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Item 4B MemoItem 4B Page 1 of 2 M E M O R A N D U M (September 1, 2020) To: Shana Yelverton, City Manager From: Rob Cohen, Director of Public Works Subject: Approve a contract renewal for the sanitary sewer and wet well rehabilitation services to Lewis Concrete Restoration (LCR) in an amount not to exceed $60,000. Action Requested: Approve a contract renewal for the sanitary sewer and wet well rehabilitation services to Lewis Concrete Restoration (LCR) in an amount not to exceed $60,000. Background Information: On July 8, 2016, sealed proposals were received from three vendors for sanitary sewer and wet well rehabilitation services. On September 20, 2016, City Council awarded this contract to Lewis Concrete Restoration with four one-year renewal options; this is the fourth and final renewal options. Preventative maintenance of the City’s concrete sewer infrastructure is needed to prevent corrosion within the collection system that could result into costly repairs or replacement. Such preventative maintenance ensures the integrity of concrete sewer components are not compromised from infiltration of ground water and tree root intrusion, and environmental contamination. In the FY 2020 adopted budget, City Council alloca ted funds to complete the rehabilitation of the N-1 sewer trunk main that is shared between the City of Southlake and Town of Westlake. This rehabilitation project consists surface preparation, concrete work and coating of 12 selected manholes along this sewer main segment. As part of interlocal agreement, the Town of Westlake will reimburse the City for 45.8% of the N-1 sewer maintenance expenses associated with this manhole rehabilitation project. Financial Considerations: As part of their contract, LCR is allowed an annual price increase on renewals. Therefore, LCR is requesting a 3% price increase to its items for this period of performance, September 2020 through September 2021. Item 4B Page 2 of 2 Below are the budgeted amounts for each FY 2020 Wastewater Projects. Wastewater Projects Cost N-1 Rehabilitation – Manholes $ 50,000 Various Manhole Rehabilitation $ 10,000 Total $ 60,000 Funding for this agreement is available via the Utility Fund from FY 2020 Wastewater Operating Budget. Expenditures will not exceed budgeted funds. Strategic Link: This item links to the City’s Strategy Map strategic focus areas of Safety & Security and Infrastructure. It specifically relates to the City’s Corporate Objectives, B2: Collaborate With Select Partners To Implement Service Solutions, B5: Enhance Service Delivery Through Continual Process Improvement, and F2: Invest To Provide & Maintain High Quality Public Assets. Citizen Input/ Board Review: None. Legal Review: The City Attorney reviewed original proposal documents as to form. Alternatives: The City Council may approve or deny the contract renewal. Staff Recommendation: Approve a contract renewal for the sanitary sewer and wet well rehabilitation services to Lewis Concrete Restoration (LCR) in an amount not to exceed $60,000. Supporting Documents: Attachment A: Contract extension documents Staff Contact: Rob Cohen, Director of Public Works Jack Thompson, Operations Manager August 20, 2020 Lewis Concrete Restoration Corporation 405 Ware Dr. Buda, Texas 78610 Attn: Ms. Sherry Lewis Subject: Notification of Contract Renewal for Sewer Manhole and Wet Well Rehabilitation Services RFP1606B420JT160016 Dear Ms. Lewis: The City of Southlake is providing notification of contract renewal for “Sewer Manhole and Wet Well Rehabilitation Services RFP1606B420JT160016”. This renewal shall become effective September 20, 2020 pending 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. 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. You have indicated your company will be requesting a three percent (3%) increase at this renewal. This increase has been approved and revised pricing is included with this renewal. All other terms and conditions of the original contract award shall remain in effect for this renewal period. The terms and conditions proposed and accepted in this renewal agreement are as follows: 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: Jack Thompson 817-748-8200 Send all billing to: City of Southlake 1400 Main Street, Suite 420, Accounts Payable Southlake, TX 76092 or Email: accountspayable@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 CPPO, CPPB City of Southlake 1400 Main Street, Suite 420 Southlake, Texas 76092 tslifka@ci.southlake.tx.us Attest: ________________________ Fax: 817-748-8010 Amy Shelley, TRMC City Secretary Contract Renewal Accepted: Signed: ____________________ Date: ______________ Approved as to Form and Legality: Mayor Laura Hill _____________________ City of Southlake City Attorney Attachment A LEWIS CONCRETE RESTORATION 9209 Williamson Rd, Buda, TX 78610 Phone: 512.983.3283 Email: slewis@lewisconcreterestoration.com “A Specialty Restoration & Preservation Company” MWSBE, TX HUB Operating in TX and LA On the Web at: www.lewisconcreterestoration.com August 19, 2020 Timothy Slifka City of Southlake 1400 Main St. Suite 440 Southlake, TX 76092 Email: tslifka@ci.southlake.tx.us RE: CONTACT RENEWAL AND PRICE INCREASE REQUEST: YEAR 2020-2021: Project: Sewer Manhole + Wet Well Rehab Services Contract: RFP1606B420JT160016 Mr. Slifka: The referenced contract has approached renewal for Year 2020-2021. In accordance with the contract renewal terms, LCR is requesting your approval of a 3% increase in pricing as outlined below. The increase is due to : travel related expenses, anticipated health insurance costs, PPE costs, personnel costs and unforeseen expenses for COVID19. ITEM # DESCRIPTION (SEWER MANHOLE) WAS RENEWAL 1 Condition 1: 4’ dia manhole $136.32 $140.40 2 Condition 2: 4’ dia manhole $197.03 $202.94 3 Condition 3: 4’ dia manhole $287.57 $293.10 4 Condition 1: 5’ dia manhole $170.40 $175.51 5 Condition 2: 5’ dia manhole $252.95 $260.53 6 Condition 3: 5’ dia manhole $346.13 $356.51 DESCRIPTION (WET WELL) 7 Wet Well Liner $11.88 $12.35 8 Additional Cement Repair >1” cement $4.22 $4.34 9 Traffic Control - TXDOT $211.15 $217.48 10 Traffic Control – Non-residential $158.36 $163.11 11 Traffic Control – Residential $79.79 $82.18 12 Wet Well Discharge Pipe Coating $52.79 $54.37 13 Other – Flow through Plugs (6”-12”) $422.30 $434.96 14 Other – Flow Through Plugs (18”-24”) $791.81 $815.56 LEWIS CONCRETE RESTORATION 9209 Williamson Rd, Buda, TX 78610 Phone: 512.983.3283 Email: slewis@lewisconcreterestoration.com “A Specialty Restoration & Preservation Company” MWSBE, TX HUB Operating in TX and LA On the Web at: www.lewisconcreterestoration.com We appreciate your consideration of the price request and renewal of the annual contract. Please contact me if you require additional information. We look forward to continued success with the City of Southlake. Regards, Sherry Lewis, CFO ORIGINAL DOCUMENT SOUTHLAKE CITY OF SOUTHLAKE Council Action:Y(19 Ord./Res.No. Date Approved J7,-I l t`t August 28,2019 II Lewis Concrete Restoration Corporation 405 Ware Dr. Buda,Texas 78610 Attn: Ms. Sherry Lewis Subject: Notification of Contract Renewal for Sewer Manhole and Wet Well Rehabilitation Services RFP1606B420JT160016 Dear Ms. Lewis: The City of Southlake is providing notification of contract renewal for "Sewer Manhole and Wet Well Rehabilitation Services RFP1606B420JT160016". This renewal shall become effective September 20, 2019 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. You have indicated your company will be requesting a three percent(3%) increase at this renewal. This increase has been approved and revised pricing is included with this renewal. All other terms and conditions of the original contract award shall remain in effect for this renewal period. The terms and conditions proposed and accepted in this renewal agreement are as follows: 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 RFP 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: Jack Thompson 817-748-8200 Send all billing to:City of Southlake 1400 Main Street,Suite 440,Accounts Payable Southlake,TX 76092 or Email: accountspayableAci.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. cere y ' 400, Tim Slifka, 'PO,CPs au tltlif/"/ Purchasing Manager,City of Southlake Attest: ), l i-O T HLq , 1400 Main Street, Suite 420 Amy ' 'elley,TRMC .41!•• Southlake,Texas 76092 City Secretary m S. tslifka(i ci.southlake.tx.us D Date: l Contr ct Renewal Accepted by i• ••••• •'••••• ••••• k 1```••lllltlt Signed: Aljrz„ AAriMA Dated / a a Yelverton,City Manager Appendix B—Proposal(continued) REQUIRED PROPOSAL INFORMATION. IN ORDER FOR A PROPOSAL TO BE CONSIDERED COMPLETE, AND TO BE EVALUATED FOR A CONTRACT AWARD BY THE 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 identified 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: Item# Quantity Description of Products/Services Unit Cost Sewer Manhole Sewer Manhole Liner Per Vertical Foot for Four Foot Diameter Manhole (4') per Scope of Services 1. Per Vertical Ft. CONDITION 1 136 . 32 Sewer Manhole Liner Per Vertical Foot for Four Foot Diameter Manhole (4') per Scope of Services 197 . 