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HomeMy WebLinkAboutC2015-395 - 9/22/2015 - Approved • CITY OF CORPUS CHRISTI MASTER SERVICES AGREEMENT FOR PROFESSIONAL SERVICES This Agreement is between the City of Corpus Christi, a Texas home rule municipal corporation, P.O. Box 9277, Corpus Christi, Nueces County, Texas 78469-9277 (City) acting through its duly authorized City Manager or designee and Vicki Marsden, a sole proprietor, 15333 Caravel Drive, Corpus Christi, Nueces County, Texas 78418, (Consultant). WHEREAS, City and Consultant previously entered into a Contract for Professional Services on March 7, 2015 for Consultant to assist the Capital Programs Department with professional engineering, architecture and construction services related to execution of the Bond and Capital Improvements Programs; WHEREAS, City and Consultant now desire to amend their original Contract by entering into a Master Services Agreement (Agreement) for Professional Services to set the terms and conditions that will govern future agreements (Task Order) under the Master Services Agreement; NOW THEREFORE, in consideration of the mutual covenants contained herein,the parties agree as follows: ARTICLE I — PROJECT TASK ORDER 1.1 This Agreement shall apply to as many tasks as City and CONSULTANT agree will be performed under the terms and conditions of this Agreement. Each task CONSULTANT performs for City hereunder shall be designated a Task Order. No Task Order shall be binding or enforceable unless and until it has been properly executed by both City and CONSULTANT. Each properly executed Task Order shall become a separate supplemental agreement to this Agreement. 1.2 The CONSULTANT shall provide its Scope of Services, to be included in each Task Order. The Scope of Services shall include all associated services required for CONSULTANT to provide such Services, pursuant to this Agreement, and any and all Services which would normally be required by law or common due diligence. 1.3 Under this Agreement, CONSULTANT will provide services on a Task Order basis for a range of services related to assisting the Capital Programs Department with professional engineering, architecture and construction services related to execution of the Bond and Capital Improvements Programs. All work will be subject to authorization from City. A detailed Scope of Services and fee estimate will be developed for each task prior to execution of work. 1.4 CONSULTANT shall comply with City standards, as specified in the UDC or Code of Ordinances, throughout the duration of the Project, unless specifically and explicitly excluded from doing so in the approved Task Order. 1.5 CONSULTANT shall perform tasks and submit deliverables as detailed in each approved Task Order. 2015-395 9/22/15 Master Services Agreement (CONSULTANT) M2015-103 Page 1 of 10 Vicki Marsden INDEXED 1.6 CONSULTANT shall provide all labor, equipment and transportation necessary to complete all services agreed to in a timely manner throughout the term of the Agreement. Additionally, CONSULTANT shall provide staff for regular, overtime, night, weekend and holiday service, as requested by City. Persons retained by CONSULTANT to perform work pursuant to this Agreement shall be employees or subconsultants of CONSULTANT. 1.7 CONSULTANT shall not begin work on any Task Order authorized under this Agreement until they are briefed on the scope of the Project and are notified in writing to proceed. ARTICLE II — COMPENSATION 2.1 The Compensation for all services included in this Agreement and in the Scope of Services for this Agreement shall not exceed $87,360.00 (Eighty Seven Thousand Three Hundred Sixty Dollars and Zero Cents). 2.2 The CONSULTANT's fee for each Task Order will be on a time and materials (T&M) basis with a negotiated not-to-exceed amount. The fees will not exceed those identified and will be full and total compensation for all services outlined in each Task Order, and for all expenses incurred in performing these services. 2.3 CONSULTANT shall submit a proposal to the City, including a rate schedule, which shall be incorporated into this agreement as Exhibit B, subject to approval by the City. 2.4 Monthly invoices will be submitted in accordance with the Payment Request (Exhibit C). CONSULTANT shall submit documentation with the monthly invoice that shows who worked on the Project, the number of hours that each individual worked on the Project and reimbursables for that individual. 2.4.1 Principals may only bill at the hourly rate of Principals when acting in that capacity. Principals acting in the capacity of staff must bill at staff rates. The CONSULTANT shall provide documentation with each payment request that clearly indicates how that individual's time is allocated and the justification for that allocation. 