HomeMy WebLinkAboutContract 58089-A1CSC No. 58089-A1
FIRST AMENDMENT TO
FORT WORTH CITY StCRETARY CONTRACT NO. 58089
This First Amendment to Fort Worth City Secretary Contract No. 58089 is made between
the City of Fort Worth C'Fort Worth"'), a muffioipal corporation and. Southern. Petroleum
Laboratories, Inc. a
V4MREAS, Fort Worth. and Vendor entered into an Agreement identified as Fort Worth
City Secretary Contract No. 59089 on September 15,2022 (the "Agreemtmt/Contracf); and
WHEREAS, it is the collective desire of both Fort Worth- and Vendor. to amend the
Agreement to include addifiwal laboratory analytical Services and to increase the contract value
to $A125.00 in -.a=rdartce with. :ft -fee, schedule in Exhibit B and in, aocordaace with the
-pravi,siQns of this Agreement;
NOW THERFYORE, Imown by All these present, Fort Worth and Vendor, doting herein by
the through their duly authorized representatives, agree to the following terms, which amend the
Agreement as follows:
L. The Agreement is: hereby amended as follows' City shall pay Vendor ia4ccordanoo
with the foe schedule in Exhibit B and in accordance. with the provisions of this, Agreement, Total
paym=t made under this Agreement by to City shall be in the amount 4 $24,125.00.. Vendor
ishaltnot pro -Ode. anyad44Qu4 -aervloes or bill expenses incurred far City not spec ff fled 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 Nendor not spoolfied by this Agreement
unless City first approves sueh expenses in writing..
2. All other terms, provisions, conditions, covenants and xecitals ofthe Agreement not
expressly amended herein shall remain in U1 force and eMet,
[Signature Page FoHoNys]
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Fitst Amndmunt t . o Fort Wor& City Secretary Contract No. 59089 page 1 ot-2
Executed effective as of the date signed by the Assistant City Manager below.
FORT WORTH:
City of Fort Worth
v au
By: Dana Burghdoff (Jan 2024 CST)
Name: Dana Burghdoff
Title: Assistant City Manager
Date:
Approval Recommended:
Cti.�rs� N,GLYY%2s^
By:
Chris Harder (Jan 11, 202411:11 CST)
Name:
Christopher Harder, P.E.
Title:
Water Department Director
Attest:
rol po4vavpnIl
�09°0
dso
pvo o=d
% "oo. a v
By:
U
Name:
Jannette S. Goodall
Title:
City Secretary
VENDOR:
Southern Petroleum Laboratories, Inc.
Contract Compliance Manager:
By signing 1 acknowledge that I am the person
responsible for the monitoring and administration
of this contract, including ensuring all performance
and reporting requirements.
By- �-2 �11' S I — )
Name: Patty Je lson
Title: Contract Services Administrator
Approved as to Form and Legality:
By: 1 7 �
Name: Taylor Paris
Title: Assistant City Attorney II
M&C: 22-0553
Date Approved: 8/09/2022
Form 1295 Certification no.: 2022-903121
By:
Name: Bill Peery
Title: Vice President of Environmental Technology
%
Date: / /l (9( 2� Zy
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
First Amendment to Fort Worth City Secretary Conti -act No. 58089 Page 2 of 2
CSC No. 58089-CAl
CITY OF FORT WORTH
ASSIGNMENT
For value, received Ana Lab Corporation ("Assignor"), hereby assigns to Southern
Petroleum Laboratories, 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 PSK
17437/CSCO 58089 (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 2 Ir — - day of A,,1 t., 5 � _ 2023.
Ana Lab Corporation
(Assignor)
By:
Print:
Title: Chief Operating Officer
Southern Petroleu� 'oratories, Inc.
(Assignee��
By:
Print: it
Title: Chief Financta Officer
Assignment Page I of
CITY OF FORT WORTH
ASSIGNMENT
For value, received Ana Lab Corporation ("Assignor"), hereby assigns to Southern
Petroleum Laboratories, 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 PSK
17437/CSCO 58089 (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.
p--h
Dated the O day of � UQ 0 2023.
