7118 - Contract Executed
Docusign City Council Transmittal Coversheet
File Name
Purchasing Contact
City Council Target Date
Piggy Back Option
Contract Expiration
Ordinance
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Agreement
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CITY OF DENTON 7118 South Bonnie Brae PH2 (Vintage Boulevard)
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised September 20, 2018
SECTION 00 52 43 1
AGREEMENT 2
THIS AGREEMENT, authorized on ______________is made by and between the City of Denton, 3
a Texas home rule municipality, acting by and through its duly authorized City Manager, (“City”), 4
and Pavecon Public Works LP, authorized to do business in Texas, acting by and through its duly 5
authorized representative, (“Contractor”). 6
City and Contractor, in consideration of the mutual covenants hereinafter set forth, agree as follows: 7
Article 1. WORK 8
Contractor shall complete all Work as specified or indicated in the Contract Documents for the 9
Project identified herein. 10
Article 2. PROJECT 11
The project for which the Work under the Contract Documents may be the whole or only a part is 12
generally described as follows: 13
South Bonnie Brae PH 2 (Vintage Boulevard) 14
Contract No: 7118 15
Article 3. CONTRACT PRICE 16
City agrees to pay Contractor for performance of the Work in accordance with the Contract 17
Documents an amount, in current funds, of Eleven million six hundred thirty-eight thousand three 18
hundred twenty-three Dollars and 40/100 cents ($11,638,323.40). 19
Article 4. CONTRACT TIME 20
4.1 Final Acceptance. 21
The Work will be complete for Final Acceptance within 450 days after the date when the 22
Contract Time commences to run, as provided in Paragraph 2.03 of the General Conditions, 23
plus any extension thereof allowed in accordance with Article 12 of the General Conditions. 24
4.2 Liquidated Damages 25
Contractor recognizes that time is of the essence for completion of Milestones, if any, and 26
to achieve Final Acceptance of the Work and City will suffer financial loss if the Work is 27
not completed within the time(s) specified in Paragraph 4.1 above. The Contractor also 28
recognizes the delays, expense and difficulties involved in proving in a legal proceeding, 29
the actual loss suffered by the City if the Work is not completed on time. Accordingly, 30
instead of requiring any such proof, Contractor agrees that as liquidated damages for delay 31
(but not as a penalty), Contractor shall pay City Two Thousand Dollars ($2,000.00) for 32
each day that expires after the time specified in Paragraph 4.1 for Final Acceptance until 33
the City issues the Final Letter of Acceptance. 34
Article 5. CONTRACT DOCUMENTS 35
5.1 CONTENTS: 36
A. The Contract Documents which comprise the entire agreement between City and 37
Contractor concerning the Work consist of the following: 38
1. This Agreement. 39
2. Attachments to this Agreement: 40
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Agreement
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CITY OF DENTON 7118 South Bonnie Brae PH2 (Vintage Boulevard)
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised September 20, 2018
a. Bid Form 1
1) Proposal Form 2
2) Vendor Compliance to State Law Non-Resident Bidder 3
b. Current Prevailing Wage Rate Table 4
c. Worker’s Compensation Affidavit 5
d. General Conditions. 6
e. Supplementary Conditions. 7
3. The following located in File 7118 at: 8
https://lfpubweb.cityofdenton.com/MaterialsManagement/Browse.aspx?startid=199
&row=1&dbid=0: 10
a. Specifications described in the Table of Contents of the Project’s Contract 11
Documents. 12
b. North Central Texas Council of Governments Standard Specifications for Public 13
Works Construction – Fourth Edition, Divisions 200-800, and as amended by 14
City, and described in the Table of Contents of the Project’s Contract Documents. 15
c. Drawings. 16
d. Addenda. 17
e. Documentation submitted by Contractor prior to Notice of Award. 18
4. The following which shall be issued after the Effective Date and delivered to the City 19
within ten (10) days of the Effective Date and before beginning Work: 20
a. Payment Bond 21
b. Performance Bond 22
c. Maintenance Bond 23
d. Power of Attorney for the Bonds 24
e. Form 1295 – Certificate of Interested Parties (email to purchasing) 25
f. Insurance Certificate 26
5. The following which may be delivered or issued after the Effective Date and, if 27
issued, become an incorporated part of the Contract Documents: 28
a. Notice to Proceed. 29
b. Field Orders. 30
c. Change Orders. 31
d. Letter of Final Acceptance. 32
33
34
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Agreement
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CITY OF DENTON 7118 South Bonnie Brae PH2 (Vintage Boulevard)
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised September 20, 2018
Article 6. INDEMNIFICATION 1
6.1 Contractor covenants and agrees to indemnify, hold harmless and defend, at its own 2
