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HomeMy WebLinkAboutC2017-287 - 9/26/2017 - Approved AGREEMENT 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 R. 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 Valenzuela Landfill Groundwater Monitoring FY 2017-2018 (Project No. E17070) ("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 $138,90Q. 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 OF CORPUS ' - =T1 TOLUNAY-WONG ENGINEERS, INC. Jeff H. Edmonds, P. . Dat / Don R. Rokohl, P. E. Date Director of Engineering Services Branch Manager 826 South Padre Island Drive Corpus Christi, TX 78416 (361) 884-5050 Office drokohl@tweinc.com 9Y COUNCIL_ 2 2017-287 9/26/17 SECRETA‘ M2017-152 )WASTE1E17070 CEFE VALENZUELA LANDFILL GROUNDWATER MONITORING FY 2017-2018\15.1215 TESTING AGRE i.DOC Roy.12)15715 Tolunay-Wang Engineers Inc. INDEXED APPROVED AS TO LEGAL FORM aa//n Aimee Akom-Reed tih 2017.09.14 Reed-05'00' Assistant City Attorney Date Project No. E17070 Accounting Unit: 1020-12506-033 Account: 530000 Activity: E17070011020EXP Account Category: 30000 Fund Name. Solid Waste Operating RTEST Encumbrance No. Re REST Huerta Date City Secretary lc)5/l -1 K(ENGINEERING DATAEXCHANGEIANGIEMISOLID WASTE1E17070 CEFE VALENZUELA LANDFILL GROUNDWATER MONITORING FY 2017.2018115_1215 TESTING AGREEMENT.DOC Rev 12115/15 Tolunav-Wong 826 South Padre Island Drive Engineers Inc. Corpus Christi,Texas 78416 Phone:(361)884-5050 September 1,2017 TWE Proposal No. P17-E099 Revl 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 2017-2018 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 2017 to 2018. 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 )c330 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 2016 and will not require any additional updates until Fiscal Year 2018 - 2019. 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. EXHIBIT "A" Page 1 of 3 Mr. Lawrence Mikolajczyk TWE Proposal No. PI 7-E099 September 1, 2017 Page 2 Scope of Work The Scope of Work includes four tasks I. Semiannual Detection Monitoring of the 30 monitoring wells (MW 1-19, 40-46 plus deep wells MW-2B, MW-IIB, 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 SS1s 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. 4. Petition TCEQ for permission to discontinue monitoring certain metals on the basis that they offer little or no definitive indication as to whether a release has occurred. Schedule Based on the City's fiscal year schedule and negotiations with TCEQ, TWE proposes to conduct the two semiannual sampling events in October 2017 and April 2018. The 2017 Annual report will be issued in January 2018. The period between the 2nd semiannual sampling event of 2017 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 l' semiannual event of 2018 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 $138,900. A cost breakdown for the major tasks is summarized below. EXHIBIT"A" Page 2 of 3 • • Mr. Lawrence Mikolajczyk TWE Proposal No. P1 7-E099 September 1, 2017 Page 3 Field Sampling Activities (includes 2 Verification Sampling Events) Labor $ 37,400 ODCs $ 6,300 Analytical $ 33,000 Reporting $ 36,100 Petition TCEO to Discontinue Metals Monitoring $ 13,600 Project Management $ 12,500 Project Total $ 138,900 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. k6 L'c 711 Don Rokohl, P.E. Mark Brotherton, P.G. Corpus Christi Branch Manager Sr. Project Manager Environmental Services Division EXHIBIT"A" Page 3 of 3 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; EXHIBIT"B" Page 1 of 6 (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 contractors 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 the same or similar conditions. 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 EXHIBIT"B" Page 2 of 6 • 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 amendmenQ 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 ----- 5d----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) $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 EXHIBIT"B" Page 3 of 6 • • reporting period provisions and identify any limitations regarding who is insured. WORKERS'COMPENSATION Statutory (All States Endorsement if Company is not domiciled in Texas) Employer's Liability $500,000/$500,000/$500,000 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 EXHIBIT"B" Page 4 of 6 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 