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HomeMy WebLinkAbout032879 ORD - 10/11/2022Ordinance authorizing a Wastewater Line License Agreement with NVA Doddridge Veterinary Management Inc, ("Licensee") to install a private wastewater force main system through City property and easements for development of proposed veterinary clinic. WHEREAS, NVA Doddridge Veterinary Management Inc, ("Licensee"), desires to install, operate, maintain, repair, and remove a private wastewater collection system and conveyance system force main ("Wastewater Line") located at 4452 Gollihar Rd, Corpus Christi, TX 78411. WHEREAS, the Licensee has requested, and the City of Corpus Christi ("City") desires to execute, a one-year term License Agreement ("Agreement"). At the end of the initial term, this Agreement renews automatically, in order to accomplish the purpose and use intended by the Licensee within the public right-of-way; WHEREAS, in accordance with Article IX, Section 1 of the City Charter, the City Council authorizes the City Manager or designee to enter into the Agreement for the benefit of the City and the Licensee, subject to the Licensee' compliance with the specified provisions of the License Agreement. BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF CORPUS CHRISTI, TEXAS: SECTION 1. The City Manager or designee is authorized to execute a one-year term License Agreement ("Agreement"). At the end of the initial term, this Agreement with NVA Doddridge Veterinary Management Inc, ("Licensee"), renews automatically, to allow the Licensee to install, operate, maintain, and remove a private wastewater sanitary sewer main ("Wastewater Line") located at 4452 Gollihar Road, Corpus Christi, TX 78411, such Agreement at all times subject to the Licensee' compliance with the conditions specified in the Agreement. A copy of the Agreement is attached to this ordinance and being incorporated by reference into this ordinance as if fully set out herein in their entirety. SECTION 2. The Agreement authorized in Section 1 of this ordinance is subject to the Licensees' compliance with the conditions of the Agreement including, but not limited to, the provisions specified below: a. In exchange for the City's authorization for use of the public easements by the Licensee for the stated purpose, the Licensee agrees to provide the City with a one-time Use Privilege Agreement fee of $4,182.00. b. The Licensee's use of the wastewater main is strictly limited to serving the Licensee's NVA Doddridge Veterinary Management, Inc. vet clinic. Licensee may not provide wastewater service through the wastewater main to any facilities other than the facilities specified in this section, nor may Licensee permit or allow anyone else to provide wastewater service or any other service through the two-inch wastewater main to any facility whether owned by the Licensee or by another person or entity. c. All costs incurred to install, operate, maintain, repair, and remove the wastewater sewer main are the sole responsibility of the Licensee. Page 1 of 2 032879 1 SCANNED That the foregoing ordina ce was read for the first time and passed to its second reading on this the o 1 day of , 2022, by the following vote: Paulette Guajardo Roland Barrera Gil Hernandez Michael Hunter Billy Lerma John Martinez Ben Molina Mike Pusley Greg Smith That the force oiin�g ordinance was read for the second time and passed finally on this the 11 I rl day of S�G�'�' 2022, by the following vote: Paulette Guajardo Roland Barrera Gil Hernandez Michael Hunter Billy Lerma John Martinezj,l? Ben Molina Mike Pusley Greg Smith j� PASSED AND APPROVED on this the f day of 0"4V , 2022. ATTEST: Rebecca Huerta - Paulette Guajardo City Secretary Mayor Page 2 of 2 032879 Wastewater Line License Agreement STATE OF TEXAS § COUNTY OF NUECES § This Wastewater Line License Agreement ("Agreement") is entered into by and between the City of Corpus Christi ("City"), a Texas home -rule municipal corporation, and NVA Doddridge Veterinary Management, Inc. ("Licensee"), a Texas corporation, whose business address is currently 1057 Doddridge Street, Corpus Christi, Texas 78411, (New Facility Address shall be 4452 Gollihar Road; Corpus Christi, Texas 78411). In accordance with Article IX, Section 1, of the City's City Charter and in consideration of a one-time payment of $4,182.00 paid by Licensee, the City has granted and conveyed, and by these presents does grant and convey to Licensee, for the term and upon the conditions stated in this Agreement, a license for the right to install, operate, maintain, repair, and remove Wastewater Line, as shown in Exhibits "A" (Location Map) and "B" (Plan View and Profile View). Exhibits "A" and "B" are attached to this Agreement and incorporated into this Agreement by reference as if fully set out herein in their entirety. The area in which the license is granted for the location of the Licensee's Wastewater Line is referred to in this Agreement as the "Licensed Area." TO HAVE