HomeMy WebLinkAboutContract 57292 CSC No. 57292
FORT WORTH
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between CPR Savers
& First Aid Supply LLC ("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 GSA GS-07F-0107W; and
4. Exhibit C—Conflict of Interest Questionnaire
Exhibits A, B, and C,which are attached hereto and incorporated herein, are made a part of this
Agreement for all purposes. Vendor agrees to provide City with the services and goods included in
Exhibit A pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all
exhibits thereto.
City shall pay Vendor in accordance with the fee schedule in Exhibit A and in accordance with
the provisions of this Agreement. Total payment made under this Agreement by City shall be in the
amount of Thirty-Five Thousand Dollars ($35,000.00). 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 is effective beginning on the date signed by the Assistant City
Manager below ("Effective Date") and expires on November 29, 2022. The City shall be able to renew
this agreement for two (2) one-year renewal options by written agreement of the parties.
Vendor agrees that City shall,until the expiration of three(3)years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said three years, have access to
and the right to examine at reasonable times any directly pertinent books,documents,papers and records,
including, but not limited to, all electronic records, of Vendor involving transactions relating to this
Agreement at no additional cost to City. Vendor agrees that City shall have access during normal
working hours to all necessary Vendor facilities and shall be provided adequate and appropriate work
space in order to conduct audits in compliance with the provisions of this section. City shall give Vendor
reasonable advance notice of intended audits.
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
CITE- TO VENDOR:
ty of Fort Worth CPR Saves&Fust Aid apply LLC
tn., Valerie Warshingiort,AssiS ant City 1 ampr Srrsana-Taylur, l aunderNke President
' M Texas Street
F WDrth,TX 76102-63)4 A€d=ss:
i~ !irttik; (817)392'-5654 „328 W Campus Dr.
Tempe.AZ 952&2 3109
ilh py in Fan Worth City Anoi y's Office at
e address 'Facsimile, 490-275-7002
tinder.gned represent,3 and wan-ants tha[ he or qbr has the pow r- au crity [u execute this
A uni :ind bind the respecri%c Vendor,
OF FORT WORTH:
[:ON' MAL TUOMPl_L&NCE MLANAGER:
BY Rio€I nclrnowJcdgr Tha; !am air lea
valerie Washington(Mar 24,202211:15 CDT) mp¢usible for the monkcffiog and admintKnHi m
Aiauae, Vfllrrio waa bingtan 6f lKe cunlrnct,invh4ng ensarin g all performcinee
T-rtle: dsran[Ci1v Mmuger and reporung,:L-qvdr--is ts-
FROk AL RECOMMENDED: By,
SGL2y`Yit�C�
Sherri Hauch(Mar 23,2022 15:37 CDT)
Marne: Sherri ffeb
Title: Nw 1s[rs#iDn Chief
J s Davis(Mar 23,202215:46 CDT) ao-o4o0UIl PROVF—D A5 TO FORM)LNO LE ALIT]:
! amc- J tne?�f]IDlvis 5�0 FgRt oaa
Title: Fim Chief aFo o.�.ta
o.
A SST, �Pa Boa /—.
dCa�ni?x 45pa .
N mr: Taylor Pans
Tide: Assist= [ rtk r�r�c�rsr_v
By J ette S.Goodall Mar 24,202213 CDT) CON-MACT AL-M RATIO-.
Nmm.— lannette Cuo"T C; N-A
Title 0tvSeeretary
VENDOR;
('P SSvim&Fiesi Aid S ('
Ely
- S Mae
Title: FoundcrA ive Ptnidnl
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
1/21/22,7:40 AM CPR Savers Quote#
Exhibit A
CPR Says QUOTE
&FIRST AID SUPPLY# 1138270
Questions or concerns? Don't hesitate to call us at 1-800-480-1277 from lam to 5pm MST(UTC-7:00)or email us any time at
service cpr-savers.com.
BIDS: ORDER 1138270 BILL TO SHIP TO
Ordered By: Sherry Carter[124191] Sherry Carter Sherry Carter
State and Local Government TX 505 W.Felix St
Order Reference: RFQ1533933S TX Fort Worth TX 76112
Invoice Date: 05 Jan 2022 United States United States
Terms: Net 0 sherry.carterCwfortworthtexas.gov sherry.carter@fortworthtexas.gov
Due: 05 Jan 2022
GSA:GS-07F-0107W
SKU ITEM NAME PRICE QTY TAX SUBTOTAL.
