HomeMy WebLinkAboutContract 63395CSC No. 63395
FORT WORTH
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between Midwest
Library Service, Inc. ("Vendor") and the City of Fort Worth ("City"), a Texas home -rule municipality,
individually referred to as "Parry" and collectively as the "Parties."
The Cooperative Purchase Agreement includes the following documents which shall be construed in the
order of precedence in which they are listed:
1. This Cooperative Purchase Agreement; OFFICIAL RECORD
2. Exhibit A — Price List;
CITY SECRETARY
3. Exhibit B — Cooperative Agency Contract SmartBuy 715-M2; and FT. WORTH, Tx
4. Exhibit C — Conflict of Interest Questionnaire
Exhibits A, B, and C, which are attached hereto and incorporated herein, are made a part of this
Agreement for all purposes. Vendor agrees to provide City with the services and goods included in
Exhibit A pursuant to the terms and conditions of this Cooperative Purchase Agreement, including all
exhibits thereto. If any provisions of the attached Exhibits conflict with the terms herein, are prohibited
by applicable law, conflict with any applicable rule, regulation or ordinance of City, the terms in this
Cooperative Purchase Agreement shall control.
City shall pay Vendor in accordance with the payment terms in Exhibit A and in accordance with
the provisions of this Agreement. Total annual payment made under this Agreement by City shall
not exceed One Hundred Thousand Dollars and Zero Cents ($100,000.00). Vendor shall not provide
any additional items or services or bill for expenses incurred for City not specified by this Agreement
unless City requests and approves in writing the additional costs for such services. City shall not be liable
for any additional expenses of Vendor not specified by this Agreement unless City first approves such
expenses in writing.
The term of this Agreement is effective beginning on the date signed by the Assistant City
Manager ("Effective Date") and expires on October 31, 2025, with additional one-year renewal options
in accordance with the Cooperative agreement. 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.
Vendor agrees that City shall, until the expiration of three (3) years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said three years, have access to
and the right to examine at reasonable times any directly pertinent books, documents, papers and records,
including, but not limited to, all electronic records, of Vendor involving transactions relating to this
Agreement at no additional cost to City. Vendor agrees that City shall have access during normal
working hours to all necessary Vendor facilities and shall be provided adequate and appropriate work
space in order to conduct audits in compliance with the provisions of this section. City shall give Vendor
reasonable advance notice of intended audits.
Notices required pursuant to the provisions of this Agreement shall be conclusively determined
to have been delivered when (1) hand -delivered to the other party, its agents, employees, servants or
representatives or (2) received by the other party by United States Mail, registered, return receipt
requested, addressed as follows:
To CITY:
City of Fort Worth
Attn: Assistant City Manager
100 Fort Worth Trail
Fort Worth, TX 76102
With copy to Fort Worth City Attorney's Office at the
same address
To VENDOR:
Midwest Library Service, Inc
11443 St. Charles Rock RD
Bridgeton, Missouri 63044
Email: banta@midwestls.com
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 Texas Public Information Act. To the extent the
Agreement requires that City maintain records in violation of the Act, City hereby objects to such
provisions and such provisions are hereby deleted from the Agreement and shall have no force or effect.
In the event there is a request for information marked Confidential or Proprietary, City shall promptly
notify Vendor. It will be the responsibility of Vendor to submit reasons objecting to disclosure. A
determination on whether such reasons are sufficient will not be decided by City, but by the Office of
the Attorney General of the State of Texas or by a court of competent jurisdiction.
The Agreement and the rights and obligations of the parties hereto shall be governed by, and
construed in accordance with the laws of the United States and state of Texas, exclusive of conflicts of
law provisions. Venue for any suit brought under the Agreement shall be in a court of competent
jurisdiction in Tarrant County, Texas. To the extent the Agreement is required to be governed by any
state law other than Texas or venue in Tarrant County, City objects to such terms and any such terms are
hereby deleted from the Agreement and shall have no force or effect.
Nothing herein constitutes a waiver of City's sovereign immunity. To the extent the Agreement
requires City to waive its rights or immunities as a government entity; such provisions are hereby deleted
and shall have no force or effect.
To the extent the Agreement, in any way, limits the liability of Vendor or requires City to
indemnify or hold Vendor or any third party harmless from damages of any kind or character, City
objects to these terms and any such terms are hereby deleted from the Agreement and shall have no force
or effect.
