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HomeMy WebLinkAboutContract 57052-CA1CSC No. 57052-CA1 CITY OF FORT WORTH ASSIGNMENT For value received Tijerina Financial Consulting LLC ("Assignor"), hereby assigns to A&C Galvan Group ("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 57052 (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 1 Jth day of July 2024. Tijerina Financial Consulting LLC (Assignor) By: t Print: Robert A. Tijerina,/ Title: Chief Executive Officer A&C Galvan Group dba as Galvan Strategy Group (Assignee) By: Print: G an Title: le xecu Ive Officer OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Assignment Page 1 of NOTARY ACKNOWLEDGEMENT On the P - - day of 2024, personally appeared f<YOh't--]-A I, ow. who acknowledgedto that (s)he is the Chief Executive Officer of Tijerina Financial Consulting LLC ("Assignor"), and that (s)he executed this document for the purposes and consideration contained herein. Tijerina Financial Consultin¢ LLC Print: idx 7 o TWe: ChiefExecutive ®..� SUBSCRIBED TO before me on this 1: LL. day of d'/z! 4-/------- - 2024. NANCy ROSALES MEN'0 �{ ►�1G�{ ��U�Lt I CS M EI�G(v2� €. _Notary Public, Ste to of Tex �, public in and for the State of T a �-I+5 5?'•, �� Comm. Expires 06 E3-2 22 �` Notary ID 1336-0 commission Expires: �i 3 NOTARY ACKNOWLEDGEMENT ,t On h LL day of 0—<< 2024, personally appeared tTtirlW.) :I A T who acknowlUied e that (s)he is the Chief Executive Officer of A&C Galvan Group ("Assignee"), and that (s)he executed this document for the purposes and consideration contained herein. A&C Galvan G up b s Galvan Strategy Group Galvan Title: Chief Executive Officer SUBSCRIBED TO before me on this �M day of �f �' • 2024. 4 DONNA JEAN VON ROSEN5ER0 a✓'r r� i _Notary Public. Slate of Texas otary Public4dand for the State of KxC4 Comm. Expires 05.07-2025 },c `�- Notary ID 0515167 Y commission Expires: J — '% — c0Oct J Assignment Page :zoo CONSENT TO ASSIGNMENT The City of Fort Worth consents to the assignment of Tijerina Financial Consulting LLC ("Assignor") to A&C Galvan Group ("Assignee"), of all its rights, title, and obligation owing and all funds due or to become due to Assignor under CSCO 57052 as long as all terms required of Assignor in said contracts are met by Assignee. CITY OF FORT WORTH —A Reginald Zeno (Aug 13, 2024 09:58 CDT) Chief Financial Services Officer City Mani/ �.00vvnnnIl c4 � foRt��add v �`o a ATTESTED BY: o° ** c d (J bnauaao Jannette Goodall, City Secretary APPROVED AS TO FORM AND LEGALITY: 3&-v, City of Fort Worth Sr. Assistant City Attorney Contract Compliance Manager: Aug 13, 2024 Date 8 / g10o l- f ate Aug 19, 2024 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. 7+U-* Employee Signature/Date Debt Manager Title Aug 13, 2024 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Assignment Page of Corporations Section �E 0, P.O.Box 13697 5 Austin, Texas 78711-3697 Office of the Secretary of State CERTIFICATE OF FILING OF A&C Galvan Group LLC 805302967 Jane Nelson Secretary of State The undersigned, as Secretary of State of Texas, hereby certifies that a Certificate of Amendment for the above named entity has been received in this office and has been found to conform to the applicable provisions oflaw. ACCORDINGLY, the undersigned, as Secretary of State, and by virtue of the authority vested in the secretary by law, hereby issues this certificate evidencing filing effective on the date shown below. Dated: 03/14/2024 Effective: 03/14/2024 Jane Nelson Secretary of State Come visit its on the internet at https:llivivit,.sos.teYas.goil Phone: (512) 463-5555 Fax: (512) 463-5709 Dial: 7-1-1 for Relay Services Prepared by: Linda Galaviz TID: 10303 Document: 1343511180002 Request for Taxpayer Give form to the Formw *9 Identification Number and Certification requester. Do not (Rev. March 2024) Department of the Treasury Go to wwwirs.gov/FormW9for instructions and the latest information. send to the IRS. Internal Revenue Service Before you beqin. For guidance related to the purpose of Form W-9, see Purpose of Form, below. 1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded entity's name on line 2.) A & C Galvan Group 2 Business name/disregarded entity name, if different from above. Galvan Strateav Group C, 13a Check the appropriate box forfederal tax classification of the entity(ndividual whose name is entered on line 1. Check 4 Exemptions (codes apply only to c of only one of the following seven boxes. certain entities, not individuals; u c ❑ Individual/sole proprietor D C corporation D S corporation D Partnership D Trust/estate see instructions on page 3): 0 ) 0 LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) S Exempt payee code (d any) a c. Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax I.i:11 classification of the LLC, unless It is a disregarded entity.A disregarded entity should instead check the appropriate Exemption from Foreign Account Tax d 1: tI box for the tax classification of its owner. Compliance Act (FATCA) reporting o, S ❑ Other (see instructions) code (if any) C. U 3b I On IIine,gga ok checke P rtners i " or'TrusUest to " Gheck "�C" a d entered "P" as its tax classification, t�sdboxlf uk ed� Iore��r�� hoer r r�etfie1(c ets.ee n�is ❑ da �Pfisli,rirus of �s�a e i wtilc n%j ave an ownership interest, check (Applies toaccounts maintained of ou a�pYi It Is , outside the United States.) 2 16 Address (number, street, and apt. or suite no.). See instructions. I Requester's name and address (optional) 101 Summit Ave, Suite 606 II (6 City, stale, and ZIP code Fort Worth, TX 76102 7 List accountnumber(s)here (optional) ■.P. �• Taxpayer Identification Number (TIN) I u..- uw i — - inc VP­P. a . wn. � tic i — Nip 1— 111— niawu L i uainc W-11 — nnc , w a Ua backup withholding. For individuals, this is generally your social security number (SSN). However, fora II o resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other u entities, it Is your employer identification number (EIN). If you do not have a number, see How to get a or TIN, later. Emolover Identification numh�r Note: If the account is in more than one name, seethe instructions for line 1. See also What Name and Number To Give the Requester for guidelines on whose number to enter. 9 3 - 4 4 1 1 3 2 8 JIM 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 di- ends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured pr rtY. ancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments other than interest and dividends you pl JrOAQ ,Sinn the rertifiration but you must nrovide vour correct TIN See the instructions for Part II later. Sign Signature of / IJ 2LJ Here U.S. person Date-t:::>- 7 General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to Www.irs.gov/FormIN9. What's New Line 3a has been modified to clarify how a disregarded entity completes this line. An LLC that is a disregarded entity should check the appropriate box for the tax classification of its owner. Otherwise, it should check the "LLC" box and enter Its appropriate tax classification. New line 3b has been added to this form. A flow -through entity is required to complete this line to indicate that it has direct or indirect foreign partners, owners, or beneficiaries when it provides the Form W-9 to another flow -through entity in which it has an ownership interest. This change is intended to provide a flow -through entity with information regarding the status of its indirect foreign partners, owners, or beneficiaries, so that it can satisfy any applicable reporting requirements. For example, a partnership that has any indirect foreign partners may be required to complete Schedules K-2 and K-3. See the Partnership Instructions for Schedules K-2 and K-3 (Form 1065). Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS is giving you this form because they Cat. No.10231X Form W-9 (Rev.3-2024) Corporations Section P.O.Box 13697 Austin, Texas 78711-3697 November 14, 2023 E OFF w � � V:' x Office of the Secretary of State Attn: Legalzoom.com, Inc. Legalzoom.com, Inc. 101 N. Brand Blvd, 1 Oth Floor Glendale, CA 91203 USA RE: A&C Galvan Group LLC File Number: 805302967 Jane Nelson Secretary of State It has been our pleasure to file the certificate of formation and issue the enclosed certificate of filing evidencing the existence of the newly created domestic limited liability company (11c). Unless exempted, the entity formed is subject to state tax laws, including franchise tax laws. Shortly, the Comptroller of Public Accounts will be contacting the entity at its registered office for information that will assist the Comptroller in setting up the franchise tax account for the entity. Information about franchise tax, and contact information for the Comptroller's office, is available on their web site at httos://window. state.tx.us/taxinfo/franchise/index.html. The entity formed does not file annual reports with the Secretary of State. Documents will be filed with the Secretary of State if the entity needs to amend one of the provisions in its certificate of formation. It is important for the entity to continuously maintain a registered agent and office in Texas. Failure to maintain an agent or office or file a change to the information in Texas may result in the involuntary termination of the entity. If we can be of further service at any time, please let us ]snow. Sincerely, Corporations Section Business & Public Filings Division (512)463-5555 Enclosure Come visit its on the internet at https:11WiPw.sos.texas.gov/ Phone: (512) 463-5555 Fax: (512) 463-5709 Dial: 7-1-1 for Relay Services Prepared by: Tracy Cardenas TID: 10285 Document: 1304665320002 Corporations Section 0 P.O.Box 13697 Austin, Texas 78711-3697 x Office of the Secretary of State CERTIFICATE OF FILING OF A&C Galvan Group LLC File Number: 805302967 Jane Nelson Secretary of State The undersigned, as Secretary of State of Texas, hereby certifies that a Certificate of Formation for the