HomeMy WebLinkAboutC2016-016 - 1/19/2016 - Approved CITY OF CORPUS CHRISTI l'ii
AMENDMENT NO. 1 C
TESTING AGREEMENT PI—
This
AGREEMENT is between the City of Corpus Christi, Texas, a Texas home-rule municipal corporation
("CITY"), acting through its duly authorized City Manager or designee ("City Engineer"), and TOLUNAY-WONG
ENGINEERS, INC., a Texas corporation or partnership ("LAB"), acting through its duly authorized representative who is
Don Rokohl P.E., Branch Manager, which agree as follows:
1. DECLARATIONS: City desires to engage Lab to provide services in connection with City's project, described
as follows: Groundwater Monitoring at Cefe Valenzuela Municipal Landfill (Project No. E15218) ("PROJECT").
2. SCOPE OF WORK: Lab shall provide services to the Project in accordance with the accompanying Scope of
Services and Fee Schedule attached as Exhibit A and the Terms and Conditions to Agreement attached as Exhibit B.
3. FEE: The City agrees to pay the Lab for services provided in accordance with Exhibit"A", Scope of Services
and Fee Schedule under this Agreement, a total fee not to exceed $100,400.00 for a restated fee not to exceed
$125,300.00. Monthly invoices will be submitted in accordance with Exhibit C.
4. CITY'S DISCLOSURE OF HAZARDOUS & TOXIC MATERIALS AND CONDITIONS AT THE PROJECT
SITE: To the best of the City's knowledge, based upon currently available information, the only hazardous or toxic
materials, as defined by the laws and regulations of the Federal government, the state, and city which exist at the
PROJECT SITE are as follows: None.
5. 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 and may not be used again
by Lab without the express terms written consent of the City Engineer. However, Lab may use standard details that are
not specific to this Project.
CI It 2 .,U HR TI TOLUNAY-WONG NGINEERS, INC.
I , /2, /(P --D— 'R- V
J. H. Edmonds, P.E. (Dat6) Don R. Rokohl, P.E. (Date)
Director of Capital Programs Branch Manager
826 South Padre Island Drive
Corpus Christi, TX 78416
RECOMMENDED (361) 884-5050 Office
1V/ A
Gustavo Gonzalez, P.E. (Date)
Assistant City Manager
of Public Works and Utilities
N% 1 ),..Z.....1.(0 - -Valerie H. Gray, P.E. (Date) 0 IAN
Exec tive Director of Public Works
! 4 aY(JO l. 01, 07. 00 is
Operating Department (Date) ... 10
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APPRO D AS TO LEGAL F RM
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Assi nt City Attnrnav /n9te)
2016-016
1/19/16
M2016-008 \E15218 GROUNDWATER MONITORING AT CEFE VALENZUELA 2015-2016\AMENDMENT 1\15-1215 TESTING AGREEMENT.DOC
Tolunay-Wong Engineers Inc. Rev 12115/15
INDEXED
AP-/OV;D
Project No. E15218
AA l /s//, Accounting Unit: 1020-12506-033
$ -e of Management (Date) Account: 530000
and Budget Activity: E15218011020EXP
Account Category: 30000
Fund Name: Solid Waste Operating
ATTEST Encumbrance No.
