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HomeMy WebLinkAbout063430-R1 - General - Contract - Wilson Bauhaus, Inc.CSC No. 63430-R1 CITY OF FORT WORTH CONTRACT RENEWAL NOTICE March 23, 2026 Wilson Bauhaus Interiors, LLC Attn: Felicia Davila, Principle/Owner 1341 W. Mockingbird Lane, Suite I IOOW Dallas, TX 75247 Re: Contract Renewal Notice Fort Worth City Secretary Contract No. 63430 ("Contract") First Renewal Term: April 1, 2026 to March 31, 2027 The above -referenced Contract with the City of Fort Worth expires on March 31, 2026 ("Expiration Date"). This letter is to inform you that the City wishes to exercise its renewal option for a First Renewal Term, which will begin immediately after the Expiration Date as outlined above. All other terms and conditions of the Contract remain unchanged. Please return this signed acknowledgment letter, along with a current copy of your insurance certificate reflecting the City of Fort Worth as the Holder, to the email address set forth below acknowledging receipt of the Contract Renewal Notice. Please log onto PeopleSoft Purchasing at http://fortworthtexas.gov/purchasing to ensure that your company information is correct and up-to-date. If you have any questions concerning this Contract Renewal Notice, please contact me at the telephone number listed below. Sincerely, Jack Brothers Jack Brothers Contract Compliance Specialist j ack.brothers&fortworthtexas. gov 817-392-4481 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Contract Renewal — CSC 63430-R1 Page 1 of 2 ACCEPTED AND AGREED: CITY OF FORT WORTH By: Y Name: William Johnson Title: Assistant City Manager Date: 04/06/2026 APPROVAL RECOMMENDED: �+o By: David Carabaja Apr 6, 2026 12:26:26 CDT) Name: David Carabajal Title: Executive Assistant Chief ATTEST: of soma° Jl °aaa Rza�oa By: Name: Jannette S. Goodall Title: City Secretary WILSON BAUHAUS INTERIORS, LLC Digitally signed by Felicia Davila Felicia Davila Date: 2026.03.2612:03:35 By: 05'00' Name: Felicia Davila Title: Principal / Owner Date: 3/26/26 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. Ka1 hryg !lqe- By: Kathryn Agee ( pr 6, 2026 :45:01 CDT) Name: Kathryn Agee Title: Senior Management Analyst APPROVED AS TO FORM AND LEGALITY: Name: Keanan M. Hall Title: Sr. Assistant City Attorney CONTRACT AUTHORIZATION: M&C: 24-0932 Date Approved: 10/29/2024 Form 1295 Certification No.: 2024-1223964 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Contract Renewal — CSC 63430-R1 Page 2 of 2 M&C Review Page 1 of 4 A CITY COUNCIL AGEND Create New From This M&C Official site of the City of Fort Worth, Texas FORT WORT11 Ir- REFERENCE **M&C 24- 13PCOOP WILSON DATE: 10/29/2024 NO.: 0932 LOG NAME: BAUHAUS INTERIORS MC CITYWIDE CODE: P TYPE: CONSENT PUBLIC NO HEARING: SUBJECT: (ALL) Authorize Agreements with Wilson Bahaus Interiors, LLC Using Various Cooperative Agreements as an Authorized Dealer for Various Manufacturers for the Purchase, Design, and Installation of Furniture for All City Departments for a Collective Amount Up to $2,090,857.00 for the Initial Term and Authorize Four Consecutive One -Year Renewal Options for Up to $821,675.00 for Year 1, $944,926.00 for Year 2, $1,086,655.00 for Year 3, and $1,249,665.00 for Year 4 RECOMMENDATION: It is recommended that the City Council authorize agreements with Wilson Bahaus Interiors, LLC, using various cooperative agreements as an authorized dealer for various manufacturers for the purchase, design, and installation of furniture for all City Departments for a collective amount up to $2,090,857.00 for the initial term and authorize four consecutive one-year renewal options for up to $821,675.00 for year 1, $944,926.00 for year 2, $1,086,655.00 for year 3, and $1,249,665.00 for year 4. DISCUSSION: The Purchasing Division was approached by the following departments to procure agreements for furniture and installation and design services: Communications & Public Engagement, Development Services, Economic Development, Property Management, Police, Fire, Municipal Courts, Aviation and the Library. Staff recommends contracting with Wilson Bahaus Interiors, LLC as an authorized dealer of various manufacturers for the purchase of furniture and installation and design services using the following cooperative contracts: Manufacturer Cooperative Name Cooperative Reference Cooperative Current Expiration Date Cooperative Final Expiration Date Allsteel, Inc. OMNIA Partners R191802 4/30/2025 4/30/2025 Allsteel, Inc. OMNIA Partners 07-76 9/30/2025 9/30/2030 Egan Visual Corporation