AND TO HOLD the same license granted unto Licensee, its successors, and assigns, together with the right under the conditions specified in this Agreement, to at any time enter upon the above described Licensed Area to install, operate, maintain, repair, or remove Licensee's Wastewater Line, and being further understood that the license granted by this Agreement is subject to the Licensee's compliance at all times with the following conditions, the City and Licensee agree as follows: A. This Agreement, and the rights granted under the Agreement, may be revoked at any time by the City upon providing the Licensee not less than 30 days notice in writing by the City's City Manager or designee ("City Manager"). In the event of a revocation by the City Manager or earlier termination of this Agreement by either party, no portion of any payment made under this Agreement is refundable to the Licensee. B. This Agreement is for a term of one (1) year from the date executed by the City. At the end of the initial term, this Agreement renews automatically unless the Licensee or the City provides written notice to revoke the Agreement. For the avoidance of doubt, except as otherwise provided herein, Licensee shall not be responsible for payment of any additional fees in connection with the renewal of this Agreement. Page 1 of 8 C. This Agreement may not be assigned by Licensee without the City Manager's prior written consent; provided, however, Licensee may assign, without the prior written consent of City Manager, to any (i) parent, subsidiary, affiliate, division or corporation controlled by or under common control of Licensee, or (ii) a successor entity related to Licensee by reorganization, merger, consolidation or the sale of all or substantially all of the capital stock or assets of Licensee. Licensee shall, by notice in writing, advise City of its intention from, on and after a stated date, to assign this Agreement. Licensee's notice shall state the name and address of the proposed assignee. D. During construction or maintenance of improvements pertaining to the Licensed Area granted under this Agreement, insurance requirements are as stated in Exhibit C, the content of which is incorporated by reference into this Agreement as if fully set out here in its entirety. Before construction or maintenance of the improvements pertaining to the Licensed Area granted under this Agreement can begin, the Licensee must deliver a certificate of insurance ("COI"), as proof of the required insurance coverages, to the City's Risk Manager and Director of Development Services Department. 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. E. Should construction be deemed necessary by Licensee in the Licensed Area, construction plans and specifications for all proposed work shall be submitted in advance by the Licensee to the City Engineer and City Development Services Engineer for approval prior to beginning the construction process. The plans must show the depth, and location of the proposed construction and distance from existing water, storm water, wastewater, and gas lines. The Licensee shall also comply with any other laws, rules, regulations, and ordinances applicable to construction in the City and in the public right-of-way, including obtaining all required permits. F. Prior to the start of any approved construction, Licensee shall require every contractor and subcontractor to provide a Certificate of Insurance reflecting insurance in coverage amounts as set forth in Exhibit "C." Additionally, Licensee shall use commercially reasonable efforts to require their contractors and subcontractors to indemnify the City, its officers, officials, employees, representatives, agents, licensees, and invitees in the same manner that Licensee has provided indemnification to the City pursuant to this Agreement. G. Licensee shall provide all necessary and proper safety devices so as to prevent injuries or accidents in the Licensed Area, in as much as possible. Page 2 of 8 H. At least 48 hours prior to beginning any approved construction, Licensee shall contact Texas811 (1-800-DIG-TESS), and any other required agency or authority. Additionally, at least 48 hours prior to beginning any approved construction, Licensee shall give notice and verify depth and location of utility lines, communication lines, and communication fiber optic cables, whichever is applicable, to the following: • City Utility Departments, including Water, Storm water, Wastewater and Gas; • American Electric Power (AEP); • American Telephone and Telegraph (AT&T); • CenturyTel; • Time Warner; • Grande Communications; and • Any and all other certified telecommunications providers. A City inspector may request a utility line be uncovered to verity its depth or location. I. Any construction process and use of the Licensed Area by Licensee shall not interfere with the construction, installation, operation, maintenance, repair, removal or replacement by the City or any of its agents, contractors, or