HomeMy WebLinkAboutContract 58858FORT WORTH CSC No. 58858
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between Tel/Logic Inc.,
d.b.a. E-Rate Central ("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 — E-Rate Central Proposal dated February 7, 2023;
3. Exhibit B — The Interlocal Purchasing System TIPS 210201; 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 the amount of Twenty -Six Thousand and 00/100 dollars ($26,000.00). Vendor shall not
provide any additional items or services or bill for expenses incurred for City not specified by this
Agreement unless City requests and approves in writing the additional costs for such services. City shall
not be liable for any additional expenses of Vendor not specified by this Agreement unless City first
approves such expenses in writing.
The term of this Agreement shall be effective beginning on the date signed by the Assistant City
Manager below ("Effective Date") and ending on June 30, 2024.
Vendor agrees that City shall, until the expiration of three (3) years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said three years, have access to
and the right to examine at reasonable times any directly pertinent books, documents, papers and records,
including, but not limited to, all electronic records, of Vendor involving transactions relating to this
Agreement at no additional cost to City. Vendor agrees that City shall have access during normal
working hours to all necessary Vendor facilities and shall be provided adequate and appropriate work
space in order to conduct audits in compliance with the provisions of this section. City shall give Vendor
reasonable advance notice of intended audits.
Notices required pursuant to the provisions of this Agreement shall be conclusively determined
to have been delivered when (1) hand -delivered to the other party, its agents, employees, servants or
representatives, (2) delivered by facsimile with electronic confirmation of the transmission, or (3)
received by the other party by United States Mail, registered, return receipt requested, addressed as
follows:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Cooperative Purchase Pagel of 21
To CITY: I To VENDOR:
City of Fort Worth Tel/Logic Inc., d.b.a. E-Rate Central
Attn: Valerie Washington, Assistant City ATTN: Legal Department
Manager 400 Post Ave., Suite 410
200 Texas Street Westbury, NY 11590-2291
Fort Worth, TX 76102-6314 Facsimile: N/A
Facsimile: (817) 392-8654
With copy to Fort Worth City Attorney's Office
at same address
IP Indemnification. Vendor agrees to indemnify, defend, settle, or pay, at its own cost and
expense, including the payment of attorney's fees, any claim or action against the City for
infringement of any patent, copyright, trade mark, service mark, trade secret, or other intellectual
property right arising from City's use of the Deliverable(s), or any part thereof, in accordance
with the Agreement, it being understood that the agreement to indemnify, defend, settle or pay
shall not apply if City modifies or misuses the Deliverable(s). So long as Vendor bears the cost and
expense of payment for claims or actions against the City pursuant to this section 8, Vendor shall
have the right to conduct the defense of any such claim or action and all negotiations for its
settlement or compromise and to settle or compromise any such claim; however, City shall have
the right to fully participate in any and all such settlement, negotiations, or lawsuit as necessary to
protect the City's interest, and City agrees to cooperate with Vendor in doing so. In the event City,
for whatever reason, assumes the responsibility for payment of costs and expenses for any claim
or action brought against the City for infringement arising under the Agreement, the City shall
have the sole right to conduct the defense of any such claim or action and all negotiations for its
settlement or compromise and to settle or compromise any such claim; however, Vendor shall fully
participate and cooperate with the City in defense of such claim or action. City agrees to give
Vendor timely written notice of any such claim or action, with copies of all papers City may receive
relating thereto.
Notwithstanding the foregoing, the City's assumption of payment of costs or expenses shall not
eliminate Vendor's duty to indemnify the City under the Agreement. If the Deliverable(s), or any
part thereof, is held to infringe and the use thereof is enjoined or restrained or, if as a result of a
settlement or compromise, such use is materially adversely restricted, Vendor shall, at its own
expense and as City's sole remedy, either: (a) procure for City the right to continue to use the
Deliverable(s); or (b) modify the Deliverable(s) to make them/it non -infringing, provided that such
modification does not materially adversely affect City's authorized use of the Deliverable(s); or (c)
replace the Deliverable(s) with equally suitable, compatible, and functionally equivalent non -
infringing Deliverable(s) at no additional charge to City; or (d) if none of the foregoing alternatives
is reasonably available to Vendor, terminate the Agreement, and refund all amounts paid to
Vendor by the City, subsequent to which termination City may seek any and all remedies available
to City under law. VENDOR'S OBLIGATIONS HEREUNDER SHALL BE SECURED BY THE
REQUISITE INSURANCE COVERAGE REQUIRED BY CITY.
Cooperative Purchase Page 2 of 21
Data Breach. Vendor further agrees that it will monitor and test its data safeguards from
time to time, and further agrees to adjust its data safeguards from time to time in light of relevant
circumstances or the results of any relevant testing or monitoring. If Vendor suspects or becomes
aware of any unauthorized access to any financial or personal identifiable information ("Personal
Data") by any unauthorized person or third party, or becomes aware of any other security breach
relating to Personal Data held or stored by Vendor under the Agreement or in connection with the
performance of any services performed under the Agreement or any Statement(s) of Work ("Data
Breach"), Vendor shall immediately notify City in writing and shall fully cooperate with City at
Vendor's expense to prevent or stop such Data Breach. In the event of such Data Breach, Vendor
shall fully and immediately comply with applicable laws, and shall take the appropriate steps to
remedy such Data Breach. Vendor will defend, indemnify and hold City, its Affiliates, and their
respective officers, directors, employees and agents, harmless from and against any and all claims,
suits, causes of action, liability, loss, costs and damages, including reasonable attorney fees, arising
out of or relating to any third party claim arising from breach by Vendor of its obligations
contained in this Section, except to the extent resulting from the acts or omissions of City. All
Personal Data to which Vendor has access under the Agreement, as between Vendor and City, will
remain the property of City. City hereby consents to the use, processing and/or disclosure of
Personal Data only for the purposes described herein and to the extent such use or processing is
necessary for Vendor to carry out its duties and responsibilities under the Agreement, any
applicable Statement(s) of Work, or as required by law. Vendor will not transfer Personal Data to
third parties other than through its underlying network provider to perform its obligations under
the Agreement, unless authorized in writing by City. Vendor's obligation to defend, hold harmless
and indemnify City shall remain in full effect if the Data Breach is the result of the actions of a
third party. All Personal Data delivered to Vendor shall be stored in the United States or other
jurisdictions approved by City in writing and shall not be transferred to any other countries or
jurisdictions without the prior written consent of City.
