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Item 4HCITY OF SOUTHLAK- MEMORANDUM June 1, 2011 To: Shana Yelverton, City Manager From: Kari Happold, Deputy Director of Community Services 4H - 1 Subject: Award contract with Millican Well Service for the drilling and installation of a water well at Bob Jones Park in the amount of $99,230 Action Requested: City Council award of bid to Millican Well Service for a contract to drill and install a well at Bob Jones Park in the amount of $99,230. Background Information: Included within the approved FY 2011 SPDC Operating Budget is $100,000 for the drilling and installation of a well at Bob Jones Park. The well will be located south of the south pond in the park and used for irrigation purposes as necessary for the softball fields. The City received and opened three (3) bids on May 6, 2011, in accordance with State bidding procedures. Millican Well Service submitted a total bid of $107,780. Per the specifications and based on a review of the bidders, Millican Well Service scored highest with regard to providing the City the best overall value. The City performed a reference check on Millican Well Service and all references indicated satisfaction with their services. Millican Well Service is located in Fort Worth and has been in operation since 1977. The drilling and well installation specifics are: Description of Product /Services Price Provide Water Well Drilling Services per Scope of Services for 3601 N. White Chapel Blvd. Location in $67,670.00 Bob Jones Park south of south pond. Install permanent equipment; well cover, discharge pipe and pumping equipment as specified in $31 "Estimate" section of bid document Total $99,230.00 City of Southlake Values: Integrity ♦ Innovation ♦ Accountability ♦ Commitment to Excellence ♦ Teamwork Shana Yelverton, City Manager City Council Meeting Date — June 7, 2011 Page 2 4H -2 Not included as part of the proposed award is the electrical work and test pump at a reduction of $8,550 of the original contract amount of $107,780. A test pump, which provides flow information, was not required for this well location, and the electrical work (approximately $2,000) will be completed by the City's electrical contractor and funded through the general fund operating budget. Financial Considerations: Funding in the amount of $100,000 is available in the SPDC Operating Budget for this project. Strategic Link: This project is aligned with the Strategic Focus Area of Infrastructure and meets the Corporate Objectives to Provide Attractive and Unique Spaces for Enjoyment of Personal Interests and Invest to Provide and Maintain High Quality Public Assets. Citizen Input/ Board Review: City Council consideration at the June 7, 2011 meeting. Staff recommends award of bid contract to Millican Well Service based on "Best Value." City Council approved the budget (7 -0) at their September 21, 2010 meeting. Legal Review: Bid process followed State bidding procedures. Contract documents and specifications standard format previously reviewed by City Attorney. Alternatives: Alternatives may include: • City Council approval as presented • City Council approval with modifications • City Council decision not to approve Supporting Documents: Proposed Award of Bid Contract Letter from Finance Department Copy of Bid document from Millican Well Service Staff Recommendation: City Council award contract with Millican Well Service for the drilling and installation of a water well at Bob Jones Park in the amount of $99,230. City of Southlake Values: Integrity ♦ Innovation ♦ Accountability ♦ Commitment to Excellence ♦ Teamwork 4H -3 C t I 01, SOUTHLAKE May 13, 2011 Millican Well Service LLC PO Box 820487 Fort Worth, Texas 76182 ATTN: Ms. Charlotte Bronning Subject: RFP1104B540SC110010 PROVIDE WATER WELL DRILLING SERVICES FOR CITY OF SOUTH LAKE Dear Ms. Bronning: The City of Southlake is pleased to inform you that Millican Well Service LLC of Fort Worth, Texas is the awarded vendor for "RFP1104B540SC110010 PROVIDE WATER WELL DRILLING SERVICES FOR CITY OF SOUTHLAKE ". 