OMNIA Partners 07-86 9/30/2025 9/30/2030 ENWORK - ASSA GROUP DBA Enwork OMNIA Partners R191819 4/30/2025 4/30/2025 Magnuson Group OMNIA Partners 07-104 9/30/2025 9/30/2030 National Office Furniture (Kimball International) OMNIA Partners R191811 4/30/2025 4/30/2025 National Office Furniture (Kimball International)I OMNIA Part 12019.0018961 5/30/2027 11 4/30/2029 Special T OMNIA Partners 07-122 9/30/2025 9/30/2030 The HON Company LLC. BuyBoard 667-22 3/31/2025 3/31/2025 The HON Company LLC. OMNIA Partners R191804 4/30/2025 4/30/2025 Via Inc. IOMNIA Partners1 07-128 9/30/2025 9/30/2030 During the initial term, the Police Department (PD) will utilize $1,376,357.23 to furnish multiple new construction and planned renovations funded through Crime Control Prevention District Capital Projects, 2018 Bond Program, Tax Notes Series 2020, 2022 Bond Program and Tax Notes Series 2024, for its different facilities as shown on the table below: Project ] http://apps.cfwnet.org/council_packet/mc_review.asp?ID=32638&councildate=10/29/2024 3/26/2026 M&C Review Page 2 of 4 ID (Project Name IlAmount 101661 South Police Station 11 $35,000.00 105488 Fiscal Year (FY) 24 PD Fiscal Storage Room $35,000.00 101919 PD Northwest Patrol Division $900,000.00 105455 PD Bob Bolen Training Shell $400,000.00 105489 FY24 PD Reg Office Reconfiguration $2,582.98 105317 PD Weapon Lobby Renovation $3,774.25 Total $1,376,357.23 Other participating departments' annual allocation for the agreements are as follows: Department Amount Development Services $ 26,500.00 Communication & Public Engagementll $ 5,000.00 Economic Development $ 3,000.00 Property Management 11s 10,000.00 Fire 11s 100,000.00 Municipal Courts 1 $ 20,000.00 Aviation 11 $ 50,000.00 Library 11s 100,000.00 RENEWAL OPTIONS: The agreements may be renewed up to four (4) consecutive one-year renewal options for up to $821,675.00 for year 1, $944,926.00 for year 2, $1,086,655.00 for year 3, and $1,249,665.00 for year 4. This action does not require specific City Council approval provided that the City Council has appropriated sufficient funds to satisfy the City's obligations during the renewal term. CURRENT AGREEMENTS: On December 4, 2023, the City entered into an agreement with Wilson Bahaus Interiors, LLC as an authorized dealer of manufacturer Special T, LLC under OMNIA Contract 07-122 for an amount up to $1,200.00 (City Secretary No. 60553) (CSC) and executed an amendment on December 14, 2023 increasing the annual amount up to $100,000.00. On December 13, 2023, the City entered into an agreement with Wilson Bahaus Interiors, LLC as an authorized dealer of manufacturer Via, Inc under OMNIA Contract 07-128 for an amount up to $100,000.00 (CSC No. 60601) and executed an amendment on February 2, 2024 authorized by Mayor & Council Communication (M&C) 24-0013 increasing the annual amount up to $200,000.00. On July 2, 2024, the City entered into an agreement with Wilson Bahaus Interiors, LLC as an authorized dealer of manufacturer The HON Company LLC under OMNIA Contract R191804 for an amount up to $100,000.00 (CSC No. 61627). For administrative ease and tracking, this M&C supersedes all prior M&Cs with Wilson Bahaus Interiors, LLC and is intended to control authorized spending authority moving forward. SUCCESSOR CONTRACTS: The City will initially use the listed BuyBoard and OMNIA Partners contracts to make purchases authorized by this M&C. In the event a BuyBoard or OMNIA Partners cooperative contract is not renewed, staff would cease purchasing at the end of the last purchase agreement coinciding with a valid cooperative contract. If the City Council were to not appropriate funds for a future year, staff would stop making purchases when the last appropriation expires, regardless of whether the then -current purchase agreement has expired. In the event a BuyBoard or OMNIA Partners cooperative agreement is not extended, but BuyBoard or OMNIA Partners executes new cooperative agreement(s) with substantially similar terms, this M&C authorizes the City to purchase the furniture and services under the new BuyBoard or OMNIA Partners contract(s). If this occurs, in no event will the City continue to purchase goods and services under the new agreement(s) for more than four (4) years without seeking Council approval. COOPERATIVE PURCHASE: State law provides that a local government purchasing an item under a cooperative purchasing agreement satisfies any state law requiring that the local government seek competitive bids for the purchase of items. BuyBoard and OMNIA