HomeMy WebLinkAboutContract 57644CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement (“Agreement”) is entered into by and between Lonestar
Municipal Equipment (“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: Buyboard 593-19; 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 for the first year by City
shall not exceed Fourteen Thousand Dollars ($14,000.00). 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 September 30, 2022.
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:
CSC No. 57644
To CITY:
City of Fort Worth
Attn: Dana Burghdoff, Assistant City Manager
200 Texas Street
Fort Worth, TX 76102-6314
Facsimile: (817) 392-8654
With copy to Fort Worth City Attorney’s Office at
same address
To VENDOR:
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr, Managing Member/Co-Owner
Address:
1105 Friendship Rd
Weatherford, TX 76085
Facsimile: 817-953-7099
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:
By: ___________________________
Name: Dana Burghdoff
Title: Assistant City Manager
Date:
APPROVAL RECOMMENDED:
By: ______________________________
Name: Chris Harder
Title: Water Director
ATTEST:
By: ______________________________
Name: Jannette Goodall
Title: City Secretary
CONTRACT COMPLIANCE MANAGER:
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.
By: ______________________________
Name: Regina Jones
Title: Contract Compliance Specialist
APPROVED AS TO FORM AND LEGALITY:
By: ______________________________
Name: Taylor Paris
Title: Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C: N/A
VENDOR:
Lonestar Municipal Equipment, LLC
By:
Name: Paul E. Folker, Jr
Title: Managing Member/Co-Owner
Date:
Christopher Harder (Jun 6, 2022 08:23 CDT)
Christopher Harder
Dana Burghdoff (Jun 6, 2022 09:51 CDT)
Dana Burghdoff
Jannette S. Goodall (Jun 6, 2022 07:21 HST)
Jannette S. Goodall
Proposal Invitation No. 593-19-Sewer Inspection and Cleaning Products(Catalogs/Pricelists must be submitted with Proposal or Proposal will not be considered¹.)PROPOSAL NOTE1. Catalogs/Pricelists are required to be submitted with ProposalPROPOSAL SPECIFICATION FORMItem No. Short Description Full DescriptionState Percent (%) of Discount off Catalog/Pricelist¹State Name of Catalog/Pricelist¹Exceptions to Discount1Discount (%) Off Catalog/Pricelist for Combination Sewer Cleaners, Single EngineDiscount (%) Off Catalog/Pricelist for Combination Sewer Cleaners, Single Engine, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%2Discount (%) Off Catalog/Pricelist for Combination Sewer Cleaners, Dual EngineDiscount (%) Off Catalog/Pricelist for Combination Sewer Cleaners, Dual Engine, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%3Discount (%) Off Catalog/Pricelist for Jetter UnitsDiscount (%) Off Catalog/Pricelist for Jetter Units, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%4Discount (%) Off Catalog/Pricelist for Trailer Jetter Units Discount (%) Off Catalog/Pricelist for Trailer Jetter Units, Attachments, Accessories and related products.Catalog/Pricelist MUST be included or proposal will not be considered.______________%NOTE: Vendors proposing various manufacturer product lines per line item on the Proposal Specification Form must submit the information as follows or proposal may not be considered: 0DQXIDFWXUHUVVKDOOEHOLVWHGLQDOSKDEHWLFDORUGHU 9HQGRU¶VPXVWOLVWRQHVSHFLILFSHUFHQWDJHGLVFRXQWIRUHDFK0DQXIDFWXUHUOLVWHGIf a vendor’s response to Proposal Specification Form states “please see attachment sheet,” all manufacturers listed on the attachment sheet must indicate per manufacturer the line item that correlates to Proposal Specification Form or Vendor’s proposal may not be considered.Section I: Sewer Cleaning Equipment, Products, and SuppliesPage 40 of 635Dyna-VacJV1000-2040Dyna-VacJVT500-20405Dyna-VacDJ6020 N/A5Dyna-Vac DJT2040Dyna-Vac DJT2040sDyna-Vac DJT4020Dyna-Vac DJT6520N/AN/AExhibit A
Proposal Invitation No. 593-19-Sewer Inspection and Cleaning Products(Catalogs/Pricelists must be submitted with Proposal or Proposal will not be considered¹.)PROPOSAL NOTE1. Catalogs/Pricelists are required to be submitted with ProposalPROPOSAL SPECIFICATION FORMItem No. Short Description Full DescriptionState Percent (%) of Discount off Catalog/Pricelist¹State Name of Catalog/Pricelist¹Exceptions to Discount5Discount (%) Off Catalog/Pricelist for Vacuum Excavation Equipment Discount (%) Off Catalog/Pricelist for Vacuum Excavation Equipment and related products.Catalog/Pricelist MUST be included or proposal will not be considered.______________%6Discount (%) Off Catalog/Pricelist for All Other Sewer Cleaning Equipment Discount (%) Off Catalog/Pricelist for All Other Sewer Cleaning Equipment, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%7Discount (%) Off Catalog/Pricelist for Portable Mini Sewer Inspection SystemsDiscount (%) Off Catalog/Pricelist for Portable Mini Sewer Inspection Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%8Discount (%) Off Catalog/Pricelist for Mainline Portable Mini Sewer Inspection Systems Discount (%) Off Catalog/Pricelist for Mainline Portable Mini Sewer Inspection Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%9Discount (%) Off Catalog/Pricelist for Portable Video Inspection CamerasDiscount (%) Off Catalog/Pricelist for Portable Video Inspection Cameras, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%10Discount (%) Off Catalog/Pricelist for Lateral and Mainline Sewer Inspection SystemsDiscount (%) Off Catalog/Pricelist for Lateral and Mainline Sewer Inspection Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%Section II: Sewer Inspection Equipment, Products and SuppliesPage 41 of 635Dyna-Vac HE800-536Dyna-VacHET500-536N/A5Please SeeAttachmentSheetN/A5Visual ImagingResources -Magnum M7N/A5Mini-CamMainlinePortable MiniSystemN/A5Visual ImagingResources -Portable VideoInspection CamerasN/A5Mini-Cam Lateraland MainlineSewer InspectionSystemsN/A
Proposal Invitation No. 593-19-Sewer Inspection and Cleaning Products(Catalogs/Pricelists must be submitted with Proposal or Proposal will not be considered¹.)PROPOSAL NOTE1. Catalogs/Pricelists are required to be submitted with ProposalPROPOSAL SPECIFICATION FORMItem No. Short Description Full DescriptionState Percent (%) of Discount off Catalog/Pricelist¹State Name of Catalog/Pricelist¹Exceptions to Discount11Discount (%) Off Catalog/Pricelist for Vehicle/Trailer Mounted TV Sewer Inspection and Rehabilitation SystemsDiscount (%) Off Catalog/Pricelist for Vehicle/Trailer Mounted TV Sewer Inspection and Rehabilitation Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%12Discount (%) Off Catalog/Pricelist for Cameras Discount (%) Off Catalog/Pricelist for Sewer Inspection Cameras, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%13Discount (%) Off Catalog/Pricelist for Camera Transporters Discount (%) Off Catalog/Pricelist for Sewer Inspection Camera Transporters, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%14Discount (%) Off Catalog/Pricelist for Pipeline Condition Assessment Software Discount (%) Off Catalog/Pricelist for Pipeline Condition Assessment Software and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%15Discount (%) Off Catalog/Pricelist for Lateral Reinstatement CuttersDiscount (%) Off Catalog/Pricelist for Lateral Reinstatement Cutters, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%16Discount (%) Off Catalog/Pricelist for Lateral Cleaning SystemsDiscount (%) Off Catalog/Pricelist for Lateral Cleaning Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%17Discount (%) Off Catalog/Pricelist for Profiling SystemsDiscount (%) Off Catalog/Pricelist for Profiling Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%Page 42 of 6355Pipe Logix -Pipeline ConditionAssessmentSoftwareN/A5Mini-CamProfilingSystemsN/AN/APlease SeeAttachmentSheet
Proposal Invitation No. 593-19-Sewer Inspection and Cleaning Products(Catalogs/Pricelists must be submitted with Proposal or Proposal will not be considered¹.)PROPOSAL NOTE1. Catalogs/Pricelists are required to be submitted with ProposalPROPOSAL SPECIFICATION FORMItem No. Short Description Full Description State Percent (%) of Discount off Catalog/Pricelist¹State Name of Catalog/Pricelist¹Exceptions to Discount18Discount (%) Off Catalog/Pricelist for All Other Sewer Inspection Systems Discount (%) Off Catalog/Pricelist for All Other Sewer Inspection Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%19Discount (%) Off Catalog/Pricelist for Repair/Replacement Parts for Sewer Cleaning and Inspection EquipmentDiscount (%) Off Catalog/Pricelist for Repair/Replacement Parts for Sewer Cleaning and Inspection Equipment. Catalog/Pricelist MUST be included or proposal will not be considered.______________%Not to Exceed Hourly Labor RateDetailed Information on Hourly Labor RateExceptions to Hourly Labor Rate20Not to Exceed Hourly Labor Rate for Installation/Repair Service of Sewer Cleaning, Inspection Products, Equipment and Related ItemsHourly Labor Rate for Installation/Repair Service of Sewer Cleaning, Inspection Products, Equipment and Related Items - State the Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products.$ ___________/HourSection IV: Installation and Repair ServiceSection III: Repair and Replacement PartsPage 43 of 635Mini-Cam AllOther SewerInspectionSystems5Mini-CamRepair &ReplacementParts ForSewer Cleaningand InspectionEquipment120Shop rate, mustbe at LME shop.Field servicework NOTavailable.Pickup &deliveryavailable at$1.50/mile.N/AN/AN/A
July 18, 2019
Sent Via Email: paul@lonestarme.com
Paul Folker
Lonestar Municipal Equipment, LLC
13233 Alyssum Drive
Fort Worth, TX 76244
Welcome to BuyBoard!
Re: Notice of The Local Government Purchasing Cooperative Award
Proposal Name and Number: Sewer Inspection and Cleaning Products, Proposal No. 593-19
Congratulations, The Local Government Purchasing Cooperative (Cooperative) has awarded your company a BuyBoard®
contract based on the above-referenced Proposal. The contract is effective 10/1/2019 through 9/30/2020, 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. 593-19 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
Exhibit B
!JJl!Jc!!J!!!!!®
12007 Research Boulevard • Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
PROPOSER'S AGREEMENT AND SIGNATURE
Proposal Name: Sewer Inspection and Cleaning
Products
Proposal Due Date/Op ening Date and Time:
January 24, 2019 at 4:00 PM
Proposal Number: 593-19
Location of Pr oposal Opening:
Texas Association of School Boards, Inc.