Cooperative Purchase Page 3 of 21
The undersigned reprrsejits and warrants that he or she has the power and authority to exeQute this
Agreement aril bind the respective Vendor.
CITY OF FORT WORTH:
Vim- OAA -.-
RV: Valerie Washington (Feb 13, 202312:22 CST)
N=e: Valerie Washiltgt€tn
Title; Assistant Cit}• Manager
Date. Feb 13, 2023
APPROVAL RE1v dldAf NbED:
By:
Name: � t, tin Gunn
Title: 11- Solutions Director
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By:
Name, Iannette GoodalI
Title' City Secretary
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CONTRACT COMPLIANCE MA NA GER:
By signing [ acknowledge that 1 am the person
responsihle for the monitoring and administration
of this contract. including ensuring al[ performance
and reporting WgUirMents.
a l.&l
B: Bobby Lee (Feb 10, 2023 17:28 CST)
Name: Bobby L�e
Title: Sr. IT Solutions Manager
APPROVED A5 TO FORM AND L,FGALfrY:
By: _
Name; TWorJa-9rk�
Title: Assistant City Attarney
CONTRALCT AUTHORIZATION;
M&C: NIA
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
( ouperative Purchase Page 4 of 21
v
E-RATE CENTRAL
February 7, 2023
Ms. Sallie Trotter
Assistant Director IT Solutions
City of Fort Worth Public Library
275 W. 13th Street
Fort Worth, TX 76102
Dear Ms. Trotter
Exhibit A
Andrew G. Eisley
400 Post Ave. Suite 410 • Westbury, NY 11590-2291
bizdev(ale-ratecentral.com . (877) 801-7880
Thank you for accepting this proposal for E-rate consulting services. When counter -signed, this letter can serve
as a contract for the services described herein.
Tel/Logic Inc., d.b.a. E-Rate Central, is a specialized educational consulting firm dedicated to simplifying the
E-rate application and funding process for state education departments, educational service agencies, school
districts, libraries and library systems, individual private and public schools, and all consortia. The firm has
been involved with E-rate at the local, state, and national levels since the program's inception.
In working with individual applicants, E-Rate Central has adopted an accountant -like approach to the E-rate
application process. We work with our clients in a strategic, operational, and tactical manner, similar to how an
accounting firm provides assurance services to clients. We collect all necessary information from the applicants,
prepare all E-rate forms, serve as the first point of contact on all SLD reviews, prepare appeals if needed, and
coordinate with suppliers on contract and billing issues.
Executive Summary
• E-Rate Central has provided nationally recognized E-rate consulting services since the inception of the
program.
• We are involved with all aspects of the E-rate program at the local, state, and national levels.
• Our reputation is for providing honest, expert, and timely support to our E-rate clients.
• Our primary business is to provide application, administrative, compliance, auditing, appeal, and
technology review services.
• Services include statewide training, procurement assistance, E-rate forms preparation, application review
and appeals.
• Our client base ranges from the largest consortia and public school districts across the nation
(Albuquerque, Chicago, Green Bay, New Orleans, and Richmond) to very small districts, private schools
and libraries.
■ Our services are used by more than 3,000 schools in 400 school districts and 300 libraries and library
systems.
• We are the State E-rate Coordinators for New York, New Mexico, Louisiana, Michigan, North Carolina,
and Nevada.
• E-Rate Central also manages statewide programs to assist libraries and library systems for the Library of
Virginia and the Texas State Library and Archives Commission (TSLAC)
• We are a member of the State E-Rate Coordinators Alliance (SECA).
• We are a founding member of the E-rate Management Professionals Association (E-mpa®) with two staff
members who formerly served as President and one currently serving as President.
Page 1 of 4
Cooperative Purchase Page 5 of 21
E-Rate Central has either directly or indirectly (on behalf of our clients) filed comments in almost
every E-rate related rule making proceeding initiated by the FCC since the inception of the
program.
Our employees have professional backgrounds that include state E-rate coordination, school district
administration, telecommunications, and administrative leadership at USAC/SLD.
Full -year E-rate Services
We are aware that at any one time, at a minimum, there are three active years with which any beneficiary deals.
Below are the normally expected three concurrent year activities.
Summer/Fall - Review of existing eligible services and contracts
- RFP coordination and Form 470 (for next FY)
- Competitive bid assessment documentation
- Collection of consortium member LOAs and Form
479s
- Reimbursement form completion (for previous FY)
- Form 500 completion
- Form 498 guidance
- CIPA compliance
Winter - Vendor contract coordination
- Discount rate calculations and optimization
- Form 471 preparation
- RFP coordination and Form 470 (if applicable)
Spring - PIA application reviews
- Form 486 completion
E-Rate Central's role throughout the E-rate application and funding cycle is to prepare all necessary applicant
forms (Forms 470, 471, 472, 486, and 500) and special requests (SPIN changes, service substitution requests,
appeals, etc.). To facilitate its work, E-Rate Central typically works with a primary contact (designated by the
applicant) to obtain required information. Although these forms are then sent to the applicant for their review,
certification, and submission (and tracked for delivery to the SLD), E-Rate Central acts as the contact person for
all forms (except for the Form 470 Request for Services) so that it can coordinate responses to any inquiries from
the SLD. Please note that ultimate responsibility for the information contained in the forms and their timely
submission remains with the applicant.
Capabilities - Secure Electronic Repository/Database
E-Rate Central's web -based tools simplify E-rate data navigation and provide funding status and tracking of
our clients' E-rate data and supporting documentation. E-Rate Central's website (www.e-ratrcentml.com ) and
its cloud -based document and email management applications are valuable resources to support our clients.
Both can be accessed 24/7, and are secure, collaborative platforms for E-Rate Central and our clients, not only
to access the USAC database dynamically, but also to share E-rate documents to clients, including emails,
creating as detailed an archived record as the client and E-Rate Central concur to use. Storage space can be
adjusted to the needs of the client. E-rate consultancy clients, upon request, are provided with secure credentials
for access to the Documents Repository, providing immediate access to the clients' E-rate data.