RCF-A1000EN DEFIBTECH LIFELINE ARM CHEST COMPRESSION SYSTEM $9975,0000 1 $0,00 $9975.00
Includes;
Compression Module(RMC-A1000GG)
Frame,Backboard(RMB-G1000GG)
Battery Pack(RCF-RBP-G1000GG)
Backpack Carry Case(RAC-U1100GG)
Patient Pad-set of 3(RPP-G 1003GG)
Stabilization Strap(RSS-U1000GG)
Wrist Straps-1 set of 2(RCF-A1010EN)
Power Module charger(RPM-G1000NA)
Quick Start Guide(RAC-U1501EN)
User Manual(RAC-A1510EN)
User Manual-Wrist Straps(RAC-U1513EN)
RBP-G1000GG Defibtech Lifeline,ARM Battery Pack'OM` $575.0000 1 $0.00 $575.00
RBC-1000 DUAL BATTERY CHARGER FOR LIFELINE ARM(RCF-RBC- S750.0000 1 S0.00 S750.00
U1000NA)
Wrist Straps-RCF-A1013EN(3sels,6pieces) $188,0000 1 $0.00 $188.00
Torso Straps-RCF-RSS-U1000GG $307.0000 1 $0.00 $307,00
FREE SHIPPING FREE SHIPPING-OM- $0.0000 1 $0.00 $0.00
................... ....
TOTAL $11795.00
https://usel.brig h tpearlapp.com/template_print.php?return-to-oid=1138270&o I D=l 138270&contacts_id=124191&template_type_id=4 112
EXHIBIT B
GSA GS-07F-0107W TERMS&CONDITIONS PRICE LIST
https://www.gsaadvantage.gov/ref text/GS07F0107W/GS07F0107W online.htm
GSA GS-07F-0107W CONTRACT CLAUSES/EXCEPTIONS
https://www.gsaelibrary.gsa.gov/ElibMain/home.dohttp:/www.gsaelibrary.%20gsa.gov/ElibMain/pdf/pdf/contra
ctCla uses.do?scheduIeNumber=MAS&contractNumber=GS-07F-
0107W&contractorName=CPR+SAVERS+%26+FIRST+AID+SUPPLY+LLC&duns=JGLM CZQHSM E7&source=ci&view=
clauses
Exhibit
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIO
For vendor doing btaslness with local govermmental entity
Trlia gLJ kaWQnFWftft rsfieors CbEnlJlea macs¢ to the law 4 HZ, tar Wh Lech Regular Saasskm- OPFIC E USE CINLY
Thus qu s1Cr'.r"a" -,Crrru3 4&!0 in a=--ffanCw vmrh C haVer*r'6,Lr—,l(a 'n mj!nl i=aid. ty 4 WXi6-r wh o
rf S 3 p r raJaLn+'e►5 s3<W i"d ixy SeO*n 1 i&.float-a o aiM-B la[al ga n'Ei7,-flenM) arilAy Wtu the - -
veFAdpr" CeM IOQLDFE .ergs UfKW SslAan I7f).tffija)
�YV Jaw rt is.q nesriannaae must re bled w4t the fomtds AdFn ratGr d Vv So�zF{ia:w"enral erolity nil iHMF
me?%the 7th tupn=day mice d&dsle ow vex C*�jwggqa of 14=dgaf mgswr&M p>iateFruerpf tD ce
+le#- Seaion:7&0061t,-ti. Lsm�GmamrrtetaCnae
A+'WM comer m an Ufferfs+r the vendor MrcwiNy vie= ;'cn +75.r305, a"Ara
OP'-F 36 L nd& I1.-s 96L'7W 35 a i'mMororearmr
1 Nxrhk al vendor whip hss a businai;&roletianship whlh hc:�al governmenlal enllty.
11 k lRis hQx iit you■�►re iiltr p am# gas prwvipu r Bled guesim nnaite.l Inc to F�grsre you hle are t+ 3,9ef
7f! IgCe� C�85;•4Flit ir9 wsrh Ow approprute tiunp auvwrh not iam?rail I he Ar4 bUMFIRCP say fmw i?w tiara on w"h
yD-, 1e0.wne awaro Ihri-ft of lg - Y ftrgd guuslrQnrtaira was m-=Trr*le or ir6-cc ra3 L-.]