If Vendor has fewer than 10 employees or this Agreement is for less than $100,000, this section
does not apply. Vendor acknowledges that in accordance with Chapter 2271 of the Texas Government
Code, the City is prohibited from entering into a contract with a company for goods or services unless
the contract contains a written verification from the company that it: (1) does not boycott Israel; and (2)
will not boycott Israel during the term of the contract. The terms "boycott Israel" and "company" has
the meanings ascribed to those terms in Chapter 2271 of the Texas Government Code. By signing this
Agreement, Vendor certifies that Vendor's signature provides written verification to the City that
Vendor: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the Agreement.
If Vendor has fewer than 10 employees or this Agreement is for less than $100,000, this section
does not apply. Vendor acknowledges that in accordance with Chapter 2276 of the Texas Government
Code, the City is prohibited from entering into a contract for goods 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 verification from the Vendor that
it: (1) does not boycott energy companies; and (2) will not boycott energy companies during the term of
this Agreement. To the extent that Chapter 2276 of the Government Code is applicable to this
Agreement, by signing 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
energy companies during the term of this Agreement.
If Vendor has fewer than 10 employees or this Agreement is for less than $100,000, this section
does not apply. Vendor acknowledges that except as otherwise provided by Chapter 2274 of the Texas
Government Code, the City is prohibited from entering into a contract for goods 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 verification from
the Vendor that it: (1) does not have a practice, policy, guidance, or directive that discriminates against
a firearm entity or firearm trade association; and (2) will not discriminate during the term of the contract
against a firearm entity or firearm trade association. To the extent that Chapter 2274 of the Government
Code is applicable to this Agreement, by signing this Agreement, Vendor certifies that Vendor's
signature provides written verification to the City that Vendor: (1) does not have a practice, policy,
guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will
not discriminate against a firearm entity or firearm trade association during the term of this Agreement.
(signature page follows)
(remainder of this page intentionally left blank)
The undersigned represents and warrants that he or she has the power and authority to execute
this Agreement and bind the respective party.
CITY OF FORT W TH:
T�ass2 3/6e
By: Dana Burghdoff (May 9, 202 CDT)
Name: Dana Burghdoff
Title: Assistant City Manager
Date: 05/19/2025
APPROVAL RECOMMENDED:
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.
By: April Jacquez (May 13, 2025 09:40 CDT)
Name: April Jacquez
Title: Sr. Contract Compliance Specialist
APPROVED AS TO FORM AND LEGALITY:
By: Midori Clark (May 15, 202513:46 CDT)
, • /
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Name: Midori Clark
By:
Title: Director, Library
Po�FORr°aa
Name: Jessika J. Williams
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Title: Assistant City Attorney
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CONTRACT AUTHORIZATION:
By:
M&C: N/A
Name: Jannette Goodall
Date Approved: N/A
Title: City Secretary
1295 Form:
MA\111111A
Midwest Library Service, Inc.
By:
Name: Trudy Barrett
Title: General Manager
Date: 05/07/2025
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
EXHIBIT A
DocuSign Envelope ID: 4D109D3F-9549-4DB9-9D98-FE57A537B58D
Contract Item List
Contract No. 715M2 Publications, Audiovisual Materials, Books, Textbooks, and Ancillary Services
Contract ID No. 715M2-2707
RFP No. 304T-20-715M2
Midwest Library Service, Inc.
K-12
School Libraries
Category
Public Libraries
(City, Regional, etc.)