expense, the city, its officers, servants and employees, from and against any and all 3
claims arising out of, or alleged to arise out of, the work and services to be performed 4
by the contractor, its officers, agents, employees, subcontractors, licensees or invitees 5
under this contract. This indemnification provision is specifically intended to operate 6
and be effective even if it is alleged or proven that all or some of the damages being 7
sought were caused, in whole or in part, by any act, omission or negligence of the city. 8
This indemnity provision is intended to include, without limitation, indemnity for any 9
and all costs, expenses and legal fees incurred by the city in defending against such 10
claims and causes of actions. 11
12
6.2 Contractor covenants and agrees to indemnify and hold harmless, at its own expense, 13
the city, its officers, servants and employees, from and against any and all loss of, 14
damage to, or destruction of, property of the city, arising out of, or alleged to arise out 15
of, the work and services to be performed by the contractor, its officers, agents, 16
employees, subcontractors, licensees or invitees under this contract. This 17
indemnification provision is specifically intended to operate and be effective even if it is 18
alleged or proven that all or some of the damages being sought were caused, in whole or 19
in part, by any act, omission or negligence of the city. 20
21
Article 7. MISCELLANEOUS 22
7.1 Terms. 23
Terms used in this Agreement which are defined in Article 1 of the General Conditions will 24
have the meanings indicated in the General Conditions. 25
7.2 Assignment of Contract. 26
This Agreement, including all of the Contract Documents may not be assigned by the 27
Contractor without the advanced express written consent of the City. 28
7.3 Successors and Assigns. 29
City and Contractor each binds itself, its partners, successors, assigns and legal 30
representatives to the other party hereto, in respect to all covenants, agreements and 31
obligations contained in the Contract Documents. 32
7.4 Severability. 33
Any provision or part of the Contract Documents held to be unconstitutional, void or 34
unenforceable by a court of competent jurisdiction shall be deemed stricken, and all 35
remaining provisions shall continue to be valid and binding upon City and Contractor. 36
7.5 Governing Law and Venue. 37
This Agreement, including all of the Contract Documents is performable in the State of 38
Texas. Venue shall be Denton County, Texas, or the United States District Court for the 39
Eastern District of Texas, Sherman Division. 40
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Agreement
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CITY OF DENTON 7118 South Bonnie Brae PH2 (Vintage Boulevard)
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised September 20, 2018
7.6 Authority to Sign. 1
Contractor shall attach evidence of authority to sign Agreement if signed by someone other 2
than the duly authorized signatory of the Contractor. 3
4
7.7 Prohibition On Contracts With Companies Boycotting Israel. 5
Contractor acknowledges that in accordance with Chapter 2270 of the Texas Government 6
Code, the City is prohibited from entering into a contract with a company for goods or 7
services unless the contract contains a written verification from the company that it: (1) 8
does not boycott Israel; and (2) will not boycott Israel during the term of the contract. 9
The terms “boycott Israel” and “company” shall have the meanings ascribed to those terms 10
in Section 808.001 of the Texas Government Code. By signing this contract, Contractor 11
certifies that Contractor’s signature provides written verification to the City that 12
Contractor: (1) does not boycott Israel; and (2) will not boycott Israel during the term of 13
the contract. 14
15
7.8 Immigration Nationality Act. 16
Contractor shall verify the identity and employment eligibility of its employees who perform 17
work under this Agreement, including completing the Employment Eligibility Verification 18
Form (I-9). Upon request by City, Contractor shall provide City with copies of all I-9 forms 19
and supporting eligibility documentation for each employee who performs work under this 20
Agreement. Contractor shall adhere to all Federal and State laws as well as establish 21
appropriate procedures and controls so that no services will be performed by any Contractor 22
employee who is not legally eligible to perform such services. CONTRACTOR SHALL 23
INDEMNIFY CITY AND HOLD CITY HARMLESS FROM ANY PENALTIES, 24
LIABILITIES, OR LOSSES DUE TO VIOLATIONS OF THIS PARAGRAPH BY 25
CONTRACTOR, CONTRACTOR’S EMPLOYEES, SUBCONTRACTORS, 26
AGENTS, OR LICENSEES. City, upon written notice to Contractor, shall have the right 27
to immediately terminate this Agreement for violations of this provision by Contractor. 28
29
7.9 No Third-Party Beneficiaries. 30
This Agreement gives no rights or benefits to anyone other than the City and the Contractor 31
and there are no third-party beneficiaries. 32