03 2. Per Vertical Ft. CONDITION 2 Sewer Manhole Liner Per Vertical Foot for Four Foot Diameter Manhole (4') per Scope of Services 287 . 57 3. Per Vertical Ft. CONDITION 3 Sewer Manhole Liner Per Vertical Foot for Five Foot Diameter Manhole (5') per Scope of Services 4. Per Vertical Ft. CONDITION 1 170 .40 Sewer Manhole Liner Per Vertical Foot for Five Foot Diameter Manhole (5') per Scope of Services 5. Per Vertical Ft. CONDITION 2 252 . 95 Sewer Manhole Liner Per Vertical Foot for Five Foot Diameter Manhole (5') per Scope of Services 346 . 13 6. Per Vertical Ft. CONDITION 3 City of Southlake RFP1606B420JT160016 Page 14 of 24 Item# Quantity Description of Products/Services Unit Cost Wet Well Wet Well Liner Per Square Foot per Scope of 7. Per Square Ft. Services 11 . 88 Additional Cementitous Repair Material Above 8. Per''/2" Initial 1"of Material 4 .22 per'/z" Traffic Control as Required by Texas Manual on Uniform Traffic Control in TXDOT Right of 9. Per Hr Way 211 . 15 Traffic Control as Required by Texas Manual on Uniform Traffic Control in High Traffic 10. Per Hr Non-Residential Area 158 . 36 Traffic Control as Required by Texas Manual 11. Per Hr on Uniform Traffic Control in Residential Area $ 79 • 79 12. Per Sq. Ft.Wet Well Discharge Pipe Coating 52 • 7por Sq.Ft. Other Vendor Charges. Please Explain. Flow through plugs 6"-12" for water flow control includes 13. Per Svc. piping each 422 . 30 Other Vendor Charges. Please Explain. Set 18"-24" flow through plug each 14. Per Svc. 791 . 81 TOTAL ALL LINE ITEMS 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 funds 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 funding 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 City of Southlake RFP1606B420JT160016 Page 15 of 24 SOUTHLAKE Timothy Slifka<tslifka@ci.southlake.tx.us> Contract Renewal for City of Southlake 3 messages Timothy Slifka<tsliika@ci.southlake.tx.us> Tue,Aug 27,2019 at 10:34 AM To:Sherry Lewis<slewis@lewisconcreterestoration.com> Good morning Ms.Lewis. Our contract is coming up for renewal.Will you be seeking an increase in contract rates at this renewal? If no,please respond with"No Increase Requested"and I will get the renewal completed. If you are requesting an increase please let me know and I will send additional paperwork for you to complete and return. Tim Timothy Slifka CPPO,CPPB Purchasing Manager City of Southlake 1400 Main Street Suite 420 Southlake,Texas 76092 817-748-8312 817-748-8010 Fax tsl ifka @ci.so u th lake.tx.u s www.cityofsouthlake.com AMeYievemeof ) 0 ilaro Procurement 2019 Award Winner Current Bidding Opportunities* 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* Internal Staff Bid Survey* Vendor Survey - How are we Doing?* Lewis Concrete Restoration 2016 Renewal 2018.pdf 1510K slewis@lewisconcreterestoration.com<slewis@lewisconcreterestoration.com> Tue,Aug 27,2019 at 11:54 AM To:tslifka@ci.southlake.tx.us Your message To: Sherry Lewis Subject: Contract Renewal for City of Southlake Sent: 8/27/2019 10:34 AM was read on 8/27/2019 11:54 AM. slewis@lewisconcreterestoration.com<slewis@lewisconcreterestoration.com> Tue,Aug 27,2019 at 5:17 PM To:Timothy Slifka<tslifka@ci.southlake.tx.us> Timothy: Good Afternoon. Due to increasing insurance rates,material rates,and labor rates,yes LCR will increase the contract rates by 3%on all items. Looking forward to working w/you. Sherry Lewis Sherry Lewis I CFO Lewis Concrete Restoration Corporation I 9209 Williamson Rd i Kyle,TX 78640 i(Office:512.983.32831 I Cell:512-983.3283 I A Fax:upon request WWW.lewiscon creterestoratio n.co m An Equal Opportunity Employer" From:Timothy Slifka<tslifka@ci.southlake.tx.us> Sent:Tuesday,August 27,2019 10:35 AM To:Sherry Lewis<slewis@lewisconcreterestoration.com> Subject:Contract Renewal for City of Southlake Good morning Ms. Lewis. Quoted text hidden] CIIY CSF SOUTHLAKE ORIGINAL DOCUMENT CITY OF SOUTHLAKE Council Action: Y6§) Ord./Res.No. August 29,2018 Date Approves Lewis Concrete Restoration Corporation 405 Ware Dr. Buda,Texas 78610 Attn: Ms. Sherry Lewis Subject: Notification of Contract Renewal for Sewer Manhole and Wet Well Rehabilitation Services RFP1606B420JT160016 Dear Ms. Lewis: The City of Southlake is providing notification of contract renewal for "Sewer Manhole and Wet Well Rehabilitation Services RFP1606B420JT160016". This renewal shall become effective September 20, 2018 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. You have indicated your company will not be requesting an increase at this renewal. Therefore all pricing,terms and conditions of the original contract award shall remain in effect for this renewal period. The terms and conditions proposed and accepted in this renewal agreement are as follows: 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 RFP 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: Jack Thompson 817-748-8200 Send all billing to:City of Southlake 1400 Main Street,Suite 440,Accounts Payable Southlake,TX 76092 or Email:accountspayable uci.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, Ti Slitka,CPPO,CB Purchasing Manager,City of Southlake Attest: /4,/ t _! /4 1400 Main Street,Suite 440 Carol Ann Borges,TRMC Southlake,Texas 76092 City Secretary N tslifkaru ci.southlake.tx.us Date: / 0' oZ ! p so ti S+++jr s Contract R- ewal Accepted by 3 h, Signed: ' G Date: ' h: a Yelverton,City Manager Ll/ 4,,**It 04 8/29/2018 Ci.southlake.tx.us Mail-Contract Renewal for City of Southlake SOUTHLAKE Timothy Slifka<tslifka@ci.southlake.tx.us> Contract Renewal for City of Southlake slewis@lewisconcreterestoration.com<slewis@Iewisconcreterestoration.com> Tue,Aug 28,2018 at 2:35 PM To:Timothy Slifka<tslifka@ci.southlake.tx.us> No Increase Requested. Sherry Lewis Sherry Lewis I CFO Lewis Concrete Restoration Corporation I :9209 Williamson Rd!Kyle T(78640 1i Office 512.983.328311 Celt.512-983.32831.-Fax upon request wwne iewiscorcreterestoration Corn An Equal Opportunity Employer' From:Timothy Slifka<tslifka@ci.southlake.tx.us> Sent:Tuesday,August 28,2018 7:14 AM To:Sherry Lewis<slewis@lewisconcreterestoration.com> Cc:Jack Thompson<jthompson@ci.southlake.tx.us> Subject:Contract Renewal for City of Southlake Good morning Ms. Lewis. https://mail.google.com/mail/u/0/?ui=2&ik=1 dc9780fd9&jsver--SJSZKm11 T48.en.&cbl=gmail_fe_180826.13_p3&view=pt&msg=165820473a869aa4&s... 1/1 ORIGINAL DOCUMENT Or SOOIJTHL AKE CITY OF SOUTHLAK$ Cowell Action:Y© Ord/Res.No, -- Date Approved gig/aa/7 September 8,2017 Lewis Concrete Restoration Corporation 405 Ware Dr Buda,Texas 78610 Attn: Ms.Sherry Lewis Subject Notification of Contract Renewal for Sewer Manhole and Wet Well Rehabilitation Services RFP1606B420.7160016 Dear Ms.Lewis: The City of Southlake is providing notification of contract renewal for"Sewer Manhole and Wet Well Rehabilitation Services RFP1606B420JT160016". This renewal shall become effective September 20,2017 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. You have indicated your company will not be requesting an increase at this renewal.Therefore all pricing,terms and conditions of the original contract award shall remain in effect for this renewal period. The terms and conditions proposed and accepted in this renewal agreement are as follows: 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: Jack Thompson 817-748-8200 Send all billing to: City of Southlake 1400 Main Street,Suite 440,Accounts Payable Southlake,TX 76092 or Email'accountspayableIci.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 ongmal 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, Pim slim,CP ,CPPB gd A 7r.Lt 2Lr'Z Purchasing Manager,City of Southlake Attest:42-1 1400 Main Street,Suite 440 Carol Borges,TRMC Southlake,Texas 76092 City Secretary tslifka(aci.south lake.tx.us Date: 04-O/, Contract R ewal Accepted i y i 4' i Dateg—g /7 s • Yelverton,City Manager iiirrr 1 1Tr crry Of SOU1 -EAKE ORIGINAL DOCUMENT CITY OF r=i4CB Council OrdJReit.No._ Date Approved (4j7.o[t(v August 16,2016 Lewis Concrete Restoration Corporation 405 Ware Dr Buda,Texas 78610 Attn: Sherry Lewis Subject Contract Award Notification for Sewer Manhole and Wet Well Rehabilitation Services RFP1606B4201T160016 Dear Ms.Lewis: The City of Southlake is pleased to inform you that Lewis Concrete Restoration Corporation of Buda,Texas,is the awarded vendor for"Sewer Manhole and Wet Well Rehabilitation Services RFP1606134201T160016" The award and this agreement are based on your proposal to the City,copy enclosed.This is a sin le or award contract.Your company's award is attached.This award was approved by the City of Southlake City Council on q ZO UAL? The terms and conditions proposed and accepted in this agreement are as follows: 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 lack Thompson 817-748-8200 Send all billing to: City of Southlake 1400 Main Street,Suite 440,Accounts Payable Soutblake,TX 76092 or via email to accountsoavable@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 South lake. Thank you fopartic'pating in our procurement process. Please call 817-748-8312 with any questions. Tim Sli&a,CPPO,C B u,,n,,,,, Purchasing Manager OJ Ltt•LAI F' City of Southlake OQ 0" 1400 Main Street,Suite 440 l Southlake,Texas 76092 m tslifka@ci.southlake.tx.us Attest: Fax:817-748-8010 Lori Payne,TRMC Contract and ward+ Accepted; City Secretary a , Signed: a .t_.l` Daterf24 f u!c, Approved/ to Form Le i Mayor Laura Hill City of Southlake City Atto Appendix B—Proposal Submittal Checkl6tt (To determine validity of proposal) Appendix B(paps J3 through 23J most be included in the proposal submittal Appeadia C Conflict of Interest Form(page 23J must be included in the proposal submittal. Form 1295 Certificate of interested Party Form must be included in the proposal submittal.Please see Page 2 Section IE. 111 pi olu,sal,Ntilrntitt.cl to the Lite of soiitbl ike„hail include thin poke with the suhmittt'd Proposal. e 'T:,1, ai, ! •r RFP1606B420JT160016 a= iJi. '' '" tea Sewer Manhole and Wet Well Rehabilitation J. t't'..it-,,IE Services Submittal. 