Ana Lab Corporation
(Assi
By:
Print:
Title:Officer
Southern Petroleum Laboratories, Inc.
(Assignee)
By:
Print:
Title: Chief Financial Officer
Assignment Page 2 of 5
NOTARY ACKNOWLEDGEMENT
On the day of 2022, personally appeared
, who acknowledged to me that (s)he is the Chief Operating Officer of Ana
Lab Corporation ("Assignor"), and that (s)he executed this document for the purposes and
consideration contained herein.
Ana Lab Corporation
By: --
Print:
Title: Chief Operating Officer
SUBSCRIBED TO before me on this day of
Notary Public in and for the State of
My commission Expires:
NOTARY ACKNOWLEDGEMENT
, 2023.
On the 2 $ �^ day of An K st 2023, personally appeared
who acknowledged to me that (s)he is the Chief Financial Officer of
Southern Petroleum Laboratories, Inc. ("Assignee"), and that (s)he executed this document for
the purposes and consideration contained herein,
Southern ieum s, Inc.
By�
`
-
Print: t3
Title: Chief Financial Officer
SUBSCRIBED TO before me on this 2 g�6 day of �u St , 2023.
W
%,��F rq ssroN�o.•��� w`.
�i'Q RY•ID NO. �,•��
NI PA�S���\
Notary Public in and for the State of Lo.L15-'
My commission Expires: ra, d,,. H-,
Assignment Page 3 of 5
NOTARY ACKNOWLEDGEMENT
On the day of '2822; personally appeared
\� who acknowled�to-that(s)he is the Chief Operating Officer of Ana
Lab Corporation ("Assignor"), and that (s)he executed this document for the purposes and
consideration contained herein.
A la Lt C brave
By:
Print: �1 \v'
Title: Chief Operating Officer
SUBSCRIBED TO before me on this E �j day of o��,�� , 2023.
i J
Reme Johnson �n�4
' MyCommissmExpres Notary I blic in and for tlt State oT'C�y��
"vJ j"r 1011612024 M commission Expires: \c, k- o ay
ID No 601774 y p
NOTARY ACKNOWLEDGEMENT
On the day of 2023, personally appeared
, who acknowledged to me that (s)he is the Chief Financial Officer of
Southern Petroleum L boratories, Inc. ("Assignee"), and that (s)he executed this document for
the purposes and consideration contained herein.
Southern Petroleum Laboratories, Inc.
By:
Print:
Title: Chief Financial Officer
SUBSCRIBED TO before me on this day of
Notary Public in and for the State of
My commission Expires:
, 2023.
nssienment Page 4 ors
CONSENT TO ASSIGNMENT
The City of Fort Worth consents to the assignment of Ana Lab Corporation ("Assignor")
to Southern Petroleum Laboratories, Inc. ("Assignee"), of all its rights, title, and obligation
owing and all funds due or to become due to Assignor under PSK 17437/CSCO 58089 as long as
all terms required of Assignor in said contracts are met by Assignee.
CITY OF FORT WORTH
Chyisl'Ophot ifai doi
Christopher Harder (Sep 5, 202316:05 CDT)
Department Director
T a SliL
Dana Burghdoff (Set) 2023 CDT)
Assistant City Manager
ATTESTED BY:
Jannette Goodall, City Secretary
APPROVED AS TO FORM AND LEGALITY:
4-d. P"+-
City of Fort Worth Assistant City Attorney
Contract Compliance Manager:
Sep 5, 2023
Date
Sep 6, 2023
Date
Sep 7, 2023
Date
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.
Patty Jean Wilson (Sep 5, 2023 15:59 CDT) Sep5 2023
Employee Signature/Date
Contract Services Administrator
Title
Assignment Page 5 of
U C C Business Organizations Trademarks Notary Account Help;Fees Briefcase
BUSINESS ORGANIZATIONS INQUIRY- VIEW ENTITY
Filing Number.
