HomeMy WebLinkAbout030679 ORD - 11/10/2015 Ordinance authorizing the City Manager to execute a use privilege
agreement with the Tuloso-Midway Independent School District
("Permittee") to install, operate, maintain, and remove a private
eight-inch PVC wastewater sanitary sewer main ("Wastewater Line")
across the Haven Drive public street right-of-way, located west of
McKinzie Road public right-of-way, subject to the Permittee's
compliance with specified conditions.
WHEREAS, Tuloso-Midway Independent School District ("Permittee"), desires to
install, operate, maintain, and remove a private eight-inch PVC wastewater sanitary
sewer main ("Wastewater Line") across the Haven Drive public street right-of-way,
located west of McKinzie Road public right-of-way;
WHEREAS, the Permittee has requested, and the City of Corpus Christi ("City") desires
to extend, a one-year term use privilege agreement ("Agreement"). At the end of the
initial term, this Agreement renews automatically, in order to accomplish the purpose
and use intended by the Permittee within the public right-of-way;
WHEREAS, in accordance with Article IX, Section 1 of the City Charter, the City Council
authorizes the City Manager to enter into the Agreement for the benefit of the City and
the Permittee, subject to the Permittee's compliance with the specified provisions of the
Use Privilege Agreement.
BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CORPUS
CHRISTI, TEXAS:
SECTION 1. The City Manager, or his designee ("City Manager"), is authorized to
execute a one-year term use privilege agreement ("Agreement"). At the end of the
initial term, this Agreement with the Tuloso-Midway Independent School District
("Permittee") renews automatically, to allow the Permittee to install, operate, maintain,
and remove a private eight-inch PVC wastewater sanitary sewer main ("Wastewater
Line") across the Haven Drive public street right-of-way, such Agreement at all times
subject to the Permittee's compliance with the conditions specified in the Agreement.
A copy of the Agreement is attached to this ordinance and being incorporated by
reference into this ordinance as if fully set out herein in their entirety.
SECTION 2. The Agreement authorized in Section 1 of this ordinance is subject to
the Permittee's compliance with the conditions of the Agreement including, but not
limited to, the provisions specified below:
a. In exchange for the City's authorization for use of the public right-of-way by the
Permittee for the stated purpose, the Permittee agrees to provide the City with a
one-time Use Privilege Agreement fee of$900.00.
b. The Permittee's use of the eight-inch wastewater sanitary sewer main is strictly
limited to serving the Permittee's Tuloso-Midway Agricultural Complex restroom
facilities. Permittee may not provide wastewater service through the eight-inch
wastewater sanitary sewer main
Page 1 of 2
030670
INDEXED
to any facilities other than the facilities specified in this section, nor may
Permittee permit or allow anyone else to provide wastewater service or
any other service through the eight-inch wastewater sanitary sewer main
to any facility whether owned by the Permittee or by another person or
entity.
c. All costs incurred to install, operate, maintain, repair, and remove the eight-inch
PVC wastewater sewer main are the sole responsibility of the Permittee.
The foreg in ordinance was read for the first time and_passed to its second reading on
this the 'I '^day of CQ 1) C., , 201_, by the following vote:
Nelda Martinez Brian Rosas _01..)
Rudy Garza Lucy Rubio aU�9
G
Chad Magill Mark Scott !
IF
Colleen McIntyre LI Carolyn Vaughn
i • I
Lillian Riojas
I
1611
The foregoin9ordinagc_enwas read for the second time and passed finally on this the
day of \ \ r , 20 is , by the following vote:
Nelda Martinez _a_ Brian Rosas
_aty_L
Rudy Garza CilLucy Rubio ___#.
Chad Magill l�l Mark Scott
n/� i
Colleen McIntyre Ott Carolyn Vaughn I_ , 0
4
Lillian Riojas iI ,
PASSED AND APPROVED this the I 0 day of 11 (g-r1d3e-fe d , 20 J5
ATTEST: \1\e 'L
Rebecca Huerta Nelda Martinez
City Secretary Mayor
Page 2 of 2
030679
USE PRIVILEGE AGREEMENT
STATE OF TEXAS §
§
COUNTY OF NUECES §
This use privilege agreement ("Agreement") is entered into by and between the City of
Corpus Christi ("City"), a Texas home-rule municipal corporation, and the Tuloso
Midway Independent School District ("Permittee"), a Texas public school district and
property owner of 2653 McKinzie Road, Corpus Christi, Texas, whose business address
is 9760 La Branch, Corpus Christi, Texas, 78410.
