Loading...
HomeMy WebLinkAboutC2016-577 - 12/13/2016 - Approved ff, s 16 rd SERVICE AGREEMENT NO. 39996 is Elevator Maintenance and Repairs THIS Elevator Maintenance and Repairs Agreement ("Agreement") is entered into by and between the City of Corpus Christi, a Texas home-rule municipal corporation ("City") and Schindler Elevator Corporation. ("Contractor"), effective upon execution by the City Manager or the City Manager's designee ("City Manager"). WHEREAS, Contractor has bid to provide elevator maintenance and repairs in response to Request for Bid/Proposal No. n/a ("RFB/RFP"), which RFB/RFP includes the required scope of work and all specifications and which RFB/RFP and the Contractor's bid or proposal response, as applicable, are incorporated by reference in this Agreement as Exhibits 1 and 2, respectively, as if each were fully set out here in its entirety. NOW, THEREFORE, City and Contractor agree as follows: 1. Scope. Contractor will provide elevator maintenance and repairs ("Services") in accordance with the attached Scope of Work, as shown in Attachment A, the content of which is incorporated by reference into this Agreement as if fully set out here in its entirety, and in accordance with Exhibit 2. 2. Term. This Agreement is for six months,with performance commencing upon the date of issuance of a notice to proceed from the Contract Administrator or Purchasing Division. This Agreement includes an option to extend the term for up to zero additional zero-month periods ("Option Period"), provided, the parties do so prior to expiration of the original term or the then-current Option Period. The decision to exercise the option to extend the term of this Agreement is, at all times, within the sole discretion of the City and is conditioned upon the prior written agreement of the Contractor and the City Manager. 3. Compensation and Payment. The total value of this Agreement is not to exceed $95,324.84, subject to approved extensions and changes. Payment will be made for Services completed and accepted by the City within 30 days of acceptance, subject to receipt of an acceptable invoice. All pricing must be in accordance with the attached Bid/Pricing Schedule, as shown in Attachment B, the content of which is incorporated by reference into this Agreement as if fully set out here in its entirety. City of Corpus Christi Page 1 of 8 SArVirP Anrccmcr,4 Ci......i...--i r---- 2016-577 12/13/16 M2016-154 Schindler Elevator Corporation INDEXED 4. Contract Administrator. The Contract Administrator designated by the City is responsible for approval of all phases of performance and operations under this Agreement, including deductions for non-performance and authorizations for payment. The City's Contract Administrator for this Agreement is as follows: Name: Paul Chapman Department: Facilities and Property Management Phone: 361-826-1984 Email: PaulC@cctexas.com 5. Insurance; Bonds. (A) Before performance can begin under this Agreement, the Contractor must deliver a certificate of insurance ("COI"), as proof of the required insurance coverages, to the City's Risk Manager and the Contract Administrator. Additionally, the COI must state that the City will be given at least 30 days' advance written notice of cancellation, material change in coverage, or intent not to renew any of the policies. The City must be named as an additional insured. The City Attorney must be given copies of all insurance policies within 10 days of the City Manager's written request. Insurance requirements are as stated in Attachment C, the content of which is incorporated by reference into this Agreement as if fully set out here in its entirety. (B) In the event a payment bond, a performance bond, or both, are required of the Contractor to be provided to the City under this Agreement before performance can commence, the terms, conditions, and amounts required in the bonds and appropriate surety information are as included in the RFB/RFP or as may be added to Attachment C, and such content is incorporated here in this Agreement by reference as if each bond's terms, conditions, and amounts were fully set out here in its entirety. 