2.5 The anticipated fee structure under this agreement is as follows: DESCRIPTION NOT TO EXCEED AMOUNT Maximum Contract Amount $87,360 Task 1 — Managing the Quality Management System TBD Task 2 —TBD TBD Task 3—TBD TBD Task 4—TBD TBD Task 5 —TBD TBD Task 6 —TBD TBD 2.6 All services shall be performed and the applicable standard of professional care set forth in Article X herein and to City's satisfaction, which satisfaction shall be judged by the Director in his/her sole Master Services Agreement (CONSULTANT) Page 2 of 10 discretion. City shall not be liable for any payment under this Agreement for services which are unsatisfactory and which previously have not been approved by the Director. 2.7 In the event of any dispute(s)between the Parties regarding the amount properly compensable for any Task Order or as final compensation or regarding any amount that may be withheld by City, CONSULTANT shall be required to make a claim pursuant to and in accordance with the terms of this Agreement and follow the procedures provided herein for the resolution of such dispute. In the event CONSULTANT does not initiate and follow the claims procedures provided in this Agreement in a timely manner and as required by the terms thereof, any such claim shall be waived. 2.8 Request of final compensation by CONSULTANT shall constitute a waiver of claims except those previously made in writing and identified by CONSULTANT as unsettled at the time of final Payment Request. 2.9 Any fee payable under this Agreement is subject to the availability of funds. The CONSULTANT may be directed to suspend work pending receipt and appropriation of funds. ARTICLE III — INSURANCE REQUIREMENTS 3.1 CONSULTANT must not commence work under this agreement until all insurance required has been obtained and such insurance has been approved by the City. CONSULTANT must not allow any subcontractor to commence work until all similar insurance required of any subcontractor has been obtained. 3.2 CONSULTANT must furnish to the Director of Capital Programs with the signed Agreement 2 copies of Certificates of Insurance (COI) 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 COI. Project name and or number must be listed in Description Box of COI. TYPE OF INSURANCE MINIMUM INSURANCE COVERAGE 30-written day notice of cancellation, Bodily Injury and Property Damage required on all certificates or by Per occurrence - aggregate applicable policy endorsements Commercial General Liability including: $1,000,000 Per Occurrence 1. Commercial Broad Form $2,000,000 Aggregate 2. Premises — Operations 3. Products/ Completed Operations 4. Contractual Liability 5. Independent Contractors 6. Personal Injury- Advertising Injury Master Services Agreement (CONSULTANT) Page 3 of 10 • AUTO LIABILITY (including) $1,000,000 Combined Single Limit 1. Owned 2. Hired and Non-Owned 3. Rented/Leased PROFESSIONAL LIABILITY $1,000,000 Per Claim (Errors and Omissions) $2,000,000 Aggregate (Defense costs not included in face value of the policy) If claims made policy, retro date must be prior to inception of agreement, have extended reporting period provisions and identify any limitations regarding who is insured. WORKERS' COMPENSATION Statutory (All States Endorsement if Company is not domiciled in Texas) Employer's Liability $500,000 /$500,000 /$500,000 3.3 In the event of accidents of any kind related to this agreement, CONSULTANT must furnish the City with copies of all reports of any accidents within 10 days of the accident. 3.4 Applicable for paid employees, CONSULTANT 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 CONSULTANT will be promptly met. An All States Endorsement shall be required if CONSULTANT is not domiciled in the State of Texas. 3.5 CONSULTANT shall obtain and maintain in full force and effect for the duration of this Contract, and any extension hereof, at CONSULTANT'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. CONSULTANT is required to provide City with renewal Certificates. Master Services Agreement (CONSULTANT) Page 4 of 10 3.6 CONSULTANT shall be required to submit a copy of the replacement certificate of insurance to City at the address provided below within 10 days of the requested change. CONSULTANT shall pay any costs incurred resulting from said changes. All notices under this Article shall be given to City at the following address: City of Corpus Christi Attn: Capital Programs P.O. Box 9277 Corpus Christi, TX 78469-9277 3.7 CONSULTANT agrees that with