HomeMy WebLinkAboutContract 54866-CA1 CSC No. 54866-CAl
CITY OF FORT WORTH
ASSIGNMENT
For value, received Envirosuite Corp. ("Assignor"), hereby assigns to EMS Bruel &
Kjaer, Inc. ("Assignee"), all of its right, title and interest in and to any and all sums of money
now due or to become due from the City of Fort Worth to Assignor under CSCO 54866 (the
"Contracts") and Assignee agrees to assume and perform all duties and obligations required by
Assignor under the terms of the Contracts.
This Assignment constitutes the entire agreement between Assignor and Assignee with
respect to the subject matter hereof. No modification of any provision of this Assignment shall
be effective unless in writing and signed by Assignor and Assignee. This Assignment shall inure
to the benefit of and be binding upon Assignor and Assignee and their respective successors and
assigns. This Assignment shall be governed by the terms of the original Contracts between
Assignor and various other entities and the City of Fort Worth and the laws of the State of Texas,
without application of principles of conflicts of law.
This Assignment may be executed in one or more counterparts each of which shall be
deemed an original but all of which together shall constitute one and the same instrument.
Signed signature pages may be transmitted by facsimile or e-mail, and any such signature shall
have the same legal effect as an original.
Dated the 3 u day of 2022.
Envirosuite Corp.
(Assignor)
By: S C
Print: Gregory Bracci
Title: Vice President
EMS Bruel &Kjaer,Inc.
(Assignee)
By: J) L
Print: GregoryC Bracci
Title: Vice President
OFFICIAL RECORD
CITY SECRETARY
Assignment FT. WORTH, TX
NOTARY ACKNOWLEDGEMENT
On the *` day of _C-�yr�L 2022, personally appeared
ev-mccti , who acknowledged to me that (s)he is the Chief Operating Officer of
Envirosui e Corp. ("Assignor"), and that (s)he executed this document for the purposes and
consideration contained herein.
Envirosuite Corp.
By:
Print: Gregory t Bracci
Title: Vice President
SUBSCRIBED TO before me on this 3��~ day of v ,2022.
JASMINE BARNES
Notary Public,State of New York Notary Public in an for the State of Q aYk
Ontario County Reg.#01 BA6427007 My commission Expires: 121 2 o 125
Commission Expires 121201-Z
NOTARY ACKNOWLEDGEMENT
On the ��� day of <Iy 2022, personally appeared
Cceo,o� 4 �roc6. , who acknowledged to me that (s)he is the Chief Financial Officer of
EMS Bruel & Kjaer, Inc. ("Assignee"), and that (s)he executed this document for the purposes
and ccnrsi-deration contained herein.
EMS Bruel & Kjaer,Inc.
By: _ L
Print: Grego C.Bracci
Title: Vice President
SUBSCRIBED TO before me on this -6 day of ^-�- , 2022.
JASMINE BARNES
Notary Public, State of New York Notary Public ' and for the State of_ P.W k-
Ontario County Reg.#01 BA6427007 My commission Expires: t2 l 20' 25
Commission Expires 12/20/ 2s—
OFFICIAL RECORD
CITY SECRETARY
Assignment FT. WORTH, TX
CONSENT TO ASSIGNMENT
The City of Fort Worth consents to the assignment of Envirosuite Corp. ("Assignor") to
EMS Bruel & Kjaer, Inc.("Assignee"), of all its rights, title, and obligation owing and all funds
due or to become due to Assignor under CSCO 54866 as long as all terms required of Assignor
in said contracts are met by Assignee.
CITY OF FORT WORTH
Reginald (Jul 29,202214:01 CDT) Jul 29, 2022
Reginal Zeno- Interim Assistant City Manager Date
44��17 Jul 29, 2022
Anthony Rousseau, Assistant Director—FMS Date
4�F IF �d
ATTESTED BY: ��o� 00�A
.7GlblblG��G GDOG�GIGG 00=� Jul 29, 2022
Jannette S.Goodall(Jul 29,202214:17 CDT) �� O
Jannette Goodall, City Secretary �d000 00000�p� Date
a4
APPROVED AS TO FORM AND LEGALITY:
John B. Strong, Assistant City Attorney
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.
AL-, Jul 29, 2022
Richard Lisenbee(Jul29,2022 11:20 CDT)
Employee Signature/Date
Sr. Water IT Manager
Title
OFFICIAL RECORD
CITY SECRETARY
Assignment FT. WORTH, TX
envirosuite
July 22,2022
Tracy Walter
Business Process Analyst—Vendor Management
Purchasing Division
City of Fort Worth,Texas
Envirosuite Legal Entity Change
Dear Ms.Walter,
EMS Bruel&Kjaer appreciates the long-term partnership with City of Fortworth. This letter is to inform you
that our corporate entity name has changed from"Envirosuite Corp."to"EMS Bruel&Kjaer Inc.dba
Envirosuite Inc.".There is no change to employees/systems that the city utilizes daily. On behalf of the entire
EMS Bruel&Kjaer dba Envirosuite team we look forward to continuing our successful partnership.
Thank you for your assistance and please contact me directly with any questions you may have regarding
Envirosuite legal entity change at 404-432-3080 or erep.bracci@envirosuite.com.
Yours sincerely,
_)3 C_(� .
Gregory Bracci
Vice President-Americas
EMS Bruel&Kjaer Inc.dba Envirosuite Inc.
greg.bracci@envirosuite.com
(404)432-3080
FnviroquifP Inc.
