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Item 4B MemoCITY OF SOUTHLAKE MEMORANDUM (June 21, 2022) To: Shana Yelverton, City Manager From: Rob Cohen, Director of Public Works Item 4B Subject: Award the contract for concrete services to Apex Concrete Construction, Inc. in an amount not to exceed $1,000,000. Action Requested Background Information: Financial Considerations: Award the contract for concrete services to Apex Concrete Construction, Inc. in an amount not to exceed $1,000,000. On May 20, 2022, the City received one sealed proposal for concrete services. Advertisements of the Request for Proposals (RFP) were posted online and in the newspaper. As the sole bidder, Apex Concrete Construction, Inc. was selected as the "Best Value" for all required services. Apex Concrete has provided excellent customer service and are very responsive to the City's needs and requests. This contract includes concrete related services such as street reconstruction and repairs, curb and gutter repairs and new installations, sidewalk new installation and repairs, retaining wall installation and repairs, and drainage flume installations. These services are necessary to maintain City streets and drainage infrastructure in good condition. The evaluation criteria for this RFP includes the following: Evaluation Criteria Weight Vendor Overall Price for Services 30% Vendor Experience Providing Required Services 35% Vendor Ability To Provide Required Services 30% Vendor Past Experience With City 5% Total 100 % This contract award includes four (4) annual renewal options, if the City chooses to renew. The RFB allows up to an eight (8) percent annual price increase on future renewals. Apex Concrete listed the Page 1 of 3 Item 4B maximum amount of four (4) percent price increase per year on renewals. Under the new terms of this contract, Apex Concrete's cost of services increased from $4,011 to $13,402. The increase in the contract value is due to an increase in services provided to the City, from 50-line items to 71-line items, in addition to after -hour services which the previous contract did not outline. In FY 2021, the City spent $691,830 on concrete related services with Apex Concrete. In FY 2022, to date the City has spent approximately $762,000, with additional projects requested to be completed by the end of the year. Therefore, staff is requesting additional authorization to complete other various projects. The table below outlines services performed in FY 2022 and proposed in FY 2023 by Apex Concrete Construction, Inc. Identified as a priority for FY 2023, the City plans to make improvements to sidewalks in Southlake Town Square to enhance pedestrian safety and experience. Apex Concrete Services Cost FY 2022 Expenses -to -date $ 762,000 FY 2022 Proposed Expenses $ 238,000 FY 2022 Total Expenditures $ 1,000,000 FY 2023 Proposed Expenses — SLTS sidewalk improvements $ 250,000 FY 2023 Proposed Expenses — Various Projects Throughout The City$ 750,000 FY 2023 Proposed Expenditures $ 1,000,000 Funding for this agreement is available in the General Fund via the Streets & Drainage Operating budget and the Capital Improvement Program budget. Strategic Link: This item links to the City's Strategy Map strategic focus areas of Mobility, Infrastructure, and Partnerships & Volunteerism. It specifically relates to the City's Corporate Objectives, 132: Collaborate With Select Partners To Implement Service Solutions, and F2: Invest To Provide & Maintain High Quality Public Assets. The Critical Business Outcome is, CBO1: Maintain A Strong Financial Position And Implement Plans And Policies To Ensure Future Financial Strength. Citizen Input/ Board Review: None. Page 2of3 Item 4B Legal Review: The City Attorney reviewed original proposal documents as to form. Alternatives: The City Council may approve or deny this contract. Staff Recommendation: Award the contract for concrete services to Apex Concrete Construction, Inc. in an amount not to exceed $1,000,000. Supporting Documents: All supporting documents pertain to RFP2201 B380AB220002 Attachment A: Bid Tabulation Attachment B: Award Letter Packet Staff Contact: Rob Cohen, Director of Public Works Jack Thompson, Deputy Director of Public Works — Operations Page 3of3 CITY OF SOUTHLAKE Department Finance for PW BID TABULATION FORM Proposal Due: 5/20/2022 �2WIB380AB220002 RFP# Form Prepared By: Tim Slifka for Public Works Name of Vendor APEX CONCRETE APEX CONCRETE Date Prepared: 5-20-2022 CONSTRUCTION INC. CONSTRUCTION INC. DANNY PORTER DANNY PORTER Bonfire Information: 5 Intent Contact Name: to Bid, 13 Document Takers, Contact Number: 817-454-1"5 817-454-1"5 325 Vendors Invited. No HUB information. Formal Purchase. 