 4 Exemptions(codes apply only to °- 3 Check appropriate box for federal tax classification;check only one of the following seven oxes: certain entities,not individuals;see TrusVestate o ❑Individual/sole proprietor or ❑ C Corporation ❑S Corporation ❑ Partnership instructions on page 3): ac single-member LLC Exempt payee code(if any) .0 ❑Limited liability company.Enter the tax classification(C C corporation,S=S corporation,P=partnership)► Exemption from FATCA reporting 3 Note.For a single-member LLC that is disregarded,do not check LLC;check the appropriate box in the line above for code(if any) inthe tax classification of the single-member owner. ryes m a��e e ed o e;de the U.S.) a-S ❑Other(see instructions)► Requester's name and address(optional) 5 A dress number,street,and apt.or suite no.) j a �waoi, a . - N 6 i state,an ZIP code fturA �c��s� 7 List account number(s)here(optional) • Taxpayer Identification Number(TIN) Social security number Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid _ backup withholding.For individuals,this is generally your social security number(SSN).However,for a _m resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other entities,it is your employer identification number(EIN).If you do not have a number,see How to get a or 77N on page 3. Employer identification number Note.if the account is in more than one name,see the instructions for line i and the chart on page 4 for :Eaiw�n_ guidelines on whose number to enter. Certification Under penalties of perjury,(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 repo al Interest d div' rids on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,acquisition or ab on s d p rty cellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other th i e n iv( nds,yo no required to sign the certification,but you must provide your correct TiN.See the instructions on page 3. Sign Signature of Date► a v" Iq Here u.s.person► � ®� •Form 1098(home mortgage interest),1098-E(student loan interest),1098 T General Instructions (tuition) Section references are to the Internal Revenue Code unless otherwise noted. •Form 1 o99-C(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 wwwAs.govlfw9. Use Form W-9 only if you are a U.S.person(ncluding a resident alien),to Purpose of Form provide your correct TIN. If you do not return Form W-9 to the requester with a TTN,you might be subject An individual or entity(Form W-9 requester)who is required to file an information See What is backup withholding?on page 2. to backup withholding.return with the IRS must obtain your correct taxpayer identification number(TIN) the filled-out form,you: which may be your social security number(SSN),individual taxpayer identification By signing 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(EIN),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 2 Certify that you are not subject to backup withholding,or returns include,but are not limited to,the following: •Form 1099-INT(interest 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 allocabte 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 1099-6{stock or mutual fund sates and certain other transactions by 4-Certify that FATCA code(s)entered on exempt from the FATCA porting is correct.iSee rWhat is FATCA t p that you re FATCAreorting?on brokers) page 2 for further information. •Form 1099-S(proceeds from real estate transactions) •Form 1099-K(merchant card and third party network transactions) Cat.No.10231X Form W-9(Rev.12-2014) Board® 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 YES, I agree or Vendor Certification Item No. NO, I do NOT agree knital. 1. Vendor Violation or Breach of Contract Terms I V-..,; C 2. Termination for Cause or Convenience ye-S 3. Equal Employment Opportunity -yes 4. Davis-Bacon Act Vp� 5. Contract Work Hours and Safety Standards Act 6. Right to Inventions Made Under a Contract or Agreement 7. Clean Air Act and Federal Water Pollution Control Act yes 8. Debarment and Suspension 9. Byrd Anti-Lobbying Amendment ia S 10. Procurement of Recovered Materials Vo 11. Profit as a Separate Element of Price V.10 12. General Compliance and Cooperation with Cooperative Members 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. Comp Signature of Authorized Co pa Official S&W S' B>e Printed Name Proposal Forms COMM/SVCS v.09.12.2019 Page 38 of 72 Beard® 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. ion" 2. 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. MONUP-Mllf- ' t ! ? ore u `n -tu eei 3. 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 party 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. Proposal Forms COMM/SVCS v.09.12.2019 Page 39 of 72 Board cooperative Purchasing 12007 Research Boulevard ' Austin,Texas 78759-2439 • PH: 800-695-2919 ' FAX: 800-211-5454 ' buyboard.com 4. 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. n0 5. 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. 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, failure to complete or deliver the work, or termination. Ig O^L�' 6. List all litigation or other legal proceedings (including arbitration proceedings), 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), nature of the claim, and resolution or current status. 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. serve d e, fflo . 