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Item 4H CITY OF SOUTHLAKE MEMORANDUM February 2, 2016 To: Shana Yelverton, City Manager From: Sharen Jackson, Chief Financial Officer Timothy Slifka, Purchasing Manager Subject: Item 4H Authorize Contract Renewal with Blagg Tire and Service for City of Southlake preventative maintenance and general repair services for light and medium vehicles Action Requested: Authorize contract renewal for preventative maintenance and general repair services for City light and medium duty vehicles. Background Information: The City Council approved the original contract with Blagg Tire and Service on February 21, 2012. The original contract allows four (4), one-year contract renewals at the City's option. This is the fourth and final renewal. This contract provides preventative maintenance and general repair services for light and medium duty vehicles for the City. No increase in pricing is requested at this renewal. Financial Considerations: Costs for City of Southlake preventative maintenance and general repair services are funded through budgeted department maintenance accounts. In FY 14-15 total expenditures with the vendor was $152,740. Strategic Link: C1 —Achieve the highest standards of safety and security. B2 — Collaborate with select partners to implement service solutions. F2 — Invest to provide and maintain high quality public assets Citizen Input/ Board Review: None Legal Review: Attorney reviewed original bid documents as to form Alternatives: Deny and re-bid preventative maintenance services Supporting Documents: Current contract with Blagg Tire and Service Staff Recommendation: Approve the renewal of this contract for preventative maintenance and general repair services with Blagg Tire and Service. Crnr OF SOLMH AKE December 31,2015 Blagg Tire&Service 604 Main Street Grapevine,Texas 76051 Attn: Mr.Perry Leonard Subject: Notification of Contract Extension for Preventative Maintenance and General Repair Services for City of Southlake Vehicles RFP1107B200TS110018 Mr.Leonard: The City of Southlake is providing notification of contract extension, pending City Council approval, for Preventative Maintenance and General Repair Services for City of Southlake Vehicles RFP1107B200TS110018, copy included. This extension shall become effective February 21, 2016 and after City Council approval (CC Award date and shall continue in full force based on the terms and conditions of the initial award. As a condition of contract renewal a price adjustment may be requested by the vendor and considered by the City. Your company has indicated no increase shall be requested at this renewal. As such, all current pricing, terms and conditions shall remain in effect during the term of this renewal. The terms and conditions proposed and accepted in this renewal agreement are as follows: Line Items Awarded: Line Items Awarded: 1,2,3,4, 5,6,7, 8,9, 10, 14, 15, 16, 18, 19,20,22,23,24,33,34,35,36,37,38,39, 40,41 Payment Terms: Net 30 days(Unless otherwise noted-such as pre-and/or partial payment) Method of Payment: Shall be made by purchasing card or purchase order. Delivery Terms: FOB Destination Delivery Locations: IF STATED IN RFB DOCUMENT Term of Contract: Shall be effective for twelve months from date of renewal City Contact: TIM SLIFKA 817-748-8312 Send all billing to: City of Southlake 1400 Main Street,Suite 440,Accounts Payable Southlake,TX 76092 or Email:accountspavablekci.southlake.tx.us Other Charges: The City of Southlake is a tax exempt municipal corporation and is exempt from all federal, state, and local sales taxes. All other specifications, terms and conditions shall be as provided in the original procurement documents. No other attachments to or in response to this agreement will be accepted unless approved in writing by the Purchasing Manager or an authorized representative of the City of Southlake. Thank you for participating in our procurement process. Please call 817-748-8312 with any questions. Sincerely, Tim Slifka Purchasing Manager CPPD,CPPB City of Southlake 1400 Main Street,Suite 440 Southlake,Texas 76092 tslifka(a ci.southlake.tx.us Attest: Fax:817-748-8048 Lori Payne,TRMC Contract and Award Accepted: City Secretary Signed: Date: Approved as to Form and Legality: Mayor Laura Hill City of Southlake City Attorney 12/21/2015 Ci.southlake.tx.us Mail-PM Services Contract Renewal 19[.QTY OF SOUTHILAKE Timothy Slifka <tslifka@ci.southlake.tx.us> PM Services Contract Renewal 4 messages Timothy Slifka <tslifka@ci.southlake.tx.us> Thu, Dec 17, 2015 at 6:36 AM To: Scott South <scott@blaggtire.com>, Perry Leonard <pleonard@carconceptsinc.com> Good afternoon Perry and Scott. It is time to get started on the upcoming final contract renewal. have attached the pricing sheet for you to complete and return to me with your requested increases. Per your original submission documents you may request up to a 4% increase to be considered by our City Council. Please complete and return the updated sheet to me by January 6th, 2016 so I may complete my presentation to Council on February 2, 2016. If pricing is to remain the same please respond with "No Increase Requested" and I will start the renewal process. Please let me know if you have any questions. Tim Timothy Slifka CPPD, CPPB Purchasing Manager City of Southlake 1400 Main Street Suite 440 Southlake, Texas 76092 817-748-8312 817-748-8048 Fax tslifka@ci.southlake.tx.us www.cityofsouthiake.com Please take a few moments and click on the appropriate link below to complete our Purchasing Department Survey. Your answers will help us to continually improve our services. City Staff Survey and Internal Bid Survey Vendor Survey IKI BLAGG TIRE Contract Renewal Pricing Sheet 12-15-2015.xis 50K Scott South <scott@blaggtire.com> Thu, Dec 17, 2015 at 6:41 AM To: tslifka@ci.southlake.tx.us Your message To: Scott South; Perry Leonard Subject: PM Services Contract Renewal Sent: 12/17/2015 6:36 AM https://m ail.google.com/m ai I/u/0/?ui=2&i k=1 dc9780fd9&view=pt&search=i nbox&th=151 affOf9d 16bb2d&si m l=151 affOf9dl6bb2d&si m l=151 b1 b907abl6663&si m I... 1/3 12/21/2015 Ci.southlake.tx.us Mail-PM Services Contract Renewal was read on 12/17/2015 6:40 AM. Scott South <scott@blaggtire.com> Thu, Dec 17, 2015 at 2:54 PM To: Timothy Slifka <tslifka@ci.southlake.tx.us>, Perry