HomeMy WebLinkAboutContract 63113Docusign Envelope ID: E2A8E25F-1 F3C-438D-A016-78678AF10716 CSC No. 63113
CKETarities
SMART
Grant Agreement
This Grant Agreement (this "Grant Agreement") is entered into between PetSmart Charities Inc., an
Arizona nonprofit corporation and tax-exempt public charity under Section 501(c)(3) of the Internal
Revenue Code ("Code"), whose address is 19601 N. 27th Avenue, Phoenix, AZ 85027 ("Charities"), and
City of Fort Worth, whose address is 200 Texas Street, Fort Worth, TX 76102 ("Grantee").
Section 1 - Grant Purpose and Terms:
"Grant Funds"
$150,000.00
Approval Comments
The grant funds in the amount of $150,000 will be used to support daily
operations and required National Adoption Week participation at the Everyday
Adoption Center ("EAC") at PetSmart store #2065 and #187 located in Fort
Worth, TX. The Grant Funds are intended to enable City of Ft Worth to develop a
"Grant Purpose"
ficient on of the EAC as l as ure t the
requirements arre met as outlined n the Elver dasAdotion Center Agreement, the
Everyday p 9
Adoption Partner Manual and the EAC Partner Manual. Grant funds can be used
for but are not limited to veterinary care, staffing, sheltering, supplies, marketing,
volunteer/foster programs, transport and technology that support animals
available for adoption in the EAC.
A minimum of 3,100 pets to be impacted during the term of the grant.
Distribution
Schedule of Grant
Single payment
Funds
"Grant Period" Upon execution through 11 /15/2025
If the Organization wishes to request an extension or amendment to utilize
anticipated unspent grant funds, the request must be submitted in writing via
email to the grant's PetSmart Charities Relationship Manager for approval a
minimum of 30 days prior to end of the grant term. The request must outline
progress to date including rationale for extension, funds expended and
"Grant Conditions" remaining, potential usage and timeline for use. Only one extension per grant
may be approved and PetSmart Charities reserves the right to consider
organizations ineligible for additional grant funding during an extension.
However; organizations that are PetSmart Charites Adoption Partners may
continue to accrue Adoption Rewards. The grantee acknowledges that future
operational funding for this organization and its programs is not guaranteed
beyond the date of the grant terms.
OFFICIAL RECORD
CITY SECRETARY Page 1 of 9
FT. WORTH, TX g
Docusign Envelope ID: E2A8E25F-1 F3C-438D-A016-78678AF10716
CPETSIMAAWT
harities
"Impact Report(s)" Final Report 11/15/2025
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Docusign Envelope ID: E2A8E25F-1F3C-438D-A016-78678AF10716
RTbMfY!
Charities
For PetSmart Charities grants issued in the amount of $100,000 or more,
partners are required to leverage the following materials:
Distribute press release with an approved quote from the president of
PetSmart Charities announcing the recent grant and its purpose to local
media outlets. Please e-mail PublicRelations(o�petsmartcharities.orq for
approval. Please also post press release on your organization's web site
Add a PetSmart Charities digital badge to your organization's donor page,
linking back to www.petsmartcharities.orq.
Include the PetSmart Charities logo on any collateral promoting the
PetSmart Charities -funded event, initiative or program. All logo use must be
approved by PetSmart Charities via email:
petsmartcharitiesmarketinq(o�petsmartcharities.orq
Share news and stories about your grant on social media using the sample
social posts provided as a guide and tag the appropriate PetSmart
Charities channel so that we can engage with your posts.
Prominently display our partnership and support by including a PetSmart
Charities logo, sign, or door cling within your organization.
Coordinate with PetSmart Charities to ensure a representative is
"Grant invited/available to attend any small events, open houses or check
Acknowledgement" presentations planned at your facility.