14390000
Entity Type: Domestic For -Profit Corporation
Original Date of Filing:
January 2. 1958
Entity Status: In existence
Formation Date:
NIA
Tax ID:
17412976486
FEIN:
Duration:
Perpetual
Name:
SOUTHERN PETROLEUM LABORATORIES, INC.
Address:
8850 INTERCHANGE DR
HOUSTON. TX 77054-2511 USA
1r u c • r� N4re�c r9tl9j f ��
- --- �—
xame -- - - — - -
Name Status Name Type ttamelneeave Dade consent Filing
SOtmiERN PETROLEUM L.B0RX70PIES INC. In use Legal
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The Science of Sure
Dear Valued Customer,
ANAO'LAB
SPL ACQUISITION OF ANA-LAB
On April 4th, 2023, SPL acquired Ana -Lab. Please update your records accordingly to reflect the new name,
mailing address, and payment/remittance delivery instructions.
NEW NAME:
Southern Petroleum Laboratories, Inc.
Tax ID: 74-1297648
Payment Instructions (ACH and Wire):
ACH Routing: 111000025
Wire Routing: 026009593
Account Number: 005770519223
SWIFT Code: BOFAUS3N
Remittance Delivery Instructions: All remittance information should be emailed to ar@spl-inc.com
Pavment Mailing Address (Checks):
P.O. Box 842013
Dallas, TX 75284-2013
Corporate Office:
24 Waterway Ave., Ste. 375
The Woodlands, TX 77380
Please notify all departments of the name change and provide a copy of this notice as well as the W-9 and
information sheet attached. If you have any questions, please send inquiries to ar@spl-inc.com.
Thank you,
Brandon Pere
CFO
SPL—Southern Petroleum Laboratories, Inc.
\``111111111„�'
RL
"ll lull''' The Science of Sure"'
VENDOR: SPL
TAX ID: 74-1297648
BANK NAME: BANK OF AMERICA
ADDRESS: 1401 ELM STREET
LOCKBOX, 5T" FLOOR
DALLAS, TX 75202
101 Ibex Lane
Lafayette, LA 70518
PAYMENT INFORMATION
ALL CHECKS MUST BE MAILED TO:
LOCKBOX: P.O. BOX 842013
DALLAS, TX 75284-2013
ACH AND WIRE TRANSFERS:
ACH ROUTING NUMBER:
111000025
WIRE ROUTING NUMBER:
026009593
ACCOUNT NUMBER:
005770519223
SWIFT CODE:
BOFAUS3N
BANK CONTACT: CUSTOMER SERVICE
PHONE NUMBER: CENTER 1-888-400-9009
CONTACT NAME AT SPL: CRYSTAL COMEAUX
CONTACT EMAIL: AR@SPL-INC.COM
PHONE NUMBER: 337-233-2066
Miranda Ruckstuhl - Corporate Controller
Request for Taxpayer
Give Form to the
runn
(Rev. October2018) Identification Number and Certification
requester. Do not
DepartmentoftheTreasury
send to the IRS.
Internal
Revenue Service ► Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
Southern Petroleum Laboratories, Inc.
2 Business name/disregarded entity name, if different from above
Ana -Lab
y3
Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
4 Exemptions (codes apply only to
ro
following seven boxes.
certain entities, not Individuals; see
a
o
❑ IndividuaVsole proprietor or R1 C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/eatate
Instructions on page 3):
ai c
single -member LLC
Exempt payee code (if any)
0
❑ Limited liability company. Enter the tax classification (C-C corporation, S=S corporation, P=Partnership) ►
`o
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check
Exemption from FATCA reporting
a
C r
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)
(
y_-
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
O
N
❑ Qthar (Se9 InSir44tlgnS) ►
(Applias to accounts m.VntaWad outsde Ilia U.S.)