Leonard <pleonard@carconceptsinc.com> Ti m, No increase requested. Thank you for your business! Scott South General Manager 817.538.3840 cell i From: Timothy Slifka [mailto:tslifka@ci.southlake.tx.us] Sent: Thursday, December 17, 2015 6:36 AM To: Scott South; Perry Leonard Subject: PM Services Contract Renewal Good afternoon Perry and Scott. [Quoted text hidden] [Quoted text hidden] tslifka@ci.southlake.tx.us <tslifka@ci.southlake.tx.us> Thu, Dec 17, 2015 at 3:03 PM To: Scott South <scott@blaggtire.com> Cc: Perry Leonard <pleonard@carconceptsinc.com> Scott, https://m ail.google.com/m ai I/u/0/?ui=2&i k=1 dc9780fd9&view=pt&search=i nbox&th=151 affOf9d 16bb2d&si m l=151 affOf9dl6bb2d&si m l=151 b1 b9O7abl6663&si m I... 2/3 12/21/2015 Ci.southlake.tx.us Mail-PM Services Contract Renewal Excellent news! I'll get you the renewal once it goes to Council in Feb! Tim Sent from my Phone [Quoted text hidden] https://m ail.google.com/m ai I/u/0/?ui=2&i k=1 dc9780fd9&view=pt&search=i nbox&th=151 affOf9d 16bb2d&si m l=151 affOf9dl6bb2d&si m l=151 b1 b9O7abl6663&si m I... 3/3 ORIGINAL DOCUMENT fx{L.aE CITY OF SOUTH�KE S�OLITT---ILAAIt.E J Council Actio Y Ord./Res. No. Date Approved �1j January 13,2015 Blagg Tire&Service 604 Main Street Grapevine,Texas 76051 Atm: Mr.Perry Leonard Subject: Notification of Contract Extension for Preventative Maintenance and General Repair Services for City of Southlake Vehicles RFP1107B200TS110018 Dear: Mr.Leonard: The City of Southlake is providing notification of contract extension, pending City Council approval, for Preventative Maintenance and General Repair Services for City of Southlake Vehicles RFP1107B200TS110018, copy included. This extension shall become effective February 21, 2015 and after City Council approval (CC Award date !- - �� and shall continue in full force based on the terms and conditions of the initial award. As a condition of contract renewal a price adjustment may be requested by the vendor and considered by the City. Your company has indicated no increase shall be requested at this renewal. As such, all current pricing, terms and conditions shall remain in effect during the term of this renewal. The terms and conditions proposed and accepted in this renewal agreement are as follows: Line Items Awarded: Line Items Awarded: 1,2,3,4,5,6,7,8,9, 10, 14, 15, 16, 18, 19,20,22,23.24,33,34,35,36,37,38,39, 40.41 Payment Terms: Net 30 days(Unless otherwise noted-such as pre-and/or partial payment) Method of Payment: Shall be made by purchasing card or purchase order. Delivery Terms: FOB Destination Delivery Locations: IF STATED IN RFB DOCUMENT Term of Contract: Shall be effective for twelve months from date of renewal and is eligible for up to one(1)more one (1)year annual renewal. City Contact: TIM SLIFKA 817-748-8312 Send all billing to: City of Southlake 1400 Main Street,Suite 440,Accounts Payable Southlake,TX 76092 or Email:accountslayablea_ci.south lake.tx.us Other Charges: The City of Southlake is a tax exempt municipal corporation and is exempt from all federal, state, and local sales taxes. All other specifications, terms and conditions shall be as provided in the original procurement documents. No other attachments to or in response to this agreement will be accepted unless approved in writing by the Purchasing Manager or an authorized representative of the City of Southlake. Thank you for participating in our procurement process. Please call 817-748-8312 with any questions. Sincerely,� Tim Slifka Purchasing Manager CPPO,CPPB 5°°.••••••q• City of Southlake ? p a° • 1400 Main Street,Suite 440 => • X Southlake,Texas 76092 " % °b tslifka(a)ci.southlake.tx.us Attest: a e0 �.• ' Fax: 817-748-8048 °°°.,••.,..•' Lori Payne,TRMC Contract and Award Accepted: City Secretary '0j+neeeee�t�•��,`, Signe Date: -a0/S Approved as to rm a gality: r Mayor John Terrell City of Southlake Cit Attorney 1/13/2015 Ci.southlake.tx.us Mail-Contract Renewal Information ca -��. K� Timothy Slifka <tslifka@ci.southiake.tx.us> Contract Renewal Information Perry Leonard <pleonard@carconceptsinc.com> Tue, Dec 23, 2014 at 1:40 PM To: Timothy Slifka <tslifka@ci.southiake.tx.us>, Scott South <scott@blaggtire.com> Cc: Steve Jordan <sjordan@jordanscarcare.com>, Perry Leonard <pleonard@carconceptsinc.com> Tim: Blagg Tire is confirming the renewal of the subject contract as is with no adjustment in pricing for the next contract period. Please let me know if you have questions. I did not see an opportunity or option to sign so please advise and I will sign the necessary paperwork. Thanks for your help and your business. I appreciate the trust you place in our company. Best regards, Perry Perry Leonard President/COO Blagg Tire&Service Car Concepts,Inc. 817-454-4183 www.carconceptsinc.com Part of the Car Concepts Family of Dealerships From:Timothy Slifka [mailto:tslifka@ci.southlake.tx.us] Sent:Tuesday, December 16, 20141:57 PM To: Perry Leonard; Scott South Subject: Contract Renewal Information Good afternoon Perry and Scott. [Quoted text hidden] https://mail.google.com/mail/u/0/?ui=2&ik=ldc97Wd9&view=pt&as from=pleonard%4Ocarconceptsinc.com&as sizeoperator=s_sl&as sizeunit=s smb&as_s... 1/2 Cnyor ORIGINAL DOCUMENT SCXITHLAiCE CITY�F SOUTHLAKE Council Action N Ord./Res. No. Date Approved Iq November 26,2013 Blagg Tire&Service 604 Main Street Grapevine,Texas 76051 Attn: Mr.Perry Leonard Subject: Notification of Contract Extension for Provide Preventative Maintenance and General Repair Services for City of Southlake Vehicles RFP 1107B200TS110018 Dear: Mr.Leonard: The City of Southlake is providing notification of contract extension,pending City Council approval,for Provide Preventative Maintenance and General Repair Services for City of Southlake Vehicles RFP I107B200TS110018, copy included for Fiscal Year 2013-2014. This extension shall become effective February 21, 2014 and after City Council approval (CC Award date (Z-L -tot____g and shall continue in full force based on the terms and conditions of the initial award.Additionally as a condition of contract renewal a price adjustment may be requested by the vendor and considered by the City. Price adjustments may only occur at the time of renewal and only upon securing the approval of the City in writing.Requests for price adjustments must be solely