6. Purchase Release Order. For multiple-release purchases of Services to be provided by the Contractor over a period of time, the City will exercise its right to specify time, place and quantity of Services to be delivered in the following manner: any City department or division may send to Contractor a purchase release order signed by an authorized agent of the department or division. The purchase release order must refer to this Agreement, and Services will not be rendered until the Contractor receives the signed purchase release order. City of Corpus Christi Page 2 of 8 Service Agreement Standard Form Approved as to Legal Form 7/1/16 7. Inspection and Acceptance. Any Services that are provided but not accepted by the City must be corrected or re-worked immediately at no charge to the City. If immediate correction or re-working at no charge cannot be made by the Contractor, a replacement service may be procured by the City on the open market and any costs incurred, including additional costs over the item's bid/proposal price, must be paid by the Contractor within 30 days of receipt of City's invoice. 8. Warranty. The Contractor warrants that all products supplied under this Agreement are new, quality items that are free from defects, fit for their intended purpose, and of good material and workmanship. The Contractor warrants that it has clear title to the products and that the products are free of liens or encumbrances. In addition, the products purchased under this Agreement shall be warranted by the Contractor or, if indicated in Attachment D by the manufacturer, for the period stated in Attachment D. Attachment D is attached to this Agreement and is incorporated by reference into this Agreement as if fully set out here in its entirety. 9. Quality/Quantity Adjustments. Any Service quantities indicated on the Bid/Pricing Schedule are estimates only and do not obligate the City to order or accept more than the City's actual requirements nor do the estimates restrict the City from ordering less than its actual needs during the term of the Agreement and including any Option Period. Substitutions and deviations from the City's product requirements or specifications are prohibited without the prior written approval of the Contract Administrator. 10. Non-Appropriation. The continuation of this Agreement after the close of any fiscal year of the City, which fiscal year ends on September 30th annually, is subject to appropriations and budget approval specifically covering this Agreement as an expenditure in said budget, and it is within the sole discretion of the City's City Council to determine whether or not to fund this Agreement. The City does not represent that this budget item will be adopted, as said determination is within the City Council's sole discretion when adopting each budget. 11. Independent Contractor. Contractor will perform the work required by this Agreement as an independent contractor and will furnish such Services in its own manner and method, and under no circumstances or conditions will any agent, servant or employee of the Contractor be considered an employee of the City. 12. Subcontractors. Contractor may use subcontractors in connection with the work performed under this Agreement. When using subcontractors, City of Corpus Christi Page 3 of 8 Service Agreement Standard Form Approved as to Legal Form 7/1/16 however, the Contractor must obtain prior written approval from the Contract Administrator if the subcontractors were not named at the time of bid or proposal, as applicable. In using subcontractors, the Contractor is responsible for all their acts and omissions to the same extent as if the subcontractor and its employees were employees of the Contractor. All requirements set forth as part of this Agreement, including the necessity of providing a COI in advance to the City, are applicable to all subcontractors and their employees to the same extent as if the Contractor and its employees had performed the work. 13. Amendments. This Agreement may be amended or modified only by written change order signed by both parties. Change orders may be used to modify quantities as deemed necessary by the City. 14. Waiver. No waiver by either party of any breach of any term or condition of this Agreement waives any subsequent breach of the same. 15. Taxes. The Contractor covenants to pay payroll taxes, Medicare taxes, FICA taxes, unemployment taxes and all other related taxes. Upon request, the City Manager shall be provided proof of payment of these taxes within 15 days of such request. 