HomeMy WebLinkAboutContract 56630-A1CSC No. 56630-Al
FIRST AMENDMENT TO
CITY SECRETARY CONTRACT NO. 56630
BETWEEN CITY OF FORT WORTH AND FIREHOUSE HYDROSTAT SERVICES,
LLC
This First Amendment to Fort Worth City Secretary Contract No. 56630 ("First
Amendment") is made between the City of Fort Worth ("Fort Worth"), a municipal corporation
and Firehouse Hydrostat Services, LLC("Vendor").
WHEREAS, Fort Worth and Vendor entered into an agreement, as authorized by chapter
791 of the Texas Government Code, identified as Fort Worth City Secretary Contract No. 56630
beginning November 09, 2021 (the "Agreement"); and
WHEREAS, it is the collective desire of both Fort Worth and Vendor to amend the
Agreement to increase the amount of the contract from $19,975.00 to $50,000.00 for MedStar
Additional Hydrostatic Testing and Cylinders.
NOW THEREFORE, known by all these present, Fort Worth and Vendor, acting herein
by the through their duly authorized representatives, agree to the following terms, which amend
the Agreement as follows:
1.Paragraph 3 of the Agreement, titled Compensation, is hereby amended to read as
follows:
3.Compensation. City shall pay Vendor in accordance with the fee schedule of
Vendor personnel who perform services under this Agreement in accordance with the
provisions of this Agreement and Exhibit "B," -Price Schedule. Total payment made
under this Agreement for Initial Term shall not exceed the amount of Fifty Hundred
Thousand and Zero Cents ($50,000.00), and the City makes no promise or guarantee
of the total amount of work that will assigned to vendor under this Agreement. Vendor
shall not perform any additional 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.
2.All other terms, provisions, conditions, covenants and recitals of the Agreement not
expressly amended herein shall remain in full force and effect.
[Signature Page Follows]
Executed effective as of the date signed by the Assistant City Manager below.
First Amendment to Fort Worth City Secretary Contract No. 56630 Page 1 of2
FORT WORTH:
City of Fort Worth By: Dana Burghdoff (Feb.20251 . CST) Name: Dana Burghdoff Title: Assistant City Manager Date: Feb 1, 2025
Approval Recommended: By: James Davis (Jan 31, 2025 08:02 CST) Name: James Davis Title: Fire Chief Attest: By: r }.,_� Name: Jannette Goodall Title: City Secretary By: Name: Title: Date: Con ct Compliance Manager: By si ing I acknowledge that I am th1 person respo sible for the monitoring and adm�tion ofthi contract, including ensuring all performance and porting requirements. By: renda Ray (Jan 28, 2025 13:44 CST) Nam f • Brenda Ray Title: • Fire Purchasing Manager App oved as to Form and Legality: �r::�-Titl�r �sistant City AttorneyContct Authorization: M& : N/A 1295 NIA
First Amendment to Fort Worth City Secretary Contract No. 56630 Page 2 of2
CSC No. 56630
ORT�ORTHH
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VENDOR SERVICES AGREEMENT
Firehouse Hydrostat Services
This VENDOR SERVICES AGREEMENT ("Agreement") is made and entered into by and
between the CITY OF FORT WORTH ("City"), a Texas home rule municipal corporation, acting by and
through its duly authorized Assistant City Manager, and Fire Hydrostat Services ("Vendor"), a Texas
Limited Liability Company and acting by and through its duly authorized representative, each indi��idually
referred to as a"party" and collectively referred to as the "parties "
AGREEMENT DOCUMENTS:
The A�reement documents sha11 include the followin�:
1. This Vendor Services Agreement;
2. Exhibit A— Scope of Services;
3. Exhibit B— Price Schedule;
4. Exhibit C— City's RFP No.21-0179
5. Exhibit D— Vendor's Bid Response to City's RFP No_ 21-0179; and
6. E�ibit E— Verification of Signature Authority Form.
Exhibits A, B, C, D, and E, which are attached hereto and incorporaxed herein, are made a part of this
Agreement for all purposes. In the event of any conflict between the terms and conditions of E�chibits A, B,
C, or D and the terms and conditions set forth in the body of this Agreement, the terms and conditions of
this A�reement shall control.
1. Scone of Services. Vendor is to supply the City with h}�drostaxic testin� services for SCBA,
SCUBA, oxygen cylinders, and large D.O.T. cylinders for the Fire Department. ("Services"), ahich are set
forth in more detail in E�ibit "A," attached hereto and incorporated herein for all purposes..
2. Term. This Agreement shall begin on the date signed by the Assistant City Manager below
("Effective Date") and expires one year after ("Expiration Date"), unless terminated earlier in accordance
with this A�reement ("Initial Term"). City will have the option, in its sole discretion, to renea� this
Agreement under the same terms and conditions, for up to four (4) one-year renewal option(s) (each a
"Renewal Term")_
3. Comnensation. City will pay Vendor in accordance with the provisions ofthis A�reement,
including Exhibit "B," which is attached hereto and incorporated herein for all purposes_ Total annuai
compensation under this Agreement will not exceed Nineteen Thousand and Nine Hundred and
Seventy-Five Dollars and Zero Cents Dollars ($19,975.00). T'he Ciry makes no promise or �uarantee of
the total amount of work that will be assigned to Vendor under this Aareement. Vendor w-ill not perform
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TjC
4. any additional services or bill for expenses incurred for City not specified by this A�eement
unless City requests and approves in writin� the addirional costs for such services_ City RJill not be liable
for any additional expenses of Vendor not spec�ed by this A�eement unless City first approves such
expenses in v��ritina.
4. Termination.
4.1. Written Notice. City or Vendor may terminate this Agreement at any time and for
any reason by providing the other party with 30 days' written notice of termination.
42 Non-appropriation of Funds. In the event no funds or insufficient funds are
appropriated by City in any fiscal period for any payments due hereunder, City �Rll notify Vendor
of such occurrence and this Agreement will terminate on the last day of the fiscal period for which
appropriations were received without penalty or expense to City of any kind whatsoever, except as
to the portions of the payments herein agreed upon for which funds have been appropriated_
4.3 Duties and Oblisations of the Parties. In the event that tlus A�eement is
terminated prior to the Expiration Date, City will pay Vendor for services actually rendered up to
the effective date of termination and Vendor will continue to pmvide City with sen%ices requested
by City and in accordance with this Agreement up to the effective date of termination_ Upon
termination of this Agreement for any reason, Vendor will provide City with copies of a1l
completed or partially completed documents prepared under this A�eement. In the event Vendor
has received access to Ciry Informarion or data as a requirement to perform ser�zces hereunder,
Vendor will return a11 City provided data to City in a machine readable format or other format
deemed acceptable to City.
5. Disclosure of Conflicts and Confidential Information.
5.1 Disclosure of Conflicts. Vendor hereby w-arrants to City that Vendor has made full
disclosure in writing of any existing or potential conflicts of interest related to Vendor's services
under this Ab eement. In the event that any conflicts of interest arise after the Effective Date of this
A�reement, Vendor hereby agrees immediately to make full disclosure to City in w-ntin�_
52 Confidential Information. Vendor, for itself and its officers, aQents and employees,
agrees that it will treat all information pro�zded to it by City ("City Information") as confidenrial
and will not disclose any such information to a third party without the prior �vritten approval of
City.
5.3 Public Information Act_ City is a government entity under the laws of the State of
Texas and all documents held or maintained by City are subject to disclosure under the Te�s Public
Information Act. In the event there is a request for informarion marked Confidential or Proprietary,
City will promptly notify Vendor. It will be the responsibility of Vendor to submit reasons objectin�
to disclosure. A determination on whether such reasons are sufficient will not be decided by City,
but by the Office of the Attomey General of the State of Texas or by a court of competent
jurisdiction.
5.4 Unauthorized Access_ Vendor must store and maintain City Information in a secure
manner and will not allow unauthorized users to access, modify, delete or otherwise corrupt City
Information in any way. Vendor must notify City immediately if the security or integrity of any
Ciry Information has been compromised or is believed to ha�e been compromised, in which event,
Vendor will, in good faith, use a11 commercially reasonable efforts to cooperate with City in
identifying what information has been accessed by unauthorized means and will fully cooperate
with Ciry to protect such City Information from further unauthorized disclosure_
6. Ri�ht to Audit. Vendor a�ees that City will, until the expiration of three (3) years after
final payment under this Aa eement, 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 A�eement at no additional cost to City. Vendor a�ees that City will have access durinQ
normal working hours to all necessary Vendor facilities and will be provided adequate and appropriate �vork
space in order to conduct audits in compliance with the provisions of this section_ City will �ive Vendor
reasonable advance notice of intended audits.
7. Independent Contractor. It is expressly understood and agreed that Vendorwill operate
as an independent contractor as to all ri�hts and privileges and work performed under this A�reement, and
not as agent, representative or employee of City. Subject to and in accordance with the conditions and
provisions of this Agreement, Vendor will have the exclusive ri�ht to conirol the details of its operations
and activities and be solely responsible for the acts and omissions of its officers, a�ents, servants,
employees, Vendors, and subcontractors. Vendor acknowledges that the doctrine of f�espondeat superior
will not apply as between City, its officers, agents, servants and employees, and Vendor, its officers, ajents,
employees, servants, contractors, and subcontractors. Vendor further ab�rees that nothing herein will be
construed as the creation of a partnership or joint enterprise between City and Vendor_ It is further
understood that City will in no way be considered a Co-employer or a Joint employer of Vendor or any
officers, agents, servants, employees, contractors, or subcontractors. Neither Vendor, nor any officers,
agents, servants, employees, contractors, or subcontractors of Vendor will be entitled to any employment
benefits from City. Vendor will be responsible and liable for any and all payment and reporting of ta�es on
behalf of itself, and any of its officers, agents, servanu, employees, contractors, or contractors_
Liabilitv and Indemnification.
8.1 LIABILITY - VENDOR WILL BE LIABLE AND RESPONSIBLE FOR A.r'�'Y
AND ALL PROPERTY LOSS, PROPERTY DAMAGE AND/OR PERS0I�TAL LNJURY,
INCLUDIIVG DEATH, TO ANY AND ALL PERSONS, OF ANY KIND OR CHARACTER,
WHETHER REAL OR ASSERTED, TO THE EXTENT CAUSED BY THE 1VEGLIGE�I�T
ACT(S) OR OMISSIOl�r(S), MALFEASANCE OR I1VTEIVTIONAL MISCO1bDUCT OF
VENDOR, ITS OFFICERS, AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, OR
SUBCONTRACTORS.
8.2 GENERAL INDEMNIFICATION - VENDOR HEREBY COVENANTS AND
AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND CITY, ITS OFFICERS,
AGENTS, SERVANTSAND EMPLOYEES, FROMAIVDAGAINSTAN"YANDALL CLAIMS
OR LAWSUITS OFANYKIND OR CHARACTER, WHETHER REAL ORASSERTED, FOR
EITHER PROPERTYDAMAGE OR LOSS (INCL UDINGALLEGED DAMAGE OR LOSS TO
VENDOR'S BUSINESS AND ANY RESULTING LOST PROFITS) A1VD/OR PERSO�VAL
INJURY, INCL UDING DEATH, TO ANY AND ALL PERSOR'S, ARISING Ol�T OF OR L�%
CONNECTION WITH THIS AGREEMENT, TO THE EXTENT CAUSED BY THE
NEGLIGENT ACTS OR OMISSIONS OR MALFEASANCE OF VENDOR, ITS OFFICERS",
AGENTS, SERVANTS, EMPLOYEES, CONTRACTORS, OR SIIBCONTRACTORS.