for the purpose of accommodating an increase in the vendor's cost, not profit. Your company has not requested an increase at this renewal. The terms and conditions proposed and accepted in this renewal agreement are as follows: Line Items Awarded: Line Items Awarded: 1,2,3,4,5,6,7,8,9, 10, 14, 15, 16, 18, 19,20,33,34,35,36,37,38,39,40,41 Payment Terms: Net 30 days(Unless otherwise noted-such as pre-and/or partial payment) Method of Payment: Shall be made by purchasing card or purchase order. Delivery Terms: FOB Destination Delivery Locations: IF STATED IN RFB DOCUMENT Term of Contract: Shall be effective for twelve months from date of renewal and is eligible for up to two(2)more one (1)year annual renewals. City Contact: TIM SLIFKA 817-748-8312 Send all billing to: City of Southlake 1400 Main Street,Suite 440,Accounts Payable Southlake,TX 76092 or Email:accountspgyable@ci.southlake.tx.us Other Charges: The City of Southlake is a tax exempt municipal corporation and is exempt from all federal, state, and local sales taxes. All other specifications, terms and conditions shall be as provided in the original procurement documents. No other attachments to or in response to this agreement will be accepted unless approved in writing by the Purchasing Manager or an authorized representative of the City of Southlake. Thank you for participating in our procurement process. Please call 817-748-8312 with any questions. Sincerely, Tim Slifka Purchasing Manager PO,CPPB o�°� vWo TH �� City of Southlake ��•`a(a•''N AA 1400 Main Street, Suite 440 Southlake,Texas 76092 p + tslifkaAci.southlake.tx.us Attest. Fax:817-748-8048 Alicia Richardson,TRMC Contract and Award Accepted: City Secretary Signed: Date: 12-'-t R-2,013 Approvedas to Foorrm�and Legal' : Mayor John Terrell City of Southlake City Attome Jul 031309:29a Blagg Tire&Service 817-481-2366 p.1 ORIGINAL DOCUMFENT CITY OF SOUTHLAKE SOUTi�`LAK Council Action: Y 0 OrdJRes. No.�. Date Approved 1 J Lily 2,2013 Mr. Perry Leonard Nagg Tire and Service 604 Main Street Grapevine, Toxas 76051 Subject: Contract Amendment# 1 for"Provide Preventative Maintenance and General Repair Services for City of Southlake Vehicles RFP1 1078200T S1 10016" Dear Mr.Leonard: The City of Southlake contract for Provide Preventative Maintenance and General Repair Services for City of Southlake Vehicles RFP110713200TS110018 requests the following additions: 1. The addition of preventative maintenance and repair services for line items 22,23 and 24. 2, A reduction in cost of line item 41 to a cost of nineteen dollars and seventy five cents ($99.75) per round trip. t Sharen JacNn n Chief Financial' Office , ity of Southlake E By signing the amendment, vendor is acknowledging and agreeing to the additions made to the terms and conditions as stated in the existing contract.Vendor must acknowledge receipt of this amendment by signing both copies and returning one signed original amendment to: City of Southlake Finance Department 1400 Main Street Suite 440 Southlake,Texas 76092 AttentlDn Tim Slifka. Signed.* Printed Name: Title: � 1r� C7 / t`C�CJ Company Name: r3C1►C} r�i`zC ` Curr Dated: 3 t:J Please-call-817-74"312 with any questions. �s�TEST °pv,�H. kF°'•,1 to Sincerely, _ • Alicia Richardson,TRM4 --z Tim Slifka C4PO City Secretary 'J •: � PPB "' ��• '� Purchasing Manager �''4 **i,1.1.10 i r i ORIGINAL DOCUMENT < QF SOUTHLAKE �.Ti1-llAK€ C �fN Ord./Res. No.Cowcil Actio 19 Date Approved January 29,2013 Blagg Tire&Service 604 Main Street Grapevine,Texas 76051 Attn: Mr.Perry Leonard Subject: Option to Extend Notification for RFP1107B200TS110018 Provide Preventative Maintenance and General Repair Services for City of Southlake Vehicles Dear: Mr.Leonard: The City of Southlake is providing notification they intend to extend the contract, pending City Council approval, resulting from your "RFP1107B200TS110018 Provide Preventative Maintenance and General Repair Services for City of Southlake Vehicles",copy included for Fiscal Year 2013.This extension shall become effective February 21,2013 and after City Council approval(CC Award date A-5•(3 )and shall continue in full force based on the terms and conditions of the initial award. Additionally as a condition of contract renewal a price adjustment may be requested by the vendor and considered by the City. In support of a price adjustment,vendor may submit documentation as to the need of the price adjustment. Requests for price adjustments may only occur at the time of renewal and only upon securing the approval of the City in writing. Requests for price adjustments must be solely for the purpose of accommodating an increase in the vendor's cost,not profit.Your company has not requested an increase at this renewal. The terms and conditions proposed and accepted in this renewal agreement are as follows: Line Items Awarded: Line Items Awarded: 1,2,3,4,5,6,7,8,9,10,145 15, 16,18,19,20,33,34,35,36,37,38,39,40,41 Payment Terms: Net 30 days(Unless otherwise noted-such as pre-and/or partial payment) Method of Payment: Shall be made by purchasing card or purchase order. Delivery Terms: FOB Destination Delivery Locations: IF STATED IN RFB DOCUMENT Term of Contract: Shall be effective for twelve months from date of renewal and is eligible for up to three(3)more one(1)year annual renewals. City Contact: TIM SLIFKA 817-748-8312 Send all billing to: City of Southlake 1400 Main Street,Suite 440,Accounts Payable Southlake,TX 76092 or Email:accountspUvable@ci.soutfilake.tx.us Other Charges: The City of Southlake is a tax exempt municipal corporation and is exempt from all federal, state, and local sales taxes. All other specifications, terms and conditions shall be as provided in the original procurement documents. No other attachments to or in response to this agreement will be accepted unless approved in writing by the Purchasing Manager or an authorized representative of the City of Southlake. Thank you for participating in our procurement process. Please call 817-748-8312 with any questions. Sincerely Tim Slifka °°.•`'vSH•LAKF!•,,� Purchasing Manager,CPPB / �0•.• «• '�, City of Southlake k :' '•� 1400 Main Street,Suite 440 = 0: Southlake,Texas 76092 } tslitka'a%.ci.southlake.tx.us Attest: lam/ •.