33
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Agreement
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CITY OF DENTON 7118 South Bonnie Brae PH2 (Vintage Boulevard)
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised September 20, 2018
7.10 No Cause of Action Against Engineer. 1
Contractor, its subcontractors and equipment and materials suppliers on the Project or their 2
sureties, shall maintain no direct action against the Engineer, its officers, employees, and 3
subcontractors, for any claim arising out of, in connection with, or resulting from the engineering 4
services performed. Only the City will be the beneficiary of any undertaking by the Engineer. 5
The presence or duties of the Engineer's personnel at a construction site, whether as on-site 6
representatives or otherwise, do not make the Engineer or its personnel in any way 7
responsible for those duties that belong to the City and/or the City's Contractors or other 8
entities, and do not relieve the Contractors or any other entity of their obligations, duties, and 9
responsibilities, including, but not limited to, all construction methods, means, techniques, 10
sequences, and procedures necessary for coordinating and completing all portions of the 11
construction work in accordance with the Contract Documents and any health or safety 12
precautions required by such construction work. The Engineer and its personnel have no 13
authority to exercise any control over any construction contractor or other entity or their 14
employees in connection with their work or any health or safety precautions. 15
16
SIGNATURE PAGE TO FOLLOW 17
18
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Agreement
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CITY OF DENTON 7118 South Bonnie Brae PH2 (Vintage Boulevard)
STANDARD CONSTRUCTION SPECIFICATION DOCUMENTS
Revised September 20, 2018
IN WITNESS WHEREOF, City and Contractor have each executed this Agreement to be effective 1
as of the date subscribed by the City’s designated City Manager (“Effective Date”). 2
3
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ATTEST: 37
ROSA RIOS, CITY SECRETARY 38
39
40
_______________________________________ 41
42
43
APPROVED AS TO LEGAL FORM: 44
AARON LEAL, CITY ATTORNEY 45
46
_______________________________________ 47
CITY OF DENTON
BY: ___________________________________
CITY MANAGER
CONTRACTOR
PAVECON PUBLIC WORKS LP
BY: ___________________________________
AUTHORIZED AGENT
_______________________________________
NAME
_______________________________________
TITLE
_______________________________________
PHONE NUMBER
_______________________________________
EMAIL ADDRESS
THIS AGREEMENT HAS BEEN
BOTH REVIEWED AND APPROVED
as to financial and operational obligations and
business terms.
_______________ ________________
SIGNATURE PRINTED NAME
__________________________________
TITLE
__________________________________
DEPARTMENT
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"General Decision Number: TX20190025 01/04/2019
Superseded General Decision Number: TX20180035
State: Texas
Construction Type: Highway
Counties: Archer, Callahan, Clay, Collin, Dallas, Delta,
Denton, Ellis, Grayson, Hunt, Johnson, Jones, Kaufman, Parker,
Rockwall, Tarrant and Wise Counties in Texas.
HIGHWAY CONSTRUCTION PROJECTS (excluding tunnels, building
structures in rest area projects & railroad construction;
bascule, suspension & spandrel arch bridges designed for
commercial navigation, bridges involving marine construction;
and other major bridges).
Note: Under Executive Order (EO) 13658, an hourly minimum wage
of $10.60 for calendar year 2019 applies to all contracts
subject to the Davis-Bacon Act for which the contract is awarded
(and any solicitation was issued) on or after January 1, 2015.
If this contract is covered by the EO, the contractor must pay
all workers in any classification listed on this wage
determination at least $10.60 per hour (or the applicable
wage rate listed on this wage determination, if it is higher)
for all hours spent performing on the contract in calendar
year 2019. If this contract is covered by the EO and a
classification considered necessary for performance of work on
the contract does not appear on this wage determination, the
contractor must pay workers in that classification at least
the wage rate determined through the conformance process set
forth in 29 CFR 5.5(a)(1)(ii) (or the EO minimum wage rate,
if it is higher than the conformed wage rate). The EO minimum
wage rate will be adjusted annually. Please note that
this EO applies to the above-mentioned types of contracts
entered into by the federal government that are subject
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to the Davis-Bacon Act itself, but it does not apply
to contracts subject only to the Davis-Bacon Related Acts,
including those set forth at 29 CFR 5.1(a)(2)-(60). Additional
information on contractor requirements and worker protections
under the EO is available at www.dol.gov/whd/govcontracts.