8.3 INTELLECTUAL PROPERT'Y INDEI�IIVIFICATIO_N — Vendor a�ees to
defend, settle, or pay, at its own cost and expense, any claim or action against City for
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infringement of any patent, copyright, trade mark, trade secret, or similar property right
arising from City's use of the software and/or documentafion in accordance with this
Agreement, it being understood that this agreement to defend, settie or pay will not app�g if
City modifies or misuses the software and/or documentation. So long as Vendor bears the
cost and expense of payment for claims or actions against City pursuant to this section,
Vendor will have the right to conduct the defense of any such claim or acfion and all
negotiations for its settlement or compromise and to settle or compromise any such claim;
however, City will have the right to fully participate in any and alf such settlement,
negotiations, or lawsuit as necessary to protect City's interest, and City ab ees to cooperate
with Vendor in doing so. In the event City, for �vhatever reason, assumes the responsibility
for payment of costs and expenses for any claim or action brought against City for
infringement arising under this Agreement, City will 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; howe�er, Vendor �vill fully participate and cooperate
with City in defense of such claim or action. City agrees to � ve Vendor timely written notice
of any such claim or action, with copies of all papers City ma,y receive relatang thereto.
Notwithstanding the foregoing, City's assumption of payment of costs or expenses �vi� not
eliminate Vendor's duty to indemnify City under this Agreement. If the software and/or
documentation 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 will, at its own expense and as City's sole remedy, either: (a) procure for
City the right to continue to use the software and/or documentation; or (b) modif� the
software and/or documentation to make it non-infrin� ng, provided that such mo�ification
does not materially adversely affect City's authorized use of the software and/or
documentation; or (c) replace the software and/or documentation with equally suitable,
compatible, and functionally equivalent non-infrin� ng software and/or documentation at no
additional charge to City; or (d) if none of the foregoing alternatives is reasonabl� available
to Vendor terminate this Agreement, and refund all amounts paid to Vendor by Cit3-,
subsequent to which termination City may seek any and all remedies available to �ty under
law.
Assi�nment and SubcontractinQ.
9.1 Assi�nment. Vendor will not assi�n or subcontract any of its duties, obligations
or rights under this Aa eement without the prior written consent of City_ If City �ra.nts consent to
an assignment, the assignee will execute a�critten agreement with City and Vendor under which
the assignee agrees to be bound by the duties and obligations of Vendor under this A�reement
Vendor will be liable for all obligations of Vendor under this Agreement prior to the effective date
of the assignment.
92 Subcontract. If City �-ants consent to a subcontract, the subcontractor will execute
a written agreement with Vendor referencing this Agreement under �vhich snbcontractor a�rees to
be bound by the duries and obligations of Vendor under this A�reement as such duties and
obligations may apply. Vendor must provide City with a fully executed copy of any such
subcontract.
10_ Insurance. Vendor must provide City with certificate(s) of insurance documenting
policies of the following types and minimum coverage limits that are to be in effect prior to commencement
of any Services pursuant to this Agreement:
10.1 CoveraQe and Limits
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(a) Commercial General Liability:
$1,000,000 - Each Occurrence
$2,000,000 - A��regate
(b) Automobile Liability:
$1,000,000 - Each occurrence on a combined single limit basis
Covera�e will be on any vehicle used by Vendor, or its employees, a�ents, or
representarives in the course of pmvidin; Services under this A�eement_ "Any
vehicle" will be any vehicle owned, hired and non-o�vned.
(c) Worker's Compensation:
Statutory limits according to the Texas ��Vorkers' Compensation Act or any other
state workers' compensation laws where the Services aze bein� performed
Employers' liability
$100,000 - Bodily Injury by accident; each accidentJoccurrence
$100,000 - Bodily Injury by disease; each employee
$500,000 - Bodily Injury by disease; policy limit
(d) Professional Liability (Errors & Omissions):
$1,000,000 - Each Claim Limit
$1,000,000 - Ag�egate Limit
Professional Liability coverage may be provided through an endorsement to the
Commercial General Liability (CGL) policy, or a separate policy specific to
Professional E&O. Either is acceptable if coverage meets aIl other requirements.
Covera�e must be claims-made, and maintained for the duration of the contractual
agreement and for two (2) years following completion of services pro��ided. An
annual certificate of insurance must be submitted to City to evidence coverage_
102 General Requirements
(a) The commercial �eneral liability and automobile liability policies must
name City as an additional insured thereon, as its interests may appear. The term
City includes its employees, o�cers, officials, agents, and volunteers in respect to
the contracted services.
(b) The workers' compensation policy must include a Wai�7er of Subm�ation
(Right of Recovery) in favor of City.
(c) A minimum of Thirry (30) days' notice of cancellarion or reduction in
limits of coverage must be provided to City. Ten (10) days' notice will be
acceptable in the event of non-payment of premium_ Notice must be sent to the
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Risk Mana�er, City of Fort Worth, 200 Texas Street, Fort Worth, Texas 76102,
with copies to the Fort Worth City Attomey at the same address_
(d) The insurers for all policies must be licensed and/or appmved to do
business in the State of Texas. All insurers must have a minimum ratinQ of A- VII
in the current A.M. Best Key Rating Guide, or have reasonably equivalent fmancial
strength and solvency to the satisfaction of Risk Mana�ement.If the ratin� is
below that required, written approval of Risk Mana�ement is required.
(e) Any failure on the part of City to request required insurance
documentation will not constitute a waiver of the ins�ance requirement_
( fl Certificates of Insurance evidencing that Vendor has obtained all required
insurance will be deli��ered to the City prior to Vendor proceeding with any �vork
pursuant to this Agreement.
11. Compliance with Laws, Ordinances, Rules and Rewlations. Vendor a�ees that in the
performance of its obligarions hereunder, it �vill comply with all applicable federal, state and locat laws,
ordinances, rules and regulations and that any work it produces in connection with this A�eement �vill also
comply with all applicable federal, state and local laws, ordinances, rules and regulations_ If City notifies
Vendor of any violation of such laws, ordinances, rules or re�ulations, Vendor must immediately desisi
from and conect the violation.
12. Non-Discrimina6on Covenant. Vendor, for itself_, its personal representati�es, assi�ns,
contractors, subcontractors, and successors in interest, as part of the consideration herein, a�ees that in the
performance of Vendor's duties and obligations hereunder, it will not discriminate in the treatment or
employment of any individual or group of individuals on any basis prohibited by law. IF ANY CLAI��I
ARiSES FROM AN ALLEGED VIOLATION OF TffiS NON-DISCRI�1'IINATION COVEN�'�iT
BY VENDOR, ITS PERSONAL REPRESENTATIVES, ASSIGNS, CONTRACTORS,
SUBCONTRACTORS, OR SUCCESSORS IN INTEREST, VENDOR AGREES TO ASSUI�
SUCH LIABILITY AND TO INDEMNIF'Y Ai�iD DEFEND CITY Ai�1D HOLD CITY HARIVII.ESS
FROM SUCH CLAIM.
13_ Notices. Notices required pursuant to the provisions of this Agreement will be
conclusively determined to have been delivered when (1) hand-delivered to the other party, its agents,
employees, servants or representarives, (2) delivered by facsimile with electronic confirmation of the
transmission, or (3) received by the other party by United States Mail, re�istered, retum receipt requested,
addressed as follows:
To CITY:
To VENDOR:
City of Fort Worth Firehouse Hydrostat Services
Attn: Assistant City Manager 200 Hillside Ln
200 Texas Street Lindsay Texas
Fort Worth, TX 76102-6314 76250
Facsimile: (817) 392-8654 sevans�a%.firchousehvdro.com
Phone: 817 948 6177
With copy to Fort Worth City Attorney's Office
at same address
14. Solicitation of Emulovees. Neither City nor Vendor will, durin� the term of this
Ab eement and additionally for a period of one year after its termination, solicit for employment or employ,
whether as employee or independent contractor, any person who is or has been employed by the other
during the term of this Agreement, without the prior written consent of the person's employer.
Notwithstanding the foregoing, this provision will not apply to an employee of either party �vho responds
to a general solicitation of advertisement of employment by either party.
15_ Governmental Powers. It is understood and agreed that by execution of this A�eement
City does not waive or surrender any of its �ovemmental powers or immunities.
16. No Waiver. The failure of City or Vendor to insist upon the performance of any term or
provision of this Agreement or to exercise any ri�ht granted herein does not constitute a waiver of City's or
Vendor's respecUve right to insist upon appropriate performance or to assert any such ri�ht on any future
occasion.
17. Governin� Law / Venue. This A�eement will be construed in accordance with the laws
of the State of Texas. If any acrion, whether real or asserted, at law or in equity, is brought pursuant to this
Agreement, venue for such action will lie in state courts located in Tarrant County, Texas or the United
States District Court for the Northern District of Texas, Fort Worth Division.
18. Severabilitv. If any provision of this Agreement is held to be invalid, illegal or
unenforceable, the validity, legality and enforceability of the remainin� provisions will not in any way be
affected or impaired.
19. Force vIaieure. City and Vendor will exercise their best efforts to meet their respective
duties and obli�ations as set forth in this A�reement, but will not be held liable for any delay or omission
in performance due to force majeure or other causes beyond their reasonable control, including, but not
limited to, compliance with any government law, ordinance, or regulation; acts of God; acts of the public
enemy; fires; strikes; lockouts; natural disasters; wars; riots; epidemics or paudemics; government action
or inaction; orders of govemment; material or labor restrictions by any governmental authority;
transportation problems; restraints or prohibitions by any court, board, department, commission, or agency
of the United States or of any States; civil disturbances; other national or re�ional emergencies; or any other
similar cause not enumerated herein but which is beyond the reasonable control of the Party whose
performance is affected (collectively, "Force Majeure Event"). The performance of any such obligation is
suspended during the period of, and only to the extent of, such prevenrion or hindrance, provided the
affected Party provides notice of the Force Majeure Event, and an explanation as to how it pre�-ents or
hinders the Party's performance, as soon as reasonably possible after the occurrence of the Force lbiajeure
Event, with the reasonableness of such notice to be determined by the City in its sole discretion_ The notice
required by this section must be addressed and delivered in accordance arith Section 13 of this A�reement
20. Headings not Controllina. Headings and titles used in this A�reement are for reference
purposes only, will not be deemed a part of this Agreement, and are not intended to define or limit the scoge
of any provision of this Agreement.
21. Review of Counsel. The parties ackno�vledge that each part� and its counsel have
reviewed and revised tbis Agreement and that the normal rules of construction to the effect that any
ambiguities are to be resolved against the draftin� party will not be employed in the interpreta.rion of this
Agreement or Exhibits A, B, and C_
22. Amendments / Modifications / Extensions. No amendment, modification, or e�ension
of this Agreement will be binding upon a party hereto unless set forth in a R�ritten instrument, v��hich is
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executed by an authorized representative of each party.
23_ Counteraarts. This Agreement may be executed in one or more counterparts and each
counterpart will, for all purposes, be deemed an original, but all such counterparts will to�ether constitute
one and the same instrument.
24. Warrantv of Services. Vendor warranu that its services will be of a high qualitv and
conform to generally prevailing industry standards. City must give written notice of any breach of this
warranty within thirty (30) days from the date that the services aze completed. In such e��ent, at `'endor's
option, Vendor will either (a) use commercially reasonable efforts to re-perform the services in a manner
that conforms with the warranry, or (b) refund the fees paid by City to Vendor for the nonconformin�
services.