T24-- 125 BOO a v loI No
Rebecca Huerta
City Secretary
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EXHIBIT A
Scope of Services and Fee Schedule
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OpTolunay-Wong 826 South Padre Island Drive Inc.Engineers, CorpuPhones(311884-5050,Texas 416
November 30, 2015
TWE Proposal No. P15-E097
Mr. Lawrence Mikolajczyk
Director of Solid Waste Operations
City of Corpus Christi
2525Hygeia St., 78415
Corpus Christi, Texas 78469-9277
Phone: 361 826-1965
Fax: 361 826-1971
LawM@cctexas.com
COST PROPOSAL FOR
GROUNDWATER MONITORING AT CEFE VALENZUELA MUNICIPAL LANDFILL
FOR FISCAL YEAR 2015 -2016
CORPUS CHRISTI,NUECES COUNTY, TEXAS
Dear Mr. Mikolajczk:
Tolunay-Wong Engineers, Inc. (TWE) is pleased to submit the following proposal to provide
groundwater monitoring services at the above-referenced facility for the City of Corpus Christi's
(City) fiscal year of 2015 to 2016. This proposal presents the fees for groundwater monitioring
Part 11. The fees for groundwater monitoring Part I were presented in the proposal dated
November 17, 2015
Background
The Site is located southeast of Petronila, TX, and the active area comprises approximately 300
acres. The landfill is a Type I Municipal Solid Waste (MSW) facility that receives domestic
waste and wastewater treatment plant sludge. It is currently in active status and groundwater is
being monitored on a semiannual basis under the detection monitoring program as specified in
Title 30 Administrative Code (30 TAC ) 330 Subchapter J Groundwater Monitoring and
Corrective Action. Constituents being monitored under this program include metals and volatile
organic compounds (VOC) listed in 40 CFR Part 258, Appendix I. In the detection monitoring
program for this facility, groundwater analytical results are compared to background concentrations
that have been determined on an intrawell basis. Statistical background concentrations are
current up through 2014 and will not require any additional updates until the end of 2016.
Objective
The objective of this project is to implement the Groundwater Sampling and Analysis Plan
(GWSAP) which outlines the City of Corpus Christi's program for groundwater monitoring in
accordance with the requirements of 30 TAC Subchapter J. The groundwater-monitoring
program includes consistent sampling and analysis procedures that are designed to ensure
•
Mr. Lawrence Mikolajczyk
TWE Proposal No. P15-E097
November 30, 2015
Page 2
monitoring results that provide an accurate representation of groundwater quality at the Cefe
Valenzuela facility.
Scope of Work
The Scope of Work includes three tasks
1. Semiannual Detection Monitoring of the 30 monitoring wells (MW 1-19, 40-46 plus deep
wells MW-2B, MW-11B, MW-12B and MW-13B) for the 15 total metals and volatile
organic compounds specified in the current GWSAP. In keeping with prior years of
groundwater monitoring, iron, manganese, nitrate-nitrogen, ammonia-nitrogen, and dissolved
organic carbon will be analyzed to facilitate the identification of geochemical processes that
can mobilize metals, and which may assist with preparing alternate source demonstrations
when background is exceeded in a well. In addition, 6 samples (3 per event) will be
collected from the landfill leachate collection system to characterize the waste in terms of
monitored constituents. This will also assist in preparation of alternate source
demonstrations and contaminant fate and transport modeling.
2. Verification re-sampling for wells that exceed the statistically determined background
concentration limit.
3. Evaluation of detection monitoring data, identification and reporting of SSIs or alternate
sources, preparation of correspondence and submittals to TCEQ, including the Annual
Report. TWE will transmit two hard copies and 1 electronic copy of the report to the City
and three hard copies to the TCEQ.
The scope of work presnted in the cost proposal dated November 17, 2015 requested sufficient
funding to only conduct semiannual sampling for 2015. The scope of work presented herein
includes the remaining tasks detailed above.
Schedule
The schedule outlined herein takes up with where the November 17 proposal leaves off, i.e., after
the completion of the second semiannual sampling event of 2015 and after an initial notice of
exceedance (if necessary) has been submitted to the TCEQ. As required by regulation, any
verification sampling must be conducted and reported within 120 days of the 2nd semiannual
sampling event of 2015. This period of time will allow up to two verification sampling events
along with data review and incorporation into the 2015 Annual Report scheduled to be issued in
April 2016. TWE proposes to conduct the first semiannual sampling event of 2016 in April/May
2016. The period following the 1st semiannual event of 2016 will also be utilized for verification
sampling if required. The 2016 semiannual sampling event is expected to take about one
working week to complete with analytical turnaround time (TAT) requiring two working weeks.