All grantees are required to share stories and visual assets (photos/videos)
showing the impact of your grant with the marketing and PR teams at
PetSmart Charities via email:
petsmartcharitiesmarketinq(o�petsmartcharities.orq
Should you require assistance or to confirm completion of these
recognition requests, please email:
petsmartcharitiesmarketinqCo�petsmartcharities.orq
Link to templated materials, including a press release, digital badge, door cling
and social media templates: <
htti)s://petsmartcharities.orq/pro/resources/marketinq-support
All press releases and marketing materials that incorporate PetSmart Charities'
logo need to be approved via email by a PetSmart Charities team member. For
all press release or media alert approvals, please e-mail
PublicRelations(�petsmartcharities.orq. For all Marketing approvals, including but
not limited to signage, please e-mail
petsmartcharitiesmarketinq(@petsmartcharities.orq. Please allow 5-10 business
days for approvals.
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Docusign Envelope ID: E2A8E25F-1 F3C-438D-A016-78678AF10716
Charities
Section 2 - Terms and Conditions
A. Use of Grant.Grantee agrees that it will not use, and will not allow any of its employees, contractors,
volunteers, agents or representatives to use, any funds provided under this Grant Agreement for any
lobbying or political activities, any purpose not permitted in Section 501(c)(3) of the Code, or any
purpose other than the Grant Purpose during the Grant Period and subject to any Grant Conditions.
If the Grant Funds include any in -kind product, Grantee may be required to execute Charities'
Donated Goods Addendum. Grantee will immediately notify Charities if it is unable to comply with
the terms of this Grant Agreement. If Grantee has previously received any form of grant from
Charities, this Grant Agreement is contingent upon successful performance by Grantee under that
agreement. If the Grant Funds include the any services or products, such support may be provided
directly by Charities or indirectly through a subsidiary, contractor, representative or agent of
Charities and Grantee will participate in any specified program, technical assistance, or training
within the guidelines, procedures and timelines defined by Charities or its authorized
representative.
B. Acknowledgment of Grant. Grantee will publicly acknowledge this Grant as required by the Grant
Acknowledgment. Before making such acknowledgement, however, Grantee will obtain prior written
approval from Charities (including details such as graphics, layout, copy, media, etc.). Grantee will
provide Charities a reasonable amount of time for such review and approval.
C. Unspent Funds; Failure of Grant Purpose or Conditions. If any Grant Funds are not spent at the
expiry or sooner termination of the Grant Period, such unspent funds must be returned to Charities
within thirty (30) days following such expiry or termination. Additionally, if Grantee is unable or
unwilling at any time during the Grant Period to comply with the Grant Purpose or the Grant
Conditions, Grantee will immediately notify Charities.
D. Modifications to Grant. Any modifications to this Grant Agreement must be in writing and signed by
both parties, except the following modifications may be made without a formal amendment if a
written request is submitted by Grantee in writing (e-mail is acceptable if acknowledged by the
recipient) and approved in writing (including e-mail) by Charities in its sole discretion:
1. Minor adjustments to the Grant Purpose or Grant Conditions that do not materially affect the
original intent of the Grant; or
2. Change or extend the Grant Period.
E. Reportinq. Grantee is required to submit the Impact Report(s) to Charities, along with information
that indicates how the Grant Funds were spent and such other information as may be reasonably
requested by Charities.
F. Early Termination by the Parties. At any time prior to the end of the Grant Period, either party may
terminate this Grant Agreement at any time, with or without cause, upon at least thirty (30) days
written notice of such termination to the other party.
G. Early Termination by Charities. Charities may immediately terminate this Grant Agreement upon
written notice to Grantee if Charities determines in its sole discretion that:
1. Grantee has not complied with the Grant Purpose or Grant Conditions;
2. Grantee is the subject of any legal, regulatory or media investigation or is engaged in any
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Docusign Envelope ID: E2A8E25F-1 F3C-438D-A016-78678AF10716
Charities
action or course that appears to be unprofessional, uncharitable or otherwise inappropriate;
3. Grantee ceases to operate or materially and adversely changes its method of operation, is
insolvent, or files for or is the subject of any type of receivership, bankruptcy or similar
proceeding;
4. Any representation made by Grantee was not accurate when made or it becomes inaccurate
at any time during the Grant Period;
5. Charities finds the results of any audit or inquiry regarding Grantee to be unacceptable;
6. Grantee (or any person or organization linked to or with Grantee) becomes disreputable or is
the subject of negative media attention, including social media; or
7. Grantee has not complied with the requirements of any other agreement Grantee has with
Charities.