In accordance with Article IX, Section 1, of the City's City Charter and in consideration
of a one-time payment of Nine Hundred Dollars ($900.00) paid by Permittee, the receipt
of which for the initial year is acknowledged, the City has granted and conveyed, and by
these presents does grant and convey to Permittee, for the term and upon the
conditions stated in this Agreement, a use privilege for the right to install, operate,
maintain, repair, and remove approximately one hundred and twenty eight linear feet
(128 L.F.) of a private eight-inch PVC sanitary sewer line ("Wastewater Line") with a
steel casing across the Haven Road public street right-of-way, as shown in Exhibits "A"
(Location Map) and "B" (Plan View and Profile View). Exhibits "A" and "B" are attached
to this Agreement and incorporated into this Agreement by reference as if fully set out
herein in their entirety. The area in which the use privilege is granted for the location of
the Permittee's Wastewater Line is referred to in this Agreement as the "Use Privilege
Area."
TO HAVE AND TO HOLD the same use privilege granted unto Permittee, its
successors, and assigns, together with the right under the conditions specified in this
Agreement, to at any time enter upon the above described Use Privilege Area to install,
operate, maintain, repair, or remove Permittee's Wastewater Line, and being further
understood that the use privilege granted by this Agreement is subject to the
Permittee's compliance at all times with the following conditions, the City and Permittee
agree as follows:
A. This Agreement, and the rights granted under the Agreement, may be
revoked at any time by the City upon providing the Permittee not less than 30
days notice in writing by the City's City Manager, or his designee ("City
Manager"). In the event of a revocation by the City Manager or earlier
termination of this Agreement by either party, no portion of any payment
made under this Agreement is refundable to the Permittee.
B. This Agreement is for a term of one (1) year from the date executed by the
City. At the end of the initial term, this Agreement renews automatically
unless the Permittee or the City provides written notice of intent not to renew
1 ) 4°'- 1
to the non-terminating party at least 60 days before the end of any annual
term.
C. This Agreement may not be assigned by Permittee without the City
Manager's prior written consent.
D. The Permittee shall acquire and maintain at all times for the term of this
Agreement insurance coverage pertaining to the Use Privilege Area granted
under this Agreement and the activities authorized by this Agreement. The
types of required insurance coverages must be in the minimum amounts set
forth in the attached Exhibit "C," the substantive content of Exhibit "C" being
incorporated by reference into this Agreement as if fully set out here in its
entirety. The insurance policies must name the City as an additional insured
and may not be canceled, renewed, or materially changed by Permittee
unless at least ten (10) days advance written notice has been provided to the
City. Upon the City Manager's written request, Permittee shall provide copies
of all requested insurance policies to the City's City Attorney.
E. Should construction be deemed necessary by Permittee in the Use Privilege
Area, construction plans and specifications for all proposed work shall be
submitted in advance by the Permittee to the City's City Engineer for approval
prior to beginning the construction process. The plans must show the depth,
and location of the proposed construction and distance from existing water,
storm water, wastewater, and gas lines. The Permittee shall also comply with
any other laws, rules, regulations, and ordinances applicable to construction
in the City and in the public right-of-way, including obtaining all required
permits.
F. Prior to the start of any approved construction, Permittee shall require every
contractor and subcontractor to provide a Certificate of Insurance reflecting
insurance in coverage amounts as set forth in Exhibit "C." Additionally,
Permittee shall require their contractors and subcontractors to indemnify the
City, its officers, officials, employees, representatives, agents, licensees, and
invitees in the same manner that Permittee has provided indemnification to
the City pursuant to this Agreement.
G. Permittee shall provide all necessary and proper safety devices so as to
prevent injuries or accidents in the Use Privilege Area, in as much as
possible.
H. At least 48 hours prior to beginning any approved construction, Permittee
shall contact 1-800-DIG-TESS and the Lone Star Notification Center (1-800-
669-8344), and any other required agency or authority. Additionally, at least
48 hours prior to beginning any approved construction, Permittee shall give
notice and verify depth and location of communication lines or communication
fiber optic cables, whichever is applicable, to the following:
Eb IoI- Z
• City Utility Departments, including Water, Storm water, Wastewater and
Gas;
• American Electric Power(AEP);
• American Telephone and Telegraph (AT&T);
• CenturyTel;
• Time Warner;
• Grande Communications; and
• Any and all other certified telecommunications providers.
A City inspector may request a utility line be uncovered to verity its depth or
location.