contracts are competitively bid to increase and simplify the purchasing power of government entities across the State of Texas. Information of publication of all cooperative purchasing agreements have been provided per the table below. Cooperative Name Solicitation Number Cooperative Reference Dates of Public Notices Bid Opened BuyBoard RFP 667-22 667-22 7/21 /2021, 7/22/2021, 7/28/2021, 7/29/2021 10/28/2021 http://apps.cfwnet.org/council_packet/mc_review.asp?ID=32638&councildate=10/29/2024 3/26/2026 M&C Review Page 3 of 4 OMNIA Partners RFP 001218 2019.001896 7/15/2019, 7/17/2019, 7/19/2019, 7/21/2019, 7/22/2019, 7/23/2019, 7/24/2019, 7/25/2019, 8/6/2019 8/21/2019 OMNIA Partners RFP 19-18 R191802 I 11/7/2019, 11/8/2019, 11/14/2019, 11/20/2019 12/11/2019 OMNIA Partners RFP 19-18 R191804 Ill1/7/2019, 11/8/2019, 11/14/2019, 11/20/2019 12/11/2019 OMNIA Partners RFP 19-18 R191811 Ill1/7/2019, 11/8/2019, 11/14/2019, 11/20/2019 12/11/2019 OMNIA Partners RFP 19-18 R191819 11/7/2019, 11/8/2019, 11/14/2019, 11/20/2019 12/11/2019 OMNIA Partners RFP 24-22 07-76 6/14/2022, 6/21/2022 7/21/2022 OMNIA PartnersI RFP 24-22 07-86 6/14/2022, 6/21/2022 7/21/2022 OMNIA PartnersI RFP 24-22 07-104 6/14/2022, 6/21/2022 7/21/2022 OMNIA PartnersI RFP 24-22 07-122 6/14/2022, 6/21/2022 7/21/2022 OMNIA PartnersI RFP 24-22 11 07-128 6/14/2022, 6/21/2022 7/21/2022 BUSINESS EQUITY: A business equity goal is not assigned when purchasing from an approved purchasing cooperative or public entity. This project will serve ALL COUNCIL DISTRICTS. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that funds are available in the current operating budgets, as previously appropriated, in the participating departments' Operating Funds to support approval of the above recommendation and award of the contract. Prior to any expenditure being incurred, the participating departments have the responsibility to validate the availability of funds. BQN\\ Fund Department Account Project Program Activity Budget I Reference # Amount ID I I ID I I I Year I (Chartfield 21 FROM Fund Department Account Project Program Activity Budget Reference # Amount ID I ID I I Year I (Chartfield 2) Submitted for City Manager's Office by: Originating Department Head: Additional Information Contact: Reginald Zeno (8517) William Johnson (5806) Reginald Zeno (8517) Neil Noakes (4212) Jo Ann Gunn (8525) Maria Canoura (2526) ATTACHMENTS Form 1295 - Wilson Bauhaus.pdf (CFW Internal) FW006-FID TABLE .xIsx (CFW Internal) FW007-FID TABLE for Wilson.xlsx (CFW Internal) FW017-FID Table for Furniture RFS.xlsx (CFW Internal) FW021-FID TABLE for Wilson Bauhaus (Furniture).xlsx (CFW Internal) FW035-FID Table Wilson Bauhaus COOP 8-26-2024.XLSX (CFW Internal) FW036-FID TABLE FIRE WILSON BAHAUS.xlsx (CFW Internal) http://apps.cfwnet.org/council_packet/mc_review.asp?ID=32638&councildate=10/29/2024 3/26/2026 M&C Review Page 4 of 4 FW038-Furniture FID TABLE.xlsx (CFW Internal) FW055-FID TABLE BLANK WITH INSTRUCTIONS V2.xlsx (CFW Internal) FW084-FID Table Wilson Bauhaus.xlsx (CFW Internal) SAMs - Wilson Bauhaus Entitylnfo 20240923-112328.pdf (CFW Internal) TX SOS - Wilson Bauhaus Interiors, LLC.pdf (CFW Internal) http://apps.cfwnet.org/council_packet/mc_review.asp?ID=32638&councildate=10/29/2024 3/26/2026 CERTIFICATE 4F INTERESTED PARTIES FORM 1295 1 of 1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2024-1217837 Wilson Bauhaus Interiors Dallas, TX United States Date Filed: 09/23/2024 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 Date Acknowledged: g Provide the identification number used by the governmental entity or state agency to track or identity the contract, and provide a description of the services, goods, or other property to be provided under the contract. R191802 Allsteel Omnia Partners, Office furniture 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION r My name is lJA ` V� _ and my date of birth is My address is J () 1v--,)'Lit U -lif i K , —75,) Ll L't (street) -6� �,L, (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in CL County, State of C UZ 5 , on the day of (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.48daS1f7 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2024-1223960 Wilson Bauhaus Interiors Dallas, TX United States Date Filed: 10/08/2024 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 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. 