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 purchasing 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 City Contact: SHANE CLOUD 817 - 748 -8026 Send all billing to: City of Southlake 1400 Main Street, Suite 440, 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 Purchasing Manager City of Southlake 1400 Main Street, Suite 440 Southlake, Texas 76092 tslifka(@,ci.southlake.tx.us Phone / Fax: 817.748.8312 / 817.748.8048 Contract and Award Accepted: Signed: DATE: Mayor John Terrell 1400 Main Street, Suite 440 Southlake, Texas 76092 N 4H -4 Appendix B — Proposal Submittal Checklist: (To determine validity of proposal) Appendix B (pages S_ through _17, mast be included in the proposal submittal Appendix C (page _17, Conflict of interest Form must be included in the proposal submittal. All proposals submitted to the City o f Proposal and affix a c opy of thisfo RFP Number: RFP1104B540SC110010 PROVIDE WATER WELL DRILLING SERVICES Project Title: FOR CITY OF SOUTHLAI E Submittal Deadline: 3:00 P.NL (CST), FRIDAY MAY 6, 2011 City Secretary's Office Submit to: 1400 Main Street, Suite 270 Southlake, TX 76092 81 748 -8016 Proposer Information: / fe I Pro poser's Legal Name: ! / ea-A k v ! e e I,(, Address: P. 4 . 06 s-- g mm City, State & zip r 4 • WO k7 r1 - T4 . 76 IS a Federal Employers Identification Number # _ / `�.5 . .2 9 S 7 3` '- 1 Phone Number: -,� ,V" UO 77 Fax Number. -Mail Address: /77 ' 4-n Wel S✓e_ �a -�e Proposer Authorization 1, 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 Re resentative: ld Signature of Authorized Representative: f Signed this J (day) of l� �/ (month),Ot � / (Year) I learned of this Request for Proposals by the following means: ❑ Newspaper Advertisement ❑ Southlake Website ❑ Mailed Me a Copy [" City E -mail Notification ❑ Cold Cali to City ❑ Other City of Southlake - RFP1104H540SC110010 - Page 8 of 21 4H —5 Appendix B — Proposal (continued) L REQUIRED PROPOSAL INFORMATION IN ORDER FOR A PROPOSAL TO BE CONSIDERED COMPLETE, AND TO BE EVALUATED FOR A CONTRACTAWARD BY THE CITY, PROPOSER MUST SUBMITALL OF THE FOLLOWINGINFORAVIATION: 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. Proiect 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 Quantit ` Description of Products/Services Price 1. 1 Svc. Provide Water Well Drilling Services per Scope of Services for 3601 N. White Chapel Location $ 2. Per Svc. Installation of Test Pump and Motor Assembly to Provide Accurate Water Flow Rate Prior to Setting of Permanent Pump and Motor Assembly $ �55 d , o d 2. Per. Other Vendor Charges. Please List: fNSf�F[ PE( $ r 0 f " 3e- G� ` 3. Per. Other Vendor Charges. Please List: $ TOTAL ALL LINE ITEMS $ City ofSouthlake - RFP1104B540SC110010 - Page 9 of 21 4H -6 MILLICAN WELL SERVICE LLC P.O. BOX 820487 FORT WORTH, TEXAS 76182 817- 232 -0077 Name 1 Address City of Southlake 1400 Main Street Suite 250 Southlake, Texas 76092 Estimate Date Well Name 5/5/2011 Bob Jones Park Qty Description Cost Total 1 Labor and equipment to drill and construct a 6" water well 67,670.00 67,670.00 completed as specified in the contract documents. 1 Labor and equipment to install testing equipment and run a 36 hour 8,550.00 8,550.00 pumping test according to the contract documents. This does not include any water samples. 1 Labor and equipment to install the permanent pumping equipment 31,560.00 31,560.00 as specified in the contract documents. Goulds 65L pump end FE 20hp 460v 3ph motor Pumping panel and submonitor 2 112" Galvanized pipe 2 112" API Couplings 2 112" Check valves #6 cable Airline and gauges Well head Well cover Insulation Discharge pipe installed r Subt $107,780.00 Jerry Br � g Sales Tax (0.0 %) $0.00 Texas Department of Licensing and Regulation P.O. Box 12157 To tal $107,780.00 : Austin, Texas 78711 512 -162 -7880 4H -7 3. Proposer's Experience / Std 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 nuinber 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 ofSouthlake - RFP1104B540SC110010 - Page 10 of 21 4_ !!s cerne &V Coact Title: ! Ad s k e e Pe P- Phone: Email: A7- q 79 - 5 8 9 L I j W eA(le r c),5+ e r „ lu Date and S 710 of Work Provided: e „ � 1e l (AlOf e-m bet, c2l' �f lC cu X S�au 4f a W Need P-d (0-S . rJ-A lJ Q.!' o -F 4 e- ive 11 s Reference #2: Client / Company Name: (- arre fte ek Contact Name: Contact Title: B.?n,� -� �e nr nct NG-(0 nl ��IIIe� � ReSic�etc_f Phone: b . Y3 f r 4 / 6 Email: Date and Scope of Work (Q Provided: r�ex`( I e. a� Lr � Se u e&a,l IV e s j _ 6'Qe.h b IeLit -F . f ` gI N,q rn/� W ".01 S PL tt r' e zr NIL It 1--+ 1°�.L A-- (J 12 r�l - S IUC eo � Phone: Email: L7CIQUlclSan �GrIt1�CZ(JU• dr Date and scope of Work Provided ; 4 A ped � l�,eiif 2rcd �o �4 pt - C '`Wa-ft2G -�,c.4Ae, nrer ��;b, g7a r�o 0 if ,0,v.s -r � ' rr, +urn -rte. �eV W ��s Reference 43: Client / Company Name: g f lvO 2A GOD C IVG lNtT1Z ( 4) Contact Name: Contact Title: ,�,�q� bfhrtclsnn! Reference #4: Client / Company Name:.r Ow ilex-g5 A sso eia,(Y`a nl Contact Name: JotwJ Idea-M Contact Title A d FF /6 - 7L , Phone: I ' J f� - 06 5 Email: Date and Scope of Work Provided: ,' Jai � ��07 k! 6 0, pV,4 *A Well �aNS -f�c uc �. �u�vr N lYly ! S !i+l SKfS�i`L j mf&4et ive!!S.��S Jed) -� / O aty of southlake - RFP1104B540SC110010 - Page 11 of 21 4H -8 References Proposer shall provide four (4) references 'where Proposer has performed similar to or the same types of services as described herein. Reference #1: Client / Company Name: gyrbe b aN� Contact Name: 4H -9 5. Trade Secrets and/or Confidential Information Trade Sqggs and/or Confidential Information: This proposal — (does) _t (does not) contain trade h trade secrets and confidential secrets and/or confidential information. If applicable, desgrube san ualifies for legal protection from information, and the basis for your assertion that such material q disclosure. 6. 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 Proposers Social Security Number: # - II. CONTRACT TERMS AND C 0 DITION& EXCEPT WAERE PROPOSER A1AKES SPECIFIC EXCEMONRV 72ZE SUBMITTED PROPOSAL, ANY CONTRACT RESULTING FROM TATS RFP WILL CONTAIN TTIE FOLLOWING TERMS AND CONDITIONS, WAICA PROPOSER Il►EREBY ASNOWLEDGES, 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 finished 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 o1; any other express written warranties provided. C. Late Delive 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 Cry until City actually receivers, takes possession, an accepts the goods and the installation of such goods, has tested the system, that it is in good and acceptable working order. 2. Nfisceffaneous A. Inde derrt Contractor: Proposer agrees that Proposer and Proposer's employees and agents have no loyee relationship with City. Proposer agrees that if Proposer is selected and awarded a contrast, 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 finish any medical or retirement benefits or any paid vacation or sick leave. B. Ass=rnents 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 ofSouthlake - RFP1104B540SC110010 - Page 12 of 21 4H - 10 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 Proposee 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 Partici ation 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. Rgq&W 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. Authori to Submit Pro sal 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 Com liance 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 1bliflion 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 NUtion 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, casts, 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. [lily of Southlake - RFP1104BS40SC110010 - Page 13 of 21 4H -11 C. Bond IfflWr prior to the com mencement 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: i. A payment bond in the amount of 100% of the total contract amount 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 100% of the total contract amount insuring full, faithful, and prompt performance of the responsibilities contained in this contract within the time parameters provided herein; and iii. A maintenance bond insuring