BuyBoard Department
12007 Research Blvd.
Austin, TX 78759
Anticipated Cooperative Board Meeting Date: Cont ract Time Period: October 1, 2019 through
September 30, 2020 with two (2) possible one-year
renewals.
July 2019
Lonestar Municipal Equipment, LLC
Name of Proposing Company
13233 Alyssum Drive
Street Address
Fort Worth, TX 76244
City, State, Zip
817.851.2243
Telephone Number of Authorized Company Official
817.953.7099
Fax Number of Authorized Company Official
01/08/2019
Date
Si2�thosc�•'#f
Paul E. Folker, Jr.
Printed Name of Authorized Company Official
Managing Member I Co-Owner
Position or 1itle of Authorized Company Official
81-4546554
Federal ID Number
Page 8 of 63 Proposal Forms COMM/SVCS v.06.14.2018
12007 Research Boulevard · Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboa rd.com
The proposing company ("you" or "your") hereby acknowledges and agrees as follows:
1. You have carefully examined and understand all Cooperative information and documentation associated with this Proposal Invitation, including the Instructions to Proposers, General Terms and Conditions, attachments/forms, item specifications, and line items (collectively "Requirements");
2. By your response ("Proposal") to this Proposal Invitation, you propose to supply the products or services submitted at the prices quoted in your Proposal and in strict compliance with the Requirements, unless specific deviations or exceptions are noted in the Proposal;
3. Any and all deviations and exceptions to the Requirements have been noted in your Proposal and no others will be claimed;
4. If the Cooperative accepts any part of your Proposal and awards you a contract, you will furnish all awarded products or services at the prices quoted and in strict compliance with the Requirements (unless specific exceptions are noted in the Proposal and accepted by the Cooperative), including without limitation the Requirements related to: a. conducting business with Cooperative members, including offering pricing to members that is the best you offer compared to similar customers; b. payment of a service fee in the amount specified and as provided for in this Proposal Invitation; c. the possible award of a piggy-back contract by another governmental entity or nonprofit entity, in which event you will offer the awarded goods and services in accordance with the Requirements; and d. submitting price sheets or catalogs in the proper format as required by the Cooperative as a prerequisite to activation of your contract;
5. You have clearly identified on the included form any information in your Proposal that you believe to be confidential or proprietary or that you do not consider to be public information subject to public disclosure under a Texas Public Information Act request or similar public information law;
6. The individual signing this Agreement is duly authorized to enter into the contractual relationship represented by this Proposal Invitation on your behalf and bind you to the Requirements, and such individual (and any individual signing a form) is authorized and has the requisite knowledge to provide the information and make the representations and certifications required in the Requirements;
7. You have carefully reviewed your Proposal, and certify that all information provided is true, complete and accurate, and you authorize the Cooperative to take such action as it deems appropriate to verify such information; and
8. Any misstatement, falsification, or omission in your Proposal, whenever or however discovered, may disqualify you from consideration for a contract award under this Proposal Invitation or result in termination of an award or any other remedy or action provided for in the General Terms and Conditions or by law.
Page 9 of 63 Proposal Forms COMM/SVCS v.06.14.2018
12007 Research Boulevard · Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.co m
VENDOR CONTACT INFORMATION
company:
Vendor Contact Name and Mailing Address for Notices:
company website:
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:
E-mail Address:
Internet Contact: Phone:
Alternate E-mail Address:
Alternate Internet Contact: Phone:
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 C"RFO"): Cooperative members will send RFQs to you by e-mail. Please provide e-mail addresses for the receipt of RFQs:
E-mail Address:
Alternate E-mail Address:
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:
Page 10 of 63 Proposal Forms COMM/SVCS v.06.14.2018
Please choose only one {1) of the fol lowing options for receipt of invoices and provide the requested information:
[i] Service fee invoices and related communications should be provided directly to my company at:
Mailing address: 1 32 33 Alyssum Drive Department: _B_il_l i_n_g ______ _
City: Fort Worth State: TX Zip Code:_7_6_2_4_4 ___ _
Contact Name: Je nni fer Fol ker Phone: 817.851.2034
Fax: 817.953. 70 99 E-mail Address: Jen@LonestarME.com
A It er native E-mail Address: Paul@LonestarME.com
In lieu of my company, I request and authorize all service fee invoices to be provided directly to the following billing agent**:
Mailing ad dress: _________________ Department: __________ _
City: ______________ State: _________ Zip Code: ________ _
Contact Name: _________________ Phone: _____________ _
Fax: ________ E-mail Address: _______________________ _
Alternative E-mail Address: ____________________________ _
In lieu of my company, I request and authorize service fee invoices to be provided to the Designated Dealer(s) receiving the purchase order(s) to which the invoiced service fees relate at the address and contact information designated on my company's Dealer Designation form as provided to the Cooperative administrator.**
If Vendor authorizes a bll/lng agent or Designated Dealer(s) to receive and process service fee Invoices,
In accordance with the General Terms and Conditions of the Contract, Vendor speclflcally acknowledges and
agrees that nothing In that designation shall rel/eve Vendor of Its responslbllltles and obllgatlons under the
Contract Including, but not 1/mlted to, payment of all service fees under any Contract awarded Vendor.
Proposal Forms COMM/SVCS v.06.14.2018
12007 Research Boulevard • Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
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 CY'.} one of the following:
My company is a publicly-held corporation. (Advance notice requirement does not apply to publicly-held corporation.) [j] My company is not owned or operated by anyone who has been convicted of a felony. My company is owned/operated 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.
Lonestar Mu nicipal Equipment, LLC
Company Name
Paul E. Folker, Jr.
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.
Lonestar Municipal Equipment, LLC
Company Name
Pau l E. Folker, Jr.
Printed Name
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12007 Research Boulevard • Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.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 (y') 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 Name 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
What is the prescribed amount or percentage? $ ______ or ______ %
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 (y') one of the following:
Yes No
By signature below, I certify that the information in Sections 1 (Resident/Nonresident Certification) and 2 (Vendor Employment Certification) above is true, complete and accurate and that I am authorized by my company to make this certification.
Company Name
Printed Name
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12007 Research Boulevard· Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
No ISRAEL BOYCOTT CERTIFICATION
Effective September 1, 2017, a Texas governmental entity may not enter into a contract with a company 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. Gov'T CODE Ch. 2270)
"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'T CODE §808.00 1(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.
Company Name
Si Printed Name
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 §§806.051, 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 true, complete and accurate; and that I am authorized by my company to make this certification.
Company Name
Signature of Authorized Compan Printed Name
Page 14 of 63 Proposal Forms COMM/SVCS v.06.14.2018
12007 Research Boulevard • Austin, Texas 78759-2439 · PH : 800-695-2919 • FAX : 800-2 11-5 454 • buyboa rd.com
HISTORI CALLY UNDERUTILIZED BUSI NESS CER TI FICATION
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 (y') 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 Owned Business {veteran defined by 38 U.S.C. §101{2), who has a service-connected disability as defined by 38 U.S.C. § 101(1 6), 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:
0 My company has NOT been certified as a HUB.
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.
Company Name
Page 15 of 63 Proposal Forms COMM/SVCS v.06.14.2018
12007 Research Boulevard · Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
CONSTRUCTION-RELATED GOODS AND SE RVICES 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 local policy.
The Advisory, available at buyboa rd.com/Vendor/Resources.aspx, provides an overview of certain legal requirements that
are potentially relevant to a Cooperative membe r'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.
Company Name
Printed Name
Date
Page 16 of 63 Proposal Forms COMM/SVCS v.06.14.2018
fuBoard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX; 800-21I-5454'buvboard.com
DrvrnrroN RNo CoMpLrRNce
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 (V) one of the followinq:
X No; Deviations
m Yes; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac JV1000-2040 (ltem 1 ) - standard delivery is 120 days from receipt
of chassis from chassis manufacturer
PLEASE PROVIDE THE FOLLOWING INFORMATIONI
1, Shipping Via: I Common Carrier f Company Truck E Prepaid and Add to Invoice E Other,
2. Payment Terms: E trtet 30 days n lozo in 10/Net 30 days I other:
3. Number of Days for Delivery: 1 20 ARo
4. Vendor Reference/Quote Number:Dyna-Vac JV1000-2040 (ltem 1)
5. state your return poricy: RETURNS ARE NoT AVAILABLE UPoN PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptableZ lyes I ruo
7. Are credit card payments acceptableZ Eyes f t'lo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Company Name
I -Y \ i-- I vv6
Sionature of Authorized Com
Prooosal Forms COIYw/SVCS v.06. 14.2018
fuB-oard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-21L-5454'buyboarcl.cam
D rvrRrro N Rtrt o Cot'rpLrRNcr
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 (V) one of the following:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac JVT500-2040 (ltem 1)- standard delivery is '120 days ARO
When "Truck Mount Option" is selected, delivery will be 120 days from receipt of chassis
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: I Common Carrier I Company Truck E Prepaid and Add to Invoice E Other:
2. Payment Terms: E tlet 30 days I 1olo in 10/Net 30 days n other:
3. Number of Days for Delivery: 120 ARo
4. Vendor Reference/Quote Number:Dyna-Vac JVTS00-2040 (ltem 1)
RETURNS ARE NOT AVAILABLE UPON PRODUCT5. State your return policy:
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptable? Iyes I ttto
7, Are credit card payments acceptableZ Eyes X ruo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Signature of Authorized Co
Prooosal Forms COM14iSVCS v.06.14.2018
fuBoard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-21I-5454'huvboard.com
D rvrRtto lrt Rtrt o CouptrRncr
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
reseryes the right to accept or reject a proposal based upon any submitted deviation.