respect to the above required insurance, all insurance policies are to contain or be endorsed to contain the following required provisions: 3.7.1 List the City and its officers, officials, employees, volunteers, and elected representatives as additional insured by endorsement, as respects operations, completed operation and activities of, or on behalf of, the named insured performed under contract with the City,with the exception of the workers' compensation policy; 3.7.2 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; 3.7.3 Workers'compensation and employers' liability policies will provide a waiver of subrogation in favor of the City; and 3.7.4 Provide thirty(30) calendar days advance written notice directly to City of any suspension, cancellation, non-renewal or material change in coverage, and not less than ten (10) calendar days advance written notice for nonpayment of premium. 3.8 Within five (5) calendar days of a suspension, cancellation, or non-renewal of coverage, CONSULTANT shall provide a replacement Certificate of Insurance and applicable endorsements to City. City shall have the option to suspend CONSULTANT'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. 3.9 In addition to any other remedies the City may have upon CONSULTANT'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 CONSULTANT to remove the exhibit hereunder, and/or withhold any payment(s) if any, which become due to CONSULTANT hereunder until CONSULTANT demonstrates compliance with the requirements hereof. 3.10 Nothing herein contained shall be construed as limiting in any way the extent to which CONSULTANT may be held responsible for payments of damages to persons or property resulting from CONSULTANT's or its subcontractor's performance of the work covered under this agreement. 3.11 It is agreed that CONSULTANT'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 agreement. Master Services Agreement (CONSULTANT) Page 5 of 10 • • 3.12 It is understood and agreed that the insurance required is in addition to and separate from any other obligation contained in this agreement. ARTICLE IV- INDEMNIFICATION CONSULTANT shall fully indemnify, hold harmless, and defend the City of Corpus Christi and its officials, officers, agents, employees, volunteers, directors and representatives ("Indemnitee")from and against any and all claims, damages, liabilities or costs, including reasonable attorney fees and defense costs, caused by or resulting from an act of negligence, intentional tort, intellectual property infringement, or failure to pay a subcontractor or supplier committed by CONSULTANT or its agent, CONSULTANT under contract or another entity over which CONSULTANT exercises control while in the exercise of rights or performance of the duties under this agreement.This Indemnification does not apply to any liability resulting from the negligent acts or omissions of the City of Corpus Christi or its employees, to the extent of such negligence. CONSULTANT must, at City's option, defend Indemnitee and with counsel satisfactory to the City Attorney. CONSULTANT must advise City in writing within 24 hours of any claim or demand against City or CONSULTANT known to CONSULTANT related to or arising out of CONSULTANT's activities under this Agreement. ARTICLE V- TERMINATION OF AGREEMENT 5.1 The City may, at any time, with or without cause, terminate this Agreement upon seven days written notice to the CONSULTANT at the address of record. 5.2 In this event, the CONSULTANT will be compensated for its services on all Task Orders authorized based upon CONSULTANT and City's estimate of the proportion of the total services actually completed at the time of termination. ARTICLE VI — RIGHT OF REVIEW AND AUDIT 6.1 CONSULTANT grants City, or its designees, the right to audit, examine or inspect, at City's election, all of CONSULTANT's records relating to the performance of the Work under this Agreement, during the term of this Agreement and retention period herein. The audit, examination or inspection may be performed by a City designee, which may include its internal auditors or an outside representative engaged by City. CONSULTANT agrees to retain its records for a minimum of four(4) years following termination of the Agreement, unless there is an ongoing dispute under this Agreement, then such retention period shall extend until final resolution of the dispute. 