above named Domestic Limited Liability Company (LLC) has been received in this office and has been found to conform to the applicable provisions oflaw. ACCORDINGLY, the undersigned, as Secretary of State, and by virtue of the authority vested in the secretary by law, hereby issues this certificate evidencing filing effective on the date shown below. The issuance of this certificate does not authorize the use of a name in this state in violation of the rights of another under the federal Trademark Act of 1946, the Texas trademark law, the Assumed Business or Professional Name Act, or the common law. Dated: 11 / 13/2023 Effective: 11 / 13/2023 Jane Nelson Secretary of State Come visit its on the internet athttps:11wivw.sos.texas.gov/ Phone: (512) 463-5555 Fax: (512) 463-5709 Dial: 7-1-1 for Relay Services Prepared by: Tracy Cardenas TID: 10306 Document: 1304665320002 IN Secretary of State P.O. Box 13697 Austin, TX 78711-3697 FAX: 512/463-5709 Filing Fee: $300 Certificate of Formation Limited Liability Company Filed in the Office of the Secretary of State of Texas Filing#: 805302967 11 /13/2023 Document#: 1304665320002 Image Generated Electronically for Web Filing Article 1 - Entity Name and Type The filing entity being formed is a limited liability company. The name of the entity is: A&C Galvan Groun LLC Article 2 - Registered Agent and Registered Office f7A. The initial registered agent is an organization (cannot be company named above) by the name of: United States Corporation Agents, Inc. OR rs. The initial registered agent is an individual resident of the state whose name is set forth below: C. The business address of the registered agent and the registered office address is: Street Address: 10601 Clarence Dr. Suite 250 Frisco TX 75033 Consent of Registered Agent A. A copy of the consent of registered agent is attached. OR P's. The consent of the registered agent is maintained by the entity. Article 3 - Governing Authority r A. The limited liability company is to be managed by managers. OR 17B. The limited liability company will not have managers. Management of the company is reserved to the members. The names and addresses of the governing persons are set forth below: Managing Member 1: Adrlan Galvan Title: Managing Member Address: 405 Forest River Cir Fort Worth TX, USA 76112 Managing Member 2: Melondy Monique Doddy-Munoz Title: Managing Member Address: 405 Forest River Cir Fort Worth TX, USA 76112 Managing Member 3: Crlstal Linda Hernandez-Galvan Title: Managing Member Address: 405 Forest River Cir Fort Worth TX, USA 76112 Article 4 - Purpose The purpose for which the company is organized is for the transaction of any and all lawful business for which limited liability companies may be organized under the Texas Business Organizations Code. xn forrnat`O� prov�s�oos `000- e�`e°tad Su [The attached addendum, if any, is incorporated herein by reference.] Initial Mailing Address Address to be used by the Comptroller of Public Accounts for purposes of sending tax information. The initial mailing address of the filing entity is: 405 Forest River Cir Fort Worth, TX 76112 USA Organizer The name and address of the organizer are set forth below. Legalzoom.com, Inc. 101 N Brand Blvd. 11th Floor. Glendale. CA 91203 PA. This document becomes effective when the document is filed by the secretary of state. OR Ps. This document becomes effective at a later date, which is not more than ninety (90) days from the date of its signing. The delayed effective date is: Execution The undersigned affirms that the person designated as registered agent has consented to the appointment. The undersigned signs this document subject to the penalties imposed by law for the submission of a materially false or fraudulent instrument and certifies under penalty of perjury that the undersigned is authorized under the provisions of law governing the entity to execute the filing instrument. Chevenne Moselev, Asst. Secretarv, Legalzoom.com Inc. Signature of Organizer FILING OFFICE COPY FORTWORTH Routing and Transmittal Slip Financial Management Services Department DOCUMENT TITLE: Consent of Assignment — Tijerian Financial Consulting LLC to A&C Galvan Group M&C CPN DATE: TO: 1. JB Strong — Sr. Assistant Attorney 2. Alex Laufer — Financial Services Manager 3. Reginald Zeno — Chief Financial Services Officer 4. David Cooke — City Manager CSO #57052 DOC# INITIALS Al - AL DATE OUT Aug 6, 2024 Aug 13, 2024 Aug 13, 2024 g//i/Za 2� DOCUMENTS FOR CITY MANAGER'S SIGNTURE: All documents received from any and all City Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review and take the next steps. NEEDS TO BE NOTARIZED: ❑ Yes-& No r RUSH: ❑ Yes ❑ No SAME DAY: ❑ Yes ❑ No NEXT DAY: Yes ❑ No ROUTING TO CSO: P Yes ❑ No Action Required: ❑ As Requested ❑ For Your Information Signature/Routing and or Recording ❑ Comment ❑ File Return to: Please call GIQ `�Cr j ❑ Attach Signature, Initial and Notary Tabs at ext.for pick up when completed. Thank you.