full and prompt maintenance, repair and/or replacement of the goods to be provided by Proposer for a period of one (1) year from date of acceptance by the City. Chy of SouthAdre - RFP1104BWSC1U1DIO - Page 14 of 21 4H - 12 Appendix C -- Form CIQ INFORMATTIONREGARDING VENDOR CONFLICT OFINT'EREST QUESTT'OAWA RE elm WHO: A person mus file a eontlict of interest queffdonnaire with the City if the Person has a employment or business relationship with an officer of the City that results tin taxable income exceeding $2,500 during the preceding twelve month period, or an officer or a member of the officer's family has accepted gifits with an aggregate value of more than $254 during the previous twelve month period and the person engages many of the fallowing actions: 1. contracts or seeks to contract for the sale or purchase of property, goods, or services with the City, including any of the following: a written and implied contracts, utility purchase$, 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 ProPffX including an auction ofproperty; U. 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 talc abatement audlor economic development incentive that will result m a contract with the City. THE FOLLOWING ARE CONSIDERED OFFICERS OF THE CITY: 1. Mayor and City Cauncil Members; 2. City Manager; 3. Board and Commission members appointed by the Mayor or City Council members; 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 signs contracts on behalf of the City. EXCLUSIONS: A questionnaire statement need not be filed if the money paid to a local government officer was a political contribution, a gift to a member of the officer's family from a family member; a Con t r actor purchase of less than $2,500 or a transaction at a price and subject w:69oa mu1 .1Misaaw=0Chapter 136AM4W=tC1Q.092W &doe Pogo r of3 CYty of Southlake - RFP1104BS40SC110010 - Page 15 of 21 4H - 13 to terms available to the public; a payment for food, lodging, transportation or entertaimnent; or a transaction subject W rate or fee regulation by a governmental entity or agency. WgAT: A person or business that contracts wth the City or who seeks to cOn Tact with the City must file a 'conflict of interest questionnaire" (FORM CIQ) which is available online at w+ww_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 inioaYpret various portions of the questionnaire. WHEN. The person or business must file: 1. the questionnaire no later than seven days after the date *a 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 Weement with the City; and 2. an updated questionnaire within seven days after the date of an event tlxat would make a filed questionnaire incomplete ar inaccurate. It does not matter if the submittal of a bid or proposal results in a contract. The statute requires a vendor to fife a FORM CIQ at the time a proposal is submitted or negotiations commence. mad or deliver a completed questionnaire to the WHERE: The vendor . The Free Deft is required by law PW the meu& an the Finance Deem City's internet websue. ENFORCRMMNT: Paiute to file a questionnaire is a class c misdemeanor punishable by a fine not to exceed $SD4. 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. W;ls*wWWc MhwFlenwAChapW 176_A=db scut CIQ.0926HAOr Page 2 oF3 City of Southlake - R"1104BWSC110010 _ Page 16 of 21 4H - 14 CONFLICT OF INTEREST QUESTIONNAIRE 1:01114 CIQ For vendor or other person doing business wfth local swemmental entity This q catty meue reneatm changes made to thm law b¢ H.B. 1491, Sao[ Lap, ftWtA r Peaslen OFFICEUSEONLY DMr Aeodmd Tflisquesdonnace isbeingittled In aecerd2ncawithChaptar176. Local Gavemment Code by a person who hasa business rela5anshipas defrwd by Section 176.1 l(i- q) local goven nserAalen*9ndtheperaoninpaisfegL &emmtsunderSadion 176.()Wa). 