16. Notice. Any notice required under this Agreement must be given by fax, hand delivery, or certified mail, postage prepaid, and is deemed received on the day faxed or hand-delivered or on the third day after postmark if sent by certified mail. Notice must be sent as follows: IF TO CITY: City of Corpus Christi Attn: Paul Chapman Title: Work Coordinator Address: 5352 Ayers St. Bldg 3A, Corpus Christi, Texas 78415 Fax: 361-826-1989 IF TO CONTRACTOR: Schindler Elevator Corporation Attn: Dave Flint Title : Sales Representative Address: 5559 Bear Ln., Ste. 310, Corpus Christi, Texas 78405 Fax: 210-490-1338 City of Corpus Christi Page 4 of 8 Service Agreement Standard Form Approved as to Legal Form 7/1/16 17. CONTRACTOR AGREES TO INDEMNIFY, HOLD HARMLESS AND DEFEND THE CITY OF CORPUS CHRISTI AND ITS OFFICERS, EMPLOYEES AND AGENTS ("INDEMNITEES') FROM AND AGAINST ANY AND ALL LIABILITY, LOSS, CLAIMS, DEMANDS, SUITS AND CAUSES OF ACTION OF ANY NATURE WHATSOEVER ON ACCOUNT OF PERSONAL INJURIES (INCLUDING DEATH AND WORKERS' COMPENSATION CLAIMS), PROPERTY LOSS OR DAMAGE, OR ANY OTHER KIND OF INJURY, LOSS, OR DAMAGE, INCLUDING ALL EXPENSES OF LITIGATION, COURT COSTS, ATTORNEYS' FEES AND EXPERT WITNESS FEES WHICH ARISE OR ARE CLAIMED TO ARISE OUT OF OR IN CONNECTION WITH THIS AGREEEMENT OR THE PERFORMANCE OF THIS AGREEMENT, REGARDLESS OF WHETHER THE INJURIES, DEATH OR DAMAGES ARE CAUSED OR ARE CLAIMED TO BE CAUSED BY THE CONCURRENT OR CONTRIBUTORY NEGLIGENCE OF INDEMNITEES, BUT NOT IF BY THE SOLE NEGLIGENCE OF INDEMNITEES UNMIXED WITH THE FAULT OF ANY OTHER PERSON. CONTRACTOR MUST, AT ITS OWN EXPENSE, INVESTIGATE ALL CLAIMS AND DEMANDS, ATTEND TO THEIR SETTLEMENT OR OTHER DISPOSITION, DEFEND ALL ACTIONS BASED THEREON WITH COUNSEL SATISFACTORY TO THE CITY ATTORNEY, AND PAY ALL CHARGES OF ATTORNEYS AND ALL OTHER COSTS AND EXPENSES OF ANY KIND ARISING FROM ANY SAID LIABILITY, DAMAGE, LOSS, CLAIMS, DEMANDS, SUITS, OR ACTIONS. THE INDEMNIFICATION OBLIGATIONS OF CONTRACTOR UNDER THIS SECTION SHALL SURVIVE THE EXPIRATION OR EARLIER TERMINATION OF THIS AGREEMENT. 18. Termination. (A) The City Manager may terminate this Agreement for Contractor's failure to perform the work specified in this Agreement or to keep any required insurance policies in force during the entire term of this Agreement. The Contract Administrator must give the Contractor written notice of the breach and set out a reasonable opportunity to cure. If the Contractor has not cured within the cure period, the City Manager may terminate this Agreement immediately thereafter. City of Corpus Christi Page 5 of 8 Service Agreement Standard Form Approved as to Legal Form 7/1/16 (B) Alternatively, the City Manager may terminate this Agreement for convenience upon 30 days advance written notice to the Contractor. The City Manager may also terminate this Agreement upon 24 hours written notice to the Contractor for failure to pay or provide proof of payment of taxes as set out in this Agreement. 19. Assignment. No assignment of this Agreement by the Contractor, or of any right or interest contained herein, is effective unless the City Manager first gives written consent to such assignment. The performance of this Agreement by the Contractor is of the essence of this Agreement, and the City Manager's right to withhold consent to such assignment is within the sole discretion of the City Manager on any ground whatsoever. 20. Severability. Each provision of this Agreement is considered to be severable and, if, for any reason, any provision or part of this Agreement is determined to be invalid and contrary to applicable law, such invalidity shall not impair the operation of nor affect those portions of this Agreement that are valid, but this Agreement shall be construed and enforced in all respects as if the invalid or unenforceable provision or part had been omitted. 