1080 KATY ROAD 1080 KATY ROAD Physical Address: KELLER, TEXAS 76244 KELLER, TEXAS 76244 ITEM Description: Per Item After Flatwork to Perform all Concrete work NO Hour Services Item # REMOVAL OR DISPOSAL Per Square Foot Additional Fee (Surcharge) 4" Thick (1-500 SF) (Flatwork to perform all concrete work 1 NO REMOVAL OR DISPOSAL $ 8.00 $ 2.50 6" Thick (1-500 SF) (Flatwork to perform all concrete work 2 NO REMOVAL OR DISPOSAL $ 10.00 $ 2.50 8" Thick (1-500 SF) (Flatwork to perform all concrete work 3 NO REMOVAL OR DISPOSAL $ 10.50 $ 2.50 4" Thick (500 and up SF) (Flatwork to perform all concrete 4 work/ NO REMOVAL OR DISPOSAL $ 7.50 $ 2.50 6" Thick (500 and up SF) (Flatwork to perform all concrete 5 work/ NO REMOVAL OR DISPOSAL $ 9.50 $ 2.50 8" Thick (500 and up SF) (Flatwork to perform all concrete 6 work/ NO REMOVAL OR DISPOSAL $ 10.25 $ 2.50 Flatwork to Perform all Concrete Work INCLUDING REMOVAL AND DISPOSAL Per Square Foot 4" Thick (1-500 SF) (Flatwork to perform all concrete work 7 INCLUDING REMOVAL AND DISPOSAL $ 10.20 $ 2.50 6" Thick (1-500 SF) (Flatwork to perform all concrete work 8 INCLUDING REMOVAL AND DISPOSAL $ 12.96 $ 2.50 8" Thick (1-500 SF) (Flatwork to perform all concrete work 9 INCLUDING REMOVAL AND DISPOSAL $ 14.75 $ 2.50 10 4" Thick (500 and up SF) (Flatwork to perform all concrete work/ INCLUDING REMOVAL AND DISPOSAL $ 10.20 $ 2.50 11 6" Thick (500 and up SF) (Flatwork to perform all concrete work/ INCLUDING REMOVAL AND DISPOSAL $ 12.50 $ 2.50 12 8" Thick (500 and up SF) (Flatwork to perform all concrete work/ INCLUDING REMOVAL AND DISPOSAL $ 14.08 $ 2.50 Retaining Wall - Perform all Concrete Work Per Linear Foot 13 6" thick, Vertical Retaining Wall (to Perform all concrete work) For projects of 1-2' High Wall $ 32.00 $ 14 6" thick, Vertical Retaining Wall (to Perform all concrete work) For projects of 2-3' High Wall $ 40.00 $ 15 6" thick, Vertical Retaining Wall (to Perform all concrete work) For projects of 34' High Wall $ 110.00 $ 16 8" thick, Vertical Retaining Wall (to Perform all concrete work) For projects of 1-2' High Wall $ 32.00 $ 17 8" thick, Vertical Retaining Wall (to Perform all concrete work) For projects of 2-3' High Wall $ 45.00 $ 18 8" thick, Vertical Retaining Wall (to Perform all concrete work) For projects of 34' High Wall $ 125.00 $ 19 1'thick, Vertical Retaining Wall (to Perform all concrete work) For projects of 1-2' High Wall $ 42.00 $ 20 1'thick, Vertical Retaining Wall (to Perform all concrete work) For projects of 2-3' High Wall $ 45.00 $ 21 1'thick, Vertical Retaining Wall (to Perform all concrete work)For projects of 34' High Wall $ 135.00 $ Curb and Gutter NO REMOVAL OR DISPOSAL Per Linear Foot 22 0 -100 linear feet of 6" curb and 18" gutter. NO REMOVAL OR DISPOSAL $ 36.00 $ 3.00 23 101- 500 linear feet of 6" curb and 18" gutter. NO REMOVAL OR DISPOSAL $ 35.00 $ 3.00 24 501-1,000 linear feet of 6" curb and 18" gutter. NO REMOVAL OR DISPOSAL $ 32.00 $ - 25 1,001-1,500 linear feet of 6" curb and 18" gutter. NO REMOVAL OR DISPOSAL $ 32.00 $ 26 1,001-1,500 linear feet of 6" curb and 18" gutter. NO REMOVAL OR DISPOSAL $ 32.00 $ 27 3,001 and Up linear feet of 6" curb and 18" gutter. NO REMOVAL OR DISPOSAL $ 32.00 $ Curb and Gutter INCLUDING REMOVAL AND DISPOSAL Per Linear Foot 28 0 -100 linear feet of 6" curb and 18" gutter. INCLUDING REMOVAL AND DISPOSAL $ 39.50 $ 3.00 29 101- 500 linear feet of 6" curb and 18" gutter. INCLUDING REMOVAL AND DISPOSAL $ 38.50 $ 3.00 30 501-1,000 linear feet of 6" curb and 18" gutter. INCLUDING REMOVAL AND DISPOSAL $ 36.50 $ 31 1,001-1,500 linear feet of 6" curb and 18" gutter. INCLUDING REMOVAL AND DISPOSAL $ 36.50 $ 32 1,501- 3,000 linear feet of 6" curb and 18" gutter. INCLUDING REMOVAL AND DISPOSAL $ 35.00 $ 33 3,001 and Up linear feet of 6" curb and 18" gutter. INCLUDING REMOVAL AND DISPOSAL $ 35.00 $ Construct Barrier -Free Curb Ram 34 Construct Barrier -Free Curb Ramp per Scope of Services $ 2,450.00 $ French Drain Installation Includes all Required Services Per Linear Foot 35 Four Inch (4") French Drain Installation $ 25.00 $ 36 Six Inch (6") French Drain Installation $ 30.00 $ 37 Eight Inch (8") French Drain Installation $ 35.00 $ Unclassified Excavation and Disposal Per Cubic Yard 38 Unclassified Excavation and Disposal Per Scope of Services $ 40.00 $ Manhole Ring and Lid Adjustment - Labor Only Per Hour 39 Manhole Ring and Lid Adjustment Per Scope of Services $ 150.00 $ Water Valve Adjustment Labor Only Per Hour 40 Water Valve Adjustment Per Scope of Services $ 150.00 $ Install, Remove and/or Replace Headwalls Per Each 41 Remove and Replace Headwalls per Scope of Services $ 3,600.00 $ 0-36" each 42 Construct New Headwall, Per Each $ 3,600.00 $ 0-36" each Install, Remove and/or Reset 12" to 36" Reinforced Concrete Pipe (RCP) all inclusive Per Linear Foot 43 Remove and Reset Reinforced Concrete Pipe (RCP) per Scope of Services $ 75.00 $ 44 Install New 12" to 36" Reinforced Concrete Pipe (RCP) all inclusive Per Linear Foot $ 150.00 $ Rough and Finish Grading including Labor and Equipment Required (Material not included) Per Square Foot 45 Rough and Finish Grading per Scope of Services $ 1.10 $ General Laborer Services including Required Equipment Per