Modification Number Publication Date
0 01/04/2019
* SUTX2011-007 08/03/2011
Rates Fringes
CONCRETE FINISHER (Paving and
Structures)......................$ 14.12
ELECTRICIAN......................$ 19.80
FORM BUILDER/FORM SETTER
Paving & Curb...............$ 13.16
Structures..................$ 13.84
LABORER
Asphalt Raker...............$ 12.69
Flagger.....................$ 10.06
Laborer, Common.............$ 10.72
Laborer, Utility............$ 12.32
Pipelayer...................$ 13.24
Work Zone Barricade
Servicer....................$ 11.68
POWER EQUIPMENT OPERATOR:
Asphalt Distributor.........$ 15.32
Asphalt Paving Machine......$ 13.99
Broom or Sweeper............$ 11.74
Concrete Pavement
Finishing Machine...........$ 16.05
Concrete Saw................$ 14.48
Crane Operator, Lattice
Boom 80 Tons or Less........$ 17.27
Crane Operator, Lattice
Boom over 80 Tons...........$ 20.52
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Crane, Hydraulic 80 Tons
or Less.....................$ 18.12
Crawler Tractor.............$ 14.07
Excavator, 50,000 pounds
or less.....................$ 17.19
Excavator, over 50,000
pounds......................$ 16.99
Foundation Drill , Truck
Mounted.....................$ 21.07
Foundation Drill, Crawler
Mounted.....................$ 17.99
Front End Loader 3 CY or
Less........................$ 13.69
Front End Loader, over 3 CY.$ 14.72
Loader/Backhoe..............$ 15.18
Mechanic....................$ 17.68
Milling Machine.............$ 14.32
Motor Grader, Fine Grade....$ 17.19
Motor Grader, Rough.........$ 16.02
Pavement Marking Machine....$ 13.63
Reclaimer/Pulverizer........$ 11.01
Roller, Asphalt.............$ 13.08
Roller, Other...............$ 11.51
Scraper.....................$ 12.96
Small Slipform Machine......$ 15.96
Spreader Box................$ 14.73
Servicer.........................$ 14.58
Steel Worker (Reinforcing).......$ 16.18
TRUCK DRIVER
Lowboy-Float................$ 16.24
Off Road Hauler.............$ 12.25
Single Axle.................$ 12.31
Single or Tandem Axle Dump
Truck.......................$ 12.62
Tandem Axle Tractor with
Semi Trailer................$ 12.86
Transit-Mix.................$ 14.14
WELDER...........................$ 14.84
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WELDERS - Receive rate prescribed for craft performing
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operation to which welding is incidental.
================================================================
Note: Executive Order (EO) 13706, Establishing Paid Sick Leave
for Federal Contractors applies to all contracts subject to the
Davis-Bacon Act for which the contract is awarded (and any
solicitation was issued) on or after January 1, 2017. If this
contract is covered by the EO, the contractor must provide
employees with 1 hour of paid sick leave for every 30 hours
they work, up to 56 hours of paid sick leave each year.
Employees must be permitted to use paid sick leave for their
own illness, injury or other health-related needs, including
preventive care; to assist a family member (or person who is
like family to the employee) who is ill, injured, or has other
health-related needs, including preventive care; or for reasons
resulting from, or to assist a family member (or person who is
like family to the employee) who is a victim of, domestic
violence, sexual assault, or stalking. Additional information
on contractor requirements and worker protections under the EO
is available at www.dol.gov/whd/govcontracts.
Unlisted classifications needed for work not included within
the scope of the classifications listed may be added after
award only as provided in the labor standards contract clauses
(29CFR 5.5 (a) (1) (ii)).
----------------------------------------------------------------
The body of each wage determination lists the classification
and wage rates that have been found to be prevailing for the
cited type(s) of construction in the area covered by the wage
determination. The classifications are listed in alphabetical
order of ""identifiers"" that indicate whether the particular
rate is a union rate (current union negotiated rate for local),
a survey rate (weighted average rate) or a union average rate
(weighted union average rate).
