Item 4H MemoCITY OF
SOUTHLAKE
Item 4H
MEMORANDUM
(April 6, 2021)
To: Shana Yelverton, City Manager
From: Rob Cohen, Director of Public Works
Subject: Ratify expenditures with Smith Pump Company Inc. for the
complete replacement and inspection of the pump and motor at
Pump Station #2 located at T.W. King Road in an amount of
$53,537.
Action
Requested: Ratify expenditures with Smith Pump Company Inc. for the complete
replacement and inspection of the pump and motor at Pump Station
#2 located at T.W. King Road in an amount of $53,537.
Background
Information: As part of the Public Works Operations Water Division's preventative
maintenance program, the Water Distribution System High Service
Pumps (HSPs) which feed the City's low and high pressure planes
require inspection and rebuilding approximately every ten years to
ensure optimum efficiency and reliable operations before peak
season. The inspection includes full disassembly, condition
assessment of the suction impellers, bearings, shafts, seals and
replacement of worn components.
At Pump Station No. 2 located at T.W. King Road, HSP #1 is original
to the Water Distribution Facility constructed in 1999. In FY 2021, the
pump, motor, and flange required inspection and maintenance. The
Ingresoll-Dresser brand vertical turbine pump and Flowserve 16ENL-
4 brand motor were last inspected and serviced in 2010. Due to
unforeseen circumstances of the barrel top flange being out of level,
it was determined necessary to level the barrel flange to prevent
damage to the distribution system.
Financial
Considerations: The City's purchasing policy is met through an Interlocal Agreement
(ILA) with the City of Fort Worth for pump repair, parts, and
replacement services. On February 10, 2020, the City of Fort Worth
renewed its contract 18-0087 for the period of April 2020 through
April 2021; this renewal is the second of four one-year renewal
options (Attachment A).
Page 1 of 2
Item 4H
Due to unforeseen circumstances of the barrel top flange being out
of level, it was determined necessary to level the barrel flange to
prevent damage to the distribution system. The cost of these
services exceeded the $50,000 threshold by $3,537 requiring City
Council action. Staff requests that City Council ratify these
expenditures. Funding for the complete replacement and inspection
of the pump and motor at Pump Station #2 is available in the FY 2021
Water Operating Budget. Expenditures did not exceed available
funds.
Strategic Link: This item links to the City's Strategy Map strategic focus area of
Infrastructure. It specifically relates to the City's Corporate
Objectives, B6: Optimize Use Of Technology, and F2: Invest To
Provide & Maintain High Quality Public Assets.
Citizen Input/
Board Review: None.
Legal
Review: None.
Alternatives: The City Council may approve or deny the request.
Staff
Recommendation: Ratify expenditures with Smith Pump Company Inc. for the complete
replacement and inspection of the pump and motor at Pump Station
#2 located at T.W. King Road in an amount of $56,668.
Supporting
Documents: Attachment A: City of Fort Worth Renewal Contract 18-0087
Attachment B: Smith Pump Company — Invoice
Staff
Contact: Rob Cohen, Director of Public Works
Jack Thompson, Operations Manager
Page 2 of 2
Attachment A
FORTWORTH
February 10, 2020
SMITH PUMP COMPANY INC
4bZ4 Martin Luther Ring Fwy
Fort Worth, TX 76119
Attention: James 50umacfier
jaamcs5@5mithpomp.Lum
Re: Kcncwal of bid SMI I R PUMP COMPANY INL 116 PUMP REPAIRPARI S
PSK 6667;18-0087
On 4/3/2020, the agreement between SMI i R PUMP LUMPANY INc, and the city of Fort worth will Expire with 3
option(s) to renew. It you agree to renew the existing agreement for an additional 12-month period, please mark
the appropriate box, sign 6eluw and return to tM5 letter to FMSParc-hasingRenewalsCuturtwurtfitexas.sov witfi
yuor current LcrtifiLate of insora%r- within 5 business days. uncE we rcccivc the rEquircd infurmatiun, we will
renew tfie agreement for the new term. Whether a purchase order will be issued is dependent on department
need and fund availability.
In urder that you receivE notice of uther pity bid opportunities and timely payments, please make sure that your
information, DN5PL odes, and payment infurmatiun are wrrect. iu verify tfiat your information is Lurrect, please
lug into the 5applier Portal at:
fittps://5applier.furtwurtntexas.gov/psi/finpr6/SUPPLIER/EKP/L/NUI FKAMEWURK.P I 1ANDINGPAGE.G6L?&
If yuu have any questions about your supplier account infurmatiun please email
F I w ERN VND MGM 1 Ca)turtwurthtexas.euv.
Eastly, in urger to pruecss payments more efficiently, please sign up to receive payments electronically instead of
by mail. If yuu wuuld like to du this yua can request this un the Supplier Portal. If you have any questions
concerning tfiis correspondence, please call 817-392-2462. Thank you for your prompt attention and for your
cuntinued interest in doing business with tfie City of Furt Wortfi.
Sinccr Ely,
FMS Purcfiasing
PorLhasing Division, Financial Management ScrviLcS Department
New Agreement Term: 4/4/2020 through 4/3/ZDZ3
vendor: SMI i Fi PUMP CUIGIPAMY INC City of Fort worth
n Yes, renew tfiis agreement
❑ No, du not renew this agreement
Ja s 500rrrachEi
Cristina Camarillo
Narchasing Manager
/
A� " CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
05/01/2019
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 policy, 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
CONTACT Kathy Sunday
NAME:
Bailey Insurance and Risk Management
aCC Ext : (254) 753-5317 aC No : (254) 753-1132
E-MAIL kathy@baileyinsurance.com
ADDRESS:
1201 Washington Ave.
INSURER(S) AFFORDING COVERAGE
NAIC #
P.O. Box 298
INSURERA: Cincinnati Insurance Company
10677
Waco TX 76701
INSURED
INSURER B : Texas Mutual Insurance Company
22945
INSURER C :
Smith Pump Company, Inc.
INSURER D :
301 M&B Industrial Blvd.
INSURER E :
INSURER F :
Waco TX 76712
COVERAGES CERTIFICATE NUMBER: 2019 - Renewal 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
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DDIYYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE �X OCCUR
DAMAGE TO
PREM SES Ea oNcuEr ante
$ 100,000
X
MED EXP (AnY one person)
5,000
$
1,000 Property Damage Deductible
PERSONAL & ADV INJURY
$ 1,000,000
A
EPP0117812
05/01/2019
05/01/2020
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRO
JECT LOC
PRODUCTS-COMP/OP AGG
$POLICY 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANYAUTO
A
OWNED SCHEDULED
AOWNED
ONLY AUTOS
EBA0117812
05/01/2019
05/01/2020
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
HIRED 11
/ NON -OWNED
AUTOS ONLY /� AUTOS ONLY
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
X
AGGREGATE
$ 5,000,000
A
EXCESS LIAB
CLAIMS -MADE
EPP0117812
05/01/2019
05/01/2020
DED I X1 RETENTION $ 0.00
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N
(Mandatory in NH)
NIA
TSF0001168283
05/01/2019
05/01/2020
SPER TATUTE EORH
X1
E.L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE -EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Bid #18-0087 - Pump Repair, Parts & Replacement
The City of Fort Worth, its Officers, Employees and Volunteers are included as Additional Insureds on the General Liability & Auto Liability policies if required
by written contract between the Named Insured and the Additional Insureds. Waiver of Subrogation in favor of the City of Fort Worth, its Officers, Employees
and Volunteers applies to the General Liability, Auto Liability & Workers Compensation policies if required by written contract. All Additional Insured and
Waiver of Subrogation references on this Certificate of Insurance are as per corresponding endorsements and policy language. Copies of all endorsements
are available upon written request.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Worth
ACCORDANCE WITH THE POLICY PROVISIONS.