25. Immi�ration Nationalitv Act. Vendor must verify the identity and employment eliQibility�
of its employees who perform work under this Agreement, including completing the Employment
Eligibility Verification Form (I-9). Upon request by City, Vendor will provide City with copies of alI I-9
forms and supporting eli�ibility documentation for each employee who performs a�ork under this
Agreement. Vendor must adhere to all Federal and State laws as well as establish appropriate procedures
and controls so that no services will be performed by any Vendor employee who is not leaally eligible to
perform such services. VENDOR WILL INDEMNIFY CITI' AND HOLD CITI' HAR�VII.ESS FROVI
ANY PENALTIES, LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS P�IRAGRAPH
BY VENDOR, VENDOR'S EMPLOYEES, CONTRACTORS, SUBCONTRACTORS, OR
AGENTS. City, upon written notice to Vendor, will have the right to immediately terminate this A�eement
for violations of this provision by Vendor.
26. Ownershin of Work Product. City will be the sole and exclusive o�vner of all reports,
work papers, procedures, �uides, and documentation that are created, published, displayed, or produced in
conjunction with the services provided under this A�eement (collectively, "Work Product")_ Further, City
will be the sole and exclusive owner of all copyright, patent, trademark, trade secret and other proprietary
rights in and to the Work Product. Ownership of the Work Product will inure to the benefit of City from
the date of conception, creation or fixation of the Work Product in a tan�ible medium of expression
(whichever occurs first). Each copyrightable aspect of the Work Product will be considered a'°work-made-
for-hire" within the meanin� of the Copyri�ht Act of 1976, as amended. If and to the extent such WorT�
Product, or any part thereof, is not considered a"work-made-for-hire" within the meanin� of the Copyri�ht
Act of 1976, as amended, Vendor hereby expressly assigns to City all exclusive nght, title and interest in
and to the Work Produet, and all copies thereof, and in and to the copyri�ht, patent, trademark, trade secret,
and all other proprietary rights therein, that City may have or obtain, without further consideration, free
from any claim, lien for balance due, or rights of retention thereto on the part of City.
27. Si6nature Authoritv. The person signing this A�eement hereby warrants that they ha�e
the legal authority to execute this Agreement on behalf of ihe respective party, and that such bindin�
authoriry has been granted by proper order, resolution, ordinance or other authorization of the entity_ This
Agreement and any amendment hereto, may be executed by any authorized representative of Vendor_ �acb
party is fully entitled to rely on these warranries and representations in entering into this Aareement or any
amendment hereto.
28. Chanae in Companv Name or O��nership. Vendor must notify City's PurchasinQ
Manager, in writing, of a company name, ownership, or address chan;e for the purpose of maintaining
updated City records. The president of Vendor or authorized official must si� the Ietter. A letter indicating
changes in a company name or ownership must be accompanied with supporting legal documentaxion such
as an updated W-9, documents filed with the state indicating such change, copy of the board of director s
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resolution approving the action, or an executed merger or acquisition a�eement. Failzzre to provide the
specified documentation so may adversely impact future invoice payments.
29. No Bovcott of Israel. If Vendor has fe�ver than 10 emplovees or this Agreement is for
less than $100,000, this section does not apply. Vendor acknowledges that in accordance ��-ith Chapter
2271 of the Texas Government Code, the Ciry is prohibited from entering into a contract with a companv
for goods or services unless the contract contains a written verification from the company that it (1) does
not boycott lsrael; and (2) will not boycott Israel during the term of the contract_ The terms "boycott IsraeP'
and "company" has the meanings ascribed to those terms in Section 2271 of the Texas Governmen� Code_
By signing this Agreement, Vendor certifies that Vendor's signature provides written verifcat�on to
the City that Vendor: (1) does not boycott Israel; and (2) will not boycott Israel during the term of
the Agreement.
30. Prohibition on Bovcottina Ener�v Companies. Vendor aclmowled�es that, in
accordance with Chapter 2274 of the Texas Govemment Code, as added by Acts 2021, 87th Leg_, RS_,
S.B. 13, � 2, the City is prohibited from enterin� into a contract for goods or services that has a �alue of
$100,000 or more that is to be paid wholly or partly from public funds of the City with a company with 10
or more full-time employees unless the con�act contains a written verification from the company that it
(1) does not boycott ener�y companies; and (2) will not boycott energy companies durin� the term ofthe
contract. The terms "boycott energy company" and "company" have the meaning ascribed to those terms
by Chapter 2274 of the Texas Govemment Code, as added by Acts 2021, 87th Leg_, R_S_, S_B_ 13, � 2_ To
the extent that Chapter 2274 of the Government Code is applicable to this Agreement, by signin� this
Agreement, Vendor certifies that Vendor's signature provides written verification to the City that Vendor:
(1) does not boycott energy companies; and (2) will not boycott ener�y companies durina the term of this
Agreement. y
31 _ Prohibition on Discrimination Aaainst Firearm and Ammunition Ind�rstries_ Vendor
acknowledges that except as otherwise provided by Chapter 2274 of the Texas Government Code, as added
by Acts 2021, 87th Leg., R.S., S.B. 19, � 1, the City is prohibited from entering into a contract for Qoods or
services that has a value of $100,000 or more that is to be paid wholly or partly from public funds of the
City with a company with 10 or more full-time employees unless the contract contains a written verificaUon
from the company that it: (1) does not have a practice, policy, �uidance, or directive that discriminates
against a firearm entity or fireazm trade association; and (2) aTill not discnminate during the term of the
contract against a firearm entity or firearm trade association. The terms "discriminate," "firearm en�ity"
and "firearm trade association" have the meaning ascribed to those terms by Chapter 2274 of the TeYas
Government Code, as added by Acts 2021, 87th Leg., R_S_, S.B_ 19, � 1_ To the extent that Chapter Z�7�
of the Government Code is applicable to this Agreement, by signin� this A�reement, Vendor cemfies that
Vendor's signature provides written verification to the City that Vendor (1) does not have apractice, policy,
guidance, or directive that discriminates against a firearm entity or firearm trade associarion; and (2) w-ill
not discriminate against a firearm entity or firearm �ade association during the term of this A�eement_
32. Electronic Sianatures. This A� eement may be executed by electronic si�ature, which
will be considered as an ori�inal sib ature for all purposes and have the same force and effect as an ori�nal
signature. For these purposes, "elecvonic signature" means electronically scanned and transmitted versions
(e_g. via pdf file or facsimile transmission) of an original si�nature, or si�atures electronically inserted via
software such as Adobe Sign_
33. Entiretv of Aareement. This A�eement, including all attachments and e�ibits, contains
the enrire understanding and agreement between City and Vendor, their assi�ns and successors in interest
as to the matters contained herein. Any prior or contemporaneous oral or written a�eement is herebv
declared null and void to the extent in conflict with any provision of this Agreement_
E
L�i WITNESS WHERE�F, the parties hereto have exeeuted this Agreement in multiples.
CITY OF FORT WORTH:
• ��.,W�..�
gy. ,�a��:_,���_h����o� �N�„ �.=��� �s ���sr,
Name: Valerie Washin�on
Title: Assistant Ci�y Mana�er
Date: Nov 9, 2021 24
APPROVAL RECOIWIlVIENDED:
BV. J _sDavis P:cv7 _ _':O:iSC°i
J
Name: Jim Davis
Title: Fire Chief
ATTEST:
?�� � �,,��
By_ �
Name: Ronald P. Gonzales
Title: Actina City Secretary
VENDOR:
Firehouse Hydrostat Services
By_
Name:
Title:
Date:
CONTRACT CONIPLIAd�CE �hrAGEF�:
By signins T aclmowledge tliat I am the persan
responsible for the monitorin� and administrazion of
this contract, includin� ensurin� all perfarmance and
reportins requirements.
- ...�...._
$y; �.���k�a����,P��,��o�=,�0„_:3;�or;
Name: Marl: Rauscher
Titie: Assistant F�re Director
APP�20VED AS TO FORiVt AND LEGA.LITY:
$y_
G���,�,.��
Name: Christopher A�stria
Title: Assistant City Attomey
COVTRACT AUTHaRIZATION:
M&C: N/A
Form 1295: \/A
flFFIG1�1L RECORD
�1T�' SECRETARY
10
FT. WORTH, TX
// t , 20 �/
EXHIBIT A
SCOPE OF SERVICES
SPECIFICATIONS
The vendor shall be D.O.T. certified as a cylinder requalification facility and must provide a copy of its
D.O.T. letter with Requalified Identification Number to the Fort Worth Fire SCBA Air Shop to keep
on record.
The vendor shall have mobile testing capability to test cylinders on location at various sites
throughout the City.
The vendor shall be able to hydrostatically test SCBA breathing air cylinders, SCUBA breathing air
cylinders, medical grade oxygen cylinders, and large D.O.T cylinders on an as needed basis per
D.O.T. 49 CFR 180 subpart C guidelines and in accordance with any and all other local, state and
Federal regulations.
The vendor shall provide the Fort Worth Fire SCBA Air Shop a spreadsheet, PDF or
printed list of all cylinders tested with the results including the pressures and expansions recorded
for the SCBA cylinders within 5 business days of testing.
CYLINDER TESTING SHALL MEET REQUIREMENTS
Cylinder shall be examined to ensure it can safely hold it pressure.
Cylinder shall be filled with a nearly incompressible liquid, in most cases water, pressurizing
the cylinder and examined for leaks or permanent changes in shape_ A visual inspection shall be pertormed
each time a cylinder goes through the pressure testing
process. The cylinder must be given an internal and external inspection in accordance with
Compressed Gas Association (CGA) pamphlets, D.O.T CFR 49 requirements and any local, state,
and federal laws. Each Cylinder tested must be legibly labeled or stamped as applicable with the new
hydrostatic test date in a manner that remain legible until the next test date or end of service
of the cylinder.
CYLINDER REJECTION The Vendor shall reject a cylinder when, after a visual inspection, it meets a
condition for rejection under the visual inspection requirements stated in the D.O_T CFR 49.
The Vendor shall notify the City that the cylinder is being rejected and provide further
requalification instructions. Be able to go and check Cylinder Locations
11
E7�IBIT B
PAYVIENT SCHEDULE
FORT WORTH.
��'!'�- BID SOLICITATiON
EvontlD .___ _.___ __..P�9�I
c: wot-ai-oi��
Event Round Version - -
1
Evcnt Namo --� �- -
ae^'tt R c.r . coc:na cor o.rlind.�rr:
StartTimo � FinishTlmc
o3%1D%zo21 o9:'so:ao cmr op��-,'<oal na;so:no Cnr
Invited: PU6UC EVEP4T DETAILS
SubmR To: Ci2y of Fot; Worth
FINAfYCIAL MANAGcMENT SERVICES
FINANCE - Purcha5ing
200 Texas S� (Lower Level, Spvchj
Fort V1�Orth TX 76102
United States
Email: FD,95PurchasingResportses@fortwoRhlexas.gnv
Lino: 7
Dcscription: . Qty UN[ UnitPricc Total
4500 PSI SCBA Hi h Pressure H ��� -�" - --
9 ydrotest, per 300.00 E:.
cylinder —�
��.� _�� '] �JL'
Ltnc: 2
Description: Qty . Unit UnilPricc 7�y
SCUBA High Pre:suro Fiydrotest, per cylintler 50.00 [A
• ?•-�� t ��J
Linc' 3
Doscriptioa: Qty Unit UnitPtico Totai
02 H dro D) SiZC 02 Hi h Pressure H � -� �--�" --- ----
Y ( 9 yCrotest. -. ....-. 550.00 EA
per cylindor � '
Y� / S-ii _i t =f�/SG
L/`�
LinC: 4
Doscription: _ __ _ Qty Unit_ UrtiWrice Total
TeOon O-nng �� 750.00 �p, � - -� -��'--
/�/v r �c -�-
Line: 5
Ocserfption: _.__ _ Otv Unit UnStPricc TeLil
Rubbcr O-ring 300.00 � cq "'�
/�,!� Fcc �}
Lirte: 6 ___. .._. ... _.--
Descripclon: QN Unit UnitPriee ToLal
-- _ .._.___
4500 PSI Hydrostalic tost. DOT (I� Sizc or 25.pq Eq
similar, percylintlCr � C_ r`----
� d
Lino: 7
similar, per e/linder
Lest.