07-76 A{Isteel Omnia Partners furniture 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION ►"J My name is z- VV-) and my date of birth is My address is `�J `t 1 �rf i �iPC- IC4!2�pi r,-J j 00Dq ll(Gt5, (street) ✓ (city) (state) (zip code) (country) I declare under penalty ofperjurythat the foregoing is true and correct. Executed inl'lQJ County, State of ��� on the 6 day of C�IUy7G'v 20.Z4. (month) (year) /A A —A 'sicirla ure of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.48da51f7 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1af1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2024-1217846 Wilson Bauhaus Interiors Dallas, TX United States Date Filed: 09/23/2024 2 Name of governmental entity or state agency that is a parry to the contract for which the form is 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. 07-86 Egan Visual, Omnia Contract, Office Furnishings 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION A _ My name is U liV� �V1 Z �� �, and my date of birth is My address is Y 'V (street) C6Wt r-- (city) (state) (zip code) (country) 116D tx) I declare under penalty of perjury that the foregoing is true and correct. Executed in /t J�� County, State of on the day of r , 20 (month) (yea gnature of authorized age t of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.48da51f7 CERTIFICATE OF INTERESTED PARTIES FORM 1295 Zofl 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. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2024-1217858 Wilson Bauhaus Interiors Dallas, TX United States Date Filed: 09/23/2024 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 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. R191819 Enwork/Assa Group Omnia contract, Office Furnishings 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION My name is A A On rp and my date of birth is �} My address is i JL I V ��- S Jam, `5 —�— W (street) c0� � , 1,1,-4(city) (state) (zip code) (country) II 06\k) I declare under penalty of perjury that the foregoing is true and correct. Executed in 1 l CL County, State of tk 5 , on the aday of 2 � (month) (year) 1;L- 0 Sib ture of authorize a ant o (Declarant) A tractin usi ntity Forms provided by Texas Ethics Commission www.ethics.state.tx.us version v4.i.0.4oua5li i CERTIFICATE OF INTERESTED PARTIES FORM 1295 1af1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2024-1217852 Wilson Bauhaus Interiors Dallas, TX United States Date Filed: 09/23/2024 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 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. 07-104 Magnuson Omnia Contract, Office Furnishings 4 Name of Interested Party City, State, Country (place of business) Nature of interest .(check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. ❑ X 6 UNSWORN DECLARATION My name is �� ` V t taN Vn/� j^/\ "e and my date of birth is My address is 13HW yy (street) —0,{ I'y (city) (state) (zip code) (country) f I declare under penalty of perjury that the foregoing is true and correct. Executed in Doc, CC County, State of on the aday of �- , 20�. (month) (year) J�A Si&rdture of authorized agent of co tracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx,us Version V4.1.0.48da5117 CERTIFICATE OF INTERESTED PARTIES FORM 1295 lofl 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. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business, 2024-1217842 Wilson Bauhaus Interiors Dallas, TX United States Date Filed_ 09/23/2024 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 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. R191811 National Office Furniture/Kimball International Omnia Contract, Office Furnishings 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION } , r ` My name is IJiJ 1 �I�i11 iM -� {� and my date of birth is ( �� My address is Uu t (street) i r J �} J } w (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct.(UV Executed in County, State of -Te� 5 on the day of , 20 q (month) (year) �2 C-� Si6ature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us version V4.1.U.4uoab1t/ CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2024-1223963 Wilson Bauhaus interiors Dallas, TX United States Date Filed: 10/0$/2024 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 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. 2019.001896 Kimball Omnia Partners Furniture 4 Name of Interested Parry City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION i My name is �e V� t ✓Y1 I �'�z� and my date of birth is My address is 't�'�-i 1 W�c r ty 1� ✓� ! 