Purchasing Division
AUTHORIZED REPRESENTATIVE
200 Texas Street
Fort Worth TX 76102�
Q, .
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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Request for Taxpayer Give Form io the
Mentincation Number and Certification roynester. Do no%
Send io Ae IRS.
1 N_ (_= the-n en yceP inoernv ;.., rezarrr). R.me is regoirea vn :Ris line; uu nor leave this line
amiiil Pump Earnp-rl„ Inc,
entity name, if differum from .bete
3 Check appropriate box for federal t_- eheek upymr,a of the felling 3evon So..es: 4 E..amp;ions ;cvatr.- app.y oniy To
Indiviaa.Fvle ro n ocrain entities, not individuals; see
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Enter year TIN in the _ppropria a ba.,. Thu TIN pr.,vided must match the name given on line 1 to avoid
b.-ekap withholding. For i6diaide.13, thin is generally your social security number ISSN]. However, for a
reJdant Jun, vale prepriatar, or dizregardad aniky, sea zha Part I instructions on page 3. For other
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Notes. If the account is i„ mare ;hen one name, see the instructions for line I and the chart on page 4 far Employer id_ntia_;i.rn nomEer
'ya!dv1!mu7 an rev home Marrill5or to enter. , 1 4 I - 1 1 1 4 1 1 v 1 v e r
CerltiflCat,lon
Under penalties of perjury, I certify that:
TRe number shown on this form is my correct taxpayer identifcafon ..ember (ere I m w itrng far a mamba, ;o be issued iv me); and
2. 1 _m net zebjewt to barkep withholding beca.Gae: (a} I am exempt from backup withholding, or (b) I have not been Retifi.d by the Internal Rv.eriea
Sarriaa (IRS) th"t I _m : ab)aat to b.vkap :ithhvldi„g as a resuh of a failure to report all interest or dividends, or;gl the IRS ha= notified me th.t I am
no ledger .cbj=.t to b...ekep 7.ithholding; and
3. 1 am a U.S. aitize., o. other U.S. person (defined below); and
4. The FATCA aede(.) entered on thin form (if any) indicating that I am exempt from FATCA reporting is co„,eet.
CertdiaaI16 - in--truetien... Yee mast vro.s ..a; i,ern 2 above if you have been notified by the IRS that you are cappentiy .-ebjeet to bRakap 7,ithholding
bee.-=e you ha-e failed to report all interest and dividends on you. tax return. For real estate transactions, item 2 does net apply. For mvrtg,.ge
interest paid, asciaLitien or .b_md.nmomt of _eaered propa..y, can,uIl.i;on of debt, contributions to an individual retirement are. angement (IRA„ .-nd
generall;, paymeRt= etha, th..- irGro;;t .rid dividends, yva are no; regoired ,., sign the certification, but you must provide your correct TIN. see the
instructions on page 3.
Sign , Signature of j i-
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General IntiLructions
. miivn rw; rcn. vt; arc to tfle Inte<„al Revenue Code unless olherw se noted.
Futuw d-,.nwI.pments. I..farrn.-tiara .-bout des: Iupmcn-.v Jim:ing Fenn :-9 Sovn
as Iegi*MT;vn ena..iou anu, we release 01 is at www.irs.gov1hv9.
Purpose of Form
ran individual or entity -Farm W-9 requester) who is require-d t- file - i-fenrratien
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„ember (ITIN), Gdoptien ;_~payer iaan;;ziva;ion nomQcr to rr IRI, u, employer
identification number pEIN). to report o., _ri infvrrwe,t-en return the -meant p_id ;a
you, er ether —van; reporragle vn an inbrmativrr rtram. Examples of information
returns include, but are riot limited te. th. tulle-irrg•
• Fvrm ; at)a In T timareaz Cornea yea yr paia)
• Form 1099-DIV [dicid■md=. 'rreledt-V theca from :took= or metan,I fends:
• Form ;agg-IO v barioos typos ui incumc prizes, awards, or gross proceeds)
• Form 1099-B (_t.r.k for mets.l fend sale:.-nd .crtain athar ;..,,,,�ac;iona vy
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• Fum 1099-S (praveed: firm Peat e=t.te tr_. ro;Iona)
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• Form 1098 (name 11198-E (; tedent la-m inccraa.) 1098-T
{zap:ion)
• Form 1099-C (._waled debt)
• Form . e93 yr aCandonment of secured property)
Uaa Form _ s only it you arc a U.S. person fIncluding a resident alien), to
provide you_ correct TIN,
d y.,o ov „vi .czv,,, rvn„ Ira ry we requester with a T1N, YOU might be s.bje.t
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4. Cert'ry that FATCA coders) ent■red .n thi: faml (if .m7) i-dia_ti g th-11 y— _Pe
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page 2 for further infornat on.
cat. Rv. w.3 - Form W-9 tnev. 12-20141
SMITH
PUMP
4624 MLK Freeway
COMPANY, INC.. (817) 589 2060
To: City of Fort Worth / Purchasing llivision
Attn: Cristina Caunnarillu, Buyer
Date: February 22, 2U18
Re: Pump Repair, Pali s and Replacement - Bid No. 1 S-UU87
Ft.Worth, TX tbl IU
FAX (81 t) 095 4UUu
Smith Pump is the authorized distributor for mowserve, Landia, Zoeller, Pioneer, SimFlo,
Liberty, Goulds, BJM, and other pump companies in Texas. Our services include sales, field
service, repair, fabrication, and engineering.
Smith rump primarily works with centrifugal pumps for the water and wastewater market. We
are capable of repair/service any centrifugal pump the city of 1,'ort Worth maintains- Our Fort
worth office has a motor repair7rewind shop with capacities up to about 250 HP.
Bid Clarificatiuns
1. We have included our warranty terms that apply listed within our standard terms and
conditions attached.
2. Smith fumy does not dcfine Holiday pay equal to Overtime and Weekend. Overtime and
Weekend pay have been listed on bid items z and 4. Smith Pump will charge our standard
rate of $168.00 per hour fur Holiday hours.
Thank you fur allowing us the opportunity to pa—ti- icipate in this bid.
Sincere regards,
5L
J s Schumacher
Smith Pump Cumpauy, Inc.
4624 Martin Luther King Fwy
Fort Worth, Texas 76119
817 589 2060 office / 817 595 4900 fax
j amcss@smithpump.com
3500 Comsoath Drive, Sahc 500
AUbtii i, I cxas /8 /44
512 310-1480
FAX 512 310-1417
4624 Martin Luther King Frwy
Fort Worth, Texas 76119
81 i 58v-2ueu
FAx 81 i 595-4900
5750 North Sam Hvaaton Pkwy
East, Saito#llu3
Ruustun, I exas t t032
(713) 997-8647
FAX (281) 912-6042
13id cover Sheet
SORT WORTH
CITY OF FORT WORTH / PURCHASING DIVISION
INVITA I ION I U BIU NU. 18-0081
PUMP REPAIR, PARTS AND REPLACEMENT
BID CCOSINu [JAI t: t-e5ruary zz, 2018
For further information contact: Cristina Cama►illu, Buyur
FAX (89 /) 3yz-844u cristina.camarl u . v wv exas.QOv
INSTRUCTIONS TO BIDDERS
Bids are solicited for furnishing the merchandise, supplies, services and/or equipment set forth in this
solicitation. Completed Bids (one (i) tmecutea original and one (1) copy on a USB flash drive) must
be received in the Purchasing Office by 1:30 P.M., February 22, 2018, no excuptions and then
pablidy upelmd and read aloud at z:uu P.M. in the Council Chambers. Bids must be returned in a sealed
envelope WITH THE BID NUMBER WRITTEN ON THE OUTSIDE OF THE ENVELOPE, addressed to
the Purchasing Manager. Bids shuald Bu inailud ur -hand de ivere a
Purchasing Division, Lower Level, City Hall
zuu I eras Street
Fort Worth, Texas 76102
Bids to be delivered by special caarier (i.e. Federal Express; Special Delivery etc.) are to be marked "B1fL
BID NO. 18-0087, MUST BE DELIVERED TO PURCHASING DIVISION BEFORE 1:30 P.M." in urderto
be tunsidered. Late bids will Be returned: they will not be opened nor considered in the evaluation of the
bid. Bids may be withdrawn at any time prior to the official upend ly. Bids may not oe altered, amended or
vvithdlawn after the official opening. I he undersigned agrees, if the bid is accepted, to furnish any and all
items upon which prices are offered, at the price(s) and upon the tClrlls and conditions contained m the
specifications. 1 ne period tur acceptance of this bid will be 90 calendar days after the bid opening date
unless the bidder submits a different date. ( days).