'.`�� � ����5��
Lino: 8
Descriptfon: Qtv Vnit UnitPriec Totxl
Edtly Currenl InspecUon, per cyhndcr 7C0.00 EA -�-- --
lQ, �.._. �
i�i 7
A hid of "0" fzero) ivill he in[erpreletl 6y the Giry as a no-Uarge (f:ee) dem antl the Gry vnll not rxpec[
to pay tor that item. A bid of "no bitl" or no response (space left binnk) �vBI be dnterpreted by the Ciry
that the Offeror does not wish to bid on that item. Be advisetl, a'no bid" or no response may be
considered as no�*res0onsive and may result in dispuai�cafion of the buf.
RFQI 21-0779 Hy4roSLa:ic Te,ting for Cylinders
PatJc 3 0( 18
'cocal Hi� Aso+._-ntc �� cJ�
-t � / �
12
EZ�IT C
CIT'Y'S RFP NO.
FORT WORTH
�- COVER PAGE
EventlD pa��
c=wci-�i-cn4 I
EventRound Version
InWted: PUBLIC EVENT DETAILS
Event Nama
: H:�dro�tat ��tinc ! _indrr::
Start Tima � � Finish Time
G'?/:0;2n2: �y:30:C0 C�T. . . ^.?i'-7/20_'1 G+�:30:C0 CDT
submit To_ Ci[y of For VR+on,h
FINANCIAL M1ftANAGEP�3E� iT SERVICES
FINANCE - Puvchasana
200 Texas St. (Lo�r.•er Level, Sou�)
FOR �North TX 76102
United States
Email: Fh1SPurchasingResponses@forS:+or4htexas.gov
Event Description
T'he City of Fort Vdorth seeks bids to finalize an Agreement for Hydrostatic Testing for SCBA_ SCUBA artd Oxygen
�ytinder for the Fire Departmen[ on an as needed basis.
5ubmission Requirements and Deadlines
All companies/individuals wishing to do 6usiness �vkh the City of rort Worth must register as a Bidder on �e
PeopleSoh Supplier Portal. Please visit
https_,5'ti;^�,�v.forf.vonhtexas.govidepartmen�nancelpurchasingr'register tor more iniormation.
Assigned Buyer: A'ja Robertson
There is no a Pre-Bid Conference Tor this bid.
Completed Quote must be received in the Purchasing Division, 200 Texas Street. Fort Worth, Texas 76702 by the
above "Finish TimelEnd �a4e Time". Quoies must he submitted via email ao:
fmspurchasingresponses@fortwoRhtexas.gov or faxed to 817-392-0440, addressed to the Buyer, and have the RFDt
Number and "Finish Time'End Date Time" cPearly marked on the email subject and/or fax cover page.
�ate quotes rnll not be considered for a+vard unless bidders are notfied other�t�se. Late quotes •.vill be
retumetl or destroyed. Quotes may be �.vithdra`m at any time pnor to the official opening by •.vriT.en notificaiion.
Quotes may not be altered. amended or �vithdraym after the "Firnsh Time,�End Daie Time"_ Quote mus£ be submftted
on this form. Freight and at� other delivery charqes shall be inclutled m the w�it pnce(s)_ The Cify is exemp[ irom
FederaE Exc6se and State Sales Ta�c, therefore, tax must not be included in the quote pnce.
Iterns quoted must meet or exceed Ciry of Fort Vl'orth Specificatlau; however, 7he CiTy of Fort V>>oAh may
wnsider and accept altemate quotes if specified herefn �a�hen most advanfageous to the City. The Cfi� reserves the
nght. hotivever. to hold to Ciry Specifications and to tletermine'or eqaal' s[atus. 7die City reserves the
nght to accept or reject in paR or whole any quote submittetl. and to ^r.aive any technicalities
tor the best interest of the City.
SoEicitation Documents
CoverPage
Bid Submission Signature Page"
Bitl Solicitation"
Part I Purchasing Agreemen4 Specifications
Part II- Scope of ServiceslSpecifications
Attachment A- Conflid of Inieresi Disclosure Requiremenf"'
Attachment B- No Quote Sheet
AttaGimeni C - Reference Sheet
Attachmenr D- Bitlders Qualification Questionnaire
Attachment E- Drait Service Agreement, attached as a separate
document
"Required to be completed and submitted. See Section 17.Q, Quotations of PaR 1 for lis: oi all required
documents that shall be submitted �vith quote. Failure to submit all items �vill be grounds tor rejection of a bid as non-
responsive to the specifications.
13
FOR7' WOR"I'H .
�T`- BID SOLICITATION
_ __ _ _ - _ ----a _ _
EventlD Pagel
cro-:sz-^�-o:-�
Event Round Version
1 :
Event Name _ _ _ _ _ _ _ _ _ _
HE�c H:drescnCic resiln. Lor C:_'_nders
IStart Time Finish Time
09l1C/_0__ ra;?G:CC CDT 09/17i20?1 02�3�:00 CDT I
InVited: PUBLIC E{lENT DETABLS
Submit To: City of Fort W'orth
FINANCIAL F.4ANAGEIl4EP!'T SERVICES
FINC.NCE - ?urchasirig
200 Texas S.. (Lrnver Level, South}
FOR Worth TX 76102
United States
Emafl: FI1ASPurchasingRsspons?s�torfaoRhtexas_gov
Line: 1
Description_ �tv Unit UnitPrice Toml
4500 PSI SCBA High Pressure Hydrotest, per 300.OD Ei�
cyfinder jI�I
� !--.�.... �
Lme: 2
Description: ON Unit UnicPrice Toral
SCUBA High Pressure Hydrotest. per cylinder SO.QO EA
� �
Line: 3
Descriptlon: �ry Unit UnaPrice Total
02 Hytlro f�) Site 02 Higb Pressure Hydrotest, 750.00 EA
per cylinder �
l I ��
Line: 4
Description: Qn Uni[ UnicPrice Tocal
Teflon 0-ring 150.00 EA
� I�
Line: 5
Description: Oty Unit UnifPnce Total
Rubber O-ring 300.00 EA
� L. ._ ._ . ._ _..... _1
Line: b
Description: pry Unit UnitPrice Total
4560 PSI Hydrostatic test, DOT (K) Size or 25.00 6i
similar, per cylinder � I�
Line: i
Description: ON Unit Cln¢Priee Sotal
6tJQ0 PSI Hydrostatic test, DOT (K) Size or 25.�0 EA
similar. per cylinder � �
Line: E
Description: _ . __ _ Qry Unit UnicPrice
_ - --
Etltly Current InspeMion, per cylintler 100.00 EA
�
A bid of "0" �zero) vrill be interpreted by the City as a no-charge (free) item and the City �uiJ not expect
to pay Tor that item. A bitl of "no bitl" or no respon52 {spaCf Ief, blank) will be in.erpreted by tne Cu,�
that the Offeror does not vrish :o hid on thai rtem. Ee ativised, a'no biQ" or no response may be
cons�tlered as non-responsive and may rewfi in disqualification of the bitl.
RFat 21-0179 Nytlroscatic 7esiing tor Cylinders
Page 3 of 18
To:.�1 aia amuatc
_YD4a1___ ...
�
_
--..__
14
PART —1
PURCHASING AGREEMENT SPECIFICATIOPlS
1.0 SCOPE
1.1 The Ci4yof FortWorth (City) seeks bids to finalize an Agreemeni to provide hyd�astaUc
testing for SCBA. SCUBA, oxygen cylinders, and large D.O.T cylinders for the Fire
Department. The successful bidder(s). kno�vn hereafteras "Contractor'!'Vendor."
i2 The term of this Agreement shall begin on the date stated in the signed Contract
("Effective Date�) and shall expire one year from the effective date, unless terminated
earlier in accordance wiih the provisions oi this Agreement. This Agreement may be
renewed under the same terms and conditions for four additional one year periais.
unless City of Vendor provides the other party •�vith no2ice of non-rene�.ti�al at least 60
days before the expiration of the initial term or renewalperiod.
1.3 Follo�ving the av✓ard. additional services of the same general category ihat could ha��e been
encompassed in the a�.a�ard oi this Agreement, and thai are not already on the Agreement,
maybe added based on the discount bid and price sheet provided •roi?h the bid.
1.4 Unit prices shall include all costs associated lviih the specified �vork, including bui
not limited to ha�dling, delivery. fuel charges. fees and certification fees. No
additional charges wiil be accepted or paid by the City.
1.5 The submission of a quote by the bidder shall be considered evidence of
compliance v✓ith these requirements.
� . . •- • .�
2.1 The Vendor hereby agrees to provide the City �vith requirements attached he�ela arec�
incorporated for all purposes incident to this Agreement ir� Part - 2, Scope of
Services/Specffications and Attachment E. Draft Vendor Service Agreement, more
specificatly describing the services to be providedhereunder.
[� 1� . •t�'d� idl� •: • lli
3.1 The Vendor shall notify the City's Purciiasing Manager, in tivriting. of a company name,
oeromership, or address change for the purpose of maintaining updatet! Cityrecards. a he
president of ihe company or au4horized official must sign the letter_ A letter indicatina
changes in a company name or ov.mership must be accompanied ��vith supparting I?�al
documentation such as an updated W-9, docucnenFs filed •wvith the state indicatingsuch
change, copy of the board of directoe"s resolution approving the action, or an execuied
merger or acquisition agreement. Failure to do so may ad�ersely impact future invoice
payments.
'�I�q_�T►�l�:�X$i1�` • � _ � � • : � � = �
4.1 The Vendor shall be responsible for meeting all Federal: lativs, ordenances andregulations;
State: Iaws, ordinance and regulaEions: County: laws. ordinances and regulations; and Cit}:
la�vs, ordinances, and regulations for safety of people, environmenT, and property. This
includes, but is noi limited to, alI Federal, Sta4e, County, and CiEy Agencies.
Administrations and Commissions such as the Environmental Protection Agency (EPA).
Occupational Safety and Health Administration (OSHAj, and the Texas Commission on
Environmental Qualiry (TCEQ). In the event any lay.�, regulation or ordinance becomes
effective after the star: of this Agreement, the Vendor is required to comply �rrith netiv policy_
Any mandates requiring the City to comply �vith nevr guidelines tivill also reqaire the Vendor
io comply.
RFQt 21-0179 Hydrostatic TesSrs� for Gy(inders
Page 4 0` 18
15
•[$���I�1 e � u �
g.� The unit prices may be adjusted for increases or decreases in Vendor's cosi during tE�e
renewal period but before the effective date of the rene�:✓al upon v.Titien reqaest fraen the
Vendor.
�.2 The Vendor must submit its price adjustmen, request, in titiriting. at least 6Q days before
the rene�val effective periad. The Vendor shall provide r•�ritten proof of cost increases tivith
price adjustmentrequest.