Category
Academic
Institutions
Category
State Agencies and
Co -Op Member
Category
Electronic and Digital Materials
Category 1 Digital pre -loaded; all -in -one audio books
Category 2 Digital pre -loaded; all -in -one audio book pack kits
Category 3 Digital pre -loaded
Category 4 Audiovisual Pre -loaded; Device included
Print Materials
Category 5 Adult trade; fiction/non-fiction hardbound net - 33%
Category 6 Adult trade; fiction/non-fiction paperback net - 10%
Category 7 Juvenile trade; fiction/non-fiction hardbound net - 33%
Category 8 Juvenile trade; fiction/non-fiction paperback net - 10%
Category 9 Mass market paperback; rack net - 10%
Category 10 Non -trade publication; hardbound L net - 15%
Category 11 Non -trade publications; paperback net - 15%
Category 12 University press net - 15%
Category 13 Adult library bound; fiction/non-fiction net - 33%
Category 14 Juvenile library bound; fiction/non-fiction net - 33%
Category 15 Pre -bound hardbound net - 10%
Category 16 Pre -bound paperback net - 10%
net - 33%
net - 33%
net - 33%
net - 10%
net - 10%
net - 10%
net - 33%
net - 33%
net - 33%
net - 10%
net - 10%
net - 10%
net - 10%
net - 10%
net - 10%
net - 15%
net - 15%
net - 15%
net - 15%
net - 15%
net - 15%
net - 15%
net - 15%
net - 15%
net - 33%
net - 33%
net - 33%
net - 33%
net - 33%
net - 33%
net - 10%
net - 10%
net - 10%
net - 10%
net - 10%
net - 10%
Nonstandard Formats
Category 17 Music/Audio Compacts Disc; Pre-recorded
Category 18 Music/Audio Record Disc, Vinyl; Pre-recorded
Audiovisual DVD/Blue-ray pre-recorded; feature/non-
Category 19 feature films
Category 20 Spoken word/audio compact disc pre-recorded; abridged
Category 21 Spoken word/audio compact disc pre-recorded; un-abridged
Category 22 Spoken word/audio MP3 format pre-recorded; un-abridged
*N/A = not awarded
DocuSign Envelope ID: 4D109D3F-9549-4DB9-9D98-FE57A537B58D
Contract Item List
Contract No. 715M2 Publications, Audiovisual Materials, Books, Textbooks, and Ancillary Services
Contract ID No. 715M2-2707
RFP No. 304T-20-715M2
Midwest Library Service, Inc.
Premium Processing - Shelf -Ready Base Price Description
Mylar Jacket (or Laminate Cover), Label Protectors, Spine $3.20
Label, Barcode, and Standard MARC Record
Mylar Jacket (or Laminate Cover), Label Protectors, Spine
Label, Barcode, RFID Tag (programmed and applied), and $3.95
Standard MARC Record
Processing Services
Base Price
Description
Brief MARC Record
No Charge
If Vendor Offers MARC records, a Brief MARC Record Shall Be Free
of Charge, Per the Terms of This RFP
Full MARC Record $0.85
Mylar Jacket $1.05
lBarcode Label $0.65
1Label (per application -Customer supplied) $0.30
Label (per application -Vendor supplied) $0.50
Genre Label $0.30
Spine Label $0.65
Label Protector $0.25
Pocket (paper) $0.30
Pocket (vinyl) $0.65
Property Stamp (per impression) $0.35
Spine Tape (inside) n/a
Spine Tape (Outside) n/a
Audio Visual Processing and Accessories
Base Price
Description
Digital Processing for Media n/a
Format Conversion Service n/a
Hub Label (per application) n/a
Shrink Wrap Removal n/a
IDVD/CD Case, Holds Single Disc (Paper) n/a
IDVD/CD Case, Holds Single Disc (Plastic) n/a
IDVD/CD Case, Holds Multiple Discs n/a
IDVD/CD Case, Locking n/a
Spoken Audio CD Case; Various Capacities n/a
Laminated Paperback Covers
Base Price
Description
Polypropylene Laminate; Various Thicknesses $2.20-3.35 Cost dependent on size of book. Hinges $0.75 - $0.95
Vinyl Laminate; Various Thicknesses n/a
RFID/Theft Deterrents
Base Price
Description
Pre-programmed RFID/Barcode Set (1 Barcode); Applied to $0.65
book
IRFID ("universal" tag programmed and applied) $0.75
1CD/DVD Overlay RFID Tag n/a
Theft Deterrent Tape/Strip $0.55
Contract Details
Glenn Hegar
Texas Comptroller of Public Accounts
Contract Details: # 715-M2
Number 715-M2
Description Publications, Audiovisual Materials, Books, Textbooks, and Ancillary Services
Category Managed
Type Term
Start Date 6/29/2020
End Date 10/31/2025
Purchase PCC C
Category
Code
(Agencies
Only)
Optional Extension: November 1, 2024, through October 31, 2025
Renewal
Terms
Purchase Customers will issue an internal purchase order that references this CPA Contract Number and current
Orders item description(s) and pricing as stated on this contract. The Contractor will not ship any products or
provide related services until receipt of a Purchase Order generated by the State Agency, Higher
Education or Cooperative member.