Page 2 of 4
Cooperative Purchase Page 6 of 21
Document and Asset Management
E-rate rules require applicants to maintain documentation for 10 years after the last date to deliver service.
Because the actual funding cycle is approximately three years long, this equates to a record keeping requirement
in excess of 10 years. Although E-Rate Central provides its clients with copies of all forms and SLD
correspondence, it assiduously maintains copies of all E-rate records in paper (ifprovided) and electronic format.
Ease of access to historical E-rate information is provided by E-Rate Central's own internal database system, its
own Web -based systems, and its knowledge of the SLD's databases and processes. In the event of audits, these
records may prove critical.
Asset Management is a critical, yet often overlooked, component of a successful E-rate program. An inadequate
asset management system exposes the applicant to audit risk for failing to comply with the FCC rules relating to
asset and inventory control. As applicants face shrinking enrollments and/or budgets and sites close, the ability
to locate and identify equipment funded with E-rate dollars is critical to ensure compliance with FCC rules. We
have worked with both very large districts and small applicants to identify the best asset tracking practices.
Procurement of E-rate Funded Services
We help ensure our clients are adopting best practices to facilitate a fair and open competitive bidding process.
We provide training to the appropriate staff in the various competitive bidding requirements, so the client
understands how E-rate procurement rules dovetail with state and local procurement rules.
E-Rate Central then works closely with the client to develop a Statement of Work that will allow the client to
meet its strategic goals while attempting to keep costs within budget. E-Rate Central will not endorse any vendor
because it places undue risk on both parties. It is important for our clients to understand that E-Rate Central will
not be an evaluator of bids. However, we may draft an E-rate compliant notional evaluation matrix based on
feedback from the client and/or will review the results of your competitive bidding process to identify arithmetic
errors or other red flags that could pose potential problems from an E-rate perspective.
Vendor Management, Invoicing and Billing
At E-Rate Central we have extensive experience managing relationships with our clients' vendors. A productive
and respectful relationship with vendors helps to ensure that our clients receive timely funding decisions from
USAC. Unlike some E-rate consultants, we do NOT perform work for E-rate vendors as we feel it could create
a conflict of interest. Our focus is solely on providing consulting services to schools and libraries.
Invoicing and Billing: A critical and time-consuming activity of the E-rate program is determining the charges
that are eligible for E-rate support. Our experienced team of experts is fully versed in understanding the
intricacies of vendor billings, especially telecommunications bills.
Audit Support
E-Rate Central will work with the client to organize all materials required in all types of reviews and audits. We
will also assist the applicant in completing any questionnaire requesting information on various aspects of the
applicant's E-rate process and practices. E-Rate Central will review all materials requested directly from the
client and advise accordingly.
Service Fees
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Cooperative Purchase Page 7 of 21
E-Rate Central charges a fixed fiscal year fee for its E-rate consulting support services. Our fees vary according
to the expected size and complexity of an applicant's E-rate application(s), but generally reflect a declining
percentage of E-rate funding (an effective proxy for the work involved). Except for onsite support, this fee is
all inclusive. Please note if the FCC substantially modifies the E-rate funding levels or processes, E-Rate Central
reserves the right to negotiate in good faith a price decrease or increase as appropriate.
E-Rate Central is proposing the following option to City of Fort Worth Public Library for our E-rate
consulting services for the term of February 3, 2023 through June 30, 2024:
We calculated your fee based on the assumption that the City will be filing for a Category 2 project in Funding
Year 2023 which may result in reimbursements of around $900 thousand. Using these funding levels, the normal
fee for services for eighteen months is $26,000.
Please identify which option best meet your needs, countersign, and return a copy via e-mail to:
bizdevna,e-ratecentral.com .
Cooperative Purchasing
If cooperative purchasing for E-Rate Central's consulting service is preferred or required, the following
purchasing vehicles are available. Please note our quoted fee excludes any charges associated with utilizing one
of the purchasing methods below and those charges, if any, will be added directly to our invoice.
Contract Holder
State
Contract Number
Current
Remaining
Final
Please
Term
Renewals
Expiration
check
Expiration
(Inc renewals)
the box
for
contract
used.
AEPA
Multi
AEPA 021.5-C
04/30/22
Three 1 r renewals
04/30/25
❑
Cooperative
NM
2021-23-AC04-ALL
02/28/25
NONE
02/28/25
❑
Educational Services
Capital Region BOCES
NY
Bid #17-021
12/31/22
One 1-yr renewal
12/31/22
❑
Goodbu
TX
20-21-5G100
06/30/23
One 1- rrenewal
06/30/24
❑
TIPS
TX
210201
08/31/24
One 1- r renewal
08/31/25
❑
Central Texas
TX
19-07-2010
06/30/26
NONE
06/30/26
❑
Purchasing Alliance
Prince William County
VA
R-TC-17012
08/31/24
One 2-yr renewal
08/31/26
❑
Public Schools
E-Rate Central is an established and experienced firm which offers a breadth and depth of E-rate and Emergency
Connectivity Funding (ECF) knowledge which we believe is unmatched by any other consultant. We look
forward to working with you.
Sincerely, Agreed:
Andrew G. Eisley
400 Post Ave. Suite 410
Westbury, NY 11590-2291
(877) 801-7880
Name: Valerie Washington, Assistant City Manager
Signature:
Date: Feb 13, 2023
Page 4 of 4
Cooperative Purchase Page 8 of 21
Exhibit B E-Rate Central TIPS 210201
TIPS VENDOR AGREEMENT
Between Tel/Logic Inc. dba E-Rate Central and
(Company Name)
THE INTERLOCAL PURCHASING SYSTEM (TIPS),
a Department of Texas Education Service Center Region 8 for
TIPS RFP 210201 E-Rate
General Information
The Vendor Agreement ("Agreement") made and entered into by and between The Interlocal Purchasing
System (hereinafter `FIRS") a government cooperative purchasing program authorized by the Region 8
Education Service Center, having its principal place of business at 4845 US Hwy 271 North, Pittsburg, Texas
75686 and the TIPS Vendor. This Agreement consists of the provisions set forth below, including provisions
of all attachments referenced herein. In the event of a conflict between the provisions set forth below and
those contained in any attachment, the provisions set forth shall control unless otherwise agreed by the
parties in writing and by signature and date on the attachment.