6.2 "CONSULTANT's records" include any and all information, materials and data of every kind and character generated as a result of the Work under this Agreement. Examples include billings, books, Master Services Agreement (CONSULTANT) Page 6 of 10 general ledger, cost ledgers, invoices, production sheets, documents, correspondence, meeting notes, subscriptions, agreements, purchase orders, leases, contracts, commitments, arrangements, notes,daily diaries, reports, drawings, receipts, vouchers, memoranda, time sheets, payroll records, policies, procedures,federal and state tax filings for issue in questions and any and all other agreements, sources of information and matters that may, in City's judgment, have any bearing on or pertain to any matters, rights, duties or obligations under or covered by any Agreement Documents. 6.3 City agrees that it shall exercise the right to audit, examine or inspect CONSULTANT's records only during City's regular business hours. CONSULTANT agrees to allow City's designee access to all of CONSULTANT's records, CONSULTANT's facilities and CONSULTANT's current or former employees, deemed necessary by City or its designee(s), to perform such audit, inspection or examination. CONSULTANT also agrees to provide adequate and appropriate work space necessary to City or its designees to conduct such audits, inspections or examinations. 6.4 CONSULTANT shall include this audit clause in any subcontractor, supplier or vendor contract. ARTICLE VII — OWNER REMEDIES 7.1 The City and CONSULTANT agree that in the event of a delay in completion for which the City suffers actual damages, the City may elect to pursue its actual damages and any other remedy allowed by law. 7.2 Pursuant to Article III, the City may assert a claim against the CONSULTANT's professional liability insurance, as appropriate. 7.3 The City may withhold or nullify the whole or part of any payment as detailed in Article II. ARTICLE VIII — CONSULTANT REMEDIES 8.1 CONSULTANT shall not be liable or responsible for any delays due to strikes, riots, acts of God, national emergency, acts of the public enemy, governmental restrictions, laws or regulations or any other causes beyond CONSULTANT's reasonable control. ARTICLE IX— CLAIMS AND DISPUTE RESOLUTION 9.1 Filing of Claims 9.1.1 Claims arising from the circumstances identified in this Agreement or other occurrences or events, shall be made by Written Notice delivered by the party making the Claim to the other party within twenty-one (21) calendar days after the start of the occurrence or event giving rise to the Claim and stating the general nature of the Claim. 9.1.2 Every Claim of CONSULTANT, whether for additional compensation, additional time or other relief, shall be signed and sworn to by a person authorized to bind the CONSULTANT by his/her signature, verifying the truth and accuracy of the Claim. Master Services Agreement (CONSULTANT) Page 7 of 10 9.1.3 The responsibility to substantiate a claim rests with the party making the Claim. 9.1.4 Within thirty(30)calendar days of receipt of notice and supporting documentation, City will meet to discuss the request, after which an offer of settlement or a notification of no settlement offer will be sent to CONSULTANT. If CONSULTANT is not satisfied with the proposal presented, CONSULTANT will have thirty(30)calendar days in which to (i)submit additional supporting data requested by the City, (ii) modify the initial request for remedy or(iii) request Alternative Dispute Resolution. 9.1.5 Pending final resolution of a claim, except as otherwise agreed in writing, CONSULTANT shall proceed diligently with performance of the Agreement and City shall continue to make payments in accordance with this Agreement. 9.2 Alternative Dispute Resolution 9.2.1 All negotiations pursuant to this clause are confidential and shall be treated as compromise and settlement negotiations for purposes of applicable rules of evidence. 9.2.2 Before invoking mediation or any other alternative dispute resolution (ADR) process set forth herein, the Parties agree that they shall first try to resolve any dispute arising out of or related to this Agreement through discussions directly between those senior management representatives within their respective organizations who have overall managerial responsibility for similar projects. This step shall be a condition precedent to the use of any other ADR process. If the parties' senior management representatives cannot resolve the dispute within thirty (30) calendar days after a Party delivers a written notice of such dispute, then the Parties shall proceed with the mediation ADR process contained herein. 9.2.3 Mediation 9.2.3.1 In the event that City or CONSULTANT shall contend that the other has committed a material breach of this Agreement, the Party alleging such breach shall, as a condition precedent to filing any lawsuit, request mediation of the dispute. 