Union Rate Identifiers
A four letter classification abbreviation identifier enclosed
in dotted lines beginning with characters other than ""SU"" or
""UAVG"" denotes that the union classification and rate were
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prevailing for that classification in the survey. Example:
PLUM0198-005 07/01/2014. PLUM is an abbreviation identifier of
the union which prevailed in the survey for this
classification, which in this example would be Plumbers. 0198
indicates the local union number or district council number
where applicable, i.e., Plumbers Local 0198. The next number,
005 in the example, is an internal number used in processing
the wage determination. 07/01/2014 is the effective date of the
most current negotiated rate, which in this example is July 1,
2014.
Union prevailing wage rates are updated to reflect all rate
changes in the collective bargaining agreement (CBA) governing
this classification and rate.
Survey Rate Identifiers
Classifications listed under the ""SU"" identifier indicate that
no one rate prevailed for this classification in the survey and
the published rate is derived by computing a weighted average
rate based on all the rates reported in the survey for that
classification. As this weighted average rate includes all
rates reported in the survey, it may include both union and
non-union rates. Example: SULA2012-007 5/13/2014. SU indicates
the rates are survey rates based on a weighted average
calculation of rates and are not majority rates. LA indicates
the State of Louisiana. 2012 is the year of survey on which
these classifications and rates are based. The next number, 007
in the example, is an internal number used in producing the
wage determination. 5/13/2014 indicates the survey completion
date for the classifications and rates under that identifier.
Survey wage rates are not updated and remain in effect until a
new survey is conducted.
Union Average Rate Identifiers
Classification(s) listed under the UAVG identifier indicate
that no single majority rate prevailed for those
classifications; however, 100% of the data reported for the
classifications was union data. EXAMPLE: UAVG-OH-0010
08/29/2014. UAVG indicates that the rate is a weighted union
average rate. OH indicates the state. The next number, 0010 in
the example, is an internal number used in producing the wage
determination. 08/29/2014 indicates the survey completion date
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for the classifications and rates under that identifier.
A UAVG rate will be updated once a year, usually in January of
each year, to reflect a weighted average of the current
negotiated/CBA rate of the union locals from which the rate is
based.
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WAGE DETERMINATION APPEALS PROCESS
1.) Has there been an initial decision in the matter? This can
be:
* an existing published wage determination
* a survey underlying a wage determination
* a Wage and Hour Division letter setting forth a position on
a wage determination matter
* a conformance (additional classification and rate) ruling
On survey related matters, initial contact, including requests
for summaries of surveys, should be with the Wage and Hour
Regional Office for the area in which the survey was conducted
because those Regional Offices have responsibility for the
Davis-Bacon survey program. If the response from this initial
contact is not satisfactory, then the process described in 2.)
and 3.) should be followed.
With regard to any other matter not yet ripe for the formal
process described here, initial contact should be with the
Branch of Construction Wage Determinations. Write to:
Branch of Construction Wage Determinations
Wage and Hour Division
U.S. Department of Labor
200 Constitution Avenue, N.W.
Washington, DC 20210
2.) If the answer to the question in 1.) is yes, then an
interested party (those affected by the action) can request
review and reconsideration from the Wage and Hour Administrator
(See 29 CFR Part 1.8 and 29 CFR Part 7). Write to:
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Wage and Hour Administrator
U.S. Department of Labor
200 Constitution Avenue, N.W.
Washington, DC 20210
The request should be accompanied by a full statement of the
interested party's position and by any information (wage
payment data, project description, area practice material,
etc.) that the requestor considers relevant to the issue.
3.) If the decision of the Administrator is not favorable, an
interested party may appeal directly to the Administrative
Review Board (formerly the Wage Appeals Board). Write to:
Administrative Review Board
U.S. Department of Labor
200 Constitution Avenue, N.W.
Washington, DC 20210
4.) All decisions by the Administrative Review Board are final.
================================================================
END OF GENERAL DECISION
"
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DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
Exhibit
CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIQ
For vendor or other person doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as
defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local government entity not later than the 7th business day after
the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a
misdemeanor.
1 Name of vendor who has a business relationship with local governmental entity.
2
Check this box if you are filing an update to a previously filed questionnaire.