NIGP 52510 ; 52520 ; 52540 ; 71504 ; 71510 ; 71546 ; 71555 ; 95610
Codes(s)
https://www.txsmartbuy.gov/browsecontracts/2231
CPA Contract Questions regarding contract management issues, price changes, amendments or other post -award
Management concerns should be directed to:
SPD Contract Management Office (SCMO)
Texas Comptroller of Public Accounts (CPA)
Phone: (512) 463-3034 option 3
Email: spd.cmo@cpa.texas.gov (mailto:spd.cmo@cpa.texas.gov)
https://www.txsmartbuy.gov/browsecontracts/2231
Contract Details
Contract Customers should contact the applicable company representative in order to set up an account.
Items and
Pricing
715-M2 Baker & Taylor, LLC Price Sheet
(http://www.txsmartbuy.gov/SSP°/`20Applications/NetSuite%201nc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20B&T%20TSB%20Contract%201tem%20Listing. pdf)
715-M2 Brodart Co. Price Sheet (http://www.txsmartbuy.gov/SSP%20Applications/NetSuite%201nc.°/o20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20Brodart%20TSB%20Contract%20ltem%20Listing.pdf)
715-M2 Yankee Book Peddler, Inc. dba GOBI Library Solutions from EBSCO Price Sheet
(http://www.txsmartbuy.gov/SSP°/o20Applications/NetSuite%20Inc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20GOBI%20Library%20Solutions%20from%20EBSCO%20TSB%20Contract%201tem%20Listing.pdf)
715-M2 Ingram Library Services LLC Price Sheet
(http://txsmartbuy.gov/SSP%20Applications/NetSuite%201nc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%201 ngram%20TSB%20Contract%201tem%20Listing_10_04_2023.pdf)
715-M2 Midwest Library Service, Inc. Price Sheet
(http://www.txsmartbuy.gov/SSP%20Applications/NetSuite%201nc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20Midwest%20Library%20Service%20TSB%20Contract%201tem%20Listing.pdf)
715-M2 Midwest Tape, LLC Price Sheet
(http://www.txsmartbuy.gov/SSP%20Applications/NetSuite%201nc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20Midwest%20Tape%20TSB%20Contract%201tem%20Listing. pdf)
715-M2 ProQuest, LLC Price Sheet
(http://www.txsmartbuy. gov/SSP%20Appl ications/NetSuite%201 nc. %20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20ProQuest%20TSB%20Contract%201tem%20Listing.pdf)
https://www.txsmartbuy.gov/browsecontracts/2231
Contract Details
Warranty Warranty/Guarantee
Details Each product proposed is to be warranted against defects in workmanship and material for a period of
ninety (90) days or the duration of the manufacturer's standard warranty, whichever is longer, following
Customer's acceptance. If no time or specific protocol for acceptance is specified elsewhere in the
Contract or the Customer purchase order, items are presumed accepted ten (10) working days after
receipt. The warranty will apply to any warranty service or repair requested by Customer during the
warranty period by contacting the Contractor or Contractor's designee with such request, regardless of the
amount of time required to complete the requested warranty service or repair. It is the intention of the
parties to this Contract that Contractor's warranty obligations hereunder will survive the termination of this
Contract.
Replacement
1) Contractor must guarantee replacement of improperly manufactured products due to defective materials
or product during the initial Contract period and any exercised renewal options.
2) Contractor must guarantee replacement or compensation to Customer if Contractor damages
Customer's property when applying ancillary or processing services.
3) The replacements must be processed and received by the Customer within two weeks of written
notification.
4) Contractor will provide replacement free of any charge, including any shipping necessary to return the
product when necessary.
5) Contractor will either replace the product with new product or refund the full purchase price of the
product, whichever the Customer prefers.
Adding New Additional products or services of the same general category that are not already on the contract may be
Products to added by submitting an Open Market Requisition (https://comptroller.texas.gov/purchasing/forms/) to the
the Contract Statewide Contract Development section at open.market@cpa.texas.gov
(maiIto: open. market@cpa.texas. gov).
Delivery If delay is foreseen, Contractor shall give written notice to the Customer and must keep Customer advised
Delays by at all times of status of order.