3 Nnm I of hq J go vernnmmi vificer at=( JWpunaVen Js being di-limWe-EL
himne Oi C?H:rpr
De54;sibe each empiayment or other business r014111 sm5#iip wilih the Jocal government offter, ar x family member of She
oitic r.us do scribed by reran 175,UQ3 a. 2}Al A1sa descrThe any family reilalio rahip with tha iacel governfnanI ofifcer.
Corn Jule subpaf irc A and 6 to r eac ii ernplayn,5nt et hus i r+egs Felat+onship Oescribed. Attaoii a ijni areal pagan to lhr s r-orm
CiQ necessary,
A. Is it�a-b c:ai govgrrmaiTt o*h--Ar w a 1arQq rnembW tir ow afiicsr r wng of 1 ely 10 fc-_em taxahhp If_-Gme:
ptt►er than mueSbneral meoFrue, rrO M the Ver iCr7
'ff a' F7 No
E, 12 ttw v andpr r MnG or kkary m rimews laxab�a bl--XkrrW-Nt*F than imweef err Inter rr=Or al tW OE;Wlwe
of#tze iacal governor uni al+keir or a family rrffrrhgr 01 the aTicer AND The tMobe income iE met rimed frtrt;#m
krz 1 FU:errLTW1el enftyF
Y � No
Er
Cam rim each employment or business retal lonxh ip host 1t:2 vegdor nam,-d irG Sete i a n S m airl lai n s with ea rarporeti on OF
011OF buslnass earthy with respect 1p Which the iOCe1 9ovomment offrcer sorvea as an aif er Or dlreefprr ar hold an
ew+mhlp interest of one percent yr mare"
5
Cr,E,� tnl 0�AMe vandur has gwm trim IdN�gavamneni Off+C;er of a ramq rnesrawf Cr,0V ottkar am or Mrg gifts
as n eal;jGn 176 (fi), M=kdkqqft deffar�m a in SwUm i76-4OWI1
/ � 3
W ti-*n yr ddr4 utz Asa w rjr_ f ilp ranenFgh Fyity DEM
` rm r"ti�'f + �y texas F:trams ia+r�r§ss+an itMr'w,e#hrCs.Slbl.B,Ii"cif tilsl"5a 1.t. i
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
A complete copy of Chapter 176 of the Local Government Code maybe found at http://www.statutes.Iegis.state.tx.us/
Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.
Local Government Code§176.001(1-a):"Business relationship"means a connection between two or more parties
based on commercial activity of one of the parties. The term does not include a connection based on:
(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an
agency of a federal, state, or local governmental entity;
(B) a transaction conducted at a price and subject to terms available to the public; or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and
that is subject to regular examination by, and reporting to, that agency.
Local Government Code§176.003(a)(2)(A)and(B):
(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:
(2) the vendor:
(A) has an employment or other business relationship with the local government officer or a
family member of the officer that results in the officer or family member receiving taxable
income, other than investment income, that exceeds $2,500 during the 12-month period
preceding the date that the officer becomes aware that
(i) a contract between the local governmental entity and vendor has been executed;
or
(ii) the local governmental entity is considering entering into a contract with the
vendor;
(B) has given to the local government officer or a family member of the officer one or more gifts
that have an aggregate value of more than$100 in the 12-month period preceding the date the
officer becomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
(ii) the local governmental entity is considering entering into a contract with the vendor.
Local Government Code§ 176.006(a)and (a-1)
(a) A vendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship
with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local
governmental entity,or a family member of the officer,described by Section 176.003(a)(2)(A);
(2) has given a local government officer of that local governmental entity, or a family member of the
officer,one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B),excluding any
gift described by Section 176.003(a-1);or
(3) has a family relationship with a local government officer of that local governmental entity.
(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator
not later than the seventh business day after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental
entity; or
(B) submits to the local governmental entity an application,response to a request for proposals
or bids, correspondence, or another writing related to a potential contract with the local
governmental entity;or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a
family member of the officer,described by Subsection(a);
(B) that the vendor has given one or more gifts described by Subsection (a);or
(C) of a family relationship with a local government officer.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021