y
5 Address (number, street, and apt. or suite no.) See Instructions. Requester's name and address (optional)
4
101 Ibex Lane
n
6 City, state, and ZIP code
Broussard, LA 70518
7 List account number(s) here (optionao
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a I I I I _ m -
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a
TIN, later. of
Note: If the account is in more than one name, see the instructions for line 1 Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
M74 - 1 2I9I/ 6 4 8
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) llial I ain 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.;;. 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 (in yuui lax tetuin. Fut teal estate tiansauliuns, dent 2 dues nut apply. Fui inutlgage inletesl paid,
acquisition or abandonment of secured properly, cancellation of debt, cuntilbuliuns to an individual ieluenienl auangeirienl (IHA), 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 11, later.
Sign Signature of►1, Here I U.S. person �Z` Date ► y c.( D -2,
General Instructio s �� • Form 1099-DIV (dividends, including those front 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.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
aflet they were published, go to www.irs.gov/FormW9.
Purpose of Form
An individual or entity (Form W-9 requester) who Is required to file an
information return with the IRS must obtain your correct taxpayer
identification number (TIN) which may be your social security number
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer Identification number
(EIN), to report on an information return the amount paid to you, or other
amount reportable on an information return. Examples of information
returhs include, but are not limited to, the following.
• Form 1099-INT (interest earned or paid)
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage interest), 1098-E (student loan interest),
1098-T (tuition)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a resident
alien), to provide your correct TIN.
It you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
City of Fort Worth, Texas
Mayor and Council Communication
DATE: 08/09/22 M&C FILE NUMBER: M&C 22-0553
LOG NAME: 13P ITB 22-0126 LABORATORY ANALYTICAL SERVICES MC WATER
SUBJECT
(ALL) Authorize Execution of Non -Exclusive Purchase Agreements with A&B Environmental Services Inc, dba A&B Labs, Ana -Lab Corporation
and Eurofins Environment Testing South Central LLC, for Laboratory Analytical Services for the Water Department In a Combined Annual Amount
Up to $193,000.00 and Authorize Five Renewal Options for the Same Amount
RECOMMENDATION:
It is recommended that the City Council authorize execution of non-exclusive purchase agreements with A&B Environmental Services Inc. dba
A&B Labs, Ana -Lab Corporation and Eurofins Environment Testing South Central LLC, for laboratory analytical services in a combined annual
amount up to $193,000,00 and authorize five renewal options for the same amount,
DISCUSSION:
The Water Department approached the Purchasing Division to procure laboratory analytical services agreements with qualified laboratories to test
water, wastewater and solid waste samples to ensure compliance with federal and stale regulatory programs,
In order to procure these services, staff Issued an Invitation to Bid (ITB), ITB No. 22-0126 consisted of water's laboratory testing specifications and
required that all environmental testing laboratories to be accredited by the National Environmental Laboratory Accreditation Program (NELAP).
The ITB was advertised in the Fort Worth Sfar-Telegram on May 4, 2022, May 11, 2022, May 18, 2022 and May 25, 2022, The City received Thee
(3) responses,
An evaluation panel, comprised of representatives of the Water and Police departments reviewed and scored the submittals using the Best Value
criteria which included the following: (a) Bidder's ability to meet the Turn Around Time (TAT) required by the City of Fort Worth to complete the
scope of work; (b) Bidder's qualifications, certifications/licenses and references related to the scope of work; (c) Bidder's ability to meet the City
needs; and (d) cost of service. Tile individual scores were averaged for each of the criteria and the final scores are listed in the following table:
Evaluation Criteria
Bidders a b c d Total Score Rank
JA&B Environmental Services Inc, dba A&B Labs
18.33
22.00
6.00
35.00
81.33
1
JEurorins Environment Testing Soulh Cenlrai LLC
18,33
22.00
6.33
31.41
78.08
2
jAna-Lab Corporation
19.17
22.00
6.67
0.00
47.83
3
After evaluation, the panel concluded that A&B Environmental Services Inc. dba A&B Labs, Ana -Lab Corporation and Eurofins Environment
Testing South Central LLC, presented the best value to the City. Therefore, the panel recommends that Council authorize laboratory analytical
services agreements with A&B Environmental Services Inc. dba A&B Labs, Ana -Lab Corporation and Eurofins Environment Testing South Central
LLC.