° Phone:817-748-8312 Fax:817-748-8048 Alicia Richardson,TfN1 , Contrac d ted: ^^ City Secretary �'`"��o�°"�� Signed: ate: ca-S- f' Approved as toForm and Legali Mayor John Terre City of Southlake City Attorney ORIGINAL DOCUMENT CITY OF aCSU i HLAKE C.ffY OF Council Action: YQ/N Ord./Res. No. SOUIJ-U_AICEDate Approved 19 February 15, 2012 Blagg Tire&Service 604 Main Street Grapevine,Texas 76051 Attn: Mr. Pert'Leonard Subject: RFP1107B200TS110018 Provide Preventative Maintenance and General Repair Services for City of Southlake Vehicles Dear Mr. Leonard: The City of Southlake is pleased to inform you that Blagg Tire&Service of Grapevine Texas is one of three (3)vendors being awarded "RFP1107B200TS110018 Provide Preventative Maintenance and General Repair Services for City of Southlake Vehicles". The award and this agreement are based on your proposal to the City RFP1107B200TS110018, copy enclosed.This is a multiple vendor award contract.Your company's portion of the award is attached.This award was approved by the City of Southlake City Council on •ala la The terms and conditions proposed and accepted in this agreement are as follows: Line Items Awarded Line Items Awarded: 1,2,3,4,5,6,7,8,9, 10, 14, 15, 16, 18, 19,20,33,34,35,36,37,38,39,40,41 Payment Terms: Net 30 days(Unless otherwise noted-such as pre-and/or partial payment) Estimated Quantities: The City does not guarantee to purchase any minimum or maximum quantity but does contemplate purchasing the awarded items exclusively during the term of the contract from the successful vendors. Method of Payment: Shall be made by City procurement card or purchase order Delivery Terms: FOB Destination Delivery Locations: Vendor Delivery or City employee pick-up. Term of Contract: The term of awarded contract shall remain in effect for twelve months from date of award and is eligible for up to four(4)one(1)year annual renewals. City Contact: TIM SLIFKA 817-748-8312 Send all billing to: City of Southlake 1400 Main Street,Suite 440,Accounts Payable Southlake,TX 76092 or via email to accountspavable(a)ci.southlake.tx.us Other Charges: The City of Southlake is a tax exempt municipal corporation and is exempt from all federal,state,and local sales taxes. All other specifications,terms and conditions shall be as provided in the original procurement documents. No other attachments to or in response to this agreement will be accepted unless approved in writing by the Purchasing Manager or an authorized representative of the City of Southlake. Thank you for participating in our procurement process. Please call 817-748-8312 with any questions. Sincerely, Tim Slifka y Purchasing Manager,CPPB City of Southlake 1400 Main Street,Suite 440 Southlake,Texas 76092 tslifka(a.ci.south Iake.tx.us Phone:817-748-8312 Fax:817-748-8048 Contra 7"cept SignDate: a.al.la Attest: ho&496 row Mayor John Te ell linia Richardso City of Southlake 6+tYSeeFet&Fy- r34 1400 Main Street,Suite 440 Southlake,Texas 76092 !� i Appendix B —Proposal Submittal Checklist: (To determine validity of prop) XX Appendix B(pages 11_dirou0 22,mst be included In the proposal submittal XX Appeodiz C Could of Interest Fars(page_22,asnst be included In the proposal sabmittaL RFP1107B200TS110018 1012lPPBI4=pOEEe] z 02 Eoo�oG-= ;Pnoe�; �� °a� PROVIDE PREVENTATIVE MAINTENANCE AND .P9 ^L99,•�9ael. a®iNnC[NI!°r:=�?eI:Y� BLE Q4unEyiati�n�EEiUM,pin�a6;E¢lia-.•�lea�iv.�'.SI .Penlei'inNN Fl�!11.1 snpeusl�fi 6 ; ;mEN»c-s..N GENERAL REPAIR SERVICES FOR CITY OF - ,� u,; r�tl; _—AKE VEffiC :;: c�aSESneaalen spec=' = H.VH �a .P :9LaPF.:nee Ca sou rE i, LES H-wn NNAMIM NO, g.2 ann -m a 3:00 P.M. (CST),FRIDAY JANUARY 20 2012 ;: 0- ==11��__erg�;;ocgggggal assn ! City Secretary's Office �!g :�tleg64 1400 Main Street, Suite 270 S:Pacaca:;s:s- EMU `vFn'aas•:•a"ne"unEneep°ec�•eeveTxpen!z��veWsLg:n�., °n =� y' , a= = e - ; Sontlilake, TX 76092 �R.M.am4a�aalE_,mr 81 748-8016 msm PP,mina_.._..... ,�.$� e.nnzaevers�w•��:�s 1.x4:E°I n eai:ea.2l a e� ..:. I!IF_i_• '}4'rvaa ieRC9aEaie•..eg5aU• 4":ate ••••,• ^,vyv • r sn=Pupae nnr.EFz�._ IFE�3'6dE" �d•L•Wli�i'��9P'wezn@ee�?��9=:,0' � :-� xa =E �.N..a6 ee a I ze' _� - 'x:enee�ev�ekSs`u'-��o-c-nn®cE�2E�^wan.u- a:Y98c'tl'_ _ _ _ wBIa99 Tire&Service x 604 S Main Street a^=26FEz'mP°"j;Pz�n:z;;_A;E E15;NE G `'_ Grapevine,Texas 76051 ix °a 3�e it 1 nh _ i'jii°;75-1458621 ;q;s9 JNNM 4,g ip F ai b �`'817-481-4578 817-481-2366 - a" A.M. �-�,E�e�.�:yy=�9P:yP�6�6��,�."�n'''`,n�''a� � rA rnceptsinc coin iuF_ •.Pax sae•:;,;:=::aaa=; al-aa "ronaaer .,bras, n.ee noema,.•, a .. k nka. avuga�uaeazuerx] q o4Pal - A a s ° ® 2 .�� ¢ a 6 ew t e .aa-E_ee.. x a NP. '�=:••: Ega�� .�e. P::as Fz:c.A-' � _.._._ m.o:annraa- a...�� n. •� �' 6av ei1I- � 'e�s�� €P TCi:IB P�LiOm• •.• _ 4 zln ¢case EzacFa en eiFevev =n 4� : - 1. n •• d: ail.129.n E n. L v n a•a�= .Ci ue3 e. .a i ION gg�III gp¢�� g6r EY � G 6 6N9� maki W. Now °uoa�.we'�2a ee reuree r•.m� _. -... -aLs.aav e0e�..z..rv-...,,,..Ns a..1... .ruataPe� -...� $e- q 1" o-a -F= I learned of this Request for Proposals by the following means: ❑ Newspaper Advertisement ❑ City E-r=1 Notification ❑ Southlake Website ❑ Cold Call to City ❑ Mailed Me a Copy IN Other (fi r Vtzo e, City of Soathlake - RF71107BZWTS110018 - Page 11 of 23 Appendix B—Proposal(eoodaved) L REOUIRED PROPOSAL INFORMATION. IN ORDER FOR A PROPOSAL TO BE CONSIDERED COMPLETE,AND TO BE EVALUATED FOR A CONTRACT AWARD BY TEE CITY,PROPOSER MUST SUBMIT ALL OF THE FOLLOWING INFORMATION: 1. Proposed Products and/or Services A. Product or Service Description: Proposers should utilize this section to describe the technical aspects, capabilities, features and options of the product and/or service proposed in accordance with the required Scope of Services as ident6ed in Appendix A. Promotional literature, brochures,or other technical information may be used. B. Additional Hardware Descriptions: Proposers should also include in this section a detailed description of what additional hardware and/or software, if any, would be required by the City in order to fully utilize the goods and/or services proposed. C. Guarantees and Warranties: Each Proposer shall submit a complete copy of any warranties or guarantees provided by the manufacturer or Proposer with the Proposal submitted D. Project Schedule/Delivery Date: Proposer must provide a project schedule noting all projected completion dates for segments of the Project,from start-up to completion,and all delivery dates for goods covered by the RFP. The Proposal must show the number of days required to deliver and install the product or equipment after the receipt of the City's Purchase Order. 