(The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business
day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)
3 Name of local government officer about whom the information in this section is being disclosed.
Name of Officer
This section, (item 3 including subparts A, B, C & D), must be completed for each officer with whom the vendor has an employment or other business relationship
as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ 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 vendor?
Yes No
B. Is the vendor 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?
Yes 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 one percent or more?
Yes No
D. Describe each employment or business and family relationship with the local government officer named in this section.
4
I have no Conflict of Interest to disclose.
5
Signature of vendor doing business with the governmental entity Date
DocuSign Envelope ID: C3DDA442-FD3C-4A45-A07D-66733B6F61A1
Certificate Of Completion
Envelope Id: C3DDA442FD3C4A45A07D66733B6F61A1 Status: Completed
Subject: Please DocuSign: 7118 - South Bonnie Brae PH 2 (Vintage Boulevard)
Source Envelope:
Document Pages: 99 Signatures: 6 Envelope Originator:
Certificate Pages: 6 Initials: 1 Laura Hermosillo
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
901B Texas Street
Denton, TX 76209
laura.hermosillo@cityofdenton.com
IP Address: 129.120.6.150
Record Tracking
Status: Original
10/29/2019 4:26:35 PM
Holder: Laura Hermosillo
laura.hermosillo@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Laura Hermosillo
laura.hermosillo@cityofdenton.com
Senior Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 129.120.6.150
Sent: 10/29/2019 4:33:40 PM
Viewed: 10/29/2019 4:34:06 PM
Signed: 10/29/2019 4:34:06 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Lori Hewell
lori.hewell@cityofdenton.com
Purchasing Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 129.120.6.150
Sent: 10/29/2019 4:34:10 PM
Viewed: 10/29/2019 5:12:38 PM
Signed: 10/29/2019 5:12:41 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Mack Reinwand
mack.reinwand@cityofdenton.com
City of Denton
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 172.58.107.186
Signed using mobile
Sent: 10/29/2019 4:36:32 PM
Viewed: 10/29/2019 4:40:43 PM
Signed: 10/29/2019 4:41:26 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Brian Cottle
brianc@pavecon.com
Brian Cottle
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 199.116.174.28
Sent: 10/29/2019 5:12:45 PM
Viewed: 10/30/2019 9:06:43 AM
Signed: 10/30/2019 9:07:21 AM
Electronic Record and Signature Disclosure:
Accepted: 10/30/2019 9:06:43 AM
ID: 70a8ba32-e2d7-4f3a-bd7d-cad3b28d605c
Signer Events Signature Timestamp
Todd Estes
Todd.Estes@cityofdenton.com
City Engineer
Capital Projects
Security Level: Email, Account Authentication
(None)
Signature Adoption: Drawn on Device
Using IP Address: 47.190.47.120
Signed using mobile
Sent: 10/29/2019 5:12:45 PM
Viewed: 10/30/2019 7:51:02 AM
Signed: 10/30/2019 7:51:17 AM
Electronic Record and Signature Disclosure:
Accepted: 10/30/2019 7:51:02 AM
ID: c1cc1d61-c86a-498a-8d2b-39e2f819257c
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 129.120.6.150
Sent: 10/30/2019 9:07:26 AM
Viewed: 11/20/2019 2:32:15 PM
Signed: 11/20/2019 2:36:27 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Todd Hileman
Todd.Hileman@cityofdenton.com
City Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 47.190.47.120
Signed using mobile
Sent: 11/20/2019 2:36:31 PM
Viewed: 11/20/2019 2:36:58 PM
Signed: 11/20/2019 2:37:04 PM
Electronic Record and Signature Disclosure:
Accepted: 7/25/2017 11:02:14 AM
ID: 57619fbf-2aec-4b1f-805d-6bd7d9966f21
Rosa Rios
rosa.rios@cityofdenton.com
City Secretary
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 129.120.6.150
Sent: 11/20/2019 2:37:08 PM
Viewed: 11/20/2019 3:44:51 PM
Signed: 11/20/2019 3:45:23 PM
Electronic Record and Signature Disclosure:
Accepted: 11/20/2019 3:44:51 PM
ID: a9cbf6e9-1add-46e9-b409-55bd0fd6e9c6
In Ierson Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 10/29/2019 4:34:09 PM
Electronic Record and Signature Disclosure:
Carbon Copy Events Status Timestamp
Not Offered via DocuSign
Sherri Thurman
sherri.thurman@cityofdenton.com
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 10/30/2019 9:07:25 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Jane Richardson
jane.richardson@cityofdenton.com
Assistant City Secretary
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 11/20/2019 2:37:08 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Robin Davis
Robin.Davis@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Sent: 11/20/2019 3:45:28 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Annie Bunger
Annie.Bunger@cityofdenton.com
Contract Control Specialist
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 11/20/2019 3:45:29 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Iitness Events Signature Timestamp
Iotary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 11/20/2019 3:45:29 PM
Certified Delivered Security Checked 11/20/2019 3:45:29 PM
Signing Complete Security Checked 11/20/2019 3:45:29 PM
Completed Security Checked 11/20/2019 3:45:29 PM
Iayment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of Denton (we, us or Company) may be required by law to provide to
you certain written notices or disclosures. Described below are the terms and conditions for
providing to you such notices and disclosures electronically through your DocuSign, Inc.