Please check (V\ one of the followinq:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac DJ6020 (ltem 3) - standard delivery is 120 days ARO from receipt
of chassis
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: n Common Carrier I CompanyTruck E Prepaid and Add to Invoice E Other:
2. Payment Terms: E trtet 30 days Z toto in 10/Net 30 days I other:
3. Number of Days for Delivery: 1 20 ARo
4, Vendor Reference/Quote
5. State your return policy:
Number: Dyna-Vac DJ6020 (ltem 3)
RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptableZ lyes n llo
7. Are credit card payments acceptable? EYes I t'lo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Cornpany Name
ProDosal Forms COFIM/SVCS v.06. 14.2018
fuBoard'
12007 Research Boulevard 'Austin, Texas 78759-2439'PH:800-695-2919 ' FAX: 800-211-5454 'buyU3grd"rcilf
D evrerro N RN o Cot'r pLrRNce
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 (V) one of the following:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac DJT2040 (ltem 4) - standard delivery is 120 days ARO
When "Truck Mount Option" is selected, delivery is '120 days from receipt of chassis
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: I Common Carrier I Company Truck E Prepaid and Add to Invoice E Other:
2. Payment Terms: E lret 30 days n t.z. in 10/Net 30 days tr other:
3. Number of Days for Delivery: 120 ARo
4, Vendor Reference/Quote
5. State your return policy:
Number: Dyna-Vac DJT2040 (ltem 4)
RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6, Are electronic payments acceptablez IYes I f'lo
7. Are credit card payments acceptableZ Eyes I t'lo
Lonestar Municipal Equipment, LLC
Cornryny Na.me
l^-1 7 _ AAj,.., /. Paul E. Folker, Jr.
Signature of Authorized Companf Official Printed Name
Page 17 of 63
ProDosal Forms COMIY/SVCS v.06.14.2018
funoard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-21I-5454'huvboa:-d.ccm
D e vratro ru eru o Cou pttRruce
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 andlor 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 (r/) one of the followinq:
I NO; Deviations
E Y€s; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac DJT2040s (ltem 4) - standard delivery is 120 days ARO
When "Truck Mount Option" is selected, delivery is 120 days from receipt of chassis
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: J Common Carrier ! Company Truck I Prepaid and Add to Invoice E Other:
2. Payment Terms: E llet 30 days A pn in 10/Net 30 days f other:
3. Number of Days for Delivery: 1 20 ARo
4. Vendor Reference/Quote Numbel Dyna-Vac DJT2040s (ltem 4)
5. state your return poticy: RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptableZ lyes f ruo
7. Are credit card payments acceptable? EYes I tlo
Lonestar Municipal Equipment, LLC
Company Name
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Signature of Authorizec
Prooosal Forms CON1[1/SVCS v,06. 14.2018
fuB-oard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-211-5454'iluvlroard.eonr
DevrRrron Rno CoupltRncr
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 (V) one of the following:
I No; Deviations
E Y€5; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac DJT4020 (ltem 4) - standard delivery is 120 days ARO
When "Truck Mount Option" is selected, delivery will be 120 days from receipt of chassis
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: Ll Common Carrier f-l Company Truck lll Prepaid and Add to Invoice llj Other:
2. Payment Terms: E t'let 30 days ! ty. in 10/Net 30 days I other:
3. Number of Days for Delivery: 120 ARo
4. Vendor Reference/Quote
5. State your return policy:
Number: Dyna-Vac DJT4020 (ltem 4)
RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptablez lyes I t'lo
7. Are credit card payments acceptableZ EYes I t'lo
Lonestar Municipal Equipment, LLC
CoqpanyName / i ./)'c*l 7 *-bl.*,t ,., /', Paul E. Folker, Jr.
P,jtt"d Nl.tre
Page 17 of 63
Prooosal Forms COMIY/SVCS v.06. 14.2018
fuB-oard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-21I-5454'buvboard.cont
Devrlrron nno ConaplrRrucr
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 (V) one of the followinq:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac DJT6520 (ltem 4) - standard delivery is 120 days ARO
When "Truck Mount Option" is selected, delivery is 120 days from receipt of chassis
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: I Common Carrier ! Company Truck E Prepaid and Add to Invoice E other:
2, Payment Terms: E titet 30 days I tvo in 10/Net 30 days f other:
3. Number of Days for Delivery: 120 ARo
4. Vendor Reference/Quote Number:Dyna-Vac DJT6520 (ltem 4)
RETURNS ARE NOT AVAILABLE UPON PRODUCT5. State your return policy:
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptable? Iyes I t'lo
7, Are credit card payments acceptableZ Eyes I ruo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Prooosal Forms COIYM/SVCS v.06, 14.2018
fuB-oard.
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-211-5454 ' buvbcard.conr
DrvrRrroru nruo Couplrnnce
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 (V) one of the followinq:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac HE800-536 (ltem 5) - standard delivery is 120 days after receipt
of chassis from chassis manufacturer
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1, Shipping Via: I Common Carrier I Company Truck f Prepaid and Add to Invoice E Other:
2. Payment Terms: E tlet 30 days I tv. in 10/Net 30 days X other:
3. Number of Days for Delivery:
'120
ARo
4. Vendor Reference/Quote Number Dyna-Vac HE800-536 (ltem 5)
5 srare rrnr r rerr rn nnrinr. RETURNS ARE NOT AVAILABLE UPON PRODUCTilt v -
APPROVAL AND ACCEPTANCE
6, Are electronic payments acceptableZ [yes I ttto
7. Are credit card payments acceptable? EYes I t'lo
Lonestar Municipal Equipment, LLC
Paul E. Folker. Jr.
Printed Name
Page 17 of 63
Prooosal Forms COlvlM/SVCS v.06, 14,2018
fuB-oard'
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' FAX: 800-21 I-5454 . bglbgg1d,eSm
D rvrnrro N Rtrt o Cot"t plrRrucr
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 lts 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 (V) one of the following:
I No; Deviations
E Y€S; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac HET500-536 (ltem 5) - standard delivery is 120 days after receipt
of chassis from chassis manufacturer
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1, Shipping Via: I Common Carrier I Company Truck E Prepaid and Add to Invoice E other:
2. Payment Terms: E Net 30 days Z toto in 10/Net 30 days I other:
3. Number of Days for Delivery: 120 ARo
4. vendor Reference/Quote Numbel Dyna-Vac HET500-536 (ltem 5)
RETURNS ARE NOT AVAILABLE UPON PRODUCT5, State your return policy:
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptableZ IYes tr t"to
7, Are credit card payments acceptableZ EYes n llo
Lonestar Municipal Equipment, LLC
Corqqany flame
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
fLJ'
Proposal Forms COMIY/SVCS v.06.14.2018
fugoart'
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH:800-695-2919 . FAX: 800-21 1-5454 . buvb*arcl.com
DrvrRrron Rno CorqptrRrucr
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 andlor communicate with Proposer(s)
regarding any submitted deviation, consistent with general procurement principles of fair competition. The Cooperative
reseryes the right to accept or reject a proposal based upon any submitted deviation.
Please check (V) one of the following:
I No; Deviations
E Y€S; Deviations
List and fully explain any deviations you are submitting:
Dyna-Vac Rhino Easement Machine (ltem 6) - standard delivery is 120 days
ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: I Common Carrier ! Company Truck E Prepaid and Add to Invoice E Other:
2. Payment Terms: E tlet 30 days Z wo in 10/Net 30 days f other:
3. Number of Days for Delivery: 120 ARo
Dyna-Vac Rhino Easement Machine (ltem 6)4. Vendor Reference/Quote Number:
RETURNS ARE NOT AVAILABLE UPON PRODUCT5. State your return policy:
APPROVAL AND ACCEPTANCE
6, Are electronic payments acceptable? Iyes n llo
7. Are credit card payments acceptable? EYes I tlo
Lonestar Municipal Equipment, LLC
com@ny Name
i,/ t -/ -_/ii iI c*-' v -d| i LL\ -
Signature of Authorized Company' Offidial
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Proposal Forms COIYM/SVCS v.06, 14.2018
fuB-oard'
1 2007 Research Boulevard ' Austin. Texas 78759-2439 ' PH: 800-695-29 19 ' FAX: 800-2 1 L-5454 ' buvboard.conr
DevIRrron Rno CorqplrRncr
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 andlor communicate with Proposer(s)
regarding any submitted deviation, consistent with general procurement principles of fair competition. The Cooperative
reseryes the right to accept or reject a proposal based upon any submitted deviation.
Please check (r/) one of the followino:
I No; Deviations
E Y€S; Deviations
List and fully explain any deviations you are submitting:
Jetter Depot Nozzles (ltem 6) - standard delivery is 21 days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1, Shipping Via: I Common Carrier E Company Truck f, Prepaid and Add to Invoice E Other:
2. Payment Terms: E trtet 30 days tr 1olo in 10/Net 30 days I other:
3, Number of Days for Delivery: 21 o*o
4. Vendor Reference/euote Numbel Jetter Depot Nozzles (ltem 6)
5 Qt:fc rrnr rr rptr rrn nnl._Jicy: RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptableZ lyes n ruo
7. Are credit card payments acceptableZ Eyes I t'lo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Comp4.ny Name
Prooosal Forms COIYM/SVCS v.06. 14.2018
fuBoard'
12007 Research Boulevard 'Austin, Texas 78759-2439'PH:800-695-2919 ' FAX: 800-21I-5454' truvboard.eom
DevrRrton Rno Coupttencr
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 (V) one of the followino:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
MEC Equipment Sewer Parts Pricing (ltem 6) - standard delivery is 21 days
ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: I Common Carrier ! Company Truck E Prepaid and Add to Invoice E Other:
2, Payment Terms: E t'tet 30 days Z tvo in 10/Net 30 days I othen
..1 A
3. Number of Days for Delivery: Z I Rno
4, Vendor Reference/Quote Number. MEc Equipment sewer Parts Pricins (ltem 6)
5, stateyourreturn poticy: RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6, Are electronic payments acceptableZ IYes I tlo
7. Are credit card payments acceptableZ EYes I tlo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
ProDosal Forms COMI\4/SVCS v.06. 14,2018
fuaoard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-211-5454 ' buybaard.conr
D evtRttolrr Rn o CouplrRrucr
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
reseryes the right to accept or reject a proposal based upon any submitted deviation.