Man, Per Hour 46 General Laborer Services per Scope of Services $ 135.00 $ Equipment + 2 Men Install 4"-6" Rip -Rap including all required Material, Labor, Equipment Per Square Foot 47 Rip -Rap Installation per Scope of Services $ 5.75 $ Exposed Aggregate Finish Per Square Foot 48 Exposed Aggregate Finish 1 to 500 SF per Scope of Services $ 11.50 $ 49 Exposed Aggregate Finish 501 and up SF per Scope of Services $ 10.50 $ Colored Concrete Per Square Foot 50 Colored Concrete 1 to 500 SF per Scope of Services $ 11.50 $ 51 Colored Concrete 501 and up SF per Scope of Services $ 10.50 $ Installation of Brick Pavers and Truncated Domes - Labor Only Per Square Foot 52 Brick Paver and Truncated Domes Installation per Scope of Services $ 6.85 $ Stamped Concrete, Per Square Foot 53 Stamped Concrete Per Scope of Services $ 14.50 $ Erosion Control Measures 54 Rock Filter Dam, Per Scope of Services, Per Cubic Yard $ 32.00 $ 55 Temporary Sediment Control Fence, Per Scope of Services, Per Linear Foot $ 2.10 $ 56 Curb Inlet Protection, Per Scope of Services, Per Linear Foot $ 10.00 $ Flowable Backfill, Per Cubic Yard 57 Flowable Backfill, Per Scope of Services, Per Cubic Yard $ 175.00 Embankment Per Scope of Services, Per Cubic Yard $ 58 Embankment per Scope of Services Per Cubic Yard $ 46.00 $ Handrail Removal and Reinstallation Services Per Linear Foot 59 Handrail Removal and Reinstallation Services Per Scope of Services Per TxDOT Type PRl Specifications $ 56.00 $ 60 Handrail Removal and Reinstallation Services Per Scope of Services Per AC1318-06 Specification $ 85.00 $ New Handrail Installation Services Per Linear Foot 61 New Handrail Installation Services Per Scope of Services Per TxDOT PR1 Specification $ 350.00 $ Decorative 62 New Handrail Installation Services Per Scope of Services Per Decorative Handrail AC1381-06 Specification $ 350.00 $ Galvanizad Fence Removal and Reinstallation Services Per Scope of Services, Per Linear Foot 63 Chain Link Fence $ 42.00 $ 8' hi h 64 Wooden Fence $ 68.00 $ 6' Cedar 65 Wrought Iron Fence $ 84.00 $ 5' 66 Barbed Wire Fence $ 55.00 $ 5 Strand 67 Vinyl Fence $ 62.00 $ 6' 68 Metal Pipe Fence $ 75.00 $ Paint not included 69 Brick Fence $ 150.00 $ 6' Install F1exBase including all required Material, Labor, Equipment Per Square Yard 70 Install F1exBase Per Scope of Services $ 22.50 $ 6" thick Install Top Soil including all required Material, Labor, Equipment Per Square Yard 71 Install Top Soil per Scope of Services $ 27.00 S 6" thick Additional Vendor Charges Not Listed. Please Describe. 72 Additional Vendor Fee Not Specifically Listed $ - S 73 Additional Vendor Fee Not Specifically Listed $ - S 74 Additional Vendor Fee Not Specifically Listed $ - S 75 Additional Vendor Fee Not Specifically Listed $ - S TOTAL ONE SERVICE ALL ITEMS $ 13,360.24 $ 42.00 First Year Escalation Percentage 4 % 4.00% Second Year Escalation Percentage 4 % 4.00% Third Year Escalation Percentage 4 % 4.00% Fourth Year Escalation Percentage 4% 4.00% First Year Renewal $ 13,894.65 $ 43.68 Second Year Renewal $ 14,450.44 $ 45.43 Third Year Renewal $ 15,028.45 $ 47.24 Fourth Year Renewal $ 15,629.59 $ 49.13 Total: $ 72,363.37 $ 227.49 NOTE TO PURCHASING MANAGER: $72,590.86 Total 1 Each Request award to Apex Concrete Construction Inc. for the following reason(s): Low Bid Delivery Time _X_ Other _BEST VALUE_ Attachment B Apex Concrete Construction Inc. 1080 Katy Road Keller, Texas 76244 Attn: Mr. Danny Porter Subject: Contract Award Notification for Concrete Services RFP2201B380AB220002 Dear Mr. Porter: The City of Southlake is pleased to inform you that Apex Concrete Construction Inc., of Keller, Texas is the awarded vendor for "Concrete Services RFP2201B380AB220002" The award and this agreement are based on your proposal to the City, copy enclosed. This is a single vendor award contract. Your company's award is attached. This award was approved by the City of Southlake City Council on 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: Anthony Blain 817-748-8604 Send all billing to: City of Southlake accountspayable&ci.southlake.tx.us (preferred) or 1400 Main Street, Suite 420, Accounts Payable, Southlake, TX 76092 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, CPPO, CPPB Purchasing Manager City of Southlake 1400 Main Street, Suite 420 Southlake, Texas 76092 tslifka(& ci. southlake.tx.us Contract and Award Accepted: Signed: Mayor John Huffman City of Southlake Date: Attest: Amy Shelley, TRMC City Secretary Approved as to Form and Legality: City Attorney Primary Responses Success: All data is valid! Numeric :,.Quantity ELRequired Per Iterr escripJi Normal Wi Flatwork to Perform all Concrete work NO REMOVAL OR DISPOSAL Per Square Foot Success: All values provided Bid #1-1 4" Thick (1-500 SF) (Flatwork to perform all 1 $ 8.00 concrete work / NO REMOVAL OR DISPOSAL Success: All values provided Bid #1-2 6" Thick (1-500 SF) (Flatwork to perform all 1 $ 10.00 concrete work / NO REMOVAL OR DISPOSAL