6.3 If ihe Cityconcludes that the rate increase being requesied is exorbitant, the Cryreserves
the right to adjust the rate request, or eejec: the rate request in its entirety and al0ov✓ the
contract to expire at the end of the contraci term. If the City elects not to exercise the
renewal option, the Purchasing Division tivill issue a newsolicitatiora.
6.4 Prices bid shall remain firm for each one-year tertn of theAgreement and shall include
all assocfaied freight and deliverycosts_
�.� Prices offered shall be used for bid anatysis and for Agreement pricing. In cases oi errors in
extensions or totals, ihe unit prices offered �r.�llgovern.
6.6 Upon expiration of the Agreemeni term the successful bidder, agrees io hotd ovee uneEer
the terms and conditions of this Agreement for a reasonable period of lime to alfow ;he city
to re-bid an agreement, not to exceed ninety (90i days. Vendor �r✓ill be reim6�rsed for this
servic? at the prior agreement raFe(s). Vendor shall remain oblig�ted to the City under all
clauses of 4his Agreement that expressly or by their nature extencEs beyond and suroives
ihe expiration or termination of this Agreement.
g.7 Goods and/or services shall not be suspended by the Vendor without a 30 day prior vnitten
notice to the City.
7.0 QUANTITIES
7.1 The quantities listed on the bid solicitation are only estimates based on previous usage
and do not indicale intent to purchase or a guarantee of future business. The Cty of Fort
Worth is obligated to pay for only those materials and services actually ordered by an
authorized City employee and then received as required and accepted by the Cit,.
:� . _. - � u .
8.1 The Vendor shall carry insurance in the types and amounts for the duraiion of ThEs conVact
as listed in the draft service agreemenF. Attachment to this solieitation, and furnish
certi5cates of insurance along with copies of polEcy declaration pages and �alicy
endorsements as evidence thereof_
9.Q PERFORMANCE
9.1 Failure of the Cityto insist in anyone or more instances upon per%rmance of anyofthe
terms and conditions of this Agreement shall not be construed as a vraiver or
relinquishment of the future performance of anyterms and condiSions. but theVendor's
obligation with respect to such performance shall continue in ful! `or� andeffect.
RFQt 21-01 i 9 Hydrostafic Testing for Cytinders
Page o of 13
��
10.0 COMPLAINTS
10.1 Complaints processed through the Ci�y Purchasing Division are to be corrected rvcih9n
fourteen (14) days of formal notice of complaint. Written response to the Purchasing
Division is required. Failure to properly resolve complaints rv�thin the fourieen ('G4)
calendar day time period may result in the cancellaiion of the appficable line item(sy in
the price agreement.
11.0 COOPERATIVE PURCHASING
11_1 Should other govemmental entities decide to paricipate in this Agreement, Bidders, shall
indicate in their bid response �vhether they agree that all terms, conciitions, speci�ication,
and pricing �,o�ould apply.
112 If the successful Bidder agrees to extend the resulting Agreement to otFier govemmental
entities, the follo:ving �a�ill apply Govemmental entities +n�ithin utilizing agreements :>�ith the
City of Fort Worth will be eligible, but not obligated. to purchase material/sen�ices under i4iis
Agreement(s) ativarded as a resultof this solicitation_ All purchases bygovernmental entities
other than the City of Fort Worth will be billed directly to that governmental entity and paid
by that governmental entity. The City of FoR Worth v✓ill not be responsible for anoEher
governmental entity's debts. Each govemmental e�tity �.+�ill order its o��rn materiaUservices
asneeded.
12.D NO BOYCOTT OF ISRAEL
12.1 If Vendor has fewer than 10 employees or this Agreement is for less than $10d,000,
this section does not apply. Vendor ackno�vledges tha6 in acxordance v.�ifh Chaptsr 2271
of the Texas Government Code, the City is prohibited from entering into a contract v.ri#h a
company for goods or services unless the contract contains a�ririttero verificafio� irom the
company that it: (1 } does not boycott Israel; and (2} �r,�ill noi boycott Israel during the ierm of
the contract. The terms "6oycott Israel" and "company" has the aneanings ascribed to those
terms in Section 2271 of the Texas Government Code. 6y signing 4his Agreement,
Vendor cert6fies that Vendor's signature provides written verificatiore to the C¢ty tfiat
Vendor: (1) does not boycott Israel; and (2) will not boycott lsrael d�arir�g 4he term of
the Agreement
13.0 PROHIBITION ON BOYCOTTING ENERGY COMPANIES
13.1 Vendor acknowledges that in accordance k�ih Chapter 2274 of ihe Texas Government
Code, as added by Acts 262i, 87th Leg.. R.S_, S.B. 13, § 2, the City is prohibred from
entering into a contract for goods or services that has a value of S100,OOQ or nnare that 9s to
be paid �.vholly or partly from public funds of the City tivith a company :a�ith 90 or more full-
time employees unless the contract contains a written verification from the cosnpany that it:
does not boycott energy companies: and (2) will not boycoti energy companies during the
term of the contract. The terms "boycot� energy company' and "company" have the
meaning ascribed to those terms by Chapter 2274 of the iexas Government Code. as
added by Acts 2021. 87ih Leg., R.S_, S_B. 13, § 2. To ihe extent Ehat �haptes� 2274 of the
Government Code is applicable to this Agreement. by signing this Agreemenl. Vendor
certifies that Vendor's signature provides �vntten verificatian to the City that Vendor {1) does
not boycott energy companies; and {2) 4vill not boycott energy companies during the Ferrra of
this Agreement.
14.0 PROHIBITION ON DISCRIMINATION AGAINST FIREARA+I AND AMMUNITION INDUSTiRIES
14.1 Vendor acknotvledges that except as othenroise provided 6y Chapter 2274 of the Texas
Govemment Code. as added by Acts 2021, 87th Leg_, R.S., S.6. 19. § 9. the City is
prohibited from entering into a contract for goods or services that has a value of S10fl,000 or
more that is to be paid +n�holly or partly from public funds of tfie City with a company vaith 16
or more full-time employees unless the coniract contains a iRitten verification from the
RFQt 27-0179 Hydrostatic Testing for Cylinders
Page 7 of 18
17
company that it: (1) does not have a practice, policy, guidance. or directive rhat discriminates
against a firearm entiry or firearm trade association: and (2) will not discriminate during the
term of the contract against a firearm entity or zirearm trade associafion. The terms
"discriminate.'�'firearm entiry� and'frearm trade assoclation' have the meaning ascribed io
those terms by Chapter 2274 of the Texas Go�emrrient Code, as added by Acts 2�J21. 87th
Leg., R.S.. S.B. 19. § 1. To the extent that Chapter 2274 of the Goverrment Code is
applicable to zhis Agreement, by signing this Agreement, Vendor ce�es �hat Vendar's
signature pro��ides tir•ritten verification to the City that Vendor: (3) does not have a practice,
policy, guidance, or directive that discriminates against a firearm eniity or firearm trr�de
association; and (2) �vill not discriminate against a firearm entity or firearm trade associafion
during the term of this Agreement.
15.0 BIDDER OUALIFIGATIONS
15.1 The follo�r�ing information must be submitted as part of the bid pau�cage and shaU be
supplied in the following order. Failure to provide the information below �r�il9 deerra tne bid as
non-responsive.
15_1.1 Number of years in business (i_e SecretaryofState)
15.1.2 Bidders shall provide evidence ihat ihey are duly qualified and capable to fulfil0
and abide by the requirements listed herein v✓ith the �id. The bidder shall
demonstrate its a6ility to secure and perform the services tivithin tfie del[very
requirements specifiedherein `
15_7.3 Detailed explanation of inethodology Vendor �vill use to provide all necessary
labor, material, personnel and equipmeret to perform the hydrostatic testing
service
15.1_4 Documentation shativing the Vendor D.O.`u . ceRified as a cylinderrequalification
faciliry and a copy of their D_O.T. letter �vith Requalifier ldentifica[ion Number_
15.1.5 In order to receive bid au�ard consideration, the bidder shalB maintai�sufficient
resources to fulfill normal City af Fort �.NoRh requir=ments.
16.0 METHOD OF AWARD
16.1 Bids �vill be evaluated based on the bidder who offers represents the "besT val�e� iothe
City. A responsible bidder is defined as a bidder that:
16.1.1 Meets alI the requirements listed in Section 15.0.
16.12 Submits a campleted bid �.vithin the stated deadline and in accordance �.vith
the bid specifications.
16.2 Bids that do not receive �0% or more of �he rotal avaflable points excludsng the poinEs for
price +.vill be deemed nonresponsive. The follo��vin5 criteria v✓iIl be considereai 40
determine the best value:
16.21 Cost of service — up to 50 pointsavailable
1622 Bidder's qualification. experience, and references - up to 26 poinis availa�Ee
162.3 Bidder s availability of resources to provide senrices (equipment, �ersonnel}— up to
15 points available
16.2.4 Bidders approach to perform services— up to 95 pointsavailabte
FFp[2�-Oi79 H,tlrosut:c7esung'orC;�inders
Page 8 0:` 16
I8
16.3 In order for the Cityto receive adequate coverage on its requirements as specified in the
solicitaiion, the Cityreserves the right to makemultipleawards.
16_d The City also reserves the right to reject the bid of a bidder who has previouslyfailed
to perform properly or complete on time agreements of a similar nature.
16_5 The evaluation factors listed above will be applied in a comparative manner to all
eligible, responsive bids. Avrard may be made ����ithout discussion W�rith Bidders
after bids are received_ Bids should, therefore, be submitted on tfie most iavorable
terms.
16_6 The City reserves and shall be free to exercise the right to evaluate bid in relation to
performance record of bidder �vith the City itself, another municipal corporation of like size,
or private corporations during the past ha�o-year period. Such preca�ions are deemecBto be
in the public interest inasmuch as Vendor failure or inability to furnish items �nrithin the
preseribed time can create emergency situa6ons and impose unnecessary hardship on
both the City as a municipal corporation and the public at large.
16.7 Tentative Schedule of Events:
RFQt Release Date September 10. 2021
Deadline for Questio�s September 14, 2021 at 5PM Local Time
Ans�ver deadline September 1b. 2021
RFQt Due Date September Z 7. 2021 at 830AM Local Time
Bid E�raluaUons 5eptember 20 — September 27. 2021
Reeommended VendorSelection Se�tember 2021
Contract Execution October 2021
17.0 QUOTATIONS
17.1 Bidders shall submit the follo�ving items v✓ith their quote. Failure to provide all
the information will deem the bid non-responsive.
17.1.1 A completed and signed Bid Submission Signature Page;
17.12 A completed Btd Solicitation Page:
17.1.3 AcompletedandsignedoriginalConflictoflnterestQuestinnnaire,�ttachmentA:
17.1.4 A completed Reference Sheet, Attachment C
17.1.5 AcompletedBidderQual�cationQuestionnaire,Attachmen4 D:
17.1.6 Documentafion showing the Vendor D.O.T_ certified as a cylinderrec�ual�cation
facility and a copy of their D.O_T. letter with Requalifier ldent�ficatioro Number_
17.1.7 Detailed explanation of inethodology Vendor will use to pro�ide all necessary labor,
material, personnel and equipment to pertorrn the hydrostatic testingservices;
17_1.8 Documentation sho�a�ing companyhas been in the marketpfaceiora minimum oftwa
(2) years (i.e. Secretary of State).
17_1.9 Sc�dnned copy of alI documents Iist�d in paragraph 17.1 ¢� fYash drive.