Please check (V) one of the followinq:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Sewer Pro Shop Bluestar Nozzles (ltem 6) - standard delivery is 21 days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1, Shipping Via: n Common Carrier n CompanyTruck E Prepaid and Add to Invoice E Other:
2. Payment Terms: E trtet 30 days I tv" in 10/Net 30 days n other:
3. Number of Days for Delivery: 21 o*o
4. Vendor Reference/Quote Number:
Sewer Pro Shop Bluestar Nozzles (ltem 6)
5. state your return poricy: RETURNS ARE NoT AVAILABLE UPoN PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptable? Iyes I ruo
7. Are credit card payments acceptableZ Eyes I t'lo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Siqnature of Authorized Com
Proposal Forms COMNIiSVCS v.06.14.2018
fupoart'
12007 Research Boulevard 'Austin, Texas 78759-2439 ' PH:800-695-2919 ' FAX: 800-21I-5454'buvboard.com
DevrRrroru nruo Couplrnruce
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 Propose(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 (r/) one of the following:
I No; Deviations
E YeS; Deviations
List and fully explain any deviations you are submitting:
Sonetics Pricelist (ltem 6) - standard delivery is 30 days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: X Common Carrier n Company Truck E Prepaid and Add to Invoice E Other,
2. Payment Terms: E tttet 30 days f t'zo in 10/Net 30 days I othen
3, Number of Days for Delivery: 30 o*o
4. Vendor Reference/Quote
5. State your return policy:
Number: Sonetics Pricelist (ltem 6)
RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AN D ACCEPTANCE
6. Are electronic payments acceptableZ trYes I t'lo
7. Are credit card payments acceptable? EYes I ruo
Lonestar Municipal Equipment, LLC
Paul E. Folker. Jr.
Printed Name
Page 17 of 63
Comqany Name
Signature of Authorized Company
ProDosal Forms COMN4/SVCS v.06,14.2018
fuB-oard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-21L-5454'buvboard.conr
DevrRrroru Rno Corqplrence
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 anv
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 andlor communicate with Proposer(s)
regarding any submitted deviation, consistent with general procurement principles of fair competition. The Cooperative
reseryes the right to accept or reject a proposal based upon any submitted deviation,
Please check (V) one of the following:
I No; Deviations
E Y€S; Deviations
List and fully explain any deviations you are submitting:
Visual lmaging Resources - Magnum M7 (ltem 7) - standard delivery is 21
days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: n Common Carrier ! CompanyTruck I Prepaid and Add to Invoice E Other:
2. Payment Terms: E tlet 30 days f tvo in 10/Net 30 days I other:
3. Number of Days for Delivery: 21 o*o
4, Vendor Reference/Quote
5. State your return policy:
Visual lmaging Resources - Magnum 1,47 (llem 7)
Number:
RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptableZ lyes I ruo
7. Are credit card payments acceptableZ EYes I ruo
Lonestar Municipal Equipment, LLC
rr"+r*y ^,"r*
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Proposal Forms COMIY/SVCS v,06.14.2018
t) /'z -/,1 ,'b;r-J ,/ # I), , .
Signature of Authorized Company Official
fugoart'
12007 Research Boulevard 'Austin, Texas 78759-2439 ' PH:800-695-2919 ' FAX: 800-21I-5454'buyboard.com
DrvrRrroru Rruo CouplrRruce
If your company intends to deviate from the General Terms and Conditions, Proposal Speciflcations or other reguirements
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 (V) one of the following:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Mini-Cam Mainline Portable Mini System (ltem B) - standard delivery is21
days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1, Shipping Via: I Common Carrier I Company Truck E Prepaid and Add to Invoice E Other:
2. Payment Terms: E t"let 30 days I t.zo in 10/Net 30 days I other:
3. Number of Days for Delivery: 21 o*o
Mini-Cam l\ilainline Portable N.4ini SVStem (ltem 8)
4. Vendor Reference/Quote Number:
RETURNS ARE NOT AVAILABLE UPON PRODUCT5. State your return policy:
APPROVAL AN D ACCEPTANCE
6. Are electronic payments acceptable? IYes I tlo
7. Are credit card payments acceptableZ Eyes f ruo
Lonestar Municipal Equipment, LLC
CoFpeny Name
Paul E. Folker. Jr.
Printed Name
Page 17 of 63
Signature of Authorized
ProDosal Forms CO14M/SVCS v.06. 14.2018
fuaoard'
12007 Research Boulevard'Austin, Texas78759-2439'PH: 800-695-2919'FAX: 800-211-5454'hUylSdld.gg1[
Drvrnrron nno Couplrnrucr
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 (V) one of the followinq:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Visual lmaging Resources - Portable Video Inspection Cameras (ltem 9) -
standard delivery is 21 days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1, Shipping Via: I Common Carrier f, Company Truck E Prepaid and Add to Invoice E Other:
2. Payment rerms: E t"tet 30 days I tv. in 10/Net 30 days I other:
3. Number of Days for Delivery: 21 o*o
Vlsual lmaging Resources - Podable Vdeo Inspecl on Cameras (ltem 9)
4, Vendor Reference/Quote Number:
q qf'fa,n,,r rpr, rn nnri^,. RETURNS ARE NOT AVAILABLE UPON PRODUCT[t v
APPROVAL AND ACCEPTANCE
6, Are electronic payments acceptable? Iyes I f'lo
7. Are credit card payments acceptablez EYes I ruo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Signature of Authorized Com
Prooosal Forms COIYM/SVCS v.06. 14.2018
fuBoard'
12007 Research Boulevard 'Austin, Texas 78759-2439' PH:800-695-2919 ' FAX: 800-211-5454'Lruvi:oard.com
Drvtartoru Rno CouptrRncr
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 (V) one of the foilowinq:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Mini-Cam Lateral and Mainline Sewer Inspection Systems (ltem 10) - standard
delivery is 21 days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: n Common Carrier I CompanyTruck E Prepaid and Add to Invoice E other:
2. Payment Terms: E trtet 30 days I l,vo in 1O/Net 30 days I other:
3, Number of Days for Delivery: 21 o*o
Mn-Aam Laleral andManlne Sewer nspecron SVilems illem 101
4. Vendor Reference/Quote Number:
RETURNS ARE NOT AVAILABLE UPON PRODUCT5. State your return policy:
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptableZ Iyes n ruo
7. Are credit card payments acceptableZ EYes I t'lo
Lonestar Municipal Equipment, LLC
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
#
Signature of nutfrorizeO'
Prooosal Forms COIVNl/SVCS v.06. 14.2018
fuaoard'
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH:800-695-2919 ' FAX: 800-21L-5454 'buvboard.com
D evtlrro ru Rru o Coptpl-tRncr
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 (V) one of the following:
I No; Deviations
E Y€S; Deviations
List and fully explain any deviations you are submitting:
Mini-Cam Trailer Mount TV Sewer Inspection System (ltem 11)- standard
delivery is 4-6 weeks after receipt of trailer from manufacturer
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: I Common Carrier I Company Truck f prepaid and Add to Invoice E Other:
2. Payment Terms: E trtet 30 days I tozo in 10/Net 30 days I Other:
3. Number of Days for Delivery: 28'42 ARo
4. Vendor Reference/Quote Number Mrntscam rra er Mounr rv sewer nspecfon svstem ( tem r l)
5. state your return poricy: RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AN D ACCEPTANCE
6. Are electronic payments acceptable? Iyes tr ruo
7. Are credit card payments acceptableZ Eyes I f'lo
Lonestar Municipal Equipment, LLC
Cor'npany Name
,.'Yl
i. j._o ''*,t-.L.,Paul E. Folker. Jr.i a*e41 ,./ v,'v,
.
Signature of Authorized Company Official Printed Name
Page 17 of 63
Proposal Forms COMlvl/SVCS v,06, 14, 2018
fu,Board'
12007 Research Boulevard 'Austin, Texas 78759-2439 ' PH 800-695-2919 ' FAX: 800-211-5454'buvboard.com
D rvrRrroN Rlrr o CoMpLrRNcr
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 anv
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 (V) one of the followinq:
I No; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Mini-Cam Truck Mount TV Sewer Inspection System (ltem 11)- standard
delivery is 4-6 weeks after receipt of trailer from manufacturer
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. shipping Via: n Common Carrier ! Company Truck E Prepaid and Add to Invoice E Otfrer:
2. Payment Terms: E tlet 30 days J wo in 10/Net 30 days n other:
3. Number of Days for Delivery: 28-42 ARo
4. Vendor Reference/Quote Number:
M n Cam Truck lvlount TV Sewer lnspect on System (llem 1 1 )
5. state your return poricy: RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AN D ACCEPTANCE
6. Are electronic payments acceptable? Iyes f ruo
7. Are credit card payments acceptableZ EYes I ruo
Lonestar Municipal Equipment, LLC
Comeany Name
-,,1-^-. Y -*i),u, Paul E. Folker, Jr.
Signature of Authorized Company Official Printed Name
Page 17 of 63
ProDosal Forms COMlvl/SVCS v.06. 14.2018
fupoart'
12007 Research Boulevard ' Austin, Texas 78759-2439 ' pH: g00-695-2919 . FAX: g00-21 r-54s4 ,
DrvrnrroN nNo CoMpLrRNce
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 anydeviations 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 complywith 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 (y') one of the followingi
f No; Deviations
E YeS; Deviations
List and fully explain any deviations you are submitting:
Pipe Logix - Pipeline Condition Assessment Software (ltem 14) - standard
delivery is 21 days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: I Common Carrier ! Company Truck f, Prepaid and Add to Invoice E Other:
2. Payment Terms: E ruet 30 days f tvo in 10/Net 30 days n other:
3. Number of Days for Delivery: 21 o*o
4. Vendor Reference/Quote Number:
Pioe I og x - P'oer,'e Co1dil on Assessrel! SofMa e (ltem 14,
5. State your return policy:RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptableZ IYes f] trto
7. Are credit card payments acceptableZ Eyes I ruo
Lonestar Municipal Equipment, LLC
Comp.n.y Nam"
Paul E. Folker. Jr.
Printed Name
Page 17 of 63
ProDosal Forms COM14/SVCS v.06. 14.2018
fuBoard'
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH: 800-695-2919 ' FAX: 800-211-5454 'buyboard,Com
DrvrRrroru Rno Coptplrnrucr
If your company intends to deviate from the General Terms and Conditions, Proposal Specifications or other requirements
associatr:d 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 anv 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
reseryes the right to accept or reject a proposal based upon any submitted deviation,
Please check (V) one of the following:
I NO; Deviations
E Y€s; Deviations
List and fully explain any deviations you are submitting:
Mini-Cam Profiling Systems (ltem 17) - standard delivery is 21 days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipp,ing Via: I Common Carrier E Company Truck E Prepaid and Add to Invoice E Other:
2. Payment Terms: E t',let 30 days ! tolo in 10/Net 30 days n other:
3, Numtrer of Days for Delivery: 21 o*o
4. Vendor Reference/Quote Numbel Mini-cam Profiling systems (ltem 17)
RETURNS ARE NOT AVAILABLE UPON PRODUCT5. State your return policy:
APPROVAL AN D ACCEPTANCE
6. Are erlectronic payments acceptable? Iyes E ruo
7. Are credit card payments acceptableZ Eyes I t'lo
Lones;tar Municipal Equipment, LLC
Conpqny Name
Signature of Authorized Company OfRclat Printed Name
) *-i H tln,r, .' Paul E. Folker, Jr.