Success: All values provided Bid #1-3 8" Thick (1-500 SF) (Flatwork to perform all 1 $ 10.50 concrete work / NO REMOVAL OR DISPOSAL Success: All values provided Bid #1-4 4" Thick (500 and up SF) (Flatwork to perform all 1 concrete work / NO REMOVAL OR DISPOSAL Success: All values provided Bid #1-5 6" Thick (500 and up SF) (Flatwork to perform all 1 concrete work / NO REMOVAL OR DISPOSAL Success: All values provided Bid #1-6 8" Thick (500 and up SF) (Flatwork to perform all 1 concrete work / NO REMOVAL OR DISPOSAL $ 7.50 $ 9.50 $ 2.50 per square foot $ 10.50 $ 2.50 per square foot $ 12.50 $ 2.50 per square foot $ 13.00 $ 2.50 per square foot $ 10.00 $ 2.50 per square foot $ 12.00 $ 10.25 $ 2.50 per square foot $ 12.75 Flatwork to Perform all Concrete Work INCLUDING REMOVAL AND DISPOSAL Per Square Foot 4" Thick (1-500 SF) (Flatwork to perform all Success: All values provided #2-1 concrete work / INCLUDING REMOVAL AND 1 $ 10.20 I $ 2.50 per square foot $ 12.70 DISPOSAL 6" Thick (1-500 SF) (Flatwork to perform all Success: All values provided Bid #2-2 concrete work / INCLUDING REMOVAL AND 1 $ 12.96 $ 2.50 per square foot $ 15.46 DISPOSAL 8" Thick (1-500 SF) (Flatwork to perform all Success: All values provided Bid #2-3 concrete work / INCLUDING REMOVAL AND 1 $ 14.75 $ 2.50 per square foot $ 17.25 DISPOSAL 4" Thick (500 and up SF) (Flatwork to perform all Success: All values provided Bid #24 concrete work / INCLUDING REMOVAL AND 1 $ 10.20 $ 2.50 per square foot $ 12.70 DISPOSAL 6" Thick (500 and up SF) (Flatwork to perform all Success: All values provided Bid #2-5 concrete work / INCLUDING REMOVAL AND 1 $ 12.50 $ 2.50 per square foot $ 15.00 DISPOSAL 8" Thick (500 and up SF) (Flatwork to perform all Success: All values provided Bid #2-6 concrete work / INCLUDING REMOVAL AND 1 $ 14.08 $ 2.50 per square foot $ 16.58 DISPOSAL Retaining Wall - Perform all Concrete Work Per Linear Foot Success: All values provided Bid #3-1 6" thick, Vertical Retaining Wall (to Perform all 1 $ 32.00 $ 0.00 NA $ 32.00 concrete work) For projects of 1-2' High Wall Success: All values provided Bid #3-2 6" thick, Vertical Retaining Wall (to Perform all 1 $ 40.00 $ 0.00 NA $ 40.00 concrete work) For projects of 2-3' High Wall Success: All values provided Bid #3-3 6" thick, Vertical Retaining Wall (to Perform all 1 $ 110.00 $ 0.00 NA $ 110.00 concrete work) For projects of 3-4' High Wall Success: All values provided Bid #34 8" thick, Vertical Retaining Wall (to Perform all 1 $ 32.00 $ 0.00 NA $ 32.00 concrete work) For projects of 1-2' High Wall Success: All values provided Bid #3-5 8" thick, Vertical Retaining Wall (to Perform all 1 $ 45.00 $ 0.00 NA $ 45.00 concrete work) For projects of 2-3' High Wall Success: All values provided Bid #3-6 8" thick, Vertical Retaining Wall (to Perform all 1 $ 125.00 $ o.00 NA $ 125.00 concrete work) For projects of 3-4' High Wall Success: All values provided Bid #3-7 1' thick, Vertical Retaining Wall (to Perform all 1 $ 42.00 $ 0.00 NA $ 42.00 concrete work) For projects of 1-2' High Wall Success: All values provided Bid #3-8 1' thick, Vertical Retaining Wall (to Perform all 1 concrete work) For projects of 2-3' High Wall Success: All values provided Bid #3-9 1' thick, Vertical Retaining Wall (to Perform all 1 concrete work)For projects of 34' High Wall Curb and Gutter NO REMOVAL OR DISPOSAL Per Linear Foot Success: All values provided Bid #4-1 0 - 100 linear feet of 6" curb and 18" gutter. NO 1 REMOVAL OR DISPOSAL Success: All values provided Bid #4-2 101 - 500 linear feet of 6" curb and 18" gutter. NO 1 REMOVAL OR DISPOSAL Success: All values provided Bid #4-3 501 - 1,000 linear feet of 6" curb and 18" gutter. 1 NO REMOVAL OR DISPOSAL Success: All values provided Bid #4-4 1,001 - 1,500 linear feet of 6" curb and 18" gutter. 1 NO REMOVAL OR DISPOSAL Success: All values provided Bid #4-5 1,001 - 1,500 linear feet of 6" curb and 18" gutter. 1 NO REMOVAL OR DISPOSAL Success: All values provided Bid #4-6 3,001 and Up linear feet of 6" curb and 18" gutter. 1 NO REMOVAL OR DISPOSAL Curb and Gutter INCLUDING REMOVAL AND DISPOSAL Per Linear Foot Success: All values provided Bid #5-1 0 - 100 linear feet of 6" curb and 18" gutter. 1 INCLUDING REMOVAL AND DISPOSAL Success: All values provided Bid #5-2 101 - 500 linear feet of 6" curb and 18" gutter. 1 INCLUDING REMOVAL AND DISPOSAL Success: All values provided Bid #5-3 501 - 1,000 linear feet of 6" curb and 18" gutter. 1 INCLUDING REMOVAL AND DISPOSAL Success: All values provided Bid #5-4 1,001 - 1,500 linear feet of 6" curb and 18" gutter. 1 INCLUDING REMOVAL AND DISPOSAL Success: All values provided Bid #5-5 1,501 - 3,000 linear feet of 6" curb and 18" gutter. 1 INCLUDING REMOVAL AND DISPOSAL Success: All values provided Bid #5-6 3,001 and Up linear feet of 6" curb and 18" gutter. 