A pre -bid conference will be held at 9:00 AM, Thursday, Femoary 8, z0i 8. bidders shall meet in the
Village UieeR Admin Conference Room located at 4500 Wilma Lane, Fort Worth, Texas, 76012.
I nave read and agreed with the attached Terms and Conditions, Instruction to Bidders and the hivitatim,
to Bid requirements. FdiIU1U LU Lu b e e tire Cy1.1Cs e- infblrT1d1iUr1 UU10W rnaV result in relectlV
bid. Principal Place of Business (Defined as at least having one permanent active business office arid
employee located in Texas).
Company Name and Address Smith Pump Company
Company's Authorized Agent
4624 Martin Luther King Fwy
Fort Worth, TX 76119
Signature:
Federal ID ID Number(TIN) or 1-74-1460081-1
Name and A* (Typed or Printed)
Social Security Number and Legal
James Schumacher - Branch Manager
Company Name Smith Pump Company
bate L/Z1/1018
I elephune Narnt)er 817-589-2060
Fax Number 817-595-4960 Email address:
'amess smith um .com
Cooperative Purchasing: Should other Governme,aal Entities decide to participate in this contract,
would you; the vendor; agree that all terms, conditions, specifications, and pricing would apply?
Yes No
If you. the vendor checked "Yes"; the following will apply: Governmental entities within Tarrant County
utilizing Inter -Governmental Contracts with the City of Furff vvurtn will de eligible; but not obligated, to
purchase material/services under this contract(s) awarded as a result of this solicitatiurl. All pal chases By
Governmental Entities other than the City of Fort vvvrtn will Be billed directly to that Governmental Entity
and paid by that Governmental Entity. The City of Fort Worth will not be responsible for arlotner
Governmental Entity's debts. Each Guvrnunental Entity will order its own material/services as needed.
BID SOLICITATION
Page 1 of 2
Printed: 01 /30/2018
BID OPENING DATE AND TIME:
2/22/2018 1:30:00 PM
BID NUMBER: 18-0087
BUYER: Cristina Camarillo
PHONE #: (817)392 - 8355 ext.
DELIVERY REQUIRED: 2/22/2018
V
Vendor Name:
S City of Ft Worth
E
H
Address:
N
1 1608 11TH AVENUE
D
P FORT WORTH TX 76102
City, State Zip Code:
O
R
T
O
Item
Class -Item
Quantity
Unit
Unit Price
Total
8.000
The City of Fort Worth seeks bids from qualified bidders to establish an
annual agreement for pump repair, parts and replacement for City
Departments per the attached specifications. The term of the agreement
shall be for a one-year (1) period, with four (4) options to renew for
additional one-year periods.
A pre -bid conference will be held at 9:00 AM, Thursday, February 8, 2018.
Bidders shall meet in the Village Creek Admin Conference Room located
at 4500 Wilma Lane, Fort Worth, Texas, 76012.
Bidders are responsible for familiarizing themselves with the work to be
performed prior to the pre -bid conference and prior to submitting bids in
order to be fully aware of the scope of the services required.
FAILURE TO ATTEND THE PRE -BID CONFERENCE MAY IMPACT A
BIDDER?S ABILITY TO SUBMIT A FULLY INFORMED AND
COMPETITIVE BID RESPONSE, ATTENDANCE IS NOT MANDATORY
BUT IS STRONGLY ENCOURAGED.
1.000
Pump Repair Regular Hours, M-F, 7:00 am to 4:00 pm.
8000
HR
2.000
Pump Repair Services Overtime Hours, M-F, 4:01 pm to 6:59am,
3000
HR
Weekends and Holidays.
3.000
Electrical Pump Repair Regular Hours, M-F, 7:00 am to 4:00 pm
8000
HR
4.000
Electrical Pump Repair Services Overtime Hours, M-F, 4:01 pm to 6:59am,
4000
HR
Weekends and Holidays.
5.000
Miscellaneous Parts, Materials and Equipment, Cost Plus %
Markup.
TOTAL:
WE AGREE TO FURNISH ANY OR ALL OF THE ITEMS QUOTED AT THE PRICES SHOWN. QUOTE
MUST BE HELD FIRM FOR PERIOD OF 90 DAYS.
TERM OF PAYMENT: COMPANY:
uECivERY:
TELEPHONE NUMBER:
FUB Destination SIGNATURE
817-589-2060
NAME AND TITLE:
Page 2 of 2
Ja Schamacher - Bjancfi Mai ayer
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local govclrimental entity
This questionnaire refle= changes made to the taw by H.B. = 84th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Govemment Code.
by a vendorwho has a business relationship as defined by Section 176.001 (1-a)With a local
governmental entity and the vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filedwith the records administor of the local govemmental
entity not later than the 7th business day after the date the vendor becomes aware of facts
tFidt regai re the statemet it to oe filed. See Section i /6.uu6(a-1), lucal Guvernment Code.
A ven3ur uummits an uffense it the ventlur knowingly violates Section 1 /fi,DUG, local
Government Code. An offense ander this section is a misdemeanor.
Name of vendor who has a business relationship with local governmental entity.
N/A
are filing an uodate to a
FORM C Q
OFFICE L1SE ONLY
Date Kecenred
(The law requires that you file an updated completed questionnaire with the appropriate filing authority not
later than the 7th business day after the date on which you became aware that the originally filed questionnaire was
incomplete or inaccurate.)
Name of local govuemmunt office about wHum the Information In this sectlun Is being disclosed.
ii!TWA
Name of Office,
This section (item 3 including subparts A, B, C, & D) must be co, ,pleted fvT ea,h officer With whom tha vendor Rao an
employmem or other business relationship as defined by Section 176.001(1-a), Local Government Code_ Atta. h additional
pagex to this Form CIO as necessary.
A. Is the local government officer named in this section receiving or likely ro receive taxable income, other than investment
income, from the vendor?
a Yes F7No
B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the Ivval
government officer named in this section AND the taxable ".,,come is ,.ot ,eceived from the la,al governmental entity?
= Yes u No
G. Is the filer of this questionnaire employed by a corporation or other business entity with ,expect tv whi.,h the local
government officer serves as an officer or airector, or nulas an ownership interest or one percent ur morn!
= Yes " No
D. Describe each employment or business and family relationship with the local government officer named in this section.
vendor doing business with the governmental entity
a4)- )81
Date
Adapted 8/7/2015
I I B I9o. 18-0087, Pump Repair, Parts and Replacement
Payc 24 of 23
FoRTWORTH.