4 nU i� 1 i I�Ii -� }< �i��� U 5 (- . (stree (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in �1CL_C, County, State of -,on the 5 day of 20 z� Do,{ (month) (year) 0 za, — ignature orized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.48da51f7 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2024-1217863 Wilson Bauhaus Interiors Dallas, TX United States Date Filed: 09/23/2024 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 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. 07-122 Special T, Omnia Contract, Office Furnishings 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is 1 and my date of birth is ! My address isZ4' r JAI. (street) ,K (city) (state) (zip code) (country) 110d w I declare under penalty of perjury that the foregoing is true and correct. Executed in � County, State of T4,cc/ s—, on the a 7�day of 120 . (month) (year) AA Q �,/� q' a Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us version v4.1.u.4uuaoli r CERTIFICATE OF INTERESTED PARTIES .FORM 1295 1of1 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. 2024-1223964 Wilson Bauhaus Interiors Dallas, TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 10/08/2024 being filed. City of Fart 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. 667-22 Hon Buyboard, Furniture 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION My name isWvy� and my date of birth is My address is �yJ� ilJ rVAVC-,1"P+1Kd 11�0 I� I�� iC! J ! X —141 fit-! Z o 5 (street) J (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. `- Executed in tC2 ✓ County, State of y on the 5 day of oC-r 120 (month) (year) Signature o authorized "agent contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.48daKH CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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 Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2024-1217843 Wilson Bauhaus Interiors Dallas, TX United States Date Filed: 09/23/2024 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 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. R191804 Hon Omnia Contract, Office Furnishings 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARATION My name is l y \ J, V t ` and my date of birth is My address is -J H I N")rk-10,A VHVA`' ` l Q S 75247 U A. (street) -6k I ~ I ! 11 j (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in �/(J�l County, State of ~ `�- on the t9�ay of / , 20�. (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V4.1.0.48cla51t7 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 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. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2024-1217860 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Wilson Bauhaus interiors Dallas, TX United States Date Filed: 09/23/2024 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 Date Acknowledged: g 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. 07-128 Via Seating, Omnia Contract, Office Furnishings 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 Parry. ❑ X 6 UNSWORN DECLARATION F My name is B --e i—n �V V frCV , and my date of birth is ! My address is 13 o1 ` { 6 , I [ a � , T > 6,3 , Lt_ 5-X—. (street) ) 10 1,0 (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in � L ` � County, State of 1 "� U- , on c the �� day of �_, 200� (month) (year) Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state,mus version v4.1.V.4ouaDJJ r FORT WORTH. City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: Wilson Bauhaus Inc. Subject of the Agreement: 1 st Renewal of CSC 63430. M&C Approved by the Council? * Yes 8 No ❑ If so, the M&C must be attached to the contract. Is this an Amendment to an Existing contract? Yes ❑ No 8 If so, provide the original contract number and the amendment number. Is the Contract "Permanent"? *Yes ❑ No 8 If unsure, see back page for permanent contract listing. Is this entire contract Confidential? *Yes ❑ No 8 If only specific information is Confidential, please list what information is Confidential and the page it is located. Effective Date: April 1, 2026 If different from the approval date. Expiration Date: March 31, 2027 If applicable. Is a 1295 Form required? * Yes 8 No 8 *If so, please ensure it is attached to the approving M&C or attached to the contract. Project Number: If applicable. *Did you include a Text field on the contract to add the City Secretary Contract (CSC) number? Yes 8 No ❑ Contracts need to be routed for CSO processing in the following order: 1. Katherine Cenicola (Approver) 2. Jannette S. Goodall (Signer) 3. Allison Tidwell (Form Filler) *Indicates the information is required and if the information is not provided, the contract will be returned to the department.