1 INCLUDING REMOVAL AND DISPOSAL Construct Barrier -Free Curb Ramp Success: All values provided Bid #6-1 Construct Barrier -Free Curb Ramp per Scope of 1 Services French Drain Installation Includes all Required Services Per Linear Foot Success: All values provided Bid #7-1 Four Inch (4") French Drain Installation 1 Success: All values provided Bid #7-2 Six Inch (6") French Drain Installation 1 Success: All values provided Bid #7-3 Eight Inch (8") French Drain Installation 1 Unclassified Excavation and Disposal Per Cubic Yard Success: All values provided Bid #8-1 Unclassified Excavation and Disposal Per Scope 1 of Services Manhole Ring and Lid Adjustment - Labor Only Per Hour Success: All values provided Bid #9.1 Manhole Ring and Lid Adjustment Per Scope of 1 Services Water Valve Adjustment Labor Only Per Hour Success: All values provided Bid #10-1 Water Valve Adjustment Per Scope of Services 1 $ 45.00 $ 0.00 NA $ 45.00 $ 135.00 $ 0.00 NA $ 135.00 $ 36.00 $ 3.00 per linear foot $ 39.00 $ 35.00 $ 32.00 $ 32.00 $ 32.00 $ 32.00 $ 39.50 $ 38.50 $ 36.50 $ 36.50 $ 35.00 $ 35.00 $ 2,450.00 $ 3.00 per linear foot $ 38.00 $ 0.00 per linear foot $ 32.00 $ 0.00 per linear foot $ 32.00 $ 0.00 per linear foot $ 32.00 $ 0.00 per linear foot $ 32.00 $ 3.00 per linear foot $ 42.50 $ 3.00 per linear foot $ 41.50 $ 0.00 per linear foot $ 36.50 $ 0.00 per linear foot $ 36.50 $ 0.00 per linear foot $ 35.00 $ 0.00 per linear foot $ 35.00 $ 0.00 each $ 2,450.00 1 $ 25.00 $ 0.00 per linear foot $ 25.00 $ 30.00 $ 0.00 per linear foot $ 30.00 $ 35.00 $ 0.00 per linear foot $ 35.00 $ 40.00 $ 0.00 per cubic yard $ 40.00 $ 150.00 $ 0.00 each $ 150.00 $ 150.00 $ 0.00 each $ 150.00 Install, Remove and/or Replace Headwalls Per Each Success: All values provided Bid #11-1 Remove and Replace Headwalls per Scope of 1 $ 3,600.00 $ 0.00 0-36" each $ 3,600.00 Services Success: All values provided Bid #11-2 Construct New Headwall, Per Each 1 $ 3,600.00 $ 0.00 0-36" each $ 3,600.00 Install, Remove and/or Reset 12" to 36" Reinforced Concrete Pipe (RCP) all inclusive Per Linear Foot Success: All values provided Bid #12-1 Remove and Reset Reinforced Concrete Pipe 1 $ 75.00 $ 0.00 per linear foot $ 75.00 (RCP) per Scope of Services Success: All values provided Bid #12-2 Install New 12" to 36" Reinforced Concrete Pipe 1 $ 150.00 $ 0.00 per linear foot $ 150.00 (RCP) all inclusive Per Linear Foot Rough and Finish Grading including Labor and Equipment Required (Material not included) Per Square Foot Success: All values provided Bid #13-1 Rough and Finish Grading per Scope of Services 1 $ 1.10 $ 0.00 per square foot $ 1.10 General Laborer Services including Required Equipment Per Man, Per Hour Success: All values provided Bid #14-1 General Laborer Services per Scope of Services 1 $ 135.00 $ 0.00 Install 4"-6" Rip -Rap including all required Material, Labor, Equipment Per Square Foot Success: All values provided Bid #15-1 Rip -Rap Installation per Scope of Services 1 $ 5.75 $ 0.00 Exposed Aggregate Finish Per Square Foot Success: All values provided Bid #16-1 Exposed Aggregate Finish 1 to 500 SF per Scope 1 of Services Success: All values provided Bid #16-2 Exposed Aggregate Finish 501 and up SF per 1 Scope of Services Colored Concrete Per Square Foot Success: All values provided Bid #17-1 Colored Concrete 1 to 500 SF per Scope of 1 Services Success: All values provided Bid #17-2 Colored Concrete 501 and up SF per Scope of 1 Services Installation of Brick Pavers and Truncated Domes - Labor Only Per Square Foot Success: All values provided Bid #18-1 Brick Paver and Truncated Domes Installation per 1 Scope of Services Stamped Concrete, Per Square Foot Success: All values provided Bid #19-1 Stamped Concrete Per Scope of Services 1 Erosion Control Measures Success: All values provided Bid #20-1 Rock Filter Dam, Per Scope of Services, Per 1 Cubic Yard Success: All values provided Bid #20-2 Temporary Sediment Control Fence, Per Scope of 1 Services, Per Linear Foot Success: All values provided I Bid #20-3 Curb Inlet Protection, Per Scope of Services, Per 1 Linear Foot Flowable Backfill, Per Cubic Yard Success: All values provided Bid #21-1 Flowable Backfill, Per Scope of Services, Per 1 Cubic Yard Equip + 2 men $ 135.00 NA $ 5.75 $ 11.50 $ 0.00 per square foot $ 11.50 $ 10.50 $ 0.00 per square foot $ 10.50 $ 11.50 $ 0.00 per square foot $ 11.50 $ 10.50 $ 0.00 per square foot $ 10.50 $ 6.85 $ 0.00 per square foot $ 6.85 $ 14.50 $ 0.00 per square foot $ 14.50 $ 32.00 $ 0.00 per cubic yard $ 32.00 $ 2.10 $ 0.00 per linear foot $ 2.10 $ 10.00 $ 0.00 per linear foot $ 10.00 $ 175.00 $ 0.00 NA $ 175.00 Embankment Per Scope of Services, Per Cubic Yard Embankment per Scope of Services Per Cubic Success: All values provided Bid #22-1 Yard 1 $ 46.00 $ 0.00 per cubic yard $ 46.00 Handrail Removal and Reinstallation Services Per Linear Foot Handrail Removal and Reinstallation Services Per Success: All values provided Bid #23-1 Scope of Services Per TxDOT Type PR1 1 $ 56.00 $ 0.00 NA $ 56.00 Specifications Success: All values provided Bid #23-2 Handrail Removal and Reinstallation Services Per 1 $ 85.00 $ 0.00 NA $ 85.00 Scope