Page 17 of 63
ProDosal Forms COMltl/SVCS v,06, 14. 2018
fuBoard=
12007 Research Boutevard . Austin, Texas 78759-2439 ' PH: 800-695-2919 ' Ftt(: 800-211-5454 ' buyboard'com
Devrnrron lno CoPtPltnrucr
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 Speciflcations 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 (/) one of the followinq:
I NO; Deviations
E Yes; Deviations
List and fully explain any deviations you are submitting:
Mini-Cam All Other Sewer Inspection Systems (ltem 1B) - standard delivery
is 21 days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
1. Shipping Via: E Common Carrier f, Company Truck E Prepaid and Add to Invoice E Other:
2. Payment Terms: E ruet 30 days I ry" in 10/Net 30 days I other:
a.l
3. Number of Days for Delivery: z I ARO
N4ini-Cam A Other Sewef lnspection Systems (ltem 1B)
4. Vendor Reference/Quote Number:
RETURNS ARE NOT AVAILABLE UPON PRODUCT
5. State your return PolicY:
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptable? Iyes I ruo
7. Are credit card payments acceptable? Eyes E ttto
Lonestar Municipal EquiPment, LLC
Co*pqny N€me
' --?- i-.{
, /*s " 'z-' ., n
Signature df Authorized Company'Offi cial
Paul E. Folker, Jr.
Printed Name
Page 17 of 63
Prooosal Forms C0l'4M/SVCS v,06, 14, 2018
fuB-oard'
12007 Research Boulevard ' Austin, Texas 78759-2439 ' PH:800-695-2919 ' FAX: 800-211-5454 ' buvboard.com
D rvrRrro N Rtrt o Cotvr plrnNce
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 (V) one of the following:
I NO; Deviations
E YeS; Deviations
List and fully explain any deviations you are submitting:
Mini-Cam Repair & Replacement Parts (ltem 19) - standard delivery is 21
days ARO
PLEASE PROVIDE THE FOLLOWING INFORMATION:
l.ShippingVia: ICommonCarrier !CompanyTruck IPrepaidandAddtolnvoice EOther:
2. Payment Terms: E ruet 30 days f] tyo in 10/Net 30 days I other:
3. Number of Days for Delivery: 21 o*o
4. Vendor Reference/Quote
5. State your return policy:
. Mini-Cam Repair & Replacement Parts (ltem 19)
Number:
RETURNS ARE NOT AVAILABLE UPON PRODUCT
APPROVAL AND ACCEPTANCE
6. Are electronic payments acceptable? IVes I tlo
7. Are credit card payments acceptableZ EYes I t'lo
Lonestar Municipal Equipment, LLC
Corpany Name
1 *,,'t i Paul E. Folker. Jr..a i."*'. *.* ''it't,'b.1t.,,-, o , I qul L' I
Signature of Authorized CompanyaOfficial Printed Name
Page 17 of 63
Prooosal Forms COMI4/SVCS v.06. 14.2018
12007 Research Boulevard • Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard.com
LOCATION /A U THORIZE D 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 be 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 form.
Company Name
Address
City State Zip
Phone Number Fax Number
Contact Person
Company Name
Address
City State Zip
Phone Number Fax Number
Contact Person
Page 18 of 63 Proposal Forms COMM/SVCS v.06.14.2018
/iJJ!'l!!!..1!'!.J!®
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.
N/A
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 Official
Page 19 of 63 Proposal Forms COMM/SVCS v.06.14.2018
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 appl/es In the space provided at the end of this form. By designating a region or regions, you are certifying that you are authorized and w//1/ng to provide the proposed products and services In those regions. Designating regions In which you are either unable or unw//1/ng to provide the specified products and services shall be grounds for either rejection of your proposal or, awarded, termination of your Contract. Additio nally, 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
statewide.
I will not service Texas
Cooperative members
statewide. I will only
service members in the
regions checked below:
Region Headguarters
Edinburg
Corpus Christi
3 Victoria
Houston
Beaumont
Huntsville
Kilgore
Mount Pleasant
Wichita Falls
Richardson
11 Fort Worth
Waco
13 Austin
Abilene
San Angelo
Amarillo
Lubbock
Midland
El Paso
San Antonio
Paul E. Folker, Jr. I will not service members
Printed Na me of the Texas Cooperative.
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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 applles In the space provided at the end of this form. By
designating a state or states, you are certifying that you are authorized and wllllng to provide the proposed
products and services In those states. Designating states In which you are either unable or unwllllng to
provide the specified products and services shall be grounds for either refection of your proposal or, If
awarded, termination of your Contract.
Please check (y) 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
Arizona
Arkansas
California (Public Contract Code 20118 & 20652)
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Page 22 of 63
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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NATIONAL PURCHASING COOP ERATIVE VENDOR AWARD AGREEMENT
In accordance with the Terms and Conditions associated with this Proposal Invitation, a contract awarded under this
Proposal Invitation may be "piggy-backed" by another governmental entity. The National Purchasing Cooperative is an
intergovernmental purchasing cooperative formed by certain school districts outside of Texas to serve its members
throughout the United States. If you agree to be considered for a piggy-back award by the National Purchasing
Cooperative, you agree to the following terms and agree to serve National Purchasing Cooperative members in the states
you have indicated on the State Service Designation form, in your Proposal.
By signing this form, Proposer (referred to in this Agreement as "Vendor") agrees as follows:
1. Vendor acknowledges that if The Local Government Purchasing Cooperative ("Texas Cooperative") awards Vendor a
contract under this Proposal Invitation ("Underlying Award''), the National Purchasing Cooperative ("National Cooperative")
may -but is not required to -"piggy-back" on or re-award all or a portion of that Underlying Award ("Piggy-Back Award'').
By signing this National Cooperative Vendor Award Agreement ("Agreement"), Vendor accepts and agrees to be bound by
any such Piggy-Back Award as provided for herein.
2. In the event National Cooperative awards Vendor a Piggy-Back Award, the National Cooperative Administrator
("BuyBoard Administrator") will notify Vendor in writing of such Piggy-Back Award, which award shall commence on the
effective date stated in the Notice and end on the expiration date of the Underlying Award, subject to annual renewals as
authorized in writing by the BuyBoard Administrator. Vendor agrees that no further signature or other action is required of
Vendor in order for the Piggy-Back Award and this Agreement to be binding upon Vendor. Vendor further agrees that no
interlineations or changes to this Agreement by Vendor will be binding on National Cooperative, unless such changes are
agreed to by its BuyBoard Administrator in writing.
3. Vendor agrees that it shall offer its goods and services to National Cooperative members at the same unit pricing and
same general terms and conditions, subject to applicable state laws in the state of purchase, as required by the Underlying
Award. However, nothing in this Agreement prevents Vendor from offering National Cooperative members better (i.e.,
lower) competitive pricing and more favorable terms and conditions than those in the Underlying Award.
4. Vendor hereby agrees and confirms that it will serve those states it has designated on the State Service Designation
Form of this Proposal Invitation. Any changes to the states designated on the State Service Designation Form must be
approved in writing by the BuyBoard Administrator.
5. Vendor agrees to pay National Cooperative the service fee provided for in the Underlying Award based on the amount of
purchases generated from National Cooperative members through the Piggy-Back Award. Vendor shall remit payment to
National Cooperative on such schedule as it specifies (which shall not be more often than monthly). Further, upon
request, Vendor shall provide National Cooperative with copies of all purchase orders generated from National Cooperative
members for purposes of reviewing and verifying purchase activity. Vendor further agrees that National Cooperative shall
have the right, upon reasonable written notice, to review Vendor's records pertaining to purchases made by National
Cooperative members in order to verify the accuracy of service fees.
6. Vendor agrees that the Underlying Award, including its General Terms and Conditions, are adopted by reference to the
fullest extent such provisions can reasonably apply to the post-proposal/contract award phase. The rights and
responsibilities that would ordinarily inure to the Texas Cooperative pursuant to the Underlying Award shall inure to
National Cooperative; and, conversely, the rights and responsibilities that would ordinarily inure to Vendor in the Underlying
Award shall inure to Vendor in this Agreement. Vendor recognizes and agrees that Vendor and National Cooperative are the
only parties to this Agreement, and that nothing in this Agreement has application to other third parties, including the
Texas Cooperative. In the event of conflict between this Agreement and the terms of the Underlying Award, the terms of
this Agreement shall control, and then only to the extent necessary to reconcile the conflict.
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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.
Proposal Invitation Number
Paul E. Folker, Jr.
Printed Name of Authorized Company Official
01/21/2019
Date
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FEDERAL AND STATE/ PURCH ASING 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: $ 2,753 ,10 .88 • (The period of the 12
month period is 0 1120 18 / 1 212018 ). 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? IF YES, LIST YEARS COMMODITY
GROUP (Y/N) AS VENDOR CATEGORY(IES)
1.Federal General Services Administration N
2. T-PASS (State ofTexas)N
3. U.S. Communities Purchasing Alliance N
4. National IPA/fCPN N
5. Houston-Galveston Area Council (HGAC)N
6.National Joint Powers Alliance (NJPA)N
7.E&I Cooperative N
8.The Interlocal Purchasing System (TIPS)N
9.Other N
Ii] 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 (%):_N_tA _________ _ Proposed Di scou nt (%): __________ _
Explanation: _N_tA _____________________________________ _
As the authorized GapVax dealer in North Texas we sold over $2.7 million through their Buy Board contract and $330,270 through their HGAC contract
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By signature below, I certify that the above is true, com plete and accurate and that I am authorized by my company to
make this certification.
Company Name
Printed Name
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GOVERNMENTAL REFE RENCES
For your Proposal to be considered, you must supply a minimum of five (5) indiv idual 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 additi onal pages if necessary.