21. Order of Precedence. In the event of any conflicts or inconsistencies between this Agreement, its attachments, and exhibits, such conflicts and inconsistencies will be resolved by reference to the documents in the following order of priority: A. this Agreement and its attachments B. the bid solicitation document, including addenda (Exhibit 1) C. the Contractor's bid response (Exhibit 2) 22. Certificate of Interested Parties. Contractor agrees to comply with Texas Government Code Section 2252.908, as it may be amended, and to complete Form 1295 "Certificate of Interested Parties" as part of this Agreement. 23. Governing Law. This Agreement is subject to all federal, State, and local laws, rules, and regulations. The applicable law for any legal disputes arising out of this Agreement is the law of the State of Texas, and such form and venue for such disputes is the appropriate district, county, or justice court in and for Nueces County, Texas. 24. Entire Agreement. This Agreement constitutes the entire agreement between the parties concerning the subject matter of this Agreement and supersedes City of Corpus Christi Page 6 of 8 Service Agreement Standard Form Approved as to Legal Form 7/1/16 all prior negotiations, arrangements, agreements and understandings, either oral or written, between the parties. (SIGNATURE PAGE FOLLOWS) City of Corpus Christi Page 7 of 8 Service Agreement Standard Form Approved as to Legal Form 7/1/16 CONTRACTO 7 Signature: Printed Name: M S r1tAID .$' t- Title: OM Date: %%V%%%1# CITY OF CORPUS CHRISTI Signature: O) Printed Name: \._, Title: Pr 0 c a Date: 4 ATTEST: __ 1 A..“141 REBECCF, HUEFITA CITY SECRETARY Attached and Incorporated by Reference: f Attachment A: Scope of Work I�170 J,t - \ Ain Attachment B: Bid/Pricing Schedule Attachment C: Insurance/Bond Requirements SY C RINCIL.. � Attachment D: Warranty Requirements SECRETARY Incorporated by Reference Only: Exhibit 1: RFB/RFP No. n/a Exhibit 2: Contractor's Bid/Proposal Response City of Corpus Christi Page 8 of 8 Service Agreement Stagdard Form Approved as to Legal Form 7/1/16 Attachment A - Scope of Work Scope of Work: This project includes performing maintenance and repairs to 17 elevators located in five properties: American Bank Center, Museum of Science and History, O.N. Stevens Water Treatment Plant, La Retama Library and City Hall. Maintenance and repairs have been identified by a qualified elevator inspector during an annual inspection required by the Texas Department of Licensing and Regulation. Each elevator and associated cost are attached. All related work should be coordinated with Facilities and Property Management, and the elevator contractor. Each elevator and associated costs are shown on page 2. Page 1 of 2 DECAL INSTALL TOTAL LOCATION # TYPE DATE REPAIRS American Bank Center Convention Center 14376 Passenger 1977 $14,418.54 14374 Passenger 1978 $12,522.00 14375 Passenger 1977 $4,669.14 14373 Freight 1985 $1,311.17 86070 Freight 2014 $13,833.17 87848 Passenger 2014 $13,833.17 40913 Passenger 2003 $1,311.17 Arena 58393 Passenger 2004 $1,311.17 58394 Passenger 2004 $1,311.17 50081 Passenger 2004 $1,311.17 59406 Passenger 2004 $3,781.77 American Bank Center Total $69,613.64 Museum Science and History 14379 Passenger 1989 $1,444.00 14380 Freight 1989 $1,686.00 Museum Science and History Total $3,130.00 O.N. Stevens Water Treatment Plant 14739 Freight 1954 $13,263.00 O.N. Stevens Water Treatment Plant $13,263.00 La Retama Library 87821 Passenger 1984 $1,264.00 14365 Passenger 1984 $3,734.60 La Retama Library Total $4,998.60 City Hall 50079 Passenger 1985 $4,319.60 City Hall Total $4,319.60 Grand Total $95,324.84 Page 2 of 2 Attachment B - Price Sheet Page 1 SUMMARY OF QEI VIOLATIONS 2015 TxMasContract#14-03FAC060 RESPONSIBLE PROPOSAL BUILDING NAME DECAL ITEM DESCRIPTION PARTY STATUS AMOUNT BUILDING TOTALS AB CENTER Convention Center 14376 1 STOP SW.SHALL BE RED SCHINDLER OPEN $ 585.37 PREVENT WATER LEAK IN PIT WATER 2 PROOF AND INSTALL SUMP PUMP SCHINDLER - OPEN $12,522.00 3 FIRE FIGHTER KEY SW.KEYED SAME SCHINDLER OPEN $ 1,311.17 Convention Center 14374 PREVENT WATER LEAK IN PIT WATER 2 PROOF AND INSTALL SUMP PUMP SCHINDLER OPEN $12,522.00 Arena 58393 REPAIR EMERGENCY LIGHT OPEN NO CHARGE IF LIGHT BULB OR BATTERY 3 FIRE FIGHTER KEY SW.KEYED SAME _SCHINDLER OPEN $ 1,311.17 Arena 58394 3IFIRE FIGHTER KEY SW.KEYED SAME [SCHINDLER lOPEN $ 1,311.17 Arena 50081 I 3IFIRE FIGHTER KEY SW.KEYED SAME [SCHINDLER [OPEN $ 1,311.17 ELEVATOR SHALL HAVE EMERGENCY