H. Effect of Termination. Upon termination of this Grant Agreement for any reason, Grantee will return
to Charities any unspent portion of the Grant Funds as provided above, and all rights and
obligations of the parties will cease, except for any rights and obligations that by their terms survive
the expiry or termination of this Grant Agreement.
I. Additional Actions by Charities. If Charities terminates this Grant Agreement as set forth in Section
2(G) above, or if anytime either during the Grant Period or for two (2) years thereafter, Charities
determines in its sole and absolute discretion that the Grant Purpose was not fulfilled or that the
Grant Conditions were not satisfied, Charities may (without limiting its other rights or remedies
hereunder or at law):
1. Withhold any pending or future payments of Grant funds; or
2. Require Grantee to provide a full refund to Charities of all previously provided Grant Funds.
J. License to Grantee. In addition and subject to Section 2(B) above, Charities may provide a paid -up,
limited, non-exclusive, revocable right to publish, print, transmit, display or otherwise use Charities'
name and logo ("Marks"), and Grantee will provide any recognition and benefits at the same level
provided to other organizations giving Grantee comparable levels of funding. Any materials that
include the Marks (or other intellectual property) of Charities, including, but not limited to, any
information to be transmitted in electronic or digital format (including e-mail, social media
platforms or websites), must be approved by Charities for quality control purposes prior to any
printing, distribution, publication or other use (even if such use is the same as or similar to prior
approved uses). The Marks may only be used in the exact form, style, font and colors as required by
Charities, and Charities may dictate the copyright, trade or service mark indicia that must
accompany each use of a Mark. Grantee will endeavor to provide Charities with at least ten (10)
business days to review a proposed use of the Marks, and each submission of such proposed use
will include the full context (e.g., media, platform, accompanying collateral or materials, etc.)
associated with such use. Grantee will not use any Marks without Charities' written approval nor
will the Marks be used in a negative light or critical manner. The foregoing limited license may not
be transferred, assigned or sublicensed. Charities may immediately terminate this license if
Charities, in its sole and absolute discretion, determines Grantee's use of the Marks to be
unacceptable.
K. License to Charities. During the Grant Period, Charities has the paid -up, limited, non-exclusive,
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Docusign Envelope ID: E2A8E25F-1 F3C-438D-A016-78678AF10716
Charities
revocable right to publish, print, transmit, display or otherwise use Grantee's name and logo
("Grantee's Marks"). Grantee's Marks will not be used in a negative light or critical manner. The
foregoing limited license may not be transferred, assigned or sublicensed. Charities' use of
Grantee's Marks will be limited to use in furtherance of Charities' mission.
Section 3 — Grantee's Representations. As of the date of this Grant Agreement and at all times during the
Grant Period, Grantee represents to Charities that:
A. Grantee is either: an organization exempt from federal income tax under Section 501(c)(3) of the
Code, (ii) a governmental entity identified in Section 170(c)(1) of the Code that will use the grant for
exclusively public purposes, or (iii) an "Indian tribal government," as defined under Section
7701(a)(40) of the Code, that is treated as a State under Section 7871 of the Code and that it will
use Grant Funds for exclusively public purposes.
B. Grantee holds and maintains all licenses, permits and registrations necessary or appropriate for its
lawful operation and fulfillment of the Grant Purpose and satisfaction of the Grant Conditions.
C. Grantee is and will remain in compliance with all applicable local, state, tribal and federal laws,
regulations and other requirements to which Grantee is subject.
D. Grantee is not on any United States federal terrorism "watch list" and all Grant Funds will be used in
compliance with all applicable anti-terrorist financing and asset control laws, statutes and
executive orders.