Entity Name
1.City of Fort Worth
Contact
Robert Dannewitz
Phone# Email Add ress Discount
Qua ntity/
Volume
(8 17) 851 -4474 robert.dannewitz@fortworthte xas.gov 3-5% $47 ,625 .55
2 _ City of Arl ington Angelo DuPont (8 17) 459-59 13 Angelo.Du pont@arlingtontx.gov 3-5% $1 ,037,41 1.62
3 _ City of Grapevine James Tuttl e (81 7) 41 0-3343 jtuttle@grapevinetexas.gov 3-5% $230,51 0.95
4 _ City of Pflugerville Max Walther (51 2) 990-6408 maxw@ pfl ugervilletx .gov 3-5% $370,626
5 _ City of Coppell Billy Williams (972) 462-5 161 bw illiams@coppelltx .gov 3-5% $297 ,302.80
Do you ever modify your written policies or standard governmental sales practices as identified in the above chart to give
better discounts (lower prices) than indicated? YES D NO Ii] If YES, please explain:
By signature below, I certify that the above is true and correct and that I am authorized by my company to make this
certification.
Lonestar Municipal Equipment, LLC Co�ny Name
s;gng fiho &�fficial
Paul E. Folker, Jr.
Printed Name
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MAR KETING STRATEGY
For your Proposal to be considered, '{OU must submit the Marketing Strateg'{ '{OU will use if the Coo12erative acce12ts all or
part of '{Our ProJ:Josal. {Example:-Ex12.laih how 111;O1.ffe cOmpilnY wilt /fiitialjy inform Goq/2@.ra tive m�m/5ers of.;'J(.our 'Bu 'ifoaril
jgntract, and.how ypu will'con tinue to •su _,12Q fNh e !l.J!@.@ r:ri. f..q !i_ th.fLcf.lJ!.i!.ti.PD Qf th e1 con tract1 �/Qfi.,)
Attach additional pages if necessary.
Lon estar Mun icipal Eq uipment, LLC wi ll ma rket our BuyBoard contract th roug h
daily in-person sales ca lls, pa rtici pation in the TM L Show, parti cipation in Texas
Water Util ity As sociation Show, th rough phone ca lls, and through emails. We also
wi ll prou dly display the "B uyBoard Ve ndor" signs at all trade shows .
Lon esta r Municipal Equipment, LLC
Company Name
Pa ul E. Fol ker, Jr.
Printed Name
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CONFIDENTIAL/ PROPRIETARY INFORMATION
A. Public Disclos ure 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?
Please check (y') one of the foll owing:
NO, I certify that none of the information included with this Proposal is considered confidential or propr ietary.
YES, I certify that this Proposal contains information considered confi dential or proprietary and all such information is
specifically identified on this fo rm.
If you responded "YES", you must identify below the specific information you con sider 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:
(A tta ch additional sh eets if needed.)
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B. Copyright Informat ion
Does your Proposal (including fo rms, documentation, or other materials su bmitted with the Proposal) contain copyright
information?
YES,
If you responded "YES", identify below the specific documents or pages containing copyri ght information.
Copyright Information :-----------------------------------
(A ttach additio nal sheets if needed)
C. Consent to Release Confidential/Proprietaty/Copyright Information to BuyBoard Members
BuyBoard members (Cooperative and nonp rofit mem bers) seeking to make purchases through the BuyBoard may wish to
view information incl uded in the Proposa ls of awarded Vendors. If you identified information on this form as confidential,
proprieta ry, 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 mem bers, including posting of such
info rmation on the secure BuyBoard website for mem bers. Note: Neither the Cooperative nor its Admi nistrator will be
responsible for the use or distribution of info rmation by BuyBoard members or any other party.
D. Consent to Release Proposal Tabulation
Notwithstanding anything in this Confidential/Proprietary Information fo rm to the contra ry, by subm itting a Proposa l,
Vendor consents and ag rees that, upon Contract award, the Cooperative may publically release, including posti ng on the
public BuyBoard website, a copy of the proposal tabulation for the Contract including Vendor name; proposed
cata log/pricelist name(s); proposed percentage discount(s), hourly labor rate(s), or other specified pricing; and Vendor
award or non-award information.
By sig nature below, I certify that the info rmation in this form is true, com plete, and accurate and that I am authorized by
my company to make this certification and all consents and agreements conta ined herei n.
Pri nted Name
Date
Proposal Forms COMM/SVCS v.06.14.2018
ASSUMED �AME CERTI FI CATE
FOR AN UNINCORPORATED BUSINESS OR PROFESS ION
(PRINT OR TYPE)
Lonesta r Municipa l Equipment
1 3233 Aly ssu m Drive
Fort Worth Texas
10 Years
Lim ited Liability Company
CERTIF ICATE OF OWN ERSHIP
13233 Alyssum Drive, Fort Worth, TX
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12007 Research Boulevard • Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard .com
VENDOR BUSI NESS NAME By submitting a Proposa l, 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:
(List the k1Ja1 name of the company seeking to con tra ct with the Cooperative. Do !:!QI lis t an assumed name, dba, aka, etc. here. Such inform ation may
be pro vide d below. If you are submitting a join t proposal with another entity to pro vide the same proposed goods or services, each subm itting entity
should complete a separate vendor inform ation fo rm. Sep arately opera ting legal business en tities, even if affilia ted entities, which propose to pro vide
goods or services separately must submit their own Proposals.)
Please check C:v'.l one of the foHow inq:
Type of Business: Individual/Sole Propri etor Corporation Li mited Liability Company Partnership X Other If other, identify __________ _
State of Incorporation (if applicable): _T_e _x_a s _________ _
Federal Employer Identifi cation Number: _8 _1 _-4_5_4 _6 _5 _5 _4 ______ _
(Vendor must include a comple ted rpg;:iif/-9 fo rm with their proposal) List the Name(s) by which Vendor, if awarded, wishes to be identified on the BuyBoard : (No te: If different than the Name of
Proposing Company listed above, only valid trade names (dba, aka, etc.) of th e Prop osing Comp any may be used and a copy of your Assumed Name
Certifica te(s), if applicable, must be attach ed.) Lonestar Municipal Equipment
Proposal Forms COMM /SVCS v.06.14.2018 Page 32 of 63
Request for Taxpayer Give Form to the
Identification Number and Certification requester. Do not
send to the IRS.
Lonestar Municipal Equipment, LLC
2
3 one 4
s ... u o ,g Note.
(Applies to accovnt.s maintained outside the U.S.)
13233 Alyssum Drive
Fort Worth, TX 76244
Taxpayer Identification Number (TIN)
or
Note.
81 -4546554
Certification
Certification instructions.
Sign Signature of Here U.S. person ► Date ►
General Instructions
Future developments.
Purpose of Form
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EDGAR VENDOR CERTIFICATI ON
(2 CFR Part 200 and Appendix II)
When a Cooperative member seeks to procure goods and services using funds under a federal grant or contract, specific
federal laws, regulations, and requirements may apply in addition to those under state law. This includes, but is not limited
to, the procurement standards of the Uniform Administrative Requirements, Cost Principles and Audit Requirements for
Federal Awards, 2 CFR 200 (sometimes referred to as the "Uniform Guidance" or new "EDGAR''). All Vendors submitting
proposals must complete this EDGAR Certification Form regarding Vendor's willingness and ability to comply with certain
requirements which may be applicable to specific Cooperative member purchases using federal grant funds. This
completed form will be made available to Cooperative members for their use while considering their purchasing options
when using federal grant funds. Cooperative members may also require Vendors to enter into ancillary agreements, in
addition to the BuyBoard contract's general terms and conditions, to address the member's specific contractual needs,
including contract requirements for a procurement using federal grants or contracts.
Fo r � of th e Items belo w, Ve ndor should cer tify Ve ndor's agreement and ab/1/ty to comply, where appllcable, by ha ving Ve ndor's authoriz ed represen ta ti ve complete and /n it/a l th e appllca ble boxes and sign th e ackn owledgment at th e end of this fo rm . If you fa ll to complete any Item In this fo rm, th e Coopera ti ve w/1I consider and may 11s t th e Ve ndor's response on th e BuyBoard as "NO," the Ve ndor Is una ble or un wllllng to comply. A "NO" response to any of the items may, if applicable, impact the ability of a Cooperative member to
purchase from the Vendor using federal funds.
1.Vendor Violati on or Breach of Contract Terms:
Contracts for more than the simplified acquisition threshold currently set at $150,000, which is the inflation adjusted
amount determined by the Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council (Councils)
as authorized by 41 USC 1908, must address administrative, contractual, or legal remedies in instances where contractors
violate or breach contract terms, and provide for such sanctions and penalties as appropriate.
Provisions regarding Vendor default are included in the BuyBoard General Terms and Conditions, including Section E.18,
Remedies for Default and Termination of Contract. Any Contract award will be subject to such BuyBoard General Te rms
and Conditions, as well as any additional terms and conditions in any Purchase Order, Cooperative member ancillary
contract, or Member Construction Contract agreed upon by Vendor and the Cooperative member which must be consistent
with and protect the Cooperative member at least to the same extent as the BuyBoard Terms and Conditions.
The remedies under the Contract are in addition to any other remedies that may be available under law or in equity. By
submitting a Proposal, you agree to these Vendor violation and breach of contract terms.
2.Termination for Cause or Convenience:
For any Cooperative member purchase or contract in excess of $10,000 made using federal funds, you agree that the
following term and condition shall apply:
"llle Cooperative member may terminate or cancel any purchase orde r under this Cont ract at any time, wi th or wi thout
cause, by providing seven (7) business days adva nce written notice to the Ve ndo r. If this Agreement is terminated in
accordance wi th this Pa ragraph, the Cooperative member shall only be required to pay Ve ndo r for goods or services
de li vered to the Cooperative member prior to the termination and not ot herwi se return ed in accordance wi th Ve ndor's
return policy. If the Cooperati ve member has paid Ve ndo r for goods or services not yet provided as of the da te of
termination, Ve ndo r shall immediately refund such payment(s).
If an alternate provision for termination of a Cooperative member purchase for cause and convenience, including the
manner by which it will be effected and the basis for settlement, is included in the Cooperative member's purchase order,
ancillary agreement, or Member Construction Contract agreed to by the Vendor, the Cooperative member's provision shall
control.
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3.Equal Employment Opportunity:
Except as otherwise provided under 41 CFR Part 60, all Cooperative member purchases or contracts that meet the
definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 shall be deemed to include the equal
opportu nity clause provided under 41 CFR 60-1 .4(b), in accordance with Executive Order 11246, "Equal Employment
Opportunity" (30 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375,
"Am ending Executive Order 11246 Relating to Equal Employment Opportunity," and impleme nting regulations at 41 CFR
Part 60, "Office of Federal Contract Compliance Programs, Equal Employment Opportunity, Department of Labor."