AT i ACHMER i G — vENuOR CONTACT INFORMATION
vendors Name: Smith Pump Company
Vendor's Local Address: 4624 Mdrtin Luther King Fwy, Furt Wurth, TX 76119
Phone: 817-589-2060 Fax: 81 1-5y5-4WU
Email: _ jamess aQsmithpump.com
Name of persons to contact when placing an order or billing questions:
Name/Title James ScFiumacher - Branch Manager
Phone: 817-589-2060 Fax: 817-595-4900
Email:_ jame5bQsmithpump.uum
Name/Title Stan Berry - Service Manager
Phone: 817-589-2060 Fax: 817-595-4900
Email: stanb[aD_smithpump.com
Name/Title
Phone: Fax:
Email:
Si tore
James Schumacher 2/21/2018
Prii,ted Name
ITB No. 18-0087, Pump Repair, Parts and Replacement
Page 16 of 28
uate
FORTWORTH.
ATTACHMENT D - REFERENCE SHEET
Please complete and return this form with your bid.
The Contractor shall furnish references for at least five (5) recent customers to whom products and/or
services have been provided that are similar to those required by this solicitation. The City will be the sole
judge of references. Please use additional sheets.
1. Company's Name
Name of Contact
Title of Contact
Present Address
City, State, Zip Code
Telephone Number ( ) Fax Number ( )
Email
2. Company's Name
Name of Contact
Title of Contact
Present Address
City, State, Zip Code
Telephone Number ( ) Fax Number ( )
Email
3. Company's Name
Name of Contact
Title of Contact
Present Address
City, State, Zip Code
Telephone Number ( ) Fax Number ( )
Email
ITB No. 18-0087, Pump Repair, Parts and Replacement
Page 27 of 28
SMITH PUMP CO.
STANDARD TERMS AND CONDITIONS
1. Applicability
These Terms and Conditions of Sale ("Terms") shall govern all sales of equipment or services to Customer.
These Terms supersede any prior written or oral agreement, understanding, representation or promise and
any pre-printed or standard terms and conditions contained in Customer's request for quote, purchase order,
invoice, order acknowledgement or similar document. These Terms may not be amended, supplemented,
changed or modified except by concurrent or subsequent written agreement signed by an authorized
representative of both Smith Pump Company ("SPCO") and Customer. SPCO's acknowledgement of
Customer's purchase order shall not constitute acceptance of any terms or conditions contained therein
which are in any way inconsistent with the Terms. Any additional or different terms or conditions included
in any acceptance of this quotation are expressly disclaimed and rejected in advance, and unless there is
prior mutual agreement otherwise, shall not become a part of any contract resulting from this quotation.
2. Price
Unless otherwise stated in this quotation, all prices are FOB shipping point. All transportation, insurance
and similar charges incident to delivery shall be borne by the customer. This quotation is valid for thirty
(30) days only. Shipping dates are approximate and are based on prompt receipt of all necessary
information. In the case of delay in furnishing complete information to SPCO, dates of shipment may be
extended for a reasonable time. In the event SPCO provides transport services, these will be quoted as a
lump sum price based on destination and shipping mode.
In the event Customer requests a delay or suspension in the completion and/or shipment of equipment or
services covered by this quotation, or any part thereof, for any reason, the parties shall agree upon any cost
and/or scheduling impact of such delay and all such costs to Customer's account. Any delay period beyond
thirty (30) days after original scheduled shipment date shall require Customer to (i) take title and risk of
loss of any equipment covered by this quotation, and (ii) make arrangements for the storage of such
equipment with SPCO or other party. SPCO's invoice, which is contractually based on shipment, shall be
issued upon SPCO's readiness to ship the equipment covered by this quotation.
SPCO shall not be liable for delay and delivery due to causes beyond its reasonable control including,
but not limited to, acts of God, acts of government, acts of Customer, fires, labor disputes, boycotts, floods,
epidemics, quarantine restrictions, war, insurrection, terrorism, riot, civil or military authority, freight
embargos, transportation shortages or delays, unusually severe weather or inability to obtain necessary
labor, materials or manufacturing facilities due to such causes. In the event of any such delay, the date of
delivery shall be extended for a length of time equal to the period of the delay
3. Warranty
SPCO warrants new equipment or parts to be free from defects in materials and workmanship for a period
of eighteen (18) months from the date of shipment or twelve (12) months from the date of startup or initial
use, whichever comes first. SPCO SHALL NOT BE RESPONSIBLE FOR ANY CONSEQUENTIAL,
INCIDENTAL, SPECIAL OR LIQUIDATED DAMAGES. NO EXPRESSED OR IMPLIED
WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE SHALL
APPLY. Repairs performed by SPCO are warranted against defects in workmanship and/or materials for a
period of twelve (12) months from the date of shipment. SPCO will not be responsible for any removal or
reinstallation charges or transportation charges in cases where equipment has failed under these warranty
conditions. SPCO's sole obligation and Customer's sole remedy under this warranty is repair or
replacement at SPCO's election. Customer agrees to provide SPCO reasonable and clear access to any
equipment covered by this warranty which may include removal or materials or structures as well as
supplying any equipment, materials or structures which are necessary to provide reasonable access to the
equipment being repaired or replaced. Costs to remove and/or reinstall equipment for warranty purposes
shall be the responsibility of Customer.
Replacement parts or repairs furnished under this warranty shall be subject to warranty provisions herein
for the remaining warranty period. All equipment repaired or replaced will be re -warranted only for the
remainder of the original warranty period. SPCO does not warrant the equipment covered by this quotation
or any repair/replacement part against the effects of erosion, corrosion, or normal wear and tear due to
operation or the environment. The warranty and remedies set forth herein are conditioned upon proper
storage, installation, use and maintenance of the equipment covered by this quotation in all material
As of August 30, 2017
respects, and in accordance with SPCO's written recommendations. Customer must notify SPCO in
writing of any warranty claim during the warranty period or within thirty (30) days thereafter.
SPCO will not be liable under this warranty if warranted goods have been exposed or subjected to any
(1) maintenance, repair, installation, handling, packaging, transportation, storage, operation, or use which is
improper or otherwise not in compliance with SPCO's instructions, (2) alteration, modification or repair by
anyone other than SPCO or those specifically authorized by SPCO, (3) accident, contamination, foreign
object damage, abuse, neglect, or negligence after shipment to Customer, (4) damage caused by failure of
an SPCO supplied product not under warranty or by any hardware or software not supplied by SPCO, (5)
use of counterfeit or replacement parts that are not manufactured by the manufacturer of goods provided by
SPCO or approved by SPCO for use in goods provided by SPCO, or (6) goods which are normally
consumed in operation or which have normal life inherently shorter than the warranty period including, but
not limited to, consumables (e.g. lamps, batteries, storage capacitors).
4. Payment
All prices are net cash to be paid thirty (30) days after date of invoice. Customer agrees to make payment
within that period. Discounts will apply only as stated on the invoice. Invoices unpaid for thirty (30) days
after issuance shall bear interest at the highest lawful rate due and payable on any invoiced account, which
is delinquent and not paid within the stated terms. Should Customer for any reason fail to pay in
accordance with these terms, Customer agrees to pay all collection costs, attorney's fees and expenses
incurred in collecting payment.
If Customer's financial condition is or becomes unsatisfactory to SPCO, SPCO reserves the right to (a)
require payment from Customer on a cash in advance basis, (b) require a letter of credit or other acceptable
security before shipment, (c) cancel shipment at any time prior to delivery without further obligation or
liability on SPCO's part, (d) terminate any contract or obligation on the part of SPCO, or (e) require other
special payment terms acceptable to SPCO to assure payment. All extensions of credit are subject to the
approval of SPCO's credit department and management.