1. Any construction process and use of the Use Privilege Area by Permittee
shall not interfere with the construction, installation, operation, maintenance,
repair, removal or replacement by the City or any of its agents, contractors, or
franchisees of any existing or future proposed sidewalks, utility lines, or other
uses. If the City or any franchisee with utilities currently located in said public
right-of-way needs access to the right-of-way, Permittee shall pay for
removing or relocating the private wastewater line in the Use Privilege Area to
allow access to utility lines for maintenance, repair, removal, or replacement
of the utility lines. The Permittee shall repair the Use Privilege Area to its
original condition or cease to use the Use Privilege Area, at which time this
AGREEMENT terminates immediately.
J. Traffic Engineer requirements pertaining to this Agreement, if applicable in
context:
1. At least 48 hours prior to commencing any approved construction, the
Permittee shall file and obtain approval for a traffic control plan with the
City's Traffic Engineer. No closure or barricading of a public right-of-way
or any portion of a public right-of-way may occur before approval of the
traffic control plan and, if applicable, approval of a detour or barricade plan
has been obtained from the City's Traffic Engineer.
2. Should Permittee require a trench, pit, or similar excavation be dug during
approved construction, the Permittee shall file and obtain approval for
barricading said trench, pit, or excavation in accordance with the Texas
Manual on Uniform Traffic Control Devices from the City's Traffic
Engineer. [See paragraph "P" of this Agreement for additional
requirements regarding trenches, pits and similar excavations.]
K. lf, as determined by the City Manager, damage occurs to any gas, water,
storm water, or wastewater line, Permittee shall allow the City immediate
access to the Use Privilege Area to perform an assessment, make repairs, or
take any other action deemed necessary by the City. Determination of the
VI 401-3
extent of damage and repairs necessary to restore the utility line(s) shall be
made by the City Manager. All costs of the City associated with said damage
and repair, including labor and materials, shall be paid by Permittee within 30
days of the City's invoice.
L. Should construction become necessary near existing water or wastewater
lines, Permittee shall take every precaution not to disturb the soil surrounding
any such lines, including all thrust blocks.
M. If any approved work is conducted near any existing water main, it shall be
done under the inspection of a City inspector at a daily rate of three-hundred
ten dollars and thirty-five cents ($310.35) for each day spent inspecting
construction, installation, maintenance, repair, removal, or replacement in the
Use Privilege Area. A half-day, being four hours or more of work time by the
City inspector, constitutes a whole working day for purposes of calculation.
Any time in excess of eight hours a day, or on Saturday, Sunday or holidays,
shall be calculated at a daily rate of fifty-eight dollars and eighteen cents
($58.18) per hour. Any assessed inspection fees shall be paid by the
Permittee to the appropriate City department within 30 days of the City's
invoice. These amounts will be adjusted annually each year on August 1 to
reflect any pay increases that may be attributable to the rates charged.
N. The parties acknowledge that the Wastewater Line is not owned by the City.
At any and all times Permittee shall be solely responsible for the repair and
maintenance of the Wastewater Line and Use Privilege Area, including any
costs associated with damage occurring due to natural weather
elements/occurrences or man-made forces. Should damage occur to the
Wastewater Line or Use Privilege Area, regardless of the type of damage,
Permittee shall immediately repair the damage upon notice by the City.
Failure to so repair terminates this Agreement immediately without any further
action needed on the part of the City.
0. Permittee shall repair, or cause to be repaired, any damage to driveways,
culverts, head walls, landscaping, sidewalks, curbs, gutters, and any other
structure, public or private, resulting from or caused by reason of
construction, installation, maintenance, repair, removal, replacement or
operation of the Wastewater Line and Use Privilege Area.
P. If a trench, pit, or other excavation is required during approved construction,
no trenches, pits, or other excavation, other than bore pits, shall be left open
overnight, except as specifically authorized by the City's Director of
Development Services and City's Engineer. Bore pits are not allowed open
for a period of longer than 14 calendar days, regardless of location. All
trenches, pits, or other excavations, other than bore pits, shall be backfilled by
the Permittee promptly and in accordance with current City standards and
specifications and as per the City inspector's request. All trenches, pits, and
lb 1101-4
other excavations, including bore pits, shall be barricaded by the Permittee in
accordance with the Texas Manual on Uniform Traffic Control Devices and as
approved by the City's Traffic Engineer. [See paragraph "J.2." for additional
requirements pertaining to trenches, pits, and other excavations.]