3.00 P.M.M.(CST),3uly 8,2016 i ..'0 I i('CI tro.`4cill *.td 'vW.securebidusa.com r . 11:wit'- ?'.. l;i-V.... . ..r',+' 41-. i,, 1. r. ritio0.41 t -p,4j *'- ,.'- . ' ' Lewis Concrete Restoration Corporation t t':_,: z}, 4.'4 405 Ware Dr J: ; _ i :• ° - Buda,TX 78610 s:;'.:-. 47:—. 41- 1,. Lr .. ldenti tiotrgin til 27-2849237 Picone Nlttmber. 512.983.3283 Fai;Nilitib ..:' n/a UMip,.kid c slewist@Iewiscancreterestoratiof.com PronoserAuthoripition • t 1,the endersigned,)cave the authority to execute this Proposal in its entirety as submitted and enter-into a contract on behalf of tJ 1-Propaser.• Printed Nameind Position 4f Authorized Repres,'{,y',(' :She Lewis Signature of Authorized-Representative: - .- Signed this 6 - , (day)of - July ,' month),_2016:(year) • . - 1 learned of this Request for Proposals by the following means: Newspaper Advertisement City E-mail Notification Southlake Website Cold Call to City U Mailed Me a Copy 5 Other El SecureSid City of Southiake RFP1606B420JT160016 Page 13 0E24 SOUTHLAKE City of Southlake REQUEST FOR PROPOSALS Proposal Reference Number: RFP1606B420JT160016 Project Title: Sewer Manhole and Wet Well Rehabilitation Services Proposal Closing Date: 3:00 P.M.(CST),Friday,July 8,2016 TABLE OF CONTENTS Table of Contents Page 1 Request for Proposals 1)Introduction Page 2 2)Definitions Page 3 3)General Information Page 3 4)RFP Withdrawals and/or Amendments Page 3 5)Proposal Submittal Requirements Page 3 6)Proposal Evaluation and Contract Award Page 4 Appendix A—Scope of Services 1)Project Title Page 6 2)Scope of Services Contact Page 6 3)Special Conditions Page 6 4)Proposal Evaluation Factors Page 6 5)Brand Manufacture Reference Page 6 6)Key Events Schedule Page 6 7)Scope of Services._.... Page 6 Appendix B—Proposal Label Format for Submittal Packet's Sealed Envelope Page 13 1 Required Proposal Information 1)Proposed Product Page 14 2)Cost of Proposed Product Page 14 3)Term of Contract and Option to Extend Page 15 4)Proposer's Experience/Staff Page 16 5)References Page 17 6)Trade Secrets and/or Confidential Information Page 18 7)Federal,State and/or Local Identification Information Page 18 8)Emergency Business Services Contact Notice Page 18 9)Cooperative Governmental Purchasing Notice Page 19 H Contract Terms and Conditions 1) Delivery of Products and/or Services Page 19 2) Miscellaneous Page 19 3) Financial Responsibility Provisions Page 20 Appendix C—Form CIQ Page 22 Appendix D—No Intent to Submit Form Page 24 City of Southlake RFP1606B420JT160016 Page 1 of 24 Southlake,Texas Request for Proposals Introduction A. Proiect Overview: The City of Southlake is requesting Proposals with the intent of awarding a contract for the purchase of goods and services contained in Appendix A—Scope of Services. B. Questions: Following are contacts for questions as identified. i. BFP Clarifications: All questions related to requirements or processes of this RFP should be submitted in writing to the Purchasing Manager identified in section 2 below. ii. Scope of Service Questions: All questions related to the scope of services should be submitted in writing to the contact person(s)noted in Appendix A—Scope of Services. iii. Replies: Responses to inquiries which directly affect an interpretation or effect a change to this RFP will be issued in writing by addendum posted to City website. All such addenda issued by City prior to the submittal deadline shall be considered part of the RFP. The City shall not be bound by any reply to an inquiry unless such reply is made by such formal written addendum. iv. Acknowledgement of Addenda: The Proposer must acknowledge all addenda by signing and returning such document(s)or by initialing appropriate area of the Proposal. C. Notification of Errors or Omissions: Proposers shall promptly notify the City of any omissions, ambiguity,inconsistency or error that they may discover upon examination of this RFP.The City shall not be responsible or liable for any errors and/or misrepresentation that result from the solicitations which are inadvertently incomplete,ambiguous,inconsistent or obviously erroneous. D. Conflict of Interest Questionnaire(Form CIO):A person or business,and their agents,who seek to contract or enter into an agreement with the City,are required by Texas Local Government Code, Chapter 176,to file a conflict of interest questionnaire(FORM CIQ)which is found in Appendix C.The form must be filed with the City Secretary no later than seven(7)days after the date the person or business begins contract discussions or negotiations with the City, or submits an application,response to a request for proposals or bids,correspondence,or other writing related to any potential agreement with the City. E. Form 1295 Certificate of Interested Parties: In 2015, the Texas Legislature adopted House Bill 1295.which added section 2252.908 of the Government Code.The law states that a governmental entity or state agency may not enter into certain contracts with a business entity unless the business entity submits a disclosure of interested parties to the governmental entity or state agency at the time the business entity submits the signed contract to the governmental entity or state agency.The law applies only to a contract of a governmental entity or state agency that either(1)requires an action or vote by the governing body of the entity or agency before the contract may be signed or 2)has a value of at least$1 million.The disclosure requirement applies to a contract entered into on or after January 1, 2016. Please go to the Texas Ethics Commission webpage www.ethics.state.tx.us) for full instructions and to complete the required steps for creation of Form 1295.Once the form is completed online, printed and notarized please return the form with your proposal submission. City of Soathlake RFP1606B420JT160016 Page 2 of 24 2. Definitions Proposal: The signed and executed submittal of the entirety of Appendix B—Proposal. Proposer: The Proposer and the Proposers designated contact signing the first page of the Proposal. City of Southlake("City"): The City of Southlake,Texas. City Secretary's Office: The office of the City Secretary of the City,located at 1400 Main Street.Suite 270,Southlake,Texas 76092.PH: (817)748-8016;Fax:(817)748-8270. Project: The name of this Request for Proposals as identified on the cover sheet and first page of Appendix A—Scope of Services. Purchasing Manager. The City of Southlake Purchasing Manager is Timothy Slifka CPPO, CPPB. Phone: (817)748-8312,E-Mail: tslitkacUci.southlake.t..us;Fax(817)748-8048. Request for Proposals(RFP): The entirety of this document,including all Appendices and Addenda. Scope of Services: The entirety of Appendix A—Scope of Services. 3. General information A. Tax Exempt Status: City purchases are exempt from State Sales Tax and Federal Excise Tax.Do not include tax in the Proposal. City will furnish Excise Tax Exemption Certificate upon request. B. Public Inspection of Proposals: The City strictly adheres to the Texas Public Information Act Texas Government Code Chapter 552.001, et seq.)and all other governing statutes,regulations, and laws regarding the disclosure of RFP information. Proposals are not available for public inspection until after the contract award. If the Proposer has notified the City,in writing,that the Proposal contains trade secrets or confidential information,the City will generally take reasonable steps to prevent disclosure of such information, in accordance with the Public Information Act. This is a statement of general policy only,and in no event shall the City be liable for disclosure of such information by the City in response to a request,regardless of the City's failure to take any such reasonable steps,even if the City is negligent in failing to do so. 4. RFP Withdrawals and/or Amendments A. RFP Withdrawal: The City reserves the right to withdraw this RFP for any reason. B. RFP Amendments:The City reserves the right to amend any aspect of this RFP by formal written Addendum prior to the Proposal submittal deadline and will endeavor to notify all potential Proposers that have registered with the City, but failure to notify shall impose no obligation or liability on the City. 5. Proposal Submittal Requirements A. Submittal Packet — Required Content: All