(DocuSign) Express user account. Please read the information below carefully and thoroughly,
and if you can access this information electronically to your satisfaction and agree to these terms
and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of
this document.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. For such copies, as long as you are an authorized user of the
DocuSign system you will have the ability to download and print any documents we send to you
through your DocuSign user account for a limited period of time (usually 30 days) after such
documents are first sent to you. After such time, if you wish for us to send you paper copies of
any such documents from our office to you, you will be charged a $0.00 per-page fee. You may
request delivery of such paper copies from us by following the procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. To indicate to us that you are changing your mind, you must
withdraw your consent using the DocuSign 'Withdraw Consent' form on the signing page of your
DocuSign account. This will indicate to us that you have withdrawn your consent to receive
required notices and disclosures electronically from us and you will no longer be able to use your
DocuSign Express user account to receive required notices and consents electronically from us
or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through your DocuSign user account all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or
made available to you during the course of our relationship with you. To reduce the chance of
you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
" "# !!# "
"! "
""!"!!!
How to contact City of Denton:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: purchasing@cityofdenton.com
To advise City of Denton of your new e-mail address
To let us know of a change in your e-mail address where we should send notices and disclosures
electronically to you, you must send an email message to us at melissa.kraft@cityofdenton.com
and in the body of such request you must state: your previous e-mail address, your new e-mail
address. We do not require any other information from you to change your email address..
In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected
in your DocuSign account by following the process for changing e-mail in DocuSign.
To request paper copies from City of Denton
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an e-mail to purchasing@cityofdenton.com and in
the body of such request you must state your e-mail address, full name, US Postal address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with City of Denton
To inform us that you no longer want to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your DocuSign account, and on the subsequent
page, select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an e-mail to purchasing@cityofdenton.com and in the body of such request you
must state your e-mail, full name, IS Postal Address, telephone number, and account
number. We do not need any other information from you to withdraw consent.. The
consequences of your withdrawing consent for online documents will be that transactions
may take a longer time to process..
Required hardware and software
Operating Systems: Windows2000? or WindowsXP?
Browsers (for SENDERS): Internet Explorer 6.0? or above
Browsers (for SIGNERS): Internet Explorer 6.0?, Mozilla FireFox 1.0,
NetScape 7.2 (or above)
Email: Access to a valid email account
Screen Resolution: 800 x 600 minimum
Enabled Security Settings:
•Allow per session cookies
•Users accessing the internet behind a Proxy
Server must enable HTTP 1.1 settings via
proxy connection
** These minimum requirements are subject to change. If these requirements change, we will
provide you with an email message at the email address we have on file for you at that time
providing you with the revised hardware and software requirements, at which time you will
have the right to withdraw your consent.
Acknowledging your access and consent to receive materials electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please verify that you
were able to read this electronic disclosure and that you also were able to print on paper or
electronically save this page for your future reference and access or that you were able to
e-mail this disclosure and consent to an address where you will be able to print on paper or
save it for your future reference and access. Further, if you consent to receiving notices and
disclosures exclusively in electronic format on the terms and conditions described above,
please let us know by clicking the 'I agree' button below.
By checking the 'I Agree' box, I confirm that:
• I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF
ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and
• I can print on paper the disclosure or save or send the disclosure to a place where I can
print it, for future reference and access; and
• Until or unless I notify City of Denton as described above, I consent to receive from
exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to me by City of Denton during the course of my relationship with you.