5. Joint Check Agreement
If Customer fails to pay laborers and materialmen within thirty (30) days after payment by SPCO, SPCO
will have the right to make future payments by check payable jointly to Customer and laborers or
materialmen to the extent of unpaid indebtedness arising out of the job. SPCO will credit joint checks
against the contract sum on the next payment application.
6. Taxes
The amount of all federal, state or local taxes applicable to the sale, use, delivery or transportation of the
equipment or services sold hereunder and all duties, imports, tariffs, and other similar levies shall be added
to the contract price and paid by the Customer except where the Customer shall furnish an appropriate
certificate of exemption.
7. Property Damage
SPCO shall not be responsible for damage to topsoil or groundcover in connection with the work or service
performed under this contract. SPCO shall not be responsible for claims arising from the pumping of water
onto the ground which is necessary in connection with the service or work provided by SPCO. The
customer agrees to hold SPCO harmless from claims arising out of damage caused by the pumping of water
onto the ground.
8. Startup
If the equipment supplied pursuant to this quotation has a warranty requirement, qualified SPCO personnel
must be present during the initial equipment startup and commissioning. Failure to request and assure the
presence of qualified SPCO personnel will void any warranty herein. Requests for startup must occur at
least seven (7) days prior to the scheduled date of the startup.
9. Limitation of Liability
The remedies set forth herein are exclusive and the total liability of SPCO with respect to this quotation,
and any contract for goods or services arising from this quotation, or for any breach thereof, whether based
on contract, warranty, torts (including negligence), indemnity, strict liability or otherwise, shall not exceed
the quotation or sales price of the specific equipment or service which gives rise to the claim.
As of August 30, 2017
10. Setoff
All amounts that Customer owes SPCO under this quotation shall be due and payable in accordance with
the terms of the quotation. Customer shall not setoff such amounts or any portion thereof, whether or not
liquidated, against sums which Customer asserts are due to it, its parent, affiliates, subsidiaries or other
division under other transactions with SPCO.
11. Customer Cancellation
Customer may cancel this order only upon written notice and payment to SPCO of reasonable and proper
cancellation charges. In the event of cancellation, Customer must pay for all material, expense and labor
costs incurred by SPCO in connection with the materials and services to be provided pursuant to this
quotation, as well as all expenses relating to any specially fabricated materials and restocking charges.
12. Assignment
Neither party may assign this order or any portion thereof without the advance, written consent of the other
party, which consent shall not be unreasonably withheld.
13. Waiver/Severability
Failure by SPCO to assert all or any of its rights upon any breach by Customer shall not be deemed a
waiver of such rights either with respect to such breach or any subsequent breach, nor shall any waiver be
implied from the acceptance of any payment. No waiver of any right shall extend to or affect any other
right Customer may possess nor shall such waiver extend to any subsequent similar or dissimilar breach.
If any portion of these Terms are determined to be illegal, invalid or unenforceable for any reason,
such provision shall be deemed stricken for the purposes of the dispute in question and all other provisions
shall remain in full force and effect.
14. Applicable Law
The contract involving the sale of the equipment and services covered by this quotation shall be interpreted
in accordance with the laws of the State of Texas. This contract is performable in McLennan County,
Texas and venue for any court action in any way relating to or arising out of this contract shall be
McLennan County, Texas.
Accepted By:
Company Name
Project Reference
Printed Name
Signed
Signed On Date
As of August 30, 2017
SMITH
PUMP
301 M&B Industrial
COMPANY, INC. (800) 299-8909 (254) 776-0377
To: Purchasing Manager
Kef: City of Fort Worth —Bid No 16-0311
Vertical Pumps, Farts and Kepaii Contract with Price Increase
Contract Renewal Date: June 22, 2018
Waco, I exas 7ti712
FAX (254) 77b-UU23
May 31, 2U18
Please accept our contract renewal for the submersible pumps, harts and repair contract. Since
the original bid iu 2016, our service rates have increased. The original ITti (invitation t'o t3id)
noted suppliers could raise the annual rates if mutually agreed upon. Fort Worth Purchasing
Department has noted rates were not to exceed the effective percentage change in the US
Producer trice index (FFI) fo, the previous twelve (12) months. The latest report from the u S
Bureau of Labor Statistics, Percent Changes for Final remand, indicates service has raised 2.4%
over past 12 months.
Therefore, to stay in pace with the market, Smith rump would like to increase our labor rates to
the following:
Labor Type
Cui rent Rate
Requested Rate
Line items 1 to 22
No Change
23 Shop Service Repair—
Regular Hours
$Su.uu
$82.00
24 Shop Service Kepair
— overtime Hours
$120.00
$123.00
25 Field Service Repair
— Regular Hours
$84.00
$86.uu
26 Field Service Repair
— Overtime flours
$126.00
$129.00
2'1 Miscellaneous Pump
Pans Cost Plus Marrkup
20%
2u%
(no change)
Smith Pump is committed to continually meet or exceed customer satisfaction by providing
quality products and services that comply with all commitments and expectations. We look
forward to working with Fort Worth once again.
Sincere regards,
" 'OL
Jam chumacher
Smith Pump Company, Inc.
4624 Martin Luther King Freeway
Fort Worth, Texas /6119
817 589 2060 office f 817 595 4900 fax
jamess@smithpump.com
3500 Comsouth Drive, Suite 500
Austin, TeAas t8t44
512310-148u
FAX 512 310-1417
4uz4 Plarffin Cutliier Kng Frwy
Fort Worth, Texas 76119
817 589-2060
FAX 81 i 595-49uu
5750 North Sam Houston Pkwy
East, Suite #1103
Huastun, Texas iiu3z
(M) 99(-B64/
FAX (281) 912-6042
FORT WORTH
April y, L018
SMI I R PUMP COMPANY INC
4624 MARTIN LUTHER KING FWY
FORT WORTH, TX 76119
Attention: JAMES SCHUMACHER
EMAIL: JAMESS@SMITHPUMP.COM
Re: Renewal of Bid VERTICAL PUMPS, PARTS AND REPAIR
Po No: PO-17-00099792 16-0311
On 6/22/2018, the agreement between SIVII I R PUMP COMPANY INC and the City of Fort Wortn will
cxpim with 1 option(s) to ienew. If you agi ee to extend the existing agreement for an additional 12
month pei iud, please mai k the appropi iate box, Sign below and return to this letter, your current
LCFtitlCatc ut hibarance and yoar current signed IRS vv-y form within 48 hours.
Filial approval of a new parLhase order is dependent on fund availability. If approved, a new purchase
order will be e-mailed to yuu. I u ensure that you feLeive your new Purchase Order, as well as
,iotiticatiuns about any new proLaremeiit uppurtaidties, please log on to the City's BuySpeed Online
system at http://torTwerFlhtCxas.gciv/purchdsing/information-update/ and update your company's
in turmation.
It you have any questions conLernhig this correspondence, please call 81i-392-2462. Thank you for your
prompt attention and for your continued interest in doing business with the City of Fort Worth.
Sincerely,
�i
Charity Karl
Parchasing Division, Financial Management Services Department
New Agreement Term: 6/23/2018 through 612212019
Vendor: SMITH PUMP COMPANY INC
City of Fort WorTh
N Yes, renew this agreement w/ PV ` `e-
❑ No, do not renew this agreement IrNct'aase Laurena Hamilrii, Buyer
\ A ln�o
JAI01 6
SLRUIVIACRER
Assistant Purchasing Director
Form
-9
Request for Taxpayer
Give Form to the
(Rev. Det.Ember 2014)
Identification Number and Certification
requester. Do not
Department of the Treasury
acnO to the IKS.
Internal Revanuo Survioe
t Name (as shown on your income tax return). (Came Is requireti on rnis line; ao not leave tnis line DIanit.
Smith Pump Company, Inc.