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/qovernment/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. EXHIBIT "B" Page 5 of 6 • 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 r o = = e c e e I = ❑ 0 0 ' 0 e " 1f 1-- C y 0 0 0 o C ) 0 0 o CO CO CO N (el u) r m U p' O N o o M N o o H H H D r R01 O N o o cr c o a c r EN; U 0 c w a Tn. way00000 0000000 000 E �, > O 00000 O O O m m m 0 O O O u) d CC m C 0 0 0 0 O 0 0 N: H H H r O r 0) C V 60 O N O N O N N O N C O •el c N I- N IO NN N Io N O) C m 43 wen 606060 w 60ww m N 00 0 0 0 0 0 0 ❑ ❑ ❑ O O O o N 0 0 0 0 0 0 0 0 0 an m m 0 0 0 0 N re V 0 0 0 0 0 O O O H H H O O O O 0 co p > « 000 (9o 43 N O w 60 cc N N N O E CN 43 43 N CO ce -O n n 60 43 60 C CO 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00003 m m 0 O O O E p (s 0 0 06 0 o6 O H H H 06 0 0 3 p 00 0 60 60 N w w w S 0 5 0 N L > C - U a - w en w in E m o O o 0 0 0 o O 0 0 0 0 0 0 0 N 0 C y 0 0 0 0 0 000 ,0m0, 0 0 0 0 , V ` 2 0 0 0 0 0 O O O H H H O 0 0 0 Q c 'p 60 0 60 43 0 o w 43 O 0 0 0 in W j > 0 O in U) O to N` Q U 43 w S w 15 1-6 H _ Z n c I0 3 N 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 LS 00000 Ooomm CO o 000 0 000000 O O n H H H l-� o n. lr o _ 000040 V N O N N 0 01 0 C 0 o A N N O t0 n N r 01 N 0- V a) H p g w w N H W K w W N W y Q m W U69 m .- 0 c W O > m 04 0 0 0 0 o 0 0 0 0 0 0 0 0 0 0 0 � J a - 0 0 0 0 0 0 0 0 m m m o 0 0 0 € o 1 0 C O o 0 0 0 0 o n H H H r O r r =i C Z 60 w N O N in w 60 N CoNN CND MO E 0 9 60 rN 0 0 U G 6060 w 60 en r60 E o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 y 0 r 0 0 0 0 O 0000.1 m m O 0 O O C co6 0 06 06 O O o H H H 0 0 0 0 0 0 0 Z 60 0 60 43 0 43 N 43 N 0 N 9 r r r d L E w w in w 5544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0. 04 0 0 0 0 0 0 o O O m m m 0 0 0 0 'p A o 0 0 0 0 O O O H H H O 6 0 04) 0 00000 06043 0 000() 04 O 0 1 C 0 0 0 0 0 y 0 a p N w N N N N N N Co I C M 0 60 43 60 60 60 43 43 60 60 Z N 0 () 0 N U) N 1-1-113 N 0 (6 m N N N Cu tw 2 N >.H 0 LL N • Z 0 0. co c N 0 CO ? J "O UdQN N L N2mA 0 O N 0 Q rCNLLm O T co C c N ` m ZC 'U co < al N (.13 0 O e 07) c n o E E a) O 0 E n 'a m a` o m o co co d 5 5 a O y N W m C H EXHIBIT"C" Page 1 of 1 CITY OF CORPUS CHRISTI DISCLOSURE OF INTEREST City of Corpus City of Corpus Christi Ordinance 17112,as amended,requires all persons or firms seeking Christi 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 ❑ 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) 2. State the names of each `official"of the City of Corpus Christi having an "ownership interest" constituting 3%or more of the ownership in the above named "firm." Name Title 3. State the names of each "board member" of the City of Corpus Christi having an "ownership interest"constituting 3%or more of the ownership in the above named"firm." Name Board, Commission or Committee 4. State the names of each employee or officer of a `consultant" for the City of Corpus Christi who worked on any matter related to the subject of this contract and has an ownership interest"constituting 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 1 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) Signature of Certifying Date: Person: 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. I "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 tiling form,and the city,state and country of the business entity's place Certificate Number: of business. 2017-258218 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 09/08/2017 being filed. City of Corpus Christi Date ckn wledg t+ 11 3 Provide the identification number used by the governmental entity or state agency to track or identify the contra ,and provide a description of the services,goods,or other property to be provided under the contract. E17070 Groundwater Monitoring at Cefe Valenzuela Municipal Landfill for Fiscal Year 2017-2018 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. ❑ X erini4soI 6 AFFIDAVIT ����1,;?,t:.C>:• o.*/ penalty perjury, ••. 7Y / I swear,or affirm,under enal ofthat the above disclosure is true and correct. • 4ie Signature of authorized agent of contracting business entity AFFIX NOTAR8P � fa��BOVE SwornAo and subscribed before me,by the said ` (V K•_ • 1 ,this the day of 20 ` ,to certify which,witness my hand and seal of office. \_ 0A1)1. Ili f C . , nn{ure of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0,3337 I a