franchisees of any existing or future proposed sidewalks, utility lines, or other uses. If the City or any franchisee with utilities currently located in said public right-of-way needs access to the right-of-way, Licensee shall pay for removing or relocating the private wastewater line in the Licensed Area to allow access to utility lines for maintenance, repair, removal, or replacement of the utility lines. The Licensee shall repair the Licensed Area to its original condition or cease to use the Licensed Area, at which time this AGREEMENT terminates immediately. J. Traffic Engineer requirements pertaining to this Agreement, if applicable in context: 1. At least 48 hours prior to commencing any approved construction, the Licensee shall file and obtain approval for a traffic control plan with the City's Traffic Engineer. No closure or barricading of a public right-of-way or any portion of a public right-of-way may occur before approval of the traffic control plan and, if applicable, approval of a detour or barricade plan has been obtained from the City's Traffic Engineer. 2. Should Licensee require a trench, pit, or similar excavation be dug during approved construction, the Licensee shall file and obtain approval for barricading said trench, pit, or excavation in accordance with the Texas Manual on Uniform Traffic Control Devices from the City's Traffic Engineer. Page 3 of 8 [See paragraph "P" of this Agreement for additional requirements regarding trenches, pits and similar excavations.] K. If, as determined by the City Manager, damage occurs to any gas, water, storm water, or wastewater line, Licensee shall allow the City immediate access to the Licensed Area to perform an assessment, make repairs, or take any other action deemed necessary by the City. Determination of the extent of damage and repairs necessary to restore the utility line(s) shall be made by the City Manager in its reasonable discretion. All costs of the City associated with said damage and repair, including labor and materials, shall be paid by Licensee within 30 days of the City's invoice. L. Should construction become necessary near existing water or wastewater lines, Licensee shall take every precaution not to disturb the soil surrounding any such lines, including all thrust blocks. M. If any approved work is conducted near any existing water main, it shall be done under the inspection of a City inspector at a daily rate of three -hundred ten dollars and thirty-five cents ($310.35) for each day spent inspecting construction, installation, maintenance, repair, removal, or replacement in the Licensed Area. A half -day, being four hours or more of work time by the City inspector, constitutes a whole working day for purposes of calculation. Any time in excess of eight hours a day, or on Saturday, Sunday or holidays, shall be calculated at a daily rate of fifty-eight dollars and eighteen cents ($58.18) per hour. Any assessed inspection fees shall be paid by the Licensee to the appropriate City department within 30 days of the City's invoice. These amounts will be adjusted annually each year on August 1 to reflect any pay increases that may be attributable to the rates charged. N. At any and all times Licensee shall be responsible for the repair and maintenance of the Wastewater Line and Licensed Area, including any costs associated with damage occurring due to natural weather elements/occurrences or man-made forces. Should damage occur to the Wastewater Line or Licensed Area, regardless of the type of damage, Licensee shall immediately repair the damage upon notice by the City. Failure to so repair terminates this Agreement immediately without any further action needed on the part of the City. O. Licensee shall repair, or cause to be repaired, any damage to driveways, culverts, head walls, landscaping, sidewalks, curbs, gutters, and any other structure, public or private, resulting from or caused by reason of construction, installation, maintenance, repair, removal, replacement or operation of the Wastewater Line and Licensed Area. P. If a trench, pit, or other excavation is required during approved construction, no trenches, pits, or other excavation, other than bore pits, shall be left open Page 4 of 8 overnight, except as specifically authorized by the City's Director of Development Services and City's Engineer. Bore pits are not allowed open for a period of longer than 14 calendar days, regardless of location. All trenches, pits, or other excavations, other than bore pits, shall be backfilled by the Licensee promptly and in accordance with current City standards and specifications and as per the City inspector's request. All trenches, pits, and other excavations, including bore pits, shall be barricaded by the Licensee in accordance with the Texas Manual on Uniform Traffic Control Devices and as approved by the City's Traffic Engineer. [See paragraph "J.2." for additional requirements pertaining to trenches, pits, and other excavations.] Q. If