2. Cost of Proposed Products and/or Services A. Pricing: Pricing shall reflect the full Scope of Services defined herein,inclusive of all associated cost for delivery,labor,insurance,taxes,overhead,and profit B. Schedule of Pricing: Proposer shall quote unit pricing in accordance with the itemized listing of products or contract segments stated in the Scope of Services and using the following format: 1. Ford F-150 Series Vehicle Unleaded Fuel 2WD Per Svc PM Level A per Scope of Services S38.50 Per Svc PM Level C per Scope of Services $ 145.00 2. Ford F-150 Series Vehicle Unleaded Fuel 4WD Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 145.00 3. Ford F-250 Series Vehicle Unleaded Fuel 2WD Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 165.00 4. Ford F-250 Series Vehicle Unleaded Fuel 4WD Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 165.00 5. Ford F-250 Series Vehicle Diesel Fuel 2WD Per Svc PM Level A per Scope of Services $ 95.00 Per Svc I PM Level C per Scope of Services $ 384.00 City of Sorthla" - RFP1107B200TS110018 - Page 12 of 23 i I 6. Ford F-250 Series Veldcle Diesel Fuel 4WD Per Svc PM Level A per Scope of Services $ 95•DO Per Svc PM Level C per Scope of Services $ 384.00 7. Ford F-350 Series Vehicle Diesel Fuel 2WD Per Svc PM Level A per Scope of Services $ 95.00 Per Svc PM Level C per Scope of Services S384.00 8. Ford F-350 Series Vehkle Diesel Fuel 4WD i Per Svc PM Level A per Scope of Services $ 95.00 Per Svc PM Level C per Scope of Services $ 395.00 9. Ford F450 Series Vehicle Diesel Fuel 2WD Per Svc PM Level A per Scope of Services $ 135.00 Per Svc PM Level C per Scope of Services $ 424.00 j 10. Ford F450 Series Vehicle Diesel Fuel 4WD Per Svc PM Level A per Scope of Services $ 135.00 Per Svc PM Level C per Scope of Services $ 424.00 11. Ford F-550 Series Vehicle Diesel Fuel Per Svc PM Level A per Scope of Services $ 135.00 Per Svc PM Level C per SoW of Services $ 424.00 12. Ford F-650 Series Diesel Fuel Per Svc PM Level A per Scope of Services $ NA Per Svc PM Level C per Scope of Services $ NA 13. Ford F-750 Series Vehicle Diesel Fuel Per Svc PM Level A per Scope of Services $ NA Per Svc PM Level C per Scope of Services $ NA 14. Ford Freestar Mini-Van Unleaded Fuel Per Svc PM Level A per LOZ of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 145.00 15. Ford Esmpe Unleaded Fuel 2WD Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 158.00 16. Ford Escape Unleaded Fuel OM Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 158.00 17. Ford Escape Hybrid Unleaded Fuel Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 158.00 City of SoutWake - RFP1107B200TS110018 - Page 13 of 23 i M Ford Explorer Unleaded Fuel 2WD Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services S135.00 19. Ford Explorer Unleaded Fuel 4WD Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 135.00 Ford E-150 through E-350 Series Van Unleaded 20. 1 Fuel Per Svc PM Level A per Scopc of Services $ 38.30 Per Svc PM Level C per Scope of Services $ 165.00 21. Ford E-350 Series Van Chassis Diesel Fuel Per Svc PM Level A per Scope of Services $ 95.00 Per Svc PM Level C per Scope of Services $ 384.00 22. Dodge Chmrger Police Vehicle Unleaded Fuel Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 135.00 23. Dodge um Police Vehicle Unleaded Fuel Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 135.00 24. Chevrolet Tahoe Police Version Unleaded Fuel Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 155.00 25. Chevrolet Tahoe 4x4 Unleaded Fuel Per Svc PM Level A per Scopc of Services $ 38.50 Per Svc PM Level C per Scope of Services S 155.00 26. Chevrolet 23 Passenger Bas Unleaded Fuel Per Svc PM Level A per Scope of Services $ 60.00 Per Svc PM Level C per Scope of Services $ 195.00 27. GMC TC6C042 Diesel Fuel Per Svc PM Level A per Scope of Services $ NA Per Svc PM Level C per Scope of Services S NA 2& GMC C7500 Series Diesel Fael Per Svc PM Level A per Scope of Services S NA Per Svc PM Level C per Scope of Services S NA City of Southiake - RFP1107B200TS110018 - Page 14 of 23 29. International Track 4400 Series Diesel Fuel Per Svc PM Level A per Scope of Services $ NA Per Svc PM Level C per Scope of Services $ NA 30. International Track 7400 Series Diesel Fuel Per Svc PM Level A per Scope of Services S NA Per Svc PM Level C per Scope of Services $ NA 31. Peterbilt 357 Series Dump Truck Diesel Fuel Per Svc PM Level A per Scope of Services $ NA Per Svc PM Level C per Scope of Services $ NA 32. Toyota Camry Hybrid Unleaded Fuel Per Svc PM Level A per Scope of Services $ 38.50 Per Svc PM Level C per Scope of Services $ 175.00 ADDITIONAL SERVICES Small Engine Powered Unit PM Services as 33. Required This shall include labor costs only.Parts and supplies Per Svc shall be additional cost item based on parts and $49.50 supplies cost rate listed below. Labor Only 34. Electric Crane PM Services This shall include labor costs only.Parts and supplies Per Svc shall be additional cost item based on parts and $49.50 supplies cost rate listed below. Labor Only 35. Ho Labor Rate for`O$-Site' General Repairs Per Hr Hourly labor rate at vendors location $ Per Hr After Hours Hourly Labor Rate for `Off-Site' 36. General Repairs Per Hr After Hours hourly labor rate at vendors location $ �4 Per Hr Hourly Labor Rate for General Repairs 37. Performed`On-Site' at City Location Per Hr 1 Hourly labor rate at City location $� Per Hr Labor Rate for General Repairs at City Location Negotiated to $79.00 per hr. City of Southlakeh - RFP1107B200TS110018 - Page 15 of 23 i After Hours Hourly Labor Rate for General 38. Repairs Performed`On-Site' at City Location Per Hr After Hours hourly labor rate at City location $ «� Sa Per Hr Parts and Supplies Cost for General Fleet List Price Minns Repairs.List Price Minus Percentage.List- °/. _ %0 Discount 39. Discount Parts and Supplies Cost for PM Services for Small List Price Nanus Engine and Electric Crane Units.List Price Minus _ %0 Discount 40. Percentage,List-%Discount Vendor Vehicle Pick Up and Drop Off Fee Per Rnd. Vehicle Pick Up and Drop Off Fee for City Vehicles 39.50 41. Trip Per Round Trip $ Other Vendor Charges.Please Describe. 