Q. If backfilling becomes necessary, all backfill, specifically including that in and
around existing utilities, shall be made by Permittee according to current City
standards and specifications and as required by a City inspector.
R. Use of the Wastewater Line authorized by this Agreement is strictly limited to
providing service to the Tuloso Midway High School Agricultural Complex
restroom facility, located at 2653 McKinzie Road, in the Use Privilege Area.
Permittee shall not provide, nor permit anyone else to provide or receive,
service through said Wastewater Line, or at any facilities within the City other
than the building facilities specifically included in this Agreement without first
obtaining a franchise or other required approval from the City. The Permittee'
use of the eight-inch wastewater sanitary sewer main is strictly limited to
serving the Permittee's Tuloso Midway Agricultural Complex restroom
facilities. Permittee may not provide wastewater service through the eight-
inch wastewater sanitary sewer main to any facilities other than the facilities
specified in this section, nor may Permittee permit or allow anyone else to
provide wastewater service or any other service through the eight-inch
wastewater sanitary sewer main to any facility whether owned by the
Permittee or by another person or entity. All costs incurred to install, operate,
maintain, repair, and remove the eight-inch PVC wastewater sewer main are
the sole responsibility of the Permittee.
S. INDEMNIFICATION. Intentionally left blank.
T. All signatories signing this Agreement warrant and guarantee that they have
the authority to act on behalf of the entity represented and make this
Agreement binding and enforceable by their signatures.
U. Unless otherwise stated in this Agreement, any notice required or permitted to
be given under this Agreement must be in writing and sent by certified mail,
return receipt requested to the following addresses:
If to Permittee: Tuloso Midway Independent School District
9760 La Branch
Corpus Christi, TX 78410
If to the City: City of Corpus Christi
Attn: Director, Development Services Department
P. 0. Box 9277
Corpus Christi, TX 78469-9277
ip 4o1- s
Any party shall, by notice to the others in accordance with the provisions of
this paragraph, specify a different address or addressee for notice purposes
within 10 days of any address change.
V. This Agreement shall be construed under and in accordance with the laws of
the State of Texas, and all obligations of the parties created pursuant to this
Agreement are performable in Nueces County, Texas. Venue for all actions
arising from, out of, or related to this Agreement must be brought in Nueces
County, Texas.
W. The Permittee further agrees, in compliance with the City of Corpus Christi
Ordinance No. 17112, to complete, as part of this Agreement, the "Disclosure
of Interests" form attached to this Agreement as Exhibit "D." Completed
versions of Exhibit "D" by the Permittee form a part of this Agreement and are
incorporated by reference into this Agreement as if set out here in their
entireties.
X. This instrument, including exhibits, constitutes the entire agreement between
the City and the Permittee, and no prior written, oral, or contemporaneous
promises, warranties, or representations shall be binding upon any parties.
This Agreement may only be amended by written instrument signed by
authorized representatives of the City and Permittee and approved as required
by City law.
Y. Any payments due by the Permittee pursuant to this Agreement will be made
from current revenue available to the Permittee.
I IS 401 - 4
EXECUTED IN DUPLICATE this I day of 4--r---"' , 20 tr— .
TULOSO MIDWAY INDEPENDENT SCHOOL DISTRICT
"iik.4;k $ likos• fi cL"" 9// 7:26Y.5-
Date /Date
President
Board oustees
ACKNOWLEDGMENT
STATE OF TEXAS §
§
COUNTY OF NUECES §
Thi�S,instrument was acknowledged before me on 0 J 2015, by
(t' , President, Board of Trustees, Tuloso Midway
Independent School District, a Texas public school district, on behalf of the district.
Notary Public's Signatur
P,AHTA ITIIIII REHE CHAIIEZ
t• MY COMMISSION EXPIRES
September 2Q,2018
I D 401- ?
ATTEST: CITY OF CORPUS CHRISTI
By:
City Secretary Daniel M. Grimsbo, P.E.
Director, Development Services Department
Approved as to legal form: , 2015
Julian Grant
Senior Assistant City Attorney
for the City Attorney
STATE OF TEXAS §
§
COUNTY OF NUECES §
This instrument was acknowledged before me on , 2015, by
Daniel M. Grimsbo, P.E., as Director, Development Services Department, of the City of
Corpus Christi, a Texas Municipal Corporation, on behalf of said corporation.
Notary Public's Signature
Ib 401- 8
I-I
C7'
0
wfY f t' r7 .7a �—, • `
fj
C\--,./
r . r
Y
r
1
PRo.,E,7 It tlx.l.