9.2.3.2 Request for mediation shall be in writing, and shall request that the mediation commence no less than thirty (30) or more than ninety (90) calendar days following the date of the request, except upon agreement of both parties. 9.2.3.3 In the event City and CONSULTANT are unable to agree to a date for the mediation or to the identity of the mediator or mediators within thirty(30) calendar days of the request for mediation, all conditions precedent in this Article shall be deemed to have occurred. 9.2.3.4 The parties shall share the mediator's fee. Venue for any mediation or lawsuit arising under this Agreement shall be Nueces County, Texas. Any agreement reached in mediation shall be enforceable as a settlement agreement in any court having jurisdiction thereof. No provision of this Agreement shall waive any immunity or defense. No provision of this Agreement is a consent to suit. Master Services Agreement (CONSULTANT) Page 8 of 10 9.3 No Waiver of Governmental Immunity. NOTHING IN THIS ARTICLE SHALL BE CONSTRUED TO WAIVE CITY'S GOVERNMENTAL IMMUNITY FROM LAWSUIT, WHICH IMMUNITY IS EXPRESSLY RETAINED TO THE EXTENT IT IS NOT CLEARLY AND UNAMBIGUOUSLY WAIVED BY STATE LAW. ARTICLE X— MISCELLANEOUS PROVISIONS 10.1 Use of Local Expertise/ Local Professional Participation. The City Council's stated policy is that City expenditures on contracts for professional services be of maximum benefit to the local economy. The CONSULTANT agrees that at least 75% of the professional work and expertise necessary to perform the work under this Agreement will be performed by persons residing within the Corpus Christi Metropolitan Statistical Area (MSA). 10.2 Assignability. The CONSULTANT will not assign, transfer or delegate any of its obligations or duties in this Agreement to any other person without the prior written consent of the City, except for routine duties delegated to personnel of the CONSULTANT staff. If the CONSULTANT is a partnership, then in the event of the termination of the partnership, this contract will inure to the individual benefit of such partner or partners as the City may designate. No part of the CONSULTANT fee may be assigned in advance of receipt by the CONSULTANT without written consent of the City. 10.3 Ownership of Documents. All documents including contract documents(plans and specifications), record drawings, contractor's field data, and submittal data will be the sole property of the City, may not be used again by the CONSULTANT without the express written consent of the Director of Engineering Services. However, the CONSULTANT may use standard details that are not specific to this project. The City agrees that any modification of the plans will be evidenced on the plans, and be signed and sealed by a professional engineer prior to re-use of modified plans. 10.4 Standard of Care. Services provided by CONSULTANT under this Agreement shall be performed with the professional skill and care ordinarily provided by competent engineers or architects practicing in the same or similar locality and under the same or similar circumstances and professional license; and performed as expeditiously as is prudent considering the ordinary professional skill and care of a competent engineer or architect. 10.5 Licensing. CONSULTANT shall be represented by personnel with appropriate licensure, registration and/or certification(s) at meetings of any official nature concerning the Project, including scope meetings, review meetings, pre-bid meetings and preconstruction meetings. 10.6 Entire Agreement. This Agreement, including Task Orders, represents the entire and integrated Agreement between City and CONSULTANT and supersedes all prior negotiations, representations or agreements, either oral or written. This Agreement may be amended only by written instrument signed by both the City and CONSULTANT. 10.7 Disclosure of Interest. CONSULTANT agrees, in compliance with City of Corpus Christi Ordinance No. 17112, to complete, as part of this contract, the Disclosure of Interests form, Exhibit D. Master Services Agreement (CONSULTANT) Page 9 of 10 10.8 Controlling Law. This Agreement is governed by the laws of the State of Texas without regard to its conflicts of laws. Venue for legal proceedings lies exclusively in Nueces County, Texas. 10.9 Severability. If, for any reason, any one or more Articles and/or paragraphs of this Agreement are held invalid or unenforceable, such invalidity or unenforceability shall not affect, impair or invalidate the remaining Articles and/or paragraphs of this Agreement but shall be confined in its effect to the specific Article, sentences, clauses or parts of this Agreement held invalid or unenforceable, and the invalidity or unenforceability of any Article, sentence, clause or parts of this Agreement, in any one or more instance, shall not affect or prejudice in any way the validity of this Agreement in any other instance. 