E. Grantee agrees that all statements made by Grantee in any application and ancillary materials are
true and accurate in all material respects. Grantee agrees to notify Charities promptly in writing of
any change regarding the ongoing truthfulness and accuracy of such statements during the Grant
Period.
Section 4 — Miscellaneous Provisions.
A. Maintenance of Records and Audit. Grantee agrees to maintain adequate books and records and
other financial documents appropriate for its organization related to this Grant Agreement
(collectively, "Records"). Grantee will maintain the Records in a manner that Charities (or its
designee) may readily determine that all Grant Funds were used exclusively for the Grant Purpose.
During the Grant Period and for two (2) years thereafter, Charities or its designee may inspect and
audit the Records to determine Grantee's compliance with this Grant Agreement upon at least ten
(10) business days prior notice and during normal business hours. Grantee will provide Charities (or
its designee) with unfettered access to the Records and will fully cooperate with such inspection or
audit. During any such audit or review, Charities may, in its sole discretion, withhold any Grant
Funds pending the outcome of the audit or review. Grantee expressly grants permission to Charities
or its designee to make inquiries and discuss with, or request documentation from, third parties
about Grantee related to Grantee's performance under this Grant Agreement.
B. Requlatory Compliance Cooperation. Grantee will fully cooperate with Charities and provide
Charities with any requested information or documentation related to this Grant Agreement
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Docusign Envelope ID: E2A8E25F-1 F3C-438D-A016-78678AF10716
Charities
reasonably required by Charities to demonstrate compliance with the requirements of any
governmental agency.
C. Independent Entities. Nothing in this Grant Agreement is intended or will be construed to create any
type of partnership, joint venture, employment, franchise or other similar relationship between the
parties. The parties agree each party is an independent entity and will be solely responsible for the
acts and omissions of its respective officers, agents, employees, and representatives and during
and after the term of this Grant Agreement. The parties further agree that there is no explicit or
implicit oral or written agreement or understanding that any Charities director, officer or other
representative will receive compensation or material benefit in connection with the Grant Funds.
D. Indemnification. Grantee hereby defends, indemnifies and holds harmless Charities and PetSmart
LLC (including their respective affiliates, directors, officers, managers, members, employees,
contractors, representatives, agents, assigns and successors), for, from and against all costs,
expenses (including reasonable attorneys' fees and expenses through all appeals), claims,
judgments, proceedings, losses, liabilities, damages (including property damage or bodily injury or
death) or intellectual property infringement incident to or arising out of Grantee's or any of its
employees', contractors', agents', representatives', or volunteers': (a) breach or violation of this
Grant Agreement; (b) willful misconduct or negligent act(s) or omission(s); (c) receipt or use of the
Grant Funds, or any program or activity of Grantee related to this Grant Agreement; (d) violation of
applicable law; or (e) infringement of intellectual property. Notwithstanding the foregoing, this
provision shall not be applicable if Grantee is a governmental entity and as such, is prohibited by
law from indemnification obligations.
E. Non -Disparagement. Grantee will not make, directly or indirectly, any negative statements, whether
written or oral (including in any digital electronic format) about Charities, PetSmart LLC, or their
respective activities, owners, members, managers, officers, directors, or employees. This includes
any statement intended, or that could be reasonably expected given its content or context, to harm
or that would lead to unwanted or unfavorable publicity.
F. Equal Opportunity. Grantee agrees that it will not discriminate by reason of race, color, creed,
religion, national origin, age, sexual orientation, disability, veteran status, gender, gender identity,
marital status or any other legally protected status.
G. Jurisdiction and Governinq Law. With respect to any action or proceeding arising out of or related
to this Grant Agreement or otherwise between the parties, the parties hereby agree that: (i) venue
and jurisdiction will be exclusively in the federal and state courts situated in Maricopa County in the
State of Arizona, U.S., and (ii) they hereby waive jury trial. This Grant Agreement will be governed by
and construed in accordance with the laws of the State of Arizona.
