HomeMy WebLinkAboutC2016-383 - 9/13/2016 - Approved 5
AGREEM ENT
for
Monitoring and Testing Services
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: Cefe F.Valenzuela Landfill FY 2016-2017 Groundwater Monitoring(Project No. E163691("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 $130,400.00. 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.
CITY Cr • '�' 11) TOLUNAY-WONG,r EN NEERS, INC.
J. H. Ed onds, P.E. Date Don Rokohl, P.E. Date
Director of Engineering Services Branch Manager
826 South Padre Island Drive
Corpus Christi, TX 78416
RECO 'AIDED ' (361)884-5050 Office
f//ii
Op-C rig Department 4) Date
A-PROVED AS T• LEGAL FORM `IAlk Whi ►-.
.�► A '1 — ;6C < i71K10 ty COUNCIL.._._. .. (� ' (r'
Assistant City Attorney Date
SECRETARY
I
2016-383
9/13/16
M2016-099 ;TE1E16369 CEFE F VALENZUELA FY 2016 TO 2017 GROUNDWATER MONITORING12015 1001 TESTING AGREEMENT OCC
Rev.09/30/15
Tolunay-Wong Engineers Inc.
•
INDEXED
AP7 V D ( I
Office of Management Irr Dat=
and Budget
Project No. E16369
Accounting Unit: 1020-12506-033
ATTEST Account: 530000
Activity: E1636901 1020EXP
PQ—L-te.66 4t/te—e-C4 Account Category: 30000
City Secretary Fund Name: Solid Waste Operating
Encumbrance No.
K\ENGINEERING DATAEXCHANGE4ANGIEM\SOLID WASTE4E16369 CEFE F VALENZUELA FY 2016 TO 2017 GROUNDWATER MONITORING\2015 1001 TESTING AGREEMENT.DOC
Rev.09130/15
Tolunay-W/ongOp
826 South Padre Island Drive
Engineers, Inc. Corpus Christi,Texas 78416
Phone:(361)884-5050
August 2,2016
TWE Proposal No. P16-E068
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 2016 -2017
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 2016 to 2017.
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 0330 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
monitoring results that provide an accurate representation of groundwater quality at the Cefe
Valenzuela facility.
i
EXHIBIT "A"
Page 1 of 3
•
•
Mr. Lawrence Mikolajczyk
TWE Proposal No. P16-E068
August 2,2016
Page 2
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. Biennial intrawell background update based on Detection Monitoring data collected in 2015
and 2016.
4. 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.
Schedule
Based on the City's fiscal year schedule and negotiations with TCEQ, TWE proposes to conduct
the two semiannual sampling events in October/November 2016 and April/May 2017. The 2016
Annual report will be issued in April 2017. The period between the 2nd semiannual sampling
event of 2016 and the Annual Report will allow for up to two verification sampling events along
with data review and incorporation of results into the Annual Report. The period following the
1St semiannual event of 2017 will also be utilized for verification sampling if required. Each
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 three days for each event with analytical TAT again
requiring two working weeks.
Proposed Project Costs
TWE will conduct the investigation on a time and material basis for a not-to-exceed base price of
$130,400. A cost breakdown for the major tasks is summarized below.
Field Sampling Activities (includes 2 Verification Sampling Events)
Labor $ 37,400
EXHIBIT"A"
Page 2 of 3
Mr. Lawrence Mikolajczyk
TWE Proposal No. P16-E068
August 2, 2016
Page 3
ODCs $ 6,300
Analytical $ 33,000
Reporting $ 36,100
Background Report Preparation $ 5,100
Project Management $ 12,500
Project Total $ 130,400
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(a,tweinc.com.
Sincerely,
Tolunay-Wong Engineers, Inc.
/24-1e6-4 7iegi
Don Rokohl, P.E. Mark Brotherton, P.G.