17.2 Failure to submitthe items listed in Sec6on 17.1 will be grounds for reiection of a bid as
non-responsive to thespe�cations.
18.0 QUESTIONS
1°_1 Questiorts, expEanations or clarifications desired by a Vendor regarding any part of the
bid must be requested in writing from the Purehasing Divisian by 5:00 PM on
RFQt 2�-01i9 Flydrostatic Testing for Cytmders
Page S o118
19
September 1A, 2021. Request can be send to Ihe follo�.ving:
A'ja Robertson, B�ayer. FMSPurchasingResponses@fortworthtexas.gov
Reference RFQt 21-0179
City� of Fort VVorth Purchasing Division
Attention: A'ja Robertson
20Q Texas SVeeF
Fort Worth, Texas 76102
Facsimile: (8'17) 392-8440, Attention: A'ja Rober'son
RFQt 2�-0779 Hydrestatic Testing fw Cyiinders
Pa�e id o"IS
�
PART 2- SCOPE OF SERVICESlSPECIFICATIONS
1.0 VENDOR SHALL MEET THE FOL OWING REQtlIREMEI�T
1.1 The vendor shall be D.O.T. certified as a cylinder requalifocation facilidy and must provide a copy of
its D.O.T. letter with Requalifier ldentification Number to the Fort Worth Fire SCBA Air Shop to keep
on record.
1.2 The vendor shall have mobile testing capability to test cylinders on location at various si�es
throughout the Ciry.
1.3 The vendor shall be able to hydrostatically test SCBA breathing air cylinders, SCUBA breathing air
cylinders, medical grade oxygen cylinders, and large D.O.T cylinders on an as needed basis per
D.O.T. 49 CFR 180 subpart C guidelines and in accordance with any and aIl other local, state and
federal regulations.
1_4 The vendor shall provide the Fort Worth Fire SCBA Air Shop an elecgronical spreadsheet, PDF o�
printed list of all cylinders tested with the resuVts including the pressures and expansions recorded
for the SCBA cylinders within 5 business days oftesting.
1_5 Vendorshall perform hydrostatictesting Monday-Friday 8:OOAM-5:OOPM, exclvdingholidays.
2.0 CYLINDER TESTING SHALL M T TH F� �WII� REQUIR M I�TS
2.1 Cylinder shall be examined to ensure it can safely hold it pressure_
22 Cylinder shall be filled with a nearly incompressible liquid. in roiost cases water, pressurizing
the cylinder and examined for leaks or perrnanent changes in shape_
2.3 A visual inspection shall be performed each time a cylinder goes through the pressure testing
process. The cylinder must be given an internal and extemal inspection in accordance �.vi�h
Compressed Gas Association {CGA) pamphlets, D_O.T CFR 49 requirements and any local,state,
and federal laws.
2.4 Each Cylinder tested must be legibly labeled or stamped as applicable with 4he ne�:�
hydrostatic test date in a manner that remain legible until ih2 ne7ct tes4 date or end of service
of the cylinder.
3.0 GYLINDER REJEGTION
3.1 The Vendor shall reject a cylinder tivhen, after a visual inspection. it meets a condition for rejectio�
under the visual inspection requirements stated in the D.O_T CFR 49.
3.1.1 The Vendor shall notify the City that the cylinder is being rejected and provide further
requalification instructions
4.0 CYLINDER L�CATIONS
4.1 Hydrostatic testing may be perFormed at the locations listed beloY�r.
4.1.1 FWFD Air Shop- 400 Grand Ave. Fort Worth, Texas76164
4.1.2 Bob Bolen Public Safety Fire Training- 505 Vsf Felix St. Fort Worth. Texas7611�
4.1.3 FW FD Equipment Services Shop- 2930 W. Bolt St. Fort Worth, Texas 76'110
4.1.4 FWFD Station 32- 10201 White Settlement Rd_ Fort Worth, Texas76108
RFQt 21-0179 Hydrosfatic Testinp for Cylinders
Page 11 of'!8
21
ATTACHMENT - A
CONFLICT OF INTEREST DISCLOSURE REQU➢RENfENT
Pursuant to Chapter 176 of the Locaf Government Code. any person or agent of a person :a�,o conuacts or
seeks to con4ract for the sale or purchase of property. goads, or services v✓ith a Iocal goverramental entity {i.e_
The City of Fort Worth} must disclose in the Questionnaire Forms CIQ ('Ques6onnaire'} the person's affiliation
or business relationship ihat might cause a conFlici of inierest �n�ith ihe local governenental enUt}�. By lavr, the
Questionnaire must be filed with the Fort Worth City Secretary no fater than seven days after the da�e the
person begins contract discussions or negotiations v��,�ith the Ciry, or sc�bmits an applicaiion or response to a
request for proposals or bids. correspondence, or another v�riting related to potential agreemerK �vith ihe City.
Updated Questionnaires mustbe filed in conformancev��th Chapter 176_
A copy of the Questionnaires Form CIQ is enclosed tivith submiFtal documents_ The form is also availabie ac
https://ww�,v.ethics.state.Uc.us/data/forms/conflicUCIQ pdf
If you have any questions about compliance. please consult your o:m legal counseE. Compliance is the
individual responsibility of each person oe agent of a person who is subject to the filing requirement An
offense under Chapter 176 is a Class C misdemeanor.
NOTE: If you are not aware of a Conffict uf Interest in any business eelationship that you rnight have
with the City, state Vendor name in the # 1, use NIA i� each of the areas on the form. However, a
signature is required in the #7 box in all cases.
RFQt 21-0179 Hydrostatic Testing for Cyd'mders
Page '12 OT 18
22
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with locai governmental entity
This questionnaire reflects changes made to the law by H.B, 23, 84th Leg.. Regular Session. OFFlCE USE ONLY
This questionnaire is being filed in accordance v.dth Chapter 'I i b. Locai Govemmenl Code, by a �endor ,vho Date r.e�eiL•e�
has a business relationship as defined by Section 476.�01fT-a) �xRh a local govemmentaF entfij and tiw_
vendor mee2s requirements under SQction 176.00c{.a}.
By lav: this questionnaire must be ;iled v.4;h the records adminis'.rator of the (ocai govemmental ent.ry� no: lafer
than the 72h business day after the date the vendor becames a+.afe o` facts tha; require the staiemen; ta be
filed. See Section 176.0�6(a-i ), Local Go�emment Code.
A vendor commits an offense if the vendor knovnngly �•iolates Section 17E.40"c, Local Govemmerrt Code. An
oifease under 13iis sectlon is a misdemeanoc
� Name of vendor who has a business relationshio with local aovernmental entitv.
� cnecK tnis pox it you are tnmg an upuate to a previousiy tuea questionnaire. �; i ne ia�.v requires m�t you me art upoa�ea
completed questionnaire •s,�th tl�e appropriate filing authoriry not laier U�an the 7th business c7ay atter tne date on �,a�hich
you became a�.vare that the onginally filed guestionnaire �.ti�as mcomptete or in�curat?.)
3 Name of local aovemment offlcer about whom the tnformation is 6eina dicclosed.
Name of OYcer
4 Describe each emolovment or other business relationshio with the local aovernment officer_ or a familv member of the
o�cer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local govemmerrt officer,
Complete subparts A and B for each employment or business relationship described. Attach additionaB pages to this Form
CIQ as necessary.
A. Is ihe Iocal govemment officer or a family member of J�e officer reeeiving or Iikely to recei�e taxab4e income,
other than investment income, from the :�endor?
� YBS � NO
B. Is ihe vendor rece6ving or likel� to receive 2axable income, oiher than investmenx income_ �rom or at the �ireciion
of the local govemment officer or a family member of the oificer AND the taxable income is not ¢eceived ;rom tS�e
local govemmental entrty?
� Yes � No
5 Describe each emolovment or business relationshin that the vendor named in Section 1 maintains rrith a coruoration 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.
6
�Check this box if the vendor has given the local go��ernment oificer or a family member of the QfScer one or more guRs
as described in Section 176.003(a)(2)(Bj, excluding gifts deseribed in Section 176.0�3(a-1 }.
7
Signature of vendor doing husiness v.nth !he govemmentat en5ty ��
nrv� � r� i r� nyarvs[auc i esung ior �„�nnaers
Page 13 0"18
23
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
Acomplete cop}� of Chapter 176 of the Local Government Code may be found at http:/h.vvr.v.siatutes.tegis_siate.tx.usl
Docs/LG/htm1LG.176.htm. For easy reference, belrn.v are sorne of the sections cited on this form.
Local Govemment Code § � 76.001(1-a): "Business relationship" means a connection be�:✓een �;✓o or more parties
based on commercial activity of one of the paRies. The term does not indude a connection based on:
(Al a transaction that is subject to rate or fee regulaGon by a federal. state, or local governrnental entity or an
agency of a federal, state, or local governmental enfity;
(B) a Vansaction canducted at a price and subject to terms a�ailable to the public: or
(C) a purchase or lease of goods or services from a person ihat is chartered by a state or federai agency and
that is subject to regular examination by. and reporting ta ,hatagency_
Locat Government Code 6 7T6.003(a1f21fA1 and fBl:
(a) A local government officer shall file a conflicts disclosure statement •�vith rasp?cY io a vendor if:
(2) thevendor:
G41 has an employment or other business retationship ��ith ihe local government officeror a
family member of the officer thai results in the officer or family member receiving laxahle
income, other than im�estment income. that exceeds 52.5Q0 dunng tfie 12-montfi� perio�
preceding the date that the o�cer becomes a•s�are that
(i) a contract betwreen the local govemmental entity and vendor has been executed:
or
(ii) the Iocal govemmental enuty is considering entering into a con�ract vrith the
vendor,
(B} hasgiventothelocalgovemmento�cerorafamilymemberoftheofficefoneormaregifts
that have an aggregate value of more than 5100 in the 12-month period preceding the date the
officer becomes a�:✓are fhat:
(i) a contract bers�een the local governmental entity and vendor has been execuied: or
fiij the local govemmental entity is considering eniering into a contract wi4h the vendor_
Local Government Code S 176.006(a! and (a-11
(a) A vendor shall file a completed conflict af in4erest ques5onnaire if the r�endor has a business rQlationship
s✓ith a local goe•emmental entity and:
(1) has an employmen2 or other business relatEonship with a local government o�cer of that Iocal
governmenial entity, ora family member of the officer, described by Secfion 176.003(a)(2}(FS);
(2) has given a local go��ernment ofticer of that local govemmeRtal entity, or a family member of the
officer, one or more gifts�r.�i`�Fr the aggregate value specified bySection 176.OD3(a){2}(B j, exdudirr� any
gift described by Seciion 176.003(a-1 }_ or
(3} has a family relaEionship �.vith a local govemmeni officer of ihat local governcnental en?ity.