A Purchase Order ("PO"), Agreement or Contract is the TIPS Member's approval providing the authority to
proceed with the negotiated delivery order under the Agreement. Special terms and conditions as agreed
between the Vendor and TIPS Member should be added as addendums to the Purchase Order, Agreement
or Contract. Items such as certificate of insurance, bonding requirements, small or disadvantaged business
goals are some, but not all, of the possible addendums.
Terms and Conditions
Freight
All quotes to Members shall provide a line item for cost for freight or shipping regardless if there is a charge
or not. If no charge for freight or shipping, indicate by stating "No Charge", "$0", "included in price" or other
similar indication. Otherwise, all shipping, freight or delivery changes shall be passed through to the TIPS
Member at cost with no markup and said charges shall be agreed by the TIPS Member unless alternative
shipping terms are agreed by TIPS as a result of the proposal award.
Warranty Conditions
All new supplies equipment and services shall include manufacturer's minimum standard warranty unless
otherwise agreed to in writing. Vendor shall be legally permitted to sell all products offered for sale to TIPS
Members if the offering is included in the Request for Proposal ("RFP") category. All goods proposed and
sold shall be new unless clearly stated in writing.
Customer Support
The Vendor shall provide timely and accurate customer support for orders to TIPS Members as agreed by
the Parties. Vendors shall respond to such requests within a commercially reasonable time after receipt of
the request. If support and/or training is a line item sold or packaged with a sale, support shall be as agreed
with the TIPS Member.
TIPS vendor Agreement 06022020_sr
Page 1
Cooperative Purchase Page 9 of 21
Agreements
Agreements for purchase will normally be put into effect by means of a purchase order(s) executed by
authorized agents of the TIPS Member participating government entities, but other means of placing an
order may be used at the Member's discretion.
Tax exempt status
Most TIPS Members are tax exempt and the related laws and/or regulations of the controlling jurisdiction(s)
of the TIPS Member shall apply.
Assignments of Agreements
No assignment of this Agreement may be made without the prior notification of TIPS. Written approval of
TIPS shall not be unreasonably withheld. Payment for delivered goods and services can only be made to the
awarded Vendor, Vendor designated reseller or vendor assigned company.
Disclosures
• Vendor and TIPS affirm that he/she, or any authorized employees or agents, has not given, offered to
give, nor intends to give at any time hereafter any economic opportunity, future employment, gift,
loan, gratuity, special discount, trip, favor or service to a public servant in connection with this
Agreement.
• Vendor shall attach, in writing, a complete description of any and all relationships that might be
considered a conflict of interest in doing business with the TIPS program.
• The Vendor affirms that, to the best of his/her knowledge, the offer has been arrived at
independently, and is submitted without collusion with anyone to obtain information or gain any
favoritism that would in any way limit competition or give an unfair advantage over other vendors in
the award of this Agreement.
Term of Agreement and Renewals
The Agreement with TIPS is for approximately three (3) years and 6 months with an option for renewal for an additional
one (1) consecutive year. If TIPS offers the renewal extension year, the Vendor will be notified by email to the primary
contact of the awarded Vendor and shall be deemed accepted by the Vendor unless the awarded Vendor notifies
TIPS of its objection to the additional term. TIPS may or may not exercise the available extension(s) provided in
the original solicitation beyond the base three-year term. Whether or not to offer the extension is at the sole
discretion of TIPS.
"Start Date" for Term Calculation Purposes Only: Regardless of actual award/effective date of Contract, for
Agreement "term" calculation purposes only, the Agreement "start date" is the last day of the month that Award
Notifications are anticipated as published in the Solicitation
Example for Standard 3-Year Term
If the anticipated award date published in the Solicitation is May 22, but extended negotiations delay
award until June 27, The end date of the resulting initial "three-year" term Agreement (which is subject to an
extension(s)) will still be May 31, 2023.
"Termination Date": The scheduled Agreement "termination date" shall be the last day of the month of the month
of the month of the Original Solicitations' Anticipated Award date plus the applicable term.
Example: If the original term is three years and the solicitation provides an anticipated award
date of May 22, 2020, the expiration date o] the original three-year term shall be May 31, 2023.
TIPS Vendor Agreement 06022020_sr Page 2
Cooperative Purchase Page 10 of 21
Extensions: Any extensions of the original term shall begin on the next day after the day the original term
expires.
Example Following the Previous Example: If TIPS offers a one-year extension, the expiration of the extended term
shall be May 31, 2024.
TIPS may offer to extend Vendor Agreements to the fullest extent the original Solicitation permits.
Automatic Renewal Clauses Incorporated in Awarded Vendor Agreements with TIPS Members ResuRing from the
Solicitation and with the Vendor Named in this Agreement.
No Agreement for goods or services with a TIPS Member by the awarded vendor named in this Agreement
that results from the solicitation award named in this Agreement, may incorporate an automatic renewal
clause that exceeds month to month terms with which the TIPS Member must comply. All renewal terms
incorporated in an Agreement by the vendor with the TIPS Member shall only be valid and enforceable when
the vendor receives written confirmation by purchase order, executed Agreement or other written
instruction issued by the TIPS Member for any renewal period. The purpose of this clause is to avoid a TIPS
Member inadvertently renewing an Agreement during a period in which the governing body of the TIPS
Member has not properly appropriated and budgeted the funds to satisfy the Agreement renewal. This term
is not negotiable and any Agreement between a TIPS Member and a TIPS awarded vendorwith an automatic
renewal clause that conflicts with these terms is rendered void and unenforceable.
Shipments
The Vendor shall ship, deliver or provide ordered products or services within a commercially reasonable time
after the receipt of the order from the TIPS Member. If a delay in said delivery is anticipated, the Vendor
shall notify TIPS Member as to why delivery is delayed and shall provide an estimated time for completion
of the order. TIPS orthe requesting entity may cancel the order if estimated deliverytime is not acceptable
or not as agreed by the parties.