Verification sampling, if required, is expected to take no more than 3 days for each event with
analytical TAT again requiring two working weeks. All groundwater sampling results acquired
in the first eight months of 2016 will be retained for reporting in the 2016 Annual report which is
not covered under this cost proposal but will come under the 2016-2017 fiscal year.
Mr. Lawrence Mikolajczyk
TWE Proposal No. P15-E097
November 30, 2015
Page 3
Proposed Project Costs
TWE will conduct the investigation on a time and material basis for a not-to-exceed base price of
$100,400. A cost breakdown for the major tasks is summarized below.
Field Sampling Activities (includes 2 Verification Sampling Events)
Labor $ 28,950
ODCs $ 4,700
Analytical $ 21,630
Reporting $ 33,350
Project Management $ 11,770
Project Total $ 100,400
Limitations
The proposal presented above, including the Scope of Work and schedule, is contingent upon the
following assumptions:
• TWE will have necessary access to the site.
• Level D Personal Protective Equipment is adequate.
• Negotiations and/or meetings with TCEQ for any other issues related to the scope of
work as outlined in this proposal will not be required.
• Unanticipated delays beyond TWE's control will constitute a change order and will
be billed according to the attached fee schedule.
Closing Remarks
If you have any questions or need additional information, please contact me at (713) 722-7064 or
by e-mail at drokohl(&tweinc.com.
Sincerely,
Tolunay-Wong Engineers, Inc. 7.)14/ 10, row_
Re...le('
Don Rokohl, P.E. Mark Brotherton, P.G.
Corpus Christi Branch Manager Sr. Project Manager
/ �, ,,®�j Environmental Services Division
47.1'
Paul Wild
Vice President
Environmental Services Division
•
EXHIBIT B
TERMS AND CONDITIONS TO TESTING AGREEMENT
ARTICLE 1. SERVICES: Lab will:
1.1 Provide only those services requested by City Engineer that, in the opinion of Lab, lie within the technical or
professional areas of expertise of Lab and which Lab is adequately staffed and equipped to perform.
1.2 Perform technical services under the supervision of a licensed professional engineer and in compliance with the
basic requirements of the appropriate standards of the American Society for Testing and Materials, where
applicable, and other standards designated in writing by the City Engineer.
1.3 Promptly submit formal reports (printed and electronic copies) of tests, inspections and services performed
indicating, where applicable, compliance with the Project specifications or other contract documents. Such reports
must be complete and factual, citing the tests performed, methods employed, values obtained and parts of the
structure of the Project area subjected to any testing.
1.4 Utilize testing equipment which has been calibrated according to applicable standards and, upon request, submit
to the City Engineer or designee documentation of such calibration.
Secure representative samples of those materials that the City's contractor proposes to use which require testing,
together with relevant data concerning such materials including the point of origin and supplier.
1.5 Consider reports to be confidential and distribute reports only to those persons, organizations or agencies
specifically designated in writing by the City Engineer.
1.6 Retain records relating to services performed for City for a period of two years following submission of any
reports, during which period the records will be made available to the City at all reasonable times.
1.7 Pay salaries, wages, expenses, social security taxes, federal and state unemployment taxes and any other similar
payroll taxes relating to the services.
ARTICLE 2. CITY RESPONSIBILITIES: City Engineer or designee will:
2.1 Provide Lab with all plans, specifications, addenda, change orders, approved shop drawings and other
information for the proper performance of services by Lab.
2.2 Issue authorization in writing giving Lab free access to the Project site and to all shops or yards where materials
are prepared or stored.
2.3 Designate in writing those persons or firms which will act as the City's representative with respect to Lab's
services to be performed under this Agreement and which must be promptly notified by Lab when it appears that
materials tested or inspected are in non-compliance. Only the City Engineer or designee has authority to transmit
instructions, receive information and data and/or interpret and define the City's policies and decisions with respect
to the Project. Lab acknowledges that certain City representatives may have different types of authority
concerning the Project.