Arena 59406 1 ALARM SCHINDLER OPEN $ 2,470.60 3 FIRE FIGHTER KEY SW.KEYED SAME SCHINDLER OPEN $ 1,311.17 Convention Center 14375 3 FIRE FIGHTER KEY SW.KEYED SAME SCHINDLER OPEN $ 1,311.17 5 21"TOE GUARD REQUIRED SCHINDLER OPEN $ 3,357.97 Convention Center 14373 3 FIRE FIGHTER KEY SW.KEYED SAME SCHINDLER OPEN $ 1,311.17 REPAIR EMERGENCY LIGHT OPEN NO CHARGE IF LIGHT BULB OR BATTERY PREVENT WATER LEAK IN PIT WATER Convention Center 86070 3 PROOF AND INSTALL SUMP PUMP SCHINDLER OPEN $12,522.00 3 FIRE FIGHTER KEY SW.KEYED SAME SCHINDLER OPEN $ 1,311.17 Convention Center 87848 PREVENT WATER LEAK IN PIT WATER 3 PROOF AND INSTALL SUMP PUMP SCHINDLER OPEN $12,522.00 3 FIRE FIGHTER KEY SW.KEYED SAME SCHINDLER OPEN $ 1,311.17 Convention Center 40913 OPEN I 3[FIRE FIGHTER KEY SW.KEYED SAME [SCHINDLER IOPEN $ 1,311.17 AB CENTER TOTAL $ 69,613.64 MUSEUM 14379 Page 2 4INEEDS WORKING LIGHT IN PIT I SCHINDLER 'OPEN $ 1,444.00 14380 I 4INEEDS WORKING LIGHT IN PIT 'SCHINDLER 'OPEN $ 1,686.00 MUSEUM TOTAL $ 3,130.00 STEVENS WATER TREATMENT 14739 1_PROPER SIGNAGE IN ELEVATOR SCHINDLER OPEN $ 150.00 RUSTED HOIST ROPES TO BE 3 REPLACED AND ELEVATOR CONVERTED TO MATERIAL LIFT SCHINDLER OPEN $12,089.00 MACHINE ROOM DOOR SELF CLOSING 5 AND LOCKING SCHINDLER OPEN $ 1,024.00 SI EVENS WA I EN TREATMENT TOTAL $ 13,263.00 CENTRAL LIBRARY I 87821 1 SUMP HOLES NEED COVERS SCHINDLER OPEN $ 1,264.00 14365 1 SUMP HOLES NEED COVERS SCHINDLER OPEN $ 1,264.00 2 INSTALL EMERGENCY LIGHT SCHINDLER OPEN $ 2,470.60 3 INSTALL EMERGENCY ALARM SCHINDLER OPEN CEN I RAL LIBRARY TOTALS $ 4,998.60 ICITY HALL I 50079 1 INSTALL EMERGENCY LIGHT IN CAR SCHINDLER —OPEN $ 2,470.60 4 MR LIGHTING NOT TO BE AUTOMATIC SCHINDLER OPEN $ 524.00 INSTALL NEW PIT LADDER SCHINDLER OPEN $ 1,325.00 CITY HALL TOTALS $ 4,319.60 DIAL OF REMAINING QEI VIOLATION ITEMS $ 95,324.84 ATTACHMENT C-INSURANCE REQUIREMENTS CONTRACTOR'S LIABILITY INSURANCE A. Contractor must not commence work under this contract until all insurance required has been obtained_and such insurance has been approved by the City. Contractor must not allow any subcontractor, to commence work until all similar insurance required of any subcontractor has been obtained. B. Contractor must furnish to the City's Risk Manager and Contract Administrator one (1) copy of Certificates of Insurance with applicable policy endorsements showing the following minimum coverage by an insurance company(s) acceptable to the City's Risk Manager. The City must be listed as an additional insured on the General liability and Auto Liability policies by endorsement, and a waiver of subrogation endorsement is required on GL, AL and WC if applicable. Endorsements must be provided with Certificate of Insurance. Project name and/or number must be listed in Description Box of Certificate of Insurance. TYPE OF INSURANCE MINIMUM INSURANCE COVERAGE 30-day advance written notice of Bodily Injury and Property Damage cancellation, non-renewal, material Per occurrence - aggregate change or termination required on all certificates and policies. COMMERCIAL GENERAL LIABILITY $1,000,000 Per Occurrence including: $2,000,000 Aggregate 1 . Commercial Broad Form 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 WORKERS'S COMPENSATION Statutory and complies with Part II (All States Endorsement if Company is of this not Exhibit. domiciled in Texas) Employers Liability $500,000/$500,000/$500,000 C. In the event of accidents of any kind related to this contract, Contractor must furnish the Risk Manager with copies of all reports of any accidents within 10 days of the accident. II. ADDITIONAL REQUIREMENTS A. Applicable for paid employees, Contractor must obtain workers' compensation coverage through a licensed insurance company. The coverage must be written on a policy and endorsements approved by the Texas Department of Insurance. The workers' compensation coverage provided must be in statutory amounts according to the Texas Department of Insurance, Division of Workers' Compensation. An All States Endorsement shall be required if Contractor is not domiciled in the State of Texas. B. Contractor shall obtain and maintain in full force and effect for the duration of this Contract, and any extension hereof, at Contractor's sole expense, insurance coverage