10.10 Conflict Resolution Between Documents. CONSULTANT hereby agrees and acknowledges if anything contained in the CONSULTANT-prepared Scope of Services or in any other document prepared by CONSULTANT and included herein, is in conflict with the terms of this Agreement and/or an approved Task Order, this Agreement and/or the Task Order shall take precedence and control to resolve said conflict. CITY OF •.: ' -S/eylopVICKI MARSDEN 7 23 /5-- 1 ►.��.�. �-��r• C\Vg\Is J.H. Ed onds, P. E. (Dat Vicki Marsden (Date) Director of Capital Programs Sole Proprietor 15333 Caravel Drive Corpus Christi, TX 78418 APPROVED (210) 379-3279 Office Le. tgatitivd qb Office of Management (Da6) and Budget APPROVED AS TO LEGAL FORM "" 4, As stant City Attorney ' (Date) for City Attorney ST CUUNCtL , f-2-7 ATTEST �� SfCR!TA Rebecca Huerta, Citysecretary Fund Name Accounting Unit Account No. Activity No. Amount Capital Programs Operating 5310-11160-011 530000 $87,360 Total $87,360 Encumbrance No. Master Services Agreement (CONSULTANT) Page 10 of 10 EXHIBIT A SAMPLE TASK ORDER This Task Order pertains to a Master Services Agreement for Professional Services by and between City of Corpus Christi, Texas (City) and Vicki Marsden (Consultant) dated , 2015 (Agreement). NE shall perform services on the project described below as provided in this Task Order and in the Agreement. This Task Order shall not be binding until it has been properly signed by both parties. Upon execution, this Task Order shall supplement the Agreement as it pertains to the project described below. TASK ORDER NO.: PROJECT NAME: 1. PROJECT DESCRIPTION 2. SCOPE OF SERVICES 3. COMPENSATION 70 T&M - $85lhour This Task Order is approved and NE may proceed. All other terms and conditions of the Agreement remain in full force and effect. CITY OF CORPUS CHRISTI [COMPANY NAME] J.H. Edmonds, P.E. (Date) (Date) Director of Capital Programs TITLE ADDRESS Corpus Christi, TX 78401 RECOMMENDED PHONE Office Operating Department (Date) APPROVED AS TO FORM Office of Management and Budget (Date) Legal Department (Date) EXHIBIT "A" Page 1 of 1 Vicki Marsden,CQIA 15333 Caravel Drive,Corpus Christi TX 78418 aualitvmanaeementsolutionstaaamail.com 210.379.3279 Mr.J.H. Edmonds,P.E. 1"August 2015 Director of Capital Programs City of Corpus Christi PO Box 9277 Corpus Christi,Texas 78469-9277 RE: CITY OF CORPUS CHRIST], CAPITAL PROGRAMS LARGE A/E QUALITY MANAGEMENT SYSTEM PROFRESSIONAL SERVICES PROPOSAL Dear Mr. Edmonds; Please accept this proposal to provide professional services to the City of Corpus Christi, Capital Programs to assist in their pursuit of organizational excellence and meet their mission of'being the best in Texas.' Specific deliverables under this contract include but are not limited to: • Document and publish remaining draft process flows: Job Order Contracts and Administrative procedures; update all previously documented procedures to reflect changes in practices (including new software programs) • Document Capital Program-specific policies(as per City requirement) • Provide training, as appropriate, on documented policies and procedures to Capital Programs personnel. • Create Capital Programs-specific Internal Quality Auditor Training Module.Train and mentor at least five Internal Quality Auditors. • Publish an Internal Quality Audit Schedule. • Performing internal quality audits at both the QMS program-level and project-level. Provide reports of all audit findings for corrective actions and process improvements. • Manage, report, and document the monthly Steering Committee and Process Focus Group activities. • Identify,collect,and report performance metrics to leadership on a monthly basis. • Perform as the Site Collection Administrator for the Process Asset Library(PAL);provide support for Capital Programs personnel on use of the PAL. My rate is$70.00 per hour,not to exceed$87,360.00,plus reimbursement for the cost of any City required insurance,for a period of up to one year,with the option for extension or renewal as needed and if mutually agreed.Invoicing would be monthly and terms would be net 30. Your consideration is greatly appreciated. If you have any questions,please don't hesitate to call me. Sincerely, Vicki Marsden,CQIA EXHIBIT "B" Page 1 of 1 Sample form for: Payment Request COMPLETE PROJECT NAME Revised 07/27/00 Project No. XXXX Invoice No. 12345 