2.4 Advise Lab sufficiently in advance of any operations so as to allow for assignment of personnel by Lab for
completion of the required services. Such advance notice will be in accordance with that established by mutual
agreement of the parties.
2.5 Direct the Project contractor, either by the Construction Contract or direct written order, to:
(a) Stop work at the appropriate times for Lab to perform contracted services;
(b) Furnish such labor and all facilities needed by Lab to obtain and handle samples at the Project and to
facilitate the specified inspection and tests;
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(c) Provide and maintain for use of Lab adequate space at the Project for safe storage and proper curing of test
specimens that must remain on the Project site prior to, during and up to 60 days after testing.
ARTICLE 3. GENERAL CONDITIONS
3.1 Lab, by the performance of services covered hereunder, does not in any way assume, abridge or abrogate any of
those duties, responsibilities or authorities with regard to the Project that, by custom or contract, are vested in the
Project architects, design engineers or any other design agencies or authorities.
3.2 Lab is not authorized to supervise, alter, relax, enlarge or release any requirement of the Project specifications or
other contract documents nor to approve or accept any portion of the work. Lab does not have the right of
rejection or the right to stop the work. City Engineer will direct the Project contractor to stop work at appropriate
times for Lab to conduct the sampling, testing or inspection of operations covered by the Agreement.
ARTICLE 4. FIELD MONITORING AND TESTING
4.1 City and Lab agree that Lab will be on-site to perform inspections for contracted services. The City and Lab also
agree that Lab will not assume responsibility for Project contractor's means, methods, techniques, sequences or
procedures of construction, and it is understood that the final services provided by Lab will not relieve the Project
contractor of its responsibilities for performing the work in accordance with the Project plans and specifications.
For the purposes of this Agreement, the word "inspection" is used to mean periodic observation of the work and
the conducting of tests by Lab as specified in the Agreement. Continuous monitoring by Lab or its subcontractors
does not mean that Lab is approving placement of materials. Inspection is not and should not be construed to be
a warranty by Lab to the City or any other party.
4.2 Samples collected or tested by Lab remain the property of the City while in the custody of the Lab. Lab will retain
the samples for a period of 60 days following the date of submission of any report related to the sample. Following
the retention period, Lab will dispose of non-hazardous samples, and return hazardous, acutely toxic or
radioactive samples and samples' containers and residues to City. City agrees to accept such samples and
samples' containers.
ARTICLE 5. STANDARD OF CARE AND WARRANTY
Services performed by Lab will be conducted in a manner consistent with that level of care and skill ordinarily exercised
by reputable members of the profession currently practicing under similar conditions in the same locality. No other
warranty either expressed or implied is made or intended by the Agreement or any reports. Lab will not be responsible for
the interpretation or use by others of data developed by Lab.
ARTICLE 6. INDEMNIFICATION
Lab shall fully indemnify and hold harmless the City of Corpus Christi and its officials,
officers, agents, employees, or other entity, excluding the engineer or architect or that
person's agent, employee or subconsultant, over which the City exercises control
("Indemnitee") from and against any and all claims, damages, liabilities or costs, including
reasonable attorney fees and court costs, to the extent that the damage is caused by or
results from an act of negligence, intentional tort, intellectual property infringement or failure
to pay a subcontractor or supplier committed by Lab or its agent, Lab under contract or
another entity over which Lab 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 or its employees, to the extent of
such negligence.
Lab shall defend Indemnitee, with counsel satisfactory to the City Attorney, from and against
any and all claims, damages, liabilities or costs, including reasonable attorney fees and court
costs, if the claim is not based wholly or partly on the negligence of, fault of or breach of
contract by Indemnitee. If a claim is based wholly or partly on the negligence of, fault of or
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•
breach of contract by Indemnitee, the Lab shall reimburse the City's reasonable attorney's
fees in proportion to the Lab's liability.