proposals must be submitted electronically. The Proposer must visit www.securebidusa.com and register. Once registered for this complimentary service,the Proposer may submit Proposal Documents electronically by selecting the appropriate Proposal Identification. B. Submittal Deadline: The deadline for submittal of Proposals shall be as identified on page 13 thirteen) of Appendix B-Proposal. It is the Proposers responsibility to have the Proposal Documents correctly electronically submitted by the submittal deadline. No extensions will be granted and no late submissions will be accepted. City of Southlake RFP1606B420.IT160016 Page 3 of 24 C. Proposals Received Late: Proposers are encouraged to submit their proposals as soon as possible. The time and date of receipt as recorded within the SecureBid electronic system shall be the official time of receipt. The City is not responsible for late submission regardless of the reason. Late Proposals will not be considered under any circumstances. D. Alterations or Withdrawals of Proposal Document: Any submitted Proposal may be withdrawn or a revised proposal substituted prior to the submittal deadline. Proposal Documents cannot be altered,amended or withdrawn by the Proposer after the submittal deadline,unless such alteration. amendment or withdrawal notice is approved in writing by the Purchasing Manager. E. Proposal Document Format: All Proposal Documents must be prepared in single-space type, on standard 8-1/2"x 11" vertically oriented pages, numbered at the bottom. The City only accepts electronic submissions via www.securebidusa.com. Any other format(via telephone, fax,email, etc.)may be rejected by the City at its discretion. F. Validity Period: Once the submittal deadline has passed,any Proposal Document shall constitute an irrevocable bid to provide the commodities and/or services set forth in the Scope of Services at the price(s)shown in the Proposal Document.Such proposal shall be irrevocable until the earlier of the expiration of ninety(90)days from the submittal deadline,or until a contract has been awarded by the City. 6. Proposal Evaluation and Contract Award A. Proposal Evaluation and Contract Award Process: An award of a contract to provide the goods or services specified herein will be made using competitive sealed proposals, in accordance with Chapter 252 of the Texas Local Government Code and with the City's purchasing policy. The City will evaluate all proposals to determine which proposers are reasonably qualified for the award of the contract, applying the anticipated evaluation factors and emphasis to be placed on each factor as identified in the Scope of Services. The City may,at its option,conduct discussions with or accept proposal revisions from any reasonably qualified proposer. The City reserves the right to determine which proposal will be most advantageous to the City. B. Completeness: If the Proposal is incomplete or otherwise fails to conform to the requirements of the RFP,City alone will determine whether the variance is so significant as to render the Proposal non-responsive,or whether the variance may be cured by the Proposer or waived by the City,such that the Proposal may be considered for award. C. Ambiguity: Any ambiguity in the Proposal as a result of omission, error,lack of clarity or non- compliance by the Proposer with specifications, instructions and all conditions shall be construed in the favor of the City. In the event of a conflict between these standard RFP requirements and details provided in Appendix A —Scope of Services or Appendix B—Proposal,the Appendices shall prevail. D. Unit Prices and Extensions: If unit prices and their extensions do not coincide, the City may accept the price most beneficial to the City,and the Proposer will be bound thereby. E. Additional Information:City may request any other information necessary to determine Proposer's ability to meet the minimum standards required by this RFP. F. partial Contract Award: City reserves the right to award one contract for some or all the requirements proposed or award multiple contracts for various portions of the requirements to different Proposers based on the unit prices proposed in response to this request,or to reject any and all Proposals and re-solicit for Proposals,as deemed to be in the best interest of City. City of Southlake RFP1606B420JT160016 Page 4 of 24 G. Terminate for Cause: The occurrence of any one or more of the following events will justify termination of the contract by the City of Southlake for cause: i) The successful proposer fails to perform in accordance with the provisions of these specifications;or ii) The successful proposer violates any of the provisions of these specifications;or iii) The successful proposer disregards laws or regulations of any public body having jurisdiction;or iv) The successful proposer transfers,assigns,or conveys any or all of its obligations or duties under the contract to another without written consent of the City. v) If one or more of the events identified in Subparagraphs G i)through iv)occurs,the City of Southlake may,terminate the contract by giving the successful proposer seven(7)days written notice. In such case, the successful proposer shall only be entitled to receive payment for goods and services provided before the effective date of termination. The successful proposer shall not receive any payment on account of loss of anticipated profits or revenue or other economic loss resulting from such termination. vi)When the contract has been so terminated by the City of Southlake,such termination shall not affect any rights or remedies of the City then existing or which may thereafter accrue. H. Terminate for Convenience: This contract may be cancelled or terminated at any time by giving vendor thirty (30)days written notice. Vendor may be entitled to payment for services actually performed;to the extent said services are satisfactory. City of Southlake RFP1606B420Jf160016 Page 5 of 24 Appendix A—Scope of Services I. Project Title:Sewer Manhole and Wet Well Rehabilitation Services 2. Scope of Services Contact Questions about the technical nature of the Scope of Services,etc. may be directed to TIM SLIFKA, Phone.817.748.8312,e-mail:tslifka@ci.southlake.tx.us. 3. Special Conditions The following special conditions shall prevail over areas of conflict in previous pages: NONE 4. Proposal Evaluation Factors Emphasis Factor 35%Vendor Ability to Provide Requested Services 30%Vendor Past Experience Providing Required Services 30%Vendor Overall Cost to Provide Requested Services 5% Vendor Past Performance With the City 5. Brand Manufacture Reference The City has determined that any manufacturer's brand defined in the Scope of Services meets the City's product and support need. The manufacturer's reference is not intended to be restrictive,and is only descriptive of the type and quality the City desires to purchase. Quotes for similar manufactured products of like quality will be considered if the Proposal is fully noted with the manufacturer's brand name and model. The City reserves the right to determine products and support of equal value, and whether other brands or models meet the City's product and support needs. 6. Key Events Schedule Proposal Release Date June 17,2016 Deadline for Submittal of Written Questions June 29,2016 Sealed Proposals Due to and Opened by City Shown on First Page of this RFP Anticipated Committee Evaluation Review Date Week ofJuly 11,2016 Anticipated City Council Award August 20I6 7. Scope of Services The City of Southlake is seeking a vendor to perform rehabilitation services for various concrete sewer system manhole, wet well or other sewer related structures. The concrete structure of our sanitary sewer manholes and wet wells in our wastewater system, due to high levels of hydrogen sulfide are deteriorating.This rehabilitation service shall consist of,but not be limited to,cleaning,repairing and coating with Raven 405, 100%solids epoxy or equivalent. (Protective Coating Material-PCM)which is resistant to hydrogen sulfide.We anticipate an estimated one hundred twenty manholes(120)to be completed over the next five(5)years per the renewal guidelines within Section 3 Term of Contract and Option to Extend.This is not a guaranteed amount. The City reserves the right to add or delete from this total.Total manholes serviced per year will be based on available budget dollars.This figure is set on an annual basis. City of Soothlake RFP1606B420JT160016 Page 6 of 24 Initial Assessment An initial assessment of the manhole,wet well or other structure shall be performed by the awarded vendor.Vendor shall submit an inspection report detailing the current condition and the recommended repair services.Vendor shall submit a sample copy of an inspection report with their proposal.Access to all current manholes is within three hundred(300)feet from roadway. Cleaning and Prep Services The awarded vendor must inspect all surfaces to be rehabilitated and notify the City of any noticeable disparities in the conditions which are different than the original assessment and designated condition once cleaning and