42. Per Svc $ Other Vendor Charges.Please Describe. 43. Per Svc $ XA Other Vendor Charges.Please Describe. 44. Per Svc $ Xtd Other Vendor Charges.Please Describe. 45. Per Svc $ AM City of Sonthhdw - RFP1107B200TS110018 - Page 16 of 23 i I 3. Term of Contract and Option to Extend Any contract resulting from this RFP shall be effective for twelve months from date of award. The City anticipates that contract shall be renewed pursuant to the availability of fiords and at the discretion of the City. The following clauses shall be included in the contract: A. Option Clause:It is agreed that City will have the option to extend the contract for up to four(4) additional years, in one-year intervals. To exercise this option,the City shall serve notice 30 days prior to contract termination or to the end of any one-year extension.The Option to Extend will not be considered if fimding is unavailable or if the contractor's past performance is not within the industry standard. B. Escalation Clause: Should market conditions prevail which dictate an increase, the successful contractor may submit documentation requesting permission to increase pricing no later than 30 days after receiving notice from the City of its intent to extend the agreement.Escalation may only occur at the time of renewal and only upon securing the approval of the City in writing.Requests for price adjustments must be solely for the purpose of accommodating an increase in the contractor's cost,not profits. Vendors shall show in this quote their anticipated percent of escalation if/when the option to extend is exercised. The percent quoted will be a maximum. In addition,the percentage proposed will be a factor in determining the best value to the City. It is the average price over the period of the contract that will be the price factor considered in the evaluation of this quote.Quotes in which negative or no escalation is shown will be considered as 0%escalation. C. Price Increases Upon Extension: If approved by the City, the Contractor shall modify the rates charged by the Contractor to reflect any changes shown in the comparative statement delivered to the City. The maximum increase allowed under this provision shall be four percent(41/o)per year. The City shall have authority,in its reasonable discretion,to determine the validity of any change in Contractor's rates.City cannot exercise the Option to Extend with any price increases unless the Vendor completes the section of the Quote requesting anticipated percentage of annual escalation. FIRST ADDITIONAL YEAR(FY 12-13)ESCALATION........................... 4 % SECOND ADDITIONAL YEAR(FY 13-14)ESCALATION....................... 4 % THIRD ADDITIONAL YEAR(FY 14-15)ESCALATION......................... 4 % FOURTH ADDITIONAL YEAR(FY 15-16)ESCALATION......................... 4 % 4. Proposer's Experience/Staff A. Project Team Identify all members of the Proposer's team (including both team members and management)who will be providing any services proposed and include information which details their experience. B. Removal or Replacement of Staff:If an assigned staff person must be removed or replaced for any reason,the replacement person must be approved by City prior to joining the project. C. Business Establishment: State the number of years the Proposer's business has been established and operating. If Proposer's business has changed names or if the principals operating the business operate any similar businesses under different names, or have operated any other businesses or changed the legal status or form of the business within the last five (5) years, all names, of predecessor business names, affiliated entities, and previous business entities operated by the principals,if different than present,must be provided; City of Southlake - RM107B200TS110018 - Page 17 of 23 i State the number of years experience the business has: 25 ; and the number of employees: 24 D. Project Related Experience: All Proposals must include detailed information that details the Proposer's experience and expertise in providing the requested services that demonstrates the Proposer's ability to logically plan and complete the requested project. 5. References Proposer shall provide four(4)references where Proposer has performed similar to or the same types of services as described herein. Reference#1: Client/Company Name:Sage Parts-DFW Airport Contact Name: Contact Title- Billy Butel-Branch Manager Branch M r Phone: 972-425-4757 EM11 bbutel@sageparts.com Date and Scope of Work Provided: Tires&Service Repair Reference#2: Client/Company Name:Bombardier Transportation-DFW Airport Contact Name: Contact Title: Eduard Po -Maintenance Manager Phone: 972-947-1305 Email: eduard.popa@transport.bombardier.com Date and Scope of Work Provided: Tires and Service Repair Reference#3: Client/Company Name: of Grapevine Contact Name: Contact Title: Mark Irvin-Parts Manager Phone: 817-410-3338 Email: Date and Scope of Work Provided: T'uw and Service Repair Reference#4: Client/Company Name:DFW Airport Contact Name: Contact Title: Hollis Trotter Phone: 972 973 5635 Email: htratter@diwairport.00m Date and Scope of Work Provided: Tires and Service Repair City of Soathlake - RFP1107B200TS110018 - Page 18 of 23 i 6. Trade Secrets and/or Confidential Information Trade Secrets and/or Confidential Information: This proposal_(does) roc (does not)contain trade secrets and/or confidential information. If applicable, describe such trade secrets and confidential information, and the basis for your assertion that such material qualifies for legal protection from disclosure. 