N
z Business name/oisregartiaa entity name, R tilRerent rrom atlove
m
C,
CO
a
3 Check appropriate box for federal tax classification; check only one of the following seven boxes:
� ERemptions tcoties apply only to
c
O
❑ IndividuaUsole proprietor or ❑✓ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
certain ionsentiton not insee
instructions on page,3):
y
m e
Q
single -member LLC
El Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ►
Empt payee cotie tit any)
ti 2
Note. For a single -member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for
Exemption from FATCA reporting
c
the tax classification of the single -member owner.
code Q T any)
a-
V
❑ Other (see instructions) ►
(App es ro accou.,rs ms..re, ea «,rsrde me o s i
5 Address (number, street, and apt. or suite no.)
Requester's name anti anoress joptionar)
301 M B Industrial
m
6 City, state, and ZIP code
CD
Waco, Texas 76712
7 List account number(s) here (optionaq
Taxpayer Identification Number (TIN}
Enter your TIN in the appropriate box. The TIN provided mast match the name given on line 1 Lo avoid
Social aecuRW number
this is -generally yoer social sI number (sale).
For ietor, th fora
Wiie�n,
5acRtipresident
resident
instry . For,
alien, sole proprietor; or disregarded entity; see the PaR I instructions on page 3. For Other
sole r disregarded
untitie5, it is your employar identlticat um ,timber (EIN). If you du not have a number, sae Flow to get a
TIN on page 3. or
Note. If the account is i,, mo,a than one hart:, serthe lnstractim,s for Tina 1 and the Chart un pave 4 t.-r Employer identification number
guiaeiines on whose number to enter. 114 I - I t 14 I ti I U I U 18 I l
Under penalties of perjury, I certify that:
i Me number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not suoject to Qackup withholding Because: (a) I am exempt from backup withholding; or (b) I have not been notified by the Internal Revenue
Service (IRS) that I a,,, 5u6ject to backup withholding as a result ut a tailare to report all interest ur dividends, or (c) tFie IRS Miss notified me tFiat I am
no longer subject to-BacKup withholding; and
3. 1 am a U.S. citizen or other U.S. person (Befinea Velow); and
4. The FATuA codets) entered on tRis roan (if any) indicating that I am exempt from FATCA reporting is correct.
t;ertrtication instructions. You must cross out item z a'Bove if you have been notified by the IRS that you are currently bQbj8CL to backup withholding
because you have tailed to report all interest and aiviaerras ti„ yucr tax return. For reai Estato transactions, itern 2 does mat apply. Fur mortvava
irrtarust paid, acquisition or abandonment or secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and
generally, payments other than interest and dividends, you aye not required to sign the certification, Got you mast pfuvidu yoer Correct TIN. see the
instrti.-tiuns on page 3. % J
Here I U.S. apersoo i►� ){ )! I/! Jlr� Date IN -
General 1
Section references are tv the Internal Revenue Code unless otherwi.a noted.
Future tievelopmerim In,ormadon apoM uevelopments affecting Form W-9 (such
as legislation enacted after we release R) is at www.irs.gov/fw9.
Purpose of Form
rvt individual or entity (Form W-9 requester) who is required to file an information
return with the IRS must obtain your correct taxpayer identification number (I IN)
which may bE your social security number (SSN), individual taxpayer identification
number (ITIN), adoption taxpayer identification number (ATIN), cr Employer
ident'rfivation number tEIN), to report on an information return the amount pain to
you, or other amount reportable on an information return. r-samples or information
returns incluce, 13M are not limirec to, the following:
• Form 1099-INT (intarst named or paia)
• Form , ogB-DIV (dividends, including those from stocks or mutual fonds)
• Form 1099-MISC tvarious types of income, prizes, awaros, or gross proceeds)
Form 1099-B (stock or mutual fund sales and pertain other transactions by
brokers)
- Form 1099-S (proceeds from real Estate transactions)
= rorm t uuii-r, imercnam cart] ano Mira parry networR transactions)
- Form 1098 (n-omu mortgage interest), 1098-E (student loan interest), 1098-T
(tuition)
- Form 1099-C (canceled debt)
• Form i Cuu-„ jacquisilion or atiantionment of secured proper
Use Form w-y only if you are a O.S. person (including a resident alien), to
provitie your correct TIN.
1f you do not rerum Form w-a ro me requesrer wirn a r nv, you mignr tie suniecr
ro bacKup wirnnoraing. see vvnar is oacKup wirnnotoingf on page z.
By signing the filled -out form, you:
1. Certify tnat the TIN you are giving is correct (or you are waiting for a number
to be issued),
2. Cenhy-that you are not subject to tiacRup witnnoioing, or
3. Claim exemption from backup withholding if you are a U.S. axernpt payee. If
applii;able, you a al.o zurtrrying that as a U.S. person, your allocable share of
any partnership income rrom a u.s. tratie or Business is not suoject to trio
:1lnnoltiing tax on foreign partners' snare or onectively conneC[eti income, aria
4. Certify- that FATCA code(s) entered on this form (if any) indicating that you are
exempt from the FATCA reporting, is correct. see vvnar is rat r t A reporringr on
page 2 for ruRner information.
Cat. no. 1134a1X rorm W-9 (Rev. tz-ztita)
/
A� " CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
05/29/2018
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 policy, 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
CONTACT Kathy Sunday
NAME:
Bailey Insurance and Risk Management
aCC Ext : (254) 753-5317 aC No : (254) 753-1132
E-MAIL kathy@baileyinsurance.com
ADDRESS:
1201 Washington Ave.
INSURER(S) AFFORDING COVERAGE
NAIC #
P.O. Box 298
INSURERA: Cincinnati Insurance Company
10677
Waco TX 76701
INSURED
INSURER B : Texas Mutual Insurance Company
22945
INSURER C :
Smith Pump Company, Inc.
INSURER D :
301 M&B Industrial Blvd.
INSURER E :
INSURER F :
Waco TX 76712
COVERAGES CERTIFICATE NUMBER: 2018 - Renewal 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
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DDIYYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE �X OCCUR
DAMAGE TO
PREM SES Ea oNcuEr ante
$ 100,000
X
MED EXP (AnY one person)
5,000
$
$1,000 Property Damage
Deductible
PERSONAL & ADV INJURY
$ 1,000,000
A
EPP0117812
05/01/2018
05/01/2019
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRO
JECT LOC
PRODUCTS-COMP/OP AGG
$POLICY 2,000,000
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANYAUTO
A
OWNED SCHEDULED
AOWNED
ONLY AUTOS
EBA0117812
05/01/2018
05/01/2019
BODILY INJURY (Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY /� AUTOS ONLY
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
X
AGGREGATE
$ 5,000,000
A
EXCESS LIAB
CLAIMS -MADE
EPP0117812
05/01/2018
05/01/2019
DED I X1 RETENTION $ 10,000
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? N
(Mandatory in NH)
NIA
TSF0001168283
05/01/2018
05/01/2019
X STER ATUTE EORH
E.L. EACH ACCIDENT
1,000,000
$
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
1,000,000
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Vertical Pumps, Parts & Repair (PO No: PO-17-00099792 16-0311)
The City of Fort Worth, its Officers, Employees and Volunteers are included as Additional Insureds on the General Liability & Auto Liability policies if required
by written contract between the Named Insured and the Additional Insureds. Waiver of Subrogation in favor of the City of Fort Worth, its Officers, Employees
and Volunteers applies to the General Liability, Auto Liability & Workers Compensation policies if required by written contract. All Additional Insured and
Waiver of Subrogation references on this Certificate of Insurance are as per corresponding endorsements and policy language. Copies of all endorsements
are available upon written request.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Worth
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Bid 16-0311
AUTHORIZED REPRESENTATIVE
200 Texas Street
Fort Worth TX 76102�
Q, .