LOC A it x
w Teem, .4 :1.5,
., •
LOCATION MAP
lit . ..
;rm.( yr
USE PRIVILEGE AGREEMENT-TULOSO MIDWAY PRIVATE SANITARY SEWER LINE(HAVEN DR.)
EXHIBIT A
o t-10h g3
i 1 i
L
, ,i,el I
ii
i
I. a
1,11 f
7)3 s
iI ' 1 ` .
• I \.;...;!
I i ' t
,
1 I
✓ I. f
Z - 1 E
O _
e1
I 1
w• 1 i
N
m
x ' a
I y
F
71
03 •C - i •• •
s_ ir.'
. c:it , ; _._. �. �. ----.
4
t
.4....,,..-_,,,+- ... ..r..-1., Jr..."
t 1' i Rs swot s+•.0 • 0 O J
1
. .
• I
•
}t ss + •
O 411 0
•
'1 . • .„ ;r;
1 •
't 1 t'"' .
i 1 1
• �f
111 I 4
I t ' . I '.1 I
I • •
,;i • , I. .
'1 • t
AGRICULTURAL COMPLEX TULOSO MIDWAY i pii E
O/KIfE UTILITY IMPROVEMENTS - •
LJ s ..
04.ERA L OFFSITE TY F-44'1 'Tii
ti -iQh a I
MATCNLINE STA S•00 MATCHLZ$ •STA 1•04:1;t}_ti��_
1.
x{'41 'I
i iH tf
~ #
3 If
e
4;: i
i❑{t�� .',1-
I. 7
tt p {t
�li 11.'.s r I. 8 :61 J- , i;rip
i,(. o IIS .. '! t
t.
X11 ,. II, o ),Il.i t,� 1,1
1! i it
I. 8 ii. R. i
t • ii 1-: '4.:- -f''t'
\ ' d
y - -1;'11� t,'
A 1
CO
' 1 !
N I*
•
•Q' t It.
t
.
MATCHLINE STA I.00
AGRICULTURAL COMPLEX TULOSO MIDWAY I-.l ME . .
OFlSITE UTILITY IMPROVfLENTS f
;.,.N8PR=:FIEt:
`A S+e-; -0 STA • ... ro
EXHIBIT C
INSURANCE REQUIREMENTS
CONTRACTOR'S LIABILITY INSURANCE
A. Contractor must not commence work under this contract until all insurance required has been obtained
and such insurance has been approved by the City. Contractor must not allow any subcontractor to
commence work until all similar insurance required of any subcontractor has been obtained.
B. Contractor must furnish to the City's Risk Manager and Director of Development Services one (1) copy
of Certificates of Insurance with applicable policy endorsements showing the following minimum
coverage by an insurance company(s)acceptable to the City's Risk Manager. The City must be listed as
an additional insured on the General liability and Auto Liability policies, and a waiver of
subrogation is required on all applicable policies. Endorsements must be provided with Certificate
of Insurance. Project name and/or number must be listed in Description Box of Certificate of
Insurance.
TYPE OF INSURANCE MINIMUM INSURANCE COVERAGE
30-day advance written notice of Bodily Injury and Property Damage
cancellation, non-renewal, material change Per occurrence- aggregate
or termination required on all certificates
and policies.
Commercial General Liability including: $1,000,000 Per Occurrence
I. Commercial Broad Form
2. Premises—Operations
3. Products/ Completed Operations
4. Contractual Liability
5. Independent Contractors
6. Personal Injury-Advertising Injury
AUTO LIABILITY (including) $500,000 Combined Single Limit
1. Owned
2. Hired and Non-Owned
3. Rented/Leased
WORKERS'S COMPENSATION Statutory and complies with Part II of this
(All States Endorsement if Company is not Exhibit.
domiciled in Texas)
Employer's Liability $500,000/$500,000!$500,000
PROPERTY INSURANCE Contractor is responsible for insuring all
owned, leased and rented personal
property.
C. In the event of accidents of any kind related to this contract, Contractor must furnish the Risk Manager
with copies of all reports of any accidents within 10 days of the accident.
IA 401- s .
II. ADDITIONAL REQUIREMENTS
A. Applicable for paid employees, Contractor must obtain workers' compensation coverage through a
licensed insurance company.The coverage must be written on a policy and endorsements approved by the
Texas Department of Insurance. The workers' compensation coverage provided must be in an amount
sufficient to assure that all workers'compensation obligations incurred by the Contractor will be promptly
met. An All States Endorsement shall be required if Contractor is not domiciled in the State of Texas.