(a-'I ) The completed conflict of interest questionnaire must be filed •�vith the appropriate records adminisfraior
not later than the seventh business day after the 6ater of:
f,1) the date that the ��endor:
(A) begins discussions or negotiations to enier into a contract uvith the Iocal �Cov=snmenoal
eniity; or
(B) submits to the tocal governmen�al entity an apptication, response to a raquest for proposals
or bids, corcespondence, or another �vriting related to a potential cantract i•✓ith ihe local
gavernmental entity; or
(2) the date the �rendor becomes a•,vare:
(Aj of an em�loyment or other business relationship v,rith a local govemrreent officer, or a
family member of the o�cer. described by Subsection (a):
f,B) 4hat the vendor has given one or more gifts described by Subsec`ion (a): or
(C) of a familp relationship �,a�ith a bcal government officer.
nrt.; n-ui � � Mydtp$T3iIC �i MO�fj Tp.' (:Yhf1tlP'S
Paqe 74 of 18
24
ATTACHMENT — B
NO QUOTE SHEET
(Please complete this form, only if, your firrn has chosen not ;o submr a bid}
A'ja Robertson,Buyer
Purchasing Division
Fax No.817-392-8440
E-mail address:FMSPurchasinqResponsesCa�fortNorlhtexas qov
If your firm has chosen not to submit a bid eor this procurement, please complete this form and submit to-
City of Fort Worth. Purchasing Division
200 Texas Street
Fort Worth, Texas 76102
{or fax to above address}
Please check the items [hat apply:
0 Do not self the item(s) required.
0 Cannot be competitive.
O Cannot mee4 the Specifications highlighied in the attached Bid.
� Cannot provide Insurance required.
0 Cannot provide Bonding required.
Q Cannot complyv:ith Indemnificaiion requirements.
0 Job too large.
0 Job too small_
0 Do not wisM to do business with the City.
0 Other reason.
Company Name:
Authorized Officer or Agent Signature:
Telephone: L _} _ FAX Number. ( _) _ _
RFQt 21-0179 H•ydrostatic Tes;ing for Cylindevs
?age 75 of t8
25
ATTACHMENT-C
REFERENCE SHEET
Bidders shall provide a reference list of a minimum of three !3) current customers {comparabPe in siz2j
r,vho the bidder has recently supplied subject item(s)land or services on a continuing basis over a receni
hvelve (12) month period. The City will be the sole judge of references. Please use additional sheets ii
necessary.
Company's Name
Name of Contact
Title of Contact
Present Address
Giry, State, Zip Code
Telephone Number
Email
2. Companys Name
Name of Contact
Title of Contact
PresentAddress
City. State. Zip Code
Telephone Number
Email
3. Company's Name
Name of Contact
Title of Contact
Present Address
City, State, Zip Code
Telephone Number
Email
( } Fax Number ( )
( ) Fax Number f D
Fax
RFQt 21-0779 Hydrostatic Testing for Cylinders
Page'lo of 1E
26
ATTACHMENT-D
BIDDER'S
QUALIFICATION
QUESTIONNAIRE
1. Date your companytia�as established?.
2. How many }�ears E�as your organization been in business under its preseniname?
a_ List anyformer names your organization has operated under and ihe timeframe(s).
3. Have you ever defaul4ed on a contract? If so. �vhy�,�ere you unable to fuffill the obligation?
4. Please provide in a separate attachment documentation showing yourcornpa�y has been in
4he marketplace for a minimum of two (2) years (i.e. SecretaryofState}_
5. Can your company fulfil the specifications listed in sections 1.0-3_0 on page 11? Please provide
a detailed explanation of inethodology Vendor will use to provide all necessary labor,
material, personnel and equipment for the hydrostatic testing.
� Yes � No
6. Is your companya D_O.T. certified as a cylinder requalification facili6y? If so, please provEde a
copy of your D.O.T. letter with Requalifier ldentification Number with your bid response.
QYes � No
RFQt 21-0179 Hydrostatic Testing for Cylinders
Page 17 of 1 E
27
ATTACHMENT E-
DRAFT SERVICE AGREEMENT
The draft service agreement is attached as a separate document.
Rrot 21-0179 Hydrostatic Testing for Cyiinders
Paae 7s ot �3
28
EXHIBIT D
VENDOR'S RESPONSE TO CITY RFP NO.
FORT WORTH
~'!''- BIQ SUBM�SSIO(� SIGNATURE PAGE
Event ID . P� Invited: PUBLIC EVENT DETq[LS
-� ai-z:-�•�n
Even[Roun�t Version ��
_ �
Event Name --- � - - —
�r,r. ±-:•d,o.:c.,cic x�--:.n� =or �•i+za.--r SubmitTo: CityolFoR4VoM
StaR 7imc FinisA Time FINANCIAL MAN.'1GEMENT SERVICES
,oiioizo;.i oe:�a:oc Ccr o._;.-,�r2' n�_.�ge.nn cn- FINAN �
- CE - Purchas:�
200 Texas St {Lnwer �eve1 Sarth)
FoR WoRh TX 76102
Uruted S:etes
Email: FMSPurchasingRespoz�ses@tornvorthtezas.gov
The undersignetl, by� hisfher sPgnature, represents tha; helshe is submzting a binding aBer and is authorized
to 6ind the respo�dent to ful�y compiy vri(h the solici;ation documert! con,amed herein. The Responden� by
submitting and signing below, ackro.,dedgps thal he/shc has received and reatl the en[ire Cocumen: packeF
secGons defined above inGUCmg all dacur.ients incorpprdted by re`erer�, arid agrees ,0 6e bound 6y the terms
therein.
i
Lega! Compan� Name_� /L���� -/( .��ST�� J� G��
CompanyAddress: C�i /r/�S'��=- G/L! —
Ciry� Sface. ZP:�jl.J� !� /x �%r.��S(�
Vendor Registration No. :175 T
Printed /NJa�me of O�cer orAulhorized Representativc: _GCi�.__C.N%'S
Title: L-C,�l �; l 1 �
Signature of Ofticer rAuthonzetl Representativ � � �lL�
Date: 6' Z � �
cmailAtltlress: S�(//i'l� � /� � ' `; F ��,/J (�%�,y?
Phone Number: � '�� � �j�7 f
Fede21 Identification Number (FID}: %� — ���
Will ag2ement be available for Cooperative Agreement use? Yes /No
RFOt 21-0779 HyCrustafic Testirg for CylNders
Pa�e 2 ot �8
29
FORT WORTH.
�'T`'—� BID SOLIG{TATION
EventlD � � Pagc
CF'1101-''1-9' 79
' Event Round Version � � � -�
1 1
Evenl Neme - � -
F.?Cr. 3vdrestatic ?escina fnr C✓lincers
� StaR Time Firtish Timc - - �.
�9/10Y2G21 Q6:3C•:00 CDT 0'.�,�17!<_�21 Oe-3a�o(I [77T
Llne: �
�escripfion: p�Y
4500 PSI SCBa High Press�re Hydrotest. per 300.00
cyllnder
Line: 2
Uescription: p�,
SCUBA High Pressure HyCrotes,, per cylinder SO.OQ
Invited: PUBLIC EVEtYT DETA�ILS
Submit To: City o` Fort WORh
FINANCIAl. 6�WNAGEtvtENT SERVtCES
FINANCc - Pu�ct:asing
200 Texas SL (Lower Level, Soathj
Fort VVarth TX 761 �2
United States
Email: FMSPurcha,i�gResponses@forhaortEi[e�cas_yrov
. UnR _ UnitPriee TotaP
� � �-S�_ % %v��
Unit UnitPricc Tpt��
EA
�_ � � ��s
Line: 3
Description• ph,
02 Hytlro (D) Size 02 High Pressure Hydrotr.st, 150.00
per cytindcr
Line: 4
Oescription:
Teflon O-ring -� � � � �
t SO.OD
Unit UrtitPrice 7ota1
EA
�7i �- . __ a��sr�
Unit _ . flnitPrice Totai
:l�.
. nb� --� I
Line: 5
Description:
Rub6cr O-ring
_ QN Unit llnitPrice Total
300.00 EA
II� rGG I .� _ __I
Linc: 6
Dvscription: Cttv Unit UnitPricc 7otaB
4500 PSI HydrostaGc [csl. DOT (I� S¢e or 25.00 EA �-�- �-� �� -� --
simiEar,percytinAr.r �� j�,.i�
� �
Lirtc: 7
DeScriPtlon• _.. Qty Unit UnitPricc Tota[
6000 PSI Hydms4atic [est, �OT (K) Size or 25.00 EA
simi[ar, per cy(inder `��1
�/`�o `= , . 5 o v �
Line: 8
Description: �tv lJni[ Uni4Preec TWaE
— _
Eddy Curcenl Inspeclion, per cylirwer 10�_00 EA
� �. � /QC'
A bitl of "0" fzero} wili be interpreted by the Cry as a no-charge (freey item a� the Cdy will not e�ect
ta pay far that item_ A bid of'no bid" or na response (space Ie[t 6lacck) ti+n71 be interpreted by ffie Ci.y
tha[ ;he Otternr does not wish m bitl on that item. Be ativisea. a"no CiU" or nn respoiue may be
considered as non-responsive and may resul7 in disqual�cation of (he bid.
RFot 21-0179 Hydrostatic Tcsting for Cy�nders
Page 3 ot �S
i
Fotal eid Aaov¢it-� (// . /
•!���
`l��
CONFLICT OF l�ITEREST QUEST[�NNAIRE FORM CIQ
For vendor doing busirtess with [ocal govemmeatal enti�r
This questionnaire reflects changes made to the Iaw by H.B. 23, 84th Leg., ReguParSessFort. OFFlCE USE ONLY
This questionnaim is being fi[ed in accordance witrt Chapter �76. Local Govemment Code, by a ventlw wAo �� ���
has a business relallonship as definod by Section �76.00t(7-a) w�lt, � W�I govert�menlal entGy and :he
vendor ncoMs roquirements urder Sec;ion t i 6.006(a).
By la�:� this qucsGonnaire musl be filed �vith the remrds adminisfra[or of fho local govemmental enlity not later
than the 7th business day aftar the date the vendor becomes a�vare o' facts fha: require the sta[emene ta be
filed. See Section 178.006(a-1), �ocal Grn•emment Gode.
A ver.dor commits an offense if the venCor knowingly viatatcs Section 7 r'6.006, Cocat Gaverrmenc Caie. An
ofSense unAer ihis settion is a misdemeanor.
� Name of vendor who has a husiness rela[[onshio with Iocal aovercimental entitv.
�- f
�!'Ld � ����'� �.� ��l �S �
z �
❑ GnecK thls box R you are t[ttng an upaate to a prevlously tlled quC5t160naFtC. { I he IaLv reqll�tES Chat ypu 7te an up03teQ
cOmpletetl questionnaire vdth the appropriate filing authotity npt Iater than the 7fh business day ahsr the date on which
you hecame aware :hat fhe originaliy filed q�estionnaire tivas incomplete or inau:urate.j
3 Name of Inr.al nevrmment o�cer a6eut whom tFe infnrmafinn ic 6nina disclosad_
Name of OKccr
4 Describe ¢ach emnlovmornt or other basiness relationshio with the local aovemmervt offfcer. or a familv mem6er of tF�e
o�cer, as described by Section '176.003(a)(2j(A). Atso describe anyfamily relafionship with the bcai govemmeret offeeer_
Complete subparts A a nd B for ea ch empfoyment or business relationsfiip described. Attach additional pages to ffiis Fartn
CIQ as necessary_
A. Is the local govemmen[ officer ar a family member of the otficer recennng or Iikety to roceive �w3bla income,
other than in+resVnent income, from the venCor7
� Vee � No
f3_ Is the �rendor receiving or Iikeiy la receive taxa6le �ncome, other than investrn�t income, :rom or aY the direGiort
of the loca( gavemment officer or a family memher of the officer AND the tazable income is not rece�ied 4rom Ihe
local go�remmental entity.>
� Yes -�No
5 Describe each emafoument or business relationshio that the vendor named in Section 1 maiMains with a co�oeation or
other business entity with respectto which the focal govemmeot offcer serves as an officer or director, ar halds an
ownership interest of one percent or more.