7. Federal,State and/or Local Identification Information A. Centralized Master Bidders List registration number: '-7 B. Prime contractor HUB/MWBE registration number: C. An individual Proposer acting as a sole proprietor must also enter the Proposer's Social Security Number. H. CONTRACT TERMS AND CONDITIONS. EXCEPT WHERE PROPOSER MAKES SPECIFIC EXCEPTION RV THE SUBMITTED PROPOSAL,ANY CONTRACT RESULTTNG FROM THIS RFP WILL CONTAIN THE FOLLOWING TERMS AND CONDITTONS� WHICH PROPOSER HEREBY ACgNOWLEDGES, AND TO WHICH PROPOSER AGREES BY SUBMHTTIIVG A PROPOSAL: 1. Delivery of Products and/or Services A. Payment Terms: Unless otherwise specified in the Scope of Services or otherwise agreed to in writing by the City,payment terms for the City are Net 30 days upon receipt of invoice. B. Wain =of Products and Services:All products furnished under this contract shall be warranted to be merchantable and good quality and fit for the purposes intended as described in this Proposal,to the satisfaction of City and in accordance with the specifications, terms, and conditions of the Scope of Services,and all services performed shall be warranted to be of a good and workmanlike quality,in addition to,and not in lieu of,any other express written warranties provided. C. Late Delivery or Performance: If Proposer fails to deliver acceptable goods or services within the timeframes established in the Project Schedule,the City shall be authorized to purchase the goods or services from another source and assess any increase in costs to the defaulting Proposer,who agrees to pay such costs within ten days of invoice. D. Title to Goods and Risk of Loss: For goods to be provided by Proposers hereunder,if any,the title and risk of loss of the goods shall not pass to City until City actually receives, takes possession, and accepts the goods and the installation of such goods,has tested the system,and determined that it is in good and acceptable working order. 2. Miscellaneons A. In ependent Contractor. Proposer agrees that Proposer and Proposer's employees and agents have no employer-employee relationship with City. Proposer agrees that if Proposer is selected and awarded a contract, City shall not be responsible for the Federal Insurance Contribution Act (FICA) payments, Federal or State unemployment taxes, income tax withholding, Workers Compensation Insurance payments, or any other insurance payments, nor will City furnish any medical or retirement benefits or any paid vacation or sick leave. B. Assignments: The rights and duties awarded the successful Proposer shall not be assigned to another without the written consent of the Purchasing Manager. Such consent shall not relieve the assigner of liability in the event of default by the assignee. City of Southlake - RFP1107B200TS110018 - Page 19 of 23 i I C. Liens: Proposer shall indemnify and save harmless the City against any and all liens and encumbrances for all labor,goods,and services which may be provided to the City by Proposer or Proposer's vendor(s), and if the City requests,a proper release of all liens or satisfactory evidence of freedom from liens shall be delivered to the City. D. Gratuities / Bribes: Proposer certifies that no bribes in the form of entertainment, gifts, or otherwise,were offered or given by the successful Proposer, or its agent or representative, to any City officer, employee or elected representative,with respect to this RFP or any contract with the City,and that if any such bribe is found to have been made this shall be grounds for voiding of the contract E. Financial Participation: Proposer certifies that it has not received compensation from the City to participate in preparing the specifications or RFP on which the Proposal is based and acknowledges that this contract may be terminated and/or payment withheld if this certification is inaccurate. F. Required Licenses: Proposer certifies that he holds all licenses required by the State of Texas for a provider of the goods and/or services described by the Scope of Services herein. G. Authority to Submit Proposal and Enter Contract: The person signing on behalf of Proposer certifies that the signer has authority to submit the Proposal on behalf of the Proposer and to bind the Proposer to any resulting contract. II. Compliance with Applicable Law: Proposer agrees that the contract will be subject to, and Proposer will strictly comply with, all applicable federal, state, and local laws, ordinances, rules, and regulations. 3. Financial Responsibility Provisions A. Insurance: The Proposer, consistent with its status as an independent contractor, shall carry, and shall require any of its subcontractors to carry,at least the following insurance in such form, with such companies,and in such amounts(unless otherwise specified)as City may require: i. Worker's Compensation and Employer's Liability insurance, including All States Endorsement, to the extent required by federal law and complying with the laws of the State of Texas; ii. Commercial General Liability insurance, including Blanket Contractual Liability, Broad Form Property Damage, Personal Injury, Completed Operations/Products Liability, Premises Liability, Medical Payments, Interest of Employees as additional insureds, and Broad Form General Liability Endorsements,for at least One Million Dollars($1,000,000) Combined Single Limit Bodily Injury and Property Damage on an occurrence basis; iii. Comprehensive Automobile Liability insurance covering all owned, non-owned or hired automobiles to be used by the Contractor, with coverage for at least One Million Dollars ($1,000,000)Combined Single Limit Bodily Injury and Property Damage. B. Indemnification: Proposer agrees to defend,indemnify and hold harmless the City,all of its officers, Council members,agents and employees from and against all claims,actions,snits, demands, proceedings, costs, damages and liabilities, including reasonable attorneys' fees, court costs and related expenses,arising out of,connected with,or resulting from any acts or omissions of Proposer or any agent,employee,sabcontmetor,or supplier of Proposer in the execution or performance of this contract without regard to whether such persons are under the direction of City agents or employees. City of Southlake - RFP1107B200TS110018 - Page 20 of 23 i Appendix C —Form CIQ VVF0Ri1MAU0NREGARDIIVG VENDOR CONFMCT OFIIVTEXUT QLTF.STIONNAME WHO: A pecsm mat file a ccon9ict of interest questionnaire with the City if dye person has a empioymeat or badness relationship with an officer of the City that rmft in tasable income exceeding 82,500 during the I N twelve month period,or an officer or a member of the omc ces family bas accepted gifts with an aggregate value of more *= 82.50 durmg the previous twelve month period and the person e 1 gages in any of the following ad>ons: 1. oonuacts of seeks to acct for the sale or purchase of property,goods,or services with the City,including any of the following: a. writbea and implied contracts, utrlity purchases, purchase orders, credit card purcbasea and nay purchase of goads and services by the City, b. contracts for the pmshase or sale of real property,personal property imbed g an auction of property; C. tax abatement and ec oma is develo m agreements; 2 submits a bid to cell goods or services,or responds to a request for proposal for services; . 