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OJ O I a CU U ; u w u4 o O u v X X o EOaO••• a— uo°x ai w w w 03 in (Uu a r° CL U U O O 0 a. , ra Z J r�-i O In LA Z J U 0- Z J [n C7 Z J H U') W fi . t� Z Exhibit C CONFLICT OF INTEREST DISCLOSURE REQUIREMENT Pursuant to Chapter 176 of the Local Government Code, any person or agent of a person who contracts or seeks to contract for the sale or purchase of property,goods,or services with a local governmental entity(i.e.The City of Fort Worth)must disclose in the Questionnaire Form CIQ("Questionnaire")the person's affiliation or business relationship that might cause a conflict of interest with the local governmental entity.By law,the Questionnaire must be filed with the Fort Worth City Secretary no later than seven days after the date the person begins contract discussions or negotiations with the City,or submits an application or response to a request for proposals or bids, correspondence,or another writing related to a potential Agreement with the City.Updated Questionnaires must be filed in conformance with Chapter 176. A copy of the Questionnaire Form CIQ is enclosed with the submittal documents. The form is also available at http://www.ethics.state.tx.us/forms/CIQ.pdf. If you have any questions about compliance,please consult your own legal counsel. Compliance is the individual responsibility of each person or agent of a person who is subject to the filing requirement.An offense under Chapter 176 is a Class C misdemeanor. NOTE: If you are not aware of a Conflict of Interest in any business relationship that you might have with the City,use N/A in each of the areas on the form.However,a signature is required in the#7 box in all cases. CONFLICT OF INTEREST QUESTIONNAIRE FORM CI For vendor doing business with local governmental entity This questionnaire reflects changes made 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 law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code. A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code.An offense under this section is a misdemeanor. -11 Name of vendor who has a business relationship with local governmental entity. MASTERTURF PRODUCTS AND SERVICES, INC. 2 ❑ Check this box if you are filing an update to a previously filed questionnaire.(The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.) 3 Name of local government officer about whom the information is being disclosed. N� Name of Officer 4 Describe each employment or other business relationship with the local government officer, or a family member of the officer,as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form CIQ as necessary. 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 I 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? Yes No 5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership interest of one percent or more. 6 Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts El as descri 7 . (a)(2 excluding gifts described in Section 176.003(a-1). 7 Va I Signature f vendor doing busines with tf governmental entity Date Form provided by Texas Ethics Commission Revised 11/30/2015 www.ethics.state.tx.us 9/21/2021 M&C Review Official site of the City of Fort Worth,Texas CITY COUNCIL AGENDA FOT+ H DATE: 10/20/2020 REFERENCE**M&C 20- LOG NAME: 13P611-20 GROUNDS NO.: 0777 MAINTENANCE EQUIP CC PARD CODE: P TYPE: CONSENT PUBLIC NO HEARING: SUBJECT. (ALL) Authorize Purchase Agreements with Multiple Vendors for Grounds Maintenance Equipment, Irrigation Parts, Supplies and Installations Using a Cooperative Contract for City Departments in the Combined Annual Amount Up to $725,000.00 and Authorize Two Annual Renewal Options RECOMMENDATION: It is recommended that the City Council authorize purchase agreements with the vendors listed below for grounds maintenance equipment, irrigation parts, supplies and installations using Texas Association of School Boards (BuyBoard) Contract No. 611-20 for City Departments in the combined annual amount up to $725,000.00 and authorize two annual renewal options. DISCUSSION: The Purchasing Division contacted all City departments to participate in a cooperative agreement for grounds maintenance equipment, irrigation parts, supplies and installations; five departments responded. Departments will purchase new equipment and replacement pieces from multiple vendors. Staff recommends awarding multiple vendors offering a variety of products offered through BuyBoard Contract No. 611-20. Recommended vendors and award amounts are listed below: Vendor Award Amount BWI Companies, Inc. $135,000.00 Professional Turf Products, LP $155,000.00 SiteOne Landscape Supply $130,000.00 WinField United $56,000.00 Ewing Irrigation Products, Inc $56,000.00 Kinloch Equipment& Supply, Inc. $43,000.00 LSM Outdoor Power $22,000.00 KBW Supply, Inc. $5,200.00 JHouston Holdings, LLC, dba, JRC $8 500.00 Associates, LLC MasterTurf Products and Services, $1,400.00 Inc. Hill Country Outdoor Power $6,000.00 Kubota Tractor Corporation $55,000.00 Austin Turf & Tractor $25,000.00 apps.cfwnet.org/council_packet/mc_review.asp?ID=28345&councildate=l 0/20/2020 1/2 9/21/2021 M&C Review State law provides that a local government purchasing an item under a cooperative purchasing agreement satisfies state laws requiring that the local government seek competitive bids for purchase of the items. BuyBoard contracts have been competitively bid to increase and simplify the purchasing power of government entities. A MBE/SBE goal is not assigned when purchasing from an approved purchasing cooperative or public entity. This agreement will commence upon City Council approval, and end May 31, 2021 to coincide with BuyBoard contract No. 611-20. The BuyBoard Agreement may be renewed at the City's option for two additional one-year terms if BuyBoard renews its contract. This action does not require specific City Council approval provided that the City Council has appropriated sufficient funds to satisfy the City's obligations during the renewal term. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that funds are available in the current operating and capital budgets, as previously appropriated, in the participating departments' Operating and Capital Funds to support the approval of the above recommendation and purchase agreement. Prior to any expenditure being incurred, the participating departments have the responsibility to validate the availability of funds. BQN\\ TO Fund Department Account Project Program Activity Budget Reference # Amount ID ID Year (Chartfield 2) FROM Fund Department Account Project Program Activity Budget Reference # Amount ID I ID L Year (Chartfield 2) Submitted for City Manager's Office by_ Jay Chapa (5804) Originating Department Head: Reginald Zeno (8517) Additional Information Contact: Cynthia Garcia (8525) Cristina Camarillo (8355) ATTACHMENTS a pps.cfwnet.o rg/council_packet/mc_review.asp?I D=28345&cou nci ddate=l 0/20/2020 2/2