backfilling becomes necessary, all backfill, specifically including that in and around existing utilities, shall be made by Licensee according to current City standards and specifications and as required by a City inspector. R. Use of the Wastewater Line authorized by this Agreement is strictly limited to providing service Licensee, located at 4452 Gollihar Road: Corpus Christi, Texas 78411, in the Licensed Area. Licensee shall not provide, nor permit anyone else to provide or receive, subject to Paragraph C hereof, service through said Wastewater Line, or at any facilities within the City other than the building facilities specifically included in this Agreement without first obtaining a franchise or other required approval from the City. S. INDEMNIFICATION. Licensee shall fully indemnify and hold harmless the City of Corpus Christi, its officers, officials, employees, and agents ("indemnitees") from and against all suits, claims, demands, actions, losses, costs, expenses, liability, damages and judgments recovered from or asserted against City for any and all property damage or injuries sustained by any person, including without limitation, workers' compensation, personal injury or death, arising from or incident to, be caused by, or be in any way connected with, either proximately or remotely, wholly or in part, the license granted. T. All signatories signing this Agreement warrant and guarantee that they have the authority to act on behalf of the entity represented and make this Agreement binding and enforceable by their signatures. U. Unless otherwise stated in this Agreement, any, notice required or permitted to be given under this Agreement must be in writing and sent by certified mail, return receipt requested to the following addresses: Page 5 of 8 If to Licensee: NVA Doddridge Veterinary Management, Inc., 1057 Doddridge Street Corpus Christi, TX 78411 If to the City: City of Corpus Christi Attn: Director, Development Services Department P. O. Box 9277 Corpus Christi, TX 78469-9277 Any party shall, by notice to the others in accordance with the provisions of this paragraph, specify a different address or addressee for notice purposes within 10 days of any address change. V. This Agreement shall be construed under and in accordance with the laws of the State of Texas, and all obligations of the parties created pursuant to this Agreement are performable in Nueces County, Texas. Venue for all actions arising from, out of, or related to this Agreement must be brought in Nueces County, Texas. W. The Licensee further agrees, in compliance with the Corpus Christi Code Sec. 2-349, to complete, as part of this Agreement, the "Disclosure of Interests" form attached to this Agreement as Exhibit "D." Completed versions of Exhibit "D" by the Licensee form a part of this Agreement and are incorporated by reference into this Agreement as if set out here in their entireties. X. This instrument, including exhibits, constitutes the entire agreement between the City and the Licensee, and no prior written, oral, or contemporaneous promises, warranties, or representations shall be binding upon any parties. This Agreement may only be amended by written instrument signed by authorized representatives of the City and Licensee and approved as required by City law. Y. Any payments due by the Licensee pursuant to this Agreement will be made from current revenue available to the Licensee. Remainder of page intentionally left blank; signature page to follow. Page 6 of 8 EXECUTED IN DUPLICATE this day of July, 2022. LICENSEE: NVA Doddridge Veterinary Management, Inc., a Texas cor By: Name: Its: c Smit General Counsel & Secretary ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of Los Angeles On 4 215f� 2021 before me, � • Pti e personally a geared Cto,'c A . , w o proved to me on the basis of satisfactory evidence to be the person44whose name( is/aie .ubscribed to the within instrument and acknowledged to me that he/shalt-hey executed the same in his/herfthreir authorized capacity4esj, and that by his/l4erAlleir signature$4 on the instrument the person(s}; or the entity upon behalf of which the person(&) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my h nd and official seal. (i\Ocn Signature (Seal) z MARTA ALPAY COMM. #2254950 z Notary Public - California o Los Angeles County • My Comm, Expires Aug. 19, 2022" Page 7 of 8 CITY OF CORPUS CHRISTI By: Albert J. Raymond III Director of Development Services ATTEST: By: Rebecca Huerta • City Secretary STATE OF TEXAS § COUNTY OF NUECES This instrument was acknowledged before me on , 2022, by Albert J. Raymond III, Director of Development Services of the City of Corpus Christi, a Texas Municipal Corporation, on behalf of said corporation. Notary Public, State of Texas STATE OF TEXAS § COUNTY OF NUECES § This instrument was acknowledged before me on this day of , 2022, by Rebecca Huerta, City Secretary, of the City of Corpus Christi, a Texas home -rule municipal corporation, on behalf of said corporation. Notary Public, State of Texas APPROVED AS TO LEGAL FORM: By: Buck Brice (Date) Assistant City Attomey For the City Attomey Page 8 of 8 01-II-f3 110.46 MI IN]N]]eIov ]NI1 eJT1VMaSd t5 2.1 • SHERW00D DR DORY ST HAMLIN DR ,RIFTW00D PL DOLPHIN PL IP" ■ CgRMe< V1� A �RkwgY 0 o ,may issi}pa, DODDRIDGE ANIMAL CLINIC Corpus Christi, Texas PLAN & PROFILE FREEMAN SCHROEDER OS-I-n 9:46 1,11,11.03 31W1.0.IAV IIIIMIN/X/IMOVAII I 16.1.1.11151038 510111MONV 11-11 !MINA iTN,J11 snnnieva /1,0 NO. z m 0 m m z S..' SI EE Et IS !it g It ,,,,4 /7 i',-----,' /7 i IFt 110 11 m ;11! 