prep services are completed. Any required additional work must be approved by City. All concrete which is not sound or has been damaged by chemical exposure shall be removed to sound concrete surface. All contaminants,including:oils,grease,incompatible and/or damaged existing coatings,waxes,form release, curing compounds, efflorescence, sealers. salts or other contaminants, must be completely removed prior to any surface applications. Contaminant removal and surface preparation methods must be based upon the designated conditions of the substrate and the requirements of the rehabilitation products. Surfaces must be cleaned and abraded to produce a sound concrete surface with adequate profile and porosity to provide a strong bond between the existing structure and the rehabilitation products. Pressure water cleaning shall be used to clean and free all foreign material within the manhole. It may be necessary to clean using a detergent or steam when grease or oils are present. All residues and materials resulting from the process of cleaning the structure must be captured and removed. All voids,joints,cracks,pipe penetrations,bug holes,honeycombs.etc shall be repaired using a non- shrink cementitous repair material(CRM). Repair and/or rebuild benches and inverts to City specifications using CRM as required. Condition Standards and Repair Methods Condition 1 Condition Standard: An Existing structure which is considered structurally sound with no indications of settlement, cracking or other signs of fatigue. Infiltration or exfiltration through pre-cast joints, mortar joints, or around the pipe connections may exist and structure may be experiencing mild corrosion or deterioration. Repair Method: Pressure wash and clean structure. Stop any infiltration using appropriate products and methods(injection grout/hydraulic cement). Fill bug holes.joints, honeycombs and around pipe penetrations with a Cementitous Repair Material as needed. Apply a minimum of 125 mils thickness of a Protective Coating Material(PCM). Condition 2 Condition Standard: An existing structure which is exhibiting early signs of structural fatigue evidenced by minor cracks,loss of mortar or brick,moderate to moderately severe corrosion(less than City of Southlake RFP1606B420JT160016 Page 7 of 24 IA inch in depth).minor cross sectional distortion(less than 10°AO;however,it is currently supporting the soil and live load. Repair Method: Pressure wash and clean structure. Stop any infiltration using appropriate products and methods(injection grout/hydraulic cement) Apply a Cementitous Repair Material to the structure at a minimum thickness of''A inch. Apply a minimum of 125 mils thickness of a Protective Coating Material(PCM). Condition 3 Condition Standard:An existing structure which is exhibiting severe structural fatigue and collapse is eminent. Conditions indicating this degree of deterioration may include very severe corrosion(loss of original profile of one inch or greater), cross sectional distortion beyond 10 percent, exposed reinforcing steel, loose or missing bricks, missing mortar,or large sections of the structure which are gone completely. Repair Method:Pressure wash and clean structure. Fill missing sections and voids with brick and/or a Cementitous Repair Material as necessary. Stop any infiltration using appropriate products and methods (i.e. hydraulic cement and/or injection of chemical grout). Apply a Cementitous Repair Material to the structure at a at a minimum thickness of 1 inch or in additional''h"Lifts/thicknesses(i.e. additional pay item)as needed to bring structure back to original profile. Apply a minimum of 250 mils thickness of a Protective Coating Material(PCM). Cementitous Repair Material(CRM) The CRM shall be a factory blended, rapid setting, high early strength. non-shrink grout which is specifically formulated for use in the underground wastewater environment. The CRM shall be capable of being trowelled or spray applied. The CRM shall be mixed with water only and applied according to manufacturer recommendations. The water used to mix the HCM should be clean and free of contaminants. The CRM must be compatible with the Protective Coating Material which is going to be used. Hydraulic Cement Material(HCM) The HCM shall be specifically designed to stop minor water infiltration and develop high-early strengths. The HCM shall be capable of being hand mixed and applied in either a"wet"or"chy"state. The water used to mix the HCM should be clean and free of contaminants. The HCM should be formulated with calcium silicate,calcium aluminate cements,mineral fillers,and specially selected additives for set control. The HCM should be used according to the manufacturer recommendations. City of Southlake RFP1606B420J7160016 Page 8 of 24 Chemical Grout Material The chemical grout shall be a semi ridged injection grout designed for sealing larger volume leaks in concrete cracks and fissures. The chemical grout shall be capable of filling voids,stabilize soils or gravel.The chemical grout shall be a two part system(grout and accelerator)which,when it makes contact with water, is designed to set-off and cut-off gushing water. Set times should be adjustable. Safety The vendor will be expected to comply with all City,State and federal standards. Particular attention is drawn to those safety requirements involving entry into a confined space. The vendor shall carry out its operations in strict accordance with all OSHA and manufacturer's safety requirements. All necessary traffic control measures shall be put into place according to the Texas Manual on Uniform Traffic Control. When bypass pumping or diversion plugs are used,every effort should be made to protect the public and the environment from any contamination from the sewer. Flow Control The vendor must coordinate with the City to establish flow control,where required,in advance of all rehabilitation jobs. All submitted bids should include any and all costs for flow control (inflow and outflow)for structures with 6"to 12"pipe diameters. Other flow control measures required shall be coordinated between the vendor and the City to determine additional cost prior to initiating additional flow control measures. Plugging and Blocking A sewer line plug shall be inserted into the upstream invert and downstream invert as necessary. The vendor shall be held responsible for any damage caused by flooding and will take care to avoid this occurrence. By-Pass Pumping Where flow is large enough to require by-pass pumping, the vendor will do so in accordance with current NASSCO Specifications. The vendor shall prepare and submit one(1) Bypass Flow Control Plan for the project. We do not anticipate by-pass pumping to be required at this time however a Bypass Flow Control Plan should be submitted along with the vendor proposaL The bypass pumping system capacity must be sized to meet all potential flows(i.e.no sanitary sewer overflows(SSO)allowed). The vendor will be held responsible for any damage caused by flooding and will take care to avoid this occurrence. The vendor is responsible for all installation,operation, and maintenance of the system. The vendor must provide manpower, fuel, and necessary utilities required by the systems. In case of emergency, vendor shall have ready-use, stand-by pumping available to ensure 100% back-up capacity in case of equipment malfunction, or higher than anticipated flows. The vendor must make their own determination of flow quantities and characteristics.We estimate the majority of flow can be stopped or adjusted for two-four(2-4)hours. City of Southlake RFP1606B420JT160016 Page 9 of 24 Installation Procedures Traffic Control The vendor will coordinate with the Owner on appropriate traffic control measures and working times. Vendor shall be responsible for all traffic control measures per Texas Manual on Uniform Traffic Control and shall be priced accordingly within the Schedule of Pricing. Confined Space Entry Prior to man entry into any structure to be rehabilitated. proper ventilation and strict confined space OSHA regulations shall be followed. Surface Preparation Proper surface preparation procedures must be followed to ensure adequate bond strength to any surface to be rehabilitated. The vendor must inspect all surfaces to be rehabilitated and notify the City of any noticeable disparities in the conditions which are different than the original assessment and designated condition. Ali concrete which is not sound or has been damaged by chemical exposure shall be removed to sound concrete surface. All contaminants,including:oils,grease,incompatible and/or damaged existing coatings,waxes,form release, curing compounds, efflorescence, sealers. salts or other contaminants, must be completely removed prior to any surface applications. Contaminant removal and surface preparation methods must be based upon the designated conditions of the substrate and the requirements of the rehabilitation products. Surfaces must be cleaned and abraded to produce a sound concrete surface with adequate profile and porosity to provide a strong bond between the existing structure and the rehabilitation