Corpus Christi Branch Manager Sr. Project Manager
Environmental Services Division
0
Paul Wild
Vice President
Environmental Services Division
EXHIBIT"A"
Page 3 of 3
•
•
•
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:
EXHIBIT"B"
Page 1 of 6
•
(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;
(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
EXHIBIT"B"
Page 2 of 6
•
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 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) a copy of the Certificate(s) 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
EXHIBIT"B"
Page 3 of 6
•
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) $500,000 Combined Single Limit
1. Owned
2. Hired and Non-Owned
3. Rented/Leased
PROFESSIONAL LIABILITY $1,000,000 Per Claim
(Errors and Omissions) (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.
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 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 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; and
(c) 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.
EXHIBIT"B"
Page 4 of 6
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.
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
4 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/government/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.
EXHIBIT "B"
Page 5 of 6
•
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.
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.
EXHIBIT"B"
Page 6 of 6
Basic Services:
Preliminary Phase
Design Phase
Bid Phase
Report Phase
Construction Phase
Subtotal Basic Services
Additional Services:
Permitting
Warranty Phase
Inspection
Platting Survey
Reporting
O & M Manuals
SCADA
Subtotal Additional Services
Summary of Fees
Basic Services Fees
Additional Services Fees
Total of Fees
COMPLETE PROJECT NAME
Project No. xxxxxx
Invoice No. 12345
Invoice Date:
Total Amount Previous Total Percent
Contract Amd No. 1 . Amd No. 2 Contract Invoiced Invoice Invoice Complete
$15,117
$0
$0
$15,117
$0
$1,000
$1,000
7%
20,818
0
0
20,818
1,000
500
1,500
7%
0
0
0
0
0
0
O
n/a
14,166
0
0
14,166
0
0
0
n/a
0%
0
0
0
0
0
0
O
$50,101
$0
$0
$50,101
$750
$1,500
$2,500
5%
$0
$0
$0
$0
$0
$0
$0
n/a
0
0
0
0
0
0
O
n/a
9,011
0
0
9,011
0
0
0
0%
29,090
0
0
29,090
0
0
0
0%
1,294
0
0
1,294
0
0
0
0%
TBD
TBD
TBD
TBD
TBD
TBD
0
0%
TBD
TBD
TBD
TBD
TBD
TBD
TBD
0%
$39,395
$0
$0
$39,395
$0
$0
$0
0%
$50,101
$0
$0
$50,101
$750
$1,500
$2,500
5%
39,395
0
0
39,395
0
0
0
0%
$89,496
$0
$0
$89,496
$750
$1,500
$2,500
3%
CITY OF CORPUS CHRISTI
:_.-.= DISCLOSURE OF INTEREST
City of
Christi 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:
STREET ADDRESS: 826 South Padre Island Drive CITY: Corpus Christi ZIP: 78416
FIRM IS: I. Corporation . 2. 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 Cityof 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 j1
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 N /A 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
+4 IA 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 3%or more of the ownership in the above named"firm."
Name 14 /A 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 Rokohl,P.E. Title: Branch Manaeer
(Type or Print)
Signature of Certifying 11 r Date:
Person: l� 12- (L" � , • la 6
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
Complete Nos. 1-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos. 1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2016-97705
Tolunay-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 08/10/2016
being filed.
City of Corpus Christi Date Acknowledged;_�,f\
-uI
1`') k(
3 Provide the identification number used by the governmental entity or state agency to track or identify the kontrabt:and provide a
description of the services,goods,or other property to be provided under the contract.
E16369
Engineering Services
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
5 Check only if there is NO Interested Party. ❑
6 AFFIDAVIT \\\\IINIIIIIIIII!/4v I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
g
i ( * ) 1 - 12.-A
.
J'Tq�TiP5 Signature of authorized agent of contracting business entity
.73; ��' *it
AFFIX NOTAF'�'1y�TALOVE
�cnbed \\\ d �v` •
9. )f_ . ,this the 11 t i
Swo o and subscribed before me,by the said )(,(J UPJ � day of Alai- ,
20 I ,to certify which,witness my hand and seal of office.
[001 1)-e0A7 tki9[1(-0-Frielia-S
Signat re of offker�a ni�t¢rin•
goatt>' Printed name of officer administering oath Tit of offic r minis a ng oath
6ffiCe M114 I NA/
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277