Invoice Date: Total Amount Previous Total Percent Basic Services: Contract Amd No. 1 Amd No. 2 Contract Invoiced Invoice Invoice Complete Preliminary Phase $1,000 $0 $0 $1,000 $0 $1,000 $1,000 100% Design Phase 2,000 1,000 0 3,000 1,000 500 1,500 50% Bid Phase 500 0 250 750 0 0 0 0% Construction Phase 2,500 0 1,000 3,500 0 0 0 0% Subtotal Basic Services $6,000 $1,000 $1,250 $8,250 $750 $1,500 $2,500 30% Additional Services: Permitting $2,000 $0 $0 $2,000 $500 $0 $500 25% Warranty Phase 0 1,120 0 1,120 0 0 0 0% Inspection 0 0 1,627 1,627 0 0 0 0% Platting Survey TBD TBD TBD TBD TBD TBD TBD 0% O & M Manuals TBD TBD TBD TBD TBD TBD TBD 0% SCADA TBD TBD TBD TBD TBD TBD TBD 0% Subtotal Additional Services $2,000 $1,120 $1,627 $4,747 $500 $0 $500 11% Summary of Fees Basic Services Fees $6,000 $1,000 $1,250 $8,250 $750 $1,500 $2,500 30% Additional Services Fees 2,000 1,120 1,627 4,747 500 0 500 11% Total of Fees $8,000 $2,120 $2,877 $12,997 $1,250 $1,500 $3,000 23% co x Z ei o0 o- ': - ci • • SUPPLIER NUMBER TO BE ASSIGNED IW CTI Y PURCHASING DIVISION City of CITY OF CORPUS CHRISTI corpus Chnsti DISCLOSURE OF INTEREST City of Corpus Christi Ordinance 17112,as amended, requires all persons or firms 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". See reverse side for Filing Requirements, Certifications and definitions. COMPANY NAME: P.O. BOX: STREET ADDRESS: CITY: ZIP: FIRM IS: I. Corporation 2. Partnership 3. Sole Owner ❑ 4. Association 5. 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 in the above named"firm." Name Job Title and City Department(if known) N/A 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 N/A 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 N/A 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 3%or more of the ownership in the above named"firm." Name Consultant N/A EXHIBIT"D" Page l of 2 FILING REQUIREMENTS If a person who requests official action on a matter knows that the requested action will confer an economic benefit on any City official or employee that is distinguishable from the effect that the action will have on members of the public in eeneral or a substantial segment thereof,you shall disclose that fact in a signed writing to the City official, employee or body that has been requested to act in the matter. unless the interest or the City official or employee in the matter is apparent. The disclosure shall also be made in a signed writing filed with the City Secretary. [Ethics Ordinance Section 2-349(d)1 CERTIFICATION I eerily that all information provided is true and correct as of the date of this statement, that I have not knowingly withheld disclosure of an) information requested: and that supplemental statements will he promptly submitted to the City of Corpus Christi. Texas as changes occur. Certifying Person: V‘Lyttc rSokv. Title: Cakua� «,nc.k YNceiNcilt 1T)pr or Print) Signature of Certifying Date: Person: �t.��t... l..,.- �`�`1 DEFINITIONS a. "Board member." A member of any board, commission, or committee appointed by the City Council of the City of Corpus Christi. Texas. b. "Economic benefit". An action that is likely to affect an economic interest if it is likely to have an effect on that interest that is distinguishable from its effect on members of the public in general or a substantial segment thereof. c. "Employee." Any person employed by the City of Corpus Christi. Texas either on a full or part- time basis. but not as an independent contractor. d. "Finn." Any entity operated for economic gain. whether professional. industrial or commercial, and whether established to produce or deal with a product or service. including but not limited to. entities operated in the form of sole proprietorship, as self-employed person. partnership, corporation, joint stock company,joint venture, receivership or trust. and entities which for purposes of taxation are treated as non-profit organizations. e. "Official." The Mayor, members of the City Council, City Manager, Deputy City Manager, Assistant City Managers. Department and Division Heads. and Municipal Court Judges oldie City of Corpus Christi. Texas. "Ownership Interest." Legal or equitable interest, whether actually or constructively held. in a firm, including when such interest is held through an agent. trust. estate. or holding entity. "Constructively held" refers to holdings or control established through voting trusts, proxies. or special terms of venture or partnership agreements." g. "Consultant." Any person or firm, such as engineers and architects. hired by the City of Corpus Christi for the purpose of professional consultation and recommendation. EXHIBIT "D" Page 2 of 2