3. enters into negotiations with the City far a contract;or 4. applies for a tax abatement and/or economic development incentive that will result m a contract widt the City. THE FOLLOWING ARE CONSIDERED OMCEBS OF THE CITY: 1. Mayor and(Sty Council Members; 2. City Manager; 3. Board and Commission members appointed by the Mayor or City Council members; 4. Diisctors of 4A and 4B development ompoaations; 5. the emwutiv a directors or manages of 4A and 4B development corpora aw%and 6. Directors of the City of Southidm wbo leave authority to sign conf"on bebtalf of the City. EXCLUSIONS: A questiemnsire statement'need tot be filed if the money paid to a local government officer was a political eonixdl>ation,a gift to a member of the oeacces family from a family member;a contract or purchase of less than S2,SM or a transaction at a pricy and subject W: Pad+r ef3 City of Soafhlake - RFP1107B200TS110018 - Page 21 of 23 i to terms availabk to the public a payment for food,lodgin&traction or i nment;or R transaction subject to rate or fee regulation by a governmcn al entity or agency. WHAT: A person or business that eonuscts with the City or who swh to contract with the City taunt file a "couffict of ntesvot 'quesbonnaire" (FORM W whi& is available online at www dx:s.statie la m and a copy of which is attached to this GGuUfix- The ilaii contains mandatory dlsrlosmrea re g "employment or business relation" with a municipal officer. Officals may be asked to clarify or interpret various portions of the quudon muo. WHEN: The person or business must file: 1. the gtiesticaoaue no later than sevens days atter the date the pe om or business begins contract discuss;am or negodatiom with the nmmic4xdity,or submits as application,nespoods to a request for proposals or blas,comspowknec,or other wrWM related to a potential omtrsct or agreement with the Citr,,and 2. an nodded queakmmm within seem days arta the date of an event that would make a filed quodormaim hicompieto or rose ti., It does not matter if tk submittal of a bid or proposal remits in a contract.'Che statute requh a a vendor to file a FORM CIQ at the firm a proposal is subnAted or negotWoos COMONCOM WHFRE: Tire vendor or poientW vendor mast mail or deliver a completed queafioaoaite to the Finance Department, fire Fianna DWwAmert it mrdred by law to pas(tie AWwoextr m the chy's ia4ernet WOM11r. ENFORCF.IYlEPM Folure to file a goestiotmai m is a class c mia3emcaoor punishable by a fine sot to eseeed 5500. It is an areeption to prosecution*d the perm fUcs a FORM CIQ not later than seven business days after the persar received nation of a violation. NOTE: The City does not have a duty to ensure that a person Em a conflict of interest W'.WOUMWwWAwWkMMXChqW r 76.Anrriro t e7Q-89Z6UA= PW 2 d3 City of Southlake - RFP1107B200TS110018 - Page 22 of 23 i i i CONFLICT OF INTEREST QUESTIONNAIRE FORM CiQ For vendor or other parses dobtp busieeas aft local gwww oso"arr5ly Yette ses fed.d ong"made m aw few h KIL 11,19f, am f,cLog,aeaaler snob. OFFIMUiECOCY Thk im iabaup9ad In acmuJanoa with Ctupter 176.Leval Gommorent Cole oer w.rss byeperw sholoss business,mWonrJipasdaI by9ecflon1xw(1a)wfbalocal goval mmmW am*i w d Fra person awah mq®amcaa ander Sadsere 176D06(a} llylawthkepeaeloraeiaeswlbeHadwilhflearcadeadmlda—offfeloealfwennrmi" Wily not laedrt mtM7*bn kwudayaft tixadaiattnparecubecomesaware affecte fwtragnhethestaflasaaestbobatAad.Sae8aeliaf176A06,Iw lOowarnmanlCode. A parson mnunbs on ofeees f IIx paean btowoQly violalse Section 176.006.Local Gwone inint4oda.An dlerwa anderthis aaown is a Chu C mbdoonsav or. lease orpous"use Yea it enewoos rawoaaelp Oram beat foeemxsod Wft Any SoutWake Staff Member z ® CM*rMbetWPM Sol VJ gwapeYbsraapiaNawlyflkdquwsoaaalrw (tbs ler ragohec that yea fle an updabd competed gaasfoewke%M fee woupTkb UN autlsorfy not tabr than tlr 711 tadneea day afer•the dab fw arIll 1j Ned gasaorenae beow a tnmrnplab or hraalr IL) Mom of bnl soreramaoaker wkl now tsar bea scsphWfmt or buwmae xelafeeshhL Any Southlake Staff Member ME ne a aAcer Thb se loo(sen 3 axdlldkp aulopam; A B.C&0) rant tea osnple>od for each nutter+eke whoa ar ear has an or cGe r busks reIoshk®ddrrd by 8ecfwt t78.0f1(t a1 Loal eava meed Code Atbdr met slow POW to fes F=CM as necwaae L A. le the brat goaewmad dlicar naiad In the—0, mcoL llg or Ihatl b rwala to mb locates,tlherfen htlwsYaert Imam,trod ft mor of we ga genal 7 =Yea K]w B_ Is In serol to moss0mmans reawty or fry bo madva taxable intone,omar tion arveshined income.Yin or lift raleerim d tea bel saraaeslera afoot rrenad b tints eedbn AAD the lauble hmnn k ant seemed ten aw Ioea1 paamaledal erll:Y7 �Yes ®k C. Is Wo fbr of ods qumbmWA awpb wed by a co iarbn or sort eelrreu aft whh moped io eYleh fie local psaraeounit odor arm as ec ofoet or dreraor,or holds an mn mIllp of is peoerst or am? E-1 van ®w . 0.Deems each amplolovart or brwa robbeAlp wdr an local gowimed aver named rn tllb seetla� .�7 O _ January 13,20 r'L SWuh-of t—sea task—WAh ae a ever DO Adop ed OWN= w: tis newt r�.lm6pe me Par 3 of3 Clty of Soethlake - R"1107B200TS110018 - Page 23 of 23 i j Appendix D—No Intent to Submit Form If your firm hos chosen not to submit a proposal for this procurement,please complete this form and szbmit to: City of Southlake Purchasing Division,Department of Finance 1400 Main Street,Suite#440 Southlake,Texas 76092 tsli&&i.southlake.tx.us Please check all items that apply: ❑ Do not sell the item(s)required ❑ Cannot provide Insurance required ❑ Cannot be competitive ❑ Cannot provide Bonding required ❑ Cannot meet specifications highlighted in the attached ❑ Cannot comply with Indemnification request requirement ❑ Job too large ❑ Job too small ❑ Do not wish to do business with the City of Southlake ❑ Other- COMPANY therCOMPANY NAME(Please print): Authorized Officer Name(Please print): Telephone: ( ) Fax: City of SoathWce - RF71107B200TS110018 - Page 24 of 23