H. Legal Fees.lf either party brings any action or proceeding against the other arising under or related
to this Grant Agreement, the prevailing party will be entitled to receive its reasonable attorneys',
experts', investigation, and other related fees, costs and expenses from the other party. Prevailing
party, as used herein, means the party in whose favor a judgment is rendered. Fee awards under
this provision are to be made without reference to A.R.S. § 12-341.01(a).
I. Assiqnment; Third -Party Beneficiaries. This Grant Agreement will be binding upon and inure to the
benefit of the parties and their respective successors and permitted assigns. Grantee will not
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Docusign Envelope ID: E2A8E25F-1 F3C-438D-A016-78678AF10716
Charities
assign, delegate or sublicense, in whole or in part, any of its rights or obligations under this Grant
without the prior written consent of Charities, which may be granted, withheld or conditioned in its
sole discretion. Nothing in this Grant Agreement is intended or will be construed to give any third
party any legal or equitable right, remedy or claim under or with respect to this Grant Agreement,
except for a party's permitted successors or assigns.
J. Survival. The terms and provisions of Section 4(E) above (Indemnification), along with any other
terms or provisions of this Grant Agreement that are by their terms intended to survive the expiry or
termination of the Grant Agreement, will survive expiry or termination of this Grant Agreement.
K. Construction. This Grant Agreement will not be construed for or against either party on the basis of
which party drafted this Grant Agreement, and each party had the opportunity to review this Grant
Agreement with their respective legal counsel (or other professional advisor) to the party's
satisfaction.
L. Notices. Any notice given or required under this Grant Agreement will be in writing and delivered to
the respective addresses of the parties set forth above or at such other address as either party
specifies in writing. Notices will be deemed received: (a) five (5) days after being sent by certified or
registered mail, postage prepaid, return receipt requested; (b) on the next business day after when
sent by overnight delivery with a major overnight courier; or (c) on receipt of confirmation following
transmission via electronic mail or facsimile if received on a business day during business hours
(otherwise, deemed received the next business day) and if followed by a hard copy sent by using
one of the delivery methods in the preceding clauses (a) or (b) of this paragraph.
M. Waiver; Severabilitv. The failure of either party to insist upon the performance of any term or
provision of this Grant Agreement or to exercise any right or remedy will not be construed as a
waiver or relinquishment of such party's right to assert or rely upon any such term or right or
remedy on any future occasion. If any provision of this Grant Agreement is held to be invalid, illegal
or unenforceable, the validity, legality and enforceability of the remaining provisions will not in any
way be affected or impaired. If one or more provisions of this Grant Agreement are held to be
unenforceable under applicable laws by a court of competent jurisdiction, those provisions will be
limited or eliminated to the minimum extent necessary.
N. Entire Agreement; Execution; Counterparts. This Grant Agreement constitutes the entire agreement
and understanding between the parties, and supersedes any and all prior discussions, negotiations
or other communications regarding the subject matter hereof. Any waiver or amendment of the
terms of this Grant Agreement is binding only if in writing and signed by the authorized
representatives of both parties, except as expressly provided herein. The parties each represent
that the individuals signing below are duly authorized to execute this Grant Agreement on behalf of
the party for which they are signing. This Grant Agreement will not be effective until all information
requested by Charities is provided by Grantee and this Grant Agreement is fully executed. This
Grant Agreement may be executed by facsimile or electronically (including exchange of scanned
signature pages by e-mail), each of which will be deemed an original, and in several counterparts,
all of which will constitute one and the same instrument.
TO EVIDENCE THEIR AGREEMENT, the parties have executed and delivered this Grant Agreement, all
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Docusign Envelope ID: E2A8E25F-1 F3C-438D-A016-78678AF10716
Charities
effective as of the last date written below.
"CHARITIES"
PetSmart Charities, Inc.
Heidi Marston
Director of Pet Placement Initiatives
Please sign:
E
D((oculSignned�by:��fNe4 LL i•rR2a10fL
3C7CB32B482A42A...
Signed On:
11/25/2024
"GRANTEE"
City of Fort Worth
Valerie Washington
Assistant City Manager
Please sign:
DocuSigned by :
Val t,Vtt, ija.S�uV 46W
CEESSSFC556147B...