The equal opportunity clause provided under 41 CFR 60-1.4(b) is hereby incorporated by reference. Vendor agrees that
such provision applies to any Cooperative member purchase or contract that meets the de finition of "federally assisted
construction contract" in 41 CFR Part 60-1.3 and Vendor ag rees that it shall comply with such pr ovision.
4.Davis-Bacon Act:
When required by Federal program legislation, Vendor agrees that, for all Cooperative member prime construction
contracts/purchases in excess of $2,000, Vendor shall comply with the Davis-Bacon Act (40 USC 3141-3 144, and 3146-
3148) as supplemented by Department of Labor regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to
Contracts Coveri ng Federally Fi nanced and Assisted Construction"). In accordance with the statute, Vendor is required to
pay wages to laborers and mechanics at a rate not less than the prevailing wages specified in a wage determinate made by
the Secretary of Labor. In addition, Vendor shall pay wages not less than once a week.
Current pre vailing wage determ inations issued by the Department of Labor are available at wdol.gov. Vendor agrees that,
for any purchase to which this requirement applies, the award of the purchase to the Vendor is conditioned upon Vendor's
acceptance of the wage determination.
Vendor further agrees that it shall also comply with the Copeland "Anti-Kickback" Act (40 USC 3145), as supplemented by
Department of Labor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building or Public Work
Financed in Whole or in Part by Loans or Grants from the United States''). The Act provides that each contractor or
subrecipient must be prohibited from inducing, by any means, any person employed in the construction, comple tion, or
repair of pu blic work, to give up any part of the compensation to which he or she is otherwise entitled.
5.Contract Work Hours and Safety Standards Act:
Where applicable, for all Cooperative member contracts or purchases in excess of $100,000 that involve the employment of
mechanics or laborers, Vendor agrees to comply with 40 USC 3702 and 3704, as supplemented by Department of Labor
regulations (29 CFR Part 5). Under 40 USC 3702 of the Act, Vendor is required to compute the wages of every mechanic
and laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible
provided that the worker is compensated at a rate of not less than one and a half times the basic rate of pay for all hours
worked in excess of 40 hours in the work week. The requirements of 40 USC 3704 are applicable to construction work and
provide that no laborer or mechanic must be required to work in surroundings or under worki ng conditions which are
unsanitary, hazardous or dangerous. These requirements do not apply to the purchases of supplies or materials or articles
ordinarily available on the open market, or con tracts for transportation or transmission of intelligence.
6.Right to Inventions Made Under a Contract or Agreement :
If the Cooperat ive member's Federal award meets the definition of "funding agreement" under 37 CFR 401.2(a) and the
reci pient or subrecipient wishes to enter into a contract with a small business firm or no nprofit organizat ion regard ing the
substitution of parties, ass ignment or performance or experimental, developmental, or research work under that "funding
agreeme nt," the re cipient or subrecipient must comply with the requirements of 37 CFR Part 401, "Rights to Inventions
Made by Nonprofit Organ izations and Small Business Firms Under Government Grants, Contracts and Cooperative
Agreements," and any implementing regulations issued by the award ing agency.
Vendor agrees to comply with the above requirements when applicable.
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12007 Research Boulevard • Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-211-5454 • buyboard .com
7. Clean Air Act and Federal Water Pollution Control Act: Clean Air Act (42 USC 7401-767 1q.) and the Federal Water Pol lution Control Act (33 USC 1251-1387), as amended -Contracts and subgrants of amounts in excess of $150,000 must contain a provision that requires the non-Federal award to agree to comply with all applicable sta ndards, orders, or regulations issued pursuant to the Clean Air Act (42 USC 7401-76 71q.) and the Federal Water Pollution Control Act, as amended (33 USC 1251-1387). Violations must be reported to the Federal awarding agency and the Regional Office of the Environmental Protection Agency (EPA). When req uired, Vendor agrees to comply with all applicable sta ndards, orders, or regulations issued pursuant to the Clean Air Act and the Federal Water Pollution Control Act.
8. Debarment and Suspension: Debarment and Suspension (Executive Orders 12549 and 12689) -A contract award (see 2 CFR 180.220) must not be made to parties listed on the govern ment-wide excl usions in the System for Award Management (SAM), in accordance with the 0MB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR Part 1966 Comp. p. 189) and 12689 (3 CFR Part 1989 Comp. p. 235), "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared ineligible under statutory or regulatory authority other than Executive Order 12549. Vendor certifies that Vendor is not currently listed on the government-wide excl usions in SAM, is not debarred, suspended, or otherwise ex cluded by agencies or declared ineligible under sta tutory or reg ulatory authority other than Executive Order 12549. Vendor further agrees to immediately notify the Cooperative and all Cooperative mem bers with pend ing purchases or seeking to purchase fro m Vendor if Vendor is later listed on the government-wide excl usions in SAM, or is debarred, suspended, or otherwise excl uded by agencies or declared ineligible under statutory or reg ulatory authority other than Executive Order 12549.
9. Byrd Anti-Lobbying Amendment: Byrd Anti-Lobbying Amendment (31 USC 1352) --Vendors that apply or bid for an award exceeding $100,000 must file the req uired certifi cation. Each tier certifies to the tier above that it will not and has not used Federal appropri ated fu nds to pay any person or organization for influencing or attempting to influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee of a member of Cong ress in connection with obtaining any Federal contract, grant or any other award covered by 31 USC 1352. Each tier must also disclose any lobbying with nonFederal funds that takes place in connecti on with obta ining any Federal award. Such disclosures are forwa rded from tier to tier up to the non-Federal award. As applicable, Vendor agrees to file all certifications and disclosures re quired by, and otherwise comply with, the Byrd Anti-Lobbying Amendment (31 USC 1352).
10. Procurement of Recovered Materials: For Cooperative member purchases utilizing Federal funds, Vendor agrees to comply with Section 6002 of the Solid Waste Disposal Act, as amended by the Resou rce Conservation and Recovery Act where appl icable and provide such information and certifi cations as a Cooperative member may require to confirm esti mates and otherwise comply. The req uirem ents of Section 6002 include procu ring only items desig nated in guideli nes of the Environmental Protection Agency (EPA) at 40 CFR Pa rt 247 that contain the hig hest percentage of recovered materials practica ble, consistent with maintaining a satisfa ctory level of competiti on, where the purchase price of the item exceeds $10,000 or the value of the qua ntity acquired during the preced ing fiscal year exceeded $10,000; procu ring solid waste management services in a manner that maxi m izes energy and resource recovery, and establishing an affirmative procurement prog ram for procurement of recove red materials identified in the EPA gu idel ines.
11. Profit as a Separate Element of Price: For purchases using fe deral funds in excess of $150,000, a Cooperative member may be req uired to negotiate profit as a separate element of the price. See, 2 CFR 200.323(b). When req uired by a Cooperative member, Vendor agrees to provide information and negotiate with the Cooperative member re garding profit as a separate element of the price for a particular purchase. However, Vendor agrees that the tota l price, including profit, cha rged by Vendor to the Cooperative member shall not exceed the awarded pricing, including any applicable discount, under Vendor's Cooperative Contract.
Proposal Forms COMM/SVCS v.06.14.2018 Page 35 of 63
12007 Research Boulevard • Austi n, 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 foregoi ng specific req uirements, Vendor agrees, in accepti ng any Purchase Order from a Cooperative member, it shall make a good fa ith effort to work with Co operative 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 reco rd keepi ng and record retention requirements. ,ve~OQ�egjfl!;;;atiQn :
¥E�, '1,�!Qt.® Oli
I �v.enclorJ...Cii:elitiflaitton1•lte m No. I NO,J clo N0ill aar.ee ;Ihitial L
1. Vendor Violation or Breach of Contract Te rms
2. Te rmination for Cause or Convenience Equal Employment Opportun ity Davis-Bacon Act Contract Work Hours and Safety Standards Act Right to Inventions Made Under a Contract or Agreement
7. Clean Air Act and Federal Water Pollution Control Act Debarment and Suspension
9. Byrd Anti-Lobbyi ng Amendment
10. Procu rement of Recovered Materials
11. Profit as a Separate Element of Price
12. General Compliance and Cooperation with Cooperative Members
By sig nature below, I certify that the information in this fo rm is true, complete, and accurate and that I am authorized by my company to make this certifi cation and all consents and agreements contained herein. C�panl}Name Signature of Authorized CompanyDI Pri nted Name
Proposal Forms COMM/SVCS v.06.14.2018 Page 36 of 63
12007 Research Boulevard • Austin, Texas 78759-2439 · PH: 800-695-2919 • FAX: 800-2 11-5454 • buyboard.com
PROPOSAL INVITATION QU ESTIONNAIRE
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, num bering your responses to correspond to
the questions/numbers below. Proposers must complete below or attach your responses to this questio nnaire, 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.
LME has been in busi ness fo r 2 ye ars and 1 month , si nce December 1, 201 6
LME is not fo r sale, nor is it involved in any transacti ons that wo uld
sig nifi cantly alte r its business or re sult in acq uisition by anoth er entity.
2. Describe the resources Proposer has to manage staff and successfully perform the Work contemplated under this
Contract. State the number and sum marize 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.
As a distri butor of prod ucts manufactu red by ot her co mpanies, LME
cu rrently exists as a fa mily-ru n co mpany co nsisti ng of my wife Jennifer and
myself and cu rrently employs no oth er personnel. I have over 20 years of
expe rience in municipal sewer sales and Jennifer has 10 years experience in administrati on.
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.
LME cu rrently has not been rated , nor has a bond been req uired . We
mainta in $2,000,000 in Com merci al General Liabil ity insurance. Paul E.
Fol ker, Jr., (minority owner) fi led a pers onal ban kru ptcy in the State of
Georg ia in June of 2011 .
Proposal Forms COM M/SVCS v.06.14.2018 Page 37 of 63
12007 Research Boulevard · Austin, Texas 78759-2439 · PH : 800-695-29 19 • FAX : 800-2 11-5454 • buyboa rd.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.
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.
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
Questio nnaire in response to the above questions is true and correct and that I am authorized by my
company to make this certification.