Contractor
Default in promised Delivery Days After Receipt of Order (ARO) without accepted reasons or failure to
meet specifications authorizes the Customer to purchase goods and services of this contract elsewhere
and charge any increased costs for the goods and services, including the cost of re -soliciting, to the
Contractor.
Failure to pay a damage assessment is cause for contract cancellation and/or debarment or removal of
the contractor, as applicable, from the State's Centralized Master Bidders List (CMBL).
https://www.txsmartbuy.gov/browsecontracts/2231
Contract Details
Compliant Delivery does not occur until the Contractor delivers products, materials or services in full compliance with
Products by the specifications to Customer's F.O.B. destination, unless delivery is specifically accepted, in whole or in
Contractor part, by the Customer. Providing products, materials or services which do not meet all specification
requirements does not constitute delivery.
Customer reserves the right to require new delivery or a refund in the event that materials or products not
meeting specifications are discovered after payment has been made.
Purchase The Customer may request that a Contractor cancel a specific line item or an entire purchase order. There
Order shall be no fees charged for cancellation of an item and/or order prior to shipment by the Contractor. A
Cancellations Purchase Order Change Notice should be processed and sent to Contractor.
Restocking The Customer may request that a Contractor accept return of products already delivered. If the return is
Fee required through no fault of the Contractor, the Contractor may request a reasonable restocking charge.
The Customer may pay a restocking charge if the CPA or Customer determines that the charge is
justifiable. As a guideline, such charges shall not exceed 10% for contractors.
Substitutions During the Contract term, the Contractor shall not substitute a product or brand unless the Contractor has
obtained prior written approval from the CPA Contract Manager in coordination with the Customer. The
Contractor must have written confirmation from the CPA Contract Manager of the substitution before
making delivery.
Contract The Statewide Procurement Division Contract Management Office (SCMO), a division of the Comptroller
Performance of Public Accounts (CPA), administers a vendor performance program for use by all customers per Texas
Government Code (TGC), §2262.055, and 34 Texas Administrative Code JAC), §20.108. The Vendor
Performance relies on the customer's participation in gathering information on vendor performance. State
agency customers shall report vendor performance on purchases of $25,000 or more from contracts
administered by CPA, or any other purchase of $25,000 or more made through delegated authority
granted by CPA JAC 20.108), or purchases exempt from CPA procurement rules and procedures. State
agencies are additionally encouraged to report vendor performance on purchases under $25,000.
Vendor Performance shall be reported through the CPAVENDOR PERFORMANCE TRACKING
SYSTEM. (https://www.comptroller.texas.gov/purchasing/programs/vendor-performance-tracking/)
The purpose of the Vendor Performance Tracking System is to:
• Identify vendors that have exceptional performance
• Aid purchasers in making a best value determination based on vendor past performance
• Protect the state from vendors with unethical business practices
• Track vendor performance for delegated and exempt purchases
Contractors
Contractor VID: 14731799749
Contractor: Baker & Taylor, LLC
Contact Name: Wendy Hardy
Email: wendy.hardy@baker-taylor.com
https://www.txsmartbuy.gov/browsecontracts/2231
Contract Details
Phone: (800) 775-1200 x2776
Alternate Contact Name: Stefanie Kremer
Alternate Email: stefanie.kremer@baker-taylor.com
Alternate Phone: (704) 998-3135
Address: 2810 Coliseum Centre Drive Suite 300 Charlotte, NC 28217
Contractor VID: 12322487583
Contractor: Brodart Co.
Contact Name: Mary Miller
Email: mary.miller@brodart.com
Phone: (800) 233-8467
Alternate Contact Name: Lisa Miosi
Alternate Email: lisa.miosi@brodart.com
Address: 500 Arch Street Williamsport, PA 17701
Contractor VID: 16217466966
Contractor: Ingram Library Services LLC
Contact Name: Stephen Casey
Email: stephen.casey@ingramcontent.com
Phone: (214) 952-6310
Alternate Email: ils.orders@ingramcontent.com
Address: One Ingram Blvd. La Vergne,TN 37086
Contractor VID: 14308345058
Contractor: Midwest Library Service, Inc.