products. Pressure water cleaning shall be used to clean and free all foreign material within the manhole. It may be necessary to clean using a detergent or steam when grease or oils are present. All residues and materials resulting from the process of cleaning the structure must be captured and removed. All voids,joints,cracks,pipe penetrations,bug holes,honeycombs,etc shall be repaired using a CRM. Repair and/or rebuild benches and inverts,as required,using a CRM. Water Infiltration Vendor shall determine the locations where infiltration is occurring and the process to use for stopping the active flow. For small leaks,a quick setting hydraulic cement product may be used. The process is as follows: The area should be free from all debris,loose brick,mortar,or concrete. Small cracks should be enlarged by chipping with a hammer and chisel to facilitate filling the crack with slurry or dry material. The product shall be placed in areas of active infiltration by hand or by trowel. City of Soutblake RFP160611420JT160016 Page 10 of 24 Reduction of infiltration will be caused by a gradual build-up of hydrated product, which creates a barrier which is impermeable to infiltrating water. This may require multiple applications. Once infiltration is stopped.the product should be brushed and cleaned to remove any loose material. If the vendor determines the infiltration is too significant for hydraulic cement,a chemical grout shall be used. The vendor shall follow manufacture recommendations. The vendor shall determine the location(s)of the infiltration. Once the leak is stopped,excess grout shall be trimmed away and removed from the structure. Cornea thous Repair Once all active infiltration,voids,and proper surface preparation have been addressed the application of the CRM can begin. Place covers over the inverts or flow lines to prevent extraneous materials from entering the pipelines. The vendor must use manufacturer approved equipment for mixing and applying the product. The product shall be mixed as per the manufacturer recommendations. The CRM shall be applied up to one(I)inch to(1 'h)inch thick in one pass;however.minimum total thickness shall not be less than V2 inch. The surface will then be trowelled to a relatively smooth finish. Care should be taken to not "over trowel". Once the initial cure has taken place,the exposed surface area should be given a broom finish. Prior to application of protective coating on any steel surfaces(i.e. manhole ring), all surfaces shall receive a Commercial Blast Cleaning of a minimum SSPC-SP6/NACE No.3, which is defined as follows: This joint standard covers the requirements for commercial blast cleaning of unpainted or painted steel surfaces by the use of abrasives. These requirements include the end condition of the surface and materials and procedures necessary to achieve and verify the end condition. A commercial blast cleaned surface,when viewed without magnification.shall be free of all visible oil,grease,dust,dirt, mill scale, rust, coating oxides, corrosion products. and other foreign matter, except for staining as noted. Random staining shall be limited to no more than 33 percent of each unit area of surface as defined, and may consist of light shadows,slight streaks,or minor discolorations caused by stains of rust,stains of mill scale,or stains of previously applied coating. Protective Coating Application procedures shall conform to the recommendations of the protective coating manufacturer, including material handling, mixing, environmental controls during application, and application equipment. City of Southlake RFP160611420JT160016 Page I 1 of 24 The intended thickness of applied materials shall be determined by the designated condition and repair method of the structure. The application equipment shall be specifically designed to accurately ratio and apply the specified PCM and shall be regularly maintained and in proper working order. Appropriate personal protection equipment shall be utilized. Once the PCM is applied, any and all flow shall be reinstated to the structure per manufacturer guidelines. Testing and Inspection Visual The City shall make a final visual inspection. Any deficiencies in the finish coating shall be marked and repaired according to the manufacturer recommendations. Thickness Testing CRM—Thickness testing of the CRM shall be done during the application by the use of a thickness gauge(example:nail or bar)and results shall be provided to City contact. Warranty The vendor must warrant all work against defects in materials and workmanship for a period of one year,unless otherwise noted,from the date of final acceptance of all work contained in the project. The vendor must repair such defects in materials or workmanship within 30 calendar days of receipt of written notice of defects. City of Southlake RFP1606B420.ff 160016 Page 12 of 24 Appendix B—Proposal Submittal Checklist: (To determine validity of proposal) Appendix B(pages_13_through 23J must be included in the proposal submittal Appendix C Conflict of Interest Form(page 23J must be included in the proposal submittal. Form 1295 Certificate of Interested Party Form must be included is the proposal submittal.Please see Page 2 Section 1E. All proposals.submitted to the Cits,of Soot hlahe shall include this page with cite submitted Proposal. RFP Number: RFP1606B420JT160016 Project Title: Sewer Manhole and Wet Well Rehabilitation Services Submittal 3:00 P.M. (CST),July 8, 2016Deadline: Submit electronically* to: www.securebidusa.com Requires email account login and password. Proposer Information: Proposer's Legal Name: Lewis Concrete Restoration Corporation Address: 405 Ware Dr City,state&Zip Buda.TX 78610 Federal Employers 27-2849237 Identification Number II Phone Number: 512.983 3283 Fax Number: n/a E-Mail Address: slewis@lewisconcreterestoration.com reposer Authorization I,the undersigned,have the authority to execute this Proposal in its entirety as submitted and enter into a contract on behalf of the Proposer. Printed Name and Position of Authorized Representative: Sherry Lewis Signature of Authorized Representative: Sherry Lewis Signed this 6 (day)of July month), 2016 (yew) I learned of this Request for Proposals by the following means: 0 Newspaper Advertisement LI City E-mail Notification Southlake Website Cold Call to City Mailed Me a Copy Other SecureBid City of Southlake RFP16068420JT160016 Page 13 of 24 Appendix B—Proposal(cu.a.ued) 1. REQUIRED PROPOSAL INFORMATION. IN ORDER FOR A PROPOSAL TO BE CONSIDERED COMPLETE,AND TO BE EVALUATED FOR A CONTRACT AWARD BY THE 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 identified 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 roducts or contract segments stated in the Scope of Services and using the following format: Item#Quantity Description of dices Unit Cost Sewer Manhole Sewer Manhole Liner Per Vertical Foot for Four Foot Diameter Manhole(4')per Scope of Services 132.35 1. Per Vertical Ft. CONDITION I Sewer Manhole Liner Per Vertical Foot for Four Foot Diameter Manhole(4')per Scope of Services 2 Per Vertical Ft. CONDITION 2 191.29 Sewer Manhole Liner Per Vertical Foot for Four Foot Diameter Manhole(4')per Scope of Services $ 27919 3. Per Vertical Ft. CONDITION 3 Sewer Manhole Liner Per Vertical Foot for Five Foot Diameter Manhole(5')per Scope of Services $ 165.44 4. Per Vertical Ft. CONDITION I Sewer Manhole Liner Per Vertical Foot for Five Foot Diameter Manhole(5')per Scope of Services 245 58 5. Per Vertical Ft. CONDITION 2 Sewer Manhole Liner Per Vertical Foot for Five Foot Diameter Manhole(5')per Scope of Services $ 336 05 6. Per Vertical Ft. CONDITION 3 City of Southtake RFP16O6B420JT160016 Page 14 of 24 Item#Quantity Description of Products/Services Unit Cost Wet Well Wet Well Liner Per Square Foot per Scope of 7.Per Square Ft. Services 11 53 Additional Cementitous Repair Material Above 8. Per'/:" initial 1"of Material S 410 pert" Traffic Control as Required by Texas Manual on Uniform Traffic Control in TXDOT Right of 205 04 9. Per Hr Way S Traffic Control as Required by Texas Manual on Uniform Traffic Control in High Traffic 10. Per Hr Non-Residential Area 153 75 Traffic Control as Required by Texas Manual 76 86 11. Per Hr on Uniform Traffic Control in Residential Area S 12. Per Sq.Ft. Wet Well DischargeCPipeCoatingS 51-25per Sq.Ft. Onowrthrough plugs 2"dor water now control includes piping each 13. Per Svc. S 410 00/Ea Other Vendor Charges.Please Exjlain. set 18"-24"flow through plug 14. Per Svc. 768 75/EA TOTAL ALL LINE ITEMS S 3,072.92 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 funds 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 funding 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 City of Southiake RFP160613420JT160016 Page 15 of 24 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 five percent(5%)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 2016-2017)ESCALATION 0 % SECOND ADDITIONAL YEAR(FY 2017-2018)ESCALATION......... 