Company Name
s2�ho��n�clal
Proposal Forms COMM/SVCS v.06.14.2018 Page 38 of 63
12007 Research Boulevard · Austin, Texas 78759-2439 · PH: 800-695-2919 · FAX: 800-211-5454 ·buyboard.com
Proposal Forms COMM/SVCS v.06.14.2018
R EQUIRED F ORMS C HECKLIST
(3OHDVHFKHFN ¥ the following)
Completed: Proposer’s Agreement and Signature
Completed: Vendor Contact Information
Completed: Felony Conviction Disclosure and Debarment Certification
Completed: Resident/Nonresident Certification
Completed: No Israel Boycott Certification
Completed: No Excluded Nation or Foreign Terrorist Organization Certification
Completed: Historically Underutilized Business (HUB) Certification)
Completed: Construction Related Goods and Services Affirmation
Completed: Deviation/Compliance
Completed: Location/Authorized Seller Listings
Completed: Manufacturer Dealer Designation
Completed: Texas Regional Service Designation
Completed: State Service Designation
Completed: National Purchasing Cooperative Vendor Award Agreement
Completed: Federal and State/Purchasing Cooperative Experience
Completed: Governmental References
Completed: Marketing Strategy
Completed: Confidential/Proprietary Information
Completed: Vendor Business Name with IRS Form W-9
Completed: EDGAR Vendor Certification
Completed: Proposal Invitation Questionnaire
Completed: Required Forms Checklist
Completed: Proposal Specification Form with Catalogs/Pricelists *Catalogs/Pricelists must be submitted with proposal response or response will not be considered.
Page 39 of 63
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Proposal Invitation No. 593-19-Sewer Inspection and Cleaning Products(Catalogs/Pricelists must be submitted with Proposal or Proposal will not be considered¹.)PROPOSAL NOTE1. Catalogs/Pricelists are required to be submitted with ProposalPROPOSAL SPECIFICATION FORMItem No. Short Description Full DescriptionState Percent (%) of Discount off Catalog/Pricelist¹State Name of Catalog/Pricelist¹Exceptions to Discount1Discount (%) Off Catalog/Pricelist for Combination Sewer Cleaners, Single EngineDiscount (%) Off Catalog/Pricelist for Combination Sewer Cleaners, Single Engine, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%2Discount (%) Off Catalog/Pricelist for Combination Sewer Cleaners, Dual EngineDiscount (%) Off Catalog/Pricelist for Combination Sewer Cleaners, Dual Engine, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%3Discount (%) Off Catalog/Pricelist for Jetter UnitsDiscount (%) Off Catalog/Pricelist for Jetter Units, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%4Discount (%) Off Catalog/Pricelist for Trailer Jetter Units Discount (%) Off Catalog/Pricelist for Trailer Jetter Units, Attachments, Accessories and related products.Catalog/Pricelist MUST be included or proposal will not be considered.______________%NOTE: Vendors proposing various manufacturer product lines per line item on the Proposal Specification Form must submit the information as follows or proposal may not be considered: 0DQXIDFWXUHUVVKDOOEHOLVWHGLQDOSKDEHWLFDORUGHU 9HQGRU¶VPXVWOLVWRQHVSHFLILFSHUFHQWDJHGLVFRXQWIRUHDFK0DQXIDFWXUHUOLVWHGIf a vendor’s response to Proposal Specification Form states “please see attachment sheet,” all manufacturers listed on the attachment sheet must indicate per manufacturer the line item that correlates to Proposal Specification Form or Vendor’s proposal may not be considered.Section I: Sewer Cleaning Equipment, Products, and SuppliesPage 40 of 635Dyna-VacJV1000-2040Dyna-VacJVT500-20405Dyna-VacDJ6020 N/A5Dyna-Vac DJT2040Dyna-Vac DJT2040sDyna-Vac DJT4020Dyna-Vac DJT6520N/AN/A
Proposal Invitation No. 593-19-Sewer Inspection and Cleaning Products(Catalogs/Pricelists must be submitted with Proposal or Proposal will not be considered¹.)PROPOSAL NOTE1. Catalogs/Pricelists are required to be submitted with ProposalPROPOSAL SPECIFICATION FORMItem No. Short Description Full Description State Percent (%) of Discount off Catalog/Pricelist¹State Name of Catalog/Pricelist¹Exceptions to Discount5Discount (%) Off Catalog/Pricelist for Vacuum Excavation Equipment Discount (%) Off Catalog/Pricelist for Vacuum Excavation Equipment and related products.Catalog/Pricelist MUST be included or proposal will not be considered.______________%6Discount (%) Off Catalog/Pricelist for All Other Sewer Cleaning Equipment Discount (%) Off Catalog/Pricelist for All Other Sewer Cleaning Equipment, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%7Discount (%) Off Catalog/Pricelist for Portable Mini Sewer Inspection SystemsDiscount (%) Off Catalog/Pricelist for Portable Mini Sewer Inspection Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%8Discount (%) Off Catalog/Pricelist for Mainline Portable Mini Sewer Inspection Systems Discount (%) Off Catalog/Pricelist for Mainline Portable Mini Sewer Inspection Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%9Discount (%) Off Catalog/Pricelist for Portable Video Inspection CamerasDiscount (%) Off Catalog/Pricelist for Portable Video Inspection Cameras, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%10Discount (%) Off Catalog/Pricelist for Lateral and Mainline Sewer Inspection SystemsDiscount (%) Off Catalog/Pricelist for Lateral and Mainline Sewer Inspection Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%Section II: Sewer Inspection Equipment, Products and SuppliesPage 41 of 635Dyna-Vac HE800-536Dyna-VacHET500-536N/A5Please SeeAttachmentSheetN/A5Visual ImagingResources -Magnum M7N/A5Mini-CamMainlinePortable MiniSystemN/A5Visual ImagingResources -Portable VideoInspection CamerasN/A5Mini-Cam Lateraland MainlineSewer InspectionSystemsN/A
Proposal Invitation No. 593-19-Sewer Inspection and Cleaning Products(Catalogs/Pricelists must be submitted with Proposal or Proposal will not be considered¹.)PROPOSAL NOTE1. Catalogs/Pricelists are required to be submitted with ProposalPROPOSAL SPECIFICATION FORMItem No. Short Description Full DescriptionState Percent (%) of Discount off Catalog/Pricelist¹State Name of Catalog/Pricelist¹Exceptions to Discount11Discount (%) Off Catalog/Pricelist for Vehicle/Trailer Mounted TV Sewer Inspection and Rehabilitation SystemsDiscount (%) Off Catalog/Pricelist for Vehicle/Trailer Mounted TV Sewer Inspection and Rehabilitation Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%12Discount (%) Off Catalog/Pricelist for Cameras Discount (%) Off Catalog/Pricelist for Sewer Inspection Cameras, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%13Discount (%) Off Catalog/Pricelist for Camera Transporters Discount (%) Off Catalog/Pricelist for Sewer Inspection Camera Transporters, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%14Discount (%) Off Catalog/Pricelist for Pipeline Condition Assessment Software Discount (%) Off Catalog/Pricelist for Pipeline Condition Assessment Software and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%15Discount (%) Off Catalog/Pricelist for Lateral Reinstatement CuttersDiscount (%) Off Catalog/Pricelist for Lateral Reinstatement Cutters, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%16Discount (%) Off Catalog/Pricelist for Lateral Cleaning SystemsDiscount (%) Off Catalog/Pricelist for Lateral Cleaning Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%17Discount (%) Off Catalog/Pricelist for Profiling SystemsDiscount (%) Off Catalog/Pricelist for Profiling Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%Page 42 of 6355Pipe Logix -Pipeline ConditionAssessmentSoftwareN/A5Mini-CamProfilingSystemsN/AN/APlease SeeAttachmentSheet
Proposal Invitation No. 593-19-Sewer Inspection and Cleaning Products(Catalogs/Pricelists must be submitted with Proposal or Proposal will not be considered¹.)PROPOSAL NOTE1. Catalogs/Pricelists are required to be submitted with ProposalPROPOSAL SPECIFICATION FORMItem No. Short Description Full Description State Percent (%) of Discount off Catalog/Pricelist¹State Name of Catalog/Pricelist¹Exceptions to Discount18Discount (%) Off Catalog/Pricelist for All Other Sewer Inspection Systems Discount (%) Off Catalog/Pricelist for All Other Sewer Inspection Systems, Attachments, Accessories and related products. Catalog/Pricelist MUST be included or proposal will not be considered.______________%19Discount (%) Off Catalog/Pricelist for Repair/Replacement Parts for Sewer Cleaning and Inspection EquipmentDiscount (%) Off Catalog/Pricelist for Repair/Replacement Parts for Sewer Cleaning and Inspection Equipment. Catalog/Pricelist MUST be included or proposal will not be considered.______________%Not to Exceed Hourly Labor RateDetailed Information on Hourly Labor RateExceptions to Hourly Labor Rate20Not to Exceed Hourly Labor Rate for Installation/Repair Service of Sewer Cleaning, Inspection Products, Equipment and Related ItemsHourly Labor Rate for Installation/Repair Service of Sewer Cleaning, Inspection Products, Equipment and Related Items - State the Not to Exceed hourly labor rate for Installation/Repair Service of Equipment and Products.$ ___________/HourSection IV: Installation and Repair ServiceSection III: Repair and Replacement PartsPage 43 of 635Mini-Cam AllOther SewerInspectionSystems5Mini-CamRepair &ReplacementParts ForSewer Cleaningand InspectionEquipment120Shop rate, mustbe at LME shop.Field servicework NOTavailable.Pickup &deliveryavailable at$1.50/mile.N/AN/AN/A
Item Number
State Percent (%) of
Discount off
Catalog/Pricelist
State Name of
Catalog/Pricelist
Exceptions to
Discount
6 5%Dyna-Vac Rhino
Easement Machine N/A
6 5%Jetter Depot Nozzles N/A
6 5%MEC Equipment
Sewer Parts Pricing N/A
6 5%Sewer Pro Shop
Bluestar Nozzles N/A
6 5%Sonetics Pricelist N/A
Item # 6
Item Number
State Percent (%) of
Discount off
Catalog/Pricelist
State Name of
Catalog/Pricelist
Exceptions to
Discount
11 5%
Visual Imaging
Resources - Trailer
Mount TV Sewer
Inspection System
N/A
11 5%
Visual Imaging
Resources - Truck
Mount TV Sewer
Inspection System
N/A
Item # 11
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
FORM CIQ
OFFICE USE ONLY
Date Received
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who
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.
1 Name of vendor who has a business relationship with local governmental entity.
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.
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 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
6
Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts
as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).
7
Signature of vendor doing business with the governmental entity Date
ownership interest of one percent or more.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021
Exhibit C
Lonestar Municipal Equipment, LLC
N/A
Revised 1/1/2021Form provided by Texas Ethics Commission www.ethics.state.tx.us
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
A complete copy of Chapter 176 of the Local Government Code may be found at http://www.statutes.legis.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.