of Services Per ACI318-06 Specification New Handrail Installation Services Per Linear Foot Success: All values provided Bid #24-1 New Handrail Installation Services Per Scope of 1 $ 350.00 $ 0.00 Decorative $ 350.00 Services Per TxDOT PR1 Specification New Handrail Installation Services Per Scope of Success: All values provided Bid #24-2 Services Per Decorative Handrail ACI381-06 1 $ 350.00 $ 0.00 Galvanized $ 350.00 Specification Fence Removal and Reinstallation Services Per Scope of Services, Per Linear Foot Success: All values provided Bid #25-1 Chain Link Fence 1 $ 42.00 $ 0.00 8' High $ 42.00 Success: All values provided Bid #25-2 Wooden Fence 1 $ 68.00 $ 0.00 6' Cedar $ 68.00 Success: All values provided Bid #25-3 Wrought Iron Fence 1 $ 84.00 $ 0.00 5' $ 84.00 Success: All values provided Bid #25-4 Barbed Wire Fence 1 $ 55.00 $ 0.00 5 Strand $ 55.00 Success: All values provided Bid #25-5 Vinyl Fence 1 $ 62.00 $ 0.00 6' $ 62.00 Success: All values provided Bid #25-6 Metal Pipe Fence 1 $ 75.00 $ 0.00 paint not included $ 75.00 Success: All values provided Bid #25-7 Brick Fence 1 $ 150.00 $ 0.00 6' $ 150.00 Install FlexBase including all required Material, Labor, Equipment Per Square Yard Success: All values provided Bid #26-1 Install FlexBase Per Scope of Services 1 $ 22.50 $ 0.00 6" Thick $ 22.50 Install Top Soil including all required Material, Labor, Equipment Per Square Yard Success: All values provided Bid #27-1 Install Top Soil per Scope of Services 1 $ 27.00 $ 0.00 6" Thick $ 27.00 Additional Vendor Charges Not Listed. Please Describe. Not Bidding No Bid #28-1 Additional Vendor Fee Not Specifically Listed 1 - Not Bidding No Bid #28-2 Additional Vendor Fee Not Specifically Listed 1 Not Bidding No Bid #28-3 Additional Vendor Fee Not Specifically Listed 1 Not Bidding No Bid #28-4 Additional Vendor Fee Not Specifically Listed 1 Appendix B — Proposal Submittal Checklist: (To determine validity of proposal) +,/ Appendix B (pages _35 through _"_) must be included in the proposal submittal Appendix C Conflict of Interest Form (page _44, must be included in the proposal submittal. Form 1295 Certificate of Interested Party must be included in the proposal submittal. See page 2. J�13B 89, SB 252, SB 13, and SB 19. See Page _41_. RFP Number: RFP2201B380AB220002 Project Title: Concrete Services Submittal 3:00 P.M. (CST), Friday May 20, 2022 Deadline. Submit Electronically* to: https://southlake.bonfirehub.com/login * Requires email account login and password. Proposer Information: Proposer's Legal Name: Oi7—'r `p C , Address: C QAA City, State & Zip Federal Employers Identification Number #e Phone Number: Fax Number: -' E-Mail Address: (� I DvJ pi & ` M Proposer 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 Repr v Signature of Authorized Representative: Signed this ��(day) of (month)& 2-2(year) City of Southlake - RFP220111380A13220002 - Page 35 of 45 Appendix B — Proposal (continued) I. 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. F1 3. 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/DelivM 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. 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: For this procurement the schedule of pricing is not available in hardcopy. You may access it via the online portal (https://southlake.bonfirehub.com/login). To submit your schedule of pricing, please download the Bid Table and fill it in accordingly per the sample below. w. w...•�.o«—. o...w. tag si. r..... wn { ....m.0 m.....—.... ....... _..Y.tiw ..e. ow.. r..w :......s rn L�ti .—..a.+..a.... e.w i� e. r .ro+.r .w�.......... nae. ......�.r. fvw t..a�..� +.++ro u..b...e..auz. no.t.e... zam..s.. �.:`� .:...h .moo v. s un o.. w.-.�e.t n+•w.•s r.R.sa e�+s. Ha t - ow.we.� ...— �a ...« ✓ie.......i n..........,� �....v. • ear...._. ......a.. ... �,7 .... �........ _. a .,,,. o,. w.-..wa ....v .......ww r w.. .wr i� For instructions on how to complete Bid Tables, please refer to this article on Bonfire's Support Website. Please note: even if you do not have additional responses, you must download and re - upload the blank document. This is to confirm that you do not require any additional costs. If you have any additional items, please fill out the Additional Responses template accordingly. 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: City of Southlake - RFP2201B380AB220002 - Page 36 of 45 4. 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 will be a factor in determining the best value to the City. It is the average price over the period of the contract that will be the price factor considered in the evaluation of this quote. Quotes in which negative or no escalation is shown will be considered as 0% escalation. C. Price Increases Upon Extension: If approved by the City, the Contractor shall modify the rates charged by the Contractor to reflect any changes shown in the comparative statement delivered to the City. The maximum increase allowed under this provision shall be four percent (4%) 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 Escalation Percentage ............................................. 