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
Table 1. Producer price indexes and percent changes for final demand'
[Nov 2009=100, unless otherwise indicated]
Grouping
Other
index
base
Relative
Impor-
tance
Dec.
Unadjusted index
Unadjusted percent
change to Apr. 2018
from:
Seasonally adjusted
percent change from:
Dec.
Mar.
Apr.
Apr.
Mar.
Jan. to
Feb. to
Mar. to
20172
20173
20183
20183
2017
2018
Feb.
Mar.
Apr.
Final demand.............................................................
100.000
113.8
115.5
115.6
2.6
0.1
0.2
0.3
0.1
Final demand goods .....................................................
33.013
112.5
113.9
114.3
2.9
0.4
-0.1
0.3
0.0
Final demand foods ...................................................
5.723
116.2
118.1
117.1
-0.3
-0.8
-0.4
2.2
-1.1
Finished consumer foods" ...........................................
00/82
4.605
207.1
209.3
207.2
-1.1
-1.0
-0.8
2.3
-1.2
Finished consumer foods, crude ...................................
00/82
0.482
221.0
225.7
201.6
-13.5
-10.7
-7.8
17.3
-11.3
Finished consumer foods, processed ..............................
00/82
4.123
206.0
207.9
208.2
0.4
0.1
0.0
0.8
0.0
Government purchased foods .......................................
0.344
119.0
119.8
119.6
-0.2
-0.2
-0.4
1.1
-0.4
Foods for export ....................................................
0.774
110.0
116.1
115.9
3.5
-0.2
1.3
2.4
-0.5
Final demand energy ..................................................
5.576
103.4
105.5
107.6
9.0
2.0
-0.5
-2.1
0.1
Finished consumer energy goods° ...................................
00/82
4.553
163.5
167.1
170.1
6.8
1.8
-0.6
-2.0
-0.2
Government purchased energy ......................................
0.783
104.9
106.7
109.1
16.9
2.2
0.4
-2.6
1.1
Energy for export ...................................................
0.240
95.8
97.4
100.6
26.2
3.3
0.8
-3.3
2.3
Final demand goods less foods and energy ............................
21.714
114.1
115.3
115.5
2.1
0.2
0.2
0.3
0.3
Finished goods less foods and energy° ..............................
00/82
12.772
200.6
202.0
202.4
1.9
0.2
0.0
0.2
0.3
Finished consumer goods less foods and energy ...................
00/82
6.900
223.5
225.6
226.2
2.6
0.3
0.1
0.3
0.4
Nondurable consumer goods less foods and energy .............
00/82
4.205
284.3
288.5
289.9
3.7
0.5
0.3
0.2
0.6
Durable consumer goods .......................................
00/82
2.695
160.2
160.3
160.3
1.0
0.0
-0.3
0.4
0.1
Private capital equipment .........................................
00/82
5.872
171.8
172.4
172.6
1.0
0.1
0.0
0.3
0.1
Private capital equipment for manufacturing industries...........
00/82
1.315
173.9
175.3
175.7
1.7
0.2
0.3
0.2
0.2
Private capital equipment for nonmanufacturing industries........
00/82
4.557
170.9
171.3
171.4
0.7
0.1
-0.1
0.3
0.1
Government purchased goods, excluding foods and energy...........
2.240
111.0
112.2
112.5
1.8
0.3
0.3
0.3
0.3
Government purchased goods excluding foods, energy, and capital
equipment......................................................
1.308
112.6
114.2
114.5
2.3
0.3
0.4
0.4
0.3
Government purchased capital equipment .........................
0.932
107.4
108.0
108.3
0.9
0.3
0.1
0.1
0.4
Goods for export, excluding foods and energy ........................
6.702
111.3
113.0
113.3
2.8
0.3
0.2
0.5
0.4
Final demand services ..................................................
65.345
114.2
116.0
115.9
2.4
-0.1
0.3
0.3
0.1
Final demand trade services5 ............................... . ..........
20.351
115.0
116.3
116.7
1.9
0.3
-0.2
0.2
0.2
Trade of finished goods ................. ............................
17.720
114.7
116.0
116.3
1.7
0.3
0.0
-0.2
0.1
Trade of personal consumption goods .............................
14.511
114.3
115.5
115.5
1.0
0.0
0.3
-0.7
-0.2
Trade of private capital equipment .................................
3.209
115.5
117.2
118.6
4.3
1.2
-1.3
2.3
1.2
Trade of government purchased goods ..............................
0.726
117.5
118.8
119.7
3.7
0.8
-0.9
1.7
0.8
Trade of government purchased goods, excluding capital
equipment ...................................................
0.446
116.6
117.4
117.8
2.8
0.3
-0.4
1.1
0.3
Trade of government purchased capital equipment .................
0.280
118.5
120.5
122.2
5.3
1.4
-1.7
2.8
1.4
Trade of exports ....................................................
1.905
116.7
118.3
119.2
3.3
0.8
-0.8
2.2
0.8
Final demand transportation and warehousing services .................
4.465
117.3
120.7
121.0
4.7
0.2
0.9
0.6
0.6
Transportation of passengers for final demand .......................
1.230
110.0
116.7
116.8
1.7
0.1
1.8
1.5
1.3
Transportation of private passengers ..............................
0.840
110.0
116.7
116.9
1.7
0.2
1.8
1.5
1.3
Transportation of government passengers .........................
0.127
110.0
116.7
116.9
1.7
0.2
1.9
1.5
1.3
Transportation of passengers for export ...........................
0.263
109.8
116.6
116.8
1.7
0.2
1.9
1.5
1.3
Transportation and warehousing of goods for final demand...........
3.235
119.6
121.6
121.9
5.4
0.2
0.5
0.3
0.2
Transportation and warehousing of finished goods° ................
2.285
118.5
120.4
120.7
5.4
0.2
0.5
0.3
0.2
Transportation and warehousing of personal consumption
goods ........................................................
1.789
118.8
120.7
121.0
5.4
0.2
0.5
0.3
0.2
Transportation and warehousing of private capital equipment.....
0.496
117.4
119.2
119.5
5.7
0.3
0.5
0.3
0.3
Transportation and warehousing of government purchased goods...
0.238
118.7
120.7
120.9
5.0
0.2
0.5
0.3
0.3
Transportation and warehousing of exports ........................
0.712
123.1
125.5
125.7
5.1
0.2
0.5
0.3
0.2
Final demand services less trade, transportation, and warehousing......
40.529
113.5
115.4
115.1
2.4
-0.3
0.3
0.3
-0.1
Finished services less trade, transportation, and warehousing°........
36.037
113.8
115.7
115.4
2.4
-0.3
0.3
0.3
-0.1
Finished consumer services less trade, transportation, and
warehousing...................................................
32.587
113.8
115.6
115.3
2.1
-0.3
0.4
0.3
-0.2
Private capital investment services less trade, transportation, and
warehousing...................................................
3.450
114.1
116.5
116.5
4.6
0.0
0.1
0.6
0.0
Government purchased services less trade, transportation, and
warehousing......................................................
3.046
109.9
111.0
110.7
1.7
-0.3
0.7
0.1
-0.2
Gov. purchased services less trade, transportation, and
warehousing, excl. capital investment ...........................
2.945
110.3
111.3
111.0
1.7
-0.3
0.7
0.0
-0.2
Government purchased capital investment services less trade,
transportation, and warehousing .................................
0.101
100.4
102.1
101.4
1.3
-0.7
-0.9
2.1
-0.7
Services for export less trade, transportation, and warehousing.......
1.446
114.6
116.5
116.5
3.5
0.0
0.2
0.7
-0.1
Final demand construction ...............................................