6
aCheck this box if the vend Iv�s given the �ocal govemment officer or a famify member o; the a�rPr or� or more gifts
a cribe ' Section OQ3{a)(2j(B;, e cluding g'rfts descri6ed in Section 176.063�a-1).
� j
' ��. . �' (Zi; 2� ��
Signalure af vendor doing business vdlh the g!rvemmen[at enlity -` pa�e
n�-�e� c i u � r� rryu«swuc i esury rw �,yureaevs
P7ge 't 3 af 1 S
31
ATTACHMENT-C
REFERENCE SHEET
Bidders shall provide a reference list of a minimum of tioree (3} current customars (comparable in size)
who the bidder has recentiy suppPied subject item(s}land or services on a cont�nuing basis over a recent
tv+elve (12) mon4h period. The City wili be the sole judge of references_ Please use additio�al sheeis if
necessary.
1. Company's Name
Name of Contact
Title of Contacc
Present Address
City, State, Zip Code
Telephone Number
Emaii
2. Company's Name
Name of Contact
Title of Cvntact
Present Address
Ciry, State, Zip Code
Telephone Number
Email
3. Company's Name
Name of Contact
Title of Contact
Present Address
City, 8tate, Zip Code
Telephone Number
Email
RFQl21-01 i9 Hydrnstatic Testing for Cy6nders
Pagc 76 of t8
32
ATTACNMENT-D
BIDOER'S
QUALiFiCATION
QUESTIONNAIRE
Date your companywas established? ZG
How�anyyears has your organization been in business underits presentname?
_ -��`�'' S
a. Listanyformernamesyourorganizationhasoperatedunderandthet;mefrarne(s}.
� //�..�/��5� %�"Q!-O �:�5 7 ��' `fi �c.�
�
3. Have you ever defaulted on a contract? If so, whywere you �nable to iul�ill the obl�gation?
�
4. Please provide in a separateattachment documentation showing yourcompanyhas been in
themarketplacefora minimum aftwo (2j years (i.e. SecretaryofState).
5. Can your company fulfil the specifica6ons fisted in sections 1.0-3_Q on page 11? Please provide
a detailed explanatiott of inethodology Vendor will use to provide all neeessary 6abor,
material, personnel and equi�ment forihe hydrostatic testing.
� Yes � Na
G. Is your companya D.O.T. certifiod a� 3 cylindar requalificaGon faralil�l tf so, plwase provide a
copy of your D.O.T. letter with Requalifier ldentification Humber with your bid respocese_
/ _ Yes � Ho
RFQt 2'I-0179 Hyarostadc Testing !or Cyllnders
Pagc 97 ot 18
33
Corpon[ions Scction -�� F, pF:, David Whitley
P.O.Bos 13G97 ;'v.`�' +�,i: Sccntar� of Siatc
Auslin,Tex�s?S?ll-3G9i �K � F'
.:^� I'.•� I 1�^lv�:'';
_ -�'
Office of the Secretary of State
CERTIFICATE OF FILII�G
OF
Firehouse Hvdrostat 5en�ices. LLC
File Number: 803�22�02
The undersigned, as Secretary of State of Texas, hereby certifies that a Certificate of Formation for ihe
above named Dornestic Limited Liability Company (T.LC) has been received in this ofFice and has been
f�und co conform to the applicable provisions of law.
ACCORDINGLY, the undersigned, as Secretary of State, and by vinue of the authority vested in the
secretary by law, hereby issues this certificate c��idencing hling effective on ihe date shown belo�v.
The issuance of d�is certificate does not authorize the use of a name in this state in violation oFlhe rights
of another under the federal Trademark Act of I946, the Texas tr<jdemark la��r, the Assumed Business or
Professional Name Act, or the common la�r.
�
Dated: O5,'20/2019
Effective: 0>/20/20l 9
�� �
,w
�I
��
7i � �
+i � �y)
���
� �t�3 .
�►� ���
1�1' � �1
� ��
�..�
David Whiticy
Secretary of State
�
Come r•i�it us on the inlentet at Itnp:''ti� u��r.sosst�te.n.vs�
Phonc: (512) �fi.'>-�555 F:Le: (512)1G;-5709 Dial: 7-I-I for Rciap Srn�ices
Prcparedby: Cazol Cm•e} TII7: 10:06 Document: 5907;312U002
34
r�
U.S. Department
of Transportation
Pipeline and Hazardous
Materials Safety Administration
JuIV 29. 2019
Expiration Datc:June 30, 2022
Revision: Address undate
Mr. Scott Evans
O�r•ncr
Firehouse Hydroslal Services LLC (Mobile Unit)
200 Hillsidc LN
Lindsay,'I'X 76250 United States
Dear Mr. Evans:
cY.IBuilO�tq, PHN-33
t?]v NrNJcr.ay:.var,ua. Soulruas:
LYGc^.:flptOn. D.C. 2�$fYl
The Pipeline and ifazardous Materials Safety Administration (PHivfSA) has reviewed your
application for approval as a cylinder requalification facility under Section 107.865 of'1`itle 49
Code of Pederal Regulations (49 CFit). At the recommendation of Stei�crwalt Associates. Inc..
this office is re-issuing the requalifier identification number (RIN) I208 to your facility ]ocated at
200 I-Iillside LN, Lindsay, TX for DOT cylinder speciFcation(s): 3A, 3AA, 3AL and Special
Pcrmit(s): 7277, 11194, 10915, 10945, 1094'7, 14387, 14339, 11005, 14003, 10869, 15136 and
]3583. 'Chis number authorizes requalification of the authorized cylinder specifications by the
"hydrostafic" tcst mcthod, applies to this location only> and is valid until the postcd cxpiration
date above or until terminated by the Associate Administrator for I Ia�ardous Materials Safety.
This number applies to mobile unit vehicics ;ara�cd at this location only. The vehicle
idcntification number(s) authorized under the provisions of this approval are as follo�us:
1GC4K1EY2HF124886. The mobile unie(s) can only travel within the following gevs:r�phical
regions: Arkansas, New NIexico, Oklahoma, Louisiana and Texas The c}�linder sizes
authorized to be tested are as follows: "fhe smallcst cyfindcr is 3" X 12". The lar�est cylinder is
10" X 66".
The RIN is valid unti! the posted expiration date abo�•e or until terminated by the Associate
Administrator for Ha-rardous Viaterials Safety. Failure to comply with the pro�isions of this
approval may result in thc suspcnsion or termination of this RiN authori•ration.
In addition to the requirements for requalification of cylinders undcr thc rclevant provisions of
Sections 180.205 through 180.215 of 49 CFR, thc followin� conditions must. be rraet:
'I'racking No: 2019075101
35
Page 1 of 3
1. You must notify this office in writing of any change in company name, address, ownership.
testing equipmcnt and approved mobile unit used, management, or testing personnel within
riventy days of thc chan��c.
2. Additional mobile units, not idcntificd above, are not authorized under this RIN approval
without prior approval from The Office of 1la�ardous Matcrials Safcty, Approvals and
Permits Division in acc�rdance tvith the pro�•isions of 49 CPR ] 07.805.
3. lf more than one mobile unit is approved undcr this RIN authorization, in addition to the R1N
number, the specific mobile unit where cylinder requalification is being conducted must be
clearly identified on the requalifier test records and calibration rccords, as rcquired by 49
CFR I 80:L 15.
4. "1'his approval is rene�vable every five years. If you ���ish to renew this approval, please
ensure tha[ your application for renewal is received by PI-IMS/� at least 60 days prior Yo the
cxpiration datc postcd abovc, in accordancc with :39 CFR 107.705(c).
5_ Rcnc���al app)ications or cnquirics chould bc scnt to ap�irnvalsii�ciot�_o��_
6. Testin� must be performed by, or in the presence oi: a designated hydrostatic tcst operator
who has been obsen�ed by the authorized independent inspection agency inspector during the
onsite audit of thc mobilc unit undcr thc provisions of 49 CPR 107.80�, or who has been
certified as meeting the training requirements of 49 CFR 172. 7d0 throu�h 49 CFR 172. 704
and has been added to your file by addition under condition number one {1) above.
7. A copy of this approva] mast 6e maintained onboard and adjacent to the mobilc testine
unit(s} and at the stationary facility at thc authoriicd address idcntired above.
8. 1'he approved stationary address, where the mobile unit{s) is ;ara�ed, must be manned.
durina normal business hours, and accessible to unannounced onsite inspecTion by AHVISA
inspectors. "I'his location must maintain a daily tog that identifies the date of inspection, the
specific mobile unit authorized under the pr�visions of this approval, and thc
location/address wltere testing is being pertormed each day.
9. Testing under this RIN approval is authorizcd only on thc authorized cylinder specifications
and testing meth�d listed abovc. Additional s�ccial �emiils (not meefinX UAp�oved festir7g
medTod uhove), DOT cylinder specifications, including UN ISO specifications mav be
reyuested only afier inspection and recommendation by an approved Independent Inspection
A�eney a�d only after additional approval is granted by PIIMSA in accordance with the
requirements of 107.705 and 107.505.
10. Copies of your RII�T applicatinn and all supportinD documentation must bc retained and made
available to DOT upon request.
1 1. Each "Hazmat employee", a5 defined in Section 171.3, who pertorms a function subject to
this approval, must receive appropriatc trainin� in aecordance with Section 172.704.
12. All correspondence with PHMSA relating to your approval must include the RIN.
"I'racking No: 2019075I O1
Pa?c 2 o f 3
36
13. This appro�•al as revised supenedes all pmvious versions.
! , . ..�_ ,.. . _ .
for W'illiam Schoonovcr
Associate Administrator For Hazardous Materials Safet��
Trackin, No: 201907� J O 1
Pa;c 3 of 3
K��
�F�
� :��?,� l� '%i�� �'
HY�ROSTAT
City of Fort worth,
Firehouse Hydrostatic Services LL[, has a 24 ft mobile testing ladratory. We can Yest onsite, limiting the
out of service time of the tylinders_ We can test as many as 150 per day. We employee ail off duty
firefighters. The employees have meet all DOT test requirements for testing. While mainiaung any
updated tranning as well. All employees are cover with Texas Workmans Comp Insurance. Along with GL
Polices.
The epuipment we used is the 500-HP-145-M Hydrostatic WaterJacket testing System. This is a
manually operated sytem with a testung rang from 2000-10,000 psi. it meets US DOT requerments.
Equipted with a calibrated pressurre gauge ranging from D-11,000 psi x20 psi increments. Class 3A-1J49'o
full range accuracy. Water jacket is safe under pressure with a 35 psi burst disk.
Scot Evans CEO
817-948-6177
sevans@firehousehydro.com
38
EXHIBIT E
VERIFICATION OF SIGNATURE AUTHORITY
FIREHOUSE HYDROST SERVICES
200 HILLSIDE LN
LINDSAY. TX 7G250
Execution of this Signature Verification Form ("Form") hereby certifies that the following
individuals and/or positions have the authority to legally bind Vendor and to execute any agreement,
amendment or change order on behalf of Vendor. Such binding authority has been granted by proper order,
resolution, ordinance or other authorizarion of Vendor. City is fully entitled to rely on the warranty and
representation set forth in this Form in entering into any agreement or amendment with Vendor. Vendor
will submit an updated Form within ten (10) business days if there are any changes to the signatory
authority. City is entitled to rely on any current executed Form until it receives a revised Form that has been
properly executed by Vendor.
1. Name:
Position:
Signature
2. Name:
Position:
Sib ature
3. Name:
Position:
Signature
Name:
Signature of President / CEO
Other Title:
Date:
39