Invoices
Each invoice or pay request shall include the TIPS Member's purchase order number or other identifying
designation as provided in the order by the TIPS Member. If applicable, the shipment tracking number or
pertinent information for verification of TIPS Member receipt shall be made available upon request.
Payments
The TIPS Member will make payments directly to the Vendor, the Vendor Assigned Dealer or as agreed by
the Vendor and the TIPS Member after receiving invoice and in compliance with applicable payment
statute(s), whichever is the greater time or as otherwise provided by an agreement of the parties.
Pricing
Price increases will be honored according to the terms of the solicitation. All pricing submitted to TIPS shall
include the participation fee, as provided in the solicitation, to be remitted to TIPS by the Vendor. Vendor
will not show adding the fee to the invoice presented to TIPS Member customer.
Participation Fees and Reporting of Sales to TIPS by Vendor
The Participation Fee that was published as part of the Solicitation and the fee published is the legally effective
fee, along with any fee conditions stated in the Solicitation. Collection of the fees by TIPS is required under
Texas Government Code §791.011 Et seq. Fees are due on all TIPS purchases reported by either Vendor or
Member. Fees are due to TIPS upon payment by the Member to the Vendor, Reseller or Vendor Assigned
TIPS Vendor Agreement 06022020_sr Page 3
Cooperative Purchase Page 11 of 21
Dealer. Vendor, Reseller or Vendor Assigned Dealer agrees that the participation fee is due to TIPS for all
Agreement sales immediately upon receipt of payment including partial payment, from the Member Entity
and must be paid to TIPS at least on a monthly basis, specifically within 31 calendar days of receipt of payment,
if not more frequently, or as otherwise agreed by TIPS in writing and signed by an authorized signatory of TIPS.
Thus, when an awarded Vendor, Reseller or Vendor Assigned Dealer receives any amount of payment, even
partial payment, for a TIPS sale, the legally effective fee for that amount is immediately due to TIPS from the
Vendor and fees due to TIPS should be paid at least on a monthly basis, specifically within 31 calendar days of
receipt of payment, if not more frequently.
Reporting of Sales to TIPS by Vendor
Vendor is required to report all sales under the TIPS contract to TIPS. When a public entity initiates a purchase
with a TIPS Awarded Vendor, if the Member inquires verbally or in writing whether the Vendor holds a TIPS
Contract, it is the duty of the Vendor to verify whether or not the Member is seeking a TIPS purchase. Once
verified, the Vendor must include the TIPS Contract number on any communications and related sales
documents exchanged with the TIPS Member entity. To report sales, the Vendor must login to the TIPS Vendor
Portal online at https://www.tips-usa.com/vendors form.cfm and click on the PO's and Payments tab. Pages
3-7 of the Vendor Portal User Guide will walk you through the process of reporting sales to TIPS. Please refer
to the TIPS Accounting FACI s for more information about reporting sales and if you have further questions,
contact the Accounting Team at accounting@tips-usa.com. The Vendor or vendor assigned dealers are
responsible for keeping record of all sales that go through the TIPS Agreement and submitting same to TIPS.
Failure to render the participation fee to TIPS shall constitute a breach of this agreement with our parent
governmental entity, Texas Education Service Center Region 8, as established by the Texas legislature and shall
be grounds for termination of this agreement and any other agreement held with TIPS and possible legal
action. Any overpayment of participation fees to TIPS by a Vendor will be refunded to the Vendor within ninety
(90) days of receipt of notification if TIPS receives written notification of the overpayment not later than the
expiration of six (6) months from the date of overpayment and TIPS determines that the amount was not
legally due to TIPS pursuant to this agreement and applicable law. It is the Vendor's responsibility to identify
which sales are TIPS Agreement sales and pay the correct participation fee due for TIPS Agreement sales. Any
notification of overpayment received by TIPS after the expiration of six (6) months from the date of
overpayment will be non-refundable. Region 8 ESC and TIPS reserve the right to extend the six (6) month
deadline to notify if approved bythe Region 8 ESC Board of Directors. TIPS reserves all rights underthe law to
collect the fees due. Please contact TIPS at tips@tips-usa.com or call (866) 839-8477 if you have questions
about paying fees.
Indemnity
The Vendor agrees to indemnify and hold harmless and defend TIPS, TIPS Member(s), officers and employees
from and against all claims and suits by third parties for damages, injuries to persons (including death),
property damages, losses, and expenses including court costs and reasonable attorney's fees, arising out of,
or resulting from, Vendor's performance under this Agreement, including all such causes of action based
upon common, constitutional, or statutory law, or based in whole or in part, upon allegations of negligent
or intentional acts on the part of the Vendor, its officers, employees, agents, subcontractors, licensees, or
invitees. Parties found liable shall pay their proportionate share of damages as agreed by the parties or as
ordered by a court of competent jurisdiction over the case. NO LIMITATION OF LIABILITY FOR DAMAGES
FOR PERSONAL INJURY OR PROPERTY DAMAGE ARE PERMITTED OR AGREED BY TIPS/ESC REGIONS. Per
Texas Education Code §44.032(f), and pursuant to its requirements only, reasonable Attorney's fees are
recoverable by the prevailing party in any dispute resulting in litigation.
State of Texas Franchise Tax
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By signature hereon, the Vendor hereby certifies that he/she is not currently delinquent in the payment of
any franchise taxes owed the State of Texas under Chapter 171, Tax Code.
Miscellaneous
The Vendor acknowledges and agrees that continued participation in TIPS is subject to TIPS sole discretion
and that any Vendor may be removed from the participation in the Program at any time with or without
cause. Nothing in the Agreement or in any other communication between TIPS and the Vendor may be
construed as a guarantee that TIPS or TIPS Members will submit any orders at any time. TIPS reserves the
right to request additional proposals for items or services already on Agreement at any time.
Purchase Order Pricing/Product Deviation
If a deviation of pricing/product on a Purchase Order or contract modification occurs between the Vendor
and the TIPS Member, TIPS must be notified within five (5) business days of receipt of change order.
