HomeMy WebLinkAboutContract 57332-CA1 CSC No.57332-CA1
CITY OF FORT WORTH
ASSIGNMENT
For value received, Wilson Office Interiors, LLC ("Assignor"), hereby assigns to
wilsonbauhaus Interiors, LLC ("Assignee"), all of its right, title and interest in and to any and all
sums of money now due or to become due from the City of Fort Worth to Assignor under PSK
15613/CSCO 57332 (the "Contracts") and Assignee agrees to assume and perform all duties and
obligations required by Assignor under the terms of the Contracts.
This Assignment constitutes the entire agreement between Assignor and Assignee with
respect to the subject matter hereof. No modification of any provision of this Assignment shall
be effective unless in writing and signed by Assignor and Assignee. This Assignment shall inure
to the benefit of and be binding upon Assignor and Assignee and their respective successors and
assigns. This Assignment shall be governed by the terms of the original Contracts between
Assignor and various other entities and the City of Fort Worth and the laws of the State of Texas,
without application of principles of conflicts of law.
This Assignment may be executed in one or more counterparts each of which shall be
deemed an original but all of which together shall constitute one and the same instrument.
Signed signature pages may be transmitted by facsimile or e-mail, and any such signature shall
have the same legal effect as an original.
Dated the day of 2022.
Wilson Office iors, LLC
(Assignor)
By:
Print.
Title: Chief Operating Officer
wilsonbauhaus Interiors LLC
{Assignee
By:
Print:
Titl : Chief Financial Officer
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 1 of
NOTARY ACKNOWLEDGEMENT
On the day of 2022, personally appeared
who acknowledged to me that (s)he is. the Chief Operating Officer of
Wilson Office Interiors, LLC, and that (s)he executed this docu lent for the purposes and
consideration contained herein.
Wilson Office Interiors, L
By:
Print:
Title: Chief Operating Officer
SUBSCRIBED TO before me on this day of lei 2022.
*' *' My Notary!o#929230278 tary Public i d for the State of 5
EExpfres December 91,2024 My commission Expires:
NOTARY ACKNOWLEDGEMENT
�," On the day of 2022, personally appeared
1�G f� who acknowledged to me that (s)he is the Chief Financial Officer of
wilsonbauhaus Inter , LLC, and that (s)he executed this document for the purposes and
consideration contained herein.
wilsonbauhaus Interiors, LLC
B
Print:
Title: Chief Financial Officer
SUBSCRIBED TO before me on this day of r�� , 2022.
DANYELLE MARIN
* My Notary ID#129230278 Public in for the State of
Expires December 41,2024
My commission Expires:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 2 of 4
CONSENT TO ASSIGNMENT
The City of Fort Worth consents to the assignment of Wilson Office Interiors, LLC
("Assignor") to wilsonbauhaus Interiors, LLC (Assignee"), of all its rights, title, and obligation
owing and all funds due or to become due to Assignor under PSK 15613/CSCO 57332, as long
as all terms required of Assignor in said contracts are met by Assignee.
CITY OF FORT WORTH
�- May 2, 2022
Reginald Zeno(May 2,2022 08:37 CDT)
Reginald Zeno, Interim Assistant City Manager Date
May 1,2022
[Cynthia Garcia,Assistant Director—FMS Date
a ��
p'A.
FORT�aa
°
ATTESTED BY: F J.o 1016,
° °
000
° o S� May 4,2022
JannetteS.Goodall(May4,202209:25CDT) �a* °*�
°° o
Jannette Goodall, City Secretary �a r°°°°°°S a� Date
EXA o.
APPROVED AS TO FORM AND LEGALITY:
John B. Strong,Assistant City Attorney
Contract Compliance Manager: j
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including ensuring all performance and
reporting requirements.
May 1, 2022
Employee Signature/Date
Assistant Director
Title
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Asslgllfll ent Page 3 of 4
Form W=9 Request for Taxpayer Give Form to the
(Rev.October2018) identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to wwwJrs.gov/For7nW9 for instructions and the latest information.