Contact Name: Trish Banta
Email: banta@midwestls.com
Phone: (800) 325-8833
Alternate Contact Name: Herbert Lesser
Alternate Email: hlesser@midwestls.com
Address: 11443 St. Charles Rock Rd. Bridgeton, Missouri 63044
Contractor VID: 13714996868
Contractor: Midwest Tape, LLC
Contact Name: Janet Timm
Email: jtimm@midwesttape.com
Phone: (800) 875-2785
Alternate Contact Name: Jeffery Jankowski
Alternate Email: jankowski@midwesttape.com
Alternate Phone: (419) 868-9370
https://www.txsmartbuy.gov/browsecontracts/2231
Contract Details
Address: PO Box 820 Holland, OH 43528
Contractor VID: 13920538553
Contractor: Proquest, LLC
Contact Name: Jess Snyder
Email: Proposals@proquest.com
Phone: (248) 496-1065
Address: Proquest, LLC 789 E. Eisenhower Parkway Ann Arbor, MI 48106
Contractor VID: 10203021430
Contractor: Yankee Book Peddler, Inc. dba GOBI Library Solutions from EBSCO
Contact Name: Bonnie LaRose
Email: bidadmin@ybp.com
Phone: (800) 258-3774 x8895
Alternate Contact Name: Kate Hartnett
Alternate Email: khartnett@ybp.com
Alternate Phone: (800) 258-3774 x8808
Address: 999 Maple Street Contoocook, NH 02339
Texas Comptroller of Public Accounts
Glenn Hegar
Home (https://comptroller.texas.gov)
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Search from the Texas State Library (https://www.tsl.texas.gov/trail/index.html)
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H B 855
Other State Sites
Texas.gov (https://texas.gov)
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Texas Veterans Portal (https://veterans.portal.texas.gov)
https://www.txsmartbuy.gov/browsecontracts/2231
EXHIBIT C
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received
has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the
vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not later
than the 7th business day after the date the vendor becomes aware of facts that require the statement to be
filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An
offense under this section is a misdemeanor.
jJ Name of vendor who has a business relationship with local governmental entity.
Midwest Library Service, Inc.
J
❑ Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated
completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
you became aware that the originally filed questionnaire was incomplete or inaccurate.)
J Name of local government officer about whom the information is being disclosed.
N/A
Name of Officer
J Describe each employment or other business relationship with the local government officer, or a family member of the
officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.
Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form
CIO as necessary.
N/A
A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income,
other than investment income, from the vendor?
Yes F-1 No
B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction
of the local government officer or a family member of the officer AND the taxable income is not received from the
local governmental entity?
71 Yes F1 No
J Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent or more.
N/A
J
❑Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts
as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).
J
05/07/2025
Signature of vendor d usiness with the governmental entity Date
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
Acomplete copy of Chapter 176 of the Local Government Code maybe found at http://www.statutes.legis.state.tx.us/
Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.
Local Government Code § 176.0010-a): "Business relationship" means a connection between two or more parties
based on commercial activity of one of the parties. The term does not include a connection based on:
(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an
agency of a federal, state, or local governmental entity;
(B) a transaction conducted at a price and subject to terms available to the public; or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and
that is subject to regular examination by, and reporting to, that agency.
Local Government Code § 176.003(a)(2)(A) and (B):
(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:
(2) the vendor:
(A) has an employment or other business relationship with the local government officer or a
family member of the officer that results in the officer or family member receiving taxable
income, other than investment income, that exceeds $2,500 during the 12-month period
preceding the date that the officer becomes aware that
(i) a contract between the local governmental entity and vendor has been executed;
or
(ii) the local governmental entity is considering entering into a contract with the
vendor;
(B) has given to the local government officer or a family member of the officer one or more gifts
that have an aggregate value of more than $100 in the 12-month period preceding the date the
officer becomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
(ii) the local governmental entity is considering entering into a contract with the vendor.
Local Government Code § 176.006(a) and (a-1)
(a) Avendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship
with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local
governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A);
(2) has given a local government officer of that local governmental entity, or a family member of the
officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any
gift described by Section 176.003(a-1); or
(3) has a family relationship with a local government officer of that local governmental entity.
(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator
not later than the seventh business day after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental
entity; or
(B) submits to the local governmental entity an application, response to a request for proposals
or bids, correspondence, or another writing related to a potential contract with the local
governmental entity; or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a
family member of the officer, described by Subsection (a);
(B) that the vendor has given one or more gifts described by Subsection (a); or
(C) of a family relationship with a local government officer.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021