Termination for Convenience of TIPS Agreement Only
TIPS reserves the right to terminate this agreement for cause or no cause for convenience with a thirty (30)
days prior written notice. Termination for convenience is conditionally required under Federal Regulations 2
CFR part 200 if the customer is using federal funds for the procurement. All purchase orders presented to
the Vendor, but not fulfilled by the Vendor, by a TIPS Member prior to the actual termination of this
agreement shall be honored at the option of the TIPS Member. The awarded Vendor may terminate the
agreement with ninety (90) days prior written notice to TIPS 4845 US Hwy North, Pittsburg, Texas 75686.
The vendor will be paid for goods and services delivered prior to the termination provided that the goods
and services were delivered in accordance with the terms and conditions of the terminated agreement.
This termination clause does not affect the sales agreements executed by the Vendor and the TIPS Member
customer pursuant to this agreement. TIPS Members may negotiate a termination for convenience clause
that meets the needs of the transaction based on applicable factors, such as funding sources or other
needs.
TIPS Member Purchasing Procedures
Usually, purchase orders or their equal are issued by participating TIPS Member to the awarded vendor and
should indicate on the order that the purchase is per the applicable TIPS Agreement Number. Orders are
typically emailed to TIPS at tipspo@tips-usa.com.
• Awarded Vendor delivers goods/services directly to the participating member.
• Awarded Vendor invoices the participating TIPS Member directly.
• Awarded Vendor receives payment directly from the participating member.
• Fees are due to TIPS upon payment by the Member to the Vendor. Vendor agrees to pay the
participation fee to TIPS for all Agreement sales upon receipt of payment including partial payment, from
the Member Entity or as otherwise agreed by TIPS in writing and signed by an authorized signatory of TIPS.
Licenses
Awarded Vendor shall maintain, in current status, all federal, state and local licenses, bonds and permits
required for the operation of the business conducted by awarded Vendor. Awarded Vendor shall remain
reasonably fully informed of and in compliance with all ordinances and regulations pertaining to the lawful
provision of goods or services under the Agreement. TIPS and TIPS Members reserves the right to stop work
and/or cancel an order orterminate this or any other sales Agreement of any awarded Vendor whose license(s)
required for performance under this Agreement have expired, lapsed, are suspended or terminated subject
to a 30-day cure period unless prohibited by applicable statue or regulation.
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Novation
If awarded Vendor sells or transfers all assets, rights or the entire portion of the assets or rights required to
perform this Agreement, a successor in interest must guarantee to perform all obligations under this
Agreement. A simple change of name agreement will not change the Agreement obligations of awarded
vendor. TIPS will consider Contract Assignments on a case by case basis. TIPS must be notified within five
(5) business days of the transfer of assets or rights.
Site Requirements (only when applicable to service or job)
Cleanup: When performing work on site at a TIPS Member's property, awarded Vendor shall clean up and
remove all debris and rubbish resulting from their work as required or directed by TIPS Member or as
agreed by the parties. Upon completion of work, the premises shall be left in good repair and an orderly,
neat, clean and unobstructed condition.
Preparation: Awarded Vendor shall not begin a project for which TIPS Member has not prepared the site,
unless awarded Vendor does the preparation work at no cost, or until TIPS Member includes the cost of
site preparation in a purchase order. Site preparation includes, but is not limited to: moving furniture,
installing wiring for networks or power, and similar pre -installation requirements.
Registered sex offender restrictions: For work to be performed at schools, awarded Vendor agrees that
no employee of a subcontractor who has been adjudicated to be a registered sex offender will perform
work at any time when students are, or reasonably expected to be, present unless otherwise agreed by
the TIPS Member. Awarded Vendor agrees that a violation of this condition shall be considered a material
breach and may result in the cancellation of the purchase order at the TIPS Member's discretion. Awarded
Vendor must identify any additional costs associated with compliance of this term. If no costs are
specified, compliance with this term will be provided at no additional charge. Safety measures: Awarded
Vendor shall take all reasonable precautions for the safety of employees on the worksite, and shall erect
and properly maintain all necessary safeguards for protection of workers and the public. Awarded Vendor
shall post warning signs against all hazards created by the operation and work in progress. Proper
precautions shall betaken pursuant to state law and standard practices to protect workers, general public
and existing structures from injury or damage.
Safety Measures
Awarded Vendor shall take all reasonable precautions for the safety of employees on the worksite, and shall
erect and properly maintain all necessary safeguards for protection of workers and the public. Awarded
vendor shall post warning signs against all hazards created by the operation and work in progress. Proper
precautions shall be taken pursuant to state law and standard practices to protect workers, general public
and existing structures from injury or damage.
Smoking
Persons working under Agreement shall adhere to the TIPS Member's or local smoking statutes, codes or
policies.
Marketing
Awarded Vendor agrees to allow TIPS to use their name and logo within TIPS website, marketing materials
and advertisement subject to any reasonable restrictions provided to TIPS in the Proposal to the
Solicitation. The Vendor may submit an acceptable use directive for Vendor's names and logos with which
TIPS agrees to comply. Any use of TIPS name and logo or any form of publicity, inclusive of press release,
regarding this Agreement by awarded vendor must have prior approval from TIPS which will not be
unreasonably withheld. Request may be made by email to TIPS@TIPS-USA.COM.
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Supplemental Agreements
The TIPS Member entity participating in the TIPS Agreement and awarded Vendor may enter into a separate
Supplemental Agreement or contract to further define the level of service requirements over and above
the minimum defined in this Agreement such as but not limited to, invoice requirements, ordering
requirements, specialized delivery, etc. Any Supplemental Agreement or contract developed as a result of
this Agreement is exclusively between the TIPS Member entity customer and the Vendor. TIPS, its agents,
TIPS Members and employees not a partyto the Supplemental Agreement with the TIPS Member customer,
shall not be made party to any claim for breach of such agreement unless named and agreed by the Party
in question in writing in the agreement. If a Vendor submitting a Proposal requires TIPS and/or TIPS
Member to sign an additional agreement, those agreements shall comply with the award made by TIPS to
the Vendor. Supplemental Vendor's Agreement documents may not become part of TIPS' Agreement with
Vendor unless and until an authorized representative of TIPS reviews and approves it. TIPS review and
approval may be at any time during the life of this Vendor Agreement. TIPS permits TIPS Members to
negotiate additional terms and conditions with the Vendor for the provision of goods or services under the
Vendor's TIPS Agreement so long as they do not materially conflict with this Agreement.