1 Name(as shown on your income tax return].Name is required on this line;do not leave this line blank.
wilson bauhaus interiors, LLC
2 Business nameldis regarded entity name,It different from above
M 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions codes apply only to
� P Y P� ( PP Y Y
m following seven boxes. certain entities,not individuals;see
a instructions on page 3):
0 ❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation p❑ Partnership ❑Trust/estate
single-member LLC Exempt payee code(if any)
ao
41 ❑✓ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)► S
o` Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
to LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is y)
.16
E another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that co de(if an
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
y ❑ Other(see instructions)► (Applies to accounts maintained outside the U S)
y 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
an 5051 Pulaski Street
6 City,state,and ZIP code
Dallas,TX 75247
7 List account number(s)here(optional)
ORM Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(S However,for a —m
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a
TIN, later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
M88 —[1] 0 7 0 9 M6O
_Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.1 am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you are not required to sign t e certification,but you must provide your correct TIN.See the instructions for Part 11,later.
Sign Signature of
Here U.S.person► Date III-
Form• 1099-DIV(dividends,including th se from stocks or mutual
General Instructions
funds)
Section references are to the Internal Revenue Code unless otherwise .Form 1099-MISC(various types of income,prizes,awards,or gross
noted. proceeds)
Future developments. For the latest information about developments .Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption .Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
Corporations Section ��E Q John B. Scott
P.O.Box 13697 �,�� �tt) Secretary of State
Austin,Texas 78711-3697 `X
Office of the Secretary of State
CERTIFICATE OF FILING
OF
wilson bauhaus interiors, llc
File Number: 804441214
The undersigned, as Secretary of State of Texas, hereby certifies that a Certificate of Formation for the
above named Domestic Limited Liability Company (LLC) has been received in this office and has been
found to conform to the applicable provisions of law.
ACCORDINGLY, the undersigned, as Secretary of State, and by virtue of the authority vested in the
secretary by law, hereby issues this certificate evidencing filing effective on the date shown below.
The issuance of this certificate does not authorize the use of a name in this state in violation of the rights
of another under the federal Trademark Act of 1946, the Texas trademark law, the Assumed Business or
Professional Name Act, or the common law.
Dated: 02/21/2022
Effective: 02/21/2022
f
John B. Scott
Secretary of State
Come visit us on the internet athttps://www.sos.texas.gov/
Phone: (512)463-5555 Fax: (512)463-5709 Dial: 7-1-1 for Relay Services
Prepared by: Linda Galaviz TID: 10306 Document: 1122326210002
W j I son wilsonbauhaus Interiors
b a u h a u S 1341 W. Mockingbird Lane
N r ER10i Suite 1100W
Dallas, TX 75247
Good morning,
We are excited to announce that, effective 04/01/2022 Bauhaus Interiors Group, Inc. and Wilson
Office Interiors, LLC. have merged and are now known as wilsonbauhaus Interiors, LLC. This
transition was done with our clients in mind, combining two longstanding enterprises doubles
our amazing talent and expertise to help our clients achieve their project goals. We look forward
to continuing our work and expect a transition with minimal disruption.
Please see the attached W-9 form for updated information. We ask that you update all future
remittance, for new invoices, to:
wilsonbauhaus Interiors, LLC.
5051 Pulaski Street
Dallas, TX 75247
Billing inquiries will now be submitted to accounting@wilsonbauhaus.com.
We look forward to maintaining our relationship and appreciate your assistance in getting our
profiles updated. If you have any questions, you may reach us by email at
accounting@wilsonbauhaus.com or by phone at (972) 488-4187.
We are also sending an updated W-9 form and ACH information. Invoices should be remitted to
the company and address listed on the invoice. If you have a Wilson Office Interiors invoice,
then still make payment to the old account and remittance address. The new remittance is only
effective for invoices generated after 4/1/2022.
Thank you and we look forward to maintaining our strong relationship,
r
JLr
Chris Ricci
Account Manager