2 % THIRD ADDITIONAL YEAR(FY 2018-2019)ESCALATION 3 % FOURTH ADDITIONAL YEAR(FY 2019-2020)ESCALATION 3 % 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; State the number of years'experience the business has: 7 ;and the number of employees: 30 D. Proiect 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. City of Southtake RFP1606B420JTi60016 Page 16 of 24 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 I Company Name: City of Kyle Contact Name: Contact Title: Warren Christian Director of Wastewater Phone: 512-738-7292 Email: wchristian@cityofkyle corn Date and Scope of Work Provided: Manhole Rehabilitation of CRM and Epoxy material across City's system 11-05-14 Thru 2-1416 Reference#2: Client/Company Name: City of Austin Contact Name: Contact Title: Mike Russ Director of Wastewater Utility Phone: 512-699-0103 Email: michael russ@austintexas.gov Date and Scope of Work Provided: Manhole Rehabilitation and Epoxy coating on various manholes for City of Austin 09-06 Thru 7-6-16 Reference#3: Client/Company Name: lnsitufomi Technologies Contact Name: Contact Title: Tim Peterie Business Development Manager Phone: 214-317-0950 Email: tpeterie@insituform.com Date and Scope of Work Provided: Lining of various manholes in North Texas for the Cottonwood Creek rehabilitation project 4-15-15 thru 5-02-15 Reference#4: Client/Company Name: SCCI-Speiss Construction Contact Name: Contact Title: Bill Geiser Project Manager Phone: 817-505-8213 Email: bgeiser©sccitanks.com Date and Scope of Work Provided: Epoxy coating of 120 manholes for the Del Rio expansion project 10-15 thru 2-16 City of Souttiiake RFP1606B420JT160016 Page 17 of 24 6. Trade Secrets and/or Confidential Information Trade Secrets and/or Confidential Information:This proposal_(does) X (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: B. Prime contractor HUB/MWBE registration number: 1272849234400 C. An individual Proposer acting as a sole proprietor must also enter the Proposer's Social Security Number# 8. Emergency Business Services Contact Notice During a natural disaster,or homeland security event,there may be a need for the City of Southlake to access your business for products or services after normal business hours and/or holidays. The City may request City employee pick up or vendor delivery of product or services. For this purpose,a primary and secondary emergency contact name and phone number are required. It is critical the vendor's emergency contact information remains current. City shall be contacted by E- mail with any change to a contact name or phone number of these emergency contacts.Updates may be emailed to vendors{ci.southlake.tx.us. All products or services requested during an emergency event are to be supplied as per the established contract prices, terms and conditions. The vendor shall provide the fee(pricing)for an after-hours emergency opening of the business,if any. In general.orders will be placed using a City of Southlake procurement card (Master Card) or City issued Purchase Order. The billing is to include the emergency opening fee,if applicable. The contractor shall provide the names, phone numbers and fee (pricing), if any, for an after-hours emergency opening of the business listed below. Business Name: n/a Contract#: Description: Primary Contact(Name): Primary Contact Phone Numbers:Home: Cell: Secondary Contact(Name): Secondary Contact Phone Numbers:Home: Cell: After Hours emergency opening fee,if applicable:$ City of Southlake RFP1606B42OJT160016 Page 18 of 24 9. Cooperative Governmental Purchasing Notice Other governmental entities maintaining interlocal agreements with the City, may desire,but are not obligated. to purchase goods and services defined in this RFB from the successful Bidder. All purchases by governmental entities, other than the City, will be billed directly to and paid by that governmental entity. The City will not be responsible for another governmental entity's debts. Each governmental entity will place their own orders with the successful Bidder and be responsible for ensuring full compliance with the RFB specifications. Prior to other governmental entities placing orders,the City will notify the successful Bidder of their intent. Please indicate below if you will permit other governmental entities to purchase from your agreement with the City. x] Yes,Others can purchase No,Only the City can purchase Il. CONTRACT TERMS AND CONDITIONS. EXCEPT WHERE PROPOSER MAIMS SPECIFIC EXCEPTION IN THE SUBMITTED PROPOSAL,ANY CONTRACT RESULTING FROM THIS RFP WILL CONTAIN THE FOLLOWING TERMS AND CONDITIONS, WHICH PROPOSER HEREBY ACKNOWLEDGES, AND TO WHICH PROPOSER AGREES BY SUBMITTING 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. Warranty 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. Miscellaneous A. Independent 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. 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 City of Sonthlake RFP1606B420JT160016 Page 19 of 24 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. H. 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(51,000,000) 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,suits, 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,subcontractor,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. C. Bond Requirements: Prior to the commencement of work on this Project,Proposer shall deliver to the City the following bonds issued by a good and sufficient surety licensed by the State of Texas and satisfactory to the City: City of Southiake RFP1606B420JT160016 Page 20 of 24 i. A payment bond in the amount of one hundred thousand dollars, ($100,000)insuring the full and prompt payment of all persons performing labor and/or furnishing materials in connection with this Project. ii. A performance bond in the amount of one hundred thousand dollars,($100,000)insuring full, faithful, and prompt performance of the responsibilities contained in this contract within the time parameters provided herein. City of Southlake RFP1606B420JT160016 Page 21 of 24 Appendix C—Form CIQ WHO: The following persons must file a Conflict of Interest Questionnaire with the City if the person has an employment or business relationship with an officer of the City that results in taxable income exceeding$2,500 during the preceding twelve—month period,or an officer or a member of the officer's family has accepted gifts with an aggregate value of more than$250 during the previous twelve—month period and the person engages in any of the following actions: I. contracts or seeks to contract for the sale or purchase of property,goods or services with the City, including any of the following. a. written and implied contracts,utility purchases,purchase orders,credit card purchases and any purchase of goods and services by the City; b. contracts for the purchase or sale of real property,personal property including an auction of property; c. tax abatement and economic development agreements; 2. submits a bid to sell goods or services,or responds to a request for proposal for services; 3. enters into negotiations with the City for a contract;or 4. applies for a tax abatement and/or economic development incentive that will result in a contract with the City THE FOLLOWING ARE CONSIDERED OFFICERS OF THE CITY: I Mayor and City Council Members; 1 City Manager; 3. Board and Commission members and appointed members by the Mayor and City Council; 4. Directors of 4A and 4B development corporations; 5. The executive directors or managers of 4A and 4B development corporations;and 6. Directors of the City of Southlake who have authority to sign contracts on behalf of the City. EXCLUSIONS:A questionnaire statement need not be filed if the money paid to a local government official was a political contribution,a gift to a member of the officer's family from a family member;a contract or purchase of less than$2,500 or a transaction at a pnce and subject to terms available to the public;a payment for food,lodging, transportation or entertainment; or a transaction subject to rate or fee regulation by a governmental entity or agency. WHAT: A person or business that contracts with the City or who seeks to contract with the City must file a Conflict of Interest Questionnaire"(FORM C1Q)which is available online at www.ethics.state.tx.us and a copy of which is attached to this guideline.The form contains mandatory disclosures regarding"employment or business relationships" with a municipal officer. Officials may be asked to clarify or interpret various portions of the questionnaire WHEN:The person or business must file: 1. the questionnaire—no later than seven days after the date the person or business begins contract discussions or negotiations with the municipality,or submits an application,responds to a request for proposals or bids,correspondence,or other writing related to a potential contract or agreement with the City;and 2. an updated questionnaire—within seven days after the date of an event that would make a filed questionnaire incomplete or inaccurate It does not matter if the submittal of a bid or proposal results in a contract.The statute requires a vendor to file a FORM CIQ at the time a proposal is submitted or negotiations commence. WHERE: The vendor or potential vendor must mail or deliver a completed questionnaire to the Finance Department Tke