Survival Clause
All applicable sales, leases, Supplemental Agreements, contracts, software license agreements, warranties or
service agreements that were entered into between Vendor and TIPS or the TIPS Member Customer under
the terms and conditions of this Agreement shall survive the expiration or termination of this Agreement. All
Orders, Purchase Orders issued or contracts executed by TIPS or a TIPS Member and accepted by the Vendor
prior to the expiration or termination of this agreement, shall survive expiration or termination of the
Agreement, subject to previously agreed terms and conditions agreed by the parties or as otherwise
specified herein relating to termination of this agreement.
Legal obligations
It is the responding Vendor's responsibility to be aware of and comply with all local, state and federal laws
governing the sale of products/services identified in the applicable Solicitation that resulted in this Vendor
Agreement and any awarded Agreement thereof. Applicable laws and regulations must be followed even if
not specifically identified herein.
Audit rights
Due to transparency statutes and public accountability requirements of TIPS and TIPS Members', the
awarded Vendor shall, at their sole expense, maintain appropriate due diligence of all purchases made by
TIPS Member that utilizes this Agreement. TIPS and Region 8 ESC each reserve the right to audit the
accounting of TIPS related purchases for a period of three (3) years from the time such purchases are made.
This audit right shall survive termination of this Agreement for a period of one (1) year from the effective
date of termination. In order to ensure and confirm compliance with this agreement, TIPS shall have
authority to conduct audits of Awarded Vendor's pricing or TIPS transaction documentation with TIPS
Members with 30 days' notice unless the audit is ordered by a Court Order or by a Government Agency with
authority to do so without notice. Notwithstanding the foregoing, in the event that TIPS is made aware of
any pricing being offered to eligible entities that is materially inconsistent with the pricing under this
agreement, TIPS shall have the ability to conduct the audit internally or may engage a third- party auditing
firm to investigate any possible non- compliant conduct or may terminate the Agreement according to the
terms of this Agreement. In the event of an audit, the requested materials shall be reasonably provided in
the time, format and at the location acceptable to Region 8 ESC or TIPS. TIPS agrees not to perform a random
audit the TIPS transaction documentation more than once per calendar year, but reserves the right to audit
for just cause or as required by any governmental agency or court with regulatory authority over TIPS or the
TIPS Vendor Agreement 06022020_sr Page 7
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TIPS Member.
Force Majeure
If by reason of Force Majeure, either party hereto shall be rendered unable wholly or in part to carry out its
obligations under this Agreement then such party shall give notice and full particulars of Force Majeure in
writing to the other party within a reasonable time after occurrence of the event or cause relied upon, and
the obligation of the party giving such notice, so far as it is affected by such Force Majeure, shall be
suspended during the continuance of the inability then claimed, except as hereinafter provided, but for no
longer period, and such party shall endeavor to remove or overcome such inability with all reasonable
dispatch.
Choice of Law
The Agreement between the Vendor and TIPS/ESC Region 8 and any addenda or other additions resulting
from this procurement process, however described, shall be governed by, construed and enforced in
accordance with the laws of the State of Texas, regardless of any conflict of laws principles.
Venue, Jurisdiction and Service of Process
Any Proceeding arising out of or relating to this procurement process or any contract issued by TIPS resulting
from or any contemplated transaction shall be brought in a court of competent jurisdiction in Camp County,
Texas and each of the parties irrevocably submits to the exclusive jurisdiction of said court in any such
proceeding, waives any objection it may now or hereafter have to venue or to convenience of forum, agrees
that all claims in respect of the Proceeding shall be heard and determined only in any such court, and agrees
not to bring any proceeding arising out of or relating to this procurement process or any contract resulting
from or any contemplated transaction in any other court. The parties agree that either or both of them may
file a copy of this paragraph with any court as written evidence of the knowing, voluntary and freely
bargained for agreement between the parties irrevocably to waive any objections to venue or to
convenience of forum. Process in any Proceeding referred to in the first sentence of this Section may be
served on any party anywhere in the world. Venue for any dispute resolution process, other than litigation,
between TIPS and the Vendor shall be located in Camp or Titus County, Texas.
Project Delivery Order Procedures
The TIPS Member having approved and signed an interlocal agreement, or other TIPS Membership
document, may make a request of the awarded Vendor underthis Agreement when the TIPS Memberdesires
goods or services awarded to the Vendor. Notification may occur via phone, the web, courier, email, fax, or
in person. Upon notification of a pending request, the awarded Vendor shall acknowledge the TIPS
Member's request as soon as possible, but must make contact with the TIPS Member within two working
days.
Status of TIPS Members as Related to This Agreement
TIPS Members stand in the place of TIPS as related to this agreement and have the same access to the
proposal information and all related documents. TIPS Members have all the same rights under the awarded
Agreement as TIPS.
Vendor's Resellers as Related to This Agreement
Vendor's Named Resellers ("Resellers") under this Agreement shall comply with all terms and conditions of
this agreement and all addenda or incorporated documents. All actions related to sales by Authorized
Vendor's Resellers under this Agreement are the responsibility of the awarded Vendor. If Resellers fail to
report sales to TIPS under your Agreement, the awarded Vendor is responsible for their contractual failures
TIPS Vendor Agreement 06022020_sr Page 8
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and shall be billed for the fees. The awarded Vendor may then recover the fees from their named reseller.
Support Requirements
If there is a dispute between the awarded Vendor and TIPS Member, TIPS or its representatives may, at TIPS
sole discretion, assist in conflict resolution if requested by either party. TIPS, or its representatives, reserves
the right to inspect any project and audit the awarded Vendor's TIPS project files, documentation and
correspondence related to the requesting TIPS Member's order. If there are confidentiality requirements by
either party, TIPS shall comply to the extent permitted by law.
Incorporation of Solicitation
The TIPS Solicitation which resulted in this Vendor Agreement, whether a Request for Proposals, the Request
for Competitive Sealed Proposals or Request for Qualifications solicitation, or other, the Vendor's response
to same and all associated documents and forms made part of the solicitation process, including any
addenda, are hereby incorporated by reference into this Agreement as if copied verbatim.