Signed On:
11/22/2024
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible for the
monitoring and administration of this contract, including ensuring all
performance and reporting requirements.
key
Randy Acosta
Management Analyst II
Ben Carson
Senior Administrative Services Manager
Assistant City Attorney
Attested:
an
.o.4FORT ➢�0
pFg °op d
_
..
Jannette Goodall
City Secretary
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Page 9 of 9
M&C Review Page 1 of 3
Official site of the City of Fort Worth, Texas
A CITY COUNCIL AGEND F°RT��RT"
Create New From This M&C
DATE: 2/11/2025 REFERENCE **M&C 25- LOG NAME: 23PETSMART
NO.: 0125 OPERATIONAL FUNDING
CODE: G TYPE: CONSENT PUBLIC NO
HEARING:
SUBJECT: (ALL) Ratify Application for, and Authorize the Acceptance of Grant Funding from
PetSmart Charities, Inc. in an Amount Not to Exceed $150,000.00 to Support the City of
Fort Worth's Everyday Adoption Centers Located at PetSmart Alliance and Hulen for
Operations and Programs, Authorize Execution of the Related Grant Agreements, and
Adopt Appropriation Ordinance
RECOMMENDATION:
It is recommended that the City Council:
1. Ratify application for, and authorize the acceptance of grant funding from PetSmart Charities, Inc.,
in an amount not to exceed $150,000.00 to support the City of Fort Worth's Everyday Adoption
Centers located at PetSmart Alliance and Hulen for operations and programs;
2. Authorize execution of the related grant agreements; and
3. Adopt the attached appropriation ordinance increasing estimated receipts and appropriations in the
Grants Operating Other Fund in an amount not to exceed $150,000.00, for the purpose of funding the
City of Fort Worth's Everyday Adoption Centers located at PetSmart Alliance and Hulen for operations
and programs.
DISCUSSION:
The purpose of this Mayor and Council Communication is to ratify the application for and the
acceptance and execution of grant agreements for grant funding from PetSmart Charities, Inc in the
amount of $150,000.00. These grant funds received from PetSmart Charties, Inc. can be used to
support operations and adoption events at the Everyday Adoption Centers located at PetSmart
Alliance and Hulen as follows: Lower Adoption Fees: Grants can allow shelters to subsidize or waive
adoption fees, making it easier for people to adopt animals, especially those who might be hesitant
due to costs.
Improved Facilities and Care
• Upgraded Shelter Conditions: Grants can help shelters improve their infrastructure, such as
expanding kennel space, improving sanitation, or upgrading medical facilities. These
enhancements can lead to a more comfortable environment for animals, making them more
adoptable.
• Better Veterinary Care: Shelters can use grant funds to cover veterinary expenses, ensuring
animals are healthy, spayed/neutered, and vaccinated before adoption. Healthy animals are more
likely to be adopted quickly.
Enhanced Adoption Programs
• Lower Adoption Fees: Grants might allow shelters to subsidize or waive adoption fees, making it
easier for people to adopt animals, especially those who might be hesitant due to costs.
• Adoption Events and Marketing: With more funds, shelters can organize adoption events or run
marketing campaigns, increasing community awareness and reaching potential adopters. Digital
marketing or partnerships with local businesses can also be funded to boost visibility.
Behavioral and Training Support
http://apps.cfwnet.org/council_packet/mc review.asp?ID=32989&councildate=2/11/2025 2/14/2025
M&C Review
Page 2 of 3
• Training Programs for Animals: Grants could fund behavioral training or rehabilitation for animals
with special needs or behavioral issues. Trained animals are more appealing to potential adopters.
• Post -Adoption Support: Some shelters use grants to provide post -adoption support, such as
behavior consultations or initial supplies for new pet owners, which can lead to more successful,
long-term adoptions.
Community Engagement and Education
• Educational Programs: Grants can enable shelters to develop educational programs that promote
responsible pet ownership, spay/neuter awareness, and proper animal care, which can reduce the
number of animals that end up in shelters and increase adoption success rates.