9y lawthisqueslionnavemLkstbetiedwdhthetecords a dminiaNdaralthelocal9m mmenial entitynat later than the 71h bus tress dayaft datethe person becomesaware offacts ihatregaasthestaj&M"Atobefiied. See S at tim176_006, Local GorremmentGode. A person commits an offense if the parson knowingly violates Sadion 176.0[)6, local Go a8'enseunderthis section is a Class misdemeanor. t Name of person who has a humlrMs rolefior►shipwlfir Iocal gove rnMOMtal wMtY. x �j I Check' rtoboafyouarenllrl08htrptl10WAp7CVi0u81Y111adQws tlonhalrc. (The law requinrs that you file an updated completed questionnalre with the appropriate Tiling auUwAy not %dsr Than the 7th Erusltless dalr atterihe date the edW aq[ ow quwlim taie becames into ptale or inacrrate.) Name at local 9wammemeflirerwIM Whom filer has emplaymiot cu'buslnass relatfhnsW. Name of Otaeer Thle snrcfion wn a including subparts A. B, C A D1 must he cwnpl°_ted Tor each outer vft whom the flier has an employment or other busibiess retabunship m dsfined by Sin Loral sovemmtYd Code. Aflath additional pages to this FWm CGS as nBmmy A. lathe local gausrrnnent alto named is nib swHon rnwhdng or elrsly 14 fecmm Taxable aloxne, ottt�ttsan inrestmeN Income. from its filer of hie 4uesfion imW Ysn dN0 B. is the 2srof the quash nnalm receiving 9r lk* to receive Wxab a thcome, 0 her Than iwesartent Income. Tram or WIN) dlretliun of the local government officer named in this seeaon AND the taxaula income Is not received from the local govemmentel enllly? C. is the filer of this questtonnalra employed by a corporation or other Mriness eatlty with respect ID which the local govermnant otpcer serves as an Y keeior, or holds an anmarship of 10 percent ar mare? yes ©_ Describe each anX&yMwt or business rewuw ahlp wdh the krrai gavenwent omcer named In ibis seellom 4 i � ✓ g; siyukn CX peron dWD boshaes wlm fin gave.." -"ty usm Adopted oer29n W .NSuutldakeilulb=HanemulChsptar 176.AfmdhmmtC1Q.0926G&doC Pap 3 of3 aF , of Southlake - R"1104H640SC110010 - Page 17 of 21 4H - 15 ADDENDUM NUMBER # 1 TO: A4 Proposers DATE: APRIL 19, 2011 REQUEST FOR PROPOSAL: RFP1104BWSC110010 PROVIDE WATER WELL DRILLING SERVICES FOR CI'T'Y OF SOUTHLAKE PROPOSAL DUE DATE: 3:00 p.m., FRIDAY MAY 6, 2011 1. ADDENDUM NO. 1. dated APRIL 1& 2011. per Addendum #1, the City of Soutblalce is Answering vendor questions from Pre - Proposal meeting. QUESTION: Will well control panel be mounted in Pump House? ANSWER: Yes. QUESTION: Is there a nearby fire hydrant for access to water for drilling purposes? ANSYMR: No. QUESTION: Can we use current well for water access for drilling purposes? ANSWER: Yes. Current well may be utilized for a maximum of twenty four (24) hours at any given tune. Well must be reconnected to discharge pipe after twenty four (24) hours to provide water flow to pond. QUESTION: Do you want a well head cover installed? ANSWER: Yes. Submitted proposal should include well head cover. QUESTION: Do you want heat tape or pipe insulation installed on well head and piping? ANSWER: Either option is acceptable. Please indicate which option is being proposed. QUESTION: ' Where will the discharge pipe be located and is vendor responsible for discharge pipe? ANSWER: Discharge pipe will be directed from well head into the on -site pond. Discharge pipe shall require burial at least twelve (12) inched deep and shall discharge directly into pond. Vendor shall be responsible for installation of discharge pipe. Uycf SWN6- - FinanceQepa&xg • 140OA1th1S Sat- 440 • S01Nhfake reM7E(19e 817.748.8317 An MOIAflirmeWeActlon InstMon 4H - 16 QUESTION: Is vendor responsible for site elm up? ANSWER: Yes. Vendor shall be responsible for site clean -up to include removal of all drilling debris and shall return drill site back to grade and life before condition. QUESTION: What is the proposed budget forthis project? ANSWER: Budget is estimated at One hundred and ten thousand dollars ($110,000.00). 2. THERE ARE NO [ETHER CHANGES. %Jt &VA—, OA UQ � Shar Director of Finance City of Southlake IN THE SUBNESSION OF HIS PROPOSAL, PROPOSER MUST ACKNOWLEDGE RECEIPT OF THIS ADDENDUM. PROPOSER SHALL ACKNOWLEDGE THIS ADDENDUM BY SIGNING AND RETURNING ONE COPY OF THIS NOTICE WI THEIR PROPOSAL. SIGNED: DATED: S j` old U COMPANYNAME: 01yof5 e 0 r=nXDWAMR ` P4AQME7SM - %ft440 • SMm 8ke, raraSM2 81774 98312 An EEO /AfflrmalNe Adon lrnsfEh9an