SECTION HEADERS OR TITLES
THE SECTON HEADERS OR TITLES WITHIN THIS DOCUMENT ARE MERELY GUIDES FOR CONVENIENCE AND
ARE NOT FOR CLASSIFICATION OR LIMITING OF THE RESPONSIBILITIES OF THE PARTIES TO THIS DOCUMENT.
STATUTORY REQUIREMENTS
Texas governmental entities are prohibited from doing business with companies that fail to certify to this
condition as required by Texas Government Code Sec. 2270.
By executing this agreement, you certify that you are authorized to bind the undersigned Vendor and that
your company (1) does not boycott Israel; and (2) will not boycott Israel during the term of the Agreement.
You certify that your company is not listed on and does not and will not do business with companies that are
on the Texas Comptroller of Public Accounts list of Designated Foreign Terrorists Organizations per Texas
Gov't Code 2270.0153 found at https:Hcomptroller.texas.gov/purchasing/docs/foreign-terrorist.pdf
You certifythat if the certified statements above become untrue at any time duringthe life of this Agreement
that the Vendor will notifyTIPS within three (3) business day of the change by a letter on Vendor's letterhead
from and signed by an authorized representative of the Vendor stating the non-compliance decision and the
TIPS Agreement number and description at:
Attention: General Counsel
ESC Region B/The Interlocal Purchasing System (TIPS)
4845 Highway 271 North
Pittsburg, TX,75686
And by an email sent to bids@tips-usa.com
Insurance Requirements
The undersigned Vendor agrees to maintain the below minimum insurance requirements for TIPS Contract
Holders:
General Liability $1,000,000each Occurrence/Aggregate
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Automobile Liability $300,000Includes owned, hired & non -owned
Workers' Compensation Statutory limits for the jurisdiction in which
the Vendor performs under this Agreement.
Umbrella Liability $1,000,000
When the Vendor or its subcontractors are liable for any damages or claims, the Vendor's policy, when the
Vendor is responsible for the claim, must be primary over any other valid and collectible insurance carried
by the Member. Any immunity available to TIPS or TIPS Members shall not be used as a defense by the
contractor's insurance policy. The coverages and limits are to be considered minimum requirements and in
no way limit the liability of the Vendor(s). Insurance shall be written by a carrier with an A-; VII or better
rating in accordance with current A.M. Best Key Rating Guide. Only deductibles applicable to property
damage are acceptable, unless proof of retention funds to cover said deductibles is provided. "Claims made"
policies will not be accepted. Vendor's required minimum coverage shall not be suspended, voided,
cancelled, non -renewed or reduced in coverage or in limits unless replaced by a policy that provides the
minimum required coverage except after thirty (30) days prior written notice by certified mail, return receipt
requested has been given to TIPS or the TIPS Member if a project or pending delivery of an order is ongoing.
Upon request, certified copies of all insurance policies shall be furnished to the TIPS or the TIPS Member.
Special Terms and Conditions
a Orders: All Vendor orders received from TIPS Members must be emailed to TIPS at tipspo@tips-
usa.com. Should a TIPS Member send an order directly to the Vendor, it is the Vendor's responsibility
to forward a copy of the order to TIPS at the email above within 3 business days and confirm its
receipt with TIPS.
• Vendor Encouraging Members to bypass TIPS agreement: Encouraging TIPS Members to purchase
directlyfrom the Vendor or through another agreement, when the Member has requested using the
TIPS cooperative Agreement or price, and thereby bypassing the TIPS Agreement is a violation of the
terms and conditions of this Agreement and will result in removal of the Vendor from the TIPS
Program.
• Order Confirmation: All TIPS Member Agreement orders are approved daily by TIPS and sent to the
Vendor. The Vendor should confirm receipt of orders to the TIPS Member (customer) within 3
business days.
• Vendor custom website for TIPS: If Vendor is hosting a custom TIPS website, updated pricing when
effective. TIPS shall be notified when prices change in accordance with the award.
• Back Ordered Products: If product is not expected to ship within the time provided to the TIPS
Member by the Vendor, the Member is to be notified within 3 business days and appropriate action
taken based on customer request.
The TIPS Vendor Agreement Signature Page is inserted here.
TIPS Vendor Agreement 06022020_sr
Page 10
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TIPS Vendor Agreement Signature Form
RFP 210201 E-Rate
Company Name Tel/Logic Inc. dba E-Rate Central
Address400 Post Ave Suite 410
Westbur NY 11590-2291
City 168017885 J State Zip
Phone Fax 5168017595
Email of Authorized Representative 1 h i msworth@e-ratecentral
Name of Authorized Representative J u l iea n n e H i m swo rth
Title Procurement Specialist
Signature of Authorized Representative n is
0311612021
Date
TIPS Authorized Representative Name
com
Title Chief Operating Officer
TIPS Authorized Representative Signature Al""g
Approved by ESC Region 8
Date 419312091
Cooperative Purchase Page 19 of 21
Exhibit C
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
OFFICEUSEONLY
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who
Date Received
has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the
vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not later
than the 7th business day after the date the vendor becomes aware of facts that require the statement to be
filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An
offense under this section is a misdemeanor.
jJ Name of vendor who has a business relationship with local governmental entity.
z
❑ 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
AJ 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
CIO 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 F-1 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 F-1 No
5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent or more.
s
Check this box if the vendor has given the local government officer or afamily 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
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015
Cooperative Purchase Page 20 of 21
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
Acomplete copy of Chapter 176 of the Local Government Code maybe 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 acon nection 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 avendor if:
(2) thevendor:
(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 aggregatevalue 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) Avendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship
with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local
governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A);
(2) has given a local government officer of that local governmental entity, or a family member of the
officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any
gift described by Section 176.003(a-1); or
(3) has a family relationship with a local government officer of that local governmental entity.
(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator
not later than the seventh business day after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental
entity; or
(B) submits to the local governmental entity an application, response to a request for proposals
or bids, correspondence, or another writing related to a potential contract with the local
governmental entity; or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a
family member of the officer, described by Subsection (a);
(B) that the vendor has given one or more gifts described by Subsection (a); or
(C) of a family relationship with a local government officer.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015
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