4 % Second Additional Year Escalation Percentage ............................................. 4 % Third Additional Year Escalation Percentage ................................................. 4 % Fourth Additional Year Escalation Percentage 4 o 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: and the number of employees: D. Project Related Experience: All Proposals must include detailed information that details the Proposer's experience and expertise in providing the requested services that demonstrates the Proposer's ability to logically plan and complete the requested project. City of Southlake - RFP2201B380AB220002 - Page 37 of 45 5. References Proposer shall provide four (4) references where Proposer has performed similar to or the same types of services as described herein. Reference #l: Client / Company Name: -- - - ' l n'L9 1�ud Contact Name: Contact Title: Phone: _ n ` Email: Q c k-. 4-Dky Date and Scope of Work Provided: �I low zrz- — 14ot9n,c� - UE Reference #2: Client / Company Name: '0 F- 'R c-kIA4-.;J Contact Name: Contact Title: Phone: -7 _ �,2-? Email: 1Qve t� Date and Scope of Work Provided: IJ Reference #3: Client / Company Name: T Contact Name: Contact Title: f Phone: _ Email:� Date and Scope of Work Provided: pA,wl,— - -6L�-�- e-+ Reference #4: Client / Company Name: Contact Name: N� &Ai- (A — Contact Title: U-) -' Phone: ` � i� _ ct, Email: Date and Scope of Work Provided: t 1 Y— ' Co, -,- City of Southlake - RFP2201B380AB220002 - Page 38 of 45 6. Trade Secrets and/or Confidential Information Trade Secrets and/or Confidential Information: This proposal _ (does) (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: 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: L �!' IF'Eve Contract #: B 1:9 D jQ a Description: CD -!S IEPIN l C-e -s Primary Contact (Name): M 06J k 1 r 7RR_r�- 2_ Primary Contact Phone Numbers: Home: t gj-1-454-199 S Cell: �I�-�►�/� � Secondary Contact (Name): Rp R C [ZT !!i L,A N i' Ij A Secondary Contact Phone Numbers: Home: :5h --4 t74-191U Cell: PrAA r- After Hours emergency opening fee, if applicable: $ /0 D /1i L City of Southlake - RFP2201B380AB220002 - Page 39 of 45 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 RFP from the successful Proposer. 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 Proposer and be responsible for ensuring full compliance with the RFP specifications. Prior to other governmental entities placing orders, the City will notify the successful Proposer of their intent. Please indicate below if you will permit other governmental entities to purchase from your agreement with the City. [>Yes, Others can purchase [ ] No, Only the City can purchase II. CONTRACT TERMS AND CONDITIONS. EXCEPT WHERE PROPOSER MAKES 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. Warrant( 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. City of Southlake - RFP2201B380AB220002 - Page 40 of 45 C. Liens: Proposer shall indemnify and save harmless the City against any and all liens and encumbrances for all labor, goods, and services which may be provided to the City by Proposer or Proposer's vendor(s), and if the City requests, a proper release of all liens or satisfactory evidence of freedom from liens shall be delivered to the City. D. Gratuities / Bribes: Proposer certifies that no bribes in the form of entertainment, gifts, or otherwise, were offered or given by the successful Proposer, or its agent or representative, to any City officer, employee or elected representative, with respect to this RFP or any contract with the City, and that if any such bribe is found to have been made this shall be grounds for voiding of the contract E. Financial Participation: Proposer certifies that it has not received compensation from the City to participate in preparing the specifications or RFP on which the Proposal is based and acknowledges that this contract may be terminated and/or payment withheld if this certification is inaccurate. F. Required Licenses: Proposer certifies that he holds all licenses required by the State of Texas for a provider of the goods and/or services described by the Scope of Services herein. G. Authority to Submit Proposal and Enter Contract: The person signing on behalf of Proposer certifies that the signer has authority to submit the Proposal on behalf of the Proposer and to bind the Proposer to any resulting contract. 