• Outreach Initiatives: Funding can also help shelters engage with underserved communities,
promoting adoption in areas where resources might be limited.
In summary, a grant can significantly boost an animal shelter's ability to adopt out more animals by
improving care, increasing capacity, and enhancing the shelter's visibility and community outreach.
We struggle with staffing and resources so this grant would benefit by providing animals with their fur -
ever homes.
The City of Fort Worth enjoys a productive relationship with PetSmart Charities, Inc. (Grantor), that
includes working together to promote animal welfare through numerous special initiatives for the
benefit of Fort Worth animal shelter animals.
No City salaries are charged to the grants, so indirect cost recovery is not applicable. There are no
matching funds required. The Grant Application Repository # is GRNT-APPL-0000000106.
The grants will serve ALL COUNCIL DISTRICTS.
FISCAL INFORMATION/CERTIFICATION:
The Director of Finance certifies that upon approval of the above recommendations and adoption of
the attached appropriation ordinance, funds will be available in the current operating budget, as
appropriated, in the Grants Operating Other Fund. The Code Compliance Department (and Financial
Management Services) will be responsible for the collection and deposit of funds due to the City. Prior
to an expenditure being incurred, the Code Compliance Department has the responsibility to validate
the availability of funds. This is an advance grant.
TO
Fund Department Account I Project Program Activity Budget I Reference # I Amount
ID ID Year I (Chartfield 2)
a :T8TkV1
Fund Department Account Project
ID ID
Submitted for Citv Manager's Office bv:
Oriciinatinci Department Head:
Additional Information Contact:
Program Activity Budget Reference # Amount
Year (Chartfield 2)
Valerie Washington (6199)
Brian Daugherty (6322)
Chris McAllister (2766)
D. Ben Carson, Jr. (6336)
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M&C Review
Page 3 of 3
ATTACHMENTS
ORD.APP 23PETSMART OPERATIONAL FUNDING AO24(r3).docx (Public)
http://apps.cfwnet.org/council_packet/mc review.asp?ID=32989&councildate=2/11/2025 2/14/2025
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
Complete Nos. 1 - 4 and 6 if there are interested parties.
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
PetSmart Charities
Phoenix, AZ United States
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of Fort Worth
1 of 2
OFFICE USE ONLY
CERTIFICATION OF FILING
Certificate Number:
2025-1296190
Date Filed:
04/15/2025
Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
10100239001
Event Grants, PetSmart Charities Sponsored Events, spay/neuter surgeries for adoptable pets
4
Name of Interested Party
Litvack, Neal
Willoughby, Dawn
Mukherjee, Debo
Jacobs, Ben
Francis, Elliott
Bacus, Lisa
Ordlock, Cherise
Singh, Majit
Hubbard, Monica
Schnaid, Alan
Nature of interest
City, State, Country (place of business) (check applicable)
Controlling Intermediary
Phoenix, AZ United States X
Phoenix, AZ United States X
Phoenix, AZ United States X
Phoenix, AZ United States X
Phoenix, AZ United States X
Phoenix, AZ United States X
Phoenix, AZ United States X
Phoenix, AZ United States X
Phoenix, AZ United States X
Phoenix, AZ United States X
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.e02d6221
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
2 of 2
Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form, and the city, state and country of the business entity's place Certificate Number:
of business. 2025-1296190
PetSmart Charities
Phoenix, AZ United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 04/15/2025
being filed.
City of Fort Worth Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a
description of the services, goods, or other property to be provided under the contract.
10100239001
Event Grants, PetSmart Charities Sponsored Events, spay/neuter surgeries for adoptable pets
Nature of interest
4
Name of Interested Party City, State, Country (place of business) (check applicable)
Controlling Intermediary
5 Check only if there is NO Interested Party.
6 UNSWORN DECLARATION
My name is Stephanie Jensen
, and my date of birth is
My address is 19601 N 27th Ave Phoenix AZ 85027 USA
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in Mari copa County, State of Arizona on the 15 day of April 20 25
(month) (year)
FSigned by:
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Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.e02d6221