Finance Department is required by law to post the statements on the City's website. ENFORCEMENT:Failure to file a questionnaire is a Class C misdemeanor punishable by a fine not to exceed 500.It is an exception to prosecution that the person files a FORM CIQ not later than seven business days after the person received notice of a violation. NOTE:The City does not have a duty to ensure that a person files a Conflict of Interest Questionnaire. City of Southlake RFP1606B420JT160016 Page 22 of 24 CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor or other person doing business with local governmental entity This questionnaire reflects changes mads to the law by KS.1491.cath Log..Regular Session. OFFICE USE ONLY This questionnaire is being fled In accordance with Chapter 176.Local Government Code Oar Reae wa by a person who has a business relationship as defined by Section 176.001(1-a)with a local governmental entity and the person meets requirements under Section 176 006(a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later then the 7th business day after the date the person becomes aware of facts that require the statement to be flied. See Section 176.006.Local Government Code. A person commits an offense If the person knowingly violates Section 176 006. Local Government Code.M offense under this section is a Class C misdemeanor. J Name of person who has a business relationship with local governmental entity. n/a J nCheek this box if you are filing an update to a previously filed questionnaire. The law requires that you tile an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the ongnally filed questionnaire becomes incomplete or inaccurate) Name of local government officer with whom filer has employment or business relationship. Name of Officer This section(item 3 including subparts A B C b D) must be completed for each officer with whom the filer has an employment or other business relationship as defined by Section 176 001(1-a).Local Government Code Attach additional pages to this Form CIO as necessary A Is the local government officer named in this section receiving or likely to receive taxable income.other than investment mcome,from the filer of the questionnaire? El Yes n No B is the Tiler of the questionnaire receiving or likely to receive taxable income,other than investment income,from or at the direction of the local government officer named in this section AND the taxable income is not received from the local governmental entity? El Yes n No C Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an officer or director,or holds an ownership of ID percent or more? ED Yes n No D Descnbe each employment or business relationship with the local government officer named in this section J Signature of person doing business with the governmental entity Date Adopted 06/24/2067 City of Southlake RFP1606B41OJT160016 Page 23 of 24 Appendix D—No Intent to Submit Form If your firm has chosen mt to submit a proposal for this procurement,please complete this form and submit to: City of Southlake Purchasing Division,Department of Finance 1400 Main Street,Suite 440 Southlake,Texas 76092 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: Cannot submit electronically Company Name(Please print): Authorized Officer Name(Please print): Telephone:( ) Fax:( City of Southlake RFP1606B420JT160016 Page 24 of 24 Car OF SOUTH —AKE ADDENDUM NUMBER#1 To: All Proposers Date: June 30,2916 Request for Proposal:RFP1606B420JT160016 Sewer Manhole and Wet Well Rehabilitation Services Proposal Due Date: 3:00 p.m.,Friday July 8,2016 Addendum No. 1, dated June 30. 2016,per Addendum #1, the City of Southlake is answering vendor submitted questions. QUESTION: In regards to approved products it states Raven 405 or approved equal. What are the approved equal products?We are an applicator of multiple different products that are equal to Raven 405. ANSWER:The request states "or equivalent" not approved equal. Per Page 6 Section 5 Brand Manufacture Reference-The City has determined that any manufacturer's brand defined in the Scope of Services meets the City's product and support need. The manufacturer's reference is not intended to be restrictive,and is only descriptive of the type and quality the City desires to purchase.Quotes for similar manufactured products of hire quality will be considered if the Proposal is fully noted with the manufacturer's brand name and model. The City reserves the right to determine products and support of equal value,and whether other brands or models meet the City's product and support needs.The City does not have an"approved equal"list 2. There are no other chances.Atveue/L ODZIAL—' Sharer Jackson() Chief Financial Officer City of Southlake In the submission of their proposal, Proposer must acknowledge receipt of this addendum. Proposer shall acknowledge this addendum by signing and returning one copy of this notice with their proposal submission. Signed: Sherry Lewis Dated: 7-7-16 Company Name: Lewis Concrete Restoration CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos.1-4 and 6 if there we interested parties. OFFICE USE ONLY Complete Nos.1,2.3,S.and 6 if there we no interested patties. CERTIFICATION OF FILING 1 Name of business entity filing form,and die city,state and country of the business entity's place Certificate Number. of busbies. 2016-102693 Lewis Concrete Restoration Buda,TX United States Dais Flied: 2 Nance of governmental entity or state agency that is a party to the contract for which the form is 08122/2016 being filed. City of Southlake Date Acknowledged: 3 Provide the identification number used by the governmental entity or sate agency to trick or identify the contract,and provide adescriptionoftheservices,goods,or other property to be provided under the contract. RFP1606B420JT160016 Sewer Manhole and Wet Wel Rehab Services Nature of interest 4 Name of Interested Party City.State,Country(place of business) (chock applicable) Controlling I Intermediary 5 Check only If there le NO Interested Party. D 6 AFFIDAVIT i swear,o. ! penally of.. - ry.that tic above•'rctosre is true and cc nett. MICNAELAMiHON7F10NES IA NOiAIiYPUBLICSTIi[fIF Af(fCOAL Oft T12 W1 ztr.,- NOM V 1308121041 r re. ,.M• -•11, 4 d contracting business entity AFFIX NOTARY STAMP/SEAL ABOVE Sworn to and subscribed before me.by the said 54_1 fI y L14 t• t!t'''''i _ this the 2 2 day of_4.14 r. 20 It •to certify which.witness my hand and seal of office. lete#7,1" lVltfl0wt si • rti0A-•S e vc. ‘eCel.r). Signature of o•stering oath Primed name of officer administering oath Tole of*o•administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version VI 0 27'I CERTIFICATE OF INTERESTED PARTIES FORM 1295 of Complete Nos.1-4 and 6 It there are interested parties. OFFICE USE ONLY Complete Nos 1,2,3,5,and 6 it there we no interested parties. CER11RCATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number. of business. 2016-102693 Lewis Concrete Restoration Buda,TX United States Date Filed: 2 rime of governmental entry or state agency that is a party to the contract for which the form is 08/22/2016 being filed City of Southlake Date Acknowledged: 08/23/2016 3 Provide the identification number used by the governmental entity or state agency to track or identity the contract,and provide a description of the services,goods,or other property to be provided under the contract. RFP1606B420JT160016 Sewer Manhole and Wet Weft Rehab Services Nature of interest 4 Name of Interested Perty City,State,Country(place of business) (check applicable) Controling Intermediary 5 Check only if there Is NO Interested Party. Q 6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP/SEAL ABOVE Sworn to and subscribed before me,by the said this the day of 20 to certify which,witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Tide of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1,2.3,5,and 6 if there are no interested parties.CERTIFICATION OF FILING 1 Name of business entity filing form,and the city.state and country of the business entity's place Certificate Number: of business. 2017-246197 Lewis Concrete Restoration Corporation Buda,TX United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 08/0712017 being filed. City of Southlake Date Admowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and p v Aa description of the services,goods, or other property to be provided under the contract. RFP1606134203T160016 SEWER MANHOLE AND WET WELL REHAB SERVICES Nature of interest 4 Name of Interested Party City,State,Country(place of business)check applicable) Controlling I Intermediary l‘i i f)( 5 Check only It there Is NO Interested Party. D 6 AFFIDAVIT Sd01" I pdc,i4 I swear. m,under pe ty perjury,ofthat above disclosure is true and correct. t '' I ' I / rs o Lb,, r Signatu e authorized age t of c ing business entity T. AFFIX NOTARY STAIsAFrf 14(t' 18/11$011 cheat/Sworn to and subscribed before me,by the said ) eITf/ r1 .#'i" tet.,.i r S this the J day of t,LS1' , 201 ,to certify which,witness my hand and seal of office. 1d4/44. .--"')- -. ; 1'/---"..;.--- --. / km 4'1/GIpi i7IG 1att-n) PAI Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883