1.642
118.0
119.1
120.4
4.2
1.1
0.1
0.2
1.1
Construction for private capital investment .............................
1.107
118.0
119.1
120.3
4.2
1.0
0.1
0.3
1.0
Construction for government ...........................................
0.535
118.0
119.0
120.4
4.2
1.2
0.0
-0.1
1.2
Special groupings
Final demand less exports .................................................
04/10
87.958
112.4
113.9
114.0
2.4
0.1
0.1
0.2
0.0
Final demand less government .............................................
04/10
91.961
112.3
114.0
114.1
2.5
0.1
0.2
0.3
0.0
Final demand less foods, food and nonalcoholic beverages for immediate
consumption, and energy6...............................................
04/10
88.148
113.1
114.7
114.7
2.3
0.0
0.3
0.3
0.2
Final demand less foods and energy6......................................
04/10
88.701
113.1
114.6
114.7
2.3
0.1
0.2
0.3
0.2
See footnotes at end of table.
13
9�
Smith Pump Company, Inc.
301 MB Industrial Blvd
Waco, TX 76712 US
Phone: 800-299-8909
Fax: 254-776-0023
www.smithi)umi).com
Invoice No. 1000833
Page 1 of 3
Shipping Southlake Public Works Department Ship Via: Bestway
address: 3655 T W King Rd Fob desc:
Southlake, TX 76092
Account address: Southlake Public Works Department
accountspayable@ci.southlake.tx.us
1400 Main StreetSuite 440
Southlake, TX 76092
Invoice Date
Due Date
Terms
Salesperson
3/17/2021
4/16/2021
Net 30 Days
TXNW - Oscar Villarreal
Order Qty Ship Qty Part ID/Description Rev U/M Unit Price Extended Price
1.00 1.00 AX PROJECT 0 EA 1,875.00 $1,875.00
HSP#1 Pull and Transport
Pricing per Fort Worth Contract 16-0311 ($86/$129)
Item of (2) man crew to Pull High Service Pump #2
Ingersoll -Dresser (Flowserve) 16NKL-4, with 400HP VHS
Pump only 3,000 Ibs
Item of crane services on 178520-06
Item of transportation services
**Owner to disconnect all power and controls**
Serviceman to lockout/tagout, relieve seal, confirm free rotation of pump, and record impeller lift.
Load former HSP #2 motor onto trailer for transport to SPCO FTW
Remove pump and load onto SPCO trailer for transportation to Smith Pump FTW shop
Pump Pulled: 9/11/2020
Shipment 10723 Our Order 179088 Your Order 22100262-001
Order Qty Ship Qty Part ID/Description Rev U/M Unit Price
1.00 1.00 AX PROJECT 0 EA 5,968.00
Teardown & Inspect HSP#1 - Flowserve 16NKL-4
Reason for service: Pump Overhaul, It has never been repaired. Motor was found to have moisture in the lower bearing.
Item of Shop Disassembly & Inspection of Vertical Turbine Pump
Includes:
1. Incoming Electrical / Mechanical Inspection
2. Teardown of Pump
3. Inspect of Parts to Determine Necessary Repairs
4. Written Shop Inspection Report
5. Provide Quotation for Recommended Repairs
6. Advise replacement and/or upgrade costs.
Nameplate not legible.
Pump Manufacturer: Flowserve (IDP)
Model: 16ENL (16NKL)
S/N: SPCO Assigned 9900-00096 (Guess of 9906TC110526)
RPM:1800 HP:400
156" Base to Bell
Extended Price
$5,968.00
Continued over .../
Smith Pump Company, Inc.
301 MB Industrial Blvd
Waco, TX 76712 US
Phone: 800-299-8909
Fax: 254-776-0023
www.smithpumi).com
Motor Manufacturer: GE Motors, VHS
Model5K509ET6163M
Frame L509TP20, WPII Enclosure
460V 3PH, 60Hz
HP:400 RPM: 1800
S/N: RPG153006
Received: 9/11/20
Disassembled and Inspected: 10/15/20
Shipment 10723 Our Order
Order Qty Ship Qty
Part ID/Description
1.00 1.00
4611
Repair Flowserve 16ENL-4 and Motor
Nameplate not received
- Pulled data from 162158
Pump Manufacturer: Flowserve (IDP)
Model: 16ENL (16NKL)
S/N: 9908TC110526 (?)
RPM:1800 HP:400
Repair Includes:
1. Replace bowl bearings (bronze, 5x)
2. Replace collets for impeller (steel, 4x)
3. True and balance impellers (4x)
4. Straighten bowl shaft
5. Replace lineshaft (416 SS)
6. Replace lineshaft bearing (rubber)
7. Replace lineshaft coupling (416 SS)
8. Straighten motor shaft
9. Replace stuffing box hardware (18-8 SS)
10. Replace stuffing box o-ring
11. Repair mechanical seal
12. Replace strainer basket
13. Replace discharge & can gaskets
14. Fabricate discharge head doors
15. Sand Blast:
a. Impellers
b. Sand cap
16. Grit Bast and coat with Tnemec N140:
a. Bowl cases
17. Brush blast and touch up top coat of entire pump as needed
18. Replace upper and lower motor bearing
19. Replace motor heater strip
20. Replace lower bearing cap o-ring
21. Recondition stator
22. Wash and bake motor
Repair Complete: 1/21/21
179114
Shipment 10723 Our Order 179114
Order Qty Ship Qty Part ID/Description
1.00 1.00 4301
Transport, Install and Start Up HSP #1
Item of two (2) servicemen to install High Service Pump #1 and motor,
perform start-up, and verify proper operation.
Invoice No. 1000833
Page 2 of 3
Your Order 22100262-001
Rev U/M Unit Price Extended Price
0 EA 28,548.00 $28,548.00
Your Order 22100262-001
Rev U/M Unit Price Extended Price
0 EA 5,792.00 $5,792.00
Continued over .../
9�
Smith Pump Company, Inc.
301 MB Industrial Blvd
Waco, TX 76712 US
Phone: 800-299-8909
Fax: 254-776-0023
www.smithi)umi).com
Servicemen to record flow, head, power, voltage, current, and vibration.
Ingersoll -Dresser (Flowserve) 16NKL-4, with 400HP VHS
PRICE INCLUDES:
1. Labor for two (2) servicemen
2. Mileage to and from job site
3. Per diems
4. Crane charges
First Install Trip (Discovered Flange Not Level): 2/3/21
Final Install and Start -Up Date: 3/9/21
Shipment 10723 Our Order 179114
Order Qty Ship Qty Part ID/Description
1.00 1.00 4012
Perform Barrel Top Flange Level Inspection
Service to Perform Machining and Level of Barrel Top - HSP #1
On trip to install pump on 2/4, we discovered barrel flange was 0.180"
out of level in 900 direction over the span of 26". It was determined
necessary to level the barrel flange. The barrel is plumb to within 0.031"
over a 15 foot depth.
Invoice No. 1000833
Your Order 22100262-001
Rev U/M
0 EA
Includes:
• Level barrel flange by machining off raised face plus enough material to finish to
250 RMS the entire face to the OD of the flange. Minor surface pitting is acceptable.
Finished level to be 0.002" per foot or better.
• SPCO personnel to help vendor unload equipment and verify machining on final day
• Travel to jobsite
***Discounted $3,131 from quote based on actual time for machining.***
Machining Complete: 3/5/21
Shipment 10723 Our Order 179114 Your Order 22100262-001
Unit Price
11,354.00
Page 3 of 3
Extended Price
$11,354.00
Invoice Sub -total $53,537.00
Freight $0.00
Tax $0.00
Invoice Total $53,537.00