B. Contractor shall obtain and maintain in full force and effect for the duration of this Contract, and any
extension hereof, at Contractor's sole expense, insurance coverage written on an occurrence basis by
companies authorized and admitted to do business in the State of Texas and with an A.M. Best's rating of
no less than A- VII.
C. Contractor shall be required to submit a copy of the replacement Certificate of Insurance to City at the
address provided below within 10 days of any change made by the Contractor or as requested by the City.
Contractor shall pay any costs incurred resulting from said changes. All notices under this Exhibit shall
be given to City at the following address:
City of Corpus Christi
Attn: Risk Manager
P.O. Box 9277
Corpus Christi, TX 78469-9277
D. Contractor agrees that, with respect to the above required insurance, all insurance policies are to
contain or be endorsed to contain the following required provisions:
• List the City and its officers, officials, employees, and volunteers, as additional insureds by endorsement
with regard to operations, completed operations, and activities of or on behalf of the named insured
performed under contract with the City, with the exception of the workers' compensation policy;
• Provide for an endorsement that the "other insurance" clause shall not apply to the City of Corpus Christi
where the City is an additional insured shown on the policy;
• Workers' compensation and employers' liability policies will provide a waiver of subrogation in favor of
the City; and
• Provide thirty(30)calendar days advance written notice directly to City of any,cancellation,non-renewal,
material change or termination in coverage and not less than ten(10)calendar days advance written notice
for nonpayment of premium.
E. Within five(5)calendar days of a cancellation,non-renewal,material change or termination of coverage,
Contractor shall provide a replacement Certificate of Insurance and applicable endorsements to City. City
shall have the option to suspend Contractor's performance should there be a lapse in coverage at any time
during this contract. Failure to provide and to maintain the required insurance shall constitute a material
breach of this contract.
F. In addition to any other remedies the City may have upon Contractor's failure to provide and maintain any
insurance or policy endorsements to the extent and within the time herein required,the City shall have the
right to order Contractor to stop work hereunder, and/or withhold any payment(s) which become due to
Contractor hereunder until Contractor demonstrates compliance with the requirements hereof.
cz Ll0j- I )
G. Nothing herein contained shall be construed as limiting in any way the extent to which Contractor may be
held responsible for payments of damages to persons or property resulting from Contractor's or its
subcontractor's performance of the work covered under this contract.
H. It is agreed that Contractor's insurance shall be deemed primary and non-contributory with respect to any
insurance or self insurance carried by the City of Corpus Christi for liability arising out of operations
under this contract.
I. It is understood and agreed that the insurance required is in addition to and separate from any other
obligation contained in this contract.
2015 Insurance Requirements
Development Services
UPA-Tuloso Midway ISD Sanitary Sewer Line Project
2'13'2015 ds Risk Management
L b 401-19
CITY OF CORPUS CHRISTI
DISCLOSURE OF INTERESTS
City of Corpus Christi ordinance 17112,as amended,requires all persons or finis seeking to do business with the City to
provide the following Information Every question must be answered. If the question is not applicable,answer with'NA'.
FIRST NAME:
STREET: CITY: ZIP:
FIRM IS: 01. Corporation D. Partnership 03. Sole Owner p4. Association 05 Other
DISCLOSURE QUESTIONS
If additional space is necessary,please use the reverse side of this page or attach separate sheet
1. State the names of each'employee of the City of Corpus Christi having an'ownership interest'constituting 3%
or more of the ownership ki the above named`firm'.
Name Job Title and City Department(if known)
2 State the names of each"official'of the City of Corpus Christi having an"ownership interest'constituting 3%or
more of the ownership in the above named'firm'.
Name Title
3 State the names of each'board member'of the City of Corpus Christi having an`ownership interest'constituting
3%or more of the ownership in the above named'firm'
Name Board,Commission,or Committee
4 State the names of each employee or officer of a'consultant'for the City of Corpus Christi who worked on any
matter related to the subject of this contract and has an 'ownership interest' constituting 35 or more of the
ownership in the above named'firm'.
Name Consultant
CERTIFICATE
I certify that all information provided is true and correct as of the date of this statement,that I have not knowingly withheld
disclosure of any Information requested: and that supplemental statements will be promptly submitted to the City of
Corpus Christi,Texas as changes occur.
Certifying Person. ik L L (3 /Ma) -{c'f! Tide: levo/•d t/er.
(Type or Pring --- Date- _ 6//?/
Signature of Certifying Person i 5
EXHIBIT D
I 401- ic