2330 B Bidwell Street,Suite 210 www.envirosuite.00m
Folsom,CA 95630 Phone:916.265.7700
United States of America
Confidential Information
County of Sacramento Original Statement FILED with Sacramento County C!erk
Department of Finance Tax Collection and FBNF2020-03311 ENVIROSUITE INC.
Business License Unit COPY
700 H Street, Room 1710, Sacramento, CA 95814
Phone(916)874-6644 a fax(916)874-8909•www.finance.saccounty.n( FILED: 5/2.2/2020
Ex p Tres: 5/22/2025
FICTITIOUS BUSINESS _.
THIS IS NOT A BUSINESS LICENSE
TYPE OR PRINT CLEARLY— MUST BE LEGIBLE
INSTRUCTIONS ON REVERSE
WHEN FILING BY MAIL,PROVIDE SELF ADDRESSED STAMPED ENVELOPE. ALL INFORMATION IS PUBLIC RECORD
Street Address, City, State,Zip of Principal Place of Business. (P.O. Box or PMB not acceptable) County
"� L
O/�30 EqC4 5 W�.�� � ' S tJ i—f,L Zoo Fo15Ja�, C !_\ Ij(OJ�� J4G('aghe��0
2 Fictitious Business Names to be Filed (Section 17900 B&P Code)
(a) (b)
f�V1V ro v�� 1 A c If more than 2 names,attach additional sheet)
3 Full Name & Complete Residence Address of Each Business Owner (P.O.Box or PMB not acceptable),
OR if a Corporation/1-LC,
Cor oration/LLC name and address as registered with Secretary Of State (include State where incorporated)
(a)
Full Name Street Address Citv State Zvi
(b) EMS� S 13vud 1, K ae(' Inc. 105,U Fu�$u�, Ar►e . Sic 2 SaCrc.wieg+0 CO
(If more than 2 owners,attach additional sheet)
4 This business conducted by:
❑an Individual ❑General Partnership ❑Limited Partnership ❑Trust
❑Married Couple ❑Co-Partners ❑Limited Liability Company ❑State or local Registered Domestic Partners
Corporation ❑Joint Venture ❑Limited Liability Partnership ❑ Unincorporated Association(other than a partnership)
5 Date began using business name_ J( !/a (write"N/A"if you have not yet begun conducting business)
Describe the type of Activities/Business_Ai t Ol bffl r Ice-s an ruvh,� es5ty% o-r 4M-5po.-4-44)s> ,
6 1 declare that all information in this statement is.true and correct.(A registrant who declares as true information which they know
to be false is guilty of a crime.)
Signed 1..�/� (ORIGINAL/WET SIGNATURE REQUIRED)
Printed Name f-e co r vj re-Cc,, Phone Number 91 (y -0 -7-7 B 2-
If a Corporation, Limited Liability Company(LLC), Limited Partnership (LP)or Limited Liability Partnership(LLP),
the following must also be completed:
Corporation/LLC Name CI`1 S dJf VC 9 `• Q<;a. , k c
Officer Title Of Signer V; c_,_ 'a,- "-,+ (For a list of acceptable Officer Titles please see instructions(6b)on reverse)
In accordance with Section 17920(a),a Fictitious Business Name Statement generally expires five years from the date it was filed with the County Clerk,except
as provided in Section 17920(b),where it expires 40 days after any change in the facts set forth in the statement pursuant to Section 17913 other than a change
in the residence address of a registered owner. A new Fictitious Business Name Statement must be filed before the expiration.
The filing of this Statement does not of itself authorize the use in this state of a Fictitious Business Name in violation of the rights of another under Federal,State,
or common law(Section 14411 et seq.,of the Business and Professions Code).
of 1, SACR
0/ 1 hereby i t at this copy is a correct copy of the original Statement on file in my office.
1* DONNA R D COUNTY CLERK
I�
BY:
aL FoaN P p t CI rk ID Checked
FBN Statement(11- 0019)
Q Request for Taxpayer
Form `�J Give Form to the
(Rev.October2018) Identification Number and Certification requester. Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information.
t Name(as shown on your income tax return).Name is required on this line;do not leave this line blank.
EMS Bruel&Kjaer Inc
2 Business name/disregarded entity name,if different from above
Envirosuite Inc
a) 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1,Check only one of the 4 Exemptions codes a only to
P Y P ( apply Y
following seven boxes, certain entities,not individuals;see
Ca
a instructions on page 3):
o ❑ Individual/sole proprietor or d❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
In single-member LLC
y C Exempt payee code(if any)
CL n ❑ Limited liability company.Enter the tax classification(C-C corporation,S=S corporation,P=Partnership)►
`p r Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
N LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is (
another LLC that is not disregarded from the owner for U.S,federal tax purposes,Otherwise,a single-member LLC that code if any)
a c is disregarded from the owner should check the appropriate box for the tax classification of its owner.
w
d ❑ Other(80e instructions)► (Applies to accounts maintained outside the U.S.)
y5 Address(number,street,and apt,or suite no.)See instructions. Requester's name and address(optional)
2330 E Bidwell Street,.Suite 210
6 City,state,and ZIP code
Folsom,CA 96630
7 List account number(s)here(optional)
Taxpayer Identification Number
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,fora m _lam
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later. For other
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a
TIN, later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
6 T8 — 0 2 9 6 3 70 1
Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3. 1 am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,YOU are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of -�
Here U.S.person► Date Po-
General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise .Form 1099-MISC(various types of income,prizes,awards,or gross
noted.
proceeds)
Future developments.For the latest information about developments .Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption .Form 1099 A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)