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. I. Compliance with HB 89: Proposer agrees per HB 89 vendor shall not boycott Israel at any time while providing roducts or services to the City of Southlake. Yes, we agree [ ] No, we do not agree [ ] N/A J. Compliance with SB 252: Proposer agrees per SB 252 vendor shall not do business with Iran, Sudan or a foreign terrorist organization while providing products or services to the City of Southlake. Kyes, we agree [ ] No, we do not agree K. Compliance with SB 13: Proposer agrees per SB 13 vendor does not boycott energy companies as those terms are defined in the Texas Government Code § 809.001, and will not boycott energy companies during the term of any contract with the City of Southlake. Yes, we agree [ ] No, we do not agree L. Compliance with SB 19: Proposer agrees per SB 19 vendor does not have a practice, policy, guidance, or directive that discriminates against a firearm entity or firearm trade association as those terms are defined in the Texas Government Code § 2274.001, and that vendor will not so discriminate during the term of any contract with the City of Southlake. MI'Ves, we agree [ ] No, we do not agree 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; City of Southlake - RFP220113380AB220002 - Page 41 of 45 ii. Commercial General Liability insurance, including Blanket Contractual Liability, Broad Form Property Damage, Personal Injury, Completed Operations/Products Liability, Premises Liability, Medical Payments, Interest of Employees as additional insureds, and Broad Form General Liability Endorsements, for at least One Million Dollars ($1,000,000) Combined Single Limit Bodily Injury and Property Damage on an occurrence basis; iii. Comprehensive Automobile Liability insurance covering all owned, non -owned or hired automobiles to be used by the Contractor, with coverage for at least One Million Dollars ($1,000,000) Combined Single Limit Bodily Injury and Property Damage. B. Indemnification: Proposer agrees to defend, indemnify and hold harmless the City, all of its officers, Council members, agents and employees from and against all claims, actions, 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. City of Southlake - RFP2201B380AB220002 - Page 42 of 45 Appendix C — Form CIQ INFORMATION RVGAgDJNG VENDOR CONFLICT ICT OF INTEREST ST OUESTIONN m r 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: 1. 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: 1. Mayor and City Council Members; 2. 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 413 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 price 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 CIQ) 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. The 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 - RFP2201B380AB220002 - Page 43 of 45 CONFLICT OF INTEREST QUESTIONNAIRE For vendor or other person doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 1491. 80th Leg.. Regular Session. This questionnaire is being filed in accordance ,, ith Chapter 176. Local Government Code by a person .,rho 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 la " this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the person becomes aware of facts that require the statement to be filed. See Section 176.006. Local Government Code. A person commits an offense if the person knowingly violates Section 176.006. Local Government Code. An offense under this section is a Class C misdemeanor. Name of person who has a business relationship with local governmental entity. ❑ Check this box if you are filing an update to a previously filed questionnaire. FORM CIQ OFFICE USE ONLY D,Ite Rece.' ed (The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date the originally 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 & 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 income. from the filer of the questionnaire? Yes a No `v B Is the filer 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? 1 / 1 Yes � No /t / 1� C Is the filer of this questionnaire employed by ��a c rporation or other business entity with respect to which the local government officer serves as an officer or director, or he d� an ownership of 10 percent or more? Yes a No /r4 D. Describe each employment or business relationship with the local government officer named in this section. luikL69W z Signature of person doing business with the governmental entity pate Adopted 06/29/2007 City of Southlake - RFP220lB380AB220002 - Page 44 of45 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Apex Concrete Construction Inc. 2022-887409 Keller, TX United States Date Filed: 05/17/2022 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Southlake, Texas Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. RFP220113380AB220002 Concrete Services 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling Intermediary V- 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION a I My name is and my date of birth My address is y1 % ke I /E iZ -7/ct42 (st et) (city) (state) (zip code) (country) I declare under penalty of�perjury the foregoing is true and correct. ythat Executed in / r iF-K �/� l�%� County, State of , L )(-/4 I on the L#ay of L 20�� (month (year) Sign ture of autho ¢ed agent of contracting business entity (Declarant) Forms nrnviriari by Tavnc Fthi- r^ - VVVVVV.GU IIL Z.JLQLMLA.Ub Version V1.1.191b5cdc