It is recommended that multiple agreements be awarded to the listed vendors to ensure services are available without delay. Under these non-
exclusive agreements, departments will order services according to lowest cost and availability.
No guarantee was made that a specific amount of services world be purchased. Staff certifies that the recommended vendors bids meet
specifications.
FUNDING: The maximum amount allowed under this agreement citywide will be $193,000.00, however the actual arnount used will be based on
the need of the department and available budget, The annual department allocation for this agreement is:
IWto rtment1Estirnat$$d Annual 3,000.00 Amount 15330102 CONTRACT -LAB ANALYSISI
Funding is budgeted in the Water and Wastewater Department's rollup within the Water & Sewer Fund.
DVIN-BE: The initial estimated bid amount for this procurement was less than $100,000.00, therefore a Business Equity goal was not applicable.
ADMINISTRATIVE CHANGE ORDER: An administrative change order or increase may be made by the City Manager up to the amount allowed by
relevant law and the Fort Worth City Code and does not require specific City Council approval as long as sufficient funds have been appropriated.
AGREEMENT TERMS: Upon City Council approval, this agreement shall begin upon execution and expire on September 30, 2022.
RENEWAL OPTIONS - The City shall have five options to renew the Agreement; four (4) one-year renewal periods (October 1 st to September
301h) and ilia fifth renewal period which shall run from October 1st to the anniversary of the dale of execution, This action does not require specific
City Council approval provided that the City Council has appropriated sufficient funds to satisfy the City's obligations during the renewal term.
FISCAL INFORMATION / CERTIFICATION:
The Director of Flnance certifies that funds are available In the current operating budget, as previously appropriated, in the Water and Sewer
Fund to support Ilia approval of the above recommendation and execution of the agreement. Prior to any expenditure being Incurred, the Water
Department has the responsibility to validate the availability of funds,
Submitted for City Manaaer's Office bv: Reginald Zeno
8517
Dana Burghdoff
8018
Oriainatlna Business Unit Head: Anthony Rousseau
4338
Christopher Harder
5020
Additional Information Contact: Cynthia Garcia
8626
Maria Canoura
2526
CERTIFICATE OF INTERESTED PARTIES FoRm 1295
loll
Complete Nos, 1- 4 and 6 it there are Interested parties. OFFICE USE ONLY
Complete Nos. 1, 2, 3, 5, and 6 it Ihere are no Interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form, and the city, state and country of the business entity's place Certificate Number:
of business. 2022-903121
Ana -Lab Corporation
Kilgore, TX United Slates Date Filed:
2 Name of governmental entity or state agency that Is a party to the contract for which the form is 06/23/2022
being filed.
City of Fort Worth Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
ITB 22-0126
Environmental Testing Services
4 Nature of Interest
Nance of Interested Party City, State, Country (place of business) (check applicable)
Controlling Intermediary
City of Fort Worth Fort Worth, TX United Stales X
5 Check only If there Is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name Is Trey Peery
My address Is 2600 Dudlev Rd
(street)
, and my date of birth is 5 January 1900
I<IlOoto Tx 75663
. GtotuL_.
(city) (stale) (zip coda) (cormlry)
I declare under penally of perjury that the foregoing Is true and correct.
Executed in Gregg County, Slate of Texas on the 24 day of June 2022
(month) (year)
Signature ojauthorized t of contracting business entity
)l)
Forms provided by Texas Ethics Commission www.eihics.slate.tuis Version V1,1.191b5cdc