written on an occurrence basis by companies authorized and admitted to do business in the State of Texas and with an A.M. Best's rating of no less than A- VII. C. Contractor shall be required to submit renewal certificates of insurance throughout the term of this contract and any extensions within 10 days of the policy expiration dates. All notices under this Exhibit shall be given to City at the following address: City of Corpus Christi Attn: Risk Manager P.O. Box 9277 Corpus Christi, TX 78469-9277 D. Contractor agrees that, with respect to the above required insurance, all insurance policies are to contain or be endorsed to contain the following required provisions: • List the City and its officers, officials, employees, and volunteers, as additional insureds by endorsement with regard to operations, completed operations, and activities of or on behalf of the named insured performed under contract with the City, with the exception of the workers' compensation policy; • Provide for an endorsement that the "other insurance" clause shall not apply to the City of Corpus Christi where the City is an additional insured shown on the policy; • Workers' compensation and employers' liability policies will provide a waiver of subrogation in favor of the City; and • Provide thirty (30) calendar days advance written notice directly to City of any, cancellation, non-renewal, material change or termination in coverage and not less than ten (10) calendar days advance written notice for nonpayment of premium. E. Within five (5) calendar days of a cancellation, non-renewal, material change or termination of coverage, Contractor shall provide a replacement Certificate of Insurance and applicable endorsements to City. City shall have the option to suspend Contractor's performance should there be a lapse in coverage at any time during this contract. Failure to provide and to maintain the required insurance shall constitute a material breach of this contract. F. In addition to any other remedies the City may have upon Contractor's failure to provide and maintain any insurance or policy endorsements to the extent and within the time herein required, the City shall have the right to order Contractor to stop work hereunder, and/or withhold any payment(s) which become due to Contractor hereunder until Contractor demonstrates compliance with the requirements hereof. G. Nothing herein contained shall be construed as limiting in any way the extent to which Contractor may be held responsible for payments of damages to persons or property resulting from Contractor's or its subcontractor's performance of the work covered under this contract. H. It is agreed that Contrac'tor's insurance shall be deemed primary and non:contributory with respect to any insurance or self insurance carried by the City of Corpus Christi for liability arising out of operations under this contract. I. It is understood and agreed that the insurance required is in addition to and separate from any other obligation contained in this contract. 2016 Insurance Requirements Facility and Property Management Elevator Maintenance 9/26/2016 my Risk Management ATTACHMENT C- BOND REQUIREMENTS No Bond Requirement is necessary for this Service Agreement. ATTACHMENT D- WARRANTY REQUIREMENTS The warranty under this agrement is a 90 day warranty on parts and labor. 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. 2016-112298 schindler elevator corp san antonio,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 09/15/2016 beingfiled. CityCorpus of Corpus Christi Date A:know'edged: ZISZL\�� 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. 39996 Elevator Services provide elevator Generator q Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling I Intermediary 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct. KENDRA W _" '= MY COMMISSION EXPIRES Ao July 7,2019 ignature of a orized agent of contracting business entity AFFIX NOTARY STAMP/SEAL ABOVE J Sworn to and subscribed before me,by the said this the day of Jf t 1 1 20((9 ,to certify which,witness my hand and seal o office. ^V- IAAA b101 \id nuc ,' Signature of officer administering oath Printed name of officer administering oath Title of officer inistering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277