Lab must advise City in writing within 24 hours of any claim or demand against City or Lab
known to Lab related to or arising out of Lab's activities under this Agreement.
ARTICLE 7. INVOICES AND PAYMENT
7.1 Lab will submit progress invoices to City Engineer monthly and final invoice upon completion of services. Each
invoice is due and payable by City within 30 days of receipt and approval to pay by the City Engineer.
7.2 All funding obligations of the City under this Agreement are subject to the appropriation of funds in its annual
budget.
ARTICLE 8. INSURANCE REQUIREMENTS
8.1 Lab must not commence work under this agreement until all required insurance has been obtained and such
insurance has been approved by the City. Lab must not allow any subcontractor to commence work until all
similar insurance required of any subcontractor has been obtained.
8.2 Lab must furnish to the Director of Engineering Services with the signed agreement (or amendment) 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, required Bodily Injury and Property Damage
on all certificates or by applicable policy Per occurrence- aggregate
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
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 must be outside policy limits)
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.
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WORKERS' COMPENSATION Statutory
(All States Endorsement if Company is not
domiciled in Texas)
Employer's Liability $500,000/$500,000/$500,000
8.3 In the event of accidents of any kind related to this agreement, Lab must furnish the City with copies of all reports
of any accidents within 10 days of the accident.
8.4 Applicable for paid employees, Lab 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 Lab will be promptly met. An All States Endorsement shall be
required if Lab is not domiciled in the State of Texas.
8.5 Lab shall obtain and maintain in full force and effect for the duration of this Contract, and any extension hereof, at
Lab'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. Lab is required to
provide City with renewal Certificates.
8.6 Lab 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. Lab 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: Engineering Services
P.O. Box 9277
Corpus Christi, TX 78469-9277
8.7 Lab agrees that with respect to the above required insurance, all insurance policies are to contain or be
endorsed to contain the following required provisions:
(a) 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
and professional liability/Errors &Omissions policy;
(b) 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;
(c) Workers' compensation and employers' liability policies will provide a waiver of subrogation in favor of the
City; and
(d) 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.
8.8 Within five (5) calendar days of a suspension, cancellation, or non-renewal of coverage, Lab shall provide a
replacement Certificate of Insurance and applicable endorsements to City. City shall have the option to suspend
Lab'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.
8.9 In addition to any other remedies the City may have upon Lab'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 Lab to
remove the exhibit hereunder, and/or withhold any payment(s) if any, which become due to Lab hereunder until
Lab demonstrates compliance with the requirements hereof.
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8.10 Nothing herein contained shall be construed as limiting in any way the extent to which Lab may be held
responsible for payments of damages to persons or property resulting from Lab's or its subcontractor's
performance of the work covered under this agreement.
8.11 It is agreed that Lab'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.
8.12 It is understood and agreed that the insurance required is in addition to and separate from any other obligation
contained in this agreement.
ARTICLE 9. TERMINATION OF AGREEMENT
The City may, at any time, with or without cause, terminate this Agreement upon seven days written notice to Lab at the
address of record. Lab will be compensated for services performed up to termination.
ARTICLE 10. 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 lie exclusively in Nueces County, Texas.
ARTICLE 11. DISCLOSURE OF INTERESTS
11.1 Lab agrees to comply with City of Corpus Christi Ordinance No. 17112 and complete the Disclosure of Interests
form as part of this Agreement, if required.
11.2 Lab agrees to comply with section 2252.908 of the Texas Government Code and complete Form 1295 Certificate
of Interested Parties as part of this Agreement, if required. For more information, please review the information
on the Texas Ethics Commission website at https://www.ethics.state.tx.us.
11.3 Lab agrees to comply with Chapter 176 of the Texas Local Government Code and file Form CIQ with the City of
Corpus Christi City Secretary's Office, if required. For more information and to determine if you need to file a
Form CIQ, please review the information on the City Secretary's website at
http://www.cctexas.com/govern ment/city-secretary/conflict-disclosure/index.