1 /if // 11 g 7-1 g . 111 V% „ „ \ I Fi q 11 11 1 I L. . Fil fli x 1 w '1 Ea r ... 111 111 11 II II II 5 :ij 2 g gl El IS Iit Et Et LZOZ/0/9 ,31VCI DODDRIDGE ANIMAL CLINIC Corpus Christi, Texas PLAN & PROFILE IMi,+iitt'grairoCtikitfuttiatiltPRV,P44,44,,AN, ENV EXHIBIT C ACORIJ CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) o7/os/zozz THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the po icy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER K&S Insurance Agency 2255 Ridge Road, Ste. 333 P. O. Box 277 Rockwall TX 75087 CONTACT Ashley Smalley NAME: PHONE (972) 771-4071 FAX (972) 771-4695 (A/C, No, Ext): (A/C, No): EMAIL asmalley@kandsins.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Continental Insurance Company 35289 INSURED Barcom Construction, Inc 1146 Heinsohn Rd Corpus Christi TX 78406 INSURERS : Texas Mutual Insurance Co. 22945 INSURER c : Hanover Insurance Company 22292 INSURER D : American Zurich Insurance Company INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 21/22 Master REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INS° SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL UABIUTY 7015627541 09/12/2021 09/12/2022 EACH OCCURRENCE $ 1,000,000 CLAIMS•MADE X OCCUR DAMAGE TO PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE X LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2, 000, 000 PRODUCTS-COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE X — _ LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON -OWNED AUTOS ONLY 7015627555 09/12/2021 09/12/2022 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAMS -MADE 7015627572 09/12/2021 09/12/2022 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED X RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y NIA 0002020407 09/12/2021 09/12/2022 X PER PEATUTE OTR E.L. EACH ACCIDENT $ 1,000, 000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 C/D Builder's Risk IHD H820420 00/ EC78621928 11/15/2021 11/15/2022 Aggregate Aggregate 10,000,000 7,500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) SEE ATTACHED OVERFLOW PAGE CERTIFICATE HOLDER CANCELLATION City of Corpus Christi PO Box 9277 Corpus Christi TX 78469-9277 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD EXHIBIT D DISCLOSURE OF INTERESTS Development Services Department 2406 Leopard St. Corpus Christi, TX 78408 1 Phone: 361.826.3240 1 platapplicationCcctexas.com 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". NAME: Doddridge Veterinary Management, Inc. STREET: 1057 Doddridge Street CITY: Corpus Christi ZIP: 78411 FIRM is: ❑■ Corporation ❑ Partnership ❑ Sole Owner ❑ Association ❑ Other DISCLOSURE QUESTIONS If additional space is necessary, please use the reverse side of this page or attach separate sheet. 1. State the names of each "employee" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm". Name Job Title and City Department (if known) N/A N/A 2. State the names of each "official" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm". Name Title N/A N/A 3. State the names of each "board member" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm". Name Board, Commission, or Committee N/A N/A 4. State the names of each employee or officer of a "consultant" for the City of Corpus Christi who worked on any matter related to the subject of this contract and has an "ownership interest" constituting 3% or more of the ownership in the above named "firm". Name Consultant N/A N/A CERTIFICATE (To Be Notarized) 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: Eric Smith Title: General Counsel & Sec. (Print) Signature of Certifying Person: Date: Land Development Division I Form No. 4011 Revised 6/13/19 I Page 1 of 2 DEFINITIONS Development Services Department 2406 Leopard St. Corpus Christi, TX 78408 I Phone: 361 .826.3240 I platapplication@cctexas.com a. "Board Member". A member of any board, commission or committee appointed by the City Council of the City of Corpus Christi, Texas. b. "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. c. "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. d. "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. e. "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 holding or control established through voting trusts, proxies or special terms of venture or partnership agreements. f. "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. Land Development Division I Form No. 4011 Revised 6/13/19 I Page 2 of 2