ARTICLE 12. CLAIMS
12.1 Claims arising from this Agreement shall be made in writing, sworn to and signed by an authorized representative.
The responsibility to substantiate a claim rests with the party making the claim.
12.2 All negotiations pursuant to this Article are confidential and shall be treated as compromise and settlement
negotiations for purposes of applicable rules of evidence.
ARTICLE 13. EXTENT OF AGREEMENT
13.1 This Agreement, including Exhibit "A" and these Terms and Conditions, represents the entire Agreement between
City and Lab and supersedes all prior negotiation, representations or agreements, written or oral. This Agreement
may be amended only by a written instrument signed by duly authorized representatives of City and Lab. If any
conflict occurs between these Terms and Conditions and any other part of this Agreement, these Terms and
Conditions are controlling.
13.2 In the event that any one or more of the provisions contained in this Agreement are for any reason held invalid,
illegal or unenforceable in any respect, the remaining terms will be in full effect and this Agreement will be
construed as if the invalid or unenforceable matters were never included in this Agreement. No waiver of any
default will be a waiver of any future default.
13.3 Neither party will assign this Agreement without the express written approval of the other, but Lab may
subcontract laboratory procedures as Lab deems necessary to meet the obligations of this Agreement.
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•
•
ARTICLE 14. SAFETY
City and Lab agree that, in accordance with the generally accepted construction practice, the Project's general contractor
will be solely and completely responsible for working conditions on the Project, including safety of all persons and property
during the performance of the work and for compliance with all municipal, state and federal laws, rules and regulations,
including OSHA. The duty of Lab in providing services is not, therefore, to include any review of, or responsibility for, the
adequacy of the Project's general contractor's safety measures in, on or near the Project site.
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EXHIBIT C
Monthly Invoices
Sample form for:
COMPLETE PROJECT NAME Payment Request
ProjectRevised 07/27/00
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%
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•
SUPPLIER NUMBER
TO BE ASSIGNED BY CITY
PURCHASING DIVISION
City of CITY OF CORPUS CHRISTI
corpus
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: Tolunay-Wong Engineers,Inc.
P.O.BOX: N/A
STREET ADDRESS: 826 South Padre Island Drive CITY: Corpus Christi ZIP: 78416
FIRM IS: I. Corporation ri2. Partnership 3. Sole Owner 0
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
4/ 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."
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
mCommittee
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
•
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 general 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 of 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)]
CERTIFICATION
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: Don R.Rokohl,P.E. Title: Branch Manager
(Type or Print) A n
Signature of Certifying Wg- fat j1-\ Date: Z
Person: /S
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. "Firm." 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 of the City of Corpus Christi,Texas.
f. "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.
CERTIFICATE OF INTERESTED PARTIES FORM 1295
1 of 1
OFFICE USE ONLY
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. 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. 20164209
Toiunay-Wong Engineers, Inc.
Corpus Christi,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 01/05/2016
being filed.
City of Corpus Christi Ack wwledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contr t,dl provide a
description of the goods or services to be provided under the contract.
E15218
Engineering Services
4 Nature of interest(check applicable)
Name of Interested Party City,State,Country(place of business)
Controlling Intermediary
5 Check only if there is NO Interested Party.
11t1tlllfffflr/J
6 AFFIDAVIT ���� .... ,l,// ,._) I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
• l%; -'' 1st`
: = 12— V.-10
9�QFPS ; Signature of authorized agent of contracting business entity
4 .•••(.4'PfRES,••'� •�����
AFFIX NOTA*/j /1/11t111110".aO ABOVE l
Sworn to and subscribed before me,by the said _l Jj�O/L /2. /20I&k/ ,this the 5 day of,/ Y'.--,}�`�,
20 /61 ,to certify which,witness my hand and seal of office./cturi 1_11 c:A7
U
a `
\tiarytee of Office„Lad hte Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.33598